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Background The periodontal flap is one of the most frequently employed procedures. Closure of reflected flap is important step in flap surgery. Black silk sutures are most often used material in routine surgical procedures. These suture materials demand more time and effort and expertise from the surgeon. Tissue adhesives have been developed as alternatives to overcome these problems such as cyanoacrylates. Objective The present study is an attempt to compare effectiveness of the black silk suture with cyanoacrylate adhesives in closing reflected periodontal flap. Method Thirty systemically healthy patients who underwent bilateral flap surgery were given 3-0 black silk sutures on one side and N-butyl cyanoacrylate adhesive on the other side to close a surgical incision. All the participants in the study were recalled on the seventh, 21st, 42nd day. Participants were evaluated for healing and plaque accumulation by assessing the gingival index, plaque index, wound healing index. Biopsy specimens were obtained on seventh and 42nd postoperative day. Result The amount of inflammation was less during the first week of healing when cyanoacrylate was compared with silk. However, over a period of 21 days to 42 days, the sites treated with both the materials showed similar healing patterns without any significant difference in the evaluated parameter. Conclusion The result of the study showed that the use of cyanoacrylate for the closure of periodontal flaps results in better initial post-operative healing as compared to closure with silk suture and that this method of closure can be advocated in a routine surgical periodontal practice.

Background: Root coverage (RC) procedures such as lateral positioned flap (LPF) have been used since long time but with limited success and specific indications., Aim: This prospective clinical study was designed to evaluate clinically the effect of modified LPF (mLPF) with platelet-rich fibrin (PRF) graft for the treatment of denuded root surfaces., Materials and Methods: Fifteen isolated Miller's Class I and II gingival recession of single-rooted teeth were selected for the study. Scaling and root planing was done, and oral hygiene instructions were given to the patients. Plaque index, gingival index, and recession parameters (probing depth, gingival recession height, clinical attachment level [CAL], and width of keratinized tissue [WKT]) were assessed at baseline. Following this, mLPF with PRF was done at the recession sites, and parameters were assessed at 3 and 6 months., Statistical Analysis: To analyze the posttreatment effect, paired t-test was performed at relevant degrees of freedom and 95% confidence level., Results: The mean percentage of RC attained was 72.2% at 3 months and 73.5% at 6 months. The WKT shows a mean gain of 2.93 mm at 3 months and 3 mm at 6 months., Conclusion: mLPF with PRF produced statistically significant reduction in recession depth and gain in both CAL and WKT by the end of 6 months.

Background: For the first time in India, allografts from human extracted teeth were prepared. A randomized, prospective, clinicoradiographical, histological study was conducted to evaluate their efficacy in comparison with freeze-dried bone allograft (FDBA) in alveolar ridge preservation., Materials and Methods: Graft preparation: with written consent, teeth were collected from three donors (full mouth extraction cases). Once donors' serums were tested negative for HIV, HBV, HCV, and Venereal disease research laboratory (VDRL), mineralized whole tooth allograft (WTA) and dentin allograft (DA) were prepared using the standard protocol of Tissue Bank at Tata Memorial Hospital, Mumbai, India., Study Design: In this randomized controlled trial, 15 patients undergoing extraction of at least four teeth were selected. In each patient after atraumatic extractions, one socket was grafted with WTA, second with DA, third with FDBA, and fourth was left ungrafted (control site). All the sites were covered with chorion membrane. To estimate three-dimensional alveolar crest changes, cone beam computed tomography scans were taken immediately after grafting and 4 months postoperatively. Bone biopsies using 3 mm trephine bur were obtained from four patients at the time of implant placement and evaluated histologically., Results: Clinically uneventful healing was observed at all sites. Compared to other sites, WTA and DA consistently showed superior results demonstrating least reduction in alveolar crest height and width which was statistically significant ( P < 0.05). Between WTA and DA sites, there was no statistically significant difference. Histological analysis also confirmed more new bone formation at WTA and DA sites., Conclusions: Rather than disposing extracted human teeth as a biomedical waste (common practice), they can be collected from suitable systemically healthy donors. With the help of tissue bank, they can be processed into an allograft, serving as an excellent alternative to conventional allografts., Competing Interests: There are no conflicts of interest.

Background: Plaque control has been shown to have a pivotal role in maintaining optimal periodontal health. Toothbrushing as a mechanical plaque control tool is the most popular and effective option for self-performed oral health maintenance. However, the detrimental effects of bristle hardness and force exerted by toothbrushes on the tooth surface are the areas of concern., Objective: The aim of this in vitro study was to evaluate the abrasive effect of two different manual toothbrushes exerting predetermined forces on cemental surfaces of the teeth., Materials and Methods: Sixty extracted first molars were selected. Totally six experimental groups were formed based on the three predetermined forces 1.5, 3, and 4.5 Newton (N) and two types of manual toothbrushes, i.e., soft and medium bristle hardness. Buccal and lingual surfaces were independently brushed for 5000 cycles using specially designed toothbrushing machine. Throughout the experiment, type and quantity of toothpaste were kept constant. Post 5000 cycles of toothbrushing, change in surface roughness was measured using profilometer in microns and change in weight indicating loss of substance was measured in milligrams., Results: Abrasion of cementum is force dependent. Data revealed that both soft and medium bristle hardness toothbrushes cause significant cemental abrasion at 3 and 4.5 N forces., Conclusions: Higher is the force, more is the cemental surface abrasion. Soft bristled toothbrush causes more cemental abrasion than medium bristled toothbrush at 3 and 4.5 N forces., Competing Interests: There are no conflicts of interest.

Background: A randomized, prospective clinical, radiographical, and histological study was conducted to evaluate healing after alveolar ridge preservation technique using two different graft materials, namely, a novel autogenous graft material i. e., autogenous tooth graft (ATG) and beta-tricalcium phosphate (β-TCP) alloplast., Materials and Methods: Fifteen patients undergoing extraction of at least three teeth were selected. Atraumatic extractions were performed. Of the three extraction sockets, one was grafted with ATG, other with β-TCP, and the third was left ungrafted. Cone-beam computed tomography scans were taken immediately after grafting and 4 months postoperatively to check the changes in alveolar crest height and width at all the sites. Three patients in whom implant placement was done after complete healing; bone samples were harvested using a 3 mm diameter trephine during osteotomy preparation from both the ridge preserved sites and studied histologically., Results: There was a statistically significant difference when the changes in width and height of alveolar crest were compared within all the three groups ( P < 0.05). Among three sites, ATG-grafted sites showed the most superior results with a minimal reduction in alveolar crest height and width. Histological analysis also showed the same trend with more new bone formation at ATG-grafted sites as compared to β-TCP-grafted sites., Conclusion: Postextraction, ridge preservation leads to more predictable maintenance of alveolar ridge height and width. ATG as compared to β-TCP provided superior results. Based on this, we conclude that ATG material can serve as a better alternative to conventional bone graft materials., Competing Interests: There are no conflicts of interest.

Context: Periodontal disease and oxidative stress (OS) are part of a vicious cycle with each causing a deleterious effect on the other causing changes in the levels of antioxidants, and enzymes of antioxidant defense. Biomarkers and methods used for measuring OS are very expensive., Aims: To see how gamma-glutamyltransferase (GGT) fares, as a biomarker for OS in periodontits along with other routinely used biomarkers., Design: A cross-sectional study involving 300 people of which 150 were cases and 150 were controls., Setting: Candidates enrolled were patients visiting the OPD of MGV's Dental College and Hospital, Nasik, India between January 2011 and December 2012., Materials and Methods: Serum samples of patients with periodontitis, and controls were analyzed for malondialdehyde, superoxide dismutase (SOD), glutathione peroxidase (GPx), uric acid, and GGT., Statistical Analysis Used: Analysis was performed using Student's t test. P <0.05 were considered to be significant., Results: Malondialdehyde values were found to be significantly higher cases, while SOD, GPx and uric acid levels were found to be lower than controls. GGT levels were significantly higher in cases as compared to controls., Conclusions: GGT may be used as a cheap, quick, easy and precise marker for measuring OS.