Impact of periodontitis on oral health-related quality of life of patients with psoriatic arthritis.

BACKGROUND: Since oral health issues can have a negative influence on a person's physical functioning, social status, and wellbeing, oral health-related quality of life (OHRQoL) becomes an indispensable part of overall health. Previous published studies report that periodontitis (PD) and psoriatic arthritis (PsA) have a significant negative impact on OHRQoL. Based on these findings, it would be reasonable to assume that patients with coexisting PsA and PD would see a comparable or maybe synergistic effect on their OHRQoL. Hence, the aim of the present study is to evaluate the OHRQoL and its impact among subjects with concurrent PsA and PD. MATERIAL AND METHODS: The present study was a comparative, cross-sectional investigation. A total of 200 participants were categorized into four groups- PD-PsA (n = 50), PsA (n = 50), PD (n = 50), and healthy controls (n = 50). Demographic data and periodontal parameters-plaque index, sites with gingival bleeding, probing pocket depth, gingival recession, and clinical attachment level were recorded for all the four groups. Number of mobile teeth due to periodontitis was recorded for the PSA-PD and PD groups. OHIP-14 questionnaire was administered to all the four groups. Collected data was then subjected to statistical analysis. RESULTS: The severity of OHIP-14 summary scores was highest in the PsA-PD group (18.06 ± 11.22) followed by the PD group (17.02 ± 9.99) and lowest in the healthy group (6.32 ± 5.59) (p < .0001). The scores of all the domains- oral pain, oral function, orofacial appearance and psychological impact were highest among the PsA-PD group followed by the PD group (p < .0001). The combined interaction of PsA and PD on the OHRQoL was statistically significant (F = 6.33, p = .012). Results of the multiple linear regression analysis indicated that there was a moderate collective significant effect between age, past dental visit, frequency of daily tooth brushing, use of other oral hygiene aids, and OHIP-14 (F(3,196) = 13.08, p < .001, R2  = 0.17, adjusted R2  = 0.15). CONCLUSION: The negative impact on OHRQoL was highest in the patients with concurrent presence of PD with PsA followed by those with PD alone. While the summary scores and dimensional scores of OHIP-14 were insignificant when patients with PsA-PD and PD alone were compared, these scores were significantly higher in patients with PsA-PD than patients with PsA alone.

Assessment of Periodontal status in Patients with Psoriatic Arthritis: A retrospective, case-control study.

BACKGROUND: Psoriatic arthritis (PsA) and periodontitis both represent chronic inflammatory disorders that share similar pathophysiological processes. However, very few studies have been done to address the link between the two diseases which remains poorly understood. The present study aimed to assess and compare the periodontal status in patients suffering from PsA and systemically healthy subjects to identify whether a possible association exists between PsA and periodontitis. MATERIAL AND METHODS: Periodontal parameters - PI, BOP, mGI, PPD and CAL were recorded in 110 patients with PsA and 110 age- and gender-matched systemically healthy patients. Mean values of the periodontal parameters were calculated for both groups and subjected to statistical analysis. Logistic regression analysis was performed to correlate the demographic data with periodontitis. RESULTS: The frequency of periodontitis and mean values of BOP, mGI, PPD and CAL were found to be significantly higher in patients with PsA than in systemically healthy controls. The number of patients with stage III periodontitis was found to be significantly higher in the PsA group. CONCLUSIONS: A possible link exists between periodontitis and psoriatic arthritis, as exhibited by the results of the present study. Dental and medical health professionals should be aware of this relationship depending on which, they should carry out adequate treatment strategies involving periodic periodontal evaluation and care. Key words:Periodontitis, psoriatic arthritis, chronic inflammation, probing pocket depth, clinical attachment loss.

Patterns of Periodontal Destruction among Smokeless Tobacco Users in a Central Indian Population.

BACKGROUND: Findings of studies testing the association between smokeless tobacco (SLT) use and periodontal health have shown varying results in different populations. Considering the high prevalence of SLT use in India, the present study was conducted to understand the pattern of periodontal destruction within different areas of the dentition among SLT users. METHODS: Age, gender, oral hygiene habits, the frequency and duration of SLT consumption, the type of SLT product used, and the site of retention of the SLT product in the oral cavity were recorded among 90 SLT users. Probing depth (PD), recession (REC), and clinical attachment loss (CAL) at SLT-associated and non SLT-associated teeth of the mandibular arch were compared based on the site of retention of the SLT product, the type of product used, and the duration of the habit. RESULTS: REC and CAL were significantly higher at the SLT-associated zones compared to non SLT-associated zones and at both interproximal and mid-buccal sites of SLT-associated teeth. Among individuals who had the habit for more than 5 years and also among those who had the habit for 5-10 years, PD, REC, and CAL were significantly higher at SLT-associated teeth than at non SLT-associated teeth. Significantly greater periodontal destruction was observed at SLT-associated teeth among khaini users and gutkha users. CONCLUSIONS: Smokeless tobacco consumption resulted in greater destruction of periodontal tissues. The severity of periodontal destruction at SLT-associated sites differed depending on the type of smokeless tobacco used, the site of retention of the SLT, and the duration of the habit.

Bioinspired Nanocomposites: Applications in Disease Diagnosis and Treatment.

Recent advancement in the field of synthesis and application of nanomaterials provided holistic approach for both diagnosis as well as treatment of diseases. Briefly, three-dimensional scaffold and geometry of bioinspired nanocarriers modulate bulk properties of loaded drug at molecular/ atomic structures in a way to conjointly modulate pathological as well as altered metabolic states of diseases, in very predictable and desired manners at a specific site of the target. While, from the pharmacotechnical point of views, the bioinspired nanotechnology processes carriers either favor to enhance the solubility of poorly aqueous soluble drugs or enable well-controlled sustained release profiles, to reduce the frequency of drug regimen. Consequently, from biopharmaceutical point of view, these composite materials, not only minimize first pass metabolism but also significantly enhance in-vivo biodistribution, permeability, bio-adhesion and diffusivity. In lieu of the above arguments, the nano-processed materials exhibit an important role for diagnosis and treatments. In the diagnostic center, recent emergences and advancement in the tools and techniques to diagnose the unrevealed diseases with the help of instruments such as, computed tomography, magnetic resonance imaging etc; heavily depend upon nanotechnology-based materials. In this paper, a brief introduction and recent application of different types of nanomaterials in the field of tissue engineering, cancer treatment, ocular therapy, orthopedics, and wound healing as well as drug delivery system are thoroughly discussed.

L:A ratio, Insulin resistance and metabolic risk in women with polycystic ovarian syndrome.

BACKGROUND AND AIMS: The plasma leptin-adiponectin ratio (L:A) has been suggested as a one of the potentially independent predictor of metabolic risk and Insulin resistance in women with polycystic ovarian syndrome (PCOS). METHODS: This is a case-control study, total 439 female subjects, comprises in to two group 223 cases (PCOS) and 216 control (non-PCOS women) according to their clinical characteristics. Further both case and control group were sub-grouped in PCOS and non-PCOS with metabolic syndrome (wMetS) and without metabolic syndrome (woMetS) as per National Cholesterol Education Program Treatment Panel (NCEPATP) guidelines. Anthropometrical measurements and biochemical analysis were done. Leptin and adiponectin level were estimated by enzyme-linked immunosorbent assay. RESULTS: Results indicated that SAD, WHR, BMI, BP, lipid profile, FPG, fasting plasma insulin, IR (HOMA-IR), leptin and L:A ratio were significantly higher (p=<0.001) in PCOS women compare to non PCOS. Furthermore anthropometrical values and level of FPG, TC, TG, Insulin, IR (HOMA-IR) and L:A ratio were significantly high (p=<0.001) in PCOS wMetS compare woMetS, however HDL (p=<0.001) and adiponectin level (p=<0.001) were significantly low. The same trend was also found in comparison between with and without MetS among non-PCOS women. The correlation between L:A Ratio with different metabolic risk markers, L:A ratio was positively significant with SAD (r=0.97, p <0.001), FPG (r=0.96, p<0.001), TC (r=0.44, p<0.001), insulin (r=0.98, p<0.001), IR (r=0.97, p<0.001), Adiponectin (r=0.21, p<0.01) and negatively significant with HDL(r=-0.42, p<0.001) in PCOS wMetS whereas L:A ratio was also positively correlated with SAD, BMI, TG in PCOS woMetS. CONCLUSIONS: Study concluded L:A ratio may be one of the potential biomarker for metabolic syndrome and insulin resistance which is independent for presence of PCOS disease.

Resistin 420C/G gene polymorphism on circulating resistin, metabolic risk factors and insulin resistance in adult women.

OBJECTIVE: To investigate the frequency association between resistin gene polymorphism with its circulating levels, metabolic risk factor and insulin resistance in adult women. DESIGN: Totally 615 subjects were enrolled for the study, 305 women were with metabolic syndrome and 310 women were without metabolic syndrome according to NCEP-ATP III criteria. Fasting circulatory level of resistin, insulin, plasma glucose and lipid profiles were estimated along with calculation of insulin resistance. Resistin 420C/G promoter region polymorphism was done by RFLP method. RESULTS: Variant genotype (CC vs CG+GG) (p<0.001: OR=2.22: 95% CI=1.60-3.10) of 420C/G resistin gene polymorphism was less frequently observed in control population. Further dividing subjects into two groups according to absence (Resistin -1) or presence (Resistin-2) of the G allele, significantly high levels of triglyceride (p<0.001), plasma glucose (p=0.012), systolic blood pressure (p<0.001), diastolic blood pressure (p<0.001), waist hip ratio (p<0.001), body mass index (p<0.001) and resistin (p<0.001), were observed in resistin-2 group. CONCLUSION: Present study shows that 420C/G polymorphism of resistin gene directly correlated to its high circulating level and metabolic risk factors, specifically markers of obesity and atherosclerosis, so it may have an important role in the development of metabolic syndrome and cardio metabolic diseases.