Background:Multiple approaches have been used to replace lost, damaged or diseased gingival tissues. Coronally advanced flap (CAF) and the use of guided tissue regeneration are among the successfully used surgical techniques to treat gingival recession. Platelet rich plasma (PRP), containing autologous growth factors, has been shown to promote soft-tissue healing. Therefore, the purpose of this study was to evaluate the efficacy of PRP in combination with CAF in the treatment of gingival recession.Materials and Methods:A total of 15 systemically healthy patients with buccal Miller's class I and class II gingival recession in cuspids or premolars participated in the study. CAF procedure was performed and PRP with collagen sponge was placed over the defect. Clinical parameters such as recession depth, recession width, surface area, width of keratinized gingival (KG), clinical attachment level (CAL), probing depth, plaque index and gingival index were evaluated at 3, 6 and 9 months post-surgery. The percentage of root coverage was calculated.Results:The results of this study suggest that the CAF procedure provides a predictable and simple technique in the treatment of localized Class I and Class II gingival recession. The additional application of PRP does significantly increase the width of KG and gain in clinical attachment.Conclusion:CAF procedure is a predictable and simple technique in the treatment of gingival recession and the additional application of PRP does significantly increase the width of KG and gain in CAL. The long-term benefits following surgical treatment of such defects needs to be determined further.

Peripheral ossifying fibroma (POF) is a solitary over growth of the gingiva known to arise from the cells of the periodontal ligament. The lesions usually start as a painless overgrowth of the interdental papilla unless associated with trauma and gradually involve the other counter parts of the gingiva. The lesion is more considered to be an inflammatory or reactive process rather than to be neoplastic. Here, the authors present a unique case of multiple POF in a young male adult aged 24 years where surgical excision was carried out quadrant wise. The biopsy specimen from multiple sites revealed similar histopathologic features consistent with POF, but also with the multicentric presentation of POF, which is a unique phenomenon. Multicentric variant of POF is indeed a rare case being only the second case so far which has been documented. Management of such case needs a multidisciplinary approach to prevent the recurrence along with regular long time follow-up.

Background & Objectives: Interleukin-35 (IL-35) is a newly identified anti-inflammatory cytokine generated by T regulatory cells. They are most effective at high inflammation sites and are a potent activator of T regulatory cells. Hence this study aimed to assess gingival crevicular fluid levels of IL-35 in healthy subjects and chronic periodontitis patients and to compare the levels of IL-35, before and after scaling and root planing in chronic periodontitis patients. Methods: Forty subjects were selected and categorised into 3 groups. Group 1: Periodontally healthy individuals, Group 2A: Chronic periodontitis patients and Group 2B: Group 2A patients who were evaluated 6 weeks after scaling and root planing. Gingival bleeding index, probing pocket depth and clinical attachment level were recorded. Gingival crevicular fluid samples were collected and stored at -800 C till they were subjected to analysis by Enzyme Linked Immunosorbent Assay (ELISA). Results: On intergroup comparison, the difference in mean IL-35 levels and clinical parameters were highly statistically significant between Group 1 and Group 2A while between Group 1 and Group 2B were not significant. On comparing Group 2A and Group 2B, the mean differences were highly statistically significant P (<0.001). Significant reductions in all parameters were noted in Group 2B. Conclusion: Significant reduction of IL-35 levels in chronic periodontitis patients, 6-8 weeks after scaling and root planing and their presence in periodontally healthy subjects suggest the role of IL-35 in controlling the inflammation and their protective role in maintaining periodontal health. Key message: IL-35 has an effective role in controlling the inflammation and in maintaining periodontal health. IL-35 can be considered as a promising prognostic biomarker in periodontal diseases.

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