Search

Background: The aim of this study is to clinically evaluate and compare the clinical success and the relative bone healing of the implants which are placed using a flapless procedure and compare it to those placed by the conventional flap technique. Materials and Methods: This study was conducted with ten patients that were randomly divided into two groups. Group A included patients with immediately placed implants after extraction with flap elevation. Group B included patients with immediately placed implants after extraction without any flap elevation. The clinical parameters recorded were Plaque index, Modified Gingival Index, Early Wound Healing Index, Buser's criteria, Distance between implant shoulder and the crestal bone (DIB), and Radiographic Examination in a standardized manner to evaluate changes for the DIB values. Results: There was an improvement in Plaque Score from baseline to 1 month and baseline to abutment placement (6 months), which was statistically significant, but the plaque score from 3 months to abutment placement (6 months) was statistically nonsignificant in both the group. There was an increase in modified gingival score from baseline to 3 months, baseline to abutment placement (6 months), and 3 months to abutment placement (6 months), which was statistically significant in both the groups. The DIB scores in Group A recorded at baseline to 6 months were 2.80 ± 0.57 and 1.90 ± 0.42, respectively, showing a mean difference of −0.90 and P = 0.001 in comparison. Whereas, the DIB scores in Group B at baseline to 6 months were 3.20 ± 0.57 and 2.50 ± 0.50, respectively, showing a mean difference of −0.70 and P = 0.001 in comparison. The DIC scores in Group A at baseline to 6 months were 1.60 ± 0.54 and 0.00 ± 0.00, respectively, showing a mean difference of −1.60 and P = 0.003 in comparison, Whereas the DIC scores in Group B at baseline to 6 months were 1.40 ± 0.54 and 0.00 ± 0.00, respectively, showing a mean difference of −1.40 and P = 0.005 in comparison. Conclusion: Implants placed in fresh extraction sockets with and without mucoperiosteal flap elevation can be successfully done with augmentation procedures. Short-term survival rates and clinical outcomes of both groups were similar and appeared to be predictable treatment modalities.

Background: The study aims to evaluate the effect of adding extracellular matrix (ECM) component – natural collagen to nanocrystalline hydroxyapatite (nHA) bone graft in the treatment of intrabony defect in chronic periodontitis patients. Materials and Methods: Forty chronic periodontitis patients having at least one intrabony defect were treated surgically by open flap debridement and the defect grafted (Group A: 20 sites grafted with nHA with natural collagen and Group B: 20 sites grafted with nHA). Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and radiographic defect depth (RDD) were evaluated. Results: The mean PPD reduced from 7.6 ± 0.88 at baseline to 4.45 ± 0.69 and 2.60 ± 0.6 at 3 and 6 months, respectively, in Group A. In Group B, the mean PPD reduced from 7.5 ± 0.89 at baseline to 4.95 ± 0.60 and 2.65 ± 0.59 at 3 and 6 months, respectively. The mean CAL reduced from 7.75 ± 0.85 at baseline to 5.05 ± 0.76 and 3.6 ± 0.68 at 3 and 6 months, respectively, in Group A. In Group B, the mean CAL reduced from 7.70 ± 0.86 at baseline to 5.8 ± 0.7 and 3.75 ± 0.64 at 3 and 6 months, respectively. The mean RDD reduced from 8.13 ± 0.78 and 8.12 ± 0.83 at baseline to 4.27 ± 0.66 and 3.94 ± 0.5 after 6 months in Groups A and B, respectively. After 3 months, a statistically significant reduction in mean PPD and CAL values was noted in Group A while the results were comparable after 6 months. Conclusion: The effectiveness of nHA composite during initial healing phase (3 months) can be attributed to the presence of ECM-collagen in bone graft matrix.

Introduction: The effect of different levels of sex hormones in the body is to bring out changes in every part of the body. The changes occurring in periodontium under the influence of female sex hormones during menstrual cycle is important from the perspective of periodontal health. Aim: The purpose of this study is to compare the neutrophil count at different time points during menstrual cycle in GCF and to compare the neutrophil count with clinical parameters. Materials and Method: Fifty five periodontally healthy women with regular menstrual cycle were included in the study. Clinical parameters recorded were Gingival bleeding index (GBI) and the Modified Gingival index (MGI) at each phase of menstrual cycle(Ovulatory phase OP, Menstrual phase MH and Premenstruation phase PMP). Gingival crevicular fluid (GCF) was collected at each study phase for analysis ofneutrophil count. Results: Both the GBI and the MGI increased remarkably during the menstrual cycle, and were significantly higher during ovulation than in menstruation and premenstruation phase. The level of neutrophils increased during the different phases of menstrual cycle, highest count being observed during the ovulatory phase. Conclusion: It was concluded that periodontal health is altered during different phases of menstrual cycle.

Background: Smoking is considered a major risk factor for the development and progression of periodontal diseases. The content of cigarettes can affect the composition of saliva, such as the levels of magnesium, calcium, and phosphate. Objectives: The purpose of this study is to compare gingival health status and salivary magnesium levels in smokers and nonsmokers. Materials and Methods: This research is a descriptive study based on a cross-sectional approach. Forty-two subjects participated in the study which was divided into two groups: smokers and nonsmokers. A purposive sampling technique was used, and a questionnaire was disseminated to collect data on age, gender, number of cigarettes smoked per day, duration of smoking, and types of cigarettes consumed. Oral health status was measured using the Löe and Silness gingival index. Saliva was collected using the spitting method, and salivary magnesium levels were measured by atomic absorption spectrometry. The data analysis was performed using the independent sample t-test and the Mann–Whitney test. Results: The gingival index scores for the smokers and nonsmokers were 0.49±0.195 and 0.26±0.207, respectively. There was a significant difference between smokers and nonsmokers gingival index (P = 0.001). The salivary magnesium levels in the smokers and nonsmokers were 54.43±17.37 and 51.29±15.97 µg/dL, respectively. There was no significant difference in the levels of magnesium saliva between the smokers and nonsmokers (P = 0.428). Conclusion: The findings of this study indicate that the gingival index in smokers is higher than that in nonsmokers. However, the results showed no difference in salivary magnesium levels between the smokers and nonsmokers in this study.

Background: Diabetic patients are subject to chronic periodontitis which could adversely affect glycemic control. Aim: This study determined the impact of chronic periodontitis in patients with diabetes mellitus type 2 (DM 2). Materials and Methods: We compared the levels of serum tumor necrosis factor-alpha (TNF-α) and HbA1c% between DM 2 patients with chronic periodontitis (study group) and DM 2 patients without chronic periodontitis (control group). Results: Statistically significant differences in fasting blood glucose (FBS), HbA1c, and gingival index (GI) were observed between the study and control group. No differences were found in TNF-α between the patients of both the groups. However, higher levels of TNF-α and FBS were shown in diabetic patients with mild periodontitis group than in those with moderate or severe periodontitis. Conclusion: Chronic periodontitis could affect HbA1c levels in DM 2 patients. In addition, HbA1c was positively correlated with FBS and GI, while negatively correlated with TNF-α, which exhibited a higher level in mild periodontitis compared with severe and moderate periodontitis.

Background: The aim of our study is to assess the effectiveness of Curcumin and Tulsi in the control of periodontal parameters when delivered in the form of local drug delivery (LDD) agents. Methods: Curenext gel® and Tulsi gel were used as the two LDD agent. A split mouth randomized clinical trial was carried out in 15 patients. Three sites in different quadrants were assigned treatment modality of scaling and root planing (SRP) alone, SRP with LDD of curcumin and SRP with LDD of Tulsi extract, respectively. Clinical parameters Probing Pocket Depth, Clinical Attachment Level, Plaque Index, Gingival Index, and modified Sulcus Bleeding Index were recorded and subgingival plaque sample collected for N-benzoyl-L-arginine-p-nitroanilide (BAPNA) assay on baseline followed by LDD with extracts in the assigned group. The parameters were recorded at baseline and on 30th day postoperatively. Unpaired and Paired-'t' test were used for intergroup and intragroup comparison of recorded clinical and microbiological parameters. Results: All the treatment modalities showed statistically significant reduction in clinical and microbiological parameters on intragroup comparison. Intergroup comparison showed statistically significant reduction in Plaque Index in curcumin group and BAPNA assay in Tulsi group when compared to SRP. Conclusion: Both the herbs were effective in improving periodontal parameters and may develop as an alternative to currently used LDD agents in near future.

Objective: The objective of this study was to determine and compare the oral health status of outpatients with mental disorders (OPMDs) and healthy controls (HCs) in a Nigerian tertiary hospital. Methodology: A comparative cross-sectional study among 140 OPMDs was consecutively recruited from the Mental Health Clinic of a Nigerian tertiary teaching hospital. Furthermore, 140 age- and sex-matched HCs screened using the 12-item General Health Questionnaire were recruited from the general outpatient clinic. Oral health status was assessed using the Decayed, Missing, and Filled Teeth (DMFT) index, the community periodontal index modified (CPI modified), the Oral Hygiene Index-Simplified (OHI-S), and the gingival index (GI). Bivariate analyses were carried out to make comparisons between the two groups, and the level of significance was set at P

Background: The cigarette smoking and its effect on the inflammatory cytokine levels in the smoker's saliva depicted the influence of electronic cigarettes on oral cytokine levels in oral fluids are scarce in the literature. Objectives: The present trial was conducted to compare and determine the proinflammatory and anti-inflammatory cytokines in whole stimulated saliva samples of electronic cigarette smokers, conventional smokers, and participants with no smoke exposure. Materials and Methods: Sixty adult participants were divided into the following four groups of nonsmokers, current smokers, smokers smoking both conventional and e-cigarettes, and e-cigarette smokers. The saliva samples were assessed for Interleukins (IL-1B, 6, 8, 10, and IL-1RA), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) using enzyme-linked immunosorbent assay. Plaque scores and Gingival Index, and body mass index were also calculated. Results: Statistically significant (P < 0.05) and remarkable relationship was seen in plaque scores and IL 1RA, 1 β, and 10 with the respective values as-0.285, 0.268, and 0.267. Regarding anti-inflammatory cytokines, CRP, IL-10, and IL-RA had the P-value of 0.073, 0.945, and 0.834 respectively. When these values were evaluated for proinflammatory cytokines, the P values were 0.0001, 0.019, 0.991, and 903 for TNF-α, IL-1 β, IL-6, and IL-8, respectively. These results were statistically significant for TNF-α (P = 0.001). Conclusion: Within its limitations, the present study concludes that smoking e-cigarettes whether solely or in combination with conventional smoking increases the levels of proinflammatory cytokines such as TNF-α and IL-1 β with decreased counter IL-1RA levels.

Background: Periodontitis is one of the most common chronic inflammatory diseases in the world. C-reactive protein (CRP) is important due to its crucial role in atherosclerosis as a marker. This study evaluates both salivary and serum CRP levels, Gingival Index, Plaque Index, Bleeding Index, and probing pocket depth. Methodology: A total of 150 participants were enrolled, out of which 50 were healthy, i.e., did not have periodontitis, 50 patients were suffering from chronic periodontitis previously called adult periodontitis, and 50 patients were suffering from aggressive periodontitis with features of rapid attachment loss and bone destruction. All these patients were divided into three groups, and salivary as well as serum samples were collected from each group which were analyzed using enzyme-linked immunosorbent assay. Results: The results showed that both salivary and serum CRP levels were highest in aggressive periodontitis patients followed by chronic periodontitis patients and least in healthy individuals. Conclusion: Both salivary and serum CRP are effective markers in evaluating the severity of periodontal disease.

Background: Tooth brushing is a very simple and effective method for removing daily dental deposits and for preventing dental and periodontal diseases. In physically or mentally challenged person, there arises difficulty in oral hygiene maintenance so that oral hygiene methods may need to be simplified or modified to suit the individual situation. Methodology: Thirty individuals of age group 15–30 years with mild to moderate degree of mental retardation were selected. A randomized double-blind split-mouth design with Clinical Phase-i (aided brushing) and Clinical Phase-ii (unaided brushing) with a washout period of 3 days was conducted. The study duration was for 0–45 days. Two types of brushing that is manual and powered brushing were done. The recording of all clinical and microbial parameters were done on 0th day and 21st day while the clinical parameters were recorded up to 45th day. Results: On intragroup comparison, throughout the study phases, both manual and powered brushing significantly reduced the Quigley–Hein plaque index (48%), gingival bleeding index (GBI) (44%), and modified gingival index (52%). The Pearson correlation between GBI and periodontal pathogens like Prevotella internedia, Porphyromonas gingivalis, and Fusobacterium nucleatum showed statistically significant relation (P < 0.05) in powered brushing group. Conclusion: Powered toothbrush was more effective than manual toothbrush in reducing plaque levels and microbial count in the mentally challenged individuals. The Colgate 360 tooth brush is advisable to mentally challenged individuals.

Background: The objective was to examine the oral hygiene, gingival, and periodontal status among smokers and to relate them with nicotine dependence. Methods: The cross-sectional study was carried out among smokers and nonsmokers in Benin-City, Edo State. Data collection was done through questionnaire and oral examination. The indices applied were Fagerstrom test, Simplified Oral Hygiene Index (OHI-S), Gingival Index (GI), Community Periodontal Index, and tooth mobility index. Results: A total of 40 (20 smokers and 20 nonsmokers) persons participated in the study. The mean OHI-S for smokers was 2.87 ± 0.92 while that of nonsmoker was 2.20 ± 0.73 and this was statistically significant (P = 0.015). The mean GI for smokers was 1.04 ± 0.36 while that of nonsmoker was 0.80 ± 0.22 and this was statistically significant (P = 0.018). The mean number of mobile teeth for smokers was 0.15 ± 0.49 while that of nonsmoker was. 00 ± 0.00 and this was not statistically significant (P = 0.178). One-quarter (25%) of smokers had score 3 and 4 while only 5% of nonsmokers had were found Shallow and deep pockets were found score 3 and 4. About half (45.0%) of the smokers had low-moderate nicotine dependency among the smokers revealed that. Participants with higher nicotine dependence had nonsignificantly poorer oral hygiene, gingival, and periodontal status than their counterparts. Conclusion: Smokers generally had poorer oral hygiene, gingival, and periodontal status as compared to the nonsmokers. Smokers with higher nicotine dependence did not have poorer oral hygiene, gingival, and periodontal status than their counterparts.

Aim: To evaluate the effectiveness in plaque removal and gingival improvement between the Modified Circular and the natural toothbrushing methods in 10- to 12-year-old children. Materials and Methods: A presented quasi-experimental study had a total of 124 fifth graders who were randomized into control and intervention groups. The examination used a structured questionnaire; gingival index (GI), plaque index (PI), and video recording were performed at baseline and follow-up. One oral examiner and one interviewer were blinded for the data collection. Both groups were trained to brush their teeth twice daily for 2 minutes. The intervention group was trained to brush using the Modified Circular and the control group was asked to brush using the same way they brush every day. The collected data were analyzed using demographic statistic, t-test and chi-squared test. Results: At baseline, no significant differences were observed in the mean PI and mean GI between the intervention group (PI = 2.37, standard deviation [SD] = 0.71; GI = 0.49, SD = 0.29) and the control group (PI = 2.26, SD = 0.64; GI = 0.52, SD = 0.29). At one-month follow-up, the intervention group had significantly lower mean PI (PI = 1.74, SD = 0.96) than the control group (PI = 2.30, SD = 1.18) (P < 0.004). The intervention group had a significantly lower mean GI (GI = 0.28, SD = 0.33) than the control group (GI = 0.51, SD = 0.40) (P < 0.002). Conclusion: The Modified Circular method can effectively remove plaque in 10- to 12-year-old children better than the natural toothbrushing method.

Introduction: The Aloe vera has pharmacological actions which include antibacterial, antioxidant, anti-inflammatory, hypoglycemic and immune- boosting properties. The purpose of this study was to evaluate anti inflammatory property of aloe vera mouthwash on gingivitis. Materials and methods: This study used 50 patients who came to a private clinic in Kerala, India, divided into 25 subjects in the test group and 25 subjects in the control group. Results: The difference is seen in the mean value of index in the subjects of scaling with the Aloe vera mouthwash of 0.97210.19543, higher than the mean on subjects without Aloe vera mouthwash of 0.76320.18754 (p

Background and Objectives: Human breath is composed of highly complex substances with numerous variable odors, which can generate unpleasant situations such as halitosis. This study aimed to evaluate the clinical and microbiological efficacy of Carica papaya seed extract on clinical parameters, such as gingival index (GI), papillary bleeding index (PBI), probing pocket depth (PPD), and on oral malodor causing organisms, respectively. Materials and Methods: Thirty subjects with oral malodor score ≥3 were selected for the study. Subjects were divided into three groups: Group A––periodontally healthy subjects, Group B––gingivitis subjects, and Group C––periodontitis subjects with PPD ≥5mm. Ultrasonic scaling was performed for all the patients at the baseline and mouthwash was prescribed for 14 days. The clinical parameters such as plaque index (PI), GI, PBI, and PPD were recorded at baseline and 14th day (T14). Benzoyl- dl -arginine-B-naphthylamide (BANA) test and breath checker readings were taken at 0, 14th, and 21st days. Results: At T14, GI, PBI, PPD, malodor scores, and BANA test results showed a statistically significant reduction (P < 0.001) in all the three groups. Regarding the outcome variables, no significant intergroup differences were observed. Conclusion: Herbal mouthwash of dried seeds of C. papaya as an adjunct to scaling provides more favorable approach in the treatment of plaque-induced gingivitis, periodontitis and also oral malodor in all the groups. However, long-term studies with more number of subjects are required to evaluate the efficacy of this herbal mouthwash as an adjunct to scaling.

Aims and Objectives: To investigate the oral health effects of using toothpaste containing granular calcium carbonate (CaG). Materials and Methods: The subjects were adult volunteers. Two kinds of toothpaste, Paste P and Q were used. Paste P contained 13% CaG, which had a mean diameter of 250 µm and a breaking strength of 20 gf. Paste Q had the same formulation without CaG. Study 1 was to evaluate the ability to remove dental plaque by toothpaste with a single use, and it was a crossover study. The subjects were 50 adults. Plaque levels were assessed using the Quigley–Hein Index (QHI). Study 2 was to investigate the effects of CaG in toothpaste on gingival health. The subjects were 60 adults. The subjects used Paste P for 3 days before the baseline assessment. On the baseline assessment, the subjects whose gingival sulci were found to contain CaG were asked to continue using the Paste P for 6 months. The pocket depth, the gingival index (GI), the QHI, and the presence of CaG in the gingival sulci at 1, 3, and 6 months from the baseline were examined. Results: In study 1, the CaG-containing toothpaste produced a significantly lower mean QHI than the control. In study 2, the QHI and GI of the gingival sulci in which CaG was detected were significantly lower than those of the gingival sulci in which CaG was not detected. Conclusion: Toothpaste containing CaG removed greater amounts of plaque and did not have adverse effects on periodontal tissue.

Background: Periodontal Regeneration of any tissue type is a complex biological process in itself, requiring a triad of cells, locally acting growth factors, systemic hormones, and the extracellular matrix components in which these interact. Aims: The aim of this study was to compare the effectiveness of autogenous dentin graft (ADG) and demineralized freeze-dried bone allograft (DFDBA) with chorion membrane in the treatment of Grade II and III Furcation defects in patients with moderate-to-severe chronic periodontitis. Subjects and Methods: A total of 20 Grade II and III furcation defects in patients with moderate-to-severe chronic periodontitis were randomly assigned to either Group I (ADG + chorion membrane) or Group II (DFDBA + chorion membrane) and evaluated clinically for Gingival Index (GI), probing pocket depth (PPD), clinical attachment level (CAL), vertical bone depth (VBD), and horizontal bone depth (HBD) and radiographically for furcation bony defect (FBD). Results: Intragroup comparisons of clinical parameters GI, PPD, and CAL have shown a statistically significant reduction at the end of 3 months and 6 months, but intergroup comparison was not statistically significant. At the end of 6 months, there was a significant reduction in VBD in Group I (2.65 ± 0.71 mm) compared with Group II (4.00 ± 1.26 mm) and HBD (1.84 ± 0.59 mm) compared with Group II (3.95 ± 1.74 mm), respectively. At the end of 3 months and 6 months, FBD depth was significantly reduced in Group I (1.21 ± 1.10 and 0.43 ± 0.22 mm2, respectively) compared with the Group II (3.04 ± 2.45 and 2.68 ± 2.50 mm2, respectively). Conclusions: The results of the present study indicate that the use of ADG and chorion membrane improved all the clinical parameters. Individuals treated with ADG and chorion membrane showed significant reduction for VBD, HBD, and FBD in the treatment of Grade II and III furcation defects than in the individuals treated with DFDBA and chorion membrane.

Background: Guided tissue regeneration is a very commonly employed technique for treating recession defects. However, achieving the required space beneath the membrane is often difficult. Aim and Objectives: The purpose of the present study was to compare and evaluate the clinical efficacy of coronally advanced flap (CAF) alone or in combination with amnion membrane (AM) or chorion membrane (CM) and demineralized freeze-dried bone allografts (DFDBAs) in the management of gingival recession (GR) defects. Materials and Methods: The sample size (Miller's Class I and Class II GR-type defects) consisted of thirty patients which were stratified into three groups randomly (ten for each group). Group A patients were treated with only CAF and Group B patients were treated by CAF in combination with CM and DFDBA. Similarly, Group C patients were treated by CAF in combination with AM and DFDBA. Clinical parameters such as gingival index, GR depth, GR width, relative attachment level, and width of keratinized tissue were assessed at baseline and 3 months postoperatively. Results: Inter- and intragroup data were analyzed by paired t-test. The percentage of root coverage obtained in the study groups was 60%, 78%, and 63%, respectively, for Groups A, B, and C. Statistically significant difference was obtained in the clinical parameters of Group B which was treated with CM and DFDBA. Conclusions: Combination of DFDBA and placental membrane (chorion/amnion) in CAF procedure provided an additional benefit over CAF alone in the treatment of Class I and II GR defects.

Aims: The aim was to evaluate the prevalence of dental caries and gingivitis among corporation school-going children and their treatment needs in Chennai city. Subjects and Methods: The present descriptive, cross-sectional study was conducted among 3–19-year-old corporation school-going children of Chennai city. It was conducted for a period of 2 months from August 20, 2018, to October 20, 2018. A sample size of 20,007 children (9707 males and 10,300 females) was examined. Oral health status with emphasis on dental caries, gingivitis, and treatment needs was recorded. Statistical Analysis Used: The obtained data was analysed using SPSS 21.0 (IBM, USA). Results: The prevalence of dental caries in the participants examined was 34.72% (6946). About 1663 (23.94%) participants had dental caries involving single tooth, 293 (4.22%) had dental caries involving two teeth, and 4 (0.06%) had dental caries involving >2 teeth. Clinical pulpal involvement with pain on percussion was found in 4067 (58.55%) participants. Nine hundred and nineteen (13.23%) participants exhibited grossly decayed tooth advised for extraction. The prevalence of gingivitis in the participants examined was 8259 (41.28%). About 2672 (32.35%) participants had mild gingival inflammation, 5563 (67.36%) had moderate gingival inflammation, and 24 (0.29%) had severe gingival inflammation based on Loe and Silness gingival index scoring. On the basis of treatment needs, 59.5% of the participants were in need of treatment. Almost 34.3% of the screened participants were in need of primary care, whereas 25.1% of the screened participants were in need of advanced care. Conclusions: The present study reveals the current oral health status of corporation school-going children in Chennai corporation. The results obtained demand a special attention toward these children of less effluent families for the promotion of oral health by regular conduct of treatment camps by corporation and other agencies.

Aims: The aim of this study was to compare the efficacy of a powered toothbrush and manual toothbrush on the periodontal and microbial parameters. Settings and Design: This was a 4-week investigator-blinded, single-center, parallel group study. Subjects and Methods: A total of 120 participants were selected and assigned to one of the two toothbrush groups: study group (power toothbrush – Oral-B® CrissCross®) and control group (Oral-B® manual toothbrush). At baseline, gingival status, plaque, and bleeding on probing levels were recorded for the plaque index, gingival index, and bleeding index, respectively. Evaluation of the intraoral soft tissue for safety and clinical parameters was done for plaque, gingival status, and bleeding scores prior to the start of the study (i.e. baseline) and on the 28th day of the study. Statistical Analysis: Two-tailed statistical analyses were performed with a significance level set at P ≤ 0.05 and calculated using SPSS software. Changes in the clinical parameters (plaque index, gingival index, and bleeding index) were calculated using paired t-test. Comparisons between the powered and manual toothbrushes were performed using unpaired t-test. Analysis of categorized data (questionnaire) was done by Fisher's exact test. Results: Clinical parameters were recorded at baseline and on the 28th day. Reduction in plaque, gingival, and bleeding indexes for powered toothbrush was 89%, 85%, and 93% and for manual toothbrush it was 68%, 75%, 72% respectively. A significant reduction was observed in the plaque scores before and after brushing with both the manual and electric brushes. There was no clinically significant soft-tissue abrasion noticed in either of the groups. Preference analysis showed an increased preference for the electric toothbrush over the manual toothbrush. Conclusions: This study concluded that the oscillating-rotating technology as incorporated in the electric toothbrush had statistically significant results over the manual toothbrush and was found to be a safe and effective toothbrush for long-term use.

Aim: The aim of the study was to clinically evaluate the efficacy of acellular dermal matrix allograft [Alloderm®] in combination with coronally positioned flap in treatment of Miller's Class I or Class II isolated gingival recessions. Materials and Methods: Fifteen systemically healthy patients with Miller's Class I or Class II isolated gingival recessions participated in the study. Coronally positioned flap was performed and acellular dermal matrix allograft [Alloderm®] was placed over the defect. Clinical parameters such as recession height, recession width, keratinized tissue height, clinical attachment level, probing depth, plaque index, and gingival index were evaluated at baseline, 3 months, and 6 months post surgery. The percentage of root coverage was calculated. Descriptive statistical analysis has been carried out using Student's t-test (two-tailed, dependent) to determine the significance of study parameters on continuous scale within each group. The Statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0, and R environment ver. 2.11.1 were used for data analysis. Results: In the study, the recession height decreased from the baseline of 2.50 ± 0.53 mm to 0.3 ± 0.48 mm at 3 months and remained unchanged after 6 months with percentage of reduction being 89%; recession width decreased from the baseline of 4.10 ± 0.74 mm to 0.7 ± 0.95 mm after 3 months and to 0.4 ± 0.52 mm after 6 months (91%), increase in the keratinized tissue height (KTH) from the baseline of 3.6 ± 0.70 mm to 4.7 ± 0.67 mm after 3 months and further increased to 6.4 ± 0.52 mm after 6 months (64%) and gain in CAL from baseline of 4 ± 0.82 mm to 1.9 ± 1.2 mm after 3 months and further reduced to 1.4 ± 0.52 mm after 6 months (74%). There was statistical difference in all the parameters indicating good percentage of root coverage. Conclusion: The use of Alloderm® along with coronally positioned flap provided significant improvement in all measured clinical parameters, indicating that graft gives favorable results in treating Miller's Class I or Class II isolated gingival recessions.

Background: Herbal products are widely substituting synthetic antimicrobials due to their minimal adverse effects and cost-effectiveness. Murraya koenigii (curry leaf) is an easily available green leafy vegetable, which is known for their antimicrobial, antioxidative, and cytotoxic activity. However, no published literature available evaluates their effectiveness in treating gingival inflammation. This study was aimed to evaluate the effectiveness of M. koenigii mouthwash in reduction of plaque and gingivitis in comparison with commercially available chlorhexidine (CHX) mouthwash. Materials and Methods: This single-center, parallel-arm, randomized controlled clinical trial was carried out among individuals reported to the institution. A total of 45 participants with mild-to-moderate gingivitis were selected and divided into three groups. Group A and B participants undergone scaling and were instructed to use M. koenigii and CHX mouthwashes, respectively. Group C participants have received only scaling. All the participants were recalled after 14 days of prescribed mouthwash use and clinical parameters were recorded. One-way analysis of variance test and Student's paired t-test were used for inter- and intra-group comparison of parameters, respectively. Results: On intragroup comparison of clinical parameters, all the three groups showed a statistically significant difference with P ≤ 0.05. On pairwise comparison, it showed a significant difference for Group B versus Group C and Group A versus Group C, while between Group A and Group B showed no significant difference. Conclusion: M. koenigii mouthwash is equally effective as CHX, in treating plaque-induced gingivitis.

Aim: The aim of the present study is to assess the effectiveness of Vitamin C supplementation, a known antioxidant, on periodontal health in patients with chronic periodontitis (CP) and salivary total antioxidant capacity (TAOC) levels. Materials and Methods: A sample of 50 patients diagnosed with CP and 50 healthy controls were selected for the present study. Fifty CP patients were further randomly divided into two groups. CP1 (25 patients received nonsurgical therapy alone) and CP2 (25 patients received Vitamin C supplementation (1500 mg/day) as an adjunct to nonsurgical therapy). Clinical parameters such as plaque index (PI) gingival index (GI), gingival bleeding index (GBI), pocket depth (PD), and clinical attachment level (CAL) were recorded at 1-month and 2-month post therapy. Salivary TAOC levels were measured by Koracevic's method at baseline and 2 months' post therapy. Results: Patients with CP showed lower salivary TAOC compared to control group (P

Background: The aim of this cross‑sectional study was to evaluate the association between stress, salivary cortisol, and periodontitis among the inmates of the central prison. Materials and Methods: Seventy inmates were grouped depending on their pocket depth into Group A (pocket depth >4 mm and

Introduction: Plaque control is fundamental to the prevention and management of periodontal diseases. However, most of the individuals do not practice plaque removal in an adequate manner. Hence, there is a need for an antiplaque agent that can be used on a daily basis without the side effects of antibacterial chemicals. The aim of the study is to evaluate the clinical efficacy of Terminalia chebula in patients with chronic gingivitis. Materials and Methods: Eighty patients, 18–40 years of age, diagnosed with chronic generalized gingivitis were selected and randomly divided into two groups. Group I underwent oral prophylaxis alone whereas Group II underwent oral prophylaxis and advised to do gingival massage by T. chebula powder. Clinical evaluation was done using plaque index (PI), gingival index (GI), and gingival bleeding index (GBI) at baseline and after 1 month. Results: Gingival massage with T. chebula powder showed a significant reduction in PI, GI, and GBI scores from baseline to 1 month. Conclusion: T. chebula powder is a useful herbal formulation for plaque control in patients with chronic gingivitis.

Background: Gingivitis is common in children which if neglected may progress to periodontitis in the adults. Therefore, early diagnosis of gingivitis and appropriate therapeutic measures in children are of utmost importance to prevent or minimize progression of periodontitis in the adult population. Aims: The aim of this study was to determine the prevalence of gingivitis and periodontitis among preschool children in Kolkata. Materials and Methods: A cross-sectional survey of 200 children aged 2–5 years were performed from March 2015 to February 2016. The gingival index (GI) and pocket depth of fully erupted teeth were measured. Results: The comparison (t-test) of mean pocket depth was least (0.89 mm) between 3- and 4-year-old children and was highest (3.09 mm) between 2- and 4-year-old children. The mean GI among boys and girls differ significantly (P Conclusion: Preschool children in and around Kolkata suffer from varying degree of gingival diseases, and comprehensive preventive programs are needed to improve their oral health.

Aim: The aim of this study is to determine the effectiveness of stevia as a daily mouthrinse among 12–15 year-old schoolchildren in Nellore District, Andhra Pradesh. Materials and Methods: A randomized, controlled triple blind trial was carried out among 108 children in B. V. S Municipallity Girls High school in Nellore. Children were randomly allocated into four groups comprising 27 in each group. Four mouthrinses composed of 0.2% chlorhexidine gluconate; 0.05% sodium fluoride, 10.6% stevioside and placebo were provided to the study participants. Plaque index, gingival index, and International Caries Detection and Assessment System (ICDAS) II, respectively, were used for assessing oral condition. The mouthrinsing was carried out for 6 months. Results: Group C showed maximum reduction of 8% and 10% on plaque and gingival scores, respectively, followed by Group A and Group B. However, Group D participants showed 1.5% and 1.8% increase in plaque and gingival scores, respectively. Analysis of ICDAS scores at 6 months indicated that values recorded were same as baseline for all the three groups except that for Group D, there was an increase in the prevalence of cavitated lesion D2–6from 5.6% to 5.8%. Conclusion: Stevia demonstrated very potent antiplaque and antigingivitis properties as compared to other mouthrinses at the end of 6 months trial.

Background: Plants have been the major source of medicine since time immemorial. Turmeric, a rhizome of Curcuma longa, is a herb known for its medicinal properties and is more acceptable and viable option for a common man. Objective: To evaluate the efficacy of golden paste, a combination of turmeric, virgin coconut oil, and black pepper as a monotherapy in treating gingivitis. Methodology: 30 patients within the age group of 25-45 years diagnosed with chronic gingivitis and were administered with golden paste as monotherapy in comparison to scaling and golden paste by using a split mouth study design. Bleeding index and gingival index were evaluated at baseline, 14 days and 21 days. Results: A significant reduction in GI and BI is seen in scaling and golden paste group in comparison to golden paste used as monotherapy.

Introduction: Conventional periodontal therapy in form of scaling and root planing (SRP) has its own limitations when used in deep pockets. Various studies have reported adjunctive use of laser therapy as a promising modality to overcome limitations of SRP. Aim and Objectives of the Study: The aim of this study was to assess the adjunctive effect of 810-nm diode laser on clinical parameters and prostaglandin E2 (PGE2) levels in gingival crevicular fluid (GCF). Materials and Methods: The present study was a split-mouth clinical study, which included 48 sites from patients diagnosed with moderate-to-severe chronic periodontitis. Test group consisted of 24 sites that received diode laser (810 nm, 2.5 W) therapy as an adjunct to SRP whereas control group consisted of 24 sites, which received SRP only. Gingival index (GI) was assessed clinically whereas Florida Probe was used to record bleeding on probing (BOP), pocket probing depth (PPD), and clinical attachment level (CAL) at baseline, 3 months, and 6 months. GCF PGE2levels were measured at baseline and 3 months post therapy using commercially available ELISA kit (Neogen™). Results: Test group showed a significant reduction in GCF PGE2levels at the end of 3 months when compared to control sites. However, the primary clinical parameters (CAL and PPD) from baseline to 3 and 6 months did not show statistically significant improvement in the test group. Conclusion: Application of diode laser resulted in a significant reduction in PGE2levels compared to SRP alone. Thus, diode laser therapy as an adjunct to SRP appears to be a promising treatment modality to reduce or modify the host response.

Background: The aim of the present study was to compare the root coverage of localized gingival recession (GR) using modified coronally advanced flap (CAF) (Sanctis and Zucchelli's technique) and root conditioning 24% ethylenediaminetetraacetic acid (EDTA) when done under magnification and without magnification. Materials and Methods: A total of 20 sites were taken with Miller's Class I GR (10 in test and 10 in control). All clinical parameters were recorded at baseline, 1 month, and 3 months. CAF and root conditioning were done with 24% EDTA. Surgical procedure at test site was carried under magnification ×3.5 and at control site was done without magnification. Results: Plaque index, gingival index, clinical attachment level, probing depth, width of keratinized tissue (WKT), recession depth (RD), and recession width (RW) at baseline and 3 months were compared using Student's t- test. Mean WKT at baseline in control and test group was 4.22 ± 2.05 and 3.22 ± 1.09 which increased to 4.56 ± 1.59 and 4.50 ± 0.94, respectively, at 3 months. RD at baseline in control and test groups was 2.56 ± 0.53 and 2.67 ± 0.87 which reduced to 1.83 ± 0.71 and 1.22 ± 1.20, respectively. RW at baseline in control and test group was 3.56 ± 1.13 and 3.67 ± 0.50 which decreased to 3.06 ± 1.01 and 1.72 ± 1.39, respectively. All the clinical parameters were statistically not significant between control and test groups. Mean visual analog scale (VAS) at 7 days postoperatively in control and test groups was 1.78 ± 0.97 and 0.22 ± 0.44, respectively. The VAS scores were found to be significantly lower in the test group at both 3rd and 7th day postoperatively showing less pain in test group. Conclusion: Microsurgery offers less pain and enhanced outcomes when compared to traditional macrosurgery.

Aims: The use of platelet-rich plasma (PRP) alone in periodontal defects has been controversial and inconclusive. Hence, the present study was designed with the aim to assess the clinical and radiographic effectiveness of PRP alone in infrabony defects. Materials and Methods: Thirty infrabony defects were treated with either autologous PRP with open flap debridement (OFD) or autologous PRP + demineralized freeze dried bone graft (DFDBA) with OFD or OFD alone. Clinical parameters recorded were gingival index, plaque index, probing depth (PD), clinical attachment level (CAL), and gingival recession (REC). Radiographic parameters included defect depth reduction, defect resolution, and crestal bone level. All the parameters were recorded at baseline and 12 months postoperatively. Results: Mean PD reduction and CAL gain were greater in PRP + DFDBA (4.88 ± 1.12 mm and 4.26 ± 1.85 mm) and PRP (4.86 ± 2.12 mm and 4.10 ± 1.47 mm) groups than the control group (2.69 ± 1.37 mm and 1.27 ± 0.89 mm). Conclusions: Within the limits of the study, all the three groups showed significant improvement in clinical parameters from baseline to postoperative 12 months. The amount of defect depth reduction and defect resolution treated with PRP alone group were significantly < PRP + DFDBA. The results pertaining to these parameters were significantly better than the control group.

Aim: The aim of the present study was to evaluate the short-term clinical and microbiological effect of chlorhexidine varnish when used as an adjuvant to scaling and root planing in the treatment of chronic periodontitis. Materials and Methods: A split-mouth design was conducted in 11 patients suffering from chronic periodontitis. The control site underwent scaling and root planing, and the experimental site was additionally treated with chlorhexidine varnish application. Clinical parameters, namely, gingival index (GI), plaque index (PI), bleeding on probing (BoP), probing pocket depth (PPD), and clinical attachment level were recorded at baseline, 1 month, and 3 months postoperatively. Furthermore, microbial examination of the plaque samples was done at baseline, 1 month, and 3 months. Results: Both treatment strategies showed significant improvement in GI, PI, BoP, PPD, and clinical attachment level, at both follow-up visits by comparison with baseline levels. At study termination, chlorhexidine varnish implemented treatment strategy resulted in additional improvement in the clinical parameters, and more reduction in the total anaerobic count at 1 month and 3 months. Conclusions: These findings suggest that a chlorhexidine varnish implemented treatment strategy along with scaling and root planing may improve the clinical outcome for the treatment of chronic periodontitis in comparison to scaling and root planing alone.

Introduction: To compare the effects of hyaluronan (Gengigel) alone and in combination with scaling using clinical, microbial, and lactate dehydrogenase (LDH) parameters. Materials and Methods: In this, the three treatment groups included were scaling, scaling plus local application of Gengigel, and Gengigel alone. The 0.2% hyaluronic acid (HA) gel was applied topically and intrasulcularly 0.8% hyaluronan was applied. The clinical parameters, and microbial and biochemical analyses of gingival crevicular fluid (GCF) LDH were assessed. Intragroup comparisons were made by Student′s unpaired t-test and intergroup comparisons were done using one-way analysis of variance followed by post hoc Turkey′s test. Results: At the end of study period (0-56 day), intergroup comparison demonstrated no significant reduction in plaque index (PI) (0.07 NS), gingival index (GI) (0.99 NS), and LDH (0.70 NS) values. A significant correlation was found between LDH values and bleeding index at all study intervals (0 days, 28 days, and 56 days); gingival index (GI) (0.007 S) was significantly correlated on day 0 and day 56. The microbial reduction was demonstrated. Conclusion: These changes in the clinical, microbial, and biochemical parameters reported with the different treatment modalities clearly support that the use of Gengigel would act as an advantageous adjunct to scaling. Further studies are required to confirm the Gengigel effect using histologic methods.

Purpose: The aim of the present investigation was to assess and compare the oral health-related quality-of-life (OHRQoL) in the rural and urban chronic periodontitis patients of Punjab using short questionnaire of oral health impact profile (OHIP-14). Materials and Methods: A total of 100 patients suffering from chronic periodontitis with pocket depth ≥4 mm in at least one proximal site and a minimum of 20 teeth were screened and divided into two groups - rural and urban (50 participants in each group). Clinical parameters, that is, plaque index (PI), gingival index (GI), pocket probing depth (PPD), and OHRQoL were assessed in all patients using OHIP-14 questionnaire. Results: Results showed that mean PI (2.11 ± 0.635), GI (1.61 ± 0.45), PPD (3.12 ± 0.692), and OHIP-14 (11.49 ± 9.733) scores were significantly higher in the rural population as compared to urban population (1.69 ± 0.45, 1.56 ± 0.355, 3.30 ± 0.973, and 5.88 ± 5.588) suffering from chronic periodontitis. Most affected domain in case of the rural population was functional limitation whereas psychological disability was most affected in the urban population. Statistically significant positive correlation was observed between the periodontal parameters and OHIP-14 (P < 0.001) in both the groups. Conclusion: Within the limitations of the study, periodontal status and OHRQoL are significantly correlated with each other in both rural and urban groups.

Aim: To determine the impact of a school-based oral hygiene instructions program on the gingival health of children in randomly selected middle schools in Riyadh, Saudi Arabia. Materials and Methods: Nine hundred and fourteen children were selected from nine schools that were randomly determined from Riyadh City public schools. After obtaining the parents′ consent, the criteria-guided enrolment of study participants yielded 457 children in the control group and 457 students in the experimental group. The intervention design was 90 days experimental period with an intermediate follow-up visit at 45 days. A calibrated examiner (HW) measured the plaque index (PI) and the gingival index (GI). The indices were measured at day 1, day 45 and day 90 in both the control and the experimental groups. Results were analyzed with Wilcoxon sign rank test for each index, site, and by sessions for each group to determine if the scores had increased, decreased, or remained the same between intervals. Results: Plaque and gingival scores in the control group showed a steady improvement throughout the experimental period when compared with the baseline scores. Scores in the experimental group were significantly improved at each session between baseline and session 2 (45 days) and session 3 (90days) respectively. Conclusions: The continued reduction of GI and PI scores at the end of the intervention observed in this pilot study suggest that a school-based oral hygiene measures program can significantly improve oral health among school children in Saudi Arabia.

Background and Objective: The aim of this study was to assess the association between Stress and Chronic Periodontitis in the Pune Mahanagar Parivahan Mahamandal Limited (PMPML) workers in Pune city, in the State of Maharashtra, India. Study Design: In this cross-sectional study, 1014 PMPML workers were examined for periodontal parameters and were given questionnaires to fill. The workers were broadly categorized as bus drivers (Group I), bus conductors (Group II), and office bearers/workers (Group III). Subjects and Methods: The clinical parameters such as the plaque index (PI), gingival index (GI), probing depth, gingival recession, and clinical attachment levels (CALs) were recorded. Stress was measured by using the occupational stress index. Results: The average PI, GI, probing depth(PD), gingival recession, CAL and stress score was significantly higher among bus drivers (Group I) and bus conductors (Group II) when compared to office bearers/workers (Group III), but did not differ significantly between bus drivers (Group I) and bus conductors (Group II). None of the periodontal parameters correlated significantly with stress levels in the group of office bearers/workers (Group III), whereas all periodontal parameters positively and significantly correlated with stress levels in bus drivers (Group I) and bus conductors (Group II). Conclusion: Stress can be a risk factor for chronic periodontitis because stress alters the immunity of an individual. Furthermore, the person's behavioral changes lead to altered oral hygiene habits, thus causing the accumulation of plaque. Hence, if good oral hygiene is combined with regular periodontal check-ups, it can drastically reduce the effects of stress on the periodontium.

Objective: The aim and objective of the present study was to determine the prevalence and severity of gingivitis and evaluate the factors associated with gingivitis in children residing in rural and urban areas of Panchkula. Materials and Methods: The present study was carried out on a sample of 1269 school children, aged 5, 12 and 15 years, randomly selected from the rural and the urban schools of Panchkula and gingival index was recorded as devised by Loe and Silness (1963) to assess the severity of gingivitis. A standardized questionnaire was self prepared, which was filled by the examiner prior to the clinical examination. The data were subjected to SPSS, version 13, and statistically analyzed using Chi test, F test, ANOVA test. Results: In the age group of 5 years, the children affected with gingivitis in the rural and the urban areas were 67 and 33%, respectively, which was statistically highly significant (P = 0.0001). In the age group of 12 years, the children affected with gingivitis in the rural and the urban areas were 94 and 92%, respectively (P = 0.537), whereas in 15-year olds, the children affected with gingivitis in the rural and the urban areas were 98 and 64%, respectively (P = 0.0001). The children who brushed once a day had higher prevalence of gingivitis as compared to children who brushed more than once per day in all the age groups. Conclusion: The results showed that the percentage of children affected with gingivitis was significantly higher in the rural areas in 5- and 15-year-old children, but this trend was not seen in 12-year age group, reflecting the lack of awareness in rural areas.

Background: The aim of this study is to compare, clinically and radiographically, the effectiveness of nanocrystalline hydroxyapatite (NHA) and synthetic resorbable hydroxyapatite (HA) in the treatment of intrabony defects. Materials and Methods: Ten subjects with bilateral defects, with probing depth (PD) 6-9 mm and radiographic evidence of an intraosseous component ≥4 mm participated in the present study. Subjects were allocated randomly to treatment with NHA (test group) or HA (control group). At baseline, 3 and 6 months after surgery, the following clinical parameters were recorded: Plaque index, gingival index, PD, relative attachment level (RAL), and radiographic reduction in intrabony defect. Results: At 6 months following therapy, the test group showed a reduction in mean PD from 6.4 ± 0.843 to 3.3 ± 0.8232 mm and a change in mean RAL from 12.9 ± 1.197 to 10.1 ± 0.7378 mm, whereas in the control group the mean PD decreased from 7.65 ± 1.8566 to 3.9 ± 1.1005 mm, and mean RAL decreased from 13.9 ± 0.9944 to 10.7 ± 0.6749 mm. On comparison of the mean difference in probing depth between the two groups after the unpaired t -test was applied at baseline, 3 months and 6 months, scores were found to be statistically non-significant ( P > 0.01). Conclusion: The results of the present study indicate that both NHA and conventional HA led to the improvement of clinical and radiographic parameters over the course of the study. However, the test group did not show any significant improvement over the control group.

Background: The relatively safe nature and cost-effectiveness of herbal extracts have led to a resurgent interest in their utility as therapeutic agents. Therefore, this prospective, double-blind, randomly controlled clinical trial was designed to compare the antiplaque and antigingivitis effects of newly formulated mouthrinse containing tea tree oil (TTO), clove, and basil with those of commercially available essential oil (EO) mouthrinse. Materials and Methods: Forty patients were selected for a 21-day study period and randomly divided into two groups. The test group patients were given newly formulated herbal mouthrinse and the control group patients were given commercially available EO mouthrinse. The Plaque Index (PI), Gingival Index (GI), and Papillary Marginal Attachment (PMA) Index were recorded at baseline, 14 days, and 21 days. The microbial colony forming units (CFU) were assessed at baseline and 21 days. Results: Test group patients using herbal mouthrinse showed significant improvement in GI (0.16), PI (0.57), and PMA (0.02) scores. These improvements were comparable to those achieved with commercially available EO mouthrinse. However, the aerobic and anaerobic CFU of microbiota were reduced with the herbal mouthrinse (P = 0.0000). Conclusion: The newly formulated herbal mouthrinse and commercially available mouthrinse were beneficial clinically as antiplaque and antigingivitis agents. Newly formulated mouthrinses showed significant reduction in microbial CFU at 21 days. So, our findings support the regular use of herbal mouthrinse as an antiplaque, antigingivitis, and antimicrobial rinse for better efficacy.

Background: Presence of plaque may be the culprit for dental caries, gingivitis, periodontal problems, and halitosis. Many mechanical aids are practiced worldwide to remove or control plaque, including tooth brushes, dental floss, mouth rinses, and dentifrices. The objective of this clinical study was to investigate the effectiveness of herbal toothpaste (Dabur Red) in controlling plaque and gingivitis, as compared to conventional (non-herbal) dentifrice (Pepsodent). Materials and Methods: In this study, 30 subjects aged 35–43 years with established gingivitis and at least 20 natural teeth, and having a probing depth

Objective: Aloe vera is the oldest medicinal plant that has maintained its popularity over the course of time. It is widely known for its medicinal uses in wound healing, as an analgesic, and for its anti-inflammatory properties. Aim: The aim of this study is to evaluate the anti-inflammatory property of aloe vera mouthwash on plaque-induced gingivitis. Materials and Methods: Forty-five patients who were diagnosed with plaque-induced gingivitis were included in the study. They were divided into three groups with fifteen patients in each group. Group 1 was asked to rinse with 10 ml of aloe vera mouthwash twice daily for three months. Group 2 were treated with scaling only. Group 3 patients were asked to rinse with aloe vera mouthwash and scaling was done. The clinical changes were evaluated with Loe and Silness gingival index (1963) and Muhlemann and Son's Sulcus bleeding index (1971) at baseline, after one month and three months, respectively. Results: The data obtained was compared statistically. The paired ‘t’ test was done for intragroup comparison and one-way analysis of variance with a post hoc Tukey test was used for intergroup comparison. The data was obtained at the baseline, end of first month, and end of the third month. The result suggested reduction in gingival inflammation in all the three groups, but it was more in the aloe vera mouthwash and scaling group. Hence, it was concluded that aloe vera had a significant anti-inflammatory property. Thus, it can be used as an adjunct to mechanical therapy for treating plaque-induced gingivitis.

Aims: The purpose of this pilot study was to determine the effects of silorane composites on gingival crevicular fluid (GCF) levels of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and IL-8, GCF volume and clinical periodontal parameters in patients with silorane composite restorations before and after restorative treatment. Materials and Methods: A total of 20 systemically healthy non-smokers, 12 female and 8 male (age range: 24-46 years), presenting with 25 instances of primary dentine caries with subgingival margins were selected for this study. Approval was obtained from the university ethics committee and treatment plans were approved by the patients. GCF samples were obtained with periopaper strips from relevant teeth for IL-6, IL-8 and TNF-α measurements. Each sample was stored at − 80°C and analyzed using the enzyme-linked immunosorbent assay (ELISA) kits. Cavities were prepared according to the common principles for adhesive restorations and restored with a silorane adhesive system (Silorane System Adhesive (3M ESPE) and silorane composite (Filtek Silorane, 3M ESPE). Cytokine levels were reassessed 2 weeks after restorative treatment. Data were analyzed using the independent t-test at a significance level of α =0.05. Associations between parameters were analyzed using Pearson correlation analysis. Results: A significant increase in gingival index (GI) and plaque index (PI) were observed after 15 days (P < 0.05). GCF volume, IL-6, IL-8 and TNF-α levels exhibited significant differences before and after restorative treatment (P < 0.05). There were strong positive correlations among parameters except for PI/GCF volume and GI/GCF volume. Conclusion: Within the limitations of this investigation, silorane composites may have some negative effects on cytokine levels, clinical parameters and GCF volume.

Background: Hyaluronic acid is an extracellular constitute of the connective tissue that acts as both a barrier to plaque bacteria and fulfils a variety of extracellular functions that are vital to the maintenance of healthy gingival tissue. Recently, 0.2% hyaluronic acid is introduced as an anti-inflammatory agent for topical application in the treatment of gingivitis. Aims: To evaluate the therapeutic efficacy of 0.2% hyaluronic acid containing gel as an adjunct to scaling. Materials and Methods: Fifty patients belonging to both gender and ages ranging 15-40 years diagnosed with plaque-induced gingivitis were included in the study. They were divided into two groups of 25 each; Group 1 (scaling and with 0.2% hyaluronic acid) and Group 2 (scaling alone). Plaque, gingival, and papillary bleeding index of each patient were recorded at baseline, 1, 2 and 4 week periods. Statistical analysis: Data was analyzed using Student′s t test. Results: Comparison of the two treatment modalities revealed a statistically significant improvement in the clinical parameters for both groups at 4 th week with mean reductions in Gingival Index (GI) was 1.13 ± 0.22 (Group 1) and 0.85 ± 0.17 (Group 2), respectively, which was statistically highly significant (P ≤ 0.001), Papillary Bleeding Index (PBI) was 1.22 ± 0.31 and 0.83 ± 0.24, respectively, which was statistically highly significant (P < 0.001). Conclusions : 0.2% hyaluronic acid containing gel is an effective agent for treating plaque-induced gingivitis as an adjunct to scaling as compared to scaling alone.

Background: Multiple approaches have been used to replace lost, damaged or diseased gingival tissues. Coronally advanced flap (CAF) and the use of guided tissue regeneration are among the successfully used surgical techniques to treat gingival recession. Platelet rich plasma (PRP), containing autologous growth factors, has been shown to promote soft-tissue healing. Therefore, the purpose of this study was to evaluate the efficacy of PRP in combination with CAF in the treatment of gingival recession. Materials and Methods: A total of 15 systemically healthy patients with buccal Miller's class I and class II gingival recession in cuspids or premolars participated in the study. CAF procedure was performed and PRP with collagen sponge was placed over the defect. Clinical parameters such as recession depth, recession width, surface area, width of keratinized gingival (KG), clinical attachment level (CAL), probing depth, plaque index and gingival index were evaluated at 3, 6 and 9 months post-surgery. The percentage of root coverage was calculated. Results: The results of this study suggest that the CAF procedure provides a predictable and simple technique in the treatment of localized Class I and Class II gingival recession. The additional application of PRP does significantly increase the width of KG and gain in clinical attachment. Conclusion: CAF procedure is a predictable and simple technique in the treatment of gingival recession and the additional application of PRP does significantly increase the width of KG and gain in CAL. The long-term benefits following surgical treatment of such defects needs to be determined further.

Sheetada is the early stage of periodontal diseases. This occurs due to negligence of oral hygiene, changing life-style, habits, and addictions. It is Kapha Rakta Pradhana Vyadhi. In modern dentistry papillary or marginal gingivitis can be correlated with Sheetada, on the basis of similarities in symptoms, involvement of anatomical structure, etiology and prognosis. The epidemiological studies conducted by American Academy of Periodontology shows that gingivitis of varying severities is nearly universal. It is estimated that over 80% of the world's population suffers from gingivitis. In this clinical study, 106 patients were registered among them 103 completed the treatment and were randomly divided by lottery method into two groups. In Group-A, Dashana Samskara paste local application on gums and in Group-B, Dashana Samskara Choorna Pratisarana on gums was given. After enrollment of the patients in the study cardinal symptoms of Sheetada (gingivitis) such as, Raktasrava, Krishnata, Prakledata, Mriduta, Mukhadaurgandhya, and also the objective criteria such as oral hygiene index, Gingival Index (GI-S), and Gingival Bleeding Index (GBI-S) were studied before and after the treatment. While considering comparative effect on subjective parameters such as Raktasrava, Dantamamsa Shiryamanata, Shotha and Chalata statistically significant results were obtained in Group-A than Group-B. In objective parameters such as, GI-S and GBI-S also showed statistically significant results in Group-A. Observations in follow-up study confirmed that the recurrence rate in the Group-Awas significantly lesser than the Group-B.

Aim : The aim of this study was to evaluate the effects of hyaluronan (HA) and chlorhexidine (CHX) gels as adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Materials and Methods: Sixty patients within the age group of 30-65 years recruited to participate in the study were randomly equally divided into three groups. Complete SRP and subgingival debridement were performed within 6 h in all the patients. For control (Group I) patients, SRP was the only treatment modality given; for Group II and III patients, at least 8 teeth with 4-8 mm probing pocket depth (PPD) were selected for subgingival application of HA gel and CHX gel, respectively. Clinical periodontal parameters such as gingival index, PPD, and clinical attachment level (CAL) were recorded at baseline and 3 months, whereas plaque index was recorded at baseline, 1 month, and 3 months. For measuring systemic/hematological parameters, blood samples for laboratory tests for total leucocyte count (TLC), differential leucocyte count (DLC), and C-reactive protein (CRP) were obtained using standard 2-mL syringe from each subject in all the three groups at baseline, 24 h, and on the 1 month and 3 months post-baseline. Results: In all the three groups, a significant reduction in PPD and gain in CAL were observed between baseline and 3 months follow-up ( P < 0.05); however, at 3 months, change in PPD and CAL was more in Group II than Group III, but the difference was non-significant, and Group I (control) showed less changes in PPD and CAL than both experimental groups. Only one patient revealed positive value for CRP at baseline only, and hence could not be statistically analyzed. In all the three groups, the peak values for TLC count were observed at 24 h. At 1-month and 3-month intervals, a significant improvement in TLC and DLC counts was observed among the experimental (HA gel/SRP and Xan-CHX gel) groups as compared to control group (SRP alone).

Introduction: The purpose of this article is to develop a new index system to identify the individual oral hygiene score (OHS) and the level of the motivation success by using some scales, which are an indicator of the individual oral hygiene status. In this way, the level of personal oral hygiene would be determined and a standard motivation success scale would be presented by comparing the oral hygiene levels measured before and after the motivation application. The Hypothesis: In this hypothesis, an index was primarily formed in order to obtain an individual OHS with the total values of plaque index (PI), gingival index (GI), and calculus index (CI) scores. Motivation success levels of the individuals were calculated and classified by using the rate of change of OHS between the sessions. Evaluation of the Hypothesis: This index system would form a basis for future strategies in preventive dentistry. Standard and common scores in one individual or a wide population will be attained easily and effectively.

Aim: Aloe vera has been suggested for a wide variety of ailments, but its use in dentistry is limited. The purpose of the study was to evaluate the effect of A. vera on the reduction of plaque and gingivitis. This effect was evaluated by randomized, parallel and double-blind clinical trial. Materials and Methods: Total 30 subjects were randomly allocated into three groups; 10 in each for (i) chlorhexidine, (ii) tea tree leaves and (iii) A. vera. Plaque index and gingival index were assessed at days 0 and 21. Subjects were asked to rinse their mouth with the mouth rinse, twice a day, during a 21-day period. Paired t-test was used test the mean difference at 0 day and 21 days. One way analysis of variance was used to check the mean difference among three mouth rinses. Results: All three mouth rinses shows a significant reduction from 0 day to 21 days (P < 0.05). However, no difference was observed when the mouth rinses were compared at 0 and at 21 days (P > 0.05). Conclusion: A. vera mouth rinse was as effective as two commercially popular mouth rinses in controlling plaque and gingivitis.

The aim of the randomized controlled single blind study is to evaluate the treatment of Miller's class II gingival recessions by coronally positioned flap (CPF) with or without acellular dermal matrix allograft (ADMA). Ten patients with 20 sites with maxillary bilateral Miller's class II facial recession defects were selected randomly into two groups of test (ADMA+CPF) and control (CPF alone) group with each group having 10 recession defects to be treated. The clinical parameters included plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), recession height (RH), recession width (RW), height of the keratinized tissue (HKT), and thickness of the keratinized tissue (TKT). These measurements were recorded at baseline and after 6 months post-surgery. Statistical analysis was made by the paired "t" test for intragroup and intergroup comparison was done by the unpaired "t" test. The percentage of root coverage for both the experimental and control groups were 82.2% and 50%, respectively. The changes from baseline to 6 months were significant in both the groups for PD, CAL, and RH; however, for parameters such as RW, HKT, and TKT significance was seen only in the experimental group. On comparison between two groups, only TKT showed statistically significance. It can be concluded that the amount of root coverage obtained with ADMA + CPF was superior compared to CPF alone.