Evaluation on the efficacy of processed hydrated and dehydrated amnion chorion membrane on the proliferation of periodontal ligament fibroblasts.

The purpose of the present study was to process and assess the effect of hydrated amnion chorion membrane and dehydrated amnion chorion membrane on proliferation of periodontal ligament (PDL) fibroblast cells. The amnion chorion membrane (ACM) from placenta of 18 systemically healthy patients was obtained from the Department of Obstetrics and Gynaecology. They were processed as hydrated and dehydrated based on different processing methods. The Periodontal ligament cells were obtained from periodontal ligament of freshly extracted premolars of systemically healthy patients, due to orthodontic reasons. The PDL cells were further cultured in laboratory and were exposed to hydrated and dehydrated amnion chorion membrane. The MTT assay was performed to assess the proliferation of PDL fibroblast cells after 24 and 48 h. The hydrated and dehydrated amnion chorion membrane showed proliferation of PDL fibroblasts after 24 and 48 h. The proliferation of PDL fibroblasts in hydrated (p = 0.043) and dehydrated (p = 0.050) amnion chorion membrane was statistically significant at the end of 24 and 48 h respectively. On inter-group comparison dehydrated ACM showed significant proliferation of PDL fibroblasts after 24 (p=0.014) and 48 h (p=0.019). Within the limits of the present study, it can be concluded: both hydrated and dehydrated amnion chorion membrane showed proliferationof PDL fibroblast cells. However, dehydrated ACM showed significant proliferation of PDL fibroblasts.

Comparative evaluation of inhibitory effect of curcumin and doxycycline on matrix metalloproteinase-9 activity in chronic periodontitis.

BACKGROUND AND OBJECTIVES: The pathogenesis of inflammatory periodontal diseases essentially involves degradation of extracellular matrix molecules, and collagen breakdown and matrix metalloproteinases (MMPs) are proteinases primarily involved in this process. It is known that doxycycline downregulates MMP activity. Curcumin has anti-inflammatory effect and also downregulates MMP activity. Thus, a study was conducted to evaluate the anti-inflammatory effect of curcumin by its inhibition of MMP-9 activity and compare the same with doxcycline, which has known anticollagenase activity. SUBJECTS AND METHODS: Gingival tissue samples were obtained from thirty patients diagnosed with chronic periodontitis. The tissue extracts were treated with Curcumin and doxycycline and inhibition of MMP-9 analyzed by gelatinzymography. Gels obtained were stained with Coomassie Brilliant Blue, and enzymatic activities detected as bands of gelatinlysis against blue background. Relative MMP-9 levels were measured by scanning the clear zones and analyzing the percentage inhibition. RESULTS: Results showed that MMP-9 activity was significantly decreased by both the drugs. Curcumin showed 61.01% reduction in the MMP-9 activity at 1500 µg/ml concentration and doxycycline showed 59.58% reduction in the MMP-9 activity at 300 µg/ml concentration. CONCLUSION: The current study showed that curcumin has inhibitory effect on polymorphonuclear leukocyte-type MMP-9 involved in matrix degradation in periodontitis. Since Curcumin has a potent anti-inflammatory effect, it may have therapeutic potential as a host modulation agent in periodontal diseases.

A comparative study of antiplaque and antigingivitis effects of herbal mouthrinse containing tea tree oil, clove, and basil with commercially available essential oil mouthrinse.

BACKGROUND: The relatively safe nature and cost-effectiveness of herbal extracts have led to a resurgent interest in their utility as therapeutic agents. Therefore, this prospective, double-blind, randomly controlled clinical trial was designed to compare the antiplaque and antigingivitis effects of newly formulated mouthrinse containing tea tree oil (TTO), clove, and basil with those of commercially available essential oil (EO) mouthrinse. MATERIALS AND METHODS: Forty patients were selected for a 21-day study period and randomly divided into two groups. The test group patients were given newly formulated herbal mouthrinse and the control group patients were given commercially available EO mouthrinse. The Plaque Index (PI), Gingival Index (GI), and Papillary Marginal Attachment (PMA) Index were recorded at baseline, 14 days, and 21 days. The microbial colony forming units (CFU) were assessed at baseline and 21 days. RESULTS: Test group patients using herbal mouthrinse showed significant improvement in GI (0.16), PI (0.57), and PMA (0.02) scores. These improvements were comparable to those achieved with commercially available EO mouthrinse. However, the aerobic and anaerobic CFU of microbiota were reduced with the herbal mouthrinse (P = 0.0000). CONCLUSION: The newly formulated herbal mouthrinse and commercially available mouthrinse were beneficial clinically as antiplaque and antigingivitis agents. Newly formulated mouthrinses showed significant reduction in microbial CFU at 21 days. So, our findings support the regular use of herbal mouthrinse as an antiplaque, antigingivitis, and antimicrobial rinse for better efficacy.

Periodontal disease as a potential risk factor for low birth weight and reduced maternal haemomglobin levels.

PURPOSE: To investigate the association between maternal periodontal disease and its effect on haemoglobin levels and low birth weight infants. MATERIALS AND METHODS: This observational study included 770 mothers. Data regarding the periodontal status, pregnancy outcome variables, haemoglobin levels (Hb%) and other factors that may contribute to adverse pregnancy outcomes were collected. The data were analysed using the chi-square test and univariate logistic regression analysis. RESULTS: Factors such as literacy (P = 0.002), adverse oral habits (P < 0.001), dental health negligence (P < 0.001), obstetric history (P = 0.001) and Hb% (P < 0.001) showed a significant association with periodontal disease. The study showed only seven mothers had not received antenatal care (ANC), which reflected the awareness of ANC during pregnancy. The reduced haemoglobin levels had an association with the severity of periodontal disease. The univariate logistic regression analysis indicated that mothers with a probing pocket depth (PPD) > 6 mm (OR = 2.21, 95% CI [1.07-4.55], P = 0.032) had a higher risk of giving birth to low birth weight infants. CONCLUSION: Periodontitis significantly influenced low birth weight. The increase in the severity of periodontal disease was associated with an increased rate of pre-term infants. The severity of periodontitis influenced the maternal haemoglobin levels, i.e. more severe peridontitis was associated with lower haemoglobin levels. Severe anaemia and periodontal infection may have an adverse effect on pregnancy and fetal development.

The evaluation of chorionic membrane in guided tissue regeneration for periodontal pocket therapy: a clinical and radiographic study.

Periodontal regenerative therapy is aimed at reconstruction and to restore the architecture and function of lost or injured tissues. Melcher (J Periodontol 47(5):256-260, 1976) introduced the concept of guided tissue regeneration (GTR) for osseous reconstructive surgery. The aim of the present innovative clinical and radiographic study was to evaluate the effect of chorionic membrane (CM) in GTR in periodontal pocket therapy. Ten patients with moderate to severe periodontitis were selected in the single blind randomized controlled clinical trial. Patients were treated with periodontal pocket therapy along with CM in study sites and the control sites were treated with periodontal pocket therapy alone. The clinical parameters were recorded at baseline and 12 months. The radiographic parameters were recorded at baseline, 6 and 12 months. Clinical parameters included gingival index (GI), plaque index (PI), pocket probing depth (PPD) and relative attachment level (RAL). Digital images were analysed for bone gain (BG) and density. Data were evaluated using t test. Statistical significant differences were found in both sites at 12 months for GI, PI, PPD and RAL. Highly significant reduction was seen in GI 0.40 ± 0.08 (p = 0.0001), PI (0.41 ± 0.18), PPD 2.50 ± 0.53 mm (p = 0.0431) and increased BG 0.86 ± 0.18 (p < 0.0001) were observed in study sites. This shows that CM when used with pocket therapy can have influence on clinical parameters. Radiographic findings from this study demonstrated significant BG and density in sites treated with CM as compared to control sites.

Phagocytic activity of peripheral blood and crevicular phagocytes in health and periodontal disease.

BACKGROUND: Neutrophils constitute the main phagocytic cell system in mammalian host defense against an infecting agent. Abnormalities in leukocyte number and function are associated with increased susceptibility to periodontal diseases. The purpose of this study is to evaluate the in vitro phagocytic properties of crevicular and peripheral blood neutrophils in healthy and periodontitis subjects. PATIENTS AND METHODS: A total of 30 subjects, that is, 10 patients in each of the following three groups: healthy controls, chronic periodontitis (CP), and localized aggressive periodontitis (LAP), were included in the study. The neutrophils were isolated from the peripheral blood and gingival crevice and tested for phagocytosis of Candida albicans. The percentage of leukocytes with ingested C. albicans was determined by light microscopy. RESULTS: A significant reduction in the phagocytic activity of crevicular fluid polymorphonuclear neutrophils (CF-PMN) of LAP subjects (mean: 54.3±7)(P<0.001) was observed, compared to healthy controls (mean: 74.2±9) and chronic periodontitis subjects (mean: 69±9)(P=0.352). The mean percentage of peripheral blood polymorphonuclear neutrophils (PMNs) with phagocytosis of opsonized C. albicans in LAP patients was significantly reduced (mean: 74.9±5)(P<0.0068) compared to the phagocytic activity of neutrophils from controls (mean:82.1±3) and chronic periodontitis subjects (mean: 82.0±5)(P=0.970). There was no significant reduction in the phagocytic activity of CF PMNs (mean: 69±9) (P=0.35) and peripheral blood PMNs (mean: 82.5)(P=0.97) in the chronic periodontitis group when compared to the control group. CONCLUSION: The phagocytic activity of both crevicular and peripheral neutrophils in subjects with periodontitis is altered, increasing the susceptibility to periodontitis. Thus individual susceptibility may be an additional and important modifying factor in the pathogenesis of periodontal disease.

A clinical and radiological evaluation of DFDBA with amniotic membrane versus bovine derived xenograft with amniotic membrane in human periodontal grade II furcation defects.

The purpose of the present study was to clinically and radiographically evaluate and compare the efficacy of demineralized freeze dried bone allograft (DFDBA) and bovine derived xenogenic bone graft (BDX) [Bio-Oss] with amniotic membrane (AM) as guided tissue regeneration (GTR) in the treatment of human periodontal Grade II buccal furcation defects. Ten patients suffering from chronic periodontitis, displaying bilateral Grade II buccal furcation defect, were randomly treated using DFDBA with AM (Experimental site A) or using bovine derived xenograft (BDX) with AM (Experimental site B). The clinical and radiographic parameters were recorded at baseline, 6 and 9 months. Healing was uneventful in all patients except one site which was treated with BDX + AM. At 9 months after therapy, soft tissue measurements for the DFDBA + AM group showed pocket depth (PD) reduction of 4.7 mm +/- 0.58, and relative attachment level gain of 4.8 mm + 0.32, while the BDX + AM group showed a PD reduction of 4.4 mm +/- 0.27, and AL gain of 5.1 mm +/- 0.09. Osseous measurements showed bone fill of 2.1 mm +/- 0.36 for the DFDBA + AM group and 2.43 mm +/- 0.38 for the BDX + AM group. Percentage gain in bone was 76.3% for the DFDBA + AM group and 79.6% for the BDX + AM group. Statistical analysis revealed there was no statistical difference between the two materials in all measurements. Within the limits of the present study, it can be concluded that: (1) at 9 months after surgery both therapies resulted in significant PD reductions and CAL gains and (2) significant improvement was seen in bone fill and percentage gain with both the material, however, there was no significant difference between both.

Partial expression of Papillon-Lefèvre Syndrome.

Papillon- Lefèvre Syndrome (PLS) is a rare autosomal recessive trait, which is transmitted with an estimated frequency of one to four per million individuals. It is characterized by palmar plantar keratosis and severe early-onset periodontitis affecting both deciduous and permanent dentition. In this report, we present clinical, microbiological and leukocyte function test findings of a thirty-five year-old patient with symptoms typical of Papillon-Lefèvre Syndrome except for premature loss of deciduous and permanent dentition. The patient exhibited palmar plantar keratosis and an isolated, moderately deep periodontal pocket in the third quadrant. No anaerobic bacteria were isolated from the plaque culture. The neutrophil function test revealed defective chemotaxis and phagocytosis while intracellular killing and respiratory burst were normal.