Periodontal health status in patients with lung cancer: Case-control study.

Objective: The objective of this study was to assess the periodontal health status of individuals with lung cancer in the North Indian population. In addition, the study aimed to determine the levels of human beta-defensin2 (Hbd-2) in the gingival crevicular fluid (GCF) and serum samples collected from the participants. Methods: The study consisted of a total of 90 participants, who were categorized into three groups: Group 1 included 30 healthy individuals, Group 2 comprised 30 patients with chronic periodontitis, and Group 3 involved 30 patients diagnosed with both lung cancer and chronic periodontitis. Various periodontal parameters, including plaque index, gingival index, probing pocket depth, and clinical attachment level (CAL), were assessed in addition to the analysis of human beta defensin2 levels in both the GCF and serum samples of all participants. Results: The study results revealed that all clinical parameters assessed were higher in Group 3 compared to both Group 2 and Group 1. Specifically, the levels of hBD-2 in the GCF were measured as 52.29 ± 46.41 pg/mL in Group 1, 27.15 ± 28.76 pg/mL in Group 2, and 86.01 ± 68.82 pg/mL in Group 3. When comparing the hBD-2 levels in serum, the values were found to be 813.72 ± 269.43 pg/mL in Group 1, 591.50 ± 263.91 pg/mL in Group 2, and 1093.04 ± 674.55 pg/mL in Group 3. These intergroup comparisons indicate variations in hBD-2 levels among the different groups. Conclusions: The study findings demonstrated significantly higher clinical and biochemical markers in patients with both lung cancer and chronic periodontitis, in comparison to individuals with chronic periodontitis alone and healthy participants. These results suggest that Hbd-2 could potentially serve as a valuable diagnostic biomarker for identifying and distinguishing individuals with both lung cancer and chronic periodontitis.

COVID-19 outbreak journey of dental care workers: A systematic review.

The conditions of health-care professionals including dental fraternity have been extremely affected during the COVID-19 pandemic. Dental care workers have suspended all routine dental activities with the fear of transmission of the virus from aerosol-generating dental procedures. They have also stood with medical care professionals as frontline warriors because of the exponentially overburdened of the COVID-19-positive patients worldwide. With the available literature, the aim of this article is to address the trajectories of the life of oral health workers during the outbreak of COVID-19 as well as to analyze what measures shall be taken to improve their overall physical, mental, social, and economic health and precautions while working in dental environment.

Giant juvenile fibroadenoma of the breast in a 12-year-old girl.

Giant juvenile fibroadenomas, encountered usually in adolescents, are rapidly growing benign breast masses which lead to discomfort, anxiety and significant psychological stress. The breasts are in their early formative years, and thus, it is important to rule out malignancy as well as plan treatment options to preserve as much breast tissue as is possible. This report highlights a case of giant juvenile fibroadenoma diagnosed in a 12-year-old female child and our endeavour to achieve a good aesthetic result.

Impact of Non-surgical Periodontal Therapy on Pulmonary functions, Periodontal Health and Salivary Matrix Metalloproteinase-8 of COPD Patients with Chronic Periodontitis: A Clinico-biochemical Study.

OBJECTIVE: The aim of the study was to assess the impact of non-surgical periodontal therapy (NSPT) on periodontal clinical parameters, spirometric indices, and salivary MMP-8 levels in patients with chronic obstructive pulmonary disease (COPD) with concurrence of chronic periodontitis (CP) compared with systemically healthy CP. MATERIAL AND METHODS: In this prospective clinico-biochemical study, a total of 75 patients belonging to various socioeconomic strata were randomly divided into cases, that is, COPD patients as per the Global Initiative for Obstructive Lung Disease (GOLD) criteria with concurrence of CP [at least ≥ 20 teeth with ≥ 2 tooth sites having pocket probing depth (PPD) or clinical attachment loss (CAL) ≥ 4mm and bleeding on probing (BOP)] and controls (systemically healthy CP). Both groups underwent NSPT and were evaluated for plaque index (PI), gingival index (GI), PPD, CAL, and BOP and spirometry (FEV1/forced vital capacity (FVC)) values at baseline, 3, 6, and 12 months and for salivary MMP-8 levels at baseline and 3 months. RESULTS: Statistical results showed that cases (COPD with CP; n = 37) were significantly older (mean age 56.16 ± 9.01 years), ex-smokers (48.6%) with male preponderance (78.4%), and belonged to the upper middle class (40.5%) as compared to controls (systemically healthy CP; n = 38). After NSPT, significant improvement in mean PI, GI, PPD, CAL, and BOP was observed in both groups at 3, 6, and 12 months with better results in controls. FEV1/FVC was significantly improved (P < .001) in cases with insignificant change in controls at 12 months. After 3 months, MMP-8 levels were significantly reduced in cases (P = .002) and controls (P < .001). CONCLUSION: The present study provided substantial evidence that COPD patients have poorer periodontal health as compared to systemically healthy counterparts. Further, these patients showed improvement in FEV1/FVC, however, with higher salivary MMP-8 levels despite NSPT at the end of the study, indicating a possible role of systemic inflammatory overburden of pulmonary disease.

Effect of periodontal therapy on disease activity in patients of rheumatoid arthritis with chronic periodontitis.

BACKGROUND: Evidence have been proposed a positive association between severity of Periodontitis and Rheumatoid arthritis (RA) activity, individuals with advanced RA are more likely to develop periodontal problems compared to their non-RA counterparts, and vice versa. Studies have been suggested that RA manifest as a result of an inflammatory imbalance and autoimmunity. In this perspective, treatment modalities that lead to inhibition of proinflammatory mediators, may prove beneficial for reducing the severity of RA. This study examined the effects of non surgical periodontal therapy (NSPT) on disease activity of RA. METHODS: Diagnosed patients of active rheumatoid arthritis with chronic periodontitis were recruited in this study and divided in to treatment and controls groups, both groups were similar in all demographics assessed. Treatment group (n = 20) and controls group (n = 20) underwent assessment for periodontal clinical parameters (plaque index, gingival index, probing pocket depth, clinical attachment level), Rheumatologic clinical (simplified disease activity index) and biochemical parameters(C-reactive protein, Rheumatoid factor, Anti-cyclic citrullinated protein) at baseline and 8 weeks. Serum levels of biochemical parameters were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: The statistically significant (p < 0.001) reduction observed in mean values of PI, GI, PPD, CAL, SDAI in treatment group at 8weeks after NSPT as compare to control group. However serum level of ACCPA, CRP and RF did not show statistically significant (p > 0.05) changes from baseline to reassessment (8 weeks) in both groups. CONCLUSIONS: The improvement in RA disease activity may occurs after non surgical periodontal therapy.

Evaluation of the relative efficacy of autologous platelet-rich fibrin membrane in combination with ß-tricalcium phosphate (Septodont- resorbable tissue replacement)™ alloplast versus ß-TCP alloplast alone in the treatment of grade II furcation defects.

INTRODUCTION: Platelet-rich fibrin (PRF) is considered as the second-generation platelet concentrate, contains combined properties of fibrin, platelets, leukocytes, growth factors, and cytokines that make it as healing biomaterial with incredible potential for hard tissue and soft tissue regeneration. The present study was aimed to evaluate the effectiveness of PRF with ß-tricalcium phosphate (ß-TCP) graft (R. T. R) and compare it with ß-TCP allograft alone in the treatment of mandibular Grade II furcation defects. MATERIAL AND METHODS: A total of 20 mandibular Grade II furcation defects sites were assigned in the study and treated with either ß-TCP alone (Group I) or ß-TCP with PRF membrane (Group II). The clinical parameters analyzed were probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), horizontal defect depth (HDD), and vertical defect depth (VDD), recorded baseline and at 6 months reentry. RESULTS: At 6 months, both groups showed statistically significant results for all parameters from their baseline value, although intergroup changes were statistically insignificant. In Group I, gain in CAL was 2.80 ± 1.40 and in Group II it was 3.00 ± 1.44. Bone fill in Group I was VDD (3.50 ± 2.12) and HDD (3.70 ± 0.67), whereas Group II showed VDD (3.70 ± 1.57) and HDD (4.0 ± 0.88), respectively. PPD reduction was higher in Group I (3.50 ± 2.27) than Group II (2.80 ± 1.93). At reentry GR was established, Group I showed higher GR (0.70 ± 0.67) and Group II (0.40 ± 0.52). CONCLUSIONS: Significant improvement was found in both groups, but the combination of PRF with ß-TCP allograft led to more favorable improvement in the management of Grade II furcation defect except PPD.

Periosteum as a lateral pedicle graft for the treatment of single tooth root recession: A novel approach.

The treatment of gingival recession defects is indicated for esthetic and functional reasons to reduce root sensitivity, to remove muscle pull, to create or augment keratinized tissue, and to prevent disease progression. The presence of sufficient amount of periosteum adjacent to gingival recession defects makes it a suitable graft. The adult human periosteum is a highly vascular connective tissue with immense regenerative potential. It contains fibroblasts, osteogenic progenitor cells, and stem cells as a result of which it has the ability to differentiate into fibroblast, osteoblast, chondrocytes, adipocytes, and skeletal myocytes. The tissue provided by these cells includes cementum with periodontal ligament fibers and bone. Therefore, in the present case, periosteum has been used as a lateral pedicle graft for the coverage of the single tooth gingival recession (mandibular central incisor). The procedure is justified by the evidence that periosteum is capable of proliferation and osteogenesis after injury.

Comparative study of nonabsorbable and absorbable barrier membranes in periodontal osseous defects by guided tissue regeneration.

BACKGROUND: Periodontal invasion of furcation area in multirooted teeth represents one of the most demanding therapeutic challenges in periodontics. Furcation therapy includes various treatment modalities like either maintenance or elimination of furcation or increased access to furcation area. Recent treatment modalities include regenerative procedures like placement of different type of bone grafts with nonabsorbable or absorbable barrier membranes, through guided tissue regeneration. This study compared the clinical efficacy of nonabsorbable barrier membrane with absorbable membrane when used with hydroxyapatite bone graft (G-Graft) in grade II buccal furcation defects in mandibular 1st molars. MATERIALS AND METHODS: Fourteen subjects with bilateral grade II buccal furcation defects in lower 1st molars were selected and treated in a split-mouth design. After phase I therapy, molars were divided randomly into two groups for the treatment with either resorbable or nonresorbable membrane in conjunction with G-Graft in both groups. RESULTS: All the clinical parameters recorded showed statistically significant improvement in both the groups but no significant difference between two groups was observed. CONCLUSION: Both nonabsorbable and absorbable barrier membranes were equally effective in treating grade II buccal furcation defects in lower molars when used in conjunction with G-Graft except with respect to horizontal bone fill in which absorbable barrier membrane showed better results.

Harmonious functional and aesthetic correction of severe localised pregnancy-induced gingival enlargement associated with capillary haemangioma.

Gingival enlargement is a clinical condition that has been widely studied and is directly associated with specific local or systemic conditions. Pregnancy has been presented to increase susceptibility to gingival inflammation. Sex hormones are believed to be a risk factor for periodontitis because of their ability to proliferate specific periodontal microorganisms and affect host immunological response, but it is unclear whether pregnancy gingivitis exposes or proceeds to periodontitis. In this case report, the patient reported with severe localised enlarged gingival mass which initiated when she was pregnant. After parturition, gingival enlargement was persisting and causing functional and aesthetic problem. Enlargement did not resolve even after non-surgical therapy; therefore, surgical excision of the entire enlarged gingival mass was preformed. Histopathological examination revealed capillary haemangioma. No evidence of malignancy was seen. No recurrence was seen even after 2 years of follow-up.