Background:Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL®) as an adjunct to scaling and root planing (SRP) in chronic periodontitis patients.Materials and Methods:One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm). Experimental sites additionally received HA gel subgingivally at baseline, 1st, 2nd, and 3rd week. Clinical parameters were re-assessed at 4th, 6th, and 12th week. At 4th week recall, a gingival biopsy was obtained from test and control site for histologic examination.Results:Intra-group analysis of all the clinical parameters at all sites from baseline to 4th, 6th, and 12th week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6th and 12th week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4th, 6th, and 12th week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment.Conclusion:Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant.

Introduction:Over the past century, the dental literature has consistently reflected a controversy related to the effect of periodontal disease on the dental pulp. Nonetheless, practitioners are of the opinion that teeth having deep periodontal pockets show variable pulpal response, which may necessitate root canal treatment. Thus, this study aimed to evaluate the changes in pulp due to advanced periodontal disease.Materials and Methods:Forty caries-free teeth affected with severe periodontitis were collected from patients aged between 18 and 55 years. The collected teeth were stored in formalin for 24 h and were then decalcified and examined histologically after staining with hematoxylin and eosin to note the changes that occurred in pulp.Results:Pulpal calcification (52.62%) and partial necrosis of pulp (52.62%) were found to be the most common findings. Inflammation, which was found in 47.38% of the cases, ranged from mild to severe in most sections and was always chronic. Pulp with complete necrosis was seen in 26.32% of cases. Fibrosis and pulpal edema were seen in 36.84% of cases.Conclusion:In the presence of moderate to severe chronic periodontitis, degenerative changes such as inflammation, fibrosis, edema, calcification and necrosis were observed to variable degree.

Background:Thyroid hormones play a significant role in bone remodeling. However, there are few studies on the effect of these hormones on periodontium.Aim:The aim of this study was to evaluate the periodontal status of hypothyroid patients on thyroxine replacement therapy.Materials and Methods:Clinical parameters (plaque index, bleeding index, probing pocket depth [PPD], and clinical attachment level [CAL]) and radiographic parameters (Mandibular cortical width and panoramic mandibular index) were recorded in 52 hypothyroid patients on thyroxine replacement therapy (Study group) and 50 individuals without signs and symptoms of thyroid dysfunction (Control group). The effect of dosage and duration of therapy on clinical and radiographical parameters were also assessed in the study group.Results:Statistically significant higher PPD (P = 0.008) and clinical attachment loss (P = 0.032) were observed in the study group in comparison to the control group. However, no significant differences were observed within the hypothyroid group with varying doses and duration of therapy. Furthermore, there was no correlation between the dosage and duration of therapy with periodontal status. Regression analysis showed that hypothyroidism and thyroxine replacement therapy was a significant predictor of PPD and CAL even after controlling for the effect of age in hypothyroid patients.Conclusion:Hypothyroid patients on thyroxine replacement therapy may be at increased risk for periodontal destruction. However, this needs to be validated through longitudinal studies.

This article reports the utilization of exostosis as a source of autogenous bone for the treatment of osseous defects. A patient presented with an exostosis on the mandibular lingual region on the right side of the jaw. Exostosis was surgically removed using a chisel and mallet. The autograft thus obtained was used to treat a shallow osseous crater between 46 and 47. New bone formation was noticed at the grafted site 6 months after grafting. Bone formed in the grafted areas showed comparable clinical features to those of native bone.

The 4 weeks use of AmF containing mouth rinse is effective in reducing the gingival inflammation and plaque.