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International Dental Journal Apr 2011Indices are important tools to measure, quantify and treat periodontitis both in epidemiological and clinical situations and are based on the prevailing understanding of... (Review)
Review
Indices are important tools to measure, quantify and treat periodontitis both in epidemiological and clinical situations and are based on the prevailing understanding of the pathogenesis of periodontal disease. However, there is dearth of literature on collective information of periodontal indices formulated to date. This article collectively describes the evolution and the present concept of formulation of periodontal indices based on the multi-factorial nature of periodontal disease and also provides some direction for future periodontal indices. Periodontal indices have evolved from the simple Russell's index to the current usage of measurement of clinical attachment level in the recording of indices. The use of dichotomous measurements and the Genetic Susceptibility Index are the new additions to the periodontal indices. Nevertheless, an ideal would be an index that will keep pace with the ever changing concept of the pathogenesis of periodontal disease.
Topics: Humans; Periodontal Index; Periodontitis; Severity of Illness Index
PubMed: 21554276
DOI: 10.1111/j.1875-595X.2011.00018.x -
Clinical Oral Investigations Apr 2023Periodontal disease and diabetes have an extensively investigated bidirectional correlation. Non-surgical periodontal treatment (NSPT) was proven to contribute to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Periodontal disease and diabetes have an extensively investigated bidirectional correlation. Non-surgical periodontal treatment (NSPT) was proven to contribute to glycemic control. Moreover, it may benefit from the association of adjunctive therapies. The aim of the present systematic review is to assess the clinical efficacy of NSPT in association with laser (LT) or photodynamic therapy (PDT) in controlled or uncontrolled diabetic patients, and to grade the level of evidence.
MATERIALS AND METHODS
Randomized controlled clinical trials with at least 3-month follow-up were searched in MEDLINE via OVID, EMBASE, and Cochrane Central, screened for inclusion, and grouped based on the performed treatments, follow-up time, type of diabetes, and level of glycemic control.
RESULTS
Eleven RCTs with 504 total subjects were included. The adjunct of PDT showed a statistically significant 6-month difference in PD changes (with low certainty of evidence), but not in CAL changes, while a significant difference in 3-month PD and CAL changes was found with the adjunct of LT (low certainty of evidence). Patients treated with PDT registered a higher decrease in HbA1c levels at 3 months, but no significant difference was noted at 6 months; LT also led to better HbA1c changes at 3 months with a moderate certainty of evidence.
CONCLUSION
Despite the promising short-term HbA1c decrease, the results should be interpreted with caution due to the small effect sizes and the statistical heterogeneity, and further evidence from well-designed RCTs is needed to support the routine use of PDT or LT in adjunct to NSPT.
Topics: Humans; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Periodontitis; Periodontal Diseases; Photochemotherapy; Chronic Periodontitis; Dental Scaling
PubMed: 36849595
DOI: 10.1007/s00784-023-04873-y -
The Bulletin of Tokyo Dental College Dec 2019Interleukin (IL)-33 is a dual-function protein that may play important roles as both a cytokine and intracellular nuclear factor. It may also function similarly to...
Correlations between Interleukin-33 and -1α Levels in Gingival Crevicular Fluid and Plasma in Patients with Chronic or Aggressive Periodontitis and Disease-free Subjects.
Interleukin (IL)-33 is a dual-function protein that may play important roles as both a cytokine and intracellular nuclear factor. It may also function similarly to prototypical alarmin IL-1α, as an endogenous danger signal to alert innate immune system cells to tissue damage during trauma or infection, as it can be released in the extracellular space after endothelial cell damage or mechanical injury. The aim of this study was to determine possible correlations between concentrations of IL-33 and IL-1α in gingival crevicular fluid (GCF) and plasma obtained from healthy patients, those with chronic periodontitis (CP), and those with generalized aggressive periodontitis (GAP) patients. Forty-five patients with an age range of 20-60 years were enrolled and divided into 3 groups: Group H, 30 samples (15 GCF and 15 plasma) from 15 patients with healthy periodontium; Group CP, 30 samples from 15 patients with CP; and Group GAP, 30 samples from 15 patients with GAP. The clinical periodontal parameters investigated in all groups comprised the gingival index score, probing pocket depth, and clinical attachment level. The GCF and plasma levels of IL-33 and IL-1α were quantitated using enzyme linked immunosorbent assay. The mean IL-33 concentrations in GCF and plasma were highest in Group GAP, followed by Group CP, with the lowest in Group H; the difference among them was statistically significant (p<0.05). Concentration of IL-1α followed the same trend as that of IL-33 in GCF, but was lower than detection levels in plasma. The GCF and plasma concentrations of IL-33 correlated with IL-1α concentrations in GCF. Concentrations of IL-33 and IL-1α in GCF varied significantly between healthy patients and those with disease, allowing healthy patients to be distinguished from those with GAP or CP. The results of this study suggest that IL-33 offers a potential inflammatory marker of periodontal disease, similar to IL-1α.
Topics: Adult; Aggressive Periodontitis; Chronic Periodontitis; Gingival Crevicular Fluid; Humans; Interleukin-33; Middle Aged; Periodontal Index; Young Adult
PubMed: 31761881
DOI: 10.2209/tdcpublication.2019-0002 -
Disease Markers 2022This study aimed to investigate and analyse the clinical efficacy and safety of periocline-assisted periodontal foundation in the therapy of chronic periodontitis. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study aimed to investigate and analyse the clinical efficacy and safety of periocline-assisted periodontal foundation in the therapy of chronic periodontitis.
METHODS
From May 2018 to January 2021, 108 patients with chronic periodontitis were treated at our institution and randomly assigned equally to either the control or the experimental group. The plaque index (PLI), sulcus bleeding index (SBI), probing depth (PD), and periodontal attachment level (AI) were evaluated before and after periodontal basic therapy in the control group and periocline as an adjunct in the experimental group. Lactobacillus (LB) and (PG) concentrations in saliva were measured before and after therapy, and adverse responses during treatment were noted.
RESULTS
The levels of PLI, SBI, PD, and AI in the two groups were significantly lower in both groups at 1 and 3 months posttreatment compared to baseline; the levels of PLI and SBI were higher, and the levels of PD and AI were lower at 3 months after treatment compared to 1 month after treatment; compared with the control group at 1 month and 3 months after treatment, the levels of PLI, SBI, PD, and AI in the experimental group were lower than those in the control group ( < 0.05). The LB level was higher and the PG level was lower in both groups compared to baseline at 1 and 3 months posttreatment. The LB level was higher and the PG level was lower at 3 months posttreatment compared to 1 month after treatment. Compared with the control group at 1 month and 3 months after treatment, the LB level was higher, and the PG level was lower in the experimental group ( < 0.05). No significant adverse effects were observed in either group during the treatment period. Only 1 patient in the experimental group had mild gastrointestinal reactions, mainly nausea, without obvious neurological symptoms or abnormal blood changes, which did not affect the treatment.
CONCLUSION
Periodontal fundamental therapy with perioclines may be a potential treatment for persistent periodontitis. It improves the primary clinical indicators, increases dysbacteriosis control, and has a strong safety profile. It could effectively control the development of clinical symptoms of periodontitis and reduce tissue destruction, with obvious clinical treatment effects. It could be used as the first choice for topical treatment of chronic periodontitis. It is recommended for further study by a wide range of researchers.
Topics: Chronic Periodontitis; Humans; Periodontal Attachment Loss; Periodontal Index; Saliva; Treatment Outcome
PubMed: 36133438
DOI: 10.1155/2022/4601259 -
International Journal of Environmental... Dec 2020This study investigated the association between periodontitis and the risk of pharyngeal cancer in Taiwan. For this population-based nested case-control study using the...
This study investigated the association between periodontitis and the risk of pharyngeal cancer in Taiwan. For this population-based nested case-control study using the Longitudinal Health Insurance Database derived from Taiwan's National Health Insurance Research Database, we identified patients ( = 1292) who were newly diagnosed with pharyngeal cancer between 2005 and 2013 and exactly paired them with propensity score matched control subjects ( = 2584). Periodontitis and scaling and root planing (SRP) were identified before the index date. Pharyngeal cancer was subdivided into 3 subgroups on the basis of anatomic location: nasopharyngeal cancer, oropharyngeal cancer, and hypopharyngeal cancer. A multiple conditional logistic regression model was applied to analyze the adjusted odds ratio (aOR). Periodontitis was associated with an increased risk of pharyngeal cancer (aOR, 1.57; 95% confidence interval (CI), 1.17 to 2.10), especially oropharyngeal cancer (aOR, 2.22; 95% CI, 1.07 to 4.60). We found a decreased risk of pharyngeal cancer in patients who had undergone SRP (aOR, 0.77; 95% CI, 0.61 to 0.96). In conclusion, this study showed that periodontitis was associated with an increased risk of pharyngeal cancer and SRP exerted a protective effect against pharyngeal cancer. Our results suggest that treating periodontitis and performing SRP, which are modifiable factors in oral health, in clinical practice may provide an opportunity to decrease the disease burden of pharyngeal cancer in Taiwan.
Topics: Adult; Aged; Aged, 80 and over; Case-Control Studies; Dental Scaling; Female; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Periodontitis; Risk Factors; Root Planing; Taiwan
PubMed: 33375028
DOI: 10.3390/ijerph18010008 -
BMC Oral Health May 2023This study aimed to evaluate the impact of dietary supplementation with omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid... (Randomized Controlled Trial)
Randomized Controlled Trial
Clinical and microbiological outcomes of subgingival instrumentation supplemented with high-dose omega-3 polyunsaturated fatty acids in periodontal treatment - a randomized clinical trial.
PURPOSE
This study aimed to evaluate the impact of dietary supplementation with omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined with scaling and root planing (SRP) in untreated periodontitis stage III and IV.
METHODS
Forty patients were randomly assigned to the test group receiving SRP plus omega-3 PUFAs (n = 20) or control group receiving SRP alone (n = 20). Clinical changes of pocket probing depths (PD), clinical attachment level (CAL), bleeding on probing (BOP) and rates of closed pockets (PPD ≤ 4 mm without BOP) were evaluated at baseline and after 3 and 6 months. Phorphyromonas gingivalis, Tanarella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans counts were analysed at baseline and at 6 months. Serum was subjected to lipid gas chromatography/mass spectrometry analysis at baseline and at 6 months.
RESULTS
Significant improvement of all clinical parameters at 3 and 6 months was observed in both groups. For the primary outcome "change of mean PD," no significant difference was detected between the groups. Patients treated with omega-3 PUFAs demonstrated significantly lower rates of BOP, higher gain of CAL and higher number of closed pockets at 3 months in comparison to the control group. After 6 months, no clinical differences between the groups were found, with the exception of lower BOP rates. Moreover, in the test group, the number of key periodontal bacteria was significantly lower than in the control group at 6 months. Increased proportions of serum n-3 PUFAs and decreased proportions of n-6 PUFAs were detected at 6 months in the patients from the test group.
CONCLUSION
High-dose omega-3 PUFA intake during non-surgical treatment of periodontitis results in short-term clinical and microbiological benefits. The study protocol was approved by the ethical committee of Medical University of Lodz (reference number RNN/251/17/KE) and registered at clinicaltrials.gov (NCT04477395) on 20/07/2020.
Topics: Humans; Chronic Periodontitis; Periodontal Pocket; Root Planing; Dental Scaling; Fatty Acids, Unsaturated; Dietary Supplements; Treatment Outcome; Follow-Up Studies; Periodontal Attachment Loss
PubMed: 37179297
DOI: 10.1186/s12903-023-03018-7 -
Journal of the American Dental... Feb 2019In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States.
BACKGROUND
In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States.
METHODS
The authors used geospatial analysis to describe the distribution of periodontists and adults, periodontists vis-à-vis estimated density of adults with severe periodontitis, and their ratios to adults with severe periodontitis. The authors identified locations of 5,415 practicing periodontists through the 2014 National Provider Identifier Registry, linked them with the weighted census number of adults, and estimated the number of adults within a series of circular distance zones.
RESULTS
Approximately 60% of adults 30 through 79 years lived within 5 miles of a periodontist, 73% within 10 miles, 85% within 20 miles, and 97% within 50 miles. Proximity to a periodontist varied widely. In urban areas, 95% of adults resided within 10 miles of a periodontist and 100% within 20 miles. Only 24% of adults in rural areas lived within 10 miles of a periodontist. Most periodontists (96.1%) practiced in urban areas, clustering along the eastern and western coasts and in the Midwest, 3.1% in urban clusters elsewhere, and 0.8% in rural areas. Ratios of fewer than 8,000 adults with periodontitis to 1 or more periodontists within 10 miles were clustered mostly in the Northeast, central East Coast, Florida, West Coast, Arizona, and Midwest.
CONCLUSIONS
In this study, the authors identified wide variations in geographic proximity to a practicing periodontist for adults with severe periodontitis.
PRACTICAL IMPLICATIONS
Dental practitioners may provide preventive care and counseling for periodontitis and referrals for specialty care. Geographic proximity to specialized periodontal care may vary widely by locality.
Topics: Adult; Counseling; Dentists; Humans; Periodontics; Periodontitis; Referral and Consultation; United States
PubMed: 30470389
DOI: 10.1016/j.adaj.2018.09.021 -
Dental Clinics of North America Oct 2015Although scaling and root planing is a cost-effective approach for initial treatment of chronic periodontitis, it fails to eliminate subgingival pathogens and halt... (Review)
Review
Although scaling and root planing is a cost-effective approach for initial treatment of chronic periodontitis, it fails to eliminate subgingival pathogens and halt progressive attachment loss in some patients. Adjunctive use of systemic antibiotics immediately after completion of scaling and root planing can enhance the degree of clinical attachment gain and probing depth reduction provided by nonsurgical periodontal treatment. This article discusses the rationale for prescribing adjunctive antibiotics, reviews the evidence for their effectiveness, and outlines practical issues that should be considered before prescribing antibiotics to treat chronic periodontitis.
Topics: Anti-Bacterial Agents; Biofilms; Chronic Periodontitis; Humans; Root Planing
PubMed: 26427574
DOI: 10.1016/j.cden.2015.06.011 -
Australian Dental Journal Jun 2008Periodontitis is an inflammatory disease which manifests clinically as loss of supporting periodontal tissues including periodontal ligament and alveolar bone. For... (Review)
Review
Periodontitis is an inflammatory disease which manifests clinically as loss of supporting periodontal tissues including periodontal ligament and alveolar bone. For decades periodontists have sought ways to repair the damage which occurs during periodontitis. This has included the use of a range of surgical procedures, the use of a variety of grafting materials and growth factors, and the use of barrier membranes. To date periodontal regeneration is considered to be biologically possible but clinically unpredictable. Recently, reports have begun to emerge demonstrating that populations of adult stem cells reside in the periodontal ligament of humans and other animals. This opens the way for new cell-based therapies for periodontal regeneration. For this to become a reality a thorough understanding of adult human stem cells is needed. This review provides an overview of adult human stem cells and their potential use in periodontal regeneration.
Topics: Adult Stem Cells; Guided Tissue Regeneration, Periodontal; Humans; Periodontitis; Periodontium; Regeneration; Tissue Engineering
PubMed: 18494965
DOI: 10.1111/j.1834-7819.2008.00019.x -
European Review For Medical and... Mar 2022Periodontitis is a chronic inflammatory disease caused by microbial dental plaque which leads to the destruction and loss of supporting tissues of the tooth. Microbial...
OBJECTIVE
Periodontitis is a chronic inflammatory disease caused by microbial dental plaque which leads to the destruction and loss of supporting tissues of the tooth. Microbial plaque alone, however, is not enough to cause the disease. The body's response plays an important role, in which an imbalance between the pro-inflammatory and anti-inflammatory effects of cytokines leads to an inflammatory reaction.
PATIENTS AND METHODS
We detected changes in mRNA expression and protein levels of MIP-1α, and metalloproteinases (MMP-2, MMP-9) contributing to cascades in the initiation and progression of inflammatory bone resorption and destruction of periodontal soft tissues in patients with aggressive (AP) or chronic (CP) forms of periodontitis in comparison with healthy individuals (control).
RESULTS
MIP-1α mRNA levels were highest in AP (280 ± 23% higher than the control) also in comparison with CP. The difference in protein level was less pronounced. MMP-2 mRNA expression values were similar (300 ± 12% higher in comparison with control), but protein levels were lower, also when compared to CP. Only in CP MMP-9 mRNA levels were significantly higher than the control (30 ± 8%), while protein levels were again higher in AP. Both AP and CP showed a positive correlation between the level of MIP-1a and MMP-2 (0.879, and 0.954 respectively). However, a strong positive correlation was only found between the levels of MMP-2 and MMP-9 in CP (0.812).
CONCLUSIONS
MIP-1α, MMP-2 and MMP-9 mRNA expression, along with the concentration of proteins in saliva in patients with periodontal disease, is higher than in healthy individuals and correlates with the severity of the disease.
Topics: Gingival Crevicular Fluid; Humans; Periodontal Index; Periodontitis; Periodontium; Saliva
PubMed: 35363329
DOI: 10.26355/eurrev_202203_28326