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Background and Objective: The enamel matrix derivative (EMD) has been used in combination with barrier membranes to optimize regeneration in vertical osseous defects. However, the osteoblast response when exposed to the EMD/barrier membrane combination has not yet been evaluated. The osteoblast behavior when exposed to a combination of regenerative materials must be evaluated to fully understand their effect on bone regeneration. Therefore, the present study was undertaken to estimate the initial adhesion and alkaline phosphatase (ALP) activity of an osteoblast cell line (SaOS-2) when exposed to four commercially available resorbable membranes and determine if the addition of EMD had any modulatory effect on osteoblast behavior. Materials and Methods: 5 x 104 SaOS-2 cells between passages 7-10 were cultured in two 24-well culture plates. Plate A was used for the adhesion assay and Plate B was used for the ALP assay. A MTT (3-[4, 5-dimethylthiazolyl-2]-2, 5-diphenyltetrazolium bromide) assay was done after 24 hours to determine the adhesion of the osteoblastic cells to four barrier membranes: 1) a non cross-linked porcine Type I and III collagen membrane (BG), 2) a weakly cross-linked Type I collagen membrane (HG), 3) a glutaraldehyde cross-linked bovine Type I collagen (BM), and 4) a resorbable polymer membrane (CP). Osteoblast differentiation was studied using an ALP assay with p-nitro phenyl phosphate as the substrate at 24 hours, 72 hours, and 1 week. A total of 50 µg/ml of EMD dissolved in 10 mM acetic acid was added into each well and the entire experimental protocol outlined above was repeated. Results: The osteoblast adhesion to collagen barriers showed a statistically insignificant reduction following the addition of EMD. Adhesion to the polymer barrier, although significantly lower when compared with collagen barriers, was unaffected by the addition of EMD. ALP activity after 1 week among the various groups was as follows: EMD alone (75.59±2.5)>EMD/BG(64.78±3.04)>EMD/HG(55.40±3.89)≈EMD/BM(54.75±4.17)>BG (51.32±2.76)>HG(49.92±2.4)>BM(48.14±1.4)>Control(46.29±1.39)>EMD/CP (37.46±3.54)>CP(32.12±1.49) Conclusion: There was no additive effect on osteoblast adhesion/ALP activity following exposure to an EMD/polymer combination. EMD/collagen positively influences osteoblast differentiation in a time dependent manner.

This case report signifies the importance of complications and early diagnosis of radicular groove and to discuss the treatment of combined endo-perio lesion using bone graft mixed with Platelet Rich Fibrin (PRF), amniotic membrane and biodentine. Labiocervical Vertical Groove (LCVG) presents various complications to the patients, especially if it extends to the pulpal space. Labiocervical vertical groove originating near the cervical area of tooth can extend to the radicular surface. These grooves can be mild, moderate or deep based on its extent and depth. This case report deals with the complications, degree of destruction and treatment of an intrabony defect associated with LCVG in maxillary central incisor in a 35-year-old male patient, who reported to the Department of Periodontics and Implantology with the chief complaint of mobility of teeth over a period of past two months. In this case report, authors have highlighted the advantages of saucerisation, PRF, amniotic membrane and biodentine to treat the bone loss along with restoration of the groove.

Purpose: The purpose of the study was to compare delayed and early loaded single-tooth implant technique. Materials and Methods: A randomized, prospective clinical trial was conducted to evaluate the clinical and radiological parameters of delayed and early loading of single-tooth implant placement. Fourteen male or female patients were selected randomly, who had single tooth missing in mandibular posterior region. A delayed implant placement technique was followed in these regions. A Hi-Tech implant (Life Care Implants) was performed. The patients were divided into two groups: delayed loading group and early loading group. In delayed loading groups, implants were loaded after 3 months, and in early loading groups, implants were loaded within 7 days to 2 months. Soft tissue and radiological bone loss were assessed at baseline, 3 months, and 6 months. The parameters assessed were plaque index, gingival index, probing pocket depth, thickness of peri-implant mucosa, and bone loss (radiographically). Results: The results show that there was no statistical difference in indexes taken between delayed loading and early loading groups. Conclusion: In this study, after first 6 months there was no difference in success rate between delayed loading or early loading of implants. This study also showed that more bone loss occurred around delayed loading implants. So it can be concluded that early loading technique can be successfully practiced instead of delayed loading of implants.

Purpose: The aim of this study was to estimate the Receptor activator of nuclear factor kappa-B ligand (RANKL) and Osteoprotegrin (OPG) levels in gingival crevicular fluid (GCF) after placement of collagen membrane with simvastatin in intrabony defects. Materials and Methods: Sixty subjects were grouped according to the treatment plan as Group I and Group II. Group I included patients with intrabony defects treated with collagen membrane. Group II included patients with intrabony defects treated with simvastatin of 1.5mg concentration incorporated into the collagen membrane. A split-mouth design was planned, in which two contralateral sites with >5mm probing pocket depth and radiographic evidence of bone loss at baseline were chosen. Probing pocket depth was standardized with acrylic stent in all the selected areas. GCF samples were collected at baseline and 21 days. The amount of RANKL and OPG in the samples was determined by commercial ELISA kits (Biomedica Medizinprodukte, Austria). Results: When comparing both the groups, Group II had more statistically significant (P < 0.001FNx08) decrease in the levels of RANKL than Group I. In contrast to RANKL, the OPG levels were significantly increased in patients (Group II) having intrabony defects treated with collagen membrane along with simvastatin. Conclusion: Simvastatin-loaded collagen membrane expressed increased OPG and decreased RANKL levels, which could have a potential role in periodontal regeneration.

Aim: Curcumin has proven properties such as anti-inflammatory, antioxidant, antimicrobial, and it also accelerates wound healing. The purpose of this study was to investigate the level of superoxide dismutase (SOD) enzyme, in gingival crevicular fluid (GCF), and the impact of nonsurgical treatment on the antioxidant profile using 0.2% curcumin strip as local drug delivery. Materials and Methods: A total of twenty subjects of age 35–55 years and 15 subjects with chronic periodontitis, each with bilateral 5–6 mm probing pocket depth, were selected for this study. Healthy group consists of 5 sites in which no bleeding on probing, no pocket depth. Group I – It consists of 15 sites with chronic periodontitis, in which scaling and root planing (SRP) was done (control group). Group II – It consists of 15 sites, in which SRP followed by the placement of curcumin strip inside the pocket (SRP + curcumin strip) (test group). GCF collection was done preoperatively and postoperatively after 21 days. The SOD activity was assessed using enzyme-linked immunosorbent assay. Results: In this study, all the clinical parameters were significantly reduced in test and control sites. Further, SOD levels were significantly improved in test sites when compared with control sites. Conclusion: Thus, the present study concluded that curcumin strip can be effectively used as an adjunct to SRP in treatment of chronic periodontitis and serves as antioxidant in subgingival environment.

Background: Periodontitis is inflammation of the periodontium and causes destruction of the connective tissue attachment of the teeth and alveolar bone. Porphyromonas gingivalis is the primary pathogen for the destructive periodontal diseases. The aim of the study is to evaluate the efficacy of probiotic on P. gingivalis . Materials and Methods: An in vitro study was done to analyze the effectiveness of probiotic BIFILAC on P. gingivalis was determined using disc diffusion method. The minimum inhibitory concentration for BIFILAC lozenges was also determined using microdilution method. Results: In disc diffusion method, the antibacterial activity of BIFILAC was analyzed using various concentrations such as 2.5, 5, 10, and 20 μg/ml, of which 20 μg/ml was proved to have a maximum inhibitory zone of 22 mm. In microdilution method, concentration ranging from 7.25 to 100 μg/ml was used and 25 μg/ml was found to have the minimum inhibitory effect on P. gingivalis . Conclusion: The present in vitro study confirms that probiotic BIFILAC has an antimicrobial effect against P. gingivalis . Thus, proving that BIFILAC probiotic can be used as an adjunctive therapeutic modality in periodontitis.

Aim: The aim of this study was to determine whether the addition of an autologous platelet rich fibrin (PRF) membrane to a coronally advanced flap (CAF) would improve the clinical outcome in terms of root coverage, in the treatment of isolated gingival recession., Materials and Methods: Systemically healthy 20 subjects each with single Miller's class I or II buccal recession defect were randomly assigned to control (CAF) or test (CAF + PRF) group. Clinical outcome was determined by measuring the following clinical parameters such as recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), width of keratinized tissue (WKT), gingival thickness (GTH), plaque index (PI), and gingival index (GI) at baseline, 3(rd), and 6(th) month postsurgery., Results: The root coverage was 65.00 ± 44.47% in the control group and 74.16 ± 28.98% in the test group at 6(th) month, with no statistically significant difference between them. Similarly, CAL, PD, and WKT between the groups were not statistically significant. Conversely, there was statistically significant increase in GTH in the test group., Conclusion: CAF is a predictable treatment for isolated Miller's class I and II recession defects. The addition of PRF to CAF provided no added advantage in terms of root coverage except for an increase in GTH.