Generalized Periodontitis Patients Research Articles

Effect of non-surgical periodontal therapy on CD14 + CD16+ monocyte counts in peripheral blood samples: a clinical interventional study

Monocytes and their macrophage progeny are thought to be involved in tissue and alveolar bone destruction in periodontal disease. It has been documented that the proportion of (CD14 + CD16+) non-classical monocytes in the blood are elevated in chronic periodontitis;A total of 20 chronic generalized periodontitis patients who were otherwise healthy, were recruited for this study. At baseline and 3 weeks after non-surgical periodontal treatment, peripheral blood was obtained to assess the levels of C-reactive protein (CRP) and the proportion of monocyte subsets. Monocyte subsets were assessed using flow cytometry;The mean percentage of CD14 + CD16+ non-classical monocytes in the peripheral blood sample at baseline was 13.95 + 2.09, that reduced to 8.94 + 1.23 3 weeks after non-surgical treatment. A distinct significant reduction in the percentage of non-classical monocytes and a concomitant increase in classical monocytes were observed following periodontal treatment compared to baseline. There was a significant reduction in the all the periodontal parameters and CRP levels 3 weeks post non-surgical periodontal treatment. A positive correlation between CRP and percentage of non-classical monocytes was also observed; Periodontal treatment potentially modulates the host response effectively.

Does smoking influence tryptophan metabolism in periodontal inflammation? A cross-sectional study.

The aim of this study was to identify the effects of smoking and periodontal inflammation on tryptophan-kynurenine metabolism as well as the correlation between these findings and clinical periodontal parameters. It has been shown that the tryptophan amino acid's primary catabolic pathway, the kynurenine pathway (KP), may serve as a key biomarker for periodontal disease. Although there are studies investigating the effect of smoking on KYN-TRP metabolism, the effect of smoking on periodontal disease through KP has not been revealed so far. The salivary and serum samples were gathered from 24 nonsmoker (NS-P) stage III, grade B generalized periodontitis and 22 smoker (S-P) stage III, grade C generalized periodontitis patients, in addition to 24 nonsmoker (NS-C) and 24 smoker (S-C) periodontally healthy control individuals. Saliva and serum IL-6, kynurenine (KYN), and tryptophan (TRP) values, and KYN/TRP ratio were analyzed by liquid chromatography-mass spectrometry. Clinical periodontal measurements were recorded. Salivary TRP values were significantly higher in both periodontitis groups than control groups (p < .05). Salivary KYN values were highest in NS-P group (p < .05). Salivary KYN values did not differ significantly between periodontitis groups (p = .84). Salivary KYN/TRP ratio was significantly lower in NS-P group compared to other groups (p < .001). Serum TRP value is higher in S-P group than other groups; however, significant difference was found in S-C group (p < .05). Serum KYN values were significantly lower in smokers than nonsmokers. Serum KYN/TRP ratio is higher in NS-P group. NS-P group has the highest salivary IL-6 levels, NS-C group has the lowest values (p < .05). Our results point out that smoking exacerbates inflammation in the periodontium and increases TRP destruction and decreases IDO activity by suppressing KP in serum. As a result, kynurenine and its metabolites may be significant biomarkers in the link between smoking and periodontal disease.

Effect of non surgical periodontal therapy on levels of inflammatory biomarkers in stage III /IV generalized periodontitis patients versus periodontally healthy individuals

Effect of non surgical periodontal therapy on levels of inflammatory biomarkers in stage III /IV generalized periodontitis patients versus periodontally healthy individuals

Cardiovascular risk assessment in periodontitis patients and controls using the European Systematic COronary Risk Evaluation (SCORE) model. A pilot study.

Aim: To investigate the use of the European SCORE model in a dental setting by exploring the frequency of a 'high' and 'very high' 10-year CVD mortality risk in patients with and without periodontitis. The secondary aim was to investigate the association of SCORE with various periodontitis parameters adjusting for remaining potential confounders. Material and methods: In this study, we recruited periodontitis patients and non-periodontitis controls, all aged ≥40years. We determined the 10-year CVD mortality risk per individual with the European Systematic Coronary Risk Evaluation (SCORE) model by using certain patient characteristics and biochemical analyses from blood by finger stick sampling. Results: In total, 105 periodontitis patients (61 localized, 44 generalized stage III/IV) and 88 non-periodontitis controls were included (mean age: 54.4years). The frequency of a 'high' and 'very high' 10-year CVD mortality risk was 43.8% in all periodontitis patients and 30.7% in controls (p = .061). In total, 29.5% generalized periodontitis patients had a 'very high' 10-year CVD mortality risk, compared to 16.4% in localized periodontitis patients and 9.1% in controls (p = .003). After adjustment for potential confounders, the total periodontitis group (OR 3.31; 95% CI 1.35-8.13), generalized periodontitis group (OR 5.32; 95% CI 1.90-14.90), lower number of teeth (OR .83; 95% CI .73-1.00) and higher number of teeth with radiographic bone loss ≥33% (OR 1.06; 95% CI 1.00-1.12) were associated with a "very high" SCORE category. In addition, various biochemical risk markers for CVD were more frequently elevated in periodontitis compared to controls (e.g., total cholesterol, triglycerides, C-reactive protein). Conclusion: The periodontitis group as well as the control group had a sizable frequency of a 'high' and 'very high' 10-year CVD mortality risk. The presence and extent of periodontitis, lower number of teeth and higher number of teeth with bone loss ≥33% are significant risk indicators for a 'very high' 10-year CVD mortality risk. Therefore, SCORE in a dental setting can be a very useful tool to employ for primary and secondary prevention of CVD, especially among the dental attenders who have periodontitis.

Expression of trefoil factor 2 and 3 and adrenomedullin in chronic periodontitis subjects with coronary heart disease.

The current study aims to determine the expression of trefoil factor 2 (TFF2), trefoil factor 3 (TFF3), and adrenomedullin (ADM) in salivary samples of periodontitis patients with and without coronary heart disease (CHD). A total of 75 patients were selected based on the inclusion and exclusion criteria and divided into three groups of 25 patients each: generalized periodontitis (GP) only; GP+CHD; and CHD only. Demographic, periodontal, and cardiac parameters were recorded, and unstimulated saliva samples were collected and analyzed for the expression of TFF2, TFF3, and ADM. Among the demographic variables, the means for age, weight, and body mass index were significantly different between the groups on statistical analysis. Plaque index, bleeding on probing, probing pocket depth, clinical attachment level, and the expression of TFF2 were highest in the GP+CHD group, and ADM was highest in the CHD group, with P valuesof <0.01 as compared to the other groups. TFF2, TFF3, and ADM were also correlated with the demographic and periodontal parameters. The study demonstrates significantly elevated levels of TFF2 in CHD and GP patients, and a higher expression of ADM in CHD patients only, suggesting the possibility of an underlying inflammatory mechanism.

Estimation of Monocyte Chemoattractant Protein-1 (MCP-1) Levels as an Inflammatory Cytokine in Chronic Generalized Periodontitis Patients

Published on: October 2022Journal of Young Pharmacists, 2022; 14(4):430-434Original Article | doi:10.5530/jyp.2022.14.87 Authors:Anushri Gupta1,*, Sumedha Srivastava1, Veena Kalburgi1, Ashutosh Dubey1, Sai Sri Harsha Nimmala1, Meghaanshu Gupta21Department of Periodontology, People’s College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, INDIA.2Dental Surgeon, Private Practitioner, Etah, Uttar Pradesh, INDIA. Abstract:Background: Monocyte chemoattractant protein-1 (MCP-1) performs assignment of inflammatory cells by triggering the chemotaxis of monocytes and also various cellular events related with chemotaxis. Its increased GCF, saliva and serum levels in periodontal disease have been reported in previous studies. The present study is aimed to evaluate the part of MCP-1 in periodontal disease continuation and also to find out the effect of periodontal treatment on MCP-1 concentration in serum and saliva. Materials and Methods: A total of 60 subjects were divided into three groups (n = 30): chronic periodontitis pre-scaling and root planning (group I), chronic periodontitis consisted of 30 subjects from group I, 4-6 weeks after treatment (group II) and healthy control (group III). Clinical parameters evaluated were gingival index (GI), oral hygiene index-simplified (OHI-S), probing pocket depth (PPD), clinical attachment level (CAL), and serum and saliva samples collected from each patient were quantified for MCP-1 using ELISA. Results: The mean MCP-1 concentration in serum and saliva was found to be the highest in group I, i.e. 160.54 pg/ml and 444.62 pg/ml respectively. The mean MCP-1 concentration in group II was 81.79 pg/ml and 262.98 pg/ml and in group III, it was 43.43 pg/ml and 151.91 pg/ ml respectively. Conclusion: MCP-1 level in serum and saliva rise with advancement of disease and decline after phase I therapy. Due to its certain correlation with clinical parameters, it can be examined as an inflammatory biomarker in periodontal disease. Hence, MCP-1 needs to be further reviewed as a therapeutic target.Keywords: Chemokine, Chronic generalized periodontitis, Inflammatory biomarker, Monocyte Chemoattractant Protein -1 (MCP-1), Non-surgical periodontal therapy..

Evaluation of the efficacy of diode laser (810 nm) as an adjunct to non-surgical treatment in chronic periodontitis at Can Tho University of Medical and Pharmacy Hospital in 2020 - 2022

Background: Diode laser 810nm as an adjunct to non-surgical treatment in chronic periodontitis is a modern and safe method with several advantages such as no need for flaps or sutures, reducing pain, controlling bleeding, etc. Objectives: To evaluate the clinical effects of diode laser used as adjunctive therapy to scaling and root planing (SRP) to that of scaling and root planing alone for the treatment of chronic periodontitis. Materials and methods: Case series report study over 20 chronic generalized periodontitis patients with ³ 4mm probing pocket deep. They were treated with scaling and root planing (SRP) and divided into 2 groups with laser and SRP alone at Can Tho University of Medicine and Pharmacy Hospital. Results: Probing pocket depth (PPD) and Clinical attachment loss (CAL) were reduced at 1 and 3 months in both groups. In the laser group, PPD and CAL were reduced 1.27±0.79mm and 1.32±0.85mm after 1 month, 1.92±0.8mm and 2.09±0,7mm after 3 months. The reduction has statistically significant compared to the no-laser group at both times (P &lt; 0.001). Conclusion: Diode laser 810nm as an adjunct to non-surgical for chronic periodontitis: good effect, suitable concept, minimal invasion, quick healing, etc.

Effect of non-surgical periodontal therapy (NSPT) on salivary and serum levels of a disintegrin-like and metalloproteinase with thrombospondin-1 (ADAMTS-1)

Objectives: A Disintegrin -like and Metalloproteinase with Thrombospondin-1 (ADAMTS-1) is a protease with structure similar to Matrix metalloproteinase. ADAMTS-1 has role in wound healing, fibroblast migration, tissue modeling, vasculogenesis and development of neuronal system. The levels of ADAMTS-1 vary in periodontal health and disease. To evaluate the effect of Non-Surgical Periodontal Therapy (NSPT) on salivary and serum ADAMTS-1 levels in generalized periodontitis patients. Methodology: Forty-five subjects suffering from generalized periodontitis were selected and periodontal parameters were assessed using periodontal probing depth (PPD) and clinical attachment level (CAL). Salivary and serum ADAMTS-1 levels were assessed using enzyme-linked immunosorbent assay. NSPT was performed involving scaling and root planning, followed by oral hygiene instructions. The patients were recalled after three months, periodontal parameters and ADMATS-1 levels were analyzed. Pre- NSPT levels of periodontal parameters and ADAMTS-1 levels were compared with post NSPT. Descriptive statistics and paired t-test were applied to compare the variables. P-value &lt; 0.05 was considered statistically significant. Results: Serum ADAMTS-1 levels pre NSPT was 119.45ng/L and elevated post NSPT to 143.43ng/L. The salivary ADAMTS-1 at baseline was 157.81 and post NSPT 161.53 ng/L and both the values were statistically significant post NSPT.

Immediate Maxillary Full-Arch Rehabilitation of Periodontal Patients with Terminal Dentition Using Tilted Implants and Bone Augmentation: A 5-Year Retrospective Cohort Study.

Background: All-on-four protocols with tilted implants in the maxilla are used to rehabilitate the terminal dentition of the severe generalized periodontitis patients. Data on long-term biological complications are scarce. Methods: Eighty-four axial and forty-six tilted immediate implants have been placed in the extraction sockets of 23 patients according to a four–six implants protocol combined with ridge augmentation. Within 72 h, a provisional prosthesis was cemented to the implants; after 6 months, a cemented ceramic–metallic prosthesis was delivered. The patients were followed for up to 5 years. Results: The 5-year survival rate of the straight and tilted implants was 100% and 97.8, and the prosthetic one was 100%. Marginal bone loss (MBL) of the straight implants was 0.42 ± 0.67 and 0.59 ±1.01 mm on the mesial and distal sides; for the tilted, it was 0.37 ± 0.68 and 0.34 ±0.62 mm, and the differences were not statistically significant. Implant position, smoking, keratinized mucosal width, and cantilever did not affect MBL. Peri-implant mucositis involved 29.4% and 22.2% of the straight and tilted implants, respectively; peri-implantitis involved 5.8% and 4.4% of the straight and tilted implants, respectively, without statistical significance. Conclusions: This immediate loading protocol’s 5-year survival and success rates were high. No difference between the straight and tilted implants was found regarding survival, success rates, and MBL.

Influence of periodontal inflammation on tryptophan-kynurenine metabolism: a cross-sectional study.

Kynurenine pathway (KP) is the primary way of degrading tryptophan (TRP) and generates several bioactive metabolites (such as kynurenine (KYN), kynurenic acid (KYNA), 3-hydroxykynurenine (3OHKYN)) to regulate biological processes that include host-microbiome signaling and immune cell response. This study is aimed to determine the relationship between periodontal inflammation and tryptophan-kynurenine metabolism and identify their association with periodontal clinical parameters. Saliva and serum samples were collected from 20 stage III, grade B generalized periodontitis patients, and 20 periodontally healthy control individuals. Samples were analyzed for IL-6, KYN, TRP, KYN/TRP ratio, KYNA, 3OHKYN, picolinic acid (PA), and quinolinic acid (QA) by liquid chromatography-mass spectrometry. Clinical periodontal parameters (plaque index (PI), probing pocket depth (PPD), gingival recession (GR), clinical attachment loss (CAL), and bleeding on probing (BOP)) were recorded. Clinical parameters were significantly higher in the periodontitis group (p < 0.001). Salivary IL-6, TRP, KYN, KYNA, PA, and QA levels were significantly higher and KYN/TRP ratio was significantly lower in periodontitis group than control group (p < 0.05). Serum KYN, KYN/TRP ratio and PA levels were significantly higher in periodontitis group than control group (p < 0.05). PPD, BOP, PI, and CAL had significantly positive correlations with salivary IL-6, TRP, PA, QA, and serum KYN and significantly negative correlations with salivary KYN/TRP ratio. Our results suggest that periodontal inflammation plays a role in local and systemic tryptophan-kynurenine metabolism. Due to their effects on the immune and inflammatory systems, kynurenines may be potential agents for diagnosis and treatment of periodontal diseases.

A clinical and microbiological study to assess the efficacy of Acmella oleracea and Acacia catechu herbs as local drug delivery in treatment of chronic generalized periodontitis patients.

Aim:A randomized controlled clinical trial was conducted to evaluate the effect of local drug delivery (LDD) of Acmella oleracea (Akarkara) and Acacia catechu (kattha) gels as an adjunct to scaling and root planing (SRP) in generalized chronic periodontitis patients.Materials and Methods:Thirty patients with ninety sites aged 25–65 years with generalized chronic periodontitis having pocket probing depth (PPD) of more than or equal to 5 mm on the basis of inclusion and exclusion criteria were selected. They were treated according to split-mouth design protocol. The placement of gel containing A. oleracea (1%) (Group 1) and A. catechu (1%) (Group 2) as LDD was placed at the two test sites, respectively, and only SRP was done in the control group (Group 3). Periodontal dressing was applied to all the three sites after procedure, and patients were given oral care guidelines. Evaluation of clinical parameters gingival index (GI), plaque index (PI), gingival bleeding index (GBI), PPD, clinical attachment level (CAL), and relative attachment level (RAL) was done at baseline, 1, 3, and 6 months, and microbiological parameter was assessed at baseline and 6 months. N-benzoyl-DL-arginine-2-napthylamide (BANA) test was used for the microbiological analysis.Results:Clinical parameters from baseline to 6 months at different time intervals demonstrated a significant reduction in mean GI, PI, GBI, and PPD and gain in CAL and RAL over a period of 6 months, and results were statistically significant in all the three treatment groups. However, on intergroup comparison, clinically significant difference was observed, but statistically, results were significant at few intervals. The microbiological analysis revealed a statistically nonsignificant reduction at the end of 6 months on intra- and intergroup comparison.Conclusion:The study concluded that the use of A. catechu gel and A. oleracea gel clinically showed improvement in clinical parameters when combined with SRP, attributing to better anti-inflammatory and healing properties.

Association of Epstein-Barr virus, cytomegalovirus and lipocalin with periodontitis in type 2 diabetic subjects.

The current study aims to evaluate and compare the lipocalin, adiponectin and periodontal viruses in the generalized periodontitis patients with and without diabetes mellitus. Seventy subjects were grouped into 35 systemically healthy (GP) and 35 patients with diabetes mellitus (GP+DM). The periodontal parameters, demographic and diabetic variables were evaluated in both the groups. The subgingival tissue samples were procured from the diseased sites and were analysed for the detection of EBV, CMV, HSV and protein markers by real-time polymerase chain reaction (RT-PCR) and lipocalin and adiponectin were identified by enzyme-linked immunosorbent assay (ELISA). The demographic variables such as age and BMI did not differ between the groups. PI and CAL were found to be significantly higher in GP+DM (p<0.05). EBV (82.9%), CMV (71.4%) and protein marker: lipocalin were also found to be statistically highly significant in GP+DM and adiponectin was found to be higher in GP group and reduced in GP+DM group (p<0.0001). The increased prevalence of EBV and CMV and lipocalin with reduced levels of adiponectin in patients with diabetes and periodontitis which may show aggravation of the diabetic status of the periodontitis patients thereby reinforcing a strong Periodontitis-DM continuum.

Comparative assessment of serum levels of vitamin d3 in chronic generalised periodontitis patients with type 2 diabetes mellitus and in simple gingivitis patients - A clinico-bio chemical study

The role of vitamin D was well established in bone metabolism as well as in the inflammatory process of a disease. The periodontal disease which is a chronic inflammatory condition with destructive bone metabolism and type II diabetes mellitus which is a metabolic condition with more prone to inflammatory reactions are prevalent in middle-aged patients. Hence the present study is done to assess the vitamin D levels in serum of chronic generalized periodontitis patients with type2 Diabetes mellitus and simple gingivitis patients Two groups with 50 patients of both periodontal disease with type 2 diabetes and 50 simple gingivitis patients of age 35 to 55 years old were recruited in this study. For all the patient's serum 25(OH)D levels, oral hygiene index (OHI), Russel’s periodontal index, and presence of bony defects in radiographs were assessed.After assessment of all the parameters patients with periodontal disease and type 2 diabetes mellitus showed significantly higher proportion levels than the simple gingivitis patients and significantly lower levels in 25(OH)D (&amp;#60;From the results, it was concluded that generalized periodontitis patients with type II diabetes mellitus showed higher levels of 25-hydroxyvitamin D levels than simple gingivitis patients.

English

BACKGROUND The focus of this study was to assess the relationship of nutrients (magnesium, iron) in periodontitis and diabetic patients. Serum magnesium (Mg) and iron (Fe) levels were evaluated in periodontitis patients and were compared between diabetic patients with periodontitis and healthy controls. METHODS Total sixty subjects (18 females and 42 males) were recruited in this cross-sectional study and were divided into three groups - Group I (healthy subjects), Group II (chronic generalized periodontitis), Group III (Type II diabetes mellitus and chronic generalized periodontitis). Loe and Silness gingival index and probing pocket depth were used for categorizing chronic generalized periodontitis patients. Serum levels of magnesium and iron were estimated and then compared among the groups. Statistical analysis was done using one-way analysis of variance (ANOVA) and Newmann-Keuls multiple post-hoc procedures. Statistical significance was accepted for P ≤ 0.05. RESULTS Mean serum levels of magnesium (Mg) were 0.89 in Group 3 (Type II DM + CGP), 1.01 in Group 2 (CGP) against 1.52 in Group 1 (Control), which were statistically significant. Mean Iron (Fe) levels showed 165.56 in Group 3 (Type II DM + CGP), 137.77 in Group 2 (CGP) against 78.17 (Control) which is also statistically significant. CONCLUSIONS In this study, we found statistically significant decrease in magnesium and increase in serum iron levels in Group 3 (Type II DM + CGP) compared to Group 2 (CGP) and healthy controls. These findings suggest that trace elements also play an important role in the progression of periodontal disease. KEY WORDS Chronic Periodontitis, Diabetes Mellitus, Iron, Magnesium

Salivary Interleukin - 6: Assessment In Chronic Generalized Periodontitis Patient With And Without Type 2 Diabetes Mellitus

Background: Periodontitis is affected by various systemic diseases, among them Diabetes Mellitus is a major systemic factor to influence the severity of chronic periodontitis. Various inflammatory markers are produced in the course of disease that can be reflected in saliva. This study evaluates the salivary concentration of interleukin-6 (IL - 6) in periodontitis patients with type 2 diabetes.&#x0D; Materials and Methods: Whole saliva samples were collected from sixty four patients who were further divided into four groups; Healthy group (control group; n = 16), Chronic Generalized Periodontitis (PD; n = 16), Diabetes Mellitus (DM; n = 16), and Chronic Generalized Periodontitis along with Diabetes Mellitus (PD + DM; n = 16 patients). Salivary IL-6 concentrations were determined by standard enzyme-linked immunosorbent assay and Clinical parameters were recorded like Gingival Index (GI), Oral Hygiene Index (OHI-S), Probing Pocket Depth (PPD), Gingival Recession (GR), Clinical Attachment Level (CAL) with the help of mouth mirror and UNC -15 graduated periodontal probe.&#x0D; Results: Result showed that the Chronic Generalized Periodontitis patients with and without Diabetes Mellitus exhibited higher concentrations of salivary IL-6 than the control group and diabetes groups. Further, the salivary IL-6 was correlated with glycosylated hemoglobin A levels in patient with diabetes. This is due to the fact that both Diabetes &amp; Periodontitis are chronic inflammatory disease that significantly increase the expression of IL-6 which cause insulin resistance in adipocyte and thereby affecting HbA1c levels. Therefore, both can affect severity of each other. Salivary concentration of IL‐6 was determined using an Human IL-6 (Interleukin- 6) ELISA Kit. Kruskal Wallis test was applied to compare any statistical difference between groups for clinical parameters, HbA1c and IL-6. Spearman correlation test was used to find any relation between HbA1c and IL -6 among all the groups. A significance level of 5% was set (P&lt;0.05).&#x0D; &#x0D; Conclusion: The salivary concentration of IL-6 was elevated in patients with periodontitis with and without diabetes. Therefore, levels of salivary IL-6 can be considered as an important biomarker in the diagnosis of periodontitis and diabetes.

Oral Diagnostic Methods for the Detection of Periodontal Disease.

Periodontitis is a common immune-inflammatory oral disease. Early detection plays an important role in its prevention and progression. Saliva is a reliable medium that mirrors periodontal health and is easily obtainable for identifying periodontal biomarkers in point-of-care diagnostics. The aim of this study is to evaluate the effectiveness of diagnostic salivary tests to determine periodontal status. Whole saliva (stimulated/unstimulated) from twenty healthy and twenty stage III grade B generalized periodontitis patients was tested for lactoferrin, alkaline phosphatase, calcium, density, osmolarity, pH, phosphate, buffer capacity, salivary flow rate and dynamic viscosity. A semi-quantitative urinary strip test was used to evaluate markers of inflammation in saliva (erythrocytes, leukocytes, urobilinogen, nitrite, glucose, bilirubin, and ketones), clinical periodontal parameters and pathogenic bacteria. Concentrations of lactoferrin, hemoglobin, and leukocytes were found to be significantly higher in the stimulated and unstimulated saliva in periodontitis patients compared to healthy patients, whereas alkaline phosphatase levels were higher in unstimulated saliva of periodontitis patients (p < 0.05). Periodontal biomarker analysis using test strips may be considered rapid and easy tool for distinguishing between periodontitis and healthy patients. The increase in lactoferrin, hemoglobin, and leucocytes—determined by strip tests—may provide a non-invasive method of periodontal diagnosis.

Effects of smoking on the gingival crevicular fluid levels of interleukin-17A, interleukin-17E, and oxidative stress following periodontal treatment process.

How smoking affects periodontal inflammation and healing still needs to be revealed with all its mechanisms. In this study, the gingival crevicular fluid (GCF) levels of: (a) interleukin-17A (IL-17A) and interleukin-17E(IL-17E) with their ratios and (b) oxidative stress by means of total oxidative stress (TOS), total anti-oxidant capacity (TAOC), and their ratios as the oxidative stress index (OSI) were evaluated and compared for smoking and non-smoking periodontitis patients after a periodontitis management process including both the non-surgical and surgical treatments. Fifteen smoker and 15 non-smoker generalized periodontitis patients as 2 distinct groups participated in the study. Conventional clinical and radiographical examinations were utilized for the periodontitis diagnosis. The clinical data and GCF samples were collected at baseline, 4week after non-surgical periodontal treatment (NSPT), and 4weeks after surgical periodontal treatment (SPT). IL-17A, IL-17E, TOS, and TAOC were determined by ELISA and Rel Assay. Clinical parameters in both smokers and non-smokers improved following periodontal treatment (P<.001) and their clinical data were similar for all the examination times (baseline, NSPT, and SPT) (P>.05). Following the treatment phases, the IL-17A concentration decreased and the IL-17E concentration increased in both the smokers and non-smokers (P<.01). The total amount of IL-17A decreased while the total amount of IL-17E increased in smokers throughout NSPT and SPT (P<.01). Such an alteration was seen only at SPT compared to NSPT and baseline in non-smokers (P<.01). The concentration and total amount of IL-17A were higher at baseline, and the concentration and total amount of IL-17E were lower at all examination time points in non-smokers as compared to smokers (P<.01). The 17A/E ratio decreased in both groups following the treatment phases and was higher in smokers at all the examination times (P<.01). TOS were higher and TAOC were lower in smokers versus non-smokers at all the time points, but the differences were significant only for TOS levels (P<.01). Throughout the treatment phases, the concentration and total amount of TOS decreased in smokers(P<.01) and only the total amount of TOS decreased in non-smokers (P<.01). The concentration and total amounts of TAOC increased throughout the treatments in both smokers and non-smokers without significant changes (P>.05). The baseline OSI was higher in smokers, and it decreased only in smokers following the treatment phases (P<.01). Smoking and periodontal inflammation were found to alter IL-17A, IL-17E, and oxidant/anti-oxidant statuses in periodontitis patients. The intra-group assessments in smokers demonstrated more apparent alterations in the oxidant/anti-oxidant statuses and IL-17A and IL-17E levels after periodontitis management.

Changes in the Salivary Metabolic Profile of Generalized Periodontitis Patients after Non-surgical Periodontal Therapy: A Metabolomic Analysis Using Nuclear Magnetic Resonance Spectroscopy.

Pattern analysis of the salivary metabolic profile has been proven accurate in discriminating between generalized periodontitis (GP) patients and healthy individuals (HI), as this disease modifies the salivary concentrations of specific metabolites. Due to the scarcity of data from previous studies, this study aimed to evaluate if non-surgical periodontal therapy (NST) could affect the metabolomic profile in GP patients’ saliva and if it compares to that of HI. Unstimulated salivary samples were collected from 11 HI and 12 GP patients before and 3 months after NST. Nuclear Magnetic Resonance (NMR) spectroscopy, followed by a supervised multivariate statistical approach on entire saliva spectra and partial least square (PLS) discriminant analysis, were performed to obtain metabolic profiles. In the GP group, periodontal treatment improved all clinical parameters, but not all the diseased sites were eradicated. PLS revealed an accuracy of 100% in distinguishing between metabolic profiles of GP patients before and after NST. Orthogonal projection to latent structure was able to discriminate between the three groups of subjects with an accuracy of 85.6%. However, the post-NST metabolic profile of GP patients could not be completely assimilated to that of HI. Although NST may produce significant changes in the metabolic profile, GP patients maintained a distinctive fingerprint compared to HI.

Salivary, Plasma, and Gingival Levels of Melatonin and TNF-&amp;alpha; in Nonsmokers and Current Smokers with and without Periodontal Disease

Aim The aim of this study was to quantify the levels of gingival, salivary, and plasma melatonin and tumor necrosis factor-α (TNF-α) in healthy individuals and chronic generalized periodontitis patients with and without cigarette smoking habit and to investigate whether a relationship exists between melatonin and TNF-α levels in the samples. Materials and methods Blood of 5 mL, 5 mL of saliva, and gingival tissue samples were obtained from 30 periodontally healthy individuals without smoking habit (HP), 30 nonsmoking patients with chronic generalized periodontitis (CP), 30 periodontally healthy individuals with current smoking habit (SHP), and 30 current smoker patients with chronic generalized periodontitis (SCP). The levels of melatonin and TNF-α in the samples were measured using commercially available enzyme-linked immunosorbent assay (ELISA) kit. The results obtained were statistically analyzed using SPSS statistical software (23.0 version). Results This study demonstrated the presence of melatonin and TNF-α in all the saliva, plasma, and gingival tissue samples. Gingival tissue melatonin levels were highest in the HP group and least in the SCP groups, while TNF-α levels were least in the HP group and highest in the SCP groups. No significant difference was observed between the groups with regard to salivary and plasma melatonin. An overall significant difference was also observed between the groups with regard to salivary TNF-α but not with regard to plasma TNF-α. Binary logistic regression analysis was carried out after dividing the study groups into current smokers and nonsmokers. Results revealed that a reduction in gingival melatonin and an increase in gingival TNF-α were associated with a transition from periodontal health to chronic generalized periodontitis in current smokers but not in nonsmokers. Conclusion This study sheds light on the anti-inflammatory actions of melatonin in the gingival tissues in states of periodontal health and disease in current smokers. Clinical significance Melatonin could be used as a supplement to boost anti-inflammatory mechanisms in periodontal therapy especially in cigarette smokers.

Evaluation of antimicrobial properties of acacia catechu (Khadir): an in-vitro studyEvaluation of antimicrobial properties of acacia catechu (Khadir): an in-vitro study

Context: Acacia catechu has got antimicrobial property. The evaluation of this property against periodontal pathogens may open new doors to treatment modalities of gingivitis and periodontitis. Aims: To evaluate the antimicrobial property of Acacia catechu (Khadir) against periodontal pathogens, Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) in subgingival plaque samples of generalized periodontitis patients. Settings and Design: Prospective, observational, microbiological, in-vitro. Methods and Material: Subgingival plaque samples of generalized periodontitis patients were collected and the two pathogens were isolated and cultured. Herbal extract was prepared in accordance with principles of Ayurveda. Antimicrobial activity was determined by minimal inhibitory concentration (MIC) and time kill assay. Statistical analysis used: None. Results: The water extract of Acacia catechu showed antibacterial property at 100μg/ml dilution in four samples for Pg and at 0.2μg/ml dilution in one sample. Antibacterial property was noted at 0.4μg/ml dilution in four samples for Aa by MIC. Bacteriostatic effect against Pg and Aa was observed by time kill assay. Conclusions: Acacia catechu bark extract exhibited antimicrobial activity against Pg and Aa. The extract also exhibited bacteriostatic effect against Pg and Aa till two hour.