Cyclosporine is used as an immunosuppressive agent in organ transplantation. It has several side effects including gingival overgrowth. We evaluated 30 renal transplant patients on cyclosporine for the degrees of the gingival overgrowth. All the patients were males with mean age of 37.5 years. Eighteen patients (60%) had moderate to severe degrees of gingival overgrowth. No correlation was found with the trough levels of cyclosporine in blood. We conclude that gingival overgrowth is associated with cyclosporine immunosuppressive therapy but may not be dose related. The effect of other factors such as dental plaque and oral hygiene should be further studied.

Crown root fractures in the maxillary anterior region represent an intriguing challenge for clinicians. An interdisciplinary approach based on exposing fractured margins and the definitive prosthetic rehabilitation represent the standard modality of treatment for these conditions to restore the appropriate biologic dimension and esthetics. However, if the margins of the fragment and the tooth show perfect juxtaposition with no interfragmentary space and immediate esthetic replacement is needed, reattachment of the fractured segment using adhesives may be indicated. The aim of this case report is to describe the treatment of a crown root fracture at CEJ of an endodontically treated tooth having porcelain fused to metal crown by means of metal post placement and reattactment of the fragment using Glass ionomer cement with follow up of one year. Conclusion: Reattachment of a tooth fragment is a viable technique that restores function and aesthetics with a very conservative approach in a single visit and can be considered when treating patients with crown/root fractures of the anterior teeth.

Background: Several etiologic factors have been listed for pathologic migration of periodontally involved teeth based mainly on clinical observations with scarce scientific evidence. Present study was carried out to find out relationship of clinical attachment loss and gingival inflammation with pathologic tooth migration. Materials and Methods: A total of 37 patients having 50 pairs of migrated and non-migrated contralateral teeth were taken into consideration. Results: Mean total attachment loss per tooth in migrated and non migrated tooth is 13.32 ± 0.74 S.E. and 8.34 ± 0.58 S.E., respectively (P < 0.001), which reveals a positive correlation. There seems to be an association between frequency of migration and severity of attachment loss since highest percentage of migrations were seen in maximum total attachment loss group. Relationship could not be established between severity of attachment loss and severity of migration for which more data may be required. Also, it was seen that gingival index was significantly higher in migrated group. Conclusion: Findings suggest that there exists a direct relationship between pathologic migration and clinical attachment loss as well as gingival inflammation. Clinical relevance: Results emphasize the importance of early treatment of periodontitis to curb inflammation, which seems to be more important since it is completely reversible, and attachment loss also in order to prevent unaesthetic complications. Moreover bleeding along with recent change in position of teeth should be considered as important sign of active, moderate to severe periodontal disease by general dentists and hygienists so that they can refer for specialist consultation.

Background: There are different techniques for the sinus augmentation; the factors that contribute to the survival rate of sinus augmentation and dental implant placement are still the subject of discussion. So we compare the two different ways of sinus floor elevation: a) Lateral antrostomy as a one or two step procedure as direct method. b) Osteotome technique with a crestal approach as indirect method. Materials and Methods: A total of twenty partially edentulous patients in maxillary posterior region who opted for implant retained prosthesis but had a low sinus and deficient alveolar ridge within the age group of 20-55 years were taken up, 25 implants were placed in combination with bone grafting material for sinus augmentation. The final bone height was measured from Orthopantomogram. Post-operative Clinical Evaluation was based on pain, gingival inflammation status, stability, swelling and bone height. Statistical analysis was done by using Statistical Package for Social Sciences (version 15.0) (SPSS Inc., Chicago, IL, USA). Results: The gain in bone height was significantly greater in direct procedure through lateral antrostomy (mean 8.5 mm) than in indirect method through crestal approach by osteotome technique (mean 4.4 mm). Conclusions: Osteotome technique can be recommended when more than 6 mm of residual bone height is present and an increase of 3-4 mm is expected. In case of more advanced resorption direct method through lateral antrostomy has to be performed. Both sinus elevation techniques did not seem to affect the implant success rate.

Recurrent pyogenic liver abscess since childhood is an uncommon finding in clinical medicine. Papillon-Lefèvre syndrome (PLS) is a rare disease characterized by skin lesions caused by palmar-plantar hyperkeratosis, and severe periodontal destruction involving both the primary and permanent dentitions. Till date, more than 200 cases have been reported worldwide. In addition to the skin and oral findings, patients may have immune suppression and an increased susceptibility to bacteria, associated with recurrent pyogenic infections of the skin. Pyogenic liver abscess is an uncommon presentation of this rare syndrome. We present a case of PLS presenting as recurrent pyogenic liver abscess since childhood.

The management of cardiovascular disorders poses a dilemma for the medical fraternity. Calcium channel blockers are one of the most commonly used drugs for the management of this disorder, and it is also a well known fact that they are one of the most common group of drugs responsible for causing gingival over growth as one of their adverse effects. Amlodipine is a new generation hypertensive, which has found wide acceptance and usage due to its duration of action. Even with all its benefits as a potent hypertensive, its effect on gingival tissues is what causes concern to the patient and dental surgeon equally. The objective of this article is to create awareness regarding the adverse oral effects of amlodipine, its underlying mechanism of action in bringing about this adverse reaction, along with providing a brief review of the pharmacologic profile of this drug.

Background: Diabetes mellitus is a common finding in the medical history of patients receiving treatment for periodontal disease. The incidence of diabetes is on the rise worldwide. Virtually, every dentist and especially the periodontist are likely to encounter an increasing number of undiagnosed diabetic patients. The conventional laboratory methods employed to detect blood glucose are time consuming and require elaborative equipment. The advent of blood glucose monitors allows the clinician to assess blood glucose at the chair side. Materials and Methods: The use of gingival capillary blood as a marker for blood glucose estimation using glucometer against the conventional laboratory method has been assessed in 60 diabetics and 70 controls. Results: The correlation between gingival and finger-stick blood was r = 0.996, P<0.001 in diabetics and controls. Correlation between gingival and laboratory method was r = 0.994, P<0.001 in cases and controls. Conclusion: The results suggest that capillary blood from the outer surface of gingiva provide an acceptable source for measuring blood glucose.

Objectives: The purpose of the present study was to clinically evaluate and compare the efficacy of an electrically active sonic toothbrush and an oscillating/rotating powered toothbrush in the reduction of plaque and gingivitis. Material and Methods: For this study, 40 healthy student volunteers (20 males, 20 females) were selected. The subjects were randomly assigned into two groups by a second examiner; one group used a current producing sonic toothbrush and the other group used a battery powered toothbrush. Plaque Index, Modified Gingival Index and Gingival Bleeding Index were assessed at baseline, 15 ^th day, 30 ^th day, 45 ^th day and 60 ^th day. Results: All the baseline indices appeared to be well balanced. At the end of the study, reduction in plaque index, modified gingival index and gingival bleeding index were statistically highly significant during each interval for both the toothbrushes. The difference in reduction of clinical parameters between the two toothbrushes was statistically non significant. Conclusion: Both the toothbrushes used in this study were clinically effective in removing plaque and improving gingival health.

Background: Melatonin, a secretory product of the vertebrate pineal gland, activates several elements of the immune system that reduce tissue destruction during the inflammatory response, either directly by scavenging free radical, reactive oxygen species and reactive nitrogen species or indirectly by modulating the action of agents such as cytokines and adhesion molecules, which contribute to the advance of cell damage. Aim: The aim of this study was to evaluate melatonin levels in saliva in periodontal health and disease. Materials and Methods: This study was conducted on a total of 20 patients with healthy periodontium and 20 patients each with mild, moderate and severe periodontitis who were patients in the Department of Periodontics, Rural Dental College and Hospital, Loni. The salivary levels of melatonin were assayed using ELISA, a competitive immunoassay using a capture antibody technique. Results: We observed that the periodontitis sufferers had a significantly lower melatonin level than the healthy subjects. Conclusion: Consequently, the reduction in the saliva production with higher age and the decreased melatonin production in older adults reflected in low salivary melatonin levels predispose these individuals to an increased risk of developing oral and periodontal disease.

Background: It has become apparent that every pathologic process in the body involves the immune system. Periodontal inflammation is not an exception. Periodontal health depends on the interaction of microbial flora and host response. Since long, research is focused on understanding the immunopathologic mechanism operating in the development and maintenance of periodontal inflammatory changes. Methods: Patients of age 20-35 were selected. Nonstimulated saliva was collected and assessed using radial immunodiffusion assay to estimate levels of IgA. Results: The present study suggests patients with gingival index 0.2-0.5 and periodontal index 0 have a concentration of IgA less than 21.4%. As values of gingival and periodontal index go on increasing, the concentration of salivary IgA also increases. Conclusion: the concentration of salivary IgA is directly and positively correlated to severity of inflammation. Also the concentration of IgA depends on the presence of plaque.