Trayambak Dutta

Abstract

Introduction: As probiotics are emerging as an essential treatment modality for chronic periodontitis its role is not well established. This study aimed to evaluate the efficacy of probiotic as an adjunct to Scaling and Root Planing (SRP) in chronic periodontitis. The clinical parameters, the levels of Matrix Metalloproteinases 8 in gingival crevicular fluid and the presence & reduction of Porphyromonas gingivalis in subgingival plaque samples were determined. Materials and Methods: This clinical study was conducted for 6 weeks with a single evaluator to investigate the effect of probiotic as an adjunct to SRP in chronic periodontitis. The clinical parameters were analyzed at baseline, 3 weeks and 6 weeks. This study also evaluated the effect of Probiotic on Matrix metalloproteinase 8 levels in GCF and on the existence of Porphyromonas gingivalis in subgingival plaque after 3 weeks. Results: Clinical parameters, gingival crevicular fluid Matrix Metalloproteinase 8 and Subgingival plaque levels of Porphyromonas gingivalis were reduced in Control (Group I) and Probiotic study (Group II) at baseline and 6 weeks. On comparing the groups, Group II had a significant decrease in clinical, microbiological and biochemical parameters than Group I, post treatment. Conclusion: Probiotics have great potential in arena of periodontics in terms of plaque formation, altering anaerobic bacterial colonization, reduction in Pocket Depth, gingival bleeding and clinical attachment level and in treating halitosis. Probiotics can be used as an effective adjunctive therapy to conventional non-surgical periodontal treatment in Chronic Periodontitis patients. Keywords: Chronic periodontitis, Probiotics, Scaling and root planing, Gingival bleeding, Halitosis.

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Abstract

Menopausal syndrome is marked by an array of psychosomatic as well as vasomotor symptoms such as hot flushes and night sweats. Amongst vasomotor symptoms of menopause, hot flushes are the most common. It consists of sudden sweating and periodic flushing with palpitations, chills, anxiety, choking and nausea. Depletion of estrogen is in part a cause for these symptoms, but not entirely. Neuronal origin of menopausal symptoms is gaining significance for better understanding the pathophysiology of vasomotor symptoms. There is significant change that occurs in the thermoregulation due to menopause. An important neuronal theory is narrowing of thermoneutral zone due to elevated central sympathetic activation. The first line therapy such as lifestyle changes, either alone or combination with dietary isoflavones, do not effectively control the vasomotor symptoms in severe cases. In such individual hormone therapy is inevitable, albeit it’s higher risk for coronary artery disease, breast carcinoma and pulmonary embolism. Therefore, it is imperative that the therapeutic target should be directed towards the central origin of symptoms and it should be devoid of these adverse effects. Medicinal plants and complimentary therapies have proved to be of great therapeutic advantage for patients with menopausal syndrome. Amongst medicinal plants studied extensively so far for reduction of menopausal symptoms, Valeriana Officinalis, Passiflora incarnata and Humulus lupulus are particularly important. Valeriana Officinalis binds to the beta subunit of the GABA-A receptor which leads to chloride channel mediated anxiolysis. It also decreases the metabolism of GABA thereby potentiating its effect. Passiflora incarnata acts by increasing the level of serotonin via modulating the content of mono-amine oxidases. Humulus lupulus increases the level of GABA thereby exerting its sedative and anxiolytic effect in menopause. The GABA mimetic action of these three ingredients controls the psychosomatic and vasomotor symptoms of menopause mediated by central sympathetic action. Clinical trials with these three herbs in European post menopausal women have led to active control and reduction in menopausal symptoms. This review delineates their role in the management of menopausal syndrome. Keywords: Valeriana officinalis, Passiflora incarnata, Humulus lupulus, Menopause.

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