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Background: Medwakh smoking has radically expanded among youth in the Middle East and around the world. The rising popularity of medwakh/dokha usage is linked to the onset of several chronic illnesses including cardiovascular diseases and cancers. Medwakh smoking is reported to increase the risk of inflammation in the lower respiratory tract owing to oxidative burden. To date, there are no reported studies investigating the impact of medwakh smoking on salivary protein profile. The current study aims to elucidate alterations in the salivary proteome profile of medwakh smokers. Methods: Saliva samples collected from 33 medwakh smokers and 30 non-smokers were subjected to proteomic analysis using UHPLC-ESI-QTOF-MS. Saliva samples were further subjected to validatory experiments involving analysis of inflammatory cytokine profile using LEGENDplex™ Human Essential Immune Response Panel. Results: Statistical analysis revealed alterations in the abundance of 74 key proteins including immune mediators and inflammatory markers in medwakh smokers (Accession: PXD045901). Proteins involved in building oxidative stress, alterations in cell anchorage, and cell metabolic processes were enhanced in medwakh smokers. Salivary immune response evaluation further validated the proteome findings, revealing significantly higher levels of IL-1β, IL-12p70, IL-23, IFN-γ (Th1 cytokines), IL-6 (Th2 cytokine), and MCP-1 (chemokine) in medwakh smokers. In addition, a substantial increase in abundance of involucrin suggesting a plausible stratified squamous cell differentiation and increased cell lysis in the oral cavity of medwakh smokers akin to chronic obstructive pulmonary diseases (COPD). The protein–metabolite joint pathway analysis further showed significantly enriched differentially expressed proteins and metabolites of glycolysis/gluconeogenesis, pentose phosphate, fructose and mannose, nicotinate and nicotinamide, and glutathione metabolism pathways among medwakh smokers. Conclusions: The findings of the study provide valuable insights on potential perturbations in various key immune molecules, cytokines, and signaling pathways among medwakh smokers. Medwakh smokers displayed elevated inflammation, increased oxidative stress and defective antioxidant responses, dysregulated energy metabolism, and alterations in proteins related to cell adhesion, migration, differentiation, and proliferation. The findings of study underscore the urgent need for comprehensive public health interventions among youth by raising awareness, implementing effective smoking cessation programs, and promoting healthy lifestyle to safeguard the well-being of individuals and communities worldwide. [ABSTRACT FROM AUTHOR]

Objective: This multi‐arm, randomized, double‐blinded, controlled clinical trial was designed to evaluate the clinical efficacy of 0.5% green tea (GT), 0.2% chlorhexidine (CHX) and aloe vera (AV) mouthwash as compared to the control (CNT) group (scaling and polishing alone with no mouthwash) in the management of dental biofilm induced gingivitis among 18–40‐year‐old patients. Material and Methods: Sixty patients with generalized dental biofilm‐induced gingivitis were randomly allocated to four study groups (n = 15 each) for treatment, namely Group GT, Group CHX, Group AV and Group CNT after scaling and polishing were administered to all the patients. Plaque index (PI), gingival index (GI) and sulcular bleeding index (SBI) were recorded at baseline, 14th and 21st day. Results: PI, GI and SBI at various time intervals (baseline, 14th and 21st day) showed high statistically significant differences within the group (p < 0.01). Among these, the maximum percentage change was found in the CHX group followed by GT when evaluated from baseline to 21st day. The least percentage change was found in the AV group for PI and GI while the CNT group showed the least percentage change for sulcular index when evaluated from 14th to 21st day. Inter‐group results showed high statistically significant differences (p < 0.01) for PI and GI when evaluated between baseline to 14th day and baseline to 21st day. SBI also showed statistically significant differences (p < 0.05) when evaluated between baselines to 14th day and baseline to 21st day. Conclusion: Green tea mouthwash displayed a significant reduction in plaque index, gingival index and sulcular bleeding index. 0.5% green tea catechin has equivalent anti‐plaque efficacy as 0.2% chlorhexidine gluconate and can be considered a potent alternative to prevent and treat gingival diseases. [ABSTRACT FROM AUTHOR]

Objectives: Thy‐1 (CD90) is a glycosylphosphatidyl‐anchored protein belonging to the immunoglobulin family and is known to control mesenchymal stromal cells differentiation into osteoblasts or adipocytes. The study aimed to investigate the salivary levels of Thy‐1 in health, periodontitis, obesity, and any potential association. Materials and Methods: Seventy‐one participants were divided into four groups: healthy (H), subjects with periodontitis (P), obese individuals (O), and obese individuals having periodontitis (PO). Unstimulated whole saliva was collected from participants who were evaluated for periodontal parameters. The levels of Thy‐1 were measured with a commercially available ELISA kit. The data were statistically analyzed. Results: A significant difference in salivary Thy‐1 levels among different groups was observed. Periodontitis patients had the maximum, and obese individuals had the minimum Thy‐1 levels. Significant differences between H and P, H and PO, P and O, and O and PO were observed. Overall correlations between Thy‐1 and periodontal parameters and a positive correlation with pocket depth in group PO were noted. Conclusion: Thy‐1 could be detected in the saliva of all study participants. It is implied that a local inflammatory condition like periodontitis elevates the salivary levels of Thy‐1 with, and without obesity. [ABSTRACT FROM AUTHOR]

CXCL16 is a chemokine associated with disease, but no clear relationship has been reported in periodontal disease. The objectives of this study were to detect, estimate, and compare the levels of CXCL16 in saliva and serum and to find out if the saliva and serum levels are comparable in healthy individuals and periodontitis patients. Thirty participants were divided into two groups: Group 1[G1(n=15)] were healthy (periodontally and systemically); Group 2 [G2(n=15)] were periodontitis patients (systemically healthy). Unstimulated whole saliva and serum were collected from each participant. Periodontal clinical variables were evaluated and levels of CXCL16 in saliva and serum of each participant were estimated using a commercially available Enzyme-Linked Immunosorbent Assay (ELISA) kit. The data were statistically analyzed. CXCL16 was detected in all the participants. Significant differences in CXCL16 levels were observed between the healthy and periodontitis groups. The levels of CXCL16 were found to be significantly higher in the healthy group, although other reports in the literature suggest that the levels are higher in inflammatory conditions. Saliva may be a reliable source for the estimation of this chemokine. [ABSTRACT FROM AUTHOR]

Obesity causes gut dysbiosis; nevertheless, little is known about the oral microbiome. We aimed to identify differences in the subgingival microbiota influenced by body weight and periodontal status. Patients (n = 75) recruited at the University Dental Hospital Sharjah, United Arab Emirates, were distributed into three equal groups (healthy weight, overweight, and obese) sub-divided into having either no-mild (NM) or moderate-severe (MS) periodontitis. Subgingival plaques were collected. Microbiota were identified by 16S rRNA sequencing using nanopore technology. Linear discriminant analysis demonstrated significant bacterial biomarkers for body weight and periodontal health. Unique microbiota signatures were identified, with enrichment of periopathogens in patients with MS periodontitis (Aggregatibacter actinomycetemcomitans in obese, Tannerella forsythia and Treponema denticola in overweight, Porphyromonas gingivalis and Fusobacterium nucleatum in healthy weight), thus reflecting differences in the microbiota affected by body weight. Other pathogenic bacteria, such as Salmonella enterica and Klebsiella pneumoniae, were enriched in overweight subjects with NM periodontitis, suggesting an increase in the relative abundance of pathogens even in patients with good periodontal health if they were overweight. Alpha and beta diversities were significantly different among the groups. Dysbiosis of the subgingival microbiota in obese and overweight individuals was associated with increased prevalence and severity of periodontal disease, which was correlated with the body mass index. This study highlights the immense importance of the oral microbiome and the need for lifestyle and dental interventions to resolve oral dysbiosis and restore normal homeostasis. [ABSTRACT FROM AUTHOR]

Modern drug discovery methods led to evolving new agents with significant therapeutic potential. However, their properties, such as solubility and administration-related challenges, may hinder their benefits. Moreover, advances in biotechnology resulted in the development of a new generation of molecules with a short half-life that necessitates frequent administration. In this context, controlled release systems are required to enhance treatment efficacy and improve patient compliance. Innovative drug delivery systems are promising tools that protect therapeutic proteins and peptides against proteolytic degradation where controlled delivery is achievable. The present review provides an overview of different approaches used for drug delivery. [ABSTRACT FROM AUTHOR]

Peri-implant diseases are frequently presented in patients with dental implants. This category of inflammatory infections includes peri-implant mucositis and peri-implantitis that are primarily caused by the oral bacteria that colonize the implant and the supporting soft and hard tissues. Other factors also contribute to the pathogenesis of peri-implant diseases. Based on established microbial etiology, mechanical debridement has been the standard management approach for peri-implant diseases. To enhance the improvement of therapeutic outcomes, adjunctive treatment in the form of antibiotics, probiotics, lasers, etc. have been reported in the literature. Recently, the use of photodynamic therapy (PDT)/antimicrobial photodynamic therapy (aPDT) centered on the premise that a photoactive substance offers benefits in the resolution of peri-implant diseases has gained attention. Herein, the reported role of PDT in peri-implant diseases, as well as existing observations and opinions regarding PDT, are discussed. [ABSTRACT FROM AUTHOR]

CXCL2 is an important chemokine produced by inflammatory cells, which has a principal role in chemotaxis of neutrophils and immune responses. The objective of this study was to detect, estimate and compare the serum levels of CXCL2 in health, periodontitis and type 2 diabetes mellitus with periodontitis which has not been reported in the literature. Forty-five participants were equally divided as Group 1(15 systemically and periodontally healthy subjects), Group 2(15 systemically healthy individuals with periodontitis) and Group 3(15 periodontitis patients with type 2 diabetes mellitus) after controlling for sources of bias. Periodontal and glycemic parameters were recorded. Serum was obtained from all participants. The levels of CXCL2 were estimated using a commercially available ELISA kit. CXCL2 levels in serum was highest in Group 1, followed by Group 2 and lowest in Group 3. A statistically significant difference was observed between Groups 1 and 2, and Groups 1 and 3. This investigation indicates lower serum CXCL2 concentrations in disease contrary to the literature which generally report elevated levels of this chemokine. Adiposity and neutrophil behaviour may influence CXCL2 expression. More studies are required to confirm a definitive association of CXCL2 in periodontitis and type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: The role of Gram-negative anaerobic periodontal pathogens in periodontal diseases has led to the loss of tooth-supporting structures. These diseases can be prevented by the inhibition of bacterial biofilm on the tooth surfaces. Many treatment modalities have been tried to prevent periodontal diseases. With the rise in resistance to synthetic antimicrobials, there is a requirement to develop natural antimicrobials for the control of periodontitis. Aim: The aim of the study was to evaluate and compare the efficacy of garlic (Allium sativum) and guava (Psidium guajava) extracts on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans using time-kill assay. Materials and Methods: Aqueous garlic extract (AGaE), ethanolic garlic extract (EGaE), aqueous guava extract (AGuE), and ethanolic guava extract (EGuE) were prepared. Time-kill assays were performed on P. gingivalis and A. actinomycetemcomitans. The aqueous and ethanolic extracts of guava and garlic were compared to assess the maximum bactericidal potency. Results: The comparison of time-kill assay of AGaE and AGuE on P. gingivalis showed a statistically significant difference at 2 h (t = 5.29, P < 0.01), 4 h (t = −4.867, P < 0.01), and 6 h (t = −3.647, P < 0.001). The comparison of time-kill assay of EGaE and EGuE on A. actinomycetemcomitans showed a statistically significant difference at 2 h (t = 4.54, P < 0.01) and highly significant difference at 4 h (t = 6.57, P < 0.001). Conclusions: The, judicious use of these phytomedicinal products could be cost-effective and also the adverse effects caused due to the long-term usage of synthetic antimicrobials can be avoided. [ABSTRACT FROM AUTHOR]

Background: The accumulation and maturation of bacterial plaque at the gingival margin is widely recognized as the primary etiological factor in the development of chronic periodontitis. 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. Aim: The aim of this study was to evaluate the efficacy of Psidium guajava (guava) and Allium sativum (garlic) on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.Materials and Methods: Aqueous guava extract (AGvE), ethanolic guava extract (EGvE), aqueous garlic extract (AGE), and ethanolic garlic extract (EGE) were prepared. The inhibitory effects of these extracts for the periodontal pathogens were tested by agar well diffusion method. Minimal inhibitory concentration (MIC) of the aqueous and ethanol extracts of guava and garlic was determined by macrobroth dilution method. Minimum bactericidal concentration (MBC) was done to observe the bactericidal effect of the guava and garlic extracts against the organisms. Results: Of the AGE, 25, 50, and 75 μL showed 16, 20, and 25 mm zone of inhibition, respectively, on P. gingivalis. The AGE showed greater bacteriostatic activity against the P. gingivalis with MIC determined at 16.6 μL/mL. MIC determined for AGvE and EGvE was at 75 μL/mL concentration for P. gingivalis, whereas EGvE showed the activity at 75 μL/mL on P. gingivalis. MIC determined for AGvE was at 50 μL/mL, whereas MIC determined for EGvE was at 3.12 μL/mL for A. actinomycetemcomitans.Conclusion: P. guajava and A. sativum displayed a significant antibacterial effect. A. sativum was found to be most effective against P. gingivalis, whereas P. guajava showed the highest efficacy on A. actinomycetemcomitans. [ABSTRACT FROM AUTHOR]

Developments in bone regenerative techniques have increased implant placement success in mandible sites previously considered unsuitable for implants. Guided bone regeneration (GBR) procedures preserve tooth sockets immediately after teeth are extracted. GBR can also be applied to regenerate lost bone in defective alveolar ridges before or in conjunction with implant emplacements. Resorbable and non-resorbable membranes have been used in GBR. Non-resorbable membranes can be used alone or in combination with bone grafts. Titanium reinforced, non-resorbable membranes have the advantage of being molded and shaped for tenting and preserving space between teeth. Expanded polytetrafluoroethylene (e-PTFE) membranes are associated with an inherent a risk of infection upon exposure to the oral environment due to its highly porous surface. However, a dense polytetrafluoroethylene (d-PTFE) membrane does not require primary flap closure because bacteria cannot penetrate its surface. This review article summarizes the utilization of non-resorbable barrier membranes alone and together with various bone graft materials, relevant clinical studies, case reports, and the advantages and limitations of various combinations of procedures. [ABSTRACT FROM AUTHOR]

The purpose of this study was comparing the amount of apically extruded irrigation solutions by using various irrigation systems: Canal CleanMax (CCM), SonicMax, RinsEndo, Passive Ultrasonic irrigation (PUI), Manual Needle Irrigation (MNI), and EndoVac irrigation systems Sixty single-rooted mandibular premolars were used. ProTaper was used to instrument the canals up to F4 finishing file. Teeth were randomly divided into 6 groups (n = 10). (CCMax, SonicMax, RinsEndo, MNI, PUI and EndoVac). Ten mL final irrigation was made with each irrigation system. Extruded irrigant from the apical foramen was collected into vials. The amount of the extruded irrigation solution was determined by calculating the difference between the initial and final weight of the vials for each group. Results were analyzed by “Kruskal Wallis” and “Conover’s multiple comparison” tests. CCMax and EndoVac groups showed no apical extrusion and these two groups were statistically different from the others significantly (SonicMax, RinsEndo, MNI and PUI systems) (p < 0.05), and no difference was found among SonicMax, MNI, Passive PUI systems (p > 0.05). Maximum apical extrusion was seen with RinsEndo. RinsEndo showed statistically difference from SonicMax and MNI (p < 0.05) but no statistically difference with PUI (p > 0.05). The negative pressure irrigation systems (CCMax and EndoVac) were demonstrated to be significantly more successful and safer in terms of apical extrusion. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the antiplaque and antigingivitis effects of a mouthwash containing tea tree oil (TTO) with a cetylpyridinium chloride (CPC) mouthwash. Materials and Methods: This was a randomized 4 × 4, controlled, cross-over, involving 20 healthy volunteers in a 5-day plaque re-growth model. Test mouthwashes were TTO (Tebodont®) and a mouthwash containing CPC 0.05% (Aquafresh®). A 0.12% chlorhexidine (CHX) mouthwash (Oro-Clense®) was used as positive and colored water (placebo [PLB]) as negative controls. Gingival bleeding index (GBI) and plaque index (PI) scores were recorded before and after each test period. Test periods were separated with 2 weeks washout period. Results: All four mouthwashes significantly (P < 0.001) reduced the GBI scores when compared to the baseline GBI scores. There was no significant difference between PLB and active mouthwashes in the GBI scores. CHX and CPC mouthwashes were found more effective in reducing the PI scores than TTO and PLB mouthwashes. There was no significant difference in PI scores of CHX and CPC mouthwashes. Conclusion: 0.05% CPC mouthwash can be an alternative to CHX mouthwash since it is alcohol free and found as efficient as CHX in dental plaque reduction with lesser side effects. More studies are needed to test antigingivitis effects of the mouthwashes used in this study, preferably without initial scaling and polishing. [ABSTRACT FROM AUTHOR]