Epidemiology of non-communicable diseases among transgender population residing in Chennai district, Tamil Nadu.

Introduction: There is a paucity of research on non-communicable diseases (NCDs) like diabetes, hypertension and coronary heart diseases among transgenders, with more importance given to diseases like HIV. The study was undertaken to determine the prevalence of NCDs, their risk factors and the associated factors among transgenders residing in Chennai district, Tamil Nadu. Methodology: This is a descriptive cross-sectional study done among 145 transgenders residing in the Chennai district, Tamil Nadu, selected by snowball sampling method. Data were collected by a pre-tested semi-structured questionnaire, anthropometric data were measured, and blood pressure was measured by a mercury sphygmomanometer using standard protocols. Data were entered in Excel software and analysed by using SPSS version 25. Results: The mean age of the study participants was 36 ± 4.2 years. Nearly 91% had only up to school education. Around 26.7% suffered from type 2 diabetes mellitus, 15.1% had a history of hypertension, 36.3% were newly diagnosed hypertensives, and 13.9% were overweight/obese. Almost 40% were either current tobacco or alcohol consumers. There was a statistically significant association found between overweight/obesity and education, work, and income of study participants. Conclusion: The high prevalence of NCDs among the study participants warrants health education among transgenders to get screened for common NCDs. Further research is needed to understand the risks of NCDs among transgenders.

Treasure from trash - Is Ecoenzyme the new panacea in conservative dentistry and endodontics?

Context: Endodontic biofilm eradication is achieved by chemo-mechanical disinfection. The search for a safer, nontoxic irrigant led us to a natural product, Ecoenzyme. Aim: This study aims to analyze Ecoenzyme (EE) and explore its antimicrobial and biofilm disrupting activity against a 1-week mature multi-species biofilm. Materials and Methods: Qualitative assessment of the phytochemicals present in EE was conducted. Minimal inhibitory concentration (MIC), minimum bactericidal concentration, and zone of inhibition (ZOI) were recorded. Multi-species biofilm of Streptococcus mutans (MTCC 497), Lactobacillus acidophilus (MTCC 10307), and Enterococcus faecalis (ATCC 29212) was grown and time-kill assay was performed to test biofilm disruption for EE, 3.5% sodium hypochlorite (NaOCl) (control). Student's t-test and one-way ANOVA with post hoc analysis were conducted for ZOI and time-kill assay, respectively. Statistical significance was set at P ≤ 0.05. Results: EE contained secondary metabolites having antibacterial properties. MIC was 25% (S. mutans), 50% (E. faecalis), and >50% (L. acidophilus). EE disrupted ~90% of biofilm species in 5 min of exposure while NaOCl achieved ~99.9% reduction. Further reduction by EE progressed over 20 min after which no viable bacteria in the biofilm was cultivable. Conclusions: Lemon peel Ecoenzyme (EE) is antimicrobial with effective biofilm-disrupting properties on a mature multi-species biofilm. However, its effects were slower than 3.5% sodium hypochlorite.

Absence of zygomycetes in the oral niche of patients with oral squamous cell carcinoma and oral potentially malignant disorders.

Mucormycosis is a fungal infection which has been regrouped under emerging infectious disease. In this COVID-19 pandemic, the incidence of mucormycosis has been reported in many parts of India. Systemic condition that weakens one's immune systems like uncontrolled diabetes, chemotherapy or chronic long-term illness poses a grave threat for this fungal infection. Patients with oral cancer and precancer remain at significant risk for developing severe infections regardless of significant developments in therapy. Few studies have reported that this opportunistic fungal pathogen may be cultured from the oral cavity. Our findings disprove the oral carriage of filamentous fungi (Zygomycetes) among the group of patients with oral squamous cell carcinoma, oral potentially malignant disorders who are susceptible to immunological deficits and healthy subjects. This finding strongly supports that the oral niche of healthy as well as the patients with oral lesions do not harbour this filamentous fungi.

Evaluation of the Antibacterial Efficacy of Daptomycin, Gentamicin, and Calcium Hydroxide-Antibiotic Combinations on Enterococcus faecalis Dentinal Biofilm: An In Vitro Study.

AIM: To evaluate the antibacterial efficacy of calcium hydroxide (CH) with antibiotic combinations: daptomycin and gentamicin against Enterococcus faecalis (E. faecalis) dentinal biofilm. MATERIALS AND METHODS: Sixty freshly extracted single-rooted mandibular premolars were inoculated with E. faecalis(ATCC 29212) (n = 30) (group A) and clinical isolates (n = 30) (group B) for 3 weeks to form a biofilm. The tooth samples of groups A and B were randomly divided into three subgroups of 10 each, groups 1A and 1B (CH), groups 2A and 2B (CH+G), groups 3A and 3B (CH+D), depending on the medicaments to be placed for one week. The difference between initial and final CFU was calculated and statistically analyzed. RESULTS: Among the clinical isolates, CH-antibiotic combinations were more effective than CH alone, which was statistically significant (p = 0.006). CONCLUSION: The dentinal biofilm of clinical isolates of E. faecalis strains exhibited more reduction in bacterial colonies with CH in combination with antibiotics (D and G). CLINICAL SIGNIFICANCE: Daptomycin and gentamicin when used as an intra-canal medicament in combination with CH are effective in eliminating E. faecalis. Keywords: Calcium hydroxide, Daptomycin, Dentinal biofilm, E. faecalis, Gentamicin.

A comparative study of Candida species diversity among patients with oral squamous cell carcinoma and oral potentially malignant disorders.

OBJECTIVES: To determine the prevalence of Candida species by PCR-RFLP method in the saliva of patients with oral squamous cell carcinoma (OSCC), oral potentially malignant disorders (OPMD) and healthy cohorts. Unstimulated saliva was collected from patients with OSCC (n = 97), OPMD (n = 200), and healthy controls (n = 200). Candida species were isolated using the standard protocol. The isolates were identified using phenotypic and genotypic methods. The odds/risk ratio was calculated using Pearson's Chi-square test. The significance of Candidal carriage was calculated by independent T-test. RESULTS: Oral Candidal carriage was 72.2%, 58% and 20.5% among patients with OSCC, OPMD, and healthy controls respectively. The oral Candidal carriage in OSCC and OPMD was highly significant (p = 0.0001). Non albicans Candida predominated over Candida albicans. Candida species were diverse among the study groups with a predominance of Candida krusei, Candida tropicalis, and Pichia anomala formerly Candida pelliculosa. P. anomala occurrence outnumbered in health. The odds/risk ratio for OSCC and OPMD were 4.25/11.87 and 3.52/6.99 respectively. A high prevalence of non albicans Candida was observed both in all the three groups (OSCC, OPMD and healthy controls). High odds and risk ratio associates Candida species to OSCC and OPMD. Candida famata may be associated with OSCC and OPMD.

Effects of chitosan oligosaccharide and calcium hypochlorite on E. Faecali dentinal biofilm and smear layer removal - SEM analysis.

BACKGROUND: The complex structure and irregularities of root canal walls are liable for infection by several bacterial species. Thus, the use of irrigants and auxiliary chemical solutions associated with instrumentation is necessary for effective eradication of the biofilm as well as complete removal of the smear layer. AIM: To evaluate the effects of calcium hypochlorite and chitosan oligosaccharide (COS) in disinfecting Enterococcus faecalis root canal biofilm and smear layer removal with minimal erosion. MATERIALS AND METHODS: A total of 70 mandibular premolars were decoronated at the cementoenamel junction. The samples were biomechanically prepared, sterilized in an autoclave, and incubated with E. faecalis (ATCC-29212) bacteria for 21 days. Cleaning and shaping were done till maximum apical file size of #45 K. Specimens were randomly divided into 4 groups: GROUP I: Control Group, GROUP II: 5% Sodium Hypochlorite (NaOCl) solution followed by 17% EDTA solution, GROUP III: 5% Calcium Hypochlorite [Ca(OCl)2] solution followed by 17% EDTA solution and GROUP IV: 5% Ca(OCl)2 solution followed by 1% COS. The samples were subjected to microbial count followed by smear layer removal under scanning electron microscope (SEM) at coronal, middle and apical third. STATISTICAL ANALYSIS USED: Kruskal-Wallis Test and post-hoc Scheffe's test. RESULTS: It was observed that Group IV showed the lowest amount of CFU count/mL and the highest amount of smear layer removal with a statistically significant difference (P < 0.05) when compared with the other three Groups. CONCLUSION: 5% Ca(OCl)2 solution with 1% COS solution effectively removed the Enterococcus faecalis biofilm and smear layer from the root canals with minimal erosion.

Coronal Bacterial Penetration after 7 days in class II endodontic access cavities restored with two temporary restorations: A Randomised Clinical Trial.

The aim of this in vivo randomised clinical trial was to assess coronal bacterial penetration after placement of Cavit G and IRM temporary restorations in Class II endodontic access cavities. After completion of endodontic treatment, placement of an orifice seal and disinfection of the operating field, sterile cotton pellets were placed in the pulp chamber and the cavities were restored with Cavit G or IRM. After 7 days, coronal and proximal restoration thickness was measured by digital radiographs. Cotton pellet was evaluated by culture methods and polymerase chain reaction assay and bacterial species identified. Bacterial growth was observed in 5 of the 27 (18%) Cavit G samples and in 11 of the 27 (40%) IRM samples which was not significant. Coronal restoration thickness of 4-5 mm and proximal restoration thickness of more than 2.15 mm for Cavit G and 2.35 mm for IRM are recommended to prevent bacterial penetration over 7 days. Adequate restoration thickness is critical to prevent bacterial penetration.

Studies on isolation, characterization of fucoidan from brown algae Turbinaria decurrens and evaluation of it's in vivo and in vitro anti-inflammatory activities.

In the present study, the anti-nociception and anti-inflammatory activity of fucoidan isolated from T. decurrens on formalin induced paw-edema in mice model were investigated. The extracted fucoidan contain 54.86% of total sugar, 23.51% of sulfate and 3.4% of protein. The monosaccharide composition analysis revealed that fucoidan encompassed of fucose (59.3%), galactose (12.6%), mannose (9.6%), rhamnose (6.4%) and xylose (11.4%). Further, the structural characterization was done by UV-visible spectroscopy, X-ray diffraction, FT-IR and 1HNMR analysis. The fucoidan reduced the licking time thereby suggesting anti-nociceptive effect and decreased the size of paw swelling in the formalin induced inflammatory edema condition. The isolated fucoidan could significantly decreased the MDA and also increase the SOD, CAT, GPx, GST and GSH activity in paw edema tissue of formalin injected mice. Furthermore, fucoidan administration retained p65/NF-κB transcription factor in the cytosol thereby showing down regulation of the gene expression of pro-inflammatory mediators such as IL-1ß, COX-2 and MMP-9 in fucoidan treated mice. The anti-inflammatory effect of fucoidan was attributed to its capacity on modulating the levels of enzymatic antioxidants, master regulator NF-κB and pro-inflammatory cytokines. The fucoidan has reduced LPS induced cytotoxicity in IC-21 macrophage at a dose depended on manner.

Bactericidal and Smear Layer Removal Efficacy of Herbal Alternatives Against Enterococcus Faecalis Dentinal Biofilm - An ex-vivo Study

Abstract Objective: To assess the antibacterial and smear layer removal ability of Trigonella foenum, Syzygium cumini, Terminalia chebula seed extracts against E. faecalis dentinal biofilm. Material and Methods: Agar well diffusion, micro broth dilution assay and time-kill curve assay were performed to determine the antibacterial activity. The ability of the herbal extracts to remove the smear layer on the root canal surface was assessed by scanning electron microscopy. Results: Antibacterial activity was observed for the extracts of S. cumini and T. chebula on E. faecalis dentinal biofilm and its planktonic counterparts. The smear layer was efficiently removed by the seed extracts of T. chebula alone. Seed extracts of T. foenum neither possessed antibacterial effect nor smear layer removal ability. Conclusion: The extracts of T. chebula seeds may replace conventional irrigant due to its antibacterial properties and smear layer removing the ability. The extracts of S. cumini may be used as an intracanal medicament as it exhibited a bactericidal effect against the E. faecalis dentinal biofilm following 18 hours of incubation.

Mutant Prevention Concentration of Ciprofloxacin against Klebsiella pneumoniae Clinical Isolates: An Ideal Prognosticator in Treating Multidrug-Resistant Strains.

BACKGROUND: Fluoroquinolone-resistant Klebsiella pneumoniae poses a therapeutic challenge when implicated in urinary tract infections, pyelonephritis, pneumonia, skin infections, osteomyelitis, and respiratory infections. The mutant prevention concentration (MPC) represents a concentration threshold above which increase of resistant mutants occurs rarely. The aim of the present study is to determine the MPC among ciprofloxacin-resistant K. pneumoniae clinical isolates. MATERIALS AND METHODS: A total of 240 clinical isolates of K. pneumoniae were collected from a tertiary care hospital. The MPCs were determined for 24 selected strains using an inoculum of 1010 CFU/ml in Müller-Hinton agar plates with serial/various concentrations (0.003-100 µg) of ciprofloxacin. In addition to the MPC, phenotypic screening for ESBL, AmpC, and carbapenemase was performed. The detection of qnr genes for 24 isolates and DNA sequencing for six isolates were performed. RESULTS: Ciprofloxacin resistance was observed in 19.6% of the K. pneumoniae clinical isolates. Among the ciprofloxacin-resistant isolates, 14 isolates showed an MPC value of more than 100 µg. The MPC ranged between 100 µg and 20 µg for ciprofloxacin-resistant isolates. ESBL producers and qnr gene-producing strains had a high MPC. 11 isolates showed the presence of either qnrB or qnrS genes. None of the samples showed the presence of the qnrA gene. CONCLUSION: From our study, we infer that ESBL producers and qnr gene-possessing strains are frequently resistant to ciprofloxacin. Estimation of the MPC in the case of multidrug-resistant isolates in the clinical setup may help in treating these drug-resistant strains.

Chromogenic medium versus PCR-RFLP in the speciation of Candida: a comparative study.

OBJECTIVE: Candida species is implicated in a wide array of clinical infections. Speciation of Candida strains is of prime importance in the epidemiological survey and laboratory diagnosis as there is an upswing of antifungal resistance and changing trends in the antifungal resistance pattern among C. albicans and non albicans Candida. Varied phenotypic methods are available for the identification of Candida species which vary in principles and cost factors. Chromogenic agar medium (HiCrome Candida differential agar) is one of the preferred phenotypic methods in limited resource laboratories. Hence, this study was aimed to assess the reliability of HiCrome Candida differential agar, M1297A (HiMedia) in the identification of Candida species compared polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Oral Candida isolates (n = 194) were inoculated onto HiCrome Candida differential agar and the potential of Candida differential Agar was compared with PCR-RFLP. RESULTS: The results were not in agreement with PCR-RFLP. Percentage of disagreement was 40.2, 50.0, 100.0 and 25.0 for Candida albicans, Candida krusei, Candida glabrata and Candida tropicalis respectively. PCR-RFLP demonstrated a very high discriminatory power in the identification of Candida species compared to agar.

Frequency of putative periodontal pathogens among type 1 diabetes mellitus: a case-control study.

OBJECTIVE: The aim of the present study is to compare and assess the risk of periodontitis due to the presence of four putative periodontopathic bacteria viz., Eikenella corrodens, Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens. To fulfil the above objective, polymerase Chain reaction using the primers targeting 16S rRNA gene of the bacterial species was performed with the subgingival plaque collected from the permanent first molars of type 1 diabetic children and age matched healthy children. RESULTS: The prevalence of periodontal pathogens in diabetic and healthy children was 6% and 16% for E. corrodens, 18% and 36% for C. rectus, 2% and 2% for P. intermedia, 4% and 0%, for P. nigrescens respectively. Statistically, significant difference was not observed for the prevalence of all the four periodontal pathogens between type 1 diabetic and healthy children (P = 1.00). The results of the present study thus reveal a negative correlation of type I diabetes to periodontitis in association to Eikenella corrodens, Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens.

Oral Candidal Carriage Among Patients with Oral Potential Malignant Disorders: A Case-Control Study

Objective: To determine the prevalence of Candida species in the saliva of patients with clinically suspected oral potentially malignant disorders (OPMD) and healthy cohorts. Material and Methods: Unstimulated saliva was collected from patients with OPMD (n=100) and age and sex matched healthy subjects (n=170). The samples were inoculated onto Sabouraud Dextrose Agar and incubated for a week. The colonies of the isolates were enumerated using a colony counter. The isolates were identified using standard phenotypic methods. The significance of oral candidal carriage was calculated using Independent T test. Odds and Risk ratio was calculated using Pearson's Chi-square test. Results: Oral candida carriage was present in 51% of patients with OPMD while healthy cohorts had a prevalence of 20.6%. A good statistical significance was observed for the prevalence of oral candidal carriage for patients with OPMD in comparison to healthy cohorts (p=0.013). Significant Odds and risk ratio was observed for the prevalence of Candida species among OPMD. Majority of the isolates in both groups were C. albicans. Colony forming units were high among patients with OPMD. Conclusion: A significant association of oral candidal carriage to oral potentially malignant disorders in comparison to healthy cohorts was observed. Candidal species may be potent risk factor for transition of OPMD to oral Squamous Cell Carcinoma.

An Herbal Alternative to Control Nosocomial Pathogens in Aerosols and Splatter During Ultrasonic Scaling

Abstract Objective: To evaluate the efficacy of herbal mouthwash (Himalaya Hiora Regular) against methicillin-resistant Staphylococcus aureus and Acinetobacter baumanni during ultrasonic scaling. Material and Methods: Group B (n=25) received herbal mouthwash and Group A (n=25) received 0.12% chlorhexidine mouthwash respectively as a preprocedural rinse. The aerosols produced by the ultrasonic unit were collected on MeReSa and Leeds Acinetobacter Agar plates. The experimental setting included eight different locations covering all areas of the operatory. The plates exposed to aerosols for a period of 30 minutes were incubated aerobically at 37ºC for 48hrs and the colony forming units (CFU) were statistically analyzed Results: Herbal mouthwash (Himalaya Hiora Regular) showed a significant reduction in mean CFU of MRSA compared to 0.12% chlorhexidine. While herbal mouthwash was on par with 0.12% chlorhexidine in the reduction of A. baumannii Conclusion: Herbal mouthwash was found to be more effective against MRSA than 0.12% Chlorhexidine mouthwash as a pre-procedural rinse. Both herbal mouthwash and chlorhexidine mouthwash was found to be effective against A. baumannii. Herbal mouthwash may be a safe alternative to chlorhexidine against nosocomial pathogens like MRSA and A. baumannii.

Evaluation of periodontal status and detection of Dialister pneumosintes in cerebral palsy individuals: A Case-Control study.

BACKGROUND: The worldwide prevalence of cerebral palsy among live births is estimated to be between 1.9 and 3.6/1000. The presence of periodontal disease in cerebral palsy children typically is due to bacterial plaque accumulation caused by their inability to correctly clean their own teeth, difficulties in chewing and swallowing food, and improper movements of masticatory muscles and tongue muscles. OBJECTIVES: The objective of this study is to estimate the periodontal status in cerebral palsy individuals and evaluate the presence of Dialister pneumosintes. MATERIALS AND METHODS: Thirty cerebral palsy children from the Spastics Society of Tamilnadu with signs of periodontitis were compared with the same number of age- and gender-matched controls for oral hygiene and periodontal parameters. Subgingival plaque samples were screened for the presence of respiratory pathogen D. pneumosintes by polymerase chain reaction (PCR). RESULTS: A variation was noted between types of cerebral palsy individuals with a mean probing pocket depth value of 6 in spastic type, 4.86 in the ataxic, and 4.3 in the dyskinetic. Clinical attachment level varied from 6.71 in spastic to 5.43 in ataxic and 3.50 in dyskinetic. Oral hygiene index-simplified ranged from 2.764 in spastic to 2.25 in ataxic and 1.41 in dyskinetic. PCR results indicated 25% and 21.7% positivity for D. pneumosintes among cerebral palsy and control group, respectively. The odds ratio calculated to estimate the risk of periodontitis due to D. pneumosintes was 0.765. CONCLUSION: It was concluded that oral hygiene status and severity of periodontitis worsens as the rigidity and muscle tone limiting limb movement increases in cerebral palsy individuals.

Detection of Tannerella forsythia bspA and prtH genotypes among periodontitis patients and healthy subjects-A case-Control study.

BACKGROUND: T. forsythia a gram negative, anaerobe inhabits the mature biofilm present at sites expressing progressive periodontitis. It is a part of "red complex" group which contributes to the pathogenesis of periodontitis. The BspA protein and prtH gene encoded cysteine protease play a vital role in the virulence of T. forsythia. The present study aims to detect the two genotypes (bspA and prtH) in periodontitis and healthy subjects. MATERIALS & METHOD: Subgingival plaque samples were collected from periodontitis patients and healthy subjects (Chronic Periodontitis n = 128, Aggressive Periodontitis n = 72, healthy subjects n = 200). The samples were screened for the presence of T. forsythia 16S rRNA, bspA and prtH genotypes by Polymerase Chain Reaction. The prevalence of the genotypes between periodontitis patients and healthy subjects was compared with Pearson's Chi-square test. A P value of < 0.05 was considered to be statistically significant. RESULTS: The prevalence for T. forsythia in Chronic Periodontitis (n = 128), Aggressive Periodontitis (n = 72) and health (n = 200) was 73.4%, 59.7% and 10.5% respectively. The prevalence of T.forsythia bspA/prtH genotypes was 81.90%/43.60%, 88.40%/53.50% and 33.30%/14.3% in Chronic Periodontitis, aggressive Periodontitis and health respectively. Compared to healthy subjects, the odds of detecting T.forsythia 16S rRNA was 18.53 times high in individuals with periodontitis (P = 0.0001). CONCLUSION: The high odds ratio of T.forsythia 16S rRNA among periodontitis strongly suggests its role in periodontitis. In addition, the high prevalence of T. forsythia bspA genotype among Chronic Periodontitis signifies it as a useful marker for chronic periodontitis.

Detection of Aggregatibacter actinomycetemcomitans leukotoxin and fimbria-associated protein gene genotypes among periodontitis patients and healthy controls: A case-control study.

BACKGROUND: Aggregatibacter actinomycetemcomitans has been reported in higher proportions in subgingival microbiota of individuals with aggressive periodontitis (AgP) compared with those with chronic periodontitis (ChP) and healthy controls. The major virulence factors are the ones that help in colonization and evasion of host's defenses. Hence, this study was aimed to assess the prevalence of A. actinomycetemcomitans 16S rRNA and its virulent genotypes (leukotoxin [lktA] and fimbria-associated protein [fap]). MATERIALS AND METHODS: In this case- control study We performed periodontal examination and measured probing depth and clinical attachment level (CAL). Subgingival plaque samples from 200 (ChP: n = 128 and AgP: n = 72) periodontitis patients and 200 healthy controls were screened for the presence of A. actinomycetemcomitans 16S rRNA, lktA, and fap genotypes by polymerase chain reaction. The prevalence of genotypes between periodontitis patients and healthy controls was compared with Pearson's Chi-square test. P < 0.05 was considered statistically significant. RESULTS: Mean pocket probing depth and CAL were high as compared to the healthy controls. The prevalence of A. actinomycetemcomitans in ChP (n = 128), AgP (n = 72), and healthy individuals (n = 200) was 32.0%, 61.1%, and 2.5%, respectively. A. actinomycetemcomitans lktA genotype prevalence was 71.8% among periodontitis patients, while A. actinomycetemcomitans fap genotype showed 31.8% prevalence. The prevalence of these genotypes was insignificant in healthy controls. CONCLUSION: The high odds ratio for A. actinomycetemcomitans prevalence suggests its strong link to periodontitis. Detection of A. actinomycetemcomitans lktA + genotype may be a useful marker for AgP as its prevalence was found to be high in AgP.

"Association of periodontopathic anaerobic bacterial co-occurrence to atherosclerosis" - A cross-sectional study.

BACKGROUND: Epidemiological studies have shown a link between periodontitis and atherosclerosis. Hence the present study was chosen to assess the presence of eight anaerobic periodontal pathogens and their virulence genes in subgingival plaque (SGP) and atheromatous plaque (AP) of patients with Ischaemic heart disease. METHODS: SGP and AP collected from 65 Ischaemic heart disease patients were screened for the presence of periodontal bacterial pathogens by Polymerase chain reaction. The samples positive for Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia were screened for virulence genes. Chronic periodontitis patients (ChP) without any systemic disease (n = 59) and healthy subjects free of both periodontitis and systemic disease were included as control groups (n = 100). RESULTS AND DISCUSSION: Statistical significance was observed for the prevalence of 16S rRNA of P. gingivalis, T. forsythia, T. denticola and P. nigrescens both in SGP and AP. Nine different periodontal bacterial co-occurrences were observed in SGP and AP of Ischaemic heart disease patients. Besides, the prevalence of these nine different bacterial co-occurrence was high in SGP OF Ischaemic heart disease patients compared to ChP without systemic disease. Among the nine different bacterial co-occurrence, only four were observed in SGP of ChP without systemic disease in spite of high prevalence of these anaerobic bacterial species. While, bacterial co-occurrences was completely absent among healthy subjects. Significant odds and risk ratio to atherosclerosis were observed for P. gingivalis, T. forsythia, T. denticola and P. nigrescens. Among the virulence genes, significance to atherosclerosis was observed for P. gingivalis type II fimA and T. forsythia bspA. CONCLUSION: The results of this study strongly correlate periodontal bacterial co-occurrence and periodontal bacterial adhesion factor to atherosclerosis.

Effect of chitosan-ethylenediamine tetraacetic acid on Enterococcus faecalis dentinal biofilm and smear layer removal.

OBJECTIVE: The objective of the study was to evaluate the effectiveness of chitosan and chitosan-ethylenediamine tetraacetic acid (EDTA) (3:1,1:1,1:3) in comparison with 5.2% sodium hypochlorite (NaOCl) in disinfecting Enterococcus faecalis biofilm on root canal dentin and in the removal of smear layer with minimal erosion. MATERIALS AND METHODS: Seventy single-rooted extracted human mandibular premolars (n = 70) were selected for the study. Forty tooth samples were biomechanically prepared, vertically sectioned, and sterilized by autoclaving. The tooth sections were artificially infected with E. faecalis (ATCC 29212 [n = 35] and clinical isolate [SBEF2, n = 35]) to form mature dentinal biofilm in vitro. The tooth samples were treated with the test solutions: chitosan and chitosan-EDTA (3:1, 1:1, 1:3), and the killing time was determined. The smear layer removal ability of the test solutions (Group A: chitosan-EDTA [1:1], Group B: EDTA, Group C: control) (n = 10 tooth/group) was assessed. RESULTS: Chitosan and chitosan-EDTA (3:1, 1:1, 1:3) exhibited antibacterial activity against both the strains of E. faecalis. Chitosan and chitosan-EDTA caused 3 log reduction in the viable count of the sessile cells of E. faecalis at 15 min while 5.2% NaOCl exhibited 99.98% inhibition at 15 min. Chitosan-EDTA (1:1) was found to be effective in removing the smear layer and showed lesser erosion than EDTA at the coronal and middle portions. CONCLUSION: Chitosan-EDTA (1:1) is a potential root canal irrigant that performs a dual role - root canal disinfection and smear layer removal.

Orthodontic instrument sterilization with microwave irradiation.

OBJECTIVE: This study was designed to evaluate the efficiency of microwave sterilization of orthodontic instruments and molar bands immersed in plain distilled water with and without oral rinse, and to ascertain the minimum time of exposure required to sterilize. MATERIALS AND METHODS: The orthodontic instruments (hinged and nonhinged), molar bands and mouth mirrorsused in the patient 's mouth were selected for the study. The instruments were divided into two groups - Group I with oral rinse-set A (0.01% chlorhexidine gluconate) and set B (0.025% betadine) and Group II (included sets C and D without oral rinse). The instruments of set A, B and C were microwaved at 2,450 MHz, 800 W for 5 min, whereas, set D was microwaved for 10 min at the same above mentioned specifications. The efficacy of sterilization was assessed by stab inoculation of the instruments onto trypticase soya agar plates. The plates were checked for bacterial growth following incubation at 37 °C for 24 h. For sterility control,Geobacillus stearothermophilus (MTCC 1518) was included. RESULTS: No growth was observed in the plates that were inoculated with the microwaved orthodontic instruments of sets A, B and D, whereas scanty bacterial growth was observed in the plates inoculatedwith the microwaved set C instruments. CONCLUSION: Effective sterilization was achieved when the orthodontic instruments and molar bands were immersed in distilled water without oral rinse and microwaved for 10 min as also for those that were immersed in distilled water with oral rinse and microwaved for 5 min.