Shilpa Trivedi

Evaluation of Antioxidant Enzymes Activity and Malondialdehyde Levels in Patients With Chronic Periodontitis and Diabetes Mellitus

BACKGROUND The aim of this study is to investigate the impact of diabetes, a known risk factor for periodontitis, on activities of antioxidant enzymes superoxide dismutase (SOD), glutathione reductase (GR), and catalase (CAT) as well as levels of free radical damage marker malondialdehyde (MDA) in blood and saliva of individuals with chronic periodontitis (CP). METHODS Sixty patients with CP (30 patients with type 2 diabetes mellitus [DMCP] and 30 systemically healthy patients [CP]) and 60 periodontally healthy individuals (30 patients with type 2 diabetes mellitus and 30 systemically healthy patients [PH]) were included in this study. After clinical measurements, blood and saliva samples were collected. SOD, GR, and CAT activities in red blood cell lysate and saliva and MDA levels in plasma and saliva samples were spectrophotometrically assayed. An analysis of variance test followed by a post hoc test was used to compare the intragroup and intergroup variances among the study groups. RESULTS MDA levels in both the periodontitis groups were higher than in the periodontally healthy groups, but the difference between the CP and DMCP groups did not reach statistical significance (P >0.05). There was a highly significant difference between the CP and PH groups for all the enzymes studied except for SOD in blood. Only salivary SOD and GR activities were significantly different in the CP and DMCP groups. CONCLUSIONS This study favors the role of oxidative stress in both diabetes and periodontitis. It shows that the compensatory mechanism of the body is partially collapsed because of excessive production of free radicals during periodontitis and is not able to cope with increased free radical generation attributable to diabetes, thereby worsening the situation.

Association of salivary lipid peroxidation levels, antioxidant enzymes, and chronic periodontitis.

This study assessed the activities of antioxidant enzymes superoxide dismutase (SOD), glutathione reductase (GR), and catalase (CAT) and free radical damage marker malondialdehyde (MDA) levels in saliva of 30 patients with chronic periodontitis (CP) compared to 30 healthy controls by spectrophotometry. MDA levels were significantly elevated in the CP group, whereas the SOD, CAT, and GR activities were significantly reduced compared to healthy controls. MDA levels demonstrated a significant direct correlation with all periodontal parameters, whereas all antioxidant enzymes studied (SOD, CAT, and GR) showed an inverse correlation. These findings support the idea that oxidative stress has a role in periodontal disease pathogenesis.

Antioxidant enzymes in periodontitis

Periodontitis is basically an inflammatory disease initiated by the subgingival biofilm and modified by the individuals aberrant inflammatory/immune response. Various studies have pointed toward the role of oxidative stress in periodontitis. As the reactive oxygen species and antioxidants are in dynamic equilibrium, any disturbance in one would lead to changes in the other. As studying, individual antioxidants is a vast field, this review focuses on the role of antioxidant enzymes in periodontitis and in other related systemic conditions. It is highlighted that oxidative stress may be the missing link in these associations of periodontitis and other conditions. Also, the antioxidant enzymes may be considered a useful biomarker for periodontal diseases and antioxidant supplementation may be of help to reduce the burden of periodontal destruction without having much extra effort.

Extramedullary plasmacytoma of the gingiva.

Extraosseous plasmacytoma, also referred to as extramedullary plasmacytoma (EMP), is defined by ICD-10 as a localised plasma cell neoplasm that arises in tissues other than bone.1 It is considered one of the three variants of plasma cell neoplasms, the other two being multiple myeloma (MM) and solitary bone plasmacytoma (SBP) (also known as medullary plasmacytoma). EMP is a relatively rare lesion, constituting 3% of all plasma cell neoplasms.2 About 1% of head and neck tumours are EMPs. It is found most commonly in the head and neck region, with 80% of cases occurring in the nasopharynx, paranasal sinuses and tonsils.3 EMPs occur less commonly in the gingiva. The first case was documented by Martinelli and Rulli4 in 1968 as a sessile neoplasm in the gingiva from the lower left to right canine, which could be confused with chronic gingivitis. Peison et al 5 reported another case extending from the maxillary right to left canine which was a …

Clinical effects of irrigation with Saussurea lappa extract in the treatment of chronic periodontitis: A pilot randomized trial

Introduction: Periodontitis is a chronic inflammatory disease manifested as the destruction of tooth supporting tissues, which may progress to tooth loss. The chemical antimicrobial agents are often applied locally into the periodontal pocket as adjuncts to conventional mechanical periodontal therapy, but these have various adverse effects. Root extract of Saussurea lappa has shown anti-inflammatory and anti-bacterial properties. Hence, the present study was aimed to assess and compare the effect of root extract of S. lappa to chlorhexidine gluconate as subgingival irrigant as an adjunct to scaling and root planing (SRP). Materials and Methods: Thirty chronic periodontitis patients in the age group of 25-45 years were selected for the study. Five hundred and forty periodontal pockets were treated by three different procedures: Group1: Subjects treated by SRP only, Group 2: In addition to SRP, irrigation with S. lappa extract was done and Group 3: Chlorhexidine was used as irrigant along with SRP. Periodontal clinical recordings (modified sulcular bleeding index, probing pocket depth, clinical attachment level, and the presence of pus discharge) were done at 0, 7, 14, 28, and 42 days. Results: The periodontal parameters studied improved in all the three groups over the time period. In 4-5 mm pockets, S. lappa treated group showed significant improvement than chlorhexidine treated group. Furthermore, a dramatic decrease in periodontal pockets with pus discharge was seen in this group. Conclusion: Subgingival irrigation with S. lappa might be a promising adjunct to conventional treatment options in the management of periodontal infections.