RESUMO
The aim of the present study was to evaluate clinically, radiographically and histologically the adjunctive treatment of periodontal intrabony defects by surgical debridment and local application of a single dose of simvastatin granules. Twenty intraosseous interproximal defects in 10 systemially healthy moderate to severe chronic periodontitis patients constituted the study sample. All patients received initial therapy, then when qualified for surgery defects were randomly divided into 2 groups. Group I defects were treated with surgical debridment and adjunctive use of local application of [2.2 mg] simvastatin granules. Group II defects were treated with surgical debridment alone. At baseline; 6 and 9 months post-surgery clinical and radiographic parameters evaluated included gingival index [GE], probing pocket depth [PPD], clinical attachment level [CAL], radiographic bone density [RBD] and linear radiographic measurement [LRM]. Both groups showed statistical reduction of PPD and gain in CAL after 9 months. Comparing both groups, there was a significant PPD reduction at 9 months and gain in CAL at 6 and 9 months [t= 2.333, 2.910] post operatively in gp I when compared to gp II. Gp I showed a statistical decrease in LRM and RBP at 6 and 9 months, whereas gp II revealed at decrease at 9 months ony. There was a significant decrease of LRM and RBP at nine months when gp I was compared to gp II [2.187, 1.579]. a histological study was carried out to assess the nature of healing 10 critical sized matched bilateral osseous defects were surgically induced at the interproximal area of mandibular 3rd and 4th premolars in 5 dogs, these defects were treated in as similar manner to their human counter parts, the animals were sacrificed at 4, 12 and 24 weeks post-surgery. Gp I revealed formation of a thick layer of new lamellated bone, typical functional orteination of periodontal ligament and enhancement of periodontal regeneration. In conclusion, simvastatin acted as a true osteoinductive material by promotion of new bone formation
RESUMO
The aim of the present case control study was to identify seroprevalence of hepatitis B and C virus [HBV and HCV] infections among one hundred cases with periodontal disease [71% gingivitis and 29% adult periodontitis] and one hundred controls with healthy gingiva matched for age and sex. Moreover, it aimed to detect hepatitis markers in saliva samples corresponding to the positive sera. Different risk factors associated with hepatitis infection and detectability rate of hepatitis markers were also studied. Methodology: enzyme linked immunosorbent assay [ELISA] technique was used to detect the presence of hepatitis B surface antigen [HBsAg], antibody to hepatitis B core antigen [anti HBc], e antigen [eAg] and antibody to hepatitis C virus [anti HCV] both in serum and saliva samples. HCV RNA was detected by polymerase chain reaction [PCR] technique. Oral examination was performed for assessment of simplified Oral Hygiene Index [OHI-S], Papillary Bleeding Index [PBI], probing pocket depth and loss of fibre attachment. cases with periodontal disease showed higher percentages of hepatitis exposure [hepex; anti HCV and/or anti HBc] and significantly higher anti HCV seropositivity than the controls [26% and 13% versus 22% and 8%, respectively]. No difference in HBsAg carrier rate nor in anti HBc seropositivity was elicited. Furthermore, cases with periodontal disease showed higher detectability rate of HBsAg, anti HBc, anti HCV or both anti HCV and/or anti HBc in whole unstimulated saliva than the controls [100% vs 66.7%, 50% vs 23.5%, 23.1% vs 0.0% and 42.3% vs 18.2%, respectively]. Stepwise logistic regression delineated two significant factors associated with the risk of hepatitis exposure, the first predictor was the rural residence and the second one was the history of blood transfusion [OR=3.10, 2.94, respectively]. Periodontal disease, severity of bleeding and bad oral hygiene were associated with the risk of hepatitis infection and with the detectability of hepatitis markers in the whole saliva