In vivo efficacy of 2% povidone iodine, chlorhexidine gluconate, and herbal extract mouthwash on SARS-CoV-2 viral load in saliva: A randomized clinical trial.

Background: One of the major techniques to reduce the transmission rate of COVID-19 would be to decrease the viral titers of SARS-CoV-2 in the saliva of infected patients and it is particularly useful in a dental setting. The present study evaluated the change in salivary viral load of COVID-19 patients using povidone iodine (PI), chlorhexidine (CHX), and an herbal extract (RightSure®) oral antiviral herbal mouthwash (HM) at clinically recommended duration and concentrations. Materials and Methods: Thirty individuals with SARS-CoV-2 were randomly allocated to three groups: (1) Group 1, PI mouthwash; (2) Group 2, CHX mouthwash; and (3) Group 3, HM mouthwash. A baseline salivary throat sample was collected from all the participants who were later instructed to rinse with their respective mouthwash for 30 s. A second salivary sample was collected 30 min after rinsing. The SARS-CoV-2 viral load was analyzed using real-time reverse-transcription polymerase chain reaction wherein the cyclic threshold (Ct) values were evaluated. Results: Independent t-test analysis reported a statistically significant difference concerning the PI group (before-after comparison) (P < 0.05). The rest of the two study groups failed to report any significant difference in the nucleocapsid gene and open reading frame 1a gene levels. Conclusion: While all three types of mouthwash increased the Ct values, a statistically significant difference was observed with PI mouthwash, indicating that it might potentially reduce the spread of the SARS-CoV-2 virus, especially via aerosol but further studies with larger sample size and longer follow-up periods are required to investigate this relationship.

Triphala: A phytomedicine for local drug delivery - A strategic intervention.

BACKGROUND: In the Indian system of medicine (ISM) Triphala is one of the oldest and longest used natural herbal remedy which consist of mixture of equal parts of the Embilica officinalis Gaertn. (Family- Euphorbiaceae), Terminalia Chebula Retz. (Family- Combretaceae) and Terminalia beleria [Gaertn.] Roxb. (Family- Combretaceae). Currently, Triphala is being extensively researched for its various therapeutic effects including its anti-caries, antioxidant, anti-collagenase and anti-microbial activities. This fruit extract is used in various forms in the treatment of periodontitis. AIM: The aim of the present study was to compare the clinical and microbiological benefits of routine scaling and root planing (SRP) with adjunctive use of Triphala (Hiora GA) as local drug delivery agent in the management of periodontitis. MATERIALS AND METHODS: Thirteen patients diagnosed with chronic periodontitis were included in the present study. The control sites received SRP alone and the test sites received SRP with locally delivered Triphala (Hiora GA). The clinical parameters were evaluated at baseline, 15 days and 1 month. The plaque samples were cultured anaerobically for the keystone-periodontal pathogen Porphyromonas gingivalis, Fusobacterium nucleatum and Prevotella intermedia. The Mann-Whitney U-test and Wilcoxon signed-rank tests were performed to compare the results between the test and control groups. RESULTS: Statistically significant improvement was observed in both groups. Intergroup comparison of prevalence of microorganisms also revealed a statistically significant difference (P = 0.0007) at 15 days and 1 month. CONCLUSION: Subgingivally delivered Triphala (Hiora GA) as an adjunct to SRP in the treatment of chronic periodontitis has shown anticipative results revealing slow and constant releasing property of Triphala.

Diode laser therapy in the management of chronic periodontitis - A clinico-microbiological study.

INTRODUCTION: Chronic periodontitis (CP) is an infectious disease resulting in inflammation of the supporting tissues of the teeth with progressive attachment loss and bone loss. This study aimed to evaluate the effect of 980-nm diode laser, as an adjunct to scaling and root planing (SRP) in the management of CP. METHODOLOGY: A total of 40 systemically healthy subjects diagnosed with CP were randomly assigned into two groups G1 (SRP and sham application of laser) and G2 (SRP and laser irradiation) with equal numbers in each. The levels of Porphyromonas gingivalis (Pg) were estimated from plaque samples using real-time polymerase chain reaction. Clinical and microbiological parameters were assessed at baseline, 4-6, and 12-14 weeks posttreatment in both groups. RESULTS: A gradual reduction in the levels of Pg and improvement in clinical parameters were observed from baseline to 4-6 and 12-14 weeks in both groups. However, the comparison between groups, although clinically relevant, was not found to be statistically significant. CONCLUSION: Although a 980-nm diode laser may not have any added benefit compared with SRP, it may emerge as an effective non-surgical treatment option in advanced periodontitis with complex inaccessible subgingival niches where comprehensive periodontal care may not be feasible.

Correlation of the interleukin-29 levels in crevicular fluid and plasma with the genetic polymorphism in chronic and aggressive periodontitis patients.

OBJECTIVE: To assess the effect of single nucleotide polymorphism (SNP) on the Interleukin (IL-29) quantity in gingival crevicular fluid (GCF) and plasma of chronic and aggressive periodontitis patients. DESIGN: Patients with periodontal health (n=30), chronic generalized periodontitis (n=30) and generalized aggressive periodontitis (n=30) were subjected to IL-29 quantity estimation in GCF and plasma using enzyme linked immunosorbent assay and was correlated with IL-29 SNP (rs30461) using polymerase chain reaction. RESULTS: IL-29 concentration in GCF and plasma was highest in aggressive periodontitis patients (114.17 ± 95.07pg/ml and 149.69 ± 109.90pg/ml respectively). The least concentration was found in subjects with healthy periodontium (47.50 ± 37.75pg/ml and 54.52 ± 37.53pg/ml) and in chronic periodontitis it was found to be 65.01 ± 41.26pg/ml and 81.17 ± 46.23pg/ml. The difference in the quantity of IL-29 in GCF and plasma among different groups was statistically significant (p<0.001 and p<0.001 respectively). rs30461 polymorphism of IL-29 analysis revealed that difference in the prevalence of A/A, A/G and G/G genotype among three groups was not statistically significant (p=0.097). CONCLUSION: Increased quantity of IL-29 in GCF and plasma of subjects with periodontitis suggests a role in pathogenesis of periodontitis and the SNP (rs30461) is not related to susceptibility to periodontitis in this population of Indian individuals.

Expression profile of IL-35 mRNA in gingiva of chronic periodontitis and aggressive periodontitis patients: a semiquantitative RT-PCR study.

BACKGROUND: Proinflammatory and anti-inflammatory cytokines play a key role in the pathogenesis of periodontal diseases. Secretion of bioactive IL-35 has been described by T regulatory cells (T(regs)) and is required for their maximal suppressive activity. T(regs) are involved in the modulation of local immune response in chronic periodontitis patients. OBJECTIVE: Hence, the present study was aimed to investigate the expression of IL-35 mRNA in chronic periodontitis and aggressive periodontitis patients. MATERIALS AND METHODS: The present study was carried out in 60 subjects, which included 20 chronic periodontitis patients, 20 aggressive periodontitis patients, and 20 periodontally healthy controls. IL-35 mRNA expression in gingival tissue samples of all subjects was semiquantitatively analyzed using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). RESULTS: The present study demonstrated the expression of IL-35 mRNA in gingival tissues of all the three groups. IL-35 mRNA expression was highest in chronic periodontitis subjects (6.87 ± 2.32) as compared to the aggressive periodontitis group (4.71 ± 1.43) and least seen in healthy patients (3.03 ± 1.91). CONCLUSION: The increased expression of IL-35 in chronic and aggressive periodontitis suggests its possible role in pathogenesis of periodontitis. Future studies done on large samples with intervention will strengthen our result.

mRNA expression of MMP-28 (Epilysin) in gingival tissues of chronic and aggressive periodontitis patients: a reverse transcriptase PCR study.

BACKGROUND AND OBJECTIVES: Matrix metalloproteinases degrade extracellular membrane and also release bioactive fragments and growth factors, thus influencing fundamental biological and pathological processes. Epilysin (MMP-28) differs from most other MMPs as it is expressed in a number of normal tissues, suggestive of functions in tissue homeostasis. The aim of the present study was to quantitatively evaluate and compare the mRNA expression of epilysin (MMP-28) in gingival tissues of healthy patients and of patients affected by chronic or aggressive periodontitis. METHODS: A total of 60 subjects, 20 periodontally healthy subjects, 20 with chronic periodontitis, and 20 with aggressive periodontitis, were included in this study. Periodontal status was evaluated by measuring gingival index, probing depth and clinical attachment level. mRNA expression of MMP-28 was determined by quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) in gingival tissue samples collected. RESULTS: Relative quantification of mRNA expression of MMP-28 was highest in healthy tissues (RQ = 0.97) when compared to subjects with chronic periodontitis (RQ = 0.37) and aggressive periodontitis (RQ = 0.23), but the difference was not statistically significant. CONCLUSION: mRNA expression of MMP-28 was highest in healthy tissues when compared to diseased periodontal tissues suggesting that MMP-28 could act as a biomarker for periodontal health.

Effect of non-surgical periodontal therapy on interleukin-29 levels in gingival crevicular fluid of chronic periodontitis and aggressive periodontitis patients.

Recently discovered interleukin 29 (IL-29) has antiviral properties and its production is induced by herpes viruses. This study was aimed at analyzing the effect of non-surgical periodontal treatment on IL-29 levels in gingival crevicular fluid (GCF) of chronic and aggressive periodontitis patients. A total of 60 participants were divided into healthy group (group 1; n=20), chronic periodontitis group (group 2; n=20), and aggressive periodontitis group (group 3; n=20). GCF samples collected from each subject at baseline and 6-8 weeks after scaling and root planing were quantified for IL-29 levels using ELISA. The mean IL-29 concentration in GCF was found to be highest in group 3 (92.37 pg/µl). The mean IL-29 level in group 1 and group 2 was 36.88 pg/µl and 69.35 pg/µl respectively. After scaling and root planing, the mean concentration of IL-29 in GCF was increased to 85.99 pg/µl in group 2 and to 114.64 pg/µl in group 3. Results of the present study indicate that antiviral IL-29 level was highest in GCF of aggressive periodontitis patients and least in subjects with healthy periodontium, while that of chronic periodontitis lying in between. After non-surgical periodontal therapy, IL-29 levels increased both in chronic and aggressive periodontitis patients and deserve further investigation as a potential therapeutic agent in treating periodontitis.