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Sample records for periodontal treatment costs

  1. Adding smoking to the Fardal model of cost-effectiveness for the life-time treatment of periodontal diseases.

    Science.gov (United States)

    Fardal, Øystein; Grytten, Jostein; Martin, John; Ellingsen, Stig; Fardal, Patrick; Heasman, Peter; Linden, Gerard J

    2018-05-16

    Little is known about the financial costs that smoking adds to the life-time treatment of periodontal disease. The total life-time cost of periodontal treatment was modelled using data from private periodontal practice. The costs of initial and supportive therapy, re-treatment and tooth replacements (with bridgework or implants) were identified using average dental charges from the American Dental Association survey. Smoking costs at $6 and $10 for 20 cigarettes were compared to the costs of life-time periodontal treatment for stable and unstable compliant patients. Smoking added 8.8% to the financial cost of the life-time cost of periodontal therapy in stable maintenance patients, 40.1% in patients who needed one extra maintenance visit and 71.4% in patients who needed two extra maintenance visits per year in addition to added re-treatment. The cost of smoking far exceeded the cost of periodontal treatment; For patients who smoked 10 to 40 cigarettes per day at the cost of $6 or $10 a pack, the cost of smoking exceeded the cost of life-time periodontal treatment by between 2.7 and 17.9 times. Smoking 40 cigarettes at $10 a packet for 3.4 years would pay for the entire life-time cost of periodontal treatment. Smoking adds considerable extra financial costs to the life-time treatment of periodontal diseases. The cost of smoking itself exceeds the cost of periodontal therapy. This article is protected by copyright. All rights reserved. © 2018 American Academy of Periodontology.

  2. Therapeutic strategies in the treatment of periodontitis

    Directory of Open Access Journals (Sweden)

    Liljana Bogdanovska

    2012-04-01

    Full Text Available Periodontitis is a chronic inflammatory process which affects the tooth - supporting structures of the teeth. The disease is initiated by subgingival periopathogenic bacteria in susceptible periodontal sites. The host immune response towards periodontal pathogens helps to sustain periodontal disease and eventual alveolar bone loss. Although scaling and root planing is the standard treatment modality for periodontitis, it suffers from several drawbacks such as the inability to reach the base of deep pockets and doesn’t arrest migration of periodontal pathogens from other sites in the oral cavity. In order to overcome the limitations of scaling and root planning, adjunctive chemotherapeutics and host modulatory agents to the treatment are used. These therapeutic agents show substantial beneficial effects when compared to scaling and root planning alone. This review will cover an update on chemotherapeutic and past and future host immune modulatory agents used adjunctively to treat and manage periodontal diseases.

  3. Periodontal disease, periodontal treatment and systemic nitric oxide in dogs.

    Science.gov (United States)

    Nemec, A; Verstraete, F J M; Jerin, A; Šentjurc, M; Kass, P H; Petelin, M; Pavlica, Z

    2013-06-01

    Thirty-two client-owned dogs treated for periodontal disease were divided in group 1 if no periodontitis, group 2 if ≤25%, and group 3 if >25% of the teeth present were affected with periodontitis. Blood was tested before and 2 weeks after periodontal therapy for nitrosyl hemoglobin (HbNO), plasma nitrite/nitrate (NOx) and 3-nitrotyrosine (NT) levels. No HbNO was detected in any of the animals tested. There was no significant difference in the NOx plasma levels within each group or across the groups before and after the treatment, but a noticeable increase in NOx plasma levels was observed in group 3 after the treatment. Plasma NT was detected in only one third of the animals. NO levels varied greatly across individual dogs. The data are suggestive of an overall increase in systemic NO response 2 weeks after periodontal treatment in dogs with advanced periodontal disease, but the response is greatly individually-dependent. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Periodontal status and treatment needs of primary school teachers ...

    African Journals Online (AJOL)

    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.

  5. Oral conditions, periodontal status and periodontal treatment need of chronic kidney disease patients

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    Modupeoluwa Omotunde Soroye

    2016-01-01

    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.

  6. [Periodontal abscess: etiology, diagnosis and treatment].

    Science.gov (United States)

    Vályi, Péter; Gorzó, István

    2004-08-01

    The periodontal abscess is an acute destructive process in the periodontium resulting in localized collections of pus communicating with the oral cavity through the gingival sulcus or other periodontal sites and not arising from the tooth pulp. The prevalence of periodontal abscess is relatively high and it affects the prognosis of the tooth. Periodontal abscesses can develop on the base of persisting periodontitis but can also occur in the absence of periodontitis. The cause of the development of periodontal abscess originating from chronic periodontitis is the marginal closure of a periodontal pocket, or the pocket lumen might be too tight to drain the increased suppuration due to changes in the composition of subgingival microflora, alteration of bacterial virulence or host defenses. Diagnosis of a periodontal abscess is based on medical and dental history as well as oral examination (pocket depth, swelling, suppuration, mobility, sensibility of the tooth). The most prevalent group of bacteria: P. gingivalis, P. intermedia, B. forsythus, F. nucleatum and P. micros. Previous studies have suggested that the complete therapy of the periodontitis patients with acute periodontal abscess has to do in two stages: the first stage is the management of acute lesions, then the second stage is the appropriate comprehensive treatment of the original and/or residual lesions. The management of acute lesions includes establishing drainage via pocket lumen, subgingival scaling and root planing, curettage of the lining pocket epithelia and seriously inflamed connective tissue, compressing pocket wall to underlying tooth and periodontal support, and maintaining tissue contact. Some authors recommend the incision or to establish drainage and irrigation, or a flap surgery, or even extraction of hopeless teeth. We recommend the use of systemic antibiotics as a preventive measure of systemic disease or in case of systemic symptoms.

  7. Interdisciplinary Treatment of a Periodontally Compromised Adult

    Directory of Open Access Journals (Sweden)

    Kshitij Bansal

    2013-01-01

    Chronic periodontal disease create multitude of complications which needs to be treated by a team of dental specialists and not by one individual; in the best interest of the patients including their apprehensions, medical and oral conditions, time and cost.

  8. Treatment of periodontal abcess with Class II furcation involvement

    OpenAIRE

    Nur Rahmah; Arni Irawaty Djais

    2016-01-01

    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...

  9. Periodontal treatment outcomes during pregnancy and postpartum.

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    Moreira, Carlos Heitor Cunha; Weidlich, Patrícia; Fiorini, Tiago; da Rocha, José Mariano; Musskopf, Marta Liliana; Susin, Cristiano; Oppermann, Rui Vicente; Rösing, Cassiano Kuchenbecker

    2015-09-01

    This study was conducted to compare periodontal therapy outcomes during pregnancy and after delivery. One hundred nine pregnant women up to the 20th gestational week (GW) were randomized into two groups: the test group (comprehensive periodontal therapy during pregnancy) and the control group (comprehensive periodontal therapy after delivery). Periodontal examinations comprised plaque index (PI), gingival index (GI), periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and gingival crevicular fluid (GCF) volume. After baseline examination, women in the test group received periodontal treatment up to the 24th GW. The final examination was performed at the 26th to the 28th GW. Women in the control group were treated 30 days after delivery and reexamined 30 days after treatment. Periodontal therapy significantly reduced periodontal inflammation in both groups. The mean percentage of sites with BOP was reduced from 49.14 % (±22.49) to 11.10 % (±7.84) and from 45.71 % (±17.86) to 8.07 % (±5.21) in the test and control groups, respectively (p = 0.95). No statistically significant differences were observed between groups concerning PI, GI, PPD, CAL, and GCF. The reduction in mean percentage of sites with BOP stratified for initial PPD ≥4 mm was higher in the control group (p pregnancy do not interfere in treatment outcomes in women with widespread gingival inflammation and limited periodontal destruction. The role of these hormonal changes in pregnant women with different disease patterns remains uncertain. Periodontal health can be reestablished irrespective of the hormonal challenge that takes place during pregnancy.

  10. Honeybee propolis extract in periodontal treatment: A clinical and microbiological study of propolis in periodontal treatment

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    Amita Coutinho

    2012-01-01

    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.

  11. Periodontal treatment for preventing adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Schwendicke, Falk; Karimbux, Nadeem; Allareddy, Veerasathpurush

    2015-01-01

    OBJECTIVES: Periodontal treatment might reduce adverse pregnancy outcomes. The efficacy of periodontal treatment to prevent preterm birth, low birth weight, and perinatal mortality was evaluated using meta-analysis and trial sequential analysis. METHODS: An existing systematic review was updated...... risk of random errors. RESULTS: Thirteen randomized clinical trials evaluating 6283 pregnant women were meta-analyzed. Four and nine trials had low and high risk of bias, respectively. Overall, periodontal treatment had no significant effect on preterm birth (odds ratio [95% confidence interval] 0.......79 [0.57-1.10]) or low birth weight (0.69 [0.43-1.13]). Trial sequential analysis demonstrated that futility was not reached for any of the outcomes. For populations with moderate occurrence (periodontal treatment was not efficacious for any of the outcomes...

  12. Orthodontic treatment in patients with aggressive periodontitis.

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    Carvalho, Cássio Volponi; Saraiva, Luciana; Bauer, Flávio Paim Falcão; Kimura, Rui Yoshio; Souto, Maria Luisa Silveira; Bernardo, Carlos Cheque; Pannuti, Cláudio Mendes; Romito, Giuseppe Alexandre; Pustiglioni, Francisco Emílio

    2018-04-01

    Aggressive periodontitis (AP) is a condition that promotes breakdown of the periodontal tissues in a short time. In severe cases, pathologic migration of teeth and tooth loss can occur, producing esthetic and functional problems for the patient. Orthodontic treatment may be recommended to restore esthetics and masticatory function. We assessed the effects of orthodontic movement in the periodontal tissues of treated patients with AP. Ten subjects (ages 25.0 ± 5.22 years) with AP received periodontal treatment followed by orthodontic treatment. Maintenance sessions were performed monthly under a strict dental biofilm control. They were compared with 10 periodontally healthy subjects (ages 22.9 ± 5.23 years) who received orthodontic treatment. Probing pocket depth, clinical attachment level, bleeding on probing, and dental plaque index were measured at baseline, after orthodontic treatment, and after 4 months. Statistical analysis showed improvement in all clinical parameters between baseline and 4 months after orthodontic treatment: probing pocket depth (0.29 mm), clinical attachment level (0.38 mm), bleeding on probing (4.0%), and dental plaque index (11%). The periodontal parameters of the AP patients remained stable during orthodontic treatment under strict biofilm control. Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  13. Gene expression in periodontal tissues following treatment

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    Eisenacher Martin

    2008-07-01

    Full Text Available Abstract Background In periodontitis, treatment aimed at controlling the periodontal biofilm infection results in a resolution of the clinical and histological signs of inflammation. Although the cell types found in periodontal tissues following treatment have been well described, information on gene expression is limited to few candidate genes. Therefore, the aim of the study was to determine the expression profiles of immune and inflammatory genes in periodontal tissues from sites with severe chronic periodontitis following periodontal therapy in order to identify genes involved in tissue homeostasis. Gingival biopsies from 12 patients with severe chronic periodontitis were taken six to eight weeks following non-surgical periodontal therapy, and from 11 healthy controls. As internal standard, RNA of an immortalized human keratinocyte line (HaCaT was used. Total RNA was subjected to gene expression profiling using a commercially available microarray system focusing on inflammation-related genes. Post-hoc confirmation of selected genes was done by Realtime-PCR. Results Out of the 136 genes analyzed, the 5% most strongly expressed genes compared to healthy controls were Interleukin-12A (IL-12A, Versican (CSPG-2, Matrixmetalloproteinase-1 (MMP-1, Down syndrome critical region protein-1 (DSCR-1, Macrophage inflammatory protein-2β (Cxcl-3, Inhibitor of apoptosis protein-1 (BIRC-1, Cluster of differentiation antigen 38 (CD38, Regulator of G-protein signalling-1 (RGS-1, and Finkel-Biskis-Jinkins murine osteosarcoma virus oncogene (C-FOS; the 5% least strongly expressed genes were Receptor-interacting Serine/Threonine Kinase-2 (RIP-2, Complement component 3 (C3, Prostaglandin-endoperoxide synthase-2 (COX-2, Interleukin-8 (IL-8, Endothelin-1 (EDN-1, Plasminogen activator inhibitor type-2 (PAI-2, Matrix-metalloproteinase-14 (MMP-14, and Interferon regulating factor-7 (IRF-7. Conclusion Gene expression profiles found in periodontal tissues following

  14. Treatment of a Periodontic-Endodontic Lesion in a Patient with Aggressive Periodontitis.

    Science.gov (United States)

    Fahmy, Mina D; Luepke, Paul G; Ibrahim, Mohamed S; Guentsch, Arndt

    2016-01-01

    Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different treatment interventions. Practical Implication. Periodontic-endodontic lesions can be successfully treated if dental professionals follow a concerted treatment protocol that integrates endodontic and periodontic specialties. General dentists can be the gatekeepers in managing these cases.

  15. Treatment of a Periodontic-Endodontic Lesion in a Patient with Aggressive Periodontitis

    Directory of Open Access Journals (Sweden)

    Mina D. Fahmy

    2016-01-01

    Full Text Available Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different treatment interventions. Practical Implication. Periodontic-endodontic lesions can be successfully treated if dental professionals follow a concerted treatment protocol that integrates endodontic and periodontic specialties. General dentists can be the gatekeepers in managing these cases.

  16. The Trimeric Model: A New Model of Periodontal Treatment Planning

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    Tarakji, Bassel

    2014-01-01

    Treatment of periodontal disease is a complex and multidisciplinary procedure, requiring periodontal, surgical, restorative, and orthodontic treatment modalities. Several authors attempted to formulate models for periodontal treatment that orders the treatment steps in a logical and easy to remember manner. In this article, we discuss two models of periodontal treatment planning from two of the most well-known textbook in the specialty of periodontics internationally. Then modify them to arrive at a new model of periodontal treatment planning, The Trimeric Model. Adding restorative and orthodontic interrelationships with periodontal treatment allows us to expand this model into the Extended Trimeric Model of periodontal treatment planning. These models will provide a logical framework and a clear order of the treatment of periodontal disease for general practitioners and periodontists alike. PMID:25177662

  17. Treatment of a Periodontic-Endodontic Lesion in a Patient with Aggressive Periodontitis

    OpenAIRE

    Fahmy, Mina D.; Luepke, Paul G.; Ibrahim, Mohamed S.; Guentsch, Arndt

    2016-01-01

    Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different tr...

  18. Periodontic and orthodontic treatment in adults.

    Science.gov (United States)

    Ong, Marianne M A; Wang, Hom-Lay

    2002-10-01

    The purpose of this article is to provide an update of the interrelationship between periodontics and orthodontics in adults. Specific areas reviewed are the reaction of periodontal tissue to orthodontic forces, the influence of tooth movement on the periodontium, the effect of circumferential supracrestal fiberotomy in preventing orthodontic relapse, the effect of orthodontic treatment on the periodontium, microbiology associated with orthodontic bands, and mucogingival and esthetic considerations. In addition, the relationship between orthodontics and implants (eg, using dental implants for orthodontic anchorage) is discussed.

  19. Systemic antibiotics in the treatment of periodontitis.

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    Feres, Magda; Figueiredo, Luciene C; Soares, Geisla M Silva; Faveri, Marcelo

    2015-02-01

    Despite the fact that several clinical studies have shown additional benefits when certain systemic antibiotics are used as adjuncts to periodontal treatment, clear guidelines for the use of these agents in the clinical practice are not yet available. Basic questions concerning the use of systemic antibiotics to treat periodontitis remain unanswered, such as: which drug(s) should be used; which patients would most benefit from treatment; which are the most effective protocols (i.e. doses and durations); and in which phase of the mechanical therapy should the drug(s) be administered? Although not all of those questions have been directly addressed by controlled randomized clinical trials, recent concepts related to the ecology of periodontal diseases, as well as the major advances in laboratory and clinical research methods that have occurred in the past decade, have significantly broadened our knowledge in this field. This article endeavored to provide a 'state of the art' overview on the use of systemic antibiotics in the treatment of periodontitis, based on the most recent literature on the topic as well as on a compilation of data from studies conducted at the Center of Clinical Trials at Guarulhos University (São Paulo, Brazil) from 2002 to 2012. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Removable dental prosthesis as periodontal treatment method

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    Aprilia Adenan

    2007-11-01

    Full Text Available The objectives of prostheses are to restore mastication force, improve esthetics and maintain gingival health. The construction and function of prosthesis restoration are mutually interdependent with condition of periodontal tissues. A properly constructed prosthesis is an integral phase of complete treatment of periodontal disease in order to maintain periodontal tissues health. This paper reports case of a man aged 47 years who came to Dental Specialist Clinic in Oral and Dental Hospital Faculty of Dentistry Universitas Padjadjaran with chief complaint of mobility in almost all his teeth and they seems to look longer. The patient has no systemic disease and did not want his teeth to be extracted. Clinical and panoramic radiographic and laboratoris examinations has been done. During treatment, oclusal adjustment and splinting had been done on tooth 33,34,35 and tooth 44,43 also tooth 43,42 splinting with composite. The following treatment was the acrylic removable partial denture for upper jaw while mandible was fitted a frame denture which functioned as a semi permanent splint. One month post treatment, patien felt comfort and the denture was well functioning.

  1. Laser therapy in the periodontitis treatment

    International Nuclear Information System (INIS)

    Pinto Nancassa, Raul; Quintana Gonzalez, Julio; Rodriguez de Bernardo, Carlos; Hernandez Cruz, Hector; Hernandez Alvarez, Victor

    2009-01-01

    We performed a controlled clinical trial to evaluate the efficacy of low-power laser surgery combined with parodontal in the treatment of periodontitis in patients undergoing surgical treatment for this condition in the municipality of Moron North Clinic from February to July 2006. The world of work consisted of all patients diagnosed with periodontitis in this period of time were operated on at the Clinic of North County Moron (N = 86), leaving the sample for 80 patients. In patients where surgery was applied parodontal combined with low power laser radiation pain appeared in only a small number of cases 48 hours and none required the use of analgesics. For seven days the largest percentage of individuals submitted a total healing of soft tissue. No side effects to treatment. Patients treated with surgery parodontal, in whole required the use of analgesics in the first 24 hours and even at 72 hours after surgery in some patients, the seven days the number of patients with partial healing of the soft tissues was although the prevailing high total healing. There was no bone gain, the patients were stable, resulting in only stop. Statistically significant differences were found between groups suggesting that allowing the treatment of low-power laser in the surgery of periodontitis as well as being easy to apply proved to be effective. (Author)

  2. Community periodontal treatment needs in South Korea.

    Science.gov (United States)

    Lee, M-Y; Chang, S-J; Kim, C-B; Chung, W-G; Choi, E-M; Kim, N-H

    2015-11-01

    This study aimed to assess the relationship between socio-economic factors and community periodontal treatment needs in Korea. Data were obtained from the year 2009 Korean National Health and Nutrition Examination Survey. Our analysis included 7510 survey participants over the age of 19 years. To assess the relationship between socio-economic factors and the need for periodontal scaling, we performed multivariate logistic regression analyses for data with a complex sampling structure. PASW statistics 19.0 (SPSS Inc., Chicago, IL, USA) was used to perform the statistical analyses, and the results were expressed as odds ratios (OR) with corresponding 95% confidence intervals (CIs). A very high percentage of Korean adults required periodontal scaling (71.5%). After adjusting for sex, age, and socio-economic factors, the need for periodontal scaling was associated with low levels of education (OR: 1.41, 95% CI: 1.03-1.93), low incomes (OR: 1.27, 95% CI: 1.01-1.60), employment as a service and sales worker (OR: 1.39, 95% CI: 1.10-1.77), and employment as a manual worker (OR: 1.31, 95% CI: 1.02-1.69). In South Korea, the need for periodontal scaling was associated with socio-economic factors, such as low levels of education, low incomes, employment as a service and sales worker and employment as a manual worker. Consequently, clinical and community dental hygienists should consider adults with these risk factors as belonging to high-priority subgroups to whom they should respond first. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Application of ozone in the treatment of periodontal disease

    Science.gov (United States)

    Srikanth, Adusumilli; Sathish, Manthena; Sri Harsha, Anumolu Venkatanaga

    2013-01-01

    Gingivitis and periodontitis are most common inflammatory diseases of supporting tissues of teeth. Role of microbial etiology and host response in progression of gingival and periodontal diseases has been well established. Because of the beneficial biological effects of ozone, due to its antimicrobial and immunostimulating effect, it is well indicated in the treatment of gingival and periodontal diseases. The objective of this article is to provide a general review about clinical applications of ozone in treatment of periodontal diseases and to summarize the available in vitro and in vivo studies in Periodontics in which ozone has been used. PMID:23946585

  4. Endodontic, surgical and periodontal treatment of dens invaginatus. Case report.

    Science.gov (United States)

    Castellarin, M; Demitri, V; Politi, M

    2001-01-01

    The aim of this paper is to propose a single stage global treatment of endodontic, periapical and periodontal lesions in a lateral maxillary incisor with dens invaginatus. A 24 year-old woman presenting a lateral maxillary incisor with dens invaginatus in association with periapica1 and periodontal lesions underwent simultaneous surgical, endodontic and periodontal regenerative procedures. At 2, 6, 12, 18 months follow-up the radiographic healing appeared to be improved and the periapical lesion healed completely 1 year after surgical intervention. Surgery in association with endodontic and periodontal procedures represents the treatment of choice to maximize long term prognosis in cases of dens invaginatus with chronic periapical and periodontal lesions.

  5. Combined periodontic-orthodonticendodontic interdisciplinary approach in the treatment of periodontally compromised tooth

    OpenAIRE

    Deepa, D; Mehta, D. S.; Puri, Viren K.; Shetty, Sadashiva

    2010-01-01

    Orthodontic treatment in adult patients is one of the most frequently encountered components involving multidisciplinary approaches. In the present report, a 28-year-old male patient was treated for localized chronic periodontitis with pocket formation, mobility, pathologic migration and malalignment of maxillary left lateral incisor tooth #22. The periodontal therapy included motivation, education and oral-hygiene instructions (O.H.I.), scaling and root planing and periodontal flap surgery. ...

  6. Total anti-oxidant capacity of saliva in chronic periodontitis patients before and after periodontal treatment.

    Science.gov (United States)

    Shirzaiy, M; Ansari, S M; Dehghan, J H; Ghaeni, S H

    2014-01-01

    Periodontal disease is among the most common inflammatory conditions which is associated with many different factors. One of the contributing factors to the pathogenesis of this condition may compromise the defensive mechanism of antioxidants. The present study evaluates the antioxidant capacity of saliva in periodontal patients before and after periodontal treatment. In this cross sectional study, 31 patients systemically healthy non smokers with chronic periodontitis were recruited. The antioxidant capacity of saliva was measured before the initial phase of periodontal therapy and after completion of the treatment. Data were analyzed using SPSS 19 software. Paired T-Test, Independent sample T-test and ANOVA tests were used as appropriated. The mean and standard deviation antioxidant capacity of the saliva after the treatment.(0.962± 0.287µM)was significantly higher than before the treatment (0.655 ± 0.281 µM ,pperiodontal treatment was higher among men than among women; however, the difference was not significant (P=0.07). The mean difference of salivary antioxidant capacity was not significantly differed among different ages (P=0.772). The antioxidant capacity of saliva was higher after periodontal therapy among patients with periodontal disease, however the change was not varied across the ages and gender. Therefore, the alterations in the defensive mechanism of antioxidants could be the key factors contribute to the pathogenesis of periodontal diseases.

  7. Photodynamic dosimetry in the treatment of periodontitis

    Science.gov (United States)

    Andersen, Roger C.; Loebel, Nicolas G.; Andersen, Dane M.

    2009-06-01

    Photodynamic therapy has been demonstrated to effectively kill human periopathogens in vitro. However, the translation of in vitro work to in vivo clinical efficacy has been difficult due to the number of variables present in any given patient. Parameters such as photosensitizer concentration, duration of light therapy and amount of light delivered to the target tissue all play a role in the dose response of PDT in vivo. In this 121 patient study we kept all parameters the same except for light dose which was delivered at either 150 mW or 220 mW. This clearly demonstrated the clinical benefits of a higher light dose in the treatment of periodontitis.

  8. Effect of nonsurgical periodontal treatment in patients with periodontitis and rheumatoid arthritis: A systematic review

    Science.gov (United States)

    Silvestre-Rangil, Javier; Bagan, Leticia; Bagan, Jose V.

    2016-01-01

    Background Periodontitis has been regarded as a potential risk factor for rheumatoid arthritis (RA). A systematic review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in terms of the clinical activity and inflammatory markers of the disease. Material and Methods A search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical treatment in patients of this kind. The search was based on the following keywords: rheumatoid arthritis AND periodontitis (MeSH), rheumatoid arthritis AND periodontal treatment. Results Eight articles on the nonsurgical treatment of patients with periodontitis and RA were finally included in the study. All of them evaluated clinical (DAS28) and laboratory test activity (ESR, CRP, IL-6, TNFα) before and after treatment. A clear decrease in DAS28 score and ESR was recorded, while other parameters such as CRP, IL-6 and TNFα showed a non significant tendency to decrease as a result of treatment. Conclusions Nonsurgical treatment improved the periodontal condition of patients with periodontitis and RA, with beneficial effects upon the clinical and laboratory test parameters (DAS28 and ESR), while other inflammatory markers showed a marked tendency to decrease. However, all the studies included in the review involved small samples sizes and follow-up periods of no more than 6 months. Larger and particularly longitudinal studies are therefore needed to more firmly establish possible significant relations between the two disease processes. Key words:Periodontitis, rheumatoid arthritis, periodontal treatment. PMID:26946202

  9. Periodontal treatment reduces chronic systemic inflammation in peritoneal dialysis patients.

    Science.gov (United States)

    Siribamrungwong, Monchai; Yothasamutr, Kasemsuk; Puangpanngam, Kutchaporn

    2014-06-01

    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.

  10. Prevention and treatment of periodontal diseases in primary care.

    Science.gov (United States)

    Matthews, Debora C

    2014-09-01

    and the current standard of oral hygiene. Record the diagnosis, suggested treatment plan and details of costs. Document any discussions you have with the patient, for example, treatment options, risks and benefits of treatment, oral hygiene advice, smoking cessation, alcohol consumption and/or other lifestyle factors. There is a need for high-quality research carried out within an appropriate governance framework to improve the evidence base in the following areas: barriers and facilitators to the delivery of oral hygiene interventions in primary care;behaviour change interventions to improve inadequate oral hygiene;optimal timescales for provision of routine supra-gingival debridement (dental prophylaxis) and supportive periodontal therapy;effectiveness of supportive periodontal therapy regimens;effectiveness of supportive therapy regimens to maintain peri-implant tissues;effectiveness of interventions to treat peri-implant mucositis and peri-implantitis.Consensus is urgently required on the importance and validity of surrogate periodontal outcomes (eg bleeding on probing, changes in clinical probing depth and clinical attachment level and bone levels) and their relationship to true outcomes (eg tooth loss and patient-centred outcomes) so that consistency can be achieved across studies. There is also a need for independent research into the effectiveness of oral hygiene tools such as toothbrushes, interdental aids, toothpastes and mouthwashes and gels containing antibacterial agents.

  11. Aggressive periodontitis treatment with diabetes mellitus : A case report

    Directory of Open Access Journals (Sweden)

    Arni Irawaty Djais

    2016-06-01

    Full Text Available Aggressive periodontitis is a periodontal disease occurring in healthy adolescent which is characterized by rapid loss alveolar bone happened in more than one permanent tooth.This disease has been classified in two types: localized and generalized. Localized aggressive periodontitis is characteristized by bone loss around the first molar and incisal, while generalized aggressive periodontitis is characterized by bone widespread pattern of periodontal distraction. One of the clinical feature aggressive periodonitis is distolabial migration of the maxillary incisors with concomitant diastema  formation. Radiographic findings show alveolar bone loss extending from the distal surface of the second premolar to the mesial surface of the second molar. Diabetes mellitus (DM is one of the predisposition factors that cause infection. DM will increase quantity of bacteria in oral, which will cause destruction in periodontal tissue, and continue to cause tooth mobility. However, well controlled DM patients can decrease the infection. The purpose of this study is to to inform a case with aggressive periodontitis with diabetes mellitus. A male 36 old presented with chief complaint mobile teeth and esthetic problem teeth. Radiographic evidence of severe attachment loss and bone loss around almost all the teeth. Treatment consisted of consulted to internist to control blood glucose level, periodontal pocket treatment with scalling root planing, splinting, flap surgery and antibiotic administration. The patient’s periodontal condition was stablized post treatment. Controlling oral hygiene to preventive disease progression was scheduled every three months. Patient refered to ortodontist to get ortodontic treatment to get esthetic result.

  12. Pattern of surgical periodontal treatment in a Nigerian Teaching Hospital: A 37 month review

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    Clement Chinedu Azodo

    2016-01-01

    Conclusion: Periodontal abscess and gingival enlargement constituted the main indications for surgical periodontal treatment while incision and drainage and gingivectomy were the main surgical periodontal treatments in this study.

  13. Bromelain: A potential strategy for the adjuvant treatment of periodontitis

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    Felipe Rodolfo Pereira da Silva

    2016-01-01

    Full Text Available Introduction: Bromelain, a mixture of proteases derived from different parts of pineapple, has been described to have therapeutic benefits in a diversity of inflammatory diseases. Such effects are associated to its proteolytic activity. As one of the most common and multifactorial diseases, periodontitis is a bacterial infection that results from the damage to the integrity of the tissues around the tooth, which includes gingiva, periodontal ligament, and alveolar bone. In periodontitis, the recruitment of defense cells occurs, which releases several pro-inflammatory cytokines. At elevated levels, they can potentiate the alveolar bone loss. Studies have been conducted trying to alleviate the damage to the periodontium, however, the regeneration of the periodontal tissues is still limited. The Hypotheses: Based on previous studies showing that bromelain can act by decreasing the periodontal microorganism growth by proteolytically cleaving important cell surface molecules in leucocytes, by reducing neutrophils migration to periodontal sites, by downregulating the inflammation mediator levels, and by decreasing alveolar bone loss in the periodontitis. Evaluation of the Hypothesis: In a first moment, to evaluate this hypothesis, could be used two animal models: the ligature or bacteria inoculation induced periodontitis. If studies using animal models show encouraging results, appropriate clinical trials should be designed to evaluate the effect of bromelain as a complementary treatment for periodontal disease in humans, during the active phase or after the healing phase of mechanical therapy could be tested; to conduct a placebo-controlled study where health and periodontitis patients could be used.

  14. Treatment of periodontal abcess with Class II furcation involvement

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    Nur Rahmah

    2016-06-01

    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.

  15. The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis.

    Science.gov (United States)

    Gaunt, Francesca; Devine, Maria; Pennington, Mark; Vernazza, Chris; Gwynnett, Erika; Steen, Nick; Heasman, Peter

    2008-09-01

    To systematically evaluate the evidence for effectiveness of supportive periodontal care (SPC) provided in specialist care and general practice for patients with chronic periodontitis; to construct a model for the cost effectiveness of SPC. Electronic database searches of MEDLINE, EMBASE and SCOPUS were performed with hand searching of relevant journals and Workshops of Periodontology. SPC for patients with chronic periodontitis, at least 12 months follow-up and clinical attachment level as a primary outcome. Three articles addressed the question (Nyman et al. 1975, Axelsson & Lindhe 1981, Cortellini et al. 1994): Deltas CAL for patients undergoing "specialist" SPC were 0.1 mm (2 years), 0.2 mm (6 years) and -0.01 mm (3 years) respectively. In generalist care the Deltas CAL during SPC were -2.2, -1.8 and -2.8 mm. Differences between specialist and generalist SPC were an extra 20.59 tooth years and 3.95 mm attachment loss for generalist SPC. Incremental cost-effectiveness ratios were an extra 288 euros for one tooth year or an extra 1503 euros/1 mm reduction in loss of attachment for SPC delivered in specialist care. SPC delivered in specialist as compared with general practice will result in greater stability of clinical attachment but this will be achieved at relatively greater cost.

  16. Periodontal parameters following orthodontic treatment in patients with aggressive periodontitis: A before-after clinical study

    Science.gov (United States)

    Khorsand, Afshin; Paknejad, Mojgan; Yaghobee, Siamak; Ghahroudi, Amir Alireza Rasouli; Bashizadefakhar, Hourieh; Khatami, Masoomeh; Shirazi, Mohsen

    2013-01-01

    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

  17. [Effect of periodontal mechanical treatment on periodontal pathogenic bacteria in gingival crevicular fluid of chronic periodontitis patients].

    Science.gov (United States)

    Ding, Fang; Meng, Huan-xin; Li, Qi-qiang; Zhao, Yi-bing; Feng, Xiang-hui; Zhang, Li

    2010-04-18

    To evaluate the subgingival prevalent rates of 6 periodontal pathogenic bacteria in gingival crevicular fluids of CP patients before and after treatment, to analyze the relationship between the prevalent variance and periodontal clinical parameters, and to provide a microbiologic method of evaluating curative effect and estimating the prognosis. Gingival crevicular fluids of 13 CP patients were collected at baseline, 2 weeks, 2 months and 4 months after periodontal mechanical treatment. Also, gingival crevicular fluids were collected from 11 healthy subjects. Six periodontal pathogenic bacteria including Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis(Pg), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Fusobacterium nucleatum(Fn), Prevotella nigrescens (Pn) were detected by 16S rRNA based PCR. The PLI, PD, BI of the CP patients 2 months and 4 months after periodontal mechanical treatment were evidently less than those before treatment. These 4 months after treatment were a little more than those 2 months after. The six bacteria were more frequently detected in the CP patients at baseline than in healthy controls. The prevalent rates of Tf (42.1%, 73.7%, 70.2%), Pg (47.4%, 68.4%, 77.2%), Aa (15.8%, 22.8%, 7.0%), Pn (38.6%, 57.9%, 64.9%), Pi(15.8%, 38.6%, 42.1%) 2 weeks, 2 months and 4 months following treatment were significantly lower than those at baseline (Tf 96.5%, Pg 93.0%, Aa 36.8%, Pn 86.0%, Pi 84.2%), but the prevalent rates of all the detected bacteria 2 months after treatment were higher than those at 2 weeks after. Tf, Pg, Aa, Pn and Pi may cooperate in the development of CP. The changes of periodontal pathogenic bacteria could be detected before the changes of clinical parameters and the patients should be re-evaluated and re-treated regularly within 2 months after treatment.

  18. Combined periodontic-orthodonticendodontic interdisciplinary approach in the treatment of periodontally compromised tooth.

    Science.gov (United States)

    Deepa, D; Mehta, D S; Puri, Viren K; Shetty, Sadashiva

    2010-04-01

    Orthodontic treatment in adult patients is one of the most frequently encountered components involving multidisciplinary approaches. In the present report, a 28-year-old male patient was treated for localized chronic periodontitis with pocket formation, mobility, pathologic migration and malalignment of maxillary left lateral incisor tooth #22. The periodontal therapy included motivation, education and oral-hygiene instructions (O.H.I.), scaling and root planing and periodontal flap surgery. Subsequently on resolution of periodontal inflammation, orthodontic therapy was carried out using the orthodontic aligner for a period of 6 months. Post-treatment (3 years) results showed complete resolution of infrabony pocket with significant bone fill, reduced tooth mobility and complete alignment of the affected maxillary left lateral incisor, thus restoring the esthetics and function.

  19. Combined periodontic-orthodontic-endodontic interdisciplinary approach in the treatment of periodontally compromised tooth

    Directory of Open Access Journals (Sweden)

    Deepa D

    2010-01-01

    Full Text Available Orthodontic treatment in adult patients is one of the most frequently encountered components involving multidisciplinary approaches. In the present report, a 28-year-old male patient was treated for localized chronic periodontitis with pocket formation, mobility, pathologic migration and malalignment of maxillary left lateral incisor tooth #22. The periodontal therapy included motivation, education and oral-hygiene instructions (O.H.I., scaling and root planing and periodontal flap surgery. Subsequently on resolution of periodontal inflammation, orthodontic therapy was carried out using the orthodontic aligner for a period of 6 months. Post-treatment (3 years results showed complete resolution of infrabony pocket with significant bone fill, reduced tooth mobility and complete alignment of the affected maxillary left lateral incisor, thus restoring the esthetics and function.

  20. Periodontitis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001059.htm Periodontitis To use the sharing features on this page, please enable JavaScript. Periodontitis is inflammation and infection of the ligaments and ...

  1. Orthodontic treatment in patients with reduced periodontal insertion

    Directory of Open Access Journals (Sweden)

    Fernanda Labayle Couhat Carraro

    2009-12-01

    Full Text Available The aim of this study was to conduct a literature review to investigate orthodontic treatment in periodontal patients. Periodontal disease causes loss of attachment that results in pathological dental migration Periodontal disease can affect young persons and adults, with a higher incidence in adults, so that the number of adults seeking orthodontic treatment has increased significantly. The periodontal disease must be controlled before the orthodontic treatment begins, and during the treatment it is important to keep the patient motivated as regards control of oral hygiene, with periodical reviews by the periodontist. With regard to assembly of the fixed appliance, special care is required not to place the accessories close to the gingival margin, in addition to using light forces porportional to the amount of periodontal attachment, and kept within the biological limits of movement. Correction of the poorly positioned teeth and controlled orthodontic movement can favor remodeling of the alveolar process in all directions. After orthodontic treatment it is important plan containment individually. Integrated orthodontic-periodontal teamwork is essential for reestablishing a healthy periodontium and satisfactory occlusion.

  2. [Magnetic therapy for complex treatment of chronic periodontal disease].

    Science.gov (United States)

    P'yanzina, A V

    The aim of the study was to elaborate the methodology of magnetic therapy for complex treatment of chronic periodontal disease (CPD). The study included 60 patients aged 35 to 65 years with moderate CPD divided in 2 groups. Patients in group 1 (controls) received impulse carbonate irrigation for 12 min №10, group 2 additionally received magnetic therapy for 5 min №10 in maxillary and mandibular areas. periodontal and rheological indices proved magnetic therapy to be useful tool for eradication of inflammation, periodontal tissue functional recovery and stabilization.

  3. Periodontal treatment in a generalized severe chronic periodontitis patient: A case report with 7-year follow-up.

    Science.gov (United States)

    Agrali, Omer Birkan; Kuru, Bahar Eren

    2015-01-01

    The aim of the periodontal treatment is to provide healthy and functional dentition all through a lifetime. In this report, periodontal treatment of a 42-year-old male patient with generalized severe chronic periodontitis is presented. He received initial periodontal treatment together with adjunctive antimicrobials. The devital teeth were endodontically treated, and free gingival grafts were placed at the inadequate keratinized tissue zones before regenerative surgery. Following the surgical treatment using enamel matrix derivatives and xenogenic bone graft combination, the patient was put on a strict recall program. After 12 months, favorable clinical and radiographical improvements were obtained. The 7-year maintenance of the present case with several initially hopeless teeth has been shown and discussed in this report. It can be concluded that optimum oral hygiene level as well as the positive cooperation of the patient enhanced the success of periodontal treatment results even in extremely severe periodontal destruction.

  4. Effect of nonsurgical periodontal treatment on C-reactive protein levels in maintenance hemodialysis patients.

    Science.gov (United States)

    Yazdi, Farin Kiany; Karimi, Noozhan; Rasouli, Manoochehr; Roozbeh, Jamshid

    2013-01-01

    C-reactive protein (CRP) has been implicated as a possible mediator of the association between periodontitis and several systemic diseases. This study evaluated the impact of nonsurgical periodontal treatment on the serum levels of CRP in chronic kidney disease (CKD) patients on hemodialysis. A total of 77 CKD patients on hemodialysis were included in this study. At baseline, periodontal examination was assessed for all the patients, and chronic periodontitis was defined through clinical attachment level and probing pocket depth, according to the American Association of Periodontology. Nonsurgical periodontal treatment was performed and serum levels of CRP were evaluated at baseline and 8 weeks after periodontal treatment. Periodontal treatment resulted in significant reductions in CRP levels (p periodontitis. Periodontitis is an important source of systemic inflammation in CKD patients. Nonsurgical periodontal treatment can effectively reduce the serum level of CRP in these patients.

  5. Influence of periodontal treatment on subgingival and salivary microbiotas

    DEFF Research Database (Denmark)

    Belstrøm, Daniel; Grande, Maria Anastasia; Sembler-Møller, Maria Lynn

    2018-01-01

    BACKGROUND: The purpose of this study was to characterize and compare subgingival and salivary microbiotas before and after periodontal treatment to learn if any changes of the subgingival microbiota were reflected in saliva. We tested the hypothesis that salivary levels of specific periopathogens...... correlate with corresponding subgingival levels before and after periodontal treatment. METHODS: Twenty-five patients with generalized chronic periodontitis completed the study. Stimulated saliva samples and subgingival plaque samples were collected at baseline and 2, 6 and 12 weeks after non......-surgical periodontal therapy. Subgingival and salivary microbiotas were processed by means of the Human Oral Microbe Next Generation Sequencing (HOMINGS) technique, and characterized based on relative abundance. Spearman signed rank test was used to test correlation of periopathogens in subgingival and saliva samples...

  6. Adjunctive Intracoronal Splint in Periodontal Treatment: Report of Two Cases

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    Mora Octavia

    2015-05-01

    Full Text Available Reduction of the amount of tooth roots which are embedded in their periodontium could cause tooth mobility. Splinting a weaker tooth with a more stable one, and using the principle of the multiple-root stabilization is one way to overcome tooth mobility. Temporary splinting aims to prevent pathological migration, restore masticatory function, stabilize teeth before/after surgery, and evaluate the prognosis of periodontal treatment. The use of intracoronal splint is still controversial because there are only a few studies that have evaluated the effect of splinting on periodontal health. We report two cases to evaluate the effect of intracoronal splint on periodontal treatment. Two periodontal cases that use intracoronal splint before, during, and after periodontal regenerative therapy using bone graft. Causes of tooth mobility were removed and the splinting principles, terms and guidelines were mastered to get the maximum results of periodontal treatment. Both cases were evaluated radiographically 10 months after treatment. In these cases, intracoronal splint has supported the therapy before, during, or after surgery. Splinting is only for adjunctive therapy, and does not serve as the sole method in getting occlusal stability.DOI: 10.14693/jdi.v21i3.193

  7. Compliance with Supportive Periodontal Treatment in Patients with Dental Implants.

    Science.gov (United States)

    Hu, Kai-Fang; Lin, Ying-Chu; Ho, Kun-Yen; Chou, Yu-Hsiang

    The need for dental implants is increasing, and supportive periodontal treatment can achieve long-term success and prevent peri-implantitis. Contributing factors to noncompliance with long-term scheduled supportive periodontal treatment remain unclear. To investigate whether demographic and clinical characteristics are associated with noncompliance, the authors analyzed data for patients who had received dental implants. The authors recruited patients participating in a supportive periodontal treatment program after receiving permanent prostheses on implants placed from 2005 to 2013. Demographic data and dental treatment histories were collected. Compliance was defined as a record of participation in a standard supportive periodontal treatment program for at least 1 year. The chi-square test, log-rank test, Kaplan-Meier survival curve, and Cox proportional hazards model were used for statistical analysis. The study included 120 patients (259 implants, 60% compliance). The two groups (compliant and noncompliant) differed significantly in frequency distributions for sex (P = .0017), educational level (P = .0325), and histories of substance use (P = .0016), periodontitis (P = .0005), and root planing or flap surgery (P = .0002). The Kaplan-Meier survival curves and log-rank test showed that increases in cumulative continuation rates were significantly associated with male sex (P = .0025); body mass index ≥ 24 kg/m² (P = .0093); and a history of periodontitis (P implant placement, root planing or flap surgery was the crucial factor in determining compliance with supportive periodontal treatment. However, well-designed large-scale studies with a larger sample size are needed to confirm the findings of this study.

  8. Efficacy of combined orthodontic-periodontic treatment for patients with periodontitis and its effect on inflammatory cytokines: A comparative study.

    Science.gov (United States)

    Zhang, Jin; Zhang, Ai-Min; Zhang, Zong-Mei; Jia, Jin-Lin; Sui, Xin-Xin; Yu, Lu-Rui; Liu, Hai-Tao

    2017-10-01

    In this study, we aimed to investigate the efficacy of combined orthodontic-periodontic treatment in the treatment of patients with periodontitis and its effects on the levels of inflammatory cytokines. A total of 117 patients with periodontitis were randomly assigned to the basic group (receiving basic periodontic treatment, n = 58) and the combined group (receiving combined orthodontic-periodontic treatment, n = 59). In addition, 52 healthy people without periodontal disease were selected as the normal group. Probing depth, tooth mobility, plaque index, clinical attachment level, and sulcus bleeding index were recorded. ELISA was applied to detect gingival crevicular fluid (GCF) and serum levels of inflammatory cytokines. A 2-year clinical follow-up was conducted. Before treatment, the periodontal parameters (probing depth, tooth mobility, plaque index, clinical attachement level, and sulcus bleeding index) and GCF and serum levels of inflammatory cytokines (high-sensitivity C-reactive protein, interleukin-1β, interleukin-5, interleukin-6, interleukin-8, tumor necrosis factor-α, and prostaglandin E2) in the combined and basic groups were higher than those in the normal group. After 6 and 18 months of treatment, the periodontal parameters and GCF and serum levels of inflammatory cytokines decreased in the combined and basic groups. The periodontal parameters and the GCF and serum levels of inflammatory cytokines in the combined group were significantly lower than those in the basic group after 18 months of treatment. The combined group had a lower recurrence rate compared with the basic group. Combined orthodontic-periodontic treatment had good clinical efficacy in the treatment of periodontitis and could effectively decrease the levels of inflammatory cytokines. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  9. Orthodontic treatment simultaneous to or after periodontal cause-related treatment in periodontitis susceptible patients. Part I: Clinical outcome. A randomized clinical trial.

    Science.gov (United States)

    Zasčiurinskienė, Eglė; Basevičienė, Nomeda; Lindsten, Rune; Slotte, Christer; Jansson, Henrik; Bjerklin, Krister

    2018-02-01

    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.

  10. Poor Response to Periodontal Treatment May Predict Future Cardiovascular Disease.

    Science.gov (United States)

    Holmlund, A; Lampa, E; Lind, L

    2017-07-01

    Periodontal disease has been associated with cardiovascular disease (CVD), but whether the response to the treatment of periodontal disease affects this association has not been investigated in any large prospective study. Periodontal data obtained at baseline and 1 y after treatment were available in 5,297 individuals with remaining teeth who were treated at a specialized clinic for periodontal disease. Poor response to treatment was defined as having >10% sites with probing pocket depth >4 mm deep and bleeding on probing at ≥20% of the sites 1 y after active treatment. Fatal/nonfatal incidence rate of CVD (composite end point of myocardial infarction, stroke, and heart failure) was obtained from the Swedish cause-of-death and hospital discharge registers. Poisson regression analysis was performed to analyze future risk of CVD. During a median follow-up of 16.8 y (89,719 person-years at risk), those individuals who did not respond well to treatment (13.8% of the sample) had an increased incidence of CVD ( n = 870) when compared with responders (23.6 vs. 15.3%, P 4 mm, and number of teeth, the incidence rate ratio for CVD among poor responders was 1.28 (95% CI, 1.07 to 1.53; P = 0.007) as opposed to good responders. The incidence rate ratio among poor responders increased to 1.39 (95% CI, 1.13 to 1.73; P = 0.002) for those with the most remaining teeth. Individuals who did not respond well to periodontal treatment had an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.

  11. Interleukin-32 levels in gingival crevicular fluid and saliva of patients with chronic periodontitis after periodontal treatment.

    Science.gov (United States)

    Öngöz Dede, F; Balli, U; Bozkurt Doğan, Ş; Güven, B

    2017-06-01

    The cytokine, interleukin (IL)-32, is a relatively new discovery. However, it is very powerful for stimulating tumor necrosis factor-alpha (TNF-α) under inflammatory conditions. The objective of this research was to explore fluctuations in the levels of TNF-α, IL-32 and IL-10, in both saliva and gingival crevicular fluid. The focus was on measurements taken before and after clinical treatment of chronic periodontitis. For the purposes of the study, a total of 27 patients with chronic periodontitis and 27 controls (periodontally healthy) were recruited. Important clinical periodontal criteria were established before and 4 wk after the start of the research. The chronic periodontitis group was given an initial form of periodontal care. Samples of saliva and gingival crevicular fluid were collected exactly 4 wk preceding and 4 wk following the care. The levels of IL-10, IL-32 and TNF-α present in saliva and gingival crevicular fluid were recorded via the use of an ELISA. At baseline, the levels of TNF-α and IL-32 in the gingival crevicular fluid and saliva were significantly higher among patients in the chronic periodontitis group than among patients in the control group (p chronic periodontitis group than the control group (p chronic periodontitis group when compared with the baseline readings. However, the levels of IL-10 were significantly higher (p periodontitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Endodontic and periodontal treatments of a geminated mandibular first premolar.

    Science.gov (United States)

    Aryanpour, S; Bercy, P; Van Nieuwenhuysen, J-P

    2002-02-01

    To describe a rare case of gemination involving a mandibular first premolar. The complex morphology of geminated teeth renders their endodontic and periodontal management difficult. Root canal and periodontal treatments were performed on a geminated mandibular first premolar with three canals. Clinical examination showed two separated crowns with united roots. Radiographically, two distinct pulp chambers with two joined and a third independent canal were seen. Conventional root canal treatment resulted in complete healing of the apical lesion. However, the occurrence of a vertical fracture led to the extraction of the mesial segment. At the follow-up visit, the distal segment was clinically healthy and continued to satisfy functional demands.

  13. Treatment of periodontal disease during pregnancy: a randomized controlled trial.

    Science.gov (United States)

    Newnham, John P; Newnham, Ian A; Ball, Colleen M; Wright, Michelle; Pennell, Craig E; Swain, Jonathan; Doherty, Dorota A

    2009-12-01

    To investigate whether treating periodontal disease prevents preterm birth and other major complications of pregnancy. This single-center trial was conducted across six obstetric sites in metropolitan Perth, Western Australia. Pregnant women identified by history to be at risk (n=3,737) were examined for periodontal disease. Approximately 1,000 women with periodontal disease were allocated at random to receive periodontal treatment commencing around 20 weeks of gestation (n=542) or 6 weeks after the pregnancy was completed (controls; n=540). The treatment included mechanical removal of oral biofilms together with oral hygiene instruction and motivation at a minimum of three weekly visits, with further visits if required. There were no differences between the control and treatment groups in preterm birth (9.3% compared with 9.7%, odds ratio [OR] 1.05, 95% confidence interval [CI 0.7-1.58], P=.81), birth weight (3,450 compared with 3,410 g, P=.12), preeclampsia (4.1% compared with 3.4%, OR 0.82, 95% CI 0.44-1.56, P=.55), or other obstetric endpoints. There were four unexplained stillbirths in the control group and no pregnancy losses in the treated group (P=.12). Measures of fetal and neonatal well-being were similar in the two groups, including abnormalities in fetal heart rate recordings (P=.26), umbilical artery flow studies (P=.96), and umbilical artery blood gas values (P=.37). The periodontal treatment was highly successful in improving health of the gums (Pperiodontal disease during pregnancy in this population prevents preterm birth, fetal growth restriction, or preeclampsia. Periodontal treatment was not hazardous to the women or their pregnancies. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00133926. I.

  14. The significance of motivation in periodontal treatment: the influence of adult patients' motivation on the clinical periodontal status.

    Science.gov (United States)

    Oruba, Z; Pac, A; Olszewska-Czyż, I; Chomyszyn-Gajewska, M

    2014-09-01

    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).

  15. Differential diagnosis and treatment of periodontitis-mimicking actinomycosis.

    Science.gov (United States)

    Kim, Nam Ryang; Park, Jun-Beom; Ko, Youngkyung

    2012-12-01

    Actinomycosis is an uncommon chronic granulomatous disease that presents as a slowly progressive, indolent, indurated infiltration with multiple abscesses, fistulas, and sinuses. The purpose of this article is to report on a case of actinomycosis with clinical findings similar to periodontitis. A 46-year-old female presented with recurrent throbbing pain on the right first and second molar of the mandible three weeks after root planing. Exploratory flap surgery was performed, and the bluish-gray tissue fragment found in the interproximal area between the two molars was sent for histopathology. The diagnosis from the biopsy was actinomycosis. The clinical and radiographic manifestations of this case were clinically indistinguishable from periodontitis. The patient did not report any symptoms, and she is scheduled for a follow-up visit. The present study has identified periodontitis-mimicking actinomycosis. Actinomycosis should be included in the differential diagnosis in cases with periodontal pain and inflammation that do not respond to nonsurgical treatment for periodontitis. More routine submissions of tissue removed from the oral cavity for biopsies may be beneficial for differential diagnosis.

  16. [Reciprocal relationships between orthodontics and periodontics in esthetic treatments].

    Science.gov (United States)

    Monnet-Corti, Virginie; Barrin, Arnaud; Goubron, Cyril

    2012-06-01

    The objective of this article is to review various unsightly periodontal defects and the treatments that have previously been used to eliminate them in order to establish guidelines for future therapy. The inter-relationship between orthodontic and periodontal disciplines is well established and needs no defense here. Periodontal tissues change throughout life and the same is true for the smile. The periodontium is an essential component of the appearance of the face as well as the lips. These are dynamic esthetic criteria while the gingiva and the static character of the dentition also contribute to the character of an individual's smile. In order to conduct orthodontic therapy most effectively it is essential that orthodontists and periodontists utilize a coordinated approach. From the beginning, they must establish an etiological diagnosis of any esthetic defects that will insure that their joint therapy is conducted appropriately and at the proper moment. © EDP Sciences, SFODF, 2012.

  17. The significance of motivation in periodontal treatment: validity and reliability of the motivation assessment scale among patients undergoing periodontal treatment.

    Science.gov (United States)

    Pac, A; Oruba, Z; Olszewska-Czyż, I; Chomyszyn-Gajewska, M

    2014-03-01

    The individual evaluation of patients' motivation should be introduced to the protocol of periodontal treatment, as it could impact positively on effective treatment planning and treatment outcomes. However, a standardised tool measuring the extent of periodontal patients' motivation has not yet been proposed in the literature. Thus, the objective of the present study was to determine the validity and reliability of the Zychlińscy motivation scale adjusted to the needs of periodontology. Cross sectional study. Department of Periodontology and Oral Medicine, Dental University Clinic, Jagiellonian University, Krakow, Poland. 199 adult periodontal patients, aged 20-78. 14-item questionnaire. The items were adopted from the original Zychlińscy motivation assessment scale. Validity and reliability of the proposed motivation assessment instrument. The assessed Cronbach's alpha of 0.79 indicates the scale is a reliable tool. Principal component analysis revealed a model with three factors, which explained half of the total variance. Those factors represented: the patient's attitude towards treatment and oral hygiene practice; previous experiences during treatment; and the influence of external conditions on the patient's attitude towards treatment. The proposed scale proved to be a reliable and accurate tool for the evaluation of periodontal patients' motivation.

  18. Smoking Habit and Self Reported Periodontal Treatment Experience ...

    African Journals Online (AJOL)

    This study ai 's to determine by questionnaire the prevalence of smoking and its associated sociodemographic factors in adult dentate populations in Southwestern Nigeria and to examine self reported periodontal treatment experience between smokers and nonsmokers. A descriptive study of prevalence of smoking and ...

  19. Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: before or during pregnancy?

    Science.gov (United States)

    Xiong, Xu; Buekens, Pierre; Goldenberg, Robert L; Offenbacher, Steven; Qian, Xu

    2011-08-01

    Several large randomized controlled clinical trials failed to find that standard periodontal therapy during pregnancy reduces the incidence of adverse pregnancy outcomes (eg, preterm birth and low birthweight). However, treating periodontal disease during pregnancy may be too late to reduce the inflammation that is related to the adverse pregnancy outcomes. Moreover, periodontal treatment during pregnancy can cause bacteremia, which itself may initiate the pathway leading to the adverse pregnancy outcomes. Finally, the periodontal treatments provided during pregnancy are not always effective in preventing the progression of periodontal disease during pregnancy. Pregnancy may not be an appropriate period for periodontal intervention(s). We hypothesize that periodontal treatment before pregnancy may reduce the rates of adverse pregnancy outcomes. Future randomized controlled trials are needed to test if treating periodontal disease in the prepregnancy period reduces the rate of adverse pregnancy outcomes. Copyright © 2011 Mosby, Inc. All rights reserved.

  20. A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis

    Science.gov (United States)

    2015-01-01

    Purpose With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (Porthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients’ periodontal health irrespective of orthodontic techniques. PMID:26734489

  1. Effect of smoking and periodontal treatment on the subgingival microflora : A retrospective study

    NARCIS (Netherlands)

    Van der Velden, U; Varoufaki, A; Hutter, JW; Xu, L; Timmerman, MF; Van Winkelhoff, AJ; Loos, BG

    Background: The effect of smoking on the prevalence of periodontal pathogens after periodontal treatment is still not clear. Some studies found no effect of the smoking status on the prevalence of periodontal pathogens after therapy, whereas others did. The aim of this retrospective study was to

  2. [Interpretation of consensuses on treatment of female patients with periodontal disease].

    Science.gov (United States)

    Wu, Y F

    2017-02-09

    Periodontal tissue is the target tissue of sex hormone, physiological change of sex hormones affects the response of periodontal tissue to bacterial plague. The treatment of periodontal disease of female patients in special periods such as adolescence, menstruation, prepregnancy, pregnancy, puerperium, and menopause should be chosen carefully and correctly. This article attempts to expound these issues.

  3. Stem-cells used in treatment of periodontal bone defects

    International Nuclear Information System (INIS)

    Perez Borrego, Amparo; Dominguez Rodriguez, Libia; Ilisastigui Ortueta, Zaida Teresa; Hernandez Ramirez, Porfirio

    2009-01-01

    The aggressive periodontitis might to provoke the tooth loss, of its function and to affect the patient's aesthetics. The techniques used for the lost bone regeneration, not always are successful and in occasions are very expensive. For years it is working in tissues regeneration by stem-cells implantation. Periodontium could be a potential for this task. This is a study of a female patient aged 26 with an apparent health status and aggressive periodontitis backgrounds treated from 10 years ago, seen in our service due to dental mobility producing mastication nuisances. At clinical examination we noted systemic chronic inflammation of gums, grade II and III dental mobility in incisives and molars teeth, 4-8 mm systemic periodontal sacs and furcation lesions in inferior molars. At radiographs advanced bone losses and a decrease of systemic bone density are noted. After written consent and the initial preparation, we carried out a periodontal flap in the 35 and 37 teeth zone, where the stem-cells concentrate was placed, in bone defects of superior molars (16-17) and previous radicular scraping and isolation, treatment consisted in stem-cells perfusion without flap. There were not postoperative side effects. At 7 days there was a normal coloration, at three months on noted at radiograph a bone neoformation, and at six months gum remained healthy, with a decrease of dental mobility in segment treated and in the evolutionary radiograph it was evidenced the formation and increase of density

  4. Periodontal health during clear aligners treatment: a systematic review.

    Science.gov (United States)

    Rossini, Gabriele; Parrini, Simone; Castroflorio, Tommaso; Deregibus, Andrea; Debernardi, Cesare L

    2015-10-01

    Clear aligner treatment (CAT) has been cited as a safe and comfortable orthodontic procedure for adult patients. However, the available evidence is scarce. To perform a systematic review of the existing literature in order to assess periodontal health during CAT. Pubmed, Pubmed Central, National Library of Medicine's Medline, Embase, Cochrane Central Register of Controlled Clinical trials, Web of Knowledge, Scopus, Google Scholar, and LILACS were searched from January 1945 to September 2014 to identify all peer-reviewed papers potentially relevant to the review. After duplicate selection and extraction procedures, the risk of bias was assessed according to the Centre for Reviews and Dissemination criteria, and a 3-point grading system, as described by the Swedish Council on Technology Assessment in Health Care (SBU), was used to rate the methodological quality of the selected papers. A PICOS table was used for data extraction. Five relevant articles were selected from the 1247 identified articles. The level of evidence was moderate for all the studies. A significant improvement of the periodontal health indexes was revealed, in particular when CAT was compared to fixed appliances. No periodontal CAT adverse effects were observed in the selected studies. Periodontal health indexes were significantly improved during CAT. The results of this review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  5. Treatment of chronic periodontitis and its impact on mastication.

    Science.gov (United States)

    Pereira, Luciano J; Gazolla, Cátia M; Magalhães, Isabela B; Ramos-Jorge, Maria Letícia; Marques, Leandro S; Gameiro, Gustavo H; Fonseca, Douglas C; Castelo, Paula M

    2011-02-01

    The aim of the present study is to assess the impact of conventional periodontal treatment of chronic periodontitis on the perception of mastication. The patients (n = 28; age range: 23 to 56 years, mean age: 37.9 years) were evaluated on two occasions (before and after treatment) with a 45-day interval using the Oral Impact on Daily Performance questionnaire. An electromyography system was used for the determination of activity in muscles of mastication and bite force. Masticatory performance was assessed using a test material. The median particle size of the masticated material was determined using a sieve method and the Rosin-Rammler equation. The clinical criteria were the number of teeth and probing depth, both determined by a single calibrated observer masked to the treatment phase. The data were analyzed in the pretreatment and post-treatment periods using Wilcoxon test; Spearman correlation coefficient; and two multiple linear regression models (backward stepwise procedure). There was a significant negative correlation between the number of teeth (number of mastication units) and difficulty eating (P mastication diminished after periodontal treatment. The number of teeth had considerable importance in the perception of impact on mastication in the sample studied.

  6. Effect of non-surgical periodontal treatment on chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Hilana Paula Carillo Artese

    2010-12-01

    Full Text Available Chronic kidney disease (CKD is a debilitating systemic condition. Our working hypothesis is that CKD predialysis patients with periodontitis would respond poorly to periodontal treatment owing to immunologic compromise. Twenty-one predialysis patients (group 1 and 19 individuals without clinical evidence of kidney disease (group 2 with chronic periodontitis were subjected to non-surgical periodontal treatment with no antibiotics. Clinical periodontal and systemic parameters were evaluated at baseline and 3 months after treatment. Both groups showed significant and similar post-treatment improvements in all periodontal parameters examined. Most interestingly, periodontal treatment had a statistically significant positive effect on the glomerular filtration rate of each individual (group 1, p = 0.04; group 2, p = 0.002. Our results indicate that chronic periodontitis in predialysis kidney disease patients improved similarly in patients with chronic periodontitis and no history of CKD after receiving non-surgical periodontal therapy. This study demonstrates that CKD predialysis patients show a good response to non-surgical periodontal treatment.

  7. The owner-animal-environment triad in the treatment of canine periodontal disease.

    Science.gov (United States)

    Hale, Fraser A

    2003-06-01

    In a perfect world, all veterinarians and veterinary dental technicians would understand periodontal disease as well as the dental specialist. They would all be able to recognize the early signs of periodontal disease and recommend treatment to prevent its progression. The owners would have the financial resources, time, and desire to maintain their pet's oral health. The dogs would all be calm and compliant with home care and have no particular anesthetic risks. Unfortunately, this is not a perfect world. Some veterinarians do not understand periodontal disease any better that I understand cosmic string theory. Some owners have limited financial resources and are not particularly committed to their pet's oral health. Some animals will not tolerate any type or manner of home care. Given that animals, their mouths, and their owners come in an infinite variety of shapes and sizes (figuratively and literally), how can we talk about the treatment of periodontal disease as if it is a single condition with a single treatment, or even only a few treatment options? Each owner, animal, and its environment must be assessed on an individual basis to develop a treatment plan that is reasonable and attainable based on the unique circumstances of each case. So, what should be the goal when treating periodontal disease? Is it the preservation of all teeth at all costs? Is it the preservation of important teeth if the costs can be kept reasonable? I would suggest that the overriding goal of periodontal treatment should be the elimination and prevention of oral infection and oral pain. In the domestic environment, dogs have no real need to defend territory. They have no need to prehend and kill live prey animals. In short, the domesticated pet dog does not need teeth at all. This may seem like an odd statement for a veterinary dentist to make, but I feel quite strongly that a dog is far better off having no teeth than having bad teeth. My preference is that a dog should have a full

  8. [Periodontal treatment for cardiovascular risk factors: a systematic review].

    Science.gov (United States)

    Deng, Linkai; Li, Chunjie; Li, Qian; Zhang, Yukui; Zhao, Hongwei

    2013-10-01

    To evaluate the efficacy of periodontal treatment for the management of cardiovascular risk factors. Eligible studies in Cochrane Controlled Trials Register/CENTRAL, PubMed, EMBASE, and China Biology Medicine disc (CBMdisc) were searched until October 13, 2011. References of the included studies were hand searched. Two reviewers assessed the risk of bias and extracted the data of the included studies in duplicate. Meta-analysis was conducted with Revman 5.1. Six randomized controlled trials involving 682 participants were included. One case had low risk of bias, another one had moderate risk of bias, and the remaining four had high risk of bias. Meta-analysis showed that periodontal treatment has no significant effect on C-reactive protein, total cholesterol, low-density lipoprotein cholesterol, and triglycerides (P > 0.05). However, the treatment had a significant effect on high-density lipoprotein cholesterol [MD = 0.05, 95% CI (0.00, 0.09), P = 0.04]. Periodontal treatment has good effects on controlling high-density lipoprotein cholesterol although more randomized controlled trials must be conducted to verify its effectiveness.

  9. Endodontic-periodontic bifurcation lesions: a novel treatment option.

    Science.gov (United States)

    Lin, Shaul; Tillinger, Gabriel; Zuckerman, Offer

    2008-05-01

    The purpose of this preliminary clinical report is to suggest a novel treatment modality for periodontal bifurcation lesions of endodontic origin. The study consisted of 11 consecutive patients who presented with periodontal bifurcation lesions of endodontic origin (endo-perio lesions). All patients were followed-up for at least 12 months. Treatment included calcium hydroxide with iodine-potassium iodide placed in the root canals for 90 days followed by canal sealing with gutta-percha and cement during a second stage. Dentin bonding was used to seal the furcation floor to prevent the ingress of bacteria and their by-products to the furcation root area through the accessory canals. A radiographic examination showed complete healing of the periradicular lesion in all patients. Probing periodontal pocket depths decreased to 2 to 4 mm (mean 3.5 mm), and resolution of the furcation involvement was observed in post-operative clinical evaluations. The suggested treatment of endo-perio lesions may result in complete healing. Further studies are warranted. This treatment method improves both the disinfection of the bifurcation area and the healing process in endodontically treated teeth considered to be hopeless.

  10. Effect of self-ligating bracket appliance on the periodontal tissues in patients with chronic periodontitis after orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Liu-Qing Yang

    2017-04-01

    Full Text Available Objective: To explore the effect of self-ligating bracket appliance on the periodontal tissues in patients with chronic periodontitis after orthodontic treatment. Methods: A total of 56 patients with chronic periodontitis who were admitted in our hospital were included in the study and divided into the observation group and the control group according to different treatment protocols. The patients in the observation group were given self-ligating brackets, while the patients in the control group were given traditional brackets. The periodontal tissues and tooth motility (TM before and after treatment in the two groups were observed and recorded. IL-1 毬 and TNF-毩 levels in the gingival crervicular fluid (GCF before and after treatment in the two groups were detected. Results: PD, CAL, SBI, and PLI after treatment in the two groups were significantly reduced, while GR was significantly elevated when compared with the control group. PD, CAL, SBI, and PLI after treatment in the observation group were significantly lower than those in the control group, while GR was significantly higher than that in the control group. TM after treatment in the two groups was significantly improved, among which the number of 0° TM was significantly increased, while the number of Ⅰ°-Ⅲ°TM was significantly reduced. IL-1β and TNF-α levels in GCF after treatment in the two groups were significantly reduced when compared with before treatment. IL-1β and TNF-α levels in GCF after treatment in the observation group were significantly lower than those in the control group. Conclusions: The self-ligating brackets can effectively improve the periodontal tissues and TM in patients with chronic periodontitis, and reduce the levels of inflammatory cytokines in periodontal tissues, with an accurate efficacy.

  11. Does smoking affect gingival crevicular fluid LL-37 levels following non-surgical periodontal treatment in chronic periodontitis?

    Science.gov (United States)

    Türkoğlu, Oya; Eren, Gülnihal; Emingil, Gülnur; Azarsız, Elif; Kutukculer, Necil; Atilla, Gül

    2016-01-01

    LL-37 contributes to maintaining the balance between health and disease. Smoking is a risk factor for periodontitis that impairs neutrophil functions. The aim of the present study was to comparatively evaluate gingival crevicular fluid (GCF) LL-37 levels in smoker and non-smoker chronic periodontitis (CP) patients and controls, as well as the effect of non-surgical periodontal treatment on GCF LL-37 levels. Thirty-one CP patients (16 smokers, 15 non-smokers) and thirty-one controls (16 smokers, 15 non-smokers) were included in the study. CP patients received non-surgical treatment. GCF LL-37 levels and periodontal parameters were assessed at baseline, 1 and 3 months after completion of non-surgical periodontal treatment. GCF LL-37 levels were analyzed by ELISA. No significant difference was observed in GCF LL-37 levels between smoker and non-smoker controls (p>0.05). Smoker CP group had significantly lower GCF LL-37 level than non-smoker CP group at baseline (pnon-smoker CP group at first week, 1 and 3 months after completion of non-surgical periodontal treatment (psmoker CP group (p>0.05). Periodontal parameters were correlated with GCF LL-37 levels in non-smoker CP group (psmoker CP group (p>0.05). GCF LL-37 levels do not seem to be affected from smoking in periodontal health. However, smoking might have a suppressive effect on GCF LL-37 levels in CP. Non-surgical treatment is effective in decreasing GCF LL-37 levels in non-smoker CP patients but not in smokers with CP. Copyright © 2015. Published by Elsevier Ltd.

  12. Is Photodynamic Therapy with Adjunctive Non-Surgical Periodontal Therapy Effective in the Treatment of Periodontal Disease under Immunocompromised Conditions

    International Nuclear Information System (INIS)

    Javed, F.; Hezaimi, K.A.; Qadri, T.; Ahmed, H.B.; Corbet, F.E.; Romanos, G.E.

    2013-01-01

    The aim was to assess whether or not photodynamic therapy (PDT) with adjunctive scaling-and-root-planing (SRP) is effective in the treatment of periodontitis under immunocompromised conditions. PubMed/Medline and Google-Scholar databases were searched from 1967 to May 2013 using various key words. Six studies (five experimental and one clinical) were included. In the clinical study, SRP with PDT was reported to be ineffective in treating chronic periodontitis in T2DM patients. All experimental studies reported significantly less bone loss in periodontal defects treated with SRP+PDT than those treated with SRP alone. Efficacy of PDT+SRP in the treatment of periodontal disease under immunocompromised conditions remains unclear. (author)

  13. Is Photodynamic Therapy with Adjunctive Non-Surgical Periodontal Therapy Effective in the Treatment of Periodontal Disease under Immunocompromised Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Javed, F.; Hezaimi, K. A. [King Saud Univ., Riyadh (Saudi Arabia). College of Applied Medical Sciences; Qadri, T. [Karolinska Inst., Huddinge (Sweden). Dept. of Dental Medicine; Ahmed, H. B. [Al-Farabi Dental College, Riyadh (Saudi Arabia). Dept. of Dentistry; Corbet, F. E. [University of Hong Kong, Hong Kong (Hong Kong). Dept. of Periodontology; Romanos, G. E. [Stony Brook University, New York (United States). School of Dental Medicine

    2013-10-15

    The aim was to assess whether or not photodynamic therapy (PDT) with adjunctive scaling-and-root-planing (SRP) is effective in the treatment of periodontitis under immunocompromised conditions. PubMed/Medline and Google-Scholar databases were searched from 1967 to May 2013 using various key words. Six studies (five experimental and one clinical) were included. In the clinical study, SRP with PDT was reported to be ineffective in treating chronic periodontitis in T2DM patients. All experimental studies reported significantly less bone loss in periodontal defects treated with SRP+PDT than those treated with SRP alone. Efficacy of PDT+SRP in the treatment of periodontal disease under immunocompromised conditions remains unclear. (author)

  14. Periodontal treatment in patients with chronic kidney disease: a pilot study.

    Science.gov (United States)

    Almeida, S; Figueredo, C M; Lemos, C; Bregman, R; Fischer, R G

    2017-04-01

    This pilot cohort study evaluated the effect of periodontal treatment on renal function, metabolic markers and asymmetric dimethylarginine (ADMA) in patients with pre-dialysis chronic kidney disease (CKD) presenting chronic periodontitis. Twenty-six patients with CKD and severe chronic periodontitis were selected. Periodontal parameters included plaque index, bleeding on probing, probing pocket depth and clinical attachment level. Estimated glomerular filtration rate (eGFR), triglycerides, total cholesterol, albumin and ADMA levels were evaluated at baseline, 90 and 180 d after periodontal therapy. eGFR was evaluated by the Modification of Diet in Renal Disease equation. All periodontal clinical parameters significantly improved (p periodontal therapy. There was a significant improvement on the median values (25%; 75% percentiles) of eGFR from 34.6 (27; 44.7) mL/min/1.73 m 2 on baseline to 37.6 (29.7; 57) mL/min/1.73 m 2 on day 90, and to 37.6 (28.6; 56) mL/min/1.73 m 2 (p periodontal treatment. No significant differences were observed at the median values of metabolic markers comparing baseline and 180 d after periodontal treatment. The results point to a link of kidney disease with endothelium dysfunction and periodontitis, suggesting that periodontal treatment may be beneficial to the course of CKD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. [Comparative study of two treatment methods for acute periodontal abscess].

    Science.gov (United States)

    Jin, Dong-mei; Wang, Wei-qian

    2012-10-01

    The aim of this short-term study was to compare the clinical efficacy of 2 different methods to treat acute periodontal abscesses. After patient selection, 100 cases of acute periodontal abscess were randomly divided into two groups. The experimental group was treated by supra- and subgingival scaling, while the control group was treated by incision and drainage. A clinical examination was carried out to record the following variables: subjective clinical variables including pain, edema, redness and swelling; objective clinical variables including gingival index(GI), bleeding index(BI), probing depth(PD),suppuration, lymphadenopathy and tooth mobility. The data was analyzed with SPSS 19.0 software package. RESULES: Subjective clinical variables demonstrated statistically significant improvements with both methods from the first day after treatment and lasted for at least 30 days(P0.05), but the experimental group showed more improvement in edema and redness than the control group(Pperiodontal abscesses.

  16. Orthodontic-periodontal interactions: Orthodontic extrusion in interdisciplinary regenerative treatments.

    Science.gov (United States)

    Paolone, Maria Giacinta; Kaitsas, Roberto

    2018-06-01

    Orthodontics is a periodontal treatment. "Guided orthodontic regeneration" (GOR) procedures use orthodontic movements in perio-restorative patients. The GOR technique includes a guided orthodontic "soft tissue" regeneration (GOTR) and a guided orthodontic "bone" regeneration (GOBR) with a plastic soft tissue approach and a regenerating reality. The increased amount of soft tissue gained with orthodontic movement can be used for subsequent periodontal regenerative techniques. The increased amount of bone can as well improve primary implant stability and, eventually, simplify a GTR technique to regenerate soft tissues, to restore tooth with external resorption in aesthetic zone or to extract a tooth to create new hard-soft tissue for adjacent teeth. Copyright © 2018. Published by Elsevier Masson SAS.

  17. The orthodontic-periodontic interrelationship in integrated treatment challenges: a systematic review.

    Science.gov (United States)

    Gkantidis, N; Christou, P; Topouzelis, N

    2010-05-01

    Orthodontic treatment aims at providing an acceptable functional and aesthetic occlusion with appropriate tooth movements. These movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, because of the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems. Aesthetic considerations, like uneven gingival margins or functional problems resulting from inflammatory periodontal diseases should be considered in orthodontic treatment planning. Furthermore, in cases with severe periodontitis, orthodontics may improve the possibilities of saving and restoring a deteriorated dentition. In modern clinical practice, the contribution of the orthodontist, the periodontist and the general dentist is essential for optimized treatment outcomes. The purpose of this systematic review is to highlight the relationship between orthodontics and periodontics in clinical practice and to improve the level of cooperation between dental practitioners. Potentials and limitations that derive from the interdisciplinary approach of complex orthodontic-periodontal clinical problems are discussed.

  18. A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis.

    Science.gov (United States)

    Han, Ji-Young

    2015-12-01

    With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients' periodontal health irrespective of orthodontic techniques.

  19. Comprehensive treatment in a case with advanced chronic periodontitis: a 15-year follow-up.

    Science.gov (United States)

    Zafiropoulos, Gregory-George; Rebbe, Jochen

    2010-01-01

    This case report describes the comprehensive treatment of generalized, advanced periodontal disease and full-mouth rehabilitation in an adult patient. Given the extensive periodontal tissue destruction, a systematic approach was needed to determine restoration possibilities and patient expectations. Subsequent oral rehabilitation was accomplished with fixed dentures in the mandible and a removable denture in the maxilla. In the maxilla, strategically important anchor teeth were replaced with implants and a palate-free horseshoe-shaped removable denture was fabricated, using telescopic crowns as abutments. This case indicates that long-term post-treatment periodontal stability can be ensured only by full patient cooperation and consistent periodontal maintenance.

  20. Fiber composites as a method of treatment splinting tooth mobility in chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Dewi Lidya Ichwana

    2016-12-01

    Full Text Available Patients with periodontal disease can lead to severe tooth mobility so often complains of pain when eating, decreased chewing ability and functional occlusion. Tooth mobility is a movement in a horizontal or vertical direction and one of the most unpleased effects from periodontal disease. Basically, tooth mobility is not a disease that requires treatment, but it is a symptom of periodontal tissue morphology changes, so it became a challenge for dentists in making decisions to maintain proper care of the teeth. Recent studies improved the use of periodontal splint with fiber reinforced composite (FRC or fiber composite may lead to a long-term prognosis of teeth mobility due to periodontal disase. The case report describes treatment of chronic periodontitis patients with splinting fiber composites as a method for stabilization of the lower anterior teeth providing aesthetics, comfort, improved functionality occlusion, mastication and a good prognosis.

  1. Impact of minocycline ointment for periodontal treatment of oral bacteria.

    Science.gov (United States)

    Nakao, Ryoma; Takigawa, Satoko; Sugano, Naoyuki; Koshi, Ryosuke; Ito, Koichi; Watanabe, Haruo; Senpuku, Hidenobu

    2011-01-01

    Topical tetracyclines, such as minocycline ointment, are frequently used for the treatment of periodontal infection. We investigated the influence of minocycline ointment use on oral bacteria, using supragingival plaque samples from adults who had not taken any antibiotics for 6 months. Initially we investigated the effect of topical minocycline administration on the emergence of tetracycline-resistant oral bacteria in four healthy adults. The isolation frequency of tetracycline-resistant oral bacteria to total viable bacteria increased substantially on day 6 after treatment, although it returned to baseline on day 25. Subsequently we investigated the isolation frequency of tetracycline-resistant oral streptococci (TOS) as a representative oral bacterium, using samples from 41 subjects with periodontal diseases. The percentage of TOS (of the total oral streptococci) increased significantly (from 11.9±15.6% to 34.2±24.0%) after minocycline treatment. Various TOS species were identified; S. mitis, S. salivarius, S. sanguinis, and S. oralis were frequently isolated. PCR and Southern blotting allowed us to identify tetM on the Tn916-like elements as the gene responsible for tetracycline-resistance. These findings suggest that the potential risk of the spread of similar genetic elements through bacteria in the oral cavity should be considered.

  2. Combined orthodontic and periodontic treatment in a child with Papillon Lefèvre syndrome.

    Science.gov (United States)

    AlSarheed, Maha A; Al-Sehaibany, Fares S

    2015-08-01

    A 9-year-old girl with Papillon-Lefèvre syndrome (PLS) was treated orthodontically 24 months after the start of mechanical and antibiotic therapy in adjunct with periodontal treatment every 6 weeks. After achieving stable periodontal conditions, orthodontic treatment was commenced to correct the teeth position, facial profile, and maxillary protraction. Following the combination therapy and a failure to detect Actinobacillus actinomycetemcomitans from any site in the oral cavity, orthodontic treatment with a fixed appliance was performed aside from creating space for eruption of permanent teeth. We found that combined periodontal and orthodontic treatment of PLS may be successful with a complex interdisciplinary regimen and close follow up. This is a 2-year follow-up case report of a girl with PLS. Orthodontic and periodontic therapy were offered using combined treatments of orthodontic and periodontal with the benefit of prosthodontic consultation, resulting in a treatment plan.

  3. Serum Lp-PLA2: as a novel viewpoint in periodontal treatment of hyperlipidaemics.

    Science.gov (United States)

    Fentoğlu, Özlem; Kirzioğlu, Fatma Yeşim; Tözüm Bulut, Memduha; Kurgan, Şivge; Koçak, Havva; Sütcü, Recep; Kale Köroğlu, Banu; Günhan, Meral

    2015-01-01

    To evaluate the effects of periodontal treatment on serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and C-reactive protein (CRP) levels in hyperlipidaemic patients with periodontitis. The study included 52 hyperlipidaemics and 28 systemically healthy controls (C) with periodontitis. Of the 52 hyperlipidaemics, 29 received a suggested diet (HD), and 23 of them were prescribed statin (HS). Clinical periodontal parameters, serum lipids, Lp-PLA2, and CRP levels were assessed at the baseline and 2 months after the completion of the nonsurgical periodontal treatment (2MPT). Serum parameters were also evaluated 1 week following the periodontal treatment (1WPT). At the baseline, patients in the HS group had a higher percentage of bleeding on probing than those in the C and HD groups. Hyperlipidaemics had higher serum triglyceride levels than the control group at 2MPT compared to the baseline. At 2MPT, the levels of Lp-PLA2 in the HS group were significantly higher compared to the baseline and 1WPT. There were no statistically significant differences in CRP levels between study periods for all groups. The periodontal treatment may affect the inflammatory control of hyperlipidaemic patients with periodontitis via increased Lp-PLA2 levels and severity of the impaired lipid metabolism. These findings may be important regarding the therapeutic strategies for hyperlipidaemics with periodontitis.

  4. Surgical-orthodontic treatment of patients suffering from severe periodontal disorders - a clinical case study.

    Science.gov (United States)

    Halimi, Abdelali; Zaoui, Fatima

    2013-09-01

    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.

  5. Clinical Evaluation of Periodontal Tissue Status in Prosthodontic Treatment of Patients with Partial Tooth Loss and Generalized Periodontitis

    Directory of Open Access Journals (Sweden)

    A. Kushlyk

    2018-01-01

    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

  6. Effects of periodontal treatment on lung function and exacerbation frequency in patients with chronic obstructive pulmonary disease and chronic periodontitis: a 2-year pilot randomized controlled trial.

    Science.gov (United States)

    Zhou, Xuan; Han, Jing; Liu, Zhiqiang; Song, Yiqing; Wang, Zuomin; Sun, Zheng

    2014-06-01

    To evaluate the direct effects of periodontal therapy in Chronic Obstructive Pulmonary Disease (COPD) patients with chronic periodontitis (CP). In a pilot randomized controlled trial, 60 COPD patients with CP were randomly assigned to receive scaling and root planing (SRP) treatment, supragingival scaling treatment, or oral hygiene instructions only with no periodontal treatment. We evaluated their periodontal indexes, respiratory function, and COPD exacerbations at baseline, 6 months, 1, and 2 years. Compared with the control group, measurements of periodontal indexes were significantly improved in patients in two treatment groups at 6-month, 1-year, and 2-year follow-up (all p periodontal therapy in COPD patients with CP may improve lung function and decrease the frequency of COPD exacerbation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Periodontal Diseases

    Science.gov (United States)

    ... 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 ...

  8. Features of clinical course and treatment principles of endodontic-periodontal lesions

    Directory of Open Access Journals (Sweden)

    P I Moroz

    2018-06-01

    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

  9. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial.

    Science.gov (United States)

    Sant'Ana, Adriana Campos Passanezi; Campos, Marinele R de; Passanezi, Selma Campos; Rezende, Maria Lúcia Rubo de; Greghi, Sebastião Luiz Aguiar; Passanezi, Euloir

    2011-04-01

    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.

  10. COMPLEX TREATMENT IN A PATIENT WITH SEVERE CHRONIC PERIODONTITIS (Case Report.

    Directory of Open Access Journals (Sweden)

    Kamen Kotsilkov

    2015-02-01

    Full Text Available INTRODUCTION: Periodontitis is characterized by progressive destruction of periodontium, caused by relatively small group of microorganisms. The treatment aims to create proper environment which hampers the colonization of pathogens. The mechanical cleaning of the root surfaces combined with meticulous oral hygiene is the consensus treatment. In advanced cases the progression of the disease could lead to different problems - gingival recessions, insufficiency of attached gingiva, mobility and tooth loss which require complex treatment. OBJECTIVE: This presentation demonstrates the multidisciplinary treatment approach in a patient with a severe chronic periodontitis. METHODS: S.S. (42 with severe chronic periodontitis, insufficient mandibular vestibule depth, lack of keratinized gingiva, class III recessions and central incisors with grade III mobility. The #12 is missing and a crossbite is present on #32. The anti-infective therapy led to stable periodontal status. The corrective phase included the creation of vestibule depth with an autogenous gingival graft, dental implant placement with immediate provisional loading for #12, extraction of #31 and #41 due to attachment loss to the apex and immediate placement of provisionals with crossbite correction. RESULT: The reevaluation demonstrated good control of the gingival inflammation and stable periodontal status. The subsequent implant and prosthetic treatment led to the restoration of a functional dentition. CONCLUSION: The long term success of the treatment of the complex cases with severe chronic periodontitis depends significantly upon the proper control of the periodontal infection and the achievement of a stable periodontal status. These are the major prerequisites for successful further implant and prosthetic rehabilitation.

  11. Nonsurgical and surgical treatment of periodontitis: how many options for one disease?

    Science.gov (United States)

    Graziani, Filippo; Karapetsa, Dimitra; Alonso, Bettina; Herrera, David

    2017-10-01

    Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Treatment of combined endodontic-periodontic lesions using guided tissue regeneration: clinical case and histology.

    Science.gov (United States)

    Ghezzi, Carlo; Virzì, Mauro; Schupbach, Peter; Broccaioli, Alessandro; Simion, Massimo

    2012-08-01

    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.

  13. Periodontal disease with treatment reduces subsequent cancer risks.

    Science.gov (United States)

    Hwang, Ing-Ming; Sun, Li-Min; Lin, Cheng-Li; Lee, Chun-Feng; Kao, Chia-Hung

    2014-10-01

    The aim of our study was to evaluate the relationship between routine treatment of periodontal disease (PD) and the subsequent risks for cancers in Taiwan. Study participants were selected from the Taiwan National Health Insurance (NHI) system database. The PD with a routine treatment cohort contained 38 902 patients. For each treatment cohort participant, two age- and sex-matched comparison (control) cohort participants were randomly selected. Cox's proportional hazards regression analysis was used to estimate the effects of PD with treatment on the subsequent risk of cancer. The overall risk of developing cancer was significantly lower in the treatment cohort than in the patients without treatment (adjusted Hazard ratio = 0.72, 95% confidence interval = 0.68-0.76). The risks of developing most gastrointestinal tract, lung, gynecological and brain malignancies were significantly lower in the treatment cohort than in the comparison cohort. In contrast, the risks of prostate and thyroid cancers were significantly higher in the treatment cohort than in the comparison cohort. Our findings suggest that PD with treatment is associated with a significantly reduced overall risk of cancer and reduced risks of certain types of cancers. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Interdisciplinary treatment for an adult patient with anterior open bite, severe periodontitis, and intellectual disability.

    Science.gov (United States)

    Kang, Da-Young; Choi, Sung-Hwan; Jung, Young-Soo; Hwang, Chung-Ju

    2015-05-01

    This case report describes the beneficial effects of the interdisciplinary treatment of an adult patient with severe skeletal periodontal problems. A 30-year-old female patient presented with anterior open bite, gummy smile, and facial asymmetry. The patient had chronic generalized severe periodontitis with pathologic maxillary anterior teeth migration and mild intellectual disability. Treatment included 6 months of periodontal treatment, followed by presurgical orthodontic treatment, a Le Fort I osteotomy with anterior segmental osteotomy, a bilateral sagittal split ramus osteotomy, and postsurgical orthodontic treatment. After treatment completion, the patient exhibited functional and aesthetic improvements. Her periodontal condition improved and was maintained after the treatment. Here, we demonstrate a successful treatment outcome in a complicated case following a systematic interdisciplinary approach performed with the correct diagnosis and treatment planning.

  15. Using laser irradiation for the surgical treatment of periodontal disease

    Science.gov (United States)

    Vieru, Rozana D.; Lefter, Agafita; Herman, Sonia

    2002-10-01

    In the marginal pr ogressive profound periodontities, we associated low level laser therapy (LLLT) to the classical surgical treatment with implant of biovitroceramics. From a total of 50 patients, 37 where irradiated with the laser. We used a diode laser, =830 nm, energy density up to 2 J cm2, in Nogier pulsed mode. The laser treatment is used in a complex of therapeutic procedures: odontal, local anti-inflammatory -- as well as in the cabinet and at home --, prosthetic, and for the morphologic and functional rebalancing. The immediate effects where: an evolution without bleeding and without post-surgical complications, as can appear at the patients who didn't benefit of laser irradiation (hematom, pain, functional alteration in the first post-surgical week). Operated tissue is recovering faster. The percentage of recurrences decreases and the success depends less on the biological potential and the immunity of each individual.

  16. Treatment of combined endodontic: periodontic lesion by sealing of palato-radicular groove using biodentine

    OpenAIRE

    Naik, Mayuri; de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

    2014-01-01

    Introduction: Palatoradicular groove is a developmental anomaly which is predominantly found in maxillary lateral incisors. It provides a susceptible alcove for the progression of localised periodontal inflammation which can further cause pulpal involvement. This case report describes the successful treatment of a large periodontic - endodontic lesion usingnon surgical endodontic therapy and biodentine for the sealing of the palatoradicular groove.

  17. Treatment of combined endodontic: periodontic lesion by sealing of palato-radicular groove using biodentine.

    Science.gov (United States)

    Naik, Mayuri; de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

    2014-11-01

    Palatoradicular groove is a developmental anomaly which is predominantly found in maxillary lateral incisors. It provides a susceptible alcove for the progression of localised periodontal inflammation which can further cause pulpal involvement. This case report describes the successful treatment of a large periodontic - endodontic lesion usingnon surgical endodontic therapy and biodentine for the sealing of the palatoradicular groove.

  18. Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Teeuw, W.J.; Slot, D.E.; Susanto, H.; Gerdes, V.E.A.; Abbas, F.; D'Aiuto, F.; Kastelein, J.J.P.; Loos, B.G.

    2014-01-01

    Aim Systematic review and meta-analyses to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile. Material and Methods Literature was searched in Medline-PubMed, Cochrane CENTRAL and EMBASE, based on controlled periodontal intervention trials,

  19. Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Teeuw, Wijnand J.; Slot, Dagmar E.; Susanto, Hendri; Gerdes, Victor E. A.; Abbas, Frank; D'Aiuto, Francesco; Kastelein, John J. P.; Loos, Bruno G.

    2014-01-01

    AimSystematic review and meta-analyses to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile. Material and MethodsLiterature was searched in Medline-PubMed, Cochrane CENTRAL and EMBASE, based on controlled periodontal intervention trials,

  20. The Effects of Mechanical Treatment on Microbiological Parameters in Periodontal Disease

    Directory of Open Access Journals (Sweden)

    Lazăr Luminiţa

    2014-11-01

    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.

  1. Treatment of periodontitis improves the atherosclerotic profile : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Teeuw, Wijnand J.; Slot, Dagmar E.; Susanto, Hendri; Gerdes, Victor E. A.; Abbas, Frank; D'Aiuto, Francesco; Kastelein, John J. P.; Loos, Bruno G.

    AimSystematic review and meta-analyses to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile. Material and MethodsLiterature was searched in Medline-PubMed, Cochrane CENTRAL and EMBASE, based on controlled periodontal intervention trials,

  2. [Clinical significance of calcitonin gene-related peptide level before and after treatment in patients with chronic periodontitis].

    Science.gov (United States)

    Yan, Ying; Xiang, Xue-Rong; Wang, Chun; Ye, Guo; Fan, Xiao-Ping

    2016-08-01

    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.

  3. A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes

    OpenAIRE

    Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

    2013-01-01

    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...

  4. RELATIONSHIPS BETWEEN INITIAL PROBING DEPTH AND CHANGES IN THE CLINICAL PARAMETERS FOLLOWING NON-SURGICAL PERIODONTAL TREATMENT IN CHRONIC PERIODONTITIS

    Directory of Open Access Journals (Sweden)

    Süleyman Emre MESELİ

    2017-10-01

    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.

  5. Periodontal and periimplant maintenance: a critical factor in long-term treatment success.

    Science.gov (United States)

    Shumaker, Nicholas D; Metcalf, Brett T; Toscano, Nicholas T; Holtzclaw, Dan J

    2009-09-01

    Periodontal maintenance (PM) is a critical factor in the long-term success of both periodontal and dental implant therapy. Studies have shown both modern periodontal and dental implant therapies are effective in maintaining natural teeth and replacing lost teeth, respectively. However, without a regular program of clinical reevaluation, plaque control, oral hygiene instruction, and reassessment of biomechanical factors, the benefits of treatment often are lost and inflammatory disease in the form of recurrent periodontitis or periimplantitis may result. This article reviews the goals, types, and appropriate frequency of PM in periodontal and dental implant therapy, as well as the incidence and etiology of periimplant disease and strategies for management when recurrent disease develops during the maintenance phase of treatment.

  6. Clinical Case Report on Treatment of Generalized Aggressive Periodontitis: 5-Year Follow-up.

    Science.gov (United States)

    Hu, Kai-Fang; Ho, Ya-Ping; Ho, Kun-Yen; Wu, Yi-Min; Wang, Wen-Chen; Chou, Yu-Hsiang

    2015-01-01

    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.

  7. [Esthetic reconstruction of the anterior teeth area following a combined periodontic-orthodontic treatment in adult periodontal patients].

    Science.gov (United States)

    Lihong, Zhu; Sa, Li; Fei, He; Yong, Wu; Yan, Zhou; Nianhong, Qin; Yi, Ding

    2014-10-01

    To evaluate the role of the combined periodontic-orthodontic treatment in the esthetic reconstruc- tion of the anterior teeth area following periodontitis. Thirteen adult patients with anterior teeth displacements were treated. The probing pocket depth (PD; 102 teeth, 612 sites), bleeding on probing (102 teeth, 204 sites), papilla index (PI; 128 papillae), and papillary height (PH; 128 papillae) of each patient were assessed at baseline, 3 months after the initial therapy, and the end of the orthodontic treatment. Non-parametric and paired-sample t tests were carried out for the statistical analysis of the data. Three months after initial therapy, the sites with PD ≤ 3 mm accounted for 79.58% (487/612) of the observed teeth, and 88.73% (181/204) of the buccal and lingual sites of the teeth showed negative bleeding on probing. These findings were better than those at baseline [26.31% (161/612) and 22.06% (45/204), respectively] (P 0.05). Prior to orthodontic treatment, the levels of the PI of 8 and 21 papillae were III and II, respectively, among the 128 observed papillae. After the orthodontic treatment, 51 papillae were at level III and 68 papillae were at level II. The PH of the 102 papillae was 2.84 mm ± 0.62 mm after ortho- dontic treatment. This result indicated significant difference compared with that of pre-orthodontic treatment (1.69 mm ± 0.57 mm) (P periodontal defects.

  8. Advanced biomaterials and their potential applications in the treatment of periodontal disease.

    Science.gov (United States)

    Chen, Xi; Wu, Guofeng; Feng, Zhihong; Dong, Yan; Zhou, Wei; Li, Bei; Bai, Shizhu; Zhao, Yimin

    2016-08-01

    Periodontal disease is considered as a widespread infectious disease and the most common cause of tooth loss in adults. Attempts for developing periodontal disease treatment strategies, including drug delivery and regeneration approaches, provide a useful experimental model for the evaluation of future periodontal therapies. Recently, emerging advanced biomaterials including hydrogels, films, micro/nanofibers and particles, hold great potential to be utilized as cell/drug carriers for local drug delivery and biomimetic scaffolds for future regeneration therapies. In this review, first, we describe the pathogenesis of periodontal disease, including plaque formation, immune response and inflammatory reactions caused by bacteria. Second, periodontal therapy and an overview of current biomaterials in periodontal regenerative medicine have been discussed. Third, the roles of state-of-the-art biomaterials, including hydrogels, films, micro/nanofibers and micro/nanoparticles, developed for periodontal disease treatment and periodontal tissue regeneration, and their fabrication methods, have been presented. Finally, biological properties, including biocompatibility, biodegradability and immunogenicity of the biomaterials, together with their current applications strategies are given. Conclusive remarks and future perspectives for such advanced biomaterials are discussed.

  9. Periodontal Condition and Treatment Needs of Some Pregnant ...

    African Journals Online (AJOL)

    Background: Periodontal diseases had been reported to be worse in the presence of hormonal imbalance as seen during pregnancy, which if that is the case, should resolve following childbirth when the hormonal level of the women should have reverted to normal. Subjects and Methods: Periodontal health of 345 pregnant ...

  10. The effect of nonsurgical periodontal treatment on serum and ...

    African Journals Online (AJOL)

    Background and Aims: The aim of this study is to compare patients with atherosclerosis and chronic periodontitis and patients who are systemically healthy and chronic periodontitis using alteration of adrenomedullin (ADM), chemokine (C-C motif) ligand 28 (CCL-28), white blood cell levels, platelet levels, high-density ...

  11. Oral hygiene and periodontal treatment needs in children and adolescents with coeliac disease in Greece.

    Science.gov (United States)

    Tsami, A; Petropoulou, P; Panayiotou, J; Mantzavinos, Z; Roma-Giannikou, E

    2010-09-01

    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.

  12. The Application of Microencapsulation Techniques in the Treatment of Endodontic and Periodontal Diseases

    Directory of Open Access Journals (Sweden)

    José Blanco Méndez

    2011-08-01

    Full Text Available In the treatment of intracanal and periodontal infections, the local application of antibiotics and other therapeutic agents in the root canal or in periodontal pockets may be a promising approach to achieve sustained drug release, high antimicrobial activity and low systemic side effects. Microparticles made from biodegradable polymers have been reported to be an effective means of delivering antibacterial drugs in endodontic and periodontal therapy. The aim of this review article is to assess recent therapeutic strategies in which biocompatible microparticles are used for effective management of periodontal and endodontic diseases. In vitro and in vivo studies that have investigated the biocompatibility or efficacy of certain microparticle formulations and devices are presented. Future directions in the application of microencapsulation techniques in endodontic and periodontal therapies are discussed.

  13. Effects of 980 diode laser treatment combined with scaling and root planing on periodontal pockets in chronic periodontitis patients

    Science.gov (United States)

    Fallah, Alireza

    2010-02-01

    Objective: This study compared the effect of 980 Diode laser + scaling and root planing (SRP) versus SRP alone in the treatment of chronic periodontitis. Method: 21 healthy patients with moderate periodontitis with a probing depth of at least 5mm were included in the study. A total of 42 sites were treated during 6weeks with a combination of 980 Diode laser and SRP (21 sites) or SRP alone (21 sites). The gingival index (GI), probing pocket depth (PPD) and bleeding on probing (BOP) were examined at the baseline and after 6 weeks after the start of treatment. Results: Both groups showed statistically significant improvements in GI, BOP and PPD after treatment. The results also showed significant improvement from laser+ SRP group to SRP alone group. Conclusion: The present data suggest that treatment of chronic periodontitis with either 980 Diode laser + SRP or SRP alone results in statistically significant improvements in the clinical parameters. The combination of 980 Diode laser irradiation in the gingival sulcus and SRP, was significantly better as compared to SRP alone.

  14. The effects of photodynamic laser therapy in the treatment of marginal chronic periodontitis

    Science.gov (United States)

    Chifor, Radu; Badea, Iulia; Avram, Ramona; Chifor, Ioana; Badea, Mîndra Eugenia

    2016-03-01

    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.

  15. Reconstruction of the maxillary midline papilla following a combined orthodontic-periodontic treatment in adult periodontal patients.

    Science.gov (United States)

    Cardaropoli, Daniele; Re, Stefania; Corrente, Giuseppe; Abundo, Roberto

    2004-02-01

    The aim of the present study was to evaluate the role of a combined orthodontic-periodontic treatment in determining the reconstruction of midline papilla lost following periodontitis. Twenty-eight patients, with infrabony defect and extrusion of one maxillary central incisor, were treated. At baseline, all patients presented opening of the interdental diastema and loss of the papilla. At 7-10 days after open-flap surgery, the intrusive movement started. For each patient, probing pocket depth (PPD), clinical attachment level (CAL) and papilla presence index (PI) were assessed at baseline, end of treatment and after 1 year. PI was also evaluated independently in patients with narrow or wide periodontal biotype (NPB-WPB). All parameters showed statistical improvement between the initial and final measurements, and showed no changes at follow-up time. The mean residual PPD was 2.50 mm, with a decrease of 4.29 mm, while the mean CAL gain was 5.93 mm. Twenty-three out of 28 patients improved the PI score at the end of therapy. No statistical difference was recorded in PI values between groups NPB and WPB. The presented clinical protocol resulted in the improvement of all parameters examined. At the end of orthodontic treatment, a predictable reconstruction of the interdental papilla was reported, both in patients with thin or wide gingiva. Copyright Blackwell Munksgaard, 2004.

  16. Subgingival microflora and treatment in prepubertal periodontitis associated with chronic idiopathic neutropenia.

    Science.gov (United States)

    Kamma, J J; Lygidakis, N A; Nakou, M

    1998-09-01

    Prepubertal periodontitis affects both primary and permanent dentition. The purpose of this study was to examine the composition of subgingival microflora of the permanent dentition in an 11-year-old Caucasian female, who had premature exfoliation of her deciduous teeth on her 5th year of age, and the response of this condition to the antibiotic therapy and supportive periodontal care. Gingival tissues were highly inflamed and alveolar bone loss was detected radiographically. The girl had experienced frequent upper respiratory tract infections, tonsilitis and recurrent otitis media. Her mother had history of early onset periodontitis associated with chronic idiopathic neutropenia. Blood chemistry tests and immunological examinations were also performed. Subgingival plaque samples were collected from the proximal sites of permanent molars, incisors, canines and maxillary premolars. 27 different microbial species were isolated from the subgingival microflora. Among the predominant species were Porphyromonas gingivalis (17.6%-7.3%), Prevotella intermedia (12.4%-4.7%), Capnocytophaga sputigena (14.4%-10.4%), Capnocytophaga ochracea (13.2%-6.9%) and Actinobacillus actinomycetemcomitans (9.3%-5.5%). Periodontal treatment consisted of scaling, root planing in conjunction with antibiotic administration of Augmentin 312.5 mg and Flagyl 200 mg, each t.i.d. for 10 days. 3 weeks after the antibiotic therapy, bacterial samples were collected from the same sites. All the periodontal pathogens were recovered in lower levels and A.actinomycetemcomitans was almost eliminated in the 3-week period. The evaluation of clinical indices at 3, 6 and 12 months showed that periodontal treatment in conjunction with antibiotics was effective and rapidly followed by marked clinical improvement. The microbiological monitoring at 3, 6 and 12 months after antibiotic treatment and each time prior to supportive periodontal care, revealed that the periodontal pathogens fluctuated in low levels even

  17. Combined endodontic-periodontic treatment of a palatal groove: a case report.

    Science.gov (United States)

    Schwartz, Scott A; Koch, Michael A; Deas, David E; Powell, Charles A

    2006-06-01

    The palatal groove is a developmental anomaly that predisposes the tooth involved to a severe periodontal defect. When further complicated by pulp necrosis, these grooves often present a diagnostic and treatment planning challenge that requires an interdisciplinary treatment approach. This case report describes the successful collaborative management of a maxillary lateral incisor with an extensive palatal groove using a combination of nonsurgical endodontic therapy, odontoplasty, and periodontal regenerative techniques.

  18. Effect of nonsurgical periodontal treatment on clinical response and glycemic control in type 2 diabetic patients with periodontitis: Controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Ajitha Kanduluru

    2014-01-01

    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

  19. Pathologies of the oral cavity in patients with non-controlled diabetes type 1 and type 2--analysis of periodontal status and periodontal treatment needs.

    Science.gov (United States)

    Preferansow, Ewa; Sawczuk, Beata; Gołębiewska, Maria; Górska, Maria

    2015-01-01

    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.

  20. Obesity Revised. Chapter at "Periodontal Disease: Symptoms, Treatment and Prevention"

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak

    2011-01-01

    Abstract: Obesity, diabetes and oral diseases (dental cariesand periodontal diseases), largely preventable chronic diseases, are described as global pandemic due their distribution and severe consequences. WHO has called for a global action for prevention and promotion of these diseases as a vital...... the likelihood of periodontitis which is one of the most common chronic diseases worldwide, described as pandemic, and closely related to DM2. Promoting good oral health is significantly essential for prevention and reducing the negative consequences of periodontal diseases, DM2 and obesity, and to maintain good...

  1. [Bio-Oss collagen bone grafting in the treatment of endodontic-periodontic lesion].

    Science.gov (United States)

    Sun, Jiang; Liu, Qiong

    2009-09-01

    To study the effect of Bio-Oss collagen for bone grafting in the treatment of endodontic-periodontic lesion. Thirty patients (37 teeth) with endodontic-periodontic lesions received root canal therapy and periodontal treatment. Four weeks after the treatment, Bio-Oss collagen was grafted in these teeth. Clinical examinations were performed 1, 3, 6, 9, and 12 months after the surgery. The mobility of these teeth improved 1 month after the surgery. At 3, 6, 9, and 12 months after the surgery, the pocket depth reduced obviously good attachment and further improvement of the tooth mobility. Bio-Oss collagen for bone grafting can achieve good therapeutic effect for endodontic-periodontic lesions.

  2. Interdisciplinary treatment of a patient with multiple missing teeth and periodontitis.

    Science.gov (United States)

    Ahn, Jae-Chan; Lee, Jae-Hong; Yoon, Joon-Ho; Lee, Ji-Yeon; Kim, Jung-Hoon

    2018-02-01

    A 49-year-old woman with several missing and periodontically compromised teeth was referred to the orthodontic department of National Health Insurance Service Ilsan Hospital by the periodontic department for interdisciplinary treatment. Multiple posterior teeth had been extracted 10 days earlier. Her chief complaint was crowding of the anterior teeth, and she wanted to improve both esthetics and function. Orthodontic, periodontic, and prosthodontic treatments were undertaken in the proper timing and sequence with an interdisciplinary approach. As a result, improved periodontal health and a stable occlusion and vertical dimension were achieved. Although there were limited teeth and alveolar bone for anchorage, good esthetic and functional treatment results were obtained through the application of temporary anchorage devices and proper biomechanics. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  3. Lemongrass essential oil gel as a local drug delivery agent for the treatment of periodontitis

    Directory of Open Access Journals (Sweden)

    Shivaraj B Warad

    2013-01-01

    Full Text Available Background: It has been long recognized that periodontal diseases are infections of the periodontium, comprising the bacterial etiology, an immune response, and tissue destruction. Treatment strategies aiming primarily at suppressing or eliminating specific periodontal pathogens include adjunct use of local and systemic antibiotics as part of nonsurgical periodontal therapy. Unwanted side effects and resistance of microorganisms toward antibiotics due to their widespread use have modified the general perception about their efficacy. Research in phytosciences has revealed various medicinal plants offering a new choice of optional antimicrobial therapy. Cymbopogon citratus, Stapf. (lemongrass is a popular medicinal plant. At a concentration ≤2%, lemongrass essential oil inhibits the growth of several kinds of microorganisms including periodontal pathogens, especially the reference strains Actinomyces naeslundii and Porphyromonas gingivalis, which were resistant to tetracycline hydrochloride. Aims: To evaluate the efficacy of locally delivered 2% lemongrass essential oil in gel form as an adjunct to scaling and root planing, as compared to scaling and root planing alone for the treatment of chronic periodontitis. Materials and Methods: 2% Lemongrass essential oil gel was prepared and placed in moderate to deep periodontal pockets after scaling and root planing. Results: Statistically significant reduction in probing depth and gingival index and gain in relative attachment level were noted in the experimental group as compared to the control group at 1 and 3 months. Conclusion: Locally delivered 2% lemongrass essential oil gel offers a new choice of safe and effective adjunct to scaling and root planing in periodontal therapy.

  4. Lemongrass essential oil gel as a local drug delivery agent for the treatment of periodontitis

    Science.gov (United States)

    Warad, Shivaraj B.; Kolar, Sahana S.; Kalburgi, Veena; Kalburgi, Nagaraj B.

    2013-01-01

    Background: It has been long recognized that periodontal diseases are infections of the periodontium, comprising the bacterial etiology, an immune response, and tissue destruction. Treatment strategies aiming primarily at suppressing or eliminating specific periodontal pathogens include adjunct use of local and systemic antibiotics as part of nonsurgical periodontal therapy. Unwanted side effects and resistance of microorganisms toward antibiotics due to their widespread use have modified the general perception about their efficacy. Research in phytosciences has revealed various medicinal plants offering a new choice of optional antimicrobial therapy. Cymbopogon citratus, Stapf. (lemongrass) is a popular medicinal plant. At a concentration ≤2%, lemongrass essential oil inhibits the growth of several kinds of microorganisms including periodontal pathogens, especially the reference strains Actinomyces naeslundii and Porphyromonas gingivalis, which were resistant to tetracycline hydrochloride. Aims: To evaluate the efficacy of locally delivered 2% lemongrass essential oil in gel form as an adjunct to scaling and root planing, as compared to scaling and root planing alone for the treatment of chronic periodontitis. Materials and Methods: 2% Lemongrass essential oil gel was prepared and placed in moderate to deep periodontal pockets after scaling and root planing. Results: Statistically significant reduction in probing depth and gingival index and gain in relative attachment level were noted in the experimental group as compared to the control group at 1 and 3 months. Conclusion: Locally delivered 2% lemongrass essential oil gel offers a new choice of safe and effective adjunct to scaling and root planing in periodontal therapy. PMID:24991068

  5. Longitudinal Relationship between Plasma Reactive Oxygen Metabolites and Periodontal Condition in the Maintenance Phase of Periodontal Treatment

    Directory of Open Access Journals (Sweden)

    Tatsuya Machida

    2014-01-01

    Full Text Available Aim. The present cohort study describes the longitudinal relationship between plasma oxidative status and periodontitis progression during the maintenance phase of treatment. Materials and Methods. Forty-five patients (mean age 58.8 years were monitored from 2008 to 2013. Periodontal conditions, including probing pocket depth (PPD and clinical attachment level (CAL, were recorded. Measurements of plasma reactive oxygen metabolites (ROM and biologic antioxidant potential (BAP were performed to evaluate plasma oxidative status. The patients were assigned into 2 groups as low and high plasma ROM level using a cut-off value which was median of plasma ROM level at baseline. Results. In the subjects with low plasma ROM level at baseline, changes in mean CAL were positively correlated with changes in plasma ROM levels, bleeding on probing, and plaque control record, but not with PPD. In the subjects with high plasma ROM at baseline, changes in CAL were significantly associated with only PPD at baseline. On the other hands there were no significant associations between changes in CAL and those in plasma BAP levels. Conclusions. When plasma ROM level in periodontitis patients was low, increases in plasma ROM level were associated with those in CAL during the maintenance phase of treatment.

  6. Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial.

    Science.gov (United States)

    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

    2016-11-01

    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.

  7. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Adriana Campos Passanezi Sant'Ana

    2011-04-01

    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.

  8. Orthodontic treatment in periodontal patients: a case report with 7 years follow-up.

    Science.gov (United States)

    Derton, Nicola; Derton, Roberto; Perini, Alessandro; Gracco, Antonio; Fornaciari, Paolo Andrea

    2011-03-01

    Tooth flaring of the anterior segment is often unesthetic and therefore a primary reason for combined orthodontic and periodontal treatment in adult patients with periodontal disease. Thus, a multidisciplinary approach is frequently chosen for these patients by a qualified dental team. A clinical case of an adult patient suffering from chronic periodontitis with horizontal bone loss in the anterior segment and consequent flaring of the anterior teeth is described. A combined approach was chosen, initially to improve and stabilize the periodontal situation via multiple scaling and root planning sessions with additional pharmacological therapy and, finally by orthodontic treatment, to resolve the malocclusion. At the end of treatment, bone resorbtion was stabilized, the vertical bone defect was improved and incisor flaring was absent. Follow-up at 7 years post-treatment confirmed the stability of the orthodontic and esthetic results. The correct combination of orthodontic and periodontal treatment may contribute efficaciously to eliminate the effects of chronic periodontitis in adult patients, as well as improving esthetic parameters. Copyright © 2011 CEO. Published by Elsevier Masson SAS. All rights reserved.

  9. Fluoroquinolones in the treatment of Actinobacillus actinomycetemcomitans associated periodontitis

    NARCIS (Netherlands)

    Kleinfelder, JW; Mueller, RF; Lange, DE

    Background: Periodontitis patients harboring Actinobacillus actinmycetemcomitans (Aa) are prime candidates for systemic antibiotic therapy. Besides tetracycline and the combination of metronidazole and amoxicillin the fluoroquinolones are also believed to have antibacterial activity against Aa. The

  10. Periodontal Condition and Treatment Needs of Some Pregnant ...

    African Journals Online (AJOL)

    been reported to have effects on periodontal health include ... hormonal imbalance as seen during pregnancy, which if that is the case, should resolve following childbirth .... tissue destruction, which will require a chronic inflammatory condition ...

  11. Maintenance after a complex orthoperio treatment in a case of generalized aggressive periodontitis: 7-year result.

    Science.gov (United States)

    Zafiropoulos, Gregory-George; di Prisco, Manuela Occipite; Deli, Giorgio; Hoffmann, Oliver; Kasaj, Adrian

    2010-10-01

    Generalized aggressive periodontitis (GAgP) encompasses a distinct type of periodontal disease exhibiting much more rapid periodontal tissue destruction than chronic periodontitis. The best method for management of GAgP may include the use of both regenerative periodontal techniques and the administration of systemic antibiotics. The treatment of a case of GAgP over a period of 6.7 years is presented in this case report. Initial periodontal therapy (week 1- 32) consisted of supragingival plaque control and three appointments of scaling and root planing. Based on the periodontal pathogens isolated (5 species), the patient also received metronidazole plus amoxicillin for one week, followed 10 weeks later by metronidazole plus amoxicillin/clavulanate for one week. The patient was put on regular supportive periodontal therapy (SPT) thereafter. Orthodontic treatment was performed after completion of the initial therapy for 96 weeks. Measurements of clinical attachment level, bleeding on probing and plaque index were obtained at every examination. Antimicrobial and mechanical treatment resulted in eradication of all periopathogens and significantly improved all clinical parameters. During orthodontic treatment and active maintenance, there was no relapse of GAgP. The patient participated in SPT for 194 weeks and thereafter decided to discontinue SPT. Twenty-four months later a relapse of GAgP was diagnosed and all teeth had to be extracted. These results indicate that a combined mechanical and antimicrobial treatment approach can lead to consistent resolution of GAgP. Further studies including a larger number of cases are warranted to validate these findings.

  12. [The clinical effect of root amputation in the treatment of periodontal/alveolar abscess].

    Science.gov (United States)

    Tan, Baochun; Wu, Wenlei; Sun, Weibin; Xiao, Jianping

    2012-06-01

    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.

  13. The effectiveness of electromagnetic terahertz radiation use in the treatment of patients with rapidly progressive periodontitis

    Directory of Open Access Journals (Sweden)

    Zelenova A.V.

    2015-12-01

    Full Text Available The aim: to increase the efficiency of treatment of patients with rapidly progressive periodontitis (RPP using electromagnetic radiation at terahertz frequencies of molecular spectrum of radiation and absorption of nitric oxide 150,176-150,664 GHz. Material and methods. The study involved 50 patients with RPP, which according to the method of therapy were divided into 2 groups: group 1 included patients receiving conventional therapy, group 2 consisted of patients who, along with traditional therapy received EHF-therapy device "Orbit" YAKUL.941526.001. The control group consisted of 20 healthy subjects with intact periodontium. For the non-invasive study of tissue blood flow in the periodontal tissue Doppler ultrasound was used MiniMax-Doppler-Phono. The study of the microvasculature of periodontitis has been conducted. To determine the reactivity of microvascular periodontal tissue reflex functional tests on the indirect effect of the cold were performed. Results. Reductions achieved values of periodontal indices, especially important index PMA, a significant increase in the linear blood flow indices, decreased pulse pressure gradient and the index followed appropriate reduction to their cold test. Conclusion. The proposed complex therapy can accelerate the relief of inflammation in the periodontal tissues of the complex, to improve the elastic properties of blood vessels, reduce their tone and restore microcirculation in periodontal tissues.

  14. The impact of education on the probability of receiving periodontal treatment. Causal effects measured by using the introduction of a school reform in Norway.

    Science.gov (United States)

    Grytten, Jostein; Skau, Irene

    2017-09-01

    The aim of the present study was to estimate the causal effect of education on the probability of receiving periodontal treatment in the adult Norwegian population. In Norway, a substantial part of the cost of periodontal treatment is subsidized by the National Insurance Scheme. In that case, one might expect that the influence of individual resources, such as education, on receiving treatment would be reduced or eliminated. Causal effects were estimated by using data on a school reform in Norway. During the period 1960-1972, all municipalities in Norway were required to increase the number of compulsory years of schooling from seven to nine years. The education reform was used to create exogenous variation in the education variable. The education data were combined with large sets of data from the Norwegian Health Economics Administration and Statistics Norway. Since municipalities implemented the reform at different times, we have both cross-sectional and time-series variation in the reform instrument. Thus we were able to estimate the effect of education on the probability of receiving periodontal treatment by controlling for municipality fixed effects and trend variables. The probability of receiving periodontal treatment increased by 1.4-1.8 percentage points per additional year of schooling. This is a reasonably strong effect, which indicates that policies to increase the level of education in the population can be an effective tool to improve oral health, including periodontal health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. The effect of periodontal treatment on serum leptin, interleukin-6, and C-reactive protein.

    Science.gov (United States)

    Shimada, Yasuko; Komatsu, Yasutaka; Ikezawa-Suzuki, Ikuyo; Tai, Hideaki; Sugita, Noriko; Yoshie, Hiromasa

    2010-08-01

    Previous studies suggest that periodontitis is closely related to obesity and metabolic syndrome. Leptin, a pleiotrophic hormone produced by adipose tissue, has been reported to be related to periodontitis. This study investigates the effects of periodontal treatment on the serum levels of leptin and other cytokines in patients with chronic periodontitis (CP). Serum samples were taken from 33 CP patients (22 non-smokers, 11 smokers) and 18 healthy subjects. The serum leptin, adiponectin, tumor necrosis factor-alpha, interleukin (IL)-6, and C-reactive protein (CRP) levels were measured before and after non-surgical periodontal treatment. Significant differences between healthy and CP patients were found in serum leptin, IL-6, and CRP levels (P = 0.0018, P = 0.0064, and P = 0.0095, respectively). The serum leptin level was associated with mean probing depth, mean clinical attachment level, mean alveolar bone loss, and body mass index. There were significant associations between serum leptin levels and IL-6 and CRP levels. After non-surgical periodontal treatment, serum leptin, IL-6, and CRP levels were significantly decreased (mean +/- SD before and after, P value, respectively: leptin, 8.02 +/- 5.5, 7.10 +/- 4.4, P = 0.015; IL-6, 1.73 +/- 1.02, 1.36 +/- 0.73, P = 0.048; and CRP, 802.0 +/- 1065, 491.2 +/- 479.3, P = 0.047). Periodontal treatment is effective in reducing serum leptin, IL-6, and CRP levels. The results suggest that leptin, IL-6, and CRP could be mediating factors that connect metabolic syndrome and periodontitis.

  16. Periodontal treatment decreases levels of antibodies to Porphyromonas gingivalis and citrulline in patients with rheumatoid arthritis and periodontitis.

    Science.gov (United States)

    Okada, Moe; Kobayashi, Tetsuo; Ito, Satoshi; Yokoyama, Tomoko; Abe, Asami; Murasawa, Akira; Yoshie, Hiromasa

    2013-12-01

    Porphyromonas gingivalis has been implicated as an etiologic agent of rheumatoid arthritis (RA) because of the expression of peptidylarginine deiminase. The present study evaluates whether periodontal treatment may affect serum antibodies to P. gingivalis and citrulline levels in relation to disease activity of RA. Fifty-five patients with RA were randomly assigned to receive oral hygiene instruction and supragingival scaling (treatment group, n = 26) or no periodontal treatment (control group, n = 29). Periodontal and rheumatologic parameters and serum levels of cytokine and inflammatory markers citrulline and immunoglobulin (Ig)G to P. gingivalis were examined at baseline and 8 weeks later. Both groups did not differ statistically in any parameters except percentage of sites with probing depth and clinical attachment level ≥ 4 mm at baseline. The treatment group exhibited a significantly greater decrease in disease activity score including 28 joints using C-reactive protein (DAS28-CRP) (P = 0.02), serum levels of IgG to P. gingivalis hemin binding protein (HBP)35 (P = 0.04), and citrulline (P = 0.02) than the control group. Serum levels of IgG to P. gingivalis HBP35 were significantly correlated positively with those of anti-cyclic citrullinated peptide antibodies (P = 0.0002). The same correlation was obtained between serum levels of IgG to P. gingivalis-sonicated extracts and those of rheumatoid factor (P = 0.02). These results suggest that supragingival scaling decreases DAS28-CRP and serum levels of IgG to P. gingivalis HBP35 and citrulline in patients with RA. These observations may reflect a role of P. gingivalis in the protein citrullination, which is related to the pathogenesis of RA.

  17. Histological analysis of effects of 24% EDTA gel for nonsurgical treatment of periodontal tissues.

    Science.gov (United States)

    de Vasconcellos, Luana Marotta Reis; Ricardo, Lucilene Hernandes; Balducci, Ivan; de Vasconcellos, Luis Gustavo Oliveira; Carvalho, Yasmin Rodarte

    2006-12-01

    The aim of this study was to investigate, by means of histological and histomorphometric analysis, the effects of 24% ethylenediaminetetraacetic acid (EDTA) gel in periodontal tissue when used in combination with conventional periodontal treatment. Periodontitis was induced in the 2nd upper left permanent molars of 45 male Wistar rats by means of ligature. After 5 weeks, this was removed and debridement was performed. The animals were then randomly divided into 3 groups; group 1: mechanical treatment, group 2: mechanical treatment and EDTA gel application for 2 min, and group 3: mechanical treatment and placebo gel application for 2 min. After the treatment, rinsing was done with 0.9% saline solution for 1 min in all cases, followed by root notching in the deepest part of the pocket. After 4, 10, and 28 days the animals were sacrificed. The averages obtained were evaluated by means of test two-way analysis of variance (ANOVA) and Tukey statistical tests (P 24% EDTA gel did not interfere with periodontal tissue repair when used in combination with conventional periodontal treatment.

  18. Comparison of Serum Levels of Endothelin-1 in Chronic Periodontitis Patients Before and After Treatment

    Science.gov (United States)

    Varghese, Sheeja S; Sankari, M.; Jayakumar, ND.

    2017-01-01

    Introduction Endothelin-1 (ET-1) is a potent vasoconstrictive peptide with multi functional activity in various systemic diseases. Previous studies indicate the detection of ET-1 in gingival tissues and gingival crevicular fluid. Aim The aim of this study was to estimate the serum ET-1 levels in clinically healthy subjects and subjects with chronic periodontitis, before and after treatment, and correlate it with the clinical parameters. Materials and Methods A total of 44 patients were included in the study. Group I comprised of 20 subjects with clinically healthy periodontium. Group II comprised of 24 subjects with chronic periodontitis. Group III comprised of same Group II subjects following periodontal management. Serum samples were collected from the subjects and an Enzyme Linked Immunosorbent Assay (ELISA) was done to estimate the ET-1 levels. The ET-1 levels were then correlated among the three groups with the clinical parameters namely, Plaque Index (PI), Sulcus Bleeding Index (SBI), probing pocket depth, clinical attachment loss and Periodontally Inflamed Surface Area (PISA). The independent t-test and paired t-test were used for comparison of clinical parameters and Pearson’s correlation coefficient test was used for correlating the ET-1 levels. Results ET-1 levels in chronic periodontitis subjects were significantly higher compared to healthy subjects (p<0.001). However, the clinical parameters did not statistically correlate with the ET-1 levels. There was a significant decrease in ET-1 levels following treatment (p<0.001). Conclusion Serum ET-1 is increased in chronic periodontitis and reduces after periodontal therapy. Further studies are required to establish ET-1 as a biomarker for periodontal disease. PMID:28571268

  19. Experience of application of ascorbate chitosan in the treatment of periodontal disease

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    Bulkina N.V.

    2013-09-01

    Full Text Available Aim. To study the clinical anti-inflammatory effect of gel form 8% ascorbate chitozan in treatment of inflammatory periodontal disease. Material and methods. The study included 30 patients: 10 patients with chronic catarrhal gingivitis, 10 patients with chronic generalized periodontitis mild and 10 moderate. Criteria for inclusion of patients in the study: age between 18 and 45 years old, reliable diagnosis, informed consent of the patient. Case history of the disease duration from one to five years. The state of periodontal tissue was evaluated clinically and radiographically by intraoral radiography. According to treatment methods patients were divided into groups: group 1 underwent traditional treatment, group 2 was treated with the use of applications of 8% of ascorbate chitosan on the area of papillae and marginal gingiva with the capture of 1-2 cm of the mucous membrane of the alveolar process. The duration of treatment was 15 minutes daily for 10 days. Results. The patterns suggest that the therapeutic effect of ascorbate chitazan caused prolonged sanation of periodontal pockets due to the antibacterial activity of chitazan. Conclusion. The data show that regeneration in patients who have a combined treatment included ascorbate chitosan has been more rapid and complete than similar processes in periodontal patients treated in a traditional way.

  20. A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes.

    Science.gov (United States)

    Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

    2013-12-09

    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

  1. Patients' Values Related to Treatment Options for Teeth with Apical Periodontitis.

    Science.gov (United States)

    Azarpazhooh, Amir; Dao, Thuan; Ungar, Wendy J; Da Costa, Jose; Figueiredo, Rafael; Krahn, Murray; Friedman, Shimon

    2016-03-01

    This study aimed to explore patients' values when selecting treatment for a tooth with apical periodontitis (AP), namely retention via root canal treatment (RCT) and extraction without replacement or replacement with implant-supported crowns or fixed or removable partial prostheses. Through 2 surveys of patients (800 university patients and 200 community patients, response rate = 43%) and dentists (498 Ontario endodontists, periodontists, prosthodontists, oral and maxillofacial surgeons, response rate = 40% and 1983 Ontario general dentists, response rate = 15%), the importance of values that might be considered important to patients when selecting treatment options for a tooth with AP were recorded. Chi-square and Kendall's tau tests were used to respectively compare the importance rating frequency by each surveyed group and its correlation to their demographic variables (P ≤ .05). Patients considered communication and trust (94%), tooth retention (90%), esthetic outcome (84% regardless of location), cost (83%), longevity (83%), and preoperative pain (81%) as the most important decision values. Dentists overrated the importance of patients' previous experience with the treatment options (94% vs. 72%), dental insurance (90% vs. 70%), and intraoperative pain (79% vs. 60%) while underestimating the importance of maintenance cost (60% vs. 79%). Dentists should respect patients' views about esthetic outcome, longevity, and cost associated with treatment options for a tooth with AP. In particular, this survey highlights the value of communication and trust between patient and dentist and preservation of the natural tooth through RCT over implant-supported crown replacement when planning treatment for a tooth with AP. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. The Effect of Nonsurgical Periodontal Treatment on Serum and ...

    African Journals Online (AJOL)

    2016-11-02

    Nov 2, 2016 ... ... J Clin Pract 2017;20:361-8. This is an open access article distributed under the terms of the Creative Commons ... determined in the examinations of atheroma plaque. It ... is known that dental and periodontal infections may underpin ... motif chemokine 28 EIAab Science Co., Ltd., Wuhan,. China) were ...

  3. Mandibulectomy for treatment of fractures associated with severe periodontal disease.

    Science.gov (United States)

    Carvalho, Carina Marchiori; Rahal, Sheila Canevese; Dos Reis Mesquita, Luciane; Castilho, Maíra Sales; Kano, Washington Takashi; Mamprim, Maria Jaqueline

    2015-03-01

    Six cases of mandibular fractures associated with severe periodontal disease that had been treated by mandibulectomy, due to intense bone loss, were evaluated retrospectively. The dogs were mainly older, small breed dogs that had suffered a traumatic event. Four dogs had a bilateral mandibulectomy and 2 a unilateral mandibulectomy.

  4. Mandibulectomy for treatment of fractures associated with severe periodontal disease

    OpenAIRE

    Carvalho, Carina Marchiori; Rahal, Sheila Canevese; dos Reis Mesquita, Luciane; Castilho, Maíra Sales; Kano, Washington Takashi; Mamprim, Maria Jaqueline

    2015-01-01

    Six cases of mandibular fractures associated with severe periodontal disease that had been treated by mandibulectomy, due to intense bone loss, were evaluated retrospectively. The dogs were mainly older, small breed dogs that had suffered a traumatic event. Four dogs had a bilateral mandibulectomy and 2 a unilateral mandibulectomy.

  5. Efficacy therapy in a nonsurgical periodontal treatment in aggressive periodontitisno

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    Nelly Garcia-Madueño

    2016-02-01

    Full Text Available La terapia periodontal no quirúrgica es la clave para el control y el mantenimiento de la enfermedad periodontal logrando evitar la fase quirúrgica en muchos casos. Paciente de sexo masculino de 46 años de edad con diagnóstico de periodontitis agresiva generalizada se realizó el control mecánico de placa bacteriana, motivación e instrucción de higiene oral, raspado y alisado radicular manual por cuadrantes, clorhexidina al 0.12% en colutorio 15 ml por 30s dos veces al día por siete días; se complementó con terapia antibiótica sistémica clindamicina de 300mg tres veces al día por siete días. Durante un año de seguimiento con tratamiento periodontal de soporte se observó una reducción de los parámetros clínicos como sangrado al sondaje, disminución de la perdida de inserción y estabilidad del nivel óseo.

  6. Adjunctive Application of Antimicrobial Photodynamic Therapy in Nonsurgical Periodontal Treatment: A Review of Literature

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    Takeshi Kikuchi

    2015-10-01

    Full Text Available Periodontal disease is caused by dental plaque biofilms, and the removal of these biofilms from the root surface of teeth plays a central part in its treatment. The conventional treatment for periodontal disease fails to remove periodontal infection in a subset of cases, such as those with complicated root morphology. Adjunctive antimicrobial photodynamic therapy (aPDT has been proposed as an additional treatment for this infectious disease. Many periodontal pathogenic bacteria are susceptible to low-power lasers in the presence of dyes, such as methylene blue, toluidine blue O, malachite green, and indocyanine green. aPDT uses these light-activated photosensitizer that is incorporated selectively by bacteria and absorbs a low-power laser/light with an appropriate wavelength to induce singlet oxygen and free radicals, which are toxic to bacteria. While this technique has been evaluated by many clinical studies, some systematic reviews and meta-analyses have reported controversial results about the benefits of aPDT for periodontal treatment. In the light of these previous reports, the aim of this review is to provide comprehensive information about aPDT and help extend knowledge of advanced laser therapy.

  7. Oral hygiene, periodontal status and treatment needs among 12-year-old students, Castro, Chile, 2014.

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    Mariana Wauters

    2015-02-01

    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

  8. Could early rheumatoid arthritis resolve after periodontitis treatment only?: case report and review of the literature.

    Science.gov (United States)

    Salemi, Simonetta; Biondo, Michela I; Fiorentino, Chiara; Argento, Giuseppe; Paolantonio, Michele; Di Murro, Carlo; Malagnino, Vito A; Canzoni, Marco; Diamanti, Andrea Picchianti; D'Amelio, Raffaele

    2014-12-01

    Rheumatoid arthritis (RA) is an immune-mediated polyarthritis; currently no pathogenic agent has been identified as a disease trigger. A patient with RA, presumably caused by periodontal infection, whose remission has been observed after periodontitis treatment in absence of specific RA therapy, is reported here for the first time, to our knowledge. A 61-year-old male patient presented migrant arthritis associated with antibodies against citrullinated protein antigens positivity. The clinical features allowed to make RA diagnosis according to the 2010 European League against Rheumatism/American College of Rheumatology RA classification criteria. X-ray of the second upper molar showed chronic apical periodontitis. After its treatment, arthritis remission has been observed in the absence of specific RA therapy. It has been suggested that periodontitis may have a trigger role in RA pathogenesis. This could be explained by the enzymatic action of Porphyromonas gingivalis, probably leading to break tolerance to collagen. The identification and subsequent treatment of periodontitis should therefore be considered pivotal in RA prophylaxis and management.

  9. Consensus training: an effective tool to minimize variations in periodontal diagnosis and treatment planning among dental faculty and students.

    Science.gov (United States)

    John, Vanchit; Lee, Seung-Jun; Prakasam, Sivaraman; Eckert, George J; Maupome, Gerardo

    2013-08-01

    Considerable disagreements and variations exist in diagnosis and treatment planning of periodontal disease. Achieving high interrater periodontal diagnosis can prove challenging. The objectives of this study were to measure variations in periodontal diagnosis and treatment planning among predoctoral periodontics faculty members after consensus training and to compare such variation with those identified in third- and fourth-year dental students. Nine electronically stored case vignettes and survey instruments were made available to eighteen faculty members and twenty dental students under standardized conditions. A chi-square test was used to compare responses between groups, and multirater kappa tests were used to evaluate interrater agreement/reliability. Of the nine cases, only one differed between groups significantly in terms of treatment. Also, third-year students differed from fourth-year students on the diagnosis of aggressive periodontitis versus chronic periodontitis. Most respondents were able to distinguish clearly among diagnoses of chronic periodontitis, aggressive periodontitis, and gingivitis. This study established a baseline assessment of the current status of consensus after training. We will reassess variations after addressing the specific challenges identified. Programs designed and implemented to help decrease the variation in periodontal diagnosis and treatment planning among faculty members may ultimately translate into better agreement and better standardization of dental instruction.

  10. The effect of periodontal treatment on the salivary bacterial load and early plaque formation

    NARCIS (Netherlands)

    Dahan, M; Timmerman, MF; Van Winkelhoff, AJ; Van der Velden, U

    2004-01-01

    Aim: The purpose of the present study was to investigate in periodontitis patients the relationship between the number of bacteria in the saliva and the amount of de novo plaque formation before and after treatment. Methods: At baseline, before any treatment was provided, patients rinsed with 10 ml

  11. The effect of periodontal treatment on the salivary bacterial load and early plaque formation

    NARCIS (Netherlands)

    Dahan, M; Timmerman, MF; Van Winkelhoff, AJ; Van der Velden, U

    Aim: The purpose of the present study was to investigate in periodontitis patients the relationship between the number of bacteria in the saliva and the amount of de novo plaque formation before and after treatment. Methods: At baseline, before any treatment was provided, patients rinsed with 10 ml

  12. Relationship between Acute Phase of Chronic Periodontitis and Meteorological Factors in the Maintenance Phase of Periodontal Treatment: A Pilot Study.

    Science.gov (United States)

    Takeuchi, Noriko; Ekuni, Daisuke; Tomofuji, Takaaki; Morita, Manabu

    2015-08-05

    The acute phase of chronic periodontitis may occur even in patients during supportive periodontal therapy. However, the details are not fully understood. Since the natural environment, including meteorology affects human health, we hypothesized that weather conditions may affect occurrence of acute phase of chronic periodontitis. The aim of this study was to investigate the relationship between weather conditions and acute phase of chronic periodontitis in patients under supportive periodontal therapy. Patients who were diagnosed with acute phase of chronic periodontitis under supportive periodontal therapy during 2011-2013 were selected for this study. We performed oral examinations and collected questionnaires and meteorological data. Of 369 patients who experienced acute phase of chronic periodontitis, 153 had acute phase of chronic periodontitis without direct-triggered episodes. When using the autoregressive integrated moving average model of time-series analysis, the independent covariant of maximum hourly range of barometric pressure, maximum hourly range of temperature, and maximum daily wind speed were significantly associated with occurrence of acute phase of chronic periodontitis (p chronic periodontitis.

  13. Association of periodontal disease with systemic health indices in dogs and the systemic response to treatment of periodontal disease.

    Science.gov (United States)

    Rawlinson, Jennifer E; Goldstein, Richard E; Reiter, Alexander M; Attwater, Daniel Z; Harvey, Colin E

    2011-03-01

    To determine whether severity of periodontal disease (PD) was associated with systemic health indices in dogs and whether treatment of PD altered systemic health indices. Prospective cohort study. 38 dogs. Healthy dogs with clinical signs of PD were included in the study. Physical examination, serum biochemical analysis, a CBC, urine evaluation, measurement of serum C-reactive protein (CRP) concentration, and a microalbuminuria test were performed prior to treatment of PD. All tooth roots were scored for gingivitis and attachment loss, and appropriate treatment of PD was performed. Laboratory data were obtained 4 weeks after treatment. The Spearman rank correlation and Wilcoxon signed rank test were used for statistical analysis. Analyses of the correlation of several variables with attachment loss or gingivitis or of differences before and after treatment revealed significant results for several variables. After applying Bonferroni corrections for family-wise error rate, significant rank correlations were found between attachment loss and platelet number (r = 0.54), creatinine concentration (r = -0.49), and the within-dog difference in CRP concentrations before and after treatment (r = 0.40). The BUN concentration was significantly higher after treatment than before treatment. Increasing severity of attachment loss was associated with changes in systemic inflammatory variables and renal indices. A decrease in CRP concentration after treatment was correlated with the severity of PD. The BUN concentration increased significantly after treatment of PD. There is a need for continued research into the systemic impact of PD.

  14. Severe Periodontal Disease Associated with Long-Term Treatment with Intravenous Immunoglobulin

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    Jôice Dias Corrêa

    2014-01-01

    Full Text Available Intravenous immunoglobulin (IVIG is used in the treatment of neuropathy. This case report presents, for the first time, a patient with severe periodontal destruction after chronic therapy with IVIG. The patient reported having extracted his maxillary anterior teeth himself due to high mobility. Clinical examination and radiographic images show a generalized and severe periodontitis. No significant alterations in genetic or microbiological features were observed. The present case suggests that periodontal disease aggravation could be considered a new adverse effect of IVIG therapy. Postulated mechanisms are immune complexes formation, complement activation, and a direct effect in osteoclasts. In conclusion, it is important that patients that will receive IVIG treatment underwent dental evaluation.

  15. National Economic Burden Associated with Management of Periodontitis in Malaysia.

    Science.gov (United States)

    Mohd Dom, Tuti Ningseh; Ayob, Rasidah; Abd Muttalib, Khairiyah; Aljunid, Syed Mohamed

    2016-01-01

    Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

  16. National Economic Burden Associated with Management of Periodontitis in Malaysia

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    Tuti Ningseh Mohd Dom

    2016-01-01

    Full Text Available Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010 data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

  17. Periodontal treatment effects on endothelial function and cardiovascular disease biomarkers in subjects with chronic periodontitis: protocol for a randomized clinical trial

    Science.gov (United States)

    2011-01-01

    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

  18. Periodontal treatment effects on endothelial function and cardiovascular disease biomarkers in subjects with chronic periodontitis: protocol for a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Arce Roger M

    2011-02-01

    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

  19. Clinical and Microbiological Effects of Photodynamic Therapy Associated with Non-surgical Treatment in Aggressive Periodontitis

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    Mohammad Taghi Chitsazi

    2014-09-01

    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.

  20. USAGE OF PASTE FOR TEMPORARY PLACEMENT IN THE TREATMENT OF CHRONIC APICAL PERIODONTITIS

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    A.V. Borysenko

    2012-03-01

    Full Text Available Summary: The aim of the present investigation was usage of medicamental paste with antibacterial and regeneration action for temporary placement in the treatment of chronic apical periodontitis. Materials and method: The medicamental paste for temporary placement of root canals consists of a mixture of metronidazole, Enterosgel (Silm and Alflutop (Biotehnos S.A., Romania. Thë paste was used for the treatment of 30 teeth with chronic apical periodontitis. Final obturation of the root canals was performed with gutta percha cones and sealer. The efficiency of the treatment was appreciated after examination on the basis of clinical and radiographic findings. Results: During the treatment of the 30 teeth, no exacerbations of the pathological process were recorded. Pain after obturation of the root canals was revealed in only 6 (20% of the treated teeth. No pain, pathologic changes of gingiva, good mastication efficiency in all teeth after treatment were revealed. Conclusions: The high clinical efficiency of the medicamental paste with antibacterial and regeneration action at the level of temporary root canals placement in the treatment of chronic apical periodontitis was shown. Keywords: chronic apical periodontitis, medicamental paste for temporary root canals placement, metronidazole, Enterosgel (Silm and Alflutop (Biotehnos S.A., Romania

  1. Pleiotropic effects of statins on the treatment of chronic periodontitis--a systematic review.

    Science.gov (United States)

    Estanislau, Ilanna Mara Gomes; Terceiro, Icrólio Ribeiro Colares; Lisboa, Mario Roberto Pontes; Teles, Patrícia de Barros; Carvalho, Rosimary de Sousa; Martins, Ricardo Souza; Moreira, Maria Mônica Studart Mendes

    2015-06-01

    Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and are an important group of hypolipidaemic drugs, widely used in the treatment of hypercholesterolaemia and cardiovascular disease. Some studies have shown that statins are able to modulate inflammation and alveolar bone loss. In order to evaluate whether statins could influence periodontal treatment, improving the clinical and radiographic parameters in chronic periodontitis, a systematic review was conducted in the databases PUBMED and BIREME, searching for articles in English and Portuguese, published between the years 2004 and 2014, using the combined keywords statin, periodontal disease, periodontitis and alveolar bone. Studies regarding the treatment of chronic periodontitis in humans, blind or double-blind, retrospective cohort or randomized controlled trials that used statins topically or systemically were selected. Statins have important anti-inflammatory and immune effects, reducing levels of C-reactive protein and matrix metalloproteinases and their intermediate products, such as tumour necrosis factor-α, and are also able to inhibit the adhesion and extravasation of leukocytes, which block the co-stimulation of T cells. Statins reduce bone resorption by inhibiting osteoclast formation and lead to increased apoptosis of these cells. The effect of statins on bone formation is related to the increased gene expression of bone morphogenetic protein in osteoblasts. Although we found biological mechanisms and clinical results that show lower alveolar bone loss and reduction of clinical signs of inflammation, further studies are needed to evaluate the clinical applicability of statins in the routine treatment of chronic periodontitis. © 2014 The British Pharmacological Society.

  2. Effect of periodontal treatment on preterm birth rate: a systematic review of meta-analyses.

    Science.gov (United States)

    López, Néstor J; Uribe, Sergio; Martinez, Benjamín

    2015-02-01

    Preterm birth is a major cause of neonatal morbidity and mortality in both developed and developing countries. Preterm birth is a highly complex syndrome that includes distinct clinical subtypes in which many different causes may be involved. The results of epidemiological, molecular, microbiological and animal-model studies support a positive association between maternal periodontal disease and preterm birth. However, the results of intervention studies carried out to determine the effect of periodontal treatment on reducing the risk of preterm birth are controversial. This systematic review critically analyzes the methodological issues of meta-analyses of the studies to determine the effect of periodontal treatment to reduce preterm birth. The quality of the individual randomized clinical trials selected is of highest relevance for a systematic review. This article describes the methodological features that should be identified a priori and assessed individually to determine the quality of a randomized controlled trial performed to evaluate the effect of periodontal treatment on pregnancy outcomes. The AMSTAR and the PRISMA checklist tools were used to assess the quality of the six meta-analyses selected, and the bias domain of the Cochrane Collaboration's Tool was applied to evaluate each of the trials included in the meta-analyses. In addition, the methodological characteristics of each clinical trial were assessed. The majority of the trials included in the meta-analyses have significant methodological flaws that threaten their internal validity. The lack of effect of periodontal treatment on preterm birth rate concluded by four meta-analyses, and the positive effect of treatment for reducing preterm birth risk concluded by the remaining two meta-analyses are not based on consistent scientific evidence. Well-conducted randomized controlled trials using rigorous methodology, including appropriate definition of the exposure, adequate control of confounders for

  3. Assessment of the Effect of Orthodontic Treatment on the Periodontal Health of Endodontically Restored Tooth.

    Science.gov (United States)

    Jalaluddin, Md; Goyal, Vinod; Naqvi, Zuber A; Gupta, Bhaskar; Asnani, Mohil M; Sonigra, Hitesh M

    2017-07-01

    Intorduction: Patients usually undergo orthodontic treatment for achieving ideal interocclusal relationship between the dental tissue and bony tissue along with improving the speech, mastication, and facial esthetic appearance. Literature quotes paucity in the studies evaluating the effect of orthodontic treatment on the periodontal health of endodontically treated teeth. Hence, we planned the present study to assess the effect of orthodontic treatment on the periodontal health of endodonti-cally restored tooth. The present study included assessment of 80 patients who underwent orthodontic treatment. All the patients were divided broadly into two study groups: groups I and II. Group I included patients with the absence of endodontically treated teeth, while group II included patients which maxillary central incisors were resorted endodontically. Examination of the periodontal health of the patients was done using the community periodontal index of treatment need (CPITN) around the selected teeth. All the values were recorded during the preorthodontic time, postorthodontic time, and after the first 6 months of starting of the orthodontic treatment. All the results were recorded separately and analyzed. In the groups I and II, 28 and 25 patients respectively, had score of 1, while 10 patients in group I and 12 patients in group II had score of 2. Nonsignificant results were obtained while comparing the CPITN score in between the two study groups when measured at the pre-, intra-, and postortho time. In patients undergoing orthodontic treatment, having endodontically resorted teeth, no difference exists in relation to the periodontal health. Orthodontic treatment can be safely carried in patients with endodontically restored teeth.

  4. Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis.

    Science.gov (United States)

    Polyzos, Nikolaos P; Polyzos, Ilias P; Zavos, Apostolos; Valachis, Antonis; Mauri, Davide; Papanikolaou, Evangelos G; Tzioras, Spyridon; Weber, Daniel; Messinis, Ioannis E

    2010-12-29

    To examine whether treatment of periodontal disease with scaling and root planing during pregnancy is associated with a reduction in the preterm birth rate. Systematic review and meta-analysis of randomised controlled trials. Cochrane Central Trials Registry, ISI Web of Science, Medline, and reference lists of relevant studies to July 2010; hand searches in key journals. Randomised controlled trials including pregnant women with documented periodontal disease randomised to either treatment with scaling and root planing or no treatment. Data were extracted by two independent investigators, and a consensus was reached with the involvement a third. Methodological quality of the studies was assessed with the Cochrane's risk of bias tool, and trials were considered either high or low quality. The primary outcome was preterm birth (pregnancy outcome (preterm birth pregnancy outcome (preterm births periodontal disease with scaling and root planing cannot be considered to be an efficient way of reducing the incidence of preterm birth. Women may be advised to have periodical dental examinations during pregnancy to test their dental status and may have treatment for periodontal disease. However, they should be told that such treatment during pregnancy is unlikely to reduce the risk of preterm birth or low birthweight infants.

  5. The effect of periodontal treatment on C-reactive protein: A clinical study.

    Science.gov (United States)

    Kumar, Santosh; Shah, Samir; Budhiraja, Shilpa; Desai, Khushboo; Shah, Chirag; Mehta, Dhaval

    2013-07-01

    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.

  6. Platelet-rich fibrin in the treatment of periodontal bone defects.

    Science.gov (United States)

    Ranganathan, Aravindhan T; Chandran, Chitraa R

    2014-05-01

    Periodontitis is characterized by the formation of true pockets, bone loss and attachment loss. Various techniques have been attempted in the past to truly regenerate the lost periodontal structures, albeit with variable outcome. In this evolution, the technique being tried out widely is the use of platelet rich concentrates, namely platelet-rich fibrin (PRF). In this report, we present a case of surgical treatment of osseous bone defects namely two walled crater and dehiscence treated in posterior teeth with autologously prepared platelet rich fibrin mixed with hydroxy apatite bone graft and PRF in the form of a membrane. Our results showed clinical improvements in all the clinical parameters postoperatively namely the pocket depth reduction and gain in attachment level and hence, PRF can be used alone or in combination with the bone graft to yield successful clinical results in treating periodontal osseous defects. Platelet-rich fibrin is an effective alternative to platelet-rich plasma (PRP) in reconstructing bone defects.

  7. Periodontal Treatment and the Risks of Cardiovascular Disease in Patients with Type 2 Diabetes: A Retrospective Cohort Study.

    Science.gov (United States)

    Peng, Chiung-Huei; Yang, Yi-Sun; Chan, Kuei-Chuan; Kornelius, Edy; Chiou, Jeng-Yuan; Huang, Chien-Ning

    2017-01-01

    Objective Periodontal disease may predispose individuals to cardiovascular disease (CVD). Diabetes mellitus, especially in patients with severe periodontitis, increases the risk of CVD mortality. However, the outcomes of periodontal therapy vary among the different treatment modalities. We aim to investigate whether periodontal treatment could influence the occurrence of CVD in patients with type 2 diabetes and periodontal problems. Methods A retrospective cohort study was conducted based on a dataset released by Taiwan National Health Insurance (NHI). The dataset was composed of randomly sampled, newly diagnosed diabetic patients who received insurance benefits from 1999 to 2001; patients who were younger than 18 years of age or who already had CVD before 1999 were excluded. The NHI code was used to identify the treatments, including subgingival curettage and flap operations. The patients' demographic variables were matched using a 1:4 propensity score. All of the subjects were followed up until the onset of CVD, or December 31, 2011. A Cox proportional hazards regression analysis was performed to evaluate the effects of periodontal treatment on the rates of myocardial infarction, heart failure and stroke. Results Three thousand thirty-nine and 12,156 diabetic subjects were classified into the advanced periodontal treatment group and the non-advanced periodontal treatment group, respectively. The Cox proportional hazards analysis revealed that although the overall incidence of CVD was not significantly improved (Hazard ratio, HR 0.95; 95% CI 0.90-1.01), advanced periodontal treatment reduced the rates of myocardial infarction (HR 0.92; 95% CI 0.85-0.99) and heart failure (HR 0.60; 95% CI 0.45-0.80). There was no significance difference in the incidence of stroke (HR 0.95; 95% CI 0.85-1.06). Conclusion Advanced periodontal therapy lowers the rate of CVD, especially myocardial infarction and heart failure. Dental management has a beneficial effect on the health of

  8. Development and applications of injectable poly(ortho esters) for pain control and periodontal treatment.

    Science.gov (United States)

    Helle, J; Barr, J; Ng, S Y; Shen, H R; Schwach-Abdellaoui, K; Gurny, R; Vivien-Castioni, N; Loup, P J; Baehni, P; Mombelli, A

    2002-11-01

    Poly(ortho esters) with a low glass transition temperature are semi-solid materials so that therapeutic agents can be incorporated at room temperature, without the use of solvents, by a simple mixing procedure. When molecular weights are limited to pain are under development and human clinical trials using the decanediol polymer for the treatment of periodontitis are also underway.

  9. Anxiety, stress, depression, and patients' responses to periodontal treatment: periodontists' knowledge and professional behavior.

    Science.gov (United States)

    Kloostra, Paul W; Eber, Robert M; Inglehart, Marita Rohr

    2007-01-01

    Anxiety, stress, and depression affect the use of health care services, treatment decision-making, and responses to periodontal treatment. This study explored periodontists' confidence in detecting patient anxiety, stress, or depression, as well as their knowledge concerning the relationships between these factors and patients' pain, use of pain medication, and wound healing after periodontal treatment. In addition, this research surveyed if (and which) special accommodations were offered when treating patients with high levels of anxiety, stress, or depression. Data were collected from 171 members of the American Academy of Periodontology (response rate = 34.41%). Most respondents were male (82.2%), white (88.2%), and practiced in solo practices (60.9%). The respondents were more knowledgeable about the effects of anxiety and stress on pain, the use of pain medication, and wound healing than about the impact of depression on these outcomes. They agreed more strongly with statements that they were more confident in their ability to perceive when patients were anxious and stressed than when they were depressed. They also offered more special accommodations for patients with anxiety and stress than for patients with depression. The respondents were significantly less knowledgeable about the impact of depression on patients' responses to periodontal treatment than about the effect of anxiety and stress. Given the evidence concerning the relationships among depression, pain, pain medication use, and wound healing, it is important to educate periodontists about the role of anxiety and stress and the significance of depression on their patients' responses to periodontal therapy.

  10. Treatment of oral malodor and periodontal disease using an antibiotic rinse.

    Science.gov (United States)

    Southward, Ken; Bosy, Anne

    2013-07-01

    The purpose of this study was to determine the effectiveness of an antibiotic rinse preparation, containing metronidazole and nystatin, in decreasing oral malodor and periodontal disease for individuals whose chief complaint was halitosis. This topical approach to oral biofilm control, by proactively managing the most pathogenic bacteria, differs from the traditional approach of reactively treating the symptoms by attempting to reduce all oral bacteria. The late Dr. Loesche, University of Michigan, School of Dentistry, had previously described these different paradigms as the specific plaque hypothesis and the non-specific plaque hypothesis, respectively. Patients in this study were measured before and after treatment for volatile sulphur compounds using a portable sulphide monitor, a digital gas chromatograph, and organoleptic assessment. The presence of periodontal disease was determined by 6-point periodontal probing, to assess pocket depth and bleeding points. Of the 1000 patient charts sent electronically to the University of Michigan for analysis, 649 participants were selected based on complete pre- and post-treatment data, and statistically analyzed by a statistician, who was an expert in case study analysis. The post-treatment reduction of oral malodor was 80% (P = 0.0001). The difference in bleeding points pre- and post-treatment was 87% (P = 0.0001). There was a decrease in the number of teeth with 6 and 7 mm pockets by 76% and teeth with 5 mm pockets decreased by 84% (P = 0.0001). Treatment with the antibiotic rinse had a positive change in the periodontal status and breath odor of these patients. These data indicate that there is considerable advantage to the use of topical antibiotic rinses. A substantial decrease in both halitosis and periodontal disease markers can be achieved without the risk of the systemic effects of an oral antibiotic.

  11. Treatment of severe generalized chronic periodontitis in a patient with Behçet's disease: A case report.

    Science.gov (United States)

    Morikawa, Satoru; Ouchi, Takehito; Asoda, Seiji; Horie, Nobuyuki; Tsunoda, Kazuyuki; Kawana, Hiromasa; Nakagawa, Taneaki

    2018-05-01

    Behçet's disease is a systemic disorder of unknown etiology. It involves multiple organ systems and is characterized by recurring episodes of oral ulcers as well as ocular, genital, and skin lesions. Oral ulcers can affect tooth brushing and impair proper oral hygiene. As a result, a dental biofilm accumulates, and the condition of the teeth and periodontal tissue deteriorates. The aim of this case report is to highlight the efficacy of periodontal treatment for patients with Behçet's disease. A 51-year-old man with Behçet's disease presented with generalized severe periodontitis. After basic treatment of the periodontal tissues, periodontal surgery was performed at several sites with bony defects. However, the patient developed severe stomatitis in the oral mucosa and gingiva after periodontal surgery. Administration of the antimicrobial agent cefdinir had little effect on recovery; however, subsequent administration of sitafloxacin resulted in significant improvement of the stomatitis. This case demonstrates that periodontal therapy is very useful for alleviating the oral signs and symptoms of Behçet's disease. Systemic antibiotic treatment with sitafloxacin (but not cefdinir) and mechanical debridement were effective in preventing the recurrence of aphthous ulcer outbreaks after periodontal surgery.

  12. [Evaluation of the need for periodontal treatment in prisons near Dakar, Senegal].

    Science.gov (United States)

    Diouf, M; Cissé, D; Lo, C M M; Faye, D; Faye, B; Benoist, H M; Souaré, N

    2009-12-01

    Oral diseases qualify as major public health problems due to their high prevalence and incidence. They usually affect poor and marginal segments of the population. This study focused on the prison population that is characterized by poor living conditions and malnutrition. The aim of study was to assess the need for periodontal care in prisoners serving time in the Dakar region of Senegal. This cross-sectional study included 375 prisoners serving in three facilities, i.e. the penal camp, Liberte VI prison for women, and Rufisque prison for women. Data were collected using a modified WHO information sheet. The community periodontal index of treatment needs (CPITN) was used for scoring. Statistical analysis with stratification by sex and age was performed and tests were considered as significant for p prison time was 39.29 months +/- 17.73. The proportion of prisoners needing periodontal treatment increased gradually according to prison time with significant differences (p prison time would reduce the need for periodontal treatment in prisons in Dakar.

  13. Generalized Aggressive Periodontitis and Its Treatment Options: Case Reports and Review of the Literature

    Directory of Open Access Journals (Sweden)

    T. Roshna

    2012-01-01

    Full Text Available Generalized aggressive periodontitis results in rapid destruction of the periodontium and can lead to early tooth loss in the affected individuals if not diagnosed early and treated appropriately. The diagnostic features of the disease are characteristic, but the clinical presentation and patterns of destructions may vary between patients. Successful management of the disease is challenging especially if diagnosed at advanced stages of the disease, but not impossible with the current therapeutic choices for the disease. A vast array of treatment modalities is available which can be employed in the treatment of generalized aggressive periodontitis with varying success rates, but a definite guideline for the management is yet to be formulated. However, with the exponential rate of developments in periodontal research, regenerative therapy, tissue engineering, and genetic technologies, the future seems promising in regard to options at managing the disease. This paper attempts to describe the clinical and radiographic diagnostic features and the current treatment options along with a suggested protocol for comprehensive management of generalized aggressive periodontitis patients with case reports and a brief review.

  14. Hemisection for treatment of an advanced endodontic-periodontal lesion: a case report.

    Science.gov (United States)

    Haueisen, H; Heidemann, D

    2002-06-01

    To emphasize the importance of primary endodontic treatment when dealing with endo-perio lesions and to demonstrate the considerable healing potential of the endodontic aspect. After several years of unsuccessful symptomatic periodontal treatment, an advanced endo-perio lesion on a right-mandibular first molar was successfully treated by root-canal treatment and hemisection after the re-evaluation of the lesion. This successful treatment appeared to have a positive effect on the patient's general well-being. The origin of a combined endo-perio lesion is indicated by its clinical and radiographic appearance. The periodontal situation is often misinterpreted. The prognosis for the endodontic element of treatment is excellent. Local pathologic processes in the oral cavity may affect a patient's general health.

  15. Multidisciplinary therapy for the treatment of malocclusion in a patient with chronic periodontitis with a five-year follow-up: A case report.

    Science.gov (United States)

    Zhang, Dongmei; Lin, Li; Tang, Xiaoling; Li, Chen; Liu, Jingbo; Wang, Hongyang; Pan, Yaping

    2017-10-01

    Multidisciplinary therapy is essential in dental practice to achieve optimized outcomes. The present case report describes the application of periodontal surgery with a five-year follow-up in a patient with malocclusion and chronic periodontitis. In the presence of periodontal inflammation, orthodontic therapy may result in further periodontal breakdown due to plaque accumulation. In order to prevent this progression, scaling and root planning with a periodontal endoscope was applied, and continuous clinical monitoring and risk assessment was performed every 3 months using a Florida Probe. This combined treatment supports the long-term maintenance of periodontal conditions, functional occlusion and harmony of the facial profile.

  16. A New Approach for the Treatment of Lateral Periodontal Cysts with an 810-nm Diode Laser.

    Science.gov (United States)

    Isola, Gaetano; Matarese, Giovanni; Lo Giudice, Giuseppe; Briguglio, Francesco; Alibrandi, Angela; Crupi, Andrea; Cordasco, Giancarlo; Ramaglia, Luca

    The aim of this study was to test whether the combination of diode laser therapy and surgical treatment for a lateral periodontal cyst (LPC) would result in greater clinical improvement compared with surgery alone. A total of 18 patients with LPCs were assessed for eligibility for this study. At baseline, each patient was randomly allocated to one of two regimens: diode laser plus surgery (test group) or traditional surgical treatment alone (control group). Healing parameters were assessed at 7 to 21 days to monitor short-term complications, and periodontal parameters were assessed at 3, 6, and 12 months to evaluate long-term healing. The test group demonstrated highly significant differences in both the short-term and long-term parameters compared with the control group. This study showed that diode laser treatment results in a shorter wound-healing period and could be considered valuable for the surgical treatment of LPCs.

  17. Treatment of periodontal disease with guided tissue regeneration technique using a hydroxyapatite and polycaprolactone membrane

    Directory of Open Access Journals (Sweden)

    L.M.A. Martins

    Full Text Available ABSTRACT The aim of this study was to evaluate the use of a malleable membrane composed of hydroxyapatite (60% and polycaprolactone (40% as treatment of periodontal disease experimentally induced in dogs. A bone defect of standardized dimensions was created between the roots of the third and fourth premolar of 12 dogs for periodontal disease induction. Six dogs had the defect covered by the membrane and six dogs received only standard treatment for periodontal disease, also applied to dogs in the treated group. The animals were clinically monitored during the experiment. Radiographs were taken after surgery and at 60 days after treatment initiation. Clinical attachment level was also assessed in those moments. On the 60th day, dental sample of all animals, containing tooth, defect and periodontal tissues, were harvested, fixed in formalin and analyzed by microtomography and histology. During the experimental period, the animals showed no pain and purulent discharge, however, there was dehiscence in 50% of animals and membrane exposure in five out of six animals in the treated group. Clinical attachment level showed no difference between groups. Radiographs showed radiopacity equal to the alveolar bone in both groups. The microtomography revealed that the control group had higher bone volume in the defect compared to the treated group; however, the furcation was not filled by new alveolar bone in any animal. Histological analysis revealed that junctional epithelium invasion was lighter in the control group. New bone was only observed in the apical edge of the defect in both groups. Although the composite is biocompatible and able to keep the space of the defect, it did not promote periodontal tissue regeneration within 60 days of observation.

  18. Periodontal and restorative considerations with clear aligner treatment to establish a more favorable restorative environment.

    Science.gov (United States)

    Boyd, Robert L

    2009-06-01

    Although standard fixed appliances are better suited to control difficult tooth movement in three planes of space, clear aligner orthodontic treatment may be requested by patients because of the superior esthetics compared with conventional fixed appliances when clear aligners can be considered. Several clinical trials have shown improved periodontal status during orthodontic treatment with clear aligners while fixed appliances have almost always been associated with increased inflammation and mild periodontal breakdown despite preventive measures performed during treatment. There have been no reports of decalcification and only one reported case of root resorption with clear aligners, whereas with fixed appliances, numerous incidents of both decalcification and root resorption have been reported. In addition, studies have also shown significantly less pain from soft-tissue injuries and muscle soreness from parafunctional habits with computer-aided clear aligners. Restorative advantages include improved esthetics and comfort during treatment for better case acceptance and the ability to bleach teeth throughout treatment. Improving tooth alignment with orthodontic treatment with fixed or clear appliances increases the clinician's potential capability to perform more conservative restorative procedures, requiring less tooth structure removal and less endodontic involvement because of better tooth positions. In those cases in which clear aligner appliances may be appropriate, less damage may occur to existing porcelain restorations than might transpire from bonding of fixed appliances and their removal, as well as potentially reduced tooth wear during treatment. This article presents three case reports that demonstrate the periodontal and restorative aspects of treatment using the computer-aided clear appliances, which have either eliminated the need for certain restorative procedures or created a better periodontal and tooth position environment for performing these

  19. Curcumin photodynamic effect in the treatment of the induced periodontitis in rats.

    Science.gov (United States)

    Theodoro, Letícia Helena; Ferro-Alves, Marcio Luiz; Longo, Mariéllen; Nuernberg, Marta Aparecida Alberton; Ferreira, Renata Pironato; Andreati, Adriele; Ervolino, Edilson; Duque, Cristiane; Garcia, Valdir Gouveia

    2017-11-01

    This study assessed the effect of curcumin as a photosensitizer in antimicrobial photodynamic therapy (aPDT) for the treatment of induced periodontitis in rats. Periodontitis was induced via a ligature around the mandibular first molar on the left side of 96 rats. The ligature was removed 7 days later, and the animals were randomized into four groups: NT, no local treatment; CUR, irrigation with curcumin solution (40 μM); LED, irradiation with a light-emitting diode (LED, InGaN, 465-485 nm, 200 mW/cm 2 , 60 s); and aPDT, irrigation with curcumin solution (40 μM) followed by irradiation with LED. Eight animals from each group were euthanized at 7, 15, and 30 days post-treatment. Treatments were assessed using alveolar bone loss (ABL) in the furcation region using histological, histometric, and immunohistochemical analyses. Rats treated with aPDT exhibited less ABL at 7 days compared to the NT group, moderate pattern immunolabeling for osteoprotegerin at 30 days, and a pattern of immunolabeling for RANKL from moderate to low. Treatments resulted in smaller numbers of TRAP-positive cells compared to the NT group. aPDT as monotherapy using curcumin as a photosensitizer and LED as the light source was effective in the treatment of induced periodontitis in rats.

  20. Cost-effectiveness of root caries preventive treatments.

    Science.gov (United States)

    Schwendicke, Falk; Göstemeyer, Gerd

    2017-01-01

    With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis.

    Science.gov (United States)

    Rosa, Maria Inês da; Pires, Patrícia Duarte Simões; Medeiros, Lidia Rosi; Edelweiss, Maria Isabel; Martínez-Mesa, Jeovany

    2012-10-01

    The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR) with 95% confidence intervals (95%CI) was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19) and low birth weights (RR = 0.92; 95%CI: 0.71-1.20). The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.

  2. Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines.

    Science.gov (United States)

    Oz, A Z; Ciger, S

    2018-03-01

    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.

  3. Periodontal treatment during pregnancy and birth outcomes: a meta-analysis of randomised trials.

    Science.gov (United States)

    George, Ajesh; Shamim, Simin; Johnson, Maree; Ajwani, Shilpi; Bhole, Sameer; Blinkhorn, Anthony; Ellis, Sharon; Andrews, Karen

    2011-06-01

    The objective of this review was to conduct a meta-analysis of all up-to-date randomised control trials to determine whether periodontal treatment during pregnancy has the potential of reducing preterm birth and low birth weight incidence. Bibliographic databases MEDLINE (1966-present), EMBASE (1980-present), CINAHL (1982-present) and the Cochrane library up to and including 2010 Issue 10 were searched. The reference list of included studies and reviews were also searched for additional literature. Eligible studies were, published and ongoing randomised control trials that compared pregnancy outcomes for pregnant women who received periodontal treatment during the prenatal period. Two of the investigators independently assessed the studies and then extracted and summarised data from eligible trials. Extracted data were entered into Review Manager software and analysed. A total of 5645 pregnant women participated in the 10 eligible trials. Meta-analysis found that periodontal treatment significantly lowered preterm birth (odd ratio 0.65; 95% confidence interval, 0.45-0.93; P = 0.02) and low birth weight (odd ratio 0.53; 95% confidence interval, 0.31-0.92; P = 0.02) rates while no significant difference was found for spontaneous abortion/stillbirth (odd ratio 0.71; 95% confidence interval, 0.43-1.16; P = 0.17). Moderate heterogeneity was observed among the studies for preterm birth and low birth weight. Subgroup analysis showed significant effect of periodontal treatment in pregnant women with low rate of previous preterm birth/low birth weight (odd ratio 0.35; 95% confidence interval, 017-0.70; P = 0.003) and less severe periodontal disease (odd ratio 0.49; confidence interval, 028-0.87; P = 0.01) as defined by probing depth. The cumulative evidence suggests that periodontal treatment during pregnancy may reduce preterm birth and low birth weight incidence. However, these findings need to be further validated through larger more targeted randomised control trials.

  4. Use of pectin in patients with diabetes mellitus type 2 in the complex treatment of the periodontal disease (report 2)

    OpenAIRE

    S. V. Kosenko; I. O. Balaban; O. B. Hayoshko; O. M. Ilnytska; N. M. Yatsynovych; S. O. Ivanov; N. I. Muzichenko

    2014-01-01

    Introduction. According the literature problem of the treatment of patients with periodontal tissues pathology, accompanied by diabetes mellitus, is serious and is not always successfully solved. Drugs that inhibit glucose absorption (polysugars) are effective in diabetes mellitus. "Pektodent" (Ukraine) applying in the treatment and prevention of chronic generalized periodontitis of II-III degree in patients with diabetes mellitus type 2 can be appropriate in this case. The objective of ...

  5. Lyotropic liquid crystal preconcentrates for the treatment of periodontal disease.

    Science.gov (United States)

    Fehér, A; Urbán, E; Eros, I; Szabó-Révész, P; Csányi, E

    2008-06-24

    The aim of our study was to develop water-free lyotropic liquid crystalline preconcentrates, which consist of oils and surfactants with good physiological tolerance and spontaneously form lyotropic liquid crystalline phase in aqueous environment. In this way these preconcentrates having low viscosity can be injected into the periodontal pocket, where they are transformed into highly viscous liquid crystalline phase, so that the preparation is prevented from flowing out of the pocket due to its great viscosity, while drug release is controlled by the liquid crystalline texture. In order to follow the structure alteration upon water absorption polarization microscopical and rheological examinations were performed. The water absorption mechanism of the samples was examined by the Enslin-method. Metronidazole-benzoate was used as active agent the release of which was characterized via in vitro investigations performed by means of modified Kirby-Bauer disk diffusion method. On the grounds of the results it can be stated that the 4:1 mixture of the investigated surfactants (Cremophor EL, Cremophor RH40) and oil (Miglyol 810) formed lyotopic liquid crystalline phases upon water addition. Polarization microscopic examinations showed that samples with 10-40% water content possessed anisotropic properties. On the basis of water absorption, rheological and drug release studies it can be concluded that the amount of absorbed water and stiffness of lyotropic structure influenced by the chemical entity of the surfactant exerted major effect on the drug release.

  6. PRACTICAL PERIODONTAL SURGERY: AN OVERVIEW

    OpenAIRE

    Krishna; Chandrashekar; Anuroopa; Senthil; Syed; Sandeep S; Kumuda; Ashwini

    2014-01-01

    The efficacy of periodontal surgery in the treatment of periodontal diseases not yet been systematically evaluated. The objective of this review was to systematically evaluate the efficacy of periodontal surgical procedures in the various treatment modalities. Periodontal disease is multifaceted in nature and scope. The problems created due to this inflammatory condition are different eg. gingival enlargement, osseous deformities, mucogingival problem which ultimately may ...

  7. Microbial changes in patients with acute periodontal abscess after treatment detected by PadoTest.

    Science.gov (United States)

    Eguchi, T; Koshy, G; Umeda, M; Iwanami, T; Suga, J; Nomura, Y; Kawanami, M; Ishikawa, I

    2008-03-01

    To investigate changes in bacterial counts in subgingival plaque from patients with acute periodontal abscess by IAI-PadoTest. Ninety-one patients were randomly allocated to either test or control groups. In all the patients, pockets with acute periodontal abscess were irrigated with sterilized physiological saline, and in the test group, 2% minocycline hydrochloride ointment was applied once into the pocket in addition. Subgingival plaque samples were collected by paper point before treatment and 7 days after treatment. The total bacterial count was determined and Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, were detected using IAI-PadoTest, a DNA/RNA probe method. The total bacterial count decreased in both groups, with a significant decrease in the test group. The counts and number of sites positive for P. gingivalis, T. forsythia and T. denticola significantly decreased in the test group after treatment, compared with those in the control group. Pocket depth decreased in the both groups, with a statistically significant decrease in the test group. Topical treatment with minocycline in pockets with acute periodontal abscess was effective in reducing the bacterial counts as shown by the microbiological investigation using PadoTest 4.5.

  8. Effect of periodontal disease treatment during pregnancy on preterm birth incidence: a metaanalysis of randomized trials.

    Science.gov (United States)

    Polyzos, Nikolaos P; Polyzos, Ilias P; Mauri, Davide; Tzioras, Spyridon; Tsappi, Maria; Cortinovis, Ivan; Casazza, Giovanni

    2009-03-01

    We conducted a metaanalysis of randomized controlled trials to determine whether periodontal disease treatment with scaling and/or root planing during pregnancy may reduce preterm birth (PTB) or low birthweight (LBW) infant incidence. Treatment resulted in significantly lower PTB (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.35-0.86; P = .008) and borderline significantly lower LBW (OR, 0.48; 95% CI, 0.23-1.00; P = .049), whereas no difference was found for spontaneous abortion/stillbirth (OR, 0.73; 95% CI, 0.41-1.31; P = .292). Subgroup analysis suggested significant effect of treatment in the absence of history of PTB or LBW (OR, 0.48; 95% CI, 0.29-0.77; P = .003) and less severe periodontal disease as defined by probing depth (OR, 0.49; 95% CI, 0.28-0.87; P = .014) or bleeding on probing site (OR, 0.37; 95% CI, 0.14-0.95; P = .04). If ongoing large and well-designed randomized trials support our results, we might need to reassess current practice or at least be cautious prior to rejecting treatment of periodontal disease with scaling and/or root planing during pregnancy.

  9. Long-term periodontal response to orthodontic treatment of palatally impacted maxillary canines.

    Science.gov (United States)

    Caprioglio, Alberto; Vanni, Arianna; Bolamperti, Laura

    2013-06-01

    One of the most important aspects to take into consideration when evaluating the outcome of treatment of impacted maxillary canines is the final periodontal status. The aim of the present study was to evaluate the long-term periodontal response of palatally impacted maxillary canines aligned using a codified procedure and the 'Easy Cuspid' compared with contralateral spontaneously erupted teeth. The periodontal conditions of the adjacent teeth were also considered. From an initial sample of 124 patients, 33 patients (24 females and 9 males) were selected. All patients who had undergone surgical orthodontic treatment conducted in accordance with a standardized protocol were recalled for follow-up at an average of 4.6 years after the end of treatment. The average treatment time was 29 months and the mean eruption time of the previously impacted tooth was 3.1 months. The average probing depth values showed no significant clinical differences. Probing depths recorded at the vestibular surface of the lateral incisor (P alignment of palatally impacted canines without damage to the periodontium.

  10. [The development of clinical guidelines for the diagnosis and treatment of chronic periodontitis in Belgium].

    Science.gov (United States)

    Cosyn, Jan; De Bruyn, Hugo

    2008-01-01

    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.

  11. Periodontal treatment to improve glycaemic control in diabetic patients: study protocol of the randomized, controlled DIAPERIO trial.

    Science.gov (United States)

    Vergnes, Jean-Noel; Arrivé, Elise; Gourdy, Pierre; Hanaire, Hélène; Rigalleau, Vincent; Gin, Henri; Sédarat, Cyril; Dorignac, Georges; Bou, Christophe; Sixou, Michel; Nabet, Cathy

    2009-08-02

    Periodontitis is a common, chronic inflammatory disease caused by gram-negative bacteria leading to destruction of tissues supporting the teeth. Epidemiological studies have consistently shown increased frequency, extent and severity of periodontitis among diabetic adults. More recently, some controlled clinical trials have also suggested that periodontal treatment could improve glycaemic control in diabetic patients. However current evidence does not provide sufficient information on which to confidently base any clinical recommendations. The main objective of this clinical trial is to assess whether periodontal treatment could lead to a decrease in glycated haemoglobin levels in metabolically unbalanced diabetic patients suffering from chronic periodontitis. The DIAPERIO trial is an open-label, 13-week follow-up, randomized, controlled trial. The total target sample size is planned at 150 participants, with a balanced (1:1) treatment allocation (immediate treatment vs delayed treatment). Periodontal treatment will include full mouth non-surgical scaling and root planing, systemic antibiotherapy, local antiseptics (chlorhexidine 0.12%) and oral health instructions. The primary outcome will be the difference in change of HbA1c between the two groups after the 13-weeks' follow-up. Secondary outcomes will be the difference in change of fructosamine levels and quality of life between the two groups. The DIAPERIO trial will provide insight into the question of whether periodontal treatment could lead to an improvement in glycaemic control in metabolically unbalanced diabetic patients suffering from periodontitis. The results of this trial will help to provide evidence-based recommendations for clinicians and a draft framework for designing national health policies. Current Controlled Trials ISRCTN15334496.

  12. Use of pectin in patients with diabetes mellitus type 2 in the complex treatment of the periodontal disease (report 2

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    S. V. Kosenko

    2014-08-01

    Full Text Available Introduction. According the literature problem of the treatment of patients with periodontal tissues pathology, accompanied by diabetes mellitus, is serious and is not always successfully solved. Drugs that inhibit glucose absorption (polysugars are effective in diabetes mellitus. "Pektodent" (Ukraine applying in the treatment and prevention of chronic generalized periodontitis of II-III degree in patients with diabetes mellitus type 2 can be appropriate in this case. The objective of this study was to develop technologies to ensure long-term rehabilitation in patients with diabetes mellitus after treatment of periodontal tissues. Materials and methods. 45 patients with diabetes type 2 with chronic generalized periodontitis of II-III severity grade were under observation for 12 months. Patients were divided into two groups, control (n = 22 and primary (n = 23. Clinical, laboratory and X-ray methods were used. The results of the treatment process were evaluated on the 1st, 7th and 14th day of research. The results of the rehabilitation process were evaluated in 30 days after treatment, and after 3, 6, and 12-month studies. Feasibilities of rehabilitation technology were determined by assessment of the influence on diabetes type 2 pathogenesis, and chronic generalized periodontitis of II-III degree Results and discussion. Endo-and exogenous application of "Pektodent" as a hygienic and prophylactic drug for oral use can significantly prolong remission period and reduce aggressive course as periodontitis and diabetes, normalizing blood pressure. Conclusions. 1. Pektodent" application in the treatment of periodontal tissues may provide long-term rehabilitation in patients with diabetes. 2. Rehabilitation period indicators in patients with diabetes mellitus type 2, such as a capillary glucose level in blood plasma, blood pressure, and impressive appearance of the lactobacilli that decrease Candida in the mouth were signs of quality treatment of

  13. Evaluation of efficacy of photodynamic therapy as an adjunct to nonsurgical periodontal therapy in treatment of chronic periodontitis patients: A clinico-microbiological study.

    Science.gov (United States)

    Raj, K Ravi; Musalaiah, Svvs; Nagasri, M; Kumar, P Aravind; Reddy, P Indeevar; Greeshma, M

    2016-01-01

    Photodynamic therapy (PDT) is a local noninvasive treatment modality without side effects caused by antibiotics. The aim of this study was to evaluate the efficacy of adjunctive use of PDT with scaling and root planing as compared with SRP alone in the treatment of chronic periodontitis. Twenty participants with chronic periodontitis having probing pocket depths (PDs) of ≥5 mm were selected for the study. Patients were randomly divided into control group and test group with ten patients in each group. Full-mouth SRP was performed in both the groups, followed by PDT in test group. Assessment of plaque index (PI), gingival index (GI), PD, and clinical attachment level (CAL) was done at baseline and after 3 months. Microbiological assessment of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola was done by polymerase chain reaction (PCR) at baseline and 3 months after the therapy. There was a significant reduction in PI, GI, PD, CAL, and microbiologic parameters in test group, following SRP and PDT, when compared with SRP alone in control group. PDT in conjunction with SRP has shown additional improvement in periodontal parameters when compared to SRP alone and has a beneficial effect in chronic periodontitis patients.

  14. Interest and satisfaction of dentists in practicing periodontics: A survey based on treatment of gingival recession.

    Science.gov (United States)

    Grover, Vishakha; Kapoor, Anoop; Malhotra, Ranjan; Sachdeva, Sonia

    2012-07-01

    Gingival recession is a common occurrence and patients often report to dental clinic with associated problems such as root surface hypersensitivity, esthetic concerns, cervical root abrasions, and root caries that make it a concern for patients. Based upon the fact that gingival recession is an enigma for clinicians because of multitude of etiological factors and plethora of treatment modalities present for its treatment, a survey was conducted to assess knowledge as well as opinion about most common etiology, classification, and preferred treatment of gingival recession and to evaluate the interest and satisfaction of dentists in practicing periodontics. Study design consisted of a cross-sectional online survey, conducted among dentists practicing in state of Punjab, India, in the month of April 2011. A structured online questionnaire consisting of 17 questions evaluating the interest of dentists in periodontics based on knowledge about gingival recession (most of them giving the possibility of multiple choices of answers) was sent to about 300 dentists. Pearson Chi-Square and Mann-Whitney U tests were used for statistical analysis of data collected. P ≤ 0.05 was considered as statistically significant and P ≤ 0.01 considered as highly significant. A greater proportion of periodontists had better knowledge about etiology (P = 0.07), classification (P = 0.000), and treatment of gingival recession (P = 0.000). A greater number of periodontists opted for the surgical modalities to correct the defects produced by gingival recession as compared to non-periodontists and had better interest (P = 0.000) and satisfaction (P = 0.000) in practicing periodontics. The results elucidated that periodontists had better interest and satisfaction in practicing periodontics, and were more inclined towards surgical correction of gingival recession as compared to non-periodontists.

  15. Early pain management after periodontal treatment in dogs – comparison of single and combined analgesic protocols

    Directory of Open Access Journals (Sweden)

    Petr Raušer

    2015-01-01

    Full Text Available The aim of this study was to assess the analgesic effectiveness of three analgesic protocols in dogs undergoing a periodontal treatment. The study was performed as a prospective, randomized, “double blind” clinical study. A total of 45 client-owned dogs scheduled for periodontal treatment were included. Dogs of Group C received carprofen (4 mg·kg-1, dogs of Group B received bupivacaine (1 mg·kg-1 and dogs of Group CB received a combination of carprofen (4 mg·kg-1 and bupivacaine (1 mg·kg-1. Carprofen was administered subcutaneously 30 min before anaesthesia, bupivacaine was administered by nerve blocks in anaesthetized dogs. Painful periodontal treatment was performed in all patients, lasting up to one hour. Modified University of Melbourne Pain Score (UMPS, Visual Analogue Scale for pain assessment (VAS, plasma glucose and serum cortisol levels were assessed 30 min before administration of analgesics (C-0, B-0, CB‑0 and 2 h after recovery from anaesthesia (C-2, B-2, CB-2. For statistical analysis Friedman test, Mann-Whitney U-test, ANOVA and Fischer exact tests were used (P < 0.05. In CB‑2 compared to CB‑0 significantly decreased modified UMPS values. In CB‑2 UMPS values were significantly lower compared to C‑2 or B‑2. In C‑2 VAS values were significantly increased compared to C‑0, and in B‑2 VAS values were significantly increased compared to B‑0. Visual Analogue Scale values were significantly lower in CB‑2 compared to C‑2 or B‑2. Significantly increased plasma glucose concentrations were found in C‑2 compared to C‑0 and in B‑2 compared to B‑0. No other significant differences were detected. Administration of carprofen, bupivacaine or their combination is sufficient for early postoperative analgesia following periodontal treatment. Carprofen-bupivacaine combination is superior to carprofen or bupivacaine administered separately.

  16. Treatment of endo-periodontal lesion using leukocyte-platelet-rich fibrin. A case report.

    Science.gov (United States)

    Betancourt, Pablo; Elgueta, Ricardo; Fuentes, Ramon

    2017-12-30

    The main objective of this paper was to report the clinical effectiveness of leukocyte- platelet- rich fibrin (L-PRF) in the treatment of a combined endo-periodontal lesion of an upper first premolar. The tooth had a profound abfraction on the vestibular aspect and presented no mobility but revealed a deep pocket measuring of 11 mm on the mesial vestibular aspect and 14 mm on the mesial palatine aspect. The three dimensional image analysis showed total bone loss in the mesial aspect and an extensively bone loss of the vestibular aspect of the vestibular root. Endodontic treatment was performed and periodontal access surgery (surgical periodontal therapy) was done with the application of autologous L-PRF. Three month and 6 months after surgery, the cone beam computed tomography (CBCT) exams showed no bone regeneration in any aspect of the tooth. However, periodontal examination showed a significative improvement in the deepness of surcus. The mesial vestibular aspect had a deep pocket of 3 mm and 5 mm on the mesial palatine aspect showing a reduction in deepness of 8 mm and 9 mm, respectively. The actual treatment for teeth with bad prognosis is the extraction and replacement with implants. Even though implants are capable of restore function and aesthetic, the abuse of this approach have led to the loss of teeth that could be successfully treated with a less invasive technique. The prognosis of teeth with endoperiodontal lesion is poor but could be enhanced with regenerative therapies. Until now there are no clinical trials and just four case report about the treatment of these teeth with platelet rich fibrin.

  17. Changes in bacterial profiles after periodontal treatment associated with respiratory quality of asthmatic children

    OpenAIRE

    Wiyarni Pambudi; Imelda Fabiola; Retno Indrawati; Haryono Utomo; Anang Endaryanto; Ariyanto Harsono

    2016-01-01

    Background Despite the reduction phenomenon of asthma exacerbation after dental plaque control, no scientific report has been found to describe the link between bacterial profiles and respiratory quality in children with asthma. Objective To investigate association between bacterial profiles changes and improvement in respiratory quality after periodontal treatment. Methods Asthmatic children with FEV1 reversibility ~ 12% and dental plaque index ~ 2 who qualified for incl...

  18. Effects of topical application of Curcuma longa extract in the treatment of early periodontal diseases

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    Vikrant Sharma

    2016-01-01

    Full Text Available Background: Treatment of plaque-induced periodontal disease is largely based on the mechanical debridement of the tooth surface and meticulous maintenance of oral hygiene thereafter. Various chemical plaque control agents are used as adjuncts along with the mechanical plaque control methods for this treatment. Most of these chemical plaque control agents have varied side effects. This has led to the search of natural products which are highly effective in controlling plaque microbes while being biocompatible. Turmeric is one such well-known plant product, known for its varied medicinal value. Aim: The aim of this study is to evaluate the clinical efficacy of Curcuma longa oral formulation in treatment of infective inflammatory early periodontal diseases. Materials and Methods: This clinical study comprised twenty individuals presenting with clinical features of plaque-induced gingivitis and mild periodontitis. Three groups were randomly made in mouth of each patient selected for the study. Group I was treated with scaling and root planing (SCRP only. Group II was treated with SCRP plus C. longa oral formulation topical application for 2 weeks. Group III was treated only with topical application of C. longa extract oral formulation for 2 weeks. Gingival index, sulcus bleeding index, and plaque index were scored in each group before and after the treatment. Results: The results showed statistically significant improvement with respect to all the clinical parameters in all the three groups. However, Group II showed the maximum improvement (P < 0.001, followed by Group I (P < 0.001 and Group III (P < 0.05. The intergroup difference between the three groups for the improvements in clinical parameters was statistically nonsignificant. Conclusion: The oral formulation containing C. longa extract is effective in treating early infective-inflammatory periodontal diseases not only when used as an adjunct to SCRP but also when used alone.

  19. Conservative treatment of immature teeth with apical periodontitis using triple antibiotic paste disinfection

    OpenAIRE

    Wang, Hsin-Ju; Chen, Yea-Huey Melody; Chen, Kuan-Liang

    2016-01-01

    The purpose of this report is to present conservative treatment for two immature premolars with apical periodontitis. A triple antibiotic paste was used to disinfect the root canal systems for revascularization. In both cases, residual vital pulp tissue was noted in the root canal system after the opening of each premolar. The canals in both cases were irrigated with copious sodium hypochlorite solution and medicated with a paste consisting of ciprofloxacin, metronidazole, and minocycline. Th...

  20. Photodynamic therapy as an adjunct to non-surgical periodontal treatment: a randomized, controlled clinical trial.

    Science.gov (United States)

    Christodoulides, Nicos; Nikolidakis, Dimitris; Chondros, Panagiotis; Becker, Jürgen; Schwarz, Frank; Rössler, Ralf; Sculean, Anton

    2008-09-01

    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.

  1. Treatment of Acute Periodontal Abscesses Using the Biofilm Decontamination Approach: A Case Report Study.

    Science.gov (United States)

    Pini-Prato, Giovanpaolo; Magnani, Cristina; Rotundo, Roberto

    2016-01-01

    The aim of this preliminary study was to show the treatment effect of the biofilm decontamination approach on acute periodontal abscesses. Clinical cases showing acute periodontitis were treated using an oral tissue decontaminant material that contains a concentrated aqueous mixture of hydroxybenzenesulfonic and hydroxymethoxybenzene acids and sulfuric acid. The material was positioned into the pocket on the root surface and left in the site for 30 seconds. No instrumentation was performed before the treatment. No systemic or local antibiotics were used in any of the cases. A questionnaire was used for each patient to record the pain/discomfort felt when the material was administered. All of the treated cases healed well and very rapidly. The infections were quickly resolved without complications, and the pockets associated with marginal tissue recession were also reduced. The momentary pain upon introduction of the material was generally well tolerated in the nonsurgically treated cases, and it completely disappeared after a few seconds. The biofilm decontamination approach seems to be a very promising technique for the treatment of acute periodontal abscess. The local application of this material avoids the use of systemic or local antibiotics.

  2. Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies.

    Science.gov (United States)

    Janket, S-J; Wightman, A; Baird, A E; Van Dyke, T E; Jones, J A

    2005-12-01

    Previous analyses regarding effects of periodontal treatment on glycemic control included studies where causal association might not be assumed, or the results were reported non-quantitatively. We initiated this meta-analysis of 10 intervention studies to quantify the effects of periodontal treatment on HbA1c level among diabetic patients, to explore possible causes for the discrepant reports, and to make recommendations for future studies. Data sources were MEDLINE (January, 1980, to January, 2005), the EBMR, Cochrane Register, and bibliographies of the published articles. Three investigators extracted data regarding intervention, outcomes, and effect size. A total of 456 patients was included in this analysis, with periodontal treatment as predictor and the actual change in hemoglobin A1c level as the outcome. The weighted average decrease in actual HbA1c level was 0.38% for all studies, 0.66% when restricted to type 2 diabetic patients, and 0.71% if antibiotics were given to them. However, none was statistically significant.

  3. 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

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    Ahmad Zare Javid

    2016-02-01

    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

  4. Efficacy of antimicrobial photodynamic therapy as an adjuvant in periodontal treatment in Down syndrome patients.

    Science.gov (United States)

    Martins, Fabiana; Simões, Alyne; Oliveira, Marcio; Luiz, Ana Claudia; Gallottini, Marina; Pannuti, Claudio

    2016-12-01

    Down syndrome (DS) has characteristics that include mental retardation, a characteristic phenotype, congenital heart defects, immune disorders, and increased risk of periodontal disease (PD). Antimicrobial photodynamic therapy (aPDT) is the combined use of photosensitizers associated with low-level laser (LLL) and oxygen, leading to singlet oxygen formation, which contributes to the antibacterial activity of the phagocytes, killing bacteria. The objective of this study was to evaluate the efficacy of aPDT as an adjuvant to conventional periodontal treatment of PD in DS patients. A double-blinded, controlled, randomized, split-mouth study was conducted. A total of 13 DS subjects who were 18 years or older and who presented at least one tooth in each quadrant of the mouth with probing pocket depth (PPD) equal to or greater than 5 mm were included. The patients were evaluated at three different times: at the baseline, PPD were obtained. After 1 week, conventional scaling and root planing (SRP) was performed, and two randomly selected quadrants also received aPDT. One month after SRP, all the patients were reevaluated. Periodontal conditions were improved among all the participants. The PDT-with-SRP group presented a nonsignificant reduction in PPD (mean = 1.27 mm, median = 1.17 mm) relative to that of the SRP group (mean = 1.00 mm, median = 0.95 mm). Changes over time were compared using the Wilcoxon test. A significant reduction in median PPD was observed in both groups (p = 0.001). Both types of periodontal treatment, with and without PDT, were similarly effective and were associated with good clinical response.

  5. Antimicrobial photodynamic therapy for the treatment of teeth with apical periodontitis: a histopathological evaluation.

    Science.gov (United States)

    Silva, Lea Assed Bezerra; Novaes, Arthur B; de Oliveira, Rafael R; Nelson-Filho, Paulo; Santamaria, Milton; Silva, Raquel Assed Bezerra

    2012-03-01

    This study evaluated the in vivo response of apical and periapical tissues of dogs' teeth with apical periodontitis after one-session endodontic treatment with and without antimicrobial photodynamic therapy (aPDT). Sixty root canals with experimentally induced apical periodontitis were instrumented and assigned to 4 groups receiving aPDT and root canal filling (RCF) or not: group aPDT+/RCF+ (n = 20): aPDT (photosensitizer phenothiazine chloride at 10 mg/mL for 3 minutes and diode laser [λ = 660 nm, 60 mW/cm(2)] for 1 minute) and RCF in the same session; group aPDT+/RCF- (n = 10); group aPDT-/RCF+ (n = 20), and group aPDT-/RCF- (n = 10). Teeth were restored, and the animals were killed after 90 days. Sections from the maxillas and mandibles were stained with hematoxylin-eosin and Mallory trichrome and examined under light microscopy. Descriptive (ie, newly formed apical mineralized tissue, periapical inflammatory infiltrate, apical periodontal ligament thickness, and mineralized tissue resorption) and quantitative (ie, periapical lesion size and number of inflammatory cells) microscopic analysis was performed. Quantitative data were analyzed by the Kruskal-Wallis and Dunn tests (α = .05). In the aPDT-treated groups, the periapical region was moderately/severely enlarged with no inflammatory cells, moderate neoangiogenesis and fibrogenesis, and the smallest periapical lesions. Although apical closure by mineralized tissue deposition was not achieved, the absence of inflammatory cells, moderate neoangiogenesis, and fibrogenesis in the periapical region in the groups treated with aPDT indicate that this can be a promising adjunct therapy to cleaning and shaping procedures in teeth with apical periodontitis undergoing one-session endodontic treatment. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  6. Minimally invasive flap surgery and enamel matrix derivative in the treatment of localized aggressive periodontitis: case report.

    Science.gov (United States)

    Kaner, Doğan; Bernimoulin, Jean-Pierre; Kleber, Bernd-Michael; Friedmann, Anton

    2009-02-01

    Localized aggressive periodontitis is a distinct entity of periodontal disease and is characterized by deep vertical bony defects that typically affect the first molars and incisors of young patients. Therapy is usually aimed at reducing the pathogenic microflora through scaling and root planing and the administration of systemic antibiotics. However, conservative periodontal therapy may result in reparative wound healing with limited regeneration of the lost tissues. Periodontal surgery combined with enamel matrix derivative has been introduced as a method to promote regeneration of the lost periodontium and has been studied extensively in the treatment of chronic periodontitis. This case report describes the treatment of a 27-year-old patient displaying severe localized aggressive periodontitis with documented disease progression. After initial therapy consisting of scaling and root planing and systemic administration of amoxicillin and metronidazole, the vertical defects were treated by minimally invasive access flaps combined with application of enamel matrix derivative. Clinical, microbiologic, and radiographic findings are reported for up to 1.5 years after initial therapy, indicating good efficacy of the therapeutic strategy and stability of the treatment outcome.

  7. A clinical case report of Hashimoto's thyroiditis and its impact on the treatment of chronic periodontitis.

    Science.gov (United States)

    Patil, B S; Giri, G R

    2012-01-01

    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.

  8. Gingival and periodontal changes in patients undergoing in vitro fertilization treatment: A clinical study

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    Leena Smadi

    2017-01-01

    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.

  9. Bisphosfonate matrix metalloproteinase inhibitors for the treatment of periodontitis: An in vitro study.

    Science.gov (United States)

    De Colli, Marianna; Tortorella, Paolo; Agamennone, Mariangela; Campestre, Cristina; Loiodice, Fulvio; Cataldi, Amelia; Zara, Susi

    2018-07-01

    Periodontitis is an inflammatory disease caused by anaerobic bacteria, including Porphyromonas gingivalis. Lipopolysaccharide (LPS)‑stimulated persistent inflammation is responsible for an increase in matrix metalloproteinase (MMP) expression, resulting in periodontal tissue destruction. The aim of the present study was to investigate synthesized bisphosphonic MMP inhibitors, in an in vitro model consisting of human gingival fibroblasts exposed to LPS, and to compare the biological responses to those induced by zoledronate (ZA), a commercial bisphosphonate. MTT and lactate dehydrogenase (LDH) assays were used to measure cell viability and cytotoxicity, respectively. ELISA was performed to evaluate prostaglandin E2 (PGE2), interleukin (IL)6 and collagen secretion, while western blotting was used to analyze MMP expression. No effect on viability and low cytotoxicity were observed following treatment with bisphosphonate compounds. In the present study, treatment with compound 1 did not increase the release of PGE2 and IL6. Increased levels of collagen I secretion were reported when compound 3 and ZA were administered. An increase of MMP8 was observed following ZA treatment, while a decrease of MMP9 and MMP14 following treatment with compounds 1, 2 and ZA were reported. The performance of compound 1 was optimal in terms of cell viability. Compound 1 also did not induce inflammation, and had the ability to counteract LPS‑induced increases in MMP expression. These data suggested that compound 1 was the most suitable treatment to progress to an in vivo animal study, with the aim to confirm its use for the treatment of periodontitis.

  10. Comparison of cefixime and amoxicillin plus metronidazole in the treatment of chronic periodontitis

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    Dukić Smiljka

    2016-01-01

    Full Text Available Introduction/Aim. Despite significant advances in current medicine and improvement of overall health education, chronic periodontitis is still a widespread disease. Losing teeth is the most serious complication of this particular illness. The aim of this study was to examine patients with chronic periodontitis in order to evaluate the efficacy of non-surgical therapy and combination of amoxicillin and metronidazole compared with cefixime, which has not been so far used for the treatment of this disease. Methods. Adult patients with chronic periodontitis (n = 90 underwent non-surgical periodontal treatment (zero-day and then randomly divided into three groups. The group I served as a control, the group II was additionally treated with the combination of amoxicillin and metronidazole (for 7 days, while the group III was treated with cefixime (also for 7 days. To assess the condition of periodontium before and seven days after the therapy, four clinical parameters were used: gingival index (GI, bleeding on probing (BOP, probing depth (PD and clinical attachment level (CAL. Results. On the day 7 after the beginning of the therapy, we found that all the three groups of patients had statistically significant clinical improvement of three parameters: GI, BOP and PD, but not of the CAL. However, the improvement of PD was only statistically, but not clinically significant. The improvement in the control group of patients on the day 7 was 19% in BOP and 28% in GI; this improvement was statistically highly significant after the addition of amoxicillin plus metronodazole (71% in BOP and 77% in GI or cefixime (62% in BOP and 82% in GI. Compared to the combination of amoxicillin and metronidazole, cefixim was statistically significantly more effective for GI (p < 0.05, while for the other three clinical parameters their effects were equal. Conclusion. The conjunction of amoxicillin plus metronidazole or cefixime to the causal treatment of patients with

  11. Comprehensive Treatment of Severe Periodontal and Periimplant Bone Destruction Caused by Iatrogenic Factors

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    Gregor-Georg Zafiropoulos

    2018-01-01

    Full Text Available Dental implant success requires placement after periodontal therapy, with adequate bone volume, plaque control, primary stability, control of risk factors, and use of well-designed prostheses. This report describes the surgical and prosthetic management of a patient with severe iatrogenic periodontal/periimplant bone destruction. Methods. A 55-year-old female smoker with fixed partial dentures (FPDs supported on teeth and implants presented with oral pain, swelling, bleeding, and a 10-year history of multiple implant placements and implants/prosthesis failures/replacements. Radiographs showed severe bone loss, subgingival caries, and periapical lesions. All implants and teeth were removed except implants #4 and #10 which served to retain an interim maxillary restoration. Bone defects were covered with nonresorbable dPTFE membranes. In the mandible, three new implants were placed and loaded immediately with a bar-retained temporary denture. Results. Seven months postoperatively, the bone defects were regenerated, and three additional mandibular implants were placed. All mandibular implants were splinted and loaded with a removable overdenture. Conclusions. In this case, periimplant infection and tissue destruction resulted from the lack of periodontal treatment/maintenance and failure to use evidence-based surgical and loading protocols. Combination therapy resolved the disease and the patient's severe discomfort while providing immediate function and an aesthetic solution.

  12. Treatment of malpositioned periodontally compromised teeth by an interdisciplinary approach - A case report

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    Sonali Deshmukh

    2009-01-01

    Full Text Available The traditional orthodontic patient-base of adolescents has changed dramatically over the last 20 years. Adult patients now comprise a very large percentage of the orthodontic patient base. These patients bring with them unique challenges to the provision of aesthetic treatment. Gingival aesthetics, for a long time the exclusive concern of the periodontist, has now become one of the chief aesthetic challenges presented to the practicing orthodontist. This report illustrates the interdisciplinary approach in a patient requiring periodontic, orthodontic and prosthodontic treatment.

  13. Changes in inflammatory mediators in gingival crevicular fluid following periodontal disease treatment in pregnancy: relationship to adverse pregnancy outcome.

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    Penova-Veselinovic, Blagica; Keelan, Jeffrey A; Wang, Carol A; Newnham, John P; Pennell, Craig E

    2015-11-01

    Periodontal disease (PD) in pregnancy is associated with an increased risk of adverse pregnancy outcomes including miscarriage and preterm birth. Evidence exists that periodontal disease treatment may reduce inflammatory mediators in gingival crevicular fluid (GCF) and the risk of inflammation-associated pregnancy complications. The aim was to determine if periodontal disease treatment during mid-pregnancy alters local inflammation in GCF and has beneficial effects on clinical dental parameters. Eighty pregnant women with clinically diagnosed PD were recruited from a randomised controlled trial on the treatment of periodontal disease in pregnancy conducted in Perth, Australia. The treatment group underwent intensive PD treatment (20-28 weeks' GA), while the control group underwent the same treatment postnatally. GCF was collected at 20 and 28 weeks' gestation and concentrations of cytokines determined by multiplex assay: IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17, TNF-α and MCP-1. Periodontal treatment significantly reduced the GCF levels of IL-1β, IL-10, IL-12p70 and IL-6 at 28 weeks' GA compared with controls, while levels of MCP-1, IL-8 and TNF-α exhibited a significant gestational age-dependent increase, but no treatment response. Post-treatment clinical parameters improved with significant reductions in bleeding on probing, clinical attachment loss, and probing depth. No changes in pregnancy-related outcomes were observed, although the severity of periodontal disease was significantly associated with an increased risk of infants born small for gestational age. PD treatment in pregnancy reduces the levels of some inflammatory mediators in the GCF and improves dental parameters, with no overt effects on pregnancy outcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Tetracycline treatment of periodontal disease in the beagle dog

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    Jeffcoat, M.K.; Williams, R.C.; Kaplan, M.L.; Goldhaber, P.

    1982-01-01

    Bone-seeking radiopharmaceutical uptake (BSRU) was used to examine alveolar bone metabolism in a longitudinal study of tetracycline efficacy in beagle dogs. BSRU was measured in untreated control dogs and in beagles receiving either 250 mg or 500 mg oral tetracycline-HCl daily for 16 months. The rate of bone loss was determined for radiographs taken semiannually for a 6-month pretreatment period and for a 24-month treatment period. Measurements of BSRU obtained at month 16 of treatment were correlated with rates of bone loss determined radiographically in an attempt to determine whether BSRU was indicative of the subsequent rate of bone loss. A reduced rate of alveolar bone loss was found in the 500 mg tetracycline group at month 16 of the study relative to the untreated controls which was consistent with the decreased bone-seeking radiopharmaceutical uptake observed in this group. A significantly increased BSRU (p<.0001) was found in the 250 mg tetracycline group at month 16 of study relative to the untreated and 500 mg tetracycline groups. A rapid increase in the rate of bone loss in the 250 mg tetracycline group which was not detectable prior to 16 months of treatment became evident radiographically by 24 months. Thus, increased BSRU in the 250 mg tetracycline group appeared to detect the loss of the effect of tetracycline (escape phenomenon). 13 references, 4 figures.

  15. Application of orthodontic treatment for the periodontal and restorative goals in adults

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    Hiroshi Kamioka

    2016-06-01

    Full Text Available There are increasing number of adult patients who started orthodontic treatment in the last decade. As for the patient with the age of 40 years or older in our clinic, it increases 4 times as much as ten years ago. It seems that orthodontic treatment for the elderly person gradually recognized in our society. At the same time, it is considered as one of the factors that the introduction from a dentist increased to facilitate their dental procedures necessary to control dental disease, restore function, and/or enhance appearance. Therefore, in this lecture, I would like to think about how we can make use of orthodontic treatment for adults to have ideal periodontal and restorative goals. In addition, the benefits and risks of adjunctive orthodontic treatment and comprehensive orthodontic treatment would be discussed with the presenting case reports.

  16. Comparing the efficiency of Er,Cr:YSGG laser and diode laser on human β-defensin-1 and IL-1β levels during the treatment of generalized aggressive periodontitis and chronic periodontitis.

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    Ertugrul, Abdullah Seckin; Tekin, Yasin; Talmac, Ahmet Cemil

    2017-11-01

    The aim of this study is to determine the suitability of the Er,Cr:YSGG and 940 ± 15-nm diode laser for the treatment of generalized aggressive periodontitis and chronic periodontitis by measuring the levels of human β-defensin-1 and IL-1β. A total of 26 patients were included in this study. The study was designed as a "split-mouth" experiment. We performed scaling and root planing in the right maxillary quadrant, scaling and root planning + Er,Cr:YSGG laser in the left maxillary quadrant, scaling and root planning + 940 ± 15-nm diode laser in the left mandibular quadrant, and only scaling and root planing in the right mandibular quadrant. The presence of human β-defensin-1 and IL-1β was analyzed with an ELISA. When the baseline and post-treatment human β-defensin-1 levels and IL-1β levels of the study groups were evaluated, a decrease in human β-defensin-1 and IL-1β were observed in the quadrant where the Er,Cr:YSGG laser was applied in both the generalized aggressive periodontitis group and the chronic periodontitis group. The use of the Er,Cr:YSGG laser at non-surgical periodontal treatment decreased both IL-1β and human β-defensin-1 levels. It is likely that Er,Cr:YSGG laser is more suitable for the treatment of generalized aggressive periodontitis and chronic periodontitis.

  17. Short-term clinical outcomes of laser supported periodontal treatment concept using Er,Cr:YSGG (2780nm) and diode (940 nm): a pilot study

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    Odor, Alin A.; Violant, Deborah; Badea, Victoria; Gutknecht, Norbert

    2016-03-01

    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

  18. Periodontal status and high-sensitivity C-reactive protein levels in polycystic ovary syndrome with and without medical treatment.

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    Porwal, Surya; Tewari, Shikha; Sharma, Rajinder K; Singhal, Savita Rani; Narula, Satish C

    2014-10-01

    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.

  19. Effect of Er, Cr: YSGG laser combined with oral basic treatment on inflammatory injury and apoptosis in patients with periodontitis

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    Wei-Xing Jin

    2017-09-01

    Full Text Available Objective: To study the effect of Er, Cr: YSGG laser combined with oral basic treatment on inflammatory injury and apoptosis in patients with periodontitis. Methods: Patients with chronic periodontitis who were treated in dental clinic of our hospital between February 2015 and March 2017 were selected as the research subjects and randomly divided into the group A who accepted ultrasonic dental cleaning, hand scaling combined with Er, Cr: YSGG laser treatment and the group B who received ultrasonic dental cleaning and hand scaling treatment. The contents of inflammatory response cytokines, protease molecules and apoptosis molecules in gingival crevicular fluid were detected before treatment and 1 week after treatment. Results: TNF-α, hs-CRP, IL-1β, IL-6, IL-8, EMMPRIN, CyPA, MMP2, MMP9, Smac, Bax, Fas and FasL contents in gingival crevicular fluid of both groups of patients 1 week after treatment were significantly lower than those before treatment, and TNF-α, hs-CRP, IL-1β, IL-6, IL-8, EMMPRIN, CyPA, MMP2, MMP9, Smac, Bax, Fas and FasL contents of group A 1 week after treatment were significantly lower than those of group B. Conclusion: Er, Cr: YSGG laser combined with oral basic treatment can inhibit the inflammatory injury and apoptosis in periodontal tissue of patients with periodontitis.

  20. Gram-positive rods prevailing in teeth with apical periodontitis undergoing root canal treatment.

    Science.gov (United States)

    Chávez de Paz, L E; Molander, A; Dahlén, G

    2004-09-01

    To identify Gram-positive rods from root canals of teeth with apical periodontitis and to examine their associations with other species. Consecutive root canal samples (RCSs) from 139 teeth undergoing root canal treatment were analyzed prospectively for cultivable microbes. Gram-positive rods in the first RCS submitted after chemo-mechanical preparation were categorised to genus level by selective media and gas-liquid chromatography (GLC), and identified to species level by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Associations between organisms were measured by odds ratios (OR). In the first samples submitted a total of 158 Gram-positive rods, 115 Gram-positive cocci, 26 Gram-negative rods and 9 Gram-negative cocci, were identified. At genus levels Gram-positive rods were classified into: Lactobacillus spp. (38%), Olsenella spp. (18%), Propionibacterium spp. (13%), Actinomyces spp. (12%), Bifidobacterium spp. (13%) and Eubacterium spp. (6%). The most frequent species were Olsenella uli, Lactobacillus paracasei and Propionibacterium propionicum. In subsequent samples taken during treatment, Gram-positive rods were also identified, although the number of strains was considerably reduced. Positive associations were observed between members of the genus lactobacilli and Gram-positive cocci (OR>2). Olsenella uli and Lactobacillus spp. predominated over other Gram-positive rods. A possible association exists between Lactobacillus spp. and Gram-positive cocci in root canals of teeth with apical periodontitis receiving treatment.

  1. Periodontitis: facts, fallacies and the future.

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    Slots, Jørgen

    2017-10-01

    This volume of Periodontology 2000 represents the 25th anniversary of the Journal, and uses the occasion to assess important advancements in periodontology over the past quarter-century as well as the hurdles that remain. Periodontitis is defined by pathologic loss of the periodontal ligament and alveolar bone. The disease involves complex dynamic interactions among active herpesviruses, specific bacterial pathogens and destructive immune responses. Periodontal diagnostics is currently based on clinical rather than etiologic criteria, and provides limited therapeutic guidance. Periodontal causative treatment consists of scaling, antiseptic rinses and occasionally systemic antibiotics, and surgical intervention has been de-emphasized, except perhaps for the most advanced types of periodontitis. Plastic surgical therapy includes soft-tissue grafting to cover exposed root surfaces and bone grafting to provide support for implants. Dental implants are used to replace severely diseased or missing teeth, but implant overuse is of concern. The utility of laser treatment for periodontitis remains unresolved. Host modulation and risk-factor modification therapies may benefit select patient groups. Patient self-care is a critical part of periodontal health care, and twice-weekly oral rinsing with 0.10-0.25% sodium hypochlorite constitutes a valuable adjunct to conventional anti-plaque and anti-gingivitis treatments. A link between periodontal herpesviruses and systemic diseases is a strong biological plausibility. In summary, research during the past 25 years has significantly changed our concepts of periodontitis pathobiology and has produced more-effective and less-costly therapeutic options. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Scaling-Stimulated Salivary Antioxidant Changes and Oral-Health Behavior in an Evaluation of Periodontal Treatment Outcomes

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    Po-Sheng Yang

    2014-01-01

    Full Text Available Aim. Our goal was to investigate associations among scaling-stimulated changes in salivary antioxidants, oral-health-related behaviors and attitudes, and periodontal treatment outcomes. Materials and Methods. Thirty periodontitis patients with at least 6 pockets with pocket depths of >5 mm and more than 16 functional teeth were enrolled in the study. Patients were divided into three groups: an abandoned group (AB group, a nonprogress outcome group (NP group, and an effective treatment group (ET group. Nonstimulated saliva was collected before and after scaling were received to determine superoxide dismutase (SOD and the total antioxidant capacity (TAOC. Results. Salivary SOD following scaling significantly increased from 83.09 to 194.30 U/g protein in patients who had irregular dental visit patterns (<1 visit per year. After scaling, the TAOC was significantly higher in patients who had regular dental visits than in patients who had irregular dental visits (3.52 versus 0.70 mmole/g protein, P<0.01. The scaling-stimulated increase in SOD was related to a higher severity of periodontitis in the NP group, while the scaling-stimulated increase in the TAOC was inversely related to the severity of periodontitis in the AB group. Conclusions. These results demonstrate the importance of scaling-stimulated salivary antioxidants as prognostic biomarkers of periodontal treatment.

  3. The effects of non-surgical periodontal treatment on glycemic control, oxidative stress balance and quality of life in patients with type 2 diabetes: A randomized clinical trial.

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    Hirofumi Mizuno

    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.

  4. Antimicrobial photodynamic therapy combined with periodontal treatment for metabolic control in patients with type 2 diabetes mellitus: study protocol for a randomized controlled trial

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    Evangelista, Erika Elisabeth; Fran?a, Cristiane Miranda; Veni, Priscila; de Oliveira Silva, Tamires; Gon?alves, Rafael Moredo; de Carvalho, Ver?nica Franco; Deana, Alessandro Melo; Fernandes, Kristianne P S; Mesquita-Ferrari, Raquel A; Camacho, Cleber P; Bussadori, Sandra Kalil; Alvarenga, Let?cia Heineck; Prates, Renato Araujo

    2015-01-01

    Background The relationship between diabetes mellitus (DM) and periodontal disease is bidirectional. DM is a predisposing and modifying factor of periodontitis, which, in turn, worsens glycemic control and increases proteins found in the acute phase of inflammation, such as C-reactive protein. The gold standard for the treatment of periodontal disease is oral hygiene orientation, scaling and planing. Moreover, systemic antibiotic therapy may be employed in some cases. In an effort to minimize...

  5. Tratamiento integrado ortoperiodontal en la periodontitis juvenil: Presentación de un caso Orthoperiodontal integrated treatment in juvenile periodontitis: A case report

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    Tatiana Peña Ruiz

    2007-12-01

    Full Text Available La periodontitis juvenil es un término que se usa para incluir diferentes tipos de periodontitis que afectan a jóvenes sanos. Esta entidad afecta a personas en la segunda década de la vida y se ha dividido en 2 formas: la localizada y la generalizada. Se presenta el caso de una paciente femenina de 13 años de edad, mestiza, estudiante de canto coral, la cual llevaba año y medio de tratamiento de ortodoncia, que después de instaurados los aparatos fijos, abandonó el seguimiento por consulta de la especialidad. Al examen físico se detecta una lesión de distribución márgino papilar, con pérdida de la morfología gingival, consistencia duroelástica, aspecto fibroedematoso y color rosado intenso con manchas melánicas aisladas, gingivorragia al sondeo, dolor y movilidad en dientes anterosuperiores y en menor escala en los anteroinferiores, bolsas periodontales de hasta 8 mm y pérdidas óseas horizontales y verticales localizadas en incisivos superiores e inferiores y en los primeros molares permanentes, constatada en las radiografías. Se presenta el tratamiento indicado y la evolución del caso mediante seguimiento imagenológico.Juvenile periodontitis is a term used to include different types of periodontitis affecting healthy young individuals. This entity affects persons on the second decade of life, and it has been divided into 2 forms: the localized and the generalized. The case of a 13-year-old black female student of choral singing, who had been under orthodontia treatment for a year and a half, and that after having the fixed appliances abandoned the follow-up, was presented. On the physical examination, it was detected a lesion of the marginal and papillary distribution with loss of gingival morphology, hardelastic consistency, fibroedematous aspect and dark pink colour with isolated melanic stains, gingivorrhagia, pain and mobility in the anterosuperior teeth, and in a less scale in the anteroinferior, periodontal pockets of

  6. Treatment of periodontal disease in a patient with Ehlers-Danlos syndrome. A case report and literature review.

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    Perez, Luis A; Al-Shammari, Khalaf F; Giannobile, William V; Wang, Hom-Lay

    2002-05-01

    Ehlers-Danlos syndrome (EDS) designates a heterogeneous group of connective tissue disorders characterized by skin elasticity, tissue fragility, and chronic joint pain. Dental findings have been reported with some types of EDS. This case report describes the periodontal findings in a patient with a previously undiagnosed EDS type VIII. Diagnostic aids utilized included microbial testing, histological examination, gingival crevicular fluid (GCF) analysis for the levels of C-telopeptide pyridinoline cross-links (ICTP), and genetic counseling. Periodontal treatment consisted of mechanical debridement and adjunctive antibiotic therapy. Genetic counseling and clinical presentation confirmed the diagnosis of EDS type VIII. Periodontal treatment led to marked clinical improvements and GCF levels of the bone resorptive marker ICTP were significantly reduced. The patient and her siblings are currently pursuing appropriate medical care and genetic counseling. Periodontal involvement may lead to the diagnosis of an underlying systemic condition. Identification of suspected etiological factors of periodontal disease may prove critical for the general well-being of some patients.

  7. Effects of periodontal treatment on carotid intima-media thickness in patients with lifestyle-related diseases: Japanese prospective multicentre observational study.

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    Kudo, Chieko; Shin, Wee Soo; Sasaki, Nobuhiro; Harai, Kazuo; Kato, Kai; Seino, Hiroaki; Goke, Eiji; Fujino, Takemasa; Kuribayashi, Nobuichi; Pearce, Youko Onuki; Taira, Masato; Matsushima, Ryoji; Minabe, Masato; Takashiba, Shogo

    2018-01-12

    Atherosclerosis, a chronic inflammatory disease in arterial blood vessels, is one of the major causes of death in worldwide. Meanwhile, periodontal disease is a chronic inflammatory disease caused by infection with periodontal pathogens such as P. gingivalis (Porphyromonas gingivalis). Several studies have reported association between periodontal infection and atherosclerosis, but direct investigation about the effects of periodontal treatment on atherosclerosis has not been reported. We have planned Japanese local clinics to determine the relationship between periodontal disease and atherosclerosis under collaborative with medical and dental care. A prospective, multicentre, observational study was conducted including 38 medical patients with lifestyle-related diseases in the stable period under consultation at participating medical clinics and 92 periodontal patients not undergoing medical treatment but who were consulting at participating dental clinics. Systemic and periodontal examinations were performed before and after periodontal treatment. At baseline, LDL-C (low-density lipoprotein cholesterol) levels and percentage (%) of mobile teeth were positively related to plasma IgG (immunoglobulin) antibody titer against P. gingivalis with multivariate analysis. Corresponding to improvements in periodontal clinical parameters after treatment, right and left max IMT (maximum intima-media thickness) levels were decreased significantly after treatment (SPT-S: start of supportive periodontal therapy, SPT-1y: at 1 year under SPT, and SPT-3y: at 3 years under SPT). The present study has clarified our previous univariate analysis results, wherein P. gingivalis infection was positively associated with progression of atherosclerosis. Thus, routine screening using plasma IgG antibody titer against P. gingivalis and periodontal treatment under collaborative with medical and dental care may prevent cardiovascular accidents caused by atherosclerosis.

  8. A Biofilm Pocket Model to Evaluate Different Non-Surgical Periodontal Treatment Modalities in Terms of Biofilm Removal and Reformation, Surface Alterations and Attachment of Periodontal Ligament Fibroblasts.

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    Tobias T Hägi

    Full Text Available There is a lack of suitable in vitro models to evaluate various treatment modalities intending to remove subgingival bacterial biofilm. Consequently, the aims of this in vitro-study were: a to establish a pocket model enabling mechanical removal of biofilm and b to evaluate repeated non-surgical periodontal treatment with respect to biofilm removal and reformation, surface alterations, tooth hard-substance-loss, and attachment of periodontal ligament (PDL fibroblasts.Standardized human dentin specimens were colonized by multi-species biofilms for 3.5 days and subsequently placed into artificially created pockets. Non-surgical periodontal treatment was performed as follows: a hand-instrumentation with curettes (CUR, b ultrasonication (US, c subgingival air-polishing using erythritol (EAP and d subgingival air-polishing using erythritol combined with chlorhexidine digluconate (EAP-CHX. The reduction and recolonization of bacterial counts, surface roughness (Ra and Rz, the caused tooth substance-loss (thickness as well as the attachment of PDL fibroblasts were evaluated and statistically analyzed by means of ANOVA with Post-Hoc LSD.After 5 treatments, bacterial reduction in biofilms was highest when applying EAP-CHX (4 log10. The lowest reduction was found after CUR (2 log10. Additionally, substance-loss was the highest when using CUR (128±40 µm in comparison with US (14±12 µm, EAP (6±7 µm and EAP-CHX (11±10 µm. Surface was roughened when using CUR and US. Surfaces exposed to US and to EAP attracted the highest numbers of PDL fibroblasts.The established biofilm model simulating a periodontal pocket combined with interchangeable placements of test specimens with multi-species biofilms enables the evaluation of different non-surgical treatment modalities on biofilm removal and surface alterations. Compared to hand instrumentation the application of ultrasonication and of air-polishing with erythritol prevents from substance-loss and results

  9. Attitudes regarding specialist referrals in periodontics.

    Science.gov (United States)

    Sharpe, G; Durham, J A; Preshaw, P M

    2007-02-24

    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.

  10. Clinical evaluation of periodontal health during orthodontic treatment with fixed appliances

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    Hănțoiu T.

    2014-12-01

    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.

  11. Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS).

    Science.gov (United States)

    Macones, George A; Parry, Samuel; Nelson, Deborah B; Strauss, Jerome F; Ludmir, Jack; Cohen, Arnold W; Stamilio, David M; Appleby, Dina; Clothier, Bonnie; Sammel, Mary D; Jeffcoat, Marjorie

    2010-02-01

    The purpose of this study was to test whether treating periodontal disease (PD) in pregnancy will reduce the incidence of spontaneous preterm delivery (SPTD) at periodontal disease does not reduce the incidence of SPTD. Copyright 2010. Published by Mosby, Inc.

  12. Interdisciplinary periodontics: the multidisciplinary approach to the planning and treatment of complex cases.

    Science.gov (United States)

    Lyons, Karl M; Darby, Ivan

    2017-06-01

    Periodontics cannot be practiced in isolation as frequently many patients have multiple dental needs or medical health issues requiring management. In addition, pathology may manifest in the periodontal tissues, and the onset and progression of periodontitis can be affected by systemic conditions, such as diabetes, and vice versa. The focus of this volume of Periodontology 2000 is interdisciplinary periodontics, and the articles included discuss the interactions and the interrelationshipbetween periodontal tissues/periodontal diseases and endodontics, fixed prosthodontics, implant dentistry, esthetics, gerodontology, radiology, orthodontics, pediatric dentistry, oral and maxillofacial surgery, oral pathology, special needs dentistry and general medicine. Previous volumes of Periodontology 2000 have covered some of the interactions between periodontal diseases and other dental disciplines, especially implant dentistry, 'and the interaction between periodontal disease and systemic disease', but there has not been a volume on interdisciplinary periodontics. The intention therefore is to show how and why periodontics should be interdisciplinary, as well as the benefits of an interdisciplinary approach; in addition, the potential consequences of using a discipline in isolation are discussed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Prevalence of herpesviruses in gingivitis and chronic periodontitis: relationship to clinical parameters and effect of treatment

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    Rucha Shah

    2016-01-01

    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.

  14. The street children of Manila are affected by early-in-life periodontal infection: description of a treatment modality: sea salt.

    Science.gov (United States)

    Michel, J F; Michel, M G; Nadan, J; Nowzari, H

    2013-01-01

    Thousands of street children of Manila are affected by early-in-life oral infection. The aim of the present investigation was to evaluate the effectiveness of a sea-salt mouthrinse solution in street children of Manila affected by mild to severe forms of periodontal disease. These children were all in need of special protection: abandoned, abused, exploited, neglected, orphaned, poor. During 3 oral-health missions in 2003, 2004 and 2005, 617 abandoned children (5 to 13 year-old), received oral examination at a non-sectarian child-caring institution in Metro Manila (Virlanie Foundation) by calibrated examiners. A treatment based on what could be done was proposed: 1. Teaching of a precise tooth brushing technique with sea-salt, controlled and reinforced every two days for one week by calibrated health educators, 2. The application of sea-salt water mouthrinse (2.5 gram in 20 ml). Periodontal measurements were repeated at the end of each mission. All children returned to child-caring institution for the followup examinations. In 2003, 10 male and 11 female (n=21) were diagnosed with aggressive periodontitis. In 2009 and 2010, none was affected by aggressive periodontitis. For all patients, the gingival index decreased from 1.08 at the first mission to 1.04 at the end of the second mission and 0.98 at the end of the third mission. The periodontal index decreased from 1.33 at the first mission to 0.98 at the second mission and 0.92 at the last mission. The present investigation confirms that prevention and early diagnosis can result in success with minimum cost. The provided oral health program empowered street children in the most desperate circumstances to be educated and become self-reliant, independent, and responsible. We propose here an antimicrobial approach which has a high degree of efficacy and tolerability, and can be implemented in virtually all parts of the world using low-cost resources.

  15. Is the Treatment with Biological or Non-biological DMARDS a Modifier of Periodontal Condition in Patients with Rheumatoid Arthritis?

    Science.gov (United States)

    Romero-Sanchez, Consuelo; Rodríguez, C; Santos-Moreno, P; Mesa, A M; Lafaurie, G I; Giraldo-Q, S; De-Avila, J; Castillo, D M; Duran, M; Chalem, P Ch; Bello Gualtero, J M; Valle-Oñate, R

    2017-01-01

    Experimental models suggest the use of different therapy protocols in rheumatoid arthritis (RA) as modulators on periodontal condition. This study evaluated the effects of conventional drug treatment and anti-TNF therapy in patients with RA on microbiological and periodontal condition, establishing the association of markers of periodontal infection with indexes of rheumatic activity. One hundred seventy nine individuals with RA were evaluated (62 with anti-TNF-. and 115 with only DMARDs). The periodontal evaluation included plaque and gingival indexes, bleeding on probing (BOP), clinical attachment loss (CAL), pocket depth (PD) and subgingival plaque samples for microbiological analysis. Rheumatologic evaluations included a clinical examination, rheumatoid factor (RF), antibodies against cyclic-citrullinated peptides (ACPAs), and activity markers (DAS28-ERS), high sensitive C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR). Anti-TNF-alpha therapy influenced periodontal microbiota with a higher frequency of T. denticola (p=0.01). Methotrexate combined with leflunomide exhibited a higher extension of CAL (p=0.005), and anti-TNF-alpha therapy with methotrexate was associated with a lower extension of CAL (p=0.05). The use of corticosteroids exerted a protective effect on the number of teeth (p=0.027). The type of DMARD affected P. gingivalis, T. forsythia and E. nodatum presence. Elevated ACPAs titers were associated with the presence of red complex periodontal pathogens (p=0.025). Bleeding on probing was associated with elevated CPR levels (p=0.05), and ESR was associated with a greater PD (p=0.044) and presence of red complex (p=0.030). Different pharmacological treatments for RA affect the clinical condition and subgingival microbiota. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. Effect of a controlled release device containing minocycline microspheres on the treatment of chronic periodontitis: A comparative study

    Science.gov (United States)

    Gopinath, V.; Ramakrishnan, T.; Emmadi, Pamela; Ambalavanan, N.; Mammen, Biju; Vijayalakshmi

    2009-01-01

    Introduction: Adjunctive therapy with locally delivered antimicrobials has resulted in improved clinical outcomes. The aim of this study was to evaluate the efficacy and safety of locally administered minocycline microspheres (Arestin™) in the treatment of chronic periodontitis. Materials and Methods: A total of 60 sites from 15 patients in the age group of 35-50 years, who had periodontal pockets measuring 5-8 mm and had been diagnosed with chronic periodontitis, were selected for the study. The selected groups were randomly assigned to either the control group (group A) or the treatment/test group (group B). Only scaling and root planing were done at the base line visit for the control sites followed by local application of Arestin™ (1 mg). Clinical parameters such as plaque index, gingival index, and gingival bleeding index were recorded at baseline, day 30, day 90, and day 180 in the selected sites of both the groups. Probing pocket depth also was recorded at baseline, day 90, and day 180 for both the groups. Results: A statistically significant reduction was observed in both groups. Group B showed better results than Group A and these differences were statistically significant. Conclusion: The results of this study clearly indicate that treatment with scaling and root planing plus minocycline microspheres (Arestin™) is more effective and safer than scaling and root planing alone in reducing the signs of chronic periodontitis. PMID:20407655

  17. Effect of a controlled release device containing minocycline microspheres on the treatment of chronic periodontitis: A comparative study

    Directory of Open Access Journals (Sweden)

    Gopinath V

    2009-01-01

    Full Text Available Introduction: Adjunctive therapy with locally delivered antimicrobials has resulted in improved clinical outcomes. The aim of this study was to evaluate the efficacy and safety of locally administered minocycline microspheres (Arestin TM in the treatment of chronic periodontitis. Materials and Methods: A total of 60 sites from 15 patients in the age group of 35-50 years, who had periodontal pockets measuring 5-8mm and had been diagnosed with chronic periodontitis, were selected for the study. The selected groups were randomly assigned to either the control group (group A or the treatment/test group (group B. Only scaling and root planing were done at the base line visit for the control sites followed by local application of Arestin™ (1mg. Clinical parameters such as plaque index, gingival index, and gingival bleeding index were recorded at baseline, day 30, day 90, and day 180 in the selected sites of both the groups. Probing pocket depth also was recorded at baseline, day 90, and day 180 for both the groups. Results: A statistically significant reduction was observed in both groups. Group B showed better results than Group A and these differences were statistically significant. Conclusion: The results of this study clearly indicate that treatment with scaling and root planing plus minocycline microspheres (Arestin™ is more effective and safer than scaling and root planing alone in reducing the signs of chronic periodontitis.

  18. The efficacy of proanthocyanidins and secnidazole in the treatment of chronic periodontitis after scaling and root planing therapy.

    Science.gov (United States)

    Li, M; Li, R; Jin, Q; Pang, J; Xu, Z

    2017-01-01

    The aim of this study is to evaluate the clinical and microbiological effect of the systemic antibiotic therapy of proanthocyanidins and secnidazole on periodontitis. Seventy-five subjects with chronic periodontitis were randomly divided into two treatment groups (secnidazole or proanthocyanidins) and one placebo control group (25 cases each). Plaque index (PI), gingival index (GI), gingival bleeding index (BI), probing pocket depth (PPD), and clinical attachment level (CAL) were carried out at baseline, post-treatment and 3 months after treatment. Microbial analysis was performed at baseline and post-treatment. The results show that the two treatment groups had greater mean reduction in BI, GI, and PPD evaluated at both post-treatment and 3 months after treatment compared to the control group (p less than 0.05), but there were no significant differences in those of PI and CAL (except CAL evaluated at post-treatment, p 0.05). After treatment, culturable bacteria counts significantly decreased. In conclusion, the adjunctive use of proanthocyanidins or secnidazole in combination with scaling and root planing in adults with periodontitis is effective in reducing the pathogenic flora and achieves significantly better clinical results to a certain degree.

  19. A case of localized juvenile periodontitis: treatment and 3 years follow-up with superimposable radiographs.

    Science.gov (United States)

    Dubrez, B; Baehni, P; Cimasoni, G

    1996-06-01

    A 17-year-old male patient with localized juvenile periodontitis was treated by subgingival instrumentation with full thickness flap on the lower molars, combined with a 3-week course of systemic tetracycline, and a programme of supervised oral hygiene. The treatment was rapidly followed by dramatic clinical and microbiological improvement. However, despite good oral hygiene, gingival inflammation recurred at regular intervals. It was necessary to maintain the clinical results by periodic subgingival instrumentation with an ultrasonic scaler. Healing of alveolar bone was monitored in the lower 1st molar regions over 3 years by using superimposable radiographs. Quantitative analysis of bone density performed with a high-resolution digitalisation technique showed a considerable improvement 1 year after therapy. However, continuous remodelling, probably related to variations in inflammation, occurred during the 3 postoperative years.

  20. Conservative treatment of immature teeth with apical periodontitis using triple antibiotic paste disinfection

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    Hsin-Ju Wang

    2016-06-01

    Full Text Available The purpose of this report is to present conservative treatment for two immature premolars with apical periodontitis. A triple antibiotic paste was used to disinfect the root canal systems for revascularization. In both cases, residual vital pulp tissue was noted in the root canal system after the opening of each premolar. The canals in both cases were irrigated with copious sodium hypochlorite solution and medicated with a paste consisting of ciprofloxacin, metronidazole, and minocycline. The teeth were sealed with mineral trioxide aggregate and restored with composite resin. There were satisfactory outcomes after 18 months. The patients were asymptomatic, with radiographic evidence of complete resolution of radiolucency, continual thickening of dentinal walls, apical closure, and increased root length.

  1. A critical assessment of adverse pregnancy outcome and periodontal disease.

    Science.gov (United States)

    Wimmer, Gernot; Pihlstrom, Bruce L

    2008-09-01

    Pre-term birth is a major cause of infant mortality and morbidity that has considerable societal, medical, and economic costs. The rate of pre-term birth appears to be increasing world-wide and efforts to prevent or reduce its prevalence have been largely unsuccessful. To review the literature for studies investigating periodontal disease as a possible risk factor for pre-term birth and adverse pregnancy outcomes. Variability among studies in definitions of periodontal disease and adverse pregnancy outcomes as well as widespread inadequate control for confounding factors and possible effect modification make it difficult to base meaningful conclusions on published data. However, while there are indications of an association between periodontal disease and increased risk of adverse pregnancy outcome in some populations, there is no conclusive evidence that treating periodontal disease improves birth outcome. Based on a critical qualitative review, available evidence from clinical trials indicates that, although non-surgical mechanical periodontal treatment in the second trimester of pregnancy is safe and effective in reducing signs of maternal periodontal disease, it does not reduce the rate of pre-term birth. Clinical trials currently underway will further clarify the potential role of periodontal therapy in preventing adverse birth outcomes. Regardless of the outcomes of these trials, it is recommended that large, prospective cohort studies be conducted to assess risk for adverse pregnancy outcome in populations with periodontal disease. It is critical that periodontal exposure and adverse birth outcomes be clearly defined and the many potential confounding factors and possible effect modifiers for adverse pregnancy outcome be controlled in these studies. If periodontal disease is associated with higher risk of adverse pregnancy outcome in these specific populations, large multicenter randomized-controlled trials will be needed to determine if prevention or

  2. Photodynamic therapy in non-surgical treatment of chronic periodontitis: short term randomized clinical trial study

    Science.gov (United States)

    Russo, C.; Palaia, G.; Loskutova, E.; Libotte, F.; Kornblit, R.; Gaimari, G.; Tenore, G.; Romeo, U.

    2016-03-01

    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.

  3. Improvement in Oral Health-related Quality of Life by Periodontal Treatment: A Case Report on Elderly Patient with Chronic Periodontitis.

    Science.gov (United States)

    Suzuki, Eiichi; Aoki, Hideo; Tomita, Sachiyo; Saito, Atsushi

    2016-01-01

    We report a case of an elderly patient with chronic periodontitis requiring periodontal surgery. An 86-year-old man presented to Tokyo Dental College Suidobashi Hospital with the chief complaint of tooth fracture in the anterior region and occlusal pain in the posterior region. Clinical examination revealed 47% of sites with a probing depth (PD) of ≥4 mm and 47% of sites with bleeding on probing. Radiographic examination revealed generalized moderate horizontal bone loss with localized vertical defects. A clinical diagnosis of moderate chronic periodontitis was made. The patient's oral health-related quality of life (QoL) was also assessed at the time of each periodontal assessment. Initial periodontal therapy was provided followed by periodontal surgery. Open flap debridement was performed at sites with a PD of ≥5 mm (teeth #15-17). Surgical crown lengthening with an apically positioned flap was performed on #11 and 13 to gain an adequate biological width for the subsequent crown restoration. After confirming the stability of the periodontal tissue, provisional restorations were replaced with final restorations. No further deterioration was observed in the periodontal condition during the subsequent 1-year period of supportive periodontal therapy. Oral health-related QoL was markedly improved by the periodontal therapy. This suggests that periodontal therapy plays an important role in improving and maintaining oral health-related QoL in elderly people.

  4. Systemic antibiotics in periodontics.

    Science.gov (United States)

    Slots, Jørgen

    2004-11-01

    This position paper addresses the role of systemic antibiotics in the treatment of periodontal disease. Topical antibiotic therapy is not discussed here. The paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology. The document consists of three sections: 1) concept of antibiotic periodontal therapy; 2) efficacy of antibiotic periodontal therapy; and 3) practical aspects of antibiotic periodontal therapy. The conclusions drawn in this paper represent the position of the American Academy of Periodontology and are intended for the information of the dental profession.

  5. Role of 1% alendronate gel as adjunct to mechanical therapy in the treatment of chronic periodontitis among smokers.

    Science.gov (United States)

    Sharma, Anuj; Raman, Achala; Pradeep, Avani Raju

    2017-01-01

    Alendronate (ALN) inhibits osteoclastic bone resorption and triggers osteostimulative properties both in vivo and in vitro, as shown by increase in matrix formation. This study aimed to explore the efficacy of 1% ALN gel as local drug delivery (LDD) in adjunct to scaling and root planing (SRP) for the treatment of chronic periodontitis among smokers. 75 intrabony defects were treated in 46 male smokers either with 1% ALN gel or placebo gel. ALN gel was prepared by adding ALN into carbopol-distilled water mixture. Clinical parameters [modified sulcus bleeding index, plaque index, probing depth (PD), and periodontal attachment level (PAL)] were recorded at baseline, at 2 months, and at 6 months, while radiographic parameters were recorded at baseline and at 6 months. Defect fill at baseline and at 6 months was calculated on standardized radiographs by using the image analysis software. Mean PD reduction and mean PAL gain were found to be greater in the ALN group than in the placebo group, both at 2 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in the ALN group (41.05±11.40%) compared to the placebo group (2.5±0.93%). The results of this study showed 1% ALN stimulated a significant increase in PD reduction, PAL gain, and an improved bone fill compared to placebo gel in chronic periodontitis among smokers. Thus, 1% ALN, along with SRP, is effective in the treatment of chronic periodontitis in smokers.

  6. Local delivery of hyaluronan as an adjunct to scaling and root planing in the treatment of chronic periodontitis.

    Science.gov (United States)

    Johannsen, Annsofi; Tellefsen, Monica; Wikesjö, Ulf; Johannsen, Gunnar

    2009-09-01

    The aim of the present study was to evaluate the adjunctive effect of the local application of a hyaluronan gel to scaling and root planing in the treatment of chronic periodontitis. Twelve patients with chronic periodontitis were recruited to participate in a study with a split-mouth design and provided informed consent. Plaque formation and bleeding on probing were evaluated pretreatment (baseline) and at 1, 4, and 12 weeks post-treatment. Probing depths and attachment levels were evaluated at baseline and at 12 weeks. The patients received full-mouth scaling and root planing. A hyaluronan gel was administered subgingivally in the test sites at baseline and after 1 week. Significant differences between test and control were evaluated using the paired t test, repeated-measures analysis of variance (Wilks lambda), and a non-parametric Wilcoxon signed-rank test. A significant reduction in bleeding on probing scores and probing depths was observed in both groups at 12 weeks (P scaling and root planing may have a beneficial effect on periodontal health in patients with chronic periodontitis.

  7. Calcium phosphate cement as a "barrier-graft" for the treatment of human periodontal intraosseous defects

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    Rajesh J

    2009-01-01

    Full Text Available Background : Calcium phosphate cements (CPC are apparently good candidates for periodontal treatment by virtue of their biocompatibility, mouldability and osteoconductivity. However, the clinical efficacy in this regard has not been established. This study is aimed at the evaluation of the efficacy of a formulation of CPC in healing human periodontal intraosseous defects in comparison with hydroxyapatite ceramic granules. Materials and Methods : In this clinical study, 60 patients with periodontal defects were divided into 2 test groups and 1 control group. The defect sites in the test groups were repaired with CPC and hydroxyapatite ceramic granules (HAG. Debridement alone was given in the control group. The progress was assessed at 3, 6, 9 and 12 months observation intervals through soft tissue parameters (probing depth, attachment level and gingival recession. Results: CPC showed significantly better outcome. Probing depth reduction values of CPC, HAG and Control at 6 months were 5.40 ± 1.43, 3.75 ± 1.71 and 2.90 ± 1.48, and those at 12 months were 6.20 ± 1.80, 4.5 ± 1.91 and 2.95 ± 1.73. Clinical attachment gain values of CPC, HAG and Control at 6 months were 5.15 ± 1.50, 3.45 ± 1.96 and 2.25 ± 1.52, and those at 12 months were 5.80 ± 2.02, 3.55 ± 2.06 and 2.30 ± 1.78, In both cases the P value was < 0.001 showing high significance. The gingival recession over 12 months, for the CPC group is lesser than that in the HAG group and the value for the control group is marginally higher than both. Soft-tissue measurements were appended by postoperative radiographs and surgical re-entry in selected cases. Conclusions: Calcium phosphate cement is found to be significantly better than hydroxyapatite ceramic granules. The material could be considered as a "barrier-graft".

  8. Dental and periodontal health and treatment needs in a mother/child rural Puerto Rican population.

    Science.gov (United States)

    López Del Valle, Lydia M

    2010-03-01

    Oral research directed toward the maternal and child dyads is important because mothers are a source of dental caries pathogens and are the health behavior managers and trainers of children. The objectives of this study were: 1) to evaluate the oral health status of the mothers in a sample of 100 children aged 12 to 60 months from a rural community in Puerto Rico, and 2) to compare the children with their mothers' oral health status. A sample of 71 women and 100 of their children, (Mean Age = 28.8 years +/- 9.0, and 36.41 mos +/- 18.2, respectively) were evaluated for DMFT/S and periodontal health or deft/s. A NIDCR calibrated dentist performed all dental evaluations of children and mothers utilizing NIDCR criteria. Descriptive statistics were produced. Mothers' bleeding point prevalence in at least one site was 63%; prevalence of at least one site with pocket depth of 4 to 6 mm was 37 %. Calculus prevalence was, no calculus 25%, supragingival calculus 56.7%, subgingival calculus 2.2%, supra and sub gingival calculus 16.3%. Mean Dental Indices for mothers were DMFS (16.51 -/+ 0.02), DMFT (12.20 +/- 6.76), Caries (2.93 +/- 2.86), Filling (7.07 +/- 8.76), Missing (2.93 +/- 4.53). Children's Mean Dental Indices were defs (4.32 +/- 9.7), deft (2.30 +/- 4.0), decalcifications lesions (1.36 +/-1.9), caries (1.96 +/- 3.2) and surfaces caries (3.81 +/- 8.68), fillings (0.22 +/- 0.83) and extracted teeth (0.043 +/- 0.45). Significant levels of treated and untreated caries and gingival disease were observed in this sample. The importance for primary and secondary prevention, as well as treatment for periodontal and dental disease, in rural Puerto Rican communities is evident from this investigation.

  9. Comparison of etoricoxib and indomethacin for the treatment of experimental periodontitis in rats

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    M.C.F. Azoubel

    2007-01-01

    Full Text Available We investigated the effect of etoricoxib, a selective cyclooxygenase-2 inhibitor, and indomethacin, a non-selective cyclooxygenase inhibitor, on experimental periodontitis, and compared their gastrointestinal side effects. A ligature was placed around the second upper left molars of female Wistar rats (160 to 200 g. Animals (6 per group were treated daily with oral doses of 3 or 9 mg/kg etoricoxib, 5 mg/kg indomethacin, or 0.2 mL saline, starting 5 days after the induction of periodontitis, when bone resorption was detected, until the sacrifice on the 11th day. The weight and survival rate were monitored. Alveolar bone loss (ABL was measured as the sum of distances between the cusp tips and the alveolar bone. The gastric mucosa was examined macroscopically and the periodontium and gastric and intestinal mucosa were examined by histopathology. The ongoing ABL was significantly inhibited (P < 0.05 by 3 and 9 mg/kg etoricoxib and by indomethacin: control = 4.08 ± 0.47 mm; etoricoxib (3 mg/kg = 1.89 ± 0.26 mm; etoricoxib (9 mg/kg = 1.02 ± 0.14 mm; indomethacin = 0.64 ± 0.15 mm. Histopathology of periodontium showed that etoricoxib and indomethacin reduced inflammatory cell infiltration, ABL, and cementum and collagen fiber destruction. Macroscopic and histopathological analysis of gastric and intestinal mucosa demonstrated that etoricoxib induces less damage than indomethacin. Animals that received indomethacin presented weight loss starting on the 7th day, and higher mortality rate (58.3% compared to etoricoxib (0%. Treatment with etoricoxib, even starting when ABL is detected, reduces inflammation and cementum and bone resorption, with fewer gastrointestinal side effects.

  10. Metronidazole-containing gel for the treatment of periodontitis: an in vivo evaluation

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    Sandra Sato

    2008-06-01

    Full Text Available The aim of this investigation was to monitor metronidazole concentrations in the gingival crevicular fluid (GCF collected from periodontal pockets of dogs after treatment with an experimental 15% metronidazole gel. Five dogs had periodontitis induced by cotton ligatures placed subgingivally and maintained for a 30-day period. After the induction period, only pockets with 4 mm or deeper received the gel. Each pocket was filled up to the gingival margin by means of a syringe with a blunt-end needle. GCF was collected in paper strips and quantified in an electronic device before and after 15 minutes, 1 h, 6 h, 24 h and 48 h of gel administration. The GCF samples were assayed for metronidazole content by means of a high performance liquid chromatography method. Concentrations of metronidazole in the GCF of the 5 dogs (mean ± SD, in µg/mL were 0 ± 0 before gel application and 47,185.75 ± 24,874.35 after 15 minutes, 26,457.34 ± 25,516.91 after 1 h, 24.18 ± 23.11 after 6 h, 3.78 ± 3.45 after 24 h and 3.34 ± 5.54 after 48 h. A single administration of the 15% metronidazole gel released the drug in the GCF of dogs in levels several-fold higher than the minimum inhibitory concentration for some periodontopathogens grown in subgingival biofilms for up to one hour, but metronidazole could be detected in the GCF at least 48 hours after the gel application.

  11. Is periodontal disease a public health problem?

    Science.gov (United States)

    Batchelor, P

    2014-10-01

    Clinically defined periodontal disease is highly prevalent, has considerable impacts on individuals and society and is costly to treat; the cost of dental care is the fourth highest costs of all diseases and consuming between 5 and 10% of all healthcare resources. Changes in the epidemiology of clinically defined periodontal diseases suggest that the prevalence of severe periodontal disease is low and rates of progression of periodontal destruction tend to be relatively slow. Current periodontal care modalities have a remarkably weak evidence base, with considerable resources allocated to fund interventions that include oral hygiene instruction, scale and polishes through to surgical interventions. The public health problem lies more in the failure in design of a contract between dental professionals and the state. Such a contract needs to recognise both the wider determinants of disease and the role that dental professionals could play: a contract that concentrated on rewarding outcomes, namely a diminution in treatment need, as opposed to one based simply on the number of interventions would be a major step forward.

  12. Compliance and its role in successful treatment of an advanced periodontal case: review of the literature and a case report.

    Science.gov (United States)

    Soolari, Ahmad

    2002-05-01

    Periodontal disease is a chronic disease that is perceived by many patients to be nonthreatening. Periodontal therapy has been shown to be less effective if a regular periodontal maintenance schedule is not followed after completion of active therapy. Periodontal maintenance is an integral part of successful periodontal therapy.

  13. Comorbidity of periodontal disease

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Damgaard, Christian; Olsen, Ingar

    2017-01-01

    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...

  14. Adjunctive Subantimicrobial Dose Doxycycline in the Treatment of Chronic Periodontitis in Type 2 Diabetic Patients: A Unique Combination Therapy

    Directory of Open Access Journals (Sweden)

    Gomaa Marwa Abdelhakim

    2018-03-01

    Full Text Available Background/Aim: To evaluate the effectiveness of combination therapy including subantimicrobial dose doxycycline (SDD and locally delivered doxycycline (LD as adjuncts to scaling and root planing (SRP in the treatment of chronic periodontitis in patients with type 2 diabetes mellitus (T2DM. Material and Methods: Forty patients with controlled T2DM (HbA1c ≤7% and chronic periodontitis were selected. They were randomly divided into two groups, twenty patients each: Test group (TG, n=20 patients was treated with combination therapy of full mouth SRP, LD gel 10% and SDD 20 mg twice daily for 6 months. Control group (CG, n=20 patients was treated with full mouth SRP only. The periodontal parameters were recorded at baseline, 3, 6 and 9 months and included periodontal probing depth (PD, clinical attachment level (CAL, and bleeding on probing (BOP. Gingival crevicular fluid (GCF samples were collected and a quantitative measurement of matrix metalloproteinase-8 (MMP-8 was carried out by using Enzyme-Linked Immunosorbent Assay (ELIZA at baseline, 3, 6 and 9 months. Results: Statistically significant reduction in all clinical parameters (PPD, CAL, and BOP was observed at TG over CG at 3, 6, and 9 months (p<0.05. Moreover, combination therapy provided significant reductions in the amount of GCF MMP-8 for the TG compared to CG at 3, 6, and 9 months evaluation period (p<0.05. Conclusions: Combination therapy including SRP, SDD, and LD, provided significantly greater clinical benefits than SRP alone in the treatment of chronic periodontitis in patients with controlled T2DM.

  15. Role of Lipids in the Onset, Progression and Treatment of Periodontal Disease. A Systematic Review of Studies in Humans

    Directory of Open Access Journals (Sweden)

    Alfonso Varela-López

    2016-07-01

    Full Text Available The risk of different oral problems (root caries, tooth mobility, and tooth loss can be increased by the presence of periodontal disease, which has also been associated with a growing list of systemic diseases. The presence of some bacteria is the primary etiology of this disease; a susceptible host is also necessary for disease initiation. In this respect, the progression of periodontal disease and healing of the periodontal tissues can be modulated by nutritional status. To clarify the role of lipids in the establishment, progression, and/or treatment of this pathology, a systematic review was conducted of English-written literature in PubMed until May 2016, which included research on the relationship of these dietary components with the onset and progression of periodontal disease. According to publication type, randomized-controlled trials, cohort, case-control and cross-sectional studies were included. Among all the analyzed components, those that have any effect on oxidative stress and/or inflammation seem to be the most interesting according to current evidence. On one hand, there is quite a lot of information in favor of a positive role of n-3 fatty acids, due to their antioxidant and immunomodulatory effects. On the other hand, saturated fat-rich diets increase oxidative stress as well the as intensity and duration of inflammatory processes, so they must be avoided.

  16. A Systematic Review on the Implication of Minerals in the Onset, Severity and Treatment of Periodontal Disease

    Directory of Open Access Journals (Sweden)

    Alfonso Varela-López

    2016-09-01

    Full Text Available Periodontal disease is an inflammatory disease with high prevalence in adults that leads to destruction of the teeth-supporting tissues. Periodontal therapy has been traditionally directed at reduction of the bacterial load to a level that encourages health-promoting bacteria and maintenance of oral-hygiene. The role of nutrition in different chronic inflammatory diseases has been the subject of an increasing body of research in the last decades. In this sense, there has been an important increase in the volume of research on role of nutrition in periodontitis since the diet has known effects on the immune system and inflammatory cascades. Minerals play a key role in all these processes due to the multiple pathways where they participate. To clarify the role of the different minerals in the establishment, progression and/or treatment of this pathology, a systemically review of published literature cited in PubMed until May 2016 was conducted, which included research on the relationship of these elements with the onset and progression of periodontal disease. Among all the minerals, calcium dietary intake seems important to maintain alveolar bone. Likewise, dietary proportions of minerals that may influence its metabolism also can be relevant. Lastly, some observations suggest that all those minerals with roles in immune and/or antioxidant systems should be considered in future research.

  17. Dietary antioxidants for chronic periodontitis prevention and its treatment: a review on current evidences from animal and human studies

    Directory of Open Access Journals (Sweden)

    Alfonso Varela-López

    2015-09-01

    Full Text Available Objectives: Given the relationship between chronic periodontitis and high levels of oxidative stress, this review aims to clarify what role can played the dietary intake of different antioxidants in maintaining a healthy periodontium and in reducing chronic periodontitis risk, as well as possible use of dietary therapies based on them for this disease treatment. Methods: The database of the National Library of Medicine, Washington, DC (MEDLINE PubMed was used and all the studies in animals and humans are on the subject of interest in English writing online available from inception of the database until May 2015 were collected. Results: Antioxidants analyzed in this regard include vitamin C, vitamin A, carotenoids and some polyphenols, and coenzyme Q; as well as minerals iron, copper and zinc that are constituents of antioxidant enzymes. Still, there is a paucity of studies with few human studies, mostly observational. Among the various antioxidants, vitamin E and polyphenols seem to have more evidence for its beneficial effect, but in general the studies are insufficient to rule out or establish what antioxidants are useful and which are not. Conclusions: Overall, the data presented indicate that dietary antioxidants are beneficial for periodontal health, at least under certain circumstances. However more studies are needed to establish the relationship between chronic periodontitis and each specific antioxidant and to design useful dietary interventions for this disease management.

  18. Periodontal regeneration.

    Science.gov (United States)

    Ivanovski, S

    2009-09-01

    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.

  19. Oral hygiene reinforcement in the simplified periodontal treatment of 1 hour.

    Science.gov (United States)

    Apatzidou, Danae A; Zygogianni, Penelope; Sakellari, Dimitra; Konstantinidis, Antonis

    2014-02-01

    To compare the clinical and microbiological outcome of the 1-h ultrasonic debridement of chronic periodontitis patients (CPP) with and without frequent sessions of oral hygiene reinforcement. Clinical measurements and subgingival plaque were collected from 44 CPP at baseline, 3- and 6-months. The control group received a single session of 1-h full-mouth ultrasonic debridement, while oral hygiene instructions (OHI) were reiterated over four visits. In the test group, OHI were limited in the 1-h treatment session. At 3-months, both groups received additional debridement and OHI. The "Checkerboard" DNA-DNA hybridization technique quantified Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola in plaque. At three months, smaller reductions in plaque and bleeding indices, and in P. gingivalis numbers were noted in the test group, while these differences disappeared at six months. After the 3-month re-treatment visit, the test group presented with a greater probing pocket depth (PPD) reduction. Plaque negatively affected PPD in a similar manner after both treatment approaches. Lack of oral hygiene reinforcement in the 1-h full-mouth debridement resulted in higher plaque and bleeding scores and numbers of P. gingivalis at three months; professional removal of dental biofilm every three months is beneficial in subjects with compromised plaque control. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Different antibiotic protocols in the treatment of severe chronic periodontitis: A 1-year randomized trial.

    Science.gov (United States)

    Borges, Ivan; Faveri, Marcelo; Figueiredo, Luciene Cristina; Duarte, Poliana Mendes; Retamal-Valdes, Belén; Montenegro, Sheyla Christinne Lira; Feres, Magda

    2017-08-01

    To evaluate the clinical effects of different dosages of metronidazole (MTZ) and durations of MTZ + amoxicillin (AMX) in the treatment of generalized chronic periodontitis (GChP). Subjects with severe GChP were randomly assigned to receive scaling and root planing (SRP)-only, or combined with 250 or 400 mg of MTZ + AMX (500 mg) thrice a day (TID), for 7 or 14 days. Subjects were monitored for 1 year. One hundred and nine subjects were enrolled. At 1 year, 61.9% and 63.6% of the subjects receiving AMX + 250 or 400 mg of MTZ for 14 days, respectively, reached the clinical endpoint for treatment (≤4 sites with probing depth ≥5 mm), against 31.8% of those taking 250 or 400 mg of MTZ for 7 days (p  .05). The adjunctive use of 400 or 250 mg of MTZ plus 500 mg of AMX/TID/14 days offers statistically significant and clinically relevant benefits over those achieved with SRP alone in the treatment of severe GChP. The added benefits of the 7-days regimen in this population were less evident. (ClinicalTrials.gov NCT02735395). © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Cost-Effective Fuel Treatment Planning

    Science.gov (United States)

    Kreitler, J.; Thompson, M.; Vaillant, N.

    2014-12-01

    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  2. Antipsychotic prescription patterns and treatment costs of ...

    African Journals Online (AJOL)

    Peshawar, Pakistan and to analyze the treatment costs associated with these drugs. Methods: One hundred ..... Kendall T. The rise and fall of the atypical antipsychotics. ... size determination in health studies: a practical manual. 1991. 18.

  3. Infrared lasers for the treatment of moderate to severe periodontitis: An american academy of periodontology best evidence review.

    Science.gov (United States)

    Chambrone, Leandro; Ramos, Umberto D; Reynolds, Mark A

    2018-04-22

    This systematic review assesses the efficacy of infrared laser therapy used alone or as an adjunct to nonsurgical or surgical periodontal therapy, on clinical and patient-centered outcomes in patients with periodontitis. Randomized clinical trials (RCTs) with a follow-up duration ≥ 3 months that evaluated root surface debridement (i.e., scaling and root debridement with or without surgical access) to laser therapy alone or laser therapy plus root surface debridement for the treatment of adult patients (≥18 years old) with moderate to severe aggressive or chronic periodontitis were considered eligible for inclusion. The MEDLINE, EMBASE and CENTRAL databases were searched for articles published up to and including March 2016. Random effects meta-analyses were used throughout the review using continuous data (i.e., mean changes from baseline), and pooled estimates were expressed as weighted mean differences (MDs) with their associated 95% confidence intervals (CIs). Additionally, summaries are presented of the included RCTs, critical remarks of the literature and evidence quality rating/strength of recommendation of laser procedures. Of the 475 potentially eligible articles, 28 were included in the review. Individual study outcomes and seven sets of meta-analysis (1 for the nonsurgical treatment of AgP and 9 for nonsurgical and surgical treatment of CP) showed a benefit of laser therapy in improving clinical attachment level (CAL) and probing depth (PD). However, the comparative differences in clinical outcomes were modest (laser therapies were considered weak or based on expert opinion. In patients with moderate to severe periodontitis, the nonsurgical treatment of AgP and CP by SRP plus infrared diode laser, and the surgical treatment of CP by Er:YAG laser therapy alone may promote statistically significant improvements in PD and/or CAL. However, these gains are relatively small (< 1 mm) and provide modest clinical relevance compared to SRP alone. This article

  4. Clinical analysis of heat gutta-percha vertical condensation in the treatment of pulpitis and periapical periodontitis

    Directory of Open Access Journals (Sweden)

    Li Fan

    2016-07-01

    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.

  5. Oral hygiene status, gingival status, periodontal status, and treatment needs among pregnant and nonpregnant women: A comparative study

    Directory of Open Access Journals (Sweden)

    Meena Kashetty

    2018-01-01

    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.

  6. PDT in non-surgical treatment of periodontitis in kidney transplanted patients: a split-mouth, randomized clinical trial

    Science.gov (United States)

    Marinho, Kelly C. T.; Giovani, Elcio M.

    2016-03-01

    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.

  7. Assessment of oral health status and periodontal treatment needs among rural, semi-urban, urban, and metropolitan population of Gurgaon District, Haryana State

    Directory of Open Access Journals (Sweden)

    Harpreet Singh Grover

    2016-01-01

    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.

  8. Common periodontal diseases of children and adolescents.

    Science.gov (United States)

    Al-Ghutaimel, Hayat; Riba, Hisham; Al-Kahtani, Salem; Al-Duhaimi, Saad

    2014-01-01

    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.

  9. Permeable treatment wall design and cost analysis

    International Nuclear Information System (INIS)

    Manz, C.; Quinn, K.

    1997-01-01

    A permeable treatment wall utilizing the funnel and gate technology has been chosen as the final remedial solution for one industrial site, and is being considered at other contaminated sites, such as a closed municipal landfill. Reactive iron gates will be utilized for treatment of chlorinated VOCs identified in the groundwater. Alternatives for the final remedial solution at each site were evaluated to achieve site closure in the most cost effective manner. This paper presents the remedial alternatives and cost analyses for each site. Several options are available at most sites for the design of a permeable treatment wall. Our analysis demonstrates that the major cost factor's for this technology are the design concept, length, thickness, location and construction methods for the reactive wall. Minimizing the amount of iron by placement in the most effective area and construction by the lowest cost method is critical to achieving a low cost alternative. These costs dictate the design of a permeable treatment wall, including selection of a variety of alternatives (e.g., a continuous wall versus a funnel and gate system, fully penetrating gates versus partially penetrating gates, etc.). Selection of the appropriate construction methods and materials for the site can reduce the overall cost of the wall

  10. Clinical effectiveness of diode laser therapy as an adjunct to non-surgical periodontal treatment: a randomized clinical study.

    Science.gov (United States)

    Dukić, Walter; Bago, Ivona; Aurer, Andrej; Roguljić, Marija

    2013-08-01

    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).

  11. Adjunctive Effect of Autologus Platelet-Rich Fibrin to Barrier Membrane in the Treatment of Periodontal Intrabony Defects.

    Science.gov (United States)

    Panda, Saurav; Sankari, Malaiappan; Satpathy, Anurag; Jayakumar, Doraiswamy; Mozzati, Marco; Mortellaro, Carmen; Gallesio, Giorgia; Taschieri, Silvio; Del Fabbro, Massimo

    2016-05-01

    Autologous platelet-rich fibrin (PRF) and barrier membranes in the treatment of intrabony defects in chronic periodontitis patients have shown significant clinical benefits. This study evaluates the additive effect of autologous PRF in combination with a barrier membrane versus the use of barrier membrane alone for the treatment of intrabony defects in chronic periodontitis patients. A randomized split-mouth design was used. Sixteen patients with 32 paired intrabony defects were included. In each patient 1 defect was treated using a resorbable collagen membrane along with PRF (test group) and the other defect by guided tissue regeneration alone (control group). The following clinical parameters were measured at baseline and after 9 months: plaque index, modified sulcus bleeding index, probing pocket depth, clinical attachment level, and gingival marginal level. The radiographic defect depth was also assessed at baseline and after 9 months. Test group showed a statistically significant improvement for probing depth (P = 0.002), clinical attachment level (P = 0.001), and radiographic defect depth (P < 0.001) after 9 months as compared with the control sites. Radiographic defect depth reduction was 58.19 ± 13.24% in the test group as compared with 24.86 ± 9.94% reduction in the control group. The adjunctive use of PRF in combination with barrier membrane is more effective in the treatment of intrabony defects in chronic periodontitis as compared with barrier membrane alone.

  12. The roles of viruses in periodontal diseases

    OpenAIRE

    C C Azodo; P Erhabor

    2015-01-01

    The roles of bacteria in the etiopathogenesis of periodontal disease are well-understand, but that of the virus found in the periodontal environment are poorly understood. The aim of this literature review was to report the roles of viruses in periodontal diseases. The roles of viruses in periodontal diseases were categorized into the role in disease etiology, role in the pathogenesis of periodontal diseases, role in diseases progression and role in response to treatment. Clearer understandin...

  13. Efficacy of Local and Systemic Antimicrobials in the Non-Surgical Treatment of Smokers With Chronic Periodontitis: A Systematic Review.

    Science.gov (United States)

    Chambrone, Leandro; Vargas, Miguel; Arboleda, Silie; Serna, Maritza; Guerrero, Marcela; de Sousa, Jose; Lafaurie, Gloria Inés

    2016-11-01

    The aim of this systematic review is to evaluate whether use of local or systemic antimicrobials would improve clinical results of non-surgical periodontal therapy for smokers with chronic periodontitis (CP). Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, and The Cochrane Central Register of Controlled Trials were searched up to and including March 2016. Randomized clinical trials of duration of at least 6 months were included if they reported on treatment of smokers (≥10 cigarettes per day for minimum 12 months) with CP with non-surgical periodontal therapy either alone or associated with local or systemic antimicrobials. Random-effects meta-analyses were undertaken to evaluate mean differences in probing depth (PD) and clinical attachment level (CAL). Of 108 potentially eligible articles, seven were included. Most individual studies (75%) testing locally delivered antibiotics reported that smokers benefited from this treatment approach. Pooled estimates found additional PD reduction of 0.81 mm (P = 0.01) and CAL gain of 0.91 mm (P = 0.01) at sites with baseline PD ≥5 mm. Conversely, meta-analysis on systemic use of antimicrobials failed to detect significant differences in mean changes from baseline, and only one trial supported their use. In smokers with CP, adjunctive use of local antimicrobials improved efficacy of non-surgical periodontal therapy in reducing PD and improving CAL at sites presenting PD ≥5 mm before treatment. Current evidence does not demonstrate similar gains when scaling and root planing plus systemic antimicrobial/antibiotics were associated with therapy.

  14. Photodynamic therapy: A new vista in management of periodontal diseases

    Directory of Open Access Journals (Sweden)

    Yogesh Doshi

    2010-01-01

    Full Text Available Aim: The purpose of this review was to evaluate the effectiveness of photodynamic therapy (PDT for periodontitis. This review also elucidates application of photodynamic therapy for noninvasive management of periodontitis without leading to bacterial resistance. Background: Periodontal diseases are one of the major causes of tooth loss in adults and are considered primarily an anaerobic bacterial infections caused by the so-called red complex species. Bacteria present in a biofilm community, enzymes, endotoxins, and other cytotoxic factors lead to tissue destruction and initiate chronic inflammation. Since many years pioneers have been working to provide logical and cost-effective therapy for management of periodontitis. Periodontal researchers have found that PDT is advantageous to suppress anaerobic bacteria. Clinical Significance: Applications of PDT in dentistry are growing rapidly. PDT application has an adjunctive benefit besides mechanical treatment at sites with difficult access. Necessity for flap surgery may be reduced, patient comfort may increase, and treatment time may decrease. The application of photosensitizing dyes and their excitation by visible light enables effective killing of periodonto-pathogens. The introduction of laser along with photosensitizers has brought a revolutionary change. Conclusion: The application of photodynamic therapy in management of periodontal diseases is very valuable. The therapy should be combined with nonsurgical periodontal therapy. Proper clinical application of photodynamic therapy can and will help patients who are systemically compromised and cannot undergo surgical therapy.

  15. Local and systemic antimicrobial therapy in periodontics.

    Science.gov (United States)

    Herrera, David; Matesanz, Paula; Bascones-Martínez, Antonio; Sanz, Mariano

    2012-09-01

    This review aimed to update the current evidence on the efficacy of the adjunctive use of local and systemic antimicrobials in the treatment of periodontitis and to assess whether it might improve the clinical limitations and shortcomings of standard nonsurgical treatment in the management of periodontitis. Relevant randomized clinical trials (RCT) with more than 3 months of follow-up, published from 2010 to 2012 for systemic antimicrobials and from 2008 to 2012 for local antimicrobials, were searched in Medline and critically analyzed. Scientific evidence evaluated in different systematic reviews and reviews presented at European and World Workshops were also included. Only adjunctive therapies were considered in the present review: articles comparing debridement alone or plus placebo, versus debridement plus systemic or local antimicrobials were included. Adjunctive systemic antimicrobials have been evaluated both in aggressive and chronic periodontitis: in aggressive periodontitis, amoxicillin and metronidazole have been extensively studied, reporting clinical and microbiological benefits; in chronic periodontitis, different products are under scrutiny, such as azithromycin. The clinical efficacy of local antimicrobials, although extensively demonstrated, is still surrounded by a constant debate on the cost-effectiveness evaluation and on its adequate indications. Despite the clinical efficacy of the adjunctive use of local and systemic antimicrobials, demonstrated in RCTs and in systematic reviews, there is a lack of evidence to support well-defined clinical protocols, including products and dosages. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Role of Low-Level Laser Therapy as an Adjunct to Initial Periodontal Treatment in Type 2 Diabetic Patients: A Split-Mouth, Randomized, Controlled Clinical Trial.

    Science.gov (United States)

    Demirturk-Gocgun, Oya; Baser, Ulku; Aykol-Sahin, Gokce; Dinccag, Nevin; Issever, Halim; Yalcin, Funda

    2017-02-01

    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.

  17. Treatment of an Erratic Extraction Socket for Implant Therapy in a Patient with Chronic Periodontitis

    Science.gov (United States)

    Prabhu, Srividya

    2016-01-01

    As implant therapy becomes more commonplace in daily practice, preservation and preparation of edentulous sites are key. Many times, however, implant therapy may not be considered at the time of tooth extraction and additional measures are not taken to conserve the edentulous site. While the healing process in extraction sockets has been well investigated and bone fill can be expected, there are cases where even when clinicians perform thorough debridement of the sockets, connective tissue infiltration into the socket can occur. This phenomenon, known as “erratic healing,” may be associated with factors that lead to peri-implant disease and should be appropriately managed and treated prior to surgical implant placement. This case report describes the successful management of an erratic healing extraction socket in a 62-year-old Caucasian male patient with chronic periodontitis and the outcomes of an evidence-based treatment protocol performed prior to implant therapy. Careful preoperative analysis and cone beam computed tomography imaging can help detect signs of impaired healing in future implant sites and prevent surgical complications. PMID:27807485

  18. Treatment of an Erratic Extraction Socket for Implant Therapy in a Patient with Chronic Periodontitis

    Directory of Open Access Journals (Sweden)

    Yusuke Hamada

    2016-01-01

    Full Text Available As implant therapy becomes more commonplace in daily practice, preservation and preparation of edentulous sites are key. Many times, however, implant therapy may not be considered at the time of tooth extraction and additional measures are not taken to conserve the edentulous site. While the healing process in extraction sockets has been well investigated and bone fill can be expected, there are cases where even when clinicians perform thorough debridement of the sockets, connective tissue infiltration into the socket can occur. This phenomenon, known as “erratic healing,” may be associated with factors that lead to peri-implant disease and should be appropriately managed and treated prior to surgical implant placement. This case report describes the successful management of an erratic healing extraction socket in a 62-year-old Caucasian male patient with chronic periodontitis and the outcomes of an evidence-based treatment protocol performed prior to implant therapy. Careful preoperative analysis and cone beam computed tomography imaging can help detect signs of impaired healing in future implant sites and prevent surgical complications.

  19. FISHing for gutta-percha-adhered biofilms in purulent post-treatment apical periodontitis.

    Science.gov (United States)

    Zehnder, M; Rechenberg, D-K; Thurnheer, T; Lüthi-Schaller, H; Belibasakis, G N

    2017-06-01

    This study investigated the possibility of depicting individual taxa in clinically relevant biofilms using fluorescent in situ hybridization (FISH). Gutta-percha samples were collected from the apical aspect of root canals associated with a chronic apical abscess (test samples, n = 8). Corresponding control samples were obtained from previously filled root canals with apparently normal periapical tissues (n = 3). The transport medium was investigated for detached biofilm fragments using FISH staining and conventional epifluorescence microscopy. Gutta-percha samples were stained by multiplex FISH, and inspected using confocal laser scanning microscopy. FISH of the transport medium confirmed the presence of the main species formerly identified by conventional methods in post-treatment purulent endodontic infections, most prominently Fusobacterium spp., Bacteroidetes and Prevotellaceae. Treponemes were identified in five of eight cases associated with purulent infections, but Enterococcus faecalis and Staphylococcus spp. were not identified. The biofilms on gutta-percha from root canals associated with apical periodontitis showed dense aggregates of variable composition. Control samples contained few, if any, bacteria in the transport medium, and featured no biofilms on the respective gutta-percha specimens. The current study revealed some direct, visual in situ information on the nature of biofilms associated with purulent periapical infections in man. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Treatment of an Erratic Extraction Socket for Implant Therapy in a Patient with Chronic Periodontitis.

    Science.gov (United States)

    Hamada, Yusuke; Prabhu, Srividya; John, Vanchit

    2016-01-01

    As implant therapy becomes more commonplace in daily practice, preservation and preparation of edentulous sites are key. Many times, however, implant therapy may not be considered at the time of tooth extraction and additional measures are not taken to conserve the edentulous site. While the healing process in extraction sockets has been well investigated and bone fill can be expected, there are cases where even when clinicians perform thorough debridement of the sockets, connective tissue infiltration into the socket can occur. This phenomenon, known as "erratic healing," may be associated with factors that lead to peri-implant disease and should be appropriately managed and treated prior to surgical implant placement. This case report describes the successful management of an erratic healing extraction socket in a 62-year-old Caucasian male patient with chronic periodontitis and the outcomes of an evidence-based treatment protocol performed prior to implant therapy. Careful preoperative analysis and cone beam computed tomography imaging can help detect signs of impaired healing in future implant sites and prevent surgical complications.

  1. Successful treatment of generalized refractory chronic periodontitis through discontinuation of waxed or coated dental floss use: A report of 4 cases.

    Science.gov (United States)

    Kelekis-Cholakis, Anastasia; Perry, John B; Pfeffer, Lorraine; Millete, Amy

    2016-12-01

    Generalized refractory chronic periodontitis is a periodontal condition that is resistant to conventional therapy. Management of this condition often is frustrating to both the patient and the clinician. The authors present 4 cases of generalized refractory chronic periodontitis characterized by an inflammatory gingival response and progressive bone loss that did not respond to extensive periodontal treatments and regular periodontal care. Histologic examination of affected gingival tissue revealed an abundance of plasma cells, a feature seen in certain oral contact hypersensitivity reactions. The authors suspected that waxed or coated dental floss was the offending contactant, and its removal from the patients' oral hygiene regimens resulted in a dramatic improvement of the periodontal characteristics. In cases of periodontal disease as described in this report, dental practitioners should consider the possibility of a contact hypersensitivity reaction to waxed or coated dental floss, whereby the floss exacerbates the condition instead of assisting in its resolution. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  2. Development and evaluation of triclosan loaded poly-ε-caprolactone nanoparticulate system for the treatment of periodontal infections

    Energy Technology Data Exchange (ETDEWEB)

    Aminu, Nafiu; Baboota, Sanjula; Pramod, K. [Jamia Hamdard, Department of Pharmaceutics, Faculty of Pharmacy (India); Singh, Manisha; Dang, Shweta [Jaypee Institute of Information Technology, Department of Biotechnology (India); Ansari, Shahid H. [Jamia Hamdard, Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy (India); Sahni, Jasjeet K.; Ali, Javed, E-mail: javedaali@yahoo.com [Jamia Hamdard, Department of Pharmaceutics, Faculty of Pharmacy (India)

    2013-11-15

    Periodontal disease affects tooth-supporting structures and nanoparticles (NPs) have been a promising approach for its treatment. The purpose of the study was to develop triclosan-loaded poly-ε-caprolactone (PCL) NPs for the treatment of periodontal infections. Solvent displacement method was used to prepare NPs following Box–Behnken design. The NPs were evaluated with respect to particle size, polydispersity index, surface morphology, zeta potential, thermal properties, in vitro drug release, and cell viability assay. The optimized NPs were in the size range of 180–230 nm with a mean size of 205.61 ± 10.4 nm. Entrapment efficiency (EE) of 91.02 ± 2.4 % was obtained with a drug loading of 21.71 ± 1.3 %. About 97 % of drug was released in vitro after 3 h. NPs demonstrated almost 100 % cell viability in L929 cell lines. Shelf life of the nanoparticles was 17.07 months. PCL affected particle size whereas triclosan affected loading and EE. The optimized NPs were spherical with smooth surface and exhibited biphasic in vitro release pattern. NPs had optimum zeta potential and PDI and were stable on storage. Absence of cytotoxicity of NPs to L929 cells indicated its safety. Triclosan-loaded PCL nanoparticles could thus serve as a novel colloidal drug delivery system against periodontal infections.

  3. A new approach to the treatment of true-combined endodontic-periodontic lesions by the guided tissue regeneration technique.

    Science.gov (United States)

    Tseng, C C; Harn, W M; Chen, Y H; Huang, C C; Yuan, K; Huang, P H

    1996-12-01

    Clinicians often have difficulty in the diagnosis and treatment of the combined endodontal and periodontal (endo-perio) lesion. A case of an endo-perio true-combined lesion on a maxillary premolar was first treated with conventional endodontic therapy. Periodontal surgery was then completed, which included scaling and root planing and apical curettage on the tooth. The facial bony defect was then filled with a decalcified freeze-dried bone allograft mixed with tetracycline powder. A non-resorbable Teflon membrane was then used to cover the bone material and the periodontal flap sutured over this. This combined treatment resulted in minimal probing depth (2 mm), maximal clinical attachment gain (8 mm), as well as radiographic evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration technique combined with osseous grafting, will restore health and function to a tooth with severe attachment loss caused by an endo-perio lesion.

  4. Development and evaluation of triclosan loaded poly-ε-caprolactone nanoparticulate system for the treatment of periodontal infections

    International Nuclear Information System (INIS)

    Aminu, Nafiu; Baboota, Sanjula; Pramod, K.; Singh, Manisha; Dang, Shweta; Ansari, Shahid H.; Sahni, Jasjeet K.; Ali, Javed

    2013-01-01

    Periodontal disease affects tooth-supporting structures and nanoparticles (NPs) have been a promising approach for its treatment. The purpose of the study was to develop triclosan-loaded poly-ε-caprolactone (PCL) NPs for the treatment of periodontal infections. Solvent displacement method was used to prepare NPs following Box–Behnken design. The NPs were evaluated with respect to particle size, polydispersity index, surface morphology, zeta potential, thermal properties, in vitro drug release, and cell viability assay. The optimized NPs were in the size range of 180–230 nm with a mean size of 205.61 ± 10.4 nm. Entrapment efficiency (EE) of 91.02 ± 2.4 % was obtained with a drug loading of 21.71 ± 1.3 %. About 97 % of drug was released in vitro after 3 h. NPs demonstrated almost 100 % cell viability in L929 cell lines. Shelf life of the nanoparticles was 17.07 months. PCL affected particle size whereas triclosan affected loading and EE. The optimized NPs were spherical with smooth surface and exhibited biphasic in vitro release pattern. NPs had optimum zeta potential and PDI and were stable on storage. Absence of cytotoxicity of NPs to L929 cells indicated its safety. Triclosan-loaded PCL nanoparticles could thus serve as a novel colloidal drug delivery system against periodontal infections

  5. Periodontitis and myocardial hypertrophy.

    Science.gov (United States)

    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

    2017-04-01

    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.

  6. Changes in Inflammatory and Bone Turnover Markers After Periodontal Disease Treatment in Patients With Diabetes.

    Science.gov (United States)

    Izuora, Kenneth E; Ezeanolue, Echezona E; Neubauer, Michael F; Gewelber, Civon L; Allenback, Gayle L; Shan, Guogen; Umpierrez, Guillermo E

    2016-06-01

    The underlying mechanisms for increased osteopenia and fracture rates in patients with diabetes are not well understood, but may relate to chronic systemic inflammation. We assessed the effect of treating periodontal disease (POD), a cause of chronic inflammation, on inflammatory and bone turnover markers in patients with diabetes. Using an investigator-administered questionnaire, we screened a cross-section of patients presenting for routine outpatient diabetes care. We recruited 22 subjects with POD. Inflammatory and bone turnover markers were measured at baseline and 3 months following POD treatment (scaling, root planing and subantimicrobial dose doxycycline). There were nonsignificant reductions in high-sensitivity C-reactive protein (6.34-5.52mg/L, P = 0.626) and tumor necrosis factor-alpha (10.37-10.01pg/mL, P = 0.617). There were nonsignificant increases in urinary C-terminal telopeptide (85.50-90.23pg/mL, P = 0.684) and bone-specific alkaline phosphatase (7.45-8.79pg/mL, P = 0.074). Patients with >90% adherence with doxycycline were 6.4 times more likely to experience reduction in tumor necrosis factor-alpha (P = 0.021) and 2.8 times more likely to experience reductions in high-sensitivity C-reactive protein (P = 0.133). Treatment of POD in patients with diabetes resulted in nonsignificant lowering of inflammatory markers and nonsignificant increase in bone turnover markers. However, adherence to doxycycline therapy resulted in better treatment effects. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  7. Pharmaceutical Treatment of Periodontal diseases. Groups of Drugs, Mechanism of Their Action, Indications and Contraindications for Use. Part VІ. Antibiotics. Literature review.

    OpenAIRE

    Kashivska, R. S.; Melnychuk, H. M.; Melnychuk, A. S.; Kyrylyuk, A. M.

    2014-01-01

    Literature of 1998-2013 has been reviewed; classifications of antibiotics have been described along with their advantages and disadvantages.    Different types of antibiotics used in treatment of generalized periodontitis have been described. It has been established that in some cases of dystrophic-inflammatory diseases antibiotic therapy may be used. Antibiotics with bone tissue tropism or the ones with bacteriostatic or bacteriocydic effect to the periodontal pathogens are used in such case...

  8. Effect of Non-Surgical Periodontal Treatment on Clinical and Biochemical Risk Markers of Cardiovascular Disease: A Randomized Trial.

    Science.gov (United States)

    Hada, Divya Singh; Garg, Subhash; Ramteke, Girish B; Ratre, Madhu Singh

    2015-11-01

    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.

  9. Development, optimization and evaluation of curcumin loaded biodegradable crosslinked gelatin film for the effective treatment of periodontitis.

    Science.gov (United States)

    Chauhan, Sheetal; Bansal, Monika; Khan, Gayasuddin; Yadav, Sarita K; Singh, Ashish K; Prakash, Pradyot; Mishra, Brahmeshwar

    2018-07-01

    Aim of the present study was to prepare curcumin (CUR) loaded biodegradable crosslinked gelatin (GE) film to alleviate the existing shortcomings in the treatment of periodontitis. Gelatin film was optimized to provide anticipated mucoadhesive strength, mechanical properties, folding endurance, and prolonged drug release over treatment duration, for successful application in the periodontitis. The film was developed by using solvent casting technique and "Design of Experiments" approach was employed for evaluating the influence of independent variables on dependent response variables. Solid-state characterization of the film was performed by FTIR, XRD, and SEM. Further, prepared formulations were evaluated for drug content uniformity, surface pH, folding endurance, swelling index, mechanical strength, mucoadhesive strength, in vitro biodegradation, and in vitro drug release behavior. Solid state characterization of the formulation showed that CUR is physico-chemically compatible with other excipients and CUR was entrapped in an amorphous form inside the smooth and uniform film. The optimized film showed degree of crosslinking 51.04 ± 2.4, swelling index 138.10 ± 1.25, and folding endurance 270 ± 3 with surface pH around 7.0. Crosslinker concentrations positively affected swelling index and biodegradation of film due to altered matrix density of the polymer. Results of in vitro drug release demonstrated the capability of the developed film for efficiently delivering CUR in a sustained manner up to 7 days. The developed optimized film could be considered as a promising delivery strategy to administer medicament locally into the periodontal pockets for the safe and efficient management of periodontitis.

  10. Tetracycline as local drug delivery in treatment of chronic periodontitis: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Prasad Shyamrajan Nadig

    2016-01-01

    Full Text Available Background: The aim of the present meta-analysis is to determine the efficacy of tetracycline group of antibiotics as local drug delivery agents in the treatment of chronic periodontitis. Materials and Methods: MEDLINE, EBSCO, Cochrane database, and Google Scholar were used to identify studies in English published up to January 31, 2017. An additional hand search of relevant journals and of the bibliographies of the paper identified was also performed. Articles retrieved were screened using specific inclusion criteria by two independent reviewers. Randomized control trials investigating the effect of tetracycline group of antibiotics as local drug delivery agents in chronic periodontitis were included in the study. Results: Ten relevant articles were selected for the meta-analysis, of which five articles were retrieved after electronic search, three articles were included after hand search, and two unpublished articles were included. The number of patients in studies ranged from 13 to 140 sites with mean age ranging from 20 to 75. A total of 588 sites were treated using tetracycline group of antibiotics as local drug delivery agents in the treatment of chronic periodontitis. The meta-analysis showed standard difference in mean −1.02 mm (95% confidence interval [CI] 0.28, 1.75 for clinical gain in attachment in favor of tetracycline group. Standard difference in mean for probing depth (PD was 1.20 mm (95% CI 0.57, 1.87 in tetracycline group. Conclusion: The results of this meta-analysis showed a significant improvement in periodontal parameters such as CAL, PD, and sulcular bleeding index in favor of tetracycline as local drug delivery compared to placebo.

  11. Mechanisms of action of systemic antibiotics used in periodontal treatment and mechanisms of bacterial resistance to these drugs

    Directory of Open Access Journals (Sweden)

    Geisla Mary Silva Soares

    2012-06-01

    Full Text Available Antibiotics are important adjuncts in the treatment of infectious diseases, including periodontitis. The most severe criticisms to the indiscriminate use of these drugs are their side effects and, especially, the development of bacterial resistance. The knowledge of the biological mechanisms involved with the antibiotic usage would help the medical and dental communities to overcome these two problems. Therefore, the aim of this manuscript was to review the mechanisms of action of the antibiotics most commonly used in the periodontal treatment (i.e. penicillin, tetracycline, macrolide and metronidazole and the main mechanisms of bacterial resistance to these drugs. Antimicrobial resistance can be classified into three groups: intrinsic, mutational and acquired. Penicillin, tetracycline and erythromycin are broad-spectrum drugs, effective against gram-positive and gram-negative microorganisms. Bacterial resistance to penicillin may occur due to diminished permeability of the bacterial cell to the antibiotic; alteration of the penicillin-binding proteins, or production of β-lactamases. However, a very small proportion of the subgingival microbiota is resistant to penicillins. Bacteria become resistant to tetracyclines or macrolides by limiting their access to the cell, by altering the ribosome in order to prevent effective binding of the drug, or by producing tetracycline/macrolide-inactivating enzymes. Periodontal pathogens may become resistant to these drugs. Finally, metronidazole can be considered a prodrug in the sense that it requires metabolic activation by strict anaerobe microorganisms. Acquired resistance to this drug has rarely been reported. Due to these low rates of resistance and to its high activity against the gram-negative anaerobic bacterial species, metronidazole is a promising drug for treating periodontal infections.

  12. [Control of generalized chronic periodontitis combined with calcium-antagonist-related gingival overgrowth by a complex periodontal-endodontic-prosthodontic treatment. Case report].

    Science.gov (United States)

    Szánto, Erika; Gera, István

    2011-12-01

    To day a relatively high percentage of elderly population of the industrialized world suffers with different cardiovascular diseases and are on permanent antihypertensive therapy. One of the most frequently used drugs is the calcium channel blockers prescribed against high blood pressure. The most common oral side effect of these drugs is the gingival enlargement that might develop even on otherwise healthy gingiva. The incidence of chronic periodontitis in this age group is also high and the Ca antagonist medication in those individuals might substantially modify the clinical course of periodontal inflammation leading to gingival enlargement and hypertrophic pocket wall. The case presented here is a 52 years old hypertonic woman with a long history of Ca-antagonist therapy and generalized chronic periodontitis combined with gingival hyperplasia. After the change of medication the 1,5 years comprehensive periodontal endodontic and prosthodontic therapy restored patient's periodontal health and provided complex dental rehabilitation. Nevertheless, only regular periodontal supportive therapy could ensure predictable outcome and guarantee long lasting periodontal health.

  13. The periodontal abscess: a review.

    Science.gov (United States)

    Herrera, D; Roldán, S; Sanz, M

    2000-06-01

    The periodontal abscess is a frequent periodontal condition in which periodontal tissues may be rapidly destroyed. Its importance is based on the possible need of urgent care, the affectation of tooth prognosis, and the possibility of infection spreading. There is scant information in the scientific literature regarding this condition and most of it has been published as case reports and text books, where conclusions are not evidence-based, but rather empirical observations made by recognised clinicians. The aim of this review was to critically analyse all available information on this subject in the dental and medical literature, including information on its prevalence, proposed etiologies and pathogenesis, diagnosis, microbiology and treatment alternatives. The periodontal abscess is the 3rd most frequent dental emergency, and it is specially prevalent among untreated periodontal patients and periodontal patients during maintenance. Different etiologies have been proposed, and 2 main groups can be distinguished, depending on its relation with periodontal pockets. In the case of a periodontitis-related abscess, the condition may appear as an exacerbation of a non-treated periodontitis or during the course of periodontal therapy. In non-periodontitis related abscesses, impaction of foreign objects, and radicular abnormalities are the 2 main causes. The abscess microflora seems to be similar to that of adult periodontitis, and it is dominated by gram-negative anaerobic rods, including well-known periodontal pathogens. Complications and consequences include tooth loss and the spread of the infection to other body sites. Diagnosis and treatment is mainly based on empiricism, since evidence-based data are not available. The role of systemic antibiotics, in the treatment of periodontal abscesses, is especially controversial.

  14. Etiological periodontal treatment with and without low-level laser therapy on IL-1β level in gingival crevicular fluid: an in vivo multicentric pilot study.

    Science.gov (United States)

    Mastrangelo, F; Dedola, A; Cattoni, F; Ferrini, F; Bova, F; Tatullo, M; Gherlone, E; Lo Muzio, L

    2018-01-01

    Cytokine proteins may have important roles during different human physiological and pathological processes. In the oral cavity, the bone loss and periodontal tissue pathology was related to inflammatory process activation. The aim of the present study was to assess the effects of etiological periodontal therapy with and without the use of Low Level Laser Therapy (LLLT) on clinical periodontal parameters and interleukin (IL)-1β level in gingival crevicular fluid (GCF) from chronic periodontitis (CP) patients. Thirty non-smoker CP patients were selected from the Foggia University Dental Clinic and other 2 private dental clinics. All patients were divided into two homogeneous randomized groups: 15 patients were treated with only scaling and root planing (group 1) and 15 patients with scaling and root planing etiological treatment and LLLT (group 2). In all sites, at baseline before treatment, the periodontal pocket depth (PPD) and bleeding on probing (BOP) were measured. In the PPD sites, the GCF samples were collected from 30 deep (≥5 mm) and shallow (≤3 mm) sites and IL-1β were evaluated at baseline, after 10 days and 1 month. In all the samples at baseline, the IL-1β concentration in GCF and BOP rate were significantly higher at deep PPD sites than at the shallow ones. After 10 days in all samples no PPD improvement was observed in the BOP rate but the IL-1 β level was statistically significantly improved (pdeep PPD sites, PPD and BOP improvements were observed. At same time, IL-1β levels were lower and statistically significantly (pdeep PPD sites with or with-out associated LLLT promotes periodontal health. Etiological treatment associated with LLLT, improves BOP and inflammation in periodontal disease. Moreover, the IL-1β concentration changes in GCF suggest these cytokines as a predictable marker of gingival inflammation in chronic periodontitis patients.

  15. Periowave demonstrates bactericidal activity against periopathogens and leads to improved clinical outcomes in the treatment of adult periodontitis

    Science.gov (United States)

    Street, Cale N.; Andersen, Roger; Loebel, Nicolas G.

    2009-02-01

    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.

  16. Periodontal disease and systemic complications

    Directory of Open Access Journals (Sweden)

    Rui Vicente Oppermann

    2012-01-01

    Full Text Available Periodontal diseases comprise a number of infectious and inflammatory conditions brought about by the interaction between supragingival and subgingival biofilms and the host inflammatory response. Periodontal diseases should be considered systemic conditions. This means that they are both modulated by the body's systems and play a role as a risk factor for systemic derangements. The current evidence supports some of these interactions, such as smoking as a risk factor for periodontal disease and diabetes mellitus, as both influenced by and influencing inflammatory changes in the periodontal tissue. Other potential associations are still being researched, such as obesity, hormonal changes, cardiovascular disease, and adverse outcomes in pregnancy. These, and others, still require further investigation before the repercussions of periodontal disease can be fully elucidated. Nevertheless, at the present time, the treatment of periodontal diseases-and, most importantly, their prevention-enables adequate intervention as a means of ensuring periodontal health.

  17. How much does an antiinflammatory treatment cost?

    Directory of Open Access Journals (Sweden)

    S. Adami

    2011-06-01

    Full Text Available NSAIDs are among the most popular drugs in the world for their efficacy in controlling pain and acute and chronic inflammation. The efficacy of these therapies is hampered by their safety profile, in particular regarding the gastroenteric tract. The NSAIDs’ side effects may heavily influence the health of the single patient and the economy of the health systems. The pharmacoeconomic evaluation of antinflammatory treatment usually considers, in addition to the drug purchase prize, also the shadow costs. This cost is mainly due to the management and prevention of gastropathy. Coxibs, even if more expensive, may become cost-effective for their better gastronteric safety. As a matter of fact, coxib treatment can be considered equivalent to a treatment with NSAID plus PPI. However, the first requirement of these drugs, that should control pain, must be the efficacy and not only safety. In this case the NNT (Number Needed to Treat is a good marker of efficacy. To calculate the real cost we must pay to reach the target (pain resolution in one patient, we can multiply NNT for the prize of a specific drug. The total cost will depend on drug prize (the cheaper, the better and on the efficacy expressed by NNT (the lower, the better. In a recent meta-analysis, the NNT of several antinflammatory drugs has been calculated. When the treatment cost was adjusted for its efficacy (NNT, the difference in favour of NSAIDs became so little to disappear because of the higher safety of coxibs (especially of etoricoxiband the possibility to reach antinflammatory and analgesic doses that are difficult to obtain with NSAIDs. Moreover, if also the cost of gastroprotection is considered, the economic impact of NSAIDs can be much higher. In conclusion the pharmacoeconomic analysis of an antinflammatory therapy cannot be based only on safety issues but also on efficacy evaluation that is the main effect we ask to these drugs.

  18. Use of Dietary Supplements in Patients Seeking Treatment at a Periodontal Clinic

    Directory of Open Access Journals (Sweden)

    Wendy E. Ward

    2013-04-01

    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.

  19. Regenerative potential and anti-bacterial activity of tetracycline loaded apatitic nanocarriers for the treatment of periodontitis

    International Nuclear Information System (INIS)

    Madhumathi, K; Sampath Kumar, T S

    2014-01-01

    Current treatment of periodontal infections includes mechanical debridement, administration of antibiotics and bone grafting. Oral administration of antibiotics results in undesirable side effects, while current modes of local administration are affected by problems concerning allergic response to the polymeric carrier agents. We have developed an osteoconductive drug delivery system composed of apatitic nanocarriers capable of providing sustained delivery of drugs in the periodontium. Calcium deficient hydroxyapatite (CDHA) nanocarriers of different Ca/P ratios were synthesized and characterized using the x-ray diffraction method, transmission electron microscopy, inductively coupled plasma atomic emission spectroscopy, Fourier transform infrared spectroscopy and the BET gas isotherm method. Loading and release studies performed with tetracycline showed a sustained release of up to 88% in phosphate buffered saline over a period of five days. Antibacterial activity studies showed that the tetracycline loaded CDHA (TC-CDHA) nanocarriers were effective against S. aureus and E. coli bacteria. The biocompatibility of the TC-CDHA nanocarriers was demonstrated using an alamar blue assay and further characterized by cell uptake studies. Interestingly, cell uptake of drug loaded CDHA also increased the cellular proliferation of human periodontal ligament fibroblast cells. Hence, it can be concluded that the CDHA nanocarriers are ideal drug delivery agents and have bone regenerative potential for local periodontal applications. (paper)

  20. Periodontal disease and adverse pregnancy outcomes.

    Science.gov (United States)

    Shub, Alexis; Swain, Jonathan R; Newnham, John P

    2006-09-01

    Periodontal disease is a common infectious disease in women of reproductive age. The disease is often not diagnosed and in studies of over 10 000 women has been associated with preterm birth, small for gestational age newborns, and preeclampsia. It has been shown in a smaller number of women that treatment of periodontal disease may reduce the rate of preterm birth. The pregnancy complications of periodontal disease may be due to lipopolysaccharide from the periodontal pockets inciting prostaglandin pathways controlling parturition. Three large randomized controlled trials of treatment of periodontal disease are underway and may provide confirmation of the importance of periodontal disease in causing complications of pregnancy.

  1. Role of diode lasers (800-980 nm) as adjuncts to scaling and root planing in the treatment of chronic periodontitis: a systematic review.

    Science.gov (United States)

    Qadri, Talat; Javed, Fawad; Johannsen, Gunnar; Gustafsson, Anders

    2015-11-01

    The purpose of this study was to systematically review currently available evidence regarding the role of diode lasers (810-980 nm) as adjuncts to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). Mechanical instrumentation of periodontal tissues followed by diode laser application leads to complete removal of pocket epithelium compared with conventional SRP. To address the focused question "Is SRP with adjunct diode lasers (810-980 nm) therapy more effective in the treatment of CP than when CP is treated by SRP alone?" databases were searched using the following key words: chronic periodontitis, diode laser, surgical, AND scaling and root planing, periodontal diseases, periodontal therapy, AND periodontal treatment. Original studies were included. Letters to the editor, case reports, commentaries, and reviews were excluded. Ten clinical studies were included. In all studies, patients were systemically healthy, and cigarette smokers were included in two studies. In five studies, SRP plus diode laser application was more effective in the treatment of CP than SRP, and three studies showed no difference. In two studies, there was a moderate reduction in periodontal inflammation using SRP plus diode laser. The diameter of optic fiber, laser wavelengths, power, pulse repetition rate, and duration of laser exposure ranged between 300 μm and 2 mm, 810-980 nm, 0.8-2.5 W, 10-60 Hz, and 10-100 ms, respectively. In CP patients with probing depths ≤5 mm, diode lasers, SRP plus diode laser (800-980 nm) is more effective in the treatment of CP than when SRP is used alone.

  2. Is the role of probiotics friendly in the treatment of periodontal diseases !!

    Directory of Open Access Journals (Sweden)

    Deepa D

    2009-01-01

    Full Text Available Probiotics utilize naturally occurring bacteria to confer a health benefit when administered in adequate amounts. A few conventional foods containing probiotics are yogurt, fermented and unfermented milk, soy beverages etc. Most often, they come from two groups of bacteria, Lactobacillus or Bifidobacterium. Probiotics have been extensively studied for their health promoting effects. Scientific understanding of probiotics and their potential for preventing and treating periodontal conditions is at its infancy, but moving ahead. Extensive research to create a probiotic product intended to maintain dental and periodontal health is needed.

  3. Clinical effect of platelet rich plasma in the treatment of periodontal intrabony defects.Systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Heber Arbildo

    2017-04-01

    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.

  4. Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

    Science.gov (United States)

    Flynn, Patrick M; Broome, Kirk M; Beaston-Blaakman, Aaron; Knight, Danica K; Horgan, Constance M; Shepard, Donald S

    2009-02-01

    A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment.

  5. Clinical significance of determination of changes of serum IL-6, hs-CRP and saliva secretory IgA levels after treatment in patients with periodontitis

    International Nuclear Information System (INIS)

    Wang Tongwu

    2009-01-01

    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)

  6. Clinical significance of measurement of serum IL-8, IL-1β and TNF-α levels after treatment in patients with periodontitis

    International Nuclear Information System (INIS)

    Wang Tongwu

    2009-01-01

    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)

  7. Clinical significance of measurement of serum hs-CRP, TNF-α and M-CSF levels after treatment in patients with periodontitis

    International Nuclear Information System (INIS)

    Zhang Yunming

    2007-01-01

    Objective: To explore the significance of changes of serum hs-CRP, TNF-α and M-CSF levels after treatment in patients with periodontitis. Methods: Serum TNF-α, M-CSF (with RIA), hs-CRP (with immuneturbitity method) levels were determined in 38 patients with periodontitis both before and after treatment as well as in 35 controls. Results: Before treatment, the serum hs-CRP, TNF-α and M-CSF levels were significantly higher in the patients than those in controls (P 0.05). Conclusion: Detection of serum hs-CRP, TNF-α and M-CSF levels might reflect the progress of disease in patients with periodontitis. (authors)

  8. Clinical significance of changes of serum IL-2, IL-6 and TNF-α levels after treatment in patients with periodontitis

    International Nuclear Information System (INIS)

    Wei Dong

    2005-01-01

    Objective: To investigate the changes of serum IL-2, IL-6 and TNF-α levels after one month of comprehensive treatment in patients with periodontitis. Methods: Serum IL-2, IL-6 and TNF-α levels were measured with RIA in 48 patients with periodontitis both before and after treatment as well as in 35 controls. Results: Before treatment, serum levels of IL-6, TNF- α in the patients were significantly higher and IL-2 levels were significantly lower than those in the controls (both P 0.05). However, the IL-2 levels were still significantly lower than those in controls (P<0.05). Conclusion: There was disturbance of immuno-modulation in patients with periodontitis as expressed by the changes of cytokines levels in the course of the disease. (authors)

  9. Effect of non-surgical periodontal treatment on the subgingival microbiota of patients with chronic kidney disease

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    Hilana Paula Carillo Artese

    2012-08-01

    Full Text Available This study investigated the effect of non-surgical periodontal therapy on the composition of subgingival microbiota of patients with chronic kidney disease (CKD. Sixteen CKD pre-dialysis individuals (CKD and 14 individuals without clinical evidence of kidney disease (C presenting chronic periodontitis were treated by scaling and root planing. Subgingival samples were collected from each patient and analyzed for their composition by checkerboard at baseline and 3 months post-therapy. Significant differences between groups at baseline were sought by the Mann-Whitney and χ² tests. Changes over time were examined by the Wilcoxon test. At baseline, the CKD group had significantly lower counts of E. faecalis compared to the C group (p < 0.05. After treatment, the levels of a greater number of species were reduced in the C group. Higher levels of A. israelii, C. rectus, F. periodonticum, P. micra, P. nigrescens, T. forsythia, N. mucosa, and S. anginosus (p < 0.05 were found in the CKD group compared to the C group. Also, non-responsive sites in CKD individuals harbored significantly higher levels of pathogenic species (T. forsythia, P. gingivalis, T. denticola, Fusobacterium spp., D. pneumosintes, E. faecalis and S. aureus; p < 0.05 than sites that responded to therapy, as well as non-responsive sites in the C group. The periodontitis-associated subgingival microbiota of CKD and systemically healthy individuals was similar in composition. However, high levels of pathogenic species persisted in the subgingival microbiota of patients with CKD after treatment.

  10. 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.

    Science.gov (United States)

    Zare Javid, Ahmad; Maghsoumi-Norouzabad, Leila; Ashrafzadeh, Elnaz; Yousefimanesh, Hojat Allah; Zakerkish, Mehrnoosh; Ahmadi Angali, Kambiz; Ravanbakhsh, Maryam; Babaei, Hosein

    2018-01-01

    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.

  11. A potential role of Chlamydia pneumoniae in the pathogenesis of periodontal disease in adolescents and adults.

    Science.gov (United States)

    Ajonuma, Louis Chukwuemeka

    2010-01-01

    Periodontal diseases are among the most common human infections that not only impact oral health but also are associated with adverse systemic diseases such as cardiovascular diseases, stroke, diabetes, and respiratory diseases. Periodontal diseases is a chronic severe inflammatory process of the gingiva leading to the destruction of tooth-supporting structures, alveolar bone, and subsequently tooth loss due to bacteria infection. While it has been reported that several oral biofilm-forming bacteria might be involved, the role of C. pneumoniae infection in the pathogenesis of periodontal disease remains unknown. The present hypothesis proposes that C. pneumoniae is involved in the pathogenesis of periodontal diseases. This will lead to a better understanding of the etiopathogenesis of periodontal disease, better treatment strategy and savings on total health care costs.

  12. One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study.

    Science.gov (United States)

    Vera, Jorge; Siqueira, José F; Ricucci, Domenico; Loghin, Simona; Fernández, Nancy; Flores, Belina; Cruz, Alvaro G

    2012-08-01

    This study analyzed the in vivo microbiological status of the root canal systems of mesial roots of mandibular molars with primary apical periodontitis after 1- or 2-visit endodontic treatment. Mesial root canals were instrumented by using either a combination of K3 and LightSpeed instruments (mesiobuccal canals) or the ProTaper system (mesiolingual canals), with 5% NaOCl irrigation. Patency files were used. Smear layer was removed, and a final rinse with 5 mL of 2% chlorhexidine was performed. In the 2-visit group (7 roots, 14 canals), canals were medicated with calcium hydroxide for 1 week and then obturated by using the continuous wave of compaction technique. In the 1-visit group (6 roots, 12 canals), canals were immediately obturated after chemomechanical procedures. Teeth were extracted 1 week after root canal instrumentation and processed for histobacteriologic analysis. In the 1-visit group, no case was completely free of bacteria; residual bacteria occurred in the main root canal (5 of 6 cases), isthmus (5 of 6), apical ramifications (4 of 6), and dentinal tubules (5 of 6). In the 2-visit group, 2 cases were rendered bacteria-free; residual bacteria were found in the main canal only in 2 cases (none of them with persistent dentinal tubule infection), in the isthmus (4 of 7 cases), and in ramifications (2 of 7). The 2 instrumentation techniques performed similarly. When filling material was observed in ramifications, it was usually intermixed with necrotic tissue, debris, and bacteria. The 2-visit protocol by using an interappointment medication with calcium hydroxide resulted in improved microbiological status of the root canal system when compared with the 1-visit protocol. Residual bacteria were more frequent and abundant in ramifications, isthmuses, and dentinal tubules when root canals were treated without an interappointment medication. Apical ramifications and isthmuses were never completely filled. The use of an antibacterial interappointment agent

  13. Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis Tratamento de doença periodontal e risco de parto prematuro: revisão sistemática e metanálise

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    Maria Inês da Rosa

    2012-10-01

    Full Text Available The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR with 95% confidence intervals (95%CI was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19 and low birth weights (RR = 0.92; 95%CI: 0.71-1.20. The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.Os eventos que levam à prematuridade ainda não são completamente compreendidos. Foi realizada uma revisão sistemática quantitativa para avaliar os efeitos do tratamento de doença periodontal durante a gravidez para prevenir o nascimento prematuro e baixo peso ao nascer. A metanálise incluiu estudos randomizados de grávidas com diagnóstico de doença periodontal antes de 20 semanas de gestação. O risco relativo (RR com intervalos de 95% de confiança (IC95% foi calculado. Avaliou-se os desfechos prematuridade e baixo peso ao nascer. Foram incluídos 13 estudos, comparando 3.576 mulheres em grupos de intervenção com 3.412 mulheres que receberam tratamento habitual. A metanálise mostrou uma redução não significativa nos partos prematuros (RR = 0,90; IC95%: 0,68-1,19 e baixo peso ao nascer (RR = 0,92; IC95%: 0,71-1,20. O gráfico de funil revelou clara evidência de viés de publicação. Em

  14. A combined approach of enamel matrix derivative gel and autogenous bone grafts in treatment of intrabony periodontal defects. A case report.

    Science.gov (United States)

    Leung, George; Jin, Lijian

    2003-04-01

    Enamel matrix derivative (EMD) has recently been introduced as a new modality in regenerative periodontal therapy. This case report demonstrates a combined approach in topical application of EMD gel (Emdogain) and autogenous bone grafts for treatment of intrabony defects and furcation involvement defects in a patient with chronic periodontitis. The seven-month post-surgery clinical and radiographic results were presented. The combined application of EMD gel with autogenous bone grafts in intrabony osseous defects resulted in clinically significant gain of attachment on diseased root surfaces and bone fill on radiographs. Further controlled clinical studies are required to confirm the long-term effectiveness of the combination of EMD gel and autogenous bone grafts in treatment of various osseous defects in subjects with chronic periodontitis.

  15. Treatment of periodontitis in smokers with multiple sessions of antimicrobial photodynamic therapy or systemic antibiotics: A randomized clinical trial.

    Science.gov (United States)

    Theodoro, Letícia Helena; Assem, Naida Zanini; Longo, Mariéllen; Alves, Márcio Luiz Ferro; Duque, Cristiane; Stipp, Rafael Nobrega; Vizoto, Natália Leal; Garcia, Valdir Gouveia

    2018-06-01

    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.

  16. Treatment of Angle Class I Malocclusion with Severe Bimaxillary Protrusion using Miniscrew Implants and Periodontal Ligament Distraction

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    K C Prabhat

    2014-01-01

    Full Text Available Bimaxillary dentoalveolar protrusion is common in Asian population. In this patient with procumbent upper and lower lips, excessive lip strain, proclined and protruded maxillary and mandibular incisors with vertical growth pattern, an acceptable treatment result, was achieved with 4-first-premolar extractions. This case report is presented with the aim, to describe the treatment approach for bimaxillary dentoalveolar protrusion using miniscrew implants for anchorage in upper arch and periodontal ligament distraction for canine retraction in lower arch and then retraction of incisors into the newly formed bone distal to lateral incisor. Treatment was completed in 18 months. The patient profile was improved, with reduction in lip procumbency, decrease in lip eversion and protrusion, and decrease mentalis strain. Dentally, the interincisal angulation improved significantly because both the maxillary and mandibular incisors were uprighted after space closer.

  17. Strategies for the inhibition of gingipains for the potential treatment of periodontitis and associated systemic diseases

    Directory of Open Access Journals (Sweden)

    Ingar Olsen

    2014-08-01

    Full Text Available Gingipains are the major virulence factors of Porphyromonas gingivalis, the main periodontopathogen. It is expected that inhibition of gingipain activity in vivo could prevent or slow down the progression of adult periodontitis. To date, several classes of gingipain inhibitors have been recognized. These include gingipain N-terminal prodomains, synthetic compounds, inhibitors from natural sources, antibiotics, antiseptics, antibodies, and bacteria. Several synthetic compounds are potent gingipain inhibitors but inhibit a broad spectrum of host proteases and have undesirable side effects. Synthetic compounds with high specificity for gingipains have unknown toxicity effects, making natural inhibitors more promising as therapeutic gingipain blockers. Cranberry and rice extracts interfere with gingipain activity and prevent the growth and biofilm formation of periodontopathogens. Although the ideal gingipain inhibitor has yet to be discovered, gingipain inhibition represents a novel approach to treat and prevent periodontitis. Gingipain inhibitors may also help treat systemic disorders that are associated with periodontitis, including cardiovascular disease, rheumatoid arthritis, aspiration pneumonia, pre-term birth, and low birth weight.

  18. The influence of anti-infective periodontal treatment on C-reactive protein: a systematic review and meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Ryan T Demmer

    Full Text Available Periodontal infections are hypothesized to increase the risk of adverse systemic outcomes through inflammatory mechanisms. The magnitude of effect, if any, of anti-infective periodontal treatment on systemic inflammation is unknown, as are the patient populations most likely to benefit. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs to test the hypothesis that anti-infective periodontal treatment reduces systemic c-reactive protein (CRP.MEDLINE, EMBASE, CENTRAL and CINAHL databases were searched using sensitivity-enhancing search terms. Eligible RCTs enrolled patients with periodontal infection, compared a clearly defined anti-infective periodontal intervention (experimental group to an "inactive control" (no periodontal intervention or to an "active control" (lower treatment intensity than the experimental group. Mean differences in final CRP values at the earliest post-treatment time point (typically 1-3 months between experimental and control groups were analyzed using random-effects regression. Among 2,753 possible studies 20 were selected, which included 2,561 randomized patients(median=57. Baseline CRP values were >3.0 mg/L in 40% of trials. Among studies with a control group receiving no treatment, the mean difference in CRP final values among experimental treatment vs. control groups was -0.37 mg/L [95%CI=-0.64, -0.11], (P=0.005, favoring experimental treatment. Trials for which the experimental group received antibiotics had stronger effects (P for interaction=0.03 and the mean difference in CRP final values among experimental treatment vs. control was -0.75 mg/L [95%CI=-1.17,-0.33]. No treatment effect was observed among studies using an active treatment comparator. Treatment effects were stronger for studies that included patients with co-morbidities vs. studies that included "systemically healthy" patients, although the interaction was not significant (P=0.48.Anti-infective periodontal

  19. Non-surgical periodontal treatment of peri-implant diseases with the adjunctive use of diode laser: preliminary clinical study.

    Science.gov (United States)

    Lerario, Francesco; Roncati, Marisa; Gariffo, Annalisa; Attorresi, Enrica; Lucchese, Alessandra; Galanakis, Alexandros; Palaia, Gaspare; Romeo, Umberto

    2016-01-01

    Peri-implant diseases present in two forms: peri-implant mucositis and peri-implantitis. The prevalence of peri-implant complications is significantly rising. The aim of this study was to compare conventional treatment of inflamed peri-implant tissues with conventional treatment together with diode laser application. Twenty-seven patients (age 36 to 67, 15 women and 12 men, 12 smokers and 15 non-smokers) requiring treatment for mucositis or peri-implantitis were taken into account for this preliminary study. Plaque index (PI), pocket depth (PD), and bleeding on probing (BoP) were recorded at baseline evaluation. Patients in control group (CG) received conventional non-surgical periodontal treatment. Patients in test group received conventional non-surgical periodontal treatment together with diode laser application (810 nm, 30 s, 1 W, 50 Hz, t on = 100 ms, t off = 100 ms, energy density = 24.87 J/cm(2)). Paired t test was used to evaluate the difference in repeated measurements of considered indexes at T 0 and T 1 (1 year) in both groups. A total of 606 sites were taken into account in the test group (TG) and 144 in the CG. PD mean variation in the TG was 2.66 mm ± 1.07, while mean PD variation in the CG was 0.94 ± 1.13 mm. Paired t testing of the variation in PD in CG and TG revealed a statistically significant difference between the two groups (p diode laser seems to be an additional valuable tool for peri-implant disease treatment.

  20. Orthodontic–periodontics interdisciplinary approach

    Science.gov (United States)

    Vinod, K.; Reddy, Y. Giridhar; Reddy, Vinay P.; Nandan, Hemant; Sharma, Meenakshi

    2012-01-01

    In this present era, when a significant number of patients seeking orthodontic treatment are adults, importance of multidisciplinary treatment approach cannot be overemphasized. Higher susceptibility of plaque accumulation in patients undergoing orthodontic treatment makes involvement of periodontist almost unavoidable. Also, orthodontic treatment frequently results in undesirable periodontal changes which require immediate attention. More recently, orthodontics has been used as an adjunct to periodontics to increase connective tissue support and alveolar bone height. The purpose of this article is to review the adverse effects of orthodontic treatment on the periodontal tissues and to discuss the mutually beneficial relationship shared between the two specialties. PMID:22628956

  1. Is adjunctive photodynamic therapy more effective than scaling and root planing alone in the treatment of periodontal disease in hyperglycemic patients? A systematic review.

    Science.gov (United States)

    Javed, Fawad; Salehpoor, Danial; Al-Dhafeeri, Talal; Yousuf, Muhammad; Malmstrom, Hans; Khan, Junad; Akram, Zohaib

    2018-02-19

    To assess the impact of scaling and root planing (SRP) with and without adjunct photodynamic therapy (PDT) in the treatment of periodontal disease (PD) in hyperglycemic patients. Databases (MEDLINE, EMBASE; and CENTRAL) were searched up to December 2017. The addressed PICO question was: "What is the effectiveness of adjunctive PDT to non-surgical periodontal treatment by means of clinical periodontal and glycemic parameters in hyperglycemic patients?" Four clinical trials and 1 experimental study were included. Energy fluence, power output, power density and duration of irradiation were 2.79 joules per square centimeters (J cm -2 ), 150 milliwatts (mW), 428 milliwatts per square centimeters (mW cm -2 ) and 133 seconds (s) respectively. All studies reporting clinical periodontal and metabolic parameters, showed that aPDT was effective in the treatment of periodontal inflammation in hyperglycemic patients at follow-up. When compared with SRP alone, none of the studies showed additional benefits of PDT as compared to SRP alone at follow up. Three studies showed no influence of SRP with or without aPDT on HbA1c levels. One study showed a significant reduction of HbA1c levels in adjunctive aPDT as compared to SRP alone at follow-up. It remains debatable whether adjunctive PDT as compared to SRP is effective in the treatment of periodontal inflammation and reduction of HbA1c levels in hyperglycemic patients. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Private dentists assess treatment required as more extensive, demanding and costly, than public sector dentists.

    Science.gov (United States)

    Tuominen, Risto; Eriksson, Anna-Leena; Vahlberg, Tero

    2012-08-01

    The aim was to evaluate whether contracted private practitioners assess required treatment more extensive, demanding and economically more rewarding than mainly salaried public sector dentists and to estimate the cost consequences of using these alternative providers. All dental services included in comprehensive treatments funded by the city of Turku and provided to adult patients during the year 2009 were recorded. Patients were distributed randomly without any determination of treatment needs before appointing them to different dentists. Treatment courses for 7432 patients in public clinics included 63 906 procedures and for 2932 patients assigned to treatment by contracted private practitioners included 21 194 procedures. Public sector dentists were mainly salaried with production incentives, and private practitioners worked purely on a fee-for-service basis. The cost estimates were based on the distributions of competence classifications recorded by the providers, which also formed the basis for reimbursement. For each studied treatment category with more than one competence classification, private contractors were less likely than their public sector counterparts to give an assessment of simple or less demanding: 8% versus 29% of examinations, 46% versus 69% of periodontal treatments, 63% versus 85% of extractions, 31% versus 46% of fillings, 18% versus 35% of root canals. The excess cost to society varied from 7.0% for root canal treatments to 21.3% for extractions, causing on average 14.4% higher cost level from use of private practitioners compared with public sector dentists. Private practitioners systematically classified the treatment procedures they provided as more demanding, and therefore more economically rewarding, than their public sector counterparts. The findings indicate that the costs of publicly funded dental care may be increased by the use of private dental contractors. © 2012 John Wiley & Sons A/S.

  3. Common Periodontal Diseases of Children and Adolescents

    OpenAIRE

    Hayat Al-Ghutaimel; Hisham Riba; Salem Al-Kahtani; Saad Al-Duhaimi

    2014-01-01

    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...

  4. Effects of nonsurgical periodontal treatment on glycated haemoglobin on type 2 diabetes patients (PARODIA 1 study): a randomized controlled trial in a sub-Saharan Africa population.

    Science.gov (United States)

    Tsobgny-Tsague, Nadia-Flore; Lontchi-Yimagou, Eric; Nana, Arnel Redon Nana; Tankeu, Aurel T; Katte, Jean Claude; Dehayem, Mesmin Y; Bengondo, Charles Messanga; Sobngwi, Eugene

    2018-02-26

    There is a burglar association between diabetes and periodontitis. Many studies has shown that periodontitis treatment can help improving glycemic control in diabetes patients but little evidence of non-surgical treatment benefit is available in sub Saharan african diabetes patients. We aimed to assess the effects of non-surgical periodontal treatment (NSPT) of chronic periodontitis on glycaemic control in poorly controlled type 2 diabetes patients (T2D) in a sub-Saharan Africa urban setting. A total of 34 poorly controlled T2D patients with chronic periodontitis aged 51.4 ± 8.8 years (mean ± SD), with known duration of diabetes of 55.5 ± 42.6 months, and HbA1c of 9.3 ± 1.3% were randomly assigned to two groups. The treatment group (Group 1, n = 17) received immediate ultrasonic scaling, scaling and root planning along with subgingival 10% povidone iodine irrigation, whereas the control group (Group 2, n = 17) was assigned to receive delayed periodontal treatment 3 months later. Pharmacological treatment was unchanged and all participants received the same standardized education session on diabetes management and dental hygiene. The primary outcome was the 3-month change in HbA1c from baseline. Plaque index (PI), gingival bleeding index (GBI), pocket depth (PD), clinical attachment loss (CAL) were also assessed prior to, at 6 and 12 weeks after enrolment. Two subjects in each group were excluded from the study. Data were analyzed on thirty patients (15 per group). Non-surgical periodontal treatment with education for better dental hygiene (group 1) significantly improved all periodontal parameters whereas education only (group 2) improved only the plaque index among all periodontal parameters. Immediate non-surgical periodontal treatment induced a reduction of HbA1c levels by 3.0 ± 2.4 points from 9.7 ± 1.6% at baseline to 6.7 ± 2.0% 3 months after NSPT, (p ˂ 0.001) but the change was not significant in group 2, from

  5. Efficiency of nonsurgical periodontal therapy in moderate chronic periodontitis.

    Science.gov (United States)

    Mlachkova, Antoaneta M; Popova, Christina L

    2014-01-01

    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

  6. Early Clinical Effectiveness of ER:Yag Laser in Association with the Red Complex of Bacteria in the Initial Treatment of Moderate Chronic Periodontitis

    Directory of Open Access Journals (Sweden)

    Yaneva Bl.

    2014-06-01

    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.

  7. Factors influencing the cost of prosthetic joint infection treatment.

    Science.gov (United States)

    Peel, T N; Cheng, A C; Lorenzo, Y P; Kong, D C M; Buising, K L; Choong, P F M

    2013-11-01

    Prosthetic joint infection (PJI) is associated with significant costs to the healthcare system. Current literature examines the cost of specific treatment modalities without assessing other cost drivers for PJI. To examine the overall cost of the treatment of PJI and to identify factors associated with management costs. The costs of treatment of prosthetic joint infections were examined in 139 patients across 10 hospitals over a 3-year period (January 2006 to December 2008). Cost calculations included hospitalization costs, surgical costs, hospital-in-the-home costs and antibiotic therapy costs. Negative binomial regression analysis was performed to model factors associated with total cost. The median cost of treating prosthetic joint infection per patient was Australian $34,800 (interquartile range: 20,305, 56,929). The following factors were associated with increased treatment costs: septic revision arthroplasty (67% increase in treatment cost; P = 0.02), hypotension at presentation (70% increase; P = 0.03), polymicrobial infections (41% increase; P = 0.009), surgical treatment with one-stage exchange (100% increase; P = 0.002) or resection arthroplasty (48% increase; P = 0.001) were independently associated with increased treatment costs. Culture-negative prosthetic joint infections were associated with decreased costs (29% decrease in treatment cost; P = 0.047). Treatment failure was associated with 156% increase in treatment costs. This study identifies clinically important factors influencing treatment costs that may be of relevance to policy-makers, particularly in the setting of hospital reimbursement and guiding future research into cost-effective preventive strategies. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  8. Changes in the Levels of Pro-Inflammatory Cytokines in Patients with Generalized Periodontitis and Hypertension, Depending on the Method of Treatment

    Directory of Open Access Journals (Sweden)

    T. Vicharenko

    2017-12-01

    Full Text Available Inflammatory mediators have an important role in the pathogenesis of periodontal disease. One of the leading mediators of the initiation of the pathological process is interleukin-1 (IL-1 – an endogenous pyrogen, a lymphocyte-activating factor. Numerous pro-inflammatory effects of interleukin-1β (IL-1β occur in synergy with tumor necrosis factor alpha (TNF-α and interleukin-6 (IL-6, effects on hematopoiesis, participates in nonspecific anti-infective defense. The objective of the study is to determine levels of interleukin-6 and tumor necrosis factor alpha (TNF-α in patients with hypertension II stage and generalized periodontitis of the II degree depending on the treatment method. There were examined 30 patients with hypertension of the II stage and with generalized periodontitis of the II degree. Patients’ age ranged from 35 to 54 years. These patients were divided into two groups. The control group included 10 patients without general somatic pathology and with healthy periodontitis of the same age.  The result of the analysis of tumor necrosis factor alpha (TNF-α in patients in the first group before the treatment was 10.69±2.33 pg/ml. After the treatment this indicator was 6.97±1.57 pg/ml (p>0.1 in patients of the first group. In patients of the second group the tumor necrosis factor alpha (TNF-α was 9.49±2.2 pg/ml; after the treatment according to the offered scheme this figure decreased up to 2.77±0.9 pg/ml (p0.1. In the second group, before the treatment the level of  interleukin-6 was 9.65±2.41 pg/ml; after the treatment according to the offered scheme it was 2.62±0.5 pg/ml (p<0.01. In the control group the interleukin-6 level was 2.24±0.51 pg/ml. Analyzing the obtained results after the treatment in both groups we can conclude: after the treatment of generalized periodontitis of the II degree in patients with hypertension of the II stage, indices of pro-inflammatory cytokines decreased and ranged in normal limits; in

  9. The effectiveness of periodontal disease treatment during pregnancy in reducing the risk of experiencing preterm birth and low birth weight: a meta-analysis.

    Science.gov (United States)

    Uppal, Anna; Uppal, Shitanshu; Pinto, Andres; Dutta, Moushumi; Shrivatsa, Shwetha; Dandolu, Vani; Mupparapu, Mel

    2010-12-01

    Treating periodontal disease during pregnancy to improve outcomes is controversial, and the results of randomized controlled trials (RCTs) are conflicting. The authors performed meta-analysis of these RCTs to assess the overall effect of treating periodontal disease during pregnancy. The authors performed a meta-analysis of studies found by means of two database aggregators OvidSP (12 databases) and EBSCOhost (11 databases). They included RCTs in pregnant women with periodontal disease who were assigned to a treatment arm (scaling and root planing with polishing) or a control arm (no treatment or only prophylaxis). Ten RCTs met the inclusion criteria for preterm birth (PTB), and eight RCTs met the inclusion criteria for low birth weight (LBW). The odds ratio of PTB in the treatment group was 0.589 (95 percent confidence interval [CI] = 0.396-0.875) and of LBW was 0.717 (95 percent CI = 0.440-1.169). Level of bias was the only significant predictor (P periodontal disease during pregnancy.

  10. A rare case report of grade III gingival enlargement associated with chronic periodontitis: Comparison of two treatment techniques.

    Science.gov (United States)

    Pant, Vandana A; Pandey, Suraj

    2015-01-01

    Idiopathic gingival enlargement (GE) is a rare entity characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely documented in literature occurring along with chronic periodontitis. This case report describes a rare case of long standing massive GE in a systemically healthy, nonsyndromic young female involving both the arches, thereby posing a diagnostic dilemma. Furthermore, in this case, we compared two surgical approaches, that is, scalpel and electrosurgery for the convenience as well as the postoperative comfort of the patient. Quadrants 1 and 3 were treated by ledge and wedge technique using scalpel and blade while quadrants 2 and 4 were treated by electrosurgery. The patient was followed postoperatively up to 1-year. The massive GE subsided without recurrence and patient was completely satisfied with the treatment, though better compliance was observed at the site treated by conventional scalpel and blade technique.

  11. Acute periodontal lesions.

    Science.gov (United States)

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    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

  12. Digital subtraction radiography evaluation of the bone repair process of chronic apical periodontitis after root canal treatment.

    Science.gov (United States)

    Benfica e Silva, J; Leles, C R; Alencar, A H G; Nunes, C A B C M; Mendonça, E F

    2010-08-01

    To monitor radiographically the progress of bone repair within chronic periapical lesions after root canal treatment using digital subtraction radiography (DSR). Twelve patients with 17 single-rooted teeth with chronic apical periodontitis associated with an infected necrotic pulp were selected for root canal treatment. Periapical radiographs were taken before treatment (baseline) and immediately post-treatment, 45, 90, 135 and 180 days after treatment. The radiographic protocol included the use of individualized film holders with silicone bite blocks. The six radiographic images were digitized and submitted to digital subtraction using DSR software, resulting in five subtracted images (SI). Quantitative analysis of these SI was performed using Image Tool software to assess pixel value changes, considering a step-wedge as the gold standard and a cut-off value of 128 pixels. The aim was to identify any increase or decrease in mineral density in the region of the periapical lesion. A minor decrease in mineral density at the canal filling session and a significant progressive mineral gain in the following evaluations (P < 0.001) occurred. Pairwise comparison of pixel grey values revealed that only the 180-day follow-up differed significantly from the previous SI. Digital subtraction radiography is a useful method for evaluating the progress of bone repair after root canal treatment. Noticeable mineral gain was observed approximately 90 days after root canal filling and definite bone repair after 180 days.

  13. Avaliação clínica e sistêmica em pacientes que procuram tratamento periodontal = Clinical and systemic evaluation of patients seeking periodontal treatment

    Directory of Open Access Journals (Sweden)

    Gusmão, Estela Santos

    2005-01-01

    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

  14. Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs' teeth with apical periodontitis.

    Science.gov (United States)

    da Silva, Lea Assed Bezerra; Nelson-Filho, Paulo; da Silva, Raquel Assed Bezerra; Flores, Daniel Silva Herzog; Heilborn, Carlos; Johnson, James D; Cohenca, Nestor

    2010-05-01

    The objective of this study was to evaluate in vivo the revascularization and the apical and periapical repair after endodontic treatment using 2 techniques for root canal disinfection (apical negative pressure irrigation versus apical positive pressure irrigation plus triantibiotic intracanal dressing) in immature dogs' teeth with apical periodontitis. Two test groups of canals with experimentally induced apical periodontitis were evaluated according to the disinfection technique: Group 1, apical negative pressure irrigation (EndoVac system), and Group 2, apical positive pressure irrigation (conventional irrigation) plus triantibiotic intracanal dressing. In Group 3 (positive control), periapical lesions were induced, but no endodontic treatment was done. Group 4 (negative control) was composed of sound teeth. The animals were killed after 90 days and the maxillas and mandibles were subjected to histological processing. The sections were stained with hematoxylin and eosin and Mallory Trichrome and examined under light microscopy. A description of the apical and periapical features was done and scores were attributed to the following histopathological parameters: newly formed mineralized apical tissue, periapical inflammatory infiltrate, apical periodontal ligament thickness, dentin resorption, and bone tissue resorption. Intergroup comparisons were done by the Kruskal-Wallis and Dunn's tests (alpha = 0.05). Although statistically significant difference was found only for the inflammatory infiltrate (P irrigation with the EndoVac system can be considered as a promising disinfection protocol in immature teeth with apical periodontitis, suggesting that the use of intracanal antibiotics might not be necessary. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  15. Clinical and radiographical evaluation of a bioresorbable collagen membrane of fish origin in the treatment of periodontal intrabony defects: A preliminary study.

    Science.gov (United States)

    Santosh Kumar, B B; Aruna, D R; Gowda, Vinayak S; Galagali, Sushama R; Prashanthy, R; Navaneetha, H

    2013-09-01

    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.

  16. Single Sitting Surgical Treatment of Generalized Aggressive Periodontitis Using GTR Technique and Immediate Implant Placement with 10-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Fatme Mouchref Hamasni

    2018-01-01

    Full Text Available This case report exhibits a patient with generalized aggressive periodontitis who has been under maintenance for the past 12 years after being surgically treated in a single sitting and restored with dental implants. A 41-year-old systemically healthy male patient presented complaining of lower anterior teeth mobility and pain in the upper right quadrant. After clinical and radiographic examination, the upper right molars and lower anterior incisors were deemed unrestorable. Covered by doxycycline, the patient received a nonsurgical periodontal treatment. Three weeks later, teeth extraction, immediate implant placement, immediate nonloading provisional prosthesis, and a guided tissue regeneration were performed at indicated areas in a single sitting. The clinical decisions were based on patient compliance, the status of the existing periodontal tissues, and the prognosis of the remaining teeth. During the 12-year follow-up period, no residual pockets were observed and there was no exacerbation of the inflammatory condition. Marginal bone stability is present on all implants. For aggressive periodontal disease, a high risk of relapse as well as limited success and survival of dental implants should be considered. This case shows proper containment of the disease based on appropriate treatment planning and a strict maintenance program.

  17. Clinical and microbiological efficacy of 3% satranidazole gel as a local drug delivery system in the treatment of chronic periodontitis: A randomized, controlled clinical trial

    Directory of Open Access Journals (Sweden)

    N Priyanka

    2015-01-01

    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.

  18. Periodontal health through public health - the case for oral health promotion

    DEFF Research Database (Denmark)

    Watt, Richard G; Petersen, Poul E

    2012-01-01

    these factors but also must recognize and act upon the distal underlying influences that determine and pattern these identified risks. Recognition also needs to be placed on the interlinking and common risk factors shared by periodontal diseases and other chronic conditions. A complementary range of public......Periodontal diseases are highly prevalent, particularly amongst socially disadvantaged populations, impact on quality of life and are costly to treat. Clinical treatments and chairside preventive approaches alone will never adequately address this problem. Indeed in many parts of the developing...... world clinical care and chairside prevention are both unaffordable and inappropriate for the control of periodontal diseases. A paradigm shift away from the individualized treatment approach to a population public health model is needed to promote periodontal health and, in particular to address social...

  19. Clinical effect of platelet rich fibrin in the treatment of periodontal intrabony defects. Systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Heber Arbildo.

    2017-05-01

    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.

  20. [Cost effectiveness in treatment of acute myeloid leukemia].

    Science.gov (United States)

    Nordmann, P; Schaffner, A; Dazzi, H

    2000-12-23

    Although the rise in health costs is a widely debated issue, in Switzerland it was until recently taken for granted that patients are given the best available treatment regardless of cost. An example of a disease requiring costly treatment is acute myelogenous leukaemia (AML). To relate cost to benefit we calculated expenditure per life years gained. To assess costs we determined the real cost of treatment up to total remission, followed by consolidation or withdrawal of treatment or death. For survival time exceeding the 2-year observation period we used data from recent literature. The average cost of treatment ranges up to 107,592 Swiss francs (CHF). In 1997 we treated 23 leukaemia patients at Zurich University Hospital and gained a total of 210 life years. This represents an average cost of CHF 11,741 per life year gained. Chief cost items were therapy and personnel costs for nursing staff, followed by hotel business and personnel costs for doctors and diagnosis. Our results for AML treatment are far removed from the $61,500 ranging up to $166,000 discussed in the literature as the "critical" QALY (quality adjusted life years) value. This is the first time the actual costs of AML therapy have been shown for a Swiss cohort. Despite high initial treatment costs and success only in a limited number of patients, the expenditure per QALY is surprisingly low and shows clearly the effectiveness of apparently costly acute medicine.

  1. Platelet rich fibrin combined with decalcified freeze-dried bone allograft for the treatment of human intrabony periodontal defects: a randomized split mouth clinical trail.

    Science.gov (United States)

    Agarwal, Ashish; Gupta, Narinder Dev; Jain, Avikal

    2016-01-01

    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.

  2. Periodontal disease bacteria specific to tonsil in IgA nephropathy patients predicts the remission by the treatment.

    Directory of Open Access Journals (Sweden)

    Yasuyuki Nagasawa

    Full Text Available BACKGROUND: Immunoglobulin (IgA nephropathy (IgAN is the most common form of primary glomerulonephritis in the world. Some bacteria were reported to be the candidate of the antigen or the pathogenesis of IgAN, but systematic analysis of bacterial flora in tonsil with IgAN has not been reported. Moreover, these bacteria specific to IgAN might be candidate for the indicator which can predict the remission of IgAN treated by the combination of tonsillectomy and steroid pulse. METHODS AND FINDINGS: We made a comprehensive analysis of tonsil flora in 68 IgAN patients and 28 control patients using Denaturing gradient gel electrophoresis methods. We also analyzed the relationship between several bacteria specific to the IgAN and the prognosis of the IgAN. Treponema sp. were identified in 24% IgAN patients, while in 7% control patients (P = 0.062. Haemophilus segnis were detected in 53% IgAN patients, while in 25% control patients (P = 0.012. Campylobacter rectus were identified in 49% IgAN patients, while in 14% control patients (P = 0.002. Multiple Cox proportional-hazards model revealed that Treponema sp. or Campylobactor rectus are significant for the remission of proteinuria (Hazard ratio 2.35, p = 0.019. There was significant difference in remission rates between IgAN patients with Treponema sp. and those without the bacterium (p = 0.046, and in remission rates between IgAN patients with Campylobacter rectus and those without the bacterium (p = 0.037 by Kaplan-Meier analysis. Those bacteria are well known to be related with the periodontal disease. Periodontal bacteria has known to cause immune reaction and many diseases, and also might cause IgA nephropathy. CONCLUSION: This insight into IgAN might be useful for diagnosis of the IgAN patients and the decision of treatment of IgAN.

  3. Periodontal disease bacteria specific to tonsil in IgA nephropathy patients predicts the remission by the treatment.

    Science.gov (United States)

    Nagasawa, Yasuyuki; Iio, Kenichiro; Fukuda, Shinji; Date, Yasuhiro; Iwatani, Hirotsugu; Yamamoto, Ryohei; Horii, Arata; Inohara, Hidenori; Imai, Enyu; Nakanishi, Takeshi; Ohno, Hiroshi; Rakugi, Hiromi; Isaka, Yoshitaka

    2014-01-01

    Immunoglobulin (Ig)A nephropathy (IgAN) is the most common form of primary glomerulonephritis in the world. Some bacteria were reported to be the candidate of the antigen or the pathogenesis of IgAN, but systematic analysis of bacterial flora in tonsil with IgAN has not been reported. Moreover, these bacteria specific to IgAN might be candidate for the indicator which can predict the remission of IgAN treated by the combination of tonsillectomy and steroid pulse. We made a comprehensive analysis of tonsil flora in 68 IgAN patients and 28 control patients using Denaturing gradient gel electrophoresis methods. We also analyzed the relationship between several bacteria specific to the IgAN and the prognosis of the IgAN. Treponema sp. were identified in 24% IgAN patients, while in 7% control patients (P = 0.062). Haemophilus segnis were detected in 53% IgAN patients, while in 25% control patients (P = 0.012). Campylobacter rectus were identified in 49% IgAN patients, while in 14% control patients (P = 0.002). Multiple Cox proportional-hazards model revealed that Treponema sp. or Campylobactor rectus are significant for the remission of proteinuria (Hazard ratio 2.35, p = 0.019). There was significant difference in remission rates between IgAN patients with Treponema sp. and those without the bacterium (p = 0.046), and in remission rates between IgAN patients with Campylobacter rectus and those without the bacterium (p = 0.037) by Kaplan-Meier analysis. Those bacteria are well known to be related with the periodontal disease. Periodontal bacteria has known to cause immune reaction and many diseases, and also might cause IgA nephropathy. This insight into IgAN might be useful for diagnosis of the IgAN patients and the decision of treatment of IgAN.

  4. Lasers in periodontics.

    Science.gov (United States)

    Elavarasu, Sugumari; Naveen, Devisree; Thangavelu, Arthiie

    2012-08-01

    Laser is one of the most captivating technologies in dental practice since Theodore Maiman in 1960 invented the ruby laser. Lasers in dentistry have revolutionized several areas of treatment in the last three and a half decades of the 20(th) century. Introduced as an alternative to mechanical cutting device, laser has now become an instrument of choice in many dental applications. Evidence suggests its use in initial periodontal therapy, surgery, and more recently, its utility in salvaging implant opens up a wide range of applications. More research with better designs are a necessity before lasers can become a part of dental armamentarium. This paper gives an insight to laser in periodontics.

  5. Defensins in periodontal health

    Directory of Open Access Journals (Sweden)

    Taran Bedi

    2015-01-01

    Full Text Available Defensins are abundant and widely distributed peptides in human and animal tissues that are involved in host defence. Defensins not only have the ability to strengthen the innate immune system but can also enhance the adaptive immune system by chemotaxis of monocytes, T-lymphocytes, dendritic cells and mast cells to the infection site. Defensins also improves the capacity of macrophage phagocytosis. A greater understanding of how these peptides act in the healthy, gingivitis and periodontitis conditions would definitely open new opportunities for identification, prevention and treatment of periodontal diseases. This discussion focuses on recent studies about biological function of defensins in human diseases and animal models.

  6. Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta-analysis.

    Science.gov (United States)

    Rabelo, Cleverton Correa; Feres, Magda; Gonçalves, Cristiane; Figueiredo, Luciene C; Faveri, Marcelo; Tu, Yu-Kang; Chambrone, Leandro

    2015-07-01

    The aim of this study was to assess the effect of systemic antibiotic therapy on the treatment of aggressive periodontitis (AgP). This study was conducted and reported in accordance with the PRISMA statement. The MEDLINE, EMBASE and CENTRAL databases were searched up to June 2014 for randomized clinical trials comparing the treatment of subjects with AgP with either scaling and root planing (SRP) alone or associated with systemic antibiotics. Bayesian network meta-analysis was prepared using the Bayesian random-effects hierarchical models and the outcomes reported at 6-month post-treatment. Out of 350 papers identified, 14 studies were eligible. Greater gain in clinical attachment (CA) (mean difference [MD]: 1.08 mm; p benefits in CA gain and PD reduction when SRP was associated with systemic antibiotics. SRP plus systemic antibiotics led to an additional clinical effect compared with SRP alone in the treatment of AgP. Of the antibiotic protocols available for inclusion into the Bayesian network meta-analysis, Mtz and Mtz/Amx provided to the most beneficial outcomes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Subgingivally delivered 1.2% atorvastatin in the treatment of chronic periodontitis among smokers: a randomized, controlled clinical trial.

    Science.gov (United States)

    Kumari, Minal; Martande, Santosh S; Pradeep, Avani R

    2017-05-01

    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.

  8. Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

    Directory of Open Access Journals (Sweden)

    Smita Nayak

    Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost

  9. Cost effectiveness of Tuberculosis Treatment from the Patients ...

    African Journals Online (AJOL)

    ... Directly Observed Treatment Short course is more cost effective from the patients' point of view. DOTS needs to be re-focused out of the hospitals and clinics and made community based in view of the increasing TB caseload occasioned by HI V/AIDS. Key Words: Cost effectiveness, Tuberculosis treatment, personal cost, ...

  10. Periodontitis and increase in circulating oxidative stress

    Directory of Open Access Journals (Sweden)

    Takaaki Tomofuji

    2009-05-01

    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.

  11. Periodontics II: Course Proposal.

    Science.gov (United States)

    Dordick, Bruce

    A proposal is presented for Periodontics II, a course offered at the Community College of Philadelphia to give the dental hygiene/assisting student an understanding of the disease states of the periodontium and their treatment. A standardized course proposal cover form is given, followed by a statement of purpose for the course, a list of major…

  12. Dose-response met-RANTES treatment of experimental periodontitis: a narrow edge between the disease severity attenuation and infection control.

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Repeke

    Full Text Available Chemokines and chemokine receptors have been implicated in the selective migration of leukocyte subsets to periodontal tissues, which consequently influences the disease outcome. Among these chemoattractants, the chemokines CCL3, CCL4 and CCL5 and its receptors, CCR1 and CCR5, have been associated with increased disease severity in mice and humans. Therefore, in this study we investigated the modulation of experimental periodontitis outcome by the treatment with a specific antagonist of CCR1 and 5 receptors, called met-RANTES. C57Bl/6 mice was orally infected with Aggregatibacter actinomycetemcomitans and treated with 0.05, 0.1, 0.5, 1.5 and 5 mg doses of met-RANTES on alternate days, and evaluated by morphometric, cellular, enzymatic and molecular methods. At 0.5 mg up to 5 mg doses, a strong reduction in the alveolar bone loss and inflammatory cell migration were observed. Interestingly, 5 mg dose treatment resulted in the maximum inhibition of inflammatory cell migration, but resulted in a similar inhibition of bone loss when compared with the lower doses, and also resulted in increased bacterial load and CRP response. When 0.5 and 5 mg therapy regimens were compared it was observed that both therapeutic protocols were able to downregulate the levels of pro-inflammatory, Th1-type and osteoclastogenic cytokines, and CD3+ and F4/80+ cells migration to periodontal tissues, but the high dose modulates host response in a more pronounced and unspecific and excessive way, interfering also with the production of antimicrobial mediators such as MPO, iNOS and IgG, and with GR1+ and CD19+ cells migration. Our results demonstrate a thin line between beneficial immunoregulation and impaired host defense during experimental periodontitis, and the determination of the exact equilibrium point is mandatory for the improvement of immune-targeted therapy of periodontitis.

  13. Comparison of full-mouth disinfection and quadrant-wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Fang, H; Han, M; Li, Q-L; Cao, C Y; Xia, R; Zhang, Z-H

    2016-08-01

    Scaling and root planing are widely considered as effective methods for treating chronic periodontitis. A meta-analysis published in 2008 showed no statistically significant differences between full-mouth disinfection (FMD) or full-mouth scaling and root planing (FMS) and quadrant scaling and root planing (Q-SRP). The FMD approach only resulted in modest additional improvements in several indices. Whether differences exist between these two approaches requires further validation. Accordingly, a study was conducted to further validate whether FMD with antiseptics or FMS without the use of antiseptics within 24 h provides greater clinical improvement than Q-SRP in patients with chronic periodontitis. Medline (via OVID), EMBASE (via OVID), PubMed and CENTRAL databases were searched up to 27 January 2015. Randomized controlled trials comparing FMD or FMS with Q-SRP after at least 3 mo were included. Meta-analysis was performed to obtain the weighted mean difference (WMD), together with the corresponding 95% confidence intervals. Thirteen articles were included in the meta-analysis. The WMD of probing pocket depth reduction was 0.25 mm (p chronic periodontitis, and they do not lead to any obvious discomfort among patients. Moreover, FMD had modest additional clinical benefits over Q-SRP, so we prefer to recommend FMD as the first choice for the treatment of adult chronic periodontitis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Stem-cells used in treatment of periodontal bone defects; Utilizacion de celulas madre en el tratamiento de defectos oseos periodontales

    Energy Technology Data Exchange (ETDEWEB)

    Perez Borrego, Amparo [Facultad de Ciencias Medicas ' Enrique Cabrera' , La Habana (Cuba); Dominguez Rodriguez, Libia; Ilisastigui Ortueta, Zaida Teresa [Facultad de Estomatologia, La Habana (Cuba); Hernandez Ramirez, Porfirio [Instituto de Hematologia e Inmunologia, La Habana (Cuba)], E-mail: amparop.borrego@infomed.sld.cu

    2009-07-01

    The aggressive periodontitis might to provoke the tooth loss, of its function and to affect the patient's aesthetics. The techniques used for the lost bone regeneration, not always are successful and in occasions are very expensive. For years it is working in tissues regeneration by stem-cells implantation. Periodontium could be a potential for this task. This is a study of a female patient aged 26 with an apparent health status and aggressive periodontitis backgrounds treated from 10 years ago, seen in our service due to dental mobility producing mastication nuisances. At clinical examination we noted systemic chronic inflammation of gums, grade II and III dental mobility in incisives and molars teeth, 4-8 mm systemic periodontal sacs and furcation lesions in inferior molars. At radiographs advanced bone losses and a decrease of systemic bone density are noted. After written consent and the initial preparation, we carried out a periodontal flap in the 35 and 37 teeth zone, where the stem-cells concentrate was placed, in bone defects of superior molars (16-17) and previous radicular scraping and isolation, treatment consisted in stem-cells perfusion without flap. There were not postoperative side effects. At 7 days there was a normal coloration, at three months on noted at radiograph a bone neoformation, and at six months gum remained healthy, with a decrease of dental mobility in segment treated and in the evolutionary radiograph it was evidenced the formation and increase of density.

  15. Osteogenesis differentiation of human periodontal ligament cells by CO2 laser-treatment stimulating macrophages via BMP2 signalling pathway

    International Nuclear Information System (INIS)

    Hsieh, Wen-Hui; Chen, Yi-Jyun; Hung, Chi-Jr; Huang, Tsui-Hsien; Kao, Chia-Tze; Shie, Ming-You

    2014-01-01

    Immune reactions play an important role in determining the biostimulation of bone formation, either in new bone formation or inflammatory fibrous tissue encapsulation. Macrophage cell, the important effector cells in the immune reaction, which are indispensable for osteogenesis and their heterogeneity and plasticity, render macrophages a primer target for immune system modulation. However, there are very few studies about the effects of macrophage cells on laser treatment-regulated osteogenesis. In this study, we used CO 2 laser as a model biostimulation to investigate the role of macrophage cells on the CO 2 laser stimulated osteogenesis. Bone morphogenetic protein 2 (BMP2) was also significantly up regulated by the CO 2 laser stimulation, indicating that macrophage may participate in the CO 2 laser stimulated osteogenesis. Interestingly, when laser treatment macrophage-conditioned medium were applied to human periodontal ligament cells (hPDLs), the osteogenesis differentiation of hPDLs was significantly enhanced, indicating the important role of macrophages in CO 2 laser-induced osteogenesis. These findings provided valuable insights into the mechanism of CO 2 laser-stimulated osteogenic differentiation, and a strategy to optimize the evaluation system for the in vitro osteogenesis capacity of laser treatment. (paper)

  16. Change in clinical indices following laser or scalpel treatment for periodontitis: A split-mouth, randomized, multi-center trial

    Science.gov (United States)

    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.

    2014-02-01

    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.

  17. The cost-utility of sodium oxybate as narcolepsy treatment

    DEFF Research Database (Denmark)

    Bolin, K; Berling, P; Wasling, P

    2017-01-01

    cost per additional QALY for the sodium oxybate treatment alternative compared with standard treatment was estimated above the informal Swedish willingness-to-pay threshold (SEK 500,000). The estimated cost per additional QALY obtained here is likely to overestimate the true cost-effectiveness ratio......AIMS AND OBJECTIVES: Based on class-I studies, sodium oxybate is regarded as a first-line treatment for both EDS and cataplexy. The cost-effectiveness of sodium oxybate is largely unknown, though. In this study, we estimate the cost-effectiveness of sodium oxybate as treatment for patients...... with narcolepsy as compared to standard treatment, by calculating incremental cost-effectiveness ratios (cost per quality-adjusted life year, QALY) for patients in a Swedish setting. MATERIALS AND METHODS: Calculations were performed using a Markov model with a 10-year time horizon. The study population consisted...

  18. Endovascular treatment of cerebral aneurysms - a cost analysis | Le ...

    African Journals Online (AJOL)

    The average cost for endovascular treatment per patient was R37 041. Surgical treatment was more expensive at R44 104, a difference of 16%. Conclusions. Despite the high cost of endovascular devices, appropriate use of this technology ultimately offers less expensive treatment than microsurgical clipping of aneurysms.

  19. Using risk assessment in periodontics.

    Science.gov (United States)

    Woodman, Alan J

    2014-08-01

    Risk assessment has become a regular feature in both dental practice and society as a whole, and principles used to assess risk in society are similar to those used in a clinical setting. Although the concept of risk assessment as a prognostic indicator for periodontal disease incidence and activity is well established in the management of periodontitis, the use of risk assessment to manage the practical treatment of periodontitis and its sequelae appears to have less foundation. A simple system of initial risk assessment - building on the use of the Basic Periodontal Examination (BPE), clinical, medical and social factors - is described, linked to protocols for delivering care suited to general dental practice and stressing the role of long-term supportive care. The risks of not treating the patient are considered, together with the possible causes of failure, and the problems of successful treatment are illustrated by the practical management of post-treatment recession.

  20. The cost of nephroblastoma treatment in South Africa: A very cost ...

    African Journals Online (AJOL)

    2014-11-08

    Nov 8, 2014 ... To determine the direct costs of treatment of nephroblastoma in South Africa (SA) and to propose a more cost-effective ... by the standard management of this disease in children may be ..... Study weaknesses and challenges.

  1. Efficacy of Chitosan gel mucoadhesive containing Doxycycline associated or not to Meloxicam as adjuvant to treatment of gingivitis in dogs with periodontal disease

    Directory of Open Access Journals (Sweden)

    Rita de Cassia da Costa Silva

    2016-06-01

    Full Text Available ABSTRACT. Silva R.C.C., Campos D. R., Oliveira P., Laguna A.G.V., Magalhães V.S., Cid Y.P., Almeida M.B., Scott F.B. & Fernandes J.I. [Efficacy of Chitosan gel mucoadhesive containing Doxycycline associated or not to Meloxicam as adjuvant to treatment of gingivitis in dogs with periodontal disease.] Eficácia de um gel de Quitosano Mucoadesivo contendo Doxiciclina associada ou não ao Meloxicam como coadjuvante ao tratamento da gengivite em cães portadores de doença periodontal. Revista Brasileira de Medicina Veterinária, 38(Supl.2:40-44, 2016. Programa de Pós-Graduação em Medicina Veterinária, Universidade Federal Rural do Rio de Janeiro, BR 465 Km 7, Seropédica, RJ 23897-000, Brasil. E-mail: vetjulio@yahoo.com.br Periodontal disease is the highest occurrence condition in the pet clinic, affecting mainly older animals because of its characteristic of chronicity. Among the clinical signs observed in afflicted animals, gingivitis is the first to be observed. The goal of this study was to develop a mucoadhesive gel, containing doxycycline and meloxicam, and evaluate its efficacy as an adjuvant in the treatment of gingivitis induced by periodontal disease, with a clinical and histopathological rating. Eighteen Beagle dogs presenting gingivitis secondary to periodontal disease were divided into three experimental groups. Group I – animals treated with placebo formulation. Group II – Animals treated with a chitosan gel formulation containing doxycycline. Group III - Animals treated with a chitosan gel formulation containing doxycycline and meloxicam. All animals were treated for seven days, every twelve hours, in the gingival margin of the right maxilla. During the clinic evaluation, only the animals treated with the product containing doxycycline had improved. Contrasting, in the histopathologic evaluation, only animals treated with association of doxycycline and meloxicam presented improvements in their clinical score, although no

  2. Association of Periodontitis and Subsequent Depression

    Science.gov (United States)

    Hsu, Chih-Chao; Hsu, Yi-Chao; Chen, Hsuan-Ju; Lin, Che-Chen; Chang, Kuang-Hsi; Lee, Chang-Yin; Chong, Lee-Won; Kao, Chia-Hung

    2015-01-01

    Abstract Periodontitis is a systemic and chronic inflammatory disease associated with multiple physical conditions. Distress and depression are other problems affecting the progression of periodontitis. However, the causal relationship between depression and periodontitis has not been adequately investigated. This aim of this study was to determine the association between periodontitis and the subsequent development of depression. We identified 12,708 patients with newly diagnosed periodontitis from 2000 to 2005 and 50,832 frequency-matched individuals without periodontitis. Both groups were followed until diagnosed with depression, withdrawal from the National Health Insurance program, or the end of 2011. The association between periodontitis and depressio was analyzed using Cox proportional hazard regression models. The incidence density rate of depression was higher in the periodontitis group than in the nonperiodontitis group, with an adjusted hazard ratio of 1.73 (95% confidence interval 1.58–1.89) when adjusting for sex, age, and comorbidity. Cox models revealed that periodontitis was an independent risk factor for depression in patients, except for comorbidities of diabetes mellitus (DM), alcohol abuse, and cancer. Periodontitis may increase the risk of subsequent depression and was suggested an independent risk factor regardless of sex, age, and most comorbidities. However, DM, alcohol abuse, and cancer may prevent the development of subsequent depression because of DM treatment, the paradoxical effect of alcohol, and emotional distress to cancer, respectively. Prospective studies on the relationship between periodontitis and depression are warranted. PMID:26705230

  3. [Diagnossis and treatment of complicated anterior teeth esthetic defects by combination of whole-process digital esthetic rehabilitation with periodontic surgery].

    Science.gov (United States)

    Li, Z; Liu, Y S; Ye, H Q; Liu, Y S; Hu, W J; Zhou, Y S

    2017-02-18

    . The new method for esthetic rehabilitation of complicated anterior teeth esthetic defects accompanied by soft tissue morphology, including patient-involved digital esthetic analysis, design, esthetic outcome prediction, 3D printing surgical guide for periodontic surgery and digital fabrication is a practical technology. This method is useful for improvement of clinical communication efficiency between doctor-patient, doctor-technician and doctors from different departments, and is conducive to multidisciplinary treatment of this complicated anterior teeth esthetic problem.

  4. PERIODONTAL DISEASE: LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    J. D. Baia

    2017-10-01

    Full Text Available The periodontal disease is the most common disorder of oral cavity of the dogs, being characterized by the inflammation of the gingiva (gingivitis and periodontium (periodontitis, as a result of aerobic bacteria accumulation on the tooth surface, shaped as a biofilm, creating a microaerophilic environment that enhances the development of pathogenic anaerobic bacteria. The process of gingivitis can be reversed after proper treatment. If untreated, it progresses to periodontitis, an irreversible condition, because of the loss of epithelial adhesion. Animals with periodontitis have bone loss and consequently tooth mobility. This condition has the feeding as the main modifier factor. This means that the more solid is the food, the more friction with the tooth it will do, helping the removal of the biofilm. There are several predisposing factors of this disease, such as race, age, occlusion problems, immunodeficiency, among others. The clinical signs of periodontal disease may vary, being halitosis and gingivitis the most common findings. The diagnosis is made by direct inspection, where furcation exposure, inflammation and dental calculus can be seen. The best complementary tool to diagnose is the intra-oral radiography, which allows the visualization of bone structures that can not be seen during clinical inspection, helping to manage the treatment. The use of antibiotics is only complementary to treatment and only chosen in special cases. The treatment for this condition is surgical and requires sedation. It basically consists in the complete removal of dental calculus, followed by teeth polishing. The whole procedure is performed using specific techniques and instrumentation. There are various prophylactic methods, although daily brushing and the awareness of the owner about this condition are considered the ideal combination.

  5. EPIDEMIOLOGICAL STUDY ON THE IMPLANT TREATMENT NEEDS IN CASES OF BONE AFFECTION IN PATIENTS WITH PERIODONTAL DISEASES

    Directory of Open Access Journals (Sweden)

    Diana Paula Radu

    2012-09-01

    Full Text Available The scope of the study is to critically evaluate and, implicitly, to establish a correlation among the status of edentation, the missing odonto-periodontal support and the necessary implantary therapy. Materials and method: The experimental group was formed of 179 patients, 93 women and 86 men, with ages between 18 and 72 years, who addressed the Clinics of Periodontology and some private consulting room between 2010-2012. The investigations involved both a minute clinical examination, by descriptive and canonic methods, and paraclinical exams: gnatophotostatic examinations on intra- and extra-oral (front and profile photos, patterns of study and radiological evaluation by OPT with markers. Results and discussion: The highest values were registered for III class Kennedy edentations, especially in the 31-50 years group of age, and mainly in women. This evaluation led to a higher number of implantary treatments. The necessary of implantary treatments was of 100% in IV, V and VI class Kennedy edentations, as well as in total edentations. Conclusions: The necessary number of interventions on bone structures for the optimization of the implantary field is of 43.92%, the highest ratios being represented by controlled bone regeneration.

  6. Effect of non-surgical periodontal treatment on HbA1c: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Liew, A K C; Punnanithinont, N; Lee, Y-C; Yang, J

    2013-09-01

    A meta-analysis of randomized clinical trials (RCTs) was conducted to evaluate whether non-surgical periodontal treatment can reduce the HbA1c% level in type 2 diabetic patients. Recent accumulation of RCTs necessitates updating of the findings of previous reviews. A search of the literature on English publications was conducted in Cochrane CENTRAL, Medline and EMBASE (until 31 March 2012). An RCT was selected if the study population was type 2 diabetic patients (≥16 years old) diagnosed with periodontitis, and compared HbA1c% change with or without non-surgical periodontal treatment for at least three months of the study duration. Weighted mean differences for pooled data and antibiotic use strata were calculated. Heterogeneity and publication bias were explored. A total of 358 articles were identified but only six were suitable. Compared to the control group, the pooled analysis (n = 422) showed -0.41% (95% CI: -0.73% to -0.09%, p = 0.013) absolute difference in HbA1c% with treatment. Studies without adjunctive antibiotic had HbA1c% change of -0.64% (95% CI: -1.06% to -0.23%, p = 0.002), but we could not conclude on the effect of adjunctive antibiotic use (p = 0.734). Publication bias was significant with Egger's test (p = 0.014) but not with Begg's test (p = 0.06). The meta-analysis suggested that non-surgical periodontal treatment was associated with a reduction in HbA1c%. © 2013 Australian Dental Association.

  7. Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response

    Directory of Open Access Journals (Sweden)

    Dezerega Andrea

    2012-03-01

    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

  8. Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response.

    Science.gov (United States)

    Dezerega, Andrea; Madrid, Sonia; Mundi, Verónica; Valenzuela, María A; Garrido, Mauricio; Paredes, Rodolfo; García-Sesnich, Jocelyn; Ortega, Ana V; Gamonal, Jorge; Hernández, Marcela

    2012-03-21

    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.

  9. Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed appliances and Invisalign system

    Science.gov (United States)

    Lu, Haili; Tang, Haifang; Zhou, Tian; Kang, Na

    2018-01-01

    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

  10. Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial.

    Science.gov (United States)

    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

    2013-01-01

    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.

  11. [Clinical effect of different sequences of debridement-antibiotic therapy in treatment of severe chronic periodontitis].

    Science.gov (United States)

    Li, Yi; Xu, Li; Lu, Rui-fang; An, Yue-bang; Wang, Xian-e; Song, Wen-li; Meng, Huan-xi

    2015-02-18

    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.

  12. Immunolocalization of heme oxygenase-1 in periodontal diseases

    Directory of Open Access Journals (Sweden)

    G Gayathri

    2014-01-01

    Conclusion: The results of our study is an increasing evidence of involvement of antioxidant enzymes like heme oxygenase-1 in periodontal inflammation and their implication for treatment of chronic periodontitis.

  13. Cost of treatment for breast cancer in central Vietnam

    Directory of Open Access Journals (Sweden)

    Nguyen Hoang Lan

    2013-02-01

    Full Text Available Background: In recent years, cases of breast cancer have been on the rise in Vietnam. To date, there has been no study on the financial burden of the disease. This study estimates the direct medical cost of a 5-year treatment course for women with primary breast cancer in central Vietnam. Methods: Retrospective patient-level data from medical records at the Hue Central Hospital between 2001 and 2006 were analyzed. Cost analysis was conducted from the health care payers’ perspective. Various direct medical cost categories were computed for a 5-year treatment course for patients with breast cancer. Costs, in US dollars, discounted at a 3% rate, were converted to 2010 after adjusting for inflation. For each cost category, the mean, standard deviation, median, and cost range were estimated. Median regression was used to investigate the relationship between costs and the stage, age at diagnosis, and the health insurance coverage of the patients. Results: The total direct medical cost for a 5-year treatment course for breast cancer in central Vietnam was estimated at $975 per patient (range: $11.7–$3,955. The initial treatment cost, particularly the cost of chemotherapy, was found to account for the greatest proportion of total costs (64.9%. Among the patient characteristics studied, stage at diagnosis was significantly associated with total treatment costs. Patients at later stages of breast cancer did not differ significantly in their total costs from those at earlier stages however, but their survival time was much shorter. The absence of health insurance was the main factor limiting service uptake. Conclusion: From the health care payers’ perspective, the Government subsidization of public hospital charges lowered the direct medical costs of a 5-year treatment course for primary breast cancer in central Vietnam. However, the long treatment course was significantly influenced by out-of-pocket payments for patients without health insurance.

  14. Differentiated embryonic chondrocytes 1 expression of periodontal ligament tissue and gingival tissue in the patients with chronic periodontitis.

    Science.gov (United States)

    Hu, Shenlin; Shang, Wei; Yue, Haitao; Chen, Ruini; Dong, Zheng; Hu, Jinhua; Mao, Zhao; Yang, Jian

    2015-04-01

    To evaluate the DEC1 expression of periodontal ligament tissue and gingival tissue in the patients with chronic periodontitis. 20 non-smoking patients with chronic periodontitis and 20 healthy individuals were enrolled. Periodontal ligament tissue and gingival tissue samples from healthy subjects were collected during teeth extraction for orthodontic reason or the third molar extraction. The parallel samples from patients with chronic periodontitis were obtained during periodontal flap operations or teeth extraction as part of periodontal treatment. The DEC1 expression and the alkaline phosphatase (ALP) activity of both the periodontal ligament tissue and gingival tissue were determined by Western blot, Immunohistochemistry and ALP Detection Kit. The DEC1 expression of periodontal ligament tissue in the patients with chronic periodontitis decreased significantly along with the decreased ALP activity. On the contrary, the DEC1 expression of gingival tissue in the patients with chronic periodontitis increased significantly. Further study found that the DEC1 expression of gingival tissue increased mainly in the suprabasal layer of gingival epithelial cells but decreased in the gingival connective tissue of the patients with chronic periodontitis. The DEC1 expression decreases in the periodontal ligament tissue which is related to the osteogenic capacity, whereas the DEC1 expression increases in the suprabasal layer of gingival epithelial cells which are involved in immune inflammatory response in the patients with chronic periodontitis. The findings provide a new target to explore the pathology and the therapy of periodontitis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Group C. Initiator paper. Periodontal regeneration--fact or fiction?

    Science.gov (United States)

    Bartold, P M

    2015-01-01

    Numerous techniques have been tried and tested to regenerate tissues lost to periodontal disease. While there has been some success to date, more work is required to move this to a reliable and clinically predictable procedure. Much of the future success for such treatments will rely largely on our understanding of the biology of both developmental and regenerative processes. Nonetheless, despite the noble goal of periodontal regeneration, the relevance of re-creation of a connective tissue attachment has been questioned. Since formation of a long junctional epithelial attachment to the tooth following a variety of periodontal treatment procedures has been shown to be no more susceptible to further breakdown than a non-diseased site, the question arises as to what purpose do we seek the ultimate outcome of periodontal regeneration? The answer lies in the "fact and fiction" of periodontal regeneration. There is no doubt that the regenerative procedures that have been developed can be shown to be biologically successful at the histological level. Furthermore, the results of periodontal regeneration (particularly guided tissue regeneration) have been stable over the long term (at least up to 10 years). However, the techniques currently under use which show the greatest promise (guided tissue regeneration and growth factors) are still clinically unpredictable because of their highly technique-sensitive nature. In addition, whether the slight clinical improvements offered by these procedures over routine open flap debridement procedures are of cost or patient benefit with regards to improved periodontal health and retention of teeth remains to be established. The next phase in regenerative technologies will undoubtedly involve a deeper understanding of the molecular signaling (both intra- and extra-cellular) and cellular differentiation processes involved in the regenerative processes. So in answer to the question of whether periodontal regeneration is fact or fiction

  16. Effect of non-surgical periodontal treatment on the subgingival microbiota of patients with chronic kidney disease

    OpenAIRE

    Artese,Hilana Paula Carillo; Sousa,Celso Oliveira de; Torres,Maria Cynésia Medeiros de Barros; Silva-Boghossian,Carina Maciel; Colombo,Ana Paula Vieira

    2012-01-01

    This study investigated the effect of non-surgical periodontal therapy on the composition of subgingival microbiota of patients with chronic kidney disease (CKD). Sixteen CKD pre-dialysis individuals (CKD) and 14 individuals without clinical evidence of kidney disease (C) presenting chronic periodontitis were treated by scaling and root planing. Subgingival samples were collected from each patient and analyzed for their composition by checkerboard at baseline and 3 months post-therapy. Signif...

  17. Evaluation of gingival fiber retention technique on the treatment of patients with chronic periodontitis: A comparative study

    Directory of Open Access Journals (Sweden)

    Pooja Palwankar

    2011-01-01

    Full Text Available The destructive action of the chronic periodontitis on the periodontal tissues has provided a continuous challenge to the dental profession to develop better methods to achieve repair of the recession regions and even regeneration of post periodontal tissues. Aims: To assess the effect of periodontal muco-periostal flap surgery with gingival fiber retention technique on minimizing the post surgical recession. Materials and Methods: The sample for the study comprised of 20 patients. The criteria for selection included patients with moderate periodontitis, with minimum recession in the anterior teeth, with adequate width of the attached gingiva, and with no traumatic occlusion. Periodontal muco-periosteal flap surgery with gingival fiber retention technique was done in the experimental site with internal bevel incision, and in control site, muco periosteal flap surgery with crevicular incision was done. Thereafter, observation period was of one week, four weeks, and eight weeks were done for both the sites. Statistical Analysis Used: The results were subjected to statistical analysis using student′s t`-test. Results: The result of this study suggests that the periodontal flap surgery with gingival fiber retention technique has a beneficial effect on the anterior teeth, as it maintains the esthetics, recontours the gingiva with minimal recession. The area of recession was more on the control site as compared to experimental site at 4 weeks, 8 weeks and 12 weeks. Conclusions: Gingival fiber retention technique showed less post-surgical recession and also there was fall in values of plaque index, gingival index, and periodontal index scores, throughout the study.

  18. Evaluation of the effect of non-surgical periodontal treatment on oral health-related quality of life: estimation of minimal important differences 1 year after treatment.

    Science.gov (United States)

    Jönsson, Birgitta; Öhrn, Kerstin

    2014-03-01

    To evaluate an individually tailored oral health educational programme on patient-reported outcome compared with a standard oral health educational programme, assess change over time and determine minimal important differences (MID) in change scores for two different oral health related quality of life (OHRQoL) instrument after non-surgical periodontal treatment (NSPT). In a randomized controlled trial evaluating two educational programmes, patients (n = 87) with chronic periodontitis completed a questionnaire at baseline and after 12 months. OHRQoL was assessed with the General Oral Health Assessment Index (GOHAI) and the UK oral health-related quality-of-life measure (OHQoL-UK). In addition, patients' global rating of oral health and socio-demographic variables were recorded. The MID was estimated with anchor-based and distributions-based methods. There were no differences between the two educational groups. The OHRQoL was significantly improved after treatment. The MID was approximately five for OHQoL-UK with a moderate ES, and three for GOHAI with a Small ES, and 46-50% of the patients showed improvements beyond the MID. Both oral health educational groups reported higher scores in OHRQoL after NSPT resulting in more positive well-being (OHQoL-UK) and less frequent oral problems (GOHAI). OHQoL-UK gave a greater effect size and mean change scores but both instruments were associated with the participants' self-rated change in oral health. The changes were meaningful for the patients supported by the estimated MID. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Single Versus Multi-visit Endodontic Treatment of Teeth with Apical Periodontitis: An in vivo Study with 1-year Evaluation.

    Science.gov (United States)

    Gill, G S; Bhuyan, A C; Kalita, C; Das, L; Kataki, R; Bhuyan, D

    2016-01-01

    Apical periodontitis (AP) is one of the most prevalent diseases of the teeth. Treatment of AP is based on the removal of the cause, i.e., bacteria from the root canals. Achievement of adequate bacterial eradication in one appointment treatment remains a controversy. This prospective study was conducted with the objective to compare the periapical healing of teeth with AP treated in (a) single visit versus (b) two visits, either with or without Vitapex as an intracanal medicament. Patients were selected randomly from the Department of Conservative Dentistry and Endodontics. Forty-three patients (81 teeth) met the inclusion criteria, i.e., AP (both symptomatic and asymptomatic) visible radiographically size ≥2 mm × 2 mm, not suffering from any immune-compromising disease, age between 16 and 65 years and tooth not accessed previously. Patients were randomly divided into three groups, i.e., single-visit group (Group 1), multi-visit group without any intracanal medicament (Group 2), and multi-visit group with Vitapex as interim intracanal medicament (Group 3). Comparison was done radiographically using periapical index (PAI). The primary outcome measure was the change in periapical radiolucency after 1 year assessed by PAI scores. The Mann-Whitney U-test was used to evaluate differences between groups at baseline (immediate postoperative) and at the 12-month follow-up evaluation. Change in PAI score for each group from baseline to 12-month follow-up evaluation was tested with the Wilcoxon signed rank test. The secondary outcome measures, proportion of teeth in each group that could be considered improved (decreased PAI score) or healed (PAI <2), were assessed with the Chi-square test. No statistically significant difference in periapical healing was found between three groups. After 1-year evaluation, no difference in periapical healing was found between single-visit treatment and multi-visit treatment groups with the given sample size.

  20. Histopathological, Microbiological, and Radiographic Analysis of Antimicrobial Photodynamic Therapy for the Treatment of Teeth with Apical Periodontitis: A Study in Rats' Molars.

    Science.gov (United States)

    Trindade, Alessandra Cesar; de Figueiredo, José Antônio Poli; de Oliveira, Sílvia Dias; Barth Junior, Valdir Cristóvão; Gallo, Stephanie Wagner; Follmann, Carina; Wolle, Carlos Frederico Brilhante; Steier, Liviu; Morgental, Renata Dornelles; Weber, João Batista Blessmann

    2017-07-01

    The aim of this study was to evaluate in vivo, by histological and radiographic analysis, the response of apical tissues of rats' teeth with experimentally induced apical periodontitis, after one- and two-session endodontic treatment with and without photodynamic therapy (PDT). A microbiological analysis was also performed to verify bacterial reduction after each treatment. Studies carried out in recent years highlighted the antibacterial potential of PDT when associated with conventional endodontic therapy in vitro. Although the antimicrobial effect of PDT is well-established, tissue response to PDT in teeth with apical periodontitis lacks studies. Thirty-two rats' root canals were assigned to four groups: one session/PDT-[chemomechanical preparation (CMP)+root canal filling (RCF)]; two sessions/PDT- [CMP+calcium hydroxide (CH) for 14 days+RCF]; one session/PDT+ [CMP+PDT+RCF], and two sessions/PDT+ [CMP+PDT+CH for 14 days+RCF]. For microbiological evaluation, samples were collected before and after proposed treatments. For radiographic and histological analysis, the animals were euthanized after 28 days and the mandibles surgically removed. PDT associated with conventional endodontic therapy was able to promote significant bacterial reduction in root canals with induced apical periodontitis, but this reduction was not significantly different to conventional endodontic therapy alone. Although radiographic evaluation showed no significant differences, histological analysis showed lower scores for neutrophils/eosinophils in PDT-treated groups and macrophages/giant cells in CH groups. The use of low-level laser as light source did not promote major improvement on radiographic and histological repair, but since the number of inflammatory cells slightly decreased, it may optimize repair by modulating inflammatory process. PDT may be indicated as an adjunct to conventional endodontic therapy for teeth with apical periodontitis, in association with an interappointment

  1. Periodontal Disease Awareness and Knowledge among Nigerian ...

    African Journals Online (AJOL)

    Periodontal disease is highly prevalent and a costly to treat condition that impacts .... effective in helping young people learn positive and healthy models of behavior. .... periodontal disease as a preventable disease [Table 7]. Best preventive ..... oral hygiene habits, health knowledge, and sources of oral health information ...

  2. Obstetric knowledge, attitude, and behavior concerning periodontal diseases and treatment needs in pregnancy: influencing factors in France.

    Science.gov (United States)

    Cohen, Laura; Schaeffer, Mickaël; Davideau, Jean-Luc; Tenenbaum, Henri; Huck, Olivier

    2015-03-01

    Many studies have shown that periodontal diseases are risk factors for adverse pregnancy outcomes. The aim of this study is to assess the knowledge and clinical attitude of French obstetricians and/or gynecologists regarding periodontal diseases. A cross-sectional study was performed on randomly selected French obstetricians and/or gynecologists using a self-administered, structured questionnaire during an annual French professional congress. The questionnaire was completed by 190 French obstetricians and/or gynecologists. Among respondents, 88% were aware of the inflammatory and infectious nature of periodontal diseases. Furthermore, 74.7% of respondents were conscious of its negative impact on pregnancy outcomes. Few obstetricians and/or gynecologists (26.3%) interviewed patients about oral health. Information on oral health was systematically provided to patients by 10.5% of the practitioners. However, 55.6% addressed this issue if they considered the patient at risk for pregnancy. Only 33.2% of practitioners systematically referred the patient to a dentist. Periodontal disease knowledge and consideration levels increased in more experienced practitioners with a private practice and a personal history of periodontal disease. Periodontal knowledge of the French obstetricians and/or gynecologists surveyed seemed satisfyingly apparent and influenced by levels of professional experience and personal history. However, clinical behavior did not adequately correlate with this knowledge.

  3. Effect of apical clearing technique on the treatment outcome of teeth with asymptomatic apical periodontitis: A randomized clinical trial.

    Science.gov (United States)

    Mittal, Priya; Logani, Ajay; Shah, Naseem; Pandey, R M

    2016-01-01

    This study aims to compare the periapical healing of teeth with asymptomatic apical periodontitis treated either by conventional apical preparation (CAP) or apical clearing technique (ACT). Twenty subjects with bilateral nonvital similar teeth exhibiting comparable periapical index (PAI) score were enrolled and randomly allocated. Group I (CAP, n = 20): Apical preparation three sizes greater (master apical file [MAF]) than the first binding file at the established working length. Group II (ACT, n = 20): Apical preparation three sizes greater than the MAF that was followed by dry reaming. Root canal therapy was accomplished in single-visit for all the teeth. They were pursued radiographically at 3, 6, 9 and 12 months. Pre- and post-treatment PAI scores were compared. To ascertain the proportion of healed teeth between the two groups, McNemar Chi-square test was applied. At 3, 6, and 9 months' time interval the proportion of healed teeth for Group II (ACT) was greater in comparison to Group I (CAP) (P < 0.05). However, at 12 months follow-up period this difference was not significant (P = 0.08). ACT enhanced the healing kinetics. However, the long-term (12 months) radiographic outcome was similar for either technique.

  4. PERAWATAN ABSES PERIODONTAL PADA PENDERITA DIABETES MELLITUS (LAPORAN KASUS)

    OpenAIRE

    Hasanuddin Thahir

    2015-01-01

    The treatment of diabetes mellitus patient who had periodontal abscess requires a careful management and good cooperation with an internist. Periodontal abscess management technique on diabetic patient is not quite difficult from other periodontal diseases, nevertheless the dentist needs to complete examination, mainly blood glucose level must be checked, pre and post treatment. The objective of this report is to know the result of periodontal abscess management in uncontrolled diabetic patie...

  5. Evidenced-based review of clinical studies on periodontics.

    Science.gov (United States)

    2009-08-01

    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.

  6. Surgical Treatment of Periodontal Intrabony Defects with Calcium Sulphate in Combination with Beta-Tricalcium Phosphate: Clinical Observations Two Years Post-Surgery

    Directory of Open Access Journals (Sweden)

    Sujith Sukumar

    2011-01-01

    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.

  7. Neutralisation treatment of AMD at affordable cost

    African Journals Online (AJOL)

    2012-06-11

    Jun 11, 2012 ... capital cost of a pump station and pipeline that can transport. 25 Mℓ/d water over ... with a fine bubble diffuser for mixing and aeration. Each batch test was ... solids were allowed to settle, clear water was decanted and then replaced with a ..... steel tank, lined to protect the metal from corrosion. It is equipped ...

  8. Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

    Science.gov (United States)

    John, Priya; Lazarus, Flemingson; Selvam, Arul; Prabhuji, Munivenkatappa Lakshmaiah Venkatesh

    2015-01-01

    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

  9. Modelling the cost effectiveness of antidepressant treatment in primary care.

    Science.gov (United States)

    Revicki, D A; Brown, R E; Palmer, W; Bakish, D; Rosser, W W; Anton, S F; Feeny, D

    1995-12-01

    The aim of this study was to estimate the cost effectiveness of nefazodone compared with imipramine or fluoxetine in treating women with major depressive disorder. Clinical decision analysis and a Markov state-transition model were used to estimate the lifetime health outcomes and medical costs of 3 antidepressant treatments. The model, which represents ideal primary care practice, compares treatment with nefazodone to treatment with either imipramine or fluoxetine. The economic analysis was based on the healthcare system of the Canadian province of Ontario, and considered only direct medical costs. Health outcomes were expressed as quality-adjusted life years (QALYs) and costs were in 1993 Canadian dollars ($Can; $Can1 = $US0.75, September 1995). Incremental cost-utility ratios were calculated comparing the relative lifetime discounted medical costs and QALYs associated with nefazodone with those of imipramine or fluoxetine. Data for constructing the model and estimating necessary parameters were derived from the medical literature, clinical trial data, and physician judgement. Data included information on: Ontario primary care physicians' clinical management of major depression; medical resource use and costs; probabilities of recurrence of depression; suicide rates; compliance rates; and health utilities. Estimates of utilities for depression-related hypothetical health states were obtained from patients with major depression (n = 70). Medical costs and QALYs were discounted to present value using a 5% rate. Sensitivity analyses tested the assumptions of the model by varying the discount rate, depression recurrence rates, compliance rates, and the duration of the model. The base case analysis found that nefazodone treatment costs $Can1447 less per patient than imipramine treatment (discounted lifetime medical costs were $Can50,664 vs $Can52,111) and increases the number of QALYs by 0.72 (13.90 vs 13.18). Nefazodone treatment costs $Can14 less than fluoxetine

  10. Alcoholism treatment and medical care costs from Project MATCH.

    Science.gov (United States)

    Holder, H D; Cisler, R A; Longabaugh, R; Stout, R L; Treno, A J; Zweben, A

    2000-07-01

    This paper examines the costs of medical care prior to and following initiation of alcoholism treatment as part of a study of patient matching to treatment modality. Longitudinal study with pre- and post-treatment initiation. The total medical care costs for inpatient and outpatient treatment for patients participating over a span of 3 years post-treatment. Three treatment sites at two of the nine Project MATCH locations (Milwaukee, WI and Providence, RI). Two hundred and seventy-nine patients. Patients were randomly assigned to one of three treatment modalities: a 12-session cognitive behavioral therapy (CBT), a four-session motivational enhancement therapy (MET) or a 12-session Twelve-Step facilitation (TSF) treatment over 12 weeks. Total medical care costs declined from pre- to post-treatment overall and for each modality. Matching effects independent of clinical prognosis showed that MET has potential for medical-care cost-savings. However, patients with poor prognostic characteristics (alcohol dependence, psychiatric severity and/or social network support for drinking) have better cost-savings potential with CBT and/or TSF. Matching variables have significant importance in increasing the potential for medical-care cost-reductions following alcoholism treatment.

  11. Interaction Between Immune Cells and Bacteria Associated With Periodontitis

    Science.gov (United States)

    2017-07-22

    Periodontal Diseases; Periodontitis; Aggressive Periodontitis; Immunologic Disease; Microbial Disease; Periodontal Pocket; Inflammation; Inflammation Gum; Dysbiosis; Rheumatoid Arthritis; Generalized Aggressive Periodontitis; Generalized Chronic Periodontitis; Chronic Periodontitis

  12. A long-term study on the clinical effects of mechanical widening of cheek teeth diastemata for treatment of periodontitis in 202 horses (2008-2011).

    Science.gov (United States)

    Dixon, P M; Ceen, S; Barnett, T; O'Leary, J M; Parkin, T D; Barakzai, S

    2014-01-01

    Cheek teeth diastemata are a common cause of painful periodontal disease in horses, but there is limited objective information on their treatment. To assess the long-term response to diastema widening in clinically affected horses. Retrospective study. Medical records from cases of cheek teeth diastemata treated by diastema widening referred to the University of Edinburgh Equine Hospital from 2008 to 2011 were analysed. During this period, 302 horses were diagnosed with clinically significant cheek teeth diastemata, of which 202, median age 11 years, with severe associated periodontitis were treated by widening of 674 problematic diastemata; 89.8% between mandibular cheek teeth and 10.2% between maxillary cheek teeth, with a mean of 1.5 treatments performed per case. These 202 cases showed quidding in 76.2%; weight loss in 33.2%; bitting problems in 20.1% and halitosis in 10.9%, with 5.4% being asymptomatic. Follow-up of 92% of treated cases, a mean of 20.8 months after their initial treatment, showed that 72.6% had complete remission of clinical signs that was permanent (for the duration of this study) in 50.5% and temporary in 22%. A partial response was obtained in 17.2%, no response was obtained in 4.3%, and owners were unsure of response in 5.9%. Clinical improvement was sometimes delayed, with 19% taking >4 weeks following treatment for improvement. Inappropriate sites were burred in individual teeth of 6 horses, causing iatrogenic pulpar exposure in 2 cases, but following treatment none developed clinical signs of apical infection. Diastema widening is an effective but potentially invasive treatment for horses with cheek teeth diastemata with severe periodontitis. Diastema widening by trained personnel is suitable for advanced cases of cheek teeth diastema, but many cases require repeated treatments. © 2013 EVJ Ltd.

  13. The costs and cost-effectiveness of an integrated sepsis treatment protocol.

    Science.gov (United States)

    Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

    2008-04-01

    Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

  14. Management of periodontally compromised patient by orthodontic treatment: Does it help esthetically and biologically?

    Directory of Open Access Journals (Sweden)

    Subhash C Rao

    2012-01-01

    Full Text Available Adults are always keen to know whether they can still opt for orthodontic treatment and they often ask the same question to the orthodontist and the orthodontist replies, it primarily depends on the health of the bone supporting the teeth. Yes, it is the bone health which is of prime importance to undergo orthodontic treatment. Here is a case report of a patient who underwent orthodontic treatment because of lower midline spacing and protrusion of the upper anteriors. The bone health of the upper and lower anteriors was compromised. At the end of the treatment, there was marked improvement in the bone level and the profile of the patient.

  15. Treatment of Severe Chronic Periodontitis with Surgical and Prosthetic Intervention: A 9-year Follow-up Case Report.

    Science.gov (United States)

    Makino-Oi, Asako; Ishii, Yoshihito; Makino, Kenshi; Kondo, Asako; Uekusa, Tomomi; Ishizuka, Yoichi; Tomita, Sachiyo; Saito, Atsushi

    2017-01-01

    A 60-year-old woman presented with the chief complaint of mobility of tooth #16. Gingival swelling and calculus were observed. Clinical examination revealed that 49.4% of sites had a probing depth (PD) of ≥4 mm and 72% of sites bleeding on probing. Radiographic examination revealed vertical bone resorption in #35 and horizontal resorption in other regions. Periapical region radiolucency on #16 and 27 suggested a perio-endo lesion. The clinical diagnosis was severe chronic periodontitis. Initial periodontal therapy mainly comprised the following: oral hygiene instruction; quadrant scaling and root planing (SRP); extraction of #16, 27, and 31; and placement of provisional restorations. Open flap debridement was performed for teeth with a PD ≥4 mm. Bone defects exceeding the root apex were found in #17, 41, 42, and 45 intraoperatively. Teeth #41, 42, and 45 were extracted. After confirming the stability of the periodontal tissue, final prostheses were placed on #14-17, 13-22, 35-37, 33-43, 44-46, and 47. Following reevaluation, the patient was placed on supportive periodontal therapy (SPT). After 6 years, the patient experienced dull pain in and pus discharge from #17. Repeated SRP yielded no improvement, so the tooth was extracted and a removable partial denture placed on #16 and 17. Nine years have passed since the start of SPT and the level of plaque control has remained adequate and periodontal condition stable.

  16. Antimicrobial photodynamic therapy combined with periodontal treatment for metabolic control in patients with type 2 diabetes mellitus: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Evangelista, Erika Elisabeth; França, Cristiane Miranda; Veni, Priscila; de Oliveira Silva, Tamires; Gonçalves, Rafael Moredo; de Carvalho, Verônica Franco; Deana, Alessandro Melo; Fernandes, Kristianne P S; Mesquita-Ferrari, Raquel A; Camacho, Cleber P; Bussadori, Sandra Kalil; Alvarenga, Letícia Heineck; Prates, Renato Araujo

    2015-05-27

    The relationship between diabetes mellitus (DM) and periodontal disease is bidirectional. DM is a predisposing and modifying factor of periodontitis, which, in turn, worsens glycemic control and increases proteins found in the acute phase of inflammation, such as C-reactive protein. The gold standard for the treatment of periodontal disease is oral hygiene orientation, scaling and planing. Moreover, systemic antibiotic therapy may be employed in some cases. In an effort to minimize the prescription of antibiotics, photodynamic therapy (PDT) has been studied as an antimicrobial technique and has demonstrated promising results. The aim of the proposed study is to determine whether PDT as a complement to periodontal therapy (PT) is helpful in the metabolic control of individuals with type 2 diabetes and the reduction of acute-phase inflammatory markers. The patients will be randomized using a proper software program into two groups: 1) PT + placebo PDT or 2) PT + active PDT. All patients will first be examined by a specialist, followed by PT performed by two other healthcare professionals. At the end of each session, PDT (active or placebo) will be administered by a fourth healthcare professional. The following will be the PDT parameters: diode laser (660 nm); power output = 110 mW; exposure time = 90 s per point (9 J/point); and energy density = 22 J/cm(2). The photosensitizer will be methylene blue (50 μg/mL). The patients will be re-evaluated 15, 30, 90 and 180 days after treatment. Serological examinations with complete blood count, fasting glucose, glycated hemoglobin and salivary examinations to screen for tumor necrosis factor alpha, interleukin 1, interleukin 6, ostelocalcin, and osteoprotegerin/RANKL will be performed at each evaluation. The data will be statistically evaluated using the most appropriate tests. The results of this study will determine the efficacy of photodynamic therapy as an adjuvant to periodontal treatment in diabetic patients. The

  17. Genetic variants in periodontal health and disease

    Energy Technology Data Exchange (ETDEWEB)

    Dumitrescu, Alexandrina L [Tromsoe Univ. (Norway). Inst. of Clinical Dentistry; Kobayashi, Junya [Kyoto Univ. (Japan). Dept. of Genome Repair Dynamics

    2010-07-01

    Periodontitis is a complex, multifactorial disease and its susceptibility is genetically determined. The present book systematically reviews the evidence of the association between the genetic variants and periodontitis progression and/or treatment outcomes. Genetic syndromes known to be associated with periodontal disease, the candidate gene polymorphisms investigated in relation to periodontitis, the heritability of chronic and aggressive periodontitis, as well as common guidelines for association studies are described. This growing understanding of the role of genetic variation in inflammation and periodontal chronic disease presents opportunities to identify healthy persons who are at increased risk of disease and to potentially modify the trajectory of disease to prolong healthy aging. The book represents a new concept in periodontology with its pronounced focus on understanding through knowledge rather than presenting the presently valid answers. Connections between genetics and periodontology are systematically reviewed and covered in detail. (orig.)

  18. New treatment of periodontal diseases by using NF-kappaB decoy oligodeoxynucleotides via prevention of bone resorption and promotion of wound healing.

    Science.gov (United States)

    Shimizu, Hideo; Nakagami, Hironori; Morita, Shosuke; Tsukamoto, Ikuyo; Osako, Mariana Kiomy; Nakagami, Futoshi; Shimosato, Takashi; Minobe, Noriko; Morishita, Ryuichi

    2009-09-01

    Nuclear factor-kappa B (NF-kappaB) is involved in osteoclast differentiation and activation. Thus, the blockade of the NF-kappaB pathway might be a novel therapeutic strategy for treating bone metabolic diseases. Periodontitis is subgingival inflammation caused by bacterial infection; this disease also is thought to be a chronic focal point responsible for systemic diseases. In this study, NF-kappaB decoy oligodeoxynucleotides (ODNs) were topically applied for experimental periodontitis in a debris-accumulation model and wound healing in a bone-defect model of beagle dogs to investigate the effect of decoy ODN on bone metabolism. Application of NF-kappaB decoy ODN significantly reduced interleukin-6 activity in crevicular fluid and improved alveolar bone loss in the analysis of dental radiographs and DEXA. Direct measurement of exposed root that lost alveolar bone support revealed that NF-kappaB decoy treatment dramatically protected bone from loss. In a bone-defect model, NF-kappaB decoy ODN promoted the healing process as compared with control scrambled decoy in micro-CT analysis. Overall, inhibition of NF-kappaB by decoy strategy prevented the progression of bone loss in periodontitis and promoted the wound healing in bone defects through the inhibition of osteoclastic bone resorption. Targeting of NF-kappaB might be a potential therapy in various bone metabolic diseases.

  19. An individually tailored treatment programme for improved oral hygiene: introduction of a new course of action in health education for patients with periodontitis.

    Science.gov (United States)

    Jönsson, B; Ohrn, K; Oscarson, N; Lindberg, P

    2009-08-01

    To describe and evaluate an individually tailored treatment programme based on a behavioural medicine approach to oral hygiene self-care for patients with chronic periodontitis. Two experimental single-case studies with multiple-baseline design across different self-administered oral hygiene behaviours were conducted. Cognitive Behavioural techniques were used to organize the strategies for the intervention and the approach to counselling was inspired by and structured in accordance with Motivational Interviewing. The central features in the programme were the individual analysis of knowledge and oral hygiene habits, individually set goals for oral hygiene behaviour, practice of manual dexterity for oral hygiene aids, continuous self-monitoring of the behaviour and prevention of relapse. Both participants reached the predecided criteria for clinical significance in reducing plaque and bleeding on probing. Reductions of periodontal probing depth were achieved as well. The positive results remained stable throughout the 2-year study period. The successful application of this educational model suggests that it could be used as a method for tailoring interventions targeted to oral hygiene for patients with periodontal conditions. The programme will now be tested in a larger randomized controlled trial.

  20. Cost trend analysis of initial cancer treatment in Taiwan.

    Directory of Open Access Journals (Sweden)

    Tsai-Yun Li

    Full Text Available BACKGROUND: Despite the high cost of initial cancer care, that is, care in the first year after diagnosis, limited information is available for specific categories of cancer-related costs, especially costs for specific services. This study purposed to identify causes of change in cancer treatment costs over time and to perform trend analyses of the percentage of cancer patients who had received a specific treatment type and the mean cost of care for patients who had received that treatment. METHODOLOGY/PRINCIPAL FINDINGS: The analysis of trends in initial treatment costs focused on cancer-related surgery, chemotherapy, radiation therapy, and treatments other than active treatments. For each cancer-specific trend, slopes were calculated for regression models with 95% confidence intervals. Analyses of patients diagnosed in 2007 showed that the National Health Insurance (NHI system paid, on average, $10,780 for initial care of a gastric cancer patient and $10,681 for initial care of a lung cancer patient, which were inflation-adjusted increases of $6,234 and $5,522, respectively, over the 1996 care costs. During the same interval, the mean NHI payment for initial care for the five specific cancers increased significantly (p<0.05. Hospitalization costs comprised the largest portion of payments for all cancers. During 1996-2007, the use of chemotherapy and radiation therapy significantly increased in all cancer types (p<0.05. In 2007, NHI payments for initial care for these five cancers exceeded $12 billion, and gastric and lung cancers accounted for the largest share. CONCLUSIONS/SIGNIFICANCE: In addition to the growing number of NHI beneficiaries with cancer, treatment costs and the percentage of patients who undergo treatment are growing. Therefore, the NHI must accurately predict the economic burden of new chemotherapy agents and radiation therapies and may need to develop programs for stratifying patients according to their potential benefit

  1. Efficacy of triclosan-based toothpastes in the prevention and treatment of plaque-induced periodontal and peri-implant diseases.

    Science.gov (United States)

    Trombelli, L; Farina, R

    2013-03-01

    To evaluate the efficacy of triclosan (T)-based toothpaste formulations in the prevention and treatment of plaque-induced periodontal and peri-implant diseases. A review of the existing literature was conducted with a systematic approach in order to retrieve pertinent articles. i) Compared with a control fluoride dentifrice, a fluoride dentifrice containing T formulations provides a more effective level of plaque control and gingival health in patients affected by gingivitis; ii) 0.3% T/2% copolymer/0.243% NaF formulation and 0.3% T/0.13% Ca glicerophosphate/1000 ppm F toothpaste in a natural Ca carbonate base seem the most effective T-based toothpaste formulations in controlling plaque and gingival inflammation in patients with gingivitis or mild/moderate periodontitis over a 6-month period; iii) 0.3% T/2% copolymer/0.243% NaF toothpaste formulation can reduce clinical attachment loss in young adolescents when compared with a 0.243% NaF toothpaste formulation, the magnitude of the difference being greater for patients with deep periodontal pockets at baseline; iv) 0.3% T/2% copolymer/0.243% NaF toothpaste formulation is either similarly or more efficacious in preventing the progression/recurrence of periodontal destruction when compared to a conventional fluoride toothpaste; v) 0.3% T/2% copolymer/0.243% NaF toothpaste formulation seems to be more effective than a fluoride toothpaste formulation in controlling the severity of mucosal inflammation, the incidence of mucosal bleeding as well as reducing probing pocket depth around dental implants.

  2. Common Periodontal Diseases of Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Hayat Al-Ghutaimel

    2014-01-01

    “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.

  3. Cost-effectiveness analysis of treatments for premenstrual dysphoric disorder.

    Science.gov (United States)

    Rendas-Baum, Regina; Yang, Min; Gricar, Joseph; Wallenstein, Gene V

    2010-01-01

    Premenstrual syndrome (PMS) is reported to affect between 13% and 31% of women. Between 3% and 8% of women are reported to meet criteria for the more severe form of PMS, premenstrual dysphoric disorder (PMDD). Although PMDD has received increased attention in recent years, the cost effectiveness of treatments for PMDD remains unknown. To evaluate the cost effectiveness of the four medications with a US FDA-approved indication for PMDD: fluoxetine, sertraline, paroxetine and drospirenone plus ethinyl estradiol (DRSP/EE). A decision-analytic model was used to evaluate both direct costs (medication and physician visits) and clinical outcomes (treatment success, failure and discontinuation). Medication costs were based on average wholesale prices of branded products; physician visit costs were obtained from a claims database study of PMDD patients and the Agency for Healthcare Research and Quality. Clinical outcome probabilities were derived from published clinical trials in PMDD. The incremental cost-effectiveness ratio (ICER) was calculated using the difference in costs and percentage of successfully treated patients at 6 months. Deterministic and probabilistic sensitivity analyses were used to assess the impact of uncertainty in parameter estimates. Threshold values where a change in the cost-effective strategy occurred were identified using a net benefit framework. Starting therapy with DRSP/EE dominated both sertraline and paroxetine, but not fluoxetine. The estimated ICER of initiating treatment with fluoxetine relative to DRSP/EE was $US4385 per treatment success (year 2007 values). Cost-effectiveness acceptability curves revealed that for ceiling ratios>or=$US3450 per treatment success, fluoxetine had the highest probability (>or=0.37) of being the most cost-effective treatment, relative to the other options. The cost-effectiveness acceptability frontier further indicated that DRSP/EE remained the option with the highest expected net monetary benefit for

  4. Periodontal Plastic Microsurgery in the Treatment of Deep Gingival Recession after Orthodontic Movement

    Directory of Open Access Journals (Sweden)

    Sérgio Kahn

    2013-01-01

    Full Text Available Gingival recession is a condition that affects a large portion of the young and adult population and negatively affects the aesthetic aspects of the smile. Many factors are related to its development, including orthodontic movement beyond the osseous limits. Many treatment options have been proposed to cover the exposed root surface. The aim of this article was to describe three cases where a subepithelial connective tissue graft was performed, using a microsurgical technique, in the treatment of deep gingival recession after orthodontic treatment. This technique resulted in successful root coverage and keratinized tissue gain, improving the gingival esthetic pattern.

  5. Cost-effectiveness analysis of treatments for vertebral compression fractures.

    Science.gov (United States)

    Edidin, Avram A; Ong, Kevin L; Lau, Edmund; Schmier, Jordana K; Kemner, Jason E; Kurtz, Steven M

    2012-07-01

    Vertebral compression fractures (VCFs) can be treated by nonsurgical management or by minimally invasive surgical treatment including vertebroplasty and balloon kyphoplasty. The purpose of the present study was to characterize the cost to Medicare for treating VCF-diagnosed patients by nonsurgical management, vertebroplasty, or kyphoplasty. We hypothesized that surgical treatments for VCFs using vertebroplasty or kyphoplasty would be a cost-effective alternative to nonsurgical management for the Medicare patient population. Cost per life-year gained for VCF patients in the US Medicare population was compared between operated (kyphoplasty and vertebroplasty) and non-operated patients and between kyphoplasty and vertebroplasty patients, all as a function of patient age and gender. Life expectancy was estimated using a parametric Weibull survival model (adjusted for comorbidities) for 858 978 VCF patients in the 100% Medicare dataset (2005-2008). Median payer costs were identified for each treatment group for up to 3 years following VCF diagnosis, based on 67 018 VCF patients in the 5% Medicare dataset (2005-2008). A discount rate of 3% was used for the base case in the cost-effectiveness analysis, with 0% and 5% discount rates used in sensitivity analyses. After accounting for the differences in median costs and using a discount rate of 3%, the cost per life-year gained for kyphoplasty and vertebroplasty patients ranged from $US1863 to $US6687 and from $US2452 to $US13 543, respectively, compared with non-operated patients. The cost per life-year gained for kyphoplasty compared with vertebroplasty ranged from -$US4878 (cost saving) to $US2763. Among patients for whom surgical treatment was indicated, kyphoplasty was found to be cost effective, and perhaps even cost saving, compared with vertebroplasty. Even for the oldest patients (85 years of age and older), both interventions would be considered cost effective in terms of cost per life-year gained.

  6. Main properties of nanocrystalline hydroxyapatite as a bone graft material in treatment of periodontal defects. A review of literature

    International Nuclear Information System (INIS)

    Bayani, Mojtaba; Torabi, Sepehr; Shahnaz, Aysan; Pourali, Mohammad

    2017-01-01

    This study aims to provide a literature review on nanocrystalline hydroxyapatite (n-HA). n-HA constitutes the principle inorganic part of hard tissues. Therefore, preparation of commercial synthetic analogues, the so-called ‘biomimetic’, has gained a lot of attention since it can precisely mimic the physicochemical features of biological apatite compounds. Due to its improved osseointegrative properties, n-HA may represent a promising class of bone graft materials. n-HA binds to the bone and by stimulation of osteoblast activity and enhancing local growth factors it improves bone healing. Periodontitis is an inflammatory condition in response to microbial plaque that leads to periodontal tissue destruction and osseous defects in alveolar bone. A review of the extant literature reveals that n-HA has certain advantages in periodontal tissue regeneration including minimal patient morbidity, better biocompatibility, and lack of toxicity

  7. An update on periodontic-orthodontic interrelationships.

    Science.gov (United States)

    Dannan, Aous

    2010-01-01

    Talking about periodontic-orthodontic interrelationships is related primarily to the 1960s, where a generalized increase in salivary bacterial counts, especially Lactobacillus, had been shown after orthodontic band placement. The purpose of this article is to provide the dental practitioner with basic understanding of the interrelationship between periodontics and orthodontics by means of representing classical studies, and, to give an update on this topic by demonstrating the most recent opinions concerning periodontic-orthodontic interrelationships. Specific areas reviewed are the ability of orthodontic treatment to afford some degree of protection against periodontal breakdown, short-term and long-term effects of orthodontic treatment on the periodontium, and some mucogingival considerations. Topics considering orthodontic treatment in periodontally compromised patients were not included in this review. While past studies have shown that orthodontic treatment can positively affect the periodontal health, recent reviews indicate an absence of reliable evidence for the positive effects of orthodontic therapy on patients' periodontal status. Periodontic-orthodontic interrelationships are still controversial issues. However, a standard language between the periodontist and the orthodontist must always be established to eliminate the existing communications barrier, and to improve the outcomes of the whole treatment.

  8. An update on periodontic-orthodontic interrelationships

    Directory of Open Access Journals (Sweden)

    Dannan Aous

    2010-01-01

    Full Text Available Talking about periodontic-orthodontic interrelationships is related primarily to the 1960s, where a generalized increase in salivary bacterial counts, especially Lactobacillus, had been shown after orthodontic band placement. The purpose of this article is to provide the dental practitioner with basic understanding of the interrelationship between periodontics and orthodontics by means of representing classical studies, and, to give an update on this topic by demonstrating the most recent opinions concerning periodontic-orthodontic interrelationships. Specific areas reviewed are the ability of orthodontic treatment to afford some degree of protection against periodontal breakdown, short-term and long-term effects of orthodontic treatment on the periodontium, and some mucogingival considerations. Topics considering orthodontic treatment in periodontally compromised patients were not included in this review. While past studies have shown that orthodontic treatment can positively affect the periodontal health, recent reviews indicate an absence of reliable evidence for the positive effects of orthodontic therapy on patients′ periodontal status. Periodontic-orthodontic interrelationships are still controversial issues. However, a standard language between the periodontist and the orthodontist must always be established to eliminate the existing communications barrier, and to improve the outcomes of the whole treatment.

  9. Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions.

    Science.gov (United States)

    Jeffcoat, Marjorie K; Jeffcoat, Robert L; Gladowski, Patricia A; Bramson, James B; Blum, Jerome J

    2014-08-01

    Treatment of periodontal (gum) disease may lessen the adverse consequences of some chronic systemic conditions. To estimate the effects of periodontal therapy on medical costs and hospitalizations among individuals with diagnosed type 2 diabetes (T2D); coronary artery disease (CAD); cerebral vascular disease (CVD); rheumatoid arthritis (RA); and pregnancy in a retrospective observational cohort study. Insurance claims data from 338,891 individuals with both medical and dental insurance coverage were analyzed in 2011-2013. Inclusion criteria were (1) a diagnosis of at least one of the five specified systemic conditions and (2) evidence of periodontal disease. Subjects were categorized according to whether they had completed treatment for periodontal disease in the baseline year, 2005. Outcomes were (1) total allowed medical costs and (2) number of hospitalizations, per subscriber per year, in 2005-2009. Except in the case of pregnancy, outcomes were aggregated without regard to reported cause. Individuals who were treated and untreated for periodontal disease were compared independently for the two outcomes and five systemic conditions using ANCOVA; age, gender, and T2D status were covariates. Statistically significant reductions in both outcomes (ppregnancy, for which costs were lower by 40.2%, 40.9%, 10.7%, and 73.7%, respectively; results for hospital admissions were comparable. No treatment effect was observed in the RA cohorts. These cost-based results provide new, independent, and potentially valuable evidence that simple, noninvasive periodontal therapy may improve health outcomes in pregnancy and other systemic conditions. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Chemistry of cost effective water treatment programme in HWP (Manuguru)

    International Nuclear Information System (INIS)

    Mohapatra, C.; Laxmana Prasad, K.

    2008-01-01

    In order to develop a water treatment programme following points must be kept in mind: Effectiveness to achieve desired water quality objectives; Compliance with regulatory requirements; Cost minimization; Safety; Easy operation and protection to equipments. Heavy Water Plant (Manuguru) laboratory has developed treatment programs to treat raw water and cooling water which satisfy the above requirements and has been in use for last several years successfully without any problem. These treatment programs have been given to other plants in Heavy Water Board for implementation. This paper describes the chemistry of the treatment program and cost minimization achieved. Further these treatments have helped the plant in achieving ΦZero Discharge and indirectly reduced the production cost. The chemistry parameters are monitored regularly to ascertain the effectiveness of these treatments. The areas where significant benefits derived are raw water treatment using polyelectrolyte instead of inorganic coagulant (alum), change over of regenerant of cation exchangers from hydrochloric acid to sulfuric acid and development of in-house cooling water treatment formulation. The advantages and cost effectiveness of these treatments are discussed in detail. Further these treatments helped the plant in achieving Zero discharge and indirectly reduced production cost of heavy water. The dosage of 3 ppm of polyelectrolyte can replace 90 ppm alum at turbidity level of 300 NTU of raw water which has resulted in cost saving of Rs. 15 - 20 Lakhs in a year besides other advantages. The changeover of regenerant from HCl to H 2 SO 4 will result in cost saving of at least Rs. 1.4 Crore a year along with other advantages. The change over of proprietary formulation to in-house formulation in cooling water treatment has resulted a saving about Rs. 11 Lakhs a year. To achieve the above objectives in a sustainable way the performance results are being monitored (author)

  11. Chronic periodontitis with multiple risk factor syndrome: a case report.

    Science.gov (United States)

    Shimoe, Masayuki; Yamamoto, Tadashi; Iwamoto, Yoshihiro; Shiomi, Nobuyuki; Maeda, Hiroshi; Nishimura, Fusanori; Takashiba, Shogo

    2011-07-01

    Multiple risk factor syndrome is a clustering of cardiovascular risk factors, such as diabetes, dyslipidemia, hypertension, and obesity associated epidemiologically with insulin resistance. This report describes the clinical course of a patient suffering from severe periodontitis with multiple risk factor syndrome, and discusses the association between periodontal infection and systemic health. The patient had a history of type 2 diabetes, dyslipidemia, and hypertension for over 10 years. At baseline, her hemoglobin A1 c was 8.1%. However, she had no diabetic complications except periodontitis. The IgG antibody titers against Porphyromonas gingivalis FDC 381 and SU63 were elevated above the mean of healthy subjects +2 standard deviations. Intensive periodontal treatment, including periodontal surgery, was performed to reduce periodontal infection and bacteremia. Her systemic and periodontal conditions were evaluated longitudinally for 10 years. Following periodontal treatment, antibody titers against Porphyromonas gingivalis and hemoglobin A1c values were significantly improved. The other clinical data and medication for her systemic condition also remained stable during supportive periodontal therapy. However, she developed myocardial infarction, and showed continuous deterioration of hemoglobin A1 c level and periodontitis. The long-term clustering of risk factors, such as diabetes, dyslipidemia, hypertension, and periodontitis, are associated with the development of myocardial infarction. Treatment of systemic conditions in combination with comprehensive periodontal treatment is important in management of patients with multiple risk factor syndrome.

  12. Cost-effective treatment for the couple with infertility.

    Science.gov (United States)

    Van Voorhis, B J; Syrop, C H

    2000-12-01

    Although the evaluation of cost-effective approaches to infertility treatment remains in its infancy, several important principles have emerged from the initial studies in this field. Currently, in treating couples with infertility without tubal disease or severe male-factor infertility, the most cost-effective approach is to start with IUI or superovulation-IUI treatments before resorting to IVF procedures. The woman's age and number of sperm present for insemination are significant factors influencing cost-effectiveness. The influence of certain diagnoses on the cost-effectiveness of infertility treatments requires further study. Even when accounting for the costs associated with multiple gestations and premature deliveries, the cost of IVF decreases within the range of other cost-effective medical procedures and decreases to less than the willingness to pay for these procedures. Indeed, for patients with severe tubal disease, IVF has been found to be more cost-effective than surgical repair. The cost-effectiveness of IVF will likely improve as success rates show continued improvements over the course of time. In addition, usefulness of embryo selection and practices to reduce the likelihood of high-order multiple pregnancies, without reductions in pregnancy rates, will significantly impact cost-effectiveness. The exclusion of infertility treatments from insurance plans is unfortunate and accentuates the importance of physicians understanding the economics of infertility treatment with costs that are often passed directly to the patient. The erroneous economic policies and judgments that have led to inequities in access to infertility health care should not be tolerated.

  13. Periodontal Disease Part IV: Periodontal Infections

    OpenAIRE

    Turnbull, Robert S.

    1988-01-01

    In Part IV of this article, the author describes two periodontal infections, acute necrotizing ulcerative gingivitis (trench mouth) and periodontal abscess, both acute painful conditions for which patients may seek advice from their family physician rather than their dentist.

  14. Outpatient treatment costs and their potential impact on cancer care

    International Nuclear Information System (INIS)

    Isshiki, Takahiro

    2014-01-01

    Cancer creates a tremendous financial burden. Cancer-related costs are categorized into direct, indirect, and psychosocial costs. Although there have been many reports on medical care costs, which are direct, those on other costs are extremely scarce. We estimated travel time and costs required for cancer patients to receive outpatient treatment. We studied 521 cancer patients receiving anti-cancer treatment between February 2009 and December 2012 at the Outpatient Chemotherapy Center of Teikyo University Chiba Medical Center. Address data were extracted from Data Warehouse electronic medical records, and travel distance and time required for outpatient treatment were calculated via MapInfo and ACT Distance Calculator Package. Transportation costs were estimated on the basis of ¥274 (=$3.00) per kilometer. The study design was approved by an ethics review board of Teikyo University (12-851). Average round-trip travel distance, time, and cost for all patients were 26.7 km, 72.5 min, and ¥7,303 ($79.99), respectively. Cancer patients incurred a travel cost of ¥4000–¥9000 ($40.00 to $100.00) for each outpatient treatment. With population aging, seniors living alone and senior households are increasing, and outpatient visits are becoming a common burden

  15. The effect of credentialism on the cost of conservation treatment

    DEFF Research Database (Denmark)

    Brajer, Isabelle Eve

    2017-01-01

    This paper focuses on the economic cost of treatment of cultural heritage using conservation of wall paintings in Danish churches over its entire period, from 1855 to 2015, as a primary data source. Financial costs for 990 individual projects harvested from archival documents were adjusted with s...

  16. Cost considerations for an ionising energy treatment facility

    International Nuclear Information System (INIS)

    Culpitt, R.A.

    1985-01-01

    Variables influencing the cost of food irradiation can be included under three broad headings: the physical characteristics of products to be treated; the operational characteristics of the plant to be used; costs of establishment and operation of an ionising energy treatment

  17. medical cost of lassa fever treatment in irrua specialist teaching

    African Journals Online (AJOL)

    2016-09-30

    Sep 30, 2016 ... Data entry and analysis was done using SPSS version 20. The average total direct cost for Lassa fever treatment ..... Dialysis and oxygen came next in the unsubsidized cost pattern accounting for ..... Barriers to Use of Maternal and Child Health Services in Asia and the Pacific Evidence from National ...

  18. Determining infertility treatment costs and out of pocket payments ...

    African Journals Online (AJOL)

    The greatest portion of indirect costs was related to accommodation expenses and the least was due to travel costs (4.898.099 and 2.738.491 rial). ... Conclusion: Due to the high expenditures related to infertility treatment services also lack of insurance coverage, policy makers should pay a particular attention on meeting ...

  19. Cost of Tuberculosis Treatment: Evidence from Iran's Health System.

    Science.gov (United States)

    Bay, Vahid; Tabarsi, Payam; Rezapour, Aziz; Marzban, Sima; Zarei, Ehsan

    2017-10-01

    This study aimed to estimate the cost of smear-positive drug-susceptible pulmonary tuberculosis (TB) treatment of the patients in the Azadshahr district, Golestan Province, Iran. In this retrospective study, all new smear positive pulmonary TB patients who had been registered at the district's health network between April, 2013 and December, 2015 and had successfully completed their treatment were entered into the study (45 patients). Treatment costs were estimated from the provider's perspective using an activity-based costing (ABC) method. The cost of treating a new smear-positive pulmonary TB patient was US dollar (USD) 1,409.00 (Iranian Rial, 39,438,260), which can be divided into direct and indirect costs (USD 1,226.00 [87%] and USD 183.00 [13%], respectively). The highest cost (58.1%) was related to care and management of TB patients (including 46.1% human resources costs and 12% directly-observed treatment, short course implementation) and then respectively related to hospitalization (12.1%), supportive activity centers (11.4%), transportation (6.5%), medicines (5.3%), and laboratory tests and radiography (3.2%). Using disease-specific cost studies can help the healthcare system management to have correct insight into the financial burden created by the disease. This can subsequently be used in prioritization, planning, operational budgeting, economic evaluation of programs, interventions, and ultimately in disease management.

  20. Periodontal abscess during supportive periodontal therapy: a review of the literature.

    Science.gov (United States)

    Silva, Geraldo L M; Soares, Rodrigo V; Zenóbio, Elton G

    2008-09-01

    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.

  1. STUDY OF THE INFLUENCE OF COMPLEX TREATMENT USING IMMUNOMODULATORS ON THE STATE OF LOCAL IMMUNITY IN PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS I-II SEVERITY ON ENTEROBIASIS

    Directory of Open Access Journals (Sweden)

    Savel’eva NN

    2016-12-01

    Full Text Available Introduction. Due to the high prevalence of chronic generalized periodontitis there is a need for a broader analysis of the causes and development of diseases, as well as the search for effective treatments for etiopathogenetical. The aim of this work was to study the effect of newly developed therapy on local immunity in patients CGP I and II severity with enterobiasis. Material & methods. The main group consisted of 32 people with СGP I degree and 60 people with СGP II severity who were treated according to our scheme. The control group consisted of 30 people with СGP I degree and 58 people with СGP II severity, treated with conventional treatment. The control group consisted of 30 people without periodontal disease and chronic diseases of other systems. All patients were studied the main group and the comparison group conducted a basic local therapeutic treatment of periodontal disease, including professional oral hygiene, temporary splinting of teeth, selective prishlifovyvanie teeth. For medical treatment of periodontal tissues using 0.05% - 0.2% solution of chlorhexidine bigluconate. Further treatment of patients of the main group carried out in 2 stages. At the first stage the main group received: irrigation and instillation of periodontal tissue in periodontal pockets antiseptic preparation "Dekasan" application keratoplastic drug "Katomas". Systemically administered drug tonic "Sage oil" probiotic "Kvertulin" immunomodulator "Erbisol". In the second phase, patients received: applications on the gums periodontal gel "Lizomukoid" systemically complex preparation "Оil extract from pumpkin seeds." All patients of the main group used toothpaste "Lacalut flora" and rinse "grapefruit". In the comparison group, patients received applications in periodontal pockets (drug Dalatsin C application to the gums (keratoplastic drug Aekol system - a probiotic Linex, immunomodulator "Echinacea compositum С". All patients with the comparison group

  2. Improvement of pustulosis palmaris et plantaris by periodontal infection control in a patient with chronic periodontitis.

    Science.gov (United States)

    Murai, Osamu; Sasaki, Daisuke; Ando, Yoshinori; Fujimura, Akira; Oikawa, Hiromi; Suwa, Nagisa; Watabe, Daisuke; Maeda, Fumihiko; Endo, Kohki; Yaegashi, Takashi; Akasaka, Toshihide; Naruishi, Koji

    2012-01-01

    Pustulosis palmaris et plantaris (PPP) is a chronic, inflammatory, autoimmune-type disease characterized by sterile pustules of skin. The skin inflammation is influenced by several factors such as drugs, sunlight, metabolic and psychogenic factors as well as metal allergy. Here, we report a rare case that intensive periodontal treatment might have contributed to the improvement of skin inflammation. Skin inflammation regressed 1 month after intensive periodontal treatment. Both CD4/CD8 ratio and % of B cells in the blood sample were slightly decreased corresponding to the improvement of periodontal inflammation. Infection control of periodontal lesions might be one of attractive therapeutic targets in management of PPP.

  3. Apical Periodontitis and Endodontic Treatment in Patients with Type II Diabetes Mellitus: Comparative Cross-sectional Survey.

    Science.gov (United States)

    Smadi, Leena

    2017-05-01

    The aims of this study were to investigate the prevalence of apical periodontitis (AP) in diabetes mellitus (DM) patients compared with nondiabetic patients and to examine the effect of glycemic control on the prevalence of AP. Radiographs of a group of DM patients were compared with those of a matched nondiabetic group to identify AP. The diabetic group was subdivided according to the level of glycemic control into two subgroups: A well-controlled DM and a poorly controlled DM. The periapical index score was used to assess the periapical status. All groups were compared in regard to the presence of AP lesions, the number of end-odontically treated teeth (ET), and the percentage of failure of endodontically treated teeth (AP/ET ratio). Statistical Package for the Social Sciences (SPSS version 20.0, Chicago, Illinois, USA) was used for all the analyses; p ≤ 0.05 was considered as statistically significant. The prevalence of AP was higher in diabetic group than in the nondiabetic group (13.5 vs 11.9% respectively). Diabetic group had more teeth with endodontic treatment ET compared with nondiabetic group (4.18 vs 1.82% respectively); this difference was statistically significant (p = 0.001) along with higher AP/ET ratio (27.7 vs 19.3 respectively). The poorly controlled DM group had a higher prevalence of AP lesions compared with the well-controlled DM group (18.29 vs 9.21 respectively). This difference was statistically significant (p = 0.001); they also had a higher percentage of ET (5.55 vs 3.13% respectively) and AP/ ET ratio (32.0 vs 21.8% respectively). This survey demonstrates a higher prevalence of AP in DM patients compared with nondiabetic group, with an increased prevalence of persistent chronic AP. Compared with a well-controlled diabetic group, a poor glycemic control may be associated with a higher prevalence of AP and increased rate of endodontic failures. Counseling diabetic patients, particularly those with poor glycemic control, about the risk of

  4. Comparison between one-session root canal treatment with aPDT and two-session treatment with calcium hydroxide-based antibacterial dressing, in dog's teeth with apical periodontitis.

    Science.gov (United States)

    Hidalgo, Lidia Regina da Costa; da Silva, Léa Assed Bezerra; Nelson-Filho, Paulo; da Silva, Raquel Assed Bezerra; de Carvalho, Fabrício Kitazono; Lucisano, Marília Pacífico; Novaes, Arthur Belem

    2016-09-01

    To evaluate one-session endodontic treatment with aPDT and two-session treatment with calcium hydroxide (CH)-based dressing in dog's teeth with apical periodontitis. After experimental induction of apical periodontitis, 48 teeth were randomly assigned to the following groups: groups OS/aPDT120d and OS/aPDT180d (one-session treatment with aPDT) and groups TS/CH120d and TS/CH180d (two-session treatment with CH-based dressing-control groups). The animals were euthanized after 120 and 180 days. After histotechnical processing, microscopic and radiographic analyses were performed. Data were analyzed by Kruskal-Wallis and Fisher's exact tests (α = 0.05). Groups TS/CHs presented repaired resorbed cemental areas, with collagen bundles and few inflammatory cells. In groups OS/aPDTs, the areas of cemental resorption were not repaired with reduced presence of cells and fibers. In the analysis of the apical closure, fluorescence microscopy and percentage of radiographic reduction of lesions, there was significant difference between groups TS/CH120d and OS/aPDT120d and between TS/CH180d and OS/aPDT180d (p session endodontic treatment using a CH-based dressing in teeth with apical periodontitis.

  5. Laser therapy for periodontitis

    Science.gov (United States)

    Efanov, O. I.

    2001-04-01

    An investigation was made of applying pulsed (lambda) equals 0.89 micrometers laser radiation in the treatment for early diagnosed periodontitis. The investigation was made on 65 patients (47 patients constituted the experimental group and 18 patients constituted a control group) affected by periodontitis. Clinical and functional tests revealed that laser therapy produced a string effect on the course of the illness. It reduced bleeding, inflammation, and pruritus. However, it did not produce an affect on electroexcitation. Biomicroscopic examinations and periodontium rheography revealed that the gingival blood flow became normal after the course of laser therapy. The capillary permeability and venous congestion decreased, which was confirmed by the increased time of vacuum tests, raised gingival temperature, reduced tissue clearance, and increased oxygen tension. Apart from that, laser therapy subsided fibrinolysis, proteolytic tissue activity, and decreased the exudative inflammation of periodontium.

  6. Оptimization of periodontitis treatment in patients with chronic brucellosis infection

    Directory of Open Access Journals (Sweden)

    L.A. Soboleva

    2010-06-01

    Full Text Available For the purpose to determine the clinical pathogenetic efficacy of Cycloferon liniment in the combined therapy of parodontitis in patients with chronic brucellosis medical examination and treatment of 50 patients was carried out. It was established that use of liniment Cycloferon in the combined treatment of patients with pariodontitis against chronic brucellosis allowed to accelerate process of normalization of parameters of lipid peroxidation and antioxidant potential of blood, to decrease infection load (herpes symplex virus I, candida albicans, staphylococcus aureus in parodontal recess and evidence of local inflammation with reduction of activity of tumour necrosis and interleukin 1b, that provided acceleration of recovery processes, lowering in frequency of pariodontitis recurrences

  7. Treatment of malpositioned periodontally compromised teeth by an interdisciplinary approach - A case report

    OpenAIRE

    Sonali Deshmukh; Sanket Agarkar; Amrita Kishore

    2009-01-01

    The traditional orthodontic patient-base of adolescents has changed dramatically over the last 20 years. Adult patients now comprise a very large percentage of the orthodontic patient base. These patients bring with them unique challenges to the provision of aesthetic treatment. Gingival aesthetics, for a long time the exclusive concern of the periodontist, has now become one of the chief aesthetic challenges presented to the practicing orthodontist. This report illustrates the interdisciplin...

  8. Regenerative treatment of an immature, traumatized tooth with apical periodontitis: report of a case.

    Science.gov (United States)

    Cotti, Elisabetta; Mereu, Manuela; Lusso, Daniela

    2008-05-01

    This case report describes the treatment of a necrotic immature permanent central incisor with complete crown fracture, suspected root fracture, and sinus tract, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the trauma literature's methods for revascularization was provided. The root canal was gently debrided of necrotic tissue with a sharp spoon excavator and irrigated for only one third of its length with NaOCl and then medicated with calcium hydroxide. After 15 days the sinus tract had healed, and the tooth was asymptomatic. The tooth was accessed, calcium hydroxide was removed, bleeding was stimulated to form an intracanal blood clot, and mineral trioxide aggregate was placed coronally to the blood clot. After 8 months, a coronal calcified barrier was radiographically evident and accompanied with progressive thickening of the root wall and apical closure. Two and a half years after treatment was initiated, the tooth remained asymptomatic, and the sinus tract had not reappeared. The progressive increase in the thickness of the dentinal walls and subsequent apical development suggest that appropriate biologic responses can occur with this type of treatment of the necrotic immature permanent tooth with sinus tract.

  9. Comparative evaluation of coenzyme Q10-based gel and 0.8% hyaluronic acid gel in treatment of chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Varun Sharma

    2016-01-01

    Full Text Available Background: The anti-inflammatory and immune enhancing effects of coenzyme Q10 (CoQ10 and hyaluronic acid are well established in medical literature. The present study was undertaken to evaluate their role in chronic periodontitis. Materials and Methods: One hundred twenty sites in 24 patients with clinically confirmed periodontitis were included in the study. A split-mouth design was used for intrasulcular application of CoQ10as adjunct to scaling and root planing (SRP, 0.8% hyaluronic acid as adjunct to SRP and SRP alone. Clinical parameters such as plaque index (PI, gingival color change index (GCCI, Eastman interdental bleeding index (EIBI, pocket depth (PD, and clinical attachment level (CAL were recorded. All the clinical parameters PI, EIBI, GCCI, PD, and CAL were recorded at baseline before SRP. Only PI, EIBI, and GCCI were recorded at 1st and 2nd week. Twenty-one days post 2nd week, i.e., 6th week all the clinical parameters were recorded again. Results: Intragroup analysis of all the clinical parameters showed clinical significant results between baseline and 6th week. However, on intergroup analysis, the results were not significant. Conclusion: The local application of CoQ10and hyaluronic acid gel in conjunction with SRP may have a beneficial effect on periodontal health in patients with chronic periodontitis.

  10. Interaction between endodontics and periodontics.

    Science.gov (United States)

    Rotstein, Ilan

    2017-06-01

    Endodontic-periodontal lesions present challenges to the clinician regarding diagnosis, treatment planning and prognosis. Etiologic factors, such as bacteria and viruses, as well as contributing factors, such as trauma, root resorptions, perforations, cracks and dental malformations, play an important role in the development and progression of such lesions. Treatment and prognosis of endodontic-periodontal lesions vary, depending on the etiology, pathogenesis and correct diagnosis of each specific condition. This chapter will appraise the interrelationship between endodontic and periodontal lesions and provide biological and clinical evidence for diagnosis, prognosis and decision-making in the treatment of these conditions. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Link between rheumatoid arthritis and chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Tomasz Kaczyński

    2018-03-01

    Full Text Available Chronic periodontitis is an infectious disease associated with the progressive destruction of periodontal tissues. In recent years, more and more data indicate an existing relationship between periodontal disease and rheumatoid arthritis. The link between both diseases has been confirmed in multiple studies. Despite the fact that this association might be based on shared environmental and genetic risk factors, a possible causal relation was advocated by experimental, epidemiological and interventional studies, with the leading role of Porphyromonas gingivalis. Individuals with chronic periodontitis are at an increased risk of developing rheumatoid arthritis, as well as rheumatoid arthritis patients are at an increased risk of chronic periodontitis and more severe forms of periodontitis. Furthermore, there is a correlation between the activity in both diseases – patients with more severe periodontitis suffer from more active rheumatoid arthritis. Intervention attempts were also performed, which demonstrated that eliminating periodontal infection and inflammation can affect the severity of rheumatoid arthritis. In this paper, we review the current knowledge about the link between both diseases, focusing on its clinical implications. Will periodontal treatment become a part of standard therapy for rheumatoid arthritis?

  12. Combined photoablative and photodynamic diode laser therapy as an adjunct to non-surgical periodontal treatment: a randomized split-mouth clinical trial.

    Science.gov (United States)

    Giannelli, Marco; Formigli, Lucia; Lorenzini, Luca; Bani, Daniele

    2012-10-01

    Comparing the efficacy of photoablative and photodynamic diode laser in adjunct to scaling -root planing (SRP) and SRP alone for the treatment of chronic periodontitis. Twenty-six patients were studied. Maxillary left or right quadrants were randomly assigned to sham-laser treatment + SRP or laser + SRP. This consisted of photoablative intra/extra-pocket de-epithelization with diode laser (λ = 810 nm), followed by single SRP and multiple photodynamic treatments (once weekly, 4-10 applications, mean ± SD: 3.7 ± 2.4) using diode laser (λ = 635 nm) and 0.3% methylene blue as photosensitizer. The patients were monitored at days 0 and 365 by clinical assessment (probing depth, PD; clinical attachment level, CAL; bleeding on probing, BOP) and at days 0, 15, 30, 45, 60, 75, 90, 365 by cytofluorescence analysis of gingival exfoliative samples taken in proximity of the teeth to be treated (polymorphonuclear leukocytes, PMN; red blood cells, RBC; damaged epithelial cells, DEC; bacteria). At day 365, compared with the control quadrants, the laser + SRP therapy yielded a significant (p Diode laser treatment (photoablation followed by multiple photodynamic cycles) adjunctive to conventional SRP improves healing in chronic periodontitis patients. © 2012 John Wiley & Sons A/S.

  13. Costs of topical treatment of pressure ulcer patients

    Directory of Open Access Journals (Sweden)

    Cynthia Carolina Duarte Andrade

    2016-04-01

    Full Text Available Abstract OBJECTIVE To evaluate the costs of a topical treatment of pressure ulcer (PU patients in a hospital unit for treatment of chronic patients in 2014. METHOD This is an activity-based costing study. This method encompasses the identification, measurement and pricing of physical and human resources consumed for dressings. RESULTS Procedure costs varied between BRL 16.41 and BRL 260.18. For PUs of the same category, of near areas and with the same type of barrier/adjuvant, the cost varied between 3.5% and 614.6%. For most dressings, the cost increased proportionally to the increase of the area and to the development of PU category. The primary barrier accounted for a high percentage of costs among all items required to the application of dressings (human and material resources. Dressings applied in sacral PUs had longer application times. CONCLUSION This study allowed us to understand the costs involved in the treatment of PUs, and it may support decision-makers and other cost-effectiveness studies.

  14. Optimal treatment cost allocation methods in pollution control

    International Nuclear Information System (INIS)

    Chen Wenying; Fang Dong; Xue Dazhi

    1999-01-01

    Total emission control is an effective pollution control strategy. However, Chinese application of total emission control lacks reasonable and fair methods for optimal treatment cost allocation, a critical issue in total emission control. The author considers four approaches to allocate treatment costs. The first approach is to set up a multiple-objective planning model and to solve the model using the shortest distance ideal point method. The second approach is to define degree of satisfaction for cost allocation results for each polluter and to establish a method based on this concept. The third is to apply bargaining and arbitration theory to develop a model. The fourth is to establish a cooperative N-person game model which can be solved using the Shapley value method, the core method, the Cost Gap Allocation method or the Minimum Costs-Remaining Savings method. These approaches are compared using a practicable case study

  15. Dental Investigations: Efficiency of Nonsurgical Periodontal Therapy in Moderate Chronic Periodontitis

    OpenAIRE

    Mlachkova Antoaneta M.; Popova Christina L.

    2014-01-01

    INTRODUCTION: 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 mic...

  16. Cost analysis of microtia treatment in the Netherlands.

    Science.gov (United States)

    Kolodzynski, M N; van Hövell Tot Westerflier, C V A; Kon, M; Breugem, C C

    2017-09-01

    Ear reconstruction for microtia is a challenging procedure. Although analyzing esthetic outcome is crucial, there is a paucity of information with regard to financial aspects of microtia reconstruction. This study was conducted to analyze the costs associated with ear reconstruction with costal cartilage in patients with microtia. Ten consecutive children with autologous ear reconstruction of a unilateral microtia were included in this analysis. All patients had completed their treatment protocol for ear reconstruction. Direct costs (admission to hospital, diagnostics, and surgery) and indirect cost (travel expenses and absence from work) were obtained retrospectively. The overall mean cumulative cost per patient was €14,753. Direct and indirect costs were €13,907 and €846, respectively. Hospital admission and surgery cover 55% and 32% of all the costs, respectively. This study analyzes the costs for autologous ear reconstruction. Hospital admission and surgery are the most important factors of the total costs. Total costs could be decreased by possibly decreasing admission days and surgical time. These data can be used for choosing and developing future treatment strategies. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. The Cost-Effectiveness of Treatment Modalities for Ureteral Stones

    Directory of Open Access Journals (Sweden)

    Justin Ji-Yuen Siu MD

    2016-10-01

    Full Text Available Additional intervention and medical treatment of complications may follow the primary treatment of a ureteral stone. We investigated the cost of the treatment of ureteral stone(s within 45 days after initial intervention by means of retrospective analysis of the National Health Insurance Research Database of Taiwan. All patients of ages ≥20 years diagnosed with ureteral stone(s( International Classification of Diseases, Ninth Revision, Clinical Modification/ICD-9-CM: 592.1 from January 2001 to December 2011 were enrolled. We included a comorbidity code only if the diagnosis appeared in at least 2 separate claims in a patient’s record. Treatment modalities (code included extracorporeal shock-wave lithotripsy (SWL; 98.51, ureteroscopic lithotripsy (URSL; 56.31, percutaneous nephrolithotripsy (PNL; 55.04, (open ureterolithotomy (56.20, and laparoscopy (ie, laparoscopic ureterolithotomy; 54.21. There were 28 513 patients with ureteral stones (13 848 men and 14 665 women in the randomized sample of 1 million patients. The mean cost was 526.4 ± 724.1 United States Dollar (USD. The costs of treatment were significantly increased in patients with comorbidities. The costs of treatment among each primary treatment modalities were 1212.2 ± 627.3, 1146.7 ± 816.8, 2507.4 ± 1333.5, 1533.3 ± 1137.1, 2566.4 ± 2594.3, and 209.8 ± 473.2 USD in the SWL, URSL, PNL, (open ureterolithotomy, laparoscopy (laparoscopic ureterolithotomy, and conservative treatment group, respectively. In conclusion, URSL was more cost-effective than SWL and PNL as a primary treatment modality for ureteral stone(s when the possible additional costs within 45 days after the initial operation were included in the calculation.

  18. Hazardous fuel treatments, suppression cost impacts, and risk mitigation

    Science.gov (United States)

    Matthew P. Thompson; Michael S. Hand; Julie W. Gilbertson-Day; Nicole M. Vaillant; Darek J. Nalle

    2013-01-01

    Land management agencies face uncertain tradeoffs regarding investments in preparedness and fuels management versus future suppression costs and impacts to valued resources and assets. Prospective evaluation of fuel treatments allows for comparison of alternative treatment strategies in terms of socioeconomic and ecological impacts, and can facilitate tradeoff analysis...

  19. Deoxyribonucleic Acid Probes Analyses for the Detection of Periodontal Pathogens.

    Science.gov (United States)

    Al Yahfoufi, Zoubeida; Hadchiti, Wahib; Berberi, Antoine

    2015-09-01

    In clinical microbiology several techniques have been used to identify bacteria. Recently, Deoxyribonucleic acid (DNA)-based techniques have been introduced to detect human microbial pathogens in periodontal diseases. Deoxyribonucleic acid probes can detect bacteria at a very low level if we compared with the culture methods. These probes have shown rapid and cost-effective microbial diagnosis, good sensitivity and specificity for some periodontal pathogens in cases of severe periodontitis. Eighty-five patients were recruited for the study. Twenty-one subjects ranging between 22 and 48 years of age fulfilled the inclusion and exclusion criteria. Seventy-eight samples became available for DNA probe analysis from the deepest pockets in each quadrant. All 21 patients showed positive results for Prevotella intermedia; also, Prevotella gingivalis was identified in 19 subjects, Aggregatibacter actinomycetemcomitans in 6 subjects. P. intermedia was diagnosed positive in 82% of the subgingival samples taken, 79% for P. gingivalis, and 23% for A. actinomycetemcomitans. This study shows a high frequency of putative periodontal pathogens by using DNA probe technology, which is semi-quantitative in this study. Deoxyribonucleic acid probes can detect bacteria at very low level about 10(3) which is below the detection level of culture methods. The detection threshold of cultural methods. The three types of bacteria can be detected rapidly with high sensitivity by using the DNA probe by general practitioners, and thus can help in the diagnosis process and the treatment.

  20. Some modern aspects of periodontal disease

    International Nuclear Information System (INIS)

    Bergenholtz, A.; Jorkjend, L.

    1990-01-01

    During the last three to four decades, extensive changes in opinion concerning the etiology, pathogenesis, and treatment of periodontal disease have taken place. During these decades, contributing factors are standardized and controlled trials, as well as epidemiological studies, were performed. Periodontics is no longer an art as it was at the end of the 19th century- it is a science based on research. Pyorrhea alveoiaris or periodontitis has been considered a multifactorial disease with bad prognosis which, together with caries, causes loss of teeth in the population. It was supposed to affect most of the population with age progress, trauma from occlusion, systemic diseases, and bad oral hygiene. The discovery that plaque was the cause of gingivitis, and that the subgingival microflora differed in composition between sites, teeth, and individuals created new suggestions and demands for the treatment of periodontal disease. The aim of this paper is to summarize some modern aspects on periodontal disease. (author)

  1. Pregnancy and periodontal disease

    OpenAIRE

    Sağlam, Ebru; Saruhan, Nesrin; Çanakçı, Cenk Fatih

    2015-01-01

    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...

  2. The periodontal pain paradox: Difficulty on pain assesment in dental patients (The periodontal pain paradox hypothesis

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    Haryono Utomo

    2006-12-01

    Full Text Available In daily dental practice, the majority of patients’ main complaints are related to pain. Most patients assume that all pains inside the oral cavity originated from the tooth. One particular case is thermal sensitivity; sometimes patients were being able to point the site of pain, although there is neither visible caries nor secondary caries in dental radiograph. In this case, gingival recession and dentin hypersensitivity are first to be treated to eliminate the pain. If these treatments failed, pain may misdiagnose as pulpal inflammation and lead to unnecessary root canal treatment. Study in pain during periodontal instrumentation of plaque-related periodontitis revealed that the majority of patients feel pain and discomfort during probing and scaling. It seems obvious because an inflammation, either acute or chronic is related to a lowered pain threshold. However, in contrast, in this case report, patient suffered from chronic gingivitis and thermal sensitivity experienced a relative pain-free sensation during probing and scaling. Lowered pain threshold which accompanied by a blunted pain perception upon periodontal instrumentation is proposed to be termed as the periodontal pain paradox. The objective of this study is to reveal the possibility of certain factors in periodontal inflammation which may involved in the periodontal pain paradox hypothesis. Patient with thermal hypersensitivity who was conducted probing and scaling, after the relative pain-free instrumentation, thermal hypersensitivity rapidly disappeared. Based on the successful periodontal treatment, it is concluded that chronic gingivitis may modulate periodontal pain perception which termed as periodontal pain paradox

  3. An evaluation of platelet-rich plasma without thrombin activation with or without anorganic bone mineral in the treatment of human periodontal intrabony defects.

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    Rodrigues, Silvia V; Acharya, Anirudh B; Thakur, Srinath L

    2011-01-01

    The efficacy of platelet-rich plasma (PRP) in periodontal regeneration is not well understood and the definite clinical viability of blood derived platelets lacks clarity. Also, the use of thrombin for platelet activation is disputed. Hence, the purpose of this study was to evaluate the efficacy of blood derived platelets without thrombin activation, alone or in combination with bovine anorganic bone mineral (ABM), in the treatment of human periodontal intrabony defects. PRP was prepared using a simple tabletop centrifuge and activated using calcium chloride without the addition of thrombin. This PRP was used alone (in Group A) and in combination with bovine ABM (in Group B) in the treatment of human periodontal angular defects. Both the control and the test groups showed definite improvement in clinical parameters. On comparison, however, there was a statistically significant improvement in the probing pocket depths and relative attachment level in Group B over Group A at 3 and 6 months intervals, whereas at the end of 9 months this difference was not statistically significant. There was no statistically significant difference between the groups with respect to the relative defect depth. Within the limitations of this study and the type of PRP used, i.e. without thrombin mediated activation, it can be concluded that both PRP and PRP combined with bovine ABM results in significant clinical improvement. Albeit statistically insignificant, there is a preponderance of better clinical results with the addition of ABM to PRP. Further studies need to be carried out on a larger sample size to confirm the results of the present study.

  4. Costs of day hospital and community residential chemical dependency treatment.

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    Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

    2008-03-01

    Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs

  5. Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia.

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    Curtis, Kate; Lam, Mary; Mitchell, Rebecca; Black, Deborah; Taylor, Colman; Dickson, Cara; Jan, Stephen; Palmer, Cameron S; Langcake, Mary; Myburgh, John

    2014-01-01

    Accurate economic data are fundamental for improving current funding models and ultimately in promoting the efficient delivery of services. The financial burden of a high trauma casemix to designated trauma centres in Australia has not been previously determined, and there is some evidence that the episode funding model used in Australia results in the underfunding of trauma. To describe the costs of acute trauma admissions in trauma centres, identify predictors of higher treatment costs and cost variance in New South Wales (NSW), Australia. Data linkage of admitted trauma patient and financial data provided by 12 Level 1 NSW trauma centres for the 08/09 financial year was performed. Demographic, injury details and injury scores were obtained from trauma registries. Individual patient general ledger costs (actual trauma patient costs), Australian Refined Diagnostic Related Groups (AR-DRG) and state-wide average costs (which form the basis of funding) were obtained. The actual costs incurred by the hospital were then compared with the state-wide AR-DRG average costs. Multivariable multiple linear regression was used for identifying predictors of costs. There were 17,522 patients, the average per patient cost was $10,603 and the median was $4628 (interquartile range: $2179-10,148). The actual costs incurred by trauma centres were on average $134 per bed day above AR-DRG costs-determined costs. Falls, road trauma and violence were the highest causes of total cost. Motor cyclists and pedestrians had higher median costs than motor vehicle occupants. As a result of greater numbers, patients with minor injury had comparable total costs with those generated by patients with severe injury. However the median cost of severely injured patients was nearly four times greater. The count of body regions injured, sex, length of stay, serious traumatic brain injury and admission to the Intensive Care Unit were significantly associated with increased costs (p<0.001). This

  6. Cost effective water treatment program in Heavy Water Plant (Manuguru)

    International Nuclear Information System (INIS)

    Mohapatra, C.; Prasada Rao, G.

    2002-01-01

    Water treatment technology is in a state of continuous evolution. The increasing urgency to conserve water and reduce pollution has in recent years produced an enormous demand for new chemical treatment programs and technologies. Heavy water plant (Manuguru) uses water as raw material (about 3000 m 3 /hr) and its treatment and management has benefited the plant in a significant way. It is a fact that if the water treatment is not proper, it can result in deposit formation and corrosion of metals, which can finally leads to production losses. Therefore, before selecting treatment program, complying w.r.t. quality requirements, safety and pollution aspects cost effectiveness shall be examined. The areas where significant benefits are derived, are raw water treatment using polyelectrolyte instead of inorganic coagulant (alum), change over of regenerant of cation exchangers from hydrochloric acid to sulfuric acid and in-house development of cooling water treatment formulation. The advantages and cost effectiveness of these treatments are discussed in detail. Further these treatments has helped the plant in achieving zero discharge and indirectly increased cost reduction of final product (heavy water); the dosage of 3 ppm of polyelectrolyte can replace 90 ppm alum at turbidity level of 300 NTU of raw water which has resulted in cost saving of Rs. 15-20 lakhs in a year beside other advantages; the change over of regenerant from HCl to H 2 SO 4 will result in cost saving of at least Rs.1.4 crore a year besides other advantages; the change over to proprietary formulation to in-house formulation in cooling water treatment has resulted in a saving about Rs.11 lakhs a year. To achieve the above objectives in a sustainable way the performance results are being monitored. (author)

  7. Opportunity cost for early treatment of Chagas disease in Mexico.

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    Janine M Ramsey

    2014-04-01

    Full Text Available BACKGROUND: Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. METHODOLOGY/PRINCIPAL FINDINGS: A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. CONCLUSIONS/SIGNIFICANCE: In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.

  8. Opportunity cost for early treatment of Chagas disease in Mexico.

    Science.gov (United States)

    Ramsey, Janine M; Elizondo-Cano, Miguel; Sanchez-González, Gilberto; Peña-Nieves, Adriana; Figueroa-Lara, Alejandro

    2014-04-01

    Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.

  9. Cost of dry eye treatment in an Asian clinic setting.

    Science.gov (United States)

    Waduthantri, Samanthila; Yong, Siew Sian; Tan, Chien Hua; Shen, Liang; Lee, Man Xin; Nagarajan, Sangeetha; Hla, Mynt Htoon; Tong, Louis

    2012-01-01

    To estimate the cost and patterns of expenditure of dry eye treatment. We retrieved data on the type and cost of dry eye treatment in Singapore National Eye Centre from pharmacy and clinic inventory databases over a 2 year period (2008-2009) retrospectively. According to the type of treatment, data were sorted into 7 groups; meibomien gland disease (MGD) treatment, preservative free lubricant eye drops, preserved lubricant eye drops, lubricant ointments and gels, cyclosporine eye drops, oral supplements and non-pharmacological treatments/procedures. Each recorded entry was considered as one patient episode (PE). Comparisons in each group between two years were carried out using Pearson Chi-Square test. Significance level was set at alpha  =  0.05. Cost data from 54,052 patients were available for analysis. Total number of recorded PEs was 132,758. Total annual expenditure on dry eye treatment for year 2008 and 2009 were US$1,509,372.20 and US$1,520,797.80 respectively. Total expenditure per PE in year 2008 and 2009 were US$22.11 and US$23.59 respectively. From 2008 to 2009, there was a 0.8% increase in total annual expenditure and 6.69% increase in expenditure per PE. Pharmacological treatment attributes to 99.2% of the total expenditure with lubricants accounting for 79.3% of the total pharmacological treatment expenditure. Total number of units purchased in preservative free lubricants, cyclosporine eye drops and MGD therapy have increased significantly (pDry eye imposes a significant direct burden to health care expenditure even without considering indirect costs. Health care planners should be aware that these direct costs appear to increase over the time and more so for particular types of medications. Given the limitations of socio-economic data, true societal costs of Dry eye syndrome are likely to be much higher than estimated.

  10. Osteoporosis and Periodontitis.

    Science.gov (United States)

    Wang, Chin-Wei Jeff; McCauley, Laurie K

    2016-12-01

    Osteoporosis and periodontitis are both diseases characterized by bone resorption. Osteoporosis features systemic degenerative bone loss that leads to loss of skeletal cancellous microstructure and subsequent fracture, whereas periodontitis involves local inflammatory bone loss, following an infectious breach of the alveolar cortical bone, and it may result in tooth loss. Most cross-sectional studies have confirmed the association of osteoporosis and periodontitis primarily on radiographic measurements and to a lesser degree on clinical parameters. Multiple shared risk factors include age, genetics, hormonal change, smoking, as well as calcium and vitamin D deficiency. Both diseases could also be risk factors for each other and have a mutual impact that requires concomitant management. Suggested mechanisms underlying the linkage are disruption of the homeostasis concerning bone remodeling, hormonal balance, and inflammation resolution. A mutual interventional approach is emerging with complex treatment interactions. Prevention and management of both diseases require interdisciplinary approaches and warrants future well-controlled longitudinal and interventional studies for evidence-based clinical guidelines.

  11. Periodontal microsurgery: A case report

    Science.gov (United States)

    Kapadia, Janak Anil; Bhedasgoankar, Surekha Y.; Bhandari, Saurabh Dilip

    2013-01-01

    The purpose of this article is to limelight the benefit of periodontal microsurgery in the surgical disciplines. It reviews the benefits and potential applications of magnification and microsurgery in the specialty of periodontics and a case report on microsurgical approach for free gingival graft surgery in the treatment of gingival recession. The increased demand for mucogingival esthetics has required the optimization of periodontal procedures. Microsurgery is a minimally invasive technique that is performed with the surgical microscope and adapted instruments and suture materials. Although this hardware and knowledge of various operations are necessary to achieve patient esthetic expectations, clinicians must be willing to undergo an extended period of systematic training to become familiar with novel operating procedures and instruments. This article describes the application of the surgical microscope to provide enhanced perioplastic treatment. PMID:24554892

  12. Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

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    Jukes Matthew CH

    2008-09-01

    Full Text Available Abstract Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly. Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year. The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This

  13. A systematic review of the cost and cost effectiveness of treatment for multidrug-resistant tuberculosis.

    Science.gov (United States)

    Fitzpatrick, Christopher; Floyd, Katherine

    2012-01-01

    Around 0.4 million cases of multidrug-resistant tuberculosis (MDR-TB) occur each year. Only a small fraction of these cases are treated according to international guidelines. Evidence relevant to decisions about whether to scale-up treatment for MDR-TB includes cost and cost-effectiveness data. Up to 2010, no systematic review of this evidence has been available. Our objective was to conduct a systematic review of the cost and cost effectiveness of treatment for MDR-TB and synthesize the available data. We searched for papers published or prepared for publication in peer-review journals and grey literature using search terms in five languages: English, French, Portuguese, Russian and Spanish. From an initial set of 420 studies, four were included, from Peru, the Philippines, Estonia and Tomsk Oblast in the Russian Federation. Results on costs, effectiveness and cost effectiveness were extracted. Assessment of the quality of each economic evaluation was guided by two existing checklists around which there is broad consensus. Costs were adjusted to a common year of value (2005) to remove distortions caused by inflation, and calculated in two common currencies: $US and international dollars (I$), to standardize for purchasing power parity. Data from the four identified studies were then synthesized using probabilistic sensitivity analysis, to appraise the likely cost and cost effectiveness of MDR-TB treatment in other settings, relative to WHO benchmarks for assessing whether or not an intervention is cost effective. Best estimates are provided as means, with 5th and 95th percentiles of the distributions. The cost per patient for MDR-TB treatment in Estonia, Peru, the Philippines and Tomsk was $US10 880, $US2423, $US3613 and $US14 657, respectively. Best estimates of the cost per disability-adjusted life-year (DALY) averted were $US598 (I$960), $US163 (I$291), $US143 (I$255) and $US745 (I$1059), respectively. The main influences on costs were (i) the model of care

  14. Neighborhood walkability and hospital treatment costs: A first assessment.

    Science.gov (United States)

    Yu, Yan; Davey, Rachel; Cochrane, Tom; Learnihan, Vincent; Hanigan, Ivan C; Bagheri, Nasser

    2017-06-01

    Health system expenditure is a g