Ramesh Babu Mutthineni

In daily practice we can come across many growths in oral cavity, mostly reactive rather than neoplastic, which are difficult to differentiate from one another posing a challenge to dentist. Peripheral ossifying fibroma (POF) is a single benign fibro osseous origin growth of gingiva which occurs due to long standing irritation by plaque, calculus, trauma, restorations, and orthodontic appliances, however the precise etiopathogenesis of POF is unclear. The standard treatment protocol involves surgical excision followed by the biopsy of the lesion. Proper follow up of the lesion is necessary due to its high recurrence. The present case report managed with diode laser excision did not showed any signs of recurrence during the follow up period of 2 years. Minimum bleeding, less postoperative pain, ease of operation and absence of recurrence makes diode laser assisted excision is the better treatment option over conventional scalpel surgery. Keywords: Diode laser, Peripheral Ossifying Fibroma, Cone Beam Computed Tomography

Background: Vitamin C, being a strong reducing agent, can regulate the resolution of the inflammatory process and stimulate the tissue repair. It enhances the synthesis of collagen type I, reduced by inflammatory process, keeps the balance between collagen I and collagen III, and modifies the rate of fibroblast proliferation. Mesotherapy is a minimally invasive procedure which involves local intradermal therapy with biologically active substances given in minor quantities to the area of pathology. However, the studies on local injection of Vitamin C showed inconclusive results. Aim: The aim of the present study is to evaluate the efficiency of the locally injected vitamin C in the treatment of persistent gingival inflammation. Materials and Methods: After one week of SRP, ten patients with persistent gingival inflammation were included in the study. In the test group, five patients were treated with single application of locally delivered vitamin C into the gingival tissues and the other five patients in the control group were given saline as the placebo. Plaque index and sulcus bleeding index were evaluated at baseline and at 1 week post-operatively. Results: Group A (Test group) showed a mean difference of 1.75 (pre and post op) in plaque scores which are statistically significant compared to that of group B (control group) that showed a mean difference of 0.15 in plaque scores which is not statistically significant. Sulcus bleeding index scores where statistically significantly (pre and post op) only in test group. There is no difference in plaque index and sulcus bleeding index between the test and control group at baseline, but a significant difference was observed between the two groups at 1 week follow up in plaque and sulcus bleeding index, favouring the test group. Conclusion: Vitamin C that is injected using mesotherapy approach has a synergistic interaction with SRP for treating persisting inflammation of the gingiva than compared to that of placebo at 1 week follow up period. Keywords: Phagocytosis, Chlorhexidine, Pharmacological

Introduction: Periodontal disease is an immune-inflammatory disease affecting the soft tissues and alveolar bone and surrounding periodontal tissues. The standard treatment involves scaling and root planing (SRP) which removes the sub gingival microbial deposits effectively and the gingival health is maintained. Sometimes the treated areas may show regrowth of the microorganisms and the non-surgical periodontal treatment alone cannot eliminate the micro-organisms in mild periodontitis cases due to the difficulty in reaching the subgingival areas which are deeper and in complex root morphologies. So now a days the non-surgical periodontal treatment combined with the use of systemic antimicrobial agents and host modulating agents has shown to use effectively in the treatment of periodontal diseases. Materials and Methods: All the patients who were diagnosed with chronic periodontitis underwent initial therapy i.e., full-mouth scaling and root planing. Then the oral hygiene instructions were given to the patients and were recalled after 1 week (baseline visit). A total of 20 patients who met the inclusion criteria and showed satisfactory condition after the initial therapy with persistent periodontal pockets were included in this study. They were randomly assigned into two groups i.e., Group-A: metronidazole gel (metrogyl) and Group B: tetracycline fibre groups with 10 patients in each group. The periodontal clinical parameters like plaque index (PI), gingival index (GI) and periodontal pocket depth (PPD) were evaluated at the baseline visit before the application of local drug delivery and 15 and 30 days after the local drug delivery application. Results: The mean plaque scores were reduced from 1.41±0.04 at baseline to 1.04±0.14 at 30 days. Likewise in Group-B the mean PI scores reduced from 1.50±0.10 at baseline to 1.25±0.18 at 30 days. The mean gingival index scores reduced from 1.41±0.04 at baseline to 1.01±0.04 at 30 days. Likewise in Group-B mean GI Scores reduced from 1.36±0.03 at baseline to 0.99±0.06 at 30 days. The mean PPD scores were reduced from 5.65±0.12 at baseline to 3.15±0.10 at 30 days in Group-A. Likewise in Group-B mean PPD scores reduced from 5.68±0.06 at baseline to 3.26±0.10 at 30 days. Conclusion: This study demonstrated that although thorough SRP is an effective treatment method for elimination of chronic periodontal pockets, improved results can be obtained by adjunctive use of locally administered metronidazole gel and tetracycline fibers.   Keywords: Local drug delivery, SRP, Metronidazole gel, Tetracycline fibres