Biochemical Examination of Plasma Ghrelin Levels in Individuals Afflicted With Chronic Periodontal Disease: A Comparative Study.

OBJECTIVE: This study intended to assess plasma ghrelin levels in individuals with chronic periodontitis and analyze potential associations with bone turnover indicators, serum cytokines, and periodontal parameters. MATERIAL AND METHODS: The research contained 80 patients each with 40 individuals with periodontally healthy controls (C) (28 males, 12 females) and 40 chronic periodontitis (CP) patients (29 males, 11 females). The blood samples were analyzed for soluble receptor activator nuclear factor kappa B ligand (sRANKL), interleukin-1 beta (IL-1ß), total and acylated ghrelin, tumor necrosis factor-alpha (TNF-α), osteocalcin (OSC) and alkaline phosphatase (ALP), and periodontal parameters were recorded. RESULTS: The CP group had considerably higher plasma concentrations of both acylated and total ghrelin than the C group (p<0.05). Gender-based investigation showed substantial differences only among men in both groups (p<0.05). Hence, no significant modifications were identified in serum sRANKL, TNFα, and ALP levels between the groups. However, there was a notable difference in serum OSC and IL-1ß levels in the CP group (p<0.05). Furthermore, total ghrelin/acylated ghrelin and total ghrelin/ALP revealed positive correlations. No significant association was found between symptoms and ghrelin levels. CONCLUSION: The study findings indicate elevated levels of ghrelin and acylated ghrelin in male CP patients.

Assessment of Periodontal Health Status among the Male Adult Population with a Dual Habit of Smoking and Gutkha Chewing: A Cross-Sectional Study.

Aims and Objective: The aim of this study was to assess the periodontal health status in subjects having dual habits of smoking and gutkha chewing among the male population of Kanpur City, Central Uttar Pradesh (UP). Materials and Methods: A total number of 500 male subjects were included, divided into three study groups: group I-164 subjects with a dual habit of smoking and gutkha chewing, group II- 170 gutkha chewers, and group III-166 smokers. Case history, clinical examination, and the following clinical parameters were recorded-oral hygiene index (OHI-S), gingival index (GI), bleeding index, clinical attachment loss (CAL), gingival recession, and furcation involvement. Result: In this study, the proportion of severe CAL was maximum in dual habit (78%) followed by smokers (70.5%) and then gutkha chewers (40.0%). A significant difference was observed in the proportion of CAL status between smokers, gutkha, and dual habit cases (P < 0.001). The result revealed that the dual habit group had more severe periodontal disease than smokers and gutkha chewers. Conclusion: Overall, it was concluded that periodontal health status was found to be very poor in both smokers and gutkha chewers, but the subjects in the dual habit group were found to have extremely poor periodontal health status.

Effect of Commercially Available Nano-Hydroxyapatite Containing Desensitizing Toothpaste and Mouthwash on Dentinal Tubular Occlusion: A SEM Analysis.

The aim of this in vitro study was to evaluate and compare the dentinal tubule occlusion using nano-hydroxyapatite (n-HAP) containing toothpaste and mouthwash under a scanning electron microscope. The specimens were randomly divided into two groups with five specimens each: group 1-toothpaste group and group 2-mouthwash group. The percentage of the occluded dentinal tubules was assessed at the baseline, 7th, 14th, 21st, and 28th days under a scanning electron microscope. The toothpaste group showed a higher percentage of occluded dentinal tubules as compared to the mouthwash group at the 7th, 14th, 21st, and 28th days, respectively. It can be concluded that brushing twice daily with n-HAP containing toothpaste for duration of 28 days produced good dentinal tubule occlusion.

Qualitative Analysis of Modified Advanced-Platelet-Rich Fibrin Buffy Coat among Diabetic Patients and Tobacco Smokers with Chronic Periodontitis: A Cell Block Cytology Study.

Aim: The aim of this study was to evaluate and compare histologically the pattern of distribution of platelet and leukocyte concentration, quality of fibrin network, and the aggregation of platelets in the three zones of modified advanced platelet-rich fibrin (A-PRF) buffy coat among uncontrolled type 2 diabetic patients, tobacco smokers, and healthy individuals with chronic periodontitis. Materials and Methods: In this cross-sectional cytology study, 180 generalized chronic periodontitis patients (46-55 years) were enrolled - Group 1 (control group): 60 systemically healthy participants, Group 2 (test group): 60 heavy tobacco smokers, and Group 3 (test group): 60 uncontrolled type 2 diabetic patients. Fifteen milliliters of blood was drawn from all study participants. Modified A- PRF membrane was prepared and then processed histologically. Results: The distribution pattern of platelet and leukocyte concentration in modified (A-PRF) gradually declines from the serum to the red blood cell (RBC) end of a clot in all groups. We have assessed that the serum and middle end of modified (A-PRF) membrane had an increasingly moderate distribution of platelets and leukocytes in both type 2 diabetics and tobacco smokers. RBC end had more of sparse distribution in all the three groups. Healthy individuals exhibited 95% of reversible pattern, whereas tobacco smokers had 78.33% and uncontrolled type 2 diabetic patients had 93.33% of irreversible aggregation pattern of platelets. Loose fibrin network pattern was seen in all the three groups. These observations conclude that tobacco smokers had a high percentage of loose fibrin network with sparse distribution of cells. Males showed more loose fibrin network pattern of modified (A-PRF) membrane than compared to females. Conclusion: In the present study, it can be concluded that the application of modified (A-PRF) may provide enhanced periodontal healing in uncontrolled type 2 diabetic patients and tobacco smokers; furthermore, females may have better regenerative capacity compared to males.

Quantitative evaluation of modified advanced platelet-rich fibrin buffy coat among diabetic patients and tobacco smokers with chronic periodontitis.

BACKGROUND: The use of biofuel like platelet-rich fibrin (PRF) may enhance the healing potential of the tissues in tobacco smokers and diabetic patients. AIM: To evaluate the modified advanced PRF (A-PRF) buffy coat quantitatively in uncontrolled type-2 diabetic patients and tobacco smokers with chronic periodontitis by determining the size outcome of the buffy coat, the platelet and leukocyte concentration, and also to find out the influence of gender on these parameters. MATERIALS AND METHODS: In this cross-sectional study, 180 generalized chronic periodontitis patients (46-55 years) were enrolled, Group 1 (Control group): 60 systemically healthy subjects; Group 2 (Test group): 60 Heavy tobacco smokers; and Group 3 (Test group): 60 uncontrolled type 2 diabetic patients. 15 ml of blood was drawn from all subjects to assess the size outcome, platelet, and leukocyte concentration also to find out the influence of gender on the various parameters of the prepared modified (A-PRF) membrane. RESULTS: Uncontrolled type-2 diabetic patients had maximum height (23.39 ± 1.69 mm) and width (7.26 ± 0.16 mm) of modified (A-PRF) clot when compared to healthy individuals and tobacco smokers. The total number of platelet (245.38 ± 40.72 1000/ul) and leukocyte count (6.11 ± 0.60 1000/ul) and their percentage of concentration were 95.21 ± 2.16% and 77.25% ±1.98%, respectively, and is significantly higher in uncontrolled type-2 diabetic patients (P ≤ 0.05). Females were associated with the larger sized modified (A-PRF) clot with more number of platelets and leukocytes count than males. CONCLUSIONS: Size outcome of modified (A-PRF) clot was found to be comparatively larger in uncontrolled type-2 diabetic patients particularly in females of all the groups when compared to males. Among the hematological parameters, the total count as well as the percentage of platelet and leukocyte in modified (A-PRF) membrane was found to be higher in uncontrolled type-2 diabetic patients. Female subjects exhibited higher platelet and leukocyte concentration than males.

Types of bone destruction and its severity in chronic periodontitis patients with tobacco smoking habit using periapical radiographs and transgingival probing: A cross-sectional study.

BACKGROUND: Tobacco smoking is an independent risk factor for periodontal disease which increases periodontal pocketing, attachment loss, as well as bone loss leading to varied severity and bone destruction in the form of horizontal and vertical patterns. AIM: The aim of the present study is to determine and measure the types and severity of bone destruction in chronic periodontitis (CP) patients with tobacco smoking habit using intraoral periapical (IOPA) radiographs and transgingival probing. MATERIALS AND METHODS: A total of 60 male participants with CP were included in the study. Group A comprised 30 heavy cigarette smokers and Group B comprised 30 nonsmokers. Clinical parameters such as plaque index (PI), probing pocket depth (PPD), and clinical attachment loss (CAL) were recorded. Amount and pattern of bone loss were assessed using IOPA and transgingival probing. RESULTS: The mean values of PI, PPD, and CAL were 2.50 ± 0.28 mm, 9.33 ± 1.42 mm, and 10.2 ± 1.62 mm, respectively, for cigarette smokers, which were found to be higher and statistically significant as compared to nonsmokers. Cigarette smokers showed more bone destruction than nonsmokers in respect to maxillary molars 4.42 ± 1.31 mm and incisors 3.90 ± 1.10 mm as compared to nonsmokers. Types of bone destruction were more of vertical patterns (93.3%) in cigarette smokers. CONCLUSIONS: Tobacco smoking was associated with severe attachment loss. Tobacco smoking not only affects soft tissues but also hard tissues such as bone. Palatal sides of maxillary molars showed significantly higher bone loss and also had more percentage of vertical patterns of bone loss compared to nonsmokers. IOPA and transgingival probing may be used as noninvasive methods for the determination of types and severity of bone destruction in CP patients with or without tobacco smoking habit.