Evaluation of bone apposition on surface modified titanium implant in experimental animal model: A systematic review and meta-analysis.

Purpose: To evaluate the response of peri-implant bone to smooth (machined) surface and surface-modified dental implants in healthy experimental animal models. Materials and Methods: Systematic electronic search was done for using PUBMED, SCOPUS, WEB OF SCIENCE, and EMBASE databases for potentially relevant records from the last 20 years. Duplicate screening and data extraction were performed to formulate the evidence tables and meta-analysis following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The outcome criteria were: 1. Bone Implant Contact (BIC) in percentage, 2. Removal Torque Values (RTV) in Ncm, 3. Implant stability Quotient (ISQ), Quality assessment was done using the ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines and SYRCLE RoB (Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias) tool. Results: Results were expressed as pooled mean difference for the respective groups viz. sandblasted and acid etched, laser modified, acid etched and anodized surface. The surface modified implants revealed somewhat higher BIC over machined surface (P < 0.01). Forest plot were drawn for all the outcome variables. Conclusions: Within the limitations of this study, the authors found a higher degree of osseointegration pertaining to bone to implant interface, RTV, and implant stability quotient (ISQ) with surface modified procedures which seemed to promote bone formation around peri-implant tissue during the early stages of healing. After analyzing all 37 included publications for the outcome of interest (BIC%, RTV, ISQ), a positive outcome was obtained for both subtractive and additive implant surface modifying procedures over machined implant surfaces when the data were pooled together. More advanced research work on healthy animal models needs to be investigated to review the impact of surface modifications on dental implant osseointegration.

Hyposalivation in patients with psoriasis: Association with severity, inflammatory, and anti-inflammatory cytokine biomarkers of the disease.

The aim of the study is to expound the effect of psoriasis on salivary glands by evaluating the secretion of saliva and salivary cytokine biomarkers in patients with psoriasis. This study was conducted by recruiting 120 subjects that included 60 patients diagnosed clinically with active psoriasis and 60 healthy controls who were age and gender matched to psoriatic subjects. Unstimulated whole saliva was collected from all the subjects by spitting method, and levels of tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interleukin-2 (IL-2), and IL-10 (IL-10) were determined via enzyme-linked immunosorbent assay (BT Lab, Shanghai, China). Secretion of saliva in psoriasis patients was considerably reduced than in healthy controls. The concentrations of pro-inflammatory cytokines (TNF-α, IFN-γ, and IL-2) were significantly increased, whereas level of anti-inflammatory cytokine (IL-10) was markedly decreased in the saliva of psoriasis patients with hyposalivation compared to healthy subjects. Our results demonstrated significant negative correlation of salivary flow rates with the disease severity. No significant correlations were obtained between salivary levels of tested cytokines and salivary flow rates in our study. Findings of the study reflect inflammation of salivary glands with reduced salivary flow rates in psoriasis patients. The inflammatory responses in salivary gland tissues by virtue of increased pro-inflammatory cytokines concentrations together with lower anti-inflammatory cytokine levels may have a role in affecting the saliva secretion in psoriasis patients. Secretion of unstimulated saliva in psoriasis patients decreases with the severity and duration of the disease.

Prevalence and Severity of Periodontal Disease and its Association with Type-II Diabetes Mellitus and Smoking by Using Periodontal Screening and Recording: A Retrospective Study.

Background: Periodontal screening recording (PSR) is considered a quick, reliable, reproducible valuable screening tool for periodontal disease. This study aims to find the prevalence and severity of periodontal disease and its association with self-reported diabetic status and smoking history of the patients by using PSR codes over a period of 2 years. Material and Methods: This was a cross-sectional retrospective study in a dental hospital in Chandigarh. Data of 10,882 patients comprising self-reported history of smoking (893) and diabetes (725) patients were assessed for the prevalence of periodontal disease by using PSR codes. Pearson Chi-Square test was used for statistical evaluation of PSR codes data. Results: Out of a total of 65,292 sextants assessed, the maximum and minimum reported PSR codes were 2 and 4, respectively. Gingivitis was found to be the most prevalent, followed by periodontitis and periodontal health in the total assessed population (P < 0.001). Mucogingival problems and complete edentulism were found to be more prevalent in posterior sextants in comparison to anterior sextants. Both self-reported smokers and type-II diabetes mellitus patients presented gingivitis as the most common clinical presentation, with the highest prevalence seen in the 55-74-year age group, which also comprised the group with maximum mucogingival problems and edentulism. Conclusion: This study gives an overview of patients' general oral health status and reflects the burden of periodontal disease in the Chandigarh region, thus contributing to the national oral health data.

Evaluation and comparison of three-dimensional finite element analysis of stress distribution in immediately placed and loaded conventional and customized three-dimensional printed dental implants.

Aim: The aim of this study was to evaluate and compare the stress distribution patterns in immediately placed and loaded conventional and customized three-dimensional (3D) printed dental implants by 3D finite element analysis. Materials and Methods: Twelve 3D finite element models [Group A-3 models; Group B-9 models] with 72 test conditions which were modeled and compared from customized 3D printed dental implants [Group A] and 3 commercially available implant systems [Group B] (Straumann, Ankylos, and Astratech) using "SolidWorks". All models were embedded in extraction socket models of the maxillary central incisor (CI) and Canine (C), Mandibular 1st Premolar. An occlusal loading by axial and nonaxial force of 100 N and 150 N at 30° and 45° was applied on the abutment using the "ANSYS" Suite. Customized 3D printed dental implant (Group A) for maxilla (Max.) CI, Max. C, and mandibular 1st premolar (PM) socket model was compared with three commercial available dental implant systems (Group B) for Max. CI, Max. C, and mandible (Mand.) 1st PM socket model to understand the stress distribution patterns. Results: With increasing oblique loads, von Mises stresses were reduced for the customized group as compared to conventional implants. Increased axial loads caused proportionate increase in the stresses for both groups, yet remained under the physiologic limits in all test conditions. Higher stresses were observed in cortical bone than in cancellous bone at bone-implant contact in general. Marked reduction in von Mises stress was observed at the boundary between compact and cancellous bone. Customized 3D printed implants performed better for oblique loads and comparable for axial load stress distribution in comparison to conventional implant systems in Max. CI and C, Mand. 1st PM. Conclusion: Thus, customized 3D printed implants appear a promising alternative for immediately placed immediately loaded protocols, with additional benefits in specific clinical situations.

To evaluate the effect of anodized dental implant surface on cumulative implant survival and success. A systematic review and meta-analysis.

Background: There have been certain apprehensions regarding the use of surface-modified dental implants due to peri-implant infection and crestal bone loss over the years. Thus, this review aims to evaluate the long-term effect of anodized implant surface on cumulative implant survival (CSR) and success rates in relation to marginal bone loss (MBL). Materials and Methods: Systematic electronic search was done using two databases, PubMed and Embase to assess the potentially relevant records from January 2008 to October 2019. Publications reporting cumulative survival and success rates with anodized dental implants were identified. Screening for duplicate articles and extraction of data was carried out to formulate evidence tables. Meta-analysis was conducted following PRISMA guidelines. Results: Out of 217 observational clinical studies, 8 studies were selected based on predefined selection criteria. The summary estimate for the included studies for CSR was reported as 0.98 (95% confidence interval [CI]: 0.96; 0.99). The heterogeneity (I2 = 37.3%) among these studies was found to be statistically nonsignificant (P = 0.1314). The mean values of MBL after the implant insertion were 0.84 mm at 0-1 year and 1.05mm by the end of follow-up period. This data were provided by five studies only. The mean difference of the analyzed studies came out to be 0.49 mm with a 95% CI (-0.22; 1.19). The heterogeneity (I 2 = 97%) for these studies was statistically significant with P < 0.01. Conclusion: The anodized dental implants have demonstrated long-term survival and success rates in terms of clinical outcomes.

The Periodontal Status of Orofacial Cleft Patients: A Systematic Review and Meta-Analysis.

Cleft lip and/or palate is the most commonly documented orofacial anomaly and may impact the status of health and disease of adjacent teeth along with their associated supporting structures. The authors performed a systematic review and meta-analysis to assess whether the presence of clefts altered the periodontal status of patients.The study was registered in PROSPERO (CRD42020210178). A systematic search of literature was performed utilizing unique search strings for PubMed, Scopus, and GoogleScholar as databases including gray literature from April 28, 2020 to October 3, 2020.Cross-sectional and longitudinal human studies published in the English language, providing information about periodontal disease and its association with cleft lip, alveolus, and palate.Periodontal outcome measures such as gingival index (GI), clinical attachment level (CAL), plaque index (PI), periodontal probing depth (PPD), and bleeding on probing (BOP) were utilized as the main outcome measures.Patients with clefts were predisposed to poorer periodontal outcomes. Subgroup analysis revealed compromised periodontal measures for clefts as compared to control sites without cleft which were statistically significant in terms of GI [Z = 2.44, P = .01], CAL [Z = 2.52, P = .01], PI [Z = 2.76, P = .006] and not statistically significant for PPD [Z = 0.27, P = .79] and BOP [Z = 1.47, P = .14].Within the limitations of the review, the authors conclude that the presence of orofacial clefts may predispose to periodontal compromise when compared to normal controls. The GRADE rating was moderate.

Effect of nano-crystalline silver membrane on early wound healing after periodontal surgery: A comparative randomized study.

BACKGROUND: Periodontal dressings are used for wound protection and patient comfort. Nano-silver particles have the ability to promote wound healing through anti-inflammatory properties. Hence, the present study aims to evaluate early wound healing parameters following periodontal surgery using nano-crystalline silver membrane as periodontal dressing. MATERIALS AND METHODS: Forty-two systemically healthy patients diagnosed with chronic periodontitis indicated for periodontal flap surgery were enrolled for the present study. Post surgery, the patients were randomly allocated to either a nano-crystalline silver dressing (Acticoat™) group (test group) or only the noneugenol dressing group (control group). Plaque index (PI) and wound healing index were recorded at the 7th- and 14th-day postsurgery. The microbiological analysis and vascular endothelial growth factor (VEGF) levels were evaluated at baseline and 7th-day postsurgery. RESULTS: The healing index was significantly higher in the test group as compared to the control group at days 7 and 14 (P < 0.001; P < 0.001). The colony-forming units/ml count of bacteria were significantly reduced postsurgery in the test group (P = 0.019). VEGF levels increased significantly 7th-day postsurgery in the test group (P = 0.001). There was no statistically significant difference in the PI on the 7th-day postsurgery between the two groups (P = 0.173). CONCLUSION: The results of the study revealed that silver can be used as a potent periodontal dressing ingredient that can decrease the microbial colonization beneath the pack and promote faster healing postsurgery due to its antimicrobial activity.

Enterococci in the oral cavity of periodontitis patients from different urban socioeconomic groups.

BACKGROUND: Enterococci are the transient constituents of the oral microbiome and have been now increasingly related to oral and systemic diseases. They have now become the most notable nosocomial pathogens and also been linked to etiology of periodontitis. This study evaluates the prevalence of Enterococci in the chronic periodontitis and healthy Indian cohort in different urban socioeconomic groups. MATERIALS AND METHODS: In this retrospective study, individuals in the age range of 18.75 years were included. Seventy individuals had mild-to-moderate periodontitis and 30 healthy persons were taken as controls. A questionnaire was administered. Paper point samples of gingival crevicular fluid were obtained, pooled, and sent to microbiology laboratory in a transport media. Forty-six isolates were identified as enterococci for statical analyzes Pearson's Chi-square test used and. P < 0.001 was considered to be significant. RESULTS: The prevalence of enterococci was seen mostly in the individuals from lower socioeconomic class, having poor oral hygiene, and smokers. This was significantly different from those of upper class (P < 0.001). The predominant species isolated was Enterococcus faecalis. CONCLUSION: Enterococci particularly E. faecalis followed by Enterococcus faecium could play a crucial role in the severity or progression of periodontitis particularly in a favorable oral environment.

Isolation of a Novel Phage and Targeting Biofilms of Drug-Resistant Oral Enterococci.

INTRODUCTION: Enterococci are now recognized as the second most cause of nosocomial infections worldwide. The emergence of multidrug-resistant strains in the organism has given rise to alternative strategies such as phage therapy. In this study, an Enterococcus faecalis infecting phage was isolated and its efficiency against biofilms formed by drug-resistant enterococci obtained from chronic periodontitis was evaluated. MATERIALS AND METHODS: Bacteriophage against E. faecalis was isolated from sewage sample. The phage was propagated and identified using transmission electron microscope (TEM). In vitro biofilm formation was assessed. RESULTS: TEM microscopy showed that the phage belonged to Siphoviridae family. In the presence of the novel phage, the metabolic activity of enterococci biofilm was reduced at 48 h of contact. A difference of at least 5 log CFU/ml was seen in the live cells of the control biofilm, and the phage treated biofilm of enterococci isolates. CONCLUSION: The study shows that the novel phage inhibits biofilm production in oral enterococci isolates from periodontitis patients but has a narrow host range. The role of bacteriophages as strong biotechnological and natural therapeutic agents for E. faecalis in chronic periodontitis can be considered.

Effect of scaling and root planing as monotherapy on glycemic control in patients of Type 2 diabetes with chronic periodontitis: A systematic review and meta-analysis.

BACKGROUND: There is enough evidence, which suggests that nonsurgical periodontal therapy (NSPT) improved the glycemic control in patients of Type 2 diabetes mellitus (T2DM) with chronic periodontitis (CP). This meta-analysis is aimed to explore the effect of NSPT, exclusively scaling and root planing (SRP) as monotherapy on glycemic control and periodontal parameters in patients of T2DM with CP. MATERIALS AND METHODS: Two databases, MEDLINE and EMBASE, were searched from June 2006 to June 2016. Initially, 464 potentially relevant studies were evaluated. Randomized controlled trials with duration of ≥3 months, based on the treatment group managed with SRP without any supportive use of local drug delivery or systemic antibiotics, while the control group received no periodontal therapy, were selected. This resulted in six appropriate articles with a total of 812 patients of T2DM with CP. Alteration in glycated hemoglobin (HbA1c) was the primary outcome measure, whereas the changes in clinical attachment level (CAL) and probing pocket depth (PPD) were the secondary outcome measures. RESULTS: SRP treatment resulted in a decrease in HbA1c by 0.26% (P = 0.17) at 3-4 months compared to the control group. Further, on subgroup analysis, SRP therapy revealed a decrease in PPD and CAL at 3-4 months, though statistically insignificant. CONCLUSION: SRP treatment leads to modest improvement in glycemic status and periodontal parameters in T2DM patients with CP at 3-4 months.

Biofilm Formation by Drug Resistant Enterococci Isolates Obtained from Chronic Periodontitis Patients.

INTRODUCTION: Enterococci are an important cause of opportunistic nosocomial infections and several multidrug resistant strains have emerged. The severity of periodontal diseases is managed by reduction in the pathogenic bacteria. There is a need to assess the prevalence and antibiotic susceptibility of enterococci colonizing the periodontal pocket and correlate its biofilm formation ability because oral biofilms provide a protective environment and are a reservoir of bacterial colonization of the gingival crevice. AIM: To investigate possible association between antibiotic susceptibility and biofilm formation in enterococci isolates from chronic periodontitis patients. MATERIALS AND METHODS: This retrospective study was conducted at Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Punjab University, Chandigarh from January 2015 to October 2015. Sterile paper points were inserted in the periodontal pocket of 100 subjects and put in a transport media. Forty -six isolates were identified as enterococci. The isolates were further examined for their ability to form biofilm by microtitre plate assay and antimicrobial susceptibility testing was done by disc diffusion method for clinically relevant antibiotics. RESULTS: Significant relationship (p<0.001) was found between biofilm production with antibiotic resistance to Vancomycin, Erythromycin, Ciprofloxacin, Tiecoplanin, Amoxycillin and Gentamycin. CONCLUSION: The study demonstrates a high propensity among the isolates of Enterococci to form biofilm and a significant association of biofilm with multiple drug resistance.

Evaluation of dentine hypersensitivity in adult population with chronic periodontitis visiting dental hospital in Chandigarh.

BACKGROUND: Periodontal attachment loss could be an earlier indicator or a possible risk factor of dentine hypersensitivity (DH). Thus, there is a need for diagnosing this condition both by questionnaire and by clinical examination before rendering both home care and in-office treatment modalities. AIMS: To investigate the relationship between various demographic factors and DH and to detect the percentage of patients using desensitizing agents. MATERIALS AND METHODS: In this cross-sectional study, 2051 patients were evaluated till the required sample size of 1000 patients was achieved who were evaluated both by questionnaire and clinical test. Association between DH clinical attachment level and apparent recession was established. RESULTS: This study found that the prevalence of dentine hypersensitivity in chronic periodontitis patients was 37.2% according to questionnaire and 47.8% according to the results of clinical test. Various demographic factors were found to affect dentine hypersensitivity such as age, gender, education, diet, and locality. CONCLUSION: The prevalence of dentine hypersensitivity in chronic periodontitis patients was 37.2% according to questionnaire and 47.8% according to the results of clinical test. Periodontal attachment loss could be an earlier indicator or a possible risk factor of DH. Only 14.36% of the patients with sensitive teeth used desensitizing paste. This could be due to the fact that either the patients did not consider the condition bad enough to warrant treatment or it was not being diagnosed.

Perceptions of Indian dental hygiene students toward their profession and its relationship with their explicit self-esteem scores.

BACKGROUND: The purpose of this study was to investigate the perceptions toward the profession, the level of explicit self-esteem (ESE) of Indian students pursuing the course of dental hygienists, to evaluate the relationship between the two and to develop educational strategies to positively influence students' perceptions. We also wished to evaluate the level of satisfaction of the students to the current status of professional employment in the country. MATERIALS AND METHODS: Students in the second year of the dental hygienist 2-year course were asked to participate in a cross-sectional survey study. An instrument was used to obtain students' perceptions about the profession by estimating the dimensions of "Motivation," "Expectation" and "Environment". Their self-esteem was evaluated using the Rosenberg self-esteem scale. Relationship of self esteem scores with perceptions towards profession was then evaluated. RESULTS: Scores for dimensions including "Motivation," "Expectation" and "Environment" were significantly high, as were the self-esteem scores. The level of ESE was positively correlated with their perceptions of the profession. CONCLUSIONS: The perception of the Indian dental hygienist students was significantly high and positively correlated to the ESE scores. We also conclude that environmental factors may be more influential than innate cultural factors for the development of self-esteem.

Role of curcumin in systemic and oral health: An overview.

Various modalities of treatment are available for different dental diseases, but the major drawback of these conventional drug therapies is the numerous side effects associated with their use. This has led to renewed interest in the discovery of novel anti-infective natural compounds derived from plants. Plants have been the major source of medicine since the time immemorial. Turmeric has been attributed a number of medicinal properties in the traditional system of medicine. The objective of this article is to review the efficacy of turmeric herb in maintenance of oral health, in particular, and overall health, in general. Turmeric, a rhizome of Curcuma longa, is a herb known for its medicinal properties and is a more acceptable and viable option for a common man. It has proven properties like anti-inflammatory, antioxidant, antimicrobial, hepatoprotective, immunostimulant, antiseptic, and antimutagenic. Due to these properties, it is quite useful in dentistry as well. It has a role in the treatment of periodontal diseases and oral cancers. Turmeric can also be used as a pit and fissure sealant, mouth wash, and subgingival irrigant in different preparations. It can also be used as a component in local drug delivery system in gel form.

Gene therapy with growth factors for periodontal tissue engineering-A review

The treatment of oral and periodontal diseases and associated anomalies accounts for a significant proportion of the healthcare burden, with the manifestations of these conditions being functionally and psychologically debilitating. A challenge faced by periodontal therapy is the predictable regeneration of periodontal tissues lost as a consequence of disease. Growth factors are critical to the development, maturation, maintenance and repair of oral tissues as they establish an extra-cellular environment that is conducive to cell and tissue growth. Tissue engineering principles aim to exploit these properties in the development of biomimetic materials that can provide an appropriate microenvironment for tissue development. The aim of this paper is to review emerging periodontal therapies in the areas of materials science, growth factor biology and cell/gene therapy. Various such material shave been formulated into devices that can be used as vehicles for delivery of cells, growth factors and DNA. Different mechanisms of drug delivery are addressed in the context of novel approaches to reconstruct and engineer oral and tooth supporting structure (AU)

Recrudescent herpes labialis mimicking primary herpes labialis in pregnancy.

CONTEXT: Herpes simplex virus (HSV) infection is prevalent worldwide. Herpes labialis is caused predominantly by HSV-1, and herpes vulvo-vaginitis is caused predominantly by HSV-2. HSV-2 may result in significant morbidity and mortality for infected neonates exposed during delivery. Due to this fact, a large amount of literature exists for HSV-2 but data for HSV -1 is scanty. CASE REPORT: We report two cases of recrudescent herpes labialis in 3(rd) trimester of pregnancy with extensive peri-oral lesions resembling primary herpes labialis. There was no obvious cause of immunosupression. The patients were followed up with a normal outcome of pregnancy and no fetal abnormality. CONCLUSIONS: The reasons for such extensive perioral lesions are uncertain. Immunosupression of pregnancy may be a factor in a sub group of patients.