Comparison of Malondialdehyde Levels among Patients with Sandblasted Acid-Etched and Anodized Surface Dental Implants: A Prospective Clinical Study.

Inflammation that occur as a part of body's response to implant-tissue contact can result in oxidative stress. Therefore, exploring the oxidative stress around different surface treated dental implants is essential to improve the performance of implants. The purpose of this study was to detect and measure the level of malondialdehyde (MDA), oxidative stress marker among patients with sandblasted acid-etched and anodized surface dental implants. In this prospective clinical study, 78 patients who had undergone implant placement for missing single posterior tooth in mandible using sandblasted acid-etched and anodized surface dental implants during August 2019 - December 2019 were enrolled according to strict inclusion and exclusion criteria and were categorized into Group 1: SLA (n = 27), Group 2: SLActive (n = 26), Group 3: TiUnite (n = 25) based on the surface modification of the implants. Peri-implant crevicular fluid (PICF) was collected and MDA was quantified using ELISA kit at 3 months and 1 year. Statistical analysis was performed using one-way ANOVA, followed by Tukey's HSD post hoc. For intragroup comparison, paired t-test was used. MDA levels in group 3 implants was significantly higher than groups 1 and 2 (P ≤ 0.05). On pairwise comparison, there was a statistically significant difference between the groups at baseline (P ≤ 0.05) and 1-year follow-up (P ≤ 0.05). Intragroup comparison showed that there was a statistically significant difference from baseline in all the three groups (P ≤ 0.05). MDA level in peri-implant crevicular fluid was high around TiUnite dental implant as compared to SLA and SLActive implants.

The Cervical Abrasion Index of Treatment Needs (CAITN) Procedure for Population Groups and Individuals.

Because of their complex epidemiology and etiology, cervical abrasions usually manifest with concealing symptoms. The buccolingual dimension of the sore is considered the most important metric to rank the damage and evaluate its long-term prognosis. In this piece, we will break this down and offer the Cervical Abrasion Index of Treatment Needs (CAITN), a simple grouping structure based on the clinical presentation of the sore that may be used to establish a basic, useful, treatment-based order. CAITN is the practical approach to routine screening and recording cervical abrasion lesions. The index provides epidemiologists, public health professionals, and practitioners with a practical means of assessing the treatment needs (TN) of cervical abrasion.

Bacterial Profile Associated with Peri-Implantitis: A Systematic Review.

This systematic review assesses the microbiological similarities and differences between healthy and diseased peri-implant sulci based on available literature evidence. A thorough electronic search was conducted in databases such as PubMed, Google Scholar, and Cochrane; a manual search employing eligibility criteria was conducted as well. After a comprehensive review, studies evaluating the microbial profile obtained from biofilm samples from healthy and diseased peri-implant sulci were chosen. Ten articles compared microbial profiles of healthy and failing implants. A statistically significant variation in the microbial profile was observed, with predominating Gram-negative, anaerobic organisms at both the genus and species level between healthy and diseased peri-implant sulci. Also, red complex organisms (P. gingivalis, T. forsythia, and P. intermedia) predominated in diseased peri-implant sulci. According to existing studies, peri-implantitis is characterized by a diverse microbial community that includes obligate anaerobic Gram-negative bacteria such as T. denticola, T. forsythia, P. gingivalis, and P. intermedia. This research will pave the way for further studies assessing specific bacterial flora in diseased peri-implant sulci, which will help in developing specific treatment targets for peri-implantitis.

Comparison of Microbial Composition of Natural Teeth and Implants by 16S rRNA Gene Sequencing.

Exploring variations in the oral microbiome that predict the early stages of oral diseases could lead to more accurate diagnosis and therapy before the disease manifests clinically. This study compared the bacterial profile around prosthesis on natural teeth and implants in a healthy oral cavity. Fifteen participants with prosthesis on natural teeth and 15 participants with implants were recruited. All participants were periodontally healthy. Plaque samples were collected and then subjected to PCR amplification with 16S rRNA gene sequencing. Using the BlastN program, the sequenced data were compared to reference bacterial gene sequences in the Human Oral Microbiome Database. Finally, bacterial species in both groups' samples were identified, and a phylogenetic tree was created to compare the bacterial profile around prosthesis on natural teeth and implants. Microorganisms identified were Streptococcus, Fusobacterium, Corynebacterium, Micrococcus, Aeromonas, Leptotrichia, and Dechloromonas species; around implants were Streptococcus, Fusobacterium, Corynebacterium, Prevotella, Eikenella, Nisseria, Rothia, Aeromonas, Leptotrichia, and Actinomyces species. On comparing the bacterial profile around prosthesis on natural teeth and implants in periodontally healthy individuals, pathogenic bacterial species including Fusobacterium nucleatum, Prevotella intermedia, and Eikenella corrodens were identified around implants.

Prevalence of Chronic Periodontitis and Chronic Stress in the South Indian Population.

Background Chronic stress is commonly thought to have a net negative effect on the efficacy of the immune response, leading to an imbalance between host and parasite and consequently resulting in a periodontal breakdown. Aim To identify the prevalence of chronic periodontitis and chronic stress as well as a comparative evaluation of clinical, demographic, and psychoanalytical parameters among the South Indian population. Materials and methods A total of 500 subjects between the ages of 30 and 60 were chosen from the Trivandrum district, Kerala, using multistage random sampling. Subjects were evaluated based on psychoanalytical parameters as well as periodontal examination. Psychoanalytical parameters were measured by the questionnaire method using the perceived stress scale. Periodontal parameters examined were the probing depth, clinical attachment loss, bleeding on probing, simplified oral hygiene index, and community periodontal index (loss of attachment). Statistical Analysis Categorical and quantitative variables were expressed as frequency (percentage) and mean ± SD respectively. Logistic regression analysis was used to analyze the association between the periodontal variables and psychoanalytical variables. All the statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows (IBM Corp., USA). Results A total of 500 subjects, of whom 308 (61.6%) were female and 192 (38.1%) were male, participated in this study. The overall prevalence of periodontitis among all the subjects was found to be 42.4%, and the proportion of periodontitis among the stressed participants was found to be 46.2%, which is 10% higher compared to the non-stressed (36.1%) participants. Conclusion Our study showed an increased frequency of periodontitis among the stressed subjects as compared to the non-stressed subjects. These findings suggest that there is a positive association between chronic stress and chronic periodontitis, but further prospective studies are required to establish the extent of the effect chronic stress has on chronic periodontitis and vice versa.

Assessment of Cervical Abrasion, Dentin Hypersensitivity, and Its Treatment Needs Using the Cervical Abrasion Index of Treatment Needs Probe.

Objective This study was intended to compare the mean buccolingual measurement of abraded teeth with/without sensitivity. The hypothesis was that the suggested treatment approaches would be in agreement with that of the treatment needs (TN) elicited using the Cervical Abrasion Index of Treatment Needs (CAITN) probe and aid in the development of a prospective CAITN index for clinical/community studies of effective therapeutic measures. Materials and methods  A cross-sectional study was carried out on 30 individuals with a mean age of 48.4±12.54 years, comprising 840 teeth with/without cervical abrasion. The buccolingual measurement of each tooth was recorded using the CAITN probe. The response to air-blast was assessed by a short blast of one-second duration at a distance of 1 cm for each tooth. An endodontist was also asked to indicate the treatment methods used by him for the treatment of abrasions. His opinions regarding the TN were later compared with the data collected by an investigator. Results The mean buccolingual measurements of all the teeth were compared with the dentinal sensitivity using the independent t-test and were statistically highly significant. Furthermore, one-way analysis of variance disclosed that there was a statistically highly significant difference found for all the TN (p<0.01) such as none, preventive, basic, and advanced restorative TN followed by Tukey honestly significant difference post hoc tests for multiple pair-wise comparisons. The running receiver operator characteristic curve discloses the best cut-off value of the buccolingual measurement to predict the various categories of TN of each tooth. As the area under the curve is more close to 1 (noticed in the majority of the teeth in the sample), the model predicts the TN more precisely based on the buccolingual measurements. Conclusion The present study enables a correct diagnosis of cervical abrasions and determines the various TN with the most appropriate restorative material. These baseline data help to design clinical studies that test relevant treatment and diagnostic strategies.

Comparison between the regenerative potential of different types of platelet concentrates in periodontal intrabony defect management: A systematic review.

This systematic review aims to compare the regenerative potential of different preparations of platelet concentrates in periodontal osseous defect regeneration. A comprehensive search was conducted on PubMed, Cochrane, and Medline electronic databases including articles published till April 2020. Search was performed as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of the total 224 studies fetched for the study, 7 were found relevant and included. Studies with a follow-up period of <6 months or those reporting periodontal intrabony defects that apically extended with endodontic involvements were excluded. Two studies reported no significant differences in outcomes between platelet-rich fibrin (PRF) and platelet-rich plasma (PRP), whereas one study reported a slightly superior effect of PRF over PRP. Titanium PRF (T-PRF) displayed significantly greater defect fill compared with leukocyte-rich-platelet-rich fibrin in one study, although other parameters were not significantly different. plasma rich in growth factors (PRGFs) and PRF show similar improvements in the outcomes. Furthermore, comparison between PRF and T-PRF did not show statistically significant differences in the two included studies. The results of the present systematic review indicate no significant differences in outcome between different platelet concentrates in the management of periodontal osseous defects. Limited evidences favor PRF over PRP and T-PRF over PRF. However, additional powered studies with much larger sample sizes are needed to obtain a more concrete conclusion.

Estimation of Serum, Salivary, and Gingival Crevicular Uric Acid of Individuals With and Without Periodontal Disease: A Systematic Review and Meta-analysis.

Introduction: Uric acid (UA) levels in serum, salivary, and gingival crevicular fluid (GCF) may be associated with periodontal diseases. Hence, this study aimed to estimate the UA concentration in serum, saliva, and GCF of periodontal disease and non-periodontal disease subjects by conducting a systematic review and a meta-analysis of the reported studies. Materials and Methods: A review of the available literature was searched in the electronic databases of PubMed, Cochrane, Science Direct, and EBSCO for the relevant publications. All the related case-control, cross-sectional, and cohort studies reporting the UA levels in the blood, salivary, and GCF between periodontal disease patients and healthy controls were analyzed. Significant heterogeneity was observed in the studies. Hence, a continuous random-effects model was used. The findings are described in forest plots with the point estimations and 95% confidence interval (CI). A value of P less than 5% was considered as a significant heterogeneity test. Results: Of the initial 166 study titles screened, 14 reported papers were eligible for quantitative review. The subgroup analysis of serum UA revealed a mean difference of 0.299 (95% CI: 0.029-0.569, I 2=85.64%, P<0.001), indicating an increase in the UA levels in periodontal disease. However, the subgroup analysis by salivary UA demonstrated a mean difference of -0.783 (95% CI: -1.577-0.011, I 2= 94.62%, P<0.001), suggesting a lower side of the UA level in periodontal diseases. The subgroup analysis based on case-control studies showed a mean difference of 0.004 (95% CI: -0.286-0.294, I 2=84.99%, P<0.001), indicating no changes in UA levels in periodontal disease. On the contrary, cohort studies and cross-sectional studies showed a mean difference : 95% CI: -1.016, -3.272-1.241, I 2=97.84%, P<0.001 and 95%: -1.230, -4.410-1.949, I 2=97.7%, P<0.001, indicating reduction in UA levels in periodontal disease cases. Conclusion: The current review suggests an increase in the serum UA levels in periodontal disease than in healthy controls. Contrarily, the salivary UA levels decreased in periodontal disease patients. It is unknown why UA levels are opposite in the blood and saliva of periodontal disease patients requiring further explanation.

Cervical Abrasion, Sexual Dimorphism, and Anthropometric Tooth Dimension.

Introduction: The aim of this study was to analyze the anatomic crowns of the maxillary and mandibular dentition concerning the mesiodistal, buccolingual measurements which will be used to establish normative data as a part of comprehensive study being carried out to determine the depth of the cervical abrasion (CA) of the individuals by predicting the CA Index of Treatment Needs (CAITN) score. Materials and Methods: A newly developed instrument termed as CAITN probe was used to measure CA of the tooth more quantitatively. The mesiodistal and buccolingual width of all the 14 maxillary and mandibular teeth from the right second permanent molar to the left second permanent molar of the study sample was measured. The ratio between buccolingual and mesiodistal measurements of each tooth of the maxillary and mandibular arch of the study sample (n=100) was also determined. Statistical analysis was performed using the SPSS 26.0 software. Results: Descriptive statistics were calculated for each group independently. The statistical significance of the difference in mean in mesiodistal and buccolingual diameters between males and females was calculated using the t-test for independent samples with p < 0.05. The ratio was highest in the left second premolar (1.752) and least in the right central incisor (0.980) of the maxillary arch. Similarly, the ratio was highest in the left central incisor (1.723) and least in the left second molar (0.910) of the mandibular arch. Conclusion: The present study was conducted as an initial step in the process of development of the novel tool or index enabling the dentists to organize the health-care needs of their patients by facilitating standardized identification of CA with objective measurements used for epidemiological or community purpose.

Association Between Cervical Abrasion, Oral Hygiene Practices and Buccolingual Dimension of Tooth Surfaces: A Cross-Sectional Study.

Background: Cervical abrasion is a multifactorial process due to the use of abrasive dentifrices along with improper brushing patterns. An extensive lesion may cause loss of structural integrity of tooth and esthetically unacceptable. The purpose of the study was to assess the prevalence of cervical abrasion with age, gender, and oral hygiene practices among workers in a spinning mill, Kerala. The study also aimed to identify the buccolingual measurements of each abraded tooth using the Community Abrasion Index of Treatment Needs (CAITN) probe. Materials and Methods: A cross-sectional study where 366 subjects (257 males and 109 females) above 20 years of age were selected using a random sampling technique. Data was collected from the assessment form comprising demographic data and oral hygiene practices of the subjects. Clinical examination for abrasion and buccolingual measurements of abraded tooth recorded using CAITN probe. The statistical analysis was done using SPSS 26.0. for calculating descriptive statistics, Chi-square test, and binary logistic regression. Results: The overall prevalence of abrasion was 37.2% and 97.7% of subjects with abrasion had sensitive teeth and were statistically significant. Age, gender (males) and combined horizontal and vertical method of brushing technique were strongly associated with the cervical lesion (P < 0.001). Binary logistic regression analysis showed that age group, gender, combined horizontal and vertical method of brushing, and presence of sensitive tooth was associated with the abrasion. Conclusion: It is concluded that the severity of the abrasion is an age-related phenomenon associated with combined horizontal and vertical strokes of brushing and is common among the male population. Dentinal hypersensitivity is also more prevalent with cervical abrasion. The novel CAITN probe can be used as an effective tool to assess the cervical abrasion and its treatment needs.

The Design, Development, and Calibration of Cervical Abrasion Index of Treatment Needs Probe for Measurement of Cervical Abrasion.

Context: Although a common dental problem, there are no simple instruments or reliable methods to measure cervical abrasion. Aim: To study the design, development, calibration, efficacy, and compliance of usage of a novel Cervical Abrasion Index of Treatment Need (CAITN) probe to measure cervical abrasion. Settings and Design: The ex-vivo study was conducted as a part of comprehensive study for the development of standardized CAITN probe and index with a standard methodology for recording the abrasion. Materials and Methods: The compliance and usage of the probe were assessed by a standardized set of questionnaires to the interns followed by an ex-vivo study in 100 subjects. Gold standard comparisons with Vernier caliper, inter-examiner, and intra-examiner reliability were analyzed using SPSS. Results: Data from the questionnaire indicate that 100% of examiners had no difficulty in handling the instrument or measuring and reading the values. Comparison between the CAITN probe and the gold standard was statistically significant indicating a correlation for cervical abrasion measurement between the two methods (p < 0.001). The mean difference between the two measurements using the CAITN probe and gold standard method was calculated with paired t-test and was insignificant (p > 0.05). High statistical significant correlation was also found for intra-examiner and inter-examiner reliability measurement of CAITN probe (p < 0.001). Conclusion: The design and structure of the CAITN probe are standardized with a fair gold standard comparison and that the novel probe can be used as an effective tool to measure the depth of cervical abrasion and its treatment needs.

Establishing the Role of Neurogenic Inflammation in the Pathogenesis of Periodontitis: A Systematic Review.

The role of neurogenic inflammation in various systemic diseases has been well established, but there is a dearth of studies and evidence regarding its role in periodontitis. This study aimed to systematically review the evidence in establishing the role of neurogenic inflammation in chronic periodontitis. Databases such as PubMed, Scopus, and Google Scholar were reviewed. We analyzed studies of any design that compared and evaluated the presence of neuropeptides such as substance P, calcitonin gene-related peptide, neurokinin A, neuropeptide Y, and vasoactive intestinal polypeptide in systemically healthy patients with and without periodontitis. We screened 2,495 articles and abstracts electronically and manually, which yielded 191 articles relevant to our study. Full-text examination of these 191 articles led to the final inclusion of 14 publications. Most studies here confirmed an association between various neuropeptides and periodontitis, but there is a high heterogeneity between the studies, making it necessary to clarify the mechanism between these two. Although most studies included in this review found a positive association between neurogenic inflammation and periodontitis, the evidence is of moderate to low quality.

Porphyromonas gingivalis and dental stem cells crosstalk amplify inflammation and bone loss in the periodontitis niche.

Periodontitis is the sixth most prevalent disease, and almost 3.5 billion people are affected globally by dental caries and periodontal diseases. The microbial shift from a symbiotic microbiota to a dysbiotic microbiota in the oral cavity generally initiates periodontal disease. Pathogens in the periodontal microenvironment interact with stem cells to modulate their regenerative potential. Therefore, this review focuses on the interaction between microbes and stem cells in periodontitis conditions. Microbes direct dental stem cells to secrete a variety of pro-inflammatory cytokines and chemokines, which increase the inflammatory burden in the damaged periodontal tissue, which further aggravates periodontitis. Microbial interaction also decreases the osteogenic differentiation potential of dental stem cells by downregulating alkaline phosphatase, runt-related transcription factor 2, type 1 collagen, osteocalcin, osteopontin, and so on. Microbe and stem cell interaction amplifies pro-inflammatory cytokine signaling in the periodontitis niche, decreasing the osteogenic commitment of dental stem cells. A clear understanding of microbial stem cell interactions is crucial in designing regenerative therapies using stem cells in the management of periodontitis.

Assessing the In Vitro Antioxidant and Anti-inflammatory Activity of Moringa oleifera Crude Extract.

BACKGROUND: Chronic inflammation and oxidative stress play a vital role in the pathogenesis of various diseases of the oral cavity including periodontal disease. Phytochemicals present in plants with antioxidant (AO) and anti-inflammatory properties could aid as a therapeutic adjunct in the management of these diseases. AIM: To assess the antioxidant and anti-inflammatory effects of aqueous and ethanolic extracts of Moringa oleifera Lam. (MOL) in an in vitro environment. MATERIALS AND METHODS: Aqueous and ethanolic extracts of M. oleifera Lam. were prepared by maceration. Antioxidant activity was assessed by FRAP, hydroxyl radical scavenging activity, and DPPH radical scavenging assay. Anti-inflammatory activity was assessed by Albumin Denaturation Assay. Experiments were repeated thrice, and mean and standard deviation were calculated. RESULTS: Both the test substances exhibited significant antioxidant and anti-inflammatory activity, and aqueous extracts exhibited higher activity than ethanolic extract. SUMMARY AND CONCLUSION: The anti-inflammatory and antioxidant activity of M. oleifera Lam. could be further explored for the management of periodontal disease as a local drug delivery system with the extract could be developed.

Microbiological Profile in Periodontitis and Peri-Implantitis: A Systematic Review.

Understanding the microbiological makeup of peri-implant biofilm could contribute to the discovery of focused treatment strategies, improving the outcome of peri-implantitis management. However, the bacterial profile in diseased periodontal and peri-implant sulci is still unclear. This systematic review aims to analyze the microbiological similarities and differences between diseased periodontal and peri-implant sulci based on the available literature evidence. A thorough search was conducted in electronic databases such as PubMed, Google Scholar, and Cochrane, as well as a manual search employing the eligibility criteria. After a thorough review, studies evaluating the microbial composition acquired from plaque samples obtained from patients with diseased periodontal and peri-implant sulci were chosen. The selected 8 studies evaluated the differences in microbial profile in periodontitis and peri-implantitis. Five studies found a statistically significant variation in the microbial profile between diseased periodontal and peri-implant sulci, while in one study, no changes in the microbiology of inflammatory peri-implant and periodontal sites were observed. In one of the two in situ studies, the structure of the transcription level and core species was different in peri-implantitis, whereas the other in situ study found that the 16S rRNA-based bacterial profile of both the diseases were different, while the functional genes, taxonomic, and virulence factor mRNA profiles were identical. According to existing studies, significant differences in the biofilm composition of diseased periodontal and peri-implant sulci were observed. Therefore, periodontitis and peri-implantitis have diverse microbial characteristics.

Comparison of Interactive Teaching in Online and Offline Platforms among Dental Undergraduates.

In recent years, the educational system has focused more on the holistic development of an individual. Modern technology has changed the educational environment to provide students with better academic opportunities. Along with the education system, teaching techniques and learning tools have also changed with digital evolution. This research was undertaken to assess the academic performance of interactive teaching methods in offline and online platforms in Periodontics among BDS undergraduates at a dental college in India. This prospective study was conducted among 49 students: Group I (n = 24, online class through Zoom) and Group II (n = 25, offline classes). The subject was divided into three modules and was covered in one week. The topics covered, teaching methods, lectures, and activities were similar for both groups. A formative assessment mark was obtained from written tests during the module, whereas the summative assessment mark was recorded from exams conducted towards the end of the module. In the results, a statistically significant difference was not observed in terms of formative assessment between Group I (77.88 ± 12.89) and Group II (77.80 ± 16.09) (p = 0.98). In addition, a statistically significant difference was not observed in terms of summative assessment between Group I (80.54 ± 8.39) and Group II (80.28 ± 11.57) (p = 0.93). Overall, this study suggests that interactive teaching methods in both offline and online platforms in Periodontics showed equivalent performance by the undergraduate dental students.

Association of SRXN1 Receptor Gene Polymorphism with Susceptibility to Periodontitis.

Background: Emerging evidence suggests that oxidative stress forms a key component in the etiopathogenesis of periodontitis. Literature evidence have shown potential antioxidants responsible for combating the pro-oxidants which stress the periodontium, but the peroxiredoxin-sulfiredoxin system is explored very minimally in periodontal disease. Thus, the present study was aimed to evaluate the genetic association of SRXN1 receptor gene polymorphism (rs6053666). Materials and Methods: A total of 100 subjects were recruited for this study, which included 50 Periodontitis patients (Stage II and above based on the criteria of American Association of Periodontology-2018) and 50 periodontally healthy or mild gingivitis. Genomic DNA was extracted from the whole blood collected from the subjects. DNA was amplified using specific primers flanking the BtgI region of the SRXN1 receptor gene. The amplicon was further subjected to genotyping using restriction fragment length using BtgI enzyme. The genotype obtained based on the restriction fragment length polymorphism pattern was recorded and used for statistical analysis. The distribution of genotypes and allele frequencies in the periodontitis and control groups were compared using the Chi-square test. The risk associated with individual alleles or genotypes was calculated as the odds ratio with 95% confidence intervals. Statistical significance in all tests was determined at P < 0.05. Results: The genotype frequency and distributions of SRXN1 receptor BtgI polymorphism did not differ significantly at ꭕ2df (P = 0.557). Our study results showed that homozygous and heterozygous mutant genotypes had no significant difference (CC vs. CT + TT) between the periodontitis patients and control group with a P = 0.4266. The detected frequency of CT (38% vs. 34%) and TT (42% vs. 52%) genotype showed no significant difference between control and test group. There was no significant difference in C allele (39% vs. 31%) and T allele (61% vs. 69%) between the test and control group. Conclusion: The present study denotes that SRXN1 receptor gene polymorphism is not associated with periodontitis in the study group analyzed.

Effect of low intensity ultra sound on bone regeneration and healing: a systematic review

ABSTRACT Objective: Low Intensity Pulsed Ultra Sound (LIPUS) is found to have stimulatory effect on bone healing and regeneration. This review aimed to assess whether LIPUS enhances bone regeneration and healing in terms of efficiency in improving clinical, radiographic, histologic parameters or serum and tissue biomarkers. Methods: A comprehensive search based on PRISMA guidelines with pre-determined eligibility criteria was conducted to identify randomized controlled clinical trials evaluating effectiveness of Low intensity pulsed ultrasound in bone regeneration and healing. The title and abstract of the entries in all languages yielded from the PubMed, Google scholar and Cochrane library were screened. Results: 14 eligible Randomized controlled trials testing the effectiveness of LIPUS was evaluated. More heterogeneity was seen in the screened studies with respect to sample characteristics, type of bone and outcome measures. The studies that screened histological parameters state that LIPUS is significantly beneficial than control. In terms of time for radiographic union, most of the studies stated that LIPUS was more effective than control but numberof studies are very few. Whereas studies which evaluated parameters such as healing time and radiographic union were showing highly inconsistent results regarding effectiveness of LIPUS. Conclusion: This review cannot give a definitive conclusion that LIPUS is effective in bone healing with respect to clinical parameters but a positive influence on radiographical and histological parameters in bone healing and regeneration is promising to pursue future research.

Comparison of interleukin-21 levels and its correlation with clinical parameters among healthy individuals, chronic periodontitis, and aggressive periodontitis patients.

BACKGROUND: Interleukin-21 (IL-21) has both anti- and pro-inflammatory roles associated with chronic inflammation. It causes tissue destruction by increasing pro-inflammatory cytokines and curbs the activity of certain immune cells that evoke an anti-inflammatory role. OBJECTIVES: The aim of this study was to compare IL-21 levels in gingival crevicular fluid among patients with generalized chronic periodontitis (GCP), aggressive periodontitis, and healthy gingiva (HG) and to correlate IL-21 levels with clinical parameters. METHODS: In this cross-sectional case-control study, 60 subjects were categorized into three groups: HG (n=20), generalized aggressive periodontitis (GAP; n=20), and GCP (n=20). IL-21 was measured using ELISA and results were correlated with clinical parameters including plaque index, gingival index, periodontal probing depth (PPD), and clinical attachment level (CAL). RESULTS: Mean IL-21 levels were 20.0±0.7 in HG, 25.9±0.9 in GCP, and 25.3±1.1 in GAP groups. Significant differences in IL-21 levels were found between HG versus GAP (P<0.05) and HG versus GCP (P<0.05). No statistically significant difference in IL-21 level was found between GCP versus GAP. IL-21 levels positively correlated with PPD (r=0.97) and CAL (r=0.93) in the GAP group and with PPD (r=0.92) and CAL (r=0.96) in the GCP group. CONCLUSION: Although periodontitis pathophysiology involves complex interplay between pro- and anti-inflammatory signaling, data on IL-21 revealed elevated levels in both GCP and GAP. Further longitudinal studies are required to characterize and determine the diagnostic value of IL-21 as a reliable biomarker in periodontal disease. RELEVANCE FOR PATIENTS: Although further longitudinal studies are necessary, IL-21 may serve as a potential inflammatory biomarker in screening for generalized chronic and aggressive periodontitis.

Moringa oleifera: Antioxidant, Anticancer, Anti-inflammatory, and Related Properties of Extracts in Cell Lines: A Review of Medicinal Effects, Phytochemistry, and Applications.

Moringa oleifera (MO), or the common drumstick possesses antioxidant properties, and its pods, seeds, leaves, and bark have been used for the treatment of inflammatory and cancerous conditions. This systematic review attempts to synthesize original studies of MO extracts in cell lines to determine their specific antiproliferative, antioxidant, anti-inflammatory, and related effects. The literature was obtained from PubMed central, the Cochrane registry, and other sources including Google Scholar, and Embase. Studies fulfilling the inclusion criteria were selected. Custom data collection forms were employed and two independent evaluators compiled the relevant information. Eighteen studies were selected after applying inclusion and exclusion criteria. In most studies, MO leaves had more potent properties compared to other parts of the plant. Ethyl acetate and ethanolic extractions improved the potency of the extract. Effects were selective (different for normal cells and cancer cells) and dose-dependent. Anticancer and antioxidant activities were consistently reported, with effects exerted at the genetic and molecular levels. MO extracts potentially could be employed for therapeutic applications. The optimal sources, preparation protocols, and dosages have been researched, though further scrutiny is needed for a comprehensive formulation. Keywords: Anticancer, Anti-inflammatory, Antioxidant, Moringa oleifera.