Effect of non surgical periodontal therapy and vitamin C supplementation on total antioxidant capacity in patients with chronic generalised periodontitis - A randomised controlled trial.

Background: Periodontal inflammation are inflammation of supporting tissues of periodontium. The microbial factor can cause infection which is polymicrobial in origin and causes dysbiosis and shift in oxidative stress with compromised antioxidant capacity. This study focused at determination of the effect of nonsurgical periodontal therapy (NSPT) and vitamin C supplementation on total antioxidant capacity (TAOC) in chronic periodontitis patients (ChP). Material & method: A total of 70 ChPand 35 periodontally healthy subjects (control) were recruited in this study. Further, ChP group was subdivided into ChP1 group (n = 35) which received NSPT only and ChP 2 group (n = 35) which received NSPT with vitamin C 500 mg once daily for 3 months. Serum and saliva samples were taken at baseline and at 3 months postNSPT for measurement of TAOC. Clinical parameters measured were measured at 1-, 3-, 6- and 12-month interval. Results: Lower levels of serum and salivary TAOC levels were observed in ChP patients than healthy subjects (p < 0.05). Improvement in Clinical parameters was observed in both the groups ChP1 and ChP 2 group post therapy (p < 0.05). The periodontal treatment showed insignificant changes in serum and salivary TAOC levels (p > 0.05). The supplemental dose of vitamin C didn't have any additional benefits (p > 0.05). Conclusion: There lies an association of oxidative stress with periodontitis, low serum and salivary TAOC levels were seen in chronic periodontitis patients. NSPT improved the periodontal inflammatory status. However, benefits of vitamin C as an adjunct to NSPT remains inconclusive and needs to be further explored by multicentre longitudinal studies.

Prevalence of suicidal behavior in adolescents in India: A systematic review and meta-analysis.

BACKGROUND: Suicidal behaviour (SB) in adolescents is an emerging public health issue globally. The present study was undertaken to estimate the overall prevalence of SB among the adolescents (10-19 years of age) in India. DATA SOURCES: In this systematic review and meta-analysis (SRMA), an extensive literature search in PubMed, Scopus, EBSCO, Web of Science, ProQuest, Embase, Cochrane, and preprint servers (medRxiv, arXiv, bioRxiv, BioRN, ChiRxiv, ChiRN, and SSRN) and assessment of all published articles until 28th February 2023 as per the PROSPERO registration protocol (CRD42023385550), was undertaken. STUDY SELECTION, DATA EXTRACTION, AND SYNTHESIS: Studies from India which reported the prevalence of suicidal ideation, suicide attempt, and suicidal plan were included. The quality of the included studies was assessed by risk of bias assessment tool. R version 4.2 was used to conduct all the relevant analyses. Heterogeneity was assessed, and a random effects model for estimating the pooled prevalence of the outcomes was applied. Subgroup analyses were planned based on region, locality (urban/rural) and the study settings (educational institutions/community-based). A meta-regression to analyze the effects of potential moderators on outcomes was done. Sensitivity analyses were planned based on the removal of outliers and poor-quality studies. Publication bias was tested by Doi plot and LFK index. MAIN OUTCOMES: Pooled prevalence of suicide attempts, suicide ideations and suicide plans RESULTS: A total of 20 studies were identified as eligible for the systematic review, and 19 studies were identified as eligible for the meta-analysis. The pooled prevalence of suicidal ideation was estimated to be 11% (95 % CI 7-15); heterogeneity between the studies was high (I2 98 %, p < 0.01). The pooled prevalence of suicidal attempts and suicidal plan was estimated to be 3 % each (95 % CI 2-5); with heterogeneity being high (I2 96 %, p < 0.01). Subgroup analysis revealed a significant variation in suicidal ideation and attempts between different regions of India (South > East > North), and higher prevalence among the educational-institute-based settings and urban areas. CONCLUSION: Overall, the prevalence of suicidal behavior among the adolescents in India is high, and they experience all types of suicidal behavior (ideations, plans and attempts).

Comparison of Chlorhexidine and Hydrogen Peroxide as Preprocedural Mouthrinse during Ultrasonic Scaling: A Triple-Blinded Randomized Controlled Clinical Trial.

Background: Every year, around 2 million people suffer from hospital-acquired infections worldwide. Aerosols are produced while performing ultrasonic scaling. They are potential source of infection and cross contamination. It can result in spread of several infections including hepatitis, HIV, SARS CoV 2, etc. Preprocedural rinse before scaling is considered an effective measure to reduce the microbial load in aerosols. Materials and Methods: This study was a triple-blinded randomized controlled trial performed on 90 participants diagnosed with chronic periodontitis. Random allocation of participants into three groups, i.e., Group-1, Group-2, and Group-3, was done, wherein 0.12% chlorhexidine (CHX), 1.5% hydrogen peroxide (HP), and distilled water (DW) were used, respectively, as preprocedural mouthrinse. The participants of each group were instructed to perform mouthrinse for 60 s before the start of ultrasonic scaling sessions. Blood agar plates were kept at three locations, i.e., operator's chest area, patient's chest area, and assistant's chest area for aerosol collection after scaling. Colony-forming units (CFUs) were counted for microbiological analysis. Results: Least number of CFUs was found in the CHX group, followed by HP and DW groups. Location wise, the patient's chest area had the highest CFU count and the least was at the assistant's chest area. CFU count between the groups was statistically significant. Conclusion: Preprocedural rinse using HP can effectively be used as a method to reduce dental aerosols generated during ultrasonic scaling.

Role of nonsurgical periodontal therapy on leptin levels and total antioxidant capacity in chronic generalised periodontitis patients - A clinical trial.

INTRODUCTION: Periodontitis causes oxidative stress and reduce total antioxidant levels. The aim of this study was to determine the effect of non-surgical periodontal treatment on leptin levels and total antioxidant capacity in chronic periodontitis. MATERIALS AND METHODS: A total of 35 chronic periodontitis (ChP) patients and 35 systemically and periodontal healthy subjects were enrolled in this study. Further, the ChP group received nonsurgical periodontal therapy (NSPT). Leptin and total antioxidant capacity (TAOC) was measured in serum and saliva samples at baseline, 3 months and 6 months after non-surgical periodontal therapy. Clinical parameters measured were measured at baseline, 1, 3 and 6 months interval. RESULTS: The mean serum leptin and TAOC levels in control group were significantly higher compared to chronic periodontitis group (p < 0.05). The control group had lower mean salivary leptin levels and higher mean salivary TAOC levels as compared to periodontitis group(p < 0.05). Clinical parameters were improved in ChP group post therapy (p < 0.05). However, the periodontal treatment showed insignificant changes in serum and salivary leptin and TAOC levels. CONCLUSION: Chronic periodontitis is significantly associated with serum and salivary TAOC and leptin levels. Non surgical periodontal therapy didn't alter the local and systemic TAOC and leptin levels.

Efficacy of Preprocedural Boric Acid Mouthrinse in Reducing Viable Bacteria in Dental Aerosols Produced during Ultrasonic Scaling.

INTRODUCTION: Aerosols and droplets contaminated with bacteria and blood are produced during ultrasonic scaling. Measures to control aerosol contamination in dental clinics are recommended by the Centers for Disease Control and Prevention. This study aimed to evaluate the efficacy of preprocedural boric acid (BA) mouthrinse in reducing bacterial contamination in dental aerosols generated during ultrasonic scaling. MATERIALS AND METHODS: This was a randomised clinical trial in 90 systemically healthy subjects (25-55 yrs) diagnosed with chronic periodontitis who were allocated into three groups of 30 subjects each to receive, Group A - 0.12% chlorhexidine (CHX), Group B - 0.75% BA and Group C-water, as a preprocedural rinse for 1 min. The aerosol generated while performing ultrasonic scaling for 30 min was collected at three locations on blood agar plates. Incubation of the blood agar plates at 37°C for next 48 h for aerobic culture was performed and subsequently colony-forming units (CFUs) were counted. RESULTS: CFUs in Group A were significantly reduced compared with Group B (P < 0.001). When we compare CFUs in all the three groups, CFUs in Groups A and B were statistically significantly reduced compared with Group C (P < 0.001). Furthermore, it was also observed that the assistant's chest area had lowest CFUs whereas patient's chest area had highest. CONCLUSION: This study recommends routine use of preprocedural mouthrinse as a measure to reduce bacterial aerosols generated during ultrasonic scaling and that 0.12% CHX gluconate is more effective than 0.75% BA mouthwash in reducing CFUs count.

Evaluation of Anti-plaque and Anti-inflammatory Effects of Oral Curcumin Gel as Adjunct to Scaling and Root Planing: A Clinical Study.

CONTEXT: The adverse effects associated with traditional adjunctive chemical agents in the management of gingivitis has stimulated research into search for alternate molecules including herbal products. Aims-To compare the effects of oral curcumin gel as an adjunct to scaling and root planing (SRP) with the effects achieved by SRP alone by assessing their effects on plaque, gingival inflammation and gingival bleeding. MATERIALS AND METHODS: Sixty patients in the age group of 20-60 years were recruited employing inclusion and exclusion criteria. Study population was randomly divided into two groups. Group A-test group was instructed to use twice daily the experimental curcumin gel after initial SRP. Group B-control group received only SRP. Parameters recorded were plaque index (PI), gingival index (GI) and sulcus bleeding index (SBI) on day 0 (baseline), days 7, 14, and 21 along with subjective assessment of any reported untoward side effect. Data was analyzed statistically. RESULTS: The PI, GI and SBI decreased in both the test group and control group from day 0 to day 21 consecutively. Intergroup comparison shows that all the parameters were statistically significant in Group A (P < 0.001) as compared to Group B. CONCLUSION: Curcumin gel has significant antiplaque and anti-inflammatory effect in the treatment of gingivitis and can be effectively employed as an adjunct to SRP.

Influence of a Low-Carbohydrate and Rich in Omega-3 Fatty Acids, Ascorbic Acid, Antioxidants, and Fiber Diet on Clinical Outcomes in Patients with Chronic Gingivitis: A Randomized Controlled Trial.

BACKGROUND: Nutrition has a significant impact on the pathophysiology of periodontal disease. Both micro- and macronutrients have an impact on periodontal health. This study aimed at the evaluation of the effects of a diet low in carbohydrate and rich in omega-3 fatty acids, ascorbic acid, antioxidants, and fiber on clinical outcomes in patients with gingival inflammation for four weeks. MATERIALS AND METHODS: Overall, 54 systemically healthy subjects were enrolled in this study. The clinical trial consisted of two groups: Group A (test group) (n = 27) was instructed to consume a diet comprising low carbohydrates, rich in omega-3 fatty acids, ascorbic acid, antioxidants, and fibers for the next four weeks; in Group B (control group) (n = 27), no alteration in dietary behavior was done, and these subjects were instructed to have their daily routine diet. Clinical parameters measured were plaque index (PI), gingival bleeding index (GI), probing depths (PD), clinical attachment level (CAL), and bleeding on probing (BOP) at one week without any dietary changes (baseline) for both the groups, followed by a one-week adaptation period; then, the parameters were checked on a weekly basis for the next four weeks. RESULTS: Primary clinical outcome BOP and secondary outcome GI showed significant changes in the test group compared with the control group (P < 0.05). However, no significant changes were seen in the plaque scores in the test group (P > 0.05). The degree of diet compliance on the clinical parameters (PI, GI, and BOP) was assessed by using regression analysis. CONCLUSION: Dietary recommendations can be beneficial in managing gingival and periodontal inflammation. Nutritional interventional studies as monotherapy are required to evaluate the clinical significance of diet in periodontal therapy.

Periosteal pedicle graft with coronally advanced flap and its comparison with modified coronally advanced flap in the treatment of multiple adjacent gingival recessions-a randomized clinical trial.

The present study aimed at evaluating clinical utility of periosteal pedicle graft with coronally advanced flap (PPG â€‹+ â€‹CAF) vs modified coronally advanced flap (M-CAF) in cases of multiple adjacent gingival recessions involving maxillary and mandibular anteriors labially. Random allocation of 40 patients with 269 gingival recessions was done into two groups. In Test group (20 patients) periosteal pedicle graft followed by coronally advanced flap (PPG â€‹+ â€‹CAF) technique was performed and in control group (20 patients) modified coronally advanced flap (M-CAF) was attempted. Primary outcome measures included percentage root coverage (PRC), gingival thickness (GT), probing depth (PD), clinical attachment level (CAL), recession depth (RD) and width of keratinized gingiva (WKG). Secondary outcomes measures were patient centred outcomes, plaque index (PI) and gingival index (GI). Patients were recalled at baseline, 3,6 and 18 months postoperatively. RESULTS: There was a significant decrease in the mean recession depth from 3.58 â€‹± â€‹0.53 â€‹mm (baseline) to 0.22 â€‹± â€‹0.01 â€‹mm (18 months) in PPG â€‹+ â€‹CAF test group and 3.7 â€‹± â€‹0.56 â€‹mm (baseline) to 0.21 â€‹± â€‹0.01 mm (18 months) in M-CAF control group. With 85% root coverage in test group and 78% root coverage in control group, the difference was statistically significant at 18 months. The test group showed significant higher clinical attachment level gain and increase in width of keratinized gingiva as compared to control group. CONCLUSION: In both the study groups PPG â€‹+ â€‹CAF and M-CAF, significant root coverage was achieved. However, in terms of increase in width of keratinized gingiva, gingival thickness and percentage root coverage, PPG â€‹+ â€‹CAF group presented significantly better results than M-CAF group at 18 months follow up. Thus, periosteum can be used as a pedicle graft along with coronally advanced flap as an alternative method in achieving better results with minimal cost.