Efficacy of surgical periodontal treatment with and without photobiomodulation in the treatment of severe periodontitis: An evaluation of periodontal, microbiological, and cytokine levels.

AIM: To compare the efficacy of surgical periodontal treatment (SPT) alone and PDT-assisted surgery in participants with severe periodontitis. MATERIAL AND METHODS: The present clinical trial was completed by 64 participants (n = 32 each). The selection was made according to predefined inclusion and exclusion criteria. Patients in group A were treated with SPT only and participants in group B were treated with SPT adjunct to PDT. Microbiological assessment of P.Gingivalis; T. Forsythia and T.Denticola were evaluated using cultural analysis and periodontal parameters plaque score (PSc), bleeding on probing (BoP) periodontal depth (PD), and clinical attachment loss (CAL) at baseline and post-treatment at 6 months and 12 months were performed. The gingival crevicular fluid (GCF) was collected for the estimation of IL-1ß and tumor necrosis factor-alpha (TNF-α) using an enzyme-linked immunosorbent assay (ELISA). For intra-group comparison and post hoc correction, Student's t-test along with Bonferroni was used. For the difference between follow-ups, an analysis of variance (ANOVA) multiple rank tests were incorporated. RESULTS: The mean age of participants in the SPT group was 55.25±4.6yrs. Whereas, participants treated with PDT adjunct to SPT were 54.88±3.6yrs. Periodontal parameters (BoP, PD, PSc, CAL) showed no significant difference at baseline. At 6 months and 12 months follow-up, a significant difference in all parameters (BoP, PD, PSc, and CAL) was found in participants treated with SPT alone and PDT adjunct to SPT (p<0.05). Inflammatory biomarkers at 6-month and 12-month follow-ups, a statistically significant difference in the level of biomarkers (IL-1ß and TNF-α) were observed in both groups from baseline (p<0.05). However, at baseline, no significant difference was noted in both groups (p> 0.05). The microbiological assessment showed a significant drop in the bacterial count in participants treated with both regimes i.e., SPT alone and PDT adjunct to SPT. CONCLUSION: Photodynamic therapy (PDT) adjunct to surgical periodontal treatment (SPT) in severe periodontitis improves microbiological and periodontal parameters and lowers the level of proinflammatory cytokines.

Efficacy of indocyanine green and methylene blue mediated-photodynamic therapy on peri-implant outcomes among diabetics with peri-implant mucositis.

BACKGROUND: This study aimed to assess the efficacy of indocyanine green (ICG)-mediated versus methylene blue (MB)-mediated photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (MD) on the peri­implant clinical, radiographic, microbiological, and immunological outcomes among diabetics with peri­implant mucositis (pi-M). METHODS: For this 3-month follow-up study, diabetics having pi-M were randomly divided into 3 groups: group-I (n = 20) subjects received only MD; group-II (n = 20) participants received ICG-mediated adjunct PDT; and group-III (n = 20) subjects received MB-mediated adjunct PDT. Peri-implant clinical (i.e., plaque index [PI], bleeding on probing [BOP], probing depth [PD]), radiographic (crestal bone loss [CBL]), microbiological (Fusobacterium nucleatum [F. nucleatum], Tannerella forsythia [T. forsythia], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans]), and immunological (interleukin [IL]-6, IL-1ß, tumor necrosis factor-alpha [TNF-α]) outcomes were assessed at baseline and 3-month follow-up. RESULTS: Mean changes between baseline and 3-month follow-up in peri­implant clinico-radiographic parameters were significantly different between control (PI: 12.42±21.80%; BOP: 12.10±19.30%; PD: 0.45±0.41 mm; CBL: 1.10±1.02 mm) and test groups (ICG-mediated PDT [PI: 26.55±25.80%; BOP: 28.77±29.24%; PD: 0.84±0.62 mm; CBL: 1.98±1.85 mm] and MB-mediated PDT [PI: 27.24±26.15%; BOP: 27.71±28.16%; PD: 0.85±0.63 mm; CBL: 1.95±1.80 mm]), however comparable differences were observed in peri­implant PI, BOP, PD, and CBL between group-II and group-III participants (p>0.05). The proportions of T. forsythia were significantly reduced in group-II (4.78 × 104 colony-forming unit per milliliter [CFU/mL]) and group-III (4.76 × 104 CFU/mL) as compared to group-I (-4.40 × 103 CFU/mL) at 3-month follow-up (p = 0.02). No statistically significant differences were observed between the study groups regarding the proportions of the other assessed target bacterial species. For IL-6 (group-I: 210±108; group-II: 298±165; group-III: 277±121 pg/mL; p = 0.03), IL-1ß (group-I: 101±95; group-II: 84±98; group-III: 86±74 pg/mL; p = 0.02), and TNF-α (group-I: 336±121; group-II: 385±210; group-III: 366±198 pg/mL; p = 0.03) peri­implant sulcular fluid [PISF] levels, all three study groups demonstrated statistically significant reduction at 3-month follow-up. CONCLUSIONS: ICG-mediated and MB-mediated adjunctive PDT showed statistically significant improvements in peri­implant clinical, radiographic, microbiological, and immunological parameters as compared to conventional MD alone at 3-month follow-up among diabetics with pi-M. However, comparable outcomes were demonstrated by ICG-mediated and MB-mediated adjunctive PDT regarding the assessed peri­implant parameters.

Comparison of the postoperative anti-inflammatory efficacy of chlorhexidine, saline rinses and herbal mouthwashes after mechanical debridement in patients with peri-implant mucositis: A randomized controlled trial.

AIM: The null hypothesis is that there is no difference in the post-operative anti-inflammatory efficacy of chlorhexidine (CHX), 2% saline rinses (SR) and a herbal mouthwash (MW) after non-surgical mechanical debridement (MD) for treatment of peri-implant mucositis (PiM). The aim was to compare the post-operative anti-inflammatory efficacy of CHX, 2% SR and a herbal oral rinse after non-surgical MD of PiM. MATERIALS AND METHODS: The present randomized controlled trial had a single-blinded parallel arm design. Patients diagnosed with PiM were enrolled. Demographic information was recorded. All patients underwent MD and were randomly divided into 4 groups: CHX-group: 0.12% non-alcoholic CHX; Sodium chloride (NaCl) group: 2% NaCl rinses; Herbal MW group: Herbal-based MW and H2 O group: distilled water with peppermint flavour. After MD, all the participants were advised to rinse twice daily (every 12 hrs) for 2 weeks with their respective MWs. In all groups, peri-implant modified plaque index (mPI), modified gingival index (mGI) and probing depth (PD) were measured at baseline and at 12 weeks of follow-up. Sample size was estimated using data from a pilot investigation; and group-comparisons were performed. Statistical significance was confirmed when P-values were below 0.01. RESULTS: Sixty individuals (15 patients/group) were included. At baseline, mPI, mGI and PD were comparable in all groups. At baseline, there was no significant difference in peri-implant mPI, mGI and PD in all groups. At 12-weeks' follow-up, there was a statistically significant reduction in peri-implant mPI (p < 0.01), mGI (p < 0.01) and PD (p < 0.01) in CHX, NaCl and herbal MW groups compared with H2 O group. There was no significant relation between implant location, duration for which, implants were functional, gender and peri-implant clinical parameters in all groups. CONCLUSION: After non-surgical MD, post-operative use of CHX and herbal and NaCl MWs is useful for the management of PiM in the short-term.

Clinical, Radiographic, and Inflammatory Peri-Implant Parameters around Narrow Diameter Implant Crowns among Prediabetic and Non-Diabetic Subjects.

Background and Objectives: To compare the clinical, radiographic, and inflammatory peri-implant parameters around narrow diameter implants (NDI) supported single and splinted crowns in non-diabetics and prediabetes. Materials and Methods: The clinical and radiographic parameters and the levels of IL-6 and TNF-α in the peri-implant crevicular fluid (PICF) of narrow diameter single (NDISCs) and splinted (NDISPs) crown implants were assessed both in non-diabetics and participants with prediabetes. The glycemic state of the patient was assessed using glycated hemoglobin (HbA1c) levels. The peri-implant soft tissue indices (Plaque index (PI), bleeding on probing (BoP), probing depth (PD)) and marginal bone loss were recorded and compared between the groups. Success of the prosthesis was assessed by the frequency of technical complications and patient satisfaction. Inter-group comparison was performed using ANOVA (one-way analysis of variance) while the normal distribution of dependent variables was calculated using Shapiro-Wilk. A p-value of less than 0.05 was considered to be statistically significant. Results: Sixty participants (30 non-diabetics and 30 with prediabetes) with a total of 178 (118 NDISCs and 60 NDISPs) platform-switched NDIs were a part of the study. Of the 118 NDISCs, 56 were placed in the non-diabetic individuals and 62 were placed in the prediabetes group whereas 30 NDISPs each were placed in both the study groups. The clinical parameters of PI, BoP and PD in the single crown and splinted crown groups showed comparable results. However, a statistically significant difference (p-value of less than 0.05) in PI, BoP and PD and in the values of IL-6 and TNF-α was found when a comparison was made between the non-diabetes and prediabetes group. A total of 91% of the patients were satisfied with the esthetics of the implants while 79% of the patients showed satisfaction with function. Conclusions: All the clinical and radiographic parameters were statistically similar in both single and splinted types of narrow diameter implants. However, the bone loss, probing depth, plaque index, and levels of inflammatory markers were statistically higher in prediabetes as compared to non-diabetes implying that a slight hyperglycemic state impacts peri-implant health.

Assessment of Caries-Affected Dentin Adhesive Interface Treated with Contemporary Conditioning Techniques.

Objective: The aim of this study was to assess shear bond strength (SBS) and failure analysis of adhesion of composite resin (CR) to caries-affected dentin (CAD) pretreated with the Er,Cr:YSGG (ECY) laser, photodynamic therapy (PDT), and etch and rinse (ER) used for cavity disinfection. Materials and methods: Methods used in this study included scanning electron microscopy (SEM), SBS analysis, failure analysis, and digital microscopy. The methods were adopted to assess bond integrity, CAD interface, smear layer, and hybridization. Thirty human third molars assessed clinically and having scores of 4 and 5 based on International Caries Detection and Assessment System (ICDAS) criteria were inspected. Infected dentin was removed. Dentin that was hard and stained pink was categorized as CAD. Ten samples were used in each group for pretreatment of CAD. Ten samples of healthy dentin [sound dentin (SD)] were collected separately and taken as controls. Samples were divided into the following groups: group 1: SD+ER; group 2: CAD+ER; group 3: CAD+ECY; and group 4: CAD+PDT after the pretreatment bonding agent was applied and the restorative procedure was performed using CR. Results: CAD conditioned with PDT before bonding to CR demonstrated the lowest SBS values (11.22 ± 0.77 MPa), whereas the highest SBS values were observed in the SD surface treated with ER (18.25 ± 1.22 MPa). In CAD and SD pretreated with ER, majority of failure modes were cohesive failure and admixed failure, whereas in CAD pretreated with PDT and the ECY laser, the adhesive failure mode was pertinent. Conclusions: The use of the ECY laser and PDT on CAD for cavity disinfection does not have potential for application in clinical settings as it decreases bond integrity of CR. Moreover, the ER pretreatment method for CAD and SD remains the gold standard.

Comparison of Whole Salivary Cortisol and Interleukin 1-Beta Levels in Light Cigarette-Smokers and Users of Electronic Nicotine Delivery Systems before and after Non-Surgical Periodontal Therapy.

There are no studies that have compared whole salivary cortisol (CL) and interleukin 1-beta (IL-1ß) levels in cigarette-smokers (CS) and electronic nicotine delivery systems (ENDS)-users before and after non-surgical periodontal therapy (NSPT). The aim was to compare whole salivary CL and IL-1ß levels in light CS and ENDS users before and after non-surgical periodontal therapy (NSPT). Self-reported current CS, ENDS users, and non-smokers were included. A questionnaire was used to collect demographic data. All patients underwent NSPT. Periodontal parameters (probing depth (PD], gingival index (GI], clinical attachment loss (AL], plaque index (PI], and marginal bone loss (MBL]) and whole salivary CL and IL-1ß were measured at baseline. At 3-months of follow-up, clinical parameters and whole salivary CL and IL-1ß were re-assessed. p-values < 1% were arbitrated as statistically significant. Fifty-four individuals (18 CS, 18 ENDS users, and 18 non-smokers) were included. Clinical AL, MT, PD, PI, and MBL were similar in all groups at baseline. At 12-weeks of follow-up, PI (p < 0.01) and PD (p < 0.01) were high in CS and ENDS-users than non-smokers. Among non-smokers, there was a statistically significant correlation between whole salivary cortisol and IL-1ß levels at 12-weeks' follow-up (p < 0.001). There was no difference in whole salivary cortisol and IL-1ß levels in CS and ENDS users at baseline and at 12-weeks follow-up. At 12-weeks of follow-up, there was a significant reduction in IL-1ß (p < 0.01) and CL (p < 0.01) than baseline. In light CS and ENDS users without periodontal disease, clinical periodontal parameters and whole-salivary CL and Il-1ß levels remain unchanged after NSPT.

Peri-implant clinicoradiographic status among betel-quid chewers and controls.

The aim of the present case-control observational study was to evaluate the peri-implant clinicoradiographic status among betel-quid chewers and controls. Self-reported betel-quid chewers and controls were included. Participants were categorized into 3 groups: Group-1: Individuals chewing betel-quid with tobacco; Group-2: Individuals chewing betel-quid without tobacco; and Group-3: Controls (individuals not using tobacco in any form). Demographic data was collected using a questionnaire. Periodontal and peri-implant clinicoradiologic parameters (plaque and gingival indices [PI and GI], probing depth [PD] and crestal bone loss/marginal bone loss [CBL/MBL]) were assessed. Clinical attachment loss (AL) around teeth was also assessed. Group comparisons were done using the one-way analysis of variance and Bonferroni Post-hoc adjustment tests. Correlation of periodontal and peri-implant inflammatory parameters with the duration of betel-quid chewing habit and duration of placement in the mouth were assessed using logistic regression analysis. P<0.05 was considered statistically significant. Thirty, 30 and 30 patients were included in groups 1, 2 and 3, respectively. Full-mouth PI (P<0.01), GI (P<0.01), clinical AL (P<0.01), PD (P<0.01) and mesial and distal MBL (P<0.01) were higher in groups 1 and 2 than Group-3. Peri-implant mPI (P<0.01), mGI (P<0.01), PD (P<0.01) and MBL/CBL (P<0.01) were significantly higher in groups 1 and 2 than Group-3 with no significant difference in groups 1 and 2. Betel-quid chewing habit either with or without tobacco is a risk-factor of peri-implant soft-tissue inflammation and CBL.

Peri-implant clinicoradiographic status among betel-quid chewers and controls

Abstract The aim of the present case-control observational study was to evaluate the peri-implant clinicoradiographic status among betel-quid chewers and controls. Self-reported betel-quid chewers and controls were included. Participants were categorized into 3 groups: Group-1: Individuals chewing betel-quid with tobacco; Group-2: Individuals chewing betel-quid without tobacco; and Group-3: Controls (individuals not using tobacco in any form). Demographic data was collected using a questionnaire. Periodontal and peri-implant clinicoradiologic parameters (plaque and gingival indices [PI and GI], probing depth [PD] and crestal bone loss/marginal bone loss [CBL/MBL]) were assessed. Clinical attachment loss (AL) around teeth was also assessed. Group comparisons were done using the one-way analysis of variance and Bonferroni Post-hoc adjustment tests. Correlation of periodontal and peri-implant inflammatory parameters with the duration of betel-quid chewing habit and duration of placement in the mouth were assessed using logistic regression analysis. P<0.05 was considered statistically significant. Thirty, 30 and 30 patients were included in groups 1, 2 and 3, respectively. Full-mouth PI (P<0.01), GI (P<0.01), clinical AL (P<0.01), PD (P<0.01) and mesial and distal MBL (P<0.01) were higher in groups 1 and 2 than Group-3. Peri-implant mPI (P<0.01), mGI (P<0.01), PD (P<0.01) and MBL/CBL (P<0.01) were significantly higher in groups 1 and 2 than Group-3 with no significant difference in groups 1 and 2. Betel-quid chewing habit either with or without tobacco is a risk-factor of peri-implant soft-tissue inflammation and CBL.

Resumo O objetivo do presente estudo observacional de casos-controles foi avaliar o estado clínico-radiográfico periimplantar dos usuários de bétele. Foram incluídos usuários que relataram utlizar a substância bétele como tabaco de mascar. Os participantes foram categorizados em 3 grupos: Grupo-1: Indivíduos que mascam bétele com tabaco; Grupo-2: Indivíduos que mascam bétele sem tabaco; e Grupo-3: Controle (indivíduos que não usam tabaco sob qualquer forma). Os dados demográficos foram recolhidos utilizando um questionário. Foram avaliados parâmetros clínico-radiográfico e periimplantares (índices placa e gengivais [IP e IG], profundidade de sondagem [PS] e perda de crista óssea/ perda óssea marginal [PCO/POM]). Também foi avaliada a perda inserção clínica (IC) em torno dos dentes. As comparações de grupo foram feitas utilizando a análise de variância unidireccional e os testes de ajustamento post-hoc de Bonferroni. A correlação dos parâmetros inflamatórios periodontais e periimplantares com a duração do hábito de mastigação da bétele e duração da colocação na boca foi avaliada utilizando a análise de regressão logística. P<0,05 foi considerado estatisticamente significativo. Foram utilizados 30 pacientes em cada grupo. O IP de boca inteira (P<0,01), IG (P<0,01), IC clínica (P<0,01), PS (P<0,01) e POM mesial e distal (P<0,01) foram mais elevados nos grupos 1 e 2 do que no grupo 3. O mPI peri-implantar (P<0,01), '(P<0,01), PD (P<0,01) e POM/PCO (P<0,01) foram significativamente mais elevados nos grupos 1 e 2 do que no grupo 3, sem diferença significativa nos grupos 1 e 2. O hábito de mastigar a substância bétele com ou sem tabaco é um fator de risco de inflamação dos tecidos moles periimplantares e PCO.

A Comparative Study on Alvogyl and a Mixture of Black Seed Oil and Powder for Alveolar Osteitis: A Randomized Double-Blind Controlled Clinical Trial.

Introduction: Alveolar osteitis (AO) is the most common complication faced by exodontia patients and is usually seen 24-74 hours after tooth extraction, heralded by severe throbbing pain. Nigella sativa is commonly known as black seed known to have anti-inflammatory and antibacterial properties along with other reparative properties that enhance bone formation. This study aimed to evaluate and compare the effects of Alvogyl and a mixture of Nigella sativa powder and oil in the treatment of dry sockets. Materials and Methods: Sixty patients above the age of 18 and below 70 years, from both genders, who underwent extraction of teeth and were clinically diagnosed with a dry socket at the clinic of the College of Dentistry, Jouf University, Saudi Arabia, were included in this study. Pain scores were assessed after placement of the dressing at the following intervals: 5 minutes, 30 minutes, 60 minutes, 2nd day, 4th day, and 7th day. Patients were randomly allocated to three groups, namely, Group 1 (Alvogyl), Group 2 (mixture of Nigella sativa's powder and oil), and Group 3 (control). Pain relief and healing of the socket were compared between the three groups. The collected data were subjected to statistical analysis through Spearman's correlation test, independent t-test, ANOVA, and post hoc test. Results: A mixture of Nigella sativa powder and oil showed a statistically significant difference in relieving pain compared to the Alvogyl group. A mixture of Nigella sativa's powder and oil required fewer dressings when compared to the Alvogyl group. Conclusion: A mixture of Nigella sativa powder and oil is the more efficacious dressing material for the management of dry sockets compared to Alvogyl. It provides immediate and complete pain relief and fewer numbers of repeated visits.

The Effectiveness of Lasers in Treatment of Oral Mucocele in Pediatric Patients: A Systematic Review.

The mucocele is the most common minor salivary gland associated disease of the oral cavity. It is also considered one of the most common biopsied oral lesions in pediatric patients. In recent years, extensive evidence has been published about the usage of lasers in treating mucoceles in pediatric patients. The aim of the present study was to assess the effectiveness of laser irradiation in the treatment of pediatric mucocele. An electronic search of databases (PubMed, Scopus, Web of Science and Google Scholar) was carried out in order to identify all relevant articles using a combination of the following keywords: "Pediatric", "Oral", "Mucocele", "Dental", "Oral Medicine", "Soft Dental Lasers", "Hard Dental Lasers", and "Lasers," for all case reports, case series, case-control and cohort studies published from 2007 to 2021. After limiting the search results, removing duplicate titles, and eligibility evaluation, 17 papers were enrolled in the study. Out of the total studies included, 10 articles were related to the diode (635 nm, 808 nm, 810 nm, and 980 nm), 5 to CO2 (10,600 nm), 3 to Er, Cr: YSGG (2780 nm), and 1 involving KTP lasers (532 nm). All studies indicated successful clinical results on mucocele excision with better intra- and post-operative indicators. The general characteristics and outcomes were summarized, and the quality of the studies was assessed using CARE guidelines in this systematic review. The reduction or absence of pain and bleeding, hemostasis, reduced operating time, minimal analgesic consumption, and an antibacterial effect were among the advantages of laser irradiation in the included studies. The laser has proven itself to play an effective role in the treatment of oral mucocele in paediatric patients.

Whole Salivary Cotinine Levels and Interleukin 1-ß Levels among Young Adults Involuntarily Exposed to Vapor from Electronic Nicotine Delivery Systems.

PURPOSE: To the assess whole salivary cotinine and interleukin 1ß (IL-1ß) levels among individuals involuntarily exposed to vapor from electronic nicotine delivery systems (ENDS) (test group) and unexposed individuals (control group). MATERIALS AND METHODS: Demographic data and information related to ENDS vapor exposure were collected using a questionnaire. Unstimulated whole saliva samples were collected, unstimulated whole-saliva flow rate (UWSFR) was calculated, and cotinine and IL-1ß levels were determined using enzyme-linked immunosorbent assay. Sample-size estimation and statistical analysis were performed. Regression analysis was performed to determine the correlation between whole salivary cotinine and IL-1ß levels. Statistical significance was set at p < 0.05. RESULTS: Forty-eight individuals (24 and 24 in test and control groups, respectively) were included. Mean ages of individuals in the test and control groups were comparable. In the test group, the mean duration for which the individuals inhaled vapor from ENDS in each session was 22.3 ± 9.5 min and they were exposed to ENDS vapor 12.2 ± 2.4 times daily. There was no difference in the UWSFR between patients in the test (0.21 ± 0.02 ml/min) and control (0.22 ± 0.04 ml/min) groups. Whole salivary cotinine (p < 0.001) and IL-1ß (p < 0.001) levels were significantly higher in the test than control group. CONCLUSION: Young adults involuntarily exposed to vapor from ENDS express elevated whole salivary cotinine and IL-1ß levels. Long-term exposure to ENDS vapor may potentially predispose vulnerable populations to oral and systemic inflammatory diseases.

Modified photoactivated methylene blue-incorporated quartz particles for dentin disinfection: A scanning electron microscope and spectroscopic analysis.

The aim of this study was to synthesize methylene blue-incorporated quartz particles (MB@QP) and to investigate its anti-bactericidal properties. Methylene blue was incorporated inside QP and characterized for morphology and chemical structure using scanning electron microscope (SEM) and Fourier transformed infrared spectroscopy (FTIR). Specimens were randomly divided into experimental and control groups (n = 9/groups). The dentin specimen infected with Enterococcus faecalis was treated using different treatment modalities: Control groups: treatment with 5.25% of sodium hypochlorite (NaOCl) for 60 s; MB: treatment with 1 ml MB solution and incubated for 60 s; MB-PDT (photodynamic therapy): treatment with 1 ml MB solution followed by irradiation using diode laser for 60 s; MB-QP-PDT: specimens treated with MB@QP and irradiated by the diode laser for 60s, and Er,Cr:YSGG laser alone. MB@PDT therapy showed the highest efficacy in reducing the survival rate of E. faecalis (0.49%) in comparison to control NaOCl (0.78%) and Er,Cr:YSGG laser treatment (2.17%). Encapsulating MB into QP followed by the PDT significantly improved the bactericidal capacity and significantly reduced the bacterial survival rate to 0.11% (p < .05) compared to other groups. The combination of MB incorporated into QP and PDT could be an alternative treatment modality to conventional disinfection method for eliminating bacteria from the tooth dentin. RESEARCH HIGHLIGHTS: Quartz particles are potent in delivering the photosensitizer. Photoactivated MB@QP has a higher efficacy in eliminating bacteria from tooth dentin.

Shear bond characteristics and surface roughness of poly-ether-ether-ketone treated with contemporary surface treatment regimes bonded to composite resin.

AIM: To evaluate and compare the influence of contemporary surface treatments of air abrasions, sulfuric acid, and Photodynamic therapy (PDT) on the adhesive bonding and surface roughness of Poly-ether-ether-ketone (PEEK) bonded to resin composite. MATERIAL AND METHODS: One hundred and fifty PEEK (disk-shaped) specimens of 10 mm diameter and 2 mm thickness were prepared. Specimens were subjected to the following surface treatments, Control (no treatment), PDT, air abrasion using Alumina particles (110 µm) (AA-AP), Sulfuric acid (SA), and air abrasion using diamond particles (10-20 µm) AA-DP. Surface roughness (Ra) of treated samples were evaluated using surface profilometer. Universal testing machine was used to evaluate shear bond strength after composite resin build-up. Stereomicroscope was utilized for failure analysis of de-bonded samples of all five groups. Statistical analysis was performed utilizing one-way analysis of variance (ANOVA) to measure means and standard deviations of SBS among studied groups and the means of SBS were paralleled by Tukey multiple comparison tests (p > 0.05). RESULTS: The highest SBS was observed by 98% SA (19.25 ± 0.68 MPa). While specimen treated with PDT (11.69 ± 0.12 MPa) showed the lowest SBS. PEEK surface, treated with PDT and AA-DP demonstrated comparable SBS (p > 0.05). PEEK when pretreated with 98% SA (2.658 ± 0.658 µm) exhibited a significantly higher Ra value as compared to other surface-treated groups (p < 0.05). CONCLUSION: PEEK surface treated with SA showed the highest SBS and surface roughness compared to other groups. Surface roughness of PEEK treated with PDT, AA-AP, and AA-DP demonstrated no difference in Ra. PEEK surface treatment technique should be further investigated to develop reliable adhesive resin bonding.

Analgesic Efficacy of Curcuma longa (Curcumin) after Surgical Periodontal Therapy.

PURPOSE: To compare the analgesic efficacy of orally administered Curcuma longa (curcumin) and mefenamic acid (MA) after surgical periodontal therapy (SPT). MATERIALS AND METHODS: Seventy-six periodontitis patients were randomly divided into two groups. In the test group, patients received curcumin capsules (200 mg), and in the control group, patients received MA (500 mg). All patients underwent post-operative antibiotic therapy using 500 mg amoxicillin and 400 mg metronidazole for 7 days. Post-operative pain and discomfort were evaluated using the numerical rating scale (NRS) and verbal rating scale (VRS), respectively. Evaluation were performed after 24 (T1), 48 (T2), and 72 h (T3). Group comparisons were done using Student's t-test and the Mann-Whitney U-test. The level of statistical significance was established at p < 0.05. RESULTS: All patients had stage 3/grade C periodontitis. The mean age of individuals in the test and control groups were 58.4 ± 7.3 and 57.2 ± 5.2 years, respectively. A family history of periodontal diseases was reported by 37.5% and 47.4% individuals in the test and control groups, respectively. In the test and control groups, the total mean duration of periodontal surgery was 168.2 ± 12.2 and 173.4 ± 10.7 min, respectively. There was no statistically significant difference in the mean NRS and VRS scores among patients in the test and control groups. In both groups, there was no statistically significant difference in the change in NRS scores at any time point. CONCLUSIONS: Compared with MA, curcumin is ineffective for pain and discomfort management after SPT. The possibility of the results being biased due to lack of operator blinding cannot be overlooked.

Effect of photobiomodulation after non-surgical mechanical debridement on cortisol levels in the peri-implant sulcular fluid among patients with peri-implant mucositis.

OBJECTIVE: The aim of this was to compare the efficacy of photobiomodulation after non-surgical mechanical debridement (MD) on cortisol levels (CL) in peri-implant sulcular fluid (PISF) among patients with peri-implant mucositis. METHODS: Patients with peri-implant mucositis were encompassed. All patients underwent non-surgical MD with (test group) and without (control group) a single application of photobiomodulation. Demographic data were collected and PISF was collected. Peri-implant modified plaque index (mPI), modified gingival index (mGI), probing depth and crestal bone loss were measured, and CL in PISF were recorded. All clinical parameters and PISF CL were re-assessed at 4 months of follow-up. p < .05 showed statistical significance. RESULTS: Seventeen (14 males and 3 females) and 17 (15 males and 2 females) patients with peri-implant mucositis were recruited in test and control groups. The mean age of patients in the test and control groups was 46.1 ± 6.5 and 50.2 ± 2.7 years respectively. At baseline, mPI, mGI, PD and PISF volume and CL in control and test groups were similar. At follow-up, there was a significant reduction in mPI (p < .001), mGI (p < .001), PD (p < .001) and PISF volume (p < .001) and CL (p < .001) in both groups compared with baseline. There was no difference in mPI, mGI, PD and PISF volume and CL in test and control groups at follow-up. CONCLUSION: In short term, non-surgical MD with photobiomodulation does not offer additional benefits in terms of reducing soft-tissue inflammatory parameters and PISF CL in patients with peri-implant mucositis.

Evaluation of serum neuron specific enolase levels among patients with primary and secondary burning mouth syndrome.

INTRODUCTION: Burning mouth syndrome is a painful condition of the oral cavity with ambiguous pathogenesis and diagnosis. Neuron-specific enolase is increased in several conditions including peripheral neuropathy of diabetes, ophthalmopathies, spinal cord injuries and tumors. Evidence on association of burning mouth syndrome and neuron-specific enolase is limited. AIM: This study aims to evaluate neuron-specific enolase levels in primary and secondary burning mouth syndrome patients and compare the levels of neuron-specific enolase with associated conditions in secondary burning mouth syndrome. METHODS: One hundred and twenty-eight patients of more than 18 years of age with no gender predilection and having clinical symptoms of burning mouth syndrome and 135 healthy subjects were included. All the patients fulfilled Scala's criteria for the diagnosis of burning mouth syndrome, including "primary" (idiopathic) and "secondary" (resulting from identified precipitating factors) burning mouth syndrome patients. Blood samples were obtained from burning mouth syndrome patients. Serum neuron-specific enolase was evaluated using enzyme-linked immunosorbent assay. To compare means and standard deviations, among primary and secondary burning mouth syndrome, data was analysed with analysis of variance and multiple comparisons test. RESULTS: The mean age of the study participants for burning mouth syndrome and healthy subjects was 53.30 and 51.6 years, respectively. Amongst the secondary burning mouth syndrome group, 32 (25%) of the patients had menopause, 15 (11.7%) had diabetes, eight (6.2%) of the patients had nutritional deficiency, seven (5.4%) had combined diabetes, menopause, and depression, six (4.6%) had combined diabetes and depression, four (3.1%) were diagnosed with Sjögren's syndrome. A minor percentage of 2.3% (three) had gastroesophageal reflux disease, while the remaining three (2.3%) patients in the secondary burning mouth syndrome group were on anti-depressants. There was a statistically significant increase in the levels of neuron-specific enolase in primary burning mouth syndrome as compared to the secondary burning mouth syndrome and healthy groups. Among the subgroups of secondary burning mouth syndrome, diabetic individuals showed a significant increase in neuron-specific enolase level when compared with other conditions in the secondary burning mouth syndrome patients.Discussion and conclusion: The raised serum neuron-specific enolase levels in patients suffering from primary burning mouth syndrome highlight a possible neuropathic mechanism. It was also increased in the sub-group of secondary burning mouth syndrome patients having diabetes. Although it cannot be ascertained whether the deranged values in the diabetic group were due to burning mouth syndrome or due to diabetes, the raised quantity of neuron-specific enolase in the primary burning mouth syndrome group is a reliable diagnostic indicator. Future studies on the assessment of neuron-specific enolase levels as a diagnostic tool for onset and management of primary and secondary burning mouth syndrome are recommended.

An assessment of unstimulated salivary flow rate, IgA and clinical oral dryness among active and passive smokers.

OBJECTIVES: The aim of this study was to assess the impact of smoking on the whole salivary flow rate (SFR), IgA levels and clinical oral dryness (COD) among active and passive smokers. MATERIAL AND METHODS: The participants were categorized as active smokers (N = 54) or passive smokers (N = 163). Saliva was collected in tubes and placed in ice storage at -70°C. Salivary IgA levels were assessed in duplication using the enzyme linked immunosorbent assay (ELISA) method. Following the saliva sample collection, the subjects were assessed for COD using the COD score, SFR and caries. Chi-square test, the t-test and ANOVA were employed to compare the clinical impact of the smoking status associated with specific variables (smoking status, number of cigarettes, active caries, gender, age, COD score, IgA level and SFR). A p-value of <0.05 was considered significant. RESULTS: Two hundred and seventeen subjects with the mean age of 32.86±6.30 years, with 145 males (66.8%) and 72 females (33.2%), were included in the study. Among the active smokers, 88.8% were males compared to 11.2% females. The active smokers had the mean age of 32.52 years, a COD score of 1.43, an IgA level of 1.39 g/l, and a SFR of 0.37 ml/min. Among the passive smokers, 59.5% were males and 40.5% were females, with the mean age of 32.97 years, a COD score of 0.87 g/l, an IgA level of 1.47, and a SFR of 0.42 ml/min. Active caries showed a positive correlation with the number of cigarettes, with significance in the >35 years age group (p < 0.05). CONCLUSIONS: The study demonstrated significant differences in SFR, IgA and COD scores among the active and passive smokers. The number of cigarettes had a negative impact on saliva production, IgA levels, the oral health status, and the progression of caries with respect to age and gender. Smoking potentially leads to xerostomia associated with active caries. Int J Occup Med Environ Health. 2022;35(1):39-51.

Baseline MMP expression in periapical granuloma and its relationship with periapical wound healing after surgical endodontic treatment.

BACKGROUND: Matrix metalloproteinases (MMPs) catalyzes the degradation of the extracellular matrix components and have a major role in many physiological processes including wound healing. In the current study, we examined the correlation of baseline MMPs 1, 2, 7, and 9 expressions with periapical wound healing after surgical endodontic treatment. METHODS: 27 patients aged between 15 and 57 years presenting with chronic apical periodontitis or chronic apical abscess of an anterior tooth with previously attempted or failed root canal treatment were included in this study. During surgical endodontic treatment, tissue from the periapical lesion sample was collected and used for gross histopathological analysis as well as mRNA expression analysis of MMPs 1, 2, 7, and 9. Patients were recalled for follow-up after 6  months to evaluate the healing status both clinically and radiographically and healing was correlated with baseline MMP expression. RESULTS: Out of 27 patients, healing was observed in 15 patients at the end of 6 months, and in 21 patients after 12 months.. Six patients showed no healing even after 12 months. Analysis of baseline MMP 1, 2, 7, and 9 expression levels with healing status showed the mean relative expression of MMP2 and MMP9 to be considerably increased in the non-healing group as compared to the healing group. CONCLUSION: Overexpression of MMP2 and MMP9 may be considered as a potential prognostic biomarker for periapical wound healing after surgical endodontic treatment. However, further studies are desirable to establish its precise relationship with periapical wound healing.

Peri-implant Sulcular Fluid Galectin-1, Soluble Urokinase Plasminogen Activator Receptor and IL-1ß Levels under Peri-implant Inflammatory Conditions.

PURPOSE: Soluble urokinase plasminogen activator receptor (suPAR) and interleukin 1-beta (IL-1ß) are inflammatory biomarkers, whereas galectin-1 is an anti-inflammatory cytokine. The relationship between suPAR, galactin-1 and IL-1ß levels in peri-implant sulcular fluid (PISF) in relation to dental implants remains unaddressed. The aim was to assess suPAR, galectin-1, and IL-1ß levels in PISF under peri-implant inflammatory conditions. MATERIALS AND METHODS: Demographic data and information related to jaw location and duration of implants in function as well as systemic health was retrieved from patients' dental records. Peri-implant plaque and gingival indices (PI and GI, respectively), probing depth (PD) and crestal bone loss (CBL) were recorded. The PISF was collected and levels of suPAR, galectin-1 and IL-1ß were determined using standard techniques. Sample-size estimation and statistical analyses were done. Correlation of suPAR and galectin-1 with IL-1ß were assessed via logistic regression. p-values < 0.05 were considered statistically significant. RESULTS: Seventy-two patients (45 males and 27 females) with peri-implant diseases were included. Thirty-six patients (22 males and 14 females) had peri-implant mucositis; 36 (23 males and 13 females) had healthy peri-implant tissues. The PISF volume was statistically significantly higher among patients with (0.52 ± 0.05 µl) than without peri-implant diseases (0.06 ± 0.01 µl) (p < 0.001). The PISF levels of suPAR (p < 0.01), galectin-1 (p < 0.01) and IL-1ß (p < 0.01) were statistically significantly higher among patients with than without peri-implant diseases. In patients with peri-implant mucositis, PISF suPAR (p < 0.001) and galectin-1 (p < 0.001) levels correlated with PISF IL-1ß levels. In patients with peri-implant mucositis, increasing peri-implant PD and IL-1ß levels directly correlated with increased PISF suPAR (p < 0.001) and galectin-1 (p < 0.05) levels. CONCLUSION: Increased PISF levels of suPAR, galectin and IL-1ß suggest that these proteins possibly contribute towards the pathogenesis of peri-implant inflammation, and are potential biomarkers of peri-implant diseases.

Clinical, radiographic and restorative parameters for short tuberosity implants placed in smokers: a retrospective study with 5 year follow-up.

This study aimed to estimate and compare the clinical, radiographic, and restorative parameters around short tuberosity implants (STIs) placed in cigarette smokers (CS) and never smokers (NS). In this 60-month follow-up retrospective study, a total of 50 (37 males + 13 females) individuals who had received 82 dental implants were included. These participants were categorized into two groups as follows: (i) Group-1: 25 self-reported systemically healthy CS with 43 STIs; and (ii) Group-2: 25 self-reported systemically healthy NS with 39 STIs. In both groups, peri-implant plaque index (PI), probing depth (PD), bleeding on probing (BOP), and crestal bone loss (CBL) and restorative parameters were measured at 12 and 60 months of follow-up. Group comparisons were performed utilizing the Kruskal-Wallis test. The significance level was set at p < 0.05. In CS and NS, the mean age of participants was 58.5 and 60.7 years, respectively. No statistically significant differences were observed in the overall mean levels of PD and CBL around STIs among CS and NS. However, a statistically significant increase was observed in the mean scores of BOP and PI around STIs in the NS and CS at 12 and 60 months follow-up, respectively. In both groups, the loosening of the implant was the most frequently encountered type of STI failure. The outcomes of the present study suggest that STIs placed in maxillary tuberosity can show reliable clinical, radiographic, and restorative stability among cigarettes smokers and non-smokers. However, the role of smoking status and oral hygiene cannot be disregarded in this scenario.