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Aim and ObjectivesTo compare and evaluate the clinical efficacy of “ofloxacin incorporated L-PRF” and “L-PRF alone” when used as an adjuvant to non-surgical periodontal therapy. Materials and MethodsA split-mouth study was conducted in 50 patients diagnosed as chronic periodontitis with pocket depth ≥6 with at least one site in each quadrant. All patients underwent scaling and root planning. Test site received with ofloxacin incorporated L-PRF and control site received L-PRF alone. Clinical parameters pocket depth (PD), plaque index (PI), and gingival bleeding index (GBI) were recorded at baseline and 1 month after scaling and root planning. ResultsIn total, 100 sites were treated (50 test group and 50 control group) with no uneventful healing effects. Statistically significant decreases in PD (P = .0001 for both test and control groups), PI (P = .001), GBI (P = .001 for both groups), between pre-treatment and 1 month post-treatment were noted in both test and control groups. For intergroup comparisons, there was a statistically significant difference in all clinical indices (P > .005). ConclusionUse of L-PRF with ofloxacin as an adjuvant to non-surgical periodontal therapy showed better improvements in clinical parameters.

The increased demand in transportation for plug-in electric vehicles (PEV) made the expansion of charging stations mandatory to keep up with this developing technology. The main drawback of plug-in electric vehicles (PEV) is the long charging time of the battery. The design of The DC fast-charging station (DCFCS) of electric vehicles overcomes this problem. In this proposed work different technology gaps in electric vehicle charging stations have been discussed. The control algorithms have been implemented for controlling the switching operation of the power electronic converter mitigating the harmonics in the source current. The different available multi-level power levels for charging electric vehicles are demonstrated. A DC fast charging station is implemented in power system computer-aided design and their electromagnetic transient response in DC (PSCAD)/EMTDC.

Periodontitis, is an inflammatory state of the tooth supporting structures and if left untreated, the disease continues to progressive bone destruction and subsequent tooth loss. The increasing prevelance of periodontal disease paved way to the development of new diagnostic tests that could detect the presence of active disease,the course of the disease and its response to treatment. Bone is a metabolically active tissue and undergo continuous remodelling, a process that largely relies on the activity of osteoclasts to remove bone and of osteoblasts to form bone. In health, bone resorption and formation are coupled to each other and its long term maintenance of skeletal balance is brought about by the systemic hormones and local mediators.In contrasts,during disease there is a pronounced in balance in bone turnover. Bone biomarkers which are produced either in health or in disease state are tell tale markers which would be used to monitor the health status. This review highlights, the recent advances in the use of biomarkers of bone remodelling,that could facilitate the screening, diagnosis and management of periodontal diseases. [ABSTRACT FROM AUTHOR]

Aims and Objectives : To assess the efficacy of flapless implant surgery on soft-tissue profile and to compare the clinical outcomes of flapless implant therapy on immediate loading (IL) implants to delayed loading (DL) implants. Materials and Methods : The study sample consisted of 20 patients who were partially edentulous in the anterior maxillary region. They were divided into two groups. In group I (IL) 10 implants were placed and immediately provisionalized and restored with a metal ceramic crown on the 14th day. In group II (DL) 10 implants were placed and loaded after 4 months. Single-piece implants were used for the IL group and two-piece implants were used for the DL group. All soft tissue parameters i.e., modified plaque index (mPI), modified bleeding index (mBI), papillary index (PPI), marginal level of soft tissue (ML) and width of keratinized mucosa (WKM) were recorded at baseline, Day 60, Day 120 and Day 180. Results: The success rate in group I was found to be 80%, which was lower than the success rate in group II which was found to be 90%. On comparison, there is no statistically significant difference in success rate between the two study groups. There was no statistically significant difference between the groups over time in parameters like mPI, mBI, ML and WKM. The mean PPI score in group II showed a significant increase from when compared to group I. Conclusion: The results of this study indicated that flapless implant surgery using either immediately loading implants or DL implants, demonstrate enhancement of implant esthetics.

Genes are specific sequences of bases that encode instructions to make proteins. When genes are altered so that encoded proteins are unable to carry out their normal functions, genetic disorders can result. Gene therapy is designed to introduce genetic material into cells to compensate for abnormal genes or to make a beneficial protein. This article reviews the fundamentals in gene therapy and its various modes of administration with an insight into the role of gene therapy in Periodontics and future percepts and the technical and ethical issues of using gene therapy.

Aim: Nanotechnology presents a promising approach for managing chronic periodontitis, a common oral disease characterized by gum inflammation and loss of supporting bone around teeth. This study aimed to evaluate the antimicrobial efficacy of acerola-mediated silver nanoparticles (AgNPs) gel and copper oxide nanoparticles (CuONPs) gel in periodontitis patients with and without diabetes., Materials and Methods: The antimicrobial efficacy of acerola-mediated AgNPs gel and CuONPs nanogel was assessed using the agar well diffusion technique, Minimum Inhibitory Concentration (MIC) assay, Minimum Bactericidal Concentration (MBC) analysis, time-kill curve assay, and cytoplasmic and protein leakage analysis from periodontitis patients with and without diabetes., Results: The study found that acerola-mediated AgNPs gel demonstrated more consistent and effective antimicrobial activity against periodontitis, with lower MIC and MBC values compared to the CuONPs gel, across all tested concentrations. These results suggest that acerola-mediated AgNPs gel may be a more effective and targeted therapeutic agent for periodontal disease management., Conclusion: The findings emphasize the importance of nanoparticle gel concentration in optimizing periodontal treatment outcomes. Acerola-mediated AgNPs gel, with its superior efficacy and consistency in bactericidal activity, shows significant potential for periodontal therapy., Clinical Significance: Innovative nanoparticles like copper and silver oxides exhibit antibacterial, anti-inflammatory, and antioxidant properties, making them promising agents for targeting periodontal pathogens. Acerola (Malpighia emarginata), with its high vitamin C content and antioxidant properties, is beneficial in mitigating oxidative stress associated with chronic periodontitis., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Amla, scientifically known as emblica officinalis and Acerola ( malphigian emarginata ) both are Vitamin C fruits possess varied medicinal properties being used for preventive disease health management strategies. Therefore, it is of interest to explore the antioxidant, anti-inflammatory, antibacterial, and cytotoxic properties of aqueous extracts from Acerola and Amla. Hence, the anti-inflammatory activity of Acerola and amla was assessed using the bovine serum albumin denaturation assay (BSA Assay), antioxidant properties were compared using DPPH (2,2-diphenyl-1-picrylhydrazyl) assay. Both extracts antibacterial activities were evaluated through the agar well diffusion technique against oral pathogens and Brine shrimp lethality assay for cytotoxicity. The current research sheds light on natural remedies for oxidative stress-related diseases, inflammatory conditions and bacterial infections, offering promising avenues for disease management and preventive healthcare strategies especially in the treatment of oral health diseases like periodontitis., (© 2024 Biomedical Informatics.)

Background: The tropical plant acerola of the genus Malpighia includes shrubs and trees with fruit that is high in nutrients and bioactive chemicals. Acerola stands out due to its exceptionally high ascorbic acid content, ranging from 1500 to 4500 mg/100 g. Vitamin C intake greatly influences gingival health. The addition of nanoparticles along with vitamin C-rich acerola exhibits high antioxidant and anti-inflammatory properties, thereby positively improving gingival health., Method: The antioxidant and anti-inflammatory properties of aqueous extracts of the acerola plant ( Malpighia emarginata ) were assessed. Silver nanoparticles (AgNPs) and copper oxide nanoparticles (CuONPs) were synthesized using the aqueous extract of acerola cherry gel by the phytogenic fabrication method. The antioxidant potential of silver and copper nanoparticles was evaluated using 2,2-diphenyl-1-picrylhydrazyl (DPPH), hydrogen peroxide, ferric reducing antioxidant power (FRAP), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and nitric oxide scavenging activities., Results: Increasing concentrations of nanoparticles showed an increase in scavenging activity. Overall, CuONPs and AgNPs exhibited remarkable radical quenching efficacies. The anti-inflammatory effectiveness of CuONPs and AgNPs was monitored, showing suppression of protein denaturation as demonstrated by bovine serum albumin (BSA), egg albumin (EA), and membrane stabilization assays. The results revealed that increasing the doses of CuONPs and AgNPs had a positive impact on the anti-inflammatory activity of the nanoparticles., Conclusion: The present study revealed that both nanoparticles provided better antioxidant and anti-inflammatory activities. This study also elaborates on the pharmacological potential of both nanoparticles, which could be further explored for application in all healthcare sectors., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Intellectual property info: Patents on (1) “A Process of Preparation of Malpighia Emarginata Based Copper Oxide Nanogel for Treating Chronic Periodontitis and Product Thereof” and (2) “A Process of Preparation of Acerola Mediated Silver Nanogel for Treating Chronic Periodontitis and Product Thereof” have been published and are pending. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Nalina Kumari Chellathurai et al.)

Background: The intricate interplay between periodontal polymicrobial flora and an altered immune response is the central cause of periodontal disease. Multiple cell death methods and their interactions, along with the associated signaling pathways, significantly impact the initiation and advancement of periodontitis. Our speculation revolves around the role of the miR-223/Ras-associated binding protein (RAB12) signaling axis in regulating autophagy-induced pyroptosis, contributing to the pathophysiology of periodontitis. Thus, this study aimed to investigate miR-223 and RAB12 expression patterns in Stage III/Grade B periodontal disease., Materials and Methods: The study included 50 healthy individuals and 50 patients diagnosed with Stage III/Grade B periodontal disease. Clinical parameters were cataloged for each participant. miRNA-223 underwent an in silico analysis to identify its potential target genes. Gingival crevicular fluid (GCF) samples were collected from the subjects for real-time polymerase chain reaction to evaluate the expression of both miR-223 and the RAB12 gene., Results: The miRTargetLink2.0 analysis highlighted the RAB12 gene as a prime target for miR-223. In periodontal disease patients, miR-223 and RAB12 gene expressions significantly increased (15.21 and 34.70-fold changes, respectively; P < 0.05). Receiver operating characteristic analysis suggested that miR-223 is a potential biomarker for periodontal disease, with 76% diagnostic accuracy and an area under the curve of 0.777 ( P < 0.01)., Conclusion: MicroRNA-223 and its target gene RAB12 exhibit high expression levels in GCF samples from individuals with periodontal disease. This suggests modulation of autophagy and the signaling mechanism for pyroptotic cell death in periodontal tissues during pathogenesis. Consequently, the miR-223/RAB12 axis might represent a plausible link for periodontal disease., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Society of Periodontology.)

Head and neck cancers (HNC) continues to dominate major cancers contributing to  mortality worldwide. Squamous cell carcinoma is the major type of HNC. Oral Squamous Cell Carcinoma grouped under HNC is a malignant tumor occurring in the oral cavity. The primary risk factors of OSCC are tobacco, alcohol consumption, etc. This review focuses on modulations, mechanisms, growth and differentiation of oral squamous cell carcinoma. Cancer cell surrounds itself with a group of elements forming a favorable environment known as tumor microenvironment (TME). It consists of numerous cells which includes immune cells, blood cells and acellular components that are responsible for the progression, immunosuppression, metastasis and angiogenesis of cancer. This review highlights the most important tissue biomarkers (mTOR, CAF, FOXp3, CD163, CD33, CD34) that are associated with TME cells. mTOR remains as the primary regulator responsible in cancer and its importance towards immune-suppression is highlighted. Tumor-associated macrophages associated with cancer development and its relationship with immunomodulatory mechanism and Tregs, which are potential blockers of immune response and its mechanism and aberrations are discussed. Cancer-associated fibroblasts that are a part of TME and their role in evading the immune response and myeloid derived suppressor cells that have slight control over the immune response and their mechanism in the tumor progression is further explained. These markers have been emphasised as therapeutic targets and are currently in different stages of clinical trials., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim The study aims to substantiate the quantitative role of the predominant periodontopathogen ( Porphyromonas gingivalis ) associated with peri-implantitis and evaluate the reactive oxygen metabolite levels in peri-implantitis patients. Methodology A total of 40 participants were taken from the department of periodontology, Thai Moogambigai Dental College and Hospital, Chennai, and divided into groups I (control) and II (test). Group I included 20 participants with healthy peri-implant tissue, and group II included 20 participants with infected peri-implant tissues. The predominant periodontopathogen was detected by using a quantitative real-time polymerase chain reaction. Samples (gingival crevicular fluid (GCF), saliva, and plasma) were collected, and a biochemical assay was conducted for reactive oxygen metabolites (ROM) analysis in healthy implants (control group) and peri-implantitis conditions (test group). ROM levels of the patients were statistically analyzed. Results The qualitative and quantitative profiles of Porphyromonas gingivalis ( P. gingivalis) associated with Peri-implantitis were analyzed, and the levels of ROM in periimplantitis patients were assessed. The study results substantiate the quantitative picture of Porphyromonas gingivalis in the detection of periimplantitis. The saliva and GCF samples showed significant differences in ROM levels between the test and control groups. Conclusion This is one of the few studies to detect the predominant bacterial pathogen associated with peri-implantitis and assess the ROM levels in periimplantitis patients. The study gives a correlation between the periopathogens and ROM levels, thereby facilitating the attainment of the best possible treatment options., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ravindran et al.)

Background: Bioceramics are widely used as a biomaterial to promote bone regeneration. Bone defect management requires the placement of bone grafts. Though there are many bone grafts available, these have certain limitations like limited supply and second surgical site morbidity. Phytochemicals in plants are known to have bone regeneration capacity and are used in traditional medicine for bone fracture healing., Objective: The purpose of the study was to create a novel biomaterial consisting of a composite of biphasic calcium phosphate (BCP), chitosan (CH), casein (CA), and ethanolic leaves extract of Ormocarpum Cochinchinense (OC) fabricated and characterized for physicochemical properties., Materials and Methods: BCP-CH-CA-OC material was prepared and immersed in Simulated body fluid (SBF) for 21 days. Physical properties were analysed through X-Ray diffraction (XRD), Fourier Transform Spectroscopy (FTIR), and Scanning Electron Microscopy with Energy dispersion spectroscopy (SEM/EDS). Mechanical properties were analysed by compressive strength and diametral tensile strength tests. Using BET (Brunauer-Emmett-Teller) analysis and Nano computed tomography (CT) scan, porosity measurements were made., Results: XRD did not show any significant change after immersion in SBF, indicating that the material was not under change and is stable. FTIR showed an increase in chitosan content, due to the loss of casein. SEM analysis showed the deposition of crystals and porous structure. EDS showed the deposition of minerals. Nano CT and BET analysis showed clinically significant porosity of 30%., Conclusion: The mechanical and physical properties of this novel biomaterial could be used in tissue engineering for the repair of bone defects in non-load-bearing areas. The physicochemical properties are at par with other materials used for the purpose of bone grafting. The novel biomaterial has the potential to be used in bone regenerative medicine in non-load-bearing applications., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Pharmacy and Bioallied Sciences.)

Background Evidence had shown a bi-directional link between diabetes mellitus and periodontitis. Chemerin, an adipose tissue-specific adipokine plays a significant role in adipocyte initiation and differentiation that directly influences glucose metabolism, lipid metabolism, and inflammatory mediators. Non-surgical periodontal therapy (NSPT) for patients with periodontitis and diabetes mellitus improves the periodontal condition and regulates glycemic level. Aims and objectives To assess the impact of chemerin on periodontal disease and diabetes mellitus pathogenesis and to analyze the impact of NSPT on saliva and gingival crevicular fluid (GCF) chemerin levels in patients with periodontitis with and without type 2 diabetes mellitus (T2DM). Materials and methods A total of 60 patients were divided into four groups: Group I: Systemically and periodontally healthy subjects (n=15), Group II: Systemically healthy subjects with periodontitis (n=15), Group III: Subjects with periodontitis and T2DM (n=15), Group IV: Periodontally healthy subjects with T2DM (n=15). Indices and parameters like plaque index (PI), gingival index (GI), periodontal probing depth (PPD), and clinical attachment level (CAL) were assessed at baseline in all four groups and six weeks after NSPT in Group II and Group III. A glycated hemoglobin (HbA1c) test was taken to assess the patient's blood glucose level. Fasting blood sugar (FBS) level was taken at baseline in all the groups and six weeks after NSPT in Group II and Group III subjects. Saliva and GCF chemerin levels were assessed at baseline in all four groups and six weeks after NSPT in Group II and Group III subjects. Results A statistically significant difference was observed in comparing chemerin levels at baseline with all four groups (p < 0.001). After NSPT, there was a reduction in clinical parameters, FBS, and chemerin levels in Group II and Group III. A positive correlation was observed between salivary chemerin and FBS in Group II, GCF chemerin, PI, and FBS in Group II, and PPD and FBS in Group III. A negative correlation was observed between salivary chemerin and all parameters in Group II and between salivary chemerin and GCF chemerin in Group III. Conclusion Based on the observed relationship between chemerin and the parameters, their utility as a dual biomarker for diagnosis and prognosis in periodontal disease seems promising. However, further studies with a larger sample size on the role of chemerin in health and various states of diseases are required to substantiate the result of the study., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, GD et al.)

Background: The excess reactive oxygen species or free radicals reaction leads to oxidative injury to the biological components such as cells and tissues, which would result in the initiation and progression of carcinogenesis. The magnitude of oxidative damage depends primarily on the balance between free radicals (pro-oxidants) and antioxidant system activity., Aim: To assess antioxidant status by evaluating the reduced glutathione (GSH) levels in various biological samples of patients with oral squamous cell carcinoma (OSCC) using available literature., Materials and Methods: An electronic literature search was carried out in PubMed (MeSH), Science Direct, Scopus and Cross Reference by using specific keywords., Results: The systematic electronic search identified 704 articles. After studying the articles' titles and abstracts, 657 articles were excluded for the following reasons; duplicated articles, animal studies, studies of low quality and not relevant to the research question. The remaining 47 articles were selected for full-text assessment. After eliminating the articles that did not match the objectives, the present qualitative synthesis finally included 27 articles for evaluation. The ten studies, which showed coherent data, were included in quantitative analysis. The GSH levels in OSCC groups are significantly decreased ( P < 0.001) in plasma and erythrocyte samples compared to healthy controls., Conclusion: The selected studies showed significantly lower levels of GSH in various biological samples of OSCC. Hence, future studies are required to validate the expression of GSH as a prognostic biomarker in oral cancer., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Oral and Maxillofacial Pathology.)

It is of interest to document theresistin levels in chronic periodontitis patients (CP) with or without type 2 diabetes mellitus (T2DM) in the gingival crevicular fluid (GCF).The expression of resistin was significantly higher in chronic periodontitis when compared to the periodontally healthy groups. Resistin levels were high in CP and T2DM. Therefore, GCF resistin levels is of interest as a potential incendiary marker for periodontitis with T2DM., Competing Interests: None, (© 2021 Biomedical Informatics.)

Objective: To qualitative and quantitatively review published literature assessing the oxidative stress marker malondialdehyde (MDA) in oral squamous cell carcinoma (OSCC)., Methodology: Pubmed (MeSH), Science Direct, Scopus, Web of Science, Willey Online Library, Cochrane, and Cross Reference were searched for studies assessing MDA levels in OSCC samples., Results: From the 1008 articles identified, 849 were excluded based on title and abstract screening due to duplication and irrelevance to the topic of interest. Full-text assessment of the remaining 159 articles led to the inclusion of only 46 articles that satisfied the selection criteria. Of these, only 26 studies had data compatible for quantitative analysis. The MDA levels in OSCC groups are significantly increased ( p < 0.00001) in plasma, serum, and saliva samples in the majority of the studies evaluated. In contrast, MDA levels in OSCC tissue samples are significantly attenuated ( p < 0.00001) compared to healthy controls, supported by fewer studies., Conclusions: The augmented MDA levels in plasma, serum, and saliva samples of the OSCC reflect the heightened oxidative stress level accurately. Further studies are required to understand the attenuated MDA levels in the tissue samples of OSCC. Correlation analysis between MDA levels with established clinicopathological prognostic markers could aid in formulating oxidative stress-based prognostication and treatment planning.

Background: Periodontal disease is one of the most common prevailing diseases, where the destruction occurs due to the direct effect of microorganisms and indirectly by the stimulation of host cells. The diverse inflammatory action of visfatin made this adipokine a potential periodontal biomarker of choice along with the periopathogen Porphyromonas gingivalis., Aim: Our study was carried out to evaluate the visfatin levels in gingival crevicular fluid (GCF) and P. gingivalis levels in subgingival plaque in periodontal health and disease., Materials and Methods: A total of 60 participants were divided into two groups of thirty participants each as Group I - patients who have healthy periodontium and Group II - patients with generalized chronic periodontitis. The clinical parameters assessed for the participants were plaque index, probing pocket depth, papillary bleeding index, and clinical attachment loss. The subgingival plaque samples were obtained to estimate P. gingivalis levels and GCF was collected to check visfatin levels., Results: The clinical parameters, P. gingivalis , and GCF visfatin levels between the two groups showed a notable significant difference. A significant positive correlation was noted on the correlation of GCF visfatin levels with clinical parameters., Conclusion: Our study outcomes propose that P. gingivalis can be the bonafide periopathogen which modulate the visfatin levels in individuals with periodontal disease and GCF visfatin can also be evaluated as a biomarker in periodontal disease., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Society of Periodontology.)

Background: Dental esthetic awareness among patients led the clinicians to introduce newer materials and predictable techniques that satisfy the patients' esthetic demands., Aim: To evaluate and compare the efficacy of subepithelial connective tissue graft (SECTG) and acellular dermal matrix (ACDM) allograft in the treatment of Millers Class I or Class II recession with the determination of gingival thickness using an impertinent method, soft tissue cone-beam computed tomography (ST-CBCT)., Materials and Methods: A split-mouth study with a total of ten patients with bilateral Millers class I or class II recession is randomly assigned by a coin toss method as Group I (SECTG) and Group II (ACDM) along with coronally advanced flap. Clinical parameters including recession height (RH), recession width (RW), probing depth, clinical attachment level (CAL), and height of keratinized tissue (HKT) were evaluated at baseline, 90 th day, and 180 th day for both groups. The thickness of keratinized tissue (TKT) was determined by most reliable, predictable and noninvasive method called ST-CBCT., Results: Statistically significant reduction in RH and RW, gain in CAL, and increase in HKT and TKT in both Group I and Group II were seen in 90 th day and 180 th day. However, when both Group I and Group II were compared between 0 and 180 th day, the change in RH and RW, gain in CAL, and increase in HKT and TKT did not show any statistically significant change., Conclusion: The present study suggested that root coverage with both SECTG and ACDM is very predictable procedure and it is stable for 6 months. ST-CBCT is a newer dimension in periodontal imaging and will certainly aid clinicians in the execution of various treatment modalities with increased predictability., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Society of Periodontology.)

Introduction Periostin, a secreted adhesion molecule, is a matricellular protein secreted most in periodontal ligament and periosteum. This periostin is needed for integrity and maturation of periodontal tissue. The present study was conducted to estimate and compare the gingival crevicular fluid and serum periostin levels in subjects having chronic periodontitis, gingivitis and healthy periodontium. Methods Ninety patients belonging to both sexes were categorized into three groups, 30 patients each as healthy periodontium (Group I), chronic gingivitis (Group II) and generalised chronic periodontitis (Group III). The clinical parameters included assessment of plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL). Gingival crevicular fluid (GCF) and serum samples were collected and the enzyme-linked immunosorbent assay was used to estimate periostin levels. Results Periostin levels in GCF were comparatively low in the chronic periodontitis than in the gingivitis and healthy periodontium groups and the difference was statistically significant. No statistical difference was found for serum periostin levels among Group I, Group II and Group III. On comparison of clinical parameters, significant difference was noticed among the three groups. GCF periostin levels were correlated inversely with the clinical parameters in chronic periodontitis patients. Conclusion GCF periostin levels were gradually reduced with the increase in severity of periodontal disease. This novel biomarker has role in maintaining normal periodontal tissue function and may be used as a potential marker in periodontal disease activity evaluation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Sophia et al.)

Background: Tumor necrosis factor-alpha (TNF-α) is indicated to play a major function in chronic inflammatory disorders., Objective: To assess and compare the cytokine level (TNF-α) in the serum of chronic periodontitis (CP), rheumatoid arthritis (RA), RA with CP, and healthy volunteers., Materials and Methods: This original research was carried out on 80 participants, divided into Group-I 20 RA patients, Group-II 20 CP patients, Group III 20 RA with CP (RA + CP), and Group IV 20 healthy volunteers. Clinical periodontal and rheumatological parameters were assessed in all the four groups. Blood serum samples have been collected from all individuals and investigated for levels of TNF-α by mean of enzyme-linked immunosorbent assay., Results: TNF-α level were remarkably elevated in the RA+CP group (30.5±2.2) followed by RA group (17.9 ± 3.6), and CP group (11.9 ± 0.96) when compared with the controls (5.5 ± 3.3). The results showed a statistical significance of P < 0.001. Correlation was not observed on comparision of clinical periodontal parameters and Rheumatological parameters with TNF-α levels., Conclusion: The outcome of this present research revealed the presence of higher levels of TNF-α in individuals with RA with CP in our samples., Competing Interests: There are no conflicts of interest.

Background: To evaluate and compare the effect of curcumin (CMN) mouth rinse with chlorhexidine (CHX) mouth rinse on clinical parameters and reactive oxygen metabolites (ROM) levels in participants with chronic gingivitis., Materials and Methods: Thirty plaque-induced generalized chronic gingivitis participants were randomly assigned to three groups - Group I (control/saline), Group II (CHX), and Group III (CMN), respectively. Baseline plaque index (PI), gingival index (GI), and salivary ROM were estimated, and oral prophylaxis was done. The parameters were recorded and evaluated again at the end of 4 weeks., Results: Overall, the three groups have shown a significant reduction in PI, GI, and ROM levels at the end of 4 weeks. However, on intragroup comparison, only CMN group have shown significant reduction in ROM levels at the end of 4 weeks ( P < 0.05)., Conclusion: CMN mouth rinse can be considered as an alternative antigingivitis agent to CHX because of its anti-inflammatory and antioxidant properties., Competing Interests: There are no conflicts of interest.

Background: Periodontal disease is not a conventional bacterial infection but is an inflammatory disease initiated by immune response against a group of microorganisms in susceptible hosts. There are many intriguing researches that unfold the secrets of chronic periodontitis. The current researches in chronic periodontitis are directed toward an approach that respects the scientific relationship between the various risk factors, the genetic factors, and the progression of the disease., Aim: This study aims to evaluate the cortisol and reactive oxygen metabolites (ROM) concentration in serum and to find out their association in periodontal health and disease., Materials and Methods: In this study, totally thirty patients have been taken and divided into two groups of chronic periodontitis (Group I) and stress-induced chronic periodontitis (Group II) and evaluated the correlation between the ROM and cortisol levels in them. This is the first study, where both the levels of ROM and cortisol are checked in the serum and saliva. The analysis is done to check the association between them., Statistical Analysis: The data were statistically analyzed using software program (SPSSV 16), Pearson correlation, and paired t -test., Results: Comparison of the mean ROM levels in Group I and Group II showed that mean ROM level in Group II is highly significant than Group I., Conclusion: Our study suggests that stress can have a role in the progression of periodontal disease by increasing the cortisol and ROM levels., Competing Interests: There are no conflicts of interest.

Introduction: Alkaline phosphatase is an intracellular destruction enzyme in the periodontium, and it takes part in the normal turnover of the periodontal ligament, alveolar bone, and root cementum formation and maintenance., Aim: The aim of this case control study was to evaluate the enzyme Alkaline Phosphatase (ALP) level in saliva of post menopausal women with and without chronic periodontitis., Materials and Methods: In this study, 40 individuals, satisfying the study inclusion and exclusion criteria, were recruited. They were categorically divided, on the basis of gingival index, probing pocket depth and clinical attachment level, into two groups: Group I (post menopausal women with a clinically healthy periodontium, n=20); and Group II (post menopausal women with generalized chronic periodontitis, n=20). Clinical parameters assessed were Plaque Index (PI), Gingival Index (GI), Clinical Attachment Level (CAL) and Probing Pocket Depth (PPD). Unstimulated salivary samples were obtained in which the ALP concentration was measured using p-Nitrophenylphosphate, and 2-amino-2-methyl-1-propanol reagents in Beckman and Coulter, AU 480 auto analyser. Mann-Whitney U test was used to find statistical difference with respect to all clinical parameters such as PI, GI, CAL, PPD and salivary ALP levels., Results: The mean ALP in saliva was found to be higher in Group II compared to Group I and the difference was statistically significant with the p-value of 0.008., Conclusion: A noteworthy increase in the ALP concentration was seen in saliva in our study (Group II) may be due to increased periodontal inflammation in post menopausal women. Thus salivary ALP can be taken as an additional biomarker to early diagnosis, development and progression of periodontitis especially among post menopausal women.

Background: Obesity represents the systemic condition capable of influencing the onset and progression of periodontal disease. Obesity is associated with oxidative stress. Plasma level of reactive oxidative metabolites (ROMs) is measured as an indicator of oxidative stress in the body. The aim of this study is to assess and compare the plasma ROM levels in obese subjects with healthy and inflammatory periodontal status., Materials and Methods: Sixty subjects selected were grouped as 15 obese or overweight subjects with generalized chronic periodontitis, 15 obese or overweight subjects with generalized chronic gingivitis, 15 obese or overweight subjects with healthy periodontium, and 15 nonobese and healthy periodontium. The clinical periodontal parameters such as plaque index, gingival index, probing pocket depth, and clinical attachment level were measured. Blood samples were obtained to measure the plasma levels of ROM., Result and Conclusion: In this study, obese subjects with chronic periodontitis (Group I) had mean plasma ROM levels (442.3 ± 15.65 Carratelli unit [CARR U]) showing 100% subjects with high oxidative stress. Obese subjects with chronic gingivitis (Group II) had mean plasma ROM levels (358.7 ± 20.61 CARR U) indicating 86.7% subjects with oxidative stress. Obese subjects with healthy periodontium (Group III) had 46.7% subjects with slight oxidative stress, and the mean ROM level was 320.2 ± 17.57. Nonobese subjects with healthy periodontium (Group IV) had 80% of subjects with normal oxidative stress and the mean plasma ROM level was 296.9 ± 20.35 CARR U. The intra- and inter-group comparison showed significant difference (P < 0.001). From our study, we report that obese subjects with periodontitis have more oxidative stress compared to obese subjects with healthy periodontium.

Periodontitis, is an inflammatory state of the tooth supporting structures and if left untreated, the disease continues to progressive bone destruction and subsequent tooth loss. The increasing prevelance of periodontal disease paved way to the development of new diagnostic tests that could detect the presence of active disease,the course of the disease and its response to treatment. Bone is a metabolically active tissue and undergo continuous remodelling, a process that largely relies on the activity of osteoclasts to remove bone and of osteoblasts to form bone. In health ,bone resorption and formation are coupled to each other and its long term maintenance of skeletal balance is brought about by the systemic hormones and local mediators.In contrasts,during disease there is a pronounced in balance in bone turnover. Bone biomarkers which are produced either in health or in disease state are tell tale markers which would be used to monitor the health status. This review highlights, the recent advances in the use of biomarkers of bone remodelling,that could facilitate the screening, diagnosis and management of periodontal diseases.

Background: Periodontitis involves intricate interactions of the biofilm with the host immunoinflammatory response and subsequent alterations in bone and connective tissue homeostasis. Neopterin is a marker, belonging to the class of pteridines, which is associated with cell-mediated immunity. It is produced by interferon-γ stimulated macrophages. The levels of neopterin in body fluids are elevated in infections, autoimmune diseases, malignancies and allograft rejections. This investigation was designed to estimate the levels of neopterin in gingival crevicular fluid (GCF) in health, chronic gingivitis and chronic periodontitis., Materials and Methods: Thirty subjects were divided into three groups of ten subjects each as with healthy periodontium (Group 1), chronic gingivitis (Group 2) and chronic periodontitis (Group 3). The GCF samples were obtained from the subjects by placing color-coded calibrated, volumetric, micro-capillary pipettes extracrevicularly. The samples were placed in plastic vials and stored at -70°C until the time of neopterin estimation using enzyme immunoassay., Results: The mean neopterin level in Group 3 (126.28 ± 37.70 nmol/L) is significantly higher than the mean neopterin level in Group 1 (48.66 ± 18.82 nmol/L) and Group 2 (70.68 ± 18.26 nmol/L) (P < 0.05). However, there is no significant relationship between neopterin levels and various clinical parameters in each study group (P > 0.05)., Conclusions: The results of our study indicate that the neopterin levels in GCF are positively associated with periodontal disease, which may provide a useful tool in monitoring its progression. Nevertheless, further longitudinal studies are required with larger sample sizes in which neopterin levels are progressively estimated and compared to baseline values.

Objectives: Statins are the group of lipid-lowering drugs commonly used to control cardiovascular and cerebrovascular diseases. Statins have potential anti-inflammatory effect by blocking the intermediate metabolites of the mevalonate pathway. The objective of this study was to evaluate the anti-inflammatory effect of statin medication in chronic periodontitis patients., Materials and Methods: Thirty patients of age group between 40 and 60 years were selected from the outpatient pool of Department of Periodontics, Thaimoogambigai Dental College and Hospital, Chennai. Thirty patients selected were grouped into two groups, Group-I consists of patients with generalized chronic periodontitis and on statin medication and Group-II consists of patients with generalized chronic periodontitis. Clinical parameters were recorded and gingival crevicular fluid (GCF) samples were analyzed for interleukin (IL)-1β using commercially available enzyme-linked immunosorbent assay., Results: The mean GCF IL-1β levels in generalized chronic periodontitis patients who are on statin medication (Group-I) were lower than the generalized chronic periodontitis patients without statin medication (Group-II)., Conclusion: Reduction of GCF IL-1β levels in statin users indicate that statins have anti-inflammatory effect on periodontal disease.

Dentists need to make clinical decisions based on limited scientific evidence. In clinical practice, a clinician must weigh a myriad of evidences every day. The goal of evidence-based dentistry is to help practitioners provide their patients with optimal care. This is achieved by integrating sound research evidence with personal clinical expertise and patient values to determine the best course of treatment. Periodontology has a rich background of research and scholarship. Therefore, efficient use of this wealth of research data needs to be a part of periodontal practice. Evidence-based periodontology aims to facilitate such an approach and it offers a bridge from science to clinical practice. The clinician must integrate the evidence with patient preference, scientific knowledge, and personal experience. Most important, it allows us to care for our patients. Therefore, evidence-based periodontology is a tool to support decision-making and integrating the best evidence available with clinical practice.

Aim: The aim of our study was to isolate H. pylori from dental plaque in gastric and duodenal ulcer patients and compare it with dental plaque of healthy subjects., Materials and Methods: Fifty patients in the age range of 25-50 years who were endoscopically proven cases of duodenal and gastric ulcer were chosen. H. pylorus was isolated from the dental plaque of these patients using culture method and rapid urease test (RUT). It was compared with the dental plaque from control group (25 students). The specificity and sensitivity of RUT was compared with culture method. The oral hygiene index (OHI) score and plaque index were assessed., Results: Ten percent positivity was observed in the study group by culture. Though RUT showed 70% positive isolation it is neither a specific test nor a conclusive test as compared to culture. The result correlates with oral hygiene in study population., Conclusion: Further, more studies are needed to compare RUT and culture, with serology and polymerase chain reactions. The ability to detect H. pylori from dental plaque using these methods offer the potential for the noninvasive test for infection and would aid in support of oral transmission of H. pylori.