N. Priyanka

Clinical Efficacy of Subgingivally Delivered 1.2-mg Simvastatin in the Treatment of Individuals With Class II Furcation Defects: A Randomized Controlled Clinical Trial

BACKGROUND Simvastatin (SMV) assists in bone regeneration and has an anti-inflammatory effect when delivered or applied locally. The present clinical trial is designed to investigate the effectiveness of 1.2-mg SMV as a local drug delivery system as an adjunct to scaling and root planing (SRP) for the treatment of Class II furcation defects. METHODS Seventy-two patients with mandibular buccal Class II furcation defects were randomized and categorized into two treatment groups: SRP plus placebo (group 1) and SRP plus 1.2-mg SMV (group 2). Clinical parameters were recorded at baseline before SRP and at 3 and 6 months; they included modified sulcus bleeding index (mSBI), probing depth (PD), and relative vertical (RVAL) and horizontal (RHAL) attachment levels. At baseline and after 6 months, radiologic assessment of bone defect fill was performed. RESULTS Both therapies resulted in significant improvements. The decrease in mSBI score at 6 months was greater in group 2 (2.02 ± 0.23) compared with group 1 (1.80 ± 0.22). The mean decrease in PD at 6 months was 1.30 ± 1.0 and 4.05 ± 1.31 mm in groups 1 and 2, respectively. A significantly greater gain in mean RVAL and RHAL was found in group 2 than in group 1 (P <0.05). Furthermore, significantly greater mean percentage of bone fill was found in group 2 (25.16%) compared with group 1 (1.54%). CONCLUSION Locally delivered SMV provides a comfortable and flexible method to improve clinical parameters and also to enhance bone formation.

Association of Progranulin and High Sensitivity CRP Concentrations in Gingival Crevicular Fluid and Serum in Chronic Periodontitis Subjects with and without Obesity

Background: Obesity is considered as a strong risk factor of inflammatory periodontal tissue destruction. The purpose of this study is to determine presence of progranulin (PGRN) and high sensitivity C reactive protein (hs CRP) levels in serum and gingival crevicular fluid (GCF) in obese subjects with chronic periodontitis and to find an association, if any. Material and methods: 40 subjects (20 males and 20 females) were selected based on their clinical parameters into four groups (10 subjects in each group): group 1 (healthy non obese), group 2 (healthy obese), group 3 (non obese with chronic periodontitis) and group 4 (obese with chronic periodontitis). Serum and GCF PGRN levels were estimated by enzyme linked immunosorbant assay (ELISA) and hs CRP levels were estimated by immunoturbidimetry method. Results: The mean PGRN and hs CRP concentration both in serum and GCF were highest for group 4 followed by group 3, group 2 and least in Group 1. Conclusion: PGRN and hs CRP may be novel biomarkers of the chronic inflammatory response in obesity and chronic periodontitis.

Correlation of MCP-4 and high-sensitivity C-reactive protein as a marker of inflammation in obesity and chronic periodontitis.

OBJECTIVES Obesity is increasing in prevalence worldwide and has emerged as a strong risk factor for periodontal disease. Conversely, the remote effects of periodontal disease on various systemic diseases have been proposed. The aim of this study is to determine the presence of MCP-4 and high sensitivity C reactive protein (hsCRP) levels in gingival crevicular fluid (GCF) and serum in obese and non-obese subjects with chronic periodontitis and to find a correlation between MCP-4 and hsCRP in GCF and serum. MATERIALS AND METHODS Forty subjects (20 males and 20 females) were selected and divided into four groups (10 subjects in each group), based on clinical parameters: group NOH (non-obese healthy), group OH (obese healthy), Group NOCP (non-obese with chronic periodontitis) and group OCP (obese with chronic periodontitis). The levels of serum and GCF MCP-4 were determined by ELISA and hsCRP levels were determined by immunoturbidimetry method. RESULTS The mean GCF and serum concentration of MCP-4 was highest for group OCP followed by group NOCP, group OH (in GCF); group OH, group NOCP(in serum) and least in group NOH. The mean hsCRP concentration was highest for group OCP followed by group OH, group NOCP and group NOH. A significant positive correlation was found between serum and GCF MCP-4 and hsCRP levels. CONCLUSION GCF MCP-4 concentrations increased in periodontal disease compared to health and correlated positively with the severity of disease indicating it as a novel marker of periodontal disease. The serum concentration of MCP-4 was found to be more in obese group as compared to nonobese group indicating it as a marker of obesity. Furthermore, based on the positive correlation of MCP-4 and hsCRP found in this study, it can be proposed that MCP-4 and hsCRP may be the markers linking chronic inflammation in obesity and periodontal disease.

Crevicular Fluid and Serum Concentrations of Progranulin and High Sensitivity CRP in Chronic Periodontitis and Type 2 Diabetes

Introduction. This study was designed to correlate the serum and gingival crevicular fluid (GCF) levels of progranulin (PGRN) and high sensitivity C-reactive protein (hs CRP) in chronic periodontitis and type 2 diabetes mellitus (DM). Design. PGRN and hs CRP levels were estimated in 3 groups: healthy, chronic periodontitis, and type 2 DM with chronic periodontitis. Results. The mean PGRN and hs CRP concentrations in serum and GCF were the highest for group 3 followed by group 2 and the least in group 1. Conclusion. PGRN and hs CRP may be biomarkers of the inflammatory response in type 2 DM and chronic periodontitis.

Crevicular and serum levels of monocyte chemoattractant protein-4 and high-sensitivity C-reactive protein in periodontal health and disease☆

OBJECTIVES Chemokines are chemotactic cytokines that are involved in destruction of the periodontal structures. The aim of this study is to determine the presence of MCP-4 and high sensitivity C reactive protein (hsCRP) levels in gingival crevicular fluid (GCF) and serum in periodontal health and disease and to find a correlation between MCP-4 and hsCRP in GCF and serum. METHODS 40 subjects (20 males and 20 females) were selected and divided into three groups based on clinical parameters and radiologic parameters: Group 1 (10 healthy); Group 2 (15 gingivitis subjects) and Group 3 (15 chronic periodontitis subjects). The levels of serum and GCF MCP-4 were determined by ELISA and hsCRP levels were determined by immunoturbidimetry method. RESULTS The mean GCF and serum concentration of MCP-4 were the highest for group 3 followed by group 2 and least in group 1. Similarly, the mean hsCRP concentrations were highest for group 3 and least in group 1. Moreover, a significant positive correlation was found between serum and GCF MCP-4 and hsCRP levels and periodontal parameters. CONCLUSION The levels of MCP-4 and hsCRP increased from healthy to periodontitis. It can be proposed that MCP-4 and hsCRP are the potential biomarkers of inflammation in periodontal health and disease.

Post-treatment levels of stem cell factor and hs-CRP in serum and crevicular fluid of chronic periodontitis subjects with type 2 diabetes.

OBJECTIVE The purpose of this study is to evaluate the stem cell factor (SCF) and high sensitive C reactive protein (hs-CRP) concentration in gingival crevicular fluid (GCF) and serum of chronic periodontitis subjects with type 2 diabetes, and to evaluate the effect of nonsurgical periodontal therapy on their GCF and serum concentrations. MATERIALS AND METHODS A total of (age and gender matched) 22 subjects were evaluated. Pre- and post-treatment levels of SCF and hs-CRP in GCF and serum were measured and compared using enzyme linked immunosorbant assay. Clinical parameters including probing depth and clinical attachment level were also measured. Paired t-test was used to compare the before- and after-treatment levels of the two molecules. RESULTS A highly significant difference (P < 0.001) was found in the GCF and serum concentrations of SCF and hs-CRP before and after treatment. CONCLUSION Our observations indicated that short-term nonsurgical therapy resulted in a significant improvement in periodontal indices and in a marked decrease of SCF and hs-CRP serum and GCF levels.

Systemic Ornidazole as an Adjunct to Non-Surgical Periodontal Therapy in the Treatment of Chronic Periodontitis: A Randomized, Double-Masked, Placebo-Controlled Clinical Trial

BACKGROUND The purpose of this clinical trial is to evaluate the adjunctive clinical effects of the systemic administration of ornidazole (ORN) in the full-mouth scaling and root planing (SRP) of individuals with moderate-to-advanced chronic periodontitis. METHODS Fifty-eight individuals presenting ≥12 teeth with probing depth (PD) ≥4 mm were selected. All participants were instructed on strict oral hygiene measures and were advised to use 0.2% chlorhexidine mouthwash for 1 week before being allocated to two groups. Thirty participants were randomly assigned to full-mouth SRP + placebo (control group), and 28 participants were assigned to full-mouth SRP + ORN (test group). The clinical outcomes evaluated were plaque index, gingival index, clinical attachment level (CAL), and PD. RESULTS Fifty participants could be evaluated by ≤6 months. At 6 months, the test group had greater mean reduction (2.84 mm) in PD compared to the control group (0.84 mm) (P <0.05), and there was also a greater mean CAL reduction (2.92 mm) in the test group compared to the control group (0.92 mm) (P <0.05). CONCLUSION The systemic use of ORN, when used in conjunction with initial periodontal treatment consisting of SRP in adults with periodontitis, achieves significantly better clinical results than initial periodontal treatment alone.

Clinical and microbiological effects of levofloxacin in the treatment of chronic periodontitis: a randomized, placebo-controlled clinical trial.

AIM The aim of the present study was to evaluate the clinical and microbiological effect of systemic levofloxacin (LFX) as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis (CP). METHODS Sixty-five patients with CP were randomly divided into a test (n = 33, SRP and LFX 500 mg, once daily [o.d.]) and a control group (n = 32, SRP and placebo, o.d.). Plaque index (PI), gingival index (GI), percentage of sites with bleeding on probing (%BoP), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, 10 days, and 1-, 3-, and 6-month intervals. The percentage of sites positive for Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis, and Tannerella forsythia were recorded at baseline and at 3 and 6 months. RESULTS Patients receiving LFX showed statistically-significant improvements in mean PD and CAL. The intergroup difference in PI, GI, and%BoP was not significant at any interval. There was a reduction in the percentage of sites positive for periodontopathic bacteria over the duration of the study in both groups, and a statistically-significant reduction in the number of sites positive for A. actinomycetemcomitans in the LFX group (P < 0.001). CONCLUSION Levofloxacin was found to significantly improve the clinical and microbiological parameters in CP individuals.

Clinical Efficacy of Subgingivally Delivered 1.2 mg Simvastatin in the Treatment of Patients with Aggressive Periodontitis: A Randomized Controlled Clinical Trial

Simvastatin (SMV) is a specific competitive inhibitor of 3-hydroxy-2-methylglutaryl coenzyme A reductase that promotes bone formation. The present clinical trial was designed to investigate the effectiveness of 1.2 mg SMV as a local drug delivery system and as an adjunct to scaling and root planing (SRP) in the treatment of aggressive periodontitis (AgP). A total of 68 intrabony defects from 24 patients with AgP were treated either with 1.2 mg SMV gel or placebo gel. The subjects were randomly assigned to SRP + placebo (group 1; n = 12) or SRP + SMV (group 2; n = 12). Clinical parameters were recorded at baseline and at 3 and 6 months and included bleeding index, Plaque Index, probing depth (PD), and clinical attachment level (CAL). At baseline and after 6 months, radiologic assessment of bone defect fill was done. The mean decrease in PD at 6 months was 1.14 ± 0.04 mm and 3.78 ± 0.62 mm in groups 1 and 2, respectively. Significant gain in mean CAL was found between the groups (P < .05). Furthermore, significantly greater mean percentage of bone fill was found in group 2 (34.01%) compared to group 1 (2.62%). Locally delivered SMV provides a comfortable method to improve clinical parameters and promotes bone formation.

Success of dental implants: Must-know prognostic factors

Dentitions damaged by periodontal disease and dental caries often cause problems to the patients and to the dentists, at least regarding the choice of therapy. A recent trend in the replacement of missing teeth is by dental implant. The role of various factors that would affect the prognosis of dental implants should be carefully considered before attempting to rehabilitate the patients with implants. Prognosis is a prediction of probable course, duration, and outcome of a specific disease based on a general knowledge of the pathogenesis of the disease and presence of risk factors for the disease. Factors that could determine the prognosis of implants are (1) periodontally compromised patients, (2) age, (3) bone density, (4) occlusion, (5) smoking, (6) genetics, (7) systemic diseases, (8) microorganisms, (9) antibiotics, and (10) type of implants.