Healthy teeth and gums make a person feel confident and fit. As people go about their daily routines and with different eating and drinking habits, the tooth enamel turns yellowish or gets stained. Polishing traditionally has been associated with the prophylaxis procedure in most dental practices, which patients know and expect. However, with overzealous use of polishing procedure, there is wearing of the superficial tooth structure. This would lead to more accumulation of local deposits. Also, it takes a long time for the formation of the fluoride-rich layer of the tooth again. Hence, now-a-days, polishing is not advised as a part of routine oral prophylaxis procedure but is done selectively based on the patients’ need. The article here, gives an insight on the different aspects of the polishing process along with the different methods and agents used for the same.
Mucosal fenestration is a clinical finding in which a portion of the tooth root is denuded of the overlying alveolar bone and gingiva or oral mucosa, thus exposing the root to the oral cavity. If left untreated, they may be a source of infection by giving entry to oral pathogen, leading to further progression of periodontal disease. Depending on their site of presence, they may also be a reason of esthetic concern to some patients. This paper reports one such infrequent case of mucosal fenestration of lower incisor region that was well treated by an interdisciplinary approach and regenerative therapy.
PurposeCyclooxygenase (COX) enzyme catalyzes the production of prostaglandins, which are important mediators of tissue destruction in periodontitis. Single nucleotide polymorphisms of COX2 enzyme have been associated with increasing susceptibility to inflammatory diseases. The present study evaluates the association of two single nucleotide polymorphisms in COX2 gene (-1195G>A and 8473C>T) with chronic periodontitis in North Indians.MethodsBoth SNPs and their haplotypes were used to explore the associations between COX2 polymorphisms and chronic periodontitis in 56 patients and 60 controls. Genotyping was done by polymerase chain reaction followed by restriction fragment length polymorphism. Chi-square test and logistic regression analysis were performed for association analysis.ResultsBy the individual genotype analysis, mutant genotypes (GA and AA) of COX2 -1195 showed more than a two fold risk (odds ratio [OR]>2) and COX2 8473 (TC and CC) showed a reduced risk for the disease, but the findings were not statistically significant. Haplotype analysis showed that the frequency of the haplotype AT was higher in the case group and a significant association was found for haplotype AT (OR, 1.79; 95% confidence interval, 1.03 to 3.11; P=0.0370) indicating an association between the AT haplotype of COX2 gene SNPs and chronic periodontitis.ConclusionsIndividual genotypes of both the SNPs were not associated while haplotype AT was found to be associated with chronic periodontitis in North Indians.
The clinical and radiographic findings of the present case suggests that HA in conjunction with a resorbable collagen membrane may be an acceptable alternative to the autogenous block graft and non-resorbable membrane in the treatment of compromised alveolar ridge deficiencies.
Background:Chronic periodontitis in lower anterior teeth results in rapidly progressive gingival recession (GR), loss of alveolar bone, decreased vestibular depth (VD) with consequential tooth mobility, and tooth loss. Treatment option for such cases in this esthetically important area of the oral cavity includes extraction followed by implants for which sufficient bone height and mucogingival complex are a prerequisite. Henceforth, an attempt was made to prolong the life of lower anterior teeth and postpone the need for implants by the treatment of chronic periodontitis with periodontal flap surgery followed by vestibular deepening in single surgical procedure.Materials and Methods:In this clinical, prospective study, conventional periodontal flap surgery was done on 74 sites in lower anterior teeth in 16 patients with attachment loss >5 mm due to chronic periodontitis. Vestibular deepening with diode laser at (wavelength - 810 nm, output power: 0.5–7 W, continuous wave, contact mode) was done after suturing the flap. All the clinical parameters: GR, pocket depth (PD), clinical attachment loss (CAL), width of keratinized gingiva, width of attached gingiva, and VD were assessed preoperatively after Phase I therapy and 6 months postoperatively.Results:At all the 74 sites, there was highly significant gain in attached gingiva, keratinized gingiva, and VD (P ≤ 0.001). Highly significant reduction in PD (P ≤ 00.001), significant reduction in attachment loss (P ≤ 0.01) but no significant reduction in GR (P = 0.897) was observed.Conclusions:The combination of periodontal flap surgery with vestibular deepening with diode laser may be a suitable cost-effective treatment option to prolong the life of periodontally involved lower anterior teeth. The surgical technique can postpone the need for extraction of teeth along with all the intangible benefits of periodontal therapy.
AIMTo test the reliability of the Sawai’s classification for dental cervical abrasions.METHODSIntraoral photographs of 70 teeth from 23 patients with tooth abrasions were taken by the first examiner MS. The teeth were marked and the photos were maintained in a soft copy sequentially. Two other examiners FA and SC were trained in the use of the classification and any clarifications needed were provided at the beginning of the study. Each examiner was then given the soft copy of the complied photographs and was asked to classify the dental cervical abrasion according to their understanding of the Sawai’s classification. They were given sheets to write their responses for every marked tooth. All the examiners were blinded to each other’s observations which were then tested for inter-rater agreement among the three examiners.RESULTSThe 70 teeth with tooth abrasions from 23 patients were examined by 3 investigators (MS, FA and SC) to test the reliability of the Sawai’s classification system for tooth abrasion. Each examiner marked their responses in separate sheets which were blinded to each other. The kappa statistics were performed for inter-rater agreement among the three examiners. The level of agreement was evaluated according to the six-level nomenclature given by Landis and Koch. ICC and 95%CI between two examiners, i.e., the inter-rater agreement among 1st examiner (MS) and 2nd examiner (FA) was 0.89. The inter-rater agreement among 1st examiner (MS) and 3rd examiner (SC) was 0.89. And the inter-rater agreement among 2nd examiner (FA) and 3rd examiner (SC) was 0.83. All the three comparisons show an almost perfect agreement between them.CONCLUSIONThere is an almost perfect agreement between multiple observers for classifying dental cervical abrasions using Sawai’s classification. Hence, this classification is reliable.
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