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Objective:To investigate the effects of removable periodontal splint combined with minocycline on periodontal indexes and tooth aesthetics in patients with severe periodontal disease.Methods:A total of 102 patients with severe periodontal disease treated in the School and Hospital of Stomatology, China Medical University from November 2018 to April 2020 were included in this study. They were randomly allocated into study and control groups ( n = 51/group). The control group was subject to repair with removable periodontal splint based on routine interventions. The study group was subject to medication with minocycline in addition to the treatments used in the control group. Clinical efficacy, periodontal status (sulcus bleeding index, plaque index, periodontal pocket depth) and gingival crevicular fluid inflammatory factors (transforming growth factor β, monocyte chemoattractant protein-1, interleukin-6, matrix metalloproteinase-8) and bone metabolism indexes [osteocalcin, N-terminal procollagen of type I (PINP), N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (CTX) levels], comfort and aesthetics scores, and patient satisfaction were compared between the two groups. Results:Total response rate was significantly higher in the study group than in the control group [94.12% (48/51) vs. 80.39% (41/51), χ2 = 4.32, P < 0.05]. At 1 and 3 months after treatment, sulcus bleeding index (1.32 ± 0.41, 1.11 ± 0.36), plaque index (1.51 ± 0.44, 1.32 ± 0.51), periodontal pocket depth [(3.29 ± 0.70) mm, (2.51 ± 0.63) mm] were significantly lower in the study group than in the control group [1.65 ± 0.39, 1.45 ± 0.38, 1.92 ± 0.42, 1.88 ± 0.49, (5.05 ± 0.79) mm, (3.82 ± 0.86) mm, t = 4.16, 4.63, 4.81, 5.65, 11.90, 8.77, all P < 0.001]. At 1 and 3 months after treatment, the level of transforming growth factor β in the gingival crevicular fluid was significantly higher, and the level of matrix metalloproteinase-8 in the gingival crevicular fluid was significantly lower, in the study group compared with the control group (both P < 0.001). At 1 and 3 months after treatment, the level of osteocalcin in the gingival crevicular fluid was significantly higher, and the level of C-terminal telopeptide of type I collagen in the gingival crevicular fluid was significantly lower, in the study group compared with the control group ( t = -9.97, -10.71, -5.77, -7.40, 7.24, 16.11, all P < 0.001). At 1 and 3 months after treatment, the scores of comfort and aesthetics in the study group were significantly higher than those in the control group ( t = 7.49, 8.26, 7.84, 9.10, all P < 0.001). Patient satisfaction in the study group was significantly higher than that in the control group (94.12% vs. 80.39%, χ2 = 4.32, P < 0.05). Conclusion:Repair with a removable periodontal splint combined with minocycline can increase the therapeutic effects through reducing periodontal inflammation and regulating bone metabolism, thereby improving the periodontal condition, and improving tooth comfort and aesthetics and patient satisfaction in patients with severe periodontal disease.
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The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.
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Humanos , Consenso , Úlceras Bucales/terapiaRESUMEN
Ulcerative Colitis (UC) has been reported to be related to Porphyromonas gingivalis (P. gingivalis). Porphyromonas gingivalis peptidylarginine deiminase (PPAD), a virulence factor released by P. gingivalis, is known to induce inflammatory responses. To explore the pathological relationships between PPAD and UC, we used homologous recombination technology to construct a P. gingivalis strain in which the PPAD gene was deleted (Δppad) and a Δppad strain in which the PPAD gene was restored (comΔppad). C57BL/6 mice were orally gavaged with saline, P. gingivalis, Δppad, or comΔppad twice a week for the entire 40 days (days 0-40), and then, UC was induced by dextran sodium sulfate (DSS) solution for 10 days (days 31-40). P. gingivalis and comΔppad exacerbated DDS-induced colitis, which was determined by assessing the parameters of colon length, disease activity index, and histological activity index, but Δppad failed to exacerbate DDS-induced colitis. Flow cytometry and ELISA revealed that compared with Δppad, P. gingivalis, and comΔppad increased T helper 17 (Th17) cell numbers and interleukin (IL)-17 production but decreased regulatory T cells (Tregs) numbers and IL-10 production in the spleens of mice with UC. We also cocultured P. gingivalis, Δppad, or comΔppad with T lymphocytes in vitro and found that P. gingivalis and comΔppad significantly increased Th17 cell numbers and decreased Treg cell numbers. Immunofluorescence staining of colon tissue paraffin sections also confirmed these results. The results suggested that P. gingivalis exacerbated the severity of UC in part via PPAD.