Serum nitric oxide concentration in generalized chronic and aggressive periodontitis in the Mexican population is not related to the severity of the disease / La concentración de óxido nítrico en suero de pacientes con periodontitis agresiva y crónica generalizada no está relacionada con la gravedad de la enfermedad

Introduction: Periodontitis is an inflammatory disease that affects the supporting tissues of teeth, the effects of excess of nitric oxide, may contribute to the symptoms of periodontitis. Objective: To determine the serum nitric oxide concentration in generalized chronic and aggressive periodontitis patients and to compare it with a healthy subject group from the Mexican population. Materials and methods: A case and control study was performed. Sixty-nine individuals were recruited from the Clínica de Posgrado de Periodoncia of the Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México. Patients with clinical features of generalized chronic periodontitis (GCP group, n=19), generalized aggressive periodontitis (GAP group, n=11), and a group of healthy subjects (HS group, n=39) were included in the study. Informed consent was obtained from each subject, and serum nitric oxide concentration was measured by an enzyme-linked immunosorbent assay. Results: Nitric oxide concentration in the study groups was greater in the GCP group (462.57 ± 16.57 µmol/L) than in the GAP group (433.84 ± 18.61 µmol/L) and the HS group (422.46 ± 12.07 µmol/L). A comparison using Student's t-test (one-tailed) between healthy subjects and generalized chronic periodontitis showed borderline significance (p<0.04), whereas no significant differences were observed in HS and GAP groups, with a p-value of 0.64, and the GAP vs. GCP p-value was 0.33. Conclusion: The serum nitric oxide concentration observed in the present study suggests that nitric oxide plays a major role in the inflammatory process, which cannot necessarily be linked to the severity of the disease and periodontal tissue destruction.

Introducción. La periodontitis es una enfermedad inflamatoria que afecta los tejidos de soporte dental; los efectos del exceso de óxido nítrico pueden contribuir a los síntomas de la periodontitis. Objetivo. Determinar la concentración de óxido nítrico en el suero de los pacientes con periodontitis agresiva y crónica generalizada, y compararla con la de individuos sanos de población mexicana. Materiales y métodos. Se trata de un estudio de casos y controles. Se incluyeron 69 individuos de la Clínica de Posgrado de Periodoncia del Centro Universitario de Ciencias de la Salud de la Universidad de Guadalajara. Se dividieron en tres grupos: pacientes con periodontitis crónica generalizada (GCP, n=19), pacientes con periodontitis agresiva generalizada (GAP, n=11) e individuos sanos periodontalmente (HS, n=39). Se obtuvo el consentimiento informado de todos los participantes. Se utililizó la prueba ELISA para medir la concentración de óxido nítrico en suero. Resultados. Las concentraciones de óxido nítrico observadas fueron mayores en el grupo GCP (462,57 ± 16,57 µmol/L) que en los grupos GAP (433,84 ± 18,61 µmol/L) y HS (422,46 ± 12,07 µmol/L). La comparación entre HS y GCP mediante la prueba estadística t de Student (una cola), mostró diferencias significativas (p<0,04), y no se observaron diferencias entre los grupos HS y GAP (p=0,64), ni entre GAP y GCP (p=0,33). Conclusiones. La concentración de óxido nítrico en suero, observada en el presente estudio, sugiere que el óxido nítrico desempeña un importante papel en el proceso inflamatorio, lo que no necesariamente está ligado a la gravedad de la enfermedad ni a la destrucción del tejido periodontal.

Efeitos clínicos da fotobiomodulação como terapia adjuvante não-cirúrgica na periodontite crônica: uma revisão integrativa da literatura / Clinical effects of photobiomodulation as non-surgical adjuvant therapy for chronic periodontitis: an integrative literature review

Introdução: A doença periodontal, de origem infecciosa, constitui diferentes quadros clínicos de caráter multifatorial e inflamatório. A fotobiomodulação é uma técnica não invasiva que tem demonstrado ser capaz de diminuir a inflamação e proporcionar alívio da dor. Estudos também demonstraram que a adoção da fotobiomodulação adjuvante à raspagem e alisamento radicular tem sido capaz de reduzir a carga bacteriana proveniente da periodontite crônica. Objetivos: Analisar os efeitos da fotobiomodulação como terapia adjuvante à raspagem e ao alisamento radicular no tratamento da periodontite crônica publicados nos últimos cinco anos. Métodos: Trata-se de uma revisão integrativa da literatura, realizada no período de setembro a novembro de 2021, mediante a utilização dos seguintes descritores: "Periodontitis", "Photobiomodulation" e "Therapy, selecionando artigos publicados em inglês durante o período entre 2016 a 2021. Resultados: Foram identificados 47 trabalhos. Destes, foram excluídos 39 estudos que se dispersaram do tema e 2 que se encontravam indisponíveis para o acesso, resultando em 6 artigos que foram consultados integralmente. Foi consenso entre os artigos consultados que a prática da fotobiomodulação tornou-se um potencial agente terapêutico no tratamento da periodontite crônica contribuindo para a redução da contagem de periodontopatógenos e que atua de maneira coadjuvante às raspagens radiculares. Conclusão: A fotobiomodulação mostrou-se uma ferramenta promissora na área odontológica. Entretanto, a grande variedade nos parâmetros de tratamentos e protocolos utilizados na fotobiomodulação impossibilita uma comparação e uma análise mais crítica e rigorosa dos resultados obtidos nos trabalhos analisados.

Introduction: Periodontal disease, which has an infectious origin, constitutes a multifactorial and inflammatory different clinical condition of multifactorial, inflammatory, and infectious origin. Photobiomodulation is a non-invasive technique that has been shown to decrease inflammation and provide pain relief. Studies also have shown that the choosing of photobiomodulation as adjuvant therapy to scaling and root planing has been able to reduce the bacterial load from chronic periodontitis. Objectives: To analyze the effects of photobiomodulation as an adjuvant therapy to scaling and root planing in the treatment of chronic periodontitis in the studies published in the last five years. Methods: This is an integrative literature review, carried out from September to November 2021, using the following descriptors: "Periodontitis", "Photobiomodulation" and "Therapy, from selected articles published in English during the period between 2016 to 2021. Results: From the research and selection of studies to compose this integrative literature review, 47 studies were initially identified based on the descriptors. From those, 39 papers that were outside from the topic and 2 papers that were unavailable for access were excluded from the present review. Then remained, 6 articles that were fully consulted. The practice of photobiomodulation has become a potential therapeutic agent in the treatment of chronic periodontitis reducing the count of periodontopathogens and as an adjunct therapy to root scaling. Conclusion: Photobiomodulation therapy has become a promising tool in the dental field, however, the great variety in the treatment parameters and protocols used for photobiomodulation makes impossible to compare and perform a more critical and rigorous analysis of the results collected in the present work.

Research advances in correlation between chronic periodontitis and prostatic diseases / 口腔医学

@#In recent years, more and more attention has been paid to the correlation between periodontitis and prostatic diseases. Aging, obesity, smoking and psychological factors are common risk factors of these two diseases, but the key correlation mechanism is not clear. This article reviews the research on and possible biological mechanism of chronic periodontitis and prostatic diseases, in order to provide basis for disease management and clinical research in the future.

Chemotherapy-induced oral mucositis induced by low dose methotrexate: a case report and literature review / 口腔疾病防治

Objective@# To investigate the diagnosis and treatment for oral mucositis induced by low-dose methotrexate and to provide a reference for clinicians@*Methods @# A case of severe chemotherapy-induced oral mucositis caused by short-term use of low-dose methotrexate (the maximum cumulative dose within 1 week) was reported and reviewed in combination with the literature.@*Results@# The patient was treated with low-dose methotrexate (2.5 mg orally every other day at weeks 1, 2, and 4; the third week, 2.5 mg each time for 3 consecutive days for twice, with a maximum cumulativedose of 15 mg within a week). After irregular medication for approximately three weeks, the patient gradually developed severe erosion of the lips, pain, difficulty eating, and skin erosion on both legs. Methotrexate was stopped after admission, and local symptomatic treatments such as Kangfuxin solution were given. Recombinant human granulocyte colony-stimulating factor was used systemically when combined with neutropenia. After treatment, the chemotherapy-induced oral mucositis and skin lesions were improved. A literature review shows that chemotherapy-induced oral mucositis is a toxic reaction to high-dose methotrexate, while cases of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate are rare. Studies have found that the more risk factors patients have, such as poor local oral conditions and systemic diseases such as liver and kidney dysfunction and diabetes, the higher the risk of chemotherapy-induced oral mucositis. Clinicians should cooperate with dentists to address oral diseases as much as possible before using chemotherapy drugs. In addition, when ordering patients to take methotrexate, we should pay attention to the patient's general condition and susceptibility factors, standardize the frequency and dose of administration, adopt personalized treatment plans, and give patients detailed medication education to prevent the occurrence of adverse consequences caused by medication errors. If methotrexate poisoning occurs, the drug should be stopped in time, detoxification and active symptomatic and supportive treatment should be given. Basic oral care, cryotherapy, laser therapy, nutritional support and analgesic drugs are common treatments for chemotherapy-induced oral mucositis. Systemic administration of granulocyte colony-stimulating factor may be considered when accompanied by neutropenia.@*Conclusion@# It is necessary to be alert to the occurrence of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate in clinical practice.

The effect of SIRT1 activator on inflammatory response in chronic Periodontal disease mice through TLR4/NF-κB signaling pathway / 中国医师杂志

Objective:To explore the effect of silent information regulator 1 (SIRT1) activator SRT1720 on inflammatory response in chronic periodontal disease mice and whether its mechanism is related to the toll like receptor 4 (TLR4)/nuclear factor κB (NF-κB) signaling pathway.Methods:Forty 8-week-old male C57BL/6 mice were selected and divided into a blank control group ( n=8) and an experimental group ( n=32). The experimental group mice were ligated with periodontal pockets and fed with high sugar drinking water. The experimental group was randomly divided into a model group ( n=8) and an SRT1720 group ( n=24). The blank control group and the model group were given physiological saline orally every day. The SRT1720 group was further divided into a low dose group [20 mg/(kg·d), n=8], a medium dose group [50 mg/(kg·d), n=8], and a high dose group [100 mg/(kg·d), n=8] based on the different doses of SRT1720. Four weeks later, the expression levels of interleukin-6 (IL-6), interleukin-1β (IL-1β) and monocyte chemoattractant protein-1 (MCP-1) in gingival crevicular fluid of mice in each group were detected by enzyme linked immunosorbent assay (ELISA); The real-time quantitative polymerase chain reaction (RT-qPCR) method was used to detect the mRNA expression levels of IL-6, IL-1β, MCP-1, SIRT1, TLR4, NF-kB p65 in the gingival tissue of mice in each group; Western blot was used to determine the expression levels of SIRT1, TLR4, and NF-κB p65 proteins in mouse gingival tissue. Results:Compared with the blank control group, the expression levels of IL-6, IL-1β, and MCP-1 inflammatory factors in the gingival crevicular fluid of experimental group mice increased, while the expression levels of IL-6, IL-1β, MCP-1, TLR4, NF-κB p65 mRNA in gingival tissue increased. The expression levels of TLR4, NF-κB p65 protein in gingival tissue increased, while the expression levels of SIRT1 mRNA and protein in gingival tissue decreased, with statistical significance (all P<0.05). Compared with the model group, the expression levels of IL-6, IL-1β, and MCP-1 inflammatory factors in the gingival crevicular fluid, IL-6, IL-1β, MCP-1, TLR4, NF-κB p65 mRNA expression levels in gingival tissue, and TLR4, NF-κB p65 protein expression levels in the gingival tissue of SRT1720 group mice showed a dose-dependent decrease. The expression levels of SIRT1 mRNA and protein in gingival tissue showed a dose-dependent increase, and the differences were statistically significant (all P<0.05). Conclusions:SIRT1 activator SRT1720 can improve the inflammatory response of chronic periodontal disease mice, which may be related to the inhibition of TLR4/NF-kB signaling pathway.

Clinical application progress on the diode laser in nonsurgical periodontal treatment / 口腔疾病防治

@#Chronic periodontitis is a chronic inflammatory disease caused by plaque microorganisms, and removal of plaque and calculus is the gold standard for nonsurgical periodontal treatment. However, complete debridement is difficult, especially in some complex anatomical sites. Excessive scaling may result in the loss of healthy cementum and lead to dental hypersensitivity. Studies have shown that a diode laser can exhibit the best performance in an environment with blood because its wavelengths (630-1 064 nm) are close to the absorption peaks of heme and melanin and they have broad application prospects in the oral field. In nonsurgical periodontal treatment, diode lasers have three treatment modes: soft diode laser, antimicrobial photodynamic therapy and low-level laser therapy, which can be used alone or in combination. Although diode lasers cannot replace mechanical treatment to remove calculus, they can remove infected periodontal pocket epithelium, change the microcirculation to promote wound healing, reduce bleeding and relieve pain through photothermal effects and biological stimulation. The effect of diode laser treatment depends on the treatment dose. It is necessary to precisely control the output intensity and control the irradiation time to avoid thermal damage to the tissue. In the future, extensive research at the molecular level is needed to reveal the tissue response. At the same time, more high-quality, large-sample randomized controlled trials are needed to standardize the use of lasers for different stages and grades of periodontitis.

Evaluation of Dentine Hypersensitivity in Adult Population with Chronic Periodontitis Visiting Government Dental College & Hospital, Srinagar

Background: A working knowledge of the prevalence of hypersensitivity in chronic periodontitis patients, is imperative to adequate prognostication, treatment planning and outcome. The present study, is a primary report of the prevalence of dentinal hypersensitivity, in relation to various patient characteristics (demographic and clinical) in chronic periodontitis patients visiting Government Dental College and Hospital, Srinagar, J&K.Material & Methods:A cross-sectional study design was used to evaluate 100 male and 100 female patients diagnosed with chronic periodontitis both by questionnaire and clinical test for the presence of dentinal hypersensitivity, in relation to various features.Results:An overall prevalence of 34% was found for self-reported and 42 % for actual dentinal hypersensitivity in chronic periodontitis patients. It was highest in females, undergraduates, rural subjects and canine teeth. The most common provoking stimulus was cold, and duration of hypersensitivity was less than 6 months. Clinical attachment loss was found to be more often associated with hypersensitivity than clinical gingival recession.76% of the patients reporting hypersensitivity also reported the use of desensitizing toothpaste.The reported prevalence of hypersensitivity was in concordance with other reports from dental college clinics. The particular geo-social background of the study location could have contributed to the observed difference in precipitating factors, effect of diet, and treatment seeking behaviour. Conclusion: The prevalence of dentine hypersensitivity in chronic periodontitis patients was 34% according to questionnaire and 42% according to the results of clinical test. Periodontal attachment loss was found to be could be an earlier indicator or a possible risk factor of DH, indicating the need for clinical initiative in the management of hypersensitivity in chronic periodontitis patients.

Comparison of gingival inflammatory parameters and pain perception on periodontal probing - a cross sectional study, part II / Comparación de parámetros inflamatorios gingivales y percepción del dolor en el sondaje periodontal - un estudio transversal, parte II

Background: Probing of the periodontal pocket is an essential part of the diagnosis of periodontal disease and 15-77% of untreated periodontal patients experience pain during probing. Therefore, the objective of this study is to evaluate the pain perceived by patients with dental plaque-induced gingivitis and chronic periodontitis during periodontal probing and the main objective includes the evaluation of the relationship between pain perceived during periodontal probing and gingival inflammatory parameters. Material and Methods: A total of 475 participants were recruited into the study. The patients were divided into two groups: Group-A (Gingivitis Group - 275 patients) and Group-B (Chronic Periodontitis Group - 200 patients). Clinical parameters included analysis of bleeding on probing, simplified gingival index, pocket depth on probing, and clinical attachment level. Pain score was recorded using the HP VAS scale and all patients participated in the study after a detailed explanation of the study protocol. Results: A significant difference in pain perception was noted between groups, highlighting the role of the degree of inflammation in the examination of periodontal parameters. Conclusion: Within the limitations of the present study, we can conclude that pain perception is directly correlated with the degree of inflammation in periodontitis rather than plaque-induced gingivitis during periodontal probing. Therefore, some form of adjuvant topical anesthesia may be considered in order to reduce pain levels in severely inflamed patients, to encourage continued acceptance of supportive periodontal therapy.

Antecedentes: El sondaje de la bolsa periodontal es una parte esencial en el diagnóstico de la enfermedad periodontal. 15-77% de los pacientes periodontales no tratados experimentan dolor durante el sondaje. Por lo tanto, el objetivo de este estudio es evaluar el dolor percibido por pacientes con gingivitis inducida por placa dental y periodontitis crónica durante el sondaje periodontal y el objetivo principal incluye la evaluación de la relación entre el dolor percibido durante el sondaje periodontal con parámetros inflamatorios gingivales. Material y Métodos: Un total de 475 sujetos fueron reclutados en el estudio. Los sujetos se dividieron en 2 grupos: Grupo - A (Grupo de gingivitis - 275 pacientes) y Grupo - B (Grupo de periodontitis crónica - 200 pacientes). Los parámetros clínicos incluyeron el análisis del sangrado al sondaje, el índice gingival simplificado, la profundidad de la bolsa al sondaje y el nivel de inserción clínica. La puntuación del dolor se registró utilizando la escala HP VAS y todos los pacientes participaron en el estudio después de una explicación detallada del protocolo del estudio. Resultados: Se notó una diferencia significativa en la percepción del dolor en el grupo B que en el grupo A, lo que significa el papel del grado de inflamación en el examen de los parámetros periodontales. Conclusión: Dentro de las limitaciones del presente estudio, podemos concluir que la percepción del dolor se correlaciona directamente con el grado de inflamación que se observa en la periodontitis más que con la gingivitis inducida por la placa dental durante el sondaje periodontal. Por lo tanto, se puede considerar alguna forma de anestesia tópica adyuvante para reducir los niveles de dolor en pacientes gravemente inflamados para fomentar la aceptación continua de la terapia periodontal de apoyo.

Associação entre doença pulmonar obstrutiva crônica e a má condição de saúde periodontal: um estudo transversal / Association between chronic obstructive pulmonary disease and poor periodontal health: a cross-sectional study

Objetivo: estudos sugerem uma associação entre a doença periodontal e a doença pulmonar obstrutiva crônica (DPOC). O objetivo deste estudo foi avaliar a condição periodontal em pacientes com DPOC. Metodologia: Este estudo transversal incluiu 33 pacientes com DPOC e 30 pacientes sem DPOC (grupo controle). Todos os pacientes realizaram espirometria e foram examinados por um dentista. A condição periodontal foi avaliada através dos seguintes índices: número de dentes, índice de placa (IP), índice de sangramento gengival (IG), profundidade de sondagem (PS), PS dos sítios doentes (PSD), nível de inserção clínica (NIC), NIC dos sítios doentes (NICD) e percentual de sítios doentes (NICDP). Para análise estatística foram utilizados o teste de qui-quadrado de Pearson, o testet de Student, análise de regressão logística e cálculo do odds ratio. Resultados: O grupo DPOC apresentou maiores IP (p=0,01), NIC (p=0,001) e NICDP (p<0,001), com odds ratio de 1,2 (95%IC: 1,023­1,408). Conclusões: Os pacientes com DPOC apresentaram pior condição periodontal. Mais estudos são necessários para esclarecer o papel da terapia periodontal no protocolo de acompanhamento dos pacientes com DPOC

Objective: evidence suggests an association between periodontal disease and chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the periodontal status in patients with COPD. Methods: this cross-sectional study included 33 patients with COPD and 30 patients without COPD (control group). All patients underwent spirometry and were examined by a dentist. Periodontal status was evaluated by the following indexes: number of teeth, plaque index (PI), gingival bleeding index (GBI), probing depth (PD), PD of diseased sites (PDD), clinical attachment level (CAL), CAL of diseased sites (CALD) and percentage of diseased sites (CALDP). The findings were analyzed under Pearson's chi-square test, independent samples t test and logistic regression with odds ratio. Results: the COPD group had higher PI (p = 0,01), CAL (p = 0,001) and CALDP (p <0,001), and the odds ratio for patients with COPD was 1.2 (95% CI: 1,023-1,408). Conclusions: patients with COPD present worse periodontal status. More studies are needed in order to clarify the role of periodontal therapy in the management of COPD.

Evaluation of Serum and Gingival Crevicular Fluid Levels of Vitamin D Binding Protein in Subjects with Clinically Healthy Periodontium and Chronic Periodontitis: A Clinico Bio-Chemical Study

Background: Advances in oral and periodontal disease diagnostic research are moving towards methods wherein periodontal risk can be identified and quantified by objective measures such as bio?markers. Given the roles of vitamin D binding protein (DBP) in modulating the immune response and in the transport of vitamin D, it is hypothesised that quantitative changes of vitamin DBP are associated with periodontal disease. Aim: The aim of the current study is to measure DBP levels in serum and gingival crevicular fluid (GCF) of patients with generalised chronic periodontitis, in comparison to healthy controls. Materials and Methods: The present cross?sectional clinico?bio?chemical study includes 30 systemically healthy subjects with 15 periodontally healthy and 15 chronic periodontitis subjects who were recruited from the out?patient Department of Periodontics. GCF and blood samples were collected from all the patients. DBP estimation was performed in both the samples using a commercially available ELISA kit. Results: Serum and GCF DBP levels in chronic periodontitis subjects were significantly higher when compared to the periodontally healthy group. There were no significant correlations found among serum and GCF DBP levels with gender and increasing age in both the groups. An increase in disease severity measured by the increase in probing pocket depth and clinical attachment loss did not show correlation with the GCF and serum DBP levels in the chronic periodontitis group. Conclusion: Based on the findings of the present study, increased serum and GCF DBP levels in chronic periodontitis seem to be a probable marker for identifying ongoing periodontal destruction.

Evaluation of pain perception on periodontal probing in patients with dental plaque induced gingivitis and chronic periodontitis - a cross sectional study, part I / Evaluación de la percepción del dolor al sondaje periodontal en pacientes con gingivitis inducida por placa dental y periodontitis crónica: un estudio transversal, parte I

Background: Probing of periodontal pockets is an essential part in the diagnosis of periodontal disease. Fifteen to seventy seven percent of untreated periodontal patients experience pain during probing. Hence the aim of this study is to evaluate the pain perceived by patients with gingivitis and periodontitis during periodontal probing. The goals of this study were to compare the patients' pain perception when using a conventional UNC15 probe and a manual pressure sensitive periodontal probe, and to relate the clinical features of gingivitis and periodontitis to the discomfort associated with periodontal probing. Material and Methods: A total of 475 subjects were recruited into the study. The subjects were initially divided into two groups ­ Group ­ A (Gingivitis group - 275 patients) and Group ­ B (Chronic Periodontitis group -200 patients) according to the AAP 1999 Classification. These two groups were further subdivided into two groups each (Gingivitis ­ Conventional Probe ­ GCP, Gingivitis ­ Manual Pressure Sensitive Probe ­ GMPS, Periodontitis - Conventional Probe ­ PCP, Periodontitis ­ Manual Pressure Sensitive Probe ­ PMPS) using a computer generated program of random numbers. Results: A significant difference was noted in pain perception when pressure sensitive probe was used compared to conventional UNC-15 probe. Reduced Bleeding on Probing and Pain scores were noted in Chronic periodontitis subjects with use of pressure sensitive probe, which was statistically significant (p<0.001). Conclusion: Dentistry has changed its focus towards painless dentistry. In this context, the present study presents data towards use of manual pressure sensitive probes, which offers an advantage of low cost when compared to more advanced computerized systems with reduced pain during periodontal examination. It could result in a positive attitude of the patients towards continuous supportive periodontal therapy thereby monitoring periodontal health.

Antecedentes: El sondaje de los sacos periodontales es una parte esencial en el diagnóstico de la enfermedad periodontal. Del quince al setenta y siete por ciento de los pacientes periodontales no tratados experimentan dolor durante el sondaje. De ahí que el objetivo de este estudio fué evaluar el dolor percibido por pacientes con gingivitis y periodontitis durante el sondaje periodontal. Los objetivos de este estudio fueron comparar la percepción del dolor de los pacientes al usar una sonda UNC15 convencional y una sonda periodontal sensible a la presión manual, y relacionar las características clínicas de la gingivitis y la periodontitis con la incomodidad asociada con el sondaje periodontal. Material y Métodos: Un total de 475 sujetos fueron reclutados en el estudio. Los sujetos se dividieron inicialmente en dos grupos - Grupo - A (grupo de Gingivitis - 275 pacientes) y Grupo - B (grupo de Periodontitis Crónica - 200 pacientes) de acuerdo con la Clasificación AAP 1999. Estos dos grupos se subdividieron en dos grupos cada uno (Gingivitis - Sonda convencional - GCP, Gingivitis - Sonda manual sensible a la presión - GMPS, Periodontitis - Sonda convencional - PCP, Periodontitis - Sonda manual sensible a la presión - PMPS) usando un programa generado por computadora de datos aleatorios. números. Resultados: Se notó una diferencia significativa en la percepción del dolor cuando se usó una sonda sensible a la presión en comparación con la sonda UNC-15 convencional (p<0,001). Conclusion: La odontología ha cambiado su enfoque hacia una odontología sin dolor. En este contexto, el presente estudio presenta datos hacia el uso de sondas manuales sensibles a la presión, que ofrece una ventaja de bajo costo en comparación con sistemas computarizados más avanzados con reducción del dolor durante el examen periodontal. Podría resultar en una actitud positiva de los pacientes hacia la terapia periodontal de apoyo continuo, monitoreando así la salud periodontal.

Comparative effect of 1.2% atorvastatin gel and 1.2% rosuvastatin as a local drug delivery in treatment of intra-bony defects in chronic periodontitis

Background: The present study was aimed to evaluate the efficacy of 1.2% Atorvastatin (ATV) with 1.2% Rosuvastatin (RSV) as local drug delivery for treatment of Chronic Periodontitis (CP). Materials and Methods: Forty patients were equally divided into two groups. Group A underwent scaling and root debridement and 1.2% ATV gel (1.2 mg/0.1 mL) was placed, whereas group B received scaling and root debridement and RSV (1.2 mg/0.1 ml) was placed. Results: The results showed that both the groups had improvement in all the recorded parameters, and the results obtained were statistically significant. When comparison was made between the groups, no significant difference was obtained between atorvastatin and rosuvastatin at baseline in all recorded parameters. However, after 6 months significant improvement was recorded in CAL (Clinical attachment level) and PD (Probing depth). The plaque index (PI) and gingival index (GI) score however showed improvement, but it did not attain the level of significance. Conclusion: The present study showed improvement in clinical parameters with the use of ATV and RSV gel when used in combination with scaling and root planing (SRP) in CP patients. Patients with RSV gel showed up significantly better than the ones in which ATV gel was placed.

Changes of gingival thickness, gingival papilla and marginal bone resorption in patients with chronic local periodontitis after single implant restoration / 中国基层医药

Objective:To investigate the functional and structural recovery of posterior teeth in patients with chronic local periodontitis after single implant restoration.Methods:A total of 133 patients with tooth loss who need single posterior tooth fixation and implantation in Shaoxing People's Hospital from January to December 2019 were included in this study. These patients were divided into periodontitis ( n = 40) and periodontitis-free ( n = 93) groups according to whether they had chronic local periodontitis. All patients were followed up for 6 months. Probing depth (PD), gingival thickness, papilla index score (PIS), modified sulcus bleeding index (mSBI) and marginal bone resorption were compared between the two groups at 1, 3 and 6 months after implant repair. The success rate of tooth implant was compared between the two groups. Results:There was no significant difference in success rate of tooth implant between periodontitis and periodontitis-free groups [100.0% (93/93) vs. 95.0% (38/40), χ2 = 1.94, P = 0.163]. There was no significant difference in the incidence of postoperative complications between periodontitis and periodontitis-free groups [0.0% (0/93) vs. 2.5% (1/40), χ2 = 0.19, P = 0.663]. In the periodontitis group, PD was significantly greater at 3 and 6 months after surgery than that at 1 month after surgery ( t = 2.31, 4.30, P = 0.020, < 0.001). In the periodontitis group, mSBI was lower at 6 months after surgery than that at 1 month after surgery ( t = 1.97, P = 0.048). In the periodontitis-free group, mSBI was lower at 3 and 6 months after surgery than that at 1 month after surgery ( t = 3.64, 4.50, both P < 0.001). There were significant differences in PD and mSBI between periodontitis and periodontitis-free groups at 6 months after surgery ( t = 2.06, 2.13, P = 0.041, 0.035). At 6 months after surgery, marginal bone resorption in both periodontitis and periodontitis-free groups improved compared with that immediately after surgery. In the periodontitis group, marginal bone resorption at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 1.64, 0.63, P = 0.100, 0.524). In the periodontitis-free group, marginal bone resorption at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 1.70, 1.18, P = 0.088, 0.236). In the periodontitis group, gingival thickness at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 0.99, 0.49, P = 0.321, 0.620). In the periodontitis-free group, gingival thickness at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 0.87, 1.36 P = 0.379, 0.173). Gingival thickness and marginal bone resorption at 1 month after surgery were not significantly different from those at 3 and 6 months after surgery in each group ( t = 0.49, 0.39, 0.54, 0.77, 0.55, 0.38, P = 0.623, 0.693, 0.590, 0.439, 0.580, 0.699). Conclusion:Single implant restoration exhibits good short-term effects on tooth loss combined with chronic local periodontitis. Single implant restoration does not have a great impact on gingival thickness and marginal bone absorption, but it leads to a higher incidence of peri-implantitis in patients with periodontitis than in patients with healthy periodontal tissue.

Therapeutic effects of Guchisan combined with orthodontics therapy on chronic periodontitis with syndrome of excessive stomach fire in 33 patients / 中国基层医药

Objective:To investigate the effects of Guchisan combined with orthodontics therapy on serum tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels. Methods:Sixty-six patients with chronic periodontitis who received treatment in Zhejiang Xin'an International Hospital between July 2013 and July 2019 were included in this study. They were randomly divided into control group ( n = 33) and treatment group ( n = 33). Both control and treatment groups received conventional interventions. The control group was treated with orthodontics therapy. The treatment group was treated with Guchisan (0.5 g once, twice a day, 2-3 minutes once) based on orthodontics therapy for 1 month. Gingival index, probing depth, attachment loss, plaque index, gingival bleeding index, and latency to symptom improvement were compared between the two groups. Clinical efficacy was compared between the two groups. Serum IL-1β and TNF-α levels were measured in each group. Results:After treatment, gingival index [(0.51 ± 0.06) vs. (1.12 ± 0.15), t = 21.69], probing depth [(2.01 ± 0.22) mm vs. (2.67 ± 0.30) mm, t = 6.50], attachment loss [(1.10 ± 0.13) mm vs. (1.70 ± 0.18) mm, t = 9.90], plaque index [(0.47 ± 0.05) vs. (1.08 ± 0.13), t = 25.57], and gingival bleeding index [(0.58 ± 0.07) vs. (1.09 ± 0.13), t = 19.84] were significantly lower than those in the control group (all P < 0.01). Latency to tooth loosening [(8.81 ± 0.96) days vs. (13.03 ± 1.62) days, t = 15.01], halitosis [(3.04 ± 0.33) days vs. (7.03 ± 0.76) days, t = 27.66], and swollen gums [(2.21 ± 0.24) days vs. (4.55 ± 0.51) days, t = 23.85] were significantly shorter than those in the control group (all P < 0.01). Total response rate in the treatment group was significantly higher than that in the control group (93.94% vs. 69.70%, χ2 = 4.99, P = 0.025). After treatment, serum levels of TNF-α [(4.01 ± 0.44) ng/L vs. (5.31 ± 0.58) ng/L, t = 10.26] and IL-1β [(16.04 ± 1.97) mg/L vs. (18.30 ± 2.55) mg/L, t = 4.03] in the treatment group were significantly lower than those in the control group (both P < 0.01). Conclusion:Based on conventional treatment, Guchisan combined with orthodontics therapy for treatment of chronic periodontitis with syndrome of excessive stomach fire can greatly improve symptoms of periodontal disease and enhance clinical efficacy. Lowering serum TNF-α and IL-1β levels may be one of effective action ways of this combined therapy.

Correlation between chronic periodontitis and pulmonary ventilation function / 中国基层医药

Objective:To investigate the correlation between chronic periodontitis and pulmonary ventilation function.Methods:A total of 135 patients with chronic periodontitis who received treatment in Yuyao People's Hospital of Zhejiang Province between June 2014 and December 2019 were included in this study. They were divided into group A (stage I, initial lesion, n = 45), group B (stage II, early lesion, n = 45), group C (stage III, confirmed lesion, n = 45) according to the severity of periodontal lesion. Lung ventilation function indexes and serum levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) were compared among the three groups. The correlation between periodontal condition and lung ventilation function indexes was analyzed. Results:Probing depth (PD), clinical attachment loss (CAL), number of missing teeth, alveolar bone resorption level were (1.67 ± 0.65) mm, (2.48 ± 0.44) mm, 0 pieces, and (1.38 ± 0.23) mm in group A, (2.05 ± 0.30) mm, (4.04 ± 0.97) mm, 1 piece, (3.37± 0.73) mm in group B, and (2.23 ± 0.47) mm, (5.17 ± 0.75) mm, 3 pieces, (6.48 ± 0.62) mm in group C. With the worsening of the disease, PD, CAL, number of missing teeth, and alveolar bone resorption level were gradually increased. PD, CAL and alveolar bone resorption level in group C were significantly higher than those in group A ( t = 4.68, 20.75, 51.74, all P < 0.001) and group B ( t = 2.17, 6.18, 21.78, P = 0.033, < 0.001, < 0.001). PD, CAL and alveolar bone resorption level in group B were significantly higher than those in group A ( t = 3.56, 9.82, 17.44, all P < 0.001). There was no significant difference in the number of missing teeth ( P > 0.05). Serum IL-6, IL-8 and TNF-α levels were (11.28 ± 4.26) ng/L, (7.48 ± 1.97) ng/L, (14.59 ± 2.11) ng/L in group A, (17.09 ± 4.91) ng/L, (10.82 ± 2.10) ng/L, (19.95 ± 4.48) ng/L in group B, and (26.47 ± 5.86) ng/L, (15.06 ± 2.75) ng/L, (33.76 ± 6.30) ng/L] in group C. With the worsening of the disease, serum IL-6, IL-8 and TNF-α levels were gradually increased. Serum IL-6, IL-8 and TNF-α levels in group C were significantly higher than those in group A ( t = 14.06, 15.03, 19.36, P < 0.001) and group B ( t = 8.23, 8.22, 11.98, all P < 0.001). Serum IL-6, IL-8 and TNF-α levels in group B were significantly higher than those in group A ( t = 6.00, 7.78, 7.26, P < 0.001). The percentage of the maximum expiratory volume in the first second to the predicted value (FEV 1%pre) and the ratio of the maximum expiratory volume in the first second to the forced vital capacity (FEV 1/FVC) were (81.53 ± 6.30)% and (68.73 ± 4.65)% in group A, (70.47 ± 5.25)% and (60.86 ± 3.42)% in group B, and (59.02 ± 3.41)% and (56.93 ± 4.21)% in group C. With the worsening of the disease, FEV 1%pre and FEV 1/FVC were gradually decreased. FEV 1%pre and FEV 1/FVC in group C were significantly lower than those in group A ( t = 21.08, 12.62, both P < 0.001) and group B ( t = 12.27, 4.86, both P < 0.001). FEV 1%pre and FEV 1/FVC in group B were significantly lower than those in group A ( t = 9.05, 9.25, both P < 0.001). Spearman correlation analysis showed that serum IL-6, IL-8 and TNF-α levels were negatively correlated with FEV1%pre and FEV 1/FVC ( r = -0.50, -0.28, -0.42, -0.61, -0.34, -0.51, all P < 0.05). Conclusion:There is a correlation between chronic periodontitis and pulmonary ventilation function. Inflammatory mediators may be involved in chronic periodontitis as internal systemic factors.

Differentially expressed genes in chronic periodontitis and the correlation with disease severity / 国际生物医学工程杂志

Objective:To study the differentially expressed genes in chronic periodontitis (CP) and to explore the correlation with disease severity.Methods:Gene expression profile data associated with CP were screened in the Gene Expression Omnibus (GEO) database and analyzed with GEO2R online software to create volcano maps. Kyoto Encyclopedia of Genes and Genomes (KEEG) and Gene Ontology (GO) analyses were performed on the screened CP-associated differentially expressed genes to predict their possible functions and signaling pathways. The protein-protein interaction database (STRING) was used to analyze the interaction relationships between the encoded proteins of the screened CP-related differentially expressed genes. Cytohubba software was used to identify key genes in the signaling pathway. One120 CP patients and 40 healthy controls were selected. The screened CP-related genes were validated by the real-time polymerase chain reaction (q-PCR) method.Results:A total of 1 151 CP differentially expressed genes that met the requirements were screened. These genes were mainly enriched in the GO pathway for positive regulation of granulocyte differentiation, helper T-cell differentiation, leukocyte aggregation, regulation of acute inflammatory response, chemokine-mediated and endoplasmic reticulum unfolded protein response, as well as in the KEGG pathway for NFB pathway, chemokine pathway, cytokine receptor interaction, leukocyte transendothelial migration pathway, B-cell receptor pathway, Toll-like receptor pathway, etc. The protein-protein interaction network was constructed using the screened CP-related differentially expressed genes, which included 78 nodes and 496 links, with a mean aggregation coefficient and mean connectivity of 0.69 and 12.7, respectively. Cytohubba analysis showed that Sell was a key gene in the signaling pathway, and its relative expression levels in the gingival fluids of the three CP groups with different degrees(1.14±0.46, 0.86±0.41, 0.52±0.46) was significantly lower than that of the control group (1.50±0.65) (all P<0.05). The area under the ROC curve (AUC) of subjects diagnosed with CP using Sell expression levels in gingival fluid was 0.79 (95% CI: 0.71 to 0.86). The AUC values were greater than 0.65 at 95% CI when Sell was used as a biological marker to evaluate the severity of CP. Conclusions:CP-related differentially expressed genes are mainly enriched in the number of pathways associated with the inflammatory response of periodontitis. The expression levels of Sell genes were significantly reduced in the gingival sulcus fluid of CP patients and correlated with the severity of the disease. The Sell genes are expected to be a biomarker for CP grading.

Prevalence of Periodontitis in Erectile Dysfunction Patients

ABSTRACT@#Erectile dysfunction (ED) and periodontitis have common risk factors, such as diabetes mellitus and tobacco smoking. Multiple reports are available in regard to the association between ED and chronic periodontitis (CP). The study aimed to determine the association of ED and CP in selected Malaysian population. In this study, 74 patients (mean age = 52.4 ± 10.9 years old) diagnosed with ED, from scores via the International Index of Erectile Function (IIEF-5) questionnaire, were included. ED severity was classified as mild, mild to moderate, moderate, and severe. Periodontal condition was recorded using basic periodontal examination (BPE) method, of which scores of 0, 1, 2, and 3 were associated with having no periodontitis while a score of 4 was considered to have periodontitis. There are 40 (54.1%) subjects found to have periodontitis and the association of ED and periodontitis showed a moderate positive degree of correlation, ρ = 0.487 (p < 0.001). The percentage of subjects having periodontitis indicated an increasing trend with the severity of ED; from 19.0% (mild ED), 54.2% (mild to moderate ED), 75.0% (moderate ED), to 84.6% (severe ED). A greater degree of correlation was noted between dental scaling experience and ED, ρ = 0.635 (p < 0.001). Binomial logistic regression had shown no other co-morbidities and factors were affecting this relation. There seemed to be an association between ED and periodontitis existing in these selected Malaysian populations.

Comportamiento de la enfermedad periodontal inflamatoria crónica en pacientes diabéticos / Behavior of chronic inflammatory periodontal disease in diabetic patients

RESUMEN Introducción: La diabetes promueve alteración en la función de neutrófilos y la deposición en los tejidos periodontales de los productos finales derivados de la glicolización avanzada. Por ello, los diabéticos son vulnerables a la enfermedad periodontal inflamatoria crónica. Estudiar su comportamiento es indispensable para acometer acciones integrales y efectivas para su control y tratamiento. Objetivo: Determinar el comportamiento de la enfermedad periodontal inflamatoria crónica en pacientes de la Consulta de Atención Integral al Paciente Diabético en el Municipio Santa Cruz del Sur. Métodos: Se realizó un estudio descriptivo transversal, desde septiembre 2018 hasta mayo 2019, en el que se incluyeron 60 pacientes que acudieron durante ese período que presentaban más de 10 dientes en boca, afección periodontal inflamatoria crónica y dieron su consentimiento para participar. Se realizó examen clínico periodontal y examen radiográfico periapical. Resultados: El mayor número de pacientes con enfermedad periodontal inflamatoria crónica fue de 41-60 años de edad, predominó el sexo femenino, en ambas variables prevaleció la periodontitis crónica avanzada, afección preponderante también en los pacientes de más de 10 años de padecimiento de la diabetes mellitus. Conclusiones: En los pacientes con control metabólico inadecuado imperó la periodontitis crónica avanzada seguida de la moderada.

ABSTRACT Introduction: Diabetes promotes impaired neutrophil function and deposition in periodontal tissues of end products derived from advanced glycolization. The refore, diabetics are vulnerable to chronic inflammatory periodontal disease. Studying their behavior is essential to undertake comprehensive and effective actions for their control and treatment. Objective: To determine the behavior of chronic inflammatory periodontal disease in patients of the Comprehensive Care Consultation for Diabetic Patients in the Municipality of Santa Cruz del Sur. Methods: A cross-sectional descriptive study was carried out, in the period from September 2018 to May 2019, in which 60 patients who were attended during this period were included, they had more than 10 teeth in the mouth with chronic inflammatory periodontal disease and gave their consent to participate. A periodontal clinical examination and periapical radiographic examination were performed. Results: The largest number of patients with periodontal disease were 41-60 years old, female sex predominated, in both variables advanced chronic periodontitis prevailed, also preponderant in patients with more than 10 years of suffering from diabetes mellitus. Conclusions: Advanced chronic periodontitis prevailed in patients with inadequate metabolic control, followed by moderate.

Full-mouth ultrasonic debridement in the treatment of patients with diabetes and severe chronic periodontitis: preliminary study / Debridamento ultrassônico de boca toda no tratamento da periodontite crônica severa em pacientes diabéticos: estudo preliminar

ABSTRACT Objective: The purpose of this study was to clinically evaluate the effect of one-stage full-mouth ultrasonic debridement in the treatment of diabetic subjects with severe chronic periodontitis. Methods: Sixteen patients with uncontrolled diabetes (glycated hemoglobin ≥ 7%) and severe chronic periodontitis (at least 8 teeth with a probing depth and bleeding on probing were selected and randomly assigned to 2 treatment groups: control group (n=7) - quadrant-wise scaling and root planning; test group (n=9) - full-mouth ultrasonic debridement in one session of 45 minutes. The following outcomes were assessed: plaque index, gingival index, bleeding on probing, probing depth, clinical attachment level and gingival margin position. All parameters were assessed at baseline, 1 and 3 months after treatment. Probing depth, clinical attachment level and gingival margin position were analyzed using ANOVA and Tukey test, and the other clinical parameters analysed with the Friedman and Mann-Whitney tests. Results: An improvement in probing depth, clinical attachment level was observed after treatment in both groups, but without statistically significant differences between them. After 3 months, in initially deep pockets, the PD decreased 1.6 mm and 1.7 mm in test and control group, respectively. Clinical attachment level gain ≥ 2 mm was statistically significant at sites in control (10.1%) and test (13,4%) groups in 3 months. Conclusions: One-stage full-mouth ultrasonic debridement promoted similar clinical outcomes to those obtained with the scaling and root planning in the treatment of diabetic subjects with severe chronic periodontitis.

RESUMO Objetivo: Avaliar clinicamente o efeito do debridamento ultrassônico de boca toda no tratamento da periodontite crônica severa em pacientes diabéticos. Métodos: Dezesseis pacientes diabéticos descompensados (Hemoglobina Glicada ≥ 7%) com periodontite crônica severa (mínimo de 8 dentes com profundidade de sondagem ≥ 5 mm e sangramento à sondagem) separados aleatoriamente em 2 grupos: Controle (7): raspagem e alisamento radicular por quadrante e Teste (9): debridamento ultrassônico sessão única de 45 minutos. Os parâmetros clínicos avaliados foram: Índice de placa, Índice gengival, Sangramento à Sondagem, Profundidade de Sondagem, Nível de inserção clínico e Posição da Margem Gengival. As variáveis foram avaliadas no início, 1 e 3 meses após o tratamento. Para análise das variáveis quantitativas (Profundidade de sondagem, Nível de inserção e Posição da margem gengival de bolsas moderadas) foram realizados ANOVA e teste de Tukey e para as demais foram utilizados os testes de Friedman e Mann-Whitney. Resultados: Observou-se melhora na profundidade de sondagem e nível de inserção clínica após o tratamento em ambos os grupos, sem diferenças estatisticamente significativas entre eles. Após 3 meses, nas bolsas inicialmente profundas, a profundidade de sondagem reduziu 1,6 e 1,7 mm nos grupos teste e controle, respectivamente. Houve um ganho estatisticamente significante no nível de inserção ≥ 2 mm nos grupos controle (10,1%) e teste (13,4%), aos 3 meses. Conclusão: O debridamento ultrassônico de boca toda promoveu resultados clínicos semelhantes aos obtidos com a raspagem e alisamento radicular no tratamento da periodontite crônica severa em indivíduos diabéticos.

Salivary lactoferrin levels, disease severity and correlates in patients with chronic periodontitis presenting to a tertiary health facility in Nigeria

Objective: This study compared the concentration of salivary lactoferrin in patients with and without chronic periodontitis and investigated correlations with clinical variables of the disease. Methods: The study included 102 participants (51 cases and 51 controls) who presented at the Periodontology Clinic of University of Benin Teaching Hospital and met the selection criteria of '4mm and above' periodontal probing depths (PPD) and positive bleeding on probing (BOP) using community periodontal index (CPI) probe. Healthy participants (controls) were patients that had PPD less than or equal to 3mm, absence of BOP and simplified oral hygiene index (OHI-S) not more than 1.2. Baseline OHI-S and CPI scores were recorded. Saliva samples were collected and analyzed using enzyme-linked immunosorbent assay. All data were analyzed with the Statistical Package for Social Sciences (SPSS) version 22.0. Results: There was a statistically significant difference between the mean (SD) lactoferrin concentration of control participants 5.27(0.59) mg/l and case participants 6.74(0.61) mg/l (p<0.001). Participants with probing pocket depths (PPD) of 6mm or more had a significantly higher mean concentration [6.85(0.06) mg/l] than that of those with PPD 4-5mm [6.71(0.67) mg/l] (p< 0.001)Lactoferrin levels were highest in participants with 'poor' oral hygiene [6.85(0.60) mg/l] and lowest in those with 'good' oral hygiene [6.65(0.83) mg/l]. Conclusion: Salivary lactoferrin levels were higher among participants with chronic periodontitis than those without chronic periodontitis and correlates positively with the main clinical characteristics of the disease