Evaluation of interleukin-1beta and 8 in gutka chewers with periodontitis among a rural Indian population

PURPOSE: Smokeless tobacco-based oral-use products like gutka are popular in India. Gutka usage leads to increased periodontal destruction and inflammation; however, the relevant mechanism remains unknown. This study aimed to elucidate the role of gutka in periodontitis by examining its effect on the levels of interleukin (IL) 1beta and IL-8 from the gingival crevicular fluid (GCF). METHODS: A total of 45 patients were enrolled in this study. Thirty patients with periodontitis (15 gutka chewers [GCP] and 15 nongutka chewers [NGC]) and 15 periodontally healthy controls (HC) were selected. The full-mouth plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and recession (RC) were recorded. The IL-1beta and IL-8 levels in the GCF of all subjects were assessed through an enzyme-linked immunosorbent assay (Quantikine). RESULTS: The IL-1beta and IL-8 levels were not significantly higher in the GCP group (IL-1beta, 369.01+/-273.44 microL; IL-8, 205.97+/-196.78 microL) as compared to those in the NGC group (IL-1beta, 195.57+/-96.85 microL; IL-8, 178.61+/-149.35 microL). More gingival RC and loss of attachment was seen among the GCP group (RC: 2.02+/-0.31, P=0.013; CAL: 4.60+/-0.56, P<0.001) than among the NGC group (RC, 1.21+/-1.15; CAL, 3.70+/-0.32); however, PD was deeper among the NGC subjects (P=0.002). PI and GI were significantly higher for the periodontitis group (P<0.001) when compared to the HC, but there was no difference among gutka chewers and non-chewers (P=0.22 and P=0.89). A positive correlation was found between the IL-8 levels and the duration of gutka chewing (r=-0.64, P<0.01). CONCLUSIONS: Gutka chewing leads to increased gingival RC and clinical loss of attachment. There was no effect seen in the proinflammatory cytokine levels in the GCF of gutka users.

Periodontitis among poor rural Indian mothers increases the risk of low birth weight babies: a hospital-based case control study

PURPOSE: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. METHODS: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing or =2,500 g. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. RESULTS: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). CONCLUSIONS: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.

Commentary on "Relationship between maternal periodontal disease and Apgar score of newborns"

No abstract available.

Fibrin sealant as an alternative for sutures in periodontal surgery

The trial compared wound healing clinically, histologically and morphometrically after the use of fibrin sealant and sutures for periodontal flap closure. Ten patients were selected for this split-mouth randomized controlled clinical trial. On the test site fibrin sealant [F] was applied for flap closure after periodontal flap surgery [n = 10] and on the control site sutures [S] were used [n = 10]. Clinically wound healing was observed at 7, 14 and 21 days and biopsy was taken on the 8th day. At seventh day better healing was observed in fibrin sealant site. Histologically mature epithelium and connective tissue formation was seen in fibrin sealant site with increased density of fibroblasts [F = 70.45 +/- 7.22; S = 42.95 +/- 4.34, p < 0.001] and mature collagen fibers. The suture site had more number of inflammatory cells [S = 32.58 +/- 4.29; F = 20.91 +/- 4.46, p < 0.001] and more number of blood vessels [S = 11.89 +/- 3.64; F = 5.74 +/- 2.41, p = 0.005]. Fibrin sealant can form a better alternative to sutures for periodontal flap surgery