Background: In the past few decades focus of research has been toward herbal medicines because of growing bacterial resistance and side effects of antimicrobial agents. The extract derived from the plants may increase the efficacy of antibiotics when used in combination against pathogenic bacteria. In the current study, the synergistic antibacterial efficacy of plant extracts in combination with antibiotics has been assessed on selected periodontal pathogens. Methods: Ethanolic extracts were prepared from Salvadora persica (Miswak) and Cinnamomum zeylanicum (Ceylon cinnamon), by the soxhalate method. Plaque samples were collected from clinical periodontitis patients to isolate and grow the periodontal pathobionts under favorable conditions. Susceptibility of bacteria to the extracts was assessed by gauging the diameter of the inhibition zones. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of plant extracts were determined against each bacterium. Synergistic activity of plants extract in combination with antibiotics against the bacteria was also assessed by measuring the diameter of the inhibition zones. Results: Ethanolic extract of both the plants showed an inhibitory effect on the proliferation and growth of all four strains of periodontal pathobionts. Maximum antibacterial activity was exhibited by C. zeylanicum against Tannerella forsythia (MIC = 1.56 ± 0.24 mg/mL, MBC = 6.25 ± 0.68 mg/mL), whereas among all the studied groups the minimum activity was reported by C. zeylanicum against Aggregatibacter actinomycetemcomitans the (MIC = 12.5 ± 3.25 mg/mL, MBC = 75 ± 8.23 mg/mL). Combination of herbal extracts with different antibiotics revealed a synergistic antibacterial effect. The best synergism was exhibited by S. persica with metronidazole against A. actinomycetemcomitans (27 ± 1.78). Conclusions: Current in vitro study showed variable antibacterial activity by experimented herbal extracts against periodontal pathobionts. The synergistic test showed significant antibacterial activity when plant extracts were combined with antibiotics.

Background:In general, it is important to assess the medical history of patients before initiating any treatment. In particular, patients seeking dental treatment could possibly have significant medical conditions that may affect the diagnosis and/or alter the treatment provided. However, many dentists assume that their patients are systemically healthy, and thus they do not record the medical history of their patients.Aim and Objective:This study aimed to determine the prevalence of medical conditions in patients seeking periodontal treatment at the dental teaching hospital of King Khalid University.Materials and Methods:Upon presentation at the periodontal clinics of the dental teaching hospital of King Khalid University, Asir Region, Saudi Arabia, patients' history from medical records was screened.Results:The medical history was taken for 455 periodontal patients. The most frequently encountered medical conditions were diabetes mellitus and hormonal disorders, followed by respiratory diseases and cardiovascular diseases.Conclusion:The results of our study found a high prevalence of medical conditions among patients seeking periodontal treatment, thereby highlighting the need to record patients' medical and dental care history in detail.

Background:The extraction of third molars is associated with some clinical outcomes and periodontal problems. It is imperative to note that the type of incision used in the surgery for the removal of the impacted third molar is critical. The design of the flap influences the healing of the surgically created defect and damage to the distal periodontal area of the adjacent second molar. However, till date, there have been conflicting reports on the influence of different flap designs used for the surgical removal of impacted third molars.Aim:The present study aimed to comparatively evaluate the clinical outcomes and periodontal status of the adjacent second molar, when two different flap designs, namely, the envelope and the modified triangular flap designs were used.Materials and Methods:Sixty female patients with bilateral impacted third molars completed the study with envelope flap on one side and modified triangular flap design on the other side of the mandible for third molar removal. Clinical parameters including pain, dehiscence and swelling were assessed postoperatively and periodontal probing depth (PPD) on the distal aspect of adjacent second molar were assessed both pre- and post-operatively.Results:The results were assessed on 1, 3 and 8 days for pain using visual analog scale. The subjective perception of swelling was evaluated on 3, 7 and 15 days postoperatively in a similar manner. The results of the periodontal parameters were evaluated both preoperatively and 3 months postoperatively, with cautious exploration using a University of North Carolina (UNC)-15 periodontal probe. The statistically significant results for swelling and PPD were noted for the two flap groups using the Chi-square test (P < 0.05).Conclusion:The study revealed that the modified triangular flap had lesser postoperative PPDs and dehiscence. The envelope flap was better when swelling was analyzed. The pain scores, though slightly higher for the modified triangular flap group, were not statistically significant.

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Objectives:To determine the occurrence of smile line and maxillary tooth shape in the Saudi Arabian subpopulation, and to estimate the association between these parameters with gingival biotype.Materials and Methods:On the fulfillment of selection criteria, total 315 patients belong to Saudi Arabian ethnic group were randomly selected. Two frontal photographs of the patients were acquired. The tooth morphology, gingival angle, and smile line classification were determined with ImageJ image analyzing software. The gingival biotype was assessed by probe transparency method. The obtained data were analyzed with SPSS 19 (IBM Corporation, New York, USA) software to determine the frequency and association between other parameters and gingival biotype.Results:Among the clinical parameters evaluated, the tapering tooth morphology (56.8%), thick gingival biotype (53%), and average smile line (57.5%) was more prevalent. The statistically significant association was found between thick gingival biotype and the square tooth, high smile line. The high gingival angle was associated with thin gingival biotype.Conclusions:The study results indicate the existence of an association between tooth shape, smile line, and gingival angle with gingival biotype.