Journal of Nepalese Society of Periodontology and Oral Implantology

Patient Centered Outcomes in Periodontal Treatment

Prof. Dr. Junima Rajkarnikar — 2026-08-19

Prevalence of Palatogingival Groove in Patients Visiting a Tertiary Care Centre

Dr. Pragati Acharya — 2026-08-19

Introduction: Palatogingival groove (PGG) is a developmental dental anomaly present as a hollow depression in the shape of a funnel, seen mostly in maxillary lateral incisors. The PGG serves as a funnel, trapping plaque difficult to clean by instrumentation and starting a localized inflammatory response in the area around it. Localized gingivitis and periodontitis with or without pulpal pathology are diseases associated with the groove. This study aimed to determine the prevalence of palatogingival grooves in dental casts of patients visiting a tertiary care centre.

Methods: This was a descriptive cross-sectional study conducted in dental casts of patients taken for diagnostic and treatment purposes in the Department of Tribhuvan University Teaching Hospital. A total of 204 dental casts were examined for the absence/ presence, unilateral/ bilateral distribution of the PGG. The data were entered in a Microsoft Excel sheet, and for the statistical analysis, Statistical Package for Social Sciences (SPSS) version 26 was used. Descriptive statistics were presented as percentages and frequencies for categorical data.

Results: A total of 204 dental casts (408 maxillary lateral incisors) were examined in the study, among which 120 (58.82%) were of females, and 84(41.18%) were of males. Out of the 408 lateral incisors examined, the prevalence of PGG was 100 (24.50%). The groove was found to be bilateral in distribution in 20 (9.80%) patients.

Conclusion: In the present study, the prevalence of PGG among dental patients was 24.5% which was higher than shown by other studies conducted in a similar setting.

Determination of Root Trunk Length of Maxillary and Mandibular First Molar

Dr. Sajeev Shrestha — 2026-08-19

Background: The length of root trunk in addition to the amount of horizontal and vertical bone loss supplements furcation classification in the determination of diagnosis, prognosis, and treatment planning.

Objectives: The primary objective was to determine the root trunk length of the maxillary and mandibular first molar. The secondary objective was to assess the association between socio demographic factors and root trunk length of maxillary and mandibular first molar..

Methods: Total of 112 patients who had indication of extraction of either upper or lower first molar teeth were recruited. After extraction of teeth, the vertical dimensions of the root trunk and root length were measured with Digital Vernier Caliber.

Results: Out of 112 teeth, 43 were obtained from male and remaining 69 from female. Similarly, out of 112, 80 teeth were mandibular first molar and remaining 32 were maxillary first molar. The mandibular buccal root trunk (BRT) and lingual root trunk (LRT) length was
4.26 ± 0.99 and 4.86 ± 0.95 mm, respectively. Similarly, the maxillary mesial root trunk (MRT), buccal root trunk (BRT) and distal root trunk (DRT) length was 4.56 ±.91, 4.91 ± .67 and 5.62 ± 0.87 mm, respectively.

Conclusion: For maxillary first molar, the longest root trunk is DRT followed by BRT and then MRT while for mandibular first molar; LRT is longer than BRT length.

Assessment of Pre-operative Anxiety among Patients undergoing Surgical Dental Procedures under Local Anaesthesia in a Tertiary Care Dental Hospital of Kathmandu, Nepal

Dr. Sagun Regmi — 2026-08-19

Introduction: Pre-operative anxiety is a common psychological response among patients undergoing surgical dental procedures. Anxiety may influence pain perception, cooperation during surgery, and overall treatment outcomes. Limited data are available regarding pre-operative anxiety among dental patients in Nepal.

Objectives: To assess the level of pre-operative anxiety and associated factors among patients undergoing surgical dental procedures under local anaesthesia.

Methods: A descriptive cross-sectional study was conducted among 157 patients undergoing surgical dental procedures under local anaesthesia at Kantipur Dental College and Hospital from June 2024 to November 2024 following ethical approval from the Institutional Review Committee (IRC-KDC; Ref. No. 09/024). Non-probability purposive sampling was applied. Eligible participants were adults aged ≥18 years scheduled for periodontal flap surgery, surgical extraction, dental implant placement, or minor oral surgical procedures under local anaesthesia. Anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Data were analysed using SPSS version 24. Chi-square test was used to determine association between preoperative anxiety and independent variables. Statistical significance was set at p < 0.05.

Results: Among 157 participants, 77.1% exhibited preoperative anxiety before dental procedures with mean subscale anxiety score (APAIS-A) of 9.5 ± 3.7 and mean subscale information desire score (APAIS-I) of 5.4 ± 2.2. Previous dental visit (p=0.007), fear of pain (p < 0.001), fear of complications (p < 0.001), and fear of the unknown (p < 0.001) were significantly associated with clinically relevant anxiety.

Conclusions: More than two thirds of the study participants undergoing surgical dental procedures under local anaesthesia experienced pre-operative anxiety. Psychological factors, particularly fear-related variables and previous dental history found significant association with preoperative anxiety. Structured patient counselling and targeted anxiety-reducing strategies are recommended in routine periodontal and oral surgical practice.

Prevalence of gingival biotype among patients visiting a dental hospital in Kathmandu

Dr. Samriddhi Vaidya — 2026-08-19

Introduction: Gingival biotype plays a significant role in predicting the response of gingiva to various dental operative procedures like periodontal, restorative, orthodontic and implant therapy.

Objective: To assess the prevalence of gingival biotype among patients visiting a dental hospital in Kathmandu

Methods: An analytical, cross-sectional study was conducted among 184 patients aged 18-55 years who attended the Department of Periodontology and Oral Implantology of Nepal Medical College Teaching Hospital, Attarkhel, Kathmandu from November 2021 to January 2022. Participants were selected by convenience sampling method. Gingival biotype of the patients was measured by probe transparency method. Prevalence of gingival biotype its association with sociodemographic and clinical characteristics were assessed.

Results: Of the total, majority had thick gingival biotype in all central incisors (113, 61.4% each in maxillary central incisors, 105, 57.1% in right mandibular central incisors and 107, 58.2% in left mandibular central incisors). Gingival biotype was significantly associated with ethnicity (p-value 0.039). Higher proportion of Janajati/ Newar (58, 72.5%) had thick gingival biotype as compared to individuals from other ethnicities.

Conclusions: Thick gingival biotype were more prevalent in maxillary and mandibular central incisors.

Prevalence of Periodontal Disease in a Tertiary Care Centre of Madhesh Province, Nepal

Dr. Rajesh Shah — 2026-08-19

Introduction: Periodontal diseases are common chronic oral conditions and a major cause of tooth loss in adults. Their prevalence varies according to oral hygiene practices, socio-demographic factors, and diagnostic criteria.

Objective: To determine the prevalence and severity of periodontal diseases at a tertiary care centre in Birgunj, Nepal.

Methods: A hospital-based cross-sectional study was conducted among 310 patients attending the Outpatient Department (OPD) of Periodontology and Oral Implantology at National Medical College, Birgunj, Nepal from June 2024 to August 2025. Socio-demographic data were collected using a structured questionnaire. Clinical examination included Plaque Index (PI), Gingival Index (GI), Clinical Attachment Loss (CAL), Probing Pocket Depth (PPD), and Bleeding on Probing (BOP). Periodontal diagnosis was established according to the 2017 World Workshop Classification of Periodontal and Peri-Implant Diseases and Conditions. Data were analysed using SPSS version 21.0. Descriptive statistics and independent t-tests were applied, and p <0.05 was considered significant.

Results: The mean age of participants was 37.69 ± 14.89 years. Of 310 participants, 18(5.8%) had healthy periodontium, 50(16.1%) had gingivitis, and 242(78.1%) had periodontitis. Stage II periodontitis was most prevalent 101(32.6%), followed by Stage I 62(20.0%), Stage III 51(16.5%), and Stage IV 28(9.0%). Participants aged ≥36 years had significantly higher PI, GI, CAL, and PPD than those aged ≤35 years
(p <0.05).

Conclusion: Periodontal diseases were highly prevalent, with periodontitis being the predominant condition. Stage II periodontitis was the most common form. Older age was associated with poorer periodontal parameters, highlighting the importance of preventive oral health measures and routine periodontal screening.

Classification of Gingival Recession: Evolution from Miller’s 1985 Classification to the 2018 Revisited System

Dr. Pratik Marattha — 2026-08-19

Gingival recession is a widely prevalent mucogingival deformity with esthetic and functional consequences. Since Sullivan and Atkins first proposed a classification in 1968, numerous systems have attempted to standardize diagnosis and prognosis, including Miller’s widely adopted marginal tissue recession (1985) classification. As Miller’s system expanded the horizon of recession classification beyond shape and size, it also provided prognostic guidance for root coverage. However, limitations such as difficulty in identifying the mucogingival junction and ambiguity between classes had prompted further refinements. Cairo’s 2011 Recession Type system improved prognostic accuracy by incorporating interproximal attachment loss, and the 2017 World Workshop extended the treatment-oriented classification by integrating recession type, gingival phenotype, and root surface features into a 4×5 matrix. In 2018, Miller revisited his classification system again after 3decades, incorporating papilla dimensions and emphasizing the role of attached gingiva, cautioning against oversimplification in then newer popular systems. Together, the evolution of these classification systems also portrays the evolution of periodontology from mucogingival surgery to perioplastic surgery era. This article outlines the basis, drawbacks and limitations of various classification systems proposed to classify gingival recession over time.

Esthetic Zone Rehabilitation Through Immediate Implant Placement and Guided Bone Regeneration- A Case Report

Dr. Aishwarya Joshi — 2026-08-19

Alveolar ridge deficiency presents a major challenge during dental implant placement in the maxillary anterior region, where esthetics and function are critical. Adequate peri-implant bone is essential for implant stability, long-term success, and healthy gingival contours. Guided bone regeneration (GBR) is a predictable technique used to augment deficient ridges and improve implant outcomes. This case report describes a 56-year-old female patient with Grade III mobility of the upper right maxillary lateral incisor and severe buccal bone deficiency. Immediate implant placement with horizontal ridge augmentation using GBR achieved satisfactory esthetic and functional outcomes.

Immediate Implant Placement with Static Three-Dimensional Surgical Guidance in the Maxillary Aesthetic Zone: A Case Report

Dr. Samina Timilsina — 2026-08-19

Advances in implant technology have significantly improved outcomes through immediate implant placement in the anterior region. Immediate implant placement increases the risk of misalignment and incorrect angulation. To enhance precision, clinicians increasingly use digitally designed surgical guides created from cone beam computed tomography imaging and digital planning workflows allowing accurate control of implant depth, orientation, and position. This case report demonstrates virtual planning, three-dimensional static guided surgery, and immediate implant placement to restore a fractured maxillary left lateral incisor in a 30-year-old female patient. The outcome achieved excellent functional and esthetic results with preserved hard and soft tissues.

Soft Tissue Augmentation with Free Gingival Graft: A Predictable Outcome after Nine Months

Dr. Rebika Shrestha — 2026-08-19

Width of attached gingiva is the distance between mucogingival junction and projection on external surface of bottom of gingival sulcus or periodontal pocket. Gingival recession is a prevalent clinical condition characterized by apical shift of marginal gingival tissue apical to cementoenamel junction, resulting in root exposure, dentinal hypersensitivity, compromised esthetics and increased susceptibility to plaque retention. Free gingival graft (FGG) is one of the most predictable method for augmenting keratinized tissue and enhancing gingival stability. This case report describes management of 21-year-old patient presenting with Cairo’s Recession Type 2 in relation to lower front region of mouth using FGG.