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Aim The aim of this study was to observe the effects of coenzyme Q10 (CoQ10) in patients with localized periodontitis and place Sticky Bone™ in defects not resolved in the test or control group. Materials and methods A total of 30 patients with periodontitis of pocket depth ≥5 mm were randomly divided into test and control groups, each comprising 25 sites, where CoQ10 was placed in the test group and methyl cellulose in the control group; all the parameters were recorded, and patients were followed up for 12 months. At the end of 12 months, patients who did not respond to subgingival placement of CoQ10 were treated surgically where Sticky Bone™ was placed and further followed up for 6 months. Results There was significant difference between plaque index (PI), gingival index (GI), and probing pocket depth (PPD) at baseline and 1 month, and there was an increase in values of PI and PPD seen at 6 months and significant increase in values of GI, PI, and PPD seen at 12 months, and no significant difference in values was seen at 12 months and baseline. Conclusion Coenzyme Q10 does not aid in the treatment of periodontitis. Clinical significance Clinically, it shows that CoQ10 has no role to play in the cases of periodontitis. In such cases, without delay patients should be taken up for periodontal flap surgery after complete scaling and root planning (SRP), if the pocket does not resolve.

Aim the current study was aimed (1) To study the effect of Botulinum toxin (BT) A on gummy smile (2) To determine the efficacy, predictability & longevity of the effect of Botox® in the management of gummy smile and lastly (3)To identify the treatment groups for Botox® as a single modality for the non-surgical treatment of gummy smile. Material and method only patients who were willing to get the treatment done with Botox® injection were enrolled in the study, irrespective for the need for the surgery. Thus, total of 32 patients were divided into two groups, group 1, having a gummy smile with less than 5 ​mm who were treated with 3 units of Botox® and group II, having gummy smile of more than 5 ​mm who were treated with 5 units of Botox® and each group underwent 2 cycles of injection 7 months apart given at the Yonsei’s point and were followed for a period of 14 months. Results the procedure was tolerated well by the patients; none developed any allergic reaction or antibodies related to BT. In the less that 5 ​mm and more than 5 ​mm of gingival show group the results remain excellent till 3 months after which gummy smile gradually reaches to the baseline levels. Significant changes start to reappear by the 5th month. Conclusion Authors recommend use of BT for the treatment of gummy smile as the technique is safe, economical and easy to use. Though not long lasting, it may motivate patients to go for surgical procedure, mainly who have gummy smile of more than 5 ​mm because of maxillary vertical excess.

Antral polyps are the most common pathologies found in maxillary sinus. If asymptomatic, it can be left untreated but if symptomatic and is encountered during posterior maxillary rehabilitation procedures like sinus augmentation procedures, it has to be treated preoperatively through FESS procedure by otolaryngologist or may be treated intra operatively during sinus elevation procedure as the case presented here.

A patient was reported with Class II gingival recession (GR) of 5 mm. After restoring abrasion with glass ionomer cement, a full-thickness flap was raised and using blunt dissection through the buccinator and loose surrounding fascia buccal fat pad (BFP) was exposed into the mouth. It was easily spread over the maxillary roots of 14, 15, and 16. It was secured and immobilized using sutures. Postoperatively, the patient did not report swelling or trismus. At 3-year postoperative, gingival margin was at cementoenamel junction, stable and healthy and did not show any recession. Thus, it can be concluded that BFP for covering GR is an excellent technique. It is simple surgical procedure with easy handling of the flap. It provides excellent color and texture match and can also be considered as an excellent procedure for increasing the width of attached gingiva.

A patient undergoing orthodontic treatment presented with multiple recession defects in maxillary anterior region. After thorough clinical examination and assessment, measurements were recorded. Maxillary anterior teeth with recession defects of 3–4 mm were treated with coronally advanced flap and platelet-rich fibrin (PRF) membrane. Regular follow-up was maintained for the patient at 3, 6 , 12, 18, 24, 30, and 36 months. After 36 months, significant root coverage of 100 percent was observed in four defects and 50% coverage in one defect. This shows that PRF membrane along with coronally advanced provides a predictable and significant result for management of recession defects.

Accurate diagnosis and treatment planning are the backbone of any medical therapy; for this reason, cone beam computed tomography (CBCT) was introduced and has been widely used. CBCT technology provides a three-dimensional image viewing, enabling exact location and extent of lesions or any anatomical region. For the very same reason, CBCT can not only be used for surgical fields but also for fields such as endodontics, prosthodontics, and orthodontics for appropriate treatment planning and effective dental care. The aim and clinical significance of this review are to update dental clinicians on the CBCT applications in each dental specialty for an appropriate diagnosis and more predictable treatment.

Aim To observe clinically and radiographically (CBCT), the extent of bone resorption in extraction socket without the use of bone graft substitutes and delayed implant placement. Material and methods 50 compliant patients were selected for study. All the patients who were advised extraction were followed up for entire duration of the treatment, at 5th week CBCT showed horizontal and vertical bone loss. To prevent further bone resorption, after 5 weeks implant was placed along with bone graft. Results Bone resorption after extraction is an unavoidable phenomenon. Clinical and radiographic (CBCT) analysis showed massive bone resorption by 5th week. At 5 month CBCT, all patients showed stable implant integration. There was no implant failure at the end of the study. Conclusion Alveolar preservation is proven to slow down socket wall collapse with the use of a bone substitute material without which larger procedures maybe needed to restore alveolar integrity and harmony. Immediate implant placement is effective when bone graft is placed in the jumping distance.

Closure of the surgical incision has been the primary function of sutures since their introduction. However, whatever the type, they are known to carry bacteria, which can be a source of infection. Five types of surgical sutures, Gut, Silk, Vicryl, PTFE, and Polyamide, were selected and tested on their ability to carry aerobic and anaerobic bacteria and were rated on the basis of forming colony-forming units (CFUs). Aerobic bacteria grown around gut sutures showed minimum CFUs (&asymp, 30 &times, 104/suture). Though very less anaerobic bacteria growth was seen among all tested suture materials, it was maximum around Vicryl and polyamide sutures. Every suture material is capable, albeit not equally, of holding bacterial biofilm formation, which can be a source of surgical site infection.

Placement of an implant in the posterior maxilla often relies heavily on a variety of procedures that increase the vertical dimensions of available bone. With numerous bone graft substitutes now available and recent advancements having been made in technique, the question arises of whether residual bone height still remains an absolute indicator for simultaneous implant placement in lateral wall sinus grafting. In addition to reviewing the literature, the authors present a case in which a direct sinus lift procedure was performed with simultaneous implant placement. The case report demonstrates how implants can be placed in a severely atrophic posterior maxilla and be successful.

Aim To measure implant stability using periotest values of implants placed in sockets augmented with calcium phosphosilicate putty (CPS Putty) as compared with implant stability in naturally healed sockets. Materials and methods Twenty two sockets were implanted with CPS Putty immediately after extraction. The sockets were re-entered after a healing period at 5 to 6 months (average 5.3 months) for implant placement. Periotest values were recorded during implant insertion to assess primary stability. These were compared with the Periotest values of 26 implants placed in 22 patients, with naturally healed sockets. Result Periotest values were significantly lower in the grafted group, indicating better implant stability in sites grafted with CPS putty. Conclusion Implant stability seems to be significantly higher in sockets augmented using CPS putty when compared to nongrafted sites. This suggests that socket grafting with CPS putty may enhance the quality of available bone for implantation. How to cite this article Mahesh L, Narayan TV, Kostakis G, Shukla S. Periotest Values of Implants Placed in Sockets Augmented with Calcium Phosphosilicate Putty Graft: A Comparative Analysis against Implants Placed in Naturally Healed Sockets. J Contemp Dent Pract 2014;15(2):181-185.

Osseointegration is the most studied and most investigated area in implantology. A thorough and complete understanding of what happens at the bone–implant interface is important for the implantologist, thereby enabling a treatment plan which conforms to the standards and gives better clinical predictability. This article serves to be a comprehensive review of the literature on the various aspects of osseointegration.

Use of bone grafting is a boon in saving ailing and failing bony structure. Today in dentistry all types of grafts are used, autogenous, xenografts, allografts alloplasts, all giving favorable results. Yet, all have demerits. Xenografts and allografts have high chances of transmission of infection. This article highlights grafts and transmission of such infections.

Background and objective Combination of platelet-rich plasma (PRP) and bone substitutes for the surgical treatment of periodontal intrabony defects is based on a sound biologic rationale; however, the clinical results indicative of the synergistic effect of PRP remain ambiguous. The objective of the present study was to clinically and radiographically evaluate the use of calcium phosphosilicate (CPS) putty alone and in combination with PRP in the treatment of periodontal intrabony defects. Materials and methods The study was performed at an outpatient facility at a teaching dental institute in north India. A split-mouth design was employed to assess the clinical parameters and radiographic bone fill following the use of CPS putty with and without PRP in patients scheduled for surgical periodontal treatment of intrabony osseous defects. Each defect was randomized to receive treatment with open flap debridement, with CPS putty alone (Group PUT), or open flap debridement with CPS putty and PRP (Group PRP). Probing pocket depth (PPD), plaque index (PI), gingival index (GI), and clinical attachment levels (CALs) were recorded at the investigated sites utilizing custom-made reference guides for measurement reproducibility. Standardized periapical radiographs were also obtained to evaluate defect fill at the surgical sites. Results Twenty patients each with at least two defects located in different quadrants were enrolled. The reduction in PPD from baseline to 1st, 3rd, 6th, and 9th month was found to be significant (p < 0.05). The percent reduction in PPD among PUT group was 57.18 ± 10.71% and among PRP group was 51.39 ± 12.60%. No statistically significant difference was observed in the percent reduction in PPD among two groups at 9 months (p = 0.48). Sites in both groups exhibited statistically significant reductions in PI and GI that were maintained throughout the study period. Similar results were seen while measuring CAL. Conclusion Calcium phosphosilicate Putty alone provides significant improvement in outcomes for the treatment of periodontal intraosseous defects. The addition of PRP to CPS putty does not seem to provide any additive benefit to treatment and the additional surgical time and trauma can be avoided. How to cite this article Shukla S, Chug A, Mahesh L, Grover HS. Effect of Addition of Platelet-rich Plasma to Calcium Phosphosilicate Putty on Healing at 9 Months in Periodontal Intrabony Defects. J Contemp Dent Pract 2016;17(3):230-234.

Root form dental implants have a high success rate and are commonly used for replacement of missing teeth, however failures occasionally occur, such implants must be removed. Like teeth, dental implants also establish microflora soon after placement and stable implants showed no significant shifts in the composition, whereas failing implants showed presence of Gram-negative anaerobic bacteria. This article reviews the microflora associated with dental implants.

Hair loss or alopecia in males is very common, and so is its treatment. Until now, platelet-rich plasma has been in use for hair regeneration, which has shown results but lacks regenerative potential as compared to platelet-rich fibrin (PRF). Injectable-PRF (i-PRF) is advanced version of PRF in liquid form which can be injected and contains stem cells with high regenerative potential. Hair regeneration in Type VI and Type VII was observed which are difficult to treat. Hair growth with i-PRF has better regenerative potential. All cases reported showed improvement in hair growth.

Implant failure results in a considerable bony defect, often requiring multistaged treatment for achieving optimal hard and soft tissue volumes prior to reimplantation. Fresh autogenous cancellous bone is ideal for secondary alveolar cleft bone grafting, for such defects, because it supplies living, immunocompatible bony cells that integrate fully with the maxilla and are essential for osteogenesis. When combined with a slowly resorbing particulate graft like a xenograft, a stable platform for implant placement can be expected.

As placement of implants into immediate sites involves management of the remaining root structure, these residual roots may be used as a guide for the development of osteotomy. This aids in implant positioning and prevents drill slippage into the residual root spaces during osteotomy drilling. Following completion of the osteotomy, the remaining root structure is extracted prior to implant placement into the site. The aim of this study is to assess the success rate of implants when the residual roots were used as anatomical guides for osteotomy. One hundred implants were placed in 57 patients, and 4 different types of implants were used: 47 Bioner TOP DM implants, 20 Nobel Biocare Replace implants, 25 Biohorizons Tapered Internal implants (Birmingham, Ala), and 8 Alpha-Bio Tec SPI Implants. The implants were placed into 57 patients. Osteotomies were placed through intact residual roots, which acted as anatomical guides for implant surgical placement. Patients had a follow-up period of 2 years, and in that time none reported discomfort after implant placement. There were no signs of peri-implantitis observed in any of the patients. Of all the implants placed, the Bioner TOP DM implant showed the least amount of crestal bone loss. Placing implants through residual roots as an anatomical guide is a useful technique that shows good results over a 2-year follow-up period.

Collagen is the most abundant protein in mammals, also making it the most important component of the body structurally and functionally. Collagen provides cell occlusiveness, biocompatibility, and resorbability. It is chemotactic for regenerative cells and may enhance the migration and attachment of fibroblasts through its space-making ability. Collagen also has the advantage of being a hemostatic agent with weak immunogenicity, easy manipulation, and the ability to augment tissue thickness. Additionally, upon breakdown through the resorption process, its byproducts are utilized by the host to form native tissue. Further, these proteins are elastic and enhance repair, properties that make the material useful for various biomedical applications. This review highlights and discusses some of the important aspects of collagen as a biomaterial in dentistry.

Extraoral cementation is a technique that utilizes a stock abutment and a laboratory fabricated crown that is cemented extra orally; the advantage of this technique is that the retained excess luting agent during intraoral cementation, which can be a source of bacterial retention and cannot be observed radio graphically and is not possible to remove with explorer all the time, does not get accumulated and can be trimmed off easily before the final placement of the crown. Thus this technique allows no retention of luting cement, providing better soft tissue contours, no soft tissue inflammation, no retention of plaque and no bone loss. In short it prevents implant failure related to retained cement around implants. This technique provides overall health of peri-implant soft tissues as compared to conventional technique of crown placement where cement retention is a common problem, leading to implant failures.

Following tooth extraction, ridge preservation procedures are employed to regenerate bone in the extraction socket, limit consequent ridge resorption, and provide a stable base for implant placement. The purpose of this study is to histologically evaluate and compare bone regeneration in extraction sockets grafted with either a putty alloplastic bone substitute or particulate anorganic bovine xenograft utilizing the socket-plug technique. Nineteen patients underwent 20 tooth extractions and ridge preservation following a standardized protocol. Ten sites were grafted with calcium phosphosilicate putty (CPS group) and the remaining 10 with anorganic bovine bone substitute (BO group). Patients were recalled after 4–6 months to evaluate the bone regeneration and to proceed with implant placement. A bone core was obtained during the implant procedure from each site and was used for histologic analysis. Histomorphometry revealed that residual graft values were significantly higher in the BO group (25.60% ± 5.89%) compared to the CPS group (17.40% ± 9.39%) (P < .05). The amount of new bone regenerated was also statistically significant higher in the alloplast group (47.15% ± 8.5%) as compared to the xenograft group (22.2% ± 3.5%) (P < .05). Results suggest that ridge preservation using a putty calcium phosphosilicate alloplastic bone substitute demonstrates more timely graft substitution and increased bone regeneration when compared to an anorganic bovine bone xenograft.

Soon after tooth extraction the bone resorption takes place reducing the height and width of alveolar ridge. This produces an altered morphology of the bone unfavorable for implant placement and implant placement becomes impossible without surgical correction. Socket grafting maintains and preserves ridge for implant placement. How to cite this article Mahesh L, Narayan TV, Bali P, Shukla S. Socket Preservation with Alloplast: Discussion and a Descriptive Case. J Contemp Dent Pract 2012;13(6):934-937.