Opinions on the interdependence between diabetes mellitus and oral periodontal disease are controversial. Experimental and clinical investigations carried out so far have not brought unique results. General objective of our research is to investigate on the strictly defined group of subjects aged 35-44 with diabetes mellitus type I the influence of metabolic control HbA1C on changes of periodontium and other organs. According to duration of diabetes mellitus the patients are divided into subdecade and postdecade groups. This group consists of 56 patients out of which 33 patients are with subdecade and 23 with postdecade insulin-dependent diabetes mellitus. In this group periodontal pocket depths, gingival index, number of extracted teeth and the volume of nonstimulated saliva are measured in comparison with a control group. The incidence of oral diseases and complications in other organs of insulin-dependent patients in subdecade and postdecade period are also examined and recorded. Periodontal diabetic disease is verified by pathohistological findings. Values of HbA1C in either subdecade or postdecade group with diabetes mellitus are above normal values. Values of periodontal pocket depths as well as the values of gingival index are substantially greater at insulin-dependent diabetes mellitus patients compared to the control group.

Diabetes mellitus and periodontal diseases

We thank Dr. Varon (1) for his interest in the relationship between periodontitis and kidney disease in type 2 diabetes, but we disagree with most of his statements and conclusions.

First, although our analysis (2) excluded individuals with kidney disease (macroalbuminuria or low glomerular filtration rate) at baseline, we did not exclude individuals with known risk factors for …

https://care.diabetesjournals.org/content/diacare/30/12/e139.full.pdf

Effect of Periodontitis on Overt Nephropathy and End-Stage Renal Disease in Type 2 Diabetes Response to Varon

Bacteremia Associated with Toothbrushing and Dental Extraction

Background: Platelet-rich fibrin (PRF) promotes tissue regeneration by releasing various growth factors. The palatal donor site of the epithelialized connective tissue (CT) graft significantly influences the patient’s morbidity. The aim of this study is to compare the effects of PRF and gelatin sponge on the healing of palatal donor sites and the patient’s morbidity.Methods: Forty patients with at least one site of Miller Class I or II gingival recession were treated by a coronally advanced flap with CT graft resulting from the de-epithelialization of a free gingival graft. In the test group (20 patients), a PRF membrane was placed over the palatal wounds; conversely, the 20 control group patients were treated with an absorbable gelatin sponge. Patients were monitored at 1, 2, 3, and 4 weeks after surgery for the complete re-epithelialization of the palatal wound (CWE), the alteration of sensitivity around the wound area, postoperative discomfort, and changes in feeding habits (CFH). Furthermore, the cons...

Clinical Comparison of Platelet-Rich Fibrin and a Gelatin Sponge in the Management of Palatal Wounds After Epithelialized Free Gingival Graft Harvest: A Randomized Clinical Trial.

Objective To review the historical and current periodontal phenotype classifications evaluating methods and characteristics. Moreover, to identify and classify the methods based on periodontal phenotype components. Overview Several gingival morphology studies have been frequently associated with different terms used causing confusion among the readers. In 2017, the World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions recommended to adopt the term "periodontal phenotype". This term comprises two terms, gingival phenotype (gingival thickness and keratinized tissue width) and bone morphotype (buccal bone plate thickness). Furthermore, gingival morphology has been categorized on "thin-scalloped", "thick-scalloped" and "thick-flat" considering the periodontal biotype. However, by definition, the term phenotype is preferred over biotype. Periodontal phenotype can be evaluated through clinical or radiographic assessments and may be divided into invasive/non-invasive (for gingival thickness), static/functional (for keratinized tissue width), and bi/tridimensional (for buccal bone plate thickness) methods. Conclusions "Thin-scalloped," "thick-scalloped," and "thick-flat" periodontal biotypes were identified. These three periodontal biotypes have been considered in the World Workshop but the term periodontal phenotype is recommended. Periodontal phenotype is the combination of the gingival phenotype and the bone morphotype. There are specific methods for periodontal phenotype evaluation. Clinical significance The term periodontal phenotype is currently recommended for future investigations about gingival phenotype and bone morphotype. "Thin-scalloped," "thick-scalloped," and "thick-flat" periodontal phenotypes can be evaluated through specific methods for gingival thickness, keratinized tissue width, and buccal bone plate thickness evaluation.

Periodontal phenotype: A review of historical and current classifications evaluating different methods and characteristics

Background: IL-1 cytokines have central roles in the pathogenesis of periodontal disease Polymorphism in the locus +3954 (C/T) of the human IL-1B gene has been shown to affect the levels of this cytokine Aim: The aim of the present study was to investigate the association between the IL-1 B (+3954) gene polymorphism and the occurrence of different clinical forms of periodontitis Materials and Methods : Genomic DNA was obtained from 90 individuals and amplified using the PCR with specific primers flanking the locus +3954 of IL-1B PCR products were submitted to restriction endonuclease digestion and analyzed by gel electrophoresis, allowing for the determination of the genotypes and detection of the polymorphism Statistical Analysis: Fisher's exact test was used for comparing the frequency of genotype distributions between groups Results: The chronic periodontitis group displayed a higher percentage of T alleles (38%) when compared to the aggressive periodontitis group (20%) and to the control group (19%) Conclusion: Our study data states that polymorphism in the locus +3954 of IL-1B gene could be a risk factor for chronic periodontitis in a sample of Indian population of Karnataka state

Evaluation of interleukin -1B (+3954) gene polymorphism in patients with chronic and aggressive periodontitis: A genetic association study.

Various classifications have been proposed to classify gingival recession. Miller's classification of gingival recession is most widely followed. With a wide array of cases in daily clinical practice, it is often difficult to classify numerous gingival recession cases according to defined criteria of the present classification systems. To propose a new classification system that gives a comprehensive depiction of recession defect that can be used to include cases that cannot be classified according to present classifications. A separate classification system for palatal recessions (PR) is also proposed. This article outlines the limitations of present classification systems and also the inability to classify PR. A new comprehensive classification system is proposed to classify recession on the basis of the position of interdental papilla and buccal/lingual/palatal recessions.

A new classification system for gingival and palatal recession

Dentistry, an art in science and tranquilizer in medicine, has seen a lot of changing concepts over a decade and one such novel innovation is piezosurgery. Piezosurgery is a true revolution in bone surgery as it fulfils both biological and technical criteria.

It has a variety of applications ranging from minor surgical procedures to complex implantology, plastic and reconstructive surgeries. Piezosurgery uses a low frequency modulated ultrasonic insert which produces microvibrations in the range of 60-200micro meter/sec and leads to safe and precise bony incision without damaging underlying vital structures like nerves, mucosa and vessels. It overcomes technical difficulties such as visibility by producing bloodless field during surgery and removes debris simultaneously through internal irrigation mechanism. The soft tissues remain safe and biological factors like release of certain cytokines promote bone healing and enhance patients recovery.

This critical review outweighs piezosurgery over traditional tools and emphasizes on its clinical and biological aspects contributing to beneficial dental health.

Escalating role of piezosurgery in dental therapeutics.

The foremost indication for gingival depigmentation is patient demand for improved aesthetics. In most cases after the removal of pigmented layer, the area is covered with periodontal packs. These dressings have no curative properties. They only minimise the likelihood of surface trauma during mastication. However, platelet-rich fibrin (PRF) accelerates wound healing by effective neovascularisation and promoting fast cicatricial tissue remodelling. In the present split mouth study, PRF membrane was applied in the first quadrant and non-eugenol dressing (Coe-Pack) in the second quadrant after depigmentation. Clinical evaluation of epithelization with toluidine blue revealed that PRF treated sites stained substantially less indicating better wound healing as compared to Coe-Pack sites, which appeared more erythematous after 5 days. The histologic evaluation also revealed greater inflammatory cell infiltrate on Coe-Pack sites as compared to PRF. Thus, PRF membrane as a periodontal dressing is a successful approach to protect the raw wound area of the depigmented site to reduce healing time and patient discomfort.

Clinical and Histologic Evaluation of Platelet-Rich Fibrin Accelerated Epithelization of Gingival Wound.

Background: To compare and evaluate the intra- and inter-examiner efficacy and reproducibility of the first-generation manual (Williams) probe and the third-generation Florida probe in terms of measuring pocket probing depth (PD) and clinical attachment level (CAL). Materials and Methods: Forty subjects/4000 sites were included in this comparative, cross-sectional study. Group- and site-wise categorizations were done. Based on gingival index, PD, and CAL, patients were divided into four groups, i.e., periodontally healthy, gingivitis, mild to moderate periodontitis, and severe periodontitis. Further, based on these parameters, a total of 4000 sites, with 1000 sites in each category randomly selected from these 40 patients, were taken. Full mouth PD and CAL measurements were recorded with two probes, by Examiner 1 and on Ramfjord teeth by Examiner 2. Results: Full mouth and Ramfjord teeth group- and site-wise PD obtained with the manual probe by both the examiners were statistically significantly deeper than that obtained with the Florida probe. The full mouth and Ramfjord teeth mean CAL measurement by Florida probe was higher as compared to manual probe in mild to moderate periodontitis group and sites, whereas in severe periodontitis group and sites, manual probe recorded higher CAL as compared to Florida probe. Conclusion: Mean PD and CAL measurements were deeper with the manual probe as compared to the Florida probe in all the groups and sites, except for the mild-moderate periodontitis group and sites where the CAL measurements with the manual probe were less than the Florida probe. Manual probe was more reproducible and showed less interexaminer variability as compared to the Florida probe.

Comparative evaluation of probing depth and clinical attachment level using a manual probe and Florida probe.

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