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Cytokines regulate periodontal pathogenesis and are relevant estimates of current disease activity. There is sparse information on status of cytokine protein levels in periodontal pocket (gingival) tissues. The current study analysed proteins and transcripts of selected cytokines in varying severity of periodontal disease and elucidated cytokine/cytokine ratios that best indicated periodontal disease severity, in gingival tissues. A total of 92 participants comprising of generalised moderate periodontitis (GMP, n = 18), generalised severe periodontitis (GSP, n = 46) and periodontally healthy controls (PHC, n = 25) were recruited for the study. Interproximal gingival tissue samples were utilised for cytokine protein estimation and mRNA quantification by qRT-PCR and ELISA respectively. Selected key pro and anti-inflammatory cytokines, also representative of various Th subsets were analysed. ROC curve analysis was performed and Youden index was calculated for individual cytokines and pro/anti-inflammatory cytokine ratio to estimate the best indicator of periodontal severity/progression in tissues. IL-1ß, TGF-ß and IFN-γ cytokine protein levels varied significantly (p ≤ 0.05) with severity of periodontal disease between groups. On comparison between deep and shallow sites within same participant, deep sites showed significant elevation of TGF-ß (p ≤ 0.01) and IFN-γ (p ≤ 0.05) and IL-17 cytokines and shallow sites showed elevation of IL-4(p ≤ 0.01) and IL-1ß (p ≤ 0.05) cytokines. Analysis of transcripts showed IFN-γ and IL-1ß transcript predominance in GSP (p = 0.01) compared to PHC. ROC analysis illustrated 97% sensitivity, 93% specificity with Youden index of 90% for IL-1ß cytokine and 81%sensitivity, 79% specificity with a Youden index of 60% for IL-1ß/TGF-ß ratio In periodontal pocket tissue, a lack of distinct predominance of specific cytokines between study groups or between shallow and deep sites affected by periodontal disease was observed. However, ROC analysis of cytokines revealed IL-1ß cytokine and IL-1ß/TGF-ß ratio as promising indicators of periodontal disease severity in gingival tissues.
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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.
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Próteses e Implantes , Humanos , RNA Ribossômico 16S , Filogenia , Genes de RNAr , Prevotella intermediaRESUMO
OBJECTIVES: To compare the rate of extraction space closure between periodontally accelerated osteogenic orthodontics (PAOO) using platelet-rich fibrin (PRF) (Group 1) and PAOO using demineralized bone xenograft (DMBM) (Group 2) and to compare the level of wound healing between the PRF group vs the DMBM group after PAOO. MATERIALS AND METHODS: A two-arm prospective single blind pilot study with a split-mouth design was used in which 14 patients requiring premolar extraction were divided into two groups: PRF and DMBM. En-masse space closure was carried out with using mini implants after the PAOO procedure. The amount of space closure was measured at five time points with 2-week intervals within 2 months. The gingival healing levels were assessed using early wound healing scores on the first postoperative day. RESULTS: The rate of extraction space closure was faster in the experimental quadrant at all time points (T1-T4) in the PRF group and at time points (T3, T4) in the DMBM group. Comparison between experimental quadrants showed a significant increase in the rate of space closure in the PRF group T1 to T3 (P < .05). The PRF group showed higher total early healing scores than the DMBM group. CONCLUSIONS: PRF, when used in the PAOO procedure, produces a faster rate of space closure with better early wound healing than DMBM.
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Ortodontia , Fibrina Rica em Plaquetas , Xenoenxertos , Humanos , Projetos Piloto , Estudos Prospectivos , Método Simples-CegoRESUMO
Background: Recession is a mucogingival condition affecting teeth causing hypersensitivity. Although many techniques are there for recession coverage, semilunar vestibular incision technique (SVIT) is a novel procedure for management of multiple gingival recession in maxillary teeth. Aim: To evaluate the efficacy of root coverage in maxillary teeth with multiple gingival recession using SVIT. Methodology: Twenty systemically healthy patients were recruited with Miller's class I and II gingival recessions in maxillary teeth. Parameters such as recession height (RH), recession weight (RW), avascular surface area (ASA), width of keratinized gingiva (WKG), width of attached gingiva (WAG), and clinical attachment level (CAL) were measured at baseline three and six months post-surgery. Results: The outcome measures were statistically significant at baseline, three and six months. A reduction of 86% was achieved in terms of RH and RW. Gain in WKG and WAG as achieved at six-month follow-up was 31.5% and 55%, respectively. An 87% decrease in ASA was obtained and reduction in CAL was 82.4%. Between three and six months there was a significant increase in WAG. Conclusion: SVIT results in improved measures of attached gingiva on six-month follow-up.
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Retração Gengival , Humanos , Retração Gengival/cirurgia , Resultado do Tratamento , Tecido Conjuntivo , Raiz Dentária/cirurgia , Retalhos Cirúrgicos , GengivaRESUMO
BACKGROUND: Periodontitis is associated with various systemic diseases one of which is poly cystic ovarian syndrome (PCOS). PCOS is a genetically complex endocrinopathy of uncertain etiology affecting women of the reproductive age group which results in the most common cause of anovulatory infertility, menstrual dysfunction, and hirsutism. PCOS has a close association with cardiometabolic risk profile, insulin resistance (IR), hyperinsulinemia, central obesity, dyslipidemia, and increasing the prevalence of cardiovascular risk factors. The common pathway is the chronic low-grade inflammation which is constituted by pro-inflammatory cytokine interleukin (IL)-6. AIM: The aim of the study was to compare salivary IL-6 levels among polycystic ovary syndrome (PCOS) patients with and without chronic periodontitis. MATERIALS AND METHODS: Newly diagnosed PCOS patients were selected for the study, and the periodontal parameters were recorded. Group A consists of 42 patients of PCOS with periodontitis and Group B consists of 42 patients of PCOS without periodontitis. Salivary levels of IL-6 were compared between the two groups and were assessed by enzyme-linked immunosorbent assay kit (bioassay). RESULTS: The mean pocket depth in Group A was 4.23 ± 0.134 and that of Group B was 1.30 ± 0.06. The mean bleeding on probing in Group A was 1.40 ± 0.40 and in Group B it was 0.91 ± 0.18. The mean clinical attachment level in Group A was 4.87 ± 0.124 and that of Group B was 1.30 ± 0.06. The mean difference in clinical parameters was statistically significant between the groups (P ≤ 0.001). IL-6 level in group A is 102.59 ± 18.2 and in Group B it was 51.3 ± 25.3. CONCLUSION: Salivary IL-6 levels show a double-fold increase in PCOS with periodontitis than in PCOS without periodontitis. This study reflects the importance of periodontal health and the prevention of periodontal disease so as to minimize IR in PCOS patients with periodontitis.
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AIM: The purpose of this study is to evaluate the increase in the width of attached gingiva (AG) in single/multiple adjacent teeth using variation of modified apically repositioned flap (MARF). MATERIALS AND METHODS: A total of 20 systemically healthy controls with inadequate width of AG were recruited for the study based on inclusion and exclusion criteria. In all the individuals, variation of MARF technique was performed to increase the width of AG. Outcomes of the surgical techniques were measured in terms of probing pocket depth, clinical attachment level, width of AG, and width of keratinized gingiva (KG). The results were followed up at 3 months and continued till 9 months to confirm the stability of results. RESULTS: Treatment with this procedure resulted in a significant increase in the width of the KG and AG. The increase in KG ranged from baseline (2.0 mm) to 3.85 mm at 3rd month and the results were stable till 9th month (P < 0.001), and the increase in AG ranged from baseline (1.0 mm) to 2.85 mm at 3rd month and the results were stable till 9th month (P < 0.001). CONCLUSION: MARF is an effective technique in increasing the width of the keratinized tissue and AG around teeth and also offers considerable advantages over other mucogingival surgery techniques.
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BACKGROUND: The differences in the oral health status between the individuals with a high socioeconomic status (SES) and those with a low SES had markedly increased. There is, however, minimal information available on women understanding the need of dental hygiene for overall health and whether pregnant women comply with the current oral health strategies. In Lieu with the above, the present study aims to assess the awareness, dental hygiene practices, and the frequency of dental visits during pregnancy in postnatal women who delivered preterm low birth weight babies of different SES in and around Puducherry. MATERIALS AND METHODS: A total of 200 individuals who visited Rajiv Gandhi Maternity Centre, Puducherry for delivery were selected. Information regarding onset of prenatal care, referral to dentist, and oral hygiene habits such as frequency of brushing, type of brush used, method of brushing, and frequency of brush change were obtained. Periodontal health status was recorded using PSR system. RESULTS: Awareness of oral hygiene practices was more among upper middle class and lower middle class compared to upper lower strata. Visit to dentist during perinatal period was high among upper middle class compared to other socioeconomic strata. CONCLUSIONS: The awareness of oral health-care practices and importance of oral care during perinatal period were less among low socioeconomic strata.
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CONTEXT: Oral behavior reflects individual perception on oral health. Behavior and attitude of oral health providers, especially dentists, towards oral health affect their capacity to deliver oral health care services. This attitude plays a important role in determining the oral health condition of population. AIM: The purpose of this study is to evaluate the oral health attitude and behavior among a group of dental students in India and to find any gender-based differences in terms of oral health attitude and behavior. MATERIALS AND METHODS: A total of 282 dental students of Indira Gandhi Institute of Dental Sciences, SBV University, Puducherry, India participated in the study. A simplified English version of Hiroshima University Dental-Behavioral Inventory (HU-DBI) was adopted. STATISTICAL ANALYSIS USED: SSP version 2.80 software was used to analyze the data. Chi-square test was used to find the differences in the distribution of "yes" among students from the different academic year as well as between male and female students. Statistical significance was set at P ≤ 0.05. RESULTS: Statistical significance was observed for the responses between the students from different academic years brushing frequency, careful brushing of teeth, using brush with hard bristles, careful self-evaluation of brushing and satisfied appearance of teeth and gums. Male students preferred to use a tooth brush with hard bristles and regular mouth washes than female students. With regards to worrying about bad breath, male students had more "yes" responses than females. CONCLUSIONS: Oral health attitude and behavior increased with the increasing levels of dental education, and no significant differences were observed among male and female dental students.
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The phenomenon of buttressing bone formation is relatively uncommon in the alveolar bone, more so in the anterior maxilla. In our case, peripheral buttressing bone formation presented as an isolated hard gingival swelling with relation to 21 in a 14-year-old girl. Radiographic presentation was normal with no evidence of bone loss or altered bone density. Therefore explorative surgery was planned. Buttressing bone formation could be appreciated, which also was the cause for swelling clinically. Osteoplasty was done and bone graft placed in the defect. On a subsequent recall visit gingivoplasty was done to reduce gingival thickness to improve esthetics. We report the case for its unusual presentation, its management with follow-up.