Introduction Various minimally invasive surgical approaches are proposed for the management of gingival recession. A modified surgical approach coined as minimally invasive coronally advanced flap (MICAF) was compared with modified coronally advanced flap (MCAF) for the management of multiple adjacent gingival recession defects. Materials and methods Seven systemically healthy subjects with bilateral multiple adjacent maxillary facial gingival recession defects (Miller I) were included in this study. In each patient, MICAF performed on one side and on the other side MCAF was performed. Comparisons of the surgical sites were made with clinical measurements at 6 months follow‐up. Results No statistically significant differences were observed between MICAF and MCAF sites in the change in gingival recession depth, gingival recession width, clinical attachment level, width of the keratinized tissue, mean, and complete root coverage after 6 months. However, patient reported outcomes of esthetics and postoperative morbidity were statistically significant (P <0.001) between the MICAF and the MCAF sides with better results in the MICAF side. Conclusions Within the confines of this study, the results depicted that MICAF is more patient‐friendly procedure with better patient acceptance. Further, long‐term studies with more sample sizes are needed for a stronger evidence base. Clinical Significance Miller Class I gingival recessions can be treated with the MICAF with successful clinical outcomes and patient acceptance. This paper reports the clinical and patient reported outcomes of the MICAF and the MCAF.

Objective. The risk to dentists, assistants, and patients of infectious diseases through aerosols has long been recognized. The aim of this study was to evaluate and compare the efficacy of commercially available preprocedural mouth rinses containing 0.2% chlorhexidine (CHX) gluconate, Befresh™ herbal mouthwash, and water in reducing the levels of viable bacteria in aerosols. Materials & Methods. This was a single-center, double-masked, placebo-controlled, randomized, three-group parallel design study. 30 patients (10 patients in each group) were recruited in the study. Patient rinsed mouth with 10 ml of CHX, 10 ml Befresh™, or 10 ml water. All the patients underwent supragingival ultrasonic scaling for a minimum of 30 min. The aerosol collection was done using a blood agar plate. The blood agar plates were kept approximately 12 inches from the patient’s mouth. The microbial culture was analyzed. The colony-forming unit (CFU) counting in all three groups was assessed using one-way ANOVA test to compare among the groups (p value <0.001). The intergroup comparison was done using the post hoc Tukey test. Result. There was a marked reduction in the CFU in the CHX group in all three areas. This was followed by Befresh™ (Sagar Pharmaceuticals) mouthwash. There was no reduction in the CFU of the water group. Conclusion. This study proves that a regular preprocedural mouth rinse could significantly reduce the majority bacteria present in aerosols generated by the use of an ultrasonic unit, and Befresh™ mouth rinse was found to be equally effective in reducing the aerosol contamination to 0.2% CHX gluconate.

Neutrophil-mediated immunity is the first host defense response against any infection. Crevicular efflux of neutrophils against bacteria is considered to be a novel defense mechanism in periodontal diseases. As a part of defense mechanism, neutrophils extrude its content and exhibit its antimicrobial activity by forming a web-like structure called neutrophil extracellular trap (NET) and undergo a process of cell death called NETosis. Under physiological conditions, NET production is limited and is balanced with its degradation, whereas NET production is found to be aggravated in chronic systemic inflammatory conditions such as diabetes mellitus and also in periodontal diseases. It is well known that a two-way relationship exists between diabetes mellitus and periodontal diseases. Interference in the process of NETosis might form a link between the two. The aim of this review is to focus on the potential role of NETosis in the pathogenesis of periodontitis and diabetes mellitus.

Background In daily dental practice, plaque‐induced gingivitis is one of the most common periodontal diseases that is frequently encountered. Accumulation of microbial biofilms on surfaces of teeth and poor or inadequate oral hygiene is the chief predisposing factor for this condition. In such a state, antimicrobial mouthwash as an adjunct to mechanical plaque control helps in maintaining good oral hygiene. Among the many conditions, fixed orthodontic treatment is one of the conditions where plaque control becomes challenging to the patient as well as the dentist. In such a situation, antimicrobial mouthwash as an adjunct to mechanical plaque control is highly recommended. Dentistry has recently evidenced a shift of approach for treating many inflammatory oral diseases by using herbal treatment modalities. Aloe vera is one such product exhibiting multiple benefits and has gained considerable importance in clinical research recently. The present study aimed to evaluate efficacy of aloe vera mouth rinse on the dental plaque and gingivitis in patients who were undergoing fixed orthodontic treatment in comparison with 0.2% chlorhexidine mouthwash. Material and Method This randomized controlled trial was conducted on 30 subjects with fixed orthodontic treatment. The subjects were grouped in the test group (15 subjects with 10 ml aloe vera mouthwash (99.6% [w/v])) and the control group (15 subjects with 0.2% 10 ml chlorhexidine mouthwash). Plaque index, gingival index and bleeding on probing were recorded for each participant at baseline, 21 days from baseline and 35 days from baseline. The findings were then statistically analysed using student paired and unpaired t‐test. Results Gingival index showed a statistically significant difference from baseline to 21 days and 35 days visit in both the groups. Plaque index and bleeding on probing were statistically significant among both groups when compared baseline to 21 days and 35 days visit, but the difference was not significant between visit 2 and visit 3. Conclusions Although chlorhexidine is still the gold standard mouthwash, aloe vera exhibits promising results in reducing plaque and gingivitis scores, without any reported adverse effects. Larger multi‐centric trials are needed to prove its effectiveness on dental plaque‐induced gingivitis.

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Introduction: Teeth with furcation involvement can be maintained in a state of function for a longer period of time if appropriately treated and if the patient is motivated adequately. This report highlights the effect of regenerative and resective therapy in the management of grade III furcation involvement. Observation: A 48 years old male patient was evaluated for furcation involvement with respect to the root canal treated lower right first molar tooth. Grade III furcation involvement was noted for which regenerative therapy was attempted with platelet rich fibrin (PRF) and bone grafts. After 2 years of follow up, the furcation involvement still persisted and patient had a complaint of food lodgement. Hence, resective osseous surgery (tunnel preparation) was done to make the furcation ease for maintaining oral hygiene. Commentary: In cases of periodontal loss, periodontal regenerative therapy must be the first treatment of choice. However, regeneration of grade III furcation involvement is more challenging and very few reports are available in the literature. Conclusion: The selection of cases for regenerative or resective therapy depends on the clinicians’ knowledge and practice. The ultimate goal of periodontal therapy is to provide a dentition that will function in health and comfort for life.

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