Comparative analysis of the blood flow values of patients with type 2 diabetes mellitus presenting with chronic periodontitis, patients with chronic periodontitis only and healthy individuals.

OBJECTIVES: Laser Doppler flowmetry (LDF) is a non-invasive technique used for various reasons in medicine and dentistry. There are many reports of vascular and microcirculatory changes in patients with diabetes mellitus. The aim of the study was to assess the gingival blood flow (GBF) measurements in patients with chronic periodontitis (Group 1), patients with chronic periodontitis and Type 2 diabetes mellitus (Group 2) and healthy controls (Group 3). METHODS: Forty-eight individuals were included in the study and divided into three groups. Gingival blood flow measurements were taken from 16 points in the upper vestibular aspect of six anterior teeth using LDF probe. In addition, plaque index (PI), gingival index (GI), probing depth (PD) and attachment loss (AL) were registered to determine the periodontal status. RESULTS: Results showed a significant correlation (p < 0.05) in clinical indices and GBF among the groups. Moreover, in Group 1, there was a correlation between GI and AL and between PD and AL. In Group 2, a correlation was observed between PI and AL and between GI and GBF. CONCLUSION: The results revealed an increase in GBF value in the chronic periodontitis group with Type 2 diabetes mellitus compared with the group with chronic periodontitis only. Diabetes can also affect GBF due to the nature of the disease, which affects the microcirculatory status.

A new bone substitute in the definitive management of furcation involvement: a case report.

Bone xenografts are used for reconstructive surgery in medicine and dentistry. The grafts are osteoconductive, serving as a matrix in bone regeneration. Furcation involvements are one of the most challenging clinical problems in periodontics. Unilab Surgibone is a bone xenograft and has been investigated in many clinical and experimental studies. In this case report, a 50-year old male patient was diagnosed with a Class III furcation problem in his upper right first molar. The tooth was surgically treated by resection of the distobuccal root after the flap elevation. The extraction defect was grafted with the Unilab Surgibone. After nine months, the patient was evaluated clinically and radiographically. The healing was uneventful. The clinical and radiographic data suggest that Unilab Surgibone supports bone regeneration.

A Papilloma-like Atypical Gingival Enlargement Treated Using Nd:YAG Laser Surgery: Report of a Case.

Gingival overgrowths can occur due to various factors, such as inflammation, or rarely without a reason and are significant in periodontology. Here, we describe the diagnosis and treatment of a 33-year old female with a papilloma-like atypical enlargement of the gingiva attached to the molar vestibular region of her lower jaw. After the patient's medical history was taken and the clinical examination done, the enlargement was surgically removed with a Nd:YAG laser and evaluated histopathologically. There was an inflamed, oedematous and vascularized stroma with a thick spongy squamous epithelium layer. After six months, there were no problems at the surgical area and recurrence was not observed.

A limited and useful approach to determine proximal periodontal health / Un enfoque limitado y útil para determinar la salud proximal periodontal

Previous researchers have shown that there exists an interaction between gingival blood flow and gingival health. The purpose of this study was to compare the papillary blood flow at sites treated by a bridge with the blood flow at untreated sites. Twenty persons with resin-bonded fixed partial dentures were included in the study. The contralateral natural teeth of the site symmetrical to that of the restorations were used as controls. Blood flow was measured from the middle point of the papillae from both test and control sites by Laser Doppler Flowmetry (LDF). The plaque index, papillary bleeding index and probing depth measurements were recorded. There was a statistically significant difference between the test and control sites in papillary blood flow measurements and clinical indices (p < 0.05). Moreover, there was statistical significance between gingival blood flow measurements and papillary bleeding index in the experimental group (p < 0.05). In short, there exists an important relationship between resin-bonded fixed partial dentures and papillary blood flow. Although there were no correlations between LDF values and clinical parameters, it can be emphasized, within the limits of the study, that LDF readings have limited diagnostic value, at least when it comes to clinical performance of fixed prosthesis.

Investigadores anteriores han mostrado que existe una interacción entre el flujo de sangre gingival y la salud gingival. El propósito de este estudio fue comparar el flujo de sangre papilar en los sitios tratado por un puente, con el flujo de la sangre en los sitios no tratados. Veinte personas con prótesis dental parcial fija adherida con resina fueron incluidas en el estudio. Los dientes naturales contralaterales del sitio simétrico al de las restauraciones, se usaron como controles. El flujo de sangre se midió a partir del punto medio de las papilas de los sitios de prueba y de control, usando un medidor de flujo mediante Láser Doppler (LDF). Se registraron el índice de la placa, el índice de sangramiento papilar, y las mediciones para el examen de la profundidad. Hubo una diferencia estadísticamente significativa entre los sitios de la prueba y los de control en las mediciones del flujo de sangre papilar y los índices clínicos (p <0.05). Más aún: hubo una diferencia estadísticamente significativa entre las mediciones del flujo de sangre gingival y el índice de sangramiento papilar en el grupo del experimento (p <0.05). En resumen, existe una relación importante entre la prótesis dental parcial fija adherida con resina y el flujo de sangre papilar. Aunque no había ninguna correlación entre los valores de LDF y los parámetros clínicos, puede subrayarse - dentro de los límites del estudio - que las lecturas de LDF tienen un valor diagnóstico limitado, al menos cuando se trata del funcionamiento clínico de la prótesis fija.

A limited and useful approach to determine proximal periodontal health.

Previous researchers have shown that there exists an interaction between gingival blood flow and gingival health. The purpose of this study was to compare the papillary blood flow at sites treated by a bridge with the blood flow at untreated sites. Twenty persons with resin-bonded fixed partial dentures were included in the study. The contralateral natural teeth of the site symmetrical to that of the restorations were used as controls. Blood flow was measured from the middle point of the papillae from both test and control sites by Laser Doppler Flowmetry (LDF). The plaque index, papillary bleeding index and probing depth measurements were recorded. There was a statistically significant difference between the test and control sites in papillary blood flow measurements and clinical indices (p < 0.05). Moreover there was statistical significance between gingival blood flow measurements and papillary bleeding index in the experimental group (p < 0.05). In short, there exists an important relationship between resin-bonded fixed partial dentures and papillary blood flow. Although there were no correlations between LDF values and clinical parameters, it can be emphasized, within the limits of the study, that LDF readings have limited diagnostic value, at least when it comes to clinical performance of fixed prosthesis.

Interleukin-1 beta levels in gingival crevicular fluid in type 2 diabetes mellitus and adult periodontitis.

Interleukin-1 beta (IL-1beta) is a potent bone-resorptive cytokine that also mediates soft-tissue destruction by stimulating prostaglandin production and inducing collagenase and other protease activity. The literature suggests that this substance may be an important mediator of attachment loss in human periodontitis, and indicates that IL-1beta may be useful for locating sites of periodontal disease activity. There is some evidence that IL-1beta is produced by cells of the periodontium, and that it can be detected in gingival crevicular fluid (GCF). Many factors are known to contribute to the destruction of periodontal tissue. One of the most important is immune deficiency in diabetes. The aim of this study was to measure and compare the concentration of IL-1beta in the GCF of patients with non-insulin-dependent diabetes mellitus (Type 2 DM), otherwise healthy adults with periodontitis, and individuals with no periodontal disease in order to assess whether diabetes alters IL-1beta levels. We also examined relationships between GCF levels and the clinical parameters of pocket depth, plaque index, and bleeding index in each group. Seventeen patients with Type 2 DM, 17 adult periodontitis patients (AP), and 17 healthy controls were selected. The levels of IL-1beta in the GCF were quantified by ELISA. The mean IL-1beta concentrations in the Type 2 DM, AP, and control groups were 200.1 +/- 65.34 pg/microl, 131.35 +/- 67.66 pg/microl, and 80.0 +/- 36.08 pg/microl, respectively. The levels in the diabetic patients were significantly higher than those in the AP and control subjects. There were no significant correlations between IL-1beta level and any of the clinical data parameters for each group. We believe that the macrophages may over produce IL-beta in Type 2 DM and increased IL-1beta levels in diabetic patients could be linked to altered immune function.

IL-6 levels in gingival crevicular fluid (GCF) from patients with non-insulin dependent diabetes mellitus (NIDDM), adult periodontitis and healthy subjects.

Cytokines play an important role in the pathology associated with chronic inflammatory diseases. One of these cytokines, interleukin 6 (IL-6) is a major mediator of the host response to tissue injury, infection and bone resorption. In the present study, gingival crevicular fluid (GCF) level of IL-6 was determined in patients with non-insulin dependent diabetes mellitus (NIDDM) with periodontitis, adult periodontitis, and healthy controls by use of an enzyme linked immunosorbent assay (ELISA). Twenty-four NIDDM patients with periodontitis, twenty-four adult periodontitis and twenty-four healthy controls were selected for the study. GCF sampling was performed on the vestibular aspects of maxillary incisors and canine teeth. Plaque index (PI), gingival index (GI), gingival bleeding time index (GBTI), probing depth (PD) and probing attachment levels (PAL) were recorded from each sampling area and also the entire dentition. NIDDM and adult periodontitis patients had numerous sites with radiographic evidence of alveolar bone resorption, loss of attachment and pocket depth greater than 3 mm. The mean GCF IL-6 level was 2.43 +/- 0.97 ng/ml in NIDDM patients, 1.31 +/- 0.92 ng/ml in adult periodontitis and 0.62 +/- 0.58 ng/ml in healthy subjects, respectively (p < 0.05). GCF IL-6 levels were markedly higher in NIDDM and adult periodontitis groups compared to the healthy controls. No correlation was found between GCF IL-6 levels and all clinical parameters. These findings suggested that GCF IL-6 levels were significantly higher in the area of inflammation and periodontal destruction locally. The high IL-6 levels in NIDDM patients might be due to different microbial flora in periodontal pockets and altered immune system. Future studies are needed to evaluate the complex interaction among IL-6 GCF levels, host response and local microbial environment in the NIDDM patients.