Clinical Attachment Level Measurements Research Articles

Comparison of oxidative stress markers in the saliva, gingival crevicular fluid, and serum samples of pregnant women with gestational diabetes and healthy pregnant women.

To compare oxidative stress (OS) markers in the saliva, gingival crevicular fluid (GCF), and serum samples of pregnant women with gestational diabetes (GDM) and healthy pregnant women and to investigate the association between periodontal health/diseases and OS and GDM. Eighty women with GDM and 80 healthy pregnant women were included in the study. Medical and clinical anamnesis was obtained from all the pregnant women included in the study, and their plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing pocket depth (PPD), and clinical attachment level (CAL) measurements were performed. GCF, saliva, and serum samples were collected for the measurements of the local and systemic total antioxidant status (TAS) and total oxidant status (TOS). Clinical periodontal parameters were found to be significantly higher in the GDM group compared to the control group. The serum and saliva TAS, TOS, and TAS/TOS values were significantly lower in the GDM group than in the control group. In the analysis of the GCF samples, the mean TAS and TAS/TOS values were significantly lower and the TOS value was significantly higher in the GDM group than in the control group. The multivariate reduced model indicated that gravidity, salivary TAS/TOS, and GCF TAS were significant independent variables in the development of GDM (p < .05). Our results indicated that the OS of serum, saliva, and GCF samples increased in patients with GDM compared to healthy pregnant women. The role of local OS parameters in GDM may be associated with elevated clinical periodontal parameters.

Subgingival host-microbiome metatranscriptomic changes following scaling and root planing in grade II/III periodontitis.

To assess the effects of scaling and root planing (SRP) on the dynamics of gene expression by the host and the microbiome in subgingival plaque samples. Fourteen periodontitis patients were closely monitored in the absence of periodontal treatment for 12 months. During this period, comprehensive periodontal examination and subgingival biofilm sample collection were performed bi-monthly. After 12 months, clinical attachment level (CAL) data were compiled and analysed using linear mixed models (LMM) fitted to longitudinal CAL measurements for each tooth site. LMM classified the sites as stable (S), progressing (P), or fluctuating (F). After the 12-month visit, subjects received SRP, and at 15 months they received comprehensive examination and supportive periodontal therapy. Those procedures were repeated at the 18-month visit, when patients were also sampled. Each patient contributed with one S, one P, and one F site collected at the 12- and 18-month visits. Samples were analysed using Dual RNA-Sequencing to capture host and bacterial transcriptomes simultaneously. Microbiome and host response behaviour were specific to the site's progression classification (i.e., S, P, or F). Microbial profiles of pre- and post-treatment samples exhibited specific microbiome changes, with progressing sites showing the most significant changes. Among them, Porphyromonas gingivalis was reduced after treatment, while Fusobacterium nucleatum showed an increase in proportion. Transcriptome analysis of the host response showed that interleukin (IL)-17, TNF signalling pathways, and neutrophil extracellular trap formation were the primary immune response activities impacted by periodontal treatment. SRP resulted in a significant "rewiring" of host and microbial activities in the progressing sites, while restructuring of the microbiome was minor in stable and fluctuating sites.

Evaluating the relationship between ankylosing spondylitis and periodontal disease: a case-control study.

This study aimed to determine the possible relationship between periodontal disease and ankylosing spondylitis (AS) by evaluating clinical periodontal measurements and gingival crevicular fluid (GCF) levels of sclerostin, interleukin-1β (IL-1ß), and matrix metalloproteinase-8 (MMP-8) levels. Twenty-eight patients with AS (AS group) and 28 systemically healthy controls (C group) were enrolled in this study. Full-mouth periodontal measurements: plaque index, bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) measurements were obtained from all patients. AS-related parameters were included in the data analyses. An enzyme-linked immunosorbent assay determined GCF IL-1β, MMP-8, and sclerostin levels. There were no significant differences in the clinical periodontal measurements between the two groups (p > 0.05). Interestingly, patients with AS had significantly lower GCF sclerostin levels than the C group (p < 0.05). But there were no statistical differences in the GCF levels of IL-1ß and MMP-8 between the two groups (p > 0.05). Serum C-reactive protein (CRP) levels strongly correlated with both BOP (r = 0.497, p < 0.05) and PPD (r = 0.570, p < 0.05) in the AS group. Bath AS Metrology Index (BASMI) also positively correlated with both BOP (r = 0.530, p < 0.05) and CAL (r = 0.568, p < 0.05). Similarly, Maastrıcht Ankylosing Spondylitis Enthesis Score (MASES) strongly correlated with both BOP (r = 0.487, p < 0.05) and CAL (r = 0.522, p < 0.05). These results suggest that the patient's systemic condition may influence local sclerostin levels in GCF, and the strong correlations between periodontal measurements and AS-related parameters may indicate an interrelationship between inflammatory periodontal disease and AS. The present study provides important information concerning the relationship between periodontal disease and ankylosing spondylitis. Thai Clinical Trials.gov (TCTR20200908001) (08. September 2020).

ACCURACY OF CLINICAL AND RADIOGRAPHIC MEASUREMENTS OF PERIODONTAL INFRABONY DEFECTS OF DIAGNOSTIC TEST ACCURACY (DTA) STUDIES: A SYSTEMATIC REVIEW AND META-ANALYSIS.

The aim of this study was to determine the accuracy of clinical and radiographic measurements of infrabony periodontal defects. The MEDLINE-Pubmed and Cochrane-CENTRAL electronic databases were searched from initiation to May 2020. The inclusion criteria were clinical trials, human subjects with at least one infrabony defect, measurements of clinical attachment level (CAL), radiographic bone level (rBL), and intraoperative bone level (iBL) used as the reference standard. In total, 11 studies including 17 comparisons were included in this meta-analysis. All 17 comparisons showed that the values of the CAL and rBL measurements underestimated the iBL values. For CAL, the analysis showed a significant difference of means of -1.22 (P < .00001; 95%CI: [-1.49; -0.95]) and for rBL -1.10 (P < .00001; 95%CI: [-1.34; -0.85]). No significant DiffM were observed between the CAL and rBL measurements (DiffM -0.05; P = .76; 95%CI: [-0.39; 0.28]). The results of this systematic review and meta-analysis show that both clinical and radiographic measurements substantially underestimate the bone level when compared to intraoperative level measurements. However, there was no significant difference in the results between the clinical attachment level measurements and the radiographic observation.

Prospective evaluation of vitamin D levels in dental treated patients: A screening study.

The available epidemiological data indicates the existence of numerous tooth deficiencies and periodontopathies in the Polish population. Successful surgical treatment is dependent upon multiple factors, including bone quality, which is affected by vitamin D - one of the regulators of calcium (Ca) and phosphorus (P) metabolism. The aim of this study was to conduct a prospective evaluation of the levels of vitamin D among patients receiving dental treatment for various reasons (conservative, surgical or prosthodontic treatment). The study involved 60 patients, who, for various reasons, were admitted for dental treatment for over a 1-week period in the summer season. A thorough interview together with a periodontological examination consisting of probing depth (PD) and clinical attachment level (CAL) measurements, were conducted. A total of 2 mL of blood was collected from each patient to determine the concentrations of vitamin D, parathyroid hormone (PTH), Ca, magnesium (Mg), and P in the blood with the use of mass spectrometry. Among the 60 patients enrolled in the study, 53 (88.3%) showed vitamin D deficiency and 18 (30%) showed a concentration below 17.8 ng/mL, which is an independent general mortality factor. The difference in the level of vitamin D between group A (without periodontitis) and group B (with periodontitis) was not statistically significant (p = 0.076), but a tendency for lower vitamin D levels in people with periodontitis was observed. We also observed a tendency for periodontal disease to occur more often with extreme vitamin D deficiency (<15 ng/mL) (p = 0.730). Low levels of vitamin D are present in a large proportion of dental patients, and an increase in the incidence of periodontal disease is likely associated with a decrease in the level of vitamin D.

Xenogeneic collagen matrix for the treatment of multiple gingival recessions in esthetics areas: a case series with 24-month follow-up

Introduction: Multiple gingival recessions (GR) are often associated with high hypersensitivity and esthetics concerns due to exposed roots. The collagen matrix (CM) associated with coronally advanced flap (CAF) may be a suitable treatment for multiple GR in esthetic areas. However, there is a lack of long term follow up investigations. Objective: To evaluate a 24-month follow-up of the CM + CAF treatment for multiple RT1 GRs in esthetics areas. Materials and Methods: Six patients presenting 6 adjacent Cairo’s gingival recessions type 1 (RT1) in the anterior maxilla were treated with CM + CAF, and based on these patients a brief statistical analysis was conduct. The evaluated parameters included gingival recession depth (GRD), gingival recession width (GRW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), gingival thickness (GT), and mean root coverage (MRC). Patient-related outcomes measurements (PROMs) were assessed using an oral health impact profile (OHIP-14) questionnaire and visual analogue scale (VAS). Results: There was significant improvement in GRD, GRW, and CAL measurements at 3 months postoperatively (p&lt;0.05). Besides, CAL also increased from 12 months to 24 months’ follow-up (p=0.0023). The MRC percentage was 82%. PD, GT, and KTW presented no statistical difference. PROMs revealed a high score for esthetics (82.2%) and a significant reduction in hypersensitivity and surgical pain/discomfort. Conclusions: Considering the limitations of a case series, the use of CM + CAF on RT1 multiple gingival recessions in esthetic areas demonstrated positive outcomes after 24 months.

Clinical Periodontal Assessment Following the Adjunctive Use of Clinical Periodontal Assessment Following the Adjunctive Use of Lycopene and Vitamin C in Non Surgical Therapy of Chronic Lycopene and Vitamin C in Non Surgical Therapy of Chronic Periodontitis: A Randomized Clinical Tria

Objective: To evaluate the clinical outcome of chronic periodontitis patients by clinical measurement of pocket depth (PD) and clinical attachment level (CAL) following non-surgical periodontal treatment with adjunctive use of lycopene and vitamin C. Subjects and Methods: 42 eligible systemically healthy patients with chronic periodontitis assigned to each group after assessment of clinical parameters plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (CAL), were recorded. Cases were allocated into 3 groups by computerized randomization, 14 patients each group (n = 14). Group I (Lycopene): Patients were supplemented with 10 mg lycopene soft gels once daily for 2 months following SRP treatment. Group II (Vitamin C): Patients were supplemented with Vitamin C 500mg once daily for two months following SRP treatment. Group III (Control): Patients were supplemented with placebo once daily for two months following SRP treatment. All the clinical parameters were assessed at baseline &amp; two months post-treatment. Results: Overall results of our study, in all groups there were a statistically significant decrease in mean PD, CAL measurements post-treatment (P-value) Conclusion: Lycopene could be considered as a promising adjunct to SRP treatment in improving periodontal inflammation and clinical outcomes

Evaluation of the effect of periodontitis on quality of life using Oral-Dental Health-Related Quality of Life-United Kingdom scale.

The aim of this study was to investigate the impact of periodontitis on oral health-related quality of life (OHQoL) using Oral-Dental Health-Related Quality of Life-United Kingdom (OHRQoL-UK) scale and evaluate the contributing factors. 50 patients with untreated periodontitis and 50 individuals without periodontitis were enrolled in the study. All subjects received detailed periodontal examination. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) measurements were examined. OHRQoL was assessed by the Oral Health Quality of Life-United Kingdom (OHRQoL-UK) scale. Symptoms of periodontitis were monitored by visual analogue scale (VAS). Socio-demographic characteristics, medical history, smoking status, hygiene habits of the participants were recorded. This study is registered at ClinicalTrials.gov as NCT04240014. Total OHRQoL-UK scores were 38.24±6.47 in periodontitis patients and 55.88±9.38 in non-periodontitis individuals (p<0.001). The scores of all 4 parameters were significantly lower in patients with periodontitis compared to healthy individuals (p <0.001). Higher PI, GI, PD and CAL values were associated with extensive negative impacts of periodontitis on OHRQoL (p<0.001). According to the results of linear regression analysis, only periodontitis was found to associate with OHRQoL. Periodontal disease reduces the total quality of life score by 15.087 (ß= -15.087; 95% CI = [(-18.934)-(-11.240)]. Individuals with periodontitis has diminished OHRQoL compared to healthy individuals.

Does parkinsonism affect periodontal health? A cross-sectional study in a tertiary hospital.

Background:Muscular rigidity, tremors, and bradykinesia with diminished motor skills are the characteristic features of Parkinson's disease (PD).Aim:The study investigated the influence of reduced motor proficiency on the periodontal health of PD patients and compared it with controls.Setting and Design:A cross-sectional study was conducted on PD patients selected from outpatient section of a tertiary healthcare center and compared with age- and gender-matched controls.Materials and Methods:Oral health status of the subjects was graded based on decayed, missing, and filled teeth index, oral hygiene index (OHI), modified gingival index, probing pocket depth (PPD), clinical attachment level (CAL), tooth mobility, interproximal PPD, and interproximal CAL measurements. PD patients were categorized based on Hoehn and Yahr scale and duration to assess the influence of PD severity and progression.Statistical Analysis:Difference in the mean values of quantitative variables was analyzed by parametric t-test and Chi-square test for categorical variables.Results:In PD patients, 84.4% of subjects had moderate–severe gingivitis, while it was 2.4% in the control group. Mean number of interproximal sites with CAL >5 mm in PD patients and control subjects was 8.41 ± 6.37 and 1.12 ± 2.28, respectively (P < 0.05). The mean OHI was 2.90 ± 0.81 in patients with mild PD and increased to 3.77 ± 0.52 as PD severity exalted.Conclusion:PD patients had impaired oral condition with higher OHI and increased gingival inflammation with a likelihood of male predisposition. Substantial interproximal tissue destruction, debilitated periodontal health as PD progresses, suggests early attention toward their oral health.

Comparative assessment of conventional periodontal probes and CEJ handpiece of electronic probes in the diagnosis and primary care of periodontal disease.

Objectives:Conventional probes (CPs) have been considered acceptable as diagnostic tools to measure probing pocket depth (PPD) and clinical attachment level (CAL) but are affected by multiple variables. Electronic probes (EPs) provide controlled force, digital readout and data storage in computers. The objectives were to compare the reproducibility in the measurement of PPD and CAL by CP and the newly introduced CEJ handpiece of EP and intra-examiner and inter-examiner errors done in two phases.Methods and Material:Selected 720 periodontal sites in 1st molar of 30 persons with chronic periodontitis ≤4 mm and >4 mm pockets were analysed by two trained investigators in two phases at 2 hours difference by CP and CEJ handpiece of EP. Standard deviation, mean difference, correlation coefficient, P value and student 't' test were done to analyse data.Results:The intra- examiner and inter-examiner analyses revealed that Pearson's correlation coefficient was above 0.080 and 0.722 in the ≤4 mm and >4 mm pockets, respectively. Mean difference was not statistically significant in both groups except in the intra- examiner findings in the 2nd phase. Interprobe analysis depicted a standard error of mean of <0.03 in ≤4 mm pockets, whereas it varied from 0.047–0.056 in >4 mm pockets.Conclusion:In conclusion, EP is advantageous for research purposes by providing automatic recording and long-term maintenance of data storage without the need of an assistant and patient education and motivation, whereas CP appears to be more useful in routine periodontal examination.

Evaluation of Salivary ?- Amylase Enzyme Activity in Smoker and Peptic Ulcer Patients affected by Periodontitis in Relation to Clinical Periodontal Parameters

Objectives: To investigate the activity of salivary ?-amylase (SA) in subject affected by periodontitis aloneor associated with peptic ulcer disease (PUD) with or without smoking.Methods: The study population was divided into control group (C), study groups; periodontitis (G1),periodontitis+ PUD+ smokers (G2), periodontitis+ PUD+ nonsmoker (G3). The clinical periodontalparameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinicalattachment level (CAL) were recorded.In addition, unstimulated whole saliva was collected from thesepatients for analysis of SA level.Results: Analysis showed that PI and GI showed significant difference among study groups versus controls.G2 exhibited significantly higher PPD and CAL as compared with G1 but not with G3. For SA activity, G2and G3 showed significantly higher activity as compared with C and G1 groups. Yet, no significant differencewas seen between C and G1 and between G2 and G3. Activity of SA was positively and significantly (P&lt;0.05) correlated with increasing PPD in all study groups and with CAL measurements of G2 only.Conclusions: The results suggested that SA could be used as a marker for the diagnosis of PUD in subjectsaffected by periodontitis with or without smoking.

Evaluation of the clinical and biochemical efficacy of erbium, chromium:ytrium-scandium-gallium-garnet (ER,CR:YSGG) laser treatment in periodontitis.

The objective of this study was to evaluate the clinical and biochemical efficacy of erbium, chromium:ytrium-scandium-gallium-garnet (Er,Cr:YSGG) laser treatment, in addition to non-surgical periodontal treatment (NSPT), in periodontitis patients. This was a single-centre, split-mouth, randomized, controlled 6-month clinical trial. Twenty-seven patients with moderate to advanced periodontitis were included in the study. The patients were randomly assigned to a debridement and laser treatment group or control group (debridement alone). Clinical measurements were performed at baseline and 1, 3 and 6months post-treatment. The following parameters were measured: plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BoP), gingival crevicular fluid (GCF) volume and IL-1β and MMP-8 levels in GCF. There were statistically significant clinical improvements in both groups, with no significant between-group differences in PD, CAL, PI and BoP clinical measurements (p < 0.05). As compared with the control group, the GI 1 and 3months post-treatment and BoP 1month post-treatment were significantly improved in the laser group (p < 0.05). There was also a significant reduction in IL-1 β levels in both groups at baseline versus those 1, 3 and 6months later (p < 0.05) There was no statistically significant difference in IL-1β and MMP-8 levels between groups (p < 0.05). Both the treatment modalities resulted in significant improvements in clinical parameters. Within the limitations of this study, Er,Cr:YSGG laser treatment applied in addition to NSPT is indicated to reduce clinical inflammation.

Neurogenic inflammation in periimplant and periodontal disease: A case-control split-mouth study.

Although the regulatory effects of substance-P (SP), neurokinin-A (NKA), calcitonin gene-linked peptide (CGRP) and neuropeptide-Y (NPY) on periodontal inflammatory responses have been described, the effects of these neuropeptides on healthy and diseased periimplant tissues are not clearly defined. Thirty-nine implants loaded at least for 12months with their symmetrically matching teeth were evaluated and compared by a split-mouth study design. Six study groups were created in this regard as follows: group 1 (healthy periodontal tissues), group 2 (healthy periimplant tissues), group 3 (gingivitis), group 4 (periimplant mucositis), group 5 (periodontitis) and group 6 (periimplantitis). Clinical examinations included Silness-Löe plaque index, Löe-Silness gingival index, bleeding on probing, probing pocket depth and clinical attachment level measurements. Gingival crevicular fluid and periimplant sulcular fluid samples were collected, and the concentrations of neuropeptides were determined by enzyme-linked immunosorbent assay. Their levels and correlations were investigated together with the clinical parameters. Neuropeptide levels were different in the teeth and implant groups according to the periodontal status (p<0.001). SP and NKA levels were increased, whereas CGRP and NPY levels were decreased in the diseased states. There were no differences between the neuropeptide levels of matching teeth and implants (groups 1-2, groups 3-4 and groups 5-6; p>0.05). Our study demonstrated the presence of local neuropeptides in healthy and diseased periimplant tissues. The neurogenic inflammatory responses were also found to be similar in both periimplant and periodontal tissues.

Clinical and radiographic evaluation of amnion chorion membrane and demineralized bone matrix putty allograft for management of periodontal intrabony defects: a randomized clinical trial.

The aim of this trial was to compare the clinical and radiographic outcomes of amnion chorion membrane (ACM) with demineralized bone matrix (DBM) in a putty form in management of periodontal intrabony defects. Twenty-two participants with severe chronic periodontitis and intrabony defects, were randomly assigned in two equal parallel groups. Each group was treated with open flap debridement (OFD) and ACM or OFD and DBM putty. Plaque index, gingival index, pocket depth (PD), clinical attachment level (CAL) and radiographic measurement of bone defect area (BDA) were recorded at baseline, 3 and 6months postoperatively. Both ACM and DBM putty demonstrated significant improvement in all clinical and radiographic outcomes at 6months compared to baseline values. However, no significant difference was observed between the two treatment modalities when compared at different time intervals. Six months postoperatively, ACM showed 3.18 ± 0.85mm, PD reduction and 2.25 ± 0.75mm CAL gain, while DBM putty revealed 3.45 ± 1.08mm PD reduction and 2.73 ± 0.85mm CAL gain. Radiographic assessment showed that mean baseline BDA for ACM group was 10.39 ± 3.86mm2, which significantly reduced to 5.21 ± 2.38 after 6months. Mean BDA mm2 in DBM putty group also significantly improved after 6months, 5.35 ± 3.63mm2 when compared to baseline values 9.80 ± 5.77mm2. Both ACM barrier and DBM putty allograft provided significant improvement in clinical and radiographic outcomes after 6months, yet no significant differences were noticed between them. This trial implied that both biomaterials have a potential regenerative capacity in treating periodontal intrabony defects.

Stent as an accessory tool in periodontal measurements: An insight.

A better reflection of periodontal destruction can be obtained by the measurement of the clinical attachment level (CAL), i.e., the distance from the probe tip to the level of the cementoenamel junction (CEJ). However, there were several problems in CEJ identification. Due to the time consumption and inherent problems in CEJ identification, CAL measurements without using a stent in surveys or other clinical trials are highly questionable. The use of stent is recommended during clinical trials which will minimize the errors in terms of over and underestimation of CALs. Hence, the stent used for vertical probing (vertical/occlusal stent), horizontal probing (furcation stent), and interdental papilla (IDP) stent for IDP-deficiency measurement is discussed to comprehend its clinical applications.

Evaluation of chemokine CXCL10 in human gingival crevicular fluid, saliva, and serum as periodontitis biomarker.

PurposeThe aim of this study was to evaluate CXCL10 as a biomarker for periodontitis by determining the CXCL10 levels in saliva, serum, and gingival crevicular fluid (GCF) samples from periodontally healthy control subjects and adult subjects with chronic periodontitis.Patients and methodsAdult patients seeking dental treatment at Umm Al-Qura University dental clinic underwent a complete periodontal examination, and saliva, serum, and GCF samples were collected. Subjects were classified as chronic periodontitis patients (n=31) if they have a periodontal probing depth (PD) of ≥4 mm and/or clinical attachment level (CAL) of ≥3 mm in >30% of the teeth. The control group (n=25) had PD ≤3 mm and/or CAL ≤2 mm. ELISA was performed to determine the concentration of CXCL10 in saliva, serum, and GCF samples. Student’s t-test was carried out to evaluate the significant difference between different groups. Spearman’s correlation test was used to analyze the relationship between the levels of CXCL10 and the clinical periodontal parameters. P-value of ≤0.05 was considered significant.ResultsSignificantly higher concentrations of CXCL10 were found in saliva and serum in chronic periodontitis patients as compared with the controls (272±60.4 pg/mL and 72±13.4 pg/mL vs 130±22.2 pg/mL and 44.08±4.5 pg/mL, P≤0.05). The CXCL10 levels in GCF were higher in the periodontitis group as compared with the control group (66.36±32.0 pg/mL and 44.56±17.5 pg/mL, respectively); the difference did not reach statistical significance (P≥0.05). Moreover, serum CXCL10 level was significantly higher in periodontitis patients with moderate to severe bone loss as compared with those with mild bone loss (71.05±4.7 pg/mL vs 54.8±7.7 pg/mL, P≤0.05). The serum CXCL10 levels were found to be related to CAL measurements (r=0.3, P=0.026), while the saliva CXCL10 levels were related to PD measurements (r=0.8, P=0.0007).ConclusionCXCL10 is significantly increased in periodontitis subjects as compared with controls and could be used as a marker for periodontal disease.

Alcohol intake and periodontitis in adults aged ≥30 years: NHANES 2009-2012.

Whether an association between alcohol consumption and periodontitis exists is still unclear. This study aimed to assess the association between alcohol consumption and periodontitis. 7062 adults 30 years or older who participated in 2009-2010 and 2011-2012 cycles of the National Health and Nutrition Examination Survey (NHANES) were included. Alcohol consumption measurement included self-reported average number of alcoholic drinks per week over the previous 12 months and was categorized into four groups (0,<1, 1-<8, and ≥8 drinks per week). Participants were categorized using surveillance case definitions for periodontitis that included both clinical attachment level (CAL) and periodontal probing depth (PD) measurements. The association between alcohol consumption and chronic periodontitis was evaluated by multivariable regression analyses adjusting for age, gender, race/ethnicity, education level, income-to-poverty ratio, smoking, self-rated overall oral health, and HbA1c . The odds ratio (95% confidence interval) of having severe periodontitis was 1.9 (1.2-3) among participants who reported alcohol consumption of ≥8 drinks compared to participants consuming some alcohol but<1 drink per week on average. Participants who consumed 1-<8, and ≥8 drinks per week, on average, also had higher mean PD, percentage of sites with PD ≥4mm, mean CAL, and percentage of sites with CAL ≥3mm compared to participants reporting consumption of<1 drink per week. Meanwhile, the odds of having periodontitis, mean PD, extent PD ≥4mm, mean CAL, and extent CAL ≥3mm were not significantly different for nondrinkers than for participants who consumed some alcohol but<1 drink per week on average. Alcohol consumption was associated with an increase in the likelihood of having periodontitis, particularly severe periodontitis. Consumption of some alcohol,<1 drink per week on average, was associated with similar odds of having periodontitis compared to consumption of no alcohol.

Evaluation of Level of TNF-α in Chronic Periodontitis Patients with Gestational Diabetes Mellitus after Phase I Periodontal Therapy

Background: There is little number of studies that address the inter-relationship of gestational diabetes mellitus (GDM) and periodontitis during pregnancy. Hence, this study was conducted to provide further evidence in the possible association between chronic periodontitis and GDM by evaluating the level of Tumor necrosis factor-alpha (TNF-α) of chronic periodontitis patients with GDM after phase I periodontal therapy.Subjects and methods: This study was conducted on 40 subjects divided into 2 groups: 20 pregnant females suffering from gestational diabetes mellitus associated with moderate to severe chronic periodontitis and 20 systemically free pregnant females suffering from moderate to severe chronic periodontitis. The periodontal status of the subjects was assessed at baseline before phase I periodontal therapy and 2 months after completion of the treatment: All subjects have been screened by comprehensive periodontal examination and full periodontal charts were obtained. The following clinical parameters were assessed to determine the clinical periodontal status of patients: Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL). Gingival crevicular fluid (GCF) and serum samples were collected from both study groups to detect TNF-α levels. Regarding the assessment of TNF-α, Real-time reverse-transcriptase Polymerase Chain Reaction (RT) PCR technique was used.Results: Results of the present study observed statistically significant reduction in TNF-α levels after 2 months from phase I periodontal therapy. The current study showed that, there was a statistically significant positive (direct) correlation between TNF-α level, PI, GI, PPD and CAL measurement at baseline and after 2 months from phase I periodontal therapy.Conclusion: It is shown that the levels of TNF-α in GCF and serum before treatment were higher in GDM group (group 1) than in the control group. Thus, the examination of TNF-α may enhance the understanding of pathogenesis of periodontitis and GDM and its assessment in the treatment process may result in better control of the disease.

Assessment of tumor necrosis factor- alpha in gingivitis and periodontitis patients

Background: Tumor necrosis factor-α, one of the cytokines, is released in various chronic inflammatory diseases including periodontitis.Aims: To estimate the level of Tumor necrosis factor- alpha (TNF-α) in gingivitis and periodontitis patientsSettings and Design: A cross-sectional study was conducted. A total of 75 patients were recruited by purposive sampling technique among the patients visiting the Department of Periodontology and Oral Implantology during the period one year from August 2014 to July 2015.Material and methods: The recruited samples were divided into gingivitis and periodontitis groups based on clinical attachment level (CAL). A periodontitis subject was defined as having at least 4 sites with pocket depth (PD) &gt;3mm and at least 4 sites with CAL&gt;3 mm, while gingivitis group included the subjects having no CAL measurements greater than 3 mm with signs of inflammation. The TNF-α level was measured using the RayBio Human TNF-alpha ELISA (Enzyme-linked Immunosorbent Assay) kit.Results: The Median TNF-α interquartile range (IQR) (minimum-maximum) in gingivitis and periodontitis was 58.37 (32.63 – 198.77) and 111.89 (39.27 – 215.0) pg/ml, respectively.Conclusion: The level of TNF-α was found to be higher in periodontitis group compared to gingivitis group, although the result was not statistically significant.

Association between asthma and chronic periodontitis -A Case–Control Study in Shimla-Himachal Pradesh

Introduction: The colonization of respiratory pathogens appears to be a risk factor for lung infection in high-risk individuals. Evidences dictate a bidirectional relationship between periodontitis and asthma. Aim: The aim of this study is to explore this potential association between asthma and periodontal disease. Materials and Methods: In a case–control study the individuals were selected from patients attending asthma clinic in a hospital. Individuals consist of fifty asthmatics and fifty nonasthmatic healthy controls evaluated for plaque index (PI), gingival index (GI), papillary bleeding index (PBI), calculus index (CI), and clinical attachment level (CAL). The data were analyzed by SPSS version 16. Results: Mean PI scores was 0.649 ± 0.316 for control group in comparison to 1.168 ± 0.46 for asthmatic group. Statistically significant difference among two groups was obtained on a comparison of GI score (P = 0.0231) CI scores (0.0461) for control group. CAL was 3.817 ± 0.722 mm and 4.964 ± 0.871 mm in control group and case group, respectively. The difference of CAL for two groups was statistically highly significant (P = 0.004). Comparison of PBI of test group and control group showed significant difference Comparison of all the parameters for two subgroups (mild asthmatics and moderate-to-severe asthmatics), i.e. PI, CI, GI, and PBI was statistically significant with P value for respective scores as 0.0281, 0.04, 0.027, and 0.0162. CAL measurement for both groups was highly significant (P = 0.001). Conclusion: The present study reveals an association between the occurrence of chronic periodontitis and asthma. Both periodontal and respiratory diseases have an inflammatory nature. Parameters measured using different indices have revealed higher scores for the asthmatics than nonasthmatics.