Several anti-inflammatory drugs have been used to reduce pain and discomfort after periodontal surgeries. This study evaluates the efficacy of using etoricoxib and dexamethasone for pain prevention after open-flap debridement surgery. In this study, 60 patients who were undergoing open flap debridment surgery were randomly assigned to receive a single dose preoperative medication 1 hour prior to surgery. The patients were divided into three groups. In Group 1, 20 patients were given placebo drug orally. In Group 2, 20 patients were given 8 mg Dexamethasone orally and in Group 3, 20 patients were given 120 mg Etoricoxib orally. Patients were instructed to complete a pain diary hourly for the first 8 hours after each surgery and three times a day on the following 3 days. The four point verbal rating scale (VRS 4) and Numerical rate scale were used to assess discomfort. Post-operative Assessment of Pain and Discomfort showed that persistent discomfort and pain were found to be more in the placebo group compared to dexamethasone and etoricoxib group. The adoption of a preemptive medication protocol using either etoricoxib or dexamethasone may be considered effective for pain and discomfort prevention after open-flap debridement surgeries.

Periodontitis is a chronic inflammatory disease of the tooth-supporting structures. The treatment of this condition is largely based on the removal of local factors and restoration of the bony architecture. Moreover, in the era of modern dentistry, successful implant therapy often requires sound osseous support. Traditionally, osseous surgery has been performed by either manual or motor-driven instruments. However, both these methods have their own advantages and disadvantages. Recently, a novel surgical approach using piezoelectric device has been introduced in the field of periodontology and oral implantology. This article discusses about the wide range of application of this novel technique in periodontology.

The investigation of disease-related oxidant-antioxidant imbalance is difficult due to the limited availability of specific biomarkers of oxidative stress, and the fact that measurement of individual antioxidant may give misleading picture because antioxidants work in concert through chain breaking reactions. Therefore, analysis of total antioxidant capacity may be the most relevant investigation. As the total blood is continuously exposed to oxidative stress, the aim of the current study was to investigate total blood antioxidant capacity in healthy and periodontitis patients by using novel Nitroblue Tetrazolium reduction test. The study was conducted on 30 non-smoking volunteers with age ranging between 18-40 years. They were categorized into two groups; chronic periodontitis group and healthy group, respectively. Total antioxidant capacity in whole blood was assessed using Nitroblue Tetrazolium reduction test. Results of the present study has shown that the total antioxidant capacity in whole blood in patients with periodontitis was significantly (P<0.005) lower than in control subjects. The reduced total blood antioxidant status in periodontitis subjects warrants further investigation as it may provide a mechanistic link between periodontal disease and several other free radical-associated chronic inflammatory diseases.

Periodontal diseases significantly impact about half of the global population, and their treatment often encompasses relieving symptoms as well as regenerating the destroyed tissues. Revolutionary research in the management of periodontal disease includes biomaterials, a boon to re-generative dentistry owing to their excellent biological properties: non-toxicity, anti-inflammatory, biocompatibility, biodegradability, and adhesion. This study aimed to fabricate an injectable fucoidan containing chitosan hydrogel and prove its effectiveness in periodontal bone regeneration. The injectable hydrogel was prepared using the sol-gel method and was subjected to various physical, chemical, and biological characterizations to understand its efficacy in formation of new bone. The effectiveness of the developed hydrogel was assessed in periodontal bony defects to study the soft and hard tissue changes. A total of 40 periodontitis patients with bony defects were recruited and randomized into two groups to receive fucoidan-chitosan hydrogel and concentrated growth factor, respectively. Customized acrylic stents were used to guide the hydrogel placement into the defect site. Post-surgical changes in clinical parameters were assessed at 3, 6, and 9 months to appreciate the soft and hard tissue changes using repeated measures analysis of variance and Bonferroni’s post hoc test. Significance was kept at 5%. The porosity, water uptake of the prepared hydrogel showed good efficacy, with particle size of the fucoidan containing chitosan hydrogel of 6.000 nm. The MG-63 osteoblasts cell line revealed biocompatibility, biodegradability and showed slow and sustained drug release, increased cell proliferation, and enhanced alkaline phosphatase secretion. Mineralization assay was greatest in the fucoidan containing chitosan hydrogel. Clinically, it exhibited significantly lower probing depth values and a higher mean improvement in clinical attachment level as compared to the concentrated growth factor (CGF) group at the end of 3 and 6 months (p < 0.05). The mean of the defect fills in the fucoidan containing chitosan group was 1.20 at the end of 9 months (p < 0.001) as compared with defect fills observed in the CGF group. The presence of fucoidan in the hydrogel significantly contributed to bone regeneration in humans, thus strengthening its potential in tissue engineering. Fucoidan-chitosan will be a promising biomaterial for bone tissue regeneration.

Background: C-reactive protein (CRP) is an emerging prognostic biomarker in patients with periodontitis and cardiovascular disease. There is a proposed pathophysiological mechanism that links periodontitis with cardiovascular disease. Early detection of periodontitis patients with cardiovascular disease events helps in accurate diagnosis and better treatment plan. But there are limited studies in the literature on serum C- reactive protein levels in periodontitis patients. Aim: This observational study aimed to investigate the associations between periodontitis severity and the serum levels of CRP in comparison with healthy and periodontitis group. Materials & Methodology: A total of 30 patients who were divided into two groups of study and control group consist of 15 patients in each group. Patients were selected based on inclusion and exclusion criteria. Blood sample collection was done by trained professional and serum samples were stored at -80 degree Celsius. The C-reactive protein levels were measured using a high‐sensitivity enzyme‐linked immunosorbent assay. Results: The mean value of 12923.41 in C-reactive protein (CRP) serum levels in gingivitis group with the standard deviation of 10272.22 was obtained with the p value of 0.01. The mean of 3994.86 in C-reactive protein (CRP) serum levels in periodontitis group with the standard deviation of 5110.81 was obtained with the p value of 0.01 with the p value of 0.01. Serum C-reactive protein levels showed statistically significant results when compared between the control and study group. Conclusion: There is a pathophysiological mechanism that links the cardiovascular diseases with periodontitis; the serum C-reactive protein levels are higher in periodontitis patients. The serum CRP levels and may be used as a cardiac biomarker in periodontitis patients.