Journal of Nepalese Society of Periodontology and Oral Implantology

Geriatric Periodontology: Need of the Hour!

Manoj Humagain — 2022-12-31

Not available.

Effect of Scaling and Root Planing with and without Diode Laser Application on Glycated Haemoglobin Levels in Type II Diabetic Patients with Chronic Periodontitis

Anjali Bhattarai — 2022-12-31

Introduction: Periodontitis and diabetes have a combined systemic and local effect on tooth supporting structure and has been reported for decades. The gold standard treatment protocol would be scaling and root planing (SRP), which when combined with laser therapy has an additional benefit in the reduction of clinical parameters and glycated haemoglobin (HbA1c) levels.

Objective: To evaluate the effectiveness of scaling and root planing with and without Diode laser application on glycated haemoglobin levels in type II diabetic patients with Chronic Periodontitis.

Methods: Twenty eight type II diabetic patients with Chronic Periodontitis recruited by convenient sampling were divided into two groups in this pretest post-test study design. Group A received scaling and root planing (SRP) and Group B received SRP with diode laser (980 nm) application. The HbA1c levels were evaluated at three and six months; and clinical parameters were evaluated at one, three, and six months post-treatment. Data were analysed in SPSS v.20.

Results: Mean values of HbA1c, probing depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI) reduced significantly after treatment in both treatment groups with more reduction in laser group. However, on intergroup comparison HbA1c and CAL reduction were not significant.

Conclusions: The findings of the current study showed significant improvements in HbA1c and clinical parameters as compared with baseline in patients treated with SRP and SRP + Diode Laser. Thus, use of diode laser showed no significant improvement statistically when used as an adjunct to scaling and root planing.

Locally Delivered Chlorhexidine Chip and Diode Laser in the Treatment of Periodontitis

Alina Bajracharya — 2022-12-31

Introduction: Scaling and root planing (SRP) reduces periodontal inflammation but complete removal of bacterial deposits and toxins is not always feasible. Thus, adjunctive therapeutic strategies like use of local delivery of chlorhexidine (CHX) chip and laser therapy have evolved.

Objective: To compare effectiveness of locally delivered CHX chip with diode laser in treatment of periodontitis.

Methods: The non-randomised trial was done in Department of Periodontics at Peoples Dental College and Hospital (PDCH) from August 2019 to July 2020 after ethical clearance from Nepal Health Research Council. Study population was patients with chronic periodontitis with bilateral periodontal pockets in contralateral hemiarches exhibiting periodontal probing depth (PPD) of ≥5-7 mm attending PDCH. Written informed consent was obtained from all participants. Baseline parameters were recorded one week after full mouth SRP. In group A CHX chip was placed and in group B diode laser treatment was done. The parameters: Oral Hygiene Index-Simplified, Plaque Index, Gingival Index, PPD, and Clinical Attachment Level (CAL) were recorded at one month, three months, and six months.

Results: Fifteen patients were analysed. Comparison showed that PPD scores at one month and three months were significantly lower in Group A compared to Group B. Comparison of CAL scores at baseline of both the groups were same. At subsequent visits, CAL for Group A was lower than Group B, but mean difference was not statistically significant.

Conclusions: Both groups showed significant improvements compared with baseline. However, the difference in improvement of the PPD and CAL between groups was not significant.

Clinical Effects of Scaling and Root Planing in Treatment of Patients with Amlodipine Induced Gingival Overgrowth

Luna Poudel — 2022-12-31

Introduction: A multifactorial condition characterised by an increase in size is called gingival enlargement. Most common form is drug induced gingival enlargement. Different treatment options to manage gingival overgrowth are categorised as non-surgical approach and surgical approach. Non-surgical mechanical periodontal treatment is gold standard of periodontal therapy and first recommended approach to control of periodontal infections.

Objective: To determine clinical effect of scaling and root planing (SRP) in treatment of patient with amlodipine induced gingival overgrowth.

Methods: A pretest post-test study was conducted from January 2021 to December 2021 among 19 subjects recruited by convenience
sampling who exhibited amlodipine induced gingival overgrowth of grade 1-2 (Miller’s and Damm index). The probing depth (PD) ≤7mm and clinical attachment level (CAL) ≤4 mm were evaluated on upper and lower anterior teeth on labial aspect, before and after SRP at one month, three months, and six months. Plaque index (PI), Gingival index (GI) were also evaluated before and after SRP at one month, three months, and six months.

Results: Statistically significant reduction was found in terms of GOS, PD, gain in CAL, PI, GI after treatment with SRP at one month, three months, and six months. However, results were not statistically significant in intragroup comparison post-treatment at one month, three months, and six months in terms of CAL, GI, and PI.

Conclusions: Scaling and root planing, has showed significant improvement in reduction of gingival overgrowth, probing depth, clinical attachment level, plaque index and gingival index as compared to pretreatment.

Assessment of Oral Hygiene Status and Practices among a Sample of 12-Year-Old Chepang Children of Nepal

Santosh Adhikari — 2022-12-31

Introduction: Hygienic oral health practices are necessary from a young age to ensure positive long-term oral and general health. The oral hygiene status and practices among the underprivileged Chepang children of Nepal have not been adequately assessed.

Objective: To assess the oral hygiene status and practices among the 12-year-old Chepang children of Nepal, and to identify the association of demographic variables and oral hygiene practices with the oral hygiene status of the children.

Methods: This was a descriptive cross-sectional study where a pretested questionnaire was used to assess the oral hygiene practices and the simplified oral hygiene index (OHI-S) to examine the status of oral hygiene among 160 Chepang children of central Nepal. Statistical analysis was done with SPSS v.17. Statistical significance was determined using an independent t-test and an ANOVA test.

Results: The study showed that 68 (42.5%) of the 12-year-old Chepang children had good oral hygiene, 68 (42.5%) had fair oral hygiene, and only 24 (15%) had poor oral hygiene. The mean OHI-S score for them was 1.62±1.09. Most of the children (138, 86.3%) regularly brushed their teeth and rinsed their mouth after meals (117, 73.1%), but tongue cleaning was performed by only 36 (22.5%) of them.

Conclusions: The study showed that oral hygiene intervention programs are needed for the Chepang children who do not go to schools and who do not stay at hostels.

Clinical Profile and Treatment Outcome of Patients with Trigeminal Neuralgia: A Retrospective study in a Tertiary Hospital of Eastern Nepal

Iccha Kumar Maharjan — 2022-12-31

Introduction: Neuropathic orofacial pain is common non-dontogenic pain. Diagnosis relies primarily on history taking with less of pathologic change visible. Trigeminal neuralgia (TGN) is a common neuropathic pain affecting the maxillofacial region of fifth cranial nerve (V).

Objective: To assess clinical characteristics, effective therapeutic regimen, side effect, radiographic and laboratory investigation in
Trigeminal neuralgia patients.

Methods: Retrospective study included all patients visiting the department with records from 2014 to 2021. After ethical approval for
study, eighty patients were diagnosed based on ICHD3 criteria. Patient with atypical feature with sensory deficit underwent CT OR MRI to rule of mass or lesion along the cerebello-pontine angle recess and other organic cause. The data were analysed using SPSS version 11.5 and Microsoft Excel 2017.

Results: A total of 80 patients were retrieved. The common side affected were right 46 (57.5%) followed by left 28 (35%), bilateral four
(5%) and anterior region two (2.5%). The most common branch involved was mandibular followed by maxillary branch and combination. Management was primarily done by carbamazepine (CBZ) or in combination. Common side effects were drowsiness, dizziness, nausea and diplopia. CT scan and MRI showed space occupying lesion in three cases. Refractory cases underwent neurolysis and symptomatic and few classical TGN cases were sent for surgical management.

Conclusions: Diagnosis of Trigeminal neuralgia is primarily based on clinical characteristic due to high cost and unavailability of imaging and nerve testing. Treatment is by single or multiple drugs with adjunct therapy.

An Interdisciplinary Approach for Management of Missing Canines with Implant Supported Cantilevered Prosthesis

Anugya Karanjit — 2022-12-31

Missing tooth in the anterior region of the maxilla lies in aesthetic zone and create quite noticeable discrepancies. With a paradigm
shift in the patient expectations towards functional as well as aesthetically appealing replacements for edentulism, the implant based
oral rehabilitation has emerged as a sole winner in fulfilling all aspects of patient needs. Interdisciplinary team treatment planning is a
paramount approach for achieving optimal final aesthetics. This article aims to present a case report of replacement of bilaterally missing maxillary canine and lateral incisors with cantilever prosthesis using an interdisciplinary approach.

Surgical Crown Lengthening: Restoring Aesthetics and Function

Sita Bhusal — 2022-12-31

Short clinical crown affects appearance and retention of the restoration placed within aesthetic zone. Thereafter, Surgical crown lengthening procedure is done to increase crown length for restorative or aesthetic reasons without breaching the biologic width. Herewith, we present a case of crown lengthening procedure along with osseous reduction on maxillary anteriors in a 25 years female patient referred to our department which resulted harmonious appearance and symmetry of tissues on follow up. Aesthetic crown lengthening procedure can be challenging. So, appropriate case selection with accurate diagnostic and interdisciplinary approach are essential for getting enhanced and conservative results in aesthetic areas.

An Interdisciplinary Approach for Rehabilitation of a Patient with Amelogenesis Imperfecta: A Case Report

Soni Bista — 2022-12-31

An interdisciplinary approach can be used to treat the uncommon hereditary defect known as amelogenesis imperfecta, which is
characterised by insufficient crown length, hypersensitivity, dental caries, and decreased vertical dimension. The present case report
describes a successfully managed case of amelogenesis imperfecta with full mouth rehabilitation using implant supported prosthesis. This interdisciplinary approach helped to restore the function and aesthetic of an adult patient, which was followed up for six years without any complications.