Sameer A. Mokeem

Shovel-shaped incisors and associated invagination in some Asian and African populations

Shovelling of the incisors is considered to be a polygenic inheritable trait. Shovelling differs considerably between groups of racial populations but is relatively stable within each group. Presence or absence of shovelling helps in racial identification and in exploration of ancestry. Periapical radiographs of patients of several nationalities from Asian and African continents were obtained. Shovelling and invaginations associated with the shovel-shaped incisors was studied according to nationality. Results indicated that the incidence of shovelling in Syrians, Jordanians, Palestinians and Filipinos was 5-6 per cent. In Saudi Arabians, Pakistanis and Indians, the incidence of shovelling was 10-12 per cent. Among Yemenis, Sudanese and Egyptians, the incidence of shovelling was 20-25 percent. The occurrence of invaginations in shovel-shaped incisors was 11 per cent.

Prevalence of shovel-shaped incisors in Saudi Arabian dental patients

The prevalence of maxillary incisor shoveling was studied radiographically in 990 Saudi patients. According to the radiomorphologic characteristics, a new classification was developed and shovel teeth were categorized. The findings of this study showed 9% shovel-shaped incisors; among those, 4% were central incisors and 5% were lateral incisors. Frequency of dens invaginatus occurrence with the shovel-shaped incisors was also investigated. Eight percent of shovel-shaped incisors showed presence of dens invaginatus. Prevalence was found to be 4% in central shovel-shaped incisors, whereas that in lateral shovel-shaped incisors was 11%.

Peri-implant defect augmentation with autogenous bone: a study in beagle dogs.

This study evaluates the success of immediate endosseous implants placed along with autogenous bone graft to fill the peri-implant gap. Thirty-two implants were inserted in 8 beagle dogs. The right and left lateral incisors in the maxilla and the mandible of all animals were extracted, and immediate postextraction implants were placed. In the control sites, no bone grafts or barrier membranes were used. In the contralateral experimental site, autogenous bone graft was used. The implants were retrieved with the jawbone for histomorphometric studies. The histomorphometric measurements were carried out using a computerized image analysis system. All implants were covered by compact, mature bone under examination in light microscopy. A high bone-implant contact percentage and bone density was observed at both grafted and nongrafted implant sites. The sites filled with autogenous bone graft showed a significantly higher crestal bone level and bone density compared to the nonfilled sites. The observations of the study emphasize that the filling of the peri-implant bone defects with autogenous bone grafts showed a better outcome compared to unfilled defects.

Hepatocyte Growth Factor Levels in the Saliva and Gingival Crevicular Fluid in Smokers with Periodontitis

Hepatocyte growth factor (HGF) production by oral fibroblasts is enhanced by various molecules that are induced during inflammatory conditions including periodontitis. HGF plays an important role in the progression of periodontitis, by stimulating intense growth of epithelial cells and preventing regeneration of connective tissue attachments. Smokers have a greater risk factor in the pathogenesis and progression of periodontal disease. The objective of the study was to estimate the level of HGF in saliva and gingival crevicular fluid (GCF) in smokers with periodontitis and to compare these levels with that of nonsmokers with periodontitis and healthy controls. The HGF levels were found to be significantly high in the saliva and GCF of smokers with periodontitis compared to both never-smokers with periodontitis and the healthy control group. The elevated levels of HGF in the saliva and GCF in the study population could explain the intrinsic mechanism triggering the severity of the periodontitis in smokers. Further studies are necessary to validate the current observations and to establish a sensitive marker to predict periodontal disease activity.

Effect of antimicrobial photodynamic therapy in open flap debridement in the treatment of peri-implantitis: A randomized controlled trial

BACKGROUND To evaluate the effects of single application of antimicrobial photodynamic therapy (aPDT) as an adjunct to open flap debridement (OFD) and OFD alone in patients with peri-implantitis (PI). MATERIALS AND METHODS Twenty four patients with PI were divided into 2 groups receiving aPDT with OFD and OFD alone respectively. Peri-implant plaque index (PI), bleeding on probing (BOP), pocket depth (PD) and marginal bone level (MBL) were assessed at baseline, 6 and 12 months post-therapy. Digital periapical radiographs were taken and viewed on a calibrated computer screen using a software for the assessment of MBL. Only single implant from each patient was included in the study protocol (intent to treat analysis). RESULTS At baseline, peri-implant PI, BOP, PD and MBL were comparable among individuals in aPDT and OFD groups. All patients had localized peri-implant PD ≥5 mm. At 6 months, aPDT and OFD significantly reduced peri-implant PI, BOP, PD and MBL. Similarly, after 12 months post-therapy, both groups reduced PI, BOP, PD and MBL. However, there was no significant difference between aPDT and OFD groups over time. CONCLUSION Single application of aPDT as an adjunct to OFD does not provide additional benefit in improving clinical and radiographic peri-implant parameters in peri-implantitis.

Effectiveness of adjunctive antimicrobial photodynamic therapy in reducing peri-implant inflammatory response in individuals vaping electronic cigarettes: A randomized controlled clinical trial

BACKGROUND There are no studies that have assessed the effectiveness of antimicrobial photodynamic therapy (aPDT) in reducing peri-implant inflammatory response in individuals vaping electronic cigarettes (e-cigs). This study explored the effectiveness of aPDT as an adjunct to mechanical debridement (MD) in the treatment of peri-implant mucositis (p-iM) in individuals vaping e-cigs. METHODS Vaping individuals with p-iM were divided into 2 groups: (a) Group-I: receiving MD with aPDT (test group); and (b) Group-II: MD only (control group). Peri-implant inflammatory parameters including plaque index (PI), bleeding on probing (BoP), and pocket depth (PD) were assessed at baseline and 12-weeks follow-up. Inter- and intra-group comparisons were made using Mann-Whitney U test and Wilcoxon signed ranks test. P-value < 0.05 was considered significant. RESULTS Thirty-eight male patients (20 in Group-I and 18 in Group-II) were included. The mean age of vaping individuals in groups I and II were 33.6 ± 2.8 and 35.4 ± 2.1 years, respectively. Mean daily frequency of vaping e-cigs in groups I and II was 7.3 ± 0.9 and 5.9 ± 1.0 whereas mean duration of vaping e-cigs was 4.8 ± 1.5 and 4.1 ± 1.3 years respectively. There was no significant difference between groups at baseline. There was significant improvement in PI (p < 0.001) and PD (p < 0.001) at 12-weeks follow-up with respect to the baseline visit in both groups. There was a significant reduction in PI (p < 0.001) and PD (p < 0.001) for group-I as compared to group-II at follow-up. There was no statistically significant difference for BoP between groups at follow-up. CONCLUSION Antimicrobial PDT is more effective compared to MD alone in the treatment of p-iM in individuals vaping e-cigs. The findings of the present study should be considered preliminary and interpreted with caution. Further randomized clinical trials should be performed in order to obtain strong conclusions.

Self-perceived oral symptoms and periodontal inflammatory conditions in habitual naswar dippers

Objectives: To compare self-perceived oral symptoms and clinical (plaque index [PI], bleeding on probing [BOP], clinical attachment loss [CAL]) and radiographic (marginal bone loss [MBL]) periodontal parameters among naswar (NW) and non-naswar dippers (NNW). Methods: One hundred and forty-two individuals (72 patients consuming naswar and 70 controls) were included. All participants completed a baseline questionnaire that included information regarding demographic characteristics and self-perceived oral symptoms. Clinical periodontal parameters (PI, BOP, PD and CAL) were recorded. MBL was measured on digital panoramic radiographs. Results: Pain in teeth, pain on chewing, bleeding gums and burning sensation in the mouth was significantly worse among NW than NNW (p<0.01). Clinical periodontal parameters and MBL were significantly high in NW than NNW (p<0.001). There was statistically significant influence of daily use and mean duration of naswar consumption on the severity of PI, BOP, PD (4 to 6 and >6 mm) and MBL among NW group. Conclusions: Self-perceived oral symptoms and periodontal parameters were worse among naswar dippers. It is highly recommended that naswar dipping should be considered a potential threat that could have major effects on periodontal tissues.

Clinical and radiographic periodontal status and whole salivary cotinine, IL-1β and IL-6 levels in cigarette- and waterpipe-smokers and E-cig users

The aim was to compare the clinical (plaque index [PI], bleeding on probing [BOP], probing pocket depth [PPD] and clinical attachment loss [CAL]) and radiographic (marginal bone loss [MBL]) periodontal parameters and whole salivary cotinine, interleukin (IL)-1β and IL-6 levels among cigarette-smokers, waterpipe-smokers, E-cig users and never-smokers. In total, 154 male individuals (39 cigarette-smokers, 40 waterpipe-smokers, 37 E-cig users and 38 never-smokers) were included. Full mouth PI, BOP, PPD and CAL were measured on all teeth (excluding third molars); and MBL was measured in digital intra-oral radiographs. Unstimulated whole salivary flow rate (UWSFR) and whole salivary cotinine, IL-1β and IL-6 levels were measured. Group comparisons were performed using one way analysis of variance and Bonferroni post-hoc tests. P-values less than 0.05 were considered statistically significant. There was no difference in UWSFR among the groups. Cotinine levels were significantly higher among cigarette- (P < 0.001) and waterpipe-smokers (P < 0.001) and E-cig users (P < 0.001) than never-smokers. IL-1β (P < 0.01) and IL-6 (P < 0.01) levels were significantly higher among cigarette- and waterpipe-smokers than E-cig users and never-smokers. There was no difference in PPD, CAL, mesial and distal MBL and whole salivary IL-1β and IL-6 levels among E-cig users and never-smokers. In conclusion, clinical and radiographic parameters of periodontal inflammation were poorer in cigarette and waterpipe smokers than E-cig users and never-smokers; and whole salivary cotinine levels were similar in all groups. Whole salivary IL-1β and IL-6 levels were higher in cigarette- and waterpipe-smokers than E-cig users and never-smokers.

Association of advanced glycation end products with peri-implant inflammation in prediabetes and type 2 diabetes mellitus patients

BACKGROUND It is postulated that peri-implant sulcular fluid (PISF) levels of advanced glycation end products (AGEs) are higher with high glycemic levels. PURPOSE In the present clinico-biochemical study, we explored the clinical and radiographic peri-implant parameters and levels of AGEs among prediabetic, type 2 diabetic (T2DM), and non-diabetic patients and to evaluate the correlation of AGEs with clinical peri-implant parameters. MATERIALS AND METHODS Ninety patients were divided into three groups of 30 patients each; group 1: patients with prediabetes; group 2: patients with T2DM; and group 3: non-diabetic individuals. Clinical and radiographic peri-implant parameters assessed included plaque index (PI), bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL). PISF was collected and analyzed for AGEs levels using enzyme-linked immunosorbent assay. Between-group comparison of means was verified with Kruskal-Wallis test and Pearson correlation coefficient for correlations of AGE levels with peri-implant parameters. RESULTS Mean peri-implant PI, BOP, PD, and MBL was significantly higher in group 1 and 2 as compared with non-diabetic patients (P < .05). Mean PI, BOP, PD, and MBL were comparable between group 1 and group 2 patients (P > .05). Mean levels of AGEs in PISF were significantly higher among prediabetic and T2DM patients as compared with non-diabetic patients (P < .05). Between group 1 and group 2, mean levels of AGEs was significantly higher in group 2 (P < .05). A significant positive correlations were found between levels of AGEs and PD (P = .0371) and MBL (P = .0117) in T2DM patients, respectively. CONCLUSION Clinical and radiographic peri-implant parameters were worse and levels of AGEs in PISF were increased in individuals with prediabetes and T2DM. AGEs may play an important role in peri-implant inflammation in prediabetes and T2DM.

Periodontal parameters in prediabetes, type 2 diabetes mellitus, and non-diabetic patients

The aim of the present study was to compare the clinical and radiographic periodontal parameters in prediabetes, type 2 diabetes mellitus (T2DM), and non-diabetic patients. Forty-one patients with prediabetes (Group 1), 43 patients with T2DM (Group 2), and 41 controls (Group 3) were included. Demographic data were recorded using a questionnaire. Full-mouth clinical (plaque index [PI], bleeding on probing [BOP], probing depth [PD], clinical attachment loss [CAL], missing teeth [MT]) and radiographic (marginal bone loss [MBL]) parameters were measured on digital radiographs. In all groups, hemoglobin A1c (HbA1c) levels were also measured. P values less than 0.05 were considered statistically significant. The mean age and HbA1c levels of participants in Groups 1, 2, and 3 were 53.4±3.5, 60.1 ± 0.6, and 56.6 ± 2.5 years and 6.1%, 8.4%, and 4.8%, respectively. The mean duration of prediabetes and T2DM in patients from Groups 1 and 2 were 1.9 ± 0.3 and 3.1 ± 0.5 years, respectively. PI, BOP, PD, MT, CAL, and MBL were significantly higher in Groups 1 (p < 0.05) and 2 (p < 0.05) than in Group 3. There was no statistically significant difference in these parameters in Groups 1 and 2. Periodontal parameters were worse between prediabetes and T2DM patients compared with controls; however, these parameters were comparable between prediabetes and T2DM patients.