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Dental local anesthetic solutions containing adrenaline may safely be used in patients with diabetes who had taken their hypoglycemic medications preoperatively.

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Objectives: Loss of the interdental papilla is multi-factorial and creates a multitude of problems. Autogenous connective tissue/biomaterial-based regeneration has been attempted for decades to reconstitute the black space created due to the loss of papilla. The aim of this present study was to regenerate papillary recession defects using an amnion-chorion membrane (ACM) allograft and to evaluate the clinical outcome up to six months postoperatively. Materials and Methods: Twenty patients with 25 Nordland and Tarnow's Class I/II interdental papillary recession defects were treated with ACM and coronal advancement of the gingivo-papillary unit via a semilunar incision on the labial aspect followed by a sulcular incision in the area of interest. A photographic image analysis was carried out using the GNU Image Manipulation software program from the baseline to three and six months postoperatively. The black triangle height (BTH) and the black triangle width (BTW) were calculated using the pixel size and were then converted into millimeters. The mean and standard deviation values were determined at baseline and then again at three and six months postoperatively. The probability values (P˂0.05 and P≤0.01) were considered statistically significant and highly significant, respectively. An analysis of variance and post hoc Bonferroni test were carried out to compare the mean values. Results: Our evaluation of the BTH and BTW showed a statistically and highly significant difference from the baseline until both three and six months postoperatively (P=0.01). A post hoc Bonferroni test disclosed a statistically significant variance from the baseline until three and six months postoperatively (P˂0.05) and a non-significant difference from three to six months after the procedure (P≥0.05). Conclusion: An ACM allograft in conjunction with a coronally advanced flap could be a suitable minimally invasive alternative for papillary regeneration.

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Fibrous overgrowths of soft tissues in oral cavity are relatively common and may be quite challenging to diagnose. Pyogenic granuloma is one such entity which occurs commonly in response to chronic local irritation, e.g., calculus, fractured tooth or restoration, foreign materials, etc. It occurs predominantly in females, probably due to the action of female hormones. These lesions are generally asymptomatic and are reported only due to difficulty in mastication. Treatment includes complete excision of the lesion along with the removal of causative factor. This paper describes a case of pyogenic granuloma in a ten-anda-half-year-old girl, presenting with a single, irregular, reddish maxillary gingival swelling in relation to mobile 63.

Aim: To determine the clinical efficacy of biphasic hydroxyapatite+β-tricalcium phosphate (HA/β-TCP) alone or in the presence of collagen membrane (CM) in the management of intrabony defects. Materials and methods: Nineteen bilateral intrabony defects with an intrabony component ≥4 mm were selected and randomly allocated in a double-blind, split-mouth design to receive either HA/β-TCP+CM (test) or HA/β-TCP (control). Analytical parameters measured at baseline and 1 year after surgery included plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), gingival recession (R), radiographic defect depth (RDD), and radiographic percentage bone fill (PBF). Results: One year after therapy, the test treatment resulted in statistically higher PD reductions (p < 0.001) and CAL gains (p < 0.001) than the control one. In the test group, all sites (100%) gained at least 3 mm of CAL, whereas in the control group only 10 sites (53%) gained CAL of ≥3 mm. The mean radiographic PBF calculated at the end of 1 year was found to be 41.3 ± 20.6% for the test group and 30 ± 20.5% for the control group, with a significant (p = 0.016) improvement in the PBF for the former. Conclusion: The present data appear to indicate that treatment with HA/β-TCP in combination with collagen barrier may result in higher clinical improvements than that achieved with HA/β-TCP alone.

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