Destructive Periodontal Disease Research Articles

Neutrophil extracellular traps induced by diabetes aggravate periodontitis by inhibiting janus kinase/signal transducers and activators of transcription signaling in macrophages

Background/purposeDiabetes, which is a systemic disease, increases susceptibility to destructive periodontal diseases, which are characterized by infectious susceptibility, but the potential mechanisms remain unknown. The aim of this study was to investigate the mechanism of high glucose environment promoting the occurrence and development of local periodontal inflammation. Materials and methodsIn this study, the effects of neutrophil extracellular traps (NETs) on macrophage polarization and the mechanism were designed to verify whether this course plays a role in periodontal tissue impairment associated with diabetes. Here, we examined the impact of NETs on macrophages in vitro. NETs were isolated from cultures of neutrophils exposed to hyperglycemia. Mouse models of diabetic periodontitis (DP) and macrophage polarization were developed, and the degrees of NET formation in the periodontal tissue of DP mice were assessed. Furthermore, western blotting was performed to analyze the related mechanisms. ResultsThe results revealed that hyperglycemia induced the formation of NETs, and abundant NET formation led to proinflammatory cytokine secretion by macrophages and low expression of JAK-2 and STAT-3 in vitro and in vivo. NETs regulated macrophage polarization through the JAK/STAT pathway. ConclusionThese results suggest that NETs target proinflammatory cytokine secretion via the JAK/STAT pathway and may play important roles in DP progression and macrophage polarization, which indicates that therapeutically referring to this regulatory pathway might be a promising method for treating diabetes-associated inflammatory diseases.

Cosmetic Makeover of Periodontally Compromised Patients using Flexible Gingival Mask and Porcelain Laminate Veneers: Report of Two Cases

Chronic periodontal disease can lead to advanced gingival tissue loss that can result in problems with esthetics, phonetics, food impaction and tooth sensitivity. One of the most difficult problem encountered in the management of periodontal disease is loss of interdental papillae which leaves unsightly “black triangles” between the teeth. The first step in the management of these problems is surgical correction of the defect. In cases where mucogingival surgery is unpredictable due to generalized recession and loss of large volume of gingival tissue, removable gingival prosthesis is an excellent alternative to correct the deformities remaining after the control of destructive periodontal disease specially in the maxillary anterior region. Gingival prostheses may be fixed or removable. It can be made from a range of materials like acrylic, silicones, porcelain- based materials and flexible resin denture material. This report describes two clinical situations in which combined periodontal/prosthodontic rehabilitation was done for patients with advanced periodontal disease. Accurately fitting flexible gingival prostheses and porcelain laminate veneers were fabricated to restore advanced gingival tissue loss in esthetic area following periodontal flap surgery. The flexible gingival masks not only help to achieve excellent cosmetic results but also reinstate the functional and psychological wellbeing of the patient.

Clinical Incorporation of the 2017 Classification of Periodontal Diseased Conditions: Part I (Diagnosis of Periodontitis Involving Data From 4,993 Patients).

Background The new classification system for periodontal and peri-implant diseases mentioned a few key points, including (1) "clinical gingival health," which was defined for the first time, and (2) staging and grading system. Thus, the present study defines the practicability of using the current classification system in day-to-day practice. Aim The primary aim of this study is to determine the effectiveness of the new classification system for periodontal and peri-implant diseases and its application in routine dental practices. Materials and methods This is a cross-sectional retrospective, non-interventional study consisting of 4,993 patients who were under active periodontal therapy as well as supportive periodontal therapy. Results Among patients diagnosed with dental biofilm-induced gingivitis with no underlying risk factors, 1105 (73.3%) exhibited bleeding on probing and 897 (45%) showed supragingival or subgingival calculus. Among the stage II grade B periodontitis group, 488 (28.9%) showed beginning destructive periodontal disease and 197 (50.4%) showed established destructive periodontal disease. Conclusion The implementation of the new classification system in routine dental practice has been readily accepted by clinicians. Staging and grading system of classification helps in assessing the severity, extent, and progression of disease.

Chemotherapeutic Agents in Periodontics: A Review

"Selman Waksman" first used the term "antibiotic" in 1942 to refer to any material produced by a bacterium that inhibits the growth of other micro-organisms in high dilution. The pathogenic bacteria, the patient, and the medication are the three main components of the antibiotic periodontal therapy idea. Patients with attachment loss or with aggressive types of periodontitis or those with periodontitis linked with underlying medical conditions are the best candidates for systemic antimicrobial therapy. The three main objectives of Periodontal Therapy are disrupting biofilms, suppressing potential periodontal pathogens throughout the entire oral cavity, and halting the illness. The microbial etiology of inflammatory periodontal disease provides the rationale for the use of antibiotic medication in periodontal therapy. This idea is predicated on the idea that a certain bacterium causes destructive periodontal disease and that antibiotic agents can be present in humans in doses greater than those required to kill or inhibit infections. Keywords: Antibiotics, Systemic drug delivery, Local drug delivery, Periodontal therapy.

Aptamer Based SPREETA Sensor for the Detection of Porphyromonas gingivalis G-Protein.

We have developed an aptamer that specifically binds to Porphyromonas gingivalis to reduce the cellular damage caused by P. gingivalis infection and applied it as a biosensor. P. gingivalis is one of the major pathogens causing destructive periodontal disease among the periodontal microorganisms constituting complex biofilms. Porphyromonas gingivalis G-protein (PGP) known to play an important role in the transmission of germs was used as a target protein for the screening of aptamer. The aptamer that has binds to the G-protein of P. gingivalis, was screened and developed through the Systemic Evolution of Ligands by Exponential Energy (SELEX) method. Modified-Western blot analysis was performed with the aptamer which consisted of 38 single-stranded DNA to confirm the selectivity. ELONA (enzyme linked oligonucleotide assay) used to confirm that the aptamer was sensitive to PGP even at low concentration of 1 μg/ml. For the rapid detection of P. gingivalis, we constructed a surface plasmon resonance biosensor with SPREETA using the PGP aptamer. It was confirmed that PGP could be detected as low concentration as at 0.1 pM, which is the minimum concentration of aptamer sensor within 5 min. Based on these results, we have constructed a SPREETA biosensor based on aptamer that can bind to P. gingivalis G-protein. It can be used as an infection diagnosis system to rapidly diagnose and analyze oral diseases caused by P. gingivalis.

Correlation Between History of Birth Control Usage and Incidence of Gingivitis among Pregnant Women in Ambulu Public Health Center, Jember District: A Cross-sectional Study

Using birth control (BC) can affect gingiva tissue, increasing the risk of developing gingivitis among women of reproductive age. Based on the Central Bureau of Statistics census, in 2021 61,77% of women in their reproductive age have used contraception and birth control in East Java. This study aims to find the correlation between the history and birth control usage and the incidence of gingivitis among pregnant women in Ambulu Public Health Center. This study uses a cross-sectional method with an analytical observational approach on pregnant women who visited the Dental Outpatient and received dental examinations in April and May of 2022. Thirty respondents were gathered with a history of birth control usage and evaluated using the dentist's Periodontal Index (PI). The results show that nine respondents (30%) had no history of using BC, two respondents (6.6%) used BC pills, ten respondents (33.3%) used 1-month injection BC, five respondents (16.6%) used 3-month injection BC, two respondents (6.6%) used implants BC and two respondents (6.6%) used IUD. From the cross table, one respondent (3.3%) was in the normal category, 1 respondent (3.3%) was in the simple gingivitis category, 15 respondents (50%) were in the early destructive periodontal disease category, and 13 respondents (43.4%) were in the destructive periodontitis. The data are analyzed using Chi-square result, showing that the significant value is p = 0,049 (p<0,05), so it can be concluded there is a significant relation between history of birth control usage and incidence of gingivitis in Ambulu Public Health Center. Dental and oral examinations are highly recommended in routine as early detection of health problems among pregnant women.

Evaluating Salivary Apelin Level among Chronic Periodontitis Patients, with and without Type 2 Diabetes Mellitus utilizing Enzyme‑Linked Immunosorbent Assay: A Comparative Study

Background: Periodontitis is a chronic inflammatory disorder mainly due to a decrease in the immune system caused by periodontal pathogens. The relationship of apelin among chronic generalized periodontitis (CGP) and type 2 diabetes mellitus (T2DM) has been reported. This study intends to assess the level of apelin in saliva from patients of healthy individuals, individuals with CGP, and CGP + T2DM, and evaluate the role of apelin adipokine in inflammation and insulin resistance. New treatment modalities can be invented using apelin in host modulation therapies. Methods: The study comprised 300 patients that were enrolled according to their clinical findings and were divided into three groups chronic periodontitis (n=100), chronic periodontitis with T2DM (n=100), and healthy controls (n=100). Probing pocket depth (PPD), clinical attachment level (CAL), and salivary Apelin (AP) were obtained. With the help of the enzyme-linked immunosorbent assay (ELISA) kit, the salivary apelin level was measured. A statistical software package was used for the surveying of collected data. Results: Group three[CGP+DM] shows the highest salivary apelin level compared to CGP patients without DM. It was 15.43±2.05ng/dl in CGP and 24.08 ± 3.60ng/dl in CGP with DM. All three groups found a statistically significant difference in mean Apelin Level, PPD, and CAL. Conclusion: This study indicated a possible role of adipokines in inflammation and glucose level regulation in patients with T2DM and CGP. In the coming era, apelin levels in saliva can be used for screening objectives in large populations to assure the risk of destructive periodontal disease. Bangladesh Journal of Medical Science Vol. 22 No. 02 April’23 Page : 305-315

Structural Basis of the Inhibition of L-Methionine γ-Lyase from Fusobacterium nucleatum.

Fusobacterium nucleatum is a lesion-associated obligate anaerobic pathogen of destructive periodontal disease; it is also implicated in the progression and severity of colorectal cancer. Four genes (FN0625, FN1055, FN1220, and FN1419) of F. nucleatum are involved in producing hydrogen sulfide (H2S), which plays an essential role against oxidative stress. The molecular functions of Fn1419 are known, but their mechanisms remain unclear. We determined the crystal structure of Fn1419 at 2.5 Å, showing the unique conformation of the PLP-binding site when compared with L-methionine γ-lyase (MGL) proteins. Inhibitor screening for Fn1419 with L-cysteine showed that two natural compounds, gallic acid and dihydromyricetin, selectively inhibit the H2S production of Fn1419. The chemicals of gallic acid, dihydromyricetin, and its analogs containing trihydroxybenzene, were potentially responsible for the enzyme-inhibiting activity on Fn1419. Molecular docking and mutational analyses suggested that Gly112, Pro159, Val337, and Arg373 are involved in gallic acid binding and positioned close to the substrate and pyridoxal-5'-phosphate-binding site. Gallic acid has little effect on the other H2S-producing enzymes (Fn1220 and Fn1055). Overall, we proposed a molecular mechanism underlying the action of Fn1419 from F. nucleatum and found a new lead compound for inhibitor development.

Efficacy of Calcium Phosphate Composite Bone Graft in Treatment of Periodontal Intrabony Defects: Clinico-Radiographic Study

Background: The loss of alveolar bone support is the main symptoms of the destructive periodontal disease. Periodontitis leads to formation of the interbony defects. For resolution of the infection, the elimination of IBD is highly needed. For the filing of the IBD and regeneration of the bone in the periodontal therapy, different bone grafts are used. Objective: The study aimed to evaluate the efficacy of calcium phosphate composite bone graft in patients suffering from periodontal intrabony problems. Study Design: It is a randomized and interventional study conducted at Multan Medical & Dental College, Multan and DOW University of Health Sciences, Karachi for the duration of six months from December 2021 to May 2022. Material and Methods: The study was conducted on 16 patients that fulfilled the inclusion criteria. All the patients completed the follow-up. The radiographic parameters were also evaluated. The baseline data from six months and three months was analyzed and data was plotted. Results: It was found that the primary closure was carried out for all the patients. There was no statistical significance found between the groups related to depth of the defect and the walls number groups before operation. There was a prominent reduction in plague concentration and gingival index. In case of test group there was a greater statistical reduction in the test group as compared to the control. The recession of gingival parameter was seen in both the groups. There was no statistical difference observed here. Conclusion This study helps to provide significant results and evidence that the easy graft crystal can be used for the treatment of periodontal intrabony issues. Keywords: Intrabony defects and calcium phosphate composite bone graft.

A mucoadhesive gingival patch with Epigallocatechin-3-gallate green tea (Camellia sinensis) as an alternative adjunct therapy for periodontal disease: A narrative review

Background: Periodontitis is a progressive destructive periodontal disease. The prevalence of periodontal disease in Indonesia reaches 74.1% and mostly occurs in the productive age group. Most of the periodontopathogenic bacteria are gram-negative bacteria and have endotoxin in the form of lipopolysaccharide (LPS), which can penetrate the periodontal tissue and induce an inflammatory response. In inflammatory conditions, osteoclastic activity is higher than osteoblastic activity, which causes bone destruction. This results in an imbalance between osteoclast-induced bone resorption and osteoblast-induced bone formation. The current preferred treatment for periodontitis is scaling root planning (SRP), but this therapy cannot repair the damaged periodontal tissue caused by periodontitis. Purpose: To describe the possibility of using a mucoadhesive gingival patch with Epigallocatechin-3-gallate (EGCG) green tea (Camellia sinensis) as alternative adjunct therapy for periodontal disease. Review: EGCG is the main component of green tea catechins, which have antitumor, antioxidant, anti-inflammatory, anti-fibrotic, and pro-osteogenic effects. However, the weaknesses so far regarding the use of EGCG as an alternative treatment is its low oral bioavailability and the concentration of EGCG absorbed by the body decreasing when accompanied by food. EGCG can be used with a mucoadhesive gingival patch to optimise bioavailability and absorption and increase local concentration and sustained release of EGCG. EGCG encourages bone development and braces mesenchymal stem cells (MSCs) differentiation for osteoblast by enhancing the expression of bone morphogenic protein 2 (BMP2). EGCG also has been proven to increase the expression of RUNX2 and ALP activity that induces osteoblast differentiation and bone mineralisation. Conclusion: A mucoadhesive gingival patch containing EGCG Green Tea (C. sinensis) may potentially induce osteoblastic activity as an adjunct therapy to repair the periodontal tissue damage due to periodontal disease.

The clinical experience of using a diode laser in the treatment of chronic generalized periodontitis

Relevance. Inflammatory and destructive periodontal diseases occupy one of the leading positions in the structure of major dental diseases. The search for effective methods of treating this pathology remains relevant to the present time. In recent years, physical methods of therapy have become the most important in the practice of a dentist. One of these methods is the use of a diode laser. The use of a laser makes it possible to offer the patient a wide range of periodontal services, both surgical and therapeutic, which, in turn, meet the high standards of dental patient care. The specialized literature presents the results of studies on the clinical effectiveness of laser therapy in the dental practice, and states that the diode laser has a wide range of indication s, high reliability, efficiency and ease of operation. Purpose. The article presents the experience of using a diode laser in the example of a clinical case describing the stages of treatment of a patient with chronic generaliz ed periodontitis. Materials and methods. The cross-sectional study focused on patient N., born in 1964, with a diagnosis of K05.31, chronic generalized periodontitis, and K06.1, hypertrophy of the gingiva. We assessed the patient’s periodontal and sysemic statuses by generally accepted clinical, radiological and laboratory methods. The conventional pathogenetic therapy included a diode laser with a wavelength of 810 nm (optical fibre with a diameter of 400 microns, power 0.5 W, radiation mode – constant). The condition of the gums before and after treatment and the changes in periodontal indices became evaluation criteria for the obtained results. Results . The study results showed that a diode laser inclusion in the complex therapy of inflammatory periodontal diseases improves the quality of life by reducing pain and lack of restrictions, rapid rehabilitation and recovery while significantly reducing the duration of treatment.

Assessment of gingival crevicular fluid levels of gamma glutamyl transferase in chronic periodontitis patients before and after non-surgical periodontal therapy: A clinico-biochemical study

ObjectivesGamma-glutamyl transferase (GGT) enzyme is a routinely used diagnostic marker to detect various systemic diseases, elevation of which indicates destructive activity. Elevated GGT levels in GCF of destructive periodontal diseases hence can be expected. Hence, the aim of this study was to investigate if gamma glutamyl transferase would be a good indicator of on-going disease activity and to also assess the effect of non-surgical therapy on Gamma glutamyl transferase in gingival crevicular fluid of clinically healthy and chronic periodontitis patients. MethodsGCF samples from 20 chronic periodontitis patients and 20 clinically healthy individuals of age group 35–45 years were collected. Clinical parameters were recorded and GGT levels in GCF assessed using semi-autoanalyser before and after appropriate non-surgical periodontal therapy in both the groups. ResultsGGT levels were higher in chronic periodontitis group compared to healthy group at baseline. There was a significant reduction in the GGT levels and clinical parameters at 30th and 90th day post treatment. ConclusionThe significant reduction in the GGT levels after Non Surgical Periodontal Therapy at every recall interval may indicate that GGT can be used as a potential diagnostic marker of periodontitis.

The efficiency of using enamel matrix derivative in therapeutic approach of periodontal furcation defects of maxillary and mandibular molars.

Periodontal disease is an inflammatory condition which affects the covering and support structures of the teeth and, if left untreated, leads to tooth loss. Resorption of the alveolar bone from bi- and trifurcation regions of a multirooted tooth due to the progression of a periodontal disease bears involvement furcation. The degree of furcation involvement is clinically assessed by changes in the vertical and horizontal plane at the root separation area. In the approach of the furcation treatment, the morphological and functional particularities of pluriradicular teeth must be considered and the current techniques look for solutions for the regeneration of the destroyed periodontal tissues. Enamel matrix derivative (EMD) has the role of stimulating healing processes through effects on various growth factors, cement formation, angiogenesis and are used single or in combination with bone graft substitute (BGS) or guided tissue regeneration (GTR) in the complex treatment of periodontal disease. The present study follows PubMed publications on the efficiency of EMD in the treatment of pluriradicular tooth furcations. The findings are that there are not many studies in the usage of EMD associated with the treatment of furcations, but it is an important choice in the complex treatment of destructive periodontal disease, and further studies are needed to be done in periodontal regeneration.

Epidemiology and microbiology of inflammatory and destructive periodontal diseases in childhood

Epidemiology and microbiology of inflammatory and destructive periodontal diseases in childhood

Stopping for Mental Health Screening Before Periodontal Treatment – Role of Psychobiological Risk Indicators in Severity of Periodontal Diseases

Background: As with many chronic infections, the initiation and progression of periodontal diseases are modified by local and systemic host conditions, or risk factors, that markedly affect the resistance of the host to infecting periodontal pathogens. There are large number of factors including genetic, environmental, and psychosocial which constitute a substantial risk in the development of periodontal destructive diseases. Aim: The aim of present study was to scrutinize the relationship between clinical depression, sleep quality and severity of periodontitis using clinical parameters and a depression and sleep quality rating scale. Materials and Methods: Hundred patients were enrolled in this case-control study, of which 50 patients diagnosed with chronic periodontitis were categorized into cases and 50 patients who were systemically and periodontally healthy were designated as controls. The periodontal parameters recorded included probing depth and simplified oral hygiene index (OHI-S). Depression was determined using Beck’s depression scale. Pittsburgh Sleep Quality Index (PSQI) was used for scrutinizing sleep quality. Results: Self‑reported scoring of depression and sleep quality by using Beck’s depression inventory and Pittsburgh Sleep Quality Index questionnaire has revealed that patients diagnosed with chronic periodontitis had an appreciable elevated score of depression and poor sleep quality than normal controls. Conclusion: Findings of this case-control study revealed a statistically significant relationship between depression, its associated oral health behavior, sleep deprivation experienced and severity of destructive periodontal diseases.

Plasminogen gene polymorphisms [c.924C>T and IVS 8+14 G>A] in periodontitis and familial Mediterranean fever: A case-control study.

The plasminogen (PLG) activation system plays an essential role in severe inflammation based diseases such as periodontitis, destructive membranous periodontal disease (ligneous periodontitis), familial Mediterranean fever (FMF), and amyloidosis. We have aimed to evaluate variations in PLG and the associations between PLG and MEFV genotypes in patients with FMF/ FMF-related secondary amyloidosis and periodontitis. A total of 247 individuals who were either diagnosed with FMF or systemically healthy were recruited to this human observational study with a cross-sectional design. All individuals were also diagnosed with periodontitis or periodontally healthy. Blood samples were obtained from patients with FMF and systemically healthy controls. Clinical periodontal indicators were recorded. All polymorphisms located in exons 6 and 8 of PLG and mutations located on exons 2 and 10 of the MEFV gene were analyzed by DNA Sanger Sequencing. Genotypes and allele frequencies of PLG and MEFV were detected and tested by the Hardy-Weinberg equilibrium. Serum levels of amyloid A (SAA), high-sensitive C-reactive protein (hs-CRP), PLG, and salivary PLG levels were determined by using enzyme-linked immunosorbent assay (ELISA). Two polymorphisms were identified in PLG: G to A polymorphism on the 14th nucleotide of intron 8 and C to T polymorphism on the 924th nucleotide of the coding region (IVS 8+14 G>A and c.924C>T, respectively). In IVS 8+14 G>A polymorphisms, wild-type genotype: GG, heterozygote genotype: GA and homozygote genotype: AA. In c.924C>T polymorphism, wild-type genotype: CC, heterozygote genotype: CT and homozygote genotype: TT. The frequency of the heterozygous polymorphisms of PLG was significantly increased (17.6%) in FMF patients with periodontitis (p = .027). A large proportion of the test group that was heterozygous for MEFV-R202Q also had heterozygous PLG polymorphisms. Remarkable exacerbation in periodontal parameters was observed in patients with FMF and amyloidosis. SAA and hs-CRP levels were significantly correlated with salivary PLG levels in patients with periodontitis and heterozygous PLG. The current study describes IVS 8+14 G>A (rs2295368) and c.924C>T (rs1380916375) polymorphisms for the first time in the periodontal literature, which might play an important role in the pathogenesis of periodontitis, FMF, or amyloidosis. The elucidation of PLG polymorphisms is beneficial from a public health perspective by increasing the quality of life in these patients and reducing the mortality and morbidity associated with inflammatory diseases such as periodontal disease, FMF, and FMF-related amyloidosis.

MORPHOLOGICAL FEATURES OF WOUND PROCESS IN PATIENTS WITH INFLAMMATORY AND DESTRUCTIVE PERIODONTAL DISEASES IN CASE OF DIABETES MELLITUS

The aim of this study implied comparing the morphology of periodontal tissues in patients with diabetes mellitus following the results of surgical intervention due to inflammatory and destructive periodontal diseases. We used an erbium laser and a standard surgical method. For this, histological samples obtained from 34 patients were examined. The biopsy samples in Group 1 were studied prior to the surgical treatment of inflammatory and destructive periodontal diseases. Group 2 included histological samples of patients following surgeries employing conventional surgical techniques. Group 3 included gum biopsies obtained after surgical interventions performed with the erbium laser. The research outcomes revealed that when performed in patients with diabetes mellitus complicated with diabetic microangiopathy of the gingival mucosa, surgical curettage or a standard surgical operation with a scalpel did not lead to any significant decrease in the chronic inflammatory process. The morphological picture of the gum soft tissues in patients with Type I and II diabetes mellitus, 3 months after the treatment with the erbium laser as a cutting tool, matched the usual structure of the mucous membrane with no obvious signs of inflammation.

Generation and functional characterization of recombinant Porphyromonas gingivalis W83 FimA

Porphyromonas gingivalis (P. gingivalis) is regarded as a keystone pathogen in destructive periodontal diseases. It expresses a variety of virulence factors, amongst them fimbriae that are involved in colonization, invasion, establishment and persistence of the bacteria inside the host cells. The fimbriae also were demonstrated to affect the host immune-response mechanisms. The major fimbriae are able to bind specifically to different host cells, amongst them peripheral blood monocytes. The interaction of these cells with fimbriae induces release of cytokines such as interleukin-1 (IL-1), IL-6, and tumor necrosis factor-α (TNF-α). The aim of this study was to generate recombinant major FimA protein from P. gingivalis W83 fimbriae and to prove its biological activity. FimA of P. gingivalis W83 was amplified from chromosomal DNA, cloned in a vector and transferred into Listeria innocua. (L. innocua).The expressed protein was harvested and purified using FPLC via a His trap HP column. The identity and purity was demonstrated by gel-electrophoresis and mass-spectrometry. The biological activity was assessed by stimulation of human oral epithelial cells and peripheral blood monocytes with the protein and afterwards cytokines in the supernatants were quantified by enzyme linked immunosorbent assay (ELISA) and cytometric bead array. Recombinant FimA could successfully be generated and purified. Gel-electrophoresis and mass-spectrometry confirmed that the detected sequences are identical with FimA. Stimulation of human monocytes induced the release of high concentrations of IL-1β, IL-6, IL-10 and TNF-α by these cells. In conclusion, a recombinant FimA protein was established and its biological activity was proven. This protein may serve as a promising agent for further investigation of its role in periodontitis and possible new therapeutic approaches.

Role of gender & age in chronic periodontal disease

There is lot of literature suggesting a gender based heterogeneity in many human chronic diseases including periodontal disease. To analyze and compare the clinical periodontal disease parameters & serum biochemical markers of periodontal inflammation in systemically healthy age stratified adult male and female patients suffering from chronic destructive periodontal disease. Cross sectional observational study in a hospital setting A total of 300 subjects, both genders were enrolled based on predefined criteria and were categorized in 6 groups of 50 subjects each. Complete medical and dental history was taken to screen before enrollment. All subjects underwent complete periodontal examination, including evaluation of Plaque index (PI), Probing pocket depth (PPD) and Clinical attachment level (CAL), Bleeding on Probing (BOP). Blood samples were taken for analysis of inflammatory biomarkers viz interleukin (IL)-1β, osteoprotegrin (OPG), matrix metalloproteinase (MMP)- 8 & interleukin (IL)- 6. IBM SPSS STATISTICS (version 22.0) Clinical parameters of periodontal status were higher in females as compared to males except BOP. However, only PPD and CAL showed significant difference. Higher serum levels of IL-1β, OPG and Il-6 were observed in females (2.10 + 26.82, 168.18 + 49.84 , 29.17 + 99.20 pg/ml) than males (1.90 + 7.27 , 145.00 + 39.60 , (25.83 + 189.09pg/ml) respectively, but significant difference was observed only for OPG. A statistically significant higher level of MMP-8 was observed in males (3003.33 + 772.33 pg/ml) as compared to females (1398.33 + 1218.10 pg/ml). The findings of current investigation has identified significant differences in the clinical and specific biochemical mediators(IL-1β, IL-6, OPG, MMP-8) across groups and subgroups of the population To ascertain the impact of gender and age in the causation and pathogenesis of inflammatory periodontal disease, further well designed prospective investigations are needed . The study findings point towards the identification of specific biomarkers in individual subgroup/group based on age and gender. These shall pave path to develop predictive models, screening tools and early diagnostic strategies for chronic periodontal disease for Indian population.

Study of effect of normal occlusion and malocclusion on periodontal condition of diabetes mellitus patients in dental OPD (Orthodontics) at tertiary care centre, Patna, Bihar, India: A case-control study

: Diabetes mellitus is a metabolic disorder in which there is an abnormal elevation of blood glucose level. The periodontitis is recognized as the sixth complication of diabetes. The role of malocclusion in accelerating plague deposition is well known however in normal occlusion with well aligned teeth is less documented. So, the objectives of the study are to study the prevalence of periodontitis in diabetic patients with malocclusion and in normal occlusion and to study the effect of various determinants of diabetes mellitus if at all exists.: It is case-control observational study. Two hundred (200) patients were included in the study from the dental OPD (Orthodontics) of Dept. of Dentistry, and from the Dept. of Endocrinology, Indira Gandhi institute of medical sciences, Patna, Bihar, India. The statistical analysis was done Microsoft office excel. The results were analysed in frequencies and percentages to estimate the prevalence of malocclusion and occlusion in patients with diabetes mellitus and their effects on periodontium of the teeth.The prevalence rate of severe destructive periodontal diseases (SDPD) in malocclusion group was 81.72% than in normal occlusion group with less prevalence rate of 55.21%.The prevalence of severe destructive periodontal diseases in the uncontrolled diabetes mellitus in malocclusion group was more than in normal occlusion group, with maximum periodontium destruction observed during first between 1-5 years of detection of diabetes.