Evaluating the Efficacy of Platelet-Rich Fibrin Matrix versus Subepithelial Connective Tissue Grafts in Dental Root Coverage: A Comparative Study Using Modified Ruben's Technique.

BACKGROUND Dental root coverage, crucial in managing gingival recessions, traditionally utilizes subepithelial connective tissue grafts. However, this approach has limitations such as donor site morbidity and graft availability. Recent studies have introduced platelet-rich fibrin (PRF) as an alternative, leveraging its regenerative potential and growth factors. Despite the promise, comparative assessments between PRF and conventional grafts remain limited. This research probes whether PRF, when used beneath a modified Ruben's mixed flap, could provide comparable or superior dental root coverage than a subepithelial connective tissue graft. MATERIAL AND METHODS We enrolled 30 patients exhibiting Miller's class I and II recession in this comparative case series. Patients were randomly assigned to receive either a connective tissue graft (15 patients) or a PRF matrix (15 patients), both covered by a modified Ruben's mixed flap. RESULTS Clinical parameters, including full mouth plaque scores, bleeding scores, probing sulcus depth, clinical attachment level, gingival position assessment, width, and thickness of attached gingiva, were assessed in both the control and test groups at baseline, 6 months, and 12 months post-surgery. Significant differences were observed at all intervals.At the 12-month mark, the control group (connective tissue graft) achieved 91% complete root coverage, while the test group (PRF matrix) achieved 86%. However, this difference was not statistically significant. CONCLUSIONS The study outcomes suggest comparable gains in root coverage and attached gingiva between the connective tissue graft and PRF matrix groups. Thus, the results support our hypothesis that a subepithelial PRF matrix can serve as a viable alternative to a subepithelial connective tissue graft for treating dental root coverage.

Potential Uses of Adhatoda Vasica in Orthodontics.

Plaque control, pain control, and modulation of inflammatory mediators to accelerate or stabilize tooth movements are hot issues in orthodontics. The recent advent of phytochemicals as biological mediators has opened new vistas in the aforementioned areas of orthodontics. Adhatoda vasica has caught the attention of investigators due to multiple properties related to orthodontics. This study addresses the potential areas of use of A. vasica in orthodontics, which provide ideas for further investigations. A. vasica possesses antibacterial activity, antifungal activity, anti-oxidant effect, anti-inflammatory activity, analgesic effect, osteogenic, and osteoclastic activities. A. vasica has huge potential in orthodontics, whereas all these vistas need careful and methodical testing before use in clinical orthodontics. In the future, investigators can focus on these aspects of the use of A. vasica to develop products.

Estimation of GCF and Salivary Levels of NT-proBNP in Systemically Healthy Subjects with Severe Chronic Periodontitis Before and After Periodontal Flap Surgery.

Purpose: The aim of the study was to estimate and compare the Saliva and GCF levels of NT-proBNP in systemically healthy subjects with severe chronic periodontitis before and after periodontal flap surgery. Materials and Methods: Twenty subjects were selected and divided into two groups based on inclusion and exclusion criteria. Healthy Controls: 10 periodontally and systemically healthy subjects. Presurgery Group: 10 systemically healthy subjects with severe chronic generalized periodontitis. Postsurgery Group included Presurgery Group subjects who will undergo periodontal flap surgery. After the periodontal parameters were measured, GCF and saliva samples were collected. Postsurgery Group subjects underwent periodontal flap surgery and both periodontal parameters and GCF and saliva levels were reassessed after 6 months. Results: Presurgery Group showed a higher mean value of plaque index, modified gingival index, probing pocket depth and clinical attachment level when compared to Healthy Controls and it was found to decrease after periodontal flap surgery (Postsurgery Group). Intergroup comparison (Presurgery Group vs Postsurgery Group) of the mean difference of salivary NT-proBNP was found to be statistically significant. GCF levels of NT-proBNP also decreased after periodontal flap surgery but the difference was not statistically significant. Conclusion: NT pro-BNP levels were found to be higher in periodontitis group as compared to the controls. The levels decreased following surgical periodontal therapy, elucidating the role of periodontal treatment on the expression of NT-proBNP as a salivary and GCF marker. NT-proBNP could serve as a potential biomarker for periodontitis in saliva and GCF in future.

Anticancer Effects of Carica papaya L. and Benzyl Isothiocyanate on an Oral Squamous Cell Carcinoma Cell Line: An In Vitro Study.

AIM: The study aimed to assess the anticancer effects of leaves of the male and female plant and seeds Carica papaya L. extract and the active compound benzyl isothiocyanate on oral squamous cell carcinoma (OSCC) cell line. MATERIALS AND METHODS: Extracts of CO2 strain C. papaya L. seeds were prepared using water, ethanol, and ethanol:water by maceration, and benzyl isothiocyanate was quantified. Alkaloid fractions of leaves of male and female plants of C. papaya L. were prepared and quantified. The anticancer effects of the test substances on the SCC-25 cell line were assessed by MTT, apoptosis assay, cell cycle analysis, and determination of mitochondrial membrane potential. RESULTS: The ethanol:water extract of C. papaya L. (seeds) demonstrated the highest quantity of benzyl isothiocyanate. Male plant leaves demonstrated greater alkaloid content. The leaves of the male plant exhibited apoptosis induction and S-phase arrest, whereas the leaves of the female plant and seeds of C. papaya L. demonstrated G2M-phase arrest and apoptosis induction. CONCLUSION: C. papaya L. and benzyl isothiocyanate demonstrated anticancer effects. There was a difference in the anticancer effects of leaves of male and female plants of C. papaya L. CLINICAL SIGNIFICANCE: The anticancer effects of papaya leaves and seeds could be further explored to develop an adjunct therapy for oral cancer to improve prognosis and reduce recurrence rates.

Antimicrobial Efficacy of Silver Nanoparticles as Root Canal Irrigant's: A Systematic Review.

Removal of microbes is imperative during endodontic therapy. Due to their antimicrobial property, silver nanoparticles have been used for endodontic irrigation of the root canals. The objective of the present study was to provide a qualitative analysis of the published literature assessing silver nanoparticles as root canal irrigants. A search of PubMed, SCOPUS, Web of Science, and Embase databases was done without any time restriction. Articles published in English were included. Data were extracted and the risk of bias was assessed. Of the 154 studies identified, after screening according to the inclusion criteria, five in vitro studies were included. The results indicate that silver nanoparticles have an anti-microbial effect to varying degrees depending on certain factors. Within the limitations of the present studies that have a moderate to low risk of bias, an antimicrobial effect of silver nanoparticles is observed. Silver nanoparticles have the potential to be used as endodontic irrigants, although their efficacy depends on particle size and the duration of contact which require further investigation.

Immunohistochemical Localization of Epithelial Mesenchymal Transition Markers in Cyclosporine A Induced Gingival Overgrowth.

INTRODUCTION: Cyclosporine, an immunosuppressive agent used in the management of renal transplant patients is known to produce Drug Induced Gingival Overgrowth (DIGO) as a side effect. Several mechanisms have been elucidated to understand the pathogenesis of DIGO. Recently, epithelial mesenchymal transition has been proposed as a mechanism underlying fibrosis of various organs. AIM: The aim of the study was to investigate if Epithelial Mesenchymal Transition (EMT) operates in Cyclosporine induced gingival overgrowth. MATERIALS AND METHODS: The study involved obtaining gingival tissue samples from healthy individuals (n=17) and subjects who exhibited cyclosporine induced gingival overgrowth (n=18). Presence and distribution of E-Cadherin, S100 A4 and alpha smooth muscle actin (α-SMA) was assessed using immunohistochemistry and cell types involved in their expression were determined. The number of α- SMA positive fibroblasts were counted in the samples. RESULTS: In control group, there was no loss of E-Cadherin and a pronounced staining was seen in the all layers of the epithelium in all the samples analysed (100%). S100 A4 staining was noted in langerhans cells, fibroblasts, endothelial cells and endothelial lined blood capillaries in Connective Tissue (CT) of all the samples (100%) while α - SMA staining was seen only on the endothelial lined blood capillaries in all the samples (100%). However in DIGO, there was positive staining of E-Cadherin only in the basal and suprabasal layers of the epithelium in all the samples (100%). Moreover there was focal loss of E-Cadherin in the epithelium in eight out of 18 samples (44%). A break in the continuity of the basement membrane was noted in three out of 18 samples (16%) on H & E staining. CONCLUSION: Based on the analysis of differential staining of the markers, it can be concluded that EMT could be one of the mechanistic pathways underlying the pathogenesis of DIGO.

Immunolocalization of Ki-67 in different periodontal conditions.

BACKGROUND: Ki-67 which is a non-histone nuclear protein which is expressed in proliferating cells, during all the active phases of the cell cycle. Increased Ki-67 expression has been seen in several inflammatory and malignant conditions like diabetes, rheumatoid arthritis, atherosclerosis, pancreatitis and squamous cell carcinoma. AIM: The aim of the present study is to analyze the expression of Ki-67 in gingival tissues by immunohistochemistry in smokers and non-smokers with healthy gingiva and chronic periodontitis. MATERIALS AND METHODS: Gingival biopsies (n = 32) were obtained from smokers who had clinically healthy gingiva (n = 8), smokers with periodontitis (n = 8), chronic periodontitis (n = 8) and healthy gingiva (n = 8). The expression of Ki-67 was evaluated immunohistochemically. STATISTICAL ANALYSIS USED: Mean and standard deviation were estimated for the gingival tissue extract sample for each study group. Mean values were compared between different study groups by, one way ANOVA, post hoc analysis. In this study P < 0.05 was considered as the level of significance. RESULTS: The mean number of Ki-67 positive cells/field was higher in the smokers with periodontitis group. When the mean Ki-67 positive cells were compared between different groups, statistical significant difference was observed between healthy and both the periodontitis groups (P = 0.000) and between smokers group (P = 0.001). CONCLUSIONS: Ki-67 was maximally expressed in smoker with periodontitis followed by chronic periodontitis patients, healthy smokers and healthy control patients which shed light on the toxic effects of tobacco in dysregulating the cell cycle and cellular proliferation. The findings of this study also help us to understand the role of the cell cycle in resolution of periodontal inflammation which is a salient feature in the pathogenesis of chronic periodontitis.