Aims and Objectives:(1) To evaluate the effect of type 2 diabetes mellitus on salivary TNF-α level in chronic periodontitis. (2) To evaluate the effect of smoking on salivary TNF-α level in chronic periodontitis. (3) To compare and correlate TNF-α level with the healthy individuals.Materials and Methods:Subjects aged 30-35 years were included for the study and divided into four groups as a group of 20 systemically and periodontally healthy individuals (group I), a group of 20 subjects with pocket probing depth (PPD) ≥5 mm and clinical attachment loss (CAL) of ≥2 mm (group II), a group of 20 diabetic subjects (of more than 5 years) with periodontal parameters as of group II as (group III) and a group of 20 subjects smoking (≥10 cigarettes a day) with periodontal parameters of group II as (group IV). Periodontal parameters of PPD, CAL, gingival index (GI), and plaque index (PI) were measured using standard indices and criteria. Three milliliter of unstimulated saliva was taken and salivary TNF-α determined by using ELISA technique (Quantikine Human total TNF-A immunoassay kit).Results:Data revealed highest mean TNF-α in group III followed by group IV, group II, and group I. Mean TNF-α of both group III (76.1%) and group IV (48.8%) was significantly higher as compared to group I (P < 0.001). Mean TNF-α of group III was also found to be significantly different and higher (68.1%) as compared to group II (P < 0.001). Although higher mean TNF-α (31.5%) was found in group IV in comparison to group II, the difference was not statistically significant. Besides above, TNF-α also showed a direct positive correlation with PPD in group II (r = 0.30, P > 0.05) and a significant negative correlation was observed between CAL and TNF-α in group IV.Conclusion:Our study clearly underlines a profound impact of diabetes and smoking on salivary TNF-α in chronic periodontitis subjects in comparison to healthy subjects. Moreover, diabetes status increased TNF-α significantly in comparison to smoking in chronic periodontitis patients.

Objective:C-reactive protein (CRP) is an acute-phase reactant and has been proved to be a significant predictor of future cardiovascular events. Recent studies have demonstrated a correlation between periodontitis and elevated CRP levels. However, most of the studies have focused on chronic periodontitis and very few studies are done in patients with aggressive periodontitis. The aim of this study was to determine and compare the relative levels of serum CRP in aggressive and chronic periodontitis patients.Materials and Methods:A total of 75 systemically healthy subjects were divided into three groups: Group I, nonperiodontitis subjects; group II, chronic generalized periodontitis patients and group III, generalized aggressive periodontitis patients. All participants were subjected to quantitative CRP analysis using enzyme-linked immunosorbent assay.Results:Mean CRP levels were significantly greater in both group II and III as compared to group I and group III having greater level than group II. Furthermore, CRP levels positively correlated with the amount of periodontal destruction as measured by probing depth and clinical attachment loss.Conclusion:The present study indicates a positive correlation between CRP and periodontal disease severity with particular concern in younger individuals that could be a possible underlying pathway in the association between periodontal disease and the observed higher risk for cardiovascular disease in periodontitis patients.

PurposeCigarette smoking is a major risk factor in periodontal diseases. The pathogenesis of periodontal diseases may be affected by alterations of the inflammatory response by smoke. Nitric oxide (NO) is a gaseous, colorless, highly reactive, short-lived free radical with a pivotal role in the regulation of various physiological and pathological mechanisms in the body. It is important in host defense and homeostasis, on the one hand, whereas, on the other hand, it modulates the inflammatory response in periodontitis, leading to harmful effects. The aim of this study was to assess the levels of NO in both the serum and saliva of smokers and nonsmokers having chronic periodontitis and to compare them with periodontally healthy controls.MethodsSixty subjects participated in the study and were divided into three groups: group I, healthy nonsmoking subjects; group II, nonsmoking patients with chronic periodontitis; group III, smoking patients with chronic periodontitis. Each group consisted of twenty subjects. The biochemical estimation of NO in the collected serum and in the saliva was performed using the Griess colorimetric reaction.ResultsThe results showed that the mean value of the salivary and serum NO was greater in group II than in group I, and also greater in group III than in group II.ConclusionsNO appears to play an important and rather complex role in the immuno-inflammatory process and in the remodeling and maintenance of osseous structures. It is therefore logical that modulation of this mediator has potential for the treatment of a number of inflammatory conditions including periodontal disease.

Necrotizing periodontitis is a distinct and specific disease characterized by rapidly progressing ulceration of the interdental gingiva and then spreading along the gingival margins and leading to acute destruction of periodontal tissues. Necrotizing ulcerative gingival lesions are common in developing countries because of poor nutritional status, poor oral hygiene and debilitating conditions. In the developed world it is mostly seen in patients with the HIV infections and other immune system dysfunctions. The exact etiology of the necrotizing lesions is still unknown; however a fuso-spirochaetal infection along with weakened host immune system seems to play a major role in the pathogenesis of these diseases. Presented is the case of acute necrotizing periodontitis in a 21 year old male patient with no systemic disease but a history of tobacco use (chewing and smoking) since 7 years. The patient was managed by conservative treatment followed by surgery for the correction of gingival defects.

Aim:The aim of this study was to determine the utility of plasma total antioxidant capacity (TAC) as marker of periodontal disease by estimating TAC of periodontally healthy and chronic periodontitis patients and the impact of scaling and root planning on total antioxidant status of periodontitis patients.Materials and Methods:Blood plasma samples were collected from randomly selected eighty individuals (40 periodontally healthy controls and 40 chronic periodontitis patients), with an age range of 20–45 years and were analyzed for TAC by ferric reducing antioxidant power assay. Scaling and root planing was performed in periodontitis patients, and TAC level was measured again after 3 weeks. Data were analyzed with t-test, using SPSS software (PSAW, Windows version 18.0).Results:The mean plasma TAC was significantly lower (792.33 ± 124.33 μmol/L, P < 0.001) in chronic periodontitis patients compared to healthy control (1076.08 ± 193.82 μmol/L). Plasma TAC level increased significantly (989.75 ± 96.80, P < 0.001) after scaling and root planing.Conclusions:An inverse relationship exists between plasma TAC and severity of chronic periodontitis suggesting disturbed oxidant-antioxidant balance in chronic periodontitis. Scaling and root planing resulted in the restoration of TAC to normal levels. These results are important from the perspective of including antioxidants in periodontal therapy regime to boost up body's antioxidant defense system and to reduce oxidative stress-mediated periodontal tissue damage. We concluded that TAC can be used as a biomarker to evaluate the health of periodontium.