Association of chronic periodontitis and type 2 diabetes mellitus with salivary Del-1 and IL-17 levels.

PURPOSE: Chronic periodontitis (CP) and Type 2 diabetes mellitus (T2DM) are chronic diseases affecting the humans and have interrelationship in their pathogenesis. Monitoring the progress with biomarker in these disease is important from treatment outcome point of view. We investigated the association of salivary developmental endothelial locus-1 (Del-1) and interleukin-17 (IL-17) levels in CP and T2DM. METHODS: Saliva was collected from 17 healthy and 68 patients (divided into 4 groups based on presence or absence of CP and T2DM). Periodontal parameters were recorded at the time of visit. Del-1 and IL-17 levels in unstimulated salivary samples were determined using enzyme-linked immunosorbent assay. RESULTS: Study found the lower levels of salivary Del-1 and higher levels of IL-17 in CP (2.23 ± 2.10 ng/mL, 56.54 ± 19.79 ng/mL), CCDM ((1.97 ± 1.36 ng/mL, 74.74 ± 17.79 ng/mL) and CUDM (1.02 ± 0.52 ng/mL, 63.84 ± 24.72 ng/mL) as compared to healthy individuals (6.54 ± 2.07; 24.47 ± 8.23 ng/mL) (p < 0.001). Del-1 and IL-17 levels were correlating with inflammatory state in CP and presence of T2DM aggravate the severity of disease in CP. An inverse correlation between salivary Del-1 & IL-17 levels was also seen. Furthermore, we also observed that the combination of T2DM and CP (CCDM and CUDM) increases the salivary IL-17 levels and decreases Del-1 levels. CONCLUSIONS: There is an upregulation of salivary IL-17 and downregulation of salivary Del-1 with increase in severity of periodontal disease as well as T2DM. Furthermore, the presence of T2DM in chronic periodontitis patients can aggravate the inflammation related periodontal destruction.

An Evaluation of the Effect of Periodontal Biotype on Inter-Dental Papilla Proportions, Distances Between Facial and Palatal Papillae in the Maxillary Anterior Dentition.

PURPOSE: Gingival esthetics are an essential segment of facial beauty. The aim of the present study was to clinically assess the impact of periodontal biotype (PB), the length between the base of interproximal contact area and the interproximal bone crest (CP-BC), the distance between the facial and palatal papillae (DFPP), and papillary proportions (PP) on the presence of interdental papillae (PIP). MATERIALS AND METHODS: 80 patients aged 18 to 60 years were recruited for study. PB and CP-BC were evaluated clinically. Alginate impressions of maxillary arches were made, and DFPPs were measured using a digital Vernier caliper. The impressions were later poured in dental stone, and PP were calculated. RESULTS: Descriptive statistics and ANOVA were used for statistical analysis for correlation among the variables. A greater proportion of individuals who had a thick PB (77.7%) had significantly higher amounts of PIP than did patients with thin PB (60.7%) (p < 0.01). A strong significant positive correlation was found between PIP in thick PB patients and DFPP (p < 0.01, r = 0.56); DFPP and PP (p < 0.01, r = 0.61). A strong negative correlation was seen between PIP in thin PB and DFPP (p < 0.01, r = -0.67). CONCLUSION: According to the results of this study, PB affected the heights and presence of maxillary interdental papillae by affecting papilla proportion and distances between the facial and palatal papillae.

Clinical assessment of the gingival contours and proximal contact areas in the maxillary anterior dentition.

Gingival display has been identified as a critical element in a beautiful smile and thus in facial esthetics. The present study aimed to assess the gingival line angle (GLA); the distance between the gingival zenith of maxillary lateral incisor and the gingival line (LID); and the ratio between the height of the proximal contact area (PCA) and crown length, referred to as the proximal contact area proportion (PCAP). Fifty patients, aged 21-30 years, were recruited for study. Maxillary impressions were made using irreversible hydrocolloid and poured in dental stone, and facebow records were used to mount the master casts in an articulator. Standardized photographs of maxillary casts were taken, and image-processing software was used to assess GLA, LID, PCA, and PCAP. Data analysis revealed a statistically significant difference between bilateral measurements of GLA (r = 0.93; P < 0.001). The mean PCA dimensions decreased from mesial to distal sites in the maxillary dentition bilaterally. A paired t test exhibited a significant correlation between the parameters GLA and PCA and showed that an increase in GLA led to an increase in PCA. The gingival zenith of the canine was apical to that of the incisors (GLA less than 90 degrees). The results of the present study may be utilized in conjunction with clinical goals and subjective parameters to help the restorative dentist obtain a more predictable esthetic outcome.

The Effect of Piezoelectric Ultrasonic Scaler Tip Wear on Root Surface Roughness at Different Working Parameters: An Atomic Force Microscopic and Profilometric Study.

OBJECTIVE: This study aimed to evaluate the influence of scaler tip wear and different working parameters, i.e., lateral force, power setting and tip angulation, on the roughness of root surfaces following treatment with piezoelectric ultrasonic scaling devices. MATERIALS: Twenty piezoelectric ultrasonic scaler inserts (10 worn/10 new) were selected to examine the erosion ratio (ER) under atomic force microscopy (AFM). A total of 160 root samples were prepared and instrumented by new (n = 80) and worn inserts (n = 80) at different working parameters (tip angulation, power setting, lateral force). Roughness change (Rc) on root surfaces after instrumentation was examined by a contact profilometer. RESULTS: Statistically significant differences were found between the mean ERs of new and worn tips (p < 0.0001). The various combinations of the assessed working parameters showed synergistic effects resulting in a wide range of root surface roughness. The present study found the higher Rc in the group with a 45° angulation, (P10) high power setting and 1.0 N lateral force (subgroup 8) when compared to other groups. Among the groups, the worn scaler tips subgroup 8 showed a higher Rc (5.692 ± 0.81) when compared to new scaler tips subgroup 8 (4.798 ± 0.51; p < 0.001). CONCLUSION: The findings of the present study highlighted that scaler tip wear strongly influences the root surface roughness when used at higher tip angulation, lateral force and power settings. Hence, ultrasonic scaler tip wear should be periodically evaluated and should be considered as much as the other working parameters.

The effect of various ultrasonic and hand instruments on the root surfaces of human single rooted teeth: A Planimetric and Profilometric study.

BACKGROUND: The purpose of this study was to compare the effectiveness of different ultrasonic scalers and a periodontal curette on the root surfaces for calculus removal and root surface roughness. MATERIALS AND METHODS: 40 single rooted teeth with subgingival calculus destined for extraction were assigned to one of three experimental groups (n = 10, in each group) and one control group (untreated, n = 10). Experimental groups were: Group 1: Piezoelectric ultrasonic group; Group 2: Magnetostrictive ultrasonic group; Group 3: Hand instrumentation group (Curette). After instrumentation, the teeth were extracted and the presence of residual deposits and root surface roughness were analyzed using Planimetric analyzing tool (Tool that measures the area of a plane figure as a mechanically coupled pointer traversing the perimeter of figure) and Surface Profilometer (Instrument used for profiling of an object). Root surface characteristics were evaluated qualitatively using SEM. Standardization of force, angulations and adaptation of instrument couldn't be achieved in our study due to in vivo study design rather than in vitro design in previous studies where procedure was done on the extracted teeth samples. RESULTS: The results of the study showed that residual deposits were similar in all experimental groups. With respect to roughness parameters, Rq (Root mean square roughness) and Rt (Total roughness) a significant difference was observed (P < 0.001) among hand instrumentation and ultrasonic devices. SEM analysis revealed a similar root surface pattern for the ultrasonic devices, but curette showed many instrument scratches, gouges, and removal of large amount of cementum. CONCLUSIONS: Curette produced the rougher root surfaces than two ultrasonic devices used in the study and caused more root surface removal. Piezoelectric devices produced minimum root surface roughness but caused more root substance removal and more cracks than Magnetostrictive ultrasonic devices.