WorldWideScience

Sample records for restorative surgical periodontal

  1. Management of periodontal destruction caused by overhanging dental restoration

    Directory of Open Access Journals (Sweden)

    Misnova Misnova

    2016-06-01

    Full Text Available Periodontal tissue inflammations are occasionally caused by positions of restoration margins, particularly if they are placed subgingivally. A 44-year old male was referred to the Dental and Mouth Hospital of Dentistry Faculty Hasanuddin University with the chief complaint of severe pain at right posterior maxillary. Clinical examinations demonstrate a 7-mm periodontal pocket at buccal aspect of 16 teeth with tooth mobility °2. Overhanging dental composite restorations of Class V were detected at the subgingival areas of 15, 16, and 17. Radiographic results show vertically and horizontally alveolar bone loss. This case report is aimed to describe the management of periodontal tissue destruction as a result of overhanging dental composite restorations. Scaling and root planing were conducted as the initial therapy. The periodontal surgery was performed a week after the initial therapy. A full-thickness flap design with sulcular incision from 14 to 18 was made before the pocket curretage and necrotic tissue debridement along with restoration recontouring. The flap was sutured with simple suture technique. Periodontal dressing was packed for a week. Antibiotics, analgetics and antiinflammatory drugs were prescribed per orally. There was no history of pain a week after the surgical procedure. Tooth mobility was decreased to °1 and the periodontal pocket was reduced to 3 mm. Overhanging dental restorations may lead to periodontal tissue destruction. The subgingivally placement of those restorations should consider the health of periodontal tissues.

  2. Clinical attachment level gain and bone regeneration around a glass ionomer restoration on root surface wall of periodontal pocket

    Science.gov (United States)

    Biniraj, K. R.; Sagir, Mohammed; Sunil, M. M.; Janardhanan, Mahija

    2012-01-01

    A case describing perio-restorative management of an accidental trauma in the mid portion of root on an upper left canine tooth following an ostectomy surgery is presented here. The traumatized root area was undergoing fast resorption and a chronic periodontal abscess had developed in relation to the lesion. The article illustrates the clinical and radiographic photo series of a periodontal flap surgery done to gain access into a subgingival region for the placement of Glass ionomer restoration on the root and its periodic follow up. The clinical condition of the area suggests 8 mm clinical attachment gain over the restoration and the review radiographs at definite intervals up to 18 months revealed evidence of consistent bone regeneration around the restoration. The article also highlights the various other possibilities, where this restorative material can be effectively used in conjunction with periodontal surgical procedures. PMID:23162344

  3. The Immediate Aesthetic and Functional Restoration of Maxillary Incisors Compromised by Periodontitis Using Short Implants with Single Crown Restorations: A Minimally Invasive Approach and Five-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Mauro Marincola

    2015-01-01

    Full Text Available The functional and aesthetic restoration of teeth compromised due to aggressive periodontitis presents numerous challenges for the clinician. Horizontal bone loss and soft tissue destruction resulting from periodontitis can impede implant placement and the regeneration of an aesthetically pleasing gingival smile line, often requiring bone augmentation and mucogingival surgery, respectively. Conservative approaches to the treatment of aggressive periodontitis (i.e., treatments that use minimally invasive tools and techniques have been purported to yield positive outcomes. Here, we report on the treatment and five-year follow-up of patient suffering from aggressive periodontitis using a minimally invasive surgical technique and implant system. By using the methods described herein, we were able to achieve the immediate aesthetic and functional restoration of the maxillary incisors in a case that would otherwise require bone augmentation and extensive mucogingival surgery. This technique represents a conservative and efficacious alternative to the aesthetic and functional replacement of teeth compromised due to aggressive periodontitis.

  4. 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.

  5. 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.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

  9. Surgical extractions for periodontal disease in a Western Lowland gorilla.

    Science.gov (United States)

    Huff, John F

    2010-01-01

    This case report describes surgical exraction of multiple premolar and molar teeth in a Western Lowland gorilla. Postoperative photographs and radiographs indicated complete healing of the extraction sites. This case report includes a review of gorilla dental anatomy, oral disease in primates, pathogenesis of periodontal disease, predisposing factors to periodontal disease, and principles of surgical tooth extraction.

  10. Effects of non-surgical periodontal therapy on serum lipids and C-reactive protein among hyperlipidemic patients with chronic periodontitis.

    Science.gov (United States)

    Tawfig, Ahmed

    2015-05-01

    To evaluate the effect of non-surgical periodontal therapy on plasma lipid levels in hyperlipidemic patients with chronic periodontitis. After considering the inclusion and exclusion criteria, 30 hyperlipidemic patients with chronic periodontitis in the age group of 30-70 years, undergoing treatment in Ahmed Gasim Cardiac and Renal transplant Centre in north Sudan were recruited for the study. Patients were randomly assigned to the study and control groups. The study group received non-surgical periodontal therapy - oral hygiene instructions, scaling and root planing. The control group participants received only oral hygiene instructions. Lipid profile [total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG)], C-reactive protein (CRP), and periodontal parameters [Plaque index (PI), Gingival index (GI), probing pocket depth (PD), and attachment loss (ATL)] were measured and compared at baseline and after 3 months of the respective intervention. Between-groups analysis was done using independent "t" test and within-group analysis was done using dependent "t" test. At baseline, groups were comparable based on lipid profile and periodontal parameters. After 3 months, the control group showed significant decrease in the PI and GI scores while there was no significant change in the other parameters. However, the study group showed significant decrease in the LDL and CRP levels along with a significant decrease in PD, ATL, PI, and GI scores, compared to the baseline values. Local non-surgical periodontal therapy resulted in improved periodontal health, with significant decrease in the LDL and CRP levels in hyperlipidemic patients with chronic periodontitis. Hence, local non-surgical periodontal therapy may be considered as an adjunct in the control of hyperlipidemia, along with standard care.

  11. Effect of Non-surgical Periodontal Therapy on Serum and Salivary Concentrations of Visfatin in Patients with Chronic Periodontitis

    Directory of Open Access Journals (Sweden)

    Nader Abolfazli

    2015-03-01

    Full Text Available Background and aims. Visfatin, mainly secreted by visceral adipose tissue, especially by macrophages, plays an impor-tant role in regulating the defense and immune functions, and functions as a growth factor, a cytokine, an enzyme and more importantly as a proinflammatory mediator. The aim of the present study was to evaluate the effect of non-surgical perio-dontal treatment on serum and salivary levels of visfatin in patients with generalized moderate-to-severe chronic periodonti-tis. Materials and methods. Eighteen patients with generalized moderate-to-severe chronic periodontitis were selected based on periodontal parameters of gingival index (GI, probing pocket depth (PPD, clinical attachment level (CAL and radio-graphic parameters. Serum and salivary samples were collected at baseline and one month following non-surgical periodon-tal therapy (scaling and root planing ([SRP]. Visfatin levels were measured using an ELISA kit. Data were analyzed by SPSS 15, using paired t-test and Pearson’s correlation coefficient. Results. Mean salivary and serum levels of visfatin significantly decreased after non-surgical periodontal treatment (P<0.05. Changes in salivary visfatin levels were more prominent. Conclusion. According to the findings of this study it seems that there is a direct relationship between periodontal tissue inflammation and disease activity with salivary and serum visfatin levels.

  12. Effect of Non‑Surgical Periodontal Therapy on the Concentration of ...

    African Journals Online (AJOL)

    Results: The results revealed that at baseline, 78.7% (48/61) of the subjects who had VSC concentration more than 250 parts per billion (ppb) were from the group with periodontal disease. Immediately after non‑surgical periodontal therapy, only 8.5% (17/200) of the subjects with periodontal disease had VSC concentration ...

  13. Effect of Non‑Surgical Periodontal Therapy on the Concentration of ...

    African Journals Online (AJOL)

    Non‑surgical periodontal therapy refers to the conventional and conservative way of ... the surface and root of the tooth that promote plaque retention, through mechanical means. ... presence of periodontal diseases, were involved in this study.

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

    Science.gov (United States)

    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

  15. Effect of Non-Surgical Periodontal Therapy on Interleukin-29 Levels in Gingival Crevicular Fluid of Chronic Periodontitis and Aggressive Periodontitis Patients

    Directory of Open Access Journals (Sweden)

    B. M. Shivaprasad

    2013-01-01

    Full Text Available Recently discovered interleukin 29 (IL-29 has antiviral properties and its production is induced by herpes viruses. This study was aimed at analyzing the effect of non-surgical periodontal treatment on IL-29 levels in gingival crevicular fluid (GCF of chronic and aggressive periodontitis patients. A total of 60 participants were divided into healthy group (group 1; n = 20, chronic periodontitis group (group 2; n = 20, and aggressive periodontitis group (group 3; n = 20. GCF samples collected from each subject at baseline and 6–8 weeks after scaling and root planing were quantified for IL-29 levels using ELISA. The mean IL-29 concentration in GCF was found to be highest in group 3 (92.37 pg/μl. The mean IL-29 level in group 1 and group 2 was 36.88 pg/μl and 69.35 pg/μl respectively. After scaling and root planing, the mean concentration of IL-29 in GCF was increased to 85.99 pg/μl in group 2 and to 114.64 pg/μl in group 3. Results of the present study indicate that antiviral IL-29 level was highest in GCF of aggressive periodontitis patients and least in subjects with healthy periodontium, while that of chronic periodontitis lying in between. After non-surgical periodontal therapy, IL-29 levels increased both in chronic and aggressive periodontitis patients and deserve further investigation as a potential therapeutic agent in treating periodontitis.

  16. Non-Surgical Periodontal Therapy Reduces Saliva Adipokine and Matrix Metalloproteinase Levels in Periodontitis.

    Science.gov (United States)

    Özcan, Erkan; Işıl Saygun, N; Serdar, Muhittin A; Umut Bengi, V; Kantarcı, Alpdoğan

    2016-08-01

    Adipokines enhance the synthesis of proinflammatory cytokines and matrix metalloproteinases (MMPs), which play a role in extracellular matrix degeneration. The aim of this study is to determine the levels of some adipokines, proinflammatory cytokines, and MMPs in the saliva of patients with periodontitis and healthy individuals and to evaluate the changes after non-surgical periodontal therapy (NSPT). Of 32 individuals included in the study, 17 had periodontitis and 15 had healthy gingiva. Saliva samples were obtained from all individuals. In patients with periodontitis, samples were recollected 3 and 6 months after NSPT. Visfatin, chemerin, progranulin, interleukin (IL)-1β, IL-8, MMP-8, and MMP-13 levels were measured using enzyme-linked immunosorbent assay. In patients with periodontitis, all of the parameters measured in the saliva were higher than those of healthy individuals. At 3 months, visfatin, progranulin, IL-8, and MMP-8 levels were significantly decreased compared with baseline values. The levels of other biochemical parameters, chemerin and IL-1β, were significantly decreased compared with baseline values at 6 months, and the levels became similar to those in healthy individuals. In the periodontitis group, positive correlations were found among visfatin and IL-8 (r = 0.909, P periodontal tissue in periodontitis by stimulating the expression of proinflammatory cytokines and MMPs.

  17. 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.

  18. Assessment of Periodontal Status of Surgically Exposed and Orthodontically Aligned Impacted Maxillary Canines

    Directory of Open Access Journals (Sweden)

    Adina Coșarcă

    2014-02-01

    Full Text Available Aim: The aim of this study was to compare the periodontal status of impacted canines after 5 years following completion of the combined surgical and orthodontic treatment. Materials and methods: We examined 20 labially impacted canines and 20 palatally impacted canines at 5 years after the end of treatment. We assessed the periodontal status of these teeth. Results: Different outcomes were found regarding the probing depth and the amount of keratinized gingiva in the two mentioned groups of teeth. Conclusions: The assessed periodontal indices may signal the appearance of a periodontal disease around the teeth that were surgically and orthodontically treated

  19. Combination therapy in chronic periodontitis: a case report

    Directory of Open Access Journals (Sweden)

    Omid Taherpour

    2018-04-01

    Full Text Available Background: The aim of periodontal treatment is to provide healthy and functional dentition for the whole life.Cases Report: A 42 year old female with sever chronic periodontitis, treated medically and surgically, is reported. She initially received antibiotic, Scaling and root planning in addition to oral hygiene instruction. After four weeks, periodontal Surgery, root canal Therapy, extraction of excess tooth and restoration of some teeth were performed, because of remaining residual pockets, and bone loss, flap Surgery and Access flap, with papilla preservation flap method, also modified Widmann flap, were done. After one month, favorable clinical improvement was obtained.Conclusion: It can be concluded that high oral hygiene level in accompanied with Suitable medical and surgical treatment, enhanced the success of periodontal treatment outcomes even in sever disease. 

  20. [Collaboration from periodontics in the aesthetic restoration of anterior teeth].

    Science.gov (United States)

    Qintao, Wang; Yumei, Zhang

    2017-10-01

    Anterior teeth are the main zones that reflect oral aesthetics. The histological structure, outside appearance, relative ratios, and other characteristics of tissues must be understood to obtain relatively ideal and natural restoration effects. A collaboration of different disciplines must be implemented to obtain harmonious and stable restoration outcomes that help the majority appreciate beauty. This article aims to discuss the role of periodontics in this collaboration and introduce several common techniques.

  1. Effects of non-surgical periodontal therapy on periodontal laboratory and clinical data as well as on disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Cosgarea, Raluca; Tristiu, Roxana; Dumitru, Raluca Bianca; Arweiler, Nicole Birgit; Rednic, Simona; Sirbu, Cristina Ioana; Lascu, Liana; Sculean, Anton; Eick, Sigrun

    2018-03-27

    To compare the effect of non-surgical periodontal therapy on clinical and inflammatory parameters in patients with moderate to severe chronic periodontitis (CP) and rheumatoid arthritis (RA) (RA-CP) with that in CP patients without RA. Eighteen patients with RA-CP and 18 systemically healthy patients with CP were treated with scaling and root planing (SRP) within 24 h. At baseline, and at 3 and 6 months after SRP, clinical periodontal parameters, inflammatory markers, and microorganisms in subgingival biofilm were assessed. In addition, disease activity markers of RA (DAS28, CRP, ESR) and specific antibodies (RF) were monitored in the RA-CP group. In both groups, non-surgical therapy yielded to statistically significant improvements in all investigated clinical periodontal variables; in RA patients, a statistically significant decrease in serum-CRP was seen at 3 months. At all time-points, levels of inflammatory markers in GCF were higher in RA-CP than in CP patients. Counts of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola decreased statistically significantly in CP but not in the RA-CP group. Changes of DAS28 correlated positively with those of P. gingivalis and negatively with the plaque index. Within their limits, the present data suggest that (a) non-surgical periodontal therapy improves periodontal conditions in CP patients with and without RA and (b) in patients with RA, eradication of P. gingivalis in conjunction with a high level oral hygiene may transiently decrease disease activity of RA. In patients with RA and CP, non-surgical periodontal therapy is a relevant modality not only to improve the periodontal condition but also to decrease RA activity.

  2. Unilateral severe chronic periodontitis associated with ipsilateral surgical resection of cranial nerves V, VI, and VII.

    Science.gov (United States)

    Zavarella, Matthew M; Leblebicioglu, Binnaz; Claman, Lewis J; Tatakis, Dimitris N

    2006-01-01

    The central and peripheral nervous systems participate in several local physiological and pathological processes. There is experimental evidence that the inflammatory, local immune, and wound healing responses of a tissue can be modulated by its innervation. The aim of this clinical report is to present a case of unilateral severe periodontitis associated with ipsilateral surgical resection of the fifth, sixth, and seventh cranial nerves and to discuss the possible contribution of the nervous system to periodontal pathogenesis. A 39-year-old female patient with a history of a cerebrovascular accident caused by a right pontine arteriovenous malformation and destruction of the right fifth, sixth, and seventh cranial nerves was diagnosed with severe chronic periodontitis affecting only the right maxillary and mandibular quadrants. The patient's oral hygiene was similar for right and left sides of the mouth. Percentages of tooth surfaces carrying dental plaque were 41% and 36% for right and left sides, respectively. Non-surgical and surgical periodontal therapy was performed, and the patient was placed on a regular periodontal maintenance schedule. Healing following initial periodontal therapy and osseous periodontal surgery occurred without complications. Follow-up clinical findings at 1 year revealed stable periodontal health. This case report suggests that periodontal innervation may contribute to the regulation of local processes involved in periodontitis pathogenesis. It also suggests that periodontal therapy can be performed successfully at sites and in patients affected by paralysis.

  3. A novel single-step surgical technique for vestibular deepening using laser in conjunction with periodontal flap surgery

    Directory of Open Access Journals (Sweden)

    Ashu Bhardwaj

    2016-01-01

    Full Text Available Moderate-to-severe chronic periodontitis results in clinical loss of attachment, reduced width of attached gingiva (AG, periodontal pockets beyond mucogingival junction (MGJ, gingival recession, loss of alveolar bone, and decreased vestibular depth (VD. The encroachment of frenal and muscle attachments on marginal gingiva increases the rate of progression of periodontal pockets, prevents healing, and causes their recurrence after therapy. Loss of VD and AG associated with continuous progression of pocket formation and bone loss requires two-stage surgical procedures. In this article, one-stage surgical procedure is being described for the first time, to treat the periodontal pockets extending beyond the MGJ by periodontal flap surgery along with vestibular deepening with diode laser to increase the AG. One-step surgical technique is illustrated whereby pocket therapy with reconstruction of lost periodontal tissues can be done along with gingival augmentation by vestibular deepening.

  4. Effect of smoking cessation on non-surgical periodontal therapy: Results after 24 months

    DEFF Research Database (Denmark)

    Francisca Rosa, Ecinele; Corraini, Priscila; Inoue, Gislene

    2014-01-01

    AIM: The aim of this 24-month prospective study was to assess the effect of smoking cessation on non-surgical periodontal therapy (NSPT) in adult subjects with chronic periodontitis. MATERIALS AND METHODS: Relative to a previous 12-month follow-up study, recruitment and follow-up period were.......05). CONCLUSION: Smoking cessation promoted additional benefits on NSPT in chronic periodontitis subjects....... extended, resulting in 116 eligible among the 286 screened subjects. They received NSPT and concurrent smoking cessation interventions. Periodontal maintenance was performed every three months. A calibrated examined, blinded to smoking status, performed full-mouth periodontal examination in six sites per...

  5. 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.

  6. Adjunctive use of the diode laser in non-surgical periodontal therapy: exploring the controversy.

    Science.gov (United States)

    Porteous, Mary Sornborger; Rowe, Dorothy J

    2014-04-01

    Despite the controversy regarding clinical efficacy, dental hygienists use the diode laser as an adjunct to non-surgical periodontal therapy. The technique to maximize successful laser therapy outcome is controversial as well. The purpose of this review is to explore the scientific foundation of the controversy surrounding the use of the diode laser as an adjunct to non-surgical periodontal therapy. Further, this paper addresses the weaknesses in study design, the heterogeneity of methodology in the published clinical studies, especially the laser parameters, and how these issues impact the collective clinical and microbial data, and thus conclusions regarding clinical efficacy. Evaluation of the literature identifies possible mechanisms that could contribute to the varied, often conflicting results among laser studies that are the foundation of the controversy surrounding clinical efficacy. These mechanisms include current paradigms of periodontal biofilm behavior, tissue response to laser therapy being dependent on tissue type and health, and that the successful therapeutic treatment window is specific to the target tissue, biofilm composition, laser wavelength, and laser energy delivered. Lastly, this paper discusses laser parameters used in the various clinical studies, and how their diversity contributes to the controversy. Although this review does not establish clinical efficacy, it does reveal the scientific foundation of the controversy and the need for standardized, well designed randomized controlled clinical trials to develop specific guidelines for using the laser as an adjunct to non-surgical periodontal therapy. Using evidence-based laser guidelines would allow dental hygienists to provide more effective non-surgical periodontal care.

  7. Comparative evaluation of stress levels before, during, and after periodontal surgical procedures with and without nitrous oxide-oxygen inhalation sedation

    Directory of Open Access Journals (Sweden)

    Gurkirat Sandhu

    2017-01-01

    Full Text Available Context: Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia. Aim: The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA during lengthy periodontal surgical procedures. Settings and Design: This was a randomized, split-mouth, cross-over study. Materials and Methods: A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures. Statistical Analysis Used: Paired t-test and repeated measure ANOVA. Results: The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation. Conclusion: Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures.

  8. Teaching methods and surgical training in North American graduate periodontics programs: exploring the landscape.

    Science.gov (United States)

    Ghiabi, Edmond; Taylor, K Lynn

    2010-06-01

    This project aimed at documenting the surgical training curricula offered by North American graduate periodontics programs. A survey consisting of questions on teaching methods employed and the content of the surgical training program was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. The chi-square test was used to assess whether the residents' clinical experience was significantly (Pperiodontal plastic procedures, hard tissue grafts, and implants. Furthermore, residents in programs offering a structured preclinical component performed significantly more procedures (P=0.012) using lasers than those in programs not offering a structured preclinical program. Devising new and innovative teaching methods is a clear avenue for future development in North American graduate periodontics programs.

  9. Recurrent periodontal abscess associated with "teeth as a tool".

    Science.gov (United States)

    Bhat, G Subraya; Singh, Vishal; Bhat, K Mahalinga

    2012-01-01

    We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertaken. A papilla preservation flap with regenerative periodontal surgical procedure was done, orthodontic and restorative treatment was planned at the follow-up. This case highlights the importance of eliciting a proper and complete personal history, including occupational details. In our patient these details helped us correlate the destruction of the periodontium to the unusual etiology.

  10. Recurrent periodontal abscess associated with "teeth as a tool"

    Directory of Open Access Journals (Sweden)

    G Subraya Bhat

    2012-01-01

    Full Text Available We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertaken. A papilla preservation flap with regenerative periodontal surgical procedure was done, orthodontic and restorative treatment was planned at the follow-up. This case highlights the importance of eliciting a proper and complete personal history, including occupational details. In our patient these details helped us correlate the destruction of the periodontium to the unusual etiology.

  11. Effect of non-surgical periodontal therapy on plasma homocysteine levels in Indian population with chronic periodontitis: a pilot study.

    Science.gov (United States)

    Bhardwaj, Smiti; Prabhuji, M L Venkatesh; Karthikeyan, Bangalore Vardhan

    2015-03-01

    Homocysteine (Hcy) is implicated in the development of cardiovascular diseases (CVD). The effect of periodontal disease and periodontal therapy on plasma Hcy remains controversial. Hence, in this pilot study we assessed the effect of periodontal disease and non-surgical periodontal therapy (NSPT) on plasma Hcy in systemically healthy Indian subjects. Forty participants (30 to 39 years) were enrolled in the study and were divided into two groups based on gingival index, probing depth, and clinical attachment level (CAL): Healthy (control group; n = 20) and Chronic Periodontitis (test group; n = 20). Plasma samples were collected and quantified at baseline and 12 weeks after scaling and root planing (SRP) for Hcy using High Performance Liquid Chromatography with fluorescent detection (HPLC-fld). Plasma Hcy levels of chronic periodontitis (17.87 ± 1.21 μmol/l) subjects was significantly higher than healthy subjects (9.09 ± 2.11 μmol/l). Post-therapy, the plasma Hcy concentration reduced significantly (11.34 ± 1.87 μmol/l) (p periodontal inflammation and therapy, respectively, indicate a direct relationship of Hcy with chronic periodontitis. NSPT may be employed as an adjunctive Hcy Lowering Therapy, contributing towards primary prevention against CVD's. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. 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

    Directory of Open Access Journals (Sweden)

    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

  13. 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.

  14. 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.

  15. Evaluation of periodontal status adjacent to interproximal surfaces restored with composite resin, in comparison with non-restored interproximal surfaces

    Directory of Open Access Journals (Sweden)

    Elvia Christina Barros de Almeida

    2008-01-01

    Full Text Available Objective: The purpose of this study was to evaluate the periodontal status of interproximal surfaces restored with composite resin, in comparison with non-restored interproximal surfaces. Methods: In 65 patients, we analyzed 145 restored surfaces and 145 non-restored surfaces. Results: Most of the restored surfaces (54.3% showed radiographic alterations, which was shown to be higher among restorations with clinically detected proximal excess (56.8% x 52.8%; with lack of restorative material (64.5% x 51.4%; in restorations with proximal overhang (67.7% x 44.4%; in teeth with gingival inflammation?/bleeding (55.1% x 40.0% and in teeth with probing depth exceeding 3 mm (64.3% x 52.9%. However, there were no significant associations for these variables. Of the non-restored surfaces, 24.4% showed radiographic alterations, however there were no significant associations. Conclusion: The results showed a statistical significance for radiographic alterations in restored and non-restored surfaces.

  16. The short-term effects of non-surgical periodontal therapy on the circulating levels of interleukin-6 and C-reactive protein in patients with chronic periodontitis.

    Science.gov (United States)

    George, Annie Kitty; Janam, Prasanthila

    2013-01-01

    Recent epidemiological studies have shown that periodontal infection is a risk factor for a number of systemic diseases and conditions. In addition to the conventional risk factors, chronic infection and the subsequent generation of a systemic inflammatory response may be associated with this increased risk. This study was conducted to determine whether the presence of chronic periodontitis and subsequent non-surgical periodontal therapy could influence the serum levels of interleukin-6 and C-reactive protein (CRP) in patients with severe chronic generalized periodontitis. Participants were selected from subjects who attended the Department of Periodontics and Oral Implantololgy, Government Dental College, Thiruvananthapuram. Sera were obtained from 25 patients with periodontitis for baseline examination and reassessment after completion of treatment. As a control, sera were also obtained from 20 subjects without periodontitis. Interleukin-6 was determined by sensitive enzyme-linked immunosorbent assay, and high-sensitivity CRP (hsCRP) was measured using latex turbidometric immunoassay. Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS) version 10. The level of interleukin-6 and hsCRP in the sera of periodontitis patients was seen to be higher than those of healthy controls. Interleukin-6 level tended to decrease with improvement of the periodontal condition following treatment and approached that of control subjects, and this decline was statistically significant. The hsCRP levels also showed a decreasing trend following periodontal treatment. In this study, we were able to show that periodontal disease significantly affects the serum levels of systemic inflammatory markers and that non-surgical periodontal therapy could bring about a decrease in the levels of these inflammatory markers.

  17. Recurrent periodontal abscess associated with “teeth as a tool”

    Science.gov (United States)

    Bhat, G. Subraya; Singh, Vishal; Bhat, K. Mahalinga

    2012-01-01

    We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertaken. A papilla preservation flap with regenerative periodontal surgical procedure was done, orthodontic and restorative treatment was planned at the follow-up. This case highlights the importance of eliciting a proper and complete personal history, including occupational details. In our patient these details helped us correlate the destruction of the periodontium to the unusual etiology. PMID:22628975

  18. The short-term effects of non-surgical periodontal therapy on the circulating levels of interleukin-6 and C-reactive protein in patients with chronic periodontitis

    Science.gov (United States)

    George, Annie Kitty; Janam, Prasanthila

    2013-01-01

    Background: Recent epidemiological studies have shown that periodontal infection is a risk factor for a number of systemic diseases and conditions. In addition to the conventional risk factors, chronic infection and the subsequent generation of a systemic inflammatory response may be associated with this increased risk. Aims: This study was conducted to determine whether the presence of chronic periodontitis and subsequent non-surgical periodontal therapy could influence the serum levels of interleukin-6 and C-reactive protein (CRP) in patients with severe chronic generalized periodontitis. Settings and Design: Participants were selected from subjects who attended the Department of Periodontics and Oral Implantololgy, Government Dental College, Thiruvananthapuram. Materials and Methods: Sera were obtained from 25 patients with periodontitis for baseline examination and reassessment after completion of treatment. As a control, sera were also obtained from 20 subjects without periodontitis. Interleukin-6 was determined by sensitive enzyme-linked immunosorbent assay, and high-sensitivity CRP (hsCRP) was measured using latex turbidometric immunoassay. Statistical Analysis: Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS) version 10. Results: The level of interleukin-6 and hsCRP in the sera of periodontitis patients was seen to be higher than those of healthy controls. Interleukin-6 level tended to decrease with improvement of the periodontal condition following treatment and approached that of control subjects, and this decline was statistically significant. The hsCRP levels also showed a decreasing trend following periodontal treatment. Conclusions: In this study, we were able to show that periodontal disease significantly affects the serum levels of systemic inflammatory markers and that non-surgical periodontal therapy could bring about a decrease in the levels of these inflammatory markers. PMID:23633770

  19. The short-term effects of non-surgical periodontal therapy on the circulating levels of interleukin-6 and C-reactive protein in patients with chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Annie Kitty George

    2013-01-01

    Full Text Available Background: Recent epidemiological studies have shown that periodontal infection is a risk factor for a number of systemic diseases and conditions. In addition to the conventional risk factors, chronic infection and the subsequent generation of a systemic inflammatory response may be associated with this increased risk. Aims: This study was conducted to determine whether the presence of chronic periodontitis and subsequent non-surgical periodontal therapy could influence the serum levels of interleukin-6 and C-reactive protein (CRP in patients with severe chronic generalized periodontitis. Settings and Design: Participants were selected from subjects who attended the Department of Periodontics and Oral Implantololgy, Government Dental College, Thiruvananthapuram. Materials and Methods: Sera were obtained from 25 patients with periodontitis for baseline examination and reassessment after completion of treatment. As a control, sera were also obtained from 20 subjects without periodontitis. Interleukin-6 was determined by sensitive enzyme-linked immunosorbent assay, and high-sensitivity CRP (hsCRP was measured using latex turbidometric immunoassay. Statistical Analysis: Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS version 10. Results: The level of interleukin-6 and hsCRP in the sera of periodontitis patients was seen to be higher than those of healthy controls. Interleukin-6 level tended to decrease with improvement of the periodontal condition following treatment and approached that of control subjects, and this decline was statistically significant. The hsCRP levels also showed a decreasing trend following periodontal treatment. Conclusions: In this study, we were able to show that periodontal disease significantly affects the serum levels of systemic inflammatory markers and that non-surgical periodontal therapy could bring about a decrease in the levels of these inflammatory markers.

  20. Assessment of oral hygiene and periodontal health around posterior primary molars after their restoration with various crown types.

    Science.gov (United States)

    Beldüz Kara, Nihal; Yilmaz, Yucel

    2014-07-01

    To compare the time-dependent changes in oral hygiene and periodontal health after restoring primary posterior molars with a traditional stainless steel crown (SSC) or an aesthetic crown using various measures of periodontal health and oral hygiene. This investigation was a randomized, non-blinded prospective controlled clinical trial in which 264 crowns of different types were fitted onto the first and/or second primary molars of 76 children. The oral hygiene and the gingival health of the restored teeth and the antagonistic teeth were evaluated clinically and radiographically at 3- and 6-month intervals for 18 months after fitting the crowns. The periodontal health of the control teeth was better than that of the remaining 215 restored teeth. The oral hygiene, as measured by the simplified oral hygiene index, and gingival health, as measured by the gingival index and the volume of gingival crevicular fluid, of the restored teeth, irrespective of crown type, progressively increased during the 18-month study period. Oral hygiene and gingival health around a restored primary tooth deteriorate with time. Our results suggest that SSC, an open-faced SSC, or a NuSmile(®) pediatric crown should be the preferred crown type for restoring posterior primary teeth. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Non-surgical approach to advanced chronic periodontitis: a 17.5-year case report.

    Science.gov (United States)

    Kawamura, M; Sadamori, S; Okada, M; Sasahara, H; Hamada, T

    2004-03-01

    This 17.5-year longitudinal case report details the treatment of advanced chronic periodontitis in a female patient commencing at 34 years of age. The woman was provided with periodontal care comprising of temporary fixation, scaling and root planing, intra-pocket irrigation using a root canal syringe and regular supervised maintenance. The patient presented with a 10-year history of bleeding gums. Therapy conducted in general practice had included simple curettage and irrigation. However, these treatments proved unsuccessful and the patient often changed dentists seeking better treatment. She presented to the University Dental Hospital, for diagnosis and treatment of her periodontal conditions after her mandibular lateral incisor had exfoliated. On presentation a purulent exudate could be expressed from all of the pockets. All anterior teeth, excluding the maxillary canines, demonstrated +2 to +3 mobility. The patient did not want any surgical treatment or her teeth extracted. It was decided to treat the patient conservatively without surgery. By postponing extraction, the authors were in a better position to determine the prognosis of the remaining teeth after the infection was under control. Although six teeth were extracted during the 17.5 years, this case report suggests that a non-surgical approach is a viable option while maintaining regular visits for periodontal care.

  2. Replacement of Anterior Composite Resin Restorations Using Conservative Ceramics for Occlusal and Periodontal Rehabilitation: An 18-Month Clinical Follow-Up

    Directory of Open Access Journals (Sweden)

    Leonardo Fernandes da Cunha

    2016-01-01

    Full Text Available This case report describes a patient with discolored and fractured composite resin restorations on the anterior teeth in whom substitution was indicated. After wax-up and mock-up, the composite was removed and replaced with minimally invasive ceramic laminates. An established and predictable protocol was performed using resin cement. Minimally invasive ceramic restorations are increasingly being used to replace composite restorations. This treatment improves the occlusal and periodontal aspects during the planning and restorative phases, such as anterior guides, and laterality can be restored easily with ceramic laminates. In addition, the surface smoothness and contour of ceramic restorations do not affect the health of the surrounding periodontal tissues. Here we present the outcome after 18 months of clinical follow-up in a patient in whom composite resin restorations in the anterior teeth were replaced with minimally invasive ceramic laminates.

  3. Periodontal probing of an impacted tooth recovered through a surgical-orthodontic approach: a case report.

    Science.gov (United States)

    Dinoi, Maria Teresa; Lacarbonara, Mariano; Dimartino, Salvatore; Monaco, Annalisa; Marzo, Giuseppe

    2014-01-27

    The aim of this work was to assess the periodontal support of a central upper incisor recovered through a surgical-orthodontic approach compared to the spontaneously erupted contralateral incisor. This case study describes an 8-year-old Caucasian female with an impacted upper right central incisor. Surgical-orthodontic treatment was performed to reset the impacted dental element in the arch. Periodontal probing was performed of all sites (mesio-buccal, central-buccal, disto-buccal, mesio-palatal, central-palatal and disto-palatal) of the recovered impacted tooth and the contralateral tooth. The results were compared to determine whether the treated element showed signs of periodontal injury. Most of the probing results on both her right and left incisors gave values of approximately 3mm, which were not considered pathological. Both dental elements had adequate and physiological osseous attachments.

  4. Assessment of Periodontal Status of Surgically Exposed and Orthodontically Aligned Impacted Maxillary Canines

    OpenAIRE

    Adina Coșarcă; Mariana Păcurar; Cecilia Petrovan; Alina Ormenișan

    2014-01-01

    Aim: The aim of this study was to compare the periodontal status of impacted canines after 5 years following completion of the combined surgical and orthodontic treatment. Materials and methods: We examined 20 labially impacted canines and 20 palatally impacted canines at 5 years after the end of treatment. We assessed the periodontal status of these teeth. Results: Different outcomes were found regarding the probing depth and the amount of keratinized gingiva in the two mentioned groups of t...

  5. 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.

  6. The Kidney and Periodontal Disease (KAPD) study: A pilot randomized controlled trial testing the effect of non-surgical periodontal therapy on chronic kidney disease.

    Science.gov (United States)

    Grubbs, Vanessa; Garcia, Faviola; Jue, Bonnie L; Vittinghoff, Eric; Ryder, Mark; Lovett, David; Carrillo, Jacqueline; Offenbacher, Steven; Ganz, Peter; Bibbins-Domingo, Kirsten; Powe, Neil R

    2017-02-01

    Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects minorities and the poor, despite intense efforts targeting traditional risk factors. Periodontal diseases are common bacterial plaque-induced inflammatory conditions that can respond to treatment and have been implicated as a CKD risk factor. However there is limited evidence that treatment of periodontal disease slows the progression of CKD. We describe the protocol of the Kidney and Periodontal Disease (KAPD) study, a 12-month un-blinded, randomized, controlled pilot trial with two intent-to-treat treatment arms: 1. immediate intensive non-surgical periodontal treatment or 2. rescue treatment with delayed intensive treatment. The goals of this pilot study are to test the feasibility of conducting a larger trial in an ethnically and racially diverse, underserved population (mostly poor and/or low literacy) with both CKD and significant periodontal disease to determine the effect of intensive periodontal treatment on renal and inflammatory biomarkers over a 12-month period. To date, KAPD has identified 634 potentially eligible patients who were invited to in-person screening. Of the 83 (13.1%) of potentially eligible patients who attended in-person screening, 51 (61.4%) were eligible for participation and 46 enrolled in the study. The mean age of participants is 59.2years (range 34 to 73). Twenty of the participants (43.5%) are Black and 22 (47.8%) are Hispanic. Results from the KAPD study will provide needed preliminary evidence of the effectiveness of non-surgical periodontal treatment to slow CKD progression and inform the design future clinical research trials. Copyright © 2016. Published by Elsevier Inc.

  7. 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

  8. Effectiveness of a diode laser in addition to non-surgical periodontal therapy: study of intervention.

    Science.gov (United States)

    Crispino, Antonio; Figliuzzi, Michele Mario; Iovane, Claudio; Del Giudice, Teresa; Lomanno, Simona; Pacifico, Delfina; Fortunato, Leonzio; Del Giudice, Roberto

    2015-01-01

    Chronic periodontitis affects 47% of adult population over the age of 30. The first phase of periodontal treatment is always represented by scaling and root planning (SRP), that is a causal, non-surgical therapy that recognizes as primary aims the control of bacterial infection and the reduction of periodontal plaque-associated inflammation. Yet, another innovative causal therapy is represented by the irradiation of periodontal pockets with laser. To evaluate the effect of a 940-nm diode laser as an adjunct to SRP in patients affected by periodontitis. Sixty-eight adult patients with moderate-to-severe periodontitis were sequentially enrolled and undergone to periodontal examination (V1) in order to detect gingival index (GI), plaque index (PI) and probing depth (PD). The patients were randomly divided into two groups: the first (n=34) received SRP treatment alone, the control group (n=34) received SRP and 940-nm diode laser therapy. Data were analyzed by Student's t-test, with two tails; for all clinical parameters, both groups reported statistically significant differences compared to basal values (pdiode laser was associated with more evident results. Considered the better clinical outcomes, diode laser can be routinely associated with SRP in the treatment of periodontal pockets of patients with moderate-to-severe periodontitis.

  9. Influence of periodontal ligament simulation on bond strength and fracture resistance of roots restored with fiber posts

    Directory of Open Access Journals (Sweden)

    Ana Maria Estivalete MARCHIONATTI

    2014-10-01

    Full Text Available Objective: Considering that periodontal ligament simulation may influence the stress distribution over teeth restored with intraradicular retainers, this study aimed to assess the combined effect of mechanical cycling and periodontal ligament simulation on both the bond strength between fiber posts and root dentin and the fracture resistance of teeth restored using glass fiber posts. Material and Methods: Ninety roots were randomly distributed into 3 groups (n=10 (C-MC: control; P-MC: polyether; AS-MC: addition silicone to test bond strength and 6 groups (n=10 (C: control; P: polyether; AS: addition silicone, without mechanical cycling, and C-MC, P-MC and AS-MC with mechanical cycling to test fracture strength, according to the material used to simulate the periodontal ligament. For the bond strength test, fiber posts were cemented, cores were built, mechanical cycling was applied (2×106 cycles, 88 N, 2.2 Hz, and 45º incline, and the teeth cut into 3 slices (2 mm, which were then subjected to the push-out test at 1 mm/min. For the fracture strength test, fiber posts were cemented, cores were built, and half of the groups received mechanical cycling, followed by the compressive strength (45° to the long axis and 1 mm/min performed on all groups. Results: Periodontal ligament simulation did not affect the bond strength (p=0.244 between post and dentin. Simulation of periodontal ligament (p=0.153 and application of mechanical cycling (p=0.97 did not affect fracture resistance. Conclusions: The materials used to simulate the periodontal ligament did not affect fracture or bond strength, therefore periodontal ligament simulation using the tested materials could be considered optional in the conditions of the study.

  10. Management of cannabis-induced periodontitis via resective surgical therapy: A clinical report.

    Science.gov (United States)

    Momen-Heravi, Fatemeh; Kang, Philip

    2017-03-01

    There is a lack of clinical research on the potential effect of cannabis use on the periodontium as well as its effect on treatment outcomes. The aim of this case report is to illustrate the clinical presentation of periodontal disease in a young woman who was a chronic cannabis user, as well as successful treatment involving motivating the patient to quit cannabis use and undergo nonsurgical and surgical therapy. A 23-year-old woman sought care at the dental clinic for periodontal treatment. During a review of her medical history, the patient reported using cannabis frequently during a 3-year period, which coincided with the occurrence of gingival inflammation. She used cannabis in the form of cigarettes that were placed at the mandibular anterior region of her mouth for prolonged periods. Localized prominent papillary and marginal gingival enlargement of the anterior mandible were present. The mandibular anterior teeth showed localized severe chronic periodontitis. The clinicians informed the patient about the potentially detrimental consequences of continued cannabis use; she was encouraged to quit, which she did. The clinicians performed nonsurgical therapy (scaling and root planing) and osseous surgery. The treatment outcome was evaluated over 6 months; improved radiographic and clinical results were observed throughout the follow-up period. Substantial availability and usage of cannabis, specifically among young adults, requires dentists to be vigilant about clinical indications of cannabis use and to provide appropriate treatments. Behavioral modification, nonsurgical therapy, and surgical therapy offer the potential for successful management of cannabis-related periodontitis. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  11. Sulforaphane restores cellular glutathione levels and reduces chronic periodontitis neutrophil hyperactivity in vitro.

    Directory of Open Access Journals (Sweden)

    Irundika H K Dias

    Full Text Available The production of high levels of reactive oxygen species by neutrophils is associated with the local and systemic destructive phenotype found in the chronic inflammatory disease periodontitis. In the present study, we investigated the ability of sulforaphane (SFN to restore cellular glutathione levels and reduce the hyperactivity of circulating neutrophils associated with chronic periodontitis. Using differentiated HL60 cells as a neutrophil model, here we show that generation of extracellular O2 (. - by the nicotinamide adenine dinucleotide (NADPH oxidase complex is increased by intracellular glutathione depletion. This may be attributed to the upregulation of thiol regulated acid sphingomyelinase driven lipid raft formation. Intracellular glutathione was also lower in primary neutrophils from periodontitis patients and, consistent with our previous findings, patients neutrophils were hyper-reactive to stimuli. The activity of nuclear factor erythroid-2-related factor 2 (Nrf2, a master regulator of the antioxidant response, is impaired in circulating neutrophils from chronic periodontitis patients. Although patients' neutrophils exhibit a low reduced glutathione (GSH/oxidised glutathione (GSSG ratio and a higher total Nrf2 level, the DNA-binding activity of nuclear Nrf2 remained unchanged relative to healthy controls and had reduced expression of glutamate cysteine ligase catalytic (GCLC, and modifier (GCLM subunit mRNAs, compared to periodontally healthy subjects neutrophils. Pre-treatment with SFN increased expression of GCLC and GCM, improved intracellular GSH/GSSG ratios and reduced agonist-activated extracellular O2 (. - production in both dHL60 and primary neutrophils from patients with periodontitis and controls. These findings suggest that a deficiency in Nrf2-dependent pathways may underpin susceptibility to hyper-reactivity in circulating primary neutrophils during chronic periodontitis.

  12. Sulforaphane restores cellular glutathione levels and reduces chronic periodontitis neutrophil hyperactivity in vitro.

    Science.gov (United States)

    Dias, Irundika H K; Chapple, Ian L C; Milward, Mike; Grant, Melissa M; Hill, Eric; Brown, James; Griffiths, Helen R

    2013-01-01

    The production of high levels of reactive oxygen species by neutrophils is associated with the local and systemic destructive phenotype found in the chronic inflammatory disease periodontitis. In the present study, we investigated the ability of sulforaphane (SFN) to restore cellular glutathione levels and reduce the hyperactivity of circulating neutrophils associated with chronic periodontitis. Using differentiated HL60 cells as a neutrophil model, here we show that generation of extracellular O2 (. -) by the nicotinamide adenine dinucleotide (NADPH) oxidase complex is increased by intracellular glutathione depletion. This may be attributed to the upregulation of thiol regulated acid sphingomyelinase driven lipid raft formation. Intracellular glutathione was also lower in primary neutrophils from periodontitis patients and, consistent with our previous findings, patients neutrophils were hyper-reactive to stimuli. The activity of nuclear factor erythroid-2-related factor 2 (Nrf2), a master regulator of the antioxidant response, is impaired in circulating neutrophils from chronic periodontitis patients. Although patients' neutrophils exhibit a low reduced glutathione (GSH)/oxidised glutathione (GSSG) ratio and a higher total Nrf2 level, the DNA-binding activity of nuclear Nrf2 remained unchanged relative to healthy controls and had reduced expression of glutamate cysteine ligase catalytic (GCLC), and modifier (GCLM) subunit mRNAs, compared to periodontally healthy subjects neutrophils. Pre-treatment with SFN increased expression of GCLC and GCM, improved intracellular GSH/GSSG ratios and reduced agonist-activated extracellular O2 (. -) production in both dHL60 and primary neutrophils from patients with periodontitis and controls. These findings suggest that a deficiency in Nrf2-dependent pathways may underpin susceptibility to hyper-reactivity in circulating primary neutrophils during chronic periodontitis.

  13. Effect of NonSurgical Periodontal Therapy on Plasma Levels of IL-17 in Chronic Periodontitis Patients with Well Controlled Type-II Diabetes Mellitus—A Clinical Study

    Directory of Open Access Journals (Sweden)

    Vishnu Jayakumar Sunandhakumari

    2018-06-01

    Full Text Available For years the pathogenesis of periodontitis was under an immunological Th1/Th2 paradigm. Th1 cells are considered to afford protection against the intracellular pathogens. These cells produce the interferons (IFN that are involved in macrophage activation, which, in turn, plays an important role in phagocytosis, complement fixation, and opsonization. Th2 cells are thought to have evolved as a form of protection against parasitic helminthes. Th17 subset of CD4Not Necessary+ T cells was identified in the year 2005, which added greater complexity to Th function and are pro inflammatory in nature. Interleukins (ILs have the ability to alter immunological changes and they also possess the ability to regulate lymphocyte differentiation and haemopoietic stem cells, cell proliferation, and motility, which are classified as pro-inflammatory and anti-inflammatory. There are numerous studies that reported IL-17 levels associated with chronic periodontitis (CP development. Type II diabetes mellitus (DM is considered a risk factor for the development of periodontal diseases because the incidence, progression, and severity of periodontal diseases are more common with Type II DM than without DM. This study was aimed at evaluating whether non-surgical periodontal therapy had any effect on plasma concentrations of Interleukin-17 in systemically healthy chronic periodontitis patients and in chronic periodontitis patients with well controlled Type II Diabetes mellitus. Patients were divided into the two groups including the chronic periodontitis group (20 subjects and the chronic periodontitis with well-controlled Type II Diabetes mellitus group (20 subjects. The Gingival Index and Plaque Index as well as the clinical Attachment Level (CAL were taken from all the patients of two groups after evaluating fasting blood sugar, post prandial blood sugar, and the Glycated Hemoglobin Level (HbA1c. Then 5 mL blood samples were collected from each patient and plasma was

  14. Effect of Non Surgical Periodontal Therapy on Gingival Crevicular Fluid and Serum Visfatin Concentration in Periodontal Health and Disease

    Directory of Open Access Journals (Sweden)

    N.M. Raghavendra

    2012-01-01

    Full Text Available Visfatin is a pleiotropic mediator which acts as growth factor, cytokine, enzyme involved in energy including nicotinamide adenine dinucleotide metabolism and has been recently demonstrated to exert several pro-inflammatory functions. The purpose of this study is to evaluate the Visfatin concentration in gingival crevicular fluid (GCF and serum in patients with chronic periodontitis, and to evaluate the effect of non-surgical periodontal therapy on the GCF and serum visfatin concentration. 30 subjects (age range: 25 to 52 years were selected and divided into two groups based on the gingival index, probing depth, periodontal attachment level, and radiologic parameters (bone loss: group 1 (15 subjects with healthy periodontium, group 2 (15 subjects with chronic periodontitis, while, Group 2 patients after 8 weeks of the treatment (scaling and root planning, SRP constituted group 3. GCF samples (by microcapillary pipettes and serum samples (by venipuncture were collected to estimate the levels of Visfatin using enzyme linked immunosorbent assay kit. The mean Visfatin concentration in GCF and serum was observed to be the highest in group 2 and lowest in group 1. While concentration in group 3 was similar to group 1. The concentration of Visfatin in GCF and serum decreased after SRP. The Visfatin concentration in GCF and serum found to be highest in chronic periodontitis group and decreases after treatment. Hence Visfatin values can be considered as an “inflammatory marker” can be explored in future as a potential therapeutic target in the treatment of periodontal disease.

  15. Assessment of surgical competence in North American graduate periodontics programs: a survey of current practices.

    Science.gov (United States)

    Ghiabi, Edmond; Taylor, K Lynn

    2010-08-01

    This cross-sectional study was designed to document the methods utilized by North American graduate periodontics programs in assessing their residents' surgical skills. A survey of clinical skills assessment was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. Thirty-four programs (59 percent) responded. The data collected were analyzed using SPSS version 15.0. The results demonstrate that the most common practice for providing feedback and documenting residents' surgical skills in the programs surveyed was daily one-on-one verbal feedback given by an instructor. The next two most commonly reported methods were a standard checklist developed at program level and a combination of a checklist and verbal comments. The majority of the programs reported that the instructors met collectively once per term to evaluate the residents' progress. The results suggest that graduate periodontics programs provide their residents frequent opportunities for daily practice with verbal feedback from instructors. However, assessment strategies identified in other health professions as beneficial in fostering the integration of clinical skills practices are not employed.

  16. The effect of the thermal diode laser (wavelength 808-980 nm) in non-surgical periodontal therapy: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Slot, D.E.; Jorritsma, K.H.; Cobb, C.M.; van der Weijden, F.A.

    2014-01-01

    Focused question What is the adjunctive effect of a diode laser (DL) following non-surgical periodontal debridement (SRP) during the initial phase of periodontal therapy on the clinical parameters of periodontal inflammation. Material and Methods The MEDLINE-PubMed, Cochrane-Central Register of

  17. 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.

  18. 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...

  19. Evaluation of the Effect of Surgical Crown Lengthening on Periodontal Parameters

    Directory of Open Access Journals (Sweden)

    Farzane Vaziri

    2015-09-01

    Full Text Available Background: Surgical crown lengthening is needed for teeth with subgingival caries, fractured teeth, insufficient crown length, and deep subgingival margin of failed restorations. Since there is no agreement on the effects of crown lengthening surgery on gingival parameters, the purpose of this study was to evaluate periodontal parameters in patients who needed crown lengthening surgery. Methods: Twenty patients who had healthy periodontium and needed surgical crown lengthening were included in this study. After professional dental cleaning, gingival parameters including gingival index (GI, probing depth (PD, bone level (BL, and transsulcular probing (TSP were recorded in interproximal and keratinized gingiva (KG in mid buccal portion. The patients were evaluated one and three months after the surgery. Results: After one and three months of the surgery, the amount of PD reduced from 2.32 mm to 1.25 mm and 1.17 mm, respectively (P=0.001. The mean of BL reduction was 0.88 mm after one month (P=0.001, but there was no reduction between 1 month and 3 months. Amounts of KG at baseline andone month later were 4.2 mm and 2.9 mm, respectively (P=0.001, and remained at the same level up to three months. TSP significantly reduced (from 3.67 mm at baseline to 2.62 mm after 1 month, and to 2.27 mm after 3 months (P=0.001, P=0.005. Conclusion: The present  study suggests that in the presence of good oral hygiene, except BW (biological width, other parameters including PD, BL, KG, and TSP had significant changes after crown lengthening surgery in the period of 1 month and 3 months (P

  20. Non-surgical periodontal therapy improves serum levels of C-reactive protein and edematous states in female patients with idiopathic edema.

    Science.gov (United States)

    Joseph, Rosamma; Narayan, Vivek; Krishnan, Rajaratnam; Melemadathil, Sreelatha

    2011-02-01

    The relationship between periodontal disease and systemic disease is revealing new and exciting associations. Idiopathic edema presents a clinical syndrome with obscure pathophysiology. The present study investigates whether non-surgical periodontal therapy is beneficial in patients who are not responding to conventional treatment of idiopathic edema. Thirty patients with idiopathic edema were allocated to intervention and control groups. All the subjects were assessed for systemic (body weight, body mass index, visual scale of edema, serum C-reactive protein, and serum albumin) and periodontal (plaque index, calculus index, and gingival index) parameters. Non-surgical periodontal therapy, including oral hygiene instructions, scaling and root planing, and systemic antibiotic therapy, was provided in the intervention group. Both groups were reevaluated after 4 weeks. Both groups were comparable at baseline. All parameters, except serum albumin, showed significant improvement after periodontal therapy. The control group showed further worsening of these parameters. This study shows that sources for systemic inflammation, such as periodontal disease, could affect the pathogenesis of idiopathic edema. Successful elimination of such covert sources of inflammation leads to a clinical benefit in patients who are distressed by this condition.

  1. Impact of Consumption of Chicory Leaf Extract in Adjunct with Non-surgical Periodontal Therapy on Serum Antioxidant and Lipid Status in Patients with Periodontal Disease: Preliminary Study

    Directory of Open Access Journals (Sweden)

    Ahmad Zare-Javid

    2016-04-01

    Full Text Available Background and Objectives: Periodontal disease is a chronic disorder with a high prevalence. There are few studies about the role of diet in prevention and treatment of periodontal disease. The aim of this study was to evaluate the effect of consumption of Chicory leaf extract in adjunct with non-surgical periodontal therapies on serum antioxidant and lipid status. Materials and Methods: This study was a double-blind, randomized controlled clinical trial conducted on 40 patients in Sina Hospital of Ahvaz Jundishapur University of Medical Sciences (Iran in 2014. The intervention (n=20 and control groups (n=20 were allocated using blocked randomization. The intervention group received 2 capsules (2 g of Chicory leaf extract daily for 8 weeks. All subjects underwent non-surgical periodontal therapy during the intervention period. Anthropometric indices, 24-hour diet records, total antioxidant capacity, malate di-aldehyde (MDA, uric acid, total cholesterol, triglyceride (TG and HDL-c was measured before and after intervention. Results: The mean level of total antioxidant capacity (1.89 ± 0.49; 1.20 ± 0.25, respectively; P<0.001 and uric acid (7.15±1.98; 4.48±1.34, respectively; P<0.001 increased in the intervention group compared with the control group post intervention. The mean level of MDA decreased in the intervention group compared with the control group post-intervention (3.01±1.15; 3.97±1.19, respectively; P.d<0.001. Cholesterol difference was not significant pre- and post-intervention between the two groups (P=0.35. The mean level of serum triglyceride (TG was significantly lower in the intervention group compared with the control group post intervention (149.50±97.88; 109.35±58.00, respectively; P.d<0.001. The mean level of HDL-c was also significantly lower in the intervention group compared with the control group post treatment (42.25±8.47; 39.80±8.94, respectively; P.d<0.001. Conclusions: It seems that consumption of Chicory

  2. Dental Investigations: Efficiency of Nonsurgical Periodontal Therapy in Moderate Chronic Periodontitis

    Directory of Open Access Journals (Sweden)

    Mlachkova Antoaneta M.

    2014-08-01

    Full Text Available 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 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. MATERIALS AND METHODS: 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. RESULTS: 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 (PD ⋋ 5 mm. Pockets with PD > 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. CONCLUSION

  3. Faktor-Faktor Periodontal yang Harus Dipertimbangkan pada Perawatan dengan Gigi Tiruan Cekat

    Directory of Open Access Journals (Sweden)

    Riemawati A. Lesmana

    2015-10-01

    Full Text Available The main aim of the treatment with fixed restoration especially the crowns and bridges is to maintain the remaining teeth of dentition and the whole masticatory system. This treatment can be successful if periodontal consideration of the abutments and the fixed restoration is given. The periodontal of a tooth are gingiva, periodontal ligament, alveolar bone and cementum. The most common type of periodontal disease is gingivitis that usually caused by bacterial plaque attached to tooth or crown surface. The other disease that involve the tooth supporting tissue is called periodontitis, it can be preceded by long standing chronic gingivitis. Trauma from occlusion presents two predominant clinical features, increasing tooth mobility and widening of the periodontal space. Periodontal pocket is a disease of periodontal attachment unit that is caused by the apical migration of the epithelial attachment. Periodontal atrophy occurs as a result of repeated traumatic that cause reduction in height of periodontium. All gingival and periodontal diseases and trauma from occlusion must be eliminated before restorative procedures are begun. Dental fixed restoration and periodontal health are inseparably interrelated. The adaptation of the margins and the contours of the restoration, the surface smoothness, the embrasure and the pontic of a bridge, have a critical biologic impact on the gingiva and supporting periodontal tissue. Dental fixed restoration therefore play a significant role in maintaining gingival and periodontal health. Plaque control must be maintained regularly and the occlusion must be checked at regular intervals after the fixed prosthesis is inserted. The occlusal relationships change with time as the result of micromovement of the natural dentition and the wear of restorative materials.

  4. Management of failed periodontal surgical intervention for a furcal lesion with a nonsurgical endodontic approach

    Directory of Open Access Journals (Sweden)

    Saeed Asgary

    2014-05-01

    Full Text Available As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning.

  5. Effect of non-surgical periodontal therapy on insulin resistance in patients with type II diabetes mellitus and chronic periodontitis, as assessed by C-peptide and the Homeostasis Assessment Index.

    Science.gov (United States)

    Mammen, Jerry; Vadakkekuttical, Rosamma Joseph; George, Joseraj Manaloor; Kaziyarakath, Jaishid Ahadal; Radhakrishnan, Chandni

    2017-08-01

    A bidirectional relationship exists between diabetes and periodontitis. In the present clinical trial, we evaluated the effects of non-surgical periodontal therapy (NSPT) on insulin resistance in patients with type II diabetes mellitus (DM) and chronic periodontitis. Forty chronic periodontitis patients with type II DM were selected and equally allocated to case and control groups. All patients were assessed for periodontal parameters and systemic parameters. The case group received NSPT, and both groups were re-evaluated after 3 months. All periodontal parameters were found to be significantly improved in the case group compared to the control group 3 months after NSPT. The mean differences in systemic parameters, such as fasting serum C-peptide, Homeostasis Assessment (HOMA) Index-insulin resistance, and HOMA-insulin sensitivity, from baseline to 3 months for the case group were 0.544 ± 0.73, 0.54 ± 0.63, and -25.44 ± 36.81, respectively; for the control group, they were significant at -1.66 ± 1.89, -1.48 ± 1.86, and 31.42 ± 38.82 respectively (P periodontal inflammation could affect glycemic control and insulin resistance. Effective periodontal therapy reduced insulin resistance and improved periodontal health status and insulin sensitivity in patients with type II DM and chronic periodontitis. © 2016 John Wiley & Sons Australia, Ltd.

  6. 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.

  7. The Interplay of Orthodontics, Periodontics, and Restorative Dentistry to Achieve Aesthetic and Functional Success.

    Science.gov (United States)

    Trushkowsky, Richard D; Alsadah, Zainab; Brea, Luis M; Oquendo, Anabella

    2015-07-01

    Previously dentists focused on repair and maintenance of function. However, the emphasis of many patients and dentists is now on esthetics. Often there is a need for the disciplines of orthodontics, periodontics, restorative dentistry, and maxillofacial surgery to work together in order to achieve optimum results. Currently the sequencing planning process begins with esthetics and then function, structure, and ultimately biology. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. THE EFFECTS OF POOR GLYCEMIC CONTROL AND OF NON-SURGICAL PERIODONTAL THERAPY IN PATIENTS WITH DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Cornelia OANȚĂ

    2015-09-01

    Full Text Available Aim: The aim of the study was to evaluate the relationship between the diabetic status and severity of the periodontal involvement, and also of the non-surgical periodontal therapy on the periodontal status of patients with diabetes mellitus. Materials and method: The study was conducted on 21 patients with type 1 diabetes mellitus (study group and 10 systemically healthy subjects (control group. We examined: the degree of glycemic control (by measuring the glycated hemoglobin, the periodontal and oral hygiene parameters at the baseline and 4 weeks, 6 months and 12 months after the periodontal treatment (scaling and root planning. Results and discussion: Subjects with a poor glycemic control presented a higher percentage of sites with attachment loss, significantly higher amounts of bacterial plaque, sub-gingival calculus and gingival bleeding - when compared with the control group or with subjects with good or moderated glycemic control. In the same group, a rapid recurrence of the deep periodontal pockets was observed after 12 months. Conclusions: A prolonged poor control of glycemia and the time elapsed from the debut of diabetes were closely related with its complications. The comparison between the diabetes and the control groups demonstrated that diabetes mellitus is a risk factor for the periodontal disease.

  11. Effect of periodontal therapy on pregnancy outcome in women affected by periodontitis.

    Science.gov (United States)

    Tarannum, Fouzia; Faizuddin, Mohamed

    2007-11-01

    There is convincing evidence to suggest that infections affecting the mother during pregnancy may produce alterations in the normal cytokine- and hormone-regulated gestation, which could result in preterm labor, premature rupture of membranes, and preterm birth (PTB). Studies in the late 1990s associated periodontitis with preterm low birth weight (PLBW) deliveries, and this may have similar pathogenic mechanisms as other maternal infections. This study determined the effect of non-surgical periodontal therapy on pregnancy outcome. A total of 200 pregnant women with periodontitis were randomly assigned to treatment and control groups. Detailed data about previous and current pregnancies were obtained. All women received a full-mouth periodontal examination, including oral hygiene index-simplified, bleeding index, and clinical attachment level. The women in the treatment group received non-surgical periodontal therapy during the gestational period, and those in the control group received periodontal treatment after delivery. Periodontal therapy included plaque control instructions and scaling and root planing performed under local anesthesia. The outcome measures assessed were gestational age and birth weight of the infant. PTB was recorded when delivery occurred at PTBs in the treatment group and 68 PTBs in the control group. Twenty-six LBW infants were recorded in the treatment group, and 48 LBW infants were noted in the control group. The mean gestational ages were 33.8+/-2.8 weeks and 32.7+/-2.8 weeks in the treatment and control groups, respectively. The difference was statistically significant at P<0.006. The mean birth weight was 2,565.3+/-331.2 g in the treatment group and 2,459.6+/-380.7 g in the control group, with the difference being statistically significant at P<0.044. A multiple regression model showed a significant effect of periodontal treatment on birth outcomes. Non-surgical periodontal therapy can reduce the risk for preterm births in mothers who

  12. 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.

  13. Effect of Periodontal Therapy on Crevicular Fluid Interleukin-6 and Interleukin-8 Levels in Chronic Periodontitis

    Directory of Open Access Journals (Sweden)

    Paschalina Goutoudi

    2012-01-01

    Full Text Available Purpose. The aim of this study was to analyse the levels of interleukin-6 (IL-6 and interleukin-8 (IL-8 in gingival crevicular fluid (GCF of patients with chronic periodontitis prior to and following surgical and/or nonsurgical periodontal therapy for a period of 32 weeks. Methods. GCF samples were obtained from 24 nondiseased and 72 diseased sites of 12 periodontal patients prior to as well as at 6, 16, and 32 weeks following non-surgical and surgical periodontal therapy. IL-6 and IL-8 levels were determined by enzyme-linked immunosorbent assay (ELISA. Results. Periodontal treatment improved all clinical parameters. Both treatment modalities resulted in similar IL-6 as well as IL-8 levels. Mean IL-6 and IL-8 concentrations were significantly higher in non-diseased compared to diseased sites and increased significantly following treatment in diseased sites. Mean total amounts of IL-6 and IL-8 (TAIL-6, TAIL-8 did not differ significantly between diseased and nondiseased sites, while following therapy TAIL-8 levels decreased significantly. Conclusions. The data suggest that periodontal therapy reduced the levels of IL-8 in GCF. However, a strong relationship between IL-6, IL-8 amounts in GCF and periodontal destruction and inflammation was not found.

  14. Effect of Topical Tetracycline Gel with Non Surgical Periodontal Therapy on Hba1c and Lipid Profile in Type 2 Diabetic Patients: A Clinico- Biochemical Study

    Directory of Open Access Journals (Sweden)

    A Haerian-Ardakani

    2014-11-01

    Full Text Available Introduction: The present study aimed to evaluate the Effect of topical tetracycline gel application with non surgical periodontal therapy on HbA1c and lipid profile in type 2 diabetic patients. Methods: A total of 30 type 2 diabetic patients were randomly divided into two groups. The first group received scaling and root planning, whereas the second group received scaling and root planning with topically applied tetracycline gel. Clinical factors such as GI, PI, PPD and biochemical factors such as HbA1c and lipid profile were assessed in beginning of study and 3 months later. Results: Comparing the clinical factors between the two groups revealed that periodontal pocket depth significantly reduced in tetracycline-received group. Regarding the biochemical factors, triglyceride levels decreased significantly in tetracycline-received group. No significant difference was observed between the two groups in regard with other clinical and biochemical factors. Conclusion: The study findings demonstrated that clinical and biochemical parameters have been improved after non surgical periodontal treatment in both groups. Although it seems that application of topical tetracycline gel combined with non-surgical periodontal therapy is effective in improvement of some clinical and biochemical factors like PPD and TG, it doesn’t offer any superiority in regard with other factors compared to mere non surgical periodontal therapy.

  15. Periodontal microsurgery: Reaching new heights of precision

    Science.gov (United States)

    Yadav, Vikender Singh; Salaria, Sanjeev Kumar; Bhatia, Anu; Yadav, Renu

    2018-01-01

    The use of magnification to perform various procedures in medical and dental field, particularly endodontics has long been recognized. Unfortunately, its application in periodontics is not widely popularized. The objective of this article is to emphasize the application of microsurgical principles in various periodontal surgical procedures and to reinforce the incorporation of microscope into periodontal practice. The most recent periodontal journals were reviewed and a search of databases such as PubMed or Medline and Google Scholar was conducted for relevant material from published literature up to 2017. Medical Subject Headings words looked for were “periodontal microsurgery” and “minimally invasive periodontal surgery.” The available literature, specifically to periodontal surgical procedures was analyzed and compiled. The analysis indicates that incorporation of magnification in periodontal practice is associated with improved visual acuity, ergonomic benefits, decreased patient morbidity, rapid healing, and enhanced patient acceptance. PMID:29568165

  16. 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 ...

  17. Epidermolysis bullosa acquisita: clinical manifestations, microscopic findings, and surgical periodontal therapy. A case report.

    Science.gov (United States)

    Hakki, S S; Celenligil-Nazliel, H; Karaduman, A; Usubütün, A; Ertoy, D; Ayhan, A; Ruacan, S

    2001-04-01

    Epidermolysis bullosa acquisita (EBA) is an uncommon, acquired, chronic subepidermal bullous disease. This report describes a case of EBA with gingival involvement. A 43-year-old woman with EBA was referred to our clinic for periodontal therapy because of gingival tenderness and bleeding. She has been on cyclosporin A therapy for the last 2 years. Clinical findings were analyzed. Anterior gingivectomy operations were performed in 2 stages. The samples obtained during the surgery were examined using histopathologic, immunohistologic, and electronmicroscopic methods. Long-term effects of the surgical periodontal treatment on gingiva were evaluated both clinically and microscopically. The dentition displayed minimal enamel hypoplasia. Decayed, missing, and filled surfaces score was found to be elevated. Periodontal examination showed generalized diffuse gingival inflammation and gingival enlargement localized mainly to the anterior region. Nikolsky's sign was positive. However, wound healing was uneventful after the operations. Microscopic findings were similar to those obtained from the skin. Twenty-one months after the operations, Nikolsky's sign was negative and no remarkable gingival inflammation was noted. Microscopic examination revealed that the blisters were fewer in number and smaller in size. These results indicate that gingival tissues may also be involved in EBA. Uneventful wound healing after periodontal surgery in this case suggests that periodontal surgery can be performed in patients with EBA. Moreover, both our clinical and histopathologic findings imply that gingivectomy proves useful in maintaining gingival integrity in these patients. Our data may also suggest that the patients with EBA are highly likely to develop dental caries.

  18. 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.

    Directory of Open Access Journals (Sweden)

    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

  19. 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

  20. Effect of dental restoration with epoxy and bioceramic paste on periodontal tissue damage

    Directory of Open Access Journals (Sweden)

    Nan-Lin Meng

    2017-05-01

    Full Text Available Objective: To study the effect of dental restoration with epoxy and bioceramic paste on periodontal tissue damage. Methods: Patients with pulpal and periapical diseases who received root canal therapy in our hospital between May 2013 and October 2016 were retrospectively analyzed, and according to the different root canal filling materials they used, they were divided into epoxy group and bioceramic group who used epoxy paste and bioceramic paste as root canal filling materials respectively. Before and after treatment, gingival crevicular fluid was collected respectively to determine the levels of inflammatory factors, oxidative stress products, cell apoptosis molecules and protease-related molecules. Results: 2 weeks after treatment, IL-1β, IL-6, CRP, ROS, MDA, AOPP, Bcl-2, Bax, Cyt-C, caspase-3, Smac, EMMPRIN, MMP-1, MMP-2, TIMP-1 and TIMP-2 levels in gingival crevicular fluid of epoxy group were not significantly different from those before treatment; IL-1β, IL-6, CRP, ROS, MDA, AOPP, Bax, Cyt-C, caspase-3, Smac, EMMPRIN, MMP-1 and MMP-2 levels in gingival crevicular fluid of bioceramic group were significantly higher than those before treatment while Bcl-2, TIMP-1 and TIMP-2 levels were significantly lower than those before treatment; IL-1β, IL-6, CRP, ROS, MDA, AOPP, Bcl-2, Bax, Cyt-C, caspase-3, Smac, EMMPRIN, MMP-1, MMP-2, TIMP-1 and TIMP-2 levels in gingival crevicular fluid were significantly different between two groups of patients after treatment. Conclusion: Epoxy paste for dental restoration causes less damage to periodontal tissue than bioceramic paste.

  1. Effect of dental restoration with epoxy and bioceramic paste on periodontal tissue damage

    Institute of Scientific and Technical Information of China (English)

    Nan-Lin Meng

    2017-01-01

    Objective:To study the effect of dental restoration with epoxy and bioceramic paste on periodontal tissue damage.Methods: Patients with pulpal and periapical diseases who received root canal therapy in our hospital between May 2013 and October 2016 were retrospectively analyzed, and according to the different root canal filling materials they used, they were divided into epoxy group and bioceramic group who used epoxy paste and bioceramic paste as root canal filling materials respectively. Before and after treatment, gingival crevicular fluid was collected respectively to determine the levels of inflammatory factors, oxidative stress products, cell apoptosis molecules and protease-related molecules.Results: 2 weeks after treatment, IL-1β, IL-6, CRP, ROS, MDA, AOPP, Bcl-2, Bax, Cyt-C, caspase-3, Smac, EMMPRIN, MMP-1, MMP-2, TIMP-1 and TIMP-2 levels in gingival crevicular fluid of epoxy group were not significantly different from those before treatment; IL-1β, IL-6, CRP, ROS, MDA, AOPP, Bax, Cyt-C, caspase-3, Smac, EMMPRIN, MMP-1 and MMP-2 levels in gingival crevicular fluid of bioceramic group were significantly higher than those before treatment while Bcl-2, TIMP-1 and TIMP-2 levels were significantly lower than those before treatment; IL-1β, IL-6, CRP, ROS, MDA, AOPP, Bcl-2, Bax, Cyt-C, caspase-3, Smac, EMMPRIN, MMP-1, MMP-2, TIMP-1 and TIMP-2 levels in gingival crevicular fluid were significantly different between two groups of patients after treatment.Conclusion:Epoxy paste for dental restoration causes less damage to periodontal tissue than bioceramic paste.

  2. Smoking-a true periodontal hazard

    Directory of Open Access Journals (Sweden)

    Mani Ameet M, Mani Shubhangi A, Tejnani Avneesh H, Gupta Ankit

    2013-04-01

    Full Text Available It is now well established that tobacco use in general and cigarette smoking in particular, is a major risk factor in the incidence and severity of several forms of periodontal diseases.A large number of studies have been published in the dental literature regarding this possible role. Much of the literature has also indicated that smokers affected with periodontitis respond less favourably to periodontal treatment be it non-surgical, surgical or regenerative. Numerous studies of the potential mechanisms whereby smoking tobacco may predispose to periodontal disease have been conducted, and it appears that smoking may affect the vasculature, the humoral immune system, and the cellular immune and inflammatory systems, and have effects throughout the cytokine and adhesion molecule network. The aim of this review is to consider the evidence for the association between smoking and periodontal diseases and to highlight the biological mechanisms whereby smoking may affect the periodontium.

  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.

    Directory of Open Access Journals (Sweden)

    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. Non-surgical periodontal therapy decreases serum elastase levels in aggressive but not in chronic periodontitis.

    Science.gov (United States)

    Eickholz, Peter; Siegelin, Yasemin; Scharf, Susanne; Schacher, Beate; Oremek, Gerhard M; Sauer-Eppel, Hildegund; Schubert, Ralf; Wohlfeil, Martin

    2013-04-01

    Assessment of the effect of non-surgical periodontal therapy (SRP) on serum inflammatory parameters in patients with untreated aggressive (AgP) and chronic (ChP) periodontitis. Overall, 31 ChP and 29 AgP were examined clinically prior to and 12 weeks after SRP (subgingival scaling of all pockets within 2 days) with systemic antibiotics for patients positive for Aggregatibacter actinomycetemcomitans (14 AgP, 9 ChP). Blood was sampled prior to, one day, 6, and 12 weeks after the first SRP visit. Serum elastase, C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), interleukin (IL) 6, 8, and leukocyte counts were assessed. At baseline, serum elastase, CRP, and LBP were significantly (p < 0.01) higher in AgP than ChP. Serum elastase, CRP, LBP, and IL-6 were significantly (p < 0.001) elevated one day after scaling in both groups. Both groups showed significant clinical improvement (p < 0.001). A significant difference was observed regarding change of serum elastase 12 weeks after SRP between AgP and ChP (p = 0.015). Multiple regression analysis revealed AgP, African origin, and bleeding on probing to be associated with more pronounced elastase reduction. CRP reduction was associated with African origin, systemic antibiotics, and baseline probing pocket depth. SRP results in serum elastase reduction in AgP but not in ChP. © 2013 John Wiley & Sons A/S.

  5. A New Multi-Ingredient Recipe for the Treatment of Localized Advanced Periodontal Disease following the Surgical Removal of Impacted Wisdom Teeth

    Directory of Open Access Journals (Sweden)

    Nabil Khzam

    2016-01-01

    Full Text Available Periodontal disease is a chronic inflammation of the tooth supporting structures. It leads to bone and attachment loss which is irreversible. Extraction of horizontally impacted lower third molar (L3M teeth may result in localized periodontal pockets at the distal aspect of the adjacent lower second molars (L2M. We present a case of a 21-year-old male who suffered from a swelling and pain around his lower right second molar following surgical removal of a mesioangular impacted lower right third molar. We showed that oral hygiene measures, surgical access, mixture of autogenous and synthetic bone graft, and guided tissue regeneration (GTR were enough to control the problem.

  6. Morphometric assessment of periodontal tissues in relation to periodontal disease in dogs.

    Science.gov (United States)

    Kyllar, Michal; Doskarova, Barbora; Paral, Vaclav

    2013-01-01

    Dimensions of periodontal tissues are thought to predispose to the development of periodontal disease in man and dogs. Several studies have suggested that thin gingiva correlates with an increased incidence of periodontal disease. In this study, we hypothesized that the dimensions of periodontal tissues will vary in different breeds of dogs and could possibly correlate with the incidence of periodontal disease. Forty-two jaws of dogs aged up to 5-years were examined post-mortem and gingival and alveolar bone thickness were measured using methods of transgingival probing and digital calipers, respectively. Dogs were divided into three groups based on their body weight. Group I (dogs compared with small and medium-sized breed dogs. Both gingival and alveolar bone dimensions may be predictors for severity of periodontal disease and influence clinical outcome in certain periodontal surgical procedures.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Repair of experimental plaque-induced periodontal disease in dogs.

    Science.gov (United States)

    Shoukry, M; Ben Ali, L; Abdel Naby, M; Soliman, A

    2007-09-01

    Forty mongrel dogs were used in this study for induction of periodontal disease by placing subgingival silk ligatures affecting maxillary and mandibular premolar teeth during a 12-month period. Experimental premolar teeth received monthly clinical, radiographic, and histometric/pathologic assessments. The results demonstrated significant increases in scores and values of periodontal disease parameters associated with variable degrees of alveolar bone loss. The experimental maxillary premolar teeth exhibited more severe and rapid rates of periodontal disease compared with mandibular premolar teeth. Histometric analysis showed significant reduction in free and attached gingiva of the experimental teeth. Histopathological examination of buccolingual sections from experimental premolar teeth showed the presence of rete pegs within the sulcular epithelium with acanthosis and erosive changes, widening of the periodontal ligament, and alveolar bone resorption. Various methods for periodontal repair were studied in 194 experimental premolar teeth exhibiting different degrees of periodontal disease. The treatment plan comprised non-surgical (teeth scaling, root planing, and oral hygiene) and surgical methods (closed gingival curettage, modified Widman flap, and reconstructive surgery using autogenous bone marrow graft and canine amniotic membrane). The initial non-surgical treatment resulted in a periodontal recovery rate of 37.6% and was found effective for treatment of early periodontal disease based on resolution of gingivitis and reduction of periodontal probing depths. Surgical treatment by closed gingival curettage to eliminate the diseased pocket lining resulted in a recovery rate of 48.8% and proved effective in substantially reducing deep periodontal pockets. Open root planing following flap elevation resulted in a recovery rate of 85.4% and was effective for deep and refractory periodontal pockets. Autogenous bone graft implantation combined with canine amniotic

  9. Effect of Periodontal Dressing on Wound Healing and Patient Satisfaction Following Periodontal Flap Surgery.

    Directory of Open Access Journals (Sweden)

    Sara Soheilifar

    2015-04-01

    Full Text Available It has been claimed that periodontal dressing reduces the risk of wound infection, bleeding and granulation tissue formation and improves tissue healing. This study sought to assess the effect of periodontal dressing on wound healing and patient satisfaction following periodontal flap surgery.This clinical trial was conducted on 33 patients presenting to Hamadan University, School of Dentistry in 2012 whose treatment plan included two periodontal surgical procedures on both quadrants of the maxilla or mandible. The variables evaluated were severity of pain, bleeding, facial swelling and ease of nutrition experienced by patient during the first 3 days after surgery and inflammation, granulation tissue formation and gingival color at 7 and 14 days. Obtained data were analyzed using SPSS version 16.0 and R software and chi-square and t-tests.The mean (±SD pain score was 1.73±1.153 and 2.79±1.933 in surgical sites with and without periodontal dressing, respectively and this difference was statistically significant (P=0.005. No significant difference was noted between sites with and without periodontal dressing in terms of swelling, bleeding, gingival consistency, granulation tissue formation, gingival color and ease of nutrition (P>0.05.According to the results of the present study, patients did not experience more bleeding, facial swelling or nutritional problems without periodontal dressing; however, the level of pain experienced was lower after surgeries with the use of periodontal dressing.

  10. 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.

  11. Necessidade de tratamento periodontal avaliada pelo CPITN e sua relação com a qualidade de acabamento cervical das restaurações Need for periodontal treatment evaluated through CPITN and its relation to the quality of the cervical margin of restorations

    Directory of Open Access Journals (Sweden)

    Getúlio da Rocha NOGUEIRA-FILHO

    2001-03-01

    Full Text Available Irregularidades do acabamento cervical de restaurações constituem fatores de retenção de placa bacteriana, dificultando o controle de placa pelos procedimentos habituais de higiene bucal, favorecendo o desenvolvimento da doença periodontal. O objetivo deste estudo foi avaliar as condições periodontais e a necessidade de tratamento em função do acabamento cervical de restaurações dentais. Foram examinados 367 dentes restaurados com classes II e V de amálgama, classe III em resina, restauração metálica fundida e próteses unitárias. Utilizando-se sonda periodontal (OMS, verificou-se a posição do término da restauração (supragengival, subgengival ou ao nível da margem gengival; a qualidade das restaurações (falta ou excesso de material restaurador e a presença de grau 2 do CPITN. Após a análise dos dados, foi possível concluir que: 1 o término supragengival ofereceu a melhor adaptação marginal e a menor freqüência de grau 2 do CPITN; 2 a falta ou excesso de material restaurador favorecem o desenvolvimento de grau 2, independentemente do material utilizado e 3 nos términos subgengivais, foi maior a freqüência de adaptação marginal incorreta, principalmente casos de excesso de material restaurador, sendo estes casos de maior ocorrência de grau 2 do CPITN.Irregularities of the cervical margin of restorations facilitate the retention of bacterial plaque, hindering plaque control through the habitual procedures of oral hygiene and favoring the development of periodontal disease. The aim of this study was to evaluate the periodontal condition and treatment needs (applying CPITN in relation to the cervical margin of dental restorations. Three hundred and sixty-seven teeth with class II and V cavities restored with amalgam, class III cavities restored with composite resin, cast metal restorations and unitary prostheses were examined. With a WHO periodontal probe, the position of the cervical margins of restorations

  12. Long-term observation of endodontic surgical intervention to treat root perforation and apical periodontitis: a case report of an amalgam-restored tooth.

    Science.gov (United States)

    Tsurumachi, Tamotsu; Hayashi, Makoto

    2003-10-01

    A case of crestal root perforation and periapical lesion in a maxillary left lateral incisor is reported. Teeth with root perforation present technical difficulties in their clinical management because of their complex defects. In the present case, surgical endodontic treatment was chosen. The apical and lateral pathology was curetted, the tooth root was resected, and a retrograde root restoration of amalgam was placed in a root-end cavity and perforation site. A 10-year follow-up clinical and radiographic examination showed an asymptomatic tooth with osseous healing proceeding.

  13. Position paper: periodontal diseases of children and adolescents.

    Science.gov (United States)

    Califano, Joseph V

    2003-11-01

    Children and adolescents are subject to several periodontal diseases. Although there is a much lower prevalence of destructive periodontal diseases in children than in adults, children can develop severe forms of periodontitis. In some cases, this destructive disease is a manifestation of a known underlying systemic disease. In other young patients, the underlying cause for increased susceptibility and early onset of disease is unknown. These diseases are often familial, suggesting a genetic predisposition for aggressive disease. Current modalities for managing periodontal diseases of children and adolescents may include antibiotic therapy in combination with non-surgical and/or surgical therapy. Since early diagnosis ensures the greatest chance for successful treatment, it is important that children receive a periodontal examination as part of their routine dental visits.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Lip reposition surgery: A new call in periodontics

    Science.gov (United States)

    Sheth, Tejal; Shah, Shilpi; Shah, Mihir; Shah, Ekta

    2013-01-01

    “Gummy smile” is a major concern for a large number of patients visiting the dentist. Esthetics has now become an integral part of periodontal treatment plan. This article presents a case of a gummy smile in which esthetic correction was achieved through periodontal plastic surgical procedure wherein a 10-12 mm of partial-thickness flap was dissected apical to mucogingival junction followed by approximation of the flaps. This novel technique gave excellent post-operative results with enormous patient satisfaction. This surgical chair-side procedure being one of its kinds with outstanding results is very rarely performed by Periodontists. Thus, a lot of clinical work and literature review with this surgical technique is required. To make it a routine surgical procedure this technique can be incorporated as a part of periodontal plastic surgery in the text. Hence, we have put forward experience of a case with critical analysis of the surgical technique including the limitations of the technique. PMID:24124310

  19. Presence of gingivitis and periodontitis significantly increases hospital charges in patients undergoing heart valve surgery.

    Science.gov (United States)

    Allareddy, Veerasathpurush; Elangovan, Satheesh; Rampa, Sankeerth; Shin, Kyungsup; Nalliah, Romesh P; Allareddy, Veerajalandhar

    2015-01-01

    To examine the prevalence and impact of gingivitis and periodontitis in patients having heart valve surgical procedures. Nationwide Inpatient Sample for the years 2004-2010 was used. All patients who had heart valve surgical procedures were selected. Prevalence of gingivitis/periodontitis was examined in these patients. Impact of gingivitis/periodontitis on hospital charges, length of stay, and infectious complications was examined. 596,190 patients had heart valve surgical procedures. Gingivitis/periodontitis was present in 0.2 percent. Outcomes included: median hospital charges ($175,418 with gingivitis/ periodontitis versus $149,353 without gingivitis/periodontitis) and median length of stay (14 days with gingivitis/periodontitis versus 8 days without gingivitis/periodontitis). After adjusting for the effects of patient- and hospital-level confounding factors, hospital charges and length of stay were significantly higher (p gingivitis/periodontitis compared to their counterparts. Further, patients with gingivitis/periodontitis had significantly higher odds for having bacterial infections (OR = 3.41, 95% CI = 2.33-4.98, p gingivitis/periodontitis. Presence of gingivitis and periodontitis is associated with higher risk for bacterial infections and significant hospital resource utilization.

  20. Periodontitis: facts, fallacies and the future.

    Science.gov (United States)

    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.

  1. Impact of Oral Health Education and a Non-Surgical Periodontal Therapy on the Quality of Life of Patients with Diabetes Mellitus*

    Directory of Open Access Journals (Sweden)

    Oanta Cornelia

    2015-11-01

    Full Text Available Aim: The aim of the study was to evaluate the impact of oral health education and non-surgical periodontal therapy on the quality of life for a group of patients with type I diabetes mellitus, in Iasi, Romania.

  2. Endodontic-periodontal microsurgery for combined endodontic-periodontal lesions: An overview.

    Science.gov (United States)

    Sharma, Ritu; Hegde, Vivek; Siddharth, M; Hegde, Rashmi; Manchanda, Gunsha; Agarwal, Pratul

    2014-11-01

    Endodontic and periodontal microsurgery has surpassed the success rates for traditional endodontic and periodontal surgical procedures. Excellent healing results are being attributed to both the techniques, when employed, for isolated endodontic or periodontal defects. Combined endodontic-periodontal lesions have been referred to as a true challenge, requiring not only endodontic microsurgical management but also concurrent bone grafting and membrane barriers techniques. The prevention of epithelial downgrowth and regeneration of periodontal cementum, fiber, and bone seals the fate of these cases. Achieving primary closure with submergence of grafts has a positive effect on GTR outcome. New techniques of periodontal microsurgery, such as minimally invasive papilla preserving flaps with passive internal mattress suturing, have managed to obtain 90% primary flap closure over grafted sites. Root surface treatment and conditioning has also shown to be beneficial for GTR. Endodontic microsurgery for the combined lesion has not integrated these advances yet. These advances, along with a recently suggested treatment strategy, are ushering in the level next in management of the combined lesions. This article offers an overview of the combined lesion, the disease, its classification, treatment strategy, regenerative tools, microsurgical recommendations, and outcome studies.

  3. A case report of Parry Romberg Syndrome initially presenting as periodontitis

    OpenAIRE

    Taylor, Greig; Culshaw, Shauna; Armas, Jose; Savarrio, Lee; Goodall, Christine

    2017-01-01

    Parry Romberg Syndrome (PRS) is a rare disorder of progressive hemifacial atrophy, involving soft tissues, fat and occasionally bone. It can co-exist with presentations of Morphea. We describe an unusual case of persistent periodontal and alveolar destruction associated with PRS. A 56-year-old African female initially presented with persistent periodontal destruction, which showed minimal response to conventional periodontal treatment. After non-surgical treatment, surgical debridement follow...

  4. Clinical decisions for anterior restorations: the concept of restorative volume.

    Science.gov (United States)

    Cardoso, Jorge André; Almeida, Paulo Júlio; Fischer, Alex; Phaxay, Somano Luang

    2012-12-01

    The choice of the most appropriate restoration for anterior teeth is often a difficult decision. Numerous clinical and technical factors play an important role in selecting the treatment option that best suits the patient and the restorative team. Experienced clinicians have developed decision processes that are often more complex than may seem. Less experienced professionals may find difficulties making treatment decisions because of the widely varied restorative materials available and often numerous similar products offered by different manufacturers. The authors reviewed available evidence and integrated their clinical experience to select relevant factors that could provide a logical and practical guideline for restorative decisions in anterior teeth. The presented concept of restorative volume is based on structural, optical, and periodontal factors. Each of these factors will influence the short- and long-term behavior of restorations in terms of esthetics, biology, and function. Despite the marked evolution of esthetic restorative techniques and materials, significant limitations still exist, which should be addressed by researchers. The presented guidelines must be regarded as a mere orientation for risk analysis. A comprehensive individual approach should always be the core of restorative esthetic treatments. The complex decision process for anterior esthetic restorations can be clarified by a systematized examination of structural, optical, and periodontal factors. The basis for the proposed thought process is the concept of restorative volume that is a contemporary interpretation of restoration categories and their application. © 2012 Wiley Periodicals, Inc.

  5. Comparison of Subgingival and Peri-implant Microbiome in Chronic Periodontitis.

    Science.gov (United States)

    Zhang, Qian; Qin, Xue Yan; Jiang, Wei Peng; Zheng, Hui; Xu, Xin Li; Chen, Feng

    2015-09-01

    To analyse the microbia composition of 10 healthy dental implants and 10 chronic periodontitis patients. Subgingival plaque and peri-implant biofilm were sampled at the first molar site before and after implant restoration. The analysis was conducted by 454-prosequencing of bacterial V1 to V3 regions of 16S rDNA. Chronic periodontitis subjects showed greater bacterial diversity compared with implant subjects. The relative abundance of sixteen genera and twelve species differed significantly between implant and chronic periodontitis subjects. The genera Catonella, Desulfovibrio, Mogibacterium, Peptostreptococcus and Propionibacterium were present in higher abundance in chronic periodontitis subjects, while implant subjects had higher proportions of Brevundimonas and Pseudomonas species. Our results demonstrate that implant restoration changes the oral microbiota. The analysis suggests that periodontal bacteria can remain for a prolonged period of time at non-dental sites, from where they can colonise the peri-implant.

  6. Clinical evaluation of combined surgical/ restorative treatment of gingival recession-type defects using different restorative materials: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Sila Cagri Isler

    2018-03-01

    Full Text Available Background/purpose: An ideal therapeutic procedure for the treatment of gingival recession associated with an NCCL has presented a challenge to clinicians. Various dental materials and surgical approaches have been used to manage gingival recessions associated with NCCLs for the most predictable combined surgical/restorative treatment. The objective of this study was to evaluate the treatment of gingival recessions associated with non-carious cervical lesions (NCCL using a modified coronally advanced flap (MCAF in combination with a connective tissue graft (CTG on restored root surfaces. Materials and methods: Twenty-three systemically healthy subjects, who were positive for the presence of three cervical lesions associated with gingival recessions in three different adjacent teeth, were enrolled in the study. The NCCL were each restored prior to surgery by using one of three different materials: nanofilled composite resin (NCR, resin-modified glass ionomer cement (RMGI or giomer. The gingival recession defects were treated by CTG. Results: Inter-group differences were not statistically significant for probing depth (PD, relative recession height (rRH, relative clinical attachment level (rCAL, keratinized tissue width (KTW or keratinized tissue thickness (KTT (p > 0.05 among the groups at any time. The mean percentage of defect coverage was 71.18 ± 23.16% for NCR + CTG group; 71.33 ± 22.33% for RMGI + CTG group; and 64.23 ± 20.33% for giomer + CTG group at 1 year postoperatively (p > 0.05. Conclusion: The combined surgical/restorative treatments provided successful clinical results. Giomer + CTG may be less effective compared to other groups for treatment of gingival recession associated with NCCL. Keywords: cervical lesions, connective tissue grafts, gingival recession, restorative materials

  7. Comparing the outcomes of incisions made by colorado microdissection needle, electrosurgery tip, and surgical blade during periodontal surgery: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rampalli Viswa Chandra

    2016-01-01

    Full Text Available Context: Electrosurgery offers many unique advantages such as hemostasis and precise tissue cutting; however, there are a number of disadvantages including thermal injury and delayed wound healing. Aims: The aim of the present study was to compare the outcomes of incisions made by Colorado® microdissection needle, electrosurgery tip, and surgical blade during periodontal surgery. Settings and Design: Twenty-two individuals participated in this study. Three quadrants in each individual were randomly assigned into each of the following experimental groups: Colorado® microdissection needle (CMD, electrosurgery tip (EC and surgical blade (BP, in which, incisions were given with Colorado® microdissection needle, straight electrocautery tip, and a scalpel blade, respectively. Materials and Methods: Blood loss (BL was measured immediately after surgery, and changes in interdental papilla dimensions were recorded at baseline, 7, 30, 120, and 180 days after surgery. Measures of periodontal disease were recorded at baseline, 120, and 180 days after surgery. Postoperative pain and wound healing were recorded at 1, 7, and 15 days after surgery. Results: The use of CMD for periodontal surgery showed better results over EC in all parameters. CMD resulted in lesser bleeding and less postoperative pain and attained similar results to that of BP in clinical parameters of periodontal disease. Conclusions: Colorado® microdissection needle may be a better choice for incisions as it seems to show less tissue damage than cautery and offers tissue healing comparable to scalpel blade.

  8. Clinical and histologic evaluation of non-surgical periodontal therapy with enamel matrix derivative: a report of four cases.

    Science.gov (United States)

    Mellonig, James T; Valderrama, Pilar; Gregory, Holly J; Cochran, David L

    2009-09-01

    Enamel matrix derivative (EMD) is a composite of proteins that was demonstrated histologically to work as an adjunct to periodontal regenerative surgical therapy. The purpose of this study was to evaluate the clinical and histologic effects of EMD as an adjunct to scaling and root planing. Four patients with severe chronic periodontitis and scheduled to receive complete dentures were accrued. Probing depth and clinical attachment levels were obtained. Unlimited time was allowed for hand and ultrasonic instrumentation. A notch was placed in the root >or=1 to 2 mm from the apical extent of root planing. EMD was inserted into the pocket, and a periodontal dressing was placed. Patients were seen every 2 weeks for plaque control. At 6 months post-treatment, soft tissue measurements were repeated, and the teeth were removed en bloc and prepared for histomorphologic analysis. Probing depth reduction and clinical attachment level gain were obtained in three-fourths of the specimens. Three of the four specimens analyzed histologically demonstrated new cementum, bone, periodontal ligament, and connective tissue attachment coronal to the notch. In one specimen, the gingival margin had receded below the notch. The results were unexpected and may represent an aberration. However, the substantial reduction in deep probing depths and clinical attachment level gain in three of four specimens, in addition to the histologic findings of new cementum, new bone, a new periodontal ligament, and a new connective tissue attachment, suggest that EMD may be useful as an adjunct to scaling and root planing in single-rooted teeth.

  9. PENYEMBUHAN LUKA SETELAH PERAWATAN BEDAH PERIODONTAL (Studi Pustaka

    Directory of Open Access Journals (Sweden)

    Natalina Natalina

    2015-08-01

    Full Text Available Background. Periodontal therapy for treatment of periodontitis involves the elimination of anatomic defect. There are two primary approaches to eliminating these anatomic defects : resective (gingivectomy, osseous resection, and apically positioned flaps, and regenerative surgery (osseous graft, guided tissue regeneration, resorbable barriers, coronally position flaps. Aims. The dentist know the outcomes after periodontal surgery. References. Periodontal regeneration means healing after periodontal surgery that results in the formation of a new attachment apparatus, consisting of cementum, periodontal ligament, and alveolar bone. Periodontal repair implies healing without restoration of the normal attachment apparatus. Histologic evaluation is the only reliable method to determine the true efficacy of periodontal therapies. Discussion. The variables involved in periodontal wound healing to solve how to achieve periodontal regeneration are manipulation of progenitor cell, alteration of pathologically exposed root surfaces, exclusion of gingival epithelium, and wound stabilization. Conclusions. Periodontal surgery usually do not result in periodontal regeneration. Gingival epithelium that proliferates apically can be inhibited by stabilization of the flap margin and regenerative surgery.

  10. Periodontal therapy reduces plasma levels of interleukin-6, C-reactive protein, and fibrinogen in patients with severe periodontitis and refractory arterial hypertension.

    Science.gov (United States)

    Vidal, Fábio; Figueredo, Carlos Marcelo S; Cordovil, Ivan; Fischer, Ricardo G

    2009-05-01

    Recent epidemiologic studies suggest that inflammation is the link between periodontal diseases and cardiovascular complications. This study aimed to evaluate the effects of non-surgical periodontal treatment on plasma levels of inflammatory markers (interleukin [IL]-6, C-reactive protein [CRP], and fibrinogen) in patients with severe periodontitis and refractory arterial hypertension. Twenty-two patients were examined and randomly divided into two groups. The test group was composed of 11 patients (mean age, 48.9 +/- 3.9 years) who received periodontal treatment, whereas the control group had 11 patients (mean age, 49.7 +/- 6.0 years) whose treatment was delayed for 3 months. Demographic and clinical periodontal data were collected, and blood tests were performed to measure the levels of IL-6, CRP, and fibrinogen at baseline and 3 months later. The clinical results showed that the mean percentages of sites with bleeding on probing, probing depth (PD) 4 to 5 mm, PD > or =6 mm, clinical attachment loss (CAL) 4 to 5 mm, and CAL > or =6 mm were significantly reduced in the test group 3 months after periodontal treatment. There were no significant differences between the data at baseline and 3 months in the control group. Periodontal treatment significantly reduced the blood levels of fibrinogen, CRP, and IL-6 in the test group. Non-surgical periodontal therapy was effective in improving periodontal clinical data and in reducing the plasma levels of IL-6, CRP, and fibrinogen in hypertensive patients with severe periodontitis.

  11. Effect of Non-Surgical Periodontal Therapy Along With Myo-Inositol on High-Sensitivity C-Reactive Protein and Insulin Resistance in Women With Polycystic Ovary Syndrome and Chronic Periodontitis: A Randomized Controlled Trial.

    Science.gov (United States)

    Deepti; Tewari, Shikha; Narula, Satish Chander; Singhal, Savita Rani; Sharma, Rajinder Kumar

    2017-10-01

    The purpose of this study is to evaluate the effect of non-surgical periodontal therapy and medical treatment on the level of a serologic marker of inflammation (high-sensitivity C-reactive protein [hsCRP]) and insulin resistance (homeostatic model assessment [HOMA]) in women with polycystic ovary syndrome (PCOS) and chronic periodontitis (CP). Women with PCOS and CP (n = 60) were randomly divided into two groups. The test group was treated with scaling and root planing (SRP) and myo-inositol (MI). The control group was treated with MI and given oral hygiene instructions. Anthropometric, metabolic, and periodontal parameters were assessed at baseline and re-evaluated at 3 and 6 months. All parameters of both groups at 6 months were compared with 25 systemically and periodontally healthy females (group A). Periodontal parameters were significantly improved in the test group compared with the control group at 3- and 6-month follow-up (P 0.05) was observed in the test group compared with the control group at 3 and 6 months. Both the test and control group showed significant consistent improvement in metabolic parameters at 3- and 6-month follow-up, which was further comparable to group A. SRP together with medical treatment results in a greater reduction of systemic inflammatory burden compared with medical treatment alone in management of women with PCOS and CP.

  12. Variation of perimplant biofilm induced by non surgical periodontal therapy and the use of probiotics

    Directory of Open Access Journals (Sweden)

    Marcello Gatti

    2010-12-01

    Full Text Available Thanks to improved surgical tecniques the use of dental implants has increased greatly. However, high rates of osseointegrated correctly implants, over the years are undermined by disease of bacterial etiology in the perimplant zone, especially by Gram negative anaerobes such as in gingivitis and periodontitis, in particular: Fusobacterium spp.(F., Treponema denticola (T.d., Tannerella forsythensis (T.f., Aggregatibacter actinomycetemcomitans (A.a., Prevotella intermedia (P.i. e Porphyromonas gingivalis (P.g.. The mechanic treatment (MS results in a reduction of the total bacterial count (TBC and a slight change in the subgingival bacterial microflora towards the less pathogenic species and more like those of a healthy periodontium.Also the use of a probiotic in the form of buccal tablets of Lactobacillus reuteri (L.r., as demonstrated in this study, is thought to improve and modulate the composition of plaque, as it is able to exert an inhibitory effect on oral bacteria that support caries, gingivitis, periodontal and perimplant disease with a combination of different mechanisms.

  13. 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.

  14. Laser technology to manage periodontal disease: a valid concept?

    Science.gov (United States)

    Low, Samuel B; Mott, Angie

    2014-06-01

    Present day dental lasers can create oral environments conducive for periodontal repair. With the bacterial etiology of periodontitis and the resulting host inflammatory reaction, clinicians continue to search for therapeutic modalities to assist in the non-surgical management of periodontal disease. Traditional chairside therapies consist of mechanical debridement with manual and/or ultrasonic instrumentation with the objective of removing calculus, biofilm, and endotoxin from tooth root surfaces. Decreasing the microbial stimuli and associated end products decreases the inflammatory reaction and allows the host an opportunity to regenerate tissue through wound healing. The purpose of this article is to examine whether dental lasers, which have been in use for the past 3 decades, may augment traditional non-surgical periodontal therapy. Review of research publications related to lasers and non-surgical periodontics with attention focused on systematic studies. Studies utilizing laser technology may demonstrate positive effects on 1) selectively decreasing the biofilm environment, 2) removing calculus deposits and neutralizing endotoxin, 3) removing sulcular epithelium to assist in reattachment and decreased pocket depth, and 4) biostimulation for enhanced wound healing. Comparisons of studies to determine the difference between lasers and their respective effects on the periodontium are difficult to assess due to a wide variation of laser protocols. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Tooth loss due to periodontal abscess: a retrospective study.

    Science.gov (United States)

    McLeod, D E; Lainson, P A; Spivey, J D

    1997-10-01

    This retrospective study focused on the frequency of tooth loss due to periodontal abscess among 42 patients who were treated by a single clinician over a 5- to 29-year period. A total of 114 patients were selected from the active periodontal recall schedule of a single periodontist at The University of Iowa College of Dentistry. The criteria for inclusion in the study included having a history of moderate to advanced periodontitis, being on 3 to 6 month recall periodontal maintenance care, and completion of active periodontal therapy prior to October 1987. Other parameters evaluated were age; gender; number of teeth present and missing at the initial, reevaluation, and last periodontal recall visit; initial periodontal prognosis; furcation involvement; non-surgical and surgical periodontal therapy; and reasons for tooth loss. Patients were grouped according to the number of teeth lost following active periodontal treatment into well-maintained (0 to 3), downhill (4 to 9), and extreme downhill (10 to 23) groups. Forty-two of the 114 patients were identified as having one or more periodontal abscesses. A total of 109 teeth were affected by periodontal abscess of which 49 (45%) teeth were lost and 60 (55%) were successfully maintained over an average of 12.5 years (5 to 29 years). More furcated teeth were lost than nonfurcated teeth and teeth given a hopeless prognosis were lost more consistently than those given a questionable prognosis in all groups. The frequency of periodontal abscess and tooth loss per patient was greater in the downhill and extreme downhill response groups than the well-maintained group. This suggests that teeth with a history of periodontal abscess can be treated and maintained for several years.

  16. Restoring accommodation: surgical technique and preliminary evaluation in rabbits

    Science.gov (United States)

    Tahi, Hassan; Chapon, Pascal F.; Hamaoui, Marie; Lee, William E.; Holden, Brien; Parel, Jean-Marie A.

    1999-06-01

    Purpose. To evaluate an innovative surgical technique for phaco-ersatz, a cataract surgery designed to restore accommodation. Techniques for very small capsulorhexis as well as the refilling procedure were developed. This study evaluates the feasibility and reproducibility of the surgical technique. Methods. The right eye of 8 NZW rabbits (~ 2 Kg) were operated following the ARVO Statements for the Use of Animals in Ophthalmic and Vision Research. The surgery is begun by making a small peripheral capsulorhexis of about 1 mm using. The lens content is then removed. The lens is then refilled with a novel in situ polymerizable gel and the corneal incision is closed using one 10/0 Nylon interrupted stitch. Results. The capsulorhexis technique was succesfully performed and reproducible in all animals. The average size of the capsulorhexis opening was 1. 2 mm (+/-0.14). Lens material removal and refilling of the capsular bag with an in situ polymerizable material was also performed in each trial study. Conclusion. This surgical technique seemed feasible and reproducible.

  17. MINIMALLY INVASIVE SINGLE FLAP APPROACH WITH CONNECTIVE TISSUE WALL FOR PERIODONTAL REGENERATION

    Directory of Open Access Journals (Sweden)

    Kamen Kotsilkov

    2017-09-01

    Full Text Available INTRODUCTION: The destructive periodontal diseases are among the most prevalent in the human population. In some cases, bony defects are formed during the disease progression, thus sustaining deep periodontal pockets. The reconstruction of these defects is usually done with the classical techniques of bone substitutes placement and guided tissue regeneration. The clinical and histological data from the recent years, however, demonstrate the relatively low regenerative potential of these techniques. The contemporary approaches for periodontal regeneration rely on minimally invasive surgical protocols, aimed at complete tissue preservation in order to achieve and maintain primary closure and at stimulating the natural regenerative potential of the periodontal tissues. AIM: This presentation demonstrates the application of a new, minimally invasive, single flap surgical technique for periodontal regeneration in a clinical case with periodontitis and a residual deep intrabony defect. MATERIALS AND METHODS: A 37 years old patient presented with chronic generalised periodontitis. The initial therapy led to good control of the periodontal infection with a single residual deep periodontal pocket medially at 11 due to a deep intrabony defect. A single flap approach with an enamel matrix derivate application and a connective tissue wall technique were performed. The proper primary closure was obtained. RESULT: One month after surgery an initial mineralisation process in the defect was detected. At the third month, a complete clinical healing was observed. The radiographic control showed finished bone mineralisation and periodontal space recreation. CONCLUSION: In the limitation of the presented case, the minimally invasive surgical approach led to complete clinical healing and new bone formation, which could be proof for periodontal regeneration.

  18. 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.

  19. Provisional Restorations – A Permanent Problem?

    Science.gov (United States)

    Keys, William F; Keirby, Naomi; Ricketts, David N J

    2016-12-01

    Provisional restorations play an important role when providing indirect restorations. There are a number of materials and techniques available for their construction. Careful planning and construction can protect the prepared tooth surface, improve the periodontal condition and help plan for the definitive restoration. A good provisional restoration can save time, money and effort. Clinical relevance: Provisional restoration construction is an integral part of the indirect restorative process for inlays, onlays, crowns and bridges.

  20. The antioxidant master glutathione and periodontal health

    Directory of Open Access Journals (Sweden)

    Vivek Kumar Bains

    2015-01-01

    Full Text Available Glutathione, considered to be the master antioxidant (AO, is the most-important redox regulator that controls inflammatory processes, and thus damage to the periodontium. Periodontitis patients have reduced total AO capacity in whole saliva, and lower concentrations of reduced glutathione (GSH in serum and gingival crevicular fluid, and periodontal therapy restores the redox balance. Therapeutic considerations for the adjunctive use of glutathione in management of periodontitis, in limiting the tissue damage associated with oxidative stress, and enhancing wound healing cannot be underestimated, but need to be evaluated further through multi-centered randomized controlled trials.

  1. 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)

  2. 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)

  3. [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.

  4. Simultaneous Occurrence of Periodontal and Skin Abscesses in a ...

    African Journals Online (AJOL)

    Pre-operative quantitative analysis of plasma CRP was 1500mg/l, moderate growth of Staphylococcus aureus and Porphyromonas gingivalis were isolated from the skin and periodontal pus respectively and basic heamatological values were within normal range. Intensive non-surgical periodontal therapy was done at ...

  5. Radiologic study of peridontal and periapical changes for the restorated teeth

    International Nuclear Information System (INIS)

    Ahn, Hyung Kyu

    1978-01-01

    The purpose of this study is to investigate the effect of dental restorations on the periodontal and periapical tissues. The author examined 620 cases of amalgam, 390 cases of fold inlay, 442 cases of crown and 644 cases of bridge through the standard intraoral films being appended in the charts that gad been kept at the Dept. of Oral Diagnosis in Seoul National University Hospital. This study obtained the following results; 1. The restorations of amalgam, gold inlay crown and bridge were found more frequently in female than in male. 2. The restorations of amalgam, gold inlay and crown were found more numerously in mandibular teeth than in maxillary teeth in both sexes. But in the case of crown, the fact is quite the reverse especially in anterior teeth. 3. On the contrary, tn the case of bridge, the restorations of bridge were much more distributed in the maxillary teeth than in the mandibular teeth. 4. Roentgenographic changes of periodontal tissues whose teeth were treated with any type of four restorations were periodontal space widening, lamina dura discontinuity and periapical lesion in the order described in both sexes. 5. On the occasion of between amalgam and gold inlay or between crown and bridge, the differences of periodontal changes were of no consequence. On the other hand, the differences of periodontal changes were apparent between the group of amalgam and gold inlay and the group of crown and bridge.

  6. Radiographic bone fill following debridement of a periodontal abscess. A case report.

    Science.gov (United States)

    Khocht, A; Faldu, M G

    1998-01-01

    A periodontal abscess often develops in association with deepened periodontal pockets. Traditional management is by establishing drainage and prescribing antibiotics. This is usually followed by surgical pocket reduction. This case report discusses the remarkable healing of a periodontal abscess by establishing drainage alone without resorting to surgical pocket reduction. A 42-year-old white male presented with swollen gingivae associated with the mesiolingual of tooth #23. Increased probing depth and suppuration were evident. Radiographic bone loss on mesial #23 was present. A diagnosis of periodontal abscess was established. The abscess was drained through the orifice of the pocket. The patient failed to return for follow-up as instructed. A year later, the patient came back. Clinical evaluation showed healthy gingival tissues with probing depth of 3 mm on the mesiolingual of tooth #23. Radiographic evaluation showed bone fill of the osseous defect on the mesial of #23. The results of this case suggest that sufficient time should be allowed for healing prior to surgical pocket reduction.

  7. Perkembangan Terkini Membran Guided Tissue Regeneration/Guided Bone Regeneration sebagai Terapi Regenerasi Jaringan Periodontal

    Directory of Open Access Journals (Sweden)

    Cindy Cahaya

    2015-06-01

    kombinasi prosedur-prosedur di atas, termasuk prosedur bedah restoratif yang berhubungan dengan rehabilitasi oral dengan penempatan dental implan. Pada tingkat selular, regenerasi periodontal adalah proses kompleks yang membutuhkan proliferasi yang terorganisasi, differensiasi dan pengembangan berbagai tipe sel untuk membentuk perlekatan periodontal. Rasionalisasi penggunaan guided tissue regeneration sebagai membran pembatas adalah menahan epitel dan gingiva jaringan pendukung, sebagai barrier membrane mempertahankan ruang dan gigi serta menstabilkan bekuan darah. Pada makalah ini akan dibahas sekilas mengenai 1. Proses penyembuhan terapi periodontal meliputi regenerasi, repair ataupun pembentukan perlekatan baru. 2. Periodontal spesific tissue engineering. 3. Berbagai jenis membran/guided tissue regeneration yang beredar di pasaran dengan keuntungan dan kerugian sekaligus karakteristik masing-masing membran. 4. Perkembangan membran terbaru sebagai terapi regenerasi penyakit periodontal. Tujuan penulisan untuk memberi gambaran masa depan mengenai terapi regenerasi yang menjanjikan sebagai perkembangan terapi penyakit periodontal.   Latest Development of Guided Tissue Regeneration and Guided Bone Regeneration Membrane as Regenerative Therapy on Periodontal Tissue. Periodontitis is a patological state which influences the integrity of periodontal system that could lead to the destruction of the periodontal tissue and end up with tooth loss. Currently, there are so many researches and efforts to regenerate periodontal tissue, not only to stop the process of the disease but also to reconstruct the periodontal tissue. Periodontal regenerative therapy aims at directing the growth of new bone, cementum and periodontal ligament on the affected teeth. Regenerative procedures consist of soft tissue graft, bone graft, roots biomodification, guided tissue regeneration and combination of the procedures, including restorative surgical procedure that is

  8. Frequency of Iatrogenic Changes Caused from Overhang Restorations

    Directory of Open Access Journals (Sweden)

    Boteva E.

    2015-11-01

    Full Text Available Overhangs from different restorations are an iatrogenic error with different results, short and long term consequences related to bone changes and periodontal diseases. Amalgam “tattoos”, idiopathic subgingival hypertrophy, marginal periodontitis and bone reductions in the intradental septum are major problems. The aim of the present study is to evaluate the frequency of traumatic restorations in distal teeth and clinical criteria, related to the x-ray findings. Evaluating criteria, for repairing the overhangs or for replacement of the restorations, is also a goal. Three hundred and sixteen - 316 patients from both sexes, 632 dental x-rays with 948 distal teeth and 632 restorations, at least two radiographs for each patient, were analyzed. Overhangs are classified in three groups: small, middle and large. In the criteria bone changes from the overhangs are analyzed separately from the existing or nonexisting bone changes from a generalized periodontal diseases. The frequency of iatrogenic changes in this cohort group is 10.6% from 632 restored teeth. This is a relatively small number compared with the other published studies. These overhangs are on distal teeth in sound teeth arches which makes them difficult for corrections. The evaluated criteria for replacement based on x-ray findings and clinical experience includes: operative and nonoperative corrections, restoration replacement, perio- and endo-therapy and follow up terms for secondary caries.

  9. Ortho-perio integrated approach in periodontally compromised patients

    Science.gov (United States)

    Ramachandra, C. S.; Shetty, Pradeep Chandra; Rege, Sanyukta; Shah, Chitrang

    2011-01-01

    It is an undisputed fact that sound and strong periodontal health is a must in patients seeking orthodontic treatment. Does this mean that we are going to deny orthodontic treatment for those adults whose number is rising, more often secondary to periodontal deterioration and pathological migration of teeth resulting in aesthetic and functional problems? Need of the hour is to have an integrated approach where in periodontal treatment precedes orthodontic treatment to restore periodontal health. Orthodontic treatment should be performed under strict plaque control measures to place the teeth in a structurally balanced and functionally efficient position. Aim of this article is to familiarize the practicing clinicians both in the field of orthodontics and periodontics with current thoughts and successful clinical techniques used in the field of periodontology to regenerate lost periodontal structures. Furthermore, it aims to integrate such techniques into the orthodontic treatment of patients with severe bone loss. PMID:22368371

  10. A videoscope for use in minimally invasive periodontal surgery.

    Science.gov (United States)

    Harrel, Stephen K; Wilson, Thomas G; Rivera-Hidalgo, Francisco

    2013-09-01

    Minimally invasive periodontal procedures have been reported to produce excellent clinical results. Visualization during minimally invasive procedures has traditionally been obtained by the use of surgical telescopes, surgical microscopes, glass fibre endoscopes or a combination of these devices. All of these methods for visualization are less than fully satisfactory due to problems with access, magnification and blurred imaging. A videoscope for use with minimally invasive periodontal procedures has been developed to overcome some of the difficulties that exist with current visualization approaches. This videoscope incorporates a gas shielding technology that eliminates the problems of fogging and fouling of the optics of the videoscope that has previously prevented the successful application of endoscopic visualization to periodontal surgery. In addition, as part of the gas shielding technology the videoscope also includes a moveable retractor specifically adapted for minimally invasive surgery. The clinical use of the videoscope during minimally invasive periodontal surgery is demonstrated and discussed. The videoscope with gas shielding alleviates many of the difficulties associated with visualization during minimally invasive periodontal surgery. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Effect of non-surgical periodontal therapy on C-reactive protein, oxidative stress, and matrix metalloproteinase (MMP)-9 and MMP-2 levels in patients with type 2 diabetes: a randomized controlled study.

    Science.gov (United States)

    Koromantzos, Panagiotis A; Makrilakis, Konstantinos; Dereka, Xanthippi; Offenbacher, Steven; Katsilambros, Nicholas; Vrotsos, Ioannis A; Madianos, Phoebus N

    2012-01-01

    It is well accepted that glycemic control in patients with diabetes mellitus (DM) is affected by systemic inflammation and oxidative stress. The effect of periodontal therapy on these systemic factors may be related to improvement on glycemic status. The aim of the present study is to assess over a period of 6 months the effect of non-surgical periodontal therapy on serum levels of high-sensitivity C-reactive protein (hsCRP), d-8-iso prostaglandin F2a (d-8-iso) as a marker of oxidative stress, and matrix metalloproteinase (MMP)-2 and MMP-9 on patients with type 2 DM. Sixty participants with type 2 DM and moderate to severe periodontal disease were randomized into intervention (IG) and control (CG) groups. IG received scaling and root planing, whereas CG received supragingival cleaning at baseline and scaling and root planing at 6 months. Participants of both groups were evaluated at baseline and 1, 3, and 6 months. Periodontal data recorded at each visit included probing depth, clinical attachment loss, bleeding on probing, and gingival index. Blood was collected at each visit for the assay of serum glycated hemoglobin A1c (A1c), hsCRP, d-8-iso, MMP-2, and MMP-9. Although there was a trend to a reduction in hsCRP, d-8-iso and MMP-9 it did not reach statistical significance. MMP-2 levels remained unchanged after periodontal treatment. Effective non-surgical periodontal treatment of participants with type 2 DM and moderate to severe periodontal disease improved significantly A1c levels but did not result in a statistically significant improvement in hsCRP, d-8-iso, MMP-2, and MMP-9 levels.

  12. Little evidence for the use of diode lasers as an adjunct to non-surgical periodontal therapy.

    Science.gov (United States)

    Dederich, Douglas N

    2015-03-01

    Medline, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase databases. Randomised controlled trials (RCTs) using thermal diode lasers as an adjunct to non-surgical conventional periodontal initial therapy conducted in patients ≥18 years old written in English or Dutch were considered. Study assessment data extraction and quality assessment was carried out independently by two reviewers. The main outcome variables were probing pocket depth (PPD) and clinical attachment loss (CAL), but plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were also considered. Meta-analysis was carried out using a random effects model. Nine studies involving 247 patients were included. Seven studies were of split mouth design and two were parallel group studies. The study designs showed considerable heterogeneity and follow up ranged from six weeks to six months. Meta-analysis found no significant effect on PPD, CAL and PS. There was however a significant effect for GI and BS favouring adjunctive use of the diode laser. The collective evidence regarding adjunctive use of the diode laser with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. With respect to BS the results showed a small but significant effect favouring the diode laser, however, the clinical relevance of this difference remains uncertainStandard . This systematic review questions the adjunctive use of diode laser with traditional mechanical modalities of periodontal therapy in patients with periodontitis. The strength of the recommendation for the adjunctive use of the diode laser is considered to be 'moderate' for changes in PPD and CAL.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Longitudinal supportive periodontal therapy for severe chronic periodontitis with furcation involvement: a 12-year follow-up report.

    Science.gov (United States)

    Komiya-Ito, Akiyo; Tomita, Sachiyo; Kinumatsu, Takashi; Fujimoto, Yoshihiro; Tsunoda, Masatake; Saito, Atsushi

    2013-01-01

    We report a case involving a 12-year follow-up after treatment for chronic periodontitis with furcation involvement. A 54-year-old woman presented with the chief complaint of hypersensitivity. Clinical examination at the first visit revealed 15% of sites with a probing depth ≥4 mm and 35% of sites with bleeding on probing. Initial periodontal therapy was implemented based on a clinical diagnosis of severe chronic periodontitis. Surgical periodontal therapy was subsequently performed at selected sites. For #44, regenerative periodontal therapy using enamel matrix derivative (Emdogain(®)) was selected. For #16, which exhibited a 2- to 3-wall vertical bony defect and class III (mesio-distal) furcation involvement, bone graft was scheduled. Other sites with residual periodontal pockets were treated by open flap debridement. For #37, with a gutter-shaped root, odontoplasty was performed. After reevaluation, the patient was placed on supportive periodontal therapy (SPT). During 12 years of SPT, the periodontal condition remained uneventful in most of the teeth. However, bone resorption was observed in the distal aspect of #37, making the prognosis poor. This indicates the need to continuously monitor risk factors, including inflammation and traumatic occlusion, during SPT. Although some problems still remain, severe periodontitis with furcation involvement was successfully maintained longitudinally with an adequate level of patient compliance and careful SPT.

  15. 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.

  16. Increased and correlated expression of connective tissue growth factor and transforming growth factor beta 1 in surgically removed periodontal tissues with chronic periodontitis.

    Science.gov (United States)

    Mize, T W; Sundararaj, K P; Leite, R S; Huang, Y

    2015-06-01

    Both gingival tissue destruction and regeneration are associated with chronic periodontitis, although the former overwhelms the latter. Studies have shown that transforming growth factor beta 1 (TGF-β1), a growth factor largely involved in tissue regeneration and remodeling, is upregulated in chronic periodontitis. However, the gingival expression of connective tissue growth factor (CTGF or CCN2), a TGF-β1-upregulated gene, in patients with periodontitis remains undetermined. Although both CTGF/CCN2 and TGF-b1 increase the production of extracellular matrix, they have many different biological functions. Therefore, it is important to delineate the impact of periodontitis on gingival CTGF/CCN2 expression. Periodontal tissue specimens were collected from seven individuals without periodontitis (group 1) and from 14 with periodontitis (group 2). The expression of CTGF and TGFβ1 mRNAs were quantified using real-time PCR. Analysis using the nonparametric Mann-Whitney U-test showed that the levels of expression of both CTGF/CCN2 and TGFβ1 mRNAs were significantly increased in individuals with periodontitis compared with individuals without periodontitis. Furthermore, analysis using a nonparametric correlation (Spearman r) test showed a positive correlation between TGFβ1 and CTGF/CCN2 mRNAs. The gingival expression levels of CTGF/CCN2 and TGFβ1 mRNAs in individuals with periodontitis are upregulated and correlated. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Interproximal periodontal defect model in dogs: a pilot study.

    Science.gov (United States)

    Jung, U-W; Chang, Y-Y; Um, Y-J; Kim, C-S; Cho, K-S; Choi, S-H

    2011-01-01

    This study aimed to evaluate the validity of a surgically created interproximal periodontal defect in dogs. Surgery was performed in the interproximal area between the maxillary second and third premolars in two beagle dogs. Following an incision and reflection of the gingival flap, a 3-mm wide and 5-mm high defect was prepared surgically at the interproximal area. A thorough root planing was performed and the flap was coronally positioned and sutured. The contra-lateral area was served as the control with no surgical intervention. After 8 weeks of healing, the animals were killed and the defect was analysed histometrically and radiographically. The interproximal periodontal defect resembled a naturally occurring defect and mimicked a clinical situation. After healing, the defect showed limited bone (0.89±0.02mm) and cementum regeneration (1.50± 0.48mm). Within the limitations of this pilot study, the interproximal periodontal defect showed limited bone and cementum regeneration. Thus, it can be considered as a standardized, reproducible defect model for testing new biomaterials. © 2010 John Wiley & Sons A/S.

  18. 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.

  19. Removable dental prosthesis as periodontal treatment method

    Directory of Open Access Journals (Sweden)

    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.

  20. Host modulation therapeutics in periodontics: role as an adjunctive periodontal therapy.

    Science.gov (United States)

    Shinwari, Muhammad Saad; Tanwir, Farzeen; Hyder, Pakiza Raza; Bin Saeed, Muhammad Humza

    2014-09-01

    Host Modulation Therapy (HMT) is a treatment concept that reduces tissue destruction and stabilizes or even regenerates inflammatory tissue by modifying host response factors. It has been used for treating osteoporosis and arthritis for several decades. However, its use in dentistry has only been recently reported. The objective of this article is to present a review of the various literatures available on HMT and also its role as adjunct therapy in periodontics. For identifying studies for this review, a PUBMED search was carried out in 2013 for all articles published till December 2012. The search was restricted to English language publications only. Longitudinal prospective and retrospective studies were included in the search. The key words used were: Host Modulation Therapy; Sub antimicrobial dose doxycycline and Non-Surgical Periodontal Therapy. The main outcomes sought were host modulation therapeutics in periodontics. Exclusion criteria included cross sectional studies, short case series as well as studies with short follow-up periods. There is a paucity of literature on HMT in periodontics although the only drug approved by United States Food and Drug Administration (FDA) is a subantimicrobial dose of doxycycline (SDD) with highly predictable results as a host modulating agent in periodontal diseases and also an effective adjunctive therapy in various diseases of periodontium. However, more randomized controlled trials are needed to obtain clinical guidelines on the usage of other host modulating agents as adjunct as well as definite therapy for periodontal diseases. SDD is an effective adjunct therapy when used in dosage of 20mg twice daily for minimum 3 months duration in various periodontal diseases with predictable clinical outcomes. It is also recommended that future clinical research on anti cytokine drugs, chemically modified tetracycline and other HMT agents should be conducted so that new drugs are available with highly predictable results.

  1. Risk of Porphyromonas gingivalis recolonization during the early period of periodontal maintenance in initially severe periodontitis sites.

    Science.gov (United States)

    Fujise, Osamu; Miura, Mayumi; Hamachi, Takafumi; Maeda, Katsumasa

    2006-08-01

    Porphyromonas gingivalis is considered a critical pathogen of periodontal diseases including recurrent periodontitis. The profound effects of active periodontal treatment (APT) on P. gingivalis elimination were previously demonstrated and revealed that the subsequent P. gingivalis-free or -suppressed status seems to be maintained during early periodontal maintenance (PMT). The aim of the present study was to show the occurrence of microbial recolonization during this early PMT period. In total, 128 sites from 11 generalized chronic periodontitis patients and one generalized aggressive periodontitis patient underwent clinical and microbiologic examination at baseline (Exam-I), after APT (Exam-II), and in PMT (Exam-III). Exam-III was carried out an average of 4.5 +/- 3.5 months after Exam-II. Detection and quantification of putative pathogens were performed using a polymerase chain reaction-based method. The PMT used was effective in maintaining the clinical conditions improved by APT. However, in microbiological examinations, Exam-III showed higher detection frequency and levels of P. gingivalis than Exam-II. This suggests that a P. gingivalis recolonization started in the early PMT period. P. gingivalis-increased sites then showed significantly more severe signs of periodontitis in Exam-I than P. gingivalis-stable sites (bleeding on probing frequency: 76.7% versus 56.5%; suppuration frequency: 41.9% versus 12.9%). On the other hand, in Exam-II, no significant differences of clinical parameters were noted between P. gingivalis-increased and -stable sites. Severe periodontitis sites before APT seemed to place them at risk of P. gingivalis recolonization in the early PMT period, and this microbial restoration could be a cause of recurrent periodontitis.

  2. Esthetic rehabilitation of complicated crown fractures utilizing rapid orthodontic extrusion and two different restoration modalities.

    Science.gov (United States)

    Milardovic Ortolan, Sladana; Strujic, Mihovil; Aurer, Andrej; Viskic, Josko; Bergman, Lana; Mehulic, Ketij

    2012-01-01

    This case report describes the management of a crown-root fractured maxillary right central incisor and a crown fractured maxillary left central incisor using two different techniques. A complex procedure was designed to manage this case including orthodontic extrusion to move the fracture line above the alveolar bone and surgical recontouring of the altered gingival margin. Finally, the right incisor was restored prosthodontically. Prosthetic treatment was based on performing a post and core, and all-ceramic crown on the extruded tooth. The left, less-damaged incisor was restored directly using composite resin. The treatment resulted in good esthetics and secured periodontal health. This case report demonstrates that a multidisciplinary treatment approach is a reliable and predictable option to save a tooth. How to cite this article: Ortolan SM, Strujic M, Aurer A, Viskic J, Bergman L, Mehulic K. Esthetic Rehabilitation of Complicated Crown Fractures Utilizing Rapid Orthodontic Extrusion and Two Different Restoration Modalities. Int J Clin Pediatr Dent 2012;5(1):64-67.

  3. Circulating interleukin-6 and high-sensitivity C-reactive protein decrease after periodontal therapy in otherwise healthy subjects.

    Science.gov (United States)

    Marcaccini, Andrea M; Meschiari, César A; Sorgi, Carlos A; Saraiva, Maria C P; de Souza, Ana M; Faccioli, Lúcia H; Tanus-Santos, José E; Novaes, Arthur B; Gerlach, Raquel F

    2009-04-01

    Periodontal disease has been associated with many chronic inflammatory systemic diseases, and a common chronic inflammation pathway has been suggested for these conditions. However, few studies have evaluated whether periodontal disease, in the absence of other known inflammatory conditions and smoking, affects circulating markers of chronic inflammation. This study compared chronic inflammation markers in control individuals and patients with periodontal disease and observed whether non-surgical periodontal therapy affected inflammatory disease markers after 3 months. Plasma and serum of 20 controls and 25 patients with periodontal disease were obtained prior to and 3 months after non-surgical periodontal therapy. All patients were non-smokers, they did not use any medication, and they had no history or detectable signs and symptoms of systemic diseases. Periodontal and systemic parameters included probing depth, bleeding on probing, clinical attachment level, hematologic parameters, as well as the following inflammatory markers: interleukin (IL)-6, high-sensitivity C-reactive protein (hs-CRP), CD40 ligand, monocyte chemoattractant protein (MCP)-1, soluble P-selectin (sP-selectin), soluble vascular adhesion molecule (sVCAM)-1, and soluble intercellular adhesion molecule (sICAM)-1. There were no differences in the hematologic parameters of the patients in the control and periodontal disease groups. Among the tested inflammatory markers, IL-6 concentrations were higher in the periodontal disease group at baseline compared to the controls (P = 0.006). Therapy was highly effective (P periodontal disease groups prior to the therapy (P = 0.009). In apparently otherwise healthy patients, periodontal disease is associated with increased circulating concentrations of IL-6 and hs-CRP, which decreased 3 months after non-surgical periodontal therapy. With regard to the CD40 ligand, MCP-1, sP-selectin, sVCAM-1, and sICAM-1, no changes were seen in the periodontal disease group

  4. Orthodontic treatment in patients with aggressive periodontitis.

    Science.gov (United States)

    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.

  5. Capping of the radicular exposed surface (part II). Surgical and not surgical treatment

    OpenAIRE

    Grados Pomarino, Sixto; Estrada, Andrew Alejandro; Maetahara Rubio, Denis Miguel; Guzmán Vera, Yanina Sara; Tello Barbarán, Javier

    2014-01-01

    The gingival recession treatment can be made surgical1y with a high predictability of success due to the great advance during the last ones of the mucogingival surgical techniques. The use of connective grafts in coverage of recessions has obtained high rates of success reason why these procedures are common within the modern periodontal surgical practice. Knowing that all patients do not accept the surgical treatment, many investigators have come studying the possibility of treating non-surg...

  6. [Chronic periodontitis with Takayasu arteritis: a case report].

    Science.gov (United States)

    Gao, Wei; Luan, Qing-xian

    2015-10-18

    This case report concerns a 23-year-old woman with chronic periodontitis who had been previously diagnosed with Takayasu arteritis (TA). Her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level were decreased before and 3 months after non-surgical periodontal therapy with no change in her prescribed medications (ESR from 31.00 mm/h to 23.0 mm/h, CRP from 21.40 mg/L to 18.46 mm/h). Through the occasional findings, we raised a hypothetical analysis about the potential relationship between periodontitis and TA with respect to inflammatory factors, bacteria and medication. Further studies of large samples are needed to verify the findings.

  7. 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.

  8. Use of minocycline as systemic antimicrobial therapy in refractory periodontitis with chronic gingival enlargement

    Directory of Open Access Journals (Sweden)

    Parag M Khatri

    2012-01-01

    Full Text Available Periodontal disease is a multifactorial disease having various risk factors, but a dynamic interaction between bacterial products and host response in association with genetic and environmental factors is considered as the primary cause for periodontal tissue destruction in periodontitis. This bacterial-host interaction which is ever-so-present in periodontitis directs us toward utilizing antimicrobial agents along with the routine mechanical debridement. This case report present a case of a female patient with recurrent periodontal infections with gingival enlargement treated with systemic Minocycline in conjunction with the conventional non-surgical approach.

  9. Use of minocycline as systemic antimicrobial therapy in refractory periodontitis with chronic gingival enlargement.

    Science.gov (United States)

    Khatri, Parag M; Kumar, Rajesh

    2012-01-01

    Periodontal disease is a multifactorial disease having various risk factors, but a dynamic interaction between bacterial products and host response in association with genetic and environmental factors is considered as the primary cause for periodontal tissue destruction in periodontitis. This bacterial-host interaction which is ever-so-present in periodontitis directs us toward utilizing antimicrobial agents along with the routine mechanical debridement. This case report present a case of a female patient with recurrent periodontal infections with gingival enlargement treated with systemic Minocycline in conjunction with the conventional non-surgical approach.

  10. Is obesity associated with healing after non-surgical periodontal therapy? A local vs. systemic evaluation.

    Science.gov (United States)

    Duzagac, E; Cifcibasi, E; Erdem, M G; Karabey, V; Kasali, K; Badur, S; Cintan, S

    2016-10-01

    We aimed to detect the role of obesity on the healing response to periodontal therapy in terms of serum lipids, C-reactive protein (CRP) and both serum and gingival crevicular fluid adipocytokines. Thirty patients with periodontitis with (CPO) (n = 15) and without (n = 15) obesity and 15 healthy controls were included. Serum high-density lipoprotein, low-density lipoprotein, triglyceride, CRP levels and levels of adiponectin, interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-10 were evaluated before and 3 mo after initial periodontal therapy. Clinical periodontal measurements were also recorded at baseline and 3 mo. Periodontal parameters improved significantly in both periodontitis groups with or without obesity (p 0.05) and change in numbers of sites with probing depth ≥ 4 mm. High-density lipoprotein significantly increased in both groups (p > 0.05). CRP decreased significantly solely in the normal weight group. IL-6, IL-10 and TNF-α levels in gingival crevicular fluid improved significantly based on therapy in both groups (p periodontitis without obesity. Patients with CPO respond to periodontal therapy as well as the non-obese controls. This similar response is accompanied with consistent adipokine levels in gingival crevicular fluid. However, obesity affects the CRP and serum adipocytokine levels in response to therapy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. An economic evaluation of a chlorhexidine chip for treating chronic periodontitis: the CHIP (chlorhexidine in periodontitis) study.

    Science.gov (United States)

    Henke, C J; Villa, K F; Aichelmann-Reidy, M E; Armitage, G C; Eber, R M; Genco, R J; Killoy, W J; Miller, D P; Page, R C; Polson, A M; Ryder, M I; Silva, S J; Somerman, M J; Van Dyke, T E; Wolff, L F; Evans, C J; Finkelman, R D

    2001-11-01

    The authors previously suggested that an adjunctive, controlled-release chlorhexidine, or CHX, chip may reduce periodontal surgical needs at little additional cost. This article presents an economic analysis of the CHX chip in general dental practice. In a one-year prospective clinical trial, 484 chronic periodontitis patients in 52 general practices across the United States were treated with either scaling and root planing, or SRP, plus any therapy prescribed by treating, unblinded dentists; or SRP plus other therapy as above but including the CHX chip. Economic data were collected from bills, case report forms and 12-month treatment recommendations from blinded periodontist evaluators. Total dental charges were higher for SRP + CHX chip patients vs. SRP patients when CHX chip costs were included (P = .027) but lower when CHX chip costs were excluded (P = .012). About one-half of the CHX chip acquisition cost was offset by savings in other charges. SRP + CHX chip patients were about 50 percent less likely to undergo surgical procedures than were SRP patients (P = .021). At the end of the trial, periodontist evaluators recommended similar additional procedures for both groups: SRP, about 46 percent; maintenance, about 37 percent; surgery, 56 percent for SRP alone and 63 percent for SRP + CHX chip. Adjunctive CHX chip use for general-practice patients with periodontitis increased costs but reduced surgeries over one year. At study's end, periodontists recommended similar additional surgical treatment for both groups. In general practice, routine use of the CHX chip suggests that costs will be partially offset by reduced surgery over at least one year.

  16. 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.

  17. Quo vadis: what is the future of periodontics? How will we get there?

    Science.gov (United States)

    Kornman, Kenneth S; Giannobile, William V; Duff, Gordon W

    2017-10-01

    Approximately 40 years ago periodontists began systematically developing the evidence to treat predictably and prevent gingivitis and periodontitis. More recently, periodontists have been among a small group of skilled dental-implant surgeons leading that revolution in dentistry. Today, much of the mild/localized moderate periodontitis is not treated by periodontists, and an increasing number of implants are placed by dentists with limited surgical training. The current field of periodontics includes a broad range of surgical skills and technologies to regenerate predictably destroyed tissues and manage complex interdisciplinary treatment that may, in some way, involve the tissues that support teeth and implants. In addition, periodontal researchers have shown that moderate-to-severe periodontitis increases the systemic inflammatory burden and transient bacteremias that result in a significant independent role for periodontitis in multiple systemic diseases. Although many periodontists have very advanced practices that incorporate certain aspects of the current and near-future dimensions of periodontics, the innovations and technologies have not yet fully integrated throughout the specialty. It is an appropriate time to ask the question: Quo vadis? Which paths have the potential to deliver great value to our patients and to the health-care system? And who will be our patients in the near future? We propose some key capabilities, knowledge and clinical applications. Perhaps most importantly, we propose new partnerships. Much of the vision centers around the application of special diagnostic technologies and surgical skills to help our dental colleagues better manage complex dental and periodontal cases and to deliver on the promise of reducing systemic inflammation sufficiently to enhance medical management of certain chronic diseases and reduce preterm births. The specialty has always been about retaining teeth in good health and in recent years has focused on

  18. Aesthetic Surgical Approach for Bone Dehiscence Treatment by Means of Single Implant and Interdental Tissue Regeneration: A Case Report with Five Years of Follow-Up

    Directory of Open Access Journals (Sweden)

    Giorgio Lombardo

    2016-01-01

    Full Text Available The replacement of single anterior teeth by means of endosseous implants implies the achievement of success in restoring both aesthetic and function. However, the presence of wide endoperiodontal lesions can lead to horizontal hard and soft tissues defects after tooth extraction, making it impossible to correctly place an implant in the compromised alveolar socket. Vertical augmentation procedures have been proposed to solve these clinical situations, but the amount of new regenerated bone is still not predictable. Furthermore, bone augmentation can be complicated by the presence of adjacent teeth, especially if they bring with them periodontal defects. Therefore, it is used to restore periodontal health of adjacent teeth before making any augmentation procedures and to wait a certain healing period before placing an implant in vertically augmented sites, otherwise risking to obtain a nonsatisfactory aesthetic result. All of these procedures, however, lead to an expansion of treatment time which should affect patient compliance. For this reason, this case report suggests a surgical technique to perform vertical bone augmentation at a single gap left by a central upper incisor while placing an implant and simultaneously to regenerate the periodontal attachment of an adjacent lateral incisor, without compromising the aesthetic result.

  19. [The supportive outcome of periodontal non-surgical therapy to severe chronic periodontitis accompanied with malformed lingual groove in lateral incisor for 6 years: a case report].

    Science.gov (United States)

    Li, Zheng; Kang, Jun

    2011-06-01

    To track the initiating and developing process of one case diagnosed as chronic periodontitis accompanied with malformed lingual groove in maxillary lateral incisor and report the long-term prognosis to the periodontal conservative and supportive therapy. The patient was diagnosed with mild chronic periodontitis 6 years ago and accepted routine periodontal scaling and root planning (SRP) plus supportive periodontal therapy (SPT) one time. Two years later the periodontal condition deteriorated by deep pockets in molars and severe bone destruction around the maxillary lateral incisor with malformed lingual groove. After SRP in sites which pocket depth more than 4mm plus root canal therapy and lingual groove plasty of maxillary right lateral incisor, the SPT regularly proceeded at 3rd, 6th and 12th month. At present the whole periodontal tissue was healthy, the bone lesion around maxillary lateral incisor recovered well, the tooth had no mobile, the cosmetic effect andtooth function was in good state, and the patient was very satisfied.

  20. Platelet-rich plasma and bi-phasic tri calcium phosphate in the management of periodontally compromised teeth with hopeless prognosis: A case report with six-year follow-up and surgical re-entry

    Directory of Open Access Journals (Sweden)

    Subramoniam Sundaram

    2014-01-01

    Full Text Available One of the main objectives of periodontal therapy is to prolong the lifespan of dentition as there is no ideal substitute for natural dentition even in the era of dental implants. Treatment of teeth with advanced periodontal disease with hopeless prognosis is always extraction. However in this case report, we discuss a novel regenerative strategy using a combination of platelet rich plasma and bi-phasic tri calcium phosphate for a lower central incisor that was considered for extraction. Clinical and radiographic examination during the six-year follow-up postoperatively revealed stable periodontal health in the lower right central incisor. The surgical re-entry done in the sixth year postoperatively revealed good periradicular healing and alloplastic bone graft incorporation within the host bone.

  1. Impact of chronic infections (periodontic and endodontic in implant dentistry

    Directory of Open Access Journals (Sweden)

    Bhumanapalli Venkata Ramesh Reddy

    2015-01-01

    Full Text Available Dental implant plays an important role in oral rehabilitation. In recent decades, the concept of restoratively driven implant placement has become well-accepted. Thus, an increasing number of patients, especially those with past or present periodontitis or with periapical infections, desire to receive dental implants to restore their lost teeth. This review discusses the relationship between chronic periodontal and periapical infections with periimplantitis, with a focus on implant outcome. The studies considered for the inclusion were searched in MEDLINE (pubmed. The search was restricted to studies published in English from 1980 to 2015. Screening of eligible studies and data extraction were carried out by the reviewers. The articles included in the review comprised in vitro studies, in vivo studies (animals and humans, abstracts, and review articles.

  2. Clinical considerations in restorative dentistry - A narrative review

    Directory of Open Access Journals (Sweden)

    Ashwini Tumkur Shivakumar

    2015-01-01

    Full Text Available The relationship between periodontal health and the restoration of teeth is intimate and inseparable. Human teeth are designed in such a way that the individual tooth contributes significantly to their own support as well as collectively the teeth in the arch. Decay on the proximal surfaces occurs mainly due to the faulty interrelationship between the contact area, marginal ridge, the embrasures and the gingiva. An adequate understanding of the relationship between periodontal tissues and restorative dentistry is paramount to ensure an adequate form, function, aesthetics and comfort of the dentition. For long-term survival of restoration, both functionally and esthetically, certain biological considerations are very critical to preserve the health of the periodontium and thus must be given due importance in clinical practice. While most clinicians are aware of this important relationship, uncertainly remains regarding specific concept such as biologic width and its maintainces.

  3. 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.

  4. Risk factors of chronic periodontitis on healing response: a multilevel modelling analysis.

    Science.gov (United States)

    Song, J; Zhao, H; Pan, C; Li, C; Liu, J; Pan, Y

    2017-09-15

    Chronic periodontitis is a multifactorial polygenetic disease with an increasing number of associated factors that have been identified over recent decades. Longitudinal epidemiologic studies have demonstrated that the risk factors were related to the progression of the disease. A traditional multivariate regression model was used to find risk factors associated with chronic periodontitis. However, the approach requirement of standard statistical procedures demands individual independence. Multilevel modelling (MLM) data analysis has widely been used in recent years, regarding thorough hierarchical structuring of the data, decomposing the error terms into different levels, and providing a new analytic method and framework for solving this problem. The purpose of our study is to investigate the relationship of clinical periodontal index and the risk factors in chronic periodontitis through MLM analysis and to identify high-risk individuals in the clinical setting. Fifty-four patients with moderate to severe periodontitis were included. They were treated by means of non-surgical periodontal therapy, and then made follow-up visits regularly at 3, 6, and 12 months after therapy. Each patient answered a questionnaire survey and underwent measurement of clinical periodontal parameters. Compared with baseline, probing depth (PD) and clinical attachment loss (CAL) improved significantly after non-surgical periodontal therapy with regular follow-up visits at 3, 6, and 12 months after therapy. The null model and variance component models with no independent variables included were initially obtained to investigate the variance of the PD and CAL reductions across all three levels, and they showed a statistically significant difference (P periodontal therapy with regular follow-up visits had a remarkable curative effect. All three levels had a substantial influence on the reduction of PD and CAL. Site-level had the largest effect on PD and CAL reductions.

  5. Assessment of restorative treatment of patients with amelogenesis imperfecta.

    Science.gov (United States)

    Chen, Chiung-Fen; Hu, Jan Ching Chun; Estrella, Maria Regina Padilla; Peters, Mathilde C; Bresciani, Eduardo

    2013-01-01

    The purpose of this study was to assess restorative treatment outcomes in the mixed dentition of amelogenesis imperfecta (AI) patients and determine the postrehabilitation oral health status and satisfaction of the patients. Clinical and radiographic examinations were performed on eight AI patients, who had 74 restorations placed in permanent incisors and molars, to allow evaluation of the integrity of the restorations and periodontal status post-treatment. Subjects completed a survey regarding esthetics, function, and sensitivity. Among the 74 restorations evaluated, seven were lost; of the remaining restorations, 31 were posterior, and 36 were anterior. Ten were rated clinically unacceptable. Teeth with stainless steel crowns had a moderate gingival index (mean=2.3) and plaque index (mean=2.0) scores. Widening of the periodontal ligament and pulp canal obliteration were common radiographic findings. Subject's recall of satisfaction regarding esthetics (P=.002) and sensitivity (brushing-P=.03; eating-P=.01) showed a statically significant difference before and after treatment. During mixed dentition, teeth with amelogenesis imperfecta may be restored with conventional treatment modalities. Direct restorations should be considered "interim" with multiple repairs anticipated. Post-treatment, gingival inflammation and plaque accumulation were observed. Subjects were satisfied with their appearance and reported a decrease of hypersensitivity.

  6. The use of the digital smile design concept as an auxiliary tool in periodontal plastic surgery.

    Science.gov (United States)

    Santos, Felipe Rychuv; Kamarowski, Stephanie Felice; Lopez, Camilo Andres Villabona; Storrer, Carmen Lucia Mueller; Neto, Alexandre Teixeira; Deliberador, Tatiana Miranda

    2017-01-01

    Periodontal surgery associated with prior waxing, mock-up, and the use of digital tools to design the smile is the current trend of reverse planning in periodontal plastic surgery. The objective of this study is to report a surgical resolution of the gummy smile using a prior esthetic design with the use of digital tools. A digital smile design and mock-up were used for performing gingival recontouring surgery. The relationship between the facial and dental measures and the incisal plane with the horizontal facial plane of reference were evaluated. The relative dental height x width was measured, and the dental contour drawing was inserted. Complementary lines are drawn such as the gingival zenith, joining lines of the gingival and incisal battlements. The periodontal esthetic was improved according to the established design digital smile pattern. These results demonstrate the importance of surgical techniques and are well accepted by patients and are easy to perform for the professional. When properly planned, they provide the desired expectations. Periodontal Surgical procedures associated with the design digital smile facilitate the communication between the patient and the professional. It is, therefore, essential to demonstrate the reverse planning of the smile and periodontal parameters with approval by the patient to solve the esthetic problem.

  7. Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics

    Science.gov (United States)

    Ioannou, Andreas L.; Kotsakis, Georgios A.; McHale, Michelle G.; Lareau, Donald E.; Hinrichs, James E.; Romanos, Georgios E.

    2015-01-01

    Implant dentistry has been established as a predictable treatment with excellent clinical success to replace missing or nonrestorable teeth. A successful esthetic implant reconstruction is predicated on two fundamental components: the reproduction of the natural tooth characteristics on the implant crown and the establishment of soft tissue housing that will simulate a healthy periodontium. In order for an implant to optimally rehabilitate esthetics, the peri-implant soft tissues must be preserved and/or augmented by means of periodontal surgical procedures. Clinicians who practice implant dentistry should strive to achieve an esthetically successful outcome beyond just osseointegration. Knowledge of a variety of available techniques and proper treatment planning enables the clinician to meet the ever-increasing esthetic demands as requested by patients. The purpose of this paper is to enhance the implant surgeon's rationale and techniques beyond that of simply placing a functional restoration in an edentulous site to a level whereby an implant-supported restoration is placed in reconstructed soft tissue, so the site is indiscernible from a natural tooth. PMID:26124837

  8. Advanced drug delivery approaches against periodontitis.

    Science.gov (United States)

    Joshi, Deeksha; Garg, Tarun; Goyal, Amit K; Rath, Goutam

    2016-01-01

    Periodontitis is an inflammatory disease of gums involving the degeneration of periodontal ligaments, creation of periodontal pocket and resorption of alveolar bone, resulting in the disruption of the support structure of teeth. According to WHO, 10-15% of the global population suffers from severe periodontitis. The disease results from the growth of a diverse microflora (especially anaerobes) in the pockets and release of toxins, enzymes and stimulation of body's immune response. Various local or systemic approaches were used for an effective treatment of periodontitis. Currently, controlled local drug delivery approach is more favorable as compared to systemic approach because it mainly focuses on improving the therapeutic outcomes by achieving factors like site-specific delivery, low dose requirement, bypass of first-pass metabolism, reduction in gastrointestinal side effects and decrease in dosing frequency. Overall it provides a safe and effective mode of treatment, which enhances patient compliance. Complete eradication of the organisms from the sites was not achieved by using various surgical and mechanical treatments. So a number of polymer-based delivery systems like fibers, films, chips, strips, microparticles, nanoparticles and nanofibers made from a variety of natural and synthetic materials have been successfully tested to deliver a variety of drugs. These systems are biocompatible and biodegradable, completely fill the pockets, and have strong retention on the target site due to excellent mucoadhesion properties. The review summarizes various available and recently developing targeted delivery devices for the treatment of periodontitis.

  9. 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.

  10. Palatal radicular groove: Clinical implications of early diagnosis and surgical sealing

    Directory of Open Access Journals (Sweden)

    P Corrêa-Faria

    2011-01-01

    Full Text Available Palatal radicular groove is a discreet alteration in tooth morphology, characterized by an invagination that begins near the cingulum of the tooth and moves in an apical direction. Clinically, palatal radicular groove may be associated with periodontal and/or endodontic problems. This paper describes a clinical case of a young patient with palatal radicular groove with no signs of periodontal disease or endodontic impairment. An early diagnosis was made and treatment consisted of surgical sealing of the defect. After a 2-year period, reexaminations demonstrated adequate hygiene, maintenance of tooth vitality and periodontal health. The early diagnosis and sealing of the groove observed surgically made the root surface smooth, avoiding subgingival bacterial plaque buildup, and preventing possible periodontal and/or pulp impairment stemming from the defect.

  11. Diagnosis and management of periodontal disease in children and adolescents: A brief review

    Directory of Open Access Journals (Sweden)

    Vineet Kini

    2016-01-01

    Full Text Available Periodontal disease when occurring in children leads to premature tooth loss, affecting the quality of life. Thus, screening pediatric and adolescent patients early, for periodontal disease is deemed imperative to its early management for improved prognosis. Chronic periodontitis (CP has slow rate of progression, whereas aggressive periodontitis (AP affecting children and young adults has rapid rate of progression. The management of AP in particular is affected by bacterial virulence of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis in plaque leading to rapid attachment and bone loss around the affected teeth. Nonsurgical treatment, use of appropriate antimicrobial therapy, and surgical correction of defects is required to mitigate disease followed by a comprehensive supportive periodontal therapy. This review visits the current understanding of periodontal disease, its management in pediatric and adolescent patients.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Multidisciplinary management of concomitant pulpal and periodontal lesion: A case report

    Directory of Open Access Journals (Sweden)

    Mustafa A. Al Attas, DDS

    2017-10-01

    Full Text Available In this case report, the management of a concomitant endodontic-periodontal lesion case is described. A 31-year-old patient presented with symptomatic apical periodontitis of tooth #36 due to failed endodontic treatment and a generalized aggressive periodontitis. Following full-mouth scaling and root-planing, a root-canal retreatment (tooth #36 was initiated. While the distal and mesio-buccal canals were successfully treated, a transportation perforation of the mesio-lingual canal occurred and was repaired by the MTA. An apical microsurgery of the mesial root combined with surgical periodontal debridement for the lower left quadrant was performed. Three weeks later, resective and regenerative periodontal surgeries of the other 3 quadrants were accomplished. Because of the 6-month post-operative healing, the regenerative periodontal surgery for the lower-left quadrant was performed. The 6-month post-operative recall showed complete healing of the mesial root lesion and reduction of the distal root lesion. The multidisciplinary approach and advanced armamentarium contributed to favourable outcome.

  14. MANAGEMENT OF MANDIBULAR THIRD MOLAR SURGERY TO PRESERVE PERIODONTAL HEALTH OF SECOND MOLAR

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2017-06-01

    Full Text Available Background: Extraction of impacted third molar violates surrounding soft and bony tissues. Various surgical approaches and surgical technics have an important impact on the periodontal health of the adjacent second molar. Purpose: The aim of this review is to analyse the causes that can affect postoperative periodontal outcomes for the mandibular second molars (LM2 adjacent to the impacted/ semi impacted mandibular third molars (LM3. Material and Methods: Electronic searches were conducted through the MEDLINE (PubMed, Scopus, etc. databases to screen all relevant articles published from inception to April 2017. Results: Different flap techniques had no significant impact on the probing depth reduction or on the clinical attachment level of LM2. Szmyd and paramarginal flap designs may be the most effective in reducing the probing depth after third molar surgery, and the envelope flap may be the least effective. Use of bone substitutes and guided tissue regeneration therapy has been proposed, to eliminate or prevent these periodontal defects, but there is still no consensus on their predictability or clinical benefit. Higher costs and the risk of postoperative inflammatory complications should also be taken into proper account, as with any surgical procedure. “Orthodontic extraction” is indicated for that impacted M3 that present a high risk of postoperative periodontal defects at the distal aspect of adjacent M2. Conclusion: Risk factors associated with bone loss following lower third molar extraction includes age, the direction of the eruption, preoperative bone defects, and resorbtion of the LM2 root surface. Prevention of such periodontal defects continues to challenge clinicians.

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

    Science.gov (United States)

    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

  16. Development of formulation device for periodontal disease.

    Science.gov (United States)

    Sato, Yasuhiko; Oba, Takuma; Watanabe, Norio; Danjo, Kazumi

    2012-01-01

    In addition to providing standard surgical treatment that removes the plaque and infected tissues, medications that can regenerate periodontal tissue are also required in the treatment of periodontal disease. As a form of regenerative medication, various growth factors are expected to be used while treating periodontal disease. A protein-like growth factor is often developed as a lyophilized product with dissolution liquid, considering its instability in the solution state. We have clarified that the formulation for periodontal disease needs to be viscous. When the lyophilized product was dissolved using a sticky solution, various problems were encountered, difficulty in dissolving and air bubbles, for example, and some efforts were needed to prepare the formulation. In this research, to identify the problem of preparing a viscous formulation, a lyophilized product (placebo) and sticky liquid were prepared by using vial and ampoule as the conventional containers. Based on these problems, a prototype administration device was developed, and its functionality was confirmed. As a result, it was suggested that the device with a useful mixing system that could shorten the preparation time was developed.

  17. 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.

  18. Gene expression in periodontal tissues following treatment

    Directory of Open Access Journals (Sweden)

    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

  19. 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.

  20. 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.

  1. Impact of the level of metabolic control on the non-surgical periodontal therapy outcomes in diabetes mellitus type 2 patients: Clinical effects

    Directory of Open Access Journals (Sweden)

    Mirnić Jelena

    2013-01-01

    Full Text Available Introduction. Diabetes mellitus as a complex metabolic disease influences functioning of numerous organs. Chronic periodontitis is one of frequent diabetic complications. Objective. The aim of this study was to compare the clinical effects of non­surgical periodontal therapy between diabetes mellitus type 2 patients (DM type 2 and non­diabetic individuals (control group. Methods. Our study included 41 DM type 2 subjects and 21 non­diabetic individuals, all of them with chronic periodontitis. The diabetic group was divided into two subgroups based on the level of glycosylated hemoglobin (HbA1c as follows: D1 - 18 subjects with good metabolic control (HbA1c<7%, and D2 - 23 subjects with poor metabolic (HbA1c≥7%. State of oral hygiene and periodontal clinical parameters of subjects, such as: plaque index (PI, gingival index (GI, papilla bleeding index (PBI, probing pocket depth (PPD and clinical attachment level (CAL, were evaluated at the baseline and 3 months after scaling and root­planning. Results. ANOVA test showed that there was no statistically significant difference of treatment success between studied groups in relation to GI (p=0.52, PBI (p=0.36 and CAL (p=0.11. Reduction of PI and PPD in the control group (ΔPI=0.84; ΔPPD=0.35 mm was significantly higher (p<0.05 than the reduction of PI and PPD in patients with the diabetes (group D1 ΔPI=0.60, ΔPPD=0.11 mm; group D2 ΔPI=0.53, ΔPPD=0.11 mm. Conclusion. Although there were differences in treatment success between DM subjects and non­diabetic individuals, they were not significant for the most measured parameters. The results of this study did not absolutely support the assumption that the level of glycemic control significantly affected the periodontal therapy outcome in diabetics. [Projekat Ministarstva nauke Republike Srbije, br. 175075

  2. 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.

  3. On the causes of persistent apical periodontitis: a review.

    Science.gov (United States)

    Nair, P N R

    2006-04-01

    Apical periodontitis is a chronic inflammatory disorder of periradicular tissues caused by aetiological agents of endodontic origin. Persistent apical periodontitis occurs when root canal treatment of apical periodontitis has not adequately eliminated intraradicular infection. Problems that lead to persistent apical periodontitis include: inadequate aseptic control, poor access cavity design, missed canals, inadequate instrumentation, debridement and leaking temporary or permanent restorations. Even when the most stringent procedures are followed, apical periodontitis may still persist as asymptomatic radiolucencies, because of the complexity of the root canal system formed by the main and accessory canals, their ramifications and anastomoses where residual infection can persist. Further, there are extraradicular factors -- located within the inflamed periapical tissue -- that can interfere with post-treatment healing of apical periodontitis. The causes of apical periodontitis persisting after root canal treatment have not been well characterized. During the 1990s, a series of investigations have shown that there are six biological factors that lead to asymptomatic radiolucencies persisting after root canal treatment. These are: (i) intraradicular infection persisting in the complex apical root canal system; (ii) extraradicular infection, generally in the form of periapical actinomycosis; (iii) extruded root canal filling or other exogenous materials that cause a foreign body reaction; (iv) accumulation of endogenous cholesterol crystals that irritate periapical tissues; (v) true cystic lesions, and (vi) scar tissue healing of the lesion. This article provides a comprehensive overview of the causative factors of non-resolving periapical lesions that are seen as asymptomatic radiolucencies post-treatment.

  4. Effect of hyaluronan on periodontitis: A clinical and histological study

    Directory of Open Access Journals (Sweden)

    Gauri Gontiya

    2012-01-01

    Full Text Available Background: Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL® as an adjunct to scaling and root planing (SRP in chronic periodontitis patients. Materials and Methods: One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm. Experimental sites additionally received HA gel subgingivally at baseline, 1 st , 2 nd , and 3 rd week. Clinical parameters were re-assessed at 4 th , 6 th , and 12 th week. At 4 th week recall, a gingival biopsy was obtained from test and control site for histologic examination. Results: Intra-group analysis of all the clinical parameters at all sites from baseline to 4 th , 6 th , and 12 th week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6 th and 12 th week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4 th , 6 th , and 12 th week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment. Conclusion: Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant.

  5. 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.

  6. Maxillary sinusitis and periapical abscess following periodontal therapy: a case report using three-dimensional evaluation.

    Science.gov (United States)

    Huang, Chih-Hao; Brunsvold, Michael A

    2006-01-01

    Maxillary sinusitis may develop from the extension of periodontal disease. In this case, reconstructed three-dimensional images from multidetector spiral computed tomographs were helpful in evaluating periodontal bony defects and their relationship with the maxillary sinus. A 42-year-old woman in good general health presented with a chronic deep periodontal pocket on the palatal and interproximal aspects of tooth #14. Probing depths of the tooth ranged from 2 to 9 mm, and it exhibited a Class 1 mobility. Radiographs revealed a close relationship between the root apex and the maxillary sinus. The patient's periodontal diagnosis was localized severe chronic periodontitis. Treatment of the tooth consisted of cause-related therapy, surgical exploration, and bone grafting. A very deep circumferential bony defect at the palatal root of tooth #14 was noted during surgery. After the operation, the wound healed without incidence, but 10 days later, a maxillary sinusitis and periapical abscess developed. To control the infection, an evaluation of sinus and alveolus using computed tomographs was performed, systemic antibiotics were prescribed, and endodontic treatment was initiated. Two weeks after surgical treatment, the infection was relieved with the help of antibiotics and endodontic treatment. Bilateral bony communications between the maxillary sinus and periodontal bony defect of maxillary first molars were shown on three-dimensional computed tomographs. The digitally reconstructed images added valuable information for evaluating the periodontal defects. Three-dimensional images from spiral computed tomographs (CT) aided in evaluating and treating the close relationship between maxillary sinus disease and adjacent periodontal defects.

  7. Evaluation of the Prevalence of Different Treatment Failure Modes after Crown Lengthening Surgical Procedures

    Directory of Open Access Journals (Sweden)

    Amirreza Babaloo

    2016-07-01

    Full Text Available Introduction: Preservation of the health of periodontium is very important for the long-term success of restored teeth and a balance should always be created between the patients’ esthetic requirements and the periodontal health. Failures of crown lengthening procedures are classified into early and late failures. The aim of this study was to evaluate the prevalence of early failures of crown leathering surgical procedures. Materials and methods: In this descriptive/cross-sectional study, 96 patients were selected from those referring to the Department of Periodontitis, Tabriz Faculty of Dentistry, who required crown lengthening procedures. The particulars of these patients were recorded in special forms and the reasons for the failure of surgical procedures were separately determined at 2- and 6-week intervals. In addition, the frequencies of the reasons for failures were determined in percentages and absolute frequencies. Data were analyzed with descriptive statistics (frequencies and percentages using SPSS 21. Statistical significance was set at P<0.05. Results: Evaluation of patients 6 weeks after surgery showed a failure rate of 14.5% for crown lengthening procedures in patients referring to the Department of Periodontics, Tabriz Faculty of Dentistry. The most common reasons for such early failures in the 6th week, in descending order, were a lack of sufficient keratinized gingiva around in tooth in question, fracture of the tooth structure after surgery, inadequate surgery (not creating a proper distance between the healthy margin and the crest and the coronal returning of the gingival tissue on the tooth. A lack of sufficient keratinized gingiva around the tooth was the most frequent reason for the early failure of crown lengthening procedure at both study intervals. Conclusion: It can be concluded from the results of the present study that during the 6th postoperative week the crown lengthening procedures exhibited a 14.5% failure rate

  8. Recurrent periodontal abscess associated with “teeth as a tool”

    OpenAIRE

    Bhat, G. Subraya; Singh, Vishal; Bhat, K. Mahalinga

    2012-01-01

    We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertak...

  9. 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.

  10. 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.

  11. PAR-2 expression in the gingival crevicular fluid reflects chronic periodontitis severity

    Directory of Open Access Journals (Sweden)

    Henrique FUKUSHIMA

    Full Text Available Abstract Recent studies investigating protease-activated receptor type 2 (PAR-2 suggest an association between the receptor and periodontal inflammation. It is known that gingipain, a bacterial protease secreted by the important periodontopathogen Porphyromonas gingivalis can activate PAR-2. Previous studies by our group found that PAR-2 is overexpressed in the gingival crevicular fluid (GCF of patients with moderate chronic periodontitis (MP. The present study aimed at evaluating whether PAR-2 expression is associated with chronic periodontitis severity. GCF samples and clinical parameters, including plaque and bleeding on probing indices, probing pocket depth and clinical attachment level, were collected from the control group (n = 19 at baseline, and from MP patients (n = 19 and severe chronic periodontitis (SP (n = 19 patients before and 6 weeks after periodontal non-surgical treatment. PAR-2 and gingipain messenger RNA (mRNA in the GCF of 4 periodontal sites per patient were evaluated by Reverse Transcription Polymerase Chain Reaction (RT-qPCR. PAR-2 and gingipain expressions were greater in periodontitis patients than in control group patients. In addition, the SP group presented increased PAR-2 and gingipain mRNA levels, compared with the MP group. Furthermore, periodontal treatment significantly reduced (p <0.05 PAR-2 expression in patients with periodontitis. In conclusion, PAR-2 is associated with chronic periodontitis severity and with gingipain levels in the periodontal pocket, thus suggesting that PAR-2 expression in the GCF reflects the severity of destruction during periodontal infection.

  12. PAR-2 expression in the gingival crevicular fluid reflects chronic periodontitis severity.

    Science.gov (United States)

    Fukushima, Henrique; Alves, Vanessa Tubero Euzebio; Carvalho, Verônica Franco de; Ambrósio, Lucas Macedo Batitucci; Eichler, Rosangela Aparecida Dos Santos; Carvalho, Maria Helena Catelli de; Saraiva, Luciana; Holzhausen, Marinella

    2017-01-26

    Recent studies investigating protease-activated receptor type 2 (PAR-2) suggest an association between the receptor and periodontal inflammation. It is known that gingipain, a bacterial protease secreted by the important periodontopathogen Porphyromonas gingivalis can activate PAR-2. Previous studies by our group found that PAR-2 is overexpressed in the gingival crevicular fluid (GCF) of patients with moderate chronic periodontitis (MP). The present study aimed at evaluating whether PAR-2 expression is associated with chronic periodontitis severity. GCF samples and clinical parameters, including plaque and bleeding on probing indices, probing pocket depth and clinical attachment level, were collected from the control group (n = 19) at baseline, and from MP patients (n = 19) and severe chronic periodontitis (SP) (n = 19) patients before and 6 weeks after periodontal non-surgical treatment. PAR-2 and gingipain messenger RNA (mRNA) in the GCF of 4 periodontal sites per patient were evaluated by Reverse Transcription Polymerase Chain Reaction (RT-qPCR). PAR-2 and gingipain expressions were greater in periodontitis patients than in control group patients. In addition, the SP group presented increased PAR-2 and gingipain mRNA levels, compared with the MP group. Furthermore, periodontal treatment significantly reduced (p periodontitis. In conclusion, PAR-2 is associated with chronic periodontitis severity and with gingipain levels in the periodontal pocket, thus suggesting that PAR-2 expression in the GCF reflects the severity of destruction during periodontal infection.

  13. Frequency of gingival and periodontal diseases among troops deployed in operational area

    International Nuclear Information System (INIS)

    Yousaf, A.; Manzoor, M.A.; Rafi, S.

    2014-01-01

    Objective: To find the Frequency of Gingival and Periodontal Diseases among Troops Deployed in Operational Area and to evaluate the treatment needs which might be helpful in oral health policy planning and specific intervention against periodontal disease. Design: Descriptive study. Place and Duration of Study: The study was conducted at 140 mobile dental unit Swat from Dec 2009 to June 2011. Subjects and Methods: the periodontal status of 1500 personnels of Pakistan Army was examined using Basic periodontal Examination Index. Data was evaluated by SPSS version 16. Percentage of various gingival and periodontal disease traits was calculated and treatment needs determined. Results: Out of total 1500 subjects 12.8% subjects were having satisfactory periodontal health and required no treatment whereas 38.3% were having gingivitis requiring oral hygiene instruction and prophylaxis. Gingivitis modified by local factors was seen in 23.5% and required oral hygiene instruction and correction of modifying factors. Some (13.6%) were having mild periodontitis and required scaling, root planning and oral hygiene instruction whereas 11.8% were having moderate or advance periodontitis and required comprehensive periodontal treatment including surgical treatment. Conclusion: A large number of cases (82.7%) of gingivitis and periodontitis were detected in subject population which shows lack of awareness and self -consciousness among troops regarding their oral hygiene. (author)

  14. Determining the relationship between atherosclerosis and periodontopathogenic microorganisms in chronic periodontitis patients.

    Science.gov (United States)

    Bozoglan, Alihan; Ertugrul, Abdullah Seckin; Taspınar, Mehmet; Yuzbasioglu, Betul

    2017-05-01

    The aim of this study is to determine the relationship between atherosclerosis and periodontopathogenic microorganisms in chronic periodontitis patients following periodontal treatment. A total of 40 patients were included in the study. 20 of these patients diagnosed with atherosclerosis and chronic periodontitis formed the test group. The remaining 20 patients were systemically healthy patients diagnosed with chronic periodontitis and formed the control group. All patients had nonsurgical periodontal treatment. The periodontopathogenic microorganism levels were determined at baseline and at 6 months in microbial dental plaque samples and WBC, LDL, HDL, PLT, fibrinogen, creatinine and hs-CRP levels were determined by blood samples. Statistically significant reduction has been achieved in clinical periodontal parameters following non-surgical periodontal treatment in test and control groups. Following periodontal treatment, WBC, LDL, PLT, fibrinogen, creatinine and hs-CRP levels significantly decreased and HDL levels significantly increased in both test and control groups. Similarly, the periodontopathogenic microorganism levels significantly decreased following periodontal treatment in the test and control groups. A statistically significant positive correlation has been determined between the periodontopathogenic microorganism levels and WBC, LDL, PLT, fibrinogen, creatinine, and hs-CRP levels in the test group. The association between hs-CRP, WBC, LDL, PLT, fibrinogen, creatinine, and the amount of periodontopathogenic microorganisms indicates the possibility that periodontal treatment could decrease the risk atherosclerosis. More studies must be conducted in order for these results to be supported.

  15. 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.

  16. Antibiotic Susceptibility of Periodontal Streptococcus Constellatus and Streptococcus Intermedius Clinical Isolates

    NARCIS (Netherlands)

    Rams, Thomas E; Feik, Diane; Mortensen, Joel E; Degener, John E; van Winkelhoff, Arie J

    2014-01-01

    Background: Streptococcus constellatus and Streptococcus intermedius in subgingival dental plaque biofilms may contribute to forms of periodontitis that resist treatment with conventional mechanical root debridement/surgical procedures and may additionally participate in some extraoral infections.

  17. 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

  18. Novel application of stem cell-derived factors for periodontal regeneration

    International Nuclear Information System (INIS)

    Inukai, Takeharu; Katagiri, Wataru; Yoshimi, Ryoko; Osugi, Masashi; Kawai, Takamasa; Hibi, Hideharu; Ueda, Minoru

    2013-01-01

    Highlights: ► Mesenchymal stem cells (MSCs) secrete a variety of cytokines. ► Cytokines were detected in conditioned medium from cultured MSCs (MSC-CM). ► MSC-CM enhanced activation of dog MSCs and periodontal ligament cells. ► MSC-CM significantly promoted alveolar bone and cementum regeneration. ► Multiple cytokines contained in MSC-CM promote periodontal regeneration. -- Abstract: The effect of conditioned medium from cultured mesenchymal stem cells (MSC-CM) on periodontal regeneration was evaluated. In vitro, MSC-CM stimulated migration and proliferation of dog MSCs (dMSCs) and dog periodontal ligament cells (dPDLCs). Cytokines such as insulin-like growth factor, vascular endothelial growth factor, transforming growth factor-β1, and hepatocyte growth factor were detected in MSC-CM. In vivo, one-wall critical-size, intrabony periodontal defects were surgically created in the mandible of dogs. Dogs with these defects were divided into three groups that received MSC-CM, PBS, or no implants. Absorbable atelo-collagen sponges (TERUPLUG®) were used as a scaffold material. Based on radiographic and histological observation 4 weeks after transplantation, the defect sites in the MSC-CM group displayed significantly greater alveolar bone and cementum regeneration than the other groups. These findings suggest that MSC-CM enhanced periodontal regeneration due to multiple cytokines contained in MSC-CM.

  19. Prevalence of human papilloma virus in marginal periodontium and its association with periodontitis: A cross sectional study.

    Science.gov (United States)

    Jacob, Anila; Janam, Presanthila; Babu Vijayamma, Janki Mohan

    2014-07-01

    Bacterial pathogens in dental plaque are necessary for the development of periodontitis but this etiology alone does not explain all its clinicopathologic features. Researchers have proven the role of certain viruses like herpes virus in periodontal disease which implies that other viral agents like human papilloma virus may also be involved. This cross-sectional study was conducted to determine the proportion of patients with human papilloma virus (HPV-16) in marginal periodontium by analyzing DNA from the gingival tissue sample and to understand its association with periodontitis. 102 systemically healthy patients between the age group of 15 and 70 years reporting to the Department of Periodontology who required surgical intervention (flap surgery for patients with periodontitis and crown lengthening for healthy patients) with internal bevel gingivectomy were selected. After scaling and root planning, gingival tissue was collected during the respective surgical procedure. DNA was isolated and amplified using specific primers for HPV-16 by polymerase chain reaction (PCR). The amplified products were checked by agarose gel electrophoresis. No HPV DNA was detected in the 102 samples analyzed. Marginal periodontium does not contain HPV in this study population and hence there was no association between HPV and periodontitis.

  20. The effect of periodontal therapy on cardiovascular risk markers: a 6-month randomized clinical trial.

    Science.gov (United States)

    Caúla, André Luis; Lira-Junior, Ronaldo; Tinoco, Eduardo Muniz Barretto; Fischer, Ricardo Guimarães

    2014-09-01

    To determine the influence of non-surgical mechanical periodontal treatment on inflammatory markers related to risk for cardiovascular disease. A total of 64 patients with severe chronic periodontitis was randomly subjected to immediately periodontal treatment (test group, n = 32) or delayed periodontal treatment, without treatment during the study period (control group, n = 32). Clinical periodontal and laboratory examinations were performed at baseline (T0), 2 months (T2), and 6 months (T6) after the initial examinations (Control group) or completion of periodontal treatment (Test group). After 2 months of periodontal treatment there was a significant reduction of erythrocyte sedimentation rate (ESR) and triglycerides (p = 0.002, p = 0.004, respectively) in the test group. Median values of C-reactive protein, ESR, total cholesterol, and triglycerides were reduced after 6 month of periodontal treatment in the test group (p periodontal treatment was effective in reducing the levels of systemic inflammation markers and improved the lipid profile in subjects with severe chronic periodontitis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Treatment of Gingival Recessions Associated to Cervical Abrasion Lesions with Subepithelial Connective Tissue Graft: A Case Report

    Science.gov (United States)

    Deliberador, Tatiana M.; Bosco, Alvaro F.; Martins, Thiago M.; Nagata, Maria J. H.

    2009-01-01

    Extensive gingival recessions associated with cervical abrasions are common among the population. Several different surgical and/or restorative therapies have been proposed to correct these lesions. This manuscript reports the treatment of multiple gingival recessions associated to cervical abrasions. The procedure involved the utilization of subepithelial connective tissue graft (SCTG) combined with coronally advanced flap onto a previously restored root surface. At the postoperative follow-up visits, the success of the restorative/surgical approach was confirmed by the absence of bleeding to probing and periodontal pockets as well as presence of gingival tissue with normal color, texture and contouring. After 18 months of follow-up, the clinical conditions are stable with satisfactory root coverage and periodontal health. An excellent esthetical outcome was achieved and the patient is satisfied with case resolution. PMID:19826605

  2. Intraosseous anesthesia using a computer-controlled system during non-surgical periodontal therapy (root planing): Two case reports.

    Science.gov (United States)

    Han, Keumah; Kim, Jongbin

    2018-02-01

    Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.

  3. Surgery for ventricular tachycardia in patients undergoing surgical ventricular restoration: the Karolinska approach.

    Science.gov (United States)

    Sartipy, Ulrik; Albåge, Anders; Insulander, Per; Lindblom, Dan

    2007-09-01

    This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical guide to the pre- and postoperative management of these patients is provided.

  4. The Role of Low-Level Laser in Periodontal Surgeries

    Science.gov (United States)

    Sobouti, Farhad; Khatami, Maziar; Heydari, Mohaddase; Barati, Maryam

    2015-01-01

    Treatment protocols with low-level Laser (also called ‘soft laser therapy) have been used in health care systems for more than three decades. Bearing in mind the suitable sub-cellular absorption and the cellular-vascular impacts, low-level laser may be a treatment of choice for soft tissues. Low-level lasers have played crucial and colorful roles in performing periodontal surgeries. Their anti-inflammatory and painless effects have been variously reported in in-vitro studies. In this present review article, searches have been made in Pub Med, Google Scholar, and Science Direct, focusing on the studies which included low-level lasers, flap-periodontal surgeries, gingivectomy, and periodontal graft. The present study has sought to review the cellular impacts of low-level lasers and its role on reducing pain and inflammation following soft tissue surgical treatments. PMID:25987968

  5. Esthetic periodontal surgery for impacted dilacerated maxillary central incisors.

    Science.gov (United States)

    Wei, Yu-Ju; Lin, Yi-Chun; Kaung, Shou-Shin; Yang, Shue-Fen; Lee, Shyh-Yuan; Lai, Yu-Lin

    2012-10-01

    Clinicians do not frequently see impacted dilacerated maxillary incisors in their patients. When they do, there are several diagnostic and management challenges for correcting root dilacerations. An unfavorable esthetic outcome might occur as a result of soft-tissue complications during surgical eruption procedures. We present 2 patients with an impacted and dilacerated maxillary central incisor. Computed tomography scans with 3-dimensional reformation were used to accurately assess the positions of the dilacerated teeth, the degree of dilaceration, and the stage of root formation. The therapy primarily involved 2-stage crown exposure surgery combined with orthodontic traction. An apicoectomy was performed on 1 dilacerated tooth; the other exhibited pulp vitality. This article highlights the periodontal surgical strategies for the esthetic management of inverted crowns. Through periodontal plastic surgery and interdisciplinary cooperation, the impacted dilacerated central incisors were properly aligned, and successful esthetic results were achieved. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  6. 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.

  7. Assessment of periodontal status following the alignment of impacted permanent maxillary canine teeth.

    Science.gov (United States)

    Szarmach, I J; Szarmach, J; Waszkiel, D; Paniczko, A

    2006-01-01

    The aim of the study was to assess the effect of orthodontic movement of the impacted canines after surgical exposure and alignment on the periodontal status of the transpositioned and adjacent teeth as well as to compare certain parameters with those of spontaneously erupted teeth. Twenty-four patients (mean age 18.4 +/- 3.66) with unilaterally impacted 24 canines were enrolled in the study. The following parameters were assessed: pocket depth (PD), clinical attachment level (CAL), platelet index (PI) of Silness and Löe, and modified sulcus bleeding index (SBI). Optic density of the alveolar bone along the root surface of the aligned canine was analysed based on digital radiological images made with the right angle technique. Control group consisted of spontaneously erupted teeth. In comparison to the control group, in the orthodonticaly treated group PD was found to increase on the mesial buccal and palatal surfaces of the first premolar (p aligned canine (p aligned tooth were statistically significant (p alignment zone and the control, and there was no link between the method of treatment and periodontal status, either. The alignment of the impacted permanent maxillary canines poses a risk of periodontal deterioration. Patients subjected to surgical-orthodontic treatment require periodic periodontal follow-ups.

  8. 10-year prospective cohort follow-up of immediately restored XiVE implants.

    Science.gov (United States)

    Degidi, Marco; Nardi, Diego; Piattelli, Adriano

    2016-06-01

    The aim of this prospective cohort study was to assess the ten-year performance of the condensing thread, self-tapping apex and internal hexagonal connection XiVE implant supporting partial fixed prostheses placed with an immediate restoration approach. All patients received a fixed two- to four-unit partial provisional restoration supported by immediately loaded implants. The final gold alloy/ceramic restorations were cemented approximately 28 weeks after implant insertion. Marginal bone level, pocket probing depth and percentage of bleeding on probing, biological or technical complications and any other adverse events were measured annually up to ten years after surgery. The overall success and survival rates at implant level were evaluated following the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference criteria. Implant placement in post-extractive or healed sites, smoking and a history of periodontal treatment were evaluated to assess whether they had an influence on bone resorption or on implant survival. Of 114 patients, for a total of 284 implants, fulfilled all the inclusion criteria and were enrolled in the study. 78 (27.5%) implants placed in 30 (26.3%) patients were lost to follow-up. Eight of 284 (2.8%) implants failed in 8 of 114 (7.0%) patients: one (12.5% of losses) due to failure to achieve osseointegration and seven (87.5% of losses) due to peri-implantitis. No cluster implant failures were assessed. The failure of the implant caused the failure of the prosthesis due to the strategic position of the implant in four patients. At the final ten-year follow-up, 121 (61.4%) implants exhibited a "full success" status with an optimal health condition, 21 (10.9%) implants scored a "satisfactory survival" condition, while 49 (25.49%) of the implants were classified as "compromised survival" status (Misch et al. 2008). Smoking was found to be statistically associated with "implant failure" (P = 0.010), while no association

  9. Importance of orthodontic movement in interdisciplinary treatment for restoring esthetics and functional occlusion

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Guimarães

    2015-01-01

    Full Text Available This article describes interdisciplinary treatment conducted in adult patients, 49-year-old, with periodontal problems, losses and dental inclination, occlusal trauma, localized bone loss, and necessity of rehabilitation with dental implants. Alignment and leveling of the teeth, the molars uprighting with cantilever, and space closure were performed the treatment was facilitated by periodic periodontal control. The resultant occlusion was stable throughout a 5-year retention period. In conclusion, interdisciplinary treatment combined with periodontics, orthodontics, implantodontist, and restorative dentistry was useful for improving the patient′s oral health, function, and esthetics.

  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. The two-way relationship between iatrogenic factor and periodontal tissues

    Directory of Open Access Journals (Sweden)

    Sri Oktawati

    2016-06-01

    Full Text Available Iatrogenic factors refer to anyinadequate medical treatment or diagnostic proceduresconducted inadvertently by practitioners who precipitate adverse injuries or symptoms. The unavoidable consequences of these factors should be corrected promptly, as they may result in erroneous treatment or new injury either on the tooth or the periodontium or both. Periodontal disease has a multifactorial etiology, which results from the interaction of local and systemic factors, intrinsically or extrinsically. Therefore, in most cases of periodontal disease, aninterdisciplinary approach is needed, such as restorative treatment of interproximal cavities that may induced food impacted. In contrary, a periodontal therapy could also act as an iatrogenic factor in the case of dentinal hypersensitivity or gingival recessionthat frequently creates an adverse effect in esthetic. Our discussion here is presented so that dentists could treat carefully and give a lot of attention to potential danger of other consequences of iatrogenic factors.

  12. Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study

    DEFF Research Database (Denmark)

    Inoue, Gislene; Rosa, Ecinele F.; Fueta Gomes, Elaine

    2016-01-01

    The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking...... cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation...... counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette...

  13. [CHRONIC PERIODONTITIS WITH SYMPTOMATIC HYPERTROPHIC GINGIVITIS: CASE REPORT AND REVIEW OF THE LITERATURE].

    Science.gov (United States)

    Shinkevich, V; Udaltsova, K; Pisarenko, E; Kolomiets, S; Khmil, T

    2015-12-01

    Gingivitis in traditional national dentistry referred to independent diseases or symptomatic condition in periodontitis and classified morphologically. The diagnostic features of the diseases are characteristic, but the clinical presentation of symptomatic gingivitis and patterns of bone destructions may vary between patients. Successful treatment of the disease depends from proper diagnosis and advanced disease stages, but for symptomatic gingivitis that accompanying chronic periodontitis, protocols include surgical excision. Despite of the high prevalence of chronic generalized periodontitis, its active treatment often start in severe destruction and bone loss (2-3 stage severity). Today etiotropic antimicrobial therapy is real way to control microbial biofilm and has solid evidence base. Applying of etiotropic antimicrobial therapy as systemic azithromycin with timely treatment of mild to moderate periodontal and bone destruction may reduce severe periodontitis incidence of and treatment-related complications in the future. This paper attempts to describe the clinical diagnostic features and the current treatment options along with a suggested protocol for comprehensive management of chronic generalized periodontitis and hypertrophic gingivitis patient with case reports and a brief review.

  14. Reactive correction of a maxillary incisor in single-tooth crossbite following periodontal therapy.

    Science.gov (United States)

    Huang, Chih-Hao; Brunsvold, Michael A

    2005-05-01

    The reactive correction of a single tooth anterior crossbite following periodontal therapy is described. This case report provides new information regarding correction of a crossbite relationship and con- firms existing reports of tooth movement following periodontal therapy. A 39-year-old woman in good general health presented with a history of recurrent periodontal abscesses of a maxillary incisor. Probing depths of the abscessed tooth ranged from 5 to 12 mm, and class 1 mobility was noted. Radiographs revealed that the tooth had previously been treated endodontically. The patient's periodontal diagnosis was generalized chronic moderate to severe periodontitis. Treatment considerations were complicated by a single-tooth crossbite relationship of the involved incisor and clinical evidence that the periodontal abscess communicated with an apical infection. Treatment of the abscess consisted of cause-related therapy, bone grafting, and occlusal adjustment. Five months after surgical treatment, an edge-to-edge incisal relationship was observed, the first indicator of tooth movement. Further correction to a normal incisal relationship resulted 1 year after modification of the proximal contact. At this time, there was normal probing depth with only slight recession and mobility. Bone fill was radiographically noted. It appears that some cases of maxillary incisor crossbite that are complicated by periodontal disease may be corrected, without orthodontic appliances, following periodontal treatment.

  15. Effect of a comprehensive plan for periodontal disease care on oral health-related quality of life in patients with periodontal disease in Taiwan.

    Science.gov (United States)

    Wang, Tze-Fang; Fang, Chun-Han; Hsiao, Kai-Jong; Chou, Chyuan

    2018-02-01

    A comprehensive plan for periodontal disease (PD) care in Taiwan provides non-surgical and supportive periodontal treatment. The aim of this study was to determine whether the care plan could improve the oral health-related quality of life of patients with PD.This study was conducted by purposive sampling and a quasi-experimental design. Patients with PD were assigned to either comprehensive periodontal treatment (n = 32) or a simple cleaning regimen (n = 32). Their oral health-related quality of life (OHRQoL) was measured using the Taiwanese version of the Brief World Health Organization Quality of Life (WHOQOL-BREF) scale (general QoL) and the Oral Health Impact Profile (OHIP-14) (OHRQoL). Both scales were completed 14, 28, and 90 days after the initial assessment. The extent of PD in the experimental group was determined again at the end of the study.On the 28-item WHOQOL-BREF scale, the scores of the experimental group were higher than those of the control group on 5 items and the environmental domain at 14 days. There was a significant improvement in the experimental group on 2 items at 28 days and at 90 days after periodontal treatment (both P improvement in the experimental group in total score at 28 and 90 days after periodontal treatment (both P plan for PD care showed some improvement in QoL, including in the environmental domain, and on the total score for OHRQoL. Comprehensive periodontal treatment also alleviated periodontal symptoms.

  16. Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review.

    Science.gov (United States)

    Nagarale, Girish P; Ravindra, S; Thakur, Srinath; Setty, Swati

    2013-03-01

    Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis. This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up. Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

  17. Human cytomegalovirus and Epstein-Barr virus type 1 in periodontal abscesses.

    Science.gov (United States)

    Saygun, I; Yapar, M; Ozdemir, A; Kubar, A; Slots, J

    2004-04-01

    Recent studies have linked herpesviruses to severe types of periodontal disease, but no information exists on their relationship to periodontal abscesses. The present study determined the presence of human cytomegalovirus (HCMV) and Epstein-Barr virus type 1 (EBV-1) in periodontal abscesses and the effect of treatment on the subgingival occurrence of these viruses. Eighteen adults with periodontal abscesses participated in the study. Subgingival samples were collected from each patient with sterile curettes from an abscess-affected site and a healthy control site. HCMV and EBV-1 were identified by polymerase chain reaction at the time of the abscess and at 4 months after surgical and systemic doxycycline therapy. HCMV was detected in 66.7% of periodontal abscess sites and in 5.6% of healthy sites (P=0.002). EBV-1 occurred in 72.2% of abscess sites but not in any healthy site (Pabscess sites. Posttreatment, HCMV and EBV-1 were not found in any study site. HCMV and EBV-1 genomes are commonly found in periodontal abscesses. These data favor a model in which a herpesvirus infection of the periodontium impairs the host defense and serves as a platform for the entrance of bacterial pathogens into gingival tissue with subsequent risk of abscess development.

  18. Novel application of stem cell-derived factors for periodontal regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Inukai, Takeharu, E-mail: t-inukai@med.nagoya-u.ac.jp [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine (Japan); Katagiri, Wataru, E-mail: w-kat@med.nagoya-u.ac.jp [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine (Japan); Yoshimi, Ryoko, E-mail: lianzi@med.nagoya-u.ac.jp [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine (Japan); Osugi, Masashi, E-mail: masashi@med.nagoya-u.ac.jp [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine (Japan); Kawai, Takamasa, E-mail: takamasa@med.nagoya-u.ac.jp [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine (Japan); Hibi, Hideharu, E-mail: hibihi@med.nagoya-u.ac.jp [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine (Japan); Ueda, Minoru, E-mail: mueda@med.nagoya-u.ac.jp [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine (Japan)

    2013-01-11

    Highlights: Black-Right-Pointing-Pointer Mesenchymal stem cells (MSCs) secrete a variety of cytokines. Black-Right-Pointing-Pointer Cytokines were detected in conditioned medium from cultured MSCs (MSC-CM). Black-Right-Pointing-Pointer MSC-CM enhanced activation of dog MSCs and periodontal ligament cells. Black-Right-Pointing-Pointer MSC-CM significantly promoted alveolar bone and cementum regeneration. Black-Right-Pointing-Pointer Multiple cytokines contained in MSC-CM promote periodontal regeneration. -- Abstract: The effect of conditioned medium from cultured mesenchymal stem cells (MSC-CM) on periodontal regeneration was evaluated. In vitro, MSC-CM stimulated migration and proliferation of dog MSCs (dMSCs) and dog periodontal ligament cells (dPDLCs). Cytokines such as insulin-like growth factor, vascular endothelial growth factor, transforming growth factor-{beta}1, and hepatocyte growth factor were detected in MSC-CM. In vivo, one-wall critical-size, intrabony periodontal defects were surgically created in the mandible of dogs. Dogs with these defects were divided into three groups that received MSC-CM, PBS, or no implants. Absorbable atelo-collagen sponges (TERUPLUG Registered-Sign ) were used as a scaffold material. Based on radiographic and histological observation 4 weeks after transplantation, the defect sites in the MSC-CM group displayed significantly greater alveolar bone and cementum regeneration than the other groups. These findings suggest that MSC-CM enhanced periodontal regeneration due to multiple cytokines contained in MSC-CM.

  19. Prevalence of human papilloma virus in marginal periodontium and its association with periodontitis: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Anila Jacob

    2014-01-01

    Full Text Available Context: Bacterial pathogens in dental plaque are necessary for the development of periodontitis but this etiology alone does not explain all its clinicopathologic features. Researchers have proven the role of certain viruses like herpes virus in periodontal disease which implies that other viral agents like human papilloma virus may also be involved. Aims: This cross-sectional study was conducted to determine the proportion of patients with human papilloma virus (HPV-16 in marginal periodontium by analyzing DNA from the gingival tissue sample and to understand its association with periodontitis. Settings and Design: 102 systemically healthy patients between the age group of 15 and 70 years reporting to the Department of Periodontology who required surgical intervention (flap surgery for patients with periodontitis and crown lengthening for healthy patients with internal bevel gingivectomy were selected. Materials and Methods: After scaling and root planning, gingival tissue was collected during the respective surgical procedure. DNA was isolated and amplified using specific primers for HPV-16 by polymerase chain reaction (PCR. The amplified products were checked by agarose gel electrophoresis. Results: No HPV DNA was detected in the 102 samples analyzed. Conclusion: Marginal periodontium does not contain HPV in this study population and hence there was no association between HPV and periodontitis.

  20. Differential benefits of amoxicillin-metronidazole in different phases of periodontal therapy in a randomized controlled crossover clinical trial.

    Science.gov (United States)

    Mombelli, Andrea; Almaghlouth, Adnan; Cionca, Norbert; Courvoisier, Delphine S; Giannopoulou, Catherine

    2015-03-01

    The specific advantage of administering systemic antibiotics during initial, non-surgical therapy or in the context of periodontal surgery is unclear. This study assesses the differential outcomes of periodontal therapy supplemented with amoxicillin-metronidazole during either the non-surgical or the surgical treatment phase. This is a single-center, randomized placebo-controlled crossover clinical trial with a 1-year follow-up. Eighty participants with Aggregatibacter actinomycetemcomitans-associated moderate to advanced periodontitis were randomized into two treatment groups: group A, antibiotics (500 mg metronidazole plus 375 mg amoxicillin three times per day for 7 days) during the first, non-surgical phase of periodontal therapy (T1) and placebo during the second, surgical phase (T2); and group B, placebo during T1 and antibiotics during T2. The number of sites with probing depth (PD) >4 mm and bleeding on probing (BOP) per patient was the primary outcome. A total of 11,212 sites were clinically monitored on 1,870 teeth. T1 with antibiotics decreased the number of sites with PD >4 mm and BOP per patient significantly more than without (group A: from 34.5 to 5.7, 84%; group B: from 28.7 to 8.7, 70%; P antibiotics, but only eight treated with placebo, achieved a 10-fold reduction of diseased sites (P = 0.007). Consequently, fewer patients of group A needed additional therapy, the mean number of surgical interventions was lower, and treatment time in T2 was shorter. Six months after T2, the mean number of residual pockets (group A: 2.8 ± 5.2; group B: 2.2 ± 5.0) was not significantly different and was sustained over 12 months in both groups. Giving the antibiotics during T1 or T2 yielded similar long-term outcomes, but antibiotics in T1 resolved the disease quicker and thus reduced the need for additional surgical intervention.

  1. Periodontal and dental effects of surgically assisted rapid maxillary expansion, assessed by using digital study models

    Science.gov (United States)

    Siqueira, Danilo Furquim; Cardoso, Mauricio de Almeida; Capelozza, Leopoldino; Goldenberg, Dov Charles; Fernandes, Mariana dos Santos

    2015-01-01

    OBJECTIVE: The present study assessed the maxillary dental arch changes produced by surgically assisted rapid maxillary expansion (SARME). METHODS: Dental casts from 18 patients (mean age of 23.3 years) were obtained at treatment onset (T1), three months after SARME (T2) and 6 months after expansion (T3). The casts were scanned in a 3D scanner (D-250, 3Shape, Copenhagen, Denmark). Maxillary dental arch width, dental crown tipping and height were measured and assessed by ANOVA and Tukey's test. RESULTS: Increased transversal widths from T1 and T2 and the maintenance of these values from T2 and T3 were observed. Buccal teeth tipping also showed statistically significant differences, with an increase in all teeth from T1 to T2 and a decrease from T2 to T3. No statistically significant difference was found for dental crown height, except for left first and second molars, although clinically irrelevant. CONCLUSION: SARME proved to be an effective and stable procedure, with minimum periodontal hazards. PMID:26154457

  2. Failing to meet the goals of periodontal recall programs. What next?

    Science.gov (United States)

    McCracken, Giles; Asuni, Abisola; Ritchie, Mark; Vernazza, Christopher; Heasman, Peter

    2017-10-01

    Supportive periodontal care is a crucial aspect of the management of chronic periodontitis and peri-implantitis and is inevitably a long-term commitment for both the clinician and the patient. The principal goals of supportive care are to achieve a high standard of plaque control, minimize bleeding and maintain pockets at less than 6 mm. Gain of attachment around natural teeth during supportive periodontal care has been reported, although gain of attachment and of bone during supportive care may be a more pragmatic and aspirational aim in the longer term. Furthermore, we occasionally see patients for whom, despite excellent home and professional care (surgical or nonsurgical), including the management of risk factors, supportive periodontal care appears to be failing and therefore for such patients the clinician needs to consider further management options. This review considers, in particular, the options of using local or systemically delivered antimicrobials to eradicate periodontal and peri-implant disease progression and discusses the extent to which culture and sensitivity testing before the prescription of systemically delivered antimicrobials may be a cost-effective alternative to prescribing 'blind'. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Restoration of traumatized teeth with resin composites

    DEFF Research Database (Denmark)

    Pallesen, Ulla; van Dijken, Jan WV

    2018-01-01

    For a long time, the primary choice for initial restoration of a crown-fractured front tooth has been resin composite material. The restoration can in most cases be performed immediately after injury if there is no sign of periodontal injury. The method’s adhesive character is conservative to tooth...... present an aesthetic problem due to exposure of un-aesthetic crown-margins. The invasive permanent crown restorations are therefore often not suc-cessful on a long-term scale. On the other hand, a conservative direct restoration of an extensively fractured incisor crown with resin composite may......-structure and with minimal risk of pulpal complication. In addition, it offers an aesthetic solution to the patient immediately after an injury, which may bring a little comfort in a sad situation. The resin composite build-up is often changed or repaired a couple of times, before the tooth is restored with a porcelain...

  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. Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review

    Directory of Open Access Journals (Sweden)

    Girish P Nagarale

    2013-01-01

    Full Text Available Background: Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis. Case Description: This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up. Clinical Implications: Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

  6. Criteria adopted by dentists to indicate the extraction of periodontally involved teeth

    Directory of Open Access Journals (Sweden)

    Carlos Heitor Cunha Moreira

    2007-10-01

    Full Text Available When dealing with patients with periodontal disease of variable severities, dentists must often choose between treating and restoring the involved tooth or indicating its extraction. Different criteria have been adopted in this decision-making process. The purpose of this study was to evaluate the criteria adopted by dentists to indicate the extraction of teeth with periodontitis. Dentists were interviewed at their private practices in three cities of the state of Rio Grande do Sul, Brazil. The evaluated criteria included severity of attachment loss, tooth mobility, furcation involvement, prosthetic planning, periodontal-endodontic lesion, possible systemic involvement due to the presence of periodontitis, referral to a periodontist for evaluation, radiographic bone loss greater than 50%, presence of extensive caries, socio-economic and cultural status of the patient, among others. The most often adopted criteria to indicate the extraction of periodontally affected teeth were the presence of mobility (37.5%, severity of attachment loss (24.3% and radiographic bone loss greater than 50% (21.2%. The results of the present study demonstrated the difficulties faced by dentists to indicate the extraction of teeth with severe attachment loss, in addition to the establishment of an adequate prognosis. Aspects associated with the past disease were still the most often reported to indicate the extraction of teeth for periodontal reasons.

  7. Autologous dental pulp stem cells in periodontal regeneration: a case report.

    Science.gov (United States)

    Aimetti, Mario; Ferrarotti, Francesco; Cricenti, Luca; Mariani, Giulia Maria; Romano, Federica

    2014-01-01

    Histologic findings in animal models suggest that the application of dental pulp stem cells (DPSCs) may promote periodontal regeneration in infrabony defects. This case report describes the clinical and radiographic regenerative potential of autologous DPSCs in the treatment of human noncontained intraosseous defects. A chronic periodontitis patient with one vital third molar requiring extraction was surgically treated. The third molar was extracted and used as an autologous DPSCs source to regenerate the infrabony defect on the mandibular right second premolar. At the 1-year examination, the defect was completely filled with bonelike tissue as confirmed through the reentry procedure.

  8. The relationship between periodontal status and peripheral levels of neutrophils in two consanguineous siblings with severe congenital neutropenia: case reports.

    Science.gov (United States)

    Tözüm, Tolga Fikret; Berker, Ezel; Ersoy, Fügen; Tezcan, Iihan; Sanal, Ozden

    2003-03-01

    Congenital neutropenia is characterized by a severe reduction in absolute neutrophil counts, resulting in an almost total absence of neutrophils. It is well known that severe neutropenia affects periodontal status. Oral manifestations include ulcerations, gingival desquamation, gingival inflammation, attachment loss, and alveolar bone loss which may result in tooth loss. Treatment with granulocyte-colony stimulating factor (G-CSF) may improve this periodontal condition. This article reports the relationship between periodontal disease status and peripheral neutrophil levels in two consanguineous siblings with severe congenital neutropenia who did not receive routine G-CSF for 2 years prior to examination. Both siblings were given scaling, root planing, and periodontal prophylaxis in regular follow-up visits. This report demonstrates that periodontal therapy supported by adequate oral hygiene may result in restoration of neutrophil counts in siblings with congenital neutropenia.

  9. Dental practitioners with a special interest in periodontics: the West Sussex experience.

    Science.gov (United States)

    Cheshire, P D; Saner, P; Lesley, R; Beckerson, J; Butler, M; Zanjani, B

    2011-02-12

    The experience of a pilot service involving practitioners with a special interest in periodontics is described. The service functioned as a clinical network between the primary and secondary sector and featured consultant outreach. Between June 2006 and May 2007 it experienced 441 referrals. It improved patient access to periodontal care and was successful in targeting specific disease categories and in meeting key performance indicators. The service was non-surgical and emphasised patient self-efficacy. It produced highly effective clinical outcomes. It was well accepted by both patients and referring practitioners. It did not replace the need for a consultant-led service in the eyes of the referring practitioners. The BPE was used to identify suitable patients; audit indicated that there was a tendency for practitioners to underscore the level of periodontal disease.

  10. A Case Report of Ridge Augmentation using Onlay Interpositional Graft: An Approach to Improve Prosthetic Prognosis of a Deficit Ridge

    Directory of Open Access Journals (Sweden)

    Devanand Shetty

    2014-01-01

    Full Text Available Background: Periodontal therapy has developed beyond the scope of the treatment of periodontal pathoses. Periodontal plastic surgery consists of the reconstructive procedures designed to enhance the both function and esthetics. Deficient ridges pose a severe problem to the restorative dentist in restoring the natural form, function and esthetics of the prosthesis replacing the natural dentition. Depending upon the severity, location of these defects and the prosthetic option chosen, hard and soft tissue ridge augmentation or non-surgical approach or a combination may help to address them. The present clinical report describes a soft tissue ridge augmentation of a localized ridge defect in maxillary aesthetic region using onlay interpositional graft followed by fixed partial denture.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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.

  13. Microbiological characteristics of subgingival microbiota in adult periodontitis, localized juvenile periodontitis and rapidly progressive periodontitis subjects.

    Science.gov (United States)

    Nonnenmacher, C; Mutters, R; de Jacoby, L F

    2001-04-01

    To describe the prevalence of the cultivable subgingival microbiota in periodontal diseases and to draw attention to the polymicrobial nature of periodontic infections. The study population consisted of 95 patients, 51 females and 44 males, aged 14-62 years. Twenty-nine patients exhibited adult periodontitis (AP), six localized juvenile periodontitis (LJP), and 60 rapidly progressive periodontitis (RPP). Two to four pooled bacterial samples were obtained from each patient. Samples were collected with sterile paper points from the deepest periodontal pockets. The samples were cultured under anaerobic and microaerophilic conditions using selective and non-selective media. Isolates were characterized to species level by conventional biochemical tests and by a commercial rapid test system. Prevotella intermedia and Capnocytophaga spp. were the most frequently detected microorganisms in all diagnostic groups. Porphyromonas gingivalis and Peptostreptococcus micros were found more frequently in AP and RPP patients, while Actinobacillus actinomycetemcomitans and Eikenella corrodens were associated with AP, LJP and RPP patients. The other bacterial species, including Actinomyces spp., Streptococcus spp. and Eubacterium spp., were detected at different levels in the three disease groups. The data show the complexity of the subgingival microbiota associated with different periodontal disease groups, indicating that the detection frequency and levels of recovery of some periodontal pathogens are different in teeth affected by different forms of periodontal disease.

  14. [Need for clinical guidelines for chronic periodontitis in general and specialized Belgian practice].

    Science.gov (United States)

    Cosyn, Jan; Thevissen, Eric; Reners, Michèle; Rompen, Eric; Klinge, Björn; De Bruyn, Hugo

    2008-01-01

    As the prevalence of periodontitis is more than 40 % in the adult Belgian population, periodontists are clearly understaffed to treat this disease in all patients. Therefore, it seems logic that mild forms of chronic periodontitis are treated by the general practitioner especially because Belgium lacks dental hygienists. Important prerequisites for organizing periodontal care as such relate to the general practitioner who should use the same techniques, have comparable communicative skills to motivate patients and create a similar amount of time for periodontal treatment as the specialist. After all, the patient has the right to qualitative treatment regardless of the level of education of the care provider. In order to guarantee this in general practice as much as possible, there is a need for clinical guidelines developed by specialists. These guidelines should not only support the general practitioner in treating disease; above all, they should assist the dentist in periodontal diagnosis. Hitherto, periodontal screening by general dentists seems to be infrequently performed even though reimbursement of the Dutch Periodontal Screening Index is implemented in the Belgian healthcare security system. In this manuscript possible explanations for this phenomenon are discussed. Apart from the need for guidelines in general practice, guidelines for surgical treatment seem compulsory to uniform treatment protocols in specialized practice. Extreme variation in the recommendation of surgery among Belgian specialists calls for consensus statements.

  15. 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.

  16. Fifteen-year Clinical Follow-up of Restoration of Extensive Cervical Resorption in a Maxillary Central Incisor.

    Science.gov (United States)

    Reston, E G; Bueno, Rpr; Closs, L Q; Zettermann, J

    Internal bleaching in endodontically treated teeth requires care and protection to prevent harm to the periodontal ligament due to peroxide and may result in external root resorption. There is a myriad of treatment options when this occurs, such as monitoring, extraction, and subsequent rehabilitation with implants or fixed prosthodontics. In some cases, such as the one described here, a conservative attempt to maintain the tooth as a single structure can be made by sealing the resorptive defect. In the present case, we show a multidisciplinary approach where orthodontics, periodontics, and restorative dentistry were involved in treating the maxillary right central incisor (#8) of a 65-year-old patient with extensive cervical resorption, whose chief complaint was esthetics. The proposed treatment was extrusion of the tooth followed by curettage and restoration of the defect with glass ionomer cement. The patient has been followed for 15 years with no signs of recurrence, maintenance of periodontal health, and patient satisfaction with the esthetic outcome.

  17. Definition of aggressive periodontitis in periodontal research. A systematic review

    DEFF Research Database (Denmark)

    Ramírez, Valeria; Hach, Maria; López, Rodrigo

    2018-01-01

    . Consequently, considerable variation in the understanding of aggressive periodontitis can be anticipated. AIM: To systematically asses, the definitions of aggressive periodontitis reported in original periodontal research. METHODS: A systematic review of original research on aggressive periodontitis published.......7% of the publications no information is provided as to how the cases were defined. Many combinations of criteria for case definition were found. CONCLUSIONS: This study revealed significant heterogeneity in the understanding and use of the term aggressive periodontitis in original research and poor documentation...

  18. 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.

  19. 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 ...

  20. Staged Hard and Soft Tissue Reconstruction Followed by Implant Supported Restoration in the Aesthetic Zone: A Case Report.

    Science.gov (United States)

    Parthasarathy, Harinath; Ramachandran, Lakshmi; Tadepalli, Anupama; Ponnaiyan, Deepa

    2017-04-01

    Alveolar ridge deficiency is a common clinical consequence following tooth loss due to chronic periodontitis complicating ideal implant placement. Advanced hard and soft tissue augmentation procedures have been developed in the recent past with predictable clinical outcomes. A male patient presented with a Grade III mobile upper right central incisor associated with advanced bone loss and soft tissue deficit. Following extraction of tooth #11, socket augmentation was done using an autogenous cortico-cancellous block graft and subsequent soft tissue augmentation was done with palatal connective tissue graft. At the end of six months, a tapered self tapping implant fixture was placed with adequate primary stability and after eight weeks, second stage implant surgery was done with the Misch technique in order to recreate papillae and the implant was prosthetically restored. The alveolar ridge was adequately recontoured following the staged surgical protocol. The implant was well integrated at the end of 15 months. Execution of sequential surgical procedures in a highly deficient edentulous site made it possible to achieve of optimal pink and white aesthetics with stable implant supported fixed prosthesis.

  1. 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.

  2. Adenovirus-mediated transfer of hepatocyte growth factor gene to human dental pulp stem cells under good manufacturing practice improves their potential for periodontal regeneration in swine.

    Science.gov (United States)

    Cao, Yu; Liu, Zhenhai; Xie, Yilin; Hu, Jingchao; Wang, Hua; Fan, Zhipeng; Zhang, Chunmei; Wang, Jingsong; Wu, Chu-Tse; Wang, Songlin

    2015-12-15

    Periodontitis is one of the most widespread infectious diseases in humans. We previously promoted significant periodontal tissue regeneration in swine models with the transplantation of autologous periodontal ligament stem cells (PDLSCs) and PDLSC sheet. We also promoted periodontal tissue regeneration in a rat model with a local injection of allogeneic bone marrow mesenchymal stem cells. The purpose of the present study is to investigate the roles of the hepatocyte growth factor (HGF) and human dental pulp stem cells (DPSCs) in periodontal tissue regeneration in swine. In the present study, we transferred an adenovirus that carried HGF gene into human DPSCs (HGF-hDPSCs) under good manufacturing practice (GMP) conditions. These cells were then transplanted into a swine model for periodontal regeneration. Twenty miniature pigs were used to generate periodontitis with bone defect of 5 mm in width, 7 mm in length, and 3 mm in depth. After 12 weeks, clinical, radiological, quantitative and histological assessment of regenerated periodontal tissues was performed to compare periodontal regeneration in swine treated with cell implantation. Our study showed that injecting HGF-hDPSCs into this large animal model could significantly improve periodontal bone regeneration and soft tissue healing. A hDPSC or HGF-hDPSC sheet showed superior periodontal tissue regeneration compared to the injection of dissociated cells. However, the sheets required surgical placement; thus, they were suitable for surgically-managed periodontitis treatments. The adenovirus-mediated transfer of the HGF gene markedly decreased hDPSC apoptosis in a hypoxic environment or in serum-free medium, and it increased blood vessel regeneration. This study indicated that HGF-hDPSCs produced under GMP conditions significantly improved periodontal bone regeneration in swine; thus, this method represents a potential clinical application for periodontal regeneration.

  3. The treatment of female pattern hair loss and other applications of surgical hair restoration in women.

    Science.gov (United States)

    Epstein, Jeffrey S

    2004-05-01

    In the specialty of surgical hair restoration, men comprise more than 90% of the patients treated; however, in the last few years the number of women undergoing the procedure has increased significantly. The reasons for this growth are many and include the increase in public awareness of the efficacy of hair transplantation from such sources as the media,the Internet, advertising and word of mouth. More importantly, advances in technique have significantly improved results, increasing the confidence level in women to undergo the procedure and in hair transplant specialists to offer it.

  4. A report of laser-assisted modified Widman flap for periodontal regeneration: Clinical and radiographic evaluation

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar Salaria

    2010-01-01

    Full Text Available Periodontitis is a relatively common disease. Various therapies have been recommended for its treatment which includes nonsurgical, antimicrobial, and surgical therapy. In recent years lasers have been used for all the three above-mentioned purposes. Lasers have been applied for hard and soft tissue debridement, contouring as well as the bacterial load reduction in the pocket. Here we present a case report of chronic periodontitis treated with the help of a new technique, laser-assisted modified Widman flap (LAMWF. The surgical procedure followed with a 980 nm diode laser has been described. The present case report resulted in significant pocket depth reduction, attachment gain, and radiographic evidence of bone fill. The laser-assisted modified Widman flap provided excellent results without complications and high patient as well as clinician satisfaction.

  5. Surgical crown lengthening: a 12-month study - radiographic results

    Directory of Open Access Journals (Sweden)

    Daniela Eleutério Diniz

    2007-08-01

    Full Text Available OBJECTIVE: The purpose of this study was to perform a radiographic follow-up evaluation after a 12-month healing period, following crown lengthening surgery. MATERIAL AND METHODS: Twenty-three periodontally healthy subjects (mean age 32.5 years that required crown lengthening surgery in premolars were recruited. In a total of 30 premolars, full thickness flaps, osseous resection, and flap suturing were performed. The restorative margin was defined in the pre-surgical phase and maintained unaltered during the healing period, serving as a reference point. Standardized bitewing radiographs were taken before and after osseous reduction, and at 2, 3, 6, and 12-month healing periods. RESULTS: Intact lamina dura was observed at both mesial and distal alveolar crests only from the 3rd month. At 12-months, all alveolar crests presented lamina dura. The overall mean distance from the restorative margin to the alveolar crest achieved after osseous resection was 3.28±0.87 mm at mesial and 2.81±0.51 mm at distal sites. No significant radiographic changes in the bone crest were observed during a 12-month healing period. CONCLUSION: The findings of this study suggest that the radiographic proximal bone level observed on bitewing radiographs following crown lengthening surgery can be used as a reference to predict the future level of the healed alveolar crest.

  6. Restorative surgery of combined injuries of neurovascular structures of limbs

    Directory of Open Access Journals (Sweden)

    I. V. Pertsov

    2015-02-01

    Full Text Available Combined damage of neurovascular structures is complicate pathology and require repeated surgical interventions and often lead to permanent disability. Aim. To define the features of restorative surgical treatment of traumatic injuries of limbs neurovascular structures and to study the effect of regional hemodynamics on the nerve function restore. Methods and results. In 98 patients with combined trauma of the neurovascular structures microcirculation indicators were established with laser Doppler flowmetry and determine the degree of restoration of nerve function. Conclusion. Strong direct correlation between the degree of restoration of nerve function and microcirculation was detected, the correlation coefficient was +0.72 at t = 3,16 p<0,05. Careful surgical restoration of blood flow helps to improve microcirculation in the limbs, makes positive impact on the recovery of limb function.

  7. 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)

  8. Effect of 1.2% of simvastatin gel as a local drug delivery system on Gingival Crevicular Fluid interleukin-6 & interleukin-8 levels in non surgical treatment of chronic periodontitis patients.

    Science.gov (United States)

    Gunjiganur Vemanaradhya, Gayathri; Emani, Shilpa; Mehta, Dhoom Singh; Bhandari, Shilpy

    2017-10-01

    The present study was carried out to evaluate the effect of 1.2% simvastatin gel as local drug delivery (LDD) system on Gingival Crevicular Fluid (GCF) Interleukin -6 (IL-6) and Interleukin-8 (IL-8) levels in chronic periodontitis patients, in addition to scaling and root planing (SRP). A total of 46 chronic periodontitis patients were equally divided into two groups. Group I patients were treated by SRP; Group II patients were treated by SRP followed by LDD of 1.2% simvastatin (SMV) gel. Plaque index (PI), Gingival index(GI), Sulcus Bleeding Index (SBI), Probing pocket depth (PPD) and Relative clinical attachment level (CAL) were recorded & GCF samples were collected at baseline (0day) and at 45th day from both the groups. The collected GCF samples were analysed for IL-6 and IL-8 levels with enzyme-linked immunosorbent assay (ELISA). Both the groups showed significant reduction in all the clinical parameters scores and IL-6 and IL-8 levels after non-surgical periodontal therapy (SRP for group I/SRP+1.2% SMV gel for group II) in contrast to baseline values. However, a greater reduction was observed in group II. A non-significant positive correlation was observed between clinical parameters and IL-6 and IL-8 levels except at baseline, a significant correlation was observed between PPD &IL 6 levels in group II. In adjunct to SRP, 1.2% Simvastatin gel acts as an effective local drug delivery agent for the management of chronic periodontitis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Cirugía de correción de márgenes gingivales como tratamiento estético periodontal

    Directory of Open Access Journals (Sweden)

    Antonio Diaz Caballero

    2013-10-01

    Full Text Available Resumen La Odontología estética es un componente multidisciplinario de la estética facial total y crear una sonrisa óptima requiere la integración de todas las disciplinas en Odontología. En cualquier plan de tratamiento restaurador se debe considerar la salud y el aspecto periodontal. Es decir, se deben evaluar las demandas de los tejidos periodontales con la finalidad de obtener resultados duraderos. Para el odontólogo, la salud periodontal y la estética periodontal son criterios de fundamental importancia para la odontología. La mayoría de los procedimientos odontológicos realizados, tiene un efecto directo o indirecto en el aumento de los valores estéticos dentofaciales; la sonrisa de encía, discrepancia del borde marginal y la carencia de papilas, son algunas situaciones antiestéticas periodontales, que las personas normalmente desean mejorar y el contorno gingival estético puede ser el procedimiento que proporcione armonía a la sonrisa. En algunas de estas situaciones, la alteración de la posición de los dientes, es preferible para corregir el problema estético; pero en otros pacientes se debe realizar estas alteraciones junto con la cirugía gingival como plan de tratamiento óptimo para mejorar aun más la apariencia estética del diente. El propósito de este artículo es describir la cirugía de corrección de márgenes gingivales como un tratamiento estético periodontal que ha aportado cambios a los planes de tratamiento y a la secuencia e integración de los procedimientos dentro de la terapia global. (DUAZARY 2010, 84 - 87AbstractAesthetic dentistry is a multidisciplinary component of total facial aesthetics and create an optimal smile requires the integration of all disciplines in dentistry. In any restorative treatment plan should be considered periodontal health and appearance. That is, they must assess the demands of the periodontal tissues in order to achieve lasting results. For the dentist, periodontal

  10. Determining the Response of Periodontal Teeth is Limited to Defects in the Integrity of the Dentition Loading

    Directory of Open Access Journals (Sweden)

    Kopytov А.А.

    2011-03-01

    Full Text Available Stability of the tooth characterizes its ability to perceive occlusal load. As the footprint specific loading functioning periodontium increases. To neutralize the impact of the load component of periodontitis should restore the integrity of the dentition

  11. 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.

    Science.gov (United States)

    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.

  12. Squamous cell carcinoma presenting as an endodontic-periodontic lesion.

    Science.gov (United States)

    Levi, Paul A; Kim, David M; Harsfield, Scott L; Jacobson, Erica R

    2005-10-01

    Regardless of advances in diagnosis and treatment during the past 40 years, the overall 5-year survival rates for oral and oropharyngeal squamous cancers have only slightly improved and remain around 50%. Thus, the early diagnosis and treatment of carcinoma by health care providers are essential in achieving a good prognosis. We report a case of invasive squamous cell carcinoma that presented as a benign endodontic-periodontic lesion with a 7-mm periodontal pocket on tooth #15 in a 40-year-old, non-smoking woman. The subsequent management of the case is also discussed. The study was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2000. Our patient was seen for a comprehensive periodontal examination including a periodontal charting, occlusal analysis, study casts, electronic pulp test for tooth #15, and complete mouth periapical radiographs. As there was a periapical radiolucency, an endodontic consultation was obtained. A periodontal flap surgical procedure was performed on teeth #13 to #15, and as there was bone erosion into the maxillary sinus, a biopsy of the soft tissue was submitted to the local hospital for histological analysis. The biopsied lesion was diagnosed as invasive, moderately differentiated squamous cell carcinoma with focal spindle and clear cell differentiation (grade II to III of IV). Bone invasion was also identified. The treatment of the carcinoma involved a hemimaxillectomy with the removal of the maxillary left posterior teeth. The patient remained free of tumor for 5 years after the initial presentation. Patient education and periodic oral cancer examinations by dental professionals are necessary to reduce diagnostic delay and improve prognosis. This case report emphasizes the important role of dental professionals, especially periodontists and endodontists, of being aware that squamous cell carcinoma may manifest itself clinically and/or radiographically as a common periodontal or endodontic lesion.

  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. Involvement of a periodontal pathogen, Porphyromonas gingivalis on the pathogenesis of non-alcoholic fatty liver disease

    Directory of Open Access Journals (Sweden)

    Yoneda Masato

    2012-02-01

    Full Text Available Abstract Background Non-alcoholic fatty liver disease (NAFLD is a hepatic manifestation of metabolic syndrome that is closely associated with multiple factors such as obesity, hyperlipidemia and type 2 diabetes mellitus. However, other risk factors for the development of NAFLD are unclear. With the association between periodontal disease and the development of systemic diseases receiving increasing attention recently, we conducted this study to investigate the relationship between NAFLD and infection with Porphyromonas gingivalis (P. gingivalis, a major causative agent of periodontitis. Methods The detection frequencies of periodontal bacteria in oral samples collected from 150 biopsy-proven NAFLD patients (102 with non-alcoholic steatohepatitis (NASH and 48 with non-alcoholic fatty liver (NAFL patients and 60 non-NAFLD control subjects were determined. Detection of P. gingivalis and other periodontopathic bacteria were detected by PCR assay. In addition, effect of P. gingivalis-infection on mouse NAFLD model was investigated. To clarify the exact contribution of P. gingivalis-induced periodontitis, non-surgical periodontal treatments were also undertaken for 3 months in 10 NAFLD patients with periodontitis. Results The detection frequency of P. gingivalis in NAFLD patients was significantly higher than that in the non-NAFLD control subjects (46.7% vs. 21.7%, odds ratio: 3.16. In addition, the detection frequency of P. gingivalis in NASH patients was markedly higher than that in the non-NAFLD subjects (52.0%, odds ratio: 3.91. Most of the P. gingivalis fimbria detected in the NAFLD patients was of invasive genotypes, especially type II (50.0%. Infection of type II P. gingivalis on NAFLD model of mice accelerated the NAFLD progression. The non-surgical periodontal treatments on NAFLD patients carried out for 3 months ameliorated the liver function parameters, such as the serum levels of AST and ALT. Conclusions Infection with high-virulence P

  15. Antimicrobial photodynamic therapy with photosensitizer in ethanol improves oxidative status and gingival collagen in a short-term in periodontitis.

    Science.gov (United States)

    Pillusky, Fernanda Maia; Barcelos, Raquel Cristine Silva; Vey, Luciana Taschetto; Barin, Luisa Machado; de Mello Palma, Victor; Maciel, Roberto Marinho; Kantorski, Karla Zanini; Bürger, Marilise Escobar; Danesi, Cristiane Cademartori

    2017-09-01

    This study evaluated the antimicrobial photodynamic therapy (aPDT) effects using the methylene blue (MB) in ethanol 20% on systemic oxidative status and collagen content from gingiva of rats with periodontitis. Rats were divided into five experimental groups: NC (negative control; no periodontitis); PC (positive control; periodontitis without any treatment); SRP (periodontitis and scaling and root planing), aPDT I (periodontitis and SRP+aPDT+MB solubilized in water), and aPDT II (periodontitis and SRP+aPDT+MB solubilized in ethanol 20%). After 7days of removal of the ligature, the periodontal treatments were performed. At 7/15/30days, gingival tissue was removed for morphometric analysis. The erythrocytes were used to evaluate systemic oxidative status. PC group showed higher lipoperoxidation levels at 7/15/30days. aPDT indicated a protective influence in erythrocytes at 15days observed by the elevation in levels of systemic antioxidant defense. aPDT II group was the only one that restored the total collagen area in 15days, and recovered the type I collagen area at the same time point. aPDT as an adjunct to the SRP can induce the systemic protective response against oxidative stress periodontitis-induced and recover the gingival collagen, thus promoting the healing periodontal, particularly when the MB is dissolved in ethanol 20%. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Oxidative Stress and Antioxidants in the Diagnosis and Therapy of Periodontitis

    Science.gov (United States)

    Tóthová, L'ubomíra; Celec, Peter

    2017-01-01

    Oxidative stress has been implicated in the pathogenesis of numerous diseases. However, large interventional studies with antioxidants failed to show benefits in the prevention or treatment of cardiovascular diseases, cancer, or diabetes mellitus. Numerous clinical studies have confirmed the association of oxidative stress markers and periodontitis. Technical and biological variability is high for most of the analyzed markers and none of them seems to be optimal for routine clinical use. In a research setting, analysis of a palette of oxidative stress markers is needed to cover lipid peroxidation, protein oxidation, and the antioxidant status. The source of reactive oxygen species and their role in the pathogenesis of periodontitis remains unclear. Interventional experiments indicate that oxidative stress might be more than just a simple consequence of the inflammation. Small studies have confirmed that some antioxidants could have therapeutic value at least as an addition to the standard non-surgical treatment of periodontitis. A clear evidence for the efficiency of antioxidant treatment in large patient cohorts is lacking. Potentially, because lowering of oxidative stress markers might be a secondary effect of anti-inflammatory or antibacterial agents. As the field of research of oxidative stress in periodontitis gains attraction and the number of relevant published papers is increasing a systematic overview of the conducted observational and interventional studies is needed. This review summarizes the currently available literature linking oxidative stress and periodontitis and points toward the potential of adjuvant antioxidant treatment, especially in cases where standard treatment fails to improve the periodontal status. PMID:29311982

  17. Oxidative Stress and Antioxidants in the Diagnosis and Therapy of Periodontitis

    Directory of Open Access Journals (Sweden)

    L'ubomíra Tóthová

    2017-12-01

    Full Text Available Oxidative stress has been implicated in the pathogenesis of numerous diseases. However, large interventional studies with antioxidants failed to show benefits in the prevention or treatment of cardiovascular diseases, cancer, or diabetes mellitus. Numerous clinical studies have confirmed the association of oxidative stress markers and periodontitis. Technical and biological variability is high for most of the analyzed markers and none of them seems to be optimal for routine clinical use. In a research setting, analysis of a palette of oxidative stress markers is needed to cover lipid peroxidation, protein oxidation, and the antioxidant status. The source of reactive oxygen species and their role in the pathogenesis of periodontitis remains unclear. Interventional experiments indicate that oxidative stress might be more than just a simple consequence of the inflammation. Small studies have confirmed that some antioxidants could have therapeutic value at least as an addition to the standard non-surgical treatment of periodontitis. A clear evidence for the efficiency of antioxidant treatment in large patient cohorts is lacking. Potentially, because lowering of oxidative stress markers might be a secondary effect of anti-inflammatory or antibacterial agents. As the field of research of oxidative stress in periodontitis gains attraction and the number of relevant published papers is increasing a systematic overview of the conducted observational and interventional studies is needed. This review summarizes the currently available literature linking oxidative stress and periodontitis and points toward the potential of adjuvant antioxidant treatment, especially in cases where standard treatment fails to improve the periodontal status.

  18. Evaluation of a model for induction of periodontal disease in dogs

    Directory of Open Access Journals (Sweden)

    Rodrigo V. Sepúlveda

    2014-06-01

    Full Text Available There are several methods for inducing periodontal disease in animal models, being the bone defect one of the most reported. This study aimed to evaluate this model, through clinical, radiographic, tomographic and histological analyzes, thus providing standardized data for future regenerative works. Twelve dogs were subjected to the induction protocol. In a first surgical procedure, a mucoperiosteal flap was made on the buccal aspect of the right third and fourth premolars and a defect was produced exposing the furcation and mesial and distal roots, with dimensions: 5mm coronoapical, 5mm mesiodistal, and 3mm buccolingual. Periodontal ligament and cementum were curetted and the defect was filled with molding polyester, which was removed after 21 days on new surgical procedure. Clinical and radiographic examinations were performed after the two surgeries and before the collection of parts for dental tomography and histological analysis. All animals showed grade II furcation exposure in both teeth. Clinical attachment level increased after induction. Defect size did not change for coronoapical and buccolingual measurements, while mesiodistal size was significantly higher than at the time of defect production. Radiographic analysis showed decreased radiopacity and discontinuity of lamina dura in every tooth in the furcation area. The horizontal progression of the disease was evident in micro-computed tomography and defect content in the histological analysis. Therefore, it is concluded that this method promotes the induction of periodontal disease in dogs in a standardized way, thus being a good model for future work.

  19. Adjunctive Non-Surgical Therapy of Inflamed Periodontal Pockets During Maintenance Therapy Using Diode Laser: A Randomized Clinical Trial.

    Science.gov (United States)

    Nguyen, Naomi-Trang; Byarlay, Matthew R; Reinhardt, Richard A; Marx, David B; Meinberg, Trudy A; Kaldahl, Wayne B

    2015-10-01

    Numerous studies have documented the clinical outcomes of laser therapy for untreated periodontitis, but very few have reported on lasers treating inflamed pockets during maintenance therapy. The aim of this study is to compare the effectiveness of scaling and root planing (SRP) plus the adjunctive use of diode laser therapy to SRP alone on changes in the clinical parameters of disease and on the gingival crevicular fluid (GCF) inflammatory mediator interleukin-1β (IL-1β) in patients receiving regular periodontal maintenance therapy. This single-masked and randomized, controlled, prospective study includes 22 patients receiving regular periodontal maintenance therapy who had one or more periodontal sites with a probing depth (PD) ≥ 5 mm with bleeding on probing (BOP). Fifty-six sites were treated with SRP and adjunctive laser therapy (SRP + L). Fifty-eight sites were treated with SRP alone. Clinical parameters, including PD, clinical attachment level (CAL), and BOP, and GCF IL-1β levels were measured immediately before treatment (baseline) and 3 months after treatment. Sites treated with SRP + L and SRP alone resulted in statistically significant reductions in PD and BOP and gains in CAL. These changes were not significantly different between the two therapies. Similarly, differences in GCF IL-1β levels between SRP + L and SRP alone were not statistically significant. In periodontal maintenance patients, SRP + L did not enhance clinical outcomes compared to SRP alone in the treatment of inflamed sites with ≥ 5 mm PD.

  20. Simple direct composite resin restoration on endodontically treated tooth: A case report

    Directory of Open Access Journals (Sweden)

    Wahyuni Suci Dwiandhany

    2016-06-01

    Full Text Available Endodontically treated teeth generally havegreat structure loss so that the resistance to fracture is reduced. Therefore, the post-endodontic restoration design that covers the entire cusp (full cuspal coverage is necessary to increase the resistance of teeth to fracture. The aim of this case report is to present direct onlay restoration technique using composite resin material in non-vital tooth with chronic apical periodontitis. A 74-years-old male patient came to the clinic complaining of discomfort in the lower right posterior tooth related to eating since 1 week ago. Clinical examination revealed a large amalgam restoration on the second lower right molar, the tooth is negative to pulp sensitivity test, and tender to percussion. Radiographically, the tooth showed periapical radiolucency at distal and mesial root. The diagnosis of the tooth was chronic apical periodontitis. The treatment plan is a non-vital root canal treatment with multiple visit. Root canal preparation with rotary files (ProTaper Next, Dentsply, Germany was performed on the first visit and irrigated with NaOCl. On the next visit, during subjective examination, there was no pain complaints and the percussion test was negative so the obturation with a single cone technique can be done. On the final visit, direct onlay restoration using nano-hybrid composite resin material (Polofil NHT, Voco, Germany was performed. In conclusion, after 3 months follow up, the marginal integrity of the restoration remains intact and the tooth were functioned properly.

  1. Normalization of periodontal tissues in osteopetrotic mib mutant rats, treated with CSF-1

    Science.gov (United States)

    Wojtowicz, A.; Yamauchi, M.; Sotowski, R.; Ostrowski, K.

    1998-01-01

    The osteopetrotic mib mutation in rats causes defects in the skeletal bone tissue in young animals. These defects, i.e. slow bone remodelling, changes in both crystallinity and mineral content, are transient and undergo normalization, even without any treatment in 6-wk-old animals. Treatment with CSF-1 (colony stimulating factor-1) accelerates the normalization process in skeletal bones. The periodontal tissues around the apices of incisors show abnormalities caused by the slow remodelling process of the mandible bone tissue, the deficiency of osteoclasts and their abnormal morphology, as well as the disorganization of periodontal ligament fibres. In contrast to the skeletal tissues, these abnormalities would not undergo spontaneous normalization. Under treatment with colony stimulating factor 1 (CSF-1), the primitive bone trabeculae of mandible are resorbed and the normalization of the number of osteoclasts and their cytology occurs. The organization of the periodontal ligament fibres is partially restored, resembling the histological structure of the normal one.

  2. Surgery without papilla incision: tunneling flap procedures in plastic periodontal and implant surgery.

    Science.gov (United States)

    Zuhr, Otto; Rebele, Stephan F; Cheung, Stefani L; Hürzeler, Markus B

    2018-06-01

    Diverse clinical advancements, together with some relevant technical innovations, have led to an increase in popularity of tunneling flap procedures in plastic periodontal and implant surgery in the recent past. This trend is further promoted by the fact that these techniques have lately been introduced to a considerably expanded range of indications. While originally described for the treatment of gingival recession-type defects, tunneling flap procedures may now be applied successfully in a variety of clinical situations in which augmentation of the soft tissues is indicated in the esthetic zone. Potential clinical scenarios include surgical thickening of thin buccal gingiva or peri-implant mucosa, alveolar ridge/socket preservation and implant second-stage surgery, as well as soft-tissue ridge augmentation or pontic site development. In this way, tunneling flap procedures developed from a technique, originally merely intended for surgical root coverage, into a capacious surgical conception in plastic periodontal and implant surgery. The purpose of this article is to provide a comprehensive overview on tunneling flap procedures, to introduce the successive development of the approach along with underlying ideas on surgical wound healing and to present contemporary clinical scenarios in step-by-step photograph-illustrated sequences, which aim to provide clinicians with guidance to help them integrate tunneling flap procedures into their daily clinical routine. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. [Biologico-periodontal considerations in restoration of teeth partially destroyed by caries or traumatism].

    Science.gov (United States)

    Carrillo Martínez, J J; Zermeño Ibarra, J A; Mercado Martínez, E G; Villanueva Neuman, Y; Castellanos Olmedo, R

    1990-01-01

    Since a great number of teeth could be rehabilitated and not extracted, in this paper we analyze the relation Perio-protesis by the point of the biology of marginal periodontal ligament, and the different options to establish this relations when are lost by decay or traumatism. We discuss the contraindications to avoid greater problems than benefits when intend to rehabilitate lost teeth.

  4. Altered T-cell responses by the periodontal pathogen Porphyromonas gingivalis.

    Directory of Open Access Journals (Sweden)

    Hazem Khalaf

    Full Text Available Several studies support an association between the chronic inflammatory diseases periodontitis and atherosclerosis with a crucial role for the periodontal pathogen Porphyromonas gingivalis. However, the interplay between this pathogen and the adaptive immune system, including T-cells, is sparsely investigated. Here we used Jurkat T-cells to determine the effects of P. gingivalis on T-cell-mediated adaptive immune responses. We show that viable P. gingivalis targets IL-2 expression at the protein level. Initial cellular events, including ROS production and [Ca(2+](i, were elevated in response to P. gingivalis, but AP-1 and NF-κB activity dropped below basal levels and T-cells were unable to sustain stable IL-2 accumulation. IL-2 was partially restored by Leupeptin, but not by Cathepsin B Inhibitor, indicating an involvement of Rgp proteinases in the suppression of IL-2 accumulation. This was further confirmed by purified Rgp that caused a dose-dependent decrease in IL-2 levels. These results provide new insights of how this periodontal pathogen evades the host adaptive immune system by inhibiting IL-2 accumulation and thus attenuating T-cell proliferation and cellular communication.

  5. Restoration of optimal ellipsoid left ventricular geometry: lessons learnt from in silico surgical modelling.

    Science.gov (United States)

    Adhyapak, Srilakshmi M; Menon, Prahlad G; Rao Parachuri, V

    2014-02-01

    Several issues that are inherent in the surgical techniques of surgical ventricular restoration (SVR) need specialized devices or techniques to overcome them, which may not always result in optimal outcomes. We used a non-invasive novel in silico modelling technique to study left ventricular (LV) morphology and function before and after SVR. The cardiac magnetic resonance imaging derived actual pre- and postoperative endocardial morphology and function was compared with the in silico analysis of the same. Cardiac magnetic resonance steady state free precession (SSFP) cine images were employed to segment endocardial surface contours over the cardiac cycle. Using the principle of Hausdorff distance to examine phase-to-phase regional endocardial displacement, dyskinetic/akinetic areas were identified at the instant of peak basal contraction velocity. Using a three-dimensional (3D) surface clipping tool, the maximally scarred, dyskinetic or akinetic LV antero-apical areas were virtually resected and a new apex was created. A virtual rectangular patch was created upon the clipped surface LV model by 3D Delaunay triangulation. Presurgical endocardial mechanical function quantified from cine cardiac magnetic resonance, using a technique of spherical harmonics (SPHARM) surface parameterization, was applied onto the virtually clipped and patched LV surface model. Finally, the in silico model of post-SVR LV shape was analysed for quantification of regional left ventricular volumes (RLVVs) and function. This was tested in 2 patients with post-myocardial infarction antero-apical LV aneuryms. Left ventricular mechanical dysynchrony was evaluated by RLVV analysis of pre-SVR, in silico post-SVR and actual post-SVR LV endocardial surface data. Following exclusion of the scarred areas, the virtual resected LV model demonstrated significantly lesser areas of akinesia. The decreases in regional LV volumes in the in silico modelling were significant and comparable with the actual

  6. [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

    To explore a new method of whole-process digital esthetic prosthodontic rehabilitation combined with periodontic surgery for complicated anterior teeth esthetic defects accompanied by soft tissue morphology, to provide an alternative choice for solving this problem under the guidance of three-dimensional (3D) printing digital dental model and surgical guide, thus completing periodontic surgery and digital esthetic rehabilitation of anterior teeth. In this study, 12 patients with complicated esthetic problems accompanied by soft tissue morphology in their anterior teeth were included. The dentition and facial images were obtained by intra-oral scanning and three-dimensional (3D) facial scanning and then calibrated. Two esthetic designs and prosthodontic outcome predictions were created by computer aided design /computer aided manufacturing (CAD/CAM) software combined with digital photography, including consideration of white esthetics and comprehensive consideration of pink-white esthetics. The predictive design of prostheses and the facial appearances of the two designs were evaluated by the patients. If the patients chose the design of comprehensive consideration of pink-white esthetics, they would choose whether they would receive periodontic surgery before esthetic rehabilitation. The dentition design cast of those who chose periodontic surgery would be 3D printed for the guide of periodontic surgery accordingly. In light of the two digital designs based on intra-oral scanning, facing scanning and digital photography, the satisfaction rate of the patients was significantly higher for the comprehensive consideration of pink-white esthetic design (Pesthetic rehabilitation. The 3D printed digital dental model and surgical guide provided significant instructions for periodontic surgery, and achieved success transfer from digital design to clinical application. The prostheses were fabricated by CAD/CAM, thus realizing the whole-process digital esthetic rehabilitation

  7. 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.

  8. Periodontal wound healing/regeneration following implantation of recombinant human growth/differentiation factor-5 (rhGDF-5) in an absorbable collagen sponge carrier into one-wall intrabony defects in dogs: a dose-range study.

    Science.gov (United States)

    Kim, Tae-Gyun; Wikesjö, Ulf M E; Cho, Kyoo-Sung; Chai, Jung-Kiu; Pippig, Susanne D; Siedler, Michael; Kim, Chong-Kwan

    2009-07-01

    Recombinant human growth/differentiation factor-5 (rhGDF-5) is being evaluated as a candidate therapy in support of periodontal regeneration. The objective of this study was to evaluate cementum and alveolar bone formation, and aberrant healing events following surgical implantation of rhGDF-5 in an absorbable collagen sponge (ACS) carrier using an established periodontal defect model. Bilateral 4 x 5 mm (width x depth), one-wall, critical-size, intrabony periodontal defects were surgically created at the mandibular second and fourth pre-molar teeth in 15 Beagle dogs. Five animals received 1 microg/defect and five animals 20 microg/defect rhGDF-5 in unilateral defect sites. Contralateral sites received treatments reported elsewhere. Five animals received rhGDF-5/ACS with 0 (buffer control) and 100 microg/defect rhGDF-5 in contralateral defect sites. The animals were euthanized at 8 weeks post-surgery for histologic and histometric evaluation. Surgical implantation of rhGDF-5 stimulated significant periodontal regeneration. Cementum formation was significantly enhanced in sites implanted with rhGDF-5 (1 and 100 microg) compared with control (phealing/regeneration in intrabony periodontal defects without complications.

  9. Esthetic, occlusal, and periodontal rehabilitation of anterior teeth with minimum thickness porcelain laminate veneers.

    Science.gov (United States)

    da Cunha, Leonardo Fernandes; Pedroche, Lorena Oliveira; Gonzaga, Carla Castiglia; Furuse, Adilson Yoshio

    2014-12-01

    Ceramic veneers of minimum thickness provide satisfactory esthetic outcomes while preserving the dental structure. Dental ceramics can both improve the esthetic appearance and reestablish the strength and function of teeth. In worn anterior teeth, functional surfaces, for example, anterior and lateral guidance, can be restored effectively. The characteristics of dental ceramics, such as color stability and mechanical and optical properties, make this material a good choice for indirect restorations, especially when optimum function and esthetics are required. This clinical report presents an occlusal, periodontal, and restorative solution with minimum thickness glass ceramic veneers for worn anterior teeth with multiple diastemas. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. 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.

  12. [The clinical study of IgA nephropathy with severe chronic periodontitis and aggressive periodontitis].

    Science.gov (United States)

    Cao, Y L; Qiao, M; Xu, Z H; Zou, G M; Ma, L L; Li, W G; Xu, B H

    2016-01-05

    To explore the clinical characteristics of IgA nephropathy (IgAN) with severe chronic periodontitis and aggressive periodontitis. A total of 436 hospitalized patients who underwent renal needle biopsy in the department of nephrology of China-Japan Friendship Hospital from November 2013 to December 2014 were recruited in the study and blindly had periodontal examination. The patients were divided into IgAN group and non-IgAN group according to the renal pathology. The patients with IgAN were further categorized as non-periodontitis, chronic periodontitis and aggressive peridontitis group by Haas classification. The chronic periodontitis group was continually divided into mild, moderate and severe periodontitis group. The levels of interleukin (IL)-1β and IL-6 in gingival crevicular fluid were analyzed by enzyme-linked immunosorbent assays. The prevalence of periodontitis in the study was 88.3% (385/436). The prevalence of chronic periodontitis and aggressive periodontitis were higher in patients with IgAN than those with non-IgAN (Pchronic periodontitis was correlated with pathologic grading of IgAN (r=0.48, Pperiodontitis, those with severe chronic and aggressive periodontitis had more severe pathology, more frequent recurrent gross hematuria, higher levels of 24 h proteinuria, serum triglyceride and uric acid, higher periodontal probing depth and clinical attatchment level, as well as higer levels of IL-1β and IL-6, but had lower creatinine clearance rate (all Pchronic and aggressive periodontitis was higher in patients with IgAN. Chronic periodontitis is correlated with the onset and development of IgAN. Patients with IgAN have worse condition with the aggravation of periodontitis.

  13. Marker of cemento-periodontal ligament junction associated with periodontal regeneration.

    Science.gov (United States)

    Hara, Ryohko; Wato, Masahiro; Tanaka, Akio

    2005-06-01

    The purpose of this study was to identify factors promoting formation of the cemento-periodontal ligament junction. Regeneration of the cemento-periodontal ligament junction is an important factor in recovery of the connective tissue attachment to the cementum and it is important to identify all specific substances that promote its formation. To clarify the substances involved in cemento-periodontal ligament junction formation, we produced a monoclonal antibody (mAb) to human cemento-periodontal ligament junction (designated as the anti-TAP mAb) and examined its immunostaining properties and reactive antigen. Hybridomas producing monoclonal antibody against human cemento-periodontal ligament junction antigens were established by fusing P3U1 mouse myeloma cells with spleen cells from BALB/c mice immunized with homogenized human cemento-periodontal ligament junction. The mAb, the anti-TAP mAb for cemento-periodontal ligament junction, was then isolated. The immunoglobulin class and light chain of the mAb were examined using an isotyping kit. Before immunostaining, antigen determination using an enzymatic method or heating was conducted. Human teeth, hard tissue-forming lesions, and animal tissues were immunostained by the anti-TAP mAb. The anti-TAP mAb was positive in human cemento-periodontal ligament junction and predentin but negative in all other human and animal tissues examined. In the cemento-osseous lesions, the anti-TAP mAb was positive in the peripheral area of the cementum and cementum-like hard tissues and not in the bone and bone-like tissues. The anti-TAP mAb showed IgM (kappa) and recognized phosphoprotein. The anti-TAP mAb is potentially useful for developing new agents promoting cementogenesis and periodontal regeneration.

  14. Role of periodontal pathogenic bacteria in RANKL-mediated bone destruction in periodontal disease.

    Science.gov (United States)

    Kajiya, Mikihito; Giro, Gabriela; Taubman, Martin A; Han, Xiaozhe; Mayer, Marcia P A; Kawai, Toshihisa

    2010-11-08

    Accumulated lines of evidence suggest that hyperimmune responses to periodontal bacteria result in the destruction of periodontal connective tissue and alveolar bone. The etiological roles of periodontal bacteria in the onset and progression of periodontal disease (PD) are well documented. However, the mechanism underlying the engagement of periodontal bacteria in RANKL-mediated alveolar bone resorption remains unclear. Therefore, this review article addresses three critical subjects. First, we discuss earlier studies of immune intervention, ultimately leading to the identification of bacteria-reactive lymphocytes as the cellular source of osteoclast-induction factor lymphokine (now called RANKL) in the context of periodontal bone resorption. Next, we consider (1) the effects of periodontal bacteria on RANKL production from a variety of adaptive immune effector cells, as well as fibroblasts, in inflamed periodontal tissue and (2) the bifunctional roles (upregulation vs. downregulation) of LPS produced from periodontal bacteria in a RANKL-induced osteoclast-signal pathway. Future studies in these two areas could lead to new therapeutic approaches for the management of PD by down-modulating RANKL production and/or RANKL-mediated osteoclastogenesis in the context of host immune responses against periodontal pathogenic bacteria.

  15. 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...

  16. Role of periodontal pathogenic bacteria in RANKL-mediated bone destruction in periodontal disease

    OpenAIRE

    Mikihito Kajiya; Gabriela Giro; Martin A. Taubman; Xiaozhe Han; Marcia P.A. Mayer; Toshihisa Kawai

    2010-01-01

    Accumulated lines of evidence suggest that hyperimmune responses to periodontal bacteria result in the destruction of periodontal connective tissue and alveolar bone. The etiological roles of periodontal bacteria in the onset and progression of periodontal disease (PD) are well documented. However, the mechanism underlying the engagement of periodontal bacteria in RANKL-mediated alveolar bone resorption remains unclear. Therefore, this review article addresses three critical subjects. First, ...

  17. Long-term prognosis of endodontically treated teeth: a retrospective analysis of preoperative factors in molars.

    Science.gov (United States)

    Setzer, Frank C; Boyer, Keith R; Jeppson, Joshua R; Karabucak, Bekir; Kim, Syngcuk

    2011-01-01

    Long-term predictability of restored endodontically treated teeth is important for the decision of tooth retention versus extraction and implant placement. The purpose of this study was to validate the hypothesis that preoperative factors can predict the long-term prognosis of molars requiring endodontic and restorative treatment for future prognostic investigations. A clinical database was searched for molar endodontic treatments with crown placement and a minimum of 4-year follow-up. Charts of 42 patients with 50 individual treatments were randomly selected. Information concerning crown lengthening; periodontal diagnosis; attachment loss; furcation involvement; mobility; and internal, external, or periradicular resorption was recorded. Radiographs from treatment initiation and follow-up were digitalized. The presence of apical periodontitis was evaluated. Available ferrule was calculated from bitewing radiographs using CAD software (AutoCAD; Autodesk, Cupertino, CA). The resulting data, age, sex, and times of restoration and follow-up were analyzed for correlation with the presence of apical radiolucency at follow-up and the following four possible outcome scenarios: "no event," "nonsurgical retreatment," "surgical retreatment," or "extraction" using Spearman rank order correlation analysis. Patients' ages ranged from 19 to 87 years, 22 were male and 20 female, and 48 teeth (96.0%) were retained at follow-up. Of those, 44 (88.0%) were without intervention ("no event"), and four (8.0%) underwent surgical or nonsurgical retreatment. Two teeth (4.0%) had been extracted. Significant positive correlations existed between "untoward events" (any form of retreatment or extraction) and "prognostic value according to periodontal status" (p = 0.047) and "attachment loss" (p = 0.042). The only preoperative factors significant for the prognosis of restored endodontically treated molars were related to periodontal prognostic value and attachment loss. It can be concluded that

  18. Periodontal profile classes predict periodontal disease progression and tooth loss.

    Science.gov (United States)

    Morelli, Thiago; Moss, Kevin L; Preisser, John S; Beck, James D; Divaris, Kimon; Wu, Di; Offenbacher, Steven

    2018-02-01

    Current periodontal disease taxonomies have limited utility for predicting disease progression and tooth loss; in fact, tooth loss itself can undermine precise person-level periodontal disease classifications. To overcome this limitation, the current group recently introduced a novel patient stratification system using latent class analyses of clinical parameters, including patterns of missing teeth. This investigation sought to determine the clinical utility of the Periodontal Profile Classes and Tooth Profile Classes (PPC/TPC) taxonomy for risk assessment, specifically for predicting periodontal disease progression and incident tooth loss. The analytic sample comprised 4,682 adult participants of two prospective cohort studies (Dental Atherosclerosis Risk in Communities Study and Piedmont Dental Study) with information on periodontal disease progression and incident tooth loss. The PPC/TPC taxonomy includes seven distinct PPCs (person-level disease pattern and severity) and seven TPCs (tooth-level disease). Logistic regression modeling was used to estimate relative risks (RR) and 95% confidence intervals (CI) for the association of these latent classes with disease progression and incident tooth loss, adjusting for examination center, race, sex, age, diabetes, and smoking. To obtain personalized outcome propensities, risk estimates associated with each participant's PPC and TPC were combined into person-level composite risk scores (Index of Periodontal Risk [IPR]). Individuals in two PPCs (PPC-G: Severe Disease and PPC-D: Tooth Loss) had the highest tooth loss risk (RR = 3.6; 95% CI = 2.6 to 5.0 and RR = 3.8; 95% CI = 2.9 to 5.1, respectively). PPC-G also had the highest risk for periodontitis progression (RR = 5.7; 95% CI = 2.2 to 14.7). Personalized IPR scores were positively associated with both periodontitis progression and tooth loss. These findings, upon additional validation, suggest that the periodontal/tooth profile classes and the derived

  19. Gore-tex® versus resolut adapt® GTR membranes with perioglas® in periodontal regeneration

    Directory of Open Access Journals (Sweden)

    Amit Wadhawan

    2012-01-01

    Full Text Available Background: Successful reconstruction of periodontal tissues destroyed due to periodontitis has been an evasive goal for the periodontists. Several GTR materials and bone grafts have been tried with varied success rates. Aims and Objectives: The aim of the present study was to evaluate and compare the efficacy of non-resorbable (GoreTex® and bioabsorbable (Resolut Adapt® membranes in combination with bioactive glass (PerioGlas® in the treatment of periodontal intrabony defects. Materials and Methods: Ten chronic periodontitis patients having bilateral matched intrabony defects were treated with non-resorbable membrane (GoreTex® and bioactive glass or the bioresorbable membrane (Resolut Adapt® and bioactive glass in split mouth design. Clinical parameters like plaque index, gingival index, probing pocket depth, clinical attachment level, and gingival recession were recorded at baseline and 9 months post-operatively. Similarly, radiographic (linear CADIA and intra-surgical (re-entry measurements were evaluated at baseline and 9 months post-operatively. Results: Both the membrane groups showed clinically and statistically significant improvement in clinical parameters i.e., reduction in probing depth (4.6 ± 1.4 mm vs. 3.7 ± 1.3 mm and gain in clinical attachment level (4.6 + 1.6 vs. 3.2 ± 1.5 mm for non-resorbable and bioresorbable membrane groups, respectively. Similar trend was observed when radiographical and intra-surgical (re-entry measurements were evaluated and compared, pre- and post-operatively at 9 months. However, on comparison between the two groups, the difference was statistically not significant. Conclusion: Both the barrier membranes i.e., non-resorbable (Gore-Tex® and bioabsorbable (Resolut Adapt® membranes in combination with bioactive glass (PerioGlas® were equally effective in enhancing the periodontal regeneration.

  20. 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.

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

    Science.gov (United States)

    Matthews, Debora C

    2014-09-01

    The aim of this guidance is to support the dental team to; manage patients with periodontal diseases in primary care appropriately; improve the quality of decision making for referral to secondary care; improve the overall oral health of the population. It focuses on the prevention and non-surgical treatment of periodontal diseases and implant diseases in primary care. The surgical treatment of periodontal and implant diseases and the management of patients by periodontal specialists or in a secondary care setting are outwith the scope of this guidance and are not discussed in detail. The guidance is based on existing guidelines, including those from the British Society of Periodontology, relevant systematic reviews, research evidence and the opinion of experts and experienced practitioners. The methodological approach is based on the international standards set out by the Appraisal of Guidelines Research and Evaluation (AGREE) Collaboration (www.agreetrust.org). The guiding principle for developing guidance within SDCEP is to first source existing guidelines, policy documents, legislation or other recommendations. Similarly, relevant systematic reviews are also initially identified. These documents are appraised for their quality of development, evidence base and applicability to the remit of the guidance under development. In the absence of these documents or when supplementary information is required, other published literature and unpublished work may be sought.Review and updating. The guidance will be reviewed in three years and updated accordingly. Recommendations are provided for assessment and diagnosis; changing patient behaviour; treatment of gingival conditions; periodontal conditions; long term maintenance; management of patients with dental implants; referral and record keeping. The key recommendations highlighted are: Assess and explain risk factors for periodontal diseases to patients. Screen all patients for periodontal diseases at every routine

  2. In Vitro Cold Transference of Bases and Restorations.

    Science.gov (United States)

    1980-07-01

    unknown. It would appear probable that long-term chronic exposures to sudden temperature changes may speed up these atrophic changes resulting in disease ...and Levy, B. Pulpal and periodontal effects of electrosurgery involving cervical metalic restorations. Oral Surg 46(5):702-710, 1978. 9. Langeland...Streptococcus sanguis. Pseudomonas aeruginosa, and Bacteroldes fragilis in the jaws of dogs . Oral Surg 48(5):454-462, 1979. 16. Peters, D., and

  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. Phase I/II Trial of Autologous Bone Marrow Stem Cell Transplantation with a Three-Dimensional Woven-Fabric Scaffold for Periodontitis

    Directory of Open Access Journals (Sweden)

    Shunsuke Baba

    2016-01-01

    Full Text Available Regenerative medicine is emerging as a promising option, but the potential of autologous stem cells has not been investigated well in clinical settings of periodontal treatment. In this clinical study, we evaluated the safety and efficacy of a new regenerative therapy based on the surgical implantation of autologous mesenchymal stem cells (MSCs with a biodegradable three-dimensional (3D woven-fabric composite scaffold and platelet-rich plasma (PRP. Ten patients with periodontitis, who required a surgical procedure for intrabony defects, were enrolled in phase I/II trial. Once MSCs were implanted in each periodontal intrabony defect, the patients were monitored during 36 months for a medical exam including laboratory tests of blood and urine samples, changes in clinical attachment level, pocket depth, and linear bone growth (LBG. All three parameters improved significantly during the entire follow-up period (p<0.0001, leading to an average LBG of 4.7 mm after 36 months. Clinical mobility measured by Periotest showed a decreasing trend after the surgery. No clinical safety problems attributable to the investigational MSCs were identified. This clinical trial suggests that the stem cell therapy using MSCs-PRP/3D woven-fabric composite scaffold may constitute a novel safe and effective regenerative treatment option for periodontitis.

  5. 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...

  6. ENDODONTIC TREATMENT AND POST-CORE RESTORATION

    Directory of Open Access Journals (Sweden)

    Evi Hafifah

    2006-04-01

    Full Text Available Endodontic root canal treatment is to maintain the tooth as long as possible in the arch’s width in a good functional status. In order to reach that goal, all irritation to the pulp should be eliminated so that the tooth has a healthy periodontal tissue support. A female patient, aged 37 years, came for her upper front tooth which had been restored with a pin crown a year ago. One month ago she had a swelling accompanied with throbbing pain. There was no history of general diseases and her oral hygiene was good. Clinically 11 was restored with a pin crown and the radiographic picture showed a narrow pulp chamber, normal roots with normal canals, thickened periodontium, broken laminar dura, and diffuse periapical rarefaction. The tooth was diagnosed with pulpal necrosis. A conventional root canal treatment was performed followed by the insertion of a post core crown. The result showed a satisfactory treatment plan, a good restoration, successful treatment in this case was due to the role of the dentist to create healthy soft and hard tissues in the oral cavity before restoration, and also due to patient cooperation.

  7. Endodontic Periodontic Lesions and Host Modulation – Case Series

    Directory of Open Access Journals (Sweden)

    Afaf Zia

    2015-07-01

    Full Text Available Host modulation, includes inhibition of matrix metalloproteinases, blocking production of proinflammatory cytokines and inhibition of osteoclastic activity, has therapeutic value as adjunctive therapy in treating chronic periodontitis. This case series presented three patients with chief complaint of teeth mobility where endo perio involvement was diagnosed. The endo perio combined lesions generally shows the communication between pulp and periodontal tissues with the same origin of dental infection. Diagnosis in such cases is difficult and generally raising problem in the management. All of the cases were managed by non surgical endodontic therapy combined with host modulation. All local factors causing the lesion were removed. Clinical outcome after six and nine months were quite satisfactory. Combined endo perio cases are challenging to the dentists and involve multidisciplinary involvement. To manage such cases, dentists have to rely on the unconventional techniques.DOI: 10.14693/jdi.v22i1.378

  8. Alterations in HbA1c following minimal or enhanced non-surgical, non-antibiotic treatment of gingivitis or mild periodontitis in type 2 diabetic patients: a pilot trial.

    Science.gov (United States)

    Madden, Theresa E; Herriges, Brock; Boyd, Linda D; Laughlin, Gayle; Chiodo, Gary; Rosenstein, David

    2008-07-01

    The purpose of this pilot study was to determine and compare the effects of two protocols aimed at reducing periodontal inflammation, upon the metabolic control of the diabetic condition in subjects with elevated baseline glycosylated hemoglobin (HbA1c). Forty-two non-smoking type 2 diabetes subjects with mildly elevated HbA1c (>7 but 9%) were randomized to one of two non-surgical periodontal therapy protocols. Patients in the "minimal therapy" (MT) group received scaling, root planning, and oral hygiene instructions on two occasions six months apart. Participants randomized to the "frequent therapy" (FT) protocol received scaling, root planing, and oral hygiene instructions at two-month intervals and were provided a 0.12% chlorhexidine rinse for home use twice daily. Neither systemic nor local antibiotics were provided to either group. Subjects were asked to report any changes in diabetic medications, nutrition, and physical activity. Data analyses (ANOVA, t-test, Mann-Whitney) grouped subjects according to baseline HbA1c (>7 and 9%), treatment protocol (minimal or frequent), and +/- medication change. In both MT and FT groups the clinical attachment level (CAL) remained unchanged but the other measures [gingival index (GI) and pocket dept (PD)] of periodontal health improved. Mean reductions in plaque showed improvement but calculus was worse in the FT group, likely due to the use of chlorhexidine. At six months, the largest reduction of HbA1c was 3.7; experienced by a subject receiving FT but no changes in diabetic medication. Among the MT and no medication change subjects, the maximum reduction was 1.6. Overall mean reduction in HbA1c of 27 subjects with baseline HbA1c >9.0 and no medication change was 0.6 with no statistical difference between the MT and FT groups. Among the medication-change subjects with baseline HbA1c >9.0, mean reduction of 1.38 was seen with FT compared to 1.10 with MT. Overall, modest improvements in HbA1c were detected with a trend

  9. 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.

  10. Root Conditioning and Agents Effect in Regeneration of Periodontal Tissue

    Directory of Open Access Journals (Sweden)

    Kadkhoda Z

    1999-12-01

    Full Text Available Periodontitis affected root surfaces are hypermineralized and contaminated with cytotoxic and"nother biologically active substances."nThe instrumented surface will inervitably be coverd by a smear layer following root planing with or without flap."nSmear layer is resistant to saline rinsing, but may be removed with agents such as acids (e.g.citric acid, tetracyclines, EDTA, and laser."nLow pH aqueous solutions such as citric acid have been used in surgical periodontal therapy mainly for two reasons, It dissolves smear layer after a relatively short exposure time and it has been claimed to selectively remove root surface associated mineral exposing collagen to varying degrees. A root surface coated with collagen appears to be a preferred surface for fibroblast attachment, a cellular event fundamental to successful periodontal wound healing."nSeveral studies indicate the potential of tetracycline (TTE-HCL in periodontal regeneration. Its acidic pH suggest that it can be used as a demineralization agent and removing the smear layer and exposing collagen matrix of the dentin."nChalating agent (EDTA working at neutral pH appears preferable with respect to preserving the integrity of exposed collagen fibers, early colonization, and wound healing. In addition, etching at neutral pH has been reported preserve adjacent tissue- vitality, while etching at low pH necrotizes the fiap and adjacent periodontium."nClinical and subclinical studies have demonstrated laser waves can remove calculus and bacterial plaque and pocket epithelium and strile the root surface and can expose the dentin collagen and dentinal tublules, and leads to pronounce reducing of probing depth around teeth diseased with periodontitis.

  11. Impact of periodontal status on oral health-related quality of life in patients with and without type 2 diabetes.

    Science.gov (United States)

    Irani, F C; Wassall, R R; Preshaw, P M

    2015-05-01

    To investigate the impact of periodontal status on oral health-related quality of life (OHRQoL) in patients with and without type 2 diabetes mellitus (T2DM). 61 patients with T2DM and 74 non-diabetic patients matched for age, gender and periodontal status (health, gingivitis, chronic periodontitis) were recruited. The oral health impact profile (OHIP)-49 was self-completed by all participants at baseline and by the patients with periodontitis at 3 months and 6 months after non-surgical periodontal therapy. There were no significant differences in the overall OHIP-49 summary scores between patients with T2DM (median; interquartile range; 37.0; 19.5-61.0) and without T2DM (30.4; 16.8-51.0) (p>0.05). Among non-diabetic patients, there were significantly higher OHIP-49 scores (indicating poorer OHRQoL) in patients with gingivitis (41.0; 19.7-75.7) and periodontitis (33.0; 19.9-52.5) compared to patients who were periodontally healthy (11.1; 7.1-34.5) (pdisability domains following periodontal treatment, indicating an improvement in OHRQoL. In contrast, there were no statistically significant changes in OHIP-49 scores following periodontal treatment in the patients with diabetes. T2DM does not impact on overall OHRQoL as measured by OHIP-49. Chronic periodontitis and gingivitis were associated with poorer OHRQoL in non-diabetic patients, with evidence of improvements following periodontal treatment, but no such effects were observed in patients with diabetes. Gingivitis and periodontitis are associated with reduced OHRQoL compared to periodontal health in non-diabetic patients, with improvements following treatment of periodontitis. No impact of type 2 diabetes on OHRQoL was noted; this may be related to the burden of chronic disease (diabetes) minimising the impact of oral health issues on OHRQoL. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. 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 ...

  13. Periodontitis in Chronic Heart Failure.

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A; Zugck, Christian; Frankenstein, Lutz

    2016-08-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases.

  14. Pre-prosthetic minor tooth movement with elastic separating ring & provisional restoration modification: case report

    Directory of Open Access Journals (Sweden)

    Haneol Shin

    2012-05-01

    Full Text Available Proximal caries or coronal defect in posterior teeth may result in the loss of proximal space and drifting of neighboring teeth, which makes restoration difficult. Inability to restore proper contours and to align tooth axis properly are commonly encountered problems when planning tooth restoration. Moreover, tilted teeth aggravate periodontal tissue breakdown, such as pseudo-pocket, and angular osseous defect. The purpose of this case presentation is to describe a simple technique for inducing minor tooth movement with orthodontic separating ring and provisional restoration modification. This method was used to create crown placement space on mesially tilted molar. This method is easy, simple and efficient technique which could be used in interproximal space gaining in selected situation.

  15. RELATIONSHIP BETWEEN PERIODONTAL DISEASE INDEX AND LOW BIRTH WEIGHT BABIES IN PREGNANT WOMEN WITH PERIODONTITIS

    Directory of Open Access Journals (Sweden)

    Ira Komara

    2016-03-01

    Full Text Available Objective: To identify the relationship between periodontitis in pregnant women through the periodontal disease index (PDI and low birth weight babies. Methods: A case-control study was conducted to determine the relationship between periodontitis in pregnant women through the periodontal disease index (PDI and the low birth weight babies (LBW. The participants were mothers with periodontitis and non-periodontitis mothers aged 20–35 years who gave birth in the Department of Obstetrics and Gynecology-Dr. Hasan Sadikin General Hospital, Bandung in the period of December to January 2005. Results: Based on the chisquare test results a highly significant relationship between periodontitis and low birth weight (p=0.002 was found. The Odd’s ratio showed that the risk of low birth weight in pregnant women with periodontitis was 15.58 times higher compared to those who did not suffer from periodontitis. The periodontal disease index has an accuracy of 88.6% in predicting the incidence of LBW. It strongly influenced the incidence of LBW with a high Odd’s ratio of 28.0. Pregnant women who suffer from periodontitis with a PDI > 3.25, have 19.2 times higher risk for delivering babies with LBW compared to the non-periodontitis mothers. Conclusions: The loss of attachment affects the possibility of delivering LBW babies.

  16. Gingival-colored Porcelain: A Clinical Report of an Esthetic-prosthetic Paradigm.

    Science.gov (United States)

    Sonune, Shital Jalandar; Kumar, Shiv; Jadhav, Manish Shivaji; Martande, Santosh

    2017-01-01

    Traditionally, periodontics has been instrumental in treating hard- and soft-tissue defect. Surgical and regenerative periodontal procedures can reconstruct the three-dimensional architecture of the hard- and soft-tissue defect. However, at times, these invasive procedures leave the patients with an esthetic problem. In such situations, the defects can be treated by the prosthetic approach. A predictable esthetically pleasing and functional outcome without any surgical procedure is being a choice of treatment for many. This article discusses about the treatment for the defect of excessive hard and soft tissue, using porcelain fused to a metal restoration with gingival-colored porcelain for both tooth-supported and implant-supported fixed prosthesis.

  17. Gingival-colored Porcelain: A Clinical Report of an Esthetic-prosthetic Paradigm

    Science.gov (United States)

    Sonune, Shital Jalandar; Kumar, Shiv; Jadhav, Manish Shivaji; Martande, Santosh

    2017-01-01

    Traditionally, periodontics has been instrumental in treating hard- and soft-tissue defect. Surgical and regenerative periodontal procedures can reconstruct the three-dimensional architecture of the hard- and soft-tissue defect. However, at times, these invasive procedures leave the patients with an esthetic problem. In such situations, the defects can be treated by the prosthetic approach. A predictable esthetically pleasing and functional outcome without any surgical procedure is being a choice of treatment for many. This article discusses about the treatment for the defect of excessive hard and soft tissue, using porcelain fused to a metal restoration with gingival-colored porcelain for both tooth-supported and implant-supported fixed prosthesis. PMID:29308371

  18. Impact of aggressive periodontitis and chronic periodontitis on oral health-related quality of life.

    Science.gov (United States)

    Llanos, Alexandre Hugo; Silva, Carlos Guillermo Benítez; Ichimura, Karina Tamie; Rebeis, Estela Sanches; Giudicissi, Marcela; Romano, Marcelo Munhóes; Saraiva, Luciana

    2018-01-01

    The purpose of this cross-sectional study was to investigate the effect of different forms of periodontal diseases on Oral Health-Related Quality of Life (OHRQoL). Fifty-two patients with Aggressive Periodontitis (AP) or Chronic Periodontitis (CP) were included: nine patients with Localized Aggressive Periodontitis (LAP), thirty-three patients with Generalized Aggressive Periodontitis (GAP) and ten patients with Generalized Chronic Periodontitis (GCP). Oral Health Impact Profile questionnaires (OHIP-14) were distributed after a clinical examination that measured the following periodontal parameters: tooth loss, bleeding on probing (BoP), probing depth (PD), gingival recession (REC) and clinical attachment level (CAL). The global OHIP-14 score means were 10.6 for LAP, 16.5 for GAP, and 17.5 for GCP. A statistically significant difference (p periodontitis. LAP, GAP and GCP have an impact on patient quality of life when measured using the OHIP-14. Patients with GAP and GCP had poorer OHRQoL than LAP patients.

  19. Restorative outcomes for endodontically treated teeth in the Practitioners Engaged in Applied Research and Learning network.

    Science.gov (United States)

    Spielman, Howard; Schaffer, Scott B; Cohen, Mitchell G; Wu, Hongyu; Vena, Donald A; Collie, Damon; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

    2012-07-01

    The authors aimed to determine the outcome of and factors associated with success and failure of restorations in endodontically treated teeth in patients in practices participating in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. Practitioner-investigators (P-Is) invited the enrollment of all patients seeking care at participating practices who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years earlier. P-Is classified endodontically reated teeth as restorative failures if the restoration was replaced, the restoration needed replacement or the tooth was cracked or fractured. P-Is from 64 practices enrolled in the study 1,298 eligible patients who had endodontically treated teeth that had been restored. The mean (standard deviation) time to follow-up was 3.9 (0.6) years. Of the 1,298 enrolled teeth, P-Is classified 181 (13.9 percent; 95 percent confidence interval [CI], 12.1-15.8 percent) as restorative failures: 44 (3.4 percent) due to cracks or fractures, 57 (4.4 percent) due to replacement of the original restoration for reasons other than fracture and 80 (6.2 percent) due to need for a new restoration. When analyzing the results by means of multivariate logistic regression, the authors found a greater risk of restorative failure to be associated with canines or incisors and premolars (P = .04), intracoronal restorations (P < .01), lack of preoperative proximal contacts (P < .01), presence of periodontal connective-tissue attachment loss (P < .01), younger age (P = .01), Hispanic/Latino ethnicity (P = .04) and endodontic therapy not having been performed by a specialist (P = .04). These results suggest that molars (as opposed to other types of teeth), full-coverage restorations, preoperative proximal contacts, good periodontal health, non-Hispanic/Latino ethnicity, endodontic therapy performed by a specialist and older patient age are associated with restorative success for

  20. Periodontal status of teeth restored with crowns and its contralateral homologue, Valdivia- Chile.

    OpenAIRE

    Israel Antonio Juárez; Sofía Larroulet; Makarena Ojeda; Cristian Rosas

    2015-01-01

    ABSTRACT Aim: To determine periodontal status of fixes single prostheses (FSP) made during the year 2013 in Austral University of Chile, and its contralateral homologue (CH).Methods: All patients with FSP made during 2013, that met the selection criteria and agreed to participate were evaluated. During the year 2014 was measured: probing depth, attachment level; bleeding on probing and dental plaque index for each FSP and CH; and consigned biological width invasion. Were measured one FSP...

  1. Regenerative Medicine for Periodontal and Peri-implant Diseases.

    Science.gov (United States)

    Larsson, L; Decker, A M; Nibali, L; Pilipchuk, S P; Berglundh, T; Giannobile, W V

    2016-03-01

    The balance between bone resorption and bone formation is vital for maintenance and regeneration of alveolar bone and supporting structures around teeth and dental implants. Tissue regeneration in the oral cavity is regulated by multiple cell types, signaling mechanisms, and matrix interactions. A goal for periodontal tissue engineering/regenerative medicine is to restore oral soft and hard tissues through cell, scaffold, and/or signaling approaches to functional and aesthetic oral tissues. Bony defects in the oral cavity can vary significantly, ranging from smaller intrabony lesions resulting from periodontal or peri-implant diseases to large osseous defects that extend through the jaws as a result of trauma, tumor resection, or congenital defects. The disparity in size and location of these alveolar defects is compounded further by patient-specific and environmental factors that contribute to the challenges in periodontal regeneration, peri-implant tissue regeneration, and alveolar ridge reconstruction. Efforts have been made over the last few decades to produce reliable and predictable methods to stimulate bone regeneration in alveolar bone defects. Tissue engineering/regenerative medicine provide new avenues to enhance tissue regeneration by introducing bioactive models or constructing patient-specific substitutes. This review presents an overview of therapies (e.g., protein, gene, and cell based) and biomaterials (e.g., resorbable, nonresorbable, and 3-dimensionally printed) used for alveolar bone engineering around teeth and implants and for implant site development, with emphasis on most recent findings and future directions. © International & American Associations for Dental Research 2015.

  2. Resistin: A Potential Biomarker for Periodontitis Influenced Diabetes Mellitus and Diabetes Induced Periodontitis

    Directory of Open Access Journals (Sweden)

    Archana Devanoorkar

    2014-01-01

    Full Text Available Biomarkers are highly specific and sensitive indicators of disease activity. Resistin is a recently discovered adipocytokine, having a potent biomarker quality. Initially resistin was thought to be produced by adipocytes alone; however, emerging evidence suggests that it is also produced in abundance by various cells of the immunoinflammatory system, indicating its role in various chronic inflammatory diseases. Data suggests that resistin plays a role in obesity, insulin resistance, cardiovascular diseases, and periodontitis. Resistin derived its name from the original observation that it induced insulin resistance (resist-in: resist insulin in mice and is downregulated in mature murine adipocytes cultured in the presence of insulin sensitizing drugs like thiazolidinediones. It is well recognized that obesity, is associated with insulin resistance and diabetes. A three-way relationship has been established between diabetes, obesity and periodontitis. Recent evidence also suggests an association between obesity and increased risk for periodontitis. Our previous research showed incremental elevation of resistin with periodontal disease activity and a reduced level of resistin, after periodontal therapy. Thus resistin would be one of the molecular links connecting obesity, periodontitis, and diabetes and may serve as a marker that links periodontal disease with other systemic diseases. A Medline/PubMed search was carried out for keywords “Diabetes Mellitus,” “Periodontitis,” and “Resistin,” and all relevant research papers from 1990 in English were shortlisted and finalized based on their importance. This review provides an insight into the biological action of resistin and its possible role in periodontitis influenced diabetes mellitus and diabetes induced periodontitis.

  3. 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.

  4. Antibacterial efficacy of triple-layered poly(lactic-co-glycolic acid)/nanoapatite/lauric acid guided bone regeneration membrane on periodontal bacteria.

    Science.gov (United States)

    Saarani, Nur Najiha; Jamuna-Thevi, Kalitheerta; Shahab, Neelam; Hermawan, Hendra; Saidin, Syafiqah

    2017-05-31

    A guided bone regeneration (GBR) membrane has been extensively used in the repair and regeneration of damaged periodontal tissues. One of the main challenges of GBR restoration is bacterial colonization on the membrane, constitutes to premature membrane degradation. Therefore, the purpose of this study was to investigate the antibacterial efficacy of triple-layered GBR membrane composed of poly(lactic-co-glycolic acid) (PLGA), nanoapatite (NAp) and lauric acid (LA) with two types of Gram-negative periodontal bacteria, Fusobacterium nucleatum and Porphyromonas gingivalis through a disc diffusion and bacterial count tests. The membranes exhibited a pattern of growth inhibition and killing effect against both bacteria. The increase in LA concentration tended to increase the bactericidal activities which indicated by higher diameter of inhibition zone and higher antibacterial percentage. It is shown that the incorporation of LA into the GBR membrane has retarded the growth and proliferation of Gram-negative periodontal bacteria for the treatment of periodontal disease.

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

    Directory of Open Access Journals (Sweden)

    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 and hematological characteristics associated with aggressive periodontitis, juvenile idiopathic arthritis, and rheumatoid arthritis

    DEFF Research Database (Denmark)

    Poulsen, Anne Havemose; Westergaard, Jytte; Stoltze, Kaj

    2006-01-01

    Periodontitis shares several clinical and pathogenic characteristics with chronic arthritis, and there is some degree of coexistence. The aims of this study were to elucidate whether patients with localized aggressive periodontitis (LAgP), generalized aggressive periodontitis (GAgP), juvenile...... idiopathic arthritis (JIA), and rheumatoid arthritis (RA) share periodontal and hematological characteristics distinguishing them from individuals free of diseases....

  7. Defect of netrophil chemotactic function is one of the etiology of aggressive periodontitis.

    Directory of Open Access Journals (Sweden)

    Yanti Rusyanti

    2016-06-01

    Full Text Available Characteristic of progressive destructive periodontal tissue in Aggressive Periodontitis is a features of disruption of the host-homeostasis as the results of imbalance between host response and specific bacterial pathogenic which presents at gingival sulcus. The objective of this study was to evaluate netrophil function of  Aggressive periodontitis molecularly by means of gen polimorphism of Formyl Peptide Receptor (FPR1 at the surface of netrophil cell, the level of IL-8 and netrophil chemotactic. The results of  the study  can be used as an early detection, prevention or to arrest tissue destruction and to restore a health-associated homeostasis in order to get better prognosis of Aggressive Periodontitis. The study was conducted during 20 months in Periodontic Clinic Dental Hospital, Faculty of Dentistry, Padjadjaran University, Genetica Moleculer Medical Laboratory of Research Institution Padjadjaran University Bandung. Research design used case control methode and sample selection is done in concecutive sampling of 32 aggressive periodontitis patients and 29 non aggressive periodontitis patients who were included in the inclusion criteria. Research materials were venous blood and gingival crevicular fluid. PCR-Sequensing methode was used to asses of gene FPR1 Polimorphism. ELISA methode was used to measure IL-8 level in gingival crevicular fluid, and Human CD66abce Microbead Kit by MACS Separation methode was used to asses netrophil chemotactic. Chi-square test, Fisher’s exact, unpaired t tests were employed to analyse the differences of  characteristic, allele frequencies and genotypic, bivariate analysis to analyse of risk factors and biserial point correlation to analyse correlation between risk factors. The results showed the existence of c576T>C>G gene FPR1 polymorphism 5.040 time-fold (p=0.006; OR=5.040 while the down regulation of IL-8( ≤0.064 pg/µl is 34.5 times-fold of having aggressive periodontitis (OR=34, and c576T

  8. Improvement of an anterior infrabone defect using combined periodontal and orthodontic therapy: A 6-year follow-up case report.

    Science.gov (United States)

    de Molon, Rafael Scaf; Kim, Yeon Jung; Dos Santos-Pinto, Ary; Cirelli, Joni Augusto

    2014-07-01

    Extensive intraosseous lesions represent a clinical challenge for the periodontist. Sites with bone defects have been shown to be at higher risk of periodontitis progression in patients who had not received periodontal therapy. Thus, the aim of this case report was to describe a novel approach for the treatment of 1-walled intraosseous defect by combining nonsurgical periodontal therapy and orthodontic movement toward the bone defect, avoiding regenerative and surgical procedures. A 47-year-old woman underwent the proposed procedures for the treatment of her left central incisor with 9 mm probing depth and 1-walled intraosseous defect in its mesial aspect. Initially, basic periodontal therapy with scaling and root planning was accomplished. Two months later, an orthodontic treatment was planned to eliminate the intraosseous lesion and to improve the interproximal papillary area. Orthodontic root movement toward the osseous defect was performed for 13 months with light forces. After 6 years postoperative it was concluded that combined basic periodontal therapy and orthodontic movement was capable of eliminating the intraosseous defect and improve the esthetics in the interproximal papillary area between the central incisors.

  9. 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...

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  12. A Novel Surgical Template Design in Staged Dental Implant Rehabilitations

    Directory of Open Access Journals (Sweden)

    Michael Patras

    2012-05-01

    Full Text Available Background: The philosophy of a gradual transition to an implant retained prosthesis in cases of full-mouth or extensive rehabilitation usually involves a staged treatment concept. In this therapeutic approach, the placement of implants may sometimes be divided into phases. During a subsequent surgical phase of treatment, the pre-existing implants can serve as anchors for the surgical template. Those modified surgical templates help in the precise transferring of restorative information into the surgical field and guide the optimal three-dimensional implant positioning. Methods: This article highlights the rationale of implant-retained surgical templates and illustrates them through the presentation of two clinical cases. The templates are duplicates of the provisional restorations and are secured to the existing implants through the utilization of implant mounts. Results: This template design in such staged procedures provided stability in the surgical field and enhanced the accuracy in implant positioning based upon the planned restoration, thus ensuring predictable treatment outcomes.Conclusions: Successful rehabilitation lies in the correct sequence of surgical and prosthetic procedures. Whenever a staged approach of implant placement is planned, the clinician can effectively use the initially placed implants as anchors for the surgical template during the second phase of implant surgery.

  13. 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...

  14. 16S rDNA analysis of periodontal plaque in chronic obstructive pulmonary disease and periodontitis patients.

    Science.gov (United States)

    Wu, Xingwen; Chen, Jiazhen; Xu, Meng; Zhu, Danting; Wang, Xuyang; Chen, Yulin; Wu, Jing; Cui, Chenghao; Zhang, Wenhong; Yu, Liying

    2017-01-01

    This study investigated if chronic obstructive pulmonary disease (COPD) is correlated with periodontitis via periodontal microbiota and if certain bacteria affect periodontitis as well as COPD. Moreover, the study investigated whether suffering from COPD is associated with a decrease in the richness and diversity of periodontal microbiota. Subgingival plaque was obtained from 105 patients. Bacterial DNA was isolated from 55 COPD and 50 non-COPD participants (either with or without periodontitis). 16S rRNA gene metagenomic sequencing was used to characterize the microbiota and to determine taxonomic classification. In the non-periodontitis patients, suffering from COPD resulted in a decrease in bacteria richness and diversity in the periodontal microenvironment. An increase in the genera Dysgonomonas , Desulfobulbus , and Catonella and in four species ( Porphyromonas endodontalis , Dysgonomonas wimpennyi , Catonella morbi , and Prevotella intermedia ) in both COPD and periodontitis patients suggests that an increase in these periodontitis-associated microbiota may be related to COPD. Three genera ( Johnsonella , Campylobacter , and Oribacterium ) were associated with COPD but not with periodontitis. The decrease in the genera Arcanobacterium , Oribacterium , and Streptomyces in COPD patients implies that these genera may be health-associated genera, and the decrease in these genera may be related to disease. These data support the hypothesis that COPD is correlated with periodontitis via these significantly changed specific bacteria.

  15. Ozone therapy in periodontics.

    Science.gov (United States)

    Gupta, G; Mansi, B

    2012-02-22

    Gingival and Periodontal diseases represent a major concern both in dentistry and medicine. The majority of the contributing factors and causes in the etiology of these diseases are reduced or treated with ozone in all its application forms (gas, water, oil). The beneficial biological effects of ozone, its anti-microbial activity, oxidation of bio-molecules precursors and microbial toxins implicated in periodontal diseases and its healing and tissue regeneration properties, make the use of ozone well indicated in all stages of gingival and periodontal diseases. The primary objective of this article is to provide a general review about the clinical applications of ozone in periodontics. The secondary objective is to summarize the available in vitro and in vivo studies in Periodontics in which ozone has been used. This objective would be of importance to future researchers in terms of what has been tried and what the potentials are for the clinical application of ozone in Periodontics.

  16. Regeneration of bone and periodontal ligament induced by recombinant amelogenin after periodontitis.

    Science.gov (United States)

    Haze, Amir; Taylor, Angela L; Haegewald, Stefan; Leiser, Yoav; Shay, Boaz; Rosenfeld, Eli; Gruenbaum-Cohen, Yael; Dafni, Leah; Zimmermann, Bernd; Heikinheimo, Kristiina; Gibson, Carolyn W; Fisher, Larry W; Young, Marian F; Blumenfeld, Anat; Bernimoulin, Jean P; Deutsch, Dan

    2009-06-01

    Regeneration of mineralized tissues affected by chronic diseases comprises a major scientific and clinical challenge. Periodontitis, one such prevalent disease, involves destruction of the tooth-supporting tissues, alveolar bone, periodontal-ligament and cementum, often leading to tooth loss. In 1997, it became clear that, in addition to their function in enamel formation, the hydrophobic ectodermal enamel matrix proteins (EMPs) play a role in the regeneration of these periodontal tissues. The epithelial EMPs are a heterogeneous mixture of polypeptides encoded by several genes. It was not clear, however, which of these many EMPs induces the regeneration and what mechanisms are involved. Here we show that a single recombinant human amelogenin protein (rHAM(+)), induced in vivo regeneration of all tooth-supporting tissues after creation of experimental periodontitis in a dog model. To further understand the regeneration process, amelogenin expression was detected in normal and regenerating cells of the alveolar bone (osteocytes, osteoblasts and osteoclasts), periodontal ligament, cementum and in bone marrow stromal cells. Amelogenin expression was highest in areas of high bone turnover and activity. Further studies showed that during the first 2 weeks after application, rHAM(+) induced, directly or indirectly, significant recruitment of mesenchymal progenitor cells, which later differentiated to form the regenerated periodontal tissues. The ability of a single protein to bring about regeneration of all periodontal tissues, in the correct spatio-temporal order, through recruitment of mesenchymal progenitor cells, could pave the way for development of new therapeutic devices for treatment of periodontal, bone and ligament diseases based on rHAM(+).

  17. [Prevalence of dental diseases among Moscow students and need of dentistry].

    Science.gov (United States)

    Makeeva, I M; Doroshina, V Iu; Protsenko, A S

    2009-01-01

    A clinical epidemiologic study was made among 432 Moscow students and as a part of it was found the high prevalence rate of pathologies of dentition and variety of nosologic forms. The most common cases were: caries, periodontal disease, deformity and anomalies of tooth position. These findings were necessary to estimate the need of all types of dentistry for Moscow students. It was specified that 43% of students were in need of filling and dental restoration, 35% were in need of crowns of tooth, 22% were in need of dental restoration by means of orthopedic constructions. Endodontic dentistry was necessary for 31% of students, surgical removal - for 8%, periodontal dentistry - for 37%.

  18. MicroRNAs and Periodontal Homeostasis.

    Science.gov (United States)

    Luan, X; Zhou, X; Trombetta-eSilva, J; Francis, M; Gaharwar, A K; Atsawasuwan, P; Diekwisch, T G H

    2017-05-01

    MicroRNAs (miRNAs) are a group of small RNAs that control gene expression in all aspects of eukaryotic life, primarily through RNA silencing mechanisms. The purpose of the present review is to introduce key miRNAs involved in periodontal homeostasis, summarize the mechanisms by which they affect downstream genes and tissues, and provide an introduction into the therapeutic potential of periodontal miRNAs. In general, miRNAs function synergistically to fine-tune the regulation of biological processes and to remove expression noise rather than by causing drastic changes in expression levels. In the periodontium, miRNAs play key roles in development and periodontal homeostasis and during the loss of periodontal tissue integrity as a result of periodontal disease. As part of the anabolic phase of periodontal homeostasis and periodontal development, miRNAs direct periodontal fibroblasts toward alveolar bone lineage differentiation and new bone formation through WNT, bone morphogenetic protein, and Notch signaling pathways. miRNAs contribute equally to the catabolic aspect of periodontal homeostasis as they affect osteoclastogenesis and osteoclast function, either by directly promoting osteoclast activity or by inhibiting osteoclast signaling intermediaries or through negative feedback loops. Their small size and ability to target multiple regulatory networks of related sets of genes have predisposed miRNAs to become ideal candidates for drug delivery and tissue regeneration. To address the immense therapeutic potential of miRNAs and their antagomirs, an ever growing number of delivery approaches toward clinical applications have been developed, including nanoparticle carriers and secondary structure interference inhibitor systems. However, only a fraction of the miRNAs involved in periodontal health and disease are known today. It is anticipated that continued research will lead to a more comprehensive understanding of the periodontal miRNA world, and a systematic

  19. Systematic review of the adjunctive use of diode and Nd:YAG lasers for nonsurgical periodontal instrumentation.

    Science.gov (United States)

    Roncati, Marisa; Gariffo, Annalisa

    2014-04-01

    The aims of this study were (1) to conduct a literature search and systematically evaluate the additional therapeutic effects of pulsed Nd:YAG or diode laser use in patients with periodontitis, (2) to assess evidence supporting the additional benefit of laser-mediated periodontal treatment in conjunction with scaling and root planning (SRP) (not as monotherapy), and (3) to interpret the evidence presented in retrieved publications. Opinions about the additional use of diode lasers in the nonsurgical treatment of plaque-induced periodontal lesions are conflicting. The April 2011 American Academy of Periodontology's "Statement on the Efficacy of Lasers in the Non-Surgical Treatment of Inflammatory Periodontal Disease" asserted that the use of a laser as monotherapy or in addition to nonsurgical periodontal instrumentation conveyed no advantage. After initial screening, 23/77 potentially relevant articles and abstracts identified through electronic and manual searches of the MEDLINE(®)/PubMed database and the Cochrane Central Register of Controlled Trials (1990-2012) were included in this review. A meta-analysis could be performed. The results indicate that Nd:YAG or diode laser, used in an adjunctive capacity to SRP, may provide some additional benefit, in 6 month studies, compared with mechanical debridement. The results show the adjunctive benefits that diode laser treatment can provide when it is used as an adjunct to nonsurgical periodontal treatment in adults with chronic periodontitis. Further long-term, well-designed, parallel randomized clinical trials are needed to assess the effectiveness of the adjunctive use of the diode laser, as well as the appropriate dosimetry and laser settings.

  20. Periodontal Emergencies in General Practice.

    Science.gov (United States)

    Wadia, Reena; Ide, Mark

    2017-05-01

    Diagnosing and managing periodontal emergencies is a common part of general dental practice. This article summarises the presentation, aetiology and management of the key periodontal emergencies, including gingival abscess, periodontal abscess, peri-coronitis/peri-coronal abscess, perio-endo lesion/ abscess, necrotising gingivitis and periodontitis, acute herpetic gingivostomatitis, acute physical/chemical/thermal injury and subgingival root fracture.

  1. 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.

  2. Telescopic overdenture: Perio-prostho concern for advanced periodontitis

    Directory of Open Access Journals (Sweden)

    Roma Goswami

    2013-01-01

    Full Text Available The crown- and sleeve-coping denture is a removable prosthesis that is supported by both selectively retained teeth and the residual ridge or mucosa. It is a versatile and successful means of achieving long-term restoration of a partially edentulous jaw. Insertion and removal of the denture and routine oral hygiene are easy to perform. The beneficial results of this form of treatment can be considered for a wide variety of clinical applications for the severely advanced periodontitis case. This paper presents a case report on the prosthetic rehabilitation of a partially edentulous patient with a telescopic overdenture for the mandible and complete denture for the maxilla.

  3. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions.

    Science.gov (United States)

    Jepsen, Søren; Caton, Jack G; Albandar, Jasim M; Bissada, Nabil F; Bouchard, Philippe; Cortellini, Pierpaolo; Demirel, Korkud; de Sanctis, Massimo; Ercoli, Carlo; Fan, Jingyuan; Geurs, Nicolaas C; Hughes, Francis J; Jin, Lijian; Kantarci, Alpdogan; Lalla, Evanthia; Madianos, Phoebus N; Matthews, Debora; McGuire, Michael K; Mills, Michael P; Preshaw, Philip M; Reynolds, Mark A; Sculean, Anton; Susin, Cristiano; West, Nicola X; Yamazaki, Kazuhisa

    2018-06-01

    a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non-carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term biologic width is replaced by supracrestal tissue attachment consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm-induced gingival inflammation and loss of periodontal supporting tissues. An updated classification of the periodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced. Case definitions and diagnostic considerations are also presented. © 2018 American Academy of Periodontology and European Federation of Periodontology.

  4. Changing trends in hair restoration surgery

    Directory of Open Access Journals (Sweden)

    Venkataram Mysore

    2006-01-01

    Full Text Available Androgenetic alopecia is an important and common cause for baldness. Despite recent advances, the drug therapy of this condition remains unsatisfactory. Surgical hair restoration is the only permanent method of treating this condition. Introduction of recent techniques such as follicular unit transplantation have improved the cosmetic results and patient satisfaction. This article discusses the latest trends in hair restoration surgery.

  5. 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.

  6. 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.

  7. Lasers in periodontics: a review of the literature.

    Science.gov (United States)

    Cobb, Charles M

    2006-04-01

    therapy. Current evidence does suggest that use of the Nd:YAG or Er:YAG wavelengths for treatment of chronic periodontitis may be equivalent to scaling and root planing (SRP) with respect to reduction in probing depth and subgingival bacterial populations. However, if gain in clinical attachment level is considered the gold standard for non-surgical periodontal therapy, then the evidence supporting laser-mediated periodontal treatment over traditional therapy is minimal at best. Lastly, there is limited evidence suggesting that lasers used in an adjunctive capacity to SRP may provide some additional benefit.

  8. Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in the Netherlands and Spain

    NARCIS (Netherlands)

    van Winkelhoff, AJ; Herrera, D; Oteo, A; Sanz, M

    Background and Aim: Antimicrobial resistance of periodontal pathogens towards currently used antibiotics in periodontics has been investigated in a previous study. Microbial resistance in the periodontal microflora was more frequently observed in Spanish patients in comparison with Dutch patients.

  9. Assessment of Periodontal Tissue Status in Patients with Generalized Periodontitis and Essential Hypertension

    Directory of Open Access Journals (Sweden)

    T I Vicharenko

    2017-06-01

    Full Text Available Vascular disorders play a significant role in the development of dystrophic inflammatory process. There is a direct correlation between the degree of damage to blood vessels in the jaw and a depth of the destructive process in periodontal tissue. A certain role is played by endogenous factors, such as: age, vitamin deficiency, diabetes mellitus, essential hypertension and others. Clinical and epidemiological studies using pathological techniques showed significant changes in vascular wall of the artery in the periodontium, the interdental artery in particular.  Atherosclerosis, essential hypertension and periodontal pathology were proven to occur in individuals older than 40 years. The objective of the research was to determine periodontal tissue status in patients with stage II hypertension and generalized periodontitis of II degree of severity. Materials and methods. The study involved 36 patients with stage II hypertension and generalized periodontitis of II degree of severity (the main group. The patients’ age ranged from 35 to 54 years. The control group included 10 patients of corresponding age without generalized periodontitis and somatic pathology. To assess the status of periodontal tissues, we applied the Papillary-Marginal-Attached Index and the Community Periodontal Index of Treatment Needs. When diagnosing periodontal disease, the classification of M.F. Danilevskyi was used. Results. The analysis of the indicators of the Community Periodontal Index of Treatment Needs index showed the following results: in patients of the main group, the index was 2.38±0.07 points (p<0.001 pointing out a need for a course of professional oral hygiene. In patients of the control group, the index was 0.5±0.17 points indicating that there was no need for treatment, however, there was a need for improving oral hygiene. The indicators of the Papillary-Marginal-Attached Index in the main group were 55.49±1.96 points pointing out a severe degree of

  10. Active matrix metalloproteinase-8 and periodontal bacteria depending on periodontal status in patients with rheumatoid arthritis.

    Science.gov (United States)

    Kirchner, A; Jäger, J; Krohn-Grimberghe, B; Patschan, S; Kottmann, T; Schmalz, G; Mausberg, R F; Haak, R; Ziebolz, D

    2017-08-01

    The aim of this clinical cross-sectional study was to determine the level of active matrix metalloproteinase-8 (aMMP-8) and periodontal pathogenic bacteria in gingival crevicular fluid in patients with rheumatoid arthritis (RA) with varying periodontal conditions. In total, 103 patients with RA and 104 healthy controls (HC) were included. The assessment of periodontal status included periodontal probing depth, bleeding on probing and clinical attachment loss. Periodontal disease was classified as healthy/mild, moderate or severe. For the determination of aMMP-8 levels using enzyme-linked immunosorbent assay and periodontal pathogenic bacteria using polymerase chain reaction, samples of gingival crevicular fluid were taken from the deepest gingival pockets. The statistical analyses used included a Mann-Whitney U-test, a chi-squared test or a Fisher's exact test, and the significance level was set at α = 5%. We found that 65% of patients with RA and 79% of HC had moderate to severe periodontal disease (p = 0.02). The prevalence of periodontal pathogens was almost equal (p > 0.05). Furthermore, depending on periodontal disease severity only minor differences in bacterial prevalence were detected. With increasing severity of periodontal disease, higher aMMP-8 levels were observed. Accordingly, a significant difference in patients with moderate periodontal disease (RA: 15.3 ± 13.8; HC: 9.1 ± 9.1; p ≤ 0.01) and severe periodontal disease (RA: 21.7 ± 13.3; HC: 13.1 ± 8.6; p = 0.07) was detected, with a greater tendency in the latter group. The increased aMMP-8 levels in the RA group indicate that the presence of RA appears to have an influence on the host response at a comparable level of bacterial load and periodontal disease severity. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Active Matrixmetalloproteinase-8 and periodontal bacteria - interlink between periodontitis and inflammatory bowel disease?

    Science.gov (United States)

    Schmidt, J; Weigert, M; Leuschner, C; Hartmann, H; Raddatz, D; Haak, R; Mausberg, R F; Kottmann, Tanja; Schmalz, G; Ziebolz, D

    2018-03-25

    The aim of this study was the investigation of concentration and prevalence of selected periodontal pathogenic bacteria and concentration of active matrix-metalloproteinase-8 (aMMP-8) within a group of patients with inflammatory bowel diseases (IBD) and to compare the results with a group of healthy control subjects (HC). 59 IBD patients with Crohn`s disease (CD, n = 30) or ulcerative colitis (UC, n = 29) and 59 HC were included in this cross-sectional study. Based on periodontal probing depth (PPD) and clinical attachment level (CAL), periodontitis was classified into healthy/mild, moderate or severe. aMMP-8 was analyzed from gingival crevicular fluid using enzyme linked immunosorbent assay. Eleven selected periodontal pathogenic bacteria were analyzed in subgingival plaque samples using polymerase chain reaction. IBD patients showed higher CAL (p periodontitis (p = 0.04), gingival bleeding (p periodontitis was associated with an increase in aMMP-8 concentration (p = 0.02). The prevalences of Eubacterium nodatum and Eikanella corrodens were significantly lower in IBD compared to HC (p = 0.01). Additionally, the prevalence of Eikanella corrodens was significantly higher in CD compared to UC group (p = 0.04). Further statistically significant differences in selected bacteria between IBD and HC or CD and UC groups could not be found (p > 0.05). The results reveal changes in host immune response of IBD patients in terms of aMMP-8. Only in CD increasing aMMP-8 was associated with severity of periodontal disease. The role of periodontal pathogenic bacteria in the interrelation between IBD and periodontitis remains unclear. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Detection of Periodontal Markers in Chronic Periodontitis

    Science.gov (United States)

    Leonhardt, Åsa; Carlén, Anette; Bengtsson, Lisbeth; Dahlén, Gunnar

    2011-01-01

    The aim was to compare the detection frequency of periodontopathogens by using the Pado Test 4.5 and checkerboard DNA-DNA hybridization technique in chronic periodontitis patients. Thirty patients with chronic periodontitis were tested cross-sectionally with DNA/RNA oligogenomic probe method (IAI Pado Test 4.5) and DNA/DNA whole genomic probe (checkerboard) method. Samples were taken by two paper points at the deepest site in each of the four quadrants and pooled into one sample for each of the two methods. The samples were sent to the two laboratories (IAI, Zuchwil, Switzerland, and Oral Microbiology Laboratory, University of Gothenburg, Sweden) and were analyzed in a routine setting for the presence and amount of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. While Pado Test 4.5 detected the four periodontal pathogens in 11 (36.7%) of the patients, the checkerboard method showed presence in all patients (100%) using the lower score (Score 1 corresponding to 104 bacterial cells) and 16 (53.3%) using a higher treshold (score 3 corresponding to between >105 and 106 cells). The results of the present study showed low agreement for a positive microbiological outcome using the two diagnostic methods. It was also concluded that microbiological analysis in practice should include a larger number of bacterial species to better serve as markers for a diseased associated flora in chronic periodontitis cases. PMID:21769304

  13. Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults.

    Science.gov (United States)

    Cope, Anwen; Francis, Nick; Wood, Fiona; Mann, Mala K; Chestnutt, Ivor G

    2014-06-26

    Dental pain can have a considerable detrimental effect on an individual's quality of life. Symptomatic apical periodontitis and acute apical abscess are common causes of dental pain and arise from an inflamed or necrotic dental pulp, or infection of the pulpless root canal system. Clinical guidelines recommend that the first-line treatment for teeth with symptomatic apical periodontitis or an acute apical abscess should be removal of the source of inflammation or infection by local, operative measures, and that systemic antibiotics are currently only recommended for situations where there is evidence of spreading infection (cellulitis, lymph node involvement, diffuse swelling) or systemic involvement (fever, malaise). Despite this, there is evidence that dentists continue to prescribe antibiotics for these conditions. There is concern that this could contribute to the development of antibiotic-resistant bacterial colonies both within the individual and within the community as a whole. To evaluate the effects of systemic antibiotics provided with or without surgical intervention (such as extraction, incision and drainage of a swelling or endodontic treatment), with or without analgesics, for symptomatic apical periodontitis or acute apical abscess in adults. We searched the following electronic databases: Cochrane Oral Health Group's Trials Register (to 1 October 2013); Cochrane Central Register of Controlled Trials (The Cochrane Library 2013, Issue 9); MEDLINE via OVID (1946 to 1 October 2013); EMBASE via OVID (1980 to 1 October 2013) and CINAHL via EBSCO (1980 to 1 October 2013). We searched the World Health Organization (WHO) International Trials Registry Platform and the US National Institutes of Health Trials Registry (ClinicalTrials.gov) on 1 October 2013 to identify ongoing trials. We searched for grey literature using OpenGrey (to 1 October 2013) and ZETOC Conference Proceedings (1993 to 1 October 2013). We placed no restrictions on the language or date of

  14. Clinical Effects of Lactobacillus rhamnosus in Non-Surgical Treatment of Chronic Periodontitis: A Randomized Placebo-Controlled Trial With 1-Year Follow-Up.

    Science.gov (United States)

    Morales, Alicia; Carvajal, Paola; Silva, Nora; Hernandez, Marcela; Godoy, Claudia; Rodriguez, Gonzalo; Cabello, Rodrigo; Garcia-Sesnich, Jocelyn; Hoare, Anilei; Diaz, Patricia I; Gamonal, Jorge

    2016-08-01

    Probiotics are living microorganisms that provide beneficial effects for the host when administered in proper quantities. The aim of this double-masked placebo-controlled parallel-arm randomized clinical trial is to evaluate the clinical effects of a Lactobacillus rhamnosus SP1-containing probiotic sachet as an adjunct to non-surgical therapy. Twenty-eight systemically healthy volunteers with chronic periodontitis were recruited and monitored clinically at baseline and 3, 6, 9, and 12 months after therapy. Clinical parameters measured included plaque accumulation, bleeding on probing, probing depths (PDs), and clinical attachment loss. Patients received non-surgical therapy, including scaling and root planing (SRP), and were assigned randomly to a test (SRP + probiotic, n = 14) or control (SRP + placebo, n = 14) group. The intake, once a day for 3 months, of an L. rhamnosus SP1 probiotic sachet commenced after the last session of SRP. Both test and control groups showed improvements in clinical parameters at all time points evaluated. However, the test group showed greater reductions in PD than the control. Also, at initial visits and after 1-year follow-up, the test group showed a statistically significant reduction in the number of participants with PD ≥6 mm, indicating a reduced need for surgery, in contrast to the placebo group. The results of this trial indicate that oral administration of L. rhamnosus SP1 resulted in similar clinical improvements compared with SRP alone.

  15. 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. ...

  16. 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

  17. Intraplaque hemorrhage, a potential consequence of periodontal bacteria gathering in human carotid atherothrombosis.

    Science.gov (United States)

    Brun, Adrian; Rangé, Hélène; Prouvost, Bastien; Meilhac, Olivier; Mazighi, Mikael; Amarenco, Pierre; Lesèche, Guy; Bouchard, Philippe; Michel, Jean-Baptiste

    2016-06-28

    Periodontal diseases are multifactorial inflammatory diseases, caused by a bacterial biofilm involving both innate and adaptative immunity, characterized by the destruction of tooth-supporting tissues. In the context of periodontitis, the spread of weak pathogenic bacteria into the bloodstream has been described. These bacteria will preferentially localize to existing clot within the circulation. Atherothrombosis of the carotid arteries is a local pathology and a common cause of cerebral infarction. Intraplaque hemorrhages render the lesion more prone to clinical complications such as stroke. The main objective of this study is to explore the biological relationship between carotid intraplaque hemorrhage and periodontal diseases. This study included consecutive patients with symptomatic or asymptomatic carotid stenosis, admitted for endarterectomy surgical procedure (n=41). In conditioned media of the carotid samples collected, markers of neutrophil activation (myeloperoxidase or MPO, DNA-MPO complexes) and hemoglobin were quantified. To investigate the presence of DNA from periodontal bacteria in atherosclerotic plaque, PCR analysis using specific primers was performed. Our preliminary results indicate an association between neutrophil activation and intraplaque hemorrhages, reflected by the release of MPO (p<0,01) and MPO-DNA complexes (p<0,05). Presence of DNA from periodontitis-associated bacteria was found in 32/41 (78%) atheromatous plaque samples. More specifically, DNA from Pg, Tf, Pi, Aa was found in 46%, 24%, 34% and 68% of the samples, respectively. Hemoglobin levels were higher in conditioned media in carotid samples where the bacteria were found, but this was not statistically significant. Our data confirm the relationship between intraplaque hemorrhage and neutrophil activation. In addition, the presence of periodontal bacteria DNA in carotid atheromatous plaque, may contribute to this activation. Further analysis is needed to fully explore the raw

  18. Efficacy of local drug delivery of Achyranthes aspera gel in the management of chronic periodontitis: A clinical study

    Directory of Open Access Journals (Sweden)

    Ramanarayana Boyapati

    2017-01-01

    Full Text Available Context: Periodontitis is an inflammatory disease of microbial origin. Locally delivered antimicrobials reduce subgingival flora. Achyranthes aspera gel has antimicrobial, antioxidant, anti-inflammatory, and immunostimulant effects. Aims: To evaluate the efficacy of local drug delivery of A. aspera gel in the management of chronic periodontitis. Materials and Methods: Thirty patients with chronic periodontitis were considered in the study and categorized into two equal groups (Group A: scaling and root planing (SRP with A. aspera gel, Group B: SRP with placebo gel. Patients were enlisted from the Department of Periodontics, Mamata Dental College and Hospital. The clinical parameters (gingival index, bleeding on probing, probing pocket depth, and clinical attachment level were recorded at baseline and 3 months. Statistical Analysis Used: All the obtained data were sent for statistical analyses using SPSS version 18. Results: The periodontitis and the Achyranthes were statistically analyzed. A comparison of clinical parameters for test group and control group from baseline to 3 months was done using paired t-test. Intergroup comparison for both the groups was done using independent sample t-test. Conclusions: A. aspera gel when delivered locally along with SRP showed a beneficial effect. A. aspera gel as a non-surgical local drug delivery system proved to be without any side effects in the management of periodontitis. A. aspera gel has strong anti-inflammatory effects in addition to its antioxidant activity.

  19. Efficacy of local drug delivery of Achyranthes aspera gel in the management of chronic periodontitis: A clinical study.

    Science.gov (United States)

    Boyapati, Ramanarayana; Gojja, Prathibha; Chintalapani, Srikanth; Nagubandi, Kirankumar; Ramisetti, Arpita; Salavadhi, Shyam Sunder

    2017-01-01

    Periodontitis is an inflammatory disease of microbial origin. Locally delivered antimicrobials reduce subgingival flora. Achyranthes aspera gel has antimicrobial, antioxidant, anti-inflammatory, and immunostimulant effects. To evaluate the efficacy of local drug delivery of A. aspera gel in the management of chronic periodontitis. Thirty patients with chronic periodontitis were considered in the study and categorized into two equal groups (Group A: scaling and root planing (SRP) with A. aspera gel, Group B: SRP with placebo gel). Patients were enlisted from the Department of Periodontics, Mamata Dental College and Hospital. The clinical parameters (gingival index, bleeding on probing, probing pocket depth, and clinical attachment level) were recorded at baseline and 3 months. All the obtained data were sent for statistical analyses using SPSS version 18. The periodontitis and the Achyranthes were statistically analyzed. A comparison of clinical parameters for test group and control group from baseline to 3 months was done using paired t -test. Intergroup comparison for both the groups was done using independent sample t -test. A. aspera gel when delivered locally along with SRP showed a beneficial effect. A. aspera gel as a non-surgical local drug delivery system proved to be without any side effects in the management of periodontitis. A. aspera gel has strong anti-inflammatory effects in addition to its antioxidant activity.

  20. A Nano-indentation Identification Technique for Viscoelastic Constitutive Characteristics of Periodontal Ligaments

    Directory of Open Access Journals (Sweden)

    Ashrafi H.

    2016-06-01

    Full Text Available Introduction: Nano-indentation has recently been employed as a powerful tool for determining the mechanical properties of biological tissues on nano and micro scales. A majority of soft biological tissues such as ligaments and tendons exhibit viscoelastic or time-dependent behaviors. The constitutive characterization of soft tissues is among very important subjects in clinical medicine and especially, biomechanics fields. Periodontal ligament plays an important role in initiating tooth movement when loads are applied to teeth with orthodontic appliances. It is also the most accessible ligament in human body as it can be directly manipulated without any surgical intervention. From a mechanical point of view, this ligament can be considered as a thin interface made by a solid phase, consisting mainly of collagen fibers, which is immersed into a so-called ground substance. However, the viscoelastic constitutive effects of biological tissues are seldom considered rigorous during Nano-indentation tests. Methods: In the present paper, a mathematical contact approach is developed to enable determining creep compliance and relaxation modulus of distinct periodontal ligaments, using constant–rate indentation and loading time histories, respectively. An adequate curve-fitting method is presented to determine these characteristics based on the Nano-indentation of rigid Berkovich tips. Generalized Voigt-Kelvin and Wiechert models are used to model constitutive equations of periodontal ligaments, in which the relaxation and creep functions are represented by series of decaying exponential functions of time. Results: Time-dependent creep compliance and relaxation function have been obtained for tissue specimens of periodontal ligaments. Conclusion: To improve accuracy, relaxation and creep moduli are measured from two tests separately. Stress relaxation effects appear more rapidly than creep in the periodontal ligaments.

  1. Clinical effect of azithromycin as an adjunct to non-surgical treatment of chronic periodontitis: a meta-analysis of randomized controlled clinical trials.

    Science.gov (United States)

    Zhang, Z; Zheng, Y; Bian, X

    2016-06-01

    evidence that azithromycin used as an adjunct to SRP significantly improves the efficacy of non-surgical periodontal therapy on reducing probing depth, BOP and improving AL, particularly at the initially deep probing depth sites. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. [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.

  3. Generalized Severe Periodontitis and Periodontal Abscess in Type 2 Diabetes: A Case Report

    Directory of Open Access Journals (Sweden)

    Sonnenschein Sarah K.

    2016-07-01

    Full Text Available The bidirectional relationship between periodontitis and diabetes mellitus can cause distinct oral symptoms that can impact the general health conditions of affected patients. The presented case report of a female diabetes type 2 patient with severe periodontitis and a periodontal abscess shows how interdisciplinary collaboration between the attending physician and dentist can significantly improve oral conditions and metabolic control.

  4. Gene polymorphisms in chronic periodontitis

    NARCIS (Netherlands)

    Laine, M.L.; Loos, B.G.; Crielaard, W.

    2010-01-01

    We aimed to conduct a review of the literature for gene polymorphisms associated with chronic periodontitis (CP) susceptibility. A comprehensive search of the literature in English was performed using the keywords: periodontitis, periodontal disease, combined with the words genes, mutation, or

  5. Evaluation of oral health related quality of life in patient with mild periodontitis among young male population of Namakkal district

    Directory of Open Access Journals (Sweden)

    Natarajan Shanmuga Sundaram

    2013-01-01

    Full Text Available Aim: The aim of the study is to assess the impact of oral health related quality of life (QOL on patients presenting for scaling and oral prophylaxis using a the oral health-related quality of life (OHRQL questionnaire. Materials and Methods: This prospective study includes a total of 100 male patients of age group 25-35 years, who visited private clinic in Namakkal district, South India. They were assessed for their perceptions of oral health using OHRQL questionnaire before initial periodontal therapy including scaling and root planning. Results: A total of 100 patients (mean age:29 years participated in the study and completed initial periodontal therapy. Before treatment 98% of the patients perceived that their oral health status impacted on their QOL in one or more ways. Bad breath was the most common complaint. Social well-being, personality and psychological function were identified as compromised OHRQL domains. More than 60% of the patients stated their overall general health is affected by periodontal disease. Conclusion: Periodontitis negatively affected QOL in this Namakkal district population of young male patients with mild periodontitis. Conventional non-surgical periodontal therapy and personality development counseling has a potential to ameliorate patient perceptions of oral health and improve their QOL.

  6. Periodontal Regenerative Therapy in Patient with Chronic Periodontitis and Type 2 Diabetes Mellitus: A Case Report.

    Science.gov (United States)

    Seshima, Fumi; Nishina, Makiko; Namba, Takashi; Saito, Atsushi

    2016-01-01

    We report a case of generalized chronic periodontitis and type 2 diabetes mellitus requiring periodontal treatment including regenerative therapy. The patient was a 66-year-old man who presented with the chief complaint of gingival inflammation and mobile teeth in the molar region. He had been being treated for type 2 diabetes mellitus since 1999. His glycated hemoglobin (HbA1c) level was 7.8%. An initial examination revealed sites with a probing depth of ≥7 mm in the molar region, and radiography revealed angular bone defects in this area. Based on a clinical diagnosis of generalized chronic periodontitis, the patient underwent initial periodontal therapy. An improvement was observed in periodontal conditions on reevaluation, and his HbA1c level showed a reduction to 6.9%. Periodontal regenerative therapy with enamel matrix derivative was then performed on #16, 26, and 27. Following another reevaluation, a removable partial denture was fabricated for #47 and the patient placed on supportive periodontal therapy (SPT). To date, periodontal conditions have remained stable and the patient's HbA1c level has increased to 7.5% during SPT. The results show the importance of collaboration between dentist and physician in managing periodontal and diabetic conditions in such patients.

  7. [Discussion on combined periodontic-endodontic lesion type].

    Science.gov (United States)

    Wang, Kai; Zhou, Li

    2008-02-01

    Combined the elaboration on periodontic-endodontic lesion in the textbook Periodontics with the deficiencies existed in the clinical and teaching work and demonstrated the understanding on the type of the combined periodontic-endodontic lesion, and suggested the viewpoint of no sub-type of combined periodontic-endodontic lesion. Only regard the type of pulp disease that induced by periodontal disease as genuine combined periodontic-endodontic lesion.

  8. 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

  9. Relationship between invasion of the periodontium by periodontal pathogens and periodontal disease: a systematic review.

    Science.gov (United States)

    Mendes, Luzia; Azevedo, Nuno Filipe; Felino, António; Pinto, Miguel Gonçalves

    2015-01-01

    Bacterial invasion of the periodontal tissues has been suggested as a relevant step in the etiopathogenesis of periodontal disease. However, its exact importance remains to be defined. The present systematic review assessed the scientific evidence concerning the relationship between the quality or quantity of periodontal microbiota in periodontal tissues and development of periodontal disease. The databases Medline-PubMed, Cochrane-CENTRAL, ISI Web of Knowledge and SCOPUS were searched, up to January 2014. Studies that reported evaluation of periodontal pathogens invasion on human tissues were selected. The screening of 440 title/abstracts elected 26 papers for full-text reading. Twenty three papers were subsequently excluded because of insufficient data or a study protocol not related to the objectives of this systematic review. All included studies were case-control studies that evaluated intracellular or adherent bacteria to epithelial cells from periodontal pockets versus healthy sulci. Study protocols presented heterogeneity regarding case and control definitions and methodological approaches for microbial identification. No consistent significant differences were found related to the presence/absence or proportion of specific periopathogens across the studies, as only one study found statistically significant differences regarding the presence of A. actinomycetemcomitans (p = 0.043), T. forsythia (P periodontal pockets vs. healthy sulci. All studies reported a larger unspecific bacterial load in or on the epithelial cells taken from a diseased site compared to a healthy sulcus. The current available data is of low to moderate quality and inconsistent mainly due to study design, poor reporting and methodological diversity. As so, there is insufficient evidence to support or exclude the invasion by periodontal pathogens as a key step in the etiopathogenesis of periodontal disease. Further research is needed.

  10. 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.

  11. 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.

  12. Regenerative potential and healing dynamics of the periodontium: a critical-size supra-alveolar periodontal defect study.

    Science.gov (United States)

    Polimeni, Giuseppe; Susin, Cristiano; Wikesjö, Ulf M E

    2009-03-01

    The nature and characteristics of the newly formed periodontium obtained following regenerative procedures remain a matter of controversy. The objective of this study was to evaluate the regenerative potential of the periodontal attachment and healing dynamics as observed from the spatial distribution of newly formed cementum, periodontal ligament (PDL) and alveolar bone following optimal circumstances for wound healing/regeneration in a discriminating animal model. Critical-size, 6-mm, supra-alveolar, periodontal defects were surgically created in six young adult Beagle dogs. Space-providing ePTFE devices with 300-microm laser-drilled pores were implanted to support wound stability and space provision in one jaw quadrant/animal. Treatments were alternated between left and right jaw quadrants in subsequent animals. The gingival flaps were advanced to submerge the defect sites for primary intention healing. Histometric analysis followed an 8-week healing interval. Healing was uneventful in all animals. The histometric analysis showed that cementum regeneration (2.99 +/- 0.22 mm) was significantly greater than PDL (2.54 +/- 0.18 mm, p=0.03) and bone regeneration (2.46 +/- 0.26 mm, p=0.03). The wound area showed significant positive non-linear effect on cementum (log beta=1.25, palveolar bone virtually regenerate in parallel under optimal circumstances for periodontal wound healing/regeneration. Moreover, space provision positively influences the extent of periodontal regeneration.

  13. Multilevel analysis of clinical parameters in chronic periodontitis after root planing/scaling, surgery, and systemic and local antibiotics: 2-year results

    Directory of Open Access Journals (Sweden)

    Ibrahimu Mdala

    2012-04-01

    Full Text Available Aim: Find the periodontal treatment that best maintained clinical results over time evaluated by changes in pocket depth (PD and clinical attachment level (CAL. Methods: 229 patients with chronic periodontitis from USA (n=134 and Sweden (n=95 were randomly assigned to eight groups receiving 1 scaling+root planing (SRP alone or combined with 2 surgery (SURG+systemic amoxicillin (AMOX+systemic metronidazole (MET; 3 SURG+local tetracycline (TET; 4 SURG; 5 AMOX+MET+TET; 6 AMOX+MET; 7 TET; and 8 SURG+AMOX+MET+TET. Antibiotics were given immediately after SRP. Plaque, gingival redness, bleeding on probing, suppuration, PD, and CAL were recorded at baseline and after 3, 6, 12, 18, and 24 months. Treatment effects were evaluated by linear multilevel regression and logistic multilevel regression models. We considered only data from sites with a baseline PD of at least 5 mm of 187 patients completing the study. Results: Surgically treated patients experienced most CAL loss. Adjunctive therapy including SURG was most effective in reducing PD. Combining SURG with AMOX, MET, and TET gave significant clinical benefits. Past and current smoking habits were significant predictors of deeper PD. Only current smoking was a significant predictor of CAL loss. Bleeding, accumulation of plaque, gingival redness, and suppuration were significant predictors of further CAL loss and deeper PD. Conclusions: Both surgical and non-surgical therapies can be used to arrest chronic periodontitis. SURG+AMOX+MET+TET gave best maintenance of clinical results.

  14. Surgical considerations and management of bilateral labially impacted canines

    Directory of Open Access Journals (Sweden)

    Yu-Shan Huang

    2016-06-01

    Full Text Available Canines are among the most commonly impacted teeth. When a canine is positioned labially, the untoward soft-tissue responses following surgical exposure may cause unfavorable esthetic outcomes. Therefore, decision making as to the choice of a proper surgical technique to uncover labially impacted teeth is critical. This case presentation describes two different surgical approaches for two maxillary impacted canines in a 12-year-old girl. A sequential approach included a first stage of surgical exposure using apically positioned flaps and orthodontic extrusion of both impacted teeth. A successive laterally positioned flap was used for the left maxillary canine to achieve a harmonious soft-tissue contour. In this case, close monitoring and cooperation during the various treatment phases led to proper canine positioning and a successful esthetic result, with good periodontal health and functional occlusion.

  15. Strengthening the prevention of periodontal disease

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Ogawa, Hiroshi

    2005-01-01

    BACKGROUND: The aim of this paper is to provide an overview of the burden of periodontal disease in adult populations worldwide, to emphasize the essential risk factors common to periodontal disease and chronic diseases, to outline important new strategies for effective prevention of periodontal...... disease, and to inform about the role of the World Health Organization (WHO) in developing a national capacity for the prevention of disease. METHODS: Information about periodontal health status as measured by the Community Periodontal Index system is stored in the WHO Global Oral Health Data Bank....... Updated information concerning WHO standard age groups was used to describe the prevalence rates of signs of periodontal disease, i.e., gingival bleeding, periodontal pocketing, and loss of attachment. RESULTS: Gingival bleeding is highly prevalent among adult populations in all regions of the world...

  16. Role of genetic in periodontal disease

    Directory of Open Access Journals (Sweden)

    Anand Narayanrao Wankhede

    2017-01-01

    Full Text Available Genetics is the study and understanding of the phenomena of heredity and variation. A large number of genes are associated with many systemic conditions. Periodontitis is inflammatory condition of periodontium. Periodontium consists of gingiva, periodontal ligament, cementum, and alveolar bone. It is considered being a multifactorial disease. Studies of animals and humans support the concept that a large number of genes' factor may be associated with periodontitis and clearly play a role in the predisposition and progression of periodontal diseases. It has been proven that genetic factors impair inflammatory and immune responses during periodontal diseases. Research on identifying specific genes causing periodontitis may improve and prevent the disease progression. The aim of this article is to focus on genetic risk factors and its influence for the various forms of periodontal disease.

  17. Growth/differentiation factor-5 significantly enhances periodontal wound healing/regeneration compared with platelet-derived growth factor-BB in dogs.

    Science.gov (United States)

    Kwon, Hyuk-Rak; Wikesjö, Ulf M E; Park, Jung-Chul; Kim, Young-Taek; Bastone, Patrizia; Pippig, Susanne D; Kim, Chong-Kwan

    2010-08-01

    Recombinant human growth/differentiation factor-5 (rhGDF-5) in a particulate beta-tricalcium phosphate (beta-TCP) carrier is being evaluated to support periodontal regeneration. The objective of this study was to evaluate periodontal wound healing/regeneration following an established clinical (benchmark) protocol including surgical implantation of rhGDF-5/beta-TCP in comparison with that following implantation of recombinant human platelet-derived growth factor-BB (rhPDGF) combined with a particulate beta-TCP biomaterial using an established canine defect model. Bilateral, 4 x 5 mm (width x depth), one-wall, critical-size, intrabony periodontal defects were surgically created at the mandibular second and fourth pre-molar teeth in five adult Beagle dogs. Defect sites were randomized to receive rhGDF-5/beta-TCP or the rhPDGF construct followed by wound closure for primary intention healing. The animals were sacrificed following an 8-week healing interval for histological and histometric examination. Clinical healing was generally uneventful. Sites receiving rhGDF-5/beta-TCP exhibited a significantly enhanced cementum formation compared with sites receiving the rhPDGF construct, averaging (+/-SD) 4.49+/-0.48 versus 2.72+/-0.91 mm (palveolar bone. Both protocols displayed beta-TCP residues apparently undergoing resorption. Application of both materials appears safe, as they were associated with limited, if any, adverse events. rhGDF-5/beta-TCP shows a significant potential to support/accelerate periodontal wound healing/regeneration. Application of rhGDF-5/beta-TCP appears safe and should be further evaluated in human clinical trials.

  18. 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.

  19. 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.

  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 endo-osseus implant in odonto-oral rehabilitation].

    Science.gov (United States)

    Vanhakendover, S

    2003-01-01

    Dental implants have critically changed the restorative procedures available to edentulous patients. Biocompatible materials, precise surgical techniques and improved instrumentation give well trained practicioners various opportunities to achieve successful treatments. The necessity of combining full expertise in surgery and rational prosthetic planning with comprehensive occlusal management is emphasized. Recent advances in periodontal treatment of osseous and soft tissue defects, new grafting techniques and surgical approaches have dramatically enlarged the scope of oral implantology.

  2. Prevalence of Clinical Periodontitis and Putative Periodontal Pathogens among South Indian Pregnant Women

    Directory of Open Access Journals (Sweden)

    Chaitanya Tellapragada

    2014-01-01

    Full Text Available In view of recent understanding of the association of periodontal infections and adverse pregnancy outcomes, the present investigation was undertaken to study the periodontal infections among 390 asymptomatic pregnant women and to find an association of bacterial etiologies with the disease. Prevalence of gingivitis was 38% and clinical periodontitis was 10% among the study population. Subgingival plaque specimens were subjected to multiplex PCR targeting ten putative periodontopathogenic bacteria. Among the periodontitis group, high detection rates of Porphyromonas gingivalis (56%, Prevotella nigrescens (44%, Treponema denticola (32%, and Prevotella intermedius (24% were noted along with significant association with the disease (P<0.05.

  3. [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.

  4. Registro periodontal simplificado em gestantes Periodontal screening and recording in pregnant women

    Directory of Open Access Journals (Sweden)

    Fernanda L. Rosell

    1999-04-01

    para minimizar a provável transmissibilidade de microrganismos bucais patogênicos para a criança, obtendo assim uma prevenção primária das principais doenças bucais.PURPOSE: The assessment using the PSR (Periodontal Screening and Recording of the prevalence and severity of and the basic treatment needs for periodontal disease in a group of pregnant women who attended the Preventive Dentistry Clinic at the School of Dentistry of Araraquara - UNESP. METHODS: Forty-one pregnant women of 16 to 37 years of age, were examined. The PSR index was evaluated with a suitable periodontal probe (Trinity - model 621-WHO with index codes scores of from 0 to 4, capable of indicating the presence of the following conditions: periodontal health, bleeding on probing, calculus, shallow and deep pockets. These codes were attributed to each sextant and could be marked with an asterisk (* to indicate the presence of gingival recession, furcation lesions, mobility or any other mucogingival alterations. RESULTS: It is shown that 100% of the pregnant women had some kind of gingival alteration, represented mainly by PSR code 2 (56.1% and " * " (19.5%. The women in the youngest age groups, 15-19 and 20-24 years, had code 2 as their highest score with no sextant excluded. In the 25-29 age group, the PSR code 2 still prevailed (54.5% although codes 3 and 4 were already appearing. The code " * " and the ocurrence of excluded sextants tended to increase in the oldest age group (30-37. In general, the affected sextants showed codes 1 and 2 more frequently, corresponding to 41.6% and 39.8% respectively, which represented a mean of 2.49 and 2.39 sextants affected in each pregnant woman. Regarding the treatment needs, 90.2% of the women needed some treatment beyond the preventive measures begun, including scaling and root planning and/or corrections of defective restorative margins (61%, and more complex treatment (29.2%. CONCLUSION: The meeting of the treatment needs during pregnancy must include

  5. Relationship between invasion of the periodontium by periodontal pathogens and periodontal disease: a systematic review

    Science.gov (United States)

    Mendes, Luzia; Azevedo, Nuno Filipe; Felino, António; Pinto, Miguel Gonçalves

    2015-01-01

    Bacterial invasion of the periodontal tissues has been suggested as a relevant step in the etiopathogenesis of periodontal disease. However, its exact importance remains to be defined. The present systematic review assessed the scientific evidence concerning the relationship between the quality or quantity of periodontal microbiota in periodontal tissues and development of periodontal disease. The databases Medline-PubMed, Cochrane-CENTRAL, ISI Web of Knowledge and SCOPUS were searched, up to January 2014. Studies that reported evaluation of periodontal pathogens invasion on human tissues were selected. The screening of 440 title/abstracts elected 26 papers for full-text reading. Twenty three papers were subsequently excluded because of insufficient data or a study protocol not related to the objectives of this systematic review. All included studies were case-control studies that evaluated intracellular or adherent bacteria to epithelial cells from periodontal pockets versus healthy sulci. Study protocols presented heterogeneity regarding case and control definitions and methodological approaches for microbial identification. No consistent significant differences were found related to the presence/absence or proportion of specific periopathogens across the studies, as only one study found statistically significant differences regarding the presence of A. actinomycetemcomitans (p = 0.043), T. forsythia (P < 0.001), P. intermedia (P < 0.001), C. ochracea (P < 0.001) and C. rectus (P = 0.003) in epithelial cells from periodontal pockets vs. healthy sulci. All studies reported a larger unspecific bacterial load in or on the epithelial cells taken from a diseased site compared to a healthy sulcus. The current available data is of low to moderate quality and inconsistent mainly due to study design, poor reporting and methodological diversity. As so, there is insufficient evidence to support or exclude the invasion by periodontal pathogens as a key step in the

  6. 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

  7. Transverse maxillary distraction in patients with periodontal pathology or insufficient tooth anchorage using custom-made devices.

    Science.gov (United States)

    Fernández-Sanromán, Jacinto; Donascimento, Montserrat González; López, Alberto Costas; Ferro, Martín Fernández; Berrondo, Ibon Almandoz

    2010-07-01

    We present our experience using modified Hyrax devices for treating transverse deficiencies of the maxilla in adult patients with periodontal pathology or insufficient tooth anchorage. The surgical technique, clinical indications, and results are discussed. Eight adult patients (6 females, 2 males) requiring maxillary expansion were studied prospectively between July 2002 and July 2007. All the patients had periodontal pathology or insufficient tooth anchorage preventing the use of conventional Hyrax devices. Patients underwent surgically assisted rapid maxillary expansion with the use of custom-made modified Hyrax devices (bone-borne or tooth-bone-borne devices). Patients received preoperatively (T1), at the end of distraction (T2), at removal of the expansion device (T3), and 12 months after surgery (T4) lateral and posterior anterior cephalograms and study models to measure the width of the anterior and posterior dental arches with a digital sliding calliper. Mean age was 28.5 years (range, 18-45 years). A significant widening of the anterior (6.3 +/- 1.6 mm) and posterior (7.1 +/- 1.2 mm) dental arches was demonstrated. No significant differences were found when comparing T3 with T4 measures. No significant complications were found. The results indicated that maxillary expansion with custom-made devices in adults was an easy, affordable, predictable and stable technique without significant complications in patients who suffer periodontal pathology or patients without enough dental support. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  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. 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.

  10. 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.

  11. Periodontics--tissue engineering and the future.

    Science.gov (United States)

    Douglass, Gordon L

    2005-03-01

    Periodontics has a long history of utilizing advances in science to expand and improve periodontal therapies. Recently the American Academy of Periodontology published the findings of the Contemporary Science Workshop, which conducted state-of-the-art evidence-based reviews of current and emerging areas in periodontics. The findings of this workshop provide the basis for an evidence-based approach to periodontal therapy. While the workshop evaluated all areas of periodontics, it is in the area of tissue engineering that the most exciting advances are becoming a reality.

  12. A combined periodontal - prosthetic treatment approach to manage unusual gingival visibility in resting lip position and inversely inclined upper anterior teeth: a case report with discussion.

    Science.gov (United States)

    Biniraj, K R; Janardhanan, Mahija; Sunil, M M; Sagir, Mohammed; Hariprasad, A; Paul, Tony P; Emmatty, Rishi

    2015-03-01

    Excessive gingival visibility during smile is a common esthetic complaint in dentistry, but excessive gingival visibility in resting lip position is relatively uncommon condition. Several exclusive radical to conservative surgical treatment or its combination with orthodontic therapy to treat this condition are within the reach of every patient nowadays. A case report of an excessive gingival visibility because of altered passive eruption along with inversely inclined maxillary anterior teeth is presented here. A relatively simple treatment approach combining periodontal and restorative therapy is used here to achieve the desirable aesthetic results. The gingival exposure resulting from altered passive eruption was completely managed by a gingivectomy, but the inclined appearance of teeth was still an aesthetic complaint. After complete healing of gingivectomy surgery, appropriately designed crowns were given to rectify the inversely inclined appearance. A complete rehabilitation of patient's smile could be achieved, the case was followed up for 3 years and the condition was found satisfactory.

  13. Dietary arginine silicate inositol complex inhibits periodontal tissue loss in rats with ligature-induced periodontitis.

    Science.gov (United States)

    Dundar, Serkan; Eltas, Abubekir; Hakki, Sema S; Malkoc, Sıddık; Uslu, M Ozay; Tuzcu, Mehmet; Komorowski, James; Ozercan, I Hanifi; Akdemir, Fatih; Sahin, Kazim

    2016-01-01

    The purpose of this study was to induce experimental periodontitis in rats previously fed diets containing arginine silicate inositol (ASI) complex and examine the biochemical, immunological, and radiological effects. Fifty two 8-week-old female Sprague Dawley rats were equally divided into four groups. The control group included those fed a standard rat diet with no operation performed during the experiment. The periodontitis, ASI I, and ASI II groups were subjected to experimental periodontitis induction for 11 days after being fed a standard rat diet alone, a diet containing 1.81 g/kg ASI complex, or a diet containing 3.62 g/kg ASI complex, respectively, for 8 weeks. Throughout the 11-day duration of periodontitis induction, all rats were fed standard feed. The rats were euthanized on the eleventh day, and their tissue and blood samples were collected. In the periodontitis group, elevated tissue destruction parameters and reduced tissue formation parameters were found, as compared to the ASI groups. Levels of enzymes, cytokines, and mediators associated with periodontal tissue destruction were lower in rats fed a diet containing ASI complex after experimental periodontitis. These results indicate that ASI complex could be an alternative agent for host modulation.

  14. Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report.

    Science.gov (United States)

    Windisch, Péter; Szendroi-Kiss, Dóra; Horváth, Attila; Suba, Zsuzsanna; Gera, István; Sculean, Anton

    2008-09-01

    Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11-20 months (mean, 13.9+/-3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8+/-1.7 mm and mean clinical attachment level gain 4.3+/-2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8+/-1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8+/-2.8% and 32.1+/-8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be

  15. Prediction of loss to follow-up in long-term supportive periodontal therapy in patients with chronic periodontitis.

    Directory of Open Access Journals (Sweden)

    Di Wu

    Full Text Available This study examined the predictors of loss to follow-up in long-term supportive periodontal therapy in patients with chronic periodontitis.A total of 280 patients with moderate to severe chronic periodontitis in a tertiary care hospital in China were investigated and followed over the course of study. Questionnaires on clinical and demographic characteristics, self-efficacy for oral self-care and dental fear at baseline were completed. Participants were followed to determine whether they could adhere to long-term supportive periodontal therapy. Binary logistic regression analysis was used to examine the association between clinical and demographic characteristics, self-efficacy for oral self-care, dental fear and loss to follow-up in long-term supportive periodontal therapy.The loss to follow-up in long-term supportive periodontal therapy was significantly associated with age [adjusted OR = 1.042, 95% confidence interval (CI: 1.012-1.074, p = 0.006], severe periodontitis [adjusted OR = 4.892, 95%CI: 2.280-10.499, p<0.001], periodontal surgery [adjusted OR = 11.334, 95% CI: 2.235-57.472, p = 0.003], and middle and low-scoring of self-efficacy scale for self-care groups. The adjusted ORs of loss to follow-up for the middle- (54-59 and low-scoring groups (15-53 were 71.899 (95%CI: 23.926-216.062, p<0.001 and 4.800 (95% CI: 2.263-10.182, p<0.001, respectively, compared with the high-scoring SESS group (60-75.Age, severity of periodontitis, periodontal surgery and the level of self-efficacy for self-care may be effective predictors of loss to follow-up in long-term supportive periodontal therapy in patients with chronic periodontitis.

  16. The effects of irradiation on the periodontal tissues of rats with the low calcium diet

    International Nuclear Information System (INIS)

    Choi, Mun Cheol; Lee, Sang Rae

    1992-01-01

    The purpose of this study was to investigate the changes of periodontal tissues in the irradiated mandibular bone in rats which were fed normal diet and low calcium diet. In order to carry out this experiment, 64 seven-week old Sprague-Dawley strain rats weighing about 150 gms were selected and equally divided into one experimental group of 32 rats and one control group with the remainder. The experimental group and the control group were then subdivided into two groups when the rats reached the age of 10 weeks, 16 rats were allotted for each subdivided group was composed of 16 rats and exposed to irradiation. The two groups were irradiated a single dose of 20 Gy on the only jaw area and irradiated with a cobalt-60 teletherapy unit. The rats in the control and experimental groups were warily dissected by fours on the 3rd, 7th, the 14th, and the 21st day after irradiation. After each dissection, both sides of the dead rat mandibular bodies were removed and fixed with 10% neutral formalin. The specimens sectioned and observed in histopathological, histochemical, and immunocellular chemical methods. The obtained results were as follows: 1. In the mandibles of rats with low calcium diet the increased number of fibroblasts of periodontal ligaments, many small capillaries and irregular arrangement of loose collagen fibers were detected and the partial resorption of dentin and cementum could be found by the microscopic studies. 2. In the group of irradiated rats, deaerated periodontal tissues led to the condition of irregular arrangement of collagen fibers and the decreased number of fibroblasts. But this condition was somewhat restored after 21 days of experiment. 3. Periodontal tissues of the irradiated rat group with low calcium diet were destroyed earlier than those of the irradiated rat group with normal diet. Soon this condition was restored and then high cellularity and dense collagen fibers were observed. 4. Many periodontal cells bearing tumor necrosis factor

  17. A Nano-indentation Identification Technique for Viscoelastic Constitutive Characteristics of Periodontal Ligaments.

    Science.gov (United States)

    Ashrafi, H; Shariyat, M

    2016-06-01

    Nano-indentation has recently been employed as a powerful tool for determining the mechanical properties of biological tissues on nano and micro scales. A majority of soft biological tissues such as ligaments and tendons exhibit viscoelastic or time-dependent behaviors. The constitutive characterization of soft tissues is among very important subjects in clinical medicine and especially, biomechanics fields. Periodontal ligament plays an important role in initiating tooth movement when loads are applied to teeth with orthodontic appliances. It is also the most accessible ligament in human body as it can be directly manipulated without any surgical intervention. From a mechanical point of view, this ligament can be considered as a thin interface made by a solid phase, consisting mainly of collagen fibers, which is immersed into a so-called ground substance. However, the viscoelastic constitutive effects of biological tissues are seldom considered rigorous during Nano-indentation tests. In the present paper, a mathematical contact approach is developed to enable determining creep compliance and relaxation modulus of distinct periodontal ligaments, using constant-rate indentation and loading time histories, respectively. An adequate curve-fitting method is presented to determine these characteristics based on the Nano-indentation of rigid Berkovich tips. Generalized Voigt-Kelvin and Wiechert models are used to model constitutive equations of periodontal ligaments, in which the relaxation and creep functions are represented by series of decaying exponential functions of time. Time-dependent creep compliance and relaxation function have been obtained for tissue specimens of periodontal ligaments. To improve accuracy, relaxation and creep moduli are measured from two tests separately. Stress relaxation effects appear more rapidly than creep in the periodontal ligaments.

  18. A Nano-indentation Identification Technique for Viscoelastic Constitutive Characteristics of Periodontal Ligaments

    Science.gov (United States)

    Ashrafi, H.; Shariyat, M.

    2016-01-01

    Introduction Nano-indentation has recently been employed as a powerful tool for determining the mechanical properties of biological tissues on nano and micro scales. A majority of soft biological tissues such as ligaments and tendons exhibit viscoelastic or time-dependent behaviors. The constitutive characterization of soft tissues is among very important subjects in clinical medicine and especially, biomechanics fields. Periodontal ligament plays an important role in initiating tooth movement when loads are applied to teeth with orthodontic appliances. It is also the most accessible ligament in human body as it can be directly manipulated without any surgical intervention. From a mechanical point of view, this ligament can be considered as a thin interface made by a solid phase, consisting mainly of collagen fibers, which is immersed into a so-called ground substance. However, the viscoelastic constitutive effects of biological tissues are seldom considered rigorous during Nano-indentation tests. Methods In the present paper, a mathematical contact approach is developed to enable determining creep compliance and relaxation modulus of distinct periodontal ligaments, using constant–rate indentation and loading time histories, respectively. An adequate curve-fitting method is presented to determine these characteristics based on the Nano-indentation of rigid Berkovich tips. Generalized Voigt-Kelvin and Wiechert models are used to model constitutive equations of periodontal ligaments, in which the relaxation and creep functions are represented by series of decaying exponential functions of time. Results Time-dependent creep compliance and relaxation function have been obtained for tissue specimens of periodontal ligaments. Conclusion To improve accuracy, relaxation and creep moduli are measured from two tests separately. Stress relaxation effects appear more rapidly than creep in the periodontal ligaments. PMID:27672630

  19. Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

    Directory of Open Access Journals (Sweden)

    Carina Maciel Silva-Boghossian

    2014-05-01

    Full Text Available The present study investigated the effect of non-surgical periodontal treatment (SRP on the composition of the subgingival microbiota of chronic periodontitis (CP in individuals with type 2 diabetes (DM2 with inadequate metabolic control and in systemically healthy (SH individuals. Forty individuals (20 DM2 and 20 SH with CP underwent full-mouth periodontal examination. Subgingival plaque was sampled from 4 deep sites of each individual and tested for mean prevalence and counts of 45 bacterial taxa by the checkerboard method. Clinical and microbiological assessments were performed before and 3 months after SRP. At baseline, those in the DM2 group presented a significantly higher percentage of sites with visible plaque and bleeding on probing compared with those in the SH group (p < 0.01. Those in the DM2 group presented significantly higher levels of C. rectus and P. gingivalis, and lower prevalence of P. micra and S. anginosus, compared with those in the SH group (p ≤ 0.001. At the 3-month visit, both groups showed a significant improvement in all clinical parameters (p < 0.01. Those in the DM2 group showed significantly higher prevalence and/or levels of A. gerencseriae, A. naeslundii I, A. oris, A. odontolyticus, C. sputigena, F. periodonticum, and G. morbillorum compared with those in the SH group (p ≤ 0.001. However, those in the DM2 group showed a significant reduction in the levels of P. intermedia, P. gingivalis, T. forsythia, and T. denticola (p ≤ 0.001 over time. Those in the SRP group showed improved periodontal status and reduced levels of putative periodontal pathogens at 3 months’ evaluation compared with those in the DM2 group with inadequate metabolic control.

  20. Periodontal diseases in military aviation crew: A pilot study in armed forces

    Directory of Open Access Journals (Sweden)

    Prasanth Thankappan

    2015-01-01

    Full Text Available Background: Recent literature suggests psychosomatic and occupational stresses have a bearing on the etiology of periodontitis. The aviation field is a high-risk environment and rich in potential stresses which can be potent environmental factors. The purpose of this pilot study was to clinically evaluate the incidence of periodontitis amongst military aviators and its management on the health-related quality of life recovery. Materials and Methods : A total of 252 individuals were examined, equally divided into ground duty and flying groups. In addition to standard parameters, the clinical attachment loss (CAL was estimated according to a three-point scale. Stress factor was evaluated as per short form of Minnesota Job Satisfaction Questionnaire (MSQ. Numbers of visits after diagnosis, limitation from flying tasks due to the acute phase of disease and during treatment were recorded. The subjects who presented with active phases of disease were taken up for surgical mode of treatment. Results: Out of 252 individuals examined in this study, active periodontitis was found in 7.9% of the total population. Group 1 and 2 subjects presented an incidence rate of 5.6 and 10.3%, respectively. Among the aviators, 12.2% of the helicopter crews, 10.3% of fighter pilots, and 8.9% of the transport crews showed active form of periodontal diseases during routine annual medical examination. Ten cases presented limitation from flying due to acute phase of disease. Conclusions : Periodontitis causes early teeth loss and compromises the quality of life. It is mandatory for quick recovery and return to professional activities in the aviators. The annual medical checkup must include a thorough check up by a dental officer/periodontist and assessment with an appropriate radiograph once in every 3years advised. The screening examination used is suggested for use as part of each aviator′s annual dental examination.

  1. The Effects of Antimicrobial Peptide Nal-P-113 on Inhibiting Periodontal Pathogens and Improving Periodontal Status

    Directory of Open Access Journals (Sweden)

    Hongyan Wang

    2018-01-01

    Full Text Available Periodontal disease consists of chronic gingival inflammation characterized by both degradation of the periodontal connective tissue and alveolar bone loss. Drug therapy is used as an auxiliary treatment method in severe chronic periodontitis, aggressive periodontitis, and periodontitis-associated systemic disease. Nal-P-113, a modified antimicrobial peptide, specifically replaces the histidine residues of P-113 with the bulky amino acid β-naphthylalanine, and our previous studies have verified that this novel peptide is not toxic to the human body within a certain concentration range. The objective of the present study was to evaluate the effect of Nal-P-113 on periodontal pathogens and periodontal status in clinical studies. In a split-mouth clinical trial, the pocket depth and bleeding index values tended to decrease in the experimental group compared with those in the control group. SEM results verified that Nal-P-113 restrained the maturation of plaque. Based on real-time polymerase chain reaction, the levels of Fusobacterium nucleatum, Streptococcus gordonii, Treponema denticola, and Porphyromonas gingivalis in subgingival plaque were decreased when the subjects were given Nal-P-113. Bacterial growth curve analysis and a biofilm susceptibility assay verified that Nal-P-113 at a concentration of 20 μg/mL restrained the growth of S. gordonii, F. nucleatum, and P. gingivalis and biofilm formation. Therefore, Nal-P-113 effectively reduces periodontal pathogens and ameliorates periodontal status.

  2. 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.

  3. Periodontal bone lesions

    International Nuclear Information System (INIS)

    Linden, L.W.J. van der.

    1985-01-01

    In the course of life the periodontum is subject to changes which may be physiological or pathological. Intraoral radiographs give insight into the hard structures of the dentomaxillar region and provides information on lesions in the bone of the periodontum in that they show radiopacities and radiolucencies caused by such lesions. In this thesis the relation is investigated between the true shape and dimensions of periodontal bone lesions and their radiographic images. A method is developed and tested of making standardized and reproducible radiographs suitable for longitudinal studies of periodontal lesions. Also the possibility is demonstrated of an objective and reproducible interpretation of radiographic characteristics of periodontal bone lesions. (Auth.)

  4. 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.

  5. Occlusal considerations for dental implant restorations.

    Science.gov (United States)

    Bergmann, Ranier H

    2014-01-01

    When placed, dental implants are put into an ever-changing oral environment in which teeth can continue to migrate. Yet, the implants themselves are ankylosed. This can lead to occlusal instability. Teeth may continue to erupt, leaving the implants in infraocclusion. Teeth may move mesially away from an implant, requiring modification to close an open contact point. Friction in the connection between teeth and implants can lead to intrusion of teeth and damage to the periodontal attachment apparatus. Implant occlusion with shallow incisal guidance minimizes lateral and tipping forces. Cross-arch stabilization allows the best distribution of occlusal forces. The choice of restorative materials influences long-term occlusal stability.

  6. 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.

  7. 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.

  8. Oxidative Stress and Antioxidant System in Periodontitis

    Science.gov (United States)

    Wang, Yue; Andrukhov, Oleh; Rausch-Fan, Xiaohui

    2017-01-01

    Periodontitis is a common inflammatory disease, which is initiated by bacterial infection and subsequently progressed by aberrant host response. It can result in the destruction of teeth supporting tissues and have an influence on systemic health. When periodontitis occurs, reactive oxygen species, which are overproduced mostly by hyperactive neutrophils, could not be balanced by antioxidant defense system and cause tissues damage. This is characterized by increased metabolites of lipid peroxidation, DNA damage and protein damage. Local and systemic activities of antioxidants can also be influenced by periodontitis. Total antioxidant capacity, total oxidant status and oxidative stress index have been used to evaluate the oxidative stress associated with periodontitis. Studies have confirmed that inflammatory response in periodontitis is associated with an increased local and systemic oxidative stress and compromised antioxidant capacity. Our review focuses on increased oxidative stress in periodontal disease, specifically, on the relationship between the local and systemic biomarkers of oxidative stress and periodontitis and their association with the pathogenesis of periodontitis. Also, the relationship between periodontitis and systemic inflammation, and the effects of periodontal therapy on oxidative stress parameters will be discussed. PMID:29180965

  9. MicroRNAs as serum biomarkers for periodontitis.

    Science.gov (United States)

    Tomofuji, Takaaki; Yoneda, Toshiki; Machida, Tatsuya; Ekuni, Daisuke; Azuma, Tetsuji; Kataoka, Kota; Maruyama, Takayuki; Morita, Manabu

    2016-05-01

    Studies demonstrated that periodontitis modulates microRNA (miRNAs) expression rates in periodontal tissue. However, the relationship between periodontitis and miRNAs profile in circulation remains unclear. In this study, we investigated the effects of periodontitis on serum miRNAs profile in a rat model. Male Wistar rats (n = 32, 8 weeks old) were divided into four groups of eight rats each. The control groups received no treatment for 2 or 4 weeks. In the other two groups, periodontitis was ligature induced for 2 or 4 weeks. Serum miRNAs expression profiles of each group were compared. Ligation around teeth induced periodontal inflammation at 2 weeks and periodontal tissue destruction at 4 weeks. Microarray results showed that 25 miRNAs were expressed with a 2 difference between the control and periodontitis groups at 4 weeks. Results of real-time PCR revealed that the periodontitis group up-regulated expression rates of serum miR-207 and miR-495 at 2 weeks, and miR-376b-3p at 4 weeks (p periodontitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. [Surgical complications of colostomies].

    Science.gov (United States)

    Ben Ameur, Hazem; Affes, Nejmeddine; Rejab, Haitham; Abid, Bassem; Boujelbene, Salah; Mzali, Rafik; Beyrouti, Mohamed Issam

    2014-07-01

    The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.

  11. Recording and surveillance systems for periodontal diseases

    DEFF Research Database (Denmark)

    Beltrán-Aguilar, Eugenio D; Eke, Paul I; Thornton-Evans, Gina

    2012-01-01

    This paper describes tools used to measure periodontal diseases and the integration of these tools into surveillance systems. Tools to measure periodontal diseases at the surveillance level have focussed on current manifestations of disease (e.g. gingival inflammation) or disease sequelae (e.......g. periodontal pocket depth or loss of attachment). All tools reviewed in this paper were developed based on the state of the science of the pathophysiology of periodontal disease at the time of their design and the need to provide valid and reliable measurements of the presence and severity of periodontal...... diseases. Therefore, some of these tools are no longer valid. Others, such as loss of periodontal attachment, are the current de-facto tools but demand many resources to undertake periodical assessment of the periodontal health of populations. Less complex tools such as the Community Periodontal Index...

  12. Porphyromonas gingivalis, Bacteroides forsythus and other putative periodontal pathogens in subjects with and without periodontal destruction

    NARCIS (Netherlands)

    van Winkelhoff, AJ; Loos, BG; van der Reijden, WA; van der Velden, U

    Background and aims: Bacteria play an essential role in the pathogenesis of destructive periodontal disease. It has been suggested that not all bacteria associated with periodontitis may be normal inhabitants of a periodontally healthy dentition. In particular, Porphyromonas gingivalis and

  13. Dental lesions and restorative treatment in molars

    Directory of Open Access Journals (Sweden)

    Gheorghiu Irina-Maria

    2017-08-01

    Full Text Available This article review specific clinical issues of the molar teeth, as well as the therapeutic approach of their pathology. The dental pathology we face in the group of molars is related to: dental caries, dental trauma (crown and crown-root fractures, dental wear phenomena. The therapeutic approach of the molar teeth is represented by: restoration of the loss of hard dental tissues; endodontic treatments of pulpal and periapical complications; surgical treatment. The restorative treatments in molars are: direct restorations, with or without supplementary anchorage for obturations; inlay, onlay; prosthetic crown.

  14. A Combined Periodontal – Prosthetic Treatment Approach to Manage Unusual Gingival Visibility in Resting Lip Position and Inversely Inclined Upper Anterior Teeth: A Case Report with Discussion

    Science.gov (United States)

    Biniraj, K R; Janardhanan, Mahija; Sunil, M M; Sagir, Mohammed; Hariprasad, A; Paul, Tony P; Emmatty, Rishi

    2015-01-01

    Excessive gingival visibility during smile is a common esthetic complaint in dentistry, but excessive gingival visibility in resting lip position is relatively uncommon condition. Several exclusive radical to conservative surgical treatment or its combination with orthodontic therapy to treat this condition are within the reach of every patient nowadays. A case report of an excessive gingival visibility because of altered passive eruption along with inversely inclined maxillary anterior teeth is presented here. A relatively simple treatment approach combining periodontal and restorative therapy is used here to achieve the desirable aesthetic results. The gingival exposure resulting from altered passive eruption was completely managed by a gingivectomy, but the inclined appearance of teeth was still an aesthetic complaint. After complete healing of gingivectomy surgery, appropriately designed crowns were given to rectify the inversely inclined appearance. A complete rehabilitation of patient’s smile could be achieved, the case was followed up for 3 years and the condition was found satisfactory. PMID:25878482

  15. Periodontitis induced by Porphyromonas gingivalis drives periodontal microbiota dysbiosis and insulin resistance via an impaired adaptive immune response.

    Science.gov (United States)

    Blasco-Baque, Vincent; Garidou, Lucile; Pomié, Céline; Escoula, Quentin; Loubieres, Pascale; Le Gall-David, Sandrine; Lemaitre, Mathieu; Nicolas, Simon; Klopp, Pascale; Waget, Aurélie; Azalbert, Vincent; Colom, André; Bonnaure-Mallet, Martine; Kemoun, Philippe; Serino, Matteo; Burcelin, Rémy

    2017-05-01

    To identify a causal mechanism responsible for the enhancement of insulin resistance and hyperglycaemia following periodontitis in mice fed a fat-enriched diet. We set-up a unique animal model of periodontitis in C57Bl/6 female mice by infecting the periodontal tissue with specific and alive pathogens like Porphyromonas gingivalis ( Pg ), Fusobacterium nucleatum and Prevotella intermedia . The mice were then fed with a diabetogenic/non-obesogenic fat-enriched diet for up to 3 months. Alveolar bone loss, periodontal microbiota dysbiosis and features of glucose metabolism were quantified. Eventually, adoptive transfer of cervical (regional) and systemic immune cells was performed to demonstrate the causal role of the cervical immune system. Periodontitis induced a periodontal microbiota dysbiosis without mainly affecting gut microbiota. The disease concomitantly impacted on the regional and systemic immune response impairing glucose metabolism. The transfer of cervical lymph-node cells from infected mice to naive recipients guarded against periodontitis-aggravated metabolic disease. A treatment with inactivated Pg prior to the periodontal infection induced specific antibodies against Pg and protected the mouse from periodontitis-induced dysmetabolism. Finally, a 1-month subcutaneous chronic infusion of low rates of lipopolysaccharides from Pg mimicked the impact of periodontitis on immune and metabolic parameters. We identified that insulin resistance in the high-fat fed mouse is enhanced by pathogen-induced periodontitis. This is caused by an adaptive immune response specifically directed against pathogens and associated with a periodontal dysbiosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Periodontal tissue reaction to customized nano-hydroxyapatite block scaffold in one-wall intrabony defect: a histologic study in dogs.

    Science.gov (United States)

    Lee, Jung-Seok; Park, Weon-Yeong; Cha, Jae-Kook; Jung, Ui-Won; Kim, Chang-Sung; Lee, Yong-Keun; Choi, Seong-Ho

    2012-04-01

    This study evaluated histologically the tissue responses to and the effects of a customized nano-hydroxyapatite (n-HA) block bone graft on periodontal regeneration in a one-wall periodontal-defect model. A customized block bone for filling in the standardized periodontal defect was fabricated from prefabricated n-HA powders and a polymeric sponge. Bilateral 4×4×5 mm (buccolingual width×mesiodistal width×depth), one-wall, critical-size intrabony periodontal defects were surgically created at the mandibular second and fourth premolars of five Beagle dogs. In each dog, one defect was filled with block-type HA and the other served as a sham-surgery control. The animals were sacrificed following an 8-week healing interval for clinical and histological evaluations. Although the sites that received an n-HA block showed minimal bone formation, the n-HA block was maintained within the defect with its original hexahedral shape. In addition, only a limited inflammatory reaction was observed at sites that received an n-HA block, which might have been due to the high stability of the customized block bone. In the limitation of this study, customized n-HA block could provide a space for periodontal tissue engineering, with minimal inflammation.

  17. The global burden of periodontal disease

    DEFF Research Database (Denmark)

    Petersen, Poul E; Ogawa, Hiroshi

    2012-01-01

    Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease...... is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases......). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper...

  18. Psychosocial distress and periodontitis in adolescents

    DEFF Research Database (Denmark)

    Lopez, Rodrigo; Ramírez, Valeria; Marró, Patricio

    2012-01-01

    Periodontitis is an inflammatory disease associated with predominantly gram negative biofilms and characterized by the progressive destruction of the supporting tissues of the teeth. Some studies conducted among adults have found a significant association between periodontitis and dimensions...... of psychosocial distress and it is unclear whether this association can be found among younger subjects in which destruction of periodontal tissues as a result of periodontitis are less severe. Purpose: The main aim of this study was to assess whether adolescents with periodontitis presented with higher scores...... for non-psychotic psychosocial disorders than control subjects without periodontitis. Materials and Methods: We used a case control study (n=160) nested in a well-defined adolescent population (n=9,163) and the 28-item Spanish version of the General Health Questionnaire. The inclusion criterion for being...

  19. Poor periodontal health: A cancer risk?

    Directory of Open Access Journals (Sweden)

    K S Rajesh

    2013-01-01

    Full Text Available Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis.

  20. Poor periodontal health: A cancer risk?

    Science.gov (United States)

    Rajesh, K S; Thomas, Deepak; Hegde, Shashikanth; Kumar, M S Arun

    2013-11-01

    Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis.

  1. Clinical attachment level gain and three-year maintenance of a maxillary incisor with 100% bone loss: A case report.

    Science.gov (United States)

    Tirone, Federico; Salzano, Stefano

    2016-01-01

    This case report discusses a patient suffering from chronic periodontal disease and diagnosed with a hopeless central incisor. The intention was to show the possibility of gaining new clinical attachment via regenerative surgery in a tooth with 100% bone loss around the root. Treatment of hopeless and questionable teeth in periodontal patients has become an ideological matter. On the one hand, dental implants have proved to be a reliable solution to replace lost teeth; on the other hand, newly emerging evidence suggests that successful periodontal treatment of teeth diagnosed as hopeless is possible. Here we describe surgical, orthodontic, and restorative treatments that led to clinical attachment gain and achieved clinical success over a three-year follow-up period.

  2. Evaluation of clinical and metabolic changes after non surgical periodontal treatment of type 2 diabetes mellitus patients: A clinico biochemical study

    Directory of Open Access Journals (Sweden)

    Kudva Praveen

    2010-01-01

    Full Text Available Aim: To evaluate the clinical and metabolic changes following nonsurgical periodontal therapy of type-2 diabetic patients and nondiabetic patients. Materials and Methods: Fifteen nondiabetics and fifteen type-2 diabetics with moderate to severe periodontitis were selected after meeting inclusion and exclusion criteria. Periodontal pocket probing was performed using a Williams graduated periodontal probe and comparisons of the clinical and biochemical parameters like plaque index, gingival index, probing depth, glycated hemoglobin, and lipid profile (total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides and very low density lipoprotein were done between and within two groups at baseline and 3 month. Results: A correlation was observed between clinical and biochemical parameters between and within two groups at baseline and 3 month. The P value of diabetic group was<0.001 in all clinical parameters (plaque index PI, Gingival index GI, and Probing Pocket Depth PPD in diabetic and nondiabetic group, showed statistically highly significant difference in GI, PI, PPD, <.01 in Glycated Hemoglobulin (HbAlc1 in test group and<0.05 in control group showed statistically significant difference. The P value of test group was >0.05 in Lipid profile (total cholesterol, low density lipoprotein, high density lipoprotein, serum triglyceride, very low density lipoprotein that showed no significant difference and in control group<0.05 in total Cholesterol, high density lipoprotein and <0.01 in Low density lipoprotein, Very Low Density Lipoprotein, and Serum Triglyceride, respectively, showed statistically significant in Total cholesterol, Low density lipoprotein, Very Low Density Lipoprotein, and Serum Triglyceride, not significant in high density lipoprotein. The P value >0.05 showed no statistical significance of correlation between the test and control groups. Conclusion: Both groups of patients showed an improvement in clinical and

  3. Periodontitis-activated monocytes/macrophages cause aortic inflammation

    Science.gov (United States)

    Miyajima, Shin-ichi; Naruse, Keiko; Kobayashi, Yasuko; Nakamura, Nobuhisa; Nishikawa, Toru; Adachi, Kei; Suzuki, Yuki; Kikuchi, Takeshi; Mitani, Akio; Mizutani, Makoto; Ohno, Norikazu; Noguchi, Toshihide; Matsubara, Tatsuaki

    2014-01-01

    A relationship between periodontal disease and atherosclerosis has been suggested by epidemiological studies. Ligature-induced experimental periodontitis is an adequate model for clinical periodontitis, which starts from plaque accumulation, followed by inflammation in the periodontal tissue. Here we have demonstrated using a ligature-induced periodontitis model that periodontitis activates monocytes/macrophages, which subsequently circulate in the blood and adhere to vascular endothelial cells without altering the serum TNF-α concentration. Adherent monocytes/macrophages induced NF-κB activation and VCAM-1 expression in the endothelium and increased the expression of the TNF-α signaling cascade in the aorta. Peripheral blood-derived mononuclear cells from rats with experimental periodontitis showed enhanced adhesion and increased NF-κB/VCAM-1 in cultured vascular endothelial cells. Our results suggest that periodontitis triggers the initial pathogenesis of atherosclerosis, inflammation of the vasculature, through activating monocytes/macrophages. PMID:24893991

  4. Human Umbilical Cord MSCs as New Cell Sources for Promoting Periodontal Regeneration in Inflammatory Periodontal Defect.

    Science.gov (United States)

    Shang, Fengqing; Liu, Shiyu; Ming, Leiguo; Tian, Rong; Jin, Fang; Ding, Yin; Zhang, Yongjie; Zhang, Hongmei; Deng, Zhihong; Jin, Yan

    2017-01-01

    Human periodontal ligament stem cells (hPDLSCs) transplantation represents a promising approach for periodontal regeneration; however, the cell source is limited due to the invasive procedure required for cell isolation. As human umbilical cord mesenchymal stem cells (hUCMSCs) can be harvested inexpensively and inexhaustibly, here we evaluated the regenerative potentials of hUCMSCs as compared with hPDLSCs to determine whether hUCMSCs could be used as new cell sources for periodontal regeneration. Methods The characteristics of hUCMSCs, including multi-differentiation ability and anti-inflammatory capability, were determined by comparison with hPDLSCs. We constructed cell aggregates (CA) using hUCMSCs and hPDLSCs respectively. Then hPDLSCs-CA and hUCMSCs-CA were combined with β-tricalcium phosphate bioceramic (β-TCP) respectively and their regenerative potentials were determined in a rat inflammatory periodontal defect model. Results hPDLSCs showed higher osteogenic differentiation potentials than hUCMSCs. Meanwhile, hUCMSCs showed higher extracellular matrix secretion and anti-inflammatory abilities than hPDLSCs. Similar to hPDLSCs, hUCMSCs were able to contribute to regeneration of both soft and hard periodontal tissues under inflammatory periodontitis condition. There were more newly formed bone and periodontal ligaments in hPDLSCs and hUCMSCs groups than in non-cell treated group. Moreover, no significant differences of regenerative promoting effects between hPDLSCs and hUCMSCs were found. Conclusion : hUCMSCs generated similar promoting effects on periodontal regeneration compared with hPDLSCs, and can be used as new cell sources for periodontal regeneration.

  5. The periodontal pain paradox: Difficulty on pain assesment in dental patients (The periodontal pain paradox hypothesis

    Directory of Open Access Journals (Sweden)

    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

  6. Periodontal therapy for the management of cardiovascular disease in patients with chronic periodontitis.

    Science.gov (United States)

    Li, Chunjie; Lv, Zongkai; Shi, Zongdao; Zhu, Ye; Wu, Yafei; Li, Longjiang; Iheozor-Ejiofor, Zipporah

    2014-08-15

    There is an association between chronic periodontitis and cardiovascular disease (CVD). However, it is not known whether periodontal therapy could prevent or manage CVD in patients with chronic periodontitis. The objective of this systematic review was to investigate the effects of periodontal therapy in preventing the occurrence of, and management or recurrence of, CVD in patients with chronic periodontitis. The electronic databases that were searched were the Cochrane Oral Health Group's Trials Register (to 7 April 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 3), MEDLINE via OVID (1946 to 7 April 2014), EMBASE via OVID (1980 to 7 April 2014), CINAHL via EBSCO (1937 to 7 April 2014), OpenGrey (to 7 April 2014), the Chinese BioMedical Literature Database (1978 to April 2014), the China National Knowledge Infrastructure (1994 to April 2014) and the VIP database (1989 to April 2014). We searched the US National Institutes of Health Trials Register, the World Health Organization (WHO) Clinical Trials Registry Platform and Sciencepaper Online for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) and quasi-RCTs were considered eligible. Studies were selected if they included patients with a diagnosis of chronic periodontitis and previous CVD (secondary prevention studies) or no CVD (primary prevention studies); patients in the intervention group received active periodontal therapy compared to maintenance therapy, no periodontal treatment or another kind of periodontal treatment in the control group. Two review authors carried out the study identification, data extraction and risk of bias assessment independently and in duplicate. Any discrepancies between the two authors were resolved by discussion or with a third review author. A formal pilot-tested data extraction form was adopted for the data extraction

  7. 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

  8. 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).

  9. Periodontal disease in primary Sjögren's Syndrome

    DEFF Research Database (Denmark)

    Schjødt, Morten; Christensen, Lisa Bøge; Petersen, P.E.

    2001-01-01

    Sjögren's syndrome, gingivitis, periodontitis, periodontal disease, xerostomia, oral manifestations......Sjögren's syndrome, gingivitis, periodontitis, periodontal disease, xerostomia, oral manifestations...

  10. Comparison of Salivary TIMP-1 Levels in Periodontally Involved and Healthy Controls and the Response to Nonsurgical Periodontal Therapy

    Directory of Open Access Journals (Sweden)

    Angel Fenol

    2014-01-01

    Full Text Available Background. Periodontal disease is a chronic inflammatory condition affecting the supporting structures of the dentition. Periodontal destruction is an outcome of the imbalance between matrix metalloproteinases and tissue inhibitors of matrix metalloproteinases (TIMPs. We wanted to prove the hypothesis that salivary TIPM-1 level will vary in different people. A decrease in TIMP-1 level could make them more susceptible to periodontitis whereas a normal level could prevent increased tissue destruction thereby inhibiting the progression from gingivitis to periodontitis. This could probably pave the way for TIPM-1 to be a specific salivary biomarker and serve as a useful diagnostic and therapeutic tool in periodontitis. Methods. Whole unstimulated saliva of 2 ml was collected from twenty-five periodontally healthy and twenty-seven systemically healthy subjects with periodontitis. Clinical parameters recorded at baseline and reevaluated after four weeks in subjects with periodontitis following nonsurgical periodontal therapy were gingival index (GI, oral hygiene index-Simplified (OHI-S, probing pocket depth, and clinical attachment level (CAL. Salivary TIMP-1 levels in both were analyzed using a commercially available ELISA kit.

  11. Gingival and Periodontal Diseases in Children and Adolescents

    OpenAIRE

    Vivek Singh Chauhan; Rashmi Singh Chauhan; Nihal Devkar; Akshay Vibhute; Shobha More

    2012-01-01

    Periodontal diseases are among the most frequent diseases affecting children and adolescents. These include gingivitis, localized or generalized aggressive periodontitis (a.k.a., early onset periodontitis) and periodontal diseases associated with systemic disorders. The effects of periodontal diseases observed in adults have earlier inception in life period. Gingival diseases in a child may progress to jeopardize the periodontium in adulthood. Therefore, periodontal diseases must be prevented...

  12. Effect of periodontal therapy on serum C-reactive protein levels in patients with gingivitis and chronic periodontitis: a clinicobiochemical study.

    Science.gov (United States)

    Patil, Veena A; Desai, Manthan H

    2013-03-01

    The aim of the present study was to evaluate the effect of periodontal therapy on serum C-reactive protein (CRP) levels in patients with gingivitis and chronic periodontitis. A total of 60 subjects (30 males and 30 females) were included in the study with 20 subjects in each of the groups classified based on community periodontal index (CPI) scores: I: Healthy, II: Gingivitis, III: Mild periodontitis. Periodontal therapy was performed on groups II and III patients. Venous blood was collected from each subject at baseline and 3 months after periodontal therapy. The collected sample was subjected to biochemical analysis to detect CRP levels by using immunoturbidimetric method. The present study demonstrated that the periodontitis group had a higher mean CRP levels (2.49 ± 0.47 ng/ml) as compared to the gingivitis group (1.40 ± 0.32 ng/ml) and healthy group (0.56 ± 0.20 ng/ml). The mean CRP values after periodontal therapy were found to be reduced to 0.44 ± 0.23 ng/ml in group II and 1.30 ± 0.36 ng/ml in group III patients. Within the limitations of this study, it can be concluded that CRP level progressively increases from periodontal health to disease. A decrease in CRP levels with periodontal treatment was also observed. Due to its opsonizing abilities CRP plays an important role in the innate host defence. It can be hypothesized that CRP is a potential biomarker of periodontal disease. A number of studies have reported elevated serum CRP levels in periodontitis subjects. Long standing periodontal disease and raised CRP levels enhance the risk of cardiovascular disease, cerebrovascular accidents and preterm low birth weight infants. There is also evidence that effective periodontal therapy can lower serum CRP levels. However, the data of interventional studies on CRP in gingivitis and periodontitis is scarce.

  13. Uncovering the molecular networks in periodontitis

    Science.gov (United States)

    Trindade, Fábio; Oppenheim, Frank G.; Helmerhorst, Eva J.; Amado, Francisco; Gomes, Pedro S.; Vitorino, Rui

    2015-01-01

    Periodontitis is a complex immune-inflammatory disease that results from a preestablished infection in gingiva, mainly due to Gram-negative bacteria that colonize deeper in gingival sulcus and latter periodontal pocket. Host inflammatory and immune responses have both protective and destructive roles. Although cytokines, prostaglandins, and proteases struggle against microbial burden, these molecules promote connective tissue loss and alveolar bone resorption, leading to several histopathological changes, namely destruction of periodontal ligament, deepening of periodontal pocket, and bone loss, which can converge to attain tooth loss. Despite the efforts of genomics, transcriptomics, proteomics/peptidomics, and metabolomics, there is no available biomarker for periodontitis diagnosis, prognosis, and treatment evaluation, which could assist on the established clinical evaluation. Nevertheless, some genes, transcripts, proteins and metabolites have already shown a different expression in healthy subjects and in patients. Though, so far, ‘omics approaches only disclosed the host inflammatory response as a consequence of microbial invasion in periodontitis and the diagnosis in periodontitis still relies on clinical parameters, thus a molecular tool for assessing periodontitis lacks in current dental medicine paradigm. Saliva and gingival crevicular fluid have been attracting researchers due to their diagnostic potential, ease, and noninvasive nature of collection. Each one of these fluids has some advantages and disadvantages that are discussed in this review. PMID:24828325

  14. Antibiotic susceptibility of periodontal Streptococcus constellatus and Streptococcus intermedius clinical isolates.

    Science.gov (United States)

    Rams, Thomas E; Feik, Diane; Mortensen, Joel E; Degener, John E; van Winkelhoff, Arie J

    2014-12-01

    Streptococcus constellatus and Streptococcus intermedius in subgingival dental plaque biofilms may contribute to forms of periodontitis that resist treatment with conventional mechanical root debridement/surgical procedures and may additionally participate in some extraoral infections. Because systemic antibiotics are often used in these clinical situations, and little is known of the antibiotic susceptibility of subgingival isolates of these two bacterial species, this study determined the in vitro susceptibility to six antibiotics of fresh S. constellatus and S. intermedius clinical isolates from human periodontitis lesions. A total of 33 S. constellatus and 17 S. intermedius subgingival strains, each recovered from separate patients with severe chronic periodontitis (n = 50) before treatment, were subjected to antibiotic gradient strip susceptibility testing with amoxicillin, azithromycin, clindamycin, ciprofloxacin, and doxycycline on blood-supplemented Mueller-Hinton agar and to the inhibitory effects of metronidazole at 16 mg/L in an enriched Brucella blood agar dilution assay. Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing interpretative standards were used to assess the results. Clindamycin was the most active antibiotic against S. constellatus (minimum inhibitory concentration at 90% [MIC90] 0.25 mg/L), and amoxicillin was most active against S. intermedius (MIC90 0.125 mg/L). A total of 30% of the S. constellatus and S. intermedius clinical isolates were resistant in vitro to doxycycline, 98% were only intermediate in susceptibility to ciprofloxacin, and 90% were resistant to metronidazole at 16 mg/L. Subgingival S. constellatus and S. intermedius exhibited variable antibiotic susceptibility profiles, potentially complicating empirical selection of periodontitis antibiotic therapy in patients who are species positive.

  15. Gingival and Periodontal Diseases in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Vivek Singh Chauhan

    2012-01-01

    Full Text Available Periodontal diseases are among the most frequent diseases affecting children and adolescents. These include gingivitis, localized or generalized aggressive periodontitis (a.k.a., early onset periodontitis and periodontal diseases associated with systemic disorders. The effects of periodontal diseases observed in adults have earlier inception in life period. Gingival diseases in a child may progress to jeopardize the periodontium in adulthood. Therefore, periodontal diseases must be prevented and diagnosed early in the life. This paper reviews the most common periodontal diseases affecting children: chronic gingivitis (or dental plaque-induced gingival diseases and aggressive periodontitis. In addition, systemic diseases that affect the periodontium in young children and necrotizing periodontal diseases are addressed. The prevalence, diagnostic characteristics, microbiology, host- related factors, and therapeutic management of each of these disease entities are discussed.

  16. Periodontal diseases in children and adolescents.

    Science.gov (United States)

    Clerehugh, V

    2008-04-26

    Unlike in adults, currently there are no nationally agreed guidelines for the assessment of periodontal diseases in children and adolescents. This paper considers the range of periodontal diseases that can affect youngsters and documents a simple periodontal screening system for the younger age groups. It includes principles of periodontal diagnosis and management for the practitioner to apply to the young patient and considers when to treat in practice and when to refer to a specialist.

  17. 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).

  18. Periodontist-Dental Hygienist Collaboration in Periodontal Care for Chronic Periodontitis: An 11-year Case Report.

    Science.gov (United States)

    Tomita, Sachiyo; Uekusa, Tomomi; Hosono, Meiko; Kigure, Takashi; Sugito, Hiroki; Saito, Atsushi

    2016-01-01

    We report a case of severe chronic periodontitis treated and longitudinally maintained by a periodontist and dental hygienists. The patient was a 45-year-old woman who presented with the chief complaint of gingival bleeding and tooth mobility. An initial examination revealed generalized gingival inflammation and subgingival calculus in the premolar and molar regions. Premature contact was observed in #14 and 45. Clinical examination revealed 42% of sites with a probing depth (PD) of ≥4 mm and 44% of sites with bleeding on probing. Radiographic examination revealed vertical bone resorption in #35, 36, and 45, and horizontal bone resorption in other regions. Based on a clinical diagnosis of severe chronic periodontitis, initial periodontal therapy consisting of plaque control, scaling and root planing, and removal of an ill-fitting prosthesis was performed. Following suppression of inflammation, occlusal adjustment of premature contact sites was performed. Open flap debridement was performed for teeth with a PD of ≥5 mm. After confirming the stability of the periodontal tissue, final prostheses were placed on #16, 35-37, and 46. Following re-evaluation, the patient was placed on supportive periodontal therapy. It has been 11 years since the patient's first visit, and the periodontal conditions have remained stable. Meticulous periodontal care maintained over a number of years by a periodontist and dental hygienist have yielded a clinically favorable outcome.

  19. Modeling susceptibility to periodontitis

    NARCIS (Netherlands)

    Laine, M.L.; Moustakis, V.; Koumakis, L.; Potamias, G.; Loos, B.G.

    2013-01-01

    Chronic inflammatory diseases like periodontitis have a complex pathogenesis and a multifactorial etiology, involving complex interactions between multiple genetic loci and infectious agents. We aimed to investigate the influence of genetic polymorphisms and bacteria on chronic periodontitis risk.

  20. 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?

  1. 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...

  2. Periodontal disease and halitosis

    International Nuclear Information System (INIS)

    Alzoman, Hamad

    2008-01-01

    Halitosis is a general term used to describe an unpleasant or offensive odor emanating from the oral cavity. It is a condition that has health and social implications in the life of those who suffer from it. The origin of halitosis is related to both systemic and oral conditions although the oral causes predominate. Volatile sulfur compound is the primary gas responsible for halitosis. They are formed as a result of gram-negative bacterial putrefaction. The major sites for oral halitosis are the dorsum of the tongue and periodontal pockets. There is a correlation between the amount of plaque on the tongue and periodontitis with the severity of halitosis. The aim of this article was to review the data and correlate periodontitis with severity of halitosis and the effect of halitosis- inducing factors on the progress of periodontal diseases. (author)

  3. Development of an Ontology for Periodontitis.

    Science.gov (United States)

    Suzuki, Asami; Takai-Igarashi, Takako; Nakaya, Jun; Tanaka, Hiroshi

    2015-01-01

    In the clinical dentists and periodontal researchers' community, there is an obvious demand for a systems model capable of linking the clinical presentation of periodontitis to underlying molecular knowledge. A computer-readable representation of processes on disease development will give periodontal researchers opportunities to elucidate pathways and mechanisms of periodontitis. An ontology for periodontitis can be a model for integration of large variety of factors relating to a complex disease such as chronic inflammation in different organs accompanied by bone remodeling and immune system disorders, which has recently been referred to as osteoimmunology. Terms characteristic of descriptions related to the onset and progression of periodontitis were manually extracted from 194 review articles and PubMed abstracts by experts in periodontology. We specified all the relations between the extracted terms and constructed them into an ontology for periodontitis. We also investigated matching between classes of our ontology and that of Gene Ontology Biological Process. We developed an ontology for periodontitis called Periodontitis-Ontology (PeriO). The pathological progression of periodontitis is caused by complex, multi-factor interrelationships. PeriO consists of all the required concepts to represent the pathological progression and clinical treatment of periodontitis. The pathological processes were formalized with reference to Basic Formal Ontology and Relation Ontology, which accounts for participants in the processes realized by biological objects such as molecules and cells. We investigated the peculiarity of biological processes observed in pathological progression and medical treatments for the disease in comparison with Gene Ontology Biological Process (GO-BP) annotations. The results indicated that peculiarities of Perio existed in 1) granularity and context dependency of both the conceptualizations, and 2) causality intrinsic to the pathological processes

  4. Comparison of Analgesic Effects of Novafen and Ibuprofen after Periodontal Surgeries

    Directory of Open Access Journals (Sweden)

    Amirreza Babaloo

    2017-01-01

    Full Text Available Introduction: Management of pain after dental procedures is one of the most important issues for dentists. Non-steroidal antiinflammatory agents, such as ibuprofen, are one of the most commonly used medications to relieve pain. Recently a new medication, Novafen, has been introduced into the Iranian pharmaceutical market, which is a combination of ibuprofen, acetaminophen and caffeine. Considering the importance of management of pain after periodontal surgeries and a paucity of studies in this respect, the present study was undertaken to compare the analgesic efficacy of Novafen and ibuprofen in alleviating pain after periodontal surgeries. Materials and methods: In the present controlled randomized clinical trial, 30 systemically healthy subjects with moderate to severe generalized chronic periodontitis, who were candidates for flap surgeries were evaluated in two groups with 30 areas in each group (two areas in each patient. After the periodontal surgical procedures, the subjects in group 1 received Novafen capsules (containing 325 mg of acetaminophen, 200 mg of ibuprofen and 40 mg of caffeine and the subjects in group 2 received ibuprofen (400 mg. The medications were selected from one pharmaceutical company and the patients only used the medications they received. The severity of pain was determined and compared at 3-minute, 1-hour and 3-hour intervals using VAS and 1, 2 and 3 days postoperatively using VRS. Results: Severity of pain at 30-minute interval in the Novafen group was significantly less than that in the ibuprofen group, with no significant differences at 1- and 3-hour intervals. However, VRS revealed significantly less pain 1, 2 and 3 days postoperatively in the Novafen group compared to the ibuprofen group. Conclusion: Based on the results of the present study, it can be concluded than Novafen can be more effective after periodontal surgeries in alleviating pain. However, its pain control capacity was similar to that of

  5. Quantitative Molecular Detection of Putative Periodontal Pathogens in Clinically Healthy and Periodontally Diseased Subjects

    Science.gov (United States)

    Göhler, André; Hetzer, Adrian; Holtfreter, Birte; Geisel, Marie Henrike; Schmidt, Carsten Oliver; Steinmetz, Ivo; Kocher, Thomas

    2014-01-01

    Periodontitis is a multi-microbial oral infection with high prevalence among adults. Putative oral pathogens are commonly found in periodontally diseased individuals. However, these organisms can be also detected in the oral cavity of healthy subjects. This leads to the hypothesis, that alterations in the proportion of these organisms relative to the total amount of oral microorganisms, namely their abundance, rather than their simple presence might be important in the transition from health to disease. Therefore, we developed a quantitative molecular method to determine the abundance of various oral microorganisms and the portion of bacterial and archaeal nucleic acid relative to the total nucleic acid extracted from individual samples. We applied quantitative real-time PCRs targeting single-copy genes of periodontal bacteria and 16S-rRNA genes of Bacteria and Archaea. Testing tongue scrapings of 88 matched pairs of periodontally diseased and healthy subjects revealed a significantly higher abundance of P. gingivalis and a higher total bacterial abundance in diseased subjects. In fully adjusted models the risk of being periodontally diseased was significantly higher in subjects with high P. gingivalis and total bacterial abundance. Interestingly, we found that moderate abundances of A. actinomycetemcomitans were associated with reduced risk for periodontal disease compared to subjects with low abundances, whereas for high abundances, this protective effect leveled off. Moderate archaeal abundances were health associated compared to subjects with low abundances. In conclusion, our methodological approach unraveled associations of the oral flora with periodontal disease, which would have gone undetected if only qualitative data had been determined. PMID:25029268

  6. C-reactive protein in patients with aggressive periodontitis

    Directory of Open Access Journals (Sweden)

    Jaroslav Mysak

    2017-12-01

    Full Text Available Background/purpose: The aim of this study was to evaluate and compare the systemic levels of C-reactive protein (CRP in peripheral blood samples of patients with aggressive periodontitis during the first twelve months of periodontal treatment, at exactly six month interval measurements, and compare them with clinical periodontal parameters. Materials and methods: All patients (N = 45 were examined prior to the initiation of periodontal treatment. Patients were divided into two groups GAgP (Generalised form of aggressive periodontitis, N = 23 and group LAgP (Localised form of aggressive periodontitis, N = 22. Control group (CON included 60 individuals with healthy periodontium. The levels of CRP were determined in both groups GAgP and LAgP three times in 6 month intervals during the periodontal treatment. Results: CRP is a plasma protein that reflects the extent of the acute phase response to inflammation and is one of the markers of choice for monitoring this response. In our study, CRP levels decreased in course of periodontal treatment in both groups (GAgP and LAgP in a similar way as bleeding on probing (BOP and probing pocket depth (PPD indices. Conclusion: Our study results showed that CRP levels, as well as bleeding on probing (BOP and probing pocket depth (PPD, indices decreased in course of periodontal treatment in patients with generalised and localised aggressive periodontitis. Therefore this marker might be exploitable as a means to evaluate periodontal health in patients with aggressive periodontitis. Keywords: aggressive periodontitis, C-reactive protein, periodontal index, cardiovascular diseases

  7. Influence of nanotopography on periodontal ligament stem cell functions and cell sheet based periodontal regeneration.

    Science.gov (United States)

    Gao, Hui; Li, Bei; Zhao, Lingzhou; Jin, Yan

    2015-01-01

    Periodontal regeneration is an important part of regenerative medicine, with great clinical significance; however, the effects of nanotopography on the functions of periodontal ligament (PDL) stem cells (PDLSCs) and on PDLSC sheet based periodontal regeneration have never been explored. Titania nanotubes (NTs) layered on titanium (Ti) provide a good platform to study this. In the current study, the influence of NTs of different tube size on the functions of PDLSCs was observed. Afterward, an ectopic implantation model using a Ti/cell sheets/hydroxyapatite (HA) complex was applied to study the effect of the NTs on cell sheet based periodontal regeneration. The NTs were able to enhance the initial PDLSC adhesion and spread, as well as collagen secretion. With the Ti/cell sheets/HA complex model, it was demonstrated that the PDLSC sheets were capable of regenerating the PDL tissue, when combined with bone marrow mesenchymal stem cell (BMSC) sheets and HA, without the need for extra soluble chemical cues. Simultaneously, the NTs improved the periodontal regeneration result of the ectopically implanted Ti/cell sheets/HA complex, giving rise to functionally aligned collagen fiber bundles. Specifically, much denser collagen fibers, with abundant blood vessels as well as cementum-like tissue on the Ti surface, which well-resembled the structure of natural PDL, were observed in the NT5 and NT10 sample groups. Our study provides the first evidence that the nanotopographical cues obviously influence the functions of PDLSCs and improve the PDLSC sheet based periodontal regeneration size dependently, which provides new insight to the periodontal regeneration. The Ti/cell sheets/HA complex may constitute a good model to predict the effect of biomaterials on periodontal regeneration.

  8. Dissemination of Periodontal Pathogens in the Bloodstream after Periodontal Procedures: A Systematic Review

    Science.gov (United States)

    Horliana, Anna Carolina Ratto Tempestini; Chambrone, Leandro; Foz, Adriana Moura; Artese, Hilana Paula Carillo; Rabelo, Mariana de Sousa; Pannuti, Cláudio Mendes; Romito, Giuseppe Alexandre

    2014-01-01

    Background To date, there is no compilation of evidence-based information associating bacteremia and periodontal procedures. This systematic review aims to assess magnitude, duration, prevalence and nature of bacteremia caused by periodontal procedures. Study Design Systematic Review Types of Studies Reviewed MEDLINE, EMBASE and LILACS databases were searched in duplicate through August, 2013 without language restriction. Observational studies were included if blood samples were collected before, during or after periodontal procedures of patients with periodontitis. The methodological quality was assessed in duplicate using the modified Newcastle-Ottawa scale (NOS). Results Search strategy identified 509 potentially eligible articles and nine were included. Only four studies demonstrated high methodological quality, whereas five were of medium or low methodological quality. The study characteristics were considered too heterogeneous to conduct a meta-analysis. Among 219 analyzed patients, 106 (49.4%) had positive bacteremia. More frequent bacteria were S. viridans, A. actinomycetemcomitans P. gingivalis, M. micros and species Streptococcus and Actinomyces, although identification methods of microbiologic assays were different among studies. Clinical Implications Although half of the patients presented positive bacteremia after periodontal procedures, accurate results regarding the magnitude, duration and nature of bacteremia could not be confidentially assessed. PMID:24870125

  9. 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.

  10. Microbiomes associated with bovine periodontitis and oral health.

    Science.gov (United States)

    Borsanelli, Ana C; Lappin, David F; Viora, Lorenzo; Bennett, David; Dutra, Iveraldo S; Brandt, Bernd W; Riggio, Marcello P

    2018-05-01

    Periodontitis is an infectious polymicrobial, immuno-inflammatory disease of multifactorial aetiology that has an impact on the health, production and welfare of ruminants. The objective of the present study was to determine the microbial profiles present in the gingival sulcus of cattle considered periodontally healthy and in the periodontal pocket of animals with periodontitis lesions using high-throughput bacterial 16S rRNA gene sequencing. Subgingival biofilm samples were collected from 40 cattle with periodontitis and 38 periodontally healthy animals. In total, 1923 OTUs were identified and classified into 395 genera or higher taxa. Microbial profiles in health differed significantly from periodontitis in their composition (p PERMANOVA) but no statistically significant differences were observed in the diversity of healthy and periodontitis microbiomes. The most prevalent taxa in health were Pseudomonas, Burkholderia and Actinobacteria, whereas in disease these were Prevotella, Fusobacterium and Porphyromonas. The most discriminative taxa in health were Gastranaerophilales, Planifilum and Burkholderia, and in disease these were Elusimicrobia, Synergistes and Propionivibrio. In conclusion, statistically significant difference exists between the microbiome in bovine oral health and periodontitis, with populations showing 72.6% dissimilarity. The diversity of the bacteria found in health and periodontitis were similar and bacteria recognised as periodontal pathogens showed increased abundance in disease. In this context, the main components of bacterial homeostasis in the biofilm of healthy sites and of dysbiosis in periodontal lesions provide unprecedented indicators for the evolution of knowledge about bovine periodontitis. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Periodontal disease and pregnancy hypertension: a clinical correlation.

    Science.gov (United States)

    Pralhad, Swati; Thomas, Betsy; Kushtagi, Pralhad

    2013-08-01

    Periodontal disease is thought to be associated with increased risk of systemic diseases and adverse pregnancy outcomes, including pregnancy hypertension (PH). The aim of the present study is to find the prevalence of periodontal disease in females with PH in a rural-based medical institute. The present case control study was performed with 200 females, 100 with PH and 100 without PH. Antenatal periodontal screening was performed within 72 hours of their hospital admission for delivery. The periodontal parameters assessed were oral hygiene index-simplified, gingival index, mean probing depth, and loss of attachment. Prevalence of periodontal disease was 65.5% and was significantly higher (P periodontal disease and PH on bivariate multiple logistic regression analysis. Nulliparous females were at higher odds to develop periodontal disease and PH (odds ratio = 1.7; 95% CI = 0.5 to 6.1). As the severity of periodontal disease increased from moderate to severe, the severity of hypertension also increased (r(2) = 0.8 and 0.5 for moderate and severe periodontal disease, respectively). Periodontal disease is more prevalent in females with PH.

  12. [Periodontal disease in pediatric rheumatic diseases].

    Science.gov (United States)

    Fabri, Gisele M C; Savioli, Cynthia; Siqueira, José T; Campos, Lucia M; Bonfá, Eloisa; Silva, Clovis A

    2014-01-01

    Gingivitis and periodontitis are immunoinflammatory periodontal diseases characterized by chronic localized infections usually associated with insidious inflammation This narrative review discusses periodontal diseases and mechanisms influencing the immune response and autoimmunity in pediatric rheumatic diseases (PRD), particularly juvenile idiopathic arthritis (JIA), childhood-onset systemic lupus erythematosus (C-SLE) and juvenile dermatomyositis (JDM). Gingivitis was more frequently observed in these diseases compared to health controls, whereas periodontitis was a rare finding. In JIA patients, gingivitis and periodontitis were related to mechanical factors, chronic arthritis with functional disability, dysregulation of the immunoinflammatory response, diet and drugs, mainly corticosteroids and cyclosporine. In C-SLE, gingivitis was associated with longer disease period, high doses of corticosteroids, B-cell hyperactivation and immunoglobulin G elevation. There are scarce data on periodontal diseases in JDM population, and a unique gingival pattern, characterized by gingival erythema, capillary dilation and bush-loop formation, was observed in active patients. In conclusion, gingivitis was the most common periodontal disease in PRD. The observed association with disease activity reinforces the need for future studies to determine if resolution of this complication will influence disease course or severity. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  13. Social gradients in periodontal diseases among adolescents.

    Science.gov (United States)

    López, Rodrigo; Fernández, Olaya; Baelum, Vibeke

    2006-06-01

    To investigate the association between socioeconomic position and periodontal diseases among adolescents. Data were obtained from 9203 Chilean high school students. Clinical examinations included direct recordings of clinical attachment level and the necrotizing ulcerative gingival lesions. Students answered a questionnaire on various dimensions of socioeconomic position. Seven periodontal outcomes were analyzed. Logistic regression analyses were used to identify socioeconomic variables associated with the periodontal outcomes. The occurrence of all periodontal outcomes investigated followed social gradients, and paternal income and parental education were the most influential variables. The study demonstrates the existence of significant social gradients in periodontal diseases already among adolescents. This is worrying, and indicates a new potential for further insight into the mechanisms of periodontal disease causation.

  14. Guided tissue regeneration for periodontal infra-bony defects.

    Science.gov (United States)

    Needleman, I G; Worthington, H V; Giedrys-Leeper, E; Tucker, R J

    2006-04-19

    Conventional treatment of destructive periodontal (gum) disease arrests the disease but does not usually regain the bone support or connective tissue lost in the disease process. Guided tissue regeneration (GTR) is a surgical procedure that specifically aims to regenerate the periodontal tissues when the disease is advanced and could overcome some of the limitations of conventional therapy. To assess the efficacy of GTR in the treatment of periodontal infra-bony defects measured against conventional surgery (open flap debridement (OFD)) and factors affecting outcomes. We conducted an electronic search of the Cochrane Oral Health Group Trials Register, MEDLINE and EMBASE up to April 2004. Handsearching included Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and bibliographies of all relevant papers and review articles up to April 2004. In addition, we contacted experts/groups/companies involved in surgical research to find other trials or unpublished material or to clarify ambiguous or missing data and posted requests for data on two periodontal electronic discussion groups. Randomised, controlled trials (RCTs) of at least 12 months duration comparing guided tissue regeneration (with or without graft materials) with open flap debridement for the treatment of periodontal infra-bony defects. Furcation involvements and studies specifically treating aggressive periodontitis were excluded. Screening of possible studies and data extraction was conducted independently. The methodological quality of studies was assessed in duplicate using individual components and agreement determined by Kappa scores. Methodological quality was used in sensitivity analyses to test the robustness of the conclusions. The Cochrane Oral Health Group statistical guidelines were followed and the results expressed as mean differences (MD and 95% CI) for continuous outcomes and risk ratios (RR and 95% CI) for dichotomous outcomes calculated using

  15. Genetic susceptibility of periodontitis

    NARCIS (Netherlands)

    Laine, M.L.; Crielaard, W.; Loos, B.G.

    2012-01-01

    In this systematic review, we explore and summarize the peer-reviewed literature on putative genetic risk factors for susceptibility to aggressive and chronic periodontitis. A comprehensive literature search on the PubMed database was performed using the keywords ‘periodontitis’ or ‘periodontal

  16. Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration.

    Science.gov (United States)

    Bonte, Katrien; Huvenne, Wouter; De Loof, Marie; Deron, Philippe; Viaene, Annick; Duprez, Fréderic; Vermeersch, Hubert

    2015-12-01

    Intractable aspiration is a serious, often life-threatening condition due to its potential impact on pulmonary function. Aspiration requires therapeutic measures, starting with conservative management but often necessitating surgical treatment. The basic surgical principle is to separate the alimentary and respiratory tracts through a variety of procedures which, unfortunately, nearly all result in the loss of phonation, with the exception of total laryngectomy (TL) which includes the placement of an indwelling voice prosthesis. In this study, we present a modified laryngotracheal separation (LTS) technique that, we believe, offers multiple advantages compared to standard TL. After reviewing the medical records of 35 patients with intractable aspiration who have undergone LTS, we describe the surgical technique and present the postoperative result. In a second surgical procedure about two months following LTS, we aimed to achieve voice restoration by placement of an indwelling voice prosthesis. Intractable aspiration was successfully treated in all patients. Placement of an indwelling voice prosthesis during a second operation was successful in 15 patients, representing the largest reported cohort thus far. LTS is a reliable surgical technique to treat intractable aspiration, with restoration of oral intake, thereby improving the general condition and quality of life of these unfortunate patients. Furthermore, voice restoration can be achieved in selected patients, by placement of a voice prosthesis.

  17. Signature of Microbial Dysbiosis in Periodontitis.

    Science.gov (United States)

    Meuric, Vincent; Le Gall-David, Sandrine; Boyer, Emile; Acuña-Amador, Luis; Martin, Bénédicte; Fong, Shao Bing; Barloy-Hubler, Frederique; Bonnaure-Mallet, Martine

    2017-07-15

    Periodontitis is driven by disproportionate host inflammatory immune responses induced by an imbalance in the composition of oral bacteria; this instigates microbial dysbiosis, along with failed resolution of the chronic destructive inflammation. The objectives of this study were to identify microbial signatures for health and chronic periodontitis at the genus level and to propose a model of dysbiosis, including the calculation of bacterial ratios. Published sequencing data obtained from several different studies (196 subgingival samples from patients with chronic periodontitis and 422 subgingival samples from healthy subjects) were pooled and subjected to a new microbiota analysis using the same Visualization and Analysis of Microbial Population Structures (VAMPS) pipeline, to identify microbiota specific to health and disease. Microbiota were visualized using CoNet and Cytoscape. Dysbiosis ratios, defined as the percentage of genera associated with disease relative to the percentage of genera associated with health, were calculated to distinguish disease from health. Correlations between the proposed dysbiosis ratio and the periodontal pocket depth were tested with a different set of data obtained from a recent study, to confirm the relevance of the ratio as a potential indicator of dysbiosis. Beta diversity showed significant clustering of periodontitis-associated microbiota, at the genus level, according to the clinical status and independent of the methods used. Specific genera ( Veillonella , Neisseria , Rothia , Corynebacterium , and Actinomyces ) were highly prevalent (>95%) in health, while other genera ( Eubacterium , Campylobacter , Treponema , and Tannerella ) were associated with chronic periodontitis. The calculation of dysbiosis ratios based on the relative abundance of the genera found in health versus periodontitis was tested. Nonperiodontitis samples were significantly identifiable by low ratios, compared to chronic periodontitis samples. When

  18. Diabetes mellitus and periodontal health: dentists' knowledge.

    Science.gov (United States)

    Al-Khabbaz, Areej K; Al-Shammari, Khalaf F

    2011-01-01

    There is a strong body of evidence to support the relationship between periodontal diseases and diabetes mellitus. Unless dental practitioners are aware of this link, they cannot apply the information to their daily practice. The aim of the study was, therefore, to evaluate the knowledge of dental practitioners concerning the effect of diabetes on periodontal health. This was a cross-sectional survey of randomly selected dental practitioners in Kuwait. Participants were asked about specific periodontal complications which they believed that patients diagnosed with diabetes were more susceptible to. A total of 220 dental practitioners (133 general dental practitioners and 87 dental specialists) participated in the study. Less than 60% of all study participants reported that tooth loss due to periodontal reasons and periodontal abscess were frequent among diabetic patients. Dental specialists, especially periodontists, were significantly more aware of periodontal complications associated with diabetes. Factors significantly associated with having knowledge about the effect of diabetes on periodontal health in logistic regression analysis were dentists who were older and those who were specialists. The results of this study indicate that knowledge about the effects of diabetes on periodontal health among this sample of dental practitioners is generally low, and dentists may underestimate the outcomes of periodontal diseases in diabetic patients. Copyright © 2011 S. Karger AG, Basel.

  19. Ubiquitination in Periodontal Disease: A Review.

    Science.gov (United States)

    Tsuchida, Sachio; Satoh, Mamoru; Takiwaki, Masaki; Nomura, Fumio

    2017-07-10

    Periodontal disease (periodontitis) is a chronic inflammatory condition initiated by microbial infection that leads to gingival tissue destruction and alveolar bone resorption. The periodontal tissue's response to dental plaque is characterized by the accumulation of polymorphonuclear leukocytes, macrophages, and lymphocytes, all of which release inflammatory mediators and cytokines to orchestrate the immunopathogenesis of periodontal disease. Ubiquitination is achieved by a mechanism that involves a number of factors, including an ubiquitin-activating enzyme, ubiquitin-conjugating enzyme, and ubiquitin-protein ligase. Ubiquitination is a post-translational modification restricted to eukaryotes that are involved in essential host processes. The ubiquitin system has been implicated in the immune response, development, and programmed cell death. Increasing numbers of recent reports have provided evidence that many approaches are delivering promising reports for discovering the relationship between ubiquitination and periodontal disease. The scope of this review was to investigate recent progress in the discovery of ubiquitinated protein in diseased periodontium and to discuss the ubiquitination process in periodontal diseases.

  20. [Effect of the compound of poly lactic-co-glycolic acid and bone marrow stromal cells modified by osteoprotegerin gene on the periodontal regeneration in Beagle dog periodontal defects].

    Science.gov (United States)

    Zhou, Wei; Zhao, Chun-Hui; Mei, Ling-Xuan

    2010-06-01

    To evaluate the effect of the osteoprotegerin (OPG) gene-modified autologous bone marrow stromal cells (BMSCs) on regeneration of periodontal defects, and to provide new experimental evidence to explore the gene therapy for periodontal disease. pSecTag2/B-opg was transduced into BMSCs by lipofectamine 2000. The expression of OPG protein in the BMSCs was detected by immunocytochemistry and Western blot. Inverted phase contrast microscope and scanning electron microscopy (SEM) were used to observe the morphology and proliferation of the BMSCs(OPG) on on the surface of the poly lactic-co-glycolic (PLGA). Horizontal alveolar bone defect (4 mmx4 mmx 3 mm) were surgically created in the buccal aspect of the mandibular premolar, and were randomly assigned to receive BMSCs(OPG)-PLGA (cells/material/OPG), BMSCs-PLGA (cells/material), PLGA (material), or root planning only (blank control). The animals were euthanized at 6 weeks post surgery for histological analysis. The height of new alveolar bone and cementum and the formation of new connective tissue were analyzed and compared. All data were statistically analyzed using the q test. The BMSCs transfected by human OPG gene can highly express OPG protein. SEM observations demonstrated that BMSCs(OPG) were able to proliferate and massively colonize on the scaffolds structure. After 6 weeks, the height of new alveolar bone and cementum and the formation of new connective tissue were significantly greater in the experimental group than in the control groups (P < 0.05). BMSCs(OPG)-PLGA can significantly promote the regeneration of dog's periodontal bone defects. Gene therapy utilizing OPG may offer the potential for periodontal tissue engineering applications.

  1. 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.

  2. Systemic antimicrobial therapy (minocycline as an adjunct to non-surgical approach to recurrent chronic generalized gingival hyperplasia

    Directory of Open Access Journals (Sweden)

    Parag M Khatri

    2014-01-01

    Full Text Available Systemic antibiotic treatment has emerged as a powerful adjunct to conventional mechanical debridement for therapeutic management of the periodontal diseases. The conceptual basis for treating periodontal diseases as infections is particularly attractive in part because of substantial data indicating that these diseases may be associated with specific putative pathogens. Further, discrete groups of patients respond well to systemic antibiotics and exhibit improvement of clinical parameters, including attachment level and inflammation. This bacterial-host interaction, which is ever-so-present in periodontitis, directs us toward utilizing antimicrobial agents along with the routine mechanical debridement. This case report presents a case of a female patient with recurrence of the chronic generalized periodontitis with gingival enlargement, which is treated thrice by referral dentist. A through clinical examination was carried out pre-operatively and treatment was planned with systemic minocycline in conjunction with the conventional non-surgical approach. There was a significant reduction of pocket depth, gain in attachment with dramatic improvement clinically.

  3. Systemic antimicrobial therapy (minocycline) as an adjunct to non-surgical approach to recurrent chronic generalized gingival hyperplasia.

    Science.gov (United States)

    Khatri, Parag M; Bacha, Shraddanand

    2014-03-01

    Systemic antibiotic treatment has emerged as a powerful adjunct to conventional mechanical debridement for therapeutic management of the periodontal diseases. The conceptual basis for treating periodontal diseases as infections is particularly attractive in part because of substantial data indicating that these diseases may be associated with specific putative pathogens. Further, discrete groups of patients respond well to systemic antibiotics and exhibit improvement of clinical parameters, including attachment level and inflammation. This bacterial-host interaction, which is ever-so-present in periodontitis, directs us toward utilizing antimicrobial agents along with the routine mechanical debridement. This case report presents a case of a female patient with recurrence of the chronic generalized periodontitis with gingival enlargement, which is treated thrice by referral dentist. A through clinical examination was carried out pre-operatively and treatment was planned with systemic minocycline in conjunction with the conventional non-surgical approach. There was a significant reduction of pocket depth, gain in attachment with dramatic improvement clinically.

  4. Periodontal disease and liver cirrhosis: A systematic review.

    Science.gov (United States)

    Grønkjær, Lea Ladegaard

    2015-01-01

    Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease and liver cirrhosis and to identify opportunities and directions for future research in this area. A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including 'liver cirrhosis', 'end-stage liver disease', 'liver diseases', 'oral health', 'periodontal disease', 'mouth disease', 'gingivitis', and 'periodontitis'. Thirteen studies published between 1981 and 2014 were found to include data on oral health and periodontal disease in cirrhotic patients. Studies indicated an increased incidence of periodontal disease in patients with liver cirrhosis, measured with several different periodontal indices. The reported prevalence of periodontal disease in cirrhosis patients ranged from 25.0% to 68.75% in four studies and apical periodontitis was found in 49%-79% of the patients. One study found that mortality was lower among patients who underwent dental treatment versus non-treated patients. Another study suggested an association between periodontal disease and the progression of liver cirrhosis, but data are sparse and conflicting as to whether periodontal disease is correlated to cirrhosis aetiology and severity. Despite the clinical reality of periodontal disease in liver cirrhosis patients, there are few published studies. Before clinical implications can be addressed, more data on the prevalence of and correlation between periodontal disease and liver cirrhosis aetiology, duration, and progression are needed.

  5. PERIODONTAL CONDITIONS IN EUROPE

    NARCIS (Netherlands)

    PILOT, T; MIYAZAKI, H

    The aim of the present overview is to evaluate the periodontal conditions in European populations. Study was made of a number of extensive surveys of periodontal diseases carried out in a number of European countries, primarily North West Europe. These surveys often provide considerable detail.

  6. Minimally invasive corticotomy in orthodontics using a three-dimensional printed CAD/CAM surgical guide.

    Science.gov (United States)

    Cassetta, M; Giansanti, M; Di Mambro, A; Calasso, S; Barbato, E

    2016-09-01

    The aim of this prospective study was to evaluate the effectiveness of an innovative, minimally invasive, flapless corticotomy procedure in orthodontics. The STROBE guidelines were followed. Ten patients with severe dental crowding and a class I molar relationship were selected to receive orthodontic treatment with clear aligners and corticotomy-facilitated orthodontics. The mean age of these patients was 21 years (range 17-28, standard deviation 6.08 years); the male to female ratio was 2:1. The main outcome was a reduction in the total treatment time to correct dental crowding. The secondary outcomes were periodontal index changes, the degree of root resorption, and patient perceptions of the method used, assessed using the short-form Oral Health Impact Profile (OHIP-14). The occurrence of early surgical complications or unexpected events was also recorded. All patients completed the treatment to correct dental crowding. The average treatment time was reduced by two-thirds. The procedure did not significantly modify the periodontal indices or oral health-related quality of life. No early surgical complications or unexpected events were observed. In short, the results indicate that this new procedure is safe and accelerates tooth movement without periodontal complications or discomfort. However, the efficacy of this procedure must be confirmed in controlled clinical trials. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Comparative evaluation of serum C-reactive protein levels in chronic and aggressive periodontitis patients and association with periodontal disease severity.

    Science.gov (United States)

    Goyal, Lata; Bey, Afshan; Gupta, N D; Sharma, Vivek Kumar

    2014-10-01

    C-reactive protein (CRP) is an acute-phase reactant and has been proved to be a significant predictor of future cardiovascular events. Recent studies have demonstrated a correlation between periodontitis and elevated CRP levels. However, most of the studies have focused on chronic periodontitis and very few studies are done in patients with aggressive periodontitis. The aim of this study was to determine and compare the relative levels of serum CRP in aggressive and chronic periodontitis patients. A total of 75 systemically healthy subjects were divided into three groups: Group I, nonperiodontitis subjects; group II, chronic generalized periodontitis patients and group III, generalized aggressive periodontitis patients. All participants were subjected to quantitative CRP analysis using enzyme-linked immunosorbent assay. Mean CRP levels were significantly greater in both group II and III as compared to group I and group III having greater level than group II. Furthermore, CRP levels positively correlated with the amount of periodontal destruction as measured by probing depth and clinical attachment loss. The present study indicates a positive correlation between CRP and periodontal disease severity with particular concern in younger individuals that could be a possible underlying pathway in the association between periodontal disease and the observed higher risk for cardiovascular disease in periodontitis patients.

  8. Expression Profile of IL-35 mRNA in Gingiva of Chronic Periodontitis and Aggressive Periodontitis Patients: A Semiquantitative RT-PCR Study

    Directory of Open Access Journals (Sweden)

    Nagaraj B. Kalburgi

    2013-01-01

    Full Text Available Background. Proinflammatory and anti-inflammatory cytokines play a key role in the pathogenesis of periodontal diseases. Secretion of bioactive IL-35 has been described by T regulatory cells ( and is required for their maximal suppressive activity. are involved in the modulation of local immune response in chronic periodontitis patients. Objective. Hence, the present study was aimed to investigate the expression of IL-35 mRNA in chronic periodontitis and aggressive periodontitis patients. Materials and Methods. The present study was carried out in 60 subjects, which included 20 chronic periodontitis patients, 20 aggressive periodontitis patients, and 20 periodontally healthy controls. IL-35 mRNA expression in gingival tissue samples of all subjects was semiquantitatively analyzed using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR. Results. The present study demonstrated the expression of IL-35 mRNA in gingival tissues of all the three groups. IL-35 mRNA expression was highest in chronic periodontitis subjects ( as compared to the aggressive periodontitis group ( and least seen in healthy patients (. Conclusion. The increased expression of IL-35 in chronic and aggressive periodontitis suggests its possible role in pathogenesis of periodontitis. Future studies done on large samples with intervention will strengthen our result.

  9. Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study

    Directory of Open Access Journals (Sweden)

    Gislene INOUE

    Full Text Available Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16–12.30, baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76–19.23, not living or working with another smoker (OR = 7.38, 95%CI 1.76–30.98 and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55–20.43. We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

  10. Evaluation of the effect of one stage versus two stage full mouth disinfection on C-reactive protein and leucocyte count in patients with chronic periodontitis.

    Science.gov (United States)

    Pabolu, Chandra Mohan; Mutthineni, Ramesh Babu; Chintala, Srikanth; Naheeda; Mutthineni, Navya

    2013-07-01

    Conventional non-surgical periodontal therapy is carried out in quadrant basis with 1-2 week interval. This time lag may result in re-infection of instrumented pocket and may impair healing. Therefore, a new approach to full-mouth non-surgical therapy to be completed within two consecutive days with full-mouth disinfection has been suggested. In periodontitis, leukocyte counts and levels of C-reactive protein (CRP) are likely to be slightly elevated, indicating the presence of infection or inflammation. The aim of this study is to compare the efficacy of one stage and two stage non-surgical therapy on clinical parameters along with CRP levels and total white blood cell (TWBC) count. A total of 20 patients were selected and were divided into two groups. Group 1 received one stage full mouth dis-infection and Group 2 received two stages FMD. Plaque index, sulcus bleeding index, probing depth, clinical attachment loss, serum CRP and TWBC count were evaluated for both the groups at baseline and at 1 month post-treatment. The results were analyzed using the Student t-test. Both treatment modalities lead to a significant improvement of the clinical and hematological parameters; however comparison between the two groups showed no significant difference after 1 month. The therapeutic intervention may have a systemic effect on blood count in periodontitis patients. Though one stage FMD had limited benefits over two stages FMD, the therapy can be accomplished in a shorter duration.

  11. Effects of nonsurgical periodontal therapy on C-reactive protein and serum lipids in Jordanian adults with advanced periodontitis.

    Science.gov (United States)

    Kamil, W; Al Habashneh, R; Khader, Y; Al Bayati, L; Taani, D

    2011-10-01

    Data on whether periodontal therapy affects serum CRP levels are inconclusive. The aim of this study was to determine if nonsurgical periodontal therapy has any effect on CRP and serum lipid levels in patients with advanced periodontitis. Thirty-six systemically healthy patients, ≥ 40 years of age and with advanced periodontitis, were recruited for the study. Patients were randomized consecutively to one of two groups: the treatment group (n = 18) or the control group (n = 18). Treated subjects received nonsurgical periodontal therapy, which included oral hygiene instructions and subgingival scaling and root planing. Systemic levels of inflammatory markers [C-reactive protein (CRP) and the lipid profile] were measured at baseline and 3 mo after periodontal therapy. Nonsurgical periodontal therapy in the treatment group resulted in a significant reduction in the serum CRP level. The average CRP level decreased from 2.3 mg/dL at baseline to 1.8 mg/dL (p periodontal therapy. The average reduction (95% confidence interval) in CRP was 0.498 (95% confidence interval = 0.265-0.731). In the treatment group, the reduction in CRP was significantly, linearly and directly correlated with the reduction in the plaque index, the gingival index and the percentage of sites with pocket depth ≥ 7 mm (Pearson correlation coefficient = 0.746, 0.425 and 0.621, respectively). Nonsurgical periodontal therapy had no effect on the lipid parameters. This study demonstrated that nonsurgical periodontal therapy results in a significant reduction in the serum CRP level. The effect of this outcome on systemic disease is still unknown. © 2011 John Wiley & Sons A/S.

  12. Interleukin-1β expression on periodontitis patients in Surabaya

    Directory of Open Access Journals (Sweden)

    Chiquita Prahasanti

    2010-12-01

    Full Text Available Background: Periodontal disease, commonly known as periodontitis is an infectious disease which has multifactorial etiologic factors. It may affect everybody in any ages with no gender nor sex predilection and usually can be detected under routine clinical examination. This disease is a manifestation of local factors, host factor and environmental factors, resulting in periodontal tissue damage which may cause tooth mobility and tooth loss. Interleukin-1 is a pro-inflammatory protein which functions primarily as inflammatory mediator in host innate immune responses. IL-1 is a regulator, affecting many biological activities including proliferation, development, homeostasis, regeneration, repair and inflammation which contribute to tissue damage and alveolar bone resorption. Purpose: This research was aimed to reveal the basic pathogenesis of periodontitis and could determine the future definitive treatment for patients with periodontitis. Methods: Data were obtained from 40 patients with aggressive periodontitis and 40 patients with chronic periodontitis. Samples were collected from periodontal tissue patients and protein expression of IL-1β was performed with immunohistochemistry. Results: Most female patient suffer aggressive periodontitis and chronic periodontitis. The datas were analyzed with t-test. The t values result was -8623, significance 0.001, with α = 5%, which indicated there was significant difference in IL-1β expression between aggressive and chronic periodontitis. The box plot diagram showed marked difference in distribution of protein expression of IL-1β between patients with aggressive periodontitis and chronic periodontitis. With a regression equation, it might be concluded that the protein expression of IL-1β might affect the incidence of aggressive periodontitis and chronic periodontitis. The OR value was calculated for 0.746 (sign.= 0.001, which indicate each increment of one unit protein expression of IL-1β will lead

  13. Protein Biomarkers of Periodontitis in Saliva

    Science.gov (United States)

    Taylor, John J.

    2014-01-01

    Periodontitis is a chronic inflammatory condition of the tissues that surround and support the teeth and is initiated by inappropriate and excessive immune responses to bacteria in subgingival dental plaque leading to loss of the integrity of the periodontium, compromised tooth function, and eventually tooth loss. Periodontitis is an economically important disease as it is time-consuming and expensive to treat. Periodontitis has a worldwide prevalence of 5–15% and the prevalence of severe disease in western populations has increased in recent decades. Furthermore, periodontitis is more common in smokers, in obesity, in people with diabetes, and in heart disease patients although the pathogenic processes underpinning these links are, as yet, poorly understood. Diagnosis and monitoring of periodontitis rely on traditional clinical examinations which are inadequate to predict patient susceptibility, disease activity, and response to treatment. Studies of the immunopathogenesis of periodontitis and analysis of mediators in saliva have allowed the identification of many potentially useful biomarkers. Convenient measurement of these biomarkers using chairside analytical devices could form the basis for diagnostic tests which will aid the clinician and the patient in periodontitis management; this review will summarise this field and will identify the experimental, technical, and clinical issues that remain to be addressed before such tests can be implemented. PMID:24944840

  14. Regeneração periodontal em cães Periodontal regeneration in dogs

    Directory of Open Access Journals (Sweden)

    Emily Correna Carlo Reis

    2011-12-01

    Full Text Available A doença periodontal pode ser definida como a condição inflamatória dos tecidos de suporte do dente em resposta ao acúmulo do biofilme. A consequencia é a formação de graves defeitos ósseos, devido à perda dos tecidos periodontais, levando, em última instância, à perda dos dentes, predisposição a fraturas de mandíbula e formação de comunicações oronasais. O principal tratamento é a prevenção, incluindo a escovação dentária diária e a profilaxia periodontal, procedimento realizado pelo médico veterinário para remoção do biofilme e cálculo dentário acumulados. A recuperação dos tecidos perdidos, ou seja, a regeneração periodontal, é um processo mais complexo, pois envolve a formação de três tecidos intimamente ligados: osso alveolar, ligamento periodontal e cemento. Assim, diversos materiais e técnicas foram e são constantemente desenvolvidos, incluindo membranas para regeneração tecidual guiada e a aplicação de enxertos e biomateriais, amplamente estudados na odontologia humana e já disponíveis para aplicação na rotina clínica veterinária. Adicionalmente, novas possibilidades surgem com a associação dessas técnicas a fatores de crescimento e células-tronco e o desenvolvimento das membranas multifuncionais.Periodontal disease can be defined as the inflammatory condition of the tooth-supportive tissues as a response to biofilm accumulation. The consequence is the formation of severe bone defects due to the loss of periodontal tissues that ultimately lead to tooth loss, predispose to mandible fractures and formation of oronasal communications. The main treatment is prevention, including daily tooth brushing and periodontal prophylaxis, a procedure done by veterinaries to remove retained biofilm and calculus. Recovering lost tissues, i.e. periodontal regeneration, is a more complex process involving the formation of three tissues highly connected: alveolar bone, periodontal ligament and

  15. Mesenchymal Stem Cells of Dental Origin for Inducing Tissue Regeneration in Periodontitis: A Mini-Review

    Directory of Open Access Journals (Sweden)

    Beatriz Hernández-Monjaraz

    2018-03-01

    Full Text Available Periodontitis is a chronic disease that begins with a period of inflammation of the supporting tissues of the teeth table and then progresses, destroying the tissues until loss of the teeth occurs. The restoration of the damaged dental support apparatus is an extremely complex process due to the regeneration of the cementum, the periodontal ligament, and the alveolar bone. Conventional treatment relies on synthetic materials that fill defects and replace lost dental tissue, but these approaches are not substitutes for a real regeneration of tissue. To address this, there are several approaches to tissue engineering for regenerative dentistry, among them, the use of stem cells. Mesenchymal stem cells (MSC can be obtained from various sources of adult tissues, such as bone marrow, adipose tissue, skin, and tissues of the orofacial area. MSC of dental origin, such as those found in the bone marrow, have immunosuppressive and immunotolerant properties, multipotency, high proliferation rates, and the capacity for tissue repair. However, they are poorly used as sources of tissue for therapeutic purposes. Their accessibility makes them an attractive source of mesenchymal stem cells, so this review describes the field of dental stem cell research and proposes a potential mechanism involved in periodontal tissue regeneration induced by dental MSC.

  16. Effect of Periodontal Therapy on Crevicular Fluid Interleukin-18 Level in Periodontal Health and Disease in Central Maharashtra (India) Population.

    Science.gov (United States)

    Mahajani, Monica J; Jadhao, Varsha A; Wankhade, Pooja S; Samson, Emmanuel; Acharya, Vishwas D; Tekale, Pawankumar D

    2017-11-01

    The incidence and progression of the periodontal disease depend on periodontal microflora and the multifaceted response of the host, and these interactions are mediated by cytokines and chemokines. Interleukin-18 (IL-18) is a proinflammatory cytokine of the IL-1 superfamily. The aim of the present study was the assessment of the periodontal therapy in IL-18 level in periodontal disease and health. Based on clinical attachment loss (CAL), probing pocket depth (PPD), gingival index (GI), and plaque index (PI) patients were divided into three groups: Group I with healthy patients, group II with chronic periodontitis, and group III with posttreatment patients having periodontitis. Mean PI, PPD, CAL, and gingival crevicular fluid (GCF) volume were significantly higher in groups II and III compared with group I. However, there were no significant differences between GI in groups I, II, and III. The total amount of IL-18 in GCF was significantly higher in group II when compared with groups I and III (p periodontally involved patients, and reduced at baseline, 3 and 6 weeks after nonsurgical periodontal therapy. The IL-18 might be hypothetically beneficial in distinguishing health from disease and monitoring periodontal disease activity.

  17. Scope of photodynamic therapy in periodontics.

    Science.gov (United States)

    Kumar, Vivek; Sinha, Jolly; Verma, Neelu; Nayan, Kamal; Saimbi, C S; Tripathi, Amitandra K

    2015-01-01

    Periodontal disease results from inflammation of the supporting structure of the teeth and in response to chronic infection caused by various periodontopathic bacteria. The mechanical removal of this biofilm and adjunctive use of antibacterial disinfectants and antibiotics have been the conventional methods of periodontal therapy. However, the removal of plaque and the reduction in the number of infectious organisms can be impaired in sites with difficult access. Photodynamic therapy (PDT) is a powerful laser-initiated photochemical reaction, involving the use of a photoactive dye (photosensitizer) activated by light of a specific wavelength in the presence of oxygen. Application of PDT in periodontics such as pocket debridement, gingivitis, and aggressive periodontitis continue to evolve into a mature clinical treatment modality and is considered as a promising novel approach for eradicating pathogenic bacteria in periodontitis.

  18. Phenotypes, serotypes and antibiotic susceptibility of Swedish Porphyromonas gingivalis isolates from periodontitis and periodontal abscesses.

    Science.gov (United States)

    Dahlén, G; Gmür, R; Yoshino, T

    2007-04-01

    This study was conducted to reveal phenotypic, serological subtypes and antibiotic susceptibility among fresh isolates of Porphyromonas gingivalis in a Swedish population with periodontitis and periodontal abscess. Fifty-five subgingival strains were isolated and tentatively designated as P. gingivalis from 55 consecutive paper-point samples taken from 51 patients with periodontitis (at least one site with >6-mm pocket depth) in Sweden and were sent in for microbiological evaluation. Eight P. gingivalis strains from periodontal abscesses were also included. Four P. gingivalis strains served as reference and another four type strains were included. The strains were characterized by colony morphology, biochemical tests, enzyme profile, gas-liquid chromatography and antibiotic susceptibility. The strains were further characterized for whole cell protein profiles using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and were identified to serotype by specific monoclonal antibodies. Among the 55 P. gingivalis strains 35 had smooth (S), 13 rough (R) and seven semi-rough colony morphologies. All strains were phenotypically homogeneous in biochemical tests, enzyme profile and antibiotic susceptibility. All strains produced phenylacetic acid and alpha-fucosidase. Almost all (96%) of the subgingival strains, but relatively fewer (62%) of the abscess strains, belonged to serotype A. Two subgingival and three abscess strains were classified as serotype B. No specific SDS-PAGE protein profiles were recorded for the two serotypes. The P. gingivalis strains from Swedish periodontitis cases showed homogeneity in terms of biochemical phenotypes and antibiotic susceptibility patterns. The strains fell into two serotypes, of which serotype A predominated in the periodontitis cases and serotype B was overrepresented in periodontal abscesses.

  19. Immediate placement and restoration of implants in the aesthetic zone with a trimodal approach: soft tissue alterations and its relation to gingival biotype.

    Science.gov (United States)

    Cabello, Gustavo; Rioboo, María; Fábrega, Javier G

    2013-10-01

    The aim of this prospective study was to evaluate the soft tissue changes around implants in the aesthetic zone, placed under a trimodal approach (immediate post-extraction placement, flapless, and immediate provisional restoration) and its relationship to gingival/periodontal biotype of the patient. The sample consisted of 14 patients from two private practices that were in need of a tooth extraction in the anterior maxillary region (cuspid to cuspid) and were candidates to a replacement with a dental implant. An initial measurement (baseline) of the position or the mesial and distal papillae and gingival zenith was made at this time, with a rigid dental-supported stent and an electronic precision caliper, able to the second tenth of a millimeter; after careful tooth extraction, the periodontal thickness, at a point 5 mm apical to de gingival buccal margin, with an analogical thickness gauge, able to one tenth of a millimeter. Once the implant was inserted an immediate provisional restoration was delivered. To evaluate the soft tissue changes measurements were repeated at 3, 6, and 12 months. A statistical analysis was performed to evaluate the changes in the gingival margin around the implant restorations and to identify a possible correlation to patient's periodontal thickness. All 14 patients received Straumann (®) implants (9 Tissue Level [TL] Regular Neck [RN], 2 TL Narrow Neck [NN], 2 Bone Level [BL] Narrow Crossfit [NC], and 1 BL Regular Crossfit [RC]). All implants integrated and none had any biological complications. Three provisional restorations presented screw loosening and retightened once and one loss retention and was recemented once. In one patient, with a severe bruxing habit, the final restoration suffered screw loosening and was retightened. Of the final restorations, 12 were screw-retained and 2 cemented on custom-made Zirconia abutments. A mean recession of the buccal margin of 0.45 mm was recorded at 12 months ( ± 0.25 mm). An acceptable

  20. Interleukin-6 and interleukin-10 gene polymorphisms and the risk of further periodontal disease progression.

    Science.gov (United States)

    Chatzopoulos, Georgios; Doufexi, Aikaterini-Ellisavet; Wolff, Larry; Kouvatsi, Anastasia

    2018-03-08

    Susceptible genotypes to periodontal disease are associated with disease onset and progression. The aim of this study was to examine the effect of gene polymorphisms on the risk of further disease progression and the need for further treatment among adults with chronic periodontal disease. Sixty-seven patients diagnosed with chronic periodontitis were grouped according to genotype status and risk of further progression of disease and tooth loss. All individuals were clinically evaluated for probing pocket depth, clinical attachment loss and bleeding on probing at baseline and 45 days after treatment. Blood samples were collected at baseline and genotyping of the polymorphisms in IL-6 (rs1800796) and IL-10 (rs1800872) genes were performed by PCR. Following DNA separation and genotyping, 65.7% of the patients were homozygous carriers of the IL-6 -572G and 49.3% were carriers of the IL-10 -592A allele. Individuals at risk of disease progression ranged from 7.5% to 62.7% based on the criteria used. Carriers of the IL-10 -592A allele were significantly associated with BOP ≥ 30% and therefore exhibited a higher risk of further periodontal breakdown (p = 0.018) with an odds ratio of 1.18. None of the other definitions of disease progression were significantly associated with the examined IL-6 and IL-10 genotypes (p > 0.05). IL-10 polymorphism was associated with an increased risk of further disease progression and the potential need for further treatment following non-surgical periodontal treatment. Susceptible IL-6 genotypes were not associated with the risk of persisting or recurrent disease activity.

  1. Quantitative assessment of periodontal bone defects

    International Nuclear Information System (INIS)

    Stelt, P.F. van der; Geraets, W.G.M.

    1987-01-01

    Radiographs are a well-accepted tool in diagnosing periodontal bone lesions and making an accurate evaluation of the treatment. However, the assessment of bone is hampered by the complicated and as it were unpredictable pattern of bone structure. Therefore, and to compensate for the bias always present in human observations, a computer aided procedure was developed to detect and describe periodontal bone lesions. This paper describes a comparison of the performance by human observers and of the computer program. Two series of artificial periodontal bone lesions served as material for the assessments. This study shows that the automated lesion detection program enables an assessment of periodontal bone lesions, which is at least comparable with the results of a group of experienced observers and probably better. It is considerably better than the results of observers individually, and decreases the time-dependent variability appearing in repeated assessments of a single observer. The computer aided detection of periodontal lesions can be considered as a useful and reliable tool in periodontal diagnosis. 9 ref.; 2 figs

  2. Diagnosis of Periodontal Diseases by Biomarkers

    Science.gov (United States)

    Kido, Jun-Ichi; Hino, Mami; Bando, Mika; Hiroshima, Yuka

    Many middle aged and old persons take periodontal diseases that mainly cause teeth loss and result in some systemic diseases. The prevention of periodontal diseases is very important for oral and systemic health, but the present diagnostic examination is not fully objective and suitable. To diagnose periodontal diseases exactly, some biomarkers shown inflammation, tissue degradation and bone resorption, in gingival crevicular fluid (GCF) and saliva are known. We demonstrated that GCF levels of calprotectin, inflammation-related protein, and carboxy-terminal propeptide of type I procollagen, bone metabolism-related protein, were associated with clinical condition of periodontal diseases, and suggested that these proteins may be useful biomarkers for periodontal diseases. Recently, determinations of genes and proteins by using microdevices are studied for diagnosis of some diseases. We detected calprotectin protein by chemiluminescent immunoassay on a microchip and showed the possibility of specific and quantitative detection of calprotectin in a very small amount of GCF. To determine plural markers in GCF by using microdevices contributes to develop accurate, objective diagnostic system of periodontal diseases.

  3. Effects of periodontal therapy on C-reactive protein and HDL in serum of subjects with periodontitis.

    Science.gov (United States)

    Leite, Anne Carolina Eleutério; Carneiro, Valéria Martins de Araújo; Guimarães, Maria do Carmo Machado

    2014-01-01

    To investigate the effects of nonsurgical periodontal therapy on levels of high-sensitivity C-reactive protein in the sera and its association with body mass index and high density lipoprotein in subjects with severe periodontitis. Sera from 28 subjects (mean age: 34.36±6.24; 32% men) with severe periodontitis and 27 healthy controls (mean age: 33.18±6.42; 33% men) were collected prior to periodontal therapy. Blood samples were obtained from 23 subjects who completed therapy (9-12 months). Oral and systemic parameters such as the number of blood cells, glucose examination, lipid profile, and high-sensitivity C-reactive protein levels accessed by high-sensitivity immunonephelometry assay, were included. Before therapy, in the periodontitis group, the ratio of subjects with high-sensitivity C-reactive protein C-reactive protein C-reactive protein C-reactive protein >0.3 mg/dL (28.91±6.03) (Pperiodontitis, periodontal therapy was associated with decreased levels of circulating high-sensitivity C-reactive protein and increase of high density lipoprotein in serum. The clinical trial was registered at http://www.clinicaltrials.gov.br/, No. RBR-24T799.

  4. Nutraceuticals in Periodontal Health: A Systematic Review on the Role of Vitamins in Periodontal Health Maintenance.

    Science.gov (United States)

    Varela-López, Alfonso; Navarro-Hortal, María D; Giampieri, Francesca; Bullón, Pedro; Battino, Maurizio; Quiles, José L

    2018-05-20

    Periodontal disease, a relevant public health problem worldwide, is generally considered a common pathology of elderly people. In this respect, there is agreement about that nutritional status may be a modifying factor in the progression and healing of the periodontal tissues. Vitamins have been recommended as nutraceuticals for prevention and treatment of some pathological conditions, such as cardiovascular diseases, obesity or cancer. Thus, a systematic approach to determining how the different vitamin type could ameliorate periodontal risks or improve periodontal health is necessary to further the understanding of the potential benefits and risks of vitamins supplementation use. For this, a systematic review of English-written literature in PubMed until February 2018, which included both human and animal research on the relationship of each vitamin with periodontal disease, was conducted. Among all the analyzed vitamins those with antioxidant capacity and effects on immune system seem to be useful for prevention or improvement of periodontal disease, as well as those implicated in bone metabolism. In the first case, there are quite information in favor of various vitamins, mainly vitamin C, that is the most studied. In the second case, vitamin D seems to have the most relevant role.

  5. Animal Models for Periodontal Disease

    Directory of Open Access Journals (Sweden)

    Helieh S. Oz

    2011-01-01

    Full Text Available Animal models and cell cultures have contributed new knowledge in biological sciences, including periodontology. Although cultured cells can be used to study physiological processes that occur during the pathogenesis of periodontitis, the complex host response fundamentally responsible for this disease cannot be reproduced in vitro. Among the animal kingdom, rodents, rabbits, pigs, dogs, and nonhuman primates have been used to model human periodontitis, each with advantages and disadvantages. Periodontitis commonly has been induced by placing a bacterial plaque retentive ligature in the gingival sulcus around the molar teeth. In addition, alveolar bone loss has been induced by inoculation or injection of human oral bacteria (e.g., Porphyromonas gingivalis in different animal models. While animal models have provided a wide range of important data, it is sometimes difficult to determine whether the findings are applicable to humans. In addition, variability in host responses to bacterial infection among individuals contributes significantly to the expression of periodontal diseases. A practical and highly reproducible model that truly mimics the natural pathogenesis of human periodontal disease has yet to be developed.

  6. Animal Models for Periodontal Disease

    Science.gov (United States)

    Oz, Helieh S.; Puleo, David A.

    2011-01-01

    Animal models and cell cultures have contributed new knowledge in biological sciences, including periodontology. Although cultured cells can be used to study physiological processes that occur during the pathogenesis of periodontitis, the complex host response fundamentally responsible for this disease cannot be reproduced in vitro. Among the animal kingdom, rodents, rabbits, pigs, dogs, and nonhuman primates have been used to model human periodontitis, each with advantages and disadvantages. Periodontitis commonly has been induced by placing a bacterial plaque retentive ligature in the gingival sulcus around the molar teeth. In addition, alveolar bone loss has been induced by inoculation or injection of human oral bacteria (e.g., Porphyromonas gingivalis) in different animal models. While animal models have provided a wide range of important data, it is sometimes difficult to determine whether the findings are applicable to humans. In addition, variability in host responses to bacterial infection among individuals contributes significantly to the expression of periodontal diseases. A practical and highly reproducible model that truly mimics the natural pathogenesis of human periodontal disease has yet to be developed. PMID:21331345

  7. 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.

  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. [Finite element analysis of the maxillary central incisor with crown lengthening surgery and post-core restoration in management of crown-root fracture].

    Science.gov (United States)

    Zhen, Min; Hu, Wen-jie; Rong, Qi-guo

    2015-12-18

    To construct the finite element models of maxillary central incisor and the simulations with crown lengthening surgery and post-core restoration in management of different crown-root fracture types, to investigate the stress intensity and distributions of these models mentioned above, and to analyze the indications of crown lengthening from the point of view of mechanics. An extracted maxillary central incisor and alveolar bone plaster model were scanned by Micro-CT and dental impression scanner (3shape D700) respectively. Then the 3D finite element models of the maxillary central incisor and 9 simulations with crown lengthening surgery and post-core restoration were constructed by Mimics 10.0, Geomagic studio 9.0 and ANSYS 14.0 software. The oblique static force (100 N) was applied to the palatal surface (the junctional area of the incisal 1/3 and middle 1/3), at 45 degrees to the longitudinal axis, then the von Mises stress of dentin, periodontal ligament, alveolar bone, post and core, as well as the periodontal ligament area, were calculated. A total of 10 high-precision three-dimensional finite element models of maxillary central incisor were established. The von Mises stress of models: post>dentin>alveolar bone>core>periodontal ligament, and the von Mises stress increased linearly with the augmentation of fracture degree (besides the core). The periodontal ligament area of the crown lengthening was reduced by 12% to 33%. The von Mises stress of periodontal ligament of the B2L2c, B2L3c, B3L1c, B3L2c, B3L3c models exceeded their threshold limit value, respectively. The maxillary central incisors with the labial fracture greater than three-quarter crown length and the palatal fracture deeper than 1 mm below the alveolar crest are not the ideal indications of the crown lengthening surgery.

  10. 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

  11. Periodontitis and increase in circulating oxidative stress

    OpenAIRE

    Takaaki Tomofuji; Koichiro Irie; Toshihiro Sanbe; Tetsuji Azuma; Daisuke Ekuni; Naofumi Tamaki; Tatsuo Yamamoto; Manabu Morita

    2009-01-01

    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. Fo...

  12. Parameters affecting tooth loss during periodontal maintenance in a Greek population.

    Science.gov (United States)

    Tsami, Alexandra; Pepelassi, Eudoxie; Kodovazenitis, George; Komboli, Mado

    2009-09-01

    Investigators have evaluated predictive parameters of tooth loss during the maintenance phase (MP). The authors conducted a retrospective study to evaluate the rate of tooth loss and to explore the parameters that affect tooth loss during MP in a Greek population. A periodontist administered periodontal treatment and maintenance care to 280 participants with severe periodontitis for a mean period +/- standard deviation of 10.84 +/- 2.13 years. The periodontist recorded the following parameters for each participant: oral hygiene index level, simplified gingival index level, clinical attachment level, probing depth measurements, initial tooth prognosis, smoking status, tooth loss during active periodontal treatment and MP, and compliance with suggested maintenance visits. The authors found that total tooth loss during active treatment (n = 1,427) was greater than during MP (n = 918) and was associated with the initial tooth prognosis, tooth type group, participants' compliance with suggested maintenance visits, smoking status and acceptability of the quality of tooth restorations. Most of the teeth extracted during maintenance had an initial guarded prognosis (n = 612). Participants whose compliance was erratic had a greater risk of undergoing tooth extraction than did participants whose compliance was complete. Participants' initial tooth prognosis, tooth type, compliance with suggested maintenance visits and smoking status affected tooth loss during MP. Initial guarded prognosis and erratic compliance increased the risk of undergoing tooth extraction during maintenance. Determining predictive parameters for disease progression and tooth loss provides critical information to clinicians so that they can develop and implement rational treatment planning.

  13. Levels of Candidate Periodontal Pathogens in Subgingival Biofilm

    OpenAIRE

    Oliveira, R.R.D.S.; Fermiano, D.; Feres, M.; Figueiredo, L.C.; Teles, F.R.F.; Soares, G.M.S.; Faveri, M.

    2016-01-01

    In recent years, several new periodontal taxa have been associated with the etiology of periodontitis. A recent systematic review provides further support for the pathogenic role of 17 species/phylotypes. Thus, the aim of this study was to assess the prevalence and levels of these species in subjects with generalized chronic periodontitis (GChP; n = 30), generalized aggressive periodontitis (GAgP; n = 30), and periodontal health (PH; n = 30). All subjects underwent clinical and microbiologica...

  14. Influence of low-intensity pulsed ultrasound on osteogenic tissue regeneration in a periodontal injury model: X-ray image alterations assessed by micro-computed tomography.

    Science.gov (United States)

    Wang, Yunji; Chai, Zhaowu; Zhang, Yuanyuan; Deng, Feng; Wang, Zhibiao; Song, Jinlin

    2014-08-01

    This study was conducted to evaluate, with micro-computed tomography, the influence of low-intensity pulsed ultrasound on wound-healing in periodontal tissues. Periodontal disease with Class II furcation involvement was surgically produced at the bilateral mandibular premolars in 8 adult male beagle dogs. Twenty-four teeth were randomly assigned among 4 groups (G): G1, periodontal flap surgery; G2, periodontal flap surgery+low-intensity pulsed ultrasound (LIPUS); G3, guided tissue regeneration (GTR) surgery; G4, GTR surgery plus LIPUS. The affected area in the experimental group was exposed to LIPUS. At 6 and 8weeks, the X-ray images of regenerated teeth were referred to micro-CT scanning for 3-D measurement. Bone volume (BV), bone surface (BS), and number of trabeculae (Tb) in G2 and G4 were higher than in G1 and G3 (pperiodontal flap surgery group. LIPUS irradiation increased the number, volume, and area of new alveolar bone trabeculae. LIPUS has the potential to promote the repair of periodontal tissue, and may work effectively if combined with GTR. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Comparisons of Subgingival Microbial Profiles of Refractory Periodontitis, Severe Periodontitis and Periodontal Health using the Human Oral Microbe Identification Microarray (HOMIM)

    Science.gov (United States)

    Colombo, Ana Paula V.; Boches, Susan K.; Cotton, Sean L.; Goodson, J. Max; Kent, Ralph; Haffajee, Anne D.; Socransky, Sigmund S.; Hasturk, Hatice; Van Dyke, Thomas E.; Paster, Bruce J.

    2013-01-01

    Aim This study compared the subgingival microbiota of subjects with refractory periodontitis (RP) to those in subjects with treatable periodontitis (GR) or periodontal health (PH) using the Human Oral Microbe Identification Microarray (HOMIM). Methods At baseline, subgingival plaque samples were taken from 47 periodontitis and 20 PH individuals, and analyzed for the presence of 300 species by HOMIM. The periodontitis subjects were classified as RP (n=17) based on mean attachment loss (AL) and/or >3 sites with AL ≥2.5 mm after SRP, surgery and systemically administered amoxicillin and metronidazole or as GR (n=30) based on mean attachment gain and no sites with AL ≥2.5 mm after treatment. Significant differences in taxa among groups were sought using the Kruskal Wallis and Chi-square tests. Results More species were detected in diseased patients (GR or RP) than those without disease (PH). RP subjects were distinguished from GR and PH by a significantly high frequency of putative periodontal pathogens such as, Parvimonas micra, Campylobacter gracilis, Eubacterium nodatum, Selenomonas noxia, Tannerella forsythia, Porphyromonas gingivalis, Prevotella spp., Treponema spp., Eikenella corrodens, as well as “unusual” species (Pseudoramibacter alactolyticus, TM7 spp. oral taxon (OT) 346/356, Bacteroidetes spp. OT 272/274, Solobacterium moorei, Desulfobulbus sp. OT 041, Brevundimonas diminuta, Sphaerocytophaga sp. OT 337, Shuttleworthia satelles, Filifactor alocis, Dialister invisus/pneumosintes, Granulicatella adiacens, Mogibacterium tidmidum, Veillonella atypica, Mycoplasma salivarium, Synergistes sp. cluster II, Acidaminococcaceae [G-1] sp. OT 132/150/155/148/135) [pspp. cluster I, Capnocytophaga sputigena, Cardiobacterium hominis, Haemophilus parainfluenzae, Lautropia mirabilis, Propionibacterium propionicum, Rothia dentocariosa/mucilagenosa, Streptococcus sanguinis (p<0.05). Conclusion RP patients present a distinct microbial profile compared to patients in the

  16. Periodontal treatment outcomes during pregnancy and postpartum.

    Science.gov (United States)

    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.

  17. [Finite element analysis of the maxillary central incisor with traditional and modified crown lengthening surgery and post-core restoration in management of crown-root fracture].

    Science.gov (United States)

    Zhen, M; Wei, Y P; Hu, W J; Rong, Q G; Zhang, H

    2016-06-01

    To construct three-dimensional finite element models with modified crown lengthening surgery and post-core restoration in management of various crown-root fracture types, to investigate the intensity and distribution of stressin models mentioned above, and to compare and analyze the indications of traditional and modified crown lengthening surgeries from the mechanic point of view. Nine three-dimensional finite element models with modified crown lengthening surgery and post-core restoration were established and analyzed by micro-CT scanning technique, dental impression scanner, Mimics 10.0, Geomagic studio 9.0 and ANSYS 14.0 software. The von Mises stress of dentin, periodontal ligament, alveolar bone, post and core, as well as the periodontal ligament area and threshold limit value were calculated and compared with the findings of traditional crown lengthening models which had been published earlierby our research group. The von Mises stress intensity of modified crown lengthening models were: dentin>post>core>alveolar bone>periodontal ligament. The maximum von Mises stress of dentin(44.37-80.58 MPa)distributed in lingual central shoulder. The periodontal ligament area of the modified crown lengthening surgery was reduced by 6% to 28%, under the same crown-root fracture conditions, the periodontal ligament area of modified crown lengthening models was larger than that of the traditional crown lengthening models. In modified crown lengthening surgery models, the von Mises stress of periodontal ligament of B3L1m, B3L2m, B3L3m models exceeded their limit values, however, the von Mises stress of periodontal ligament of the B2L2c, B2L3c, B3L1c, B3L2c, B3L3c models exceeded their limit values in traditional crown lengthening surgery models. The modified crown lengthening surgery conserves more periodontal supporting tissues, which facilitates the long-term survival of teeth. The indication of modified crown lengthening surgery is wider than traditional method. The

  18. Antibiotic Resistance in Human Chronic Periodontitis Microbiota

    NARCIS (Netherlands)

    Rams, Thomas E.; Degener, John E.; van Winkelhoff, Arie J.

    Background: Patients with chronic periodontitis (CP) may yield multiple species of putative periodontal bacterial pathogens that vary in their antibiotic drug susceptibility. This study determines the occurrence of in vitro antibiotic resistance among selected subgingival periodontal pathogens in

  19. Scope of photodynamic therapy in periodontics

    Directory of Open Access Journals (Sweden)

    Vivek Kumar

    2015-01-01

    Full Text Available Periodontal disease results from inflammation of the supporting structure of the teeth and in response to chronic infection caused by various periodontopathic bacteria. The mechanical removal of this biofilm and adjunctive use of antibacterial disinfectants and antibiotics have been the conventional methods of periodontal therapy. However, the removal of plaque and the reduction in the number of infectious organisms can be impaired in sites with difficult access. Photodynamic therapy (PDT is a powerful laser-initiated photochemical reaction, involving the use of a photoactive dye (photosensitizer activated by light of a specific wavelength in the presence of oxygen. Application of PDT in periodontics such as pocket debridement, gingivitis, and aggressive periodontitis continue to evolve into a mature clinical treatment modality and is considered as a promising novel approach for eradicating pathogenic bacteria in periodontitis.

  20. Periodontal Disease and Systemic Health

    Science.gov (United States)

    ... Club Program Perio Store Education & Careers Careers in Periodontics Perio Exam for Dental Licensure Recommended Competencies Periodontal ... may also help with the management of other chronic inflammatory conditions. Diabetes heart Disease Other Diseases Members ...

  1. Gene therapy and its implications in Periodontics

    Science.gov (United States)

    Mahale, Swapna; Dani, Nitin; Ansari, Shumaila S.; Kale, Triveni

    2009-01-01

    Gene therapy is a field of Biomedicine. With the advent of gene therapy in dentistry, significant progress has been made in the control of periodontal diseases and reconstruction of dento-alveolar apparatus. Implementation in periodontics include: -As a mode of tissue engineering with three approaches: cell, protein-based and gene delivery approach. -Genetic approach to Biofilm Antibiotic Resistance. Future strategies of gene therapy in preventing periodontal diseases: -Enhances host defense mechanism against infection by transfecting host cells with an antimicrobial peptide protein-encoding gene. -Periodontal vaccination. Gene therapy is one of the recent entrants and its applications in the field of periodontics are reviewed in general here. PMID:20376232

  2. Knowledge of risk factors and the periodontal disease-systemic link in dental students' clinical decisions.

    Science.gov (United States)

    Friesen, Lynn Roosa; Walker, Mary P; Kisling, Rebecca E; Liu, Ying; Williams, Karen B

    2014-09-01

    This study evaluated second-, third-, and fourth-year dental students' ability to identify systemic conditions associated with periodontal disease, risk factors most important for referral, and medications with an effect on the periodontium and their ability to apply this knowledge to make clinical decisions regarding treatment and referral of periodontal patients. A twenty-one question survey was administered at one U.S. dental school in the spring semester of 2012 to elicit the students' knowledge and confidence regarding clinical reasoning. The response rate was 86 percent. Periodontal risk factors were accurately selected by at least 50 percent of students in all three classes; these were poorly controlled diabetes, ≥6 mm pockets posteriorly, and lack of response to previous non-surgical therapy. Confidence in knowledge, knowledge of risk factors, and knowledge of medications with an effect on the periodontium improved with training and were predictive of better referral decision making. The greatest impact of training was seen on the students' ability to make correct decisions about referral and treatment for seven clinical scenarios. Although the study found a large increase in the students' abilities from the second through fourth years, the mean of 4.6 (out of 7) for the fourth-year students shows that, on average, those students missed correct treatment or referral on more than two of seven clinical cases. These results suggest that dental curricula should emphasize more critical decision making with respect to referral and treatment criteria in managing the periodontal patient.

  3. Identification of subgingival periodontal pathogens and association with the severity of periodontitis in patients with chronic kidney diseases: a cross-sectional study.

    Science.gov (United States)

    Ismail, Fidan Bahtiar; Ismail, Gener; Dumitriu, Anca Silvia; Baston, Catalin; Berbecar, Vlad; Jurubita, Roxana; Andronesi, Andreea; Dumitriu, Horia Traian; Sinescu, Ioanel

    2015-01-01

    The aim of our study was to assess the subgingival profile of 9 periodontal pathogens, by means of real-time PCR, in a group of predialysis chronic kidney disease patients with and without periodontal disease and to identify the risk factors associated with periodontal disease in these patients. This is a single centre cross-sectional cohort study performed on 70 CKD patients. Patients received a full-mouth periodontal examination and the following parameters were assessed: periodontal pocket depth (PPD), clinical attachment level, bleeding on probing, and plaque index; subgingival biofilm samples were collected from the deepest periodontal pocket of each quadrant and were pooled in one transporting unit. Clinical data were drawn from the medical file of the patients. T. denticola (P = 0.001), T. forsythia (P < 0.001), and P. micros (P = 0.003) are significantly associated with periodontal disease in CKD subjects but in a multivariate model only age and T. forsythia remain independent risk factors for periodontal disease in patients with CKD. In our cohort, age and T. forsythia are independently associated with periodontitis in CKD patients. Within the limits of this study, CKD was not significantly associated with a particular subgingival periodontal pathogens profile in periodontitis patients.

  4. Identification of Subgingival Periodontal Pathogens and Association with the Severity of Periodontitis in Patients with Chronic Kidney Diseases: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Fidan Bahtiar Ismail

    2015-01-01

    Full Text Available Background. The aim of our study was to assess the subgingival profile of 9 periodontal pathogens, by means of real-time PCR, in a group of predialysis chronic kidney disease patients with and without periodontal disease and to identify the risk factors associated with periodontal disease in these patients. Material and Methods. This is a single centre cross-sectional cohort study performed on 70 CKD patients. Patients received a full-mouth periodontal examination and the following parameters were assessed: periodontal pocket depth (PPD, clinical attachment level, bleeding on probing, and plaque index; subgingival biofilm samples were collected from the deepest periodontal pocket of each quadrant and were pooled in one transporting unit. Clinical data were drawn from the medical file of the patients. Results. T. denticola (P=0.001, T. forsythia (P<0.001, and P. micros (P=0.003 are significantly associated with periodontal disease in CKD subjects but in a multivariate model only age and T. forsythia remain independent risk factors for periodontal disease in patients with CKD. Conclusions. In our cohort, age and T. forsythia are independently associated with periodontitis in CKD patients. Within the limits of this study, CKD was not significantly associated with a particular subgingival periodontal pathogens profile in periodontitis patients.

  5. Periodontal disease and liver cirrhosis: A systematic review

    Science.gov (United States)

    2015-01-01

    Objectives: Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease and liver cirrhosis and to identify opportunities and directions for future research in this area. Methods: A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including ‘liver cirrhosis’, ‘end-stage liver disease’, ‘liver diseases’, ‘oral health’, ‘periodontal disease’, ‘mouth disease’, ‘gingivitis’, and ‘periodontitis’. Results: Thirteen studies published between 1981 and 2014 were found to include data on oral health and periodontal disease in cirrhotic patients. Studies indicated an increased incidence of periodontal disease in patients with liver cirrhosis, measured with several different periodontal indices. The reported prevalence of periodontal disease in cirrhosis patients ranged from 25.0% to 68.75% in four studies and apical periodontitis was found in 49%–79% of the patients. One study found that mortality was lower among patients who underwent dental treatment versus non-treated patients. Another study suggested an association between periodontal disease and the progression of liver cirrhosis, but data are sparse and conflicting as to whether periodontal disease is correlated to cirrhosis aetiology and severity. Conclusion: Despite the clinical reality of periodontal disease in liver cirrhosis patients, there are few published studies. Before clinical implications can be addressed, more data on the prevalence of and correlation between periodontal disease and liver cirrhosis aetiology, duration, and progression are needed. PMID:26770799

  6. 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...

  7. The Effect of Nonsurgical Periodontal Therapy on HNP1-3 Level in Gingival Crevicular Fluid of Chronic Periodontitis Patients.

    Science.gov (United States)

    Dolińska, Ewa; Skurska, Anna; Pietruska, Małgorzata; Dymicka-Piekarska, Violetta; Milewski, Robert; Pietruski, Jan; Sculean, Anton

    2017-08-01

    The rich bacterial flora of oral cavity is controlled by innate immune response, including antibacterial peptides and among them human neutrophil peptides 1-3 (HNP1-3). The knowledge of the involvement of HNPs in innate and acquired immunity of the periodontium is fragmentary. The aim of the study was to assess alterations in HNP1-3 levels in the gingival crevicular fluid (GCF) of chronic periodontitis patients before and after nonsurgical periodontal therapy. Nineteen patients with chronic periodontitis were qualified to the study. After periodontal examination, one site with pocket depth (PD) ≥4 mm was selected. All the patients received periodontal treatment involving scaling and root planing with additional systemic antibiotic therapy (Amoxicillin 375 mg three times daily and Metronidazole 250 mg three times daily for 7 days). Prior to therapy, 3 and 6 months after it, clinical periodontal parameters were measured and GCF was collected from previously chosen site. The level of HNP1-3 in GCF was determined by means of a commercially available enzyme-linked immunoassay kit. The periodontal therapy caused a statistically significant (p periodontal therapy with additional systemic administration of Amoxicillin and Metronidazole increases the level of HNP1-3 in GCF.

  8. Evaluation of cross-protection by immunization with an experimental trivalent companion animal periodontitis vaccine in the mouse periodontitis model.

    Science.gov (United States)

    Hardham, John; Sfintescu, Cornelia; Evans, Richard T

    2008-03-01

    Companion animal periodontal disease is one of the most prevalent diseases seen by veterinarians. The goal of this study was to evaluate the vaccine performance of a trivalent canine periodontitis vaccine in the mouse oral challenge model of periodontitis. Mice vaccinated subcutaneously with an inactivated, whole-cell vaccine preparation of Porphyromonas denticanis, Porphyromonas gulae, and Porphyromonas salivosa displayed significantly reduced alveolar bone loss in response to heterologous and cross-species challenges as compared to sham vaccinated animals. Based on the results of these studies, a periodontitis vaccine may be a useful tool in preventing the initiation and progression of periodontitis caused by the most commonly isolated pigmenting anaerobic bacteria in animals.

  9. Comparisons of subgingival microbial profiles of refractory periodontitis, severe periodontitis, and periodontal health using the human oral microbe identification microarray.

    Science.gov (United States)

    Colombo, Ana Paula V; Boches, Susan K; Cotton, Sean L; Goodson, J Max; Kent, Ralph; Haffajee, Anne D; Socransky, Sigmund S; Hasturk, Hatice; Van Dyke, Thomas E; Dewhirst, Floyd; Paster, Bruce J

    2009-09-01

    This study compared the subgingival microbiota of subjects with refractory periodontitis (RP) to those in subjects with treatable periodontitis (GRs = good responders) or periodontal health (PH) using the Human Oral Microbe Identification Microarray (HOMIM). At baseline, subgingival plaque samples were taken from 47 subjects with periodontitis and 20 individuals with PH and analyzed for the presence of 300 species by HOMIM. The subjects with periodontitis were classified as having RP (n = 17) based on mean attachment loss (AL) and/or more than three sites with AL >or=2.5 mm after scaling and root planing, surgery, and systemically administered amoxicillin and metronidazole or as GRs (n = 30) based on mean attachment gain and no sites with AL >or=2.5 mm after treatment. Significant differences in taxa among the groups were sought using the Kruskal-Wallis and chi(2) tests. More species were detected in patients with disease (GR or RP) than in those without disease (PH). Subjects with RP were distinguished from GRs or those with PH by a significantly higher frequency of putative periodontal pathogens, such as Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Campylobacter gracilis, Eubacterium nodatum, Selenomonas noxia, Tannerella forsythia (previously T. forsythensis), Porphyromonas gingivalis, Prevotella spp., Treponema spp., and Eikenella corrodens, as well as unusual species (Pseudoramibacter alactolyticus, TM7 spp. oral taxon [OT] 346/356, Bacteroidetes sp. OT 272/274, Solobacterium moorei, Desulfobulbus sp. OT 041, Brevundimonas diminuta, Sphaerocytophaga sp. OT 337, Shuttleworthia satelles, Filifactor alocis, Dialister invisus/pneumosintes, Granulicatella adiacens, Mogibacterium timidum, Veillonella atypica, Mycoplasma salivarium, Synergistes sp. cluster II, and Acidaminococcaceae [G-1] sp. OT 132/150/155/148/135) (P spp. cluster I, Capnocytophaga sputigena, Cardiobacterium hominis, Haemophilus parainfluenzae, Lautropia mirabilis

  10. 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.

  11. 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.)

  12. Evaluation of nonsurgical periodontal therapy in chronic periodontitis patients with anemia by estimating hematological parameters and high-sensitivity C-reactive protein levels.

    Science.gov (United States)

    Musalaiah, S V V S; Anupama, M; Nagasree, M; Krishna, Ch Murali; Kumar, Aravind; Kumar, P Mohan

    2014-07-01

    Periodontal tissues mount an immune inflammatory response to bacteria and their products. Certain inflammatory cytokines produced during periodontal inflammation increase the production of acute phase proteins like high‑sensitivity C‑reactive protein (hs‑CRP) and can depress erythropoietin production leading to the development of anemia. The aim of this study is to investigate the efficacy of nonsurgical periodontal therapy on red blood cell (RBC) parameters and hs-CRP in chronic periodontitis patients with anemia. This is a longitudinal, interventional study with 6-month follow-up. A total of 30 subjects with anemia and chronic periodontitis with age group of 33-55 years were selected by screening hemoglobin (Hb) levels and examining periodontal findings. The clinical parameters plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline. Laboratory blood investigations were performed to evaluate RBC count, Hb, packed cell volume (PCV), erythrocyte sedimentation rate (ESR) and red cell indices, hs-CRP at baseline. Nonsurgical periodontal therapy was performed for all patients. Patients were recalled after 6 months. The clinical and hematological parameters were re-evaluated to analyze the changes after nonsurgical periodontal therapy. The results showed that there was a significant increase in Hb levels, RBC count and PCV from baseline to 6 months after nonsurgical periodontal therapy. There is significant decrease in levels of ESR and hs-CRP levels after nonsurgical periodontal therapy indicating resolution of periodontal inflammation. There is a significant decrease in PPD, scores of PI and GI and significant increase in CAL gain. Minimal changes in mean corpuscular volume, mean corpuscular hemoglobin (MCH) and MCH concentration indicated that the lower values of red cell parameters are not due to any vitamin and mineral deficiencies, but secondary to the chronic inflammatory changes

  13. 16S rRNA based microarray analysis of ten periodontal bacteria in patients with different forms of periodontitis.

    Science.gov (United States)

    Topcuoglu, Nursen; Kulekci, Guven

    2015-10-01

    DNA microarray analysis is a computer based technology, that a reverse capture, which targets 10 periodontal bacteria (ParoCheck) is available for rapid semi-quantitative determination. The aim of this three-year retrospective study was to display the microarray analysis results for the subgingival biofilm samples taken from patient cases diagnosed with different forms of periodontitis. A total of 84 patients with generalized aggressive periodontitis (GAP,n:29), generalized chronic periodontitis (GCP, n:25), peri-implantitis (PI,n:14), localized aggressive periodontitis (LAP,n:8) and refractory chronic periodontitis (RP,n:8) were consecutively selected from the archives of the Oral Microbiological Diagnostic Laboratory. The subgingival biofilm samples were analyzed by the microarray-based identification of 10 selected species. All the tested species were detected in the samples. The red complex bacteria were the most prevalent with very high levels in all groups. Fusobacterium nucleatum was detected in all samples at high levels. The green and blue complex bacteria were less prevalent compared with red and orange complex, except Aggregatibacter actinomycetemcomitas was detected in all LAP group. Positive correlations were found within all the red complex bacteria and between red and orange complex bacteria especially in GCP and GAP groups. Parocheck enables to monitoring of periodontal pathogens in all forms of periodontal disease and can be alternative to other guiding and reliable microbiologic tests. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. The relationship between depression and periodontal diseases.

    Science.gov (United States)

    Hwang, S H; Park, S G

    2018-03-01

    A cross-sectional study was conducted to investigate whether depression is associated with periodontal diseases in a representative sample of South Korean adults Methods: We used data from the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), conducted in 2014. We included in this study 4328 participants aged over 20 years (1768 males and 2560 females). Depression was assessed with the Patient Health Questionnaire (PHQ-9) and history of physician-diagnosed depression. Periodontal diseases were assessed a gingival bleeding, calculus and periodontal pockets. The data were analyzed using the chi-square test and multiple logistic regression. People with any periodontal diseases tended to be old, male, married, low income, poor education, blue-collar occupation, diabetes mellitus, hypertension, overweight, smoking, not using dental floss or interdental brush in univariate analysis. Neither self-reported nor diagnosed depression was associated with the presence of any or severe periodontal disease in the total sample. In participants aged 20-29 years only, the presence of any periodontal disease was associated with self-reported depression (OR, 2.031; 95% CI, 1.011-4.078). In the same age group, the presence of severe periodontal disease was associated with both self-reported depression (OR, 6.532; 95% CI, 2.190-19.483) and diagnosed depression (OR, 7.729; 95% CI, 1.966-30.389). Self-reported depression was significantly associated with the presence of any or severe periodontal disease, and diagnosed depression was significantly associated with severe periodontal diseases only in participants aged 20-29 years. Copyright© 2018 Dennis Barber Ltd.

  15. Staphylococcus spp. in the oral cavity and periodontal pockets of chronic periodontitis patients Staphylococcus spp. na cavidade bucal e na bolsa periodontal de indivíduos com periodontite crônica

    Directory of Open Access Journals (Sweden)

    Jussara Cia S. Loberto

    2004-06-01

    Full Text Available Staphylococcus spp are not usually isolated from the oral cavity, and when this occurs, they are considered to belong to the transitory microbiota. Individuals with periodontal disease represent possible reservoirs of these opportunistic bacteria in the oral cavity. The use of antibiotics for treatment of periodontal disease or other infections may predispose to the increase of the number of Staphylococcus spp. in the oral cavity. These microorganisms easily become resistant to antibiotics, and may result in superinfection. The purpose of this study was to evaluate the presence of Staphylococcus spp. in the oral cavity and in periodontal pockets of patients with chronic periodontitis, identify the isolates and verify the relationship between the presence of Staphylococcus spp. in the oral cavity and presence of periodontal pockets. The study included eighty-eight patients, 25-60 years of age, with chronic periodontitis, and at least two sites with probing depth > 5 mm. Individual data examination was assessed. Then, samples were colleted from the periodontal pocket with the aid of paper tips and from the oral cavity through mouth rinses. Out of the total of patients, 37.50% presented Staphylococcus spp. in the periodontal pocket and 61.36% in the oral cavity, 27.27% presented the bacteria in both sites. S. epidermidis was the most prevalent specie in the periodontal pocket (15.9% and oral cavity (27.27%. The occurrence of higher proportions of nonresident's microorganisms in subgingival samples and oral sites may represent significant problem in causing and maintaining periodontal infections.Staphylococcus spp. não são usualmente isolados a partir da cavidade bucal. Quando presentes, são considerados pertencentes à microbiota transitória. Indivíduos que apresentam doença periodontal representam possíveis reservatórios dessas bactérias oportunistas na cavidade bucal. O uso de antibióticos para o tratamento da doença periodontal ou

  16. Management of Chronic Periodontitis Using Chlorhexidine Chip and Diode Laser-A Clinical Study.

    Science.gov (United States)

    Jose, Kachapilly Arun; Ambooken, Majo; Mathew, Jayan Jacob; Issac, Annie Valayil; Kunju, Ajithkumar Parachalil; Parameshwaran, Renjith Athirkandathil

    2016-04-01

    The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Department of Periodontics. Randomized clinical trial with split mouth design. Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using paired T test, one-way ANOVA, Tukey's HSD test and repeated measure ANOVA. Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination

  17. Management of Chronic Periodontitis Using Chlorhexidine Chip and Diode Laser-A Clinical Study

    Science.gov (United States)

    Ambooken, Majo; Mathew, Jayan Jacob; Issac, Annie Valayil; Kunju, Ajithkumar Parachalil; Parameshwaran, Renjith Athirkandathil

    2016-01-01

    Introduction The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. Aim To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Study and Design Department of Periodontics. Randomized clinical trial with split mouth design. Materials and Methods Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Statistical analysis Results were statistically analysed using paired T test, one-way ANOVA, Tukey’s HSD test and repeated measure ANOVA. Results Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The

  18. [Pregnancy and periodontal disease--is there a relation?].

    Science.gov (United States)

    Mayer, Y; Levin, L; Oettinger-Barak, O; Machtei, E

    2008-01-01

    Pregnancy complications, especially low birth weight (defined as birth weight less than 2.500 kilograms (kg)), pre-term delivery (less than 37 weeks) and pre-ecclampsia (elevated maternal blood pressure), continue to be a significant public health issue in both developed and developing countries. Recent data indicate that periodontal disease might confer risk for several systemic disorders. The relationship between periodontal diseases in pregnancy and obstetric complications has been increasingly investigated, showing inconclusive results. The purpose of this study is to review the current literature regarding the influence of periodontal status on pregnancy outcome, including the effect of periodontal treatment. Further research in this area is required, particularly with respect to the effect of population differences on this potential association between periodontal diseases and pregnancy complications as well as on the exact mechanism of this association. Since pregnancy tends to influence periodontal status, and considering the potential reported relation between periodontal disease and pregnancy complications, careful periodontal diagnosis and treatment before as well as during pregnancy is warranted.

  19. Endodontic and periodontal management of a severely affected maxillary lateral incisor having combined mucosal fenestration and palatogingival groove

    Directory of Open Access Journals (Sweden)

    Sarang Sharma

    2015-01-01

    Full Text Available Mucosal fenestrations, wherein the tooth root apices are clinically discernible in the oral cavity subsequent to loss of overlying alveolar bone and mucosa, are rare pathologic entities. Palato gingival grooves- anatomic aberrations are also infrequent occurrences that notoriously predispose to periodontal pathologies of varying extent. Both conditions independently are known to popularly affect maxillary lateral incisors. Coexistent fenestration defect and palato gingival groove in the same tooth is extremely rare and undoubtedly is a perfect combination to precipitate severe endodontic-periodontal consequences. In this report, a 34-year-old patient presented to the dental department with complaint of esthetics in relation to exposed root of right maxillary lateral incisor. On closer inspection, a palato gingival groove in addition to fenestration defect was evident on the root surface along with a periodontal pocket of >5 mm. An interdisciplinary treatment was instituted which included endodontic treatment followed by root end resection, osseous bone graft placement and guided tissue regeneration procedures for repair of mucosal fenestration defect. Debridement of the palatal pocket, with saucerization of the groove and restoration with glass ionomer cement were simultaneously employed to correct the palatal defect.

  20. Periodontitis-associated risk factors in pregnant women

    Directory of Open Access Journals (Sweden)

    Maria Dilma Bezerra de Vasconcellos Piscoya

    2012-01-01

    Full Text Available OBJECTIVE: The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1 socio-demographic variables; 2a variables related to nutritional status, smoking, and number of pregnancies; and 2b variables related to oral hygiene. Periodontitis was defined as a probing depth > 4 mm and an attachment loss > 3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.