Thamil Selvan Muthuraj
@rajasdentalcollege.edu.in
Associate Professor, Department of Periodontics and Implantology
Rajas Dental College and Hospital
RESEARCH, TEACHING, or OTHER INTERESTS
Dentistry, Periodontics, Oral Surgery, Dental Hygiene
Scopus Publications
Scopus Publications
Renganath Murugan Jeyasree, Thamil Selvan Muthuraj, Gomakumar Kanakasabhapathi Usha, and Jacob Raja
Medknow
Abstract Gingival abscess is a localized, acute inflammatory lesion which is caused by various factors that include microbial plaque infection, foreign body impaction, and trauma. Management includes a simple incision and draining of the purulent exudate along with systemic antibiotics in most of the cases. This article reports a case of a 16-year-old female patient, with a chief complaint of painful and swollen gums in her lower right front tooth region of the jaw along with fever for the past 5 days. Emergency treatment of abscess drainage was done on day 1. On 5th day of review, the case presented with persistent signs of gingival inflammation in relation to 43 to 41. Considering the provisional diagnosis as dentigerous cyst with persistent gingival abscess, definitive treatment was performed by transalveolar extraction of the impacted canine and debridement of the osseous lesion. The histologic analysis of the lesion exhibited foci of eosinophilic coagulum-like areas with epicentric and radiating filamentous appearance at the periphery, which is suggestive of an inflamed dentigerous cyst with actinomycosis infection of periodontium.
Thamil Selvan Muthuraj, Puja Sarkar, Murugan Jeyasree Renganath, and Pillaiyar Gurusamy Senthilkumaran
Wiley
AbstractIntroductionGingival depigmentation procedure has gained widespread popularity in the recent years due to increased esthetic demands among patients. Among the various depigmentation procedures, cryosurgery is inexpensive and straightforward method. This case report discusses a rare complication associated with tetrafluoroethane (TFE) cryosurgical depigmentation method.Case PresentationA 27‐year‐old systemically healthy male patient reported with the complaint of esthetic concerns associated with gingival melanin pigmentation. Cryosurgery with TFE was planned for the maxillary first quadrant. The patient developed angioedema immediately after exposure to the TFE cryogen during the procedure. Cold urticaria was considered, and the patient was prescribed nonsedating antihistamines for a week. One month follow‐up showed completely healed and depigmented gingiva without any recession or attachment loss.ConclusionsTFE cryosurgery depigmentation was found to be an effective depigmentation procedure. However, various complications including cold urticaria have been associated with its application. Therefore, the procedure's success depends on the proper case selection, complete isolation of the operating area, and preoperative test for gingival tissue response.Key pointsWhy is this case new information? Cold urticaria formation after applying cryosurgery has never been reported in the literature to the best of the authors' knowledge. What are the keys to the successful management of this case? Preoperative testing for tissue response to cryosurgery will prevent complications like cold urticaria. What are the primary limitations to success in this case? Improper medical history and not taking tissue response test for cryosurgery.
Suchi Suvra Bagchi, Thamil Selvan Muthuraj, Puja Sarkar, Prasanta Bandyopadhyay, and Papita Ghosh
Medknow
Background: Several studies have suggested a relationship between periodontitis and serum creatinine levels. Both low and high serum creatinine levels have been reported in individuals with periodontitis. The impact of periodontal therapy on serum creatinine levels has not been fully investigated yet. The aim of the study is to estimate the influence of nonsurgical periodontal therapy (NSPT) on serum creatinine levels in systemically healthy individuals with periodontitis at stage II and stage III with grade A and grade B. Materials and Methods: Sixty-eight systemically healthy individuals included in the study were divided into Group A (GA) (Periodontally healthy) and Group B (GB) (Periodontitis: stage II and III with grade A and grade B). Gingival index, sulcular bleeding index, probing pocket depth, clinical attachment level, body mass index, and serum creatinine levels were recorded at baseline for both GA and GB, 90 days after NSPT for GB only. Collected data were analyzed statistically. Results: Serum creatinine levels in GB were significantly higher when compared with GA and serum creatinine levels in GB before and 90 days after NSPT were statistically insignificant. Conclusions: Serum creatinine levels were higher in individuals with periodontitis when compared with periodontally healthy individuals and NSPT has no considerable influence on the serum creatinine levels in individuals with periodontitis. Further studies are required to confirm these findings.
ThamilSelvan Muthuraj, Puja Sarkar, Prasanta Bandyopadhyay, and Papita Ghosh
Medknow
Background: Matrix metalloproteinases (MMPs) are a major group of enzymes, released in inflamed periodontal tissues in large quantities, resulting in connective tissue matrix breakdown. One of the most predominant MMPs is MMP-9. Association between chronic periodontitis (CP) and MMP-9 gene polymorphism (GP) in some ethnic populations has been already established. The aim of the current study was to assess the association of single-nucleotide polymorphism in the promoter region of MMP-9 gene with CP in Kolkata population, if any. Materials and Methods: Forty eligible individuals were recruited for the study and grouped as A and B: Group A (twenty periodontally healthy individuals) and Group B (twenty CP patients). Venous blood samples collected from all the forty individuals were used to isolate the genomic DNA. GP for MMP-9 gene was detected using polymerase chain reaction and sequencing method. The data obtained were then analyzed statistically. Results: A significantly different genotypic and allelic variation was observed in the control and test groups, with C/T genotype and T allele present in only CP group. Conclusion: Within the limitations of this study, we can conclude that there was no significant association between patients with periodontitis and MMP-9-1562 C/T promoter GP.
ThamilSelvan Muthuraj, Papita Ghosh, Prasanta Bandyopadhyay, Snehasikta Swarnakar, Puja Sarkar, and Abinaya Varatharajan
Medknow
Background: Matrix metalloproteinases (MMPs) are a group of host-derived zinc-dependent enzymes which mediates the destruction of the extracellular matrix. In periodontitis, there is excess production of MMPs associated with periodontal tissue destruction. The aim of this study was to estimate the level MMP-9 in both active and latent form in gingival tissue (GT) samples collected from periodontitis patients with different rates of progression and compare it with healthy individuals. Materials and Methods: Sixty patients were selected and divided into three groups, 20 each: Group A (slowly/moderately progressing periodontitis), Group B (rapidly progressing periodontitis), and Group C (clinical periodontal health). Plaque index, gingival index, periodontal probing depth (PPD), and clinical attachment level were recorded. GT samples were collected from all 60 patients and MMP-9 expressions were measured using gelatin zymography and western blotting. Results: Levels of active MMP-9 (aMMP-9) and latent MMP-9 (lMMP-9) were significantly high in both Group A (GA) (aMMP-9: 2.05 arbitrary unit [AU]/lMMP-9: 2.54 AU) and Group B (GB) (aMMP-9: 1.32 AU/lMMP-9: 1.74 AU) when compared to that of Group C (GC) (aMMP-9: 0.93/lMMP-9: 1.08 AU). In GA, levels of aMMP-9 showed a significant correlation with PPD values. No other correlations were found. Conclusion: The levels of aMMP-9 and lMMP-9 were increased in both the types of periodontitis when compared with periodontally healthy individuals. A significant correlation was found between PPD and activities of aMMP-9 in slowly/moderately progressing periodontitis patients. However, further studies are required to confirm these findings.
ThamilSelvan Muthuraj, Somen Bagchi, Prasanta Bandyopadhyay, Soma Mallick, Papita Ghosh, and MuruganJeyasree Renganath
Medknow
Background: According to the American Association of Periodontology, subepithelial connective tissue graft (SCTG) is one the most reliable surgical technique available for the treatment of gingival recession (GR) with Miller's Class I defect. However, due to its various disadvantages, alternate grafts such as acellular dermal matrix (ADM) grafts have been introduced for recession coverage. The present study compares the clinical outcome of these two grafts in treating Miller's Class I GR. Materials and Methods: All the 15 patients participated in the study who had totally 30 bilateral Miller's Class I GR were divided randomly into SCTG group and ADM group each containing 15 defects. In the SCTG group, coronally advanced flap (CAF) with SCTG was performed, and in ADM group, CAF with ADM was done. Clinical parameters were measured on the day of surgery (baseline) and after 6 months. Data collected were statistically analyzed using paired and unpaired t-tests. Results: The analysis of the data collected at the baseline and 6 months later showed that there were no statistically significant differences in the recorded clinical parameters such as probing pocket depth, clinical attachment loss, and GR depth. ADM group showed a better color match than the SCTG group, while SCTG group achieved more keratinized tissue width than ADM group. Conclusion: From the outcome of the current study, we can conclude that ADM is an efficient substitute for SCTG for treating Miller's Class I GR. However, additional studies with greater number of samples and lengthier follow-up periods are necessary to validate the present inference.
ThamilSelvan Muthuraj, Jacob Raja, JohnsonRaja James, JeyarajPrince Mohan Raj, Divya Subramnian, and Abinaya Varatharajan
Medknow
Background: Identification and documentation of the proper and improper dental ergonomic postures have gained its importance in the recent years due to the increased prevalence of work-related musculoskeletal disorders (WMSDs) among dentists and dental students who do not practice proper ergonomic procedure. Aim: The aim of the present study is to analysis ergonomic posture among dental students while performing supragingival scaling (SGS) procedure, using the standardized photometric assessment method (SPAM). Materials and Methods: A total number of 90 students from the third year (III year) to final year (IV year) and internship (Intern) (30 each) were included in the study. All the 90 students were asked to perform SGS procedure and were photographed and analyzed using the current technique. Eight dental ergonomic postures were analyzed in this study and grouped according to the classification system developed for scoring dental ergonomic postures by Garbin et al., in 2011. Analysis of variance test with Bonferroni correction was used to statistically analyze the collected data. Results: The mean index value for III year, IV year and Intern were 2.00, 2.03, and 2.13, respectively, which was not statistically significant (P = 0.709). Conclusions: Analysis of the dental students using the current method showed that most of them come under inadequate and regular category which puts them in a high risk for developing WMSDs. The SPAM to analyze the dental ergonomic posture was simple and effective and should be further explored in the future studies for its pros and cons.