Evaluation of a Panel of Single-Nucleotide Polymorphisms in miR-146a and miR-196a2 Genomic Regions in Patients with Chronic Periodontitis.

BACKGROUND: Periodontitis is an inflammatory disease caused by bacterial triggering of the host immune-inflammatory response, which in turn is regulated by microRNAs (miRNA). Polymorphisms in the miRNA pathways affect the expression of several target genes such as tumor necrosis factor-α and interleukins, which are associated with progression of disease. OBJECTIVE: The objective of this study was to identify the association between the MiR-146a single nucleotide polymorphisms (SNPs) (rs2910164, rs57095329, and rs73318382), the MiR-196a2 (rs11614913) SNP and chronic periodontitis. METHODS: Genotyping was performed for the MiR-146a (rs2910164, rs57095329, and rs73318382) and the MiR-196a2 (rs11614913) polymorphisms in 180 healthy controls and 190 cases of chronic periodontitis by the direct Sanger sequencing technique. The strength of the association between the polymorphisms and chronic periodontitis was evaluated using logistic regression analysis. Haplotype and linkage analyses among the polymorphisms was performed. Multifactorial dimensionality reduction was performed to determine epistatic interaction among the polymorphisms. RESULTS: The MiR-196a2 polymorphism revealed a significant inverse association with chronic periodontitis. Haplotype analysis of MiR-146a and MiR-196a2 polymorphisms revealed 13 different combinations, of which 5 were found to have an inverse association with chronic periodontitis. CONCLUSION: The present study has demonstrated a significant inverse association of MiR-196a2 polymorphism with chronic periodontitis.

Surgical augmentation of interdental papilla - A case series.

Formation of black triangles between teeth due to loss of interdental palpilla is one of the common problems encountered in routine clinical practice, as extreme importance is given to esthetics. This paper discusses two different surgical approaches in treating three cases with papillary loss in the first case the reconstruction of papilla was achieved by using a semilunar coronally repositioned papilla technique and in second and the third case reconstruction of the papilla was achieved by modification of Nodland's microsurgical technique. In all the three cases a free connective tissue graft was used to reconstruct the lost volume of interdental papilla. Complete reconstruction of the lost papilla was achieved in all the three cases 6 months postoperatively.

Relationship between interleukin 1α levels in the gingival crevicular fluid in health and in inflammatory periodontal disease and periodontal inflamed surface area: A correlative study.

BACKGROUND: Periodontitis has been suggested as a source of inflammation for pathological changes in distant sites. Interleukin-1 alpha (IL-1α) has shown to have specific roles in inflammation, immunity, tissue breakdown, and tissue homeostasis. This study assessed the correlation of periodontal inflamed surface area (PISA) index with the gingival crevicular fluid (GCF) levels of IL-1α, which would be helpful in evaluating the validity of PISA index in terms of reflection of the disease. MATERIALS AND METHODS: A total of 40 subjects were recruited for this study and 20 subjects with healthy gingiva (Group I) served as controls and 20 subjects served as cases with periodontitis (Group II). Samples of GCF were obtained from one site in each patient by placing color-coded, calibrated, volumetric microcapillary pipettes extracrevicularly, and subjected to ELISA test. RESULTS: There was a statistical significance for mean probing depth (PD) and periodontal epithelial surface area (PESA) (P < 0.01), mean bleeding on probing and PISA, IL-1α (P < 0.01) and PESA (P < 0.05) in Group I. Statistical significance was found between PISA and IL-1α in Group I (P < 0.01). A positive correlation was found in Group II between mean PD and mean attachment loss (P < 0.01), PISA, IL-1α and PESA (P < 0.01), PISA and IL-1α levels (P < 0.01) which was statistically significant. CONCLUSION: The inflammatory burden index was statistically significant in the periodontitis group correlating with higher IL-1α levels, which clearly indicates the validity of PISA index.

Mandibular Tori: A source of autogenous bone graft.

Restoration of lost alveolar bone support remains as one of the main objectives of periodontal surgery. Amongst the various types of bone grafts available for grafting procedures, autogenous bone grafts are considered to be the gold standard in alveolar defect reconstruction. Although there are various sources for autogenous grafts including the mandibular symphysis and ramus, they are almost invariably not contiguous with the area to be augmented. An alternative mandibular donor site that is continuous with the recipient area and would eliminate the need for an extra surgical site is the tori/exostoses. Bone grafting was planned for this patient as there were angular bone loss present between 35-36 and 36-37. As the volume of bone required was less and bilateral tori were present on the lingual side above the mylohyoid line, the tori was removed and used as a source of autogenous bone graft, which were unnecessary bony extensions present on the mandible and continuous with the recipient area. Post-operative radiographs taken at 6 and 12 month intervals showed good bone fill and also areas of previous pockets, which did not probe after treatment indicates the success of the treatment. The use of mandibular tori as a source of autogenous bone graft should be considered whenever a patient requires bone grafting procedure to be done and presents with a tori.

Efficacy of a root conditioning agent on fibrin network formation in periodontal regeneration: A SEM evaluation.

BACKGROUND: Even though numerous biomaterials have been devised and employed for periodontal regeneration, it should be well understood that the root surface receptiveness to clot formation and maintenance during initial periodontal wound healing, decides the nature of the connective tissue attachment. So this study was carried out with the prime objective of assessing the initial wound healing events occurring in vivo after the application of citric acid on to the root surfaces during periodontal regenerative therapy. MATERIALS AND METHODS: Thirty-two human teeth were used for this in vitro study. Two dentin blocks each measuring 4 × 2 × 1 mm were made from each tooth. These dentin blocks were planed and treated differently with Phosphate Buffered Saline (PBS), citric acid, PBS and fresh human blood, citric acid and fresh human blood and were segregated into eight groups. Finally all the dentin blocks were processed and subjected to a scanning electron microscope study. RESULTS: In PBS-treated samples, the dentin surface was irregular corresponding to smear layer and the dentinal tubule openings were obscured. Whereas, in those treated with citric acid revealed a smooth dentin surface devoid of smear layer and the dentinal tubular openings were clear. Further samples that were treated with PBS plus blood showed little or no fibrin network formation whereas with those citric acid plus blood showed a fine thick fibrin network formation adhered to dentinal surface. CONCLUSION: The results of this present in vitro study suggests that use of citric acid as a root conditioning agent has a beneficial effect on initial wound healing events, which are critical for periodontal regenerative therapies.