ABSTRACT
INTRODUCTION: Communication between pulp and periodontal tissue has been well established. However, it is unknown when periodontal disease begins to affect the clinical response of pulp tissue. The aim of this study was to assess the influence of periodontal severity on pulp sensibility by means of electric and thermal cold testing. METHODS: The teeth assessed in this study were allocated into 3 groups considering radiographic alveolar bone loss (ABL) as follows: slight periodontitis (SP, ABL ≤7 mm without reaching the apex, n = 25), moderate periodontitis (ABL >7 mm without reaching the apex, n = 23), and severe periodontitis (SvP, ABL >7 reaching the apex, n = 8). Gingival recession (GR), probing depth (PD), and clinical attachment level (CAL) were also measured. RESULTS: The results showed higher levels of PD and CAL in the SvP group compared with the SP group (P < .05), with no significant difference in GR (P > .05). The SvP group showed significant ABL compared with the other groups (P > .05). The SP group showed a significant number of teeth with a positive pulp response, whereas the SvP group showed a significant number of teeth with a negative pulp response (P < .05); no significant differences were observed between the thermal cold and electric tests (P > .05). CONCLUSIONS: Within the limits of this study, it can be concluded that pulp clinical involvement with a negative response to thermal cold and electric testing occurs only in the most advanced stage of chronic periodontitis with apical involvement.
Subject(s)
Chronic Periodontitis/complications , Dentin Sensitivity/etiology , Adult , Aged , Alveolar Bone Loss/complications , Alveolar Bone Loss/diagnostic imaging , Cold Temperature/adverse effects , Dental Pulp/innervation , Dental Pulp/physiology , Electric Stimulation/adverse effects , Female , Humans , Male , Middle Aged , Radiography, Dental , Severity of Illness IndexABSTRACT
OBJECTIVES: The aims of this study were to evaluate periodontal conditions and identify the presence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia, and four different species of Candida (C. albicans, C. dubliniensis, C. glabrata and C. tropicalis) in periodontal pockets and furcation sites of insulin-dependent type 2 diabetic and non-diabetic patients with generalised chronic periodontitis. DESIGN: Clinical parameters, including oral status assessed using plaque index, gingival index, probing depth, gingival recession and clinical attachment level and systemic conditions with fasting glucose level or glycosylated haemoglobin were measured in diabetic and non-diabetic patients with chronic periodontitis. Samples of subgingival biofilm were obtained from the periodontal pockets and furcation sites and submitted to phenol-chloroform DNA extraction and PCR analysis using specific primers. RESULTS: Clinical conditions of diabetic and non-diabetic patients were similar, without statistical differences in both periodontal indexes and glucose levels (p>0.05). Diabetics had a higher prevalence of Candida spp., mainly C. albicans and C. dubliniensis, and a lower frequency of T. forsythia, when compared to non-diabetic patients, for both periodontal sites. C. glabrata and C. tropicalis were not found in periodontal pockets and furcation sites of non-diabetic patients. CONCLUSION: The results demonstrated a strong colonisation of Candida spp. in the periodontal sites of diabetic patients that have generalised chronic periodontitis with a higher prevalence of C. dubliniensis followed by C. albicans.
