Chronic Periodontitis Subjects Research Articles

Gingival crevicular fluid levels of sclerostin in chronic periodontitis and healthy subjects.

ObjectivesChronic periodontitis is a common inflammatory disease of the oral cavity that causes destruction of periodontal tissues and bone around the teeth. Sclerostin is a protein encoded by the SOST gene. In this study, gingival crevicular fluid (GCF) levels of sclerostin in patients with chronic periodontitis were compared with those of healthy subjects.Materials and MethodsIn this case-control study, a total of 40 subjects were enrolled and divided into the healthy group (n=23) and chronic periodontitis group (n=17). GCF samples were collected, and the concentration of sclerostin was evaluated using enzyme-linked immunosorbent assay. Comparison of significance between groups was assessed using Mann-Whitney U test.ResultsSclerostin concentration was significantly higher in the chronic periodontitis group compared with the healthy group (P<0.005).ConclusionDespite the limitations of this study, sclerostin can be a possible marker for assessment of periodontal health status.

Detection of antibodies against Aggregatibacter actinomycetemcomitans in serum and saliva through ELISA in periodontally healthy individuals and individuals with chronic periodontitis

BackgroundPeriodontitis is a persistent polymicrobial infection, which leads to chronic inflammation in the tooth supporting tissues. Aggregatibacter actinomycetemcomitans are normal commensals of oral cavity but are low in number in periodontally healthy subjects. They are one of the major pathogens aetiologically linked to periodontal disease. Plasma and salivary antibody measurement may be useful to support diagnosis, disease activity, classification and prognosis of periodontitis. The aim of the present study was to investigate the association between the serum and salivary antibody levels to A. actinomycetemcomitans and therefore, to find whether this association was varying in different grades of periodontitis. MethodTotal of 50 periodontally healthy and 50 chronic periodontitis subjects (35–65 years) of both sexes were included for the study. 2 ml of un-stimulated saliva and 5 ml of venous blood was collected under sterile conditions. The detection of antibodies against A. actinomycetemcomitans in periodontally healthy individuals and individuals with chronic periodontitis was performed using indirect ELISA. ResultsResults showed serum IgG, IgA mean levels against A. actinomycetemcomitans were higher in chronic periodontitis subjects compared to mean levels in periodontally healthy subjects. Similarly, salivary IgG, IgA levels were also raised in chronic periodontitis patients as compared in healthy subjects. Also the mean levels of serum IgG and salivary IgA were increased as the severity of disease increased. ConclusionAntibody titer using saliva and serum could be useful tool for screening of patients with chronic periodontitis. Further, monitoring the various phases of treatment outcome using saliva could be a useful, non-invasive, prognostic indicator.

IFN-γR2 is strongly expressed on endothelial cells of gingival tissues from patients with chronic periodontitis.

Chronic periodontitis (CP) is characterized by gingival inflammation and bone destruction. It has been reported that interferon-gamma (IFN-γ) levels are high in CP patients; however, the IFN-γ receptor (IFN-γR) has not been studied in gingival tissue from these patients.Objective:To evaluate IFN-γ levels and IFN-γR expression in gingival tissue biopsies from chronic periodontitis patients compared with healthy subjects (HS).Material and Methods:Gingival tissues were obtained from all study subjects, CP (n = 18) and healthy subjects (HS) (n = 12). A tissue section of each study subject was embedded in paraffin blocks to determine the expression of IFN-γ R (IFN-γR1 and IFN-γR2) through immunohistochemistry. Another section of the tissue was homogenized and IFN-γ was measured by the ELISA technique.Results:No significant differences were found in the IFN-γR1 expression within the cell layers of the gingival tissue of the study groups. When analyzing the IFN-γR2 expression it was found that IFN-γR2 is strongly expressed in the endothelial cells of CP patients when compared to HS (p<0.05). IFN-γ concentrations in the gingival tissue were significantly higher in CP patients than in HS. No significant correlation between IFN-γ levels and the expression of IFN-γR1 and IFN-γR2 was found. However, a positive correlation between IFN-γ levels and clinical parameters [probing depth (PD) and clinical attachment level (CAL)] was found.Conclusion:The study of IFN-γR expression in gingival tissue samples from patients with CP showed an increase only in the IFN-γR2 chain in endothelial cells when compared to HS.

Influence of non-surgical periodontal therapy on insulin resistance in chronic periodontitis subjects with prediabetes

Prediabetes (PRD) has been closely associated with chronic periodontitis (CP). Lately, studies have proposed the role of glutathione peroxidase (GPx), a ubiquitous antioxidant, in potentiating insulin resistance (IR), a significant factor in PRD. As overexpression of GPx is associated with CP as well as IR, the current study was undertaken to evaluate the influence of nonsurgical periodontal therapy (NSPT) on GPx levels and hence the IR in CP subjects with PRD. Forty-seven subjects were divided into two major groups: healthy controls (n = 11) and CP (n = 36), according to probing depth (PD) and clinical attachment loss (CAL). The CP patients were subdivided into CP only (n = 18) and CP with PRD (n = 18) based on baseline FBS levels. Serum and crevicular GPx and malondialdehyde (MDA) were measured in all the subjects using spectrophotometry. The participants underwent NSPTat baseline and 3 months. At 6 months, all the parameters were re-recorded. At 6 months after NSPT, there was significant improvement in periodontal health (p < 0.05) in all the three groups which was associated with reduced GPx and MDA levels. Besides, a significant reduction in IR was noted in both CP and CP with PRD groups (p < 0.05). NSPT may be a vital tool in reducing IR in CP subjects with PRD. This was clearly evident as there was progressive decline in IR with GPx levels along with improvement in other parameters, specifically in the PRD group.

Is salivary fluoride a better noninvasive indicator of progressive periodontal disease than invasive serum fluoride – A Cross Sectional study

Periodontitis is seen as resulting from a complex interplay of bacterial infection and host response, modified by behavioral and systemic risk factors.There is high prevalence of endemic fluorosis among the patients in certain regions in India and scarcity of information on the effects of levels of fluoride in serum and saliva to the periodontal disease severity. Aim of the present study was to estimate the levels of fluoride in serum and saliva and in ground water of chronic periodontitis subjects in the endemic fluorosed area and to correlate the levels of fluoride in serum and saliva to the periodontal disease severity.140 subjects were divided into two groups. Group I (Test group) consisted of 100 dental subjects diagnosed with dental fluorosis and chronic periodontitis. Group II (Control group) consisted of 40 non-fluorosed subjects. Ion selective electrode method was used for assessingthe fluoride in serumand saliva. There was no significant correlation between salivary and serum fluoride levels and the periodontal disease severity. However the mean salivary fluoride levels were found to significantly influence the dental fluorosis severity (p&lt;0.005*).

Antimicrobial peptide gene expression in periodontitis patients: A pilot study.

Antimicrobial peptides (AMPs) are one of the most active components of innate immunity and have characteristics that could place them at the heart of the pathogenesis of periodontal disease. This study investigated differences in the expression of AMP coding genes obtained using a simple harvesting technique, gingival smear, between two groups of patients: chronic periodontitis subjects versus healthy ones. Twenty-three patients were enrolled in two groups: 12 were diagnosed with moderate or severe generalized chronic periodontitis, and 11 were diagnosed as clinically healthy. Gingival smears were retrieved and studied using reverse transcription-quantitative PCR (RT-qPCR) after mRNA purification. Fifteen gene expressions were obtained using real-time RT-qPCR. Three AMP genes, histatin 3 (HTN3), α-defensin 4 (DEFA4) and lysozyme C (LYZ), presented different expression levels in periodontitis patients compared with healthy subjects. The relative expression level of DEFA4 appeared to be a protective factor against periodontitis. Gingival smears studied by RT-qPCR may be used to assess the expression of AMPs coding genes. A lack of expression of DEFA4 could be a potential indicator of periodontitis status.

8-Isoprostane in chronic periodontitis and type II diabetes: Exploring the link.

Background. Reactive oxygen species (ROS) are associated with the pathogenesis of inflammatory diseases and have a direct or indirect role in tissue damage constituting oxidative stress. ROS are also involved in impairment of β-cell function during development of diabetes, which leads to genetic ablation of KATP channels, triggering up-regulation of antioxidant enzymes. Several markers of lipid peroxidation, protein oxidation and DNA damage induced by ROS can be measured. Over the last decade, isoprostanes have been considered as the best markers of lipid peroxidation. The aim of this study was to determine the presence of 8-isoprostane in healthy, chronic periodontitis and chronic periodontitis subjects with type II diabetes and to find the correlation between 8-isoprostane levels among groups and with clinical parameters like gingival index, probing depth and clinical attachment levels. Methods. Ninety subjects were selected and divided into 3 groups: healthy, chronic periodontitis and chronic periodontitis subjects with type II diabetes (n=30 each). Saliva was collected from these subjects after obtaining consent and analyzed for 8-isoprostane levels using ELISA kit. Statistical analysis was performed using Kruskal-Wallis test, Mann-Whitney U test and Spearman’s correlation coefficient (P<0.001). Results. Statistically significant difference was found in the levels of 8-isoprostane between healthy, chronic periodontitis and chronic periodontitis subjects with type II diabetes and with all clinical parameters. Conclusion. 8-isoprostane can be considered as a pathophysiological marker to measure oxidative stress in periodontal diseases.

Evaluation of Resistin Levels in Saliva of Patients with Chronic Periodontitis and Healthy Subjects.

To evaluate resistin levels in the saliva of patients with chronic periodontitis, and healthy subjects. Thirty-four subjects aged between 25 and 50 years were included and divided into healthy group (n = 19) and chronic periodontitis group (n = 15). The saliva levels of resistin were assessed by enzyme-linked immunosorbent assay. Comparisons of resistin levels between the two groups were made with the Mann-Whitney Test. The chronic periodontitis group showed significantly higher resistin levels than the control group (P = 0.001). The level of resistin in saliva might help to determine the inflammatory status of periodontal diseases.

Analysis of interleukin-10 gene polymorphisms in patients with chronic periodontitis and healthy controls.

Interleukin-10 (IL-10) is an anti-inflammatory cytokine that has important roles in the periodontal diseases. The IL10-1082, -819, and -592 polymorphisms in the promoter region of IL-10 gene have been associated with various IL-10 expressions. The aim of this study was to investigate the association between these gene polymorphisms with chronic periodontitis in a sample of Iranian populations from Southeast of Iran. IL-10 single nucleotide polymorphisms were analyzed in 210 patients with chronic periodontitis (CP) and 100 individuals without CP by polymerase chain reaction-restriction fragment length polymorphism method. Statistical analysis of data was performed using the Chi-square test. The risk associated with single alleles, genotypes, and haplotypes were calculated by performing a multiple logistic regression analysis to estimate the odds ratio (OR) and 95% confidence interval (CI). P < 0.05 for statistical significance. The prevalences of AG and GG genotypes of IL10-1082 were significantly different between CP and control groups in comparison to AA genotype (OR = 2.671; CI = 1.482-4.815; P = 0.001 for AG vs. AA, OR = 4.151; CI = 2.128-8.097; P < 0.001 for GG vs. AA). In addition, subjects with at least one IL10-1082-G allele were significantly had an increased risk for CP (OR = 2.157; CI = 1.531-3.038; P < 0.001). The distribution of the IL10-819 and IL10-592 genotypes was not different between CP and control subjects (P = 0.109 and P = 0.139, respectively). The combination of different genotypes showed that GCC haplotype was significantly different between groups (OR = 4.379; CI = 1.077-17.807; P = 0.039). The results demonstrated that IL10-1082 polymorphism was a putative risk factor for chronic periodontitis and associated with increased susceptibility to CP.

Dermatoglyphic Patterns and Periodontal Diseases

Background: Periodontal disease is initiated by bacterial accumulation but some risk factors like genetics also can be responsible for disease progression. Genetic determinants that exist could be suggestive of specific dermatoglyphic patterns for periodontitis. Hence, the present study was an attempt to find if there is any correlation between fingerprint patterns and periodontal diseases.&#x0D; Aim: To compare the fingerprint patterns in generalised chronic periodontitis and chronic generalised gingivitis subjects.&#x0D; Materials and methods: 800 subjects were included in the study. 437 subjects were diagnosed with generalised chronic periodontitis and 363 subjects were diagnosed with chronic generalised gingivitis. Fingerprint patterns were recorded and were analysed manually with illuminated 6X high powered magnifying glass. SPSS software was used for statistical analysis.&#x0D; Results: An increased frequency of radial loop pattern (39.01%) was found in chronic generalised gingivitis subjects, whereas; in generalised chronic periodontitis subjects higher frequency of ulnar loop (37.53%) and central pocket whorl pattern (36.16%) was observed.&#x0D; Conclusion: Dermatoglyphics could be used together with the other diagnostic aids for prediction of periodontal diseases.

Serum interleukin-17 (IL-17) in chronic periodontitis patients

Introduction: Explorations into the periodontal medicine relationship have discovered interleukin-17 (IL-17) cytokine as one of the pro-inflammatory mediators that play a crucial role in the initiation and progression of the chronic periodontal disease. This case and control study aimed to compare the serum IL-17 concentration between chronic periodontitis and healthy subjects and to assess the relationship between the IL-17 serum and the clinical periodontal parameters in chronic periodontitis patients. Methods: This study was a case-control study. The subjects were selected using purposive sampling method. The periodontal screening assessment in the Family Treatment Center and Postgraduate Dental Clinic, Universiti Sains Malaysia Hospital. A total of 55 samples who fit with the inclusion and exclusion study criteria of full-mouth clinical periodontal records together with blood serums were obtained from 28 chronic periodontitis patients and from 27 healthy subjects. The concentration of IL-17 cytokine in serum was measured using ELISA test. Results: Subjects with periodontal disease presented significantly worse clinical parameters (p&lt;0.001) compared to control. The level of serum IL-17 concentration was significantly higher (p=0.026) in chronic periodontitis subjects 3.6 (1.03) pg/mL compared to the control 3.1 (0.70) pg/mL. Conclusions: There was no correlation between the level of IL-17 concentration in the serum and clinical periodontal parameters.

English

BACKGROUND : C.albicans is an opportunistic pathogen and its presence has been demonstrated in periodontal pockets. Periodontitis is an infectious disease that could increase the risk for colonization by Candida. Candidal infection could in turn lead to progression of periodontal disease. Hence, it is important to understand the relation between C.albicans and periodontitis. AIM : To study the prevalence of C.albicans in subgingival plaque samples of patients with chronic periodontitis. MATERIALS AND METHODS : This study included 108 chronic periodontitis subjects of age ranging from 30 to 55 years. Clinical parameters like plaque index (PlI), probing depth (PD), and clinical attachment level (CAL) were measured and smoking status of the individuals assessed. Sabouraud’s dextrose agar and the CHROMagar media were used to culture C.albicans from clinical plaque samples. RESULTS : In this study, clinical parameters (PlI, PD, and CAL), disease severity and sex showed no significant relation with the presence of C.albicans. On the other hand smoking habits was significantly correlated with the presence of the pathogen. CONCLUSION : The results of the present study showed that, C.albicans was present in higher amounts in the periodontal pockets of patients with severe chronic periodontitis. Smokers had greater chances of being of C.albicans positive than non smokers. The prevalence of C.albicans did not have a predilection for particular sexes.

Association of microRNA-125a and microRNA-499a polymorphisms in chronic periodontitis in a sample south Indian population: A hospital-based genetic association study

Periodontitis is a chronic inflammatory disease, caused by interaction between periodontopathic bacteria and the host immune response. MicroRNAs are small, single-stranded molecules, which play a key role in the regulation of diverse biological processes. Dysregulation of microRNAs function can lead to several diseases such as autoimmune and chronic inflammatory diseases. The objective of the study was to determine the association between selected single nucleotide polymorphisms in miR-125a, miR-499 and LIN28 homology A with chronic periodontitis susceptibility in a sample population from south India. Genotyping of the single nucleotide polymorphisms in miR-125a (rs41275794, rs12976445, rs10404453 and rs12975333), miR-499 (rs3746444) and LIN28 homolog A (rs3811463) was performed in DNA from288 controls (individuals with healthy gingiva) and 262 cases (chronic periodontitis patients) by direct dye-terminator sequencing. Disease association analysis revealed a significant association of the variant alleles of the miR-499a polymorphism (rs3746444) in chronic periodontitis [OR=2.07; 95%CI (1.35–3.17)]. The risk associated C-allele frequency was found to be higher in chronic periodontitis subjects as compared to that of healthy individuals. Similar results were also observed in the dominant model [OR=2.42; 95% CI (1.67–3.51)]. The recessive model for miR-125a polymorphism (rs12976445) was also found to be statistically significant with OR=1.54 and 95% CI (1.03–2.30). The haplotype “GCGGCA” was found to be higher in chronic periodontitis subjects than in healthy individuals. Pairwise linkage disequilibrium analysis exhibited that the polymorphisms, rs41275794 and rs12976445 in miR-125a, were in strong linkage equilibrium (D′=0.97). Epistatic interaction by multifactorial dimensionality reduction analysis revealed that the genotypes of the polymorphisms of miR-125a (rs41275794, rs12976445, rs10404453), miR-499a (rs3746444) and LIN28 (rs3811463) were interacting significantly [OR=2.54 (1.65–3.92)], thereby contributing to the risk of chronic periodontitis.

Analysis of IL-6, IL-10 and NF-κB Gene Polymorphisms in Aggressive and Chronic Periodontitis.

Pro-inflammatory cytokines, interleukin-6 (IL-6), demonstrated to be suppressed by interleukin-10 (IL-10) are known to be regulated by the transcription factor nuclear factor-κB(NF-κB). The aim of this study was to ascertain the association between genetic polymorphism of these genes (IL-6(-174), IL-10(-597) and NF-κB1-94ins/del)) and chronic/aggressive periodontitis. Forty-five patients with chronic periodontitis (CP), 58 patients with aggressive periodontitis (AP) and 38 periodontally healthy subjects were included in this study. Genomic DNA was isolated from whole blood samples. The NF-κB, IL-6, and IL-10 polymorphisms were determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Among subjects for the ins/ins genotypes of NF-κB1 gene, the AA genotypes of IL-10 presented a higher frequency in chronic periodontitis group than in healthy controls (p=0.023). A statistically significant difference in genotyping frequencies between AP group and healthy controls was observed for the IL-6 gene. The AA genotype of IL-10 was overrepresented in CP and AP groups compared to healthy controls (OR=9.93, 95% CI: 2.11-46.7, OR=5.7, 95% CI: 1.22-26.89, respectively). Within the limits of this study, it can be concluded that the IL-10 (-597) AA genotype is associated with susceptibility to chronic/aggressive periodontitis and IL-6 (-174) GG genotypes and G allele seems to be associated with aggressive periodontitis. Clinical relevance: The results of the current study indicate that IL-6 and IL-10 genotypes seem to be associated with aggressive periodontitis. Also, the AA genotypes of IL-10 presented a higher frequency in chronic periodontitis subjects with carrying NF-κB1 ins/ins genotypes.

The Association between Periodontal Status, Serum Lipid Levels, Lipoprotein Associated Phosholipase A2 (Lp-PLA2) in Chronic Periodontitis Subjects and Healthy Controls.

Lipoprotein associated phospholipase A2 (Lp-PLA2) has been explored as a potential biomarker for Cardiovascular Disease (CVD). The human Lp-PLA2 is a serine-dependent, Ca2+- independent enzyme. It gives way to oxidised free fatty acids and lysophosphatidyl choline by hydrolysing oxidised phospholipids, that leads to smooth muscle cell apoptosis, inflammatory cell chemotaxis and endothelial cell dysfunction in CVD. Owing to its role in inflammation, it may influence the development and progression of periodontitis as well. To compare the demographic variables, Gingival Index(GI), Bleeding On Probing (BOP), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) with serum lipid profile and Lp-PLA2 level in Chronic Periodontitis (CP) subjects. A total of 75 subjects were selected and divided into three groups; based on the inclusion and exclusion criteria: Group I - 25 subjects with severe generalized CP with CAL ≥ 5 mm in more than 30% of sites. Group II -25 subjects with moderate generalized CD with clinical CAL 3 mm-4 mm in more than 30% of sites. Group III- 25 systemically and periodontally healthy volunteers who served as control. Clinical parameters such as Plaque Index (PI), BOP, Probing Depth (PD) and CAL, lipid profile such as Total Cholesterol (TC), Triglyceride (TG), High density Lipoprotein (HDL), Low Density Lipoprotein (LDL), Very Low Density Lipoprotein (VLDL) as well as Lp-PLA2 were assessed. One-way ANOVA and Tukey's Post-hoc test were used for data analysis. Age was higher in Group I and II when compared to Group III. Group II showed a significant correlation between PI and LDL. In Group III, lower PI was significantly correlated with high HDL and low LDL and BOP was positively correlated with TG and HDL. A significant association of Lp-PLA2 was found to be higher with increase in the TG and VLDL level in Group I and Group II when compared to Group III. The study concluded that Lp-PLA2, TG and VLDL already being a predictor biomarker for atherosclerotic disease can be an inflammatory marker for periodontitis.

Comparison of Serum Levels of Endothelin-1 in Chronic Periodontitis Patients Before and After Treatment.

Endothelin-1 (ET-1) is a potent vasoconstrictive peptide with multi functional activity in various systemic diseases. Previous studies indicate the detection of ET-1 in gingival tissues and gingival crevicular fluid. The aim of this study was to estimate the serum ET-1 levels in clinically healthy subjects and subjects with chronic periodontitis, before and after treatment, and correlate it with the clinical parameters. A total of 44 patients were included in the study. Group I comprised of 20 subjects with clinically healthy periodontium. Group II comprised of 24 subjects with chronic periodontitis. Group III comprised of same Group II subjects following periodontal management. Serum samples were collected from the subjects and an Enzyme Linked Immunosorbent Assay (ELISA) was done to estimate the ET-1 levels. The ET-1 levels were then correlated among the three groups with the clinical parameters namely, Plaque Index (PI), Sulcus Bleeding Index (SBI), probing pocket depth, clinical attachment loss and Periodontally Inflamed Surface Area (PISA). The independent t-test and paired t-test were used for comparison of clinical parameters and Pearson's correlation coefficient test was used for correlating the ET-1 levels. ET-1 levels in chronic periodontitis subjects were significantly higher compared to healthy subjects (p<0.001). However, the clinical parameters did not statistically correlate with the ET-1 levels. There was a significant decrease in ET-1 levels following treatment (p<0.001). Serum ET-1 is increased in chronic periodontitis and reduces after periodontal therapy. Further studies are required to establish ET-1 as a biomarker for periodontal disease.

Estimation and Comparison of Erythrocyte and Hemoglobin Levels in Subjects with Healthy Periodontium and Chronic Periodontitis

Objective: To compare and evaluate the relationship between anemia and periodontitis by estimation of peripheral blood between healthy patients and chronic periodontitis patients. Material and Methods: Of the total of 230 outpatients approached to participate in the study, 100 eligible patients were selected as per the selection criteria. After written consent, these patients were divided into two groups according to the clinical parameters as healthy and disease (chronic periodontitis) groups. Under aseptic conditions, venous blood samples were obtained by vein-puncture in the ante-cubital fossa without excessive venous stasis and the mean value of erythrocytes (EC), hemoglobin concentration (HGB), mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were measured. Paired t-test was employed to find the significance of study parameters on continuous scale within the group analysis and unpaired t-test (two tailed, dependent) was used to find the significance of study parameters on continuous scale in the inter group analysis. Results: Generally, the healthy group reported higher levels of EC, HGB, MCV and MCH than the periodontitis group. The mean hemoglobin level was significantly higher (p-value<0.05) in healthy patients (12.66 ±1.41 gm/dl) whereas a slightly lower level of 11.32±1.85 gm/dl was observed in patients with chronic periodontitis. Similarly, the range of erythrocyte count of healthy patients was significantly higher (3.69-5.29 million/µl) than chronic periodontitis patients (3.33-5.97 million/µl). Whilst MCV was higher in healthy patients but non-significant, higher mean MCH of 27.75 ± 3.25 pg/cell was reported in healthy patients compared to mean of 25.73 ± 3.22 pg/cell in patients with chronic periodontitis. Conclusion: Significant hematological differences in EC, HGB, MCV and MCH between healthy periodontium and chronic periodontitis subjects were seen indicating mild anemia.

Gamma Glutamyl Transpeptidase, Smokeless Tobacco, Chronic Periodontitis: Exploring the Link.

Oxidative Stress (OS) is implicated in the pathogenesis of many systemic and oral diseases such as periodontal disease. Smokeless tobacco extract produces apoptosis and causes an imbalance between reactive oxygen species and antioxidants, such as Gamma Glutamyl Transpeptidase (GGT). Epidemiological research implied serum GGT within its normal range to be an early sensitive enzyme related to OS. To assess how GGT fares as a biomarker in periodontitis subjects with or without the usage of smokeless tobacco and correlate it with clinical parameters. Ninety subjects were divided into three groups of healthy, chronic periodontitis, and smokeless tobacco users with chronic periodontitis from the dental outpatient department of P.M. Nadagouda Memorial Dental College and Hospital. Serum samples of patients were collected after obtaining consent and analyzed for GGT. Statistical Analysis was performed using ANOVA, and Pearson's correlation coefficient. GGT levels were found to be significantly higher in chronic periodontitis patients compared to smokeless tobacco users with chronic periodontitis and healthy subjects. Conclusion: GGT may be used as a quick, easy and precise marker for measuring OS in patients with chronic periodontitis and smokeless tobacco users.

Efficacy of Oral Probiotics as an Adjunct to Scaling and Root Planing in Nonsurgical Treatment Outcome of Generalized Chronic Periodontitis Patients: A Clinico-Microbiological Study

ABSTRACT Aim: This study aims to find out the effects of Probiotics, delivered with a lozenge for its effect on clinical and microbiological parameters in subjects with chronic periodontitis after scaling and root planing (SRP). Materials and methods: A total of 40 generalized mild to moderate chronic periodontitis subjects were finally enrolled in a double-blind, placebo-controlled, randomized clinical study. Selected subjects after SRP were randomly divided into two groups: Group I (test group) with 20 subjects receiving probiotic tablet once daily and group II (control group) receiving placebo tablets once daily. Clinical parameters and bacterial count for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum were evaluated at baseline, 2, and 4 months after the medication. Results: On comparative evaluation between the two groups, results indicated that group I (probiotic group) exhibited statistically significant reduction in both clinical and microbiological levels than group II (control group) over the entire span of the study. Conclusion: Our results proved that daily oral supplementation of probiotics could be a useful adjunct to SRP in chronic periodontitis patients. How to cite this article Mani A, Saini R, Saini SR. Efficacy of Oral Probiotics as an Adjunct to Scaling and Root Planing in Nonsurgical Treatment Outcome of Generalized Chronic Periodontitis Patients: A Clinico-Microbiological Study. Int J Experiment Dent Sci 2017;6(1):6-13.

Effect of Pranayama on Ppar-γ, Nf-κB Expressions and Red Complex Microorganisms in Patients with Chronic Periodontitis – A Clinical Trial

Sudarshankriya pranayama is the control of breathing movements to regulate the energy flow throughout the body, which has shown to positively affect immune function, autonomic nervous system and psychologic-neuro pathways. The practice of pranayama has been proven to show several benefits such as reduction in stress levels, relieves anxiety and depression, increase in antioxidant levels, reduces insulin resistance and improves respiratory function. The objective of the study was to evaluate the levels of Peroxisome Proliferator-Activated Receptor Gamma (PPAR-γ), Nuclear Factor-Kappa B (NF-κB) and the presence of Red Complex Microorganisms (RCM) such as Treponema denticola, Porphyromonas gingivalis and Tannerella forsythia in the subgingivalpl aque samples of chronic periodontitis subjects before and after intervention with pranayama as an adjunct to Scaling and Root Planing (SRP). A total of 30 subjects (control group) were treated with SRP and 30 subjects (pranayama group) underwent SRP and pranayama for three months. Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Bleeding Index (BI) and Plaque Index (PI) were recorded and the presence of PPAR-γ, NF-κB and RCM were assessed at baseline and after three months using polymerase chain reaction. ANCOVA test was done to compare the clinical parameters between the groups. Fisher's Exact test was done to identify RCM and Mann-Whitney and Wilcoxon-signed test was used to identify the expression of NF-κB and PPAR-γ in the plaque samples. The change in the mean CAL from baseline to third month was significantly higher in pranayama group compared to control group (p≤0.05). There was a statistically significant reduction in the expression of NF-κB and increase in PPAR-γ expression levels in pranayama group on comparison with the control group (p<0.001). The reduction in number of positive samples with T.denticola, P.gingivalis and T.forsythia at third month post-intervention did not affect the change in the expression levels of NF-κB and PPAR-γ. The CAL showed significant improvement with reduction in the RCM, NF-κB and increase in PPAR-γ levels in subjects who underwent pranayama as an adjunct to SRP. In future, pranayama can be used as an additional treatment modality to provide a new dimension in treatment of periodontitis.