Association of adipocyte fatty acid-binding protein and tumor necrosis factor alpha with periodontal health and disease: A cross-sectional investigation.

BACKGROUND: Adipocyte fatty acid binding protein (A-FABP) is a novel biomarker of inflammation for various chronic systemic diseases. Since periodontitis is a chronic inflammatory disease, this study explores the association of A-FABP with periodontal disease parameters and tumor necrosis factor-alpha (TNF-α) levels in gingival crevicular fluid in periodontal health and disease. MATERIALS AND METHODS: This original research article describes a cross-sectional study conducted at the Department of Periodontics, M. R. Ambedkar Dental College and Hospital, Bangalore, India. This cross-sectional investigation was conducted on sixty subjects which were divided into three groups of twenty subjects each - healthy, gingivitis, and chronic periodontitis. Clinical parameters - plaque index, bleeding index, probing depth, and clinical attachment loss were recorded. Gingival crevicular fluid samples were analyzed for A-FABP and TNF-α levels using ELISA. One-way analysis of variance was used to find the significance of study parameters on a continuous scale between three groups. Pearson's correlation has been used to find the relationship between Gingival crevicular fluid concentration of markers and periodontal parameters. Multiple linear regression analysis was applied to the study. The statistical significance was considered at P < 0.05. RESULTS: Mean concentration of A-FABP (6.43 ± 2.51) and TNF-α (3454.82 ± 1566.44) was highest in the periodontitis group, and the difference among the groups was statistically significant (P < 0.05). A positive correlation was observed between clinical attachment loss and the two markers among all groups. The correlation between A-FABP and TNF-α in periodontitis groups was positive and statistically significant (P < 0.05). Multiple linear regression model was statistically significant (P < 0.05) indicating that there is a significant relationship between the set of predictors and the clinical attachment loss. CONCLUSION: A-FABP and TNF-α levels in GCF were significantly elevated in the presence of inflammation. A-FABP has a probable stimulatory effect on TNF-α; however, its role needs to be explored. A-FABP could serve as a novel inflammatory biomarker of periodontitis and the scope of using A-FABP inhibition as a treatment modality could be investigated with interventional studies.

Estimation of soluble CD14 levels in gingival crevicular fluid and serum in diseased and healthy periodontium.

OBJECTIVE: To estimate the levels of sCD14 in gingival crevicular fluid and serum under periodontally-healthy and diseased conditions. METHODS: The subjects were divided into three groups of 15, each as follows: healthy, gingivitis, and periodontitis. Periodontal parameters including Probing pocket depth, Clinical attachment level, Bleeding index, and Plaque index. Gingival crevicular fluid and serum samples were collected and analyzed for sCD14 levels using commercially-available ELISA kits. RESULTS: The mean concentration of sCD14 in GCF was significantly lower in the gingivitis (134.5 ± 26.85 ng/mL) and periodontitis (103.23 ± 20.36 ng/mL) groups than in the healthy group (172.77 ± 46.33 ng/mL); p < 0.001. The mean serum concentration of sCD14 in the healthy group was 1528.13 ± 387.37 ng/mL, which was significantly less than that of the periodontitis group (2051.50 ± 381.10 ng/mL); p = 0.011. CONCLUSIONS: The serum sCD14 levels in the periodontitis groups were significantly higher than those in the healthy controls. The levels of sCD14 in GCF were significantly lower in the gingivitis and periodontitis groups than in the healthy group.

Impact of Weight Reduction on Adiponectin and TNF-α Levels in the Gingival Crevicular Fluids of Obese Patients with and without Periodontal Disease.

AIM: The aim of the current study was to assess the impact of weight loss on the gingival crevicular fluids (GCF) levels of adiponectin and TNF-α in obese patients with periodontal disease. MATERIALS AND METHODS: Sixty obese subjects were recruited into the study and were divided into three groups of 20 each. Group 1-periodontally healthy obese patients, group 2-obese patients with gingivitis, group 3-obese patients with periodontitis. The GCF levels of adiponectin and tumor necrosis factor α (TNF-α) were evaluated using ELISA, and the same was correlated with the probing pocket depth (PPD) and clinical attachment loss (CAL) at baseline and after attainment of ≥10% weight reduction. RESULTS: Reductions in body weight resulted in elevated adiponectin and reduced TNF-α levels in the GCF. Adiponectin levels showed significant positive correlations and TNF-α negative correlation with improved periodontal parameters. CONCLUSION: Weight reduction has an impact on obesity-related inflammatory changes on periodontal disease. CLINICAL SIGNIFICANCE: Obesity can be a potential risk factor for periodontitis, weight reduction measures can considerably reduce the inflammatory burden on the periodontium.

Effect of Weight Reduction on the Serum Adiponectin and Tumor Necrosis Factor-α Levels and the Clinical Parameters of Obese Patients with and without Periodontal Disease.

OBJECTIVE: The objective of the current study was to assess the impact of weight reduction on the attenuation of obesity-related periodontal inflammation. METHODS: This study was conducted enrolling 60 obese subjects. They were divided into three groups of 20 each. Group 1-healthy group, Group 2-gingivitis group, and Group 3-periodontitis group. The body mass index and waist/hip ratio, periodontal parameters such as plaque index, bleeding index, full mouth periodontal probing depth (PPD) using the University of North Carolina 15 (UNC 15) probe and full mouth clinical attachment loss (CAL) with cementoenamel junction as the reference using UNC 15 probe was evaluated at baseline and after the attainment of ≥10% weight loss by the subjects. Adiponectin and tumor necrosis factor-alpha (TNF-α) levels were measured in the serum at baseline and after attainment of ≥10% reduction in weight in a period of 3-18 months. RESULTS: Adherence to weight reduction program until the achievement of ≥10% reduction in body weight resulted in statistically significant (P < 0.0001) elevated serum adiponectin and reduced serum TNF-α levels in all three groups. Furthermore, elevations of adiponectin following weight reduction showed significant negative correlations with PPD in all the three groups and in patients with periodontitis, (Group 3) serum adiponectin levels showed significant negative correlations (P = 0.0001) with CAL in Group 3. CONCLUSIONS: Controlling obesity presents a good opportunity to alleviate the burden of periodontal disease. Simple weight reduction programs with diet and exercise-related lifestyle modifications may be an efficacious and barrier-free option.

Effectiveness of Platelet Rich Plasma and Bone Graft in the Treatment of Intrabony Defects: A Clinico-radiographic Study.

BACKGROUND & OBJECTIVES: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment and alveolar bone around the affected tooth. Different modalities have been employed in the treatment and regeneration of periodontal defects which include the use of bone grafts, PRP and other growth factors.The purpose of this prospective, randomized controlled study was to compare the regenerative efficacy of PRP and bonegraft in intrabony periodontal defects. METHODOLOGY: This randomized control trial was carried out in the Department of Periodontics & Oral Implantology, Kalinga Institute of Dental Sciences and Hospital, KIIT University, Bhubaneswar. The study sample included 20 periodontal infrabony defects in 20 patients, 12 males and 8 females. The patients were aged between 25 -45 years(with mean age of 35 years). The 20 sites selected for the study were was randomly divided into 2 groups of 10 sites each. Group A: PRP alone, Group B: Bone Graft. STATISTICAL ANAYSIS & RESULTS STATISTICAL ANALYSIS WAS DONE USING SPSS VERSION 180: Statistical analysis was done usingpaired 't' tests and ANOVA that revealed a significant reduction ingingival index, plaque index, probing pocket depth and gain in clinical attachment level at various time intervalswithin both the groups. Radiographic evaluation revealed statistically significant defect fill (p<0.001) at the end of 6months within both the groups. However, there was astatistically significant difference seen in group B radiographically, when compared to group A. CONCLUSION: Both the groups showed promising results in enhancing periodontal regeneration; however the resultswith bonegraftwere comparatively better, although not statistically significant when compared to PRP alone.

Effect of Alox-15 Polymorphism on GCF Levels of Lipoxin-A4 in Chronic Periodontitis: A Preliminary Study.

Lipoxins play an important role in periodontal resolution, hence, investigation of genetic polymorphism of lipoxin gene may provide important information on the role of lipoxins in periodontal disease pathogenesis. The aim of this study was to investigate a polymorphism of C-to-T substitution at position c.-292 in ALOX15 (reticulocyte-type 15 lipoxygenase 1) gene in patients with chronic periodontitis and to associate the polymorphism with gingival crevicular fluid (GCF) lipoxin A4 (LXA4) levels. Forty-five chronic periodontitis and 45 periodontally healthy patients were included in this case-control study. Plaque index, calculus index, sulcus bleeding index, full mouth probing depth (PD) and clinical attachment loss (CAL) were recorded. GCF and blood samples were collected. GCF was analyzed for LXA4 levels by enzyme linked immunosorbant assay. Genotyping of ALOX15 polymorphism was studied using PCR. Mean LXA4 was lower in periodontitis group compared to the periodontally healthy group. There was a negative correlation between CAL and LXA4. The CC genotype was higher in the study group than in the control group. In the study group, mean CAL was significantly lower among individuals with the CT genotype. Mean LXA4 was significantly lower in CC genotype (45.0±7.11 ng/mL) compared to CT genotype (50.81±5.81 ng/mL) among the patients with periodontitis. The results suggest that LXA4 and c.-292T allele are associated with periodontal health. Polymorphisms in the ALOX15 gene may influence periodontal disease pathogenesis. Hence, investigation of such polymorphisms could benefit the evaluation of lipoxins role in periodontal disease.

Use of Platelet Rich Plasma in the Management of Periodontal Intra-Osseous Defects: A Clinical Study.

BACKGROUND: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment, and alveolar bone around the affected tooth. Alveolar bone support and attachment apparatus regeneration has been achieved through various processes and have given elusive results. An expedient and cost-effective approach to obtain autologous platelet-derived growth factor (PDGF) and transforming growth factor (TGF)-ß is the use of platelet-rich plasma (PRP). PRP is obtained by sequestrating and concentrating platelets by gradient density centrifugation. AIMS: The current study was aimed at evaluating the regenerative potential of platelet-rich plasma in comparison with open flap debridement. SETTINGS AND DESIGNS: This study was a randomized controlled clinical trial conducted in the Department of Periodontics and Oral Implantology, KIDS, Bhubaneswar, Odisha. MATERIALS AND METHODS: Twenty periodontal infrabony defects in 10 patients; 6 males and 4 females of age between 25-45 years were included in this study and were followed up for a period of 6 months. STATISTICAL ANALYSIS: Both the groups showed a mean plaque index of 2.10 and 2.50 at baseline, 1.75 and 2.05 at 3 months, and 1.28 and 1.53 at the end of 6 months. The mean reduction of 0.35 and 0.45 at three months and 0.82 and 0.97 at six months was achieved, which was statistically significant. (P < 0.001). When comparison was done between the two groups it was not found to be statistically significant (P < 0.05). In each of the group there was definitive reduction in plaque score over a period of time. RESULTS AND CONCLUSION: There was no statistically significant difference in the treatment outcome between open flap debridement and PRP alone. Platelet-rich plasma application holds promise and needs further exploration.

Effect of Alox-15 Polymorphism on GCF Levels of Lipoxin-A4 in Chronic Periodontitis: A Preliminary Study

Lipoxins play an important role in periodontal resolution, hence, investigation of genetic polymorphism of lipoxin gene may provide important information on the role of lipoxins in periodontal disease pathogenesis. The aim of this study was to investigate a polymorphism of C-to-T substitution at position c.-292 in ALOX15 (reticulocyte-type 15 lipoxygenase 1) gene in patients with chronic periodontitis and to associate the polymorphism with gingival crevicular fluid (GCF) lipoxin A4 (LXA4) levels. Forty-five chronic periodontitis and 45 periodontally healthy patients were included in this case-control study. Plaque index, calculus index, sulcus bleeding index, full mouth probing depth (PD) and clinical attachment loss (CAL) were recorded. GCF and blood samples were collected. GCF was analyzed for LXA4 levels by enzyme linked immunosorbant assay. Genotyping of ALOX15 polymorphism was studied using PCR. Mean LXA4 was lower in periodontitis group compared to the periodontally healthy group. There was a negative correlation between CAL and LXA4. The CC genotype was higher in the study group than in the control group. In the study group, mean CAL was significantly lower among individuals with the CT genotype. Mean LXA4 was significantly lower in CC genotype (45.0±7.11 ng/mL) compared to CT genotype (50.81±5.81 ng/mL) among the patients with periodontitis. The results suggest that LXA4 and c.-292T allele are associated with periodontal health. Polymorphisms in the ALOX15 gene may influence periodontal disease pathogenesis. Hence, investigation of such polymorphisms could benefit the evaluation of lipoxins role in periodontal disease.

Resumo Lipoxinas desempenham um papel importante na recuperação periodonta, portanto, a investigação do polimorfismo genético do gene da lipoxina pode fornecer informações importantes sobre o papel das lipoxinas na patogênese da doença periodontal. O objetivo deste estudo foi investigar um polimorfismo de substituição C-to-T na posição c-292 no gene ALOX15 (reticulócito-tipo 15 lipoxigenase 1) em pacientes com periodontite crônica e associar o polimorfismo com a lipoxina A4 (LXA4) do fluido gengival crevicular (FGC). Quarenta e cinco pacientes com periodontite crônica e 45 pacientes periodonalmente saudáveis foram incluídos neste estudo caso-controle. Índice de placa, índice de cálculo, índice de sangramento do sulco, profundidade de sondagem (PS) da boca toda e perda de inserção clínica (PIC) foram registrados. Amostras do FGC e de sangue foram coletadas. O FGC foi analisado quanto aos níveis de LXA4 por ensaio imunoadsorvente ligado à enzima (ELISA). A genotipagem do polimorfismo ALOX15 foi estudada por PCR. A média de LXA4 foi menor no grupo de periodontite em comparação com o grupo periodontalmente saudável. Houve uma correlação negativa entre PIC e LXA4. O genótipo CC foi maior no grupo de estudo do que no grupo controle. No grupo de estudo, a média de PIC foi significativamente menor entre os indivíduos com o genótipo CT. A média de LXA4 foi significativamente menor no genótipo CC (45,0 ± 7,11 ng / mL) em comparação com o genótipo CT (50,81 ± 5,81 ng / mL) entre os pacientes com periodontite. Os resultados sugerem que o alelo LXA4 e o alelo c-292T estão associados à saúde periodontal. Polimorfismos no gene ALOX15 podem influenciar a patogênese da doença periodontal. Assim, a investigação de tais polimorfismos pode beneficiar a avaliação do papel das lipoxinas na doença periodontal.

Association of interferon lambda-1 with herpes simplex viruses-1 and -2, Epstein-Barr virus, and human cytomegalovirus in chronic periodontitis.

AIM: Periodontal tissues facilitate the homing of herpes viruses that elicit the immune-inflammatory response releasing the interferons (IFN). IFN lambda-1 (λ1) can suppress the replication of viruses, and induces the antiviral mechanism. The aim of the present study was to evaluate the association between IFN-λ1 and periodontal herpes viruses in the immunoregulation of chronic periodontal disease. METHODS: The cross-sectional study design included 30 chronic periodontitis patients with a mean age of 42.30 ± 8.63 years. Gingival crevicular fluid collected was assessed for IFN-λ1 using enzyme-linked immunosorbent assay and four herpes viruses were detected using multiplex polymerase chain reaction technique. IFN-λ1 levels were compared between virus-positive and -negative patients for individual and total viruses. RESULTS: Fifty per cent (n = 15) of patients were positive for the four herpes viruses together; 50% (n = 15), 30% (n = 9), 26.7% (n = 8), and 40% (n = 12) were positive for herpes simplex virus (HSV)-1, Epstein-Barr virus, HSV-2, and human cytomegalovirus, respectively. The mean concentrations of IFN-λ1 in virus-positive patients (14.38 ± 13.95) were lower than those of virus-negative patients (228.26 ± 215.35). INF-λ1 levels in individual virus groups were also lower in virus-positive patients compared to virus-negative patients, with P < 0.001. CONCLUSIONS: These results suggest that IFN-λ1 could have antiviral and therapeutic value against the viruses in the pathogenesis of chronic periodontitis.

Role of autoimmune responses in periodontal disease.

Periodontal diseases are characterized by localized infections and inflammatory conditions that directly affect teeth supporting structures which are the major cause of tooth loss. Several studies have demonstrated the involvement of autoimmune responses in periodontal disease. Evidences of involvement of immunopathology have been reported in periodontal disease. Bacteria in the dental plaque induce antibody formation. Autoreactive T cells, natural killer cells, ANCA, heat shock proteins, autoantibodies, and genetic factors are reported to have an important role in the autoimmune component of periodontal disease. The present review describes the involvement of autoimmune responses in periodontal diseases and also the mechanisms underlying these responses. This review is an attempt to throw light on the etiopathogenesis of periodontal disease highlighting the autoimmunity aspect of the etiopathogenesis involved in the initiation and progression of the disease. However, further clinical trials are required to strengthen the role of autoimmunity as a cause of periodontal disease.

Extramedullary plasmacytoma of gingiva and soft tissue in neck.

Plasmacytoma is a malignant disease that present either in bone marrow (medullary plasmacytoma), within the bone (solitary plasmacytoma of bone), or outside of bone, as the extramedullary plasmacytoma. Extramedullary plasmacytoma accounts for 3% of all plasma cell tumours and approximately 90% of extramedullary plasmacytomas affect the head and neck region commonly affecting the nasal cavity, paranasal sinuses, tonsillar fossa and oral cavity. Multiple extramedullary plasmacytoma is defined when there is more than one extramedullary tumour of clonal plasma cells and such presentations are extremely rare. We report such a rare case of multiple extramedullary plasmacytoma involving gingiva and neck. Here is a case report of a 65-year-old female patient presenting with extramedullary plasmacytoma of the gingiva and soft tissue in neck.

Awareness of the association between periodontal disease and pre-term births among general dentists, general medical practitioners and gynecologists.

In the recent decades, periodontal disease has been identified as a risk factor for pre-term deliveries. Hence, it is important to evaluate the awareness of health-care providers of the association between periodontal diseases and pre-term birth. A self-administered questionnaire was distributed to random samples representing general medical practitioners (GMPs), general dental practitioners (GDPs) and Gynecologists for this study. A knowledge score was calculated for correct answers to 11 survey questions related to oral health effects during pregnancy and compared among the three groups. In this study, 133 physicians, 135 dentists and 100 Gynecologists completed the questionnaire. More GDPs (67.4%) than GMPs (56.4%) and Gynecologists (63%) reported there was an association between periodontal disease and pre-term low birth weight. Efforts to increase this awareness may prove valuable in improving preventive care during pregnancy.

Effect of smoking on neutrophil apoptosis in chronic periodontitis: an immunohistochemical study.

CONTEXT: Periodontal disease is caused by chronic infection inducing an inflammatory reaction leading to breakdown of tooth-supporting tissues. There are various risk factors for the disease, and smoking is one of them. Apoptosis plays a critical role in the regulation of inflammation and host immune response which helps in tissue homeostasis, and a disturbance in this is often associated with disease. The imbalance between the apoptosis and proliferation in the periodontal tissue results in periodontal disease. Neutrophils play an important role in the defense mechanism and are the most abundant immune cells in gingival inflammatory infiltrate in patients suffering from periodontal disease. Neutrophil disorders are associated with rapid destruction of periodontal tissues. AIM: To study the influence of smoking on apoptosis of neutrophils by quantifying them in the gingival connective tissue of smoking and nonsmoking subjects suffering from chronic periodontitis. MATERIALS AND METHODS: Thirty gingival biopsies were harvested from 15 smoking and 15 nonsmoking subjects who suffered from chronic periodontitis. The apoptosis of neutrophils was assessed and quantified using p53 monoclonal mouse antihuman antibody. STATISTICAL ANALYSIS USED: Chi-square/Fisher's exact test was used to find the significance of study parameters on a categorical scale between the two groups. RESULTS: Neutrophil apoptosis was significantly more in the group of nonsmokers. There was no statistical difference between plaque and bleeding index, but there was a significant increase in clinical attachment loss among smokers. CONCLUSIONS: The study reveals that smoking plays a significant role in the inhibition of neutrophil apoptosis, thereby contributing to the destruction of periodontal tissues in periodontitis.

Efficacy of a new interdental cleaning aid.

BACKGROUND: It is now well established that removal of bacterial plaque can reduce the severity of chronic inflammatory periodontal disease. Periodontal disease is seen to progress faster interdentally and plaque control in these areas is of great importance. Various types of interdental cleaning aids have been developed in recent years. This study was aimed at evaluating the efficacy of a newly developed interdental cleaning aid, BrushPick, in a split mouth randomized clinical trial. MATERIALS AND METHODS: This was a split mouth design study where the quadrant on one side of the oral cavity served as the control while another quadrant on the opposite side served as the test sample. Fifty-seven patients with mild-to-moderate periodontitis, presenting with open interdental embrasures, were selected for the study. After non-surgical periodontal therapy, they were asked to use the BrushPick in the embrasures on one side of the arch in a spilt mouth design study and the embrasures on the other side acted as controls. The Rustogi et al. modified Navy plaque index (RMNPI) and interdental bleeding index (IBI) were recorded at baseline, seven days, 14 days, and 28 days. STATISTICAL ANALYSIS: The mean differences between test and control sites were compared using the studentt test. The mean difference was compared between different durations using analysis of variance (ANOVA). RESULTS: The mean RMNPI was significantly different between the test and control sites at P<0.001 on both days 14 and 28. At 28 days the mean IBI was 0.08 (SD=0.02) for the experimental sites and 0.28 (SD=0.11) for the control sites. The difference was statistically significant at P<0.001. ANOVA showed that the mean RMNPI scores and mean IBI scores showed a statistically significant difference when compared at different durations at the test sites (P<0.0001). But, at the control sites there was no significant change. CONCLUSION: This study suggested that BrushPick reduces plaque and gingival bleeding in open interdental embrasures. Further large sampled clinical trials and comparative studies using gold standard interdental cleaning aids are required to establish the efficacy of this device.

Estimation of the level of tumor necrosis factor- α in gingival crevicular fluid and serum in periodontal health & disease: A biochemical study.

UNLABELLED: Tumor Necrosis Factor-α(TNF-α), a "major inflammatory cytokine" not only plays an important role in periodontal destruction, but also is extremely toxic to the host. Till date, there are not many studies comparing the levels of TNF-α in GCF and serum and its relationship to periodontal disease. aim: Hence, an attempt is made to estimate the level of TNF-α in GCF and serum, its relationship to periodontal disease, and to explore the possibility of using the level of TNF-α in GCF as a biochemical "marker" of periodontal disease. MATERIALS AND METHODS: 60 subjects participated in the study and were grouped into control, gingivitis and periodonititis groups. The GCF and serum samples were assayed for TNF-α levels by Enzyme Linked Immunosorbent Assay (ELISA) method. RESULTS: Showed elevated levels of TNF-α in group II and III subjects as compared to healthy controls in both GCF and serum, suggesting an association between periodontal disease and levels of TNF-α. CONCLUSION: It remains a possibility that the absence or low levels of TNF-α in GCF might indicate a stable lesion and elevated levels might indicate an active site but only longitudinal studies taking into account, the disease "activity" and "inactivity" could suggest the possibility of using TNF-α in GCF as an "Indicator" of periodontal disease.

Association between gingival crevicular fluid prostaglandin E 2 level and preterm low birth weight.

BACKGROUND: Periodontal infections, which serve as a reservoir of inflammatory mediators such prostaglandin E 2 (PGE 2), may pose a threat to the fetal-placental unit and cause preterm delivery. AIM: This study was conducted to estimate the PGE 2 levels in gingival crevicular fluid (GCF) and to explore the association between GCF-PGE 2 levels and preterm low birth weight (PLBW). MATERIALS AND METHODS: Twenty-two pregnant patients were selected for the study. GCF samples were collected from these patients before delivery and again at 1 month after delivery. PGE 2 level was estimated using a commercially available ELISA kit (Neogen). RESULTS: The mean GCF-PGE 2 level was 5.8 ng/ml before parturition and 5.5 ng/ml after parturition, but the difference was not statistically significant. There was negative correlation between PGE 2 levels and gestational age at birth. CONCLUSION: The study provides weak evidence that there is correlation between GCF-PGE 2 levels and birth outcome. Further clinical trials with large samples are required to confirm the association between GCF-PGE 2 levels and PLBW.

Effect of gene polymorphisms on periodontal diseases.

Periodontal diseases are inflammatory diseases of supporting structures of the tooth. It results in the destruction of the supporting structures and most of the destructive processes involved are host derived. The processes leading to destruction and regeneration of the destroyed tissues are of great interest to both researchers and clinicians. The selective susceptibility of subjects for periodontitis has remained an enigma and wide varieties of risk factors have been implicated for the manifestation and progression of periodontitis. Genetic factors have been a new addition to the list of risk factors for periodontal diseases. With the availability of human genome sequence and the knowledge of the complement of the genes, it should be possible to identify the metabolic pathways involved in periodontal destruction and regeneration. Most forms of periodontitis represent a life-long account of interactions between the genome, behaviour, and environment. The current practical utility of genetic knowledge in periodontitis is limited. The information contained within the human genome can potentially lead to a better understanding of the control mechanisms modulating the production of inflammatory mediators as well as provides potential therapeutic targets for periodontal disease. Allelic variants at multiple gene loci probably influence periodontitis susceptibility.

The effect of platelet derived growth factor-AB on periodontal ligament fibroblasts: An in vitro study.

BACKGROUND AND OBJECTIVES: Traditional methods of periodontal therapy produce results in healing of tissues by repair; however, what we require is regeneration of the lost tissues. The periodontal ligament (PDL) cells appear to be important in periodontal wound healing. Platelet derived growth factor (PDGF), a potent mitogen and useful mediator for wound healing, has been extensively studied in periodontal regeneration. This in vitro study was designed to evaluate the effect of PDGF-AB on human PDL fibroblasts (hPDLF) at 50, 100 and 150 ng/ml dosages at 24, 48 and 72 hours time duration. MATERIALS AND METHODS: Tissue explants from three different patients were harvested from the roots of freshly extracted, uninfected and impacted third molars. The cells cultured from all samples were divided into 4 groups: Group-1 was the control group, and the experimental groups were designated as Group-2, Group-3 and Group-4, to test the effect of PDGF-AB at 50, 100 and 150 ng/ml by proliferation assay carried out at 24, 48 and 72 hours. RESULTS: The results revealed maximum mitogenic response of PDL cells at 100 ng/ml and at 48 hours, suggesting that the mitogenic response of PDGF-AB is both, time and dose dependent. CONCLUSIONS: The results of this in vitro study suggest that PDGF has maximum mitogenic response on hPDLF at 48 hours and for 100 ng dose. However for clinical application, randomized controlled clinical trials are required to substantiate the results of this in vitro study.

Gingival crevicular fluid prostaglandin E2 level as a predictor of preterm low birth weight: a pilot investigation.

Periodontal infections, which serve as a reservoir of inflammatory mediators such as prostaglandin E(2) (PGE(2)), may pose a threat to the fetal-placental unit and cause preterm delivery. This study was conducted to estimate the levels of PGE(2) in gingival crevicular fluid (GCF) and serum to explore the possible use of the GCF-PGE(2) level as a risk predictor of preterm low birth weight (PLBW). Twenty-two pregnant female patients were selected for the study. Samples of GCF and serum were collected from each patient, and sampling was repeated at one month after parturition. The level of PGE(2) in GCF and serum was estimated using a commercially available ELISA kit (NeogenTM). The mean serum PGE(2) level was 4.4 ng/ml and 1.64 ng/ml before and after parturition, respectively, and the difference was statistically significant (P < 0.001). The mean GCF-PGE(2) level was 5.8 ng/ml and 5.5 ng/ml before and after parturition, respectively, but the difference was not significant. There was positive correlation between the serumPGE(2) and GCF-PGE(2) levels, and there was a negative correlation between PGE(2) level and gestational age. The present findings suggest that there is a weak correlation between maternal GCF-PGE(2) level and birth outcome. Further clinical trials with a larger sample size are warranted for further investigation of the association between GCF-PGE(2) level and PLBW.

Effect of smoking on gingival microvasculature: A histological study.

BACKGROUND: Smoking has been reported as a major risk factor for periodontal disease. Studies have demonstrated decreased bleeding on probing and reduced inflammatory response among smokers, which has been attributed to the alterations in gingival microvasculature, gingival epithelium. In previous investigations, vascular and epithelial changes have been studied in the gingival tissues of smokers suffering from periodontitis and compared with healthy periodontium of non smokers. Inflammation is known to cause vascular and epithelial changes in the gingiva on its own in the absence of smoking. Hence, in the present investigation, an attempt is made to study and to compare the vascular and epithelial changes in the gingiva of smokers and non smokers suffering from chronic periodontitis. AIM OF STUDY: The purpose of this study was to evaluate the vascular and epithelial changes in gingiva of smokers and non smokers with chronic periodontitis. STUDY DESIGN: Cross sectional study MATERIALS AND METHODS: Gingival biopsies were obtained from 33 male patients (18 smokers and 15 non smokers) who were undergoing periodontal therapy or extraction. The sections were stained with eosin and hematoxylin. Vascular density, area of the lumen, and epithelial thickness were assessed using histomorphometric image analysis. STATISTICAL METHOD: Data was analyzed using student unpaired 't' test, Karl Pearsons correlation, and Chi-square test. RESULTS: The mean blood vessel density for smokers was 12.388±6.472 and for non smokers was 14.800±4.91. The mean lumen area of the vessels among smokers and non smokers was 19.290±8.775 µm(2) and 20.044±7.896 µm(2), respectively. The mean epithelial thickness among smokers was 150.551±32.994 µ and 134.941±30.63 µ for non smokers. CONCLUSION: Based on the present histomorphometric study, it could be concluded that smokers have less vascular density and reduced lumen area and increased epithelial thickness than non smokers. However, these changes were not statistically significant.