Oruba, Z; Pac, A; Olszewska-Czyż, I; Chomyszyn-Gajewska, M
Motivation plays an important role in the treatment process of chronic diseases, as treatment requires behavioural change and lifelong adherence to medical recommendations. Periodontitis is a good example of such health condition as to maintain good periodontal health patients have to adhere to a strict oral hygiene regimen. To examine whether the motivation of patients suffering from chronic periodontitis influences their clinical periodontal condition. Cross sectional study. Department of Periodontology and Oral Medicine, Dental University Clinic, Jagiellonian University, Krakow, Poland. 199 adult periodontal patients, aged 20-78 years. Questionnaire concerning patients' medical and dental history, modified Zychlińscy motivation assessment questionnaire, clinical periodontal examination. The extent of motivation. Periodontal status evaluated with the use of periodontal indices (API, BOP, CPITN). The mean motivation score was 57.4. The mean API and BOP values were 55.7% and 46.4%, respectively. For most of the patients the recorded CPITN value was 3. Correlations were observed between motivation and both API and BOP, and between API and BOP. Periodontal patients with greater motivation having better oral health (lower API and BOP) suggests an influence on the quality of their self-management of the disease (i.e. adherence to their oral hygiene regimen).
Conclusion: Within the limits of this study, it can be concluded that altered hormonal levels in infertile women undergoing assisted reproductive therapy and infertile women not undergoing this treatment can lead to increased attachment loss, suggesting that these women may require constant periodontal monitoring.
Full Text Available The problem of selection and application of dental prostheses in periodontal disease is especially relevant in case of severe generalized periodontitis, which is accompanied by mobile tooth removal resulting in overloading the periodontium of the remaining teeth as well as the increase in tooth mobility. Therefore, in generalized periodontitis, it is important to apply the method of direct dental prosthetic rehabilitation since, in case of partial tooth loss, it will prevent the development of generalized periodontitis complications. The objective of the research was to improve the effectiveness of combination therapy for patients with generalized periodontitis and partial tooth loss applying the developed method of direct fixed dental prosthetic rehabilitation based on the study of the periodontal status. Materials and methods. The study included 129 patients with general periodontitis, II-III degree and partial tooth loss over the age of 45 years. According to prosthodontic treatment, all the patients were divided into three groups: Group I consisted of 42 (20 women and 22 men patients who immediately after tooth extraction were rehabilitated with the application of direct plastic laminar immediate prosthesis and selective tooth grinding; permanent dental prosthetic rehabilitation was performed 6 weeks after tooth extraction; Group II included 43 (21 women and 22 men patients who underwent traditional permanent dental prosthetic rehabilitation using fixed dental bridges 6 weeks after mobile tooth removal and wound healing; Group III comprised 44 (21 women and 23 men patients who immediately after mobile tooth removal were rehabilitated with the application of direct fixed sectional dental bridge (Ukrainian patent UA 20995. 2007 Feb 15 and selective tooth grinding; permanent dental prosthetic rehabilitation was performed 6 months after tooth extraction. The control group consisted of 26 people with intact dentitions over the age of 45 years
Timur V. Melkumyan
Full Text Available The objective of this study was to compare the periodontal status in postmenopausal women with osteopenia and osteoporosis. Material and Methods: We examined 43 postmenopausal women aged from 55 to 74 years. Material assessment of bones in every patient was performed by means of dual energy X-ray absorptiometry (DXA from two points on the skeleton – part of the femur neck and between the first and fourth lumbar vertebrae. A lipid blood test was done for patients of both groups. All patients were divided into two groups (the 1st with osteopenia, and the 2nd with osteoporosis. All patients were subjected to an oral clinical examination: the periodontal examination was composed of Plaque Index (PI, Pocket Score (PS, and Papillary Bleeding Index (PBI. X-ray analysis was performed for every patient. Results: The results of the clinical periodontal examination demonstrated that the mean PBI in patients in the 1st group had no significant differences from the PBI in patients in the 2nd group. PI value and PS findings in patients with general osteoporosis also had no statistical differences from the same parameters in patients with osteopenia. Conclusion: Under the circumstances of these patients’ characteristics and within the limits of the present study, we concluded that there is no significant difference in the periodontal status of postmenopausal women with systemic osteopenia and with osteoporosis.
Javier Elpidio Monzón
Full Text Available Background and Objectives: Prostaglandin E2 (PGE2 is present in gingival crevicular fluid the (GCF and is evidenced in periodontal disease (PD. However, there are no enough reports to correlate the PGE2 concentrations in GCF in periodontal health and disease with clinical and radiographic indicators, age and gender. Hence, the present study is aimed to estimate the levels of PGE2 in GCF of subjects without periodontal disease (SEP and periodontal disease (CEP. Materials and Methods: 99 subjects were selected, 33 without PD (G1 and 66 with PD, 33 with gingivitis (G2 and 33 with periodontitis (G3, which were submitted to a clinical and radiographic diagnosis, registering samples FGC, being stored, centrifuged and refrigerated for preservation. Subsequently the concentration of crevicular PGE2 was measured by using the enzyme linked immunosorbent assay (ELISA, determining the concentration of each subject. Results: PGE2 was detected in all the samples. The G1 presented a concentration of 28.82 ± 2.88 pg / mL, G2 44.91 ± 4.37 pg / mL and G3 148.67 ± 74.74 pg / mL (0.0001. PGE2 levels were significantly correlated with bleeding on probing, probing depth, attachment loss and bone loss (0.05. PGE2 levels were modified by age, but not gender. Conclusion: It is well known that activated inflammatory cells produce inflammatory mediators that stimulate the production of PGE2. The findings of this study demonstrate an increased concentration of PGE2 in FCG according to the presence of greater severity of PD. PGE2 may be considered as a biomarker in PD progression. However, controlled, longitudinal studies are needed to confirm this possibility.
Full Text Available Different studies have documented an association between periodontal disease and low birth-weight delivery. Hence, knowledge of periodontal status during pregnancy and postpartum is important in order to reduce the risks of both diseases. This study aimed to analyze periodontal status at successive stages of pregnancy and 3-6 weeks postpartum in women with initial periodontal alterations.Ninety-six pregnant women were examined at 8-10 weeks (pregnancy diagnosis, baseline, 21-23 weeks and 34-36 weeks of gestation and at 40 days postpartum to record plaque scores, clinically assessed gingival inflammation and probing depth (mean depth and % sites with depth >3 mm. Bivariate and multivariate analyses were performed. Type 1 (α error was established at 0.05.Plaque Index increased (p = 0.043 throughout pregnancy (baseline, 42%±0.18; 21-23 weeks, 42.6%±0.14; 34-36 weeks, 45.6%±0.13 and decreased postpartum (44.8%±0-13. Gingival Index increased (p3 mm increased (p<0.001 throughout pregnancy (baseline, 17.6%±0.16; 21-23 weeks, 23.9%±0.17; 34-36 weeks, 31.1%±0.17 and decreased postpartum (21.2%±0.17 but remained significantly (p<0.02 higher than at baseline.Periodontal status deteriorates during gestation but improves postpartum.
Fernanda Campos MACHADO
Full Text Available Abstract This study was aimed to provide a longitudinal overview of the subgingival bacterial microbiome using fluorescence in situ hybridization (FISH technique, in women in the second trimester of pregnancy (between 14 and 24 weeks, and 48 h and 8 weeks postpartum. Of 31 women evaluated during pregnancy, 24 returned for the 48-h and 18 for their 8-week exams postpartum. Probing depth (PD, bleeding on probing, clinical attachment level, and presence of calculus were recorded. Subgingival plaque samples were collected, and FISH was used to identify the numbers of eight periodontal pathogens. Friedman test was used to compare differences between follow-up examinations, followed by a multiple comparison test for a post hoc pairwise comparison. Clinically, a significantly greater number of teeth with PD = 4–5 mm were found during pregnancy than on postpartum examinations. Microbial analysis showed a statistically significant decrease in cell count over the study period for Prevotella nigrescens. P. intermedia, Campylobacter rectus, and Porphyromonas gingivalis also decrease, although not significantly, and Aggregatibacter actinomycetemcomitans increased. No significant changes were found for Fusobacterium nucleatum, Treponema denticola, or Tannerella forsythia. Our data demonstrate a change in the subgingival microbiota during pregnancy, at least for P. nigrescens.
Objectives: It is hypothesized that soccer players with periodontal disease exhibit raised serum creatine kinase (CK) levels as compared to those without periodontal disease. We assessed the clinical gingival status and serum CK levels among young soccer players. Materials and Methods: Demographic data were ...
González-Jaranay, Maximino; Téllez, Luís; Roa-López, Antonio; Gómez-Moreno, Gerardo; Moreu, Gerardo
Different studies have documented an association between periodontal disease and low birth-weight delivery. Hence, knowledge of periodontal status during pregnancy and postpartum is important in order to reduce the risks of both diseases. This study aimed to analyze periodontal status at successive stages of pregnancy and 3-6 weeks postpartum in women with initial periodontal alterations. Ninety-six pregnant women were examined at 8-10 weeks (pregnancy diagnosis, baseline), 21-23 weeks and 34-36 weeks of gestation and at 40 days postpartum to record plaque scores, clinically assessed gingival inflammation and probing depth (mean depth and % sites with depth >3 mm). Bivariate and multivariate analyses were performed. Type 1 (α) error was established at 0.05. Plaque Index increased (p = 0.043) throughout pregnancy (baseline, 42%±0.18); 21-23 weeks, 42.6%±0.14; 34-36 weeks, 45.6%±0.13 and decreased postpartum (44.8%±0-13). Gingival Index increased (ppregnancy (baseline, 56.7%±0.20; 21-23 weeks, 66.36%±0.17; 34-36 weeks, 74.5%±0.18) and decreased postpartum (59.3%±0.21). Probing Depth increased (ppregnancy (baseline, 2.51±0.05; 21-23 weeks, 2.63±0.053; 34-36 weeks 2.81±0.055) and decreased postpartum (2.54±0.049). Percentage of sites with Probing Depth >3 mm increased (ppregnancy (baseline, 17.6%±0.16; 21-23 weeks, 23.9%±0.17; 34-36 weeks, 31.1%±0.17) and decreased postpartum (21.2%±0.17) but remained significantly (pPeriodontal status deteriorates during gestation but improves postpartum.
Xie, Yiqiong; Xiong, Xu; Elkind-Hirsch, Karen E; Pridjian, Gabriella; Maney, Pooja; Delarosa, Robert L; Buekens, Pierre
This study explored whether there is any change of periodontal disease status during and after pregnancy. We also examined whether the change is different between females with a history of gestational diabetes mellitus (GDM) and females without GDM during pregnancy. A follow-up study was conducted at Woman's Hospital, Baton Rouge, Louisiana. Thirty-nine females who were previously enrolled in a case-control study during pregnancy were followed an average of 22 months postpartum. Periodontal status was assessed through dental examinations performed both during and after pregnancy. Clinical periodontal parameters included bleeding on probing (BOP), mean probing depth (PD), and mean clinical attachment level (CAL). Periodontitis was defined as the presence of ≥1 sites exhibiting PD ≥4 mm or CAL ≥4 mm. We used generalized estimating equation analysis to examine the change of periodontal status. Mean number and percentage of sites with BOP decreased from 10.7 ± 11.6 (mean ± SD) and 6.5% ± 7.0% during pregnancy to 7.1 ± 8.8 and 4.3% ± 5.3% at 22 months postpartum (P periodontitis decreased from 66.7% to 33.3% (P periodontal status between females with GDM and females without GDM during pregnancy. Pregnancy may be associated with an increased risk of periodontal disease. The association is not different between females with GDM and females without GDM during pregnancy.
Kirchner, A; Jäger, J; Krohn-Grimberghe, B; Patschan, S; Kottmann, T; Schmalz, G; Mausberg, R F; Haak, R; Ziebolz, D
The aim of this clinical cross-sectional study was to determine the level of active matrix metalloproteinase-8 (aMMP-8) and periodontal pathogenic bacteria in gingival crevicular fluid in patients with rheumatoid arthritis (RA) with varying periodontal conditions. In total, 103 patients with RA and 104 healthy controls (HC) were included. The assessment of periodontal status included periodontal probing depth, bleeding on probing and clinical attachment loss. Periodontal disease was classified as healthy/mild, moderate or severe. For the determination of aMMP-8 levels using enzyme-linked immunosorbent assay and periodontal pathogenic bacteria using polymerase chain reaction, samples of gingival crevicular fluid were taken from the deepest gingival pockets. The statistical analyses used included a Mann-Whitney U-test, a chi-squared test or a Fisher's exact test, and the significance level was set at α = 5%. We found that 65% of patients with RA and 79% of HC had moderate to severe periodontal disease (p = 0.02). The prevalence of periodontal pathogens was almost equal (p > 0.05). Furthermore, depending on periodontal disease severity only minor differences in bacterial prevalence were detected. With increasing severity of periodontal disease, higher aMMP-8 levels were observed. Accordingly, a significant difference in patients with moderate periodontal disease (RA: 15.3 ± 13.8; HC: 9.1 ± 9.1; p ≤ 0.01) and severe periodontal disease (RA: 21.7 ± 13.3; HC: 13.1 ± 8.6; p = 0.07) was detected, with a greater tendency in the latter group. The increased aMMP-8 levels in the RA group indicate that the presence of RA appears to have an influence on the host response at a comparable level of bacterial load and periodontal disease severity. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Heins, Paul J.; Mackenzie, Richard S.
An adaptation of the inquiry method of teaching, which develops skills of information retrieval and reasoning through systematic questioning by the teacher, is proposed for instruction in clinical periodontics. (MSE)
Boggess, Kim A; Espinola, Janice A; Moss, Kevin; Beck, Jim; Offenbacher, Steven; Camargo, Carlos A
Maternal periodontal disease is found in pregnancy outcomes. Vitamin D deficiency may play a role in periodontal disease and tooth loss, and insufficient vitamin D status is common among pregnant women. The objective of this study is to examine the relationship between maternal vitamin D status and periodontal disease. A case-control study was conducted. Cases were defined as pregnant women with clinical moderate to severe periodontal disease; controls were pregnant women who were periodontally healthy. Maternal data were chart abstracted and serum was collected between 14 and 26 weeks of gestation. Serum 25-hydroxyvitamin D (25[OH]D) levels were measured using liquid chromatography-tandem mass spectrometry. Median serum 25(OH)D levels and prevalence of vitamin D insufficiency (defined as periodontal disease among women with vitamin D insufficiency was calculated using multivariable logistic regression, adjusting for maternal race, season of blood draw, and other potential confounders. A total of 117 cases were compared to 118 controls. Cases had lower median 25(OH)D levels than controls (59 versus 100 nmol/l; P periodontal disease among women with vitamin D insufficiency was 2.1 (0.99 to 4.5). Vitamin D insufficiency (serum 25[OH]D periodontal disease during pregnancy. Vitamin D supplementation represents a potential therapeutic strategy to improve maternal oral health.
Modupeoluwa Omotunde Soroye
Conclusion: Majority of the CKD patients reviewed had poor periodontal status with code 2 TN. We, therefore, recommend nonsurgical periodontal treatment for all CKD patients to improve their oral health and forestall the systemic effects of periodontal pathology.
Periodontal status and treatment needs of primary school teachers in the absence of ... on probing, periodontal pocketing and treatment needs with CPITN and tooth ... Is In the form of oral prophylaxis and non-surgical periodontal treatment.
Full Text Available Periodontal disease consists of chronic gingival inflammation characterized by both degradation of the periodontal connective tissue and alveolar bone loss. Drug therapy is used as an auxiliary treatment method in severe chronic periodontitis, aggressive periodontitis, and periodontitis-associated systemic disease. Nal-P-113, a modified antimicrobial peptide, specifically replaces the histidine residues of P-113 with the bulky amino acid β-naphthylalanine, and our previous studies have verified that this novel peptide is not toxic to the human body within a certain concentration range. The objective of the present study was to evaluate the effect of Nal-P-113 on periodontal pathogens and periodontal status in clinical studies. In a split-mouth clinical trial, the pocket depth and bleeding index values tended to decrease in the experimental group compared with those in the control group. SEM results verified that Nal-P-113 restrained the maturation of plaque. Based on real-time polymerase chain reaction, the levels of Fusobacterium nucleatum, Streptococcus gordonii, Treponema denticola, and Porphyromonas gingivalis in subgingival plaque were decreased when the subjects were given Nal-P-113. Bacterial growth curve analysis and a biofilm susceptibility assay verified that Nal-P-113 at a concentration of 20 μg/mL restrained the growth of S. gordonii, F. nucleatum, and P. gingivalis and biofilm formation. Therefore, Nal-P-113 effectively reduces periodontal pathogens and ameliorates periodontal status.
T I Vicharenko
Full Text Available Vascular disorders play a significant role in the development of dystrophic inflammatory process. There is a direct correlation between the degree of damage to blood vessels in the jaw and a depth of the destructive process in periodontal tissue. A certain role is played by endogenous factors, such as: age, vitamin deficiency, diabetes mellitus, essential hypertension and others. Clinical and epidemiological studies using pathological techniques showed significant changes in vascular wall of the artery in the periodontium, the interdental artery in particular. Atherosclerosis, essential hypertension and periodontal pathology were proven to occur in individuals older than 40 years. The objective of the research was to determine periodontal tissue status in patients with stage II hypertension and generalized periodontitis of II degree of severity. Materials and methods. The study involved 36 patients with stage II hypertension and generalized periodontitis of II degree of severity (the main group. The patients’ age ranged from 35 to 54 years. The control group included 10 patients of corresponding age without generalized periodontitis and somatic pathology. To assess the status of periodontal tissues, we applied the Papillary-Marginal-Attached Index and the Community Periodontal Index of Treatment Needs. When diagnosing periodontal disease, the classification of M.F. Danilevskyi was used. Results. The analysis of the indicators of the Community Periodontal Index of Treatment Needs index showed the following results: in patients of the main group, the index was 2.38±0.07 points (p<0.001 pointing out a need for a course of professional oral hygiene. In patients of the control group, the index was 0.5±0.17 points indicating that there was no need for treatment, however, there was a need for improving oral hygiene. The indicators of the Papillary-Marginal-Attached Index in the main group were 55.49±1.96 points pointing out a severe degree of
Full Text Available The objective of this study was to evaluate and compare the periodontal status of orthodontic patients and non-orthodontic patients, aged 15–28 years, of both genders. The cross-sectional study included 100 orthodontic and 100 non-orthodontic patients evaluated using a Community Periodontal Index for Treatment Need (CPITN probe on the index teeth. A questionnaire was distributed to the participants to assess and evaluate the use of oral hygiene aids. The data were analyzed using SPSS version 17, and various comparisons were performed using the chi-square test. The study revealed that there was a statistically significant association in CPITN scores between the orthodontic and non-orthodontic patients (p < 0.01. The study showed that patients undergoing orthodontic treatment have increased plaque accumulation and probing depth resulting in periodontal tissue destruction. Proper oral hygiene practices and interdental aids should be employed to control plaque.
Flores, Manuela F; Montenegro, Marlon M; Furtado, Mariana V; Polanczyk, Carisi A; Rösing, Cassiano K; Haas, Alex N
There are scarce data on the impact of the periodontal condition in the control of biomarkers in patients with cardiovascular disease (CVD). The aim of this study is to assess whether periodontal inflammation and tissue breakdown are associated with C-reactive protein (CRP) and lipids in patients with stable heart disease. This cross-sectional study included 93 patients with stable coronary artery disease (57 males; mean age: 63.5 ± 9.8 years) who were in outpatient care for at least 6 months. After applying a structured questionnaire, periodontal examinations were performed by two calibrated periodontists in six sites per tooth at all teeth. Blood samples were collected from patients on the day of periodontal examination to determine levels of CRP, lipids, and glycated hemoglobin. Multiple linear regression models were fitted to evaluate the association among different periodontal and blood parameters controlling for sex, body mass index, glycated hemoglobin, use of oral hypoglycemic drugs, and smoking. Overall, the sample presented high levels of periodontal inflammation and tissue breakdown. Unadjusted mean concentrations of triglycerides (TGs), very-low-density lipoprotein cholesterol, and glucose were significantly higher in individuals with severe periodontitis. When multiple linear regression models were applied, number of teeth with clinical attachment loss ≥6 mm and presence of severe periodontitis were significantly associated with higher CRP concentrations. Bleeding on probing was significantly associated with TGs, total cholesterol, and non-high-density lipoprotein cholesterol. In this sample of patients with stable CVD, current periodontal inflammation and tissue breakdown are associated with cardiovascular inflammatory markers, such as CRP and lipid profile.
Uppal, Ranjit Singh; Bhandari, Rajat; Singh, Karanparkash
In recent years, evidence has come forth supporting the notion that localized infectious diseases such as periodontal disease may indeed influence a number of systemic diseases. Erectile dysfunction (ED) and chronic periodontitis have common risk factors such as diabetes mellitus, cardiac diseases and smoking etc. The aim was to evaluate the periodontal status of the subjects suffering from ED and to find association between vasculogenic ED and chronic periodontitis, if any. A total of 53 subjects suffering from vasculogenic ED were enrolled for the study and were divided into three groups on the basis of severity of ED. The clinical (probing pocket depth) and radiographic parameters (alveolar bone loss) were recorded and periodontal status of three groups was evaluated, compared and an attempt was made to find an association between ED and chronic periodontitis. Karl Pearson's correlation was used to assess an association between the two conditions. One-way ANOVA and Scheffe's test were used to find the significant difference of chronic periodontitis with severity of ED. Karl Pearson's correlation was used to find an association between chronic periodontitis and ED. Statistically significant mean differences of 1.73 mm, 0.56 mm and 1.17 mm were recorded when comparison was made among Group I and III, Group I and II and Group II and III, respectively. Mean differences in bone loss among three groups were also statistically significant. Both the diseases were positively correlated to each other. It may be concluded that chronic periodontitis and ED are associated with each other. However, further large scale studies with confounder analysis and longitudinal follow-up are warranted to explore the link between these two diseases.
Full Text Available Curettage is used in periodontics to scrap off the gingival wall of a periodontal pocket, and is needed to reduce loss of attachment (LOA by developing new connective tissue attachment in patients with periodontitis. The purpose of this study was to evaluate the success of curettage by the formation of tissue attachment. This clinical experiment was done by comparing LOA before curettage, 2 weeks and 3 weeks after curettage on 30 teeth with the indication of curettage. Study population were periodontitis patient who attending dental clinic at Hospital University Science Malaysia (HUSM with inclusion criteria good general health condition, 18 to 55 years old male or female and presented with pocket depth > 3mm. The teeth were thoroughly scaling before intervention and evaluated by measuring the periodontal attachment before curettage, two weeks and three weeks after curettage. Repeated measure ANOVA and Paired T Test were used to analyze the data. The result of the study showed that there was reduction in the periodontal attachment loss in periodontitis patient after curettage either in the anterior or posterior teeth which were supported by statistical analysis. This study concluded that curettage could make reattachment of the tissue
Schlosser, Robert; Hebbes, Trudy
Medically compromised patients attending the dental clinic at the Toronto Rehabilitation Institute have considerable gingival inflammation and breath odor. The objective of this study was to evaluate the effect of toothbrushing on the periodontal status of these patients and to determine if there were any additional benefit in combining brushing with an application of an antibiotic rinse. During the first 7 days of the study, the teeth of 11 participants were brushed twice a day by a dental hygienist using a soft-bristle suction toothbrush without toothpaste. Soft interproximal brushes were used to clean interproximal surfaces from the facial aspect. During the second week, facial and interproximal cleaning were repeated in the same patients, but the toothbrush and interproximal brush were dipped in 10-mL of a solution consisting of water and 40 mg/mL of metronidazole with nystatin. Each patient underwent an oral examination and biofilm sampling at baseline, after brushing without toothpaste (week 1), and after brushing with antibiotic solution (week 2). After week 1, tissues improved substantially, and there was a notable change in the biofilm on the teeth. The addition of an antibiotic solution increased healing and resulted in a further decrease in oral biofilm. Medically compromised patients would benefit considerably from a treatment regimen of antibiotic solution to decrease oral infection followed by a daily oral care program of brushing and interdental cleaning to maintain healthy oral tissues.
Zasčiurinskienė, Eglė; Basevičienė, Nomeda; Lindsten, Rune; Slotte, Christer; Jansson, Henrik; Bjerklin, Krister
To compare two treatment strategies regarding the effect of orthodontic treatment on periodontal status in patients with plaque-induced periodontitis. This was a randomized clinical trial. Fifty periodontal patients were randomly assigned to the test or control groups according to periodontal treatment timing. All patients received supra- and subgingival debridement following baseline examination. Control group patients received cause-related periodontal treatment before the start of orthodontic treatment and which was performed simultaneous to orthodontic treatment for the test group patients. No difference between the test and control groups was found regarding change of clinical attachment level (CAL) after periodontal-orthodontic treatment. Fewer sites with initial pocket depth (PD) of 4-6 mm healed after periodontal-orthodontic treatment in the test group (20.5%, IQR = 11.9%) in comparison with controls (30.4%, IQR = 27.1%) (p = .03). Anterior teeth [OR 2.5] and teeth in male patients [OR 1.6] had a greater chance for PD improvement ≥2 mm. Total periodontal-orthodontic treatment duration was significantly longer for the control group (p Orthodontic treatment, simultaneously to the periodontal treatment, could be used in the routine treatment of patients with plaque-induced periodontitis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Capasso, Francesca; Vozza, Iole; Capuccio, Veronica; Vestri, Anna Rita; Polimeni, Antonella; Ottolenghi, Livia
To assess correlations between periodontal status, maternal age and adverse pregnancy outcomes, such as pre-term and low birth weight in a sample of pregnant women. Study population was represented by outpatient pregnant women, gestational age > 26 weeks. Medical history questionnaires were administered to all participants who underwent clinical evaluation; clinical obstetric outcome records were collected after delivery. A questionnaire was administered regarding personal information, socio-economic status, oral hygiene habits, and oral health conditions. A clinical oral examination was performed to collect Simplified Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI). Pregnancy outcome records included: delivery week, kind and causes of delivery, any relevant complications, and birth weight. Descriptive statistics were used to depict the data from the questionnaire while the relationship between delivery week, birth weight, maternal age and periodontal status was evaluated through multivariate tests of significance. 88 pregnant women were enrolled in the study. The results showed a statistically significant correlation (Pperiodontal disease and adverse pregnancy outcomes. No statistical correlation was found among pre-term and low birth weight, smoking, ethnicity and educational level of mothers. The results highlight the importance of including a routine oral and periodontal health examination in pregnant women older than 40 years of age. The correlation between periodontal status and adverse pregnancy outcomes in older mothers indicates the need for routine oral health examination and periodontal status assessment and care in pregnant women older than 40 years of age.
Staufenbiel, I; Weinspach, K; Förster, G; Geurtsen, W; Günay, H
Investigations about possible correlations between vegetarian diet and periodontal conditions are rare and characterized by small case numbers. The aim of this clinical study was to investigate the influence of a vegetarian diet on periodontal parameters with an appropriate sample size. A total of 200 patients, 100 vegetarians and 100 non-vegetarians, were included in the study. All patients were examined including a full mouth assessment of the periodontal and dental conditions. In addition, a questionnaire was handed out to ask for patients' oral hygiene habits and level of education. For statistical analysis the Mann-Whitney Test (χ(2) for analysis of the questionnaire) was applied (level of significance: Pvegetarians versus 41.72 years non-vegetarians). Vegetarians had significantly lower probing pocket depths (P=0.039), bleeding on probing (P=0.001), periodontal screening index (P=0.012), a better hygiene index (Pvegetarians. Furthermore, vegetarians had a higher level of education (PVegetarians revealed better periodontal conditions (less inflammation signs, less periodontal damage and a better dental home care). However, it should be considered that vegetarians are not only avoiding meat in their nutrition but are also characterized by an overall healthier life style.
Dec 2, 2015 ... Key words: Periodontal disease, serum creatine kinase, soccer players ... has also been reported that poor oral health status influences the quality of life of an individual ..... A short‑term longitudinal randomized case‑control study. Clin Oral ... crevicular fluid from chronic periodontitis patients before and after.
Gupta, Radhika; Kumar, Uttam; Mallapragada, Siddharth; Agarwal, Pallavi
Periodontitis, a chronic infectious disease, affects most of the population at one time or the other and its expression is a combination of hosts, microbial agents, and environmental factors. Extensive literature exists for the relationship between periodontal disease and diabetes mellitus, cardiovascular diseases, and adverse pregnancy outcomes. Only a few studies performed in a limited number of patients have reported peri-odontal health status in chronic renal failure patients. Hence, the aim of the present study is to assess and compare the periodontal status of patients with chronic renal failure undergoing dialysis, predialysis with systemically healthy individuals. A total of 90 patients were divided into three groups. Group I: 30 renal dialysis patients. Group II: 30 predialysis patients. Control group comprised 30 systemically healthy patients who formed group III. Periodontal examination was carried out using oral hygiene index-simplified (OHI-S), plaque index (PI), gingival index (GI), probing depth, and clinical attachment loss. The results of the study showed that the periodontal status of patients with chronic renal failure undergoing dialysis (dialysis group) and patients with chronic renal failure not undergoing renal dialysis (predialysis) when compared with systemically healthy subjects showed significantly higher mean scores of OHI-S, PI, and clinical attachment loss. Thus, patients with chronic renal failure showed poor oral hygiene and higher prevalence of periodontal disease. The dental community's awareness of implications of poor health within chronic renal failure patients should be elevated.
Maria Sueli Marques Soares
Full Text Available Objective: The aim of the study was to evaluate the correlation between CD4+ cell count and viral load with periodontal and dental status in HIV seropositive patient. Methods: Forty HIV seropositive patients were selected from the dental clinic of the Clementino Fraga Hospital in João Pessoa, Paraíba, Brazil. The Community Periodontal Index, Simplified Oral Hygiene Index and Decayed, Missing or Filled Teeth Index were determined. The values of CD4+ lymphocyte count and viral load were collected from the medical records. Descriptive analysis was made and Spearman’s correlation test was applied, with values of p<0.05 being significant. Results: HIV seropositive patients were aged 33 to 47 years (mean = 40 years, 26 were men and 14 women. The mean CD4+ lymphocyte count was 507.82±306.4 cells/mm3, with 41% being a high, 38.5% a medium and 20.5% a low level. Sixty-five percent of the patients had undetectable viral load, 12.5% had a high, 5% a low and 5% a medium viral load. Most patients (87.5% presented with periodontal disease, calculus was the most frequent condition (40%. The mean Decayed, Missing or Filled Tooth Index was 19.7±6.8, with prevalence of the missing component. There was significant statistical correlation between the CD4+ count and the periodontal condition, p=0.046. There was no significant correlation between the CD4+ count and the Decayed, Missing or Filled Teeth Index (p=0.469 and the Simplified Oral Hygiene Index (p=0.189 indexes, and between viral load and Decayed, Missing or Filled Teeth Index (p=0.452, the Simplified Oral Hygiene Index (p=0.158 and Community Periodontal Index (p=0.216. Conclusion: The periodontal condition was influenced to a greater by the CD4+ cell count than the viral load, while there was no correlation between the decayed condition and the CD4+ cell count or the viral load condition.
-smokers presenting with calculus deposits (Code 2). However, more smokers had poorer periodontal status by scoring CPITN maximum codes 3 and 4. The mean calculus scores of Oral Hygiene Index (Green and Vermillon) in the smokers ...
Amanda Lamer Schjetlein
Full Text Available Background: Diabetes is becoming more common in the Greenlandic population. Patients with diabetes are more prone to periodontal disease. Periodontal status may have an effect on metabolic control. Objective: The aim of this study was to estimate the prevalence of periodontitis amongst patients with diabetes in Nuuk, Greenland, and secondly, to observe if dental care was associated with improved periodontal status and metabolic control. Study design: Observational cross-sectional study and a pilot study of a dental care intervention. Methods: Sixty-two Greenlandic patients with diabetes were included in the study. Data were collected from the Electronic Medical Records (EMR, in addition to a telephone interview. Patients were offered 3 dental examinations with a 3-month interval. The dental examinations consisted of a full-mouth assessment of number of remaining teeth and assessment of periodontal status. Patients received scaling and root planing, together with information and instructions on oral hygiene. Information on glycated haemoglobin (HbA1C values was collected from the EMR at each dental examination. Results: In this study, 21.0% (13/62 of patients with diabetes had periodontitis. About 42% had less than 20 teeth. The association between diabetes and periodontitis was known by 20 out of the 62 patients. Over half of the patients had been to a dental examination within the last year. The prevalence of periodontitis decreased significantly from 21.0 to 0% (p<0.001 after 3 dental examinations. No change in HbA1C levels was observed (p=0.440. Conclusion: Periodontitis was common among patients with diabetes in Nuuk. Dental health status based on Periodontal Screening Index (PSI and bleeding on probing (BOP seemed to improve after dental health care, indicating a need for increased awareness among patients and health care professionals. HbA1C levels were not improved among the patients.
Ranjit Singh Uppal; Rajat Bhandari; Karanparkash Singh
Background: In recent years, evidence has come forth supporting the notion that localized infectious diseases such as periodontal disease may indeed influence a number of systemic diseases. Erectile dysfunction (ED) and chronic periodontitis have common risk factors such as diabetes mellitus, cardiac diseases and smoking etc. Aim: The aim was to evaluate the periodontal status of the subjects suffering from ED and to find association between vasculogenic ED and chronic periodontitis, if a...
Full Text Available The detection of salivary biomarkers has a potential application in early diagnosis and monitoring of periodontal inflammation. However, searching sensitive salivary biomarkers for periodontitis is still ongoing. Oxidative stress is supposed to play an important role in periodontitis progression and tissue destruction. In this cross-sectional study, we investigated total antioxidant capacity (TAC and total oxidant status (TOS in saliva of periodontitis patients compared to healthy controls and their relationship with periodontopathic bacteria and periodontal disease severity. Unstimulated saliva was collected from 45 patients with generalized severe periodontitis and 37 healthy individuals and the TAC/TOS were measured. In addition, salivary levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum in saliva were measured. Salivary TAC was lower in periodontitis patients compared to healthy controls. Moreover, a significant negative correlation of salivary TAC with clinical attachment loss was observed in periodontitis patients. No significant difference in the salivary TOS was observed between periodontitis patients and healthy controls. Bacterial load was enhanced in periodontitis patients and exhibited correlation with periodontal disease severity but not with salivary TAC/TOS. Our data suggest that changes in antioxidant capacity in periodontitis patients are not associated with increased bacterial load and are probably due to a dysregulated immune response.
Zhang, Taowen; Andrukhov, Oleh; Haririan, Hady; Müller-Kern, Michael; Liu, Shutai; Liu, Zhonghao; Rausch-Fan, Xiaohui
The detection of salivary biomarkers has a potential application in early diagnosis and monitoring of periodontal inflammation. However, searching sensitive salivary biomarkers for periodontitis is still ongoing. Oxidative stress is supposed to play an important role in periodontitis progression and tissue destruction. In this cross-sectional study, we investigated total antioxidant capacity (TAC) and total oxidant status (TOS) in saliva of periodontitis patients compared to healthy controls and their relationship with periodontopathic bacteria and periodontal disease severity. Unstimulated saliva was collected from 45 patients with generalized severe periodontitis and 37 healthy individuals and the TAC/TOS were measured. In addition, salivary levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum in saliva were measured. Salivary TAC was lower in periodontitis patients compared to healthy controls. Moreover, a significant negative correlation of salivary TAC with clinical attachment loss was observed in periodontitis patients. No significant difference in the salivary TOS was observed between periodontitis patients and healthy controls. Bacterial load was enhanced in periodontitis patients and exhibited correlation with periodontal disease severity but not with salivary TAC/TOS. Our data suggest that changes in antioxidant capacity in periodontitis patients are not associated with increased bacterial load and are probably due to a dysregulated immune response. PMID:26779448
Background: There are diverse reports on the prevalence and severity of chronic periodontitis in human immunodeficiency virus (HIV) positive persons. Few studies have been carried out in developing countries in Sub.Saharan Africa. This study was aimed at comparing the prevalence and severity of chronic periodontitis of ...
Full Text Available Background: Type 2 diabetes mellitus (type 2 DM and chronic periodontitis are common chronic diseases in adults in the world population. Once periodontal disease is established, the chronic nature of this infection may contribute to worsening of diabetic status leading to more severe diabetes-related complications. It has been proposed that the relation of periodontitis and diabetes is bidirectional. Objectives: The objective was to compare the clinical response and glycemic control in type 2 DM patients with periodontitis, before and after the nonsurgical periodontal treatment with controls. Materials and Methods: A total 70 type 2 DM patients with chronic generalized moderate periodontitis was divided into 2 groups. Treatment group (35 received one stage full mouth scaling and root planning plus oral hygiene instructions; the control group (35 received only oral hygiene instructions. At baseline, 1 st month and 3 rd month, the clinical periodontal parameters (plaque index [PI], gingival index [GI], pocket depth [PD], clinical attachment loss [CAL], gingival recession [GR], and bleeding on probing [BOP] and glycemic parameters (fasting blood sugar [FBS], and postprandial blood sugar [PPBS] were recorded, whereas the glycated hemoglobin (HbA1c was recorded only at baseline and 3rd month. The collected data were subjected to statistical analysis. Results: When comparing the mean scores of clinical parameters for both the groups, there was a significant difference in all clinical parameters, that is, mean PI, GI, BOP, PD, CAL scores except mean GR, whereas for the glycemic parameters, there was a significant difference in mean FBS; PPBS values and no significant difference in mean percentage of HbA1c for treatment group at 3 rd month follow-up. Conclusion: Findings of the present study showed that nonsurgical periodontal treatment resulted in lower glycemic levels and the reduction of clinical parameters of periodontal infection, confirming the
Periodontal diseases have several implications for the practice of endodontics. First, advanced periodontitis often has direct implications for the long-term prognosis of the case and requires careful evaluation and coordinated treatment of both the periodontic and endodontic diseases. Second, the potential for functional interactions between odontogenic pathoses and marginal periodontitis requires careful collection of clinical observations and monitoring the outcome of various treatments. In this section, we provide an analysis of recent clinical studies in this area.
Cao, Y L; Qiao, M; Xu, Z H; Zou, G M; Ma, L L; Li, W G; Xu, B H
To explore the clinical characteristics of IgA nephropathy (IgAN) with severe chronic periodontitis and aggressive periodontitis. A total of 436 hospitalized patients who underwent renal needle biopsy in the department of nephrology of China-Japan Friendship Hospital from November 2013 to December 2014 were recruited in the study and blindly had periodontal examination. The patients were divided into IgAN group and non-IgAN group according to the renal pathology. The patients with IgAN were further categorized as non-periodontitis, chronic periodontitis and aggressive peridontitis group by Haas classification. The chronic periodontitis group was continually divided into mild, moderate and severe periodontitis group. The levels of interleukin (IL)-1β and IL-6 in gingival crevicular fluid were analyzed by enzyme-linked immunosorbent assays. The prevalence of periodontitis in the study was 88.3% (385/436). The prevalence of chronic periodontitis and aggressive periodontitis were higher in patients with IgAN than those with non-IgAN (Pchronic periodontitis was correlated with pathologic grading of IgAN (r=0.48, Pperiodontitis, those with severe chronic and aggressive periodontitis had more severe pathology, more frequent recurrent gross hematuria, higher levels of 24 h proteinuria, serum triglyceride and uric acid, higher periodontal probing depth and clinical attatchment level, as well as higer levels of IL-1β and IL-6, but had lower creatinine clearance rate (all Pchronic and aggressive periodontitis was higher in patients with IgAN. Chronic periodontitis is correlated with the onset and development of IgAN. Patients with IgAN have worse condition with the aggravation of periodontitis.
Gundala, Rupasree; Chava, Vijay K.
Background: The health model which forms the basis is knowledge, attitude, temporary, and permanent behaviors. Currently, more emphasis has been directed towards the combined influence of lifestyle, education, levels and socioeconomic factors, instead of regular risk factors in dealing with chronic illnesses. The present study is conducted to correlate the periodontal health of people with reference to lifestyle, education level, and socioeconomic status. Materials and Methods: A cross-sectional study was conducted in the Department of Periodontics, Narayana Dental College and Hospital, Nellore. A total of 1350 subjects were examined and 948 patients were randomly selected from out patient department. Information about their lifestyle, education level, and socioeconomic status were recorded using a questionnaire and correlated with the periodontal status. Results: The statistical analysis showed significant decrease in periodontitis when income and education levels increased. Also the prevalence of periodontitis associated with a healthy lifestyle is significantly lower when compared to an unhealthy lifestyle. Conclusions: There is a strong association of lifestyle, education level, and socioeconomic status with periodontal health. PMID:22114373
Conclusion: Subgingival irrigation with propolis extract as an adjuvant to periodontal treatment was more effective than scaling and root planing as assessed by clinical and microbiological parameters.
Natasia Melita Kohar
Full Text Available Background: Fixed orthodontic appliances may interfere with daily oral hygiene procedure, causing more abundant plaque accumulation, therefore increasing the risk of periodontal disease. Probiotic methods represent a breakthrough approach in maintaining oral health and preventing periodontal disease. Purpose: The aim of this study was to compare the effect between probiotic lozenges containing Lactobacillus reuteri and probiotic drinks containing Lactobacillus casei strain Shirota towards periodontal status of orthodontic patients. Method: Fixed orthodontic patients (n=30 from Faculty of Dentistry, Trisakti University Dental Hospital were included in this clinical trial. Periodontal status consisting of Plaque Index (PlI, Interdental Hygiene Index (HYG, and Papillary Bleeding Index (PBI were then recorded from each patient. All patients received the phase one of periodontal treatment, as well as plaque control instruction. The subjects (n=10/gp were randomly assigned to one of three groups; control group; probiotic lozenges group (Biogaia®; and probiotic drinks group (Yakult®. For 14 days, the probiotic groups were instructed to use the probiotic. Periodontal index improvement (PlI, HYG, and PBI was found in all groups after 14 days research periode. These indices were then analyzed using Kruskal-Wallis analysis test. Result: It was found that L. reuteri and L. casei strain Shirota may improve periodontal status in fixed orthodontic patients. The best results were obtained from probiotic lozenges group. However, the results were not statistically significant (p>0.05. Conclusion: It was concluded that probiotics consumption containing L. reuteri and L. casei strain Shirota may slightly improve periodontal status in fixed orthodontic patients.
Wu, Yan-min; Liu, Jia; Sun, Wei-lian; Chen, Li-li; Chai, Li-guo; Xiao, Xiang; Cao, Zheng
Objective: To investigate the periodontal status and associated risk factors among women of childbearing age to increase the awareness of oral health. Methods: The study was conducted on childbearing age women in Cixi, a city in Zhejiang Province in the southeast of China. A total of 754 women participated in periodontal examination while receiving prenatal care. Data of the women were collected from the Cixi Family Planning Commission and during an interview. Clinical periodontal indices, such as bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were measured during the examination. Statistical analysis on subject-based data was performed. Results: The prevalence of periodontal disease among childbearing age women in Cixi was high (84.7%). A significant association was found between the disease and educational level, pregnancy, taking oral contraceptives, stress, alcohol consumption, overweight, dental visit, and teeth brushing (Pperiodontal disease showed deep PD, obvious BOP, and clinical attachment loss. Among this population, pregnancy was closely associated with higher BOP percentage; teeth brushing no more than once per day or brushing for less than 1 min (Pperiodontal status of childbearing age women in Cixi needs to be improved urgently. Attention towards the periodontal health should be warranted, especially for those in special statuses and with poor awareness. PMID:23463766
Full Text Available Aims and Objectives: To find out the effect of nonsurgical periodontal therapy on serum zinc (Zn, magnesium (Mg, and copper (Cu concentration and glycemic status in type 2 diabetes with chronic periodontitis (CP. Materials and Methods: One hundred and twenty patients were included in this study, which was further divided into three groups. Group 1 consisted of forty patients with CP, Group 2 consisted of forty patients of CP with controlled diabetes, and Group 3 consisted of forty patients of CP with uncontrolled diabetes. Periodontal parameters such as plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment levels (CALs were evaluated. Blood samples were collected to assess the levels of fasting blood sugar, glycosylated hemoglobin, Zn, Mg, and Cu. All parameters were evaluated at baseline and 3 months after nonsurgical periodontal therapy. Results: The results showed statistically significant reduction in all the clinical parameters within the groups except for the CAL in group 1 patients (P = 0.05. The glycemic status also showed a statistically significant reduction after treatment (P < 0.001. The intragroup comparison was taken between the values of micronutrients, showed substantial increase in the levels of both Zn and Mg and decrease in the level of Cu after nonsurgical periodontal treatment (P < 0.001. Conclusion: Patients with diabetes and periodontitis had altered metabolism of Zn, Mg, and Cu contributing to the progression and complication of diabetes mellitus and periodontitis. Nonsurgical periodontal treatment improved the variation and concentration of plasma micronutrients and also the periodontal status and glycemic level.
Onigbinde, Oo; Sorunke, Me; Braimoh, Mo; Adeniyi, Ao
Gingival changes during pregnancy have been well-documented. The prevalence of gingivitis in pregnant women has reportedly ranged from 30% to 100%. Increase in both the rate of estrogen metabolism and synthesis of prostaglandins by the gingiva contributed to the gingival changes observed during pregnancy. In effect increased prevalence of dental caries, gingivitis, periodontitis and tooth mobility may be encountered in pregnancy. The purpose of the study was to determine the association of some variables and the periodontal status in a sample of pregnant women attending the Ante Natal Clinic (ANC) of Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos. Women at various stages of pregnancy, attending the ANC of LASUTH, constituted the target population. The questionnaire was administered on each patient followed by dental examinations. Periodontal status was assessed using the community periodontal index (CPI) of treatment needs. Oral hygiene status was evaluated according to Green and Vermilion simplified oral hygiene index (OHI-S). The association between the CPI scores; OHI-S scores and variables such as trimester and dental visits were statistically significant. This study indicated that the gestational age of pregnancy and dental visits have a definite impact on the periodontal status. Oral health education should be included as an integral part of antenatal care to increase the women awareness. This would improve the mothers' dental care-seeking behavior.
Full Text Available In view of recent understanding of the association of periodontal infections and adverse pregnancy outcomes, the present investigation was undertaken to study the periodontal infections among 390 asymptomatic pregnant women and to find an association of bacterial etiologies with the disease. Prevalence of gingivitis was 38% and clinical periodontitis was 10% among the study population. Subgingival plaque specimens were subjected to multiplex PCR targeting ten putative periodontopathogenic bacteria. Among the periodontitis group, high detection rates of Porphyromonas gingivalis (56%, Prevotella nigrescens (44%, Treponema denticola (32%, and Prevotella intermedius (24% were noted along with significant association with the disease (P<0.05.
Full Text Available This case report presents two female patients whose chief complaint was discoloration of teeth. On careful clinical examination it was found that the patients had features of amelogenesis imperfecta and localised aggressive periodontitis. This article will give an insight of clinical and radiographic features of amelogenesis imperfecta with localised aggressive periodontitis, which is a rare clinical entity.
Correia, André Ricardo Maia; da Silva Lobo, Fábio Daniel; Miranda, Mónica Célia Pereira; Framegas de Araújo, Filipe Miguel Soares; Santos Marques, Tiago Miguel
The purpose of this study was to evaluate whether the use of removable partial dentures affects the periodontal status of abutment teeth. An observational cross-sectional study was done on a sample of patients rehabilitated with removable partial dentures (2010 to 2013). At a recall appointment, a clinical examination was done to collect data related to the rehabilitation and periodontal status of the abutment teeth. Of 145 invited patients, 54 attended the requested follow-up appointment (37.2%). Mean patient age was 59.1 years, and the study population was 42.6% male and 57.4% female. The mean follow-up time for the prosthesis was 26 months. Abutment teeth had higher values in all periodontal variables (P removable partial dentures is affected by these rehabilitations. A recall program for these patients involving removable prosthodontics and periodontology appointments is mandatory.
Full Text Available Introduction: More than one-third of the tobacco consumed in India is of smokeless form. While the smokeless tobacco (ST products have been strongly associated with oral cancer, the association between ST and periodontal disease is less clear. The present study was conducted on industrial workers because in premises, there is a ban on smoking tobacco and hence workers tend to consume more of ST products. Aim: The aim of this study is to assess periodontal status in ST chewers and nonchewers among industrial workers in North Bengaluru. Materials and Methods: A cross-sectional analytical study was conducted on 800 industrial workers (400 ST chewers and 400 nonchewers of North Bengaluru. Information regarding ST habits was obtained using the Global Adult Tobacco Survey questionnaire, followed by clinical examination to assess periodontal status using the community periodontal index and attachment loss. The comparison between chewers and nonchewers was done using Pearson's Chi-square test. Logistic regression analysis was used to estimate the difference of periodontal status and loss of attachment (LOA between chewers and nonchewers. Results: ST chewing habit was observed the maximum (46.5% among age group 25–44 years. Most of male chewers had habit of chewing gutkha followed by khaini, and majority of the female chewers were using khaini followed by betel nut quid. A significantly higher prevalence of bleeding on probing and calculus was found among nonchewers. ST chewers had 2.06 (95% confidence interval [CI]: 1.55–2.75 times more risk of developing periodontal pockets and 2.23 (95% CI: 1.68–2.98 times more risk of having LOA when compared with nonchewers. Conclusions: ST has deleterious effects on the periodontium. Hence, it is one of the important risk factors for periodontal disease.
83% of the subjects presented predominately with the worst condition recorded, code 2 (i.e. calculus), which is a reversible condition. A mean of 0.6 healthy sextants, 2.3 bleeding sextants and 3.1 calculus-accumulated sextants was calculated. A statistical difference in periodontal status was noted with age, the younger ...
Lohana, M H; Suragimath, G; Patange, R P; Varma, S; Zope, S A
There is an overwhelming body of evidence strongly suggesting that periodontal infection may have a significant negative impact on pregnancy outcome in some women. The aim of this study was to determine the association between periodontal disease and preterm low birth weight of babies. A total of 300 pregnant women, between 20 and 24 weeks of gestation i.e., second trimester, were considered for the study. The periodontal status was recorded using the following parameters: probing pocket depth, clinical attachment level, oral hygiene index and plaque index. After initial examination in the second trimester, the pregnant women were followed till delivery of the baby. Postpartum data i.e., weight of baby, gestational age of pregnancy and type of delivery, were recorded. Out of 300 pregnant women, 248 women had full-term delivery (12 low birth weight and 236 normal birth weight) while 52 had preterm delivery (6 normal birth weight and 46 low birth weight). There was significant association between body mass index and level of periodontal disease severity of pregnant women with birth weight of babies, gestational age of pregnant women and mode of delivery, respectively. As the level of periodontal disease severity increased, the proportion of delivering preterm and low birth weight babies also increased. The conclusions obtained revealed that Periodontal disease is a potential risk factor for preterm low birth weight babies of pregnant women.
Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu
Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized controlled trial (RCT) has examined if treating periodontal disease before pregnancy reduces adverse birth outcomes. This study aims to examine if the pre-conception treatment of periodontal disease will lead to improved periodontal status during late pregnancy and subsequent birth outcomes. A sample of 470 (235 in each arm of the study) pre-conception women who plan to conceive within one year and with periodontal disease will be recruited for the study. All participants will be randomly allocated to the intervention or control group. The intervention group will receive free therapy including dental scaling and root planning (the standard therapy), supragingival prophylaxis, and oral hygiene education. The control group will only receive supragingival prophylaxis and oral hygiene education. Women will be followed throughout their pregnancy and then to childbirth. The main outcomes include periodontal disease status in late pregnancy and birth outcomes measured such as mean birth weight (grams), and mean gestational age (weeks). Periodontal disease will be diagnosed through a dental examination by measuring probing depth, clinical attachment loss and percentage of bleeding on probing (BOP) between gestational age of 32 and 36 weeks. Local and systemic inflammatory mediators are also included as main outcomes. This will be the first RCT to test whether treating periodontal disease among pre-conception women reduces periodontal disease during pregnancy and prevents adverse birth outcomes. If
N. A. Chrysanthakopoulos
Full Text Available Objective: The aim of the present study was to examine the periodontal condition of an adult population in three isolated regions in Greece and to determine the association of periodontal disease with several demographic, behavioral and environmental factors.Materials and Methods: The study population consisted of 640 individuals, aged 20to69 years from three isolated regions. The following indices were assessed: Pocket Depth (PD, Clinical Attachment Level (CAL, Dental Plaque, Calculus and Bleeding on Probing (BOP. Statistical analysis was accomplished by multiple linear regression model which was used to assess the association between the mean clinical attachment loss and clinical, demographic and behavioral parameters.Results: The samples of the study showed high levels of dental plaque, dental calculus and BOP. The final multivariate model showed that age (p=0.000, gender (p=0.016 and presence of calculus (p=0.000 were associated with the mean clinical attachment loss. Age (p=0.000, gender (p=0.000 and dental plaque (p=0.027 were associated with gingival recession, while age (p=0.018 and gender (p=0.000 were associated with probing depth. Bleeding on probing, dental plaque, toothbrush frequency, level of education, tobacco consumption and reasons for dental visits were not associated with the mean clinical attachment loss.Conclusion: Periodontal disease consists of a complicated destructive condition of the Periodontal tissue with a.multi-factorial etiology. Oral hygiene instructions and a regular dental follow-up could play a significant role in the prevention of periodontal disease.Key Words: Periodontal Disease; Epidemiology; Risk Factors
Levrini, Luca; Mangano, Alessandro; Montanari, Paola; Margherini, Silvia; Caprioglio, Alberto; Abbate, Gian Marco
The aim of this prospective study was to compare the periodontal health and the microbiological changes via real-time polymerase chain reaction (PCR) in patients treated with fixed orthodontic appliances and Invisalign(®) system (Align Technology, Santa Clara, California). Seventy-seven patients were enrolled in this study and divided into three groups (Invisalign(®) group, fixed orthodontic appliances group and control group). Plaque index, probing depth, bleeding on probing were assessed. Total biofilm mass and periodontal pathogens were analyzed and detected via real-time PCR. All these data were analyzed at the T0 (beginning of the treatment) T1 (1-month) and T2 (3 months); and statistically compared using the Mann-Whitney test for independent groups. After 1-month and after 3 months of treatment there was only one sample with periodontopathic anaerobes found in patient treated using fixed orthodontic appliances. The Invisalign(®) group showed better results in terms of periodontal health and total biofilm mass compared to the fixed orthodontic appliance group. A statistical significant difference (P < 0.05) at the T2 in the total biofilm mass was found between the two groups. Patients undergoing orthodontic treatment with the Invisalign(®) System show a superior periodontal health in the short-term when compared to patients in treatment with fixed orthodontic appliances. Invisalign(®) should be considered as a first treatment option in patients with risk of developing periodontal disease.
Full Text Available Objectives. The aim of the present pathfinder study was to screen and map the periodontal status of Georgian population in accordance with the guidelines of the World Health Organization for population based surveys. Methods. During 2012, a pathfinder study was conducted to collect this data. For the periodontal portion of the study, 15-year-old school children were examined in the capital city of Tbilisi as well as in two other large cities and 4 smaller villages. All participants were examined by a trained dental team in a classroom using a dental mirror and a periodontal probe. Periodontal examination included plaque scores, calculus scores, probing depth measurements and bleeding on probing. These measurements were recorded for the Ramfjord index teeth. Results. A total of 397 15-year-old participants were examined in this pathfinder study. There were 240 females (60.45% and 157 males (39.55%. Of the total participants 196 (49.37% were urban adolescents while 201 (50.63% were from rural communities. Mean probing depth was 3.34 ± 0.57 mm with a range of 1 to 10 mm; a relatively high proportion (34.26% of these subjects presented with at least one site with pockets of 5 mm or deeper. Males presented with greater plaque, calculus and probing depths than females. When urban and rural populations were compared, urban participants presented with more plaque, probing depths and bleeding on probing. Greater pocket depths were found to be related to the presence of plaque calculus and bleeding on probing. Conclusions. Overall, rather high incidences of periodontal pockets ≥ 5 mm were detected in this population. This data should serve to prepare further more detailed epidemiological studies that will serve to plan and implement prevent and treat strategies for periodontal diseases in Georgia and also help make manpower decisions.
Levin, Liran; Margvelashvili, Vladimer; Bilder, Leon; Kalandadze, Manana; Tsintsadze, Nino; Machtei, Eli E
Objectives. The aim of the present pathfinder study was to screen and map the periodontal status of Georgian population in accordance with the guidelines of the World Health Organization for population based surveys. Methods. During 2012, a pathfinder study was conducted to collect this data. For the periodontal portion of the study, 15-year-old school children were examined in the capital city of Tbilisi as well as in two other large cities and 4 smaller villages. All participants were examined by a trained dental team in a classroom using a dental mirror and a periodontal probe. Periodontal examination included plaque scores, calculus scores, probing depth measurements and bleeding on probing. These measurements were recorded for the Ramfjord index teeth. Results. A total of 397 15-year-old participants were examined in this pathfinder study. There were 240 females (60.45%) and 157 males (39.55%). Of the total participants 196 (49.37%) were urban adolescents while 201 (50.63%) were from rural communities. Mean probing depth was 3.34 ± 0.57 mm with a range of 1 to 10 mm; a relatively high proportion (34.26%) of these subjects presented with at least one site with pockets of 5 mm or deeper. Males presented with greater plaque, calculus and probing depths than females. When urban and rural populations were compared, urban participants presented with more plaque, probing depths and bleeding on probing. Greater pocket depths were found to be related to the presence of plaque calculus and bleeding on probing. Conclusions. Overall, rather high incidences of periodontal pockets ≥ 5 mm were detected in this population. This data should serve to prepare further more detailed epidemiological studies that will serve to plan and implement prevent and treat strategies for periodontal diseases in Georgia and also help make manpower decisions.
Reddy, Kommuri Sahithi; Doshi, Dolar; Kulkarni, Suhas; Reddy, Bandari Srikanth; Reddy, Madupu Padma
The sense of coherence (SOC) has been suggested to be highly applicable concept in the public health area because a strong SOC is stated to decrease the likelihood of perceiving the social environment as stressful. This reduces the susceptibility to the health-damaging effect of chronic stress by lowering the likelihood of repeated negative emotions to stress perception. The demographic data and general information of subjects' oral health behaviors such as frequency of cleaning teeth, aids used to clean teeth, and dental attendance were recorded in the self-administered questionnaire. The SOC-related data were obtained using the short version of Antonovsky's SOC scale. The periodontal status was recorded based on the modified World Health Organization 1997 pro forma. The total of 780 respondents comprising 269 (34.5%) males and 511 (65.5%) females participated in the study. A significant difference was noted among the subjects for socioeconomic status based on gender ( P = 0.000). The healthy periodontal status (community periodontal index [CPI] code 0) was observed for 67 (24.9%) males and 118 (23.1%) females. The overall SOC showed statistically negative correlation with socioeconomic status scale ( r = -0.287). The CPI and loss of attachment (periodontal status) were significantly and negatively correlated with SOC. The present study concluded that a high level of SOC was associated with good oral health behaviors, periodontal status, and socioeconomic status.
Marta Silveira da Mota Krüger
Full Text Available Objective. The aims of this study were to evaluate the periodontal health of pregnant women and to investigate the association of periodontal status with demographic and socioeconomic characteristics, as well as medical and dental history. Materials and Methods. A total of 311 pregnant women were interviewed to obtain sociodemographic data along with medical and dental histories. Clinical examinations were performed to record the presence of visible plaque, gingival bleeding, and caries activity. The periodontal condition was evaluated by Community Periodontal Index of Treatment Needs (CPITN in one tooth of each sextant (16, 11, 26, 36, 31, and 46. Results. After the adjustment analysis, the presence of visible plaque remained the main determinant of gingival bleeding (OR = 2.91, CI = 1.91–4.48. First-trimester pregnancy status was also a predictor, with a lower prevalence of gingival bleeding observed in the second (OR = 0.87, CI = 0.77–0.99 and third (OR = 0.82, CI = 0.73–0.93 trimesters. Conclusion. In pregnant women, the presence of dental plaque and first-trimester pregnancy status were the main implicated factors predicting gingival bleeding.
Nagarajappa, Ramesh; Sharda, Archana; Asawa, Kailash; Tak, Aniruddh; Jalihal, Sagar
Objective: To assess and compare the oral hygiene and periodontal status among children with Poliomyelitis having upper limb disability, lower limb disability and both upper and lower disability at Udaipur city, Rajasthan, India. Study design: Total sample comprised of 344 Poliomyelitis children (upper limb disability: 33.4%; lower limb disability: 33.7%; both upper and lower limb disability: 32.9%) in the age group of 12-15 years. Clinical examination included recording Simplified Oral Hygiene Index and Community Periodontal Index. Analysis of variance (ANOVA), multiple logistic and stepwise linear regression were used for statistical analysis. Results: The mean OHI-S (2.52±1.05) score was found to be highest among children who had both upper and lower limb disability (poral hygiene and periodontal status was limb involved in the disability. Conclusion: The results of the study depicted an overall poor oral hygiene and periodontal status of the group. It was recognized that limbs involved in the disability had an impact on the oral hygiene and periodontal condition. The situation in this specialized population draws immediate attention for an integrated approach in improving the oral health and focus towards extensive research. Key words:Poliomyelitis, upper limb disability, lower limb disability, oral hygiene, periodontal status. PMID:22549671
Valensia, Rosy; Masulili, Sri Lelyati C.; Lessang, Robert; Radi, Basuni
Coronary heart disease (CHD) is an abnormal narrowing of heart arteries associated with local accumulation of lipids, in the form of cholesterol and triglycerides. Periodontal disease is a chronic inflammatory that suggests link to the development of CHD. In periodontitis have been reported changes in lipid profile, include increased of cholesterol levels of blood. Objective: to analyse correlation between blood cholesterol level with periodontal status of CHD and non CHD subjects. Methods: Periodontal status and blood cholesterol level of 60 CHD and 40 non CHD subjects was measured. Result: Blood cholesterol level in CHD subjects differs from non CHD subjects (p=0.032). Blood cholesterol level correlates with pocket depth (p=0.003) and clinical attachment loss (CAL) (p=0.000) in CHD subjects. Blood cholesterol level correlates with pocket depth (p=0.010) in non CHD subjects. There is no significant correlation between blood cholesterol level and bleeding on probing (BOP) in CHD subjects. There is no significant correlation between blood cholesterol level with BOP and CAL in non CHD subjects. Conclusion: Blood cholesterol level in control group is higher than CHD patients. Blood cholesterol level positively associated with pocket depth (r=0.375) and CAL (r=0.450) in CHD patients. Blood cholesterol level is positively associated with pocket depth (r=0.404) in control group.
Szarmach, I J; Szarmach, J; Waszkiel, D; Paniczko, A
The aim of the study was to assess the effect of orthodontic movement of the impacted canines after surgical exposure and alignment on the periodontal status of the transpositioned and adjacent teeth as well as to compare certain parameters with those of spontaneously erupted teeth. Twenty-four patients (mean age 18.4 +/- 3.66) with unilaterally impacted 24 canines were enrolled in the study. The following parameters were assessed: pocket depth (PD), clinical attachment level (CAL), platelet index (PI) of Silness and Löe, and modified sulcus bleeding index (SBI). Optic density of the alveolar bone along the root surface of the aligned canine was analysed based on digital radiological images made with the right angle technique. Control group consisted of spontaneously erupted teeth. In comparison to the control group, in the orthodonticaly treated group PD was found to increase on the mesial buccal and palatal surfaces of the first premolar (p aligned canine (p aligned tooth were statistically significant (p alignment zone and the control, and there was no link between the method of treatment and periodontal status, either. The alignment of the impacted permanent maxillary canines poses a risk of periodontal deterioration. Patients subjected to surgical-orthodontic treatment require periodic periodontal follow-ups.
Impact of Cranberry Juice Enriched with Omega-3 Fatty Acids Adjunct with Nonsurgical Periodontal Treatment on Metabolic Control and Periodontal Status in Type 2 Patients with Diabetes with Periodontal Disease.
Zare Javid, Ahmad; Maghsoumi-Norouzabad, Leila; Ashrafzadeh, Elnaz; Yousefimanesh, Hojat Allah; Zakerkish, Mehrnoosh; Ahmadi Angali, Kambiz; Ravanbakhsh, Maryam; Babaei, Hosein
Cranberries, high in polyphenols, have been associated with a favorable glycemic response in patients with type 2 diabetes and also are beneficial for oral health. Because type 2 diabetes mellitus and periodontal disease have a physiological relationship, this study aimed to evaluate the hypothesis that cranberry juice enriched with omega-3 will improve glycemic and lipid profiles and periodontal status in patients with diabetes with periodontal disease. In this randomized clinical trial, 41 patients with diabetes (age 35-67 years) with periodontal disease were recruited and randomly assigned to 4 groups: control (C; n = 12), receiving omega-3 (I1; n = 10, 1 g/ twice daily), cranberry juice (I2; n = 9, 200 ml, twice daily), and cranberry juice enriched with omega-3 (I3; n = 10, 200 ml, containing 1 g omega-3) twice daily for 8 weeks. Nonsurgical periodontal therapy was provided for all patients during the study. Fasting blood glucose and glycated hemoglobin, lipid profile, probing depth, anthropometric indices, and 3-day 24-hour dietary recalls were measured pre- and postintervention. Glycated hemoglobin was decreased significantly in I1 and I3 groups. Serum high-density lipoprotein cholesterol (HDL-C) levels increased significantly in the I3 group compared to baseline and compared to I1 and I2 groups. Probing depth was significantly reduced in all groups postintervention. Consumption of cranberry juice enriched with omega-3 can be beneficial as adjuvant therapy with nonsurgical periodontal therapy in decreasing glycated hemoglobin, increasing HDL-C, and improving periodontal status in patients with diabetes with periodontal disease.
Herrera, D; Roldán, S; González, I; Sanz, M
Little information is available regarding the diagnosis and microbiology of periodontal abscesses. The aim of this descriptive clinical and microbiological study was to provide more information in order to help in the characterisation of the periodontal abscess associated to periodontitis. 29 consecutive patients with a periodontal abscess were studied by the assessment of clinical variables, including both subjective (pain, edema, redness and swelling) and objective (bleeding on probing, suppuration, probing pocket depth, tooth mobility and cervical lymphadenopathy) parameters. Microbiological samples were taken for anaerobic microbiology and processed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards. 62% of the abscesses affected untreated periodontitis patients, and 69% were associated with a molar tooth. More than 75% of the abscesses had moderate-severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all abscesses, while suppuration on sampling was detected in 66%. Mean associated pocket depth was 7.28 mm, and 79% of teeth presented some degree of mobility. Cervical lymphadenopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% of the patients. High prevalences of putative periodontal pathogens were found, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus. The periodontal abscess has clear clinical characteristics and is usually associated with severe periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacterial mass with a high prevalence of well-recognised periodontal pathogens.
Corlan Puşcu, Dorina; Ciuluvică, Radu Constantin; Anghel, Andreea; Mălăescu, Gheorghe Dan; Ciursaş, Adina Nicoleta; Popa, Gabriel Valeriu; Agop Forna, Doriana; Busuioc, Cristina Jana; Siloşi, Izabela
Periodontal disease is one of the most frequent diseases affecting people all over the world. The relation between periodontal disease and diabetes mellitus raised the interest both of dentists and doctors treating metabolic diseases, as the two conditions influence one another. In our study, we analyzed a number of 75 patients with diabetes mellitus and periodontal disease that presented to the medical consultory for conditions of the dental maxillary system. The clinical study showed that periodontal disease and diabetes may affect young adults as well, still this pathological association more frequently appears after the age of 50. The disease was identified especially in the women living in urban area. The clinical examination of the dental maxillary system identified the presence of gingival ulcerations, dental calculus, gingival bleeding, radicular leftovers with anfractuous margins, fixed prostheses with an inappropriate cervical adjustment. Of the systemic diseases associated to periodontal disease and diabetes mellitus, there was observed that 66.66% of the patients also suffered from cardiovascular diseases (high blood pressure, ischemic cardiopathy, heart failure), and 37.33% suffered from obesity. The histopathological and immunohistochemical tests highlighted the presence of an inflammatory chronic, intense reaction, mainly formed of lymphocytes, plasmocytes, macrophages and granulocytes, heterogeneously disseminated and alteration of the structure of marginal and superficial periodontium. The inflammatory reaction in the patients with periodontal disease and diabetes was more intense than in the patients with periodontal disease without diabetes.
Khorsand, Afshin; Paknejad, Mojgan; Yaghobee, Siamak; Ghahroudi, Amir Alireza Rasouli; Bashizadefakhar, Hourieh; Khatami, Masoomeh; Shirazi, Mohsen
Background: The success of combined periodontal and orthodontic approach in the treatment of aggressive periodontitis patients with the pathologic extruded anterior teeth is a main concern and stability of the treatment results is an important factor to evaluate the treatment. The present study investigated the periodontal parameters at the end of the orthodontic treatment in patients with the aggressive periodontitis. Materials and Methods: Eight patients with an aggressive periodontal disease, extruded maxillary incisors, infrabony defects and probing depth of ≥5 mm were enrolled in this clinical trial (before, after). After periodontal therapy, orthodontic treatment was carried out for intrusion and alignment of teeth. Plaque index (PI), probing pocket depth (PPD), distance between incisal edge and interdental papilla, root length (RL), and defect dimensions (depth and width) were examined at the end of treatment and three as well as 6 months afterward. The data were subjected to repeated measure ANOVA test. P orthodontic approach would be a successful treatment with acceptable stability in the case of regular follow-up visits and controlled oral hygiene habits. PMID:24379862
Nigerian Journal of Clinical Practice • Jan-Feb 2016 • Vol 19 • Issue 1. Abstract .... Helsinki and was approved by the Health Research and. Ethics Committee of the Institution. Study design. This was a comparative cross‑sectional, analytical study carried out at a ..... probing depths and gingival marginal recession..
Sayar, F; Fallah, S; Akhondi, N; Jamshidi, S
Periodontal and cardiovascular diseases share some common underlying mechanisms. Hyperlipidemia is a major risk factor for cardiovascular diseases. This study sought to assess the association of hyperlipidemia and statin consumption with periodontal status. This cross-sectional study was conducted on 150 participants including 50 individuals with normal lipid profile (group C), 50 hyperlipidemic patients without drug therapy (group N), and 50 hyperlipidemic patients on drug therapy for a minimum of 3 months (group S). Periodontal parameters including plaque index (PI), clinical attachment level (CAL), bleeding on probing (BOP), and pocket depth (PD) were measured for all teeth except for the third molars. Serum levels of total cholesterol (TC), HDL, LDL, and triglycerides (TGs) were measured. The mean values of CAL and PD were significantly higher in the two hyperlipidemic groups compared with the C group (P < 0.005). Also, CAL and PD had significant associations with serum levels of TGs, LDL, and TC (P < 0.0001); PI in the group S was significantly lower than that in the other groups (P < 0.005). Hyperlipidemic patients showed higher values of periodontal parameters compared with the statin-treated and control groups. Lower PI in the group S may indicate the anti-inflammatory effect of statin. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Sayar, Ferena; Akhondi, Nasrin; Fallah, Soltanali; Moalemnia, Amir Abbas; Cheraghi, Azra
Hyperlipidemia is a major risk factor for cardiovascular diseases. Considering the suggested association between periodontal and cardiovascular diseases, this study sought to assess the association, if any, between serum triglyceride (TG) levels and gemfibrozil consumption with periodontal parameters. This cross-sectional study was conducted on 90 participants, including 30 individuals with a normal lipid profile (group H), 30 patients with hypertriglyceridemia and not on medication (group N), and 30 patients with hypertriglyceridemia and taking gemfibrozil over a 3-month period (group M). Periodontal parameters including probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index were measured at four sites of each tooth. Serum levels of total cholesterol (TC), TG, low-density lipoprotein, and high-density lipoprotein were measured. Mean values for PD and CAL in the two hypertriglyceridemic groups were significantly higher than those of the H group (P <0.001). After controlling for confounding variables, significant linear correlations were noted between PD and BOP, PD and TC, PD and TG, and CAL and TG in each group (P <0.01). Patients with hypertriglyceridemia had worse periodontal status than healthy controls. Patients with hypertriglyceridemia who were taking gemfibrozil did not show significant differences in CAL and PD compared with untreated patients with hypertriglyceridemia.
Full Text Available Periodontitis is an infectious disease concerning supporting tissues of the teeth. The primary etiological agent for disease development and progression is the subgingival biofilm, but recently it is known that host factors may modify the pathological process or may affect the severity and /or extent. The increasing levels of some specific pathogenic subgingival bacteria such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia and others can result in periodontal destruction and possibly correlate with disease severity. Data from controlled studies show high prevalence of P. gingivalis, T. forsythia and Tr. denticola which represent the red complex (coexistence of these three species in patients with moderate and severe chronic periodontitis. Parallel investigation of probing depth (PD and clinical attachment level (CAL with the microbiological testing may give a confirmation of relation between subgingival pathogenic bacteria and severity of periodontitis.
Gümüş, Pınar; Emingil, Gülnur; Öztürk, Veli-Özgen; Belibasakis, Georgios N; Bostanci, Nagihan
Periodontal diseases may affect local and systemic inflammation, and reactive oxygen species (ROS) levels. This systemic health burden could compromise the outcome of pregnancy in expectant mothers. The aim of the present study was to evaluate oxidative stress markers, including glutathione peroxidase (GPx), thiobarbituric acid-reactive substances (TBARS) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), and total bacterial loads in the saliva of pregnant and postpartum women, and to investigate their association with periodontal disease severity. A total of 187 women were originally recruited for this case-control study, assigned to the following groups a) pregnant group, b) postpartum group: the pregnant group re-evaluated 6 months after giving birth, c) control group: systemically healthy and non-pregnant women. The levels of the studied oxidative stress markers in saliva were measured by commercially available kits. The levels of salivary 8-OHdG were significantly elevated in the pregnant, compared with the control group. Although salivary 8-OHdG levels slightly decreased after giving birth (postpartum group), the difference did not reach significance. In contrast, the activity of antioxidant enzyme GPx in saliva was significantly lower in the pregnant than the control group. Although no differences in lipid peroxidation (represented by TBARS) were observed between the pregnant and control groups, after giving birth TBARS levels were significantly lowered. Only in the postpartum and control groups did clinical measurements of periodontal disease severity correlate with oxidative stress markers. Interestingly, there were no such correlations with TBARS in the pregnant and postpartum groups. The present study shows changes in the oxidant/antioxidant balance in saliva during pregnancy and after birth, which may be affected by periodontal health status in the latter case. Whether this is associated with adverse pregnancy outcomes, or not, remains to be elucidated. Early
Full Text Available Aim: The aim of this study was to compare the periodontal status of impacted canines after 5 years following completion of the combined surgical and orthodontic treatment. Materials and methods: We examined 20 labially impacted canines and 20 palatally impacted canines at 5 years after the end of treatment. We assessed the periodontal status of these teeth. Results: Different outcomes were found regarding the probing depth and the amount of keratinized gingiva in the two mentioned groups of teeth. Conclusions: The assessed periodontal indices may signal the appearance of a periodontal disease around the teeth that were surgically and orthodontically treated
Shiloah, J; Scarbecz, M; Bland, P S; Hottel, T L
Traditional periodontics clinical examinations in dental education frequently assess a narrow set of clinical skills and do not adequately assess the ability of students to independently manage a periodontal patient. As an alternative, the authors developed a comprehensive periodontics competency case experience (CCCE) for senior dental students and surveyed students regarding their experience with the CCCE. Students challenging the CCCE must treat a patient with moderate periodontitis and must independently decide when a state of periodontal and oral health has been achieved. Students are also required to conduct an oral presentation to periodontology faculty. Dental students who completed the CCCE had a favourable impression of the experience, compared with the traditional clinical examinations taken in the junior year. The majority of students rated all the components of the CCCE as 'somewhat' or 'very helpful'. About 72.4% of students felt that being able to work independently on the examination was very helpful for learning about the clinical management of patients with periodontal disease, followed by 'simulation of care in private practice' (65.5%), and oral photography experience (55.2%). The greatest difficulty reported by students was finding an acceptable patient. About 62.1% of students rated 'finding the right patient' as very difficult. Students reported having to screen a mean of 5.9 patients (SD: 4.5) to find a qualified patient. The results of the survey will be useful in improving the examination as an assessment tool in periodontal therapy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available The effect of socio-cultural status on periodontal condition in pregnant women has been reported by a number of researches. This study aimed to investigate the effect of socio-cultural status on periodontal condition in pregnancy. The periodontal condition was evaluated for 84 pregnant women at their first, second, and third trimesters. The clinic indices include gingival index, plaque index, and the amount of subgingival plaque bacterial colonies. Statistical testing used one way Anova at 95% confidence level (α = 0.05, and t-test for the differences in the gingivitis severity of each group. The results of the study showed that gingival index, plaque index, and the amount of subgingival plaque bacterial colonies increased gradually in the first, second, and third trimesters, and that most severe gingivitis in pregnant women was associated with low level of education and unemployment. The conclusion of this study showed (1 increasing severity of gingivitis in pregnancy, (2 higher level of education is related to lower severity of gingivitis, and (3 employed women have lower rate of severe gingivitis than unemployed women.
Tak, Mridula; Nagarajappa, Ramesh; Sharda, Archana; Asawa, Kailash; Tak, Aniruddh; Jalihal, Sagar
To assess and compare the oral hygiene and periodontal status among children with Poliomyelitis having upper limb disability, lower limb disability and both upper and lower disability at Udaipur city, Rajasthan, India. Total sample comprised of 344 Poliomyelitis children (upper limb disability: 33.4%; lower limb disability: 33.7%; both upper and lower limb disability: 32.9%) in the age group of 12-15 years. Clinical examination included recording Simplified Oral Hygiene Index and Community Periodontal Index. Analysis of variance (ANOVA), multiple logistic and stepwise linear regression were used for statistical analysis. The mean OHI-S (2.52 ± 1.05) score was found to be highest among children who had both upper and lower limb disability (phealthy sextants were found among those with only lower limb disability (4.53 ± 2.05) and among those with both upper and lower limb disability (0.77 ± 1.39), respectively (poral hygiene and periodontal status was limb involved in the disability. The results of the study depicted an overall poor oral hygiene and periodontal status of the group. It was recognized that limbs involved in the disability had an impact on the oral hygiene and periodontal condition. The situation in this specialized population draws immediate attention for an integrated approach in improving the oral health and focus towards extensive research.
Ahmad, Nafisah Ibrahim; Masulili, Sri Lelyati C.; Lessang, Robert; Radi, Basuni
Studies found an association between periodontitis and coronary heart disease (CHD), but relationship between periodontal status CHD patients with LDL (Low Density Lipoprotein) levels, as risk factors for atherosclerosis, has not been studied. Objective: To analyze relationship between LDL and periodontal status CHD. Methods: Periodontal status of 60 CHD, 40 controls were examined (PBI, PPD, CAL) and their blood was taken to assess levels of LDL. Result: Found significant differences LDL (p=0.005), correlation between LDL with PPD (p=0.003) and CAL CHD (p=0.013), and PPD (p=0.001), CAL (p=0.008) non-CHD, but no significant correlation between LDL with PBI CAD (p=0.689) and PBI non-CHD (p=0.320). Conclusion: There is a correlation between the LDL levels with periodontal status.
Butar-Butar, Mardiah Rizqo
Diabetes melitus adalah penyakit gangguan metabolisme ditandai dengan meningkatnya kadar gula darah yang terjadi karena kelainan sekresi insulin, kerja insulin, atau kedua-duanya. Diabetes melitus merupakan salah satu penyakit sistemik yang berperan sebagai faktor risiko penyakit periodontal. Penelitian ini bertujuan untuk mengetahui status oral higiene dan periodontal dan odd rasio periodontitis pada pasien Diabetes melitus dan non-Diabetes. Rancangan penelitian adalah case-control. Popul...
Patil, B S; Giri, G R
Periodontitis is a multifactorial disease with microbial dental plaque as the initiator of periodontal disease. However, the manifestation and progression of the disease is influenced by a wide variety of determinants and factors. The strongest type of causal relationship is the association of systemic and periodontal disease. Hashimoto's thyroiditis has also been considered as one of the causes of periodontal disease. This clinical case report highlights the impact of Hashimoto's thyroiditis on the outcome of periodontal therapy.
Cabanilla, Leyvee; Molinari, Gail
Periodontal diseases and conditions, as defined by The 1999 International Workshop for Classification of Periodontal Diseases and Conditions presented some significant paradigm shifts based on evidence that the transition from plaque-associated reversible gingival diseases to periodontitis can occur in children and adolescents with characteristics which were previously thought to be typical of adult periodontitis. The purposes of this paper are to present the periodontal diseases and conditions described in the 1999 workshop sponsored by the American Academy of Periodontology, review the risk factors for the development of periodontal diseases in the pediatric and adolescent populations, and present appropriate clinical periodontal assessment and management for these age groups.
Conclusion: Within the limitations of this study, these results suggest that not only periodontal status was not negatively affected by intrusion, but also there were signs of periodontal improvement including attachment gain and shortening of clinical crown height.
Schloss, Alexander J
Ethical dilemmas are becoming increasingly common in dentistry and periodontics. Clinicians, challenged with such dilemmas, may not know how to apply the appropriate moral reasoning needed to resolve these situations especially when any of the five fundamental principles of ethics that form the foundation of the American Dental Association Principles of Ethics and Code of Professional Conduct--patient autonomy, nonmaleficence, beneficence, justice, and veracity--come into conflict with each other. The author describes one clinical case that presented with an ethical dilemma. An analytic framework, used in medicine, is introduced and used to solve the clinical case on whether to proceed with periodontal surgery on a patient who is not aware of his terminal prognosis from metastatic prostate cancer. Upon using the analytic framework, recommendations are made on the ethically appropriate path for the periodontist to follow in providing care for the patient's periodontal problem consistent with the principles of patient autonomy, respect for persons, and veracity.
Full Text Available Periodontal disease has very complex and multi factor etiology. Plaque bacteria is the main cause of periodontal disease and another risk factor that also plays a role is a smoking habit. Cigarette product such as nicotine can influence the development of periodontal disease that can directly and systemically damage the function of PMN cell. The research was conducted by taking a clinical examination on the smoking influence that covers the number of cigarettes and the period of smoking, and kind of cigarette to the worse of periodontal disease, and by measuring the epithelial attachment loss and the bleeding index. The research was conducted to 152 male aged 20-45 years old, comprised 80 smokers and 72 nonsmokers at the Clinic of Faculty of Dentistry Universitas Indonesia, Jakarta. The result of the research showed that smoking gave influence on the worse of the periodontal disease. There was a profound relationship between the smoking period and the number of cigarettes consumed everyday indicated by the epithelial attachment loss. Smoking did not enhance gingival bleeding. The relationship between kinds of cigarette and the gingival bleeding score and the epithelial attachment loss did not show a significant bleeding.
Periodontal Diseases is one of the most common chronic disorders of infectious origin known in humans. It may present as gingivitis or periodontitis. Gingivitis is the inflammatory condition of the soft tissues surrounding the teeth and periodontitis, the destruction of the supporting structures of the teeth, including the ...
Conclusions: The results of our study showed that the periodontal and oral hygiene status of 18-year-old Lithuanian population could be characterized as poor. In total, 77.1% of the study participants were found to have periodontal conditions such as gum bleeding, dental calculus, and shallow pockets. The anterior teeth of the mandible were most frequently affected.
Full Text Available Background: Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL® as an adjunct to scaling and root planing (SRP in chronic periodontitis patients. Materials and Methods: One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm. Experimental sites additionally received HA gel subgingivally at baseline, 1 st , 2 nd , and 3 rd week. Clinical parameters were re-assessed at 4 th , 6 th , and 12 th week. At 4 th week recall, a gingival biopsy was obtained from test and control site for histologic examination. Results: Intra-group analysis of all the clinical parameters at all sites from baseline to 4 th , 6 th , and 12 th week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6 th and 12 th week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4 th , 6 th , and 12 th week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment. Conclusion: Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant.
Kurata, Hiroshi; Awano, Shuji; Yoshida, Akihiro; Ansai, Toshihiro; Takehara, Tadamichi
This study investigated whether an improvement in periodontal health resulted in changes in the prevalence of periodontopathogenic bacteria in saliva and tongue coatings and a reduction in volatile sulfur compounds (VSCs: H(2)S and CH(3)SH) linked to oral malodour. The subjects were 35 patients who visited the breath odour clinic of Kyushu Dental College, Japan. Their mean age was 51.2+/-18.3 years (mean+/-sd). A clinical examination performed at baseline and 2 months after periodontal treatment assessed VSCs in mouth air using gas chromatography, periodontal probing depth and bleeding on probing (BOP) in all subjects; saliva and tongue coatings were also collected. Genomic DNA was isolated from the samples, and the proportions of five periodontopathogenic bacteria (Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Prevotella intermedia and Prevotella nigrescens) were investigated using quantitative real-time PCR. The subjects were classified into four groups based on the presence of a periodontal pocket of more than 4 mm (PD) and VSCs above the organoleptic threshold level (VSCT) as follows: -PD/-VSCT group, subjects without PD or VSCT; -PD/+VSCT group, those without PD but with VSCT; +PD/-VSCT group, those with PD but without VSCT; and +PD/+VSCT group, those with PD and VSCT. Although the mean PD values in the +PD/-VSCT and +PD/+VSCT groups, BOP in the +PD/+VSCT group, and H(2)S and CH(3)SH concentrations in the -PD/+VSCT and +PD/+VSCT groups were greater than in the other groups at baseline, we found no significant difference among the four groups after periodontal treatment. The proportion of periodontopathogenic bacteria in saliva was higher in the +PD/-VSCT and +PD/+VSCT groups than in the -PD/-VSCT and -PD/+VSCT groups at baseline and after treatment, but the proportions of bacteria in saliva after treatment were reduced compared to the baseline. Furthermore, the differences in the proportions of the five target bacteria in the tongue
Full Text Available Objectives: The gingival and periodontal changes during pregnancy are well known. Gingivitis is the most prevalent oral manifestations associated with pregnancy. The hormonal and vascular changes that accompany pregnancy are known to exaggerate the inflammatory response to the local irritants. Hence, a study was designed to assess oral hygiene status, gingival status, periodontal status, and treatment needs (TNs among pregnant and nonpregnant women. Materials and Methods: A cross-sectional study was conducted among 120 pregnant and 120 nonpregnant women of 18–44 years age attending the Outpatient Department of Gynaecology and Obstetrics in Government Hospital of Belgaum city, Karnataka, India. The study consisted of an interview and oral examination. Type 3 examination was followed. Simplified Oral Hygiene Index (OHI-S, Gingival Index, and Community Periodontal Index and TNs Index were used to assess “oral hygiene status,” “gingival status,” and “periodontal status and TNs,” respectively. Results: The pregnant women showed poor oral hygiene with the mean OHI-S score as 2.68. Gingivitis was prevalent in almost all the pregnant and nonpregnant women. However, it was found more severe in pregnant women with mean gingival score as 1.25. A definite increase in gingivitis was found from Trimester II to Trimester III. The mean number of sextants showing healthy gingiva was significantly (P < 0.01 lower among pregnant women. Conclusions: Pregnant women showed poor oral hygiene, more gingival inflammation, and more periodontal disease as compared to nonpregnant women. The severity of gingivitis increased in Trimester III. Proper oral hygiene practice can prevent these diseases and further complications.
Lembariti, BS; Van't Hof, MA; Pilot, T; Van Palenstein-Helderman, WH
The purpose of this study was to investigate the relationship between clinical parameters and periodontitis in a population receiving no regular prophylactic dental care. From a sample of 164 adult rural and urban Tanzanian subjects aged between 30 and 44 years, 16% were identified with
Adina Coșarcă; Mariana Păcurar; Cecilia Petrovan; Alina Ormenișan
Aim: The aim of this study was to compare the periodontal status of impacted canines after 5 years following completion of the combined surgical and orthodontic treatment. Materials and methods: We examined 20 labially impacted canines and 20 palatally impacted canines at 5 years after the end of treatment. We assessed the periodontal status of these teeth. Results: Different outcomes were found regarding the probing depth and the amount of keratinized gingiva in the two mentioned groups of t...
Full Text Available Introduction: The effect of fluoride in the reduction of dental caries is well established, its effect on periodontal tissues is enigmatic. Aim: The aim of this study is to investigate the association between dental fluorosis and the periodontal status. Materials and Methods: A cross-sectional study was conducted on a sample of 600 subjects suffering from fluorosis. Variables such as age, gender, and smoking, which could act as covariates for the periodontal disease were recorded. The oral examination included assessment of oral hygiene index-simplified (OHI-S, community periodontal index and treatment need, and assessment of dental fluorosis by Jackson's fluorosis index. Results: Periodontitis was more common in females than in males. As the age advances, the rate of periodontal disease increases steadily. Periodontitis was significantly associated with poor oral hygiene and tobacco usage. As the degree of fluorosis increased, the severity of gingivitis reduced and periodontitis increased. Conclusion: There is a strong association between the degree of dental fluorosis and periodontal disease along with other factors such as age, gender, OHI-S, and tobacco usage.
The Effect of Resveratrol Supplementation in Adjunct with Non-surgical Periodontal Treatment on Blood Glucose, Triglyceride, Periodontal Status and Some Inflammatory Markers in Type 2 Diabetic Patients with Periodontal Disease
Ahmad Zare Javid
Full Text Available Background and Objectives: Diabetes mellitus and periodontal disease are two chronic and common diseases with close relationship together affecting public health and quality of life. The aim of this study was to investigate the effect of resveratrol supplementation in adjunct with non-surgical periodontal treatment (NST on blood glucose, triglyceride, periodontal status and inflammatory markers in type 2 diabetic patients with periodontal disease. Materials and Methods: This double-blind clinical trial study was conducted on 43 diabetic patients with periodontitis referred to the Endocrinology Clinic at Golestan Hospital in Ahvaz, Iran. All subjects were randomly assigned into two groups of intervention and control. The intervention and control groups received either 480 mg/d resveratrol or placebo capsules (2 PCs for four weeks. All subjects underwent non-surgical periodontal therapy during the intervention period. Anthropometric parameters, 24-hour dietary recall, fasting blood sugar, insulin, insulin resistance (HOMA-IR, triglycerides, pocket depth (PD, IL6 and TNF&alpha were evaluated in all subjects pre- and post-intervention. Results: The mean serum levels of fasting insulin and insulin resistance (HOMA-IR were significantly (P=0.02, P=0.045, respectively lower in the intervention group compared with the control group (10.42 ± 0.28 and 10.92 ± 0.9 3.66 ± 0.97 and 4.49 ± 1.56, respectively . Moreover, significant difference (P < 0.001 was obtained in the mean pocket depth (PD between the intervention and control groups (2.35 ± 0.6 and 3.38 ± 0.5, respectively post-intervention. In the intervention group, the mean serum level of IL6 was reduced significantly (P= 0.039 post-intervention (1.58 ± 1.06 and 2.19± 1.09. No significant differences were seen in the mean levels of fasting blood sugar, triglycerides, IL6 and TNF&alpha between the two groups post-intervention. Conclusions: It is suggested that resveratrol may be recommended as
Porwal, Surya; Tewari, Shikha; Sharma, Rajinder K; Singhal, Savita Rani; Narula, Satish C
Recently, some studies have revealed the effect of polycystic ovary syndrome (PCOS) on gingival inflammation. This cross-sectional study attempts to assess the periodontal status and systemic inflammation of women receiving medical treatment for PCOS and women newly diagnosed with PCOS. A total of 126 participants comprising 41 newly diagnosed patients with PCOS (PCOS-N), 45 patients with PCOS on medical treatment (PCOS-MT), and 40 systemically healthy controls (control group [CG]) were examined. Periodontal parameters, anthropometric parameters, and serum levels of high-sensitivity C-reactive protein (hsCRP) were recorded. Women with newly diagnosed PCOS had increased sites with bleeding on probing (BOP), probing depth, clinical attachment level (CAL), waist circumference (WC), hsCRP, and prevalence of periodontitis compared with control and PCOS-MT groups (P ≤0.05). On partial correlation analysis after controlling for confounders, BOP and CAL correlated positively and significantly with hsCRP (P = 0.01 and P = 0.005). Multivariate linear regression analysis revealed that BOP and CAL (dependent variable) (P = 0.009/R(2) = 0.05 and P = 0.005/R(2) = 0.07, respectively) had significant association with hsCRP. Furthermore, hsCRP, when considered as outcome, also exhibited association with CAL and WC (P = 0.002/R(2) = 0.07 and P = 0.04/R(2) = 0.106). Logistic regression analysis demonstrated that the PCOS-N group had 2.88 times increased likelihood of having moderate periodontitis (adjusted odds ratio 2.88, 95% confidence interval 1.18 to 6.98). Women with newly diagnosed PCOS may have increased prevalence and likelihood for periodontitis, with higher measures of periodontal inflammation and breakdown than those on medical treatment for PCOS and systemically healthy females. Furthermore, periodontal breakdown might depend on systemic inflammation and vice versa.
López, Lydia M; Guerra, María Elena
The aim of this study was to determine the caries rate and periodontal status in a sample of pregnant women with HIV+ infections from Puerto Rico. A pilot study was conducted on a cross sectional convenience sample of 25 pregnant women with HIV+ infections from Puerto Rico who visit the CEMI clinic (Centro de Estudios Materno Infantil) at the University of Puerto Rico. The women subjects were evaluated for caries, DMFT (D: Decay tooth; M: Missing tooth due to caries; F: Filled tooth) index, oral lesions associated with HIV+/AIDS and periodontal disease parameters, with a Florida probe by a calibrated dentist on periodontal indexes such as as bleeding on probing, CEJ (cemento-enamel junction) and pocket depth. Periodontal disease was classified as having 4 sites with pocket depth greater than 4 mm and caries were identified following the Radike criteria. Data was statistically analyzed using the SSPS Program (Statistical Software Program for Social Sciences) and descriptive statistics were calculated. Mean DT (decayed teeth), MT (missing teeth due to caries), FT (filled teeth) and DMFT (decay, missing and filled teeth) were 4.8, 1.86, 5.3 and 12, respectively; mean sites of bleeding on probing=12.06; mean sites with pocket depth>4 mm=6.95 and mean sites with loss of attachment greater than 4 mm=7.66. [Almost 50% of the patients had generalized chronic periodontitis. A 72% prevalence of periodontal disease was found. No oral lesions related to HIV+/AIDS were reported. CD4 and viral load was statistically associated with bleeding on probing and severe signs of periodontal disease. High levels of dental disease were found in pregnant women with HIV+/AIDS infections from Puerto Rico, and these women were in need of substantial dental services.
Pushpa S Pudakalkatti
Full Text Available Background: A major challenge in clinical periodontics is to find a reliable molecular marker of periodontal tissue destruction. Aim: The aim of the present study was to assess, whether any correlation exists between salivary immunoglobulin A (IgA level against lipopolysaccharide of Porphyromonas gingivalis and clinical periodontal parameters (probing depth and clinical attachment loss. Materials and Methods: Totally, 30 patients with chronic periodontitis were included for the study based on clinical examination. Unstimulated saliva was collected from each study subject. Probing depth and clinical attachment loss were recorded in all selected subjects using University of North Carolina-15 periodontal probe. Extraction and purification of lipopolysaccharide were done from the standard strain of P. gingivalis (ATCC 33277. Enzyme linked immunosorbent assay (ELISA was used to detect the level of IgA antibodies against lipopolysaccharide of P. gingivalis in the saliva of each subject by coating wells of ELISA kit with extracted lipopolysaccharide antigen. Statistical Analysis: The correlation between salivary IgA and clinical periodontal parameters was checked using Karl Pearson′s correlation coefficient method and regression analysis. Results: The significant correlation was observed between salivary IgA level and clinical periodontal parameters in chronic periodontitis patients. Conclusion: A significant strong correlation was observed between salivary IgA against lipopolysaccharide of P. gingivalis and clinical periodontal parameters which suggest that salivary IgA level against lipopolysaccharide of P. gingivalis can be used to predict the severity of periodontal destruction in chronic periodontitis patients.
Full Text Available Introduction: Periodontitis is referred to as the sixth complication of diabetes mellitus. If left untreated, periodontitis can lead to tooth loss, thereby compromising a patient's ability to maintain a proper diet and affecting the quality of life. Aim: To assess the periodontal status among type II diabetic and nondiabetic individuals in Chennai city. Materials and Methods: A hospital based cross-sectional comparative study was conducted among diabetics and nondiabetic population attending a government hospital in Chennai city. The WHO Oral Health Assessment Form (1997 was used to assess the periodontal status. The final sample size of the study was 1000 which included 500 diabetics and 500 nondiabetics. Results: This study showed a significant association between the diabetic status and periodontal disease. The severity of periodontal disease was high among diabetics when compared to nondiabetics. The mean number of sextants with shallow pockets was 0.76 ± 1.20 among diabetics and 0.49 ± 0.86 among nondiabetics (P < 0.0001. The mean number of sextants with Loss of Attachment score of 1 (4–5 mm was 0.67 ± 1.05 among diabetics and 0.32 ± 0.70 among nondiabetics. Conclusion: Periodontal disease was more frequent and severe in diabetic patients as compared to nondiabetics although there are a number of questions need to be answered in future research.
Full Text Available Background and Objectives: Periodontal disease is a chronic disorder with a high prevalence. There are few studies about the role of diet in prevention and treatment of periodontal disease. The aim of this study was to evaluate the effect of consumption of Chicory leaf extract in adjunct with non-surgical periodontal therapies on serum antioxidant and lipid status. Materials and Methods: This study was a double-blind, randomized controlled clinical trial conducted on 40 patients in Sina Hospital of Ahvaz Jundishapur University of Medical Sciences (Iran in 2014. The intervention (n=20 and control groups (n=20 were allocated using blocked randomization. The intervention group received 2 capsules (2 g of Chicory leaf extract daily for 8 weeks. All subjects underwent non-surgical periodontal therapy during the intervention period. Anthropometric indices, 24-hour diet records, total antioxidant capacity, malate di-aldehyde (MDA, uric acid, total cholesterol, triglyceride (TG and HDL-c was measured before and after intervention. Results: The mean level of total antioxidant capacity (1.89 ± 0.49; 1.20 ± 0.25, respectively; P<0.001 and uric acid (7.15±1.98; 4.48±1.34, respectively; P<0.001 increased in the intervention group compared with the control group post intervention. The mean level of MDA decreased in the intervention group compared with the control group post-intervention (3.01±1.15; 3.97±1.19, respectively; P.d<0.001. Cholesterol difference was not significant pre- and post-intervention between the two groups (P=0.35. The mean level of serum triglyceride (TG was significantly lower in the intervention group compared with the control group post intervention (149.50±97.88; 109.35±58.00, respectively; P.d<0.001. The mean level of HDL-c was also significantly lower in the intervention group compared with the control group post treatment (42.25±8.47; 39.80±8.94, respectively; P.d<0.001. Conclusions: It seems that consumption of Chicory
Ina Hendiani; Dede Hadidjah; Agus Susanto; Indra Mustika Setia Pribadi
ABSTRACT Introduction: Periodontitis is an inflammatory disease that attacks the periodontal tissue comprises the gingiva, periodontal ligament, cementum and alveolar bone caused mainly by plaque bacteriophage or other specific dominant type of bacteria. The purpose of this study was to determine the therapeutic effect of clinical application of mangosteen peel extract gel as adjunctive therapy scaling and root planing in patients with chronic periodontitis. This research was expect...
Tak, Mridula; Nagarajappa, Ramesh; Sharda, Archana; Asawa, Kailash; Tak, Aniruddh; Jalihal, Sagar
Objective: To assess and compare the oral hygiene and periodontal status among children with Poliomyelitis having upper limb disability, lower limb disability and both upper and lower disability at Udaipur city, Rajasthan, India. Study design: Total sample comprised of 344 Poliomyelitis children (upper limb disability: 33.4%; lower limb disability: 33.7%; both upper and lower limb disability: 32.9%) in the age group of 12-15 years. Clinical examination included recording Simplified Oral Hygie...
Yunita, Dina Suci; Masulili, Sri Lelyati C.; Tadjoedin, Fatimah M.; Radi, Basuni
Coronary heart disease (CHD) is a disease that causes narrowing of the coronary arteries. Currently, there is a hypothesis regarding periodontal infection that increases risk for heart disease. Alkaline phosphatase (ALP) as a marker of inflammation will increase in atherosclerosis and periodontal disease. The objective of this research is analyzing the relationship between the levels of alkaline phosphatase in saliva with periodontal status in patients with CHD and non CHD. Here, saliva of 104 subjects were taken, each 1 ml, and levels of Alkaline Phosphatase was analyzed using Abbott ci4100 architect. We found that no significant difference of Alkaline Phosphatase levels in saliva between CHD patients and non CHD. Therefore, it can be concluded that Alkaline Phosphatase levels in patients with CHD saliva was higher than non CHD and no association between ALP levels with periodontal status.
Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu
Background Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized cont...
Full Text Available Shoei Omori,1,2 Fumihiko Uchida,3 Sechang Oh,4,5 Rina So,6 Takehiko Tsujimoto,7 Toru Yanagawa,8 Satoshi Sakai,4 Junichi Shoda,4,5 Kiyoji Tanaka,9 Hiroki Bukawa8 1Oral and Maxillofacial Surgery, Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; 2Department of Dental Oral Surgery, Kitaibaraki City Hospital, Kitaibaraki, Ibaraki, Japan; 3Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; 4Department of Medical Sciences, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; 5The Center of Sports Medicine and Health Sciences, Tsukuba University Hospital, Tsukuba, Ibaraki, Japan; 6Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Kawasaki, Kanagawa, Japan; 7Department of Sports Medicine, Faculty of Human Sciences, Shimane University, Matsue, Shimane, Japan; 8Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; 9Department of Sports Medicine, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan Background and purpose: Periodontal disease is closely related to lifestyle-related diseases and obesity. It is widely known that moderate exercise habits lead to improvement in lifestyle-related diseases and obesity. However, little research has been undertaken into how exercise habits affect periodontal disease. The purpose of this study was to examine the effect of exercise habits on periodontal diseases and metabolic pathology. Methods: We conducted a prospective intervention research for 12 weeks. The subjects were 71 obese men who participated in an exercise and/or dietary intervention program. Fifty subjects were assigned to exercise interventions (exercise intervention group and 21 subjects were assigned to dietary interventions (dietary intervention group. This research was
Full Text Available Introduction & Objective: Recent studies have presented evidence that periodontal disease in pregnant women may be a determining factor for newborn’s low birth weight. The present investigation was carried out to verify whether there is an association between maternal periodontal disease and low birth weight of newborns.Materials and Methods: This was a case-control study on 330 women, containing 110 mothers having live newborns with weight 2500 g (control group. The existence of an association between periodontal disease and newborn’s low birth weight was evaluated by means of analytic statistics that considered other risk factors for low weight. The two groups were compared with regard to urinary infection, preeclampsia, premature rupture of membrane, placenta previa, primiparous, smoking, age, height, socioeconomic status and periodontal disease.Results: There were no statistically significant differences between the case and control groups for any of the covariables (P>0.05, but there was significant differences for principal independent variable (periodontal disease P<0.05.Conclusion: Results indicated a positive association between periodontal disease and newborn’s low birth weight. Thus periodontal disease is a possible risk factor for low birth weight.
Harpreet Singh Grover
Full Text Available Background: Role of various etiologic factors in periodontal disease has been investigated by means of epidemiologic surveys and clinical studies. The community periodontal index of treatment needs (CPITN provides a picture of the public health requirements in the periodontal field, which is essential for national oral health policy-making and specific interventions. Materials and Methods: This study was conducted on 4000 individuals among rural, semi-urban, and metro population of Gurgaon District, Haryana State, to find out the oral health status and periodontal treatment needs (TNs using CPITN index. Results: An inference was drawn from the results that among 4000 participants from all the four population groups' maximum, i.e., 63.80% of individuals needed TN2 whereas 18.20% of individuals needed TN3 and 18.10% of individuals needed TN1. Conclusion: It can be concluded with a word of hope and a word of warning. Hope lies in the fact that the measurement of periodontal diseases by epidemiological study of this condition is improving and receiving wide spread attention. The warning lies in the varied nature of the condition which goes to make up periodontal disease and perplexing ways in which these conditions blend. In addition to dental practitioner, periodontist and public health workers must devote more time and effort toward controlling periodontal disease than they seem to be devoting at present.
Nagarajan, R.; Miller, C.S.; Dawson, D.; Al-Sabbagh, M.; Ebersole, J.L.
Periodontal diseases are a major public health concern leading to tooth loss and also shown to be associated with several chronic systemic diseases. Smoking is a major risk factor for developing numerous systemic diseases, as well as periodontitis. While it is clear that smokers have a significantly enhanced risk for developing periodontitis leading to tooth loss, the population varies with regards to susceptibility to disease associated with smoking. This investigation focuses on identifying differences in four broad sets of variables consisting of: (a) host response molecules, (b) periodontal clinical parameters, (c) antibody measures for periodontal pathogens and oral commensal bacteria challenge, and (d) other variables of interest in a smoking population with (n = 171) and without periodontitis (n = 117). Subsequently, Bayesian network structured learning techniques (BNSL) techniques were used to investigate potential associations and cross-talk between the four broad sets of variables. BNSL revealed two broad communities with markedly different topology between the non-periodontitis and periodontitis smoking population. Confidence of the edges in the resulting network also showed marked variations within and between the periodontitis and non-periodontitis groups. The results presented validated known associations, as well as discovered new ones with minimal precedence that may warrant further investigation and novel hypothesis generation. Cross-talk between the clinical variables and antibody profiles of bacteria were especially pronounced in the case of periodontitis and mediated by the antibody response profile to P. gingivalis. PMID:27431617
Hajishengallis, George; Hajishengallis, Evlambia; Kajikawa, Tetsuhiro; Wang, Baomei; Yancopoulou, Despina; Ricklin, Daniel; Lambris, John D
Periodontitis is a dysbiotic inflammatory disease leading to the destruction of the tooth-supporting tissues. Current therapies are not always effective and this prevalent oral disease continues to be a significant health and economic burden. Early clinical studies have associated periodontitis with elevated complement activity. Consistently, subsequent genetic and pharmacological studies in rodents have implicated the central complement component C3 and downstream signaling pathways in periodontal host-microbe interactions that promote dysbiosis and inflammatory bone loss. This review discusses these mechanistic advances and moreover focuses on the compstatin family of C3 inhibitors as a novel approach to treat periodontitis. In this regard, local application of the current lead analog Cp40 was recently shown to block both inducible and naturally occurring periodontitis in non-human primates. These promising results from non-human primate studies and the parallel development of Cp40 for clinical use highlight the feasibility for developing an adjunctive, C3-targeted therapy for human periodontitis. Copyright © 2016 Elsevier Ltd. All rights reserved.
Javed, Fawad; Al-Kheraif, Abdulaziz A; Al Amri, Mohammad D; Alshehri, Mohammed; Vohra, Fahim; Al-Askar, Mansour; Malmstrom, Hans; Romanos, Georgios E
Whole salivary interleukin (IL)-1β and IL-6 in smokers and never-smokers with prediabetes remains uninvestigated. The aim of this study is to assess the periodontal status and whole salivary IL-1β and IL-6 levels among smokers and never-smokers with and without prediabetes (controls). Ninety-five males (45 with prediabetes and 50 systemically healthy controls) were included. Twenty-seven controls and 29 patients with prediabetes were smokers. Periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment loss, and marginal bone loss) were measured, and the number of missing teeth were recorded. Fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded. Unstimulated whole saliva samples were collected, unstimulated whole salivary flow rate (UWSFR) was determined, and IL-1β and IL-6 levels were measured. P values prediabetes than controls. All patients with prediabetes were hyperglycemic. UWSFR was significantly higher among controls than among patients with prediabetes (P prediabetes. Among controls, periodontal parameters and whole salivary IL-1β and IL-6 levels were higher among smokers than never-smokers (P prediabetes, periodontal inflammation and whole salivary IL-1β and IL-6 levels were comparable between smokers and never-smokers.
Fujinaka, Hidetake; Takeshita, Toru; Sato, Hirayuki; Yamamoto, Tetsuji; Nakamura, Junji; Hase, Tadashi; Yamashita, Yoshihisa
More than 600 bacterial species have been identified in the oral cavity, but only a limited number of species show a strong association with periodontitis. The purpose of the present study was to provide a comprehensive outline of the microbiota in dental plaque related to periodontal status. Dental plaque from 90 subjects was sampled, and the subjects were clustered based on bacterial composition using the terminal restriction fragment length polymorphism of 16S rRNA genes. Here, we evaluated (1) periodontal clinical parameters between clusters; (2) the correlation of subgingival bacterial composition with supragingival bacterial composition; and (3) the association between bacterial interspecies in dental plaque using a graphical Gaussian model. Cluster 1 (C1) having high prevalence of pathogenic bacteria in subgingival plaque showed increasing values of the parameters. The values of the parameters in Cluster 2a (C2a) having high prevalence of non-pathogenic bacteria were markedly lower than those in C1. A cluster having low prevalence of non-pathogenic bacteria in supragingival plaque showed increasing values of the parameters. The bacterial patterns between subgingival plaque and supragingival plaque were significantly correlated. Chief pathogens, such as Porphyromonas gingivalis, formed a network with other pathogenic species in C1, whereas a network of non-pathogenic species, such as Rothia sp. and Lautropia sp., tended to compete with a network of pathogenic species in C2a. Periodontal status relates to non-pathogenic species as well as to pathogenic species, suggesting that the bacterial interspecies connection affects dental plaque virulence.
Full Text Available Background: Assess the prevalence of herpesviruses in healthy subjects, gingivitis, and chronic periodontitis patients, to assess the relationship between the prevalence of herpesviruses and periodontal clinical parameters, and to evaluate the effect of phase-I therapy on the level of viral detection. Materials and Methods: Hundred patients consisting of 20 healthy subjects, 40 gingivitis, and 40 chronic periodontitis were included in the study. Clinical parameters recorded included plaque index, gingival index, sulcus bleeding index, probing depth, and clinical attachment level. The gingivitis and chronic periodontitis patients received phase-I periodontal therapy including oral hygiene instructions, full mouth scaling for gingivitis patients and scaling and root planing for chronic periodontitis patients. Gingival crevicular fluid (GCF was collected, and the presence of herpes simplex virus-1 (HSV-1, HSV-2, cytomegalovirus, and Epstein–Barr virus (EBV was analyzed using polymerase chain reaction (PCR. Recording of periodontal parameters as well as GCF collection was performed at baseline and 6 weeks postphase-I therapy. Results: At baseline, the levels of HSV-1 and EBV detection were lower in healthy controls as compared to gingivitis (P < 0.05 and chronic periodontitis cases (P < 0.001. Phase-I therapy led to reduction in the amount of HSV-1 and EBV in gingivitis patients (P < 0.05 and for HSV-1, human cytomegalovirus and EBV in chronic periodontitis patients (P < 0.05 in comparison to baseline. The prevalence of EBV in chronic periodontitis patients was positively associated with increased gingival index, probing depth and loss of clinical attachment (P < 0.05. Conclusions: Higher prevalence of HSV-1 and EBV viruses in GCF of gingivitis and chronic periodontitis suggests a strong association between these viruses and periodontal diseases and periodontal therapy can lead to a reduction in herpesviruses at infected sites.
Martinez-Herrera, Mayte; Silvestre-Rangil, Javier
Background Obesity is a very prevalent chronic disease worldwide and has been suggested to increase susceptibility of periodontitis. The aim of this paper was to provide a systematic review of the association between obesity and periodontal disease, and to determine the possible mechanisms underlying in this relationship. Material and Methods A literature search was carried out in the databases PubMed-Medline and Embase. Controlled clinical trials and observational studies identifying periodontal and body composition parameters were selected. Each article was subjected to data extraction and quality assessment. Results A total of 284 articles were identified, of which 64 were preselected and 28 were finally included in the review. All the studies described an association between obesity and periodontal disease, except two articles that reported no such association. Obesity is characterized by a chronic subclinical inflammation that could exacerbate other chronic inflammatory disorders like as periodontitis. Conclusions The association between obesity and periodontitis was consistent with a compelling pattern of increased risk of periodontitis in overweight or obese individuals. Although the underlying pathophysiological mechanism remains unclear, it has been pointed out that the development of insulin resistance as a consequence of a chronic inflammatory state and oxidative stress could be implicated in the association between obesity and periodontitis. Further prospective longitudinal studies are needed to define the magnitude of this association and to elucidate the causal biological mechanisms. Key words:Periodontal disease, periodontitis, periodontal infection, obesity, abdominal obesity. PMID:29053651
the frequency of periodontitis among pregnant women, ranging from 35% to ... Department of Preventive Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. Abstract .... by the stress and anxiety during pregnancy, which may lead to a neglect of .... Khader YA, Al‑shishani L, Obeidat B, Khassawneh M,.
Preferansow, Ewa; Sawczuk, Beata; Gołębiewska, Maria; Górska, Maria
Decompensated diabetes is a major risk factor in the development of periodontal diseases. This leads to disturbances of carbohydrates, protein, and fat and morphological changes in many organs. These changes also apply to the masticatory system, especially periodontal tissues. The aim of the study was to assess the periodontal status and periodontal treatment needs in patients with non-controlled diabetes type 1 and type 2 (HbA1c > 7%), and to compare the results with the data obtained in a group of generally healthy patients. The study included 275 patients, 155 of them were patients with non-controlled diabetes during hospitalisation (study group), while 120 subjects constituted the control group of healthy people. The study excluded edentulous people. CPITN index (according to Ainamo et al.) was used to assess the periodontal state and periodontal treatment needs. The average level of glycated haemoglobin HbA1C among patients in the study group was 9.43% in women and slightly more at 9.57% in men. The periodontal status in healthy people was satisfactory, dominated by the maximum values of CPITN = 0, CPITN = 1, and CPITN = 2. The study group more frequently revealed the maximum values of CPITN = 3 and CPITN = 4. This shows the more advanced periodontal changes in this group. Due to the bad condition of the periodontium, the periodontal treatment needs proved to be far greater in the study group and related primarily to comprehensive specialist treatment (TN3). Decompensated diabetes may be an important cause of changes in periodontal tissues and may cause a significant loss of masticatory function in patients.
S A Jacob Raja
Full Text Available Aim: After the introduction of the multidrug therapy, the incidence of leprosy is decreasing every year. However, periodontal complaints are commonly seen in these patients due to compromised immunity and impaired oral hygiene. The aim of the present study is to assess the oral and periodontal status of the leprosy patients in Dindigul district. Materials and Methods: The study was conducted on 62 patients treated in a leprosy center at Dindigul district. Among these, 22 (35.5% were female patients and 40 were male patients (64.5%. Age ranges between 40 and 70 with the mean age being 52. Facial changes, periodontal status, dental caries, attrition, tooth loss, plaque index (Silness and Loe, and calculus component of oral hygiene index-simplified were assessed. Results: Majority of the patients presented with loss of eyebrows and eyelashes, saddle nose, ocular involvement, and leonine facies. Gingival recession (54.8% was a predominant finding followed by tooth loss (69.5%, mobility (60.86%, attrition (56%, chronic pulpitis (34.7%, and dental caries (26%. Most of the patients had severe periodontitis. Conclusions: Compromised immunity and altered autonomy pave way for many dental complaints such as periodontitis and deposits in tooth with poor oral hygiene. Awareness about the oral health problems and reinforcement of oral hygiene should be insisted to the leprosy patients to prevent further morbidity.
Cavalcanti, Alessandro L; Ramos, Ianny A; Cardoso, Andreia M R; Fernandes, Liege Helena F; Aragão, Amanda S; Santos, Fábio G; Aguiar, Yêska P C; Carvalho, Danielle F; Medeiros, Carla C M; De S C Soares, Renata; Castro, Ricardo D
Obesity is a serious problem of public health and affects all socio-economic groups, irrespective of age, sex or ethnicity. The aim of this study was to evaluate the association between periodontal condition and nutritional status of adolescents. This was a cross-sectional study using a probability cluster sampling, and the sample was defined by statistical criterion, consisting of 559 students aged 15-19 yr enrolled in public schools of adolescents of Campina Grande, PB, Brazil in 2012. Socioeconomic characteristics were analyzed, as well as self-reported general and oral health, anthropometric data and periodontal condition (CPI and OHI-S). Descriptive and analytical analysis from bivariate and multivariate Poisson regression analysis with 5% significance level was performed. Of the 559 adolescents, 18.6% were overweight and 98.4% had some form of periodontal changes such as: bleeding (34.3%), calculus (38.8%), shallow pocket (22.9%) and deep pocket (2.3%). There was association between presence of periodontal changes with obesity ( P periodontal changes and obesity status in adolescents was indicated.
Rai, Narendra Parkash; Kumar, Prafful; Mustafa, Shabil M; Divakar, Darshan D; Kheraif, Abdulaziz Al; Ramakrishnaiah, Ravikumar; Vellapally, Sajith; Dalati, M H N; Parine, Narashimha Reddy; Anil, Sukumaran
Oral lichen planus (OLP) is a common chronic mucocutaneous disease mostly seen in middle aged and elderly females. Oral lichen planus can occur in different oral sites such as gingiva, labial, buccal mucosa and on the tongue. And can have an indirect effect on initiating periodontitis. The purpose of the study was to evaluate the periodontal status of OLP patients and compare it with that of healthy controls. The presence of erosive lesions among gingival tissues makes oral hygiene procedures difficult to perform for obvious reasons. Plaque control and rigorous oral hygiene are primary requisites for the treatment of any oro-mucosal disease. Thirty patients with the erosive and reticular form of OLP as a study group and 30 healthy subjects as a control group were selected. The periodontal status of all subjects including gingival index (GI), Russell's periodontal index (PI) and bleeding on probing (BOP) were evaluated in both groups. Finally, the data was analyzed by a paired t-test using SPSS software v. 22. The mean values of GI, PI and BOP were observed to be higher in the study group compared to the control group, and this was statistically significant (p oral lichen planus patients with larger sample size, and careful follow-up of these will assure an increase in the quality of life of these patients. The patient should be informed regarding the risk of periodontal problems in OLP and should be advised to have regular dental checkups to avoid a worsening of the conditio.
P I Moroz
Full Text Available Aim. To study the characteristic differences in the clinical course of chronic generalized periodontitis in the presence of periapical infection focus and the principles of combined treatment of endodontium and periodontium. Methods. A clinical and X-ray examination of 1525 patients of different age groups was performed. As a result, a clinical group of 68 patients with chronic generalized moderate and severe periodontitis was formed, who were divided into two groups depending on the presence or absence of periapical destruction. In group 1, 32 patients with the presence of chronic generalized periodontitis and signs of chronic apical periodontitis were united. Group 2 included 36 patients with chronic generalized periodontitis and no periapical infection and damage. The index estimation of the periodontal tissues state in the dynamics of combined endodontic and periodontal treatment was performed. Results. The initial task of treating endodontic periodontal lesions, regardless of the localization of the primary lesion focus, is the elimination or reversal of chronic periapical inflammatory processes of the teeth. The proposed monitoring system in the course of treatment and dynamic follow-up for 18 months for patients suffering from endodontic periodontal lesions using clinical and radiological methods of examination involves: (1 interim epicrisis or conclusion about negative or positive compliance 1-2 months after the completion of endodontic treatment and hygiene procedures; (2 periodontal treatment (according to indications with the assessment of clinical efficacy 6 and 12 months after the start of treatment; (3 epicrisis after 18 months. Conclusion. The use of proposed concept of complex treatment of endodontic-periodontal lesions, monitoring system in the course of dental therapeutic and preventive measures and dynamic follow-up for 18 months allows achieving positive compliance in 85% of patients according to the clinical examination and
Caúla, André Luis; Lira-Junior, Ronaldo; Tinoco, Eduardo Muniz Barretto; Fischer, Ricardo Guimarães
To determine the influence of non-surgical mechanical periodontal treatment on inflammatory markers related to risk for cardiovascular disease. A total of 64 patients with severe chronic periodontitis was randomly subjected to immediately periodontal treatment (test group, n = 32) or delayed periodontal treatment, without treatment during the study period (control group, n = 32). Clinical periodontal and laboratory examinations were performed at baseline (T0), 2 months (T2), and 6 months (T6) after the initial examinations (Control group) or completion of periodontal treatment (Test group). After 2 months of periodontal treatment there was a significant reduction of erythrocyte sedimentation rate (ESR) and triglycerides (p = 0.002, p = 0.004, respectively) in the test group. Median values of C-reactive protein, ESR, total cholesterol, and triglycerides were reduced after 6 month of periodontal treatment in the test group (p periodontal treatment was effective in reducing the levels of systemic inflammation markers and improved the lipid profile in subjects with severe chronic periodontitis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Konoplya, A I; Goldobin, D D; Loktionov, A L
The aim of the study was to define local immune and oxidative changes in patients with exacerbated chronic apical periodontitis. These changes were assessed in saliva of 67 patients with the mean age of 31±2.5 before and after treatment. The study revealed disturbances in cytokines and complement system balance and activation of lipids peroxidation. Combination of Gepon or Vobenzim with Essentiale forte H and Kaskatol proved to be the most effective for correction of this imbalance.
Shin, Daniel; Hamada, Yusuke; John, Vanchit
Currently, the protocol for treating periodontitis follows a standardized and straightforward algorithm: 1) review and reinforce oral hygiene; 2) perform scaling and root planing; 3) proceed to periodontal surgery if the disease process has not been arrested; then 4) enroll the patient in a customized periodontal maintenance recall program to maintain the health of the reduced periodontium. Multiple longitudinal studies have demonstrated that the aforementioned treatment regimen can arrest the progression of periodontitis and can increase the likelihood of tooth retention and periodontal stability.
Full Text Available Aims: The aim of this study was to investigate the effect of in vitro fertilization (IVF treatment on different parameters of periodontal status. Settings and Design: This was a clinical observational study. Materials and Methods: One hundred and seventy-nine patients who underwent IVF treatment according to the standard IVF protocols were examined using the simplified oral hygiene, gingival index (GI, sulcus bleeding index (SBI, and determining the clinical attachment loss (CAL. A full-mouth examination except for the third molars was performed at 4 sites per tooth (mesiobuccal, distobuccal, mesiolingual, and distolingual. Periodontal evaluation was performed before infertility treatment, at the end of infertility treatment, and 14 days after embryo transfer. Statistical Analysis: The Kruskal–Wallis or Fisher's tests were used to compare the median or mean values as appropriate. Results: The oral hygiene index simplified was 0.49, 0.32, and 0.37 at pretreatment, on the day of human chorionic gonadotropin (HCG trigger, and on the day of the pregnancy test, respectively. The GI showed significant differences before and after treatment. The mean GI was 0.13 at pretreatment compared to 0.51 and 0.53 on the days of HCG trigger and of the pregnancy test, respectively. The same trend was seen for SBI. There were no differences in CAL among the three examinations. There was no difference between the two groups except for GI (0.71 vs. 0.48 for a positive pregnancy test vs. nonpregnancy, respectively. Conclusions: IVF medications and a superphysiological condition affect oral health, particularly gingival and periodontal statuses, and likely complicate the relationship between infertility, sex hormones, and infertility management. Larg-scale studies are needed to confirm the effect of such treatment on oral health.
The objective of this research was to evaluate dental status and identify oral health influencing factors for the purpose of periodontal disease prophylaxis in dogs. The research took place between March 2015 - October 2015 at LSMU Dr. Leono Kriauceliuno smalll animal clinic and other, named “X”, “Y”, “Z”. Measures used in research: questionnaire, examination protocol, dental plaque disclosing solution „REVEAL“. The dogs dental status in dogs was examined visually, by OHI, QHT, MRCI, MGI indi...
Wang, Yu; Jin, Ying; Wang, Yi-Yue; Xu, Dan-Ni; Lin, Xiao-Ping
To investigate the influence of IL-35 in the pathogenesis of periodontitis and oral lichen planus, and the correlation between periodontitis and oral lichen planus patients. The gingival crevicular fluid（GCF） and serum were collected from patients with oral lichen planus (n=20), periodontitis (n=20), periodontitis and oral lichen planus (n=20) and healthy controls (n=12). The patients' basic information, probing depth, clinical attachment loss, gingival index, sulcus bleeding index were measured and collected. The expression of IL-35 in GCF and serum was detected by ELISA. SPSS19.0 software package was used for statistical analysis. The concentration of IL-35 in patients with periodontitis and oral lichen planus was significantly higher than that of other groups(Poral lichen planus may increase the concentration of IL-35 both in serum and GCF. The expression of IL-35 was positively correlated with periodontitis and oral lichen planus.
Ghezzi, Carlo; Virzì, Mauro; Schupbach, Peter; Broccaioli, Alessandro; Simion, Massimo
The aim of this case report is to histologically evaluate periapical healing after combined endodontic-periodontic treatment. A maxillary left central incisor was treated with conventional endodontic therapy, followed by periodontal surgery. The facial bony defect was filled with a mixture of autologous bone and Bio-Oss. A resorbable membrane was used. Histology showed the presence of new cementum, ligament, and bone around the apex of the treated tooth. This finding was clinically associated with minimal residual probing depth and maximum attachment gain. This histologic report demonstrates the possibility of true regeneration in a case of severe periodontal attachment loss resulting from an endodontic-periodontic lesion.
Full Text Available Abstract Background Information on the socio-behavioral distribution of periodontal status and tooth loss in pregnancy emanating from sub Saharan Africa is sparse. This study examined periodontal status and tooth loss in pregnant Ugandan women and assessed the relationship with socio-demographics factors, parity, dental care and oral hygiene. Methods Mothers were participants of a multicentre cluster-randomized behavioral intervention study (PROMISE-EBF Safety and Efficacy of Exclusive Breast feeding Promotion in the Era of HIV in Sub-Saharan Africa. In Uganda, these were pregnant women resident in Mbale district, recruited into the PROMISE EBF study between January 2006 and June 2008. A total of 886 women were eligible to participate of whom information became available for 877 (participation rate 98.9%, mean age 25.6 women who participated in the recruitment interview and 713 (mean age 25.5 women who got a clinical oral examination. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN. Results The prevalence of tooth loss was 35.7%, 0.6% presented with pockets shallow pockets (4–5 mm, whereas 3.3% and 63.4% displayed bleeding and calculus, respectively. A total of 32.7% were without any sign of periodontal disease. Binary logistic regression analyses revealed that older women, women from larger households and those presenting with microbial plaque were respectively, 3.4, 1.4 and 2.5 times more likely to have CPI score >0. Rural (OR = 0.9, nulliparous (OR = 0.4 and women who never visited a dentist (OR = 0.04 were less likely, whereas women from larger households (OR = 1.5 were more likely to have lost at least one tooth. Conclusion The results revealed moderate prevalence of bleeding and tooth loss, high prevalence of calculus, low frequency of pockets 4–5 mm. Disparity in pregnant women's oral health related to parity suggests that education of maternity care providers concerning oral health in
Mumghamba, E G S; Manji, K P; Michael, J
To determine the oral hygiene practices, periodontal conditions, dentition status and self-reported bad mouth breath (S-BMB) among young mothers. This was a cross-sectional descriptive study conducted at Muhimbili National Hospital, Dar es Salaam, Tanzania. A total of 302 postpartum mothers, aged 14-44 years, were interviewed on oral hygiene practices and S-BMB using structured questionnaire. Oral hygiene, dentition and periodontal status were assessed using the Community Periodontal Index probe and gingival recessions (GR) using Williams Periodontal probe. Tooth brushing practice was 99%; tongue brushing (95%), plastic toothbrush users (96%), chewing stick (1%), wooden toothpicks (76%), dental floss (oral health promotion and periodontal therapy are recommended. This study provides baseline information on oral health status and the complaint on bad mouth breath which necessitates in the future need for objective assessment, diagnosis and management of bad mouth breath for enhanced social and professional interaction without embarrassment.
Full Text Available ABSTRACT Introduction: Periodontitis is an inflammatory disease that attacks the periodontal tissue comprises the gingiva, periodontal ligament, cementum and alveolar bone caused mainly by plaque bacteriophage or other specific dominant type of bacteria. The purpose of this study was to determine the therapeutic effect of clinical application of mangosteen peel extract gel as adjunctive therapy scaling and root planing in patients with chronic periodontitis. This research was expected to developed new treatment in the field of dentistry, particularly in periodontics, which can be used as supporting material for the treatment of chronic periodontitis. Methods: Quasi-experimental research, split mouth, with as many as 14 chronic periodontitis patients. Mangosteen rind was prepared to be formed into extract gel, dried at room temperature, then the dried samples were macerated by using ethanol, then evaporated and decanted for 3 days until obtained condensed extract. The samples were patients with chronic periodontitis in at least 2 teeth with pockets ≥ 5 mm. Clinical parameters of pocket depth, gingival bleeding, and clinical epithelial attachment level were measured at baseline and 1 month after treatment. Analysis of data using the t-test. Results: The comparison of average gap ratio of pockets depth, gingival index, gingival bleeding and epithelium attachment levels, before and after treatment showed significant differences, such as in the test and control sides. Conclusion: The mangosteen rind gel as adjunctive therapy for scaling and root planing is able to reduce pockets depth, gingival index, and gingival bleeding, and improve clinical epithelial attachment.
Fátima de Lourdes Bolzan Pion
Full Text Available Este estudo transversal determinou a condição periodontal e sua associação com fatores de risco em uma amostra de conveniência de 588 indivíduos atendidos na Universidade Guarulhos, entre 1999 e 2003. Características geográficas, demográficas e comportamentais, parâmetros bucais e periodontais foram tabulados e analisados em SPSS 11.5. Os testes t Student e Qui-quadrado determinaram a significância (p 3,0 mm com fatores de risco (por exemplo: idade, sexo, fumo e comportamentais. A análise de regressão linear multivariada determinou a associação entre exposição aos fatores de risco e doença. A população estudada com média de idade de 36,1 ± 14,5 anos foi composta principalmente por mulheres (72,1% e minoria fumante (13,3%. Os valores médios de dentes ausentes e profundidade de sondagem (PS foram de 5,7 ± 5,9 dentes e 2,2 ± 0,8 mm, respectivamente. A prevalência de PS > 3,0mm (valor referência foi de 13,5%; e a distribuição regional da população de acordo com este critério foi: centro, 2,0%; zona oeste, 17,8%; zona leste, 38,0%; zona sul, 6,7% ; e zona norte, 35,5%. As freqüências médias dos índices de placa e sangramento a sondagem foram de 75,3% e 34,1%, respectivamente. A condição periodontal exibiu correlação com idade, fumo e presença de biofilme supragengival. Exceto pela última, estas variáveis também mostraram associação pela análise de regressão multivariada. A população estudada exibiu elevado grau de inflamação gengival e baixo percentual de bolsas periodontais, estando a condição periodontal associada à idade e ao hábito de fumar.This cross-sectional study determined the periodontal status and its association with risk factors in a convenience sample of 588 subjects seen at the dental clinic of Guarulhos University from 1999 to 2003. To reach the study objectives, geographic, demographic and behavioral characteristics, as well as, oral and periodontal parameters were tabulated and
Pralhad, Swati; Thomas, Betsy; Kushtagi, Pralhad
Periodontal disease is thought to be associated with increased risk of systemic diseases and adverse pregnancy outcomes, including pregnancy hypertension (PH). The aim of the present study is to find the prevalence of periodontal disease in females with PH in a rural-based medical institute. The present case control study was performed with 200 females, 100 with PH and 100 without PH. Antenatal periodontal screening was performed within 72 hours of their hospital admission for delivery. The periodontal parameters assessed were oral hygiene index-simplified, gingival index, mean probing depth, and loss of attachment. Prevalence of periodontal disease was 65.5% and was significantly higher (P periodontal disease and PH on bivariate multiple logistic regression analysis. Nulliparous females were at higher odds to develop periodontal disease and PH (odds ratio = 1.7; 95% CI = 0.5 to 6.1). As the severity of periodontal disease increased from moderate to severe, the severity of hypertension also increased (r(2) = 0.8 and 0.5 for moderate and severe periodontal disease, respectively). Periodontal disease is more prevalent in females with PH.
Full Text Available The present study aims to determine the level of oral hygiene, periodontal status and treatment needs, indicating if there are differences between men and women, in 12-year-old students from Castro, Los Lagos region, during March and April of 2014. A cross-sectional study was carried out. A total of 242 12-year-old students from municipal and subsidized private schools in Castro were selected through a stratified random sample representative of each school. Students were evaluated by a calibrated examiner to determine the Simplified Oral Hygiene Index (OHI-S and the Community Periodontal Index of Treatment Needs (CPITN. Data were transferred to a Microsoft Excel spreadsheet and statistically analyzed to calculate the amount and percentage of the variables. Mann-Whitney U-test was used for comparison between genders. From the total, 59.5% of the students have regular hygiene. Also, 86.4% of the assessed adolescents have gingivitis and 13.6% of them have periodontitis. The periodontal treatment need indicates that 58% of the students require oral hygiene instructions and scaling. No statistically significant differences were found for gender. There is a higher prevalence of periodontal diseases associated with regular oral hygiene than the regional and national reference in 12-year-old adolescents in Castro. Then, it is necessary to teach and promote specific public health strategies based on epidemiological data
Evaluation of association between psychological stress and serum cortisol levels in patients with chronic periodontitis - Estimation of relationship between psychological stress and periodontal status.
Jaiswal, Roshni; Shenoy, Nina; Thomas, Biju
Stress classically describes a destructive notion that can have a bearing on one's physical and mental health. It may also add to an increased propensity to periodontal disease. To investigate the association between psychological stress and serum cortisol levels in patients with chronic periodontitis. Forty subjects were recruited from the outpatient department at the Department of Periodontics, from a college in Mangalore, divided into two groups, i.e., twenty as healthy controls and twenty were stressed subjects with chronic periodontitis. The clinical examination included the assessment of probing pocket depth, clinical attachment level and oral hygiene index-simplified. Serum cortisol levels were estimated biochemically using the enzyme-linked immunosorbent assay method and the estimation of psychological stress was done by a questionnaire. Descriptive statistics such as mean and standard deviation was used to review the collected data. Independent sample t -test was used for comparison and correlation was evaluation using Pearson's correlation test. As per our observation, high serum cortisol levels and psychological stress are positively linked with chronic periodontitis establishing a risk profile showing a significant correlation ( P periodontitis patients as it should be considered as an imperative risk factor for periodontal disease.
Evaluation of association between psychological stress and serum cortisol levels in patients with chronic periodontitis - Estimation of relationship between psychological stress and periodontal status
Full Text Available Background: Stress classically describes a destructive notion that can have a bearing on one's physical and mental health. It may also add to an increased propensity to periodontal disease. Aim: To investigate the association between psychological stress and serum cortisol levels in patients with chronic periodontitis. Materials and Methods: Forty subjects were recruited from the outpatient department at the Department of Periodontics, from a college in Mangalore, divided into two groups, i.e., twenty as healthy controls and twenty were stressed subjects with chronic periodontitis. The clinical examination included the assessment of probing pocket depth, clinical attachment level and oral hygiene index-simplified. Serum cortisol levels were estimated biochemically using the enzyme-linked immunosorbent assay method and the estimation of psychological stress was done by a questionnaire. Results: Descriptive statistics such as mean and standard deviation was used to review the collected data. Independent sample t-test was used for comparison and correlation was evaluation using Pearson's correlation test. As per our observation, high serum cortisol levels and psychological stress are positively linked with chronic periodontitis establishing a risk profile showing a significant correlation (P < 0.05. Conclusion: Routine serum cortisol assessment may be a reasonable and a valuable investigative indicator to rule out stress in periodontitis patients as it should be considered as an imperative risk factor for periodontal disease.
Pillusky, Fernanda Maia; Barcelos, Raquel Cristine Silva; Vey, Luciana Taschetto; Barin, Luisa Machado; de Mello Palma, Victor; Maciel, Roberto Marinho; Kantorski, Karla Zanini; Bürger, Marilise Escobar; Danesi, Cristiane Cademartori
This study evaluated the antimicrobial photodynamic therapy (aPDT) effects using the methylene blue (MB) in ethanol 20% on systemic oxidative status and collagen content from gingiva of rats with periodontitis. Rats were divided into five experimental groups: NC (negative control; no periodontitis); PC (positive control; periodontitis without any treatment); SRP (periodontitis and scaling and root planing), aPDT I (periodontitis and SRP+aPDT+MB solubilized in water), and aPDT II (periodontitis and SRP+aPDT+MB solubilized in ethanol 20%). After 7days of removal of the ligature, the periodontal treatments were performed. At 7/15/30days, gingival tissue was removed for morphometric analysis. The erythrocytes were used to evaluate systemic oxidative status. PC group showed higher lipoperoxidation levels at 7/15/30days. aPDT indicated a protective influence in erythrocytes at 15days observed by the elevation in levels of systemic antioxidant defense. aPDT II group was the only one that restored the total collagen area in 15days, and recovered the type I collagen area at the same time point. aPDT as an adjunct to the SRP can induce the systemic protective response against oxidative stress periodontitis-induced and recover the gingival collagen, thus promoting the healing periodontal, particularly when the MB is dissolved in ethanol 20%. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available Aim: This study was conducted to analyze and compare the oral hygiene and periodontal status in patients with clefts of palate (CP and patients with unilateral cleft lip, palate and alveolus (UCLPA. Materials and Methods: The study group consisted of 120 cleft patients. Subjects were divided into two groups of 60 each. Group I - patients with UCLPA and Group II - patients with CP. For comparison, all the four quadrants were defined, Q1-right upper quadrant, Q2-left upper quadrant, Q3-left lower quadrant and Q4-right lower quadrant, in both groups and the following parameters were recorded: Plaque Index (PI, Silness and Loe, Sulcus Bleeding Index (SBI, Muhlemann and Son, Probing Pocket Depth (PPD, Clinical Attachment Level (CAL, Mobility Index (Miller and Radiographic Amount of Bone Loss. Results: The periodontal destruction was seen to be higher in UCLPA patients compared with CP patients. The poor oral hygiene status, as indicated by higher values of PI, and the periodontal status, evaluated by SBI, PPD, CAL, mobility and Radiographic Amount of Bone Loss, were higher in patients with UCLPA than in patients with CP. Conclusion: In this study, patients with cleft lip, palate and alveolus had poor oral hygiene and periodontal status compared with patients with cleft palate.
Sales-Peres, Sílvia Helena de Carvalho; de Moura-Grec, Patrícia Garcia; Yamashita, Joselene Martinelli; Torres, Elza Araujo; Dionísio, Thiago José; Leite, Celso Vieira de Souza; Sales-Peres, Arsenio; Ceneviva, Reginaldo
The aim this study was to evaluate the influence of gastric bypass surgery (GBS) on periodontal disease and quantify the periodontopathogenic bacteria in patients undergoing this surgery. This prospective study was composed of 50 patients who underwent bariatric surgery and the data collection was performed in three periods pre-operative, 6 (6M) and 12 months (12 M) postoperative. The oral clinical examination to assess periodontal disease; gingival fluid sample collection for quantification of the periodontopathogenic bacteria Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia using q-PCR; body mass index (BMI) and for collection of the individual's health-related data from medical files. There was a significant reduction in serum C-reactive protein (CRP) and glucose levels after surgery. The mean probing pocket depth (PPD) and clinical attachment level (CAL) increased significantly in the postoperative period of 6 months (p = 0.001). In the same period, the amount of P. gingivalis increased (p = 0.028) and the other bacteria decreased slightly (p > 0.050). In the presence of P. gingivalis, T. forsythia, T. denticola and P. intermedia, a poor periodontal condition was observed. The periodontal disease increased in severity and P. gingivalis increased after GBS. A systemic inflammation resolution due to bariatric surgery in obese subjects does not seem to affect the course of periodontal disease. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Süleyman Emre MESELİ
Full Text Available Purpose: The aim of this study was to evaluate the relationship between initial probing depth (IPD and changes in clinical parameters following non-surgical periodontal treatment (NPT in chronic periodontitis patients. Subjects and Methods: A total of 1672 periodontal pockets having 3mm≤IPD≤9mm of depth in 15 chronic periodontitis patients were included. NPT consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD, clinical attachment level, gingival recessions (GR were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth. Results: Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p<0.001. Attachment gains (AG were significant in all single-rooted teeth (p<0.001 again except those having IPD=3mm. However, AG was significant in multi-rooted teeth having only 7mm≤IPD≤9mm (p<0.05. Positive correlations were observed between IPD and PD reduction, GR increase and AG in single-rooted teeth (p<0.001. Furthermore, positive correlations were found between IPD and PD reduction and GR increase in multi-rooted teeth (p<0.001, but there was no correlation between IPD and AG. Conclusion: NPT may lead to positive association between IPD and PD reduction as well as GR increase, which is independent from tooth root anatomy.
Hada, Divya Singh; Garg, Subhash; Ramteke, Girish B; Ratre, Madhu Singh
Various studies have shown periodontal disease is one of the risk factors for coronary heart disease (CHD), and periodontal treatment of patients with CHD has also been correlated with reduction in systemic markers of CHD. The aim of this study is to evaluate the effect of non-surgical periodontal treatment (NSPT) on the cardiovascular clinical and biochemical status of patients with CHD. Seventy known patients with CHD were allocated randomly to either a control group (C; no periodontal therapy) (n = 35) or an experimental group (E; NSPT in the form of scaling and root planing [SRP]) (n = 35). Cardiovascular status was assessed using clinical parameters such as pulse, respiratory rate, blood pressure (BP), and biochemical parameters, such as high-sensitivity C-reactive protein (hsCRP), lipid profile, and white blood cell (WBC) count, at baseline and 1, 3, and 6 months. Intergroup and intragroup comparisons were performed using Student t test, and P C, n = 25; group E, n = 30). Highly statistically significant reduction was observed in systolic BP (7.1 mm Hg) and very-low-density lipoproteins (VLDLs; 5.16 mg/dL) in group E. Changes were also observed in other cardiovascular biochemical and clinical parameters but were not statistically significant. NSPT (in the form of SRP) positively affects limited cardiovascular (clinical and biochemical) status of patients with CHD. Reduction in triglyceride, VLDL, total WBC, lymphocyte, and neutrophil counts and increase in hsCRP, total cholesterol, high-density lipoprotein, and low-density lipoprotein levels were observed. Highly significant reduction in VLDL cholesterol levels and systolic BP was observed among the various parameters measured.
Full Text Available The research goal is to determine risk factors of periodontal disease development, psychophysiological personal types and their interrelations in clinically healthy persons. 47 first-year cadets of St.-Petersburg Military School of radio electronics have been examined. This group of respondents has been chosen by presence of such social stressor as change of place of living (97,9% cadets have arrived in St.-Petersburg from other cities and republics of the Russian Federation and strict disciplinary conditions. The research has revealed a low level of oral hygiene, cases of mild gingivitis in most respondents. The general mental state of group under study is characterized by raised level of personal anxiety and low indices of reactive anxiety. The examined group has demonstrated anxiety, tension, indecision and lowered stress stability. Clinically healthy persons are more liable to develop inflammatory and inflammatory-destructive periodontal diseases. It was possible to determine psychophysiological features correlated with physiological parameters of risk degree of periodontal diseases. It may have a great significance in defining of periodontal disease etiology and pathogenesis
Tözüm, Tolga Fikret; Berker, Ezel; Ersoy, Fügen; Tezcan, Iihan; Sanal, Ozden
Congenital neutropenia is characterized by a severe reduction in absolute neutrophil counts, resulting in an almost total absence of neutrophils. It is well known that severe neutropenia affects periodontal status. Oral manifestations include ulcerations, gingival desquamation, gingival inflammation, attachment loss, and alveolar bone loss which may result in tooth loss. Treatment with granulocyte-colony stimulating factor (G-CSF) may improve this periodontal condition. This article reports the relationship between periodontal disease status and peripheral neutrophil levels in two consanguineous siblings with severe congenital neutropenia who did not receive routine G-CSF for 2 years prior to examination. Both siblings were given scaling, root planing, and periodontal prophylaxis in regular follow-up visits. This report demonstrates that periodontal therapy supported by adequate oral hygiene may result in restoration of neutrophil counts in siblings with congenital neutropenia.
Göhler, André; Hetzer, Adrian; Holtfreter, Birte; Geisel, Marie Henrike; Schmidt, Carsten Oliver; Steinmetz, Ivo; Kocher, Thomas
Periodontitis is a multi-microbial oral infection with high prevalence among adults. Putative oral pathogens are commonly found in periodontally diseased individuals. However, these organisms can be also detected in the oral cavity of healthy subjects. This leads to the hypothesis, that alterations in the proportion of these organisms relative to the total amount of oral microorganisms, namely their abundance, rather than their simple presence might be important in the transition from health to disease. Therefore, we developed a quantitative molecular method to determine the abundance of various oral microorganisms and the portion of bacterial and archaeal nucleic acid relative to the total nucleic acid extracted from individual samples. We applied quantitative real-time PCRs targeting single-copy genes of periodontal bacteria and 16S-rRNA genes of Bacteria and Archaea. Testing tongue scrapings of 88 matched pairs of periodontally diseased and healthy subjects revealed a significantly higher abundance of P. gingivalis and a higher total bacterial abundance in diseased subjects. In fully adjusted models the risk of being periodontally diseased was significantly higher in subjects with high P. gingivalis and total bacterial abundance. Interestingly, we found that moderate abundances of A. actinomycetemcomitans were associated with reduced risk for periodontal disease compared to subjects with low abundances, whereas for high abundances, this protective effect leveled off. Moderate archaeal abundances were health associated compared to subjects with low abundances. In conclusion, our methodological approach unraveled associations of the oral flora with periodontal disease, which would have gone undetected if only qualitative data had been determined. PMID:25029268
Desvarieux, Moïse; Demmer, Ryan T.; Jacobs, David R.; Papapanou, Panos N.; Sacco, Ralph L.; Rundek, Tatjana
Background No prospective studies exist on the relationship between change in periodontal clinical and microbiological status and progression of carotid atherosclerosis. Methods and Results The Oral Infections and Vascular Disease Epidemiology Study examined 420 participants at baseline (68±8 years old) and follow‐up. Over a 3‐year median follow‐up time, clinical probing depth (PD) measurements were made at 75 766 periodontal sites, and 5008 subgingival samples were collected from dentate participants (average of 7 samples/subject per visit over 2 visits) and quantitatively assessed for 11 known periodontal bacterial species by DNA‐DNA checkerboard hybridization. Common carotid artery intima‐medial thickness (CCA‐IMT) was measured using high‐resolution ultrasound. In 2 separate analyses, change in periodontal status (follow‐up to baseline), defined as (1) longitudinal change in the extent of sites with a ≥3‐mm probing depth (Δ%PD≥3) and (2) longitudinal change in the relative predominance of bacteria causative of periodontal disease over other bacteria in the subgingival plaque (Δetiologic dominance), was regressed on longitudinal CCA‐IMT progression adjusting for age, sex, race/ethnicity, diabetes, smoking status, education, body mass index, systolic blood pressure, and low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol. Mean (SE) CCA‐IMT increased during follow‐up by 0.139±0.008 mm. Longitudinal IMT progression attenuated with improvement in clinical or microbial periodontal status. Mean CCA‐IMT progression varied inversely across quartiles of longitudinal improvement in clinical periodontal status (Δ%PD≥3) by 0.18 (0.02), 0.16 (0.01), 0.14 (0.01), and 0.07 (0.01) mm (P for trendperiodontal microbial status (Δetiologic dominance). Conclusion Longitudinal improvement in clinical and microbial periodontal status is related to a decreased rate of carotid artery IMT progression at 3‐year average
Aren, Gamze; Sepet, Elif; Ozdemir, Didem; Dinççağ, Nevin; Güvener, Bora; Firatli, Erhan
The aim of this study was to determine whether detectable periodontal destruction and alterations in the salivary status were present with duration of diabetes in children with type 1 insulin-dependent diabetes mellitus (type 1 DM) as compared to healthy controls. Sixteen newly diagnosed children with DM (group 1), 16 children with type 1 DM of long duration (group 2), and 16 healthy children (group 3) participated in the study. Periodontal health was assessed by plaque index, gingival index, bleeding on probing, and periodontal probing depths. The flow rate, pH, buffering capacity, and peroxidase activities of stimulated saliva were determined. The data were analyzed by Kruskall-Wallis, Student t test, and Pearson's correlation analysis. The mean values for fasting blood glucose levels for the diabetic groups were significantly higher than for the controls. The mean values for salivary buffering capacities and salivary pH from the diabetic groups were significantly lower than for the controls. The plaque index values for the diabetic groups were significantly higher than for the controls. The mean gingival index value for group 1 was significantly lower than for group 2. The mean periodontal probing depths for group 1 were similar to those of the non-DM controls, but the mean periodontal probing depths for group 2 were significantly greater than for both the non-DM controls and group 1. Group 1 had significantly greater bleeding on probing scores than did the other groups (P diabetic subjects affects the periodontal probing depths, salivary pH, buffering capacity, and peroxidase activity.
Yan, Ying; Xiang, Xue-Rong; Wang, Chun; Ye, Guo; Fan, Xiao-Ping
To explore the clinical significance of calcitonin gene-related peptide (CGRP) levels in patients with chronic periodontitis before and after treatment, and to detect the calcitonin gene-related peptide content in human venous blood. Thirty healthy controls and thirty patients with mild, moderate, severe periodontitis were enrolled from August 2014 to June 2015.CGRP level in the patients' peripheral blood was detected by ELISA. Three months after periodontal treatment, CGRP level in mild, moderate, severe periodontitis patients' peripheral blood was re-examined by ELISA. Then the correlation between calcitonin gene-related peptide and inflammation of chronic periodontitis was analyzed with SPSS 22.0 software package. The content of CGRP in healthy controls was significantly higher than that in patients with periodontitis. With the aggravation of periodontal inflammation, blood level of CGRP decreased gradually, and the lowest was in patients with severe periodontitis (Pperiodontal treatment, CGRP content was significantly higher compared with that before treatment (Pperiodontitis (P>0.05). The level of CGRP in venous blood decreased with the increasing severity of chronic periodontitis, and CGRP was negatively correlated with the degree of inflammation of chronic periodontitis. CGRP may be involved in the occurrence and development of chronic periodontitis. CGRP content in serum of patients with chronic periodontitis after treatment was significantly increased, CGRP may be used as the basis for clinical detection of chronic periodontitis.
Estela Santos Gusmão
Conclusion: Taking into consideration the method employed and the results obtained, it may be concluded that the clinical and radiographic examinations performed are effective tools for diagnosing furcation involvement in teeth affected with periodontal disease.
Conclusions: From a clinical and radiologic point of view at 6 months after surgery, the use of PRF as the sole grafting material seems to be an effective modality of regenerative treatment for periodontal intrabony defects.
Sant'Ana, Adriana Campos Passanezi; Campos, Marinele R de; Passanezi, Selma Campos; Rezende, Maria Lúcia Rubo de; Greghi, Sebastião Luiz Aguiar; Passanezi, Euloir
The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG--"no intervention" (n=17) or IG--"intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (pperiodontal conditions of IG and NIG were observed at 2nd examination (ppregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.
Avila, Walkiria Samuel; Timerman, Lilia; Romito, Giuseppe Alexandre; Marcelino, Sílvia Linard; Neves, Itamara Lúcia Itagiba; Zugaib, Marcelo; Grinberg, Max
The periodontal disease during pregnancy of women with rheumatic valve disease imply infective endocarditis risks and higher rate of preterm birth and low birth weight. To study the periodontal disease rate of women with rheumatic valve disease during pregnancy. We studied 140 pregnant women who included 70 patients with rheumatic valve disease and 70 healthy women. The periodontal examination included: 1) periodontal clinical exam regard the follow variables: a) probing depth; b) gingival margin; c) clinical attachment level; d) bleeding on probing; e) plaque index and f) gingival index; and 2) microbiological test was performed in samples serum and gingival crevicular fluid and considered positive controls to Porphyromonas gingivalis, Tannerella forsithia e Aggregobacter actinomycetemcomitans. Age and parity were similar between groups; as single or combined the mitral valve disease was prevalent among the rheumatic valve lesion in 45 (32.1%) e 20 (28.5%) cases, respectively. Among the periodontal variables gingival margin (p=0.01) and plaque index (p=0.04) were different between groups. The periodontal disease was identified in 20 (14,3%) pregnant women, seven (10%) of them were patients with valve rheumatic disease and the remain 13 (18,6%) were healthy women, its percentual was not different between groups (p=0,147). Microbiological analyses of oral samples showed higher percentual of P. gingivalis in healthy pregnant women (p=0.004). The clinical and microbiological study during pregnancy showed comparable incidence of periodontal disease between women with rheumatic valve disease and healthy women.
Israel Antonio Juárez; Sofía Larroulet; Makarena Ojeda; Cristian Rosas
ABSTRACT Aim: To determine periodontal status of fixes single prostheses (FSP) made during the year 2013 in Austral University of Chile, and its contralateral homologue (CH).Methods: All patients with FSP made during 2013, that met the selection criteria and agreed to participate were evaluated. During the year 2014 was measured: probing depth, attachment level; bleeding on probing and dental plaque index for each FSP and CH; and consigned biological width invasion. Were measured one FSP...
Dwiyanti, Stephani; Soeroso, Yuniarti; Sunarto, Hari; Radi, Basuni
Coronary heart disease is a narrowing of coronary artery due to plaque build-up.  Chronic periodontitis increases risk of cardiovascular disease. P.gingivalis is linked to both diseases. Objective: to analyse quantitative difference of P.gingivalis on dental plaque and its relationship with periodontal status of CHD patient and control. Methods: Periodontal status of 66 CHD patient and 40 control was checked. Subgingival plaque was isolated and P.gingivalis was measured using real-time PCR. Result: P.gingivalis of CHD patient differs from control. P.gingivalis is linked to pocket depth of CHD patient. Conclusion: P.gingivalis count of CHD patient is higher than control. P.gingivalis count is not linked to any periodontal status, except for pocket depth of CHD patient.
Ranjit Singh Uppal
Conclusion: It may be concluded that chronic periodontitis and ED are associated with each other. However, further large scale studies with confounder analysis and longitudinal follow-up are warranted to explore the link between these two diseases.
Colombo, A P; Haffajee, A D; Dewhirst, F E; Paster, B J; Smith, C M; Cugini, M A; Socransky, S S
The purpose of this investigation was to compare the clinical parameters and the site prevalence and levels of 40 subgingival species in successfully treated and refractory periodontitis subjects. 94 subjects received scaling and root planing and if needed, periodontal surgery and systemically administered tetracycline. 28 refractory subjects showed mean full mouth attachment loss and/or > 3 sites showing attachment loss > 2.5 mm within 1 year post-therapy. 66 successfully treated subjects showed mean attachment level gain and no sites with attachment loss > 2.5 mm. Baseline subgingival plaque samples were taken from the mesial aspect of each tooth and the presence and levels of 40 subgingival taxa were determined using whole genomic DNA probes and checkerboard DNA-DNA hybridization. The mean levels and % of sites colonized by each species (prevalence) was computed for each subject and differences between groups sought using the Mann-Whitney test. Most of the 40 species tested, including Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Bacteroides forsythus, were equally or less prevalent in the refractory group. Prevotella nigrescens was significantly more prevalent in successfully treated subjects, while refractory subjects harbored a larger proportion of Streptococcus species, particularly Streptococcus constellatus. The odds of a subject being refractory was 8.6 (p or = 3.5% of the total DNA probe count. Since few microbiological differences existed between treatment outcome groups using DNA probes to known species, the predominant cultivable microbiota of 33 subgingival samples from 14 refractory subjects was examined. 85% of the 1649 isolates were identified using probes to 69 recognized subgingival species. The remaining unidentified strains were classified by analyzing 16S rRNA gene sequences. Many sequenced isolates were of taxa not considered a common part of the oral microbiota such as Acinetobacter baumanni
Yoshida, Toshiyuki; Washio, Kaoru; Iwata, Takanori; Okano, Teruo; Ishikawa, Isao
It has been shown that stem cell transplantation can regenerate periodontal tissue, and several clinical trials involving transplantation of stem cells into human patients have already begun or are in preparation. However, stem cell transplantation therapy is a new technology, and the events following transplantation are poorly understood. Several studies have reported side effects and potential risks associated with stem cell transplantation therapy. To protect patients from such risks, governments have placed regulations on stem cell transplantation therapies. It is important for the clinicians to understand the relevant risks and governmental regulations. This paper describes the ongoing clinical studies, basic research, risks, and governmental controls related to stem cell transplantation therapy. Then, one clinical study is introduced as an example of a government-approved periodontal cell transplantation therapy. PMID:22315604
Full Text Available It has been shown that stem cell transplantation can regenerate periodontal tissue, and several clinical trials involving transplantation of stem cells into human patients have already begun or are in preparation. However, stem cell transplantation therapy is a new technology, and the events following transplantation are poorly understood. Several studies have reported side effects and potential risks associated with stem cell transplantation therapy. To protect patients from such risks, governments have placed regulations on stem cell transplantation therapies. It is important for the clinicians to understand the relevant risks and governmental regulations. This paper describes the ongoing clinical studies, basic research, risks, and governmental controls related to stem cell transplantation therapy. Then, one clinical study is introduced as an example of a government-approved periodontal cell transplantation therapy.
Irani, F C; Wassall, R R; Preshaw, P M
To investigate the impact of periodontal status on oral health-related quality of life (OHRQoL) in patients with and without type 2 diabetes mellitus (T2DM). 61 patients with T2DM and 74 non-diabetic patients matched for age, gender and periodontal status (health, gingivitis, chronic periodontitis) were recruited. The oral health impact profile (OHIP)-49 was self-completed by all participants at baseline and by the patients with periodontitis at 3 months and 6 months after non-surgical periodontal therapy. There were no significant differences in the overall OHIP-49 summary scores between patients with T2DM (median; interquartile range; 37.0; 19.5-61.0) and without T2DM (30.4; 16.8-51.0) (p>0.05). Among non-diabetic patients, there were significantly higher OHIP-49 scores (indicating poorer OHRQoL) in patients with gingivitis (41.0; 19.7-75.7) and periodontitis (33.0; 19.9-52.5) compared to patients who were periodontally healthy (11.1; 7.1-34.5) (pdisability domains following periodontal treatment, indicating an improvement in OHRQoL. In contrast, there were no statistically significant changes in OHIP-49 scores following periodontal treatment in the patients with diabetes. T2DM does not impact on overall OHRQoL as measured by OHIP-49. Chronic periodontitis and gingivitis were associated with poorer OHRQoL in non-diabetic patients, with evidence of improvements following periodontal treatment, but no such effects were observed in patients with diabetes. Gingivitis and periodontitis are associated with reduced OHRQoL compared to periodontal health in non-diabetic patients, with improvements following treatment of periodontitis. No impact of type 2 diabetes on OHRQoL was noted; this may be related to the burden of chronic disease (diabetes) minimising the impact of oral health issues on OHRQoL. Copyright © 2015 Elsevier Ltd. All rights reserved.
Tan, Baochun; Wu, Wenlei; Sun, Weibin; Xiao, Jianping
To study the clinical effect of root amputation in the treatment of periodontal/alveolar abscess teeth with one severe lesion root. 30 periodontal/alveolar abscess teeth with one severe lesion root were chosen in the study. After root canal treatment, supragingival scaling, subgingival scaling and root planning, occlusal adjustment were done. Then the teeth were treated by root amputation. The clinical effect was evaluated 3 months, 6 months and 1 year after surgery. One year after surgery, 27 of 30 teeth were successful, 1 mandibular molar occurred root fracture, 1 mandibular molar was removed because of tooth loosening secondary to periodontal damage. 1 patient lost. Root amputation is an effective solution of periodontal/alveolar abscess.
Lee, Jaebum; Wikesjö, Ulf M E
Growth/differentiation factor-5 (GDF-5) plays critical roles in mesenchymal cell differentiation and stimulates human periodontal ligament cell proliferation. Potentially, GDF-5 may also play roles in wound healing including periodontal regeneration and alveolar augmentation. The objective of this review was to provide up-to-date information from pre-clinical/clinical studies evaluating GDF-5 for these indications. A comprehensive search using PubMed and Google search engines was conducted to identify reports on GDF-5 applied to periodontal and alveolar indications. Two reviewers independently screened the titles and abstracts from a total of 479 reports. Full-length articles of 17 pre-clinical and four clinical studies were selected and reviewed. Canine-, porcine- and non-human primate-based models as well as human clinical trials were used in the evaluation of GDF-5 in support of periodontal regeneration and alveolar augmentation. An absorbable collagen sponge (ACS), β-tricalcium phosphate (β-TCP) and a poly(lactic-co-glycolic) acid (PLGA) were evaluated as candidate carriers for GDF-5 using various dose and healing intervals demonstrating significantly enhanced periodontal regeneration/alveolar augmentation including cementum, periodontal ligament and alveolar bone with limited, if any, adverse effects. Growth/differentiation factor-5 supports periodontal regeneration/alveolar augmentation without aberrant healing events documented in qualified pre-clinical models and clinical pilot studies. In perspective, GDF-5 appears a promising technology for periodontal regeneration/alveolar augmentation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Leblebicioglu, Binnaz; Kulekci, Guven; Ciftci, Sevgi; Keskin, Fahriye; Badur, Selim
Saliva may become a potential source of contamination through vertical and horizontal transmissions as well as cross-infections. This study aims to use saliva as a screening tool to detect putative periodontal pathogens in a young population with fairly good oral hygiene. Stimulated saliva samples were obtained from 134 dental students (20.5+/-1 years, range 18-22 years). Among those, 77 subjects also completed a periodontal examination including attachment loss, modified dental, gingival and plaque indices (AL, mDI, GI and PI). The test bacteria were identified using a 16S rRNA-based PCR detection method. One or more of the test bacteria was found in 67% of the subjects. Prevotella nigrescens was detected as single bacterium in 16% of the subjects followed by Treponema denticola (4%), Porphyromonas gingivalis (2%), Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans (1%) and Tannerella forsythia (1%). Two or more pathogens were detected in 42% of the subjects. Clinical examination revealed health with no attachment loss (AL) in 84% of the students. In no AL group, 38% of the students were pathogen free while this was 25% for students in localized AL group (p>0.05). There was a statistically significant association between the detection of salivary periodontal pathogen in general and higher PI (p=0.018) and GI (p=0.043). Within the limits of this study, it is possible to detect all six periodontal pathogens in the saliva of dental students. Although a correlation can be observed between the presence of salivary periodontal pathogen and clinical signs of inflammation such as plaque accumulation and gingival bleeding, detection of specific bacteria in saliva is not related to the presence of localized AL based on the presented study population.
Cosyn, Jan; Thevissen, Eric; Reners, Michèle; Rompen, Eric; Klinge, Björn; De Bruyn, Hugo
As the prevalence of periodontitis is more than 40 % in the adult Belgian population, periodontists are clearly understaffed to treat this disease in all patients. Therefore, it seems logic that mild forms of chronic periodontitis are treated by the general practitioner especially because Belgium lacks dental hygienists. Important prerequisites for organizing periodontal care as such relate to the general practitioner who should use the same techniques, have comparable communicative skills to motivate patients and create a similar amount of time for periodontal treatment as the specialist. After all, the patient has the right to qualitative treatment regardless of the level of education of the care provider. In order to guarantee this in general practice as much as possible, there is a need for clinical guidelines developed by specialists. These guidelines should not only support the general practitioner in treating disease; above all, they should assist the dentist in periodontal diagnosis. Hitherto, periodontal screening by general dentists seems to be infrequently performed even though reimbursement of the Dutch Periodontal Screening Index is implemented in the Belgian healthcare security system. In this manuscript possible explanations for this phenomenon are discussed. Apart from the need for guidelines in general practice, guidelines for surgical treatment seem compulsory to uniform treatment protocols in specialized practice. Extreme variation in the recommendation of surgery among Belgian specialists calls for consensus statements.
Canetta, R; Franks, C; Smaldone, L; Bragman, K; Rozencweig, M
Carboplatin, a cisplatin derivative, shows promise of being an effective weapon against ovarian, cervical, and small-cell lung cancer, as well as epidermoid cancer of the head and neck, with fewer toxic effects than cisplatin. It has successfully completed phase III investigation and clinical trials continue.
Pejcic, A; Kesic, L J; Milasin, J
Periodontitis has been identified as a potential risk factor for systemic pathologies such as cardiovascular disease (CVD). The aims of this investigation were to assess the relationship between periodontitis and systemic inflammatory factor, as well as to discover whether there is a relation to the severity of periodontitis and to the periodontopathogens. Periodontal examinations and serum C-reactive protein (CRP) level measurements were performed in 50 patients with periodontitis. Periodontal health indicators included the gingival bleeding on probing index and periodontal disease status. The patients with moderate periodontitis had low attachment loss and pocket depth periodontitis had high attachment loss and pocket depth >5 mm. The control group comprised 25 volunteers with healthy gingiva, gingival sulcus periodontal parameters and CRP levels were significantly higher in the patients with periodontitis. Patients who had severe periodontitis, with high levels of mean clinical attachment loss, and subjects with moderate periodontitis had higher mean CRP levels. The percentage of subjects with elevated levels of CRP >5 mg/l was greater in the higher clinical attachment loss group compared to the group with lower attachment loss. The presence of P. gingivalis and A. actinomycetemcomitans were also associated with elevated CRP levels and poor periodontal status. Periodontitis and the presence of P. gingivalis are associated with an enhanced inflammatory response expressed by higher CRP levels. The association of periodontitis with CRP levels appears to be a contributing factor for CVD and might be a possible intermediate pathway in this association.
Kita, Daichi; Kinumatsu, Takashi; Yokomizo, Atsushi; Tanaka, Miki; Egawa, Masahiro; Makino-Oi, Asako; Tomita, Sachiyo; Saito, Atsushi
This study aimed to evaluate clinically the effect of a novel dentifrice containing three kinds of bactericidal ingredients on periodontal disease. This was a single-arm, prospective clinical study that enrolled patients with periodontitis undergoing supportive periodontal therapy. Periodontal examination, microbiological testing of saliva samples, and evaluation of inflammatory markers (IL-1β, IL-6, IL-8, TNF-α) in gingival crevicular fluid were performed. After 4 weeks of the use of test dentifrice, these parameters were re-evaluated. The use of dentifrice was also subjectively evaluated by clinicians and participants. Among 30 participants, there were significant improvements in the periodontal and microbiological parameters, and the level of interleukin-1β in the gingival crevicular fluid, following the use of the test dentifrice. In clinicians' subjective evaluation of the overall usefulness of the dentifrice, 'mild' and 'moderate' improvement accounted for 83% of the total responses. In the participants' subjective evaluation, the majority indicated their experience of the use as favorable. Within the limitations of this study, it is suggested that the progression of periodontal disease during the supportive periodontal therapy can be prevented by the use of the test dentifrice. Trial registration UMIN Clinical Trials Registry (UMIN-CTR) 000023175. Date of formal registration: July 14, 2016 ( https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026716 ).
Full Text Available Background: Our understanding of pathogenesis of periodontal disease has changed remarkably over a few decades. Rather than being confined to periodontium, periodontal disease may have a wide ranging systemic effects. It is now recognized that it shares most of the common risk factors for diabetes, coronary heart disease preterm low birth weight, miscarriage or early pregnancy loss and preeclampsia. Materials and Methods: The study group comprised of 400 women (200 pregnant women and 200 non-pregnant with an age range of 18-40 years. Maternal demographic and medical data were collected. Periodontal examinations included: Oral hygiene index (OHI-S, gingival index (GI, pocket probing depth and clinical attachment loss (CAL. Results: The results were analyzed using test of proportion when OHI-S was compared in pregnant women with that of non-pregnant individuals, there was no significant difference in good oral hygiene group (P = 0.187, Z = 1.32. When the GI index was evaluated, a definite statistical difference was noted in mild, moderate and severe gingivitis (P - 0.000, Z = 0.365; P - 0.00, Z = 4.17; P - 0.000, Z = 0.75. CAL index revealed a statistical difference was observed healthy periodontium, mild, moderate and severe periodontitis in both pregnant and non-pregnant women (P = −0.000, Z = 3.65; P - 0.000, Z = 5.83; P - 0.001, Z - 3.24; P - 0.000, Z - 6.47. Conclusion: The present study conducted supports the hypothesis that there is a definite correlation between the pregnant women and poor oral hygiene (gingivitis and periodontitis as compared with the non-pregnant controls.
The participants were divided into a chronic periodontitis group (n = 114) and a control group (n = 108) with no history of periodontitis. The Toronto Alexithymia Scale (TAS‑20) was used to evaluate alexithymia status of the subjects. Clinical data were collected on parameters such as the plaque index, bleeding on probing, ...
Smith, M.M.; Zontine, W.J.; Willits, N.H.
Twenty-four dogs admitted for routine teeth cleaning were selected arbitrarily to undergo a periodontal examination and a dental radiographic examination before the dental procedure. Data pertaining to the physical and radiographic manifestations of periodontal disease of 783 teeth were collected. All dogs had lesions consistent with periodontal disease, ranging from mild gingivitis and minimal plaque accumulation to severely inflamed gingiva, exuberant calculus formation, and root exposure. Of the 783 teeth examined, 153 (20%) had a pocket depth greater than or equal to 4 mm and less than or equal to 9 mm. Data regarding these teeth were subjected to statistical analysis. The clinical signs of plaque, calculus, mobility, pocket depth, and furcation were positively associated with radiographic signs of periodonta disease. The association between grossly evident gingivitis and radiographic signs of periodontal disease was not significant. Conditional probability analysis was applied to determine confidence intervals for the probability of a radiographic sign of periodontal disease occurring given that a clinical sign of periodontal disease occurs. (author)
Engebretson, Steven P; Hyman, Leslie G; Michalowicz, Bryan S; Schoenfeld, Elinor R; Gelato, Marie C; Hou, Wei; Seaquist, Elizabeth R; Reddy, Michael S; Lewis, Cora E; Oates, Thomas W; Tripathy, Devjit; Katancik, James A; Orlander, Philip R; Paquette, David W; Hanson, Naomi Q; Tsai, Michael Y
Chronic periodontitis, a destructive inflammatory disorder of the supporting structures of the teeth, is prevalent in patients with diabetes. Limited evidence suggests that periodontal therapy may improve glycemic control. To determine if nonsurgical periodontal treatment reduces levels of glycated hemoglobin (HbA1c) in persons with type 2 diabetes and moderate to advanced chronic periodontitis. The Diabetes and Periodontal Therapy Trial (DPTT), a 6-month, single-masked, multicenter, randomized clinical trial. Participants had type 2 diabetes, were taking stable doses of medications, had HbA1c levels between 7% and less than 9%, and untreated chronic periodontitis. Five hundred fourteen participants were enrolled between November 2009 and March 2012 from diabetes and dental clinics and communities affiliated with 5 academic medical centers. The treatment group (n = 257) received scaling and root planing plus chlorhexidine oral rinse at baseline and supportive periodontal therapy at 3 and 6 months. The control group (n = 257) received no treatment for 6 months. Difference in change in HbA1c level from baseline between groups at 6 months. Secondary outcomes included changes in probing pocket depths, clinical attachment loss, bleeding on probing, gingival index, fasting glucose level, and Homeostasis Model Assessment (HOMA2) score. Enrollment was stopped early because of futility. At 6 months, mean HbA1c levels in the periodontal therapy group increased 0.17% (SD, 1.0), compared with 0.11% (SD, 1.0) in the control group, with no significant difference between groups based on a linear regression model adjusting for clinical site (mean difference, -0.05% [95% CI, -0.23% to 0.12%]; P = .55). Periodontal measures improved in the treatment group compared with the control group at 6 months, with adjusted between-group differences of 0.28 mm (95% CI, 0.18 to 0.37) for probing depth, 0.25 mm (95% CI, 0.14 to 0.36) for clinical attachment loss, 13.1% (95% CI, 8
Lenggogeny, Putri; Masulili, Sri Lelyati C.; Tadjoedin, Fatimah M.; Radi, Basuni
Periodontitis is a risk factor for coronary heart disease (CHD). Both diseases are an inflammatory diseases and have the same potential pathogenic mechanisms. Interleukin-1β as a pro-inflammatory main cytokine, can be found in this both diseases. Gingival crevicular fluid (GCF) derived from the serum of gingival sulcus, affected by inflammatory mechanism and the amount of this fluid will increase in that situation. Objective: To analyze the relationship of interleukin-1β levels in gingival crevicular fluid (GCF) of CHD and non-CHD patients with periodontal status. Methods: Oral clinical examination (plaque index, bleeding on probing, pocket depth and clinical attachment loss) for 35 subjects with CHD and 35 non CHD were checked, laboratory test to measure the levels of Interleukin-1β was checked with enzyme-linked immunosorbent assay (ELISA). Results: There was no significant differences between interleukin-1β levels in CHD and non-CHD patients (p>0.05); there was no significant difference between the level of Interleukin-1β with periodontal status in CHD and control (non CHD) patients (p>0.05). Conclusions: levels of Interleukin-1β in CHD patients do not have a relationships with plaque index, pocket depth and clinical attachment loss, but has a relationships with bleeding on probing.
Full Text Available Periodontal disease is a chronic multifactor pathology, characterized by the progressive destruction of the dental structures support tissues. Patients with some type of disability have a higher predisposition to develop periodontal disease, due to bad hygiene, product of their motor and psychological deficiencies, and to their systemic alterations that difficult the defense against periodontopathogenic microorganisms. The purpose of this study was to evaluate and compare the periodontal status of a group of children with special needs, and a control group. 47 patients with mental retardation and Down syndrome from three special education centers, and 31 healthy patients of ages ranging from 6 to 15 years, were dentally evaluated, to determine their plaque index, gingival index, and the presence of calculus. After gathering the data and tabulating the results, a 1.08 plaque index was determined, and a gingival index of 1.03, corresponding to a mild gingivitis in the study group. On the other hand, on the group of regular patients, there was a 1.08 PI and a 0.96 GI. Calculus percentage was similar on both groups. However, a large percentage of children with mild gingival inflammation was observed in the group of special patients (53.19%, compared to the control group (29%.
Hakki, S S; Celenligil-Nazliel, H; Karaduman, A; Usubütün, A; Ertoy, D; Ayhan, A; Ruacan, S
Epidermolysis bullosa acquisita (EBA) is an uncommon, acquired, chronic subepidermal bullous disease. This report describes a case of EBA with gingival involvement. A 43-year-old woman with EBA was referred to our clinic for periodontal therapy because of gingival tenderness and bleeding. She has been on cyclosporin A therapy for the last 2 years. Clinical findings were analyzed. Anterior gingivectomy operations were performed in 2 stages. The samples obtained during the surgery were examined using histopathologic, immunohistologic, and electronmicroscopic methods. Long-term effects of the surgical periodontal treatment on gingiva were evaluated both clinically and microscopically. The dentition displayed minimal enamel hypoplasia. Decayed, missing, and filled surfaces score was found to be elevated. Periodontal examination showed generalized diffuse gingival inflammation and gingival enlargement localized mainly to the anterior region. Nikolsky's sign was positive. However, wound healing was uneventful after the operations. Microscopic findings were similar to those obtained from the skin. Twenty-one months after the operations, Nikolsky's sign was negative and no remarkable gingival inflammation was noted. Microscopic examination revealed that the blisters were fewer in number and smaller in size. These results indicate that gingival tissues may also be involved in EBA. Uneventful wound healing after periodontal surgery in this case suggests that periodontal surgery can be performed in patients with EBA. Moreover, both our clinical and histopathologic findings imply that gingivectomy proves useful in maintaining gingival integrity in these patients. Our data may also suggest that the patients with EBA are highly likely to develop dental caries.
Adriana Campos Passanezi Sant'Ana
Full Text Available OBJECTIVES: The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. MATERIAL AND METHODS: Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG - "no intervention" (n=17 or IG- "intervention" (n=16. IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP, professional prophylaxis (PROPH and oral hygiene instruction (OHI. NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD, clinical attachment level (CAL, plaque index (PI and sulcular bleeding index (SBI at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (0.05 at IG and worsening of all periodontal parameters at NIG (p<0.0001, except for PI. Signifcant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001. The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. CONCLUSIONS: Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.
Lombardo Bedran, Telma Blanca; Marcantonio, Rosemary Adriana C; Spin Neto, Rubens; Alves Mayer, Marcia Pinto; Grenier, Daniel; Spolidorio, Luis Carlos; Spolidorio, Denise Palomari
Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated. The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and Tannerella forsythia, and to evaluate the ability of periodontal treatment to reduce these pathogens. Patients with generalized chronic periodontitis were selected by recording clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Subgingival samples from 30 diseased nonadjacent sites (CAL≥5 mm, PD between 5 and 7 mm and positive BOP) and 30 healthy nonadjacent sites (PD≤3 mm and negative BOP) were collected and subjected to microbial analysis by quantitative polymerase chain reaction (qPCR) The variables of age, PD, CAL and BOP of all individuals were analyzed using the paired t-test (GrapPad Prism5(®)). Data of bacteria quantification were subjected to a normality test (D'Agostino-Pearson Test). For bacterial correlation analysis, the Spearman correlation was used. Our results showed that diseased sites had significantly higher levels of P. endodontalis compared to healthy sites, similar to the results obtained for P. gingivalis and T. forsythia. The numbers of all bacterial species were reduced significantly after mechanical periodontal treatment. P. endodontalis was significantly correlated with the presence of T. forsythia and P. gingivalis in the diseased group. Our results suggest that there is a high prevalence of P. endodontalis, P. gingivalis and T. forsythia in periodontitis sites and that mechanical periodontal treatment is effective at reducing the pathogens studied.
Lombardo Bedran, Telma Blanca; Marcantonio, Rosemary Adriana C.; Spin Neto, Rubens; Alves Mayer, Marcia Pinto; Grenier, Daniel; Spolidorio, Luis Carlos; Spolidorio, Denise Palomari
Background Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated. Objective The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and Tannerella forsythia, and to evaluate the ability of periodontal treatment to reduce these pathogens. Design Patients with generalized chronic periodontitis were selected by recording clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Subgingival samples from 30 diseased nonadjacent sites (CAL≥5 mm, PD between 5 and 7 mm and positive BOP) and 30 healthy nonadjacent sites (PD≤3 mm and negative BOP) were collected and subjected to microbial analysis by quantitative polymerase chain reaction (qPCR) The variables of age, PD, CAL and BOP of all individuals were analyzed using the paired t-test (GrapPad Prism5®). Data of bacteria quantification were subjected to a normality test (D'Agostino-Pearson Test). For bacterial correlation analysis, the Spearman correlation was used. Results Our results showed that diseased sites had significantly higher levels of P. endodontalis compared to healthy sites, similar to the results obtained for P. gingivalis and T. forsythia. The numbers of all bacterial species were reduced significantly after mechanical periodontal treatment. P. endodontalis was significantly correlated with the presence of T. forsythia and P. gingivalis in the diseased group. Conclusion Our results suggest that there is a high prevalence of P. endodontalis, P. gingivalis and T. forsythia in periodontitis sites and that mechanical periodontal treatment is effective at reducing the pathogens studied. PMID:22232719
Telma Blanca Lombardo Bedran
Full Text Available Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated.The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and Tannerella forsythia, and to evaluate the ability of periodontal treatment to reduce these pathogens.Patients with generalized chronic periodontitis were selected by recording clinical attachment level (CAL, probing depth (PD, and bleeding on probing (BOP. Subgingival samples from 30 diseased nonadjacent sites (CAL ≥ 5 mm, PD between 5 and 7 mm and positive BOP and 30 healthy nonadjacent sites (PD ≤ 3 mm and negative BOP were collected and subjected to microbial analysis by quantitative polymerase chain reaction (qPCR The variables of age, PD, CAL and BOP of all individuals were analyzed using the paired t-test (GrapPad Prism5®. Data of bacteria quantification were subjected to a normality test (D'Agostino-Pearson Test. For bacterial correlation analysis, the Spearman correlation was used.Our results showed that diseased sites had significantly higher levels of P. endodontalis compared to healthy sites, similar to the results obtained for P. gingivalis and T. forsythia. The numbers of all bacterial species were reduced significantly after mechanical periodontal treatment. P. endodontalis was significantly correlated with the presence of T. forsythia and P. gingivalis in the diseased group.Our results suggest that there is a high prevalence of P. endodontalis, P. gingivalis and T. forsythia in periodontitis sites and that mechanical periodontal treatment is effective at reducing the pathogens studied.
Thanakun, Supanee; Izumi, Yuichi
Obesity and periodontitis are associated with an inflammatory background. Inflammatory mediators involved may have reciprocal effects on one another. In this study, the levels of inflammatory mediators implicated in overweight or obese status and periodontitis are simultaneously evaluated. Body mass index (BMI) and waist circumference, periodontal disease status, and plasma levels of adiponectin, leptin, intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule 1, C-reactive protein (CRP), immunoglobulin (Ig)G antibody against Porphyromonas gingivalis, and IgG against Aggregatibacter actinomycetemcomitans in 109 periodontitis participants with various BMIs were measured. BMI ≥23.0 kg/m(2) was considered overweight or obese. Plasma adiponectin was decreased (P = 0.04), whereas CRP and IgG against P. gingivalis were increased (P = 0.04 and P = 0.001, respectively) in patients with severe periodontitis compared with patients with mild or moderate periodontitis, independent of overweight or obese status. Plasma CRP, ICAM-1, and leptin were increased (P periodontitis severity. No interaction effect between periodontitis and overweight or obese status existed for these protein levels after the data were adjusted for age, sex, plasma levels of triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, and blood pressure (P = 0.48). Periodontitis and overweight or obese BMI change plasma levels of the inflammatory mediators adiponectin and CRP, independently. This study suggests a role of periodontitis in systemic inflammatory response in Thai people who are overweight or obese.
Full Text Available Abstract Background Oxidative stress and matrix metalloproteinases -9 and -2 are involved in periodontal breakdown, whereas gingival crevicular fluid has been reported to reflect apical status. The aim of this study was to characterize oxidant balance and activity levels of MMP -2 and -9 in apical lesions and healthy periodontal ligament; and second, to determine whether potential changes in oxidant balance were reflected in gingival crevicular fluid from asymptomatic apical periodontitis (AAP-affected teeth at baseline and after endodontic treatment. Methods Patients with clinical diagnosis of AAP and healthy volunteers having indication of tooth extraction were recruited. Apical lesions and healthy periodontal ligaments, respectively, were homogenized or processed to obtain histological tissue sections. Matrix metalloproteinase -9 and -2 levels and/or activity were analyzed by Immunowestern blot, zymography and consecutive densitometric analysis, and their tissue localization was confirmed by immunohistochemistry. A second group of patients with AAP and indication of endodontic treatment was recruited. Gingival crevicular fluid was extracted from AAP-affected teeth at baseline, after endodontic treatment and healthy contralateral teeth. Total oxidant and antioxidant status were determined in homogenized tissue and GCF samples. Statistical analysis was performed using STATA v10 software with unpaired t test, Mann-Whitney test and Spearman's correlation. Results Activity of MMP-2 and MMP-9 along with oxidant status were higher in apical lesions (p Conclusions Apical lesions display an oxidant imbalance along with increased activity of matrix metalloproteinase-2 and -9 and might contribute to AAP progression. Oxidant imbalance can also be reflected in GCF from AAP-affected teeth and was restored to normal levels after conservative endodontic treatment. These mediators might be useful as potential biomarkers for chair-side complementary diagnostic
Dezerega, Andrea; Madrid, Sonia; Mundi, Verónica; Valenzuela, María A; Garrido, Mauricio; Paredes, Rodolfo; García-Sesnich, Jocelyn; Ortega, Ana V; Gamonal, Jorge; Hernández, Marcela
Oxidative stress and matrix metalloproteinases -9 and -2 are involved in periodontal breakdown, whereas gingival crevicular fluid has been reported to reflect apical status. The aim of this study was to characterize oxidant balance and activity levels of MMP -2 and -9 in apical lesions and healthy periodontal ligament; and second, to determine whether potential changes in oxidant balance were reflected in gingival crevicular fluid from asymptomatic apical periodontitis (AAP)-affected teeth at baseline and after endodontic treatment. Patients with clinical diagnosis of AAP and healthy volunteers having indication of tooth extraction were recruited. Apical lesions and healthy periodontal ligaments, respectively, were homogenized or processed to obtain histological tissue sections. Matrix metalloproteinase -9 and -2 levels and/or activity were analyzed by Immunowestern blot, zymography and consecutive densitometric analysis, and their tissue localization was confirmed by immunohistochemistry. A second group of patients with AAP and indication of endodontic treatment was recruited. Gingival crevicular fluid was extracted from AAP-affected teeth at baseline, after endodontic treatment and healthy contralateral teeth. Total oxidant and antioxidant status were determined in homogenized tissue and GCF samples. Statistical analysis was performed using STATA v10 software with unpaired t test, Mann-Whitney test and Spearman's correlation. Activity of MMP-2 and MMP-9 along with oxidant status were higher in apical lesions (p Apical lesions display an oxidant imbalance along with increased activity of matrix metalloproteinase-2 and -9 and might contribute to AAP progression. Oxidant imbalance can also be reflected in GCF from AAP-affected teeth and was restored to normal levels after conservative endodontic treatment. These mediators might be useful as potential biomarkers for chair-side complementary diagnostic of apical status in GCF.
Full Text Available Aim. To assess the clinical periodontal and medical parameters in patients with chronic renal failure (CRF at different levels of renal disease. Background. CRF is a progressive and irreversible loss of renal function associated with a decline in the glomerular filtration rate. Periodontal disease is a destructive inflammatory disease affecting periodontal tissues that shows high prevalence in patients with CRF. Materials and Methods. 102 CRF patients were included and divided into an early stage group (EG, predialysis group (PDG, and hemodialysis group (HDG. The medical parameters were taken from the patients’ records. Results. Periodontal clinical condition differed among the CRF groups. Clinical attachment loss was greater in the HDG and PDG group compared to the EG (p=0.0364; the same was observed in the Plaque Index (p=0.0296; the others periodontal parameters did not show any differences. Ferritin levels were significantly higher in the HDG when compared to the EG and PGD (p<0.0001, and fibrinogen was higher in PDG compared with the others (p<0.0001; the triglycerides also showed higher values in the HDG compared with the other groups (p<0.0001. Conclusion. The patients with renal involvement should have a multidisciplinary approach to an improvement in their oral and systemic health.
Siribamrungwong, Monchai; Yothasamutr, Kasemsuk; Puangpanngam, Kutchaporn
Chronic systemic inflammation, a non traditional risk factor of cardiovascular diseases, is associated with increasing mortality in chronic kidney disease, especially peritoneal dialysis patients. Periodontitis is a potential treatable source of systemic inflammation in peritoneal dialysis patients. Clinical periodontal status was evaluated in 32 stable chronic peritoneal dialysis patients by plaque index and periodontal disease index. Hematologic, blood chemical, nutritional, and dialysis-related data as well as highly sensitive C-reactive protein were analyzed before and after periodontal treatment. At baseline, high sensitive C-reactive protein positively correlated with the clinical periodontal status (plaque index; r = 0.57, P periodontal disease index; r = 0.56, P periodontal therapy, clinical periodontal indexes were significantly lower and high sensitivity C-reactive protein significantly decreased from 2.93 to 2.21 mg/L. Moreover, blood urea nitrogen increased from 47.33 to 51.8 mg/dL, reflecting nutritional status improvement. Erythropoietin dosage requirement decreased from 8000 to 6000 units/week while hemoglobin level was stable. Periodontitis is an important source of chronic systemic inflammation in peritoneal dialysis patients. Treatment of periodontal diseases can improve systemic inflammation, nutritional status and erythropoietin responsiveness in peritoneal dialysis patients. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.
Cosgarea, Raluca; Tristiu, Roxana; Dumitru, Raluca Bianca; Arweiler, Nicole Birgit; Rednic, Simona; Sirbu, Cristina Ioana; Lascu, Liana; Sculean, Anton; Eick, Sigrun
To compare the effect of non-surgical periodontal therapy on clinical and inflammatory parameters in patients with moderate to severe chronic periodontitis (CP) and rheumatoid arthritis (RA) (RA-CP) with that in CP patients without RA. Eighteen patients with RA-CP and 18 systemically healthy patients with CP were treated with scaling and root planing (SRP) within 24 h. At baseline, and at 3 and 6 months after SRP, clinical periodontal parameters, inflammatory markers, and microorganisms in subgingival biofilm were assessed. In addition, disease activity markers of RA (DAS28, CRP, ESR) and specific antibodies (RF) were monitored in the RA-CP group. In both groups, non-surgical therapy yielded to statistically significant improvements in all investigated clinical periodontal variables; in RA patients, a statistically significant decrease in serum-CRP was seen at 3 months. At all time-points, levels of inflammatory markers in GCF were higher in RA-CP than in CP patients. Counts of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola decreased statistically significantly in CP but not in the RA-CP group. Changes of DAS28 correlated positively with those of P. gingivalis and negatively with the plaque index. Within their limits, the present data suggest that (a) non-surgical periodontal therapy improves periodontal conditions in CP patients with and without RA and (b) in patients with RA, eradication of P. gingivalis in conjunction with a high level oral hygiene may transiently decrease disease activity of RA. In patients with RA and CP, non-surgical periodontal therapy is a relevant modality not only to improve the periodontal condition but also to decrease RA activity.
Kongstad, Johanne; Enevold, Christian; Christensen, Lisa Bøge
of The Danish Health Examination Survey (DANHES). METHODS: A total of 4,402 adults aged 18-96 years from the general health examination of DANHES had a periodontal examination consisting of half-mouth registration at 6 sites per tooth including probing pocket depth (PPD) and clinical attachment level (CAL......). Periodontitis was defined according to severe periodontitis, EWP-specific, meanCAL≥2.55mm, CAL-tertile, and PPD-CAL definition. Multivariable logistic regression models fitted the association of age, gender, smoking status, diabetes, educational level, alcohol consumption, body mass index, physical activity...
Full Text Available Objective: To evaluate the periodontal status of HIV seropositive patients and to find out if any correlation exists between the severity of periodontal disease and the CD4 cell count in HIV patients. Methods: One hundred and thirty patients attending the Viral Diseases OPD, Calcutta School of Tropical Medicine, Kolkata were examined. They were grouped according to the CD4 cell count as Group A - Subjects with CD4 Cell count < 200/ 毺 L and Group B - Subjects with CD4 Cell count 曒 200/ 毺 L. Their community periodontal index of treatment needs (CPITN score were recorded. Results: It was found that most of the patients in each group were having score ‘2’ (i.e. presence of supra or subgingival calculus, as their highest score. A statistically significant association was found between immune status as depicted by CD4 cell count and periodontal status as shown by highest CPITN score in the present study. Conclusions: The present study confirms the effect of immunosuppression on periodontal diseases in HIV infected patients.
Kumar, Santosh; Shah, Samir; Budhiraja, Shilpa; Desai, Khushboo; Shah, Chirag; Mehta, Dhaval
Chronic periodontitis in amultifactorial inflammatory disease which is caused by various microorganisms. Many studies have found close association between chronic periodontitis and C-reactive protein (CRP). CRPis an inflammatory marker which increases in all inflammatory condition. The present clinical study was designed to show the effect of periodontal treatment on the CRP levels of gingival crevicular fluid and to determine the effect of nonsurgical therapy in minimizing the CRP levels in chronic generalized periodontitis. Gingival crevicular fluid was collected using a micro capillary pipette that was hand calibrated at every 1 mm till 10 mm, from selected sites in the subjects on the 1st, 14th and 45th days. Decreased CRP levels of gingival crevicular fluid were observed at the end of the study. There was a 37% reduction in probing pocket depth and 45% gain in clinical attachment level and a reduction of about 57% after 14 days and 90% reduction of CRP levels in gingival crevicular fluid after 45 days. Thus, the results show that the presence of CRP level is more significant in gingival crevicular fluid and confirms the underlying inflammatory component of the disease activity in chronic periodontitis.
Alagl, Adel S
To evaluate the periodontal abscess as a possible oral clinical diagnostic criteria for the diagnosis of diabetes mellitus in the elderly. In this clinical outpatient department, cross-sectional study of 84 months, 143 212 subjects between the ages of 40 and 84 years were screened for the presence of periodontal abscess. Relevant medical and dental histories were recorded using a questionnaire. The subjects who fulfilled the inclusion criteria of undiagnosed diabetes mellitus, presence of periodontal abscess, and absence of other systemic disease were referred for laboratory diagnosis of diabetes mellitus (HbA1c). The subjects tested positive for the diabetes were noted, statistical evaluation was undertaken to correlate between undiagnosed diabetes mellitus and periodontal abscess. It was found out that 0.05% undiagnosed diabetes was noted among the 143 212 patients. Among the 143 212 subjects, 1352 met the inclusion criteria having periodontal abscess. Mean age of the participants was 57 ± 14.2 years. Among the 1352 subjects with periodontal abscess: 793 (58.65%) subjects had increased HbA1c (≥6.5% or 47.5 mmol/mol or 7.8 mmol/L); 559 (41.35%) individuals reported to have normal HbA1c (≤6.5% or 47.5 mmol/mol or 7.8 mmol/L). The difference was found to be statistically significant. Periodontal abscess can be considered as possible oral clinical diagnostic criteria for the diagnosis of diabetes mellitus. Elderly individuals visiting dental clinics need to be given due attention to find out the possibility of having this systemic condition. Medical fraternities are advised to consider oral health parameters in the evaluation of the medical status of elderly individuals. © 2016 John Wiley & Sons Australia, Ltd.
In order to recognize in which stage rapidly progressing destruction of periodontal ligament fibers occurs, a number of diagnostic methods are studied in this thesis. It turns out that the actual much utilized clinical methods can not be improved while radiological and biochemical diagnositic methods are much more promising. 106 refs.; 20 figs.; 36 tabs
Mohammad Taghi Chitsazi
Full Text Available Background and aims. The aim of this study was to compare the effectiveness of adjunctive photodynamic therapy (PDT in the treatment of aggressive periodontitis. Materials and methods. A total of 24 patients with clinical diagnosis of aggressive periodontitis received scaling and root planing (SRP for periodontal treatment. In a split-mouth design study, the teeth of one quadrant of each arch with ≥4 mm of probing depth were selected randomly for additional treatment with PDT (test group. PDT was performed with a diode laser beam with a wavelength of 670-690 nm and a power of 75 Mw. The control group consisted of selected teeth of the contralateral quadrant (SRP only. Before any treatment, subgingival plaque samples were collected by an endodontic paper cone for microbiological analysis by real-time polymerase chain reaction (PCR for detection of Aggregatibacter actinomy-cetecommitans. Clinical parameters including clinical attachment loss (CAL as primary outcome, plaque index (PI, bleed-ing on probing (BOP, probing depth (PD and gingival recession (REC were measured at baseline and after 90 days. Inter-group and intra-group statistical analyses were performed. Results. Treatment groups showed an improvement in all the clinical parameters and a significant reduction in the counts of A. actinomycetecommitans at 90 days compared to baseline (P 0.05. Conclusion. Within the limitations of this study, the results did not show additional benefits from PDT as an adjunctive treatment for patients with aggressive periodontitis.
Friesen, Lynn Roosa; Walker, Mary P; Kisling, Rebecca E; Liu, Ying; Williams, Karen B
This study evaluated second-, third-, and fourth-year dental students' ability to identify systemic conditions associated with periodontal disease, risk factors most important for referral, and medications with an effect on the periodontium and their ability to apply this knowledge to make clinical decisions regarding treatment and referral of periodontal patients. A twenty-one question survey was administered at one U.S. dental school in the spring semester of 2012 to elicit the students' knowledge and confidence regarding clinical reasoning. The response rate was 86 percent. Periodontal risk factors were accurately selected by at least 50 percent of students in all three classes; these were poorly controlled diabetes, ≥6 mm pockets posteriorly, and lack of response to previous non-surgical therapy. Confidence in knowledge, knowledge of risk factors, and knowledge of medications with an effect on the periodontium improved with training and were predictive of better referral decision making. The greatest impact of training was seen on the students' ability to make correct decisions about referral and treatment for seven clinical scenarios. Although the study found a large increase in the students' abilities from the second through fourth years, the mean of 4.6 (out of 7) for the fourth-year students shows that, on average, those students missed correct treatment or referral on more than two of seven clinical cases. These results suggest that dental curricula should emphasize more critical decision making with respect to referral and treatment criteria in managing the periodontal patient.
Full Text Available Context: Widespread interest in epidermal ridges developed only in the last several decades; however, it is still at infancy in the world of dentistry. The word “dermatoglyphics” comes from two Greek words (derma: Skin and glyphe: Carve and refers to the epidermal skin ridge formations which appear on the fingers, palms of the hands, and soles of the feet. Aims: This study aims to assess the relationship between finger prints and chronic periodontitis. Materials and Methods: Two hundred patients were equally divided into chronic periodontitis and periodontally healthy group. The fingerprint patterns of the participants were recorded with a rolling impression technique using duplicating ink on executive bond paper. Statistical Analysis Used: The descriptive analysis of the data was presented as percentage frequency. The percentage frequencies of each pattern on each individual finger were calculated, and statistical tests were applied. Unpaired t-test was used for intergroup comparisons (P < 0.05. Results: There were statistically more whorls and less arches in both right and left hands in patients with chronic periodontitis. Conclusions: Dermatoglyphics can lead to early diagnosis, treatment, and better prevention of many genetic disorders of the oral cavity and other diseases whose etiology may be influenced directly or indirectly by genetic inheritance.
Full Text Available Aim: The aim of this study was to find the relationship of orthodontic malocclusion with periodontal status, dental caries, and sociodemographic factors. Materials and Methods: The study population comprised 400 school-going children of age 11–14 years. The severity of malocclusion was determined by Treatment Priority Index. The sociodemographic factors were evaluated using a questionnaire that enquired about age, gender, parents' monthly income, and their educational status. Periodontal status was assessed using Community Periodontal Index of Treatment Need (CPITN index. To know about dental caries, decayed, missing, filled teeth (DMFT index was used in this study. Statistical Analysis Used: Spearman's rank correlation coefficients were used to find an association between variables. The effect of sociodemographic factors on treatment priority index (TPI scores was examined using Chi-square test. Student's t-test (to compare TPI scores of different genders and analysis of variance (to compare TPI scores among different age groups were used in this study. Results: Out of a total of 400 children included in the study, 19.5% students had normal occlusion whereas a majority of them (80.5% showed some sort of malocclusion. CPITN scores revealed that 3.1% pupils had no sign of the disease, 57.5% showed gingival bleeding after gentle probing, and 39.4% had supra or subgingival calculus. Conclusions: No statistically significant correlation was found between the orthodontic treatment need, periodontal status, and sociodemographic factors while a significant relation is observed of TPI with DMFT.
Kvarnvik, Christine; Söljegård, Emelie; Charalampakis, Georgios; Suksu-Art, Narong; Dahlén, Gunnar
The aim was to clinically and microbiologically describe the periodontal conditions in a remote adult Asian population with poor oral hygiene. The subjects were 30-60-year-old adults of Karen Hill tribes with no access to dental care. Eighty-six subjects were selected randomly. Clinical registrations included number of remaining teeth, plaque index (PlI), bleeding on probing (BoP), clinical attachment loss (CAL), and probing pocket depth (PPD). Subgingival plaque samples were collected and analyzed with the checkerboard method. Subjects of the study group had mean number of remaining teeth of 26.5 despite the abundant plaque and a high bleeding score. Severe periodontitis (CAL ≥ 7 mm) was recorded in 12.9% of the youngest age group (30-39 years) while it was significantly higher (52%) in the middle group (40-49 years) and (60%) in the eldest age group (50-60 years). Pathological pocketing (PPD ≥ 7 mm) was significantly lower in all age groups. Age, betel chewing, and a microbiological cluster including at least one of Prevotella tannerae, Filifactor alocis and Porphyromonas endodontalis significantly correlated with the severity of periodontal disease. Age, betel chewing, and a new bacterial complex other than the "red complex" correlated to periodontal breakdown in this remote adult Asian population. © 2015 Wiley Publishing Asia Pty Ltd.
Azarpazhooh, Amir; Dao, Thuan; Ungar, Wendy J; Chaudry, Faiza; Figueiredo, Rafael; Krahn, Murray; Friedman, Shimon
To effectively engage patients in clinical decisions regarding the management of teeth with apical periodontitis (AP), there is a need to explore patients' perspectives on the decision-making process. This study surveyed patients for their preferred level of participation in making treatment decisions for a tooth with AP. Data were collected through a mail-out survey of 800 University of Toronto Faculty of Dentistry patients, complemented by a convenience sample of 200 patients from 10 community practices. The Control Preferences Scale was used to evaluate the patients' preferences for active, collaborative, or passive participation in treatment decisions for a tooth with AP. Using bivariate and logistic regression analyses, the Gelberg-Andersen Behavioral Model for Vulnerable Populations was applied to the Control Preferences Scale questions to understand the influential factors (P ≤ .05). Among 434 of 1,000 respondents, 44%, 40%, and 16% preferred an active, collaborative, and passive participation, respectively. Logistic regression showed a significant association (P ≤ .025) between participants' higher education and preference for active participation compared with a collaborative role. Also, immigrant status was significantly associated with preference for passive participation (P = .025). The majority of patients valued an active or collaborative participation in deciding treatment for a tooth with AP. This pattern implied a preference for a patient-centered practice mode that emphasizes patient autonomy in decision making. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Lu, Haili; Tang, Haifang; Zhou, Tian; Kang, Na
Abstract Background: At present, many scholars have studied the periodontal health status of patients undergoing orthodontic treatment with fixed appliances and invisalign. However, those results are inconsistent. Therefore, we conducted this meta-analysis, and then provide reference for clinical treatment. Methods: Most databases, such as the Cochrane Library, EMBASE, PubMed, Medline, Chinese Biomedical Literature Database, CNKI, and Wan Fang Data were retrieved for related articles from the establishment of the database to October 2017. Meanwhile, we also searched the references of the related literatures manually, in order to increase the included literatures. Two researchers screened the related literatures according to the inclusion criteria and exclusion criteria. Stata 12.0 software was used for data analysis, and results are estimated by odds ratio (OR) and 95% confidence interval (CI). Results: Finally, 7 articles, including 368 patients, were included into our meta-analysis. Meta-analysis results showed that there was no statistically significant difference of gingival index (GI) and sulcus probing depth (SPD) status between the invisalign group and the control group, including at 1, 3, and 6 months (all P > .05). When compared with the control group, the invisalign group presented a lower plaque index (PLI) and sulcus bleeding index (SBI) status at 1 month (OR = −0.53, 95% CI: −0.89 to −0.18; OR = −0.44, 95% CI: −0.70 to −0.19, respectively), 3 months (OR = −0.69, 95% CI: −1.12 to −0.27; OR = −0.49, 95% CI: −0.93 to −0.05, respectively), and 6 months (OR = −0.91, 95% CI: −1.47 to −0.35; OR = −0.40, 95% CI: −0.63 to −0.07, respectively). Subgroup analysis showed that the SPD status was lower in the invisalign group at 6 months when measured the teeth using Ramfjord index (OR = −0.74, 95% CI: −1.35 to −0.12). However, there was no statistically significant difference between the 2
Background Periodontal disease (PD) is an infectious clinical entity characterized by the destruction of supporting tissues of the teeth as the result of a chronic inflammatory response in a susceptible host. It has been proposed that PD as subclinical infection may contribute to the etiology and to the pathogenesis of several systemic diseases including Atherosclerosis. A number of epidemiological studies link periodontal disease/edentulism as independent risk factor for acute myocardial infarction, peripheral vascular disease, and cerebrovascular disease. Moreover, new randomized controlled clinical trials have shown an improvement on cardiovascular surrogate markers (endothelial function, sICAM, hsPCR level, fibrinogen) after periodontal treatment. Nonetheless, such trials are still limited in terms of external validity, periodontal treatment strategies, CONSORT-based design and results consistency/extrapolation. The current study is designed to evaluate if periodontal treatment with scaling and root planning plus local delivered chlorhexidine improves endothelial function and other biomarkers of cardiovascular disease in subjects with moderate to severe periodontitis. Methods/Design This randomized, single-blind clinical trial will be performed at two health centers and will include two periodontal treatment strategies. After medical/periodontal screening, a baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD) and other systemic surrogate markers will be obtained from all recruited subjects. Patients then will be randomized to receive either supragingival/subgingival plaque cleaning and calculus removal plus chlorhexidine (treatment group) or supragingival plaque removal only (control group). A second and third FMD will be obtained after 24 hours and 12 weeks in both treatment arms. Each group will consist of 49 patients (n = 98) and all patients will be followed-up for secondary outcomes and will be monitored through a coordinating
Arce Roger M
Full Text Available Abstract Background Periodontal disease (PD is an infectious clinical entity characterized by the destruction of supporting tissues of the teeth as the result of a chronic inflammatory response in a susceptible host. It has been proposed that PD as subclinical infection may contribute to the etiology and to the pathogenesis of several systemic diseases including Atherosclerosis. A number of epidemiological studies link periodontal disease/edentulism as independent risk factor for acute myocardial infarction, peripheral vascular disease, and cerebrovascular disease. Moreover, new randomized controlled clinical trials have shown an improvement on cardiovascular surrogate markers (endothelial function, sICAM, hsPCR level, fibrinogen after periodontal treatment. Nonetheless, such trials are still limited in terms of external validity, periodontal treatment strategies, CONSORT-based design and results consistency/extrapolation. The current study is designed to evaluate if periodontal treatment with scaling and root planning plus local delivered chlorhexidine improves endothelial function and other biomarkers of cardiovascular disease in subjects with moderate to severe periodontitis. Methods/Design This randomized, single-blind clinical trial will be performed at two health centers and will include two periodontal treatment strategies. After medical/periodontal screening, a baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD and other systemic surrogate markers will be obtained from all recruited subjects. Patients then will be randomized to receive either supragingival/subgingival plaque cleaning and calculus removal plus chlorhexidine (treatment group or supragingival plaque removal only (control group. A second and third FMD will be obtained after 24 hours and 12 weeks in both treatment arms. Each group will consist of 49 patients (n = 98 and all patients will be followed-up for secondary outcomes and will be monitored
Perumal, Ramesh; Rajendran, Maheashwari; Krishnamurthy, Malathi; Ganji, Kiran Kumar; Pendor, Sunil Dattuji
Background: The primary etiologic factor of periodontitis is the subgingival infection with a group of Gram negative pathogens. Transient bacteremia in periodontitis patients underlie chronic production and systemic increases of various proinflammatory mediators, including Interleukin (IL)-1α, IL-6, C-reactive protein and Tumor necrosis factor (TNF)-α. P- selectin is a member of selectin family of cell surface receptor which is located in the membrane of the secretory granules (alpha granules) of platelets and in the membrane of the Weibel-Palade bodies of the vascular endothelial cells. P selectin redistributes from the membrane of the granules to the plasma membrane when platelets and endothelial cells are activated and thus degranulated. Aim: To compare the level of platelet activation, soluble P Selectin level and morphological changes and aggregation of platelets in patients in periodontitis patients compared to healthy controls. Materials and Methods: 80 patients were included in the study with the age group of 35-60. The patients were divided into 2 groups, 40 subjects with generalized chronic periodontitis and 40 healthy subjects taken as control. Periodontal Examination using clinical parameters namely, Bleeding Index, Plaque Index, Probing Pocket Depth and Clinical Attachment Level were recorded. Collection of blood samples for estimation of serum soluble P- selectin level by ELISA method. Evaluation of Platelet morphology and grading the platelet aggregation. Results: P-selectin expression shows that the mean value for control group is 4.97 ± 16.56 ng/mL and study group 13.05 ± 29.94 ng/mL which was significantly higher than control group with P value 0.001. Platelet morphological changes shows small form – mean value for control group is 75.83% ± 14.24% while for study group is 39.08%. ± 21.59; Big form – mean value for control group 0.80% ± 0.35% while for study group 0.48% ± 1.3%and Spider form- mean value for control group 23.88% ± 14
Full Text Available Studies among long term survivors of childhood cancer who had received high dose irradiation therapy of 4-60 Gy, demonstrated acute and chronic dental effects including periodontal diseases. However, the possible effects of low to moderate doses of radiation on dental health are sparse. The aim of this study is to investigate the association between childhood exposure to low-moderate doses of ionizing radiation and periodontal health following 50 years from the exposure. The study population included 253 irradiated subjects (treated for Tinea Capitis in the 1950s and, 162 non-irradiated subjects, treated for Tinea Capitis in the 1950s. The estimated dose to the teeth was 0.2-0.4Gy. Dental examination was performed according to the Community Periodontal Index (CPI. Socio-economic and health behavior variables were obtained through a personal questionnaire. Periodontal disease was operationally defined as deep periodontal pockets. A multivariate logistic regression model was used for the association of irradiation status and other independent variables with periodontal status.The results showed that among the irradiated subjects, 23% (95% CI 18%-28% demonstrated complete edentulousness or insufficient teeth for CPI scoring as compared to 13% (95% CI 8%-19% among the non-irradiated subjects (p=0.01. Periodontal disease was detected among 54% of the irradiated subjects as compared to 40% of the non-irradiated (p=0.008. Controlling for education and smoking, the ORs for the association between radiation and periodontal disease were 1.61 (95% CI 1.01-2.57 and 1.95 (95% CI 1.1-3.5 for ever never and per 1 Gy absorbed in the salivary gland, respectively. In line with other studies, a protective effect for periodontal diseases among those with high education and an increased risk for ever smokers were observed. In conclusion, childhood exposure to low-moderate doses of ionizing radiation might be associated with later outcomes of dental health. The
Mdala, Ibrahimu; Olsen, Ingar; Haffajee, Anne D; Socransky, Sigmund S; Thoresen, Magne; de Blasio, Birgitte Freiesleben
To understand degeneration of healthy sites and identify factors associated with disease progression in patients with chronic periodontitis. Data on healthy sites from 163 American and Swedish subjects were analysed using two-three-state (health, gingivitis, chronic periodontitis) Markov models based on bleeding on probing (BOP), and either clinical attachment level (CAL) + BOP or pocket depth (PD) + BOP. In 2 years, 10% (CAL + BOP) and 3% (PD + BOP) of healthy sites developed chronic periodontitis. On average, healthy sites remained healthy for 32 months before transiting in both models. Most transitions (87-97%) from health were to the gingivitis state. The expected duration of the gingivitis lesion was 4-5 months and sites recovered with a high probability (96-98%). Disease severity as measured by number of sites with CAL/PD > 4 mm at baseline and smoking, were associated with fast progression from health to chronic periodontitis within 6 months as were gingival redness in the PD + BOP model only. With age, the rate of disease progression to gingivitis decreased. Transition probabilities for gingivitis and chronic periodontitis were higher with CAL + BOP than with PD + BOP. Smoking and disease severity were significant predictors for fast progression. © 2014 The Authors. Journal of Clinical Periodontology Published by John Wiley & Sons Ltd.
Cosyn, Jan; De Bruyn, Hugo
In many disciplines of medicine guidelines are developed for the diagnosis and treatment of disease. These are essentially intended to standardize care and to optimize communication between the general practitioner and the specialist. Guidelines have already been described in the literature for chronic periodontitis. However, given the unique conditions in Belgium, these may not be appropriate for the average dental practice. In this manuscript the development of Belgian clinical guidelines for the diagnosis and treatment of chronic periodontitis is described. Basically, ten clinical questions were used as a basis for a thorough literature search. Evidence-based clinical guidelines were developed and adapted during three peer review sessions. In the final session Belgian specialists, who had all been invited, participated. This made sure that the scientific input was sufficiently transformed into clinical guidelines which are actually feasible today in Belgium.
MS Khafari ghosheh
Full Text Available Abstract Background & aim: Entamoeba gingivalis and Trichomonas tenax are oral protozoa that could cause periodontitis and gingivitis. The present study was done to determine the prevalence of these two protozoa in people over 14 years with periodontitis and gingivitis. Methods: In this descriptive, cross-sectional study, 540 patients referring Resalat Dental Clinic, Shahrekord were enrolled and assigned in two groups of 270 patients with periodontitis and gingivitis and270 healthy individuals. The prepared specimens were examined by extensive wet procedures, Gimsa staining and Trichorom staining. Data were analyzed by chi-square, Fisher’s exact test, and logistic regression in SPSSv.20. Results: No E. gingivalis- and T. tenax-positive cases were seen in the healthy group. The prevalence of E. gingivalis and T. tenax was obtained 3% by extensive wet procedure, 1.9% by Trichoderma staining, and 0.7% by Giemsa staining respectively. By logistic regression model, none of variables of age, gender, place of residence, smoking, tooth brushing, flossing, and oral PH were associated protozoan infection of E. gingivalis and T. tenax (P>0.05. Conclusion: In patients with periodontitis and gingivitis referred to the dental clinic, parasitic infections were attenuated to gingivialis and trichomoniasis vaginalis, and possibly other non-parasitic agents, including bacteria or other microorganisms, may play a role.
Huang, Ding-ming; Fu, Chun-hua; Zhou, Xue-dong
To investigate the distribution of Bacteroides forsythus in root canals with chronic apical periodontitis and to determine its associations with clinical symptoms. Thirty-eight tooth root canals from 31 subjects were studied with a 16S rDNA-directed polymerase chain reaction (PCR). These teeth were classified into symptomatic and asymptomatic groups according to the clinical symptoms and signs, including spontaneous pain, percussion pain, sinus tract and swelling, respectively. Ten of the 38 root canal samples were positive for B. forsythus. The prevalence of B. forsythus was 26.3% for 38 root canals, 45.5% for spontaneous pain group, 39.1% for percussion pain group, 29.4% for sinus tract group, 42.9% for swelling group, respectively. Significant positive associations were observed between B. forsythus in infected root canals and the spontaneous pain, percussion pain, and swelling of apical periodontitis, respectively (OR=infinity, 9, 12; Papical periodontitis (OR=1.33). B. forsythus colonized in the infected root canals. It is the putative pathogen of apical periodontitis.
Sağlam, Ebru; Saruhan, Nesrin; Çanakçı, Cenk Fatih
Some maternal immunological changes due to pregnancy increases susceptibility to infections. Periodontal disease, the main cause is plaque, is a common disease which is seen multifactorial and varying severity. There are many clinical criteria for diagnosis of periodontal disease. Correlation between pregnancy and periodontal inflammation is known for many years. Periodontal disease affects pregnant’s systemic condition and also has negative effects on fetus. Periodontal disease increases the...
Mdala, Ibrahimu; Olsen, Ingar; Haffajee, Anne D; Socransky, Sigmund S; Thoresen, Magne; de Blasio, Birgitte Freiesleben
Aim To understand degeneration of healthy sites and identify factors associated with disease progression in patients with chronic periodontitis. Material and Methods Data on healthy sites from 163 American and Swedish subjects were analysed using two-three-state (health, gingivitis, chronic periodontitis) Markov models based on bleeding on probing (BOP), and either clinical attachment level (CAL) + BOP or pocket depth (PD) + BOP. Results In 2 years, 10% (CAL + BOP) and 3% (PD + BOP) of healthy sites developed chronic periodontitis. On average, healthy sites remained healthy for 32 months before transiting in both models. Most transitions (87–97%) from health were to the gingivitis state. The expected duration of the gingivitis lesion was 4–5 months and sites recovered with a high probability (96–98%). Disease severity as measured by number of sites with CAL/PD > 4 mm at baseline and smoking, were associated with fast progression from health to chronic periodontitis within 6 months as were gingival redness in the PD + BOP model only. With age, the rate of disease progression to gingivitis decreased. Conclusion Transition probabilities for gingivitis and chronic periodontitis were higher with CAL + BOP than with PD + BOP. Smoking and disease severity were significant predictors for fast progression. PMID:24888705
Herrera, D; Roldán, S; O'Connor, A; Sanz, M
The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute periodontal abscesses. After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3-5 days, 10-12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10-12 days). Blood and urine samples were collected at baseline and after 10-12 days. Microbiological samples were processed by anaerobic culturing, and isolated periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (pperiodontal abscesses in periodontitis patients.
Full Text Available Proses penuaan merupakan salah satu faktor sistemik yang mempengaruhi respon tubuh terhadap terjadinya penyakit periodontal. Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan, sikap dan perilaku terhadap pemeliharaan kebersihan gigi dan mulut dengan status kesehatan periodontal pra lansia. Penelitian ini merupakan penelitian non eksperimental, dengan rancangan cross sectional. Subjek penelitian berjumlah 225 orang pra lansia dari 9 Posbindu di Kecamatan Indihiang Tasikmalaya, yang diambil dengan cara purposive sampling. Variabel pengaruh terdiri dari pengetahuan, sikap dan perilaku terhadap pemeliharaan kebersihan gigi dan mulut. Variabel pengetahuan diukur menggunakan kuesioner tertutup dengan pilihan jawaban benar atau salah. Variabel sikap dan perilaku diukur menggunakan kuesioner dibuat menurut skala Likert. Kuesioner telah diuji validitas (koefisien korelasi ≥ 0,30 dan uji reliabilitas (alpha cronbach >0,60. Variabel terpengaruh adalah status kesehatan periodontal yang diukur menggunakan indeks CPITN. Analisa data menggunakan analisis korelasi dan regresi berganda. Hasil analisis regresi berganda menunjukkan bahwa variabel pengetahuan, sikap dan perilaku terhadap pemeliharaan kebersihan gigi dan mulut mempunyai hubungan signifikan terhadap status kesehatan periodontal (F =30,681 dan p =0,001, dan memberikan kontribusi pengaruh sebesar 29,4% (R² = 0,294 terhadap status kesehatan periodontal. Perilaku terhadap pemeliharaan kebersihan gigi dan mulut memberikan kontribusi pengaruh paling besar terhadap status kesehatan periodontal yaitu sebesar 6,9%. Kesimpulan dari penelitian ini adalah semakin baik pengetahuan, sikap dan perilaku terhadap pemeliharaan kebersihan gigi dan mulut, semakin baik status kesehatan periodontal pra lansia. Perilaku terhadap pemeliharaan kebersihan gigi dan mulut memberikan kontribusi pengaruh paling besar terhadap status kesehatan periodontal pra lansia. Correlation Between Knowledge, Attitude
Koçak, E.; Sağlam, M.; Kayış, S.A.; Dündar, N.; Kebapçılar, L.; Loos, B.G.; Hakki, S.S.
In order to evaluate whether nonsurgical periodontal treatment with/without diode laser (DL) decontamination improves clinical parameters, the levels of IL-1β, IL-6, IL-8, intercellular adhesion molecule (ICAM), and vascular cell adhesion molecule (VCAM) in gingival crevicular fluid and metabolic
Cortelli, Sheila C; Costa, Fernando O; Rodrigues, Edson; Cota, Luis O M; Cortelli, Jose R
Nitrite is a biologic factor relevant to oral and systemic homeostasis. Through an oral bacteria reduction process, it was suggested that periodontal therapy and chlorhexidine (CHX) rinse could affect nitrite levels, leading to negative effects, such as an increase in blood pressure. This 6-month randomized clinical trial evaluated the effects of periodontal therapeutic protocols on salivary nitrite and its relation to subgingival bacteria. One hundred patients with periodontitis were allocated randomly to debridement procedures in four weekly sections (quadrant scaling [QS]) or within 24 hours (full-mouth scaling [FMS]) in conjunction with a 60-day CHX (QS + CHX and FMS + CHX), placebo (QS + placebo and FMS + placebo), or no mouthrinse (QS + none and FMS + none) use. Real-time polymerase chain reaction determined total bacterial, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Streptococcus oralis, and Actinomyces naeslundii levels. Salivary nitrite concentration was determined with Griess reagent. Data were analyzed statistically at baseline and 3 and 6 months by analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests (P periodontal pockets. The relationship between nitrite and bacterial levels appears weak. Short-term scaling exhibited a greater influence on nitrite concentrations then long-term CHX use.
Prasanth, Chandra Sekhar; Betsy, Joseph; Jayanthi, Jayaraj L.; Nisha, Unni G.; Prasantila, Janam; Subhash, Narayanan
Since conventional techniques using periodontal probes have inherent drawbacks in the diagnosis of different grades of gingival inflammation, development of noninvasive screening devices becomes significant. Diffuse reflectance (DR) spectra recorded with white light illumination is utilized to detect periodontal inflammation from the oxygenated hemoglobin absorption ratio R620/R575. A multispectral imaging system is utilized to record narrow-band DR images at 575 and 620 nm from the anterior sextant of the gingivia of 15 healthy volunteers and 25 patients (N=40). An experienced periodontist assesses the level of gingival inflammation at each site through periodontal probing and assigns diagnosis as healthy, mild, moderate, or severe inflammation. The DR image ratio R620/R575 computed for each pixel (8-μm resolution) from the monochrome images is pseudo-color-mapped to identify gingival inflammation sites. The DR image ratio values at each site are compared with clinical diagnosis to estimate the specificity and sensitivity of the DR imaging technique in inflammation mapping. The high diagnostic accuracy is utilized to detect underlying inflammation in six patients with a previous history of periodontitis.
Ramandeep Singh Gambhir
Full Text Available Background: Periodontal disease is one of the most prevalent dental diseases, which affects the adult population of the world, varying only in degree from mild to severe. Transport industry is considered an important pillar for socioeconomic development of any nation. The present study was carried out to assess the periodontal health status of transport workers working in Chandigarh Transport Undertaking (CTU buses, Chandigarh (Union territory. Materials and Methods: A cross-sectional study was conducted on all available CTU workers at all three bus depots. The data were recorded on a modified WHO format (1997. A total of 998 subjects were included for community periodontal index (CPI and attachment loss computations after doing necessary exclusions. Periodontal status was evaluated using CPI. Results: About 8.13% of the subjects had healthy periodontium while maximum subjects (73.2% had a score 2 (calculus as evaluated by CPI. 3.4% (12 of the subjects belonging to upper middle class had deep pockets as compared to 1.9% (10 of the subjects in the lower middle class. None of the subjects in the upper high, high, and upper middle socioeconomic status (SES category had a loss of attachment score 4. 25.9% of the postgraduates had a CPI score of 0 whereas 0.7% high school subjects had a loss of attachment score 4. Conclusion: Advanced periodontal disease (CPI score, 4 affected small number of subjects with maximum subjects (73% having a CPI score of 2. There was statistically significant association of SES and education level with the CPI score and loss of attachment level.
Ambooken, Majo; Mathew, Jayan Jacob; Issac, Annie Valayil; Kunju, Ajithkumar Parachalil; Parameshwaran, Renjith Athirkandathil
Introduction The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. Aim To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Study and Design Department of Periodontics. Randomized clinical trial with split mouth design. Materials and Methods Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Statistical analysis Results were statistically analysed using paired T test, one-way ANOVA, Tukey’s HSD test and repeated measure ANOVA. Results Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The
Jose, Kachapilly Arun; Ambooken, Majo; Mathew, Jayan Jacob; Issac, Annie Valayil; Kunju, Ajithkumar Parachalil; Parameshwaran, Renjith Athirkandathil
The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Department of Periodontics. Randomized clinical trial with split mouth design. Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using paired T test, one-way ANOVA, Tukey's HSD test and repeated measure ANOVA. Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination
Silva, Geraldo L M; Soares, Rodrigo V; Zenóbio, Elton G
The aim of this review is to present the current status of the occurrence and management of a periodontal abscess during supportive periodontal therapy (SPT). A periodontal abscess depicts typical features and has been described in patients under SPT in clinical trials. Common periodontal pathogens have been observed in this lesion and some etiologic factors may be responsible for its recurrence. This condition can be isolated or associated with factors that can change the prognosis of affected teeth. Although it has been frequently noticed in untreated periodontitis, the periodontal abscess can also occur in patients under SPT and has been regarded as one of the possible complications of SPT. Patients with a high susceptibility to periodontal disease lost more teeth than those with a healthy periodontium. Early diagnosis and appropriate intervention for periodontal abscesses in patients under SPT are extremely important for the management of the periodontal abscess since this condition can lead to loss of the involved tooth. A single case of a tooth diagnosed with periodontal abscess that responds favorably to adequate treatment does not seem to affect its longevity. An accurate diagnosis and adequate treatment can preserve the longevity of affected teeth.
Momen-Heravi, Fatemeh; Kang, Philip
There is a lack of clinical research on the potential effect of cannabis use on the periodontium as well as its effect on treatment outcomes. The aim of this case report is to illustrate the clinical presentation of periodontal disease in a young woman who was a chronic cannabis user, as well as successful treatment involving motivating the patient to quit cannabis use and undergo nonsurgical and surgical therapy. A 23-year-old woman sought care at the dental clinic for periodontal treatment. During a review of her medical history, the patient reported using cannabis frequently during a 3-year period, which coincided with the occurrence of gingival inflammation. She used cannabis in the form of cigarettes that were placed at the mandibular anterior region of her mouth for prolonged periods. Localized prominent papillary and marginal gingival enlargement of the anterior mandible were present. The mandibular anterior teeth showed localized severe chronic periodontitis. The clinicians informed the patient about the potentially detrimental consequences of continued cannabis use; she was encouraged to quit, which she did. The clinicians performed nonsurgical therapy (scaling and root planing) and osseous surgery. The treatment outcome was evaluated over 6 months; improved radiographic and clinical results were observed throughout the follow-up period. Substantial availability and usage of cannabis, specifically among young adults, requires dentists to be vigilant about clinical indications of cannabis use and to provide appropriate treatments. Behavioral modification, nonsurgical therapy, and surgical therapy offer the potential for successful management of cannabis-related periodontitis. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.
Windisch, Péter; Szendroi-Kiss, Dóra; Horváth, Attila; Suba, Zsuzsanna; Gera, István; Sculean, Anton
Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11-20 months (mean, 13.9+/-3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8+/-1.7 mm and mean clinical attachment level gain 4.3+/-2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8+/-1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8+/-2.8% and 32.1+/-8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be
Kanaparthy, Rosaiah; Kanaparthy, Aruna; Mahendra, Muktishree
Periodontal subgingival pathogens affect local and systemic immune and inflammatory response and cause the release of cytokines; this results in periodontal destruction and initiation of an acute phase systemic inflammatory response characterized by the release of C-reactive proteins (CRP). This study set out to evaluate the serum concentration of CRP that can be used as a marker of periodontal disease as well as a risk indicator for cardiovascular disease. Based on their periodontal status, 45 patients were divided into three groups. The following clinical parameters were recorded: plaque index, gingival index, bleeding index, probing pocket depth, and clinical attachment levels. Scoring was done on six tooth surfaces for all teeth. For the CRP assessment, blood samples were collected from subjects at the time of clinical examination. The results indicated an increase in serum CRP levels in patients with generalized aggressive periodontitis and chronic periodontitis as compared to controls.
Gusmão, Estela Santos; Picarte, Ana Carolina Lessa Cavalcanti; Ben Barbosa, Maria Bernadete Cavalcanti; Rösing, Cassiano Kuchenbecker; Cimoes, Renata
Aim : The aim of the present study was to determine the occurrence of furcation involvement in the molars of patients with chronic periodontitis and correlate clinical and radiographic findings. Seventy subjects aged 35-69 years enrolled for treatment at a periodontics specialization program in Pernambuco, Brazil (EAP-SCDP-ABO/PE) participated in the study, comprising a total of 350 molars examined. The clinical diagnosis of furcation involvement was performed with a horizontal Nabers probe, whereas the radiographic examination was performed with periapical and bite-wing radiographs. The images were analyzed with an X-ray viewer at 3× magnification. The Chi-square test was used, with the level of significance set at 5%. A total of 64.5% individuals presented with furcation involvement, 43.1% of whom had degree II furcation. A significant association (P = 0.0060) was found between tooth type and frequency of furcation involvement. The first lower and upper molars were affected in 64.5 and 58.5% of cases, respectively. Adequate agreement (0.65) was observed between the clinical and radiographic findings. Taking into consideration the method employed and the results obtained, it may be concluded that the clinical and radiographic examinations performed are effective tools for diagnosing furcation involvement in teeth affected with periodontal disease.
О. М. Slaba
Full Text Available The aim. To assess the influence of liver fibrosis stage on the clinical course of periodontal diseases in patients with chronic hepatitis C. Material and Methods. 122 patients with chronic hepatitis C, treated at the 7th department ofLvivRegionalInfectiousDiseasesHospital during 2013 – 2015 were included into dental investigation. The periodontal disease was diagnosed in accordance with the classification of M. F. Danilevsky (1994. The clinical condition of periodontium was assessed by the papillary marginal alveolar index (PMA in the modification ofParma, by the periodontal index – PI (AL Russel, 1956, by the Muhlemann and Son index – the degree of bleeding in the region of the gingival papilla (PBI. The stage of liver fibrosis was determined according to the medical history. The significance of the difference between two or more relative indicators was calculated using the Fisher test with the Metropolis algorithm. The correlation dependence between the clinical condition of periodontal tissues and the stage of liver fibrosis in patients with viral hepatitis C was studied using the Spearman rank correlation coefficient. Results. The highest percentage of patients with stage of liver fibrosis F0 (70.00 ± 15.28 % was registered in patients with healthy periodont, the lowest - in patients with generalized periodontitis of the third stage (7.89 ± 4.37 %. The highest frequency of patients with the stage of liver fibrosis F3 (73.68 ± 7.14 % was also observed in persons suffering from generalized periodontitis stage III (73.68 ± 7.14 %. Conclusions. The distribution of periodontal lesion severity statistically significant (p < 0.001 depended on the stage of liver fibrosis in patients with chronic hepatitis C. Direct (R = 0.70; p < 0.001 strong correlation between the clinical state of periodontal tissues and the stage of liver fibrosis in patients with chronic hepatitis C (using the Spearman rank correlation coefficient has been determined
Wu, T; Trevisan, M; Genco, R J; Falkner, K L; Dorn, J P; Sempos, C T
Using data from the Third National Health and Nutrition Examination Survey (1988-1994), the authors examined the relation between periodontal health and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen. A total of 10,146 participants were included in the analyses of cholesterol and C-reactive protein and 4,461 in the analyses of fibrinogen. Periodontal health indicators included the gingival bleeding index, calculus index, and periodontal disease status (defined by pocket depth and attachment loss). While cholesterol and fibrinogen were analyzed as continuous variables, C-reactive protein was dichotomized into two levels. The results show a significant relation between indicators of poor periodontal status and increased C-reactive protein and fibrinogen. The association between periodontal status and total cholesterol level is much weaker. No consistent association between periodontal status and high density lipoprotein cholesterol was detectable. Similar patterns of association were observed for participants aged 17-54 years and those 55 years and older. In conclusion, this study suggests that total cholesterol, C-reactive protein, and fibrinogen are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.
Modupeoluwa Omotunde Soroye
Full Text Available Aim: This study aimed to examine the clinical management of patients who attended a Nigerian teaching hospital with periodontal abscesses. Setting and Design: This is a retrospective study among patients who attended the Periodontics Clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between January 2008 and December 2015. Patients and Methods: Information about the diagnosis was obtained from the departmental log book, and case notes were retrieved from record department. Data collection elicited information on age, sex, tribe, frequency of tooth brushing, dental attendance, medical history, clinical features, involved tooth/teeth, and treatment received. Statistical Analysis Used: Epi info version 3.5.1 was used for statistical analysis. Results: Patients aged between 15 and 87 years, with a mean age of 35.53 ± 19.30 years. Majority of patients were males, had minor ethnic extractions, had some form of education, first dental clinic attendees, indulged in once-daily toothbrushing, fully dentate, and had fair/poor oral hygiene. A total of 8.8% and 31.6% of the participants smoked cigarettes and consumed alcohol, respectively. A fifth of the participants had systemic diseases such as hypertension, diabetes mellitus, and peptic ulcer disease. Majority of the participants (91.2% had severe pain. About two-fifths had periodontal abscess around the incisors and the molars. The upper right quadrant was mostly involved (31.6%. Two-fifth of the patients had extraction done. Conclusion: Data from this study revealed periodontal abscess as a severely painful condition in naÏve dental patients, successfully treated mainly through extraction of the implicated tooth/teeth. This implies that oral health awareness and regular dental attendance may prevent its occurrence.
Christodoulides, Nicos; Nikolidakis, Dimitris; Chondros, Panagiotis; Becker, Jürgen; Schwarz, Frank; Rössler, Ralf; Sculean, Anton
Recent preclinical and clinical data have suggested a potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of this study was to evaluate the clinical and microbiologic effects of the adjunctive use of PDT to non-surgical periodontal treatment. Twenty-four subjects with chronic periodontitis were randomly treated with scaling and root planing followed by a single episode of PDT (test) or scaling and root planing alone (control). Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), gingival recession, and clinical attachment level (CAL) were measured at baseline and 3 and 6 months after therapy. Primary outcome variables were changes in PD and CAL. Microbiologic evaluation of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia (previously T. forsythensis), Treponema denticola, Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, and Capnocytophaga spp. was performed at baseline and 3 and 6 months following therapy by using a commercially available polymerase chain reaction test. At 3 and 6 months after treatment, there were no statistically significant differences between the groups with regard to CAL, PD, FMPS, or microbiologic changes. At 3 and 6 months, a statistically significantly greater improvement in FMBS was found in the test group. The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PD reduction and CAL gain, but it resulted in a significantly higher reduction in bleeding scores compared to scaling and root planing alone.
Rams, Thomas E; Feik, Diane; Mortensen, Joel E; Degener, John E; van Winkelhoff, Arie J
Streptococcus constellatus and Streptococcus intermedius in subgingival dental plaque biofilms may contribute to forms of periodontitis that resist treatment with conventional mechanical root debridement/surgical procedures and may additionally participate in some extraoral infections. Because systemic antibiotics are often used in these clinical situations, and little is known of the antibiotic susceptibility of subgingival isolates of these two bacterial species, this study determined the in vitro susceptibility to six antibiotics of fresh S. constellatus and S. intermedius clinical isolates from human periodontitis lesions. A total of 33 S. constellatus and 17 S. intermedius subgingival strains, each recovered from separate patients with severe chronic periodontitis (n = 50) before treatment, were subjected to antibiotic gradient strip susceptibility testing with amoxicillin, azithromycin, clindamycin, ciprofloxacin, and doxycycline on blood-supplemented Mueller-Hinton agar and to the inhibitory effects of metronidazole at 16 mg/L in an enriched Brucella blood agar dilution assay. Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing interpretative standards were used to assess the results. Clindamycin was the most active antibiotic against S. constellatus (minimum inhibitory concentration at 90% [MIC90] 0.25 mg/L), and amoxicillin was most active against S. intermedius (MIC90 0.125 mg/L). A total of 30% of the S. constellatus and S. intermedius clinical isolates were resistant in vitro to doxycycline, 98% were only intermediate in susceptibility to ciprofloxacin, and 90% were resistant to metronidazole at 16 mg/L. Subgingival S. constellatus and S. intermedius exhibited variable antibiotic susceptibility profiles, potentially complicating empirical selection of periodontitis antibiotic therapy in patients who are species positive.
Hatipoglu, Hasan; Canbaz Kabay, Sibel; Gungor Hatipoglu, Mujgan; Ozden, Hilmi
The aim of this study was to evaluate the association between different disability states in patients with multiple sclerosis (MS) as determined by the expanded disability status scale (EDSS) and dental-periodontal measures. Eighty patients with MS (64 females and 16 males) were included in this study. Data on MS types, attack frequency, disease duration, EDSS scores and orofacial complaints prior to an MS attack were obtained from medical records. The plaque index (PI), probing depth (PD), clinical attachment level (CAL), gingival index (GI), decayed-missing-filled teeth (DMFT) index and number of present teeth were measured during one dental examination for each subject. The MS patients were divided into the following 2 groups based on their EDSS scores: low physical disability (L-DS) and high physical disability (H-DS). Differences in dental parameters between groups of low and high disability were investigated. p disability in MS patients. In addition, some maxillofacial-oral complaints prior to an MS attack were observed. © 2015 S. Karger AG, Basel.
Elvia Christina Barros de Almeida
Full Text Available Objective: The purpose of this study was to evaluate the periodontal status of interproximal surfaces restored with composite resin, in comparison with non-restored interproximal surfaces. Methods: In 65 patients, we analyzed 145 restored surfaces and 145 non-restored surfaces. Results: Most of the restored surfaces (54.3% showed radiographic alterations, which was shown to be higher among restorations with clinically detected proximal excess (56.8% x 52.8%; with lack of restorative material (64.5% x 51.4%; in restorations with proximal overhang (67.7% x 44.4%; in teeth with gingival inflammation?/bleeding (55.1% x 40.0% and in teeth with probing depth exceeding 3 mm (64.3% x 52.9%. However, there were no significant associations for these variables. Of the non-restored surfaces, 24.4% showed radiographic alterations, however there were no significant associations. Conclusion: The results showed a statistical significance for radiographic alterations in restored and non-restored surfaces.
Baňasová, Lenka; Kamodyová, Natália; Janšáková, Katarína; Tóthová, Ľubomíra; Stanko, Peter; Turňa, Ján; Celec, Peter
Previous observational studies have shown that periodontal status is associated with salivary markers of oxidative damage. A direct comparison of periodontitis patients and controls using a wide palette of salivary markers of oxidative stress is lacking. Characteristics of salivary DNA in periodontitis are unknown. The aim of this study was to compare the salivary markers of oxidative stress and characteristics of salivary DNA between patients with chronic periodontitis and periodontitis-free controls. Saliva was collected from 23 patients with chronic periodontitis and 19 periodontitis-free controls. All participants underwent a clinical periodontal examination. Markers of oxidative and carbonyl stress were measured in saliva. Human and bacterial DNA was quantified, and human DNA integrity was assessed. Salivary thiobarbituric acid-reacting substances were higher in patients than in controls; at least in men, the difference was significant (p periodontitis patients. The results confirmed the association of salivary thiobarbituric acid-reacting substances with periodontitis. Lipid peroxidation in periodontitis seems to be caused by increased production of reactive oxygen species in men and by decreased antioxidant status in women. Whether lower salivary DNA integrity is involved in the pathogenesis of periodontitis remains to be elucidated. Salivary thiobarbituric acid-reacting substances are associated with periodontitis at least on a population level. Sex-specific causes of lipid peroxidation might point towards different pathogenic mechanisms.
Buonavoglia, Alessio; Latronico, Francesca; Pirani, Chiara; Greco, Maria Fiorella; Corrente, Marialaura; Prati, Carlo
In this study, the association of red complex (RC) bacteria that include Treponema denticola, Tannerella forsythia and Porphyromonas gingivalis with acute, exacerbated or chronic apical periodontitis was evaluated. Seventy-one patients with periapical disease were evaluated by clinical examination and microbiological samples obtained from the root canals were analyzed by a polymerase chain reaction assay. Twenty-one (29.6%) samples were positive for RC bacteria, with T. denticola, T. forsythia and P. gingivalis being detected in 14 (19.7%), 10 (14.1%) and 6 (8.5%) samples, respectively. RC bacteria were mainly associated with acute apical periodontitis (29.2%) and phoenix abscess (63.2%), while they were only sporadically detected (7.1%) in patients with chronic apical periodontitis. Generally, RC bacteria were associated with pain and a higher frequency of intracanalar/intrasulcular pus drainage. Involvement of RC bacteria in symptomatic periapical disease should be suspected in the presence of particularly severe clinical pain and pus drainage.
Chackartchi, Tali; Barkana, Idit; Klinger, Avigdor
The aim of this study was to analyze alveolar bone morphology following periodontally accelerated osteogenic orthodontics. Treated patients were called for a full periodontal examination and a cone beam computed tomography scan. Mean treatment time was 6.08 months. Mean probing pocket depth was 2.7 mm. No gingival recessions were noted. In the maxilla, buccal plate thickness was 0.48 to 2.14 mm. In the mandible, bone thickness was 0.2 to 1.82 mm. Root fenestrations and dehiscences were present in up to 40% of the anterior teeth. Although clinical outcomes were favorable, due to the presence of multiple posttreatment bone fenestrations and dehiscences, a revision of the treatment protocol might be considered.
Andersen, Roger C.; Loebel, Nicolas G.; Andersen, Dane M.
Photodynamic therapy(PDT) has been demonstrated to effectively kill human periopathogens in vitro. To evaluate the efficacy of PDT in vivo a series of clinical trials was carried out in multiple centers and populations. Clinical parameters including clinical attachment level, pocket probing depth and bleeding on probing were all evaluated. All groups received the standard of care, scaling and root planing, and the treatment group additionally received a single treatment of PDT. Of the total 309 patients and over 40,000 pockets treated in these 5 trials it was determined that photodynamic therapy provided a statistically significant improvement in clinical parameters over scaling and root planing alone.
Full Text Available Patients with acquired immunodeficiency syndrome (AIDS are at high risk of opportunistic infections. Oral manifestations have been associated with the level of immunosuppression, these include periodontal diseases, and understanding the microbial populations in the oral cavity is crucial for clinical management. The aim of this study was to examine the salivary bacterial diversity in patients newly admitted to the AIDS ward of the Public Health Clinical Center (China. Saliva samples were collected from fifteen patients with AIDS who were randomly recruited between December 2013 and March 2014. Extracted DNA was used as template to amplify bacterial 16S rRNA. Sequencing of the amplicon library was performed using a 454 GS-FLX Titanium sequencing platform. Reads were optimized and clustered into operational taxonomic units for further analysis. A total of 10 bacterial phyla (106 genera were detected. Firmicutes, Bacteroidetes and Proteobacteria were preponderant in the salivary microbiota in AIDS patients. The pathogen, Capnocytophaga sp., and others not considered pathogenic such as Neisseria elongata, Streptococcus mitis and Mycoplasma salivarium but which may be opportunistic infective agents were detected. Dialister pneumosintes, Eubacterium infirmum, Rothia mucilaginosa and Treponema parvum were preponderant in AIDS patients with periodontitis. Patients with necrotic periodontitis had a distinct salivary bacterial profile from those with chronic periodontitis. This is the first study using advanced sequencing techniques focused on hospitalized AIDS patients showing the diversity of their salivary microbiota.
Sharma, Praveen; Cockwell, Paul; Dietrich, Thomas; Ferro, Charles; Ives, Natalie; Chapple, Iain L C
trial later, data on cardio-renal function, periodontal health and patient-reported outcomes will be collected at each time point. This pilot randomised controlled trial will investigate the viability of undertaking a larger-scale study investigating the effect of treating periodontitis and maintaining periodontal health on cardio-renal outcomes in patients with CKD. National Institute of Health Research (NIHR) Clinical Research Network (UKCRN ID: 18458), ID: ISRCTN10227738 . Registered retrospectively to both registers on 23 April 2015.
Dukić, Walter; Bago, Ivona; Aurer, Andrej; Roguljić, Marija
The aim of this randomized clinical study is to evaluate the effect of a 980-nm diode laser as an adjunct to scaling and root planing (SRP) treatment. Thirty-five patients with chronic periodontitis were selected for the split-mouth clinical study. SRP was performed using a sonic device and hand instruments. Quadrants were equally divided between the right and left sides. Teeth were treated with SRP in two control quadrants (control groups [CG]), and the diode laser was used adjunctively with SRP in contralateral quadrants (laser groups [LG]). Diode laser therapy was applied to periodontal pockets on days 1, 3, and 7 after SRP. Baseline data, including approximal plaque index (API), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), were recorded before the treatment and 6 and 18 weeks after treatment. Changes in PD and CAL were analyzed separately for initially moderate (4 to 6 mm) and deep (7 to 10 mm) pockets. The results were similar for both groups in terms of API, BOP, PD in deep pockets, and CAL. The laser group showed only significant PD gain in moderate pockets during the baseline to 18-week (P 0.05). The present study indicates that, compared to SRP alone, multiple adjunctive applications of a 980-nm diode laser with SRP showed PD improvements only in moderate periodontal pockets (4 to 6 mm).
Tsami, A; Petropoulou, P; Kafritsa, Y; Mentis, Y A; Roma-Giannikou, E
To investigate the possible presence of H. pylori in subgingival dental plaque of children with upper gastrointestinal symptoms, as well as of their parents' and to detect any association between the presence of H. pylori and oral hygiene together with the periodontal status of children and their parents. The study comprised of 35 children with upper gastrointestinal symptoms, aged 4 to 14 years and 45 family members (mothers and/or fathers). Gastric biopsies were collected from all children for CLO-test, histology and culture. Serology was used to assess the H. pylori infection status of their parents. Before endoscopy, subgingival dental plaque from children and their parents were collected from 4 healthy and 4 diseased sites, and the clinical indices (gingival index, plaque index, bleeding on probing, pocket depth, loss of clinical attachment) after plaque collection were recorded. The Chi-square test was performed to investigate possible differences between children and their parents and logistic regression analysis was used to evaluate the association of parental infection status with that of children. 15 out of 35 children (42.86%) were found H. pylori-positive. In 6 out of the 15 infected children (40%) H. pylori was also identified in their subgingival plaque samples, as well as in one among the 20 non infected children. The presence of H. pylori in dental plaque was significantly associated with its presence in the gastric antrum (p=0.0274). H. pylori was identified in the dental plaque of 7 mothers corresponding to children with positive PCR in their dental plaque and of 4 fathers (one corresponding with his child found H. pylori positive in dental plaque). Children who had H. pylori identified in their dental plaque belonged to families with members also having H. pylori in dental plaque. No significant relationship between periodontal clinical parameters and detection of H. pylori in dental plaque in both children and their parents was found. However
Dursun, Erhan; Akalin, Ferda Alev; Genc, Tolga; Cinar, Nese; Erel, Ozcan; Yildiz, Bulent Okan
Periodontal disease is a chronic inflammatory disease of the jaws and is more prevalent in obesity. Local and systemic oxidative stress may be an early link between periodontal disease and obesity. The primary aim of this study was to detect whether increased periodontal disease susceptibility in obese individuals is associated with local and systemic oxidative stress. Accordingly; we analyzed periodontal status and systemic (serum) and local (gingival crevicular fluid [GCF]) oxidative status markers in young obese women in comparison with age-matched lean women.Twenty obese and 20 lean women participated. Periodontal condition was determined by clinical periodontal indices including probing depth, clinical attachment level, gingival index, gingival bleeding index, and plaque index. Anthropometric, hormonal, and metabolic measurements were also performed. Blood and GCF sampling was performed at the same time after an overnight fasting. Serum and GCF total antioxidant capacity (TAOC), and total oxidant status (TOS) levels were determined, and oxidative stress index (OSI) was calculated.Clinical periodontal analyses showed higher gingival index and gingival bleeding index in the obese group (P = 0.001 for both) with no significant difference in probing depth, clinical attachment level, and plaque index between the obese and the lean women. Oxidant status analyses revealed lower GCF and serum TAOC, and higher GCF and serum OSI values in the obese women (P < 0.05 for all). GCF TOS was higher in the obese women (P < 0.05), whereas there was a nonsignificant trend for higher serum TOS in obese women (P = 0.074). GCF TAOC values showed a negative correlation with body mass index, whereas GCF OSI was positively correlated with fasting insulin and low-density lipoprotein-cholesterol levels (P < 0.05 for all). Clinical periodontal indices showed significant correlations with body mass index, insulin, and lipid levels, and also oxidant status markers
Full Text Available Context: Periodontitis is an inflammatory disease of microbial origin. Locally delivered antimicrobials reduce subgingival flora. Achyranthes aspera gel has antimicrobial, antioxidant, anti-inflammatory, and immunostimulant effects. Aims: To evaluate the efficacy of local drug delivery of A. aspera gel in the management of chronic periodontitis. Materials and Methods: Thirty patients with chronic periodontitis were considered in the study and categorized into two equal groups (Group A: scaling and root planing (SRP with A. aspera gel, Group B: SRP with placebo gel. Patients were enlisted from the Department of Periodontics, Mamata Dental College and Hospital. The clinical parameters (gingival index, bleeding on probing, probing pocket depth, and clinical attachment level were recorded at baseline and 3 months. Statistical Analysis Used: All the obtained data were sent for statistical analyses using SPSS version 18. Results: The periodontitis and the Achyranthes were statistically analyzed. A comparison of clinical parameters for test group and control group from baseline to 3 months was done using paired t-test. Intergroup comparison for both the groups was done using independent sample t-test. Conclusions: A. aspera gel when delivered locally along with SRP showed a beneficial effect. A. aspera gel as a non-surgical local drug delivery system proved to be without any side effects in the management of periodontitis. A. aspera gel has strong anti-inflammatory effects in addition to its antioxidant activity.
Boyapati, Ramanarayana; Gojja, Prathibha; Chintalapani, Srikanth; Nagubandi, Kirankumar; Ramisetti, Arpita; Salavadhi, Shyam Sunder
Periodontitis is an inflammatory disease of microbial origin. Locally delivered antimicrobials reduce subgingival flora. Achyranthes aspera gel has antimicrobial, antioxidant, anti-inflammatory, and immunostimulant effects. To evaluate the efficacy of local drug delivery of A. aspera gel in the management of chronic periodontitis. Thirty patients with chronic periodontitis were considered in the study and categorized into two equal groups (Group A: scaling and root planing (SRP) with A. aspera gel, Group B: SRP with placebo gel). Patients were enlisted from the Department of Periodontics, Mamata Dental College and Hospital. The clinical parameters (gingival index, bleeding on probing, probing pocket depth, and clinical attachment level) were recorded at baseline and 3 months. All the obtained data were sent for statistical analyses using SPSS version 18. The periodontitis and the Achyranthes were statistically analyzed. A comparison of clinical parameters for test group and control group from baseline to 3 months was done using paired t -test. Intergroup comparison for both the groups was done using independent sample t -test. A. aspera gel when delivered locally along with SRP showed a beneficial effect. A. aspera gel as a non-surgical local drug delivery system proved to be without any side effects in the management of periodontitis. A. aspera gel has strong anti-inflammatory effects in addition to its antioxidant activity.
Carlos Eduardo Repeke
Full Text Available Periodontitis comprises a group of multifactorial diseases in which periodontopathogens accumulate in dental plaque and trigger host chronic inflammatory and immune responses against periodontal structures, which are determinant to the disease outcome. Although unusual cases of non-inflammatory destructive periodontal disease (NIDPD are described, their pathogenesis remains unknown. A unique NIDPD case was investigated by clinical, microbiological, immunological and genetic tools. The patient, a non-smoking dental surgeon with excessive oral hygiene practice, presented a generalized bone resorption and tooth mobility, but not gingival inflammation or occlusion problems. No hematological, immunological or endocrine alterations were found. No periodontopathogens (A. actinomycetemcomitans, P. gingivalis, F. nucleatum and T. denticola or viruses (HCMV, EBV-1 and HSV-1 were detected, along with levels of IL-1β and TNF-a in GCF compatible with healthy tissues. Conversely ALP, ACP and RANKL GCF levels were similar to diseased periodontal sites. Genetic investigation demonstrated that the patient carried some SNPs, as well HLA-DR4 (*0404 and HLA-B27 alleles, considered risk factors for bone loss. Then, a less vigorous and diminished frequency of toothbrushing was recommended to the patient, resulting in the arrest of alveolar bone loss, associated with the return of ALP, ACP and RANKL in GCF to normality levels. In conclusion, the unusual case presented here is compatible with the previous description of NIDPD, and the results that a possible combination of excessive force and frequency of mechanical stimulation with a potentially bone loss prone genotype could result in the alveolar bone loss seen in NIDPD.
Martin, R.R.; Naftel, S.J.; Nelson, A.J.; Edwards, M.; Mithoowani, H.; Stakiw, J. (UWO); (Saskatchewan)
Periodontitis is a serious disease that affects up to 50% of an adult population. It is a chronic condition involving inflammation of the periodontal ligament and associated tissues leading to eventual tooth loss. Some evidence suggests that trace metals, especially zinc and copper, may be involved in the onset and severity of periodontitis. Thus we have used synchrotron X-ray fluorescence imaging on cross sections of diseased and healthy teeth using a microbeam to explore the distribution of trace metals in cementum and adhering plaque. The comparison between diseased and healthy teeth indicates that there are elevated levels of zinc, copper and nickel in diseased teeth as opposed to healthy teeth. This preliminary correlation between elevated levels of trace metals in the cementum and plaque of diseased teeth suggests that metals may play a role in the progress of periodontitis.
Nguyen, Naomi-Trang; Byarlay, Matthew R; Reinhardt, Richard A; Marx, David B; Meinberg, Trudy A; Kaldahl, Wayne B
Numerous studies have documented the clinical outcomes of laser therapy for untreated periodontitis, but very few have reported on lasers treating inflamed pockets during maintenance therapy. The aim of this study is to compare the effectiveness of scaling and root planing (SRP) plus the adjunctive use of diode laser therapy to SRP alone on changes in the clinical parameters of disease and on the gingival crevicular fluid (GCF) inflammatory mediator interleukin-1β (IL-1β) in patients receiving regular periodontal maintenance therapy. This single-masked and randomized, controlled, prospective study includes 22 patients receiving regular periodontal maintenance therapy who had one or more periodontal sites with a probing depth (PD) ≥ 5 mm with bleeding on probing (BOP). Fifty-six sites were treated with SRP and adjunctive laser therapy (SRP + L). Fifty-eight sites were treated with SRP alone. Clinical parameters, including PD, clinical attachment level (CAL), and BOP, and GCF IL-1β levels were measured immediately before treatment (baseline) and 3 months after treatment. Sites treated with SRP + L and SRP alone resulted in statistically significant reductions in PD and BOP and gains in CAL. These changes were not significantly different between the two therapies. Similarly, differences in GCF IL-1β levels between SRP + L and SRP alone were not statistically significant. In periodontal maintenance patients, SRP + L did not enhance clinical outcomes compared to SRP alone in the treatment of inflamed sites with ≥ 5 mm PD.
Shah N; Sundaram K
Periodontal disease is the most common cause of tooth loss. It is has insidious onset, chronic course, and commonly result due to cumulative effect of dietary habits, oral hygiene methods and oral habits practiced over the years. This study was planned to evaluate the periodontal health status of elderly population (above 60 years) in the community, using CPITN index, gingival recession, mobility of teeth and halitosis, using modified WHO Oral Health Survey Proforma. In addition, impact of se...
Chronic periodontitis is caused by the immune reaction between bacteria and host. Some forms of examination have been developed to detect the development of periodontitis disease through saliva. Saliva consists of water, protein, electrolytes, gingival sulcus fluids, bacteria, organic molecules, antioxidant components. Antioxidants are released at inflammation sites by PMNs to protect from theReactive Oxygen Species (ROS).ROSsuch as O2 dan H2O2 are released by PMNs during phagocytosis that ca...
Raman, Renukanth Patabi Cheta; Taiyeb-Ali, Tara Bai; Chan, Siew Pheng; Chinna, Karuthan; Vaithilingam, Rathna Devi
40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals. 40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals. 15 subjects from NSPT group and 17 from OHI group completed the study. The difference in plaque index (PI) between NSPT and OHI groups were significant at 2 months recall (p = 0.013). There was no significant difference between NSPT and OHI group for all other clinical periodontal parameters, HbA1c and CRP levels. At 3 months post-therapy, periodontal parameters improved significantly in both groups with sites with probing pocket depth (PPD) c levels decreased in both groups with NSPT group recording statistically significant reduction (p = 0.038). Participants who demonstrated ≥ 50% reduction in PPD showed significant reductions of HbA1c and hs-CRP levels (p = 0.004 and p = 0.012). NSPT significantly reduced PI at 2 months post-therapy as compared to OHI. Both NSPT and OHI demonstrated improvements in other clinical parameters as well as HbA1c and CRP levels. ClinicalTrials.gov: NCT01951547.
Agrawal, Amit Arvind
Platelet concentrates (PC) [platelet-rich plasma (PRP) and platelet-rich fibrin (PRF)] are frequently used for surgical procedures in medical and dental fields, particularly in oral and maxillofacial surgery, plastic surgery and sports medicine. The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration. Although leukocyte rich and leukocyte poor PRP's have their own place in literature, the importance of non-platelet components in a platelet concentrate remains a mystery. PC have come a long way since its first appearance in 1954 to the T-PRF, A-PRF and i-PRF introduced recently. These PC find varied applications successfully in periodontics and implant dentistry as well. However, the technique of preparation, standing time, transfer process, temperature of centrifuge, vibration, etc ., are the various factors for the mixed results reported in the literature. Until the introduction of a proper classification of terminologies, the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion. This review intends to clarify all these confusion by briefing the exact evolution of PC, their preparation techniques, recent advances and their various clinical and technical aspects and applications.
Rajendra, Anjana; Spivakovsky, Silvia
Data sourcesMedline, Embase and CENTRAL databases were searched up to December 2014. Unpublished data were sought by searching a database listing unpublished studies OpenGray [http://www.opengrey.eu/], formerly OpenSIGLE.Study selectionRandomised clinical trials assessing treatment of patients with AgP comparing scaling and root planing (SRP) alone with SRP plus a single antibiotic or a combination of drugs with a minimum of three months follow-up were considered. Studies specifically designed to evaluate smokers or subjects with diabetes mellitus and HIV/AIDS were not included.Data extraction and synthesisTwo researchers independently screened titles, abstracts and full texts of the search results. The studies, which fulfilled inclusion criteria, underwent validity assessment and data extraction using a specifically designed form. The quality of included studies was assessed using the Cochranes collaboration tool for risk of bias. Only two of the 11 included trials were considered at a low risk of bias. The data extracted from ten studies was analysed by pair-wise meta-analyses and the data extracted from five studies was included in Bayesian network meta-analyses pooled estimates. The six studies evaluated in the pairwise meta-analyses were excluded in the pooled estimates because four studies included patients with advanced disease only and one study did not present average data for pocket depth (PD) and clinical attachment level (CAL) and another one for using a different mechanical treatment.ResultsFourteen studies reporting 11 randomised clinical trials with a total of 388 patients were included in the review. Nine of 11 studies reported a statistically significant greater gain in full mouth mean clinical attachment (CA) and reduction in probing depth (PD) when a systemic antibiotic was used. From those studies the calculated mean difference for CA gained was 1.08 mm (p benefits in CA gain and PD reduction when SRP was associated with systemic antibiotics
Pei, Xi Yan; He, Lu; Ouyang, Xiang Ying
To propose a novel, three-level (severe, moderate, mild) case definition using probing depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP) for epidemiologic studies on periodontitis. Case definitions (DEF) 1-30 with PD, CAL and BOP were made. Based on data from epidemiologic research in Chengde (Hebei Province, China) in 1992, prevalence of periodontitis by DEF1-30 was calculated and compared with a reference (definitions by Centers for Disease Control and Prevention/American Academy of Periodontology in 2012). Sensitivity, specificity, Youden Index, Cohen's kappa coefficient (CKC) and the area under the receiver operator characteristic curve (AUC) were calculated for the definitions selected. DEF1 and DEF18 for periodontitis, DEF2, DEF3, DEF19 for moderate and severe periodontitis, and DEF5, DEF13, DEF14, DEF21 and DEF25 for severe periodontitis, which were similar for estimation of periodontitis prevalence compared with the reference, were selected. DEF18 for periodontitis, DEF19 for moderate and severe periodontitis, and DEF5 for severe periodontitis were selected because they showed higher values for the Youden Index, CKC and AUC, and formed a three-level definition. A novel three-level case classification of periodontitis using three parameters of PD, CAL and BOP was proposed. The estimated periodontitis prevalence according to the novel proposed definition is close to the prevalence according to the CDC/AAP definition.
Mellonig, James T; Valderrama, Pilar; Gregory, Holly J; Cochran, David L
Enamel matrix derivative (EMD) is a composite of proteins that was demonstrated histologically to work as an adjunct to periodontal regenerative surgical therapy. The purpose of this study was to evaluate the clinical and histologic effects of EMD as an adjunct to scaling and root planing. Four patients with severe chronic periodontitis and scheduled to receive complete dentures were accrued. Probing depth and clinical attachment levels were obtained. Unlimited time was allowed for hand and ultrasonic instrumentation. A notch was placed in the root >or=1 to 2 mm from the apical extent of root planing. EMD was inserted into the pocket, and a periodontal dressing was placed. Patients were seen every 2 weeks for plaque control. At 6 months post-treatment, soft tissue measurements were repeated, and the teeth were removed en bloc and prepared for histomorphologic analysis. Probing depth reduction and clinical attachment level gain were obtained in three-fourths of the specimens. Three of the four specimens analyzed histologically demonstrated new cementum, bone, periodontal ligament, and connective tissue attachment coronal to the notch. In one specimen, the gingival margin had receded below the notch. The results were unexpected and may represent an aberration. However, the substantial reduction in deep probing depths and clinical attachment level gain in three of four specimens, in addition to the histologic findings of new cementum, new bone, a new periodontal ligament, and a new connective tissue attachment, suggest that EMD may be useful as an adjunct to scaling and root planing in single-rooted teeth.
Srinivasa, T S; Agrawal, Parul; Goyal, Pravesh; Farista, Sana; Sowmya, N K; Deonani, Sushmita
Glycosylated haemoglobin (HbA1c) level can consequently be interpreted as an average of the blood glucose present over the past 3-4 months. Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine the level of HbA1c in healthy and periodontitis patients who were previously not diagnosed with diabetes mellitus. A total of 40 patients were selected for study and divided into two groups. Group 1 included patients with a healthy periodontium, and Group 2 included patients suffering from chronic periodontitis. Finger stick blood was collected by special collection unit (A1CNOW+® Bayer Health Care, Tarrytown New York, USA), for estimating level of HbA1c. Both groups showed similar HbA1c levels clinically with slight increase in levels in the test group, but was statistically significant (test--5.66 ± 0.35%, control--5.17 ± 0.3% P = 0.003). Indians are at a high-risk of developing periodontitis and diabetes. These data suggest a possible link between periodontitis and glycemic control in nondiabetic individuals, periodontal disease may be a potential contributor to the development of type 2 diabetes.
T S Srinivasa
Full Text Available Objective and Background: Glycosylated haemoglobin (HbA1c level can consequently be interpreted as an average of the blood glucose present over the past 3-4 months. Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine the level of HbA1c in healthy and periodontitis patients who were previously not diagnosed with diabetes mellitus. Materials and Methods: A total of 40 patients were selected for study and divided into two groups. Group 1 included patients with a healthy periodontium, and Group 2 included patients suffering from chronic periodontitis. Finger stick blood was collected by special collection unit (A1CNOW +® Bayer Health Care, Tarrytown New York, USA, for estimating level of HbA1c. Result: Both groups showed similar HbA1c levels clinically with slight increase in levels in the test group, but was statistically significant (test - 5.66 ± 0.35%, control - 5.17 ± 0.3% P = 0.003. Conclusion: Indians are at a high-risk of developing periodontitis and diabetes. These data suggest a possible link between periodontitis and glycemic control in nondiabetic individuals, periodontal disease may be a potential contributor to the development of type 2 diabetes.
Full Text Available The paper presents the results of a comparative study of microbial landscape features in patients with generalized periodontitis at pre-clinical and radiological stage of its development in 42 patients. The purpose of the study is a comparative study of the composition of microbiocenosis of periodontal tissues in patients with chronic catarrhal gingivitis (CCG and chronic generalized periodontitis (CGP at an early stage of development and development studies of microbiological criteria for early emergence of the destructive process in periodontal structures. We found that the microflora isolated from dento-gingival grooves is of importance in diagnostics to identify the etiology of chronic generalized catarrhal gingivitis (CGCG and chronic generalized periodontitis in the early stages of its development. It was established that the presence of two or more types of fixed parodonto-pathogenic microorganisms in microbial association increases the likelihood of inflammatory and destructive events in periodontal tissues in patients with GCCG and is one of the reasons of is becoming CGP.
Prasanth, Chandra Sekhar; Betsy, Joseph; Subhash, Narayanan; Jayanthi, Jayaraj L.; Prasanthila, Janam
In clinical diagnostic procedures, gingival inflammation is considered as the initial stage of periodontal breakdown. This is often detected clinically by bleeding on probing as it is an objective measure of inflammation. Since conventional diagnostic procedures have several inherent drawbacks, development of novel non-invasive diagnostic techniques assumes significance. This clinical study was carried out in 15 healthy volunteers and 25 patients to demonstrate the applicability of diffuse reflectance (DR) spectroscopy for quantification and discrimination of various stages of inflammatory conditions in periodontal disease. The DR spectra of diseased lesions recorded using a point monitoring system consisting of a tungsten halogen lamp and a fiber-optic spectrometer showed oxygenated hemoglobin absorption dips at 545 and 575 nm. Mean DR spectra on normalization shows marked differences between healthy and different stages of gingival inflammation. Among the various DR intensity ratios investigated, involving oxy Hb absorption peaks, the R620/R575 ratio was found to be a good parameter of gingival inflammation. In order to screen the entire diseased area and its surroundings instantaneously, DR images were recorded with an EMCCD camera at 620 and 575 nm. We have observed that using the DR image intensity ratio R620/R575 mild inflammatory tissues could be discriminated from healthy with a sensitivity of 92% and specificity of 93%, and from moderate with a sensitivity of 83% and specificity of 96%. The sensitivity and specificity obtained between moderate and severe inflammation are 82% and 76% respectively.
Biniraj, K. R.; Sagir, Mohammed; Sunil, M. M.; Janardhanan, Mahija
A case describing perio-restorative management of an accidental trauma in the mid portion of root on an upper left canine tooth following an ostectomy surgery is presented here. The traumatized root area was undergoing fast resorption and a chronic periodontal abscess had developed in relation to the lesion. The article illustrates the clinical and radiographic photo series of a periodontal flap surgery done to gain access into a subgingival region for the placement of Glass ionomer restoration on the root and its periodic follow up. The clinical condition of the area suggests 8 mm clinical attachment gain over the restoration and the review radiographs at definite intervals up to 18 months revealed evidence of consistent bone regeneration around the restoration. The article also highlights the various other possibilities, where this restorative material can be effectively used in conjunction with periodontal surgical procedures. PMID:23162344
Turton, Mervyn; Africa, Charlene W J
Although there is increasing evidence to suggest an association between periodontal disease and adverse pregnancy outcomes, the issue remains controversial. This study tested the hypothesis that periodontal disease is a risk indicator for preterm delivery of low-birthweight infants. The study sample comprised 443 pregnant women with a mean (± standard deviation) age of 24.13 (±5.30) years. At first visit, maternal oral health status was assessed by the measurement of probing pocket depth and clinical attachment loss, and periodontal status was graded as absent, mild, moderate or severe. An association was sought between pregnancy outcomes and maternal periodontal status. While controlling for other factors, significant associations were found between pregnancy outcomes and maternal periodontal index scores. This study provides further evidence that periodontal disease is a risk indicator for adverse pregnancy outcomes. © 2016 FDI World Dental Federation.
Omori, Shoei; Uchida, Fumihiko; Oh, Sechang; So, Rina; Tsujimoto, Takehiko; Yanagawa, Toru; Sakai, Satoshi; Shoda, Junichi; Tanaka, Kiyoji; Bukawa, Hiroki
Periodontal disease is closely related to lifestyle-related diseases and obesity. It is widely known that moderate exercise habits lead to improvement in lifestyle-related diseases and obesity. However, little research has been undertaken into how exercise habits affect periodontal disease. The purpose of this study was to examine the effect of exercise habits on periodontal diseases and metabolic pathology. We conducted a prospective intervention research for 12 weeks. The subjects were 71 obese men who participated in an exercise and/or dietary intervention program. Fifty subjects were assigned to exercise interventions (exercise intervention group) and 21 subjects were assigned to dietary interventions (dietary intervention group). This research was conducted before and after each intervention program. In the exercise intervention group, the number of teeth with a probing pocket depth (PPD) ≥4 mm significantly decreased from 14.4% to 5.6% ( P periodontal disease-causing bacteria and PPD and BOP. Our results are the first to show that exercise might contribute to improvements in periodontal disease.
Krustrup, Ulla; Petersen, Poul Erik
OBJECTIVES: To assess the periodontal health status in the Danish adult population and to analyze how the level of periodontal health is associated with age, gender, urbanization, socio-economic factors, and dental visiting habits; furthermore, to compare the periodontal health status of Danish a...... is needed with further emphasis on preventive care, and public health programs should focus on risk factors shared by chronic diseases in order to improve the periodontal health of Danish adults.......OBJECTIVES: To assess the periodontal health status in the Danish adult population and to analyze how the level of periodontal health is associated with age, gender, urbanization, socio-economic factors, and dental visiting habits; furthermore, to compare the periodontal health status of Danish...... Organization Basic Methods Criteria. RESULTS: The clinical examination revealed a low prevalence of healthy periodontal conditions in both age groups: at age 35-44 years 7.7% and at age 65-74 years 2.4% had healthy periodontal conditions. A high proportion of the elderly had scores of severe periodontal health...
Full Text Available Objectives: Fixed orthodontic appliances make daily application of oral hygiene standard procedures more difficult and in time may lead to accumulation of oral biofilms and development of gingivitis and hyperplasia. The aim of the study is to evaluate the periodontal health expressed by clinical indices in patients under orthodontic treatment with fixed appliances, according to different oral hygene maintenance programs. Material and method: We performed a randomized prospective study on 60 patients with fixed orthodontic appliances (17-25 years of age devided in three study groups. The clnical indices recorded were: modified gingival index, plaque index and sulcular bleeding index. Statistical analysis or the results were carried out using Student t test. Results: The patients were randomly divided into three groups: group A-patients were instructed to use electric brush, water flosser and interdental brush, group B- electric brush, interdental brush and fluoride and group C- manual brushing and fluoride. Statistical comparison of the values of the indexes with the Student t test for independent samples showed statistically significant differences in all three groups of patients studied between initial and final values of all recorded clinical parameters. Conclusions: Fixed orthodontics do not induce periodontal disease if basic principles of oral hygiene are followed in compliant patients, which are correctly instructed to deal with real challenge, represented by complete elimination of debris and bacterial accumulation.
Jakovljevic, Aleksandar; Knezevic, Aleksandra; Karalic, Danijela; Soldatovic, Ivan; Popovic, Branka; Milasin, Jelena; Andric, Miroslav
This study aimed to compare the levels of tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) between apical periodontitis lesions with different clinical and histological features. Based on clinical data and history of disease, 100 human apical periodontitis lesions were categorised as either asymptomatic or symptomatic lesions. According to histological examination, lesions were divided into periapical granulomas and radicular cysts. Pulp tissues of 25 impacted wisdom teeth were used as controls. Homogenised tissue samples were centrifuged and supernatants were used for the determination of cytokine levels by enzyme-linked immunosorbent assay. Significantly higher levels of IL-1β and IL-6 were found in symptomatic lesions compared with asymptomatic lesions and control tissues (P < 0.001, P < 0.001, respectively). The concentration of IL-1β was significantly higher in radicular cysts compared with periapical granulomas (P = 0.003). Symptomatic lesions, as judged by high local production of IL-1β and IL-6, represent an immunologically active stage of the disease. © 2014 Australian Society of Endodontology.
Full Text Available This study focused on the search for new biomarkers based on liquid chromatography-multiple reaction monitoring (LC-MRM proteomics profiling of whole saliva from patients with periodontitis compared to healthy subjects. The LC-MRM profiling approach is a new and innovative method that has already been validated for the absolute and multiplexed quantification of biomarkers in several diseases. The dataset for this study was produced using LC-MRM to monitor protein levels in a multiplex assay, it provides clinical information on salivary biomarkers of periodontitis. The data presented here is an extension of our recently published research article (Mertens et al., 2017 . Keywords: Clinical chemistry, Mass spectrometry, Proteomics, Saliva biochemistry, Oral disease, Periodontitis
Full Text Available Aims and Objectives: (1 To evaluate the need of antibiotics in periodontal surgeries in reducing postsurgical infections and explore if antibiotics have any key role in reducing or eliminating inflammatory complications. (2 To establish the incidence of postoperative infections in relation to type of surgery and determine those factors, which may affect infection rates. Materials and Methods: A prospective randomized double-blind cross over clinical study was carried out for a period of 1-year with predefined inclusion and exclusion criteria. All the patients included in the study for any periodontal surgery were randomly divided into three categories: Group A (prophylactic, Group B (therapeutic, and Group C (no antibiotics. Patients were followed up for 1-week after surgery on the day of suture removal and were evaluated for pain, swelling, fever, infection, delayed wound healing and any other significant findings. Appropriate statistical analysis was carried out to evaluate the objectives and P < 0.05 was considered as statistically significant. Results: No infection was reported in any of 90 sites. Patients reported less pain and postoperative discomfort when prophylactic antibiotics were given. However, there were no statistical significant differences between the three groups. Summary and Conclusion: There was no postoperative infection reported in all the 90 sites operated in this study. The prevalence of postoperative infections following periodontal surgery is <1% and this low risk does not justify the routine use of systemic antimicrobials just to prevent infections. Use of prophylactic antibiotics may have role in prevention of inflammatory complication, but again not infection.
Odor, Alin A.; Violant, Deborah; Badea, Victoria; Gutknecht, Norbert
Backgrounds: Er,Cr:YSGG (2780nm) and diode (940 nm) lasers can be used adjacent to the conventional periodontal treatment as minimally invasive non-surgical devices. Aim: To describe the short-term clinical outcomes by combining Er,Cr:YSGG (2780nm) and diode 940 nm lasers in non-surgical periodontal treatment. Materials and methods: A total of 10 patients with periodontal disease (mild, moderate, severe) - 233 teeth and 677 periodontal pockets ranging from 4 mm to 12 mm - were treated with Er,Cr:YSGG (2780nm) and diode (940 nm) lasers in adjunct to manual and piezoelectric scaling and root planning (SRP). Periodontal parameters such as mean probing depth (PD), mean clinical attachment level (CAL) and mean bleeding on probing (BOP) were evaluated at baseline and 6 months after the laser treatment using an electronic periodontal chart. Results: At baseline, the mean PD was 4.06 ± 1.06 mm, mean CAL was 4.56 ± 1.43 mm, and mean BOP was 43.8 ± 23.84 %. At 6 months after the laser supported periodontal treatments the mean PD was 2.6 ± 0.58 mm (p laser wavelengths in adjunct to SRP offers significant improvements of periodontal clinical parameters such as PD, CAL and BOP. Keywords: Laser supported periodontal treatment concept, Er,Cr:YSGG and diode 940nm lasers, Scaling and root planning, Minimally invasive non-surgical device
Laky, Markus; Bertl, Kristina; Haririan, Hady; Andrukhov, Oleh; Seemann, Rudolf; Volf, Ivo; Assinger, Alice; Gruber, Reinhard; Moritz, Andreas; Rausch-Fan, Xiaohui
Vitamin D plays an essential role in bone metabolism as well as in immunity. Hence, it might affect the development and extent of periodontal disease. The aim of this study was the assessment of 25-hydroxyvitamin D (25(OH)D) status in periodontal disease. Twenty-nine patients with severe periodontal disease and 29 healthy volunteers were recruited in this case-control-study. Serum 25(OH)D levels, Periodontal Probing Depth (PPD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP), Body Mass Index (BMI), and current smoking status and smoking history (packyears) were assessed in all participants. Serum 25(OH)D levels were compared between controls and cases. Multivariable logistic regression was used to determine the odds ratio (OR) and 95 % confidence interval (CI) for periodontal disease in 25(OH)D deficient probands. Patients with periodontal disease presented a significantly higher proportion of deficient 25(OH)D levels (i.e., periodontal disease with vitamin D deficiency was 1.5 (95 % CI, 1.13-1.98). No correlation between serum 25(OH)D levels and CAL, PPD, and BOP in the group with periodontal disease was found. In this case-control-study 25(OH)D deficiency is significantly associated with periodontal disease. The assessment of vitamin D levels in patients presenting with periodontal disease seems advisable, as vitamin D deficiency might be involved in the onset and progression of periodontal disease.
Gupta, Namita; Gupta, N D; Gupta, Akash; Khan, Saif; Bansal, Neha
Periodontitis is an inflammatory disease of the periodontium. Any imbalance between the matrix metalloproteinases (MMPs) secreted by neutrophils and tissue inhibitors initiates the destruction of collagen in gum tissue, leading to chronic periodontitis. This study aimed to correlate salivary levels of MMP-8 and periodontal parameters of chronic periodontitis to establish MMP-8 as a noninvasive marker for the early diagnosis of chronic periodontitis. The study involved 40 subjects visiting the periodontic OPD of Dr. Ziauddin Ahmad Dental College and Hospital, located in Aligarh, U.P., India, from 2011 to 2012. The subjects were divided into two groups: group I consisted of 20 periodontally healthy subjects (controls) while group II consisted of 20 patients with chronic periodontitis. Chronic periodontitis was assessed on the basis of several periodontal parameters, including pocket probing depth (PPD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI). Around 3ml of unstimulated and whole expectorated saliva was collected for MMP-8 estimation by ELISA using Quantikine human total MMP-8 immunoassay kits. Data were analyzed using STATISTICA (Windows version 6) software. Salivary MMP-8 levels of groups I and II were 190.91 ± 143.89 ng/ml and 348.26 ± 202.1 ng/ml, respectively. The MMP-8 levels and periodontal status (PPD, CAL, GI, and PI) of groups I and II showed positive and significant correlations (for PPD, r = 0.63, P chronic periodontitis.
Background and Objectives: Psoriasis is a common, chronic, inflammatory, and hyperproliperative skin disease. It has been known that the infectious agents play a role in triggering and exacerbation of the disease. Periodontal diseases are chronic inflammatory gum diseases initiated by microorganisms in dental plaques.
Jwan Ibrahim Jawzali
Conclusion: Salivary free sialic acid may be used as a diagnostic oxidative stress biomarker for periodontal diseases among young current smokers. Cumulative destructive effect of long duration of smoking on the periodontum can be controlled by smoking cessation, good oral hygiene and diet habit in early old ages.
Clinical and microbiological effects of mechanical instrumentation and local antimicrobials during periodontal supportive therapy in aggressive periodontitis patients: smoker versus non-smoker patients.
Guarnelli, Maria Elena; Farina, Roberto; Cucchi, Alessandro; Trombelli, Leonardo
To compare the clinical and microbiological effects of ultrasonic mechanical instrumentation (UMI) associated to home-care use of amine fluoride/stannous fluoride (AmF/SnF(2) )-containing mouthrinse and toothpaste in smoker and non-smoker patients affected by generalized aggressive periodontitis (G-AgP) during a recall session of supportive periodontal therapy (SPT). Thirteen smokers and 25 non-smokers G-AgP patients enrolled in an SPT programme received a single session of UMI associated with home-care use of AmF/SnF(2) -containing mouthrinse and toothpaste. Clinical and microbiological parameters were assessed pre-treatment, at 6 and 12 weeks post-treatment. In both groups, UMI plus AmF/SnF(2) -implemented oral hygiene use determined a significant decrease of total bacterial counts, with non-smokers exhibiting a lower count compared with smokers at 12 weeks. No significant differences were observed between smokers and non-smokers in the counts of total pathogens and red complex species at each observation interval. Clinically, a significant reduction of supragingival plaque, gingival inflammation and probing pocket depth was similarly observed in both groups. A combined mechanical/chemical plaque control approach based on UMI and the use of AmF/SnF(2) agents resulted in the reduction of supragingival plaque deposits, gingival inflammation and subgingival periodontal pathogens in G-AgP patients during SPT, with no substantial difference between smokers and non-smokers. © 2010 John Wiley & Sons A/S.
Full Text Available Introduction: Antioxidant agents such as cocoa could have some benefits in treatment of inflammation including periodontitis. The aim of this study was to investigate the effects of cocoa consumption on moderate chronic periodontitis. Materials &Methods: This single-blind randomized clinical trial study was performed on 40 subjects who were randomly divided into two groups. Treatment group received 30 gr dark chocolate (78% cocoa and control group received 22.5 gr white chocolate three times a day for 4 weeks. Saliva samples were collected from patients at baseline and t wenty-eight days after eating chocolate. Probing pocket depth (PPD, Gingival index (GI, Silness and Loe, Modified papillary bleeding index (MPBI, Barnett, Clinical attachment loss (CAL were recorded at baseline and 2nd, 4th, 6th, 8th weeks later in ramfjord teeth. Total antioxidant capacity (TAC and lipid peroxidation of saliva were estimated by Ferric reducing antioxidant power (FRAP and Tiuborbituric acid reactive substances ( TBARS methods. Data of clinical parameters were analyzed using t-test and repeated measures test. Biochemical parameters were analyzed using t-test. Results: Intra-group comparison of clinical parameters demonstrated significant decrease in both groups (p<0.0001 and inter-group comparison showed significant decrease of MPBI in treatment group, (p<0.03. MPBI and GI were significantly decreased in treatment group compared to the control in the weeks of 4th, 6th and 8th, according t-test ( GI4, P=0.008-GI6, P=0.008-GI8, P=0.009, (MPBI4, MPBI6, MPBI8, P<0.0001. Treatment group showed the increase in FRAP, (p<0.00001 and decrease in TBARS, ( P<0.015 which were statically significant in compare with control group. Conclusion: Consuming dark chocolate could increase TAC and decrease lipid peroxidation, gingival bleeding and inflammation.
Ladegaard Grønkjær, Lea; Holmstrup, Palle; Schou, Søren
Background Periodontitis and edentulism are prevalent in patients with cirrhosis, but their clinical significance is largely unknown. Objective The objective of this article is to determine the association of severe periodontitis and edentulism with mortality in patients with cirrhosis. Methods...... A total of 184 cirrhosis patients underwent an oral examination. All-cause and cirrhosis-related mortality was recorded. The associations of periodontitis and edentulism with mortality were explored by Kaplan–Meier survival plots and Cox proportional hazards regression adjusted for age, gender, cirrhosis...... etiology, Child–Pugh score, Model for End-Stage Liver Disease score, smoker status, present alcohol use, comorbidity, and nutritional risk score. Results The total follow-up time was 74,197 days (203.14 years). At entry, 44% of the patients had severe periodontitis and 18% were edentulous. Forty...
Palle, Ajay Reddy; Reddy, C M Sanjeeva Kumar; Shankar, B Shiva; Gelli, Vemsi; Sudhakar, Jaradoddi; Reddy, K Krishna Mohana
Chronic periodontitis is multifactorial and numerous risk factors have been identified to contribute in the disease progression. Current study aimed to conduct a cross-sectional study in a population of patients with cardiovascular diseases in order to correlate the association between obesity [body mass index (BMI) and waist circumference (WC)] and periodontal disease parameters. The study was of a cross-sectional design and a total of 201 patients were examined after obtaining their informed consent. Subjects who had a history of cardiovascular diseases and under treatment were included in the study. Two indicators of obesity were used: BMI and WC. The following periodontal parameters were assessed: Probing depth, clinical attachment level. The oral hygiene status of the subjects was assessed by the oral hygiene index (OHI, simplified) given by John C Greene and Jack R Vermillion. The influence of the BMI and other confounding variables on periodontitis severity was assessed by multivariate logistic regression analysis. Data were analyzed using SPSS. Significant association was seen with low density lipoproteins (LDL) and severity of periodontitis (p < 0.005), triglyceride levels (TGL) and severity of periodontitis (p < 0.005), cholesterol and severity of periodontitis (p < 0.005), BMI and severity of periodontitis (p < 0.001), OHI and severity of periodontitis (p < 0.001). Significant association was seen with smoking and severity of periodontitis (p < 0.005), BMI and severity of periodontitis (p < 0.001), WC and severity of periodontitis (p < 0.001), cholesterol and severity of periodontitis (p < 0.001), OHI and severity of periodontitis (p < 0.001). Obesity has been implicated as a risk factor for several conditions including cardiovascular disease, diabetes, etc. In our study the relation between measures of overall and abdominal obesity (BMI and WC) and periodontal disease showed significant association in the multivariate logistic regression analysis
Anwar, N; Zaman, N; Nimmi, N; Chowdhury, T A; Khan, M H
There have been an association between systemic diseases and hormonal changes particularly diabetes which has been cited as a risk factor in the progression of periodontitis in pregnant women. The incidence and severity of periodontal diseases are increasing at a higher rate and a common condition in pregnant diabetic women among Bangladeshi population. This cross sectional study included 200 pregnant women who were selected from gynecological department and examined at the dental unit. The clinical parameters used were the Silness and Loe plaque index (PI), gingival scores and periodontal status and any relationship to socio demographic variables (age, occupation, level of education and urban or rural residence) and clinical variables (gestation period, previous pregnancy, type of diabetes and periodontal maintenance) were evaluated. The results showed that these clinical parameters increased concomitantly with an increase in the stage of pregnancy and in women with multiple pregnancies. Increased age, lower level of education, unemployment and patients residing in rural areas were associated with significantly higher gingival scores and periodontal measures. Women with increased age and multiple pregnancies usually have less interest to frequent periodontal maintenance showing a significant statistical relation between an increased age and changes in gingival and periodontal status; however no significant association was found between increased age and plaque index. It is concluded that gingival inflammatory symptoms are aggravated during pregnancy in diabetic women and are related to different clinical and demographic variables.
Full Text Available Background: Puberty, menses, pregnancy, and menopause are the different phases of a woman′s life which have a varied influence on oral health. During the menopause, women go through biological and endocrine changes, particularly in their sex steroid hormone production which affects their health. Because the oral mucosa contains estrogen receptors, variations in hormone levels can be seen directly in the oral cavity leading to a few oral conditions and diseases seen more frequently during postmenopausal years. Objective: The objective of this study is to assess periodontal health status in postmenopausal women in and around Meerut city. Materials and Methods: The study sample comprised ninety postmenopausal women. History of menopause was recorded, and the dental examinations were done by measuring the following parameters of periodontal health: plaque index (PI, gingival index (GI, bleeding on probing (BOP, pocket probing depth, and Russell′s periodontal index. The collected data were subjected to statistical analyses. Results and Conclusion: In the study group, mean age was 55 years, mean missing teeth were 10.3, mean duration of menopause was 9.23. Eleven percent females were completely edentulous, and 5 females had never brushed. Mean PI-s was 1.99, mean GI-s was 1.74, mean BOP was 52.85, and mean Russell′s periodontal index was 4.34. Eleven patients were at the initial stages of destructive periodontal disease, 34 had established destructive periodontal disease while thirty patients had the terminal periodontal disease. These findings suggest that females after menopause are at a risk of developing destructive periodontal disease if proper oral hygiene practices are not followed.
Full Text Available Treatment of periodontal abscess with furcation involvement has its own challenges in achieving the success of periodontal treatment. Teeth with periodontal abscesses often indicate the presence of furcation involvement. Most periodontal abscess occurs in approximately 92.5% molar. Furcation involvement on tooth abscesses had a greater challenge to the success of periodontal therapy. A male patient aged 36 years came to the clinic with active periodontal disease. On examination, the teeth are sensitive to percussion and 2o mobility. There is 13 mm deep pockets around the roots of teeth. On radiographic examination, appears severe bone destruction in the root area and furcation. Oral hygiene status was fair. Patients had a history of systemic disease type II diabetes mellitus. The periodontal abscess with furcation involvement with systemic disease type II diabetes mellitus can be treated with open flap and debridement so it can achieve a better prognosis. Systemic disease do not become a hindrance in periodontal treatment as long as the disease is controlled. Prognosis of teeth with abscess depend on the nature and extent of bone loss. Chronic periodontal abscess has a slow progressive bone destruction.
Salem, Daliah; Natto, Zuhair; Elangovan, Satheesh; Karimbux, Nadeem
The aim of this review is to evaluate the levels of clinical evidence for bone replacement grafts available in the United States for periodontics and oral implantology purposes. A search was performed using PubMed, the Cochrane Library, and Google Scholar for articles relating to the use of bone replacement grafts in implant and/or periodontics by two independent reviewers. Articles unrelated to the topic, not involving patients, not including abstracts, or in languages other than English were excluded. Selected articles were graded according to "levels of evidence" based on guidelines originally introduced by Wright et al. (2003). There was limited published peer-reviewed clinical literature available regarding US commercially available bone replacement grafts in periodontics and oral implantology. Of 144 bone replacement grafts available in the United States according to Avila-Ortiz et al. (2013), only 52 met the inclusion criteria. The majority of materials used were allografts (26 of 93 available in the United States), followed by alloplasts (15 of 30) and xenografts (11 of 21). Dental providers should be aware of the limited evidence that qualified for a strong rating supporting the clinical efficacy of these materials for periodontics and oral implantology purposes using the inclusion criteria selected in this study.
Shibukawa, Yoshihiro; Fujinami, Koushu; Yamashita, Shuichiro
In this case report, we describe the clinical course over a 14-year follow-up in a 47-year-old diabetes patient with severe chronic periodontitis and nifedipine-induced gingival overgrowth. The patient had a history of hypertension for over 5 years and uncontrolled type 2 diabetes. Overgrown gingiva was observed in most of the teeth and was marked in the upper and lower anterior teeth. A probing pocket depth of ≥ 4 mm and bleeding on probing (BOP) were observed in 94 and 90% of sites examined, respectively. At baseline, his hemoglobin A1c (HbA1c) was 8.5%. The patient received periodontal and diabetic treatment simultaneously. Medication was changed from nifedipine chloride to an angiotensin-converting enzyme inhibitor. After initial therapy and subsequent periodontal surgery, gingival overgrowth disappeared and probing depth and BOP showed a significant improvement. No recurrence was observed during supportive periodontal therapy (SPT). The HbA1c level improved from 8.5 to 6.3% after periodontal treatment, subsequently remaining at a good level during SPT over 10 years. This study demonstrated that periodontal treatment, withdrawal of medication and control of diabetes can result in remarkable improvements in type 2 diabetes patients with chronic periodontitis and nifedipine-induced gingival overgrowth. These results suggest that comprehensive periodontal treatment in combination with treatment for diabetes mellitus can exert a positive influence on blood glucose levels and periodontal condition in diabetic patients.
Vishnu Jayakumar Sunandhakumari
Full Text Available For years the pathogenesis of periodontitis was under an immunological Th1/Th2 paradigm. Th1 cells are considered to afford protection against the intracellular pathogens. These cells produce the interferons (IFN that are involved in macrophage activation, which, in turn, plays an important role in phagocytosis, complement fixation, and opsonization. Th2 cells are thought to have evolved as a form of protection against parasitic helminthes. Th17 subset of CD4Not Necessary+ T cells was identified in the year 2005, which added greater complexity to Th function and are pro inflammatory in nature. Interleukins (ILs have the ability to alter immunological changes and they also possess the ability to regulate lymphocyte differentiation and haemopoietic stem cells, cell proliferation, and motility, which are classified as pro-inflammatory and anti-inflammatory. There are numerous studies that reported IL-17 levels associated with chronic periodontitis (CP development. Type II diabetes mellitus (DM is considered a risk factor for the development of periodontal diseases because the incidence, progression, and severity of periodontal diseases are more common with Type II DM than without DM. This study was aimed at evaluating whether non-surgical periodontal therapy had any effect on plasma concentrations of Interleukin-17 in systemically healthy chronic periodontitis patients and in chronic periodontitis patients with well controlled Type II Diabetes mellitus. Patients were divided into the two groups including the chronic periodontitis group (20 subjects and the chronic periodontitis with well-controlled Type II Diabetes mellitus group (20 subjects. The Gingival Index and Plaque Index as well as the clinical Attachment Level (CAL were taken from all the patients of two groups after evaluating fasting blood sugar, post prandial blood sugar, and the Glycated Hemoglobin Level (HbA1c. Then 5 mL blood samples were collected from each patient and plasma was
Fadel, Hani T; Pliaki, Anthi; Gronowitz, Eva; Mårild, Staffan; Ramberg, Per; Dahlèn, Gunnar; Yucel-Lindberg, Tülay; Heijl, Lars; Birkhed, Dowen
This study aims to assess clinical, microbiological and inflammatory parameters as indicators for caries and periodontal disease in adolescents with obesity. Twenty-seven adolescents with obesity [body mass index (BMI) 37 ± 4 kg/m(2)] and 28 controls (BMI 20 ± 2 kg/m(2)) answered questionnaires and were investigated regarding salivary parameters, plaque pH drop after a 1-min glucose rinse, oral clinical parameters, inflammatory markers in gingival crevicular fluid (GCF) and sub-gingival mirobiota. Compared with controls, adolescents with obesity had a lower stimulated salivary secretion rate (1.55 ± 0.63 vs. 2.05 ± 1.05 mL/min, p periodontal pockets were observed. Following the glucose rinse, a slightly more pronounced drop in plaque pH was observed in the obesity group (p > 0.05). No differences in sub-gingival inflammatory or microbial indicators were detected (p > 0.01). More caries and gingival inflammation were observed in adolescents with obesity. Of the indicators tested, salivary secretion rate was lower and sIgA levels were higher in the obesity group. We are unable to confirm whether differences in caries and gingival inflammation are due to systemic changes that are associated with obesity or due to possible irregular dietary/oral hygiene habits. Customised oral health preventive programmes and appropriate collaboration with medical personnel in selecting the best diet, medication and psychological support can help improve the general well-being, including oral health, of children with obesity. This may even reduce the risk of oral diseases.
Telma Blanca Lombardo Bedran; Rosemary Adriana C. Marcantonio; Rubens Spin Neto; Marcia Pinto Alves Mayer; Daniel Grenier; Luis Spolidorio; Denise Spolidorio
Background: Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated. Objective: The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and ...
Oz, A Z; Ciger, S
The aim of the present study was to evaluate the changes of incisor root resorption associated with impacted maxillary canines and health of periodontal tissues around maxillary canines erupted with orthodontic treatment. Twenty patients with a unilateral palatally impacted maxillary canine were included in the study. Cone-beam computed tomography images taken before and after orthodontic treatment were compared with the contralateral canines serving as control teeth. Root resorption was present in 10% of central and 40% of lateral incisors before treatment. After treatment, the incidence of resorption decreased. The thickness of the buccal bone surrounding the impacted canines was similar to that surrounding the contralateral canines, except in the apical area. Periodontal pocket depth and alveolar bone loss were greater for the impacted canine teeth than for the contralateral canines. Incisor root resorption associated with impacted canine teeth showed signs of repair after orthodontic treatment. Slight differences related to periodontal health were found between the previously impacted teeth and contralateral canine teeth.
Moreno, Sandra; Parra, Beatriz; Botero, Javier E; Moreno, Freddy; Vásquez, Daniel; Fernández, Hugo; Alba, Sandra; Gallego, Sara; Castillo, Gilberto; Contreras, Adolfo
Periodontitis is an infectious disease that affects the support tissue of the teeth and it is associated with different systemic diseases, including cardiovascular disease. Microbiological studies facilitate the detection of microorganisms from subgingival and cardiovascular samples. To describe the cultivable periodontal microbiota and the presence of microorganisms in heart valves from patients undergoing valve replacement surgery in a clinic in Cali. We analyzed 30 subgingival and valvular tissue samples by means of two-phase culture medium, supplemented blood agar and trypticase soy agar with antibiotics. Conventional PCR was performed on samples of valve tissue. The periodontal pathogens isolated from periodontal pockets were: Fusobacterium nucleatum (50%), Prevotella intermedia/ nigrescens (40%), Campylobacter rectus (40%), Eikenella corrodens (36.7%), Gram negative enteric bacilli (36.7%), Porphyromonas gingivalis (33.3%), and Eubacterium spp. (33.3%). The pathogens isolated from the aortic valve were Propionibacterium acnes (12%), Gram negative enteric bacilli (8%), Bacteroides merdae (4%), and Clostridium bifermentans (4%), and from the mitral valve we isolated P. acnes and Clostridium beijerinckii. Conventional PCR did not return positive results for oral pathogens and bacterial DNA was detected only in two samples. Periodontal microbiota of patients undergoing surgery for heart valve replacement consisted of species of Gram-negative bacteria that have been associated with infections in extraoral tissues. However, there is no evidence of the presence of periodontal pathogens in valve tissue, because even though there were valve and subgingival samples positive for Gram-negative enteric bacilli, it is not possible to maintain they corresponded to the same phylogenetic origin.
Full Text Available The purpose of this study was to investigate the effects of non-surgical periodontal treatment on hemoglobinA1c (HbA1c levels, oxidative stress balance and quality of life (QOL in patients with type 2 diabetes mellitus (T2DM compared to no periodontal treatment (simple oral hygiene instructions only.The design was a 6-month, single-masked, single center, randomized clinical trial. Patients had both T2DM and chronic periodontitis. Forty participants were enrolled between April 2014 and March 2016 at the Nephrology, Diabetology and Endocrinology Department of Okayama University Hospital. The periodontal treatment group (n = 20 received non-surgical periodontal therapy, including scaling and root planing plus oral hygiene instructions, and consecutive supportive periodontal therapy at 3 and 6 months. The control group (n = 17 received only oral hygiene instructions without treatment during the experimental period. The primary study outcome was the change in HbA1c levels from baseline to 3 months. Secondary outcomes included changes in oxidative stress balance (Oxidative-INDEX, the Diabetes Therapy-Related QOL and clinical periodontal parameters from baseline to 3 months and baseline to 6 months.Changes in HbA1c in the periodontal treatment group were not significantly different with those in the control group at 3 and 6 months. Systemic oxidative stress balance and QOL significantly improved in the periodontal treatment group compared to the control group at 3 months. In the subgroup analysis (moderately poor control of diabetes, the decrease in HbA1c levels in the periodontal treatment group was greater than that in the control group at 3 months but not significant.In T2DM patients, non-surgical periodontal treatment improved systemic oxidative stress balance and QOL, but did not decrease HbA1c levels at 3 months follow-up.Current Controlled Trials UMIN-ICDR UMIN 000013278 (Registered April 1, 2014.
Ouyang, X Y
Periodontitis could be categorized as mild, moderate, and severe according to the severity of the disease. This categorizing system could also be used together with other classification systems. The present article introduced the status about the case definition of severe periodontitis, including the standard of case definitions for surveillance of periodontitis reported by the Centers for Disease Control and Prevention (CDC) in partnership with the American Academy of Periodontology (AAP) and the consensus report on the definition of periodontitis case for use in risk factor research by Europe workshop. A consensus on the state of the art definition of severe periodontitis for use in clinical work was gained base on the expertise of Chinese Society of Periodontology, Chinese Association of Stomatology. The background of this consensus and the significance of the criteria for the case definition were discussed.
Lu, Haili; Tang, Haifang; Zhou, Tian; Kang, Na
At present, many scholars have studied the periodontal health status of patients undergoing orthodontic treatment with fixed appliances and invisalign. However, those results are inconsistent. Therefore, we conducted this meta-analysis, and then provide reference for clinical treatment. Most databases, such as the Cochrane Library, EMBASE, PubMed, Medline, Chinese Biomedical Literature Database, CNKI, and Wan Fang Data were retrieved for related articles from the establishment of the database to October 2017. Meanwhile, we also searched the references of the related literatures manually, in order to increase the included literatures. Two researchers screened the related literatures according to the inclusion criteria and exclusion criteria. Stata 12.0 software was used for data analysis, and results are estimated by odds ratio (OR) and 95% confidence interval (CI). Finally, 7 articles, including 368 patients, were included into our meta-analysis. Meta-analysis results showed that there was no statistically significant difference of gingival index (GI) and sulcus probing depth (SPD) status between the invisalign group and the control group, including at 1, 3, and 6 months (all P > .05). When compared with the control group, the invisalign group presented a lower plaque index (PLI) and sulcus bleeding index (SBI) status at 1 month (OR = -0.53, 95% CI: -0.89 to -0.18; OR = -0.44, 95% CI: -0.70 to -0.19, respectively), 3 months (OR = -0.69, 95% CI: -1.12 to -0.27; OR = -0.49, 95% CI: -0.93 to -0.05, respectively), and 6 months (OR = -0.91, 95% CI: -1.47 to -0.35; OR = -0.40, 95% CI: -0.63 to -0.07, respectively). Subgroup analysis showed that the SPD status was lower in the invisalign group at 6 months when measured the teeth using Ramfjord index (OR = -0.74, 95% CI: -1.35 to -0.12). However, there was no statistically significant difference between the 2 groups when using other measure methods (OR = 0.12, 95% CI: -0.26 to 0.17). Our
Neeraj C Deshpande
Full Text Available Background: This randomized, controlled clinical study was planned to evaluate the use of anti-inflammatory drug flurbiprofen in the form of locally delivered controlled release gel in the treatment of periodontal disease. Materials and Methods: The flurbiprofen gel was indigenously prepared in the concentration of 0.3%. The 30 patients with localized periodontal pockets measuring ≥5 mm were randomly divided into three groups. The groups received flurbiprofen gel, flurbiprofen gel after prophylaxis, and placebo gel after oral prophylaxis, respectively. The clinical parameters for plaque and gingival inflammation were evaluated at baseline, 7 th day, and 14 th day. Results: The results of the study suggested the statistically significant ( P < 0.05 improvement in the gingival status of the patients with the use of flurbiprofen gel as an adjunct to scaling and root planing as compared to oral prophylaxis or gel alone. Conclusion: The data demonstrated that the additional use of local drug delivery of flurbiprofen through gel media enhances the positive effects of scaling and root planing and helps in faster resolution of the inflammation.
Full Text Available Background and aims. Recent epidemiological studies have shown that individuals with periodontitis have a significantly higher risk of developing coronary heart disease, which might be attributed to the complex microbiota in the dental plaque. Periodontopathogens have been reported as risk factors for cardiovascular disease. This study evaluated association of chronic periodontitis and periodontopathogens with CRP in systemically healthy Serbian adults. Materials and methods. Serum C-reactive protein levels were measured in 24 patients with moderate periodontitis, 26 patients with severe periodontitis, and 25 periodontally healthy subjects. Periodontal health indicators included gingival bleeding on probing and periodontal disease status. Patients with moderate periodontitis had low attachment loss and pocket depths of 5 mm. The control group with healthy gingiva had gingival sulcus of 5 mol/L was greater in the higher clinical AL group compared to the group with less attachment loss. Presence of periodontopathogens was also associated with elevated CRP levels and poor periodontal status. Conclusions. PD and subgingival periodontopathogens are associated with increased CRP levels. These findings suggest that periodontal infection may contribute to systemic inflammatory burden in otherwise healthy individuals.
Gupta, G; Mansi, B
Gingival and Periodontal diseases represent a major concern both in dentistry and medicine. The majority of the contributing factors and causes in the etiology of these diseases are reduced or treated with ozone in all its application forms (gas, water, oil). The beneficial biological effects of ozone, its anti-microbial activity, oxidation of bio-molecules precursors and microbial toxins implicated in periodontal diseases and its healing and tissue regeneration properties, make the use of ozone well indicated in all stages of gingival and periodontal diseases. The primary objective of this article is to provide a general review about the clinical applications of ozone in periodontics. The secondary objective is to summarize the available in vitro and in vivo studies in Periodontics in which ozone has been used. This objective would be of importance to future researchers in terms of what has been tried and what the potentials are for the clinical application of ozone in Periodontics.
Meuric, Vincent; Le Gall-David, Sandrine; Boyer, Emile; Acuña-Amador, Luis; Martin, Bénédicte; Fong, Shao Bing; Barloy-Hubler, Frederique; Bonnaure-Mallet, Martine
Periodontitis is driven by disproportionate host inflammatory immune responses induced by an imbalance in the composition of oral bacteria; this instigates microbial dysbiosis, along with failed resolution of the chronic destructive inflammation. The objectives of this study were to identify microbial signatures for health and chronic periodontitis at the genus level and to propose a model of dysbiosis, including the calculation of bacterial ratios. Published sequencing data obtained from several different studies (196 subgingival samples from patients with chronic periodontitis and 422 subgingival samples from healthy subjects) were pooled and subjected to a new microbiota analysis using the same Visualization and Analysis of Microbial Population Structures (VAMPS) pipeline, to identify microbiota specific to health and disease. Microbiota were visualized using CoNet and Cytoscape. Dysbiosis ratios, defined as the percentage of genera associated with disease relative to the percentage of genera associated with health, were calculated to distinguish disease from health. Correlations between the proposed dysbiosis ratio and the periodontal pocket depth were tested with a different set of data obtained from a recent study, to confirm the relevance of the ratio as a potential indicator of dysbiosis. Beta diversity showed significant clustering of periodontitis-associated microbiota, at the genus level, according to the clinical status and independent of the methods used. Specific genera ( Veillonella , Neisseria , Rothia , Corynebacterium , and Actinomyces ) were highly prevalent (>95%) in health, while other genera ( Eubacterium , Campylobacter , Treponema , and Tannerella ) were associated with chronic periodontitis. The calculation of dysbiosis ratios based on the relative abundance of the genera found in health versus periodontitis was tested. Nonperiodontitis samples were significantly identifiable by low ratios, compared to chronic periodontitis samples. When
Smit, Menke de; Westra, Johanna; Vissink, Arjan; Doornbos-van der Meer, Berber; Brouwer, Elisabeth; van Winkelhoff, Arie Jan
INTRODUCTION: The association between rheumatoid arthritis (RA) and periodontitis is suggested to be linked to the periodontal pathogen Porphyromonas gingivalis. Colonization of P. gingivalis in the oral cavity of RA patients has been scarcely considered. To further explore whether the association
Anca Mihaela Stupu
Full Text Available Introduction: In the periodontal pathology of the pediatric pacient, the therapeutical management depends on an early, as precise as possible diagnosis, as well as on a correct evaluation of the causes and risk factors involved in such processes. The aim of the study: The paper discusses a clinicostatistical study devoted to the evaluation and comparison of the periodontal health condition of a group of children and teenagers subjected to a local etiological treatment. Materials and method: The experimental study was formed of 70 patients selected from the total number of patients having addressed a dentist. Over the whole period of the therapy, oral hygiene, the aspect of marginal gingiva, and the vitality of the teeth under treatment were carefully monitored. Comparisons between the initial and the final moment were based on: periodontal diagnosis, condition of marginal gingiva, number and depth of periodontal pockets, hygiene and dental mobility. Results: Improvement of the periodontal condition or its maintaining at the initial level was observed in patients with good or satisfactory oral hygiene, which was not the case of those with a scarce hygiene, in whom the periodontal problems evolved. Conclusions: Periodontal management should observe the basic principles of the initial causal, corrective and maintainance therapy. The main elements to be here considered are: age, the extent of patient’s involvement, his / her cooperation and motivation, and the support expressed by the family, all of them reflecting the periodontal diagnosis.
Halimi, Abdelali; Zaoui, Fatima
Orthodontic or, more precisely, surgico-orthodontic treatment of patients suffering from periodontal disorders generally requires a multidisciplinary approach by a qualified dental team. Periodontal bone healing is an essential factor for successful orthodontic treatment in a compromised periodontal situation. We report on the case of an adult patient suffering from severe chronic periodontitis; he was a hyperdivergent skeletal Class III with dento-alveolar compensation, esthetic problems and a significant lack of dental material. A multidisciplinary approach was adopted. First of all, periodontal treatment was undertaken (root scaling and planing) accompanied by appropriate medical treatment and a bone graft to strengthen the area of the lower incisors. After that, surgical and orthodontic treatment to correct the malocclusion was begun. The difficulty lay in the significant absence of dental material to ensure proper intercuspation. A surgical repositioning splint was constructed on an articulator to ensure adequate mandibular retraction after maxillary advancement surgery. After treatment, the missing teeth were replaced by a prosthesis. Following treatment, the periodontal bone resorption was stabilized; the bone deficit was improved and the malocclusion had been corrected; the missing teeth were replaced by appropriate dentures. Short- and medium-term follow-up confirmed the stability of the results obtained, which will be discussed. The right combination of properly managed orthodontic, periodontal and prosthetic treatment can contribute to effective elimination of chronic periodontitis, even at an advanced stage in an adult patient, while at the same time improving esthetic and functional parameters. Copyright © 2013. Published by Elsevier Masson SAS.
The ultimate goal of periodontal therapy is the regeneration of the tissues destroyed as a result of periodontal disease. Currently, two clinical techniques, based on the principles of "guided tissue regeneration" (GTR) or utilization of the biologically active agent "enamel matrix derivative" (EMD), can be used for the regeneration of intrabony and Class II mandibular furcation periodontal defects. In cases where additional support and space-making requirements are necessary, both of these procedures can be combined with a bone replacement graft. There is no evidence that the combined use of GTR and EMD results in superior clinical results compared to the use of each material in isolation. Great variability in clinical outcomes has been reported in relation to the use of both EMD and GTR, and these procedures can be generally considered to be unpredictable. Careful case selection and treatment planning, including consideration of patient, tooth, site and surgical factors, is required in order to optimize the outcomes of treatment. There are limited data available for the clinical effectiveness of other biologically active molecules, such as growth factors and platelet concentrates, and although promising results have been reported, further clinical trials are required in order to confirm their effectiveness. Current active areas of research are centred on tissue engineering and gene therapy strategies which may result in more predictable regenerative outcomes in the future.
Full Text Available It has long been recognised that the presence of dental plaque leads to gingivitis and periodontal disease, as well as dental caries. Today tooth brushing is the most widely accepted method of removing plaque. Hence this present clinical study was undertaken to evaluate the effectiveness of an ionic toothbrush on oral hygiene status. For this study, 20 dental students in the age group of 18-20 years were included. All the subjects after undergoing dental prophylaxis were then provided with ionic toothbrushes, either active (equipped with lithium battery or inactive (without lithium battery. Plaque index and gingival bleeding index were examined at 7th, 14th, and 21st day. Microbial assessment was done for detection of colony forming units (CFU from the plaque samples which were collected on 0 day and 21st day, both before brushing and after brushing. Results shown a significant reduction in all the parameters and the reduction was more significant in active and inactive ionic toothbrush users. It was concluded that both active and inactive ionic toothbrushes reduced the plaque index and gingival bleeding index scores significantly and active ionic tooth brushes were more effective as compared to inactive ionic toothbrushes. There was no soft tissue trauma following the use of both type of toothbrushes, which showed that ionic toothbrushes were equally safe for regular long-term use.
Full Text Available Literature data have reported that certain Gram-negative anaerobe bacteria from the subgingival environment are important etiological agents of chronic periodontal disease. Based on published criteria identifying periodontal pathogens, major evidences has been shown for: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia; moderate evidences for: Prevotella intermedia, Peptostreptococcus /Micromonas/ micros, Fusobacterium nucleatum, Eubacterium nodatum, Campylobacter rectus, and spirochetes (Treponema denticola. Microbiological data has been suggested by several studies as a useful indicator of disease progression, selection of an adjunctive antimicrobial administration, healing assessment and disease recurrence. The results of this study demonstrate statistically significant correlation between periodontal attachment loss and the prevalence of Porphyromonas gingivalis, Tannerella forsythia and Peptostreptococcus (Micromonas micros in deep periodontal pockets of severe chronic periodontitis patients.
Hu, Kai-Fang; Ho, Ya-Ping; Ho, Kun-Yen; Wu, Yi-Min; Wang, Wen-Chen; Chou, Yu-Hsiang
Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease associated with considerably more rapid periodontal tissue destruction than chronic periodontitis. This study presents the 5-year follow-up of a patient with GAgP. A 29-year-old man reported experiencing increasing gingival recession. He was treated using cause-related therapy, provisional splints, and flap surgery combined with allograft grafting and was followed up for 5 years. This case study shows that elimination of infectious microorganisms and meticulous long-term maintenance provide an effective treatment modality for aggressive periodontitis cases. This treatment modality can restore the masticatory function and provide the GAgP patient with improved quality of life.
Stelmakh, V; Slot, D E; van der Weijden, G A
Women can experience symptoms of gingival inflammation during pregnancy. However, whether clinical signs of gingival inflammation were present already before pregnancy and whether women perceive an alteration in their periodontal health status during pregnancy compared to their periodontal health status before pregnancy remain unclear. The aim of this study was to evaluate the self-reported periodontal conditions in pregnant Dutch women as perceived before and during pregnancy. This cross-sectional survey was performed by asking women visiting two midwifery practices to complete a structured questionnaire. The data, which considered the women's oral hygiene habits, perceived periodontal health status before and during pregnancy and dental visits, were gathered and analysed. Parametric and nonparametric tests were used when appropriate. Most of the respondents (mean age: 29.6 years) brushed their teeth twice a day (72.2%), and 62.0% used interdental cleaning devices. Significant differences in periodontal health before and during pregnancy were perceived. No differences with respect to periodontal disease symptoms between the three trimesters during pregnancy were found. The symptom with the greatest increase was bleeding gums. This was followed by symptoms of painful and swollen gums. Of the 61.5% women who disclosed their plans to become pregnant to their dental care practitioner, 53.9% received information regarding the possibility of alterations in oral health status during pregnancy. Because of the perceived alterations in oral health status during pregnancy, approximately 11% of the women scheduled an additional appointment with their dental care professional for advice. During the pregnancy period, perceived alterations in periodontal health status were reported as compared to the oral health situation before pregnancy. Furthermore, approximately 50% of the women who visited a dental professional and disclosed their (plans) of pregnancy did not receive
Sharpe, G; Durham, J A; Preshaw, P M
To examine the attitudes of dental practitioners towards specialist periodontal referral in the North East of England. Semi-structured interviews were conducted with a purposive sample of 10 practitioners. Interviews continued until data saturation occurred. The data were organised using a framework and analysed by two researchers working independently. Perceptions of periodontal disease and treatment appear to be heavily influenced by the NHS remuneration system. Treatment in general practice was limited to simple scaling and there was an apparent reluctance to treat advanced periodontitis. Such cases were commonly referred to specialists, confirming the demand for a referral service in periodontics. The perceived potential for medico-legal consequences was a strong driver of referrals. Distance to the referral centre and the perceived costs of treatment were significant barriers to referral. Dentists valued the specialist's personal reputation and clinical skills more highly than academic status. Deficiencies in communication between primary and secondary care were highlighted. Increased resources are required to manage periodontal diseases within the NHS. There is a need for a periodontal referral service in the North East of England to improve accessibility to specialist care. This would appear to be most appropriately delivered by increased numbers of specialist practitioners.
Full Text Available Aim: The present clinical trial was designed to investigate the effectiveness of subgingivally delivered satranidazole (SZ gel as an adjunct to scaling and root planing (SRP in the treatment of chronic periodontitis. Materials and Methods: Seventy subjects with probing depth (PD ≥5 mm were selected. Thirty-five subjects each were randomly assigned to SRP + placebo (Group 1 and SRP + SZ (Group 2. The clinical outcomes evaluated were plaque index, gingival index, clinical attachment level (CAL, and PD at baseline; 1 month, 3 months, and 6 months interval. Furthermore, microbial analysis using polymerase chain reaction was done to estimate the number of sites harboring periodontopathogens. Results: Sixty four subjects were evaluated up to 6 months. At 6 months, the Group 2 resulted in greater mean reduction (4.10 mm in PD as compared to Group 1 (1.49 mm, and also a greater mean CAL gain (4.20 mm in Group 2 as compared to Group 1 (1.13 mm. These subjects also showed a significant reduction in the number of sites harboring periodontopathogens. Conclusion: The use of 3% SZ gel, when used as an adjunct to nonsurgical periodontal therapy in subjects with periodontitis, achieved better results than initial periodontal treatment alone.
Gingival crevicular fluid tissue/blood vessel-type plasminogen activator and plasminogen activator inhibitor-2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy.
Kurgan, Ş; Önder, C; Balcı, N; Fentoğlu, Ö; Eser, F; Balseven, M; Serdar, M A; Tatakis, D N; Günhan, M
The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on clinical parameters and gingival crevicular fluid levels of tissue/blood vessel-type plasminogen activator (t-PA) and plasminogen activator inhibitor-2 (PAI-2) in patients with periodontitis, with or without rheumatoid arthritis (RA). Fifteen patients with RA and chronic periodontitis (RA-P), 15 systemically healthy patients with chronic periodontitis (H-P) and 15 periodontally and systemically healthy volunteers (C) were included in the study. Plaque index, gingival index, probing pocket depth, clinical attachment level, bleeding on probing, gingival crevicular fluid t-PA and PAI-2 levels, erythrocyte sedimentation rate, serum C-reactive protein and disease activity score were evaluated at baseline and 3 mo after mechanical nonsurgical periodontal therapy. All periodontal clinical parameters were significantly higher in the RA-P and H-P groups compared with the C group (p periodontitis groups (p periodontitis and RA, nonsurgical periodontal therapy reduced the pretreatment gingival crevicular fluid t-PA levels, which were significantly correlated with gingival crevicular fluid PAI-2 levels. The significantly higher t-PA and PAI-2 gingival crevicular fluid levels in periodontal patients, regardless of systemic status, suggest that the plasminogen activating system plays a role in the disease process of periodontitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Jaramillo, Adriana; Contreras, Adolfo; Lafaurie, Gloria Inés; Duque, Andrés; Ardila, Carlos Martín; Duarte, Silvia; Osorio, Lyda
Metabolic syndrome (MetS) is a common chronic condition that increases the cardiovascular disease risk and is also linked to periodontitis. The study aim was to determine if a relationship exists between MetS and chronic periodontitis in adult Colombians. Participants were 220 healthy-gingivitis subjects and 431 periodontitis patients coming from the three largest Colombian cities. Periodontal status and MetS were determined in subjects. Univariate analysis and odds ratio were calculated within the 95 % confidence intervals and chi 2 test compared the groups. Variables were compared among the clinical periodontal groups and MetS by Wilcoxon and multivariate analysis, and logistic regression was performed for MetS and periodontitis. MetS had higher prevalence in periodontitis group (6.3 %) versus controls (3.2 %). In multivariate analysis, periodontitis was associated with MetS (adjusted OR = 2.72, 95 % CI 1.09-6.79), glucose intolerance with another component of MetS (adjusted OR = 1.78, 1.16 to 2.72), glucose resistance (adjusted OR = 11.46, 95 % CI 1.41-92.88), smoking (OR = 1.72, 95 % CI 1.09-2.71), and city of origin (2.69, 95 % CI 1.79-4.04). The study confirmed the positive association between MetS and periodontitis, being glucose sensitivity the strongly associated component. MetS must be taken into account by the dentist when evaluating risk factors for periodontitis, being useful for dentists to evaluate glycemia, lipidic profile, central obesity, and high blood pressure in patients. Interdisciplinary treatment must be recommended when a patient with MetS and periodontitis is being treated.
Kudo, Chieko; Shin, Wee Soo; Minabe, Masato; Harai, Kazuo; Kato, Kai; Seino, Hiroaki; Goke, Eiji; Sasaki, Nobuhiro; Fujino, Takemasa; Kuribayashi, Nobuichi; Pearce, Youko Onuki; Taira, Masato; Maeda, Hiroshi; Takashiba, Shogo
It has been revealed that atherosclerosis and periodontal disease may have a common mechanism of "chronic inflammation". Several reports have indicated that periodontal infection is related to atherosclerosis, but none have yet reported such an investigation through the cooperation of local clinics. This study was performed in local Japanese clinics to examine the relationship between periodontal disease and atherosclerosis under collaborative medical and dental care. A pilot multicenter cross-sectional study was conducted on 37 medical patients with lifestyle-related diseases under consultation in participating medical clinics, and 79 periodontal patients not undergoing medical treatment but who were seen by participating dental clinics. Systemic examination and periodontal examination were performed at baseline, and the relationships between periodontal and atherosclerosis-related clinical markers were analyzed. There was a positive correlation between LDL-C level and plasma IgG antibody titer to Porphyromonas gingivalis. According to the analysis under adjusted age, at a cut-off value of 5.04 for plasma IgG titer to Porphyromonas gingivalis, the IgG titer was significantly correlated with the level of low-density lipoprotein cholesterol (LDL-C). This study suggested that infection with periodontal bacteria (Porphyromonas gingivalis) is associated with the progression of atherosclerosis. Plasma IgG titer to Porphyromonas gingivalis may be useful as the clinical risk marker for atherosclerosis related to periodontal disease. Moreover, the application of the blood examination as a medical check may lead to the development of collaborative medical and dental care within the local medical clinical system for the purpose of preventing the lifestyle-related disease.
Jayaprakash, Deepika; Aghanashini, Suchetha; Vijayendra, Ranganatha Rao; Chatterjee, Anirban; Rosh, Radhika Mohan; Bharwani, Ashit
C-reactive protein (CRP) is a type I acute phase reactant. A number of studies have reported elevated serum CRP levels in periodontitis subjects, which decrease following periodontal therapy. However, the data of interventional studies on gingival crevicular fluid (GCF) levels of CRP is very scarce. The aim of the present study was to evaluate the effect of periodontal therapy on GCF CRP levels in patients with gingivitis and chronic periodontitis. A total of 60 subjects were included in the study with 20 subjects each in following groups: I-Healthy, II-Gingivitis, III-Mild periodontitis based on community periodontal index scores. Periodontal therapy was performed on Group II and Group III patients. GCF was collected from each subject at baseline and 3 months after periodontal therapy. The collected sample was subjected to biochemical analysis to detect CRP levels by using commercially available chemiluminescence immunoassay kit. The present study demonstrated that the periodontitis group had a higher mean CRP level (2.49 ± 0.47 ng/ml) when compared with the Gingivitis group (1.40 ± 0.32 ng/ml) and Healthy group (0.56 ± 0.20 ng/ml). The mean CRP values after periodontal therapy were found to be reduced to 0.44 ± 0.23 ng/ml in Group II and 1.30 ± 0.36 ng/ml in Group III patients. Within the limitations of this study, it can be concluded that GCF CRP level progressively increases from periodontal health to disease. It can also be stated that there is a decrease in GCF CRP levels with periodontal treatment.
Pradeep, Avani R; Singh, Sonender P; Martande, Santosh S; Naik, Savitha B; N, Priyanka; Kalra, Nitish; Suke, Deepak K
The aim of the present study was to evaluate the clinical and microbiological effect of systemic levofloxacin (LFX) as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis (CP). Sixty-five patients with CP were randomly divided into a test (n = 33, SRP and LFX 500 mg, once daily [o.d.]) and a control group (n = 32, SRP and placebo, o.d.). Plaque index (PI), gingival index (GI), percentage of sites with bleeding on probing (%BoP), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, 10 days, and 1-, 3-, and 6-month intervals. The percentage of sites positive for Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis, and Tannerella forsythia were recorded at baseline and at 3 and 6 months. Patients receiving LFX showed statistically-significant improvements in mean PD and CAL. The intergroup difference in PI, GI, and%BoP was not significant at any interval. There was a reduction in the percentage of sites positive for periodontopathic bacteria over the duration of the study in both groups, and a statistically-significant reduction in the number of sites positive for A. actinomycetemcomitans in the LFX group (P < 0.001). Levofloxacin was found to significantly improve the clinical and microbiological parameters in CP individuals. © 2014 Wiley Publishing Asia Pty Ltd.
Li, Yi; Xu, Li; Lu, Rui-fang; An, Yue-bang; Wang, Xian-e; Song, Wen-li; Meng, Huan-xi
To evaluate the feasibility of full-mouth debridement (subgingival scaling and root planning, SRP) by 2 times within 1 week and compare the clinical effects of different sequences of debridement-antibiotic usage in patients with severe chronic periodontitis (CP). A double-blinded, placebo-controlled, randomized clinical trial was conducted in 30 severe CP patients (14 males and 16 females, 40.5 ± 8.4 years old on average from 35 to 60) receiving 3 different sequences of debridement-antibiotictherapy: Group A, antibiotic usage (metronidazole, MTZ, 0.2 g, tid, 7 d; amoxicillin, AMX 0.5 g, tid, 7 d) was started together with SRP (completed by 2 times in 7 d); Group B, antibiotic usage (MTZ 0.2 g, tid, 7 d; AMX 0.5 g, tid, 7 d) was started 1 d after SRP(completed by 2 times in 7 d); Group C, SRP alone[probing depth (PD), bleeding index (BI) and tooth mobility] was examined. The average full-mouth probing depth, the average full-mouth proximal probing depth (pPD), the percentage of sites with PD>5 mm (PD>5 mm%), the percentage of sites with proximal PD>5 mm (pPD>5 mm%), the average bleeding index (BI) and the percentage of sites with bleeding on probing (BOP%) were calculated. Clinical examinations were performed at baseline and 2 months post therapy. (1) Compared with baseline conditions, all the subjects showed clinical improvements in all the parameters evaluated 2 months post therapy, Pantibiotic usage at the same time comparing with patients using antibiotics after SRP or SRP alone.
Haytural, O; Yaman, D; Ural, E C; Kantarci, A; Demirel, Korkud
The aim of this study was to investigate the chemokine expression profiles in gingival crevicular fluid (GCF) and serum in patients with advanced chronic periodontitis and to assess the impact of smoking on local and systemic levels of chemokines. Thirty patients with chronic periodontitis (CP; 20 smokers and 10 non-smokers) and 20 periodontally healthy subjects (10 smokers and 10 non-smokers) were recruited. Clinical parameters included the plaque index (PI), gingival index (GI), and bleeding on probing (BOP). Macrophage inflammatory protein-1 alpha (MIP-1α), macrophage inflammatory protein-1 beta (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), and regulated on activation normal T cell expressed and secreted chemokine (RANTES) were measured in gingival crevicular fluid (GCF) and serum using a multiplex immunoassay. MIP-1α levels were significantly lower (10.15 ± 1.48; p = 0.039) while MIP-1β levels were significantly higher (42.05 ± 8.21; p = 0.005) in sera from non-smoker patients with CP compared to non-smoker healthy subjects. MCP-1 concentration in sera was significantly higher in smoker periodontitis patients (8.89 ± 1.65) compared to non-smoker patients with periodontitis (8.14 ± 0.97; p = 0.004). MIP-1α and RANTES were significantly higher in GCF of the patients with CP (p = 0.001) while there were no statistically significant correlations between the GCF levels of these analytes and the smoking status. Periodontal inflammation increases the chemokine concentrations in the GCF while smoking suppresses chemokine levels in serum suggesting that different local and systemic mechanisms are involved during the response to periodontitis in smokers. Understanding the local and systemic chemokine responses in smokers will enable the development of biologically-based treatment methods for chronic periodontitis.
Zhang, Qiuxiang; Zhang, Xiaoli; Feng, Guijaun; Fu, Ting; Yin, Rulan; Zhang, Lijuan; Feng, Xingmei; Li, Liren; Gu, Zhifeng
Disease of systemic lupus erythematosus (SLE) and periodontal disease (PD) shares the common multiple characteristics. The aims of the present study were to evaluate the prevalence and severity of periodontal disease in Chinese SLE patients and to determine the association between SLE features and periodontal parameters. A cross-sectional study of 108 SLE patients together with 108 age- and sex-matched healthy controls was made. Periodontal status was conducted by two dentists independently. Sociodemographic characteristics, lifestyle factors, medication use, and clinical parameters were also assessed. The periodontal status was significantly worse in SLE patients compared to controls. In univariate logistic regression, SLE had a significant 2.78-fold [95% confidence interval (CI) 1.60-4.82] increase in odds of periodontitis compared to healthy controls. Adjusted for potential risk factors, patients with SLE had 13.98-fold (95% CI 5.10-38.33) increased odds against controls. In multiple linear regression model, the independent variable negatively and significantly associated with gingival index was education (P = 0.005); conversely, disease activity (P periodontitis of SLE in multivariate logistic regression (OR 1.348; 95% CI: 1.183-1.536, P < 0.001). Chinese SLE patients were likely to suffer from higher odds of PD. These findings confirmed the importance of early interventions in combination with medical therapy. It is necessary for a close collaboration between dentists and clinicians when treating those patients.
Rams, Thomas E; Feik, Diane; Mortensen, Joel E; Degener, John E; van Winkelhoff, Arie J
Background: Streptococcus constellatus and Streptococcus intermedius in subgingival dental plaque biofilms may contribute to forms of periodontitis that resist treatment with conventional mechanical root debridement/surgical procedures and may additionally participate in some extraoral infections.
van der Reijden, Wil A.; Bosch-Tijhof, Carolien J.; van der Velden, Ubele; van Winkelhoff, Arie Jan
Objective: To investigate the serotype distribution and stability of Aggregatibacter actinomycetemcomitans over an 8-year period in untreated Indonesian subjects. Material and Methods: Clinical periodontal status and the presence of A. actinomycetemcomitans were established in 1994 and 2002 in 107
Moore, Yolanda R; Dickinson, Douglas P; Wikesjö, Ulf M E
Therapeutic concepts involving the application of matrix, growth and differentiation factors have been advocated in support of periodontal wound healing/regeneration. Growth/differentiation factor-5 (GDF-5), a member of the bone morphogenetic protein family, represents one such factor. The purpose of this review is to provide a background of the therapeutic effects of GDF-5 expressed in various musculoskeletal settings using small and large animal platforms. A comprehensive literature search was conducted to identify all reports in the English language evaluating GDF-5 using the PubMed and Google search engines, and a manual search of the reference lists from the electronically retrieved reports. Two reviewers independently screened the titles and abstracts from a total of 69 reports, 22 of which were identified as pre-clinical (in vivo) evaluations of GDF-5. The full-length article of the 22 pre-clinical reports was then reviewed. Various applications including cranial and craniofacial bone formation, spine fusion, long bone fracture healing, cartilage, and tendon/ligament repair using a variety of small and large animal platforms evaluating GDF-5 as a therapeutic agent were identified. A majority of studies, using biomechanical, radiographic, and histological analysis, demonstrated significant dose-dependent effects of GDF-5. These include increased/enhanced local bone formation, fracture healing/repair, and cartilage and tendon/ligament formation. GDF-5 frequently was shown to accelerate wound maturation. Several studies demonstrated GDF-5 to be a realistic alternative to autograft bone. Studies using pre-clinical models and human histology suggest GDF-5 may also increase/enhance periodontal wound healing/regeneration. GDF-5 appears a promising therapeutic agent for periodontal wound healing/regeneration as GDF-5 supports/accelerates bone and tendon/ligament formation in several musculoskeletal settings including periodontal tissues.
Jnaneswar, Avinash; Subramaniya, Goutham Bala; Pathi, Jayashree; Jha, Kunal; Suresan, Vinay; Kumar, Gunjan
Over 5% of the world's population has disabling hearing loss. The oral health of the disabled may be disused for the reason of the disabling condition, a challenging disease or the limited access to oral health care. The objectives of the study were to assess the prevalence of dental caries and periodontal status of institutionalized hearing impaired (HI) children in Khordha district of Odisha. A descriptive cross-sectional study on the HI children was conducted in Khordha district, Odisha. Type III examination procedure was conducted to assess the oral health status of the children. Statistical analysis was performed by Chi-square test and Student's t-test, and the significance level was fixed at P caries prevalence was 19.3%. Statistically highly significant difference was found for mean decayed teeth (DT), missing teeth decayed, missing filled teeth (FT) (P dental services as well as dental health education is necessary to ensure the optimum dental health within the reach of these less fortunate children.
Full Text Available Scope of the study – determination of the types and intensity of the gingival-periodontal manifestations in in vitro fertilized pregnant women, and establishment of the role played by the hormonal treatment in the initiation and maintenance of such manifestations. Materials and method. The study was performed on patients fertilized in vitro between the years 2010-2012, in the Section of Assisted Human Reproduction of the “Panait Sârbu” Clinical Hospital of Obstretics and Ginecology – Bucuresti. All patients received the same amount and concentration of progesteronic compounds for maintaining their state of pregnancy, being examined in the first gestation weeks, immediately after confirmation of pregnancy through the β-hCG blood test. Results anddiscussion: In the last decades, the effects of estrogen and progesterone have drawn special attention from the part of the researchers. During pregnancy, the gingiva represents the maintissular target for the action of steroid hormones. Pregnancy-induced gingivitis is directly correlated with the presence of the microbial flora, known as the determining factor of the disease, being still exacerbated by the action of the sexual hormones, especially during the second and third quarter of pregnancy. Conclusions: The influence of gestational hormones upon the immune system of the organism may further contribute to the initiation and worsening of pregnancy-induced gingivitis, by reducing the immune response vs. the bacterial plaque.
Holmstrup, Palle; Damgaard, Christian; Olsen, Ingar
Increasing evidence has suggested an independent association between periodontitis and a range of comorbidities, for example cardiovascular disease, type 2 diabetes, rheumatoid arthritis, osteoporosis, Parkinson's disease, Alzheimer's disease, psoriasis, and respiratory infections. Shared....... The present article presents an overview of the evidence linking periodontitis with selected systemic diseases and calls for increased cooperation between dentists and medical doctors to provide optimal screening, treatment, and prevention of both periodontitis and its comorbidities....... inflammatory pathways are likely to contribute to this association, but distinct causal mechanisms remain to be defined. Some of these comorbid conditions may improve by periodontal treatment, and a bidirectional relationship may exist, where, for example, treatment of diabetes can improve periodontal status...
Full Text Available Objective: To explore the clinical effect of heat gutta-percha vertical condensation in the treatment of pulpitis and periapical periodontitis. Methods: A total of 120 patients with pulpitis and periapical periodontitis who were admitted in our hospital from February, 2015 to February, 2016 were included in the study and randomized into the observation group and the control group. The patients in the observation group were given heat gutta-percha vertical condensation for root canal filling, while the patients in the control group were given cold gutta-percha lateral condensation root canal filling. The root canal filling was evaluated. The changes of GI, SBI, and PD before and after treatment were observed. Results: The correct filling, shorting filling, and extra filling in the observation group were significantly superior to those in the control group. After treatment, GI, SBI, and PD were significantly reduced, and the reduced degree in the observation group was significantly superior to that in the control group. Conclusions: Heat gutta-percha vertical condensation in the treatment of pulpitis and periapical periodontitis can significantly enhance the therapeutic effect, and improve GI, SBI, and PD, with a significant clinical effect; therefore, it deserves to be widely recommended.
Marinho, Kelly C. T.; Giovani, Elcio M.
This study was to evaluate clinical and microbiological effectiveness of photodynamic therapy (PDT) in the treatment of periodontal disease in kidney-transplanted patients. Eight kidney transplanted patients treated at Paulista University were arranged in two groups: SRP performed scaling and root planning by ultrasound; SRP+PDT- in the same patient, which was held to PDT in the opposite quadrant, with 0.01% methylene blue and red laser gallium aluminum arsenide, wavelength 660 nm, power 100 mW. There was reduction in probing pocket depth after 45 days and 3 months regardless the group examined; plaque and bleeding index showed improvement over time, regardless the technique used, and bleeding index in the SRP+PDT group was lower when compared with the baseline the other times. There was no difference in the frequency of pathogens. Photodynamic therapy may be an option for treatment of periodontal disease in renal-transplanted patients and its effectiveness is similar to conventional therapy.
Full Text Available Introduction: The periodontal disease represents a malady characterized by an extremely high incidence. The manifestations and evolution of the periodontal diseases vary for each form in part, being influenced by systemic and local risk factors. Scope of the study: To evaluate the periodontal status on a group of patients, versus the syste‐ mic and local factors. Materials and method: The study was performed on a group of 170 patients, whose odonto‐periodontal status was evaluated by strict clinical and paraclinical examinations, on establishing the inflammation indices and the periodontal diagnosis. Results: The main cause of the analysis was gingival ble‐ eding; an increased number of smokers was registered among the patients. Out of the local factors, especially important were edentations and malocclusions. Also, a higher number of aggressive generalized periodontites has been noticed. Discussion: The forms of the periodontal diseases are obviously influenced by the systemic context, while the forms of localized chronic periodontitis associa‐ ted with generalized chronic gingivitis reflect the role pla‐ yed by the local risk factors. Conclusions: Stress and smoking represent significant risk factors in the installation of periodontal pathology, with a really alarming preva‐ lence. The aggressive forms of periodontitis showed a higher frequency than that recorded in literature.
Euzebio Alves, Vanessa Tubero; de Andrade, Ana Karina Pinto; Toaliar, Janaita Maria; Conde, Marina Clemente; Zezell, Denise Maria; Cai, Silvana; Pannuti, Claudio Mendes; De Micheli, Giorgio
This randomized split-mouth clinical trial was designed to evaluate the efficacy of scaling and root planing associated to the high-intensity diode laser on periodontal therapy by means of clinical parameters and microbial reduction. A total of 36 chronic periodontitis subjects, of both genders, were selected. One pair of contralateral single-rooted teeth with pocket depth >5 mm was chosen from each subject. All patients received non-surgical periodontal treatment, after which the experimental teeth were designated to either test or control groups. Both teeth received scaling, root planing and coronal polishing (SRP) and teeth assigned to the test group (SRP + DL) were irradiated with the 808 ± 5 nm diode laser, for 20 s, in two isolated appointments, 1 week apart. The laser was used in the continuous mode, with 1.5 W and power density of 1,193.7 W/cm(2). Clinical and microbiological data were collected at baseline, 6 weeks and 6 months after therapy. There was a significant improvement of all the clinical parameters-clinical attachment level (CAL), probing depth (PD), plaque index (PI) and Bleeding on Probing (BOP)-for both groups (P 0.05) was observed as far as colony forming units (CFU) is concerned, for both groups. As for black-pigmented bacteria, a significant reduction was observed in both groups after 6 months. However, the difference between test and control groups was not significant. There was no association between group and presence of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans at any time of the study. After 6 months of evaluation, the high-intensity diode laser has not shown any additional benefits to the conventional periodontal treatment. The high intensity diode laser did not provide additional benefits to non-surgical periodontal treatment. More studies are necessary to prove the actual need of this type of laser in the periodontal clinical practice.
Mombelli, Andrea; Almaghlouth, Adnan; Cionca, Norbert; Courvoisier, Delphine S; Giannopoulou, Catherine
The specific advantage of administering systemic antibiotics during initial, non-surgical therapy or in the context of periodontal surgery is unclear. This study assesses the differential outcomes of periodontal therapy supplemented with amoxicillin-metronidazole during either the non-surgical or the surgical treatment phase. This is a single-center, randomized placebo-controlled crossover clinical trial with a 1-year follow-up. Eighty participants with Aggregatibacter actinomycetemcomitans-associated moderate to advanced periodontitis were randomized into two treatment groups: group A, antibiotics (500 mg metronidazole plus 375 mg amoxicillin three times per day for 7 days) during the first, non-surgical phase of periodontal therapy (T1) and placebo during the second, surgical phase (T2); and group B, placebo during T1 and antibiotics during T2. The number of sites with probing depth (PD) >4 mm and bleeding on probing (BOP) per patient was the primary outcome. A total of 11,212 sites were clinically monitored on 1,870 teeth. T1 with antibiotics decreased the number of sites with PD >4 mm and BOP per patient significantly more than without (group A: from 34.5 to 5.7, 84%; group B: from 28.7 to 8.7, 70%; P antibiotics, but only eight treated with placebo, achieved a 10-fold reduction of diseased sites (P = 0.007). Consequently, fewer patients of group A needed additional therapy, the mean number of surgical interventions was lower, and treatment time in T2 was shorter. Six months after T2, the mean number of residual pockets (group A: 2.8 ± 5.2; group B: 2.2 ± 5.0) was not significantly different and was sustained over 12 months in both groups. Giving the antibiotics during T1 or T2 yielded similar long-term outcomes, but antibiotics in T1 resolved the disease quicker and thus reduced the need for additional surgical intervention.
Muhammad Ihsan Rizal
Full Text Available Background: Periodontal disease is common chronic adult condition. Antioxidants are present in the body fluid as protection against free radical. Uric acid is one of antioxidants that can be found in saliva. Moreover, the relationship among the antioxidant enzymes activities and clinical periodontal status were investigated. Objectives: The aim of the study was to observe uric acid level activities in the saliva of gingivitis and periodontitis patients. Methods: Six patients with gingivitis and six patients with periodontitis in Dental Hospital Trisakti University were included in the study. Clinical condition of each subject, the plaque index, and probing depth were determined. The salivary uric acid level was measured using the Folin-Wu method. Result: Salivary uric acid levels in the periodontitis patients with a mean ± SD 7.40 ± 0.31 (p = 0.004 were found to be higher compared to the gingivitis patients (mean ± SD = 6.84 ± 0.19. In addition, there were no significant differences in salivary uric acid levels between gender (p = 0.641. Conclusion: Uric acid levels in periodontitis patients were found to be higher than in gingivitis patients. Moreover, uric acid has more role on periodontitis than in gingivitis as an antioxidant agent.
Castro Dos Santos, Nídia Cristina; Andere, Naira Maria Rebelatto Bechara; Araujo, Cássia Fernandes; de Marco, Andrea Carvalho; Dos Santos, Lúcio Murilo; Jardini, Maria Aparecida Neves; Santamaria, Mauro Pedrine
Diabetes has become a global epidemic. Its complications can have a significant impact on quality of life, longevity, and public health costs. The presence of diabetes might impair the prognosis of periodontal treatments due to its negative influence on wound healing. Antimicrobial photodynamic therapy (aPDT) is a local approach that can promote bacterial decontamination in periodontal pockets. The aim of this study was to investigate the local effect of adjunct aPDT to ultrasonic periodontal debridement (UPD) and compare it to UD only for the treatment of chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Two periodontal pockets with probing depth (PD) and clinical attachment level (CAL) ≥5 mm received UPD only (UPD group) or UPD plus adjunct aPDT (UPD + aPDT group). Periodontal clinical measures were collected and compared at baseline and 30, 90, and 180 days. After 180 days of follow-up, there were statistically significant reductions in PD from 5.75 ± 0.91 to 3.47 ± 0.97 mm in the UPD group and from 6.15 ± 1.27 to 3.71 ± 1.63 mm in the UPD + aPDT group. However, intergroup analysis did not reveal statistically significant differences in any of the evaluated clinical parameters (p > 0.05). The adjunct application of aPDT to UPD did not present additional benefits for the treatment of chronic periodontitis in type 2 diabetic patients. The ClinicalTrials.gov identifier of the present study is NCT02627534.
dermatitis associated with Rothia mucilaginosa bacteremia: a case report ,”American Journal of Dermatopathol- ogy, vol. 32, no. 2, pp. 175–179, 2010.  P...root- filled teeth with chronic apical periodontitis ,” International Endodontic Journal, vol. 34, no. 6, pp. 429–434, 2001.  L. C. de Paz...of Rothiamucilaginosa DY-18: A Clinical Isolate with DenseMeshwork-Like Structures from a Persistent Apical Periodontitis Lesion Kazuyoshi Yamane,1
Nagayama, Masao; Yang, Sunghoon; Geocadin, Romergryko G.; Kaplan, Peter W.; Hoshiyama, Eisei; Shiromaru-Sugimoto, Azusa; Kawamura, Mitsuru
Nonconvulsive status epilepticus (NCSE) has rapidly expanded from classical features such as staring, repetitive blinking, chewing, swallowing, and automatism to include coma, prolonged apnea, cardiac arrest, dementia, and higher brain dysfunction, which were demonstrated mainly after the 2000s by us and other groups. This review details novel clinical features of NCSE as a manifestation of epilepsy, but one that is underdiagnosed, with the best available evidence. Also, we describe the new concept of epilepsy-related organ dysfunction (Epi-ROD) and a novel electrode and headset which enables prompt electroencephalography. PMID:28979770
Demirturk-Gocgun, Oya; Baser, Ulku; Aykol-Sahin, Gokce; Dinccag, Nevin; Issever, Halim; Yalcin, Funda
In this split-mouth clinical trial, we evaluated the clinical benefits of low-level laser therapy (LLLT) as an adjunct to nonsurgical periodontal treatment in patients with type 2 diabetes mellitus (DM). The impaired wound healing seen in diabetic patients may affect the results of periodontal treatment and may require an additional approach. In total, 22 chronic periodontitis patients with type 2 DM were included. Applying a split-mouth design, two quadrants were treated with only scaling and root planing (SRP) as the control and those in the other two were treated with SRP + LLLT as the test sites in each patient. An 808 nm GaAlAs diode laser was performed in the test sites at the energy density of 4.46 J/cm 2 on days 1, 2, and 7 after SRP. Plaque index (PI), probing depth (PD), bleeding on probing (BOP), and clinical attachment level were measured at baseline and again at 1 and 3 months after treatment. Deep periodontal pockets (PD ≥4 mm) were evaluated separately. Test sites showed significant improvement in PI and BOP in deep pockets at the 1-month follow-up period (p < 0.001 and <0.001, respectively), whereas no difference was found between the control and the test sites in other periodontal parameters. LLLT during periodontal treatment offered minimal short-term additional benefit in deep pocket healing in patients with type 2 DM.
Cirano, Fabiano Ribeiro; Pera, Claudia; Ueda, Paulo; Casarin, Renato Correa Viana; Ribeiro, Fernanda Vieira; Pimentel, Suzana Peres; Casati, Marcio Zaffalon
To evaluate the therapeutic potential of one-stage, full-mouth, ultrasonic debridement (FMUD) as a treatment for type 2 diabetic patients with generalized severe chronic periodontitis. Sixteen patients diagnosed with generalized severe chronic periodontitis and type 2 diabetes mellitus were allocated to the diabetic group; another 15 subjects with periodontitis but without metabolic disorders were placed in the nondiabetic group. Both groups were treated using the FMUD protocol, a unique 45-minute session of ultrasonic debridement of all sites presenting periodontal disease. Patients were analyzed for the following parameters: plaque and bleeding indices, gingival recession, probing depth, and clinical attachment level. Further, diabetic subjects were assessed using fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) tests. Patients were evaluated at 3 and 6 months for all parameters. ANOVA and the Tukey test were used for data analysis (P periodontal health after treatment. There were no significant differences between the groups for any of the parameters assessed (P > .05). Diabetic subjects treated with FMUD had a clinical response similar to that of nondiabetic subjects at all pocket depths. No adverse effects or medical disturbances were observed in either group during treatment. FPG and HbA1c levels remained unaltered after treatment. Within the limitations of this study, FMUD promoted clinical improvements in patients with type 2 uncontrolled diabetes and generalized severe chronic periodontitis.
Tyagi, Prashant; Vaish, Shubhra; Dodwad, Vidya
Recent developments suggest that the local delivery of antimicrobials into periodontal pockets can improve periodontal health. Azithromycin (AZM) has a wide antimicrobial spectrum of action toward anaerobic bacteria as well as Gram-negative bacilli. It is effective against periodontal pathogens such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Therefore, this study was undertaken to investigate the clinical effectiveness of AZM at 0.5% concentration in an indigenously prepared bioabsorbable controlled release gel as an adjunct to non-surgical mechanical therapy in the treatment of chronic periodontitis. Thirty sites in patients with chronic periodontitis and probing depth (PD) 4-6 mm were categorized randomly into two treatment groups: Scaling and root planing (SRP) plus 0.5% AZM gel (group 1) and SRP only (group 2). Clinical evaluation was undertaken using the Gingival Index (GI) of Loe and Silness and plaque was assessed using the Turesky et al. modification of Quigley Hein Index at baseline and 21 days. Pocket PD and clinical attachment level (CAL) were also measured. Results were expressed as mean±standard deviation and percentages and the data were analyzed using Statistical Package for Social Sciences (SPSS version 16.0, SPSS, Chicago, IL) software. Both therapies resulted in significant improvements. Mean reduction in GI from baseline to 21 days was 1.20±0.41 and 0.73±0.45 in group 1 and group 2, respectively. Plaque Index also improved through the study period in both groups, i.e., 0.86±0.51 in group 1 and 1.6±0.97 in group 2. Mean PD reduced significantly with SRP plus AZM gel application in group 1, i.e., 2.1±0.91 mm as compared to 1.0±1.06 mm achieved with SRP alone. A significant gain in mean CAL gain was observed in the test group (1.8±0.63 mm) as compared to control group (1.0±1.06 mm). Although both treatment strategies seem to benefit patients, the adjunctive use of 0.5% of AZM showed significant results.
Full Text Available Introduction: One of the consequences of periodontitis is periodontal intrabony defects (PID. Various biomaterials have been used for its treatment, but there is still no biomaterial considered as the gold standard. Current research is focused on the use of platelet-rich plasma (PRP for the treatment of PID. Objective: To determine the clinical effect of PRP in the treatment of PID through a systematic review with meta-analysis. Materials and Methods: A literature search was conducted until February 2017 in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, SIGLE, LILACS, IBECS, and the Cochrane Central Register of Clinical Trials. The criteria for the selection of the studies, which were randomized clinical trials, were the following: articles or papers published in the last 5 years, reporting clinical effects, with a follow-up time equal to or greater than 6 months, and a sample size equal to or greater than 10 patients reporting the use of PRP as a treatment for PID. The methodological quality of the studies was analyzed using the Cochrane Handbook of Systematic Reviews of Interventions as a reference. Results: The search strategy yielded nine articles reporting a reduction in probing depth and gingival recession, and an increase in clinical insertion level when using PRP alone or in combination with another biomaterial. Conclusion: The reviewed literature suggests that the use of PRP in the treatment of PID has a positive clinical effect.
Suzuki, Jun-Ichi; Sato, Hiroki; Kaneko, Makoto; Yoshida, Asuka; Aoyama, Norio; Akimoto, Shouta; Wakayama, Kouji; Kumagai, Hidetoshi; Ikeda, Yuichi; Akazawa, Hiroshi; Izumi, Yuichi; Isobe, Mitsuaki; Komuro, Issei
There is a deep relationship between cardiovascular disease and periodontitis. It has been reported that myocardial hypertrophy may be affected by periodontitis in clinical settings. Although these clinical observations had some study limitations, they strongly suggest a direct association between severity of periodontitis and left ventricular hypertrophy. However, the detailed mechanisms between myocardial hypertrophy and periodontitis have not yet been elucidated. Recently, we demonstrated that periodontal bacteria infection is closely related to myocardial hypertrophy. In murine transverse aortic constriction models, a periodontal pathogen, Aggregatibacter actinomycetemcomitans markedly enhanced cardiac hypertrophy with matrix metalloproteinase-2 activation, while another pathogen Porphyromonas gingivalis (P.g.) did not accelerate these pathological changes. In the isoproterenol-induced myocardial hypertrophy model, P.g. induced myocardial hypertrophy through Toll-like receptor-2 signaling. From our results and other reports, regulation of chronic inflammation induced by periodontitis may have a key role in the treatment of myocardial hypertrophy. In this article, we review the pathophysiological mechanism between myocardial hypertrophy and periodontitis.
Wendy E. Ward
Full Text Available Dietary supplement use may modify the risk of periodontal disease but effects on wound healing after periodontal procedures are less clear. This study characterized dietary supplement use by male and female patients (n = 376 attending a periodontal clinic—information that is essential for evidence-based intervention studies that may improve patient outcomes after periodontal procedures. Calcium, vitamin D, multivitamin and vitamin C were most commonly used. A greater (p ≤ 0.05 number of males took no supplements compared to females, and more (p ≤ 0.05 females than males took ≥ four supplements. Females took more (p ≤ 0.05 calcium, vitamin D, fish oil, green tea, magnesium, omega 3,6,9 and B vitamin complex. Younger patients (31–50 years had the highest (p ≤ 0.05 frequency of no supplement use compared to older age groups. Patients over age 50 had a higher (p ≤ 0.05 frequency of using ≥ four supplements including calcium and vitamin D. Supplement use was lower (p ≤ 0.05 in smokers, particularly for calcium, fish oil, green tea and vitamin D. In conclusion, females, older individuals and non-smokers have higher supplement use. Future dietary intervention studies can focus on supplements with known biological activities—anti-inflammatory, antioxidant or osteogenic activity—that may enhance wound healing after reconstructive periodontal procedures.
Murphy, Alexia J; Hill, Rebecca J; Buntain, Helen; White, Melinda; Brookes, Denise; Davies, Peter S W
Nutritional status is an important consideration in many pediatric clinical conditions. This paper aimed to examine and compare the nutritional status, represented by body cell mass (BCM), of children with cancer, Crohn's disease (CD), cystic fibrosis (CF) and anorexia nervosa (AN). Anthropometry was measured and BCM was calculated from whole body potassium-40 counting in 259 children being treated for clinical conditions (n = 66 cancer; n = 59 AN; n = 75 CF; n = 59 CD) and 108 healthy children. BCM was adjusted for height (BCMI) and expressed as a Z-score relative to laboratory reference data. The CD (-0.80 ± 1.61; p = 0.0001) and AN (-1.13 ± 0.99; p = 0.0001) groups had significantly lower BMI Z-score than the healthy control (0.13 ± 0.75), cancer (0.50 ± 1.40) and CF groups (-0.09 ± 0.95). The cancer (-1.16 ± 1.60; p = 0.0001), CD (-1.13 ± 1.36; p = 0.0001) and AN (-0.97 ± 1.18; p = 0.0001) groups had significantly reduced BCM compared to the healthy control (0.07 ± 0.93) and CF group (0.31 ± 1.08). According to BCMI Z-score, 42.4% of patients with cancer, 41.7% of the patients with CD, 27.1% of patients with AN, and 4.0% of patients with CF were considered malnourished. This study demonstrates that children undergoing treatment for clinical conditions may have alterations in BCM, independent of BMI. Children with cancer, CD and AN all had a high prevalence of malnutrition. Assessment of body composition, not just body size, is vital to understand nutritional status in children with clinical conditions. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Duque, Thais M; Prado, Maira; Herrera, Daniel R; Gomes, Brenda P F A
The aim of the present study was to investigate the effects of a calcium hydroxide-based intracanal medication (ICM) on periodontal and endodontic infectious/inflammatory contents and on periodontal clinical parameters in teeth with primary periodontal lesion and secondary endodontic involvement. Ten patients with abnormal pulp test results and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Samples were collected from root canals (RC) and periodontal pockets (PP) in order to investigate the microbiological status, levels of endotoxin (LPS), cytokines, and matrix metalloproteinases (MMP), before and after ICM. PCR was used for microbiological assessment. The kinetic-chromogenic LAL assay was used for LPS quantification. Quantikine ELISA kits were used for measurement of IL-1 α, IL-1 β, TNF-α, PGE 2 , MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 levels. The statistical analyses were made using the Friedman and Wilcoxon tests (p 0.05); however, the levels of the other MMPs and cytokines were reduced (p < 0.05). After 1 year of the root canal treatment, tooth mobility was significantly reduced (p ≤ 0.05). The use of a calcium hydroxide-based ICM showed positive effects for periodontal treatment prognosis, as it reduced LPS, cytokine, and MMP levels in periodontal pockets. Patients presenting deep probing depth and undergoing periodontal treatment for at least 6 months, with no positive response to periodontal therapy, might benefit with the endodontic treatment.
Ramieri, G A; Spada, M C; Austa, M; Bianchi, S D; Berrone, S
In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Surgi-Tec NV, Brugge, Belgium) was applied after osteotomy of the anterolateral walls of the maxillary sinuses, midpalatal suture, and, eventually, separation of the pterygomaxillary sutures. Expansion proceeded at a rate of 0.33-0.66 mm per day and the device was retained for 4-6 months for consolidation. Active orthodontic therapy was started after 8-10 weeks. The increment of arch width and the perimeter were evaluated using dental casts. Tooth thermal sensitivity and the periodontal side effects of treatment were monitored clinically after distraction, at device removal, and after 1 year. Bone healing was also investigated during the procedure using conventional radiological techniques. This experience confirms that transverse maxillary distraction is an effective technique in adult patients, leading to the formation of new bone. There were no noticeable intraoperative complications, but postsurgical periodontal side effects were documented. The procedure offers advantages over traditional teeth-borne appliances in terms of rapidity of treatment and the absence of mechanical forces acting on the teeth. Further evaluation is required to assess the long-term stability and periodontal consequences of this technique.
Soroye, M; Ayanbadejo, P; Savage, K; Oluwole, A
To evaluate the association between periodontal disease and pregnancy outcomes like preterm birth and low birth weight. Interviewer-administered questionnaires were completed by the subjects who attended the antenatal clinic of the Lagos University Teaching Hospital, Lagos. Information obtained included; maternal age, gestational age, marital status, educational status, occupation and expected date of delivery. After delivery, the questionnaire was completed with baby's weight at birth and the actual date of delivery. Clinical assessment of the periodontium was done using Oral Hygiene Index (OHI) and Community Periodontal Index of Treatment Needs (CPITN). Participants were divided into three groups: Test, Control I and Control II groups. Scaling and polishing were done for all patients with periodontal disease before (Test group) and after delivery (Control I). All Control II participants (those without periodontal disease) were given Oral hygiene instructions. Descriptive and comparative analyses were done using Epi info version 2008. Four hundred and fifty women received the questionnaire but the response rate was 94%, giving an actual sample size of 423 participants. Maternal age range was between 18 and 34 years with mean age of 29.67 (± 3.37). Gestational age at the point of recruitment was between 10 weeks and 26 weeks with mean of 23.34 (± 4.05). The prevalence of periodontal disease among the study group was 33.38%. About 71% of the participants attained tertiary level of education; only 0.7% had no formal education. There was 9.9% use of alcohol among the participants. The mean oral hygiene score for the participants was 1.94 (± 1.31). The prevalences for preterm deliveries, low birth weight and spontaneous abortion were 12.5%, 12.1% and 1.42% respectively. This study confirms periodontal disease as a probable risk for adverse pregnancy outcomes such as preterm delivery and low birth weight. Therefore, health workers should be encouraged to promote good
Takaishi, Y; Miki, T; Nishizawa, Y; Morii, H
Etidronate 200 mg daily was administered to four female patients with periodontitis and resultant alveolar pyorrhoea for periods of 2 weeks, followed by off-periods of 10 weeks or more, for 2-3 years. The macroscopic appearance of gingival mobility of the teeth, depth of periodontal pockets, and X-ray findings of alveolar bones improved markedly during this time. The effects were first observed after 6-12 months of treatment. These findings indicate that bisphosphonates may be effective in the treatment of periodontitis and resultant alveolar pyorrhoea. The effect may be mediated by the inhibitory action on bone resorption and the anti-inflammatory action of etidronate. Concomitant conventional dental management is also required.
Fujise, Osamu; Miura, Mayumi; Hamachi, Takafumi; Maeda, Katsumasa
Porphyromonas gingivalis is considered a critical pathogen of periodontal diseases including recurrent periodontitis. The profound effects of active periodontal treatment (APT) on P. gingivalis elimination were previously demonstrated and revealed that the subsequent P. gingivalis-free or -suppressed status seems to be maintained during early periodontal maintenance (PMT). The aim of the present study was to show the occurrence of microbial recolonization during this early PMT period. In total, 128 sites from 11 generalized chronic periodontitis patients and one generalized aggressive periodontitis patient underwent clinical and microbiologic examination at baseline (Exam-I), after APT (Exam-II), and in PMT (Exam-III). Exam-III was carried out an average of 4.5 +/- 3.5 months after Exam-II. Detection and quantification of putative pathogens were performed using a polymerase chain reaction-based method. The PMT used was effective in maintaining the clinical conditions improved by APT. However, in microbiological examinations, Exam-III showed higher detection frequency and levels of P. gingivalis than Exam-II. This suggests that a P. gingivalis recolonization started in the early PMT period. P. gingivalis-increased sites then showed significantly more severe signs of periodontitis in Exam-I than P. gingivalis-stable sites (bleeding on probing frequency: 76.7% versus 56.5%; suppuration frequency: 41.9% versus 12.9%). On the other hand, in Exam-II, no significant differences of clinical parameters were noted between P. gingivalis-increased and -stable sites. Severe periodontitis sites before APT seemed to place them at risk of P. gingivalis recolonization in the early PMT period, and this microbial restoration could be a cause of recurrent periodontitis.
Izabela Korona-Głowniak; Radosław Siwiec; Marcin Berger; Anna Malm; Jolanta Szymańska
The microorganisms that form dental plaque are the main cause of periodontitis. Their identification and the understanding of the complex relationships and interactions that involve these microorganisms, environmental factors and the host’s health status enable improvement in diagnostics and targeted therapy in patients with periodontitis. To this end, molecular diagnostics techniques (both techniques based on the polymerase chain reaction and those involving nucleic acid analysis via hybridi...
Timmerman, MF; Van der Weijden, GA; Abbas, F; Arief, EM; Armand, S; Winkel, EG; Van Winkelhoff, AJ; Van der Velden, U
Background, aims: In order to investigate the role of various putative clinical and microbiological risk markers, a longitudinal study was initiated in a young population deprived of regular dental care. In 1987 all inhabitants in the age range 15-25 years living in a village with approximately 2000
Lourenço, Alan Grupioni; Ribeiro, Ana Elisa Rodrigues Alves; Nakao, Cristiano; Motta, Ana Carolina Fragoso; Antonio, Luana Grupioni Lourenço; Machado, Alcyone Artioli; Komesu, Marilena Chinali
The majority of HIV-infected patients develop Candida spp-associated clinical oral lesions. Studies have shown that asymptomatic oral colonization of Candida spp may lead to oral lesions or become a source of disseminated infections. The aim of this study was to verify the effects of periodontal conditions on Candida spp prevalence and Candida spp carriage in the oral cavity of HIV-infected patients compared to non-infected patients. Twenty-five patients not infected with HIV and 48 HIV-infected patients were classified according to periodontal conditions as being periodontal healthy or with periodontal disease. Candida spp carriage and classification were performed in oral rinse samples. Viral load and CD4+ T lymphocyte (CD4+L) counts were performed in blood samples from HIV-infected patients. No differences in Candida spp prevalence related to HIV status or periodontal condition were detected. However, Candida spp carriage was increased in periodontally affected HIV-infected patients when compared to periodontally healthy HIV-infected patients (p= 0.04). Periodontally healthy HIV-infected patients presented Candida spp carriage in similar levels as healthy or periodontally affected non-HIV-infected patients. Candida spp carriage was correlated with CD4+L counting in HIV-infected patients. We concluded that periodontal disease is associated with increased Candida spp carriage in HIV-infected patients and may be a predisposing factor to clinical manifestations of candidiasis.
Full Text Available Introduction: Over 5% of the world's population has disabling hearing loss. The oral health of the disabled may be disused for the reason of the disabling condition, a challenging disease or the limited access to oral health care. Objectives: The objectives of the study were to assess the prevalence of dental caries and periodontal status of institutionalized hearing impaired (HI children in Khordha district of Odisha. Materials and Methods: A descriptive cross-sectional study on the HI children was conducted in Khordha district, Odisha. Type III examination procedure was conducted to assess the oral health status of the children. Statistical analysis was performed by Chi-square test and Student's t-test, and the significance level was fixed at P < 0.05. Results: The final population consisted of 540 HI children out of which 262 (48.5% were male and 278 (51.5% were female, 285 (52.8% children had severe hearing loss and 227 (42.0% had profound hearing loss. Bleeding on probing was found in 72 (13.3% female children as compared to 57 (10.6% male children. While 131 (24.3% female children had calculus, 124 (23.0% male children had the same condition. Total caries prevalence was 19.3%. Statistically highly significant difference was found for mean decayed teeth (DT, missing teeth decayed, missing filled teeth (FT (P < 0.001, while for mean FT there was no statistically significant difference according to age groups. Statistically highly significant difference was found for mean DT, extracted teeth and decayed, extracted, filled teeth (P < 0.001. Conclusion: An improved accessibility to dental services as well as dental health education is necessary to ensure the optimum dental health within the reach of these less fortunate children.
Full Text Available Background: Periodontal infections, which serve as a reservoir of inflammatory mediators, may pose a threat to the fetal-placental unit and cause adverse pregnancy outcomes. Objective: The aim of this study was assessing the periodontal status of women during puerperium and determining the possible relationship between their periodontal disease and low birth weight delivery. Materials and Methods: This was a case-control study. The sample included 88 ex-pregnant women were seen at maternity hospitals of Yazd, Iran. Half of the mothers had low birth babies (LBW (birth weight below 2500g- case group and the others had normal weight babies (>2500g- control group. The mothers’ data were obtained from medical files, interview and periodontal clinical examination carried out up to 3 days after delivery. Bleeding on probing, presence of supra-gingival calculus and CPITN (Community Periodontal Index for Treatment Needs were used for periodontal assessment Results: Among the known risk factors of LBW babies, history of previous LBW infant among case mothers reached statistical significance (p=0.0081, Student t-test. Mothers of LBW infants had less healthy areas of gingiva (p=0.042, and more deep pockets (p=0.0006, Mann-Whitney test. Conclusion: The maternal periodontal disease can be a potential independent risk factor for LBW.
Poulsen, Anne Havemose; Westergaard, Jytte; Stoltze, Kaj
Periodontitis shares several clinical and pathogenic characteristics with chronic arthritis, and there is some degree of coexistence. The aims of this study were to elucidate whether patients with localized aggressive periodontitis (LAgP), generalized aggressive periodontitis (GAgP), juvenile...... idiopathic arthritis (JIA), and rheumatoid arthritis (RA) share periodontal and hematological characteristics distinguishing them from individuals free of diseases....
Azeredo, Stéphane V.; Brasil, Sabrina C.; Antunes, Henrique; Marques, Fábio V.; Pires, Fábio R.
Background Macrophages and plasma cells play a key role in the regulation of innate and adaptive immunity. The aim of this study was to assess the presence of these cells in apical periodontitis and their distribution comparing with clinical and image data. Material and Methods Thirty-three lesions were selected and divided in two groups (17 periapical cysts and 16 periapical granulomas). Immunoreactions using anti-CD68 and anti-CD138 antibodies were carried out; image analysis was performed with an optical microscope and 5 high-power fields from each slide were evaluated leading to an average score of immunoexpression. This mean score was compared between the two groups and correlated with the clinical and image data. Results There was no statistically significant difference (p >0.05) for the mean average score of CD68+ macrophages and CD138+ plasma cells when comparing the two groups (cysts x granulomas) and the specimens included in each specific group. No statistically significant differences (p >0.05) were also observed when comparing the average scores with clinical and image data. Conclusions The presence of CD68+ macrophages and CD138+ plasma cells was similar in periapical cysts and granulomas and the presence of these cells did not correlate with clinical and image data from both groups. Key words:Macrophages, plasma cells, apical periodontitis, periapical granuloma, periapical cyst. PMID:29075406
Al-Ghutaimel, Hayat; Riba, Hisham; Al-Kahtani, Salem; Al-Duhaimi, Saad
Background. Since 2000, studies, experiments, and clinical observations revealed high prevalence of periodontal diseases among children and adolescents. Therefore, this paper was designed to provide an update for dental practitioners on epidemiology, microbiology, pathology, prevention, diagnosis, and treatment of periodontal diseases in children and adolescents. Methods. This paper reviews the current literature concerning periodontal diseases in pediatric dentistry. It includes MEDLINE database search using key terms: "periodontal diseases in children," "Periodontal diseasesin adolescents," "periodontal diseases risk factors," "microbiology of periodontal diseases," "classification of periodontal diseases," "epidemiology of periodontal diseases," and "treatment of periodontal diseases." Articles were evaluated by title and/or abstract and relevance to pediatric dentistry. Sixty-five citations were selected by this method and by the references within the chosen articles. A review of the comprehensive textbooks on pediatric dentistry and periodontology was done. Some recommendations were based on the opinions of experienced researchers and clinicians, when data were inconclusive.
Street, Cale N.; Andersen, Roger; Loebel, Nicolas G.
Periodontitis affects half of the U.S. population over 50, and is the leading cause of tooth loss after 35. It is believed to be caused by growth of complex bacterial biofilms on the tooth surface below the gumline. Photodynamic therapy, a technology used commonly in antitumor applications, has more recently been shown to exhibit antimicrobial efficacy. We have demonstrated eradication of the periopathogens Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans in vitro using PeriowaveTM; a commercial photodisinfection system. In addition, several clinical studies have now demonstrated the efficacy of this treatment. A pilot study in the U.S. showed that 68% of patients treated with PeriowaveTM adjunctively to scaling and root planing (SRP) showed clinical attachment level increase of >1 mm, as opposed to 30% with SRP alone. In a subsequent larger study, a second PeriowaveTM treatment 6 weeks after initial treatment led to pocket depth improvements of >1.5 mm in 89% of patients. Finally, in the most recent multicenter, randomized, examiner-blinded study conducted on 121 subjects in Canada, PeriowaveTM treatment produced highly significant gains in attachment level (0.88 mm vs. 0.57 mm; p=0.003) and pocket depth (0.87 mm vs. 0.63 mm; p=0.01) as compared to SRP alone. In summary, PeriowaveTM demonstrated strong bactericidal activity against known periopathogens, and treatment of periodontitis using this system produced significantly better clinical outcomes than SRP alone. This, along with the absence of any adverse events in patients treated to date demonstrates that PDT is a safe and effective treatment for adult chronic periodontitis.
Kinney, Janet S; Morelli, Thiago; Oh, Min; Braun, Thomas M; Ramseier, Christoph A; Sugai, Jim V; Giannobile, William V
Assess the ability of a panel of gingival crevicular fluid (GCF) biomarkers as predictors of periodontal disease progression (PDP). In this study, 100 individuals participated in a 12-month longitudinal investigation and were categorized into four groups according to their periodontal status. GCF, clinical parameters and saliva were collected bi-monthly. Subgingival plaque and serum were collected bi-annually. For 6 months, no periodontal treatment was provided. At 6 months, patients received periodontal therapy and continued participation from 6 to 12 months. GCF samples were analysed by ELISA for MMP-8, MMP-9, Osteoprotegerin, C-reactive Protein and IL-1β. Differences in median levels of GCF biomarkers were compared between stable and progressing participants using Wilcoxon Rank Sum test (p = 0.05). Clustering algorithm was used to evaluate the ability of oral biomarkers to classify patients as either stable or progressing. Eighty-three individuals completed the 6-month monitoring phase. With the exception of GCF C-reactive protein, all biomarkers were significantly higher in the PDP group compared to stable patients. Clustering analysis showed highest sensitivity levels when biofilm pathogens and GCF biomarkers were combined with clinical measures, 74% (95% CI = 61, 86). Signature of GCF fluid-derived biomarkers combined with pathogens and clinical measures provides a sensitive measure for discrimination of PDP (ClinicalTrials.gov NCT00277745). © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Natalia Alves Fernandes
Full Text Available Periodontal disease (PD is widely known among veterinarians for its high prevalence and serious consequences to the dogs. The objective of this study was to assess the occurrence of PD in dogs that live in the micro-region of Viçosa, treated at the Veterinary Hospital of the Federal University of Viçosa (HVT - Hospital Veterinário da Universidade Federal de Viçosa, as well as to assess how aware of this disease dog owners are. In order to do so, all dogs treated at the HVT from March 10th, 2009 to November 30th, 2009, on alternate days, had their oral cavities examined. Medical history data, such as age, type of food, main complaint and owner consent, halitosis, presence of dental calculus, inflammation and gingival recession and tooth loss, were collected. A prevalence of 88.67% was found for PD in dogs referred to the HVT, and 2.67% were referred due to this disease. Of all the owners who participated in the study, 43.83% knew about periodontal disease and of these 17.46% made use of some type of prevention or treatment. Therefore, periodontal disease is highly prevalent and the owners are not aware of the disease. Thus, a dog owner clarification program on periodontal disease is needed in the area where HVT-UFV operates.
Seethalakshmi, C; Reddy, R C Jagat; Asifa, Nisha; Prabhu, S
Diabetes mellitus is a chronic disease affecting many parts of the body. A number of oral diseases have been associated with diabetes mellitus with an increased risk of dental caries and periodontal disease. The aim of the study was to evaluate the salivary pH and incidence of dental caries and periodontal status in diabetes mellitus compared to that of the normal subjects. The study population consisted of 40 patients divided into 2 groups with group I comprising of 20 known diabetes mellitus patients and group II comprising of 20 non diabetic subjects as control group. The pH of the saliva was determined using a digital pH meter. Dental caries and periodontal status were assessed by DMFT and PDI indices respectively. There was a decrease in the mean salivary pH of 6.51 in the study group, compared to the normal mean salivary pH of 7.88 in the control group. The mean DMFT index was higher in the study group (8.10) when compared to that of control group (1.15). The mean PDI score was also higher in the study group (4.0) as compared to that of the control group (0.45). The results of the present study concluded that there was a significant relationship between the diabetes mellitus and increased incidence of dental caries and periodontitis and there was also a significant reduction in the salivary pH in diabetes mellitus patients, compared to that of non diabetic subjects.
Surekha Ramrao Rathod
Full Text Available Background: This human study was carried out to evaluate the possible effects of severe chronic periodontal disease on the different aspect of dental pulp structure. Materials and Methods: A total of 20 permanent teeth with a hopeless prognosis due to severe chronic periodontitis were extracted from systemically healthy adults, with a pocket probing depth of ≥8 mm and a mobility of grade 3. After extraction, the apical 2-3 mm of the roots were immediately sectioned with a fissure bur. Results: Inflammation was usual finding in the samples, however, only 15% of the teeth showed no inflammation. Pulpal necrosis (partial or complete was seen in different sections, and it was observed that 50% sections had no necrosis. Partial necrosis was a common finding seen when compared to complete necrosis (6.7%. About 60% of samples showed edematous pulp. Only 6.7% of samples showed absence of fibrosis. Pulp with moderate fibrosis was seen commonly seen in many sections. A majority of teeth (70% also displayed a loss of odontoblastic integrity. In only 25% of samples, pulp stones were detected. Conclusion: Our results revealed that severe chronic periodontitis can affect dental pulp. The cumulative effect of the periodontal disease, as indicated by the factors of calcifications, apposition of calcified tissue, resorption or inflammation from the root caries or from the involved lateral canals, is damaged pulp tissue, but total disintegration is a certainty only when all main apical foramina are involved by bacterial plaque. Proper evaluation and treatment of periodontal-endodontic involvement is recommended.
Hickman, M Ashley; Boggess, Kim A; Moss, Kevin L; Beck, James D; Offenbacher, Steven
We sought to determine if maternal periodontal disease is associated with oxidative stress as measured by serum 8-isoprostane. A secondary analysis was conducted using prospective data from the Oral Conditions and Pregnancy Study. Healthy women enrolled at periodontal disease status was categorized as healthy, mild, or moderate to severe by clinical criteria. Maternal serum was analyzed for 8-isoprostane using ultrasensitive enzyme-linked immunosorbent assay. Elevated 8-isoprostane level was defined as ≥ 75th percentile. Maternal factors associated with elevated 8-isoprostane were determined using chi-square or T test. Multivariable logistic regression was used to assess association between elevated 8-isoprostane and maternal factors. Seven hundred ninety-one women had complete data. Median (interquartile) 8-isoprostane serum level was 1806 (16 to 81,870) pg/dL. Using bivariate analysis, maternal age, race, marital status, utilization of public assistance, and mild or moderate to severe periodontal disease were associated with elevated serum 8-isoprostane. Using logistic regression, moderate to severe periodontal disease (adjusted odds ratio 2.9, 95% confidence interval: 1.7 to 5.0) remained significantly associated with an elevated serum 8-isoprostane level. Maternal periodontal disease is associated with oxidative stress during pregnancy. Further study is needed to determine the role of maternal oxidative stress in periodontal disease-associated adverse pregnancy outcomes. © Thieme Medical Publishers.
Theodoro, Letícia Helena; Assem, Naida Zanini; Longo, Mariéllen; Alves, Márcio Luiz Ferro; Duque, Cristiane; Stipp, Rafael Nobrega; Vizoto, Natália Leal; Garcia, Valdir Gouveia
The aim of this study was to evaluate the effects of non-surgical periodontal therapies on smokers with chronic periodontitis, involving multiple adjunctive applications of antimicrobial photodynamic therapy (aPDT), and systemic metronidazole (MTZ) with amoxicillin (AMX). All participants were treated with scaling and root planing (SRP). Seventeen patients received 400 mg of MTZ and 500 mg of AMX three times per day for 7 days (MTZ + AMX). Additionally, 17 patients received a placebo, and 17 patients were treated with three applications of aPDT (immediately, 48 h and 96 h after SRP). Clinical and microbiological examinations were performed at baseline and at 90 and 180 days post-therapy. Subgingival samples were analyzed using real-time polymerase chain reaction. After 180 days, the patients in groups MTZ + AMX and aPDT had significantly lower mean probing depths, more clinical attachment level gains and less bleeding on probing. At 180 days, in the moderate pocket there was a reduction in the levels of Porphyromonas gingivalis and Prevotella nigrescens in the MTZ + AMX group, while group aPDT showed a reduction in Prevotella nigrescens. Furthermore, at 180 days, in the deep pocket a reduction in Porphyromonas gingivalis, Prevotella intermedia and Prevotella nigrescens was observed in group MTZ + AMX, as well as a reduction in the levels of Prevotella intermedia and Prevotella nigrescens in group aPDT. In smokers with periodontitis, the MTZ + AMX and aPDT treatments significantly improved the effects of SRP. Copyright © 2018 Elsevier B.V. All rights reserved.
Musalaiah, S V V S; Anupama, M; Nagasree, M; Krishna, Ch Murali; Kumar, Aravind; Kumar, P Mohan
Periodontal tissues mount an immune inflammatory response to bacteria and their products. Certain inflammatory cytokines produced during periodontal inflammation increase the production of acute phase proteins like high‑sensitivity C‑reactive protein (hs‑CRP) and can depress erythropoietin production leading to the development of anemia. The aim of this study is to investigate the efficacy of nonsurgical periodontal therapy on red blood cell (RBC) parameters and hs-CRP in chronic periodontitis patients with anemia. This is a longitudinal, interventional study with 6-month follow-up. A total of 30 subjects with anemia and chronic periodontitis with age group of 33-55 years were selected by screening hemoglobin (Hb) levels and examining periodontal findings. The clinical parameters plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline. Laboratory blood investigations were performed to evaluate RBC count, Hb, packed cell volume (PCV), erythrocyte sedimentation rate (ESR) and red cell indices, hs-CRP at baseline. Nonsurgical periodontal therapy was performed for all patients. Patients were recalled after 6 months. The clinical and hematological parameters were re-evaluated to analyze the changes after nonsurgical periodontal therapy. The results showed that there was a significant increase in Hb levels, RBC count and PCV from baseline to 6 months after nonsurgical periodontal therapy. There is significant decrease in levels of ESR and hs-CRP levels after nonsurgical periodontal therapy indicating resolution of periodontal inflammation. There is a significant decrease in PPD, scores of PI and GI and significant increase in CAL gain. Minimal changes in mean corpuscular volume, mean corpuscular hemoglobin (MCH) and MCH concentration indicated that the lower values of red cell parameters are not due to any vitamin and mineral deficiencies, but secondary to the chronic inflammatory changes
Mammen, Jerry; Vadakkekuttical, Rosamma Joseph; George, Joseraj Manaloor; Kaziyarakath, Jaishid Ahadal; Radhakrishnan, Chandni
A bidirectional relationship exists between diabetes and periodontitis. In the present clinical trial, we evaluated the effects of non-surgical periodontal therapy (NSPT) on insulin resistance in patients with type II diabetes mellitus (DM) and chronic periodontitis. Forty chronic periodontitis patients with type II DM were selected and equally allocated to case and control groups. All patients were assessed for periodontal parameters and systemic parameters. The case group received NSPT, and both groups were re-evaluated after 3 months. All periodontal parameters were found to be significantly improved in the case group compared to the control group 3 months after NSPT. The mean differences in systemic parameters, such as fasting serum C-peptide, Homeostasis Assessment (HOMA) Index-insulin resistance, and HOMA-insulin sensitivity, from baseline to 3 months for the case group were 0.544 ± 0.73, 0.54 ± 0.63, and -25.44 ± 36.81, respectively; for the control group, they were significant at -1.66 ± 1.89, -1.48 ± 1.86, and 31.42 ± 38.82 respectively (P periodontal inflammation could affect glycemic control and insulin resistance. Effective periodontal therapy reduced insulin resistance and improved periodontal health status and insulin sensitivity in patients with type II DM and chronic periodontitis. © 2016 John Wiley & Sons Australia, Ltd.
... diseases. The primary research focus was on oral bacteria. Periodontal diseases were thought to begin when chalky white ... tools to target their treatment specifically to the bacteria that trigger periodontal disease. At the same time, because biofilms form ...
Full Text Available The aim: to study clinical and X-ray specifics of chronic generalized periodontitis of women during a postmenopaus-al period determined by mineral bone density. Material and Methods. 80 women having chronic generalized periodontitis during a postmenopausal period were examined using clinical and X-ray research. Material of bone density was taken into consideration. Results. Decrease of hygienic indices of women at postmenopausal period has been found. It depends on the degree of severity of chronic generalized periodontitis. There was a reverse connection of periodon-tal index and mineral density of bone tissues in the 1-st group: — 0.9 (p<0.05, in the 2-nd group: — 0.5 (p<0.05, in the 3-rd group: — 0.79 (p<0.05. Cone-beam computer tomography made possible to find out the initial signs of edge osteoporosis of interdental partitions at the light degree of chronic generalized periodontitis and signs of spot and homogenous osteoporosis of gum bones, osteoporosis of interdental partitions with osteolysis at mild and severe degrees of severity. Conclusion. The clinical researches with cone-beam computer tomography and densitometry have revealed the exact data on the condition of bone tissues. The results have given an opportunity to plan osteotropic therapy and to control the dynamics of the process correctly.
Naik, Sandhya P; Punathil, Sameer; Shetty, Praveena; Jayanti, Ipsita; Jalaluddin, Md; Avijeeta, Anisha
The aim of the present study was to evaluate the effectiveness of different bristle designs of toothbrushes and the periodontal status among patients undergoing fixed orthodontic treatment. This randomized controlled trial (RCT) consisted of 45 adolescents (comprising 20 males and 25 females) undergoing fixed orthodontic treatment. The study participants were randomly allocated to three groups, each group being assigned a locally available toothbrush with a particular design of toothbrush bristle. In the first test phase, group I study participants were allocated to toothbrush with flat bristles, group II study subjects were allocated to toothbrush with zigzag bristles, and group III study participants were allocated to toothbrush with crisscross bristles. The study participants were recalled after 4 weeks to check the effectiveness of the allocated toothbrushes. A washout period of 1 week was maintained to ensure that there was no carryover effect of the different bristle designs. In the second test phase, each patient used the opposite toothbrush bristle design (group I: toothbrush with zigzag bristles, group II: toothbrush with crisscross bristles, and group III: toothbrush with flat bristles). Plaque scores were measured using Turesky-Gilmore-Glickman modification of Quigley-Hein plaque index (PI). In both phase 1 and 2 of this RCT, toothbrush with crisscross bristles exhibited maximum plaque reduction among the three different bristle design toothbrushes following 30 days (p = 0.312 ± 0.102 and 0.280 ± 0.110, respectively), which was statistically significant. It was concluded that all the three designs of toothbrushes were effective in removing plaque in patients with fixed orthodontic appliances. But among the three different toothbrushes, toothbrush with crisscross bristles showed the highest mean plaque reduction. Plaque accumulation around the orthodontic brackets and gingival margins is quite common among the fixed orthodontic patients, who encounter
Kehinde Adesola Umeizudike
Full Text Available Objective: To determine the prevalence and determinants of chronic periodontitis in HIV positive patients. Methods: A total of 120 HIV positive patients attending the dedicated HIV outpatient clinic of the Lagos University Teaching Hospital, Nigeria were recruited for the study. Their periodontal status was assessed using the community periodontal index of treatment needs. Their CD4+ cell count was determined using the flow-cytometer method. The risk factors for periodontitis including age, gender, education, smoking, CD4+ cell counts, bleeding on probing (BOP were determined. Results: Prevalence of periodontitis was high (63.3% in the HIV positive patients. In a bivariate analysis, significant associations were observed between severity of periodontitis and age ≥35 years (P=0.021, male gender (P=0.005, smoking (P=0.040 and ≥3 community periodontal index of treatment needs sextants exhibiting BOP (P=0.004. In a binary logistic regression, independent predictors of periodontitis were ≥3 sextants exhibiting BOP (odds ratio 1.738, 95% CI 1.339 to 2.256, P=0.000 and age ≥35 years (odds ratio 1.057, 95% CI 1.005 to 1.111, P=0.030. The CD4+ cell counts were not associated with periodontitis in the HIV positive patients (P=0.988. Conclusions: A high prevalence of periodontitis was found among the HIV positive Nigerian patients in this study. Older age ≥35 years and BOP were the determinants of periodontitis. There is therefore a need for close periodontal monitoring of HIV positive Nigerian patients with emphasis on preventive, professional oral prophylaxis.
Azodo, C C; Umoh, A O
Teacher-led oral health education is equally effective in improving the oral health knowledge and oral hygiene status of adolescents as dentist-led and peer-led strategies. The aim was to determine periodontal disease awareness and knowledge among Nigerian primary school teachers. This cross-sectional study was conducted among primary school teachers in Edo State, Nigeria. A self-administered questionnaire which elicited information on demography, awareness of the periodontal disease and source of information, knowledge of etiology, and symptoms of the periodontal disease, was the data collection tool.. The test of association was done using either Chi-square or Fisher's exact statistics. P value was set at 0.05 for significance level. Out of 180 teachers recruited from seven public primary schools in Benin City, Edo State, Nigeria, 151 of them fully participated by filling the study questionnaires giving a 83.9% (151/180) response rate. The majority 74.2% (112/151) of the participants reported having heard of the periodontal disease and the leading source of information was television. A total of 29.8% (45/151) of participants considered periodontal disease as the main cause of tooth loss among adult Nigerian. Only 12.6% (19/151) of the participants knew dental plaque as soft debris on teeth and 29.1% (44/151) attested that plaque can cause periodontal disease. The majority of the participants were not aware of age 81.5% (123/151) and gender 96.7% (146/151) predisposition to periodontal disease. The perceived manifestations of the periodontal disease reported by were mainly gum bleeding 35.1% (53/151) and swollen gum 20.5% (31/151). A total of 70.2% (106/151) of the participants considered periodontal disease as a preventable disease and about half 49.0% (74/151) of the participants considered daily mouth cleaning as the best preventive method. The majority 95.4% (144/151) of the participants expressed interest in learning about the periodontal disease and the
Azodo, CC; Umoh, AO
Background: Teacher-led oral health education is equally effective in improving the oral health knowledge and oral hygiene status of adolescents as dentist-led and peer-led strategies. Aim: The aim was to determine periodontal disease awareness and knowledge among Nigerian primary school teachers. Subjects and Methods: This cross-sectional study was conducted among primary school teachers in Edo State, Nigeria. A self-administered questionnaire which elicited information on demography, awareness of the periodontal disease and source of information, knowledge of etiology, and symptoms of the periodontal disease, was the data collection tool.. The test of association was done using either Chi-square or Fisher's exact statistics. P value was set at 0.05 for significance level. Results: Out of 180 teachers recruited from seven public primary schools in Benin City, Edo State, Nigeria, 151 of them fully participated by filling the study questionnaires giving a 83.9% (151/180) response rate. The majority 74.2% (112/151) of the participants reported having heard of the periodontal disease and the leading source of information was television. A total of 29.8% (45/151) of participants considered periodontal disease as the main cause of tooth loss among adult Nigerian. Only 12.6% (19/151) of the participants knew dental plaque as soft debris on teeth and 29.1% (44/151) attested that plaque can cause periodontal disease. The majority of the participants were not aware of age 81.5% (123/151) and gender 96.7% (146/151) predisposition to periodontal disease. The perceived manifestations of the periodontal disease reported by were mainly gum bleeding 35.1% (53/151) and swollen gum 20.5% (31/151). A total of 70.2% (106/151) of the participants considered periodontal disease as a preventable disease and about half 49.0% (74/151) of the participants considered daily mouth cleaning as the best preventive method. The majority 95.4% (144/151) of the participants expressed interest in
Costa, Fernando Oliveira; Vieira, Thaís Riberal; Cortelli, Sheila Cavalca; Cota, Luís Otávio Miranda; Costa, José Eustáquio; Aguiar, Maria Cássia Ferreira; Cortelli, José Roberto
It is well established that regular compliance during periodontal maintenance therapy (PMT) maintains the stability of periodontal clinical parameters obtained after active periodontal therapy (APT). However, compliance during PMT has not yet been related to subgingival bacterial levels. Thus, this study followed individuals in PMT over 6 years and longitudinally evaluated the effects of compliance on periodontitis-associated bacterial levels and its relation to periodontal status. From a 6-year prospective cohort study with 212 individuals in PMT, 91 were determined to be eligible. From this total, 28 regular compliers (RC) were randomly selected and matched for age and sex with 28 irregular compliers (IC). Complete periodontal examination and microbiological samples were obtained 5 times: T1 (prior to APT), T2 (after APT), T3 (2 years), T4 (4 years), and T5 (6 years). Total bacteria counts and levels of Actinomyces naeslundii, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were evaluated through quantitative polymerase chain reaction. RC had less tooth loss and better clinical and microbiological conditions over time when compared with IC. IC had higher total bacterial counts and higher levels of T. denticola. Moreover, among IC, total bacterial counts were positively associated with plaque index and bleeding on probing, while levels of A. naeslundii, T. forsythia, and T. denticola were negatively associated with clinical attachment loss (4 to 5 mm) among RC. Compliance positively influenced subgingival microbiota and contributed to stability of periodontal clinical status. Regular visits during PMT sustained microbiological benefits provided by APT over a 6-year period. © 2018 American Academy of Periodontology.
Sudhanshu, Archika; Sharma, Urvi; Vadiraja, H S; Rana, Rakesh Kumar; Singhal, Richa
Yoga is considered to be one of the most important, effective, and valuable tools available for man to overcome various physical and psychological problems. Stress contributes significantly to the pathogenesis of periodontal diseases; hence, it becomes important to reduce the level of stress for prevention and management of diseases. The present study was aimed: (1) To understand and analyze the possibilities of employing yogic practices in the treatment of periodontal disease along with conventional dental therapy, (2) to understand the effect of stress on periodontal treatment outcome, (3) to evaluate the efficacy of yoga in the management of periodontal disease with reference to stress. An outpatient department-based parallel group randomized study was performed with standard treatment for periodontal disease yoga therapy as Group II and only standard treatment as Group I. Periodontal health status was recorded using indices of modified plaque index (PI), bleeding on probing (BOP), probing depth, and clinical attachment loss (CAL). The Cohen's perceived stress questionnaire was also used to determine stress severity. The yogic intervention consists of lectures and practical sessions on asanas, pranayama, kriyas, and meditation. Repeated measure analysis of variance revealed a significant difference ( P stress scale score also reduced by 18.76 points in Group II as compared to only 2.58 points in Group I, BOP also shows better improvement in Group II with a reduction of 0.68 as compared to reduction of only 0.08 in Group I. The results obtained ascertained the role of yoga in stress reduction in periodontal disease. Although yoga does not play a direct role in improving periodontal disease, it accelerates the treatment outcomes by combating the stress which is a major factor affecting the treatment of periodontal disease.
Sanjeev Kumar Salaria
Full Text Available Periodontitis is a relatively common disease. Various therapies have been recommended for its treatment which includes nonsurgical, antimicrobial, and surgical therapy. In recent years lasers have been used for all the three above-mentioned purposes. Lasers have been applied for hard and soft tissue debridement, contouring as well as the bacterial load reduction in the pocket. Here we present a case report of chronic periodontitis treated with the help of a new technique, laser-assisted modified Widman flap (LAMWF. The surgical procedure followed with a 980 nm diode laser has been described. The present case report resulted in significant pocket depth reduction, attachment gain, and radiographic evidence of bone fill. The laser-assisted modified Widman flap provided excellent results without complications and high patient as well as clinician satisfaction.
Full Text Available Background: The systemic use of non-steroidal anti-inflammatory drugs are associated with various side-effects like hepatotoxicity, blood dyscrasias, nephrotoxicity and gastric irritability. Among these, gastric irritability is the most common and the most important one, which should be taken care of. Therefore, it may be preferable to use a local formulation such as a mouthwash to treat the inflammatory conditions of the oral cavity. Aim: To determine the efficacy and acceptability of 0.074% diclofenac mouthwash in relieving pain and inflammation of post-periodontal surgery patients. Materials and Methods: The study was designed as a double-blind, placebo-controlled clinical trial. Twenty chronic periodontitis patients who were scheduled for full-mouth periodontal flap surgery were randomized to receive either diclofenac mouthwash or placebo to rinse with 15 ml of solution daily for a period of 7 days. Modified gingival index (Lobene 1986 was used to verify gingival inflammation and visual analog scale was used to assess pain. After the baseline measurements for all the parameters were recorded, spontaneous pain and burning were evaluated daily while redness and edema were recorded on the 3 rd and 7 th day from the day of treatment. Results: Data obtained were analyzed statistically using paired " t" test for intragroup comparison and unpaired " t"-test for intergroup comparison. Spontaneous pain was significantly reduced by diclofenac mouthwash. Other parameters, i.e. gingival inflammation and swelling, had not shown significant reduction in scores in either group, although the reduction was higher in the test group. Conclusion: The new 0.074% diclofenac mouthwash is an effective and tolerable medicinal product for post-surgical symptomatic relief.
Nur Rahmah; Arni Irawaty Djais
Treatment of periodontal abscess with furcation involvement has its own challenges in achieving the success of periodontal treatment. Teeth with periodontal abscesses often indicate the presence of furcation involvement. Most periodontal abscess occurs in approximately 92.5% molar. Furcation involvement on tooth abscesses had a greater challenge to the success of periodontal therapy. A male patient aged 36 years came to the clinic with active periodontal disease. On examination, the teeth are...
Wang, Kai; Zhou, Li
Combined the elaboration on periodontic-endodontic lesion in the textbook Periodontics with the deficiencies existed in the clinical and teaching work and demonstrated the understanding on the type of the combined periodontic-endodontic lesion, and suggested the viewpoint of no sub-type of combined periodontic-endodontic lesion. Only regard the type of pulp disease that induced by periodontal disease as genuine combined periodontic-endodontic lesion.
Periodontitis and quality of life: What is the role of socioeconomic status, sense of coherence, dental service use and oral health practices? An exploratory theory-guided analysis on a Norwegian population.
Holde, Gro Eirin; Baker, Sarah R; Jönsson, Birgitta
To utilise Andersen's behavioural model for health services' use as the theoretical framework to examine direct and indirect relationships between population characteristics, oral health behaviours and periodontitis and oral health impacts. The model was tested in a general adult population (n = 1,886) in Norway, using structural equation modelling. Socioeconomic status, sense of coherence (SOC), dental anxiety, perceived treatment need, oral health behaviours and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal examinations consisted of full-mouth recordings. Andersen's model explained a large part of the variance in use of dental services (58%) and oral health-related impacts (55%), and to a less extent periodontitis (19%). More social structure and stronger SOC was related to more enabling resources, which in turn was associated with more use of dental services. More use of dental services was related to more periodontitis and more periodontitis was associated with increased oral health impacts. A stronger SOC was associated with less oral impacts. There was no association between use of dental services and oral health impacts. The result demonstrated complex relationships between population characteristics, oral health-related behaviours and oral health outcomes. Socioeconomic factors and smoking were main predictors of periodontitis. Regular dental visiting habits did not, however, reduce the likelihood of periodontitis. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ziebolz, D; Jahn, C; Pegel, J; Semper-Pinnecke, E; Mausberg, R F; Waldmann-Beushausen, R; Schöndube, F A; Danner, B C
The aim of the study was to detect periodontal pathogens DNA in atrial and myocardial tissue, and to investigate periodontal status and their connection to cardiac tissue inflammation. In 30 patients, biopsy samples were taken from the atrium (A) and the ventricle myocardium (M) during aortic valve surgery. The dental examination included the dental and periodontal status (PS) and a collection of a microbiological sample. The detection of 11 periodontal pathogens DNA in oral and heart samples was carried out using PCR. The heart samples were prepared for detecting the LPS-binding protein (LBP), and for inflammation scoring on immunohistochemistry (IHC), comprising macrophages (CD68), LPS-binding protein receptor (CD14), and LBP (big42). 28 (93%) patients showed moderate to severe periodontitis. The periodontal pathogens in the oral samples of all patients revealed a similar distribution (3-93%). To a lesser extent and with a different distribution, these bacteria DNA were also detected in atrium and myocardium (3-27%). The LBP was detected in higher amount in atrium (0.22±0.16) versus myocardium (0.13±0.13, p=0.001). IHC showed a higher inflammation score in atrial than myocardial tissue as well as for CD14, CD68 and for LBP. Additional, periodontal findings showed a significant correlation to CD14 and CD68. The results provide evidence of the occurrence of oral bacteria DNA at the cardiac tissue, with a different impact on atrial and myocardial tissue inflammation. Influence of periodontal findings was identified, but their relevance is not yet distinct. Therefore further clinical investigations with long term implication are warranted. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available AbstractBackground and Objective: Many clinical researches have been carried out to investigate the relationship between myocardial infarction (MI and periodontitis. Despite most of them indicated that the periodontitis may be associated with an increased risk of MI, the findings and study types of these studies have been inconsistent. The goal of this meta-analysis was to critically assess the strength of the association between MI and periodontitis in case-control studies.Methods: PubMed and the Cochrane Library were searched for eligible case-control studies reporting relevant parameters that compared periodontal status between MI and control subjects. The odds ratios (ORs and 95% confidence intervals (CIs from each study were pooled to estimate the strength of the association between MI and periodontitis. The mean differences and 95% CIs for periodontal-related parameters were calculated to determine their overall effects.Results: Seventeen studies including a total of 3456 MI patients and 3875 non-MI control subjects were included. The pooled OR for the association between MI and periodontitis was 2.531 (95% CI: 1.927-3.324. The mean differences (95% CIs for clinical attachment loss, probing depth, bleeding on probing, plaque index, and the number of missing teeth were 1.000 (0.726-1.247, 1.209 (0.538-1.880, 0.342 (0.129-0.555, 0.383 (0.205-0.560, and 4.122 (2.012-6.232, respectively. Conclusion: With the current evidence, the results support the presence of a significant association between MI and periodontitis. Moreover, MI patients had worse periodontal and oral hygiene status and fewer teeth than did control subjects. More high-quality and well-designed studies focusing on the casual relationship between MI and periodontitis should be conducted in the future.
Full Text Available Objective: The aim of the study was to evaluate periodontal health status in patients diagnosed with type 1 diabetes mellitus (DM1 and to establish a correlation between metabolic control and periodontal health status. Materials and Methods: Periodontal health parameters namely plaque index (PI, gingival index (GI, probing pocket depth (PPD and clinical attachment loss (CAL were recorded in 28 patients diagnosed with type 1 diabetes mellitus (DM1 and 20 healthy controls. Diabetes history was recorded based on the information provided by the physician and it included date of diagnosis, duration, age of diagnosis, latest values of glycosylated haemoglobin and existing diabetic complications. Statistical analysis was performed to evaluate the relationship between periodontal parameters and degree of metabolic control, the duration of the disease and the appearance of complications. Results: The periodontal health in the diabetic group was compromised and they had greater bleeding index (P < 0.001, probing pocket depth (P < 0.001 and clinical attachment level (P = 0.001. Patients diagnosed for diabetes for shorter duration of time (4-7 years showed bleeding index-disease severity correlation to be 1.760 0.434. Conclusion: Periodontal disease was more evident in type 1 diabetes mellitus patients and periodontal inflammation is greatly increased in subjects with longer disease course, poor metabolic control and diabetic complications.
Full Text Available Background: In periodontal regeneration, several alloplastic materials are being used with a goal to reconstruct new osseous tissue in the infrabony defect sites. The present study was undertaken to evaluate the efficacy of hydroxyapatite-bioactive glass (HA:BG composite granules in the management of periodontal bony defects. Materials and Methods: A randomized control study was conducted. Subjects with infrabony defects were divided into three groups. Test Group 1 (n = 10: Defect site was treated with HA:BG, with a biodegradable membrane. Test Group 2 (n = 10: Defect site was treated with HAP, with a biodegradable membrane. Control group (n = 10: Defect site was treated with open flap debridement with a biodegradable membrane Results: The healing of defects was uneventful and free of any biological complications. The gain in clinical attachment level, reduction of probing pocket depth, and defect fill were statistically significant in all three groups. TG1 sites showed significant defect fill than TG2 and CG sites. Conclusion: The performance of HA:BG was better compared to HAP and open flap debridement for the reconstruction of infrabony defects.
Gonzales, Jose R; Harnack, Lutz; Schmitt-Corsitto, Gabriella; Boedeker, Rolf H; Chakraborty, Trinad; Domann, Eugen; Meyle, Joerg
We aimed to analyze clinical, microbiologic, and serologic effects of chlorhexidine (CHX) chips used as a subgingival controlled-release delivery device before and immediately after scaling and root planing (SRP). Twenty-four patients presenting with ≥12 teeth with probing depth (PD) ≥5 mm and bleeding on probing were assigned in test or control groups. After prophylaxis, CHX chips (test) or placebo chips (control) were placed in pockets with PD ≥5 mm. Ten days later, SRP was performed in all teeth with PD ≥4 mm in a single appointment. Immediately after SRP, new chips were inserted in all pockets with PD ≥5 mm. Parameters were assessed at baseline; beginning of SRP; and 1, 3, and 6 months after treatment. Subgingival samples were obtained at baseline; beginning of SRP; and at 1 month after treatment. Periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola were analyzed. Serum levels of high sensitive C-reactive and lipopolysaccharide-binding proteins were measured. The changes of the parameters between and within the groups were tested by Mann-Whitney U test (P periodontitis.
Full Text Available Background: The aim of the present study was to evaluate and compare the clinical and microbiological effectiveness of Periochip TM as an adjunct to scaling and root planing (SRP with SRP alone in patients with chronic periodontitis. Materials and Methods: This randomized, split mouth, 3-month clinical and microbiological trial included 30 sites in 15 patients aged 30-50 years diagnosed with chronic periodontitis. In each patient, two bilateral pockets probing 5-7 mm were randomly assigned to test and control groups. The test group received SRP plus Periochip TM , whereas the control group received SRP alone. Clinical indices and anaerobic culture analysis was done at baseline, 1 month, and 3 months interval. Total bacterial count and analysis of four major periodontopathogenic bacteria Porphyromonas gingivalis (Pg, Prevotella intermedia (Pi, Aggregatibacter actinomycetemcomitans (Aa, and Fusobacterium nucleatum (Fn was done. Results: Significant improvement was obtained in all clinical variables in the test group as compared to the control group over the study period. Total colony counts were significantly reduced in the test group as compared to control over the period of time. At baseline Aa was recovered from 4 test group sites and 5 control group sites, Pg from 15 test group and 14 control group sites, Pi from 5 test group and 2 control group sites, Fn from 7 test and 7 control group sites. At 3 months, Aa was recovered from 1 test group and 4 control group sites, Pg from 4 test group and 8 control group sites, Pi from 1 test group and 1 control group site, Fn from 3 test and 4 control group sites. Conclusion: Periochip TM placement as an adjunct to SRP, showed promising results, when compared to SRP alone. Healthy microflora can be maintained for a longer period of time and delay in the repopulation by periodontopathic microorganisms was observed.
Full Text Available Background: There is currently no gold standard biomaterial for the treatment of periodontal intrabony defects (PIDs. One of the current options is the use of platelet-rich fibrin (PRF. Objective: To determine the clinical effect of PRF in the treatment of PID through a systematic review and meta-analysis. Materials and Methods: A literature search was conducted up to February 2017 in the following biomedical databases: Pubmed, Embase, Scielo, Science Direct, SIGLE, LILACS and in the Cochrane Central Register of Clinical Trials. The selection criteria included: randomized clinical trials published in the last 5 years, reporting clinical effects (probing depth, clinical insertion level or gingival recession, with a follow-up time equal to or greater than 6 months, and sample size larger than or equal to 10 patients reporting the use of PRF as a treatment for PID. The methodological quality of the studies was analyzed using the Cochrane Handbook of Systematic Reviews of Interventions as a reference. Results: The search strategy yielded 20 articles. A reduction in probing depth and an increase in clinical insertion level or a reduction in gingival recession is reported, when using PRF alone or in combination with another biomaterial or substance that stimulates tissue regeneration. Conclusion: The literature suggests that the use of PRF in the treatment of PIDs has a beneficial clinical effect when compared to control treatments.
Objective: To explore the clinical significance of changes of serum IL-6, hs-CRP and saliva secretory IgA levels after treatment in patients with periodontitis. Methods: Serum IL-6, saliva secretory IgA (with RIA) and serum hs-CRP (with immuno-tarbility method) levels were measured in 42 patients with periodontitis both before and after treatment as well as in 35 controls. Results: Before treatment serum IL-6, hs-CRP and saliva secretory IgA levels in the patients wree significantly higher than those in controls (P 0.05). However, the saliva secreatory IgA levels were still significantly higher than those in controls (P<0.05). Conclusion: There was disturbance of immunomodulation in patients with periodontitis as expressed by the changes of cytokines levels in the course of the diseases. (authors)
Objective: To explore the significance of changes of serum IL-8, IL-1β and TNF-α levels after treatment in patients with periodontitis. Methods: Serum IL-8, IL-1β and TNF-α(with RIA) levels were determined in 36 patients with periodontitis both before and after treatment as well as in 35 controls. Results: Before treatment, serum IL-8, IL-1β and TNF-α levels were significantly higher in the patients than those in controls (P 0.05). Conclusion: Detection of serum IL-8, IL-1β and TNF-α levels might reflect the progress of disease in patients with periodontitis and might be of important clinical value. (authors)
Scaling and root planning, and locally delivered minocycline reduces the load of Prevotella intermedia in an interdependent pattern, correlating with symptomatic improvements of chronic periodontitis: a short-term randomized clinical trial
Deng, S.; Wang, Y.; Sun, W.; Chen, H.; Wu, G.
Background: To evaluate the respective or combinatory efficacy of locally delivered 2% minocycline (MO) and scaling and root planning (SRP) by assessing both clinical parameters and the loads of four main periodontal pathogens in treating chronic periodontitis (CP). Methods: Seventy adults with CP
Zhao, Haijiao; Li, Chen; Lin, Li; Pan, Yaping; Wang, Hongyan; Zhao, Jian; Tan, Lisi; Pan, Chunling; Song, Jia; Zhang, Dongmei
This study used con-beam computed tomography (CBCT) to investigate the prevalence and severity of alveolar bone loss in middle-aged (40-59 years) Chinese with chronic periodontitis. The study group comprised 145 dentate individuals aged 40 to 59 years residing in China who suffered from chronic periodontitis. CBCT and the application of NNT software were used to examine the level and location of alveolar bone loss. The study revealed that 40-59 year old patients with chronic periodontitis had severe bone loss. At 5,286 sites (34.7%), alveolar bone loss was mild; severe alveolar bone loss was found at 5,978 sites (39.2%). A comparison of bone loss in different jaws revealed that the area with the highest degree of bone loss was on the lingual side of the maxillary molar (56.3 ± 7.2%), and that the area with the lowest degree was primarily on the lingual side of the mandibular canine (27.5 ± 6.3%). There was a lower degree of alveolar bone loss in males than females. Differences were observed when comparing the incidence of bone loss between males and females (P chronic periodontitis, the highest degrees of bone loss in the incisors, premolars, and molars were on the lingual side, mesial side and lingual side, respectively. Menopause in females and smoking may affect the level of bone loss.
He, Yan-ping; Xie, Ming; Jiao, Ting
To detect the expressions of EMMPRIN and its ligand CyPA in gingival crevicular fluid (GCF) of chronic periodontitis (CP) patients and explore their possible relation to the status of periodontal inflammation. GCF of CP patients (group CP) and periodontitis-free patients with intact dentition (the control group) were collected and assayed for EMMPRIN and CyPA expressions by ELISA. The clinical periodontal status of these patients were examined. Statistical analysis was performed by use of SPSS 17.0 software package. Spearman's correlation analysis was utilized to determine the relationships between the expressions of EMMPRIN and CyPA in GCF and the clinical parameters. In addition, analysis of variance (ANOVA) was used for comparing the difference between group CP and the control group. In group CP, GCF volume was positively correlated with EMMPRIN total amount, CyPA total amount and some clinical periodontal indexes (GI,SBI,AL). EMMPRIN total amount was positively correlated with GCF volume, CyPA total amount and some of clinical periodontal indexes (GI,SBI,AL), but it was negatively correlated with smoking status (PEMMPRIN total amount and some of clinical periodontal indexes (GI,SBI,AL). In the control group,there were significant positive correlations among GCF volume, EMMPRIN total amount and CyPA total amount. The difference of GCF, EMMPRIN and CyPA between the 2 groups were statistically significant (PEMMPRIN and its ligand CyPA in GCF of periodontitis-free patients with intact dentition and CP patients were all detected. As the progress of periodontal inflammation, GCF secretion increases, as well as the expressions of EMMPRIN and CyPA in GCF.
Full Text Available Bacterial plaque has the primary etiologic role in triggering the pathological changes of periodontal disease. A major goal of periodontal therapy is supraand subgingival bacterial flora reduction through scaling and root planning, through local and general antimicrobial treatment. The aim of our study was to evaluate the effectiveness of the mechanical treatment of scaling and root planning in reducing or suppressing bacterial species from the periodontal pockets. In order to conduct this study we collected and analyzed subgingival plaque samples taken from the 50 periodontal pockets with a depth of about 5mm, from 50 subjects with diagnosis of generalized chronic periodontitis, before and after scaling and root planning. The usage of API 20A test allows a quick and easy identification of anaerobic bacteria based on biochemical properties. Additional complementary tests were used, such as examining the culture and the morpho-tinctorial features to confirm and complete the identification. The microbial flora that we were able to isolate from the periodontal pockets before scaling and root planning was very rich. After scaling and root planning the subjects showed clinical improvement in the periodontal status, and the microbiological analysis of the periodontal pockets mostly showed a quantitative and qualitative reduction of bacterial species. A local or general antimicrobial treatment is recommended to assure improved effectiveness because mechanical treatment alone cannot completely suppress bacterial flora.
Gülseren, D; Karaduman, A; Kutsal, D; Nohutcu, R M
Recurrent aphthous stomatitis (RAS) is a common oral mucosal disease with unknown etiology. This cross-sectional study aimed to test the hypothesis that Helicobacter pylori and periodontal disease might play an etiological role in RAS. Dental plaque samples obtained from 38 patients with RAS and 43 healthy individuals via periodontal examinations were examined for H. pylori colonization. H. pylori was identified using the rapid urease test (RUT). The periodontal status of the patients and controls was based on the following periodontal parameters: periodontal pocket depth (PPD), the plaque index (PI), the gingival index (GI), and clinical attachment loss (CAL). RUT results were positive in 34 (89.5 %) of the 38 patients and 24 (55.8 %) of the 43 controls (P = 0.002). There were not any significant differences in mean PPD, PI, GI, or CAL between the patient and control groups (P > 0.05). Mean PPD, PI, GI, and CAL were higher in the RUT-positive RAS patients than in the RUT-negative patients (P > 0.05, for all). The present findings show that H. pylori might have played an etiological role in RAS and might have caused periodontal disease, but RAS was not associated with any of the periodontal parameters examined in this study. The present study indicates that H. pylori plays a role in the development of RAS, but periodontal diseases have no effect on it. Eradicating H. pylori might be useful to prevent RAS.
Boggess, Kim A; Beck, James D; Murtha, Amy P; Moss, Kevin; Offenbacher, Steven
The objective of the study was to determine whether periodontal disease is associated with delivery of a small-for-gestational-age infant. In a prospective study of oral health, periodontal disease was categorized as health, mild, or moderate/severe on the basis of clinical criteria. Small for gestational age was defined as birth weight less than the 10th percentile for gestational age. A risk ratio (95th percentile confidence interval) for a small-for-gestational-age infant among women with moderate or severe periodontal disease was calculated. Sixty-seven of 1017 women (6.6%) delivered a small-for-gestational-age infant, and 143 (14.3%) had moderate or severe periodontal disease. The small-for-gestational-age rate was higher among women with moderate or severe periodontal disease, compared with those with health or mild disease (13.8% versus 3.2% versus 6.5%, P periodontal disease was associated with a small-for-gestational-age infant, a risk ratio of 2.3 (1.1 to 4.7), adjusted for age, smoking, drugs, marital and insurance status, and pre-eclampsia. Moderate or severe periodontal disease early in pregnancy is associated with delivery of a small-for-gestational-age infant. Understanding the mechanism of periodontal disease-associated adverse pregnancy outcomes could lead to interventions to improve fetal growth.
Full Text Available Aim: To evaluate the clinical and metabolic changes following nonsurgical periodontal therapy of type-2 diabetic patients and nondiabetic patients. Materials and Methods: Fifteen nondiabetics and fifteen type-2 diabetics with moderate to severe periodontitis were selected after meeting inclusion and exclusion criteria. Periodontal pocket probing was performed using a Williams graduated periodontal probe and comparisons of the clinical and biochemical parameters like plaque index, gingival index, probing depth, glycated hemoglobin, and lipid profile (total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides and very low density lipoprotein were done between and within two groups at baseline and 3 month. Results: A correlation was observed between clinical and biochemical parameters between and within two groups at baseline and 3 month. The P value of diabetic group was<0.001 in all clinical parameters (plaque index PI, Gingival index GI, and Probing Pocket Depth PPD in diabetic and nondiabetic group, showed statistically highly significant difference in GI, PI, PPD, <.01 in Glycated Hemoglobulin (HbAlc1 in test group and<0.05 in control group showed statistically significant difference. The P value of test group was >0.05 in Lipid profile (total cholesterol, low density lipoprotein, high density lipoprotein, serum triglyceride, very low density lipoprotein that showed no significant difference and in control group<0.05 in total Cholesterol, high density lipoprotein and <0.01 in Low density lipoprotein, Very Low Density Lipoprotein, and Serum Triglyceride, respectively, showed statistically significant in Total cholesterol, Low density lipoprotein, Very Low Density Lipoprotein, and Serum Triglyceride, not significant in high density lipoprotein. The P value >0.05 showed no statistical significance of correlation between the test and control groups. Conclusion: Both groups of patients showed an improvement in clinical and
Hayat Al-Ghutaimel; Hisham Riba; Salem Al-Kahtani; Saad Al-Duhaimi
Background. Since 2000, studies, experiments, and clinical observations revealed high prevalence of periodontal diseases among children and adolescents. Therefore, this paper was designed to provide an update for dental practitioners on epidemiology, microbiology, pathology, prevention, diagnosis, and treatment of periodontal diseases in children and adolescents. Methods. This paper reviews the current literature concerning periodontal diseases in pediatric dentistry. It includes MEDLINE data...
Acharya, Anirudh B; Thakur, Srinath; Muddapur, M V; Kulkarni, Raghavendra D
Chronic periodontitis may influence systemic cytokines in type 2 diabetes. This study aimed to evaluate the cytokine ratios in type 2 diabetes with, and without chronic periodontitis. Gingival status, periodontal, glycemic parameters and serum cytokines were evaluated in participants grouped as healthy, chronic periodontitis, and type 2 diabetes with, and without chronic periodontitis. Cytokine ratios showed significant differences in type 2 diabetes and chronic periodontitis, were highest in participants having both type 2 diabetes and chronic periodontitis, with a statistically significant cut-off point and area under curve by receiver operating characteristic. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Xue, Dong; Tang, Lu; Bai, Yuhao; Ding, Qian; Wang, Pengcheng; Zhao, Ying
To evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planing (SRP) in patients with untreated chronic periodontitis based on up-to-date evidence. MEDLINE and the Cochrane Library were systematically searched to identify eligible randomized controlled trials (RCTs), supplemented by a manual literature search. Mean differences (MD) and the corresponding 95% confidence intervals (CI) of probing depth (PD) reduction and clinical attachment level (CAL) gain were synthesized. The I 2 test and Q statistics were used to determine the inter-study heterogeneity. Subgroup analysis based on smoking status was performed. Eleven RCTs with a total of 243 subjects were included. Significant improvement in PD reduction (MD=0.13, CI:0.02-0.24, p=0.02) and marginal significant improvement in CAL gain (MD=0.18, CI:-0.005-0.363, p=0.056) were observed in favor of SRP+PDT at 3months. When evaluated at 6months after baseline, the association of PDT with SRP resulted in a significant benefit in PD reduction (MD=0.40, CI:0.05-0.74, p=0.03), but not in CAL gain (MD=0.37, CI:-0.18-0.93, p=0.18). Subgroup analysis revealed that the combined therapy produced no significant improvements in PD and CAL at neither 3months nor 6months for studies with smokers. No treatment-related adverse events or side effects had been reported by the included studies. Pooled analysis suggests a short-term benefit of PDT as an adjunct to SRP in clinical outcome variables. However, evidence regarding its long-term efficacy is still insufficient and no significant effect has been confirmed in terms of CAL gain at 6months. Future clinical trials of high methodological quality are needed to establish the optimal combination of photosensitizer and laser configuration. Copyright © 2017 Elsevier B.V. All rights reserved.
Chandy, Swaroop; Joseph, Kiran; Sankaranarayanan, Anila; Issac, Annie; Babu, George; Wilson, Bobby; Joseph, Jumol
Periodontal disease is characterised by chronic infection and inflammation in periodontal tissues leading to destruction of alveolar bone with subsequent tooth loss. Periodontal infections are the result of an interaction between tooth associated microbial biofilms and the host defences. Periodontal pathogens can affect local and systemic immune and inflammatory responses. The aim of the present study was to evaluate serum C-Reactive Protein (CRP), plasma fibrinogen and peripheral blood levels in healthy subjects, chronic and aggressive periodontitis patients. A total of 55 subjects, 27 males and 28 females were selected for the study. Blood samples were taken from healthy controls (n=20) and patients with chronic periodontitis (n=20) and aggressive periodontitis (n=15). The periodontal status of each patient was assessed by recording Oral Hygiene Index-Simplified (OHI-S), Bleeding Index (BI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL). The levels of serum CRP were measured using high sensitivity Enzyme Linked Immunosorbent Assay (ELISA) and levels of plasma fibrinogen were measured using Quantitative Immunoturbidimetric assay. Data description was done in the form of mean and standard deviation and analysis of data was done using one way ANOVA (Analysis of Variance) and Students t-test to test the statistical significance between groups. The levels of serum CRP and plasma fibrinogen was increased in patients with chronic and aggressive periodontitis when compared to healthy controls (pperiodontitis and cardiovascular diseases.
Choi, Youn-Hee; Kosaka, Takayuki; Ojima, Miki; Sekine, Shinichi; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro; Ono, Takahiro; Amano, Atsuo
The association of periodontal bacteria with lipid profile alteration remains largely unknown, although it has been suggested that chronic periodontitis increases the atherosclerotic risk. This cross-sectional study investigated the relationship between the prevalence and total burden of periodontal bacteria and serum lipid profile. Saliva from enrolled participants was collected to detect 4 major periodontal bacteria (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Prevotella intermedia) using Polymerase Chain Reaction method. High-density lipoprotein (HDL) cholesterol, triglycerides (TG), and low-density lipoprotein cholesterol were assessed using blood samples. We compared the averages of each lipid in association with the prevalence of each bacterial species, their burden (low, moderate, and high), and the combination of bacterial burden and periodontal status, defined as periodontitis, using the Community Periodontal Index, after adjustment for other potential confounding factors, by employing general linear models with least square means. A total of 385 Japanese individuals (176 men, 209 women; mean age 69.2 years) were enrolled. The number of bacterial species and their co-existence with periodontitis were significantly related to a decrease in HDL (p for trend Periodontal bacterial burden is suggested to be independently involved in lowering serum HDL level. Our findings suggest that bacterial tests in a clinical setting could be a useful approach for predicting the risk of HDL metabolism dysregulation.
Kalra, Monika; Tangade, Pradeep; Punia, Himanshu; Gupta, Vipul; Sharma, Hunny; Jain, Ankita
Gestational diabetes mellitus (GDM) is glucose intolerance which begins during pregnancy. Few studies have examined the association between periodontal disease and GDM. The aim of this study was to assess the association between periodontal disease and GDM. The study population comprised ninety patients, out of which thirty were cases and sixty were controls. All cases underwent a laboratory screening test for GDM between 24 and 30 weeks of gestation based on the recommendation of the obstetricians and gynecologists. To assess the periodontal status, a full-mouth periodontal examination assessing the probing depth, periodontal depth, bleeding on probing, clinical attachment level, and gingival recession was performed on all study participants by a single trained examiner. Tests for associations were performed using Chi-square statistics and multivariate logistic regression analysis. None of the periodontitis conditions was found to be a significant predictor of GDM. In GDM patients, 70% of females were having periodontal disease whereas non-GDM patients 77% of patient had periodontal disease. The present study did not show any positive association between periodontal disease and GDM.
Full Text Available Chronic periodontitis is a result of polymicrobial infection and its treatment aims removal of dental calculus and biofi lm from the periodontal pocket. Many hand and power-driven instruments are created for this purpose. In recent years, lasers are widely discussed tools for periodontal therapy. The aim of the present study is to evaluate the early microbiological and clinical effectiveness of the Er:YAG laser in the treatment of chronic periodontitis. 30 patients with moderate chronic periodontitis were enrolled in the study. Using a split-mouth design they were treated either with Er:YAG laser (chisel tip, 100 mJ, 15 Hz, 5-6 water spray-test group or with Gracey curettes- control group. Probing pocket depth (PPD, gingival recession (GR, clinical attachment level (CAL, bleeding on probing and plaque presence were evaluated at baseline and one month after the therapy. Microbiological samples were taken from the deepest four pockets of each quadrant from 20 randomly selected patients (n = 80. They were evaluated using real time PCR for periodontal pathogens from the red complex (Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia. One month after therapy in the control group PPD decreased from 4.59 mm to 3.36 mm, the CAL gain was 1.09 mm and the reduction of bleeding and plaque - from 87.9% to 33.7% and from 75.9% to 40.9%, respectively. In the test group PPD decreased from 4.58 mm to 3.15 mm, the CAL gain was 1.37mm and the reduction of bleeding and plaque was from 85.6% to 25.9% one month after the treatment. The results were statistically significant in favour of the laser group (p < 0.05. Microbiological analysis revealed that the pathogens from the red complex decreased 3 times in the control and 6 times in the test group. Therefore, the Er:YAG laser demonstrate pronounced early effectiveness in chronic periodontitis treatment and would be appropriate alternative of the conventional periodontal therapy.
Keskiner, I; Saygun, I; Bal, V; Serdar, M; Kantarci, A
Recent studies have demonstrated the beneficial effects of omega-3 polyunsaturated fatty acids (PUFAs) on physiological processes and on a variety of chronic inflammatory diseases, including periodontal diseases. In this study, we evaluated the impact of omega-3 PUFAs in conjunction with scaling and root planing (SRP) on salivary markers in patients with chronic periodontitis. Thirty systemically healthy subjects with chronic periodontitis were enrolled and randomly allocated into two groups. The control group (n = 15) was treated with SRP + placebo whereas the test group was treated with SRP and dietary supplementation of low-dose omega-3 PUFAs (6.25 mg eicosapentaenoic acid and 19.19 mg docosahexaenoic acid). Clinical parameters were taken at baseline, 1, 3 and 6 mo following therapy. Saliva samples were obtained at the same time intervals and analyzed for tumor necrosis factor-α (TNF-α) and superoxide dismutase (SOD). Both groups showed significant changes in clinical parameters in response to treatment compared to baseline with no significant difference between groups. Salivary TNF-α levels showed a statistically significant decrease in the test group at 6 mo compared to the control group. Salivary SOD levels increased significantly at 3 and 6 mo in the test group and at 6 mo in placebo groups compared to baseline with no statistically significant differences between the groups. The results demonstrated that dietary supplementation with low-dose omega-3 PUFAs improves salivary TNF-α without any significant impact on clinical parameters in patients with chronic periodontitis, suggesting that the systemic benefits of dietary omega-3 PUFAs may not be translated to periodontal health. (ClinicalTrials.gov ID NCT02719587). © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Alyousef, Abdullah A; Divakar, Darshan Devang; Muzaheed
Although periodontal diseases are caused by some of the specific pathogens, most of the tissue damage is caused by the host reaction to disease and not actually by the infections. Therefore, host modulatory therapy (HMT) has advanced benefit for the treatment of periodontitis, which works basically by reducing tissue destruction and regeneration in periodontium by altering the critical aspects of host response regulation and up regulating defensive regenerative responses. The present study was conducted with the goal to test an innovative therapeutic option using chemically modified tetracycline in patients affected with generalized, moderate and severe chronic periodontitis. We assumed that CMT might have the potential to provoke an assessable clinical result and pharmacologically impede the level inflammatory flow. CMT (incyclinide) treated group had significantly higher CAL (clinical attachment) values than Placebo Control suggesting an improved CAL in CMT treatment. Host modulation therapy width incyclinide can be as an adjunct to conventional nonsurgical therapies without antimicrobial resistance. Progress was noticed in the clinical parameters but not the serum CRP level in our study establishing the role of CMTs in controlling chronic periodontitis. Also CMT treatment indicates its role in anti-inflammatory process as it inhibited IL-12 and TNF alpha but IL-10 level was not affected. However, more randomized placebo-controlled clinical trials with large sample size are required in order to authenticate the usage of CMTs in chronic periodontitis treatment. Based on this understanding, exploration of the novel, low-cost synthetic inhibitors that can be used as potential therapeutic agents, has been tested. Copyright © 2017 Elsevier Ltd. All rights reserved.
Agarwal, Ashish; Gupta, Narinder Dev; Jain, Avikal
Polypeptide growth factors of platelet rich fibrin (PRF) have the potential to regenerate periodontal tissues. Osteoinductive property of demineralized freeze-dried bone allograft (DFDBA) has been successfully utilized in periodontal regeneration. The aim of the present randomized, split mouth, clinical trial was to determine the additive effects of PRF with a DFDBA in the treatment of human intrabony periodontal defects. Sixty interproximal infrabony defects in 30 healthy, non-smoker patients diagnosed with chronic periodontitis were randomly assigned to PRF/DFDBA group or the DFDBA/saline. Clinical [pocket depth (PD), clinical attachment level (CAL) and gingival recession (REC)] and radiographic (bone fill, defect resolution and alveolar crest resorption) measurements were made at baseline and at a 12-month evaluation. Compared with baseline, 12-month results indicated that both treatment modalities resulted in significant changes in all clinical and radiographic parameters. However, the PRP/DFDBA group exhibited statistically significantly greater changes compared with the DFDBA/saline group in PD (4.15 ± 0.84 vs 3.60 ± 0.51 mm), CAL (3.73 ± 0.74 vs 2.61 ± 0.68 mm), REC (0.47 ± 0.56 vs 1.00 ± 0.61 mm), bone fill (3.50 ± 0.67 vs 2.49 ± 0.64 mm) and defect resolution (3.73 ± 0.63 vs 2.75 ± 0.57 mm). Observations indicate that a combination of PRF and DFDBA is more effective than DFDBA with saline for the treatment of infrabony periodontal defects.
Darby, I; Phan, L; Post, M
The aim of this study was to investigate the prevalence and severity of periodontal disease and possible risk factors in clients attending the Plenty Valley Community Health (PVCH) dental clinic. After ethics approval and calibration of examiners, all consenting patients attending PVCH were examined for periodontal status using the Community Periodontal Index (CPI) system and a World Health Organization (WHO) probe. A total of 2861 patients were screened, of which 1751 were female. The majority of patients were Australian born followed by Mediterranean birth. Just under 50% brushed their teeth twice a day and only 20% flossed regularly. It was found that 28.4% had CPI scores of 3 and 4 with only 3.1% recording 0 and a widespread presence of calculus. The severity of periodontal status increased with age, male gender, decreased frequency of brushing, lower level of education, diabetes and reflected country of birth. PVCH has a higher prevalence of periodontal disease than the most recent national survey which reflects the population studied. © 2012 Australian Dental Association.
S Raja Rajeswari
Full Text Available Background and Objective: Transmucosal analgesic delivery is a promising approach to periodontal postoperative pain management. The purpose of this clinical trial is to appraise the effectiveness of transmucosal drug delivery system with meloxicam films and to identify its minimum effective dosage via this route after periodontal flap surgery. Materials and Methods: The analgesic mucoadhesive films were formulated using meloxicam and hydroxypropyl methyl cellulose polymer by solvent casting method. The sample size consisted of 60 chronic periodontitis patients who require periodontal flap surgery. The subjects were randomized using lottery method into four groups (Group A - 45 mg; B - 30 mg; C - 20 mg; D - 10 mg meloxicam per film. After periodontal flap surgery, the respective meloxicam mucoadhesive films were placed over the surgical site and were removed on 4 th day of postsurgery. The primary outcome measure was postsurgical pain level and recorded at 1 st , 2 nd , 3 rd , 4 th , 5 th , 24 th , and 48 th h using a 0-10 mm visual analog scale with markings from 0 = no pain to 10 = extreme pain. Results: The postoperative pain control observed in Groups A and B was found to be effective, and the patient comfort level was very satisfactory. Whereas in Group C, it was found to be high in the first 3 h postsurgically, after which adequate pain relief was seen. Group D exhibited inadequate pain relief. No adverse reactions were noted after applying the film in any of the groups. Conclusion: Transmucosal delivery of meloxicam was found to be effective and safe in postsurgical pain control of periodontal flap surgery. The minimum effective dosage via this route for meloxicam was found to be with 30 mg mucoadhesive films.
Gusmão, Estela Santos
Full Text Available Com o objetivo de estabelecer as condições clínicas e sistêmicas de pacientes portadores de doença periodontal atendidos na Escola de Aperfeiçoamento Profissional da Associação Brasileira de Odontologia Secção Pernambuco (EAP-ABO/PE nos anos de 2000-2001, foram levantados 249 prontuários dos quais, 65 foram desconsiderados por falta de preenchimento. Os dados de interesse foram anotados em ficha específica e trabalhados no programa SPSS versão 10. 0. Para análise estatística foram adotadas distribuições de freqüência, medidas de tendência central e teste do qui-quadrado (?2. Dos 184 prontuários válidos, 61,4% eram de pacientes do sexo feminino. A idade média foi de 39,9 anos, o número médio de dentes presentes foi de 25,4 e o de dentes ausentes, foi de 6,7/pessoa. O ?2 mostrou significância entre idade e número de dentes presentes (P < 0,001. A gengivite foi a alteração periodontal mais freqüente e o diagnóstico de periodontite de progressão lenta prevaleceu em 38,6% das fichas analisadas. Envolvimento de furca grau III, mobilidade grau III e profundidade de sulco = 8 mm foi observada em, respectivamente, 1,1%, 1,8% e 3,8% dos dentes. Alterações sistêmicas das mais diversas (úlcera, artrite, febre reumática, lúpus etc. atingiram 50% dos pacientes, 18,4% dos pacientes eram hipertensos. Não foi observada significância entre idade e diagnóstico periodontal (P = 0,672 e idade e condições sistêmicas (P = 0,586. O ?2 comprovou existir significância estatística entre condição sistêmica e diagnóstico periodontal (P < 0,001 sendo, portanto, sugestivo de que a condição sistêmica interfere no estado periodontal
Santosh Kumar, B B; Aruna, D R; Gowda, Vinayak S; Galagali, Sushama R; Prashanthy, R; Navaneetha, H
Recently, there has been interest in non-mammalian collagen sources such as fish collagen in periodontal regeneration. In the present study, collagen barrier membrane of fish origin was assessed in the treatment of periodontal intrabony defects. Ten systemically healthy chronic periodontitis patients having a paired osseous defect in the mandibular posterior teeth were selected and randomly assigned to receive a collagen membrane (test) or open flap debridement (control) in a split mouth design. Clinical parameters such as Plaque index, Gingival bleeding index, Probing pocket depth, Relative attachment level, and Recession were recorded at baseline, 3, 6, and at 9 months, while radiographic evaluation was done to assess alveolar crestal bone level and percentage of defect fill at 6 and 9 months using autoCAD 2007 software. Student's t test (two-tailed, dependent) was used to find the significance of study parameters on continuous scale. Significance was set at 5% level of significance. Wilcoxon signed rank test was used to find the significance of percentage change of defect fill. The comparison between the two groups did not show any statistically significant differences in the parameters assessed (P > 0.05) but, within each group, clinical parameters showed statistically significant differences from baseline to 9 months (P < 0.05). Within the limits of the study, it can be inferred that no significant differences were found either by using collagen membrane of fish origin or open flap debridement in the treatment of periodontal intrabony defects.
Russo, C.; Palaia, G.; Loskutova, E.; Libotte, F.; Kornblit, R.; Gaimari, G.; Tenore, G.; Romeo, U.
Introduction: Periodontitis is a chronic inflammatory disease due to exposition to plaque and tartar. Conventional treatments consist of scaling and root planing (SRP) and antibiotics administration. Among them encouraging results have been obtained using alternative protocols, like the antimicrobial photodynamic therapy (PDT). Aim of the Study: Evaluation of PDT effects added to conventional methods. Materials and Methods: 11 patients (4M/7F, 37-67 years aged, non-smoking) affected by untreated chronic periodontal disease, with >3mm pockets in at least 4 teeth were divided in two groups, test and control group. Each patient had to made full-intraoral before and after the treatment. The test group received SRP+PDT, while the control group was subjected to SRP. The PDT was performed through the HELBO®TheraLite (Bredent Medical), diode laser battery powered 670nm with an output of 75mW/cm2. The Helbo Blue photosensitizer, containing methylene blue, was used. The exposure time to the laser effect was of 10'' for each site, for a total of 60'' at 3J/cm2. Results: Both groups had a significant improvement in the reduction of pocket depth (PD), above all in the test group. Statistical analysis was performed through the T-test, evaluating PD between the two groups p=0.96 (p> 0.05), resulting not statistically significant. Conclusion: PDT is a promising support to SRP, achieving a significant reduction in the pocket depth, but more cases are needed to confirm the validity of the used protocol.
Rich, Sandra K; Keim, Robert G; Shuler, Charles F
To evaluate efficacy of a problem-based learning (PBL) pedagogy in preclinical and clinical teaching, test scores of 234 undergraduate dental students from the conventionally taught classes of 2003 and 2004 were compared with scores of 274 dental students from the PBL classes of 2005 and 2006. Although the groups' means were close together, t-test analysis of scores revealed that PBL students performed significantly better than traditional (TRAD) students on midterm (p=.0001) and final (p=.015) examinations taken on student partner/mock patients. ANOVA comparing the classes with each other showed significant differences for the midterm and final, but not for the clinical examination. Further multiple comparison tests (Tukey HSD) for the midterm and final revealed that differences specifically reflected superior performance of PBL classes against one of the TRAD classes (2004). There was no difference in performance between PBL (n=134) and TRAD (n=233) students on examinations taken with actual clinical patients who were undergoing nonsurgical periodontal treatment. Over a two-year period, PBL students rated their program instructors at a mean of 4.41 on a Likert-type scale of 1 (not helpful) to 5 (outstanding). The program provides a PBL model for teaching preclinical and clinical skills supported by a four-year evaluation of manual skills outcomes.
Nemec, Ana; Pavlica, Zlatko; Stiblar-Martincic, Draga; Petelin, Milan; Erzen, Damjan; Crossley, David
The purpose of this investigation was to evaluate the pulp of dog teeth affected by advanced periodontal disease. Histological examination was done on demineralized teeth extracted during clinical treatment of mature, client owned small and medium-size breed dogs with either good periodontal health or with advanced naturally occurring periodontal disease. Routinely stained sections from 5 clinically normal teeth and 22 teeth with advanced periodontitis from dogs between 5 and 12-years of age were examined using light microscopy. The pulp cavities of most teeth were narrow with low cellularity and some fibrosis of the pulp. Findings specific to periodontally affected teeth included acute and chronic pulpitis, vascular congestion, and pulp necrosis. A glomus body was identified in the pulp of one tooth and areas of poorly mineralized cementum were seen in both normal and diseased teeth. Age related changes in dog teeth appear similar to those reported for man and the rat. In addition to age related changes, the pulp of dog teeth with advanced periodontal disease were frequently inflamed or necrotic. This may reflect the advanced periodontitis affecting these teeth or a mechanical effect related to excessive tooth mobility. Further study is required to determine the etiology and significance of these findings and to investigate pulp status in less severely diseased teeth.
Gaetti-Jardim, Elerson; Pereira, Maurício Fabiano; Vieira, Evanice Menezes Marçal; Schweitzer, Christiane Marie; Okamoto, Ana Cláudia; Ávila-Campos, Mario J
The present study was designed to evaluate the occurrence of periodontal pathogens in the subgingival biofilm of 100 native Brazilians living at the Umutina Indian Reservation, Mato Grosso State, Brazil. Periodontal clinical examinations were carried out prior to collection of subgingival biofilm, and the presence of 14 periodontal microorganisms was evaluated by polymerase chain reaction (PCR). The prevalence and risk analysis was performed using Cochran and Mantel-Haenszel statistics for dichotomous variables or Pearson's chi-squared test for analysis of proportions when variables had three or more categories. The interrelations between clinical and microbiological parameters were assessed using Fisher's exact test and the Mann-Whitney U test. Individuals with chronic periodontitis were frequently colonized by the association between Porphyromonas gingivalis and Campylobacter rectus, P. gingivalis and Prevotella intermedia, or P. gingivalis and Tannerella forsythia. Patients with chronic periodontitis were also colonized by Porphyromonas gulae and P. intermedia or by the association between P. gulae and T. forsythia. P. gulae was detected only in the subgingival samples from natives on a traditional diet. Gingival bleeding was associated with Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, T. forsythia, P. gingivalis, P. gulae, Porphyromonas endodontalis, P. intermedia, and Prevotella nigrescens. Treponema denticola was uncommon. Peculiar microbiota was demonstrated to be associated with different periodontal disease statuses in native Brazilians, with modest occurrence of certain pathogens, such as T. denticola, and the presence of P. gulae in natives with gingivitis or chronic periodontitis. Copyright © 2015. Published by Elsevier Ltd.
Chifor, Radu; Badea, Iulia; Avram, Ramona; Chifor, Ioana; Badea, Mîndra Eugenia
The aim of this study was to assess the effects of the antimicrobial photodynamic laser therapy performed during the treatment of deep periodontal disease by using 40 MHz high frequency ultrasonography. The periodontal data recorded during the clinical examination before each treatment session were compared with volumetric changes of the gingiva measured on periodontal ultrasound images. The results show a significant decrease of gingival tissue inflammation proved both by a significant decrease of bleeding on probing as well as by a decrease of the gingival tissues volume on sites where the laser therapy was performed. Periodontal tissues that benefit of laser therapy besides classical non-surgical treatment showed a significant clinical improvement of periodontal status. Based on these findings we were able to conclude that the antimicrobial photodynamic laser therapy applied on marginal periodontium has important anti-inflamatory effect. The periodontal ultrasonography is a method which can provide useful data for assessing the volume changes of gingival tissues, allowing a precise monitoring of marginal periodontitis.
Full Text Available Background: Development of periodontal disease (PD may be affected by socioeconomic status. This study examined the relationship between occupational status and PD in a 5-year prospective cohort of Japanese workers. Methods: In total, 19,633 participants had initial examinations at the Aichi Health Promotion Foundation, of whom 8210 participants aged 20 years or older did not have PD. Follow-up examinations were conducted for 3757 participants, accounting for 45.8% of baseline participants. Ultimately, 3390 participants were analyzed according to the criterion of job classification at baseline, which was based on the International Standard Classification of Occupations, 1987. Oral examinations were performed using the Community Periodontal Index (CPI. The CPI scores were coded as follows: healthy (score of 0; bleeding after probing (1; dental calculus (2; shallow pockets (3; and deep pockets (4. Participants with one or more sextants with a score >2 were diagnosed with PD. Poisson regression analysis was performed to adjust for age and other potential confounders. Results: Overall, 31.6% of men and 23.8% of women had developed PD (CPI scores of 3 or 4. The adjusted relative risk (RR for PD (CPI scores of 3 or 4 in men was not significant. On the other hand, the adjusted RRs for PD (CPI score of 4 in men were 2.52-, 2.39-, and 2.74-fold higher for skilled workers, sales persons, and drivers, respectively, than for professionals. In contrast, we found no gradient in women. Conclusions: We found a gradient related to the risk of developing PD according to occupational status among men in a Japanese worker population.
Irie, Koichiro; Yamazaki, Toru; Yoshii, Saori; Takeyama, Hideo; Shimazaki, Yoshihiro
Development of periodontal disease (PD) may be affected by socioeconomic status. This study examined the relationship between occupational status and PD in a 5-year prospective cohort of Japanese workers. In total, 19,633 participants had initial examinations at the Aichi Health Promotion Foundation, of whom 8210 participants aged 20 years or older did not have PD. Follow-up examinations were conducted for 3757 participants, accounting for 45.8% of baseline participants. Ultimately, 3390 participants were analyzed according to the criterion of job classification at baseline, which was based on the International Standard Classification of Occupations, 1987. Oral examinations were performed using the Community Periodontal Index (CPI). The CPI scores were coded as follows: healthy (score of 0); bleeding after probing (1); dental calculus (2); shallow pockets (3); and deep pockets (4). Participants with one or more sextants with a score >2 were diagnosed with PD. Poisson regression analysis was performed to adjust for age and other potential confounders. Overall, 31.6% of men and 23.8% of women had developed PD (CPI scores of 3 or 4). The adjusted relative risk (RR) for PD (CPI scores of 3 or 4) in men was not significant. On the other hand, the adjusted RRs for PD (CPI score of 4) in men were 2.52-, 2.39-, and 2.74-fold higher for skilled workers, sales persons, and drivers, respectively, than for professionals. In contrast, we found no gradient in women. We found a gradient related to the risk of developing PD according to occupational status among men in a Japanese worker population. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.
You, M; Chan, Y; Lacap-Bugler, D C; Huo, Y-B; Gao, W; Leung, W K; Watt, R M
Treponema denticola and other species (phylotypes) of oral spirochetes are widely considered to play important etiological roles in periodontitis and other oral infections. The major surface protein (Msp) of T. denticola is directly implicated in several pathological mechanisms. Here, we have analyzed msp sequence diversity across 68 strains of oral phylogroup 1 and 2 treponemes; including reference strains of T. denticola, Treponema putidum, Treponema medium, 'Treponema vincentii', and 'Treponema sinensis'. All encoded Msp proteins contained highly conserved, taxon-specific signal peptides, and shared a predicted 'three-domain' structure. A clone-based strategy employing 'msp-specific' polymerase chain reaction primers was used to analyze msp gene sequence diversity present in subgingival plaque samples collected from a group of individuals with chronic periodontitis (n=10), vs periodontitis-free controls (n=10). We obtained 626 clinical msp gene sequences, which were assigned to 21 distinct 'clinical msp genotypes' (95% sequence identity cut-off). The most frequently detected clinical msp genotype corresponded to T. denticola ATCC 35405 T , but this was not correlated to disease status. UniFrac and libshuff analysis revealed that individuals with periodontitis and periodontitis-free controls harbored significantly different communities of treponeme clinical msp genotypes (Pdiversity than periodontitis-free controls (Mann-Whitney U-test, Pdiversity of Treponema clinical msp genotypes within their subgingival niches. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Mlachkova, Antoaneta M; Popova, Christina L
Chronic periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by microorganisms in the dental biofilm, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation and gingival recession. Treatment of chronic periodontitis aims at arresting the inflammation and stopping the loss of attachment by removal and control of the supra- and subgingival biofilm and establishing a local environment and microflora compatible with periodontal health. The AIM of this study was to evaluate the effectiveness of non-surgical therapy (scaling and root planning) in the treatment of moderate chronic periodontitis. The study included 30 patients aged between 33 and 75 years, of which 46.7% women and 53.3% men, diagnosed with moderate and, at some sites, severe periodontitis. They were treated with non-surgical periodontal therapy methods (scaling and root planning and curettage if indicated). Additionally, chemical plaque control with rinse water containing chlorhexidine was applied. The diagnostic and reassessment procedures included measuring the periodontal indices of 601 periodontal units before and after the therapy. The indices measured were the papillary bleeding index (PBI), the hygiene index (HI), the probing pocket depth (PPD) and the clinical attachment level (CAL). Significant reduction of plaque and gingival inflammation was found in all treated patients; we also found a statistically significant reduction of periodontal pockets with clinically measured depth 5 mm did not show statistically significant lower incidence rates probably due to the initially small percentage of deep pockets in the patients studied. There was a statistically significant reduction of all sites with attachment loss, the highest significance found at sites where the attachment loss was greater than 5 mm. The results of the study suggest that nonsurgical periodontal therapy is effective in managing the moderate
Full Text Available Khushboo Goel,1 Shaili Pradhan,2 Madhur Dev Bhattarai3 1Department of Periodontology and Oral Implantology, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, 2Department of Dental Surgery, Periodontics Unit, Bir Hospital, 3Nepal Diabetes Association, Kathmandu, Nepal Objectives: Despite several investigations, evidence is still controversial regarding the effect of periodontal treatment on diabetes. This study evaluates and compares the effect on glycemic control and periodontal status with or without nonsurgical periodontal therapy in patients with type 2 diabetes mellitus and chronic periodontitis in a Nepalese population. Materials and methods: A total of 82 patients attending the diabetes clinic and fulfilling enrollment criteria with moderate to severe periodontitis were selected. They were assigned in an alternative sequence, into test and control group. Both groups were instructed to continue with their medical treatment without modifications. Scaling and root surface debridement were performed in the test group whereas the control group received oral hygiene instructions with no treatment during the 3-month study period. Results: There were 41 participants in each group with the mean age of 50.66±7.70 and 53.80±9.16 years, average diabetes duration of 6.32±4.21 and 6.24±4.00 years, mean body mass index of 24.78±1.85 and 24.6±1.79 kg/m2, and glycated hemoglobin (HbA1c level of 6.71±0.50% and 6.80±0.45%, in the test and control group, respectively. After 3 months, there was significant reduction in HbA1c levels in the test group compared to the control group (p=0.029. Clinical periodontal parameters of gingival index, probing depth (PD, and clinical attachment level (CAL significantly improved in the test group (p<0.001 with PD reduction by 0.9 mm and gain in CAL by 0.3 mm compared to the control group (p>0.001 who showed an increase by 0.05 mm. Conclusion: This study showed that nonsurgical periodontal
Periodontal disease is a multifactorial infectious disease and a number of microbial, systemic, genetic and environmental risk factors have been reported to influence its expression. Numerous risk factors as plaque biofilm, systemic conditions as diabetes mellitus, human immunodeficiency virus infection, stress, genetics and smoking may interact to render subjects at increased risk of periodontal disease (Kianane et al., 1999). In Periodontitis, there is an increased turnover of alveolar bone although there may be a dominance of bone resorption over bone formation, leading to alveolar bone loss and loss of attachment (Lee et al., 1999). Chronic Periodontitis has been defined as an infectious disease resulting in inflammation within the supporting structures of the teeth, progressive attachment loss and bone loss. It is the most prevalent form of periodontitis. Although it is most frequently observed in adults it can occur in children and adolescents in response to chronic plaque and calculus accumulation (Fleming, 1999). Payne et al., 1997 Studied the association between the estrogen status of postmenopausal women and alveolar bone density. The results indicated that the estrogen-sufficient women displayed a mean net gain in alveolar bone density and higher frequency of sites demonstrating a gain in alveolar density, the estrogen-deficient women displayed a men net loss in alveolar bone density and a higher frequency of sites demonstrating loss in alveolar bone density. The periodontal diseases are associated with an imbalance between oxidants and antioxidants because of increase in free radical production and defect in the total antioxidant activity (Diab-Ladki et al, 2003). Antioxidants are defined as those substances which when present at low concentrations compared to those of an oxidizable substrate will significantly delay or prevent oxidation of that substrate (Waddington , 2000). Vitamin C plays an important role in the maintenance of collagen which
Mohamed, D. M. [National Centre for Radiation Research and Technology, AEA, Cairo (Egypt)
Periodontal disease is a multifactorial infectious disease and a number of microbial, systemic, genetic and environmental risk factors have been reported to influence its expression. Numerous risk factors as plaque biofilm, systemic conditions as diabetes mellitus, human immunodeficiency virus infection, stress, genetics and smoking may interact to render subjects at increased risk of periodontal disease (Kianane et al., 1999). In Periodontitis, there is an increased turnover of alveolar bone although there may be a dominance of bone resorption over bone formation, leading to alveolar bone loss and loss of attachment (Lee et al., 1999). Chronic Periodontitis has been defined as an infectious disease resulting in inflammation within the supporting structures of the teeth, progressive attachment loss and bone loss. It is the most prevalent form of periodontitis. Although it is most frequently observed in adults it can occur in children and adolescents in response to chronic plaque and calculus accumulation (Fleming, 1999). Payne et al., 1997 Studied the association between the estrogen status of postmenopausal women and alveolar bone density. The results indicated that the estrogen-sufficient women displayed a mean net gain in alveolar bone density and higher frequency of sites demonstrating a gain in alveolar density, the estrogen-deficient women displayed a men net loss in alveolar bone density and a higher frequency of sites demonstrating loss in alveolar bone density. The periodontal diseases are associated with an imbalance between oxidants and antioxidants because of increase in free radical production and defect in the total antioxidant activity (Diab-Ladki et al, 2003). Antioxidants are defined as those substances which when present at low concentrations compared to those of an oxidizable substrate will significantly delay or prevent oxidation of that substrate (Waddington , 2000). Vitamin C plays an important role in the maintenance of collagen which
Chen, Jiazhen; Miao, Xinyu; Xu, Meng; He, Junlin; Xie, Yi; Wu, Xingwen; Chen, Gang; Yu, Liying; Zhang, Wenhong
Members of the genera Prevotella, Veillonella and Fusobacterium are the predominant culturable obligate anaerobic bacteria isolated from periodontal abscesses. When determining the cumulative number of clinical anaerobic isolates from periodontal abscesses, ambiguous or overlapping signals were frequently encountered in 16S rRNA gene sequencing chromatograms, resulting in ambiguous identifications. With the exception of the genus Veillonella, the high intra-chromosomal heterogeneity of rrs genes has not been reported. The 16S rRNA genes of 138 clinical, strictly anaerobic isolates and one reference strain were directly sequenced, and the chromatograms were carefully examined. Gene cloning was performed for 22 typical isolates with doublet sequencing signals for the 16S rRNA genes, and four copies of the rrs-ITS genes of 9 Prevotella intermedia isolates were separately amplified by PCR, sequenced and compared. Five conserved housekeeping genes, hsp60, recA, dnaJ, gyrB1 and rpoB from 89 clinical isolates of Prevotella were also amplified by PCR and sequenced for identification and phylogenetic analysis along with 18 Prevotella reference strains. Heterogeneity of 16S rRNA genes was apparent in clinical, strictly anaerobic oral bacteria, particularly in the genera Prevotella and Veillonella. One hundred out of 138 anaerobic strains (72%) had intragenomic nucleotide polymorphisms (SNPs) in multiple locations, and 13 strains (9.4%) had intragenomic insertions or deletions in the 16S rRNA gene. In the genera Prevotella and Veillonella, 75% (67/89) and 100% (19/19) of the strains had SNPs in the 16S rRNA gene, respectively. Gene cloning and separate amplifications of four copies of the rrs-ITS genes confirmed that 2 to 4 heterogeneous 16S rRNA copies existed. Sequence alignment of five housekeeping genes revealed that intra-species nucleotide similarities were very high in the genera Prevotella, ranging from 94.3-100%. However, the inter-species similarities were
Full Text Available Introduction: Because dermatoglyphic features are strongly affected by genetic and environmental factors, using it as supportive evidence in the diagnosis of hereditary disorders becomes a reality. Offspring of patients suffering from chronic periodontitis have a high prevalence rate of periodontal breakdown, suggesting strong familial influence. Aims: The present study intends to evaluate and compare the dermatoglyphic patterns in controls and periodontally compromised patients. Settings and Design: A hospital based cross-sectional study was conducted, including a total of 60 individuals, divided into study and control groups of 30 each. The study group included clinically diagnosed periodontitis patients.Materials and Methods: The digital prints were collected using biometric scanner and palmer prints using digital flatbed scanner. Care was taken to ensure that full prints of ridges were obtained. The periodontal status of all 60 participants was assessed clinically for attachment level and pocket depth. Later, Russell's periodontal index was also calculated. Statistical Analysis: The data obtained was subjected to statistical analysis using chi square and Student's t-test. Results: Among the finger ridge patterns, whorl pattern was found to be the most common in the study group whereas loop pattern was the most common in the control group. Mean total finger ridge count in the study group (165.69 ± 25.30 was significantly higher (P = 0.001 than the control group (125.4 ± 16.38. Mean dat angle was significantly higher (P = 0.039 in the study group (60.60 ± 2.76 than the control group (59.20 ± 2.62. Conclusion: Dermatoglyphics may serve as an early predictor in identifying high risk group individuals of developing diseases like periodontitis.
Huynh, A H S; Veith, P D; McGregor, N R; Adams, G G; Chen, D; Reynolds, E C; Ngo, L H; Darby, I B
The aim of this study was to compare the proteome composition of gingival crevicular fluid obtained from healthy periodontium, gingivitis and chronic periodontitis affected sites. Owing to its site-specific nature, gingival crevicular fluid is ideal for studying biological processes that occur during periodontal health and disease progression. However, few studies have been conducted into the gingival crevicular fluid proteome due to the small volumes obtained. Fifteen males were chosen for each of three different groups, healthy periodontium, gingivitis and chronic periodontitis. They were categorized based on clinical measurements including probing depth, bleeding on probing, plaque index, radiographic bone level, modified gingival index and smoking status. Gingival crevicular fluid was collected from each patient, pooled into healthy, gingivitis and chronic periodontitis groups and their proteome analyzed by gel electrophoresis and liquid chromatography electrospray ionization ion trap tandem mass spectrometry. One hundred and twenty-one proteins in total were identified, and two-thirds of these were identified in all three conditions. Forty-two proteins were considered to have changed in abundance. Of note, cystatin B and cystatin S decreased in abundance from health to gingivitis and further in chronic periodontitis. Complement proteins demonstrated an increase from health to gingivitis followed by a decrease in chronic periodontitis. Immunoglobulins, keratin proteins, fibronectin, lactotransferrin precursor, 14-3-3 protein zeta/delta, neutrophil defensin 3 and alpha-actinin exhibited fluctuations in levels. The gingival crevicular fluid proteome in each clinical condition was different and its analysis may assist us in understanding periodontal pathogenesis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Kumari, Minal; Martande, Santosh S; Pradeep, Avani R
Statins are known to have a beneficial effect in the treatment of chronic periodontitis (CP). The current study was designed to investigate the effectiveness of a 1.2% atorvastatin (ATV) local drug delivery system as an adjunct to scaling and root planing (SRP) in the treatment of intrabony defects (IBD) in CP among smokers. Seventy-one smokers with CP were categorized into two treatment groups: SRP + 1.2% ATV gel and SRP + placebo gel. Clinical parameters, modified sulcus bleeding index, probing depth, and clinical attachment level were recorded at baseline before SRP and at 3, 6, and 9 months. At baseline, 6 months, and 9 months, the percentage of radiographic defect depth reduction was determined using computer-aided software. The mean probing depth reduction and mean clinical attachment level gain were found to be greater in the ATV group than the placebo group at 3, 6, and 9 months. A significantly greater mean percentage of radiographic defect depth reduction was found in the ATV group compared to the placebo group after 9 months. The ATV local drug delivery as an adjunct to SRP can be used in the treatment of IBD in CP among smokers. © 2016 John Wiley & Sons Australia, Ltd.
Full Text Available The study was designed to evaluate the clinical outcome of a composite material, beta-tricalcium phosphate in combination with calcium sulphate, in the treatment of periodontal intrabony defects. The combination of these materials is believed to aid in guided tissue regeneration owing to their properties. A total of 47 teeth with intrabony defects in 26 periodontitis patients were treated with Fortoss® Vital (Biocomposites, Staffordshire, UK. Clinical parameters were evaluated which included changes in probing depth, clinical attachment level/loss and gingival recession at the baseline and 2 years postoperatively. The mean differences in measurements between the baseline and 2 years postoperatively were a reduction of 2.07±1.14 mm (p=0.000 in case of probing depth and a gain of 1.93±1.36 mm (p=0.000 in clinical attachment level; but an increase of 0.14±0.73 mm (p=0.571 in gingival recession. The study results show that the treatment with a combination of beta tricalcium phosphate and calcium sulphate led to a significantly favorable clinical improvement in periodontal intrabony defects 2 years after the surgery.
Full Text Available Diabetes mellitus is a systemic disease characterized by increased blood glucose levels and abnormalities of lipid metabolism due to absence or decreased level of insulin. It affects all the body organs and their functions either directly or indirectly. Every dentist should have a basic understanding of the etiopathogenesis, oral and systemic manifestations of this disease. The periodontal diseases are a consequence of extension of the gingival inflammation into the underlying supporting structures of the periodontium, initiated by the presence of plaque and its products on the surfaces of the teeth and the adjoining structures. The progression of periodontal disease is influenced by variety of factors like microorganisms, host response, systemic background, and genetic makeup of the host. Amongst them, diabetes mellitus tops the list. Diabetes and periodontitis influence the clinical outcome of each other and control of both influences the clinical improvement of each.
Petersen, Poul Erik; Ogawa, Hiroshi
BACKGROUND: The aim of this paper is to provide an overview of the burden of periodontal disease in adult populations worldwide, to emphasize the essential risk factors common to periodontal disease and chronic diseases, to outline important new strategies for effective prevention of periodontal...... disease, and to inform about the role of the World Health Organization (WHO) in developing a national capacity for the prevention of disease. METHODS: Information about periodontal health status as measured by the Community Periodontal Index system is stored in the WHO Global Oral Health Data Bank....... Updated information concerning WHO standard age groups was used to describe the prevalence rates of signs of periodontal disease, i.e., gingival bleeding, periodontal pocketing, and loss of attachment. RESULTS: Gingival bleeding is highly prevalent among adult populations in all regions of the world...
Santos, Vanessa R; Lima, Jadson A; Miranda, Tamires S; Gonçalves, Tiago E D; Figueiredo, Luciene C; Faveri, Marcelo; Duarte, Poliana M
The aim of this randomized controlled clinical trial was to evaluate the clinical effects of chlorhexidine (CHX) application in a full-mouth disinfection (FMD) protocol in poorly controlled type-2 diabetic subjects with generalized chronic periodontitis. Thirty-eight subjects were randomly assigned into FMD group (n=19): full-mouth scaling and root planing (FMSRP) within 24 h + local application of CHX gel + CHX rinses for 60 days or Control group (n = 19): FMSRP within 24 h + local application of placebo gel + placebo rinses for 60 days. Clinical parameters, glycated haemoglobin and fasting plasma glucose were assessed at baseline, 3, 6 and 12 months post-therapies. All clinical parameters improved significantly at 3, 6 and 12 months post-therapies for both groups (p clinical parameters, and glycemic condition at any time-point (p > 0.05). The treatments did not differ with respect to clinical parameters, including the primary outcome variable (i.e. changes in clinical attachment level in deep pockets), for up to 12 months post-treatments. © 2012 John Wiley & Sons A/S.
Full Text Available Oxidative stress has been implicated in the pathogenesis of numerous diseases. However, large interventional studies with antioxidants failed to show benefits in the prevention or treatment of cardiovascular diseases, cancer, or diabetes mellitus. Numerous clinical studies have confirmed the association of oxidative stress markers and periodontitis. Technical and biological variability is high for most of the analyzed markers and none of them seems to be optimal for routine clinical use. In a research setting, analysis of a palette of oxidative stress markers is needed to cover lipid peroxidation, protein oxidation, and the antioxidant status. The source of reactive oxygen species and their role in the pathogenesis of periodontitis remains unclear. Interventional experiments indicate that oxidative stress might be more than just a simple consequence of the inflammation. Small studies have confirmed that some antioxidants could have therapeutic value at least as an addition to the standard non-surgical treatment of periodontitis. A clear evidence for the efficiency of antioxidant treatment in large patient cohorts is lacking. Potentially, because lowering of oxidative stress markers might be a secondary effect of anti-inflammatory or antibacterial agents. As the field of research of oxidative stress in periodontitis gains attraction and the number of relevant published papers is increasing a systematic overview of the conducted observational and interventional studies is needed. This review summarizes the currently available literature linking oxidative stress and periodontitis and points toward the potential of adjuvant antioxidant treatment, especially in cases where standard treatment fails to improve the periodontal status.
Tóthová, L'ubomíra; Celec, Peter
Oxidative stress has been implicated in the pathogenesis of numerous diseases. However, large interventional studies with antioxidants failed to show benefits in the prevention or treatment of cardiovascular diseases, cancer, or diabetes mellitus. Numerous clinical studies have confirmed the association of oxidative stress markers and periodontitis. Technical and biological variability is high for most of the analyzed markers and none of them seems to be optimal for routine clinical use. In a research setting, analysis of a palette of oxidative stress markers is needed to cover lipid peroxidation, protein oxidation, and the antioxidant status. The source of reactive oxygen species and their role in the pathogenesis of periodontitis remains unclear. Interventional experiments indicate that oxidative stress might be more than just a simple consequence of the inflammation. Small studies have confirmed that some antioxidants could have therapeutic value at least as an addition to the standard non-surgical treatment of periodontitis. A clear evidence for the efficiency of antioxidant treatment in large patient cohorts is lacking. Potentially, because lowering of oxidative stress markers might be a secondary effect of anti-inflammatory or antibacterial agents. As the field of research of oxidative stress in periodontitis gains attraction and the number of relevant published papers is increasing a systematic overview of the conducted observational and interventional studies is needed. This review summarizes the currently available literature linking oxidative stress and periodontitis and points toward the potential of adjuvant antioxidant treatment, especially in cases where standard treatment fails to improve the periodontal status. PMID:29311982
Mesa, Francisco; Pozo, Elena; Blanc, Vanessa; Puertas, Alberto; Bravo, Manuel; O'Valle, Francisco
The aim of this study is to determine whether periodontal clinical parameters, periodontal bacterial profiles, and inflammatory infiltrate in placental chorionic villi are associated with adverse pregnancy results. The authors designed an observational case-control study in 244 postpartum females: mothers with preterm/low-birth weight newborns (n = 91 cases) and mothers with full-term, normal-weight infants (n = 153 controls). Sociodemographic, gynecologic, and periodontal variables were gathered for all participants. Data on placental inflammatory infiltrate in biopsies from 68 cases and 65 controls and the gingival bacterial profile in mothers with periodontitis were gathered, detecting associations with bivariate analyses and constructing a multiple logistic regression model with the number of positive inflammatory cells as the dependent variable. Periodontal values were significantly worse in cases versus controls. Numbers of leukocyte subsets per square millimeters in maternal and fetal vascular spaces were similar between cases and controls. CD45 in maternal placental space was related to the presence of periodontitis (P = 0.029) but not to case or control group (P = 0.264). The anaerobic and commensal bacterial profile in mothers with periodontitis was similar between the groups. Periodontal disease was more severe and a periodontitis diagnosis more frequent in mothers with preterm or low-birth weight versus normal delivery. No differences in anaerobic or commensal bacterial profile were found between mothers with periodontitis in the two groups. Local placental factors, such as the nature of the inflammatory infiltrate and slightly higher expression of cyclooxygenase-2 in the females with these adverse pregnancy outcomes, may be related to a subclinical proinflammatory status that could contribute to triggering premature labor.
Dula, Linda J; Ahmedi, Enis F; Lila-Krasniqi, Zana D; Shala, Kujtim Sh
The aim of this retrospective study was to evaluate the effect of removable partial dentures in periodontal abutment teeth in relation to the type of denture support and design of RPD in a five-year worn period. Methods : A total of 64 patients with removable partial dentures (RPDs), participated in this study. It were examined ninety-one RPDs. There were seventy-five RPDs with clasp-retained and sixteenth were RPDs with attachments. There were 28 females and 36 males, aged between 40-64 years, 41 maxillary and 50 mandible RPDs. For each subjects the following data were collected: denture design, denture support, and Kennedy classification. Abutment teeth were assessed for plaque index (PI), calculus index (CI), blending on probing (BOP), probing depth (PD), gingival recession (GR), tooth mobility (TM). Level of significance was set at pdenture support of RPD, BOP, PD, PI, GR, CI and TM-index showed no statistically significant difference. Based on the denture design of RPD's, BOP, PD, PI, CI, and TM-index proved no statistically significant difference. Except GR-index according to denture design confirmed statistically significant difference in RPD with clasp pdentures and below the clasp arms in abutment teeth.
Peddle, Gordon D; Drobatz, Kenneth J; Harvey, Colin E; Adams, Allison; Sleeper, Meg M
To identify risk factors potentially associated with the development of bacterial endocarditis in dogs and determine whether periodontal disease and surgical procedures (oral and nonoral) were associated with bacterial endocarditis. Retrospective case-control study. 76 dogs with (cases) and 80 dogs without (controls) bacterial endocarditis. Medical records were reviewed for information on signalment, physical examination findings, recent medical history, and results of echocardiography, clinicopathologic testing, and necropsy. None of the dogs with endocarditis had a history of undergoing any dental or oral procedure in the 3 months prior to the diagnosis of endocarditis, and no significant difference was found between groups with regard to the prevalence of oral infection. Dogs with endocarditis were significantly more likely to have undergone a nonoral surgical procedure that required general anesthesia in the preceding 3 months or to have developed a new heart murmur or a change in intensity of an existing heart murmur. Preexisting cardiac dis-ease (congenital or acquired) was not found to be a risk factor. Results did not provide any evidence of an association between bacterial endocarditis in dogs and either dental or oral surgical procedures or oral infection. Findings suggested that the routine use of prophylactic antimicrobial administration in dogs undergoing oral procedures needs to be reevaluated.
John, Priya; Lazarus, Flemingson; Selvam, Arul; Prabhuji, Munivenkatappa Lakshmaiah Venkatesh
Introduction PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. Aim The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). Settings and Design The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. Materials and Methods In a split–mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. Results In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. Conclusion The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis. PMID:26155567
Tsami, A; Petropoulou, P; Panayiotou, J; Mantzavinos, Z; Roma-Giannikou, E
To evaluate the factors that influence the oral hygiene and the periodontal treatment needs of children and adolescents with coeliac disease (CD) in Greece. The sample consisted of 35 children and adolescents, aged 4-18 years. The evaluation included consideration of the detailed medical history, the duration of CD and of gluten-free diet, the history of oral mucosal findings and a dental questionnaire that included information about oral hygiene habits, symptoms of periodontal disease and dental attendance. The clinical dental examination consisted of the simplified gingival index, the oral hygiene index and the periodontal screening and recording index. The chi square and logistic regression analysis were performed in order to determine the factors or parameters that had a statistically significant (p ≤ 0.05) impact on oral hygiene and periodontal treatment needs of children and adolescents with CD. The periodontal treatment need of children and adolescents with CD were high and most of them needed treatment of gingivitis (60.01%) and only a few subjects had a healthy periodontium (34.29%). The periodontal treatment need index, the simplified gingival index and the hygiene index correlated statistically significantly with the presence of a coexisting disease, frequency of tooth brushing, bleeding upon brushing and oral malodor. The periodontal treatment need of children and adolescents with CD correlated with factors that related to the presence of a second medical condition and to the personal oral hygiene habits. Additionally, the oral hygiene level and periodontal status of children with CD do not have any specific characteristics but they have similarities to the oral hygiene level and periodontal status of the children of the general population.
Oliveira, R.R.D.S.; Fermiano, D.; Feres, M.; Figueiredo, L.C.; Teles, F.R.F.; Soares, G.M.S.; Faveri, M.
In recent years, several new periodontal taxa have been associated with the etiology of periodontitis. A recent systematic review provides further support for the pathogenic role of 17 species/phylotypes. Thus, the aim of this study was to assess the prevalence and levels of these species in subjects with generalized chronic periodontitis (GChP; n = 30), generalized aggressive periodontitis (GAgP; n = 30), and periodontal health (PH; n = 30). All subjects underwent clinical and microbiologica...
Full Text Available Aim: Find the periodontal treatment that best maintained clinical results over time evaluated by changes in pocket depth (PD and clinical attachment level (CAL. Methods: 229 patients with chronic periodontitis from USA (n=134 and Sweden (n=95 were randomly assigned to eight groups receiving 1 scaling+root planing (SRP alone or combined with 2 surgery (SURG+systemic amoxicillin (AMOX+systemic metronidazole (MET; 3 SURG+local tetracycline (TET; 4 SURG; 5 AMOX+MET+TET; 6 AMOX+MET; 7 TET; and 8 SURG+AMOX+MET+TET. Antibiotics were given immediately after SRP. Plaque, gingival redness, bleeding on probing, suppuration, PD, and CAL were recorded at baseline and after 3, 6, 12, 18, and 24 months. Treatment effects were evaluated by linear multilevel regression and logistic multilevel regression models. We considered only data from sites with a baseline PD of at least 5 mm of 187 patients completing the study. Results: Surgically treated patients experienced most CAL loss. Adjunctive therapy including SURG was most effective in reducing PD. Combining SURG with AMOX, MET, and TET gave significant clinical benefits. Past and current smoking habits were significant predictors of deeper PD. Only current smoking was a significant predictor of CAL loss. Bleeding, accumulation of plaque, gingival redness, and suppuration were significant predictors of further CAL loss and deeper PD. Conclusions: Both surgical and non-surgical therapies can be used to arrest chronic periodontitis. SURG+AMOX+MET+TET gave best maintenance of clinical results.
Zhang, Z; Zheng, Y; Bian, X
The results of recent published studies focusing on the effect of azithromycin as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis are inconsistent. We conducted a meta-analysis of randomized controlled clinical trials to examine the effect of azithromycin combined with SRP on periodontal clinical parameters as compared to SRP alone. An electronic search was carried out on Pubmed, Embase and the Cochrane Central Register of Controlled Trials from their earliest records through December 28, 2014 to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Data were extracted independently by two authors. Either a fixed- or random-effects model was used to calculate the overall effect sizes of azithromycin on probing depth, attachment level (AL) and bleeding on probing (BOP). Heterogeneity was evaluated using the Q test and I(2) statistic. Publication bias was evaluated by Begg's test and Egger's test. A total of 14 trials were included in the meta-analysis. Compared with SRP alone, locally delivered azithromycin plus SRP statistically significantly reduced probing depth by 0.99 mm (95% CI 0.42-1.57) and increased AL by 1.12 mm (95% CI 0.31-1.92). In addition, systemically administered azithromycin plus SRP statistically significantly reduced probing depth by 0.21 mm (95% CI 0.12-0.29), BOP by 4.50% (95% CI 1.45-7.56) and increased AL by 0.23 mm (95% CI 0.07-0.39). Sensitivity analysis yielded similar results. No evidence of publication bias was observed. The additional benefit of systemic azithromycin was shown at the initially deep probing depth sites, but not at shallow or moderate sites. The overall effect sizes of systemic azithromycin showed a tendency to decrease with time, and meta-regression analysis suggested a negative relation between the length of follow-up and net change in probing depth (r = -0.05, p = 0.02). This meta-analysis provides further
Full Text Available This study used con-beam computed tomography (CBCT to investigate the prevalence and severity of alveolar bone loss in middle-aged (40-59 years Chinese with chronic periodontitis.The study group comprised 145 dentate individuals aged 40 to 59 years residing in China who suffered from chronic periodontitis. CBCT and the application of NNT software were used to examine the level and location of alveolar bone loss.The study revealed that 40-59 year old patients with chronic periodontitis had severe bone loss. At 5,286 sites (34.7%, alveolar bone loss was mild; severe alveolar bone loss was found at 5,978 sites (39.2%. A comparison of bone loss in different jaws revealed that the area with the highest degree of bone loss was on the lingual side of the maxillary molar (56.3 ± 7.2%, and that the area with the lowest degree was primarily on the lingual side of the mandibular canine (27.5 ± 6.3%. There was a lower degree of alveolar bone loss in males than females. Differences were observed when comparing the incidence of bone loss between males and females (P < 0.05. Menopause in females and smoking in both genders may affect the level of bone loss. Male smokers experienced a greater degree of bone loss (41.67 ± 5.76% than male non-smokers (32.95 ± 4.31%. A 42.23 ± 6.34% bone loss was found in menopausal females versus 31.35 ± 3.62% in non-menopausal females.The study revealed that different sites and teeth exhibited a diverse degree of bone loss. In middle-aged patients with chronic periodontitis, the highest degrees of bone loss in the incisors, premolars, and molars were on the lingual side, mesial side and lingual side, respectively. Menopause in females and smoking may affect the level of bone loss.
Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano
This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute
Wei Dong; Zhang Xiaolei
Objective: To investigate the changes of serum IL-1β and TNF-α levels in patients with periodontitis. Methods: Serum IL-1β and TNF-α levels were measured with RIA in 42 patients with periodontitis and 35 controls. Results: Serum IL-1β and TNF-α levels in the patients were significantly higher than those in controls (P<0.01). Serum IL-1β level was positively correlated with TNF-α level (r=0.4182, P<0.01). Conclusion: Increase of serum IL-1β and TNF-α levels in patients with periodontitis was closely related to the pathogenesis of the disease. (authors)
Kalha, Anmol S; Kachiwala, Viral Ashok; Govardhan, Singatagere Nagaraj; McLaughlin, Richard P; Khurshaid, Syed Zameer
To assess the rate of tooth movement, anchorage loss, root resorption, and alkaline phosphatase (ALP) activity in the gingival crevicular fluid (GCF) as a marker for bone remodeling during orthodontic space closure using two different mechanisms. Space closure was completed in 20 patients with extraction of all 4 premolars. Lateral cephalograms and radio-visiographs taken before (T1) and after (T2) space closure were assessed for anchorage loss and root resorption. Alkaline phosphatase levels were measured in 10 patients, which were divided into two groups of five each. Spaces were closed with a screw device in the first group and with active tie-backs in the second. Gingival crevicular fluid samples, collected at intervals, were assayed for alkaline phosphatase spectrophotometrically in each patient. The mean rate of tooth movement was 1.32 ± 0.22 mm/month. The mean amount of anchorage loss in the maxilla and mandible was 1.23 ± 0.60 mm and 1.08 ± 0.65 mm, respectively. Sixty (25%) roots showed no root resorption, while 180 (75%) roots displayed mild to moderate blunting of their apices. Gingival crevicular fluid-alkaline phosphatase level increased significantly from day 7 to day 28 in both groups, but significantly more in the screw retraction group (Pspace closure occurs more rapidly with sequential repetitive loading of the periodontal ligament than with conventional active tie-backs. This observation is in concurrence with a significant increase in the gingival crevicular fluid-alkaline phosphatase level. © 2010 BY QUINTESSENCE PUBLISHING CO, INC.
Mullally Brian H
Full Text Available Abstract This paper reviews the evidence for cigarette smoking as a risk factor for the development of severe destructive periodontal disease in young adults. A high prevalence of cigarette smoking has been identified among young individuals with aggressive periodontitis and tobacco usage increases the risk of periodontal destruction most significantly in young populations. The effect appears to be dose related and is independent of levels of plaque accumulation. Young smokers have more alveolar bone loss and attachment loss than non smoking equivalents. Prolonged and heavy smoking can reduce gingival bleeding and therefore mask the clinical marker of bleeding on probing often used by dentists to monitor periodontal health. This has implications for potential misdiagnosis and failure to detect periodontitis at an early stage. Nicotine metabolites concentrate in the periodontal tissues and can have local effects as well as the potential to affect the systemic host response. Dentists are well placed to assess the smoking status of their young patients and have a role to play in the delivery of smoking cessation advice especially as it pertains to periodontal health. In this way the dental profession can also make a significant contribution to the general health and well being of our youth and future generations.
Jagjit Singh Dhaliwal
Full Text Available Background: The literature is replete with reports that pregnant women have an increased level of periodontal disease as compared with non-pregnant women of the same age. There are many studies correlating the effect of periodontal disease on the adverse pregnancy outcomes. The development of periodontal diseases during pregnancy can be influenced by factors such as preexisting oral conditions, general health, and socio-cultural background. There is very little data studying the effect of socio-demographic factors on the periodontal health of pregnant women. This study evaluated the periodontal status of a sample of pregnant women of Chandigarh and adjoining areas. The study also investigated the relationship between these variables and a series of demographic and clinical variables. Materials and Methods: The participants were 190 pregnant women attending Gynecology and Obstetrics outpatient department of Government Medical College and Hospital, Chandigarh. The participants were examined for their periodontal health and various socio-demographic variables were recorded on performas designed for the purpose of study. Statistical analysis was done. Results: The results revealed that the mean bleeding index scores and probing depth increased with statistical significance when the socio-economic status was lower ( P0.1. The plaque index was not significantly associated with the socio-economic status, profession, place of residence, and trimester of pregnancy ( P>0.1. Conclusion: In the population of pregnant women investigated under this study, the clinical and socio-demographic characteristics showed non-significant correlation except socio-economic status which showed statistically significant correlation with bleeding on probing and pocket depth. Further studies may be required in Indian population to determine the association of periodontal diseases in pregnant women with socio-demographic variables.
Full Text Available With recent refinements in immunosuppression techniques, the first successful reports of small bowel transplantation in humans have now been made, increasing interest in bowel transplantation among clinicians and patients alike. This article reviews recent developments in understanding of the functional capabilities and requirements for effective immune suppression in bowel transplantation. Both experimental and clinical experience with transplantation are discussed, as are the areas which appear to offer the most promise for future developments. Finally guidelines for consideration of patient selection for this procedure are reviewed.
Kanaparthy, Aruna; Kanaparthy, Rosaiah; Niranjan, Nandini
Periodontal subgingival pathogens affect local and systemic immune responses and initiate an acute phase systemic inflammatory response characterized by the release of C-reactive proteins (CRPs). This study has been carried out to evaluate the serum concentration of CRPs, which can be used as a marker of periodontal disease as well as a risk indicator for cardiovascular diseases. In a retrospective study a total number of 45 subjects were selected from the outpatient department of periodontics a mean age of 40 years. Based on the periodontal status, the subjects were divided into 3 groups of 15 subjects each. Group I: Control group [with attachment loss (AL) ≤ 2 mm and pocket depth (PD) periodontitis (AL ≤ 5 mm), Group III: chronic periodontitis (AL ≥ 2 mm, PD ≥ 5 mm), which includes moderate and severe periodontitis. The clinical parameters recorded were plaque index,gingival index, bleeding index, probing PD, and clinical attachment levels and scoring was done on 6 surfaces of all teeth. For the CRP assessment, blood samples were collected from subjects at the time of clinical examination. Analysis of covariance was used for comparison of mean values between the groups to adjust the ages (P value periodontitis compared with controls. This was found to be statistically significant. A statistically significant difference (P = 0.012) was found in the CRP level between groups I and II and between groups II and III, and between groups I and III. The results of the present study indicated an increase in serum CRP levels in subjects with generalized aggressive periodontitis and chronic periodontitis as compared with the controls.
Kanaparthy, Aruna; Kanaparthy, Rosaiah; Niranjan, Nandini
Background: Periodontal subgingival pathogens affect local and systemic immune responses and initiate an acute phase systemic inflammatory response characterized by the release of C-reactive proteins (CRPs). This study has been carried out to evaluate the serum concentration of CRPs, which can be used as a marker of periodontal disease as well as a risk indicator for cardiovascular diseases. Materials and Methods: In a retrospective study a total number of 45 subjects were selected from the outpatient department of periodontics a mean age of 40 years. Based on the periodontal status, the subjects were divided into 3 groups of 15 subjects each. Group I: Control group [with attachment loss (AL) ≤ 2 mm and pocket depth (PD) periodontitis (AL ≤ 5 mm), Group III: chronic periodontitis (AL ≥ 2 mm, PD ≥ 5 mm), which includes moderate and severe periodontitis. The clinical parameters recorded were plaque index,gingival index, bleeding index, probing PD, and clinical attachment levels and scoring was done on 6 surfaces of all teeth. For the CRP assessment, blood samples were collected from subjects at the time of clinical examination. Analysis of covariance was used for comparison of mean values between the groups to adjust the ages (P value chronic periodontitis compared with controls. This was found to be statistically significant. A statistically significant difference (P = 0.012) was found in the CRP level between groups I and II and between groups II and III, and between groups I and III. Conclusion: The results of the present study indicated an increase in serum CRP levels in subjects with generalized aggressive periodontitis and chronic periodontitis as compared with the controls. PMID:23087729
Full Text Available Background: Drug abuse is one of the most important etiologic and deteriorating factors in periodontal disease. Amphetamines and opioids, the most commonly used drugs worldwide, play an important role in this regard. The aim of this study was to compare the periodontal status of amphetamines and opioids consumers in Kermanshah city, Iran in 1393. Methods: Three drug rehabilitation clinics were selected randomly in Kermanshah. According to inclusion and exclusion criteria, 20 amphetamine consumers and 20 opioid consumers were selected randomly and participated in this study. A questionnaire for drug use and periodontal variables was designed. The collected data were entered into SPSS-18 software and Mann-Whitney and t-test were used for statistical analysis. Results: Pocket depth, gingival index and gingival bleeding in amphetamines users were more than those in opioids consumers (P<0.021. Plaque index and gingival recession in opioids users were more than those of amphetamines consumers (P<0.001. The number of periodontal disease cases in amphetamines group were 13 persons (65% and in opioids group 8 persons (40%. Conclusion: Our study showed that periodontal hygine in amphetamine consumers was worse than opioid consumers.
Akpata, E Samuel; Adeniyi, Abiola A; Enwonwu, Cyril O; Adeleke, Oyeladun A; Otoh, Emmanuel C
To report the periodontal status of older adults in Plateau State, Nigeria, and determine its Association with alcohol consumption. Periodontal disease is common among Nigerians, and the prevalence increases with age. The role that alcohol consumption plays in the occurrence of the disease among Africans is uncertain. Sample selection was performed using a multistage cluster sampling technique among older adults in Plateau State, Nigeria. Interviews, using structured questionnaires, were conducted for each of the participants. Clinical examinations were then carried out to determine the occurrence of periodontal disease, assessed by clinical attachment loss and probing depth. The prevalence of periodontal disease was 79%, being severe in 46% of the population. Almost half of the participants (46.7%) examined were still actively consuming alcohol, among which 48% reported a history of intoxication. There was no statistically significant relationship between periodontal disease and the frequency of alcohol consumption, or quantity consumed on each occasion. However, alcohol consumption was highly correlated with periodontal disease among those who reported intoxication from the drink (r = 0.095; p = 0.033). A history of intoxication with alcohol was the only significant predictor of periodontal disease, after adjusting for age and gender. Periodontal disease was highly prevalent among older Nigerians in this study. Apart from those who reported intoxication from alcohol, there was no statistically significant relationship between the prevalence of periodontal disease and the frequency of alcohol consumption or the quantity consumed on each occasion. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
Vieira Colombo, Ana Paula; Magalhães, Clarissa Bichara; Hartenbach, Fátima Aparecida Rocha Resende; Martins do Souto, Renata; Maciel da Silva-Boghossian, Carina
The ecological diversity of the periodontal microenvironment may provide suitable conditions for the colonization of species not usually considered members of the oral microbiota. In this investigation, we aimed to determine the prevalence and levels of pathogenic species of medical relevance in the microbiota of individuals with distinct periodontal clinical status. Subgingival biofilm was obtained from patients with periodontal health (H, n = 81), gingivitis (G, n = 55), generalized aggressive (AgP, n = 36) or chronic periodontitis (CP, n = 98), and analyzed for 39 microbial taxa using a checkerboard DNA-DNA hybridization technique. Microbial differences among groups, as well as associations between clinical and microbiological parameters were sought by non-parametric and univariate correlation tests. Neisseria spp., Peptostreptococus anaerobius, Candida albicans, enterobacteria, Pseudomonas aeruginosa, Eubacterium saphenum, Clostridium difficile and Olsenella uli were detected in high mean prevalence and counts in the subgingival microbiota of the study population. Species that were more related to periodontal inflammation and tissue destruction at the patient and site levels included enterobacteria, C. albicans, Neisseria spp., P. aeruginosa, O. uli, Hafnia alvei, Serratia marcescens and Filifactor alocis (p < 0.05). In contrast, Fusobacterium necrophorum, Lactobacillus acidophilus, Staphylococcus aureus and Streptococcus pneumoniae were associated with periodontal health (p < 0.05). Pathogenic species of medical importance may be detected in high prevalence and levels in the periodontal microbiota. Regardless of their role in periodontal health or disease, the periodontal biofilm may be a source for dissemination and development of systemic infections by these pathogenic microorganisms. Copyright © 2015 Elsevier Ltd. All rights reserved.
Radochova, Vladimira; Kacerovska Musilova, Ivana; Stepan, Martin; Vescicik, Peter; Slezak, Radovan; Jacobsson, Bo; Kacerovsky, Marian
Periodontal disease is frequently suggested as a possible causal factor for preterm delivery. The link between periodontal disease and preterm delivery is a possible translocation of periopathogenic bacteria to the placenta and amniotic fluid as well as a systemic response to this chronic inflammatory disease. However, there is a lack of information on whether there is an association between clinical periodontal status in women with preterm prelabor rupture of membranes (PPROM) and the presence of microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation (IAI). Therefore, the main aim of this study was to evaluate the incidence and severity of periodontal disease in women with PPROM. The secondary aim was to characterize an association between periodontal status and the presence of intra-amniotic PPROM complications (MIAC and/or IAI). Seventy-eight women with PPROM at gestational ages between 24 + 0 and 36 + 6 weeks were included in this study. The samples of amniotic fluid were obtained at admission via transabdominal amniocentesis, and amniotic fluid interleukin (IL)-6 concentrations were determined using a point-of-care test. All women had a full-mouth recording to determine the periodontal and oral hygiene status. Probing pocket depth and clinical attachment loss were measured at four sites on each fully erupted tooth. In total, 45% (35/78) of women with PPROM had periodontal disease. Mild, moderate, and severe periodontal disease was present in 19% (15/78), 19% (15/78), and 6% (5/78) of women, respectively. The presence of MIAC and IAI was found in 28% (22/78) and 26% (20/78) of women, respectively. Periopathogenic bacteria (2 × Streptococcus intermedius and 1 × Fusobacterium nucleatum) was found in the amniotic fluid of 4% (3/78) of women. There were no differences in periodontal status between women with MIAC and/or IAI and women without these intra-amniotic complications. The presence of MIAC and IAI was not related
K Pallavi Nanaiah
Full Text Available Background: Periodontitis is a group of inflammatory diseases affecting the supporting tissues of the tooth. Both aggressive periodontitis (AP and chronic periodontitis (CP have a multifactorial etiology, with dental plaque as the initiating factor. However, the initiation and progression of periodontitis are influenced by other factors including microbiologic, social and behavioral and systemic and genetic factors. The prevalence of periodontal diseases varies in different regions of the world according to the definition of periodontitis and the study population, and there are indications that they may be more prevalent in developing than in developed countries. Materials and Methods: A cross-sectional study was conducted among the adolescents of 15-18 years of age in Mangalore City. One thousand one hundred students aged 15-18 years were selected for the study from the schools and colleges in Mangalore City using a convenient sampling method. The prevalence of AP and CP were assessed in the study using a community periodontal index. Students who were diagnosed clinically and radiographically were subjected to microbiological examination to confirm AP. Results: A high prevalence of gingivitis and periodontitis was found in students belonging to the lower socioeconomic status group compared with the higher socioeconomic groups, which were associated with poor oral hygiene habits. The prevalence of AP was found to be 0.36% and that of CP was found to be 1.5%. Conclusion: Oral diseases have a significant impact on the social and psychological aspects of an individual′s life. Exposure to risk factors, such as age, low socio-economic status, poor education, low dental care utilization, poor oral hygiene levels, smoking, psychosocial stress and genetic factors are significantly associated with an increased risk of periodontitis among adolescents. Although genetic factors play a major role in periodontitis, the treatment outcome will still be
Reynolds, Ian; Duane, Brett
Data sourcesMedline, Embase, OpenGrey, Journal of Clinical Periodontology, Journal of Periodontology and a hand search of the bibliographies of retrieved publications.Study selectionTwo reviewers screened the title and abstract of 1134 studies from the literature and selected 37 suitable publications for inclusion following full text analysis of 109 papers and agreement between both reviewers. The search included observational, epidemiological studies and clinical trials that fufilled the inclusion criteria. The publications assessed contained a periodontal clinical examination and a validated OHRQoL questionnaire. There were no language restrictions and the review was performed according to the MOOSE statement.Data extraction and synthesisData were extracted from each study applying the PECO format. The quality of the observational studies was evaluated by the Newcastle Ottawa Scale (NOS) and clinical trials by the (MINORS) methodological index for non-randomised studies. The Strength of Grading Taxonomy (SORT) was utilised to assess the level of evidence and strength of recommendation of the included studies. A meta-analysis was not undertaken due the heterogeneity of the included studies, therefore results were synthesised by applying a vote counting method.ResultsThirty-seven studies included in the review were evaluated by the vote counting method. According to NOS and MINORS the risk of bias was identified as moderate with most studies assessing 50% to 83% of the parameters established. A level two for quality of evidence and a level B for strength of recommendation were applicable for the relationship between clinically diagnosed periodontal disease and OHRQoL. The evidence level was consistent across the studies. Nineteen of the studies examined a distinct population group with respect to diagnosis of systemic disease, socioeconomic status, demographic background or periodontal diagnosis. Twenty-eight of the included studies reported an association between
Grzech-Leśniak, K; Sculean, A; Gašpirc, Boris
The objective of this study was to evaluate the microbiological and clinical outcomes following nonsurgical treatment by either scaling and root planing, combination of Nd:YAG and Er:YAG lasers, or by Er:YAG laser treatment alone. The study involved 60 patients with generalized chronic periodontitis, randomly assigned into one of three treatment groups of 20 patients. The first group received scaling and root planing by hand instruments (SRP group), the second group received Er:YAG laser treatment alone (Er group), and the third group received combined treatment with Nd:YAG and Er:YAG lasers (NdErNd group). Microbiological samples, taken from the periodontal pockets at baseline and 6 months after treatments, were assessed with PET Plus tests. The combined NdErNd laser (93.0%), followed closely by Er:YAG laser (84.9%), treatment resulted in the highest reduction of all bacteria count after 6 months, whereas SRP (46.2%) failed to reduce Treponema denticola, Peptostreptococcus micros, and Capnocytophaga gingivalis. Full-mouth plaque and bleeding on probing scores dropped after 6 months and were the lowest in both laser groups. The combination of NdErNd resulted in higher probing pocket depth reduction and gain of clinical attachment level (1.99 ± 0.23 mm) compared to SRP (0.86 ± 0.13 mm) or Er:YAG laser alone (0.93 ± 0.20 mm) in 4-6 mm-deep pockets. Within their limits, the present results provide support for the combination of Nd:YAG and Er:YAG lasers to additionally improve the microbiological and clinical outcomes of nonsurgical periodontal therapy in patients with moderate to severe chronic periodontitis.
Lalla, E; Kaplan, S; Yang, J; Roth, G A; Papapanou, P N; Greenberg, S
Diabetes is associated with an increased risk for vascular disease and periodontitis. The aim of this study was to assess the effects of periodontal treatment in diabetes with respect to alterations in the pro-inflammatory potential of peripheral blood mononuclear cells. Ten patients with diabetes and moderate to severe periodontitis received full-mouth subgingival debridement. Blood samples for serum/plasma and mononuclear cell isolation were collected prior to and 4 wk after therapy. Mononuclear cells were analyzed by flow cytometry and stimulated with lipopolysaccharide or ionomycin/phorbol ester to determine the pro-inflammatory capacity of macrophages and lymphocytes, respectively. Following periodontal treatment, all patients demonstrated a significant improvement in clinical periodontal status (p C-reactive protein significantly decreased by 37% (p periodontal therapy and a potential impact on atherosclerosis-related complications in diabetic individuals.
Harris, David M.; Nicholson, Dawn M.; McCarthy, Delwin; Yukna, Raymond A.; Reynolds, Mark A.; Greenwell, Henry; Finley, James; McCawley, Thomas K.; Xenoudi, Pinelopi; Gregg, Robert H.
Data are presented from a multi-center, prospective, longitudinal, clinical trial comparing four different treatments for periodontitis, (1) the LANAPTM protocol utilizing a FR pulsed-Nd:YAG laser; (2) flap surgery using the Modified Widman technique (MWF); (3) traditional scaling and root planing (SRP); and (4) coronal debridement (CD). Each treatment was randomized to a different quadrant. Fifty-one (54) subjects were recruited at five centers that included both private practice and university-based investigators. At 6-months and 12 months post-treatment the LANAPTM protocol and MWF yielded equivalent results based on changes in probing depths. The major difference observed between the two procedures was that patients reported significantly greater comfort following the LANAP™ procedure than following the MWF (P<0.001). There was greater reduction in bleeding in the LANAPTM quadrant than in the other three at both 6 and 12 months. Improvements following SRP were better than expected at 6 months and continued to improve, providing outcomes that were equivalent to both LANAPTM and MWF at 12 months. The improvement in the SRP quadrants suggests the hypothesis that an aspect of the LANAPTM protocol generated a significant, positive and unanticipated systemic (or trans-oral) effect on sub-gingival wound healing.
Silva, Emmanuel João Nogueira Leal; Menaged, Karyne; Ajuz, Natasha; Monteiro, Maria Rachel Figueiredo Penalva; Coutinho-Filho, Tauby de Souza
The aim of this randomized, controlled, prospective clinical study was to determine if foraminal enlargement instrumentation during endodontic treatment is associated with more postoperative pain compared with standard nonenlargement instrumentation. Forty volunteers with a single root canal were diagnosed with asymptomatic necrosis with apical periodontitis and randomized into 2 experimental groups (ie, the control group and the foraminal enlargement group). Endodontic treatment was performed in a single visit, and volunteers were instructed to record pain intensity (ie, none, slight, moderate, and severe). Scores from 1 to 4 were attributed to each kind of pain after 12, 24, and 48 hours. The Kolmogorov-Smirnov and Student's t tests were used to determine significant differences at P .05, Student's t test). Postoperative pain showed no statistically significant difference between the groups at any observation period (P > .05). Also, no significant difference was observed in the mean number of analgesic tablets used between the groups (P > .05). The foraminal enlargement and nonenlargement techniques resulted in the same postoperative pain and necessity for analgesic medication. This may suggest that the use of foraminal enlargement should be performed for endodontic treatment previsibility without increasing postoperative pain. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Pradeep, A R; Patnaik, Kaushik; Nagpal, Kanika; Karvekar, Shruti; Guruprasad, C N; Kumaraswamy, K M
The aim of this study is to investigate efficacy of metformin (MF) 1% gel as an adjunct to scaling and root planing (SRP) in the treatment of moderate and severe chronic periodontitis (CP). Seventy patients were categorized into two treatment groups: 1) SRP plus 1% MF and 2) SRP plus placebo. Clinical parameters were recorded at baseline and 3, 6, and 9 months. They included plaque index (PI), modified sulcus bleeding index (mSBI), probing depth (PD), and clinical attachment level (CAL). Radiologic assessment of intrabony defects (IBDs) and percentage defect depth reduction (DDR%) was done at baseline and 6- and 9-month intervals using computer-aided software. PD, CAL, and DDR% were evaluated in two subgroups in both the placebo and MF group: 1) initial PD of 5 to 7 mm and 2) initial PD of >7 mm. Mean PD reduction and mean CAL gain was found to be greater in the MF group than the placebo group at all visits. Clinical parameters (PD, CAL) in both subgroups, with initial PDs of 5 to 7 and >7 mm, showed significant improvement in the 1% MF group compared with the placebo group. A significantly greater mean DDR% was found in the MF group than the placebo group at 6 and 9 months in both subgroups, 5 to 7 and >7 mm of initial PD. There was a greater decrease in PD and more CAL gain with significant IBD depth reduction at sites treated with SRP plus locally delivered MF in patients with CP in both initial PD = 5 to 7 and >7 mm subgroups compared with placebo.
Teran, Felipe; Harper-Kirksey, Katrina; Jagoda, Andy
Seizures and status epilepticus are frequent neurologic emergencies in the emergency department, accounting for 1% of all emergency department visits. The management of this time-sensitive and potentially life-threatening condition is challenging for both prehospital providers and emergency clinicians. The approach to seizing patients begins with differentiating seizure activity from mimics and follows with identifying potential secondary etiologies, such as alcohol-related seizures. The approach to the patient in status epilepticus and the patient with nonconvulsive status epilepticus constitutes a special clinical challenge. This review summarizes the best available evidence and recommendations regarding diagnosis and resuscitation of the seizing patient in the emergency setting.
Leonardo Fernandes da Cunha
Full Text Available This case report describes a patient with discolored and fractured composite resin restorations on the anterior teeth in whom substitution was indicated. After wax-up and mock-up, the composite was removed and replaced with minimally invasive ceramic laminates. An established and predictable protocol was performed using resin cement. Minimally invasive ceramic restorations are increasingly being used to replace composite restorations. This treatment improves the occlusal and periodontal aspects during the planning and restorative phases, such as anterior guides, and laterality can be restored easily with ceramic laminates. In addition, the surface smoothness and contour of ceramic restorations do not affect the health of the surrounding periodontal tissues. Here we present the outcome after 18 months of clinical follow-up in a patient in whom composite resin restorations in the anterior teeth were replaced with minimally invasive ceramic laminates.
Full Text Available One of the most common inflammation disease in the oral cavity for the past few years is the chronic form of parodontitis. Every 2nd or 3rd patient who has been to the dentist has the illness. If a person has this illness he cannot have an implant treatment done, because it is temporarily contraindicated until the oral hygiene and status is restored. Patients with reoccurring chronic periodontitis, who need an implant treatment are a real challenge for the dental surgeon and the prosthetis.
Doença periodontal em portadoras de valvopatia durante a gravidez: estudo clínico e microbiológico Enfermedad periodontal en portadoras de valvopatía durante la gravidez: estudio clínico y microbiológico Periodontal disease in pregnant patients with rheumatic valvular disease: clinical and microbiological study
Walkiria Samuel Ávila
disease during pregnancy of women with rheumatic valve disease imply infective endocarditis risks and higher rate of preterm birth and low birth weight. OBJECTIVE: To study the periodontal disease rate of women with rheumatic valve disease during pregnancy. METHODS: We studied 140 pregnant women who included 70 patients with rheumatic valve disease and 70 healthy women. The periodontal examination included: 1 periodontal clinical exam regard the follow variables: a probing depth; b gingival margin; c clinical attachment level; d bleeding on probing; e plaque index and f gingival index; and 2 microbiological test was performed in samples serum and gingival crevicular fluid and considered positive controls to Porphyromonas gingivalis, Tannerella forsithia e Aggregobacter actinomycetemcomitans. RESULTS: Age and parity were similar between groups; as single or combined the mitral valve disease was prevalent among the rheumatic valve lesion in 45 (32.1% e 20 (28.5% cases, respectively. Among the periodontal variables gingival margin (p=0.01 and plaque index (p=0.04 were different between groups. The periodontal disease was identified in 20 (14,3% pregnant women, seven (10% of them were patients with valve rheumatic disease and the remain 13 (18,6% were healthy women, its percentual was not different between groups (p=0,147. Microbiological analyses of oral samples showed higher percentual of P. gingivalis in healthy pregnant women (p=0.004. CONCLUSION: The clinical and microbiological study during pregnancy showed comparable incidence of periodontal disease between women with rheumatic valve disease and healthy women.
Full Text Available Reactive oxygen species (ROS are products of normal cellular metabolism. However, excessive production of ROS oxidizes DNA, lipids and proteins, inducing tissue damage. Studies have shown that periodontitis induces excessive ROS production in periodontal tissue. When periodontitis develops, ROS produced in the periodontal lesion diffuse into the blood stream, resulting in the oxidation of blood molecules (circulating oxidative stress. Such oxidation may be detrimental to systemic health. For instance, previous animal studies suggested that experimental periodontitis induces oxidative damage of the liver and descending aorta by increasing circulating oxidative stress. In addition, it has been revealed that clinical parameters in chronic periodontitis patients showed a significant improvement 2 months after periodontal treatment, which was accompanied by a significant reduction of reactive oxygen metabolites in plasma. Improvement of periodontitis by periodontal treatment could reduce the occurrence of circulating oxidative stress. Furthermore, recent studies indicate that the increase in circulating oxidative stress following diabetes mellitus and inappropriate nutrition damages periodontal tissues. In such cases, therapeutic approaches to systemic oxidative stress might be necessary to improve periodontal health.
Reinhardt, John W
This article summarizes the current status of the operation and management of dental school clinics as schools strive to provide excellent patient-centered care in an environment that is educationally sound, efficient, and financially strong. Clinical education is a large component of dental education and an area in which many dental schools have an opportunity to enhance revenue. Clinical efficiencies and alternative models of clinical education are evolving in U.S. dental schools, and this article describes some of those evolutionary changes. This article was written as part of the project "Advancing Dental Education in the 21 st Century."
Petrukhina, N B; Zorina, O A; Rabinovich, I M; Shilov, A M
The study of risk factors for cardio-vascular continuum (CVC), the influence of the digestive tract endobiosis on lipid-carbohydrate metabolism and clinical status, a retrospective analysis of 1000 medical records of patients, suffering from various diseases of internal organs (Gastrointestinal tract, coronary heart disease, type 2 diabetes, obesity) in combination with periodontitis of varying severity, aged 20 to 55 years. A statistically significant relationship is directly proportional to the severity of inflammation of periodontal tissues with body mass index (BMI), especially pronounced in patients with a BMI ≥225 kg/m2 which is the "calling card" of the metabolic syndrome - clinical model polymorbidity.
Jensen, Anne Birkeholm; Ennibi, Oum Keltoum; Ismaili, Zouheir
AIM: To perform a cross-sectional study on the carrier frequency of JP2 and non-JP2 genotypes of A. actinomycetemcomitans in Moroccan schoolchildren and relate the presence of these genotypes to the periodontal status in the mixed dentition. MATERIAL AND METHODS: A plaque sample from 513 children...... the JP2 genotype and 186 (36.3%) were positive for non-JP2 genotypes, whereas A. actinomycetemcomitans could not be detected in the remaining 281 subjects. Among 75 subjects with mixed dentition and selected for clinical examination, clinical attachment loss (CAL) ≥3 mm at two or more periodontal sites...