Chronic periodontitis and diabetes mellitus share a two-way relationship, the common factor being the inflammatory-mediated pathway, and various cytokines are released during this inflammatory cascade, one of which being matrix metalloproteinase-9. The aim of this study was to identify whether the levels of matrix metalloproteinase-9 are increased due to type-II diabetes mellitus in chronic periodontitis patients. It was an observational, analytical, case-control study. Thirty subjects were recruited in the test group, who were suffering from type-II diabetes mellitus and chronic periodontitis, and 30 subjects in the control group, who were subjects with chronic periodontitis but systemically healthy. Periodontal parameters, including the plaque score, gingival bleeding index, probing pocket depth and clinical attachment level of the subjects, were measured, saliva samples of all of the subjects were collected and salivary matrix metalloproteinase-9 levels were analyzed by an enzyme-linked immunosorbent assay (ELISA) technique. The statistical analysis was performed using SPSS 24. Overall, the matrix metalloproteinase-9 levels of the diabetic patients with chronic periodontitis were increased almost twofold (156.95 ± 29.80 ng/mL) compared to the levels in the controls (74.96 ± 6.32 ng/mL) (p < 0.001). Similarly, the periodontal parameters were far worse in diabetics with chronic periodontitis compared to the controls. The average gingivitis score for the test subjects was 78.45 ± 8.93%), compared to 29.32 ± 12.96% in the controls (p < 0.001). The mean probing pocket depth for the test group was 5.39 ± 0.60 mm, and, for the control group, it was 4.35 ± 0.31 mm (p < 0.001). For the test subjects, the average clinical attachment level was 5.86 ± 0.58 mm, and it was 4.66 ± 0.32 mm for the controls (p < 0.001). It was ascertained that there is a two-fold increase in the levels of salivary matrix metalloproteinase-9 in the test group compared to the control group. In addition, the level of periodontal apparatus destruction was greater in the test group. This proved that type-II diabetes mellitus influences the levels of matrix metalloproteinase-9 in humans and elevates them, causing further periodontal destruction.
Aim: To see the efficacy of titanium mesh in orbital floor reconstruction to correct the post-traumatic enophthalmos in orbito-zygomatic complex fractures. Methods: This retrospective study was carried out in the department of Oral and Maxillofacial Surgery, University College of Medicine & Dentistry, University of Lahore, Pakistan from January 2017 to January 2020. All patients who had enophthalmos after orbito-zygomatic fractures and were treated for orbital floor reconstruction with titanium mesh were included in the study. Computer tomography (CT scan) was done to diagnose and measure the orbital floor defect. Pre-operative and post-operative hertalex ophthalmometry was done to measure and compare the enophthalmos. Results: Among the 30 patients, 23 were male and 7 were female. The mean age of the patients was 30±5.80 years. Fourteen patients had right and 16 patients had left side orbitozygomatic complex fracture. The mean orbital floor defect size was 1.72±0.78 cm preoperatively measured by CT scan. There was a correction of enophthalmos in 23 patients out of 30(76.66%). Conclusion: Titanium mesh is a commonly used and easily available material for the correction of orbital floor defects. It is efficacious in terms of the correction of post-traumatic enophthalmos resulting from orbito-zygomatic complex fracture. Keywords: Enophthalmos, titanium mesh, orbitozygomatic fractures
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