Effect of low intensity ultra sound on bone regeneration and healing: a systematic review

ABSTRACT Objective: Low Intensity Pulsed Ultra Sound (LIPUS) is found to have stimulatory effect on bone healing and regeneration. This review aimed to assess whether LIPUS enhances bone regeneration and healing in terms of efficiency in improving clinical, radiographic, histologic parameters or serum and tissue biomarkers. Methods: A comprehensive search based on PRISMA guidelines with pre-determined eligibility criteria was conducted to identify randomized controlled clinical trials evaluating effectiveness of Low intensity pulsed ultrasound in bone regeneration and healing. The title and abstract of the entries in all languages yielded from the PubMed, Google scholar and Cochrane library were screened. Results: 14 eligible Randomized controlled trials testing the effectiveness of LIPUS was evaluated. More heterogeneity was seen in the screened studies with respect to sample characteristics, type of bone and outcome measures. The studies that screened histological parameters state that LIPUS is significantly beneficial than control. In terms of time for radiographic union, most of the studies stated that LIPUS was more effective than control but numberof studies are very few. Whereas studies which evaluated parameters such as healing time and radiographic union were showing highly inconsistent results regarding effectiveness of LIPUS. Conclusion: This review cannot give a definitive conclusion that LIPUS is effective in bone healing with respect to clinical parameters but a positive influence on radiographical and histological parameters in bone healing and regeneration is promising to pursue future research.

Periodontal vaccines: a systematic review / Vacinas periodontais: uma revisão sistemática

Background: vaccination is the best known application of immunology to human health. Effective vaccines have successfully eradicated the prevalence of several infectious diseases that were common less than a generation ago. The success of Periodontal vaccines is still elusive due to the complexity of periodontal pathogens that have multiple serotypes. No periodontal vaccine trials have satisfied all the requirements such as preventing colonization of pathogens, protection against tissue destruction and alveolar bone loss, elicit immunoglobulins for phagocytosis, stimulation of T-helper cells. This review aims to discuss the various immunization strategies attempted so far. Objective: this review aims to discuss the various in-vitro and in vivo studies that present supporting evidence for the feasibility of formulating a prophylactic periodontal vaccine that could emerge as an adjunct to mechanical therapy in the future. Material and Methods: an extensive literature Search was performed in electronic databases, such as PUBMED, Cochrane central register of controlled trials, Google scholar and science direct using various search terms such as " periodontal vaccines", " porphyromonas gingivalis", "chronic periodontitis", " genomic vaccine ", " recombinant vaccine", "immune response", " vaccination against periodontal bacteria". No limits and language restriction were applied during the electronic search to include all the possible animal studies, clinical trials in the potential relevant article search phase of the systematic review. Conclusion: Studies evaluating Porphyromonas gingivalis are the most common and the structures showing the most potential as a vaccine candidate are Outer membrane proteins, fimbriae and gingipains, the structure having the least potential is Lipopolysaccharide. (AU)

Fundamentação: a vacinação é a aplicação mais conhecida da imunologia à saúde humana. As vacinas eficazes erradicaram com sucesso a prevalência de várias doenças infecciosas que eram comuns há menos de uma geração atrás. O sucesso das vacinas periodontais ainda é ilusório devido à complexidade de patógenos periodontais que possuem múltiplos sorotipos. Nenhum estudo de vacina periodontal atendeu a todos os requisitos, como prevenção da colonização de patógenos, proteção contra destruição de tecidos e perda óssea alveolar, estimulação de imunoglobulinas para fagocitose, estimulação de células T auxiliares. Esta revisão tem como objetivo discutir as várias estratégias de imunização tentadas até o momento. Objetivo: esta revisão tem como objetivo discutir os vários estudos in vitro e in vivo que apresentam evidências de apoio à viabilidade de formular uma vacina periodontal profilática que possa emergir como um complemento da terapia mecânica no futuro. Material e Métodos: Foi realizada uma extensa pesquisa bibliográfica em bancos de dados eletrônicos, como PUBMED, registro central de ensaios controlados Cochrane, Google Acadêmico e science direct, usando vários termos de pesquisa como "vacinas periodontais", "porphyromonas gingivalis", "periodontite crônica" , "Vacina genômica", "vacina recombinante", "resposta imune", "vacinação contra bactérias periodontais". Nenhum limite e restrição de idioma foi aplicado durante a busca eletrônica para incluir todos os possíveis estudos em animais e ensaios clínicos na fase de busca de artigos potencialmente relevantes da revisão sistemática. Conclusão: Estudos avaliando Porphyromonas gingivalis são os mais comuns e as estruturas que mostram maior potencial como candidato a vacina são proteínas de membrana externa, fímbrias e gengivinas, a estrutura com o menor potencial é lipopolissacarídeo.(AU)

Role of endothelin‑1 in periodontal diseases: A structured review.

Background and Objective: Endothelin‑1 (ET‑1) is a 21‑amino acid peptide and is a potent vasoconstrictor produced by endothelial cells. It plays a role in the development of diseases such as hypertension and atherosclerosis. Previous studies have identified ET‑1 in gingival tissues obtained from patients affected by chronic periodontitis or gingival overgrowth. Thus, there is a need to appraise the role of ET‑1 in periodontal disease. Materials and Methods: The electronic search strategy included the databases such as PubMed, PubMed Central, LILACS, MEDLINE, ScienceDirect, MeSH, Cochrane database of systematic reviews, and EMBASE databases. Hand search of relevant journals was also carried out until September 2013. The included studies were both cross‑sectional and longitudinal performed in vivo/in vitro, which measures the expression of ET‑1 from various cells of the periodontium and in periodontal disease. Further, studies assessing the factors which influence ET‑1 expression were included in the study. Results: A total of 15 articles were found relevant and fulfilled the inclusion criteria posed in this review. Ten studies discussed the concentration of ET‑1 in periodontal disease, whereas eight studies investigated the cells expressing ET‑1. Nine studies assessed the factors influencing ET‑1 expression and two studies evaluated the influence of ET‑1 on inflammatory mediators and other cytokines. The results suggested that ET‑1 is elevated in periodontal diseases and is influenced by inflammatory cytokines and periodontal pathogens. Conclusion: ET‑1 was found to have a role in periodontal disease, but further research will be required to substantiate its use as a biomarker.

Ocular clinical profile of patients with pseudoexfoliation syndrome in a Tertiary Eye Care Center in South India

To study the clinical profile of pseudoexfoliation [PEX] syndrome in a hospital setting. A case series of patients with PEX, with and without glaucoma attending the general ophthalmology clinic of a tertiary care center in South India. All patients underwent a complete ophthalmologic evaluation including recording diurnal variation of tension [DVT], gonioscopy and visual field assessment. The study cohort comprised 529 patients [752 eyes]. There were 296 [56%] females. The highest number of patients [261 patients] was from the age group between 60 and 69 years. Of 752 eyes, 57.8% eyes had unilateral PEX and 72% had established PEX. Gonioscopy showed open angles in 98.1% of eyes. Intraocular pressure [IOP] greater than 21 mmHg in at least 1 of 4 measurements was recorded in 5.7% eyes. DVT was normal in 96.4% of unilateral PEX eyes, similar to fellow non-PEX eyes. Pseudoexfoliation glaucoma occurred in 1.9% of eyes and 4.7% of eyes were glaucoma suspects. There was no correlation between the stage of PEX and increased IOP. Mean central corneal thickness of PEX eyes was 522 +/- 27æ. Pupillary dilatation in 90.5% eyes with early PEX was=7 mm. Conclusions: A small percentage of PEX eyes had raised IOP, and the number of eyes with glaucomatous optic neuropathy was even lower. PEX eyes did not demonstrate wide fluctuations in IOP. No correlation was found between raised IOP and stage of PEX. There was good pupillary dilatation in early stage PEX eyes suggesting that all PEX eyes may not have poor pupillary dilatation and related complications

Missed diagnosis of a wooden intra-orbital foreign body.

Intraorbital foreign bodies often present a confusing clinical picture. Wooden foreign bodies are notorious for remaining quiescent for a long time, before presenting with a variety of complications. The wound of entry may often be small and self-sealing. Wooden foreign bodies also show a propensity to break during attempted removal. Intraorbital wood is often not detected by standard diagnostic tests like the computed tomography scan, adding to the diagnostic dilemma. The presence of an intraorbital mass with a discharging sinus should evoke suspicion of a retained organic foreign body, regardless of the time interval between the trauma and current presentation. It is imperative to maintain a high index of suspicion in such cases to avoid misdiagnosis. We report an unusual case of a missed wooden intraorbital foreign body, which spontaneously extruded after five years.

Bilateral choroidal metastasis from carcinoma of the submandibular gland.

Metastatic tumor is the most common uveal malignancy. However, choroidal metastasis from a salivary gland neoplasm is extremely rare. We report a case of bilateral, multifocal choroidal metastasis from carcinoma of the submandibular gland.