Anti-Cyclic Citrullinated Peptide Antibody and Periodontal Status in Rheumatoid Arthritis Patients

Objectives: Studies have shown that periodontal disease and Rheumatoid Arthritis [RA] shared similar pathogenesis. Anti-Cyclic Citrullinated Peptide anibodies [anti-CCP] has recently been used for diagnosis of RA. Thus, this study aimed to assess the levels of anti-CCP antibodies and periodontal status in RA patients

Methods: Forty four RA patients were included in this study. The blood samples were analysed for anti-CCP levels. Plaque Score [PS], Gingivitis Score [GS], Probing Pocket Depth [PPD] and Clinical Attachment Loss [CAL] were recorded for assessment of periodontal status. Relevant clinical information was obtained from medical records

Results: Mean anti-CCP level was 180.8 +/- 290.3 Unit/ml. The results showed that 27.3% patients had poor oral hygiene [PS >60%; mean anti-CCP 84.22 +/- 167.51 Unit/ml], 52.3% had generalized gingivitis [mean anti-CCP 145.07 +/- 269.17 Unit/ml], and 20.5% had mean CAL of >3mm [mean anti-CCP 56.81 +/- 119.02 Unit/ml]. None of patients presented with deep PPD > 4mm. The levels of anti-CCP showed no significant association with periodontal status [p=0.27]

Conclusion: Most RA patients were positive for anti-CCP antibodies and presented with generalized gingivitis. Oral hygiene education should be reinforced in RA patients to prevent further progression of periodontal disease. Nevertheless, studies with larger sample size should be carried out to obtain more conclusive findings

Hypertension and its association with the severity of chronic periodontitis: a preliminary study

Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).

In-vitro antimicrobial effectiveness of herbal-based mouthrinses against oral microorganisms

OBJECTIVE: To evaluate the in vitro antimicrobial effectiveness of commercial herbal-based mouthrinses against oral microorganisms. METHODS: A total of three mouthrinses (OX, Pesona and Watsons) were tested for their antimicrobial activity against six oral organisms, Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Lactobacillus salivarius (L. salivarius), Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa) and Candida albicans (C. albicans) by standard agar-disk diffusion assay. Oradex mouthrinse containing 0.12% chlorhexidine gluconate and sterile distilled water was served as positive and negative controls, respectively. RESULTS: All mouthrinse formulations were effective in inhibiting the growth of S. mutans, S. sobrinus, L. salivarius and C. albicans. Among the tested mouthrinses, Pesona was the only effective mouthrinse against S. aureus and P. aeruginosa, similar to Oradex mouthrinse. Pesona mouthrinse formulation appears to be as effective as Oradex mouthrinse formulation to kill S. aureus and P. aeruginosa. Statistical analysis showed no significant difference among the tested formulations regarding their antimicrobial activities (P > 0.05). CONCLUSIONS: Pesona was not the only herbal mouthrinse effective in inhibiting the growth of S. mutans, S. sobrinus, L. salivarius and C. albicans in vitro. All tested formulations were effective against those strains. Our findings may serve as a guide for selecting a kind of herbal mouthrinses as well as providing information to the dental professionals about the efficacy of these products.

Root-crown ratios of permanent teeth in Malay patients attending HUSM Dental Clinic

The objectives of this study were to determine the normal mean value of the root-crown (R/C ratios) in Malay patients and their variations by gender and dental arch from orthopantomogram radiographs (OPGs). Two thousand nine hundred and twenty teeth with fully developed roots were measured from 112 OPGs. Subjects with history of maxillofacial trauma or orthodontic therapy were excluded. The mean age of the subjects was 19.1 (SD 2.08) years old for males while females 18.9 (SD 2.19) years old in the range from 15 to 22 years old. The intra-examiner reproducibility of the assessment method was good (Intraclass correlation coefficient 0.81). Results of this study showed that there was no significant difference between R/C ratios of males and females groups. However, the ratios of the antagonist teeth for both males and females were significantly greater in the mandible than in the maxilla (p<0.05 for right and left lateral incisors and right first premolars in male; p<0.001 for all other teeth). In both gender, the highest R/C ratio was mandibular second premolars and the lowest R/C ratio were maxillary central incisors. The rootcrown ratio could be used as a baseline data and reference to help in orthodontic diagnosis, treatment planning and prognosis as well as evaluation developmental root deficiency.

Effects of lower third molar removal on attachment level and alveolar bone height of the adjacent second molar

The purpose of this study was to evaluate the periodontal status distal to the adjacent second molar following the extraction of a partially or fully impacted mandibular third molar at Klinik Pergigian Pakar Hospital Universiti Sains Malaysia (KPPHUSM) from April of 2008 until June of 2008.This was a prospective study which involved the clinical and radiological study of patients. In this study, convenience sampling method had been used. The sample size was 22 patients aged 18-32 years old with inclusion criteria. The outcomes measured in this study were periodontal pocket depth (PPD), clinical attachment level (CAL) and alveolar bone height (ABH). Subjects were examined at distal surface (disto-buccal, mid-distal and disto-lingual) of second molar for PPD and CAL before and 3 months after the impacted adjacent lower third molar extraction. OPG was taken each before and after the third molar removal. These data were analyzed using SPSS version 16 and Wilcoxon-signed-ranks test was used to compare the PPD, CAL and ABH pre and post operatively. All the results were not significant with p >0.05. For PPD, median = 3mm pre and post extraction. CAL median= 2mm pre and post operatively and ABH median of 3.10mm (before) and 2.8mm (after) the third molar removal. From our study, we concluded that there were no significant changes of PPD, CAL and ABH at distal side of second molar after 3 months of the adjacent impacted lower third molar removal.