Background: Curcumin has anti-inflammatory properties. The aim of this study was to compare interleukin-1b (IL-1b) and chemokine (C-C motif) ligand 28 (CCL28) levels following a topical application of curcumin (CRM), chlorhexidine (CHX) and chlorhexidine-metronidazole (CHX-MTZ) in an experimental gingivitis human model. Methods: Sixty systemically healthy selected subjects were randomly assigned to one of three topical antigingivitis gels. Each gel was applied twice daily for 10 minutes as the sole method of oral hygiene for 29 days on the test quadrant only. Modified gingival index (MGI), plaque index (PI), bleeding on probing (BOP) and probing depth (PD) were assessed at baseline, 29 days and 60 days. Estimation of IL-1b and CCL28 levels in gingival crevicular fluid was done at baseline and at 29 days. Results: The increase of IL-1b in the CRM (14.52 AE 16.6 pg/ml) and CHX-MTZ (31.63 AE 15.96) groups was significantly less than that of the CHX group (70.55 AE 38.81). Similar results were also observed for CCL28 (CRM: 8.12 AE 8.78 pg/ml; CHX-MTZ: 12.81 AE 18.68; CHX: 41.15 AE 22.82). All groups had a significant increase in MGI, PI and BOP at 29 days. Conclusions: The anti-inflammatory potential of topical curcumin was similar to CHX-MTZ but superior to CHX in affecting IL-1b and CCL28 levels.

Periodontitis is a chronic bacterial infection resulting in destruction of the supporting structures of the teeth. Regeneration of the lost tissues has faced difficulties primarily due to the lack of support during the intricate healing processes. A surgical additive which can ‘jump start’ the healing process to a more predictable regenerative process is always on the wish list of any periodontist. Platelet-rich fibrin (PRF) is a second generation platelet concentrate that has been considered to be an important, easy to obtain, predictable surgical additive for periodontal regeneration. This autologous scaffold provides the much needed bio-chemical mediators which has the potential for enhancing reconstruction of the periodontium. This review article tries to understand as to why PRF would be an important link to reach predictable periodontal regeneration.

PurposeLow birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies.MethodsA hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ≥2,500 g. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth.ResultsLBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2).ConclusionsPeriodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.Graphical Abstract

The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by measuring dental caries prevalence and severity. An electronic database (MEDLINE) was initially searched using relevant keywords. This was followed by use of the search string in the following electronic databases: Scopus, EBSCOhost, Cochrane, and Open Grey. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction, which was facilitated using JBI SUMARI software. The primary outcome was the decayed missing filled teeth (DMFT) score and dental caries prevalence. Subgroup analysis was done by country of publication to identify causes of heterogeneity. Forest plots were used with the standardized mean difference (SMD) and publication bias was assessed using the Egger test with funnel plot construction. For the final review, 43 articles were selected and 34 were meta-analyzed. The pooled mean DMFT for both the permanent dentition (SMD = 0.26; 95% CI 0.13–0.39) and deciduous dentition (SMD = 0.67; 95% CI 0.47–0.87) was higher for the Indigenous population than for the general population. Indigenous populations experienced more decayed teeth (SMD = 0.44; 95% CI 0.25–0.62), a slightly higher number of missing teeth (SMD = 0.11&#x3c; 95% CI –0.05 to 0.26), and lesser filled teeth (SMD = –0.04; 95% CI –0.20 to 0.13) than their nonindigenous counterparts. The prevalence of dental caries (SMD = 0.27; 95% CI 0.13–0.41) was higher among indigenous people. Globally, indigenous populations have a higher caries prevalence and severity than nonindigenous populations. The factors which have led to such inequities need to be examined.

PurposeSmokeless tobacco-based oral-use products like gutka are popular in India. Gutka usage leads to increased periodontal destruction and inflammation; however, the relevant mechanism remains unknown. This study aimed to elucidate the role of gutka in periodontitis by examining its effect on the levels of interleukin (IL) 1β and IL-8 from the gingival crevicular fluid (GCF).MethodsA total of 45 patients were enrolled in this study. Thirty patients with periodontitis (15 gutka chewers [GCP] and 15 nongutka chewers [NGC]) and 15 periodontally healthy controls (HC) were selected. The full-mouth plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and recession (RC) were recorded. The IL-1β and IL-8 levels in the GCF of all subjects were assessed through an enzyme-linked immunosorbent assay (Quantikine).ResultsThe IL-1β and IL-8 levels were not significantly higher in the GCP group (IL-1β, 369.01±273.44 µL; IL-8, 205.97±196.78 µL) as compared to those in the NGC group (IL-1β, 195.57±96.85 µL; IL-8, 178.61±149.35 µL). More gingival RC and loss of attachment was seen among the GCP group (RC: 2.02±0.31, P=0.013; CAL: 4.60±0.56, P<0.001) than among the NGC group (RC, 1.21±1.15; CAL, 3.70±0.32); however, PD was deeper among the NGC subjects (P=0.002). PI and GI were significantly higher for the periodontitis group (P<0.001) when compared to the HC, but there was no difference among gutka chewers and non-chewers (P=0.22 and P=0.89). A positive correlation was found between the IL-8 levels and the duration of gutka chewing (r=-0.64, P<0.01).ConclusionsGutka chewing leads to increased gingival RC and clinical loss of attachment. There was no effect seen in the proinflammatory cytokine levels in the GCF of gutka users.Graphical Abstract

Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer.

Background Oral microbiome transplantation (OMT) is a novel concept of introducing health-associated oral microbiota into the oral cavity of a diseased patient. The premise is to reverse the state of oral dysbiosis, and restore the ecological balance to maintain a stable homeostasis with the host immune system. This study will assess the effectiveness, feasibility, and safety of OMT using an interdisciplinary approach. Methods/Design To find donors suitable for microbial transplantation, supragingival plaque samples will be collected from 600 healthy participants. Each sample (200μL) will subsequently be examined in two ways: 1) 100μL of the sample will undergo high-throughput 16S rRNA gene amplicon sequencing and shotgun sequencing to identify the composition and characterisation of a healthy supragingival microbiome, 2) the remaining 100μL of the plaque sample will be mixed with 25% artificial saliva medium and inoculated into a specialised in-vitro flow cell model containing a hydroxyapatite disk. To obtain sufficient donor plaque, the samples would be grown for 14 days and further analysed microscopically and sequenced to examine and confirm the growth and survival of the microbiota. Samples with the healthiest microbiota would then be incorporated in a hydrogel delivery vehicle to enable transplantation of the donor oral microbiota. The third step would be to test the effectiveness of OMT in caries and periodontitis animal models for efficacy and safety for the treatment of oral diseases. Discussion If OMTs are found to be successful, it can form a new treatment method for common oral diseases such as dental caries and periodontitis. OMTs may have the potential to modulate the oral microbiota and shift the ecological imbalances to a healthier state.

Background: Fibrin sealant (FS) is a biologically derived tissue adhesive for securing flaps. The aim of the present randomized controlled clinical trial was to compare early wound healing by assessing interleukin-1b (IL-1b) and interleukin-8 (IL-8) levels from gingival crevicular fluid (GCF) after using FS and suture for periodontal flap closure. Methods: Thirty selected quadrants in 15 periodontitis patients were randomly assigned to either a test (fibrining) or control group (suturing) for flap closure. IL-1b and IL-8 were assessed in GCF using enzyme-linked immunosorbent assay (ELISA) before and eight days after surgery. Patients were recalled at 7, 14, 21 days and 3 months after surgery for clinical assessment. Results: There was a statistically significant decrease in IL-1b (84.82 AE 77.18, 29.2 AE 21.97 pg/ll) and 21.82 AE 21.93 pg/ll) levels in the test side after fibrining while there was an increase in the control side (IL-1b 31.40 AE 16.82, 128.8 AE 45.14; IL-8 31.40 AE 16.82, 128.83 AE 45.14 pg/ll) (p < 0.05). The change in concentration of IL-1b and IL-8 following intervention correlated significantly in both the sites. Clinical parameters differed significantly only on the seventh day with less plaque and bleeding on the test sites. Conclusions: Fibrin sealant enhances early wound healing by reducing inflammation after periodontal flap surgery.