Clinical and microbiological efficacy of 4% Garcinia mangostana L. pericarp gel as local drug delivery in the treatment of chronic periodontitis: A randomized, controlled clinical trial.

AIM: The aim of the present study was to assess the periodontal status of individuals and the presence of red complex microorganisms (RCM), such as Treponema denticola (Td), Porphyromonas gingivalis, and Tannerella forsythia in the subgingival tissues of periodontitis patients before and after the application of 4% mangostana gel (Garcinia mangostana [MGA]) as an adjunct to scaling and root planing (SRP). METHODS: Twenty-five patients (MGA group) were treated with SRP, and the subgingival application of mangostana gel was used as local drug delivery. Twenty-five patients (placebo group) were treated with SRP and placebo gel. Clinical parameters were recorded, and the presence of RCM was assessed at baseline and at the third month. RESULTS: Clinical parameters, such as probing pocket depth, clinical attachment level, bleeding index, plaque index, and Td, were significantly reduced in the MGA group compared to the placebo group from baseline to the third month. CONCLUSION: There was a significant improvement in the periodontal status with a reduction in Td with the application of mangostana gel in periodontal pockets. In the near future, 4% mangostana gel can be used as an adjunct to SRP to provide a new dimension to periodontal therapy.

Effect of Pranayama on Ppar-γ, Nf-κB Expressions and Red Complex Microorganisms in Patients with Chronic Periodontitis - A Clinical Trial.

INTRODUCTION: Sudarshankriya pranayama is the control of breathing movements to regulate the energy flow throughout the body, which has shown to positively affect immune function, autonomic nervous system and psychologic-neuro pathways. The practice of pranayama has been proven to show several benefits such as reduction in stress levels, relieves anxiety and depression, increase in antioxidant levels, reduces insulin resistance and improves respiratory function. AIM: The objective of the study was to evaluate the levels of Peroxisome Proliferator-Activated Receptor Gamma (PPAR-γ), Nuclear Factor-Kappa B (NF-κB) and the presence of Red Complex Microorganisms (RCM) such as Treponema denticola, Porphyromonas gingivalis and Tannerella forsythia in the subgingivalpl aque samples of chronic periodontitis subjects before and after intervention with pranayama as an adjunct to Scaling and Root Planing (SRP). MATERIALS AND METHODS: A total of 30 subjects (control group) were treated with SRP and 30 subjects (pranayama group) underwent SRP and pranayama for three months. Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Bleeding Index (BI) and Plaque Index (PI) were recorded and the presence of PPAR-γ, NF-κB and RCM were assessed at baseline and after three months using polymerase chain reaction. ANCOVA test was done to compare the clinical parameters between the groups. Fisher's Exact test was done to identify RCM and Mann-Whitney and Wilcoxon-signed test was used to identify the expression of NF-κB and PPAR-γ in the plaque samples. RESULTS: The change in the mean CAL from baseline to third month was significantly higher in pranayama group compared to control group (p≤0.05). There was a statistically significant reduction in the expression of NF-κB and increase in PPAR-γ expression levels in pranayama group on comparison with the control group (p<0.001). The reduction in number of positive samples with T.denticola, P.gingivalis and T.forsythia at third month post-intervention did not affect the change in the expression levels of NF-κB and PPAR-γ. CONCLUSION: The CAL showed significant improvement with reduction in the RCM, NF-κB and increase in PPAR-γ levels in subjects who underwent pranayama as an adjunct to SRP. In future, pranayama can be used as an additional treatment modality to provide a new dimension in treatment of periodontitis.

Epigenetics and Periodontitis: A Contemporary Review.

Periodontitis is characterized by infection and inflammation of the tooth supporting structures. Few signs of susceptibility and recurrence after treatment are seen due to the outgrowth of various pathogenic microorganisms. Many studies have been done to understand the genetic basis of periodontal disease. An increased risk for periodontitis has been shown with the variations in genes related to the inflammatory response. Interestingly, some of the genes regulated by epigenetic modifications are modified in response to environmental stimuli. Conditions such as cancer, autoimmune or inflammatory diseases have been dispensed by epigenetic mechanisms. The understanding of these molecular mechanisms and the early detection of susceptibility may guide in future periodontal disease treatment and prevention.