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Dentofacial esthetics demands have increased tremendously in the past decade. Although gingival melanin pigmentation does not present a medical problem, clinicians are often faced with the challenge of achieving gingival esthetics. Melanin pigmentation of the gingiva occurs in all races. Gingival hyper-pigmentation is seen as a genetic trait in some populations and is more appropriately termed physiologic or racial gingival pigmentation. Pigmentation of gingiva not just has an impact on esthetics but also creates psychological negativity.Treatment of gingival melanin pigmentation can be done using scalpel, chemical agents, abrasion, grafts, electro surgery, cryosurgery or lasers. Recent reports on treatment of gingival melanin pigmentation using bur abrasion method which shows results in terms of ease of use, acceptance and patient comfort to be far superior to other techniques.

Modern periodontics strives on the maintenance of teeth and their supporting structures in the prime of their health. Most periodontal practices focus on prevention of disease, initial therapy and corrective surgical treatment to eliminate deep periodontal pockets. However, restoring supporting tissues to their healthy level is a critical area that offers a much more appealing and in fact a more desired outcome for the patients. Over the last decades different modalities of regenerative treatments have been developed and applied clinically. One such treatment is use of osseous grafts, this article discusses the various types of osseous grafts, their mechanism and advances in regenerative periodontal therapy.

Dental implant is considered as the rehabilitative anchor in the present era of dentistry. The continuous upgradation in terms of implant design, augmented by newer technology and technique-driven strategic implant placement makes the surgery minimally invasive and shortens the treatment duration, thereby increasing the predictability of replacing missing teeth in partially and completely edentulous cases. However, certain medical conditions like Diabetes Mellitus is still viewed as a relative contraindication for dental implant therapy. Also, with the increasing prevalence of diabetes mellitus over the years, the need for a better inference is needed to rule out the controversy over efcacy and safety of dental implants in diabetics. Hence, this review summarizes the interlink between peri-implantitis and diabetes mellitus by assessing the recent evidences involving diabetic patients and incidences of peri-implantitis.

An esthetic smile is directly related to the alignment and contour of the gingiva. Excessive gingival exposure (gummy smile) may be the reason for an unaesthetic smile. It can be caused by various etiological factors, one such factor is altered passive eruption. We report a case of a 24-year-old female patient who came with the chief complaint of an unaesthetic smile, diagnosed with altered passive eruption along with its surgical management involving an internal bevel gingivectomy and osseous resective procedure. &nbsp

Background: A high lip line often known commonly as gummy smile is seldom a cause for concern for the patient and leads to the desire for its correction. The gummy smile is usually caused by the hyperactive pull of the elevator muscles. Methods: The procedure used in this case is a modied lip repositioning procedure wherein the labial frenum is left intact in order to maintain the midline. Result: The results following the surgery one month followed by ve months were satisfactory as around 4 mm reduction in the amount of gingiva displayed was observed. Conclusion: This modied lip repositioning can be used as a non-invasive procedure can be used to reduce the excessive display of gingiva effectively

Gingival recession is the apical shift of the marginal gingiva from its normal position on the crown of the tooth to levels on the root surface beyond the cemento-enamel junction.It is a widespread clinical finding in adults with more than 50% of the population having one or additional sites with gingival recession of 1mm or more and its severity increases with age. Root surfaces exposure in oral environment can cause root hypersensitivity, root caries and create esthetic problems. The pedicle graft is simple and less time-consuming surgical procedure with excellent results, without involving second surgical site for donor harvesting. In this case report the Miller’s Class-II isolated gingival recession defect was treated with lateral pedicle graft and postoperative clinical outcome showed stable & significant root coverage. Keywords: Gingival recession, Lateral pedical graft, laterally positioned flap, Root coverage, Mucogingival surgery

OBJECTIVE: The aim of the study was to assess the impact of non-surgical periodontal therapy (NSPT) on periodontal clinical parameters, spirometric indices, and salivary MMP-8 levels in patients with chronic obstructive pulmonary disease (COPD) with concurrence of chronic periodontitis (CP) compared with systemically healthy CP. MATERIAL AND METHODS: In this prospective clinico-biochemical study, a total of 75 patients belonging to various socioeconomic strata were randomly divided into cases, that is, COPD patients as per the Global Initiative for Obstructive Lung Disease (GOLD) criteria with concurrence of CP [at least ≥ 20 teeth with ≥ 2 tooth sites having pocket probing depth (PPD) or clinical attachment loss (CAL) ≥ 4mm and bleeding on probing (BOP)] and controls (systemically healthy CP). Both groups underwent NSPT and were evaluated for plaque index (PI), gingival index (GI), PPD, CAL, and BOP and spirometry (FEV(1)/forced vital capacity (FVC)) values at baseline, 3, 6, and 12 months and for salivary MMP-8 levels at baseline and 3 months. RESULTS: Statistical results showed that cases (COPD with CP; n = 37) were significantly older (mean age 56.16 ± 9.01 years), ex-smokers (48.6%) with male preponderance (78.4%), and belonged to the upper middle class (40.5%) as compared to controls (systemically healthy CP; n = 38). After NSPT, significant improvement in mean PI, GI, PPD, CAL, and BOP was observed in both groups at 3, 6, and 12 months with better results in controls. FEV(1)/FVC was significantly improved (P < .001) in cases with insignificant change in controls at 12 months. After 3 months, MMP-8 levels were significantly reduced in cases (P = .002) and controls (P < .001). CONCLUSION: The present study provided substantial evidence that COPD patients have poorer periodontal health as compared to systemically healthy counterparts. Further, these patients showed improvement in FEV1/FVC, however, with higher salivary MMP-8 levels despite NSPT at the end of the study, indicating a possible role of systemic inflammatory overburden of pulmonary disease.

Background: The purpose of the present study was to envisage the anti-plaque and anti-inflammatory properties of neem (Azadirachta) in the form of a mouth gel. Materials and Methods: A total of 60 subjects (33 males and 27 females) from age group 19 - 35 years, suffering from mild to moderate gingivitis were randomly divided into two groups. Group A (n = 30) participants were advised experimental (neem) gel and Group B (n = 30) participants were advised 0.2% chlorhexidine gel. All the clinical parameters (the gingival index by Loe and Silness [1], Plaque index by Silness and Loe [2] and sulcus bleeding index by Muhlemann H. R. and Sen S. [3]) were recorded at baseline, on the 14th day and 21st day by the same clinician in both groups. Results: on intragroup comparison the gingival index, plaque index and sulcus bleeding index decrease significantly in both the groups in all assessed periods. On intergroup comparison the indices did not differ significantly at baseline but after 2nd and 3rd week, the indices in Group B decrease more than the group A, which was statistically significant. Conclusion: Based on the observations of our study, it can be concluded that chlorhexidine gluconate as well as neem gel can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. chlorhexidine gluconate gel has been found to be more effective when antiplaque and anti-inflammatory properties were considered. The effect of neem observed maybe because of its anti-inflammatory action. The antiplaque action of chlorhexidine gluconate is due to its substantivity. Substantivity of neem is required to be further studied.

Vajradanti means strong teeth in Hindi. The medicinal properties of Vajradanti plant are well reported in Ayurveda. Its botanical name is Barleria prionitis L. and it belongs to family Acanthaecae. The use of herbal products in the field of medicine has gained popularity in recent years. In India, herbal plants are used as a regular source of medicine. Plants, such as Turmeric, Ashoka and Triphala, are some common household names being widely used nowadays. One such name is Barleria prionitis L. or Vajradanti, having anti-arthritic, anti-inflammatory and anti-fertility properties. The leaves of this flower are also believed to provide relief in tooth ache. So these properties lead us to the use of this shrub in the remedy of dental diseases. Materials and Methods: The study was conducted in the Department of Periodontology, in collaboration with the Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, King George’s Medical University, Lucknow, India and N.B.R.I. Lucknow. A total of 80 subjects, from age group 20 - 50 years, were selected. The study unit consisted of patients of chronic gingivitis. Simple random sampling, utilizing computer generated random numbers, was employed to assign the participants to two groups, “I” and “II”, each having 40 participants. In patients of Group-I scaling and root planing was performed, whereas in patients of Group-II, scaling and root planing was performed and subjects were advised to apply Vajradanti gel twice daily after brushing. Statistical Analysis: Data were summarized as mean ± SD. Pre and post outcome results of two groups were compared by the paired t-test. Conclusions: Based on the observations and results of our study, it can be concluded that scaling and root planing remains the gold standard for the treatment of gingival and periodontal diseases while the Vajradanti gel (Barleria prionitis L.) can be effectively used as an adjunct to mechanical plaque control in prevention of chronic gingivitis. The beneficial effect of Vajradanti can be attributed to its anti inflammatory properties.

Introduction: Nowadays, dental implants permit consideration of as one of the most reliable therapeutic modalities during the establishment of any prosthetic treatment plan. In numerous clinical situations, implants can clearly contribute to a notable simplification of therapy, frequently enabling removable prostheses to be avoided, keeping it less invasive with respect to remaining tooth structure. The aim of the present study was to clinically assess the peri-implant and periodontal conditions after the placement of crowns in partially edentulous patients. Materials and Methods: Twenty-five participants with 28 implant supported crowns were recruited in the study. After the insertion of suprastructure, meticulous scaling and root planing were performed on adjacent teeth which served as control. The clinical examination was carried out by a single examiner after placement of crowns at an interval of 1, 3, 6, 9, and 12 months and included the assessment of modified plaque index (mPlI), bleeding score, calculus score, probing pocket depth (PPD), and recession on the four aspects of each implant and adjacent teeth. Results: The mPlI, modified bleeding index (mBlI), calculus score, PPD, and recession decreased from 1 month to 12 months in both implants and in control teeth. The mean mPlI, mBlI, and calculus score were comparatively high in control teeth than implants. PPD was found to be more on implants than in control teeth. Recession was slightly higher in control teeth than implants throughout the study period, but it was not statistically significant. Conclusion: An implant patient must always be enrolled in a supportive therapy program that involves recall visits at regular intervals.

Objective: The aim of the present study was to investigate the prevalence of periodontal diseases among individuals with type I and type II diabetes in north India and evaluate the association of this condition with behavioral and clinical variables. Materials and Methods: A cross-sectional study was carried out on a calculated sample of 300 individuals with diabetes. Periodontitis was defined as clinical attachment loss (CAL) >3 mm in two or more non-adjacent teeth or those that exhibited CAL >5 mm in 30.0% of teeth. All subjects were over 30 years of age and underwent a periodontal examination. Behavioral characteristics as well as medical history and dental history were obtained with a structured interview. Discrete (categorical) groups were compared by Chi-square (χ2) test. A two-tailed (α=2) P

Introduction: Trigeminal neuralgia (TN) is an uncommon disorder seen in dental and neurologic practice, which presents with brief lancinating pain in the face, in the area distributed by the trigeminal nerve. The wide ranges of treatments currently used for TN are ample evidence that there is no simple answer to how it should be managed. Purpose: In this study, we want to evaluate, if repeated peripheral alcohol injection is an effective treatment of TN patients. Material and Methods: Retrospective data analysis of patients treated with peripheral alcohol injections from November 2011 to July 2017 were conducted. We selected the patients who reported at least three times for alcohol injection and duration of pain relief recorded as reported by patients. Results: Effects of 96% absolute alcohol injection alcohol injection ranging from 13 to 15 months pain relief, but in second or third time, this duration was decreased to 11–12 months, whereas no much significant complication were observed. Conclusion: Even single time neurectomy is not permanent cure, so patients choose less invasive option such as peripheral alcohol injections in repeated use instead of a surgical option.

Introduction Cleaning and shaping of root canal does not guarantee complete disinfection of the canal, regardless of the systems and techniques used for this purpose. Therefore, it becomes mandatory for the endodontic filling materials to have a good antimicrobial potential especially against E. faecalis. This research was aimed therefore to evaluate the antibacterial efficacy and flow properties of different root canal sealers. Aim To study invitro antimicrobial activity and flow characteristics for Resin based (AH Plus), Mineral Trioxide Aggregate based (MTA Fillapex), Calcium hydroxide based (CRCS) and Flowable Gutta-Percha (Gutta Flow 2) endodontic sealers on Enterococcus faecalis. Materials and methods Enterococcus faecalis ATCC 29212 was used to test antibacterial potential of sealers by Agar diffusion test (ADT) and Direct Contact Test (DCT). ADT was performed by punching the sealers on a well of 4×6mm diameter on Muller Hinton agar plates. These plates were inoculated with standard suspension of E. faecalis and the zone of inhibition was measured at 24 hours and after 7 days. All the sealers were prepared in accordance with the manufacturer's recommendations. Flow of sealers was measured according to ADA specification no. 57. Results All sealers showed antibacterial activity against E. faecalis except Gutta Flow 2. At 24 hours, zone of inhibition was highest in Calcibiotic Root Canal Sealer (CRCS) and lowest in AH Plus. After 7 days the zone of inhibition decreased in AH plus, CRCS and MTA Fillapex. DCT showed a significant lower number of organisms in AH Plus, CRCS and MTA than controls at both the time intervals. Gutta Flow 2 did not show any significant antimicrobial action. Maximum and minimum flow was shown by AH Plus and CRCS respectively. Conclusion Highest microbial inhibition was shown by (CRCS), followed by MTA Fillapex and AH Plus. Gutta Flow 2 did not show any inhibition of E. faecalis by ADT. Maximum reduction in antibacterial property with time against E. faecalis was seen with AH Plus. Maximum flow was shown by AH Plus and minimum by CRCS.

Introduction: Platelet-rich fibrin (PRF) is considered as the second-generation platelet concentrate, contains combined properties of fibrin, platelets, leukocytes, growth factors, and cytokines that make it as healing biomaterial with incredible potential for hard tissue and soft tissue regeneration. The present study was aimed to evaluate the effectiveness of PRF with β-tricalcium phosphate (β-TCP) graft (R. T. R) and compare it with β-TCP allograft alone in the treatment of mandibular Grade II furcation defects. Material and Methods: A total of 20 mandibular Grade II furcation defects sites were assigned in the study and treated with either β-TCP alone (Group I) or β-TCP with PRF membrane (Group II). The clinical parameters analyzed were probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), horizontal defect depth (HDD), and vertical defect depth (VDD), recorded baseline and at 6 months reentry. Results: At 6 months, both groups showed statistically significant results for all parameters from their baseline value, although intergroup changes were statistically insignificant. In Group I, gain in CAL was 2.80 ± 1.40 and in Group II it was 3.00 ± 1.44. Bone fill in Group I was VDD (3.50 ± 2.12) and HDD (3.70 ± 0.67), whereas Group II showed VDD (3.70 ± 1.57) and HDD (4.0 ± 0.88), respectively. PPD reduction was higher in Group I (3.50 ± 2.27) than Group II (2.80 ± 1.93). At reentry GR was established, Group I showed higher GR (0.70 ± 0.67) and Group II (0.40 ± 0.52). Conclusions: Significant improvement was found in both groups, but the combination of PRF with β-TCP allograft led to more favorable improvement in the management of Grade II furcation defect except PPD.

Rehabilitation of endodontically treated teeth by post and core preparation is a common procedure in day to day dental practice. However, in some instances, post space preparation can produce excessive frictional heat leading to significant damage to the attachment apparatus of the tooth as well as to the overlying soft tissue. This report describes a case of mucosal dehiscence arising due to trauma induced by inadvertent post space preparation. The denuded mucosa was restored to its physiological position with the help of free gingival autograft obtained from the palatal donor site. The aesthetic results obtained were excellent and have been stable for a period of 2 years.

Introduction: Turmeric commonly known as “Haldi” is a popular spice frequently used in Indian foods and curry. Turmeric holds a high place in Ayurvedic medicine as a “detoxifier of the body,” and today, science has documented several diseased conditions that can be healed by the active ingredients of turmeric. Curcumin is the most active constituent of turmeric curcuminoids obtained from the rhizome of Curcuma longa. Curcumin has been found to have antioxidant, anti-tumor, anti-inflammatory, antiviral, antibacterial, antifungal, analgesic, anti-allergic, antiseptic properties and thus has a potential against various diseases. Due to these properties it was felt that promotion of turmeric in dental practice may prove beneficial. Materials and Methods: The study was conducted in the Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, India. A total of 40 subjects of both the sexes from age group 20-35 years. Simple random sampling was followed and the participants were assigned to two groups ‘A’ and ‘B’ of 20 participants each. Group A subjects were advised 0.2% chlorhexidine gluconate gel. Group B 30 subjects were advised experimental (turmeric) gel. Statistical Analysis: Data were summarized as mean ± SD. Pre and post outcome measures of two groups were compared by repeated measures analysis of variance (RM ANOVA) using general linear models (GLM) and the significance of mean difference within and between the groups was done by Bonferroni post hoc test after adjusting for multiple contrasts (comparisons). Conclusions: Based on the observations of our study, it can be concluded that chlorhexidine gluconate as well as turmeric gel can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. chlorhexidine gluconate gel has been found to be more effective when antiplaque and anti-inflammatory properties were considered. The effect of turmeric observed may be because of its anti-inflammatory action. The antiplaque action of chlorhexidine gluconate is due to its substantivity. Substantivity of tutmeric is required to be further studied.