IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices

PURPOSE: The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. MATERIALS AND METHODS: A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. RESULTS: The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). CONCLUSION: IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.

[Evaluating thrombotic markers in chronic periodontitis with hypertension]

Chronic Periodontitis is accompanied with subacute systemic inflammatory responses and a procoagulant state which manifests in changes of some serological vascular thrombotic markers levels. This study aimed to evaluate several vascular thrombotic markers levels in patients with chronic periodontitis. Study population consisted of 60 individuals ,36 males, 24 females, aged between 30- 48 years, [mean 36.33 years], were divided into 2 groups; the first, [n=20],was the control healthy individuals, and the second, [n=40],was patients with chronic periodontitis. Registration included, systolic blood pressure[sBP], body mass index and the periodontal disease indices; dental plaque[PI], gingival inflammation[GI], bleeding on probing[BOP], pocket probing depth[PPD],clinical attachment loss[CAL]. Blood tests included platelets count[Plt], fibrinogen[Fib], prothrombin time[PT], activated partial thromboplastin [aPTT], and Von Willebrand factor antigen [vWF:Ag]. Statistics, included independent Ttest and Pearson correlation, were performed at [P<0.05] by means of SPSS 19th ed. There were significant differences between the two groups in [sBP] [P=0.022], [Plt] [P=0.004], [Fib] [P=0.001], [vWF:Ag] [P=0.011], and in all of the periodontal indices [P<0.05]. Furthermore, there was a significant moderate positive correlation [r= 0.4, P<0.05] between all of the periodontal indices thrombotic markers, and was more evident in [Plt] with [GI], [Fib] with [PI], [GI], [BOP], [PPD], and [vWF:Ag] with [PI]. Periodontitis was associated with higher values of systolic blood pressure, platelets count, fibrinogen level, Von Willebrand factor activity, and periodontal indices positively correlated with the thrombotic markers. These findings would point out to the role of the periodontal disease as a risk indicator in precipitating a procoagulant state

[Short implants activated by plasma rich in growth factors success of in chronic periodontitis]

The success of implants is based on the quantity and height of the alveolar bone which reduce in the patients with chronic periodontitis.The purpose of this study was: to estimate the success of short implants activated by plasma rich in growth factors in the posterior areas of bone resorption following chronic periodontitis and radiographic study of the crestal bone height. A total of 23 short implants[Bicon Integra] length[5-5.7-6-8]mm, diameter [4-4.5-5-6]mm,[6 upper -17 lower] were placed in 11 patients [9 males and 2 females] aged 35-60 years [mean age 49,9 years] with posterior edentulous areas and limited bone height following treated chronic periodontitis, the patients were selected from the periodontal clinic -Damascus university. Plaque index[PI] gingival index [GI] ,bleeding on probing [POB] probing depth [PD] ,clinical attachment loss [CAL] and digital panoramic radiographs were taken before implantation. Plasma rich in growth factors[PRGF]and fibrin membrane were prepared from the patient's own blood and used to activate and cover implants. Implants success rate was studied according to Albrektsson et al. 1986 and periapical radiographs were used to determine the vertical difference in crestal bone level measurements, from the baseline[day of loading]to 6 months and 12 months .Statistical study [T Student test ,Mann-Whitney U and Person]at p<0.05. The success rate of the short implants activated by PRGFwas 100%,and no statistically significant differences in [PI], [GI], [POB] pre loading and post loading in 6-12 months and no statistically significant differences in the height measurements of crestal bone after loading in 6-12 months, and no correlation between [[PI], [GI], [POB]]and the height of crestal bone at p<0.05. Short implants activated by PRGF have obvious short term success in the patients with treated and stable chronic periodontitis and the most important thing is the stability in the height of the crestal bone

[Assessment of root restorations effect on treatment of gingival recessions by gingival connective tissue grafts]

This study was carried out To assess Of Root Restorations Effect [GC Fuji II] On Treatment Of Gingival Recessions By Gingival Connective Tissue Grafts fifteen patients [12 females,3 males],aged 19 to 54 years [mean age 36 years] have 29 teeth with Miller class I and II gingival recessions associated with Billings degree1St ,2nd and 3rd root caries were selected. The recessions were assigned randomly to receive Subepithelial Connective Tissue Graft [SCTG] or Subepithelial Connective Tissue Graft and Restoration [SCTG+R]. Plaque index [PI],gingival index [GI] sulcus bleeding index [SBI], probing depth [PD], gingival recession [GR], clinical attachment loss [CAL], width of keratinized gingival [WKG], width of attached gingiva [WAG], and dental hypersensitivity index [DHI] were measured at baseline, 45 days, 3, and 6 months postoperatively. Anova and t-test were used to compare group means. P values 0.05], but was not statistically significant for WKG, WAG [P>0.05]. The differences between groups were not statistically significant except DHI, wherein a greater reduction in DHI was observed in [SCTG] group. These results indicate that gingival connective tissue grafts with or without restorative treatment is effective procedure for treatment of gingival recessions associated with root caries, and GIC restorations did not achieve sufficient improvement in periodontal indexes

Osteoporosis prediction from the mandible using cone-beam computed tomography

PURPOSE: This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. MATERIALS AND METHODS: Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: 13 cmx15 cm; voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. RESULTS: RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. CONCLUSION: Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.

[Comparative study of chronic periodontitis severity in atherosclerosis patients]

The relationship between chronic periodontitis and atherosclerosis has been debated. Therefore, the purpose of this study was to compare the clinical and radiological indices in chronic periodontitis subjects with and without atherosclerosis. Two hundreds chronic periodontitis patients [184 males and 16 females, mean age 52.61 years] were divided into two groups: first group consisted of 100 subjects with atherosclerosis [92 males and 8 females, mean age 52.06]; second group consisted of 100 subjects without atherosclerosis [92 males and 8 females, mean age 53.16]. Probing depth, gingival recession and clinical attachment loss were performed for each patient. Alveolar bone loss was assessed using apical digital radiography. Chi square and Mann Whitney U were used for the statistical study [p<0.05]. Values of clinical attachment loss and alveolar bone loss were significantly higher in the atherosclerosis group vs. non-atherosclerosis group. The odds ratio of having atherosclerosis was higher when the clinical attachment loss was >3 mm [OR=0.327]. Also, the odds ratio of having atherosclerosis was higher when alveolar bone loss was moderate and severe vs. mild [OR=1.568]. These results support the role of severe chronic periodontitis as a possible risk indicator for having atherosclerosis, which may suggest the need for more studies looking at the possible effect of periodontal treatment on atherosclerosis progression which is the main cause of cardiovascular diseases

[Role of interleukin 1 genes in atherosclerosis and chronic periodontitis in Syrian populat]

The role of Interleukin-1 genes in the association between chronic periodontitis and atherosclerosis has been under debate. The purpose of this study is to compare the existence of interleukin 1 genes polymorphism in the chronic periodontitis subjects with and without atherosclerosis. 200 chronic periodontitis patients [184 male, 16 female, mean age 52.61] were divided into two groups: first group 100 subjects with atherosclerosis [92 male, 8 female, mean age 52.06]; second group 100 subjects without atherosclerosis [92 male, 8 female, mean age 53.16]. Probing depth and clinical attachment loss were performed for each patient. Alveolar bone loss was performed for the patients using apical digital radiography. Blood samples were collected from the patients for genotyping analysis of IL-1alpha+4845, IL-1beta+3954, IL-1s-511 and IL-1RN VNTR using PCR-RFLP technique. The Mann-Whitney U and Chai square tests were used for the statistical study [P<0.05] with the computer program SPSS.V17. Clinical attachment loss and alveolar bone loss were significantly higher in the atherosclerosis group. An association between IL-1alpha+4845 genotypes and atherosclerosis was shown; genotype 1.1 was higher significantly in the atherosclerosis and periodontitis group. An association between IL-1alpha +4845, IL1beta+3954, IL-1beta-511 genotypes and alveolar bone loss was also shown. An association between IL-1alpha+4845, IL-1s-511 genotypes and both alveolar bone loss and atherosclerosis was also shown. The IL-1alpha+4845, IL-1beta-511 genotypes may play a role in the association between chronic periodontitis and atherosclerosis in the studied sample

[Clinical follow-up of aggressive periodontitis after comprehensive periodontal therapy supported by systematic metronidazol and amoxicillin]

The outcomes of aggressive peiodontitis therapy [AgP] are not always successful. The aim of the study is to assess the improvement of periodontal status of AgP after surgical periodontal therapy supported by systemic dosages of metronidazol and amoxicillin. 26 patients mean age 22.39 years were selected at the department of periodontology faculty of dentistry- Damascus University. They were distributed into 2 groups: 15 patients exhibiting AgP [10female, 5meals] man age21.2 years and 11 [7 female, 4meals] mean age [23.41 years] healthy individual from their families .Probing depths [PD], clinical attachment loss [CAL] and papillae bleeding index [PBI] were performed for each individual. Periodontal therapy included mechanical, surgical therapy supported by dosage of Metronidazol 250mg/3 time daily and Amoxicillin 500 mg /4 times daily for a week after surgery. Mechanical medical therapies were repeated after 6 months and when PBI was more than 50%. T-test: Tow Samples Assuming Variance and tests was used for statistics p< 0.05 . The statistical analysis showed significant differences P <0.05 for periodontal indices between 2 healthy and AgP groups, this did not include the numbers of teeth loss P>0.05. PD, CAL, PIB decreased significantly P<0.05 after 3 and 12 months of periodontal therapy in AgP group and with no statistical differences between 3 and 12 months P>0.05. No difference was observed also in PBI among the 2 examined groups P>0.05 .comprehensive periodontal therapy; mechanical and surgical supported by repeated dosage of Metronidazol and Amoxicillin have introduced improvement in AgP, but this did not reach the healthy status except of PBI

[Studying thrombotic markes in chronic periodontitis with hypertension]

Recent studies has focused on the impact of periodontal disease on the general health like cardiovascular disease and hypertension and their interactions. We aimed to study several vascular thrombotic markers levels in patients with chronic periodontitis and hypertension. Study population consisted of 80 patients aged 30- 68 years, [mean 43.7 years], [53 males, 27 females], were divided into 2 groups; the first, [n=40], had only chronic periodontitis, and the second,[n=40], were hypertensives with chronic periodontitis. Registrations included systolic blood pressure] [sBP], body mass index[BMI], and periodontal disease indices; dental plaque [PI], gingival inflammation [GI], bleeding on probing [BOP], and clinical attachment loss [CAL] Blood tests included; platelets count [Plt], fibrinogen [Fib], prothrombin time [PT], activated partial thromboplastin [aPTT], and Von Willebrand factor antigen [vWF:Ag]. Independent T-test and Pearson correlation, were performed at [P<0.05] by means of SPSS 19th ed. Hypertensives with periodontitis showed higher significant differences in age [P=0.001], [sBP] [P=0.001], [FBG] [P=0.001] [Plt] [P=0.022], [Fib] [P=0.001], and in [PPD] [P=0.008], [CAL] [P=0.001]. Significant moderate positive correlation was found between [Plt] and both of [PPD] and [CAL], while [Fib] correlated with[CAL], [r= 0,3- P<0.05]. Periodontitis in hypertensives was associated with an elevation in platelets count and fibrinogen concomitantly with an increase in blood glucose levels and body mass index,in addition to greater pocket probing depth and clinical attachment loss, compared with periodontitis only.These results shed the light on periodontitis as a risk indicator for hypertension and thrombotic propensity in susceptible individuals

[ epidemiologic study of prevalence of aggressive periodontitis in schoolchildren in the southern districts of Syria]

Aggressive periodontitis [AgP] is a periodontal disease characterized by frequently severe clinical manifestations that normally affect young individuals, progress rapidly and can involve multiple family members. The purpose of this study is to investigate the prevalence of AgP and the association with some risk factors among students aged 12 to 18 years in southern districts of Syria. In a cross-sectional study, a total of 1216 students [596 males and 620 females] from Daraa [827] and Swaida [389] governorates were examined according to the recommendations of the Community Periodontal Index of Treatment Needs [CPITN] by using WHO ball-tip probe, and daylight for illumination. Six teeth were examined" including first molars and central incisors" at four sites of each one, in addition to simplified oral hygiene "OHI-S", gingival recession "GR", clinical attachment loss "CAL", and bleeding on probing "BOP" indices which were recorded as clinical parameters. Every student exhibited CAL

[Prevalence and risk factors of aggressive periodontitis in schoolchildren in the eastern district of Syria]

Aggressive periodontitis [AgP] is one of the periodontal diseases which affects systemically healthy individuals usually under the age of 30. The disease is characterized by a rapid attachment loss and destruction of alveolar bone. The aim of the present study is to assess the prevalence of [AgP] among schoolchildren in the eastern districts of Syria and to investigate the role of some and risk factors and determinants. In a cross sectional study, a random sample of 1200 students was drawn [568 males and 614 females] aged from 12-20 years [mean=16 years] from Deirezzor and Al-hasakah govrnorates in the eastern districts of Syria. Students completed a written questionnaire for determinants [age, gender, race] and risk factores [oral hygiene, smoking,soci-economic and education level] for [AgP], and have been examined according to [CPITN] by WHO probe, Gingival recession[GR], Probing Pocket Depth[PPD] and simplified oral hygiene[OHI-S] indices. Students who exhibited clinical attachment loss [CAL] >/= 4 mm at one or more tooth surface were scheduled for further periodontal examination. [AgP] was diagnosed according to the AAP classification 1999. chi-square test was used at P

[Progression of periodontal disease in patients with phenytoin gingival overgrowth]

Gingival overgrowth [GO] is one of many side effects of phenytoin [PHE] antiepileptic agent. The aim of this study was to evaluate the development of periodontitis in patients taking PHE and its relation with GO, age, duration of drug administration. Thirty-four patients [14 females, 20 males: range 9-49 years; mean age 29.5] undergoing PHE treatment [range 2-32 years; mean 11.8] from the department of periodontology, faculty of dentistry, Damascus University was included in the study. Medical history including drug duration and clinical measurement of GO index, probing depth [PD] periodontal pocket bleeding points index [BPI] and panoramic radiographs for bone loss [BL], were performed for each patient. For statistical analysis Correlation test [r] was used to determine the correlation between age, duration and periodontal indices. 76.4% of the examined patients showed mean PD value >5mm and 41% showed moderate to sever BL, whereas, GO was noted in 64%. Statistical analysis showed significant correlation between PD with GO, BPI, BL, age and duration. Positive correlation was noted between GO, periodontal index, age and duration, the correlation between GO and age was higher in younger patients. The relation between duration and GO reaches [72%] in [5-10 years]; that becomes negative with increasing time. However PD and BL presented a positive correlation with age and increased in long duration of drug administration [20-32 years]. Periodontal index and GO were clearly correlated with PHE administration. Long-term of drug administration could create the adequate conditions to periodontal disease progression

Clinical response of early onset periodontitis to periodontal therapy supported by adjunctive tetracycline and metronidazole: long term follow-up

Early onset periodontitis EOP is infected periodontal disease, affecting individuals younger than thirty-five years old. It is characterized by a rapid rate of bone loss and disease progression with defects in host response and specific etiological microbial flora. The purpose of the study is to evaluate the response of different types of EOP not associated with systemic diseases and with Papillion- Lefevre syndrome to periodontal therapy in long-term follow-up patients 9 from 6 families were studied, exhibiting localized EOP [LEOP] and generalized EOP [GEOP] aged from 3-21 years old. Clinical and radiographic examination were performed. Initial phase of treatment composed of oral hygiene instructions, hygiene instructions, scaling and root planning, subgingival irrigation with anti microbial agent and surgery. Adjunctive antibiotic tetracycline in LEOP or metronidazole + amoxycillin in GEOP. Scaling and root planning, antibiotics and the anti-inflammatory agent ibuprofen were administrated in phases of maintenance. More clinical and radiographic improvement was evident in LEOP. GEOP was characterized by an increased tendency of teeth loss during the temporary denture and acute phases. Adjunctive therapy with metronidazole gave more adequate response than tetracycline in GEOP, and acute phases of LEOP. Topical application of metronidazole was effective in resolution of persistent periodontal pockets. Puberty was associated with recurrence of inflammatory gingival overgrowth, that was controlled by ciproflex administration. lboprofen reduced dermatic hyperkeratosis of Papillon-Lefevre syndrome. Conclusion:. Periodic periodontal treatment changes the type of lesion and reduces number of infected teeth. Period of clinical improvement did not signify complete resolution of EOP. Antibiotic administration may introduce modification in periodontal environment and determine the type of response