[ correlation between cigarette smoking and periodontal disease]

Smoking is considered as a risk factor for health in our society. Furthermore, different and somehow contradictory results have been reported regarding the effect of cigarette smoking on periodontal status of patients. The present study compared the gingival index, plaque index and periodontal index in active smokers, previous smokers and non-smokers in patients referred to Shahid Beheshti Dental School and Abolfazl Clinic of Ray city on 2006. In an analytical study, 90 patients including 30 active smokers, 30 previous smokers with passing at least 1 year from smoking stop and 30 non-smokers were selected by non-randomized sampling method. Maxillary centrals and first premolars of left side, mandibular centrals and first premolars of right side, maxillary first molar of right side and mandibular first molar of left side were examined. The gingival and plaque indices were recorded by Loe and Sillness method and periodontal index by Russell method. The data were subjected to Kruskal-wallis, Mann-whitney U tests and Spearman coefficient ratio. The most values of gingival, plaque and periodontal indices were note in active smokers with the least values in non-smokers. The previous smokers were ranked amongst two groups. Significant differences were noted comparing three indices in the groups [all: P<0.001]. No significant differences were found between active and previous smokers regarding periodontal and gingival indices; however, comparison of the all other paired groups led in significant differences. Positive and significant correlations were found in two active and previous smokers regarding all indices and the number of packs per year. The results of the present study suggest cigarette smoking to be correlated with periodontium diseases and giving the smoking up may reverse the severity and development of the disease. These findings resemble most studies done in the field

[Effect of locally delivered phenytoin 1% on improvement of chronic periodontitis parameters]

Different adjunctive treatment options have been proposed for treating periodontal diseases other than standard scaling and root planning due to higher incidence of periodontal conditions. Phenytoin is a drug primarily used for the treatment of epilepsy. However, its positive effect on wound healing process has encouraged researchers to recommend it for patients with periodontitis. The aim of this study was to assess the effect of Phenytoin 1% gel in the improvement of periodontal parameters in chronic periodontitis. In an experimental split-mouth study, 18 patients with moderate periodontitis having at least 2 contra lateral teeth, pocket depth of 4-5 mm and no history of systemic disease were selected. After standard scaling and root planning treatment, both right or left side of the oral cavity was randomly assigned for local delivery of phenytoin 1% gel and, the other side was selected as control. Pocket depth [PD] and connective tissue adhesion [CTA] indices were assessed at the baseline and also two, four and eight weeks after the first injection. The data were analyzed using Repeated Measures ANOVA and Paired T-tests, considering the baseline measures as covariates. Using baseline PD and CTA values as covariates, significant reduction was observed in mean PD [P<0.05] and significant increase in mean CTA [P<0.001] during the study period. Also there were significant difference between the control experimental sites in terms of mean PD index and CTA [P< 0.001 for both]. Using Phenytoin after standard scaling and root planning can relatively improve the status of Pocket depth and connective tissue adhesion

Correlation between periodontal diseases and mouth breathing

Some studies have reported direct relationship between mouth breathing and increased susceptibility of patients to develop periodontal diseases. The present study was designed to evaluate the correlation between periodontal diseases and mouth breathing in Iranian population. This historical cohort study was conducted with 90 participants aged 20-35 years-old, who were referred to Isfahan Dental School and few other private dental clinics in the city of Isfahan in the year 2003. All participants had to be free of relevant systemic conditions. The cases were defined as patients with mouth breathing, having dome-shaped palate and open mouth [lips] when in rest position. Oral examination was conducted using 3 diagnostic criteria. Forty-five patients who were confirmed by all three criteria were included in the study as cases. The control group was composed of subjects who had normal breathing from their nose. The gingival index was determined for posterior and anterior regions of all participants. The statistical analysis was conducted and Mann- Whitney U tests was used in order to determine group differences. The gingival indices in the anterior region of cases were determined. The number of individual with scores 1, 2 and 3 were five [11.1%], 36 [80%] and four [8.9%] respectively. The scores in control group for five subjects [11.1%] was [0] or had no gingival condition, 32 [71.1%] subjects had score one and eight [17.8%] had score 2. The group differences were statistically significant [P < 0.001]. No significant difference was detected in posterior gingival indices [P > 0.05]. Mouth breathing can be a contributing factor in increasing the risk of periodontal diseases

[Association between chronic periodontitis and acute myocardial infarction]

Chronic periodontitis has been associated with cardiovascular diseases. The hypothesis that oral espically periodontal, infections systemic implications, is now gaining evidence. In this Case- control study, cases were 45-60 years old patients who had been hospitalized in one of cardiologic care units or emergency wards of Isfahan city such Chamran and Khorshid Shahr hospitals, for acute myocardial infarction [AMI]. Control group had no evidence of acute myocardial infarction, all receiving comprehensive periodontal examination. Information such as age, socioeconomic state, smoking and Dm history were obtained from hospital records and direct interview. Dependent variants attachment loss [AL] and lost teeth have been considered as characteristics of periodontal disease. In this research a total of 56 samples participated in our study, based on informed consent. The association between mean attachment level and number of missing teeth with studied groups were analyzed with paired t -test and SPSS 15 software. Research findings showed that AL index mean in patients group [MI patients] and control group [healthy group] was 3.11 +/- 1.05 and 2.46 +/- .85 and lost teeth index mean in patients group and control group was 7.78 +/- 5.12 and 4.67 +/- 3.47 respectively. The statistical test showed that these differences in both indexes with p<0.05 are significant. According to the findings, we can advise if elders in ordinary dentistry examinations show signs of periodontal disease and have some lost teeth may have higher risks for cardiovascular disease

[Comparative study of CBC, CRP and coagulation factors as the possible risk factors of cardio vascular diseases in patients with gingivitis in comparison with the control group]

Patients with periodontitis have more risk factors for cardio-vascular diseases in comparison with healthy people. Considering higher prevalence of cardio-vascular and gingival inflammatory diseases in the society, the present study was carried out to evaluate the means of CBC, CRP and coagulation factors as possible risk factors of cardio-vascular diseases in patients with gingivitis. In the case-control retrospective study, 40 male patients [2D-25 years old] referred Isfahan Dental School, who were selected by non-randomized sample method, were divided into 2 groups: group 1: gingivitis cases and group 2: controls [healthy gingiva]. The patients underwent clinical examinations and their bleeding index [CBI] was recorded. Blood sampling was carried out in the patients meeting the study criteria VII-factor were investigated. Data were analyzed statistically by t-test and ANOVA. RBC was 5.3x10[6] and 5.08x10[6] in case and control samples, WBC was 6.35x10[3] and 6.16x10[3] in case and controls and HB was 13.52 and 13.93 gr/dlit in case and control groups. Hematocryte, CRP, fibrinogen and VII factor were respectively 42.72%, 2.05, 215.3 and 176 in cases and 43.07%, 2 04, 183.5 and 181mg/dlit in controls. No significant differences were found between two groups in these factors. The results showed no significant differences between the patients having gingivitis and healthy gingival, but due to a strong probability for the bacteria and their products to enter the blood in gingivitis and aggravating atherosclerosis, it s recommended to inform the patients and society about these risk factors

Association between chronic periodontitis and acute myocardial infarction: a case-control study in Isfahan

Chronic periodontitis has been associated with cardiovascular diseases. The hypothesis that oral, especially periodontal, infections have potentially serious systemic implications, is now gaining credence. Cases were 45-60 years old patients who had been hospitalized in one of cardiologic care units or emergency wards of Isfahan Medical University, for acute myocardial infarction [AMI]. Controls had no evidence of acute myocardial infarction, all receiving comprehensive periodontal examination. Information such as age, socioeconomic state, smoking, and diabetes history were obtained from hospital records and direct interview. A total number of%6 people participated in our study, based on informed consent, were designated as two groups of case and control. The association between mean attachment level and number of missing teeth with studied groups were analyzed with SPSS statistical software. The association of the mean attachment level and also the number of missing teeth with case status were statically significant associated [P<0.05]. The results are in accordance with those reports that show the positive association between these two diseases. Our findings suggest that the patients who demonstrate evidence of attachment loss around several teeth, at routine dental visit can be identified as being at risk for future AMI. Such subjects should be referred for medical and periodontal examination and treatment