Anil Sukumaran | SAVEETHA UNIVERSITY (original) (raw)

Papers by Anil Sukumaran

In recent years, there have been major advances and increasing amounts of research on the utiliza... more In recent years, there have been major advances and increasing amounts of research on the utilization of natural polymeric materials as drug delivery vehicles due to their biocompatibility and biodegradability. Seaweed polysaccharides are abundant resources and have been extensively studied for several biological, biomedical, and functional food applications. The exploration of seaweed polysaccharides for drug delivery applications is still in its infancy. Alginate, carrageenan, fucoidan, ulvan, and laminarin are polysaccharides commonly isolated from seaweed. These natural polymers can be converted into nanoparticles (NPs) by different types of methods, such as ionic gelation, emulsion, and polyelectrolyte complexing. Ionic gelation and polyelectrolyte complexing are commonly employed by adding cationic molecules to these anionic polymers to produce NPs of a desired shape, size, and charge. In the present review, we have discussed the preparation of seaweed polysaccharide-based NPs using different types of methods as well as their usage as carriers for the delivery of various therapeutic molecules (e.g., proteins, peptides, anti-cancer drugs, and antibiotics). Seaweed polysaccharide-based NPs exhibit suitable particle size, high drug encapsulation, and sustained drug release with high biocompatibility, thereby demonstrating their high potential for safe and efficient drug delivery.

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Background: Resolution of peri-implant defects resulting from implant placement in the freshly ex... more Background: Resolution of peri-implant defects resulting from implant placement in the freshly extracted site demands for a bone graft substitute that stimulates bone regeneration and hence facilitates implant integration. In view of this, the addition of silica to hydroxyapatite (HASi) could enhance the bioactive behavior of ceramic materials and implant surfaces coated with bioactive ceramics might benefit the interaction between bone and implant.

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Over the past two decades numerous studies have been reported on seaweeds-derived polysaccharides... more Over the past two decades numerous studies have been reported on seaweeds-derived polysaccharides for biomedical and biological applications (tissue engineering, drug delivery, wound healing, and biosensor). Alginate, carrageenan, fucoidan, and ulvan are widely used marine derived polysaccharides for biological and biomedical applications due to their biocompatibility and availability. The gel forming property of alginate has increased its applications in tissue engineering and drug delivery as an extracellular matrix and delivery vehicle, respectively. Other sulfated polysaccharides such as carrageenan and fucoidan show promising application in tissue engineering due to their capacity of inducing important osteogenic, adipogenic, and chondrogenic differentiation in stem cells. In this review, we explained the extraction/isolation methods and applications of these seaweed derived polysaccharides as well as their roles in therapeutics, drug delivery, and tissue engineering.

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The purpose of this in vitro study was to compare the primary stability and removal torque of bon... more The purpose of this in vitro study was to compare the primary stability and removal torque of bone level and tissue level implants in different bone qualities. Twenty tissue level and bone level implants (3.3 3 10 mm and 4.1 3 10 mm) were used for assessing the stability in type II and type IV bone. Forty bovine rib blocks were used in this study. The primary stability of the implant was measured by the resonance frequency using an Osstel device. The removal torque values (RTV) of the implants was assessed using a digital torque gauge instrument. The implant stability quotient (ISQ) values and the RTV showed a marginally higher stability with bone level implants as compared to tissue level implants. However, these differences were not statistically significant in both type of bone used (P. 0.05). On the other hand, compared to type IV, type II bone showed significant differences in the ISQ (P , 0.01) and RTV (P , 0.001) of bone level and tissue level implants. The study concluded that bone quality is an important factor in establishing primary stability than the implant dimension. Bone level and tissue level implants of same dimensions can be selected based on the esthetic demands since they showed similar mechanical properties.

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Background: Reduced vertical bone level in the implantation area is often considered one of the l... more Background: Reduced vertical bone level in the implantation area is often considered one of the limiting factors before implant insertion. Inserting implants of reduced length might be useful in order to avoid vertical bone augmentation prior to implantation. The uses of short implants in compromised sites are considered an alternative procedure to avoid extensive surgical procedures such as sinus lifting and grafting.

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Objectives: To study the healing of defects around titanium implants filled with biphasic calcium... more Objectives: To study the healing of defects around titanium implants filled with biphasic calcium phosphates (BCP). Material and methods: Forty custom-made, titanium implants (Ti) with a diameter of 5 mm, and length of 8 mm, with two-sided gaps, were fabricated and installed in the femoral condyle of 20 rabbits. Following a randomization protocol, implants were alternately installed in one condyle without BCP bone substitute material (Ti) in the gaps and in the contralateral condyle gaps were filled with BCP bone substitute material (Ti+BCP). The implants were retrieved after 4 and 12 weeks of healing, after which histological and histomorphometrical analyses were done to assess the percentage of bone implant contact (BIC), the percentage of bone area (BA) and the percentage of particle area (PA) within the region of interest (ROI); the rectangular area joining the two arms of the L-shaped implant was considered as the ROI. Results: After 4 and 12 weeks of healing, Ti+BCP showed significantly higher BIC and BA values compared to Ti. Further, the BCP particles showed a significant decrease from 4 to 12 weeks of healing. The BCP particles (PA) showed a significant reduction from 31.6 AE 11.0% at 4 weeks to 21.0 AE 7.2% at 12 weeks.

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ABStRACt Autologous platelet-rich plasma (PRP) can be a valid agent that is effective in inducing... more ABStRACt Autologous platelet-rich plasma (PRP) can be a valid agent that is effective in inducing and accelerating bone healing for the treatment of periodontal defects and also to accelerate alveolar bone regeneration. Early healing appeared to be impaired by the presence of microfibrillar collagen (MFC) and impeded by the presence of oxidized regenerated cellulose (ORC). In contrast, alkylene oxide copolymer (AOC) did not inhibit bone healing and suggest that AOC may be a better bone hemo-static material for procedures where bony fusion is critical and immediate hemostasis required. How to cite this article: Al Fouzan K, Pillai H, Sukumaran A, Rajendran R. Effectiveness of Agents Like Platelet-rich Plasma, Oxidized Regenerated Cellulose and Microfibrillar Collagen in Hard-tissue Healing: Validation of their Comparative Effectiveness. Oral Maxillo fac Pathol J 2015;6(2):609-611.

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Abstract OBJECTIVES: We aimed to investigate the effect of brief exposure to sub-cidal concentrat... more Abstract
OBJECTIVES:
We aimed to investigate the effect of brief exposure to sub-cidal concentrations of nystatin, amphotericin B, ketoconazole, fluconazole and chlorhexidine gluconate on the adhesion of oral Candida dubliniensis isolates to the surface of acrylic dentures.
METHODS:
After determining the minimum inhibitory concentration of each drug, 20 oral isolates of C. dubliniensis were exposed to sub-cidal concentrations of the drugs for 1 h. The drugs were then removed by dilution, and the adhesion of the isolates to denture acrylic strips was assessed by an in vitro adhesion assay.
RESULTS:
Compared to the controls, exposure to nystatin, amphotericin B, ketoconazole, fluconazole and chlorhexidine gluconate suppressed the ability of C. dubliniensis isolates to adhere to acrylic denture surfaces with a reduction of 74.68, 74.27, 57.31, 44.57 and 56.53% (p < 0.001 for all drugs), respectively.
CONCLUSIONS:
Brief exposure to sub-cidal concentrations of anti-mycotics suppressed the adhesion of C. dubliniensis oral isolates to acrylic denture surfaces.
© 2014 S. Karger AG, Basel.
PMID: 25471106 [PubMed - indexed for MEDLINE]

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Abstract BACKGROUND: Minimizing crestal bone loss following immediate implant placement is consid... more Abstract
BACKGROUND:
Minimizing crestal bone loss following immediate implant placement is considered the most challenging aspect in implant therapy. Implant surface topography and chemical modifications have been shown to influence the success of Osseointegration. The Straumann Bone Level implant, featuring SLActive surface, has been introduced with the aim of enhancing bone apposition. Similarly, the OsseoSpeed implants from Astra Tech claim to have an enhanced osseointegration. Because of the specific features in the implant design, both companies claim that crestal resorption is minimal with these implants.
OBJECTIVE:
To evaluate the osseointegration and crestal bone level following immediate placement of Straumann Bone Level implant and OsseoSpeed implants in fresh extraction sockets in Beagle dogs.
METHOD:
The distal roots of the second, third and fourth premolars were extracted in both sides of the mandible. The distal roots were removed using a dental elevator. A total of 60 fixtures were installed in 10 Beagle dogs. Two types of implants were used: Straumann Bone-Level implants, which were 8 × 3.3 mm in size, and Astra Tech OsseoSpeed 3.5 S MicroThread implants, which were 8 × 3.5 mm in size. The histomorphometrical evaluation was performed at the end of 4- and 12-week healing. The implant-bone contact and bone volume percentage were assessed.
RESULTS:
The bone-to-implant contact (BIC) and the bone volume did not show any significant changes for both types of implants. The OsseoSpeed™ implants showed 67.4% and 65.3% BIC, respectively, at 4 and 12 weeks compared with 71.7 and 73.1 for the Straumann Bone-Level implants. The bone volume around both types of implants did not differ significantly at both time periods. The crestal bone resorption was observed for both types of implants. The first BIC at buccal side and lingual side of the implants also did not differ significantly for both implant systems.
CONCLUSIONS:
This study showed that Straumann Bone Level and OsseoSpeed implants induced similar bone response after immediate implantation at 4 and 12 weeks. The immediate implant placement resulted in peri-implant crestal bone-level changes for both types of implants.
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
KEYWORDS:
bone level; bone preservation; implant design; microgap
PMID: 24690000 [PubMed - in process]

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Calcium phosphate (CaP) ceramic coatings have been used to enhance the biocompatibility and osteo... more Calcium phosphate (CaP) ceramic coatings have been used to enhance the biocompatibility and osteoconduc-tive properties of metallic implants. The chemical composition of these ceramic coatings is an important parameter, which can influence the final bone performance of the implant. In this study, the effect of phase composition of CaP-sputtered coatings was investigated on in vitro dissolution behavior and in vivo bone response. Coatings were prepared by a radio frequency (RF) magnetron sputtering technique; three types of CaP target materials were used to obtain coatings with different stoichiometry and calcium to phosphate ratios (hydroxyapatite (HA), a-tricalciumphosphate (a-TCP), and tetracalciumphosphate (TTCP)) were compared with non-coated titanium controls. The applied ceramic coatings were characterized by X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy, and inductively coupled plasma optical emission spectros-copy. The in vitro dissolution/precipitation of the CaP coat

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This study compared the surface topography, hydrophilicity, and bioactivity of titanium implants ... more This study compared the surface topography, hydrophilicity, and bioactivity of titanium implants after 3 different surface treatments (sandblasting and acid etching, modified sandblasting and acid etching, and thermal oxidation) with those of machined implants. One hundred indigenously manufactured threaded titanium implants were subjected to 3 methods of surface treatment. The surface roughness of the nontreated (Group A) and treated samples (Groups B through D) was evaluated with a scanning electron microscope (SEM) and profilometer. The wettability was visually examined using a colored dye solution. The calcium ions attached to the implant surface after immersing in simulated body fluid (SBF) were assessed on days 1, 2, and 7 with an atomic electron spectroscope. The data were analyzed statistically. The SBF test allowed the precipitation of a calcium phosphate layer on all surface-treated samples, as evidenced in the SEM analysis. A significantly higher amount of calcium ions and increased wettability were achieved in the thermally oxidized samples. The mean roughness was significantly lower in Group A (0.85 6 0.07) compared to Group B (1.35 6 0.17), Group C (1.40 6 0.14), and Group D (1.36 6 0.18). The observations from this in vitro study indicated that surface treatment of titanium improved the bioactivity. Moreover, results identified the implants that were sandblasted, acid etched, and then oxidized attracted more calcium ions.

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Saliva plays a key role in maintaining oral homeostasis, function, and health. The prevalence of ... more Saliva plays a key role in maintaining oral homeostasis, function, and health. The prevalence of xerostomia and its consequences are rising due to the increasing aging population, the effects of some systemic diseases, medical management, and commonly-prescribed medications that reduce saliva production. When salivary function is diminished, patients are at a greater risk of developing caries, discomfort in wearing dentures, and opportunistic diseases, such as candidiasis. The psychosocial aspects of xerostomia can range from a mild effect on self-rated oral health to frustration, embarrassment, unhappiness, or substantial disruptions in quality of life. This article reviews the clinical features, diagnosis, and prevalence of dry mouth, as well as its treatment strategies.

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Background: Observations from several epidemiologic and clinical studies suggest that psychologic... more Background: Observations from several epidemiologic and clinical studies suggest that psychological stress has a role in the etiology and progression of periodontal diseases (PD). The aim of the present study was to systematically analyze the influence of stress on periodontal disease reported in various case control, cross sectional and prospective clinical trials. The focused question analyzed in this systematic review was whether there is sufficient evidence to consider stress as risk factor for periodontal disease.

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Despite the success in the use of superparamagnetic iron oxide nanoparticles (SPION) for various ... more Despite the success in the use of superparamagnetic iron oxide nanoparticles (SPION) for various scientific applications, its potential in biomedical fields has not been exploited to its full potential. In this context, an in situ substitution of Mn 2+ was performed in SPION and a series of ferrite particles, Mn x Fe 1Àx Fe 2 O 4 with a varying molar ratio of Mn 2+ : Fe 2+ where 'x' varies from 0–0.75. The ferrite particles obtained were further studied in MRI contrast applications and showed appreciable enhancement in their MRI contrast properties. Manganese substituted ferrite nanocrystals (MnIOs) were synthesized using a novel, one-step aqueous co-precipitation method based on the use of a combination of sodium hydroxide and trisodium citrate (TSC). This approach yielded the formation of highly crystalline, superparamagnetic MnIOs with good control over their size and bivalent Mn ion crystal substitution. The presence of a TSC hydrophilic layer on the surface facilitated easy dispersion of the materials in an aqueous media. Primary characterizations such as structural, chemical and magnetic properties demonstrated the successful formation of manganese substituted ferrite. More significantly, the MRI relaxivity of the MnIOs improved fourfold when compared to SPION crystals imparting high potential for use as an MRI contrast agent. Further, the cytocompatibility and blood compatibility evaluations demonstrated excellent cell morphological integrity even at high concentrations of nanoparticles supporting the non-toxic nature of nanoparticles. These results open new horizons for the design of biocompatible water dispersible ferrite nanoparticles with good relaxivity properties via a versatile and easily scalable co-precipitation route.

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Abstract PURPOSE: To evaluate the accuracy of impressions on changing the implant component (copi... more Abstract
PURPOSE:
To evaluate the accuracy of impressions on changing the implant component (coping and abutment replica) between Brånemark and BIOMET 3i and between Straumann and Allfit.
MATERIALS AND METHODS:
Two master casts were constructed, one containing pair of Brånemark self-tap Mk II fixtures (Nobel Biocare) labeled Master cast I and the other containing pair of Straumann Standard plus implant, SLA fixtures (Straumann) labeled Master cast II. Ten impressions of each master cast were made by open tray technique using polyether impression material. Five out of 10 impressions made from master cast I contained Brånemark pair of coping and replica and the other 5 contained 3i (Implant Innovations). Five out of 10 impressions made from master cast II contained Straumann pair of copings and replica and the remaining 5 contained Allfit implants (Ihde Dental). Duplicated casts were prepared, and distances between copings were measured using traveling microscope and compared the distance in master casts.
RESULT:
No significant difference was observed in mean value between 2 master casts and their duplicates.
CONCLUSION:
The interchangeability of coping and abutment replica between Brånemark and BIOMET 3i and between Straumann and Allfit was found to be possible without compromising the quality of impressions.
PMID: 25783050 [PubMed - in process]

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Paradental cyst is an inflammatory odontogenic cyst arising in association with partially erupted... more Paradental cyst is an inflammatory odontogenic cyst arising in association with partially erupted third molars affected with pericoronitis. The common location is on the buccal aspect of the molar teeth. Radiographically, the characteristic presen tation is a welldefined radiolucency superimposed on the roots. Histologically, cysts were lined with nonkeratinized epithelium. The various concepts underlining the origin/pathogenesis of this rare entity is discussed and critically apprised.

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Objective: To evaluate the influence of Expasyl ® gingival retraction paste on the shear bond str... more Objective: To evaluate the influence of Expasyl ® gingival retraction paste on the shear bond strength of self-etch and total-etch adhesive systems. Materials and methods: Twenty-four specimens of extracted, caries-free, sound human molars were used in this study. The molars were then cut vertically into halves through the buccal and lingual cusps. Forty-eight specimens were divided into four groups (total-etch, total-etch with Expasyl application, self-etch, self-etch with Expasyl application) and the shear bond strength was tested. Results: Expasyl significantly reduced the shear bond strength of the self-etch and total-etch adhesive systems. The self-etch system showed relatively lower performance compared with the total-etch adhesive system. The shear bond strength values of the total-etch adhesive without Expasyl showed the highest bond strength (21.48 ± 2.89), while the self-etching group adhesive treated with Expasyl showed the lowest shear bond strength value (14.89 ± 1.81). Conclusion: From the observations of this in vitro study, it can be concluded that the use of Expasyl ® gingival retraction system can negatively affect bond strength of adhesives. The total-etch system showed better compatibility to the Expasyl gingival retraction system than the self-etch.

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Secretion of hydrolytic enzymes such as hemolysin is considered an important virulence attribute ... more Secretion of hydrolytic enzymes such as hemolysin is considered an important virulence attribute of the opportunistic pathogenic fungus Candida. It is known that Candida spp. isolated from HIV-infected patients produce copious hemolysins. As common antifungal agents may perturb the production of extracellular enzymes, we evaluated the effect of three antifungals nystatin, amphotericin B and fluconazole on the hemolytic activity of Candida albicans and Candida tropicalis isolates from HIV-infected individuals. The impact of antimycotics on hemolytic activity was assessed by a previously described in vitro plate assay, after exposing ten isolates each of C. albicans and C. tropicalis recovered from HIV-infected individuals to sub-minimum inhibitory concentrations (sub-MIC) of nystatin, amphotericin B and fluconazole. All Candida isolates showed a significant reduction in hemolytic activity. The reduction was highest for amphotericin B-exposed C. albicans and C. tropicalis followed by nystatin and fluconazole. The effect of antimycotics was more pronounced on the hemolytic activity of C. tropicalis compared to that of C. albicans. Commonly used antifungal agents significantly suppress hemolysin activity of Candida species. This implies that the antifungals, in addition to their lethality, may modulate key virulence attributes

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Aim: The purpose of this study was to determine the anesthetic efficacy of inferior alveolar nerv... more Aim: The purpose of this study was to determine the anesthetic efficacy of inferior alveolar nerve block (IANB) using 4% articaine and 2% lidocaine supplemented with buccal infiltration. Materials and methods: Forty five patients, diagnosed with irreversible pulpitis of a mandibular posterior tooth were included in the study. The first group of 15 patients received 2% lidocaine with 1:200000 epinephrine, the second group 2% lidocaine with 1: 80,000 epinephrine and the third group of 15 subjects received 4% articaine with 1:100000 epinephrine. During the access cavity preparation those patients who complained of pain received an additional buccal infiltration. The percentage of subjects who got profound anesthesia and failure to achieve anesthesia were calculated and tabulated using a visual analog scale. Results: The results revealed that 87% of subjects who received 4% Articaine with 1:100,000 epinephrine got satisfactory anesthesia with inferior alveolar nerve block alone. Only 2 (13%) subjects received an additional buccal infiltration and none of the patients failed to obtain complete anesthesia with articaine. In comparison only 40% of subjects got complete anesthesia with 2% lidocaine with 1:200000 and 60% with 2% lidocaine with 1:80,000. Conclusion: It can be concluded that 4% articaine can be used effectively for obtaining profound anesthesia for endodontic procedures in patients with irreversible pulpitis.

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Abstract BACKGROUND AND OBJECTIVE: Gingival overgrowth is a prominent side effect of cyclosporine... more Abstract
BACKGROUND AND OBJECTIVE:
Gingival overgrowth is a prominent side effect of cyclosporine (CsA) therapy in renal transplant patients. Although the exact mechanism by which this drug induces gingival overgrowth is uncertain, marked variations in individual susceptibility to this drug suggest a genetic predisposition. Studies have shown that genetic variation (polymorphism) in the trinucleotide cytosine-adenine- guanine (CAG) sequence in exon 1 of the androgen receptor (AR) gene is related to altered activity of the AR as a transcription factor. However, the relationship between the length of the CAG repeat and gingival overgrowth has not yet been studied. The present study was carried out to determine whether there is an association between CsA-induced gingival overgrowth and the length of the CAG repeats in the AR gene.
MATERIAL AND METHODS:
Genomic DNA samples were prepared from the blood of 50 renal transplant patients with CsA-induced gingival overgrowth and from the blood of 100 renal transplant patients on CsA with no gingival overgrowth.
RESULTS:
The difference in allele distribution among the subjects with gingival overgrowth and control samples was statistically significant (p = 0.001).
CONCLUSION:
The findings suggest a link between CsA7induced gingival overgrowth and a smaller size of CAG repeat in the AR gene.
© 2013 The Authors. Journal of Periodontal Research published by John Wiley & Sons Ltd.
KEYWORDS:
adverse effects; cyclosporine; genetic role; gingival overgrowth; polymorphism
PMID: 24206119 [PubMed - indexed for MEDLINE]

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