Comparative analysis of sulfiredoxin and total oxidative stress levels in diabetic individuals with periodontitis: A case-control study.

BACKGROUND: The delicate balance between oxidative stress and its antioxidant system can be disrupted in diabetes mellitus (DM), making the tissue susceptible to injury. Hence, this case-control study aims to estimate and correlate the gingival tissue sulfiredoxin and crevicular total oxidative stress (TOS) levels in generalized periodontitis Stage II individuals Grade C (PSII) with and without type II DM. MATERIAL AND METHODS: A total of 72 individuals were grouped based on their glycosylated hemoglobin (HbA1c) levels and clinical parameters: group I, periodontally healthy non-diabetic (HbA1c < 5.7%) (n = 24); group II, non-diabetic with PSII (n = 24); and group III, diabetic individuals (HbA1c > 6.5%) with PSII (n = 24). Gingival tissues and crevicular fluid samples were collected. The samples with adequate protein concentrations (n = 72) were further estimated for sulfiredoxin and TOS levels by enzyme-linked immunosorbent assay (ELISA) and calorimetric method, respectively. RESULTS: Tissue sulfiredoxin and crevicular TOS levels are increased significantly in the periodontitis group compared to the non-periodontitis group (p < 0.001).The tissue sulfiredoxin levels did not vary significantly between the two periodontitis groups (p < 0.179). The TOS levels are significantly higher in the diabetic compared to non-diabetic periodontitis group (p < 0.001). Correlation statistics showed a significant positive correlation (r = 0.65 and p < 0.005) between sulfiredoxin and TOS levels in diabetes with PSII group, however, no such significant correlation was observed in the non-diabetic PSII group (r = 0.255 and p < 0.422). CONCLUSION: Diabetic individuals showed inadequate sulfiredoxin-mediated antioxidant response to an increase in oxidative stress levels in periodontitis Stage II Grade C individuals.

Does the diabetes status of an individual have effects on mechanical and biologic properties of platelet-rich fibrin? An in vitro comparative evaluation.

OBJECTIVE: Clinical research in the field of regeneration presents challenges for regulating inflammation and speeding up healing and regenerative processes, which are lacking in individuals with diabetes. Platelet-rich fibrin (PRF) has shown promising results in regeneration. Variations in its properties are attributed mainly to the centrifugation method and other parameters. Hence, the present in vitro study on leukocyte-PRF (L-PRF) and advanced-PRF (A-PRF) membranes, with varying protocols amongst diabetes, was conducted. METHOD AND MATERIALS: Sixty-four PRF membranes from 30 individual's venous blood samples (16 nondiabetic and 16 diabetic) were assessed for platelet parameters, tensile strength, strain, and growth factor release. The resulting data were statistically analyzed. RESULTS: The A-PRF membrane had better tensile strength, strain, and growth factor level in comparison with the L-PRF membrane in healthy individuals. Significantly (P < .05) higher strain and growth factor levels in the A-PRF membrane and marginally higher tensile strength in the L-PRF membrane were seen in diabetic individuals. CONCLUSIONS: The nondiabetic A-PRF membrane had better tensile strength, strain, and growth factor release. Well-controlled diabetic individuals had higher growth factor release, suggesting the use of A-PRF membrane as a suitable autogenous regenerative material.

Microorganisms of maternal periodontitis cause adverse pregnancy outcomes in gestational diabetic individuals: a preliminary observational report.

OBJECTIVE: To evaluate the association of Fusobacterium nucleatum and Capnocytophaga species in dental plaque, cord blood, pericrevicular vaginal samples, and adverse pregnancy outcomes in gestational diabetic mellitus (GDM) women with and without periodontitis stage II. METHOD AND MATERIALS: In this prospective cohort study, 415 pregnant women were screened and 60 primigravidae with diagnosis of GDM were recruited. Glycosylated hemoglobin (HbA1c) was recorded at weeks 24, 28, and 32, and at parturition. Subgingival plaque sample, cord blood, and pericrevicular vaginal swab were taken immediately postpartum from both the groups. Identification of F nucelatum and Capnocytophaga species was done using polymerase chain reaction. Adverse pregnancy outcomes such as preterm birth, low birth weight, and macrosomia were prospectively checked in all the recruited individuals. RESULTS: Incidence of adverse pregnancy outcomes was significantly higher in the GDM with periodontitis group (48%) than the nonperiodontitis GDM group (14%) with P < .07. There was a moderate positive correlation (r = 0.429) between Gingival Index and HbA1c and microorganisms in the three samples at parturition. Macrosomia was seen in equal percentages in both groups. CONCLUSION: Concomitant existence of F nucleatum and Capnocytophaga species in all three samples was shown to be associated with increased incidence of adverse pregnancy outcomes in the GDM with periodontitis group. Of the adverse outcomes, preterm birth and low birth weight were more closely related to the periodontitis group than macrosomia.

Influence of antibacterial effects of tetracycline, laser, and photodynamic therapy on cell viability, cell damage, and virulence of Porphyromonas gingivalis.

INTRODUCTION: This study compares and evaluates the efficacy of tetracycline, laser and photodynamic therapy on bacterial counts, cell damage, cell viability and neutralization of gingipains. MATERIAL AND METHODS: P.gingivalis (ATCC 33,277) was cultured anaerobically. The minimal inhibitory concentration (MIC) for 50% inhibition of P.gingivalis by tetracycline, laser, and toluidine blue (TB) was determined using spectrophotometry. The antibacterial effects, cell viability, cell damage and neutralization of gingipains of the treated groups was evaluated by microbial culture and counting, 2,3 Bis 2 Methyloxy-4 Nitro-5 Sulphophenyl 2 H tetrazolium-5-Carboxaanilide (MTT) assay, lactate dehydrogenase (LDH) assay, and gingipain assay (BAPNA). RESULTS: The MIC of tetracycline, toulidine, diode laser (810nmm; 0.5 Watts) is 1 µg/mL, 50 µg/mL and 15 s respectively. Comparative analysis for bacterial colony reduction was highest in tetracycline followed by PDT and then laser group at p < 0.01. MTT assay shows a significantly lesser number of viable cells in the tetracycline and PDT group when compared to laser group p < 0.01. Comparative analysis for cell damage using LDH shows the highest results for PDT followed by tetracycline and laser at p < 0.01. The highest neutralization of the gingipains is seen in the PDT group followed by tetracycline and laser groups at p < 0.01. CONCLUSION: PDT shows highest antibacterial activity, gingipain neutralization, cell damage, and least number of viable cells in comparison with tetracycline and laser.

Does Cigarette Smoking Induce Changes in Biologic and Mechanical Properties of Platelet-Rich Fibrin Membranes?

Smoking has a profound effect on platelet morphology and activation and has also been shown to affect hemostasis, coagulation, and healing cascade. To date, no previous reports are available to assess the impact of cigarette smoke on leukocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) membranes. Therefore, this study aims to analyze the impact of cigarette smoking on the mechanical and biologic properties of L-PRF and A-PRF membranes. Sixty blood samples from both smokers (n = 34) and nonsmokers (n = 26) who were matched for age and other factors were collected and subjected to complete blood count and platelet indices (mean platelet volume, platelet distribution width, platelet large cell ratio, and plateletcrit). The L-PRF membrane (2,700 rpm; 12 minutes) and A-PRF membrane (1,500 rpm; 14 minutes) were prepared using a standard protocol. A total of 64 experimental L-PRF and A-PRF membranes from 16 individuals selected randomly from the two groups were subjected to tensile strength evaluation using a micro universal testing machine and growth factor release analysis (platelet-derived growth factor [PDGF-AB], vascular endothelial growth factor [VEGF], and bone morphogenic protein-2 [BMP-2]) using ELISA (enzyme-linked immune sorbent assay). Results were tabulated, and statistical analysis was done using Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests. Tensile strengths of L-PRF and A-PRF did not show a statistical difference between groups (P = .47). BMP-2 was not detected in any of the groups. A high initial release of PDGF-AB and VEGF was noticed in A-PRF samples from smokers. Although statistically insignificant, cigarette smoking does affect platelet activation and influences the tensile strength of L-PRF membranes as well as growth factor release in A-PRF membranes in smokers.

Evaluation of gingival tissue samples for predicting the time of death using histological and biochemical tests.

Thanatochemistry also known as chemistry of death and is used to determine post mortem interval (PMI). It is arguably one of the critical steps in forensic investigation. Recent addition of analyzing biochemical changes along with the traditional methods have gained importance, as they help us to record very early changes in the tissue specimens. In this view, our study aimed to correlate both histological changes and enzymatic changes in gingival tissue samples at intervals of immediate, 1 h, 5 h, 24 h and 48 h after death. Histologic changes noted were loss of epithelial architecture, chromatin clumping, nuclear vacuolation, karryopyknosis, eosinophilia and wide intercellular junctions. Two enzymes which differentiate between the autolytic phase (acid phosphatase) and putrefactive phase (ammonia) of decomposition were evaluated using UV spectrometer. Results in our study demonstrated there were variations as in gradual increase in ammonia levels (1.13±0.24-26.6±2.09) and gradual decrease in acid phosphatase levels (5.61±0.67-1.25±0.53) at different time intervals till 48 h. The cellular changes in gingival tissue could also be related to time. The result of our study helps us to identify potential of enzymatic changes which when correlated with histological reports helps us to predict the time of death accurately. Replicating this experiment in various known taphonomic conditions and other enzymes could highlight the usefulness of gingival tissue samples in determining time of death.

Utility of procalcitonin as an early diagnostic marker of bacteremia in individuals with periodontitis Stage II and III.

BACKGROUND: The aim of the present study is to assess the ability of procalcitonin (PCT) to differentiate between periodontal health and Stage II and III periodontitis. We further assessed, if PCT can reflect early bacteremia induced by non-surgical periodontal treatment (NSPT). METHODS: Sixty-four systemically healthy individuals were divided into Group I, periodontally healthy, and Group II, Stage II and III periodontitis. NSPT was done for both the groups. Standardized serum and salivary samples were obtained and analyzed for PCT levels using highly sensitive double antibody sandwich enzyme-linked immunosorbent assay at baseline and 2 weeks. In addition, the serum levels of PCT were recorded at immediate and 1-hour post-NSPT. RESULTS: Mean PCT levels (saliva = 0.03 ng/mL and serum = 0.05 ng/mL) in periodontally healthy group were considerably lower than that in the periodontitis group (saliva = 0.22 ng/mL and serum = 1.85 ng/mL) with significant intergroup comparison at P < 0.001. Post NSPT the mean serum PCT values increased from 1.854 ng/mL to 1.871 ng/mL at the immediate interval and remained at 0.879 ng/mL after 2 weeks at P < 0.001. Spearman correlation showed highly significant positive correlation between serum and salivary PCT values to clinical attachment level (CAL) at P < 0.001 and rho = 0.78 and 0.75, respectively. Linear regression model showed serum PCT to be a significant predictor for CAL. CONCLUSION: Screening for serum PCT levels in patients with periodontitis could act not only as a guide to assess the bacterial load and use of antibiotics but also as a predictor for CAL loss in patients with periodontitis.

Effect of Cigarette Smoking on Morphologic Characteristics of Two Different Platelet-Rich Fibrin Membranes: A Scanning Electron Microscopic Study.

PURPOSE: Platelet concentrates are used for regenerative periodontal and implant therapy. Up to now, no study has reported the influence of smoking on platelet-rich fibrin membranes. Hence, this cross-sectional in vitro study aimed to analyze the influence of cigarette smoking on platelet morphology and fiber characteristics of both leukocyte- and platelet-rich fibrin and advanced platelet-rich fibrin membranes. MATERIALS AND METHODS: Sixty blood samples from both smokers (n = 34) and nonsmokers (n = 26) based on power analysis were collected and subjected for complete blood count and platelet morphology indices (mean platelet volume, platelet distribution width, platelet-large cell ratio, and plateletcrit). Leukocyte- and platelet-rich fibrin membrane (2,700 revolutions per minute for 12 minutes) and advanced platelet-rich fibrin membrane (1,500 revolutions per minute for 14 minutes) were prepared using a standard protocol. Thirty-two platelet-rich fibrin membranes from 16 individuals were selected randomly from the two groups and were subjected to morphologic examination using a scanning electron microscope. RESULTS: Both of the groups were matched for age. Red cell counts and white cell counts showed no statistical difference between the groups. Platelet indices of smokers did show slightly higher values than the nonsmoking group. Scanning electron microscopic analysis showed variations in the fiber width and pattern among smokers in both the leukocyte- and platelet-rich fibrin and advanced platelet-rich fibrin membranes. Platelet cell morphology of the smoking group demonstrated spiky architecture, suggesting an active state, while in the nonsmoking group, the platelet cells were seen in clusters, suggesting a resting state. CONCLUSION: Scanning electron microscopic results show that long-term cigarette smoking does affect the thickness and arrangement of fiber architecture in both leukocyte- and platelet-rich fibrin and advanced platelet-rich fibrin membranes and also could have an impact on activation of platelets.

Microbial contamination and plaque scores of nanogold-coated toothbrush.

OBJECTIVE: The study aimed to evaluate the microbial contamination and plaque scores of nanogold-coated and uncoated toothbrushes. METHODS: This study was designed as a single-centre, parallel, examiner-blinded, randomized, two-group clinical trial. Eighty-four participants were enrolled and randomly assigned to receive either a nanogold or uncoated toothbrush. Basic periodontal therapy was performed for all the recruited subjects, and plaque scores of zero were considered baseline values. All participants were instructed to follow a twice-daily brushing regimen without dentifrice and to refrain from other oral hygiene care during the one-week study period. Plaque levels were assessed after one week using the Turesky modification of the Quigley-Hein Plaque Index (TMQHPI). The bristles were tested for microbial contamination by viable cell counting. The recorded data were statistically analysed, and a P-value of <.05 was accepted as statistically significant. RESULTS: After one week of brushing without using toothpaste, the mean plaque index scores were 0.37 ± 0.07 in the nanogold group and 0.58 ± 0.10 in the uncoated group. A significant difference in the mean plaque scores was observed between the groups (P < .001). The mean colony-forming unit (CFU) was 21 ± 48.8 for the nanogold-coated group and 100 ± 128.4 for the uncoated group. The difference in the mean CFUs observed between the groups was significant (P = .014). CONCLUSION: The use of a nanogold-coated toothbrush demonstrated significantly lower bristle contamination and lower plaque scores after one week compared with uncoated toothbrushes without using dentifrice.

Impact of well-controlled type 2 diabetes mellitus on implant stability and bone biomarkers.

PURPOSE: To evaluate initial implant stability and initial healing around newly placed dental implants in well-controlled type 2 diabetes patients. MATERIALS AND METHODS: Forty patients requiring implant therapy comprising 15 nondiabetic and 25 diabetic patients were recruited for this prospective study. Implant stability quotient and bone biomarkers such as osteopontin, receptor activator of nuclear factor-kB ligand, and interleukin 8 were evaluated at baseline and 1 and 3 months using Osstell Mentor and enzyme-linked immunosorbent assay, respectively. RESULTS: Mean implant stability quotient values showed a statistically significant difference at each interval in both of the groups except between 1 and 3 months in the diabetic group. The percentage increase in implant stability quotient values was more in the nondiabetic (14.2%) than in the diabetic group (6.03%) from 1 to 3 months. Significant variations were observed in all three bone biomarkers between baseline and 3 months at P < .002 in both groups. In the diabetic group, receptor activator of nuclear factor-kB ligand showed a higher reduction from baseline to 3 months, whereas interleukin 8 showed a less significant decrease between baseline and 1 month. Changes in correlation between implant stability and bone biomarkers were noted in the initial period of healing between the two groups. CONCLUSION: Variations in the pattern of response of osteopontin, receptor activator of nuclear factor-kB ligand, interleukin 8, and initial implant stability are noted in well-controlled diabetic individuals.