The effect of curcumin as an adjunct in the treatment of chronic periodontitis: A systematic review and meta-analysis.

BACKGROUND: A large number of trials has been conducted using curcumin as the main ingredient in mouth rinses, topical oral gel, subgingival irrigant, locally delivered gel and locally delivered chips to reduce gingival inflammation and probing pocket depth. However, the results of these trials vary and are debatable. OBJECTIVE: To evaluate the effectiveness of oral curcumin products as compared to the routinely used ones in reducing gingival inflammation and probing pocket depth in adults. METHODS: Electronic databases such as Pubmed/Medline and Cochrane Library and hand searching was done for randomised controlled trials (RCTs), which yielded 148 results, of which 27 RCTs compared curcumin products with routinely used ones. Meta-analysis was conducted to check for plaque reduction, gingival inflammation and pocket depth. RESULTS: 963 participants in the 27 RCT studies were considered for a systematic review. We found that for a long-term evaluation of probing pocket depth in nine studies each with 400 participants, there was a statistically significant difference in the reduction when curcumin topical gel was used as compared with the control [SMD -0.87, 95% CI: -1.31 to -0.43]. However, in the evaluation of short-term plaque and gingival scores, we found no statistically significant differences in the reduction when curcumin mouth rinse was used [SMD -0.76, 95% CI: -2.25 to 0.73] and [MD: -0.09, 95% CI: -0.29 to 0.10]. CONCLUSION: Curcumin topical and local delivery gel, mouth rinses and sub-gingival irrigants were found to be equally effective compared to the routinely used agents for reduction of plaque and gingival inflammation. Curcumin local delivery gel had greater reduction in probing pocket depth.

Topography-Guided Femto-LASIK in Virgin Eyes: Treating Manifest versus Measured Astigmatism.

PURPOSE: To assess the stability, safety, predictability, and efficacy of topography-guided myopic Femto-LASIK with two different treatment protocols. SETTING: Ebsar Eye center, Benha, Qalyopia, Egypt. DESIGN: Single-center, retrospective, COHORT control study. METHODS: A total of 330 eyes enrolled in the study in group A and 322 eyes enrolled in group B underwent uncomplicated primary bilateral topography-guided Femto-LASIK. Group A was treated with the subjective clinical refraction; however, group B was treated with the modified refraction according to ALCON protocol. RESULTS: The mean preoperative refractive spherical equivalent (MRSE) was -4.85±1.90D and -5.0±1.93D in group A and B, respectively (P = 0.86), and a cylinder of -0.95±0.80 D and -0.92±0.81D, respectively. At the 12 months' postoperatively, the residual manifest SE within ± 0.5D was achieved by 82.86% of eyes in group A compared to 83.93% in group B. Of eyes, 92.06% had ≤0.5 astigmatism dioptre, while 100% of eyes had ≤1.0 astigmatism dioptre in group A (315 eyes); however, 91.80% of eyes had ≤0.5 astigmatism dioptre, while 100% of eyes had ≤1.0 astigmatism dioptre in group B. CONCLUSION: Topographic modification of the magnitude and axis of astigmatism treated using ALCON protocol when different from the clinical refraction may offer good refractive outcomes when we apply the Alcon precalculation considerations.

Assessment of membrane-organizing extension spike protein as a biomarker for periodontal disease by comparing its level in gingival crevicular fluid in individuals with and without chronic severe periodontitis - A pilot study.

BACKGROUND: Membrane-organizing extension spike protein (Moesin) is a cytoskeletal protein expressed in the gingival crevicular fluid (GCF) which may play a role in the immune response in periodontal disease. The objective of this study was to evaluate whether Moesin can be used as a biomarker for periodontal disease. MATERIALS AND METHODS: Thirty patients satisfying the required inclusion criteria were selected from those reporting to the out patient (OP) of the department of periodontics and divided into two groups: Group A - systemically healthy controls with no periodontitis and Group B - systemically healthy controls with chronic severe periodontitis. Periodontal parameters were recorded. GCF was collected, and Moesin levels in the two groups were assessed using enzyme-linked immunosorbent assay. Scaling and root planing (SRP) was done in Group B patients who were reviewed, and samples were collected again after 4 weeks and analyzed. RESULTS: At baseline, the mean GCF Moesin level in Group A was 666.95 ± 471.872 pg/ml, while in Group B, it was found to be 27435.35 ± 14179.77 pg/ml, which showed a high statistically significant difference on comparison. The mean GCF Moesin level in patients with chronic severe periodontitis was 27435.35 ± 14179.77 pg/ml at baseline, and on review 1 month after SRP, it was found to have undergone a statistically significant reduction to 27161.23 ± 14161.57 pg/ml (P = 0.001). CONCLUSION: Within the limits of this study, it can be concluded that Moesin can serve as a potential biomarker for periodontal disease.

A Qualitative Analysis of Periodontal Pathogens in Chronic Periodontitis Patients after Nonsurgical Periodontal Therapy with and without Diode Laser Disinfection Using Benzoyl-DL Arginine-2-Naphthylamide Test: A Randomized Clinical Trial.

INTRODUCTION: Periodontal diseases are caused by pathogenic bacteria locally colonized in the dental biofilm creating infection; the main etiological factor is represented by dental plaque and in particular by anaerobic Gram-negative bacilli. For that reason, the first phase of periodontal treatment is always represented by the initial preparation which primarily aims at the elimination or reduction of bacterial infection and the control of periodontal plaque-associated inflammation. Yet, another innovative causal therapy is represented by the irradiation of periodontal pockets with LASER. The aim of this randomized clinical study is to compare and to detect the presence of periodontal pathogens in chronic periodontitis patients after nonsurgical periodontal therapy with and without diode LASER disinfection using BANA test. MATERIALS AND METHODS: This randomized clinical trial includes 20 patients having chronic periodontitis. From each patient, one test site and one control site were selected and assessed for gingival index (GI), oral hygiene index (OHI), pocket probing depth and clinical attachment level (CAL), and presence of BANA pathogens. The test site underwent scaling and root planning along with diode LASER therapy as an adjuvant while the control site received scaling and root planning alone. Patients were recalled for review after 2 weeks and 2 months where periodontal parameters were assessed and plaque samples were collected and analyzed for BANA pathogens. RESULTS: The test site where LASER was used as an adjuvant showed significant reduction in pocket probing depth, CAL, OHI, GI, and periodontal pathogens which shows that the amount of recolonization of microbes is less when LASER is used as an adjuvant to conventional therapy. CONCLUSION: Diode LASER as an adjuvant to SRP has shown additional benefits over conventional therapy in all the clinical parameters evaluated and this can be associated in the treatment of periodontal therapy. BANA-enzymatic kit is a simple chair side kit which can be reliable indicator of BANA positive species in dental plaque.

The effect of cigarette smoking on the severity of periodontal diseases among adults of Kothamangalam Town, Kerala.

AIMS AND OBJECTIVES: Smoking is one of the major risk factors for periodontal disease. This study aims at examining the difference in the periodontal status of current smokers, former smokers, and nonsmokers among the adults of Kothamangalam, Kerala. It investigates the association between the level of cigarette consumption and periodontal attachment loss taking into account the effect of age, gender, and oral hygiene. METHODOLOGY: The study population consisted of 30 subjects and divided into three groups as current, former, and nonsmokers with periodontal disease. All clinical parameters were recorded. Smoking assessment was done using a self-reported questionnaire, and statistical analysis was carried out. RESULTS: Current smokers had a higher percentage of sites with mean probing depth, and greater mean clinical attachment level than former smokers and nonsmoker. A significant difference (P < 0.05) was found in clinical attachment loss (CAL) between Group I (current smokers) and III (nonsmokers), that shows the increased risk of current smokers for future periodontal destruction. The CAL for current smokers was 5.20 ± 2.440 and for the nonsmokers was 1.50 ± 1.265. A significant difference (P < 0.05) was found in CAL between Group I and III. SUMMARY AND CONCLUSION: The study revealed a marked association between cigarette smoking and the risk of periodontitis. The increased destruction among current smokers showed a dose-dependent relationship with the amount of cigarette consumption. For former smokers, the duration since quitting smoking was associated with a lower risk for severe periodontitis.

Comparative analysis of gingival crevicular fluid ß-glucuronidase levels in health, chronic gingivitis and chronic periodontitis.

BACKGROUND AND OBJECTIVES: Current methods available for periodontal disease diagnosis are seriously deficient in terms of accuracy, in the ability to predict ongoing or future disease activity and indeed in determining whether previously diseased sites are in an arrested phase or still active. One area that is receiving a great deal of attention is the biochemical investigation of gingival crevicular fluid (GCF). ß-glucuronidase (ßG) is one of the enzymes found in GCF that is involved in degradation of the ground substance and fibrillar components of host connective tissue. GCF ßG activity might be a good indicator or predictor of periodontal disease activity. This study was conducted to estimate and compare the GCF ßG levels in patients with healthy periodontium, chronic gingivitis, and chronic periodontitis. METHODOLOGY: Subjects were classified into three groups of 20 patients each; healthy individuals, chronic gingivitis, and chronic periodontitis. After recording the plaque index, gingival index and probing pocket depth, 1 µL GCF was collected by placing a calibrated microcapillary pipette extracrevicularly and transferred to sterile plastic vials containing 350 µL of normal saline with 1% bovine serum albumin. Analysis of ßG was done by spectrophotometry. RESULTS: ßG levels in GCF were significantly higher in chronic periodontitis group (mean value - 2.04743), followed by chronic gingivitis group (mean - 1.11510) and healthy group (0.53643). CONCLUSION: Increased ßG levels were observed in patients with increased periodontal destruction, hence GCF ßG levels can be used as biochemical marker for periodontal disease activity.

Six year follow-up of a root coverage procedure on a lower molar tooth with lateral pedicle flap.

Loss of periodontal attachment and subsequent recession is one of the most common deformities that affects the periodontium. Gingival recession is a muco-gingival defect, which is commonly treated for esthetic and physiologic reasons. Adequate thickness of attached gingiva and root coverage is essential in restored teeth for proper masticatory function as well as for oral hygiene maintenance. Various root coverage procedures Nill have been proposed to correct recession defects, including coronally advanced flap and lateral pedicle flap (LPF). A case report is presented dealing with the treatment of a gingival recession on a mandibular molar tooth using LPF with a 6-year follow-up.