Assessment of sclerostin levels in the gingival crevicular fluid of patients with periodontitis: A clinico-biochemical crosssectional study.

Background: Sclerostin, a glycoprotein, plays a key role in regulating bone mass. In this study, sclerostin levels in the gingival crevicular fluid (GCF) were assessed in patients with Stage III Grade C generalized periodontitis (SIII-GC) and Stage III Grade B generalized periodontitis (SIII-GB). Methods: This cross-sectional study included 30 participants divided equally into three groups: group I (gingival health), group II (SIII-GC), and group III (SIII-GB). Clinical periodontal parameters like plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PD), and clinical attachment level (CAL) were recorded. A sandwich ELISA was used to determine the sclerostin levels in GCF samples. One-way ANOVA and post hoc Tukey tests were used to analyze the clinical parameters and GCF sclerostin levels. The association between GCF sclerostin levels and periodontal parameters was assessed using Pearson's correlation coefficient (r). Results: Patients in groups II and III had much higher sclerostin levels in their GCF than in group I (P≤0.05). In contrast, no significant difference in sclerostin levels was observed between the two diseased conditions (P=0.841). Concerning periodontal parameters, a statistically significant difference was observed between the three groups. There was a positive correlation between the periodontal clinical parameters and the expression levels of sclerostin in GCF (P≤0.05). Conclusion: Increased expression of sclerostin in GCF in patients with periodontitis indicated that it could be considered a reliable biomarker of periodontal disease activity.

An Overview of Chitosan and Its Role in Periodontics.

Chitosan is a biopolymer with numerous biological properties such as antibacterial, anti-inflammatory, and wound healing. Chitosan also stimulates cell proliferation and osteogenesis and thus used as a scaffold material in tissue engineering. The physical proprieties of chitosan such as biocompatibility and biodegradability give promising results in periodontal therapies. This review gives an updated explanation of the applications of chitosan in dentistry and periodontics. Furthermore, the review demonstrates the actions of chitosan in detail and its role in the regeneration of periodontal structures.

Sclerostin and its role as a bone modifying agent in periodontal disease.

BACKGROUND: Periodontitis is a highly prevalent inflammatory disease affecting the periodontium that results from an imbalance between periodontopathogens and host mechanisms. Continuous progression of the disease may lead to tissue and bone destruction, eventually resulting in tooth loss. The extent of bone loss depends on the dysregulated host immune response. Various host-elicited molecules play a major role in disease progression. The discovery of the glycoprotein sclerostin and its role as a regulator of bone mass has led to a better understanding of bone metabolism. HIGHLIGHT: Sclerostin, which is primarily expressed by osteocytes, is a negative regulator of bone formation. It is a potent antagonist of the canonical Wingless-related integration site (Wnt) pathway, which is actively involved in bone homeostasis. Sclerostin is known to stimulate bone resorption by altering the osteoprotegerin (OPG)/receptor activator of nuclear factor kappa- ß ligand (RANKL) balance. Additionally, in periodontitis, activation of the inflammatory cascade also increases the synthesis of sclerostin. CONCLUSION: The recently discovered sclerostin antibody has emerged as a positive therapeutic tool for the treatment of metabolic bone diseases. It has been reported to improve bone strength, bone formation, osseointegration around implants and lower the risk of bone fractures in various animal and human models. This review describes the properties and action of sclerostin, its role in periodontal diseases, and the advent and efficacy of sclerostin antibodies.

Ancient Seed for Modern Cure - Pomegranate Review of Therapeutic Applications in Periodontics.

Punica granatum (pomegranate), the member of Punicaceae family, is used in the prevention and treatment of health disorders. P. granatum contains diverse range of phytochemicals including ellagic acid, punicalagin, pedunculagin, quercetin, rutin, tannic acid, polyphenol, anthocyanins, and catechins. This review aims at providing an overview of the chemical constituents, antibacterial, anti-inflammatory, and antioxidant properties of P. granatum, and its role in the prevention and treatment of gingival and periodontal diseases.

Prevalence of gingival enlargement secondary to calcium channel blockers in patients with cardiovascular diseases.

AIM: The purpose of the present study was to determine the prevalence and extent of gingival overgrowth in patients treated with calcium channel blockers for cardiovascular diseases. BACKGROUND: Calcium channel blockers are widely used in the treatment of hypertension, vasoplastic angina, and cardiacarrythmias. Gingival overgrowth resulting from the use of calcium channel blockers is of primary concern to dentists. The purpose of the present study is to determine the prevalence and extent of gingival overgrowth in patients treated with calcium channel blockers for various cardiovascular diseases, to assess their periodontal status and to correlate the factors like age, sex, duration, dosage, type of drugs that result in gingival overgrowth. MATERIALS AND METHODS: A cross-sectional study was done in cardiac patients treated with calcium channel blockers, visiting The Railway hospital, Perumbur, Chennai. Information regarding medical history, type, duration, dosage of medication were recorded and analyzed. The periodontal condition of the patients was assessed using the plaque index, gingival index, calculus index, papillary bleeding index, and extent of gingival overgrowth using appropriate indices. The data was later subjected to statistical analysis. RESULTS: In this study, a total of 213 cardiac patients (145 males and 68 females) who met the inclusion and exclusion criteria were screened. The patients were between 19 and 69 years. CONCLUSIONS: From the results of the present study it can be concluded that gingival overgrowth does occur with calcium channel blockers. Elderly males appeared to be more susceptible to the development of drug-induced gingival overgrowth, which was independent of dosage, duration of drug administered but the presence of local factors seemed to aggravate the same.