The current scenario of the COVID‐19 pandemic has forced dentists to seek different options for delivering healthcare services other than the in‐person direct examination in clinical practice. Teledentistry is one of the options for remote patient care and monitoring. Objective. The present survey was conducted to assess the knowledge and perception of the dentists in Pakistan regarding teledentistry as an emergent supportive tool. Materials and Methods. A self‐administered, close‐ended, and prevalidated survey questionnaire was used, comprising 21 questions, and distributed electronically via e‐mail, WhatsApp, and Facebook Messenger to evaluate the knowledge and perception of dentists regarding teledentistry. The data collected was compiled in a systematic manner and analyzed in terms of frequency (yes/no). Results. Out of a total of 350 dentists, 325 responded to the questionnaire, and it was seen that 62.5% of them did not have knowledge about teledentistry prior to COVID‐19. 65.8% of dentists considered the practice of teledentistry in nonpandemic situations in the future. Conclusion. In the present study, it was observed that most of the dental professionals had inadequate knowledge about teledentistry before COVID‐19, but the awareness and perception regarding teledentistry were currently satisfactory among the dental professionals in Pakistan. This emerging trend gives a positive hope for the implementation of teledentistry in the healthcare setup of Pakistan in the near future, as it will prove to be beneficial for safe dental practice during times of pandemic and even after.

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.

Objective. Teledentistry is considered to be a technological advancement in providing dental care to patients while effectively addressing the time management. Furthermore, the pandemic of COVID‐19 has been here for quite long now, forcing the dental practitioners to ponder upon other methods of healthcare delivery apart from the traditional in‐office direct clinical examination. The aim of this study was to explore the perceptions of dental professionals of Malaysia regarding teledentistry, which can act as a future pedestal for improvements in virtual dental practice and patient care. Materials and Methods. It was a descriptive, cross‐sectional study involving an electronic survey of a sample of dental professionals of Malaysia. A prevalidated, 26‐item, 5‐point Likert‐scale questionnaire was used in assessing the perceptions of dental professionals regarding teledentistry in four domains: existing concerns about teledentistry use, the potential of teledentistry in improving practice, usefulness of teledentistry for dental practice, and its usefulness for patients. Statistical analyses involved descriptive statistics which included frequency distributions. Results. An overall response rate of 31.0% was observed with 310 dental practitioners participating in the survey. More than 60% of respondents agreed that teledentistry would benefit the dental practice through enhancement of communication with peers, guidance, and new patients’ referral. However, a substantial proportion of practitioners (70‐80%) expressed uncertainty with accuracy of diagnosis, technical reliability, and privacy. Conclusion. Generally, the results of this study point towards the readiness of dental professionals of Malaysia to engage in teledentistry practice. However, further work needs to be done to assess the commercial feasibility of teledentistry, not only in Malaysia but also in other parts of the world. To start with, directed campaigns in reference to teledentistry are necessary to educate dentists and the public about the technology and its potential.

Objective: This study was undertaken to assess whether advanced glycation end-products had any influence on the levels of matrix metalloproteinase-1 in patients with type-II diabetes mellitus and chronic periodontitis. Material & Methods: It was a case-control study. 30 subjects were recruited in test group, who had chronic periodontitis and known cases of type-II diabetes mellitus. 30 subjects were kept in control group, who had chronic periodontitis but no systemic diseases. Periodontal parameters were recorded, samples of saliva were collected for all the subjects, and assessment of matrix metalloproteinase-1 levels was undertaken via enzyme linked immunosorbent assay. Statistical analysis was done using SPSS 26. Results: The levels of matrix metalloproteinase-1 showed a significant elevation in test group in comparison to the controls (p<0.001). Likewise, all the periodontal parameters had greater readings in the test group as compared to the controls (p<0.05). Conclusions:As there is a significant increase in the levels of salivary matrix metalloproteinase-1 due to advanced glycation end-products, as released in diabetic subjects, the destruction of periodontal apparatus was also, in return, greater in the diabetic subjects as compared to non-diabetic ones. This proves that advanced glycation end-products further elevate the levels of matrix metalloproteinase-1 in humans, resulting in greater destruction of periodontium. Clinical Relevance:This study observes that if MMP-1 is inhibited by tissue inhibitors of metalloproteinases (TIMPs), the periodontal destruction in patients of type-II diabetes mellitus can be controlled and vice versa.

Purpose : The aim of this study was to examine the current perceptions in prescription of systemic antibiotics for treating periodontal and peri-implant diseases. Methods : It was a descriptive, cross-sectional study involving an electronic survey of a sample of periodontists from Pakistan. A pre-validated questionnaire was disseminated to Pakistan Medical and Dental Council registered periodontists of Pakistan in order to ascertain their prescribing patterns of systemic antibiotics for various periodontal diseases. These included plaque-induced gingivitis, aggressive periodontitis, chronic periodontitis, acute gingival and periodontal conditions, conditions associated with dental implants, mucogingival surgery and periodontal regeneration. Results : From the 68 periodontists that responded to this study, 44 completed the questionnaire and their responses were analyzed. Prescribing trends of systemic antibiotics varied individually as well as for different periodontal conditions among the responding periodontists. Highest rate of antibiotics prescription was recorded for the management of aggressive periodontitis, which was 95.5%. Succeeding this were acute periodontal conditions, implant placement surgery, periodontal regeneration procedures and mucogingival surgery, having a prescription rate of 93.2%, 79.5%, 50% and 29.5%, respectively. Combination of amoxicillin and metronidazole, azithromycin, and amoxicillin were the three drugs of choice for various periodontal conditions. Conclusion : Based on the results from this survey, it was deduced that systemic antibiotics are widely prescribed by the periodontists in Pakistan, with varying rates and patterns for different periodontal and peri-implant diseases. These results highlight the need for guidelines and recommendations in the prescription of antibiotics for various periodontal diseases and peri-implant conditions.