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Ponnaiyan D, Rughwani RR, Shetty G, Mahendra J, Victor DJ, Thakare KS, Reddy NS. Exploring the Potential Consortium of Migraine and Periodontitis. Int J Dent 2024; 2024:3559500. [PMID: 38699683 PMCID: PMC11065492 DOI: 10.1155/2024/3559500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/04/2024] [Accepted: 03/13/2024] [Indexed: 05/05/2024] Open
Abstract
Objectives Various researches have shown periodontitis to share common pathophysiological pathways with systemic diseases such as diabetes, cardiovascular diseases, and osteoporosis and recently neurological disorders. This article provides a narrative review summarizing the various linking mechanisms and the nature of association between two multifactorial diseases-periodontitis and migraine. Materials and Methods A literature search was performed for articles related to periodontitis and migraine up till the year 2023 which yielded totally 14 articles. There were only three randomized controlled clinical trials; therefore, we were unable to conduct a systematic review and focused on a narrative review. The keywords searched were "migraine", "periodontitis" and "biomarkers" in PubMed/Medline, Web of Science, and Embase databases. Any article related to the association of periodontitis and migraine and the dental management of subjects with headache disorders were included and studies with migraine and other dental diseases were excluded. Results It is found that the occurrence of periodontitis and migraine are associated with each other. There is reasonable evidence to believe that periodontitis and migraine are linked by direct and indirect mechanisms which can eventually lead to chronic inflammatory conditions like periodontitis worsening neurovascular conditions such as migraine. However, upon detailed analysis it was found that the strength of association is weak owing to the presences of various common confounding and risk factors. Conclusions The association between periodontitis and migraine cannot be denied, however, not all the criteria are fulfilled while examining the nature of association and future long-term studies are required to prove the same. Clinical Relevance. Various studies have reported poor periodontal health in patients with migraine. The risk of exacerbation of migraine also increases in subject undergoing dental therapy if the triggering factors are manipulated. Hence, knowing the precise pathophysiologic mechanisms linking both the diseases would be favorable in planning treatment protocols for subjects with migraine.
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Affiliation(s)
| | | | | | - Jaideep Mahendra
- Meenakshi Academy of Higher Education and Research, Chennai, India
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Ilango P, Mahendra J, Mahendra L, Cherian SM, Suresh V, Mahalingam A, Khanna VV, Vummidi AV, Thanigaimalai A, Dave PH. Evidence linking the association of periodontal viruses and pentraxins in periodontitis patients with coronary artery disease. J Periodontol 2024; 95:325-336. [PMID: 37483128 DOI: 10.1002/jper.23-0096] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/24/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Although there is ample evidence in the literature supporting a significant positive association between key periodontal pathogens and established inflammatory markers of periodontitis and coronary artery disease (CAD), their exact role remain unclear. Especially, the role of viruses in the etiology and specific biomarkers have not been validated. Thus, the current study aims to evaluate the role of periodontal viruses such as Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus (HSV), as well as the inflammatory marker pentraxin-3 (PTX3), and to analyze their association with CAD. METHODS The study included 240 patients divided into four groups of 60 patients each: nonperiodontitis + noncardiac (NP+NC) group, periodontitis + noncardiac patients (P+NC) group, nonperiodontitis + cardiac patients (NP+C) group, and periodontitis + cardiac (P+C) group. The cardiac surgery group (C-S) was a subgroup of NP+C and P+C. It consisted of 60 patients from the abovementioned two cardiac groups in whom coronary artery bypass graft (CABG) was indicated. Demographic variables, cardiac parameters, and periodontal parameters were recorded. The viruses (EBV, CMV, and HSV) and the inflammatory marker PTX3 were evaluated in the subgingival plaque samples of all the four groups and atheromatous plaque samples of the C-S using reverse transcriptase-polymerase chain reaction (RT-PCR) and quantitative polymerase chain reaction (qPCR), respectively, and were compared between the groups. The results were obtained and statistically analyzed. RESULTS The demographic variables did not differ significantly between the groups, except for age. Systolic blood pressure, diastolic blood pressure, low-density lipoprotein, and random blood sugar were significantly higher in NP+C and P+C, whereas high-density lipoprotein was significantly lower (p ≤ 0.05) in the same. Plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were significantly higher (p ≤ 0.05) in P+NC and P+C. PTX were significantly elevated in P+C among the four groups. On evaluating the subgingival plaque samples, EBV and CMV were significantly higher in the two periodontitis groups P+NC and P+C (p = 0.000). HSV was significantly higher in the two cardiac groups (NP+C and P+C) (p ≤ 0.05). Cardiac EBV and CMV were significantly elevated in the P+C group with a p value of 0.004 and 0.033, respectively. Cardiac HSV was found in the NP+C group with statistical insignificance (p = 0.410) between the groups. On correlation, oral PTX were significantly associated with bleeding index (BI), PPD, and CAL (p = 0.000). Similarly, cardiac PTX showed significant association with PI, BI, PPD, and CAL (p = 0.000). Oral and cardiac PTX also showed significant correlation with each other. Multiple logistic regression analysis revealed a significant association between CAL and oral EBV (p ≤ 0.05). Similarly, cardiac EBV showed a significant association with CAL and oral EBV (p ≤ 0.05). Multiple logistic regression analysis also revealed that both cardiac and oral PTX showed a significant association only with oral EBV, CMV, and HSV. CONCLUSION The results of the current study suggest that the clinical severity of periodontitis (CAL), etiology of periodontitis (EBV and CMV), and inflammatory marker of periodontitis (PTX3) were found to be significantly elevated in CAD. These findings suggests that periodontal diseases may be a risk factor that could influence the progression of CAD.
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Affiliation(s)
- Paavai Ilango
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Little Mahendra
- Department of Periodontics, Maktoum bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Sanjay M Cherian
- Department of Cardiac Surgery, Frontier Lifeline Hospital, Chennai, India
| | - Vasugi Suresh
- Department of Physiology, Indira Medical College and Hospital, Chennai, India
| | - Arulpari Mahalingam
- Department of Pedodontics, Thai Moogambigai Dental College & Hospital, Chennai, India
| | - V Vinoth Khanna
- Department of Animal Biotechnology, Madras Veterinary College, Vepery, Chennai, India
| | - Ayswarya V Vummidi
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
| | - Abirami Thanigaimalai
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
| | - Pavithra H Dave
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India
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Ponnaiyan D, Rughwani RR, Shetty G, Mahendra J. The effect of adjunctive LASER application on periodontal ligament stem cells. Front Cell Dev Biol 2024; 11:1341628. [PMID: 38283989 PMCID: PMC10811063 DOI: 10.3389/fcell.2023.1341628] [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: 11/20/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
Periodontal regeneration involves the composite action of cell, scaffolds and signaling molecules. There are numerous autologous sources of regenerative cells which are present close to the vicinity of the periodontally debilitated site, the primary one being the periodontal ligament stem cell, which is believed to have a key role in regeneration. Various methods can be harnessed to optimize and enhance the regenerative potential of PDLSCs such as the application of LASERs. In the last few years there have been various studies which have evaluated the effect of different types of LASERs on PDLSCs and the present review summarizes the photo-biomodulative activity of LASERs in general and its beneficial role in the stimulation of PDLSC specifically.
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Affiliation(s)
| | | | | | - Jaideep Mahendra
- Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
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Bains VK, Mahendra J, Mittal M, Bedi M, Mahendra L. Technical considerations in obtaining platelet rich fibrin for clinical and periodontal research. J Oral Biol Craniofac Res 2023; 13:714-719. [PMID: 37731846 PMCID: PMC10507643 DOI: 10.1016/j.jobcr.2023.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/12/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
Autologous platelet rich fibrin (PRF), is currently being widely used and investigated across the globe by clinicians and periodontal research. The technical aspect required for the procurement of PRF includes revolution per minute (RPM), relative centrifugal force (RCF) or G-force, rotor radius, rotor angle, stability or vibration in the centrifugal machine and material of test-tube, besides the systemic health of the individual may influence the final outcome. Present technical note intends to compile these aspects for better understanding and appropriate outcome while preparing PRF in varying clinical scenarios.
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Affiliation(s)
- Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College & Hospital, Lucknow, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Madhukar Mittal
- Department of Endocrinology & Metabolism, AIIMS, Jodhpur, India
| | - Muskan Bedi
- Department of Basic Medical Sciences, Sri Ramachandra Medical College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University College, Dubai, United Arab Emirates
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Ilango P, Mahendra J, Mahendra L, Cherian SM, Suresh V, Mahalingam A, Khanna VV, Thanigaimalai A. Association of pentraxin in periodontitis patients with coronary artery disease. J Indian Soc Periodontol 2023; 27:612-618. [PMID: 38434506 PMCID: PMC10906795 DOI: 10.4103/jisp.jisp_487_22] [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: 11/07/2022] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 03/05/2024] Open
Abstract
Objectives Pentraxin 3 (PTX3) is a biomarker, associated with the pathogenesis of Periodontitis and coronary artery disease (CAD) individually, but their role in patients with both diseases remains unclear. The current study aims to evaluate the association of PTX in patients with concomitant periodontitis and CAD. Materials and Methods In a case-control study, 240 participants were selected and divided into four groups. Nonperiodontitis + noncardiac = 60 patients, periodontitis + noncardiac (P + NC) = 60 patients, nonperiodontitis + cardiac (NP + C) = 60 patients, periodontitis + cardiac (P + C) = 60 patients. Demographic variables, cardiac and periodontal parameters were recorded. PTX was evaluated in the subgingival plaque and atheromatous plaque samples using real-time quantitative polymerase chain reaction and compared between the groups. The results were statistically analyzed. Results Among the demographic variables, age showed a significant difference between the groups. Systolic and diastolic blood pressure, low-density lipoprotein, and random blood sugar were significantly higher in NP + C and P + C groups (P ≤ 0.05). The plaque index, probing pocket depth, and clinical attachment loss were significantly higher in P + NC and P + C groups (P ≤ 0.05). PTX was significantly elevated in P + C group (P = 0.000). Pearson's correlation revealed a significant correlation between the periodontal parameters and PTX in both the cardiac and oral samples. Conclusion PTX3 levels were elevated in CAD patients with periodontitis suggesting the influence of periodontal inflammation in the progression of CAD. PTX3 may serve as a diagnostic and prognostic tool for both periodontitis and CAD. This study could provide an understanding and awareness about the potential role of PTX3 in both periodontitis and CAD.
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Affiliation(s)
- Paavai Ilango
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Little Mahendra
- Department of Periodontics, Maktoum bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Sanjay M. Cherian
- Department of Cardiac Surgery, Frontier Lifeline Hospital, Chennai, Tamil Nadu, India
| | - Vasugi Suresh
- Department of Physiology, Indira Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Arulpari Mahalingam
- Department of Pedodontics, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - V. Vinoth Khanna
- Department of Animal Biotechnology, Madras Veterinary College, Chennai, Tamil Nadu, India
| | - Abirami Thanigaimalai
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, Tamil Nadu, India
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Ravindran MP, Geetha A, Rajendran S, Mahendra J, Jyothi M, Namasivayam A. Correlation of Serum and Gingival Crevicular Fluid Levels of Caspase-3 and Milk Fat Globule-Epidermal Growth Factor 8 on Gingival Health. Indian J Dent Res 2023; 34:359-364. [PMID: 38739812 DOI: 10.4103/ijdr.ijdr_62_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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 09/08/2023] [Indexed: 05/16/2024] Open
Abstract
AIM This study aimed to estimate and correlate the serum and gingival crevicular fluid (GCF) levels of caspase-3 and milk fat globule-epidermal growth factor 8 (MFG-E8) in healthy, gingivitis and generalised chronic periodontitis subjects. MATERIALS AND METHODS A total of 24 subjects were selected and divided into three groups. After recording the periodontal parameters (plaque index (PI), modified gingival index (MGI), probing depth (PD) and clinical attachment level (CAL)), the serum and GCF samples were collected and the levels of caspase-3 and MFG-E8 were estimated using enzyme-linked immunoassay (ELISA). RESULTS The mean values of PI, MGI, PD and CALs were significantly higher in group III when compared to group II and group I. The mean value of serum and GCF caspase-3 increased with increasing disease severity, whereas the mean serum and GCF values of MFG-E8 decreased with increasing severity of disease. Spearman's correlation showed a strong positive correlation between the serum and GCF levels of caspase-3 and periodontal parameters, whereas serum and GCF levels of MFG-E8 showed a strong negative correlation with the periodontal parameters. CONCLUSION The findings of this study are suggestive that the serum and GCF levels of caspase-3 and MFG-E8 could serve as a potential biomarker for the role of apoptosis in periodontal disease. However, further studies are required to explore the mechanism and understand the relationship between these apoptotic markers and periodontitis.
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Affiliation(s)
- Manonmani Pavithra Ravindran
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, Tamil Nadu, India
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Mohit J, Ari G, Mahendra J, Prakash P, Bedi M, Dave PH, Logaranjani A, Namasivayam A. Determination of serum and gingival crevicular fluid levels of omentin in healthy and rheumatoid arthritis subjects with and without periodontitis. Oral Dis 2023. [PMID: 37498907 DOI: 10.1111/odi.14695] [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: 04/13/2023] [Revised: 06/06/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE The aim of this study was to assess and correlate the serum and GCF levels of omentin with the periodontal status of rheumatoid arthritis (RA) patients with and without periodontitis. METHODS Forty-four patients were divided into four groups: group H: 11 systemically and periodontally healthy subjects; group P: 11 systemically healthy subjects with periodontitis; group RA: 11 periodontally healthy subjects with rheumatoid arthritis and group RA + P: 11 rheumatoid arthritis subjects with periodontitis. Periodontal parameters (plaque index, modified gingival index, probing depth, and clinical attachment level) were recorded and serum and GCF samples were collected for the estimation of omentin using ELISA. RESULTS The mean value of plaque index, modified gingival index, probing depth, and clinical attachment level were significantly higher whereas serum and GCF omentin levels were found to be decreased in group IV when compared to the other groups. The significant correlation was found between the serum and GCF omentin levels with all the periodontal parameters. CONCLUSION The omentin level in serum and GCF was found to be lower in RA patients with periodontitis. It is also inversely correlated with the periodontal parameters. Thus, omentin can serve as a significant diagnostic and therapeutic tool in both periodontal and rheumatoid disease.
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Affiliation(s)
- Jyothi Mohit
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Geetha Ari
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Prashanthi Prakash
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Muskan Bedi
- Department of Basic Medical Sciences, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Pavithra H Dave
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Anitha Logaranjani
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
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Mahendra J, Muralidharan J, Srinivasan S, Mahendra L, Cherian SM, Fathima L, Prakash P, Namasivayam A, Dave PH, Bedi M, Muralidharan H. Calprotectin and periostin levels in periodontitis patients with coronary artery disease. Oral Dis 2023. [PMID: 37499075 DOI: 10.1111/odi.14686] [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: 05/02/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE The aim of the study was to assess the effect of non-surgical periodontal therapy (NSPT) on periodontal and cardiac parameters as well as on the expression of calprotectin and periostin levels in periodontitis patients with and without coronary artery disease (CAD). METHODS Ninety subjects were categorised into three groups: Group H: periodontally and systemically healthy subjects, Group P: stage III grade B periodontitis subjects with no associated systemic diseases and Group P + CAD: stage III grade B periodontitis subjects diagnosed with CAD. Demographic, periodontal and cardiac parameters were recorded at baseline (0 day) and on the 180th day after NSPT. Gingival crevicular fluid was collected from all participants at baseline (0 day) and after the 180th day. Calprotectin and periostin expression were reassessed. RESULTS A significant increase in the levels of calprotectin (34.05 ± 11.72) was seen at baseline in the P + CAD group, whereas on the contrary, a decreased periostin (1.59 ± 0.41) was also noted at baseline. The study also showed a significant improvement in periodontal and cardiac parameters on the 180th day following NSPT. CONCLUSION Detection of calprotectin and periostin expression in GCF samples could represent a link to the association of periodontitis and CAD.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Janani Muralidharan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Sruthi Srinivasan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Sanjay M Cherian
- Department of Cardiac Surgery, Frontier Lifeline Hospital, Chennai, India
| | - Lubna Fathima
- Department of Periodontology, Madha Dental College, Chennai, India
| | - Prashanthi Prakash
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | | | - Pavithra H Dave
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Muskan Bedi
- Department of Basic Medical Sciences, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Harini Muralidharan
- Department of Pharmacy, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Bains VK, Mahendra J, Mahendra L, Mittal M, Gunam V. Quantitative Association of Platelet-Rich Fibrin (PRF) and Hyperacute Serum (HAS) with Glycemic Control (HbA1c) in Chronic Periodontitis Patients: An Ex vivo Study. J Pharm Bioallied Sci 2023; 15:S601-S607. [PMID: 37654372 PMCID: PMC10466603 DOI: 10.4103/jpbs.jpbs_428_22] [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: 09/30/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 09/02/2023] Open
Abstract
Aim To evaluate correlation of PRF and HAS with glycemic control (HbA1c) and other systemic parameters amongst the chronic periodontitis patients. Materials and Methods Twenty-seven non-smoker, non-tobacco users, non-alcoholic moderate chronic periodontitis volunteers (Stage II, Grade A or B), aging between 40 and 50 years of both genders with type 2 diabetes mellitus (T2DM, HbA1c >6.5%) or without T2DM (HbA1c <6.5%), were recruited. After recording vitals and demographic parameters, 20 ml of intravenous fasting blood was collected, of which 11 ml blood was used for investigating complete blood count, lipid profile, glycated hemoglobin (HbA1c), C-reactive protein, and fasting insulin level. As per the standard protocol, PRF and HAS was prepared from the 9-ml blood sample of the patients. PRF obtained was quantified using Wensar's analytical balance with a readability of 0.0001 g. Prepared HAS from the fibrin clot was quantified using a micropipette and stored in 2 ml Eppendorf vials. Results Mean values of PRF and HAS obtained in the study were 2.0089 ± 0.844 g (ranged between 0.0 g and 3.968 g) and 1.540 ± 0.552 ml (ranged between 0.00 and 3.500 ml), respectively. The amount of PRF and HAS obtained were significantly higher in non-diabetic patients (mean 2.3093 g and 1.743 ml, respectively) as compared to diabetic patients (mean 1.5762 g and 1.266 ml, respectively). Results suggested a significant correlation between HbA1c level and quantification of PRF (P=0.007) and HAS (P=0.037), whereas no correlation was observed between HbA1c levels and hematologic, lipid, and demographic parameters. Conclusion Within the limitation of the present study, it can be concluded that a significant correlation exists between the HbA1c level and quantification of PRF and HAS.
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Affiliation(s)
- Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University College, Dubai, United Arab Emirates
| | - Madhukar Mittal
- Department of Endocrinology and Metabolism, AIIMS, Jodhpur, Rajasthan, India
| | - Valli Gunam
- College of Allied Health Sciences, Sri Venkateswaraa University, Chennai, Tamil Nadu, India
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10
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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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Mahendra J, Mahendra L, Divya D, Ilango P, Devarajan N, Thanigaimalai A. Association of Epstein-Barr virus, cytomegalovirus and lipocalin with periodontitis in type 2 diabetic subjects. Oral Dis 2023; 29:1163-1171. [PMID: 34850506 DOI: 10.1111/odi.14091] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 07/28/2020] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The current study aims to evaluate and compare the lipocalin, adiponectin and periodontal viruses in the generalized periodontitis patients with and without diabetes mellitus. MATERIALS AND METHODS Seventy subjects were grouped into 35 systemically healthy (GP) and 35 patients with diabetes mellitus (GP+DM). The periodontal parameters, demographic and diabetic variables were evaluated in both the groups. The subgingival tissue samples were procured from the diseased sites and were analysed for the detection of EBV, CMV, HSV and protein markers by real-time polymerase chain reaction (RT-PCR) and lipocalin and adiponectin were identified by enzyme-linked immunosorbent assay (ELISA). RESULTS The demographic variables such as age and BMI did not differ between the groups. PI and CAL were found to be significantly higher in GP+DM (p < 0.05). EBV (82.9%), CMV (71.4%) and protein marker: lipocalin were also found to be statistically highly significant in GP+DM and adiponectin was found to be higher in GP group and reduced in GP+DM group (p < 0.0001). CONCLUSION The increased prevalence of EBV and CMV and lipocalin with reduced levels of adiponectin in patients with diabetes and periodontitis which may show aggravation of the diabetic status of the periodontitis patients thereby reinforcing a strong Periodontitis-DM continuum.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Little Mahendra
- Department of Periodontics, Maktoum bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Dhana Divya
- Department of Periodontics, Sri Ramachandra Dental College and Hospital, Chennai, India
| | - Paavai Ilango
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
| | - Nalini Devarajan
- Central research laboratory, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Abirami Thanigaimalai
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
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14
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Devarajan N, Nathan J, Mathangi R, Mahendra J, Ganesan SK. Pharmacotherapeutic values of berberine: A Chinese herbal medicine for the human cancer management. J Biochem Mol Toxicol 2023; 37:e23278. [PMID: 36588295 DOI: 10.1002/jbt.23278] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/27/2022] [Accepted: 12/02/2022] [Indexed: 01/03/2023]
Abstract
Berberine (BBR), a traditional Chinese phytomedicine extracted from various parts of Berberis plants, is an isoquinoline alkaloid used for centuries to treat diabetes, hypercholesterolemia, hypertension, and so forth. It has recently received immense attention worldwide to treat cancer due to its potent pro-apoptotic, antiproliferative, and anti-inflammatory properties. BBR efficiently induces tumor apoptosis, replicative quiescence and abrogates cell proliferation, epithelial-mesenchymal transition, tumor neovascularization, and metastasis by modulating diverse molecular and cell signaling pathways. Furthermore, BBR could also reverse drug resistance, make tumor cells sensitive to current cancer treatment and significantly minimize the harmful side effects of cytotoxic therapies. This review comprehensively analyzed the pharmacological effects of BBR against the development, growth, progression, metastasis, and therapy resistance in wide varieties of cancer. Also, it critically discusses the significant limitations behind the development of BBR into pharmaceuticals to treat cancer and the future research directions to overcome these limitations.
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Affiliation(s)
- Nalini Devarajan
- Central Research Laboratory, Meenakshi Academy of Higher Education and Research - MAHER (Deemed to be University), Chennai, Tamilnadu, India
| | - Jhansi Nathan
- Zebrafish Developmental Biology Laboratory, AUKBC Research Centre for Emerging Technologies, Anna University, Chennai, Tamil Nadu, India
| | - Ramalingam Mathangi
- Department of Biochemistry, Sree Balaji Dental College and Hospital, BIHER, Chennai, Tamil Nadu, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Senthil Kumar Ganesan
- Laboratory of Functional Genomics, Structural Biology & Bioinformatics Division, CSIR-Indian Institute of Chemical Biology, Kolkata, West Bengal, India
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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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16
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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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17
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Mahendra J, Srinivasan S, Kanakamedala A, D N, Namasivayam A, Mahendra L, Muralidharan J, Cherian SM, Ilango P. Expression of trefoil factor 2 and 3 and adrenomedullin in chronic periodontitis subjects with coronary heart disease. J Periodontol 2022; 94:694-703. [PMID: 36565448 DOI: 10.1002/jper.22-0467] [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: 08/10/2022] [Revised: 11/05/2022] [Accepted: 11/30/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND The current study aims to determine the expression of trefoil factor 2 (TFF2), trefoil factor 3 (TFF3), and adrenomedullin (ADM) in salivary samples of periodontitis patients with and without coronary heart disease (CHD). METHODOLOGY A total of 75 patients were selected based on the inclusion and exclusion criteria and divided into three groups of 25 patients each: generalized periodontitis (GP) only; GP+CHD; and CHD only. Demographic, periodontal, and cardiac parameters were recorded, and unstimulated saliva samples were collected and analyzed for the expression of TFF2, TFF3, and ADM. RESULTS Among the demographic variables, the means for age, weight, and body mass index were significantly different between the groups on statistical analysis. Plaque index, bleeding on probing, probing pocket depth, clinical attachment level, and the expression of TFF2 were highest in the GP+CHD group, and ADM was highest in the CHD group, with P values of < 0.01 as compared to the other groups. TFF2, TFF3, and ADM were also correlated with the demographic and periodontal parameters. CONCLUSIONS The study demonstrates significantly elevated levels of TFF2 in CHD and GP patients, and a higher expression of ADM in CHD patients only, suggesting the possibility of an underlying inflammatory mechanism.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Sruthi Srinivasan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Anilkumar Kanakamedala
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Nalini D
- Central Research Laboratory, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Ambalavanan Namasivayam
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Little Mahendra
- Dean, Department of Periodontics, Maktoum bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Janani Muralidharan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Sanjay M Cherian
- Dr. K.M. Cherian's Frontier Lifeline Hospitals, Chennai, Tamil Nadu, India
| | - Paavai Ilango
- Department of Periodontics, Priyadharshini Dental College and Hospital, Thiruvallur, Chennai, Tamil Nadu, India
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18
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Mahendra J, Mahendra L, Sharma V, Alamoudi A, Bahammam HA, Mugri MH, Bahammam SA, Bahammam MA, Zidane B, Abirami Nayaki RP, Muralidharan J, Dave PH, Balaji TM, Bhandi S, Patil S. Red-Complex Bacterial Levels in Pregnant Women With Preeclampsia and Chronic Periodontitis. Int Dent J 2022:S0020-6539(22)00229-5. [DOI: 10.1016/j.identj.2022.10.003] [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] [Received: 06/13/2022] [Revised: 09/10/2022] [Accepted: 10/08/2022] [Indexed: 11/19/2022] Open
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19
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Suresh S, Mahendra J, Saketharaman P, Sivsankar P, Selvakumar J, Elangovan R. Evaluation of Reactive Oxygen Metabolites, Resistin, and Red Complex Bacteria in Obese Subjects with or without Periodontitis. J Contemp Dent Pract 2022; 23:703-708. [PMID: 36440516] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
AIM The study's aim was to assess and compare the clinical parameters, plasma reactive oxygen metabolites (ROM) levels, gingival crevicular fluid (GCF) resistin, serum resistin values, and red complex bacteria in obese or overweight subjects with and without periodontitis and also to determine the effect of non-surgical periodontal therapy (NSPT) on plasma ROM, serum, and GCF resistin values in obese or overweight subjects with chronic periodontitis. MATERIAL AND METHODS A total of 160 subjects were recruited and designated into four groups with 40 subjects each as group I - obese with chronic periodontitis; group II - normal weight subjects with chronic periodontitis; group III - obese subjects with healthy periodontium; and group IV - normal weight subjects with healthy periodontium. The periodontal parameters, plasma ROM, GCF resistin and serum resistin, and red complex bacteria levels were estimated at baseline. After baseline assessment, scaling and root planing (SRP) were done in the patients of groups I and II. Two months after the completion of SRP, clinical parameters such as plaque index (PI), probing pocket depth (PPD), gingival index (GI), and clinical attachment loss (CAL), plasma ROM levels, serum resistin, and GCF resistin levels were analyzed. RESULTS An increase in plasma ROM, GCF resistin, and red complex bacteria levels was observed in obese subjects with periodontal disease and the increase was noted in obese subjects with healthy periodontium. Comparing plasma ROM, GCF resistin values between groups I and II, 2 months after SRP, a decrease in these levels were observed in group II. CONCLUSION Our study results depict that obesity can be considered as a risk indicator for periodontal disease. CLINICAL SIGNIFICANCE Obesity has a negative impact on both general health and oral health. Promoting appropriate physical activity, healthy eating behavior, and oral hygiene practice are fundamental elements of the prevention of both obesity and periodontal disease.
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Affiliation(s)
- Snophia Suresh
- Department of Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
| | - Parthiban Saketharaman
- Department of Periodontics, Adhiparasakthi Dental College, Melmaruvathur, Tamil Nadu, India, Phone: +91 9884299618, e-mail:
| | - P Sivsankar
- Department of Periodontics, Tamilnadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - J Selvakumar
- Department of Periodontics, Adhiparasakthi Dental College, Melmaruvathur, Tamil Nadu, India
| | - Ramnath Elangovan
- Department of Periodontics, Adhiparasakthi Dental College, Melmaruvathur, Tamil Nadu, India
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Mahendra J, Palathingal P, Mahendra L, Alzahrani KJ, Banjer HJ, Alsharif KF, Halawani IF, Muralidharan J, Annamalai PT, Verma SS, Sharma V, Varadarajan S, Bhandi S, Patil S. Impact of Red Complex Bacteria and TNF-α Levels on the Diabetic and Renal Status of Chronic Kidney Disease Patients in the Presence and Absence of Periodontitis. Biology (Basel) 2022; 11:451. [PMID: 35336824 PMCID: PMC8945045 DOI: 10.3390/biology11030451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Scientific evidence shows a positive association in the etiopathogenesis of periodontitis and chronic kidney disease (CKD). Various confounding factors, such as obesity, diabetes, and inflammation, also play a significant role in the progression of CKD, which remains unexplored. We hypothesise the role of red complex bacteria with various confounding factors associated with chronic kidney disease. The study comprised a total of 120 participants categorised into 4 groups: the control group (C), periodontitis subjects without CKD (P), periodontally healthy chronic kidney disease subjects (CKD), and subjects having both periodontitis and CKD (P + CKD), with 30 subjects in each group. Demographic variables, and periodontal, renal, and diabetic parameters were recorded. Tumour necrosis factor (TNF)-α levels and those of red complex bacteria such as Prophyromonas gingivalis (P.g), Treponema denticola (T.d), and Tonerella forsythia (T.f) were assessed, and the obtained results were statistically analysed. Among the various demographic variables, age showed a level of significance. Mean PI, GI, CAL, and PPD (the proportion of sites with PPD ≥ 5 mm and CAL ≥ 3 mm) were elevated in the P + CKD group. Diabetic parameters such as fasting blood sugar (FBS) and HbA1c levels were also greater in the P + CKD group. Renal parameters such as eGFR and serum creatinine levels were greater in CKD patients. The estimation of red complex periodontal pathogens such as Pg, Td and Tf levels were significantly greater in the P and P + CKD groups. Pearson correlation analysis revealed significant correlation of red complex bacteria with all variables. Greater levels of P.g, T.d and T.f were found in the P groups, thus indicating their important role in the initiation and progression of inflammation of periodontitis and CKD, with diabetes as one of the confounding factors. The study also confirmed a log-linear relationship between TNF-α levels and red complex bacteria, thereby demonstrating the role of inflammatory biomarkers in periodontal disease progression that could contribute to the development of systemic inflammation such as CKD.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Greater Education and Research, Chennai 600095, India;
| | - Plato Palathingal
- Department of Periodontics, PSM College of Dental Science and Research, Thrissur 680519, India;
| | - Little Mahendra
- Department of Periodontics, Dean, Maktoum Bin Hamdan Dental University, Dubai 122002, United Arab Emirates;
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Hamsa Jameel Banjer
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Khalaf F. Alsharif
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Ibrahim Faisal Halawani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (K.J.A.); (H.J.B.); (K.F.A.); (I.F.H.)
| | - Janani Muralidharan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Greater Education and Research, Chennai 600095, India;
| | | | - Shyam Sankar Verma
- Department of Nephrology, Jubilee Medical College Hospital, Thrissur 680005, India;
| | - Vivek Sharma
- Department of Periodontics, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh 114141, India;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
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21
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Ilango P, Mahendra J, Mahendra L, Cherian SM, Suresh V, Mahalingam A, Khanna VV, Abirami T. Evaluation of the periodontal viruses in cardiovascular patients associated with periodontitis. Oral Dis 2022; 29:1826-1835. [PMID: 35229412 DOI: 10.1111/odi.14175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/24/2022] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The current study aims in evaluating the prevalence of Epstein-barr virus (EBV), Cytomegalovirus (CMV) and Herpes simplex virus (HSV) in periodontitis and/or Coronary artery disease (CAD) patients to compare with their healthy controls and insist their significance in the same. METHODOLOGY Two hundred and forty patients were divided into 4 groups. Non-periodontitis+non-cardiac (NP+NC) =60 patients, periodontitis+non-cardiac patients (P+NC)=60 patients, non-periodontitis+cardiac patients (NP+C)=60 patients and periodontitis+cardiac (P+C)=60 patients. Demographic variables, cardiac and periodontal parameters were recorded. EBV, CMV and HSV were evaluated in the sub- gingival plaque samples using RT-PCR (Real time polymerase chain reaction) and compared between the groups. The results were statistically analysed using Students t test, Pearson's chi square, Turkey post hoc analysis and multiple logistic regression analysis. RESULTS The demographic variables did not differ significantly between the groups, except for age. Systolic blood pressure, Diastolic blood pressure, Low density lipoprotein, Random blood sugar were significantly higher in NP+C and P+C (p≤0.05). The Plaque Index, Probing Pocket Depth and Clinical Attachment Loss (p≤0.05) were significantly higher in P+NC and P+C. EBV and CMV was significantly higher in the two periodontitis groups P+NC and P+C (p-value=0.000). HSV was significantly higher in the two cardiac groups (NP+C and P+C) (p≤0.05). Multiple logistic regression analysis revealed a significant association between EBV and CAL (p≤0.05). CONCLUSION The study concluded that higher prevalence of EBV and CMV were found in groups with periodontitis patients. This indicates the significant role of the viruses in periodontitis as confirmed by association of EBV and CAL. The viruses were said to be highest in periodontitis patients with CAD. This could pave a new link in the risk of CAD in periodontitis patients.
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Affiliation(s)
- Paavai Ilango
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, 600 095, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, 600 095, India
| | - Little Mahendra
- Department of Periodontics, Dean, Maktoum bin Hamdan Dental University, Dubai
| | - Sanjay M Cherian
- Department of Cardiac Surgery, Frontier Lifeline Hospital, Chennai, 600 037, India
| | | | - Arulpari Mahalingam
- Department of Pedodontics, Thai Moogambigai Dental College and Hospital, Chennai, 600 107, India
| | - V Vinoth Khanna
- Department of Animal Biotechnology, Madras Veterinary college, VeperyS, Chennai, 600 007, India
| | - T Abirami
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, 600 095, India.,Department of Physiology, Priyadarshini Dental College and Hospital, Chennai, 600 095, India
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22
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Mahendra J, Sivapathasundharam B, Mahendra L, Chandrasekaran S, Srinivasan S, Muralidharan J, Balaji TM, Bhandi S, Patil S. Effectiveness of Online Learning vs Traditional Learning during COVID-19 Pandemic in Chennai: A Questionnaire Study. J Contemp Dent Pract 2022; 23:295-302. [PMID: 35781433] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Digitalization of education became a need of the hour when the COVID-19 pandemic affected the traditional modalities of learning, and it was widely implemented in various fields including dentistry. AIMS The aim of this study was to assess the effectiveness of online learning against traditional learning systems among dental students in Chennai. METHODS AND MATERIALS A Google Form questionnaire comprising 29 dental learning-based questions was designed and distributed to dental students across colleges in Chennai using online distribution platforms. The study responses were closed after the stipulated period of 1 month. The data were analyzed using SPSS software version 17. RESULTS The survey was answered by 834 participants comprising 76.9% females and 22.3% males. Of the total study population, 71.1% of them did not have previous online learning experiences. Approximately, 15.5% of the study population were not satisfied with the facilities provided by the online learning platforms. Also, one-third of the study population reported difficulty during the presentation. Three-fourths of the study participants did not prefer online learning over traditional learning and reported that the attention span and communication between the students and teachers were lower in online classes. Overall, 43% of the study participants rated the quality of online video-based learning to be good and 8.5% found it to be poor. CONCLUSION Online-based learning systems are evolving and can provide a wide array of knowledge from global experts. However, structured planning and technique may be needed for the dental curriculum.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontics, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India, e-mail:
| | | | - Little Mahendra
- Department of Periodontics, Maktoum Bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Shruthi Chandrasekaran
- Department of Periodontics, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Sruthi Srinivasan
- Department of Periodontics, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Janani Muralidharan
- Department of Periodontics, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Shilpa Bhandi
- Department of Restorative Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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23
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Shankar P, Chellathurai BNK, Kumar SA, Mahendra J, Mugri MH, Sayed M, Almagbol M, Al Wadei MHD, Vijayalakshmi R, Ambalavanan N, Raj AT, Patil S. A Comparison in Patient Comfort Using Conventional Syringe and Needleless Jet Anesthesia Technique in Periodontal Surgery—A Split-Mouth Randomized Clinical Trial. Medicina (B Aires) 2022; 58:medicina58020278. [PMID: 35208601 PMCID: PMC8880158 DOI: 10.3390/medicina58020278] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 01/29/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Periodontal surgery requires local anesthetic coverage to alleviate patient discomfort. Needles and injections can engender feelings of fear and anxiety in individuals. This study aimed to assess the level of comfort and anxiety in patients during the administration of local anesthesia using needleless jet anesthesia (JA) when compared to a conventional syringe (CS) in periodontal surgery. Method and Materials: 60 sites were designated for injection in a split-mouth design in 30 subjects who required periodontal surgery. Local anesthesia was administered in two appointments scheduled one week apart using either a JA system or a CS. The Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and Beck’s anxiety inventory were used to report the pain and anxiety levels while injecting local anesthesia. Statistical analysis of the results was performed using the Shapiro–Wilks test and Paired t-test. Results: Patients reported greater comfort with JA. The VAS and VRS values were statistically significant—(p = 0.003) and (p = 0.001), respectively. Patients showed fear and were nervous about receiving a local anesthetic using a CS. A few subjects experienced lingering pain with the CS, whereas greater comfort and no lingering soreness were reported post-operatively at the site of JA administration. Conclusion: This study provides the first comprehensive assessment of using JA for periodontal surgical procedures. Lower pain scores were consistently observed with the use of jet injectors. Patients were at ease and reported lesser anxiety and greater comfort with jet injectors, making it ideally suited for providing local anesthesia in periodontal surgery.
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Affiliation(s)
- Preethi Shankar
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - Burnice Nalina Kumari Chellathurai
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
- Correspondence: (B.N.K.C.); (S.P.)
| | - S. Ashok Kumar
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - Jaideep Mahendra
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - Maryam H. Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Mohammed Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Mohammad Almagbol
- Department of Community and Periodontics, Faculty of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | | | - Rajaram Vijayalakshmi
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - Namasivayam Ambalavanan
- Department of Periodontology, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Chennai 600095, India; (P.S.); (S.A.K.); (J.M.); (R.V.); (N.A.)
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Correspondence: (B.N.K.C.); (S.P.)
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24
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Palathingal P, Mahendra J, Annamalai PT, Varma SS, Mahendra L, Thomas L, Baby D, Jose A, Srinivasan S, R A. A Cross-Sectional Study of Serum Glutathione Peroxidase: An Antioxidative Marker in Chronic Periodontitis and Chronic Kidney Disease. Cureus 2022; 14:e22016. [PMID: 35340502 PMCID: PMC8913512 DOI: 10.7759/cureus.22016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background and aim: Oxidative stress as an individual risk for periodontitis and chronic kidney disease (CKD) has been elaborated through various mechanical pathways, yet its role in association with both diseases remains unexplored. Thus, the current study aims in evaluating serum glutathione peroxidase, an oxidative stress marker in CKD patients with periodontitis, and compare it with the healthy controls. Methodology: One hundred and twenty subjects were divided into four groups as control (C=30 subjects), periodontitis and non-CKD patients (CP=30 patients), non-periodontitis and CKD patients (CKD=30 patients), and periodontitis and CKD patients (CKD+CP=30 patients). Demographic variables, periodontal parameters, such as plaque index (PI), gingival index (GI), probing pocket depth (PPD), percentage proportion of sites with probing pocket depth more than 5 mm, clinical attachment loss (CAL), percentage proportion of sites with clinical attachment loss more than 3 mm and serum stress marker, and glutathione peroxidase were compared between the groups and the results were statistically analyzed. Results: The demographic variables did not differ significantly between the groups, except for age. The means PI, GI, PPD, percentage proportion of sites with probing pocket depth more than 5 mm, CAL, percentage proportion of sites with clinical attachment loss were higher in CKD+CP. The glutathione peroxidase was significantly higher in CP group (p=0.001) and significantly correlated with periodontal parameters. Conclusion: The oxidative stress marker glutathione peroxidase was higher in CP, followed by the CKD groups. This could pave a strong link of oxidative stress as a risk factor for chronic periodontitis, as well as chronic kidney disease.
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25
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Mahendra J, Bains V, Mahendra L, Mittal M, Valli G. Markers, pathways, and current evidence for periodontitis-associated insulin resistance: A narrative review. J Int Soc Prev Community Dent 2022; 12:475-487. [DOI: 10.4103/jispcd.jispcd_92_22] [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] [Received: 04/08/2022] [Revised: 07/26/2022] [Accepted: 08/16/2022] [Indexed: 11/07/2022] Open
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26
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Rajendran S, Srinivasan S, Mahendra J, Mahendra L, Dewan H, Ahmed ZH, Baeshen HA, Varadarajan S, Bhandi S, Patil S. Root Membrane Concept: Shield the Socket-A Case Report. J Contemp Dent Pract 2022; 23:100-104. [PMID: 35656666] [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: 06/15/2023]
Abstract
Edentulousness affects the mental health of most patients. Missing teeth in the anterior esthetic zones is a matter of concern, especially for young adults. Various replacement options such as fixed partial dentures, removable partial dentures, and dental implants are available to treat edentulousness. Dental implants have been a booming treatment option in modern-day dentistry as they more closely mimic the natural tooth. The most important criterion for placement of the implant in the esthetic zone is the conservation of alveolar bone, especially in the anterior region which is usually compromised due to tooth extraction or resorption of the ridge. The root membrane concept or the socket shield technique is a recently introduced concept in implant dentistry where a portion of the root acts as a shield to protect against alveolar bone resorption and maintain bone integrity, especially in the esthetic area. This case report describes the clinical management of fractured upper anterior teeth using a dental implant and the root membrane technique. Keywords: Anterior zone, Esthetics, Immediate implants, Implant, Missing teeth, Root membrane technique, Socket shield.
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Affiliation(s)
- Sathish Rajendran
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Sruthi Srinivasan
- 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, e-mail:
| | - Little Mahendra
- Dean of Research, Maktoum Bin Hamdan Dental University, Dubai, United Arab Emirates
| | - Harisha Dewan
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Zeeshan H Ahmed
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hosam A Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Shilpa Bhandi
- Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Science, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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27
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Mahendra J, Palathingal P, Mahendra L, Muralidharan J, Alzahrani KJ, Sayed M, Mugri MH, Almagbol M, Varadarajan S, Balaji TM, Bhandi S, Srinivasan S, Raj AT, Patil S. Isolated Systolic Blood Pressure and Red-Complex Bacteria-A Risk for Generalized Periodontitis and Chronic Kidney Disease. Microorganisms 2021; 10:50. [PMID: 35056499 PMCID: PMC8781149 DOI: 10.3390/microorganisms10010050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/13/2021] [Accepted: 12/24/2021] [Indexed: 12/29/2022] Open
Abstract
Hypertension is a risk factor for generalized periodontitis (GP) and chronic kidney diseases (CKD). However, the role of isolated systolic blood pressure as one of the major risks for these inflammatory diseases has not been explored. Very limited studies exist identifying the red-complex bacteria in association with the isolated systolic blood pressure. Hence, the main objective of this study was to assess the isolated systolic blood pressure and the red-complex bacteria along with the demographic variables, periodontal parameters, and renal parameters in patients with generalized periodontitis and chronic kidney disease. One hundred twenty participants (age 30-70 years) were divided into four groups-Group C: control (systemically and periodontally healthy subjects), Group GP: generalized periodontitis, Group CKD: subjects with CKD with good periodontal health, Group CKD + GP: subjects with both generalized periodontitis and CKD. Demographic variables and periodontal parameters were measured and recorded. Blood pressure measurements and a detailed history and renal parameters such as serum creatinine, eGFR, and fasting blood sugar were recorded. The red-complex bacteria (RCB) were assessed in the subgingival plaque samples of all four groups using RT-PCR. Older participants (above 50 years) showed worse periodontal scores in the CKD + GP group along with elevated isolated systolic blood pressure, higher serum creatinine, and fasting blood sugar. eGFR was significantly decreased compared to the other groups. Bacterial counts were higher in the GP + CKD group, suggesting that they may be at a higher risk for generalized periodontitis and chronic kidney disease. Isolated systolic blood pressure (ISBP) and RCB were significantly correlated with the renal and periodontal parameters. A log-linear relationship exists between periodontal disease, CKD, RCB, and isolated systolic hypertension levels.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai 600 095, Tamil Nadu, India; (J.M.); (S.S.)
| | - Plato Palathingal
- Department of Periodontics, Annoor Dental College, Ernakulam 686673, Kerala, India;
| | - Little Mahendra
- Research Department of Periodontics, Maktoum bin Hamdan Dental University, Dubai 213620, United Arab Emirates;
| | - Janani Muralidharan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai 600 095, Tamil Nadu, India; (J.M.); (S.S.)
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Mohammed Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Maryam H. Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Mohammad Almagbol
- Department of Community and Periodontics, Faculty of Dentistry, King Khalid University, Abha 62529, Saudi Arabia;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, Tamil Nandu, India; (S.V.); (A.T.R.)
| | | | - Shilpa Bhandi
- Department of Restorative Dental Science, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Sruthi Srinivasan
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai 600 095, Tamil Nadu, India; (J.M.); (S.S.)
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, Tamil Nandu, India; (S.V.); (A.T.R.)
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
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28
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Kumar A, Mahendra J, Mahendra L, Abdulkarim HH, Sayed M, Mugri MH, Ahmad ZH, Bhati AK, Faqehi HH, Algregri WO, Varadarajan S, Balaji TM, Baeshen HA, Patil S. Synergistic Effect of Biphasic Calcium Phosphate and Platelet-Rich Fibrin Attenuate Markers for Inflammation and Osteoclast Differentiation by Suppressing NF-κB/ MAPK Signaling Pathway in Chronic Periodontitis. Molecules 2021; 26:molecules26216578. [PMID: 34770985 PMCID: PMC8587053 DOI: 10.3390/molecules26216578] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Periodontitis is characterized by excessive osteoclastic activity, which is closely associated with inflammation. It is well established that MAPK/NF-kB axis is a key signaling pathway engaged in osteoclast differentiation. It is stated that that biphasic calcium phosphate (BCP) and platelet-rich fibrin (PRF) have significant antiostoeclastogenic effects in chronic periodontitis. Objective: We aimed to elucidate the synergetic effect of PRF/BCP involvement of the nuclear factor kappa–light–chain–enhancer of activated B cells (NF-kB) and the mitogen-activated protein kinase (MAPK) signaling pathway in osteoclast differentiation in chronic periodontitis. Methods: We induced osteoclast differentiation in vitro using peripheral blood mononuclear cells (PBMCs) derived from patients with chronic periodontitis. We assessed osteoclast generation by tartrate-resistant acid phosphatase (TRAP) activity, proinflammatory cytokines were investigated by ELISA and NF-κB, and IKB by immunoblot, respectively. MAPK proteins and osteoclast transcription factors were studied by Western blot analysis and osteoclast transcriptional genes were assessed by RT-PCR. Results: The results showed that the potent inhibitory effect of PRF/BCP on osteoclastogenesis was evidenced by decreased TRAP activity and the expression of transcription factors, NFATc1, c-Fos, and the osteoclast marker genes, TRAP, MMP-9, and cathepsin-K were found to be reduced. Further, the protective effect of PRF/BCP on inflammation-mediated osteoclastogenesis in chronic periodontitis was shown by decreased levels of proinflammatory cytokines, NF-kB, IKB, and MAPK proteins. Conclusions: PRF/BCP may promote a synergetic combination that could be used as a strong inhibitor of inflammation-induced osteoclastogenesis in chronic periodontitis.
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Affiliation(s)
- Anil Kumar
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai 600095, India;
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai 600095, India;
- Correspondence: (J.M.); (S.P.)
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University College, Dubai 213620, United Arab Emirates;
| | - Hesham H. Abdulkarim
- Advanced Periodontal and Dental Implant Care, Missouri School of Dentistry and Oral Health, A. T. Still University, St. Louis, MO 63104, USA;
| | - Mohammed Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Maryam H. Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Zeeshan Heera Ahmad
- Dental College Hospital, King Saud University Medical City, Riyadh 12372, Saudi Arabia;
| | - Ashok Kumar Bhati
- Division of Periodontics Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | | | | | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Thodur Madapusi Balaji
- Department of Periodontology, Tagore Dental College and Hospital, Chennai 600127, India;
| | - Hosam Ali Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah 22254, Saudi Arabia;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
- Correspondence: (J.M.); (S.P.)
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29
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Mahendra J, Rao AN, Mahendra L, Sayed ME, Mugri MH, Balaji TM, Varadarajan S, Jagannathan R, Srinivasan S, Baeshen HA, Mathew R, Patil S. The Expression of Allele Changes in NLRP3 (rs35829419) and IL-1β (+3954) Gene Polymorphisms in Periodontitis and Coronary Artery Disease. Materials (Basel) 2021; 14:ma14175103. [PMID: 34501201 PMCID: PMC8433916 DOI: 10.3390/ma14175103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Inflammasomes have been shown to play a pivotal role in periodontal disease pathogenesis. However, their role in periodontitis subjects with coronary heart disease remains unclear. This study aimed to obtain the expression of NLRP3 (rs35829419) and IL-1β (+3954) gene polymorphisms in the subgingival plaque and blood samples of generalized periodontitis (GP) subjects with and without coronary heart disease (CHD). METHODS A total of 70 subjects were grouped into two; GP and GP with CHD. Demographic variables and periodontal and cardiac parameters were recorded from both the groups. Subgingival plaque and blood samples were obtained from both the groups and were further subjected to the identification of NLRP3 (rs35829419) and IL-1β (+3954) expression and allele change using a conventional polymerase chain reaction (PCR) and gene sequencing (Sanger's method). RESULTS Amongst the demographic variables, age and monthly income were statistically significant between the two groups. Plaque index (PI), clinical attachment level (CAL), high-density lipoprotein (HDL), and low density-lipoprotein (LDL) exhibited statistically significant levels between the two groups. The NLRP3 (rs35829419) and IL-1β (+3954) genes showed a statistically significant association with allele change (frequency) among the groups. The general comparison of all the parameters with the allele change of NLRP3 (rs35829419) and IL-1β (+3954) in the subgingival plaque and blood samples showed statistically significant associations among the two groups. CONCLUSION The present study highlighted an allele change in IL-1β (+3954) gene polymorphisms which may play an important role in the pathogenesis of periodontitis and coronary heart disease.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai 600095, India; (A.N.R.); (S.S.)
- Correspondence: (J.M.); (S.P.)
| | - Abirami Nayaki Rao
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai 600095, India; (A.N.R.); (S.S.)
| | - Little Mahendra
- Department of Periodontology, Maktoum Bin Hamdan Dental University College, Dubai 213620, United Arab Emirates;
| | - Mohammed E. Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Maryam H. Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Thodur Madapusi Balaji
- Department of Dentistry, Bharathiraja Hospital and Research Institute, Chennai 600017, India;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | | | - Sruthi Srinivasan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai 600095, India; (A.N.R.); (S.S.)
| | - Hosam Ali Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Reji Mathew
- College of Dental Medicine, Midwestern University, Downers Grove, IL 60515, USA;
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Correspondence: (J.M.); (S.P.)
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30
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Mahendra J, Mahendra L, Mugri MH, Sayed ME, Bhandi S, Alshahrani RT, Balaji TM, Varadarajan S, Tanneeru S, P. ANR, Srinivasan S, Reda R, Testarelli L, Patil S. Role of Periodontal Bacteria, Viruses, and Placental mir155 in Chronic Periodontitis and Preeclampsia-A Genetic Microbiological Study. Curr Issues Mol Biol 2021; 43:831-844. [PMID: 34449559 PMCID: PMC8929077 DOI: 10.3390/cimb43020060] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 12/24/2022] Open
Abstract
Previous studies assessed the involvement and impact of periodontal bacteria in preeclamptic women with chronic periodontitis. To explore further, the current study aimed to associate periodontal viruses and bacteria with mir155 levels in placental tissues of preeclamptic women with generalized chronic periodontitis. Four-hundred 45 pregnant women, 18-35 years of age, were selected and divided into four groups (controls, A, B, and C) where the Controls included 145 systemically and periodontally healthy pregnant women Group A-100 systemically healthy pregnant women with chronic periodontitis, Group B- 100 preeclamptic women with chronic periodontitis, Group C- 100 preeclamptic women without chronic periodontitis. Age, BMI, SES, and periodontal parameters such as PI, BOP, PPD, and CAL were noted. Periodontal pathogens such as Tf, Td, Pg, Pi, Fn, HSV, EBV, and HCMV were tested in subgingival plaque, placental tissues, and mir155. We observed that PI, BOP, PPD, CAL, Tf, and EBV were highly significant in Group B. We found a higher number of periodontal bacteria, viruses, and mir 155 in Group B showing a higher risk of preeclampsia. More genetic studies in this field are advised to ascertain the role of periodontopathogens and mir 155 in preeclampsia and periodontal inflammation. What is already known on this subject? Periodontal diseases pose an increased risk of developing preeclampsia and delivering preterm and/or low-birth-weight babies. What do the results of this study add? Periodontal variables such as PI, pocket depth, BOP, and clinical attachment levels, were found to be increased in the preeclamptic women with chronic periodontitis. The significant difference was seen in the relative fold expression of mir155 with higher gene expression of mir155 in groups B and A as compared to group C and controls. What are the implications of these findings for clinical practice and/or further research? In our study, mir155 correlation with the periodontal parameters and periodontal pathogens further strengthen the evidence of periodontal inflammation as a risk of preeclampsia in pregnant women especially when associated with chronic periodontitis. mir155 can be considered to be one of the genetic biomarkers and can be used as a diagnostic tool for the early detection of PE.
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Affiliation(s)
- Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai 600095, India; (A.N.R.P.); (S.S.)
- Correspondence: (J.M.); (S.P.)
| | - Little Mahendra
- Department of Periodontology, Maktoum Bin Hamdan Dental University College, Dubai 213620, United Arab Emirates;
| | - Maryam H. Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Mohammed E. Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | | | | | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Swetha Tanneeru
- Department of Periodontics, Narayana Dental College and Hospital, Nellore 534003, Andhra Pradesh, India;
| | - Abirami Nayaki Rao P.
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai 600095, India; (A.N.R.P.); (S.S.)
| | - Sruthi Srinivasan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai 600095, India; (A.N.R.P.); (S.S.)
| | - Rodolfo Reda
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00161 Rome, Italy; (R.R.); (L.T.)
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences, University of Rome La Sapienza, 00161 Rome, Italy; (R.R.); (L.T.)
| | - Shankargouda Patil
- Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
- Correspondence: (J.M.); (S.P.)
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Grover V, Mahendra J, Gopalakrishnan D, Jain A. Effect of octenidine mouthwash on plaque, gingivitis, and oral microbial growth: A systematic review. Clin Exp Dent Res 2021; 7:450-464. [PMID: 34227746 PMCID: PMC8404485 DOI: 10.1002/cre2.386] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on plaque formation, gingivitis, and oral microbial growth in subjects with or without periodontal disease. MATERIALS AND METHODS PubMed/MEDLINE, ScienceDirect, Google Scholar, and Cochrane Library were searched for relevant studies. The review was conducted per PRISMA guidelines. Only randomized controlled trials and observational studies comparing octenidine with placebo or other mouthwashes in healthy subjects with or without periodontal disease, were considered for this review. The endpoints included percentage reduction in plaque index (PI), gingival index (GI), absolute reduction in the mean number of colony-forming units (CFU/ml [log10 ]) and adverse effects (AEs; tooth staining/mucosal tolerance). RESULTS Ten randomized controlled and six observational studies fulfilled the selection criteria. Twice or thrice daily rinsing with 0.1% octenidine for 30-60 s produced significant reduction in plaque, gingivitis and oral microbial growth. Compared to control mouthwash or baseline, 0.1% octenidine inhibited plaque formation by ~38.7%-92.9%, which was either equal or greater than that of chlorhexidine gluconate. 0.1% octenidine reduced gingivitis by ~36.4%-68.37% versus control mouthwash or baseline and microbial growth by 0.37-5.3 colony-forming units (vs. chlorhexidine: 0.4-4.23 colony-forming units). Additional benefits of 0.1% octenidine were significant reduction in the number of bleeding sites, papilla bleeding index, sulcus bleeding index, and gingival fluid flow. CONCLUSION Within the limitations of this study, there exists moderate evidence that 0.1% OCT was found to be an effective antiplaque agent. Octenidine inhibited plaque formation upto 93% and gingivitis upto 68% versus placebo and was either superior or comparable to chlorhexidine. Octenidine was well-tolerated and safe and can be an effective alternative to CHX and other contemporary mouthwashes.
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Affiliation(s)
- Vishakha Grover
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital, Panjab university, Chandigarh, Punjab, India
| | - Jaideep Mahendra
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Ashish Jain
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital, Panjab university, Chandigarh, Punjab, India
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Gopichandran L, Srivastsava AK, Vanamail P, Kanniammal C, Valli G, Mahendra J, Dhandapani M. Effectiveness of Progressive Muscle Relaxation and Deep Breathing Exercise on Pain, Disability, and Sleep Among Patients With Chronic Tension-Type Headache: A Randomized Control Trial. Holist Nurs Pract 2021; Publish Ahead of Print:00004650-900000000-99942. [PMID: 34054116 DOI: 10.1097/hnp.0000000000000460] [Citation(s) in RCA: 1] [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: 11/25/2022]
Abstract
A randomized control trial was conducted to assess the effectiveness of progressive muscle relaxation and deep breathing exercises on pain, disability, and sleep quality among patients with chronic tension-type headache. Of the 169 randomly selected patients, 84 performed the intervention and reported less pain severity and disability and better sleep quality after 12 weeks.
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Affiliation(s)
- Lakshmanan Gopichandran
- College of Nursing (Dr Gopichandran), Neurology Department (Dr Srivastsava), and Biostatistics Department (Dr Vanamail), All India Institute of Medical Sciences (AIIMS), New Delhi, India; SRM College of Nursing, Chennai, India (Dr Kanniammal); Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research (MAHER), Chennai, India (Drs Valli and Mahendra); and National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India (Dr Dhandapani)
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Balaji TM, Varadarajan S, Jagannathan R, Mahendra J, Fageeh HI, Fageeh HN, Mushtaq S, Baeshen HA, Bhandi S, Gupta AA, Raj AT, Reda R, Patil S, Testarelli L. Melatonin as a Topical/Systemic Formulation for the Management of Periodontitis: A Systematic Review. Materials (Basel) 2021; 14:ma14092417. [PMID: 34066498 PMCID: PMC8124881 DOI: 10.3390/ma14092417] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/29/2021] [Accepted: 05/02/2021] [Indexed: 01/23/2023]
Abstract
Objectives: To qualitatively and quantitatively review the use of melatonin as a topical/systemic formulation for the management of periodontitis. Materials and methods: PubMed; Scopus; and Web of Science databases were searched using the MesH terms “melatonin” and “periodontitis”. Title and abstracts were screened to eliminate irrelevant and duplicate articles. The full text data of the screened articles were assessed using the selection criteria. Results: Of 176 identified articles (PubMed-66; Scopus-56; Web of Science-52; Cross-reference-2), only 12 studies qualified to be included in the systematic review. Four studies assessed the independent effect of 1% topical melatonin formulation while 8 articles assessed the adjunctive use of systemic melatonin formulation (1–10 mg) following scaling and root planing (SRP). All studies showed an improvement in periodontal parameters such as pocket depth, clinical attachment loss, periodontal disease index, community periodontal index, gingival bleeding scores, and prognostic marker levels in saliva and serum. A meta-analysis of data from 2 studies revealed that 1–2 mg (systemic) melatonin supplementation reduced pocket depth; although the difference was not statistically significant and hence cannot be interpreted or used for conclusive evidence. Risk of Bias Assessment tool (RoBANS) and Cochrane Collaboration RoB tool elicited a high risk of bias in the included studies. GRADE (recommendation assessment, development, and evaluation) inferred a weak recommendation for the use of melatonin in periodontitis management. Conclusions: Melatonin supplementation (topical and systemic) in periodontitis patients improved key periodontal parameters including pocket depth and clinical attachment loss. Clinical relevance: Melatonin could be a potential host modulatory agent for periodontitis management; although the data from the present review should be interpreted carefully due to the associated high risk of bias.
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Affiliation(s)
- Thodur Madapusi Balaji
- Department of Dentistry, Bharathiraja Hospital and Research Institute, Chennai 600017, India;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (S.V.); (A.T.R.)
| | | | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Chennai 600095, India;
| | - Hammam Ibrahim Fageeh
- Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (H.I.F.); (H.N.F.)
| | - Hytham N. Fageeh
- Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia; (H.I.F.); (H.N.F.)
| | - Shazia Mushtaq
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Hosam Ali Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia;
| | - Archana A. Gupta
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital Dr. D. Y. Patil Vidyapeeth, Pune 411018, India;
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (S.V.); (A.T.R.)
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (L.T.)
| | - Shankaragouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
- Correspondence:
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (L.T.)
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Perumalsamy R, Mahendra J, Mahendra L, Sethuraman M, Kavyasri, Rao VM. Protective role of neutrophils in periodontal inflammation. Indian J Dent Res 2021; 31:872-876. [PMID: 33753656 DOI: 10.4103/ijdr.ijdr_106_19] [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] [Indexed: 11/04/2022] Open
Abstract
Aim The quantification of neutrophils in blood is done to primarily screen the patients with acute infections. On the other hand, the neutrophils have also shown the antimicrobial activity by allowing the host cells to perform the primary function of preventing the wounds from being infected. The aim of this study was to quantify the blood neutrophil count in patients with chronic gingivitis and chronic periodontitis and to compare with the healthy controls in order to assess the protective role of neutrophils in periodontal inflammation. Methods and Material A total of 30 subjects in the age group of 30-55 years were selected. Based on the clinical examination, the subjects were divided into three groups Group I (healthy), Group II (chronic gingivitis) and Group III (chronic periodontitis). The clinical parameters such as modified gingival index (MGI) and clinical attachment level (CAL) were recorded. Two millilitres of venous blood was collected from each participant in all the groups and the differential neutrophil counts were obtained using the Neubauer's chamber under a light microscope. One way ANOVA test was used to calculate the mean and standard deviation for MGI, CAL and blood neutrophil count among various groups. Results The mean neutrophil counts in the various study groups were 63.300, 64.100 and 60.800 in Group I, Group II and Group III, respectively. Though there was a decrease in the mean neutrophil count from Group II to Group III, there was no statistically significant difference between the groups. Conclusion In our study, there was no significant increase in neutrophil count in chronic periodontitis as compared to healthy controls, thereby explaining the protective role of neutrophils in periodontal inflammation.
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Affiliation(s)
- Rajapriya Perumalsamy
- Department of Periodontology, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Dubai, UAE
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Dubai, UAE
| | | | - Meenakshi Sethuraman
- Department of Dentistry, Meenak Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Kavyasri
- Department of Dentistry, Meenak Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - V Madhusudhan Rao
- Department of Physiology, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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Devarajan N, Jayaraman S, Mahendra J, Venkatratnam P, Rajagopal P, Palaniappan H, Ganesan SK. Berberine-A potent chemosensitizer and chemoprotector to conventional cancer therapies. Phytother Res 2021; 35:3059-3077. [PMID: 33559280 DOI: 10.1002/ptr.7032] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 08/18/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 12/14/2022]
Abstract
Chemotherapy and radiotherapy are mainstay treatments for cancer patients. However, their clinical outcomes are highly limited by the resistance of malignant tumors to these therapies and the incurrence of serious damages in vital organs. This in turn necessitates the development of adjunct drugs that overcomes chemo/radioresistance in refractory cancers and protects vital organs from the cytotoxic effects of cancer therapies. In recent years, Berberine (BBR), a natural isoquinoline alkaloid has garnered more attention due to its potent chemosensitizing and chemoprotective properties. BBR effectively sensitizes refractory cancers to chemotherapy and radiotherapy by ameliorating the diverse events underlying therapy resistance. Furthermore, it protects the heart, liver, lungs, and kidneys from severe damages caused by these therapies. In this review, we discuss the molecular mechanisms underlying the chemo/radiosensitizing and chemo/radioprotective potential of BBR during cancer treatment. Also, we highlight the limitations that hamper the clinical application of BBR as an adjunct drug and how novel innovations have been made in recent years to circumvent these challenges.
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Affiliation(s)
- Nalini Devarajan
- Central Research Laboratory, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Selvaraj Jayaraman
- Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College, and Hospital, Chennai, India
| | - Purushothaman Venkatratnam
- Central Research laboratory, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Ponnulakshmi Rajagopal
- Central Research Laboratory, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Hema Palaniappan
- Department of Pharmacology, Coimbatore Medical College, Coimbatore, India
| | - Senthil Kumar Ganesan
- Laboratory of Functional Genomics, Structural Biology & Bioinformatics Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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Ghorpade SR, Rajaram V, Mahendra J, Chelladurai BN, Namasivayam A. Evaluation of Salivary Procalcitonin and Macrophage Activating Factor in Generalised Chronic Periodontitis Patients with and without Type 2 Diabetes Mellitus. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/47123.15181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Periodontitis is a polymicrobial and multifactorial oral disease and is the sixth complication of diabetes mellitus. Early diagnosis is important, and the use of non invasive biomarkers are highly useful for this purpose. The level of Macrophage Activating Factor (MAF) and Procalcitonin (ProCT) corresponds to the intensity of the inflammatory response and the severity of infection; thereby indicating that an increase in concentration or persistence of high values is considered as a prognostic indicator for severity of infection with an adverse outcome. Aim: To assess the periodontal parameters and quantify the levels of MAF and ProCT in saliva samples of generalised chronic periodontitis subjects with and without type 2 diabetes mellitus and to correlate these levels with the periodontal parameters. Materials and Methods: The study was a single centre cross- sectional study carried out at the Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India, from November 2018 to November 2019. A total of 80 subjects with generalised severe chronic periodontitis were selected and divided into two groups. Group I comprised of 40 subjects who were diagnosed with generalised chronic periodontitis without type 2 diabetes mellitus, whereas group II comprised of 40 subjects with generalised chronic periodontitis who had already been diagnosed with type 2 diabetes mellitus. Periodontal parameters such as Plaque Index (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) were recorded. The collected samples were subjected to molecular analysis for evaluating ProCT and MAF using Enzyme-Linked Immunosorbent assay (ELISA). Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 25.1 (Chicago, USA Inc). Student’s Independent t-test was used to compare the mean values for the variables in the control and test group. The Pearson’s correlation test was used to evaluate correlation between all the variables. The p-value <0.05 was set as the level of significance. Results: On comparing the periodontal parameters between group I and group II, there was no significant difference between the groups p-value >0.05. The mean salivary ProCT level in group I and group II was 268.76±152.78 ng/mL and 785.75±244.37 ng/mL, respectively. The mean salivary MAF level in group I and group II was 7.15±2.02 ng/mL and 26.56±9.12 ng/mL, respectively. On comparing MAF and ProCT value between group I and group II, there was a statistically significant increase in group II (p-value <0.001) and a weak correlation value with the periodontal parameters was seen. Conclusion: There was a significant difference in levels of MAF and ProCT in saliva samples of generalised chronic periodontitis subjects with and without type 2 diabetes mellitus, however the periodontal variables in each group did not correlate with MAF and ProCT.
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Muthukumar S, Rajaram V, Mahendra J, Rao PAN, Nalinakumari CB. Serum and Salivary Sialic Acid and Nitric Oxide Levels Estimation and Comparison after Nonsurgical Periodontal Therapy in Generalised Chronic Periodontitis Patients. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/45760.14435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: An exigency for a biomarker arises to expeditiously detect the periodontal disease evolution and to advocate more robust therapy efficacy measurements. Nitric oxide and sialic acid have been proved to be potential inflammatory markers. Hence, the evaluation of the involvement of nitric oxide and sialic acid in periodontal disease will enable us to assimilate the aspect of the complex process of periodontal disease progression. Aim: To estimate and compare the effect of nonsurgical periodontal therapy on serum and salivary sialic acid and nitric oxide levels in generalised chronic periodontitis patients. Materials and Methods: This study was a case-control as well as an interventional study. The subjects for this study were recruited from the Meenakshi Ammal Dental College and Hospital, Chennai from April 2017 to October 2018. Hundred patients were selected for this study. Control group consisted of 50 periodontally healthy subjects and test group consisted of 50 generalised chronic periodontitis subjects. After blood and saliva sample collection for determination of salivary and serum sialic acid and nitric oxide levels, evaluation of periodontal parameters like plaque index, probing pocket depth and Clinical Attachment Level (CAL) was done. Then the test group subjects underwent nonsurgical periodontal therapy and on 90th day post SRP parameters were re-evaluated. The collected data were analysed with IBM SPSS Statistics software, Version 23.0. In the above statistical tool the probability value 0.05 was considered as significant level. Results: The mean difference of plaque index, probing pocket depth, CAL, serum sialic acid, salivary sialic acid, serum Nitric Oxide (NO) and salivary nitric oxide: between the control and test group at baseline was -2.05, -5.01 mm, -5.56 mm, -12.515 mg/dL, -11.97 mg/dL, -129.762 μMol/L and -78.978 μMol/L respectively; for the test group at baseline and 90 days after nonsurgical periodontal therapy was 1.332, 3.15 mm, 3.285 mm, 14.206 mg/dL, 12.76 mg/dL, 130.082 μMol/L, 82.004 μMol/L, respectively. All the values were statistically significant with p-value <0.001. Conclusion: Nonsurgical periodontal therapy led to a decrease in the serum and salivary sialic acid and nitric oxide levels in subjects with generalised chronic periodontitis. A decrease in biochemical parameters was associated with a reduction in probing pocket depth and gain in attachment level.
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Chand YB, Mahendra J, Jigeesh N, Mahendra L, Shivasubramanian L, Perika SB. Comparison of Stress Distribution and Deformation of Four Prosthetic Materials in Full-mouth Rehabilitation with Implants: A Three-dimensional Finite Element Study. J Contemp Dent Pract 2020; 21:1210-1217. [PMID: 33850065] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM This study aimed to compare the von Mises stress distribution and deformation on the implant, abutment, and abutment screw using metal-ceramic, zirconia, polyether ether ketone (PEEK), and Trinia as prosthetic materials for full-mouth cement-retained implant prosthesis using finite element analysis. MATERIALS AND METHODS Four, 3-dimensional mandibular models were designed using Solidworks software. Six conical implants of 4.5 × 11.5 mm, with an internal hexagonal abutment, were fabricated and placed. The physical properties of the implant components, bone, and crowns were simulated to mesh the three-dimensional finite element models. The bite was recorded, and various contact points were marked, on which 50 N loads were applied. The von Mises stress distribution and resultant deformation were analyzed using the finite element method. RESULTS Higher stress distribution was recorded on the implants, abutments, and abutment screws when zirconia and PEEK prosthesis were used in comparison to metal-ceramic and Trinia. In consideration of deformation, zirconia and Trinia resulted in higher deformation of the implant assembly, abutment, and abutment screw when compared to metal-ceramic and PEEK prosthesis. Anterior implants showed a higher deformation and stress distribution when compared to posterior implants for all four prosthetic materials. CONCLUSION Within the limitations of the study, metal-ceramic and Trinia showed less stress distribution, while metal-ceramic and PEEK exhibited less deformation on implant and its components. Hence in future, Trinia and PEEK along with metal-ceramic can be promising prosthetic materials of choice in full-mouth rehabilitation with implants. CLINICAL SIGNIFICANCE Considering the deformation and stress distribution on the implant and its components, the selection of prosthetic material in full-mouth rehabilitation has always been a challenge. Findings of the abovementioned cross-sectional observational study could give an overall insight into materials such as metal-ceramic and Trinia as materials of choice, which can provide a basis for future clinical trials.
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Affiliation(s)
- Yemineni Bhavan Chand
- Department of Dental and Oral Surgery, ASRAM Medical College, Hospital and Research Centre, Eluru, West Godavari, Andhra Pradesh, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India, Phone: +91 9444963973, e-mail:
| | - Nasina Jigeesh
- Department of Operations and Information Technology, IBS Hyderabad, ICFAI Foundation for Higher Education (A Deemed to be University), Hyderabad, Telangana, India
| | - Little Mahendra
- Department of Periodontology, Maktoum Bin Hamdan Dental University College, Dubai, UAE
| | - Lakshmi Shivasubramanian
- Department of Prosthodontics and Implantology, Meenakshi Academy of Higher Education and Research, Faculty of Dentistry, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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Ganesan SK, Venkatratnam P, Mahendra J, Devarajan N. Increased mortality of COVID-19 infected diabetes patients: role of furin proteases. Int J Obes (Lond) 2020; 44:2486-2488. [PMID: 32873908 PMCID: PMC7461147 DOI: 10.1038/s41366-020-00670-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/06/2020] [Accepted: 08/19/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Senthil Kumar Ganesan
- Laboratory of Functional Genomics, Structural Biology & Bioinformatics Division, CSIR-Indian Institute of Chemical Biology, TRUE Campus, CN Block-6, Sector V, Salt Lake, Kolkata, 700091, India. .,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
| | | | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Nalini Devarajan
- Central Research Laboratory, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Maduravoyal, Chennai, Tamil Nadu, India.
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Janardhanan S, Mahendra J, Mahendra L, Devarajan N. Cytotoxic Effects of Mangosteen Pericarp Extracts on Oral Cancer and Cervical Cancer Cells. Asian Pac J Cancer Prev 2020; 21:2577-2583. [PMID: 32986355 PMCID: PMC7779451 DOI: 10.31557/apjcp.2020.21.9.2577] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Despite immense advancements in treatment modalities, cancer remains a dreadful disease until the present. The major influencing factors behind the increased mortality rate of cancer are increased drug resistance and severe adverse effects caused by conventional cancer therapies. To overcome these limitations, the current medical field is focusing more on natural phyto-derived molecules to mitigate cancer. Mangosteen is a phytotherapeutic with potent anti-inflammatory and antioxidant properties. In the present study, we investigated the anticancer potential of the crude ethanolic extract of mangosteen against two dreadful forms of cancers, namely, oral cancer and cervical cancer, in vitro. Methodology: The pericarp of Garcinia mangostana or mangosteen was removed, air-dried, ground to fine powder, and macerated with ethanol. The extract obtained was then filtered and extracted with water for 48 h. The aqueous fraction thus obtained was then concentrated with a rotary evaporator at 40°C and dried with a freeze dryer. The anticancer efficacy of these extracts was investigated in human tongue squamous cell carcinoma (H357) cells and cervical cancer cells (HeLa) using the MTT assay, TUNEL assay, western blotting, and flow cytometry techniques. Results: The crude mangosteen pericarp extract (MPE) significantly inhibited the growth of H357 and HeLa cells in a dose-dependent manner. Moreover, mangosteen induced early apoptosis in these cells after 48 h of incubation. Mangosteen also upregulated the expression of pro-apoptotic proteins, including caspases and Bax, and downregulated the expression of anti-apoptotic protein Bcl-2. Conclusion: The MPE exerted significant cytotoxicity against the H357 and HeLa cells in a dose-dependent manner and promoted their apoptosis. Hence, this natural phytoextract can be considered a potent anticancer agent for treating oral cancer and cervical cancer.
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Affiliation(s)
- Sunitha Janardhanan
- Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Jaideep Mahendra
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research Meenakshi Ammal Dental College and Hospital Chennai Chennai, India
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University College, Dubai, United Arab Emirates
| | - Nalini Devarajan
- Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College and Hospital, Chennai, India
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Sunitha J, Mahendra J, Mahendra L, Devaraj N. Molecular docking studies of α-mangostin with oral cancer targets ARRB1, FLNA, CALM3 and HTT. Bioinformation 2020; 16:625-630. [PMID: 33214751 PMCID: PMC7649016 DOI: 10.6026/97320630016625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 07/29/2020] [Indexed: 12/02/2022] Open
Abstract
Background and Aim: The genes ARRB1, FLNA, CALM3, and HTT are commonly expressed in oral cancer and have been hypothesized to be involved in the carcinogenic pathway. The present
study investigates the inhibitive properties of alpha mangostin on the above gene using Autodock molecular docking tool. Materials and Methods: The structures of the proteins were
downloaded from the protein databank with PDB IDs 3HOP, 2F3Z, IZSH and 3IO6F for the genes FLNA, CALM3, ARRB1 and HTT, respectively. Autodock was used for molecular docking of the
target proteins with the ligand molecule. Results shows HTT having good inhibition features with the Alpha Mangostin followed by the CALM3, FLNA and finally ARRB1 in the decreasing
order. CALM3 gene had the lowest binding energy, which easily bound with the target ligand with greater affinity towards the binding followed by ARRB1, HTT, FLNA in the increasing
order of binding energy and decreasing order of binding affinity. CALM3 and HTT were promising targets for anticancer treatment using alpha mangostin. Future exploration of the
interaction of alpha mangostin and these genes could delineate the role of alpha mangostin as an anticancer agent.
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Affiliation(s)
| | - Jaideep Mahendra
- Meenakshi Ammal Dental College and Hospital, India
- Jaideep Mahendra
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Yemineni BC, Mahendra J, Nasina J, Mahendra L, Shivasubramanian L, Perika SB. Evaluation of Maximum Principal Stress, Von Mises Stress, and Deformation on Surrounding Mandibular Bone During Insertion of an Implant: A Three-Dimensional Finite Element Study. Cureus 2020; 12:e9430. [PMID: 32864255 PMCID: PMC7450897 DOI: 10.7759/cureus.9430] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim The present study evaluated maximum principal stress, von Mises stress, and deformation on the mandible and surrounding structures during the insertion of an implant in various anatomical positions. Materials and Methods Finite element models of straight two-piece implants of 4.5 mm × 11.5 mm were modeled using Ansys software, v. 16.0 (Ansys, Inc., Houston, TX, USA). The mandibular model was derived through cone-beam computed tomography of a cadaveric mandible using Mimics software (Materialise NV, Leuven, Belgium). An osteotomy was performed at the first molar region, second premolar region, lateral incisor region, central incisor region, canine region, and second molar region that had varying bone densities. Implant insertion was simulated with a variable load of 1 - 180 Newton, which was applied axially downward with a rotational velocity of 30 - 120 rpm. Maximum principal stresses, von Mises stress distribution at the implant insertion site, and maximum deformation on the entire mandible were recorded during the insertion of the implants. Results Maximum principal stress was highest in the crestal area of the right first molar region and least in the middle third of the central incisor region during implant insertion. Von Mises stress in the mandible was highest in the right first molar region and the least in the lateral incisor region during implant insertion. The extent deformation was recorded on the x-axis, y-axis, and z-axis of the mandible. Deformation on the x-axis was highest at the crestal region of the canine and least for the lateral incisor. On the y-axis, deformation was highest at the symphysis region during implant insertion at the first molar region and the least at the condylar area during implant placement in the canine area. On the z-axis, the deformation was highest at the condylar region during implant insertion at the first molar region, and the least was observed in the symphysis region during implant placement in the second molar region. Conclusion When overall stress was considered, there is a direct correlation between stress and quality of bone. The highest maximum principal stress and von Mises stress were recorded during the placement of implants in posterior regions of the mandible, which suggests that the presence of dense cortical bone results in higher stress values. The maximum deformation was observed at different regions of the mandible, away from the site of implant insertion. The resultant stress and deformation exerted on the bone during placement of implants at different sites in the mandible varies, which could be detrimental factors in the longevity of the implant.
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Affiliation(s)
- Bhavan Chand Yemineni
- Dental and Oral Surgery, Alluri Sitarama Raju Academy Of Medical Sciences College and Hospital, Eluru, IND
| | - Jaideep Mahendra
- Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, IND
| | - Jigeesh Nasina
- Operations & Information Technology, ICFAI Business School (IBS) Hyderabad - Institute of Chartered Financial Analysts of India (ICFAI) Foundation for Higher Education, Hyderabad, IND
| | - Little Mahendra
- Periodontics, Maktoum Bin Hamdan Dental University College, Dubai, ARE
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Ilango P, Mahendra J, Mahendra L, Cherian SM, Kathaperumal K, Suresh V, Mahalingam A, T A. Evidence linking the role of periodontal viruses in coronary artery disease with and without periodontitis. J Periodontol 2020; 92:113-122. [PMID: 32449954 DOI: 10.1002/jper.19-0704] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 12/11/2019] [Revised: 03/09/2020] [Accepted: 04/08/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Viruses are considered to be a newer family associated with inflammatory diseases. Yet the role of periodontal viruses in coronary artery diseases (CAD) remains unclear. Thus, the current study aims to evaluate the prevalence of periodontal viruses and compare the same in cardiac samples of CAD patients with and without periodontitis. METHODS A total of 60 patients with CAD indicated for coronary artery bypass graft surgery (CABG) were included. These were grouped into 36 patients with healthy periodontium (CAD only) and 24 patients with periodontitis (CAD + P). The demographic variables, cardiac parameters and periodontal parameters were recorded. Cardiac tissue samples were collected during the CABG surgery and were analyzed by reverse transcriptase polymerase chain reaction for periodontal viruses such as Epstein-Barr virus (EBV), cytomegalovirus (CMV) and Herpes simplex virus. All the parameters were statistically analyzed. RESULTS Among the demographic variables, age was statistically significant between the groups. Plaque index, bleeding index, probing depth, and clinical attachment level (CAL) were significantly higher in CAD+P group (P ˂0.05). Periodontal viruses such as EBV and CMV were significantly higher (62.5% and 75% respectively, P ˂0.05) in the cardiac samples of the CAD+P than CAD only (25% and 47.2%, respectively). A significant association between EBV and CAL was revealed by multiple logistic regression analysis. (B = 0.374, P = 0.046) CONCLUSIONS: The results revealed a higher prevalence of periodontal viruses such as EBV and CMV in CAD patients with periodontitis suggesting it as one of the risk factors for CAD. This is supported by the fact that severity of periodontal disease (CAL) is associated with the presence of EBV in coronary artery plaque samples in the current study.
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Affiliation(s)
- Paavai Ilango
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Little Mahendra
- Department of Periodontics, Maktoum bin Hamdan Dental University, Dubai, UAE
| | - Sanjay M Cherian
- Department of Cardiac Surgery, Frontier Lifeline Hospital, Chennai, India
| | - Kumanan Kathaperumal
- Department of Animal Biotechnology, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Vasugi Suresh
- Department of Pedodontics, Thai Moogambigai Dental College and Hospital, Chennai, India
| | - Arulpari Mahalingam
- Department of Physiology, Priyadarshini Dental College and Hospital, Chennai, India
| | - Abirami T
- Department of Periodontics, Priyadarshini Dental College and Hospital, Chennai, India
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Ruth D, Mahendra J, Kumar A, Namasivayam A, Mahendra L, Devarajan N. Role of Cluster of Differentiation 163 in Diabetes-Periodontitis Interplay. Cureus 2020; 12:e8523. [PMID: 32656036 PMCID: PMC7346304 DOI: 10.7759/cureus.8523] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background The aim of the present study was to assess and quantify cluster of differentiation 163 (CD163) protein levels and CD163 messenger RNA (mRNA) gene expression in subgingival plaque samples of generalized chronic periodontitis subjects with and without type II diabetes mellitus (DM). Materials and methods Eighty chronic periodontitis subjects were selected and divided into 40 systemically healthy, generalized chronic periodontitis subjects (Group I) and 40 generalized chronic periodontitis subjects diagnosed with type II diabetes mellitus (Group II). Age, body mass index (BMI), income, plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded. CD163 protein and gene expressions were quantified and compared between the groups. Results The mean age, BMI, income, PI, BOP %, and CD163 protein and gene expression were higher in Group II (p< 0.05) as compared to Group I. In Group I, CD163 protein levels showed a negative correlation with respect to BMI and PI, and this was statistically significant. In Group II, all the periodontal parameters showed a positive correlation with CD163 protein levels. Overall, PI and BOP % were significantly correlated with CD163 protein levels. Both CD163 protein and gene expression showed a negative correlation with each other (p= 0.001). Conclusion The elevated protein levels of CD163 in the subgingival plaque samples of generalized chronic periodontitis individuals with type II diabetes mellitus signify the involvement of CD163 in the pathogenesis of both periodontitis and diabetes mellitus. CD163 can play a challenging role as a diagnostic, as well as a prognostic biomarker, in both these inflammatory diseases.
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Affiliation(s)
- Daliah Ruth
- Periodontics, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College and Hospital, Chennai, IND
| | - Jaideep Mahendra
- Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, IND
| | - Anilkumar Kumar
- Periodontics, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College and Hospital, Chennai, IND
| | - Ambalavanan Namasivayam
- Periodontics, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College and Hospital, Chennai, IND
| | - Little Mahendra
- Periodontics, Maktoum Bin Hamdan Dental University College, Dubai, ARE
| | - Nalini Devarajan
- Research, Central Research Laboratory, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College and Hospital, Chennai, IND
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Tanneeru S, Mahendra J, Shaik MV. Evaluation of Microflora (Viral and Bacterial) in Subgingival and Placental Samples of Pregnant Women with Preeclampsia with and without Periodontal Disease: A Cross-Sectional Study. J Int Soc Prev Community Dent 2020; 10:171-176. [PMID: 32670905 PMCID: PMC7339998 DOI: 10.4103/jispcd.jispcd_341_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/13/2019] [Accepted: 12/15/2019] [Indexed: 11/04/2022] Open
Abstract
Aim Previous studies showed associated periodontal disease with various systemic ailments. This research work was aimed at studying the presence and role of periodontal microflora on preeclampsia during pregnancy. Materials and Methods A cross-sectional study was designed on pregnant women with preeclampsia with and without chronic periodontitis, attending Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India, for prenatal checkups. After obtaining consents, 445 women were recruited in the study. On the basis of systemic and periodontal health, subjects were grouped into Group 1 (women with preeclampsia with chronic periodontitis) and Group 2 (women with preeclampsia without chronic periodontitis). Clinical parameters such as plaque index, bleeding on probing, probing depth, and clinical attachment level were recorded. Quantification of periodontopathic bacteria (Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia, Tannerella forsythia, Treponema denticola), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus (HSV), were detected using real-time polymerase chain reaction in subgingival samples at one point of time and later compared in placental tissue after parturition. Results T. forsythia, T. denticola, F. nucleatum, P. intermedia, EBV, CMV, and HSV were expressed more in Group 3 compared to those in Groups 2, 4, and 1, in their subgingival and placental samples. Conclusion Elevated levels of bacteria and viruses were expressed in subgingival and placental samples in women with preeclampsia with chronic periodontitis compared to those in women with preeclampsia without chronic periodontitis. This shows that chronic periodontitis is a risk factor for preeclampsia. The results concluded that periodontal flora is not only localized to periodontal tissues but can also enter uterine cavity and may elicit their pathological response on mother and developing fetus.
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Affiliation(s)
- Swetha Tanneeru
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education & Research, Chennai, Tamil Nadu, India
| | - Mahaboob Vali Shaik
- Department of Advanced Research Centre, Narayana Medical College, Nellore, Andhra Pradesh, India
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Ramamoorthy A, Mahendra J, Mahendra L, Govindaraj J, Samu S. Effect of Sudharshan Kriya Pranayama on Salivary Expression of Human Beta Defensin-2, Peroxisome Proliferator-Activated Receptor Gamma, and Nuclear Factor-Kappa B in Chronic Periodontitis. Cureus 2020; 12:e6905. [PMID: 32064220 PMCID: PMC7006603 DOI: 10.7759/cureus.6905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction Sudharshan kriya pranayama (SKP) is a form of yoga that reduces inflammation and contributes to general health. Very few prior studies have examined the role of pranayama on oral health. We evaluated the clinical status and inflammatory biomarkers in patients with chronic periodontitis before and after SKP. Materials and methods Ninety male subjects were considered for the study and divided into three groups: subjects with a healthy periodontium (Group1), subjects with chronic gingivitis (Group2), and subjects with chronic periodontitis (Group3). The clinical parameters included plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and salivary markers human beta-defensin-2(HBD-2), peroxisome proliferator-activated receptor gamma (PPAR-γ), and nuclear factor-kappa B (NF-κB). These parameters and markers were evaluated before and after 90 days of SKP. The data obtained were statistically evaluated by McNemar's test, paired sample t-test, and one-way analysis of variance. Results There was a significant improvement in PI in all three groups. GI showed an improvement in Groups 2 and 3. PPD and CAL also showed an improvement in Group 3. HBD-2 and NF-κB decreased with SKP, whereas PPAR-γ expression increased after the intervention. In Groups 2 and 3 with the decrease in GI, there was a corresponding decrease in HBD-2. In Group 3 with an improvement in PPD and CAL, there was an improvement in PPAR-γ expression. Conclusions The results show that SKP can significantly decrease periodontal inflammation and improve periodontal status. It also effectively improves the expression of PPAR-γ, thereby decreasing salivary levels of HBD-2 and NF-κB, respectively. Based on our results, pranayama can be an effective adjunct in maintaining oral health.
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Affiliation(s)
| | - Jaideep Mahendra
- Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, IND
| | - Little Mahendra
- Periodontics, Maktoum Bin Hamdan Dental University College, Dubai, ARE
| | | | - Subramaniam Samu
- Biochemistry, Regenix Super Speciality Laboratories Research Center, Chennai, IND
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Krishnakumar D, Mahendra J, Ari G, Perumalsamy R. A clinical and histological evaluation of platelet-rich fibrin and CGF for root coverage procedure using coronally advanced flap: A split-mouth design. Indian J Dent Res 2020; 30:970-974. [PMID: 31939381 DOI: 10.4103/ijdr.ijdr_16_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The management of gingival recession associated with esthetic concerns and root hypersensitivity is challenging and its sequelae are based on the assessment of etiological factors and the degree of tissue involvement. Procedures using pedicle flaps, free soft-tissue grafts, combination of pedicle flaps with grafts, barrier membranes, and the use of platelet concentrates are all effective for this purpose. The use of the second-generation platelet concentrate, platelet rich fibrin (PRF) has been widely used. Lately, concentrated growth factor (CGF) has evolved as a promising regenerative material, wherein it also acts as a scaffold and accelerates wound healing due to its dense fibrin meshwork. A 21-year-old male patient presented with bilateral multiple gingival recessions due to faulty tooth brushing. Coronally advanced flap with Zuchelli's technique was planned as a treatment modality. Platelet concentrates PRF and CGF were placed bilaterally during the procedure, and the outcome of the treatment was compared. The percentage of root coverage was clinically evaluated, and histological evaluation was also done to assess the density of fibrin meshwork in the platelet concentrates. Nearly 100% of root coverage was achieved with both PRF and CGF membrane 3 months postoperatively. However, CGF showed satisfactory wound healing by the 10th-day postoperatively compared to PRF. As CGF operates on varying centrifugation to separate cells in the venous blood, thereby resulting in fibrin-rich blocks that are much larger, denser, and richer in growth factors as also shown histologically.
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Affiliation(s)
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
| | - Geetha Ari
- Department of Periodontology, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
| | - Rajapriya Perumalsamy
- Department of Periodontology, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
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Yagnik K, Mahendra J, Kurian VM. The Periodontal-Cardiovascular alliance: Evaluation of miRNA-146a in subgingival plaque samples of chronic periodontitis patients with and without coronary heart disease. ACTA ACUST UNITED AC 2019; 10:e12442. [PMID: 31338994 DOI: 10.1111/jicd.12442] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 03/11/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 01/08/2023]
Abstract
AIM To quantify the levels of miRNA-146a in subgingival plaque samples, and correlate with periodontal and cardiac parameters, in chronic periodontitis patients with and without coronary heart disease. METHODS The study involved 90 subjects; 30 patients with chronic periodontitis and coronary heart disease (CP + CHD) as part of Group I; group II comprising 30 with chronic periodontitis alone (CP); and group III comprising 30 systemically healthy controls. Demographic variables, periodontal parameters such as plaque index, bleeding on probing, probing pocket depth and clinical attachment levels, cardiac parameters such as total cholesterol, high-density lipoprotein, low-density lipoprotein, triglyceride levels, and systolic and diastolic blood pressure were recorded from the patients. miRNA-146a level was analyzed in subgingival plaque samples by real-time polymerase chain reaction assay and correlated with periodontal and cardiac parameters. RESULTS miRNA-146a showed the highest levels in the CP + CHD group and also showed a positive correlation with body mass index, and periodontal and cardiac parameters. CONCLUSION miRNA-146a is involved in the pathogenesis of both periodontitis and coronary heart disease.
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Affiliation(s)
- Krutika Yagnik
- Department of Periodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Jaideep Mahendra
- Department of Periodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - V M Kurian
- Institute of Cardiovascular Diseases, Adult Cardiac Surgery, Madras Medical Mission Hospital, Chennai, India
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Ganesh B, Burnice NKC, Mahendra J, Vijayalakshmi R, K AK. Laser-Assisted Lip Repositioning With Smile Elevator Muscle Containment and Crown Lengthening for Gummy Smile: A Case Report. Clin Adv Periodontics 2019; 9:135-141. [PMID: 31490039 DOI: 10.1002/cap.10060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/19/2018] [Accepted: 12/24/2018] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Treating the patients with excessive gingival display to provide a pleasant smile is a challenge to the periodontist. Gummy smile can be due to excessive vertical bone growth, dentoalveolar extrusion, short upper lip, upper lip hyperactivity, or altered passive eruption. Gummy smile associated with hyperactivity of smile elevator muscles can be treated by surgical techniques like lip repositioning, botulinum toxin injection, lip elongation with rhinoplasty, detachment of the lip muscles, and myectomy. Regardless of the technique used, to achieve a predictable result with long-term stability limiting upper lip movement when the patient smiles, firm muscle containment is imperative. CASE PRESENTATION The case report describes the excessive gingival display having a multifactorial etiology in a 25-year-old female patient. Altered passive eruption in upper anterior teeth was treated by crown lengthening followed by management of hyperactive lip using a diode laser-assisted lip repositioning along with traction and muscle containment. Excellent and predictable results were obtained after a 1-year follow-up without the relapse of gummy smile. CONCLUSIONS The case report showed an excellent result when treated by a combined approach of an innovative procedure with laser-assisted lip repositioning aimed at maintaining the traction and containment of the smile elevator muscles along with crown lengthening procedure by gingivectomy.
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Affiliation(s)
- Balaji Ganesh
- Department of Periodontology, Meenakshi Ammal Dental College, Chennai, Tamilnadu, India
| | | | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College, Chennai, Tamilnadu, India
| | - Rajaram Vijayalakshmi
- Department of Periodontology, Meenakshi Ammal Dental College, Chennai, Tamilnadu, India
| | - Anil Kumar K
- Department of Periodontology, Meenakshi Ammal Dental College, Chennai, Tamilnadu, India
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Karthikeyan J, Vijayalakshmi R, Mahendra J, Kanakamedala AK, Chellathurai BNK, Selvarajan S, Namachivayam A. Diode Laser as an Adjunct to Kirkland Flap Surgery-A Randomized Split-Mouth Clinical and Microbiological Study. Photobiomodul Photomed Laser Surg 2019; 37:99-109. [PMID: 31050933 DOI: 10.1089/photob.2018.4519] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Mechanical methods of periodontal therapy alone may fail to eliminate the tissue-invasive pathogenic flora; therefore, considerable attention has been given to adjunctive antimicrobial measures. Objective: The aim of this study was to investigate and compare the clinical and microbiological effects of diode laser (DL) as an adjunct to Kirkland flap surgery versus Kirkland flap surgery alone for the treatment of generalized chronic periodontitis. Materials and methods: A total of 20 patients with generalized chronic periodontitis with probing pocket depth ≥5 mm after phase I therapy were included in this split-mouth study. Two contralateral quadrants of each patient were randomly assigned to either test or control group. Control group was treated with Kirkland flap surgery alone, whereas test group was treated with DL as an adjunct to Kirkland flap surgery. Periodontal parameters were recorded, and subgingival plaque samples were collected from both the control and test groups at baseline and third and sixth month. The plaque samples were then analyzed for red complex organisms using quantitative real-time polymerase chain reaction. Results: Compared with baseline, both treatments showed an improvement in periodontal parameters at the third and sixth month. However, test group produced a significant improvement in plaque index (1.039 ± 0.069 vs. 1.392 ± 0.17, p < 0.001), bleeding on probing (16.512 ± 5.982 vs. 37.051 ± 7.459, p < 0.001), probing pocket depth (1.727 ± 0.39 vs. 3.016 ± 0.47, p < 0.001), and clinical attachment level (2.054 ± 0.524 vs. 3.354 ± 0.728, p < 0.001) at third and sixth month compared with the control group. Moreover, in the test group, levels of red complex bacteria were significantly reduced at third and sixth month compared with the control group. Conclusions: DL as an adjunct to Kirkland flap surgery has resulted in a greater reduction in clinical and microbiological parameters compared with Kirkland flap surgery alone, thereby offering additional benefit in treating generalized chronic periodontitis patients.
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Affiliation(s)
- Janani Karthikeyan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | - Rajaram Vijayalakshmi
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | - Anil Kumar Kanakamedala
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
| | | | - Shalini Selvarajan
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai
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