Correlation of ABO Blood Groups and Rh Factor with The Severity of Generalized Chronic Periodontitis: Across Sectional Study in Riyadh, Saudi Arabia

BACKGROUND: The development of periodontal diseases depends on the presence of causative microorganisms, host immunity and risk factors. Although variability present among the types of periodontal diseases, all are represented to a shared interaction between host and bacteria. ABO blood groups are the most investigated erythrocyte antigen system. However, limited investigations have been conducted to explore the alliance between ABO blood groups and periodontal diseases. AIM: Our purpose was to explore any possible association between the severity of chronic periodontitis with ABO blood groups and Rh factor. METHODS: A cross-sectional study was carried out on 205 patients out of 1126 generalised chronic periodontitis patients (GCP) who were referred to Al-Farabi Colleges, Riyadh, Saudi Arabia. They were categorized into; group I (mild), group II (moderate) and group III (sever). RESULTS: The patients with blood group O were at a greater risk to develop GCP irrespective of its severity, followed by those with blood group A, B, and AB. The dispensation of the Rh factor in all groups exhibited a significantly greater distribution of Rh positive. CONCLUSION: Genetic factors such as ABO blood group antigens may act as a risk influencer that affects the progression and severity of the chronic periodontitis

Awareness of Dental Interns to Treat Pregnant Patients

BACKGROUND: Pregnancy causes major changes in maternal physiology and metabolism, which may lead to increased susceptibility to oral infection. AIM: Aim of this study is to assess the awareness of dental interns regarding the management of the dental needs of pregnant patients. METHODS: A cross-sectional questionnaire survey was conducted among 188 interns of a private dental college in Saudi Arabia. The questionnaire comprised of 14 knowledge-based questions regarding their training, awareness and practice management of the pregnant patient in dental clinics. Four questions to record and evaluate their training, the number of pregnant patients treated by them and their confidence level in the dental management of the pregnant patient. Excel spreadsheet was used for mathematical calculations. RESULTS: Almost 62% of our participants never treated a pregnant female during their training. About 65% of the interns knew using antibiotics, almost 55% have a clear idea of the safest NSAIDS, and 43% regarded local anaesthesia to be safe when used among pregnant females. Conversely, about 50% of the participants had no clear knowledge of the FDA category of drugs. Only 24% considered dental radiographs to be safe in pregnant patients. 57% thought to postpone the dental treatment in an acute active dental infection in expecting mothers. Results also showed a lack of confidence among interns to provide dental care to gestating female. CONCLUSION: On analysing the results, we found that there is a need to improve the knowledge, awareness and confidence levels among the interns who are the future dentists treating these patients

Correlation of Blood and Salivary pH Levels in Healthy, Gingivitis, and Periodontitis Patients before and after Non-Surgical Periodontal Therapy

Periodontitis is an infectious illness which leads to the inflammation of protective tissues around the teeth and the continuous loss of alveolar bone and conjunctive tissue. Biomarker analysis in serum and saliva helps in the evaluation of disease progression and activity. It is also established that every inflammatory change along with resultant damage of tissues ends up in altered pH values in the fluids and tissues. Aim: To correlate the connection of pH levels in both blood as well as saliva in healthy, periodontitis, and gingivitis patients. Materials and Methods: The current research involved 145 subjects amidst the age of 20 and 55 years. The subjects were split into three different groups: healthy (Group A), gingivitis (Group B), and finally chronic periodontitis (Group C). The recording of clinical parameters was done by gingival index (GI), probing depth (PD), and plaque index (PI). pH of saliva and blood was analyzed with the help of digital single electrode pH meter. Subjects have gone through scaling and root planning (SRP) coupled with the instructions of oral hygiene. They were recalled post 4 weeks, and saliva and blood samples were gathered for analyzing pH. Results: Clinical parameters GI and PI were statistically important in both group C as well as group B post SRP. A crucial change has been observed in attachment levels (AL) and PD in the case of periodontitis group post SRP. The difference in the salivary pH values were significant between group B vs. C and A vs. C before the treatment because the values for group C were acidic, whereas in groups B and A the pH was alkaline. After the treatment, the values were still significant because the pH has become more alkaline compared to preoperative value in both group B and C. Saliva’s pH levels have demonstrated a statistically significant reduction in group C post SRP. Conclusion: Salivary pH levels and blood evidently became alkaline in the group C patients post SRP and there is a positive correlation between them and the clinical parameters

ROLE OF INNATE IMMUNITY IN PERIODONTAL DISEASE: A BRIEF UPDATE

Periodontitis disease is the most condition caused by the inflammatory response in the periodontal tissue. It is well known and established that alone the presence of pathogenic bacteria is insufficient in causing periodontitis disease. Immune response and pathways play a key role in development of lesions and hence it is necessary to understand the same to assess on how the disease is progressing. Further, it is observed that a comprehensive immune response is initiated in cases with periodontal disease. It is essential to summarize the mechanisms of the immune system involved in periodontal disease. Hence, to understand the immune mechanism and pathways that are also contributory factors for the progression of the disease, a database search is conducted with the keywords and two research articles are shortlisted and reviewed in this review article

Awareness of Consumer Protection Act among the dental fraternity in India

Background: The medical and dental professionals have been included in the Consumer Protection Act (CPA) to shield the patients in case of any unethical treatment given by the doctor. Though there is ample literature regarding the CPA and its importance, insufficient data is available from the Indian subcontinent regarding the awareness of dentists in India and the problems faced by them in clinical practice. Thus, there is a need to know the awareness of the dental fraternity in India and their knowledge about CPA. Objective: To evaluate the knowledge, awareness, and practices regarding the CPA among dental professionals in India. Materials and Methods: In a cross-sectional study, a total of 467 dental professionals (198 males, 269 females) comprising (117) Bachelor of Dental Surgery (BDS) practitioners, (114) Master of Dental Surgery (MDS) practitioners, (104) interns, and (79) postgraduate (PG) students were surveyed using a self-administered structured electronic questionnaire. The questionnaire comprised 20 questions about the awareness of CPA and whether these professionals were following the recommendations of CPA. Chi-square test was used to know the significance. Results: The CPA awareness scores were significantly higher among MDS practitioners when compared with those of BDS practitioners, interns, and postgraduates. Almost 66% of the participants found the taking of written consent to be time-consuming. Nearly 70% and 69.3% of the BDS and MDS practitioners, respectively, were updating the medical ethics. Conclusion: Considering the present scenario, a better understanding of CPA is necessary for dentists in order to be on the safer side and an educational program would be helpful to increase the knowledge and confidence of dentists in any medical legal jurisprudence to avoid any litigation

Oral health in diabetic and nondiabetic patients with chronic kidney disease

The objective of our study is to assess the subjective and objective oral manifestations and salivary pH in diabetic and nondiabetic uremic patients at a nephrology clinic. A total of 194 diabetic and nondiabetic patients with chronic kidney disease (CKD), who were divided into four groups, Group A, B, C, D, and who were attending a nephrology clinic were included in the study. Predialytic unstimulated whole salivary pH was recorded using pH- measuring strips. Subjective and objective findings were evaluated and recorded in the specially designed pro forma. Dental health assessment consisted of decayed, missing, and filled teeth index and community periodontal index (CPI). Dysgeusia was found to be significantly more prevalent in nondiabetic patients on dialysis. Uremic odor showed high significance (P <0.05) with 75% patients being positive in diabetic dialysis. There was no significant difference in the incidence of tongue coating between the four groups. A statistically high significance was observed with the objective oral manifestation of mucosal petechiae, with P = 0.01. There was an increased periodontal pocket depth among diabetic CKD patients as compared to that in nondiabetic patients. A moderate significance was found, with a CPI score showing P <0.05. Increased prevalence of caries was noticed among the diabetic CKD patients (Groups A, B). Recorded salivary pH showed no significant difference among diabetic and nondiabetic CKD patients. Findings suggest that these patients are at risk of developing complications, related to systemic health causing morbidity and mortality. Hence, these patients are to be motivated for comprehensive professional oral care and self oral hygiene instructions. Additional research is necessary to elucidate and correlate the combined influence of diabetes, CKD, and dialysis on oral health

Gingival Recession: Review and Strategies in Treatment of Recession

One of the most common esthetic concerns associated with the periodontal tissues is gingival recession. Gingival recession is the exposure of root surfaces due to apical migration of the gingival tissue margins; gingival margin migrates apical to the cementoenamel junction. Although it rarely results in tooth loss, marginal tissue recession is associated with thermal and tactile sensitivity, esthetic complaints, and a tendency toward root caries. This paper reviews etiology, consequences, and the available surgical procedures for the coverage of exposed root surfaces, including three case reports

Comparative Evaluation of Pain Scores during Periodontal Probing with or without Anesthetic Gels

Context. The initial periodontal examination which includes full-mouth periodontal probing is one of the discomforting procedures for a patient. Aim. To evaluate the efficacy of two local anesthetic gels in the reduction of pain during periodontal probing using Florida probe in CGP patients in comparison with manual probing. Materials and Methods. Ninety systemically healthy patients with moderate to severe CGP patients were recruited. In each patient, the quadrants were randomly assigned to manual probing with UNC-15 probe, probing with Florida probe, and Florida probing with lidocaine 10% gel and with benzocaine 20% gel. In the quadrants undergoing probing with anesthetic gels, the sites were isolated and the gel was injected using syringe and a blunt-end cannula. Pain was measured using 10 mm horizontal VAS. Statistical Analysis. The analysis was carried out using SPSS version 18. The comparison of mean VAS scores was done using repeated measures ANOVA with post hoc Bonferroni test. Results. Mean VAS for manual probing was significantly more than Florida probing. Further, the mean VAS score for Florida probing was higher than the two gels. Conclusion. It is suggested that the gels might be useful in reducing pain experienced during full-mouth periodontal probing in patients with CGP

"Dental implant radiology" - Emerging concepts in planning implants

Dental radiology has long played an exciting and critical diagnostic role in dentistry. This has been never truer than now with the rapidly expanding array of imaging modalities. Radiography offers the sole method of (non-surgical) analysis of bone required for implant therapy. The choice of when to image, along with which imaging modality to use, depends on a combination of factors including determination of the bone quality and quantity to establish the most favorable position of implant placement, detection of the presence or absence of pathoses and accessibility at a reasonable cost to the patient. In addition, exposing patients to radiation dose as low as reasonably achievable should always be considered when selecting radiographic examinations. This article, reviews the current concepts on implant planning using different radiographic techniques and their applicability to facilitate the clinician′s work in successful implant placement

Role of antimicrobial peptides in periodontal innate defense mechanism

The periodontal epithelium neighboring the tooth is precise to form a seal and attachment around the tooth. This exclusive function imparts unique challenges to the tissue and leads to certain vulnerabilities allied with periodontal disease, particularly in view of the continual exposure to the bacterial biofilm (dental plaque) that form that is formed on the tooth surface at the junction of the soft tissue. It is obvious that oral epithelial cells can counter unbroken microbial challenges from dental plaque by the production of antimicrobial peptides (AMPs), chemokines and cytokines that boost inflammation and immune response in periodontal tissues. AMPs are early responders of the innate immune system that search and destroy invading pathogens. The large variety of AMPs presumably allows for an effective response to the large variety of microorganisms that invade the mouth and airways. The present paper portrays the association between altered expression of AMPs and some types of periodontitis along with AMPs and their clinical significance in other oral diseases