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BACKGROUND The revival of older treatment modalities like splinting requires the assessment of newer patient centric parameters like survival, compliance, anaesthetics apart from changing the biomaterials employed alone. The purpose of this study was to assess the association between type of splint, chief complaint and survival of splint based on different clinical scenarios with long term follow-up. METHODS The present study was a prospective university based clinical trial with convenience sampling to include clinical scenarios which required splinting in a Chennai Dental College. Ninety-five adult patients were included in the study comprising 50 men and 45 women, aged between 19 - 65 years where parameters like demographic distribution, type of splint, location of the splint, patient compliance and survival were included. The primary end point of the present study was recall of patients periodically every month till 6 - 8 months to assess the duration of survival of splints and associate the same with age, gender, patient compliance, type of splint and rationale for splinting. RESULTS Among the 95 patients included (524 teeth splinted together), all patients completed the treatment protocol, stainless steel wire composite splints were given to 70 patients while composite mesh splints were used in 20 patients. A likelihood ratio of 0.024 (P < 0.05) was seen while associating composite mesh splints, rationale for use, survival time and patient compliance. CONCLUSIONS Within the limits of the present study, a conclusion was made that one must emphasise on the importance of retaining natural teeth based on appropriate clinical scenarios where maximum benefit could be obtained among compliant patients. KEY WORDS Periodontal Splints, Survival Rate, Patient Compliance, Rationale for Splinting, Tooth Fractures, Tooth Reimplantation

Periodontitis is a multifactorial disease, one of the responsible factors include Bacteria present in the oral cavity. Bacteria, like all other organisms, are dependent on the environment for their survival and are influenced by the various host as well as environmental factors for their sustenance. Some of the major environmental factors include nutrition, the presence of oxygen, along with pH, which dictate the nature of the bacteria present as certain bacteria thrive better in acidic environments while others in Alkali environments. In medicine, sutures are extensively used with the aim of post-surgical wound edge approximation or wound healing by the primary union. However, pH is one factor that is constantly changing in the oral cavity due to dietary intake or systemic factors or local accumulation of pus. The present study wished to assess the biohostability of different suture material such as silk, vicryl and chromic gut when pH was changed to 5,6,7 keeping all other environmental factors a constant, including five pieces of sterilised standardised suture lengths & diameter, incubated in ph of 5,6, and 7 exposed to a microbial load of 0.5 McFarland units Lactobacillus subculture in brain heart infusion and incubated at 35 degrees Celsius for four hours to assess the number of bacterial colonies using visual click method. It was found that pH plays a vital role in the Biohostability of suture material as the current study suggests an acidic pH of 5 had more colony-forming units seen among all three suture materials as compared to the other two groups.

Nano-silver (AgNP) has biological properties which are significant for consumer products, food technology, and medical applications (e.g., wound care products, implantable medical devices, in diagnosis, drug delivery, and imaging). Thus, the use of nano-silver is becoming more and more widespread in medicine. However, the effect of these AgNPs on zebrafish remains unclear. Whereas, lycopene, a fat-soluble carotenoid acts as a potent antioxidant has proved its major role in treating many oral health problems such as lichen planus, and periodontitis. Usage of these lycopene AgNPs would yield better results in wound healing. In this study, we investigated the cytotoxic effects of AgNPs on fibroblasts cells of humans. To investigate the toxic effects of the lycopene-mediated AgNPs on the zebrafish (Danio rerio) and to examine these effects on the embryonic development of the fetus of this species. In this study, zebrafish embryos were treated with AgNPs 0.5, 1, 2, 3, 4 or 5 L nanoparticles/ml for 24 to 96 h post fertilization. Our results showed that with the increasing concentration of nanoparticles, there was a very mild toxic effect. Less toxic effects were observed with 1μl. Our results show that exposure to silver nanoparticles is less toxic to embryonic zebrafish at lower concentrations. The results will contribute to the current understanding of the potential biotoxic effects of nanoparticles and will aid in the safety assessment and synthesis of silver oxide nanoparticles.

Tobacco is a common name for the plants belonging to the genus Nicotiana and nightshade family. It contains a highly addictive stimulant which is used in cigarettes and other smokeless forms of tobacco. The product has a lot of carcinogens and other harmful mixtures which lead to the causation of oral submucous fibrosis, leukoplakia and erythroplakia. In this study, we would be seeing how common it is to have a history of tobacco usage in the patients diagnosed with Leukoplakia between march 2019 and march 2020 in Saveetha dental college. Materials and methods: This study was done in Saveetha dental college, Chennai, Tamilnadu, India. The study data were taken between March 2019 to March 2020. We took patients reporting with oral leukoplakia and checked their history for Smoking or smokeless tobacco usage. These data are recorded by the dental students in saveetha dental college. A total of 100 patient's record was taken and among the patients with smoking, history was identified. The number of patients with and without smoking/smokeless tobacco usage record was deduced. Results: There were a total of 100 participants, in which 95 were males and 5 were females who reported to the clinic with oral leukoplakia. In this sample, a total of 76 patients had a homogenous variant of leukoplakia while 24 patients had a non-homogenous variant. Eighty-four patients had the habit of smoking, while 16 patients had the habit of smokeless tobacco usage. Conclusion: There were 100 participants and with the result deduced from the data obtained from the participants, it is clear that smoking is one of the major etiology of Oral leukoplakia.

Periodontitis is a chronic inflammatory disease, highly prevalent almost around 10-15% of adults. Periodontitis is a group of chronic, progressive bacterial infections causing inflammation and destruction of supporting structures of teeth and has multiple factors affecting the quality of an individual's life. Diabetes is also a chronic inflammatory disease. Both diseases share a common platform in disease pathogenesis, a periodontal abscess is the sixth complication of diabetes, and there is clear evidence showing the relationship between periodontitis and diabetes Overall no clear evidence and studies which correlate diabetes and periodontal parameters. This study aims to compare blood sugar levels with demographic data age, gender and to assess the association between periodontal severity with diabetic status. Results: Periodontal severity was found to be greater in both male and female with diabetic Mellitus. 39 out of 52 subjects have generalized chronic periodontitis, and 13 was found to have localized chronic periodontitis. The age group of (50-70) years had high severity of clinical attachment loss. No significant difference between male and female on periodontal severity was found. Conclusion: This study concludes the age group of 50-60 years more prevalent among diabetes with periodontitis. The male is more affected by diabetes and periodontitis. The association between periodontal severity (CAL, PD) increases with an increase in blood sugar level was statistically significant.

Ergonomics can be defined as a discipline that studies workers and their relationship to their occupational environment. To prevent musculoskeletal disorders which can develop over time and can lead to long-term disability proper ergonomic design is necessary. Periodontal work covers most of the areas in the oral cavity including distal aspects of posterior teeth which are difficult to approach. Hence preventing work related strain was of greater significance in ensuring long term successful practice as a periodontists. The purpose of this survey was to assess the knowledge attitude and practice of ergonomics and musculoskeletal disorders as an occupational hazard in periodontists in India .A survey was conducted among 150 periodontists in India in which 120 periodontists responded. The survey was distributed through questionnaire printouts and electronic media. The data was collected, analysed and interpreted. The results suggested that 85% of the periodontists had adequate knowledge and attitude towards ergonomics, however the practical application was not as satisfactory. This survey concludes that the knowledge and attitude of periodontists in India regarding ergonomics and musculoskeletal disorders as an occupational hazard is good overall, but the practice is needs some improvement.

Aim of the present study is comparative evaluation of the inherent antimicrobial properties of the copper and stainless steel suction tube also evaluate bacterial adherence and reduction with time within the suction tube. Present study was performed in an in vitro setting in Saveetha dental college and hospital. Both the metals suction tubes were cut into equal lengths of 2.3 inches and dipped in a sterile container for 5 minutes which had bacterial suspension of Streptococcus Mutans. Each group included three samples of copper and stainless steel suction tubes. Control group was taken out at 0 mins post initial dipping period de-coated in a sterile container and immediately cultured on Brain heart infusion agar, followed by group 1 at 15 minutes group 2 at 60 minutes and group 3 at 180 minutes respectively. Bacterial colonies were counted after overnight incubation. Copper suction tubes demonstrated less initial adhesion of bacterial colonies than that of stainless steel suction tubes. Percentage reduction in bacterial colonies was observed more in stainless steel suction tubes with respect to time. Spite of high initial adhesion stainless steel suction tube demonstrated higher degree of percentage reduction in bacterial colonies with time hence proven better for antimicrobial properties than copper suction tube.

Background and Aims: Melatonin is an indolamine that is primarily secreted by the pineal gland. It has immunomodulatory as well as antioxidant properties. It is a potent anti-oxidant that protects against inflammation and cellular damage caused by reactive oxygen species, also has potent angiogenic function that adds on to the benefits of melatonin. As a result of these actions, melatonin may be useful as an adjuvant in the treatment of various conditions in the oral cavity. The aim of this study is to systematically evaluate the role of melatonin in periodontal disease. Methods: An extensive review of the scientific literature was carried out using PubMed, Science Direct, Google Scholar and the Cochrane base. Research articles were collected upto December 2017. Results: Melatonin may have beneficial effects in certain inflammatory oral pathologies, mainly periodontal diseases where they inhibit bone resorption destroy reactive oxygen species, stimulates osteoblastic differentiation. Salivary melatonin could also act as a risk indicator for periodontal diseases. Conclusion: Many studies showed that the melatonin levels in GCF, Saliva, Serum of patients suffering from chronic periodontitis is lowered suggesting that may play a pivotal role in protecting the tissue from damage caused by oxidative stress. However, there exists no data on the concentration needed, method of application for potential benefits. Randomized clinical trials in this field are needed to fill the lacunae and better improve our understanding.

Introduction: The regeneration of supportive periodontal tissues after destructive periodontal disease has become one of the primary objectives of periodontal therapy. Demineralized bone matrix (Osseograft), when used, has shown osteoinductive potential and collagen membrane (GTR) prevents the migration of epithelium into it. The literature showed that eggshell which consists of hydroxyapatite and calcium carbonate shows osteoconductive as well as inductive properties. Eggshell membrane which is made of type X collagen matrix can be used as a barrier membrane. Hence, the aim of the study was to compare the demineralized bone matrix with GTR membrane to eggshell constituents and its membrane as a regenerative material in Wistar rats. Materials and Methods: A critical size periodontal defect of 1.5 × 6 mm was created on either side adjacent to mandibular incisors after raising the full thickness flap. Osseograft and collagen membrane covered the defect on one side and the eggshell components and its membrane filled the defects. The animals were sacrificed on the 45th day. Results: Histological evaluation showed intensive new bone formation on both sides of the defect. Inflammation has resolved completely with no signs of eosinophils. Complete defect healing was noted in both the defects. A minimal amount of epithelial entrapment was noted in both the sites. There was no significant difference observed between the comparisons. More connective tissue was found in the test group. Conclusion: Within the limits, it can be concluded that eggshell powder along with membrane can be used as a potential graft material.

Periodontal regeneration can be defined as complete restoration of lost periodontal tissues to their original architecture and function. A variety of treatment modalities have been proposed to achieve it. Plasma rich in growth factors (PRGF) is a concentrated suspension of growth factors that promotes restoration of lost periodontal tissues. The objective of the present study is to assess the effect of PRGF associated with guided tissue regeneration (GTR) versus GTR only in the treatment of intrabony defects (IBDs) in patients with chronic periodontitis (CP).Patients with CP (n = 14) with 42 contralateral 2- and 3-walled defects were randomly assigned to test (PRGF+GTR) and control (GTR alone) treatment groups. Clinical and radiographic assessments performed at baseline and after 6 months were: 1) gingival index (GI), 2) probing depth (PD), 3) clinical attachment level (CAL), 4) radiologic defect depth, and 5) bone fill.Comparison of parameters measured at baseline and after 6 months showed mean PD reduction of 3.37 ± 1.62 mm in the control group (P0.001) and 4.13 ± 1.59 mm in the test group (P0.001). There was a significant difference in mean change in CAL (P0.001) in the control group (5.42 ± 1.99) and the test group (5.99 ± 1.77). Mean change in GI was 1.89 ± 0.32 and 1.68 ± 0.58 in the control group and test group, respectively, and the difference was statistically significant (P0.001). When compared between groups, clinical parameters did not show any statistically significant variations. Mean radiographic bone fill was 1.06 ± 0.81 and 1.0 ± 0.97 in the control group and test group, respectively. However, the difference was not statistically significant.PRGF with GTR, as well as GTR alone, was effective in improving clinical and radiographic parameters of patients with CP at the 6-month follow-up. There was no additive effect of PRGF when used along with GTR in the treatment of IBDs in patients with CP in terms of both clinical and radiologic outcomes.

Background Chronic obstructive pulmonary disease (COPD) and periodontitis are severe debilitating disorders of inflammatory origin. COPD manifests as inflammation of the lung connective tissue caused by irritants such as smoking and dust particles, resulting in narrowing of the airway. Periodontitis follows the same inflammatory course with the resultant destruction of the local connective tissue, and several irritants are well-documented risk factors for this disease. Highlights Neutrophilic dominance is well established in both of these conditions, and some evidence suggests that periodontopathogens play a role in causing respiratory infections. Given the similarities in the etiopathogenesis and the risk factor profiles of these diseases, a common foundation exists to suggest an inter relationship between the two diseases. Conclusion The present article briefly reviews the interlinking mechanisms between the two diseases, starting with the role of periodontal pathogens, innate immunity, and, ultimately, imbalances in oxidative stress and the protease–antiprotease system. Although epidemiological evidence provides no clear association between these two diseases, the striking commonalities should not be overlooked. Hence, future research should be targeted to this area in order to obtain constructive information.

Aim: To evaluate the effect of systemic Amoxycillin and Metronidazole against Azithromycin as an adjunct to non-surgical therapy and correlate the clinical periodontal parameters at baseline, 10 days and 30 days in subjects with generalized aggressive periodontitis (GAP). Study Design: Randomized controlled clinical trial. Place and Duration of the Study: The study was conducted in Saveetha Dental College and Hospitals from February 2015 to August 2015. Methods: Subjects were recruited from the outpatient department of Periodontics and were categorized as GAP according to AAP criteria. A total of 16 patients with GAP were included in the study. Clinical periodontal parameters like sulcus bleeding index [SBI], gingival index [GI], Probing depth [PD] and clinical attachment loss [CAL] were recorded at baseline. The subjects were then randomly allotted into Group 1 [Amoxycillin+Metronidazole] and Group II [Azithromycin]. After evaluation of clinical parameters at baseline, scaling and root planning [SRP] was done in both the Groups and systemic antibiotics, namely combination of Amoxycillin and Metronidazole in Group I and Azithromycin in Group II were administered. Subjects were recalled at day 10 and 30 for re-evaluation of clinical parameters. Within Group comparison was made using paired “t test” and inter Group comparison was made using Un-paired “t test”. Results: Intra-Group comparisons of clinical parameters between baseline and 30 days, in both the Groups were statistically significant (P 0.05). Conclusion: Systemic administration of Azithromycin as an adjunct to SRP in subjects with GAP resulted in better improvement of clinical periodontal parameters compared to a combination of Amoxycillin and Metronidazole.

Background: The relationship between periodontitis and cardiovascular diseases has been a debatable topic since over a century, yet the debate is still ongoing. Periodontitis and coronary artery disease are both immuno- inflammatory in origin with many confounding risk factors associated with each other. Various epidemiological and interventional studies have been carried out to prove its biologic plausibility. There is however deficient literature on the exact pathophysiology of the spread of periodontal disease to cardiovascular disease. Objective: This review article aims to highlight on the most recent scientific evidence to substantiate on the causal relationship between the two diseases. Results: Various interventional and epidemiological studies suggest that there is a strong correlation between periodontitis and cardiovascular diseases, however there is a lacunae in literature in the in-vitro and long term clinical trials to support its exact biological mechanism. Conclusion: In the interest of public health, the cardiologists and the periodontists at large should be made to understand the role of maintaining good oral hygiene for general well being and refer to the specialist when necessary. Key words: Cardiovascular Disease, Focal infection, Focal Sepsis, Heart Disease, Periodontitis.

BACKGROUND Growing evidence suggests that oxidative stress forms a key component in the etiopathogenesis of periodontitis. Studies have shown potential antioxidants responsible for combating the pro-oxidants which stress the periodontium. But, peroxiredoxin-sulfiredoxin system is the least explored in periodontal disease. METHODS A case-control study was conducted on 30 participants who fulfilled the inclusion criteria from the Department of Periodontics, Saveetha Dental College and Hospital, Chennai, India. The patients were divided into two groups: 1) Group A- healthy controls (n = 18), 2) Group B- patients with generalized chronic periodontitis (n = 17). Following clinical examination, gingival tissue samples were procured from both the groups and subjected to protein quantification by Lowry method. The samples with adequate protein concentration (n = 30) from the two groups were further analyzed by enzyme-linked immunosorbent assay for estimation of sulfiredoxin levels. RESULTS Sulfiredoxin levels were significantly higher in the gingival tissues of chronic periodontitis patients (171.20 ± 16.97 ng/mL) than in healthy controls (131.20 ± 22.87) with P

The aim of the present review is to systematically evaluate the additive effect of autologous platelet concentrates (APCs) in treatment of intrabony defects when used along with other regenerative procedures and when used alone in terms of clinical and radiological outcomes. A search was performed in electronic databases (i.e., MEDLINE and the Cochrane Central Register of Controlled Trials) in order to identify randomized clinical trials (RCTs) assessing the additive efficacy of APCs for healing and regeneration of hard and soft tissues in patients undergoing regenerative surgical procedures for the treatment of intrabony defects, having a follow-up of at least 9 months. Included studies underwent risk of bias assessment and data extraction. The main variables evaluated for efficacy were: pocket depth (PD), clinical attachment level (CAL), radiographic bone filling, and postoperative pain. The effect of APCs adjunct was evaluated for the following procedures: open flap debridement (OFD) alone, OFD plus grafting of the defect with autogenous bone or bone substitutes, and grafting in combination with a covering membrane for guided tissue regeneration (GTR). Platelet-rich fibrin (PRF) has a significant additive effect when used along with OFD. Platelet-rich plasma (PRP) has a significant additive effect when used along with bone grafts. Conversely, PRP was found to be ineffective when used in combination with GTR procedures. No study evaluated the effect of APCs on postoperative pain. Platelet-rich plasma may be used advantageously as an adjunct to grafting materials, but not in combination with GTR, for treatment of intrabony defects. Moreover, PRF can be effective as a sole regenerative material, in combination with OFD. There is still a lack of evidence regarding the effect of PRF in combination with grafting materials and GTR, the effect of other types of APCs such as plasma rich in growth factors, and the effect of APCs on postoperative pain.

Periodontitis is a multifactorial disease, it is mainly due to infection from periodontal bacteria present in the dental plaque and host response. The lipopolysaccharide from bacteria results in greater tissue destruction leading to increased blood loss which is manifested by increase in bleeding on probing. There are numerous studies which have been done which shows the association between anemia and chronic periodontitis, but there are very few studies which compare chronic periodontitis, aggressive periodontitis and health. Hence this study was done to assess the periodontal and haematological parameters in chronic periodontitis, aggressive periodontitis and healthy subjects. A total of 50 patients were screened for assessment of periodontitis and 15 patients were then categorised into healthy, chronic and aggressive periodontitis based on AAP classification. Various periodontal and haematological parameters were assessed. There was significant association in the periodontal parameters among the chronic periodontitis patients, aggressive periodontitis patients and healthy subjects. Among the haematological parameters, there was a statistically significant increase in serum ferritin level in chronic periodontitis patients when compared to healthy subjects. The results indicated an association of chronic periodontitis and anemia of chronic disease, which was not seen in aggressive periodontitis

Background: Periodontal dressings have over the years undergone numerous changes in composition as well as usage and yet controversies prevail over the use of these dressings in periodontal procedures. Aim: To assess the knowledge, awareness and practice of placing periodontal dressings- (to pack or not to pack) among periodontal surgeons. Materials and Methods: A cross sectional study based on a structured questionnaire comprising 20 questions was distributed among 150 periodontists who were asked to select the most appropriate answer and the resultant data was expressed in percentages. Results: Based on the given responses, the percentage of periodontists who place periodontal dressings, who do not support placement of periodontal dressings, the type of dressing they use, rationale behind the type of dressing, problems they have experienced in their practice with or without placement of periodontal dressings were analyzed. Conclusion: Most of the doctors seemed to place periodontal dressings after surgical procedures. Some stated that dressings are more advantageous whereas others did not believe so. Most commonly used dressing was COE pack and dressings were commonly use for regenerative procedures

Purpose.Inflammation and tissue breakdown are led by an array of inflammatory destructive mediators associated with initiation and progression of inflammatory diseases like periodontitis. Current evidence shows that these inflammatory mediators have a definitive role in the pathogenesis of various systemic diseases with an inflammatory component. Interleukin-21 (IL-21) has been associated with systemic diseases like rheumatoid arthritis and Crohn’s disease that follow a chronic inflammatory cascade. Similarly recent studies have associated Interleukin-21 levels with periodontitis. This systematic review was aimed to assess the levels of IL-21 in subjects with periodontitis.Methods.A complete literature search was done in PubMed, Medline, Science Direct, and Cochrane databases and Google Scholar based on the inclusion/exclusion criteria. Six relevant articles were procured. Full text was read individually by two reviewers and data extraction was done based on STROBE statement.Results.After data extraction five observational and one interventional study were obtained. All the studies showed an increased expression of IL-21 in periodontitis and the interventional study showed reduction in IL-21 levels after nonsurgical periodontal therapy (NSP).Conclusion.Interleukin-21 levels are higher in periodontitis than controls. With this limited evidence further longitudinal studies are required to consider this as a definitive inflammatory marker.