Periodontology

Periodontal health: A welcome addition Ashish Kumar Journal of Indian Society of Periodontology 2019 23(4):297-298

Indian Society of Periodontology: The pillar of periodontics Anil Melath Journal of Indian Society of Periodontology 2019 23(4):299-300

Are we addressing the core issues through bridge course? Abhay Kolte Journal of Indian Society of Periodontology 2019 23(4):301-302

Effect of scaling and root planing as monotherapy on glycemic control in patients of Type 2 diabetes with chronic periodontitis: A systematic review and meta-analysis Akanksha Jain, Jyoti Gupta, Dipika Bansal, Shaveta Sood, Shipra Gupta, Ashish Jain Journal of Indian Society of Periodontology 2019 23(4):303-310 Background: There is enough evidence, which suggests that nonsurgical periodontal therapy (NSPT) improved the glycemic control in patients of Type 2 diabetes mellitus (T2DM) with chronic periodontitis (CP). This meta-analysis is aimed to explore the effect of NSPT, exclusively scaling and root planing (SRP) as monotherapy on glycemic control and periodontal parameters in patients of T2DM with CP. Materials and Methods: Two databases, MEDLINE and EMBASE, were searched from June 2006 to June 2016. Initially, 464 potentially relevant studies were evaluated. Randomized controlled trials with duration of ≥3 months, based on the treatment group managed with SRP without any supportive use of local drug delivery or systemic antibiotics, while the control group received no periodontal therapy, were selected. This resulted in six appropriate articles with a total of 812 patients of T2DM with CP. Alteration in glycated hemoglobin (HbA1c) was the primary outcome measure, whereas the changes in clinical attachment level (CAL) and probing pocket depth (PPD) were the secondary outcome measures. Results: SRP treatment resulted in a decrease in HbA1c by 0.26% (P = 0.17) at 3–4 months compared to the control group. Further, on subgroup analysis, SRP therapy revealed a decrease in PPD and CAL at 3–4 months, though statistically insignificant. Conclusion: SRP treatment leads to modest improvement in glycemic status and periodontal parameters in T2DM patients with CP at 3–4 months.

Effects of recombinant human bone morphogenetic protein-2 compared to other biomaterials in the treatment of intrabony defects in periodontitis patients: A systematic review Raghavendra Shrishail Medikeri, Vinayak Venkoosa Meharwade, Kumar Ankit Sinha Journal of Indian Society of Periodontology 2019 23(4):311-315 Background: Bone morphogenetic proteins have a powerful osteoinductive capacity and have been used as a new adjunct to graft materials for bone regeneration. The objectives of this systematic review are to assess the amount of radiographic bone fill, clinical attachment level (CAL) gain, and reduction in pocket depth (PD) in patients with intrabony defects in periodontitis patients following the use of recombinant human bone morphogenetic protein-2 (rhBMP-2). Materials and Methods: Electronic bibliographic databases search of Medline, Science Direct, and Google Scholar was made from January 1980 to December 2017. Studies using rhBMP-2 to treat periodontal intrabony defects of the maxillary or mandibular region with follow-up period of at least 6 months were searched. Two reviewers performed the systematic review using the PRISMA Statement for reporting and the Cochrane risk-of-bias tool was used for quality assessment. Results: It was found that rhBMP-2 showed statistically significant results with respect to radiographic defect resolution, CAL, and PD reduction at 9 months compared to open-flap debridement but showed statistically significant results only with respect to radiographic bone fill when compared with platelet-rich fibrin at 6 months. Conclusion: The rhBMP-2 may provide a promising alternative to traditional grafting procedures therapy that can enhance periodontal regeneration in patients having intrabony defects. Due to limited human studies, it can be concluded that no definitive evidence exists to ascertain the effectiveness of rhBMP-2 in the treatment of intrabony defects in periodontal diseases.

Estimation of phagocytic activity of polymorphonuclear leukocytes in chronic and aggressive periodontitis patients with nitroblue tetrazolium test Jagadish Reddy Gooty, Andem Shashirekha, Vikram Reddy Guntakala, Rajababu Palaparthi Journal of Indian Society of Periodontology 2019 23(4):316-321 Context: The phagocytic activity of polymorphonuclear leukocytes (PMN) is influenced by the type of disease entity, i.e., chronic generalized periodontitis, generalized aggressive periodontitis, and chronic generalized gingivitis. Aims: The purpose of this experimental study was to evaluate the phagocytic activity of PMN in patients with chronic generalized periodontitis, generalized aggressive periodontitis, and chronic generalized gingivitis. Materials and Methods: A total of 60 patients, 20 patients with chronic generalized periodontitis, 20 patients with generalized aggressive periodontitis, and 20 patients with chronic generalized gingivitis were selected for this study. Blood samples were collected from the patients. Peripheral smears were prepared from the samples, and the slides were stained using nitroblue tetrazolium test, and the phagocytic activity of the neutrophils was compared using the test results. Statistical Analysis Used: Intragroup comparison using Mann–Whitney U-test and intergroup comparison using Kruskal–Wallis one-way ANOVA test were done. Results: The results of the present study suggest that PMN phagocytic defect was present in most of the patients affected by generalized aggressive periodontitis; however, the phagocytic defect cannot be attributed to age, sex, or clinical parameters such as the plaque index or gingival index and probing pocket depths. Conclusions: The phagocytic activity of neutrophils in generalized aggressive periodontitis was low compared to chronic generalized periodontitis and chronic generalized gingivitis.

Comparative evaluation of growth factors from platelet concentrates: An in vitro study Anirban Chatterjee, Koel Debnath Journal of Indian Society of Periodontology 2019 23(4):322-328 Aim: The aim of the study was to compare and evaluate the various growth factors released for a period of 23 days from platelet rich fibrin (PRF) and platelet rich fibrin matrix (PRFM). Materials and Methods: A total of 15 systemically healthy controls were recruited and 10 ml of blood sample was withdrawn from the individual. Following the standard centrifugation protocol, PRF and PRFM were prepared. The platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), transforming growth factor (TGF), and insulin growth factor (IGF) were evaluated for 23 days. Results: The PDGF released from PRFM was statistically significant from PRF till the 15th day of release. The VEGF too had an increased release up till the 15th day from PRFM group as compared to PRF, but no statistically significant difference could be obtained. EGF from the 15th day to 23rd day had a greater release from PRFM group as compared to PRF group. FGF from 7th day to 23rd day had statistically significant difference in the PRFM group as compared to PRF group. TGF and IGF had statistically significant difference in PRFM group as compared to PRF group from 11th day to 23rd day and 1st to 17th day, respectively. Conclusion: The initial and robust release of GFs was seen in PRFM group at earlier days, whereas a steady and constant release of six GFs could be appreciated from PRF group upto 23rd day. Therefore, for a rapid and early healing and regeneration, both the platelet concentrates can be utilized in periodontal therapy.

Assessment of membrane-organizing extension spike protein as a biomarker for periodontal disease by comparing its level in gingival crevicular fluid in individuals with and without chronic severe periodontitis – A pilot study Anjali Sreedharan, Mohammed Shereef, Jayachandran Perayil, Angel Fenol, Rajesh Vyloppillil, Biju Balakrishnan Journal of Indian Society of Periodontology 2019 23(4):329-333 Background: Membrane-organizing extension spike protein (Moesin) is a cytoskeletal protein expressed in the gingival crevicular fluid (GCF) which may play a role in the immune response in periodontal disease. The objective of this study was to evaluate whether Moesin can be used as a biomarker for periodontal disease. Materials and Methods: Thirty patients satisfying the required inclusion criteria were selected from those reporting to the out patient (OP) of the department of periodontics and divided into two groups: Group A – systemically healthy controls with no periodontitis and Group B – systemically healthy controls with chronic severe periodontitis. Periodontal parameters were recorded. GCF was collected, and Moesin levels in the two groups were assessed using enzyme-linked immunosorbent assay. Scaling and root planing (SRP) was done in Group B patients who were reviewed, and samples were collected again after 4 weeks and analyzed. Results: At baseline, the mean GCF Moesin level in Group A was 666.95 ± 471.872 pg/ml, while in Group B, it was found to be 27435.35 ± 14179.77 pg/ml, which showed a high statistically significant difference on comparison. The mean GCF Moesin level in patients with chronic severe periodontitis was 27435.35 ± 14179.77 pg/ml at baseline, and on review 1 month after SRP, it was found to have undergone a statistically significant reduction to 27161.23 ± 14161.57 pg/ml (P = 0.001). Conclusion: Within the limits of this study, it can be concluded that Moesin can serve as a potential biomarker for periodontal disease.

Evaluation of the cone-beam computed tomography accuracy in measuring soft tissue thickness in different areas of the jaws Ehsan Moudi, Sina Haghanifar, Maryam Johari, Hemmat Gholinia, Mohammad Kazemi Ghanbarabadi Journal of Indian Society of Periodontology 2019 23(4):334-338 Purpose: Due to the extensive use of cone-beam computed tomography (CBCT) in dentistry, especially in measuring thicknesses of hard and soft tissues, and the fact that CBCT has low contrast resolution, the aim of this study was to evaluate the accuracy of CBCT in measuring soft tissue thickness. Materials and Methods: In this cross-sectional study, pink baseplate wax as a soft tissue simulation was overlaid in different areas of the jaws on the dry human skull, and the probe was used to determine the thicknesses of 1, 2, 3, and 5 mm. These thicknesses were then measured accurately with a digital caliper by one person four times at interval of a week. The skull was scanned using two CBCT scanners, and the different thicknesses of wax were measured by two observers four times with a week interval. The CBCT measurements were compared with digital caliper measurements as a reference. Results: Statistical analysis showed no significant difference between CBCT and digital caliper measurements for thickness <2 mm (P &#62; 0.05). Conclusions: Statistically, the difference between digital caliper and CBCT measurements was <0.1 mm, but this difference is not clinically important. The accuracy of CBCT in measuring soft tissue thickness was 0.1 mm.

Effects of amine fluoride and probiotic mouthwash on levels of Porphyromonas gingivalis in orthodontic patients: A randomized controlled trial Neeraj Goyal, Pavithra Untagodu Shamanna, Sanju Thomas Varughese, Reji Abraham, Bobby Antony, Rishi Emmatty, Parson Paul Journal of Indian Society of Periodontology 2019 23(4):339-344 Introduction: Porphyromonas gingivalis is one among the major etiological agent in periodontal diseases and has been proved to cause gingival inflammation under orthodontic appliances. Aim: To assess the effect of amine fluoride and probiotic mouthwashes on levels of P. gingivalis during orthodontic treatment, using real time-polymerase chain reaction (RT-PCR). Materials and Methods: A randomised controlled trial was performed including 45 patients. There were three groups: Group A (control group), Group B (patients using Amflor mouthwash) and Group C (patients using probiotic mouthwash). During the treatment, all the 3 groups were advised to brush twice a day using Colgate tooth paste and Group B patients were advised to swish 15 ml fluoridated mouthwash (Amflor) and Group C advised to swish probiotic for 60 s before swallowing, once in the morning and once before sleep. After gently removing supragingival plaque, subgingival plaque samples were collected by inserting a sterile dental curette into the bottom of the gingival crevice around 31, 32, 41, and 42 at two different intervals: T1 at start and T2 after 6 months of fixed orthodontic treatment. Sub-gingival plaque samples collected were transferred to laboratory within 48 h for RT-PCR analysis in Tris-buffer solution, to maintain the integrity of bacterial DNA. Results: The levels of P. gingivalis were significantly decreased with probiotic mouth wash. Conclusions: Probiotic mouth wash can be used as an adjunctive measure along with regular brushing to improve periodontal status during fixed orthodontic treatment.

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