Background:Simvastatin (SMV), a new locally delivered drug of class statins, is a specific competitive inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. Statins, besides having lipid-lowering abilities, also have pleiotropic effects like host modulation and bone regeneration. The present study was designed to investigate the effectiveness of SMV, 1.2 mg, in an indigenously prepared biodegradable controlled-release gel as an adjunct to scaling and root planing (SRP).Materials and Methods:A total of 60 sites, with pocket depth ≥5 mm, two from each of 30 patients after SRP, were categorized into two treatment groups, for subgingival placement of placebo (Gp 1) or SMV (Gp 2). Clinical parameters were recorded at baseline and at 1, 3 and 6 months comprising plaque index, gingival index, probing pocket depth (PPD) and clinical attachment level (CAL). The osseous changes were evaluated radiographically by measuring vertical gain, INFRA 1 and angle of the defect, INFRA 2 from baseline to 6 months.Results:All subjects tolerated the drug, without any post-application complication. The treatment improved the periodontal condition in both the groups but significant reductions in PPD (p= 0.04), and INFRA 1 (p= 0.000), along with gain in CAL (p= 0.02) and INFRA 2 (p= 0.000) were observed in Gp 2. In one site, an unexpected 5 mm decrease in INFRA 1 was found.Conclusion:Local drug delivery of SMV enhanced the beneficial effect of SRP, in pocket reduction, gain in CAL and bone fill.
Background:Periodontal dressings have been used for several years as a protection over injured tissue to shield the area from further insult. Several dressings are commercially available. A recently introduced light-cured resin, claimed to be more biocompatible and esthetic, needs critical evaluation.Aim:To compare this dressing with most widely used non-eugenol pack in the perspective of esthetics, acceptance, and healing following periodontal flap surgery.Materials and Methods:Twenty patients suffering from generalized chronic periodontitis, requiring periodontal flap surgery on contralateral sides of the arch, were selected and divided randomly into Group I (control) and Group II (test). In Group I, a non-eugenol dressing and in Group II light-cured dressing were applied after flap surgery. Pain and discomfort scores were recorded on day 1, 2, and 3 while plaque scores, gingival index, and bleeding index were recorded on day 7. Patient's subjective evaluation and preference for the dressing material were recorded. The data was collected and statistically analyzed.Results:Group II showed better results than Group I when plaque scores, bleeding scores, modified gingival index scores, and pain and discomfort scores were compared though the differences were not statistically significant. Subjects found no unpleasant taste/smell and perceived the light-cured dressing to be better. A significantly higher number of patients preferred light-cured resin as a post-surgical dressing over Coe-pak.Conclusion:The light-cured dressing showed better patient acceptability and proves to be a better alternative to Coe-pak as a dressing material.
A rare presentation of an angiofibroma in the oral cavity is reported, which was treated with a diode laser. The benefits of laser treatment include bloodless procedure with instant precise coagulation of vessels. Although rare and unusual, it is suggested that angiofibroma should be included as one of the differential diagnoses of soft tissue swellings in the oral cavity.
Traumatic fibroma is a benign exophytic and reactive oral lesion that develops secondary to repetitive trauma or irritation. Most commonly affected sites are tongue, buccal mucosa, and lower labial mucosa. These are well demarcated, smooth, pedunculated or sessile, exophytic lesions which are similar to the surrounding mucosa in color. Generally, it is non-tender but local irritation may lead to painful ulceration. Treatment plan includes complete excision and removal of the cause of irritation. Excision can be done by scalpel, electrocautery or Laser. The excision of the fibroma with diode laser is a safe procedure, with minimum postoperative discomfort and complications. Recurrences are rare but may occur due to repetitive trauma at the same site.
Idiopathic gingival enlargement is a rare non-hemorrhagic, slowly proliferative fibrous lesion of the gingival tissue in which no causative agent can be identified. These type of enlargement causes esthetic and functional problems. This case report highlights the diagnosis and treatment of the idiopathic gingival enlargement of a 14 years old female patient who presented with a generalized diffuse type of gingival enlargement in both the maxillary and mandibular arches which covers maximum portion of the crowns. Based on family history and clinical examination, diagnosis was made following which segment wise gingivectomy was carried out. Histopathologic evaluation was also done. Post operative enlargement was noticed on first week which gradually decreased to some extent in the third week post operatively.
Frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, gingiva, and the underlying periosteum. The frena may endanger the gingival health when they are attached closely to the gingival margin. An aberrant frenum is presupposed to create functional and aesthetic problems. Archer’s ‘classical frenectomy’ is an extensive procedure including the excision of fibers, interdental papilla, and exposure of the alveolar bone up to the palatine papilla. The aftermath delayed healing, loss of interdental papilla, and unusual scar led toward the traditional approaches such as Edward’s frenectomy, frenum relocation by Z-plasty, and free gingival graft, with their practical and esthetic restriction. A superior approach to make a primary closure in midline and to bypass anaesthetic scar by creating a zone of attached gingiva, frenectomy is associated with lateral pedicle graft. Miller, in his study on 27 subjects, proposed that newly created zone of attached gingiva may have bracing effect inhibiting reopening of diastema. A case report of this approach with its well defined benefits is presented.
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