Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management.

Frailty and sarcopenia are frequently observed in patients with end-stage liver disease. Frailty is a complex condition that arises from deteriorations across various physiological systems, including the musculoskeletal, cardiovascular, and immune systems, resulting in a reduced ability of the body to withstand stressors. This condition is associated with declined resilience and increased vulnerability to negative outcomes, including disability, hospitalization, and mortality.

Evaluation of gingival crevicular fluid interleukin-35 as a marker for identification of periodontal disease activity.

Background: This study was carried out to evaluate and compare the levels of IL-35 in gingival crevicular fluid (GCF) in periodontally healthy subjects, patients with gingivitis and chronic periodontitis and to assess IL-35 as a marker for identification of periodontal disease activity.

Methods: GCF samples were obtained from periodontally healthy subjects (N.=15), gingivitis patients (N.

Reconstruction of Interimplant Papilla by Demineralized Freeze-dried Bone Allograft Block Fixed by Titanium Screw in Maxillary Esthetic Zone.

Aim: To evaluate effectiveness of demineralized freeze-dried bone allograft (DFDBA) block fixed by titanium screw for reconstructing interimplant papilla in maxillary esthetic zone during one-stage early loading multiple implant procedure.

Materials And Methods: A total of 20 implants were placed in 10 systemically healthy patients (2 implants per patient) for replacement of multiple teeth by early loading one-stage implants along with interimplant papilla reconstruction using DFDBA block fixed by titanium screw. At the baseline, 6 months, and at 1 year, clinical measurements (interimplant papillary height measurement, papilla contour) and radiographic measurements were recorded.

Evaluation of survival of 8 mm-length implants in posterior resorbed ridges: A pilot study.

Context: Rehabilitation of jaws with reduced bone height is technically demanding and expensive. Short implants are emerging as an alternate in such cases.

Aim: This study aimed to evaluate the survival of implants of 8 mm in length (short implants), clinically and radiographically, in posterior resorbed ridges.

Efficacy of Human Umbilical Stem Cells Cultured on Polylactic/ Polyglycolic Acid Membrane in the Treatment of Multiple Gingival Recession Defects: a Randomized Controlled Clinical Study.

Statement Of The Problem: Recently allogenic mesenchymal stem cells are proposed to have multipotential progenitor cell capabilities to differentiate into cementoblasts, osteoblasts, and periodontal ligament fibroblasts.

Purpose: The aim of the present study was to compare the efficacy of human umbilical stem cells cultured on polylactic acid (PLA), polyglycolic acid (PGA) membrane with PLA/PGA membrane alone in the treatment of multiple gingival recession defects.

Materials And Method: A total number of 14 cases of multiple gingival recession (Miller's Class I or II) located in the anterior region were randomly selected and divided into test (stem cells in combination with PLA/PGA membrane) and control group (PLA/PGA membrane alone).

Role of Chemically Modified Tetracyclines in the Management of Periodontal Diseases: A Review.

Researchers have found that Chemically Modified Tetracyclines (CMTs) act through multiple mechanisms, affecting several parameters of osteoclast function and consequently inhibit bone resorption by altering intracellular calcium concentration and interacting with the putative calcium receptor; decreasing ruffled border area; diminishing acid production; diminishing the secretion of lysosomal cysteine proteinases (cathepsins); inducing cell retraction by affecting podosomes; inhibiting osteoclast gelatinase activity; selectively inhibiting osteoclast ontogeny or development; and inducing apoptosis or programmed cell death of osteoclasts. Thus TCs/CMTs, as anti-resorptive drugs, may act similarly to bisphosphonates and primarily affect osteoclast function. Researchers have evaluated the influence of various chemically modified tetracyclines from CMT-1 to CMT-10 on collagenases and gelatinases through in vitro or animal studies and concluded that all the CMTs except CMT-5 inhibited periodontal breakdown through MMP inhibition in the following order of efficacy: CMT-8>CMT-1>CMT-3>CMT-4>CMT-7.

Alveolar Bone Housing- A Modified Wilkodontics Approach- A Case Report.

Accelerated orthodontic treatment is the need of the hour in current scenario as the conventional orthodontics is time taking. Corticotomy assisted orthodontics have been used for years to reduce the treatment duration by reducing the resistance provided by alveolar bone housing. This case report describes the orthodontic treatment combined with the modification in conventional wilkodontic technique in a patient to accelerate tooth movement and shorten the treatment time with an anterior open bite and flared and spaced upper and lower incisors.

Evaluation of effectiveness of hyaluronic acid in combination with bioresorbable membrane (poly lactic acid-poly glycolic acid) for the treatment of infrabony defects in humans: A clinical and radiographic study.

Background: The combination of biomaterials, bone graft substitutes along with guided tissue regeneration (GTR) has been shown to be an effective modality of periodontal regenerative therapy for infrabony defects. Therefore, the present randomized controlled clinical study was undertaken to evaluate the effectiveness of hyaluronic acid (HA) in combination with bioresorbable membrane for the treatment of human infrabony defects.

Materials And Methods: Twenty four infrabony defects in 20 systemically healthy patients were randomly assigned to test (HA in combination with bioresorbable membrane) and control (bioresorbable membrane alone) treatment groups.

Comparative evaluation of the effectiveness of acellular dermal matrix allograft and subepithelial connective tissue to coronally advanced flap alone in the treatment of multiple gingival recessions: A clinical study.

Background: Obtaining predictable and esthetic root coverage has become an important part of periodontal therapy. Several techniques have been developed to achieve these goals with variable outcomes. The aim of this study was to appraise the effectiveness of acellular dermal matrix allograft (ADMA) and subepithelial connective tissue graft (SCTG) compared to coronally advanced flap (CAF) in the treatment of multiple gingival recessions.

Stem Cells Cultured on Beta Tricalcium Phosphate (β-TCP) in Combination with Recombinant Human Platelet-Derived Growth Factor - BB (rh-PDGF-BB) for the Treatment of Human Infrabony Defects.

Knowledge gained from the field of tissue engineering, helped to develop a biological substitute that promotes tissue regeneration. The usual biological substitute consists of stem cells, growth factors and an appropriate scaffold. The present randomized controlled clinical and radiographic study was undertaken to evaluate the effectiveness of mesenchymal stem cells cultured on beta tricalcium phosphate (β-TCP) in combination with rh-PDGF-BB in treatment of infrabony defect in humans.

Soft tissue expansion before vertical ridge augmentation: Inflatable silicone balloons or self-filling osmotic tissue expanders?

Recent advances in periodontal plastic surgical procedures allow the clinician to reconstruct deficient alveolar ridges in more predictable ways than previously possible. Placement of implant/s in resorbed ridges poses numerous challenges to the clinician for successful esthetic and functional rehabilitation. The reconstruction frequently utilizes one or combination of periodontal plastic surgical procedures in conjunction with autogenous bone grafting, allogenic bone block grafting, ridge split techniques, distraction osteogenesis, or guided bone regeneration (GBR) for most predictable outcomes.

A comparison between connective tissue grafts combined with either double pedicle grafts or coronally positioned pedicle grafts: A clinical study.

Background: Various surgical techniques have been proposed for treating gingival recession. This randomized clinical study compared the effectiveness of using a sub-epithelial connective tissue graft (SCTG) combined with an overlying double pedical graft (DPG) or a coronally positioned flap (CPF) in the treatment of isolated gingival recession.

Materials And Methods: A total of 20, healthy, non-smoking subjects with single Miller's Class I or Class II recession defects were selected.

Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples.

The present study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed as per WHO guideline.

A comparative evaluation of rhPDGF-BB + β-TCP and subepithelial connective tissue graft for the treatment of multiple gingival recession defects in humans.

Today's patients are increasingly conscious of personal appearance, and much attention has been focused on denuded roots that are exposed during smiling. These concerns have given rise to numerous approaches for covering denuded root surfaces. Therefore, this study was undertaken to compare the effectiveness of recombinant human platelet-derived growth factor BB (rh-PDGF-BB) + β-tricalcium phosphate (β-TCP) and subepithelial connective tissue graft (SCTG) for the treatment of multiple gingival recession defects in humans.

Genetic mapping in papillon-lefèvre syndrome: a report of two cases.

Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive heterogeneous trait which is characterized by erythematous palmoplantar hyperkeratosis, early-onset periodontitis, and associated calcification of dura mater. The etiology of PLS is multifactorial with genetic, immunological, and microbial factors playing a role in etiopathogenesis. Recently identified genetic defect in PLS has been mapped to chromosome 11q14-q21, which involves mutations of cathepsin C.

A comparative evaluation of the effectiveness of guided tissue regeneration by using a collagen membrane with or without decalcified freeze-dried bone allograft in the treatment of infrabony defects: A clinical and radiographic study.

Background: The present, randomized, controlled clinical and radiographic study was undertaken to compare the effectiveness of guided tissue regeneration (GTR) by using a collagen membrane barrier with or without decalcified freeze-dried bone allograft (DFDBA) in the treatment of periodontal infrabony defects characterized by unfavorable architecture.

Materials And Methods: Sixteen systemically healthy patients with 20 periodontal infrabony defects were selected for the study. Each patient had at least ≥ 5 mm clinical probing pocket depth (PPD) at the selected site and depth of intrabony component ≥ 3 mm as assessed by clinical and radiographic measurements.

Early loading of single-piece implant for partially edentulous posterior arch: a prospective one-year case report.

Implant therapy is now well established, and there is an increasing need for shorter rehabilitation time. Original prerequisites of osseointegration have been reassessed to satisfy continuously increasing patient's expectation of reduced treatment time, improved esthetics, and increased comfort. Shorter healing time may be appropriate in some circumstances, and examples of early loading have been reported in animal and human studies.

Comparative evaluation of the effectiveness of coronally positioned flap with or without acellular dermal matrix allograft in the treatment of multiple marginal gingival recession defects.

Gingival recession remains an important problem in dental esthetics. Various surgical techniques have been proposed for treating multiple gingival recessions. The objective of this study was to evaluate and compare the effectiveness of a coronally positioned flap (CPF) with or without acellular dermal matrix allograft (ADMA) in the treatment of multiple marginal tissue recession.

Periodontal regeneration using platelet-derived growth factor in infrabony defects: a series of three cases.

The periodontal researchers and clinicians, in an effort to develop effective regenerative therapies, have sought to understand key events involved in the regeneration of periodontium. Polypeptide growth factors are a class of natural biological mediators which regulate key cellular events in tissue repair. Platelet-derived growth factor (PDGF) is the most thoroughly studied growth factor in periodontal regeneration.

Open flap debridement in combination with acellular dermal matrix allograft for the prevention of postsurgical gingival recession: a case series.

Open flap debridement with flap repositioning may result in significant gingival recession. Patients with chronic periodontitis were treated with open flap debridement followed by placement of an acellular dermal matrix allograft (ADMA) underneath the flap to minimize the occurrence of postsurgical gingival recession. Ten patients (total, 60 teeth) with periodontal pockets in the anterior dentition underwent open flap debridement combined with ADMA.

Interimplant papilla reconstruction by using demineralized freeze dried bone allograft block fixed by titanium screw: a case report.

Dental implants are now considered as a predictable treatment modality for the oral rehabilitation of partially or fully edentulous patients. Recently emphasis has changed towards achieving a predictable esthetic success. Creating aesthetically successful implant-supported restoration in the anterior region of oral cavity depends on the presence of interimplant papilla when multiple implants are used.

A comparative clinical evaluation of acellular dermal matrix allograft and sub-epithelial connective tissue graft for the treatment of multiple gingival recessions.

Background: Obtaining predictable and aesthetic root coverage has become an important part of periodontal therapy. Several techniques have been developed to obtain these results with variable outcomes. The aim of this study was to compare and evaluate the effectiveness of acellular dermal matrix allograft (ADMA) and subepithelial connective tissue graft (SCTG) in combination with coronally positioned flap in the treatment of multiple gingival recessions in aesthetic areas.

The effectiveness of enamel matrix protein (Emdogain(®)) in combination with coronally advanced flap in the treatment of multiple marginal tissue recession: A clinical study.

Background: Gingival recession resulting in root exposure is a common problem faced by clinicians. This clinical study compared the results obtained by treating gingival recession using enamel matrix derivative (Emdogain gel(®)) along with coronally positioned flap and coronally positioned flap alone.

Materials And Methods: Twenty patients with a total of 46 gingival recession defects, each patient with a minimum of two recession defects, were included in the study.

Serum alkaline phosphatase: a potential marker in the progression of periodontal disease in cirrhosis patients.

Objective: As a consequence of their liver dysfunction, cirrhotic patients have elevated levels of serum alkaline phosphatase (ALP). Increased ALP activity is seen in periodontal tissues during the progression of periodontitis. The present study was carried out to compare ALP levels in cirrhosis patients with and without periodontitis and to correlate ALP levels with the severity of periodontitis.