Estimation of neopterin as a biomarker in biofluids of pre and post-menopausal women after initial periodontal therapy: A biochemical assay.

CONTEXT: Periodontitis (PDD) is a chronic inflammatory condition by nature which destroys the surrounding tooth structures. Menopause (pre and post) worsens the inflammatory state. Biofluids could serve as sources of biomarkers that could diagnose or indicate the intensity and extent of both conditions. AIMS: This study aimed to guestimate the various biofluids of neopterin (NP) levels in premenopause (pre-m) and postmenopausal (post-m) women with PDD after initial periodontal therapy (IPT). SETTINGS AND DESIGN: This was an interventional cross-sectional study. MATERIALS AND METHODS: Based on menstrual history, within the age range of 40-60 years, 30 female patients having PDD participated, who were grouped into pre-m and post-m, each group comprised 15 subjects. A biochemical test of NP levels was done at the initial and three months following IPT. Statistics used: Group comparisons and percentage decrement using independent sample t-test and paired t-test for intragroup comparison were done with the version 21, IBM SPSS software. RESULTS: Intragroup NP analysis at different time points showed significant improvement. Intergroup comparison, however, has shown significant improvement in the premenopausal group (Group I) only. CONCLUSIONS: Reduced levels of NP were found in pre-m and post-m groups 3 months after IPT, inferring that IPT is a paragon in periodontal therapy and NP might be a good diagnostic marker to detect PDD.

Radiosurgery in periodontics: Have we forgotten it?

Radiosurgery (RS) has evolved from electrosurgery and uses ultra-high-frequency radio waves at a frequency ranging from 3 to 4 MHz. It is used to address numerous soft-tissue concerns in dentistry and as well as medicine with excellent and predictable results. A review of the indexed literature disclosed that RS has been employed for various periodontal procedures such as gingivectomy, gingivoplasty, crown lengthening, minimally invasive closed osteotomy, frenectomies, operculectomies, depigmentation, gingival curettage, periodontal flap procedures, mucogingival surgeries, harvesting soft-tissue grafts, and also in implantology. Reduced lateral heat production with minimal tissue damage, faster healing, availability of specialized electrodes, increased perception, and cost-effectiveness are some of the notable advantages of RS. The evidence available implies that RS when used appropriately might be a better and economical alternative to a scalpel, electrosurgery, and laser. Inadequate knowledge on the use of this treatment modality due to short of research conducted in this area could be the reason behind it becoming obsolete. This review is an attempt to reminiscence the uses of this versatile tool in periodontal therapy and reinstate its use in present-day clinical practice.

Assessing Coronavirus Fear in Indian Population Using the Fear of COVID-19 Scale.

The current study aimed to determine the level of fear of COVID-19 among Indian residents using the Fear of COVID-19 Scale (FCV-19S) and compare it with demographic variables. This cross-sectional online survey conducted among the Indian population employed a convenient snowball sampling technique. Age, gender, marital status, educational qualifications, health care worker status and state of residence were the demographic details (six items) collected. The seven-item FCV-19S was used to assess fear regarding COVID-19 on a five-point Likert scale. The mean score for the responses was calculated and compared based on demographic variables. A comparison of low and high levels of fear and a multiple logistic regression analysis of levels of fear with demographic variables were conducted. p < 0.05 was considered statistically significant. The study population comprised 45.6% (683) males and 54.4% (816) females, with approximately 68% belonging to the age group of 20-40 years. The overall mean score for the questionnaire was 18.00 + 5.68. A significantly higher number of the study population reported low fear (54.8%). Only gender (p = 0.08) and health care worker status (p = 0.02) revealed a significant difference based on the level of fear. Females, married status, lower educational status and being a health care worker displayed significantly higher odds for high level of fear compared to their respective counterparts in this study population. The findings of this study may help to identify the groups most at risk and formulate tailor-made intervention strategies to ensure their optimal health in this time of global crisis.

Biochemical Analysis of Three Biological Fluids and its Response to Non-Surgical Periodontal Therapy in Pre and Postmenopausal Women with Periodontitis.

OBJECTIVES: Periodontitis is a common chronic inflammatory disease characterized by the destruction of the supporting structures of the teeth. The stages of menopause also worsen inflammatory condition. Biomarkers from biological fluids can be used as a diagnostic indicator to correlate these two conditions of present and future disease activity. The aim of the present study was to evaluate the neopterin levels in three biological fluids obtained from pre- and postmenopausal women with periodontitis following non-surgical periodontal therapy (NSPT, that is, scaling). METHODS: This was a cross-sectional interventional study. Thirty women, aged 40-60 years, with periodontitis were selected according to their menstrual history. They were divided into the pre- and postmenopausal groups, with each group including 15 participants. The neopterin levels were measured in both groups at baseline and 3 months after NSPT. Intergroup comparison and percentage decrement analysis were performed using the independent sample t test, and intragroup comparison was performed using the paired t test. RESULTS: There were statistically significant reductions in the mean values of saliva, urine, and plasma from baseline to 3 months after NSPT in the groups. Intergroup comparison showed no significant values in the postmenopausal group, and a significant reduction was seen in the mean values was seen in the mean values. CONCLUSIONS: Neopterin levels decreased at 3 months after NSPT in both the groups, suggesting that NSPT can be a gold standard therapy and that the neopterin level could be a indicator to identify periodontal destruction.

Evaluation of periodontal response to nonsurgical therapy in pre- and post-menopausal women with periodontitis.

CONTEXT: : The influence of sex steroid hormones on periodontium can be lowered with good plaque control. AIMS: The aim of the present study was to evaluate periodontal status in pre- and post-menopausal women with periodontitis following nonsurgical therapy. SETTINGS AND DESIGN: Interventional pre-post clinical trial. SUBJECTS AND METHODS: Periodontal status was measured by periodontal index (PRI), and oral hygiene status was measured by plaque index (PI). Both the parameters were measured at baseline, i.e. before scaling and root planing and after 3 months intervals posttreatment. STATISTICAL ANALYSIS USED: IBM SPSS version 21. RESULTS: The mean PRI scores in premenopausal group were 5.68 ± 0.64 and 2.53 ± 0.13 and PI scores were 1.84 ± 0.17 and 0.91 ± 0.13, respectively, at baseline and 3 months. The mean PRI scores in postmenopausal group were 6.08 ± 0.47 and 2.54 ± 0.12 and PI scores were 1.86 ± 0.25 and 1.00 ± 0.24, respectively, at baseline and 3 months. CONCLUSIONS: There was more desirable response to nonsurgical periodontal therapy in both the groups but not much variation in between two groups.

Evaluation of collagenase-3 matrix metalloproteinase-13 gene-associated polymorphisms 11A/12A and -77A/G and its associated alleles with and without periodontitis.

CONTEXT: Connective tissue devastation in periodontitis and other chronic inflammatory diseases is a major concern. There are several inflammatory mediators associated with this process among which matrix metalloproteinases (MMPs) play a predominant role. Collagen degradation is primarily mediated by the collagenases. MMP-13 is familiar as collagenase-3, which has the aptitude to humiliate fibrillar collagen. AIMS: This study aims to evaluate MMP-13 promoter polymorphism, 11A/12A, and -77A/G and associated alleles in patients with and without chronic periodontitis (CP). SETTINGS AND DESIGN: This was an observational case-control study. MATERIALS AND METHODS: Of the total 100 patients, 50 with CP (test group) and 50 without CP (Control group), blood was collected for deoxyribonucleic acid isolation. The 11A/12A and -77A/G polymorphisms of the MMP-13 gene were picked out by polymerase chain reaction (PCR)- single-strand conformation polymorphism analysis method and PCR-restriction fragment length polymorphism by BseNI restriction enzyme, respectively. STATISTICAL ANALYSIS USED: Association between MMP-13 genotype (GTs) (11A/12A, 11A/11A, 12A/12A) and (AA, AG, GG) was assessed by Chi-square and Student's t-test for intergroup comparison. RESULTS: 11A/12A GT was seen in 24% and 20%, 11A/11A 64% and 72%, 12A/12A 12% and 8% in test and control groups, respectively. However, the association was not statistically significant. -77A/G polymorphism associated GT s AA was 56% and 62%, AG 24% and 28%, GG 20% and 10% in test and controls, respectively. An association of GG was statistically significant. CONCLUSION: The present study results indicated that MMP-13 -77A/G gene polymorphisms, GG GT may be predicted intensive ability for CP. On the other hand, there was no significant association between MMP-13 11A/12A gene polymorphisms with CP.

Comparative Evaluation of Salivary Neopterin Levels and Its Effects to Periodontal Therapy in Pre- and Post-Menopausal Women.

OBJECTIVES: Neopterin is a valuable diagnostic biomarker, which is elevated in inflammatory conditions like periodontitis, that is characterized by destruction of the supporting structures of the teeth. Among the biomarkers, neopterin occurs in body fluids, and acts as a diagnostic marker for present and future disease activity. METHODS: Thirty female subjects with chronic periodontitis, mean age 50 years (40-60 years) were included in this study. Depending upon their menstrual history, subjects were categorized into two groups of fifteen each. Group I 15 pre-menopausal women, and Group II 15 post-menopausal women. Saliva was collected, and neopterin levels were assessed by enzyme-linked immunosorbent assay in both the groups, at base line and after three months of nonsurgical periodontal therapy (NSPT). Periodontal parameters like pocket probing depth (PD) and Russell's periodontal disease index (PDI) were assessed before treatment as well as after three months of scaling and root planning. RESULTS: Intra group analysis showed significant markdown in the mean values of all the parameters from baseline to three months (P < 0.001), for all patients. The intergroup comparison, from baseline to 3 months also showed no significant change in PD and PDI values, but there was a statistically significant difference in the salivary neopterin levels (P = 0.04). CONCLUSIONS: Neopterin levels were found to be reduced in three months after NSPT in both the groups, suggesting that the NSPT is the gold standard therapy, and also that neopterin levels in saliva can be used as an indicator to identify periodontal inflammation and destruction.

A Comparative Analysis of Pre- and Postmenopausal Females with Periodontitis and Its Response to a Non Invasive Clinical Approach.

OBJECTIVES: The influence of sex steroid hormones on periodontium can be knockdown with good plaque control. The aim of the present study was to evaluate periodontal status in pre- and postmenopausal women with periodontitis following non-surgical therapy. METHODS: Total 60 female patients' periodontal status was measured by periodontal index (PRI), and oral hygiene status was measured by plaque index (PI). Both the parameters were measured at baseline i.e. before scaling and root planing and after 3 months intervals post treatment. Data were analyzed using SPSS version 21. RESULTS: The mean PRI scores in premenopausal group were 5.68 ± 0.64 and 2.53 ± 0.13, and PI scores were 1.84 ± 0.17 and 0.91 ± 0.13 respectively at baseline and 3 months. The mean PRI scores in postmenopausal group were 6.08 ± 0.46 and 2.55 ± 0.12, and PI scores were 1.86 ± 0.24 and 1.00 ± 0.24 respectively at baseline and 3 months. CONCLUSIONS: There was more desirable response to non-surgical periodontal therapy in both the groups but not significant variation in between two groups.

Correlative analysis of plasma and urine neopterin levels in the pre- and post-menopausal women with periodontitis, following nonsurgical periodontal therapy.

CONTEXT: Periodontitis is an inflammatory condition which is distinguished by the devastation of the supported tooth structures. In such inflammatory conditions, some biomarkers such as neopterin will be secreted and elevated in the body fluids, which can be used as a diagnostic marker for the present and future disease activity. AIMS: Assessment of the neopterin as a biomarker in inflammatory conditions such as menopause and periodontitis. SETTINGS AND DESIGN: A cross-sectional interventional study. MATERIALS AND METHODS: Sixty female individuals with a mean age of 40-60 years with chronic periodontitis were included in this study. All were categorized into two groups of thirty each, depending on their menstrual history: Group I - thirty premenopausal women and Group II - thirty postmenopausal women. Urine and plasma were collected from both groups to estimate neopterin levels. ELISA kit was used to assess the neopterin levels at baseline and after 3 months of nonsurgical periodontal therapy (NSPT). STATISTICAL ANALYSIS USED: IBM SPSS version 21 software. RESULTS: A significant depreciation in the mean values of all the parameters from baseline to 3 months (P < 0.001), in the intragroup analysis, was observed. Plasma (0.006) and urine (0.004) reduction was seen. CONCLUSIONS: In both the groups, in 3 months after NSPT, decreased neopterin levels were found, suggesting that the NSPT is the definitive therapy. Further, suggesting that, neopterin levels in the plasma and urine can be used as an index to identify the periodontal inflammation and destruction.

Effect of Alendronate with ß - TCP Bone Substitute in Surgical Therapy of Periodontal Intra-Osseous Defects: A Randomized Controlled Clinical Trial.

INTRODUCTION: Alendronate (ALN), an aminobisphosphonate, inhibits osteoclastic bone resorption and also stimulates osteogenesis. Beta-Tricalcium Phosphate (ß-TCP) is an osteoconductive graft material which provides a scaffold for bone formation and also a widely used drug delivery vehicle for growth factors and antibiotics. Drug delivery vehicles, like ß-TCP, improve the potency of the drugs by specific local site delivery of the drug, optimal release characteristics and easy handling. AIM: The aim of the this study was to evaluate the bone formation potential of 400µg ALN delivered in ß-TCP in the treatment of periodontal intra-osseous defects. MATERIALS AND METHODS: Thirty patients with periodontal defects were randomly assigned to 400µg ALN + ß-TCP + Saline (test) group and ß-TCP + Saline (active-control) group. Clinical parameters like Clinical Attachment Level (CAL) gain, Probing Depth (PD) reduction, post-operative Gingival Recession (GR) were assessed from the baseline, 3 months and 6 months recordings. Radiographic parameters like Linear Bone Growth (LBG), Percentage Bone Fill (%BF), and change in alveolar crest height (ACH) were assessed from baseline and 6 months radiographs. RESULTS: Mean measurements in the ALN test group for CAL gain (3.4 ± 0.74 mm), PD reduction (4.33 ± 0.82 mm), LBG (2.88 ± 0.88 mm), and %BF (51.98 ± 15.84%) were significantly greater with a p-value <0.05 compared to the mean measurements of CAL gain (2.20 ± 0.86 mm), PD reduction (3.20 ± 1.15 mm), LBG (1.70 ± 0.39 mm), and %BF (30.35 ± 6.88%) of the control group. There was mild alveolar crestal apposition (0.32 ± 0.68 mm) in the ALN test group and mild alveolar crestal resorption (-0.24 ± 0.40 mm) in the control group. CONCLUSION: 400µg ALN combined with ß-TCP bone graft material was effective in improving soft tissue parameters, inhibiting alveolar crestal resorption and enhancing bone formation, compared to ß-TCP alone.

Plasma Cell Gingivits-A Conflict of Diagnosis.

Plasma Cell Gingivitis (PCG) is a rare condition of the gingiva which is benign in nature. In this condition there is enlargement of the marginal and attached gingiva. It is not only unaesthetic in appearance but also causes difficulty in speech and mastication. Hence, it creates an area for plaque accumulation because of which there is difficulty in carrying out the routine oral hygiene procedures. The aetiology is unknown and is thought to be a hypersensitive reaction to an allergen. This condition is characterized by massive infiltration of the plasma cells into the sub-epithelial connective tissue layers. Here we are presenting two cases of PCG associated with swollen lips, which is an uncommon condition. These cases were treated by gingivectomy and followed up to six months.

Platelet-rich fibrin, "a faster healing aid" in the treatment of combined lesions: A report of two cases.

Anatomically the pulp and periodontium are connected through apical foramen, and the lateral, accessory, and furcal canals. Diseases of one tissue may affect the other. In the present case report with two cases, a primary periodontal lesion with secondary endodontic involvement is described. In both cases, root canal treatment was done followed by periodontal therapy with the use of platelet-rich fibrin (PRF) as the regenerative material of choice. PRF has been a breakthrough in the stimulation and acceleration of tissue healing. It is used to achieve faster healing of the intrabony defects. Absence of an intraradicular lesion, pain, and swelling, along with tooth stability and adequate radiographic bone fill at 9 months of follow-up indicated a successful outcome.