Innate immunity is the first line of host defense and represents inherited resistance to infection. Innate immunity works through toll-like receptors (TLRs), which recognize the conserved molecular patterns on pathogenic bacteria known as pathogen-associated molecular patterns. The periodontium is a unique environment in which oral microorganisms are in constant contact with the host immune system. The TLRs present on gingival epithelial cells are continuously stimulated, resulting in production of cytokines and defensins that help to maintain oral health. If the epithelial barrier is breached, allowing invasion of bacteria into the underlying connective tissue, the TLRs on other resident and non-resident cells of the periodontium become activated. This leads to an exaggerated release of pro-inflammatory cytokines and other biological mediators, which may cause host tissue destruction. The present review examines the role of TLRs and their signaling in periodontal health and disease.

Gingival epithelium provides first line of defence from the microorganisms present in dental plaque. It not only provides a mechanical barrier but also has an active immune function too. Gingival epithelial cells participate in innate immunity by producing a range of antimicrobial peptides to protect the host against oral pathogens. These epithelial antimicrobial peptides (EAPs) include the β-defensin family, cathelicidin (LL-37), calprotectin, and adrenomedullin. While some are constitutively expressed in gingival epithelial cells, others are induced upon exposure to microbial insults. It is likely that these EAPs have a role in determining the initiation and progression of oral diseases. EAPs are broad spectrum antimicrobials with a different but overlapping range of activity. Apart from antimicrobial activity, they participate in several other crucial roles in host tissues. Some of these, for instance, β-defensins, are chemotactic to immune cells. Others, such as calprotectin are important for wound healing and cell proliferation. Adrenomedullin, a multifunctional peptide, has its biological action in a wide range of tissues. Not only is it a potent vasodilator but also it has several endocrine effects. Knowing in detail the various bioactions of these EAPs may provide us with useful information regarding their utility as therapeutic agents.

Periodontal disease is an inflammatory disease process resulting from the interaction of a bacterial attack and host inflammatory response. Arrays of molecules are considered to mediate the inflammatory response at one time or another, among these are free radicals and reactive oxygen species (ROS). Periodontal pathogens can induce ROS overproduction and thus may cause collagen and periodontal cell breakdown. When ROS are scavenged by antioxidants, there can be a reduction of collagen degradation. Ubiquinol (reduced form coenzyme Q10) serves as an endogenous antioxidant which increases the concentration of CoQ10 in the diseased gingiva and effectively suppresses advanced periodontal inflammation.

Background and Objectives:Coenzyme Q10 is a well studied antioxidant in medical literature, but studies regarding its efficacy in periodontal diseases are few. Hence, the aim of this study was to test the efficacy of coenzyme Q10 in the form of gel (Perio-Q) in patients with chronic gingivitis and periodontitis.Materials and Methods:A total of 12 patients were enrolled. A split mouth design was used for topical (extrasulcular) application, intra-pocket application alone, intra-pocket application combined with scaling and root planing (SRP) and SRP only in each quadrant, respectively. Clinical parameters such as plaque index, gingival index, gingival bleeding index, probing pocket depth, clinical attachment level were assessed at baseline, 3rd week, and 6th week. The results were subjected to statistical analysis, which were expressed as mean±SD and proportions as percentages. Intra group comparisons were made by paired t-test and one way analysis of variance (ANOVA) for inter-group comparisons. Categorical data was analyzed by Fisher's exact test.Results:The results showed on intra-group analysis significant reduction (P<0.01) of clinical parameters (plaque index (PI), gingival index (GI), gingival bleeding index (GBI), periodontal probing pocket depth (PPD), and clinical attachment level (CAL)) in all four treatment groups, whereas on inter-group analysis, intra-pocket gel application in combination with SRP showed significant reduction (P<0.05) for PI, GI, GBI, and CAL in comparison to intra-pocket gel alone.Interpretation and Conclusion:In the present study, in chronic periodontitis patients, sub-gingival mechanical debridement only and with Perio-Q gel showed almost similar clinical results without any statistically significant differences. Hence, it confirmed the primary role of basic mechanical approaches in periodontal therapy and did not provide enough clinical support for the superiority of adjunctive use of Perio-Q gel. However, it appears that Perio-Q gel in this study may have a potential additive effect. Further, long term clinical studies of Perio-Q gel with various doses and duration need to be conducted.

Background: The aim of this study was to assess the oral health awareness, methods adopted to maintain hygiene, prevalent myths regarding oral health in pregnancy, and importance of oral health during pregnancy, to help formulate oral health program for pregnant females in partaking hospital. Materials and Methods: A total of 225 pregnant females participated in the study. After complete demographic assessment of participants, a questionnaire was provided to them. Questionnaire included simple multiple choice questions on how they maintained oral hygiene, their oral health status, visit to the dentist, and barriers in seeking treatment. This was followed by a questionnaire regarding common myths and understanding of the importance of oral health during pregnancy which had three choices: true, false, and do not know. The results were expressed in percentages, and one sample t -test for percentages was applied where ever required. Results: Majority of participants self-reported some form of oral health problems with bleeding gums as a chief complaint leading the survey. Around half of the participants had never visited a dentist, and an abundant number of pregnant females reported safety concerns for developing the child as a reason for not taking any treatment during pregnancy. A highly significant number of participants were unaware of the importance of oral health during pregnancy and believed in age-old myths. Conclusion: The oral health care still remains on the backseat in care provided to pregnant female. A complete overhaul of understanding through individual, family, and community counseling is required to spread awareness.