Clinical Attachment Loss Research Articles

Association between periodontitis and cardiovascular health in rheumatoid arthritis patients: Prospective effect of periodontal treatment on cardiovascular risk

Rheumatoid arthritis (RA) patients are more likely to develop cardiovascular disease (CVD), which increases the risk of morbidity and mortality. Periodontitis is known to be associated with CVD, yet its relationship with CVD in RA is limited. To examine the relationship between periodontitis with subclinical atherosclerosis and with long term CVD risk. Examining if periodontitis treatment can be associated with CVD improvement was well thought out. This prospective interventional study included 49 adults with RA. Demographic, clinical and therapeutic data and laboratory markers were assessed. Dental examination for periodontitis was performed. The carotid intima media thickness (CIMT) and Framingham risk score (FRS) were evaluated. Medical treatment was provided to RA patients with periodontitis, and assessments were repeated after 6 months. The mean age of the patients was 46.4 ± 12.4 years, disease duration 10.9 ± 5.4 years and 79.6% were females. 25 (51%) patients had subclinical atherosclerosis, 30 (61.2%) had periodontitis and 25 (51%) had both. RA patients with subclinical atherosclerosis had higher clinical attachment loss (CAL) (3.12 ± 1.45) and higher probing depth (PD) (4.96 ± 1.37) compared to those without (p < 0.001). CAL (β = 0.01, 95 %CI: 0–0.01, p < 0.001), and PD (β = 0.01, 95% CI: 0–0.01; p < 0.001) were independently associated with CIMT. The 30 patients after treatment of periodontitis showed an average improvement in the mean CIMT (0.14 mm, p < 0.001). Periodontitis is associated with subclinical atherosclerosis in RA. Treatment of periodontitis could improve the cardiovascular health in RA patients and prompts physicians to early diagnose and treat periodontitis.

Comparison of full-mouth and partial-mouth disinfection modalities in nonsurgical periodontal treatment for periodontitis: a randomized clinical trial in vietnam

Background: Periodontitis is the most common form of periodontal disease, greatly affecting the aesthetics, function as well as patient’s quality of life. In the periodontal disease treatment strategy, nonsurgical treatment is considered as the initial phase for anti-infection and soft-tissue management. Objective: This study aims to compare the effect of two nonsurgical periodontal modalities: one-stage full-mouth and partial-mouth protocols for periodontitis. Materials and Methods: 60 patients with chronic periodontitis were randomly allocated to 2 groups. Group I (n = 30) was treated according to partial-mouth therapy. Group II (n = 30) was treated according to full-mouth disinfection therapy. Periodontal parameters were assessed at baseline and 1, 3, and 6 months, including plaque index, gingival index, periodontal probing depth, clinical attachment loss, and bleeding on probing. Results: Both two treatment modalities resulted in significant improvements in all clinical parameters over the entire duration of the study (p &lt; 0.05). Full-mouth disinfection therapy showed significantly better improvements than the partial-mouth one during follow-up times (p &lt; 0.05). Conclusion: Nonsurgical periodontal treatment has positive effects on controlling periodontitis. Full-mouth therapy shows clinical benefits over partial-mouth therapy in improving periodontal conditions. Key words: Periodontitis, nonsurgical periodontal therapy, full-mouth therapy, partial-mouth therapy.

Pattern of grade C molar-incisor pattern periodontitis in families.

The aim of this study was to determine the clinical and inflammatory response patterns for individual siblings diagnosed with grade C molar-incisor pattern periodontitis (C-MIP) and between the related siblings within families. Sixty-nine siblings within 28 families with moderate-to-severe C-MIP were included. Clinical parameters were evaluated for symmetry regarding the affected type of teeth, side and/or arch, and bone loss pattern. The protein concentrations from in vitro whole blood cultures for 14 different lipopolysaccharide-stimulated inflammatory markers were correlated with the extent and severity of disease, within an individual sibling and among siblings within a family. A similar disease pattern was observed among all siblings and within families. The most common teeth affected were first molars and incisors or first molars only within the permanent dentition and only molars within the primary dentition (p<0.001). Symmetry involving molars was higher than in incisors in siblings, regardless of arch or side affected (p=0.020). Arc-shape/vertical bone defects were the most common (p=0.006) and higher symmetry was found for these defects in the permanent dentition (p=0.005). Positive correlations were found between age, clinical attachment loss, and percent affected sites with several inflammatory markers. The inflammatory responses for several inflammatory markers were correlated within and among families (p<0.050). Specifically, the intraclass correlation coefficient within families was highest (>0.5) for interleukin (IL)-8, IL-6, and IL-10. Families with C-MIP presented similar patterns of disease. The level of an inflammatory response to bacteria seemed to play a role in the extent and severity of this disease, exemplified by the high degree of correlation in these families.

Effect of Ocimum sanctum L as LDD in periodontal therapy.

Ocimum sanctum L (Tulsi) has various properties like antibacterial, anti-inflammatory and anti-oxidant. To compare the effect of the local-drug delivery system containing 2% Ocimum sanctum L (Tulsi) as an adjunct to scaling and root planing (SRP).The main aim of the study was to evaluate the efficacy of Ocimum sanctum L (Tulsi) gel with Tetracycline fibers (Actisite) for the treatment of periodontitis patients. 40 subjects with periodontitis (pocket depth of 5 mm) were selected and divided into 2 groups Group I: Ocimum sanctum L (Tulsi) gel (n= 20) and Group II: Tetracycline fibers (Actisite) (n = 20). Clinical parameters assessed were Gingival Index , Plaque Index , Probing Depth and Clinical Attachment Loss were assessed at baseline, 1 month, 3 months, 6 months, 8 months. Our results showed that Gingival index and Plaque index for for GROUP I: Ocimum sanctum L (Tulsi) and GROUP II: Tetracycline fibers (Actisite)are not statistically significant p>0.05 for baseline, at 1 month, 3 months, 6 months, 8 months. Probing depth and Clinical attachment are not significant p>0.05 for baseline, at 1 month, 3 months, 6 months, and statistically significant difference seen at 8 months p<0.05. 2% Ocimum sanctum L (Tulsi) gel can be effectively used as an adjunct to scaling and root planing. When used as an adjunct to scaling and root planing, it helps in reduction of pocket depth and gain of clinical attachment. Ocimum sanctum L (Tulsi) showed promising results when compared to Tetracycline fibers (Actisite).

Clinical And Radiographic Assessment Of Autogenous Dentin Nanoparticles In Treatment Of Stage Iii Periodontitis: A Split-Mouth Clinical Study.

To compare autogenous dentin nanoparticles with allograft bone grafts in the treatment of stage III periodontitis. The randomised study was conducted at the Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Kafrelsheikh University Hospital, Egypt, from January 2021 to January 2022, and comprised adult patients of either gender with stage III periodontitis. Each patient's bilateral intrabony defect was randomly treated with an allograft on one side and a graft made of dentin nanoparticles on the testside. Each patient'sremoved tooth was ground into these nanoparticles. Both groups had their probing pocket depth and clinical attachment loss evaluated at baseline and six months aftersurgery. Additionally, digital periapical films were collected in both groups at baseline and six months after therapy to assess vertical bone loss. Data was analysed using SPSS 20. Of the 20 patients, 8(40%) were males and 12(60%) were females with overall mean age 31.00±4.06 years(range: 18-50 years). Of the 40 sites, 20(50%) each were in test and control groups. Compared to baseline values, both groups showed significant improvement in probing pocket depth, clinical attachment loss and vertical bone loss post intervention (p<0.05). There was no significant difference between the postoperative outcomes of the two groups(p>0.05). Autogenous dentin nanoparticles were found to be an effective and promising biomaterial for bone regeneration in intrabony defects. NCT05258006 link: https://clinicaltrials.gov/ct2/show/NCT05258006, Registration date of the Trial 10/2/2022.

Clinical outcomes of diode laser as an adjunct to nonsurgical periodontal therapy for residual periodontal pockets in mandibular second molars-a randomized controlled clinical trial.

The aim of this study was to evaluate the clinical outcomes of diode laser as an adjunct to nonsurgical periodontal therapy (NSPT) for residual periodontal pockets in mandibular second molars. Sixty-seven mandibular second molars (154 residual periodontal pockets) were recruited into the study and randomly assigned to the Laser + NSPT group and the NSPT group. The Laser + NSPT group underwent NSPT adjunct with diode laser radiation (wavelength: 810nm, power: 1.5 W, 40s maximum), while the NSPT group underwent nonsurgical periodontal therapy alone. Clinical parameters were measured at baseline (T0) and 4(T1), 12(T2), and 24(T3), weeks after treatment. Periodontal pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP) in both groups showed significant improvements at the end of study compared to baseline. The reductions of PPD, CAL, and BOP in the Laser + NSPT group were significantly greater than NSPT group. At T3, the Laser + NSPT group had a mean PPD of 3.06 ± 0.86mm, CAL of 2.58 ± 0.94mm and BOP of 15.49%, while the NSPT group had a mean PPD of 4.46 ± 1.57mm, CAL of 3.03 ± 1.25mm and BOP of 64.29%. The diode laser as an adjunct to nonsurgical periodontal therapy may contribute to clinical outcomes for residual periodontal pockets. However, the approach may cause reductionof keratinized tissue width. This study was registered in the Chinese Clinical Trial Registry ChiCTR2200061194. Diode laser as an adjunct to nonsurgical periodontal therapy may contribute to the clinical outcomes for residual periodontal pockets in mandibular second molars.

Periodontal and peri-implant status and whole salivary interleukin 1-beta levels among individuals using selective serotonin reuptake inhibitors: an observational study

ObjectiveSelective serotonin reuptake inhibitors (SSRI) are commonly used for managing psychological diseases such as depression. These disorders are also directly associated with periodontal and peri-implant diseases, namely periodontitis and peri-implantitis, respectively. It is hypothesized that there is no difference in periodontal and peri-implant clinicoradiographic status and unstimulated whole salivary interleukin (IL)-1β levels in participants using selective serotonin reuptake inhibitors (SSRI) and controls (individuals not using SSRI). The aim of the present observational case-control study was to compare periodontal and peri-implant clinicoradiographic statuses and whole salivary IL-1β in participants using SSRI and controls.MethodsUsers of SSRI and controls were included. In all participants, periodontal (plaque index [PI], gingival index [GI], probing depth [PD], clinical attachment loss [AL] and marginal bone loss [MBL]) and peri-implant (modified PI [mPI], modified GI [mGI], PD and crestal bone loss [CBL]) were assessed. Unstimulated whole saliva was collected and IL-1β levels were determined. Information related to duration of implants in function, duration of depressive symptoms and treatment of depression was retrieved from healthcare records. Sample-size was estimated using 5% error and group comparisons were performed. P < 0.05 was considered statistically significant.ResultsThirty-seven SSRI users and 35 controls were assessed. Individuals using SSRI had a history of depression of 4.2 ± 2.5 years. The mean age of SSRI-users and controls were 48.7 ± 5.7 and 45.3 ± 5.1 years, respectively. Tooth brushing twice daily was reported by 75.7% and 62.9% SSRI-users and controls, respectively. There was no statistically significant difference in PI, mPI, GI, mGI, PD, clinical AL, numbers of MT and mesial and distal MBL and CBL among individuals using SSRI compared with controls (Tables 3 and 4). The unstimulated whole salivary flow rate in individuals using SSRI and controls was 0.11 ± 0.003 and 0.12 ± 0.001 ml/min, respectively. Whole salivary IL-1β levels in individuals using SSRI and controls were 57.6 ± 11.6 pg/ml and 34.6 ± 5.2 pg/ml, respectively.ConclusionUsers of SSRI and controls demonstrate healthy periodontal and peri-implant tissue statuses with no marked differences in whole salivary IL-1β levels provided oral hygiene is stringently maintained.

Evaluation and comparison of the effect of ozone therapy and photodynamic therapy in non-surgical management of chronic periodontitis

Among the non-invasive therapies to achieve better plaque control, photodynamic therapy (PDT) and ozonated water therapy (OT) are being widely recognized as two reliable techniques. PDT using low-level laser irradiation is known to selectively target the periodontal pathogens without potentially damaging the host tissues. Ozone therapy on the other hand has antimicrobial, analgesic, immune-stimulating, immune-modulatory, and anti-inflammatory properties, it also oxygenates tissues and enhances their regeneration potential. It has been proven to strongly inhibit the formation of dental plaque. Objective: To evaluate and compare the effect of ozonated oil therapy (OT) and photodynamic therapy (PDT) in nonsurgical management of chronic periodontitis. Methodology: Twelve patients diagnosed with chronic generalized periodontitis were subjected to the study. Following the assessment of gingival index, periodontal pocket depth, and clinical attachment loss, all patients underwent full-mouth scaling and root planing. The study had a split-mouth design, one quadrant of each patient was subjected to ozonated oil therapy with a 22-gauge needle and the contralateral quadrant was treated with PDT, using indocyanine green dye. Patients were recalled after one month and the clinical parameters were recorded again. Results: A statistically significant reduction was observed in all the clinical parameters in both the study groups at 1 month follow up period. Conclusion: Results showed that there was equal improvement in the clinical outcomes in both the groups. Key words: Chronic periodontitis, Ozone therapy, Photodynamic therapy

Periodontal diseases in Thai schoolchildren. Clinical and microbiological observations.

The prevalence of periodontitis among Thai schoolchildren is unknown. In a cross-sectional study, the prevalence and severity of periodontal diseases, in a group of Thai schoolchildren, along with the presence and numbers of bacterial species commonly associated with periodontitis were investigated. A consent form was sent out to 192 schoolchildren in one school (Chanachanupathom School) in Chana, Southern Thailand (in the age range of 12-18years) and 119 attended for a clinical and microbiological examination. Clinical recordings included number of teeth present, DMFT, plaque index, bleeding index, clinical attachment loss (CAL), and probing pocket depth (PPD). Pooled plaque samples were analyzed with culture and qPCR against bacteria associated with periodontitis. The children had low caries experience (DMFT = 3.2 ± 2.3), poor oral hygiene, high bleeding scores, and 67 (56.3%) had at least one interproximal site with CAL ≥ 1mm. Thirty-seven (31.1%) of the children were diagnosed with periodontitis stage I, and sixteen (13.4%) were classified as periodontitis Stage II. Aggregatibacter actinomycetemcomitans was sparsely found in all but the healthy clinical groups (gingivitis, periodontitis Stage I and II), while the groups showed a high prevalence of Fusobacterium spp., Prevotella intermedia/nigrescens, and Campylobacter species as well as of the periodontitis-associated species Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. Thai schoolchildren have poor oral hygiene with abundant amounts of plaque and high presence of bleeding. Early onset periodontitis is common but mostly in its mild form and is not associated with the presence of A. actinomycetemcomitans.

Prevalence, Severity of Extension, and Risk Factors of Gingivitis in a 3-Month Pregnant Population: A Multicenter Cross-Sectional Study.

The scope of this study was to assess the prevalence, severity of extension, and risk factors of gingivitis among pregnant women. In this cross-sectional study, 220 nulliparous women at 3 months of pregnancy were recruited in 2022 at the first obstetrical visit in Dakar, Senegal. Demographic characteristics, lifestyle habits, prenatal clinical status, and oral clinical parameters were recorded. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. Eighty-eight percent of women had gingivitis, 15% were classified as moderate and 73% as severe. A total of 66.7% (95% CI [28.8-92.1]) of the sites had bleeding on interdental brushing. The odds for gingivitis decreased significantly for women consuming more than five portions of fruits and vegetables per day (OR = 0.15; 95% CI [0.03-0.66]) and increased in women who had a professional activity (OR = 6.75; 95% CI [1.27-35.87]) and high education. Concomitantly, the percentage of dental plaque (OR = 131.6; 95% CI [10.80-1619.71] and the severity of clinical attachment loss (OR = 7.70; 95% CI [3.16-18.92]) were important risk factors. Inverse associations were observed with increasing body mass index (OR = 0.76; 95% CI [0.63-0.93]). Our results underline that gingivitis cases and bleeding were particularly high among 3-month pregnant women. Literacy and adequate oral hygiene actions to modify behaviors and to achieve meticulous biofilm disorganization could make a favorable change in the gingival health outcome. Additionally, further research is necessary to precisely determine the role of biofilm-induced gingivitis and systemic-induced gingivitis in improving gingival conditions.

Salivary interleukin-1β as a biomarker to differentiate between periodontal health, gingivitis, and periodontitis.

Periodontal diagnosis is based on recording clinical parameters including bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL). These techniques may be prone to errors due to different factors. Available biomarkers in the oral biofluid such as interleukin (IL)-1β could provide solutions for these issues. The study aimed to determine the potential of salivary IL-1β to differentiate periodontal health from disease and between gingivitis and periodontitis. Patients with gingivitis (N.=25), periodontitis (N.=50), and healthy periodontium (N.=25) were recruited for this study. For each patient, whole unstimulated saliva was collected followed by recording periodontal parameters namely; Plaque Index (PI), BOP, PPD, CAL. Level of salivary IL-1β was assayed by using enzyme-linked immunosorbent assays. Sensitivity and specificity of IL-1β, to differentiate any given condition, was determined by Receiver operating characteristic curve and area under the curve (AUC). Both BOP and PI were significantly higher in association with gingivitis and periodontitis groups as compared to controls. Concentration of salivary IL-1β in periodontal health was significantly lower than gingivitis and periodontitis groups. The biochemical analyses showed that salivary IL-1β differentiated periodontal health from gingivitis (AUC 0.949) and periodontitis (AUC 0.852) but could not discriminate gingivitis from periodontitis (AUC 0.532). The proposed cut-off points to differentiate periodontal health from gingivitis was 103.8 pg/mL, while the value of the biomarker to differentiate periodontal health from periodontitis was 102.0 pg/mL. Salivary IL-1β could be a reliable biomarker with a good level of accuracy to differentiate periodontal health from disease but not to discriminate gingivitis from periodontitis.

Clinical and Microbiologic Outcomes of Ceramic Laminate Veneers Bonded to Teeth Without a Finish Line: 1-year Results of a Prospective Study.

Purpose: To evaluate changes in the periodontium of teeth restored with ultrathin (0.2 to 0.39 mm) ceramic laminate veneers (CLVs) placed subgingivally without a finish line compared to the same teeth before restorative treatment and to nonrestored antagonist teeth in healthy periodontium patients. Materials and Methods: A total of 73 CLVs were bonded onto the enamel surface of teeth without a finish line and with the cervical margin placed about 0.5 mm subgingivally. The gingival crevicular fluid was collected before bonding (baseline) and at 7, 180, and 365 days after bonding to quantify S mitis, P intermedia, and P gingivalis by quantitative polymerase chain reaction analysis. Visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), gingival recession (GR), and marginal adaptation were evaluated from baseline to 365 days in both groups. Results: No statistically significant differences were observed in VPI, PD, or BOP at any time point in the intragroup or intergroup comparisons (P > .05). All restorations obtained the alpha concept for marginal adaptation (ie, the restoration margin remained ideal at all time points). There was a statistically significant difference for S mitis between 180 and 365 days (P = .03). No statistically significant difference was observed for P gingivalis at any time point (P > .05). Conclusion: The periodontium in the restored group showed a clinical behavior similar to baseline. Overcontouring of the ultrathin (up to 0.39 mm) CLV, similar to the cementoenamel junction convexity, did not contribute to plaque accumulation or changes in the oral microbiota of patients with a healthy periodontium and proper oral hygiene instruction.

The influence of smoking on oral neutrophils and matrix metalloproteinase-8 in periodontitis patients before and after nonsurgical treatment.

To evaluate and compare the oral neutrophil numbers (ONN) in saliva, the level of matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid (GCF) and the periodontal parameters in smokers versus non-smokers with periodontitis, before and after nonsurgical periodontal treatment (NSPT). 40 chronic periodontitis patients including 20 smokers and 20 non-smokers were enrolled in this quasi-experimental study. All patients were received the NSPT included instructing oral hygiene, scaling and root planing. At baseline (T0) and after NSPT 1 month (T1) and 3 months (T3), all patients were assessed for salivary ONN, GCF MMP-8, and clinical parameters like plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss (CAL). The differences between the two groups were analyzed using the independent sample t-test and the Mann-Whitney U test; and the differences between T0, T1 and T3 of each group were analyzed with paired-samples t-test and Wilcoxon signed-rank test. The level of significance was set at 0.05. The ONN was significantly less in smokers than in non-smokers although there was no significant difference in other parameters between the two groups at baseline (p>0.05). All clinical periodontal parameters reduced significantly after 1 month and 3 months of NSPT in both groups (p<0.01). PPD of non-smokers was significantly lower than those of smokers at T1 and T3. ONN and MMP-8 level showed a significant decrease in non-smoking subjects, while there was no significant difference in smoking ones after NSPT (T1 and T3). At 1 month after treatment, ONN tended to reduce in non-smokers whereas to increase in smokers significantly. Smoking reduced ONN, impaired treatment effect in reducing PPD, and changed the MMP-8 level in gingival crevicular fluid to NSPT. Identifier NCT04974502 in CLinicalTrials.gov.

Estimation of Salivary IL-6 Level in relation of Periodontal Status in Patients with Hyperthyroidism

Background: The overproduction of thyroid hormones is known as hyperthyroidism. Increased susceptibility to caries and periodontal disease are two potential oral symptoms. The interleukin-6 (IL-6) was observed to significantly increased in the hyperthyroid group. According to multiple research, IL-6 dysregulation has been linked to a number of oral disorders, including periodontal diseases. The study aimed to evaluate periodontal health status in relation to IL6 among hyperthyroidism patients. Subjects and Methods: The sample was composed of 90 female patients aged 25-45 years attending endocrine disorder center in al-Najaf Governorate/Iraq which include hyperthyroid group and healthy group, the hyperthyroid patients were diagnosed by specialist and under treatment with carbimazole. The clinical examination of periodontal health status assessment was performed according to WHO (2013) in addition to evaluation the Plaque and gingival condition. The Saliva was collected to evaluate IL-6 concentrations. Results: The plaque index (PLI) in the study group was more than the control with a significant difference (P&lt;0.05). The gingival index (GI) in the study was more than the control but with no significant difference (P&gt;0.05). Both periodontal pocket depth (PPD) and clinical attachment loss (CAL) were higher in the study group than in the control group, with a significant difference. IL-6 was higher in the study group than in control with a significant difference. There was a positive non-significant correlation between PPD and CAL with IL-6 in hyperthyroid patients.

Association of anxiety, age and oral health-related quality of life with periodontitis: A case-control study.

This case-control study evaluated the association of sociodemographic profile, mental health disorders and oral health-related quality of life (OHRQoL) with periodontitis. Patients with periodontitis (PP, n = 50) and control patients (CP, n = 50) were allocated into 2 groups after a complete periodontal examination. Data collection included age, sex, marital status, education and application of 2 questionnaires: Hospital Anxiety and Depression Scale for the diagnosis of anxiety/depression and Impact Profile on Oral Health (OHIP-14) for classification of well-being. An adjusted multiple binary logistic regression analysis was performed to assess the effect of all studied covariates on periodontitis. The results show that mean clinical attachment loss and periodontal probing depth were 5.92 (SD = 0.42) and 5.46 (SD = 0.78) in PP and 0.00 (SD = 0.00) and 2.85 (SD = 0.23) in CP, respectively (p < 0.001). The regression analysis demonstrated a significant effect on periodontitis for age (OR = 1.13; p < 0.0001; 95% CI: 1.07-1.20), with the PP having more people aged 50 years or older than CP, anxiety (OR = 1.25; p = 0.020; 95% CI: 1.04-1.50) and OHIP-14 (OR = 1.17; p < 0.0001; 95% CI: 1.08-1.226). The findings showed a positive association between anxiety, OHRQoL and age with periodontitis.

Assessment and Correlation of Salivary Ca, Mg, and pH in Smokers and Non-Smokers with Generalized Chronic Periodontitis.

Background and Objectives: Diagnostic evaluation with the aid of biomarkers has reached newer heights to assess disease activity. Salivary calcium, magnesium, and pH are one of the biochemical parameters which can be helpful in assessing the progression of periodontal disease. Smokers are at topnotch threat for having oral diseases, predominantly periodontal diseases. The aim of this study was to assess the salivary calcium, magnesium, and pH levels in smokers compared with non-smokers with chronic periodontitis. Materials and Methods: The current study was conducted on 210 individuals affected with generalized chronic periodontitis, with the age group between 25 and 55 years. Based on their smoking habit, an equal number of patients were categorized into two groups; namely, group I consisted of non-smokers and group II consisted of smokers. The clinical parameters that were measured included Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Loss (CAL). The biochemical variables that were evaluated in the current study included salivary calcium, magnesium, and pH using an AVL9180 electrolyte analyzer (Roche, Germany). The gathered data were analyzed with an unpaired t test was using SPSS 20.0. Results: A statistically significant higher PPD (p < 0.01), CAL (p < 0.05), and salivary calcium levels (p < 0.001) were observed in the smokers' compared with their non-smoking counterparts. Among the biochemical parameters, calcium showed a significantly (p < 0.001) higher level in smokers (5.79 ± 1.76) in contrast to non-smokers (3.87 ± 1.03). Additionally, a significant negative correlation (p < 0.05) between calcium and PPD was observed in non-smokers, whereas a non-significant inverse relation (p > 0.05) was seen in smokers. Conclusions: The present study indicates that the salivary calcium level can be a potential biochemical parameter to assess the progression of periodontal disease in smokers and non-smokers. Within the limitations of the current study, the salivary biomarkers appear to have an essential role in the identification and indication of the status of periodontal diseases.

The expression of Runx2 in the pathogenesis of periodontitis.

Runt-related transcription factor 2 (Runx2) plays an important role in bone metabolism; however, the relationship between Runx2 and periodontitis remains unclear. We investigated Runx2 expression in the gingiva of patients to explore its role in periodontitis. Gingival samples of patients were collected, including healthy samples (control group) and periodontitis samples (P group). Periodontitis samples were divided into three groups based on the periodontitis stage. Samples with stage I and grade B periodontitis were in the P1 group, stage II and grade B in the P2 group, and stage III or IV and grade B in the P3 group. Immunohistochemistry and western blotting were performed to detect Runx2 levels. The probing (PD) and clinical attachment loss (CAL) were recorded. Runx2 expression levels in the P and P3 groups were higher than those in the control group. In addition, Runx2 expression was positively correlated with CAL and PD (r1 = 0.435, r2 = 0.396). The high expression level of Runx2 in the gingiva of patients with periodontitis may be correlated with the pathogenesis of periodontitis.

Is Ozone a Valid Adjuvant Therapy for Periodontitis and Peri-Implantitis? A Systematic Review.

Ozone is a naturally occurring unstable compound with three oxygen atoms that generally transforms into an oxygen molecule, releasing one oxygen atom. This feature has been exploited in dentistry for numerous applications, including for periodontal diseases and peri-implantitis. This review was performed in relation to the PRISMA flow chart and was annotated in the PROSPERO register. PICO questions were used as research questions. The risk of bias in the non-randomized clinical trials was appraised using the ROBINS-I tool. An electronic search found a total of 1073 records, in particular, 842 from MEDLINE/PubMed, 13 from Bio Med Central, 160 from Scopus, 1 from the Cochrane library databases, and 57 from the PROSPERO register. A total of 17 studies were included in the present systematic review. Information regarding the characteristics of the periodontal clinical and radiographic parameters for gaseous ozone, ozonate water, ozonate oil, and ozone gel, including clinical attachment loss (CAL) probing depth (PPD), bleeding on probing (BoP), plaque index (PI), gingival index (GI), and marginal bone levels (MBL), were obtained. The studies included in this systematic review show different results regarding the ozone in periodontal treatment in association with or without SRP.

Clinical and Radiographic Evaluation of Locally Delivered Plant Stem Cells for Treatment of Periodontitis: Randomized Clinical Trial.

Periodontitis causes the destruction of soft and hard tissues. Stem cells have immense potential in regenerative cellular therapy. This clinical trial aimed to evaluate clinically and radiographically the effectiveness of the local application of Edelweiss stem cells as a nonsurgical treatment for stage III periodontitis. The trial included 40 periodontal pockets in participants who have stage III periodontitis with probing pocket depth (PPD) ≥5 mm and clinical attachment loss (CAL) ≥5 mm. Pockets were randomly divided into two groups Group 1: was given oral hygiene instruction, scaling, root planing, and subgingival application of plant stem cells on gel foam carrier after that a periodontal dressing was applied. The procedures were repeated after 2 weeks. Group 2: was treated only by scaling and root planing. Gingival index, CAL, and PPD were measured at baseline and 3 months' posttherapy. The radiographical evaluation was done by digital long-cone parallel periapical radiographs at baseline and 6 months posttherapy. Clinical parameters for both groups showed a statistically significant improvement. Regarding radiographic evaluation, there was a significant increase in bone density in favor of the study group. Locally applied Edelweiss stem cells can be considered a promising nonsurgical treatment modality for periodontal regeneration.

Effect of Smoking on Periodontal Status and Salivary Biomarkers Procalcitonin, C Reactive Protein and Matrixmetalloproteinase-8

Objective: The study aimed to determine the salivary levels of C reactive Protein (CRP), Procalcitonin (PCT), and Matrixmetalloproteinase-8(MMP-8) in periodontitis patients and compare these levels between smokers and non-smokers.Methods: Eighty male subjects aged 25-60 years were chosen and divided into four groups, each comprising 20 individuals: group I: non-smokers without periodontitis, group II: smokers without periodontitis, group III: non-smokers with periodontitis, and group IV: smokers with periodontitis, based on their smoking habit and clinical periodontal parameters which included plaque index (PI%), bleeding index (BI%), pocket probing depth (PPD) and clinical attachment loss (CAL). To assess the salivary concentration, enzyme-linked immunosorbent assay (ELISA) was used for PCT, CRP, and MMP-8, IBM SPSS program version 22 was used for analysis, while ANOVA and Kruskal-Wallis test were used to compare the means and medians in normally distributed and non-normally distributed variables, respectively.Results: There were significant variations in the clinical variables PI, BI, PPD, and CAL between the test and control groups (P&lt;0.05). Furthermore, significant differences were detected in the levels of biomarkers PCT, CRP, and MMP-8 among the four groups. Also, a significant difference was recorded between the levels of these biomarkers and smoking (P&lt;0.05).Conclusions: The study found higher levels of salivary biomarkers in periodontitis and smoker individuals compared to non-periodontitis and non-smoker individuals.