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This comprehensive review delves into the forefront of research on the human oral microbiome, exploring recent advancements that span microbial colonization, state-of-the-art detection methodologies, and the complex interplay involved in disease progression. Through an exhaustive analysis of the contemporary literature, we illuminate the dynamic orchestration of microbial communities within the oral cavity, underscoring their pivotal role in health and disease. Cutting-edge detection techniques, including metagenomics and high-throughput sequencing, are discussed regarding their transformative impact on understanding the intricacies of oral microbial ecosystems. As we stand on the cusp of a new decade, this review anticipates a paradigm shift in the field, emphasizing the potential for rapid identification and targeted management of detrimental oral microorganisms. Insights gained from this exploration not only contribute to our fundamental understanding of the oral microbiome but also hold promise for the development of innovative therapeutic strategies to maintain oral health. This article aims to serve as a valuable resource for researchers, clinicians, and public health professionals engaged in unraveling the mysteries of the microbial symphony within the human oral cavity. [ABSTRACT FROM AUTHOR]

Introduction: Furcation regions present some of the most significant challenges to the successful outcome of periodontal therapy. Due to their anatomical complexities, the areas become inaccessible, and instrumentation is generally tricky and often incomplete. Hence, it is essential to have a thorough knowledge of molar anatomy to assess the case difficulty, appropriate diagnosis, and treatment planning. Aim: To radiographically evaluate and classify the furcation anatomy of mandibular first and second molars based on root trunk length and root divergence angle. Materials and Methods: This retrospective observational study was carried out in AB Shetty Memorial Institute of Dental sciences, Mangalore between February and March 2020. Orthopantomograms (OPG) with permanent healthy first (25 right and 25 left) and second mandibular molars (25 right and 25 left) with no alveolar bone loss obtained from systemically healthy individuals were selected for the study. They were screened for root divergence angle and root length to root trunk length ratio. According to the root divergence angle, the total sample was classified as Group I (with angle <30°), Group II (with angle 30°to 60°), Group III (with angle >60°). They were classified into Type A, B, and C based on Hou and Tsai classification. Type A root trunks involving the cervical third or less, Type B involves upto cervical half of the length of the root and Type C involves cervical two-thirds of the root, respectively. The data were collected and entered in the Microsoft Excel sheet. Mean and standard deviation was calculated for root divergence. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 23.0. Student t-test was used to compare intragroup variations in root divergence in the left and right molars. The p<0.05 was considered to be significant. Results: Total 100 teeth (50 mandibular first molar (25 left and 25 right) and 50 mandibular second molars (25 left and 25 right)) were included in the study and analysed. In terms of Furcation Angle (FA), mandibular left first molar showed an increased frequency of Group II (48%) and Group III (48%), while mandibular left second molar showed an increased frequency of Group II (68%). Among mandibular right first molar Group III (56%) showed an increased frequency, while Group II (92%) was commonly seen in right second molar. Intergroup comparison revealed a statistically significant difference in divergence between mandibular left first and second molars (36 and 37) p<0.01, mandibular right first and second molars (46 and 47) (p<0.01). Divergence of furcation was more significant in 36 and 46 than 37 and 47, respectively. The current study results showed a higher frequency of Type A in all the four involved teeth, i.e., left first (96%) and second (68%) molars, right first (92%) and second (88%) molars. Conclusion: The study results showed an increased frequency of Group II FA and Type A root trunks. The divergence of furcation was greater in first molars compared to the second molars. [ABSTRACT FROM AUTHOR]

It is a fact that diabetes affects 9.3% of the world's population and the number of afflicted individuals is anticipated to increase by 11% by 2045. Diabetes mellitus (DM) is a category of metabolic disease characterized by hyperglycemia caused by abnormalities in insulin production, insulin action, or both. It is also attributed to a number of micro and macrovascular problems, the etiology of which is complicated and involves metabolic and hemodynamic abnormalities such as hyperglycemia, dyslipidemia, insulin resistance, and immunological dysfunction. Since the oral cavity is likewise extensively vascularized and innervated, diabetic oral sequelae are to be expected. Despite the fact that there is significant data supporting the link between diabetes and dental health, there is a lack of oral health knowledge among health professionals and even diabetic patients. In this review, we will assess potential oral complications, elaborate on the pathogenic mechanisms and some literature studies that might explain the associations between DM and potential oral manifestations. [ABSTRACT FROM AUTHOR]

Context: Periodontitis and chronic obstructive pulmonary disease (COPD) are chronic progressive inflammatory conditions. Smoking has been associated with both chronic periodontitis and COPD. Hence, the present study was designed to correlate serum levels of cotinine with the severity of periodontal disease with or without COPD. Settings and Design: A total of eighty patients, twenty healthy individuals, twenty patients with chronic generalized periodontitis without smoking and without COPD, twenty patients who are smokers with chronic periodontitis without COPD and twenty patients who are smokers with chronic periodontitis and COPD in the age range of 43–65 years were selected for the study. Subjects and Methods: Serum cotinine level assessment, smoking history, and periodontal examination were done in all the patients and the data obtained were statistically analyzed. Results: The mean serum cotinine level was highest in smokers with chronic periodontitis and COPD (93.642 ± 14.727) and it differed significantly between the four groups (P < 0.001). There is a significant positive correlation between the number of cigarettes and serum cotinine levels in both groups involving smoking. There was no significant correlation between serum cotinine level and clinical attachment loss in chronic periodontitis smokers with or without COPD. Conclusions: The result of this study indicates that increased smoking with COPD causes a higher chance of progression of periodontal destruction but it is not statistically significant. Furthermore, this study indicates that the assessment of serum cotinine levels is a reliable method to evaluate smoking exposure. [ABSTRACT FROM AUTHOR]

Objectives. The objective of the study was to understand and analyze the prescription patterns of dentists across various demographic locations for managing oral infections and pain with antibiotics and explore the evidence-based practices by clinicians as well as the need for further education. Materials and methods. This cross-sectional study was carried out using an online questionnaire framed to explore the knowledge, attitude, and practices among dentists with varying levels of experience and qualifications, regarding antimicrobial prescription. The questions were validated from previous published studies that explored the knowledge, attitude, and practice (KAP) with respect to antimicrobial prescription. In total, N = 300 of dentists from four different countries responded to the online questionnaire out of which 53% were specialists while 47% were general dentists. After data collection, descriptive analysis was carried out along with a one-sided hypothesis test to depict the power of the sample. Results. It was seen from the results of the study that the first-choice antibiotics for 67.8% of dentists were found to be the β-lactam group while sulfonamides and tetracyclines at 20% were the second most prescribed group. Another important finding was that 45.6% of dentists ignored hypersensitivity testing before prescription of antibiotics even though 83.3% of the total dentists interviewed were aware of the increase in antibiotic resistance. Conclusion. In conclusion, the dentists are partially aware of the guidelines but need further training and education on antimicrobial prescription that enables evidence-based decision-making for better practices and outcomes. [ABSTRACT FROM AUTHOR]

Background: Collagen fibers are the main element of gingival connective tissue and contribute a leading role in the preservation of structural integrity and tissue function. Hence, its degradation is regarded as the main marker of periodontal disease progression. Aim: The aim of this study is to analyze and compare collagen fibers, their birefringence pattern in healthy and in diseased gingival tissues stained using picrosirius red stain (PRS) and the polarizing microscope. Materials and Methods: A total of 90 participants screened were divided into the control group (healthy gingiva) and experimental group (moderate periodontitis and severe periodontitis) based on the clinical parameters. Gingival tissue sections were stained with PRS and observed under the polarized microscope to assess the type of collagen fibers in healthy and diseased gingival tissue. Statistical analysis was performed using the one-way ANOVA and Tukey multiple comparison test. Results: The healthy group revealed well-packed collagen in a parallel pattern with a strong birefringence, whereas in severe periodontitis group showed loosely packed collagen fibers in a haphazard pattern suggestive of severe destruction of the extracellular matrix. The moderate periodontitis group had a blended mixture of thick and thin fibers. Conclusions: Collagen fibers showed birefringence property when stained with PRS that helps in a better understanding of normal and pathological conditions. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this research was to evaluate the serum level of vitamin C in patients with type 2 diabetes mellitus with and without periodontitis, and also to interpret whether raised or lessened serum vitamin C levels might be associated to a possibility for building oxidative stress in type 2 diabetes mellitus with periodontitis. Material and Methods: Investigation was conducted on diabetic subjects with and without periodontitis. The serum vitamin C level was determined using the 2, 4-dinitrophenylhydrazine method, and the spectrometer was used to read the concentration of serum vitamin C. The data attained were statistically calculated using the ANOVA test and post-hoc test. Results: The findings revealed that average serum vitamin C levels were reduced considerably among test groups (groups B, C, D) (p< 0.0001) in contrary to the healthy control group. Conclusion: The existing results are proof that reduced concentration of antioxidants such as vitamin C is related to a greater threat to the increase of oxidative stress in patients with type 2 diabetes mellitus and periodontitis. [ABSTRACT FROM AUTHOR]

Background and Aims: Pre and post-operative nutritional status are not often tested on a consistent basis when patients are analyzed and diagnosed with Type 2 Diabetes Mellitus (T2DM) or have chronic periodontitis. Thus, this study pursues to evaluate the predictive value of serum vitamin C and lead levels in this population at baseline and after periodontal treatment. Materials and Methods: In an interventional study setting we enrolled 120 subjects which were later categorized into four sub-groups: set 1 - individuals with chronic periodontitis, set 2 - individuals with T2DM, set 3 - individuals with T2DM and chronic periodontitis respectively set 4 - healthy individuals as control group. Scaling and root planing was performed only to individuals with periodontitis and T2DM. At baseline and 21 days after periodontitis treatment blood was obtained from the subjects and analysis of serum vitamin C and serum lead was done and data obtained was statisticaly analysed. Results: ANOVA test showed baseline values of both the parameters to be statistically significant different between groups and within groups (p<0.001). Alteration was seen in the parameters postoperatively regarding serum vitamin C was increased and lead level decreased; paired t-test showed statistically significant difference (p<0.001). Conclusion: Serum Vitamin C can be considered a key biomarker. Increased lead level can be a risk factor for commencement and progression of T2DM and chronic periodontitis. [ABSTRACT FROM AUTHOR]

Background: Periodontal diseases are a group of inflammatory conditions resulting from interaction between a pathogenic bacterial biofilm and susceptible host's inflammatory response eventually leading to the destruction of periodontal structures and subsequent tooth loss. Hence, investigation of salivary proteins in individuals with periodontal diseases may be useful to enhance the knowledge of their roles in these diseases. Materials and Methods: This case-control study was conducted at A.B. Shetty Memorial Institute of Dental Sciences, Mangalore. The study comprised of 90 patients of age between 25-60 years who were clinically examined and divided into three groups of 30 each: namely clinically healthy, gingivitis and chronic periodontitis. These were classified according to the values of gingival index score, clinical attachment loss and probing pocket depth. Unstimulated saliva was collected and salivary mucin, amylase and total protein levels were determined. Statistical analysis: Results obtained were tabulated and statistically analyzed using ANOVA test and Karl pearson's correlation test. Results: The results of the study showed an increased concentration of salivary mucin, amylase and total protein in gingivitis patients and increased levels of amylase and total protein in saliva of chronic periodontitis patients compared to healthy individuals which were statistically significant. Adecrease in mucin concentration was observed in the periodontitis group compared to gingivitis group. A positive correlation was present between salivary mucin, amylase and total protein levels in the three groups. Conclusion: Salivary mucin, amylase and total protein may serve as an important biochemical parameter of inflammation of the periodontium. Also, it can be hypothesized that various enzyme inhibitors might be useful as a part of host modulation therapy in the treatment of periodontal diseases. [ABSTRACT FROM AUTHOR]

Introduction: Magnesium is an essential cation playing a crucial role in many physiological functions and its imbalance is associated with greater number of pathological situations. Oxidative stress is usually increased due to decreased essential nutrients. Hence, any imbalance of essential nutrients like serum magnesium can significantly play a role in the pathobiology of periodontitis in the presence of diabetes, as diabetes and chronic periodontitis are two chronic diseases that have been biologically linked. Aim: To evaluate the association of serum magnesium in type 2 diabetes mellitus and chronic periodontitis patients, also to evaluate and associate the influence of serum magnesium on periodontal health. Materials and Methods: A single blinded, randomized study was conducted that comprised of 120 subjects divided into four groups. Individuals with periodontitis and type 2 diabetes mellitus formed the test group. Subjects with chronic periodontitis diagnosed clinically according to 1999 American Academy of Periodontology classification, without any medical history and drug history were included as the study subjects. Gingival Index and Plaque Index were scored for all the groups at baseline and after 21 days of scaling and root planing. Scaling and root planing was done only in the test group. Blood was drawn from the patients at baseline and 21 days after scaling and root planning and estimation of serum magnesium level was done using semi-autoanalyzer. Data obtained was statistically analyzed using the paired t-test, one-way ANOVA, post-hoc test. Results: The result of the present study showed that mean serum magnesium among healthy was 1.40±0.565mmol/l as compared to 1.01±0.287mmol/l among subjects with periodontitis, 0.920±0.23mmol/l among diabetics with periodontitis and 0.93±0.29mmol/l among diabetics without periodontitis. Serum magnesium was significantly decreased in chronic periodontitis and diabetic patients with and without chronic periodontitis as compared to controls. Conclusion: Imbalance of serum magnesium level was seen in patients with chronic periodontitis and type 2 diabetes mellitus. Hence, it can be a biomarker which can predict the occurrence of type 2 diabetes mellitus and chronic periodontitis. [ABSTRACT FROM AUTHOR]

Context: In most women bone mass reaches its peak in the third decade of life and declines thereafter with the onset of menopause and might lead to osteoporosis. Osteoporosis may result in reduced jaw bone mass and alterations of the mandibular structure. Qualitative and quantitative indices have been used for panoramic radiographs to assess the alveolar bone quality. Aims: The purpose of this study was to compare the alveolar bone quality of premenopausal and postmenopausal women using the panoramic mandibular index (PMI). This study also aimed to estimate the levels of serum calcium in premenopausal and postmenopausal women. Settings and Design: Single centre case control study. Materials and Methods: A total of 30 patients were divided into three groups of ten each - the healthy group, control group, and study group. Alveolar bone mass was evaluated by the PMI. Serum calcium was also assessed for all the patients. Statistical analysis used: The results obtained were subjected to statistical analysis by one-way analysis of variance using Statistical Software SPSS version 17, Tukey test for comparision, Pearson's correlation coefficient was employed. Results: Premenopausal women had the highest values for alveolar cortical bone mass as recorded by the PMI, followed by postmenopausal women with a healthy periodontium. The lowest values were recorded in the group of postmenopausal women with chronic generalized periodontitis. Similar results were found for serum calcium values. Conclusion: Postmenopausal women exhibit a reduced alveolar bone mass and lowered levels of serum total calcium with the increasing age. These changes may be useful indicators for low skeletal bone mineral density or osteoporosis. [ABSTRACT FROM AUTHOR]

With the rise in bacterial resistance to antibiotics, there is considerable interest in the development of other classes of antimicrobials for the control of infection. Garlic (Allium sativum Linn.) has been used as medicine since ancient times and has long been known to have antibacterial, antifungal, and antiviral properties. This study was undertaken to assess the inhibitory effect of garlic on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, to assess the time-kill curve of P. gingivalis and A. actinomycetemcomitans, and to determine the antiproteolytic activity of garlic on P. gingivalis. Ethanolic garlic extract (EGE) and aqueous garlic extract (AGE) were prepared and the inhibitory effects of these extracts for two periodontal pathogens (P. gingivalis and A. actinomycetemcomitans) were tested. Antiproteolytic activity on protease of P. gingivalis was determined. 25 microliter (μl), 50 μl, and 75 μl of AGE showed 16 mm, 20 mm, and 25 mm zone of inhibition, respectively, on P. gingivalis. The AGE showed greater bacteriostatic activity against the P. gingivalis with minimum inhibitory concentration determined at 16.6 μl/ml. The time-kill assay of AGE and EGE were compared for P. gingivalis and A. actinomycetemcomitans. AGE showed better antiproteolytic activity on total protease of P. gingivalis compared to the EGE. Thus, the study concludes the antimicrobial activity of garlic extract against periodontal pathogens, P. gingivalis, A. actinomycetemcomitans. Its action against P. gingivalis includes inhibition of total protease activity, and this raises the possibility that garlic may have therapeutic use for periodontitis and possibly other oral infections.