Rucha Shah

Effects of intranasal administration of norethisterone on folliculogenesis, cervical mucus, vaginal cytology, endometrial morphology and reproductive-endocrine profile in women

The effects of intranasal administration of norethisterone (NET) on menstrual cycle length, folliculogenesis, serum levels of estradiol, FSH, LH and progesterone, vaginal cytology, cervical mucus and endometrial morphology were studied in 8 volunteers (age 28 to 39 years, weighing between 46 and 54 kg). The study period comprised 4 consecutive menstrual cycles. In the first cycle (pretreatment cycle), only the vehicle (alcohol, propylene glycol, water; 3:3:4) was sprayed intranasally (100 microliters in each nostril), using a metered nebulizer, once daily from day 3 to the last day of menstrual cycle. In the next two cycles (treatment cycles), NET (300 micrograms/day) was administered once daily, starting from day one of menstrual cycle, between 9 and 10 a.m. The fourth cycle was a post-treatment cycle in which the volunteers were monitored for recovery. Blood samples (about 5 ml each) were collected once daily from day 8 to 24 and thereafter on alternate days until the last day of cycle during all the 4 cycles. Levels of estradiol, FSH, LH and progesterone were measured in the serum samples by radioimmunoassay methods. Cervical mucus samples and vaginal smears were collected once daily starting from day 7 or 8 of each cycle until the mucus was very scanty. Serial pelvic ultrasonography was performed starting from day 7 or 8 until the growing follicle disappeared or throughout the cycle in case a growing follicular cyst was observed. Endometrial aspirates were collected once around day 22 in each cycle and processed for routine histological examination.

Amnion membrane for coverage of gingival recession: A novel application

Introduction: Amnion allograft has been used in the field of medicine for its exceptional wound-modulating properties. However, in the field of dentistry, only a limited number of reports have explored its potential in healing of oral wounds. Materials and Methods: Amnion allograft in conjunction with coronally advanced flap has been used in the management of gingival recession. Results: A complete coverage along with excellent esthetics and an improvement in gingival biotype was observed at 6 months postoperatively. Discussion: Because of its inherent wound-modulating properties, amnion allograft may be used to enhance periodontal wound healing and enable tissue regeneration such as that in the coverage of gingival recession. Conclusion: Amnion allograft may provide an alternative to other conventional methods of treating gingival recession.

Ultrasonographic monitoring of ovarian follicles in women using norethisterone for contraception

Objective: The purpose of this study was to examine the effect of intranasal and oral norethisterone (NET) on ovarian folliculogenesis. Methods: Sixteen healthy, sterilized women with regular menstrual cycles were recruited to the study. NET 300 μg per day was administered orally (n = 8) or intranasally (n = 8) for two consecutive menstrual cycles. Serial pelvic ultrasonography was performed to monitor ovarian follicular growth. Results: Ultrasonographic evidence of normal follicular growth and ovulation was observed in 10 cycles whilst 22 cycles were anovulatory. Formation of follicular cysts was seen in 14 cycles, 13 of which were anovulatory and in one ovulation was observed in the opposite ovary. The size of the cysts varied between 27 and 44 mm. The cysts disappeared when NET treatment was discontinued. A positive correlation between cyst size and estradiol levels was observed with intranasal NET in 50% of cyst cycles. In three cycles, although normal follicular growth and endocrine profile were observed, the follicles failed to rupture. These were classified as luteinized unruptured follicles. Immature follicles < 10 mm were seen in six cycles. Conclusion: The study showed that NET administered either orally or intranasally evidently disturbs normal follicular growth and rupture.

Prevalence of herpesviruses in gingivitis and chronic periodontitis: relationship to clinical parameters and effect of treatment

Background: Assess the prevalence of herpesviruses in healthy subjects, gingivitis, and chronic periodontitis patients, to assess the relationship between the prevalence of herpesviruses and periodontal clinical parameters, and to evaluate the effect of phase-I therapy on the level of viral detection. Materials and Methods: Hundred patients consisting of 20 healthy subjects, 40 gingivitis, and 40 chronic periodontitis were included in the study. Clinical parameters recorded included plaque index, gingival index, sulcus bleeding index, probing depth, and clinical attachment level. The gingivitis and chronic periodontitis patients received phase-I periodontal therapy including oral hygiene instructions, full mouth scaling for gingivitis patients and scaling and root planing for chronic periodontitis patients. Gingival crevicular fluid (GCF) was collected, and the presence of herpes simplex virus-1 (HSV-1), HSV-2, cytomegalovirus, and Epstein–Barr virus (EBV) was analyzed using polymerase chain reaction (PCR). Recording of periodontal parameters as well as GCF collection was performed at baseline and 6 weeks postphase-I therapy. Results: At baseline, the levels of HSV-1 and EBV detection were lower in healthy controls as compared to gingivitis (P < 0.05) and chronic periodontitis cases (P < 0.001). Phase-I therapy led to reduction in the amount of HSV-1 and EBV in gingivitis patients (P < 0.05) and for HSV-1, human cytomegalovirus and EBV in chronic periodontitis patients (P < 0.05) in comparison to baseline. The prevalence of EBV in chronic periodontitis patients was positively associated with increased gingival index, probing depth and loss of clinical attachment (P < 0.05). Conclusions: Higher prevalence of HSV-1 and EBV viruses in GCF of gingivitis and chronic periodontitis suggests a strong association between these viruses and periodontal diseases and periodontal therapy can lead to a reduction in herpesviruses at infected sites.

Reproductive endocrine effects of intranasal administration of norethisterone (NET) to women

Four consecutive menstrual cycles were studied in six healthy parous women. A solvent mixture comprising propylene glycol:ethanol:water (3:3:4) was sprayed intranasally daily using a glass atomizer between days 5 and 24 of the first (control) menstrual cycle. NET was dissolved in the solvent and similarly administered at a daily dose of 100 mcg during the second and third menstrual cycles. Nasal sprays were not administered during the fourth post-treatment cycle. Blood samples were taken during four consecutive cycles between days 8 and 15 and again between days 20 and 24 of the cycle to estimate levels of estradiol (E2), FSH, LH and progesterone (P). These studies revealed that nasal sprays of NET were well accepted and that no adverse clinical effects or menstrual disturbances occurred. NET inhibited ovulation in one cycle. The E2-induced mid-cycle rise in FSH and LH was either suppressed or inhibited in nine out of the 12 treated cycles. P levels in three treated cycles were indicative of luteal inadequacy. These endocrine effects of NET persisted into the post-treatment cycle in two cases.

Application of herbal products in management of periodontal diseases: A mini review

Periodontal disease is a chronic inflammatory disease affecting the supporting structures of teeth and may lead to bleeding gums, tooth mobility, and eventually tooth loss. With the limited effectiveness of current forms of mechanical therapy in the management of periodontal diseases, there has been a shift in focus on to alternative therapies. One such area where maximum research has been going on is phytotherapy. Several studies now focus on the efficacies of herbal extracts on various important periodontal pathogens such as Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Treponema denticola and Tannerella forsythia. Furthermore, recent studies have explored the benefits of using plant-based products on various periodontal clinical parameters such as gingival inflammation, gingival bleeding, etc. The aim of this review to focus on potential, of pros and cons of the several plants/extracts that have been used in vitro or in vivo for management of periodontal diseases and also to highlight the direction of future research to improve their efficacy.

The effect of cuspal inclination on stress distribution and implant displacement in different bone qualities for a single tooth implant: A finite element study

Background: The aim of the present finite element study was to analyze effect of cuspal inclination on stress distribution and implant displacement in different bone densities for a single tooth implant. Materials and Methods: A three dimensional finite element model of mandibular molar section of the D1 bone (entirely cortical) and D4 bone (1 mm cortical shell with low density trabecular core) to receive an implant was constructed. Three ceramic crowns with cusp inclinations of 0 degree, 10 degree and 30 degree were modeled. A mechanical load of 202.23 N was applied at three different regions; the central fossa and 1- and 2-mm offsets horizontally from the center to the buccal side for the varying inclinations. The finite element analysis was performed and stress levels using von Mises stresses and maximum displacement (in mm) were calculated. Results: The maximum stress concentration in cortical bone was seen around the neck of the implant. There was favorable distribution of stresses during loading at the central fossa with maximum stress being 15.10 Mpa for 0 degree, which increased to 54.09 Mpa for 10 degree and 86.19 Mpa for 30 degree inclination at 2 mm offset. Higher stresses were generated in D4 than D1 bone density under all loading conditions. Conclusion: The occlusal topography plays an important role in stress distribution and may be helpful in preventing crestal bone loss. This phenomenon is more pronounced in poor quality bone. Therefore, proper occlusal morphology becomes a critical issue in poor quality bone for implant longevity.

Recent modifications of free gingival graft: A case series

Free gingival grafts have been used in periodontal procedures to augment attached gingiva and cover denuded root surfaces. However, there are few limitations of the same such as esthetic mismatch, mal-alignment of muco-gingival junction formation and bulky appearance. Several modifications have recently been proposed to minimize some of the unfavorable aspects of free gingival grafts. Three cases presenting with Millers Class I/II gingival recession were treated by each different modifications. Satisfactory root coverage and better color match as a compared to free gingival graft was obtained in all the three cases. When indicated these modifications can be advantageous over conventional free gingival grafts in management of Millers Class I/II gingival recession.

Neutrophil priming: Implications in periodontal disease

Periodontal disease is a well-regulated response to bacterial infection directed by the inflammatory cells of the host immune system. The host response to injury or insult is implicated to be a vital feature of the majority of periodontal diseases. The excessive activation of neutrophils plays a role in the pathogenesis in diseases such as acute respiratory distress syndrome, rheumatoid arthritis, and periodontitis by contributing to inflammatory tissue injury. In the recent times, there has been a shift of paradigm from a hypo- to hyper-responsive/primed model of neutrophil dysfunction in periodontal etiopathogenesis. The aim of this review is to outline the mechanisms and effects of neutrophil priming, and thereafter, discuss the current controversy that exists regarding the role of primed neutrophils in periodontal etiopathogenesis.

Titanium particles in tissues from peri-implant mucositis: An exfoliative cytology-based pilot study

Background: To evaluate the presence of titanium particles in the peri-implant mucosa of unloaded single implants. Materials and Methods: Forty participants with single unloaded implants were selected. They were divided equally into two groups: Group 1 with mild and Group 2 with moderate-to-severe peri-implant mucositis. Cytologic smears of peri-implant mucosa were obtained using cytobrush during second-stage surgery. Results: Study states that 60% of participants of Group 2 were positive for titanium particles in peri-implant cytology. Conclusion: This study concludes that the titanium particles might be the initiators of the inflammation around implant.