Assessment of Salivary Flow Rate in Patients with Chronic Periodontitis

Background:

Chronic periodontitis (CP) is an infectious disease, primarily affecting the attachment apparatus of the dentition, and is categorized into mild, moderate, and severe periodontitis on the basis of its severity. It is a well-established and proven fact that an adequate level of saliva is essential for maintaining the integrity of oral tissues including the periodontium. Although various factors, such as stimulation, circadian rhythm, diet, age, and drugs, can affect the salivary flow rate, many recent studies have provided evidence that it can be altered by pathological inflammatory conditions such as periodontal diseases. Therefore, this study has been undertaken to assess the unstimulated and stimulated salivary flow rate in the different clinical stages of chronic periodontitis.

Materials and Methods:

This study comprised 60 study participants, who were divided into four groups depending on clinical attachment level (CAL). In all, both unstimulated and stimulated saliva were collected, and the flow rate was expressed in milliliter per minute.

Results:

Statistical analysis was accomplished with Statistical Package for the Social Sciences (SPSS) software. One-way analysis of variance (ANOVA) was used to analyze differences in salivary flow rate among the groups. Statistical significance was set at P < 0.05. The amount of unstimulated saliva in healthy subjects, in mild, moderate, and severe periodontitis was 0.766, 0.400, 0.270, and 0.146 mL/min, respectively. Likewise, the amount of stimulated saliva in healthy subjects, in mild, moderate, and severe periodontitis was 1.017, 0.494, 0.347, and 0.236 mL/min, respectively.

Conclusion:

The study identified a significant decrease in both unstimulated and stimulated salivary flow rate with the severity of progression of chronic periodontitis.

Effect of Nonsurgical Periodontal Therapy on Serum Levels of Interleukin-1β and Interleukin-8 in Smokers and Nonsmokers with Chronic Periodontitis

Aim:

The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on serum levels of interleukin-1β (IL-1β) and interleukin-8 (IL-8) in smokers and nonsmokers with chronic periodontitis before and after scaling and root planing (SRP).

Materials and Methods:

This was a comparative interventional study including a total of 52 (26 smokers and 26 nonsmokers with chronic periodontitis) subjects. Clinical parameters (gingival index [GI], plaque index [PI], recession, probing pocket depth [PPD], and clinical attachment level [CAL]) were recorded at baseline and 4 weeks after initial periodontal therapy. Initial periodontal therapy included oral hygiene instructions and full mouth SRP. Venous blood sample of 5 mL was collected from each subject at baseline and 4 weeks after initial periodontal therapy to evaluate serum IL-1β and IL-8. These biochemical parameters were assayed using enzyme-linked immunosorbent assay (ELISA) method.

Results:

The periodontal parameters such as PI, GI, recession, PPD, and CAL were reduced after nonsurgical periodontal therapy. Smokers with chronic periodontitis showed statistically significant lower GI and higher PI, gingival recession, PPD, and CAL as compared to nonsmokers with chronic periodontitis. Statistically significant reduction in periodontal parameters was seen in both groups after periodontal therapy. IL-1β and IL-8 were increased in both groups at baseline; after SRP both groups showed statistically significant reduction in IL-1β and smokers with chronic periodontitis showed statistically significant increase in IL-8 after SRP.

Conclusion:

Smokers with chronic periodontitis showed more periodontal destruction and systemic inflammatory markers compared to nonsmokers with chronic periodontitis. After periodontal therapy both groups showed statistically significant improvement in clinical parameters and biochemical parameters excluding IL-8.

An In Vitro Study to Evaluate and Compare the Hemocompatibility of Titanium and Zirconia Implant Materials after Sandblasted and Acid-etched Surface Treatment

AIM

This study was aimed to investigate the hemocompatibility of zirconia and titanium implant materials after surface treatment with sandblasting and acid etching (SLA).

MATERIALS AND METHODS

Sixty specimens were procured from manufacturers of dimension 10mm × 3mm, thirty of each were prefabricated medical grade titanium (Ti-6Al-4V) and thirty of sintered zirconia. Silicon carbide grit papers of 240 to 1200pm, was used to polish the specimen surface. The surfaces were rinsed with water to remove any remnant particles after polishing. Later ultrasonic cleaning was done for 5 minutes using distilled water. The control specimens included 15 specimens each from titanium (groups A1) and zirconia (groups B1). The remaining 15 specimens (groups A2 and B2) were sandblasted using alumina particles of 150 microns particle size and using 20% hydrochloric acid, acid etching was done for 30 seconds. The specimens were scanned under electron microscope after surface treatment for analysis purpose and evaluated for surface characteristics. Before the exposure of specimens to blood, percentage hemolysis, prothrombin, platelet aggregation and activation, and thrombin time values were calculated. one mL of blood was added to each specimen for testing. The values before and after the exposure of specimens to blood were noted. Using a t-test, the values noted were statistically Results: A₁ (polished titanium) showed highest mean values after exposure, in platelet count (184.67 ± 1.29), leucocyte count (7.27 ± 0.08), and thrombin time (10.15 ± 0.34) while prothrombin time's highest mean value after exposure were showed by A₂ (SLA treated titanium) with a mean value of 10.04 ± 0.24.

CONCLUSION

Surface treatment with sandblasting and acid etching (SLA) using 150 microns alumina particles and 20% hydrochloric acid increased the surface roughness of the titanium and zirconia implant materials and polished titanium showed maximum hemocompatibility.

CLINICAL SIGNIFICANCE

The implant's success depends on its biocompatibility and its property of osseointegration. The adverse interaction between blood and the artificial surface is detected by the hemocompatibility test for medical materials, to know if the surface can activate or destruct the blood components. The success of implant placement also depends on the interaction between the blood and the specimen.

Effect of Nonsurgical Periodontal Therapy on Serum Level of Interleukin-6 and Tumor Necrosis Factor-α in Chronic Periodontitis Patients with and without Hypothyroidism

AIM

The aim of this article was to determine the effect of nonsurgical periodontal therapy on clinical parameters and also to evaluate serum level of interleukin (IL)-6 and tumor necrosis factor (TNF)-α in chronic periodontitis patients with and without hypothyroidism.

MATERIALS AND METHODS

Subjects were 40 female patients (20 systemically healthy subjects with chronic periodontitis and 20 subjects with hypothyroidism and chronic periodontitis). Clinical parameters like plaque score, gingival score, gingival recession, probing pocket depth, and clinical attachment level were recorded at baseline and 4 weeks after nonsurgical periodontal therapy. Nonsurgical periodontal therapy included oral hygiene instructions and full-mouth scaling and root planing. A total of 5 mL of venous blood sample was collected from each subject at baseline and 4 weeks after nonsurgical periodontal therapy.

RESULTS

The clinical parameters and biochemical parameters like IL-6 and TNF-α in both groups showed pronounced reduction at the end of 4 weeks following nonsurgical periodontal therapy. However, simultaneous comparison of clinical and biochemical parameters between the two groups was not statistically significant.

CONCLUSION

This study provides evidence that nonsurgical periodontal therapy contributes to reduction in serum level of IL-6 and TNF-α in systemically healthy subjects with chronic periodontitis and subjects with hypothyroidism and chronic periodontitis.

CLINICAL SIGNIFICANCE

The prevalence of periodontitis as well as hypothyroidism is increasing nowadays. Interleukin-6 and TNF-α are found to play a significant role in pathobiology of both periodontitis and hypothyroidism. With the treatment of periodontitis, it is found that there is improvement in periodontal and thyroid status of the patients. So, it is an alert to health professionals about the relation of hypothyroidism and periodontitis so that they consider a multidisciplinary approach.