Antimicrobial efficacy of grape seed extract in terminating the ramifications of plaque microorganisms: a randomized control study.

Background: Grape seed extract contains Proanthocyanin, which reduces collagen degradation by inhibiting interstitial and extracellular collagenase, thus having the potential to reduce the progression of periodontitis. Here we compare and evaluate the aerobic and anaerobic microorganism's CFUs (colony forming units) in plaque samples of Group A, Group B, Group C and severity of periodontal disease on day 0 and 7. Methods: Forty-five subjects in age range 18-30 years were selected among undergraduate students and randomly divided into Group A: 15, 2% grape seed extract mouthwash (GSE), Group B: 15, 0.2% chlorhexidine mouthwash (CHX) and Group C: 15, distilled water (control). The supragingival plaque was collected into transport media. Kruskal Wallis test followed by Mann Whitney test was used to compare the mean CFUs (×103) of microorganisms and severity of periodontal disease was compared, by clinical parameters among all groups on day 0 and 7. Results: There was a significant difference concerning mean scores of all clinical parameters (P<0.001) and mean CFUs of microorganisms between 3 study groups (P=0.005) at 7 days post-intervention period. Intragroup comparison, mean scores were significantly reduced on day 7 as compared to day 0 at (P<0.001) in Group A and B, but no significant difference was noted with Group C. Conclusion: Intervention with GSE mouthwash showed a positive effect on reducing CFUs in the plaque when compared with the control group. GSE group also showed similar results in reducing CFUs in plaque when compared to CHX group, thereby demonstrating the agent's antimicrobial efficacy, therapeutic effect and its potential usefulness in controlling plaque and periodontal diseases.

Effect of smokeless tobacco use on salivary glutathione levels among chronic periodontitis patients before and after non-surgical periodontal therapy.

INTRODUCTION: Smokeless tobacco (SLT) jeopardizes periodontal health and also produces an imbalance between reactive oxygen species (ROS) and antioxidants (AO) such as glutathione. Glutathione is an important redox regulator in saliva and its maintenance is essential for periodontal health. Periodontitis patients have a reduced total AO capacity in whole saliva, and periodontal therapy restores the redox balance. Hence, the purpose of this study was to investigate the effects of smokeless tobacco use on saliva glutathione levels in patients with chronic periodontitis and to evaluate these effects after non-surgical periodontal therapy. METHODS: The study included 100 subjects in four groups; healthy, gingivitis, and chronic periodontitis (CP) patients with and without SLT use. Saliva samples were collected, and clinical periodontal parameters were recorded at baseline and at one month after non-surgical periodontal therapy. Glutathione levels were analyzed using spectrophotometry at 412 nm. Statistical analysis was carried out using paired t-test, chi-squared, and analysis of variance (ANOVA). RESULTS: Mean glutathione values in saliva were found to be lower in periodontitis patients compared to SLT users at baseline and at 1 month post non-surgical periodontal therapy (p<0.001) In addition, non-surgical therapy leads to a highly significant improvement in the glutathione levels in gingivitis, in the CP with and without ST groups (p<0.001). CONCLUSIONS: Successful non-surgical periodontal therapy leads to considerable progress in the redox balance, thus regulating glutathione levels and reducing the effects of SLT on the periodontium. This emphasises the importance of non-surgical therapy, especially among SLT users.

8-Isoprostane in chronic periodontitis and type II diabetes: Exploring the link.

Background. Reactive oxygen species (ROS) are associated with the pathogenesis of inflammatory diseases and have a direct or indirect role in tissue damage constituting oxidative stress. ROS are also involved in impairment of ß-cell function during development of diabetes, which leads to genetic ablation of KATP channels, triggering up-regulation of antioxidant enzymes. Several markers of lipid peroxidation, protein oxidation and DNA damage induced by ROS can be measured. Over the last decade, isoprostanes have been considered as the best markers of lipid peroxidation. The aim of this study was to determine the presence of 8-isoprostane in healthy, chronic periodontitis and chronic periodontitis subjects with type II diabetes and to find the correlation between 8-isoprostane levels among groups and with clinical parameters like gingival index, probing depth and clinical attachment levels. Methods. Ninety subjects were selected and divided into 3 groups: healthy, chronic periodontitis and chronic periodontitis subjects with type II diabetes (n=30 each). Saliva was collected from these subjects after obtaining consent and analyzed for 8-isoprostane levels using ELISA kit. Statistical analysis was performed using Kruskal-Wallis test, Mann-Whitney U test and Spearman's correlation coefficient (P<0.001). Results. Statistically significant difference was found in the levels of 8-isoprostane between healthy, chronic periodontitis and chronic periodontitis subjects with type II diabetes and with all clinical parameters. Conclusion. 8-isoprostane can be considered as a pathophysiological marker to measure oxidative stress in periodontal diseases.

Gamma Glutamyl Transpeptidase, Smokeless Tobacco, Chronic Periodontitis: Exploring the Link.

INTRODUCTION: Oxidative Stress (OS) is implicated in the pathogenesis of many systemic and oral diseases such as periodontal disease. Smokeless tobacco extract produces apoptosis and causes an imbalance between reactive oxygen species and antioxidants, such as Gamma Glutamyl Transpeptidase (GGT). Epidemiological research implied serum GGT within its normal range to be an early sensitive enzyme related to OS. AIM: To assess how GGT fares as a biomarker in periodontitis subjects with or without the usage of smokeless tobacco and correlate it with clinical parameters. MATERIALS AND METHODS: Ninety subjects were divided into three groups of healthy, chronic periodontitis, and smokeless tobacco users with chronic periodontitis from the dental outpatient department of P.M. Nadagouda Memorial Dental College and Hospital. Serum samples of patients were collected after obtaining consent and analyzed for GGT. Statistical Analysis was performed using ANOVA, and Pearson's correlation coefficient. RESULTS: GGT levels were found to be significantly higher in chronic periodontitis patients compared to smokeless tobacco users with chronic periodontitis and healthy subjects. Conclusion: GGT may be used as a quick, easy and precise marker for measuring OS in patients with chronic periodontitis and smokeless tobacco users.

Betacellulin in Chronic Periodontitis Patients With and Without Type 2 Diabetes Mellitus: An Immunohistochemical Study.

BACKGROUND: The host immune response to bacterial dental plaque determines periodontal disease susceptibility by increasing the secretion of inflammatory cytokines. The Epidermal Growth Factor family cytokines stimulate proliferation and keratinization of cells in dermis and oral epithelium. Epidermal Growth Factor family consists of Amphiregulin, Betacellulin, Epiregulin, Epigen, Heparin binding Epidermal Growth Factor like growth factor and transforming Growth Factor-alpha. AIM: The current study aimed to investigate expression of Betacellulin in chronic periodontitis patients with and without type 2 diabetes mellitus and thereby assessing role of betacellulin in periodontal health and disease. MATERIALS AND METHODS: Present study comprised of 90 participants, age ranges from 18 to 60-year-old, for the period of March 2010 to May 2011. Participants were categorized into three groups based Gingival index (GI), probing depth (PD) and clinical attachment loss (CA Loss). Group 1 consisted 30 individuals with clinically healthy periodontium, Group-2 consisted 30 individuals with GI>1, PD≥5 mm, and CA Loss>3 mm. Group-3 (Chronic Periodontitis with type 2 diabetes mellitus) consisted 30 with GI >1, PD≥5 mm, and CA Loss>3 mm. Immunohistochemical localization and quantification of Betacellulin was done in gingival tissue samples from all groups. RESULTS: Data showed expression of Betacellulin were higher in chronic periodontitis as compared to healthy. A positive correlation found in Betacellulin expression and Probing Depth in chronic periodontitis. CONCLUSION: This footmark study impacts the role of Betacellulin in pathogenesis and progression of periodontal disease which will help in exploration of novel immunotherapeutic strategies and immunological research activity in this field.

Determining the Effect of Gutkha on Serum Levels of Vitamin B12 and Folic Acid as Compared to Smoking among Chronic Periodontitis Subjects : A Cross-Sectional Study.

BACKGROUND: Periodontitis, being a common inflammatory disease has a multifactorial origin , with smoking and gutkha as few of the causative entities. The role of smoking as a risk factor for periodontitis is been well documented in literature. Cigarette smoke also affects vitamin B12 and folic acid mechanisms. Nutritionally derived vitamin B12 occurs mainly as either hydroxycobalamin or deoxyadenosycobalmin. Folic acid is also heat sensitive and water soluble, closely linked to vitamin B12 in its metabolism. However, effect of smokeless tobacco in form of gutkha on serum levels of vitamin B12 and folic acid is yet to be explored. AIMS AND OBJECTIVES: To estimate and correlate serum vitamin B12 (VB12) and folic acid (FA) levels among periodontally healthy subjects and Chronic Periodontitis (CP) subjects with habit of smoking and gutkha chewing. MATERIALS AND METHODS: The study included 111 subjects ranging in age from 18 to 60 y. Participants were divided into four groups: 30 healthy subjects (Group I), 29 subjects with CP (Group II), 25 smokers with CP (Group III) and 27 gutkha chewers with CP (Group IV). Clinical parameters included pocket probing depth (PPD), clinical attachment level (CAL) & gingival index (GI) following which VB12 and FA levels were estimated through UV-spectrophotometry method and data was analysed using Statistical Package for Social Scientists software, Mann-Whitney U-test and Pearson correlation coefficient. p-values less than 0.05 were considered as significant. Results : Pairwise comparison by Mann-Whitney U-test showed an increase in the serum VB12 in Group IV when compared to Group I (p=0.01) and Group II (p=0.01). Although serum FA levels were found to be low in Group III (7.61 ug/ml) & Group IV (8.64 ug/ml), Group III was found to be statistically significant (P=0.046). The clinical parameters GI, PPD and CAL among the four groups of patients were also statistically significant (p < 0.05). CONCLUSION: The study results suggested that among the patients with periodontal disease, serum VB12 levels are directly related while serum FA levels are inversely related to inflammation and tissue destruction in periodontium as occurred in Group IV.

Expression profile of IL-35 mRNA in gingiva of chronic periodontitis and aggressive periodontitis patients: a semiquantitative RT-PCR study.

BACKGROUND: Proinflammatory and anti-inflammatory cytokines play a key role in the pathogenesis of periodontal diseases. Secretion of bioactive IL-35 has been described by T regulatory cells (T(regs)) and is required for their maximal suppressive activity. T(regs) are involved in the modulation of local immune response in chronic periodontitis patients. OBJECTIVE: Hence, the present study was aimed to investigate the expression of IL-35 mRNA in chronic periodontitis and aggressive periodontitis patients. MATERIALS AND METHODS: The present study was carried out in 60 subjects, which included 20 chronic periodontitis patients, 20 aggressive periodontitis patients, and 20 periodontally healthy controls. IL-35 mRNA expression in gingival tissue samples of all subjects was semiquantitatively analyzed using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). RESULTS: The present study demonstrated the expression of IL-35 mRNA in gingival tissues of all the three groups. IL-35 mRNA expression was highest in chronic periodontitis subjects (6.87 ± 2.32) as compared to the aggressive periodontitis group (4.71 ± 1.43) and least seen in healthy patients (3.03 ± 1.91). CONCLUSION: The increased expression of IL-35 in chronic and aggressive periodontitis suggests its possible role in pathogenesis of periodontitis. Future studies done on large samples with intervention will strengthen our result.

Female sex hormones and periodontal health-awareness among gynecologists - A questionnaire survey.

UNLABELLED: Sex hormones play an important role in periodontal health and disease. For example, puberty, menses, pregnancy, menopause, and oral contraceptive use influence a woman's periodontal health. Periodontal infection has also been associated with adverse pregnancy outcomes. Subsequently, it is important that gynecologists are educated about hormonal effects on women's oral health. The current study assessed gynecologist's awareness regarding the effect of female sex hormones on periodontal health, preterm delivery, and maternal periodontal disease. METHODS: Gynecologists from the Bagalkot district of the Karnataka state, India, completed a questionnaire regarding female hormonal and periodontal health. Respondents were divided into two groups: Group A (doctors that practiced at a medical college or hospital) and Group B (doctors that practiced at private hospitals). Out of 73 gynecologists, 62 (85%) completed the survey, with 19 (30.6%) participants in Group A and 43 (69.4%) participants in Group B. Survey responses were collected in the presence of the investigator, and data between the groups were statistically compared. RESULTS: Our findings showed that most gynecologists were aware and concerned about female patient's oral health during various hormonal phases. However, gynecologists practicing at medical colleges and hospitals (Group A) had significantly greater health awareness than doctors practicing at private hospitals (Group B). CONCLUSION: Women have special periodontal health care considerations, and there is a need for better oral health education among caregivers. Our results suggest that increasing dental health awareness among gynecologists would significantly improve women's health and pregnancy outcomes.

Analysis of inorganic ions in gingival crevicular fluid as indicators of periodontal disease activity: A clinico-biochemical study.

AIM: Gingival crevicular fluid (GCF) is regarded as a promising medium for detection of markers of periodontal disease activity. Very few investigators have examined concentration of electrolytes in GCF, but most results are not in agreement to one another. This study was undertaken with an objective of quantitative estimation of sodium, potassium and calcium concentrations of GCF in gingivitis and periodontitis, to find the reliability of these ions as diagnostic markers and to analyze the relation of these ions to one another. This will indicate stage of disease activity which helps in early diagnosis, prevention and treatment of periodontal diseases. MATERIALS AND METHODS: The patients selected for the study included both sexes, aging from 18 to 55 years, divided into two groups: gingivitis (group I) and periodontitis (group II). Using volumetric microcapillary pipette, 5 µl GCF was collected for quantitative analysis of sodium, potassium and calcium using flame photometry. RESULTS: The concentrations of sodium, potassium and calcium in GCF and their significant correlation with gingival index and pocket depth measurements reflect the clinical status of gingival and periodontal tissues. CONCLUSIONS: Estimation of these electrolytes may be used as potential diagnostic markers of active disease status in periodontal tissues and to predict the effective methods of prevention and treatment.

ABO blood groups and Rhesus factor: an exploring link to periodontal diseases.

BACKGROUND: The presence or absence of blood group antigens has been associated with various diseases, with antigens also acting as receptors for infectious agents. Scanty literature is available in assessing the relative liability of blood group phenotypes to periodontal diseases. This research was conducted to determine the association of the ABO blood group and Rhesus (Rh) factor to periodontal diseases to assess whether they could be the predictors of periodontal diseases. MATERIALS AND METHODS: A total of 1,220 subjects aged between 20 and 55 years were selected on a random basis. The study populations were segregated into three groups according to Ramfjord's periodontal disease index: Healthy, Gingivitis and Periodontitis. Blood samples were collected to identify the ABO blood groups and the Rh factor by the slide method. RESULTS: Blood group A showed a significantly higher percentage in the gingivitis group and blood group O showed a higher percentage in the periodontitis group. The blood group AB showed the least percentage of periodontal diseases. The distribution of Rh factor in all groups showed a significantly higher distribution of Rh-positive. CONCLUSION: The genetic factors may alter the oral ecology and the process of periodontal disease. These data are suggestive of a broad correlation between periodontal diseases and blood groups, which may act as risk predictors for periodontal diseases. This will make it possible to better-understand the risk factors of diseases of the periodontal tissues and to predict the effective methods of prevention and treatment of periodontal diseases.