European Journal of Molecular & Clinical Medicine

Background: Normal kidney secretes nitrogenous waste product, regulate volume and
acid /base balance of plasma and synthesize erythropoietin, 25-(OH)2- cholecalciferol
and renin. Chronic kidney disease (CKD) is caused by a progressive and irreversible
decline in the number of nephrons. A wide variety of oral manifestations occurs in CKD
patients. Determination and identification of these manifestations will improve the
quality of life in these patients.
Methods: Thus, this cross-sectional study was conducted in the Department of
Medicine, Sanjay Gandhi Memorial Hospital (SGMH), associated with Shyam Shah
Medical College (SSMC), Rewa, in the Vindhya region between February 2019 and
August 2020.
Results: Out of 127 patients, maximum prevalence of oral manifestations occurring was
pallor (93.70%), xerostomia (84.25%), halitosis (72.44%), sore throat (64.56%), lip
pigmentation (63.77%), periodontitis (48.81%). High Urea levels were found to be
highly significant when correlated with halitosis (p<0.00052). Xerostomia was found
significant when correlated with duration of dialysis (<1 year) with p<0.032.
Conclusions: Manifestations of CKD are common during the progression of uremia. In
the patients studied, the impact of CKD on the oral cavity was evidenced by significant
changes, which pointed to an inter-relationship between oral health and CKD.

Geriodontology refers to the field of dentistry that mainly encompasses diagnosis, treatment and prevention of oral diseases and conditions in the elderly individuals. With increasing life expectancy attributed to the developments in the field of medicine, there is concomitant increase in the comorbidities and complications in the older population. In the dental perspective, increased attrition of teeth, xerostomia induced dental caries, chronic periodontal diseases and partial edentulousness are the most frequently encountered problems. The management in these instances requires additional considerations, keeping in mind the presence or absence of other systemic diseases, age and the social and environmental factors. In order to provide efficient treatment and also to encourage their constant maintenance protocols,a multimodal treatment planning has to be designed and dentists must be specifically educated and specialised in dealing with the geriatric patients. This review paper highlights the various aspects on periodontal management of geriatric patients with few futuristic suggestions in order to improve their oral healthcare in this phase of life.

Aim:To assess the effectiveness of Triphala against gingivitis and periodontitis. Triphala is a mixture of three myrobalans known as Emblica officinalis (Amalaki), Terminalia bellerica (Bibhitaki), Terminalia chebula (Haritaki)
Methods: A search of the PubMed, Google Scholar, Web of Science and Scopus database was conducted.
Results: Triphala possess varying therapeutic potentials. Particularly antimicrobial and anti-inflammatory, anti collagenase and anti oxidant properties are of greater importance in dentistry. Various studies show that Triphala is equally as effective as a standard chemotherapeutic agent that is chlorhexidine in treatment and prevention of gingivitis and periodontitis respectively.
Conclusion: Triphala can be a promising therapeutic agent in treatment of gingivitis and peridontitis with no side effects on long term use.

Dental implants are commonly used in situations for replacement of natural teeth. Despite many advances, techniques, and implant-design, implant failure is a significantconcern for the patient and dentist. The dental implants are designed that best suits the various types of bone. Different etiology for the implant failure and their contributing factors has been discussed in this review article. The purpose of this concise review is to discuss the etiology of implant failure by highlighting the various classification put forth by different authors

Abstract: Background- Excessive accumulation of fat results into obesity. Obesity further
have an adverse effect on health as it has been seen to be associated with diabetes mellitus,
hypertension, heart disease like coronary artery disease, cerebrovascular disease such as
hemorrhagic and ischemic stroke, metabolic syndrome like insulin resistance, some
cancers such as cancer of esophagus, thyroid, kidney, uterus, colon and breast, and
psychosocial problems. Also, obesity is considered to be a risk factor for periodontitis
which is an inflammation of supporting periodontal structures around the tooth which
results from the complex interaction between pathogenic bacteria and the host immune
response. However, the impact of obesity on different severity of periodontal disease is not
evaluated in rural population. Aim: To evaluate the relationship between obesity and the
severity of periodontal disease in Rural population. Methodology: A total 400 obese
subjects will be included in the study. Biometric parameters like age, weight, height, waist
and neck circumference, subcutaneous skin fold will be evaluated. Also periodontal
parameters like Plaque index (PI), Papillary bleeding index (PBI), Probing pocket depth
(PPD), Clinical attachment level (CAL) and Gingival recession (REC) will be evaluated
and co-relation between these parameters will be carried out. Results: A statistically
significant association will be observed between BMI and periodontitis of overweight and
obese study individuals having periodontitis. A positive co-relation will be observed
between biometric parameters and periodontal status of obese individual. Conclusion: A
significant association will be observed between BMI and periodontitis of overweight and
obese study individuals having periodontitis in rural population.

Nonsurgical therapy aims to eliminate bacteria within the microbial biofilm and calcified biofilm microorganisms from the tooth surface and adjacent soft tissues. Complete elimination of such pathogenic microorganisms is probably over-ambitious. However, absence of inflammation in the periodontium results in beneficial clinical changes.In addition, nonsurgical therapy aims to form an environment during which the host can more effectively prevent pathogenic microbial recolonization using personal oral hygiene methods..The various methods utilized in nonsurgical therapy, like hand instrumentation, ultrasonic and sonic scalers, and ablative laser therapy

Background: Nishamalaki or Nisha Amalaki representing various combination formulations of Turmeric and Indian gooseberry is recommended in Ayurveda, proven efficacious and widely practiced in the management and prevention of complications of Madhumeha (Diabetes).
Aims: To assess the effectiveness of scaling and root planing on the glycemic status and gingival crevicular fluid (GCF) levels of Malondialdehyde, Superoxide Dismutase, Catalase and Osteocalcin in Type II diabetes patients with chronic periodontitis under systemic administration of Nishamalaki, an ayurvedic hypoglycemic formulation.
Material and methods: The study included 90 newly diagnosed Type II diabetic patients in the age group between 30 to 50 years with mild to moderate chronic periodontitis and was randomly divided into 45 patients of two groups each. Group A were Type II diabetic patients with mild to moderate chronic periodontitis taking supplements of Nishamalaki 1 gram twice daily for 3 months and Group B were Type II diabetic patients with mild to moderate chronic periodontitis undergoing scaling and root planing and receiving supplements of Nishamalaki 1 gram twice daily for 3 months.
Results: Independent t-test has been applied to compare the two groups. It has been observed there is no significant difference exists between the two groups. However administration of Nishamalaki and scaling has been all effective in group B parameters.
Conclusion: Nishamalaki showed protective effect and appeared to be useful in reducing the glycemic status, levels of superoxide dismutase, catalase, lipid peroxidase and osteocalcin in GCF in type-2 diabetes patients with chronic periodontitis.

Chronic periodontitis (CP), the most common periodontal disease, is an inflammatory disease leading to the destruction of connective tissue and loss of the adjacent supporting bone and is multifactorial in etiology. Periodontal therapy including either surgical and/or non-surgical methods usually results in improvements in periodontal health. In some cases, scaling and root planing (SRP) is insufficient to solve periodontal infection. SRP combined with local antibiotics has been shown to yield better results than SRP only. Recently, minocycline, a broad spectrum antibiotic is found to be effective against periodontal pathogenic micro-organisms.
The aim of this systematic review is to evaluate the clinical efficacy of locally delivered minocycline in the treatment of periodontitis.an electronic search was carried out using the keywords, “minocycline”. “periodontal” and “periodontitis” via the PubMed/Medline, ISI Web of Science and Google Scholar databases for relevant articles published from 1949 to February 2019. The addressed focused question was: To review current literature, to analyse the efficacy of minocycline as a local adjunct to SRP in the treatment of periodontitis. Following the removal of duplicate results, the primary search resulted in articles and articles were excluded based on title and abstract. Hence, articles were read completely for eligibility. After exclusion of irrelevant studies,6 articles were included. All of them were RCT’s, all of them were human studies, were clinical and were microbial analysis.

The aim was to study the prevalence and risk factors of dental disease development in
pregnant women living in different Uzbekistan regions. The prevalence and intensity of dental
caries among pregnant women are 1.3 times higher in the Urgenchdistrict of the Khorezm
region compared to the Kibray district of the Tashkent region. These figures increase with
each subsequent pregnancy. The same pattern is observed for periodontal and oral mucosa
diseases. The most significant medical and biological factors contributing to the development
of dental diseases in pregnant women were age, several pregnancies, intergenerational period,
course and terms of pregnancy, the presence of extragenital diseases. Among medical and
social risk factors, the most significant were education, living conditions, oral hygiene,
sanitary culture, and medical activity of pregnant women.

Aim: Aim of our research was to evaluate the amount of stress as well as performance pressure on the oral hygiene in our study participants.
Methodology: Survey was conducted in 200 patients who had reported to various private clinics over a period of 6 months. Questionnaire was given having 12 questions, which helped us assess their stress levels related to their oral hygiene status. Descriptive analysis was carried out with the data received from the study participants.
Results: Maximum participants had moderate stress levels (47%), whereas around 34 % experienced oral health problems. 67% were conscious about their appearance, and their smile. Only 14 % went for regular dental check-ups, which further shows less awareness for preventive care.
Conclusion: Our findings suggest that individuals with greater perceived stress also report poorer oral health. These findings may warrant greater attention be paid to the role of psychological stress in the development of oral disease.

The article presents information about the hygienic state of the oral cavity, the state of periodontal tissues, the level of hygienic knowledge and measures of therapeutic and prophylactic measures among workers of silk-winding production. The object of study was 97 workers of the alkaline-winding industry "Bukhara Brilliant Silk", who are exposed to industrial noise, as one of the harmful production factors, also the dustiness of the air in working rooms in various workshops and, in terms of importance, harmful, production factors are microclimatic conditions, at the age of 29 59 years. The control group consisted of 44 employees of the administrative and managerial apparatus, whose work process excludes the impact of factors of the working environment. The results of the research revealed the total prevalence of diseases of hard tissues of teeth (99.1%) and periodontal disease (100%) among workers of the alkaline industry "Bukhara Brilliant Silk", a high prevalence of diseases of the oral mucosa - 58.7%, a low level of oral hygiene and hygiene knowledge. There is an obvious need to develop a targeted prevention program, including a comprehensive - individual, professional oral hygiene and health education.

Nonsurgical therapy for the control of periodontitis consists of sub-gingival debridement, with oral hygiene instructions. Sub-gingival debridement without oral hygiene measures results in a limited healing response. Instruction on oral hygiene in the absence of sub-gingival debridement results in a suboptimal response clinically. The basic approach to periodontal infection has always been the removal of supra & sub-gingival bacterial deposits by scaling & root planning. Certain other aids such as the irrigants which are used by home or professional methods are also there other than mouth washes and systemic antibiotics. Newer advancements such as the local drug delivery the vector system and the probiotics also help in improving the maintenance of the oral hygiene status.

The aim of the present study is to assess the current trends in antibiotic prescription for various periodontal flap surgical procedures among periodontists in Chennai. Retrospective data collection was conducted from June 2019 to March 2020 on patients who visited the outpatient department of Periodontics for multitude of flap surgical procedures. The type of flap surgery done and the antibiotic regimen prescribed were recorded. The data was tabulated using excel and SPSS software version 23.0 (Statistical Package For The Social Sciences) was used for descriptive statistics.The distribution of antibiotics after flap surgical procedure among the above mentioned groups were expressed in terms of percentage. Chi square test was done to assess the association between the study variables.Based on this hospital based assessment, it was found that the most commonly prescribed antibiotic was amoxicillin 500mg, followed by a combination of amoxicillin and metronidazole for flap surgical procedures like Open flap debridement, Resective osseous surgery and regenerative osseous surgery. The least preferred antibiotics were azithromycin and doxycycline.There was statistically significant association between gender and type of antibiotic given, with a higher percentage of males receiving a combination of amoxicillin and metronidazole than females. There was no significant difference between the antibiotics prescribed for patients who underwent Resective or regenerative flap surgery. Thus Amoxicillin is the most preferred, cost-effective and less toxic drug which acts against both aerobic and anaerobic microorganisms. However care must be taken in administering antibiotics in order to avoid misuse and overuse of antibiotics.

The aim of the study was to investigate the association between haemoglobin level & severity of chronic periodontitis. This retrospective study was carried out by analysing the patient records from June 2019 to March 2020 at Saveetha Institute of Medical & Technical sciences (SIMATS).Two forty four patients were included in the study. Parameters assessed were a)Demographic details – Patient name, Patient identity number, Age & Sex; b)Periodontal parameters – Probing pocket depth (PDD), Loss of attachment (LOA), Bleeding on probing (BOP), Severity of Periodontitis (mild, moderate & severe);c) Blood parameters - Haemoglobin levels (g/dl). Data was analysed using SPSS version 23.0. Bivariate Pearson correlation of Haemoglobin with mean PPD, mean LOA & mean BOP score were calculated. Mean Hb was compared with severity of periodontitis using ANOVA. A total of 244 patients were included in the study. The mean age of the study sample was 40.42 (±11.38). Females constituted about 58.06%, whereas males constituted 41.4% of the study sample. Majority of the population had severe periodontitis (64.76%), followed by mild periodontitis (18.03%) & moderate periodontitis (17.21%). The mean haemoglobin level in severe periodontitis (13.35g/dl) is higher when compared to moderate and mild periodontitis (13.30g/dl & 13.18g/dl respectively). Mean PPD was 5.24 mm, mean LOA was 4.6 mm & mean BOP score was 0.98. Association between mean CAL and mean haemoglobin levels was positive and statistically significant with a p value of 0.012. Mean Hb level was not significantly different with varying severity of periodontitis

Background: Trauma from occlusion has been defined as injury to the periodontium resulting from occlusal forces that exceeds the reparative capacity of the attachment apparatus. It refers to tissue injury due to distorted occlusion. Gingival recession is the exposure of root surfaces due to apical migration of the gingival tissue margins.
Objective: The aim of this study was to evaluate the association of trauma from occlusion with gingival recession in mandibular anterior teeth.
Materials And Methods: This retrospective cross-sectional study was conducted from June 2019 to April 2020 using the patient records from the Department of Periodontics, Saveetha Dental College and Hospitals, Chennai. 200 patients with trauma from occlusion were recruited. Presence or absence of gingival recession in mandibular anteriors were studied. Data was tabulated in excel and statistically analysed.
Results: Among 200 patients with trauma from occlusion, 89 patients had gingival recession in relation to mandibular anteriors. There was no significant association between trauma from occlusion and gingival recession in mandibular anterior teeth (chi-square test; p= 0.120, not significant).
Conclusion: The present study showed no significant association between trauma from occlusion and gingival recession in mandibular anterior teeth.

Of the several pathologies that affect the oral cavity, malocclusion is the third most important problem in the world population. It not only affects the appearance but also affects the periodontal health. The aim of the study was to assess the association between periodontal health and different angle’s malocclusion. This retrospective study was conducted among outpatients reported to Saveetha Dental College and Hospitals, Chennai from June 2019 to March 2020. The study consisted of 300 patients (50 patients in each group). Patients were segregated into six groups based on Angle’s classification (Group 1: Class I; Group 2: Class II division 1; Group 3: Class II division 2; Group 4: Class II subdivision; Group 5: Class III; Group 6: Class III subdivision). The type of molar relationship was then correlated with the periodontal status. Out of 300 patients, the prevalence of gingivitis (92%) was higher among Class II subdivision patients and the prevalence of periodontitis (22%) was higher among Class II division patients. Also, the correlation between different types of malocclusion and periodontal health was assessed and found to be statistically not significant (p=0.306).

Periodontal disease is one of the most common chronic diseases in adults. It is an inflammatory disease affecting the soft and hard tissues of the oral cavity. It is associated with various risk factors. Tobacco is one of the potent risk factors for periodontal disease. The aim of the present study was to find the impact of smoking on periodontal health. A retrospective study was conducted using the case records of patients in a private institution between June 2019 to March 2020. A total of 200 male patients (Group 1: 100 smokers; Group 2: 100 non-smokers) were recruited. Data regarding the periodontal status of the patients were collected from their records. Descriptive and inferential statistics were done using SPSS software. The present study showed that smokers had a high prevalence of periodontitis (37.5%) when compared to non-smokers (8.5%). Whereas, non-smokers had a high prevalence of gingivitis (41.5%) when compared to smokers (12.5%). Also, there was a statistically significant association between smoking and periodontal health (p=0.000). The findings of the present study showed that smokers had increased risk of periodontitis than non-smokers.

Smoking is a highly prevalent addiction present worldwide, especially in India. It not only affects the pulmonary system but also has a major impact on oral health. Periodontal disease comprises a range of polymicrobial infectious diseases such as gingivitis and periodontitis that affect the tooth-supporting structures. Smoking has been identified as a risk factor for periodontal disease progression and can also alter treatment response. This study aims at associating the type of tobacco use and periodontal disease progression. This retrospective study was conducted among 500 patients using their records from the Department of Periodontics, Saveetha Dental College and Hospitals, Chennai from June 2019-April 2020 and patients who had smoking habits were identified. Data regarding their age, gender, type of tobacco use and periodontal status were collected and then subjected to statistical analysis. Microsoft Excel 2016 data spreadsheet was used to collect data and later exported to the Statistical Package for Social Science for Windows (SPSS version 20.0,IL,Chicago,USA) for analysis. The results of the study showed that among the patients with smoking habits, individuals within the age group of 25-35 years (31.4%) showed the highest prevalence of tobacco use whereas people among 65-75 years (1.2%) had the least. Majority of the smokers were diagnosed with periodontitis (84.4%), followed by gingivitis (12.4%) but diagnosis of healthy gingiva was very rare (3.2%). Smokeless form of tobacco was commonly used (61.2%). There was a male predominance (94.2%). Smoking, especially the type of tobacco used and severity of periodontal disease was found to have a strong association (p=0.000). The study draws attention to the fact that tobacco usage has a negative impact on oral health and can lead to periodontitis.

Smoking is recognised as a risk factor for human health. It is related to many problems like respiratory problems, cardiovascular disease, cancer, etc. Smoking is associated with incidence of gingivitis, periodontitis, epithelial malignancy in the oral cavity. It increases the number and depth of periodontal patients. Loss of tissue strength caused due to harmful compounds like tobacco, increase gingival recession and changes to the oral cavity. Prevalence of moderate and severe diseases are higher in smokers than non-smokers. Smoking affects both gingival epithelium and connective tissue. Density of blood vessels is decreased in smokers. Effect of smoking on vascular status is caused by nicotine compounds. This review was done based on the articles obtained from various platforms like PubMed, PubMed central and Google Scholar. They were collected with a restriction in time basis from 2000-2020. The inclusion criteria were original research papers. In vitro, studied among various conditions and articles that contain pros and cons. Exclusion criteria came into account for review articles, retracted articles and articles of other languages. All the articles are selected based on the effect of smoking on gingival health. Thus, smoking results in various oral health problems like incidence of gingivitis, periodontitis, epithelial malignancy in the oral cavity. It affects gingival recession and changes to the oral mucosa. This review article gives knowledge about the correlation between smoking and health of gingival treatment with various dental problems.