Subraya G Bhat

Allele, genotype, and composite genotype effects of IL-1A +4845 and IL-1B +3954 polymorphisms for chronic periodontitis in an Indian population

INTRODUCTION The pro-inflammatory cytokine interleukin-1 (IL-1) is a key modulator of host responses to microbial infection and a major modulator of extracellular matrix catabolism and bone resorption, and polymorphisms in the IL-1 gene cluster have been associated with an increased risk of developing severe adult periodontitis. A case control study was performed to determine the role of IL-1A+4845 and IL-1B+3954 polymorphisms in the predisposition to chronic periodontitis. MATERIALS AND METHODS The study was conducted with 103 unrelated participants recruited from Manipal College of Dental Sciences, Manipal, which included 51 chronic periodontitis patients and 52 normal periodontally healthy individuals. Extensive clinical data were collected, bone loss was the major outcome variable and smokers and diabetics were excluded from the study to eliminate the influence of these risk factors. Genomic DNA was isolated from the blood samples of participants for genotyping IL-1A+4845 and IL-1B+3954 polymorphisms by polymerase chain reaction-restriction fragment length polymorphism and the data statistically analyzed. RESULTS Allele 2 of the IL-1A+4845 polymorphism was carried by 38% of all participants; of these only 6 were homozygous for the allele. Allele 2 of the IL-1B+3954 was carried by 21% of the subjects; only 1 was homozygous for allele 2. The composite genotype was carried by 31% of the cases and by 38% of the controls. Overall, 35% participants carried the composite IL-1 genotype. No statistically significant association was found for the distributions. CONCLUSIONS The distribution of the IL-1 positive composite genotype is in concordance with the frequencies reported in the Caucasians. Association was not found for the effect of allele, genotype, composite genotype, and haplotypes of IL-1A+4845 and IL-1B+3954 polymorphisms with periodontitis. Its utility as a risk marker in this population was not borne out by the study.

PAOO technique for the bimaxillary protrusion: Perio-ortho interrelationship.

An increasing number of adult patients have been seeking orthodontic treatment, and a short treatment time has been a recurring request. To meet their expectations, a number of innovative techniques have been developed to accelerate orthodontic tooth movement. Significant acceleration in orthodontic tooth movement has been extensively reported following a combination of selective alveolar decortication and bone grafting surgery with the latter being responsible for the increased scope of tooth movement and the long-term improvement of the periodontium. Six patients who have been diagnosed as class I malocclusion with bimaxillary protrusion were selected. A modified corticotomy procedure was carried out The active orthodontic treatment was begun within 1 week after surgery and follow up. All the patients reported the minmalpain and mild swelling 2 days following the surgical procedure. The mean treatment time for these patients was 17.4 months, with the distalization of the canines being mostly completed in 8.5 months. Periodontallyaccelerated osteogenicsorthodontic tooth movement procedure or selective alveolar decortications or corticotomy approach is one of the surgical techniques developed to reduce the time for orthodontic treatment. This newer approach is leading to short orthodontic treatment time and great patient acceptance.

Ultra morphological changes of root canal dentin induced by 940 nm diode laser: An in-vitro study

Aim: The aim of this in-vitro study was to investigate the ultra-morphological changes of the root canal dentin after irradiation with 940 nm diode laser along with 2.5% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) irrigation. Materials and Methods: Ten freshly extracted human permanent mandibular premolar teeth were selected. Teeth were decoronated and the working length was established. Cleaning and shaping was performed using protaper rotary system and the canals were enlarged up to F3 size. Canals were irrigated with 2.5% NaOCl between each instrument change and later with a final flush of 5 ml of 17% EDTA for 1 min. All the prepared teeth were then longitudinally grooved and split into two halves. One-half of each tooth (Group A) ( n = 10) was analyzed without laser irradiation and other half (Group B) ( n = 10) was analyzed after irradiation with 1.5 W continuous wave of 940 nm diode laser. Samples from both groups A and B were then subjected to scanning electron microscope analysis. Photomicrographs were taken at 2 mm, 7 mm, and 12 mm from the apex representing the apical, middle, and coronal regions at 2000Χ. Energy dispersive X-ray spectroscopy (EDX) analysis of the same samples was done under EDX analyzer to assess the calcium (Ca), phosphorus (P) and magnesium content and to determine the Ca P ratio. Results: Examination of the surface of the root canals revealed that, at middle and apical thirds smear layer removal was better with laser irradiated group. However, in the coronal third there was no statistically significant difference between both the groups. There was a mild variation in values when both group A and group B were compared to Ca, P, magnesium content, and the Ca phosphorous ratio but the difference was not statistically significant. Conclusion: 940 nm diode laser irradiation of root dentin along with NaOCl and EDTA irrigation, resulted in better removal of smear layer without significant additional loss of mineral content.

Rare case of asymptomatic mucous membrane pemphigoid.

We are hereby reporting a rare case of desquamative gingivitis associated with the mucous membrane pemphigoid. Desquamative gingivitis is a manifestation of a variety of diseases. It is characterized by epithelial desquamation, erythema, ulceration, and/or the presence of vesiculobullous lesions of gingiva and other oral tissues. This phenomenon can be associated with number of dermatoses, most commonly lichen planus, pemphigus vulgaris cicatricial pemphigoid (benign mucous membrane pemphigoid) and bullous pemphigoid. In aged individuals, desquamative gingivitis often affects their routine life because of associated pain and discomfort. The term pemphigoid applies to a number of cutaneous, immune-mediated, subepithelial bullous diseases characterized by a separation of the basement membrane zone. The term is used because clinically it often appears similar (the meaning of the ‘-oid’ suffix) to pemphigus The pemphigoid includes bullous pemphigoid, mucous membrane pemphigoid and pemphigoid (herpes) gestationis. Among these conditions, bullous pemphigoid and mucous membrane pemphigoid, also known as benign mucous membrane pemphigoid or cicatricial pemphigoid have received considerable attention. Current molecular findings on these two diseases clearly indicate that they are separate entities. However, considerable histological and immunopathological overlap exists between the two diseases such that their differentiation may be impossible based on these two criteria. In many cases, the clinical findings are probably the best cognitive element to discriminate them. The term bullous pemphigoid is preferred when the disease has no scarring and mainly affects the skin. The term cicatricial pemphigoid is commonly used when scarring occurs and the disease is mainly confined to the mucous membrane. Oral mucosal involvement in mucous membrane pemphigoid is often the first and usually the only site of disease involvement. Desquamative gingivitis, vesiculobullous lesions and ulcerations are the common intraoral manifestations. Epithelial sloughing and exposure of painful bleeding surfaces beneath (positive Nikolsky’s sign) is most commonly observed. Period of exacerbation and remission are common and some lesions may remain unrelenting for several years. The gingival lesions are by far the most common intraoral sites affected and the lesions tend to heal with insignificant scarring. Presented herein, is a unique case report in which there was only involvement of the gingiva which remained asymptomatic for more than 15 years without involvement of the other parts of the oral cavity and the other parts of the body A 53-year-old male patient, a bank manager, came to our dental clinic in 1994 complaining of carious teeth which he wanted to get filled. It was the patient’s first dental visit. He did not complain of bleeding or pain. His medical history was of good general health and he was not taking any medications. His personal history and working condition in the bank was recorded to rule out any involvement of stress. At the time of initial presentation, the patient had noticed changes in the gingiva but did not have any complaints regarding the same. On further enquiries about the changes in the gingiva, he reported the appearance of occasional swelling in the gingiva on applying digital pressure. The swelling subsided or the superficial layer would have separated from the underlying tissue. Even during this period, the patient was asymptomatic. The patient reported a normal diet and had not avoided any spicy food because of the changes in the gingiva. He was using the same toothpaste which he had been using since childhood. His personal history revealed that he was not a smoker, was not consuming alcohol and brushing his teeth twice daily. He did not complain of any skin lesions, lesions in the eye or in any other part of the body. However, the patient was referred to the skin specialist and ophthalmologist to rule out any involvement of the skin and eye. In between these periods, the patient was transferred to different places as he was employed in a nationalized bank and did not visit our clinic. He reported that he visited different dentists Geriatr Gerontol Int 2011; 11: 369–373

Glucometer as a chairside device to assess blood glucose in periodontal patients

Background: Diabetes mellitus is a common finding in the medical history of patients receiving treatment for periodontal disease. The incidence of diabetes is on the rise worldwide. Virtually, every dentist and especially the periodontist are likely to encounter an increasing number of undiagnosed diabetic patients. The conventional laboratory methods employed to detect blood glucose are time consuming and require elaborative equipment. The advent of blood glucose monitors allows the clinician to assess blood glucose at the chair side. Materials and Methods: The use of gingival capillary blood as a marker for blood glucose estimation using glucometer against the conventional laboratory method has been assessed in 60 diabetics and 70 controls. Results: The correlation between gingival and finger-stick blood was r = 0.996, P<0.001 in diabetics and controls. Correlation between gingival and laboratory method was r = 0.994, P<0.001 in cases and controls. Conclusion: The results suggest that capillary blood from the outer surface of gingiva provide an acceptable source for measuring blood glucose.