Comparative evaluation of diffused calcium and hydroxyl ion release from three different Indirect pulp capping agents in permanent teeth - An in vitro study.

BACKGROUND: Indirect pulp capping therapy has gained increased popularity in paediatric dentistry since it is less invasive, and is of low cost. The aim of the present study was to evaluate and to compare the diffusion of calcium (Ca2+) and hydroxyl (OH-) ions through coronal dentin into pulp after indirect pulp capping in vitro using TheraCal LC, ProRoot MTA and Calcimol LC. MATERIALS AND METHODS: Total of 60 human caries-free maxillary first premolars were selected for the study. Samples were divided into 4 groups with 15 in each group: Group 1 TheraCal LC; Group 2 ProRoot MTA; Group 3 Calcimol LC; Group 4 Control Group. Indirect pulpcapping on the coronal RDT (remaining dentine thickness) system was performed using pulp-capping materials, such as TheraCal LC, ProRoot MTA and Calcimol LC, on the respective samples. The control group was completely filled with composite. Ca2+ ions (ppm) and OH- ions (pH) were analysed in deionized water using a multimeter connected to a calcium probe (calcium ion electrode) and pH metre connected to a temperature-compensated pH probe after 3 h, 24 h, 7 days, 14 days, 28 days and 60 days. RESULTS: Calcium release was significantly higher (P < 0.05) in the TheraCal LC group than in the other groups. Slightly alkaline pH values were observed in all the groups except for the control. CONCLUSION: TheraCal is a new light-curable pulp capping material that initially releases high Ca2+ ions and creates an environmental pH close to physiological pH after 60 days.

Noninvasive Technique for Estimating Blood Glucose Levels among Diabetic Patients.

AIM: The present study was aimed to assess the fasting and postprandial gingival crevicular blood (GCB) glucose and finger stick blood glucose measurements using a glucometer. MATERIALS AND METHODS: A total of 30 subjects with periodontitis and positive bleeding on probing were considered. Subjects were instructed to report to the department after overnight fasting. Gingival crevicular blood samples were collected from anterior region showing bleeding on probing followed by finger stick blood sample collection. Then, the patients were instructed to take 75 gm of glucose and after 2 hours blood samples from two sites were collected similarly. Results were analyzed using unpaired t test and Pearson's correlation. RESULTS: Mean glucose levels form GCB and finger stick blood did not differ either during fasting or postprandial (p > 0.05). Significant correlation was found between GCB glucose levels and capillary finger stick blood (CFB) glucose levels during fasting (r = 0.946, p < 0.001) and postprandial (r=0.930, p < 0.001) blood estimation. CONCLUSION: Periodontal probing can be considered as an alternate noninvasive method of blood glucose estimation for screening of diabetes mellitus (DM). The technique described is safe, easy to perform, and helps to increase the frequency of diabetes screening in dental office. CLINICAL SIGNIFICANCE: The GCB from probing can be a good source of blood for estimating blood glucose levels and screening for diabetes using portable glucose monitors. Also, it will be a simple and relatively inexpensive in office screening procedure for any patient suspected to have diabetes.

Assessment of Systemic Inflammatory Markers in Patients with Aggressive Periodontitis.

BACKGROUND: "Aggressive periodontitis (AgP) is a destructive disease characterized by the following: The involvement of multiple teeth with a distinctive pattern of periodontal tissue loss; a high rate of disease progression; an early age of onset; and the absence of systemic diseases.'' Chronic low-level bacteremia and systemic inflammatory response have been suggested as a pathogenic link between periodontal disease and systemic disease. The present study was aimed to assess the levels of systemic inflammatory markers in patients with AgP. METHODS: A sample of 50 systemically healthy patients comprised two groups, based on full mouth periodontal examination: Group I healthy individuals, includes 25 periodontally healthy subjects with fully functioning dentition. Group II includes 25 patients diagnosed clinically as AgP. Laboratory blood investigation included white blood cell (WBC) count, neutrophil count, lymphocyte count, and platelet count. Serum protein parameters included total protein (TP), albumin (ALB), and globulin (GLB). Periodontal clinical parameters including plaque index, gingival index, probing pocket depth, and clinical attachment level were recorded. RESULTS: Data analysis shows an increase in WBC, neutrophil, lymphocyte, and platelet count and a decrease in TP, ALB, and GLB in AgP patients when compared to healthy individuals. CONCLUSION: Results of the present study shows an increase in blood parameters and decrease in serum protein parameters in AgP. Hence, AgP could be considered as one of the risk factors associated with the cardiovascular diseases as assessed by changes in the level of systemic inflammatory markers observed.

Estimation of Specific Salivary Enzymatic Biomarkers in Individuals with Gingivitis and Chronic Periodontitis: A Clinical and Biochemical Study.

BACKGROUND: Host response to periodontal disease includes the release of different enzymes from stromal, epithelial or inflammatory cells. The enzymes which are produced from these cells are associated with cell injury and cell death like: Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP) and Blood urea nitrogen (BUN). Normal enzymatic activity of these enzymes is necessary for healthy functioning of gingiva and periodontium. The aim of the study is to estimate the levels of enzymes AST, ALT, ALP and BUN and to correlate the level of estimated enzymes with that of clinical parameters in the saliva of Healthy subjects, Gingivitis patients and patients with chronic periodontitis. METHODS: The study included a total of 40 male subjects within the age group of 21 to 50 years, and examined the activity of enzymes AST, ALT, ALP and BUN in saliva spectrophotometrically and compared their values between healthy subjects, gingivitis and chronic periodontitis patients. Clinical parameters like OHI - S (Oral hygiene index - Simplified, SBI (Sulcus Bleeding Index), PPD (Probing Pocket Depth), CAL (Clinical Attachment Level), and PI (Periodontal Index) were recorded. RESULTS: Obtained results showed statistically significant increases of activity of AST, ALT, ALP, and BUN in saliva from patients with periodontal disease (p<0.001) in relation to gingivitis and control groups. There was also an increase in periodontal parameters with an increase in salivary enzymes. CONCLUSION: The present study shows that the salivary enzyme activity can be used as biomarkers to determine periodontal tissue damage, which may be useful in diagnosis, prognosis and evaluation of post therapy effects in periodontal disease.

Effect of Neem containing Toothpaste on Plaque and Gingivitis--A Randomized Double Blind Clinical Trial.

AIM: The present study was designed to assess the effect of toothpaste containing neem on plaque and gingivitis. MATERIALS AND METHODS: Randomized, double blind clinical trial was designed. Thirty first year dental students volunteered to participate in the study. Neem containing tooth paste was used as an intervention. Clinical examination was carried out using Silness and Loe plaque index (PI) and Loe and Silness gingival index (GI). Independent t-test and paired t-test was used for the intergroup and the intragroup comparison. RESULTS: Out of 30 participants, 22 (73.3%) were females and eight (26.7%) were males. A statistically significant difference was found between the test and control group after intervention with respect to the PI and GI. CONCLUSION: Neem containing toothpaste can be used as an adjunct for maintenance of oral hygiene. CLINICAL SIGNIFICANCE: Regular brushing with neem toothpaste might act as an adjunct to maintenance of good oral hygiene, and thus improve oral health.