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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Hyaluronic acid (HA) is essential for the function of extracellular matrices in both hard and soft periodontal components. HA plays an important role in the mechanisms underlying inflammation and wound healing. HA is located in periodontal tissues in differing amounts, including non-mineralized tissues, such as gingiva and periodontal ligament, and lower levels located in mineralized tissues, such as cementum and alveolar bone. According to preliminary findings, HA exhibits potential in the regulation of periodontal tissue regeneration and in the treatment of periodontal disease. HA promotes symptomatic relief in both marginal gingiva and deeper periodontal tissues. The present review aimed to examine the role of HA in periodontal therapy, and investigate the current literature supporting its use in periodontal regeneration. Contents1. Introduction 2. Properties of HA 3. Synthesis of HA 4. Role of HA in wound healing 5. Role of HA and overview of studies in periodontal therapy 6. Conclusion

Periodontitis is a condition that occurs because of inflammation-mediated tissue degeneration. Many studies have been conducted to identify inflammatory molecules in periodontitis, but the well-defined role of cells from the immune system in the progression of periodontitis as well as in gingival tissue degeneration has not been appropriately established. The objective of the present study was to characterize the monocytes isolated from the gingival crevicular fluid (GCF) in patients with periodontitis. GCF was obtained from periodontitis patients and healthy controls. Cytokine levels of CCL2 were evaluated by ELISA in GCF samples. CD14+ monocytes were separated using magnetic sorting from GCF. RT-qPCR was performed to assess the gene expression. Cytometric bead array analysis was performed to analyze the levels of cytokines and chemokines in the secretome of cells. CD14+ monocytes from GCF secreted higher levels of CCL2 and showed elevated expression of genes responsible for monocyte migration. Additionally, upon lipopolysaccharide stimulation, these monocytes secreted higher levels of inflammatory cytokines and chemokines. This investigation aids in understanding the inflammatory microenvironment of periodontitis by characterizing GCF in terms of infiltrated CD14+ monocytes, cytokines, and molecules secreted by these monocytes, which are specific for cellular differentiation.

The aim was to provide a comprehensive qualitative and quantitative assessment of any potential differences in melatonin levels in periodontitis vs. the healthy state.The keyword combination "melatonin" AND "periodontitis" was searched in Web of Science, PubMed, and Scopus. Qualitative analysis and quantitative analysis were | Inclusion criteriaOriginal research in English language assessing the melatonin levels in saliva, plasma, gingival crevicular fluid, or gingival tissue samples of humans with and without periodontitis was included in the study. | Exclusion criteriaReviews, letters, conference abstracts, articles in a language other than English, articles based on animal models, and articles wherein sufficient details on the melatonin level in periodontitis could not be elucidated were excluded from the study. | Focus question"Do the melatonin levels vary between healthy individuals and patients with periodontitis?" | Search strategyThe keyword combination "melatonin" AND "periodontitis" was searched on June 22nd, 2020, in Web of Science, PubMed, and Scopus. The identified articles were manually cross-referenced for potential articles. The search results in the databases are presented as Supporting information. | Study selection and data extraction1. The identified articles were screened using their titles and abstracts for potential duplicates and relevance to the topic Radioimmunoassay Mean melatonin levels in plasma Controls: 14.33 ± 4.05 picograms/ml Cases: 9.46 ± 3.18 picograms/ml A significant lowering of melatonin was observed in the plasma of cases compared with controls (p < .001) Negative correlation between age and plasma melatonin in controls observed (r = −0.672, p < .001). No correlation was observed in cases. Mean melatonin levels in saliva Controls: 4.22 ± 0.87 picograms/ml Cases: 2.55 ± 0.99 picograms/ml A significant lowering of melatonin was observed in the saliva of cases compared with controls (p < .001) Mean salivary to plasma melatonin ratio Controls: 0.30 ± 0.06 Cases: 0.31 ± 0.07 No significant difference in cases and controls (p > .05) Plasma melatonin levels increase in patients with CPI scores of 3 and 4 CD4 + counts in plasma had a negative correlation with both plasma and salivary melatonin levels in cases (p

Background and objective The antioxidant potential of vitamin C is useful in reducing oxidative stress, free radicals, and reactive oxygen species, which may assist in the improved outcomes of periodontal therapy. This systematic review was aimed to evaluate the effectiveness of vitamin C supplementation as an adjunct to non-surgical periodontal therapy, in the management of periodontitis. Data sources PubMed, EMBASE, Cochrane Library, and Web of Science. Study eligibility criteria Randomized controlled trials published between January 1990 and March 2020. Participants People 18 years and older with periodontitis. Study appraisal and synthesis methods The Critical Appraisal Skills Programme (CASP) quality appraisal tool. Results The initial search yielded 441 articles out of which six studies fulfilled the inclusion criteria. Vitamin C supplementation helped improve bleeding indices in gingivitis but did not significantly lead to reduction of probing depths or clinical attachment gain for periodontitis. Conclusion Administration of vitamin C as an adjunct to non-surgical periodontal therapy did not result in clinically significant improvements in pocket probing depths at 3 months in periodontitis patients. With the limited evidence available, no recommendation can be made for supplementation of vitamin C in conjunction with initial periodontal therapy for subjects with periodontitis to improve primary treatment outcome measures.

Reinfection with SARS-CoV-2 is a rare phenomenon. To date, there has been some cases reported from countries such as United States, Ecuador, Hong Kong, the Netherlands and Belgium. This case report presents the first case of reinfection from Saudi Arabia, and probably the first dental student to have been re-infected with COVID-19. A 24-year-old male dental student presents with reinfection after a period of three months since he was first infected with COVID-19. The signs and symptoms reported by the patient were similar in both instances, except that he developed fever only at the time of reinfection. The infection and reinfection were confirmed with a RT-PCR test reports. This report highlights how it is necessary to continue to observe all the prescriptions recently indicated in the literature in order to avoid new contagion for all health workers after healed from covid-19 or asymptomatic positive, since as seen sometimes the infection does not ensures complete immunity in 100% of cases.

Conventional osteotomy techniques can, in some cases, induce higher stress on bone during implant insertion as a result of higher torque. The aim of the present study was to evaluate and compare the stress exerted on the underlying osseous tissues during the insertion of a tapered implant using different osteotomy techniques through a dynamic finite element analysis which has been widely applied to study biomedical problems through computer-aided software. In three different types of osteotomy techniques, namely conventional (B1), bone tap (B2), and countersink (B3), five models and implants designed per technique were prepared, implant insertion was simulated, and stress exerted by the implant during each was evaluated. Comparison of stress scores on the cortical and cancellous bone at different time points and time intervals from initiation of insertion to the final placement of the implant was made. There was a highly statistically significant difference between B1 and B2 (p = 0.0001) and B2 and B3 (p = 0.0001) groups. In contrast, there was no statistically significant difference in the stress scores between B1 and B3 (p = 0.3080) groups at all time points of implant placement. Overall, a highly significant difference was observed between the stresses exerted in each technique. Within the limitations of our study, bone tap significantly exerted lesser stresses on the entire bone than conventional and countersink type of osteotomy procedures. Considering the stress distribution at the crestal region, the countersink showed lower values in comparison to others.