Background and Objectives:Alendronate, an aminobisphosphonate, is capable of inhibiting periodontitis associated osteoclastic activity and hence is effective in protecting the alveolar bone in periodontitis. In the present study, we explored the efficacy of local delivery of alendronate on the alveolar bone following mucoperiosteal flap surgery. This is the first study to use polymer impregnated gel based delivery of alendronate.Materials and Methods:A total of 15 patients with chronic periodontitis in the age group of 35 - 55 years, of both sexes, with pocket depth of ≥ 5mm and radiographic evidence of identical osseous defects in the mandibular molar region bilaterally were included in this prospective study. A gel based drug delivery system of Alendronate was formulated. Following surgical flap debridement, 0.1 ml alendronate gel and 0.1 ml placebo gel was placed at the experimental and control sites respectively. Clinical and radiographic parameters were recorded at baseline, three months and six months post surgery.Results:Alendronate was more effective in improving clinical and radiographic parameters compared to placebo.Interpretation and Conclusion:Alendronate is effective in the management of periodontitis associated bone loss. Gel based local delivery of the drug addresses the critical concern of exposing the patient to adverse effects of systemic administration.

Background:Gingival recession (GR) can result in root sensitivity, esthetic concern to the patient, and predilection to root caries. The purpose of this randomized clinical study was to evaluate (1) the effect of guided tissue regeneration (GTR) procedure using a bioabsorbable collagen membrane, in comparison to autogenous subepithelial connective tissue graft (SCTG) for root coverage in localized gingival recession defects; and (2) the change in width of keratinized gingiva following these two procedures.Materials and Methods:A total of 10 cases, showing at least two localized Miller's Class I or Class II gingival recession, participated in this study. In a split mouth design, the pairs of defects were randomly assigned for treatment with either SCTG (SCTG Group) or GTR-based collagen membrane (GTRC Group). Both the grafts were covered with coronally advanced flap. Recession depth (RD), recession width (RW), width of keratinized gingiva (KG), probing depth (PD), relative attachment level (RAL), plaque index (PI), and gingival index (GI) were recorded at baseline, 3 and 6 months postoperatively.Results:Six months following root coverage procedures, the mean root coverage was found to be 84.84% ± 16.81% and 84.0% ± 15.19% in SCTG Group and GTRC Group, respectively. The mean keratinized gingival width increase was 1.50 ± 0.70 mm and 2.30 ± 0.67 mm in the SCTG and GTRC group, respectively, which was not statistically significant.Conclusion:It may be concluded that resorbable collagen membrane can be a reliable alternative to autogenous connective tissue graft in the treatment of gingival recession.

Until recently, periodontal therapy was predominantly focused on establishing biologically and functionally stable periodontium. The presence of mucogingival problems and gingival recession around anterior teeth exemplifies a situation in which a treatment modality that addresses not only biological and functional but also esthetic demands are required from the periodontist. The advent of procedure such as subepithelial connective tissue graft in the mid-1980s and its various modifications thereafter, have led to improved and more predictable outcomes of root coverage. Thus, the present day clinicians have become more capable of addressing the esthetic demands of their patients. This case report shows the usage of subepithelial connective tissue graft for root coverage of upper right first premolar, which shows successful root coverage with a stable result. The technique used here created a healthy, functional and esthetic gingival unit that appeared resistant to further breakdown at a 6-month follow-up.

Buccal administration of drugs leads to systemic circulation through internal jugular vein, bypassing them from hepatic first pass metabolism and leading to greater bioavailability. Buccal mucosa is most preferred site for both local as well as systemic action. For administration of drug through mucosal route, various types of dosage forms can be prepared. Buccal films can release topical drugs with controlled and sustained effects. Buccal films have the advantage of improved patient compliance because of reduced size with a suitable thickness as compare to other delivery systems. Buccal film can enhance absorption of active medicament as compared to others. Synthetic natural and semi synthetic polymers in low concentration can be used for the preparation of buccal films. Such types of dosage forms are cost effective, non-irritating, easy to handle, elegant, rapidly absorbable and most preferred by consumer. The review describes the anatomy of oral mucosa, mechanism of buccal absorption, methods to increase drug delivery via a buccal route, formulation aspects and evaluation parameters of buccal films.

Until recently, periodontal therapy was predominantly focused on establishing biologically and functionally stable periodontium. The presence of mucogingival problems and gingival recession around anterior teeth exemplifies a situation in which a treatment modality that addresses not only biological and functional but also esthetic demands are required from the periodontist. The advent of procedure such as subepithelial connective tissue graft in the mid-1980s and its various modifications thereafter, have led to improved and more predictable outcomes of root coverage. Thus, the present day clinicians have become more capable of addressing the esthetic demands of their patients. This case report shows the usage of subepithelial connective tissue graft for root coverage of upper right first premolar, which shows successful root coverage with a stable result. The technique used here created a healthy, functional and esthetic gingival unit that appeared resistant to further breakdown at a 6-month follow-up.