Chairside Screening for Undiagnosed Diabetes and Prediabetes in Patients with Periodontitis.

Introduction: Globally, it is estimated that half of all people with diabetes are undiagnosed. Because of the well-documented bidirectional link between diabetes and periodontitis, dentists and dental hygienists may have the possibility to screen a targeted population for diabetes during routine dental visits. The aim of the present study is to investigate the effectiveness of one device for diagnosis of diabetes/prediabetes used in one private dental practice and investigate the correlation between the levels of HbA1c and periodontal parameters. Methods: Periodontal patients that were never diagnosed with diabetes were asked to fill a risk assessment questionnaire for type 2 diabetes mellitus. PD, CAL, FMBS%, FMPS%, and HbA1c through a prick-finger test were measured before and after periodontal therapy or only once in patients following supportive periodontal therapy. Results: A total of 98 subjects were screened, and among them, one had diabetes and 30 had prediabetes. The mean value of HbA1c was 5.62% for patients with untreated periodontitis and 5.42% for periodontally treated patients. The diagnosis of diabetes resulted to be correlated to FMBS% and FMPS%, while HbA1c levels were correlated to FMBS%, FMPS%, and periodontitis grade. Conclusion: The present chairside diabetes-screening protocol allowed a consistent proportion of patients to become aware of their pathological or prepathological condition and to seek proper and timely medical care. Thus, dentists and dental hygienists could provide health promotion services and preventive measures.

Oral Care and Quality Evaluation: A Multicentric Study on Periodontal Treatment.

PURPOSE: No information is available on the perception of the quality of care in patients treated for periodontitis. The purpose of this article was to assess how periodontitis-affected patients perceive the quality of periodontal treatment (PT) and to measure the factors which may influence it. MATERIALS AND METHODS: 306 subjects who completed PT were invited to participate. Questionnaires and visual analogic scales (VAS) evaluating perception of quality of care, symptoms, and oral health related quality of life (OHRQoL) were handed out. Oral and periodontal indicators were collected before and after treatment. The impact of different factors on perception of quality was assessed with a regression model. RESULTS: Quality evaluation was high yet unrelated for both patients and clinicians (p = 0.983). Quality was negatively influenced by the number of residual oral infections (p < 0.001), patient's age (p = 0.07) and presence of residual pain at completion of PT (p = 0.02). Professionalism, kindness of the staff and communication skills were the characteristics mostly appreciated. The OHRQoL was influenced by the number of residual teeth (p < 0.001), increasing age of patients (p = 0.08), number of residual infections (p < 0.01) and pain (p = 0.04). CONCLUSIONS: Patients' quality perception appeared to be influenced by clinical and emotional aspects. Oral care providers should be aware of the impact of non-clinical factors in patients' appreciation of quality of treatment.

Minimally Invasive Surgical Technique in Periodontal Regeneration: A Randomized Controlled Clinical Trial Pilot Study.

The purpose of this study was to compare two minimally invasive surgical techniques (MISTs) for the treatment of periodontal defects: (1) guided tissue regeneration (GTR) using resorbable minimembrane and particulate xenograft (DBBM); and (2) inductive periodontal regeneration (IPR) using enamel matrix derivatives and DBBM. A sample of 20 infrabony periodontal defects in 20 patients were randomly assigned to either the GTR or the IPR group. A follow-up was performed at 12 months postoperative. Significant improvement in clinical parameters was observed in both groups, although no intergroup differences were found. MIST with GTR or IPR demonstrated very good outcomes 1 year after surgery, with no differences between treatment groups.

Orthodontic treatment of periodontally involved teeth after tissue regeneration.

In this consecutive series, 14 patients with severe intrabony defects and pathologic tooth migration were treated with guided tissue regeneration (GTR) and subsequent orthodontic therapy in an attempt to evaluate the validity of this multidisciplinary approach. Probing pocket depths (PPD), clinical attachment levels (CAL), and gingival recessions were assessed at baseline, 1 year after GTR, and at the end of orthodontic therapy. Radiographs were obtained at all time points. Esthetic parameters were recorded with the papilla presence index (PPI). Statistical analyses were carried out to compare the data at each time point. From baseline to 1 year after GTR, the mean PPD reduction was 5.57 mm, with a residual mean PPD of 2.71 mm; mean CAL gain was 5.86 mm. Both differences were statistically significant. There were no statistically significant differences between 1 year after GTR and the end of orthodontic therapy (mean PPD reduction 0.07 mm; mean CAL gain 0.43 mm). The reduction in PPI reflected the enhancement of papilla height that was observed in 9 of the 14 patients. Within the limits of this research, this study affirms the possibility of a combined orthodontic-periodontal approach that prevents damaging the regenerated periodontal apparatus and produces esthetic improvements as a result of realignments and enhancement of papilla height.

Morphological and molecular analysis of idiopathic gingival fibromatosis: a case report.

AIM: We analyse a case of idiopathic gingival overgrowth using morphological and molecular methods. As this overgrowth involves collagen accumulation in the gingival connective tissue, we measured the collagen turnover to clarify the pathogenic mechanisms potentially involved. MATERIALS AND METHODS: The patient was a 29-year-old Italian woman with enlargement of the gingivae throughout the entire mandible and maxilla. Morphological analyses were carried out on haematoxylin-eosin and Sirius red-stained paraffin-embedded gingival sections. mRNA levels of collagen type I and III, matrix metalloproteinase (MMP)-1, transforming growth factor-beta1 and lysyl hydroxylase (LH)2b were determined by RT-PCR on cultured gingival fibroblasts and compared with healthy control fibroblasts. Interstitial collagen and MMP-1 content in the supernatants were assessed, respectively, by dot blot and SDS zymography. RESULTS AND CONCLUSIONS: In Sirius red-stained sections of the patient's overgrown gingivae, interstitial collagen content was 29% higher than controls. Her gingival fibroblasts had higher collagen type I, MMP-1 and LH2b gene expression and unmodified interstitial collagen, type I protein levels in the supernatants. These findings would seem to suggest that in this case collagen accumulation in the gingival connective tissue was not associated with increased synthesis and decreased degradation.

Avaliação comparativa da atividade biológica de heparinas não-fracionadas em produtos farmacêuticos / Comparison of the biological activities of unfractionated heparins in pharmaceutical products

Realizou-se a avaliação biológica de potência de heparinas convencionais contra o 5º Padrão Internacional de heparina suína pelos ensaios preconizados da inibição da coagulação do plasma ovino (ICPO), tempo de tromboplastina parcial ativada (TTPA) e anti-fator Xa. Correlacionaram-se os resultados, demonstrando que o ICPO fornece potências em média 10,72 por cento, significativamente superiores aos outros procedimentos. Analisou-se a influência de diferentes lotes de plasma sobre o resultado do ensaio do ICPO observando-se variação de até 7,32 por cento. Como alternativa, padronizou-se o ensaio do anti-fator IIa e efetuou-se a determinação de potência das amostras obtendo-se valores reprodutíveis, comparáveis ao método do anti-fator Xa, que demonstram a viabilidade da inclusão como ensaio harmonizado para o controle da qualidade. Os resultados de potência, fornecidos lote a lote, em geral, cumprem as especificações farmacopéicas e demonstram a qualidade que garante a segurança e eficácia clínica dos medicamentos