The microbial etiology of periodontal disease has been the focus of researchers for a long time. The search for the pathogens of periodontal diseases has been underway for more than 100 years, and continues up today. Despite the increasing knowledge about oral microbiota, we are not able to implicate any one particular organism that can be considered as a candidate pathogen. In fact the term “candidate pathogen” has lost its steam with a myriad of microorganisms being incriminated from time to time. Most studies of the bacterial etiology of periodontitis have used either culture-based or targeted deoxyribonucleic acid approaches and so it is likely that pathogens remain undiscovered. The advent of 16S cloning and sequencing has facilitated identification of several uncultivable bacteria in the oral cavity. The concept that not one single organism, but several organisms contained in the biofilm orchestrating in a medley of the show appears to be more plausible. The present review highlights some lesser known bacteria associated with periodontal destruction.
Peripheral ossifying fibroma (POF) is a non-neoplastic enlargement seen more often in females, in the interdental papilla and the anterior part of the maxilla, accounts for about 9% of all gingival growths. Of unknown etiology, unpredictable clinical course and pronicity for recurrence, POF is a clinician's cause for concern. Surgical excision is the treatment of choice, but with a reported recurrence rate of 7-45%, the management is often frustrating. With increasing acceptance of lasers in the repertoire of clinician's armory, laser excision of such lesions has become a possible, feasible, and patient-preferred approach. The purpose of this article is to report successful management and 1 year follow-up of two cases of POF using neodymium-doped yttrium aluminum garnet (Nd: YAG) laser. The absence of operative bleeding, relative ease of the procedure and patient acceptance lends the laser excision as an alternate therapeutic modality for excision of gingival enlargements of suspicious and vexatious nature.
Tissue engineering" also referred as regenerative medicine indicates a new interdisciplinary initiative, which has the goal of growing tissues or organs directly from a single cell taken from an individual. Originally coined to denote the construction in the laboratory of a device containing viable cells and biologic mediators in a synthetic or biologic matrix that could be implanted in patients to facilitate regeneration. However, the term has crept into clinical armory of periodontists and has attained certain halo and glamour even when used in mundane and prosaic situations. Thus, this paper critically evaluates its role and application in clinical scenario.
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