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P Rao AN, Rajaram V, Mahendra J, Dave PH, Ambalavanan N, Mahendra L. Gum drop technique with pericardial membrane for treating gingival recession - A case report. Indian J Dent Res 2023; 34:320-322. [PMID: 38197356 DOI: 10.4103/ijdr.ijdr_109_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Introduction Gingival recession was treated with gum drop technique (GDT) along with pericardial membrane, advanced platelet rich fibrin (A-PRF) and injectable platelet rich fibrin (i-PRF) in the defect sites for regeneration of soft tissue. Patient Concerns Several 3-4 mm of recession sites in the maxillary right and left canine and premolar region. These sites were selected and divided into two groups: A and B based on the application with A-PRF and pericardium, respectively. Probing pocket depth (PPD), clinical attachment level (CAL), recession height (RH), recession width (RW) and keratinized tissue width (KTW) were assessed. The keratinized tissue width (KTW) was measured as the distance between the marginal gingiva and the mucogingival junction. Treatment The defects were treated with the GDT following irrigation with i-PRF and followed up for 6 months. Both groups achieved significant root coverage which was stable even after 6 months post operatively. Keratinized tissue showed a 1 mm gain with pericardial membrane.
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Affiliation(s)
- Abirami N P Rao
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Vijayalakshmi Rajaram
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Pavithra H Dave
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - N Ambalavanan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Little Mahendra
- Department of Periodontology, Maktoum Bin Hamdan Dental University College, Dubai, United Arab Emirates
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Senthil S, R V, C BNK, Mahendra J, N A. Current opinion on guided implant surgery. Bioinformation 2023; 19:786-789. [PMID: 37885775 PMCID: PMC10598351 DOI: 10.6026/97320630019786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 10/28/2023] Open
Abstract
Implant dentistry has been evolving with various new technologies, materials and techniques of placement. Conventionally, determination of implant position, size and placement depend on pre-surgical diagnostic imaging, which is limited to two-dimensional radiographs and on the guiding acrylic stent which will be usually prepared over the duplicated casts. Guided implant surgery using cone beam computed tomography, virtual treatment planning software and stereolithographic surgical templates has undoubtedly been a major step toward achieving optimal 3-D implant positioning with respect to both anatomical and prosthetic parameters. This article discusses about the indications, advantages and the concept of guided implant surgery in the successful outcome of the implant placement.
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Affiliation(s)
- Surthi Senthil
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai - 600095, Tamil Nadu
| | - Vijayalakshmi R
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai - 600095, Tamil Nadu
| | - Burnice Nalina Kumari C
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai - 600095, Tamil Nadu
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai - 600095, Tamil Nadu
| | - Ambalavanan N
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai - 600095, Tamil Nadu
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Ramani S, Vijayalakshmi R, Kumari CBN, Mahendra J, Ambalavanan N. A short review on minimally invasive implants. Bioinformation 2023; 19:655-658. [PMID: 37886160 PMCID: PMC10599681 DOI: 10.6026/97320630019655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 10/28/2023] Open
Abstract
In the last 30 years, the use of dental implants to replace missing teeth has increased immensely. Brånemark pioneered the use of extensive surgical flaps to visualise the surgical field during implant surgery. Since then, several changes have been made to the flap design with aesthetic considerations now being incorporated. Such major innovations have contributed to the wide acceptance of flapless implant surgery. Therefore, it is of interest to describe the various techniques, requirements, advantages and disadvantages of minimally implant surgery.
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Affiliation(s)
- Saathvika Ramani
- Department of Periodontology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600 095, Tamil Nadu, India
| | - R Vijayalakshmi
- Department of Periodontology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600 095, Tamil Nadu, India
| | - C. Burnice Nalina Kumari
- Department of Periodontology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600 095, Tamil Nadu, India
| | - Jaideep Mahendra
- Department of Periodontology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600 095, Tamil Nadu, India
| | - N Ambalavanan
- Department of Periodontology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600 095, Tamil Nadu, India
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R V, Srinivasan S, N A. A short note on bioglass in Periodontics. Bioinformation 2023; 19:341-344. [PMID: 37808378 PMCID: PMC10557441 DOI: 10.6026/97320630019341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 10/10/2023] Open
Abstract
Bone augmentation grafts may act as space-maintaining devices to allow coronal migration of periodontal progenitor cells. The ideal bone replacement graft should be able to trigger osteogenesis, cementogenesis and formation of a functional periodontal ligament. It has been theorized that bioactive glass, which is a ceramic has bioactive properties that guide and promote osteogenesis allowing rapid formation of bone. Bioactive glass consists of sodium and calcium salts, phosphates and silicon dioxide for dental applications. When this material comes into contact with tissue fluids, the surface of the particles becomes coated with hydroxy carbonate apatite, incorporates organic ground proteins such as chondroitin sulfate and glycosaminoglycans and attracts osteoblasts that rapidly form bone.
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Affiliation(s)
- Vijayalakshmi R
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Maduravoyal, Chennai - 600095
| | - Sruthi Srinivasan
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Maduravoyal, Chennai - 600095
| | - Ambalavanan N
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Maduravoyal, Chennai - 600095
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R V, N A, S R, Mahendra J. Antimicrobial and anti-inflammatory activity of Terminalia arjuna. Bioinformation 2023; 19:184-189. [PMID: 37814683 PMCID: PMC10560303 DOI: 10.6026/97320630019184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 10/11/2023] Open
Abstract
Terminalia arjuna is one of the important herbal plants with cardioprotective, antihyperlipidemic activity and many more applications. In the present investigation, In order to find out the protective role, we prepared aqueous and ethanolic extract of Terminalia arjuna. The objective of this study was to comparatively evaluate the antimicrobial and anti-inflammatory activity of aqueous and ethanolic extract of Terminalia arjuna and to compare between the two. Antimicrobial activity of the plant extract was assessed by using agar well diffusion method against oral pathogens. The anti-inflammatory activity of prepared Terminalia arjuna plant extract was analyzed using egg albumin denaturation assay. The results of this study, showed that both aqueous and ethanolic extract had very good antimicrobial activity against Staphylococcus aureus, Pseudomonas species followed by Escherichia coli. However, the aqueous extract showed higher anti-inflammatory activity when compared with ethanolic extract. So it can be concluded that aqueous extract of Terminalia arjuna could be used as a local drug delivery agent in the treatment of chronic periodontitis.
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Affiliation(s)
- Vijayalakshmi R
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India
| | - Ambalavanan N
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India
| | - Rajeshkumar S
- Nanobiomedicine Lab, Saveetha dental college and Hospital, SIMATS, Saveetha University, Chennai, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India
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Travers C, Dolma K, Gentle SJ, Shukla V, Armstead KM, Ambalavanan N, Carlo WA. Mid or standard frequency ventilation in infants with respiratory distress syndrome (MIDOS): a randomized clinical trial. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00469-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Shukla VV, Gentle SJ, Cooley A, Singh A, Ambalavanan N, Carlo WA, Salas A. Prediction of early oral feeding achievement in preterm infants. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00608-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Weaver L, Gentle SJ, Shukla VV, Nakhmani A, Rahman F, Ambalavanan N, Askenazi DJ, Travers C. Early fluid status and prediction of severe intraventricular hemorrhage or death in extremely preterm infants. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Gentle S, Travers C, Winter L, Tucker J, Purvis D, Ambalavanan N, Carlo W. Improving survival without bronchopulmonary dysplasia in extremely preterm infants. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00727-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Vu B, Seales C, Rahman A, Travers C, Willis KA, Lal CV, Crabb D, Ratliff A, Atkinson P, Waites K, Carlo WA, Ambalavanan N, Shukla V. Association of mycoplasma and ureaplasma respiratory colonization and bronchopulmonary dysplasia in extremely preterm infants- a propensity score matched case-control study. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00472-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Gentle SJ, Singh A, Travers C, Nakhmani A, Carlo WA, Ambalavanan N. Achieved oxygen saturations and risk for bronchopulmonary dysplasia-associated pulmonary hypertension in preterm infants. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00440-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Ari G, Rajendran S, Mahendra J, Ambalavanan N, Vijayaraj S, Mahendra L, Madapusi Balaji T, Ali Baeshen H, Patil S, Reda R, Testarelli L. Estimation of GCF and Salivary Levels of NT-proBNP in Systemically Healthy Subjects with Severe Chronic Periodontitis Before and After Periodontal Flap Surgery. Int J Gen Med 2023; 16:1809-1816. [PMID: 37213473 PMCID: PMC10198276 DOI: 10.2147/ijgm.s402929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/26/2023] [Indexed: 05/23/2023] Open
Abstract
Purpose The aim of the study was to estimate and compare the Saliva and GCF levels of NT-proBNP in systemically healthy subjects with severe chronic periodontitis before and after periodontal flap surgery. Materials and Methods Twenty subjects were selected and divided into two groups based on inclusion and exclusion criteria. Healthy Controls: 10 periodontally and systemically healthy subjects. Presurgery Group: 10 systemically healthy subjects with severe chronic generalized periodontitis. Postsurgery Group included Presurgery Group subjects who will undergo periodontal flap surgery. After the periodontal parameters were measured, GCF and saliva samples were collected. Postsurgery Group subjects underwent periodontal flap surgery and both periodontal parameters and GCF and saliva levels were reassessed after 6 months. Results Presurgery Group showed a higher mean value of plaque index, modified gingival index, probing pocket depth and clinical attachment level when compared to Healthy Controls and it was found to decrease after periodontal flap surgery (Postsurgery Group). Intergroup comparison (Presurgery Group vs Postsurgery Group) of the mean difference of salivary NT-proBNP was found to be statistically significant. GCF levels of NT-proBNP also decreased after periodontal flap surgery but the difference was not statistically significant. Conclusion NT pro-BNP levels were found to be higher in periodontitis group as compared to the controls. The levels decreased following surgical periodontal therapy, elucidating the role of periodontal treatment on the expression of NT-proBNP as a salivary and GCF marker. NT-proBNP could serve as a potential biomarker for periodontitis in saliva and GCF in future.
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Affiliation(s)
- Geetha Ari
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, 600095, India
| | - Sathish Rajendran
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, 600095, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, 600095, India
- Correspondence: Jaideep Mahendra, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, 600095, India, Email
| | - N Ambalavanan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, 600095, India
| | - Shonali Vijayaraj
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, 600095, India
| | - Little Mahendra
- Department of Periodontics, Maktoum Bin Hamdan Dental University College, Dubai, 213620, United Arab Emirates
| | - Thodur Madapusi Balaji
- Department of Periodontology, Tagore Medical and Dental College, Chennai, Tamil Nadu, 600127, India
| | - Hosam Ali Baeshen
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, 84095, USA
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600 077, India
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy
- Department of Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, India
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy
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Ambalavanan N, Aschner JL. Management of hypoxemic respiratory failure and pulmonary hypertension in preterm infants. J Perinatol 2016; 36 Suppl 2:S20-7. [PMID: 27225961 DOI: 10.1038/jp.2016.45] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 02/10/2016] [Accepted: 02/16/2016] [Indexed: 01/26/2023]
Abstract
While diagnoses of hypoxemic respiratory failure (HRF) and pulmonary hypertension (PH) in preterm infants may be based on criteria similar to those in term infants, management approaches often differ. In preterm infants, HRF can be classified as 'early' or 'late' based on an arbitrary threshold of 28 postnatal days. Among preterm infants with late HRF, the pulmonary vascular abnormalities associated with bronchopulmonary dysplasia (BPD) represent a therapeutic challenge for clinicians. Surfactant, inhaled nitric oxide (iNO), sildenafil, prostacyclin and endothelin receptor blockers have been used to manage infants with both early and late HRF. However, evidence is lacking for most therapies currently in use. Chronic oral sildenafil therapy for BPD-associated PH has demonstrated some preliminary efficacy. A favorable response to iNO has been documented in some preterm infants with early PH following premature prolonged rupture of membranes and oligohydramnios. Management is complicated by a lack of clear demarcation between interventions designed to manage respiratory distress syndrome, prevent BPD and treat HRF. Heterogeneity in clinical phenotype, pathobiology and genomic underpinnings of BPD pose challenges for evidence-based management recommendations. Greater insight into the spectrum of disease phenotypes represented by BPD can optimize existing therapies and promote development of new treatments. In addition, better understanding of an individual's phenotype, genotype and biomarkers may suggest targeted personalized interventions. Initiatives such as the Prematurity and Respiratory Outcomes Program provide a framework to address these challenges using genetic, environmental, physiological and clinical data as well as large repositories of patient samples.
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Affiliation(s)
- N Ambalavanan
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J L Aschner
- Department of Pediatrics, and Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine; Children's Hospital at Montefiore, Bronx, NY, USA
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Balasubramaniam AS, Thomas LJ, Ramakrishnanan T, Ambalavanan N. Short-term effects of nonsurgical periodontal treatment with and without use of diode laser (980 nm) on serum levels of reactive oxygen metabolites and clinical periodontal parameters in patients with chronic periodontitis: a randomized controlled trial. Quintessence Int 2016; 45:193-201. [PMID: 24570986 DOI: 10.3290/j.qi.a31206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to compare the clinical efficiency of a diode laser as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis patients, and also to evaluate the changes in the clinical parameters such as clinical attachment level in teeth with periodontal pockets and blood reactive oxygen metabolites. METHOD AND MATERIALS A total of thirty patients (mean age 38.2 years) with chronic periodontitis were selected for this study. The patients were randomly assigned into two groups of 15 patients each, as the control group and test group. The control group received only conventional SRP and the test group received conventional SRP and diode laser (GaAlAs)-assisted pocket debridement. The clinical parameters (Plaque Index, bleeding on probing, probing pocket depth, and clinical attachment level) were recorded at baseline and day 60, and the serum levels of reactive oxygen metabolites were estimated at baseline, day 30, and day 60 for both the groups. RESULTS When the groups were compared, there was statistically significant improvement in Plaque Index score, decrease in bleeding on probing and probing pocket depth, and gain in clinical attachment level (P < .001) in both the groups from baseline to day 60. There was significant reduction in reactive oxygen metabolites in both the groups from baseline to day 30 and day 60 (P < .001). However no statistically significant changes were present between the treatment groups from baseline to day 60 in terms of clinical parameters and blood reactive oxygen metabolites. CONCLUSION From the results observed in this study it can be concluded that use of diode laser as an adjunct to SRP did not provide any significant difference compared to use of SRP alone in terms of clinical parameters and reactive oxygen metabolites.
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Varughese V, Mahendra J, Thomas AR, Ambalavanan N. Resection and Regeneration - A Novel Approach in Treating a Perio-endo Lesion. J Clin Diagn Res 2015; 9:ZD08-10. [PMID: 25954710 DOI: 10.7860/jcdr/2015/11096.5643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 11/22/2014] [Indexed: 12/15/2022]
Abstract
The pulp and the periodontium are invariably anatomically and functionally related to each other. Lesions involving both the periodontium and the pulp complicate diagnosis, treatment planning and prognosis. An emerging approach to periodontal therapy is the concept of regeneration. In this case report, a novel combination therapy of a blend of platelet rich fibrin with bone graft and guided tissue regeneration membrane was used in the treatment of a perio-endo lesion of a multirooted tooth. A successful outcome in alleviating patient's symptoms and regeneration was seen.
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Affiliation(s)
- Vineetha Varughese
- Post Graduate Student, Department of Periodontology, Meenakshi Ammal Dental College , Madurovoyal, Chennai, India
| | - Jaideep Mahendra
- Professor, Department of Periodontology, Meenakshi Ammal Dental College , Madurovoyal, Chennai, India
| | - Anchu Rachel Thomas
- Post Graduate Student, Department of Conservative Dentistry, Meenakshi Ammal Dental College , Madurovoyal, Chennai, India
| | - N Ambalavanan
- Professor and Head, Department of Periodontology, Meenakshi Ammal Dental College , Madurovoyal, Chennai, India
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Taft D, Ward D, Ollberding N, Schibler K, Ambalavanan N, Yu Z, Newburg D, Davidson B, Morrow A. Preterm Infant Gut Microbiome and Weight at 36 Weeks Corrected Gestational Age. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.601.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Diana Taft
- CAGE Cincinnati Children's HospitalUnited States
| | - D Ward
- Perinatal Institute Cincinnati Children's HospitalUnited States
| | - N Ollberding
- Biostatistics and Epidemiology Cincinnati Children's HospitalUnited States
| | - K Schibler
- Perinatal Institute Cincinnati Children's HospitalUnited States
| | - N Ambalavanan
- PediatricsUniversity of Alabama at BirminghamUnited States
| | - Z Yu
- BiologyBoston CollegeUnited States
| | | | - B Davidson
- Perinatal Institute Cincinnati Children's HospitalUnited States
| | - A Morrow
- Perinatal Institute Cincinnati Children's HospitalUnited States
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Vikram V, Ramakrishnan T, Anilkumar K, Ambalavanan N. Changes in Transforming Growth Factor-β1 in Gingival Crevicular Fluid of Patients with Chronic Periodontitis Following Periodontal Flap Surgery. J Clin Diagn Res 2015; 9:ZC13-6. [PMID: 25859517 PMCID: PMC4378799 DOI: 10.7860/jcdr/2015/11039.5539] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 11/22/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of the study was to assess changes in Transforming Growth Factor- β1 (TGF-β1) levels in gingival crevicular fluid (GCF) and examine correlation of TGF-β1 levels and periodontal parameters: probing pocket depth (PPD) and clinical attachment level (CAL) in sites with chronic periodontitis at various time intervals before and after periodontal surgery. MATERIALS AND METHODS The effects of non-surgical and surgical therapy on periodontal parameters and GCF TGF-β1 levels in 18 sites affected with chronic periodontitis were assessed upto 6 weeks post conventional flap surgery. GCF was collected and PPD, CAL recorded at Baseline. GCF was collected and PPD, CAL recorded at Pre-surgery and flap surgery performed. GCF was collected from all sites at Two Weeks Post-surgery. GCF was collected and PPD, CAL recorded at Six Weeks Post-surgery. The concentration of TGF-β1 in GCF was determined using a human TGF-β1 enzyme immunometric assay kit. RESULTS Mean TGF-β1 concentrations were significantly reduced at Pre-surgery, at Two Weeks Post-surgery and at Six Weeks Post-surgery (p<0.05) when compared to Baseline TGF-β1 values. There was a statistically significant reduction in PPD and gain in CAL following non-surgical and surgical therapy when compared to baseline (p<0.05). CONCLUSION RESULTS indicate that TGF-β1 may play a role in the pathogenesis and diagnosis of periodontal disease and could be considered as a disease predictive biomarker.
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Affiliation(s)
- Vignesh Vikram
- PG Student, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India
| | - T. Ramakrishnan
- Professor, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India
| | - K. Anilkumar
- Reader, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India
| | - N. Ambalavanan
- Professor & HOD, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India
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Abstract
AIMS AND OBJECTIVES The aim of the study was to assess and compare the effect of smoking on mRNA expression of MMP -8 and TIMP-1 in patients with untreated chronic periodontitis and in periodontally healthy subjects and to examine the correlation of MMP-8 and TIMP-1 levels with clinical parameters. MATERIALS AND METHODS Out of 60 subjects, 40 were selected subjects for the study, and were divided into Group I (periodontitis subject) and Group II (healthy subjects). Each group was further subdivided into subgroups I-A (chronic periodontitis smokers CPS), and I-B (chronic periodontitis non-smokers CPN), subgroup II-A (healthy smokers HS) and II B (healthy non-smokers HS). Both the groups underwent periodontal examination and clinical parameters were recorded. Tissue samples from both groups were subjected to the isolation of RNA which was then followed by qRT-PCR and the expression of the mRNA levels of MMP-8 and TIMP-1 were analyzed. RESULTS The mRNA expression of MMP-8 and TIMP-1 was further compared with the periodontal status of all the four groups. The mRNA expression of MMP-8 was compared between the groups and showed that Group I-A (CPS) had higher expression of MMP-8 compared to group I-B (CPN). Group I-B (CPN) vs Group I-A (CPS) showed statistically significant difference in MMP-8/TIMP-1 with higher values for Group I-A (CPS) than Group I-B (CPN). A positive correlation was found between MMP-8 expression and probing depth and clinical attachment level (CAL) among Group I-B (CPN) and Group I-A (CPS) subjects. A significant correlation was also found between MMP-8 and TIMP-1 expression with probing depth and CAL among Group II B(HN) group subjects. TIMP-1 also showed a positive correlation with gingival index (GI) among group II A (HS) subjects. CONCLUSION It is concluded that smoking has an impact on the periodontal status and mRNA expression of MMP-8 and TIMP-1 in chronic periodontitis patients. The earlier evaluation of MMP-8 and TIMP-1, can be used as a biomarker in predicting periodontal disease susceptibility.
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Affiliation(s)
- Rahul Visvanathan
- P.G Student, Department of Periodontology, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
| | - Jaideep Mahendra
- Professor, Department of Periodontology, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
| | - Ambalavanan N
- Professor & Hod , Department of Periodontology, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
| | - Pandisuba
- Lecturer and Biotechnologist, Central Research Laboratory, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
| | - Chalini
- Research Assistant, Central Research Laboratory, Meenakshi Ammal Dental College Maduravoyal, Chennai, India
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Sanders YY, Hagood JS, Liu H, Zhang W, Ambalavanan N, Thannickal VJ. Histone deacetylase inhibition promotes fibroblast apoptosis and ameliorates pulmonary fibrosis in mice. Eur Respir J 2014; 43:1448-58. [DOI: 10.1183/09031936.00095113] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Balasubramaniam AS, Reddy SR, Thomas LJ, Ramakrishnan T, Ambalavanan N. Surgical Lip Repositioning in Two Patients Undergoing Orthodontic Treatment, With Degree I Vertical Maxillary Excess and Short Hypermobile Upper Lip. Clin Adv Periodontics 2014. [DOI: 10.1902/cap.2012.120051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Konduri GG, Sokol GM, Van Meurs KP, Singer J, Ambalavanan N, Lee T, Solimano A. Impact of early surfactant and inhaled nitric oxide therapies on outcomes in term/late preterm neonates with moderate hypoxic respiratory failure. J Perinatol 2013; 33:944-9. [PMID: 23867958 PMCID: PMC3841912 DOI: 10.1038/jp.2013.83] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 05/23/2013] [Accepted: 06/07/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We conducted a post-hoc analysis of early inhaled nitric oxide (iNO)-randomized controlled trial data to identify associations pertinent to the management of moderate hypoxic respiratory failure in term/late preterm infants. STUDY DESIGN Univariate and multivariate logistic regression analyses were used to determine risk factors for the progression of respiratory failure and extracorporeal membrane oxygenation (ECMO)/death. RESULT Among the 299 enrolled infants, oxygenation index (OI) <20 at enrollment (odds ratio 0.52, confidence interval (CI) 0.27 to 0.97) and surfactant use before randomization (odds ratio 0.47, CI 0.24 to 0.91) were associated with decreased ECMO/death rates. Early surfactant use for respiratory distress syndrome, perinatal aspiration syndrome and pneumonia/sepsis was associated with lower risk of ECMO/death (P<0.001). Early iNO (OI 15 to 25) decreased the progression of respiratory failure to OI >30 (P=0.002) and to composite outcome of OI >30 or ECMO/death (P=0.02). CONCLUSION This post-hoc analysis suggests that early use of surfactant and iNO in moderate respiratory failure is associated with improved outcomes.
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Affiliation(s)
- G G Konduri
- Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA,Division of Neonatology, Department of Pediatrics, Children's Corporate Center Suite C410, 999N 92 Street, Wauwatosa, WI 53226, USA. E-mail:
| | - G M Sokol
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K P Van Meurs
- Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - J Singer
- Center for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| | - N Ambalavanan
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - T Lee
- Center for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
| | - A Solimano
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Saravanan P, Ramakrishnan T, Ambalavanan N, Emmadi P, John TL. Efficacy of guided bone regeneration using composite bone graft and resorbable collagen membrane in Seibert's Class I ridge defects: radiological evaluation. J ORAL IMPLANTOL 2013; 39:455-62. [PMID: 23964779 DOI: 10.1563/aaid-joi-d-10-00211] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of the study was to evaluate radiologically the efficacy of guided bone regeneration using composite bone graft (autogenous bone graft and anorganic bovine bone graft [Bio-Oss]) along with resorbable collagen membrane (BioMend Extend) in the augmentation of Seibert's class I ridge defects in maxilla. Bone width was evaluated using computerized tomography at day 0 and at day 180 at 2 mm, 4 mm, and 6 mm from the crest. There was a statistically significant increase in bone width between day 0 and day 180 at 2 mm, 4 mm, and 6 mm from the crest. The results of the study demonstrated an increase in bone width of Seibert's class I ridge defects in the maxilla of the study patients.
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Affiliation(s)
- Pushparajan Saravanan
- Department of Oral Pathology & Oral Medicine & Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
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Priyanka M, Sruthi R, Ramakrishnan T, Emmadi P, Ambalavanan N. An overview of frenal attachments. J Indian Soc Periodontol 2013; 17:12-5. [PMID: 23633765 PMCID: PMC3636930 DOI: 10.4103/0972-124x.107467] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 10/01/2012] [Indexed: 11/04/2022] Open
Abstract
Frenal attachments are thin folds of mucous membrane with enclosed muscle fibers that attach the lips to the alveolar mucosa and underlying periosteum. Most often, during the oral examination of the patient the dentist gives very little importance to the frenum, for assessing its morpholology and attachment. However, it has been seen that an abnormal frenum can be an indicator of a syndrome. This paper highlights the different frenal attachments seen in association with various syndromic as well as non-syndromic conditions.
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Affiliation(s)
- M Priyanka
- Department of Periodontology, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
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Kondreddy K, Ambalavanan N, Ramakrishna T, Kumar RS. Effectiveness of a controlled release chlorhexidine chip (PerioCol™-CG) as an adjunctive to scaling and root planing when compared to scaling and root planing alone in the treatment of chronic periodontitis: A comparative study. J Indian Soc Periodontol 2013; 16:553-7. [PMID: 23493496 PMCID: PMC3590726 DOI: 10.4103/0972-124x.106909] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 01/05/2012] [Indexed: 11/18/2022] Open
Abstract
Aims and objectives: The aim of this study is to evaluate the effectiveness of a controlled-release chlorhexidine chip as an adjunctive therapy to scaling and root planing when compared with scaling and root planing alone in the treatment of chronic periodontitis. Materials and Methods: 20 patients with a total number of 40 posterior sites were selected. These sites were divided into two groups in a split mouth design,: Group A (control site) had 20 sites treated with scaling and root planing alone and Group B (test site) had 20 sites treated with scaling and root planing and PerioCol™-CG. The clinical parameters (Plaque index, bleeding on probing, probing pocket depth, clinical attachment level) were recorded at baseline, 90th and 180th day for both the groups. Results: When both groups were compared the change in Plaque index was significantly higher in Group B when compared to Group A on the 90th day and 180th day. However, there was no statistically significant difference in the mean percentage of gingival bleeding sites between the two groups on the 90th day, though Group B showed a statistically higher reduction in the mean percentage of gingival bleeding sites at the end of 180th day. There was no statistically significant difference in probing pocket depth between the two groups on both 90th and 180th day. Gain in clinical attachment level was significantly higher in Group B when compared to Group A on the 90th and 180th day. Conclusion: From the results observed in this study, it can be concluded that the adjunctive use of PerioCol™-CG was safe and provided significant improvement in both Plaque index and gingival bleeding index. It was also more favorable than scaling and root planing alone for gain in clinical attachment level.
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Affiliation(s)
- Kameswari Kondreddy
- Department of Periodontology and Imlantology, Meenakshi Ammal Dental College, Maduravoyal, Chennai, India
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George R, Kumar S, Ramakrishna T, Emmadi P, Ambalavanan N. Effects of tetracycline-containing gel and a mixture of tetracycline and citric acid-containing gel on non-surgical periodontal therapy. Indian J Dent Res 2013; 24:52-9. [DOI: 10.4103/0970-9290.114949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pushparajan S, Ramakrishnan T, Ambalavanan N, Emmadi P. EFFICACY OF GBR USING COMPOSITE BONE GRAFT AND RESORBABLE COLLAGEN MEMBRANE IN SEIBERT'S CLASS I RIDGE DEFECTS- RADIOLOGICAL EVALUATION. J ORAL IMPLANTOL 2012. [DOI: 10.1563/aaid-joi-d-10-00211.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Anand N, Emmadi P, Ambalavanan N, Ramakrishnan T. Effect of a volatile smoke component (acrolein) on human gingival fibroblasts: An in vitro study. J Indian Soc Periodontol 2012; 15:371-5. [PMID: 22368362 PMCID: PMC3283935 DOI: 10.4103/0972-124x.92573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 01/25/2011] [Indexed: 11/14/2022] Open
Abstract
Aim: Tobacco and some of its volatile and non-volatile components have been found to affect many types of cells including human gingival fibroblasts. The aim of this present study was to estimate the effect of acrolein, a volatile fraction of cigarette smoke on the attachment, proliferation and ultra structure of human gingival fibroblasts in culture. Materials and Methods: Human gingival fibroblasts strains obtained from healthy subjects aged 20-30 years, were grown to confluency and utilized between 3rd -6th passages. The cell cultures seeded in 96 well microtitration plates at a density of 45,000 cells/well were incubated with acrolein at concentrations of 10-4, 3×10-5 and 10-5 . Attachment ability was evaluated after three hours using Neubauer hemocytometer. For the proliferation assay cell cultures seeded at a density of 10,000 cells/well were incubated at concentrations of 10-4, 3×10-5, 10-5, 3×10-6, 10-6 and cell count determined after 5 days using a hemocytometer. Cell morphology was examined under phase contrast microscope. Results: Acrolein produced a dose-dependent cytotoxic effect on human gingival fibroblasts with complete inhibition of attachment and proliferation at higher concentrations. Conclusion: This supports the hypothesis that cigarette smoke is a great risk factor in the development and progression of periodontal disease.
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Affiliation(s)
- Nithya Anand
- Department of Periodontics, Sree Balaji Dental College and Hospital, Narayanapuram, Pallikaranai, India
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Ravindran DM, Sudhakar U, Ramakrishnan T, Ambalavanan N. The efficacy of flapless implant surgery on soft-tissue profile comparing immediate loading implants to delayed loading implants: A comparative clinical study. J Indian Soc Periodontol 2011; 14:245-51. [PMID: 21731251 PMCID: PMC3118076 DOI: 10.4103/0972-124x.76930] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 12/06/2010] [Indexed: 11/17/2022] Open
Abstract
Aims and Objectives To assess the efficacy of flapless implant surgery on soft-tissue profile and to compare the clinical outcomes of flapless implant therapy on immediate loading (IL) implants to delayed loading (DL) implants. Materials and Methods The study sample consisted of 20 patients who were partially edentulous in the anterior maxillary region. They were divided into two groups. In group I (IL) 10 implants were placed and immediately provisionalized and restored with a metal ceramic crown on the 14th day. In group II (DL) 10 implants were placed and loaded after 4 months. Single-piece implants were used for the IL group and two-piece implants were used for the DL group. All soft tissue parameters i.e., modified plaque index (mPI), modified bleeding index (mBI), papillary index (PPI), marginal level of soft tissue (ML) and width of keratinized mucosa (WKM) were recorded at baseline, Day 60, Day 120 and Day 180. Results: The success rate in group I was found to be 80%, which was lower than the success rate in group II which was found to be 90%. On comparison, there is no statistically significant difference in success rate between the two study groups. There was no statistically significant difference between the groups over time in parameters like mPI, mBI, ML and WKM. The mean PPI score in group II showed a significant increase from when compared to group I. Conclusion: The results of this study indicated that flapless implant surgery using either immediately loading implants or DL implants, demonstrate enhancement of implant esthetics.
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Affiliation(s)
- Deepak Moses Ravindran
- Department of Periodontology and Implatology, Meenakshi Ammal Dental College, Chennai, India
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Gopinath V, Ramakrishnan T, Emmadi P, Ambalavanan N, Mammen B, Vijayalakshmi. Effect of a controlled release device containing minocycline microspheres on the treatment of chronic periodontitis: A comparative study. J Indian Soc Periodontol 2009; 13:79-84. [PMID: 20407655 PMCID: PMC2847129 DOI: 10.4103/0972-124x.55844] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 07/09/2009] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Adjunctive therapy with locally delivered antimicrobials has resulted in improved clinical outcomes. The aim of this study was to evaluate the efficacy and safety of locally administered minocycline microspheres (Arestin) in the treatment of chronic periodontitis. MATERIALS AND METHODS A total of 60 sites from 15 patients in the age group of 35-50 years, who had periodontal pockets measuring 5-8 mm and had been diagnosed with chronic periodontitis, were selected for the study. The selected groups were randomly assigned to either the control group (group A) or the treatment/test group (group B). Only scaling and root planing were done at the base line visit for the control sites followed by local application of Arestin (1 mg). Clinical parameters such as plaque index, gingival index, and gingival bleeding index were recorded at baseline, day 30, day 90, and day 180 in the selected sites of both the groups. Probing pocket depth also was recorded at baseline, day 90, and day 180 for both the groups. RESULTS A statistically significant reduction was observed in both groups. Group B showed better results than Group A and these differences were statistically significant. CONCLUSION The results of this study clearly indicate that treatment with scaling and root planing plus minocycline microspheres (Arestin) is more effective and safer than scaling and root planing alone in reducing the signs of chronic periodontitis.
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Affiliation(s)
- V. Gopinath
- Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospital, Poonamalee High Road, Velapanchavadi, Chennai - 77, India
| | - T. Ramakrishnan
- Professor, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
| | - Pamela Emmadi
- Professor and Head, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
| | - N. Ambalavanan
- Professor, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
| | - Biju Mammen
- Associate Professor, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
| | - Vijayalakshmi
- Lecturer, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
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Sudhakar U, Vijayalakshmi R, Emmadi P, Ambalavanan N, Babu MR. Salivary J1-Glucuronidase as a marker for chronic Periodontitis. J Indian Assoc Public Health Dent 2009. [DOI: 10.4103/2319-5932.196162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Abstract
OBJECTIVE Proper management of very low weight (<1500 g) infants requires specific expertise. During July and August, pediatric interns start new rotations and advance in responsibilities by postgraduate level. We test the hypothesis that low weight births in teaching hospitals exhibit increased neonatal mortality during the initial training months. STUDY DESIGN Population-based cohort of 5184 very low weight and 15 232 moderately low weight infants in California from 19 regional teaching hospitals with medical training programs. Logistic regression methods controlled for both individual covariates and temporal patterns in neonatal mortality. RESULT We found no difference in neonatal mortality between very low weight infants born in teaching hospitals during July and August and those born in other months (adjusted odds ratio (AOR): 0.98, 95% confidence interval (CI), 0.78 to 1.23). Investigation of moderately low birth weight infants also indicated no increased neonatal mortality. CONCLUSION Infants most likely to die in the neonatal period do not appear to be at elevated risk of neonatal mortality during July and August.
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Affiliation(s)
- T A Bruckner
- Department of Epidemiology, School of Public Health, University of California at Berkeley, CA 94704, USA.
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Ahathya RS, Deepalakshmi D, Ramakrishnan T, Ambalavanan N, Emmadi P. Subepithelial connective tissue grafts for the coverage of denuded root surfaces: a clinical report. Indian J Dent Res 2008; 19:134-40. [PMID: 18445931 DOI: 10.4103/0970-9290.40468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS AND OBJECTIVES The aim of this study is to determine the effectiveness of subepithelial connective tissue grafts (SCTG) in the coverage of denuded roots. MATERIALS AND METHODS A total of 16 sites with > or =2 mm of recession height were included in the study for treatment with SCTG. The clinical parameters, such as recession height, recession width, width of keratinized gingiva, probing pocket depth, and clinical attachment level were measured at the baseline, third month, and at the end of the study [sixth month]. The defects were treated with a coronally positioned pedicle graft combined with connective tissue graft. RESULTS Out of 16 sites treated with SCTG, 11 sites showed complete (100%) root coverage; the mean root coverage obtained was 87.5%. There was a statistically significant reduction in recession height, recession width, and probing pocket depth. There was also a statistically significant increase in the width of keratinized gingiva and also a gain in clinical attachment level. The postoperative results were both clinically and statistically significant ( P 0.05). CONCLUSION From this study, it may be concluded that SCTG is a safe and effective method for the coverage of denuded roots.
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Affiliation(s)
- R S Ahathya
- Department of Periodontology and Implantology, Meenakshiammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai, Tamil Nadu, India.
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Flemingson, Emmadi P, Ambalavanan N, Ramakrishnan T, Vijayalakshmi R. Effect of three commercial mouth rinses on cultured human gingival fibroblast: an in vitro study. Indian J Dent Res 2008; 19:29-35. [PMID: 18245921 DOI: 10.4103/0970-9290.38929] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM To examine the effect of three commercial mouth rinses (Hexidine 0.2%, Listerine Cool Mint, Betadine 1%) upon cultured human gingival fibroblast proliferation. MATERIALS AND METHODS Human gingival fibroblasts were cultured and incubated in Dulbecco's Minimum Eagle's Medium containing Chlorhexidine, Listerine, Povidone-Iodine at varying concentrations (1%, 2%, 5%, 10%, 20% and 100% of the given solution) at 37 degrees C for 1, 5 and 15 min. Control cells received an equal volume of Dulbecco's Minimum Eagle's Medium without adding mouth rinses, for similar duration of exposure at 37 degrees C. Following incubation the media were removed, cells were washed twice with medium, supplemented with 10% Fetal Bovine Serum, and fibroblasts in the test and control group were allowed to recover in the same media for 24 h. RESULTS In all the three groups, the proliferation inhibition was dependent on the concentration of solublized mouth rinses in the cell culture but independent of the duration of exposure to all three mouth rinses. The results showed that all three solutions were toxic to cultured human gingival fibroblasts, Chlorhexidine being the most cytotoxic. It was seen that at dilute concentrations (1% and 2% of given solutions) Listerine was more cytotoxic than Chlorhexidine and Povidone-Iodine. CONCLUSION These results suggest that Chlorhexidine, Listerine and Povidone-Iodine are capable of inducing a dose-dependent reduction in cellular proliferation of fibroblasts. The results presented are interesting, but to know the clinical significance, further studies are needed.
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Affiliation(s)
- Flemingson
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, India
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Vijayalakshmi R, Anitha, Emmadi P, Ambalavanan N, Ramakrishnan T, Saravanakumar R. Association between Periodontal Disease and Acute Myocardial Infarction - A Cross-Sectional Study. J Indian Assoc Public Health Dent 2007. [DOI: 10.4103/2319-5932.195266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Anitha, Srilakshmi, Sudhakar U, Ramakrishnan T, Emmadi P, Ambalavanan N. Occurrence of gingival overgrowth in post renal transplant patients treated with Cyclosporine- A and its possible associations with periodontal and pharmacological variables. J Indian Assoc Public Health Dent 2007. [DOI: 10.4103/2319-5932.195260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Ambalavanan N, Baibergenova A, Carlo WA, Saigal S, Schmidt B, Thorpe KE. Early prediction of poor outcome in extremely low birth weight infants by classification tree analysis. J Pediatr 2006; 148:438-444. [PMID: 16647401 DOI: 10.1016/j.jpeds.2005.11.042] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Revised: 09/28/2005] [Accepted: 11/30/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To predict death or neurodevelopmental impairment (NDI) in extremely low birth weight infants by classification trees with recursive partitioning and automatic selection of optimal cut points of variables. STUDY DESIGN Data from the Trial of Indomethacin Prophylaxis in Preterms were randomly divided into development (n=784) and validation sets (n=262). Three models were developed for the combined outcome of death (8 days to 18 months) or NDI (cerebral palsy, cognitive delay, deafness, or blindness at 18 months corrected age): antenatal: antenatal data; early neonatal: antenatal+first 3 days data; and first week: antenatal, first 3 days, and 4th to 8th days data. Decision trees were tested on the validation set. RESULTS Variables associated with death/NDI in each model were: Antenatal: Gestation<or=25.5 weeks and antenatal steroids<7 days. Early neonatal: Birth weight<or=787 g and fluid intake>01 mL/kg/d. First week: Birth weight<or=787 g: transfusion>3 mL/kg/d. Birth weight>787 g: cranial echodense intraparenchymal lesion and transfusion>1 mL/kg/d. Correct classification rates were 61% to 62% for all models. CONCLUSIONS The ability to predict long-term morbidity/death in extremely low birth weight infants does not improve significantly over the first week of life. Effects of different variables depend on age.
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Affiliation(s)
- N Ambalavanan
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
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El-Ferzli GT, Ambalavanan N, Bulger A, Philips JB. 137 A NOVEL GAS EXCHANGE ASSIST DEVICE IN JUVENILE ACUTE LUNG INJURY. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0008.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Ambalavanan N, Arunmozhi U. Hospital periodontal surgery. Indian J Dent Res 2005; 16:122-5. [PMID: 16454328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Phenytoin-induced gingival overgrowth is a recognized side effect in many cerebral palsy patients using diphenyl hydantoin for the control of seizures. Severe gingival overgrowth in these patients can affect normal masticatory function, lead to poor occlusal development, and compromise esthetics. This report addresses the complex nature of treating phenytoin-induced gingival overgrowth in a mentally retarded 20-year-old female patient. For this patient, full-mouth gingivectomy procedure was performed under general anesthesia in a single session. Post operative follow-up was uneventful. This article discusses major indications, contraindications, and protocols to be followed for periodontal surgical procedures done under general anesthesia.
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Affiliation(s)
- N Ambalavanan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai
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James ML, Ross AC, Bulger A, Philips JB, Ambalavanan N. 405 SYNERGISTIC EFFECT OF VITAMIN A AND RETINOIC ACID IN REDUCING NEONATAL HYPEROXIC LUNG INJURY. J Investig Med 2005. [DOI: 10.2310/6650.2005.00006.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Fabres J, Ambalavanan N, Phillips V, Howard G, Carlo WA. 184 HIGH LEVELS OF PaCO 2AND INTRAVENTRICULAR HEMORRHAGE IN VERY LOW BIRTH WEIGHT INFANTS. J Investig Med 2005. [DOI: 10.2310/6650.2005.00006.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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El-Ferzli G, Ambalavanan N, Bulger A, Philips JB. 409 A NOVEL GAS EXCHANGE ASSIST DEVICE IN A MODEL OF NEONATAL PULMONARY HYPERTENSION. J Investig Med 2005. [DOI: 10.2310/6650.2005.00006.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Carlo WA, Prince LS, St John EB, Ambalavanan N. Care of very low birth weight infants with respiratory distress syndrome: an evidence-based review. Minerva Pediatr 2004; 56:373-80. [PMID: 15457135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Since 1959, when it was reported that many preterm infants had surfactant deficiency, there has been a remarkable improvement in the prevention of respiratory distress syndrome (RDS) and in the care of infants who develop RDS. Antenatal corticosteroids and surfactant replacement have improved the care of very low birth weight infants.
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Affiliation(s)
- W A Carlo
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233-7335, USA.
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Tanner JM, Wolfe M, Ambalavanan N, Dimmitt RA, Schelonka RL. 226 HYPEROXIC LUNG INJURY IN A MURINE MODEL. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
AIMS To compare the prediction of mortality in individual extremely low birth weight (ELBW) neonates by regression analysis and by artificial neural networks. STUDY DESIGN A database of 23 variables on 810 ELBW neonates admitted to a tertiary care center was divided into training, validation, and test sets. Logistic regression and neural network models were developed on the training set, validated, and outcome (mortality) predicted on the test set. Stepwise regression identified significant variables in the full set. Regression models and neural networks were then tested using data sets with only the identified significant variables, and then with variables excluded one at a time. RESULTS The area under the curve (AUC) of receiver operating characteristic (ROC) curves for neural networks and regression was similar (AUC 0.87+/-0.03; p=0.31). Birthweight or gestational age and the 5-min Apgar score contributed most to AUC. CONCLUSIONS Both neural networks and regression analysis predicted mortality with reasonable accuracy. For both models, analyzing selected variables was superior to full data set analysis. We speculate neural networks may not be superior to regression when no clear non-linear relationships exist.
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Affiliation(s)
- N Ambalavanan
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, 525 New Hillman Bldg., 619 South 19th Street, Birmingham, AL 35233-7335, USA.
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Abstract
Recent experimental and clinical data demonstrate that both hypocapnia and hypercapnia during the neonatal period may result in beneficial or adverse consequences. Multiple retrospective studies report a strong association between PaCO2 levels less than 25 to 30 mm Hg and an increased incidence of cystic PVL and CP in preterm infants. Prolonged exposure to PaCO2 values less than 25 to 30 mm Hg is also associated with hearing loss in term and near-term infants. A low tidal volume strategy combined with permissive hypercapnia is potentially a strategy that could prevent lung injury. Clearly, more randomized, controlled trials are needed before this latter strategy or that of permissive hypercapnia can be recommended routinely for preterm, near-term, or term gestation infants with respiratory disorders.
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Affiliation(s)
- N Ambalavanan
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Abstract
Levcromakalim (LKM; a K(ATP) channel opener) reverses hypoxic pulmonary vasoconstriction in isolated pulmonary arteries and perfused lungs. This vasorelaxation is blocked by glibenclamide (GLB; a K(ATP) channel blocker). We evaluated the hemodynamic effect of LKM followed by GLB in a chronically instrumented neonatal porcine model of pulmonary hypertension, created by exposing piglets to hypoxia (n = 7) or heat-killed group B streptococci (GBS) (n = 6). Hypoxia increased pulmonary arterial pressure (PAP), which LKM decreased, and GLB subsequently increased in a dose-dependent manner. Systemic arterial pressure (SAP) did not change with hypoxia but was also decreased by LKM and increased by GLB. GBS also led to increased PAP, but LKM significantly reduced only SAP, which was then increased by GLB. We conclude LKM is capable of reversing hypoxic, but not GBS-induced, pulmonary hypertension but lacks specificity for the neonatal pulmonary vasculature.
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Affiliation(s)
- N Ambalavanan
- Department of Pediatrics, University of Alabama at Birmingham, 35233, USA.
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Ambalavanan N, Carlo WF, Bulger A, Shi J, Philips JB. Effect of cigarette smoke extract on neonatal porcine vascular smooth muscle cells. Toxicol Appl Pharmacol 2001; 170:130-6. [PMID: 11162777 DOI: 10.1006/taap.2000.9094] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RATIONALE Cigarette smoke exposure in the perinatal period increases the risk of various prenatal and postnatal complications, including sudden infant death syndrome (SIDS) and persistent pulmonary hypertension of the newborn (PPHN). We investigated the cellular effects of cigarette smoke extract (CSE) in the developing vasculature. METHODS Vascular smooth muscle cells (VSMC) were isolated from neonatal porcine carotid arteries, splenic arteries, and main and resistance pulmonary arteries. Effects of CSE on VSMC proliferation, viability, apoptosis, and media nitrates and nitrites were evaluated. The effects of known constituents of CSE (nicotine, benzopyrene, acrolein, acetaldehyde), aged CSE, CSE with added hemoglobin, devolatilized CSE, CSE with added dithiothreitol (DTT), and reduced glutathione (GSH) on cell proliferation and viability were assessed. RESULTS CSE caused a dose- and time-dependent decrease in neonatal VSMC numbers isolated from all four sites, mainly as a result of increased cell necrosis and not apoptosis. Nitrates and nitrites were below the threshold of detection. Nicotine and benzopyrene did not affect cell counts, while acrolein and acetaldehyde decreased cell counts in a dose-dependent manner. Addition of hemoglobin, devolatilization, and the addition of DTT or GSH slightly decreased CSE inhibition. CONCLUSIONS CSE causes necrosis of neonatal VSMC, and this toxicity is mediated mainly by volatile components such as acrolein and acetaldehyde, possibly in association with nitric oxide and carbon monoxide.
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Affiliation(s)
- N Ambalavanan
- Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, 525 New Hillman Bldg., Birmingham, AL 35233-7335, USA.
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Carlo WF, Villamor E, Ambalavanan N, DeMey JG, Blanco CE. Chronic exposure to cigarette smoke extract impairs endothelium-dependent relaxation of chicken embryo pulmonary arteries. Neonatology 2001; 80:247-50. [PMID: 11585991 DOI: 10.1159/000047151] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Maternal smoking may increase the risk for various adverse neonatal outcomes including persistent pulmonary hypertension of the newborn (PPHN). We investigated whether chronic prenatal cigarette smoke extract (CSE) exposure could produce abnormal vasoreactivity in pulmonary arteries. Daily injections of CSE (diluted in phosphate buffered saline) or vehicle were added to the air cells of fertilized eggs starting on day 5 of the 21-day incubation period of the chicken embryo. On day 19, pulmonary arteries were dissected out and their contractile properties were assessed using small vessel myography. Endothelium-dependent and endothelium-independent vasorelaxations were examined by using acetylcholine (ACh, 10(-8) to 10(-4) M) and sodium nitroprusside (SNP, 10(-8) to 10(-4) M), respectively. The drug concentration inducing 50% of the maximal relaxation was determined for each concentration-response curve and expressed as negative log molar (pD(2)). Exposure to CSE significantly decreased the sensitivity of pulmonary arteries to ACh (pD(2) control group: 7.29 +/- 0.24; pD(2) CSE-exposed group 6.24 +/- 0.12, p < 0.05). SNP elicited similar responses in vessels of both groups at all tested concentrations. In conclusion, chronic prenatal exposure to CSE impaired endothelium-dependent but not endothelium-independent vasodilation in chicken embryo pulmonary arteries. This observation suggests that cigarette smoke components may produce deleterious effects on fetal vascular endothelial vasorelaxant pathways, leading to the development of adverse outcomes such as PPHN.
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Affiliation(s)
- W F Carlo
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, USA
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Abstract
OBJECTIVE (1) Identify major determinants of adverse neurodevelopmental outcome in extremely low birth weight (ELBW) infants. (2) Compare neural networks and regression analysis in the prediction of major handicaps and Bayley scores (MDI and PDI) in individual ELBW neonates followed to 18 months. STUDY DESIGN Retrospective cohort study of regional tertiary care NICU database. A database with 21 selected variables was divided into training (n = 144) and test sets (n = 74). The training set was used to train a neural network and develop regression equations to predict outcomes in the test set. RESULTS Determinants (descending order of contribution to variance): Major handicap: intraventricular hemorrhage (IVH) grade, necrotizing enterocolitis > or = stage II, black race, and no chorioamnionitis; low MDI: IVH grade, plurality, bronchopulmonary dysplasia (BPD), lower maternal grade, and no chorioamnionitis; low PDI: IVH grade, BPD, periventricular leukomalacia, lower maternal grade, and no chorioamnionitis. Regression techniques and neural networks were comparable and had relatively low sensitivity and correlation with adverse outcomes. CONCLUSION Much of the variance in ELBW neurologic outcome cannot be explained by either regression analysis or neural network approaches.
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Affiliation(s)
- N Ambalavanan
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, 525 New Hillman Building, Birmingham, AL 35233-7335, USA
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