Background. Psychological stress is known to be a relevant risk factor for many inflammatory conditions, including periodontal disease. A few studies have probed the relationship between obesity and periodontal disease. Therefore this cross-sectional study was aimed to examine the relationship between psychological stress and obesity and periodontal disease in smokers and non-smokers.Methods. The participants included 90 patients, equally divided into three groups of non-smokers and periodontally healthy, non-smokers and smokers with untreated moderate-to-severe chronic periodontitis. Socioeconomic data, psychosocial measurements, physical parameters and clinical findings of PPD, CAL, PI and GI were recorded.Results. The clinical parameters were assessed for three groups in three different anxiety levels of mild, moderate and severe. Intra-group comparison of PPD and CAL in the three anxiety levels showed increased periodontal destruction with an increase in anxiety levels, the results being statistically highly significant for PPD differences in smokers (P < 0.0001). The mean differences in PPD and CAL in severe anxiety levels between smokers and non-smokers were 0.68 mm and 0.70 mm and both the findings were statistically significant. The mean PPD and CAL in smoker and non-smoker groups in obese patients was higher as compared to non-obese patients and the differences were highly significant (P < 0.001).Conclusion. The results of our study indicated a positive and strong correlation between anxiety, obesity and periodontal disease in smokers and non-smokers. Smoking appears to further attenuate this association.

PurposeThe aim of this study was to measure the thickness of the mucous membrane lining the maxillary sinus and to correlate this thickening of the Schneiderian membrane with the presence or absence of periodontal bone loss of adjacent teeth, by using cone beam computed tomography (CBCT).Methods255 CBCT images were analyzed of which 140 images were selected for the study. Based upon the absence of radiographic periodontal bone loss and presence of 50% or more bone loss, these CBCT images were respectively divided into two groups viz. Group I (Healthy) and Group II (Periodontal Bone Loss Group), each group consisting of 70 images each. The thickening of the mucous membrane lining of the floor of maxillary sinus was measured at four points on the CBCT. These points were the anterior most point of the thickened mucosa, the posterior most point of the thickened mucosa, at the midpoint (MP) (point midway between the anterior most and the posterior most point) and the point of maximum thickness of the sinus mucosa.ResultsThe age adjusted mean thickness for Group II was significantly greater than that of Group I (p < 0.001) at all the four points. There was a positive association between presence of periodontal bone loss and thickening of Schneiderian membrane at the floor of the sinus. There was a weak positive association between age and mucosal thickness. Of all the four points measured, the maximum correlation between age and thickness was obtained at MP (r = 0.171), which was statistically significant (p = 0.044).ConclusionThe present study concluded that there is a positive association between presence of periodontal bone loss and thickening of mucosa of floor of maxillary sinus and also exhibited a weak positive relation between age and increased mucosal thickening of floor of maxillary sinus.

Background The present study aimed to investigate the serum and salivary ghrelin and cortisol levels in smokers and non‐smokers with Stage III Periodontitis. Methods The present study comprised of a total of 90 systemically healthy patients categorized in three groups: Group I‐ Periodontally healthy patients; Group II‐Non‐smokers with Stage III Periodontitis and Group III‐Smokers with Stage III periodontitis. Clinical parameters of Probing pocket depth (PPD), Clinical attachment levels (CAL), Plaque Index (PI), Gingival Index (GI) and Papillary Bleeding Index (PBI) were recorded and biochemical parameters of serum and salivary ghrelin and cortisol levels were analyzed via Enzyme Linked Immunosorbent Assay (ELISA). Stress levels were assessed using Zung's self‐rating depression scale. Results Serum and salivary ghrelin values were found to be higher in Group II (620.25 ± 260.86 pg/mL, 892.40 ± 271.65 pg/mL respectively) as compared to Group III. Similarly, salivary as well as serum cortisol levels were higher in Group III (20.78 ± 9.23 pg/mL, 399.37 ±189.21 pg/mL respectively) as compared to Group II (16.36 ± 8.88 pg/mL, 320.68 ± 107.01 pg/mL respectively). In Group III, a direct correlation was observed between stress, serum and salivary cortisol levels while an inverse correlation was found between stress, serum and salivary ghrelin levels. Group III showed a greater number of depressed patients followed by Group II and I. Conclusion As per the results smokers with Stage III Periodontitis exhibit an elevated stress and cortisol levels, lower serum and salivary ghrelin levels as compared to the non‐smokers.

Background:Decision-making in periodontal therapeutics is critical and is influenced by accurate diagnosis of osseous defects, especially furcation involvement. Commonly used diagnostic methods such as clinical probing and conventional radiography have their own limitations. Hence, this study was planned to evaluate the dimensions of furcation defects clinically (pre- and post-surgery), intra-surgically, and by cone beam computed tomography (CBCT) (pre- and post-surgery).Materials and Methods:The study comprised a total of 200 Grade II furcation defects in forty patients, with a mean age of 38.05 ± 4.77 years diagnosed with chronic periodontitis which were evaluated clinically (pre- and post-surgically), by CBCT (pre- and post-surgically), and intrasurgically after flap reflection (40 defects in each). After the presurgical clinical and CBCT measurements, demineralized freeze-dried bone allograft was placed in the furcation defect and the flaps were sutured back. Six months later, these defects were evaluated by recording measurements clinically, i.e., postsurgery clinical measurements and also postsurgery CBCT measurements (40 defects each).Results:Presurgery clinical measurements (vertical 6.15 ± 1.71 mm and horizontal 3.05 ± 0.84 mm) and CBCT measurements (vertical 7.69 ± 1.67 mm and horizontal 4.62 ± 0.77 mm) underestimated intrasurgery measurements (vertical 8.025 ± 1.67 mm and horizontal 4.82 ± 0.67 mm) in both vertical and horizontal aspects, and the difference was statistically not significant (vertical P = 1.000, 95% confidence interval [CI], horizontal P = 0.867, 95% CI). Further, postsurgery clinical measurements (vertical 2.9 ± 0.74 mm and horizontal 1.52 ± 0.59 mm) underestimated CBCT measurements (vertical 3.67 ± 1.17 mm and horizontal 2.45 ± 0.48 mm). There was statistically significant difference between presurgery clinical–presurgery CBCT (P < 0.0001, 95% CI) versus postsurgery clinical–postsurgery CBCT (P < 0.0001, 95% CI) values in both vertical and horizontal aspects.Conclusion:The use of CBCT appears to be prudent for accurate diagnosis of furcation defects in advanced periodontal diseases. Presurgical and postsurgical three-dimensional imaging enable the clinician to optimize treatment decisions and assess the quantum of healing more definitively.

Background: Numerous studies have assessed the effect of photodynamic therapy (PDT) both as a primary mode of treatment and as an adjunct to scaling and root planing in the treatment of periodontitis. Some results were nondefinitive and, in part, inconsistent with respect to the clinical and biochemical effects. Hence, the aim of this study was to evaluate the effect of PDT as an adjunct to nonsurgical periodontal therapy (NSPT) on the gingival crevicular fluid (GCF) interleukin-6 (IL-6), IL-8, and IL-10 levels in the treatment of chronic periodontitis (CP). Materials and Methods: In 21 patients with CP, two contralateral sites (premolar and molar) were randomly divided into: control sites (treated with NSPT only) and test sites (treated with NSPT + PDT). Clinical parameters including bleeding on probing (BOP), probing pocket depth, clinical attachment level were evaluated at baseline, 1- and 3 months and biochemical parameters of GCF levels of IL-6, IL-8, and IL-10 were evaluated at baseline and 3-month post-therapy through enzyme-linked immunosorbant assay. Results: A greater improvement in BOP score at 1 month (41.10% ± 3.58%) and 3-months (38.00% ± 3.62%) posttherapy was found in the test site as compared to control site. Regarding cytokines, test sites exhibited significant reductions in IL-6 (4.29 ± 0.67 pg/ml) and IL-8 (308.16 ± 36.04 pg/ml) levels and increase in IL-10 (14.25 ± 0.83 pg/ml) level at 3 months ( P < 0.0001). Conclusion: Additional application of PDT, adjunctive to NSPT, resulted in a significant reduction in BOP score as well as GCF pro-inflammatory cytokine levels along with an increase in anti-inflammatory cytokine levels, compared to NSPT alone.