Demineralized freeze-dried bone allograft with/without i-Platelet-rich fibrin in 3 wall intrabony defects

Demineralized freeze-dried bone allograft (DFDBA) contains bone morphogenetic proteins (BMPs), hence is osteoinductive. Autologous platelet concentrates exhibit a higher quantity of growth factors. Both these biomaterials aid in bone regeneration when placed in three-wall intrabony defects. However, their efficacy when used alone and in conjugation is not clear. Aim: To assess clinical and radiographic efficacy of injectable platelet-rich fibrin (i-PRF) with microsurgical access flap in the treatment of three-wall intrabony defects in chronic periodontitis patients. Methods: Thirty sites with three-wall intrabony defects were randomly assigned to control and test group by computer generated method. The test group obtained i-PRF mixed with DFDBA while the control group received only DFDBA. Clinical parameters such as site-specific Plaque index (PI), Radiographic intrabony defect depth (IBDD), modified- Sulcular bleeding index (mSBI), Clinical attachment level (CAL), and Probing pocket depth (PPD) were measured at baseline, three and six months. Results: Intragroup comparison within the control group and test group exhibited statistically highly significant variation of mean PI, mSBI, PPD, CAL, and IBDD score from baseline to 3 months and from 3-6 months (p<0.001). However, intergroup comparison demonstrated no statistically significant variation of mean IBDD at all 3 intervals (p>0.05). Conclusion: i-PRF combined with DFDBA enhanced the radiographic and clinical parameters as opposed to DFDBA alone. The role of i-PRF is promising in its capacity for easy obtainability and increased potential to aid in regeneration

Prevalencia de Porphyromonas gingivalis en fluido gingival y su relación con la periodontitis / Prevalence of Porphyromonas gingivalis in gingival fluid and its relationship with periodontitis

Introducción: la periodontitis es una enfermedad infecciosa multifactorial asociada a un biofilm de microorganismos patógenos. Objetivo: el objetivo del trabajo fue establecer la prevalencia de Porphyromonas gingivalis en pacientes con periodontitis y relacionarla con la severidad de la enfermedad. Material y métodos: participaron 45 pacientes, sistémicamente saludables, con edades entre 35 y 65 años. El grado de periodontitis se definió según los criterios de Papapanou y colaboradores. Como grupo control, se incluyeron 20 sujetos de ambos sexos sin periodontitis y sin enfermedades sistémicas. Se tomaron muestras de fluido gingival en dos sitios más profundos. Porphyromonas gingivalis se detectó por PCR (reacción en cadena de la polimerasa). Resultados: la frecuencia relativa de periodontitis fue de 13.3% grado I, 46.7% grado II y 40% grado III. El sexo masculino presentó periodontitis grado III 72.2% y grado II 52.3%. El grado I se registró con mayor frecuencia en el sexo femenino, 66.7%. La prevalencia de Porphyromonas gingivalis en la población con periodontitis fue de 44.4%. Se obtuvieron diferencias estadísticamente significativas entre los grados de severidad de periodontitis y la presencia de Porphyromonas gingivalis (p = 0.0002, α = 5%). Conclusión: la periodontitis predominó en el sexo masculino. La prevalencia de Porphyromonas gingivalis en la población con periodontitis crónica fue de 44.4% y su presencia está relacionada con la severidad (AU)

Introduction: periodontitis is a multifactorial infectious disease associated with a biofilm of pathogenic microorganisms. Objective: the objective of the work was to establish the prevalence of Porphyromonas gingivalis in patients with periodontitis and relate it to the severity of the disease. Material and methods: 45 systemically healthy patients, aged between 35 and 65 years old, participated. The degree of periodontitis was defined according to the criteria of Papapanou et al. As a control group, 20 patients of both sexes without periodontitis and without systemic diseases were included. Gingival fluid samples were taken from two deeper sites. Porphyromonas gingivalis was detected by PCR (polymerase chain reaction). Results: the relative frequency of periodontitis was 13.3% grade I, 46.7% grade II and 40% grade III. The male sex presented periodontitis grade III 72.2% and grade II 52.3%. Grade I was recorded more frequently in the female sex, 66.7%. The prevalence of Porphyromonas gingivalis in the population with periodontitis was 44.4%. Statistically significant differences were obtained between the degrees of severity of periodontitis and the presence of Porphyromonas gingivalis (p = 0.0002, α = 5%). Conclusion: periodontitis predominated in males. The prevalence of Porphyromonas gingivalis in the population with chronic periodontitis was 44.4% and its presence is related to severity (AU)

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.

Effectiveness of Platelet-Rich Fibrin with Decalcified Freeze-Dried Bone Allograft Compared to Decalcified Freeze-Dried Bone Allograft Alone in Mandibular Grade-II Furcation Defects: A Quasi-Experimental Study

ABSTRACT Objective: To assess the effectiveness of platelet-rich fibrin (PRF) with decalcified freeze-dried bone allograft (DFDBA) compared to DFDBA alone in mandibular grade-II furcation defects. Material and Methods: A quasi-experimental study was conducted on nine patients with chronic periodontitis, each having two almost identical mandibular grade II furcation defects. Test sites (left mandibular first molars) were treated with open flap debridement (OFD), DFDBA, and PRF, whereas control sites (right mandibular first molars) received OFD and DFDBA alone. Clinical parameters (plaque index (PI), gingival index (GI), vertical clinical attachment level (VCAL) and horizontal clinical attachment level (HCAL) into the furcation defect) and radiographic measurements (mean alveolar bone defect) were done at baseline and after six months postoperatively. Results: The gain in relative horizontal clinical attachment level (RHCAL) in the test sites was 2.94±0.52 mm compared to 1.33±0.35 mm in control sites (p=0.01). Improvement in mean alveolar bone defect (MABD) (was 1.21±0.5 mm2 at test sites compared to 1.15±0.7 mm2 at control sites) probing pocket depth (PPD), recession, relative vertical attachment level (RVCAL), and percentage of bone fill was found in the test sites compared to control, which statistically insignificant. Conclusion: The test sites had better outcomes than control sites, which was significant for the parameter RHCAL. Therefore, combining the biological benefits of autologous PRF with DFDBA is an efficient and economical treatment modality for the management of mandibular grade II furcation defects.

Asociación del hábito de fumar con la periodontitis crónica y la artritis reumatoide / Association of smoking with chronic periodontitis and rheumatoid arthritis

Introducción: Porphyromonas gingivalis es un microorganismo presente en las periodontitis, productor de la enzima peptidil arginina desminasa, inductora de la citrulinación de proteínas que convierte en antígenos, y que son reconocidos por los anticuerpos antipéptido cíclico citrulinados, marcadores específicos de la artritis reumatoide. Estudios clínicos y epidemiológicos relacionan el hábito de fumar con la periodontitis y la artritis reumatoide. Objetivo: Evaluar la asociación entre el hábito de fumar, la periodontitis crónica y la artritis reumatoide. Métodos: Se realizó un estudio observacional, analítico, de corte transversal, de casos y controles de pacientes con diagnóstico de artritis reumatoide tratados en el Centro de Reumatología y pacientes atendidos por medicina interna en el Hospital Clínico Quirúrgico 10 de octubre de La Habana, en el periodo entre septiembre del 2017 y mayo del 2019. Se estudiaron las variables edad, sexo, hábito de fumar y estado periodontal evaluado a través del índice de enfermedad periodontal de Russell y el nivel de inserción clínica. Para identificar la asociación entre variables se empleó la prueba de ji al cuadrado y el odds ratio. Se respetaron las legislaciones éticas. Resultados: En el estudio prevaleció el grupo de 35 a 44 años y el sexo femenino. El hábito de fumar predominó en los pacientes artríticos, con manifiesto incremento de la prevalencia y gravedad de la enfermedad periodontal. Conclusiones: El hábito de fumar incrementó el riesgo de periodontitis crónica en ambos grupos, y con menos intensidad de riesgo en la artritis reumatoide.

Introduction: Porphyromonas gingivalis is a microorganism present in periodontitis, producer of the enzyme peptidyl arginine deminase that induces citrullination of proteins, turning them into antigens, which are recognized by anti-citrullinated cyclic peptide antibodies, specific markers of rheumatoid arthritis. Clinical and epidemiological studies link smoking with periodontitis and rheumatoid arthritis. Objective: To evaluate the association between smoking, the presence of chronic periodontitis and rheumatoid arthritis. Methods: An observational, analytical, cross-sectional study of cases and controls of patients with a diagnosis of rheumatoid arthritis treated at the Rheumatology Center and patients treated by Internal Medicine in 10 de Octubre Surgical- Clinic Hospital in Havana, between September 2017 and May 2019. The variables were: age, sex, smoking habit and periodontal status evaluated through the Russell Periodontal Disease Index and Level of Clinical Insertion. For the association and relationship between variables, the chi square and the odds ratio were used. Ethical legislation was respected. Results: In the study the group of 35 to 44 years old and the female sex prevailed. Smoking prevailed in arthritic patients with a remarkable increase in the prevalence and severity of periodontal disease. Conclusions: Smoking increased the risk of chronic periodontitis in both groups with less intensity of risk in rheumatoid arthritis.

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.

Caracterización del tipo de sensibilidad dental de pacientes con periodontitis y su respuesta a los dentífricos / Characterization of the type of dental sensitivity of patients with periodontitis and their response to dentifrices

La hipersensibilidad de la dentina surge ante la exposición de esta y en respuesta a estímulos de diverso tipo, fundamentalmente de origen térmico, evaporativo, táctil, osmótico o químico. Se realizó una investigación abocada a caracterizar la hipersensibilidad dental de pacientes atendidos en consulta de odontología y la respuesta a determinado dentífrico utilizado. En el análisis de estimulación dental se tomaron 308 mediciones de la sensibilidad dental para todos los participantes (n=22), con 7 factores de tiempo (T0 antes del uso del producto, T3 días, T5 días, T8 días, T22 días y T29 días después del uso del dentífrico). Se realizó la prueba paramétrica regresión lineal simple para identificar la tendencia y el ajuste de los datos, al considerar dichas variables como una serie temporal. Se utilizaron 22 tratamientos. Casi el 91,0% expreso que el dentífrico había cumplido sus expectativas, fundamentalmente por la reducción de la hipersensibilidad a corto plazo, mientras que aproximadamente 91,0% de los casos afirmó que compraría el dentífrico (20 casos, IC 95%: 72,2% y 97,5%), respectivamente(AU)

Dentin hypersensitivity arises when exposed to it and in response to various types of stimuli, mainly of thermal, tactile evaporative, osmotic or chemical origin. An investigation was carried out aimed at characterizing the dental hypersensitivity of patients seen in the dental office and the response to a certain toothpaste used. In the dental stimulation analysis, 308 measurements of tooth sensitivity were taken for all participants (n = 22), with 7 time factors (T0 before use of the product, T3 days, T5 days, T8 days, T22 days and T29 days after using the toothpaste). The simple linear regression parametric test was performed to identify the trend and the fit of the data, considering these variables as a time series. 22 treatments were used. Almost 91.0% believed that the toothpaste had met their expectations, mainly due to the reduction in hypersensitivity in the short term, while approximately 91.0% of the cases stated that they would buy the toothpaste (20 cases, 95% CI: 72 , 2% and 97.5%), respectively(AU)

Use and effectiveness of propolis on chronic periodontitis: a systematic review / Uso y efectividad del propóleo en periodontitis crónica: una revisión sistemática

Abstract The aim of this study was to determine the effect of propolis on non- surgical periodontal therapy in patients with chronic periodontitis (CP) as it appears in the recent literature. Propolis is a natural and biocompatible resinous substance that has shown, by means of several scientific studies, to possess medicinal properties such as antimicrobial, healing, anesthetic, anti-inflammatory, and analgesic, among others. There are several studies that have reported the use of propolis as a non- surgical treatment of CP, its comparison with other antimicrobials, and the improvement of clinical and microbiological parameters with scaling and root planing (SRP). A bibliographic search was conducted in the PubMed, Google Scholar, Web of Science, and Science Direct databases up to 2021. The results showed that there are very few reports focused on clinical studies; however, according to the analyzed data, propolis could be a good adjuvant for the treatment of patients with chronic periodontitis compared to the conventional treatment (SRP).

Resumen El objetivo de este estudio fue determinar el efecto del propóleo sobre la terapia periodontal no quirúrgica en pacientes con periodontitis crónica (PC) en la literatura reciente. El propóleo es una sustancia resinosa natural y biocompatible que ha sido demostrado a través de varios estudios científicos que posee propiedades medicinales como antimicrobianas, cicatrizantes, anestésicas, antiinflamatorias, analgésicas, entre otras. Existen varios estudios que han reportado el uso del propóleo como tratamiento no quirúrgico de la PC y su comparación con otros antimicrobianos y la mejora de los parámetros clínicos y microbiológicos con el raspado y alisado radicular (SRP). Se realizó una búsqueda bibliográfica en las bases de datos directas de PubMed, Google Scholar, Web of Science y Science hasta el 2021. Los resultados muestran que existen muy pocos reportes enfocados a estudios clínicos, sin embargo, según los datos analizados, el propóleo podría ser un buen adyuvante para el tratamiento de pacientes con periodontitis crónica en comparación con el tratamiento convencional (SRP).

Gingival crevicular fluid as Biomarker's source for alzheimer's disease / Fluido crevicular gingival como biomarcador de enfermedad de Alzheimer

Abstract Periodontitis is a low-grade inflammatory disease caused by a subgingival dysbiotic microbiota. Multiple studies have determined the higher prevalence of tooth loss and poor oral hygiene in patients with Alzheimer's disease (AD). However, the periodontal diagnosis, periodontal bacteria or mediators has not been measured to date. Aim: To determine the periodontal status, the pro-inflammatory mediators, Porphyromonas gingivalis load, and Apoliporpotein E (ApoE) in patients with AD. A complete dental examination was performed on 30 patients, and cognitive status was determined by the Montreal Cognitive Assessment (MoCA). Subgingival microbiota and GCF samples were then taken from all patients from the deepest sites. Total DNA was isolated from the microbiota samples for the quantification of the 16S ribosomal subunit. Pro-inflammatory mediators and ApoE were quantified from the gingival crevicular fluid (GCF). Patients with AD had periodontitis stage III-IV in 80%, a higher concentration of pro-inflammatory and ApoE mediators, and a higher P. gingivalis load compared to healthy subjects. The pro-inflammatory mediators, P. gingivalis load had a negative correlation with the MoCA test scores. Finally, a ROC curve was performed to assess the specificity and sensitivity of ApoE levels, detecting an area of 84.9%. In AD patients, we found a more severe periodontitis, a higher levels of pro-inflammatory mediators, and higher bacterial load. In addition, there is an increase in ApoE that allows to clearly determine patients with health, periodontitis and periodontitis and AD.

Resumen La periodontitis es una enfermedad crónica no transmisible que se caracteriza por generar una inflamación sistémica de bajo grado causada por una microbiota disbiótica subgingival. Múltiples estudios han determinado la mayor prevalencia de pérdida de dientes y mala higiene bucal en pacientes con enfermedad de Alzheimer (EA). Sin embargo, el diagnóstico periodontal, bacterias periodontales o mediadores pro-inflamatorio no se ha medido hasta la fecha. Determinar el estado periodontal, los mediadores pro-inflamatorios, la carga de Porphyromonas gingivalis y la apoliporpoteína E (ApoE) en pacientes con EA. Se realizó un examen odontológico completo en 30 pacientes y el estado cognitivo se determinó mediante la Evaluación Cognitiva de Montreal (MoCA). Luego, se tomaron muestras de microbiota subgingival y FCG de todos los pacientes de los sitios más profundos. Se aisló el DNA total de las muestras de microbiota para la cuantificación de la subunidad ribosómica 16S. Los mediadores pro-inflamatorios y la ApoE se cuantificaron a partir del líquido crevicular gingival (GCF). Los pacientes con EA tenían periodontitis en estadio III-IV en 80%, una mayor concentración de mediadores pro-inflamatorios y ApoE, y una mayor carga de P. gingivalis en comparación con los sujetos sanos. Los mediadores pro-inflamatorios y la carga de P. gingivalis tuvieron una correlación negativa con las puntuaciones de la prueba MoCA. Finalmente, se realizó una curva ROC para evaluar la especificidad y sensibilidad de los niveles de ApoE, detectando un área del 84,9%. En los pacientes con EA encontramos una periodontitis más severa, mayores niveles de mediadores pro-inflamatorios y mayor carga bacteriana. Además, un aumento de ApoE que permite determinar claramente a los pacientes con salud, periodontitis y periodontitis y EA.

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.

Comparison of Oncostatin M in Patients with Chronic Periodontitis with and without Diabetes

Abstract Objective: To compare the Oncostatin M (OSM) concentrations in tissues of patients with chronic periodontitis with and without diabetes. Material and Methods: Sixty-four subjects visiting the dental outpatient department were categorized as "healthy" (Group 1), "periodontitis" (Group 2), and "diabetes with periodontitis" (Group 3) groups. The clinical oral examination included assessment of plaque, gingivitis, probing depth, clinical attachment level. Blood glucose was assessed for group 3 patients. OSM concentration in the tissues was assessed using ELISA in all groups. Results: The mean OSM was 0.02 ± 0.04 pg/mg in the healthy group, 0.12 ± 0.09 pg/mg in the chronic periodontitis group and 0.13 ± 0.10 pg/mg in the diabetes-periodontitis group. A significantly higher mean OSM was seen in Group 2 and Group 3 than Group 1. The amount of OSM positively correlated with probing depth and clinical attachment level. Conclusion: Periodontal disease causes a rise in Oncostatin M, independent of the diabetic status. Expression of OSM in the gingival tissues can serve as an inflammatory marker.

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

Comparison of initial periodontal therapy and its correlation with white blood cell level in periodontitis patients with or without diabetes mellitus / 北京大学学报(医学版)

OBJECTIVE@#To compare the clinical efficacy of initial periodontal therapy in periodontitis patients with or without type 2 diabetes mellitus and its correlation with white blood cell counts.@*METHODS@#In this study, 32 chronic periodontitis patients without systemic disease (CP group) and 27 chronic periodontitis patients with type 2 diabetes mellitus (CP+DM group) were enrolled. At admission, all the patients went through periodontal examination and fasting blood examination(baseline). Probing depth (PD), attachment loss (AL), bleeding index (BI), plaque index (PLI), white blood cells (WBC) counts and fasting blood glucose (FBG) were recorded respectively, while hemoglobin A1c (HbA1c) was recorded only in CP+DM group. After that, initial periodontal therapy was performed. All the tests were repeated 3 and 6 months after treatment. The changes of periodontal clinical indexes and WBC levels were compared between the two groups before and after treatment, and the correlation between WBC and periodontal clinical indexes and glucose metabolism indexes were analyzed by generalized linear mixed model.@*RESULTS@#At baseline, the periodontal inflammation and destruction were similar in CP and CP+DM group, but the WBC level was significantly higher in CP+DM groups [(6.01±1.26)×109/L vs. (7.14±1.99)×109/L, P=0.01]. After 3 and 6 months of initial periodontal therapy, the mean PD, AL, BI, and PLI in CP+DM and CP groups were significantly lower than the baseline, and the PD in CP+DM group was further decreased by 6 months compared with 3 months [(3.33±0.62) mm vs. (3.61±0.60) mm, P < 0.05]. However, none of these periodontal indexes showed significant difference between the two groups by 3 or 6 months. In CP+DM group, HbA1c at 3 months and 6 months were significantly lower than the baseline [(7.09±0.79)% vs. (7.64±1.16)%, P < 0.05; (7.06±0.78)% vs. (7.64±1.16)%, P < 0.05], and FBG was significantly lower than the baseline by 6 months [(7.35±1.14) mmol/L vs. (8.40±1.43) mmol/L, P < 0.05]. The WBC level in CP group was significantly lower than the baseline level by 3 months [(5.35±1.37)×109/L vs. (6.01±1.26)×109/L, P < 0.05], while that in CP+DM group was significantly lower than the baseline level by 6 months [(6.00±1.37)×109/L vs. (7.14±1.99)×109/L, P < 0.05]. The analysis of genera-lized linear mixed model showed that WBC level was significantly positively correlated with PD and FBG (P < 0.05).@*CONCLUSION@#Initial periodontal therapy can effectively improve the periodontal clinical status of patients with or without type 2 diabetes mellitus, and have benefits on glycemic control in diabetic patients. However, the response of periodontal indexes and WBC level to initial therapy were relatively delayed in diabetic patients. WBC plays an important role in the correlation between diabetes mellitus and periodontitis.

Estimation of salivary malondialdehyde Levels in smokeless tobacco chewers with chronic periodontitis-A cross sectional clinico biochemical study / Estimación de los niveles de malondialdehído salival en masticadores de tabaco sin humo con periodontitis crónica: un estudio bioquímico clínico transversal

ABSTRACT: Despite the reported effects of smokeless tobacco (ST) on the periodontium and high prevalence of ST use in rural populations and in males studies on this specific topic are limited. The purpose of this cross-sectional investigation was to measure lipid peroxidation (as an end product of oxidative stress) end product i.e. Malondialdehyde (MDA) in saliva of patients with gingivitis, chronic periodontitis and to assess the influence of smokeless tobacco on Salivary Malondialdehyde (S-MDA). Total 30 patients with gingivitis, 30 with chronic periodontitis and 30 Smokeless Tobacco Chewers with Chronic Periodontitis and 30 periodontally healthy subjects were included in the study. Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PD), and Clinical Attachment Loss (CAL) were recorded followed by stimulated Saliva sample collection. Salivary MDA Levels were assessed by UV Spectrophotometry. There was a statistically significant increase in the salivary MDA levels in gingivitis, chronic periodontitis and in smokeless tobacco chewers with chronic periodontitis when compared with healthy group. Higher salivary MDA levels in gingivitis group, chronic periodontitis, and smokeless tobacco chewers with chronic periodontitis reflects increasedoxygen radical activity during periodontal inflammation.

RESUMEN: A pesar de los efectos reportados del tabaco sin humo (TS) sobre el periodonto y la alta prevalencia del uso de TS en poblaciones rurales y en hombres, los estudios sobre este tema específico son limitados. El propósito de esta investigación transversal fue medir el producto final de la peroxidación lipídica (como producto final del estrés oxidativo), es decir, malondialdehído (MDA) en la saliva de pacientes con gingivitis, periodontitis crónica y evaluar la influencia del tabaco sin humo en el malondialdehído salival (S-MDA). Se incluyeron en el estudio un total de 30 pacientes con gingivitis, 30 con periodontitis crónica y 30 masticadores de tabaco sin humo con periodontitis crónica y 30 sujetos periodontalmente sanos. Se registraron el índice de placa (PI), el índice gingival (GI), la profundidad de la bolsa de sondeo (PD) y la pérdida de adherencia clínica (CAL), seguidos de la recogida de muestras de saliva estimuladas. Los niveles de MDA en saliva se evaluaron mediante espectrofotometría UV. Hubo un aumento estadísticamente significativo en los niveles de MDA en saliva en gingivitis, periodontitis crónica y en masticadores de tabaco sin humo con periodontitis crónica en comparación con el grupo sano. Los niveles más altos de MDA en saliva en el grupo de gingivitis, periodontitis crónica y masticadores de tabaco sin humo con periodontitis crónica reflejan un aumento de la actividad de los radicales de oxígeno durante la inflamación periodontal.

Enfermedad periodontal inmunoinflamatoria crónica y factores de riesgo en adolescentes de instituciones deportivas / Chronic immune-inflammatory periodontal disease and risk factors in adolescents from sports institutions

RESUMEN Fundamento: La enfermedad periodontal inmunoinflamatoria crónica se considera un problema de salud bucal a escala mundial; los deportistas también son susceptibles de padecerla. Objetivo: Identificar el estado periodontal de adolescentes de la Escuela de Iniciación Deportiva Provincial Lino Salabarría de Sancti Spíritus. Metodología: Se realizó un estudio observacional descriptivo de corte transversal durante el curso 2020-2021. La población se constituyó por 810 adolescentes de 7.mo a 12.mo grados de la Escuela de Iniciación Deportiva Provincial Lino Salabarría de Sancti Spíritus; se seleccionó la muestra de 36 mediante muestreo probabilístico, aleatorio simple estratificado. Se estudiaron las variables estado periodontal y factores de riesgo. Se determinó el estado periodontal mediante el índice de Rusell y la higiene bucal por el de higiene bucal simplificado. Resultados: Se constató que el 94.4 % de los adolescentes presentó gingivitis y solo el 5.6 % periodontitis. El 100 % presentó higiene bucal deficiente, el 94.2 % apiñamiento dentario y el 91.7 % cálculo dental. Conclusiones: La mayoría de los adolescentes presentó gingivitis y entre los factores de riesgo se constató la totalidad con higiene bucal deficiente y casi todos con apiñamiento dentario y cálculo dental.

ABSTRACT Background: Chronic immune-inflammatory periodontal disease is considered a worldwide oral health problem; athletes are also susceptible to it. Objective: To identify the periodontal state of adolescents from the Sancti Spíritus Provincial Sports Initiation School Lino Salabarría. Methodology: A cross-sectional descriptive observational study was conducted during the 2020-2021 school year. The population consisted of 810 adolescents from 7th to 12th grades from the Sancti Spíritus Provincial Sports Initiation School Lino Salabarría; the sample of 36 was selected by stratified simple random probability sampling. The variables periodontal state and risk factors were studied. Periodontal status was determined by Rusell index and oral hygiene by the simplified oral hygiene index. Results: It was found that 94.4 % of adolescents had gingivitis and only 5.6 % had periodontitis. 100 % presented poor oral hygiene, 94.2 % dental crowding and 91.7 % dental calculus. Conclusions: Most adolescents presented gingivitis and among the risk factors, all had poor oral hygiene also almost all had dental crowding and dental calculus.

¿Es la proteína C reactiva un indicador de riesgo periodontal? / Is C Reactive Protein a Risk Indicator for Periodontal Disease?

RESUMEN: La periodontitis es una enfermedad inflamatoria crónica, multifactorial, causada por microorganismos y caracterizada por la destrucción progresiva del tejido de soporte dental. En los últimos años se han realizado estudios que señalan cierta similitud y asociación entre la periodontitis y la enfermedad cardiovascular aterosclerótica. Esta relación se ha establecido por tener ciertos factores de riesgo en común y por producir incremento plasmático de la proteína C reactiva (P-CR). A esta proteína se le atribuyen características favorables como marcador inflamatorio. Este estudio busca establecer si existe algún tipo de relación, entre la periodontitis y los valores de la P-CR antes de iniciar el tratamiento periodontal, en un grupo de pacientes de la Facultad de Odontología de la Universidad de Costa Rica. Se hicieron exámenes periodontales a 30 pacientes y se obtuvo una muestra de sangre de cada uno para determinar la concentración de P-CR. Con respecto al valor de la P-CR, se encontró que el promedio fue de 3.72mg/L (IC95%: 2.06-5.38), lo que constituye un marcador de riesgo de moderado a severo. El 54% de los pacientes presentó enfermedad periodontal crónica generalizada, sin que se encontrara diferencia estadísticamente significativa por sexo (p=0.416), ni edad (p=0.477). El 43% de los pacientes padecía de enfermedad periodontal crónica localizada y el 3% de los pacientes presentaron gingivitis. Se observó que el género femenino mostró relativamente, un mayor riesgo cardiovascular respecto al género opuesto (p=0.640). No se encontró diferencia estadísticamente significativa en el valor de P-CR por sexo, edad o la presencia de otras enfermedades, aunque esta cifra fue mayor en los que presentaron enfermedades metabólicas (5.5mg/L) con respecto a quienes no las padecían (2.7mg/L).

ABSTRACT: Periodontitis is an inflammatory multifactorial chronic disease, caused by microorganisms that destroys periodontal tissues. In the last years, several studies have described an association between periodontitis and atherosclerotic cardiovascular disease. This relationship has been made since both diseases share the same risk factors and they both increase C reactive proteins levels. C-reactive protein (C-RP) is a well-known inflammatory marker. This study was designed to try to stablish the relationship between C-RP levels and periodontitis in a group of patients that need periodontal treatment at Odontology Faculty in Universidad de Costa Rica. Periodontal examinations were done to 30 patients and blood samples were taken. The mean value of C-RP found was 3.72mg/L (IC95%: 2.06-5.38) which represents a medium- high risk level. 54% of the patients had generalized chronic periodontitis, without statistical difference when compared gender (p=0.416) or age (p=0.477). 43% had chronic localized periodontitis and 3% gingivitis. Females showed a higher risk for cardiovascular disease (p=0.640). No statistical differences were found between C-RP values relating gender, age or other comorbilities, even though mean values were always higher in those suffering metabolic diseases (5.5mg/L) compared to those values from patients not suffering the same diseases (2.7mg/L).

Periodontitis, dislipidemia y obesidad. Su relación / Relationship between periodontitis and dyslipidemia and obesity

Introducción: Desde hace algunos años, se reporta en la literatura médica una posible asociación entre la periodontitis con otras enfermedades y condiciones sistémicas. Objetivo: Determinar la relación entre la periodontitis con las dislipidemia, obesidad o ambas. Material y Método: Estudio analítico transversal. Del universo de 9 350 individuos residentes en el municipio Plaza de la Revolución en edades entre 35 y 70 años, ambos sexos; se seleccionó una muestra probabilística utilizando el esquema muestreo aleatorio simple de 1 200 individuos que otorgaron su consentimiento para participar. Debían presentar, en su historia clínica médica, resultados de análisis complementarios para detectar dislipidemia en los últimos seis meses y como mínimo seis dientes en boca. Las variables estudiadas fueron: periodontitis, dislipidemia, obesidad y presencia de dislipidemia y obesidad en el mismo individuo. Los sujetos se clasificaron en tres grupos: con presencia de dislipidemia, obesos y ambas entidades (dislipidemia+obesidad). Resultados: La variable más encontrada fue dislipidemia (73,0 por ciento), seguida de periodontitis (62,2 por ciento). La periodontitis se encontró con mayor frecuencia en individuos que presentaban dislipidemia (48,1 por ciento), los obesos presentaron en su mayoría periodontitis, en los sujetos que presentaron dislipidemia + obesidad, la periodontitis fue más frecuente que en los que no presentaban ambas entidades unidas. Conclusiones: La periodontitis se relacionó con la dislipidemia, obesidad y ambas unidas, no así con la obesidad, aunque fue más frecuente en estos últimos que en los no obesos(AU)

Introduction: A possible association between periodontitis and other diseases and systemic conditions has been reported by the medical literature for many years. Objective: To determine the relationship between periodontitis and dyslipidemia and obesity or both of them. Material and Methods: An analytical cross-sectional study was conducted. The universe consisted of 9 350 individuals between the ages of 35 and 70 years, of both sexes who live in Plaza de la Revolución Municipality. From this universe, a sample composed of 1 200 individuals who gave their consent to participate in the study was selected by simple random sampling method. Their clinical records should include the results of complementary tests to determine dyslipidemia in the last six months; also, they should have at least six teeth in the mouth. The variables studies included: periodontitis, dyslipidemia, obesity and the presence of dyslipidemia and obesity in the same individual. The subjects were divided into three groups: with dyslipidemia, obese and with both entities (dyslipidemia+obesity). Results: The most common variable found was dyslipidemia (73,0 percent), followed by periodontitis (62,2 percent). Periodontitis was more frequently found in individuals with dyslipidemia (48,1 percent), and the majority of obese subjects had periodontitis. Periodontitis was more frequent in individuals with dyslipidemia + obesity than in the ones that did not present both entities at the same time. Conclusions: Periodontitis was associated with dyslipidemia, obesity and with both entities at the same time, but it was not associated with obesity only. However, it was more frequent in obese subjects than in non-obese ones(AU)

Uso de probióticos como adición al tratamiento periodontal no quirúrgico en pacientes con periodontitis / Use of probiotics as an adjunctive therapy to non-surgical periodontal treatment in patients with periodontitis

RESUMEN Introducción: El tratamiento periodontal no quirúrgico corresponde a la terapia estándar para la periodontitis crónica. En este contexto, se ha propuesto que el uso de probióticos orales como complemento al tratamiento estándar podría mejorar los resultados obtenidos clínicamente, sin embargo no existe claridad respecto a su efectividad. Métodos: Se realizó una búsqueda en Epistemonikos: base de datos de revisiones sistemáticas en salud mantenida mediante el cribado de múltiples fuentes de información, la cuál incluye MEDLINE, EMBASE, Cochrane, entre otras. Se extrajeron los datos desde las revisiones identificadas y un análisis de los datos de los estudios primarios. Se realizó un metanálisis y se preparó una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Se Identificaron seis revisiones sistemáticas que en conjunto incluyeron 14 estudios primarios, todos correspondientes a ensayos aleatorizados. De los resultados analizados se concluye que el uso de probióticos orales como complemento al tratamiento no quirúrgico de periodontitis crónica probablemente resulta en nula o poca diferencia en la reducción de la profundidad de sondaje, el sangrado al sondaje y una ganancia de nivel de inserción clínico en los sitios afectados. Por otro lado, no se encontraron estudios que evaluaran el riesgo de presentar halitosis en pacientes sometidos a terapia periodontal no quirúrgica con adición de probióticos.

ABSTRACT: Introduction: Non-surgical periodontal treatment is the standard treatment to chronic periodontitis. It has been proposed that the use of oral probiotics as an adjunctive therapy may improve clinical outcomes, however there is no clarity regarding its effectiveness. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified six systematic reviews including 14 studies overall, of which all were randomized trials. We concluded that the addition of probiotics to non-surgical periodontal treatment probably results in little or no difference in probing depth reduction, clinical attachment level gain and reduction in bleeding on probing. No studies were found evaluating halitosis in patients undergoing non-surgical periodontal treatment with the addition of probiotics.