Gingival crevicularfluid osteoprotegerin levels in Indian population

Background: Initial research indicated that higher concentration of osteoprotegerin (OPG) is associated with healthy periodontium (protective) and its concentration decreases as the periodontal disease progresses. However, till date, there are no studies to investigate the levels of OPG in gingival crevicular fluid (GCF) after the treatment of periodontitis. Hence, the present study was carried out to assess its concentration in GCF to find out their association if any, and to explore its possible use as a 'novel bone marker' of the host modulation of periodontal disease. Materials and methods: Sixty-four subjects were divided into 4 groups (16 each), based on clinical attachment loss (CAL) and radiological parameters (bone loss); healthy (group I), gingivitis (group II), slight periodontitis (group III), and moderate-to-severe periodontitis (group IV). Moderate-to-severe periodontitis subjects, after nonsurgical periodontal treatment, (SRP) constituted group V. GCF samples were collected to estimate the levels of OPG using enzyme-linked immunosorbent assay (ELISA). The Kruskal-Wallis, Man-Whitney U test, and Wilcoxon signed-rank tests were carried out to compare OPG levels among groups. The Spearman rank correlation test was used to correlate OPG levels between the study groups and the clinical parameters; P < 0.05 was considered significant. Results: The highest mean OPG concentration in GCF was obtained for group I (162.47 ± 51.171 pg/ μL) and the least for group IV (10.92 ± 1.913 pg/μL), suggesting a negative correlation between OPG concentration and CAL. OPG concentrations in GCF after the treatment of group IV increased from 10.92 ± 1.913 pg/μL to 15.63 ± 4.679 pg/μL. Conclusion: OPG concentration in GCF was inversely proportional to CAL and not an active progression factor for periodontal disease. Further, after the treatment of moderate-to-severe periodontitis subjects (group IV), OPG concentrations increased. Hence, it can be concluded that OPG could be considered as a 'novel bone marker' the host modulation of periodontal disease

Gingival crevicularfluid osteoprotegerin levels in Indian population

Background: Initial research indicated that higher concentration of osteoprotegerin (OPG) is associated with healthy periodontium (protective) and its concentration decreases as the periodontal disease progresses. However, till date, there are no studies to investigate the levels of OPG in gingival crevicular fluid (GCF) after the treatment of periodontitis. Hence, the present study was carried out to assess its concentration in GCF to find out their association if any, and to explore its possible use as a 'novel bone marker' of the host modulation of periodontal disease. Materials and methods: Sixty-four subjects were divided into 4 groups (16 each), based on clinical attachment loss (CAL) and radiological parameters (bone loss); healthy (group I), gingivitis (group II), slight periodontitis (group III), and moderate-to-severe periodontitis (group IV). Moderate-to-severe periodontitis subjects, after nonsurgical periodontal treatment, (SRP) constituted group V. GCF samples were collected to estimate the levels of OPG using enzyme-linked immunosorbent assay (ELISA). The Kruskal-Wallis, Man-Whitney U test, and Wilcoxon signed-rank tests were carried out to compare OPG levels among groups. The Spearman rank correlation test was used to correlate OPG levels between the study groups and the clinical parameters; P < 0.05 was considered significant. Results: The highest mean OPG concentration in GCF was obtained for group I (162.47 ± 51.171 pg/ μL) and the least for group IV (10.92 ± 1.913 pg/μL), suggesting a negative correlation between OPG concentration and CAL. OPG concentrations in GCF after the treatment of group IV increased from 10.92 ± 1.913 pg/μL to 15.63 ± 4.679 pg/μL. Conclusion: OPG concentration in GCF was inversely proportional to CAL and not an active progression factor for periodontal disease. Further, after the treatment of moderate-to-severe periodontitis subjects (group IV), OPG concentrations increased. Hence, it can be concluded that OPG could be considered as a 'novel bone marker' the host modulation of periodontal disease

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Prevalence and clinical aspects of cracks and fractures in teeth

Vertical root fracture (VRF) is one of the important causes of root canal treatment failure. The diagnosis of VRF can be difficult and it may occur many years after root canal treatment. In this thesis, the clinical and radiographic aspects of VRF, the factors associated with VRF and the time from root canal treatment to a diagnosis of VRF was investigated. This thesis also investigated the prevalence of microcracks in teeth without root canal treatment. The effect of root filling length on VRF and the effect of in vivo root canal instrumentation on the formation of radicular microcracks was also evaluated. The first part of this thesis concluded that the mean time period from root filling to the clinical presentation of VRFs in root canal treated teeth restored with crowns and without posts was 4.35 (± 1.96) years. Posterior teeth, older patients (>40 years), female patients, and overfilled canals were found to be potential risk factors for VRF. The second part of this thesis has reported a 7.1% prevalence of radicular dentinal microcracks in teeth without root canal treatment, which were found more commonly in mandibular teeth and in older patients (>40 years). The third part of this thesis has indicated that root canal filling to or beyond the radiographic apex can be associated with VRF. The final part of this thesis concluded that the in vivo preparation of root canals with ProTaper hand or ProTaper rotary instruments did not result in the formation of root dentinal microcracks

Gene Therapy in Periodontics: A Review and Future Implications

Abstract New advancements in gene therapy continue to have a significant impact on dentistry since 1995. At the same time, periodontal disease has attracted the attention of scholars and research scientists as a global concern. With a better understanding of disease progression and new advancement in biological science, gene therapy has emerged to enhance existing therapy and has radically recast approaches to the management of periodontal disease. Since the advent of gene therapy in dentistry, significant progress has been made to control periodontal disease and reconstruct the dentoalveolar apparatus. However, to date, gene therapy methods have not been developed to control periodontal disease due to its multifactorial origin, complex genetic predisposition, and risk associated with it. This review article provides a brief insight into the ever-expanding field of gene therapy and its possible future implication in the field of periodontics. Most of the modalities described in this article are more theoretical and still in infancy stage except for genetically fabricated materials used for regenerative purposes. Citation Karthikeyan BV, Pradeep AR. Gene Therapy in Periodontics: A Review and Future Implications. J Contemp Dent Pract 2006 July;(7)3:083-091. </jats:sec