Assessment of Sirtuin 3 and Sirtuin 4 Level in Patients with Diabetes Mellitus and Periodontitis: A Clinical Study.

AIM: Periodontitis is considered as infection in periodontal supporting structure leading to tooth mobility and ulcerated periodontal pockets. The present study was conducted to assess Sirtuin 3 (SIRT 3) and SIRT 4 level in patients with diabetes mellitus (DM) and periodontitis. MATERIALS AND METHODS: The present study was conducted on 60 subjects. Subjects were divided into four groups, groups I to IV. Each group comprised of 15 subjects. In all subjects, fasting blood glucose level was assessed. Plaque index (PI), bleeding on probing (BOP), gingival index (GI), and clinical attachment level (CAL) were measured. The SIRT 3 and SIRT 4 were estimated by Western blot analysis. RESULTS: In group I, mean age was 44.13 ± 1.35 years, in group II, it was 43.53 ± 1.45 years, in group III it was 43.93 ± 1.22 years, and in group IV, it was 44.47 ± 0.74 years. The mean BOP score was significantly higher in group IV (5.74 ± 0.30) compared with group I (1.92 ± 0.44), group II (2.25 ± 0.22), and group III (5.31 ± 0.54). A statistically significant (p < 0.001) difference was observed in mean PI score in group I (2.25 ± 0.23), group II (2.26 ± 0.13), group III (4.37 ± 0.60), and group IV (3.25 ± 0.16). Mean GI score was significantly higher in group IV (8.89 ± 0.89) as compared with group I (0.78 ± 0.23), group II (0.95 ± 0.18), and group III (8.69 ± 1.13). A statistically significant difference was seen in mean CAL in group III (5.66 ± 0.64) and group IV (6.37 ± 0.30). Mean fasting blood sugar (mg/dL) in group I was 80.40 ± 13.05, in group II, it was 160.40 ± 27.20, in group III, it was 77.00 ± 12.78, and in group IV, it was 264.20 ± 53.17. The nonsignificant mean expression of SIRT 3 was seen in group I (29.20 ± 3.14), group II (29.19 ± 2.18), group III (28.89 ± 2.77), and group IV (29.59 ± 5.82). In group I, the mean level of SIRT 4 was 28.93 ± 12.55, in group II, it was 28.82 ± 9.14, in group III, it was 28.88 ± 6.03, and in group IV, it was 29.05 ± 10.68. CONCLUSION: Association of DM and periodontitis is well known. The SIRT 3 and SIRT 4 are useful indicators of glycemic level in patients with DM. CLINICAL SIGNIFICANCE: The SIRT 3 and SIRT 4 in DM show variation in their level. Early assessment may be proved beneficial in patients who are not responding to other drugs.

Effect of Subgingival Doxycycline Placement on Clinical and Microbiological Parameters in Inflammatory Periodontal Disease: Both in Vivo and in Vitro Studies.

AIM: To eva luate the effect of subgingival placement of doxycy-cline in the form of a resorbable membrane on the clinical and microbiological parameters in the treatment of inflammatory periodontal disease. Material and methods; We evaluated the effects of a controlled release system containing doxycycline both in vivo and in vitro conditions. Drug systems were prepared for both, and a total of 19 patients were included in the study with age range from 35 to 50 years. Clinical parameters like gingival index, probing depth, attachment loss, and gingival shrinkage were evaluated along with microbiological evaluation as well for a period of 10 weeks. RESULTS: In vitro study showed that the doxycycline hydroxy-propyl methylcellulose films are capable of releasing the drug in a sustained way with respect to time. It was observed that the gingival index score, periodontal probing depth, and gingival shrinkage showed low levels at the doxycycline-treated sites as compared to the placebo group. The microbial culture results also showed a marked reduction in the total anaerobic count post-treatment and till the end of the 10 week study period in the doxycycline-treated group. Thus, overall results showed that 30% doxycycline methylcellulose strips have significant effects and benefits on clinical and microbial parameters in more than 5 mm deep periodontal pockets. CONCLUSION: We conclude that 30% doxycycline both in vivo and vitro study has proven to be an effective antibiotic of choice both clinically and microbiologically. CLINICAL SIGNIFICANCE: Doxycycline has proven to have great promise as an antibiotic of choice. Thus, there is a significant advantage in the clinical use of doxycycline formulation for both the therapist and the patient. It can help dental professionals as an additional means to maintain an improved clinical health in periodontal problems of their patients. With this new therapeutic modality, we can augment the ability to treat periodontitis more effectively.