Periodontitis Patients Research Articles

Analyses of gingival papilla blood flow via color doppler flow imaging and micro-flow imaging in patients with advanced periodontitis: a clinical pilot study

BackgroundResearch investigating the potential link between gingival microvascular blood flow and inflammatory status is scarce. This study aims to assess color doppler flow imaging (CDFI) and micro-flow imaging (MFI) as tools for the assessment of gingival papilla blood flow (GPBF) and to examine their diagnostic utility as a noninvasive means of detecting gingival bleeding.MethodsCDFI and MFI were used to assess the GPBF grade (0–4) of 140 anterior gingival papilla sites in advanced periodontitis patients. Correlations between GPBF grades and periodontal characteristics were examined, and diagnostic performance as a means of predicting bleeding on probing (BOP) was examined using receiver operating characteristic curves.ResultsGPBF grades 0 and 1 assessed by the MFI were 14.29% and 15.71% respectively, lower than the 28.57% and 24.29% assessed by the CDFI. In contrast, MFI detected a higher frequency of GPBF grade 2 sites (40.71%) relative to CDFI (22.14%). The CDFI and MFI provided consistent results in 62.14% of the sites, while the MFI demonstrated higher ratings in rest 37.86% of the sites. A significant positive correlation was detected between GPBF grade and the modified gingival index (MGI), bleeding index (BI), BOP, and probing depth (PD). It showed high accuracy for CDFI or MFI to diagnosing BOP with a sensitivity of 80.51% and 96.43% and a specificity of 77.27% and 57.14%, respectively. Area under the receiver operator characteristic curve values when predicting BOP based on the GPBF grade determined using CDFI and MFI approaches 0.887 (95% CI 0.833–0.942) and 0.917 (95% CI 0.862–0.972), respectively, and there were no significant differences between these values (Z = − 1.502, p = 0.133).ConclusionsBoth MFI and CDFI can be employed for the evaluation of GPBF, and MFI is better suited to detecting mild inflammation.Trial registration ChiCTR2200066021 (Date of registration: 22/11/2022).

Expression of CCL2 signaling pathway genes in patients with periodontitis and atherosclerosis.

Periodontitis and atherosclerosis are chronic inflammatory diseases characterized by leukocyte infiltration. We investigated the expression of CCL4, CCR5, c-Jun, c-Fos, NF-κB, and CCL2 as well as the possible mechanism involved in the regulation of CCL2 in human periodontitis tissues and atherosclerotic aorta based on previous research on the CCL4/CCR5/c-Jun and c-Fos/CCL2 pathway leading to CCL2 expression in collagen-induced arthritis (CIA) rat. Sixty-five volunteers were recruited and the condition of their gingiva and coronary arteries were assessed. The subjects were divided into four groups: healthy control, chronic periodontitis (CP), coronary artery diseases (CAD), and noncoronary artery diseases (non-CAD). Total RNA was isolated from gingiva in periodontitis patients and control populations and from the aorta in patients with and without CAD. PCR was used to examine CCL4, CCR5, c-Jun, c-Fos, NF-κB, and CCL2 levels. The production of CCL2 in the gingiva and aorta was analyzed by immunostaining. PCR revealed that CCL4, CCR5, and CCL2 mRNA levels were increased in CP patients' gingivae and aortas from coronary artery bypass grafting (CABG) patients. Marked c-Jun, c-Fos, and NF-κB gene productions were detected in CP patients' gingivae but did not show statistical differences between the CAD and non-CAD groups. Stronger immunoreactivity against CCL2 was observed in periodontitis gingiva and aorta from CABG patients. Our findings suggest that the CCL4/CCR5/c-Jun and c-Fos/CCL2 pathways may be involved in CCL2 expression in periodontitis. CCL4, CCR5, and CCL2 might act as possible nodes to link the presence of periodontitis and atherosclerosis.

Exploring the interplay between Porphyromonas gingivalis KGP gingipain, herpes virus MicroRNA-6, and Icp4 transcript in periodontitis: Computational and clinical insights.

Porphyromonas gingivalis, a major pathogen in periodontitis, produces KGP (Lys-gingipain), a cysteine protease that enhances bacterial virulence by promoting tissue invasion and immune evasion. Recent studies highlight microRNAs' role in viral latency, potentially affecting lytic replication through host mechanisms. Herpes virus (HSV) establishes latency via interactions between microRNA-6 (miRH-6) and the ICP4 transcription factor in neural ganglia. This suggests a potential link between periodontitis and HSV-induced latency. This study aims to identify and validate the insilico inhibitory interaction of P. gingivalis KGP with ICP4 transcripts and correlate the presence of viral latency-associated transcript micro-RNA-6 with periodontitis. Computational docking analysis was performed to investigate the potential interaction between ICP4 and KGP gingipain. The binding energy and RMSD ligand values were calculated to determine the interaction's strength. Ten patients with recurrent clinical attachment loss despite conventional therapy were included in the clinical study. Subgingival tissue samples were collected post-phase I therapy, and HSV microRNA-6 presence was detected via polymerase chain reaction and confirmed through gel electrophoresis. Computational docking identified the ICP4-KGP gingipain complex with the lowest binding energy (-288.29 kJ mol^1) and an RMSD ligand of 1.5 Angstroms, indicating strong interaction potential. Gel electrophoresis confirmed miRH-6 presence in all samples. The identification of miRNA-6 in periodontitis patients and the strong interaction potential between P. gingivalis KGP gingipain and ICP4 transcripts indicate a possible link between bacterial virulence factors and viral latency dynamics in periodontal tissues. These results highlight the complex interplay between oral pathogens, viral microRNAs, and host immune responses in periodontitis.

Outcomes of Nonsurgical Periodontal Therapy in Gingivitis and Periodontitis Patients Treated by Senior Dental Students.

This retrospective study aimed to evaluate the outcomes of nonsurgical periodontal therapy performed by senior dental students. Electronic records of patients treated by senior dental students at the comprehensive care clinic in King Abdulaziz University Dental Hospital were reviewed retrospectively. Patients diagnosed with gingivitis or periodontitis who had undergone at least one session of scaling and root planing were included in this study. The following periodontal parameters were assessed: BOP, PI, PD and number of residual pockets. A total of 618 patients were included in this study (60.2% females and 39.8% males). BOP reduced from a median of 40% (IQR: 26.0%-62.0%) at baseline to 13% (IQR: 9.0%-20.3%) at re-evaluation in the gingivitis group (p < 0.0005). Similarly, a significant reduction in BOP, from 45% (IQR: 28.0%-64.3%) at baseline to 14% (IQR: 9.0%-21.5%) after phase I therapy, was observed in the periodontitis group (p > 0.001). In both groups, 31%-32% of patients had BOP < 10 at re-evaluation. PD of ≥ 5 mm was observed in 50.8% of patients with periodontitis at baseline; however, 38% of these patients had no residual pockets at re-evaluation. NSPT performed by senior dental students was effective in improving the periodontal status of the patients. Both gingivitis and periodontitis patients showed significant improvement in BOP and PI. Approximately, 32% of patients showed a reduction in BOP suggestive of a bleeding score associated with periodontal health. Moreover, patients diagnosed with periodontitis exhibited a significant reduction in the number of sites with deep probing (≥ 5).

Exploring Salivary Alpha-Amylase as a Biomarker in Periodontitis: A Comparative Analysis of Disease Stages and Clinical Correlations

Periodontal disease, characterized by bacterial plaque accumulation and subsequent immune response, can lead to gingivitis and periodontitis if untreated. Salivary alpha-amylase (sAA) has emerged as a potential biomarker with implications in periodontal disease progression. Objectives: This study aimed to assess and compare salivary alpha-amylase levels in individuals with periodontitis and healthy controls and to investigate its relationship with clinical parameters of periodontal disease. Forty-five participants were categorized into periodontally healthy (n = 13), Stage I and II Periodontitis (n = 17), and Stage III and IV periodontitis (n = 15) groups. Saliva samples were collected and analyzed using ELISA kits. Statistical analyses included tests for normality, group comparisons, post hoc analysis, and correlation analysis. Significant differences in salivary alpha-amylase levels were observed among severity groups (p &lt; 0.05), with higher levels in periodontitis patients than healthy controls. Spearman correlation revealed moderate positive associations between alpha-amylase levels and probing depth (PD) and clinical attachment loss (CAL). Elevated salivary alpha-amylase levels were found to be associated with more severe periodontal disease, suggesting its potential as a biomarker for periodontitis severity. These findings support the utility of salivary biomarkers in periodontal disease diagnosis and monitoring, although further validation and standardization are warranted for clinical application.

The role of the oral microbiota in the causal effect of adjunctive antibiotics on clinical outcomes in stage III–IV periodontitis patients

BackgroundPeriodontitis, a prevalent chronic inflammatory disease, offers insights into the broader landscape of chronic inflammatory conditions. The progression and treatment outcomes of periodontitis are closely related to the oral microbiota’s composition. Adjunctive systemic Amoxicillin 500 mg and Metronidazole 400 mg, often prescribed thrice daily for 7 days to enhance periodontal therapy’s efficacy, have lasting effects on the oral microbiome. However, the precise mechanism through which the oral microbiome influences clinical outcomes in periodontitis patients remains debated. This investigation explores the pivotal role of the oral microbiome's composition in mediating the outcomes of adjunctive systemic antibiotic treatment.MethodsSubgingival plaque samples from 10 periodontally healthy and 163 periodontitis patients from a randomized clinical trial on periodontal therapy were analyzed. Patients received either adjunctive amoxicillin/metronidazole or a placebo after mechanical periodontal treatment. Microbial samples were collected at various intervals up to 26 months post-therapy. Using topic models, we identified microbial communities associated with normobiotic and dysbiotic states, validated with 86 external and 40 internal samples. Logistic regression models evaluated the association between these microbial communities and clinical periodontitis parameters. A Directed Acyclic Graph (DAG) determined the mediating role of oral microbiota in the causal path of antibiotic treatment effects on clinical outcomes.ResultsWe identified clear distinctions between dysbiotic and normobiotic microbial communities, differentiating healthy from periodontitis subjects. Dysbiotic states consistently associated with below median %Pocket Probing Depth ≥ 5 mm (OR = 1.26, 95% CI [1.14–1.42]) and %Bleeding on Probing (OR = 1.09, 95% CI [1.00–1.18]). Factors like microbial response to treatment, smoking, and age were predictors of clinical attachment loss progression, whereas sex and antibiotic treatment were not. Further, we showed that the oral microbial treatment response plays a crucial role in the causal effect of antibiotic treatment on clinical treatment outcomes.ConclusionsThe shift towards a normobiotic subgingival microbiome, primarily induced by adjunctive antibiotics, underscores the potential for microbiome-targeted interventions to enhance therapeutic efficacy in chronic inflammatory conditions. This study reaffirms the importance of understanding the oral microbiome's role in periodontal health and paves the way for future research exploring personalized treatment strategies based on individual microbiome profiles.D_npUcg1WaKKucWMF28BqgVideo

Estimation of the concentration of some biochemical parameters and bacterial profile in patients with periodontitis and its relationship with cardiovascular disease

Background: Concerning the widespread occurrence of hyperlipidemia, a significant risk factor for cardiovascular disease, and unclear findings on the connection between periodontal disease and the levels of lipids in the blood. Aim of the study: This study aimed to isolation different bacterial type from periodontitis patients and evaluated level of lipid profile in the same patients Material and methods: The study included a collection age group of 90 samples swaps (patient and control), 60 samples from patients with periodontitis attending outpatient clinics and Balad General Hospitalthe sample were collected for different ages between 15-55 years old and both sexes, from july 2023to December 2024. The sample was taken using a sterile cotton swab (transport cotton swab). The blood samples were taking from their arms from (cubital vien), 5cc of venous blood taken from patients &amp; control healthy individual, Samples were cultured directly using the plotting method on culture media suitable for bacterial growth, which included blood agar, MacConkey agar, mannitol salt agar, MSB agar, and chromo agar. The plates were incubated upside down at 37°C for 18–24 days. The bacterial isolates were identified based on physiological tests and biochemical tests. Result: The present study’s result showed About (60%) showed positive bacterial growth which were Prophyromonas gingivalis (30%), Staph. aureus (16.7%), Strep. pneumonia (11.7%), Staph. epidermidis (10%), Strep. pyogenes, Strep. Viridans, Strep. mutans (8.3% %) for them, and (6.7%) for Enterococcus fecalis that was diagnosed based on biochemical tests, and the diagnosis of some bacterial species was confirmed with the VITEK device., whereas (40%) showed no growth, And there were a high significant differences between the periodontitis patient compared with control group in mean level of cholesterol, HDL and LDL which scored (151.1±42.7, 139.9±41.4, 184.9±25.4) respectively in patient compared with controls (80.0±16.8, 46.2±14.6, 99.1±27.1). While Triglyceride and VLDL showed no differences between studied groups. Conclusion: This study concluded increase cholesterol and low-density lipoprotein in periodontitis patient, While no differences in Triglyceride and VLDL level

The effects of photobiomodulation and/or azithromycin treatment on bone resorption biomarkers in gingival crevicular fluid from patients with stage III-IV grade C periodontitis.

This study aims to investigate the impact of photobiomodulation (PBM) and/or azithromycin (AZM) therapy in combination with full-mouth subgingival instrumentation (FSI) on receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) levels and RANKL/OPG ratios in gingival crevicular fluid (GCF) on patients with stage III-IV grade C periodontitis. The study was conducted on 77 stage III-IV grade C periodontitis patients and 20 periodontally healthy controls. Patients with stage III-IV grade C periodontitis were categorized into four treatment groups: 1) only FSI (FSI) group; 2) FSI&#43;AZM (AZM) group; 3)FSI&#43;PBM (PBM) group and 4) FSI&#43;PBM&#43;AZM (AZM&#43;PBM) group. Clinical periodontalparameters and RANKL and OPG levels and RANKL/OPG ratios in GCF were measured at thebaseline and month 3rd of the therapy. Compared with the periodontally healthy controls,all the baseline clinical parameters were higher in the Stage III-IV grade C periodontitis groups (P< 0.05); however, there were no statistically significant differences between the Stage III-IV gradeC periodontitis groups (P>0.05). In month 3rd, the lowest values in all clinical parameters weregenerally observed in the antibiotics groups whereas the highest values were observed in the FSIgroup. Furthermore, the highest RANKL and OPG values in antibiotic groups and the highestRANKL/OPG ratio in PBM group were observed in the third months. RANKL/OPG ratios did notchange in the FSI and antibiotics groups after the treatment, but it increased significantly in thePBM group. While PBM treatment combined with FSI increases the RANKL levels,AZM increases OPG levels. Also, PBM&#43;AZM treatment shows additional clinical andimmunological beneficial efficacy.

Direct impact of psoriasis on gingival crevicular fluid levels of VEGF-A in periodontitis patients: a mediation analysis

Direct impact of psoriasis on gingival crevicular fluid levels of VEGF-A in periodontitis patients: a mediation analysis

Study on the Mechanism of Nd:YAG Laser-Assisted Therapy on the Changes of Subgingival Flora in Periodontitis.

This study evaluated the therapeutic efficacy of combining Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser with subgingival curettage and root planing (SRP) in generalised stage III/grade C periodontitis patients and its effects on cytokine dynamics and microbial community. Fifteen patients diagnosed with stage III/grade C periodontitis were included in the cohort. The right and left sides of the mouth were randomly assigned either the conventional SRP (control) group or the SRP supplemented with Nd:YAG laser group (experimental group, 160 mJ, 4 W) in a split-mouth design. Clinical periodontal indices were recorded at baseline and at the 6-week follow-up post-treatment. ELISA was utilised to measure IL-1β and TNF-α levels in gingival crevicular fluid. The subgingival microbiota's composition and variations were characterised using 16S rDNA amplicon sequencing, while quantitative real-time polymerase chain reaction (qRT-PCR) was employed to analyse the changes in the red-complex bacteria in subgingival plaque. The SRP&#43;Nd group exhibited a statistically significant reduction in record probing depth (PD) and bleeding on probing (BOP) compared to the SRP group after treatment (p0.05). The SRP&#43;Nd group showed a markedly lower IL-1β level than the SRP group (p0.05). Furthermore, there was no statistically significant difference in the dominant subgingival microbiota composition and level of the red-complex bacteria between the two groups (p>0.05). The adjunctive use of Nd:YAG laser with SRP demonstrates promising short-term therapeutic benefits for patients with extensive stage III/grade C periodontitis. Both SRP as a standalone treatment and its combination with Nd:YAG laser effectively facilitate a transition in the dominant bacterial community from periodontitis-associated to periodontal health-associated microbiota.

The 2018 Classification of Periodontal Diseases: An Observational Study on Inter-examiner Agreement among Undergraduate Students.

The objective of the present observational study was to assess the inter-examiner agreement for the diagnosis of periodontitis using the 2018 CPD among fourth and fifth year undergraduate students. It is hypothesised that there is no difference in the inter-examiner relaibility between fourth- and fifth-year undergraduate students regarding staging and grading periodontal disease using the 2018 Classification of Periodontal Diseases (CPD). All participants received training on the 2018 CPD scheme through a mandatory periodontics course conducted by a periodontist. Documentation for seven deidentified periodontitis patients, comprising medical history, dental history including tooth loss, intra-oral photographs and radiographs, periodontal charts reporting probing depth, plaque and bleeding on probing scores, furcation involvement and clinical attachment loss, was sent via e-mail to undergraduate students. The cases consisted of one sextant, and the participants were instructed to assume the sextant to be a true representation of the entire dentition. Power analysis was done on pilot data, and the level of significance was set at p0.05. The percentage of undergraduate students in the fourth and fifth year that correctly identified the stage of periodontitis according to the 2018 CPD ranged between 28% and 72% and 18.5% and 77.8%, respectively. The percentage of undergraduate students in the fourth and fifth year that correctly identified the grade of periodontitis ranged between 40% and 88% and 51.8% and 92.5%, respectively. The overall staging and grading ranged between 22.8% and 74.1%, and 45.66% and 87.4%, respectively. There was no statistically significant difference between fourth- and fifth-year undergraduate students with regards to assigning the correct diagnoses to case documentation in terms of either stage or grade. Fourth- and fifth-year undergraduate students demonstrated high inter-examiner agreement using the 2018 CPD.

Improvement of salivary biomarkers vitronectin and fetuin-A levels in periodontitis patients with coronary artery disease post scaling and root planing.

Two biomarkers that are gaining attention for their roles in the progression of both periodontal and cardiovascular diseases are vitronectin and fetuin-A. This study evaluated vitronectin and fetuin-A expression in saliva samples of periodontitis (P) patients with and without coronary artery disease (CAD) after scaling and root planing (SRP). Sixty patients were divided into three groups: PH+SH (periodontally and systemically healthy), P (stage II/III grade B periodontitis), and P+CAD (periodontitis with CAD). Demographic, periodontal, and cardiac parameters were recorded. Unstimulated saliva samples were collected at baseline (day 0) and after SRP. On day 90, periodontal parameters and vitronectin/fetuin-A expression were reassessed. P+CAD patients had higher age, weight, BMI, and lower income (p<.001,.025,.002,<.001, respectively), along with elevated plaque index, bleeding on probing, probing pocket depth, and reduced clinical attachment levels (p<.001). Vitronectin was elevated, while fetuin-A was lower in P+CAD, but both improved post-SRP (p<.001). Enhanced vitronectin and fetuin-A levels post-SRP indicate their potential as biomarkers and therapeutic targets for both periodontal and CAD.

Identification of key signaling pathways and novel computational drug target for oral cancer, metabolic disorders and periodontal disease

AimDue to conventional endocrinological methods, there is presently no shared work available, and no therapeutic options have been demonstrated in oral cancer (OC) and periodontal disease (PD), type 2 diabetes (T2D), and obese patients. The aim of this study is to determine the similar molecular pathways and potential therapeutic targets in PD, OC, T2D, and obesity that may be used to anticipate the progression of the disease. MethodsFour Gene Expression Omnibus (GEO) microarray datasets (GSE29221, GSE15773, GSE16134, and GSE13601) are used for finding differentially expressed genes (DEGs) for T2D, obese, and PD patients with OC in order to explore comparable pathways and therapeutic medications. Gene ontology (GO) and pathway analysis were used to investigate the functional annotations of the genes. The hub genes were then identified using protein-protein interaction (PPI) networks, and the most significant PPI components were evaluated using a clustering approach. ResultsThese three gene expression-based datasets yielded a total of seven common DEGs. According to the GO annotation, the majority of the DEGs were connected with the microtubule cytoskeleton structure involved in mitosis. The KEGG pathways revealed that the concordant DEGs are connected to the cell cycle and progesterone-mediated oocyte maturation. Based on topological analysis of the PPI network, major hub genes (CCNB1, BUB1, TTK, PLAT, and AHNAK) and notable modules were revealed. This work additionally identified the connection of TF genes and miRNAs with common DEGs, as well as TF activity. ConclusionPredictive drug analysis yielded concordant drug compounds involved with T2D, OC, PD, and obesity disorder, which might be beneficial for examining the diagnosis, treatment, and prognosis of metabolic disorders and Oral cancer.

Multifactorial analysis of factors influencing premolar mobility in stage III/IV grade C periodontitis patients ≤ 35 years of age: a cross-sectional study

BackgroundPrevious studies have suggested a potential link between the crown-to-root ratio (CRR) and root morphology in patients with mild chronic periodontitis, which may be associated with tooth mobility. However, these findings have not been thoroughly investigated. Our previous study found that 76% of patients with aggressive periodontitis, particularly those with premolar involvement, exhibited abnormal root morphology, severe alveolar bone loss, and increased tooth mobility, leading to poor clinical outcomes. This study aims to investigate the specific correlations among alveolar bone resorption, root morphology, CRR, and periodontal clinical indicators with premolar mobility in stage III/IV grade C periodontitis patients aged ≤ 35 years.Materials and methodsA total of 1,064 premolars from 151 stage III/IV grade C periodontitis patients aged ≤ 35 years were included in the study. Clinical periodontal parameters and radiographic measurements were recorded. Logistic regression analysis was used to explore the relationships between these indicators and tooth mobility.ResultsSignificant variations in premolar root lengths were observed, ranging from 6.80 mm to 20.96 mm. Teeth with shorter roots (mean length: 10.22 mm) exhibited grade I mobility with only 28% alveolar bone resorption, whereas those with medium-length (mean length: 12.67 mm) and longer roots (mean length: 14.91 mm) exhibited mobility at 34% and 37% bone resorption, respectively. Regression models incorporating the bone-level CRR, average probing depth, and root length demonstrated strong predictive accuracy for tooth mobility (P < 0.001, AIC = 1700.574).ConclusionPremolar mobility is influenced by variations in root length, alveolar bone resorption, and probing depth. The bone-level CRR is an effective predictor for assessing tooth mobility, especially when there are differences in root length and alveolar bone resorption.

Multi-site analysis of biosynthetic gene clusters from the periodontitis oral microbiome.

Background. Bacteria significantly influence human health and disease, with bacterial biosynthetic gene clusters (BGCs) being crucial in the microbiome-host and microbe-microbe interactions.Gap statement. Despite extensive research into BGCs within the human gut microbiome, their roles in the oral microbiome are less understood.Aim. This pilot study utilizes high-throughput shotgun metagenomic sequencing to examine the oral microbiota in different niches, particularly focusing on the association of BGCs with periodontitis.Methodology. We analysed saliva, subgingival plaque and supragingival plaque samples from periodontitis patients (n=23) and controls (n=16). DNA was extracted from these samples using standardized protocols. The high-throughput shotgun metagenomic sequencing was then performed to obtain comprehensive genetic information from the microbial communities present in the samples.Results. Our study identified 10 742 BGCs, with certain clusters being niche-specific. Notably, aryl polyenes and bacteriocins were the most prevalent BGCs identified. We discovered several 'novel' BGCs that are widely represented across various bacterial phyla and identified BGCs that had different distributions between periodontitis and control subjects. Our systematic approach unveiled the previously unexplored biosynthetic pathways that may be key players in periodontitis.Conclusions. Our research expands the current metagenomic knowledge of the oral microbiota in both healthy and periodontally diseased states. These findings highlight the presence of novel biosynthetic pathways in the oral cavity and suggest a complex network of host-microbe and microbe-microbe interactions, potentially influencing periodontal disease. The BGCs identified in this study pave the way for future investigations into the role of small-molecule-mediated interactions within the human oral microbiota and their impact on periodontitis.

Assessment of the Efficacy of Indigenously Prepared Azadirachta Indica Mouthwash on P. Gingivalis in Chronic Periodontitis Patients: A Microbiological Study

Aim: The present study aimed to compare and evaluate the antimicrobial effect of Azadirachta Indica (Neem mouthwash) to chlorhexidine mouthwash on P. gingivalis. Materials ans Methods: The subjects were divided into 2 groups. Group I included 5 subjects who used self-prepared neem mouthwash, and Group II included 5 subjects who used 0.2% chlorhexidine mouthwash. Subgingival plaque samples were taken at baseline and the 15th day after using the mouthwash and subjected to microbiological evaluation. Results: The colony forming unit (CFU) of P. gingivalis was calculated at baseline and on the 15th day after using mouthwash using the digit colony counter. A comparison of the total CFU of both mouthwashes revealed that the neem mouth was effective in reducing the microbial colonies of P. gingivalis from baseline to the 15th day. Conclusion: It was concluded that the self-prepared neem mouthwash was effective in reducing the colony-forming unit of P. gingivalis in the sub-gingival plaque samples and showed better results than the commercially available chemical-based chlorhexidine mouthwash.

Guava leaf extract - Phytochemical therapy for periodontitis patients

Introduction: Periodontitis is one of the most prevailing diseases associated with the oral cavity. It is important to treat the disease effectively as it results in tooth loss and also affects the host extensively. Treatment of periodontitis includes various surgical and non-surgical modalities. Non-Surgical modalities include Scaling and Root Planing (SRP), Local Drug Delivery (LDD), laser and HMT therapy. In the present study, the effect of guava leaf extract gel as a local drug delivery agent for the treatment of chronic periodontitis is evaluated. Aim: The aim of this study is to analyze the efficacy of guava gel extract as a local drug delivery agent in patients with periodontitis following scaling and root planing (SRP). Materials and method: A randomized, controlled study was conducted in 21 systemically healthy patients suffering from moderate periodontitis with isolated pockets (pocket depths 45mm). Clinical parameters GI, PI and PPD were recorded at baseline and subsequently after 7th, 14th and 21st day. The study design consisted of three groups, each group having 7 subjects, allocated in these groups randomly. Group A - Guava leaf extract gel (7), Group B – Chlorhexidine group (7), Group C - Control group (7). Results: Both the groups, Group A and Group B showed similar reduction in Gingival Index, Plaque Index and Probing Pocket Depth values when compared at baseline and on 21st day but the differences failed to reach the level of significance. Conclusions: The results suggest that Guava leaf extract gel as a local drug delivery is highly effective and comparable to gold standard.

Expression of Serum and Salivary Levels of Obestatin in Periodontitis Patients with and without Iron Deficiency Anemia

Expression of Serum and Salivary Levels of Obestatin in Periodontitis Patients with and without Iron Deficiency Anemia

Differences Between Vietnamese Living in Germany and German Periodontitis Patients in Periodontal Conditions and Subgingival Microbiota

Introduction and aimsA number of studies have reported ethnic differences in the prevalence and severity of periodontitis. Such discrepancies could be attributed to disparities in periodontal risk factors, as well as variations in the composition of the subgingival microbiota. Given the substantial Vietnamese population residing in the former German Democratic Republic, the present study aimed to compare the clinical and microbial characteristics of periodontitis patients of Vietnamese Asian origin living in Germany with those of German Caucasian periodontitis patients. MethodsA total of 60 patients with a minimum stage II periodontitis diagnosis were included in the study. Of these, 30 were of Vietnamese origin, with an average age of 55 years and a male prevalence of 33.3%. The remaining 30 patients were of German origin, with an average age of 54.5 years and a male prevalence of 40%. The periodontal diagnosis was made in accordance with the recently revised classification of periodontal disease. The pooled subgingival plaque samples were subjected to next-generation sequencing on the MiSeq platform (Illumina). ResultsThe German patients were significantly more likely to be smokers (56.7% vs 13.3%), had significantly higher body mass index (26 vs 22.6 kg/m²), probing depth (4.1 vs 3.6 mm), and clinical attachment loss (5 vs 4.1 mm). In terms of microbiota, the Vietnamese patients exhibited significantly lower beta diversity compared to the German patients, and smokers demonstrated a significantly higher beta diversity compared to nonsmokers. The microbiota of both groups differed most significantly in the relative abundance of Porphyromonas gingivalis (Vietnamese) and Fusobacteriia (German). ConclusionsGerman patients with periodontitis showed more severe periodontal symptoms and more pronounced periodontal risk factors compared to Vietnamese patients. Both patient groups also showed significant differences in the subgingival microbiota. Clinical relevanceCompared to Vietnamese living in Germany, German patients have a higher need for periodontal treatment and at the same time the risk factors of smoking and obesity should be reduced. More research is needed before the differences in oral microbiota between the two groups can lead to individualised therapeutic approaches.

Prediabetes Associates with Matrix Metalloproteinase-8 Activation and Contributes to the Rapid Destruction of Periodontal Tissues.

The aim of this cross-sectional study was to investigate the relationship between periodontitis, potential periodontitis oral fluid biomarkers, and prediabetes. This study included 150 Greek adults aged 25 to 78 years who were tested with an Hemoglobin A1C (HBA1c) diagnostic system, an active-matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test, and several salivary biomarkers enzyme-linked immunosorbent assay tests and gelatin zymography. A full-mouth clinical examination was performed to assess their periodontal and oral health status. The Kruskal-Wallis test was used to determine the statistically significant difference in the levels of periodontal oral fluid biomarkers between the different periodontitis stages, periodontitis grades, and the stages and grades of periodontitis combined. Spearman's rank correlation was performed to assess the strength and direction of the association between aMMP-8 and HbA1c levels (<5.7 and ≥5.7%) and with the other oral fluid biomarkers among patients with severe periodontitis. A two-sided p-value below 0.05 was considered statistically significant in this study. aMMP-8, but not total MMP-8 or other biomarkers, associated significantly with the stage and grade of periodontitis combined (p < 0.001, Kruskal-Wallis test). Among stage III grade C periodontitis patients, aMMP-8 levels were significantly positively correlated with prediabetes (Spearman's rho = 0.646, p = 0.044), total MMP-8 (rho = 0.636, p = 0.048), PMN Elastase (rho = 0.729, p = 0.017), total MMP-9 (rho = 0.721, p = 0.019), and total MMP-8/TIMP-1 molar ratio (rho = 0.879, p < 0.001). Prediabetic disease development can upregulate MMP-8 expression (total MMP-8) in rapidly progressing, severe periodontitis, where MMP-8 latent species are further activated into their active forms (aMMP-8). Simultaneously, several proinflammatory biomarker levels are elevated in this tissue-destructive biomarker cascade. This development is easily detectable online/in real-time within 5 minutes by aMMP-8 PoC testing at the dentist's office.