Objective: Periostin is a matricellular protein highly expressed in periosteum, periodontal ligament and is essential for tissue integrity and maturation. It plays a role in collagen fibrillogenesis and is downregulated in periodontal disease. Biostimulation utilizing low-level laser therapy (LLLT) influences periodontal ligament fibroblast proliferation. This study was conducted with the objective of estimating periostin levels in chronic periodontitis (CP) patients following LLLT as an adjunct to root surface debridement (RSD). Materials and Methods: Thirty periodontally healthy participants (Group I) and sixty CP participants were recruited. Based on the therapeutic intervention, CP patients were allocated to either RSD (Group II) or to RSD with LLLT (Group III) group. Clinical parameters and gingival crevicular fluid (GCF) periostin levels were assessed at the baseline and at the 3^rd month. Results: Periostin levels were significantly lower in CP patients when compared to healthy individuals at the baseline (P < 0.01). Following nonsurgical periodontal treatment (NSPT), periostin levels significantly increased in both Group II and III, when compared to baseline values (P < 0.001). Comparison of mean periostin levels between both the treatment groups showed a significant increase in LLLT group than RSD at the 3^rd month (P < 0.05). Conclusion: Within the limitations of the present study, LLLT application was found to have additional benefits over RSD with respect to clinical periodontal parameters and GCF periostin levels. Moreover, periostin may be used as a possible biomarker to evaluate the outcome following NSPT.

Type 2 diabetes mellitus (DM) is a known systemic risk factor for periodontitis. An increased expression of CD44 has been suggested in type 2 diabetics and periodontitis patients. The present study aimed to assess the expression of CD44 antigen in patients with chronic periodontitis (CP) and type 2 DM in a South Indian urban population. Additionally, the relationships between the expression of CD44 antigen in gingival tissues, periodontal clinical parameters, and the random blood sugar (RBS) and glycated hemoglobin (HbA1c) levels were assessed. A total of 63 subjects were divided into 3 groups: systemically and periodontally healthy controls (group H); CP patients, otherwise healthy (group CP); and CP patients with type 2 DM (group CP+DM). Periodontal parameters were recorded for all groups, and additionally the RBS and HbA1c levels for group CP+DM. Gingival tissue samples were obtained and subjected to immunohistochemical analysis for CD44. The expression of CD44 was significantly higher in the diseased groups. Epithelial CD44 expression was significantly stronger in group CP+DM as compared to groups CP and H (p < 0.001), whereas connective tissue CD44 expression was similar in groups CP and CP+DM (p = 0.657). Furthermore, an inverse relationship was observed between blood glucose parameters and CD44 expression in the epithelium and connective tissue. The expression of CD44 increased with the severity of periodontal disease. Additionally, glycemic control in patients with CP and type 2 DM had an impact on CD44 expression. Our findings indicate a possible destructive role of CD44 in the pathogenesis of periodontal diseases in individuals with type 2 DM.

Maxillary gingival recessions can be managed by both semilunar coronally repositioned flap (SLCRF) and coronally advanced flap (CAF). The objective of this study was to compare SLRCF and CAF in terms of wound healing and periodontal parameters in the presence of magnification. Thirty patients with Miller’s class I gingival recession in maxillary anteriors and premolars were assigned to 2 groups including SLCRF and CAF. All procedures were performed using 2.5× magnifying loupes. Wound healing and periodontal clinical parameters were assessed at baseline and at 2nd, 4th, 8th and 12th week. No significant difference was observed in wound healing and mean percentage root coverage in both the groups at 12th week (p > 0.05). However, SLCRF showed a statistically significant reduction in percentage of root coverage (PRC) at 12th week compared to 2nd week (p < 0.05). A significant gain in Clinical attachment level, width of keratinised tissue and a significant reduction in Recession Depth and Probing Depth were seen in both the groups at 12th week. Within the limitation of this study, both techniques resulted in similar wound healing at 12th week with the use of magnification. CAF provided more root coverage compared to SLCRF technique in the maxillary class I gingival recession defects.

Background: The aim of this study was to evaluate and compare preprocedural dental anxiety levels and postprocedural pain perception in chronic periodontitis patients during conventional-staged root surface debridement (RSD) and single-stage RSD. Materials and Methods: Thirty-seven adult generalized chronic periodontitis patients requiring RSD were recruited in this study. Preprocedural anxiety levels were assessed using a self-reported questionnaire and postprocedural pain perceptions were assessed using 0–10 cm visual analog scale. The subject population was divided into two groups: staged RSD (n = 18) and single-stage RSD (n = 19). Staged RSD patients visited four times as opposed to single-stage RSD patients. Data were subjected to Pearson Chi-square test, Mann–Whitney U-test, and Spearman's rank correlation. Results: There was no statistically significant difference in dental anxiety levels or pain perceptions in both the groups. Within Group 1, there was statistical significant difference in dental anxiety levels between visit 4 and visit 3 (P = 0.037) and pain perception between visit 3 and visit 1 (P = 0.005), visit 4 and visit 1 (P = 0.002), and visit 4 and visit 2 (0.04) was statistically significant. There was a positive correlation of anxiety questionnaire (Q1–Q4) to the pain score in Group 1 which was statistically significant and in single-stage RSD. Conclusion: Conventional quadrant-wise RSD tends to cognitively condition the anxiety experience thus influencing pain experience.

The gold standard approach to diagnose periodontitis is based on clinical examination and radiographic investigations. This, however, is expensive, tedious, and not feasible in population-level assessments. The self-reported periodontitis questionnaire offers great benefit to facilitate larger epidemiological surveys. There is limited evidence on cognitive validation of self-reported periodontitis questionnaire. This study employed a think aloud approach to investigate if participants interpreted, comprehended, and understood the items in a self-reported periodontitis questionnaire, in the same way as researchers' intended. 20 adults, resident of the UK and fluent in English participated in online recorded think aloud interviews. The self-reported periodontitis questionnaire consists of 15 questions and 2 open ended questions. The interviews were then transcribed and coded by two independent researchers according to predefined categories representing comprehension and conventional content analysis was used to analyse open-ended data. The think aloud approach revealed that most of the questions in the self-reported periodontitis questionnaire were well understood by the participants. Two items, however, were identified as problematic: one was misinterpreted, and another question was not understood by most of the participants. Qualitative conventional content analysis of open-ended questions reiterated and complemented the findings of the think aloud study. Further questions coded as problematic for 3 or more participants were then considered for rephrasing. This study revealed the interpretation and understanding of self-reported periodontitis questions by English speaking UK residents and highlighted the probable reason for lower sensitivity values of the self-reported periodontitis questionnaire. This study employed think-aloud approach to capture the thought process of the participants as they answered questions on self-reported periodontitis questionnaire. Overall, the questionnaire was well received by the participants, however, some questions were misunderstood/misinterpreted. This study highlights the potential information bias if participants do not understand the questions in epidemiological surveys.

Local Anesthetics are used clinically for anesthesia and analgesia either following surgery or for management of acute and chronic pain conditions. Liposomal Encapsulation aids in improved delivery at the tissue level. This paper deals with formulation and characterization of Gadus morhua derived liposome encapsulated Lidocaine nanoparticles. Water Soluble liposomes were synthesized and encapsulated to lidocaine. The prepared liposomes were assessed using field emission scanning electron microscope, TEM, FTIR, Zetapotential, Anti-inflammatory property and Drug release kinetics. The structural and morphological characters of the conjugated liposomes were studied using SEM & TEM, surface charge Zetapotential. The cumulative drug release was studied for up to 72 h in which more than 70 % of the drug was released from the Liposomal nanoparticles. FTIR revealed similar functional groups like the control. Stability of the drug was superior than the control. Liposomal conjugation delays the drug release which can be used in slow release applications. Improving the drug release kinetics can be advantageous in many chronic pain conditions. Additionally, the changes in the functional groups can also aid in reduction or masking of bitterness.