The condition known as chronic Desquamative Gingivitis (DG) was first documented in 1894. In 1932, Prinz the term ‘chronic diffuse desquamate gingivitis’ to describe instances of chronic diffuse inflammation that were marked by significant shedding of the outer layer of cells in the marginal gingiva. In 1960, it was proposed that this was a non specific clinical response of the gingiva to various mucocutaneous conditions and not a diagnosis per se. To effectively diagnose mucocutaneous lesions, one must possess a thorough understanding of their genesis and clinical progression. Additionally, proficiency in various biopsy procedures using modern diagnostic technologies is essential. Accurate diagnosis is crucial in cases with DG, as the appropriate therapy and subsequent monitoring will be determined by the specific illness present. Nevertheless, the illnesses responsible for DG typically provide diagnostic challenges due to the clinical similarity of their lesions and the limited ability of conventional histological investigation to distinguish between them. Immunohistology, namely immunofluorescence, is now being used more often with standard histology to enhance the accuracy of diagnosing DG disorders. Direct immunoflourescence analysis is not only proving very useful for differential diagnosis, but also adds insight into possible pathogenic mechanisms of DG.

Background: Periodontal ligament stem cells (PDLSCs) are mesenchymal stem cells with potential for periodontal regeneration. Native collagen membranes are widely used scaffolds due to their biocompatibility and support for cell growth. This study aimed to evaluate the viability, proliferation, and characterization of PDLSCs cultured on native collagen membranes. Materials and Methods: Human PDLSCs were isolated from healthy premolars and cultured using explant techniques. Morphology was assessed using phase-contrast microscopy, while viability and population doubling time were measured using trypan blue exclusion. Clonogenic potential was evaluated using a colony-forming unit assay. Immunophenotyping was performed by flow cytometry for mesenchymal markers (CD73, CD90, and CD105) and negative hematopoietic markers (CD34 and CD45). Multilineage differentiation was tested using osteogenic and adipogenic media. The biocompatibility of collagen membrane eluates and scaffolds was evaluated using water-soluble tetrazolium salt-1 and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays. Results: Four PDLSC lines exhibited high viability (>99%) and retained fibroblast-like morphology. Flow cytometry confirmed mesenchymal marker expression. Cells showed successful osteogenic and adipogenic differentiation. Both direct seeding and eluate exposure from collagen membranes supported PDLSC viability and proliferation, particularly at 24-h eluate intervals. Conclusion: Native collagen membranes are biocompatible scaffolds that support PDLSC proliferation, offering promise for future periodontal regenerative therapies.

BackgroundDental anxiety associated with dental implant surgery can adversely affect patient comfort, cooperation, and overall procedural outcomes. Both pharmacological and non-pharmacological interventions are commonly employed to manage preoperative anxiety; however, their comparative effectiveness remains unclear. A systematic evaluation of these approaches is important to determine their relative benefits in terms of anxiety reduction, onset of action, safety profile, and patient acceptability. Existing evidence suggests that pharmacological interventions may provide rapid anxiolytic effects, whereas non-pharmacological approaches, such as relaxation techniques, mindfulness-based interventions, and audio distraction, may reduce anxiety without the potential adverse effects associated with medication use. Therefore, this systematic review aims to compare the effectiveness of pharmacological and non-pharmacological anxiety control strategies in dental implant surgery and evaluate their clinical applicability in optimizing patient management.MethodsA comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library to identify randomized controlled trials evaluating the effectiveness of pharmacological and non-pharmacological interventions for the management of dental anxiety in adult patients undergoing dental implant surgery, up to September 2025. The systematic review was conducted according to a pre-specified protocol in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodological quality and risk of bias of the included studies were assessed using the revised Cochrane Risk of Bias tool (RoB 2.0).ResultsThe electronic database search identified a total of 225 articles related to anxiety management during dental implant placement. By evaluating titles, abstracts, and full texts, 15 articles met the inclusion criteria; however, no relevant studies were found through hand searching. The evidence suggested that that multimodal anxiety-reduction strategies, particularly dexmedetomidine sedation and behavioural distraction techniques, are effective in reducing dental anxiety during implant proceduresConclusionBoth non-pharmacological and pharmacological anxiety management strategies demonstrate considerable potential in reducing dental anxiety during implant placement. Behavioural interventions, including effective communication, relaxation techniques, distraction methods, and complementary therapies, appear beneficial for patients with mild to moderate anxiety, whereas pharmacological sedation is particularly effective for managing moderate to severe dental fear, thereby enhancing patient cooperation, procedural comfort, and overall acceptance of implant therapy.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261376502, identifier CRD420261376502.

Abstract Reactive vascular lesions of the oral cavity often mimic neoplasms due to their rapid growth, erythematous appearance, and tendency to bleed. Among these, gingival overgrowths are commonly associated with local irritants, systemic influences, and deleterious habits. This case describes a 55-year-old female with habit-associated gingival overgrowth linked to long-term areca nut and pan chewing. Clinically, multiple lobulated erythematous swellings with surface ulceration and bleeding were observed in the mandibular anterior region. Histopathology confirmed a pyogenic granuloma (lobular capillary hemangioma type). Management included thorough scaling, surgical excision, and reinforcement of habit cessation. Healing was uneventful, with normalization of gingival architecture and no recurrence at 2-month follow-up. This case highlights the contributory role of deleterious oral habits and poor oral hygiene in reactive vascular lesions, emphasizing the importance of eliminating etiologic factors alongside surgical therapy. Early diagnosis and comprehensive management are essential to prevent recurrence and maintain periodontal health.

Background:Heat shock proteins (HSPs) are a group of stress proteins that participate in physiological processes such as cellular folding, assembly, translocation of polypeptides across membranes, and protein repair after cell damage. HSP60 has been implicated in the pathogenesis of both chronic periodontitis (CP) and coronary heart disease (CHD). Aim:The aim was to assess the possible link between CP and CHD by estimating and comparing the serum HSP60 levels in patients with CP with and without CHD. Settings and Design:Ninety patients in the age group of 30-60 years were involved in this study. The patients were categorized as CP (control group) and CP with CHD (case group). Materials and Methods:Gingival index (GI) and periodontal parameters such as probing pocket depth and clinical attachment levels were documented. Enzyme-linked immunosorbent assay was used to determine the HSP60 levels in serum samples obtained from the patients. Statistical Analysis:Results were statistically analyzed using the SPSS version 16.0 software to estimate the mean and standard deviation using independent t-test and Mann-Whitney U-test. Results:The findings of the research indicated that patients with CP with CHD exhibited elevated serum HSP60 levels compared to CP without CHD (P < 0.05). In addition, a statistically significant rise in GI was noted in the case group. However, the periodontal measurements did not reveal any significant differences. Conclusion:As a result, HSP60 levels were observed to be elevated in the case group compared to the control group. Consequently, there is a connection between periodontal disease and CHD that contributes to the overall inflammatory burden.

Background: Chronic desquamative gingivitis (CDG) is an inflammatory condition often linked to immune-mediated disorders. Oxidative stress plays a role in periodontal damage and can be assessed using salivary malondialdehyde (MDA) and superoxide dismutase (SOD). This study evaluates changes in these markers before and after nonsurgical periodontal therapy. Aim: To assess and compare salivary MDA and SOD levels in CDG patients before and after nonsurgical periodontal treatment. Methodology: The study included 46 participants (23 CDG patients, 23 healthy controls). Salivary MDA and SOD levels were measured biochemically. CDG patients underwent nonsurgical periodontal therapy, and post-treatment samples were collected after 10 days. Data were analyzed using t-tests. Results: No significant changes were observed in MDA (p = 0.712) or SOD (p = 0.385) levels post-treatment. Additionally, no significant differences were found between CDG patients and healthy controls (MDA: p = 0.576, SOD: p = 0.333). Conclusion: Nonsurgical periodontal therapy had no significant effect on oxidative stress markers in CDG. Oxidative stress levels in CDG patients were comparable to healthy individuals, indicating a limited role in disease progression. Clinical Significance: These findings highlight the need for further research into alternative therapeutic strategies for managing CDG.

INTRODUCTION:Menopause affects the oral cavity along with various hormonal changes; for example, the level of follicle stimulating hormone (FSH) increases, whereas the level of estrogen and progesterone decreases. High bone turnover in post-menopausal women is primarily caused due to the increased alkaline phosphatase (ALP) levels. Thus, finding an association between FSH, ALP, and chronic periodontitis is essential, which will aid in early diagnosis and treatment planning. MATERIALS AND METHODS:Sixty post-menopausal females in the age group of 45-57 years visiting the Department of Periodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, were selected. The subjects were assigned in each group based on the periodontal parameters; that is, group I consisted of 30 post-menopausal females without chronic periodontitis and group II consisted of 30 post-menopausal females with chronic periodontitis. Serum FSH and ALP levels were evaluated, and the data obtained were statistically analyzed. RESULTS:The result showed that age did not differ significantly between groups I and II. Although serum FSH levels were high for both groups I and II, it was however not statistically significant. Serum ALP levels were significantly raised in both the groups and were statistically significant (P = 0.001). The periodontal parameters like gingival index, probing depth, and clinical attachment loss were recorded. CONCLUSION:A causal relationship between FSH and periodontitis could not be established. However, ALP is shown to be increased in post-menopausal women with chronic periodontitis. ALP is an intracellular enzyme produced by many cells such as polymorphonuclear leukocytes, macrophages, fibroblasts, osteoblasts, and white blood cells. When periodontal tissue is destroyed, secretion of this enzyme actively increases and hence can be related with disease severity. Thus, it could be used as a reliable diagnostic marker for periodontal disease in post-menopausal women.

This comprehensive review delves into the forefront of research on the human oral microbiome, exploring recent advancements that span microbial colonization, state-of-the-art detection methodologies, and the complex interplay involved in disease progression. Through an exhaustive analysis of the contemporary literature, we illuminate the dynamic orchestration of microbial communities within the oral cavity, underscoring their pivotal role in health and disease. Cutting-edge detection techniques, including metagenomics and high-throughput sequencing, are discussed regarding their transformative impact on understanding the intricacies of oral microbial ecosystems. As we stand on the cusp of a new decade, this review anticipates a paradigm shift in the field, emphasizing the potential for rapid identification and targeted management of detrimental oral microorganisms. Insights gained from this exploration not only contribute to our fundamental understanding of the oral microbiome but also hold promise for the development of innovative therapeutic strategies to maintain oral health. This article aims to serve as a valuable resource for researchers, clinicians, and public health professionals engaged in unraveling the mysteries of the microbial symphony within the human oral cavity.

Introduction Maintenance of periodontal health is very important during fixed orthodontic treatment as accumulation of plaque can cause dental challenges that may interfere with orthodontic treatment; hence the present investigation was carried out to examine the knowledge of patients who were using interdental brushes during fixed orthodontic treatment. Methods Total 150 subjects aged 14 to 30 years from Mangalore city were selected. Majority of them were in the age group of 14 to 18 years (39.33%). Overall, 77 females (51.3%) and 73 males (48.7%) who were undergoing fixed orthodontic treatment and had given consent for the participation in epidemiological questionnaire survey were included. Demographic information and use of interdental brushes during fixed orthodontic treatment for maintaining periodontal health were included in the survey. Result Overall, 58% of the participants undergoing fixed orthodontic treatment were using interdental brushes, which was statistically significant. The frequency of using interdental brush was 72.4%, 19.5%, and 8.04% daily, weekly, and monthly, respectively. Conclusion The majority of the study participants who sought fixed orthodontic treatment were using interdental brushes daily in order to maintain periodontal health, which was statistically significant. Patient education and motivation was shown to be strongly associated with maintaining of periodontal health among study participants.

Background Despite the success of titanium (Ti) implants in dental rehabilitation, emerging evidence implicates the release of titanium oxide nanoparticles (TiO2NPs) from the implant surface as a potential contributor to the initiation of the pathogenic process leading to peri-implantitis and ultimately failure of the implants. However, a comprehensive investigation to elucidate the dose-dependent effects of TiO2NPs on cytotoxicity and inflammatory responses is lacking. The present study was undertaken to evaluate the effect of different concentrations of TiO2NPs on the cytotoxicity and inflammatory cytokine expression in Human Gingival Fibroblasts (HGFs). Methods HGFs were isolated from gingival tissue samples obtained from periodontally and systemically healthy subjects. Ti standard solution for ICP was diluted to create concentrations of (0.001 ppm, 0.01 ppm, 0.1 ppm, 1 ppm, 10 ppm, and 100 ppm) for cell culture media containing titanium. HGFs were then cultured in these varying concentrations for specific time periods (days 1, 3, 5, and 7) to assess cell viability. A cytotoxicity assay was performed to determine the levels and expression of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and anti-inflammatory cytokines (IL-10, IL-12, TGF-β) using qRT-PCR and ELISA techniques. Results Our findings demonstrate a concentration and duration-dependent decrease in HGF viability upon exposure to titanium nanoparticles. Notably, a 50% reduction in cell viability was observed at the highest concentration (100 ppm). qRT-PCR analysis revealed a significant upregulation of pro-inflammatory cytokines, particularly IL-1β and IL-6, in HGFs exposed to titanium. Interestingly, the expression of anti-inflammatory cytokines (IL-10, IL-12, and TGF-β) remained comparable or even equivalent compared to controls across different titanium concentrations. Conclusions The study revealed a concentration and duration-dependent influence on HGF viability and cytokine profile, suggesting potential cytotoxicity and modulation of the inflammatory response mediated by TiO2NPs. Further research is necessary to elucidate the underlying mechanisms and their implications for dental implant biocompatibility.

Background: The physiological phenomenon known as perimenopause affects women as they age. Menopausal state has been linked to periodontal disease. Both the general composition and periodontal turnover of bone is impacted by calcium. Salivary calcium is an exclusive kind of bone marker associated with periodontitis and an accelerated rate of bone mass loss in older women. Calciumi is crucial for the continual development of bone and teethi. Objectives: The intention of this study was to juxtapose thei implications of psychological stress on calcium levels in the saliva of women approaching menopause who had chronic periodontitis to those who did not. Methods: A comprehensive periodontal examination was administered on a total of 24 perimenopausal women who had chronic periodontitis and 24 perimenopausal women without chronic periodontitis. The examination measured the pocket depth, number of lost teeth, plaque index, and calculus index. These parameters were adopted to stratify the participants in accordance with the severity associated with their periodontal disease. Application of the O-Cresolphthalein complex algorithm (OCPC), salivary calcium was quantified. The study focused on an association between salivary calcium levels and psychological stress in individuals mitigating chronic periodontitis. Results: There is a negative correlation between stress levels and salivary calcium. It signifies that salivary calcium diminishes when psychological stress levels are elevated, but this correlation is not statisticallyi significant (p ≤0.05). Conclusion: Salivary calcium levels exhibited a negative correlation with psychological stress, and perimenopausal women who succumbed to psychological stress also bound to have more periodontal impairment.

Objectives The psychological and physiological distress and social isolation could adversely affect sleep. As sleep disturbances may persist and deteriorate health, it is important to assess prevalence and related factors of sleep disturbances among the residents of Karnataka state during the coronavirus disease 2019 (COVID-19) infection.Methods In this study, 250 responders across the state of Karnataka accessed the survey voluntarily during September 2021 and January 2022. Pittsburgh Sleep Quality Index, Insomnia Severity Index scales, features that are related to sleep quality, and some hypothesized risk factors of sleep disturbances in context of COVID-19 infection are employed to format a self-reported questionnaire.Results In this study, females 27(19.1%) experienced more sleep disturbances than males 9 (8.3%). The study revealed the participants who received both the doses of vaccination (126; 54.3%) had better sleep. The participants who reported themselves to be stressed (182; 72.8%) had more disturbances in sleep. A total number of 45 participants (18.4%) experienced difficulty in breathing and out of all the responders 11 (47.8%) were actually worried about their current sleep problem.Conclusion COVID-19 infection and changes imposed during the pandemic have led to a surge in individuals reporting sleep problems across the globe. The findings raise the need to screen for worsening sleep patterns to create more awareness about the secondary consequences of COVID-19 infection.

Context:Periodontitis is a complex disease in which disease expression involves intricate interactions of the biofilm with the host immune inflammatory response. Micronutrients like zinc, copper and selenium play an important role in antioxidant defense, immune regulation, and neutralization of the inflammation process at the cellular level. It has been reported that deficiencies of several macro and micronutrients adversely influence the prognosis of periodontal infections. Aims:This study has been designed to estimate and compare the serum levels of micronutrients (zinc, copper and selenium) in healthy, gingivitis and periodontitis patients before and after non-surgical periodontal therapy. Settings and Design: This study is a case-control study. Methods and Material: The comprised of 75 patients who were divided into three groups - Group I consisting of 25 periodontally healthy subjects, Group II consisting of 25 subjects with chronic gingivitis and Group III consisting of 25 subjects with chronic periodontitis. Atomic absorption spectrophotometry method was used to measure the clinical level of selenium, zinc and copper in serum. Statistical analysis used: One way ANOVA with Tukey Post-Hoc test and Paired t-test was used. Results: Results show highly significant increase in copper levels and decrease in zinc and selenium levels in periodontitis group compared to the control. There is an increase in the zinc and decrease in copper pre and post treatment levels. Conclusions: Imbalance of Zinc, copper and selenium levels in the serum can predispose an individual to the risk of developing periodontitis.

The length from the root surface of a tooth to the junctional epithelium and connective tissue attachment is termed as biological width (BW). It protects the tooth from diseases and infections by acting as a natural seal. On an average it is 2.04 mm. In clinical practice the BW is determined by periodontal probe. The calculation of BW can be done by several methods. An identification of BW breach is confirmed when the length is observed to be less than 2 mm at multiple locations or at a single location. When we are considering the prolonged health benefits of any restoration or a natural tooth, the health of the gingiva is of prime importance. An excess of BW breach leads to innumerable adverse effects, which are talked about in this review article. The article sheds light on BW in association to implants and conservative procedures and its evaluation clinically, and also a discussion about the procedures that can be used to rectify BW breaches in routine practice.

INTRODUCTION:Menopause is a normal developmental stage in a woman's life marking the permanent cessation of menstruation. Periodontitis and osteoporosis are noteworthy health concerns in post-menopausal women. Calprotectin is an inflammatory biomarker for precise diagnosis of periodontal disease. MATERIALS AND METHODS:This study was performed to evaluate the variations in salivary calprotectin levels and bone mineral density in post-menopausal women with and without chronic periodontitis. The study included 24 post-menopausal women aged 45-57 years and was divided into group 1 (12 post-menopausal women without chronic periodontitis) and group 2 (12 post-menopausal women with chronic periodontitis). Unstimulated salivary samples, panoramic radiographs and clinical examination were performed. RESULTS:The collected samples were combined with CALPRO antibody with horseradish peroxide (HRP) that results in the formation of antigen-antibody complex. Tetramethylbenzidine (TMB) solution was added that turned blue. Colour change was measured at 450nm. A human ELISA kit was used. Data collected were sent for statistical analysis. DISCUSSION:There was a statistically significant difference in salivary calprotectin levels between groups 1 and 2 ( P = 0.016) and no statistical difference in mean bone mineral density levels between the two groups ( P = 0.235). A positive correlation was seen between salivary calprotectin levels and bone mineral density in group 2 ( P = 0.013).

Abstract Root coverage procedures are predictable but are often complicated by an inappropriate case selection. Root coverage is a challenge and limited cases have been reported in literature. The present report aims to highlight the successful coverage of exposed molar roots with coronally advanced flap and lateral pedicle graft to cover maxillary right first molar (16) and mandibular left first molar (36), respectively. When performing routine periodontal therapy. The root coverage and the periodontal therapy helped the patient get relieved of his complaint of dentinal hypersensitivity and breath malodor.

A multifaced rather than streamlined approach has always been at the forefront of periodontal diagnostics. With the evolution of how diagnostic medicine is applied and executed, the ability to accurately anticipate the probability of dysbiosis in a patient has become the need of the hour. Translational metabolomics has already exhibited an astounding potential in the field of diagnostic medicine, both as an indicator as well as a predictor of disease activity. However, it is currently still an evolving technique and is not without its fair share of pitfalls. Addressing these lacunae and active research towards making it possible for implementation into clinical periodontal practice can be invaluable source and should be explored, more so now than ever with the constant evolution of disease pathogenesis and progression as well. The current paper focuses on the practical utility of the rapidly expanding plethora of metabolomics highlighting the concerns surrounding their applications in periodontal diagnosis.