Purpose This prospective study was conducted to evaluate the bone regeneration capacity of synthetic hydroxyapatite mixed with autogenous bone marrow aspirate when used as a bone graft substitute in maxillo-mandibular osseous defects. Methods This study included nine patients with histopathalogically proven benign osteolytic lesions in maxilla and mandible that were treated with enucleation or marginal resection followed by bone marrow aspirate coated synthetic biphasic hydroxyapatite (hydroxyapatite and beta tricalcium phosphate) graft placement. Incorporation of graft was assessed based on Irwin's radiologic staging. The efficacy of graft to form new bone was radiologically evaluated by observing the sequential changes of density at grafted site using gray scale level histogram which was processed in adobe photoshop 7.0 elements. Clinical assessment of recipient and donor sites was done. Results Based on Irwin's radiologic staging, at 6 month follow up period, obvious incorporation of graft with new bone was observed. Sequential changes in bone density measured by gray scale histogram revealed initial resorption followed by replacement of BMA coated hydroxyapatite with new bone formation. None of the patients eventually had complications like infection, wound dehiscence, graft loss at recipient sites at 6 months follow up period. Conclusion Autogenous bone marrow aspirate in combination with synthetic hydroxyapatite is an effective option for accelerating bone regeneration in small to moderate sized jaw bone defects. This mixture provides all the three critical elements needed for bone regeneration (osteogenesis, osteoinduction and osteoconduction) with an added advantage of obviating donor site morbidity.
To clinically and microbiologically evaluate the association of periodontitis and pre-diabetes. The trial was designed as a randomized controlled clinical trial with a sample size of total of 100 with 1:1 gender ratio. Test group taken were patients with chronic periodontitis with prediabetes and Control group were patients with periodontitis without prediabetes. Body mass index (BMI), Periodontal Probing Depth (PPD),Bleeding on probing (BOP),Clinical Attachment Loss(CAL) using UNC colour coded periodontal probe were recorded. The microbial load in pre-diabetes patients was assessed using samples collected from the periodontal pockets ≤5mm. Fasting Blood sugar (FBS), Post Prandial blood sugar (PPBS), Fasting Insulin were recorded at baseline, 6 weeks,12 weeks and after Non-surgical periodontal therapy (SRP) after taking consent from the patient. The data collected were entered into Microsoft excel 2018. Statistical analysis was done using IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp. Descriptive analyses were done. Student’s t-test, repeated measures of ANOVA were used for determination of the significance of HOMA-IR, HOMA- β mean differences between and within the groups. In both test and control groups, there was a significant difference (p<0.0001) in probing depth, CAL, gingival bleeding index from baseline to the post treatment (NSPT) till 12 week period. When these clinical parameters were evaluated and correlated with HOMA-IR, HOMA-β, BMI, FBS, post prandial blood sugar at regular intervals, significant (p<0.0001) decrease in HOMA-IR, HOMA-β, BMR, post prandial blood sugar was observed in test group when compared to control group. There is a significant association between prediabetes state and periodontitis. Early diagnosis of periodontitis and a proper treatment in prediabetic group can prevent the progression of prediabetic condition to diabetes and vise versa.
Periodontitis is often associated with diabetes and might be considered one of the chronic complications of diabetes mellitus (DM), both in Type 1 (T1DM) and Type 2 (T2DM). This cross sectional study was designed to evaluate the possible association between clinical periodontal disease status and glycemic levels in diabetes patients (T2DM) among the population of city Hyderabad, INDIA. A total of 200 individuals were examined and out of which 179 were enrolled fulfilling the selection criteria were initially given a health questionnaire to gather information regarding their demographic data, oral hygiene practices. Based on Fasting plasma glucose (FPG) levels, they were grouped into: Good, Moderately and Poorly controlled Type 2 Diabetic patients. Oral hygiene index-simplified, CPI and clinical attachment level (CAL), Tooth mobility and Tooth loss due to mobility were evaluated. Nearly Half the individuals have good glycemic control. (47.5% are <121mg/dl), 29.1% have moderately controlled (<121-180mg/dl), 23.5% have poorly controlled (<181-240mg/dl) plasma sugar levels. Average Patients showed 5-10 years of diabetic history with 121- 180mg/dl fasting plasma glucose (FPG) levels. Average participants had fair OHI-S scores. Patients with Good FPS levels showed fair oral hygiene status. Community periodontal index (CPI) scores showed (14.52%) Gingivitis, (20.11%) mild, (8.93%) moderate, (2.79%) severe periodontitis patients with good controlled FPS Levels. Average CAL values ranged between 3-5mm in good to moderately controlled FPS levels. Tooth mobility and tooth loss is less in over all participants. Patients with high plasma sugar levels were more susceptible for severe periodontal disease. CPI values and mobility of teeth was less in subjects with FPG<126mg/dl. With Loss of attachment up to 5mm was observed. Both Periodontist and Diabetologist individually and together should improve awareness regarding periodontal health and diabetic control.
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