A novel amnion-chorion allograft membrane combined with a coronally advanced flap: a minimally invasive surgical therapy to regenerate interdental papillary soft tissue recession – a six-month postoperative image analysis-based clinical trial

Unnati Pitale,Pritish Chandra Pal,Ramanarayana Boyapati,Ashish Bali,Manish Varma,Shaleen Khetarpal 대한구강악안면외과학회 2021 대한구강악안면외과학회지 Vol.47 No.6

Objectives: Loss of the interdental papilla is multi-factorial and creates a multitude of problems. Autogenous connective tissue/biomaterial-based regen-eration has been attempted for decades to reconstitute the black space created due to the loss of papilla. The aim of this present study was to regenerate papillary recession defects using an amnion-chorion membrane (ACM) allograft and to evaluate the clinical outcome up to six months postoperatively. Materials and Methods: Twenty patients with 25 Nordland and Tarnow’s Class I/II interdental papillary recession defects were treated with ACM and coronal advancement of the gingivo-papillary unit via a semilunar incision on the labial aspect followed by a sulcular incision in the area of inter-est. A photographic image analysis was carried out using the GNU Image Manipulation software program from the baseline to three and six months postoperatively. The black triangle height (BTH) and the black triangle width (BTW) were calculated using the pixel size and were then converted into millimeters. The mean and standard deviation values were determined at baseline and then again at three and six months postoperatively. The prob-ability values (P˂0.05 and P≤0.01) were considered statistically significant and highly significant, respectively. An analysis of variance and post hoc Bonferroni test were carried out to compare the mean values. Results: Our evaluation of the BTH and BTW showed a statistically and highly significant difference from the baseline until both three and six months postoperatively (P=0.01). A post hoc Bonferroni test disclosed a statistically significant variance from the baseline until three and six months postoperatively (P˂0.05) and a non-significant difference from three to six months after the procedure (P≥0.05). Conclusion: An ACM allograft in conjunction with a coronally advanced flap could be a suitable minimally invasive alternative for papillary regeneration.

Diplopia following posterior superior alveolar nerve block: a case report and review of literature

Aditya Mohan Alwala,Padminii Ellapakurthi,Sushma Mudhireddy,Ramanarayana Boyapati 대한치과마취과학회 2022 Journal of Dental Anesthesia and Pain Medicine Vol.22 No.1

Posterior superior alveolar nerve block (PSANB) is one of the most common and safe injection techniques in the field of dentistry. As with any other procedure, it also has inherent complications, of which ophthalmic complications are relatively rare. Transient diplopia following the administration of PSANB is rare and daunting for both the patient and the clinician. We present a case of transient diplopia in a 26-year-old female patient following administration of PSANB and review its probable pathophysiology and management and prevention.

Effect of nonsurgical periodontal therapy and smoking status on hematological variables related to anemia of chronic disease in chronic periodontitis patient: a case-control study

Sangita Show,Somen Bagchi,Arka Kanti Dey,Ramanarayana Boyapati,Pritish Chandra Pal,Kanikanti Siva Tejaswi 영남대학교 의과대학 2022 Yeungnam University Journal of Medicine Vol.39 No.3

Background: Chronic infectious, inflammatory, or neoplastic disorders are associated with anemia of chronic disease. Chronic inflammatory diseases such as periodontitis may contribute to masked anemia, especially in smokers. This study was aimed at verifying and comparing the efficacy of nonsurgical periodontal therapy (NSPT) for improving anemia among chronic periodontitis patients with and without the habit of smoking. Methods: Thirty systemically healthy individuals with chronic periodontitis were divided into two groups of 15 each, smokers (group A) and nonsmokers (group B). The groups were compared based on hematological parameters such as serum erythropoietin (SE) and serum ferritin (SF) levels at baseline and 3 months after NSPT for anemia evaluation. Results: The baseline SE levels in groups A and B were 11.84 and 15.19 mIU/mL (p=0.031), respectively; the corresponding levels at 3 months after NSPT were 13.00 and 17.74 mIU/mL (p=0.022). The baseline SF levels in groups A and B were 95.49 and 44.86 ng/mL (p=0.018), respectively; the corresponding levels at 3 months after NSPT were 77.06 and 39.05 ng/mL (p=0.009). Group B showed a significant increase and decrease in the SE and SF levels, respectively, at 3 months after NSPT (p=0.035 and p=0.039, respectively), whereas group A showed insignificant changes (p=0.253 and p=0.618, respectively). Conclusion: NSPT led to an improvement in anemia among chronic periodontitis patients. However, the improvement is less in smokers compared to that in nonsmokers. Furthermore, SF and SE levels might serve as effective biomarkers for assessing anemia in smokers and nonsmokers with chronic periodontitis.

Regenerative potential of biphasic calcium phosphate and enamel matrix derivatives in the treatment of isolated interproximal intrabony defects: a randomized controlled trial

( Pritish Chandra Pal ),( Ashish Bali ),( Ramanarayana Boyapati ),( Sangita Show ),( Kanikanti Siva Tejaswi ),( Sourabh Khandelwal ) 영남대학교 의과대학 2022 Yeungnam University Journal of Medicine Vol.39 No.4

Background: The combined use of biomaterials for regeneration may have great biological relevance. This study aimed to compare the regenerative potential of biphasic calcium phosphate (BCP) alone and with growth factor enamel matrix derivatives (EMDs) for the regeneration of intrabony defects at 1 year. Methods: This randomized controlled trial included 40 sites in 29 patients with stage II/III periodontitis and 2/3 wall intrabony defects that were treated with BCP alone (control group) or a combination of BCP and EMD (test group). BCP alloplastic bone grafts provide better bio-absorbability and accelerate bone formation. EMDs are commercially available amelogenins. Mean values and standard deviations were calculated for the following parameters: plaque index (PI), papillary bleeding index (PBI), vertical probing pocket depth (V-PPD), vertical clinical attachment level (V-CAL), and radiographic defect depth (RDD). Student paired and unpaired t-tests were used to compare the data from baseline to 12 months for each group and between the groups, respectively. The results were considered statistically significant at p< 0.05. Results: At 12 months, the PI and PBI scores of the control and test groups were not significantly different (p >0.05). The mean V-PPD difference, V-CAL gain, and RDD difference were statistically significant in both groups at 12 months (p<0.001 for all parameters). Intergroup comparisons showed that the mean V-PPD reduction (2.13±1.35 mm), V-CAL gain (2.53±1.2 mm), and RDD fill (1.33±1.0 mm) were statistically significant between the groups at 12 months (p<0.001 for all parameters). Conclusion: BCP and EMDs combination is a promising modality for the regeneration of intrabony defects.

Evaluation of periodontal status in women with polycystic ovary syndrome versus healthy women: a cross-sectional study

Sandhya Pavankumar,Pavan Kumar Yellarthi,Sandeep JN,Ramanarayana Boyapati,Trinath Kishore Damera,Naveen Vital Kumar G 영남대학교 의과대학 2023 Yeungnam University Journal of Medicine Vol.40 No.-

Background: Polycystic ovary syndrome (PCOS) affects approximately 4% to 12% of females of reproductive age. Previous studies have shown an association between systemic and periodontal diseases. This study aimed to compare the prevalence of periodontal disease in women with PCOS and healthy women. Methods: A total of 196 women aged 17 to 45 years were included in this study. Oral hygiene index-simplified (OHI-S), gingival index (GI), community periodontal index (CPI), and loss of attachment (LA) were assessed. Individuals who smoked, were pregnant, had any systemic disease (such as type 1 or type 2 diabetes mellitus, cardiovascular disease, malignancy, osteoporosis, and thyroid dysfunction), had a history of systemic antibiotic use in the past three months, or received any periodontal intervention in the past 6 months of screening were excluded. Student t-test was used to analyze the data. A p-value of <0.05 was considered statistically significant. Results: Despite similar OHI-S scores (p=0.972) in the two groups, women with PCOS had significantly higher GI, CPI, and LA scores than healthy women (p<0.001). Conclusion: Periodontal disease was more prevalent in women with PCOS than in healthy women. This finding may be due to the synergistic effects of PCOS and periodontitis on proinflammatory cytokines. PCOS may have an effect on periodontal disease, and vice versa. Hence, education on periodontal health and early detection and intervention for periodontal diseases is of paramount importance in patients with PCOS.