Microbial Symphony: Navigating the Intricacies of the Human Oral Microbiome and Its Impact on Health.

This comprehensive review delves into the forefront of research on the human oral microbiome, exploring recent advancements that span microbial colonization, state-of-the-art detection methodologies, and the complex interplay involved in disease progression. Through an exhaustive analysis of the contemporary literature, we illuminate the dynamic orchestration of microbial communities within the oral cavity, underscoring their pivotal role in health and disease. Cutting-edge detection techniques, including metagenomics and high-throughput sequencing, are discussed regarding their transformative impact on understanding the intricacies of oral microbial ecosystems. As we stand on the cusp of a new decade, this review anticipates a paradigm shift in the field, emphasizing the potential for rapid identification and targeted management of detrimental oral microorganisms. Insights gained from this exploration not only contribute to our fundamental understanding of the oral microbiome but also hold promise for the development of innovative therapeutic strategies to maintain oral health. This article aims to serve as a valuable resource for researchers, clinicians, and public health professionals engaged in unraveling the mysteries of the microbial symphony within the human oral cavity.

Evaluation of salivary IL-8 and calcium levels in postmenopausal females with and without periodontitis-A comparative study.

Background and Objective: Menopause is a normal developmental stage in a woman's life marking the permanent cessation of menstruation. Calcium is predominant in intracellular signalling and its intracellular increase can affect the cell's proliferation, phagocytosis and cytokine secretion. IL-8 expression in various cells such as neutrophils and osteoblasts was reported to involve a calcium signalling pathway. Well-known functions of IL-8 includes help in angiogenesis, role in tumour progression, tissue remodelling, etc., Hence, the aim of this study was to establish the relationship between calcium-dependent IL-8 and periodontal disease in postmenopausal females. Method: The study population included 52 postmenopausal women aged 45-57 years. The patients were divided into two groups in which group I included postmenopausal women without periodontitis and group II with periodontitis. Unstimulated salivary samples were collected from all the participants to evaluate IL-8 and calcium levels. Results: There was a statistically significant difference in salivary IL-8 levels between the two groups (P < 0.001), but there was no statistical difference in salivary calcium levels between the two groups (P = 0.730). A weak negative correlation between salivary IL-8 and calcium was found in group I, while a weak positive correlation was found between the same in group II. Conclusion: Analysis of salivary IL-8 from the present study was in accordance with several previous studies. It can be concluded that saliva can also be used as a reliable oral diagnostic fluid for IL-8 and calcium detection in periodontitis.

Characterization and evaluation of ascorbic acid-induced cell sheet formation in human periodontal ligament stem cells: An in vitro study.

OBJECTIVES: Periodontal ligament-derived stem cells (PDLSCs) are regarded as a viable option for periodontal regeneration using cell sheet technology. The objective of the present in vitro study was to characterize human PDLSCs based on their phenotypic and biological properties and to evaluate the ascorbic acid (AA or vitamin C)-induced cell sheet by analyzing the molecular markers. METHODS: PDLSCs were established from premolars, and their morphology, viability, proliferation, phenotypic marker expression, and ability to differentiate into osteocytes and adipocytes were analyzed. PDLSCs were then induced to form cell sheets using 100 µM AA, and gene expression was examined by real-time polymerase chain reaction. RESULTS: PDLSCs showed fibroblastic morphology with >95% viability. The cells were highly proliferative and positive for surface antigens CD29, CD73, and CD90 but negative for CD34 and CD45. They were capable of differentiating into osteocytes and adipocytes. Induction with 100 µM AA transformed PDLSCs into two-to three-layered cell sheets. There was no significant upregulation in ALP and RUNX2 expression in the AA-induced cell sheet. However, the expression levels of late osteoblast differentiation marker (bone gamma-carboxy glutamate protein); cementogenic markers (cementum attachment protein and CP23), and genes encoding extracellular matrix (ECM) proteins [collagen type 1 alpha 1 and integrin beta 1) were higher in AA-induced cell sheets by PDLSCs. CONCLUSIONS: The stimulating effect of AA on cell sheet formation by PDLSCs was confirmed by the expression of typical markers involved in osteogenesis/cementogenesis and ECM secretion, which makes this procedure a prospective option for periodontal tissue regeneration applications.

Comparative evaluation of serum cotinine levels in chronic periodontitis and chronic obstructive pulmonary disease.

CONTEXT: Periodontitis and chronic obstructive pulmonary disease (COPD) are chronic progressive inflammatory conditions. Smoking has been associated with both chronic periodontitis and COPD. Hence, the present study was designed to correlate serum levels of cotinine with the severity of periodontal disease with or without COPD. SETTINGS AND DESIGN: A total of eighty patients, twenty healthy individuals, twenty patients with chronic generalized periodontitis without smoking and without COPD, twenty patients who are smokers with chronic periodontitis without COPD and twenty patients who are smokers with chronic periodontitis and COPD in the age range of 43-65 years were selected for the study. SUBJECTS AND METHODS: Serum cotinine level assessment, smoking history, and periodontal examination were done in all the patients and the data obtained were statistically analyzed. RESULTS: The mean serum cotinine level was highest in smokers with chronic periodontitis and COPD (93.642 ± 14.727) and it differed significantly between the four groups (P < 0.001). There is a significant positive correlation between the number of cigarettes and serum cotinine levels in both groups involving smoking. There was no significant correlation between serum cotinine level and clinical attachment loss in chronic periodontitis smokers with or without COPD. CONCLUSIONS: The result of this study indicates that increased smoking with COPD causes a higher chance of progression of periodontal destruction but it is not statistically significant. Furthermore, this study indicates that the assessment of serum cotinine levels is a reliable method to evaluate smoking exposure.

Efficacy of Xanthan-Based Chlorhexidine Gel on the Levels of Interleukin-1ß in Chronic Periodontitis: An Interventional Study.

AIMS AND OBJECTIVES: Xanthan-based chlorhexidine gel (Chlosite®) is a local drug delivery system that exposes the sub-gingival bacteria to the effects of chlorhexidine (CHX) for a prolonged time. Hence, the study aimed at evaluating the clinical efficacy of the subgingival application of Chlosite gel as an adjunctive to mechanical scaling and root planing (SRP) and at evaluating the salivary interleukin (IL)-1ß level to substantiate the clinical efficacy of xanthan-based CHX gel. MATERIALS AND METHODS: A total number of 40 patients with chronic periodontitis in the age group of 30-50 years were enrolled in this interventional study. The patients were assigned to group A, in which only SRP was done, and group B, in which SRP along with the subgingival application of Chlosite gel was done. Periodontal parameters and salivary IL-1ß level were evaluated, and the data obtained were statistically analyzed by using paired and unpaired "t" tests. RESULTS: The results obtained showed a statistically significant reduction in the mean gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and salivary IL-1ß values in both the groups from baseline to 30 days. There was a statistically significant reduction in GI, in group B when compared with group A, after the treatment. Salivary IL-1ß value in group B was slightly lower when compared with group A after the treatment, but it was not statistically significant. CONCLUSIONS: The xanthan-based CHX gel is therapeutically effective when used as an adjunct to SRP. The study also indicated that salivary IL-1ß can be used as a reliable biomarker.

Salvaging the Lost Pink Triangle: A Case Series of Papilla Reconstruction.

INTRODUCTION: The interdental papilla may be lost or reduced in height, forming black triangles due to various reasons, which gives an unaesthetic appearance when the patient smiles. Various noninvasive and invasive techniques have been used to augment/reconstruct the interdental papilla, to reclaim the pink triangle. The most satisfactory and natural appearance can be obtained by augmenting or reconstructing the lost papilla as the pink esthetics is as important as the white esthetics. CASES: Two female patients and 1 male patient reported to the dental department with the complaint of a small black gap in the gum area between their upper front teeth since 6 months and 1 year, respectively. On examination, the interdental papillae in all three cases were classified as class 1 (Nordland and Tarnow's). The interdental papilla was augmented surgically by using three different approaches in each case. RESULT AND CONCLUSION: Postoperatively and after 1-month follow-up, there was a complete fill of the interdental area by the interdental papilla normal (Nordland and Tarnow's). As a result, the black triangle was successfully converted into a natural pink triangle in all three cases.

Rare phenomena of tacrolimus-induced gingival hyperplasia.

In the modern world, men and women are very much concerned about their esthetic appearance. The gingival perspective of esthetics is more often concerned with the soft tissue envelope surrounding the teeth. Gingival enlargement/overgrowth is numerous in nature and often poses a clinical challenge by altering the function, resulting in poor oral health of an individual. Tacrolimus, an immunosuppressive drug, has been broadly used for organ-transplant rejection. It results in much less severe hypertension, hypertrichosis and gingival overgrowth compared to cyclosporine and calcium channel blocker-induced gingival enlargements. However, there is scanty literature available regarding the tacrolimus-induced gingival enlargements. Therefore, the present case report with a 6-month follow-up period describes the execution of the proper treatment plan and surgical protocol for the management of a severe case of generalized gingival enlargement attributed to tacrolimus-induced therapy following renal transplant.

Estimation of Sialic Acid and IL10 Levels in Stage 1 and 2 Periodontitis Patients.

OBJECTIVE: The role of biomarkers in staging and grading periodontal disease has become detrimental in relation to the overall treatment plan. This study aimed at evaluating and comparing the role of sialic acid and IL10 in the early and moderate stages of periodontitis. MATERIALS AND METHODS: Patients were selected according to the assessment of pocket depth and radiographic bone loss. Bone loss was calculated as <15% for stage 1 and 15-33% for stage 2. Salivary samples were collected using spit technique 2 hrs post consumption of food. The unstimulated saliva was collected in a sterile graduated container every minute for 5-8 minutes. IL10 estimation was done using ELISA, and sialic acid estimation was done using the diphenylamine method. The variables for the three groups were assessed using ANOVA, and intragroup comparisons for quantitative data were evaluated using the post hoc Bonferroni test (P < 0.05). RESULTS: On comparing sialic acid levels among the three groups, stage 2 showed the highest mean (8.61) compared with the other two groups and was highly significant (P < 0.001). On the contrary, IL10 when compared to stage 1 and 2 periodontitis revealed insignificant change. CONCLUSION: The value of IL10 was higher as patients progressed from health to periodontitis.

A comparative evaluation of the micronutrient profile in the serum of diabetes mellitus Type II patients and healthy individuals with periodontitis.

BACKGROUND: Micronutrients play an important part in metabolism and maintenance of tissue function the maintenance of the integrity and vitality of the periodontal tissues depends on the availability of adequate nutrients, and it is possible that deficiencies can produce pathological alterations in the periodontal tissues. However, the association between nutritional factors and periodontal health is not fully understood. The essential micronutrients for maintaining health include zinc, copper, selenium, and iron. These micronutrients are required for a variety of biomolecules to maintain the normal structure, function, and proliferation of cells and also immune functions. Periodontal disease and diabetes mellitus (DM) are considered to have a bidirectional relationship, and periodontitis is recognized as the 6th major complication of DM. The number of studies on the role of micronutrients with regard to periodontal disease is limited. AIMS: This study aims to evaluate the role of micronutrients-zinc, copper, selenium, and iron, in the serum of chronic periodontitis patients and chronic periodontitis with DM Type II patients, to see whether they can serve as potential markers for chronic periodontitis and also to assess whether periodontitis can have systemic effects. MATERIALS AND METHODS: A volume of 5 ml of venous blood was collected from each of the study participants, from the antecubital vein. The blood was then centrifuged and stored at -20°C before being analyzed. Zinc, copper, and selenium were estimated by the atomic absorption spectrophotometry, bathophenanthroline method was used to estimate iron. STATISTICAL ANALYSIS: It was carried out using Student's t-test and analysis of variance. The honestly significant difference Tukey test and Pearson's correlation was also used. RESULTS: The mean serum zinc levels were significantly higher in healthy controls as compared to Periodontitis and Periodontitis with DM type II. The mean serum copper levels were significantly higher in Periodontitis with diabetes as compared to controls and periodontitis. Serum selenium levels were significantly higher in controls as compared to periodontitis with diabetes. The mean serum iron levels were significantly higher in periodontitis with diabetes. The Zinc: Copper (Zn: Cu) ratio was found to be significant for the periodontitis with diabetes group. CONCLUSION: The results obtained from this study suggests that the serum levels of micronutrients Zn and Se were decreased and levels of Cu and Fe are increased in chronic periodontitis as compared to healthy control. There was a potentiated difference in the values in patients with DM Type II. The results show that the levels of these micronutrients can be used as effective biomarkers for chronic periodontitis and that periodontitis has systemic manifestations.

Effect of Hyaluronic Acid Added to Suture Material and its Relationship with Bacterial Colonization: An In vitro Study.

AIMS AND OBJECTIVES: The aims of this study were to evaluate the presence of Staphylococcus aureus and Escherichia coli, in polyglycolic acid (PGA) 4-0 and silk sutures, with or without hyaluronic acid (HA) treatment. MATERIALS AND METHODS: This in vitro study measured S. aureus and E. coli growth on PGA and silk sutures, through incubation in agar media for 24 h. The suture length was 10 cm and divided into three parts: A (8 h), B (16 h), and C (24 h), which were observed every 8 h, followed by suspension on a microscopic slide. This was repeated thrice. The number of S. aureus and E. coli cells was recorded and compared between the suture types. RESULTS: The mean S. aureus colony forming units (CFUs) differed at each time point between non-HA and HA-PGA sutures (P = 0.0016), with a greater number of CFUs on non-HA-PGA. The mean S. aureus CFUs were significantly higher on non-HA silk than on HA-silk sutures (P = 0.008). There was a significant increase in E. coli CFUs on non-HA silk than on HA-silk sutures (P = 0.008). E. coli CFUs were higher on non-HA-PGA than on HA-PGA sutures (P = 0.006). We performed repeated measures two-way ANOVA (SPSS version 13.0) for comparison between group factors and time points and Posthoc analysis using independent samples t-test. CONCLUSIONS: HA reduced wicking in both PGA and silk sutures.

Salivary and Serum Antioxidants in Women with Preeclampsia with or Without Periodontal Disease.

Background and Objectives: Preeclampsia is a challenging disease of human pregnancy that affects the mother and her foetus. It is a common obstetric syndrome of undefined aetiology affecting 7-10% of pregnant women. This study aimed to investigate the total antioxidant capacity (TAC), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, malondialdehyde levels, uric acid, vitamin C, and vitamin E levels in serum and saliva of preeclamptic and normotensive pregnant women with and without periodontitis. Methods: Sixty pregnant women, divided into four groups, preeclamptic women with and without periodontitis, and normotensive pregnant women with and without periodontitis, were recruited between 26 and 36 weeks of gestation from the Outpatient Department of Obstetrics and Gynaecology, KS Hedge Hospital, Mangalore. Pocket depth, clinical attachment loss, and gingival index were measured in all subjects. Saliva and serum levels of TAC, SOD, and GPx activities, malondialdehyde levels, vitamin C, vitamin E, uric acid were determined using spectrophotometer. Results: Comparison of sociodemographic variables among the study groups showed no significant differences. Salivary malondialdehyde levels were highest (p = 0.025), levels of antioxidants vitamin C (p = 0.027) and uric acid (p = 0.013) being significantly lower in preeclamptic women with periodontitis. This group also had significantly lower serum levels of vitamin C (p = 0.041) and SOD (p = 0.004). Conclusions: The results of our study show that periodontal disease may be potential risk factor for severity, progression, and even initiation of preeclampsia because of reduced antioxidant capacity or increased oxidative stress.

A Comparative Evaluation of Serum Magnesium in Diabetes Mellitus Type 2 Patients with and without Periodontitis - A Clinico-biochemical Study.

INTRODUCTION: Magnesium is an essential cation playing a crucial role in many physiological functions and its imbalance is associated with greater number of pathological situations. Oxidative stress is usually increased due to decreased essential nutrients. Hence, any imbalance of essential nutrients like serum magnesium can significantly play a role in the pathobiology of periodontitis in the presence of diabetes, as diabetes and chronic periodontitis are two chronic diseases that have been biologically linked. AIM: To evaluate the association of serum magnesium in type 2 diabetes mellitus and chronic periodontitis patients, also to evaluate and associate the influence of serum magnesium on periodontal health. MATERIALS AND METHODS: A single blinded, randomized study was conducted that comprised of 120 subjects divided into four groups. Individuals with periodontitis and type 2 diabetes mellitus formed the test group. Subjects with chronic periodontitis diagnosed clinically according to 1999 American Academy of Periodontology classification, without any medical history and drug history were included as the study subjects. Gingival Index and Plaque Index were scored for all the groups at baseline and after 21 days of scaling and root planing. Scaling and root planing was done only in the test group. Blood was drawn from the patients at baseline and 21 days after scaling and root planning and estimation of serum magnesium level was done using semi-autoanalyzer. Data obtained was statistically analyzed using the paired t-test, one-way ANOVA, post-hoc test. RESULTS: The result of the present study showed that mean serum magnesium among healthy was 1.40±0.565mmol/l as compared to 1.01±0.287mmol/l among subjects with periodontitis, 0.920±0.23mmol/l among diabetics with periodontitis and 0.93±0.29mmol/l among diabetics without periodontitis. Serum magnesium was significantly decreased in chronic periodontitis and diabetic patients with and without chronic periodontitis as compared to controls. CONCLUSION: Imbalance of serum magnesium level was seen in patients with chronic periodontitis and type 2 diabetes mellitus. Hence, it can be a biomarker which can predict the occurrence of type 2 diabetes mellitus and chronic periodontitis.

Comparative evaluation of subgingivally delivered chlorhexidine varnish and chlorhexidine gel in reducing microbial count after mechanical periodontal therapy.

CONTEXT: Antimicrobial efficacy of subgingival chlorhexidine (CHX) application using two different vehicles of delivery. AIMS: The aim was to evaluate the efficacy of CHX varnish and gel as an adjunct to scaling and root planing (SRP) in reducing microbial count within moderate to deep periodontal pockets. SETTINGS AND DESIGN: Experimental parallel mouth study. SUBJECTS AND METHODS: A total of 30 subjects between the age groups 25 and 55 years having moderate to severe periodontitis, with pocket depth ≥ 5 mm were selected for the study. The selected patients were randomized into three groups of 10 each. Subjects in Group 1 received SRP followed by subgingival application of CHX varnish, subjects in Group 2 received SRP followed by subgingival application of CHX gel, subjects in Group 3 received SRP alone. Subgingival plaque samples were collected to estimate mean motile and nonmotile microbial counts using dark field microscopy at baseline, 1 week, 1 month, and 3 months. RESULTS: After 3 months, there was statistically significant reduction in nonmotile microbial count in all the three groups. Motile microbial count was significantly reduced in all the three groups till 1 month from baseline. Only subjects in Group 1 who received subgingival CHXvarnish after SRP showed a significant reduction in motile microbial count till 3 months from baseline. CONCLUSIONS: Subgingival application of highly concentrated CHX varnish following SRP is beneficial in reducing microbial count in moderate to deep periodontal pockets.

Association of salivary calcium, phosphate, pH and flow rate on oral health: A study on 90 subjects.

BACKGROUND AND OBJECTIVES: This study was designed to compare inorganic salivary calcium, phosphate, flow rate and pH of un-stimulated saliva and oral hygiene of healthy subjects, patients with periodontitis and dental caries and to correlate salivary calcium level with the number of intact teeth. MATERIALS AND METHODS: The present study consisted of 90 patients aged between 18 and 55 years and were divided into three groups, periodontitis, dental caries and controls. Oral hygiene index-simplified, probing pocket depth, clinical attachment level and number of teeth present, teeth with active carious lesions were recorded. Salivary flow rate and pH was recorded and subjected to biochemical investigation. Estimation of inorganic calcium and phosphate was performed by colorimetric method. RESULTS: Results showed statistically significant increase in salivary inorganic calcium and phosphate levels, poor oral hygiene status, pH and salivary flow rate in patients with periodontitis when compared with dental caries group and controls. INTERPRETATION AND CONCLUSION: Individuals who have increased salivary inorganic calcium, phosphate, pH, flow rate and maintain poor oral hygiene could be at a higher risk for developing periodontitis and may have less dental caries and more number of intact teeth.

A comparative evaluation of antioxidant enzymes and selenium in the serum of periodontitis patients with diabetes mellitus type 2.

CONTEXT: Chronic periodontitis is an inflammatory disease with an aberrant response characterized by exaggerated inflammation, involving the release of excess proteolytic enzymes and reactive oxygen species (ROS). Diabetes mellitus is a group of complex multisystem metabolic disorders characterized by a relative or absolute insufficiency of insulin secretion and or concomitant resistance to the metabolic action of insulin on target tissues. Increased production of ROS necessitates elevated requirements for the nutrients involved in antioxidant defenses: Selenium, zinc, and copper. Inflammatory states promote a decrease in the amount of systemic glutathione levels. Catalase is a central antioxidant enzyme constituting the primary defense against oxidative stress. AIMS: This study has been designed to evaluate the comparison of glutathione, catalase, and selenium levels in the serum of diabetes mellitus type 2 patients and healthy individuals with and without periodontal disease. SETTINGS AND DESIGN: This study is a case control study. MATERIALS AND METHODS: The study was designed as a case - control study comprising of 150 subjects, inclusive of both sexes and were divided into three groups of 50 patients each. Group I: 50 subjects with type 2 diabetes mellitus and chronic periodontitis. Group II: 50 subjects who are systemically healthy with the chronic periodontitis. Group III: 50 subjects who are systemically healthy and not suffering from. PERIODONTITIS: Serum samples were taken for estimation of glutathione, catalase, and selenium from all groups, and Subjected to biochemical analysis after which atomic absorption spectrophotometry method was used to obtain their levels in serum. STATISTICAL ANALYSIS USED: ANOVA and Tukey HSD. RESULTS: The serum levels of glutathione in diabetic patients with periodontitis were significantly lower with a mean of 61.36 + 8.054 when compared to healthy individuals with and without periodontitis with a mean of 56.93 + 6.874 and 90.36 + 6.564 respectively (P ≤ 0.005). The serum levels of catalase were significantly lower in diabetic patients with periodontitis with a mean of 19.30 + 7.355 when compared to healthy individuals with and without periodontitis with a mean of 20.71 + 6.472 and 36.09 + 5.108 respectively (P ≤ 0.005). The serum levels of selenium were significantly lower in diabetic patients with periodontitis with a mean of 81.41 + 55.419 when compared to healthy individuals with and without periodontitis with a mean of 161.44 + 84.787 and 193.84 + 66.713 respectively (P ≤ 0.005). CONCLUSIONS: The findings from the study suggest that the levels of glutathione, catalase, and selenium are significantly lower in diabetic patients with periodontitis and also in healthy individuals with periodontitis, but are highest in healthy controls, showing that the serum levels are inversely proportional to inflammation and tissue destruction.

Evaluation of the association between chronic periodontitis and acute coronary syndrome: A case control study.

BACKGROUND: The periodontal tissues mount an immune inflammatory response to bacteria and their products and the systemic challenge with these agents also induce a major vascular response. Although many studies have found a correlation between chronic periodontitis and cardiovascular diseases, the role of infection in acute coronary syndrome is disputed. The aim of this study is to investigate whether there is an association between chronic periodontitis and acute coronary syndrome. MATERIALS AND METHODS: A total of 30 patients, ages ranging from 30 -80. 15 patients from A. B. Shetty Memorial Institute of Dental Sciences and 15 patients admitted to Coronary Care Unit of Justice K. S. Hegde Charitable Hospital Deralakatte Mangalore were included in the study. Variables age more than 40 and gender were also analyzed. RESULTS: Of the 30 patients analyzed in this study, periodontitis was recognized in 11 patients of the acute coronary syndrome group and 10 patients in the healthy group. Fisher's exact test yielded a p value of 0.4539 with an odds ratio of 0.727(95% confidence interval 0.151 to 3.493). CONCLUSION: No significant association was found between periodontal disease and acute coronary syndrome. Periodontitis may contribute to cardiovascular disease and stroke in susceptible subjects. Properly powered longitudinal case control and intervention trials are needed to identify how periodontitis and periodontal interventions may have an impact on cardiovascular diseases.

Correlation between leptin and the health of the gingiva: a predictor of medical risk.

CONTEXT: Over the past decade, a growing body of scientific evidence has suggested an exquisite association between oral infection and systemic diseases (e.g. atherosclerosis, cardiovascular diseases, premature or low birth weight babies, pulmonary diseases, etc.) and also between systemic diseases (e.g. arthritis, diabetes, HIV infection and osteoporosis) and oral and craniofacial diseases and disorders. Leptin is a hormone secreted by the adipocytes in varying quantities and regulates the body weight. The present study was undertaken in the context of knowing the role of leptin in the inflammatory process occurring in the gingiva as the disease progressed from gingivitis to periodontitis. AIMS: The present study was done to correlate the concentrations of leptin and interleukin (IL)-6 within the gingiva in healthy, gingivitis and periodontitis groups of patients and to correlate gingival leptin and IL-6 concentrations with plasma leptin and IL-6 concentrations in the healthy, gingivitis and periodontitis groups of patients. SETTINGS AND DESIGN: This was a cross-sectional study and was carried out on the patients from the out-patient department of Periodontics in A B Shetty Memorial Institute of Dental Sciences. PATIENTS AND METHODS: Seventy-five patients in the age group of 18-60 years were selected and grouped based on the gingival index (Loe and Sillness) and their clinical attachment levels into healthy, gingivitis and periodontitis groups. Leptin and IL-6 levels were estimated within gingiva and the plasma of each subject using an enzyme-linked immunosorbent assay kit. The results of this study were tabulated and subjected to statistical analysis. Mean and the standard deviation were calculated using analysis of variance Fisher's F-test and then the results were subjected to Tukey's Honest significance difference method for multiple comparison among the three groups. Correlation among the three groups was estimated using Pearson's correlation analysis. RESULTS: Results showed a statistically significant decrease in the concentration of gingival leptin and a statistically significant increase in the concentration of plasma leptin as the gingival disease progressed. CONCLUSION: It was concluded that as the gingival disease progressed, the gingival leptin concentration decreased, whereas the plasma leptin concentration increased, indicating a possible correlation between leptin concentration in the gingiva and the risk of developing systemic disease like the cardiovascular disease.

Mucocutaneous manifestations of chikungunya Fever: a study from an epidemic in coastal karnataka.

BACKGROUND: Chikungunya fever (CF) epidemic has recently re-emerged in India affecting large population. Mucocutaneous manifestations are an important clinical feature of the disease. We have reviewed mucocutaneous manifestations of the disease during a recent epidemic in coastal Karnataka. PATIENTS AND METHODS: Seventy-five "suspect cases" of CF with dermatological manifestations were examined. RESULTS: WE CATEGORIZED THE MUCOCUTANEOUS MANIFESTATION INTO SIX GROUPS: 1. skin rash, 2. apthae like ulcers, 3. pigmentary changes, 4. desquamation, 5. exacerbation of the existing dermatoses, 6. miscellaneous. Skin rashes were the most commonly observed skin changes followed by apthae like ulcers and pigmentary changes. Desquamation of the skin over the face is a new manifestation observed by us. CONCLUSION: wide spectrum of mucocutaneous manifestations is observed in CF. We have provided a classification for these manifestations, which may help in better recognition and uniform recording in future.