Pritma Singh

Salivary TNF-alpha: A potential marker of periodontal destruction

Aims and Objectives: (1) To evaluate the effect of type 2 diabetes mellitus on salivary TNF-α level in chronic periodontitis. (2) To evaluate the effect of smoking on salivary TNF-α level in chronic periodontitis. (3) To compare and correlate TNF-α level with the healthy individuals. Materials and Methods: Subjects aged 30-35 years were included for the study and divided into four groups as a group of 20 systemically and periodontally healthy individuals (group I), a group of 20 subjects with pocket probing depth (PPD) ≥5 mm and clinical attachment loss (CAL) of ≥2 mm (group II), a group of 20 diabetic subjects (of more than 5 years) with periodontal parameters as of group II as (group III) and a group of 20 subjects smoking (≥10 cigarettes a day) with periodontal parameters of group II as (group IV). Periodontal parameters of PPD, CAL, gingival index (GI), and plaque index (PI) were measured using standard indices and criteria. Three milliliter of unstimulated saliva was taken and salivary TNF-α determined by using ELISA technique (Quantikine Human total TNF-A immunoassay kit). Results: Data revealed highest mean TNF-α in group III followed by group IV, group II, and group I. Mean TNF-α of both group III (76.1%) and group IV (48.8%) was significantly higher as compared to group I (P < 0.001). Mean TNF-α of group III was also found to be significantly different and higher (68.1%) as compared to group II (P < 0.001). Although higher mean TNF-α (31.5%) was found in group IV in comparison to group II, the difference was not statistically significant. Besides above, TNF-α also showed a direct positive correlation with PPD in group II (r = 0.30, P > 0.05) and a significant negative correlation was observed between CAL and TNF-α in group IV. Conclusion: Our study clearly underlines a profound impact of diabetes and smoking on salivary TNF-α in chronic periodontitis subjects in comparison to healthy subjects. Moreover, diabetes status increased TNF-α significantly in comparison to smoking in chronic periodontitis patients.

Dental health attitude in Indian society.

Every society provides a unique soil for a health-care programmer to build upon. Indian society is similarly unique in factors such as social mindset, prevalent beliefs and customs. These factors should not be given a passive glance and should be explored carefully giving an adequate weight to each factors background and its progress to the present status in contemporary dental practice. Only a careful scientific analysis of society is therefore the need of the hour for oral health-care programmers.

Effect of smoking on potential salivary markers of periodontal disease: A clinical and biochemical study

Introduction: Tobacco smoking exerts a harmful effect on the periodontal tissues manifested by periodontal pockets, attachment loss, and periodontal bone loss. Various factors contribute to the deleterious periodontal effects of smoking, including alteration of both microbial and host response factors. Moreover, smoking may exert effects throughout the cytokine network. Aims: The aim of this study was to evaluate the influence of smoking on periodontal biomarkers possibly related to the development of periodontitis including inflammatory mediators and pro-inflammatory cytokines in saliva. Materials and Methods: A total of sixty subjects aged 30–55 years were included in the study and divided into three groups: systemically and periodontally healthy individuals (Group 1), subjects with pocket probing depth (PPD) ≥5 mm and clinical attachment loss (CAL) of ≥2 mm (Group 2), and a subjects smoking (≥10 cigarettes a day) with periodontal parameters of Group 2 (Group 3). Periodontal parameters of PPD, CAL, gingival index (GI), and plaque index were measured using standard indices and criteria. Three milliliters of unstimulated saliva was taken, and salivary tumor necrosis factor-alpha (TNF-α) and matrix metalloproteinase-8 (MMP-8) were determined using ELISA technique. Results: The mean GI was lowest for Group 3, but the mean probing depth of Group 3 (4.93 ± 0.41) was highest. The mean TNF-α level of Group 3 was significantly different and higher as compared to Group 1 and Group 2 (24.32 ± 8.32 ng/ml vs. 6.43 ± 2.65 ng/ml, q = 16.14; P< 0.001). Similarly, the mean MMP-8 level of Group 3 (461.71 ± 58.01 ng/ml) was significantly different (P < 0.001) and higher as compared to Group 1 (192.96 ± 134.89 ng/ml) and Group 2 (347.83 ± 206.72 ng/ml). Both markers showed positive and significant correlation with their periodontal status. Conclusion: Our study clearly indicates a profound effect of smoking on salivary markers of periodontal disease (TNF-α and MMP-8) in chronic periodontitis subjects in comparison to healthy controls.

Sclerostin and occlusion: A brief review

In its pursuit of understanding the wonders of human body, mankind has stumbled upon yet another discovery which not only is a key to chest of unanswered queries but also opens a plethora of new possibilities. Till recently the osteocytes were considered latent cells merely entrapped in the matrix of bone. With the discovery of beta-catenin pathway and sclerostin molecule, these cells are now being recognized to perform a multitude of physiological functions which are important to bone function and turnover. Mechanosensor function of osteocytes via sclerostin molecule offers new possibilities in alveolar bone preservation. Sclerostin and its inhibitors have potential in prosthetic, regenerative and preventive therapy in dentistry. Osteocytic pathway of sclerostin release and mechanism of its interaction with occlusion is discussed in this article.

Dental fluorosis and periodontium: A game of shadows?

Dental fluorosis is a condition which is said to be present when the morphologic features of a tooth are altered clinically, in the form of discoloration or anatomic malformation which is attributed to the developmental changes induced by excess fluoride levels in plasma at the time of tooth formation. In India, an estimated 60 million people are at risk and 6 million people are disabled due to fluorosis. Lack of understanding into the effects of fluorosis on periodontium has left a blind spot in the vision of management of periodontitis in such patient groups. This article suggests the important connection these two conditions can have and emphasize research in this study field.

Questionnaire-based community periodontal susceptibility screening index

Periodontal diseases are major causes of tooth loss and contribute to significant morbidity and healthcare costs. Therefore, identifying areas that deliver substantial returns with community-based preventive programs are a dire necessity. Planning and implementing preventive measures in periodontal oral care require identification of not only a population with current disease burden, but also of future susceptibility to disease. All major periodontal indices that have been used in community periodontal surveys are designed to identify either severity, prevalence, or treatment needs of periodontal diseases. No known index exists based on scientifically proven risk factors of periodontal disease to identify population susceptible to the disease, and to determine the need for preventive planning and interventions. In this article, a simple questionnaire-based index has been proposed to identify both individual and community susceptibility to periodontal disease.