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Soft-tissue defect and alveolar bundle bone resorption (horizontally and vertically) are inevitable events following tooth extraction predominately on the buccal aspect which will impact the implant surgical planning starting from implant size selection, position, emergence profile, etc. To overcome the same, complex soft and hard tissue regeneration procedures have been recommended in the literature but they are highly expensive and technique sensitive too. To prevent buccal bone resorption and gain good emergence profile socket-shield technique (SST) is widely recommended. Additionally, in order to improve implant biomechanical primary stability, bone mineral density, and bone to implant contact novel osseodensification approach is recommended for osteotomy preparation and sinus membrane lift whereas platelet rich fibrin (PRF) autograft is a suitable alternative for the protection of Schneiderian membrane during immediate implant placement in sinus sub cavity. The present case report describes the successful single-stage management of symptomatic endodontically maltreated posterior root stumps site utilizing SST in conjunction with Densah Bur and PRF autograft-assisted minimally invasive osteotomy preparation and sinus lift with immediate implant placement. [ABSTRACT FROM AUTHOR]

The use of magnification to perform various procedures in medical and dental field, particularly endodontics has long been recognized. Unfortunately, its application in periodontics is not widely popularized. The objective of this article is to emphasize the application of microsurgical principles in various periodontal surgical procedures and to reinforce the incorporation of microscope into periodontal practice. The most recent periodontal journals were reviewed and a search of databases such as PubMed or Medline and Google Scholar was conducted for relevant material from published literature up to 2017. Medical Subject Headings words looked for were "periodontal microsurgery" and "minimally invasive periodontal surgery." The available literature, specifically to periodontal surgical procedures was analyzed and compiled. The analysis indicates that incorporation of magnification in periodontal practice is associated with improved visual acuity, ergonomic benefits, decreased patient morbidity, rapid healing, and enhanced patient acceptance. [ABSTRACT FROM AUTHOR]

The lateral periodontal cyst (LPC) is a nonkeratinized, noninflammatory developmental cyst occurring adjacent or lateral to tooth root. It is a relatively uncommon lesion found in the maxillary incisors and found mostly in adults during 5th to 7th decades. In this case, 45-year-old male patient reported with occasional mild discomfort between left maxillary central and lateral incisor region since 1 year. Interproximally, a well-defined round radiolucent area with corticated borders was determined radiographically between vital tooth #21 and #22. Preliminary diagnosis of LPC was established based on clinical and radiographical findings. Following enucleation of the lesion, an anticipated residual tunnel osseous defect was observed, which was managed successfully utilizing bone graft and guided tissue regeneration-assisted technique. Cystic tissue removed was examined histologically; hematoxylin- and eosin-stained sections showed features suggestive of LPC. Complete healing of tunnel defect was achieved at 1 year follow-up. [ABSTRACT FROM AUTHOR]

Advancements in the field of implantology such as three-dimensional imaging, implant-planning software, computer-aided-design/computer-aided-manufacturing (CAD/CAM) technology, computer-guided, and navigated implant surgery have led to the computerization of implant-dentistry. This three-dimensional computer-generated implant-planning and surgery has not only enabled accurate preoperative evaluation of the anatomic limitations but has also facilitated preoperative planning of implant positions along with virtual implant placement and subsequently transferring the virtual treatment plans onto the surgical phase via static (guided) or dynamic (navigated) systems aided by CAD/CAM technology. Computerized-implant-dentistry being highly predictable and minimally invasive in nature has also allowed implant placement in patients with medical comorbidities (e.g. radiation therapy, blood dyscrasias), in patients with complex problems following a significant alteration of the bony anatomy as a result of benign or malignant pathology of the jaws or trauma and in patients with other physical and emotional problems. With significant achievements accomplished in the field of computerized implant-dentistry, attempts are now been made toward complete automation of implant-dentistry. [ABSTRACT FROM AUTHOR]

The role of periodontium in supporting the tooth structures is well-known. However, less is known about its contribution to the field of ophthalmology. Corneal diseases are among major causes of blindness affecting millions of people worldwide, for which synthetic keratoprosthesis was considered the last resort to restore vision. Yet, these synthetic keratoprosthesis suffered from serious limitations, especially the foreign body reactions invoked by them resulting in extrusion of the whole prosthesis from the eye. To overcome these shortcomings, an autologous osteo-odonto keratoprosthesis utilizing intraoral entities was introduced that could positively restore vision even in cases of severely damaged eyes. The successful functioning of this prosthesis, however, predominantly depended on the presence of a healthy periodontium for grafting. Therefore, the following short communication aims to acknowledge this lesser-known role of the periodontium and other oral structures in bestowing vision to the blind patients. [ABSTRACT FROM AUTHOR]

Soft-tissue defect and alveolar bundle bone resorption (horizontally and vertically) are inevitable events following tooth extraction predominately on the buccal aspect which will impact the implant surgical planning starting from implant size selection, position, emergence profile, etc. To overcome the same, complex soft and hard tissue regeneration procedures have been recommended in the literature but they are highly expensive and technique sensitive too. To prevent buccal bone resorption and gain good emergence profile socket-shield technique (SST) is widely recommended. Additionally, in order to improve implant biomechanical primary stability, bone mineral density, and bone to implant contact novel osseodensification approach is recommended for osteotomy preparation and sinus membrane lift whereas platelet rich fibrin (PRF) autograft is a suitable alternative for the protection of Schneiderian membrane during immediate implant placement in sinus sub cavity. The present case report describes the successful single-stage management of symptomatic endodontically maltreated posterior root stumps site utilizing SST in conjunction with Densah Bur and PRF autograft-assisted minimally invasive osteotomy preparation and sinus lift with immediate implant placement., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Society of Periodontology.)

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Society of Periodontology.)

Inflammatory fibrous hyperplasia, pyogenic granuloma, peripheral ossifying fibroma, irritational fibroma (IF), peripheral giant cell granuloma, etc., are the different types of reactive gingival lesions that may occur in response to mild chronic irritation associated with subgingival factors, root remnant, iatrogenic factors, and trauma. Gingival IF is one of the most common reactive lesions and is usually sessile in nature, and its size is usually not more than 1.5 cm. Complete surgical excision along with the elimination of precipitating/aggravating factors is the treatment of choice generally adopted by a general dentist without giving due consideration to its size, location, and postoperative sequel. The present rare case describes the simple, easy to perform, and effective periodontal plastic treatment for the management of expected residual soft tissue defect, following surgical excision of large recurrent IF in the posterior maxillary teeth at 9 months postoperatively, in addition to its conceivable etiology and diagnosis., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Society of Periodontology.)

A radicular cyst (RC) is one of the types of inflammatory cyst of odontogenic origin. It is usually associated with nonvital teeth and is mostly observed in males. It is routinely treated by nonsurgical endodontic therapy; however, if the cystic lesion does not respond to endodontic therapy, then surgical intervention with or without regeneration is the treatment of choice, depending upon the size, location of lesion, the bone integrity of the cystic lesion wall, proximity to vital structures and residual bone defect elicit after enucleation, etc., We hereby present successful interdisciplinary management of rare true lateral RC in the interproximal site with respect to teeth number 21 and 22 as well as associated mucosal fenestration that was occurred postoperatively other than its apparent etiology and diagnosis., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Society of Periodontology.)

Background: PepGen P-15, a xenograft, has proven its periodontal regenerative potential. Platelet-rich fibrin (PRF) is an autologous platelet concentrate which too contributes to periodontal redevelopment through the release of different polypeptide progression factors. The present study intended to evaluate the regenerative potential of PepGen P-15 xenograft when used unaccompanied or in blend with PRF in periodontal intraosseous defects in humans through clinical and a novel computed tomography (CT) scan analysis technique., Materials and Methods: Twelve chronic periodontitis individuals with paired periodontal intraosseous defects were randomly treated either with PepGen P-15 exclusively (Control/Group A) or in concoction with PRF (Test/Group B) utilizing split-mouth study design. Pocket probing depth (PPD), relative attachment level (RAL), and relative position of gingival margin were assessed at 3- and 6-month interval, whereas the linear and volumetric bone defect regeneration were assessed at 6 months postoperatively using CT scan., Results: Both the groups validated statistically significant PPD reduction, RAL gain at 3 and 6 months, but on intergroup comparison, test group CT images revealed significantly greater linear bone gain and volumetric bone gain, with mean difference of 0.73 ± 0.28 ( P = 0.018) and 2.70 ± 1.36 ( P = 0.06) at 6 months in comparison to the baseline data., Conclusions: PepGen P-15 and PRF blend had better regeneration potential for the management of intrabony defects. Further long-term investigations on large sample size are recommended to authenticate the same., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Indian Society of Periodontology.)

Background: Hyper-melanin pigmentation of the gingiva (GMP) is one of the imperative contributory factors for smile-sensitive individuals. Numerous gingival depigmentation (GD) procedures have been attempted in the literature to evaluate the clinical outcome mostly. Hence, a randomized clinical-histopathological triple-blinded trial was planned to evaluate the pain experienced by the patient, gingival wound healing, and density of melanocytes following liquid nitrogen-assisted GD (LNAGD) and electrocautery-assisted GD (ECAGD) procedures., Materials and Methods: Thirty-two arches with bilateral physiologic labial/buccal GMP extending from distal aspect tooth #14-24 and #34-44 in 16 healthy individuals were selected and were equally treated with LNAGD and ECAGD techniques. Dummett oral pigmentation index and Hedin melanin index were evaluated at baseline and 3 months' postoperatively (PO). The visual analog scale was utilized for the intensity of pain assessment at baseline (immediately after treatment) and 1 st day and 7 th day PO. Histological wound healing and density of melanocytes were evaluated using Gal et al .'s wound-healing assessment index and Patsakas et al .'s criterion, at baseline (0), 8, 24, 72, and 96 h; 1 st , 2 nd , 3 rd , and 4 th week; and 3 months and at 0 and 3 months' PO, respectively. Statistical analysis was done using one-way ANOVA, post hoc Tukey, unpaired, and paired "t" test., Results: Both groups showed a statistically significant influence on the parameters evaluated., Conclusion: The LNAGD had a substantial superior result in terms of early wound healing, reduction in density of melanocytes, reduction in pain experienced by the patient, with reduction and delay in the recurrence of GMP., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Indian Society of Periodontology.)

Periodontal plastic surgery often involves palatal donor site, thereby creating an open wound that is prone to postoperative complications such as bleeding, pain, and slow healing process. To prevent the same, platelet-rich fibrin (PRF) and gelatin sponge (GS) were utilized equally at the donor site in six patients. Patients were monitored at the 1 st , 2 nd , 3 rd , and 4 th weeks after surgery for postoperative discomfort (D), consumption of analgesics during first postoperative week, alteration of sensitivity (AS), change in feeding habits (CFH), complete wound epithelialization (CWE), and healing index (Landry et al. 1998). Two patients in the GS group showed significantly early CWE, higher healing index score, and less D, AS, and CFH postoperatively in comparison to the PRF group. It was suggested that GS can also be considered as an effective, economical, and biocompatible dressing material of choice to enhance wound healing and to minimize postoperative complications associated with the donor site., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Indian Society of Periodontology.)

Exophytic gingival lesions are more frequently encountered intraorally, out of which few are reactive in nature. Pyogenic granuloma (PG) is one of the commonly occurring reactive benign mucocutaneous lesions; exact etiopathogenesis remains unclear. Although surgical excision is the treatment of choice, sometimes it may induce residual soft defect formation which further creates an esthetic problem, root sensitivity, etc., The present case report not only describes the diagnosis and treatment of PG but also the immediate successful management of residual gingival defect in the esthetic area (which was originated as a sequel of the excisional biopsy of recurrent PG) by utilizing platelet-rich fibrin in conjunction with coronally advanced flap in single-stage surgery. Clinical healing was uneventful and satisfactory at 2 weeks, and excellent coverage of residual mucogingival defect with gingival esthetic and normal sulcus depth was observed at 3 and 6 months postoperatively without any sign of a complication., Competing Interests: There are no conflicts of interest.