Background:The relation between diabetes mellitus and periodontitis has been discussed for years. Many adipokines were reported to play a major role in periodontal inflammation. Chemerin is one of these adipokines which is blamed to be involved in inflammatory conditions such as diabetes. Fibroblast growth factor 21 (FGF21) is another adipokine which is believed to induce regulation of glucose. The current study aimed to spot the light on the potential role of gingival crevicular fluid (GCF) level of FGF21 and chemerin as biomarkers of periodontal disease activity and an attempt to understand their role in the link between periodontitis and diabetes. Methods: The study was conducted on 45 individuals, 15 diabetic patients with periodontitis, 15 periodontitis patients and 15 healthy controls. GCF samples were collected from all participants for assessment of chemerin and FGF 21. Samples were analysed using enzyme linked immunosorbent assay (ELISA). Results: Periodontitis patients with diabetes had significant higher levels of chemerin and FGF21 than the periodontitis patients without diabetes followed by healthy controls. ROC analysis showed a 100% diagnostic accuracy for chemerin and FGF21. Conclusion: FGF21 and chemerin in GCF are valuable biomarkers of periodontal disease suggesting a role in the link between diabetes and periodontitis.
Aim: The aim of this randomized clinical trial (RCT) is to evaluate the clinical and radiographic effectiveness of Entire papilla preservation surgical technique (EPP) to Modified minimally invasive surgical technique (M-MIST) in the treatment of periodontal intraosseous defects in stage III periodontitis patients. Methodology: A total of twenty patients (20-60) years old suffering from Stage III periodontitis were recruited, assigned and allocated randomly to one of two groups, group A (intervention group) to receive Entire Papilla Preservation technique (EPP) and group B (control group) to receive Modified Minimally Invasive Surgical technique (M-MIST). Each patient presented intra-bony defects; the selected sites were divided randomly into two treatment groups. Clinical attachment level gain (CAL gain) was recorded as primary outcome and recall appointments were carried out at 3-, 6- and 12-months post operatively. Radiographical parameters were evaluated pre-surgically and after 6 and 12 months. Patient satisfaction was evaluated at 12 months. A dropout of four patients were excluded during the study period. Results: Both groups demonstrated statistically significant improvement where group A exhibited 4.13 mm CAL gain at twelve months, while group B exhibited 3.81 mm CAL gain twelve months after treatment.
Background: Gingival overgrowth is one of the side-effects seen as a result of the regular administration of the calcium channel blocker anti-hypertensive drug Nifedipine. Fibronectin (FN), is an adhesive high molecular weight extra cellular matrix glycoprotein which plays an important role in influencing cell growth, adhesion, migration as well as extracellular matrix organization. It also contributes to fibroblast attachment and proliferation, and participates in the regulation of tissue fibrosis. Erbium: YAG laser was approved in 1997 by the U.S. Food and Drug Administration for hard and soft tissue treatment in dentistry. Several studies have been published to demonstrate its efficacy for bone cutting, plaque and subgingival calculus removal, as well as having an antiseptic effect on both soft and hard periodontal tissues. Conventional scaling in combination with Erbium: YAG laser has unexpectedly showed complete healing with normalization of the gingiva, making further surgical treatment for gingival volume reduction unecessary.
Objectives:The aim of this study was to investigate the expression of fibronectin and its connection with the development of drug-induced gingival overgrowth. It also explores the effect of Erbium:YAG laser on the amount of fibronectin expression.
Materials and methods:Paraffin embedded biopsies were obtained from 3 groups of patients: 10 normal patients (group C), 10 patients who underwent conventional scaling with surgical correction of gingival enlargement caused by the regular administration of nifedipine (group A), and 10 patients undergoing scaling and surgical removal of the overgrown gingiva due to the regular administration of nifedipine followed by Erbium:YAG laser treatment (group B). All Specimens were stained with Hematoxyin and Eosin to allow analyses of tissue morphology as well as immunostaining to detect fibronectin. Staining intensity in all groups was calculated by semi quantitative analysis. The results were subjected to statistical analysis.Results: Fibronectin stained less intensely nifedipine induced gingival hyperplasia after one single laser application when compared to gingival over growth without laser therapy.
Conclusion:Erbium: YAG laser could be considered an effective option for the nonsurgical treatment of drug-induced gingival overgrowth which surpassing surgical procedures. It also promoted fast healing and ensured a higher surgical compliance when compared to the conventional techniques.
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