mRNA Expression of Ezrin in Gingival Crevicular Fluid and Whole Blood of Gingivitis and Chronic Periodontitis Patients - A Polymerase Chain Reaction Study.

Background: A comparative analysis of protein expression of gingival crevicular fluid (GCF) obtained from healthy individuals and individuals with periodontal diseases would help to identify proteins involved in periodontal disease progression. Among the identified proteins, Moesin which is a disease-associated protein belongs to the ezrin-radixin-moesin protein family and was proved to play an important role in the recognition of oral bacteria contributing to the consequent development of inflammatory immune responses involved in periodontal disease development. Aim: The aim of the study is to quantify and compare mRNA expression levels of ezrin in GCF and whole blood of gingivitis and chronic periodontitis patients. Materials and Methods: A total of 60 patients were selected for the study and were divided into three groups as follows: Group 1 (20 participants with healthy gingiva), Group 2 (20 participants with gingivitis), and Group 3 (20 participants with chronic periodontitis). Clinical parameters such as gingival index, periodontal index, probing pocket depth, and clinical attachment level were assessed. GCF and blood samples were taken from these patients and assessed for the mRNA expression of ezrin using real-time polymerase chain reaction. Results: The expression and mean relative quantification of mRNA expression of ezrin in GCF and blood were higher for periodontitis (18.32 ± 8.398, 19.34 ± 9.487) when compared to that of gingivitis (5.34 ± 3.609, 5.48 ± 4.428) and healthy individuals (2.33 ± 0.643, 3.47 ± 1.923) and they positively correlated with the clinical parameters. Conclusion: The increased expression of ezrin can be considered as a good indicator to assess the inflammatory activity in periodontitis and gingivitis.

Comparative Evaluation of Antibacterial Effect of GIC Containing Chlorhexidine and Miswak on Streptococcus mutans and Streptococcus sobrinus in Early Childhood Caries Children: A PCR Study.

BACKGROUND AND AIM: The therapeutic procedures used in the treatment of caries do not always eliminate all the microorganisms. Persisting cariogenic bacteria can cause recurrent caries and failure of restoration. Incorporation of an antimicrobial agent in the restorative material may be of paramount significance. The purpose of this study was to evaluate and compare the antibacterial effect of glass ionomer cement (GIC) containing CHX and miswak extract on Streptococcus mutans and Streptococcus sobrinus in ECC children using polymerase chain reaction (PCR). MATERIALS AND METHODS: Forty-five children with ECC in the age-group 3-6 years were selected. The children were randomly allocated into three groups. Supragingival plaque samples (S1) were collected from sound buccal or labial surfaces of primary teeth. Cavity preparation was done and the teeth were restored according to the group to which the child had been allotted. The second plaque sample (S2) was collected 1 month and the final sample after 3 months of restoring all the decayed teeth. All the samples were sent for PCR analysis. RESULTS: Intergroup analysis was done using Kruskal-Wallis test followed by Mann-Whitney post hoc test showed statistically significant difference in S. mutans and S. sobrinus count between group I (CHX) and group III (control) and group II (miswak) and group III (control) but no statistically significant difference between group I (CHX) and group II (miswak) in S. mutans and S. sobrinus count. CONCLUSION: 1% chlorhexidine digluconate and aqueous extract of miswak are equally effective against S. mutans and S. sobrinus. Miswak can be used as an alternative herbal antimicrobial that can be incorporated in anhydrous GIC. HOW TO CITE THIS ARTICLE: Kalpavriksha AJ, Siddaiah SB, Bilichodmath S, et al. Comparative Evaluation of Antibacterial Effect of GIC Containing Chlorhexidine and Miswak on Streptococcus mutans and Streptococcus sobrinus in Early Childhood Caries Children: A PCR Study. Int J Clin Pediatr Dent 2021;14(2):229-234.

Ozone Therapy in Periodontics: A Meta-analysis.

Gingival and periodontal diseases constitute a major distress in the field of dentistry. The greater part of the contributing and etiologic factors are diminished or treated with all forms of ozone. Ozone which is well known for its antimicrobial and tissue regenerative properties is indicated in all the stages of gingival and periodontal diseases. The aim of this study was to review literature on the effects of ozone as an adjunct to mechanical therapy in periodontitis patients. A search of literature was conducted to identify articles of ozone therapy in periodontitis published during the period from January 1, 2010, to July 30, 2018. PubMed, Medline, Embase, Cochrane, and Google Scholar search and hand searching of journals were conducted to identify relevant articles. The search strategy employed both dental subject headings and free-text terms. Out of a total of 123 studies that fit the initial inclusion criteria, 117 studies were further excluded. Only six studies were included in the meta-analyses. A high level of heterogeneity in the selected studies was found as demonstrated by Q-value of 10.241 and I 2 value of 80.49%. However, the funnel plots showed symmetrical shape, with prevalence studies indicating absence of publication bias. Ozone therapy can be used effectively as an adjunct to scaling and root planing in the treatment of periodontitis.

Effect of Full-Mouth Rehabilitation on Streptococcus mutans and Streptococcus sobrinus Levels in Children with Severe Early Childhood Caries.

Purpose: To investigate the effect of full-mouth rehabilitation on the levels of Streptococcus mutans and Streptococcus sobrinus in plaque samples of children suffering from severe early childhood caries using the quantitative reverse transcription polymerase chain reaction method.
Methods: A dental examination was performed to determine the decayed, missing, and filled primary teeth and surfaces (dmft and dmfs, respectively) in three- to five-year-old children using the World Health Organization's caries diagnostic criteria. Supragingival plaque samples were collected from all tooth surfaces with a sterile universal scaler at baseline and six months after full-mouth rehabilitation. The Wilcoxon signed-rank test was used to compare the mean values of dmft and dmfs scores and the mean values of S. mutans and S. sobrinus levels between the pre- and post-treatment period.
Results: At six months, the mean relative quantification values of S. mutans and S. sobrinus showed significant reductions (P > 0.05) in the post-treatment samples but the mean dmft scores remained the same.
Conclusion: Full-mouth rehabilitation is effective in reducing levels of S. mutans and S. sobrinus, thus diminishing the cariogenic challenge in the oral cavity.

Identification of Specific Anaerobic Bacteria in Endodontic Infections of Primary Teeth-A PCR Study.

INTRODUCTION: Invasion of microorganisms and their multiplication in root canals (RCs) results in endodontic infections of primary teeth. Acute and chronic inflammation may be present in the periapical area and are based on the amount and virulence of microorganisms, especially anaerobic bacteria present in the RC. To identify microorganisms very precisely in endodontic infections, polymerase chain reaction (PCR) is used. AIM: The aim of the present study is to identify the specific anaerobic bacteria like Porphyromonas gingivalis, Prevotella intermedia, and Actinomyces naeslundii in the RCs of primary teeth using real-time PCR. METHODOLOGY: Fifteen subjects aged 3-8 years who had endodontic infections in primary molars were selected. The cases who had been selected did not receive any endodontic treatment and antibiotics within 3 months, and children with systemic diseases were not included. SAMPLE COLLECTION: Samples were taken by placing absorbent paper points into the largest canals of maxillary and mandibular molars for 60 seconds and are then transferred to a sterile Eppendorf tube with tris-hydochloride EDTA (TE) buffer. The samples were stored at -80°C. All samples were subjected to PCR analysis. RESULT: The specific anaerobes detected in the samples were A. naeslundii (93.3%), Prevotella intermedia (53.3%), and Porphyromonas gingivalis (13.3%). CONCLUSION: The results suggested a high bacterial diversity in the RCs of infected primary teeth. HOW TO CITE THIS ARTICLE: Thimmegowda U, Thomas J, et al. Identification of Specific Anaerobic Bacteria in Endodontic Infections of Primary Teeth-A PCR Study. Int J Clin Pediatr Dent 2019;12(1):1-4.

Evaluation of the Efficacy of Strontium Chloride, Biodentine® and Biodentine® in Combination with Diode Laser in the Management of Dentinal Hypersensitivity- An In vitro SEM Study.

OBJECTIVE: To evaluate the efficacy of strontium chloride, Biodentine® alone and Biodentine® in combination with diode laser in the management of dentinal hypersensitivity using scanning electron microscope. MATERIALS AND METHODS: This comparative in vitro, single blind study was carried out on 80 randomly selected extracted teeth. The selected 80 extracted teeth were categorized as: Group 1 - 20 teeth acid etched only; Group 2 - 20 teeth treated with strontium chloride;Group 3 - 20 teeth treated with Biodentine®; Group 4 - 20 treated with Biodentine® and diode laser. The samples underwent scanning electron microscope analysis. RESULTS: The qualitative analysis showed no occlusion of dentinal tubules in Group 1 (control group). Dentinal tubule occlusion was 91.2% in strontium chloride. CONCLUSION: Within the limitations of this study it was concluded that Biodentine® alone showed better results than Biodentine® in combination with diode laser for dentinal tubule occlusion. However, when laser was used over Biodentine® in contact mode, the results showed Biodentine® to have a melted appearance, rather than the irregular fibrillar structures usually seen. This in vitro study was performed on extracted teeth which do not mimic the natural biological environment. Therefore, in vivo studies should be carried out to assess the potency of Biodentine® in occluding and sealing dentinal tubules and its potential for treatment of dentinal hypersensitivity.

mRNA expression of IFN-λs in the gingival tissue of patients with chronic or aggressive periodontitis: A polymerase chain reaction study.

BACKGROUND: Several studies have proven the existence of herpesviruses in periodontal pockets of patients with chronic or aggressive periodontitis. Recently discovered interferon lambda (IFN-λ) has antiviral properties and is induced by herpesviruses. The present study was a quantitative analysis of messenger RNA (mRNA) expression of IFN-λs (IFN-λ1, IFN-λ2, IFN-λ3) in the gingival tissues of patients with chronic or aggressive periodontitis. METHODS: A total of 90 participants (50 men and 40 women; age range 19-50 years, mean age 31.50 ± 7.8) were categorized into three groups: healthy participants, patients with chronic periodontitis, and patients with aggressive periodontitis. mRNA expression of IFN-λs in gingival tissues was estimated using reverse transcriptase polymerase chain reaction and was correlated with clinical parameters such as gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL). RESULTS: mRNA of IFN-λ1, IFN-λ2, and IFN-λ3 was expressed in gingival tissues of healthy participants and in patients with chronic or aggressive periodontitis. The highest level of IFN-λ1 was observed in patients with aggressive periodontitis (3.049 ± 9.793), whereas IFN-λ2 (4.322 ± 11.310) and IFN-λ3 (11.932 ± 27.479) were highest in patients with chronic periodontitis. The difference in mRNA expression of IFN-λ1 (P = 0.008) and IFN-λ3 (P = 0.043) among three groups was statistically significant CONCLUSION: Increased quantity of IFN-λs in patients with chronic and patients with aggressive periodontitis suggests a role in periodontitis. Variation in the expression of IFN-λ1 and IFN-λ3 in patients with periodontitis needs to be further evaluated. The mRNA expression of antiviral IFN-λs in gingival tissues might enhance our understanding related to viral pathogenesis of periodontal diseases.

Comparative Evaluation of Bioactive Glass (Putty) and Platelet Rich Fibrin in Treating Furcation Defects.

The aim of this study was to compare a second-generation bioactive glass putty biomaterial against platelet rich fibrin in treating grade II furcation defects. Subjects were 15 systemically healthy patients (10 males and 5 females, ages 20-50 with a mean age of 38.33) with 20 mandibular molar class II furcation defects according to Glickman's classification. The 20 mandibular molar furcation defects were randomly allocated as follows: Group I, 10 furcation defects were treated using bioactive glass (NovaBone) bone graft putty material; Group II, 10 furcation defects were treated using platelet rich fibrin (PRF). Customized acrylic stents were fabricated on study casts and trimmed to the height contour of the teeth to serve as a fixed reference point for measurements. The following measurements were collected: gingival index, plaque index, vertical probing depth (from gingival margin to base of the pocket), clinical attachment level (CEJ to the base of the pocket), and horizontal probing depth of furcation involvement (using stent). Results showed that both groups had improvement in gingival index (GI) and plaque index (PI) at the recall intervals. There was an overall reduction in both vertical and horizontal probing depth in both groups; however, the Putty group (Group I) showed consistently more vertical probing depth reduction than the PRF group (Group II) at the end of third month (P-value = 0.0004), sixth month (P-value = 0.00001), and ninth month (P-value = 0.0004). Our conclusion was that use of bioactive glass osteostimulative biomaterial yields superior clinical results, including increased pocket depth reduction of class II furcation defects as compared to an autologous platelet concentrate. The clinical significance of our findings include the ease of use and superior biologic performance of second-generation putty bioglass biomaterials in furcation defects.

Betacellulin in Chronic Periodontitis Patients With and Without Type 2 Diabetes Mellitus: An Immunohistochemical Study.

BACKGROUND: The host immune response to bacterial dental plaque determines periodontal disease susceptibility by increasing the secretion of inflammatory cytokines. The Epidermal Growth Factor family cytokines stimulate proliferation and keratinization of cells in dermis and oral epithelium. Epidermal Growth Factor family consists of Amphiregulin, Betacellulin, Epiregulin, Epigen, Heparin binding Epidermal Growth Factor like growth factor and transforming Growth Factor-alpha. AIM: The current study aimed to investigate expression of Betacellulin in chronic periodontitis patients with and without type 2 diabetes mellitus and thereby assessing role of betacellulin in periodontal health and disease. MATERIALS AND METHODS: Present study comprised of 90 participants, age ranges from 18 to 60-year-old, for the period of March 2010 to May 2011. Participants were categorized into three groups based Gingival index (GI), probing depth (PD) and clinical attachment loss (CA Loss). Group 1 consisted 30 individuals with clinically healthy periodontium, Group-2 consisted 30 individuals with GI>1, PD≥5 mm, and CA Loss>3 mm. Group-3 (Chronic Periodontitis with type 2 diabetes mellitus) consisted 30 with GI >1, PD≥5 mm, and CA Loss>3 mm. Immunohistochemical localization and quantification of Betacellulin was done in gingival tissue samples from all groups. RESULTS: Data showed expression of Betacellulin were higher in chronic periodontitis as compared to healthy. A positive correlation found in Betacellulin expression and Probing Depth in chronic periodontitis. CONCLUSION: This footmark study impacts the role of Betacellulin in pathogenesis and progression of periodontal disease which will help in exploration of novel immunotherapeutic strategies and immunological research activity in this field.

Toll-like receptor 9 gene polymorphism in chronic and aggressive periodontitis patients.

AIM: Periodontitis is a multifactorial disease, with microbial dental plaque as the primary etiological factor. However, the manifestation and progression of periodontitis is influenced by a wide variety of other determinants and factors such as social and behavioral factors, systemic factors, microbial composition of dental plaque, genetic, and many other emerging risk factors. The aim of this study was to analyze genetic polymorphisms in the toll-like receptor 9 (TLR9) gene at - 1237C/T and its association with chronic and generalized aggressive periodontitis (GAgP) in an Indian population. MATERIALS AND METHODS: This study was carried out on 90 subjects, which included 30 GAgP and 30 chronic periodontitis patients and 30 healthy controls. Within the limitations of our study, only 30 subjects were included in each group due to the low prevalence of GAgP patients. Blood samples were drawn from the subjects and analyzed for TLR9 genetic polymorphism at - 1237C/T by using polymerase chain reaction-restriction fragment length polymorphism method. RESULTS: No significant difference was found in genotype and allele frequency of TLR9 genetic polymorphism (- 1237C/T) in generalized aggressive and chronic periodontitis patients and healthy controls. CONCLUSION: Toll-like receptor 9 genetic polymorphism at - 1237C/T may not be associated with GAgP and chronic periodontitis patients in Indian population.

Interleukin-6 promoter polymorphism (-174 G/C) in Indian patients with chronic periodontitis.

Recent studies have focused on genetic polymorphism of the interleukin-6 (IL-6) gene, which has led to a better understanding of the intricate interactions between host response, microorganisms, and genetics. Genotype prevalence appears to vary by the race and ethnicity of the population studied. We used a polymerase chain reaction technique to determine the prevalence of single nucleotide polymorphism in IL-6 at position -174 G>C in a population of 30 South Indians. Blood samples were collected from 15 chronic periodontitis patients and 15 healthy controls. The results showed that the G/G genotype was significantly more frequent in the chronic periodontitis group and that the C/C genotype was significantly more frequent in the control group (P = 0.0069 for both). The G allele was more frequent in chronic periodontitis patients (76.67%), whereas the C allele was more frequent in the control group (73.33%). Among chronic periodontitis patients, the odds ratio for having the G allele, as compared with the controls, was 9.04. In this population, the presence of the G/G genotype of IL-6 (-174) might increase susceptibility to chronic periodontitis, whereas the C/C genotype may have a protective effect.

Herpesviruses in chronic and aggressive periodontitis patients in an Indian population.

Many recent studies have assessed the prevalence and role of herpesviruses in the etiopathogenesis of periodontal diseases, which has led to the realization of intricate interactions between viruses and bacteria within periodontal pockets. It has also been shown that the occurrence of herpesviruses may vary depending upon the age of the patient and the race of the population studied. Thus, the present study aimed at detecting herpes simplex virus type 1 and 2 (HSV 1 and 2), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in periodontal pockets of Indian patients with chronic and aggressive periodontitis. Subgingival plaque samples (n = 33) were collected from 19 randomly chosen chronic periodontitis and 14 aggressive periodontitis patients. Herpesviruses were detected using multiplex polymerase chain reaction technique. Chronic periodontitis patients revealed presence of HSV-1 in 19 (100%) samples, HSV-2 in 3 (15.7%), EBV in 15 (78.9%) and HCMV in 5 (26.31%) samples. Samples from aggressive periodontitis patients showed the presence of HSV-1 in 8 (57.14%), EBV in 4 (28.57%) and HCMV in 1 (7.14%), whereas HSV-2 was not detected in any specimen. In this population, herpesviruses were found more frequently in chronic periodontitis than in aggressive periodontitis patients and their prevalence may vary according to the age and race of the patient.