Periodontal considerations in chemotherapy of patients with head and neck cancers

Dental clinics may encounter patients who are involved with head and neck cancer and are under chemotherapy. This review discuss about oral and periodontal complications due to chemotherapy and current ways to decrease this complications. 20 articles about chemotherapy and related complications were used for this review. Periodontist has to participate before and during the treatment of patients with head and neck cancers who receive chemotherapic agents and his / her cooperation with oncologist is necessary to achieve the best results. Participation of periodontist in all treatment stages of patients with head and neck cancers is critical. Participation of periodontist is necessary before beginning of treatment of patients with head and neck cancers and this cooperation must continue during and after treatment to achieve the best results

[Evaluation of the effect of adjunctive use of calcium hydroxide combined with periodontal dressing on dentin hypersensitivity after periodontal surgery]

Dentinal hypersensitivity is one of the most common complications which many patients complain in different ways. Dentinal hypersensitivity is caused by the opening of dentinal tubules to an oral cavity due to fractures, attritions, etc. It is a common complications after periodontal surgery. Many treatments have been suggested for this problem, till now. Calcium hydroxide is one of the materials used for treatment of root hypersensitivity after periodontal surgery. The aim of this study was to evaluate the effect of calcium hydroxide combined with periodontal dressing on root hypersensitivity after periodontal surgery. This study was done on 30 patients with severe periodontitis who needed periodontal surgery for both quadrants in each jaw. In each patient one quadrant was treated as a test and the other side was used as a control. In the test group 90mg of Calcium Hydroxide powder mixed with 1cm of Co-pack covered the site surgical. Twenty-one patients completed the procedure After surgery, a periodontal dressing combined with calcium hydroxide covered the area on the test side. The other side was used as a control and covered with a pure dressing. After one week the dressing was removed and the amount of hypersensitivity was measured with air flow and an explorer using the visual analog scale. Data were analyzed using the Wilcoxon sign rank test. The results showed that there were not any significant differences between the two sides in root sensitivity, but Plaque index in the test sides was lower than the control side. The periodontal dressing can not be used as a carrier for calcium hydroxide to reduce root hypersensitivity after periodontal surgery. Decrease in plaque accumulation after using the combination of calcium hydroxide and periodontal dressing may accelerate surgical wound healing but further investigations are necessary

[ evaluation of periodontium in patient's with spastic parapareseis related to HTLVI virus]

HTLVI virus is one of human's retroviruses which is the cause of T Lymphocytes Leukemia and spastic parpareseis or HTLVI associated myelopathy and some other inflammatory diseases, in some patients. Regarding that HTLVI is an endemic virus in Khorasan and the lack of studies and researches about its intraoral clinical signs, we decided to study periodontal status in patients with HTLVI associated Spastic Paraparesis. This was a case- control study with easy sampling that performed on about 30 patients [10 men and 20 women] with the mean age of 42 years in Mashhad dental school in 2004. Patients, whose HTLV1 involvement had been proved, took part in this study. Patients were chosen among people refered to neurology Department of Mashhad Ghaem hospital. Periodontal state, gingival disease, pocket depth, presence of leukoplakia, gingival linear erythema, candida infection, ANUG, NUP, were studied and three indices including Debris, Calculus Index [Green and Vermelion] and Gingival Index [Loe and silness] were recorded. In the view of Debris, Calculus and gingival indices, there were significant differences between control and case groups but there were no significant differences between two groups in pocket depth, leukoplakia, candida infection, ANUG and NUP. The patients with HAM/TSP have higher plaque, calculus and inflammation, compered to the healthy individuals. To eliminate Plaque and prevent of gingival disease, good oral hygiene is recommended

[-vitro evaluation of periodontal dressing plus calcium hydroxide on L929 fibroblast cells]

In most cases, after the surgical procedures were completed, the area was covered with a surgical pack. Dentin hypersensitivity is one of the common problems after periodontal surgeries. Calcium Hydroxide is an inexpensive and available material used for desensitizing. The purpose of this study was to evaluate the cytotoxicity of mixture of calcium hydroxide and periodontal dressing on L929 fibroblasts. In this study Rat fibroblasts were used. For preparing extracts, we added 0, 1, 5 and 10 mg of calcium hydroxide to 1 gr of periodontal dressing. Then, they were placed in autoclave followed by 5[cc] of basal media [DMEM].A control group consisting of L929 fibroblasts plus basal media was also considered. After 24, 48 and 72 hours incubation, we examined the numbers [quantity] as well as the morphology of the cells [quality]. For quantitative evaluation [MTT assay] after adding Tetrazolium salt to cells, we read the optical density of each plate using ELISA reader. The data were analyzed statistically using chi-square and Kruskal wallis test. All of the plates had the same quality but the cells in the control group showed more proliferation. All of the plates had plenty of vital and normal fibroblasts but in comparison with the control group the cells had developed less proliferation. Statistical test analysis of the data showed a significant difference between the optical density of the experimental plates and the control group indicating that the number of vital cells in control group was significantly greater than the test groups. Because the number of active vital cells in the plates with periodontal dressing was equal to other plates but less than control group, it can be concluded that the cytotoxic effects in the different plates were related to periodontal dressing, not Calcium hydroxide

Review of Microbiologic Similarities of Refractory periodontitis and refractory Periapical Periodontitis

Treatment resistance cases in both endodontal and periodontal diseases are sometimes encountered in spite of a good treatment. These cases may be caused by microbial agents and / or inefficient host responses. The microbial factors need further investigation and host response in discussed in this section. Thirty two articles and two text were reviewed for this discussion. The main cause of innate and specific immune system involvement in refractory periapical periodontitis are microbial factors, where as in refractory periodontitis the bacterial factor is less prominent and cigarette smoking is considered the main factor with emotional stressors micronutient deficiency and herpesviruses being contributing factors