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Sample records for symptomatic apical periodontitis

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

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    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

  2. Monocyte chemotactic protein-3: possible involvement in apical periodontitis chemotaxis.

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    Dezerega, A; Osorio, C; Mardones, J; Mundi, V; Dutzan, N; Franco, M; Gamonal, J; Oyarzún, A; Overall, C M; Hernández, M

    2010-10-01

    To study the expression of monocyte chemotactic protein-3 (MCP-3, also known as chemokine CCL-7) in tissue from apical lesions (AL) and to associate MCP-3 expression with symptomatic or asymptomatic apical periodontitis. To determine the expression of MCP-3 in AL, biopsies obtained during tooth extraction procedures were fixed, subjected to routine processing and diagnosed as apical granuloma (AG) (n = 7) or radicular cyst (RC) (n = 5). As controls, apical periodontal ligament (PDL) specimens from healthy premolars extracted for orthodontics reasons were included (n = 7). All specimens were immunostained for MCP-3 and examined under a light microscope. In addition, homogenates from AL (n = 14) and healthy PDL samples (n = 7) were studied through immunowestern blot. Finally, periapical exudates samples were collected from root canals of teeth having diagnosis of symptomatic (n = 14) and asymptomatic apical periodontitis (n = 14) during routine endodontic treatments and analysed by immunowestern blot and densitometry.   MCP-3 was detected in AG and RC and localized mainly to inflammatory leucocytes, whereas no expression was observed in healthy PDLs. MCP-3 was also detected in periapical exudate, and its levels were significantly higher in symptomatic than in asymptomatic apical periodontitis. MCP-3 was expressed in AL and its levels associated with clinical symptoms. MCP-3 might play a role in disease pathogenesis, possibly by stimulating mononuclear chemotaxis. © 2010 International Endodontic Journal.

  3. Pathogenesis of Apical Periodontitis: a Literature Review

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    Indre Graunaite

    2011-09-01

    Full Text Available Objectives: This review article discusses the host response in apical periodontitis with the main focus on cytokines, produced under this pathological condition and contributing to the degradation of periradicular tissues. The pace of research in this field has greatly accelerated in the last decade. Here we provide an analysis of studies published in this area during this period.Material and methods: Literature was selected through a search of PubMed electronic database. The keywords used for search were pathogenesis of apical periodontitis cytokines, periapical granuloma cytokines, inflammatory infiltrate apical periodontitis. The search was restricted to English language articles, published from 1999 to December 2010. Additionally, a manual search in the cytokine production, cytokine functions and periapical tissue destruction in the journals and books was performed.Results: In total, 97 literature sources were obtained and reviewed. The topics covered in this article include cellular composition of an inflammatory infiltrate in the periapical lesions, mechanisms of the formation of the innate and specific immune response. Studies which investigated cytokine secretion and functions were identified and cellular and molecular interactions in the course of apical periodontitis described.Conclusions: The abundance and interactions of various inflammatory and anti-inflammatory molecules can influence and alter the state and progression of the disease. Therefore, periapical inflammatory response offers a model, suited for the study of many facets of pathogenesis, biocompatibility of different materials to periapical tissues and development of novel treatment methods, based on the regulation of cytokines expression.

  4. Pathogenesis of apical periodontitis: a literature review.

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    Graunaite, Indre; Lodiene, Greta; Maciulskiene, Vita

    2012-01-01

    This review article discusses the host response in apical periodontitis with the main focus on cytokines, produced under this pathological condition and contributing to the degradation of periradicular tissues. The pace of research in this field has greatly accelerated in the last decade. Here we provide an analysis of studies published in this area during this period. Literature was selected through a search of PubMed electronic database. The keywords used for search were pathogenesis of apical periodontitis cytokines, periapical granuloma cytokines, inflammatory infiltrate apical periodontitis. The search was restricted to English language articles, published from 1999 to December 2010. Additionally, a manual search in the cytokine production, cytokine functions and periapical tissue destruction in the journals and books was performed. In total, 97 literature sources were obtained and reviewed. The topics covered in this article include cellular composition of an inflammatory infiltrate in the periapical lesions, mechanisms of the formation of the innate and specific immune response. Studies which investigated cytokine secretion and functions were identified and cellular and molecular interactions in the course of apical periodontitis described. The abundance and interactions of various inflammatory and anti-inflammatory molecules can influence and alter the state and progression of the disease. Therefore, periapical inflammatory response offers a model, suited for the study of many facets of pathogenesis, biocompatibility of different materials to periapical tissues and development of novel treatment methods, based on the regulation of cytokines expression.

  5. Pathogenesis of Apical Periodontitis: a Literature Review

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    Graunaite, Indre; Lodiene, Greta; Maciulskiene, Vita

    2012-01-01

    ABSTRACT Objectives This review article discusses the host response in apical periodontitis with the main focus on cytokines, produced under this pathological condition and contributing to the degradation of periradicular tissues. The pace of research in this field has greatly accelerated in the last decade. Here we provide an analysis of studies published in this area during this period. Material and methods Literature was selected through a search of PubMed electronic database. The keywords...

  6. Healing of apical periodontitis through modern endodontic retreatment techniques.

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    Ray, Jarom J; Kirkpatrick, Timothy C

    2013-01-01

    The presence of apical periodontitis in teeth which have undergone initial root canal treatment is largely attributed to bacteria residing in or invading from the apical root canal space. Bacteria-associated apical periodontitis will not heal spontaneously, nor will systemic antibiotics eradicate the infection. Only endodontic retreatment, endodontic surgery, or extraction will control the bacterial etiology. Modern retreatment is an effective means of addressing apical periodontitis. A mandibular premolar with apical periodontitis, apical root resorption, and overfilled gutta percha was retreated with post removal, retrieval of gutta percha from beyond the apex, ultrasonic irrigation and disinfection, and placement of a collagen internal matrix to facilitate a well-controlled MTA apical fill. The magnification and illumination imparted by the operating microscope was integral to achievement of treatment objectives. The patient's symptoms were resolved and complete osseous healing occurred. During treatment planning, clinicians should consider the capability of modern endodontic techniques to overcome technical challenges, often allowing the natural dentition to be preserved and restored to function days after retreatment.

  7. [Histopathology and etiopathogenesis of chronic apical periodontitis--periapical granuloma].

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    Kovác, J; Kovác, D

    2011-06-01

    Periapical lesions are among the most frequently diagnosed apical odontogenic pathologies in human teeth. The condition is generally described as apical periodontitis. Apical periodontitis is a sequel to endodontic infection and manifests itself as the host defense response to microbial challenge emanating from the root canal system to the periapical tissue. It is viewed as a dynamic encounter between microbial factors and host defenses at the interface between infected radicular pulp and periodontal ligament that results in local inflammation, resorption of hard tissues, destruction of other periapical tissues, and eventual formation of various histopathological categories of apical periodontitis, commonly referred to as periapical lesions. There are also factors located within the inflamed periapical tissue that can interfere with post-treatment healing of the lesion. The purpose of this article is to provide a comprehensive overview of the etiopathogenesis of apical periodontitis and causes of failed endodontic treatment. This study presents a histopathological analysis through optical microscopy of periapical lesions, commonly referred to as solid dental or periapical granuloma.

  8. Pathogenesis of apical periodontal cysts: guidelines for diagnosis in palaeopathology

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    Dias, G. J.; Prasad, K.; Santos, A. L.

    2007-01-01

    Apical periodontal cysts are benign lesions developing in relation to the apices of non-vital teeth due to inflammatory response from the infective pulp. These are epithelium-lined bony cavities containing fluid. Despite being widely reported in medical/dental literature, this common condition is poorly diagnosed and documented in the archaeological literature. We aim to clarify the correct terminology, demonstrate bony manifestations at different stages of pathogenesis of chronic periapical ...

  9. Assessment of apical periodontitis by MRI. A feasibility study

    International Nuclear Information System (INIS)

    Geibel, M.A.; Schreiber, E.S.; Bracher, A.K.; Rasche, V.; Hell, E.; Ulrici, J.; Sailer, L.K.; Ozpeynirci, Y.

    2015-01-01

    The purpose of this clinical feasibility study was to evaluate the applicability of magnetic resonance imaging (MRI) for the assessment of apical periodontitis in direct comparison with cone beam CT (CBCT). 19 consecutive patients (average age 43 ± 13 years) with 34 lesions in total (13 molars, 14 premolars and 7 front teeth) were enrolled in this feasibility study. Periapical lesions were defined as periapical radiolucencies (CBCT) or structural changes in the spongy bone signal (MRI), which were connected with the apical part of a root and with at least twice the width of the periodontal ligament space. The location and dimension of the lesions were compared between MRI and CBCT. While mainly mineralized tissue components such as teeth and bone were visible with CBCT, complimentary information of the soft tissue components was assessable with MRI. The MRI images provided sufficient diagnostic detail for the assessment of the main structures of interest. Heterogeneous contrast was observed within the lesion, with often a clear enhancement close to the apical foramen and the periodontal gap. No difference for lesion visibility was observed between MRI and CBCT. The lesion dimensions corresponded well, but were slightly but significantly overestimated with MRI. A heterogeneous lesion appearance was observed in several patients. Four patients presented with a well circumscribed hyperintense signal in the vicinity of the apical foramen. The MRI capability of soft tissue characterization may facilitate detailed analysis of periapical lesions. This clinical study confirms the applicability of multi-contrast MRI for the identification of periapical lesions.

  10. Assessment of apical periodontitis by MRI. A feasibility study

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    Geibel, M.A. [Ulm Univ. (Germany). Oral and Maxillofacial Surgery; Schreiber, E.S.; Bracher, A.K.; Rasche, V. [Ulm Univ. (Germany). Internal Medicine II; Hell, E.; Ulrici, J. [Sirona Dental Systems GmbH, Bensheim (Germany). Dental Imaging; Sailer, L.K. [DOC Praxisklinik im Wiley, Neu-Ulm (Germany). MKG; Ozpeynirci, Y. [Ulm Univ. (Germany). Diagnostic and Interventional Radiology

    2015-04-15

    The purpose of this clinical feasibility study was to evaluate the applicability of magnetic resonance imaging (MRI) for the assessment of apical periodontitis in direct comparison with cone beam CT (CBCT). 19 consecutive patients (average age 43 ± 13 years) with 34 lesions in total (13 molars, 14 premolars and 7 front teeth) were enrolled in this feasibility study. Periapical lesions were defined as periapical radiolucencies (CBCT) or structural changes in the spongy bone signal (MRI), which were connected with the apical part of a root and with at least twice the width of the periodontal ligament space. The location and dimension of the lesions were compared between MRI and CBCT. While mainly mineralized tissue components such as teeth and bone were visible with CBCT, complimentary information of the soft tissue components was assessable with MRI. The MRI images provided sufficient diagnostic detail for the assessment of the main structures of interest. Heterogeneous contrast was observed within the lesion, with often a clear enhancement close to the apical foramen and the periodontal gap. No difference for lesion visibility was observed between MRI and CBCT. The lesion dimensions corresponded well, but were slightly but significantly overestimated with MRI. A heterogeneous lesion appearance was observed in several patients. Four patients presented with a well circumscribed hyperintense signal in the vicinity of the apical foramen. The MRI capability of soft tissue characterization may facilitate detailed analysis of periapical lesions. This clinical study confirms the applicability of multi-contrast MRI for the identification of periapical lesions.

  11. CLINICAL EFFECTIVENESS OF TREATMENT THE PATIENTS WITH CHRONIC APICAL PERIODONTITIS

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    N. G. Gadzhula

    2017-02-01

    Full Text Available Background. The success of endodontic treatment is provided by a thorough instrumental and antiseptic treatment of infected root canals, and it depends on the composition of filling material, the degree of adhesion to dentin, hermetic obturation of apical foramen, solubility of sealer. Objective. The study was aimed to evaluate the effectiveness of root canal obturation with BioRootTM RCS sealer in the treatment of patients with chronic apical periodontitis. Methods. Endodontic treatment of 23 teeth in 20 patients with chronic apical periodontitis by method of lateral compaction of gutta-percha was carried out. In the main group root canals were obturated with BioRootTM RCS, in the control group the canals were filled with Apexit Plus. The percentage of efficient or non-efficient cases was evaluated on the basis of radiographic comparison of treated chronic apical periodontitis immediately after obturation, in three, six months and one year. Radiographic conditions were defined as existing state, improvement and worsening. Results. In a year of dynamic evaluation the final results were: in the main group – 54.55% of the patients had complete bone healing, in 27.27% of cases the focus of bone destruction was decreased by ½ or more of the initial sizes, 18.18% – resorption lesion was decreased by less than ½; in the control group – 33.33% of improvement, 25.0% of existing state and 41.66% of worsening. Conclusions. BioRootTM RCS using for root canals obturation in the treatment of chronic apical periodontitis we proved the high effectiveness of the treatment undertaken: complete healing or improvement of radiographic conditions of periapical bone destruction with X-ray signs of bone regeneration.

  12. Periapical fluid RANKL and IL-8 are differentially regulated in pulpitis and apical periodontitis.

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    Rechenberg, Dan-K; Bostanci, Nagihan; Zehnder, Matthias; Belibasakis, Georgios N

    2014-09-01

    The dental pulp space can become infected due to a breach in the surrounding hard tissues. This leads to inflammation of the pulp (pulpitis), soft tissue breakdown, and finally to bone loss around the root apex (apical periodontitis). The succession of the molecular events leading to apical periodontitis is currently not known. The main inflammatory mediator associated with neutrophil chemotaxis is interleukin-8 (IL-8), and with bone resorption the dyad of receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG). The levels of RANKL, OPG and IL-8 were studied in periapical tissue fluid of human teeth (n = 48) diagnosed with symptomatic irreversible pulpitis (SIP) and asymptomatic apical periodontitis (AAP). SIP represents the starting point, and AAP an established steady state of the disease. Periapical tissue fluid samples were collected using paper points and then evaluated using enzyme-linked immunosorbent assays (ELISAs). Target protein levels per case were calibrated against the corresponding total protein content, as determined fluorometrically. RANKL was expressed at significantly higher levels in SIP compared to AAP (P < 0.05), whereas OPG was under the detection limit in most samples. In contrast, IL-8 levels were significantly lower in SIP compared to AAP (P < 0.05). Spearman's correlation analysis between RANKL and IL-8 revealed a significantly (P < 0.05) negative correlation between the two measures (rho = -.44). The results of this study suggest that, in the development of apical periodontitis, periapical bone resorption signaling, as determined by RANKL, occurs prior to inflammatory cell recruitment signaling, as determined by IL-8. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. [Expression of interleukin-17F in human apical periodontitis lesions].

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    Sun, Hui; Li, Song

    2012-06-01

    To examine the expression of interleukin-17F (IL-17F) in apical periodontitis lesions. Human apical periodontitis lesions were collected after periapical surgery from November 1, 2009 to August 1, 2011. After histological processing, serial sectioning, HE staining, and microscopic analysis, 33 periapical cysts and 18 periapical granulomas were selected for immunohistochemical analysis for IL-17F. Five alveolar bone samples were obtained from a group of impacted third molars recommended for extraction. These bone samples did not show any inflammation and were used as normal samples. Differences in IL-17F expression between the tissues with periapical cyst and periapica granuloma were subsequently analyzed by rank-sum test. IL-17F was expressed in epithelial cells, lymphocytes, fibroblast and endothelial cells of both types of lesions. Both types of lesions presented increased IL-17F expression when compared to healthy periapical alveolar bone. The expression of IL-17F in apical cyst (0.2365 ± 0.0708) and apical granuloma (0.8852 ± 0.0576) was significantly different (Z = 3.735, P granuloma was significantly different.

  14. Herpesviruses viral loads and levels of proinflammatory cytokines in apical periodontitis.

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    Jakovljevic, A; Knezevic, A; Nikolic, N; Soldatovic, I; Jovanovic, T; Milasin, J; Andric, M

    2018-01-09

    This study aimed to analyse Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) viral loads in symptomatic and asymptomatic apical periodontitis lesions, to determine levels of TNF-α, IL-1β and IL-6 in these lesions and to investigate a possible correlation between herpesviral copy numbers and levels of proinflammatory cytokines. A total of 100 samples of apical periodontitis were subjected to HCMV and EBV copy numbers analysis by nested polymerase chain reaction (PCR) and TaqMan real-time PCR. The concentrations of TNF-α, IL-1β and IL-6 were determined by ELISA method. SPSS software was used for statistical analysis. There were no significant differences in the occurrence of EBV and HCMV between symptomatic and asymptomatic periapical lesions (p = .686, p = .879, respectively). Only 12 of 74 EBV (16.2%) and four of 54 HCMV (13.5%) nested PCR-positive samples showed increased viral copy numbers above the limit of 125 copies/ml. There was no significant correlation between the levels of analysed proinflammatory cytokines and herpesviral copy numbers in our sample. The observed low viral loads point to a relatively rare occurrence of active EBV and HCMV infection in our sample. Latent herpesviral infection does not enhance the production of investigated proinflammatory cytokines. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.

  15. Bacterial communities associated with apical periodontitis and dental implant failure

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    Dingsdag, Simon; Nelson, Stephen; Coleman, Nicholas V.

    2016-01-01

    Background Previously, we demonstrated that bacteria reside in apparently healed alveolar bone, using culture and Sanger sequencing techniques. Bacteria in apparently healed alveolar bone may have a role in peri-implantitis and dental implant failure. Objective To compare bacterial communities associated with apical periodontitis, those colonising a failed implant and alveolar bone with reference biofilm samples from healthy teeth. Methods and results The study consisted of 196 samples collected from 40 patients undergoing routine dental implant insertion or rehabilitation. The bacterial 16S ribosomal DNA sequences were amplified. Samples yielding sufficient polymerase chain reaction product for further molecular analyses were subjected to terminal restriction fragment length polymorphism (T-RFLP; 31 samples) and next generation DNA sequencing (454 GS FLX Titanium; 8 samples). T-RFLP analysis revealed that the bacterial communities in diseased tissues were more similar to each other (p<0.049) than those from the healthy reference samples. Next generation sequencing detected 13 bacterial phyla and 373 putative bacterial species, revealing an increased abundance of Gram-negative [Prevotella, Fusobacterium (p<0.004), Treponema, Veillonellaceae, TG5 (Synergistetes)] bacteria and a decreased abundance of Gram-positive [(Actinomyces, Corynebacterium (p<0.008)] bacteria in the diseased tissue samples (n=5) relative to reference supragingival healthy samples (n=3). Conclusion Increased abundances of Prevotella, Fusobacterium and TG5 (Synergistetes) were associated with apical periodontitis and a failed implant. A larger sample set is needed to confirm these trends and to better define the processes of bacterial pathogenesis in implant failure and apical periodontitis. The application of combined culture-based, microscopic and molecular technique-based approaches is suggested for future studies. PMID:27834171

  16. Immunoexpression of interleukin 17 in apical periodontitis lesions.

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    Ajuz, Natasha C; Antunes, Henrique; Mendonça, Thais A; Pires, Fábio R; Siqueira, José F; Armada, Luciana

    2014-09-01

    Interleukin (IL)-17 expression has been detected in apical periodontitis lesions, but its role in the disease process remains unclear. The present study compared the expression of IL-17 in periradicular cysts and granulomas and evaluated the association of this cytokine with clinical and radiographic findings. Apical periodontitis lesions (18 cysts and 20 granulomas) were obtained from 38 patients subjected to periradicular surgery. Some clinical, radiographic, and cone-beam computed tomographic features were recorded. Silanized slides containing paraffin sections were used for the immunohistochemical reactions using anti-IL-17 antibody. Image analysis was performed using an optical microscope, and each sample was divided into 5 high-power fields, which were evaluated for the expression of IL-17 in the epithelium and connective tissues. Results were evaluated for correlations with the lesion size and the occurrence of symptoms and sinus tract. Expression of IL-17 was significantly higher in cysts than in granulomas (P = .02). Among the periradicular cysts, a thin epithelium showed significantly increased labeling for IL-17 when compared with a hyperplastic epithelium (P = .003). IL-17 expression was usually associated with focal accumulations of polymorphonuclear leukocytes. No association of IL-17 expression with symptoms, sinus tract, or lesion size was observed (P > .05). The present study reinforces the notion that IL-17 may take part in the pathogenesis of apical periodontitis lesions. A role in the exacerbation of chronic inflammation and cyst formation is suspected. Further studies are required to shed light on the specific functions of IL-17 in periradicular inflammatory processes. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. Bacterial communities associated with apical periodontitis and dental implant failure

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    Simon Dingsdag

    2016-11-01

    Full Text Available Background: Previously, we demonstrated that bacteria reside in apparently healed alveolar bone, using culture and Sanger sequencing techniques. Bacteria in apparently healed alveolar bone may have a role in peri-implantitis and dental implant failure. Objective: To compare bacterial communities associated with apical periodontitis, those colonising a failed implant and alveolar bone with reference biofilm samples from healthy teeth. Methods and results: The study consisted of 196 samples collected from 40 patients undergoing routine dental implant insertion or rehabilitation. The bacterial 16S ribosomal DNA sequences were amplified. Samples yielding sufficient polymerase chain reaction product for further molecular analyses were subjected to terminal restriction fragment length polymorphism (T-RFLP; 31 samples and next generation DNA sequencing (454 GS FLX Titanium; 8 samples. T-RFLP analysis revealed that the bacterial communities in diseased tissues were more similar to each other (p<0.049 than those from the healthy reference samples. Next generation sequencing detected 13 bacterial phyla and 373 putative bacterial species, revealing an increased abundance of Gram-negative [Prevotella, Fusobacterium (p<0.004, Treponema, Veillonellaceae, TG5 (Synergistetes] bacteria and a decreased abundance of Gram-positive [(Actinomyces, Corynebacterium (p<0.008] bacteria in the diseased tissue samples (n=5 relative to reference supragingival healthy samples (n=3. Conclusion: Increased abundances of Prevotella, Fusobacterium and TG5 (Synergistetes were associated with apical periodontitis and a failed implant. A larger sample set is needed to confirm these trends and to better define the processes of bacterial pathogenesis in implant failure and apical periodontitis. The application of combined culture-based, microscopic and molecular technique-based approaches is suggested for future studies.

  18. Calcium hydroxide as intracanal dressing for teeth with apical periodontitis

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    Sari Dewiyani

    2011-03-01

    Full Text Available Background: Root canal infection and periapical diseases are caused by bacteria and their products. Long term infection may spread bacteria throughout the root canal system. Apical periodontitis caused by infectious microbe that persistent in root canals can cause radiographic and histopathology periapical changes. Chemomechanical preparation and intracanal dressing then are recommended to be conducted and used in between visits to eliminate microbes in root canals. Calcium hydroxide (Ca(OH2 can be used as intracanal dressing since it can be used as musical physical defense barrier to eliminate re-infection in root canal and to disturb nutrition supply for bacterial development. Purpose: The aim of this study is observe the effectiveness of Ca(OH2 in treating endodontic teeth with apical periodontitis. Cases: Case 1 and 3 are about patients whose left posterior mandibular teeth had spontaneous intermittent pain. Case 2 is about a patient whose left posterior maxillary teeth had gingival abscess and fracture history. Based on the radiographic examination, it was known that the filling of root canal was incomplete and there was radiolucency in the apical area. Case management: The cases were treated with triad endodontics, which involves preparation, disinfection by using 2.5% NaOCl as irrigation substance and calcium hydroxide as intracanal dressing, and then the filling of root canal with gutta percha and endomethasone root canal cement. Evaluations were conducted one month, 12 months, and 24 months after the treatment. Conclusion: Calcium hydroxide is effective to be used as intracanal dressing in apical periodontitis cases.Latar belakang: Infeksi saluran akar dan penyakit periapeks disebabkan oleh mikroba dan produknya. Infeksi yang berlangsung lama memungkinkan bakteri masuk ke dalam seluruh sistem saluran akar. Periodontitis apikal disebabkan oleh infeksi persisten mikroba di dalam sistem saluran akar disertai perubahan radiografik dan

  19. Frecuencia de periodontitis apical en tratamientos endodónticos de pregrado Frequency of apical periodontitis in endodontic treatment in undergraduate

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    P León; MJ Ilabaca; M Alcota; FE González

    2011-01-01

    La periodontitis apical es una enfermedad de los tejidos periapicales de etiología bacteriana. Su tratamiento requiere erradicar los microorganismos del conducto radicular y obturarlo para lograr la reparación posterior. El objetivo de éste trabajo fue determinar la frecuencia de periodontitis apical en la población que asiste a la clínica de Endodoncia de la Facultad de Odontología de la Universidad de Chile y su relación con diferentes variables: diagnóstico específico, edad, sexo, agudas v...

  20. Variability interexaminer of chronic apical periodontitis diagnostics in panoramic radiographs

    International Nuclear Information System (INIS)

    Montero Aguilar, Mauricio; Zeledon Mayorga, Rodolfo; Ramirez Mora, Tatiana; Monestel Umana, Silvia

    2009-01-01

    The accuracy of radiological diagnosis of Apical Periodontitis (AP) is reported between examiners with differents levels of clinical experience using panoramic radiographs. 1032 teeth in 41 panoramic radiographs have been diagnosed. The evaluation of the x-rays and radiological diagnosis is performed by three independent dentists for AP to each tooth. The teeth have presented without radiological signs of AP in 96.6%. The number of teeth classified with an uncertain diagnosis of AP at the has been inversely proportional to the number of years of experience of the examiner. The examiner A has been used as a reference and compared the diagnoses of other examiners.The percentage agreement for all teeth was 95% for examiner B and 94% for examiner C. Kappa for all has been of 0.44 for examiner B and 0.43 for examiner C. The different categories were analyzed separately, the inferior teeth and the anterior teeth have obtained the best results. The level of clinical experience of the examiner has been indifferent in the diagnosis of AP in panoramic radiographs; however, it is important experience in the number of radiographs extras that will be needed to give a radiological diagnosis definitive. The panoramic radiographs were reliable diagnostic tools for AP. (author) [es

  1. Frecuencia de periodontitis apical en tratamientos endodónticos de pregrado Frequency of apical periodontitis in endodontic treatment in undergraduate

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    P León

    2011-12-01

    Full Text Available La periodontitis apical es una enfermedad de los tejidos periapicales de etiología bacteriana. Su tratamiento requiere erradicar los microorganismos del conducto radicular y obturarlo para lograr la reparación posterior. El objetivo de éste trabajo fue determinar la frecuencia de periodontitis apical en la población que asiste a la clínica de Endodoncia de la Facultad de Odontología de la Universidad de Chile y su relación con diferentes variables: diagnóstico específico, edad, sexo, agudas vs. crónicas, éxito/fracaso del tratamiento y rehabilitación post-tratamiento. Se recolectó información de 292 dientes de pacientes tratados en dicha clínica, analizándose la información de aquellos con dientes diagnosticados con algún tipo de periodontitis apical clasificándolo según la nueva nomenclatura de la asociación de endodoncia americana. La frecuencia de periodontitis apical fue de un 36.7% (92 pacientes, de los cuales un 77.8% presentaron patologías de tipo crónicas. Un 75% de los pacientes pertenecieron al sexo femenino y la 5ta década representó un 34.8% de los pacientes. El 100% de los pacientes que acudieron a control presentó éxito en sus tratamientos según variables clínico-radiográficas, mientras que la restauración más frecuente post-tratamiento fue la resina compuesta (52.4%. Dado el pequeño número de pacientes que concurrieron a la citación de control para determinar el éxito del tratamiento, esta variable debe ser considerada como preliminar. Nuestros resultados mostraron que la condición mas frecuente fue la periodontitis apical de tipo crónica, afectando más a mujeres y a la 5ta década.Apical periodontitis is a microbially induced inflammatory disease of the periapical tissues. Its treatment requires eliminating microorganism from root canal and sealing it properly to induce further tissue repair. The aim of this study was to determine the frequency of apical periodontitis and its distribution by

  2. Management of Teeth with Persistent Apical Periodontitis after Root Canal Treatment Using Regenerative Endodontic Therapy.

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    Saoud, Tarek Mohamed A; Huang, George T-J; Gibbs, Jennifer L; Sigurdsson, Asgeir; Lin, Louis M

    2015-10-01

    Regenerative endodontic therapy (RET) is currently used to treat immature teeth with necrotic pulp and/or apical periodontitis. However, recently RET has been used to treat mature teeth with necrotic pulp and/or apical periodontitis and resulted in regression of clinical signs and/or symptoms and resolution of apical periodontitis. The purpose of this case report was to describe the potential of using RET to treat 2 mature teeth with persistent apical periodontitis after root canal therapy using RET. Two male patients, one 26-year old and another 12-year old, presented for retreatment of persistent apical periodontitis after root canal treatment of 2 mature teeth (#9 and #19). The gutta-percha fillings in the canals of teeth #9 and #19 were removed with Carvene gutta-percha solvent (Prevest DenPro, Jammu, India) and ProTaper Universal rotary retreatment files (Dentsply Maillefer, Ballaigues, Switzerland). The canals of both teeth were further chemomechanically debrided with rotary retreatment files and copious amounts of sodium hypochlorite irrigation and dressed with Metapaste (Meta Biomed, Chungbuk, Korea). RET was performed on teeth #9 and #19. Periapical bleeding was provoked into the disinfected root canals. The blood clots were covered with mineral trioxide aggregate plugs, and the access cavities were restored with intermediate restorative material. Teeth #9 and #19 showed regression of clinical signs and/or symptoms and healing of apical periodontitis after 13-month and 14-month follow-ups, respectively. Tooth #9 revealed narrowing of the canal space and apical closure by deposition of hard tissue. RET has the potential to be used to retreat teeth with persistent apical periodontitis after root canal therapy. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  3. Risk Factors for Apical Periodontitis Sub-Urban Adult Population.

    Science.gov (United States)

    Oginni, A O; Adeleke, A A; Mejabi, M O; Sotunde, O A

    2015-06-01

    To assess the risk factors of apical periodontitis (AP) in a Nigerian sub-urban adult population and to compare the findings with those previously reported for various population groups. The study was based on a full mouth radiographic survey of 285 patients. Patients' age ranged from 18-60 years. All teeth were assessed individually and data recorded for caries, fractured / cracked teeth, root fillings, and tooth restorations. The gender, smoking habit, and frequency of dental visit were also recorded. Multiple logistic regression analyses were performed to identify predictors of AP in the individual. The prevalence of AP was 74.4%. The average number of teeth with AP per patient was 2.8 (range 1-5). AP was found to be more prevalent among people 40- 49 years old (87.2%). Primary carious lesions, fractured / cracked teeth, root fillings and coronal fillings were associated with the incidence of AP in the individual. Fractured teeth had a higher risk of developing AP than carious teeth. The presence of root fillings and coronal restorations were also associated with the development of AP. Smoking (OR=3.82; CI=2.17-6.75) and irregular dental visit (OR=6.73; CI=3.75-12.06) were statistically significant risk factors for developing AP. Gender was not a risk factor for AP (OR=0.86; CI=0.50-1.46). The prevalence of AP among adult Nigerians is slightly higher than reported figures for many Western societies. Fractured/cracked teeth had a higher risk of developing AP than carious teeth; hence patients with fractured / cracked teeth should seek treatment early to prevent the development of AP.

  4. Frecuencia de periodontitis apical en tratamientos endodónticos de pregrado

    OpenAIRE

    León, P.; Ilabaca, M.J.; Alcota, M.; González, F.E.

    2011-01-01

    La periodontitis apical es una enfermedad de los tejidos periapicales de etiología bacteriana. Su tratamiento requiere erradicar los microorganismos del conducto radicular y obturarlo para lograr la reparación posterior. El objetivo de éste trabajo fue determinar la frecuencia de periodontitis apical en la población que asiste a la clínica de Endodoncia de la Facultad de Odontología de la Universidad de Chile y su relación con diferentes variables: diagnóstico específico, edad, sexo, agudas v...

  5. Criterios Clínicos y Radiológicos de la Periodontitis Apical.

    OpenAIRE

    Jiménez Planas, Amparo

    2017-01-01

    Se realiza un trabajo con 271 casos diagnosticados de periodontitis apical, clínica o radiológicamente, en los que se valoran parámetros clínicos y radiológicos que nos permitan delimitar las diferentes formas clínicas de este proceso. se propone, como consecuencia de los resultados, una clasificación clara, simple, coherente y evolutiva de la periodontitis apical y se hacen diversas consideraciones sobre la nomenclatura, etiología, cl...

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

    Science.gov (United States)

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

    2012-03-01

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

  7. Biofilms and apical periodontitis: study of prevalence and association with clinical and histopathologic findings.

    Science.gov (United States)

    Ricucci, Domenico; Siqueira, José F

    2010-08-01

    This study evaluated the prevalence of bacterial biofilms in untreated and treated root canals of teeth evincing apical periodontitis. The associations of biofilms with clinical conditions, radiographic size, and the histopathologic type of apical periodontitis were also investigated. The material comprised biopsy specimens from 106 (64 untreated and 42 treated) roots of teeth with apical periodontitis. Specimens were obtained by apical surgery or extraction and were processed for histopathologic and histobacteriologic techniques. Bacteria were found in all but one specimen. Overall, intraradicular biofilm arrangements were observed in the apical segment of 77% of the root canals (untreated canals: 80%; treated canals: 74%). Biofilms were also seen covering the walls of ramifications and isthmuses. Bacterial biofilms were visualized in 62% and 82% of the root canals of teeth with small and large radiographic lesions, respectively. All canals with very large lesions harbored intraradicular biofilms. Biofilms were significantly associated with epithelialized lesions (cysts and epithelialized granulomas or abscesses) (p granulomas was 95%, 83%, and 69.5%, respectively. No correlation was found between biofilms and clinical symptoms or sinus tract presence (p > 0.05). Extraradicular biofilms were observed in only 6% of the cases. The overall findings are consistent with acceptable criteria to include apical periodontitis in the set of biofilm-induced diseases. Biofilm morphologic structure varied from case to case and no unique pattern for endodontic infections was identified. Biofilms are more likely to be present in association with longstanding pathologic processes, including large lesions and cysts. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  8. One versus two appointment endodontic treatment on teeth with apical periodontitis

    Directory of Open Access Journals (Sweden)

    Juni Jekti Nugroho

    2016-06-01

    Full Text Available The microbiological purpose of endodontic treatment on tooth with apical periodontitis is reducing microbes to achieve periradicular tissue healing and prevent microbes recolonized. This is achieved by antimicrobial measures, including chemomechanical procedures and intracanal medication, with root canal obturation steps. One of the problem in endodontic is the planning consideration to treat with one or two visits. Does intra-appointment medication is an absolute measure to promote desinfection and treatment success. To provide a guideline about  one or two visit endodontic treatment decision making for dental professionals. Root canal system on tooth with apical periodontitis treated in two visit endodontic and calcium hydroxide as the intra-appointment medication achieved better microbiological status than the one treated in one visit endodontic.

  9. Traumatic bone cyst suggestive of large apical periodontitis.

    Science.gov (United States)

    Rodrigues, Cleomar Donizeth; Estrela, Carlos

    2008-04-01

    This case report shows the importance of establishing the correct diagnosis to provide the appropriate treatment options The traumatic bone cyst is a pseudocyst, usually asymptomatic and found by a routine radiographic examination. Unicystic radiolucency is almost always observed, which can involve the periradicular area of teeth, simulating an inflammatory lesion of endodontic origin. Differential diagnosis should include other pathologies, such as odontogenic keratocyst, central giant cell granuloma, and unicystic ameloblastoma. Its etiology and pathogenesis are not yet definitely established. In the present study, after review of the medical and dental histories and clinical and radiographic examination of teeth #24-27 (pulpal vitality test showed positive), the primary diagnosis was traumatic bone cyst. The planning was excisional biopsy. After surgical exploration, only one small blood clot was observed in the intraosseous socket, which was carefully curetted and filled with blood. A clinical and radiographic examination after 6 months showed apical formation and pulpal vitality preserved.

  10. Oxidative Stress in the Local and Systemic Events of Apical Periodontitis

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    Patricia Hernández-Ríos

    2017-11-01

    Full Text Available Oxidative stress is involved in the pathogenesis of a variety of inflammatory disorders. Apical periodontitis (AP usually results in the formation of an osteolytic apical lesion (AL caused by the immune response to endodontic infection. Reactive oxygen species (ROS produced by phagocytic cells in response to bacterial challenge represent an important host defense mechanism, but disturbed redox balance results in tissue injury. This mini review focuses on the role of oxidative stress in the local and associated systemic events in chronic apical periodontitis. During endodontic infection, ligation of Toll-like receptors (TLRs on phagocytes' surface triggers activation, phagocytosis, synthesis of ROS, activation of humoral and cellular responses, and production of inflammatory mediators, such as, cytokines and matrix metalloproteinases (MMPs. The increment in ROS perturbs the normal redox balance and shifts cells into a state of oxidative stress. ROS induce molecular damage and disturbed redox signaling, that result in the loss of bone homeostasis, increased pro-inflammatory mediators, and MMP overexpression and activation, leading to apical tissue breakdown. On the other hand, oxidative stress has been strongly involved in the pathogenesis of atherosclerosis, where a chronic inflammatory process develops in the arterial wall. Chronic AP is associated with an increased risk of cardiovascular diseases (CVD and especially atherogenesis. The potential mechanisms linking these diseases are also discussed.

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

    Directory of Open Access Journals (Sweden)

    Dezerega Andrea

    2012-03-01

    Full Text Available Abstract Background Oxidative stress and matrix metalloproteinases -9 and -2 are involved in periodontal breakdown, whereas gingival crevicular fluid has been reported to reflect apical status. The aim of this study was to characterize oxidant balance and activity levels of MMP -2 and -9 in apical lesions and healthy periodontal ligament; and second, to determine whether potential changes in oxidant balance were reflected in gingival crevicular fluid from asymptomatic apical periodontitis (AAP-affected teeth at baseline and after endodontic treatment. Methods Patients with clinical diagnosis of AAP and healthy volunteers having indication of tooth extraction were recruited. Apical lesions and healthy periodontal ligaments, respectively, were homogenized or processed to obtain histological tissue sections. Matrix metalloproteinase -9 and -2 levels and/or activity were analyzed by Immunowestern blot, zymography and consecutive densitometric analysis, and their tissue localization was confirmed by immunohistochemistry. A second group of patients with AAP and indication of endodontic treatment was recruited. Gingival crevicular fluid was extracted from AAP-affected teeth at baseline, after endodontic treatment and healthy contralateral teeth. Total oxidant and antioxidant status were determined in homogenized tissue and GCF samples. Statistical analysis was performed using STATA v10 software with unpaired t test, Mann-Whitney test and Spearman's correlation. Results Activity of MMP-2 and MMP-9 along with oxidant status were higher in apical lesions (p Conclusions Apical lesions display an oxidant imbalance along with increased activity of matrix metalloproteinase-2 and -9 and might contribute to AAP progression. Oxidant imbalance can also be reflected in GCF from AAP-affected teeth and was restored to normal levels after conservative endodontic treatment. These mediators might be useful as potential biomarkers for chair-side complementary diagnostic

  12. Complete Genome Sequence of Rothia mucilaginosa DY-18: A Clinical Isolate with Dense Meshwork-Like Structures from a Persistent Apical Periodontitis Lesion

    Science.gov (United States)

    2010-09-25

    chromosome. Regarding stress responsive systems known to affect biofilm formation in many bacteria , DY-18 genome possessed only two sigma factor genes...mucilaginosa strain DY-18 (DY-18), was isolated from the bacteria that were present in a persistent apical periodontitis lesion [8]. Apical periodontitis is a...collection isolated from a persistent apical periodontitis lesion, where the presence of bacteria was noted in root canals after numerous treatments [8

  13. Aging effects in the expression of macrophages in post-treatment apical periodontitis lesions.

    Science.gov (United States)

    de Almeida, Natália Freire; Brasil, Sabrina de Castro; Ferreira, Dennis de Carvalho; Armada, Luciana

    2017-09-01

    To evaluate the CD68 immunoexpression in post-treatment apical periodontitis lesions of older patients and compare them with lesions of younger/middle age adults. Biopsy specimens from 21 apical periodontitis lesions (12 granulomas and 9 cysts) were selected from older patients and 25 apical periodontitis lesions from younger/middle age adults (12 cysts and 13 granulomas) were selected and analyzed by immunohistochemistry using silanized slides with anti-CD68 antibody. The slides were subdivided in five high-power fields and the images were observed under an optical microscope to evaluate the epithelial and connective tissues. The results showed that there was no statistical difference for the CD68 expression in epithelial tissue of cysts between younger/middle age adults and older patients. However, for the connective tissue of both cysts and granulomas, there was a statistical difference between the two age groups. There was a statistical difference between the epithelial and the connective tissues in cysts of younger/middle age adults, and also when the epithelial tissue of the cysts was compared with connective tissue of the granuloma. In the group of older patients, there was no statistical difference between the connective tissue of the cysts and granulomas. The intensity of the macrophage staining was greater in the connective tissue of cysts and granulomas alike in the younger/middle age adult patients, suggesting that these cells participate actively in this tissue. Immune responses in older patients may be compromised, suggesting that there is a greater tendency for the endodontic treatment of these patients to fail. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.

  14. Pulp Revascularization in Immature Permanent Tooth with Apical Periodontitis Using Mineral Trioxide Aggregate

    Directory of Open Access Journals (Sweden)

    Katsura Saeki

    2014-01-01

    Full Text Available Mineral trioxide aggregate (MTA is a material that has been used worldwide in several clinical applications, such as apical barriers in teeth with immature apices, repair of root perforations, root-end filling, pulp capping, and pulpotomy. The purpose of this case report was to describe successful revascularization treatment of an immature mandibular right second premolar with apical periodontitis in a 9-year-old female patient. After preparing an access cavity without anesthesia, the tooth was isolated using a rubber dam and accessed. The canal was gently debrided using 5% sodium hypochlorite (NaOCl and 3% hydrogen peroxide irrigant. And then MTA was packed into the canal. X-ray photographic examination showed the dentin bridge 5 months after the revascularization procedure. Thickening of the canal wall and complete apical closure were confirmed 10 months after the treatment. In this case, MTA showed clinical and radiographic success at revascularization treatment in immature permanent tooth. The successful outcome of this case suggests that MTA is reliable and effective for endodontic treatment in the pediatric dentistry.

  15. Prevalence of apical periodontitis and quality of root canal treatment in an adult Saudi population

    Directory of Open Access Journals (Sweden)

    Saad A. Al-Nazhan

    2017-04-01

    Full Text Available Objectives: To determine the health status of periradicular tissue and the quality of root canal fillings in an adult Saudi population attending dental clinics for the first time. Methods: This cross sectional study was conducted in the dental clinics at King Saud University, Riyadh and other dental centers (Jeddah, Najran, and Albaha City, Kingdom of Saudi Arabia between year 2010 and 2012. Good-quality panoramic radiographs of 926 Saudi subjects (540 males and 386 femaleswere analyzed based on the gender, age, health status, smoking habits, periapical status of the endodontically treated teeth, technical quality of the root canal fillings, and the presence or absence of coronal restoration. Data were calibrated and statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA version 17. Results: Of the 25,028 teeth examined, 1,556 teeth (6.2% had apical periodontitis (AP. Male subjects aged over 55 years and females between 36 and 45 years had higher AP. A total of 36 diabetic and 87 smokers subjects had AP. The AP was more common in male diabetics than female (p=0.383, and in female smokers more than male (p=0.44. Only 42.2% of male and 57.7% of female teeth had adequate root canal treatment. Conclusions: Apical periodontitis was significantly related to diabetes, smoking, and inadequate endodontic treatment.

  16. Light microscopic study of periapical lesions associated with asymptomatic apical periodontitis.

    Science.gov (United States)

    Kabak, S L; Kabak, Y S; Anischenko, S L

    2005-04-01

    The purpose of the study has been to evaluate the degree of chronic inflammation in tissues surrounding the apex of the tooth root in patients with apical periodontitis in the remission phase. The material included 37 apical granulomas and radicular cysts obtained as a result of apiectomy, and 20 teeth which were removed together with the focus of the periapical inflammation. Routine histological techniques, as well as the immunofluorescent and immuno-chemical methods were used to examine the material. Despite the absence of clinical symptoms in 23 of 57 cases, the morphological signs of chronic inflammation were observed in the apical area of the tooth root. Morphological signs of viral invasion of epithelial and stromal cells in the radicular cyst wall were revealed in six cases. The presence of the virus of Herpes simplex I in epithelial cells (five cases) and adenoviral invasion (one case) was confirmed by immuno-fluorescent and immuno-chemical methods. Histological examination often reveals morphological signs of an active inflammatory process in the periapical tissues of patients treated during clinical remission. In our opinion, the presence of viruses in the epithelial cells of the radicular cyst may contribute to the persistence of the active stage of the inflammatory process.

  17. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis.

    Science.gov (United States)

    Estrela, Carlos; Bueno, Mike Reis; Leles, Cláudio Rodrigues; Azevedo, Bruno; Azevedo, José Ribamar

    2008-03-01

    The aim of this study was to evaluate the accuracy of imaging methods for detection of apical periodontitis (AP). Imaging records from a consecutive sample of 888 imaging exams of patients with endodontic infection (1508 teeth), including cone beam computed tomography (CBCT) and panoramic and periapical radiographs, were selected. Sensitivity, specificity, predictive values, and accuracy of periapical and panoramic radiographs were calculated. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic accuracy of the panoramic and periapical images. Prevalence of AP was significantly higher with CBCT. Overall sensitivity was 0.55 and 0.28 for periapical and panoramic radiographs, respectively. ROC curves and area under curve (AUC) with periapical radiography showed a high accuracy for the cutoff value of 5 for both periapical (AUC, 0.90) and panoramic (AUC, 0.84) radiographs. AP was correctly identified with conventional methods when showed advanced status. CBCT was proved to be accurate to identify AP.

  18. Levels of oxidative stress biomarkers and bone resorption regulators in apical periodontitis lesions infected by Epstein-Barr virus.

    Science.gov (United States)

    Jakovljevic, A; Andric, M; Nikolic, N; Coric, V; Krezovic, S; Carkic, J; Knezevic, A; Beljic-Ivanovic, K; Pljesa-Ercegovac, M; Miletic, M; Soldatovic, I; Radosavljevic, T; Jovanovic, T; Simic, T; Ivanovic, V; Milasin, J

    2018-01-09

    To investigate whether apical periodontitis lesions infected by Epstein-Barr virus (EBV) exhibit higher levels of oxidative stress biomarkers [8-hydroxydeoxyguanosine (8-OHdG) and oxidized glutathione (GSSG)] and bone resorption regulators [receptor activator of nuclear factor (NF-κB) ligand (RANKL) and osteoprotegerin (OPG)] compared to EBV-negative periapical lesions and healthy pulp tissues. The experimental group consisted of 30 EBV-positive and 30 EBV-negative periapical lesions collected in conjunction with apicoectomy. The pulp tissues of 20 impacted third molars were used as healthy controls. The qualitative and quantitative analysis of EBV was performed by nested and real-time polymerase chain reaction (PCR), respectively. The levels of RANKL and OPG were analysed by reverse transcriptase real-time PCR. The levels of 8-OHdG and GSSG were determined by enzyme-linked immunosorbent assay (ELISA). Mann-Whitney U-test and Spearman's correlation were used for statistical analysis. The levels of RANKL, OPG, 8-OHdG and GSSG were significantly higher in apical periodontitis lesions compared to healthy pulp controls (P = 0.001, P < 0.001, P < 0.001 and P < 0.05, respectively). RANKL and OPG mRNA expression was significantly higher in EBV-positive compared to EBV-negative periapical lesions (P < 0.05). There was no significant correlation between EBV copy numbers and levels of RANKL, OPG, 8OH-dG and GSSG in apical periodontitis. Levels of bone resorption regulators and oxidative stress biomarkers were increased in apical periodontitis compared to healthy pulp tissues. EBV-positive periapical lesions exhibited higher levels of RANKL and OPG compared to EBV-negative periapical lesions. EBV may contribute to progression of apical periodontitis via enhanced production of bone resorption regulators. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  19. Influence of intracanal post on apical periodontitis identified by cone-beam computed tomography

    International Nuclear Information System (INIS)

    Estrela, Carlos; Porto, Olavo Cesar Lyra; Rodrigues, Cleomar Donizeth; Bueno, Mike Reis; Pecora, Jesus Djalma

    2009-01-01

    The determination of the success of endodontic treatment has been often discussed based on outcome obtained by periapical radiography. The aim of this study was to verify the influence of intracanal post on apical periodontitis detected by cone-beam computed tomography (CBCT). A consecutive sample of 1020 images (periapical radiographs and CBCT scans) taken from 619 patients (245 men; mean age, 50.1 years) between February 2008 and September 2009 were used in this study. Presence and intracanal post length (short, medium and long) were associated with apical periodontitis (AP). Chi-square test was used for statistical analyses. Significance level was set at p<0.01. The kappa value was used to assess examiner variability. From a total of 591 intracanal posts, AP was observed in 15.06%, 18.78% and 7.95% using periapical radiographs, into the different lengths, short, medium and long, respectively (p=0.466). Considering the same posts length it was verified AP in 24.20%, 26.40% and 11.84% observed by CBCT scans, respectively (p=0.154). From a total of 1,020 teeth used in this study, AP was detected in 397 (38.92%) by periapical radiography and in 614 (60.19%) by CBCT scans (p<0.001). The distribution of intracanal posts in different dental groups showed higher prevalence in maxillary anterior teeth (54.79%). Intracanal posts lengths did not influenced AP. AP was detected more frequently when CBCT method was used. (author)

  20. Influence of intracanal post on apical periodontitis identified by cone-beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Estrela, Carlos; Porto, Olavo Cesar Lyra; Rodrigues, Cleomar Donizeth [Federal University of Goias (UFG), Goiania, GO (Brazil). Dental School; Bueno, Mike Reis [University of Cuiaba (UNIC), MT (Brazil). Dental School; Pecora, Jesus Djalma, E-mail: estrela3@terra.com.b [University of Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Dental School

    2009-07-01

    The determination of the success of endodontic treatment has been often discussed based on outcome obtained by periapical radiography. The aim of this study was to verify the influence of intracanal post on apical periodontitis detected by cone-beam computed tomography (CBCT). A consecutive sample of 1020 images (periapical radiographs and CBCT scans) taken from 619 patients (245 men; mean age, 50.1 years) between February 2008 and September 2009 were used in this study. Presence and intracanal post length (short, medium and long) were associated with apical periodontitis (AP). Chi-square test was used for statistical analyses. Significance level was set at p<0.01. The kappa value was used to assess examiner variability. From a total of 591 intracanal posts, AP was observed in 15.06%, 18.78% and 7.95% using periapical radiographs, into the different lengths, short, medium and long, respectively (p=0.466). Considering the same posts length it was verified AP in 24.20%, 26.40% and 11.84% observed by CBCT scans, respectively (p=0.154). From a total of 1,020 teeth used in this study, AP was detected in 397 (38.92%) by periapical radiography and in 614 (60.19%) by CBCT scans (p<0.001). The distribution of intracanal posts in different dental groups showed higher prevalence in maxillary anterior teeth (54.79%). Intracanal posts lengths did not influenced AP. AP was detected more frequently when CBCT method was used. (author)

  1. Immunolocalization of matrix metalloproteinases-2 and -9 during apical periodontitis development.

    Science.gov (United States)

    Corotti, Mauro V; Zambuzzi, Willian F; Paiva, Katiúcia B S; Menezes, Renato; Pinto, Lidiane C; Lara, Vanessa S; Granjeiro, José M

    2009-08-01

    The objective of this study was to determine the expression of matrix metalloproteinase-2 (MMP-2) and -9 (MMP-9) during apical periodontitis development. Using an experimental design of induced periapical lesions in rats and immunohistochemistry assay as investigative tool, the MMP-2 and MMP-9 expression and distribution were evaluated at 3, 7, 14, 21, 30, 60 and 90 days after coronary access and pulp exposure of the first left mandibular molar to the oral environment. Two blind observers scored the immunoreactivity. A semi-quantitative analysis was performed. Except at day 3, MMP-2 and MMP-9 immunostaining was observed in all experimental periods. The MMP-2 (p=0.004) and MMP-9 (p=0.005) immunostaining was higher in the period between 7 and 21 days. They were mainly observed in cells surrounding the apical foramen and adjacent periapical areas. Cells into the hypercementosis areas were strongly stained while both osteoblasts and osteoclasts presented discrete staining along of this study. No staining was observed on epithelial walls. At 30, 60 and 90 days, the subjacent connective tissue presented intense MMP-2 and MMP-9 immunostaining in mononuclear cells (suggestive of fibroblasts, macrophages, infiltrating neutrophils and lymphocytes). The results observed in this study suggest that MMP-2 and MMP-9 play a critical role in the development of inflammatory periapical lesions, probably involved in the extracellular matrix (ECM) degradation during the initial phase of the lesion development.

  2. 18F-FDG accumulation in the oral cavity is associated with periodontal disease and apical periodontitis. An initial demonstration on PET/CT

    International Nuclear Information System (INIS)

    Shimamoto, Hiroaki; Kakimoto, Naoya; Murakami, Shumei; Furukawa, Souhei; Tatsumi, Mitsuaki; Shimosegawa, Eku; Hatazawa, Jun; Hamada, Seiki

    2008-01-01

    The objective of this study was to prospectively investigate the relationship between high accumulation of 2-deoxy-2-[ 18 F] fluoro-D-glucose (FDG) in the oral cavity and dental infections on positron emission tomography/computed tomography (PET/CT). FDG-PET/CT scans of 103 patients who underwent a health screening were evaluated. The dental examination was performed prior to each PET/CT scan, and dental infections were assessed. Dental infections were classified into six blocks. The severity of dental caries was classified into five grades, and periodontal disease and apical periodontitis were classified into three grades. Two radiologists classified the PET images in the same manner as the dental examination. They evaluated the intensity of FDG uptake by a four-point visual PET image score for each block. The comparison of the dental examination, as a gold standard, and the visual PET image score was performed on a patient or block basis. On a patient-based analysis, 21 of 103 patients (20.4%) showed PET positive findings in the oral cavity; 18 of the 21 patients (85.7%) had dental infections. On a block-based analysis, 25 of 605 blocks (4.1%) showed PET positive findings in the oral cavity; 22 of the 25 blocks (88.0%) had dental infections. On a detailed block-based analysis, a significant difference was observed between the presence of periodontal disease, or apical periodontitis and the positivity of the visual PET image findings (P<0.01). Their severity correlated with the visual PET image score (P<0.05). Periodontal disease or apical periodontitis, but not dental caries, caused FDG accumulation in the oral cavity. This finding should be taken into account when a head and neck FDG-PET study is interpreted. (author)

  3. Accuracy of cone-beam computed tomography and periapical radiography in apical periodontitis diagnosis.

    Science.gov (United States)

    López, Fernanda Ullmann; Kopper, Patrícia Maria Poli; Cucco, Carolina; Della Bona, Alvaro; de Figueiredo, José Antônio Poli; Vier-Pelisser, Fabiana Vieira

    2014-12-01

    This study aimed to investigate the correlation and the agreement between periapical radiography (PR) and cone-beam computed tomography (CBCT) correlating to histologic findings in the diagnosis of apical periodontitis (AP). One hundred thirty-four premolar root canals from 10 dogs were treated after AP induction. Four months later, the animals were killed, and standard digital PRs were obtained. The area of AP was measured by using ImageJ software. CBCT (i-CAT) images from each arch were obtained, and AP area and volume were measured by using Osiri-X software. The apical inflammatory infiltrate was evaluated under light microscopy. The correlation between imaging methods was evaluated by using the Pearson coefficient. The Bland-Altman method was used to assess the agreement between PR and CBCT data. The Spearman coefficient was used to correlate the imaging data and histologic findings. Despite a strong correlation between PR and CBCT areas, the agreement limits were very broad (95% limits of agreement, 0.19-1.08). PR only measured, on average, 63% of CBCT values. Although there was a strong correlation between PR area and CBCT volume, the Bland-Altman method suggests that the larger the CBCT volume, the more underestimated the PR value. When APs had a volume smaller than 6 mm(3), the PR estimation of CBCT data was unpredictable. A positive correlation was found for PR area, CBCT area, CBCT volume, and histology data. The diagnosis of AP based on PR data is clinically limited, and it should not be used for scientific investigations. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Calcium-enriched mixture pulpotomy of a human permanent molar with irreversible pulpitis and condensing apical periodontitis

    Science.gov (United States)

    Asgary, Saeed

    2011-01-01

    This case report describes a pulpotomy treatment of a permanent mature molar tooth with established irreversible pulpitis and condensing apical periodontitis, using calcium-enriched mixture (CEM) cement. Clinical examination revealed that the first right lower molar had a large carious lesion with history of spontaneous/lingering pain; radiographic examination showed condensing apical periodontitis. Pulpotomy was opted as the treatment; cervical pulpotomy was carried out. Following hemostasis, the radicular pulp stumps were covered with ~2-mm-thick layer of the prepared CEM cement; the tooth was restored with amalgam. Two-year follow-up showed that the treated tooth had been symptomless, and there were no clinical signs/symptoms of either inflammation or infection. Radiographically, the periradicular lesion was completely healed with reconstruction of bone structures to normal appearance; the root canals were not calcified. According to chemical, physical, and biological properties of the CEM cement, this novel biomaterial may be suitable for endodontic treatment. PMID:21691516

  5. Quantification of cultivable bacteria and endotoxin in post-treatment apical periodontitis before and after chemo-mechanical preparation.

    Science.gov (United States)

    Endo, M S; Martinho, F C; Zaia, A A; Ferraz, C C R; Almeida, J F A; Gomes, B P F A

    2012-10-01

    This clinical study was conducted to quantify cultivable bacteria and endotoxin in root canals with post-treatment apical periodontitis by correlating their levels with clinical features and to evaluate the effect of chemo-mechanical preparation (CMP) with 2 % chlorhexidine gel + 17 % EDTA on bacterial and endotoxin removal/elimination. Moreover, target strict Gram-negative anaerobic bacteria were investigated by polymerase chain reaction (PCR). Fifteen teeth with post-treatment apical periodontitis were sampled before (s1) and after (s2) CMP. Culture techniques determined the number of colony-forming units (CFU). PCR (16S rDNA) and limulus amebocyte lysate (LAL) assay were used for bacterial and endotoxin detection, respectively. Prevotella nigrescens (4/15), Prevotella intermedia (2/15), and Tannerella forsythia (2/15) were the most frequently detected species. Endotoxin was recovered in 100 % of the samples. At s1, bacteria and endotoxin were detected at a median value of 5.14 × 10(3) CFU/mL and 3.96 EU/mL, respectively. Higher levels of endotoxin were related to a larger size of radiolucent area (>5 mm) (p area in the periapical region. Moreover, CMP was effective in reducing both bacterial and endotoxin contents in post-treatment apical periodontitis.

  6. Influence of cigarette smoking on synthesis of eicosanoids, isoprostanes and lipoxygenase metabolites in apical periodontitis.

    Science.gov (United States)

    Eder, Andreas; Koegl, Elke; von Duvillard, Serge P; Sinzinger, Helmut; Berent, Robert

    2012-08-01

    Arachidonic acid (AA) is metabolized to eicosanoids and isoprostanes (IPs) via different pathways. The presence of granuloma in apical periodontitis (AP) is linked with inflammation and the synthesis of metabolites of AA. We investigated the conversion rate of (14)C labelled arachidonic acid ((14)C-AA), the lipoxygenases (LOX) products and the endogenous synthesis of eicosanoids and IPs in extracted granuloma. Furthermore, we assessed if there are markers for bone destruction and the influence of cigarette smoking. In 46 patients with symptoms and corresponding radiological signs of AP, teeth were extracted including the periapical granuloma. The endogenous synthesis of eicosanoids and IPs, the conversion rate of (14)C-AA and LOX products in extracted granuloma were analyzed. We found that smoking increases significantly the synthesis of IPs and LOX-metabolites in granuloma. Furthermore, smoking may have contributed to significant differences in qualitative and quantitative profile of eicosanoids, IPs and the conversion rate of (14)C-AA independent of the size of the granuloma. Our data demonstrate that in smokers with granuloma due to AP products of lipid peroxidation as 8-iso-PGF(2α) and products of the LOX-pathway are increased at the expense of cyclooxygenase products. The size of granuloma did not influence the amount of synthesized eicosanoids, IPs or LOX-metabolites out of (14)C-AA whereas cigarette smoking was a significantly influencing and modifiable risk factor. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Retrospective analysis of nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions in a population of Taiwanese patients.

    Science.gov (United States)

    Huang, Hsun-Yu; Chen, Yuk-Kwan; Ko, Edward Cheng-Chuan; Chuang, Fu-Hsiung; Chen, Ping-Ho; Chen, Ching-Yi; Wang, Wen-Chen

    2017-07-01

    We aimed to evaluate nonendodontic periapical lesions clinically misdiagnosed as endodontic periapical pathoses in a population of Taiwanese patients. Cases (2000-2014) of histopathological diagnoses of nonendodontic periapical lesions were retrieved from all cases with a clinical diagnosis of radicular cyst, apical granuloma, or apical periodontitis in the institution. These cases were regarded as misdiagnosed nonendodontic periapical lesions, of which the types and frequencies, in addition to the demographic data, were determined. Four thousand and four specimens were clinically diagnosed as endodontically associated pathoses, of which 118 cases (2.95%) received a histopathological diagnosis of a nonendodontic pathologic entity, the most frequent lesion being keratocystic odontogenic tumor (KCOT, n = 38, 32.20%), followed by fibro-osseous lesion (n = 18, 15.25%), and dentigerous cyst (n = 13, 11.02%). Nine malignant lesions in the periapical area [squamous cell carcinoma (n = 7, 5.93%), adenoid cystic carcinoma (n = 1, 0.85%), and Langerhans cell histiocytosis (n = 1, 0.85%)] were also noted. A wide variety of histopathological diagnoses, including benign odontogenic and non-odontogenic cystic and tumorous lesions and infectious diseases, as well as malignant lesions, was noted in these 118 cases of nonendodontic periapical lesions. Squamous cell carcinoma was the most predominant malignancy of nonendodontic periapical lesions misdiagnosed as apical periodontitis lesions from imaging examination overlooking the clinical findings. The current data form a useful basis for clinicopathological investigation and educational teaching regarding nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions.

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

    Science.gov (United States)

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

    2016-03-01

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

  9. Myocardial scarring on cardiovascular magnetic resonance in asymptomatic or minimally symptomatic patients with “pure” apical hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Kim Kyung-Hee

    2012-07-01

    Full Text Available Abstract Background Late gadolinium enhancement (LGE cardiovascular magnetic resonance (CMR enables state-of-the-art in vivo evaluations of myocardial fibrosis. Although LGE patterns have been well described in asymmetrical septal hypertrophy, conflicting results have been reported regarding the characteristics of LGE in apical hypertrophic cardiomyopathy (ApHCM. This study was undertaken to determine 1 the frequency and distribution of LGE and 2 its prognostic implication in ApHCM. Methods Forty patients with asymptomatic or minimally symptomatic pure ApHCM (age, 60.2 ± 10.4 years, 31 men were prospectively enrolled. LGE images were acquired using the inversion recovery segmented spoiled-gradient echo and phase-sensitive inversion recovery sequence, and analyzed using a 17-segment model. Summing the planimetered LGE areas in all short axis slices yielded the total volume of late enhancement, which was subsequently presented as a proportion of total LV myocardium (% LGE. Results Mean maximal apical wall thickness was 17.9±2.3mm, and mean left ventricular (LV ejection fraction was 67.7 ± 8.0%. All but one patient presented with electrocardiographic negative T wave inversion in anterolateral leads, with a mean maximum negative T wave of 7.2 ± 4.7mm. Nine patients (22.5% had giant negative T waves, defined as the amplitude of ≥10mm, in electrocardiogram. LGE was detected in 130 segments of 30 patients (75.0%, occupying 4.9 ± 5.5% of LV myocardium. LGE was mainly detected at the junction between left and right ventricles in 12 (30% and at the apex in 28 (70%, although LGE-positive areas were widely distributed, and not limited to the apex. Focal LGE at the non-hypertrophic LV segments was found in some ApHCM patients, even without LGE of hypertrophied apical segments. Over the 2-year follow-up, there was no one achieving the study end-point, defined as all-cause death, sudden cardiac death and hospitalization for heart failure

  10. Distribution of macrophages and plasma cells in apical periodontitis and their relationship with clinical and image data.

    Science.gov (United States)

    Azeredo, Stéphane V; Brasil, Sabrina C; Antunes, Henrique; Marques, Fábio V; Pires, Fábio R; Armada, Luciana

    2017-09-01

    Macrophages and plasma cells play a key role in the regulation of innate and adaptive immunity. The aim of this study was to assess the presence of these cells in apical periodontitis and their distribution comparing with clinical and image data. Thirty-three lesions were selected and divided in two groups (17 periapical cysts and 16 periapical granulomas). Immunoreactions using anti-CD68 and anti-CD138 antibodies were carried out; image analysis was performed with an optical microscope and 5 high-power fields from each slide were evaluated leading to an average score of immunoexpression. This mean score was compared between the two groups and correlated with the clinical and image data. There was no statistically significant difference ( p >0.05) for the mean average score of CD68+ macrophages and CD138+ plasma cells when comparing the two groups (cysts x granulomas) and the specimens included in each specific group. No statistically significant differences ( p >0.05) were also observed when comparing the average scores with clinical and image data. The presence of CD68+ macrophages and CD138+ plasma cells was similar in periapical cysts and granulomas and the presence of these cells did not correlate with clinical and image data from both groups. Key words: Macrophages, plasma cells, apical periodontitis, periapical granuloma, periapical cyst.

  11. Accuracy of periapical radiography and cone-beam computed tomography scans in diagnosing apical periodontitis using histopathological findings as a gold standard

    NARCIS (Netherlands)

    de Paula-Silva, F.W.G.; Wu, M.K.; Leonardo, M.R.; da Silva, L.A.B.; Wesselink, P.R.

    2009-01-01

    Introduction: The aim of this study was to evaluate the accuracy of two imaging methods in diagnosing apical periodontitis (AP) using histopathological findings as a gold standard. Methods: The periapex of 83 treated or untreated roots of dogs' teeth was examined using periapical radiography (PR),

  12. Accuracy of single and parallax film and digital periapical radiographs in diagnosing apical periodontitis - a cadaver study.

    Science.gov (United States)

    Kanagasingam, S; Hussaini, H M; Soo, I; Baharin, S; Ashar, A; Patel, S

    2017-05-01

    To compare the accuracy of film and digital periapical radiography (PR) in detecting apical periodontitis (AP) using histopathological findings as a reference standard. Jaw sections containing 67 teeth (86 roots) were collected from nine fresh, unclaimed bodies that were due for cremation. Imaging was carried out to detect AP lesions using film and digital PR with a centred view (FP and DP groups); film and digital PR combining central with 10˚ mesially and distally angled (parallax) views (FPS and DPS groups). All specimens underwent histopathological examination to confirm the diagnosis of AP. Sensitivity, specificity and predictive values of PR were analysed using rater mean (n = 5). Receiver operating characteristics (ROC) analysis was carried out. Sensitivity was 0.16, 0.37, 0.27 and 0.38 for FP, FPS, DP and DPS, respectively. Both FP and FPS had specificity and positive predictive values of 1.0, whilst DP and DPS had specificity and positive predictive values of 0.99. Negative predictive value was 0.36, 0.43, 0.39 and 0.44 for FP, FPS, DP and DPS, respectively. Area under the curve (AUC) for the various imaging methods was 0.562 (FP), 0.629 (DP), 0.685 (FPS), 0.6880 (DPS). The diagnostic accuracy of single digital periapical radiography was significantly better than single film periapical radiography. The inclusion of two additional horizontal (parallax) angulated periapical radiograph images (mesial and distal horizontal angulations) significantly improved detection of apical periodontitis. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  13. Outcome of Er,Cr:YSGG laser-assisted treatment of teeth with apical periodontitis: a blind randomized clinical trial.

    Science.gov (United States)

    Martins, Miguel R; Carvalho, Manuel F; Pina-Vaz, Irene; Capelas, Jose A; Martins, Miguel A; Gutknecht, Norbert

    2014-01-01

    As clinical studies conducted to explore the safety and efficacy of new procedures are considered an important focus in endodontic research, the aim of this controlled clinical study was to compare a laser-assisted endodontic treatment using an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser and radial firing tips (RFT) versus the conventional use of 3% sodium hypochlorite and interim calcium hydroxide paste, in teeth with chronic apical periodontitis. Forty-three single-rooted and premolar teeth were randomly assigned. In group 1, teeth were prepared and irrigated with 3% sodium hypochlorite and calcium hydroxide inter-appointment dressing was applied; in group 2 teeth were prepared with saline solution and irradiated with Er,Cr:YSGG laser using RFT2 (140 μs, 37.5 mJ, 20 Hz) and RFT3 (140 μs, 62.5 mJ, 20 Hz) at the first and second appointments, respectively, four times each, moving at 2 mm/sec(-1) from apical to coronal. The primary outcome measure was change in apical bone density at 12 months, using the periapical index (PAI) for blind radiographic assessment. Thirty teeth were examined and subjected to statistical analysis, 12 in the control group and 18 in the test group. There were two treatment failures in the control group that were not included for analysis; both groups exhibited statistically significant decreases in PAI scores. The present findings suggest that for single-rooted and premolar teeth, this laser-assisted protocol can achieve predictable endodontic outcomes, comparable to conventional strategies in 1 year of follow-up.

  14. Investigation of cultivable bacteria isolated from longstanding retreatment-resistant lesions of teeth with apical periodontitis.

    Science.gov (United States)

    Signoretti, Fernanda G C; Gomes, Brenda P F A; Montagner, Francisco; Jacinto, Rogério C

    2013-10-01

    The objective of this research was to investigate the presence of viable bacteria in tissue samples from persistent apical lesions and to correlate the microbiological findings with the histopathological diagnosis of the lesion. Twenty persistent apical lesions associated with well-performed endodontic retreatment were collected. Tissue samples were processed through culture techniques including serial dilution, plating, aerobic and anaerobic incubation, and biochemical tests for microbial identification followed by histopathological diagnosis. Cysts were more frequently diagnosed (13/20). Strict anaerobic species predominated in both cysts (80.4% of the species detected) and granulomas (65% of the species detected). Viable gram-positive bacteria were frequently recovered from apical lesions (cysts = 70.6%, granulomas = 84.4%). Gemella morbillorum and Propionibacterium acnes were the most frequently recovered species from cysts and granulomas, respectively. At least 1 gram-positive bacterial species was present in almost every sample (cysts = 12/13, granulomas = 7/7). No significant correlation was found between histologic findings and bacterial species. In conclusion, although cysts were more frequent than granulomas in cases of failure of endodontic retreatment, bacteria were isolated from both types of lesions, with a predominance of gram-positive species, suggesting that these species can survive outside the root canal and might be related to the persistence of the pathological process even after accurate endodontic retreatment. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  15. Histopathological, Microbiological, and Radiographic Analysis of Antimicrobial Photodynamic Therapy for the Treatment of Teeth with Apical Periodontitis: A Study in Rats' Molars.

    Science.gov (United States)

    Trindade, Alessandra Cesar; de Figueiredo, José Antônio Poli; de Oliveira, Sílvia Dias; Barth Junior, Valdir Cristóvão; Gallo, Stephanie Wagner; Follmann, Carina; Wolle, Carlos Frederico Brilhante; Steier, Liviu; Morgental, Renata Dornelles; Weber, João Batista Blessmann

    2017-07-01

    The aim of this study was to evaluate in vivo, by histological and radiographic analysis, the response of apical tissues of rats' teeth with experimentally induced apical periodontitis, after one- and two-session endodontic treatment with and without photodynamic therapy (PDT). A microbiological analysis was also performed to verify bacterial reduction after each treatment. Studies carried out in recent years highlighted the antibacterial potential of PDT when associated with conventional endodontic therapy in vitro. Although the antimicrobial effect of PDT is well-established, tissue response to PDT in teeth with apical periodontitis lacks studies. Thirty-two rats' root canals were assigned to four groups: one session/PDT-[chemomechanical preparation (CMP)+root canal filling (RCF)]; two sessions/PDT- [CMP+calcium hydroxide (CH) for 14 days+RCF]; one session/PDT+ [CMP+PDT+RCF], and two sessions/PDT+ [CMP+PDT+CH for 14 days+RCF]. For microbiological evaluation, samples were collected before and after proposed treatments. For radiographic and histological analysis, the animals were euthanized after 28 days and the mandibles surgically removed. PDT associated with conventional endodontic therapy was able to promote significant bacterial reduction in root canals with induced apical periodontitis, but this reduction was not significantly different to conventional endodontic therapy alone. Although radiographic evaluation showed no significant differences, histological analysis showed lower scores for neutrophils/eosinophils in PDT-treated groups and macrophages/giant cells in CH groups. The use of low-level laser as light source did not promote major improvement on radiographic and histological repair, but since the number of inflammatory cells slightly decreased, it may optimize repair by modulating inflammatory process. PDT may be indicated as an adjunct to conventional endodontic therapy for teeth with apical periodontitis, in association with an interappointment

  16. Asociación entre niveles de TNF-α en fluido crevicular gingival de dientes con periodontitis apical asintomática Levels of TNF-α increase in gingival crevicular fluid of teeth with asymptomatic apical periodontitis

    Directory of Open Access Journals (Sweden)

    M Garrido Flores

    2011-12-01

    Full Text Available Introducción: Como consecuencia de necrosis pulpar séptica, el ingreso de productos bacterianos en el periápice induce la producción de citoquinas pro-inflamatorias como el Factor de Necrosis Tumoral (TNF- a, que entre otras funciones participa en la diferenciación y activación de los osteoclastos para inducir reabsorción ósea, fenómeno característico de la periodontitis apical asintomática (PAA. El fluido crevicular gingival (FCG ofrece un gran potencial como fuente de factores asociados con la actividad osteoclástica. El objetivo del presente estudio fue determinar los niveles de TNF- a en FCG de dientes con PAA y controles sanos contralaterales. Métodos: Se incluyeron 14 pacientes en la Clínica de Endodoncia de la Facultad de Odontología de la Universidad de Chile con diagnóstico clínico de PAA y se obtuvieron muestras de FCG con tiras de papel a partir de los dientes afectados y sanos contralaterales por un periodo estandarizado de 30 segundos. Se determinaron las concentraciones de proteínas totales mediante el método del ácido bisciconitico y los niveles de TNF- a, mediante ensayo ELISA. Los datos se analizaron con Test-t pareado utilizando el programa StataV11. Resultados: Se detectaron niveles de TNF- a significativamente mayores en el FCG de dientes con PAA estandarizados, tanto por 30 segundos de toma de muestra como por mg de proteínas totales. Conclusiones: Este estudio provee evidencia preliminar de que los niveles de TNF- a en el FCG reflejan la presencia de PAA y podría ser de utilidad como complemento al diagnóstico clínico y monitoreo del estado de salud o enfermedad de los tejidos perirradiculares.Introduction: As a consequence of septic pulp necrosis, the entry of bacterial products into periapical tissues induces the release of pro-inflammatory cytokines, such as the tumor necrosis factor (TNF- a. This pleiotropic cytokine is involved in the differentiation and activation of osteoclasts to induce bone

  17. Histologic characterization of engineered tissues in the canal space of closed-apex teeth with apical periodontitis.

    Science.gov (United States)

    Gomes-Filho, João Eduardo; Duarte, Paulo Carvalho Tobias; Ervolino, Edilson; Mogami Bomfim, Suely Regina; Xavier Abimussi, Caio José; Mota da Silva Santos, Ludmilla; Lodi, Carolina Simonetti; Penha De Oliveira, Sandra Helena; Dezan, Elói; Cintra, Luciano Tavares Angelo

    2013-12-01

    The aim of this study was to investigate the capacity of endodontic regenerative procedures combining an induced blood clot, platelet-rich plasma (PRP), and bone marrow aspirate (BMA) to regenerate dental pulp in canine closed-apex necrotic teeth. Apical periodontitis was induced in 20 upper and lower premolars of 2 dogs. After biomechanical preparation, enlargement to a #60 file, and disinfection with a triantibiotic paste for 28 days, the roots were randomly assigned to 4 treatment groups: blood clot (BC), BC + PRP gel, BC + BMA gel, and BC + BMA/PRP gel. Negative controls were also included. After a 3-month follow-up period, the animals were killed. Histologic analysis showed the presence of newly formed vital tissues (connective, cement-like, and bone-like tissue) in 23 of the 32 treated roots (71.87%). There was no statistically significant difference between the treatment groups. New vital tissues were formed and characterized as connective, cementum-like, or bone-like, but not as pulp-like tissue; PRP and/or BMA did not improve the tissue ingrowth. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  18. Bacterial quantification in teeth with apical periodontitis related to instrumentation and different intracanal medications: a randomized clinical trial.

    Science.gov (United States)

    Manzur, Aldo; González, Ana Maria; Pozos, Amaury; Silva-Herzog, Daniel; Friedman, Shimon

    2007-02-01

    The antibacterial efficacy of intracanal medication with calcium hydroxide [Ca(OH)2], 2% chlorhexidine gel (CHX), and a combination of both [Ca(OH)2/CHX] was assessed in teeth with chronic apical periodontitis. Thirty-three canals were instrumented, randomly divided into three groups, and medicated with either Ca(OH)2, CHX, or Ca(OH)2/CHX. Bacteriological samples obtained from the operative field and the root canals before (S1) and after instrumentation (S2) in the first treatment session, and after medication (S3) in the second session 1 week later, were assessed for bacterial growth, observed by turbidity and in agar plates, and viable colony-forming unit (CFU) counts. Bacterial growth and CFU counts decreased significantly from S1 to S2 (Mann-Whitney, p<0.05). Differences in growth and counts between S2 to S3 were not statistically significant for all three intracanal medication groups. It was concluded that the antibacterial efficacy of Ca(OH)2, CHX, and Ca(OH)2/CHX was comparable.

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

    Science.gov (United States)

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

    2010-08-01

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

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

    OpenAIRE

    Mustafa A. Al Attas, DDS; Hadeel Y. Edrees, PhD; Aya M.N. Sammani, MSc; Ahmad A. Madarati, PhD

    2017-01-01

    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 a...

  1. The Antibacterial Effect of Nd:YAG Laser Treatment of Teeth with Apical Periodontitis: A Randomized Controlled Trial.

    Science.gov (United States)

    Granevik Lindström, Maria; Wolf, Eva; Fransson, Helena

    2017-06-01

    The aim of this blind, in vivo, randomized controlled trial was to evaluate the antibacterial effect of Nd:YAG laser irradiation in endodontic treatment of single-rooted teeth with apical periodontitis. The hypothesis was that mechanical enlargement of the root canal and Nd:YAG laser irradiation would yield more negative bacterial samples than conventional treatment. Forty-one patients (45 teeth) were allocated to the laser (n = 22) or control (n = 23) group. The teeth in the laser group were instrumented, irrigated with saline, and irradiated with Nd:YAG laser according to a standard protocol. The teeth in the control group were similarly instrumented but irrigated with 1% unbuffered sodium hypochlorite and 15% EDTA solution. Bacterial samples were taken before and after treatment, blinded, and immediately sent for culturing and analysis. The initial bacterial samples were positive in 20 of 22 teeth in the laser group and 18 of 23 (P = .414) in the control group. After the initial treatment, negative bacterial samples were found in 11 teeth in the laser group and 13 (P = .768) in the control group. After 2 to 4 days with no antibacterial dressing in the root canals, 5 teeth in the laser group and 9 (P = .337) in the control group yielded negative bacterial samples. After intervention, neither the test group nor the control group yielded predictable negative bacterial samples. Thus, the results failed to verify the hypothesis that Nd:YAG laser irradiation would yield significantly more negative bacterial samples than conventional irrigation with 1% unbuffered sodium hypochlorite solution. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Endodontic retreatment of dens invaginatus presenting with gutta-percha overfilling at the attached gingiva and chronic apical periodontitis: unusual clinical report.

    Science.gov (United States)

    Robazza, Carlos Roberto Colombo; Alves e Motta, Julio Cesar; de Carli, Marina Lara; de Oliveira Pedreira, Fernanda Rafaelly; Hanemann, Joao Adolfo Costa

    2013-05-01

    This work describes the retreatment of an unusual case of dens invaginatus with gutta-percha overfilling at the gingival mucosa and chronic apical periodontitis in a 34-year-old woman. Initial periapical radiograph showed the presence of type II dens invaginatus with poor quality obturation, root perforation and chronic apical periodontitis of tooth 22. Dens invaginatus is a tooth malformation caused by infolding of the dental papilla during tooth development. This anomaly has been associated with increased prevalence of pulpal and periapical diseases. Conventional endodontic retreatment was performed using rotary files and calcium hydroxide paste as intracanal dressing. After 7 days, root canal was filled with guttapercha points and Sealapex® sealer. Obturation was radiographically followed and, after 3 years, absence of fistula and periapical radiolucency was observed, thus conventional endodontic therapy proved to be successful. Conventional endodontic retreatment of type II dens invaginatus has been successful for a 3-year period, showing a better treatment alternative. Conservative endodontic retreatment of dens invaginatus should be considered to promote periapical healing with complete reconstitution of bone and periodontal ligament regeneration without signs of recurrence over a period of 3 years. Moreover, it preserves the entire tooth.

  3. Cellular Profile and Expression of Immunologic Markers in Chronic Apical Periodontitis from HIV-infected Patients Undergoing Highly Active Antiretroviral Therapy.

    Science.gov (United States)

    Gama, Túlio Gustavo Veiga; Pires, Fabio Ramoa; Armada, Luciana; Gonçalves, Lucio Souza

    2016-06-01

    This study tested the hypothesis that the inflammatory cell profile (CD3-, CD4-, CD8-, CD20-, and CD68-positive cells) and the expression of immunologic markers (tumor necrosis factor α, interferon-γ, interleukin-6, and interleukin-18) in chronic apical periodontitis are the same between non-HIV-infected patients and HIV-infected patients undergoing highly active antiretroviral therapy (HAART). Thirty-four surgically excised chronic apical periodontitis lesions were sampled from 34 patients (17 HIV-infected and 17 non-HIV-infected). The lesions were extracted from teeth with no previous endodontic treatment. All HIV-infected patients were undergoing HAART. The specimens were submitted to histopathologic and immunohistochemical analyses by using an optical microscope. Immunoexpression was graded into 2 levels, focal to weak and moderate to strong. The χ(2), Fisher exact, and Mann-Whitney tests were used to analyze all significant differences between groups. Periapical cysts represented 70.6% and 52.9% of the lesions in the HIV-infected and non-HIV-infected groups, respectively; however, no statistically significant difference was observed (P = .481). There were no statistically significant differences between groups for the inflammatory cell profile and for any of the immunologic markers (P > .05). There are no statistically significant differences of the cellular profile and expression of immunologic markers in chronic apical periodontitis between non-HIV-infected patients and HIV-infected patients undergoing HAART. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Immune-Inflammatory Cell Profile and Receptor Activator of Nuclear Factor Kappa B Ligand/Osteoprotegerin Expression in Persistent Apical Periodontitis after Root Canal Retreatment Failure.

    Science.gov (United States)

    Estrela, Carlos; Decurcio, Daniel de Almeida; Silva, Júlio Almeida; Batista, Aline Carvalho; de Souza Lima, Nathália Caroline; de Freitas Silva, Brunno Santos; de Souza, João Antonio Chaves; Souza Costa, Carlos Alberto

    2016-03-01

    This study assessed the immune-inflammatory profile and the expression of bone resorption activators receptor activator of nuclear factor kappa B ligand (RANKL) and inhibitor osteoprotegerin (OPG) in apical periodontitis (n = 20) that persisted after root canal retreatment. Immunohistochemistry was used to characterize lymphocyte populations (CD3+, CD45RO+, CD8+, and FoxP3+ cells), macrophages (CD68+), RANKL+ and OPG+ cells in persistent apical periodontitis (PAP) and primary periapical lesions (PPLs). By using quantitative real-time polymerase chain reaction, the mRNA expression of RANKL and OPG in PAP and periodontal ligament from healthy teeth was comparatively analyzed. The data were analyzed by Mann-Whitney, Pearson χ2, and Wilcoxon tests (5% level). PAP showed an elevated number of FoxP3+ cells compared with PPL (P .05 for all comparisons). No differences in the RANKL, OPG, and immune-inflammatory cells were demonstrated when comparing PAP microscopically classified as cyst with those classified as granulomas (P > .05 for all comparisons). The assessment of mRNA expression revealed higher levels of RANKL and OPG in PAP compared with the periodontal ligament from healthy teeth (control) samples (P < .001). Also, a greater expression of RANKL in comparison with OPG was observed in PAP (P < .001). These findings indicate that PAP consists of biologically active lesions that demonstrate potential of bone resorption (higher expression of RANKL) and is characterized by an immune-inflammatory cell profile that suggests a suppressive and regulatory environment (higher number of FoxP3+ cells and lower number of macrophages) favorable to more chronic clinical behavior. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  5. Apical Periodontitis and Endodontic Treatment in Patients with Type II Diabetes Mellitus: Comparative Cross-sectional Survey.

    Science.gov (United States)

    Smadi, Leena

    2017-05-01

    The aims of this study were to investigate the prevalence of apical periodontitis (AP) in diabetes mellitus (DM) patients compared with nondiabetic patients and to examine the effect of glycemic control on the prevalence of AP. Radiographs of a group of DM patients were compared with those of a matched nondiabetic group to identify AP. The diabetic group was subdivided according to the level of glycemic control into two subgroups: A well-controlled DM and a poorly controlled DM. The periapical index score was used to assess the periapical status. All groups were compared in regard to the presence of AP lesions, the number of end-odontically treated teeth (ET), and the percentage of failure of endodontically treated teeth (AP/ET ratio). Statistical Package for the Social Sciences (SPSS version 20.0, Chicago, Illinois, USA) was used for all the analyses; p ≤ 0.05 was considered as statistically significant. The prevalence of AP was higher in diabetic group than in the nondiabetic group (13.5 vs 11.9% respectively). Diabetic group had more teeth with endodontic treatment ET compared with nondiabetic group (4.18 vs 1.82% respectively); this difference was statistically significant (p = 0.001) along with higher AP/ET ratio (27.7 vs 19.3 respectively). The poorly controlled DM group had a higher prevalence of AP lesions compared with the well-controlled DM group (18.29 vs 9.21 respectively). This difference was statistically significant (p = 0.001); they also had a higher percentage of ET (5.55 vs 3.13% respectively) and AP/ ET ratio (32.0 vs 21.8% respectively). This survey demonstrates a higher prevalence of AP in DM patients compared with nondiabetic group, with an increased prevalence of persistent chronic AP. Compared with a well-controlled diabetic group, a poor glycemic control may be associated with a higher prevalence of AP and increased rate of endodontic failures. Counseling diabetic patients, particularly those with poor glycemic control, about the risk of

  6. The Efficacy of Calcium Hydroxide Powder mixed with 0.2% Chlorhexidine Digluconate or mixed with Normal Saline as Intracanal Medicament in the Treatment of Apical Periodontitis.

    Science.gov (United States)

    Menakaya, Ifeoma N; Adegbulugbe, Ilemobade C; Oderinu, Olabisi H; Shaba, Olufemi P

    2015-08-01

    To compare the efficacy of calcium hydroxide powder mixed with 0.2% chlorhexidine digluconate or mixed with normal saline as intracanal medicament in the treatment of apical periodontitis. Subjects were 55 in number aged 17 to 60 years. Two-visit conventional root canal treatment was performed on 70 teeth. The teeth were divided by randomization (balloting) into two groups: control group and experimental group, each with 35 teeth treated with calcium hydroxide mixed with normal saline or with 0.2% chlorhexidine digluconate as intracanal medicament respectively. All treated teeth were evaluated clinically and radiographically for signs and symptom of periapical infection at specified periods postoperatively. Overall efficacy of medicament was rated based on quality guidelines for endodontic treatment by the European Society of Endodontology 2006. A postoperative favorable outcome of 97.1% in the control group and 94.3% in the experimental group was observed at 6-month review. This difference was not statistically significant (p > 0.05). The use of normal saline or 0.2% chlorhexidine digluconate to mix calcium hydroxide used as intracanal medicament during endodontic treatment resulted in high postoperative favorable outcomes. Efficacy of 0.2% chlorhexidine digluconate as a vehicle for mixing calcium hydroxide as an intracanal medicament in the treatment of apical periodontitis is comparable to the efficacy of calcium hydroxide mixed with normal saline.

  7. [Controversial matters of arrangement of dental assistance within the framework of healthcare system reform and ways to increase of efficiency of diagnosing destructive processes in apical periodont].

    Science.gov (United States)

    ZHero, N I

    2014-01-01

    In conditions of reform of primary level of medical sanitary assistance a tendency for decrease of availability of dental care for population has been revealed. Increase in number of complicated cases of typical dental diseases, inter alia, destructive affection of apical periodont. An examination of 347 patients with apical periodontitis has been held. For the purpose of improvement of differential diagnostics of radicular cysts and periapical granulomas as well as choice of adequate method of treatment postprocessing of digital dental roentgenograms has been used. 241 granulomas, 106 cysts (simplex and complex) and cystogranulomas--have been diagnosed. For improvement of visualization of destruction zone of alveolar bone possibilities of digital processing of image have been utilized. Postprocessing of digital roentgenograms significantly supplemented results of visual examination and excluded impact of subjective factor in composition of diagnostic conclusion. Upon results of examination of histograms of optical density of radiographic image of pathological zone signs of specific for granulomas, cysts and have been detected. Diagnostic conclusion coincides with results of pathomorphological study.

  8. 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 ...

  9. Comparison between one-session root canal treatment with aPDT and two-session treatment with calcium hydroxide-based antibacterial dressing, in dog's teeth with apical periodontitis.

    Science.gov (United States)

    Hidalgo, Lidia Regina da Costa; da Silva, Léa Assed Bezerra; Nelson-Filho, Paulo; da Silva, Raquel Assed Bezerra; de Carvalho, Fabrício Kitazono; Lucisano, Marília Pacífico; Novaes, Arthur Belem

    2016-09-01

    To evaluate one-session endodontic treatment with aPDT and two-session treatment with calcium hydroxide (CH)-based dressing in dog's teeth with apical periodontitis. After experimental induction of apical periodontitis, 48 teeth were randomly assigned to the following groups: groups OS/aPDT120d and OS/aPDT180d (one-session treatment with aPDT) and groups TS/CH120d and TS/CH180d (two-session treatment with CH-based dressing-control groups). The animals were euthanized after 120 and 180 days. After histotechnical processing, microscopic and radiographic analyses were performed. Data were analyzed by Kruskal-Wallis and Fisher's exact tests (α = 0.05). Groups TS/CHs presented repaired resorbed cemental areas, with collagen bundles and few inflammatory cells. In groups OS/aPDTs, the areas of cemental resorption were not repaired with reduced presence of cells and fibers. In the analysis of the apical closure, fluorescence microscopy and percentage of radiographic reduction of lesions, there was significant difference between groups TS/CH120d and OS/aPDT120d and between TS/CH180d and OS/aPDT180d (p session endodontic treatment using a CH-based dressing in teeth with apical periodontitis.

  10. Diagnostic accuracy of periapical radiography and cone beam computed tomography in detecting apical periodontitis using histopathological findings as a reference standard.

    Science.gov (United States)

    Kanagasingam, S; Lim, C X; Yong, C P; Mannocci, F; Patel, S

    2017-05-01

    To compare the diagnostic accuracy of periapical radiography (PR) and cone beam computed tomography (CBCT) in detecting apical periodontitis (AP) using histopathological findings as a reference standard. Jaw sections containing 67 teeth (86 roots) were collected from unclaimed bodies due for cremation. Imaging was carried out to detect AP by digital PR with a central view (DP group), digital PR combining central with 10˚ mesially and distally angled (parallax) views (DPS group) and CBCT scans. All specimens underwent histopathological examination to confirm the diagnosis of AP. Sensitivity, specificity and predictive values of PR and CBCT were analysed using rater mean (n = 5). Receiver-operating characteristic (ROC) analysis was carried out. Sensitivity was 0.27, 0.38 and 0.89 for DP, DPS and CBCT scans, respectively. CBCT had specificity and positive predictive value of 1.0 whilst DP and DPS had specificity and positive predictive value of 0.99. The negative predictive value was 0.39, 0.44 and 0.81 for DP, DPS and CBCT scans, respectively. Area under the curve (AUC) for the various imaging methods was 0.629 (DP), 0.688 (DPS), and 0.943 (CBCT). All imaging techniques had similar specificity and positive predictive values. Additional parallax views increased the diagnostic accuracy of PR. CBCT had significantly higher diagnostic accuracy in detecting AP compared to PR, using human histopathological findings as a reference standard. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  11. [Expression of receptor activator of nuclear factor kappaB ligand and osteoprotegerin in chronic apical periodontitis].

    Science.gov (United States)

    Fan, Rong; Zhang, Cheng-Fei; Gao, Yan

    2008-02-18

    To investigate the expression of key mediators that regulate bone resorption, receptor activator of nuclear factor-kappaB ligand (RANKL) and osteoprotegerin (OPG) in human periapical granuloma (PG) and radicular cyst (RC) characterized by periapical bone destruction. Immunohistochemical technique was performed using monoclonal antibody to detect RANKL and OPG expression in PG (n= 20 ) and RC (n= 20 ). As control group, healthy periodontal ligament tissues (n = 6 ) were obtained from teeth with orthodontic indication of extraction. The RANKL protein expression was significantly higher in PG (43.74 +/- 8.40) and RC (40.33 +/- 7.53) than in control group (15.47 +/- 2.59, P=0.000) , but no statistical significance could be found between PG and RC groups(P=0.161) .The expression of OPG in PG (27.81 +/- 5.17), RC (26.35 +/- 3.86) and control group (24.33 +/- 3.50) show no statistical significance (P >0.05). Moreover, RANKL/OPG ratio in PG (1.59 +/- 0.26) and RC (1.54 +/- 0.24) was much higher than that in control group (0.64 +/- 0.10, P=0.000), however the ratio of RANKL/OPG showed no significant difference between PG and RC groups (P= 0.504) . RANKL and OPG were observed in the periapical lesions. RANKL may be responsible for bone resorption in periapical lesions. RANKL and OPG may play an important role in the development of periapical lesions.

  12. Diagnostic Accuracy of Cone-beam Computed Tomography and Conventional Radiography on Apical Periodontitis: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Leonardi Dutra, Kamile; Haas, Letícia; Porporatti, André Luís; Flores-Mir, Carlos; Nascimento Santos, Juliana; Mezzomo, Luis André; Corrêa, Márcio; De Luca Canto, Graziela

    2016-03-01

    Endodontic diagnosis depends on accurate radiographic examination. Assessment of the location and extent of apical periodontitis (AP) can influence treatment planning and subsequent treatment outcomes. Therefore, this systematic review and meta-analysis assessed the diagnostic accuracy of conventional radiography and cone-beam computed tomographic (CBCT) imaging on the discrimination of AP from no lesion. Eight electronic databases with no language or time limitations were searched. Articles in which the primary objective was to evaluate the accuracy (sensitivity and specificity) of any type of radiographic technique to assess AP in humans were selected. The gold standard was the histologic examination for actual AP (in vivo) or in situ visualization of bone defects for induced artificial AP (in vitro). Accuracy measurements described in the studies were transformed to construct receiver operating characteristic curves and forest plots with the aid of Review Manager v.5.2 (The Nordic Cochrane Centre, Copenhagen, Denmark) and MetaDisc v.1.4. software (Unit of Clinical Biostatistics Team of the Ramón y Cajal Hospital, Madrid, Spain). The methodology of the selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. Only 9 studies met the inclusion criteria and were subjected to a qualitative analysis. A meta-analysis was conducted on 6 of these articles. All of these articles studied artificial AP with induced bone defects. The accuracy values (area under the curve) were 0.96 for CBCT imaging, 0.73 for conventional periapical radiography, and 0.72 for digital periapical radiography. No evidence was found for panoramic radiography. Periapical radiographs (digital and conventional) reported good diagnostic accuracy on the discrimination of artificial AP from no lesions, whereas CBCT imaging showed excellent accuracy values. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Histologic Findings of a Human Immature Revascularized/Regenerated Tooth with Symptomatic Irreversible Pulpitis.

    Science.gov (United States)

    Peng, Chufang; Zhao, Yuming; Wang, Wenjun; Yang, Yuan; Qin, Man; Ge, Lihong

    2017-06-01

    Pulp revascularization/regeneration in immature permanent teeth with necrotic pulp and/or apical periodontitis is an effective approach for inducing root maturation. Previous histologic studies showed cementoid/osteoid tissue and/or periodontal ligament-like tissue formed within the root canals. This case report describes the histologic findings of a human symptomatic irreversible pulpitis immature permanent tooth with most of the pulp removed after a revascularization/regeneration procedure. A human immature permanent mandibular premolar (tooth #29) was diagnosed as symptomatic irreversible pulpitis with symptomatic apical periodontitis at the emergency department. Most of the pulp was removed. The tooth was treated with revascularization/regeneration. At the 12-month recall, the radiographic examination revealed thickening of the root canal wall, narrowing of the root apex, and lengthening of the root. The tooth was extracted at 12 months for orthodontic treatment. The specimens were processed for histologic examination. Histologically, the apical third of the root canal was filled with newly formed dentinlike and pulplike tissue. There was a layer of flattened odontoblastlike cells lining the dentinal wall. In the midportion of the root canal, the newly formed dentinlike tissue gradually changed to cementumlike tissue. In the upper third of the root canal, there was a presence of cementocytelike cells housed in the lacunae of cementumlike tissue around the loose connective tissue. In the present case, regeneration of the pulplike tissue and the periodontium existed after a revascularization/regeneration procedure in an immature permanent tooth clinically diagnosed as symptomatic irreversible pulpitis. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  14. 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.

  15. [Bacterial localization in apical cementum at the epithelial insertion using scanning electron microscopy].

    Science.gov (United States)

    García Núñez, J A; Herrera, I; Cerezo Lapiedra, R; Santa María, I

    1989-02-01

    Extracted teeth due to consequence of chronic periodontitis of adult are fractured and the apical cementum to junction epithelium is examined under S.E.M. (scanning electron microscopy) being found bacterias forms inside niches of the apical cementum.

  16. Five-year longitudinal assessment of the prognosis of apical microsurgery

    DEFF Research Database (Denmark)

    von Arx, Thomas; Jensen, Simon S; Hänni, Stefan

    2012-01-01

    Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohor...

  17. Scaling and root planning, and locally delivered minocycline reduces the load of Prevotella intermedia in an interdependent pattern, correlating with symptomatic improvements of chronic periodontitis: a short-term randomized clinical trial.

    Science.gov (United States)

    Deng, Shuli; Wang, Ying; Sun, Wei; Chen, Hui; Wu, Gang

    2015-01-01

    To evaluate the respective or combinatory efficacy of locally delivered 2% minocycline (MO), and scaling and root planning (SRP) by assessing both clinical parameters and the loads of four main periodontal pathogens in treating chronic periodontitis (CP). Seventy adults with CP were randomly assigned to the three treatment groups: 1) SRP alone; 2) MO alone; and 3) combinatory use of SRP and MO (SRP + MO). Before and 7 days after the treatments, we evaluated both clinical parameters (pocket depth [PD] and sulcus bleeding index [SBI]) and the gene load of four main periodontal pathogens (Aggregatibacter actinomycetemcomitans [Aa], Fusobacterium nucleatum [Fn], Porphyromonas gingivalis [Pg], and Prevotella intermedia [Pi]). The bacterial prevalence per patient was: Aa, 31.25%; Fn, 100%; Pg, 95.31%; and Pi, 98.44%. Seven days after treatment, the three treatments significantly reduced both PD and SBI, but not detection frequencies of the four pathogens. For PD, the reduction efficacy of SRP + MO was significantly higher than that of either MO or SRP. Only Pg responded significantly to SRP. Pg and Fn were significantly reduced in the presence of MO. Only SRP + MO showed a significant reduction effect on the gene load of Pi. The reduction of PD significantly correlated with the gene load of Pi (r=0.26; P=0.042) but not of the other bacteria. SRP and MO reduced the load of Pi in an interdependent pattern, which correlated with symptomatic improvements of CP.

  18. Regenerative endodontic treatment of an immature tooth with a necrotic pulp and apical periodontitis using platelet-rich plasma (PRP) and mineral trioxide aggregate (MTA): a case report.

    Science.gov (United States)

    Sachdeva, G S; Sachdeva, L T; Goel, M; Bala, S

    2015-09-01

    To report the successful clinical and radiographic outcome of a regenerative endodontic treatment. A 16-year-old male patient presented with a discoloured, maxillary left lateral incisor with a necrotic pulp. Radiographic examination revealed an incompletely developed root with an open apex. Under local anaesthesia and rubber dam isolation, an access cavity was prepared and the necrotic pulpal remnants were removed. The canal was disinfected without mechanical instrumentation with 5.25% NaOCl solution and dried with sterile paper points. A triple antibiotic (metronidazole, ciprofloxacin and minocycline) mixed with distilled water was packed in the canal and left for 28 days. Ten millimetres of whole blood was drawn by venipuncture from the patients antecubital vein for preparation of platelet-rich plasma (PRP). After removal of the antibiotic mixture, the PRP was injected into the canal space up to the cementoenamel junction level. Three millimetres of white MTA was placed directly over the PRP clot. Two days later, the tooth was restored with permanent filling materials. The patient was recalled for 3, 6, 12, 24 and 36 months clinical/radiographic follow-up. A 3-year follow-up radiograph revealed resolution of the periapical lesion, increased thickening of the root walls, further root development and continued apical closure of the root apex. The tooth was not responsive to cold tests; however, sensitivity tests with an electric pulp tester (EPT) elicited a delayed positive response. Regeneration is a viable treatment modality that allows continued root development of immature teeth with open apices and necrotic pulps. Platelet-rich plasma appears to be a suitable scaffold for regeneration of vital tissues in teeth with a necrotic pulps and an associated periapical lesion. Regenerative endodontic procedures may offer an effective treatment option to save teeth with compromised structural integrity. © 2014 International Endodontic Journal. Published by John Wiley

  19. Establishing Apical Patency and its Effect on Endodontic Outcomes

    Science.gov (United States)

    2012-06-01

    accurate prognosis and improved treatment planning related to establishing apical patency. The preliminary results of this interim analysis indicate there...canal space and periodontal ligament. Establishing apical patency is controversial with only 50% of dental programs in the United States teaching the...concept. Both sides can cite articles favoring their position. However, the clinical impact of establishing patency on endodontic treatment outcome

  20. Scaling and root planning and locally delivered minocycline could reduce the load of Prevotella intermedia in an interdependent pattern, which correlated with symptomatic improvements of chronic periodontitis: a short-term randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Deng S

    2015-12-01

    Full Text Available Shuli Deng,1 Ying Wang,1 Wei Sun,1 Hui Chen,1 Gang Wu2 1Department of Conservative Dentistry, Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China; 2Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA, VU University Amsterdam and University of Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, the Netherlands Background: To evaluate the respective or combinatory efficacy of locally delivered 2% minocycline (MO and scaling and root planning (SRP by assessing both clinical parameters and the loads of four main periodontal pathogens in treating chronic periodontitis (CP.Methods: Seventy adults with CP were randomly assigned to the three treatment groups: 1 SRP alone; 2 MO alone; and 3 combinatory use of SRP and MO (SRP + MO. Before and 7 days after the treatments, we evaluated both clinical parameters (pocket depth [PD] and sulcus bleeding index [SBI] and the gene load of four main periodontal pathogens (Aggregatibacter actinomycetemcomitans [Aa], Fusobacterium nucleatum [Fn], Porphyromonas gingivalis [Pg], and Prevotella intermedia [Pi].Results: The bacterial prevalence per patient was Aa, 31.25%; Fn, 100%; Pg, 95.31%; and Pi, 98.44%. Seven days after treatments, the three treatments could significantly reduce both PD and SBI, but not detection frequencies of the four pathogens. For PD, the reduction efficacy of SRP + MO was significantly higher than that of both MO and SRP. Only Pg responded significantly to SRP. Pg and Fn could be significantly reduced in the presence of MO. Only SRP + MO but not the respective showed a significant reduction effect on the gene load of Pi. The reduction of PD significantly correlated with the gene load of Pi (r=0.26; P=0.042 but not of the other bacteria.Conclusion: SRP and MO could reduce the load of Pi in an interdependent pattern, which correlated with symptomatic improvements of CP

  1. Radiographic study of the prevalence of apical periodontitis and endodontic tratment in the adult population of São Luís, MA, Brazil Estudo radiográfico da prevalência de periodontite apical e tratamento endodôntico na população adulta de São Luís, MA, Brasil

    Directory of Open Access Journals (Sweden)

    Analúcia Guerra Terças

    2006-06-01

    Full Text Available This study investigated the prevalence of apical periodontitis (AP and its association with endodontically treated teeth in residents of São Luís, MA, Brazil. Two-hundred complete series of periapical radiographs taken over a 10-year period (1993-2003 were retrieved from the files of four prosthesists and five periodontists. The Periapical Index (PAI was used and the age range, sex, tooth groups, location and association with endodontic treatment (ET were also analyzed. The Cohen Kappa and Chi-square tests were used for statistical analysis. Out of 200 patients, 135 presented at least one case of AP, which corresponds to a prevalence of 67.5%. Of the 5008 teeth examined, 296 had AP and 553 had ET. Therefore, considering the total number of teeth, AP and ET prevalences were 5.9% and 11%, respectively. Of the 553 endodontically treated teeth, 235 (42.5% were associated with AP. Chi-square test showed a strong correlation between AP and ET (p0.05. The maxillary incisors were the most affected group of teeth (pO objetivo deste estudo foi investigar a prevalência de Periodontite Apical (PA e sua associação com dentes tratados endodonticamente em residentes de São Luís, MA, Brasil. Foram selecionadas 200 séries completas de radiografias periapicais de arquivos de quatro protesistas e cinco periodontistas dos últimos 10 anos (1993-2003. O Índice Periapical (PAI foi utilizado e a faixa etária, sexo, grupos dentais, localização de maior prevalência e associação aos dentes com tratamento endodôntico (TE foram analisados. Os testes Cohen Kappa e qui-quadrado foram utilizados para análise estatística. Dos registros de 200 pacientes, 135 apresentavam algum caso de PA, resultando numa prevalência de 67,5%. Do total de 5008 dentes, 296 tinham PA e 553 tinham TE. Desse modo, a prevalência de PA foi de 5.8% e de TE foi de 11%. Dos 553 casos de dentes tratados endodonticamente, 235 (42.5% estavam associados com PA. A faixa etária de 40 anos

  2. Apical Negative Pressure irrigation presents tissue compatibility in immature teeth

    Directory of Open Access Journals (Sweden)

    Carolina Maschietto Pucinelli

    Full Text Available Abstract Aim: To compare the apical negative pressure irrigation (ANP with conventional irrigation in the teeth of immature dogs with apical periodontitis. Methods: Fifty-two immature pre-molar root canals were randomly assigned into 4 groups: ANP (n=15; conventional irrigation (n=17; healthy teeth (control (n = 10; and teeth with untreated apical periodontitis (control (n=10. After induction of apical periodontitis, teeth were instrumented using EndoVac® (apical negative pressure irrigation or conventional irrigation. The animals were euthanized after 90 days. The sections were stained by HE and analyzed under conventional and fluorescence microscopy. TRAP histoenzymology was also performed. Statistical analyses were performed with the significance level set at 5%. Results: There was difference in the histopathological parameters between ANP and conventional groups (p0.05. However, a lower number of osteoclasts was observed in the ANP group (p<0.05. Conclusion: The EndoVac® irrigation system presented better biological results and more advanced repair process in immature teeth with apical periodontitis than the conventional irrigation system, confirming the hypothesis.

  3. Apical Closure in Apexification: A Review and Case Report of Apexification Treatment of an Immature Permanent Tooth with Biodentine.

    Science.gov (United States)

    Vidal, Karla; Martin, Gabriela; Lozano, Oscar; Salas, Marco; Trigueros, Jaime; Aguilar, Gabriel

    2016-05-01

    Materials such as calcium hydroxide paste and mineral trioxide aggregate are used in apexification treatment of immature permanent teeth, but the search for improved materials with higher characteristics of biocompatibility results in different materials. Biodentine is a tricalcium silicate cement that possesses adequate handling characteristics and acceptable mechanical and bioactivity properties. This report describes the case of a 9-year-old boy who was referred to the Department of Dental Clinic of Querétaro Autonomous University of Mexico. One month prior the patient had suffered a dental trauma of his upper left central incisor and had been treated by another dentist. The clinical diagnosis was previously initiated therapy and symptomatic apical periodontitis. The treatment was apexification with Biodentine. At follow-ups performed at 3, 6, and 18 months after treatment the tooth was asymptomatic. The cone-beam computed tomography scan at 18-month postoperative follow-up revealed continuity of periodontal ligament space, absence of periapical rarefactions, and a thin layer of calcified tissue formed apical to the Biodentine barrier. On the basis of sealing ability and biocompatibility, apexification treatment with Biodentine was applied in the present case report. The favorable clinical and radiographic outcome in this case demonstrated that Biodentine may be an efficient alternative to the conventional apexification materials. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Periodontal Diseases

    Science.gov (United States)

    ... that number would be much lower. The fundamental role of the immune system in causing periodontal diseases was largely overlooked just a generation ago. Research has established that periodontal diseases arise ... role in causing periodontitis. Periodontal diseases are no longer ...

  5. Does apical root resection in endodontic microsurgery jeopardize the prosthodontic prognosis?

    Directory of Open Access Journals (Sweden)

    Sin-Yeon Cho

    2013-05-01

    Full Text Available Apical surgery cuts off the apical root and the crown-to-root ratio becomes unfavorable. Crown-to-root ratio has been applied to periodontally compromised teeth. Apical root resection is a different matter from periodontal bone loss. The purpose of this paper is to review the validity of crown-to-root ratio in the apically resected teeth. Most roots have conical shape and the root surface area of coronal part is wider than apical part of the same length. Therefore loss of alveolar bone support from apical resection is much less than its linear length.The maximum stress from mastication concentrates on the cervical area and the minimum stress was found on the apical 1/3 area. Therefore apical root resection is not so harmful as periodontal bone loss. Osteotomy for apical resection reduces longitudinal width of the buccal bone and increases the risk of endo-perio communication which leads to failure. Endodontic microsurgery is able to realize 0 degree or shallow bevel and precise length of root resection, and minimize the longitudinal width of osteotomy. The crown-to-root ratio is not valid in evaluating the prosthodontic prognosis of the apically resected teeth. Accurate execution of endodontic microsurgery to preserve the buccal bone is essential to avoid endo-perio communication.

  6. Does apical root resection in endodontic microsurgery jeopardize the prosthodontic prognosis?

    Science.gov (United States)

    Cho, Sin-Yeon; Kim, Euiseong

    2013-05-01

    Apical surgery cuts off the apical root and the crown-to-root ratio becomes unfavorable. Crown-to-root ratio has been applied to periodontally compromised teeth. Apical root resection is a different matter from periodontal bone loss. The purpose of this paper is to review the validity of crown-to-root ratio in the apically resected teeth. Most roots have conical shape and the root surface area of coronal part is wider than apical part of the same length. Therefore loss of alveolar bone support from apical resection is much less than its linear length.The maximum stress from mastication concentrates on the cervical area and the minimum stress was found on the apical 1/3 area. Therefore apical root resection is not so harmful as periodontal bone loss. Osteotomy for apical resection reduces longitudinal width of the buccal bone and increases the risk of endo-perio communication which leads to failure. Endodontic microsurgery is able to realize 0 degree or shallow bevel and precise length of root resection, and minimize the longitudinal width of osteotomy. The crown-to-root ratio is not valid in evaluating the prosthodontic prognosis of the apically resected teeth. Accurate execution of endodontic microsurgery to preserve the buccal bone is essential to avoid endo-perio communication.

  7. Microbiology and Treatment of Acute Apical Abscesses

    Science.gov (United States)

    Rôças, Isabela N.

    2013-01-01

    SUMMARY Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium, Parvimonas, Prevotella, Porphyromonas, Dialister, Streptococcus, and Treponema. Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease. PMID:23554416

  8. Scaling and root planning, and locally delivered minocycline reduces the load of Prevotella intermedia in an interdependent pattern, correlating with symptomatic improvements of chronic periodontitis: a short-term randomized clinical trial

    NARCIS (Netherlands)

    Deng, S.; Wang, Y.; Sun, W.; Chen, H.; Wu, G.

    2015-01-01

    Background: To evaluate the respective or combinatory efficacy of locally delivered 2% minocycline (MO) and scaling and root planning (SRP) by assessing both clinical parameters and the loads of four main periodontal pathogens in treating chronic periodontitis (CP). Methods: Seventy adults with CP

  9. Antibacterial effect of root canal preparation and calcium hydroxide paste (Calen intracanal dressing in primary teeth with apical periodontitis Efeito antibacteriano do preparo biomecânico e do curativo de demora com pasta à base de hidróxido de cálcio (Calen em dentes decíduos com lesão periapical

    Directory of Open Access Journals (Sweden)

    Gisele Faria

    2005-12-01

    Full Text Available The aim of this study was to evaluate the antibacterial action of root canal mechanical preparation using 2.5% sodium hypochlorite as the irrigating solution and a calcium hydroxide paste as the antibacterial intracanal dressing in human primary teeth root canals with pulp necrosis and apical periodontitis by means of microbial culture. A total of 26 root canals of human primary teeth with pulp necrosis and apical periodontitis were used. Samples were collected before, 72h after biomechanical treatment and 72h after removal of the intracanal dressing. Comparison by Wilcoxon test showed that root canal mechanical preparation effectively eliminated all microorganisms in 20% of the root canals, and the intracanal dressing in 62.5%; however, the cumulative action of biomechanical treatment and intracanal dressing eliminated the microorganisms of 70% of the root canals (pO objetivo do presente estudo foi avaliar, por meio de cultura bacteriológica, a ação antibacteriana do preparo biomecânico utilizando como solução irrigadora o hipoclorito de sódio a 2,5% e da pasta Calen utilizada como curativo de demora em canais radiculares de dentes decíduos de humanos com necrose pulpar e lesão periapical. Foram selecionados 26 dentes decíduos de humanos portadores de necrose pulpar e lesão periapical. As colheitas microbiológicas foram efetuadas antes e 72 horas após o preparo biomecânico e 72 horas após a remoção do curativo de demora. A comparação por meio do teste de Wilcoxon mostrou que o preparo biomecânico foi eficaz na eliminação dos microrganismos dos canais radiculares em 20% dos casos e o curativo de demora em 62,5%, enquanto que a ação cumulativa do preparo biomecânico e do curativo de demora eliminou os microrganismos em 70,0% dos casos (p<0.001. Pôde-se concluir que o preparo biomecânico, isoladamente, apresentou resultados microbiológicos inferiores àqueles obtidos quando o mesmo foi associado ao curativo de demora

  10. 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.

  11. Clinical study of single-visit root canal treatment with a nickel-titanium (Ni-Ti) rotary instrument combined with different ultrasonic irrigation solutions for elderly patients with chronic apical periodontitis.

    Science.gov (United States)

    Tang, Zhenyu; Wang, Hui; Jiang, Shiyong

    2015-01-01

    The study involved 300 elderly patients with chronic periapical periodontitis. The patients were randomly assigned into three groups. The treatment for group A used a Mtwo Ni-Ti rotary instrument combined with ultrasonic irrigation of a 2.5% NaOCl solution. The group B used the same instrument combined with ultrasonic irrigation of an active silver ion antibacterial solution. The group C used the same instrument combined with syringe irrigation of a 2.5% NaOCl solution. The root canal fillings were performed immediately after canal preparation. Twenty-four hours after the procedure, patients self-assessed pain levels according to the VAS table. The three groups returned after seven days so their postoperative acute reactions could be evaluated clinically. After six and twelve months, efficacy was evaluated. The self-assessed pain levels for group A and B were significantly lower than group C. The incidence of postoperative acute reactions after seven days for group A and B were significantly lower than those of group C. The effective rates after six and twelve months did not differ among these groups. The single-visit root canal treatment with a nickel-titanium rotary instrument combined with ultrasonic irrigation for elderly patients with chronic periapical periodontitis achieved short and long term efficacy and stability.

  12. Apically Extruded Sealers: Fate and Influence on Treatment Outcome.

    Science.gov (United States)

    Ricucci, Domenico; Rôças, Isabela N; Alves, Flávio R F; Loghin, Simona; Siqueira, José F

    2016-02-01

    This retrospective study evaluated cases of unintentional overfillings for the fate of the extruded sealers and their influence on treatment outcome. One hundred five teeth treated by a single operator and exhibiting overfillings in the postobturation radiograph were included in the study. Seventy-five teeth exhibited apical periodontitis lesions at the time of treatment. Sealers included Pulp Canal Sealer (Sybron Dental, Orange, CA), PCS Extended Working Time-EWT (Sybron Dental), Tubli-Seal (Sybron Endo), Endomethasone (Septodont, Saint-Maur-des-Fossés, France), AH Plus (DeTrey GmbH, Konstanz, Germany), and Apexit (Ivoclar Vivadent, Schaan, Lichtenstein). Recall radiographs were compared with immediate postobturation films for removal of the extruded material and status of the periradicular tissues. Data were grouped as 1-, 2- and >4-year recall and statistically analyzed using the chi-square and Fisher exact tests. As for the sealers' fate, the only statistically significant differences at the 1-year recall were observed when comparing Tubli-Seal with AH Plus, Apexit, and Endomethasone (P .05). Data from the >4-year recall revealed that 79% of the teeth with apical periodontitis lesions at the time of treatment had healed in comparison with 100% of the teeth with no apical periodontitis (P extruded sealers were predictably removed from the periradicular tissues. Treatment outcome was not significantly affected by the type of extruded sealer. A significantly better outcome was observed for teeth with no lesion in comparison with teeth with apical periodontitis. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts.

    Science.gov (United States)

    Lin, Louis M; Ricucci, Domenico; Lin, Jarshen; Rosenberg, Paul A

    2009-05-01

    It is a general belief that large cyst-like periapical lesions and apical true cysts caused by root canal infection are less likely to heal after nonsurgical root canal therapy. Nevertheless, there is no direct evidence to support this assumption. A large cyst-like periapical lesion or an apical true cyst is formed within an area of apical periodontitis and cannot form by itself. Therefore, both large cyst-like periapical lesions and apical true cysts are of inflammatory and not of neoplastic origin. Apical periodontitis lesions, regardless of whether they are granulomas, abscesses, or cysts, fail to heal after nonsurgical root canal therapy for the same reason, intraradicular and/or extraradicular infection. If the microbial etiology of large cyst-like periapical lesions and inflammatory apical true cysts in the root canal is removed by nonsurgical root canal therapy, the lesions might regress by the mechanism of apoptosis in a manner similar to the resolution of inflammatory apical pocket cysts. To achieve satisfactory periapical wound healing, surgical removal of an apical true cyst must include elimination of root canal infection.

  14. Delayed-enhancement MRI of apical hypertrophic cardiomyopathy: assessment of the intramural distribution and comparison with clinical symptoms, ventricular arrhythmias, and cine MRI

    International Nuclear Information System (INIS)

    Amano, Yasuo; Fukushima, Yoshimitsu; Kumita, Shinichiro; Takayama, Morimasa; Kitamura, Mitsunobu

    2011-01-01

    Background: Hypertrophic cardiomyopathy (HCM) is reported to show patchy midwall myocardial hyper enhancement on delayed-enhancement magnetic resonance imaging (DE-MRI). The intramural distribution of myocardial hyper enhancement and its correlation with clinical symptoms, ventricular arrhythmias, and cardiac function have not been described for symptomatic apical HCM. Purpose: To evaluate the features and significance of myocardial hyper enhancement on DE-MRI in symptomatic apical HCM. Material and Methods: Thirteen patients with symptomatic apical HCM and their 65 apical segments were investigated. Myocardial hyper enhancement and regional and global functional parameters were determined with MRI. We investigated the intramural distribution and frequencies of this myocardial hyper enhancement and compared them with the patients' clinical symptoms, the presence of ventricular arrhythmias, and cine MRI. Results: Eight (61.5%) patients with symptomatic apical HCM displayed apical myocardial hyper enhancement, and 22 (33.8%) of the 65 apical segments examined showed myocardial hyper enhancement. Of the myocardial hyper enhancement observed, 81.8% showed a subendocardial pattern.The Hyperenhanced apical myocardium had a lower percentage of systolic myocardial thickening, and was associated with serious symptoms (e.g. syncope) and ventricular arrhythmias. Conclusion: Patients with symptomatic apical HCM showed myocardial hyper enhancement involving the subendocardial layer, which might be related to regional systolic dysfunction, serious clinical symptoms, and ventricular arrhythmias

  15. Delayed-enhancement MRI of apical hypertrophic cardiomyopathy: assessment of the intramural distribution and comparison with clinical symptoms, ventricular arrhythmias, and cine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Amano, Yasuo; Fukushima, Yoshimitsu; Kumita, Shinichiro (Dept. of Radiology, Nippon Medical School, Tokyo (Japan)), email: yas-amano@nifty.com; Takayama, Morimasa (Dept. of Cardiology, Sakakibara Heart Inst., Tokyo (Japan)); Kitamura, Mitsunobu (Coronary Care Unit, Chiba-Hokuso Hospital of Nippon Medical School, Chiba (Japan))

    2011-07-15

    Background: Hypertrophic cardiomyopathy (HCM) is reported to show patchy midwall myocardial hyper enhancement on delayed-enhancement magnetic resonance imaging (DE-MRI). The intramural distribution of myocardial hyper enhancement and its correlation with clinical symptoms, ventricular arrhythmias, and cardiac function have not been described for symptomatic apical HCM. Purpose: To evaluate the features and significance of myocardial hyper enhancement on DE-MRI in symptomatic apical HCM. Material and Methods: Thirteen patients with symptomatic apical HCM and their 65 apical segments were investigated. Myocardial hyper enhancement and regional and global functional parameters were determined with MRI. We investigated the intramural distribution and frequencies of this myocardial hyper enhancement and compared them with the patients' clinical symptoms, the presence of ventricular arrhythmias, and cine MRI. Results: Eight (61.5%) patients with symptomatic apical HCM displayed apical myocardial hyper enhancement, and 22 (33.8%) of the 65 apical segments examined showed myocardial hyper enhancement. Of the myocardial hyper enhancement observed, 81.8% showed a subendocardial pattern.The Hyperenhanced apical myocardium had a lower percentage of systolic myocardial thickening, and was associated with serious symptoms (e.g. syncope) and ventricular arrhythmias. Conclusion: Patients with symptomatic apical HCM showed myocardial hyper enhancement involving the subendocardial layer, which might be related to regional systolic dysfunction, serious clinical symptoms, and ventricular arrhythmias

  16. Abceso apical agudo

    OpenAIRE

    Jara Ortiz, M.; López, M.; Gómez Viglino, L.; Maydana, N.; Hervit, M.; Bertola, N.

    2015-01-01

    En casos de urgencia, muchas veces debemos poner a prueba distintos elementos de diagnóstico para encontrar la mejor respuesta posible. En este caso se reporta un absceso apical agudo en la zona palatina del sector 1, que, de acuerdo al test de vitalidad pulpar y correcta interpretación radiográfica se localiza la pieza causal N° 1.8.Asistió a la consulta un paciente masculino 30 años de edad, dolor a la masticación, edema y tumefacción, en zona palatina comprendida en piezas 1.5; 1.6; 1.7 y ...

  17. Periodontal Vaccines

    Directory of Open Access Journals (Sweden)

    Daisy Happy

    2013-01-01

    Full Text Available Periodontitis is an infectious disease caused by predominantly gram-negative, anaerobic bacteria like P. gingivalis, A. actinomycetemcomitans T. denticola and T. forsythus etc.. Various immunization approaches both as active and passive immunization, against periodontal pathogens have been explored either using the whole microorganism or their specific virulence factors. Non-human primate and other study models have demonstrated raised production of specific antibody titers against various antigens without any recognizable systemic side-effects. But, the current status of our understanding in the field of vaccines against periodontal disease is incomplete. Ongoing research & collaborative efforts can result in development of functional periodontal vaccine for human use in future.

  18. Single Versus Multi-visit Endodontic Treatment of Teeth with Apical ...

    African Journals Online (AJOL)

    [3] Treatment of AP aims at the removal of cause, i.e., bacteria present in the canal. Single Versus Multi-visit Endodontic Treatment of. Teeth with Apical Periodontitis: An In vivo ... periapical healing of teeth with AP treated in (a) single visit versus (b) two visits, either with or .... The canal was left empty, and access cavity was.

  19. Single Versus Multi‑visit Endodontic Treatment of Teeth with Apical ...

    African Journals Online (AJOL)

    Background: Apical periodontitis (AP) is one of the most prevalent diseases of the teeth. Treatment of AP is based on the removal of the cause, i.e., bacteria from the root canals. Achievement of adequate bacterial eradication in one appointment treatment remains a controversy. Aim: This prospective study was conducted ...

  20. Filifactor alocis - involvement in periodontal biofilms

    Directory of Open Access Journals (Sweden)

    Göbel Ulf B

    2010-03-01

    Full Text Available Abstract Background Bacteria in periodontal pockets develop complex sessile communities that attach to the tooth surface. These highly dynamic microfloral environments challenge both clinicians and researchers alike. The exploration of structural organisation and bacterial interactions within these biofilms is critically important for a thorough understanding of periodontal disease. In recent years, Filifactor alocis, a fastidious, Gram-positive, obligately anaerobic rod was repeatedly identified in periodontal lesions using DNA-based methods. It has been suggested to be a marker for periodontal deterioration. The present study investigated the epidemiology of F. alocis in periodontal pockets and analysed the spatial arrangement and architectural role of the organism in in vivo grown subgingival biofilms. Results A species-specific oligonucleotide probe, FIAL, was designed and evaluated. A total of 490 subgingival plaque samples were submitted to PCR and subsequent dot blot hybridization to compare the prevalence of F. alocis in patients suffering from generalized aggressive periodontitis (GAP, chronic periodontitis (CP, and control subjects resistant to periodontitis. Moreover, a specially designed carrier system was used to collect in vivo grown subgingival biofilms from GAP patients. Subsequent topographic analysis was performed using fluorescence in situ hybridization. While the majority of patients suffering from GAP or CP harboured F. alocis, it was rarely detected in the control group. In the examined carrier-borne biofilms the organism predominantly colonized apical parts of the pocket in close proximity to the soft tissues and was involved in numerous structures that constitute characteristic architectural features of subgingival periodontal biofilms. Conclusions F. alocis is likely to make a relevant contribution to the pathogenetic structure of biofilms accounting for periodontal inflammation and can be considered an excellent marker

  1. Expression levels of matrix metalloproteinase-9 and gram-negative bacteria in symptomatic and asymptomatic periapical lesions.

    Science.gov (United States)

    Ahmed, Geraldine M; El-Baz, Alaa A; Hashem, Ahmed Abdel Rahman; Shalaan, Abeer K

    2013-04-01

    The aim of this study was to test the hypothesis that the expression of matrix metalloproteinase (MMP)-9 is significantly elevated in patients with symptomatic apical periodontitis and to correlate this with the detected amount of gram-negative bacteria. Twenty-six patients with periapical lesions involving at least 2 teeth were included in this study. The patients were divided into 2 groups: the symptomatic (SYM) group included 13 patients expressing pain with periapical lesions, and the asymptomatic (ASYM) group included 13 patients expressing no pain. Root canal treatment was performed followed by endodontic surgery and periapical lesion collection. Periapical lesions were serially cut into 4-μ sections. Some sections were processed for histologic examination using hematoxylin-eosin stain. Other sections were processed for immunohistochemical examination. For MMP-9, the area fraction of the positive cells was measured, and the percentage of the MMP-9-immunopositive area to the total area of the microscopic field was calculated. For gram-negative stain cells, the number of cells showing the pink-red color was counted per microscopic field. The Student's t test was used to compare the SYM and ASYM groups. The Pearson correlation coefficient was used to determine a significant correlation between the number of cells and the MMP-9 level. The significance level was set at P ≤ .05. The SYM group showed a statistically significantly higher mean number of gram-negative cells (P = .001) and MMP-9 area percent (P negative cells and the MMP-9 area percent (Pnegative bacteria and MMP-9 in symptomatic periapical lesions. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Statistical Evaluation of Chronic Apical Periodontitis and Radicular Cysts

    OpenAIRE

    Baghaei-Naeini F; Hajloo R

    2000-01-01

    Up to now, no complete study was carried out about the prevalence and location of periapical granuloma and radicular cysts from the point of view of clinical symptoms (e.g. pain and swelling fistula) in Iran. The data was collected from the files available in the Department of Pathology, faculty of Dentistry, Tehran University of Medical Sciences. With a consideration on different therapeutic methods. a proper method was selected. Radicular cyst occurred in 59.3 percent of 324 cases while 45....

  3. Statistical Evaluation of Chronic Apical Periodontitis and Radicular Cysts

    Directory of Open Access Journals (Sweden)

    Baghaei-Naeini F

    2000-05-01

    Full Text Available Up to now, no complete study was carried out about the prevalence and location of periapical granuloma and radicular cysts from the point of view of clinical symptoms (e.g. pain and swelling fistula in Iran. The data was collected from the files available in the Department of Pathology, faculty of Dentistry, Tehran University of Medical Sciences. With a consideration on different therapeutic methods. a proper method was selected. Radicular cyst occurred in 59.3 percent of 324 cases while 45.7 percent were granuloma. The most common incidence of these lesions was in the range of 24-25 years old. The most common location of lesions was the maxillary anterior. Sinus tracts occurred in 74 of all cases. 47.3 percent of these patients have been previously received root canal therapy. It is noticeable that 24 percent of all patients were treated endodontically before surgery. Higher incidence of granuloma occurred in small lesions while cysts were more common in large lesions. 232 of all cases showed one of the clinical symptoms, 16% pain, 35.8% swelling and 22.8% fistula. No symptoms were found in 92 cases.

  4. Changes of Root Length and Root-to-Crown Ratio after Apical Surgery

    DEFF Research Database (Denmark)

    von Arx, Thomas; Jensen, Simon S; Bornstein, Michael M

    2015-01-01

    INTRODUCTION: Apical surgery is an important treatment option for teeth with post-treatment periodontitis. Although apical surgery involves root-end resection, no morphometric data are yet available about root-end resection and its impact on the root-to-crown ratio (RCR). The present study assessed...... the length of apicectomy and calculated the loss of root length and changes of RCR after apical surgery. METHODS: In a prospective clinical study, cone-beam computed tomography scans were taken preoperatively and postoperatively. From these images, the crown and root lengths of 61 roots (54 teeth in 47....... The following parameters were assessed for all treated teeth as well as for specific tooth groups: length of root-end resection and percentage change of root length, preoperative and postoperative RCRs, and percentage change of RCR after apical surgery. RESULTS: The mean length of root-end resection was 3...

  5. Macrophage polarization differs between apical granulomas, radicular cysts, and dentigerous cysts.

    Science.gov (United States)

    Weber, Manuel; Schlittenbauer, Tilo; Moebius, Patrick; Büttner-Herold, Maike; Ries, Jutta; Preidl, Raimund; Geppert, Carol-Immanuel; Neukam, Friedrich W; Wehrhan, Falk

    2018-01-01

    Apical periodontitis can appear clinically as apical granulomas or radicular cysts. There is evidence that immunologic factors are involved in the pathogenesis of both pathologies. In contrast to radicular cysts, the dentigerous cysts have a developmental origin. Macrophage polarization (M1 vs M2) is a main regulator of tissue homeostasis and differentiation. There are no studies comparing macrophage polarization in apical granulomas, radicular cysts, and dentigerous cysts. Forty-one apical granulomas, 23 radicular cysts, and 23 dentigerous cysts were analyzed in this study. A tissue microarray (TMA) of the 87 consecutive specimens was created, and CD68-, CD11c-, CD163-, and MRC1-positive macrophages were detected by immunohistochemical methods. TMAs were digitized, and the expression of macrophage markers was quantitatively assessed. Radicular cysts are characterized by M1 polarization of macrophages while apical granulomas show a significantly higher degree of M2 polarization. Dentigerous cysts have a significantly lower M1 polarization than both analyzed periapical lesions (apical granulomas and radicular cysts) and accordingly, a significantly higher M2 polarization than radicular cysts. Macrophage cell density in dentigerous cysts is significantly lower than in the periapical lesions. The development of apical periodontitis towards apical granulomas or radicular cysts might be directed by macrophage polarization. Radicular cyst formation is associated with an increased M1 polarization of infiltrating macrophages. In contrast to radicular cysts, dentigerous cysts are characterized by a low macrophage infiltration and a high degree of M2 polarization, possibly reflecting their developmental rather than inflammatory origin. As M1 polarization of macrophages is triggered by bacterial antigens, these results underline the need for sufficient bacterial clearance during endodontic treatment to prevent a possible M1 macrophage-derived stimulus for radicular cyst

  6. Bacteria in the apical root canals of teeth with apical periodontitis

    Directory of Open Access Journals (Sweden)

    Li-Wan Lee

    2017-06-01

    Conclusion: Root canal infections are usually caused by a mixture of two or three species of bacteria. Specific kinds of antibiotic can be selected to control these bacterial infections after antibiotic sensitivity testing.

  7. Symptomatic epilepsy in children

    OpenAIRE

    Еlaginykh E.S.

    2014-01-01

    Research goals were to evaluate the etiological structure of symptomatic epilepsy in children, age structure of period of disease manifestation, average length of latent period among children with different characters of lesions, dependence between frequency of seizures and character of lesion. Material and methods. A total of 180 case-records of patients with symptomatic epilepsy were analyzed by the next criteria: anamnesis, materials of electroencephalogram and neurovisualization. Results....

  8. Localized juvenile periodontitis or localized aggressive periodontitis.

    Science.gov (United States)

    Araujo, Maria

    2002-01-01

    In general, the new term "localized aggressive periodontitis" replaces what was previously known as "localized juvenile periodontitis." Similarly, "generalized aggressive periodontitis" replaces what used to be called "generalized juvenile periodontitis." Aggressive periodontitis is a specific type of periodontitis with clearly identifiable clinical and laboratory findings, making it sufficiently different from chronic periodontitis and warranting separate classification. Not all the characteristics must be present to assign a diagnosis or classify the disease. The diagnosis may be based on clinical, radiographic, and historical data, and laboratory testing may not be essential for assigning a diagnosis.

  9. Reestablishing the Function and Esthetics in Traumatized Permanent Teeth with Large Apical Lesion

    Directory of Open Access Journals (Sweden)

    Alexandra Rubin Cocco

    2016-01-01

    Full Text Available Dental trauma is a challenge for dental integrity and can lead to pulp necrosis. The clinical case reports the diagnosis of a maxillary right central incisor traumatized and its multidisciplinary treatment. Calcium hydroxide material was used to perform the processing apexification. An apical surgery was carried out to remove the apical periodontitis and to return the aesthetics to the patient; internal and external tooth whitening in maxillary right central incisor was performed. We conclude that surgery associated with the root filling in the central incisor led to a successful completion. Moreover, it is of utmost importance to demonstrate the interaction between the various areas of dentistry.

  10. 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.

  11. Periodontal diagnostics.

    Science.gov (United States)

    Kinane, D F

    2000-10-01

    Periodontitis affects a subset of the population and our current thinking is that progression of periodontal disease may be either continuous or cyclical (burst hypothesis). These features make screening and diagnostic tools desirable in the management of this disease. Although many potential markers exist, several difficulties hamper our ability to declare them diagnostic tests with proven utility. The 'gold standard' for active periodontal disease is not available and inflammation due to gingivally confined lesions (gingivitis) and periodontal inflammation which results in attachment loss is a potential confounder of any test based on assessing the host response elements of the disease. The current absence of proof for the progression of periodontal disease i.e., whether or not the burst hypothesis is correct, is a further problem. Although much is written about the need for markers of current or future disease which will prevent us from overtreating pockets, the time, effort and cost involved in testing these sites has to be balanced against the relative ease and speed of routine therapy such as root planing. In addition, we are still some way from the development and validation of reliable host or microbial testing methods. In terms of screening tests for diseases such as the early-onset forms of periodontitis, the research and development on diagnostic tools involving genetic polymorphisms, specific genes, systemic antibodies or leucocyte cell surface markers of the patients, may become a clinical reality in time. One could envisage chairside tests using blood from thumb pricks being capable of determining a young individual's risk of developing disease at a later age, and thus the need for a timely prevention programme. Before applying any test we should reconsider what treatment planning effects a positive or negative result will have, and any test which does not influence the treatment plan is redundant. Whether periodontal diagnostic tests will be

  12. Saving Single-rooted Teeth with Combined Endodontic-periodontal Lesions.

    Science.gov (United States)

    Pico-Blanco, Alexandre; Castelo-Baz, Pablo; Caneiro-Queija, Leticia; Liñares-González, Antonio; Martin-Lancharro, Pablo; Blanco-Carrión, Juan

    2016-12-01

    Teeth affected by combined endodontic-periodontal lesions are usually considered by all prognosis classifications as hopeless teeth. The development of new biomaterials combined with modern endodontic and periodontal regeneration techniques may improve dental prognosis and maintain the affected teeth. Moreover, 1 of the replacement options for those teeth, dental implants, has shown an increasing number of biological and technical complications. Five patients were included in this case series study. Full periodontal and radiographic examination revealed generalized chronic periodontitis. Moreover, endodontic-periodontal lesions affecting single-rooted teeth were detected in those patients with tissue destruction beyond the apex. After splinting those teeth, conventional endodontic and nonsurgical periodontal treatment was performed. Three months later, periodontal regeneration was applied at those teeth in order to reconstruct supporting tissues and to improve dental prognosis. After a follow-up period ranging from 14 months to 17 years, it was observed that all teeth remain asymptomatic and in normal function. No signs of apical pathosis were observed, and the periodontium was stable. All patients were included in a strict maintenance program to check the periodontal and apical status. This case series shows that it is possible to change the prognosis of teeth affected by combined endodontic-periodontal lesions, even if the periodontal support is destroyed beyond the apex. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. 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

  14. Tissue reaction to Endométhasone sealer in root canal fillings short of or beyond the apical foramen

    Directory of Open Access Journals (Sweden)

    Patrícia Suzuki

    2011-10-01

    Full Text Available OBJECTIVE: This study evaluated the response of periapical tissues to the endodontic sealer Endométhasone in root canal fillings short of or beyond the apical foramen. MATERIAL AND METHODS: Twenty root canals of premolars and incisors of 2 mongrel dogs were used. After coronal access and pulp extirpation, the canals were instrumented up to a size 55 K-file and the apical cemental barrier was penetrated with a size 15 K-file to obtain a main apical foramen, which was widened to a size 25 K-file. The canals were irrigated with saline at each change of file. The root canals were obturated either short of or beyond the apical foramen by the lateral condensation of gutta-percha and Endométhasone, originating 2 experimental groups: G1: Endométhasone/short of the apical foramen; G2: Endométhasone/beyond the apical foramen. The animals were killed by anesthetic overdose 90 days after endodontic treatment. The individual roots were obtained and serial histological sections were prepared for histomorphological analysis (H&E and Brown & Brenn techniques under light microscopy. The following parameters were examined: closure of the apical foramen of the main root canal and apical opening of accessory canals, apical cementum resorption, intensity of the inflammatory infiltrate, presence of giant cells and thickness and organization of the apical periodontal ligament. Each parameter was scored 1 to 4, 1 being the best result and 4 the worst. Data were analyzed statistically by the Wilcoxon nonparametric tests (p=0.05. RESULTS: Comparing the 2 groups, the best result (p<0.05 was obtained with root canal filling with Endométhasone short of the apical foramen but a chronic inflammatory infiltrate was present in all specimens. CONCLUSIONS: Limiting the filling material to the root canal space apically is important to determine the best treatment outcome when Endométhasone is used as sealer.

  15. Computed tomographic features of apical infection of equine maxillary cheek teeth: a retrospective study of 49 horses.

    Science.gov (United States)

    Bühler, M; Fürst, A; Lewis, F I; Kummer, M; Ohlerth, S

    2014-07-01

    Computed tomographic (CT) studies evaluating the relevance of individual CT features of apical infection in maxillary cheek teeth are lacking. To study the prevalence and relationship of single CT features in horses with and without clinical evidence of apical infection in maxillary cheek teeth. Retrospective case-control study. Multislice CT scans of the head of 49 horses were evaluated retrospectively. Changes of the infundibulum, pulp, root, lamina dura, periodontal space and alveolar bone in maxillary cheek teeth were recorded. Single CT changes were much more prevalent in the 28 horses with clinical signs. However, infundibular changes and a nondetectable lamina dura were also common in the 21 horses without clinical evidence of apical infection. Computed tomographic abnormalities of the pulp, root, periapical bone and periodontal space and the presence of a tooth fracture were significantly related. Infundibular changes were not associated with other CT signs of apical infection. Although nondetectable lamina dura was the most frequent CT change in all teeth in both studied groups, it was most commonly a solitary feature in otherwise normal teeth. Apical infections, defined as ≥3 CT changes, occurred mainly in the 108/208, 109/209 and 110/210 (Triadan numbers) and were found only in horses with clinical evidence of apical infection, except in one horse without clinical signs that had one affected root. Combined CT changes of the pulp, root, lamina dura, periapical bone and periodontal space and the presence of a tooth fracture appear to be reliable features to diagnose apical infection in maxillary cheek teeth. As a solitary feature, a nondetectable lamina dura should be interpreted cautiously and may even be considered normal due to its minor thickness and/or too low resolution of the imaging modality. © 2013 EVJ Ltd.

  16. 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.

  17. Periodontally accelerated osteogenic orthodontics

    Directory of Open Access Journals (Sweden)

    Shailesh Mohanlal Bhandari

    2016-01-01

    Full Text Available This case report demonstrates an orthodontic method that offers short treatment time and the ability to simultaneously reshape and increase the buccolingual thickness of the supporting alveolar bone. A 23-year-old female with Angle′s Class I moderately to severely crowded malocclusion with periodontal pocket with 31 and reduced thickness of the buccal cortical plate of lower anteriors, requested shortened orthodontic treatment time. This surgery technique included buccal full-thickness flaps, selective partial decortication of the cortical plates, concomitant bone grafting/augmentation, and primary flap closure. Following the surgery, orthodontic adjustments were made approximately every 2 weeks. From bracketing to debracketing, the case was completed in approximately 7 months and 3 weeks. Posttreatment evaluation of patient revealed good results. Preexisting thin labial bony cortical plate with lower anteriors was covered. This finding suggests credence to the incorporation of the bone augmentation procedure into the corticotomy surgery because this made it possible to complete the orthodontic treatment with a more intact periodontium. The rapid expansive tooth movements with no significant apical root resorption may be attributed to the osteoclastic or catabolic phase of the regional acceleratory phenomenon.

  18. Left ventricular apical ballooning syndrome

    International Nuclear Information System (INIS)

    Rahman, N.; Tai, J.; Soofi, A.

    2007-01-01

    The transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction in the absence of obstructive epicardial coronary disease. Although the syndrome has been reported in Japan since 1990, it is rare in other regions. Rapid recognition of the syndrome can modify the diagnostic and therapeutic attitude i.e. avoiding thrombolysis and performing catheterization in the acute phase. (author)

  19. Bacterial infections of pulp and periodontal origin.

    Science.gov (United States)

    González-Moles, Miguel Angel; González, Nabila M

    2004-01-01

    The anatomical and structural characteristics of the pulp make this structure prone to altering as a result of, for instance, periodontal conditions (proximity), iatrogenic alterations, infections and involvement of vascular and nerve structures (it is surrounded by hard tissues that prevent expansion), to name just a few. Pulpitis is a process that courses with pain of varying intensity that allows us to determine the location of the lesion in clinical terms. Its evolution varies and may even progress to pulpar necrosis that in turn, produces neuritis-like pain. Diagnosis is established by means of clinical symptomatology and supported by X-rays, palpation of tissues at painful sites, application of electrical stimuli, heat, etc. Periodontitis is a bacterial infection originating in the apex. The most important form is the so-called acute apical periodontitis that arises as a result of a prior episode of pulpitis. It is characterized by acute pain located in the tooth, accompanied by the feeling of having a long-tooth. The patient refers being unable to chew on that side; there may be painful mobility of the tooth and an outflow of pus that alleviates symptoms. X-rays do not provide a lot of information, but may attest to a widening of the apical space. This pathology may disseminate to surrounding tissues, leading to conditions of considerable severity.

  20. Histological evaluation of the root apices of failed endodontic cases

    Directory of Open Access Journals (Sweden)

    Camilla Nicole Pecora

    2015-01-01

    Full Text Available Aim: The aim of this histological study was to evaluate the different causes of the failures of the endodontic treatment. Materials and Methods: Adult patients who were referred for endodontic surgery and for whom root-end resection was considered suitable were invited to participate in this study. The inclusion criteria were: (1 Patients aged between 18 and 65 years; (2 teeth with apical periodontitis that was diagnosed radiographically; (3 the tooth could not be adequately and better managed by root-canal retreatment; and (4 the crown of the tooth was adequately restored. One hundred root apices were surgically removed together with the periapical pathological tissue from 92 patients (56 males and 36 women.Histological sectioning was performed on calcified specimens that were embedded in a suitable medium. Results: The causes of endodontic failure identified through histological evaluation were as follows: Presence of bacterial and debris into canals (51%, apex transposition and overfilling (3%, presence of the isthmus (21%, bacterial colonization of root surface (2%, untreated canals (11%, and filling material outside root canal (4%. There was no significant difference between the distribution of teeth and the causes of endodontic failures (P = 0.32. Conclusions: The present study demonstrated that the most common cause of endodontic failure is the insufficient cleaning of the root canal system. It also explores the effectiveness of histological evaluation of the root apex following root-end resection in exploring the causes of endodontic failures.

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

    Science.gov (United States)

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

    2002-02-01

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

  2. Some aspects of periodontitis pathogenesis in children

    Directory of Open Access Journals (Sweden)

    Shcherbina I.N.

    2013-12-01

    Full Text Available Inflammatory processes in the tissues surrounding tooth root are frequent enough and develop as the direct complication of caries. As acute periodontitis is manifested with grinding toothache and violation of ph¬y¬sio¬logical act of chewing, symptoms of general intoxication, the continuous sluggish chronic periodontitis is harmful and dangerous to the organism as well. It forms the state of chronic оdontogenetic intoxication and chroneosepsis with wrong functioning of some internal organs and body systems. The like complications can cause significant disturbance to the function of kidneys, liver, heart, joints and their treatment without ablating focus of inflammation is often in- effective; this must be taken into account by doctors-interns. However, scanning of the oral cavity by conservative means has its difficulties mostly because of ignoring pathogenesis of such inflammation. That is why activity of ferments of blood dehydrogenases from the periapical tissues of the teeth affected with the chronic periodontitis was studied. The level of succinate dehydrogenase and alpha-glycerophosphate degydrogenase of lymphocytes of 110 schoolchildren aged 13-17 years old was studied. The main group of examined individuals included those of infected with tuber¬culousis – 50 individuals, and the control group (60 individuals – clinically healthy ones without tuberculousis desease. All schoolchildren had 1 or 2 teeth affected with chronic periodontitis of the apical localization. The researchers found that a significant inhibition of activity of succinate dehydrogenase and alpha-glycerophosphate degydrogenase ferments occurs in the inflammatory periodontal tissues, which indicates to local immunity decline, and as a consequence, pathogenic bacteria activation. In people infected with tuberculousis these violations were more developed. Such features of periodontitis pathogenesis must be taken into account when providing a combined treatment.

  3. [Smoking and periodontal disease].

    Science.gov (United States)

    Shizukuishi, Satoshi

    2007-02-01

    Over the past 20 years, numerous investigations have demonstrated epidemiologically and biologically that smoking is one of the most significant risk factors with respect to the development and progression of periodontal disease. In terms of the mechanism via which smoking influences periodontitis progression, various factors contribute to the deleterious periodontal effects of smoking, including alteration of both microbial and host response factors. Furthermore, since it is well known that smoking is also a risk factor of osteoporosis, the combination of smoking with osteoporosis further enhances the risk of periodontal disease. Recent investigations reported that passive smoking exposure may be a risk factor of periodontal disease and may stimulate inflammatory responses of periodontal tissue.

  4. Tolerance of brightness and contrast adjustments on chronic apical abscess and apical granuloma interpretation

    Science.gov (United States)

    Purnamasari, L.; Iskandar, H. H. B.; Makes, B. N.

    2017-08-01

    In digitized radiography techniques, adjusting the image enhancement can improve the subjective image quality by optimizing the brightness and contrast for diagnostic needs. To determine the value range of image enhancement (brightness and contrast) on chronic apical abscess and apical granuloma interpretation. 30 periapical radiographs that diagnosed chronic apical abscess and 30 that diagnosed apical granuloma were adjusted by changing brightness and contrast values. The value range of brightness and contrast adjustment that can be tolerated in radiographic interpretations of chronic apical abscess and apical granuloma spans from -10 to +10. Brightness and contrast adjustments on digital radiographs do not affect the radiographic interpretation of chronic apical abscess and apical granuloma if conducted within the value range.

  5. 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.

  6. Smoking and Periodontal Disease

    OpenAIRE

    Borojevic, Tea

    2012-01-01

    Periodontitis is a group of inflammatory diseases affecting the supporting tissues of the tooth (periodontium). The periodontium consists of four tissues : gingiva, alveolar bone and periodontal ligaments. Tobbaco use is one of the modifiable risk factors and has enormous influance on the development, progres and tretmen results of periodontal disease. The relationship between smoking and periodontal health was investigated as early as the miiddle of last century. Smoking is an independent ri...

  7. Human Memory B Cells in Healthy Gingiva, Gingivitis, and Periodontitis.

    Science.gov (United States)

    Mahanonda, Rangsini; Champaiboon, Chantrakorn; Subbalekha, Keskanya; Sa-Ard-Iam, Noppadol; Rattanathammatada, Warattaya; Thawanaphong, Saranya; Rerkyen, Pimprapa; Yoshimura, Fuminobu; Nagano, Keiji; Lang, Niklaus P; Pichyangkul, Sathit

    2016-08-01

    The presence of inflammatory infiltrates with B cells, specifically plasma cells, is the hallmark of periodontitis lesions. The composition of these infiltrates in various stages of homeostasis and disease development is not well documented. Human tissue biopsies from sites with gingival health (n = 29), gingivitis (n = 8), and periodontitis (n = 21) as well as gingival tissue after treated periodontitis (n = 6) were obtained and analyzed for their composition of B cell subsets. Ag specificity, Ig secretion, and expression of receptor activator of NF-κB ligand and granzyme B were performed. Although most of the B cell subsets in healthy gingiva and gingivitis tissues were CD19(+)CD27(+)CD38(-) memory B cells, the major B cell component in periodontitis was CD19(+)CD27(+)CD38(+)CD138(+)HLA-DR(low) plasma cells, not plasmablasts. Plasma cell aggregates were observed at the base of the periodontal pocket and scattered throughout the gingiva, especially apically toward the advancing front of the lesion. High expression of CXCL12, a proliferation-inducing ligand, B cell-activating factor, IL-10, IL-6, and IL-21 molecules involved in local B cell responses was detected in both gingivitis and periodontitis tissues. Periodontitis tissue plasma cells mainly secreted IgG specific to periodontal pathogens and also expressed receptor activator of NF-κB ligand, a bone resorption cytokine. Memory B cells resided in the connective tissue subjacent to the junctional epithelium in healthy gingiva. This suggested a role of memory B cells in maintaining periodontal homeostasis. Copyright © 2016 by The American Association of Immunologists, Inc.

  8. Essentials in Periodontal Regeneration

    OpenAIRE

    F. Haghighati; G. Saaveh

    2007-01-01

    Various materials and techniques have been used in the treatment of periodontal disease to achieve regeneration of lost periodontal tissues including cementum, periodontal ligament (PDL) and alveolar bone. The composition, regenerative potential, application and therapeutic characteristics of several regenerative materials have been evaluated in the present study.

  9. Evaluating the clinical and esthetic outcome of apically positioned flap technique in augmentation of keratinized gingiva around dental implants

    OpenAIRE

    Reddy, Vineela Katam; Parthasarathy, Harinath; Lochana, Priya

    2013-01-01

    Purpose: Dental implants though a successful treatment modality there exists controversies regarding the relationship between the adequacy of the keratinized gingiva (KG) and peri-implant health. The presence of an adequate amount of peri-implant KG reduces gingival inflammation and hence soft-tissue augmentation should be frequently considered. Among the various periodontal plastic surgical procedures, the apically displaced flap increases the width of keratinized tissue with reduced patient...

  10. Symptomatic mesodiverticular bands in children

    African Journals Online (AJOL)

    Materials and methods A computer-assisted (PubMed) search of the literature to identify all cases of symptomatic. MDB reported in English with patients' age ranging from. 0 to 14 years was performed. Results Eight cases of symptomatic MBD in pediatric age. (0–14 years) were found in the literature in the last. 50 years.

  11. Multiple diastema closure in periodontally compromised teeth: How to achieve an enamel-like emergence profile.

    Science.gov (United States)

    Saratti, Carlo Massimo; Krejci, Ivo; Rocca, Giovanni Tommaso

    2016-11-01

    This article describes a direct composite resin technique for the closure of multiple diastemas. The described procedure allows an anatomic and esthetic emergence profile of the apical third of the tooth to be obtained in periodontally compromised teeth without the use of interproximal wedges. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  12. Regenerative periodontal therapy.

    Science.gov (United States)

    Hägi, Tobias T; Laugisch, Oliver; Ivanovic, Aleksandar; Sculean, Anton

    2014-03-01

    The goal of regenerative periodontal therapy is to completely restore the tooth's supporting apparatus that has been lost due to inflammatory periodontal disease or injury. It is characterized by formation of new cementum with inserting collagen fibers, new periodontal ligament, and new alveolar bone. Indeed conventional, nonsurgical, and surgical periodontal therapy usually result in clinical improvements evidenced by probing depth reduction and clinical attachment gain, but the healing occurs predominantly through formation of a long junctional epithelium and no or only unpredictable periodontal regeneration. Therefore, there is an ongoing search for new materials and improved surgical techniques, with the aim of predictably promoting periodontal wound healing/regeneration and improving the clinical outcome. This article attempts to provide the clinician with an overview of the most important biologic events involved in periodontal wound healing/ regeneration and on the criteria on how to select the appropriate regenerative material and surgical technique in order to optimize the clinical outcomes.

  13. Absorbable Suture as an Apical Matrix in Single Visit Apexification with Mineral Trioxide Aggregate

    Directory of Open Access Journals (Sweden)

    Ayush Goyal

    2016-01-01

    Full Text Available Several procedures have been recommended to induce the root end barrier formation in teeth with open apices. Conventional treatment for such cases will require many appointments with an average duration of 12.9 months. During this period, the root canal is susceptible to reinfection from around the provisional restoration, which may promote apical periodontitis and arrest of apical repair. Mineral trioxide aggregate (MTA has been successfully used for one visit apexification wherein the root canal can be obturated within 24 hours after placement of MTA. Using a matrix prior to the placement of MTA avoids its extrusion, reduces leakage in the sealing material, and allows favorable response of the periapical tissues. This report presents a case of apexification where an absorbable suture was used as an apical matrix. Use of an absorbable suture circumvents all the problems associated with other conventional materials. Conclusion. Placement of the matrix made from the suture material is predictable and is easily positioned at the apex and the length can be adjusted as required. 10-month follow-up of the case shows resorbed matrix and bone healing in the periapical region. The patient was asymptomatic during the whole follow-up period and tooth exhibited mobility within physiologic limits and was functioning normally.

  14. Dentists, diabetes and periodontitis.

    Science.gov (United States)

    Bjelland, S; Bray, P; Gupta, N; Hirscht, R

    2002-09-01

    This review updates the relationship between diabetes mellitus and periodontitis. A checklist has been included to assist the general dental practitioner identify individuals with undiagnosed diabetes. The literature indicates a similar incidence of periodontitis exists between well-controlled diabetics and non-diabetics. However, a greater incidence and severity of periodontitis is observed in both Type 1 and 2 long-term diabetics with poor metabolic control. There is an undeniable link between diabetes mellitus and periodontitis with complex interactions occurring between these diseases. A critical review of the literature fails to support the notion that periodontal therapy has a beneficial effect on the long-term control of diabetes. We have explored the associations between periodontitis and diabetes in the hope of providing the general dental practitioner with the knowledge to support the diabetic patient with the best possible dental care and advice.

  15. The periodontal pocket.

    Science.gov (United States)

    Donos, Nikolaos

    2018-02-01

    Periodontal disease is synonymous with the presence of periodontal pockets, and very often the clinical success of periodontal therapy is based on periodontal pocket depth reduction. Therefore, in the fields of periodontology and implant dentistry, significant research effort has been placed on the etiopathogenesis, diagnosis and treatment of periodontal/peri-implant disease and as a consequence on pocket pathology. In this volume of Periodontology 2000, the in-depth reviews include topics ranging from preclinical models, anatomy and structure of tissues, and molecular and bacterial components, to treatments of pockets around teeth and implants. These reviews aim to provide the readers with current and future perspectives on the different areas of research into the periodontal pocket. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. A New Classification of Endodontic-Periodontal Lesions

    Directory of Open Access Journals (Sweden)

    Khalid S. Al-Fouzan

    2014-01-01

    Full Text Available The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

  17. Prevention of periodontal diseases.

    Science.gov (United States)

    Dentino, Andrew R; Kassab, Moawia M; Renner, Erica J

    2005-07-01

    The ultimate goal of periodontal disease prevention is to maintain the dentition over a lifetime in a state of health, comfort, and function in an aesthetically pleasing presentation. This article focuses on primary and secondary periodontal disease prevention as they relate to gingivitis and periodontitis. Risk assessment, mechanical plaque control, chemical plaque control, current clinical recommendations for optimal prevention, and future preventive strategies are discussed.

  18. Full Pulpotomy with Biodentine in Symptomatic Young Permanent Teeth with Carious Exposure.

    Science.gov (United States)

    Taha, Nessrin A; Abdulkhader, Sakhaa Z

    2018-04-19

    This prospective study evaluated the outcome of Biodentine (Septodont, Saint Maur des Fosses, France) pulpotomy in young permanent teeth with carious exposure. Twenty permanent molar teeth in 14 patients with carious pulp exposure were treated with Biodentine pulpotomy. The age of the patients ranged from 9-17 years (12.3 ± 2.7 years). A preoperative pulpal and periapical diagnosis was established. After informed consent, the tooth was anesthetized, isolated via a dental dam, and disinfected with 5% sodium hypochlorite before caries excavation. Full pulpotomy was performed by amputating the exposed pulp to the level of the canal orifices, hemostasis was achieved via a cotton pellet moistened with 2.5% sodium hypochlorite, a 3-mm layer of Biodentine was placed as the pulpotomy agent, a Vitrebond liner (3M ESPE, St Paul, MN) was applied, and the tooth was subsequently restored. Postoperative periapical radiographs were taken after placement of the permanent restoration. Clinical and radiographic evaluation was completed after 6 months and 1 year postoperatively. Pain levels were scored preoperatively and 2 days after treatment. Statistical analysis was performed using the Fisher exact test. Clinical signs and symptoms suggestive of irreversible pulpitis were established in all teeth and symptomatic apical periodontitis in 14 of 20 (70%). Two days after treatment, all patients reported complete relief of pain. All teeth were clinically successful at 6 months and 1 year postoperatively. Radiographically, immature roots showed continued root development; dentin bridge formation was detected in 5 of 20 teeth. Seven of 7 teeth with preoperative periapical rarefaction showed signs of healing; 1 tooth had signs of internal root resorption at 1 year with an overall success rate of 95% (19/20). Young permanent teeth with carious exposure can be treated successfully with full pulpotomy using Biodentine, and clinical signs and symptoms of irreversible pulpitis are

  19. A Comparative Study of Apical Healing of Open Apices Using MTA and Ca(OH2 Apical Plugs in Cats

    Directory of Open Access Journals (Sweden)

    M. H. Zarrabi

    2005-06-01

    Full Text Available Statement of problem: Endodontic treatment of necrotic teeth with open apices is a challenge. After ruling out surgery as a treatment scheme and introduction of the multivisit apexification which in turn had its disadvantages, apical plug seems to be a suitable substitute treatment plan for such cases. Apical plug makes the treatment through formation of a barrier against the obturating material in a single visit.Purpose: The purpose of this study was to compare histologically the periapical healing using MTA and calcium hydroxide apical plugs after intervals of 4 and 12 weeks in cats.Materials and Methods: In this clinical trial study 64 canines of 16 healthy and mature cats were divided into 3 groups after a periapical lesion formation by over instrumentation in the apical area with files up to no.120. The first group included 24 teeth on which MTA apical plug was applied. The second group included 24 teeth on which Ca (OH 2 apical plug was applied. In both groups the canals were filled with gutta percha and sealer. The third group included 16 control teeth whose canals were left empty after instrumentation and debridement. The access cavities of all teeth were sealed with varnish and amalgam and the vital perfusion of cats was performed in 4 and 12 week intervals. Statistical analysis was established by χ2 and independence test.Results: After 4 weeks, periapical healing in the first group was 90%, in the second group 80% and in the third group, it was only 12.5 %. After 12 weeks, periapical healing occurred in 100% of the MTA group, while it was 57.1% in the second and 40%in the third group .Generally, in the study of histological parameters of healing, no statistical significant difference was observed between the 2 experimental groups,although the MTA group results were much better than the Ca (OH 2 group especially at 12 weeks.Conclusion: The use of MTA apical plug is more effective than Ca (OH 2 in treatment of necrotic teeth with open

  20. PERIODONTAL DISEASE AND BONE PATHOGENESIS: THE CROSSTALK BETWEEN CYTOKINES AND PORPHYROMONAS GINGIVALIS.

    Science.gov (United States)

    Ballini, A; Cantore, S; Farronato, D; Cirulli, N; Inchingolo, F; Papa, F; Malcangi, G; Inchingolo, A D; Dipalma, G; Sardaro, N; Lippolis, R; Santacroce, L; Coscia, M F; Pettini, F; De Vito, D; Scacco, S

    2015-01-01

    Periodontal disease is the most frequent cause of tooth loss among adults. It is defined as a plaque-induced inflammation of the periodontal tissues that results in a loss of support of the affected teeth. This process is characterized by destruction of the periodontal attachment apparatus, increased bone resorption with loss of crestal alveolar bone, apical migration of the epithelial attachment, and formation of periodontal pockets. Although the presence of periodontal pathogens such as Porphyromonas gingivalis is a prerequisite, the progression of periodontal disease is dependent on the host response to pathogenic bacteria that colonize the tooth surface. Nowadays, a growing body of literature has accumulated to investigate the association between bone diseases, periodontal pathogens and periodontal diseases. The integration of pathogen-associated molecular patterns from microorganisms with their surface receptors in the immune cells, induces the production of several cytokines and chemokines that present either a pro- and/or anti-inflammatory role and the activation of mechanisms of controlling this and the related disease, such as osteoporosis and rheumatoid arthritis. This review focuses on the evidence and significance of bone host cell invasion by Porphyromonas gingivalis in the pathogenesis of bone disorders, as well as the different lines of evidence supporting the role of cytokines in bone diseases.

  1. Terapi Bedah Flep dan Cangkok Tulang pada Periodontitis Agresif di Regio Gigi Anterior Mandibula

    Directory of Open Access Journals (Sweden)

    Levina Mulya

    2012-06-01

    Occurs at a young age with the disease spreading fast and found the bacteria. Commonly aggressive periodontitis associated with hereditary factors and lack of immune system so as to reveal any family history with the same disease, and found savere alveolar bone destruction that may ultimately lead to tooth loss. Aggressive periodontitis and generalized aggressive periodontitis. The development of aggressive periodontitis is difficult to predict, so the mechanical therapy is not sufficient, and required antibiotic therapy or surgical therapy. Aim: the purpose of this case report is to explain the procedures and result of surgical treatment of the flap surgery with bone graft in anterior teeth of the patients with generalized aggressive periodontitis. Case report: Cases one and two with complaints of anterior teeth mobility. On clinical examination teeth mobility two and three degree, absolute pocket depth 4-6 mm. Radiograpic examination bone loss reached one third apical in all region. The diagnosis of both cases in generalized aggressive periodontitis. Treatment: After initial theraphy heve been evaluated, flap surgery with bone graft done in booth cases. Control evaluation after 6 month from surgery, in clinically reduced pocket depth 1-2m and tooth mobility, in radiographically increased bone height and bone fill. Conclusion: Flap surgery with bone graft in generalized aggressive periodontitis can assist periodontal regeneration.

  2. Microbiology of aggressive periodontitis.

    Science.gov (United States)

    Könönen, Eija; Müller, Hans-Peter

    2014-06-01

    For decades, Aggregatibacter actinomycetemcomitans has been considered the most likely etiologic agent in aggressive periodontitis. Implementation of DNA-based microbiologic methodologies has considerably improved our understanding of the composition of subgingival biofilms, and advanced open-ended molecular techniques even allow for genome mapping of the whole bacterial spectrum in a sample and characterization of both the cultivable and not-yet-cultivable microbiota associated with periodontal health and disease. Currently, A. actinomycetemcomitans is regarded as a minor component of the resident oral microbiota and as an opportunistic pathogen in some individuals. Its specific JP2 clone, however, shows properties of a true exogenous pathogen and has an important role in the development of aggressive periodontitis in certain populations. Still, limited data exist on the impact of other microbes specifically in aggressive periodontitis. Despite a wide heterogeneity of bacteria, especially in subgingival samples collected from patients, bacteria of the red complex in particular, and those of the orange complex, are considered as potential pathogens in generalized aggressive periodontitis. These types of bacterial findings closely resemble those found for chronic periodontitis, representing a mixed polymicrobial infection without a clear association with any specific microorganism. In aggressive periodontitis, the role of novel and not-yet-cultivable bacteria has not yet been elucidated. There are geographic and ethnic differences in the carriage of periodontitis-associated microorganisms, and they need to be taken into account when comparing study reports on periodontal microbiology in different study populations. In the present review, we provide an overview on the colonization of potential periodontal pathogens in childhood and adolescence, and on specific microorganisms that have been suspected for their role in the initiation and progression of aggressive

  3. Apical dominance and apical control in multiple flushing of temperate woody species.

    Science.gov (United States)

    M. Cline; C. Harrington

    2007-01-01

    In young plants of many woody species, the first flush of growth in the spring may be followed by one or more flushes of the terminal shoot if growing conditions are favorable. The occurrence of these additional flushes may significantly affect crown form and structure. Apical dominance (AD) and apical control (AC) are thought to be important control mechanisms in this...

  4. Apical root resorption in orthodontically treated adults.

    Science.gov (United States)

    Baumrind, S; Korn, E L; Boyd, R L

    1996-09-01

    This study analyzed the relationship in orthodontically treated adults between upper central incisor displacement measured on lateral cephalograms and apical root resorption measured on anterior periapical x-ray films. A multiple linear regression examined incisor displacements in four directions (retraction, advancement, intrusion, and extrusion) as independent variables, attempting to account for observed differences in the dependent variable, resorption. Mean apical resorption was 1.36 mm (sd +/- 1.46, n = 73). Mean horizontal displacement of the apex was -0.83 mm (sd +/- 1.74, n = 67); mean vertical displacement was 0.19 mm (sd +/- 1.48, n = 67). The regression coefficients for the intercept and for retraction were highly significant; those for extrusion, intrusion, and advancement were not. At the 95% confidence level, an average of 0.99 mm (se = +/- 0.34) of resorption was implied in the absence of root displacement and an average of 0.49 mm (se = +/- 0.14) of resorption was implied per millimeter of retraction. R2 for all four directional displacement variables (DDVs) taken together was only 0.20, which implied that only a relatively small portion of the observed apical resorption could be accounted for by tooth displacement alone. In a secondary set of univariate analyses, the associations between apical resorption and each of 14 additional treatment-related variables were examined. Only Gender, Elapsed Time, and Total Apical Displacement displayed statistically significant associations with apical resorption. Additional multiple regressions were then performed in which the data for each of these three statistically significant variables were considered separately, with the data for the four directional displacement variables. The addition of information on Elapsed Time or Total Apical Displacement did not explain a significant additional portion of the variability in apical resorption. On the other hand, the addition of information on Gender to the

  5. Periodontitis and myocardial hypertrophy.

    Science.gov (United States)

    Suzuki, Jun-Ichi; Sato, Hiroki; Kaneko, Makoto; Yoshida, Asuka; Aoyama, Norio; Akimoto, Shouta; Wakayama, Kouji; Kumagai, Hidetoshi; Ikeda, Yuichi; Akazawa, Hiroshi; Izumi, Yuichi; Isobe, Mitsuaki; Komuro, Issei

    2017-04-01

    There is a deep relationship between cardiovascular disease and periodontitis. It has been reported that myocardial hypertrophy may be affected by periodontitis in clinical settings. Although these clinical observations had some study limitations, they strongly suggest a direct association between severity of periodontitis and left ventricular hypertrophy. However, the detailed mechanisms between myocardial hypertrophy and periodontitis have not yet been elucidated. Recently, we demonstrated that periodontal bacteria infection is closely related to myocardial hypertrophy. In murine transverse aortic constriction models, a periodontal pathogen, Aggregatibacter actinomycetemcomitans markedly enhanced cardiac hypertrophy with matrix metalloproteinase-2 activation, while another pathogen Porphyromonas gingivalis (P.g.) did not accelerate these pathological changes. In the isoproterenol-induced myocardial hypertrophy model, P.g. induced myocardial hypertrophy through Toll-like receptor-2 signaling. From our results and other reports, regulation of chronic inflammation induced by periodontitis may have a key role in the treatment of myocardial hypertrophy. In this article, we review the pathophysiological mechanism between myocardial hypertrophy and periodontitis.

  6. 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

  7. Comorbidity of periodontal disease

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Damgaard, Christian; Olsen, Ingar

    2017-01-01

    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......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....

  8. Nicotine and periodontal tissues

    Directory of Open Access Journals (Sweden)

    Malhotra Ranjan

    2010-01-01

    Full Text Available Tobacco use has been recognized to be a significant risk factor for the development and progression of periodontal disease. Its use is associated with increased pocket depths, loss of periodontal attachment, alveolar bone and a higher rate of tooth loss. Nicotine, a major component and most pharmacologically active agent in tobacco is likely to be a significant contributing factor for the exacerbation of periodontal diseases. Available literature suggests that nicotine affects gingival blood flow, cytokine production, neutrophil and other immune cell function; connective tissue turnover, which can be the possible mechanisms responsible for overall effects of tobacco on periodontal tissues. Inclusion of tobacco cessation as a part of periodontal therapy encourages dental professionals to become more active in tobacco cessation counseling. This will have far reaching positive effects on our patients′ oral and general health.

  9. Smoking and periodontal disease.

    Science.gov (United States)

    Zee, K-Y

    2009-09-01

    Periodontal disease is considered to be an opportunistic infection as a result of interactions between the causative agents (dental plaque) and the host responses which may be modulated by genetic, environmental and acquired risk factors. Besides being a well-confirmed risk factor in a number of systemic diseases, tobacco smoking has also been associated with periodontal disease. Over the past 10-15 years, more and more scientific data on the impact of smoking on various aspects of periodontal disease and the underlying mechanisms has been published. The purpose of this review was to provide an overview of the available data in order to give practitioners a better understanding of the relationship between smoking and periodontal disease. Subsequently, they can use some of the information in treatment decisions and give advice to patients who are smokers suffering from periodontal disease.

  10. Sequential colonization of periodontal pathogens in induction of periodontal disease and atherosclerosis in LDLRnull mice.

    Science.gov (United States)

    Chukkapalli, Sasanka S; Easwaran, Meena; Rivera-Kweh, Mercedes F; Velsko, Irina M; Ambadapadi, Sriram; Dai, Jiayin; Larjava, Hannu; Lucas, Alexandra R; Kesavalu, Lakshmyya

    2017-01-01

    Periodontal disease (PD) and atherosclerotic vascular disease (ASVD) are both chronic inflammatory diseases with a polymicrobial etiology and have been epidemiologically associated. The purpose is to examine whether periodontal bacteria that infect the periodontium can also infect vascular tissues and enhance pre-existing early aortic atherosclerotic lesions in LDLRnull mice. Mice were orally infected with intermediate bacterial colonizer Fusobacterium nucleatum for the first 12 weeks followed by late bacterial colonizers (Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia) for the remaining 12 weeks mimicking the human oral microbiota ecological colonization. Genomic DNA from all four bacterial was detected in gingival plaque by PCR, consistently demonstrating infection of mouse gingival surfaces. Infected mice had significant levels of IgG and IgM antibodies, alveolar bone resorption, and showed apical migration of junctional epithelium revealing the induction of PD. These results support the ability of oral bacteria to cause PD in mice. Detection of bacterial genomic DNA in systemic organs indicates hematogenous dissemination from the gingival pockets. Bacterial infection did not alter serum lipid fractions or serum amyloid A levels and did not induce aortic atherosclerotic plaque. This is the first study examining the causal role of periodontal bacteria in induction of ASVD in LDLRnull mice. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Incidental apical disease at CT scanning

    International Nuclear Information System (INIS)

    McLoud, T.C.; Satoh, K.; Shepard, J.O.; Moore, E.H.; Kosiuk, J.P.

    1990-01-01

    Apical caps are commonly noted on standard radiographs. This paper determines how often abnormalities in the extreme apex of the lung could be identified on CT scans obtained for other reasons. A total of 158 consecutive CT scans were reviewed prospectively. Excluded were patients with obvious upper lobe pleural or parenchymal disease. Apical abnormalities were identified in 74 (46.8%) of the 158 cases. The prevalence increased with age (19% in the 8-39-year age group and 82% in patients older than 80 years). Opacities were unilateral in 44.5% and bilateral in 55.5%. The most common abnormality was linear opacities (95%)

  12. Relationship between the Apical Preparation Diameter and the Apical Seal: An In Vitro Study

    Directory of Open Access Journals (Sweden)

    Kaoutar Laslami

    2018-01-01

    Full Text Available Objectives. The aim of the study is to define the relationship between the apical preparation diameter and the apical sealing ability to highlight the importance of the preservation of the diameter and the original position of the apical foramen. Materials and Methods. 50 extracted maxillary incisors were randomly allocated into three groups of 15 teeth each (n = 15 according to the apical preparation size: Group 1: finishing file F1 corresponding to size 20 reached the working length (ProTaper Universal system Dentsply®; Group 2: prepared up to size 30 corresponding to finishing file F30; Group 3: prepared up to size 50 corresponding to finishing file F5. Five teeth were assigned to positive and negative control groups. After the filling of the root canals, the teeth were isolated and immersed in a dye solution, then cut longitudinally, photographed, and the dye penetration were calculated using a computer software. Results. Comparison of the three different apical preparation sizes showed no statistically significant differences regarding the apical microleakage. Conclusion. The most important value of the dye penetration was observed in the group with the largest apical diameter.

  13. Malignant Arrhythmia in Apical Ballooning Syndrome: Risk Factors and Outcomes

    Directory of Open Access Journals (Sweden)

    Samuel J. Asirvatham

    2008-08-01

    Full Text Available Objectives: We sought to determine the frequency and outcomes with symptomatic arrhythmia in patients with apical ballooning syndrome (ABS. Methods: A retrospective review of the Mayo Clinic Angiography database was conducted to identify patients who met the Mayo criteria for ABS. Patients with documented arrhythmias formed the study group, and 31 randomly selected patients with ABS but without arrhythmia formed the control group.Results: Out of 105 patients identified with ABS, 6 (5.7% women aged 69 +/- 9 years experienced significant arrhythmia (ventricular fibrillation, asystole, 2 patients died, and 1 required permanent pacemaker implantation. When compared with controls, the study group showed no significant difference with respect to ECG characteristics (QT, QRS duration or axis except for R-R interval variability (see comments below (30.6±6 vs 14.5±17 p = 0.0004, QTc, and P-R interval. Patients without arrhythmia were more likely to be on beta-blocker therapy than the study population (33% vs 80.6% p = 0.02. Conclusion: Life-threatening arrhythmia is uncommon (5.7% with ABS despite marked, structural abnormalities. When arrhythmias do occur, the outcome is poor. Prominent variability in R-R intervals appears to be predictive of significant arrhythmias in ABS. The role of beta-blocker therapy in preventing arrhythmia with ABS requires further investigation.

  14. Autoimmunity-Basics and link with periodontal disease.

    Science.gov (United States)

    Kaur, Gagandeep; Mohindra, Kanika; Singla, Shifali

    2017-01-01

    Autoimmune reactions reflect an imbalance between effector and regulatory immune responses, typically develop through stages of initiation and propagation, and often show phases of resolution (indicated by clinical remissions) and exacerbations (indicated by symptomatic flares). The fundamental underlying mechanism of autoimmunity is defective elimination and/or control of self-reactive lymphocytes. Periodontal diseases are characterized by inflammatory conditions that directly affect teeth-supporting structures, which are the major cause of tooth loss. Several studies have demonstrated the involvement of autoimmune responses in periodontal disease. Evidence of involvement of immunopathology has been reported in periodontal disease. Bacteria in the dental plaque induce antibody formation. Autoreactive T-cells, natural killer cells, ANCA, heat shock proteins, autoantibodies, and genetic factors are reported to have an important role in the autoimmune component of periodontal disease. The present review describes the involvement of autoimmune responses in periodontal diseases and also the mechanisms underlying these responses. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Treatment of aggressive periodontitis.

    Science.gov (United States)

    Teughels, Wim; Dhondt, Rutger; Dekeyser, Christel; Quirynen, Marc

    2014-06-01

    Despite etiological differences between aggressive and chronic periodontitis, the treatment concept for aggressive periodontitis is largely similar to that for chronic periodontitis. The goal of treatment is to create a clinical condition that is conducive to retaining as many teeth as possible for as long as possible. When a diagnosis has been made and risk factors have been identified, active treatment is commenced. The initial phase of active treatment consists of mechanical debridement, either alone or supplemented with antimicrobial drugs. Scaling and root planing has been shown to be effective in improving clinical indices, but does not always guarantee long-term stability. Antimicrobials can play a significant role in controlling aggressive periodontitis. Few studies have been published on this subject for localized aggressive periodontitis, but generalized aggressive periodontitis has been subject to more scrutiny. Studies have demonstrated that systemic antibiotics as an adjuvant to scaling and root planing are more effective in controlling disease compared with scaling and root planing alone or with supplemental application of local antibiotics or antiseptics. It has also become apparent that antibiotics ought to be administered with, or just after, mechanical debridement. Several studies have shown that regimens of amoxicillin combined with metronidazole or regimens of clindamycin are the most effective and are preferable to regimens containing doxycycline. Azithromycin has been shown to be a valid alternative to the regimen of amoxicillin plus metronidazole. A limited number of studies have been published on surgical treatment in patients with aggressive periodontitis, but the studies available show that the effect can be comparable with the effect on patients with chronic periodontitis, provided that proper oral hygiene is maintained, a strict maintenance program is followed and modifiable risk factors are controlled. Both access surgery and

  16. 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.)

  17. Apical Hypertrophic Cardiomyopathy Mimicking Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Lütfü Bekar

    2013-03-01

    Full Text Available Apical hypertrophic cardiomyopathy is a rare form of hypertrophic cardiomyopathy and it can be mistaken for coronary artery disease due to the symptoms and electrocardiography findings. In this report, we aimed to present a patient referred to our clinic with complaints of chest pain and electrocardiography findings who had been misdiagnosed as non-ST elevation acute coronary syndrome.

  18. The resection angle in apical surgery

    DEFF Research Database (Denmark)

    von Arx, Thomas; Janner, Simone F M; Jensen, Simon S

    2016-01-01

    OBJECTIVES: The primary objective of the present radiographic study was to analyse the resection angle in apical surgery and its correlation with treatment outcome, type of treated tooth, surgical depth and level of root-end filling. MATERIALS AND METHODS: In the context of a prospective clinical...

  19. Effects of Angipars on oxidative inflammatory indices in a murine model of periodontitis

    Directory of Open Access Journals (Sweden)

    M Mousavi-Jazi

    2010-12-01

    Full Text Available Background and the purpose of the study: There are strong evidences linking overproduction of reactive oxygen species and periodontal disease. The aim of this study was to evaluate efficacy of Angipars a natural potent anti oxidative agent on markers of the oxidative damages and periodontal inflammation in the rat. Methods: Periodontitis was induced by single injection of lipopolysaccharide (LPS from E. coli (10 µg/µl saline into rat mandibular gingiva. After 10 days, animals in the test group received Angipars (2.1 mg/kg by gavage once a day and those of control group received same amount of vehicle. The amount of interleukin (IL-1β, lipid peroxidation (LPO, and 8-hydroxydeoxyguanosine (8-OHdG were measured in gingival biopsy samples and the degree of apical migration of junctional epithelium (JE, alveolar bone resorption, and the number of polymorphonuclears (PMN were evaluated by histological analysis of block samples of the left mandibular first molars. Results: Periodontitis group showed a significant increase in periodontal IL-1β, LPO, 8-OHdG, apical migration of JE, alveolar bone resorption and number of PMNs. Angipars treatment resulted in a significant decrease in gingival IL-1β, LPO, 8-OHdG and the apical migration of JE; however, the reduction of alveolar bone resorption was not significant. The number of PMN increased significantly after treatment with Angipars. While intake of vehicle resulted in a significant decrease in gingival IL-1β and LPO, the reduction of 8-OHdG, apical migration of JE, and alveolar bone resorption were not significant. Interestingly, PMNs were increased in groups received Angipars or the vehicle. Conclusion: From the results of this study, it seems that Angipars is beneficial in periodontitis by reduction of inflammatory and oxidative damage. Unexpected increase of PMN count by Angipars strengthens the hypothesis that chronic inflammatory disorders like periodontitis may need more time to get best

  20. Comparison of Quick-Set and mineral trioxide aggregate root-end fillings for the regeneration of apical tissues in dogs.

    Science.gov (United States)

    Kohout, George D; He, Jianing; Primus, Carolyn M; Opperman, Lynne A; Woodmansey, Karl F

    2015-02-01

    Quick-Set (Avalon Biomed Inc, Bradenton, FL) is a calcium aluminosilicate cement that is a potential alternative to mineral trioxide aggregate (MTA) with greater acid resistance and faster setting. The purpose of this study was to compare the regeneration of apical tissues after root-end surgery when the apical tissues were exposed to Quick-Set or White ProRoot MTA (Dentsply Tulsa Dental Specialties, Tulsa, OK) by root-end resection. The root canals of 42 mandibular premolars in 7 beagle dogs were accessed, cleaned and shaped, and obturated with Quick-Set or white MTA. Osteotomies and root-end resections were performed immediately. The dogs were sacrificed at 90 days, and the teeth and surrounding tissues were removed and prepared for histologic analysis. The sections of the apical areas were scored for inflammation, new cementum formation, periodontal ligament formation, and bone quality. At 90 days, both materials supported some degree of cementum formation on the surface of the material, periodontal ligament regeneration, and excellent bone quality. The only significant difference was greater inflammation found in the Quick-Set group. Quick-Set and White ProRoot MTA had a similar effect on bone quality, cementum formation, and periodontal ligament formation after root-end surgery in dogs. Quick-Set was associated with greater inflammation. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. Apical versus Non-Apical Lead: Is ICD Lead Position Important for Successful Defibrillation?

    Science.gov (United States)

    Amit, Guy; Wang, Jia; Connolly, Stuart J; Glikson, Michael; Hohnloser, Stephan; Wright, David J; Brachmann, Johannes; Defaye, Pascal; Neuzner, Joerg; Mabo, Philippe; Vanerven, Liselot; Vinolas, Xavier; O'Hara, Gilles; Kautzner, Josef; Appl, Ursula; Gadler, Fredrik; Stein, Kenneth; Konstantino, Yuval; Healey, Jeff S

    2016-05-01

    We aim to compare the acute and long-term success of defibrillation between non-apical and apical ICD lead position. The position of the ventricular lead was recorded by the implanting physician for 2,475 of 2,500 subjects in the Shockless IMPLant Evaluation (SIMPLE) trial, and subjects were grouped accordingly as non-apical or apical. The success of intra-operative defibrillation testing and of subsequent clinical shocks were compared. Propensity scoring was used to adjust for the impact of differences in baseline variables between these groups. There were 541 leads that were implanted at a non-apical position (21.9%). Patients implanted with a non-apical lead had a higher rate of secondary prevention indication. Non-apical location resulted in a lower mean R-wave amplitude (14.0 vs. 15.2, P defibrillation was similar between propensity score matched groups (89%). Over a mean follow-up of 3 years, there were no significant differences in the yearly rates of appropriate shock (5.5% vs. 5.4%, P = 0.98), failed appropriate first shock (0.9% vs. 1.0%, P = 0.66), or the composite of failed shock or arrhythmic death (2.8% vs. 2.3% P = 0.35) according to lead location. We did not detect any reduction in the ICD efficacy at the time of implant or during follow-up in patients receiving a non-apical RV lead. © 2016 Wiley Periodicals, Inc.

  2. Periodontally accelerated osteogenic orthodontics (PAOO) - a review.

    Science.gov (United States)

    Amit, Goyal; Jps, Kalra; Pankaj, Bhatiya; Suchinder, Singla; Parul, Bansal

    2012-12-01

    With an increasing number of adult patients coming to the orthodontic clinic, the orthodontic professional is constantly looking for ways to accelerate tooth movement. Surgical intervention to affect the alveolar housing and tooth movement has been described in various forms for over a hundred years. However, it is the spirit of interdisciplinary collaboration in orthodontics has expanded the realm of traditional orthodontic tooth movement protocols. Periodontal accelerated osteogenic orthodontics (PAOO) is a clinical procedure that combines selective alveolar corticotomy, particulate bone grafting, and the application of orthodontic forces. This procedure is theoretically based on the bone healing pattern known as the regional acceleratory phenomenon (RAP). PAOO results in an increase in alveolar bone width, shorter treatment time, increased post treatment stability, and decreased amount of apical root resorption. Tooth movement can be enhanced and cases completed with increased alveolar volume providing for a more intact periodontium, decreased need for extractions, degree of facial remodeling and increased bone support for teeth and overlying soft tissues, thereby augmenting gingival and facial esthetics.The purpose of this article is to describe the history, biology, clinical surgical procedures, indications, contraindications and possible complications of the PAOO procedure. Key words:Periodontics, corticotomy, osteogenic, orthodontics.

  3. 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)

  4. Periodontitis and osteoporosis.

    Science.gov (United States)

    Straka, Michal; Straka-Trapezanlidis, Michaela; Deglovic, Juraj; Varga, Ivan

    2015-01-01

    Today's knowledge and studies show a firm correlation between osteoporosis and periodontitis, particularly in postmenopausal women. This review study deals with epidemiological and etiopathogenetic association between chronic periodontitis and an osteoporosis. A special emphasis is put on explanation of possible relations between a premature tooth loss and decrease of length and density of jaw bones, particularly their alveolar prolongations. The second part of the paper deals with principles of treatment in patients suffering of osteoporosis. Osteoporosis reduces density of jaw bones and decreases a number of teeth in jaws, but it does not affect other clinical signs and markers of periodontitis such as inflammation, bleeding and the depth of periodontal pockets and microbial plaque.

  5. A modern approach to surgical endodontics: ultrasonic apical preparation.

    Science.gov (United States)

    Kellert, M; Solomon, C; Chalfin, H

    1994-01-01

    Ultrasonic devices are capable of generating better apical preparations than rotary instruments with less sacrifice of root structure. Regardless of the technique used, good lighting and magnification are necessary to insure an adequate apical preparation.

  6. Risk Factors for Periodontitis

    OpenAIRE

    Van Dyke, Thomas E.; Dave, Sheilesh

    2005-01-01

    In recent years, it has become apparent that the pathogenesis of periodontal diseases is more complex than the presence of virulent microorganisms. In fact, it is now widely accepted that susceptibility to periodontitis varies greatly between individuals who harbor the same, pathogenic microflora. To date, the bulk of evidence points to the host response to bacterial challenge as a major determinant of susceptibility. In this review, we will assess the data implicating various inherited and a...

  7. Smoking and Periodontal Diseases

    OpenAIRE

    Torkzaban; Khalili; Ziaei

    2013-01-01

    Context The aim of this review was to examine evidences for the association between smoking and periodontal disease, to discuss possible biological mechanisms whereby smoking may adversely affect the periodontium, and to consider the effect of smoking on periodontal treatment. Evidence Acquisition A web-based search in PubMed and Google Scholar was performed to identify publications regarding the effects of smoking on various aspe...

  8. MR Imaging in symptomatic osteochondromas

    International Nuclear Information System (INIS)

    Kim, Soo Young; Kim, Jee Young; Kim, Sang Heum; Chun, Kyung Ah; Park, Young Ha

    1998-01-01

    The purpose of this study is to assess the MR findings of symptomatic osteochondromas. We evaluated 31 patients who between July, 1994 and May, 1997 underwent MR imaging for symptomatic osteochondroma. Fourteen were males and 17 were females, and their ages ranged from 8 to 49 (mean, 23) years. Using T1WI, T2WI and gadolinium-DTPA-enhanced T1WI, images were analysed according to signal intensity in the osseous component of the osteochondroma, thickness of the cartilage cap, and associated change in surrounding soft tissue. Clinical manifestation included a palpable mass or tendency to grow (n=22) and pain on movement (n=9). Complications were of three types : that which followed change in the osseous component of the tumor, associated change in surrounding soft tissue, and malignant transformation. In the osseous component, bone marrow edema or contusion was seen in 21 cases (67.7%), and in two (65%), fracture was observed. In surrounding soft tissue, muscle impingement was seen in 21 cases (67.7%), bursitis was in 7 cases (22.6 %), tenosynovitis in seven (22.6 %), and vascular compression in five (16.1 %). In three cases (9.7%), transformation to chondrosarcoma had occurred; two of these were derived from osteochondromatosis and one from a single osteochondroma. The thickness of the cartilage cap was as follow : 10 mm (n=3). In patients with symptomatic osteochondroma, MR imaging is useful for detecting both complications and malignant transformation. (author). 21 refs., 1 tab., 6 figs

  9. Cell therapy with allogenic canine periodontal ligament-derived cells in periodontal regeneration of critical size defects.

    Science.gov (United States)

    Nuñez, Javier; Sanchez, Nerea; Vignoletti, Fabio; Sanz-Martin, Ignacio; Caffesse, Raul; Santamaria, Silvia; Garcia-Sanz, Jose A; Sanz, Mariano

    2017-12-29

    The objective of this in vivo experimental study to evaluate the regenerative potential of a cell therapy combining allogenic periodontal ligament-derived cells within a xenogeneic bone substitute in a similar experimental model. In nine beagle dogs, critical size 6-mm supra-alveolar periodontal defects were created around the PIII and PIV. The resulting supra-alveolar defects were randomly treated with either 1.4 × 10 6 allogenic canine periodontal ligament-derived cells seeded on de-proteinized bovine bone mineral with 10% collagen (DBBM-C) (test group) or DBBM-C without cells (control group). Specimens were obtained at 3 months, and histological outcomes were studied. The histological analysis showed that total furcation closure occurred very seldom in both groups, being the extent of periodontal regeneration located in the apical third of the defect. The calculated amount of periodontal regeneration at the furcation area was comparable in both the test and control groups (1.93 ± 1.14 mm (17%) versus 2.35 ± 1.74 mm (22%), respectively (p = .37). Similarly, there were no significant differences in the amount of new cementum formation 4.49 ± 1.56 mm (41%) versus 4.97 ± 1.05 mm (47%), respectively (p = .45). This experimental study was unable to demonstrate the added value of allogenic cell therapy in supra-crestal periodontal regeneration. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Regeneration of okra (Abelmoschus esculentus L.) via apical shoot ...

    African Journals Online (AJOL)

    USER

    2012-10-25

    Oct 25, 2012 ... The present study was undertaken to evaluate the most suitable concentration of growth regulators for regeneration of okra (Abelmoschus esculentus L. Monech) via apical shoot culture system. The study of apical shoot culture system was found effective for regeneration of apical shoots. The okra (A.

  11. Regeneration of okra ( Abelmoschus esculentus L.) via apical shoot ...

    African Journals Online (AJOL)

    The present study was undertaken to evaluate the most suitable concentration of growth regulators for regeneration of okra (Abelmoschus esculentus L. Monech) via apical shoot culture system. The study of apical shoot culture system was found effective for regeneration of apical shoots. The okra (A. esculentus L. Monech) ...

  12. 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...

  13. Type III apical transportation of root canal

    Directory of Open Access Journals (Sweden)

    Shiv P Mantri

    2012-01-01

    Full Text Available Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA. Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

  14. Evaluation of three instrumentation techniques at the precision of apical stop and apical sealing of obturation

    Directory of Open Access Journals (Sweden)

    Özgür Genç

    2011-08-01

    Full Text Available OBJECTIVE: The aim of this study was to investigate the ability of two NiTi rotary apical preparation techniques used with an electronic apex locator-integrated endodontic motor and a manual technique to create an apical stop at a predetermined level (0.5 mm short of the apical foramen in teeth with disrupted apical constriction, and to evaluate microleakage following obturation in such prepared teeth. MATERIAL AND METHODS: 85 intact human mandibular permanent incisors with single root canal were accessed and the apical constriction was disrupted using a #25 K-file. The teeth were embedded in alginate and instrumented to #40 using rotary Lightspeed or S-Apex techniques or stainless-steel K-files. Distance between the apical foramen and the created apical stop was measured to an accuracy of 0.01 mm. In another set of instrumented teeth, root canals were obturated using gutta-percha and sealer, and leakage was tested at 1 week and 3 months using a fluid filtration device. RESULTS: All techniques performed slightly short of the predetermined level. Closest preparation to the predetermined level was with the manual technique and the farthest was with S-Apex. A significant difference was found between the performances of these two techniques (p<0.05. Lightspeed ranked in between. Leakage was similar for all techniques at either period. However, all groups leaked significantly more at 3 months compared to 1 week (p<0.05. CONCLUSIONS: Despite statistically significant differences found among the techniques, deviations from the predetermined level were small and clinically acceptable for all techniques. Leakage following obturation was comparable in all groups.

  15. Rethinking periodontal inflammation.

    Science.gov (United States)

    Offenbacher, Steven; Barros, Silvana P; Beck, James D

    2008-08-01

    Clinical signs and symptoms, as well as medical and dental history, are all considered in the clinical determination of gingival inflammation and periodontal disease severity. However, the "biologic systems model" highlights that the clinical presentation of periodontal disease is closely tied to the underlying biologic phenotype. We propose that the determination and integration of subject-level factors, microbial composition, systemic immune response, and gingival tissue inflammatory mediator responses will better reflect the biology of the biofilm-gingival interface in a specific patient and may provide insights on clinical management. Disease classifications and multivariable models further refine the biologic basis for the increasing severity of periodontal disease expression. As such, new classifications may better identify disease-susceptible and treatment-non-responsive individuals than current classifications that are heavily influenced by probing and attachment level measurements alone. New data also suggest that the clinical characteristics of some complex diseases, such as periodontal disease, are influenced by the genetic and epigenetic contributions to clinical phenotype. Although the genetic basis for periodontal disease is considered imperative for setting an inflammatory capacity for an individual and, thus, a threshold for severity, there is evidence to suggest an epigenetic component is involved as well. Many factors long associated with periodontitis, including bacterial accumulations, smoking, and diabetes, are known to produce strong epigenetic changes in tissue behavior. We propose that we are now able to rethink periodontal disease in terms of a biologic systems model that may help to establish more homogeneous diagnostic categories and can provide insight into the expected response to treatment.

  16. Scanning electron microscopic study of apical and intracanal resorption.

    Science.gov (United States)

    Delzangles, B

    1989-07-01

    Apical radicular and intracanal surfaces of extracted teeth with apical lesions were examined by means of scanning electron microscopy. The distribution of apical and intracanal resorption areas varied with the presence of a granuloma or a cyst. Teeth bearing granulomas showed an apical resorption centered on the main foramina whereas the hard tissue underlying a cyst showed little or no resorption. Intracanal resorption was always marked in the apical third and more scattered in the middle and cervical third. The resorption disrupted the anatomical structures.

  17. MR Imaging in symptomatic osteochondromas

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    Kim, Soo Young; Kim, Jee Young; Kim, Sang Heum; Chun, Kyung Ah; Park, Young Ha [Catholic University of Korea, Seoul (Korea, Republic of)

    1998-06-01

    The purpose of this study is to assess the MR findings of symptomatic osteochondromas. We evaluated 31 patients who between July, 1994 and May, 1997 underwent MR imaging for symptomatic osteochondroma. Fourteen were males and 17 were females, and their ages ranged from 8 to 49 (mean, 23) years. Using T1WI, T2WI and gadolinium-DTPA-enhanced T1WI, images were analysed according to signal intensity in the osseous component of the osteochondroma, thickness of the cartilage cap, and associated change in surrounding soft tissue. Clinical manifestation included a palpable mass or tendency to grow (n=22) and pain on movement (n=9). Complications were of three types : that which followed change in the osseous component of the tumor, associated change in surrounding soft tissue, and malignant transformation. In the osseous component, bone marrow edema or contusion was seen in 21 cases (67.7%), and in two (65%), fracture was observed. In surrounding soft tissue, muscle impingement was seen in 21 cases (67.7%), bursitis was in 7 cases (22.6 %), tenosynovitis in seven (22.6 %), and vascular compression in five (16.1 %). In three cases (9.7%), transformation to chondrosarcoma had occurred; two of these were derived from osteochondromatosis and one from a single osteochondroma. The thickness of the cartilage cap was as follow : < 5 mm (n=16), 5-10 mm (n=12), and > 10 mm (n=3). In patients with symptomatic osteochondroma, MR imaging is useful for detecting both complications and malignant transformation. (author). 21 refs., 1 tab., 6 figs.

  18. 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

  19. Symptomatic management in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Pushkar Shah

    2015-01-01

    Full Text Available Multiple sclerosis (MS is the commonest cause of disability in young adults. While there is increasing choice and better treatments available for delaying disease progression, there are still, very few, effective symptomatic treatments. For many patients such as those with primary progressive MS (PPMS and those that inevitably become secondary progressive, symptom management is the only treatment available. MS related symptoms are complex, interrelated, and can be interdependent. It requires good understanding of the condition, a holistic multidisciplinary approach, and above all, patient education and empowerment.

  20. Periodontics: 8. Periodontal problems associated with compromised anterior teeth.

    Science.gov (United States)

    Byrne, Patrick J; Irwin, Chris; Mullally, Brian; Allen, Edith; Ziada, Hassan

    2008-01-01

    Periodontal disease can significantly impact on the appearance of the anterior teeth. Prior to any definitive treatment, stabilization of the periodontal condition is a requirement. Treatment options can range from the placement of simple restorations, through orthodontic realignment, to the extraction and replacement of hopeless teeth. Each treatment plan must be individually tailored to the patient and level of periodontal disease, and must include provision for maintenance periodontal therapy. Periodontal diseases may compromise the prognosis of anterior teeth. Management is challenging and clinicians should take into consideration the short and long-term survival in treatment planning.

  1. Relationship between diabetes and periodontal infection

    OpenAIRE

    Llambés, Fernando; Arias-Herrera, Santiago; Caffesse, Raúl

    2015-01-01

    Periodontal disease is a high prevalent disease. In the United States 47.2% of adults ≥ 30 years old have been diagnosed with some type of periodontitis. Longitudinal studies have demonstrated a two-way relationship between diabetes and periodontitis, with more severe periodontal tissue destruction in diabetic patients and poorer glycemic control in diabetic subjects with periodontal disease. Periodontal treatment can be successful in diabetic patients. Short term effects of periodontal treat...

  2. Serum antibodies to periodontal bacteria as diagnostic markers of periodontitis.

    Science.gov (United States)

    Dye, Bruce A; Herrera-Abreu, Miriam; Lerche-Sehm, Julia; Vlachojannis, Christian; Pikdoken, Levent; Pretzl, Bernadette; Schwartz, Aaron; Papapanou, Panos N

    2009-04-01

    Assessment of periodontal conditions in epidemiologic studies usually requires a clinical examination, which is resource-intensive. We investigated the ability of serum immunoglobulin G (IgG) antibodies to periodontal bacteria to reflect clinical periodontal status. We used checkerboard immunoblotting to assess serum IgG levels to 19 species, including established/putative periodontal pathogens and non-pathogenic bacteria, in 5,747 dentate adults aged > or = 40 years who participated in the third National Health and Nutrition Examination Survey between 1988 and 1994. Three earlier described alternative definitions of periodontitis were used, based on specific combinations of probing depth and attachment level values. Optimized elevated titer thresholds and corresponding sensitivities and specificities were calculated for each definition. Titers significantly associated with periodontitis were identified in univariable and multivariable logistic regression models. Parsimonious models were subsequently developed using age, gender, race/ethnicity, education, smoking, and diagnosed diabetes. In unadjusted models, high titers to Porphyromonas gingivalis were most strongly associated with periodontitis across all definitions (odds ratio, 2.07 to 2.74; P periodontitis, whereas high Eubacterium nodatum titers were associated with periodontal health in two of three definitions. Receiver operating characteristic curves for the parsimonious multivariable models showed that the area under the curve ranged between 0.72 and 0.78. Serum IgG titers to selected periodontal species, combined with demographic and behavioral characteristics, resulted in a moderately accurate classification of periodontal status in epidemiologic studies. The external validity of these findings must be examined further.

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

    DEFF Research Database (Denmark)

    Ramírez, Valeria; Hach, Maria; López, Rodrigo

    2018-01-01

    Since its introduction in 1999, the term aggressive periodontitis has been the topic of many investigations. Articles supporting the International Workshop for a Classification of Periodontal Diseases list several disease features, but do not offer operational criteria for identifying cases....... 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...... in English. RESULTS: The electronic search yielded 833 abstracts. Of these, 472 publications fulfilled the inclusion criteria and were appraised. In 26.5% of the publications no information on aggressive periodontitis operationalization is presented, but reference is made to another article. In 12...

  4. [Treatment of localized intrabony periodontal defects with enamel matrix derivative (Emdogain). Case series].

    Science.gov (United States)

    Szatmári, Péter; Gera, István

    2014-03-01

    The solitary vertical or horisonto-vertical bone lesions are mainly characteristic of aggressive periodontitis. Only a combined conservative-surgical approach can result in predictable healing. From the early 50's basically two surgical techniques were used for correcting vertical bony defects. The so called bone resective techniques combined with apically positioned flap resulted in the flattening of the bone contour by removing substantial amount of alveolar bone but compromising the periodontal support of the neighboring teeth. The other surgical approach was the facilitation of the reformation of new periodontal attachment and bone with or without bone grafting. Since the mid 80's the gold standard in the therapy of deep vertical bony defects is the guided tissue regeneration (GTR), although an alternative approach has also been developed using different growth and differentiation factors promoting periodontal wound healing. Today in the clinical practices both in periodontal osseous and mucogingival surgeries the most widely used biological factor is the amelogenin and its commercially available product the Enamel Matrix Derivative (Emdogain). With the presented five solitary horisonto-vertical bony defects of three patients the possibilities and the late results are presented that could have been achieved with the application of EMD and thorough postoperative follow-up. The clinical results were comparable to the current data presented by articles in peer reviewed periodontal journals.

  5. Diabetes and periodontal disease

    Directory of Open Access Journals (Sweden)

    Rajkumar Daniel

    2012-01-01

    Full Text Available Diabetes mellitus is a systemic disease characterized by increased blood glucose levels and abnormalities of lipid metabolism due to absence or decreased level of insulin. It affects all the body organs and their functions either directly or indirectly. Every dentist should have a basic understanding of the etiopathogenesis, oral and systemic manifestations of this disease. The periodontal diseases are a consequence of extension of the gingival inflammation into the underlying supporting structures of the periodontium, initiated by the presence of plaque and its products on the surfaces of the teeth and the adjoining structures. The progression of periodontal disease is influenced by variety of factors like microorganisms, host response, systemic background, and genetic makeup of the host. Amongst them, diabetes mellitus tops the list. Diabetes and periodontitis influence the clinical outcome of each other and control of both influences the clinical improvement of each.

  6. Defining a periodontitis case

    DEFF Research Database (Denmark)

    Baelum, Vibeke; Lopez, Rodrigo

    2012-01-01

    Aim The purpose of the present study was to assess the extent to which the three periodontitis case definition systems proposed by van der Velden, Tonetti & Claffey and Page & Eke identify the same cases in a population of never-treated adults with limited tradition for oral hygiene procedures...... of the concomitant presence of CAL and BOP at the site level. Results The case definitions by Tonetti & Claffey and by Page & Eke yielded similar results, which were also quite similar to the results of simply identifying a case of periodontitis as a person having at least one site showing both CAL ≥ 4 mm and BOP....... Conclusions The results indicate that it should be feasible for the periodontal community to reach an agreement over the distinction between a case and a non-case. The classification system proposed by van der Velden is better suited for providing clinicians with a clear image of the case....

  7. Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse-A prospective multicenter study

    DEFF Research Database (Denmark)

    Rahkola-Soisalo, Päivi; Altman, Daniel; Falconer, Christian

    2017-01-01

    OBJECTIVE: To study the effects on quality of life in women operated for apical pelvic organ prolapse using the Vaginal Uphold™ System. STUDY DESIGN: In this prospective cohort study, women (n=207) with symptomatic apical prolapse, with or without cystocele, were operated using the Uphold™ Vaginal...... Support System. Follow-up for quality of life was performed at 12 months after surgery, and assessed by the PFDI-20, and PFIQ-7, and sexual function by the PISQ-12. We used odds ratios (ORs) with 95% confidence intervals (CIs) for outcome association analyses using logistic regression. RESULTS: At one......-year follow-up majority of women experienced an overall postoperative improvement in quality of life (p

  8. Chronic periodontitis and implant dentistry.

    Science.gov (United States)

    Smith, Michael M; Knight, Ellie T; Al-Harthi, Latfiya; Leichter, Jonathan W

    2017-06-01

    Dental implants are regularly placed in patients with a history of periodontitis, even though peri-implant tissues are susceptible to the same host-modulated plaque-induced factors that initiate and sustain periodontitis. This article endeavors to clarify the evidence regarding the history of periodontitis as a risk factor for implant success and survival, and the role of supportive periodontal therapy in maintaining implants for individuals with a history of periodontitis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. 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.

  10. Multimodality imaging in apical hypertrophic cardiomyopathy

    Science.gov (United States)

    Parisi, Rosario; Mirabella, Francesca; Secco, Gioel Gabrio; Fattori, Rossella

    2014-01-01

    Apical hypertrophic cardiomyopathy (AHCM) is a relatively rare morphologic variant of HCM in which the hypertrophy of myocardium is localized to the left ventricular apex. Symptoms of AHCM might vary from none to others mimic coronary artery disease including acute coronary syndrome, thus resulting in inappropriate hospitalization. Transthoracic echocardiography is the first-line imaging technique for the diagnosis of hypertrophic cardiomyopathies. However, when the hypertrophy of the myocardium is localized in the ventricular apex might results in missed diagnosis. Aim of this paper is to review the different imaging techniques used for the diagnosis of AHCM and their role in the detection and comprehension of this uncommon disease. PMID:25276293

  11. Predicting periodontitis progression?

    Science.gov (United States)

    Ferraiolo, Debra M

    2016-03-01

    Cochrane Library, Ovid, Medline, Embase and LILACS were searched using no language restrictions and included information up to July 2014. Bibliographic references of included articles and related review articles were hand searched. On-line hand searching of recent issues of key periodontal journals was performed (Journal of Clinical Periodontology, Journal of Dental Research, Journal of Periodontal Research, Journal of Periodontology, Oral Health and Preventive Dentistry). Prospective and retrospective cohort studies were used for answering the question of prediction since there were no randomised controlled trials on this topic. Risk of bias was assessed using the validated Newcastle-Ottawa quality assessment scale for non-randomised studies. Cross-sectional studies were included in the summary of currently reported risk assessment tools but not for risk of progression of disease, due to the inability to properly assess bias in these types of studies. Titles and abstracts were scanned by two reviewers independently.Full reports were obtained for those articles meeting inclusion criteria or those with insufficient information in the title to make a decision. Any published risk assessment tool was considered. The tool was defined to include any composite measure of patient-level risk directed towards determining the probability for further disease progression in adults with periodontitis. Periodontitis was defined to include both chronic and aggressive forms in the adult population. Outcomes included changes in attachment levels and/or deepening of periodontal pockets in millimeters in study populations undergoing supportive periodontal therapy. Data extraction was performed independently and in collaboration by two reviewers; completed evidence tables were reviewed by three reviewers. Studies were each given a descriptive summary to assess the quantity of data as well as further assessment of study variations within study characteristics. This also allowed for

  12. Apices of maxillary premolars observed by swept source optical coherence tomography

    Science.gov (United States)

    Ebihara, Arata; Iino, Yoshiko; Yoshioka, Toshihiko; Hanada, Takahiro; Sunakawa, Mitsuhiro; Sumi, Yasunori; Suda, Hideaki

    2015-02-01

    Apicoectomy is performed for the management of apical periodontitis when orthograde root canal treatment is not possible or is ineffective. Prior to the surgery, cone beam computed tomography (CBCT) examination is often performed to evaluate the lesion and the adjacent tissues. During the surgical procedure, the root apex is resected and the resected surface is usually observed under dental operating microscope (DOM). However, it is difficult to evaluate the details and the subsurface structure of the root using CBCT and DOM. A new diagnostic system, swept source optical coherence tomography (SS-OCT), has been developed to observe the subsurface anatomical structure. The aim of this study was to observe resected apical root canals of human maxillary premolars using SS-OCT and compare the findings with those observed using CBCT and DOM. Six extracted human maxillary premolars were used. After microfocus computed tomography (Micro CT; for gold standard) and CBCT scanning of the root, 1 mm of the apex was cut perpendicular to the long axis of the tooth. Each resected surface was treated with EDTA, irrigated with saline solution, and stained with methylene blue dye. The resected surface was observed with DOM and SS-OCT. This sequence was repeated three times. The number of root canals was counted and statistically evaluated. There was no significant difference in the accuracy of detecting root canals among CBCT, DOM and SS-OCT (p > 0.05, Wilcoxon test). Because SS-OCT can be used in real time during surgery, it would be a useful tool for observing resected apical root canals.

  13. Intrasellar Symptomatic Salivary Gland Rest

    Directory of Open Access Journals (Sweden)

    Chih-Hao Chen

    2007-05-01

    Full Text Available Ectopic salivary gland tissue in sellar turcica is frequently observed in microscopic examination at autopsy. This tissue is considered clinically silent. Only 2 symptomatic cases have been previously reported. Here we report a 28-year-old woman presenting with galactorrhea and hyperprolactinemia. Magnetic resonance imaging revealed a 6×5-mm nodule in the posterior aspect of the pituitary gland. This nodule showed isointensity on T1- and T2-weighted images and less enhancement on post-contrast T1-weighted images. Transsphenoidal exploration revealed a cystic lesion within the pituitary gland, which consisted of a grayish gelatinous content. The pathologic examination confirmed the diagnosis of salivary gland rest.

  14. Desired Diversity and Symptomatic Anxiety

    DEFF Research Database (Denmark)

    Friis Christensen, Jannick; Muhr, Sara Louise

    2018-01-01

    This paper conceptualises organisational diversity as constituted by psychoanalytic lack. Empirically, we show how diversity as Lacanian lack is understood as nothing in or of itself, but as an empty signifier with no signified. The lack of diversity becomes a catalyst for desiring particular ideas...... of diversity that, however, constantly change due to the empty form of diversity. Anxiety manifests itself in the obsession of unobtainable idealised forms of diversity as well as in the uncertainty associated with the traumatic experience of always falling short of what is desired in an object...... – the experience of failed diversity. Conclusively, we discuss the productive potential of the power of lack. The impossibility of diversity is what, at once, conditions the possibility of diversity. We therefore suggest that the symptomatic anxiety provoked by the lack should be enjoyed in order to engage...

  15. Symptomatic outcome after laparoscopic cholecystectomy.

    Science.gov (United States)

    Niranjan, B; Chumber, S; Kriplani, A K

    2000-01-01

    Patients with gallstones often present with multiple complaints. We wanted to study the major complaints of our patients undergoing laparoscopic cholecystectomy and the symptomatic relief afforded by the operation. We studied 113 patients with symptomatic gallstone disease who underwent laparoscopic cholecystectomy in a single surgical unit. Patients with proven common bile duct stones, obstructive jaundice, cholangitis, present or past associated abdominal pathology or cholecystoenteric fistula were excluded from the study. The mean follow up period was 18 months (range 10-22 months). A detailed account of the symptoms of gallstones, length of post-operative stay, persistence of symptoms, development of fresh symptoms and resumption of fat containing diet were assessed. The male to female ratio was 1:4. Common presenting symptoms were abdominal pain (96%), flatulence or feeling of fullness of abdomen (85%), heartburn (66%), belching (62%), sour eructation (52%), vomiting (48%) and nausea (45%). Mean postoperative hospital stay was 28 hours (range 9-68 hours). Biliary pain was relieved in 99% of patients after laparoscopic cholecystectomy (p cholecystectomy. Fresh symptoms that developed after laparoscopic cholecystectomy were heart-burn (6%), belching (3.5%), sour eructation (1%) and vomiting (0.5%). Post-cholecystectomy post-prandial diarrhoea occurred in 20% of the patients. The patients' appreciation of a satisfactory cosmetic result of operation scars was 100 percent. Fifteen female patients (13.5%) complained of increased weight gain of more than 5 kg after laparoscopic cholecystectomy [(p > 0.05; not significant (NS)]. Laparoscopic cholecystectomy significantly relieved symptoms of gall stone disease. Biliary pain, nausea, vomiting and sour eructations had better outcome compared to belching, flatulence and heartburn, which are also relieved in majority. Postcholecystectomy post-prandial diarrhea was a significant new symptom after cholecystectomy. Pre

  16. Evaluation and Comparison of Frequency of Pulp Stones in Histologic Sections of Severe Chronic Periodontitis Affected Teeth and Healthy Teeth

    Directory of Open Access Journals (Sweden)

    F vaziri

    2017-01-01

    Full Text Available Introduction: Relationship between periodontal infection and pulp pathosis has been debated for many years. This human case control study was performed to evaluate the possible effects of moderate to advanced chronic periodontitis on pulp stone formation and pulpal calcifications. Methods: Current study is an experimental case control study.  Samples included 23 hopeless permanent teeth, affected with periodontitis in the case group and 23 periodontally healthy teeth in the control group, which were extracted for reasons like full denture treatment plan. After extraction and sectioning the apical 2-3 mm of root, teeth were immersed in 10% Formalin solution for 7 days. Then, teeth were decalcified in 5% HNO3 for 10 days. After implementation of tissue preparation steps, sections were made of apical, middle and coronal part of root of each sample. After histological processing, sections were examined by an experienced pathologist under a light microscope. Prescence of pulp stone was investigated in the sections and the results of the two groups were compared with each other. Results: Frequency of pulp stone showed no significant differences between the case and control groups in non of sections. (P-value= 0.730, 0.300, 0.760. Conclusion: Inflammation of periodontium in chronic periodontitis has no influence on pulp stone formation.

  17. Nonsurgical periodontal therapy.

    Science.gov (United States)

    Drisko, C H

    2001-01-01

    Regular home care by the patient in addition to professional removal of subgingival plaque is generally very effective in controlling most inflammatory periodontal diseases. When disease does recur, despite frequent recall, it can usually be attributed to lack of sufficient supragingival and subgingival plaque control or to other risk factors that influence host response, such as diabetes or smoking. Causative factors contributing to recurrent disease include deep inaccessible pockets, overhangs, poor crown margins and plaque-retentive calculus. In most cases, simply performing a thorough periodontal debridement under local anesthesia will stop disease progression and result in improvement in the clinical signs and symptoms of active disease. If however, clinical signs of disease activity persist following thorough mechanical therapy, such as increased pocket depths, loss of attachment and bleeding on probing, other pharmacotherapeutic therapies should be considered. Augmenting scaling and root planing or maintenance visits with adjunctive chemotherapeutic agents for controlling plaque and gingivitis could be as simple as placing the patient on an antimicrobial mouthrinse and/or toothpaste with agents such as fluorides, chlorhexidine or triclosan, to name a few. Since supragingival plaque reappears within hours or days after its removal, it is important that patients have access to effective alternative chemotherapeutic products that could help them achieve adequate supragingival plaque control. Recent studies, for example, have documented the positive effect of triclosan toothpaste on the long-term maintenance of both gingivitis and periodontitis patients. Daily irrigation with a powered irrigation device, with or without an antimicrobial agent, is also useful for decreasing the inflammation associated with gingivitis and periodontitis. Clinically significant changes in probing depths and attachment levels are not usually expected with irrigation alone. Recent

  18. Periodontal pathogens in atheromatous plaque.

    Science.gov (United States)

    Rath, Saroj K; Mukherjee, Manish; Kaushik, R; Sen, Sourav; Kumar, Mukesh

    2014-01-01

    There has been increasing attention paid in recent years to the possibility that oral bacterial infection, particularly periodontal disease may influence the initiation and or progression of systemic diseases. These studies confirm the observation that heart disease is the most commonly found systemic condition in patients with periodontal disease. Moreover, the literature has also highlighted substantial evidence indicating the presence of Gram-negative periodontal pathogens in atheromatous plaques. This study intends to investigate the possible association between periodontal health and coronary artery disease by evaluating periodontal status, association between the periodontal plaque and coronary atheromatous plaques for presence of micro-organisms such as, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia. A case-control study was designed with seven patients who had undergone coronary endarterectomy for cardiovascular disease and 28 controls. The periodontal examination for cases was performed 1 day before vascular surgery and the controls were clinically examined. The atheromatous plaque sample collected during endarterectomy and the intraoral plaque samples were subjected to polymerase chain reaction for identification of A. actinomycetemcomitans, P. gingivalis, P. intermedia and T. forsythia. The presence of periodontal bacteria DNA in coronary atheromatous plaques and sub-gingival plaque samples of the same patients was confirmed by this study. CONCLUSION A correlation was established between putative bacteria contributing to atheromatous plaques and species associated with periodontal disease. One particularly important study to be carried out is the investigation of a possible clinically meaningful reduction in coronary heart disease resulting from the prevention or treatment of periodontal disease.

  19. 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.

  20. Necrotizing ulcerative periodontitis.

    Science.gov (United States)

    Novak, M J

    1999-12-01

    In patients with no known systemic disease or immune dysfunction, necrotizing periodontitis (NUP) appears to share many of the clinical and etiologic characteristics of necrotizing ulcerative gingivitis (NUG) except that patients with NUP demonstrate loss of clinical attachment and alveolar bone at affected sites. In these patients, NUP may be a sequela of a single or multiple episodes of NUG or may be the result of the occurrence of necrotizing disease at a previously periodontitis-affected site. The existence of immune dysfunction may predispose patients to NUG and NUP, especially when associated with an infection of microorganisms frequently associated with periodontal disease such as Treponema and Selenomonas species, Fuscobacterium nucleatum, Prevotella intermedia, and Porphyromonas gingivalis. The role of immune dysfunction is exemplified by the occasionally aggressive nature of necrotic forms of periodontal disease seen in patients with HIV infection or malnutrition, both of which may impact host defenses. Clinical studies of HIV-infected patients have shown that patients with NUP are 20.8 times more likely to have CD4+ cell counts below 200 cells/mm3. However, these same studies have demonstrated that most patients with CD4+ cell counts below 200 cells/mm do not have NUP, suggesting that other factors, in addition to immunocompromisation, are involved. Further studies are needed to define the complex interactions between the microbial, or viral, etiology of necrotic lesions and the immunocompromised host. It is, therefore, recommended that NUG and NUP be classified together under the grouping of necrotizing periodontal diseases based on their clinical characteristics.

  1. Maxillary Sinus Impaction of a Core Carrier Causing Sustained Apical Periodontitis, Sinusitis, and Nasal Stenosis

    DEFF Research Database (Denmark)

    Bjørndal, Lars; Amaloo, Catharina; Markvart, Merete

    2016-01-01

    INTRODUCTION: The aim was to present a case report of a full-length extrusion of an obturator's core carrier into the maxillary sinus, causing clinical symptoms from the nose region with differential diagnostics aspects, which, in turn, led to several surgical treatments of the nostrils before di...... report represents a challenging differential diagnostic topic urging the importance of a medical and dental interdisciplinary dialogue. The use of cone-beam computed tomographic imaging was crucial for the surgical retreatment.......INTRODUCTION: The aim was to present a case report of a full-length extrusion of an obturator's core carrier into the maxillary sinus, causing clinical symptoms from the nose region with differential diagnostics aspects, which, in turn, led to several surgical treatments of the nostrils before......, a root canal treatment was performed on the maxillary right first molar. Intraoral radiographs revealed 10-mm overfilling of root filling material into the maxillary sinus from the palatal root of tooth #3. METHODS: Before surgical removal of the excess root filling material, orthograde revision...

  2. Endodontic decision making for asymptomatic root-filled teeth with apical periodontitis - A radiographic survey.

    Science.gov (United States)

    Taha, Nessrin A; Albashaireh, Zakereyya S; Alfied, Rmdan G

    2018-03-23

    The aim of the study was to compare decision making for asymptomatic root-filled teeth among dentists with differing educational backgrounds. Case scenarios based on 14 radiographs were created and 150 participants were asked to choose from five alternative treatment decisions and to state the rationale. Demographic data of the participants were recorded. Frequency distribution and cross-tabulation were performed; chi square testing was used for comparisons and logistic regression was performed to detect significant differences. The overall response rate was 87.3%. The practitioners chose intervention predominantly with non-surgical retreatment a common choice. Poor technical quality was a driving factor, while the existing poor coronal restoration and the need for a crown were generally not taken into account by general dentists. Speciality and experience were significant factors. Practitioners were more inclined to retain rather than extract teeth. It is concluded that clear guidelines listing factors to consider for intervention are required. © 2018 Australian Society of Endodontology Inc.

  3. Influence of cigarette smoking on synthesis of eicosanoids, isoprostanes and lipoxygenase metabolites in apical periodontitis

    OpenAIRE

    Eder, Andreas; Koegl, Elke; von Duvillard, Serge P.; Sinzinger, Helmut; Berent, Robert

    2012-01-01

    I Brage finner du siste tekst-versjon av artikkelen, og den kan inneholde ubetydelige forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på www.sciencedirect.com: http://dx.doi.org/10.1016/j.archoralbio.2012.05.004 / In Brage you'll find the final text version of the article, and it may contain insignificant differences from the journal's pdf version. The original publication is available at www.sciencedirect.com: http://dx.doi.org/10.1016/j.archoralbio.2012.05.004 Arac...

  4. Tumor Necrosis Factor-Alpha in Peripical Tissue Exudates of Teeth with Apical Periodontitis

    Directory of Open Access Journals (Sweden)

    Sonja Pezelj-Ribaric

    2007-01-01

    Full Text Available Aim. The aim of this study was to determine tumor necrosis factor-alpha (TNF-α levels in periapical exudates and to evaluate their relationship with radiological findings. Methodology. Periapical exudates were collected from root canals of 60 single-rooted teeth using absorbent paper points. TNF-α levels were determined by enzyme-linked immunosorbent assays. The samples were divided into three groups according to the periapical radiolucent area. Results. Nonparametric Kruskal-Wallis test revealed significant differences between TNF-α concentrations in control group (40, 57±28, 15 pg/mL and group with larger radiolucent areas (2365, 79±582, 95 pg/mL, as well as between control and canals with small radiolucent areas (507, 66±278, 97 (P<.05. Conclusions. The levels of TNF-α increase significantly in teeth with periapical pathosis, from smaller to bigger lesions. This research and its results have shown that objective analysis of the TNF-α levels enables establishment of a relationship between different concentrations of TNF-α and different radiological changes.

  5. Lip reposition surgery: A new call in periodontics

    Directory of Open Access Journals (Sweden)

    Tejal Sheth

    2013-01-01

    Full Text Available "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.

  6. 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

  7. 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

  8. Quality of the calcium-enriched mixture apical plug in simulated apexification model; Effect of different mixing and placement methods.

    Science.gov (United States)

    Rahimi, Saeed; Ghasemi, Negin; Razi, Tahmineh; Rezaiepour, Akbar

    2017-10-01

    Presence of voids at root canal wall‒apical seal material interface gives rise to the entrapment of toxins and microorganisms, which might have a relationship with post treatment disease. The present study was carried out to evaluate the effect of different mixing (manual and ultrasonic) and placement (manual and manual in association with indirect ultrasonic) methods of Calcium-enriched Mixture (CEM) cement on the number and dimensions of voids in the apical plug in simulated apexification models. A total of 80 human maxillary central incisors with mature apices were selected. After simulation of the open apices, the teeth were divided into 4 groups (n=20) based on the mixing and placement techniques of CEM cement: group 1, manual mixing‒manual placement; group 2, manual mixing‒manual placement in association with indirect ultrasonic technique; group 3, ultrasonic mixing‒manual placement; and group 4, ultrasonic mixing‒manual placement in association with indirect ultrasonic technique. The samples were placed within gypsum sockets in which the periodontal ligament was reconstructed with polyether impression material. After placement the apical plugs, a wet piece of cotton was placed on canal orifices, followed by dressing with Cavit. The samples were incubated at 37°C and 100% relative humidity for 7 days. Then the voids between the material and root canal walls were counted with the CBCT technique. The void dimensions were scored with the following scoring system: score 1, no voids; score 2, the void size less than half of the size of the evaluated cross-section; score 3, the void size larger than half of the size of the evaluated cross-section. Statistical analyses were carried out with chi-squared and Fisher's exact tests. Statistical significance was defined at P 0.05). Void dimensions in all the study groups were in score 2 category and no score 3 was recorded in the study groups. Under the limitations of the present study, manual placement in

  9. Prevalence of Cyclospora cayetanensis among symptomatic and ...

    African Journals Online (AJOL)

    Naguib M. Massoud

    2012-04-24

    Apr 24, 2012 ... There was no sig- nificant difference between symptomatic Cyclospora infected and noninfected cases as regards the duration of diarrhea and clinical presentations. Conclusion: Cyclospora infection in immune-competent symptomatic and asymptomatic children in Alexandria is common. Physicians should ...

  10. Symptomatic mesodiverticular bands in children | Bertozzi | Annals ...

    African Journals Online (AJOL)

    Symptomatic mesodiverticular bands in children. ... Abstract. Objective: The aim of this study was to review the English literature about a rare condition such as symptomatic mesodiverticular bands (MDBs) in children. Background: The MDB is an ... All cases reported an intestinal occlusion as clinical picture. Internal hernia ...

  11. The Relationship between Diabetes Mellitus and Periodontitis

    OpenAIRE

    A.M.Hussain

    2011-01-01

    Chronic gingivitis and periodontitis are common inflammatory conditions of the periodontal tissues. Given the ‘right’ concurrence of risk factors, a person with periodontitis can experience significant destruction of tooth-supporting bone, ultimately resulting in tooth loss. Poorly controlled diabetes is an important risk factor for periodontitis, and gingivitis and periodontitis are sometimes the first sign that a patient has diabetes. As severe periodontitis can lead to the loss of teeth, i...

  12. Periodontal Regeneration Using Periodontal Ligament Stem Cell-Transferred Amnion

    Science.gov (United States)

    Iwasaki, Kengo; Yokoyama, Naoki; Tanaka, Yuichi; Taki, Atsuko; Honda, Izumi; Kimura, Yasuyuki; Takeda, Masaki; Akazawa, Keiko; Oda, Shigeru; Izumi, Yuichi; Morita, Ikuo

    2014-01-01

    Periodontal disease is characterized by the destruction of tooth supporting tissues. Regeneration of periodontal tissues using ex vivo expanded cells has been introduced and studied, although appropriate methodology has not yet been established. We developed a novel cell transplant method for periodontal regeneration using periodontal ligament stem cell (PDLSC)-transferred amniotic membrane (PDLSC-amnion). The aim of this study was to investigate the regenerative potential of PDLSC-amnion in a rat periodontal defect model. Cultured PDLSCs were transferred onto amniotic membranes using a glass substrate treated with polyethylene glycol and photolithography. The properties of PDLSCs were investigated by flow cytometry and in vitro differentiation. PDLSC-amnion was transplanted into surgically created periodontal defects in rat maxillary molars. Periodontal regeneration was evaluated by microcomputed tomography (micro-CT) and histological analysis. PDLSCs showed mesenchymal stem cell-like characteristics such as cell surface marker expression (CD90, CD44, CD73, CD105, CD146, and STRO-1) and trilineage differentiation ability (i.e., into osteoblasts, adipocytes, and chondrocytes). PDLSC-amnion exhibited a single layer of PDLSCs on the amniotic membrane and stability of the sheet even with movement and deformation caused by surgical instruments. We observed that the PDLSC-amnion enhanced periodontal tissue regeneration as determined by micro-CT and histology by 4 weeks after transplantation. These data suggest that PDLSC-amnion has therapeutic potential as a novel cell-based regenerative periodontal therapy. PMID:24032400

  13. MRI pelvic landmark angles in the assessment of apical pelvic organ prolapse.

    Science.gov (United States)

    Ginath, Shimon; Garely, Alan; Luchs, Jonathan S; Shahryarinejad, Azin; Olivera, Cedric; Zhou, Sue; Ascher-Walsh, Charles; Condrea, Alexander; Brodman, Michael; Vardy, Michael

    2011-08-01

    The aim of the study was to evaluate the utility of magnetic resonance imaging (MRI) pelvic landmark angles and lines in the assessment of apical vault prolapse. Seventeen women were evaluated as part of a prospective surgical trial. Baseline data are presented as a pilot study of the utility of MRI in addition to this evaluation of 6 nulliparous volunteers without prolapse and 11 parous women with symptomatic ≥ stage II uterine prolapse. Each patient underwent assessment for pelvic organ prolapse quantification (POPQ) and pelvic MRI. Pelvic landmark angles and lines were measured. Mann-Whitney Rank sum test and Spearman's Rank order correlation test were used to assess agreement. Women with prolapse had a significantly larger h angle, g angle, and e angle at rest than those without prolapse. Correlation between apical vault descent was measured clinically by POPQ point C with MRI measurements: h angle (r = 0.61, p = 0.01), g angle (r = 0.64, p = 0.005), and e angle (r = 0.62, p = 0.007). MRI measurements of pelvic landmark angles reliably differentiate between women with and without uterine prolapse and correlate best with POPQ point C.

  14. Osteoporosis, jawbones and periodontal disease

    OpenAIRE

    Guiglia, Rosario; Di-Fede, Olga; Lo-Russo, Lucio; Sprini, Delia; Rini, Giovan B.; Campisi, Giuseppina

    2012-01-01

    The association between osteoporosis and jawbones remains an argument of debate. Both osteoporosis and periodontal diseases are bone resorptive diseases; it has been hypothesized that osteoporosis could be a risk factor for the progression of periodontal disease and vice versa. Hypothetical models linking the two conditions exist: in particular, it is supposed that the osteoporosis-related bone mass density reduction may accelerate alveolar bone resorption caused by periodontitis, resulting i...

  15. Periodontal pathogens in atheromatous plaque

    OpenAIRE

    Saroj K. Rath; Manish Mukherjee; R Kaushik; Sourav Sen; Mukesh Kumar

    2014-01-01

    Background: There has been increasing attention paid in recent years to the possibility that oral bacterial infection, particularly periodontal disease may influence the initiation and or progression of systemic diseases. These studies confirm the observation that heart disease is the most commonly found systemic condition in patients with periodontal disease. Moreover, the literature has also highlighted substantial evidence indicating the presence of Gram-negative periodontal pathogens in a...

  16. An apical granuloma with epithelial integument.

    Science.gov (United States)

    Nair, P N; Schmid-Meier, E

    1986-12-01

    A chronic periapicalesion--apical granuloma--of the first left maxillary molar, which had rarefied the bony plate and grown into the maxillary sinus, was observed in a 64-year-old white male patient. Light microscopic study of the epon-embedded specimen showed a lesion that had been infiltrated predominantly by mononuclear cells and that had isolated neutrophil-dominated foci. The lesion contained extensive networks and arcades of proliferating epithelium. Unlike the classic granulomas of the periapex, which are generally delimited by a well-developed connective tissue capsule, this particular lesion was lined with epithelial tissue consisting of ciliated columnar and stratified squamous components. While the former seemed to be an extension of the sinus epithelium, the latter appeared to be an outgrowth of the proliferating epithelium encountered within the lesion.

  17. Symptomatic splenomegaly and palliative radiotherapy

    International Nuclear Information System (INIS)

    Yaneva, M.; Vlaikova, M.

    2005-01-01

    We analysed the effect of irradiation of an enlarged spleen in some hematologic diseases: chronic myelaemia, osteomyelophybrosis and chronic lymphadenosis, where splenectomy had been contraindicated and where pain has been a leading symptom and also the discomfort because of an enlarged spleen. For 20 years in the Clinic of Radiotherapy have been treated 23 patients with the above mentioned diseases. We have irradiated all patients using X-ray and later- Co-60. To reach a palliative effect we have irradiated patients with single doses from 50 cGy to 100 cGy with an interval of 2-3 days between each fraction, but the total doses have been different- from 400 cGy to 1500 cGy. The enlarged spleen has reached the pelvis in 3 cm to 17 cm below the costal margin, and in some patients has crossed the median line of the body going in some centimetres on the other side. The reduction of splenic size and volume is as follows: full reduction in 6 patients (26.1%) and partial in 17 (73.9%). All patients resulted in decreases in pain and tension in abdomen and the total discomfort. No serious side haematologic effects were encountered. Our experience indicates that cautious splenic irradiation can be a safe and useful therapeutic alternative. The symptomatic palliation in patients, where splenectomy is not an option, is effective and is an additional alternative for an improvement of their general condition

  18. 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

  19. Periodontal disease and atherosclerosis

    Directory of Open Access Journals (Sweden)

    Jeferson Freitas Toregeani

    2014-09-01

    Full Text Available Atherosclerotic disease (AD is one of the most important causes of morbidity and mortality in the world. It expresses inflammatory markers such as C-reactive protein (CRP and can provoke arterial wall thickening, which can be evaluated using Doppler ultrasound. Risk factors associated with AD include diabetes mellitus, systemic arterial hypertension, dyslipidemia and smoking. More recently, periodontal disease (PD has been identified as a factor related to AD. Periodontal disease has a high prevalence in the global population and the inflammatory process and bacterial activity at the periodontium appear to increase the risk of AD. Encouraging good oral hygiene can reduce expression of inflammatory markers of AD. A review of literature on PD, AD and inflammatory markers and the interrelationships between the two diseases was conducted using data published in articles indexed on the PUBMED, SCIELO and BIREME databases.

  20. Paramolar concrescence and periodontitis.

    Science.gov (United States)

    Venugopal, Sanjay; Smitha, B V; Saurabh, S Prithyani

    2013-05-01

    Concrescence is a developmental anomaly of dental hard tissues. It is a condition showing union of adjacent teeth by cementum. The concrescence leads to a loss of gingival architecture leading to the development of funnels, which may cause plaque accumulation thus, resulting in periodontal tissue destruction. There is a slight predilection for the mandible especially in the premolar area followed by the molar and anterior regions. Awareness of these developmental disturbances with proper diagnosis and treatment is very essential because it can compromise the periodontal attachment and can lead to the tooth loss. This article highlights the presence of a concrescence between mandibular second molar and the supernumerary fused teeth with their clinical and radiographic findings, along with its management.

  1. Apical extrusion of debris using reciprocating files and rotary ...

    African Journals Online (AJOL)

    Procedure: Sixty extracted human mandibular premolars were used. The root canals were instrumented using reciprocating (WaveOne, Reciproc, SafeSider) or rotary ... and cross‑sections, and kinematics, and this situation may influence the amount of apically extruded debris through the apical foramen.[15]. The aim of this ...

  2. Association of ST elevation with apical aneurysm in hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Ozcan Ozeke

    2015-09-01

    Conclusions: Clinicians and specifically echocardiographers must pay special attention on the electrocardiography to correctly detect the frequently overlooked apical aneurysm in HCM patients, and should be careful for apical aneurysm particularly in the presence of STE in V4-6 derivations.

  3. Apical Shell Sculpture of some African Freshwater Limpets ...

    African Journals Online (AJOL)

    A Scanning Electron Microscope has been used to describe in detail the apical shell sculpture of sevenAfrican species (three genera) of freshwater limpet snails (Ancylidae). The apical sculpture of Ancylus fluviatilis (? syn. strigatus and ? brondeli) is striate, but quite different in basic pattern from the other three striate ...

  4. Apical Hypertrophic Cardiomyopathy in Association with PulmonaryArtery Hypertension

    Directory of Open Access Journals (Sweden)

    Mehdi Peighambari

    2012-09-01

    Full Text Available Apical Hypertrophic Cardiomyopathy is an uncommon condition constituting 1% -2% of the cases with Hypertrophic Cardiomyopathy (HCM diagnosis. We interestingly report two patients with apical hypertrophic cardiomyopathy in association with significant pulmonary artery hypertension without any other underlying reason for pulmonary hypertension. The patients were assessed by echocardiography, cardiac catheterization and pulmonary function parameters study.

  5. Apical extrusion of debris using reciprocating files and rotary ...

    African Journals Online (AJOL)

    ... the other groups, with the exception of the Typhoon group (P < 0.05). Conclusion: According to our study, all systems caused apical debris extrusion. However, the Reciproc group was associated with less debris extrusion when compared to the other groups. Key words: Apical extrusion, endodontics, single file systems ...

  6. Diagnosis of apical hypertrophic cardiomyopathy: T-wave inversion and relative but not absolute apical left ventricular hypertrophy.

    Science.gov (United States)

    Flett, Andrew S; Maestrini, Viviana; Milliken, Don; Fontana, Mariana; Treibel, Thomas A; Harb, Rami; Sado, Daniel M; Quarta, Giovanni; Herrey, Anna; Sneddon, James; Elliott, Perry; McKenna, William; Moon, James C

    2015-03-15

    Diagnosis of apical HCM utilizes conventional wall thickness criteria. The normal left ventricular wall thins towards the apex such that normal values are lower in the apical versus the basal segments. The impact of this on the diagnosis of apical hypertrophic cardiomyopathy has not been evaluated. We performed a retrospective review of 2662 consecutive CMR referrals, of which 75 patients were identified in whom there was abnormal T-wave inversion on ECG and a clinical suspicion of hypertrophic cardiomyopathy. These were retrospectively analyzed for imaging features consistent with cardiomyopathy, specifically: relative apical hypertrophy, left atrial dilatation, scar, apical cavity obliteration or apical aneurysm. For comparison, the same evaluation was performed in 60 healthy volunteers and 50 hypertensive patients. Of the 75 patients, 48 met conventional HCM diagnostic criteria and went on to act as another comparator group. Twenty-seven did not meet criteria for HCM and of these 5 had no relative apical hypertrophy and were not analyzed further. The remaining 22 patients had relative apical thickening with an apical:basal wall thickness ratio >1 and a higher prevalence of features consistent with a cardiomyopathy than in the control groups with 54% having 2 or more of the 4 features. No individual in the healthy volunteer group had more than one feature and no hypertension patient had more than 2. A cohort of individuals exist with T wave inversion, relative apical hypertrophy and additional imaging features of HCM suggesting an apical HCM phenotype not captured by existing diagnostic criteria. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Periodontal diseases in the child and adolescent.

    Science.gov (United States)

    Oh, Tae-Ju; Eber, Robert; Wang, Hom-Lay

    2002-05-01

    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 which includes generalized or localized prepubertal periodontitis and juvenile periodontitis) and periodontal diseases associated with systemic disorders. The best approach to managing periodontal diseases is prevention, followed by early detection and treatment. This paper reviews the current literature concerning the most common periodontal diseases affecting children: chronic gingivitis (or dental plaque-induced gingival diseases) and early onset periodontitis (or aggressive periodontitis), including prepubertal and juvenile periodontitis. In addition, systemic diseases that affect the periodontium and oral lesions commonly found in young children are addressed. The prevalence, diagnostic characteristics, microbiology, host-related factors, and therapeutic management of each of these disease entities are thoroughly discussed.

  8. Endodontic treatment enhances the regenerative potential of teeth with advanced periodontal disease with secondary endodontic involvement.

    Science.gov (United States)

    Kwon, Eun-Young; Cho, Yunjung; Lee, Ju-Youn; Kim, Sung-Jo; Choi, Jeomil

    2013-06-01

    The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

  9. Osteoporosis and Periodontitis.

    Science.gov (United States)

    Wang, Chin-Wei Jeff; McCauley, Laurie K

    2016-12-01

    Osteoporosis and periodontitis are both diseases characterized by bone resorption. Osteoporosis features systemic degenerative bone loss that leads to loss of skeletal cancellous microstructure and subsequent fracture, whereas periodontitis involves local inflammatory bone loss, following an infectious breach of the alveolar cortical bone, and it may result in tooth loss. Most cross-sectional studies have confirmed the association of osteoporosis and periodontitis primarily on radiographic measurements and to a lesser degree on clinical parameters. Multiple shared risk factors include age, genetics, hormonal change, smoking, as well as calcium and vitamin D deficiency. Both diseases could also be risk factors for each other and have a mutual impact that requires concomitant management. Suggested mechanisms underlying the linkage are disruption of the homeostasis concerning bone remodeling, hormonal balance, and inflammation resolution. A mutual interventional approach is emerging with complex treatment interactions. Prevention and management of both diseases require interdisciplinary approaches and warrants future well-controlled longitudinal and interventional studies for evidence-based clinical guidelines.

  10. Osteoporosis and Periodontitis

    Science.gov (United States)

    Wang, Chin-Wei (Jeff); McCauley, Laurie K.

    2017-01-01

    Osteoporosis and periodontitis are both diseases characterized by bone resorption. Osteoporosis features systemic degenerative bone loss that leads to loss of skeletal cancellous microstructure and subsequent fracture, whereas periodontitis involves local inflammatory bone loss, following an infectious breach of the alveolar cortical bone, and it may result in tooth loss. Most cross-sectional studies have confirmed the association of osteoporosis and periodontitis primarily on radiographic measurements and to a lesser degree on clinical parameters. Multiple shared risk factors include age, genetics, hormonal change, smoking, as well as calcium and vitamin D deficiency. Both diseases could also be risk factors for each other and have a mutual impact that requires concomitant management. Suggested mechanisms underlying the linkage are disruption of the homeostasis concerning bone remodeling, hormonal balance, and inflammation resolution. A mutual interventional approach is emerging with complex treatment interactions. Prevention and management of both diseases require interdisciplinary approaches and warrants future well-controlled longitudinal and interventional studies for evidence-based clinical guidelines. PMID:27696284

  11. Efficacy of Biodentine as an Apical Plug in Nonvital Permanent Teeth with Open Apices: An In Vitro Study

    Directory of Open Access Journals (Sweden)

    Mehmet Bani

    2015-01-01

    Full Text Available The aim of this study was to evaluate the apical microleakage of Biodentine and MTA orthograde apical plugs and to compare the effect of thickness of these biomaterials on their sealing ability. A total of eighty maxillary anterior teeth were used. The apices were removed by cutting with a diamond disc (Jota, Germany 2 mm from the apical root end in an attempt to standardize the working length of all specimens to 15 ± 1 mm. Both materials were placed in 1–4 mm thickness as apical plugs root canal. Root canal leakage was evaluated by the fluid filtration technique. One-way ANOVA was used in order to determine normality of dispersal distribution of parameters; thereafter, results were analyzed by Kolmogorov-Smirnov test. Overall, between microleakage values of MTA and Biodentine regardless of apical plug thickness, no difference was observed. In terms of plug thickness, a statistically significant difference was observed between the subgroups of MTA and Biodentine (p<0.05. The apical sealing ability of Biodentine was comparable to MTA at any apical plug thickness.

  12. [Diabetes mellitus and periodontal disease].

    Science.gov (United States)

    Sliz, Monika; Olszewska-Czyz, Iwona; Kantorowicz, Malgorzata; Chomyszyn-Gajewska, Maria

    2013-01-01

    Scientific studies confirm correlation between periodontitis and systemic diseases such as: arteriosclerosis, diabetes, heart diseases, stroke, diseases of the respiratory system, kidney diseases, osteoporosis, rheumatoid arthritis, premature birth and low birth weight. The interaction between periodontitis and diabetes mellitus is described, based on the literature.

  13. Relationship between periodontitis and diabetes

    DEFF Research Database (Denmark)

    Pontes Andersen, Carla C; Flyvbjerg, Allan; Buschard, Karsten

    2007-01-01

    BACKGROUND: A great amount of investigations have provided evidence that both type 1 and type 2 diabetes increase the risk and severity of periodontitis; several alterations in the diabetic periodontium are likely to be involved. Conversely, periodontitis has been shown to have an impact on diabe...

  14. Centipeda periodontii in human periodontitis

    NARCIS (Netherlands)

    Rams, Thomas E.; Hawley, Charles E.; Whitaker, Eugene J.; Degener, John E.; van Winkelhoff, Arie J.

    This study assessed the subgingival occurrence of the flagellated, Gram-negative, anaerobic rod Centipeda periodontii in chronic periodontitis and periodontal health/gingivitis with species-specific nucleic acid probes, and evaluated the in vitro resistance of subgingival isolates to therapeutic

  15. Successful pulpal anesthesia for symptomatic irreversible pulpitis.

    Science.gov (United States)

    Drum, Melissa; Reader, Al; Nusstein, John; Fowler, Sara

    2017-04-01

    Profound pulpal anesthesia after a successful inferior alveolar nerve block can be difficult to achieve when the clinical condition is a pulpal diagnosis of symptomatic irreversible pulpitis. The authors reviewed the literature as it relates to the anesthesia necessary for endodontic therapy of patients with painful, vital, mandibular teeth diagnosed with symptomatic irreversible pulpitis. Supplemental anesthetic techniques and medications are available that can be used to improve pulpal anesthesia for patients with the clinical condition of symptomatic irreversible pulpitis. The authors identified treatment recommendations for anesthesia in the case of symptomatic irreversible pulpitis based on a review of the available evidence. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  16. Effect of different mixing and placement methods on the quality of MTA apical plug in simulated apexification model.

    Science.gov (United States)

    Ghasemi, Negin; Janani, Maryam; Razi, Tahmineh; Atharmoghaddam, Faezeh

    2017-03-01

    It is necessary apical plug material to exhibit proper adaptation with the root canal walls. Presence of voids at the interface between the root canal wall and this material result in micro leakage, which might have a relationship with post treatment disease. The aim of the present study was to evaluate the effect of different mixing (manual and ultrasonic) and placement (manual and manual in association with indirect ultrasonic) method of Mineral Trioxide Aggregate (MTA) on the void count and dimension in the apical plug in natural teeth with simulated open apices. Eighty human maxillary central incisors were selected. After simulation of the open apex model, the teeth were assigned to 4 groups based on the mixing and placement techniques of MTA: group 1, manual mixing and manual placement; group 2, manual mixing and manual placement in association with indirect ultrasonic; group 3, ultrasonic mixing and and manual placement; and group 4, ultrasonic mixing and manual placement in association with indirect ultrasonic. The prepared samples were placed within gypsum sockets in which the periodontal ligament was reconstructed with polyether impression material. In group 1, after mixing, the material was condensed with a hand plugger. In group 2, after mixing, the ultrasonic tip was contacted with the hand plugger for 2 seconds. In groups 3 and 4, mixing was carried out with the ultrasonic tip for 5 seconds and in groups 3 and 4, similar to groups 1 and 2, respectively, the materials were placed as apical plugs, measuring 3 mm in length. A wet cotton pellet was placed at canal orifices and dressed with Cavit. After one week, the cone beam computed tomography (CBCT) technique was used to count the number of voids between the material and root canal walls. The void dimensions were determined using the following scoring system: score 1, absence of voids; score 2, the void size less than half of the dimensions of the evaluated cross-section; score 3, the void size larger

  17. Symptomatic pericardial cyst: a case series.

    Science.gov (United States)

    Najib, Mohammad Q; Chaliki, Hari P; Raizada, Amol; Ganji, Jhansi L; Panse, Prasad M; Click, Roger L

    2011-11-01

    Pericardial cysts are most commonly located at the cardiophrenic angle or, rarely, in the posterior or anterior superior mediastinum. The majority of pericardial cysts are asymptomatic and are found incidentally. Symptomatic pericardial cysts present with dyspnoea, chest pain, or persistent cough. We describe four patients with symptomatic pericardial cysts who were treated with either echocardiographically guided percutaneous aspiration or video-assisted thoracoscopic surgery, or both; thoracotomy; or conservative therapy.

  18. Periodontal Dressing: A Review Article

    Directory of Open Access Journals (Sweden)

    Zahra Baghani

    2013-12-01

    Full Text Available The purpose of this paper was to review the commercially available periodontal dressings, their physical and chemical properties, biocompatibility and therapeutic effects. Electronic search of scientific papers from 1956 to 2012 was carried out using PubMed, Scopus and Wiley InterScience search engines using the searched terms periodontal dressing, periodontal pack. Numerous in vitro and in vivo studies have evaluated various properties of periodontal dressings. Physical and chemical properties of dressings are directly related to their dimensional changes and adhesion properties. Their biocompatibility and therapeutic effect are among the other factors evaluated in the literature. Chlorhexidine is the most commonly used antibacterial agent in studies. In general, when comparing the advantages with the disadvantages, application of periodontal dressing seems to be beneficial. Numerous factors are involved in selection of an optimal dressing such as surgeon’s intention, required time for the dressing to remain on the surgery site and its dimensional changes.

  19. Impact of Periodontitis Case Criteria

    DEFF Research Database (Denmark)

    Kongstad, Johanne; Enevold, Christian; Christensen, Lisa Bøge

    2017-01-01

    BACKGROUND: Associations of risk factors/indicators with periodontitis may depend on the included case criterion. The objective was to evaluate differences in outcome by applying five periodontitis case definitions for cross-sectional associations with lifestyle factors among participants...... of The Danish Health Examination Survey (DANHES). METHODS: A total of 4,402 adults aged 18-96 years from the general health examination of DANHES had a periodontal examination consisting of half-mouth registration at 6 sites per tooth including probing pocket depth (PPD) and clinical attachment level (CAL......). Periodontitis was defined according to severe periodontitis, EWP-specific, meanCAL≥2.55mm, CAL-tertile, and PPD-CAL definition. Multivariable logistic regression models fitted the association of age, gender, smoking status, diabetes, educational level, alcohol consumption, body mass index, physical activity...

  20. Apical trafficking in epithelial cells: signals, clusters and motors.

    Science.gov (United States)

    Weisz, Ora A; Rodriguez-Boulan, Enrique

    2009-12-01

    In the early days of epithelial cell biology, researchers working with kidney and/or intestinal epithelial cell lines and with hepatocytes described the biosynthetic and recycling routes followed by apical and basolateral plasma membrane (PM) proteins. They identified the trans-Golgi network and recycling endosomes as the compartments that carried out apical-basolateral sorting. They described complex apical sorting signals that promoted association with lipid rafts, and simpler basolateral sorting signals resembling clathrin-coated-pit endocytic motifs. They also noticed that different epithelial cell types routed their apical PM proteins very differently, using either a vectorial (direct) route or a transcytotic (indirect) route. Although these original observations have generally held up, recent studies have revealed interesting complexities in the routes taken by apically destined proteins and have extended our understanding of the machinery required to sustain these elaborate sorting pathways. Here, we critically review the current status of apical trafficking mechanisms and discuss a model in which clustering is required to recruit apical trafficking machineries. Uncovering the mechanisms responsible for polarized trafficking and their epithelial-specific variations will help understand how epithelial functional diversity is generated and the pathogenesis of many human diseases.

  1. The roles of viruses in periodontal diseases

    Directory of Open Access Journals (Sweden)

    C C Azodo

    2015-01-01

    Full Text Available 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 understanding of roles of viruses in periodontal diseases will facilitate the provision of effective periodontal disease prevention and treatment.

  2. Adult stem cell therapy for periodontal disease.

    Science.gov (United States)

    Kim, Su-Hwan; Seo, Byoung-Moo; Choung, Pill-Hoon; Lee, Yong-Moo

    2010-05-01

    Periodontal disease is a major cause of tooth loss and characterized by inflammation of tooth-supporting structures. Recently, the association between periodontal disease and other health problems has been reported, the importance of treating periodontal disease for general health is more emphasized. The ultimate goal of periodontal therapy is regeneration of damaged periodontal tissues. The development of adult stem cell research enables to improve the cell-based tissue engineering for periodontal regeneration. In this review, we present the results of experimental pre-clinical studies and a brief overview of the current state of stem cells therapy for periodontal diseases.

  3. Periodontal pathogens in atheromatous plaque

    Directory of Open Access Journals (Sweden)

    Saroj K. Rath

    2014-01-01

    Full Text Available Background: There has been increasing attention paid in recent years to the possibility that oral bacterial infection, particularly periodontal disease may influence the initiation and or progression of systemic diseases. These studies confirm the observation that heart disease is the most commonly found systemic condition in patients with periodontal disease. Moreover, the literature has also highlighted substantial evidence indicating the presence of Gram-negative periodontal pathogens in atheromatous plaques. Aim: This study intends to investigate the possible association between periodontal health and coronary artery disease by evaluating periodontal status, association between the periodontal plaque and coronary atheromatous plaques for presence of micro-organisms such as, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia. Materials and methods: A case-control study was designed with seven patients who had undergone coronary endarterectomy for cardiovascular disease and 28 controls. The periodontal examination for cases was performed 1 day before vascular surgery and the controls were clinically examined. The atheromatous plaque sample collected during endarterectomy and the intraoral plaque samples were subjected to polymerase chain reaction for identification of A. actinomycetemcomitans, P. gingivalis, P. intermedia and T. forsythia. Results: The presence of periodontal bacteria DNA in coronary atheromatous plaques and sub-gingival plaque samples of the same patients was confirmed by this study. CONCLUSION A correlation was established between putative bacteria contributing to atheromatous plaques and species associated with periodontal disease. One particularly important study to be carried out is the investigation of a possible clinically meaningful reduction in coronary heart disease resulting from the prevention or treatment of periodontal disease.

  4. 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.

  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. 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...

  7. Conditioned Medium from Periodontal Ligament Stem Cells Enhances Periodontal Regeneration.

    Science.gov (United States)

    Nagata, Mizuki; Iwasaki, Kengo; Akazawa, Keiko; Komaki, Motohiro; Yokoyama, Naoki; Izumi, Yuichi; Morita, Ikuo

    2017-05-01

    Periodontal disease is one of the most common infectious diseases in adults and is characterized by the destruction of tooth-supporting tissues. Mesenchymal stem cells (MSCs) comprise the mesoderm-originating stem cell population, which has been studied and used for cell therapy. However, because of the lower rate of cell survival after MSC transplantation in various disease models, paracrine functions of MSCs have been receiving increased attention as a regenerative mechanism. The aim of this study was to investigate the regenerative potential of transplanted conditioned medium (CM) obtained from cultured periodontal ligament stem cells (PDLSCs), the adult stem cell population in tooth-supporting tissues, using a rat periodontal defect model. Cell-free CM was collected from PDLSCs and fibroblasts, using ultrafiltration and transplanted into surgically created periodontal defects. Protein content of CM was examined by antibody arrays. Formation of new periodontal tissues was analyzed using microcomputed tomography and histological sections. PDLSC-CM transplantation enhanced periodontal tissue regeneration in a concentration-dependent manner, whereas fibroblast-CM did not show any regenerative function. Proteomic analysis revealed that extracellular matrix proteins, enzymes, angiogenic factors, growth factors and cytokines were contained in PDLSC-CM. Furthermore, PDLSC-CM transplantation resulted in the decreased mRNA level of tumor necrosis factor-α (TNF-α) in healing periodontal tissues. In addition, we found that PDLSC-CM suppressed the mRNA level of TNF-α in the monocyte/macrophage cell line, RAW cells, stimulated with IFN-γ. Our findings suggested that PDLSC-CM enhanced periodontal regeneration by suppressing the inflammatory response through TNF-α production, and transplantation of PDLSC-CM could be a novel approach for periodontal regenerative therapy.

  8. Mineral trioxide aggregate apical plugs in teeth with open apical foramina: a retrospective analysis of treatment outcome.

    Science.gov (United States)

    Mente, Johannes; Hage, Nathalie; Pfefferle, Thorsten; Koch, Martin Jean; Dreyhaupt, Jens; Staehle, Hans Joerg; Friedman, Shimon

    2009-10-01

    Teeth with open apical foramina present a challenge during root canal treatment, and little is known about the clinical outcome of treatment in such teeth. This retrospective study assessed healing of teeth with open apices managed by the placement of mineral trioxide aggregate apical plugs. Seventy-two patients with 78 teeth with apical resorption or excessive apical enlargement, treated between 2000 and 2006, were contacted for follow-up examination 12 to 68 months after treatment (median 30.9 months). Treatments were provided by supervised undergraduate students (27%), general dentists (32%), or dentists who had focused on endodontics (41%). The outcome based on clinical and radiographic criteria was assessed by calibrated examiners and dichotomized as "healed" or "disease." Of 56 teeth examined (72% recall), 84% were healed. Teeth without or with preoperative periapical radiolucency had a healed rate of 100% and 78%, respectively. None of the variables analyzed had a significant effect on the outcome. The results supported the management of open apical foramina with mineral trioxide aggregate apical plugs.

  9. Efficacy of Biodentine as an Apical Plug in Nonvital Permanent Teeth with Open Apices: An In Vitro Study.

    Science.gov (United States)

    Bani, Mehmet; Sungurtekin-Ekçi, Elif; Odabaş, Mesut Enes

    2015-01-01

    The aim of this study was to evaluate the apical microleakage of Biodentine and MTA orthograde apical plugs and to compare the effect of thickness of these biomaterials on their sealing ability. A total of eighty maxillary anterior teeth were used. The apices were removed by cutting with a diamond disc (Jota, Germany) 2 mm from the apical root end in an attempt to standardize the working length of all specimens to 15 ± 1 mm. Both materials were placed in 1-4 mm thickness as apical plugs root canal. Root canal leakage was evaluated by the fluid filtration technique. One-way ANOVA was used in order to determine normality of dispersal distribution of parameters; thereafter, results were analyzed by Kolmogorov-Smirnov test. Overall, between microleakage values of MTA and Biodentine regardless of apical plug thickness, no difference was observed. In terms of plug thickness, a statistically significant difference was observed between the subgroups of MTA and Biodentine (p Biodentine was comparable to MTA at any apical plug thickness.

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

    OpenAIRE

    LLANOS, Alexandre Hugo; SILVA, Carlos Guillermo Benítez; ICHIMURA, Karina Tamie; REBEIS, Estela Sanches; GIUDICISSI, Marcela; ROMANO, Marcelo Munhóes; SARAIVA, Luciana

    2018-01-01

    Abstract 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 ques...

  11. Phenotypic overlap in hypertrophic cardiomyopathy: apical hypertrophy, midventricular obstruction, and apical aneurysm.

    Science.gov (United States)

    Minami, Yuichiro; Haruki, Shintaro; Hagiwara, Nobuhisa

    2014-12-01

    Within the diverse phenotypic spectrum of hypertrophic cardiomyopathy (HCM), subgroups of patients with apical hypertrophy (APH), midventricular obstruction (MVO), and apical aneurysm (APA) have emerged. While previous studies have suggested the existence of considerable overlap between APH, MVO, and APA, there are still many unanswered questions. Therefore, we attempted to clarify the relationship of the above three phenotypes of HCM with respect to prevalence, overlap, and outcomes. Among the 544 study HCM patients (mean follow-up period: 11.6±7.4 years), 170 with APH (31.3%), 51 with MVO (9.4%), and 24 with APA (4.4%) were examined. There was phenotypic overlap between APH and MVO in 17 patients, APH and APA in 14 patients, and MVO and APA in 14 patients. Furthermore, a combination of APH, MVO, and APA was observed in eight patients. Detailed analysis of the relationship between overlapping phenotypes and the prognosis showed that APA patients without a history of APH had an extremely poor outcome (probability of the combined endpoint of sudden death and potentially lethal arrhythmic events ≥50%). Conversely, APH patients without MVO had a strikingly good outcome (probability of the combined endpoint <5%). Other patients had an intermediate outcome (probability of the combined endpoint 10-40%). Our results suggest that overlap between these three forms of HCM is substantial, and that detailed classification of the overlapping phenotypes is clinically meaningful. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  12. Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-11-01

    Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

  13. Viruses: Bystanders of periodontal disease.

    Science.gov (United States)

    Aggarwal, Titiksha; Lamba, Arundeep Kaur; Faraz, Farrukh; Tandon, Shruti

    2017-01-01

    Bacterial etiology of periodontal disease is an established fact today. However, despite advances in the field of pharmacology with advent of newer and better antibiotics prevalence of the disease could not be abated. Moreover, unpredictable remissions and indefinite pattern in a single host force us to go back to the exact etiology of the disease. Present is a short review highlighting the role and plausible mechanisms by which viruses can affect the development of periodontal disease. This broadens our concept and will help establish a better treatment protocol for periodontal disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Relationship between diabetes and periodontal infection

    Science.gov (United States)

    Llambés, Fernando; Arias-Herrera, Santiago; Caffesse, Raúl

    2015-01-01

    Periodontal disease is a high prevalent disease. In the United States 47.2% of adults ≥ 30 years old have been diagnosed with some type of periodontitis. Longitudinal studies have demonstrated a two-way relationship between diabetes and periodontitis, with more severe periodontal tissue destruction in diabetic patients and poorer glycemic control in diabetic subjects with periodontal disease. Periodontal treatment can be successful in diabetic patients. Short term effects of periodontal treatment are similar in diabetic patients and healthy population but, more recurrence of periodontal disease can be expected in no well controlled diabetic individuals. However, effects of periodontitis and its treatment on diabetes metabolic control are not clearly defined and results of the studies remain controversial. PMID:26185600

  15. [Relationship between periodontitis and systemic diseases].

    Science.gov (United States)

    Jepsen, S; Kebschull, M; Deschner, J

    2011-09-01

    Periodontitis is a biofilm-induced inflammatory disease affecting the periodontium with a high and even increasing prevalence in the German population. During recent years, there is emerging evidence for systemic effects of a periodontal infection, in particular in relation to diabetes and atherosclerosis. There is a bi-directional relationship between periodontitis and diabetes. Diabetes promotes the occurrence, the progression, and the severity of periodontitis. The periodontal infection complicates the glycemic control in diabetes, increases the risk of diabetes-associated complications and possibly even of its onset. As a consequence, the treatment of periodontal infections should become an integral part of the management of diabetes, whereas glycemic control is a prerequisite for successful periodontal therapy. Periodontal infections are considered as independent risk factor for atherosclerosis and their clinical sequelae, e.g., cerebro- and cardiovascular diseases. The positive association is only moderate, however remarkably consistent. Periodontal therapy can result in positive effects on subclinical markers of atherosclerosis.

  16. [Effects of smoking on periodontal disease].

    Science.gov (United States)

    Underner, M; Maes, I; Urban, T; Meurice, J-C

    2009-12-01

    Smoking is an independent risk factor for periodontal disease and tooth loss. Smoking impairs inflammatory and immune responses to periodontal pathogens, and exerts both systemic and local effects. Periodontal disease is increased both in prevalence and severity in smokers. Smoking is a predisposing factor to acute necrotizing ulcerative gingivitis and is associated with an increased rate of periodontal disease in terms of pocket formation and attachment loss, as well as alveolar bone loss. Cigar, pipe, water-pipe and cannabis smoking have similar adverse effects on periodontal health as cigarette smoking. Passive smoking is also an independent periodontal disease risk factor. Smokeless tobacco is associated with localized periodontal disease. Smokers respond less favourably to both non-surgical and surgical treatments and have higher failure rates and complications following dental implantation. Smoking cessation may halt the disease progression and improve the outcome of periodontal treatment. Smoking cessation counselling should be an integral part of periodontal therapy and prevention.

  17. Relationship between adipokines and periodontitis

    Directory of Open Access Journals (Sweden)

    Reiko Furugen

    2010-08-01

    Full Text Available Obesity is associated with an increased risk for developing characteristic features of metabolic syndrome, including hypertension, type 2 diabetes, and dyslipidemia. Interestingly, chronic exposure to periodontal pathogens’ endotoxin and increased cytokine production have been proposed to enhance the risk for causing type 2 diabetes and cardiovascular complications. Obesity has also recently been reported to be associated with periodontitis. Obesity induces macrophage accumulation in adipose tissue, promotes chronic low-grade inflammation, and increases adipokines derived from adipocytes. In this review, we summarize recent advances in understanding the roles of adipokines in chronic inflammatory states such as periodontitis and focus primarily on adiponectin, leptin, and resistin. Understanding the role of adipokines may help elucidate relationships among periodontitis, obesity, type 2 diabetes, and cardiovascular diseases.

  18. Orthodontic Management in Aggressive Periodontitis

    Science.gov (United States)

    Bhattarai, Bhagabat

    2017-01-01

    Aggressive periodontitis is a type of periodontitis with early onset and rapid progression and mostly affecting young adults who occupy a large percentage of orthodontic patients. The role of the orthodontist is important in screening the disease, making a provisional diagnosis, and referring it to a periodontist for immediate treatment. The orthodontist should be aware of the disease not only before starting the appliance therapy, but also during and after the active mechanotherapy. The orthodontic treatment plan, biomechanics, and appliance system may need to be modified to deal with the teeth having reduced periodontal support. With proper force application and oral hygiene maintenance, orthodontic tooth movement is possible without any deleterious effect in the tooth with reduced bone support. With proper motivation and interdisciplinary approach, orthodontic treatment is possible in patients with controlled aggressive periodontitis. PMID:28299350

  19. Orthodontic Management in Aggressive Periodontitis

    Directory of Open Access Journals (Sweden)

    Rajesh Gyawali

    2017-01-01

    Full Text Available Aggressive periodontitis is a type of periodontitis with early onset and rapid progression and mostly affecting young adults who occupy a large percentage of orthodontic patients. The role of the orthodontist is important in screening the disease, making a provisional diagnosis, and referring it to a periodontist for immediate treatment. The orthodontist should be aware of the disease not only before starting the appliance therapy, but also during and after the active mechanotherapy. The orthodontic treatment plan, biomechanics, and appliance system may need to be modified to deal with the teeth having reduced periodontal support. With proper force application and oral hygiene maintenance, orthodontic tooth movement is possible without any deleterious effect in the tooth with reduced bone support. With proper motivation and interdisciplinary approach, orthodontic treatment is possible in patients with controlled aggressive periodontitis.

  20. Periodontal tissue damage in smokers

    Directory of Open Access Journals (Sweden)

    Hutojo Djajakusuma

    2006-09-01

    Full Text Available Dental plaque is the primary etiological factor in periodontal diseases. However, there are many factors that can modify how an individual periodontal tissue will respond to the accumulation of dental plaque. Among such risk factors, there is increasing evidence that smoking tobacco products alters the expression and rate of progression of periodontal diseases. The aim of this study was to find out the loss of periodontal tissue adhesion in smokers by measuring pocket depth using probe, and by measuring alveolar bone damage using Bone Loss Score (BLS radiographic methods on teeth 12, 11, 21, 22, 32, 31, 41, 42. Based on T Test statistical analysis, there were significant differences in pocket depth damage of alveolar bone in smokers and non smokers. In conclusion there were increasing pocket depth and alveolar bone damage in smokers.

  1. Periodontal disease in the older patient.

    Science.gov (United States)

    Irwin, Chris R

    2011-03-01

    Population projections predict an increasing number of dentate older people who will require assessment and treatment of periodontal disease. Studies show that healthy, older patients show no increased risk of periodontal disease progression compared to younger individuals, while periodontal treatment can be equally successful in the older age group. However, co-morbidity can impact negatively on both the periodontal tissues and the dentition. These effects range from a reduced ability to maintain adequate plaque control, to the use of drug and other therapies directly affecting the periodontal tissues and salivary flow. An individualized treatment plan is required for older patients, taking account of all factors impacting on the periodontal tissues.

  2. Etiology and pathogenesis of periodontal diseases.

    Science.gov (United States)

    Tatakis, Dimitris N; Kumar, Purnima S

    2005-07-01

    The two most prevalent and most investigated periodontal diseases are dental plaque-induced gingivitis and chronic periodontitis. The last 10 to 15 years have seen the emergence of several important new findings and concepts regarding the etiopathogenesis of periodontal diseases. These findings include the recognition of dental bacterial plaque as a biofilm, identification and characterization of genetic defects that predispose individuals to periodontitis, host-defense mechanisms implicated in periodontal tissue destruction, and the interaction of risk factors with host defenses and bacterial plaque. This article reviews current aspects of the etiology and pathogenesis of periodontal diseases.

  3. Host response in aggressive periodontitis.

    Science.gov (United States)

    Kulkarni, Cyelee; Kinane, Denis F

    2014-06-01

    It is critical to understand the underlying host responses in aggressive periodontitis to provide a better appreciation of the risk and susceptibility to this disease. Such knowledge may elucidate the etiology and susceptibility to aggressive periodontitis and directly influence treatment decisions and aid diagnosis. This review is timely in that several widely held tenets are now considered unsupportable, namely the concept that Aggregatibacter actinomycetemycomitans is the key pathogen and that chemotactic defects in polymorphonuclear leukocytes are part of the etiopathology. This review also serves to put into context key elements of the host response that may be implicated in the genetic background of aggressive periodontitis. Furthermore, key molecules unique to the host response in aggressive periodontitis may have diagnostic utility and be used in chairside clinical activity tests or as population screening markers. It is becoming increasingly appreciated that the microbial etiology of aggressive periodontitis and the histopathology of this disease are more similar to than different from that of chronic periodontitis. An important therapeutic consideration from the lack of support for A. actinomycetemycomitans as a critical pathogen here is that the widely held belief that tetracycline had a role in aggressive periodontitis therapy is now not supported and that antibiotics such as those used effectively in chronic periodontitis (metronidazole and amoxicillin) are not contraindicated. Furthermore, A. actinomycetemycomitans-related molecules, such as cytolethal distending toxin and leukotoxin, are less likely to have utility as diagnosis agents or as therapeutic targets. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. [Early diagnosis of periodontal disease].

    Science.gov (United States)

    Sicilia, A M; Cobo Plana, J; López Arranz, J S; Ainamo, J

    1988-12-01

    Early diagnosis is necessary if the prevalence of periodontal disease is to be brought under control. For periodontal screening in dental practice we propose to employ the C.P.I.T.N. system, combined with examination of two or four dental bite-wing radiographs. Both of these procedures can be accurately applied in general dental practice conditions. The screening is not time consuming and can yield very important diagnostic data.

  5. Periodontitis and systemic lupus erythematosus

    OpenAIRE

    Sete, Manuela Rubim Camara; Figueredo, Carlos Marcelo da Silva; Sztajnbok, Flavio

    2016-01-01

    ABSTRACT A large number of studies have shown a potential association between periodontal and autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus (SLE). Similar mechanisms of tissue destruction concerning periodontitis and other autoimmune diseases have stimulated the study of a possible relationship between these conditions. This study aims to review the literature about this potential association and their different pathogenic mechanisms. Considering that peri...

  6. Porphyromonas gingivalis and Treponema denticola Mixed Microbial Infection in a Rat Model of Periodontal Disease

    Directory of Open Access Journals (Sweden)

    Raj K. Verma

    2010-01-01

    Full Text Available Porphyromonas gingivalis and Treponema denticola are periodontal pathogens that express virulence factors associated with the pathogenesis of periodontitis. In this paper we tested the hypothesis that P. gingivalis and T. denticola are synergistic in terms of virulence; using a model of mixed microbial infection in rats. Groups of rats were orally infected with either P. gingivalis or T. denticola or mixed microbial infections for 7 and 12 weeks. P. gingivalis genomic DNA was detected more frequently by PCR than T. denticola. Both bacteria induced significantly high IgG, IgG2b, IgG1, IgG2a antibody levels indicating a stimulation of Th1 and Th2 immune response. Radiographic and morphometric measurements demonstrated that rats infected with the mixed infection exhibited significantly more alveolar bone loss than shaminfected control rats. Histology revealed apical migration of junctional epithelium, rete ridge elongation, and crestal alveolar bone resorption; resembling periodontal disease lesion. These results showed that P. gingivalis and T. denticola exhibit no synergistic virulence in a rat model of periodontal disease.

  7. 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

  8. CT findings in apical versus basal involvement of pulmonary tuberculosis.

    Science.gov (United States)

    Yoon, Ji Young; Lee, In Jae; Im, Hyoung June; Lee, Kwanseop; Lee, Yul; Bae, Sang Hoon

    2013-01-01

    We aimed to compare clinical features and computed tomography (CT) findings of pulmonary tuberculosis (TB) in lower lobe basal segments and upper lobe apical or apicoposterior segments. We retrospectively reviewed medical records and chest CT scans of 986 adults who were diagnosed with active pulmonary TB. Active pulmonary TB confined to the basal segments was found in 21 patients. Sixty patients had disease localized to the apical or apicoposterior segments only. Clinical features and CT abnormalities of the lung parenchyma, airways, mediastinal and hilar lymph nodes, and pleura were compared between these two groups. A significant difference was observed between two groups in terms of underlying disease prevalence associated with an immunocompromised state (basal, 6/21, 28.6%; apical or apico- posterior, 3/60, 5%; P = 0.008). Chest CT findings, including consolidation (P = 0.0016), lymphadenopathy (P = 0.0297), and pleural effusion (P = 0.008), were more common in basal segment TB than in apical or apicoposterior segment TB. Small nodules were less common in basal segment TB than in apical or apicoposterior segment TB (P = 0.0299). The tree-in-bud sign was the most common CT finding in both basal segment TB (17/21, 81%) and apical or apicoposterior segment TB groups (53/60, 88.3%) (P = 0.4633). Lower lobe basal segment TB was more commonly present with common CT findings of primary pulmonary TB including consolidation, mediastinal and hilar lymphadenopathy, and pleural effusion than apical or apicoposterior segment TB.

  9. The clinical, microbiological and systemic characteristics of periodontitis and their changes after periodontal therapy

    NARCIS (Netherlands)

    Bizzarro, S.

    2015-01-01

    The aim of this thesis was to study 1. the relationship between periodontitis and systemic conditions and 2. the effect of 4 periodontal treatment modalities on clinical and microbiological periodontal parameters as well as systemic conditions. Our results showed that periodontitis is associated

  10. 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 idi...... idiopathic arthritis (JIA), and rheumatoid arthritis (RA) share periodontal and hematological characteristics distinguishing them from individuals free of diseases....

  11. Surgically Treated Symptomatic Prolapsed Lumbar and Sacral ...

    African Journals Online (AJOL)

    The intention of this study is to share the experience of the author in the occurrence, possible causative factors, and treatment of surgically symptomatic prolapsed lumbar and sacral intervertebral discs in females, and to compare this experience in Switzerland, Nigeria, and Jamaica using surgery records for a period of over ...

  12. Endovascular treatment of symptomatic intracranial atherosclerotic disease

    Directory of Open Access Journals (Sweden)

    Syed I Hussain

    2011-02-01

    Full Text Available Abstract: Symptomatic intracranial atherosclerotic disease (ICAD is responsible for approximately 10% of all ischemic strokes in the United States. The risk of recurrent stroke may be as high as 35% in patient with critical stenosis greater than 70% in diameter narrowing. Recent advances in medical and endovascular therapy have placed ICAD at the forefront of clinical stroke research to optimize the best medical and endovascular approach to treat this important underlying stroke etiology. Analysis of symptomatic ICAD studies lead to the question that whether angioplasty and or stenting is a safe, suitable and efficacious therapeutic strategy in patients with critical stenoses that are deemed refractory to medical management. Most of the currently available data in support of angioplasty and or stenting in high risk patients with severe symptomatic ICAD is in the form of case series and randomized trial results of endovascular therapy versus medical treatment are awaited. This is a comprehensive review of the state of the art in the endovascular approach with angioplasty and or stenting of symptomatic intracranial atherosclerotic disease.

  13. Prevalence of Cyclospora cayetanensis among symptomatic and ...

    African Journals Online (AJOL)

    Microsporidia, Giardia lamblia and Hymenolepis nana were also detected in the symptomatic group. There was no significant difference as regards age and residency of Cyclospora positive and negative cases in both groups. In asymptomatic group, Cyclospora infected cases were males while in negative cases, 50% were ...

  14. Prevalence and incidence of symmetrical symptomatic peripheral ...

    African Journals Online (AJOL)

    Background. Symptomatic symmetrical peripheral neuropathy (SSPN) is common in patients with HIV infection. It is also a common adverse event associated with both tuberculosis (TB) treatment and antiretroviral therapy (ART), particularly stavudine. While tenofovir is the one of recommended first-line nucleotide reverse ...

  15. Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy.

    Science.gov (United States)

    Wald, Arnold

    2003-03-01

    Constipation, diarrhea, and symptomatic hemorrhoids are disorders common in the general population, particularly in women. These conditions, if mild, often are self-treated with various home remedies or nonprescription preparations. Few of these patients, moreover, are referred to gastroenterologists, as primary care providers generally are confident managing these conditions, unless they are severe, refractory to conventional management, or require additional diagnostic studies.

  16. Diagnosis and Management of Chronic and Aggressive Periodontitis Part 2: Periodontal Management.

    Science.gov (United States)

    Chatzistavrianou, Despoina; Blair, Fiona

    2017-05-01

    The first paper of this three-part series discussed periodontal disease pathogenesis and highlighted elements in the clinical assessment which will help the clinician to establish the diagnosis of chronic and aggressive periodontitis. This second paper will focus on the management of chronic and aggressive periodontitis. Finally, the diagnosis and management of chronic and aggressive periodontitis will be reviewed in the third part of the series using two clinical examples. Clinical relevance: This paper aims to provide the general dental practitioner with an understanding of the aim of periodontal treatment, the management of chronic and aggressive periodontitis and the prognosis of periodontally involved teeth.

  17. Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

    Directory of Open Access Journals (Sweden)

    Marília Pacífico Lucisano

    2016-01-01

    Full Text Available The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11 had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.

  18. [Mineral trioxide aggregate (MTA) a success story in apical surgery].

    Science.gov (United States)

    von Arx, Thomas

    2016-01-01

    The objective of apical surgery is to retain teeth with persistent apical pathosis following orthograde root canal treatment if endodontic non-surgical revision is difficult or associated with risks, or is even declined by the patient. Since the most frequent cause of recurrent apical disease is bacterial reinfection from the (remaining) root canal system, the bacteria-tight root-end filling is the most important step in apical surgery. In the early 1990s, mineral trioxide aggregate (MTA) was developed at the Loma Linda University in California/USA. Preclinical studies clearly showed that MTA has a high sealing capability, a good material stability and an excellent biocompatbility. Multiple experimental studies in animals highlighted the mild tissue reactions observed adjacent to this material. Furthermore, histological analysis of the periapical regions demonstrated a frequent deposition of new cementum not only onto the resection plane (cut dentinal surface), but also directly onto MTA. For these reasons, MTA is considered a bioactive material. In 1997 MTA was cleared for clinical use in patients. Multiple prospective clinical and randomized studies have documented high and constant success rates of MTA-treated teeth in apical surgery. A recently published longitudinal study showed that MTA-treated teeth remained stable over five years; hence the high healed rates documented after one year are maintained during long-term observation.

  19. Regulation of Regenerative Periodontal Healing by NAMPT

    NARCIS (Netherlands)

    Nokhbehsaim, M.; Keser, S.; Jager, A.; Jepsen, S.; Deschner, J.

    2013-01-01

    Periodontitis is an inflammatory disease characterized by destruction of the tooth-supporting tissues. Obese individuals have an increased risk of periodontitis, and elevated circulating levels of nicotinamide phosphoribosyltransferase (NAMPT) may be a pathomechanistic link between both diseases.

  20. Regulation of regenerative periodontal healing by NAMPT.

    Science.gov (United States)

    Nokhbehsaim, Marjan; Keser, Sema; Jäger, Andreas; Jepsen, Søren; Deschner, James

    2013-01-01

    Periodontitis is an inflammatory disease characterized by destruction of the tooth-supporting tissues. Obese individuals have an increased risk of periodontitis, and elevated circulating levels of nicotinamide phosphoribosyltransferase (NAMPT) may be a pathomechanistic link between both diseases. Recently, increased levels of NAMPT have also been found in patients with periodontitis, irrespective of the presence of obesity. This in vitro study sought to examine the effects of NAMPT on the regenerative capacity of human periodontal ligament (PDL) cells and, thereby, periodontal healing. PDL cells treated with enamel matrix derivative (EMD), which was used to mimic regenerative healing conditions in vitro, were grown in the presence and absence of NAMPT for up to 14 d. EMD stimulated significantly (P periodontal regeneration are counteracted by NAMPT. Enhanced levels of NAMPT, as found in obesity and periodontal inflammation, may compromise the regenerative capacity of PDL cells and, thereby, periodontal healing in the presence of EMD.

  1. Periodontal microsurgery: Reaching new heights of precision

    Directory of Open Access Journals (Sweden)

    Vikender Singh Yadav

    2018-01-01

    Full Text Available 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.

  2. Antibiotic Susceptibility of Periodontal Enterococcus faecalis

    NARCIS (Netherlands)

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

    Background: Enterococcus faecalis may contribute to periodontal breakdown in heavily infected subgingival sites, particularly in patients responding poorly to mechanical forms of periodontal therapy. Because only limited data are available on the antimicrobial sensitivity of enterococci of

  3. Periodontal changes following molar intrusion with miniscrews

    Directory of Open Access Journals (Sweden)

    Shahin Bayani

    2015-01-01

    Conclusion: Within the limitations of this study, these results suggest that not only periodontal status was not negatively affected by intrusion, but also there were signs of periodontal improvement including attachment gain and shortening of clinical crown height.

  4. The localised aggressive periodontitis prevalence in Morocco.

    Science.gov (United States)

    Belhaissi, F E; Cherkaoui, A; Laporte, C; Miquel, J L

    2004-03-01

    This work concerns a retrospective study of prevalence records and the clinical characteristics of localised aggressive periodontitis in the breast of consultants in the periodontitis service in Dental Medicine Faculty of Rabat (Morocco) from 1997 to 1999.

  5. The clinical, microbiological and systemic characteristics of periodontitis and their changes after periodontal therapy

    OpenAIRE

    Bizzarro, S.

    2015-01-01

    The aim of this thesis was to study 1. the relationship between periodontitis and systemic conditions and 2. the effect of 4 periodontal treatment modalities on clinical and microbiological periodontal parameters as well as systemic conditions. Our results showed that periodontitis is associated with a prothrombotic state, a condition involved in the development of cardiovascular diseases. In particular alveolar bone loss and the host immune response to two established periodontal pathogenic ...

  6. 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...

  7. Spontaneous coronary artery dissection associated with apical hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Tuncer, M.; Gumrukcuoglu, H.A.; Ekim, H.; Gunes, Y.; Simsek, H.

    2010-01-01

    Apical hypertrophic cardiomyopathy (HCM) is a relatively uncommon inherited disease. Spontaneous coronary artery dissection (SCAD) is also uncommonly observed, which often occurs in pregnant or post partum women but is rare in men. This report describes a 38 years old man with apical hypertrophic cardiomyopathy who developed SCAD leading to acute inferior myocardial infarction. After emergent appendectomy operation at another hospital, he was immediately transferred to the Cardiology Department of our hospital due to acute myocardial infarction. He emergently underwent coronary angiography which showed a long dissection involving the right coronary. He underwent an emergent CABG with cardiopulmonary bypass. Postoperative recovery was uneventful and he was discharged. According to our knowledge, no case of spontaneous coronary artery dissection associated with apical hypertrophic cardiomyopathy unrelated to postpartum period or oral contraceptive use has been reported so far. (author)

  8. Histological assessment of pulp condition after apical vital root transection in one root of multirooted teeth in dogs: a preliminary study.

    Science.gov (United States)

    Yaghmaiee, Massoud; Yavari, Amir Saeed; Mashhadiabbas, Fatemeh; Bahrami, Afshin; Farnia, Pupak; Sharifi, Davoud; Ghanavi, Jalaledin; Eslami, Behnan

    2007-09-01

    One of the most important aspects in surgery is the healing process after the periapical surgery. Past studies have shown occasional encounters with vital root resection and have noted varying degrees of pulpal response after root resection in periodontal disease. The purpose of this investigation was to observe the pulpal and periapical responses to intentional apical vital root transection in one root of multirooted teeth of German-Canadian dogs over a 6-month postoperative period. This is an experimental study performed on left maxillary and mandibular quadrants of four adult German-Canadian dogs after a 3- and 6-month period. Four teeth were assessed in each interval. One of the roots of multirooted teeth in the left quadrant of both maxillary and mandibular jaws was surgically transected. Tissue blocks were prepared by routine histological methods after 12 and 24 weeks after the surgery. The results showed a disruption of the normal pulpal architecture, with initial pulpal degeneration and subsequent early replacement by the periodontal ligament tissue after 24 weeks. Hypercementosis was seen around the apical portion of the root in all specimens. Pulpal regeneration was seen in the both upper and lower molars (p = 0.03). Resorption took place only in two specimens (p = 0.46). The inflammation in the 12th week was more than the 24th week. The pulp of multirooted teeth remains vital after transection of the apical part of the root in dogs. Longer follow-up periods are recommended because root canal therapy or extraction is indicated if resorption, necrosis, or ankylosis is seen.

  9. Mineral trioxide aggregate as apical plug in teeth with necrotic pulp and immature apices: a 10-year case series.

    Science.gov (United States)

    Pace, Riccardo; Giuliani, Valentina; Nieri, Michele; Di Nasso, Luca; Pagavino, Gabriella

    2014-08-01

    This 10-year study evaluated the clinical and radiologic outcomes of teeth with necrotic pulp, immature apices, and periapical lesions treated with the mineral trioxide aggregate (MTA) apical plug technique. Seventeen single-rooted immature teeth with necrotic pulp and periapical lesion from 17 patients treated between January 2001 and December 2001 were included in this study. Apical obturation on all teeth included in the study was completed in 2 visits: first using calcium hydroxide as an interappointment intracanal medication and a second visit for the creation of the artificial apical barrier with MTA. The outcome, based on clinical and radiographic criteria, was assessed by 2 calibrated investigators using the periapical index (PAI). The Friedman test was used to verify the differences between baseline and the 1-, 5-, and 10-year PAI scores. Of the 17 patients treated, 1 patient dropped out at 5 years. At the 10-year follow-up, 15 teeth were healed (PAI ≤2), and 1 tooth had been extracted because of the presence of a longitudinal root fracture. The PAI score exhibited a significant decrease between baseline and 1 year and between 1 and 5 years. The difference between 5 and 10 years was not significant. The apical plug with MTA was a successful and effective technique for long-term management of this group of teeth with necrotic pulps with immature root development and periapical lesions. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Lessons learned and unlearned in periodontal microbiology

    Science.gov (United States)

    Teles, Ricardo; Teles, Flavia; Frias-Lopez, Jorge; Paster, Bruce; Haffajee, Anne

    2013-01-01

    Periodontal diseases are initiated by bacterial species living in polymicrobial biofilms at or below the gingival margin and progress largely as a result of the inflammation initiated by specific subgingival species. In the past few decades, efforts to understand the microbiota of periodontal diseases have led to an exponential increase in information about biofilms associated with periodontal health and disease. In fact, the oral microbiota is one of the best characterized microbiomes that colonize the human body. Despite this increased knowledge, one has to ask if our fundamental concepts of the etiology and pathogenesis of periodontal diseases have really changed. In this chapter we will review how our comprehension of the structure and function of the subgingival microbiota evolved over the years in search of lessons learned and unlearned in periodontal microbiology. More specifically, this review focuses on: 1) how the data obtained through molecular techniques has impacted our knowledge of the etiology of periodontal infections; 2) the potential role of viruses in the etiopathogenesis of periodontal diseases; 3) how concepts of microbial ecology have expanded our understanding of host microbial interactions that might lead to periodontal diseases; 4) the role of inflammation in the pathogenesis of periodontal diseases; and 5) the impact of these evolving concepts on treatment and preventive approaches to periodontal infections. We will conclude by reviewing how novel systems biology approaches promise to unravel new details of the pathogenesis of periodontal diseases and, hopefully, lead to a better understanding of periodontal disease mechanisms. PMID:23574465

  11. Periodontal Disease Awareness and Knowledge among Nigerian ...

    African Journals Online (AJOL)

    the participants heard about periodontal disease from nondental clinic sources. There existed a poor awareness of etiology, ... Keywords: Knowledge, Periodontal awareness, Periodontal disease, Teachers, Tooth loss. Access this article online ... questions. The protocol for this study was reviewed and approval granted by ...

  12. Probable autoimmune causal relationship between periodontitis and ...

    African Journals Online (AJOL)

    Periodontitis is a multifactorial disease with microbial dental plaque as the initiator of periodontal disease. However, the manifestation and progression of the disease is influenced by a wide variety of determinants and factors. The strongest type of causal relationship is the association of systemic and periodontal disease.

  13. Periodontal health knowledge and smoking are associated with periodontal treatment need according to tooth brushing levels.

    Science.gov (United States)

    Demirer, S; Gũrsoy, U K; Ozdemir, H; Erdemir, E O; Uitto, V J

    2012-03-01

    The aim of this study is to determine whether periodontal health knowledge is associated with frequency of tooth brushing and periodontal treatment need. Four hundred and two subjects participated in the study. Data on sociodemographic variables (age, gender, marital status, income, and education), general health, smoking behaviour tooth cleaning habits and knowledge on periodontal health/disease were collected with a questionnaire. Periodontal treatment need was examined using the Community Periodontal Index of Treatment Needs (CPITN). According to the CPITN scores, the treatment needs were grouped as minimum (CPITN = 0), low-level (CPITN = 1-2), or high-level (CPITN = 3-4). Statistical differences were found between the frequency of tooth brushing and smoking status, marital status, periodontal health knowledge and periodontal treatment needs. Gender (females), place of residence (urban areas), education and periodontal health knowledge had positive relationship with tooth brushing frequency, while smoking and periodontal treatment need had negative relationship. When multivariate logistic regression analysis was applied, age, marriage and poor periodontal knowledge were associated with increased low-level periodontal treatment needs, and age, marriage and smoking were associated with increased high-level periodontal treatment need. In the limits of this study, we suggest that gender, smoking habits, marital status, place of residence, education and periodontal health knowledge are determining factors related to tooth brushing frequency. Periodontal knowledge and smoking are associated with periodontal treatment needs.

  14. Determination of the Influence of Chronic Periodontitis on Pulp Sensibility by Means of Electric and Thermal Cold Testing.

    Science.gov (United States)

    Neves, Vanessa C Q; Toledo, Benedicto E C; Camargo, Gabriela A C G; Souza, Alessandra A; Zuza, Elizangela P

    2017-11-01

    Communication between pulp and periodontal tissue has been well established. However, it is unknown when periodontal disease begins to affect the clinical response of pulp tissue. The aim of this study was to assess the influence of periodontal severity on pulp sensibility by means of electric and thermal cold testing. The teeth assessed in this study were allocated into 3 groups considering radiographic alveolar bone loss (ABL) as follows: slight periodontitis (SP, ABL ≤7 mm without reaching the apex, n = 25), moderate periodontitis (ABL >7 mm without reaching the apex, n = 23), and severe periodontitis (SvP, ABL >7 reaching the apex, n = 8). Gingival recession (GR), probing depth (PD), and clinical attachment level (CAL) were also measured. The results showed higher levels of PD and CAL in the SvP group compared with the SP group (P  .05). The SvP group showed significant ABL compared with the other groups (P > .05). The SP group showed a significant number of teeth with a positive pulp response, whereas the SvP group showed a significant number of teeth with a negative pulp response (P  .05). Within the limits of this study, it can be concluded that pulp clinical involvement with a negative response to thermal cold and electric testing occurs only in the most advanced stage of chronic periodontitis with apical involvement. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  15. Osteoporosis, jawbones and periodontal disease.

    Science.gov (United States)

    Guiglia, Rosario; Di Fede, Olga; Lo Russo, Lucio; Sprini, Delia; Rini, Giovan-Battista; Campisi, Giuseppina

    2013-01-01

    The association between osteoporosis and jawbones remains an argument of debate. Both osteoporosis and periodontal diseases are bone resorptive diseases; it has been hypothesized that osteoporosis could be a risk factor for the progression of periodontal disease and vice versa. Hypothetical models linking the two conditions exist: in particular, it is supposed that the osteoporosis-related bone mass density reduction may accelerate alveolar bone resorption caused by periodontitis, resulting in a facilitated periodontal bacteria invasion. Invading bacteria, in turn, may alter the normal homeostasis of bone tissue, increasing osteoclastic activity and reducing local and systemic bone density by both direct effects (release of toxins) and/or indirect mechanisms (release of inflammatory mediators). Current evidence provides conflicting results due to potential biases related to study design, samples size and endpoints. The aim of this article is to review and summarize the published literature on the associations between osteoporosis and different oral conditions such as bone loss in the jaws, periodontal diseases, and tooth loss. Further well-controlled studies are needed to better elucidate the inter-relationship between systemic and oral bone loss and to clarify whether dentists could usefully provide early warning for osteoporosis risk.

  16. Pro-Inflammatory Cytokine TNF-α Attenuates BMP9-Induced Osteo/ Odontoblastic Differentiation of the Stem Cells of Dental Apical Papilla (SCAPs

    Directory of Open Access Journals (Sweden)

    Feilong Wang

    2017-03-01

    Full Text Available Background/Aims: Periapical periodontitis is a common oral disease caused by bacterial invasion of the tooth pulp, which usually leads to local release of pro-inflammatory cytokines and osteolytic lesion. This study is intended to examine the effect of TNF-α on BMP9-induced osteogenic differentiation of the stem cells of dental apical papilla (SCAPs. Methods: Rat model of periapical periodontitis was established. TNF-α expression was assessed. Osteogenic markers and ectopic bone formation in iSCAPs were analyzed upon BMP9 and TNF-α treatment. Results: Periapical periodontitis was successfully established in rat immature permanent teeth with periapical lesions, in which TNF-α was shown to release during the inflammatory phase. BMP9-induced alkaline phosphatase activity, the expression of osteocalcin and osteopontin, and matrix mineralization in iSCAPs were inhibited by TNF-α in a dose-dependent fashion, although increased AdBMP9 partially overcame TNF-α inhibition. Furthermore, high concentration of TNF-α effectively inhibited BMP9-induced ectopic bone formation in vivo. Conclusion: TNF-α plays an important role in periapical bone defect during the inflammatory phase and inhibits BMP9-induced osteoblastic differentiation of iSCAPs, which can be partially reversed by high levels of BMP9. Therefore, BMP9 may be further explored as a potent osteogenic factor to improve osteo/odontogenic differentiation in tooth regeneration in chronic inflammation conditions.

  17. Environmental and Pathogenic Factors Inducing Brown Apical Necrosis on Fruit of English (Persian) Walnut.

    Science.gov (United States)

    Scotton, Michele; Bortolin, Enrico; Fiorin, Antonio; Belisario, Alessandra

    2015-11-01

    Brown apical necrosis (BAN) is a most recently described disease affecting English (Persian) walnut fruit. BAN was only recorded in intensively managed walnut orchards and was found to be a disease complex mainly caused by Fusarium species. All fungi associated with this disease are polyphagous and ubiquitous, not specific to walnut. Consequently, BAN occurrence is more strictly dependent, than generally, on the interaction between pathological features and environmental conditions. Environmental variables identified with regression analysis showed that maximum temperature, angle of main wind direction versus tree row orientation, and orchard distance to the closest river/canal, all representative of climatic conditions occurring in the orchard, were related to fruit drop. The factor displaying the highest influence on severity of BAN fruit drop was maximum temperature and only subordinately factors are associated with relative humidity. BAN symptoms were reproduced with in planta artificial inoculation, and fruit drop of symptomatic fruit was significantly higher than that of the noninoculated trees for each type of inoculum (Fusarium semitectum, F. graminearum, and Alternaria spp.). F. semitectum and F. graminearum were more aggressive than Alternaria species, and the earliest artificial inoculations in mid-May resulted in the highest fruit drop. The extension of walnut fruit susceptibility and the conducive environmental factors to BAN are discussed.

  18. Interaction between endodontics and periodontics.

    Science.gov (United States)

    Rotstein, Ilan

    2017-06-01

    Endodontic-periodontal lesions present challenges to the clinician regarding diagnosis, treatment planning and prognosis. Etiologic factors, such as bacteria and viruses, as well as contributing factors, such as trauma, root resorptions, perforations, cracks and dental malformations, play an important role in the development and progression of such lesions. Treatment and prognosis of endodontic-periodontal lesions vary, depending on the etiology, pathogenesis and correct diagnosis of each specific condition. This chapter will appraise the interrelationship between endodontic and periodontal lesions and provide biological and clinical evidence for diagnosis, prognosis and decision-making in the treatment of these conditions. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. The antimicrobial effect of apical box versus apical cone preparation using iodine potassium iodide as root canal dressing

    DEFF Research Database (Denmark)

    Markvart, Merete; Dahlén, Gunnar; Reit, Claes-Erik

    2013-01-01

    . Methods. Twenty-four patients were centrally randomized to apical box preparation (size #60) or cone preparation (apical size #25). The groups were comparable regarding the presence of primary caries and type of coronal restoration. In the course of canal preparation each tooth was irrigated with 2.5% Na......-week post-sampling, a power calculation revealed that over 900 patients are needed to show a difference of 9% between the two protocols tested. Conclusions. Future trials should be conducted using stringent protocols and as multi-centre trials for reaching the required information size....

  20. Relationship Between Periodontal Screening and Recording Index Scores and Need for Periodontal Access Surgery.

    Science.gov (United States)

    Rams, Thomas E; Loesche, Walter J

    2017-10-01

    The validity of using pretreatment Periodontal Screening and Recording (PSR) index sextant scores to estimate periodontal access surgery needs is evaluated in patients with chronic periodontitis before and after completion of non-surgical periodontal therapy. In 110 adults, pretreatment probing data identified 486 sextants with PSR scores of 4 and 125 sextants with PSR scores of 3. Periodontal access surgery needs for all sextants were determined prior to treatment and after completion of non-surgical periodontal therapy for 213 sextants in 38 patients by two experienced periodontist examiners. PSR scores of 4 identified untreated sextants with periodontal access surgery needs significantly better than PSR scores of 3 (odds ratio = 27.8; P periodontal access surgery need continued to have surgical access needs after completion of non-surgical periodontal therapy. A higher percentage of sextants with PSR scores of 4 or 3 revealed periodontal access surgical needs when Class II or III furcation involvements and/or Grade II or III tooth mobility were also detected in the sextant than when these parameters were not detected. Pretreatment PSR index scores of 4 were a strong indicator of periodontal access surgery needs in untreated dentition sextants but markedly overestimated surgical access needs remaining after completion of non-surgical periodontal therapy. These findings raise questions about the usefulness of pretreatment PSR evaluations for estimating potential periodontal access surgery needs in patients to be initially treated with non-surgical periodontal therapy.

  1. Diabetes and periodontal diseases: interplay and links.

    Science.gov (United States)

    Lakschevitz, Flavia; Aboodi, Guy; Tenenbaum, Howard; Glogauer, Michael

    2011-11-01

    The association between diabetes and periodontal diseases is well-established. Diabetes is a risk factor for periodontal disease, with diabetic patients exhibiting an increased prevalence, extent and severity of gingivitis and perio- dontitis compared to healthy adults. Several mechanisms involved in the pathogenesis of diabetes have also been associated with periodontal disease progression. It is recognized today that there is a bidirectional relationship between diabetes and periodontal disease, with recent research showing that periodontal disease may affect the metabolic control of diabetes in diabetic patients. In this review, we present the current knowledge of the interplay between periodontal diseases and diabetes through the evaluation of randomized control and longitudinal cohort studies published in the past 15 years. Current data support the conclusion that diabetic patients are at increased risk for periodontal diseases, and that patients with poorly controlled diabetes are at risk for severe periodontitis. This results in the destruction of oral connective tissue and generalized bone loss, leading ultimately to tooth loss. Although the effect of periodontal disease on glycemic control in type 1 diabetic patients is controversial, evidence does show a direct correlation between periodontal health and glycemic control in type 2 diabetic patients. Furthermore, several studies have demonstrated the beneficial effect of periodontal treatment on metabolic control of type 2 diabetic patients.

  2. 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.

  3. Subgingival microflora in Turkish patients with periodontitis.

    Science.gov (United States)

    Doğan, Başak; Antinheimo, Johanna; Cetiner, Deniz; Bodur, Ayşen; Emingil, Gülnur; Buduneli, Eralp; Uygur, Cem; Firatli, Erhan; Lakio, Laura; Asikainen, Sirkka

    2003-06-01

    No information exists on periodontitis-associated subgingival microbiota from Turkey. We determined the occurrence, interspecies relationships, and clonal characteristics for a group of periodontal bacteria in a Turkish study population. Subgingival microbial samples were obtained from patients with localized (LAgP, N = 18) or generalized (GAgP, N = 17) types of aggressive periodontitis, generalized chronic periodontitis (GCP, N = 14), and non-periodontitis subjects (N = 20). Culture methods were used to recover 6 periodontal bacterial species and yeasts, and a polymerase chain reaction technique was used to detect Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Intraspecies characterization of A. actinomycetemcomitans was carried out by serotyping and genotyping. All species, except for Micromonas micros (formerly Peptostreptococcus micros) occurred more frequently (P periodontitis than non-periodontitis subjects. Detection frequencies for Tannerella forsythensis (formerly Bacteroides forsythus) and Campylobacter rectus differed among the periodontitis subgroups; the lowest frequency occurred in LAgP. The mean proportions of A. actinomycetemcomitans, P. gingivalis, and C. rectus were higher (P periodontitis subjects. Significant positive associations were seen between 7 of the 22 possible combinations (P periodontitis. However, A. actinomycetemcomitans was not overrepresented in LAgP, and the serotype distribution resembled that reported from the East. The high frequency of non-serotypeable isolates suggests local characteristics of the species.

  4. 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......; advanced disease with deep periodontal pockets (> or =6 mm) affects approximately 10% to 15% of adults worldwide. The available evidence shows that important risk factors for periodontal disease relate to poor oral hygiene, tobacco use, excessive alcohol consumption, stress, and diabetes mellitus...

  5. 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.

  6. 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.

  7. Association between postmenopausal osteoporosis and experimental periodontitis.

    Science.gov (United States)

    Luo, Kai; Ma, Souzhi; Guo, Jianbin; Huang, Yongling; Yan, Fuhua; Xiao, Yin

    2014-01-01

    To investigate the correlation between postmenopausal osteoporosis (PMO) and the pathogenesis of periodontitis, ovariectomized rats were generated and the experimental periodontitis was induced using a silk ligature. The inflammatory factors and bone metabolic markers were measured in the serum and periodontal tissues of ovariectomized rats using an automatic chemistry analyzer, enzyme-linked immunosorbent assays, and immunohistochemistry. The bone mineral density of whole body, pelvis, and spine was analyzed using dual-energy X-ray absorptiometry and image analysis. All data were analyzed using SPSS 13.0 statistical software. It was found that ovariectomy could upregulate the expression of interleukin- (IL-)6, the receptor activator of nuclear factor- κB ligand (RANKL), and osteoprotegerin (OPG) and downregulate IL-10 expression in periodontal tissues, which resulted in progressive alveolar bone loss in experimental periodontitis. This study indicates that changes of cytokines and bone turnover markers in the periodontal tissues of ovariectomized rats contribute to the damage of periodontal tissues.

  8. Accuracy of NHANES periodontal examination protocols.

    Science.gov (United States)

    Eke, P I; Thornton-Evans, G O; Wei, L; Borgnakke, W S; Dye, B A

    2010-11-01

    This study evaluates the accuracy of periodontitis prevalence determined by the National Health and Nutrition Examination Survey (NHANES) partial-mouth periodontal examination protocols. True periodontitis prevalence was determined in a new convenience sample of 454 adults ≥ 35 years old, by a full-mouth "gold standard" periodontal examination. This actual prevalence was compared with prevalence resulting from analysis of the data according to the protocols of NHANES III and NHANES 2001-2004, respectively. Both NHANES protocols substantially underestimated the prevalence of periodontitis by 50% or more, depending on the periodontitis case definition used, and thus performed below threshold levels for moderate-to-high levels of validity for surveillance. Adding measurements from lingual or interproximal sites to the NHANES 2001-2004 protocol did not improve the accuracy sufficiently to reach acceptable sensitivity thresholds. These findings suggest that NHANES protocols produce high levels of misclassification of periodontitis cases and thus have low validity for surveillance and research.

  9. In vitro comparison of apical microleakage following canal ...

    African Journals Online (AJOL)

    hope&shola

    2010-11-03

    Nov 3, 2010 ... The purpose of this study was to compare apical microleakage following canal obturation with lateral .... mm and the maximum was 6.69 mm. Statistical analysis of mean differences for independent groups (Independent samples t-test) showed that there was no ..... Clinical and radiographic evaluation of.

  10. Evaluation of the amount of apically extruded debris during ...

    African Journals Online (AJOL)

    2015-04-06

    Apr 6, 2015 ... (Dentsply Maillefer, Ballaigues, Switzerland). Root canal preparation and obturation. A size 15 K‑file (Dentsply Maillefer, Ballaigues, Switzerland) was placed into the canal until it was visible at the apical foramen. The working length (WL) was established as. 1 mm shorter than this length. The canals were ...

  11. Shoot apical meristem arrest in brassica and tomato

    NARCIS (Netherlands)

    Jonge, de J.

    2013-01-01

    A pool of cells known as stem cells located in the center of the shoot apical meristem (SAM) are responsible to maintain meristematic activity throughout a plants life in order to produce organs. The maintenance of these stem cells is tightly controlled by a complex genetic and hormonal network. Any

  12. Protein modeling of apical membrane antigen-1(AMA-1) of ...

    African Journals Online (AJOL)

    Apical membrane Antigen-1(AMA-1), an asexual blood stage antigen of Plasmodium cynomolgi, is an important candidate for testing as a component of malarial vaccine. The degree of conservation of. AMA-1 sequences implies a conserved function for this molecule across different species of Plasmodium. Since the AMA-1 ...

  13. Histology of periapical lesions obtained during apical surgery.

    Science.gov (United States)

    Schulz, Malte; von Arx, Thomas; Altermatt, Hans Jörg; Bosshardt, Dieter

    2009-05-01

    The aim of this was to evaluate the histology of periapical lesions in teeth treated with periapical surgery. After root-end resection, the root tip was removed together with the periapical pathological tissue. Histologic sectioning was performed on calcified specimens embedded in methylmethacrylate (MMA) and on demineralized specimens embedded in LR White (Fluka, Buchs, Switzerland). The samples were evaluated with light and transmission electron microscopy (TEM). The histologic findings were classified into periapical abscesses, granulomas, or cystic lesions (true or pocket cysts). The final material comprised 70% granulomas, 23% cysts and 5% abscesses, 1% scar tissues, and 1% keratocysts. Six of 125 samples could not be used. The cystic lesions could not be subdivided into pocket or true cysts. All cysts had an epithelium-lined cavity, two of them with cilia-lined epithelium. These results show the high incidence of periapical granulomas among periapical lesions obtained during apical surgery. Periapical abscesses were a rare occasion. The histologic findings from samples obtained during apical surgery may differ from findings obtained by teeth extractions. A determination between pocket and true apical cysts is hardly possible when collecting samples by apical surgery.

  14. Phenotypic plasticity to altered apical bud temperature in Cucumis sativus

    NARCIS (Netherlands)

    Savvides, Andreas; Ieperen, van Wim; Dieleman, Janneke A.; Marcelis, Leo F.M.

    2017-01-01

    Many studies investigated temperature effects on leaf initiation and expansion by relating these processes to air temperature or the temperature of a specific organ (e.g. leaf temperature). In reality plant temperature is hardly ever equal to air temperature or spatially uniform. Apical bud

  15. Evaluation of the Amount of Apically Extruded Debris during ...

    African Journals Online (AJOL)

    Objective: To evaluate the amount of apically extruded debris during retreatment (with or without solvent) of root canals filled by two obturation techniques. Materials and Methods: Forty‑eight root canals were prepared using ProTaper Universal F3 and filled with Gutta‑percha and AH 26 sealer using single cone or lateral ...

  16. In vitro comparison of apical microleakage following canal ...

    African Journals Online (AJOL)

    hope&shola

    2010-11-03

    Nov 3, 2010 ... the cause of failing case in which the instructions were not followed and/or the goals of the technique were not achieved. Conclusion. Since the present study did not exhibit any differences in apical microleakage following canal obturation with lateral and thermoplasticized gutta-percha compaction techni-.

  17. [Nonsurgical retreatment in a case of a radiolucent apical lesion].

    Science.gov (United States)

    Vicente Gómez, A; Rodríguez Ponce, A

    1989-01-01

    We present a case of failure that was helpful solved without surgical endodontic treatment. We don't achieve clinical success besides endodontic treatment was twice remade. Finally we decided to put a temporary filling with calcium hydroxide and wait until apical radiolucency disappear and complete our treatment with gutta-percha, sealer and lateral condensation.

  18. Apical dominance and growth in vitro of Alstroemeria

    NARCIS (Netherlands)

    Pumisutapon, P.

    2012-01-01

    In Alstroemeria, micropropagation is achieved by axillary bud outgrowth. However, the multiplication rate is rather low (1.2–2.0 per cycle of 4 weeks) due to strong apical dominance. Even though several factors (i.e. culture media, growth regulators, and environmental conditions) have been

  19. Enhanced periodontal tissue regeneration by periodontal cell implantation

    NARCIS (Netherlands)

    Yu, N.; Oortgiesen, D.A.W.; Bronckers, A.L.; Yang, F.; Walboomers, X.F.; Jansen, J.A.

    2013-01-01

    AIM: Due to a lack of regenerative potential, current treatments for periodontal defects do not always provide satisfactory clinical results. Previously, the implantation of a biomaterial scaffold-cell construct has been suggested as a clinically achievable approach. In this study, it was aimed to

  20. Enhanced periodontal tissue regeneration by periodontal cell implantation

    NARCIS (Netherlands)

    Yu, N.; Oortgiesen, D.A.W.; Bronckers, A.L.J.J.; Yang, F.; Walboomers, X.F.; Jansen, J.A.

    2013-01-01

    Aim Due to a lack of regenerative potential, current treatments for periodontal defects do not always provide satisfactory clinical results. Previously, the implantation of a biomaterial scaffold-cell construct has been suggested as a clinically achievable approach. In this study, it was aimed to

  1. Aggressive and acute periodontal diseases.

    Science.gov (United States)

    Albandar, Jasim M

    2014-06-01

    Inflammatory periodontal diseases are highly prevalent, although most of these diseases develop and progress slowly, often unnoticed by the affected individual. However, a subgroup of these diseases include aggressive and acute forms that have a relatively low prevalence but show a rapid-course, high rate of progression leading to severe destruction of the periodontal tissues, or cause systemic symptoms that often require urgent attention from healthcare providers. Aggressive periodontitis is an early-onset, destructive disease that shows a high rate of periodontal progression and distinctive clinical features. A contemporary case definition of this disease is presented. Population studies show that the disease is more prevalent in certain geographic regions and ethnic groups. Aggressive periodontitis is an infectious disease, and recent data show that in affected subjects the subgingival microbiota is composed of a mixed microbial infection, with a wide heterogeneity in the types and proportions of microorganisms recovered. Furthermore, there are significant differences in the microbiota of the disease among different geographic regions and ethnicities. There is also evidence that the Aggregatibacter actinomycetemycomitans-JP2 clone may play an important role in the development of the disease in certain populations. The host response plays an important role in the susceptibility to aggressive periodontitis, where the immune response may be complex and involve multiple mechanisms. Also, genetic factors seem to play an important role in the pathogenesis of this disease, but the mechanisms of increased susceptibility are complex and not yet fully understood. The available data suggest that aggressive periodontitis is caused by mutations either in a few major genes or in multiple small-effect genes, and there is also evidence of gene-gene and gene-environment interaction effects. Diagnostic methods for this disease, based on a specific microbiologic, immunologic or

  2. 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.

  3. An Atypical Case of Apical Hypertrophic Cardiomyopathy: Absence of Giant T Waves in spite of Extreme Apical Wall Hypertrophy

    Directory of Open Access Journals (Sweden)

    Elias Sanidas

    2015-01-01

    Full Text Available Apical hypertrophic cardiomyopathy is an uncommon variant of hypertrophic cardiomyopathy, with hypertrophy mainly affecting the apex of the left ventricle. We hereby describe a case of an octogenarian female patient who was randomly diagnosed with AHCM due to other comorbidities.

  4. Periodontitis and systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Manuela Rubim Camara Sete

    2016-04-01

    Full Text Available ABSTRACT A large number of studies have shown a potential association between periodontal and autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus (SLE. Similar mechanisms of tissue destruction concerning periodontitis and other autoimmune diseases have stimulated the study of a possible relationship between these conditions. This study aims to review the literature about this potential association and their different pathogenic mechanisms. Considering that periodontal disease is a disease characterized by inflammation influenced by infectious factors, such as SLE, it is plausible to suggest that SLE would influence periodontal disease and vice-versa. However, this issue is not yet fully elucidated and several mechanisms have been proposed to explain this association, as deregulation mainly in innate immune system, with action of phagocytic cells and proinflammatory cytokines such as IL-1β and IL-18 in both conditions’ pathogenesis, leading to tissue destruction. However, studies assessing the relationship between these diseases are scarce, and more studies focused on common immunological mechanisms should be conducted to further understanding.

  5. Aggressive periodontitis: The unsolved mystery.

    Science.gov (United States)

    Clark, Danielle; Febbraio, Maria; Levin, Liran

    2017-01-01

    Aggressive periodontal disease is an oral health mystery. Our current understanding of this disease is that specific bacteria invade the oral cavity and the host reacts with an inflammatory response leading to mass destruction of the alveolar bone. Aggressive periodontal disease is typically observed in a population under the age of 30 and occurs so rapidly that it is difficult to treat. Unfortunately, the consequence of this disease frequently involves tooth extractions. As a result, the aftermath is chewing disability and damage to self-esteem due to an altered self-image. Furthermore, patients are encumbered by frequent dental appointments which have an economic impact in regards to both personal financial strain and absent days in the workplace. Aggressive periodontal disease has a tremendous effect on patients' overall quality of life and needs to be investigated more extensively in order to develop methods for earlier definitive diagnosis and effective treatments. One of the mysteries of aggressive periodontal disease is the relatively nominal amount of plaque present on the tooth surface in relation to the large amount of bone loss. There seems to be a hidden factor that lies between the response by the patient's immune system and the bacterial threat that is present. A better mechanistic understanding of this disease is essential to provide meaningful care and better outcomes for patients.

  6. Periodontal Status of Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Timur V. Melkumyan

    2014-06-01

    Full Text Available The objective of this study was to compare the periodontal status in postmenopausal women with osteopenia and osteoporosis. Material and Methods: We examined 43 postmenopausal women aged from 55 to 74 years. Material assessment of bones in every patient was performed by means of dual energy X-ray absorptiometry (DXA from two points on the skeleton – part of the femur neck and between the first and fourth lumbar vertebrae. A lipid blood test was done for patients of both groups. All patients were divided into two groups (the 1st with osteopenia, and the 2nd with osteoporosis. All patients were subjected to an oral clinical examination: the periodontal examination was composed of Plaque Index (PI, Pocket Score (PS, and Papillary Bleeding Index (PBI. X-ray analysis was performed for every patient. Results: The results of the clinical periodontal examination demonstrated that the mean PBI in patients in the 1st group had no significant differences from the PBI in patients in the 2nd group. PI value and PS findings in patients with general osteoporosis also had no statistical differences from the same parameters in patients with osteopenia. Conclusion: Under the circumstances of these patients’ characteristics and within the limits of the present study, we concluded that there is no significant difference in the periodontal status of postmenopausal women with systemic osteopenia and with osteoporosis.

  7. 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

  8. ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY

    Directory of Open Access Journals (Sweden)

    Ece Barça

    2015-10-01

    Full Text Available Periodontal diseases are infectious diseases with a mixed microbial aetiology and marked inflammatory response leading to destruction of underlying tissue. Periodontal therapy aims to eliminate pathogens associated with the disease and attain periodontal health. Periodontitis is generally treated by nonsurgical mechanical debridement and regular periodontal maintenance care. Periodontal surgery may be indicated for some patients to improve access to the root surface; however, mechanical debridement alone may not be helpful in all cases. In such cases, adjunctive systemic antibiotic therapy remains the treatment of choice. It can reach microorganisms at the base of the deep periodontal pockets and furcation areas via serum, and also affects organisms residing within gingival epithelium and connective tissue. This review aims to provide an update on clinical issues regarding when and how to prescribe systemic antibiotics in periodontal therapy. The points discussed are the mode of antibiotic action, susceptible periodontal pathogens, antibiotic dosage, antibiotic use in treatment of periodontal disease, and mechanism of bacterial resistance to each antibiotic.

  9. Oxidative Stress and Antioxidant System in Periodontitis

    Directory of Open Access Journals (Sweden)

    Yue Wang

    2017-11-01

    Full Text Available 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.

  10. [Therapy of polyneuropathies. Causal and symptomatic].

    Science.gov (United States)

    Müller-Felber, W

    2001-05-28

    In the first instance, polyneuropathies are treated causally. The most common underlying cause is diabetes mellitus or alcohol abuse. In a large number of patients with polyneuropathy, however, the underlying cause cannot be definitively identified. For these--but equally for patients with etiologically clear polyneuropathy--a stock-taking of clinical symptoms should be carried out and, where indicated, symptomatic treatment initiated. In addition to medication aimed at combating pain, muscular spasm, autonomic functional disorders, and for the prevention of thrombosis, physical measures (physiotherapy, foot care, orthopedic shoes) are of primary importance.

  11. Mitoses and microorganisms in the periodontal membrane after storage in milk or saliva.

    Science.gov (United States)

    Lindskog, S; Blomlöf, L; Hammarström, L

    1983-12-01

    Milk and saliva were tested in vitro as potential storage media for avulsed teeth. Developing monkey teeth were extracted and stored in milk or saliva for periods ranging from 1 to 6 h. The osmolality, pH, conductivity and number of viable bacteria in the media were determined after predetermined intervals during the storage periods. After the storage periods the teeth were either prepared for scanning electron microscopy or cultured for 24 h in Eagle's medium supplemented with 3H-thymidine. In the scanning electron microscope numerous adherent bacteria were seen covering the periodontal membrane after storage in saliva but none were found after storage in milk. The cultured teeth were sectioned and evaluated with autoradiography. Superficial parts of the periodontal membrane were rapidly injured by storage in saliva while the epithelial root sheath and the apical pulpal cells were affected at a later stage. Cells neighboring the cementoblasts incorporated 3H-thymidine after 6 h storage in milk but not after storage in saliva for the same length of time. It was concluded that the low osmolality in combination with bacteria which adhered to the periodontal membrane made saliva less suited than milk for long time storage of avulsed teeth. Furthermore, a viable layer of cells close to the root surface seemed to be a prerequisite for a successful healing without root resorption after replantation.

  12. Apical organs in echinoderm larvae: insights into larval evolution in the Ambulacraria.

    Science.gov (United States)

    Byrne, Maria; Nakajima, Yoko; Chee, Francis C; Burke, Robert D

    2007-01-01

    The anatomy and cellular organization of serotonergic neurons in the echinoderm apical organ exhibits class-specific features in dipleurula-type (auricularia, bipinnaria) and pluteus-type (ophiopluteus, echinopluteus) larvae. The apical organ forms in association with anterior ciliary structures. Apical organs in dipleurula-type larvae are more similar to each other than to those in either of the pluteus forms. In asteroid bipinnaria and holothuroid auricularia the apical organ spans ciliary band sectors that traverse the anterior-most end of the larvae. The asteroid apical organ also has prominent bilateral ganglia that connect with an apical network of neurites. The simple apical organ of the auricularia is similar to that in the hemichordate tornaria larva. Apical organs in pluteus forms differ markedly. The echinopluteus apical organ is a single structure on the oral hood between the larval arms comprised of two groups of cells joined by a commissure and its cell bodies do not reside in the ciliary band. Ophioplutei have a pair of lateral ganglia associated with the ciliary band of larval arms that may be the ophiuroid apical organ. Comparative anatomy of the serotonergic nervous systems in the dipleurula-type larvae of the Ambulacraria (Echinodermata+Hemichordata) suggests that the apical organ of this deuterostome clade originated as a simple bilaterally symmetric nerve plexus spanning ciliary band sectors at the anterior end of the larva. From this structure, the apical organ has been independently modified in association with the evolution of class-specific larval forms.

  13. The Effects of Cigarette Smoke Condensate and Nicotine on Periodontal Tissue in a Periodontitis Model Mouse.

    Directory of Open Access Journals (Sweden)

    Mikiko Kubota

    Full Text Available Cigarette smoking is a major lifestyle-related risk factor for periodontal diseases. However, the pathophysiological role of cigarette smoking in periodontal disease has yet to be fully elucidated. Here we report that the systemic administration of cigarette smoke condensate or nicotine, which is the major ingredient of cigarette smoke, augmented alveolar bone loss. Concomitantly, the number of osteoclasts in periodontal tissues increased and the expression of receptor activator of nuclear factor κB ligand was upregulated at the ligated side in mice with periodontitis. Nicotine also attenuated alveolar bone repair after ligature removal. These observations highlight the destruction of periodontal tissue by smoking and the unfavorable clinical course of periodontal disease in patients with a cigarette smoking habit. The present study demonstrates that periodontal disease models are useful for elucidating the pathogenesis of cigarette smoking-related periodontal diseases.

  14. The Effects of Cigarette Smoke Condensate and Nicotine on Periodontal Tissue in a Periodontitis Model Mouse.

    Science.gov (United States)

    Kubota, Mikiko; Yanagita, Manabu; Mori, Kenta; Hasegawa, Shiori; Yamashita, Motozo; Yamada, Satoru; Kitamura, Masahiro; Murakami, Shinya

    2016-01-01

    Cigarette smoking is a major lifestyle-related risk factor for periodontal diseases. However, the pathophysiological role of cigarette smoking in periodontal disease has yet to be fully elucidated. Here we report that the systemic administration of cigarette smoke condensate or nicotine, which is the major ingredient of cigarette smoke, augmented alveolar bone loss. Concomitantly, the number of osteoclasts in periodontal tissues increased and the expression of receptor activator of nuclear factor κB ligand was upregulated at the ligated side in mice with periodontitis. Nicotine also attenuated alveolar bone repair after ligature removal. These observations highlight the destruction of periodontal tissue by smoking and the unfavorable clinical course of periodontal disease in patients with a cigarette smoking habit. The present study demonstrates that periodontal disease models are useful for elucidating the pathogenesis of cigarette smoking-related periodontal diseases.

  15. Symptomatic and asymptomatic candidiasis in a pediatric intensive care unit.

    Science.gov (United States)

    Arslankoylu, Ali Ertug; Kuyucu, Necdet; Yilmaz, Berna Seker; Erdogan, Semra

    2011-11-21

    This study aimed to examine the incidence, epidemiology, and clinical characteristics of symptomatic and asymptomatic candidiasis in a pediatric intensive care unit (PICU), and to determine the risk factors associated with symptomatic candidiasis. This retrospective study included 67 patients from a 7-bed PICU in a tertiary care hospital that had Candida-positive cultures between April 2007 and July 2009. Demographic and clinical characteristics of the patients, Candida isolates, antimicrobial and antifungal treatments, and previously identified risk factors for symptomatic candidiasis were recorded, and symptomatic and asymptomatic patients were compared. In all, 36 (53.7%) of the patients with Candida-positive cultures had asymptomatic candidiasis and 31 (46.3%) had symptomatic candidiasis. Candida albicans was the most common Candida sp. in the asymptomatic patients (n = 20, 55.6%), versus Candida parapsilosis in the symptomatic patients (n = 15, 48.4%). The incidence of central venous catheter indwelling, blood transfusion, parenteral nutrition, and surgery was higher in the symptomatic patient group than in the asymptomatic patient group (P candidiasis according to forward stepwise multivariate logistic regression analysis (OR: 6.1; 95% CI: 1.798-20.692). Surgery was the only risk factor significantly associated with symptomatic candidiasis and non-albicans Candida species were more common among the patients with symptomatic candidiasis. While treating symptomatic candidiasis in any PICU an increase in the incidence of non-albicans candidiasis should be considered.

  16. Salivary levels of suspected periodontal pathogens in relation to periodontal status and treatment.

    Science.gov (United States)

    von Troil-Lindén, B; Torkko, H; Alaluusua, S; Jousimies-Somer, H; Asikainen, S

    1995-11-01

    The primary ecological niche for suspected periodontal pathogens seems to be the subgingival area, even though periodontal pathogens are also frequently recovered from saliva. The interrelationship of different periodontal conditions and the salivary levels of suspected periodontal pathogens is not known. In the present study, salivary levels of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Campylobacter rectus, and Peptostreptococcus micros were determined by bacterial culture and related to clinical periodontal status in 40 subjects with either advanced, moderate, or initial/no periodontitis. Culture-positive subjects harbored the 5 bacterial species in mean numbers ranging from 2 x 10(5) to 6 x 10(7) colony-forming units (CFU)/mL saliva. A. actinomycetemcomitans was found in none and P. gingivalis in one of the subjects with initial periodontitis, whereas both species were found in 33% and 44%, respectively, of the subjects with moderate periodontitis and in 60% and 40%, respectively, of the subjects with advanced periodontitis. The mean numbers of CFU/mL of P. intermedia, C. rectus and P. micros were significantly higher in subjects with advanced periodontitis than in subjects with initial/no periodontitis. Ten patients with advanced periodontitis were treated mechanically and with adjunctive systemic metronidazole, and were re-examined 1 and 6 months after treatment. Periodontal treatment eradicated or significantly reduced the levels of salivary periodontal pathogens for half a year, whereas in untreated subjects, the levels and the detection frequencies generally remained fairly stable. In conclusion, the results showed that the salivary levels of periodontal pathogens reflect the periodontal status of the patient.

  17. Impaired neutrophil and monocyte chemotaxis in chronic and aggressive periodontitis and effects of periodontal therapy.

    Science.gov (United States)

    Kumar, R Santhosh; Prakash, Shobha

    2012-01-01

    Depressed chemotactic activity of polymorphoneutrophil (PMN) and monocyte (MN) appears to be one of the significant risk factors in the development of periodontal disease. Although bacteria are the primary etiologic factor in periodontal disease, the patient's host response is a determinant of disease susceptibility. Depressed chemotaxis of PMN and MN could lead to periodontal destruction by altering the host response i.e. impairment of the normal host response in neutralizing infection and alterations that result in destruction of the surrounding periodontal tissues. Thirty patients (10 healthy subjects, 10 chronic periodontitis, and 10 with aggressive periodontitis) participated in this study. Clinical parameters like plaque index, gingival index, probing pocket depth, and radiographic assessment were done. The peripheral blood PMNs and MNs were isolated from the patient and the chemotactic response was studied. Statistical analysis was performed using post-hoc Newman-Keul range test. PMN and MN chemotaxis was found to be statistically significant (Pperiodontal therapy in chronic and aggressive periodontitis group compared to healthy subjects. However on comparison between chronic and aggressive periodontitis group statistical significance was not found (P>0.05).Comparision between chronic periodontitis, aggressive periodontitis with healthy subjects, PMN and MN chemotaxis showed statistical significance (Pperiodontal therapy, Whereas statistically there was no difference when chronic periodontitis was compared with aggressive periodontitis. Depressed chemotaxis of PMN and MN results in increased periodontal destruction. In this study, depressed PMN and MN chemotaxis is seen in both aggressive periodontitis group and chronic periodontitis group and the response was altered although to a lesser degree after periodontal therapy in both groups indicating that effect of treatment does exist.

  18. Community periodontal index of treatment needs index: An indicator of anaerobic periodontal infection

    OpenAIRE

    Muthukumar S; Suresh R

    2009-01-01

    Background : Community periodontal index of treatment needs (CPITN) index is commonly used to measure periodontal disease. It′s uniqueness, apart from assessing the periodontal status, also gives the treatment needs for the underlying condition. Benzoyl-DL-arginine napthylamide (BANA) test is a chair side diagnostic test used to detect the presence of putative periodontal pathogens. We correlated the CPITN scores of patients with BANA test results to assess the validity of CPITN as an ...

  19. Treatment of periodontal intrabony defects using autologous periodontal ligament stem cells: a randomized clinical trial

    OpenAIRE

    Chen, Fa-Ming; Gao, Li-Na; Tian, Bei-Min; Zhang, Xi-Yu; Zhang, Yong-Jie; Dong, Guang-Ying; Lu, Hong; Chu, Qing; Xu, Jie; Yu, Yang; Wu, Rui-Xin; Yin, Yuan; Shi, Songtao; Jin, Yan

    2016-01-01

    Background Periodontitis, which progressively destroys tooth-supporting structures, is one of the most widespread infectious diseases and the leading cause of tooth loss in adults. Evidence from preclinical trials and small-scale pilot clinical studies indicates that stem cells derived from periodontal ligament tissues are a promising therapy for the regeneration of lost/damaged periodontal tissue. This study assessed the safety and feasibility of using autologous periodontal ligament stem ce...

  20. Detection and diagnosis of periodontal conditions amenable to prevention

    OpenAIRE

    Preshaw, Philip M

    2015-01-01

    Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory diseases. Gingivitis affects the majority of people, and advanced periodontitis is estimated to affect 5-15% of adults. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. All patients should undergo periodontal assessment as part of routine oral examination. Periodontal screening using methods such as the Basic Periodontal Examination/Community Periodont...

  1. 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...

  2. Radiological features of a symptomatic splenic hamartoma

    International Nuclear Information System (INIS)

    Thompson, S.E.; Walsh, E.A.; Cramer, B.C.; Pushpanathan, C.C.; Hollett, P.; Ingram, L.; Price, D.

    1996-01-01

    Symptomatic splenic hamartomas are rare in the pediatric age group, with only four previous reports in the literature. Splenic hamartoma has been reported as a solid homogeneous mass without calcification on CT and ultrasound (US), and only one previous report of the findings on MRI has been published. We report a case of a large symptomatic splenic hamartoma in a 14-year-old girl who presented with splenomegaly, pancytopenia and growth retardation. A solid mass with multiple punctate foci resembling calcifications was seen on US. The mass was heterogeneous and better demarcated on enhanced CT. Radiocolloid scintigraphy demonstrated uptake within the lesion, but less than that of normal spleen. The mass was isointense relative to normal splenic tissue on T1-weighted MRI (0.5 T) and of increased intensity with T2 weighting. At splenectomy, a red pulp hamartoma was identified, which contained nodules of hyalinization and necrosis thought to account for the punctate foci seen on US. (orig.). With 4 figs

  3. Palliative radiotherapy for symptomatic osseous metastases

    International Nuclear Information System (INIS)

    Shigematsu, Naoyuki; Ito, Hisao; Toya, Kazuhito; Ko, Weijey; Kutsuki, Shouji; Tsukamoto, Nobuhiro; Kubo, Atsushi; Dokiya, Takushi; Yorozu, Atsunori.

    1995-01-01

    Bone matastases are one of the most common and serious conditions requiring radiotherapy, but there is still a considerable lack of agreement on optimal radiation schedule. We analyzed patients with symptomatic osseous matastases from lung (72 patients) and breast (63 patients) carcinoma treated by palliative radiotherapy between 1983 and 1992. In this series, the incidences of symptomatic bone metastases appearing within 2 years after the first diagnosis of the primary lesion were 96% and 36% for lung and breast carcinomas, respectively. Thirty percent of bone metastases from breast carcinoma were diagnosed more than 5 years after the first diagnosis. Thus careful follow-up must be carried out for a prolonged period. Pain relief was achieved at almost the same rate for bone metastases from lung and breast carcinomas (81% and 85%, respectively), an the rapid onset of pain relief (15 Gy or less) was obtained in about half the patients for both diseases. The rapid onset of pain relief and the lack of association between the onset of pain relief and primary tumor argued against the conventional theory that tumor shrinkage is a component of the initial response. In contrast to the fact that almost all lung carcinoma patients had very poor prognoses, one third of the breast carcinoma patients were alive more than 2 years after palliative radiotherapy. Thust, the late effects of radiation, such as radiation myelopathy, must be always considered especially in breast carcinoma patients even when it is 'just' palliative radiotherapy for bone metastases. (author)

  4. Review of acute symptomatic urolithiasis in Auckland.

    Science.gov (United States)

    Loeff, Stephanie; Saluja, Manmeet; Rice, Michael

    2018-02-02

    To evaluate the incidence of acute symptomatic urolithiasis in the Auckland region. Associated epidemiological factors and stone characteristics were also studied and compared to previous research conducted in order to analyse trends. All patients that presented acutely with symptomatic urolithiasis to the Auckland District Health Board (AHDB) between July 2014 and June 2015 were studied. Clinical data was obtained from medical records and population data was based on estimates provided by the Ministry of Health. Two-tailed tests and the Pearson Chi-Square tests were used for analysis. Overall, 1,125 patients (1,328 events) presented with an incidence of 85 per 100,000 per year, which was lower than that reported in 2006. The highest incidence was found among the Middle Eastern ethnic subgroup (0.130 %), followed by Māori (0.102%), Asian (0.087%), European (0.084%) and Pacific (0.041%) ethnicity. Males were more likely to be affected than females. Urolithiasis was most common in the fifth decade of life (25%). Forty-seven percent of the study population presented with multiple stones and 64% had recurrent urolithiasis or were 'high risk' stone formers. Distal ureteric stones Auckland. This deviation could be attributed to the large influx of Asian immigrants observed in this period of time. A caucasian male, between 40-49 years, with a calculus <5mm in the distal ureter with a history of a previous urolithiasis has the highest chance to present with renal colic.

  5. Radiological features of a symptomatic splenic hamartoma

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, S.E. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Walsh, E.A. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Cramer, B.C. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Pushpanathan, C.C. [Department of Pathology, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Hollett, P. [Department of Nuclear Medicine, Health Sciences Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Ingram, L. [Department of Pediatrics, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Price, D. [Department of Surgery, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada)

    1996-09-01

    Symptomatic splenic hamartomas are rare in the pediatric age group, with only four previous reports in the literature. Splenic hamartoma has been reported as a solid homogeneous mass without calcification on CT and ultrasound (US), and only one previous report of the findings on MRI has been published. We report a case of a large symptomatic splenic hamartoma in a 14-year-old girl who presented with splenomegaly, pancytopenia and growth retardation. A solid mass with multiple punctate foci resembling calcifications was seen on US. The mass was heterogeneous and better demarcated on enhanced CT. Radiocolloid scintigraphy demonstrated uptake within the lesion, but less than that of normal spleen. The mass was isointense relative to normal splenic tissue on T1-weighted MRI (0.5 T) and of increased intensity with T2 weighting. At splenectomy, a red pulp hamartoma was identified, which contained nodules of hyalinization and necrosis thought to account for the punctate foci seen on US. (orig.). With 4 figs.

  6. The Effect of Canal Contamination with Saliva on Apical Sealing

    Directory of Open Access Journals (Sweden)

    S Sabaghi

    2014-08-01

    Methods: In this laboratory study, 58 human uni-root teeth were cleaned and shaped for obturation with gutta percha and sealer AH26. In the case group, specimens were contaminated with human saliva immediately before obturation, whereas the teeth in the control group were kept dry. All canals were filled by lateral condensation technique. Moreover, the teeth were placed in methylene blue dye for 3 days. Dye penetration was measured using a stereomicrosope. As a matter of fact, the study data were analyzed via utilizing t-test. Results: A significant difference was found between the two groups in regard with the apical leakage(P<0.001. The microleakage mean of dye in the dry group was 3/48mm, whereas it was 6/36mm in the saliva contaminated group. Conclusion: The study findings revealed that complete drying of canal can improve apical sealing.

  7. Apical versus Basal Neurogenesis Directs Cortical Interneuron Subclass Fate

    Directory of Open Access Journals (Sweden)

    Timothy J. Petros

    2015-11-01

    Full Text Available Fate determination in the mammalian telencephalon, with its diversity of neuronal subtypes and relevance to neuropsychiatric disease, remains a critical area of study in neuroscience. Most studies investigating this topic focus on the diversity of neural progenitors within spatial and temporal domains along the lateral ventricles. Often overlooked is whether the location of neurogenesis within a fate-restricted domain is associated with, or instructive for, distinct neuronal fates. Here, we use in vivo fate mapping and the manipulation of neurogenic location to demonstrate that apical versus basal neurogenesis influences the fate determination of major subgroups of cortical interneurons derived from the subcortical telencephalon. Somatostatin-expressing interneurons arise mainly from apical divisions along the ventricular surface, whereas parvalbumin-expressing interneurons originate predominantly from basal divisions in the subventricular zone. As manipulations that shift neurogenic location alter interneuron subclass fate, these results add an additional dimension to the spatial-temporal determinants of neuronal fate determination.

  8. Characterization of human apical papilla-derived stem cells.

    Science.gov (United States)

    Cantore, S; Ballini, A; De Vito, D; Martelli, F S; Georgakopoulos, I; Almasri, M; Dibello, V; Altini, V; Farronato, G; Dipalma, G; Farronato, D; Inchingolo, F

    2017-01-01

    Dental tissues represent an alternative and promising source of post-natal Mesenchymal stem cells (MSCs) for tissue engineering. Furthermore, dental stem cells from apical papilla (SCAPs) cells can be obtained from the wisdom tooth which is unnecessary for human masticatory function and frequently extracted for orthodontic reasons or dysodontiasis. More precisely, apical papilla is the immature, mostly uncalcified, precursor of the tooth root, therefore is composed of more undifferentiated cells than dental pulp. In addition, tooth extraction, especially by piezosurgery technique, can be considered less invasive in comparison to bone marrow or other tissues biopsy. Our work is aimed to investigate the safety of and predictable procedure on surgical immature third molar extraction and to provide new insight on SCAP research for future biomedical applications. The isolated cells were examined for stem cell properties by analyzing their colony-forming efficiency, differentiation characteristics and the expression of MSC markers.

  9. Transient apical dyskinesia with a pacemaker: Electrocardiographic features.

    Science.gov (United States)

    Núñez-Gil, Iván J; Feltes, Gisela I; Mejía-Rentería, Hernán D; Biagioni, Corina; De Agustín, J Alberto; Vivas, David; Fernández-Ortiz, Antonio

    2015-04-01

    Transient apical dyskinesia syndromes present features similar to acute coronary syndromes, but with normal coronary arteries and rapid complete resolution of wall motion alterations. We report the case of a 73-year-old woman who was admitted to hospital because of typical chest pain at rest after her brother's death. She had had a pacemaker implanted in 2001. Troponin levels were elevated and apical hypokinesia was shown by ventriculography and echocardiography, with normal coronary arteries. Evolving ECG alterations were observed in spite of the continued pacing rhythm. All these alterations were fully resolved after discharge. This case shows that, even in the presence of a pacemaker, evolving ECG alterations can be observed in Takotsubo syndrome. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  10. Detection of aggressive periodontitis by calprotectin expression

    Directory of Open Access Journals (Sweden)

    Desi Sandra Sari

    2009-12-01

    Full Text Available Background: Calprotectin is a calcium-binding protein expressed by neutrophil, monocytes, gingival keratinocytes, and oral epithelial cells. The concentrations of calprotectin increase in plasma, urine and synovial fluid of patients with inflammatory diseases. This protein is known as a marker for periodontal diseases and is detected in gingival crevicular fluids. Purpose: This study was aimed to investigate the detection of inflammation on the aggressive periodontitis by calprotectin expression. Method: The gingival crevicular fluids were taken from five aggressive periodontitis patients and five healthy subjects by using sterile paper points. Calprotectin expression was analyzed by ELISA technique. Result: The results showed the significant difference in calprotectin expression between subject with aggressive periodontitis and healthy subjects p = 0.002 (p < 0.05. Conclusion: It was concluded that the calprotectin expression on the aggressive periodontitis patients may be useful for evaluation the progression of inflammation in periodontitis.

  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. Periodontal-Derived Mesenchymal Cell Sheets Promote Periodontal Regeneration in Inflammatory Microenvironment.

    Science.gov (United States)

    Guo, Shujuan; Kang, Jian; Ji, Baohui; Guo, Weihua; Ding, Yi; Wu, Yafei; Tian, Weidong

    2017-07-01

    In this study, we investigated the periodontal regenerative potential of dental follicle cell (DFC) sheets and periodontal ligament cell (PDLC) sheets in the simulating inflammatory microenvironment of periodontitis, to confirm their regenerative potential for clinical application and explain the possible mechanism. The biological characteristics of DFC sheets and PDLC sheets were explored in lipopolysaccharide from Porphyromonas gingivalis (P. gingivalis LPS)-induced inflammation microenvironment in vitro, then cell sheets were transplanted into canine periodontal defects with experimental periodontitis in situ for 3 months. The results showed that P. gingivalis LPS greatly impaired the differentiation of PDLC sheets, whereas promoted gene expression of bone sialoprotein (BSP), osteopontin (OPN), and periostin (POSTN) in DFC sheets. LPS activated toll-like receptor 4 and NF-κB p65 phosphorylation in PDLC sheets. In experimental periodontitis, new periodontal attachment could be obtained in both PDLC sheets and DFC sheets. However, the complete periodontal regeneration, including periodontal ligament-cementum complex structure was observed only in DFC sheet groups, which also showed more alveolar bone formation than PDLC sheets. These results suggest that DFC sheets were more effective for periodontal regeneration in chronic inflammatory microenvironment of periodontitis. It is probably because of their ability to adapt the inflammatory environment and strong capacity to promote periodontal regeneration. This approach provides a tangible pathway toward clinical translation.

  13. Periodontics: 3. Non-surgical periodontal therapy in general dental practice.

    Science.gov (United States)

    Mullally, Brian; Irwin, Chris; Ziada, Hassan; Allen, Edith; Byrne, Patrick J

    2007-01-01

    Non-surgical periodontal therapy is an integral part of periodontal treatment and has been defined as plaque removal, plaque control, supra- and subgingival scaling, root surface debridement, and the adjunctive use of chemical agents. Knowledge of the role of non-surgical periodontal therapy is central to good patient care.

  14. 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.

  15. 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.

  16. Impact of osmotic dehydration on the encapsulated apices survival ...

    African Journals Online (AJOL)

    L-1 activated charcoal) prior to encapsulation in alginate (3%) beads with calcium chloride (1.32M). Then, the apices were exposed to osmotic dehydration with two concentrations of sucrose (0.75M and 1.25M) at two durations (24h and 40h) before their culture in M2 medium (MS + 2mg.L-1 BAP, 100?g.L-1 d'ANA and 2g.

  17. Isolation and characterization of multipotent mesenchymal stromal cells from the gingiva and the periodontal ligament of the horse

    Directory of Open Access Journals (Sweden)

    Pfarrer Christiane

    2011-08-01

    Full Text Available Abstract Background The equine periodontium provides tooth support and lifelong tooth eruption on a remarkable scale. These functions require continuous tissue remodeling. It is assumed that multipotent mesenchymal stromal cells (MSC reside in the periodontal ligament (PDL and play a crucial role in regulating physiological periodontal tissue regeneration. The aim of this study was to isolate and characterize equine periodontal MSC. Tissue samples were obtained from four healthy horses. Primary cell populations were har-vested and cultured from the gingiva, from three horizontal levels of the PDL (apical, midtooth and subgingival and for comparison purposes from the subcutis (masseteric region. Colony-forming cells were grown on uncoated culture dishes and typical in vitro characteristics of non-human MSC, i.e. self-renewal capacity, population doubling time, expression of stemness markers and trilineage differentiation were analyzed. Results Colony-forming cell populations from all locations showed expression of the stemness markers CD90 and CD105. In vitro self-renewal capacity was demonstrated by colony-forming unit fibroblast (CFU-F assays. CFU-efficiency was highest in cell populations from the apical and from the mid-tooth PDL. Population doubling time was highest in subcutaneous cells. All investigated cell populations possessed trilineage differentiation potential into osteogenic, adipogenic and chondrogenic lineages. Conclusions Due to the demonstrated in vitro characteristics cells were referred to as equine subcutaneous MSC (eSc-MSC, equine gingival MSC (eG-MSC and equine periodontal MSC (eP-MSC. According to different PDL levels, eP-MSC were further specified as eP-MSC from the apical PDL (eP-MSCap, eP-MSC from the mid-tooth PDL (eP-MSCm and eP-MSC from the subgingival PDL (eP-MSCsg. Considering current concepts of cell-based regenerative therapies in horses, eP-MSC might be promising candidates for future clinical applications in

  18. Regulation of Regenerative Periodontal Healing by NAMPT

    OpenAIRE

    Nokhbehsaim, M.; Keser, S.; Jager, A.; Jepsen, S.; Deschner, J.

    2013-01-01

    Periodontitis is an inflammatory disease characterized by destruction of the tooth-supporting tissues. Obese individuals have an increased risk of periodontitis, and elevated circulating levels of nicotinamide phosphoribosyltransferase (NAMPT) may be a pathomechanistic link between both diseases. Recently, increased levels of NAMPT have also been found in patients with periodontitis, irrespective of the presence of obesity. This in vitro study sought to examine the effects of NAMPT on the reg...

  19. Lessons learned and unlearned in periodontal microbiology

    OpenAIRE

    Teles, Ricardo; Teles, Flavia; Frias-Lopez, Jorge; Paster, Bruce; Haffajee, Anne

    2013-01-01

    Periodontal diseases are initiated by bacterial species living in polymicrobial biofilms at or below the gingival margin and progress largely as a result of the inflammation initiated by specific subgingival species. In the past few decades, efforts to understand the microbiota of periodontal diseases have led to an exponential increase in information about biofilms associated with periodontal health and disease. In fact, the oral microbiota is one of the best characterized microbiomes that c...

  20. Periodontal conditions of elders in Northeastern Brazil

    OpenAIRE

    Maria Vieira de Lima Saintrain; Maria Daucirlene Costa Aquino

    2015-01-01

    Objective: To evaluate the periodontal conditions of elderly patients assisted in a Specialized Dentistry Center in Northeastern of Brazil. Methods: Quantitative and cross-sectional study conducted with 152 elders. It was used a questionnaire to get information about socio-demographic aspects (age, sex, gender, income, and education), general healthand periodontal clinical examination based on the Communitarian Periodontal Index (CPI), an indicator recommended by the World Health Organization...

  1. Emdogain--periodontal regeneration based on biomimicry.

    Science.gov (United States)

    Gestrelius, S; Lyngstadaas, S P; Hammarström, L

    2000-06-01

    Biomimicry has been introduced as a term for innovations inspired by nature [1]. Such innovations may appear in almost every part of modern society. This review on the effects of enamel matrix proteins on the formation of cementum and the development of emdogain for regeneration of periodontal tissues lost due to periodontitis shows an example of biomimicry in dentistry. Findings from clinical and laboratory investigations are summarized and the biological basis for enamel matrix-induced periodontal regeneration is discussed.

  2. 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

  3. Protein Biomarkers of Periodontitis in Saliva

    OpenAIRE

    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 dis...

  4. Association between Postmenopausal Osteoporosis and Experimental Periodontitis

    OpenAIRE

    Luo, Kai; Ma, Souzhi; Guo, Jianbin; Huang, Yongling; Yan, Fuhua; Xiao, Yin

    2014-01-01

    To investigate the correlation between postmenopausal osteoporosis (PMO) and the pathogenesis of periodontitis, ovariectomized rats were generated and the experimental periodontitis was induced using a silk ligature. The inflammatory factors and bone metabolic markers were measured in the serum and periodontal tissues of ovariectomized rats using an automatic chemistry analyzer, enzyme-linked immunosorbent assays, and immunohistochemistry. The bone mineral density of whole body, pelvis, and s...

  5. Aggregatibacter actinomycetemcomitans: Important pathogen in periodontitis

    OpenAIRE

    Ramos Perfecto, Donald; Profesor Auxiliar, Dpto de C. Básicas. Laboratorio de Microbiología UNMSM.; Moromi Nakata, Hilda; Profesor Principal Dpto. de C. Básicas. Laboratorio de Microbiología UNMSM.; Martínez Cadillo, Elba; Profesor Asociado Dpto. de C. Básicas. Laboratorio de Microbiología UNMSM.; Mendoza Rojas, Alejandro; Profesor Principal Dpto. de C. Básicas. Laboratorio de Microbiología UNMSM.

    2014-01-01

    Aggregatibacter actinomycetemcomitans is a pathogen extensively studied in the clinical conditions of the Periodontitis, already identified in the early twentieth century. Over the years it has undergone changes in its denomination and multiple virulence factors that make it an important pathogen in the periodontal disease have been discovered, specifically in the localized Aggressive Periodontitis. This review tries to explain its morphology, virulence factors, culture and other important ch...

  6. Prevalence and characteristics of aggressive periodontitis

    OpenAIRE

    Diatri Nariratih; Janti Rusjanti; Agus Susanto

    2011-01-01

    Aggressive Periodontitis is one of periodontal disease that generally affects individuals less than 30 years old, with a rapid attachment loss and alveolar bone destruction. Special features of the disease are affected incisors and first molars with symmetrical bilateral destruction. The purpose of this study was to determine the prevalence and characteristics of Aggressive Periodontitis at Student Clinics, Faculty of Dentistry Padjadjaran University on May to July 2010. Based on accidentally...

  7. The clinical assessment of aggressive periodontitis patients

    OpenAIRE

    Cho, Chan-Myung; You, Hyung-Keun; Jeong, Seong-Nyum

    2011-01-01

    Purpose Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. Methods The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from ...

  8. Association of Treponema spp. with canine periodontitis.

    Science.gov (United States)

    Nordhoff, Marcel; Rühe, Bärbel; Kellermeier, Claudia; Moter, Annette; Schmitz, Rose; Brunnberg, Leo; Wieler, Lothar H

    2008-03-18

    To evaluate the association of oral Treponema (T.) spp. with severity of canine periodontitis, subgingival plaque samples of dogs of various breeds undergoing surgery were investigated. A wide range of oral Treponema spp. was analysed by a molecular and culture-independent approach applying DNA-DNA dot blot hybridization analysis and fluorescence in situ hybridization using Treponema specific oligonucleotide probes specific for phylogenetic groups I-VII of oral treponemes as well as probes specific for T. socranskii and T. denticola. To assess the periodontal status of affected dogs clinical parameters were measured and the periodontal status was classified from grade 0 (physiological periodont) to 3 (severe periodontitis). The periodontal status correlated significantly with an increasing concentration of volatile sulfur compounds (VSC, r=0.854) determined with a Halimeter, indicating a positive correlation between the presence of VSC-producing bacteria and periodontitis. In this study Treponema spp. of phylogenetic groups III, V-VII were not detected in any sample, whereas T. denticola-like treponemes were found only in 2 of 51 animals. However, treponemes belonging to phylogenetic groups I, II and IV of oral treponemes or T. socranskii were found in up to 64.84% of the dogs. The detection rate of Treponema spp. was significantly associated with an increased periodontal status. Treponemes present in periodontal lesions were also visualized by fluorescence in situ hybridization of gingival biopsies showing Treponema spp. not only in the microbial biofilm but also within the gingival tissue. The data presented here indicate that oral Treponema spp. are associated with canine periodontitis. Similar to human periodontitis, treponemes of groups I, II and IV and T. socranskii were found more frequently the higher the degree of periodontitis was.

  9. The Effect of Canal Contamination with Saliva on Apical Sealing

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    S Sabaghi

    2014-08-01

    Full Text Available Introduction: Root canal obturation aims at sealing the root canal system to prevent re-contamination of canal and periapical space. Presence of moisture in canal before obturation may posit a negative effect on the quality of canal sealing. Therefore, this study was conducted to investigate the effect of canal contamination with saliva on apical microleakage. Methods: In this laboratory study, 58 human uni-root teeth were cleaned and shaped for obturation with gutta percha and sealer AH26. In the case group, specimens were contaminated with human saliva immediately before obturation, whereas the teeth in the control group were kept dry. All canals were filled by lateral condensation technique. Moreover, the teeth were placed in methylene blue dye for 3 days. Dye penetration was measured using a stereomicrosope. As a matter of fact, the study data were analyzed via utilizing t-test. Results: A significant difference was found between the two groups in regard with the apical leakage(P<0.001. The microleakage mean of dye in the dry group was 3/48mm, whereas it was 6/36mm in the saliva contaminated group. Conclusion: The study findings revealed that complete drying of canal can improve apical sealing.

  10. Evaluating the clinical and esthetic outcome of apically positioned flap technique in augmentation of keratinized gingiva around dental implants

    Directory of Open Access Journals (Sweden)

    Vineela Katam Reddy

    2013-01-01

    Full Text Available Purpose: Dental implants though a successful treatment modality there exists controversies regarding the relationship between the adequacy of the keratinized gingiva (KG and peri-implant health. The presence of an adequate amount of peri-implant KG reduces gingival inflammation and hence soft-tissue augmentation should be frequently considered. Among the various periodontal plastic surgical procedures, the apically displaced flap increases the width of keratinized tissue with reduced patient morbidity. The current study aims at evaluating the esthetic improvement in KG around dental implants applying apically positioned flap (APF technique. Materials and Methods: A total of 10 endosseous dental implants were placed in eight systemically healthy patients. APF surgery was performed at the implant site on the buccal aspect either at the time of implant placement (one stage surgical protocol or during the implant recovery stage (two stage surgical protocols for increasing the width of KG and reviewed until 12 weeks post-operatively. The width of KG was evaluated at baseline and at the end of 12 weeks after surgery. Paired t-test was performed to evaluate the changes in the width of KG at baseline and at 12 weeks post-operatively. In addition, soft-tissue esthetic outcome was assessed by using visual analog scale (VAS. Results: The mean width of KG at baseline was 1.47 mm and 12 weeks post-operatively was 5.42 mm. The gain in KG from baseline was 3.95 mm with the P value of 0.000, which was highly statistically significant. The assessment of esthetic outcome using VAS gave an average score of 7.1 indicating good esthetics. Conclusion: The technique of APF yielded a significant improvement in keratinized tissue, which is both functionally and esthetically acceptable.

  11. Evaluating the clinical and esthetic outcome of apically positioned flap technique in augmentation of keratinized gingiva around dental implants.

    Science.gov (United States)

    Reddy, Vineela Katam; Parthasarathy, Harinath; Lochana, Priya

    2013-07-01

    Dental implants though a successful treatment modality there exists controversies regarding the relationship between the adequacy of the keratinized gingiva (KG) and peri-implant health. The presence of an adequate amount of peri-implant KG reduces gingival inflammation and hence soft-tissue augmentation should be frequently considered. Among the various periodontal plastic surgical procedures, the apically displaced flap increases the width of keratinized tissue with reduced patient morbidity. The current study aims at evaluating the esthetic improvement in KG around dental implants applying apically positioned flap (APF) technique. A total of 10 endosseous dental implants were placed in eight systemically healthy patients. APF surgery was performed at the implant site on the buccal aspect either at the time of implant placement (one stage surgical protocol) or during the implant recovery stage (two stage surgical protocols) for increasing the width of KG and reviewed until 12 weeks post-operatively. The width of KG was evaluated at baseline and at the end of 12 weeks after surgery. Paired t-test was performed to evaluate the changes in the width of KG at baseline and at 12 weeks post-operatively. In addition, soft-tissue esthetic outcome was assessed by using visual analog scale (VAS). The mean width of KG at baseline was 1.47 mm and 12 weeks post-operatively was 5.42 mm. The gain in KG from baseline was 3.95 mm with the P value of 0.000, which was highly statistically significant. The assessment of esthetic outcome using VAS gave an average score of 7.1 indicating good esthetics. The technique of APF yielded a significant improvement in keratinized tissue, which is both functionally and esthetically acceptable.

  12. Psychosocial distress and periodontitis in adolescents

    DEFF Research Database (Denmark)

    Lopez, Rodrigo; Ramírez, Valeria; Marró, Patricio

    2012-01-01

    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...

  13. Link between rheumatoid arthritis and chronic periodontitis

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    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?

  14. Determinantes del diagnóstico periodontal

    OpenAIRE

    Botero,JE; Bedoya,E

    2010-01-01

    Un correcto diagnóstico periodontal es necesario para la realización de una terapia periodontal exitosa en nuestro paciente. Entendiendo que la enfermedad periodontal es un proceso infeccioso-inflamatorio, diferentes variables se deben analizar clínicamente para determinar el diagnóstico. El diagnóstico entonces es un análisis concienzudo de la expresión clínica de la enfermedad, desde gingivitis hasta periodontitis. Este artículo analiza los determinantes más importantes del diagnóstico peri...

  15. Periodontal risk assessment, diagnosis and treatment planning.

    Science.gov (United States)

    Pihlstrom, B L

    2001-01-01

    The prevention and treatment of the periodontal diseases is based on accurate diagnosis, reduction or elimination of causative agents, risk management and correction of the harmful effects of disease. Prominent and confirmed risk factors or risk predictors for periodontitis in adults include smoking, diabetes, race, P. gingivalis, P. intermedia, low education, infrequent dental attendance and genetic influences. Several other specific periodontal bacteria, herpesviruses, increased age, male, sex, depression, race, traumatic occlusion and female osteoporosis in the presence of heavy dental calculus have been shown to be associated with loss of periodontal support and can be considered to be risk indicators of periodontitis. The presence of furcation involvement, tooth mobility, and a parafunctional habit without the use of a biteguard are associated with a poorer periodontal prognosis following periodontal therapy. An accurate diagnosis can only be made by a thorough evaluation of data that have been systematically collected by: 1) patient interview, 2) medical consultation as indicated, 3) clinical periodontal examination, 4) radiographic examination, and 5) laboratory tests as needed. Clinical signs of periodontal disease such as pocket depth, loss of clinical attachment and bone loss are cumulative measures of past disease. They do not provide the dentist with a current assessment of disease activity. In an attempt to improve the ability to predict future disease progression, several types of diagnostic tests have been studied, including host inflammatory products and mediators, enzymes, tissue breakdown products and subgingival temperature. In general, the usefulness of these tests for predicting future disease activity remains to be established in terms of sensitivity, specificity and predictive value. Although microbiological analysis of subgingival plaque is not necessary to diagnose and treat most patients with periodontitis, it is helpful when treating

  16. Restorative options for the periodontal patient.

    Science.gov (United States)

    Andreana, Sebastiano

    2010-01-01

    Periodontal and restorative dentistry are mutually important facets of clinical dentistry. Today's clinicians have many treatment options at their disposal, including biotolerant restorative materials and implants, to maintain periodontal health. It is crucial for the clinician to understand the biologic principles that form the foundation for restorative reconstruction of the periodontally involved tooth. This article discusses new techniques and trends in the critical management of the restorations, particularly at the gingival margins, and explores the role of implant dentistry as an option for the restorative plan of the periodontal patient.

  17. [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 (Pperiodontitis 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 Paggressive 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.

  18. Experimental periodontal disease. Immediate hypersensitivity.

    Science.gov (United States)

    Asaro, J P; Nisengard, R; Beutner, E H; Neiders, M

    1983-01-01

    Immediate hypersensitivity reactions were induced in the periodontium and skin of monkeys sensitized with novo alcalase. Animals were challenged in the gingival papillae with 0.1, 1.0, and 10 micrograms of antigen for 1, 3, 5, or 7 consecutive days prior to sacrifice. At the same time, skin sites were challenged with 1 microgram of antigen. With repetitive immediate hypersensitivity reactions, the inflammatory infiltrate changed from one characterized by polymorphonuclear leukocytes to one characterized by plasma cells and lymphocytes. The repetitive gingival exposure to bacterial antigens which occur in periodontal disease could lead to repetitive immediate hypersensitivity reactions. Such reactions could play a role in the histopathology of human periodontal disease.

  19. Nonsurgical endodontic treatment of teeth associated with large periapical lesion using triple antibiotic paste and mineral trioxide aggregate apical plug: A case series

    Science.gov (United States)

    Kunhappan, Sanjeev; Kunhappan, Neerja; Saraf, K. K.; Kridutt, Vaibhav

    2017-01-01

    Periapical diseases are induced as a result of the direct or indirect involvement of oral bacteria. The etiologic factor being the degenerating pulp tissue. A periapical lesion is formed within an area of apical periodontitis which cannot form by itself and is inflammatory in origin. If the microbial etiology of periapical lesions and in the root canal is removed by nonsurgical root canal therapy the lesions regress. Mere surgical removal of the periapical lesions without proper root canal disinfection and obturation will not result in the healing of periapical tissues. Nonsurgical treatment with triple antibiotic paste offers a high success rate in the healing of large periapical lesions. The present clinical cases show the nonsurgical endodontic management of large periapical pathosis using triple antibiotic paste and mineral trioxide aggregate. PMID:28855765

  20. Periodontal Disease and Pregnancy Outcomes

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    Dolapo A. Babalola

    2010-01-01

    Full Text Available An increasing number of studies are confirming an association between periodontal disease (PD and adverse outcomes in pregnancy. PD places pregnant women at greater risk for preterm birth than alcohol consumption or smoking. This underscores the importance of offering dental screening to women who are pregnant or contemplating pregnancy and the need for physicians who provide obstetric care to be aware of the possible connection between poor dental health and poor pregnancy outcomes.

  1. Periodontal disease and perinatal outcomes.

    Science.gov (United States)

    Matevosyan, Naira Roland

    2011-04-01

    To elucidate plausible associations between periodontal disease (PD) and pregnancy events through meta-analysis of original research published between 1998 and 2010. One hundred and twenty-five randomized, case-control, matched-cohort studies on pregnancy and postpartum specifics in women with PD are identified through PubMed, LILACS, and Cochrane Register. Meta-study is performed on a sample of 992 births allocated from studies of level I-II-1 evidence. An oral inflammation score (OIS) is composed from parameteric and observational components of maternal PD. Pearson arrival process is modeled for exchangeable correlations. Women with preeclampsia and preterm birth have poor periodontal parameters in both, treatment and placebo groups (OR 1.94-2.9). In puerperae with severe periodontitis birth weight is negatively correlated with maternal probing depth (r = -0.368), and C-reactive protein (r = -0.416). Higher rates of tobacco use (RR 3.02), bacterial vaginosis (RR 2.7), clinical attachment level (OR 2.76), and fetal tyrosine kinase (OR 1.6) contribute in increased rates of preeclamsia (RR 1.68), and prematurity (RR 2.75). After adding confounders into the model OIS remains significantly associated with preterm birth (OR 2.3). Maternal PD has strong associations with preeclampsia and prematurity.

  2. [Laparoscopic cleavage in splenic symptomatic cyst].

    Science.gov (United States)

    Fernández-López, Antonio-José; Candel-Arenas, Marifé; González-Valverde, Francisco-Miguel; Luján-Martínez, Delia; Medina-Manuel, Esther; Albarracín Marín-Blázquez, Antonio

    2017-12-01

    Splenic cysts are rare diseases that are diagnosed incidentally during imaging studies. When cysts are recognized, surgical treatment is recommended adapted to the particular case, depending on the size and location of the cyst and the age of the patient in order to avoid dangerous complications such as spleen rupture or cyst infection with abscess. We report 2patients with symptomatic splenic epidermoid cyst treated by laparoscopic cleavage. Laparoscopic cleavage is a surgical option for splenic cyst, with the goal of reducing postoperative complications while preserving splenic function. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  3. 25-Hydroxyvitamin D and symptomatic ischemic stroke

    DEFF Research Database (Denmark)

    Brøndum-Jacobsen, Peter; Nordestgaard, Børge G; Schnohr, Peter

    2013-01-01

    OBJECTIVE: We tested the hypothesis that low plasma concentrations of 25-hydroxyvitamin D are associated with increased risk of symptomatic ischemic stroke in the general population. METHODS: We measured plasma 25-hydroxyvitamin D in 10,170 individuals from the general population, the Copenhagen...... City Heart Study. During 21 years of follow-up, 1,256 and 164 persons developed ischemic and hemorrhagic stroke, respectively. In a meta-analysis of ischemic stroke, we included 10 studies, 58,384 participants, and 2,644 events. RESULTS: Stepwise decreasing plasma 25-hydroxyvitamin D concentrations...... were associated with stepwise increasing risk of ischemic stroke both as a function of seasonally adjusted percentile categories and as a function of clinical categories of 25-hydroxyvitamin D (p for trend ≤ 2 × 10(-3) ). In a Cox regression model comparing individuals with plasma 25-hydroxyvitamin D...

  4. Periodontal and endodontic pathology delays extraction socket healing in a canine model

    Science.gov (United States)

    2017-01-01

    Purpose The aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology. Methods The mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls. The mandibular 4th premolar teeth were then extracted with minimal trauma, followed by careful wound debridement. The animals were sacrificed at days 1, 7, 30, 60, and 90 post-extraction for analysis, and the healing patterns at the healthy and diseased extraction sites were compared using radiography, scanning electron microscopy, histology, and histometry. Results During the first 7 days of healing, a significant presence of inflammatory granulation tissue was noted at the diseased sites (day 1), along with a slightly accelerated rate of fibrin clot resolution on day 7. On day 30, the diseased extraction sites showed a greater percentage of persistent fibrous connective tissue, and an absence of bone marrow formation. In contrast, healthy sites showed initial signs of bone marrow formation on day 30, and subsequently a significantly greater proportion of mature bone marrow formation on both days 60 and 90. Radiographs exhibited sclerotic changes adjoining apical endodontic lesions, with scanning electron microscopy showing collapsed Volkmann canals protruding from these regions in the diseased sites. Furthermore, periodontal ligament fibers exhibited a parallel orientation to the alveolar walls of the diseased sites, in contrast to a perpendicular arrangement in the healthy sites. Conclusions Within the limitations of this study, it appears that a history of periodontal and endodontic pathology may critically affect bone formation and maturation, leading to delayed and compromised extraction socket

  5. Comparison between inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements

    Directory of Open Access Journals (Sweden)

    Gulnara Scaf

    2007-12-01

    Full Text Available The advances in digital imaging technology in dentistry have provided an alternative to film-based radiography and have given new options to detect periodontal bone loss. The purpose of this study was to compare inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements. Thirty-five film-based periapical radiographs of patients suffering from moderate to advanced untreated periodontal bone loss associated to lower premolar and molars was selected from the department files, with 40 bone loss areas. The film-based radiographs were digitized with a flatbed scanner with a transparency and radiograph adapter used for transilluminating the radiograph imaging. Digitization was performed at 600 dpi and in gray scale. The images were digitized using Image Tool software by applying image inversion, that is, transformation of radiopaque structures into radiolucent structures and vice-versa. The digital data were saved as JPEG files. The images were displayed on a 15-inch and 24-bit video monitor under reduced room lighting. One calibrated examiner performed all radiographic measurements, three times, from the cementoenamel junction to the most apical extension of the bone loss, in both types of image (inverted and unprocessed. Brightness and contrast were adjusted according to the examiner's individual demand. Intraclass correlation coefficient was used to compare the measurements from both types of images. The means of radiographic measurements, in mm, for inverted and unprocessed digitized imaging were 6.4485 and 6.3790, respectively. The intraclass correlation coefficient was significant (0.99 The inverted and unprocessed digitized radiographic images were reliable and there was no difference in the diagnostic accuracy between these images regarding periodontal bone loss measurements.

  6. Diabetes y su impacto en el territorio periodontal Diabetes and its impact in periodontal tissues

    Directory of Open Access Journals (Sweden)

    P Smith

    2012-08-01

    Full Text Available Diabetes y enfermedad periodontal corresponden probablemente al mejor ejemplo de cómo una enfermedad sistémica puede tener un efecto en el territorio periodontal. Si bien esta asociación ha sido extensamente estudiada, muchas de las asociaciones propuestas presentan contradicciones. En la presente revisión de la literatura se analizan los siguientes tópicos relevantes para la práctica clínica en periodoncia e implantología: i Identificación de enfermedad periodontal severa y su capacidad para diagnosticar casos de diabetes; ii Efectos de la diabetes sobre la enfermedad periodontal; iii Efectos de la diabetes sobre la reparación periodontal y periimplantaria; iv Efecto del tratamiento periodontal sobre el control metabólico de la diabetes.Diabetes and periodontal disease correspond to conditions that probably exemplify how a systemic disease may have a strong impact in the periodontium. Although this association has been studied for several years, many of these studies still show contradictory results. The present review analyses the following questions relevant for the clinician in the fields of periodontology: i Value of the diagnosis of severe periodontitis and its capacity to identify previously un-diagnosed cases of diabetes; ii Effects of diabetes on periodontal disease; iii Effects of diabetes on periodontal and peri-implant tissue repair and regeneration and; iv Effect of periodontal therapy on the metabolic control of diabetes.

  7. Impact of Periodontal Intervention on Local inflammation, Periodontitis and HIV Outcomes

    Science.gov (United States)

    Valentine, J.; Sanders, A E; Saladyanant, T; Ramsey, K; Blake, J; Morelli, T; Southerland, J; Quinlivan, E B; Nelson, J; DeParis, K; Webster-Cyriaque, J

    2016-01-01

    Objective Periodontal disease resolution was hypothesized to impact systemic HIV measures. Methods In this longitudinal cohort study, 73 HIV-positive subjects received comprehensive dental care. AAP, CDC/AAP and biofilm gingival interface case definitions determined periodontal classification. In a subset, IL-6 was measured. Multivariable binary logistic regression models estimated odds of periodontitis development for comparisons between HIV and NHANES (2009–12) groups. Results In both groups, moderate/severe periodontitis was positively associated with non-white race, smoking, male gender, low income and increased pro-inflammatory cytokines. Likelihood of HIV periodontitis was higher across demographic variables. Subjects with severe periodontitis on antiretroviral therapy demonstrated high plasma viral loads at baseline (median= 464 co/ml; mean 65,773 co/ml). Post intervention, HIV periodontitis distribution became similar to NHANES and IL-6 levels decreased 2-fold (p=0.07). Subjects with suppressed viral load at baseline demonstrated increased CD4 counts at 12 months post intervention (P=0.027) (n=26). Conclusions Smoking, being non-white and low income were associated with periodontitis in HIV and NHANES. Higher Il-6, higher HIV VL and lower CD4 were associated with moderate/severe periodontal disease. Periodontitis decreased significantly with treatment producing periodontal profiles mirroring the national norm. In a subset of suppressed subjects, decreased oral inflammation, and associated microbial translocation, yielded improved CD4 counts. PMID:27109277

  8. The Use of Different Irrigation Techniques to Decrease Bacterial Loads in Healthy and Diabetic Patients with Asymptomatic Apical Periodontitis

    Directory of Open Access Journals (Sweden)

    Mai Ghoneim

    2016-12-01

    CONCLUSION: The EndoVac can be considered as a promising tool in combination with irrigant solution to defeat the bacterial colonies living in the root canal system. Additional studies ought to be done to improve the means of bacterial clearance mainly in immune-compromised individuals.

  9. Cementum, apical morphology and hypercementosis: a probable adaptive response of the periodontal support tissues and potential orthodontic implications

    Directory of Open Access Journals (Sweden)

    Alberto Consolaro

    2012-02-01

    Full Text Available Information about orthodontic movement of teeth with hypercementosis is scarce. As cementum deposition continues to occur, cementum is expected to change the shape of the root and apex over time, but this has not yet been demonstrated. Nor has it ever been established whether it increases or decreases the prevalence of root resorption during orthodontic treatment. The unique biological function of the interconnected network of cementocytes may play a role in orthodontic movement and its associated root resorptions, but no research has ever been conducted on the topic. Unlike cementum thickness and hypercementosis, root and apex shape has not yet been related to patient age. A study of the precise difference between increased cementum thickness and hypercementosis is warranted. Hypercementosis refers to excessive cementum formation above and beyond the extent necessary to fulfill its normal functions, resulting in abnormal thickening with macroscopic changes in the tooth root, which may require the delivery of forces that are different from conventional mechanics in their intensity, direction and distribution. What are the unique features and specificities involved in moving teeth that present with hypercementosis? Bodily movements would be expected to occur, since inclination might prove difficult to achieve, but would the root resorption index be higher or lower?

  10. Ultrastructural examination of failed molar retreatment with secondary apical periodontitis: an examination of endodontic biofilms in an endodontic retreatment failure.

    Science.gov (United States)

    Carr, Gary B; Schwartz, Richard S; Schaudinn, Christoph; Gorur, Amita; Costerton, J William

    2009-09-01

    A light and electron microscope examination of the resected root tip of a failing endodontically re-treated lower molar was examined. The tooth had been initially treated 10 years ago and then re-treated 2 years ago. The resected root tip was sectioned axially, and thin sections were examined through the entire length of the specimen. Thin sections were examined with a transmission electron microscope. The thin sections were randomly chosen along the isthmus areas between the mesiobuccal and mesiolingual canals. Our findings suggest that a complex, variable, multispecies biofilm was present the entire length of the specimen.

  11. Management of Apical Periodontitis : Healing of Post-treatment Periapical Lesions Present 1 Year after Endodontic Treatment

    NARCIS (Netherlands)

    Zhang, Ming-Ming; Liang, Yu-Hong; Gao, Xue-Jun; Jiang, Lan; van der Sluis, Luc; Wu, Min-Kai

    Introduction: Post-treatment periapical lesions present 1 year after treatment may heal during the second year or later. The aim of this study was to assess second-year volumetric changes in post-treatment periapical radiolucencies detected 1 year after treatment. Methods: Post-treatment periapical

  12. Periodontal herpesviruses: prevalence, pathogenicity, systemic risk.

    Science.gov (United States)

    Slots, Jørgen

    2015-10-01

    Periodontitis is an infectious/inflammatory disease characterized by the loss of periodontal ligament and alveolar bone. Herpesviruses are frequent inhabitants of periodontitis lesions, and the periodontopathogenicity of these viruses is the topic of this review. In 26 recent studies from 15 countries, subgingival cytomegalovirus, Epstein-Barr virus and herpes simplex virus type 1, respectively, yielded median prevalences of 49%, 45% and 63% in aggressive periodontitis, 40%, 32% and 45% in chronic periodontitis, and 3%, 7% and 12% in healthy periodontium. An active herpesvirus infection of the periodontium exhibits site specificity, is a potent stimulant of cellular immunity, may cause upgrowth of periodontopathic bacteria and tends to be related to disease-active periodontitis. Pro-inflammatory cytokines induced by the herpesvirus infection may activate matrix metalloproteinases and osteoclasts, leading to breakdown of the tooth-supportive tissues. The notion that a co-infection of herpesviruses and specific bacteria causes periodontitis provides a plausible etiopathogenic explanation for the disease. Moreover, herpesvirus virions from periodontal sites may dislodge into saliva or enter the systemic circulation and cause diseases beyond the periodontium. Periodontal treatment can diminish significantly the periodontal load of herpesviruses, which may lower the incidence and magnitude of herpesvirus dissemination within and between individuals, and subsequently the risk of acquiring a variety of medical diseases. Novel and more effective approaches to the prevention and treatment of periodontitis and related diseases may depend on a better understanding of the herpesvirus-bacteria-immune response axis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Oxidative Stress and Periodontal Disease in Obesity.

    Science.gov (United States)

    Dursun, Erhan; Akalin, Ferda Alev; Genc, Tolga; Cinar, Nese; Erel, Ozcan; Yildiz, Bulent Okan

    2016-03-01

    Periodontal disease is a chronic inflammatory disease of the jaws and is more prevalent in obesity. Local and systemic oxidative stress may be an early link between periodontal disease and obesity. The primary aim of this study was to detect whether increased periodontal disease susceptibility in obese individuals is associated with local and systemic oxidative stress. Accordingly; we analyzed periodontal status and systemic (serum) and local (gingival crevicular fluid [GCF]) oxidative status markers in young obese women in comparison with age-matched lean women.Twenty obese and 20 lean women participated. Periodontal condition was determined by clinical periodontal indices including probing depth, clinical attachment level, gingival index, gingival bleeding index, and plaque index. Anthropometric, hormonal, and metabolic measurements were also performed. Blood and GCF sampling was performed at the same time after an overnight fasting. Serum and GCF total antioxidant capacity (TAOC), and total oxidant status (TOS) levels were determined, and oxidative stress index (OSI) was calculated.Clinical periodontal analyses showed higher gingival index and gingival bleeding index in the obese group (P = 0.001 for both) with no significant difference in probing depth, clinical attachment level, and plaque index between the obese and the lean women. Oxidant status analyses revealed lower GCF and serum TAOC, and higher GCF and serum OSI values in the obese women (P periodontal indices showed significant correlations with body mass index, insulin, and lipid levels, and also oxidant status markers.Our results suggest that young obese, otherwise healthy, women show findings of early periodontal disease (gingival inflammation) compared with age-matched healthy lean women, and that local/periodontal oxidative stress generated by obesity seems to be associated with periodontal disease.

  14. 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.

  15. Periodontal inflamed surface area as a novel numerical variable describing periodontal conditions.

    Science.gov (United States)

    Park, Shin-Young; Ahn, Soyeon; Lee, Jung-Tae; Yun, Pil-Young; Lee, Yun Jong; Lee, Joo Youn; Song, Yeong Wook; Chang, Yoon-Seok; Lee, Hyo-Jung

    2017-10-01

    A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes. This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study. PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; P variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation.

  16. Arthroscopic one-piece reshaping for symptomatic discoid medial meniscus with anomalous amalgamating into anterior cruciate ligament

    Science.gov (United States)

    Choi, Hyung Suk

    2015-01-01

    Discoid shapes of lateral menisci are relatively common finding, whereas discoid medial menisci are less common. Discoid medial meniscus with associated anomalous variants has been reported. However, symptomatic complex tear of complete type discoid medial meniscus with anomalous blending with anterior cruciate ligament is an extremely rare pathology. A 35-year-old male was admitted to our hospital with left knee pain and loss of terminal extension for 2 years. On physical examination, the patient presented with clicking and restriction during the extension motion of the knee joint. Magnetic resonance imaging and arthroscopy indicated complex tear of complete discoid medial meniscus in association with anomalous connection between entire apical portion of discoid medial meniscus and tibial insertion portion of the anterior cruciate ligament. We obtained a successful outcome with arthroscopic resection and shaping in one-piece method using no. 11 scalpel blade. PMID:26015618

  17. Quorum Sensing Inhibition, Relevance to Periodontics

    OpenAIRE

    Yada, Sudheer; Kamalesh, B; Sonwane, Siddharth; Guptha, Indra; Swetha, R K

    2015-01-01

    Quorum sensing helps bacteria to communicate with each other and in coordinating their behavior. Many diseases of human beings, plants, and animals are mediated by quorum sensing. Various approaches are being tried to inhibit this communication to control the diseases caused by bacteria. Periodontal pathogens also communicate through quorum sensing and new approaches to treat periodontal disease using quorum sensing inhibition need to explored.

  18. Smoking affects the subgingival microflora in periodontitis

    NARCIS (Netherlands)

    van Winkelhoff, AJ; Bosch-Tijhof, CJ; Winkel, EG; van der Reijden, WA

    Background: Tobacco smoking has been identified as one major risk factor for destructive periodontal disease. Scaling and root planing have been shown to be less effective in smokers with periodontitis. The aim of the present study was to compare the subgingival microbial flora of treated and

  19. 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

  20. [Diabetes and periodontitis: A bidirectional relationship].

    Science.gov (United States)

    Bascones-Martínez, Antonio; Muñoz-Corcuera, Marta; Bascones-Ilundain, Jaime

    2015-07-06

    Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, a defect in insulin action or a combination of both. Periodontitis is now considered a chronic localized infection of the oral cavity that can trigger inflammatory host immune responses at local and systemic levels, and can also be a source of bacteremia. It is now known that periodontitis has an influence on the pathogenesis of certain systemic diseases. The biological relationship between diabetes and periodontal disease is well documented. In the mid-90s sufficient scientific support for the association between diabetes and periodontitis was published, and periodontitis was designated as the sixth complication of diabetes. There have been studies that show an improvement in both clinical and immunological parameters of periodontitis and glycemic control in long-term diabetes after treatment of periodontal disease. In addition, scientific evidence confirms that poorer glycemic control contributes to a worse periodontal condition. The interplay between the 2 conditions highlights the importance of the need for a good communication between the internist and dentist about diabetic patients, considering always the possibility that the 2 diseases may be occurring simultaneously in order to ensure an early diagnosis of both. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. Comparative periodontal status of human immunodeficiency virus ...

    African Journals Online (AJOL)

    Background: There are diverse reports on the prevalence and severity of chronic periodontitis in human immunodeficiency virus (HIV) positive persons. Few studies have been carried out in developing countries in Sub.Saharan Africa. This study was aimed at comparing the prevalence and severity of chronic periodontitis of ...

  2. Periodontal Disease Awareness and Knowledge among Nigerian ...

    African Journals Online (AJOL)

    Subjects and Methods: This cross‑sectional study was conducted among primary school teachers in Edo State, Nigeria. A self-administered questionnaire which elicited information on demography, awareness of the periodontal disease and source of information, knowledge of etiology, and symptoms of the periodontal ...

  3. Lessons to be learned from periodontitis

    NARCIS (Netherlands)

    Janssen, Koen M. J.; Vissink, Arjan; de Smit, Menke J.; Westra, Johanna; Brouwer, Elisabeth

    Purpose of review This article reviews the link between periodontitis and rheumatoid arthritis (RA) with regard to similarities in genetic risk factors and immunopathogenesis. Emphasis is paid to the potential role of the periodontal pathogen Porphyromonas gingivalis in the etiopathogenesis of both

  4. The effects of periodontal treatment on diabetes.

    Science.gov (United States)

    Taylor, George W

    2003-10-01

    Diabetes mellitus and periodontal diseases are common chronic diseases in the United States. Periodontal infection may adversely affect glycemic control in people with diabetes. This article reviews the evidence regarding how treatment of periodontal diseases affects glycemic control. The review consisted of a MEDLINE literature search to identify primary research reports on the relationship between periodontal therapy and changes in glycemic control. The review identified three randomized clinical trials and nine nonrandomized clinical follow-up studies. The strength, quantity and breadth of evidence are varied, precluding clear-cut guidance for determining whether treating periodontal infection has a beneficial effect on glycemic control. Despite the variation and limitations in the literature, evidence supports the concept that periodontal diseases can contribute to poorer glycemic control in people with diabetes. Although the evidence is not unequivocal, it provides sufficient support for additional investigations of the effect of preventing and treating periodontal infections on managing glycemic control. Sufficient evidence exists to incorporate oral examinations and periodontal care in management regimens for people with diabetes. It is prudent to assess patients' glycemic control status and communicate the importance of referring patients with diabetes for thorough oral health evaluations and necessary care.

  5. Diagnosis of periodontal diseases using different classification ...

    African Journals Online (AJOL)

    A total of six periodontal conditions was the outputs of the classification unit. The accuracy of the suggested methods was compared according to their resolution and working time. Results: DT and SVM were best to classify the periodontal diseases with a high accuracy according to the clinical research based on 150 ...

  6. Linkage Between Periodontal Disease and Diabetes Mellitus

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Flyvbjerg, Allan

    2016-01-01

    and the presence of bacteria in the periodontal pockets, which, as the result of daily procedures, may spread after penetration of the vasculature, are possible mediators of systemic consequences. This chapter deals with the possible association between periodontitis and diabetes mellitus which is believed...

  7. Comparative periodontal status of human immunodeficiency virus ...

    African Journals Online (AJOL)

    was independent of lower education. Key words: Chronic periodontitis, community periodontal index, human immunodeficiency virus -positive, Nigeria. Date of Acceptance: 12-Apr-2015. Address for correspondence: Dr. KA Umeizudike,. Department of Preventive Dentistry, Faculty of Dental Sciences,. College of Medicine of ...

  8. Quorum sensing inhibition, relevance to periodontics.

    Science.gov (United States)

    Yada, Sudheer; Kamalesh, B; Sonwane, Siddharth; Guptha, Indra; Swetha, R K

    2015-01-01

    Quorum sensing helps bacteria to communicate with each other and in coordinating their behavior. Many diseases of human beings, plants, and animals are mediated by quorum sensing. Various approaches are being tried to inhibit this communication to control the diseases caused by bacteria. Periodontal pathogens also communicate through quorum sensing and new approaches to treat periodontal disease using quorum sensing inhibition need to explored.

  9. Linkage Between Periodontal Disease and Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Nielsen, Claus Henrik

    2016-01-01

    and the presence of bacteria in the periodontal pockets, which, as the result of daily procedures, may spread after penetration of the vasculature, are possible mediators of systemic consequences. The present chapter deals with the possible association of periodontitis with rheumatoid arthritis, which may possess...

  10. The clinical assessment of aggressive periodontitis patients.

    Science.gov (United States)

    Cho, Chan-Myung; You, Hyung-Keun; Jeong, Seong-Nyum

    2011-06-01

    Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from January to December, 2010. Clinical parameters (probing depth, gingival recession, periodontal attachment loss) were measured by a single examiner, and radiographic examination was performed at the baseline. Twenty-eight (1.65%) patients showed clinical features of aggressive periodontitis, of which 27 patients exhibited the generalized form, and 1 exhibited the localized form. There was no significant difference between the percentage of male and female patients. The probing pocket depth of the maxillary first molar was deeper than that of the other teeth and gingival recession was also the most serious at the maxillary first molar. The periodontal attachment loss was the highest at the maxillary first molar. The average number of missing teeth was 1.29 per subject. Loss of the second molar was prominent. Within the limitations of this study, the periodontal breakdown evaluated by attachment loss was found to be most severe at the first molars of aggressive periodontitis patients. However, further large scale multicenter studies are necessary to access more precise data, including prevalence.

  11. Immune processes in periodontal disease: a review.

    Science.gov (United States)

    Kinane, Denis F; Lappin, David F

    2002-12-01

    The inflammatory and immune processes in periodontitis are complex and, although a great deal of information is available, many questions remain. Variation in human susceptibility to periodontitis has long been accepted, but the pathological basis of this is poorly understood. Similarly, we know little of the differences, if any, between the pathology of chronic and aggressive periodontitis. Genetics and environmental influences play a role in the susceptibility process, but if and how that translates through the immune and inflammatory processes to produce the plasma cell-dominated lesions seen in periodontitis remain to be elucidated. This review will focus on immunological aspects of the inflammatory changes seen in gingivitis and periodontitis, addressing both humoral and cellular responses to the microbial insult from dental plaque. A tendency for an individual or site to form an extensive plasma cell infiltrate may indicate an inability to defend against periodontopathogens and thus a predisposition to periodontitis. The issues to be considered include: 1) homing of immune and inflammatory cells to target tissues; 2) their local proliferation and synthetic activity; 3) the cytokine profile of the leukocytes; 4) the immunoglobulin subclasses of locally produced antibodies; 5) mucosal and systemic immune characteristics of the response; 6) the humoral immune response in periodontal health and disease states; and 7) the antigenic target of the immune response in periodontal lesions.

  12. Primary prevention of periodontitis: managing gingivitis

    NARCIS (Netherlands)

    Chapple, I.L.C.; van der Weijden, F.; Doerfer, C.; Herrera, D.; Shapira, L.; Polak, D.; Madianos, P.; Louropoulou, A.; Machtei, E.; Donos, N.; Greenwell, H.; van Winkelhoff, A.J.; Eren Kuru, B.; Arweiler, N.; Teughels, W.; Aimetti, M.; Molina, A.; Montero, E.; Graziani, F.

    2015-01-01

    Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic

  13. Primary prevention of periodontitis : managing gingivitis

    NARCIS (Netherlands)

    Chapple, Iain L. C.; Van der Weijden, Fridus; Doerfer, Christof; Herrera, David; Shapira, Lior; Polak, David; Madianos, Phoebus; Louropoulou, Anna; Machtei, Eli; Donos, Nikos; Greenwell, Henry; Winkelhoff, van Ari J.; Kuru, Bahar Eren; Arweiler, Nicole; Teughels, Wim; Aimetti, Mario; Molina, Ana; Montero, Eduardo; Graziani, Filippo

    Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic

  14. Relationship between depression and chronic periodontitis.

    Science.gov (United States)

    Sundararajan, Shiyamali; Muthukumar, Santhanakrishnan; Rao, Suresh Ranga

    2015-01-01

    Periodontitis is a chronic, multifactorial, polymicrobial disease causing inflammation in the supporting structures of the teeth. There is a plethora of nonoral risk factors which can be quoted to aid in the development of chronic periodontitis. According to WHO, depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt, disturbed sleep or appetite, low energy and poor concentration. Depression is associated with negligent oral health care and another mechanism proposed disturbance in the hypothalamic-pituitary axis system and hypothalamic-pituitary-thyroid system, which can affect the periodontal status by affecting the immune system. The aim of this study was to assess the association between periodontal clinical parameters and depression rating. The study design is a case-control study with 35 patients each in case and control group. The periodontal parameters taken for measurement were probing depth and clinical attachment loss. Depression was calculated using Beck's depression scale. The statistical analysis was performed by means of SPSS software (SPSS Inc., Chicago, IL, USA; version 17.0 under windows 2000). Student's t-test was used to determine the relationship between the clinical periodontal parameters and depression. Self-reported scoring of depression by using Beck's depression inventory has shown that periodontal patients had a significantly higher total depression score than normal controls. This study reveals that there is a direct correlation between the severity of periodontal disease and the severity of depression in patients.

  15. Relationship between Alexithymia and Chronic Periodontitis

    African Journals Online (AJOL)

    2017-05-22

    May 22, 2017 ... Periodontitis is one of the most common chronic disorders in the world today. It is initiated by gum colonization by pathogenic bacteria, followed by the activation of host defense mechanisms.[1] The etiological significance of some biological and behavioral risk factors for periodontal diseases, which include ...

  16. Relationship between alexithymia and chronic periodontitis | Sezer ...

    African Journals Online (AJOL)

    The participants were divided into a chronic periodontitis group (n = 114) and a control group (n = 108) with no history of periodontitis. The Toronto Alexithymia Scale (TAS‑20) was used to evaluate alexithymia status of the subjects. Clinical data were collected on parameters such as the plaque index, bleeding on probing, ...

  17. Progressive, generalized, apical idiopathic root resorption and hypercementosis.

    Science.gov (United States)

    Schätzle, Marc; Tanner, Sandro D; Bosshardt, Dieter D

    2005-11-01

    Root resorption is a multifactorial process that results in loss of tooth structure. The causes of root resorption may vary, leading to several types of resorptions. Some factors have been identified and may be categorized into physiological resorption, local factors, systemic conditions, and idiopathic resorptions. The objective of this report was to present a case of a 17-year-old white female with progressive, generalized, apical idiopathic root resorption followed up for 34 months. Two panoramic radiographs, 14 and 34 months after initial clinical and radiological examinations, showed the rapid progression of apical root resorption. Two molars, teeth #15 and #16, which had to be extracted, and a bone sample from the distal aspect of tooth #15 were processed for histologic analysis. Two millimeters apical to the cemento-enamel junction, an abrupt increase in the cementum thickness was noted, amounting to 300 and 800 microm in teeth #15 and #16, respectively. The thickening of the cementum layer was due to an accelerated deposition of cellular intrinsic fiber cementum. An unusually high number of mineralization foci were observed in association with acellular extrinsic fiber cementum, and both free and fused cementicles were seen. In contrast to tooth #16, tooth #15 revealed extensive dentin replacement by a bone-like and a cementum-like tissue. Furthermore, ankylosis was demonstrated in tooth #15 and confirmed in the bone sample. At present, there is no preventive or therapeutic regimen for the type of root resorption seen in this case report. Treatment usually consists of the extraction of teeth with advanced lesions.

  18. SEM investigation of Er:YAG laser apical preparation

    Science.gov (United States)

    Bǎlǎbuc, Cosmin; Todea, Carmen; Locovei, Cosmin; RǎduÅ£ǎ, Aurel

    2016-03-01

    Endodontic surgery involves the incision and flap elevation, the access to the root tip, its resection, the cavity retrograde preparation and filling it with biocompatible material that provides a good seal of the apex[1]. Apicoectomy is compulsory in endodontic surgery. The final stage involves the root retropreparation and the carrying out of the retrograde obturation. In order to perform the retrograde preparation the endodontist can use various tools such as lowspeed conventional handpieces, sonic and ultrasonic equipment. The ideal depth of the preparation should be 3 mm, exceeding this value may affect the long-term success of the obturation [2]. Resection at the depth of 3 mm reduces apical ramifications by 98% and lateral root canals by 93%. The ultrasonic retropreparation has numerous advantages compared to the dental drill. Firstly, the cavity will be in the axis of the tooth which implies a minimum destruction of the root canal morphology. The preparations are precise, and the cutting pattern is perpendicular to the long axis of the root, the advantage being the reduction in the number of dentinal tubules exposed at the resected area [3]. Therefore, the retrograde filling is the procedure when an inert and non-toxic material is compacted in the apically created cavity.[4,5]. The Er:YAG laser is the most common wavelength indicated for dental hard tissue preparation. Its natural selectivity offers a significant advantage compared to the conventional hard tissue preparation [6-9].The purpose of this in vitro study was to investigate the quality of Er:YAG laser apical third preparation using Scanning Electron Microscopy (SEM), in comparison with the conventional ultrasonic method.

  19. Apical Na+ permeability of frog skin during serosal Cl- replacement.

    Science.gov (United States)

    Leibowich, S; DeLong, J; Civan, M M

    1988-05-01

    Gluconate substitution for serosal Cl- reduces the transepithelial short-circuit current (Isc) and depolarizes short-circuited frog skins. These effects could result either from inhibition of basolateral K+ conductance, or from two actions to inhibit both apical Na+ permeability (PapNa) and basolateral pump activity. We have addressed this question by studying whole-and split-thickness frog skins. Intracellular Na+ concentration (CcNa) and PapNa have been monitored by measuring the current-voltage relationship for apical Na+ entry. This analysis was conducted by applying trains of voltage pulses, with pulse durations of 16 to 32 msec. Estimates of PapNa and CcNa were not detectably dependent on pulse duration over the range 16 to 80 msec. Serosal Cl- replacement uniformly depolarized short-circuited tissues. The depolarization was associated with inhibition of Isc across each split skin, but only occasionally across the whole-thickness preparations. This difference may reflect the better ionic exchange between the bulk medium and the extracellular fluid in contact with the basolateral membranes, following removal of the underlying dermis in the split-skin preparations. PapNa was either unchanged or increased, and CcNa either unchanged or reduced after the anionic replacement. These data are incompatible with the concept that serosal Cl- replacement inhibits PapNa and Na,K-pump activity. Gluconate substitution likely reduces cell volume, triggering inhibition of the basolateral K+ channels, consistent with the data and conclusions of S.A. Lewis, A.G. Butt, M.J. Bowler, J.P. Leader and A.D.C. Macknight (J. Membrane Biol. 83:119-137, 1985) for toad bladder. The resulting depolarization reduces the electrical force favoring apical Na+ entry. The volume-conductance coupling serves to conserve volume by reducing K+ solute loss. Its molecular basis remains to be identified.

  20. Symptomatic relapse of HIV-associated cryptococcal meningitis in ...

    African Journals Online (AJOL)

    Objectives. Cryptococcal meningitis is the most common cause of adult meningitis in southern Africa. Much of this disease burden is thought to be due to symptomatic relapse of previously treated infection. We studied the contribution of inadequate secondary fluconazole prophylaxis to symptomatic relapses of cryptococcal ...

  1. Advanced Engineering Strategies for Periodontal Complex Regeneration

    Directory of Open Access Journals (Sweden)

    Chan Ho Park

    2016-01-01

    Full Text Available The regeneration and integration of multiple tissue types is critical for efforts to restore the function of musculoskeletal complex. In particular, the neogenesis of periodontal constructs for systematic tooth-supporting functions is a current challenge due to micron-scaled tissue compartmentalization, oblique/perpendicular orientations of fibrous connective tissues to the tooth root surface and the orchestration of multiple regenerated tissues. Although there have been various biological and biochemical achievements, periodontal tissue regeneration remains limited and unpredictable. The purpose of this paper is to discuss current advanced engineering approaches for periodontal complex formations; computer-designed, customized scaffolding architectures; cell sheet technology-based multi-phasic approaches; and patient-specific constructs using bioresorbable polymeric material and 3-D printing technology for clinical application. The review covers various advanced technologies for periodontal complex regeneration and state-of-the-art therapeutic avenues in periodontal tissue engineering.

  2. Advanced Engineering Strategies for Periodontal Complex Regeneration

    Science.gov (United States)

    Park, Chan Ho; Kim, Kyoung-Hwa; Lee, Yong-Moo; Seol, Yang-Jo

    2016-01-01

    The regeneration and integration of multiple tissue types is critical for efforts to restore the function of musculoskeletal complex. In particular, the neogenesis of periodontal constructs for systematic tooth-supporting functions is a current challenge due to micron-scaled tissue compartmentalization, oblique/perpendicular orientations of fibrous connective tissues to the tooth root surface and the orchestration of multiple regenerated tissues. Although there have been various biological and biochemical achievements, periodontal tissue regeneration remains limited and unpredictable. The purpose of this paper is to discuss current advanced engineering approaches for periodontal complex formations; computer-designed, customized scaffolding architectures; cell sheet technology-based multi-phasic approaches; and patient-specific constructs using bioresorbable polymeric material and 3-D printing technology for clinical application. The review covers various advanced technologies for periodontal complex regeneration and state-of-the-art therapeutic avenues in periodontal tissue engineering. PMID:28787856

  3. [Association between periodontitis and diabetes mellitus].

    Science.gov (United States)

    Meng, Huan-xin

    2007-02-18

    This paper focused on the relationship between periodontitis and Type 2 diabetes mellitus (T2DM). There is an abundance of evidence that diabetes mellitus play important etiological roles in periodontal diseases. In addition, periodontal diseases have powerful and multiple influences on the occurrence and severity of systemic conditions and diseases, such as diabetes mellitus, cardiovascular disease, respiratory disease and pregnancy complications. The relationship of periodontitis and diabetes has been supported by sufficient evidences in the past twenty years: (1) diabetes is an independent risk factor of chronic periodontitis; (2) metabolic control will improve the prognosis of chronic periodontitis; (3) the treatment of chronic periodontitis will improve the metabolic level. Our recent investigation on periodontal status in the families of type 2 diabetes mellitus further confirmed the relationship. It was showed that the periodontal index such as probing depth (PD), attachment loss (AL) and numbers of tooth loss in diabetes family members were significantly higher than non-diabetes family members, while no difference of periodontal parameters was found between well control family members and non diabetes family members. In the development of type 2 diabetes (T2DM) and its complications, the advanced glycation end products (AGEs) and its receptors were to be recognized as important factors. The distributions of AGEs and the receptor for AGEs (RAGE) are highly consistent in various tissues. One study in our laboratory demonstrated that RAGE was strongly expressed in gingival tissues gathered from T2DM patients with periodontitis compared with systemically healthy chronic periodontitis patients, the expression of RAGE was positively correlated with the expression of TNF-alpha, indicating that AGE-RAGE pathway was involved in the development of periodontitis in T2DM patients. It is known that inflammation could induce the prediabetic status characterized by

  4. The orthodontic periodontal interface: A narrative review

    Directory of Open Access Journals (Sweden)

    Gurkeerat Singh

    2014-01-01

    Full Text Available The purpose of this review is to highlight the orthodontics and periodontics interface in clinical practice for optimized treatment outcomes. Orthodontic treatment aims at providing an acceptable functional and esthetic occlusion. Tooth movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, due to the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems.Esthetic considerations, like uneven gingival margins or functional problems resulting from inflammatory periodontal diseases, should be considered in orthodontic treatment planning. Potentials and limitations that derive from the interdisciplinary approach of complex orthodontic-periodontal clinical problems are discussed along with the role of light forces and self-ligating brackets.

  5. Automated system for periodontal disease diagnosis

    Science.gov (United States)

    Albalat, Salvador E.; Alcaniz-Raya, Mariano L.; Juan, M. Carmen; Grau Colomer, Vincente; Monserrat, Carlos

    1997-04-01

    Evolution of periodontal disease is one of the most important data for the clinicians in order to achieve correct planning and treatment. Clinical measure of the periodontal sulcus depth is the most important datum to know the exact state of periodontal disease. These measures must be done periodically study bone resorption evolution around teeth. Time factor of resorption indicates aggressiveness of periodontitis. Manual probes are commonly used with direct reading. Mechanical probes give automatic signal but this method uses complicated and heavy probes that are only limited for University researchers. Probe position must be the same to have right diagnosis. Digital image analysis of periodontal probing provides practical, accurate and easy tool. Gum and plaque index could also be digitally measured with this method.

  6. Some modern aspects of periodontal disease

    International Nuclear Information System (INIS)

    Bergenholtz, A.; Jorkjend, L.

    1990-01-01

    During the last three to four decades, extensive changes in opinion concerning the etiology, pathogenesis, and treatment of periodontal disease have taken place. During these decades, contributing factors are standardized and controlled trials, as well as epidemiological studies, were performed. Periodontics is no longer an art as it was at the end of the 19th century- it is a science based on research. Pyorrhea alveoiaris or periodontitis has been considered a multifactorial disease with bad prognosis which, together with caries, causes loss of teeth in the population. It was supposed to affect most of the population with age progress, trauma from occlusion, systemic diseases, and bad oral hygiene. The discovery that plaque was the cause of gingivitis, and that the subgingival microflora differed in composition between sites, teeth, and individuals created new suggestions and demands for the treatment of periodontal disease. The aim of this paper is to summarize some modern aspects on periodontal disease. (author)

  7. Essentials of periodontal medicine in preventive medicine

    Directory of Open Access Journals (Sweden)

    Minkle Gulati

    2013-01-01

    Full Text Available Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer′s disease, gastrointestinal disease, prostatitis, renal diseases, which has also been scientifically validated. This side of the oral-systemic link has been termed Periodontal Medicine and is potentially of great public health significance, as periodontal disease is largely preventable and in many instances readily treatable, hence, providing many new opportunities for preventing and improving prognosis of several systemic pathologic conditions. This review article highlights the importance of prevention and treatment of periodontal diseases as an essential part of preventive medicine to circumvent its deleterious effects on general health.

  8. Psychosocial distress and periodontitis in adolescents

    DEFF Research Database (Denmark)

    Lopez, Rodrigo; Ramírez, Valeria; Marró, Patricio

    2012-01-01

    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...... 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...... a case was clinical attachment level ≥ 3 mm in at least two teeth. Multiple logistic regression analyses were used to assess the association between periodontitis and psychosocial distress. Results: The response rate was high and 94% of the participants answered all the items of the questionnaire...

  9. 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.

  10. Longitudinal Association Of Alcohol Consumption To Periodontitis

    DEFF Research Database (Denmark)

    Kongstad, Johanne; Hach, Maria; Hvidtfeldt, Ulla Arthur

    Objective: To analyse longitudinal relationship between alcohol consumption at three different time points and periodontitis in data of The Copenhagen City Heart Study (CCHS). Methods: CCHS is a prospective study of general health and risk factors carried out in Denmark in 1983-1984, 1991......-1994, and in 2001-2003. Participants were randomly selected from the cohort of CCHS. In total 1,597 individuals aged 20-95 years underwent a periodontal examination in 2004-2007. The periodontal examination was based on full-mouth registration at 6 sites per tooth and included level of gingival margin, probing...... pocket depth (PPD) and calculation of clinical attachment level (CAL). Periodontitis was defined according to severe periodontitis as ≥2 interproximal sites with CAL ≥6mm (not on the same tooth) and ≥1 interproximal site with PPD ≥5mm (Page & Eke 2007). Alcohol consumption and relevant covariates were...

  11. 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.

  12. Locus of the apices of projectile trajectories under constant drag

    Science.gov (United States)

    Hernández-Saldaña, H.

    2017-11-01

    Using the hodograph method, we present an analytical solution for projectile coplanar motion under constant drag, parametrised by the velocity angle. We find the locus formed by the apices of the projectile trajectories, and discuss its implementation for the motion of a particle on an inclined plane in presence of Coulomb friction. The range and time of flight are obtained numerically, and we find that the optimal launching angle is smaller than in the drag-free case. This is a good example of a problem with constant dissipation of energy that includes curvature; it is appropriate for intermediate courses of mechanics.

  13. Pyogenic granuloma subsequent to apical fenestration of a primary tooth.

    Science.gov (United States)

    Aguiló, Luz; Bagán, José V

    2002-05-01

    The authors present two case reports of patients exhibiting pyogenic granulomas in the maxillary labial mucosa, which were related to an apical fenestration of a primary incisor. Several researchers have reported that the gingival wound and surrounding inflammatory tissue typically heal spontaneously after extraction of a fenestrated primary tooth. However, in the cases presented here, the gingival lesion did not heal after the fenestrated teeth were extracted. After extracting fenestrated teeth, clinicians need to examine the labial area at a follow-up appointment to ensure that the gingival hyperplasia heals properly. The authors suggest performing curettage of the surrounding abnormal tissue at the time of the tooth extraction.

  14. Thermal effects from modified endodontic laser tips used in the apical third of root canals with erbium-doped yttrium aluminium garnet and erbium, chromium-doped yttrium scandium gallium garnet lasers.

    Science.gov (United States)

    George, Roy; Walsh, Laurence J

    2010-04-01

    To evaluate the temperature changes occurring on the apical third of root surfaces when erbium-doped yttrium aluminium garnet (Er:YAG) and erbium, chromium-doped yttrium scandium gallium garnet (Er,Cr:YSGG) laser energy was delivered with a tube etched, laterally emitting conical tip and a conventional bare design optical fiber tip. Thermal effects of root canal laser treatments on periodontal ligament cells and alveolar bone are of concern in terms of safety. A total of 64 single-rooted extracted teeth were prepared 1 mm short of the working length using rotary nickel-titanium Pro-Taper files to an apical size corresponding to a F5 Pro-Taper instrument. A thermocouple located 2 mm from the apex was used to record temperature changes arising from delivery of laser energy through laterally emitting conical tips or plain tips, using an Er:YAG or Er,Cr:YSGG laser. For the Er:YAG and Er,Cr:YSGG systems, conical fibers showed greater lateral emissions (452 + 69% and 443 + 64%) and corresponding lower forward emissions (48 + 5% and 49 + 5%) than conventional plain-fiber tips. All four combinations of laser system and fiber design elicited temperature increases less than 2.5 degrees C during lasing. The use of water irrigation attenuated completely the thermal effects of individual lasing cycles. Laterally emitting conical fiber tips can be used safely under defined conditions for intracanal irradiation without harmful thermal effects on the periodontal apparatus.

  15. Symptomatic unruptured cerebral aneurysms. Features and surgical outcome

    International Nuclear Information System (INIS)

    Date, Isao

    2010-01-01

    Development of less invasive imaging studies, such as magnetic resonance angiography, has increased the chances that unruptured cerebral aneurysms are found. The rupture risk of 'symptomatic' aneurysms is higher than for 'asymptomatic' aneurysms; so 'symptomatic' aneurysms are more often surgically treated. Many reviews examine 'asymptomatic' unruptured cerebral aneurysms, but few evaluate 'symptomatic' aneurysms. The author has treated many patients with symptomatic unruptured cerebral aneurysms and found that improved cranial nerve signs can be expected if the surgical treatment is performed before the symptoms become irreversible; the critical period is approximately 3 months. It is important to suppress the pulsation of the aneurysms compressing the cranial nerves; both a clipping procedure and endovascular coiling are effective. Cranial nerve signs are more commonly the symptoms of unruptured cerebral aneurysms, but large to giant aneurysms can also be the causes of hemiparesis, hydrocephalus, epilepsy, or even cerebral infarction. This review summarizes the features and surgical outcome of symptomatic unruptured cerebral aneurysms. (author)

  16. Cytokine ratios in chronic periodontitis and type 2 diabetes mellitus.

    Science.gov (United States)

    Acharya, Anirudh B; Thakur, Srinath; Muddapur, M V; Kulkarni, Raghavendra D

    Chronic periodontitis may influence systemic cytokines in type 2 diabetes. This study aimed to evaluate the cytokine ratios in type 2 diabetes with, and without chronic periodontitis. Gingival status, periodontal, glycemic parameters and serum cytokines were evaluated in participants grouped as healthy, chronic periodontitis, and type 2 diabetes with, and without chronic periodontitis. Cytokine ratios showed significant differences in type 2 diabetes and chronic periodontitis, were highest in participants having both type 2 diabetes and chronic periodontitis, with a statistically significant cut-off point and area under curve by receiver operating characteristic. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  17. Periodontal diseases and osteoporosis: association and mechanisms.

    Science.gov (United States)

    Wactawski-Wende, J

    2001-12-01

    There is increasing evidence that osteoporosis, and the underlying loss of bone mass characteristic of this disease, is associated with periodontal disease and tooth loss. Periodontitis has long been defined as an infection-mediated destruction of the alveolar bone and soft tissue attachment to the tooth, responsible for most tooth loss in adult populations. Current evidence including several prospective studies supports an association of osteoporosis with the onset and progression of periodontal disease in humans. The majority of studies have shown low bone mass to be independently associated with loss of alveolar crestal height and tooth loss. However studies that focus on the relation of clinical attachment loss and osteoporosis are less consistent. To date, the majority of studies on the relationship between periodontal disease and osteoporosis have been hindered by small sample sizes, limited control of other potential confounding factors, varying definitions of both periodontal disease and osteoporosis, and few prospective studies where the temporality of the association can be established. Potential mechanisms by which host factors may influence onset and progression of periodontal disease directly or indirectly include underlying low bone density in the oral cavity, bone loss as an inflammatory response to infection, genetic susceptibility, and shared exposure to risk factors. Systemic loss of bone density in osteoporosis, including that of the oral cavity, may provide a host system that is increasingly susceptible to infectious destruction of periodontal tissue. Studies have provided evidence that hormones, heredity, and other host factors influence periodontal disease incidence and severity. Both periodontal disease and osteoporosis are serious public-health concerns in the United States. Prevalence of both osteoporosis and tooth loss increase with advancing age in both women and men. Understanding the association between these common diseases and the

  18. Periodontal regeneration: management of periodontal osseous defects by the periodontist-dental hygienist team.

    Science.gov (United States)

    Schallhorn, Rachel A; McClain, Pamela K

    2014-06-01

    Periodontal health can be restored through assessment, diagnosis, treatment and management of periodontal osseous defects by the periodontist-dental hygienist team. Treatment of periodontitis has evolved over time, with regenerative periodontal therapy at the forefront in cutting-edge periodontal care. While the techniques and materials available today are allowing therapists to push the limits of periodontal regeneration and achieve success in increasingly more difficult cases, the principles of successful regeneration remain the same. Case selection, identification and resolution of etiologic and contributing factors, proper surgical technique, follow-up and patient education are keys to obtaining a successful outcome. The impact of the dental hygienist in assessment and maintenance is highlighted. Literature review of the key research studies evaluating the etiology and contributing factors in the development osseous defects, osseous defect and tooth-related characteristics, and principles of successful regenerative therapy. The authors draw upon their experience with patient care and clinical research to synthesize the evidence relevant to today's dental hygienist. Periodontal regeneration is a well-supported and predictable therapy that can be utilized to restore periodontal support and health. The dental hygienist is key in assessing and caring for the periodontal health of patients over time. Identifying who may benefit from regenerative periodontal therapy is an essential skill for today's practicing dental hygienist. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Resistin: a potential biomarker for periodontitis influenced diabetes mellitus and diabetes induced periodontitis.

    Science.gov (United States)

    Devanoorkar, Archana; Kathariya, Rahul; Guttiganur, Nagappa; Gopalakrishnan, D; Bagchi, Paulami

    2014-01-01

    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.

  20. Self-report Assessment of Severe Periodontitis: Periodontal Screening Score Development.

    Science.gov (United States)

    Carra, Maria Clotilde; Gueguen, Alice; Thomas, Frédérique; Pannier, Bruno; Caligiuri, Giuseppina; Steg, Philippe Gabriel; Zins, Marie; Bouchard, Philippe

    2018-04-03

    To derive from a validated questionnaire a periodontal screening score, intended as an user-friendly tool to identify individuals at risk of periodontitis in epidemiological studies. A French 12-item self-reported questionnaire was developed by translating English questions previously used for periodontitis screening and surveillance. After a cognitive evaluation, the questionnaire was validated in a sample of 232 individuals (mean age: 46.1±12.6 years) receiving full-mouth periodontal examination, including probing pocket depth and clinical attachment level recordings. Case definition was based on the American Academy of Periodontology/Centers for Disease Control and Prevention criteria. Logistic regression analyses and C-statistics were used to assess the validity and accuracy of the questionnaire and to develop the periodontal screening score. The sample was constituted of 109 individuals with severe periodontitis, who were compared with 123 individuals with no/moderate periodontitis. The questionnaire had moderate-to-high accuracy in identifying severe cases; the periodontal screening score (calculated on 5 self-report items, age, and smoking) showed a sensitivity of 78.9% and a specificity of 74.8%, with an area under the receiver operating characteristics curve of 0.821. The periodontal screening score represents a valuable and accurate tool to screen for severe periodontitis at the population level. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  1. Determinantes del diagnóstico periodontal Determinants of periodontal diagnosis

    Directory of Open Access Journals (Sweden)

    JE Botero

    2010-08-01

    Full Text Available Un correcto diagnóstico periodontal es necesario para la realización de una terapia periodontal exitosa en nuestro paciente. Entendiendo que la enfermedad periodontal es un proceso infeccioso-inflamatorio, diferentes variables se deben analizar clínicamente para determinar el diagnóstico. El diagnóstico entonces es un análisis concienzudo de la expresión clínica de la enfermedad, desde gingivitis hasta periodontitis. Este artículo analiza los determinantes más importantes del diagnóstico periodontal utilizados en la práctica clínica diaria.The correct diagnosis of periodontal disease is a pre-requisite for an appropriate periodontal treatment. Periodontal disease is an infectious-inflammatory process that affects different clinical variables that must be analyzed before reaching the diagnosis. The diagnosis should be a carefully performed analysis of the clinical expression of the disease, from gingivitis to periodontitis. This article reviews the most important determinants of periodontal diagnosis.

  2. Periodontal ligament-derived cells for periodontal regeneration in animal models: a systematic review.

    Science.gov (United States)

    Bright, R; Hynes, K; Gronthos, S; Bartold, P M

    2015-04-01

    Implantation of periodontal ligament stem cells is emerging as a potential periodontal regenerative procedure. This systematic review considers the evidence from animal models investigating the use of periodontal ligament stem cells for successful periodontal regeneration. PubMed, Embase, MEDLINE and Google Scholar were searched to December 2013 for quantitative studies examining the outcome of implanting periodontal ligament stem cells into experimental periodontal defects in animals. Inclusion criteria were: implantation of periodontal ligament stem cells into surgically created periodontal defects for periodontal regeneration; animal models only; source of cells either human or animal; and published in English. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From the literature search, 43 studies met the inclusion criteria. A wide variety of surgical defects were created in four species of animal (dog, rat, pig and sheep). Owing to wide variability in defect type, cell source and cell scaffold, no meta-analysis was possible. Outcome measures included new bone, new cementum and new connective tissue formation. In 70.5% of the results, statistically significant improvements of these measures was recorded. These results are notable in that they indicate that irrespective of the defect type and animal model used, periodontal ligament stem cell implantation can be expected to result in a beneficial outcome for periodontal regeneration. It is recommended that there is sufficient evidence from preclinical animal studies to warrant moving to human studies to examine the efficacy, safety, feasibility (autologous vs. allogeneic transplantation) and delivery of periodontal ligament stem cells for periodontal regeneration. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Prognosis of periodontitis recurrence after intensive periodontal treatment using examination of serum IgG antibody titer against periodontal bacteria.

    Science.gov (United States)

    Sugi, Noriko; Naruishi, Koji; Kudo, Chieko; Hisaeda-Kako, Aya; Kono, Takayuki; Maeda, Hiroshi; Takashiba, Shogo

    2011-01-01

    Chronic periodontitis is associated with systemic diseases such as atherosclerosis. In this study, we evaluated the efficacy of serum IgG antibody titer to periodontal bacteria for prognosis of periodontitis recurrence during supportive periodontal therapy (SPT) phase. The 139 patients during SPT phase were selected and divided to two groups as follows: "Stable" and "Recurrence" group at SPT phase for case-control study: "High IgG titer" and "Normal IgG titer" group before transition to SPT phase for cohort study. We examined whether clinical findings or serum IgG antibody titers to periodontal bacteria are risk factors for the development of periodontitis recurrence. Case-control study showed that there were significant differences between the stable and recurrence groups in age and number of teeth. The serum IgG antibody titer to Eikenella corrodens FDC1073, Porphyromonas gingivalis SU63, and Campylobacter rectus ATCC33238 was significantly higher in the recurrence group. Next, we found, that the recurrence ratio in the high IgG titer group to Gram-negative obligate anaerobe, Prevotella intermedia, Treponema denticola, and C. rectus was significantly higher than that of the normal IgG titer group. Taken together, serum IgG antibody titer test is useful in the prognosis of periodontitis recurrence during the SPT phase. © 2011 Wiley-Liss, Inc.

  4. Periodontal disease and diabetes mellitus.

    Science.gov (United States)

    Negrato, Carlos Antonio; Tarzia, Olinda; Jovanovič, Lois; Chinellato, Luiz Eduardo Montenegro

    2013-01-01

    Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the English and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in English and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes-related complications.

  5. Periodontal disease and diabetes mellitus

    Science.gov (United States)

    NEGRATO, Carlos Antonio; TARZIA, Olinda; JOVANOVIČ, Lois; CHINELLATO, Luiz Eduardo Montenegro

    2013-01-01

    Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. Objective: The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the english and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. Methods: This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in english and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. Results: This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. Conclusions: The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes

  6. Periodontitis and diabetes: a two-way relationship

    OpenAIRE

    Preshaw, P. M.; Alba, A. L.; Herrera, D.; Jepsen, S.; Konstantinidis, A.; Makrilakis, K.; Taylor, R.

    2011-01-01

    Periodontitis is a common chronic inflammatory disease characterised by destruction of the supporting structures of the teeth (the periodontal ligament and alveolar bone). It is highly prevalent (severe periodontitis affects 10?15% of adults) and has multiple negative impacts on quality of life. Epidemiological data confirm that diabetes is a major risk factor for periodontitis; susceptibility to periodontitis is increased by approximately threefold in people with diabetes. There is a clear r...

  7. Clinical and postextraction evaluation of periodontal disease indicators

    OpenAIRE

    Rajashri Kolte; Abhay Kolte; Pooja Wattamwar

    2016-01-01

    Background: Clinical attachment level is the most frequently used and acceptable parameter in monitoring periodontal status in diseased individual and denotes patterns of periodontal destruction. Awareness of root morphology and the condition of the periodontal tissues is essential for reliable periodontal pocket probing and for effective debridement of root surfaces. Clinically, it is challenging to observe exact nature of complex periodontal attachment loss. The aim of the present study was...

  8. Diagnostic challenges of symptomatic uncomplicated diverticular disease.

    Science.gov (United States)

    Cremon, Cesare; Bellacosa, Lara; Barbaro, Maria R; Cogliandro, Rosanna F; Stanghellini, Vincenzo; Barbara, Giovanni

    2017-06-01

    Colonic diverticulosis is a common condition in Western industrialized countries occurring in up to 65% of people over the age of 60 years. Only a minority of these subjects (about 10-25%) experience symptoms, fulfilling Rome III Diagnostic Criteria for irritable bowel syndrome (IBS) diagnosis (IBS-like symptoms) in 10% to 66% of cases. Symptomatic uncomplicated diverticular disease (SUDD) is a syndrome characterized by recurrent abdominal symptoms attributed to diverticula in the absence of macroscopically evident alterations other than the presence of diverticula. Due to the different peak of incidence, the overlap between SUDD and IBS is predominantly present in middle-aged or older patients. In these cases, it is very complex to establish if the symptoms are related to the presence of diverticula or due to an overlapping IBS. In fact, the link between gastrointestinal symptoms and diverticula is unclear, and the mechanism by which diverticula may induce the development of IBS-like symptoms remains to be elucidated. Currently, the etiology and pathophysiology of SUDD, particularly when IBS-like symptoms are present, are not completely understood, and thus these two entities remain a diagnostic challenge not only for the general practitioner but also for the gastroenterologist. Although many issues remain open and unresolved, some minimize the importance of a distinction of these two entities as dietary and pharmacological management may be largely overlapping.

  9. [Laparoscopic management of symptomatic urachal anomalies].

    Science.gov (United States)

    Sánchez-Ismayel, Alexis; Cruz-González, Germán; Sánchez, Renata; Sánchez-Salas, Rodolfo; Rodríguez, Omaira; Sanabria, Erasmo; Sotelo, Rene; Sánchez-Salas, Rafael E

    2009-03-01

    Acquired urachal anomalies are a rare pathology. Gold-standard treatment for this clinical situation remains the resection of the urachus in its entire tract with or without partial resection of the bladder. Our aim is to up-date authors's experience in the minimally invasive surgical treatment of acquired urachal disease. From 2001 to 2007, 14 patients were operated for acquired urachal disease at our institution. A three portal technique previously described by the authors was employed. The diagnosis of acquired uracal disease was confirmed in all cases and the resection of the urachus in its entire tract performed in cephalocaudal direction onto the bladder. Operative and demographic data was prospectively collected and analysis retrospectively performed. Mean operative time was 63 minutes (45,110), minimal blood loss, and no conversions to open surgery or perioperative complications were verified. The majority of the patients were discharged in the first 24 hours. At a follow-up of 22 months no recurrences of urachal pathology recurrences have been verified. Laparoscopy plays a significant role in the management of symptomatic urachus anomalies. It allows objective confirmation of clinical diagnosis and adequate resection of the urachus in a safe and efficient fashion, while providing the well-known advantages of minimally acces surgery. Preoperative evaluation work-up has minimal impact of therapeutical decision.

  10. Acute symptomatic hyponatremia in a flight attendant.

    Science.gov (United States)

    Madero, Magdalena; Monares, Enrique; Domínguez, Aurelio Méndez; Ayus, Juan Carlos

    2015-08-01

    Acute symptomatic hyponatremia after thiazide diuretic initiation is a medical emergency. Here we describe the case of a flight attendant who developed acute hyponatremia during a flight and the potential risk factors for developing this condition. A 57-year-old flight attendant with history of essential hypertension was recently started on a thiazide diuretic. As she did routinely when working, she increased her water intake during a flight from London to Mexico City. She complained of nausea and headache during the flight. Upon arrival, she developed severe disorientation and presented to the hospital emergency room (ER) with a Glasgow scale of 12, hypoxia, and a generalized tonic clonic seizure. Her laboratory results on arrival were consistent with severe hyponatremia (serum Na 116 mEql/L) and severe cerebral edema by CT scan. She was treated with hypertonic saline, with complete resolution of the neurologic symptoms. We describe high water intake and hypoxia related to decreased partial pressure of oxygen in the cabin as the two main risk factors for thiazide-induced acute hyponatremia in this case.

  11. Neonatal management of symptomatic transplacental cryoglobulinaemia.

    Science.gov (United States)

    Laugel, V; Goetz, J; Wolff, S; Beladdale, J; Sibilia, J; Messer, J

    2004-04-01

    This study reports the first case of symptomatic placental transfer of cryoglobulins and discusses the potential pathogenic processes and the basic guidelines for neonatal management. A 32-y-old woman was affected by essential type I cryoglobulinaemia and displayed the cold-triggered cutaneous symptoms of the disease due to a monoclonal immunoglobulin G (IgG) cryoglobulin. She gave birth to healthy dizygotic twins who were placed in incubators immediately after birth and did not show any cutaneous or visceral lesion in the first 2 d. Cyanotic macules appeared on the hand and foot of one of the newborns when they were removed from the incubators. The same monoclonal IgG-lambda cryoglobulin was identified in the two newborns' cord blood and in the mother's serum. The skin lesions disappeared within 1 wk as both twins were transiently replaced in incubators. No recurrence of skin lesions was observed even at room temperature and, 6 mo later, both twins were healthy and their clinical examination was normal. To the authors' knowledge, this is the first report of placental transfer of cryoglobulins and the first description of any neonatal effect. Neonates born to mothers suffering from IgG cryoglobulinaemia should be protected against cold to avoid precipitation of the pathogenic cryoglobulins, until spontaneous resolution.

  12. Supportive periodontal therapy and periodontal biotype as prognostic factors in implants placed in patients with a history of periodontitis.

    Science.gov (United States)

    Aguirre-Zorzano, Luis-Antonio; Vallejo-Aisa, Francisco-Javier; Estefanía-Fresco, Ruth

    2013-09-01

    To evaluate bone loss around implants placed in patients with a history of treated chronic periodontitis and who did or did not attend supportive periodontal therapy, after one year in function. Furthermore, the influence of periodontal biotype and level of plaque was also evaluated. Forty-nine patients participated voluntarily in the study. All subjects had a history of chronic periodontitis, which had been previously treated. After the active treatment, 27 patients attended supportive periodontal therapy (SPT) and the rest did not (No SPT). The O'Leary plaque index and periodontal biotype were recorded for each subject and 246 Astra Tech® OsseospeedTM implants were radiographically analysed (123 placed in SPT patients and 123 in No SPT patients) at the time of loading and one year later, measuring marginal bone loss with the program Dental Studio NX 6.0®. The statistical analysis was performed with Windows SPSS, applying Pearson's correlation index and the Kruskal-Wallis and U-Mann Whitney non-parametric tests. Six patients were found to have periimplantitis and sixteen mucositis. The survival rate was 99.59% (100% SPT and 99.18% No SPT). Mean bone loss was 0.39 mm (range [-0.71 - 8.05]). Among SPT patients, 95% of the implants had losses less than or equal to the mean (mean bone loss of 0.16 mm) compared to 53.7% for the No SPT group (mean bone loss of 0.62 mm). A statistically significant relationship was demonstrated between bone loss around the implant and the patient's periodontal biotype and plaque index. The marginal bone loss around implants in patients with treated chronic periodontitis is minimal if they are in a controlled SPT programme and there is individual control of plaque index. Moreover, the presence of a thin periodontal biotype represents a risk factor for additional bone loss.

  13. Periodontal considerations in older individuals.

    Science.gov (United States)

    Darby, I

    2015-03-01

    In the next few years there will be a great increase in the percentage of the population aged over 65. Not only will they have more teeth than previous generations, but also a large number of implants. The increase in age is accompanied by an increase in the prevalence and incidence of periodontal diseases. In addition, there is a decrease in manual dexterity and an increase in co-morbidity and medications affecting the oral cavity. Dental care in aged care facilities can be poor and access to dental professionals difficult. This article discusses these issues. © 2015 Australian Dental Association.

  14. Systemic antibiotic therapy in periodontics

    Directory of Open Access Journals (Sweden)

    Anoop Kapoor

    2012-01-01

    Full Text Available Systemic antibiotics in conjunction with scaling and root planing (SRP, can offer an additional benefit over SRP alone in the treatment of periodontitis, in terms of clinical attachment loss (CAL and pocket depth change, and reduced risk of additional CAL loss. However, antibiotics are not innocuous drugs. Their use should be justified on the basis of a clearly established need and should not be substituted for adequate local treatment. The aim of this review is to discuss the rationale, proper selection, dosage and duration for antibiotic therapy so as to optimize the usefulness of drug therapy.

  15. Periodontitis agresiva. Reporte de caso

    OpenAIRE

    López Pinedo, Martha L.; Docente del Departamento Académico de Clinica Estomatológica. Facultad de Estomatología. Universidad Peruana Cayetano Heredia.; Hidalgo Medina, Elizabeth; Estudiante de Pregrado. Facultad de Estomatología. Lima,

    2014-01-01

    La periodontitis agresiva es una infección con baja prevalencia, caracterizada clínicamente por pérdidas rápidas de inserción y radiográficamente por reabsorciones óseas severas, que se presentantempranamente alrededor de la infancia en niños y adultos jóvenes sanos. El presente reporte de caso describe a un paciente de sexo masculino de trece años de edad, el cual acude a la consulta odontológica por presentar movilidad y separación de piezas dentarias especialmente en el sector antero super...

  16. Apical canal sealing ability of calcium phosphate based cements.

    Science.gov (United States)

    Yoshikawa, M; Inamoto, T; Hakata, T; Toda, T

    1996-12-01

    The apical canal sealing ability of newly developed calcium phosphate cement (TDM-C), an equimolar mixture of tetracalcium and dicalcium phosphate dihydrate kneaded with McIlvain's buffer solution containing sodium carboxymethyl cellulose, was evaluated in a relative comparison with several recognized available products. The latter included BONETRIX (alpha-tricalcium phosphate mixed with citric acid and tannic acid), ARS (alpha-tricalcium phosphate and hydroxyapatite mixed with polyacrylic acid), and zine oxide eugenol sealer (ZOE). Canals of forty extracted human maxillary central incisors were prepared to the file size #70, divided into four groups, and obturated with each of the four above materials. Setting of all sealers took place either in 30% bovine serum solution or in phosphate buffered saline solution. Teeth were then decalcified and cleared to measure linear penetration of India ink from the apex into the canal. Results were statistically analyzed by Student's t-test. Surfaces of all materials, after setting, were also observed by scanning electron microscopy (SEM). We found that TDM-C, BONETRIX, and ZOE all showed excellent apical sealing ability whereas ARS was less effective in this regard. SEM analysis revealed micropores on the surface of every apatitic product, but ZOE was free of such porosity. It was concluded that TDM-C and BONETRIX may prove clinically useful as root canal sealant materials.

  17. Apical versus Basal Neurogenesis Directs Cortical Interneuron Subclass Fate.

    Science.gov (United States)

    Petros, Timothy J; Bultje, Ronald S; Ross, M Elizabeth; Fishell, Gord; Anderson, Stewart A

    2015-11-10

    Fate determination in the mammalian telencephalon, with its diversity of neuronal subtypes and relevance to neuropsychiatric disease, remains a critical area of study in neuroscience. Most studies investigating this topic focus on the diversity of neural progenitors within spatial and temporal domains along the lateral ventricles. Often overlooked is whether the location of neurogenesis within a fate-restricted domain is associated with, or instructive for, distinct neuronal fates. Here, we use in vivo fate mapping and the manipulation of neurogenic location to demonstrate that apical versus basal neurogenesis influences the fate determination of major subgroups of cortical interneurons derived from the subcortical telencephalon. Somatostatin-expressing interneurons arise mainly from apical divisions along the ventricular surface, whereas parvalbumin-expressing interneurons originate predominantly from basal divisions in the subventricular zone. As manipulations that shift neurogenic location alter interneuron subclass fate, these results add an additional dimension to the spatial-temporal determinants of neuronal fate determination. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Trafficking Ion Transporters to the Apical Membrane of Polarized Intestinal Enterocytes.

    Science.gov (United States)

    Engevik, Amy Christine; Goldenring, James R

    2018-01-02

    Epithelial cells lining the gastrointestinal tract require distinct apical and basolateral domains to function properly. Trafficking and insertion of enzymes and transporters into the apical brush border of intestinal epithelial cells is essential for effective digestion and absorption of nutrients. Specific critical ion transporters are delivered to the apical brush border to facilitate fluid and electrolyte uptake. Maintenance of these apical transporters requires both targeted delivery and regulated membrane recycling. Examination of altered apical trafficking in patients with Microvillus Inclusion disease caused by inactivating mutations in MYO5B has led to insights into the regulation of apical trafficking by elements of the apical recycling system. Modeling of MYO5B loss in cell culture and animal models has led to recognition of Rab11a and Rab8a as critical regulators of apical brush border function. All of these studies show the importance of apical membrane trafficking dynamics in maintenance of polarized epithelial cell function. Copyright © 2018 Cold Spring Harbor Laboratory Press; all rights reserved.

  19. Comparison of salivary calcium level in smokers and non-smokers with chronic periodontitis, aggressive periodontitis, and healthy controls

    OpenAIRE

    Kambalyal, Preeti; Kambalyal, Prabhuraj; Hungund, Shital

    2015-01-01

    Objective: The purpose of this study was to compare salivary calcium (Ca) level in smokers and non-smokers with chronic periodontitis, aggressive periodontitis, and healthy controls. Materials and Methods: 56 subjects were included in the study and were grouped as follows: 12 subjects who were periodontally healthy (Group I), 12 subjects having chronic periodontitis who were non-smokers (Group II), 12 non-smokers having aggressive periodontitis (Group III), 12 smokers with chronic periodontit...

  20. EVALUATION OF AGGREGATIBACTER ACTINOMYCETEMCOMITANS LEVELS IN LOCALIZED AGGRESSIVE PERIODONTITIS BEFORE AND AFTER PERIODONTAL SURGERY

    Directory of Open Access Journals (Sweden)

    Saranyan Ravi, Priya Kesavan, Manovijay Balagangadharan, Raja Arasapan, Nisha N, Ann Joseph Anthraper

    2015-07-01

    Full Text Available Background The role of microorganisms in the etiology of periodontal disease is well understood. The association of specific organisms in the pathogenesis of periodontal disease was established by the specific plaque hypothesis. This study examined the effects of periodontal surgery on Aggregatibacteractinomycetemcomitans (Aa levels in localized aggressive periodontitis before and after periodontal surgery. Method: A clinical study was done on 24 male and 16 female patients who underwent surgical periodontal therapy. Bacterial counts were assessed from the plaque samples and gingival specimens. Results: Mean reduction of pre and post operative bacterial counts were statistically significant at 1%.COnclusion: A reduction of bacterial count was observed in plaque and gingival tissue samples after surgery.

  1. 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

  2. [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.

  3. Clinical evaluation in periodontitis patient after curettage

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    Widowati Witjaksono

    2006-09-01

    Full Text Available Curettage is used in periodontics to scrap off the gingival wall of a periodontal pocket, and is needed to reduce loss of attachment (LOA by developing new connective tissue attachment in patients with periodontitis. The purpose of this study was to evaluate the success of curettage by the formation of tissue attachment. This clinical experiment was done by comparing LOA before curettage, 2 weeks and 3 weeks after curettage on 30 teeth with the indication of curettage. Study population were periodontitis patient who attending dental clinic at Hospital University Science Malaysia (HUSM with inclusion criteria good general health condition, 18 to 55 years old male or female and presented with pocket depth > 3mm. The teeth were thoroughly scaling before intervention and evaluated by measuring the periodontal attachment before curettage, two weeks and three weeks after curettage. Repeated measure ANOVA and Paired T Test were used to analyze the data. The result of the study showed that there was reduction in the periodontal attachment loss in periodontitis patient after curettage either in the anterior or posterior teeth which were supported by statistical analysis. This study concluded that curettage could make reattachment of the tissue

  4. Periodontitis and Cognitive Decline in Alzheimer's Disease.

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    Mark Ide

    Full Text Available Periodontitis is common in the elderly and may become more common in Alzheimer's disease because of a reduced ability to take care of oral hygiene as the disease progresses. Elevated antibodies to periodontal bacteria are associated with an increased systemic pro-inflammatory state. Elsewhere raised serum pro-inflammatory cytokines have been associated with an increased rate of cognitive decline in Alzheimer's disease. We hypothesized that periodontitis would be associated with increased dementia severity and a more rapid cognitive decline in Alzheimer's disease. We aimed to determine if periodontitis in Alzheimer's disease is associated with both increased dementia severity and cognitive decline, and an increased systemic pro inflammatory state. In a six month observational cohort study 60 community dwelling participants with mild to moderate Alzheimer's Disease were cognitively assessed and a blood sample taken for systemic inflammatory markers. Dental health was assessed by a dental hygienist, blind to cognitive outcomes. All assessments were repeated at six months. The presence of periodontitis at baseline was not related to baseline cognitive state but was associated with a six fold increase in the rate of cognitive decline as assessed by the ADAS-cog over a six month follow up period. Periodontitis at baseline was associated with a relative increase in the pro-inflammatory state over the six month follow up period. Our data showed that periodontitis is associated with an increase in cognitive decline in Alzheimer's Disease, independent to baseline cognitive state, which may be mediated through effects on systemic inflammation.

  5. 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.

  6. Association between Postmenopausal Osteoporosis and Experimental Periodontitis

    Directory of Open Access Journals (Sweden)

    Kai Luo

    2014-01-01

    Full Text Available To investigate the correlation between postmenopausal osteoporosis (PMO and the pathogenesis of periodontitis, ovariectomized rats were generated and the experimental periodontitis was induced using a silk ligature. The inflammatory factors and bone metabolic markers were measured in the serum and periodontal tissues of ovariectomized rats using an automatic chemistry analyzer, enzyme-linked immunosorbent assays, and immunohistochemistry. The bone mineral density of whole body, pelvis, and spine was analyzed using dual-energy X-ray absorptiometry and image analysis. All data were analyzed using SPSS 13.0 statistical software. It was found that ovariectomy could upregulate the expression of interleukin- (IL-6, the receptor activator of nuclear factor-κB ligand (RANKL, and osteoprotegerin (OPG and downregulate IL-10 expression in periodontal tissues, which resulted in progressive alveolar bone loss in experimental periodontitis. This study indicates that changes of cytokines and bone turnover markers in the periodontal tissues of ovariectomized rats contribute to the damage of periodontal tissues.

  7. Relationship between alexithymia and chronic periodontitis.

    Science.gov (United States)

    Sezer, U; Üstün, K; Şenyurt, S Z; Altınbaş, K; Erciyas, K

    2017-05-01

    The aim of this study was to investigate the potential relationship between alexithymia and chronic periodontitis. A case-control study of 222 male and female subjects aged 21-63 years was conducted. The participants were divided into a chronic periodontitis group (n = 114) and a control group (n = 108) with no history of periodontitis. The Toronto Alexithymia Scale (TAS-20) was used to evaluate alexithymia status of the subjects. Clinical data were collected on parameters such as the plaque index, bleeding on probing, probing depth, and the clinical attachment level (CAL). Socioeconomic data on the patients were also recorded. Chronic periodontitis group showed higher frequency in alexithymic patients as compared to control group. The proportion of high dental anxiety did not differ between the groups. The total TAS-20 score was statistically significantly higher in male subjects than in female subjects (P psychometric measures and the periodontal parameters revealed positive correlations with the severity of periodontal disease/CAL and the total TAS-20 score (P periodontitis. Further research is needed to identify the underlying mechanism.

  8. Vegetarian diet as a risk factor for symptomatic gallstone disease.

    Science.gov (United States)

    McConnell, T J; Appleby, P N; Key, T J

    2017-06-01

    Previous small studies have shown either no difference or a lower risk of symptomatic gallstone disease in vegetarians than in non-vegetarians. This study examined the incidence of symptomatic gallstone disease in a cohort of British vegetarians and non-vegetarians, and investigated the associations between nutrient intake and risk of symptomatic gallstone disease. The data were analysed from 49 652 adults enroled in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study, one-third of whom were vegetarian. The linked databases of hospital records were used to identify incident cases. Risk by diet group was estimated using Cox proportional hazards models. Further analysis quantified risk by intakes of selected macronutrients. There were 1182 cases of symptomatic gallstone disease during 687 822 person-years of follow-up (mean=13.85 years). There was a large significant association between increasing body mass index (BMI) and risk of developing symptomatic gallstone disease (overall trend Pvegetarians had a moderately increased risk compared with non-vegetarians (HR: 1.22; 95% CI: 1.06-1.41; P=0.006). Although starch consumption was positively associated with gallstones risk (P=0.002 for trend), it did not explain the increased risk in vegetarians. There is a highly significant association of increased BMI with risk of symptomatic gallstone disease. After adjusting for BMI, there is a small but statistically significant positive association between vegetarian diet and symptomatic gallstone disease.

  9. FAM5C contributes to aggressive periodontitis.

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    Flavia M Carvalho

    2010-04-01

    Full Text Available Aggressive periodontitis is characterized by a rapid and severe periodontal destruction in young systemically healthy subjects. A greater prevalence is reported in Africans and African descendent groups than in Caucasians and Hispanics. We first fine mapped the interval 1q24.2 to 1q31.3 suggested as containing an aggressive periodontitis locus. Three hundred and eighty-nine subjects from 55 pedigrees were studied. Saliva samples were collected from all subjects, and DNA was extracted. Twenty-one single nucleotide polymorphisms were selected and analyzed by standard polymerase chain reaction using TaqMan chemistry. Non-parametric linkage and transmission distortion analyses were performed. Although linkage results were negative, statistically significant association between two markers, rs1935881 and rs1342913, in the FAM5C gene and aggressive periodontitis (p = 0.03 was found. Haplotype analysis showed an association between aggressive periodontitis and the haplotype A-G (rs1935881-rs1342913; p = 0.009. Sequence analysis of FAM5C coding regions did not disclose any mutations, but two variants in conserved intronic regions of FAM5C, rs57694932 and rs10494634, were found. However, these two variants are not associated with aggressive periodontitis. Secondly, we investigated the pattern of FAM5C expression in aggressive periodontitis lesions and its possible correlations with inflammatory/immunological factors and pathogens commonly associated with periodontal diseases. FAM5C mRNA expression was significantly higher in diseased versus healthy sites, and was found to be correlated to the IL-1beta, IL-17A, IL-4 and RANKL mRNA levels. No correlations were found between FAM5C levels and the presence and load of red complex periodontopathogens or Aggregatibacter actinomycetemcomitans. This study provides evidence that FAM5C contributes to aggressive periodontitis.

  10. Periodontal assessment of postmenopausal women receiving risedronate.

    Science.gov (United States)

    Palomo, Leena; Bissada, Nabil F; Liu, James

    2005-01-01

    The purpose of this study was to compare periodontal status of postmenopausal women with mild to moderate osteoporosis who use risedronate therapy with those who do not. In this cross-sectional study, a total of 60 age-matched postmenopausal women with mild to moderate osteoporosis diagnosed by a bone density scan T score below -2.5 at either spine or hip were divided into two groups. Women in the experimental group had used systemic risedronate once weekly (35 mg) for at least 3 months. Women in the control group had never used bisphosphonate therapy. The periodontal status of each subject was evaluated through a clinical periodontal examination including evaluation of periodontal probing depth, gingival recession, gingival index, plaque score, attachment loss, and alveolar bone level. The significance in differences between the two groups was assessed using two-tailed paired t tests. Significant differences (P periodontal probing depth (2.6 vs 2.9 mm), gingival index (0.37 vs 0.71), plaque score (56.2 vs 77.0), attachment loss (2.8 vs 3.2 mm), and alveolar bone level (3.1 and 4.0), respectively. Gingival recession parameters did not differ significantly. Five of six periodontal parameters evaluated show that postmenopausal women with mild to moderate osteoporosis using risedronate therapy have healthier periodontal status than those who do not use bisphosphonates. Women using risedronate therapy show significantly less plaque accumulation, less gingival inflammation, lower probing depths, less periodontal attachment loss, and greater alveolar bone levels. These observations suggest that risedronate therapy may play a beneficial role in periodontal status.

  11. Periodontal Disease, Tooth Loss, and Cancer Risk.

    Science.gov (United States)

    Michaud, Dominique S; Fu, Zhuxuan; Shi, Jian; Chung, Mei

    2017-01-01

    Periodontal disease, which includes gingivitis and periodontitis, is highly prevalent in adults and disease severity increases with age. The relationship between periodontal disease and oral cancer has been examined for several decades, but there is increasing interest in the link between periodontal disease and overall cancer risk, with systemic inflammation serving as the main focus for biological plausibility. Numerous case-control studies have addressed the role of oral health in head and neck cancer, and several cohort studies have examined associations with other types of cancers over the past decade. For this review, we included studies that were identified from either 11 published reviews on this topic or an updated literature search on PubMed (between 2011 and July 2016). A total of 50 studies from 46 publications were included in this review. Meta-analyses were conducted on cohort and case-control studies separately when at least 4 studies could be included to determine summary estimates of the risk of cancer in relation to 1) periodontal disease or 2) tooth number (a surrogate marker of periodontal disease) with adjustment for smoking. Existing data provide support for a positive association between periodontal disease and risk of oral, lung, and pancreatic cancers; however, additional prospective studies are needed to better inform on the strength of these associations and to determine whether other cancers are associated with periodontal disease. Future studies should include sufficiently large sample sizes, improved measurements for periodontal disease, and thorough adjustment for smoking and other risk factors. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Neutrophil Functions in Periodontal Homeostasis

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    Ricarda Cortés-Vieyra

    2016-01-01

    Full Text Available Oral tissues are constantly exposed to damage from the mechanical effort of eating and to microorganisms, mostly bacteria. In healthy gingiva tissue remodeling and a balance between bacteria and innate immune cells are maintained. However, excess of bacteria biofilm (plaque creates an inflammation state that recruits more immune cells, mainly neutrophils to the gingiva. Neutrophils create a barrier for bacteria to reach inside tissues. When neutrophils are insufficient, bacteria thrive causing more inflammation that has been associated with systemic effects on other conditions such as atherosclerosis, diabetes, and cancer. But paradoxically when neutrophils persist, they can also promote a chronic inflammatory state that leads to periodontitis, a condition that leads to damage of the bone-supporting tissues. In periodontitis, bone loss is a serious complication. How a neutrophil balance is needed for maintaining healthy oral tissues is the focus of this review. We present recent evidence on how alterations in neutrophil number and function can lead to inflammatory bone loss, and how some oral bacteria signal neutrophils to block their antimicrobial functions and promote an inflammatory state. Also, based on this new information, novel therapeutic approaches are discussed.

  13. Reactive oxygen species in periodontitis

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    Parveen Dahiya

    2013-01-01

    Full Text Available Recent epidemiological studies reveal that more than two-third of the world′s population suffers from one of the chronic forms of periodontal disease. The primary etiological agent of this inflammatory disease is a polymicrobial complex, predominantly Gram negative anaerobic or facultative bacteria within the sub-gingival biofilm. These bacterial species initiate the production of various cytokines such as interleukin-8 and TNF-α, further causing an increase in number and activity of polymorphonucleocytes (PMN along with these cytokines, PMNs also produce reactive oxygen species (ROS superoxide via the respiratory burst mechanism as the part of the defence response to infection. ROS just like the interleukins have deleterious effects on tissue cells when produced in excess. To counter the harmful effects of ROS, human body has its own defence mechanisms to eliminate them as soon as they are formed. The aim of this review is to focus on the role of different free radicals, ROS, and antioxidants in the pathophysiology of periodontal tissue destruction.

  14. Comparison of salivary calcium level in smokers and non-smokers with chronic periodontitis, aggressive periodontitis, and healthy controls.

    Science.gov (United States)

    Kambalyal, Preeti; Kambalyal, Prabhuraj; Hungund, Shital

    2015-12-01

    The purpose of this study was to compare salivary calcium (Ca) level in smokers and non-smokers with chronic periodontitis, aggressive periodontitis, and healthy controls. 56 subjects were included in the study and were grouped as follows: 12 subjects who were periodontally healthy (Group I), 12 subjects having chronic periodontitis who were non-smokers (Group II), 12 non-smokers having aggressive periodontitis (Group III), 12 smokers with chronic periodontitis (Group IV), and 8 smokers with aggressive periodontitis (Group V). Clinical measurements and non-stimulated whole saliva samples were obtained and analyzed for Ca levels by ion-selective electrolyte analyzer. When salivary Ca values were compared between the groups, they showed statistically significant values (P periodontitis and smokers with aggressive periodontitis, respectively, than in other groups. Between groups II and III also, the mean salivary Ca level was statistically significant (P periodontitis than in non-smokers having aggressive periodontitis. The present study showed that smokers having chronic periodontitis as well as smokers having aggressive periodontitis have higher salivary calcium levels. Also, patients with aggressive periodontitis were found to have lesser salivary calcium level than chronic periodontitis patients by ion-selective electrolyte analyzer.

  15. Pediatric intracerebral hemorrhage: acute symptomatic seizures and epilepsy.

    Science.gov (United States)

    Beslow, Lauren A; Abend, Nicholas S; Gindville, Melissa C; Bastian, Rachel A; Licht, Daniel J; Smith, Sabrina E; Hillis, Argye E; Ichord, Rebecca N; Jordan, Lori C

    2013-04-01

    Seizures are believed to be common presenting symptoms in neonates and children with spontaneous intracerebral hemorrhage (ICH). However, few data are available on the epidemiology of acute symptomatic seizures or the risk for later epilepsy. To define the incidence of and explore risk factors for seizures and epilepsy in children with spontaneous ICH. Our a priori hypotheses were that younger age at presentation, cortical involvement of ICH, acute symptomatic seizures after presentation, ICH due to vascular malformation, and elevated intracranial pressure requiring urgent intervention would predict remote symptomatic seizures and epilepsy. Prospective cohort study conducted between March 1, 2007, and January 1, 2012. Three tertiary care pediatric hospitals. Seventy-three pediatric subjects with spontaneous ICH including 20 perinatal (≥37 weeks' gestation to 28 days) and 53 childhood subjects (>28 days to Acute symptomatic seizures (clinically evident and electrographic-only seizures within 7 days), remote symptomatic seizures, and epilepsy. Acute symptomatic seizures occurred in 35 subjects (48%). Acute symptomatic seizures as a presenting symptom of ICH occurred in 12 perinatal (60%) and 19 childhood (36%) subjects (P = .07). Acute symptomatic seizures after presentation occurred in 7 children. Electrographic-only seizures were present in 9 of 32 subjects (28%) with continuous electroencephalogram monitoring. One-year and 2-year remote symptomatic seizure-free survival rates were 82% (95% CI, 68-90) and 67% (95% CI, 46-82), respectively. One-year and 2-year epilepsy-free survival rates were 96% (95% CI, 83-99) and 87% (95% CI, 65-95), respectively. Elevated intracranial pressure requiring acute intervention was a risk factor for seizures after presentation (P = .01; Fisher exact test), remote symptomatic seizures, and epilepsy (P = .03, and P = .04, respectively; log-rank test). Presenting seizures are common in perinatal and childhood ICH. Continuous

  16. Regenerative therapy: a periodontal-endodontic perspective.

    Science.gov (United States)

    Kinaia, Bassam Michael; Chogle, Sami M A; Kinaia, Atheel M; Goodis, Harold E

    2012-07-01

    Periodontal and endodontic diseases are inflammatory responses leading to periodontal and pulpal tissue loss. Regenerative therapies aim to restore the lost structures to vitality and function. Various materials and treatments methods have been used such as bone grafts, guided tissue regeneration, enamel matrix derivatives, growth and differentiation factors, and stem cells. Although the current materials and methods demonstrated adequate clinical results, true and complete biological tissue regeneration is not yet attainable. The current article reviews chronologically the materials and methods used in periodontal and endodontic regeneration highlighting their clinical success and shortcomings, and discussing future directions in regenerative therapy. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Smoking and periodontal tissues: a review.

    Science.gov (United States)

    César Neto, João Batista; Rosa, Ecinele Francisca; Pannuti, Cláudio Mendes; Romito, Giuseppe Alexandre

    2012-01-01

    The impact of smoking on general health has been widely studied and is directly related to several important medical problems including cancer, low birth weight, and pulmonary and cardiovascular disease. In the past 25 years, there has also been an increasing awareness of the role of cigarette consumption in oral health problems such as periodontal disease. Smoking is considered the major risk factor in the prevalence, extent and severity of periodontal diseases. This article will discuss the available evidence and provide the reader with an overview of the impact of smoking and its cessation on the pathogenesis and treatment of periodontal diseases.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    Amita Coutinho

    2012-01-01

    Conclusion: Subgingival irrigation with propolis extract as an adjuvant to periodontal treatment was more effective than scaling and root planing as assessed by clinical and microbiological parameters.

  20. 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.

  1. 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

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

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    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. Combined periodontal and implant treatment of a case of aggressive periodontitis.

    Science.gov (United States)

    Hoffmann, Oliver; Beaumont, Christian; Zafiropoulos, Gregor-Georg

    2007-01-01

    Aggressive periodontitis renders a great challenge to clinicians with regards to treatment and prosthodontic rehabilitation. A compromised remaining dentition and a tendency toward refractory disease make it difficult to establish a treatment plan that renders an adequate long-term prognosis. Although the use of implants has become a common treatment modality, limited data are available on the use of dental implants in patients with aggressive periodontitis, especially for cases necessitating the use grafting procedures preceding implant placement. In this case report the successful treatment of a patient with aggressive periodontitis by the combined use of periodontal and implant treatment necessitating preceding augmentive procedures is described.

  4. Periodontal inflamed surface area as a novel numerical variable describing periodontal conditions

    Science.gov (United States)

    2017-01-01

    Purpose A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes. Methods This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study. Results PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; Pperiodontal indexes, such as BOP and the plaque index (PI) (r=0.94; Pperiodontal classification, PI, bleeding index, and smoking, but not in the multivariate analysis. In the multivariate linear regression analysis, PISA values were positively correlated with the quantity of current smoking, PI, and severity of periodontal disease. Conclusions PISA integrates multiple periodontal indexes, such as probing pocket depth, BOP, and PI into a numerical variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation. PMID:29093989

  5. 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

  6. Relationship between inferior wall of maxillary sinus and maxillary posterior teeth using cone-beam computed tomography in healthy and chronic periodontitis patients

    Directory of Open Access Journals (Sweden)

    Alkananda Chand

    2017-01-01

    Full Text Available Background: For dental implant planning in maxillary posterior region, it is essential to know their relationship with maxillary sinus. Maxillary posterior teeth affected by chronic periodontitis usually have a poor prognosis, ultimately leading to tooth loss. Following tooth loss, significant bone resorption occurs resulting in compromised remaining bone support for dental implant placement. Aim: The study aims to determine the relationship between inferior wall of maxillary sinus and the root apices of maxillary posterior teeth. Materials and Methods: The study sample consisted of cone-beam computed tomography images of 150 patients. Vertical distance between inferior wall of maxillary sinus and root apices and furcation area of maxillary posterior teeth as well as crest of the edentulous ridge were measured in periodontally healthy individuals (Group 1, chronic periodontitis patients (Group 2, and in patients with edentulous maxillary posterior region (Group 3. The data were analyzed using one-way analysis of variance and Tukey's test to compare mean distances between groups and molars. Results: There was a significant difference in mean distances between Group 1 (3.067 ± 1.600, Group 2 (1.602 ± 0.536 and Group 3 (1.279 ± 0.476 (P = 0.00001 and between mean distances of four sites (7.101, 0.932, 0.903, and 0.402 mm (P ≤ 0.05. There was no significant difference in mean distances between the first and second molars (2.1469; 2.0996 (P = 0.787. Conclusion: For planning of dental implant placement in maxillary posterior region, the clinician should consider the vertical relationship between maxillary sinus floor and root apices of maxillary molars.

  7. Placental histopathology lesions and pregnancy outcome in pregnancies complicated with symptomatic vs. non-symptomatic placenta previa.

    Science.gov (United States)

    Weiner, Eran; Miremberg, Hadas; Grinstein, Ehud; Schreiber, Letizia; Ginath, Shimon; Bar, Jacob; Kovo, Michal

    2016-10-01

    The mechanisms involved in bleeding in cases of placenta previa (PP) and the effect on pregnancy outcome is unclear. We aimed to compare pregnancy outcome and placental histopathology in pregnancies complicated with symptomatic (bleeding) vs. non-symptomatic PP, and to study the effects of the co-existence of histopathological retro-placental hemorrhage (RPH) in cases of symptomatic PP on neonatal and maternal outcomes. Labor and maternal characteristics, neonatal outcome and placental histopathology lesions of pregnancies with PP, delivered between 24 and 42weeks, during 2009-2015, were reviewed. Results were compared between PP who had elective cesarean delivery (CD) (previa group) and PP with bleeding necessitating emergent CD (symptomatic previa group). Placental lesions were classified to lesions consistent with maternal malperfusion or fetal thrombo-occlusive disease (vascular and villous changes), and inflammatory lesions. Compared to the previa group (n=63), the symptomatic previa group (n=74) was characterized by older patients (pPlacentas within the symptomatic previa group were smaller, with higher rates of weightplacenta previa is associated with increased placental malperfusion lesions suggesting an association of maternal malperfusion with abnormal placental separation. The coexisting finding of RPH with symptomatic placenta previa can be seen as a marker for more extensive/severe placental separation, hence the association with maternal transfusion requirements and poorer fetal outcome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Influence of Different Apical Preparations on Root Canal Cleanliness in Human Molars: a SEM Study.

    Science.gov (United States)

    Plotino, Gianluca; Grande, Nicola M; Tocci, Luigi; Testarelli, Luca; Gambarini, Gianluca

    2014-04-01

    To compare the influence of type and dimensions of the apical preparation on the cleanliness of the apical area in molars. A total of 120 root canals (MB and DB root canals from 30 maxillary molars and mesial root canals from 30 mandibular molars) were instrumented with Mtwo NiTi rotary instruments to a size 25/0.06 taper and were equally divided into three different experimental groups depending on the subsequently apical root canal preparation: Group 1: no further apical preparation, Group 2: apical preparation with Mtwo files to a size 40/0.04 taper, Group 3: apical preparation with Mtwo Apical Files. All root canals were observed through scanning electron microscopy (SEM). Presence of superficial debris and smear layer was evaluated using a score system. Data were statistically analysed using the Kruskal-Wallis and Bonferroni tests with a level of significance set at P 0.05), while at the apical level, there was a significant difference for both residual debris and presence of smear layer between Group 1 and both Group 2 (P = 0.003 and P = 0.014) and 3 (P = 0.012 and P = 0.021), while no difference was present between Group 2 and Group 3 (P = 0.871 and P = 0.923). Cleanliness of the apical third in terms of debris and smear layer was statistically better when an apical preparation was performed to a size 40/0.04 taper or with the use of the Mtwo Apical Files.

  9. Influence of Different Apical Preparations on Root Canal Cleanliness in Human Molars: a SEM Study

    Directory of Open Access Journals (Sweden)

    Gianluca Plotino

    2014-07-01

    Full Text Available Objectives: To compare the influence of type and dimensions of the apical preparation on the cleanliness of the apical area in molars. Material and Methods: A total of 120 root canals (MB and DB root canals from 30 maxillary molars and mesial root canals from 30 mandibular molars were instrumented with Mtwo NiTi rotary instruments to a size 25/0.06 taper and were equally divided into three different experimental groups depending on the subsequently apical root canal preparation: Group 1: no further apical preparation, Group 2: apical preparation with Mtwo files to a size 40/0.04 taper, Group 3: apical preparation with Mtwo Apical Files. All root canals were observed through scanning electron microscopy (SEM. Presence of superficial debris and smear layer was evaluated using a score system. Data were statistically analysed using the Kruskal-Wallis and Bonferroni tests with a level of significance set at P 0.05, while at the apical level, there was a significant difference for both residual debris and presence of smear layer between Group 1 and both Group 2 (P = 0.003 and P = 0.014 and 3 (P = 0.012 and P = 0.021, while no difference was present between Group 2 and Group 3 (P = 0.871 and P = 0.923. Conclusions: Cleanliness of the apical third in terms of debris and smear layer was statistically better when an apical preparation was performed to a size 40/0.04 taper or with the use of the Mtwo Apical Files.

  10. 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

  11. 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.

  12. 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.

  13. Bone Density and Dental External Apical Root Resorption.

    Science.gov (United States)

    Iglesias-Linares, Alejandro; Morford, Lorri Ann; Hartsfield, James Kennedy

    2016-12-01

    When orthodontic patients desire shorter treatment times with aesthetic results and long-term stability, it is important for the orthodontist to understand the potential limitations and problems that may arise during standard and/or technology-assisted accelerated treatment. Bone density plays an important role in facilitating orthodontic tooth movement (OTM), such that reductions in bone density can significantly increase movement velocity. Lifestyle, genetic background, environmental factors, and disease status all can influence a patients' overall health and bone density. In some individuals, these factors may create specific conditions that influence systemic-wide bone metabolism. Both genetic variation and the onset of a bone-related disease can influence systemic bone density and local bone density, such as observed in the mandible and maxilla. These types of localized density changes can affect the rate of OTM and may also influence the risk of unwanted outcomes, i.e., the occurrence of dental external apical root resorption (EARR).

  14. Serious arrhythmias in patients with apical hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Okishige, Kaoru; Sasano, Tetsuo; Yano, Kei; Azegami, Kouji; Suzuki, Kou; Itoh, Kuniyasu [Yokohama Red Cross Hospital (Japan)

    2001-05-01

    We report cases of serious arrhythmias associated with apical hypertrophic cardiomyopathy (AHCM). Thirty-one patients were referred to our institute to undergo further assessment of their AHCM from 1988 to 1999. Three patients with nonsustained ventricular tachycardia demonstrated an {sup 123}I-MIBG regional reduction in the tracer uptake. In two patients with ventricular fibrillation (VF), the findings from {sup 123}I-MIBG imaging revealed regional sympathetic denervation in the inferior and lateral regions. Electrophysiologic study demonstrated reproducible induction of VF in aborted sudden death and presyncopal patients, resulting in the need for an implantable defibrillator device and amiodarone in each patient. Patients with refractory atrial fibrillation with a rapid ventricular response suffered from serious congestive heart failure. A prudent assessment and strategy in patients with this disease would be indispensable in avoiding a disastrous outcome. (author)

  15. Geometry of shoot apical dome and distribution of growth rates

    Directory of Open Access Journals (Sweden)

    Jerzy Nakielski

    2014-01-01

    Full Text Available The distribution of the relative elementary rate of growth (RERG in apical domes of various shapes and patterns of displacement lines can be analytically examined. The geometry of these domes may be described by parabolas of n-th order, the variant of the distribution of linear growth rate should be established along any displacement line (e.g. along the axis and then the RERG can be studied as the function depending on the position coordinates and the parameter n. Such investigations of several aplical domes of various shapes have been performed. The results confirm the occurrence of the minimum of relative, elementary growth rate (in volume in the subapical region of the dome independently of the type of geometry (n parabola order.

  16. Analysis of clinical manifestations of symptomatic acquired jejunoileal diverticular disease

    OpenAIRE

    Liu, Chia-Yuan; Chang, Wen-Hsiung; Lin, Shee-Chan; Chu, Cheng-Hsin; Wang, Tsang-En; Shih, Shou-Chuan

    2005-01-01

    AIM: To analyze systematically our experience over 22 years with symptomatic acquired diverticular disease of the jejunum and ileum, exploring the clinical manifestations and diagnosis of this rare but life-threatening disease.

  17. Surgical aspects of symptomatic cholecystolithiasis and acute cholecystitis

    NARCIS (Netherlands)

    Keus, F.; Broeders, I. A. M. J.; van Laarhoven, C. J. H. M.

    2006-01-01

    Indications for cholecystectomy are limited to clearly symptomatic gallstones. Relatively high failure rates of pain relief are probably caused by incorrect selection of patients for the operation. Contraindications for (laparoscopic) cholecystectomy are related to anaesthesiological considerations.

  18. ACUTE NEUROINFECTIONS AND SYMPTOMATIC EPILEPSY IN CHILDREN: CAUSAL RELATIONSHIP (review

    Directory of Open Access Journals (Sweden)

    E. Yu. Gorelik

    2017-01-01

    Full Text Available Convulsions in case of acute neuroinfections can both complicate the disease course and transfer to symptomatic epilepsy which is one of the most important medical and social problems. The review article presents the data on epidemiology of convulsive disorder and symptomatic epilepsy in case of neuroinfections in children. There are considered the current immune and biochemical aspects of epileptogenesis in case of infectious pathology. There is given the information on neurophysiological and radial features of symptomatic epilepsy developed in case of neuroinfections of different etiology. There is underlined the practical significance of timely complex etio-pathogenetic therapy for neuroinfections complicated by convulsion that allows to reduce the frequency of symptomatic epilepsy development. There are presented the data on the results of transcranial magnetic stimulation in case of refractory epilepsy.

  19. A challenge with Porphyromonas gingivalis differentially affects the osteoclastogenesis potential of periodontal ligament fibroblasts from periodontitis patients and non-periodontitis donors

    NARCIS (Netherlands)

    Sokos, D.; Scheres, N.; Schoenmaker, T.; Everts, V.; de Vries, T.J.

    2014-01-01

    Aim Porphyromonas gingivalis (Pg) may cause an immune-inflammatory response in host cells leading to bone degradation by osteoclasts. We investigated the osteoclast-inducing capacity of periodontal ligament fibroblasts from periodontitis patients and non-periodontitis donors after a challenge with

  20. Renal alterations in prediabetic rats with periodontitis

    DEFF Research Database (Denmark)

    Andersen, Carla Cruvinel Pontes; Holmstrup, Palle; Buschard, Karsten

    2008-01-01

    BACKGROUND: Periodontitis was shown to have an impact on glucose levels in prediabetic and diabetic rats. The Zucker fatty rat (ZFR) is a well-characterized model of prediabetes presenting with impaired glucose tolerance, hyperinsulinemia, dyslipidemia, and moderate hypertension. The aim...... of the present study was to investigate whether periodontitis influences kidney changes in ZFRs. METHODS: Male adult ZFRs (N = 19) and their lean littermates (N = 18) were studied. Periodontitis was induced with ligatures in half of the ZFRs and lean rats, whereas the other half served as controls. After 4 weeks...... IValpha1, fibronectin, and nephrin. Urinary albumin excretion and creatinine clearance were also evaluated. RESULTS: In prediabetic ZFRs, periodontitis was associated with kidney hypertrophy (P = 0.03) and a tendency for increased glomerular volume (P = 0.06). In lean littermates, elevated fibronectin m...