1.Evaluation of titanium-prepared platelet-rich fibrin incorporated with amoxiclav, metronidazole, and neem gel on bone regeneration in Wistar rats: a pilot study
Shiva Shankar GUMMALURI ; Trinath Kishore DAMERA ; Viswa Chandra RAMPALLI ; Anusha BODDEDA ; Naveen Vital Kumar GIDIJALA ; Ramanarayana BOYAPATI ; Kaarthikeyan GURUMOORTHY
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2026;52(2):80-93
Objectives:
Titanium platelet-rich fibrin (T-PRF) usage as sustained drug delivery system (SDDS) has been recently started. Hence present study aimed to evaluate hard tissue regenerative efficacy of T-PRF clots incorporated with amoxiclav (AMX)/metronidazole (MET)eem (NE) gels individually in osseous defects created in Wistar rats.
Materials and Methods:
In this in vivo animal model trial, 12 female Wistar rats were procured and subjected to ligature induced periodontitis.Bone defects were created and incorporated with T-PRF plain, T-PRF clots+AMX/MET/NE gels individually. Rats were sacrificed after 2 months and checked under light microscopy and micro (µ)-computed tomography analysis for bone regeneration. Frequency distribution percentages, chi-square test, ANOVA and un-paired t-test were used for conducting the statistical analysis.
Results:
Inflammatory response was reported in T-PRF+MET Group followed by AMX Group and no inflammatory response was recorded for T-PRF plain with statistical significance (P=0.008), for mineralized and un-mineralized bone formation there was no significant difference (P=0.133). Mean comparisons of bone density there was no significant difference (P=0.545) among all (AMX=551.00±18.68, MET=578.00±18.25, NE=569.00±24.58, T-PRF plain=507.67±118.50). For gene expression significantly (P<0.001) higher alkaline phosphatase and bone morphogenetic protein-2 levels were recorded for T-PRF+NE Group (7.60±3.04, 10.85±1.28) followed by MET (4.65±1.52, 4.64±0.45)>AMX (2.47±0.84, 1.89±0.18)>T-PRF plain (1.00±0.00, 1.00±0.00).
Conclusion
Research results showed that T-PRF can be a SDDS and addition of antibiotics or herbal extract didn’t alter the hard tissue healing property of T-PRF and resulted in new bone formation.
2.Galectin-3 as a possible link between periodontitis and chronic kidney disease: a cross-sectional study
Sri Vidhya MARIMUTHU ; Devi ARUL ; Muthukumar SANTHANAKRISHNAN ; Ramprasad ELUMALAI ; Sandhya SURESH ; Sathya SELVARAJAN ; Ravindranath DHULIPALLA ; Ramanarayana BOYAPATI
Journal of Yeungnam Medical Science 2025;42(1):22-
Background:
Chronic periodontitis is associated with various systemic inflammatory diseases; however, research on its association with chronic kidney disease (CKD) is relatively limited. Because both conditions share common risk factors, systemic inflammation plays a key role in the progression of these diseases. Galectin-3 (Gal-3) is a proinflammatory cytokine that plays an important role in chronic inflammatory diseases and is a potential biomarker. This study aimed to measure salivary Gal-3 levels in patients with periodontitis and CKD to better understand their association and evaluate Gal-3 as a diagnostic biomarker for these conditions.
Methods:
Seventy-five patients were categorized into three groups: Group I, patients with CKD and periodontitis (n=25); Group II, patients with chronic periodontitis who were systemically healthy (n=25); and Group III, patients with CKD without chronic periodontitis (n=25). Demographic characteristics and periodontal and renal parameters were recorded for each patient. Saliva samples were collected to evaluate Gal-3 levels using an enzyme-linked immunosorbent assay.
Results:
Patients with chronic periodontitis and CKD and those with chronic periodontitis alone (Groups I and II, respectively) showed significantly higher salivary Gal-3 levels than patients with CKD alone (Group III) (p<0.001). Bivariate correlation analysis indicated a strong relationship between clinical parameters and Gal-3 levels across all three groups.
Conclusion
Salivary Gal-3 level is a valuable early diagnostic marker of chronic periodontitis and CKD.
3.Galectin-3 as a possible link between periodontitis and chronic kidney disease: a cross-sectional study
Sri Vidhya MARIMUTHU ; Devi ARUL ; Muthukumar SANTHANAKRISHNAN ; Ramprasad ELUMALAI ; Sandhya SURESH ; Sathya SELVARAJAN ; Ravindranath DHULIPALLA ; Ramanarayana BOYAPATI
Journal of Yeungnam Medical Science 2025;42(1):22-
Background:
Chronic periodontitis is associated with various systemic inflammatory diseases; however, research on its association with chronic kidney disease (CKD) is relatively limited. Because both conditions share common risk factors, systemic inflammation plays a key role in the progression of these diseases. Galectin-3 (Gal-3) is a proinflammatory cytokine that plays an important role in chronic inflammatory diseases and is a potential biomarker. This study aimed to measure salivary Gal-3 levels in patients with periodontitis and CKD to better understand their association and evaluate Gal-3 as a diagnostic biomarker for these conditions.
Methods:
Seventy-five patients were categorized into three groups: Group I, patients with CKD and periodontitis (n=25); Group II, patients with chronic periodontitis who were systemically healthy (n=25); and Group III, patients with CKD without chronic periodontitis (n=25). Demographic characteristics and periodontal and renal parameters were recorded for each patient. Saliva samples were collected to evaluate Gal-3 levels using an enzyme-linked immunosorbent assay.
Results:
Patients with chronic periodontitis and CKD and those with chronic periodontitis alone (Groups I and II, respectively) showed significantly higher salivary Gal-3 levels than patients with CKD alone (Group III) (p<0.001). Bivariate correlation analysis indicated a strong relationship between clinical parameters and Gal-3 levels across all three groups.
Conclusion
Salivary Gal-3 level is a valuable early diagnostic marker of chronic periodontitis and CKD.
4.Galectin-3 as a possible link between periodontitis and chronic kidney disease: a cross-sectional study
Sri Vidhya MARIMUTHU ; Devi ARUL ; Muthukumar SANTHANAKRISHNAN ; Ramprasad ELUMALAI ; Sandhya SURESH ; Sathya SELVARAJAN ; Ravindranath DHULIPALLA ; Ramanarayana BOYAPATI
Journal of Yeungnam Medical Science 2025;42(1):22-
Background:
Chronic periodontitis is associated with various systemic inflammatory diseases; however, research on its association with chronic kidney disease (CKD) is relatively limited. Because both conditions share common risk factors, systemic inflammation plays a key role in the progression of these diseases. Galectin-3 (Gal-3) is a proinflammatory cytokine that plays an important role in chronic inflammatory diseases and is a potential biomarker. This study aimed to measure salivary Gal-3 levels in patients with periodontitis and CKD to better understand their association and evaluate Gal-3 as a diagnostic biomarker for these conditions.
Methods:
Seventy-five patients were categorized into three groups: Group I, patients with CKD and periodontitis (n=25); Group II, patients with chronic periodontitis who were systemically healthy (n=25); and Group III, patients with CKD without chronic periodontitis (n=25). Demographic characteristics and periodontal and renal parameters were recorded for each patient. Saliva samples were collected to evaluate Gal-3 levels using an enzyme-linked immunosorbent assay.
Results:
Patients with chronic periodontitis and CKD and those with chronic periodontitis alone (Groups I and II, respectively) showed significantly higher salivary Gal-3 levels than patients with CKD alone (Group III) (p<0.001). Bivariate correlation analysis indicated a strong relationship between clinical parameters and Gal-3 levels across all three groups.
Conclusion
Salivary Gal-3 level is a valuable early diagnostic marker of chronic periodontitis and CKD.
5.Galectin-3 as a possible link between periodontitis and chronic kidney disease: a cross-sectional study
Sri Vidhya MARIMUTHU ; Devi ARUL ; Muthukumar SANTHANAKRISHNAN ; Ramprasad ELUMALAI ; Sandhya SURESH ; Sathya SELVARAJAN ; Ravindranath DHULIPALLA ; Ramanarayana BOYAPATI
Journal of Yeungnam Medical Science 2025;42(1):22-
Background:
Chronic periodontitis is associated with various systemic inflammatory diseases; however, research on its association with chronic kidney disease (CKD) is relatively limited. Because both conditions share common risk factors, systemic inflammation plays a key role in the progression of these diseases. Galectin-3 (Gal-3) is a proinflammatory cytokine that plays an important role in chronic inflammatory diseases and is a potential biomarker. This study aimed to measure salivary Gal-3 levels in patients with periodontitis and CKD to better understand their association and evaluate Gal-3 as a diagnostic biomarker for these conditions.
Methods:
Seventy-five patients were categorized into three groups: Group I, patients with CKD and periodontitis (n=25); Group II, patients with chronic periodontitis who were systemically healthy (n=25); and Group III, patients with CKD without chronic periodontitis (n=25). Demographic characteristics and periodontal and renal parameters were recorded for each patient. Saliva samples were collected to evaluate Gal-3 levels using an enzyme-linked immunosorbent assay.
Results:
Patients with chronic periodontitis and CKD and those with chronic periodontitis alone (Groups I and II, respectively) showed significantly higher salivary Gal-3 levels than patients with CKD alone (Group III) (p<0.001). Bivariate correlation analysis indicated a strong relationship between clinical parameters and Gal-3 levels across all three groups.
Conclusion
Salivary Gal-3 level is a valuable early diagnostic marker of chronic periodontitis and CKD.
6.Evaluating the antimicrobial efficacy, growth factor release drug kinetics of titanium platelet-rich fibrin loaded with amoxiclav, metronidazole and neem gel: an in vitro study
Shiva Shankar GUMMALURI ; Trinath Kishore DAMERA ; Viswa Chandra RAMPALLI ; Ramanarayana BOYAPATI ; Kaarthikeyan GURUMOORTHY
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2025;51(6):369-383
Objectives:
The use of titanium platelet-rich fibrin (T-PRF) as a sustained drug delivery system (SDDS) has been limited. Hence present study aimed to evaluate the antimicrobial efficacy, drug kinetics and growth factor release of T-PRF injected with amoxicillin+clavulanic acid (amoxiclav gel), metronidazole (MTZ) and neem (NE) gels separately.
Materials and Methods:
12 Healthy volunteers were recruited for this in vitro analysis. Drug kinetics were monitored at 0, 2, 24, 48, and 72 hours.Antimicrobial efficacy was assessed at 48 hours post inoculation in culture plates and growth factor release was measured at 3, 7 and 10 days. Kruskal– Wallis test, Dunn’s Post hoc test, Bonferroni’s correction and Mann–Whitney U test were used to compare the drug release over time frames, inhibition zone diameters (IZDs) and growth factor release were expressed in (mean and standard deviations) millimetres, pico g/mL and nano g/mL.
Results:
In terms of drug kinetics, both T-PRF clots and collagen sponges when injected with antibiotic/ herbal gels individually there was a sustained drug release up to 72 hours and there was a greater release observed in collagen sponge. IZDs were recorded for T-PRF injected with amoxiclav/MTZ/ NE gel for anti-microbial efficacy. Growth factor release was also observed for T-PRF plain and T-PRF injected with gels, with levels were numerically higher in T-PRF plain.
Conclusion
Within the limitations of the study T-PRF demonstrated sustained drug release with superior antibacterial activity. Growth factor release was not compromised, aiding in the preservation of regenerative capacity. Therefore, T-PRF can be used as a SDDS.
7.Diplopia following posterior superior alveolar nerve block: a case report and review of literature
Aditya Mohan ALWALA ; Padminii ELLAPAKURTHI ; Sushma MUDHIREDDY ; Ramanarayana BOYAPATI
Journal of Dental Anesthesia and Pain Medicine 2022;22(1):71-74
Posterior superior alveolar nerve block (PSANB) is one of the most common and safe injection techniques in the field of dentistry. As with any other procedure, it also has inherent complications, of which ophthalmic complications are relatively rare. Transient diplopia following the administration of PSANB is rare and daunting for both the patient and the clinician. We present a case of transient diplopia in a 26-year-old female patient following administration of PSANB and review its probable pathophysiology and management and prevention.
8.A novel amnion-chorion allograft membrane combined with a coronally advanced flap: a minimally invasive surgical therapy to regenerate interdental papillary soft tissue recession – a six-month postoperative image analysis-based clinical trial
Unnati PITALE ; Pritish Chandra PAL ; Ramanarayana BOYAPATI ; Ashish BALI ; Manish VARMA ; Shaleen KHETARPAL
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2021;47(6):438-444
Objectives:
Loss of the interdental papilla is multi-factorial and creates a multitude of problems. Autogenous connective tissue/biomaterial-based regen-eration has been attempted for decades to reconstitute the black space created due to the loss of papilla. The aim of this present study was to regenerate papillary recession defects using an amnion-chorion membrane (ACM) allograft and to evaluate the clinical outcome up to six months postoperatively.
Materials and Methods:
Twenty patients with 25 Nordland and Tarnow’s Class I/II interdental papillary recession defects were treated with ACM and coronal advancement of the gingivo-papillary unit via a semilunar incision on the labial aspect followed by a sulcular incision in the area of interest. A photographic image analysis was carried out using the GNU Image Manipulation software program from the baseline to three and six months postoperatively. The black triangle height (BTH) and the black triangle width (BTW) were calculated using the pixel size and were then converted into millimeters. The mean and standard deviation values were determined at baseline and then again at three and six months postoperatively. The probability values (P<0.05 and P≤0.01) were considered statistically significant and highly significant, respectively. An analysis of variance and post hoc Bonferroni test were carried out to compare the mean values.
Results:
Our evaluation of the BTH and BTW showed a statistically and highly significant difference from the baseline until both three and six months postoperatively (P=0.01). A post hoc Bonferroni test disclosed a statistically significant variance from the baseline until three and six months postoperatively (P<0.05) and a non-significant difference from three to six months after the procedure (P≥0.05).
Conclusion
An ACM allograft in conjunction with a coronally advanced flap could be a suitable minimally invasive alternative for papillary regeneration.

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