Background:Nanosized ceramics may represent a promising class of bone graft substitutes due to their improved osseointegrative properties. Nanocrystalline Hydroxyapatite (NcHA) bind to bone and stimulate bone healing by stimulation of osteoblast activity. The present study aims to explore the clinical and radiographical outcome of NcHA bonegraft (Sybograf®) with collagen membrane (Periocol®), in comparison with open flap debridement (OFD), in the treatment of intrabony periodontal defects.Materials and Methods:A parallel-group, randomized, controlled clinical trial was designed to conduct the study. Eighteen intrabony defects in 14 systemically healthy patients aged between 25 to 65 years were randomly assigned to test and control group. The plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (REC) were recorded at baseline, and were reevaluated at 6 months. In addition to this, radiographic bone fill was assessed using digital software. At the test site, NcHA bone graft and collagen membrane was placed, whereas at the control site, only OFD was done. Recall appointments were made at 7 days, 30 days, and then at 3 months and 6 months.Results:The data were subjected to statistical analysis using the Mann-Whitney ‘U’ Test and Wilcoxon signed rank sum test. In the control group, the mean reduction of PPD was 3.22±1.09 mm (P=0.007) and CAL gain was 2.77±1.09 mm (P=0.007). In the test group, the mean PPD reduction of 4.33±0.5 mm (P=0.006) and mean gain in CAL was 3.77±0.66 mm (P=0.006) at 6 months. The mean increase in REC was 0.55±0.72 mm (P=0.025) in test, and 0.44±0.52 mm (P=0.046) in control group. The mean gain in radiographic defect fill was 2.07±0.67 mm (P=0.008) in test and 0.91±0.21 mm (P=0.007) in control group.Conclusion:The nanocrystalline hydroxyapatite bone graft in combination with collagen membrane demonstrated clinical advantages beyond that achieved by OFD alone.

Over the past few years, there has been a rapid rise in the older segments of the world population, which has brought along with it a major health concern: dementia. Alzheimer's disease, considered to be the most common cause of dementia, has become a prospect feared by the elderly. Inflammation of the brain is strongly implicated in Alzheimer's disease which could be enhanced by systemic inflammation. Periodontitis being a chronic inflammatory condition, which can cause systemic inflammation, the question is whether chronic periodontitis can initiate or hasten the rate of progression of Alzheimer's disease in susceptible individuals. In this article, the authors outline the proposed oral systemic link between periodontitis and Alzheimer's disease.

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ObjectivesThe debridement of diseased root surface is usually performed by mechanical scaling and root planing using manual and power driven instruments. Many new designs in ultrasonic powered scaling tips have been developed. However, their effectiveness as compared to manual curettes has always been debatable. Thus, the objective of this in vitro study was to comparatively evaluate the efficacy of manual, magnetostrictive and piezoelectric ultrasonic instrumentation on periodontally involved extracted teeth using profilometer and scanning electron microscope (SEM). Material and Methods30 periodontally involved extracted human teeth were divided into 3 groups. The teeth were instrumented with hand and ultrasonic instruments resembling clinical application. In Group A all teeth were scaled with a new universal hand curette (Hu Friedy Gracey After Five Vision curette; Hu Friedy, Chicago, USA). In Group B CavitronTM FSI - SLITM ultrasonic device with focused spray slimline inserts (Dentsply International Inc., York, PA, USA) were used. In Group C teeth were scaled with an EMS piezoelectric ultrasonic device with prototype modified PS inserts. The surfaces were analyzed by a Precision profilometer to measure the surface roughness (Ra value in µm) consecutively before and after the instrumentation. The samples were examined under SEM at magnifications ranging from 17x to 300x and 600x. ResultsThe mean Ra values (µm) before and after instrumentation in all the three groups A, B and C were tabulated. After statistically analyzing the data, no significant difference was observed in the three experimental groups. Though there was a decrease in the percentage reduction of Ra values consecutively from group A to C. ConclusionWithin the limits of the present study, given that the manual, magnetostrictive and piezoelectric ultrasonic instruments produce the same surface roughness, it can be concluded that their efficacy for creating a biologically compatible surface of periodontally diseased teeth is similar.

Background:Ganglia are the most common benign cystic swellings found over both the dorsal and volar aspects of the wrist. In spite of technical advancement, both operative and non-operative interventions achieve more or less similar results. Complete evacuation of gelatinous fluid followed with intra cystic instillation of triamcinolone has given encouraging results.Aims:To assess the efficacy and safety of drainage of cyst and instillation of triamcinolone in wrist ganglion.Materials and Methods:A prospective study was conducted on patients with simple ganglion cysts on the wrist. Total of 219 patients underwent this study. Out of this, 105 patients underwent the aspiration of the cyst fluid followed by intracystic instillation of triamcinolone, and 114 patients underwent surgical excision of wrist ganglia. Two years follow up was done for recurrence.Results:Most ganglia of wrist occurred in the extensor aspect. Complications noted among the surgically excised group were post operative pain and restricted mobility of wrist with a recurrence rate of 21.5%. Instillation of Triamcinolone into the ganglion yielded early resolution with a low recurrence of 8.4%.Conclusions:Intracystic instillation of triamcinolone after complete evacuation of cyst fluid is a simple and effective technique for treatment of ganglion.

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BACKGROUND:Bone marrow examination is the gold standard test in determining the cause of thrombocytopenia; whether it is of hypoproductive or hyperdestructive nature. However, this process has distinct disadvantages such as being invasive, not feasible in critical situations and is often not preferred by clinicians and patients alike. The introduction of platelet indices in automated hematology analyzers has provided a small window into the cause of thrombocytopenias in the recent years. Mean platelet volume (MPV) has evoked much interest in this regard. This study aimed at assessing the predictive value of MPV in determining the aetiology of thrombocytopenia. MATERIALS AND METHODS:We analyzed 100 cases of thrombocytopenia (platelet count < 100x10 3 / cu.mm) on a retrospective basis for a period of one month. The cases were divided into 2 groups: with and without bone marrow diseases; based on individual pathophysiology. A statistical analysis was done to assess predictive values, odds ratio and confidence intervals and also to elicit a cut-off value for MPV. RESULTS: The mean MPV in the group with marrow disease was 8.95fl while the group without marrow disease was 9.42fl. The difference in MPV between the 2 groups was not statistically significant (P value: 0.088). The sensitivity and specificity scores as tabulated by the receptor operating characteristic (ROC) curve at a cut-off of 9.35fl were 69% and 55% respectively. CONCLUSIONS: The study concluded that although MPV may provide a small initial insight into the aetiology of thrombocytopenia, it is limited by insufficient sensitivity and specificity. A bone marrow examination continues to be the gold standard to differentiate the hypoproductive and hyperdestructive thrombocytopenias.

Objective: To compare the reduction of plaque and gingivitis from the following three toothpaste formulations containing: 0.3% Triclosan, 1,000ppm fluoride and 0.13% calcium glycerophosphate in a natural calcium carbonate base (a new paste); 0.2% Triclosan and 1,000ppm fluoride in a precipitated calcium carbonate base; 0.3% Triclosan, 1,000ppm fluoride and Gantrez in a silica base. A control group was maintained, which used commercially available toothpastes without the above actives. Methods: A double‐blind, four‐cell, stratified, parallel group design study. Subjects brushed twice daily with their allocated toothpaste for 12 weeks. Plaque, MGI and gingival bleeding assessments were carried out at baseline, after 6 and 12 weeks of product use. Results and conclusion: An analysis of covariance of the 12‐week results showed significant differences between products [p<0.0001] for plaque, MGI and gingival bleeding. The new toothpaste formulation containing 0.3% Triclosan, 1,000ppm fluoride and 0.13% calcium glycerophosphate in a natural calcium carbonate base was shown to be significantly more effective in reducing plaque and gingivitis than the other toothpaste formulations in the study.