Periodontitis is a polymicrobial disease caused by complex interactions between distinct pathogens in a biofilm resulting in the destruction of periodontal tissues. It seems evident that unknown microorganisms might be involved in onset or progression of periodontitis. For many decades, research in the field of oral microbiology failed to identify certain subgingival microbiota due to technical limitations but, over a period of 12 years using molecular approaches and sequencing techniques, it became feasible to reveal the existence of new periodontal pathogens. Therefore, it is evident that in addition to conventional periodontal pathogens, other microbes might be involved in onset and progression of periodontitis. The novel pathogens enlisted under periodontal phylogeny include Cryptobacterium curtum, Dialister pneumosintes, Filifactor alocis, Mitsuokella dentalis, Slackia exigua, Selenomonas sputigena, Solobacterium moorei, Treponema lecithinolyticum, and Synergistes. The polymicrobial etiology of periodontitis has been elucidated by comprehensive techniques, and studies throwing light on the possible virulence mechanisms possessed by these novel periodontal pathogens are enlisted.

Aims and Objectives:People in rural areas neglect oral health as they lack awareness on dental diseases and also due to inadequate availability of dental services. The prevalence of illiteracy is also a reason which can be attributed to a poor oral health. This epidemiological study is undertaken to assess the prevalence of periodontal diseases in the rural population of Mustabad – in Krishna, Andhra Pradesh.Materials and Methods:A cross-sectional study based on randomized sampling method was carried out using the WHO assessment form (1997) on a population of 470. The data were subjected to statistical analysis using Statistical Package for Social Sciences Version 15.0.Results:The subjects were 220 males and 250 females. Maximum numbers of subjects were in the age group of 35-44 years (21.91%). Prevalence of periodontal disease was found to be 73.62%. The periodontal status deteriorated with aging. Prevalence of periodontitis was higher in females (56.35%) compared to males (43.65%). Males had a higher prevalence of deep pockets (3.18%), whereas females had a higher prevalence of shallow pockets (3.20%). Females had twice the bleeding tendency (18.80%) compared to males (8.64%).Conclusion:The increasing prevalence of periodontal diseases is an impending problem which needs immediate intervention, if not it would have a serious negative impact on the future oral health. The need of the hour is more epidemiological studies with a bigger sample are required.

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Context:Antimicrobial efficacy of subgingival chlorhexidine (CHX) application using two different vehicles of delivery.Aims:The aim was to evaluate the efficacy of CHX varnish and gel as an adjunct to scaling and root planing (SRP) in reducing microbial count within moderate to deep periodontal pockets.Settings and Design:Experimental parallel mouth study.Subjects and Methods:A total of 30 subjects between the age groups 25 and 55 years having moderate to severe periodontitis, with pocket depth ≥ 5 mm were selected for the study. The selected patients were randomized into three groups of 10 each. Subjects in Group 1 received SRP followed by subgingival application of CHX varnish, subjects in Group 2 received SRP followed by subgingival application of CHX gel, subjects in Group 3 received SRP alone. Subgingival plaque samples were collected to estimate mean motile and nonmotile microbial counts using dark field microscopy at baseline, 1 week, 1 month, and 3 months.Results:After 3 months, there was statistically significant reduction in nonmotile microbial count in all the three groups. Motile microbial count was significantly reduced in all the three groups till 1 month from baseline. Only subjects in Group 1 who received subgingival CHXvarnish after SRP showed a significant reduction in motile microbial count till 3 months from baseline.Conclusions:Subgingival application of highly concentrated CHX varnish following SRP is beneficial in reducing microbial count in moderate to deep periodontal pockets.

BACKGROUND In recent days a high success rate has been documented for dental implants as a treatment option for missing teeth replacement. Low level laser therapy (LLLT) is a novel therapeutic modality reported to enhance bone healing. Few studies reported that LLLT enhances proliferation and differentiation of osteoblasts and also reduces postoperative pain. The purpose of this study was to assess if post-operative lowlevel laser irradiation of the implant site has any influence on crestal bone loss and pain reduction around dental implants. METHODS In this split mouth randomised study, 9 subjects with bilateral edentulous sites in the mandibular posterior region willing for replacement were taken into consideration. A total of 30 implants were placed on either side of the mandible followed by Low Level Laser irradiation on the test side immediately after implant placement, on 4th and 7th day. Crestal bone level assessment was done radiographically at 3 months and post-operative pain was assessed using visual analogue scale (VAS) scoring by patients from baseline to 6 days. Statistical analysis was done using unpaired t test for inter group crestal bone loss and Mann-Whitney U test for intergroup pain reduction scores. RESULTS The mean crestal bone loss of control group was 1.40 with a standard deviation of 0.39 and for test group it was 0.76 with a standard deviation of 0.26. A significant difference was observed between control and test groups with respect to crestal bone loss scores at 3 months. On comparing VAS pain scores between the two groups from day 1 to 6, significant difference between the groups was observed on day 2, 3 and 4 with P-values 0.042, 0.0011, 0.0036 respectively. CONCLUSIONS Low level irradiation around the dental implants showed a significant reduction in crestal bone loss and post-operative pain. KEY WORDS Dental Implant, Low Level Laser Therapy, Crestal Bone Loss, Post-Operative Pain

Dental implants have been used for missing teeth replacement with a high success rate. Melatonin is an antioxidant and acts as a free radical scavenger. It retards the resorption of bone by regulating RANKL and OPG synthesis, and increases the BIC (Bone to implant contact) and also bone perimeter and bone mineralization. Objective: The aim of the study was to assess if topical melatonin application at the osteotomy site has any influence on the stability and marginal bone level around the implant Methods: In this split mouth double blind randomized control trial 30 implants were placed on either side of the mandible in which test sites were irrigated with melatonin solution prior to the implant placement and the control site on the other side was irrigated with normal saline. Crestal bone level and implant stability assessment was done at baseline and 3 months. Results: A significant difference was observed between the groups with respect to crestal bone loss scores at 3 months. Regarding implant stability a significant difference(p<0.05) was observed within the groups at baseline and 3 months and also between the groups at 3 months only. Conclusion: Melatonin showed a statistically significant reduction in crestal bone loss and an increase in implant stability.