Effective and Affordable Method of Screening for Diabetes Mellitus Using Gingival Crevicular Blood

The increasing prevalence of obesity and physical inactivity due to population growth, aging, urbanization has prompted the rise in the incidence of diabetes mellitus (DM). Diabetes has emerged as a major healthcare problem in India. About half of the diabetic patients are undiagnosed, as diabetes mellitus is asymptomatic in its early stages. Diabetes and periodontitis interact in a bidirectional manner. Therefore, there is a need to screen patients for diabetes in dental clinics. Glucometers are reliable, rapid, and commonly used for blood glucose determination in diabetes screening. Routine oral examination of patients with periodontal inflammation with or without diabetes produce ample bleeding, which can be used in glucometers for screening DM. Therefore, the main aim of this study is to assess if gingival crevicular blood (GCB) is as efficient as capillary finger prick technique in estimating the glycemic status. Methods: A total of 48 patients participated in the clinical study. All of them were seeking dental check-up or treatment at Department of Periodontology, Government Dental College, Jammu. Probing was done until a sufficient amount of blood appeared in the gingival crevice. Accu -Check Instant S Meter, Roche Diabetes Care India Pvt Ltd. Results: The Gingival crevicular blood(GCB), Capillary finger prick blood (CFB) glucose value ranged between 82 and 299 mg/dl with mean value being 145.25±38.12 and the CFB glucose value ranged between 83 and 289 with a mean value of 138.88±51.243. Pearson’s correlation coefficient showed a positive correla¬tion between GCB and CFB. Conclusion: It is be concluded that GCB may serve as a potential source for screening of blood glucose during routine periodontal examination in populations with an unknown history of DM. Thus, with minimal cost and time investment dental professionals can play a critical role in diagnosis of DM.

Association between Chronic Periodontitis and Serum Lipid Levels

Hyperlipidemia is a known risk factor for cardiovascular diseases. A common biologic mechanism between systemic diseases, such as cardiovascular diseases, and periodontal diseases has been suggested. The aim of this study is to examine the association between blood lipid profile and periodontitis. Aim: To study the correlation between serum lipid profile and periodontitis. Methods: The levels of serum lipid profile in 60 subjects, 30 with chronic generalized periodontitis based on clinical attachment loss (CAL) constituting the test group and 30 without periodontitis constituting the control group, were measured and compared with each other. Both these groups were free from other systemic illnesses. Statistical Analysis: The mean CAL was positively correlated with serum low-density lipoprotein (LDL) cholesterol (P < 0.01). Results: The mean serum LDL cholesterol (126.62) and total cholesterol (173.32) in periodontitis patients were found to be significantly higher as compared to that of the controls. The mean CAL (5.32 mm) was positively correlated with serum LDL cholesterol. The frequency of persons with pathologic values of LDL cholesterol and total cholesterol was significantly higher in periodontitis patients compared with that of the controls. Conclusion: These results showed that high serum LDL cholesterol and total cholesterol may be associated with periodontitis in otherwise healthy people. However, it is unclear whether periodontitis causes an increase in the levels of serum LDL.

Long†term results after treatment of periodontitis in patients with Papillon Lefevre syndrome with or without antibiotics a comparative study

Aim: Evaluation of periodontal status in patients with Papillon–Lefèvre syndrome (PLS) observed for ≥5 years, Treatment of patients of PLS with SRP and maintenance for a period of ≥5 years, Comparing the effects of treatment of periodontitis in (PLS) patients with SRP (scaling and root planning) as a monotherapy with antibiotics as an adjunct. Materials and methods: All subject showing signs and symptoms of PLS, were selected for this study comprising of both the sexes, visiting outpatient Department of Periodontology, Govt. Dental College and Hospital Srinagar. Eight patients (aged 5-12 years) from five families (three pairs of siblings) were included. Subjects were randomly distributed into two groups 4 patients each. Control group- Group A given SRP + Placebo and Treatment group- Group B given SRP + 250 mg of amoxicillin TDS and 125 clavulanate for 14 days and metronidazole 250 mg BD for 14 days . Results: In this study by comprehensive maintenance therapy in both the groups we delay the loss of dentition of the patients of PLS. The use of antibiotics had proven to show a statistically significant difference in retaining the teeth of PLS. Patients compared to the control. Conclusion: PLS patients, periodontitis may be arrested by combined mechanical and antibiotic periodontal treatment; extraction of severely diseased teeth; oral hygiene instructions; intensive maintenance therapy; and microbiological monitoring and treatment of the infection with Aggregatibacter actinomycetemcomitans.

Comparison of tooth brushing with traditional miswak in maintenance of oral hygiene

Background: Chewing sticks were used throughout the ancient times many communities till date. Many people in today’s modern days still have maintained this practice of oral hygiene due to reasons like cost, customs and religious reasons and accessibility. The miswak, obtained from the twigs of the Salvadora persica tree, may be beneficial due to its mechanical cleaning. The aim of the present study was to compare the oral hygiene status and gingival conditions following the use of conventional tooth brushing and miswak over a period 100 days. Materials and methods: The study was conducted in a madrasa in outskirts of Jammu and Kashmir. Out of the total 154 subjects, a total of 148 subjects who were voluntarily willing to participate in the study were selected. Out of these subjects 72 subjects were using miswak (Group I), 76 subjects were using tooth brush and tooth paste (Group II) as an oral hygiene aid. All of these subjects were evaluated for Gingival and Plaque status on 50th and 100th day following oral prophylaxis. Results: Both Group I showed a significant difference (p≤0.05), at 50th and 100th day in their mean plaque scores. The mean gingival scores recorded for subjects using only miswak and those subjects using both miswak as well as tooth brush and tooth paste increased from 50th day to 100th day and showed a statistical difference between the two means in group I. Conclusion: The results of the present study suggest that miswak can be used as an effective adjunct for oral hygiene maintenance along with toothbrush and tooth paste as it is readily available and inexpensive.

Using of BANA-Enzymatic™ test kit to detect periodontal heath of patients with generalised chronic periodontitis before and after scaling and root planing – A randomized control study

Background: Clinical improvements after SRP are associated with microbiological changes that include a decrease in microbial load and a mean percentage change of certain periodontal pathogens, such as Treponema denticola, Porphyromonas gingivalis and Tarnella forsythus. These species are gram negative anaerobes which possess, in vivo an enzyme capable of hydrolyzing synthetic trypsin substrate, BANA (N-Benzoyl D-L Arginine -2 Naphalamide). BANA a colorless substrate, it releases β- naphthylamide, which turns orange red when a drop of fast garnet is added to the solution. Several Bacteroides and Capnocytophaga species were occasionally BANA positive, only when in large CFU‟s. Loesche proposed the use of this BANA reaction in subgingival plaque samples to detect the presence of any of these periodontal pathogens and thus serve as a marker of disease activity. Aim and objective:The aim and objective of this study was to detect the presence of BANA microorganisms and also to determine the effect of scaling and root planning in adult periodontitis patients. Materials and Methods: 30 Subjects randomly selected comprising of both the sexes, visiting outpatient department of Periodontology, Govt. Dental College and Hospital Srinagar, were considered for the present clinical study after meeting inclusion and exclusion criteria. Subjects were randomly assigned into two groups:- 15 Subjects in Control Group (Group A ) and 15 Subjects in Abhima Kumar, Prabhati Gupta, Rashida. Using of BANA-Enzymatic™ test kit to detect periodontal heath of patients with generalised chronic periodontitis before and after scaling and root planing – A randomized control study. IAIM, 2019; 6(4): 100-106. Page 101 Treatment Group (Group B ) i.e. The Control group- Group A Treatment group- Group B Four test sites were selected from each patient and assessed for plaque index, bleeding index and pocket depth and attachment loss before and after scaling and root planning. BANA test was used for the detection and prevalence of the “red complex” bacteria in plaque samples. Results: The BANA tests are statistically correlated with the severity of periodontal destruction. There was a statistically significant correlation between the BANA test results and the parameters used to test the periodontal heath. Conclusion: This study encourages the use of BANA as chair-side tests for a proper diagnosis of periodontal condition. It also gives a picture of microbiological flora of the plaque.

Effects Of Scaling And Root Planing And 0.2 % Chlorhexidine Rinse On Clinical And Microbiological Parameters In Generalised Chronic Periodontitis– A Clinico - Microbiological Study

Background: Periodontitis is result of cumulative exposure of dental plaque, thus the main aim of periodontal therapy is the prevention of plaque accumulation and maintain periodontal health. The clinical effect of scaling and root-planning (SRP) are well documented .Antimicrobial agents act as an adjunct to periodontal therapy. One of the most frequently used antimicrobial agents is chlorhexidine gluconate (CHX), it is a broad spectrum antiseptic with a pronounced antimicrobial effect Clinical improvements after SRP are associated with microbiological changes that include a decrease in microbial load and a mean percentage change of certain periodontal pathogens , such as Treponema denticola, Porphyromonas gingivalis and Tarnella forsythus. These species are gram negative anaerobes which possess, an enzyme capable of hydrolyzing synthetic trypsin substrate, BANA. Methods: This study included 30 individuals who were randomly distributed in two groups test (SRP + CHX) and control (SRP) Results: The results of the study stated that the treatment with SRP and CHX improved clinical and microbiological parameters compared to the SRP alone as a monotherapy. Conclusion: CHX rinsing and repeated professional plaque removal could have equivalent therapeutic benefits, the use of CHX offers the great advantage of not requiring the patient’s presence in the dental office

Effectiveness of Hydrogen Peroxide as a sub gingival irrigant – A clinical study

Introduction: Periodontitis a chronic inflammatory disease results in the destruction of tooth supporting tissues, eventually progresses to tooth loss. Non-surgical periodontal therapy in form of scaling and root planning although considered as a gold standard, does not completely eradicate periodontal pathogens. Limitation of access and bacterial invasion of periodontal tissues being the main reason and hence the demand for an adjunctive measure is necessitated. Sub gingival irrigation interferes with various plaque components predominantly anaerobic bacterial flora which is known to initiate and perpetuate periodontal destruction. The aim of this study is to investigate the effect of sub gingival irrigation with 3% H2O2 compared to normal saline. Material and methods: 20 patients were taken for the study. After scaling and root planing, quadrants in each patient’s mouth were randomly treated two with 20 ml 3% H2O2 sub gingival irrigation and the other two with normal saline. Sub gingival irrigation was performed at baseline and after 1 and 2 weeks. The clinical parameters were recorded at baseline at the end of week 3 and at the end of week 5. Results: Results showed that sub gingival irrigation with 3% H2O2 produced a significant reduction in gingival bleeding, pocket depths and a significant gain in clinical attachment level compared to the control. Tahira Ashraf, Suhail Majid Jan, Roobal Behal, Rafiya Nazir, Abhima Kumar. Effectiveness of Hydrogen Peroxide as a sub gingival irrigant - A clinical study. IAIM, 2017; 4(11): 177-181. Page 178 Conclusion: The results of the present study conclude that that sub gingival irrigation with 3% H2O2 results in inflammation control manifested as decreased gingival bleeding, reduction in pocket depth and gain in relative attachment levels.

Papillon lefevre A rare syndrome

Papillon lefevre syndrome (PLS) belongs to a heterogeneous group of skin diseases that are characterized by hyperkeratosis of palms and soles and presence of severe and early onset periodontitis. Genetic studies have shown that mutation in the major gene locus of chromosome 11q14 with the loss of function of cathepsin C (CTSC) gene is responsible for PLS. Loss of CTSC function is responsible for the severe periodontal destruction seen clinically. This report represents classical signs and symptoms of PLS in a 6 year old girl.