Association between metabolic syndrome and salivary MMP-8, myeloperoxidase in periodontitis.

OBJECTIVE: This study investigated the effect of metabolic syndrome (MetS) on periodontal clinical parameters and salivary biomarkers' matrix metalloproteinase-8 (MMP-8) and myeloperoxidase (MPO) in patients with periodontitis. METHODS: A total of 120 participants aged 25-55 were categorized into three groups: MetS with periodontitis (n = 40); systemically healthy with periodontitis (n = 40); and systemically and periodontally healthy controls (n = 40). Data collected included systemic parameters like waist circumference (WC), blood pressure (BP), high- and low-density lipoproteins, triglycerides (TG), fasting blood sugar (FBS), and glycated hemoglobin (HbA1c). Periodontal parameters estimated included bleeding on probing score (BoP), full-mouth plaque score (FMPS), periodontal probing depth (PPD), clinical attachment loss (CAL), and the number of missing teeth. Unstimulated whole saliva was analyzed via ELISA for active MMP-8 (aMMP-8), total MMP-8 (tMMP-8), and MPO. RESULTS: Participants with MetS and periodontitis exhibited significantly higher periodontal parameters, salivary aMMP-8, and MPO (26.26 vs. 24.1 ng/mL and 13.53 vs. 11.55 ng/mL compared to systemically healthy periodontitis patients) (all p < 0.01). Positive correlations occurred between aMMP-8 and WC, TG, and FBS (p < 0.01), and between MPO and WC, BP, and TG (p < 0.01). CONCLUSIONS: The positive associations between these biomarkers and metabolic parameters indicate their potential utility for monitoring cardiovascular and glycemic risk in patients with periodontal disease.

Knowledge of the monkeypox 2022 outbreak among dental hygienists and students in Saudi Arabia: A cross-sectional study.

OBJECTIVE: This study aimed to assess the knowledge of monkeypox infection among dental hygiene professionals and students in Saudi Arabia. METHODS: A cross-sectional study was conducted among a convenience sample of dental hygiene professionals (n = 259). The questionnaire was developed based on previous literature, and descriptive analysis and a Chi-square test were performed. RESULTS: A total of 159 dental hygienists responded to the questionnaire. Results indicated that only 1.7% had good knowledge, 7.7% had moderate knowledge and 90.6% had low knowledge of the monkeypox outbreak. The mean knowledge scores varied among dental hygiene students, practitioners and faculty members. Significant group differences were observed for some questions (p < 0.05). CONCLUSION: Our study concludes that dental hygienists had moderate to low level of knowledge of the monkeypox infection and its implications for oral health and patient care, indicating a need for more education on the subject.

Gymnemic acid-conjugated gelatin scaffold for enhanced bone regeneration: A novel insight to tissue engineering.

Bone tissue engineering deals with the design of bone scaffolds. The selection of porous scaffold for osteoblast attachment and suppression of microbial infections are the major challenges that were addressed by designing gelatin scaffolds conjugated with gymnemic acid. Gelatin scaffold was prepared by loading gymnemic acid and morphological characterization, porosity, water absorption behavior, and biocompatibility of the scaffold were studied. The scaffold was introduced to the rat calvarial bone defect (BD) and analyzed the serum C reactive protein, alkaline phosphatase activity, and histology for 1 month to study the reconstruction. Adult Sprague-Dawley rats were used as sham operated control, animal with BD, and animal with BD which was implanted with scaffold (BDMB). The scanning electron micrograph revealed porous nature of scaffold. There was no significant difference in water absorption ability of scaffold. The C reactive protein was not observed in the serum collected on the 5th day postsurgery, supported the biocompatibility. The alkaline phosphatase activity in BDMB was increased when compared with BD on 15th and 20th day and then decreased. New bone tissue formation was detected with hematoxylin-eosin staining. The scaffold is effective in enhancing bone regeneration, which will have therapeutic significance in orthopedics and dentistry.

The Design of 3D-Printed Polylactic Acid-Bioglass Composite Scaffold: A Potential Implant Material for Bone Tissue Engineering.

Bio-based and patient-specific three-dimensional (3D) scaffolds can present next generation strategies for bone tissue engineering (BTE) to treat critical bone size defects. In the present study, a composite filament of poly lactic acid (PLA) and 45S5 bioglass (BG) were used to 3D print scaffolds intended for bone tissue regeneration. The thermally induced phase separation (TIPS) technique was used to produce composite spheres that were extruded into a continuous filament to 3D print a variety of composite scaffolds. These scaffolds were analyzed for their macro- and microstructures, mechanical properties, in vitro cytotoxicity and in vivo biocompatibility. The results show that the BG particles were homogeneously distributed within the PLA matrix and contributed to an 80% increase in the mechanical strength of the scaffolds. The in vitro cytotoxicity analysis of PLA-BG scaffolds using L929 mouse fibroblast cells confirmed their biocompatibility. During the in vivo studies, the population of the cells showed an elevated level of macrophages and active fibroblasts that are involved in collagen extracellular matrix synthesis. This study demonstrates successful processing of PLA-BG 3D-printed composite scaffolds and their potential as an implant material with a tunable pore structure and mechanical properties for regenerative bone tissue engineering.

Chitosan bioactive glass scaffolds for in vivo subcutaneous implantation, toxicity assessment, and diabetic wound healing upon animal model.

This study aims to develop chitosan-bioactive glass (BG) scaffolds for diabetic wound healing, toxicity valuation, and subcutaneous implantation in animals for biocompatibility assessment. The scaffolds were prepared by lyophilization technique. In specific BG without sodium (Na), composited with chitosan for better biological activities. The equipped scaffolds were studied for their physiochemical, biological, in vitro and in vivo performances. The chitosan and chitosan-BG (Na free) scaffolds show reliable biocompatibility, cytocompatibility, anti-oxidant, and tissue regeneration. The biocompatibility, toxicity assessments, and diabetic skin wound healing experiments were examined through in vivo studies using Sprague Dawley rats. The extracted tissue samples were analyzed using hematoxylin-eosin- (H and E) and Masson's trichrome staining. Further, tissue excised after scaffold implantation declared non-toxic, non-allergic, and anti-inflammatory nature of chitosan scaffolds. Moreover, the total ribonucleic acid (RNA) expression levels were measured using reverse transcription-polymerase chain reaction (RT-PCR) for the scaffolds against vascular endothelial growth factor (VEGF), and collagen type one (Col-1) primers. Admirably, the scaffolds achieved the best level of skin wound healing via tissue regeneration by increasing epithetical cell formation and collagen deposition. Thus, the biocompatibility, non-toxicity, anti-inflammatory, and wound healing efficiency proved that the chitosan-BG (Na free) scaffold can be readily substantial for wound healing.

Isolation, Culture, and Characterization of Dental Pulp Stem Cells from Human Deciduous and Permanent Teeth.

In the realm of regenerative medicine and therapeutic applications, stem cell research is rapidly gaining traction. Dental pulp stem cells (DPSCs), which are present in both deciduous and permanent teeth, have emerged as a vital stem cell source due to their accessibility, adaptability, and innate differentiation capabilities. DPSCs offer a readily available and abundant reservoir of mesenchymal stem cells, showcasing impressive versatility and potential, particularly for regenerative purposes. Despite their promise, the main hurdle lies in effectively isolating and characterizing DPSCs, given their representation as a minute fraction within dental pulp cells. Equally crucial is the proper preservation of this invaluable cellular resource. The two predominant methods for DPSC isolation are enzymatic digestion (ED) and outgrowth from tissue explants (OG), often referred to as spontaneous growth. This protocol concentrates primarily on the enzymatic digestion approach for DPSC isolation, intricately detailing the steps encompassing extraction, in-lab processing, and cell preservation. Beyond extraction and preservation, the protocol delves into the differentiation prowess of DPSCs. Specifically, it outlines the procedures employed to induce these stem cells to differentiate into adipocytes, osteoblasts, and chondrocytes, showcasing their multipotent attributes. Subsequent utilization of colorimetric staining techniques facilitates accurate visualization and confirmation of successful differentiation, thereby validating the caliber and functionality of the isolated DPSCs. This comprehensive protocol functions as a blueprint encompassing the entire spectrum of dental pulp stem cell extraction, cultivation, preservation, and characterization. It underscores the substantial potential harbored by DPSCs, propelling forward stem cell exploration and holding promise for future regenerative and therapeutic breakthroughs.

Cone-Beam Computed Tomography-Assisted Evaluation of the Bone Regenerative Potential of Modulated Sol-Gel-Synthesized 45S5 Bioglass Intended for Alveolar Bone Regeneration.

Objectives: The objective of the study was to evaluate the in vitro cell compatibility and in vivo regenerative potential of 45S5 Bioglass (45S5-BG)-based bone graft implanted in critical-size defects (CSD) created at rat calvaria using cone-beam computed tomography (CBCT). Materials and Methods: In vitro cell compatibility of 45S5-BG was assessed using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) test. For in vivo experiments, CSD of diameter 6 mm was created in the parietal bone and was treated with 45S5-BG bone graft in the test group (Group B), while the control group (Group A) CSD remained empty. Rats were euthanized at the 4th and 8th postsurgical weeks, and CBCT analysis was done for samples. The grayscale value in VGi and the selected region of interest (ROI, in mm) of CSD diameter were calculated. Results: In vitro cytotoxicity analysis of 45S5-BG showed that cell viability of more than 70% as compared to the control confirmed cell compatibility. CBCT analysis of CSD confirmed a significant increase in VGi (P < 0.001) and reduction in ROI of CSD (P < 0.001) from the 4th and 8th weeks in the test group as compared to the control. Conclusions: In vitro cytotoxicity analysis confirmed cell compatibility of 45S5-BG bone graft and CBCT analysis revealed its bone regenerative potential.

Perception of COVID-19 Booster Dose Vaccine among Healthcare Workers in India and Saudi Arabia.

Background: COVID-19 vaccines were made available to the public by the end of 2020. However, little is known about COVID-19 booster dose (CBD) vaccine perception among healthcare workers (HCW) worldwide. The present study aims to assess the perception of CBD vaccines among healthcare workers in India and Saudi Arabia (SA). Methods: A cross-sectional study was conducted among HCWs in two countries, India and SA. Data were gathered through the use of a self-administered questionnaire. A convenience sampling technique was utilized to collect the data. Results: A total of 833 HCW responses were collected from the two countries, with 530 participants from India and 303 participants from SA responding to the questionnaire. Among them, 16% from India and 33% from SA were unwilling to take a CBD (p < 0.005). The primary reasons for not being willing were concerns about whether the vaccine would be effective (32%) and concerns about probable long-term side effects (31%). Concerns about not knowing enough about the vaccination (30%) and the possibility of long-term side effects (28%) were the primary concerns in SA. Regression analysis showed that males, urban residents, and post-graduates were more willing to take the CBD. Conclusion: There is a good perception of CBD and some hesitancy in receiving the booster dose among HCWs in both countries. The introduction of personalized education, risk communication, and deliberate policy could help to reduce the number of people who are unwilling to take a booster shot.

3D-printed monolithic biofilters based on a polylactic acid (PLA) - hydroxyapatite (HAp) composite for heavy metal removal from an aqueous medium.

High flux, monolithic water purification filters based on polylactic acid (PLA) functionalised with fish scale extracted hydroxyapatite (HAp) were prepared by solvent-assisted blending and thermally induced phase separation (TIPS), followed by twin-screw extrusion into filaments and processed via three-dimensional (3D) printing. The printed filters with consistent pore geometry and channel interconnectivity as well as homogenous distribution of HAp in the PLA matrix showed adsorption capabilities towards heavy metals i.e. cadmium (Cd) and lead (Pb) with maximum adsorption capacity of 112.1 mg gHAp -1 and 360.5 mg gHAp -1 for the metal salt of Pb and Cd, respectively. The adsorption was found to be driven by a combination of ion exchange, dissolution and precipitation on HAp and surface complexation.

Effectiveness of Platelet-Rich Fibrin with Decalcified Freeze-Dried Bone Allograft Compared to Decalcified Freeze-Dried Bone Allograft Alone in Mandibular Grade-II Furcation Defects: A Quasi-Experimental Study

ABSTRACT Objective: To assess the effectiveness of platelet-rich fibrin (PRF) with decalcified freeze-dried bone allograft (DFDBA) compared to DFDBA alone in mandibular grade-II furcation defects. Material and Methods: A quasi-experimental study was conducted on nine patients with chronic periodontitis, each having two almost identical mandibular grade II furcation defects. Test sites (left mandibular first molars) were treated with open flap debridement (OFD), DFDBA, and PRF, whereas control sites (right mandibular first molars) received OFD and DFDBA alone. Clinical parameters (plaque index (PI), gingival index (GI), vertical clinical attachment level (VCAL) and horizontal clinical attachment level (HCAL) into the furcation defect) and radiographic measurements (mean alveolar bone defect) were done at baseline and after six months postoperatively. Results: The gain in relative horizontal clinical attachment level (RHCAL) in the test sites was 2.94±0.52 mm compared to 1.33±0.35 mm in control sites (p=0.01). Improvement in mean alveolar bone defect (MABD) (was 1.21±0.5 mm2 at test sites compared to 1.15±0.7 mm2 at control sites) probing pocket depth (PPD), recession, relative vertical attachment level (RVCAL), and percentage of bone fill was found in the test sites compared to control, which statistically insignificant. Conclusion: The test sites had better outcomes than control sites, which was significant for the parameter RHCAL. Therefore, combining the biological benefits of autologous PRF with DFDBA is an efficient and economical treatment modality for the management of mandibular grade II furcation defects.

Prevalence of oral, skin, and oral and skin lesions of lichen planus in patients visiting a dental school in southern India.

BACKGROUND: Lichen planus (LP) is a mucocutaneous disease that is relatively common among adult population. LP can present as skin and oral lesions. This study highlights the prevalence of oral, skin, and oral and skin lesions of LP. AIMS: The aim of this study was to evaluate the prevalence of oral, skin, and oral and skin lesions of LP from a population of patients attending the Department of Oral Medicine and Radiodiagnosis, Pushpagiri College of Dental Sciences, Tiruvalla, Kerala, India. MATERIALS AND METHODS: A cross-sectional study was designed to evaluate the prevalence of oral, skin, and oral and skin lesions of LP. This is a ongoing prospective study with results of 2 years being reported. LP was diagnosed on the basis of clinical presentation and histopathological analysis of mucosal and skin biopsy done for all patients suspected of having LP. Statistical analysis was carried out using SPSS (Statistical package for social sciences) software version 14. To test the statistical significance, chi-square test was used. RESULTS: Out of 18,306 patients screened, 8,040 were males and 10,266 females. LP was seen in 118 cases (0.64%). Increased prevalence of LP was observed in middle age adults (40-60 years age group) with lowest age of 12 years and highest age of 65 years. No statistically significant differences were observed between the genders in skin LP group (P=0.12) and in oral and skin LP groups (P=0.06); however, a strong female predilection was seen in oral LP group (P=0.000036). The prevalence of cutaneous LP in oral LP patients was 0.06%. CONCLUSION: This study showed an increased prevalence of oral LP than skin LP, and oral and skin LP with a female predominance.

Biocompatibility and cytotoxic evaluation of drug-loaded biodegradable guided tissue regeneration membranes.

BACKGROUND: In periodontology, Guided Tissue Regeneration (GTR) is based on the concept of providing a space for entry of cells with regenerative potential into the wound environment to initiate the regeneration of structures lost due to periodontal disease. First generation GTR membranes were primarily non-absorbable membranes like expanded polytetrafluorethylene which required a second surgery for its removal. This led researchers to explore absorbable materials like collagen and synthetic biodegradable polymers to fabricate GTR membranes. In the present study, biodegradable Polylactic acid (PLA) is used to fabricate membranes with the potential to be used for GTR therapy. MATERIALS AND METHODS: Biocompatibility of the PLA membranes were evaluated in a subcutaneous guinea pig model. Antimicrobial effect of the drug-loaded PLA membranes were assessed against a drug-resistant Staphylococcus aureus bacterial isolate. The cytocompatibility of the drug-loaded membranes were evaluated using HeLa cell lines. RESULTS: The PLA membranes were shown to be biocompatible. The drug-loaded PLA membranes showed significant activity against the bacterial isolate. Among the drug-loaded membranes, tetracycline-loaded membrane showed minimal cellular toxicity. CONCLUSION: The results of this study indicate that biodegradable drug-releasing polylactide membranes have the potential to be used for periodontal regeneration. It has the necessary characteristics of a GTR membrane like biocompatibility, space maintaining ability, and tissue integration. Among the various antimicrobial agents loaded in the PLA membranes, tetracycline-loaded membranes exhibited minimal cellular toxicity against HeLa cells; at the same time showing significant activity against a pathogenic bacterium.

Fabrication and anti-microbial evaluation of drug loaded polylactide space filler intended for ridge preservation following tooth extraction.

BACKGROUND: The preservation or reduction of alveolar ridge resorption following tooth extraction is important in patients especially for those intended for implants at a later stage. One way to achieve this is by using membranes, graft materials, and biodegradable space fillers to prevent alveolar bone resorption and promote regeneration. A major attraction for using biodegradable and biocompatible polymers as space fillers for ridge preservation is their safety profile in comparison to xenograft materials like lyophilized bone and collagen. MATERIALS AND METHODS: Biocompatible polylactide space fillers were fabricated by fusing porous polylactide particles. The sponges were loaded with drugs by placing them in the respective solutions. Pseudomonas aeruginosa was isolated from a chronic periodontitis patient and in vitro anti-microbial evaluation was done with the drug loaded sponges. RESULTS: Chlorhexidine loaded space filler showed significant anti microbial effect against multiple drug resistant Pseudomonas aeruginosa isolated from a patient with chronic periodontitis. CONCLUSION: The results of this study indicate that biodegradable drug releasing polylactide space fillers has the potential to be used for ridge preservation following tooth extraction. Release of drugs in the socket may prove useful in preventing development of alveolar osteitis post extraction which can interfere with normal healing of the socket. Synthetic biodegradable polymers also exhibit a controlled degradation rate to achieve complete resorption within the intended time.