i-manager's Journal of the Indian Dental Association Tamil Nadu (JIDAT)


Volume 6 Issue 4 July - September 2016

Dental Pulp Stem Cells for Treating Unhealed Diabetic Foot Ulcer: A Pioneering Attempt

Sankaranarayanan * , P. Ramachandran **, V. R. Ravi ***, Divya A.****

Abstract

Chronic lower extremity ulcers are a physical and financial burden to the health and economic establishments worldwide. Foot complications account for about 25% of all diabetic admissions, with 50,000 lower-limb amputations performed annually. Lower extremity wounds are caused by venous disease, arterial insufficiency, diabetic neuropathy, or a combination of these factors. Other etiologies may include vasculitis, TAO/burns, and trauma. The last decade has witnessed a dramatic increase in the mechanistic understanding of angiogenesis and arteriogenesis, the two processes by which the body responds to the obstruction of large conduit arteries. This knowledge has been translated into novel therapeutic approaches to the treatment of peripheral arterial disease. In chronic wounds, senescent cells, due to inhibition of fibroblast proliferation, are unable to divide and hence become unresponsive to growth factors. Stanley and Osler showed that a human venous leg ulcer with more than 15% of senescent cells would be more difficult to heal.Given the poor prognosis associated with critical limb ischemia (CLI), numerous interventions have been attempted, primarily based on the stimulation of angiogenesis to allow the formation of collateral blood vessels. According to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASCII), treatment for CLI should focus on revascularization using surgical or percutaneous means. Unfortunately, less than half of the patients are eligible for these procedures, and efficacy is limited. Additionally, many patients require resurgical interventional procedures due to high levels of restenosis caused by the complex anatomy of the vascular occlusion and/or the presence of other risk factors. Nonsurgical options for CLI are limited to medical therapy, which offers limited or no benefit. Noninvasive stem cell therapy has been proposed as an alternative for such patients. Recent articles on this disease have proposed stem cell therapy along with endovascular procedures as well.

Digital Intra-Oral Radiography for the General Dentist

N. Arunakiry* **

Abstract

Digital radiography has been available in India since the early 1990s, but less than 15% of today's practices employ this potent diagnostic and educative tool. Today's dental practices are not just practices; they are, in fact, part of a promising dental industry whose resources are still widely untapped. Even small dental offices have to consider themselves part of this industry. Each of our practices has to acclimatize to this remarkable transformation. Digital radiography has a vital role in this era of evolving dentistry. The transition from an average analog dentist to a digital dentist requires an immense amount of social, psychological, and financial independence from the dentist. Apart from the multitude of social and psychological constraints, the primary hiccup for the film-based dentist is the financial aspect of digital radiography. But today's dentists have to evolve amidst all these nightmares to experience the sunshine of digital radiography.

Periodontitis Associated with Palatoradicular Groove – A Case Report

S. Agila* , S. P. K. Kennedy Babu**

Abstract

Palato-radicular groove is a discreet alteration in tooth morphology, characterized by an invagination that begins near the cingulum of the tooth and moves in an apical direction. Clinically, palatoradicular groove may be associated with periodontal and/or endodontic problems. This paper describes a clinical case of a young patient with palatoradicular groove in the maxillary right lateral incisor with signs of periodontitis but no endodontic impairment. An early diagnosis was made, and treatment consisted of surgical sealing of the defect. After a six-month period, re-examinations demonstrated adequate hygiene, maintenance of tooth vitality, and periodontal health. The early diagnosis and surgical sealing of the groove made the root surface smooth, avoiding subgingival bacterial plaque buildup, and preventing possible periodontal and/or pulp impairment stemming from the defect.

Comparison Between Chlorhexidine and Herbal Mouthwash in Reduction of Plaque and Gingivitis - A Clinical Study

Ruchi Pandey* , Madhumala Thiruneervannan**, R. Saranyan***, P. Sreekanth****

Abstract

The aim of the study is to ascertain the reduction in plaque and gingivitis by using two mouthwash formulations, herbal and Chlorhexidine (CHX) 0.12%, and also to evaluate the efficacy of herbal mouthwash over CHX. This study was conducted after approval from the ethical committee, and written consent was obtained from the subjects. A total of 20 subjects aged between 18-35 years having mild to moderate gingivitis were randomly allotted to two groups, 10 each. The examiner was blinded towards groups (single-blinded). Plaque and gingival index were recorded at baseline and at the end of 21 days. Statistical analysis was performed using the percentage distribution test for comparing the post-effects of two mouthwashes, and the paired t-test was used for evaluating intra-group changes from baseline. The independent t-test was used to see inter-group changes. Results revealed that there was a significant reduction of plaque and gingival score in both groups, but on comparing the two groups, there was no significant difference. It was concluded that there was no significant difference between the herbal and the Chlorhexidine mouthwash; both are equally efficient in reducing plaque and gingival scores.

Local Drug Delivery System for Treatment of Periodontitis - A Review

S. Srinivasan * , M. Thirumavalavan**, S. Mangaleshwari ***

Abstract

Periodontitis results from the extension of the inflammatory process initiated in the gingiva to the supporting periodontal tissues. Antibacterial agents have been used effectively in the management of periodontal infection. The periodic use of local delivery systems in reducing probing depths and stabilizing attachment ensures increased local drug concentration at the periodontal site to maintain an effective concentration over an extended period of time. This review approaches the main delivery systems for the administration of drugs to the periodontal pocket, their usefulness, as well as the advancement of these systems' effectiveness in periodontal therapy.