Pregnancy Outcomes and Maternal Periodontal Diseases: The Unexplored Connection.

In the early 20th century, numerous in-vitro studies, animal studies, epidemiological studies, and human trials have attempted to demonstrate the interrelationship between pregnancy outcomes and maternal periodontal disease. This review aims to shed light on the unexplored connections between pregnancy outcomes and maternal periodontal diseases. A literature search was conducted using electronic databases such as PubMed, Scopus, Google Scholar, Web of Science, and Embase. Our research focuses on the role of epigenetics, maternal vitamin D status, stress levels, genetic factors, innate immunity, pattern recognition receptors, and any potential paternal influence, and their possible connections to maternal periodontal disease. Although the precise etiologies and pathogenic mechanisms of the adverse pregnancy outcomes remain obscure, substantial affirmation of the inter-relationship between maternal periodontal diseases and adverse pregnancy outcomes may prove to be of public health relevance as periodontitis can certainly be prevented and treated. Maternal periodontal disease may augment the probability of jeopardizing maternal health causing adverse effects on the pregnancy and neonatal morbidity. Hence, emphasis should be placed on an early diagnosis and management of periodontal diseases. Routine oral health evaluation during prenatal care should be encouraged to combat complications. Ensuing endeavors should be undertaken to help find plausible mechanisms keeping in view the future research domains and new pathways.

Rituximab in Childhood and Juvenile Pemphigus Vulgaris: A Systematic Review.

Pemphigus vulgaris (PV) is a chronic autoimmune blistering disorder characterized by the loss of intraepithelial adhesion, affecting the skin and mucous membranes. Both males and females are affected, although it predominantly affects females in their fifth and sixth decades of life. Approximately 1.4 to 3.7% of PV cases occur in the pediatric population (≤18 years of age), and may be classified into childhood/pediatric PV, which affects individuals under 12 years old, and juvenile/adolescent PV, affecting those between 12 and 18 years old. Due to its rare occurrence in children and adolescents, there is often a delay in diagnosis and treatment in this age group. A systematic literature search was conducted on MEDLINE/PubMed, Web of Science, EMBASE, SCOPUS, and Cochrane Library databases to evaluate the efficacy of rituximab (RTX) in childhood and juvenile PV patients. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was employed to assess the risk of bias in case reports and series, while the Cochrane ROBINS-I tool was utilized for evaluating observational studies or non-randomized intervention studies. A total of 18 studies encompassing 46 juvenile or childhood PV patients in the pediatric and adolescent age groups were included for qualitative synthesis. The studies included nine case reports, two case series, five retrospective studies, one prospective study, and one open-label pilot study. Almost all cases of childhood and juvenile PV achieved either complete or partial remission after undergoing RTX treatment during the final follow-up periods. Furthermore, most cases reported no relapse, and only minor adverse events were noted in the RTX treatment group. Despite its potential benefits, the utilization of RTX in pediatric patients raises concerns due to the scarcity of evidence and the absence of controlled studies specific to this age group. Further exploration is necessary to establish a standardized treatment regimen for RTX in pediatric PV, which involves identifying the optimal dosage, frequency, treatment cycle duration, and maintenance therapy duration.

Comparative Evaluation of the Effectiveness of Three Commercially Available Desensitizing Mouthwash on Dentinal Tubule Occlusion: An In Vitro Scanning Electron Microscopic Study.

Aim: To compare and evaluate the effectiveness of three commercially available desensitizing mouthwashes on dentinal tubule occlusion in vitro using a scanning electron microscope (SEM). Materials and Methods: Twenty-seven premolar maxillary teeth were collected and cleaned to remove debris and tissue using an ultrasonic scaler. Enamel was removed with the help of a high-speed plain cut tungsten carbide fissure bur under continuous water spray. Dentinal discs measuring 5 mm × 5 mm × 3 mm were prepared from the coronal region of the extracted teeth using a double-sided carborundum disc and straight micromotor handpiece. Using carborundum paper, the discs were polished and washed with distilled water. The discs were etched using 37% phosphoric acid to remove any smear layer that was caused by the grinding process and to simulate dentinal hypersensitivity by opening the dentinal tubules. The specimens were again washed and stored in distilled water until use. Samples were then randomly allocated into Group A: calcium sodium phosphosilicate mouthwash, Group B: potassium nitrate mouthwash, and Group C: dipotassium oxalate monohydrate mouthwash. The specimens were immersed in a test tube filled with the respective mouthwash and vigorously shaken for 60 s for simulating the natural mouth rinsing action. This procedure was repeated for 7 days, twice daily. To compare and assess the proportion of dentinal tubule occlusion, all the samples were processed and examined under an SEM. Results: The efficacy of the mouthwash on the obliteration of dentinal tubules was compared using the Kruskal-Walis analysis of variance test followed by the post hoc Mann-Whitney U test for pairwise comparison. Group A showed completely occluded tubules in 5 (55.6) and mostly occluded tubules in 4 (44.4). Group B showed mostly occluded in 4 samples (44.4) and partially occluded in 5 samples (55.6) and Group C showed completely occluded tubules in 3 samples (33.3) and mostly occluded tubules in 6 samples (66.7). A P value of 0.05 or less is regarded as statistically significant. *P ≤ 0.05 is statistically significant. Between Group A and Group B as well as between Group B and Group C, there was a statistically significant difference. However, a statistically significant difference between Group A and Group C does not exist. Conclusion: The calcium sodium phosphosilicate group was shown to have the most occlusion of the dentinal tubule, followed by dipotassium oxalate monohydrate and potassium nitrate group.

Comparative Assessment of Periodontal Status in Subjects with and without Polycystic Ovary Syndrome and its Correlation with Body Mass Index: A Cross-Sectional Study.

New avenues for research have opened, which assess the influence of systemic disease on periodontium and vice versa. To find the correlation between polycystic ovary syndrome (PCOS) and periodontium by assessing clinical parameters [plaque index (PI), probing depth, periodontal disease index (PDI)] and the anthropological parameter [body mass index (BMI)] and to find the correlation between body mass index and periodontal disease index in subjects with and without PCOS. Sixty females comprising 30 with PCOS and 30 without PCOS were selected. Clinical, anthropological, and radiological assessment was done. Double blinding was incorporated. There was a statistically highly significant difference in mean age, mean PI, and mean PDI (P < 0.001) in PCOS group when compared to those without PCOS group by unpaired t-test for inter-group analysis. A statistically significant difference was found in mean probing depth and mean BMI (P < 0.05) in PCOS group when compared to those without PCOS group by unpaired t-test for inter-group analysis. No statistically significant correlation was found between mean PDI and mean BMI in PCOS and non-PCOS group subjects using Spearman's rank correlation. Women suffering from PCOS may be at a heightened risk for developing periodontal disease as our study re-establishes this association with respect to some periodontal parameters. With such a result, general practitioners/gynecologists can be encouraged to refer cases of PCOS to periodontists for early detection, prevention of periodontal disease, and maintenance of periodontal health.

Identifying the Potential Determinants of Tobacco Counseling Implementation among Oral Health Professionals of India: A Cross-Sectional Survey

ABSTRACT Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India.

Pharmacokinetics and tissue distribution of tenofovir, emtricitabine and dolutegravir in mice.

BACKGROUND: Studies of antiretroviral drug (ARV) tissue distribution in preclinical models, such as mice, are key to understanding viral persistence. OBJECTIVES: To determine the plasma and tissue pharmacokinetics and tissue distributions of tenofovir, emtricitabine and dolutegravir in mice. METHODS: ARVs were simultaneously administered to two different strains, and their levels in plasma and tissue samples were determined by a validated LC-MS/MS method. A non-compartmental analysis was performed to estimate the main pharmacokinetic parameters. A tissue penetration factor (TPF) was calculated as the ratio of the concentration in the tissue concerned to that in plasma. RESULTS: ARV plasma pharmacokinetic parameters in both strains were similar to those estimated in the clinical context. Tissue concentrations were highest in the digestive tract, followed by the liver and kidneys, lymphatic system, pancreas, adipose tissue and lungs. Tissue concentrations were lowest in the brain. Triple therapy could not be considered effective in any of the tissues considered. The TPF values obtained showed that tenofovir diffused widely, especially in the digestive tract, liver and kidneys. Emtricitabine had a TPF above 100% in two-thirds of the tissues. Dolutegravir was poorly distributed to all tissues. CONCLUSIONS: Drug specificity was observed, with higher levels of exposure to tenofovir than to emtricitabine or dolutegravir. Tissue specificity was also observed, with strong penetration of the digestive tract and weak penetration of the brain. These data have important implications for future preclinical and clinical studies for developing new HIV therapies with the goal of an HIV cure.