Serum levels of various vitamins in periodontal health and disease- a cross sectional study.

Objectives: Vitamins are micronutrients that are required in small or trace amounts. They play an essential role in the metabolism and maintenance of tissue function. This investigation aimed to assess if a deficiency of certain essential vitamins is a risk factor for developing periodontitis. Methods: The subject population consisted of 100 subjects, 50 with generalized chronic periodontitis and 50 periodontally healthy volunteers. The following clinical parameters were measured: Gingival Index, pocket depth (mm); Clinical Attachment Loss (mm). Serum samples were collected and analyzed for levels of cis-ß-carotene, ß-cryptoxanthin, vitamin B 12, folate, vitamin D, and vitamin E. Individual data collected was summarized and analyzed using statistical software. Results: All the clinical parameters for periodontal status in the periodontitis group compared to healthy volunteers were highly significant (p < 0.0001). The mean levels of all the micronutrients, vitamin A precursors cis-ß-carotene and ß-cryptoxanthin, folate, vitamin B 12, D & E were lower in the periodontitis group than the healthy volunteers, although the difference was statistically significant only in case of ß-cryptoxanthin, Vitamin B12 and Vitamin D (p < 0.05). Conclusions: The findings of our study suggest that serum micronutrient levels especially Vitamin A, Vitamin B 12, and Vitamin D may be modifiable risk factors for periodontal disease. Providing an optimized combination of various vitamins in each meal in combination with sufficient measures of standard oral hygiene care may provide an important role in the prevention of periodontitis.

Gustatory dysfunction and oral ulceration in COVID-19 patients: A cross sectional study.

Background: Over the past year, patients infected by severe acute respiratory syndrome coronavirus-2 presented with severe gustatory dysfunction, the prevalence of which varies among different populations. Furthermore, there have been sporadic reports of oral ulceration observed in coronavirus disease-19 (COVID-19) patients due to varied reasons. The aim of this study was to investigate and characterize the presence of gustatory disorders, oral ulceration, and other oral changes in patients with laboratory-confirmed COVID-19 infection. Materials and Methods: In this cross-sectional observational study, a total of 402 participants who were detected COVID-19 positive by reverse transcription-polymerase chain reaction were included. Their demographic and clinical data were recorded through hospital records. The participants were interviewed either in person or on the telephone to record any change in taste and/or changes within the oral cavity. t-test for independent means was used to compare mean age, while other characteristics were compared by Chi-square test and Z-score test. P < 0.05 was taken as significant. Results: Out of the total sample of 402 individuals, 262 were male and 140 were female. The prevalence of gustatory dysfunction and oral ulceration was 43.53% and 15.67%, respectively, in the studied sample. Significantly more females had gustatory dysfunction than males and older subjects more commonly than younger. The symptom of loss/change of taste and oral ulceration were more probable to occur together. In addition, the tongue was the most common site for ulceration in our studied sample. Conclusion: Loss of taste is a common symptom of COVID-19 patients, whereas oral ulceration is not so commonly reported. However, the presence of both these symptoms could impair the quality of life of patients and hamper adequate nutritional uptake.

Effect of nonsurgical periodontal therapy on gingival crevicular fluid levels of Interleukin-35 in patients with periodontitis.

Objective: Interleukin (IL)-35 is a comparatively novel immunosuppressive cytokine produced by T-regulatory cells, the purpose of which in periodontal well being and disease still eludes the researchers. This study intends to measure and compare the levels of IL-35 in gingival crevicular fluid (GCF) taken from periodontitis patients before and at first, second and third week post non-surgical periodontal therapy. Methodology: ology: Twenty patients having generalized chronic periodontitis (mean age of 36.25 ± 5.12 years) with moderate to severe disease were assessed clinically for the following parameters: plaque index, gingival index, probing pocket depth, and clinical attachment loss. GCF samples were collected from deepest pockets before performing a full mouth non-surgical periodontal therapy. GCF samples were again collected at 1st, 2nd, and 3rd week after non-surgical periodontal therapy and, IL-35 levels in the GCF samples were measured using an ELISA kit. Results: All the clinical parameters improved significantly over time from baseline to 3rd week. The results for plaque index, gingival index, and probing pocket depth were highly significant (p < 0.001) and significant (p < 0.05) for clinical attachment loss. The IL-35 concentration in GCF increased post periodontal therapy from baseline till third week and results were statistically highly significant (p < 0.001). A significant negative correlation (p < 0.001) was found between clinical parameters and IL-35 levels. Conclusions: With the healing of the previously diseased periodontal tissues, the levels of IL-35 in GCF increases significantly. Therefore, IL-35 can be considered as potential inflammatory marker of periodontal health and disease.

Oral health awareness and practices in pregnant females: A hospital-based observational study.

BACKGROUND: The aim of this study was to assess the oral health awareness, methods adopted to maintain hygiene, prevalent myths regarding oral health in pregnancy, and importance of oral health during pregnancy, to help formulate oral health program for pregnant females in partaking hospital. MATERIALS AND METHODS: A total of 225 pregnant females participated in the study. After complete demographic assessment of participants, a questionnaire was provided to them. Questionnaire included simple multiple choice questions on how they maintained oral hygiene, their oral health status, visit to the dentist, and barriers in seeking treatment. This was followed by a questionnaire regarding common myths and understanding of the importance of oral health during pregnancy which had three choices: true, false, and do not know. The results were expressed in percentages, and one sample t-test for percentages was applied where ever required. RESULTS: Majority of participants self-reported some form of oral health problems with bleeding gums as a chief complaint leading the survey. Around half of the participants had never visited a dentist, and an abundant number of pregnant females reported safety concerns for developing the child as a reason for not taking any treatment during pregnancy. A highly significant number of participants were unaware of the importance of oral health during pregnancy and believed in age-old myths. CONCLUSION: The oral health care still remains on the backseat in care provided to pregnant female. A complete overhaul of understanding through individual, family, and community counseling is required to spread awareness.

Antimicrobial Efficacy of Various Essential Oils at Varying Concentrations against Periopathogen Porphyromonas gingivalis.

INTRODUCTION: Porphyromonas gingivalis (P.gingivalis) is a notorious perio-pathogen with the ability to evade host defense mechanism and invade into the periodontal tissues. Many antimicrobial agents have been tested that curb its growth, although these agents tend to produce side effects such as antibiotic resistance and opportunistic infections. Therefore search for naturally occurring anti-microbials with lesser side effects is the need of the hour. AIM: The aim of this study was to substantiate the antimicrobial activity of various essential oils; eucalyptus oil, chamomile oil, tea tree oil and turmeric oil against P. gingivalis. MATERIALS AND METHODS: Pure cultures of P. gingivalis were grown on selective blood agar. Antimicrobial efficacy of various concentrations of essential oils (0%, 25%, 50% and 100%) was assessed via disc diffusion test. Zone of inhibition were measured around disc after 48 hours in millimeters. RESULTS: Zones of inhibition were directly proportional to the concentration of essential oils tested. At 100% concentration all the tested oils possess antimicrobial activity against P.gingivalis with eucalyptus oil being most effective followed by tea tree oil, chamomile oil and turmeric oil. CONCLUSION: All essential oils tested were effective against P.gingivalis. After testing for their clinical safety they could be developed into local agents to prevent and treat periodontitis.

Association of Fc gamma-receptors IIa, IIIa, and IIIb genetic polymorphism with susceptibility to chronic periodontitis in South Indian population.

BACKGROUND AND OBJECTIVE: Fc gamma receptors (FcγRs) are the members of the immunoglobulin superfamily and may play a role in the pathogenesis of periodontitis. Genetic variation in these receptors and its link with various forms of periodontitis is being studied in different populations. The aim of the present study is to determine whether specific FcγRIIa, FcγRIIIa, and FcγRIIIb alleles and/or genotypes are associated with risk for susceptibility to generalized chronic periodontitis (GCP) in South Indian population. MATERIALS AND METHODS: The study population consisted of 120 South Indian subjects; 60 with GCP and 60 periodontally healthy. Deoxyribonucleic acid (DNA) was extracted from samples collected by scrapping buccal epithelium. FcγRIIa and FcγRIIIa genotyping were performed by polymerase chain reaction (PCR) amplification of DNA with allele-specific primers followed by allele-specific restriction digestion of the products. However, FcγRIIIb genotyping was done by allele-specific PCR. RESULTS: No significant difference in the distribution of FcγRIIa H/R and FcγRIIIa NA1/NA2 genotypes or their respective alleles was observed in GCP patients and healthy subjects. For FcγRIIIa F/V genetic polymorphism, the homozygous V/V genotype and V allele were significantly overrepresented in GCP patients while F/F genotype and F allele in controls. CONCLUSION: The present study demonstrates that FcγRIIIa V/V genotype, as well as V allele, could be a possible risk factor for chronic periodontitis in South Indian population.

Genetic polymorphism of Fcγ-receptors IIa, IIIa and IIIb in South Indian patients with generalized aggressive periodontitis.

Recent evidence suggests that polymorphisms in Fcγ receptors are associated with different forms of periodontitis. However, the FcγR genotypes and their allele frequency differ among subjects from different ethnic backgrounds. The aim of the present study was to determine whether specific FcγRIIa, FcγRIIIa, and FcγRIIIb alleles and/or genotypes are associated with susceptibility to generalized aggressive periodontitits (GAgP) in a South Indian population. Buccal scrapings were obtained from 60 subjects with GAgP and 60 periodontally healthy individuals, and DNA was extracted from each of the samples. FcγRIIa and FcγRIIIa genotyping was performed by polymerase chain reaction (PCR) amplification of DNA with allele-specific primers followed by allele-specific restriction digestion of the products, whereas FcγRIIIb genotyping was done by allele-specific PCR. There was no significant difference in the distribution of the FcγRIIa H/R genotype between GAgP patients and healthy subjects, although significant over-representation of the R allele was noted in GAgP patients. With regard to FcγRIIIa F/V genetic polymorphism, the homozygous V/V genotype and V allele were significantly over-represented in the GAgP group, whereas the F/F genotype and F allele were over-represented in the controls. Furthermore, there was significant over-representation of the FcγRIIIb-NA2 allele and NA2/NA2 genotype in GAgP patients, and of the NA1/NA1 genotype and NA1 allele in the controls. These data suggest that the FcγRIIIa V/V genotype and/or V allele, as well as the FcγRIIIb NA2/NA2 and/or NA2 allele, along with the FcγRIIa- R allele, may be risk factors for GAgP in the population of South India.

Toll-like receptors and their dual role in periodontitis: a review.

Innate immunity is the first line of host defense and represents inherited resistance to infection. Innate immunity works through toll-like receptors (TLRs), which recognize the conserved molecular patterns on pathogenic bacteria known as pathogen-associated molecular patterns. The periodontium is a unique environment in which oral microorganisms are in constant contact with the host immune system. The TLRs present on gingival epithelial cells are continuously stimulated, resulting in production of cytokines and defensins that help to maintain oral health. If the epithelial barrier is breached, allowing invasion of bacteria into the underlying connective tissue, the TLRs on other resident and non-resident cells of the periodontium become activated. This leads to an exaggerated release of pro-inflammatory cytokines and other biological mediators, which may cause host tissue destruction. The present review examines the role of TLRs and their signaling in periodontal health and disease.

A rare case report of peri-implant bone necrosis: Mapping the distance of initial peri-implant complication toward a path of success.

In the past decade, science of implant placement has greatly advanced and at the same time much success has been experienced with the endosseous implant. Despite the long-term predictability of the implants, however, biological, technical and esthetic complications do occur. The use of osseointegrated implants as a foundation for prosthetic replacement of missing teeth has been highly predictable, but still at present, there is no consensus of how to best manage the complications occurring after implant placement. In this report, we discuss post-insertion complication of bone necrosis and its successful management.