Journal of Nepalese Society of Periodontology and Oral Implantology

Integrating Periodontal Insight into Diabetes Care in Nepal

Khushbu Adhikari — 2025-10-15

Evaluation of Gingival Phenotype in Maxillary Central Incisors among Patients Visiting a Tertiary Care Centre of Madhesh Province, Nepal

Harish Kumar Shah — 2025-10-15

Introduction: Gingival phenotype plays an important role in maintenance of healthy periodontium. Therefore, it is crucial to determine
gingival phenotype before any dental related therapy as it helps in decision making process for better prognosis.
Objective: To evaluate the type of gingival phenotypes in maxillary central incisor teeth and also to test possible effects of probing depth,
width of keratinised gingiva, age, gender, religion, smoking, and brushing habits on the gingival phenotype among patients.
Methods: This analytical cross-sectional study was conducted in 268 systemically healthy patients aged 20-50 years in the Department
of Periodontology and Oral Implantology, National Medical College from 2023 April and 2024 October after institutional ethical approval.
Convenience sampling method was utilised. The gingival phenotype was measured via the probe transparency method. The width of the
keratinised gingiva and probing depth were measured in nearest millimetre (mm). Chi-square tests and independent t-tests were applied to
determine the possible associations between the dependent and independent variables at the 95% confidence level (p ≤0.05).
Results: Out of 268 patients, 167 (62.3%) had thick gingival phenotype while 101 (37.7%) had thin gingival phenotype. The average width
of keratinised gingiva of right and left central incisors were 5.17±1.46 mm and 5.34±1.58 mm respectively, whereas average probing depth
were 1.62±0.62 mm and 1.70±0.71 mm respectively. Both the mean width of keratinised gingiva and probing depth were significantly
different between thin and thick gingival phenotype (p <0.001).
Conclusions: A thicker gingival phenotype was more prevalent in maxillary central incisor teeth. The width of keratinised gingiva was
greater in thick than in thin gingival phenotypes. By contrast, greater probing depths were measured for the thick than for thin gingival
phenotypes.

Patterns of Oral Health Conditions among Children attending Paediatric Dental Department at a Tertiary Care Centre in Nepal

Ankita Agrawal — 2025-11-14

Introduction: Presentation of dental disease varies depending on different cultural practices, conditioning, awareness, and a person’s
attitude towards seeking oral health care services. Lack of oral hygiene practices, feeding at will, and excessive consumption of sweets lead
to early tooth decay.
Objective: To assess pattern of distribution of various oral health conditions among children.
Methods: This hospital-based, analytical, cross-sectional study was carried out among 431 children from one week to 14 years old in the
department of Paedodontics and Preventive Dentistry, Universal College of Medical Sciences, Siddharthanagar from 2025 January to June
after obtaining institutional ethical clearance. Informed consent and assent were obtained from parents and children before enrolment
in this study. Participants were selected using convenience sampling method and divided into two groups: group I included 211 children
aged one week to six years and group II ranged from seven years to 14 years of age comprising of 220 children. Distribution of disease
depending upon presenting complaints was recorded over a period of six months. The data collected were tabulated and subjected to
statistical analyses using SPSS v.20 Descriptive statistics were obtained and frequency distribution were calculated. Chi-square test was
used for the analysis.
Results: Out of total study population,166 (38.5%) children showed presence of dental caries, 105 (24.4%) had dentoalveolar abscess.
Children presented with retained deciduous were 49 (11.4%), whereas 36 (8.4%) complained mobility, 24 (5.6%) cases were of trauma, and 14
(3.2%) malocclusions followed by 13 (3%) gingivitis, 12 (2.8%) developmental anomalies, seven (1.6 %) pericoronitis, four (0.9 %) precocious
teeth, and one (0.2%) tongue tie as their chief complaint
Conclusions: The present study highlights that dental caries and dentoalveolar abscess were most frequently reported oral health problems
among children, particularly in younger age group. Male children showed higher prevalence of traumatic dental injuries.

Healing and Flap Closure Time with N-butyl Cyanoacrylate and Silk Suture

Asmita Koju — 2025-10-15

Introduction: Silk suture is the most commonly used material in periodontal flap surgery. However, healing thereafter may be compromised due to accumulation of food particles into the suture knots and bacterial ingress into the site. Recently, n-butyl cyanoacrylates have emerged in periodontics that may overcome the limitations of intraoral usage of silk suture.

Objective: To compare effectiveness of n-butyl cyanoacrylate with silk suture in the closure of periodontal flaps by assessing healing and flap closure time.

Methods: A split-mouth study was carried out amongst 16 patients indicated for bilateral periodontal flap surgeries in Periodontology and Oral Implantology Unit, National Academy of Medical Sciences (NAMS), Bir Hospital from 2022 September to 2023 August. Each patient served as his own control creating two sites: control site (4-0 silk suture) and test site (n-butyl cyanoacrylate); and flap closure time (FCT) for both sites was recorded. Inter-site comparison with Plaque index (PI), Papillary marginal attachment index (PMAI), and wound healing index (WHI) was performed for 3rd, 7th, and 30th post-operative days.

Results: The FCT was statistically higher for control site than test site. Similarly, PI and PMAI were statistically increased in the control site on 3rd and 7th post-operative days (p <0.005). There was no change in WHI between the sites.

Conclusion: This study suggests that n-butyl cyanoacrylate is as effective as silk suture for the closure of periodontal flaps. The easier application, less flap closure time and requirement of little armamentarium make n-butyl cyanoacrylate a promising alternative.

Assessment of Buccal Plate Thickness in the Maxillary and Mandibular Posterior Dentition using Cone Beam Computed Tomography

Savvy Pokhrel — 2025-10-15

Introduction: Adequate buccal plate thickness sustains alveolar bone remodelling without significant peri-implant bone resorption, thereby, preventing peri-implant bone defects like fenestrations and dehiscences, and maintaining the integrity of overlying soft tissues.

Objective: To assess the buccal plate thickness in the maxillary and mandibular posterior dentition using cone beam computed tomography (CBCT).

Methods: An analytical cross-sectional study was conducted in the Department of Periodontology and Oral Implantology, Kantipur Dental College Teaching Hospital and Research Centre, from 2021 December to 2023 July. After ethical approval, CBCT scans obtained from 60 participants in the age range of 21-49 years, selected through non-probability convenience sampling, fulfilling all the inclusion and exclusion criteria, were retrospectively analysed for buccal plate thickness at three measurement points, 1 mm, 3 mm, and 5 mm from the crest, with an additional measurement from cementoenamel junction (CEJ) to the crest, on 1,440 roots, using Carestream (CS) 3D imaging software version 3.5.18. The data were then compared between jaws, measurement points, sides, and genders using SPSS v.20 software.

Results: In the maxilla, the thinnest buccal plate was presented by mesiobuccal root of first molar at 1 mm, and by first premolar at 3 mm and 5 mm, while the thickest buccal plate was presented by mesiobuccal and distobuccal roots of second molar at 5 mm, and at 1 mm and 3 mm respectively. In the mandible, first premolar had the thinnest buccal plate while distobuccal root of second molar had the thickest buccal plate at all three measurement points.

Conclusions: The study presented the tendency of buccal plate to increase in thickness from anterior to posterior, and from coronal to apical along the roots, in both jaws. No significant differences could be determined between right and left sides, or between genders.

Desquamative Mucosal Reactions: A Potential Side Effect of Chlorhexidine Gluconate Mouthwash

Jeni Basnet — 2025-10-15

Chlorhexidine gluconate is most commonly used mouthwash in dentistry. Though infrequent, adverse reaction to the use of chlorhexidine compounds have been reported which range from teeth staining, altered taste, parotid gland swelling, mucosal erosions, anaphylaxis, and sometimes even death. Immunologic reactions which are commonly seen involve type I hypersensitivity reaction and contact stomatitis (type IV hypersensitivity reaction). Desquamative mucosal and gingival lesions have been previously observed with 0.2% of chlorhexidine compounds. This case report also involves a presentation of desquamative mucosal and gingival lesions in a patient with chlorhexidine gluconate mouthwash prescription.

Aesthetic Crown Lengthening Surgery: A Remedy for Excessive Gingival Display

Sagar Gyawali — 2025-10-15

Excessive gingival display is a descriptive term rather than a diagnosis. Gummy smile is a non-pathological condition causing aesthetic disharmony in which an excessive amount of gingival tissue is exposed when smiling. Among several aetiologies, altered passive eruption is one responsible for gummy smile which is corrected through aesthetic crown lengthening surgical procedure. Identification, diagnosis, and classification of all factors resulting in gummy smile is imperative for appropriate management. Here a case of aesthetic crown lengthening surgery in a 24-year-old female with gummy smile is presented.

Amlodipine Induced Gingival Enlargement: A Conservative Treatment Strategy

Dr. Sujata Rana — 2025-10-15

Amlodipine, a commonly prescribed calcium channel blocker for hypertension, is associated with gingival enlargement, which can lead to aesthetic concerns and difficulty with speech, mastication, and oral hygiene. This condition presents a challenge due to its unclear pathogenesis and the risk of recurrence. This case report highlights the success of a conservative treatment strategy, including scaling and root planing combined with drug substitution, in controlling gingival overgrowth. The intervention led to a noticeable reduction in gingival enlargement, reducing the need for extensive surgical procedures.

Autogenous Bone Grafting in the Anterior Maxilla for Implant Placement

Dr. Elija Bajagain — 2025-10-15

Congenitally missing canines are rare clinical findings with significant functional and aesthetic challenges. This case report describes the comprehensive management of a 23-year-old female patient presenting with bilateral maxillary canines and left lateral incisor agenesis, retained deciduous teeth, and missing mandibular first molars. Treatment included a staged approach involving autogenous bone grafting from the mandibular symphysis, extraction of retained deciduous lateral incisor and subsequent implant placement in relation to 23 leading to successful functional and aesthetic rehabilitation.

Predictable Root Coverage in Multiple Recession using a Modified Coronally Advanced Flap

Dr. Sumiran Joshi — 2026-05-03

Rehabilitation of a Maxillary Lateral Incisor using Osseodensification and Guided Bone Regeneration

Dr. Min Bahadur Gurung — 2026-05-03