Methodological Considerations in Salivary Proteomics for Periodontal Research-A Review.

The diagnosis and management of periodontal diseases can be enhanced by the identification of biomolecules which can predict disease susceptibility, indicate current disease activity, and monitor response to therapy. Salivary proteomics is a major avenue in the ongoing search for a biomarker in periodontal research. Saliva is a valuable diagnostic vehicle which "mirrors" oral and systemic health and disease. Standardized methods of saliva sampling and processing will increase diagnostic test accuracy and decrease bias in measurements. Prominent databases such as PubMed/Medline, PMC, Scopus, and Google Scholar were searched and literature evidence from January 2000 till September 2022 were studied to identify the methodological considerations employed in salivary proteomics for periodontal research. Evidence and recommendations in this regard were collated into this narrative review. The methods of saliva collection and processing presented in this review will help researchers conduct salivary proteomic studies with standardized protocols.

Effectiveness of Platelet-Rich Fibrin with Decalcified Freeze-Dried Bone Allograft Compared to Decalcified Freeze-Dried Bone Allograft Alone in Mandibular Grade-II Furcation Defects: A Quasi-Experimental Study

ABSTRACT Objective: To assess the effectiveness of platelet-rich fibrin (PRF) with decalcified freeze-dried bone allograft (DFDBA) compared to DFDBA alone in mandibular grade-II furcation defects. Material and Methods: A quasi-experimental study was conducted on nine patients with chronic periodontitis, each having two almost identical mandibular grade II furcation defects. Test sites (left mandibular first molars) were treated with open flap debridement (OFD), DFDBA, and PRF, whereas control sites (right mandibular first molars) received OFD and DFDBA alone. Clinical parameters (plaque index (PI), gingival index (GI), vertical clinical attachment level (VCAL) and horizontal clinical attachment level (HCAL) into the furcation defect) and radiographic measurements (mean alveolar bone defect) were done at baseline and after six months postoperatively. Results: The gain in relative horizontal clinical attachment level (RHCAL) in the test sites was 2.94±0.52 mm compared to 1.33±0.35 mm in control sites (p=0.01). Improvement in mean alveolar bone defect (MABD) (was 1.21±0.5 mm2 at test sites compared to 1.15±0.7 mm2 at control sites) probing pocket depth (PPD), recession, relative vertical attachment level (RVCAL), and percentage of bone fill was found in the test sites compared to control, which statistically insignificant. Conclusion: The test sites had better outcomes than control sites, which was significant for the parameter RHCAL. Therefore, combining the biological benefits of autologous PRF with DFDBA is an efficient and economical treatment modality for the management of mandibular grade II furcation defects.

Antimicrobial Prescription Patterns among Oral Implantologists of Kerala, India: A Cross-Sectional Survey.

Background and Objectives: Antimicrobial resistance is a grave public health concern, and it is important to optimize the use of antimicrobials in dental surgeries. Antimicrobial prescriptions in dental implant placements are often empiric and not guided by consensus or specific guidelines. The aim of this study was to elucidate antibiotic prescribing patterns among oral implantologists. The objectives were to identify the frequency of antimicrobial usage and preferences regarding the perioperative timing of prescriptions, type of antibiotic, dosage, and duration in different implant placement scenarios. Subjects and Methods: An anonymized web-based survey was carried out. Participants were drawn from the lists of oral implantologists from all local branches of the Indian Dental Association in the state of Kerala, India, until the required sample size was met. Responses were recorded using an Internet-based validated questionnaire sent via e-mail to the participants. The questionnaire contained five sections with both open-ended and closed-ended questions. Results: Among the 93 participants, 59% of the dental implantologists preferred 0.2% povidone-iodine as a preprocedural mouth rinse in the backdrop of the COVID-19 pandemic, and 68% prescribed 0.12%-0.2% chlorhexidine as the postoperative mouth rinse. The majority of the participants (73%) routinely prescribed systemic antibiotics perioperatively during implant placement surgery. Interestingly, while none of the participants preferred a solely preoperative regimen, 92.4% of the dentists in our survey prescribed both pre- and postoperative antibiotics. Antibiotics of choice as the preoperative agents were amoxicillin and amoxicillin plus clavulanic acid. The most preferred postoperative agent was amoxicillin plus clavulanic acid. The popularly reported rationale behind a preoperative antibiotic was to decrease or eliminate local or systemic infections (79%), and the majority of the participants (60%) prescribed postoperative antibiotics to prevent postoperative infection. Conclusions: Systemic antibiotic prescriptions in implant placement surgery are not based on currently available evidence. Most oral implantologists who participated in the survey prescribed systemic antibiotics to prevent perioperative infection, even in simple and straightforward implant placements. Specific guidelines need to be generated in complex implant placement situations and implant placement in medically compromised patients to prevent excessive prescriptions.

A pilot study on glycemia and insulin resistance in patients with severe periodontitis.

CONTEXT: The potential impact of severe periodontitis on glycemia in systemically healthy individuals is not clearly established. It was hypothesized that among individuals who were previously undiagnosed for diabetes mellitus, patients with severe periodontitis have impaired glycemia and insulin resistance. AIMS: The aim of our study was to assess and compare glycemia in severe periodontitis patients and in individuals with clinically healthy periodontium. MATERIALS AND METHODS: A cross-sectional analytical design was employed. From among individuals who were undiagnosed for diabetes mellitus, 37 patients with severe periodontitis and 37 individuals with healthy periodontium in the age group of 25-55 years were recruited for the study. The fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), and insulin resistance by the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were assessed and compared between the two groups. RESULTS: The mean FBS, HOMA-IR, and HbA1c were significantly higher for patients with severe periodontitis than those individuals with healthy periodontium. After adjustments for age, gender, and body mass index, patients with severe periodontitis had a statistically significant association with impaired glucose metabolism (HbA1c ≥5.7) (adjusted odds ratio [OR] of 9.56; 95% confidence interval [CI]: 1.819-46.08; P < 0.01). Furthermore, patients with severe periodontitis had significantly greater odds to develop impaired fasting glucose (adjusted OR of 7.489, 95% CI: 1.408-39.839; P < 0.01). CONCLUSIONS: The mean FBS, HbA1c, and HOMA-IR were significantly higher in severe periodontitis patients than in the control group. A higher proportion of patients presented with prediabetes, incident diabetes, and insulin resistance in the severe periodontitis group.

An in vitro investigation and comparison of the mechanical properties of human amnion and bovine collagen membrane

Introduction: The human amnion membrane is now increasingly used in Guided Tissue Regeneration(GTR). These placental allografts have excellent biologic properties. There is limited information regarding their mechanical properties as compared to other collagen membranes used in GTR. The aim of this study was to test and compare the mechanical properties of human amnion membrane with commercially available bovine collagen. Materials and methods: After measurement of average thickness, three strips of 5×1cm were cut from both amnion and bovine collagen membranes. Mechanical testing was done in a universal testing machine. Test speed was 1mm/min with a load cell of 100N. Tensile strength, Young's modulus and elongation at break were calculated. A suture retention test was also carried out using 3x1 cm size strips. Groups were compared through the Mann-Whitney U test. Results: Average thickness of amnion membrane was 0.46mm and thickness of bovine collagen membrane was 0.37mm.Tensile strength, Young's modulus and elongation at break of amnion membrane were 0.156MPa, 0.645MPa and 17mm; and that of bovine collagen membrane were 2.94MPa, 7.42MPa and 11.00mm, respectively (p = 0.05). Maximum load which can be applied during suturing for amnion membrane was 0.104N and for bovine collagen membrane was 2.07N (p = 0.037). Conclusion: There is no statistically significant difference in terms of tensile strength, Young's modulus and elongation at break between human amnion and bovine collagen membranes.(p=0.05)Membranes can only be considered different on the maximum load which can be applied during suturing.(p=0.037) (AU)

Acute herpetic gingivostomatitis associated with herpes simplex virus 2: report of a case.

Herpetic gingivostomatitis represents the most commonly observed clinical manifestation of primary herpes simplex virus (HSV) infection. HSV-1 has been associated with oro-labial disease, with most infections occurring during childhood, and HSV-2 with genital disease. However, it is possible for HSV-2 to cause oro-labial herpes and HSV-1 to cause genital herpes. An unusual case of acute herpetic gingivostomatitis (AHGS) that presented as extremely painful multiple ulcerations of the gingiva and hard palate in a 32-year-old male patient is presented. The association of HSV-2 in the etiology of oral lesions is highlighted. The clinical presentation, course, differential diagnosis and management of AHGS are discussed. How to cite the article: George AK, Anil S. Acute herpetic gingivostomatitis associated with herpes simplex virus 2: Report of a case. J Int Oral Health 2014;6(3):99-102.

The short-term effects of non-surgical periodontal therapy on the circulating levels of interleukin-6 and C-reactive protein in patients with chronic periodontitis.

BACKGROUND: Recent epidemiological studies have shown that periodontal infection is a risk factor for a number of systemic diseases and conditions. In addition to the conventional risk factors, chronic infection and the subsequent generation of a systemic inflammatory response may be associated with this increased risk. AIMS: This study was conducted to determine whether the presence of chronic periodontitis and subsequent non-surgical periodontal therapy could influence the serum levels of interleukin-6 and C-reactive protein (CRP) in patients with severe chronic generalized periodontitis. SETTINGS AND DESIGN: Participants were selected from subjects who attended the Department of Periodontics and Oral Implantololgy, Government Dental College, Thiruvananthapuram. MATERIALS AND METHODS: Sera were obtained from 25 patients with periodontitis for baseline examination and reassessment after completion of treatment. As a control, sera were also obtained from 20 subjects without periodontitis. Interleukin-6 was determined by sensitive enzyme-linked immunosorbent assay, and high-sensitivity CRP (hsCRP) was measured using latex turbidometric immunoassay. STATISTICAL ANALYSIS: Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS) version 10. RESULTS: The level of interleukin-6 and hsCRP in the sera of periodontitis patients was seen to be higher than those of healthy controls. Interleukin-6 level tended to decrease with improvement of the periodontal condition following treatment and approached that of control subjects, and this decline was statistically significant. The hsCRP levels also showed a decreasing trend following periodontal treatment. CONCLUSIONS: In this study, we were able to show that periodontal disease significantly affects the serum levels of systemic inflammatory markers and that non-surgical periodontal therapy could bring about a decrease in the levels of these inflammatory markers.