Genetic Biomarkers in Periodontal Disease Diagnosis

Periodontitis is a chronic inflammatory disease with multifactorial etiology. The anaerobic bacteria have been implicated as the main etiological factor for periodontal destruction. Not all the individuals having the similar amount of plaque and calculus develop the periodontitis. Thus, the host susceptibility to periodontal pathogens plays a significant role in the etiopathogenesis of periodontitis. The genetic factor is the major determinant of the host susceptibility. There are contradictory results and varied results of the association of various genetic loci of different genes with periodontitis in different ethnic populations. This chapter will briefly discuss the various candidates’ gene approach in understanding the etiopathogenesis of periodontitis. This chapter also throws some light on the relationship of the recent advances in genetic analysis like genome wide association studies, epigenetic regulation, and infectogenomics with periodontal destruction

The link between the genetic polymorphisms of the innate immune signaling molecular factors with periodontitis

Periodontitis is a chronic inflammatory disease causing destruction of supporting tissues of teeth. Even though the gramnegative anaerobes are essential for the initiation of periodontal destruction, multiple risk factors are essential for the progression of the disease. The genetic risk factor plays a significant role in the etiopathogenesis of periodontal disease. The innate immune mechanism is the first line of defense in screening and combating the invading periodontal pathogens. The genetic polymorphisms in the 3’UTR region of the innate immune signaling molecular factors like toll-like receptors, nod-like receptors and the polymorphisms in the epigenetic regulators of these factors like microRNA146a, apolipoproteinE might play an important role in the etiopathogenesis of periodontal destruction

Comprehensive rehabilitation using dental implants in generalized aggressive periodontitis

Generalized aggressive periodontitis (GAP) is a debilitating form of the disease and it results in deteriorating effects on the esthetic and functional aspects of the oral cavity. This case report describes the comprehensive rehabilitation of GAP patient using dental implants. The treatment planning involved thorough scaling and root planning (SRP) with oral hygiene instructions. The patient was motivated to adhere to a strict oral hygiene regimen following which periodontal flap surgery employing guided tissue regeneration and bone grafts was performed. Bacterial culture for anaerobic microorganisms was done using a gas pack pre- and postperiodontal treatment to confirm the effectiveness of the periodontal treatment regimen and also to proceed with dental implant placement. The rigorous maintenance program ensured the stability of the periodontium following which immediate placement of dental implants in the maxillary and mandibular anterior region was done. The fixed metal-ceramic prosthesis was fabricated in a step-by-step process and the patient was recalled on a periodic basis over a 3-year follow-up duration. This case is a testimonial to the postperiodontal treatment long-term stability with excellent patient cooperation and strict maintenance protocol

Esthetic lip repositioning: A cosmetic approach for correction of gummy smile – A case series

Gummy smile has been a prevalent esthetic disorder commonly affecting younger individuals due to various causes such as skeletal, dento-alveolar, or soft-tissue origin. It can be due to jaw deformities, altered passive eruption, or tooth malpositioning. Usually, the corrective measures incorporate orthognathic surgery and orthodontic treatment. Orthognathic surgery results in significant morbidity and hospitalization. Lip repositioning can be employed as an alternative cosmetic treatment modality for the correction of an excessive gingival display with minimal risk or side effects. Although there are many articles existing in the literature on this topic, a series of three cases is unique in demonstrating the esthetic smile enhancement in an orthodontic patient and also a combination of lip–repositioning technique and laser-assisted crown lengthening in vertical maxillary excess cases. This case series also showed the predictability of lip-repositioning technique with a follow-up of 2 years

Detection of cytomegalovirus, Epstein–Barr virus, and torque teno virus in subgingival and atheromatous plaques of cardiac patients with chronic periodontitis

Background: Periodontitis and atherosclerosis represent a chronic inflammatory process. The incidence of periodontitis in cardiac patients with atherosclerosis is a well-established fact. The role of viruses in the etiopathogenesis of both has been proposed. Aim: The aim of the study was to evaluate the prevalence of Torque Teno virus (TTV), Epstein–Barr virus (EBV), and cytomegalovirus (CMV) in cardiac patients with atherosclerosis and coexisting chronic periodontitis (CP). Materials and Methods: Thirty patients (17 males and 13 females) with atherosclerotic plaques and coexisting periodontitis were recruited for this cross-sectional study. Viral DNA was extracted from the subgingival and atheromatous plaque. The presence of CMV, EBV, and TTV in the plaque samples was identified using polymerase chain reaction. The collected data were statistically analyzed for the prevalence of the viruses and Chi-squared test was performed to find out its association with atheroma and CP. Results: The prevalence of CMV, EBV, and TTV in atheromatous plaque was 63.3%, 56.7%, and 46.7%, respectively, as compared to rates of 80%, 63.3%, and 53.3% in subgingival plaque. Results also indicated no significant association of CMV, EBV, and TTV in both samples (P = 0.08, 0.346, and 0.261, respectively). Conclusions: There was no significant association of CMV, EBV, and TTV between subgingival and atheromatous plaque. The prevalence of CMV, EBV, and TTV was high in atheromatous plaque. TTV was isolated from more than 50% of participants in atheromatous plaque, which is a significant finding

Prevalence of TT Virus in patients with chronic periodontitis, patients with aggressive periodontitis and healthy controls - a pilot study

teno virus (TTV), a novel DNA virus resides in peripheral blood mononuclear cells and replicates when these cells get activated. The TTV replication shifts the immunobalance. Aim: To determine the presence of TTV in the gingiva of patients with aggressive periodontitis, patients with chronic periodontitis, and healthy controls, and to correlate the presence of TTV with probing pocket depth and clinical attachment level. Methods: Forty-two subjects (22 males and 20 females) aged 21 to 55 years were recruited for this study. Subjects were stratified into aggressive periodontitis (Group I), chronic periodontitis (Group II) and healthy controls (Group III). Gingival tissue biopsy was taken from all the subjects and the presence of TTV was analyzed using PCR and 2% agarose gel electrophoresis. Results: TTV was identified in half of the subjects and more number of subjects with periodontitis have TT virus compared to controls. There was significant association between presence of TT virus and pocket depth, clinical attachment level. Conclusions: The findings from the present study shows that there was no significant association between TT virus and periodontitis, even though it was isolated from more number of subjects with aggressive periodontitis, and TTV was associated with pocket depth and clinical attachment level. These findings need to be investigated in further studies

Prevalence of TT Virus in patients with chronic periodontitis, patients with aggressive periodontitis and healthy controls - A pilot study

Torque teno virus (TTV), a novel DNA virus resides in peripheral blood mononuclear cells and replicates when these cells get activated. The TTV replication shifts the immunobalance. Aim: To determine the presence of TTV in the gingiva of patients with aggressive periodontitis, patients with chronic periodontitis, and healthy controls, and to correlate the presence of TTV with probing pocket depth and clinical attachment level. Methods: Forty-two subjects (22 males and 20 females) aged 21 to 55 years were recruited for this study. Subjects were stratified into aggressive periodontitis (Group I), chronic periodontitis (Group II) and healthy controls (Group III). Gingival tissue biopsy was taken from all the subjects and the presence of TTV was analyzed using PCR and 2% agarose gel electrophoresis. Results: TTV was identified in half of the subjects and more number of subjects with periodontitis have TT virus compared to controls. There was significant association between presence of TT virus and pocket depth, clinical attachment level. Conclusions: The findings from the present study shows that there was no significant association between TT virus and periodontitis, even though it was isolated from more number of subjects with aggressive periodontitis, and TTV was associated with pocket depth and clinical attachment level. These findings need to be investigated in further studies

Analysis of the association between interleukin -1β (+3954) gene polymorphism and chronic periodontitis in a sample of the south Indian population

Aim : The aim of this study was to determine the association between IL-1B (+3954) gene polymorphism and chronic periodontitis in a sample of the south Indian population. Settings and Design: This study employed a cross-sectional design involving individuals from the state of Tamil Nadu in the southern part of India. Materials and Methods : Genomic DNA was obtained from the white blood cells of 30 patients with chronic periodontitis (18 males and 12 females) and 31 healthy controls (20 males and 11 females). The age of the subjects ranged from 30 to 55 years old and all were non smokers. DNA was amplified using the polymerase chain reaction (PCR) with specific primers flanking the locus +3954 of IL-1β gene and analyzed by 3% agarose gel electrophoresis. Statistical Analysis : A Chi-square test was used to determine the genotype distribution between the groups and the relative risk was estimated with a 95% confidence interval. Results and Conclusion : The chronic periodontitis group displayed a higher percentage of T allele, even though it was not statistically significant. The relative risk analysis between genotypes showed that the risk was higher for the CT genotype compared with the CC genotype and the risk was significant. In conclusion, our data suggested that there was no significant association between IL-1β (+3954) gene polymorphism and chronic periodontitis in the south Indian population

Analysis of association of TaqI VDR gene polymorphism with the chronic periodontitis in Dravidian ethnicity

Aim: The aim of this study is to analyze the association of TaqI vitamin D receptor (VDR) gene polymorphism with the chronic periodontitis (CP) in Dravidian ethnicity. Materials and Methods: A total of 120 subjects were recruited for this study, which included 60 CP and 60 healthy controls. TaqI VDR gene polymorphism was analyzed using specific primers and amplified by polymerase chain reaction (PCR) and visualized under 2% agarose gel. Results: Our study results showed that Tt and tt genotype had a higher frequency of occurrence in CP compared with controls. Similarly, t allele was found to be associated with CP. Conclusion: Our study concludes that TaqI VDR gene polymorphism is associated with CP in Dravidian ethnicity