Effectiveness of photodynamic therapy on clinical and biomarker related periodontal parameters and oral health related quality of life (OHRQoL) in Parkinson's disease patients with stage III periodontitis.

AIMS: To evaluate the clinical, radiographic, immune modulatory biomarkers and quality of life with the application of photodynamic therapy (PDT) as an adjunctive treatment to dental scaling and root planing (SRP) in patients with chronic periodontitis and Parkinson's disease. METHODOLOGY: Individuals who had a confirmed diagnosis of stage III periodontitis and stage 4 Parkinson's disease according to Hoehn and Yahr scale were involved in this study. The participants were divided into two groups: Group SRP (n = 25) received traditional dental scaling procedure including full-mouth debridement and disinfection, and Group PDT + SRP (n = 25) received both traditional cleaning procedures along with adjunctive chloro­aluminum phthalocyanine (CAPC) gel (0.005% concentration) mediated PDT. CAPC photosensitizer was activated using a diode laser (wavelength=640 nm, energy=4 J, 150 mW power, and overall power density of 300 J/cm2) for 60 s. The study measured clinical parameters such as plaque score (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic alveolar bone loss (ABL). Proinflammatory cytokine levels such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) and oral health related quality of life were also assessed. RESULTS: The mean age of patients in Group SRP was 73.3 years, while the mean age in Group PDT + SRP was 71.6 years. The PDT + SRP group showed a significant reduction in all clinical parameters at 6 and 12 months compared to the SRP group alone (p < 0.05). IL-6 and TNF-α levels were significantly reduced in the PDT + SRP group at 6 months compared to the SRP group alone (p < 0.05). However, at 12 months, both groups showed comparable TNF-α levels. The results showed that Group PDT + SRP had significantly lower OHIP scores compared to Group SRP, with a mean difference of 4.55 (95% confidence interval [CI]: 1.98 to 7.12) (p < 0.01). CONCLUSION: Combined SRP with PDT showed significant improvement compared to SRP alone in terms of clinical parameters, cytokine levels, and oral health-related quality of life in individuals diagnosed with stage III periodontitis associated with Parkinson's disease.

Titanium-Based Nanoarchitectures for Sonodynamic Therapy-Involved Multimodal Treatments.

Sonodynamic therapy (SDT) has considerably revolutionized the healthcare sector as a viable noninvasive therapeutic procedure. It employs a combination of low-intensity ultrasound and chemical entities, known as a sonosensitizer, to produce cytotoxic reactive oxygen species (ROS) for cancer and antimicrobial therapies. With nanotechnology, several unique nanoplatforms are introduced as a sonosensitizers, including, titanium-based nanomaterials, thanks to their high biocompatibility, catalytic efficiency, and customizable physicochemical features. Additionally, developing titanium-based sonosensitizers facilitates the integration of SDT with other treatment modalities (for example, chemotherapy, chemodynamic therapy, photodynamic therapy, photothermal therapy, and immunotherapy), hence increasing overall therapeutic results. This review summarizes the most recent developments in cancer therapy and tissue engineering using titanium nanoplatforms mediated SDT. The synthesis strategies and biosafety aspects of Titanium-based nanoplatforms for SDT are also discussed. Finally, various challenges and prospects for its further development and potential clinical translation are highlighted.

Antimicrobial photodynamic therapy using chloro-aluminum phthalocyanine for treating advanced stage-III periodontitis in smoking patients.

PURPOSE: To evaluate the bacterial, clinical, and cytokine profile of adjunctive photodynamic therapy using chloro-aluminum phthalocyanine (CAP/aPDT) with root surface debridement (RSD) versus RSD alone in cigarette smokers (CS) and never-smokers (NS) during the period of 6 months. METHODS: Twenty-nine patients [CS - 14 and NS - 15] were recruited for the trial having stage-III periodontitis. All candidates from the study groups were subjected to a split-mouth treatment technique receiving CAP/aPDT + RSD and RSD alone. Periodontal parameters including plaque levels (PL), bleeding on probing (BP), probing depth (PD), clinical attachment loss (CAL), and marginal bone loss (MBL) were assessed. Polymerase chain reaction (qPCR) assay was used to analyze the copy numbers of Porphyromonas gingivalis (Pg) and Tannerella forsythia (Tf). Levels of tumor necrosis factor-alpha (TNF-α) interleukin (IL)-6 in the crevicular fluid were evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS: CAP/aPDT+RSD decreased BP in smokers after 6 months (p < .05). Probing depth and CAL reported statistically significant reductions within both CAP/aPDT+RSD and RSD groups and also within the NS and CS (p < .05). Pg and Tf stayed elevated in smokers at the 6-month evaluation period (p < .01). Only CAP/aPDT+RSD significantly decreased Pg and Tf at 3- and 6-month follow-up in smokers (p < .05). CAP/aPDT+RSD showed decreased IL-6 levels in the NS during the 6-month follow-up (p < .01). TNF-α levels were significantly reduced in the CS group with CAP/aPDT+RSD and RSD alone until 6 months (p < .01). CONCLUSION: CAP-mediated aPDT along with nonsurgical periodontal therapy helped to improve the bacteriological outcomes among smokers and never-smokers with stage-III CP patients.

Chloro-aluminum phthalocyanine-mediated photodynamic therapy in the treatment of stage-II chronic periodontitis among smokers.

PURPOSE: To assess the clinical periodontal, bacterial, and immunological outcomes of chloro-aluminum phthalocyanine-mediated photodynamic therapy (PDT) as an adjunct to dental scaling (DS) versus DS alone among cigarette smokers (CS) and never-smokers (NS). METHODS: A total of 26 patients (13 CS and 13 NS) with clinical and radiographic diagnosis of stage-II chronic periodontitis were recruited. Each patient from both groups were subjected with two parallel therapies (split-mouth): PDT + DS (test side) and DS alone (control side). Periodontal parameters were investigated by evaluating plaque scores (PS), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and alveolar bone loss (ABL). Subgingival plaque was collected to detect and quantify Porphyromonas gingivalis and Tannerella forsythia using real-time quantitative polymerase chain reaction (RT-qPCR) assay. Gingival crevicular fluid was sampled for the quantification of interleukin (IL)-1ß and tumor necrosis factor-alpha (TNF-α) using enzyme linked immunosorbent assay. All assessments were performed at baseline, 3 months, and 6 months. RESULTS: Bleeding on probing was significantly reduced at 6 months after PDT + DS in CS groups (p < .05). Mean PD and CAL significantly reduced after both PDT + DS and DS subgroups and among NS and CS groups (p < .05). At 6 months follow-up, the copy number of both P. gingivalis and T. forsythia remained significantly high in CS group (p < .01). Only PDT + DS subgroup in CS significantly reduced the counts of P. gingivalis and T. forsythia at 3 months and 6 months (p < .05). Only at 6 months did PDT + DS showed statistically significantly reduced IL-1ß levels in the NS group (p < .01). TNF-α levels significantly reduced in CS group with PDT + DS and DS alone at both 3 months and 6 months follow-up (p < .01). CONCLUSION: Chloro-aluminum phthalocyanine-mediated PDT helped to improve the non-surgical periodontal therapy outcomes among stage-II chronic periodontitis patients among smokers and never-smokers.

Extraction, identification, and environmental risk assessment of microplastics in commercial toothpaste.

Microplastics in personal care and food products are given much importance globally due to the adverse impact of microplastics on living beings. In the present study, microplastics from ten different commercially sold toothpaste in India were extracted by vacuum filtration and characterized with microscopic and Fourier-transform infrared spectroscopic analyses. Results revealed that colorless fragments and fibers were the microparticle types of common occurrence which ranged from 0.2 to 0.9% weight in the toothpaste with an abundance range of 32.7-83.2%. Fifty percent of the toothpaste samples showed more than 50% microplastic particle abundance indicating that the microplastic plastic particles were added by the manufacturers. The minimum size of microplastics recorded in the present study was 3.5 µm with a maximum size exceeding 400 µm. The maximum number of microplastics in the toothpaste was 167, 508 and 193 respectively, distributed in the size range of <100 µm, 100-400 µm, and >400 µm. The present study recorded four major polymer types, viz., cellophane, polypropylene, polyvinyl chloride, and polyamide in the toothpaste samples. Surprisingly, polyethylene-a common polymer reported in toothpaste was not traced in the present samples. Regarding the Indian context, the current study is a new addition to the knowledge of the occurrence of microplastics in toothpaste. The average annual addition of microplastics into the environment through toothpaste was calculated as 1.4 billion g/year for India, posing a significant threat to the environment.

Tumor Microenvironment Responsive Single-Atom Nanozymes for Enhanced Antitumor Therapy.

Single-atom nanozymes (SAzymes) with specific response to the unique tumor microenvironment (TME) feature providing 100 % metal atoms utilization for high-efficient enzyme-catalyzed therapy and accurate template for the study of therapeutic mechanisms. In this review, we first introduce the various synthetic strategies of SAzymes, and the TME-responsive SAzymes activities. Next, the TME-responsive enhanced antitumor therapeutic approaches based on the enzymatic activities of SAzymes are summarized, and the corresponding therapy mechanisms are elaborated. Subsequently, a concise but concentrated summary, and the challenges and opportunities for the future design and engineering of SAzyme are outlined. As a new discipline, SAzymes have vast space for development in enhanced antitumor therapy. This timely review provides guidance and constructive suggestions for the future of SAzymes.

A Plausible Proposition of CCL20-Related Mechanism in Fusobacterium nucleatum-Associated Oral Carcinogenesis.

OBJECTIVE: The objective of this prospective observational case-control study is to evaluate the prevalence of Fusobacterium nucleatum in the tissues of oral squamous cell carcinoma (OSCC). Reconnoitering the CCL20-related mechanism of carcinogenesis in Fusobacterium nucleatum-positive OSCC is another objective. METHODOLOGY: Tissues from 50 OSCC patients and 30 healthy oral tissues were collected. The prevalence of Fusobacterium nucleatum was evaluated in both tumour and healthy tissue by polymerase chain reaction. The immunohistochemistry of OSCC tissues was conducted to evaluate the difference in the expression of CCL20 between Fusobacterium nucleatum-positive and -negative OSCC tissues. RESULTS: Fusobacterium nucleatum was significantly (p < 0.001) prevalent in OSCC tissues (74%), compared to healthy tissues (26%). No association of Fusobacterium nucleatum or CCL20 immuno-expression with any clinical or histopathological features of OSCC was observed. While the intensity of CCL20 immuno-expression did not differ (p = 0.053), the CCL20-positive cell population was significantly different (p = 0.034) between Fusobacterium nucleatum-positive and -negative OSCC. CONCLUSION: Fusobacterium nucleatum is possibly prevalent in oral cancer tissues in the Indian population. By using immunohistochemistry, this is the first study to propose that the carcinogenesis in Fusobacterium nucleatum-positive OSCC may be CCL20-related. The findings enrich the knowledge of mechanisms involved in Fusobacterium nucleatum-mediated oral carcinogenesis.

Luteolin-Fabricated ZnO Nanostructures Showed PLK-1 Mediated Anti-Breast Cancer Activity.

The present work describes a facile and convenient procedure for synthesizing zinc oxide nanoparticles using luteolin isolated from Eclipta alba plant (L-ZnONPs) at room temperature. The formation of as-grown L-ZnONPs was confirmed by X-ray diffraction analysis (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), high-resolution transmission electron microscopy (HR-TEM), and selected area electron diffraction (SAED). The Wurtzite structure of ZnO was observed by its hexagonal phases in diffraction patterns. The SEM images revealed the different sizes and morphologies of L-ZnONPs, with diameters between 12 and 25 nm. The HR-TEM result showed that the inter-planar distance between two lattice fringes was 0.262 nm, which coincides with the d-spacing of (002) and (101) lattice planes of the as-obtained material. The anticancer activity of L-ZnONPs against the breast cancer cell line MCF-7 was greater as compared to that of luteolin or ZnO alone. The mechanistic evaluation of such an activity carried out using in silico methods suggested that the anti-breast cancer activity of L-ZnONPs was mediated by polo-like kinase 1 (PLK1) proteins.

Biogenic Synthesis of NiO Nanoparticles Using Areca catechu Leaf Extract and Their Antidiabetic and Cytotoxic Effects.

Nanoworld is an attractive sphere with the potential to explore novel nanomaterials with valuable applications in medicinal science. Herein, we report an efficient and ecofriendly approach for the synthesis of Nickel oxide nanoparticles (NiO NPs) via a solution combustion method using Areca catechu leaf extract. As-prepared NiO NPs were characterized using various analytical tools such as powder X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and UV-Visible spectroscopy (UV-Vis). XRD analysis illustrates that synthesized NiO NPs are hexagonal structured crystallites with an average size of 5.46 nm and a hexagonal-shaped morphology with slight agglomeration. The morphology, size, and shape of the obtained material was further confirmed using SEM and TEM analysis. In addition, as-prepared NiO NPs have shown potential antidiabetic and anticancer properties. Our results suggest that the inhibition of α-amylase enzyme with IC 50 value 268.13 µg/mL may be one of the feasible ways through which the NiO NPs exert their hypoglycemic effect. Furthermore, cytotoxic activity performed using NiO NPs exhibited against human lung cancer cell line (A549) proved that the prepared NiO NPs have significant anticancer activity with 93.349 µg/mL at 50% inhibition concentration. The biological assay results revealed that NiO NPs exhibited significant cytotoxicity against human lung cancer cell line (A549) in a dose-dependent manner from 0-100 µg/mL, showing considerable cell viability. Further, the systematic approach deliberates the NiO NPs as a function of phenolic extracts of A. catechu with vast potential for many biological and biomedical applications.

Role of PDT as an adjunct to SRP on whole salivary RANKL and OPG ratio in type-2 diabetic and normoglycemic individuals with chronic periodontitis.

OBJECTIVE: The aim was to assess the effect of scaling and root planing (SRP) with and without adjunct photodynamic therapy (PDT) on the levels of osteoprotegerin (OPG) receptor activator of NF-kappa B ligand (RANKL) in the unstimulated whole saliva (UWS) of type-2 diabetic and normoglycemic individuals with chronic periodontitis (CP). METHODS: Type-2 diabetic and normoglycemic subjects with CP (Groups 1 and 2, respectively) were divided into test- (SRP + PDT) and control (SRP only) groups. Patient demographics were recorded; and periodontal parameters (marginal bone loss [MBL], probing depth [P.D], plaque index [PI], gingival index [GI], and clinical attachment loss [CAL]) were assessed at baseline and at 3-months-follow-up. Rate of flow of unstimulated whole saliva and levels of RANKL and osteoprotegerin were measured at both time intervals. P < 0.05 was considered statistically significant. RESULTS: Eighty-four persons with CP (42 with and 42 without type-2 DM) were included. At baseline, clinicoradiographic parameters were comparable in all groups. At 3-months of follow-up, there was no significant difference in the clinicoradiographic parameters in all groups. At 3-months of follow-up, there was no significant reduction in whole salivary RANKL and osteoprotegerin levels among individuals in the test and control groups among CP patients with and without CP. CONCLUSION: The whole salivary RANKL/OPG ratio remains high in patients with poorly-controlled type-2 DM after SRP with or without adjunct PDT.

Periodontal Conditions and Whole Salivary IL-17A and -23 Levels among Young Adult Cannabis sativa (Marijuana)-Smokers, Heavy Cigarette-Smokers and Non-Smokers.

In the United States, prevalence of marijuana-use has doubled in the past 2 decades. The aim was to compare the periodontal conditions and whole-salivary IL-17A and IL-23 levels among young adult marijuana-smokers, heavy cigarette-smokers and non-smokers. Self-reported marijuana-smokers, heavy-cigarette-smokers, non-smokers with periodontitis and periodontally-healthy non-smokers were included. Demographic data was recorded and full-mouth plaque index (PI), bleeding on probing (BoP), probing depth (PD) and clinical attachment loss (AL), marginal bone loss (MBL) and missing teeth were recorded. Levels of IL-17A and IL-23 levels were measured in the whole saliva. p < 0.01 was considered statistically significant. Fifteen-marijuana-smokers, 15 heavy-cigarette-smokers, 16 non-smokers-with-periodontitis and 15 periodontally-healthy-non-smokers) were included. The clinicoradiographic parameters were worse among marijuana-smokers (p < 0.01), cigarette-smokers (p < 0.01) and non-smokers-with-periodontitis (p < 0.01) than periodontally-healthy-non-smokers. Marijuana- and cigarette-smokers had Stage-IV/Grade C and non-smokers with periodontitis had Stage-III/Grade-C. Salivary IL-17A and IL-23 levels were higher in marijuana-smokers than cigarette-smokers (p < 0.01) and non-smokers-with-periodontitis (p < 0.01). Whole salivary IL-17A and IL-23 levels were higher among cigarette-smokers than non-smokers with periodontitis (p < 0.01) and periodontally-healthy-individuals (p < 0.01). Marijuana- and heavy cigarette-smokers have comparable clinicoradiographic periodontal statuses. This rejects hypothesis-1. However, whole salivary immunoinflammatory response may be moderately worse in marijuana-smokers compared with heavy cigarette-smokers and non-smoker with periodontitis thereby supporting hypothesis-2.

Comparison of RANKL and osteoprotegerin levels in the gingival crevicular fluid of young cigarette- and waterpipe-smokers and individuals using electronic nicotine delivery systems.

OBJECTIVE: The aim of the present observational case-control study was to compare the levels of Receptor activator of NF-kappa B ligand (RANKL) and osteoprotegerin (OPG) in the gingival crevicular fluid (GCF) of cigarette- and waterpipe-smokers and electronic-nicotine-delivery-systems (ENDS)-users. METHODS: Demographic data was collected using a questionnaire. Clinical periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD] and clinical attachment loss [CAL]) were measured; and GCF samples were collected from the deepest periodontal pocket of the mandibular right first molar. The GCF volume was determined and levels of RANKL and OPG were determined. Group comparisons were performed and P < 0.05 was considered statistically significant. RESULTS: One hundred and twenty male individuals (30 cigarette-smokers, 30 waterpipe users, 30 ENDS-users and 30 non-smokers) were included. Scores of PI (P < 0.01) and PD (P < 0.01) were significantly higher among cigarette- and waterpipe smokers, and ENDS-users than non-smokers. The GCF volume was significantly higher among cigarette- (0.92 ±â€¯0.05 µl) (P < 0.01) and waterpipe-smokers (0.66 ±â€¯0.08 µl) (P < 0.001) and ENDS-users (0.62 ±â€¯0.03 µl) (P < 0.01) than non-smokers (0.21 ±â€¯0.007 µl). The GCF RANKL levels were significantly higher among cigarette- (14.9 ±â€¯8.2 pg/ml) (P < 0.001) and waterpipe-smokers (12.6 ±â€¯8.8 pg/ml) (P < 0.01) and ENDS-users (11.5 ±â€¯8.4 pg/ml) (P < 0.01) than non-smokers (3.5 ±â€¯0.7 pg/ml). The GCF OPG levels were significantly higher among cigarette- (95.9 ±â€¯7.2 pg/ml) (P < 0.001) and waterpipe-smokers (86.6 ±â€¯5.8 pg/ml) (P < 0.01) and ENDS-users (77.5 ±â€¯3.4 pg/ml) (P < 0.05) than non-smokers (21.5 ±â€¯10.7 pg/ml). There was no significant difference in GCF RANKL and OPG levels among cigarette- and waterpipe smokers, ENDS users. CONCLUSION: Cigarette- and waterpipe smoking and ENDS usage is associated with an increased expression of RANKL and OPG in the GCF.

Cu2 MoS4 /Au Heterostructures with Enhanced Catalase-Like Activity and Photoconversion Efficiency for Primary/Metastatic Tumors Eradication by Phototherapy-Induced Immunotherapy.

Photoimmunotherapy can not only effectively ablate the primary tumor but also trigger strong antitumor immune responses against metastatic tumors by inducing immunogenic cell death. Herein, Cu2 MoS4 (CMS)/Au heterostructures are constructed by depositing plasmonic Au nanoparticles onto CMS nanosheets, which exhibit enhanced absorption in near-infrared (NIR) region due to the newly formed mid-gap state across the Fermi level based on the hybridization between Au 5d orbitals and S 3p orbitals, thus resulting in more excellent photothermal therapy and photodynamic therapy (PDT) effect than single CMS upon NIR laser irradiation. The CMS and CMS/Au can also serve as catalase to effectively relieve tumor hypoxia, which can enhance the therapeutic effect of O2 -dependent PDT. Notably, the NIR laser-irradiated CMS/Au can elicit strong immune responses via promoting dendritic cells maturation, cytokine secretion, and activating antitumor effector T-cell responses for both primary and metastatic tumors eradication. Moreover, CMS/Au exhibits outstanding photoacoustic and computed tomography imaging performance owing to its excellent photothermal conversion and X-ray attenuation ability. Overall, the work provides an imaging-guided and phototherapy-induced immunotherapy based on constructing CMS/Au heterostructures for effectively tumor ablation and cancer metastasis inhibition.

Clinicoradiographic markers of peri-implantitis in cigarette-smokers and never-smokers with type 2 diabetes mellitus at 7-years follow-up.

BACKGROUND: It is hypothesized that in the long-term, (a) peri-implant inflammatory variables (plaque index [PI], bleeding on probing [BOP], probing depth (PD) and crestal bone loss [CBL]) are worse in cigarette-smokers (CS) and patients with type-2 diabetes mellitus (T2DM) than never-smokers (NS) without T2DM. The aim of the present 7-year follow-up clinical observational study was to assess the survival of dental implant in CS and NS with T2DM. METHODS: Study participants were divided into four groups based on glycemic status and self-reported cigarette-smoking habit: a) CS with T2DM; b) CS without T2DM; c) NS with T2DM; and d) NS without T2DM. Demographic information was collected using a questionnaire and hemoglobin A1c (HbA1c) levels were measured. Peri-implant PI, BOP, PD, and CBL were measured. Sample-size was estimated was statistical analysis was done using analysis of variance. P <0.01 was considered significant. RESULTS: In total, 101 male patients were included. There was no significant contrast in age among the groups. Every partaker in the study groups had one dental implant placed in posterior maxilla or mandible. The mean HbA1c levels were significantly higher among CS (P <0.01) and NS (P <0.01) with T2DM than individuals without T2DM. Peri-implant PI (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher among CS and NS with T2DM and CS without T2DM than NS without T2DM. Peri-implant BOP was significantly higher among CS and NS with T2DM than CS and NS without T2DM (P <0.01). CONCLUSIONS: Peri-implant inflammatory variables were worse among CS and NS with T2DM than NS without T2DM. A state of chronic hyperglycemia seems to be a stronger mediator of inflammation than cigarette smoking in patients with T2DM.

Efficacy of mechanical debridement with and without adjunct antimicrobial photodynamic therapy in the treatment of peri-implantitis among moderate cigarette-smokers and waterpipe-users.

OBJECTIVE: The aim was to assess the efficacy of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of peri-implantitis among cigarette-smokers and waterpipe-users. MATERIALS AND METHODS: Patients diagnosed with peri-implantitis were included. Demographic data was collected using a questionnaire. Individuals in the test- and control-groups underwent MD with adjunct aPDT and MD alone, respectively. Peri-implant clinical (plaque-index [PI], bleeding on probing [BOP] and probing depth [PD]) and radiographic (crestal bone loss [CBL]) inflammatory parameters were measured at baseline and at 6- and 12-months follow-up. Sample-size estimation was performed, and statistical analysis was done. P-values <0.05 were considered statistically significant. RESULTS: Ninety-eight male patients with peri-implantitis (34 cigarette-smokers, 32 waterpipe-users and 32 never-smokers) were included. At baseline, there was no difference in the peri-implant PI, PD and CBL in all groups; and BOP levels were significantly high among never-smokers (n = 16) (P < 0.01) than cigarette-smokers (n = 17) and waterpipe-users (n = 16). There was no difference in PI, BOP, PD and CBL among cigarette-smokers (n = 17) and waterpipe-users (n = 16) that underwent MD alone at 3- and 6-months' follow-up compared with baseline. Compared with baseline, PI (P < 0.05) and PD (P < 0.05) were significantly lower among cigarette-smokers (n = 17) and waterpipe-users (n = 16) that underwent MD + aPDT at 3-months' follow-up. At 6-months' follow-up, PI, BOP and PD were significantly lower in never-smokers (n = 16) than their respective baseline and 3-months' follow up outcomes. CONCLUSION: MD with adjunct aPDT is effective for the treatment of peri-implantitis. Routine oral hygiene maintenance plays a role in the overall success of MD with or without aPDT in patients with peri-implantitis.

Comparison of cotinine levels in the peri-implant sulcular fluid among cigarette and waterpipe smokers, electronic-cigarette users, and nonsmokers.

BACKGROUND: Assessment of cotinine levels in the peri-implant sulcular fluid (PISF) may serve as a valuable biomarker of peri-implant diseases in nicotine-product users. PURPOSE: The aim of the present study was to compare cotinine levels in the PISF among cigarette smokers, waterpipe users, electronic-cigarette users, and nonsmokers. MATERIALS AND METHODS: Cigarette smokers, waterpipe smokers, electronic-cigarette users, and nonsmokers were included. A questionnaire was used to collect information about age, gender, duration of smoking and vaping, family history of smoking, duration of smoking/vaping, and daily frequency of smoking/vaping. Implant-related data including implant dimensions and duration of implants in function were also recorded. In all groups, peri-implant probing depth (PD), bleeding on probing (BoP), and plaque index (PI) were assessed. Using standard techniques, PISF was collected and levels of cotinine in the PISF were measured. Sample-size estimation was performed, and statistical comparisons were done using one-way analysis of variance and Bonferroni post hoc adjustment tests. P values below .05 were categorized as statistically significant. RESULTS: One hundred two male individuals (35 cigarette smokers, 33 waterpipe smokers, 34 electronic-cigarette users, and 35 nonsmokers) were included. Scores of peri-implant PI (P < .05) and PD (P < .05) were significantly higher among cigarette smokers, waterpipe smokers, and electronic-cigarette users compared with nonsmokers. Peri-implant BoP was more often manifested in nonsmokers compared with cigarette smokers (P < .05), waterpipe smokers (P < .05), and electronic-cigarette users (P < .05). The volume of collected PISF was significantly higher among cigarette (P < .05) and waterpipe smokers (P < .05) and electronic-cigarette users (P < .05) than nonsmokers. Cotinine levels were significantly higher in the PISF of cigarette (P < .05) and waterpipe smokers (P < .05) and electronic-cigarette users (P < .05) than nonsmokers. CONCLUSIONS: Habitual use of nicotinic products enhances the expression of cotinine in the PISF. Cotinine levels in the PISF of cigarette and waterpipe smokers and electronic-cigarette users are comparable.

Efficacy of mechanical debridement with adjunctive probiotic therapy in the treatment of peri-implant mucositis in cigarette-smokers and never-smokers.

BACKGROUND: Efficacy of mechanical debridement (MD) with adjunctive probiotic therapy (PT) in the treatment of peri-implant mucositis (PiM) in cigarette-smoking and never-smoking subjects remains uninvestigated. PURPOSE: The aim was to assess the efficacy of MD with adjunctive PT in the treatment of PiM in cigarette-smoking and never-smoking individuals. MATERIALS AND METHODS: Patients with (group I) and without PiM (group II) were included. Demographic data was collected using a questionnaire. Treatment-wise, patients in groups I and II were subdivided into: (a) Patients that underwent MD with adjunct PT (using Lactobacillus reuteri); and (b) MD alone. In all groups, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were measured at baseline and compared after 3- and 6-months. Baseline peri-implant crestal bone levels were also measured. Sample-size estimation was performed, and statistical comparisons were done using one-way analysis of variance and Bonferroni post-hoc adjustment tests. P values under .05 were deemed significant. RESULTS: Eighty individuals (group I: 40 cigarette-smokers and group II: 40 never-smokers) with PiM participated in this study. At all-time intervals, no significant difference in PD, PI, and BOP were observed in all patients in group I. At 3-months' follow-up, the differences in BOP (P < .05), and PI (P < .05) were significantly higher in group II that underwent MD + PT than MD alone. At 6-months' follow-up, there was no difference in the changes in BOP and PI among subjects that underwent MD with and without adjunct PT. CONCLUSION: On a short-term basis, MD with adjunct PT is more effectual in the treatment of PiM than MD alone in never-smokers. Cigarette-smoking compromises peri-implant soft tissue healing following MD with or without adjunct PT.

Soft tissue status and crestal bone loss around conventionally-loaded dental implants placed in cigarette- and waterpipe (narghile) smokers: 8-years' follow-up results.

BACKGROUND: We hypothesized that crestal bone loss (CBL) and peri-implant soft tissue inflammation are increased when conventionally-loaded dental implants are placed in cigarette and waterpipe smokers compared to nonsmokers. PURPOSE: The present 8-years' follow-up retrospective clinical study evaluated the stability of the conventionally-loaded dental implants placed in cigarette- and waterpipe (narghile) smoking and nonsmoking population group. MATERIALS AND METHODS: Self-reported cigarette-smokers, waterpipe users along with never-smokers have been included. Data pertaining to gender, age, duration and frequency of cigarette-smoking, and usage of waterpipe were collected using a preformed questionnaire. Probing depth (PD), bleeding on probing (BOP), and peri-implant plaque index (PI) were recorded measuring mesial and distal CBL on digital bitewing radiographs. Study power estimated with group comparisons performed using the Kruskal-Wallis and Bonferroni post-hoc adjustment tests. Statistically significant P-values of less than 0.05 were considered. RESULTS: Forty-one cigarette-smokers, forty waterpipe-users, and forty-two never-smokers with mean ages of 44.5 ± 4.3, 41.2 ± 4.7, 43.3 ± 2.8 years, respectively, were included. The mean duration of smoking habit and duration of each session of cigarette-smoking was 5.5 ± 0.3 years and 7.7 ± 1.2 minutes, respectively. The mean period of waterpipe use and time of each session of was 10.6 ± 0.8 years and 20.2 ± 3.1 minutes, respectively. Among cigarette-smokers, waterpipe-users and never-smokers, the implants had been in function for 8.5 ± 0.3, 8.6 ± 0.3, and 8.5 ± 0.5 years, respectively. PD, CBL, and peri-implant PI were positively more among cigarette and waterpipe smoking users (P < 0.05) than with never-smokers. Peri-implant bleeding on probing was significant among never-smokers (P < 0.05) compared to waterpipe-users and cigarette-smokers. There was no difference in Peri-implant PI, PD, and CBL in cigarette-smokers and waterpipe-users. CONCLUSIONS: Cigarette-smokers and waterpipe users are vulnerable to peri-implant soft tissue inflammation and CBL than never-smokers. There is no variation in the severity of peri-implant soft tissue inflammation and CBL in waterpipe and cigarette users.

Effectiveness of scaling and root planning with and without adjunct antimicrobial photodynamic therapy in the treatment of chronic periodontitis among cigarette-smokers and never-smokers: A randomized controlled clinical trial.

OBJECTIVE: The aim of the present short-term randomized clinical trial was to assess the efficacy of scaling and root planing (SRP) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of chronic periodontitis (CP) among cigarette-smokers and never-smokers. MATERIALS AND METHODS: Demographic information was collected using a questionnaire. Cigarette-smokers (group-1) and never-smokers (group-2) with CP were included. Treatment wise, these individuals were divided into two subgroups as follows: (a) SRP alone and (b) SRP with adjunct aPDT. Periodontal parameters (plaque index [PI], bleeding on probing [BOP], clinical attachment loss [AL] and probing pocket depth≥4 mm [PD] were measured at baseline and at 1 month and 3 months' follow-up. Group comparisons were done using the Kruskall-Wallis test. RESULTS: Eighty-three male patients with CP (Group-1: 42 cigarette-smokers and; Group-2: 41 never-smokers) were included. In group-1, individuals that received SRP alone and SRP with adjunct aPDT had a mean history of cigarette smoking of 11.7 ± 0.3 and 12.5 ± 0.4 pack years. At baseline, PI, BOP, PD and clinical AL were comparable among all individuals in groups 1 and 2. At 1 month and 3 months' follow-up, PI (P < 0.05), PD (P < 0.05) and clinical AL (P < 0.05) were higher among all individuals in group-1 compared with group-2. In Group-2, PI, BOP, PD and clinical AL were comparable among all individuals at 1 month and 3 months' follow-up. CONCLUSION: Outcomes of SRP with or without aPDT for the treatment of CP are compromised in cigarette-smokers. Among never-smokers with CP, outcomes of SRP with or without aPDT are comparable. The significance of aPDT in this regard remains questionable.

Oral Candida carriage among cigarette- and waterpipe-smokers, and electronic cigarette users.

OBJECTIVE: The aim of this cross-sectional study was to compare oral Candida carriage among cigarette- and waterpipe-smokers, electronic cigarette (E-Cig) users, and never-smokers. METHODS: Demographic data and information regarding smoking and vaping were collected using a questionnaire. Number of missing teeth and unstimulated whole salivary flow rate (UWSFR) were recorded. Oral Candida samples were collected and identified using concentrated oral rinse culture technique and PCR, respectively. Level of significance was set at p < 0.05. RESULTS: Thirty-four cigarette-smokers (Group-1), 33 waterpipe-smokers (Group-2), 30 E-Cig users (Group-3), and 32 never-smokers (Group-4) were included. All were male participants with comparable mean ages. In groups 1, 2, 3, and 4, oral Candida carriage rate was 100%, 100%, 83.3% and 50%, respectively. The most commonly isolated oral yeast species in all groups was C. albicans. C. albicans carriage was significantly higher in groups 1 (p < 0.05), 2 (p < 0.05), and 3 (p < 0.05) than Group-4. Data stratification for age, missing teeth, and UWSFR showed no significant difference in oral yeasts carriage in groups 1, 2, and 3. CONCLUSIONS: Oral C. albicans carriage was significantly higher among cigarette- and waterpipe-smokers and E-Cig users than never-smokers. No significant differences were identified among groups in the oral carriage of other Candida species.