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.

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.

Stress assessment awareness among practitioners during dental procedures: a cross-sectional study

Aim: Patient anxiety during dental procedures impacts oral health and well-being. Dental practitioners are vital in managing this stress. Our study aims to explore, analyze, and draw comparisons regarding the understanding and awareness levels of stress and anxiety assessment during routine dental procedures among general dental practitioners and specialists. Method: A self-administered questionnaire was sent to 503 Indian dental practitioners, encompassing both general dentists and specialists. Comprising 13 sections, the questionnaire covered demographic information and delved into topics such as dental anxiety assessment tools, familiarity with stress-reducing techniques, and awareness of the impact of anxiety on treatment outcomes. Following this, data analysis was performed using SPSS software, employing a range of descriptive and inferential statistics, including the Chi-square test. Results: Significant knowledge disparities were observed. While 78.3% of specialists assessed patient stress, only 75% of general dentists did, with no statistical difference (p=0.386). Both groups recognized the impact of gender dynamics and environmental factors on stress, but these findings lacked significant differences (p=0.314, p=0.40, p=0.86). However, specialists showed significantly more awareness of the link between stress and periodontal disease (p=0.043), genetics' role in stress (p=0.008), and the implications of epigenetics for stress and oral health (p=0.000). Conclusion: This study highlights a noticeable knowledge gap between general dentists and specialists in assessing patient stress during dental procedures. While both groups share similar views on gender dynamics and environmental factors, significant differences exist in their awareness of connections between stress, periodontal disease, genetics, and epigenetics. Targeted educational efforts are necessary to bridge this knowledge gap, improve patient care, and advance dental medicine

Two-Stage Mucogingival Surgery with Free Gingival Autograft and Biomend Membrane and Coronally Advanced Flap in Treatment of Class III Millers Recession.

Introduction. Gingival recession is an apical shift of the gingival margin with exposure of the root surface. This migration of the marginal tissue leads to esthetic concerns, dentin hypersensitivity, root caries, and cervical wear. It is, paradoxically, a common finding in patients with a high standard of oral hygiene, as well as in periodontally untreated populations with poor oral hygiene. Changing the topography of the marginal soft tissue in order to facilitate plaque control is a common indication for root coverage procedures and forms a major aspect of periodontal plastic surgeries. The regeneration of a new connective tissue attachment to denuded root surface is by allowing the selective coronal regrowth of periodontal ligament cells while excluding the gingival tissues from the root during wound healing by means of a barrier membrane. Case Presentation. This case reports a two-stage surgical technique for treatment of Miller's class III defect using free gingival autograft and type I absorbable collagen membrane (BioMend®, Zimmer Dental, USA)(§). Conclusions. The 6-month follow-up of the case showed a significant increase in attached gingiva suggesting it as a predictable alternative in the treatment of Millers class III defects.