Evaluation of Antimicrobial Susceptibility and Resistance Patterns of Treponema denticola Isolated From Periodontal Disease: An In Vitro Study.

Background Periodontal disease poses a significant oral health challenge, involving inflammatory conditions impacting tooth-supporting structures. Treponema denticola, a "red complex" organism, plays a crucial role in periodontal pathogenesis, forming biofilms in subgingival environments and contributing to dysbiosis. Antimicrobial therapy is pivotal in managing periodontal disease, requiring a nuanced understanding of susceptibility patterns exhibited by key pathogens like T. denticola. Aims and objectives This study aims to investigate the antimicrobial susceptibility and resistance profiles of Treponema denticola, a prominent bacterium in periodontal disease, by examining its responses to various antimicrobial agents commonly used in periodontal therapy. Methodology Plaque samples were meticulously collected from individuals diagnosed with periodontal disease to ensure a diverse representation of the oral microbiome. All the samples were cultured, and red complex bacteria were isolated under anaerobic culture. Treponema denticola isolates were cultured from these samples under anaerobic conditions, and molecular techniques were employed for species identification. A comprehensive panel of antimicrobial agents was selected to assess the response of Treponema denticola. In vitro antimicrobial susceptibility testing (AST) was conducted using the antimicrobial gradient method, employing a hybrid approach combining elements of disk-diffusion and dilution methods. Results Treponema denticola had exhibited resistance to metronidazole, a commonly used antibiotic effective against anaerobic bacteria, emphasizing limitations in its applicability. However, the bacterium displayed sensitivity to tetracycline, imipenem, cefoperazone, chloramphenicol, clindamycin, and moxifloxacin, offering diverse therapeutic options. The antimicrobial gradient strip test provided detailed minimum inhibitory concentration (MIC) values, contributing to a nuanced understanding of susceptibility and resistance patterns. Conclusion This study significantly advances our understanding of Treponema denticola's antimicrobial susceptibility and resistance profiles in the context of periodontal disease. The findings underscore the importance of tailored treatment strategies and contribute to broader efforts in antimicrobial stewardship, aligning with global initiatives to combat antibiotic resistance. This research lays the foundation for more effective and personalized approaches to periodontal care, emphasizing the intricate microbial dynamics associated with periodontal health and disease.

Evaluation of Antimicrobial and Cytotoxic Activity of Nanoformulated Chamomile and Green Tea-Based Mouthwash: An In Vitro Study.

Introduction Nanotechnology plays a significant role in the biomedical and dental fields, offering numerous benefits to humans. Particularly, nanoparticles synthesised through green methods involving herbal formulations present promising advantages. Zinc oxide nanoparticles (ZnONPs) demonstrate strong antibacterial properties. Utilising treatments incorporating chamomile tea and green tea may potentially reduce toxicity while enhancing antibacterial effectiveness against oral infections. This study aimed to develop a mouthwash containing ZnONPs, followed by an evaluation of both its cytotoxicity and antibacterial effectiveness. Materials and methods This study was conducted at Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Chennai, India. In the synthesis of ZnONPs, a formulation consisting of chamomile tea and green tea was employed. Subsequently, these synthesised nanoparticles were used in the preparation of mouthwash. An antimicrobial test of the produced ZnONPs was carried out using the agar well diffusion technique for oral pathogens. For analysis of cytotoxicity, brine shrimps were used in an assay, and comparisons were made with a commercially available mouthwash. Results The antimicrobial properties were assessed, and the formulated mouthwash demonstrated a zone of inhibition of Staphylococcus aureus (20 mm), Enterococcus faecalis (11 mm), Streptococcus mutans (15 mm) and Candida albicans (13 mm), when the agar well diffusion assay was carried out. Furthermore, the formulated mouthwash exhibited lower cytotoxicity compared to the commercially available mouthwash when cytotoxicity was checked in brine shrimps. Conclusion In our study, the ZnONP synthesis with chamomile tea and green tea showed notable antibacterial and antifungal effects. In addition, lower toxicity was observed compared to the commercially available mouthwash. These findings suggest that mouthwash formulated with green-synthesis ZnONPs could serve as a viable alternative to synthetic mouthwash options. As a result, it is suggested that ZnONPs could be employed in mouthwash formulations at concentrations of 40 µL.

Anti-microbial activity of Ocimum sanctum L. gel against black pigmented microbes.

Black pigmented gram negative anaerobes are associated with periodontal disease and tooth loss. Therefore, it is of interest to evaluate the antimicrobial activity of Ocimum Sanctum.L (Tulsi) gel against black pigmented anaerobes. Plaque samples were collected from the subject and kept in anaerobic broth for 4 hours of incubation at 37°C. 50µL concentration of Tulsi gel was added and kept in gas pack system for 3-5 days. Zone of inhibition was measured. Ocimum sanctum L. (Tulsi) exhibits strong antibacterial activity against Black Pigmented bacteroides at 1% and 2%.Tulasi gel was effective at higher concentrations, indicating the possibility of using it as an adjunct to standard periodontal treatment.

Preparation of Ocimum Sanctum-Based Hydrogel and Evaluation of Its Cytotoxicity: An In Vitro Study.

INTRODUCTION: While traditional periodontal treatments like scaling and root planing, antibiotics, and surgical intervention remain the primary approaches, herbal medicine is continuously evolving as an alternative for the management of periodontal diseases. This study focused on the evaluation of the cytotoxicity of Ocimum sanctum (OS)-based hydrogel for its use in local drug delivery in periodontitis. METHODS: OS-based hydrogel was prepared using 50 g of OS powder and 200 ml of ethanol, along with carboxymethyl cellulose gel and sorbitol. The prepared formulation was evaluated for its cytotoxicity by using the MTT assay, cell viability, cell morphology, and brine shrimp egg assessment. RESULTS: Cell viability was assessed, and it was above 95% for the control and 85% for the OS hydrogel by the 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide assay. Brine shrimp egg assessment also showed a survival rate of 80% at low concentrations. The cell morphology test showed round and uniform cells growing in a monolayer shape. CONCLUSION: The findings of this study confirmed that OS-based hydrogel is cytocompatible and, hence, can be used as a local drug delivery agent for periodontitis management, especially in resource-constrained settings where affordable and natural treatment options are highly valued.

Effect of Ocimum sanctum L as LDD in periodontal therapy.

Ocimum sanctum L (Tulsi) has various properties like antibacterial, anti-inflammatory and anti-oxidant. To compare the effect of the local-drug delivery system containing 2% Ocimum sanctum L (Tulsi) as an adjunct to scaling and root planing (SRP).The main aim of the study was to evaluate the efficacy of Ocimum sanctum L (Tulsi) gel with Tetracycline fibers (Actisite) for the treatment of periodontitis patients. 40 subjects with periodontitis (pocket depth of 5 mm) were selected and divided into 2 groups Group I: Ocimum sanctum L (Tulsi) gel (n= 20) and Group II: Tetracycline fibers (Actisite) (n = 20). Clinical parameters assessed were Gingival Index , Plaque Index , Probing Depth and Clinical Attachment Loss were assessed at baseline, 1 month, 3 months, 6 months, 8 months. Our results showed that Gingival index and Plaque index for for GROUP I: Ocimum sanctum L (Tulsi) and GROUP II: Tetracycline fibers (Actisite)are not statistically significant p>0.05 for baseline, at 1 month, 3 months, 6 months, 8 months. Probing depth and Clinical attachment are not significant p>0.05 for baseline, at 1 month, 3 months, 6 months, and statistically significant difference seen at 8 months p<0.05. 2% Ocimum sanctum L (Tulsi) gel can be effectively used as an adjunct to scaling and root planing. When used as an adjunct to scaling and root planing, it helps in reduction of pocket depth and gain of clinical attachment. Ocimum sanctum L (Tulsi) showed promising results when compared to Tetracycline fibers (Actisite).

Comparison of Antimicrobial Activity of Injectable Platelet-Rich Fibrin (i-PRF) and Leukocyte and Platelet-Rich Fibrin (l-PRF) Against Oral Microbes: An In Vitro Study.

Aim Injectable platelet-rich fibrin (i-PRF) and leukocyte and platelet-rich fibrin (l-PRF) are both blood-derived products used in regenerative medicine and dentistry. They contain platelets, growth factors, and leukocytes, which can have antimicrobial properties to some extent, but their primary purpose is tissue regeneration and wound healing. i-PRF and l-PRF may have some indirect antimicrobial properties due to their composition and ability to enhance tissue healing and immune responses, and they are primarily used in dentistry for their regenerative and wound healing capabilities rather than as standalone antimicrobial agents. This study aims to compare the anti-microbial activity of i-PRF and l-PRF against oral microbes. Methodology This study included 30 patients who were selected using G*Power software version 3.1 (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) calculation with the population size. The plaque samples were collected from the subjects using area-specific Gracey curettes used for scaling and root planing to remove plaque and calculus from the teeth and root surfaces. The collected plaque samples were transferred to a tube containing 5 ml of saline (sterile saltwater). The purpose of using saline is to preserve the microbial content of the plaque sample without altering the microbial composition. To obtain a uniform solution, the samples in the saline-containing tube were vortexed for 5 minutes. After vertexing, a small amount of the suspension (0.1 ml) was taken for further analysis. The 0.1 ml suspension was used to plate blood agar using the streak method. A loop or needle is used to streak the sample back and forth across the surface of the agar, leading to the dilution and separation of the bacteria. Results Results state that i-PRF has a maximum zone of inhibition (2.19±0.47 mm) when compared with metronidazole (0.14±0.09 mm). It can be stated that platelet concentrates demonstrate better antimicrobial activity due to their higher oxygen metabolites which help in the aggregation and internalization of microorganisms, which enhances the clearance of pathogens from the bloodstream. Paired t-test has been used for the comparison between the two groups, and the p-value is >0.05 stating that the difference is statistically significant. Conclusion The present study states that i-PRF demonstrated better antimicrobial efficacy as compared to l-PRF. Hence, i-PRF helps in reducing microbial load at the periodontally infected sites when compared with l-PRF.

Formulation, development, and evaluation of anti-inflammatory and antimicrobial effects of a novel polyherbal mouthwash-An in vitro study.

AIM: The aim of this study was to prepare a polyherbal mouthwash and evaluate its antimicrobial and anti-inflammatory efficacy against commercially available herbal mouthwash. The objective was to signify whether the novel herbal combination (extracts of Zingiber officinale [ginger], Curcuma longa [turmeric], and Syzygium aromaticum [clove] 5% v/w) could be a better alternative to commercially available herbal mouthwashes. MATERIALS AND METHODS: An in vitro study was undertaken in which extracts of Z. officinale (ginger), C. longa (turmeric), and S. aromaticum (clove) 5% v/w were used. Seven different concentrations were prepared and tested against Streptococcus mutans, Enterococcus faecalis, Candida albicans, and Staphylococcus aureus in Mueller-Hinton agar medium. Plates were incubated aerobically at 37° C for 48 h, and the zone of inhibition was measured using a vernier caliper. Commercially available herbal mouthwash (Hiora) was used as a control group. The data were analyzed by descriptive analytics. RESULTS: Results showed that the efficacy of novel polyherbal mouthwash had comparatively less significant antimicrobial properties against the microorganisms as compared to the commercially available herbal mouthwash. The minimum inhibitory concentration was also found to be very high, that is, 100 µg/mL. CONCLUSION: There was no significant antimicrobial and anti-inflammatory effects for the polyherbal mouthwash as compared to commercially available herbal mouthwash (Hiora). Because this combination is readily available, it can be a cost-effective alternative to commercially available herbal mouthwashes.

A Comparision of conventional and laser assisted desensitization techniques for treating dentinal hypersensitivity.

The study's objective was to assess the effectiveness of conventional and laser-assisted desensitization in treating dentinal hypersensitivity (DH). Twenty patients were divided into experimental and control groups. Following scaling, patients in the control group were instructed to utilize desensitization paste; however, after comprehensive scaling, patients in the experimental group received treatment with the erbium, chromium, yttrium, scandium, gallium garnet (Er, Cr: YSGG) laser. Before laser emission, the visual analog scale (VAS) score was obtained for both groups. Postoperative VAS scores were recorded right away, 1 week and 1 month later for the test group, and 1 week and 1 month later for the control group, following the use of desensitizing paste. In comparison to the control group, the Er, Cr: YSGG laser treatment had a substantially higher desensitizing impact right away, according to the data. The variances in the mean VAS scores between baseline and all time periods after treatment for the test group were statistically significant. At any subsequent assessment, there were no discernible variations in plaque index between the test and control groups. The Er, Cr: YSGG laser is found to be more effective than the control group in treating DH within the confines of this investigation.

Evaluation of occlusal pattern in periodontitis patients using T-scan analysis.

Occlusal analysis is important to analyze any disharmony in occlusion. Atraumatic dental occlusion leads to evolution of T-scan. T-scan gives a valuable procedure for clinical assessment and perception of occlusal problems. T-scan can also be used in periodontitis patients for checking the occlusal pattern. Occlusal problems and periodontal disease relationship remains controversial. Further research is needed to determine whether occlusal adjustment is necessary for periodontal treatment. The main aim of the study was to assess the occlusal pattern using T-scan in periodontitis patients. Thirty periodontitis subjects were taken and checked for occlusion using T-scan. The subject's age group was 35-55 years. The study included 15 males and 15 females. Plaque index, gingival index, attachment loss, probing depth, centric occlusion (CO), protrusion, right lateral, and left lateral were the parameters studied. Occlusal adjustments were needed to decrease and dissipate the abnormal occlusal forces. The significance of statistical tests for various movements are as follows: CO (right and left) (P = 0.077) P > 0.05; protrusion (right and left) (P = 0.09) P > 0.05; left side lateral (right side and left side) (P = 0.01) P < 0.05; right lateral (right side and left side) (P = 0.00) P < 0.05. CO and protrusion (right, left) for males and females are not significant. Left lateral and right lateral (right, left) for males and females were significant. The T-scan manages adequate specificity and sensitivity. Hence, these act as a distinctive tool for diagnosis and better unreliable when used intraorally. The T-scan method is definitely a valuable tool for examining and evaluating the occlusal contacts during maximal intercuspation.

Comparative clinical data for gingivitis treatment using gels from Ocimum sanctum (Tulsi) and chlorhexidine (CHX).

Ocimum sanctum (Tulsi) has various properties like anti bacterial, anti inflammatory, anti oxidant for curing diseases. It is a plant with known medicinal value in Indian system of medicine. Therefore, it is of interest to evaluate the effectiveness of Ocimum sanctum with Chlorhexidine (CHX) which is a standard material for the treatment of gingivitis. We used 30 gingivitis subjects divided into 2 groups. Group I used Tulsi gel (n= 15) and Group II used CHX gel (n = 15) for treatment. Tulsi and CHX gel use was advised for 1 month. The Clinical parameters assessed were gingival Index (GI), plaque Index (PI), probing depth (PD) and clinical attachment loss (CAL) assessed at a time interval of 30 days. Statistical analysis was completed using the SPSS software 23.0. Data showed that GI and PD for Tulsi and CHX in pre and post groups are not significant with p > 0.05. Moreover, PI is not significant with p>0.05 among pre Tulsi, pre CHX and post CHX. However, data is significant with p<0.05 for Tulsi group. CAL is significant with p<0.05 among pre/post Tulsi groups. However, this is not significant with p>0.05 among pre/post CHX groups. Data shows that 2% of Tulsi is effective in reducing gingival bleeding and inflammation. Thus, clinical data shows that Tulsi gel is promising for the treatment of gingivitis.

Anti-inflammatory, anti-oxidant effect and cytotoxicity of ocimum sanctum intra oral gel for combating periodontal diseases.

It is of interest to evaluate the anti-inflammatory, anti-oxidant effect and cytotoxicity of Ocimum sanctum (an Indian herb, Thulsi) intra oral gel in combating periodontal diseases. Hence, 2% of O. sanctum gel was prepared with Carbopol940 soaked in purified water containing 0.2% w/v sodium benzoate overnight. Hydroxy proplyl methyl cellulose (HPMC) solution was mixed with propylene glycol using using tissue homogenizer. Anti-oxidant effect was analyzed using DPPH radical assay and anti-inflammatory effect was assessed using the inhibition of albumin denaturation assay. Ocimum sanctum gel with various dilutions from10 micro litres to 50 micro litres showed exponential increase in percentage of inhibition from 60.9 to 72.2 exhibiting antioxidant activity. The anti-inflammatory effect of Ocimum sanctum gel showed comparatively equivalent effect with standard diclofenac gel with values ranging from 76.6 for 50 micro liters of Ocimum sanctum gel and 89.6 for standard gel at 50 micro liters. Ocimum sanctum showed less toxicity towards brine shrimp nauplii. Thus we show that Ocimum sanctum gel showed potent anti-oxidant and anti-inflammatory effect and less toxic to brine shrimp nauplii as a promising agent for the treatment of periodontal diseases.

Association of Periodontal Disease and Pre-term Low Birth Weight Infants.

The incidence of pre-term low birth weight still prevails in developed as well as developing countries though the numbers may vary. Periodontitis is a chronic inflammatory process with multifactorial etiology and adversely affects the outcome of pregnancy which becomes a major public health problem. The association of periodontitis as risk factor for pre-term birth has been in extensive research in the past two decades when a number of studies investigated this relationship. However, definite connection has not been proved yet and research is still ongoing. This article describes about the possible relationship that can exist between pre-term low birth weight infants and periodontal disease.

Comparison of Salivary Beta Glucuronidase Activity in Chronic Periodontitis Patients with and without Diabetes Mellitus.

AIM OF THE STUDY: The aim of the study was to estimate the salivary beta glucuronidase (ß) activity in patients with chronic periodontitis with and without diabetes mellitus and to evaluate the relationship between Beta Glucuronidase activity and Periodontal clinical parameters. MATERIALS AND METHODS: The study consisted of 80 patients of both sexes with age ranging from 20-60 years and they were divided into four groups. Clinical parameters such as Gingival index, Probing depth and Clinical attachment loss were measured. Salivary Beta Glucuronidase activity was measured using spectrophotometer with reagents like phenolphthalein glucuronic acid, phosphate and glycine buffer. RESULTS: The mean BG activity of Group IV (1.17 ± 0.27) was significantly higher than mean BGA levels of Group I, II, III. The p-value was < 0.05. The mean BGA levels of Group III (0.78 ± 0.17) was significantly higher than mean BGA levels of Group I, Group II at 5 % level. There was a significant positive linear relationship between salivary ß Glucuronidase level and Probing Depth, clinical attachment level in the experimental Groups. CONCLUSION: The salivary ß Glucuronidase level was higher in Diabetic patients with periodontitis than nondiabetic periodontitis patients.