Efficacy of injectable platelet-rich fibrin (i-PRF) for gingival phenotype modification: a split-mouth randomized controlled clinical trial.

OBJECTIVES: Gingival phenotype is decisive in periodontal health, aesthetics, and function and is a predictor of treatment outcomes. Injectable platelet-rich fibrin is a recently proposed method of gingival augmentation due to its enhanced regenerative potential. The objective of the present study was to evaluate the efficacy of injectable platelet-rich fibrin for gingival phenotype modification. MATERIALS AND METHODS: In this split-mouth study, 30 healthy volunteers with thin gingival biotypes in either maxillary or mandibular incisors were included. iPRF was prepared using 64 g relative centrifugal force for 3 min. i-PRF was injected into the attached gingiva using a 27-gauge disposable needle in relation to the test sites (n = 360), and contralateral sites were kept as control. Re-evaluation was done at the end of 3 and 6 months. Post-operative complications and patient-reported experience measures were also recorded. Statistical analysis was done using paired t-test and analysis of covariance. RESULTS: Statistically significant increase in gingival thickness was found in the test group at the individual site and tooth level. An overall increase in gingival thickness of 26.56% after 3 months and 29% after 6 months compared to baseline was noticed in the test group. No significant difference was found in the width of keratinized gingiva in any of the comparisons. CONCLUSION: The non-surgical application of i-PRF is promising for enhancing gingival thickness. Future well-controlled studies with long-term follow-up in different patient populations can provide more evidence. CLINICAL RELEVANCE: Gingival phenotype modification is a useful therapy to prevent the occurrence of gingival recession in patients with thin phenotypes. TRIAL REGISTRATION: Clinical Trial Registration Number: CTRI/2021/04/032650.

Evaluation of salivary glycated albumin in periodontitis patients with and without type 2 diabetes mellitus and its changes with non-surgical periodontal therapy.

Background: Bidirectional relationship exists between diabetes mellitus and periodontitis. Glycated albumin is an emerging biomarker to assess intermediate glycemic control. Salivary glycated albumin has not been evaluated in periodontitis. Aim: The aim of the study was to compare salivary glycated albumin in periodontitis patients with and without diabetes mellitus before and after periodontal therapy. Materials and Methods: This comparative cross-sectional study was conducted in the Department of Periodontics. Ninety subjects (mean age 41.8 ± 6.82) were categorized into three groups. Clinical examination and saliva sample collection were done at baseline and 4 weeks after scaling and root debridement. Salivary glycated albumin levels were estimated using an enzyme-linked immunosorbent assay. One-way analysis of variance with post hoc test and paired t-test was done for inter- and intra-group comparison. The optimal cut-off value was calculated using the receiver operating characteristic curve and by maximization of the Youden index. Results: Mean salivary glycated albumin was the highest in diabetic patients followed by non-diabetic periodontitis patients and least in healthy controls. All the intergroup comparisons were significant. A cut-off value of 72.19 ng/ml of salivary glycated albumin could predict diabetic status with a sensitivity and specificity of 75%. Salivary glycated albumin was significantly reduced in a similar manner in both groups after periodontal therapy (19.4% and 18.5%). Conclusion: Periodontitis patients with diabetes mellitus were presented with the highest salivary glycated albumin. Non-surgical periodontal therapy resulted in a similar reduction of salivary glycated albumin in periodontitis with and without diabetes mellitus.

Urgency for sustainable development in coastal urban areas with reference to weather pattern, land use, and water quality.

Water pollution is one of the most critical problems affecting mankind. Weather pattern and land use of catchment area have significant role in quality of water bodies. Due to climate change, there is frequent variation in weather pattern all over the world. There is also rapid change in land use due to increase in population and urbanization. The study was carried out to analyze the effect of change in weather pattern during the monsoon periods of 2008 and 2012 on water quality of a tropical coastal lake system. The nature and extent of variation in different water quality parameters namely electrical conductivity (EC), magnesium (Mg), sodium (Na), chloride (Cl), sulphate (SO4), turbidity, Secchi disk depth, biochemical oxygen demand (BOD), phosphate (PO4), calcium (Ca), and water temperature as well as the effect of various land use activities in the lake basin on water quality have also been studied. There is significant reduction in precipitation, EC, Mg, Na, Cl, SO4, turbidity, and Secchi disk depths whereas a significant rise in the BOD, PO4, Ca, and water temperature were observed in 2012. This significant reduction in electrical conductivity during 2012 revealed that because of less precipitation, the lake was separated from the sea by the sandbar during most of the monsoon period and thereby interrupted the natural flushing process. This caused the accumulation of organic matter including phosphate and thereby resulting reduction in clarity and chlorophyll-a (algae) in the lake. The unsustainable development activities of Thiruvanathapuram city are mainly responsible for the degradation of water bodies. The lack of maintenance and augmentation activities namely replacement of old pipes and periodical cleaning of pipe lines of the old sewer system in the city results in the bypass of sewage into water bodies. Because of the existence of the old sewerage system, no effort has been taken by the individual establishment/house of the city to provide their own treatment system for sewage and sullage and the untreated wastes are discharged into these old sewer pipes and ultimately the wastes reach the water bodies. In this context, decentralized treatment of sewage, sullage, and garbage by individual houses/establishments/hotels/hospitals is a better option for the developing countries. With the rapid developmental activities, and due to the variation of precipitation due to climate change, it is highly essential to provide proper waste treatment/augmentation facilities in urban lake system because a slight variation in the weather pattern can result in serious implications in the already polluted water bodies.

Salivary fructosamine in diabetic and non-diabetic individuals with healthy and diseased periodontium and its changes after non-surgical periodontal therapy.

AIMS: A bidirectional relationship has been reported between diabetes mellitus and periodontitis. The present study aimed to estimate salivary fructosamine in diabetic and non-diabetic individuals with healthy and diseased periodontium and to measure its changes after non-surgical periodontal therapy. Another aim was to identify the cut-off value of salivary fructosamine to diagnose diabetes mellitus and to correlate it with glycated hemoglobin. METHODS: Salivary fructosamine and HbA1c were assessed in periodontally healthy individuals and periodontitis patients (n = 60 in each group). Both groups comprised of equal number of patients with and without diabetes mellitus. Salivary fructosamine estimation was repeated 4 weeks after non-surgical periodontal therapy in periodontitis patients. RESULTS: HbA1c and Salivary fructosamine were significantly higher in the periodontally diseased compared to the healthy group. Significantly higher values of these biomarkers were noticed in diabetic patients with periodontitis compared to the non-diabetic group. Periodontal therapy significantly reduced salivary fructosamine in both diabetic and nondiabetic periodontitis patients. A significant positive high correlation was noticed between salivary fructosamine and HbA1c (r = 0.76). The cut-off value of salivary fructosamine was found to be 68 µg/mL with 95% sensitivity, 81.67% specificity, 83.82% positive predictive value, and 94.23% negative predictive value. CONCLUSION: Periodontitis can contribute to glycemic control and periodontal therapy can bring about improvement in glycemic status. Salivary fructosamine could be used as an alternate glycemic biomarker and its advantages over HbA1c include simple and non-invasive collection of saliva and it can provide intermediate glycemic status. CLINICAL TRIAL REGISTRY OF INDIA: 2020/11/038496.

Diffuse reflectance spectroscopy: diagnostic accuracy of a non-invasive screening technique for early detection of malignant changes in the oral cavity.

BACKGROUND: Strong proof-of-principle for utilisation of diffuse reflectance spectroscopy, a non-invasive tool for early detection of malignant changes, has emerged recently. The potential of this technique in distinguishing normal tissue from hyperplastic and dysplastic tissues was explored. METHODS: Diffuse reflectance (DR) spectra in the 400-700 nm region were obtained from the buccal mucosa of 96 patients and 34 healthy volunteers. The DR spectral data were compared against the gold standard biopsy and histopathology results. A principal-component analysis was performed for dimensional reduction in the normalised spectral data with linear discriminant analysis as the classifying technique. The receiver operator characteristic curve technique was employed for evaluating the performance of the diagnostic test. RESULTS: DR spectral features for different lesions, such as normal/healthy, hyperplastic, dysplastic and squamous cell carcinoma (SCC), varied significantly according to the intensity of oxygenated haemoglobin absorption. While the classification based on discriminant scores provided an overall sensitivity of 98.5% and specificity of 96.0% for distinguishing SCC from dysplasia, they were 100.0% and 95.0%, respectively, for distinguishing dysplasia from hyperplasia. Similarly, the analysis yielded a sensitivity of 95.0% and specificity of 100.0% for distinguishing hyperplasia from healthy tissue. The areas under the receiver operator characteristic curves were 0.98 (95% CI 0.95 to 1.00) and 0.95 (95% CI 0.90 to 1.00) for distinguishing dysplasia from SCC and hyperplasia from dysplasia, respectively. CONCLUSION: DR spectral data efficiently discriminate healthy tissue from oral malignant lesions. Diagnostic accuracies obtained in this study highlight the potential use of this method for routine clinical practice.

Optimum wavelength for the differentiation of brain tumor tissue using autofluorescence spectroscopy.

OBJECTIVE: The role of autofluorescence spectroscopy in the detection and staging of benign and malignant brain tumors is being investigated in this study, with an additional aim of determining an optimum excitation wavelength for the spectroscopic identification of brain tumors. MATERIALS AND METHODS: The present study involves in-vitro autofluorescence monitoring of different human brain tumor samples to assess their spectroscopic properties. The autofluorescence measurement at four different excitation wavelengths 320, 370, 410, and 470 nm, were carried out for five different brain tumor types: glioma, astrocytoma, meningioma, pituitary adenoma, and schwannoma. RESULTS: The fluorescence spectra of tumor tissues showed significant differences, both in intensity and in spectral profile, from those of adjacent normal brain tissues at all four excitation wavelengths. The data were then subjected to multivariate statistical analysis and the sensitivities and specificities were calculated for each group. Of the four excitation wavelengths being considered, 470 nm appeared to be the optimal wavelength for detecting tissue fluorescence of brain tumor tissues. CONCLUSIONS: In conclusion, the spectroscopic luminescence measurements carried out in this study revealed significant differences between tumor tissue and adjacent normal tissue of human brains for all the tumor types tested, except for pituitary adenoma. From the results of this study we conclude that excitation wavelengths ranging from 410-470 nm are most suitable for the detection of brain tumor tissue. Moreover, in this particular study, only excitation at 470 nm indicated that samples we considered to be normal tissue were not normal, and that these were indeed pituitary adenoma tissues. This distinction was not clear at other excitation wavelengths.