Alcohol and Periodontal Disease: A Narrative Review.

The scientific literature dealing with alcohol and alcoholic beverages revealed that these drinks possess an adverse impact on periodontal tissues. Additionally, other principal risk factors include tobacco, smoking, poor oral hygiene, etc. It has been observed that among chronic alcoholics, there are further issues, such as mental, social, and physical effects, that promote alcoholism. These people may have weak immunity for defense against pathogenic organisms and bacteria. Thus, chances of gingival bleeding, swollen gums, bad breath, and increased bone loss are there. Different alcoholic beverages in the market cause less salivation; these beverages contain sugars that promote acid production in the oral cavity by pathogens that demineralize the enamel and damage gum and teeth. This chronic alcohol consumption can progress into different types of oral disorders, including cancer, halitosis, and caries, and is also associated with tobacco and smoking. Chronic alcohol consumption can cause alteration of the oral microbiome and increase oral pathogens, which lead to periodontal disease and an environment of inflammation created in the body due to malnutrition, diminished immunity, altered liver condition, brain damage, and gut microbiota alteration. Heavily colored alcoholic beverages produce staining on teeth and, due to less saliva, may cause other toxic effects on the periodontium. Over-dependency on alcohol leads to necrotizing lesions such as necrotizing gingivitis, necrotizing periodontitis, and necrotizing stomatitis. These pathological impairments instigate severe damage to oral structures. Therefore, proper counseling by the attending dental surgeon and related health professionals is urgently required for the patient on the basis that the individual case needs to go away from the regular heavy consumption of alcohol.

A randomized comparative study of platelet-rich fibrin along with hydroxyapatite graft for the treatment of 3-walled defects in chronic periodontitis.

Background: Platelet Rich Fibrin (PRF) is a concentrate of leucocyte and platelets that contains various polypeptide growth factors. It has immense potential for use as a periodontal regenerative material in periodontal defects. Porous hydroxyapatite (HA) has long been used as bone grafting material. Recently it has been reported that when PRF is used in combination with HA, itgives a synergistic effect and results in a better periodontal regeneration. The present study aims to explore the clinical and radiographic effectiveness of autologous PRF versus PRF+HA in the regenerative treatment of intrabony defects (IBD) in patients with chronic periodontitis. Methods: Sixty patients with IBDs were divided into test and control groups. The test group patients were treated with autologous PRF, whereas the control group patients were treated with PRF+HA. Clinical parameters were recorded at baseline, three months, six months and nine months' time interval. Radiographic measurements were recorded at baseline and nine months. Results: A reduction in PI, MGI, PPD, RAL, and IBD was observed in both the groups at nine months. Mean IBD reduction in the control group was 3.70 ± 1.16 mm, whereas, the mean reduction in the test group was 4.80 ± 1.03 mm, showing a significant reduction in IBDs. Similarly, the percentage of bone fill in the test group was 65% ± 3.67%, whereas bone fill in controls was 56.7% ± 3.56%, showing a significant bone fill in the study group. Conclusion: Treatment of IBDs with PRF+HA showed a significant improvement in all the clinical and radiographic parameters. When HA was added to PRF, it increased the regenerative effect in the treatment of 3 wall IBDs.

GCF Resistin As A Novel Marker in Patients with Chronic Periodontitis and Rheumatoid Arthritis.

BACKGROUND: The associational studies between periodontitis and rheumatoid arthritis are less documented, although they are found to have similar inflammatory pathogenesis. Resistin, a novel adipokine is suggested to be a common link between periodontitis and rheumatoid arthritis. The aim of the present study was to reinforce the inter-relationship between periodontitis and rheumatoid arthritis by using resistin as a potent inflammatory marker. MATERIALS AND METHODS: Hundred patients (aged >30 y) of either sex were selected for this study and were divided equally into four groups of 25 patients each. Group A consisted of healthy individuals, Group B consisted of patients with chronic periodontitis, Group C of patients with rheumatoid arthritis and Group D had patients suffering from both arthritis and periodontitis. Periodontal parameters assessed were plaque index (PI), modified gingival index (GI) and probing depth (PD). Panoramic radiographs were taken to confirm the diagnosis of periodontitis. Rheumatoid arthritis was confirmed by the rheumatologists and seropositivity for rheumatoid factor (RF) was checked. Resistin levels were analysed in GCF collected from all the four groups and statistical analysis was done by using Pearson correlation coefficient. RESULTS: The GCF of all the patients showed presence of resistin. The level of resistin was highest in Group D patients and least in Group A patients. On analysing the samples together positive co-relation was found between GCF resistin and PD, PI, GI and RF. CONCLUSION: Resistin levels are increased in both chronic periodontitis and rheumatoid arthritis. Therefore, the increased level of GCF resistin can be regarded as potential inflammatory marker for periodontitis and rheumatoid arthritis.

Significance of maternal periodontal health in preeclampsia.

OBJECTIVE: The aim of the present case-control study was to evaluate the association between maternal periodontitis and preeclampsia. Association studies between maternal periodontitis and elevated risk for preeclampsia have shown conflicting results. Periodontal maintenance is necessary to reduce the risk of adverse pregnancy outcomes like preeclampsia. MATERIALS AND METHODS: Periodontal parameters [bleeding on probing, probing depth (PD), and clinical attachment level (CAL)] of 1320 women were assessed, followed by retrieval of their demographic and medical data from the medical records. Based on the medical records, 80 women were excluded from the study, leaving 1240 females as the eligible sample for the study. The women were divided into control group (1120 non-preeclamptic women who gave birth to infants with adequate gestational age) and case group (120 preeclamptic women). Logistic regression analysis revealed that primiparity and maternal periodontitis were the two significant variables causing preeclampsia. Further analysis was carried out by matching the two groups for primiparity to find the significance of maternal periodontitis. Maternal periodontitis was defined as PD ≥4 mm and CAL ≥3 mm at the same site in at least four teeth. RESULTS: The results showed that maternal periodontitis (odds ratio 19.8) was associated with preeclampsia. Maternal periodontitis also remained associated with preeclampsia after matching for primiparity, which was another significant confounding factor in the study (odds ratio 9.33). CONCLUSION: Maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

Influence of aspirin on post-extraction bleeding - A clinical study.

AIM: The aim of the study was to evaluate the influence of aspirin on post-extraction bleeding in a clinical setup. MATERIALS AND METHODS: Two hundred patients aged between 50 and 65 years who were indicated for dental extraction for endodontic reason were selected from the outpatient Department of Oral and Maxillofacial Surgery. The patients were randomly divided into aspirin continuing group (group A) and aspirin discontinuing group (group B). After checking all the vital signs, the extractions were carried out. Bleeding time and clotting time were recorded for evaluation by Chi-square test. RESULTS: Chi-square test revealed that the bleeding time increased (3.8 ± 0.75) in group A patients continued with the aspirin therapy where as group B discontinued aspirin. Similarly, the clotting time increased in group B patients and decreased in group A patients. But in both the groups, bleeding and clotting time remained within normal limits. CONCLUSION: Reviewing most of the dental and medical literature, it can be concluded that there is absolutely no need to discontinue antiplatelet therapy for any ambulatory dental procedure, and even if the practitioner wishes to discontinue, it should not be for more than 3 daAQ2ys. This is also stated in the guidelines of the American Heart Association.

The effect of periodontal treatment on C-reactive protein: A clinical study.

BACKGROUND: Chronic periodontitis in amultifactorial inflammatory disease which is caused by various microorganisms. Many studies have found close association between chronic periodontitis and C-reactive protein (CRP). CRPis an inflammatory marker which increases in all inflammatory condition. AIMS AND OBJECTIVE: The present clinical study was designed to show the effect of periodontal treatment on the CRP levels of gingival crevicular fluid and to determine the effect of nonsurgical therapy in minimizing the CRP levels in chronic generalized periodontitis. MATERIAL AND METHOD: Gingival crevicular fluid was collected using a micro capillary pipette that was hand calibrated at every 1 mm till 10 mm, from selected sites in the subjects on the 1st, 14th and 45th days. RESULTS AND CONCLUSION: Decreased CRP levels of gingival crevicular fluid were observed at the end of the study. There was a 37% reduction in probing pocket depth and 45% gain in clinical attachment level and a reduction of about 57% after 14 days and 90% reduction of CRP levels in gingival crevicular fluid after 45 days. Thus, the results show that the presence of CRP level is more significant in gingival crevicular fluid and confirms the underlying inflammatory component of the disease activity in chronic periodontitis.

Evaluation of calcium sulphate barrier to collagen membrane in intrabony defects.

PURPOSE: The aim of this study was to clinically and radiographically evaluate and compare treatment of intrabony defects with the use of decalcified freeze-dried bone allograft in combination with a calcium sulphate barrier to collagen membrane. METHODS: Twelve patients having chronic periodontal disease aged 20 to 50 years and with a probing depth >6 mm were selected. Classification of patient defects into experimental and control groups was made randomly. In the test group, a calcium sulphate barrier membrane, and in control group, a collagen membrane, was used in conjunction with decalcified freeze-dried bone graft in both sides. Ancillary parameters as well as soft tissue parameters along with radiographs were taken at baseline and after 6 months of surgery. Parameters assessed were plaque index, modified gingival index, probing depth, relative attachment level, and location of the gingival margin. A Student's t-test was done for intragroup and a paired t-test for intergroup analysis. RESULTS: Intragroup analysis revealed statistically significant improvement in all the ancillary parameters and soft tissue parameters with no statistically significant difference in intergroup analysis. CONCLUSIONS: The study concluded that a calcium sulphate barrier was comparable to collagen membrane in achieving clinical benefits and hence it can be used as an economical alternative to collagen membrane.