Tooth loss and periodontal status in patients with cardiovascular disease in the Serbian population: A randomized prospective study.

OBJECTIVES: Chronic periodontal infections may predispose to cardiovascular disease. Since tooth loss may be due to periodontitis it is assumed that tooth loss can also predisposes cardiovascular disease. The aim was to investigate the possible relationship between the severity of the clinical picture of periodontitis and the occurrence of cardiovascular disease. METHODS: We evaluated the association between clinical periodontal parameters, tooth loss and cardiovascular incident. A total of 100 subjects (50 subjects diagnosed with cardiovascular disease and 50 in control group without cardiovascular disease) underwent a dental examination. Tooth loss in all participants was caused only as a consequence of periodontitis. In addition to periodontal status, conventional risk factors for cardiovascular diseases (hypertension, smoking, obesity, hypercholesterolemia, diabetes) were measured, too. RESULTS: Periodontal status was worse in patients in the group with cardiovascular disease compared to the group without cardiovascular disease. A significant association was observed between tooth loss levels and cardiovascular disease. In the group of patients who had cardiovascular disease, tooth loss was more than 50%. In the group of patients without cardiovascular disease, tooth loss was about 20% of the total number of teeth. A significant association was observed between tooth loss levels and cardiovascular disease prevalence. CONCLUSION: This study presents relationship between number of teeth and cardiovascular disease, indicating a link between oral health and cardiovascular disease.

Can the chokeberry juice be used as additional therapy for burning mouth syndrome in menopausal women?

The researchers' aims were to evaluate the effects of chokeberry juice in the treatment of burning mouth syndrome (BMS) and oral discomfort in menopausal women. The following validated scales and questionnaires were used before and after treatment: questionnaire used for selection of research participants with xerostomia, the xerostomia inventory, Visual Analogue Scale (VAS), localization of pain before and after treatment, short-form McGill pain questionnaire. There was statistically significant decrease in number of research participants who felt pain after therapeutic procedure (p < 0.05). Chokeberry juice, as additional therapy for BMS, reduced intensity of characteristic types of pain sensations and oral dryness feeling.

Oral Health-Related Risk Factors Among Students in Southeast Serbia.

BACKGROUND An association between insufficient or irregular oral hygiene with the occurrence of dental caries, gingival/periodontal diseases, and consequently general diseases has been established. The null hypothesis that there is no difference in the oral health status among students in a preclinical medical program and those who went through a clinical medical program was tested. The main objective of the study was to analyze oral health risk factors (oral hygiene practices, attitudes, and behavior) as well as their impact on oral health by using convenience sampling. MATERIAL AND METHODS We investigated risk factors for oral health conditions by examining oral hygiene practices, attitudes, and behaviors among the students in the medical program of the University of Nis, collecting data using questionnaires. The study included 396 students of medicine, dentistry, pharmacy, and vocational studies. Participants filled out the anonymous questionnaire. RESULTS In both groups, parents were mostly employed, with the representation of employed fathers significantly higher in student group 1 (P<0.05), which is also the only statistically significant difference between the groups. In terms of oral hygiene practices, students were most often trained by parents (68.69%). A very high percentage of students brushed their teeth every day (97.22%), and 54.55% did this twice a day. Of the total number of students, 78.28% thought that it was necessary to use interdental brushes/floss/toothpick. The duration of teeth cleaning was 3 minutes in 39.39%, whereas 55.30% thought that it should be longer than 3 minutes. The most common brushing movements were combined movements and were used by 60.35% of all students. Of all students, 253 (63.89%) never smoked, 182 (49.96%) regularly went to the dentist, and 141 (35.61%) visited the dentist 6 months ago. The majority of students, 265 (66.92%), obtained the greatest amount of information about oral and tooth care from their dentist, which was the case in both age groups. CONCLUSIONS This study highlights oral health risk factors among students at the University of Nis. It is essential to determine their oral health knowledge, as it is of great significance both to patients and to students. Also, these students will be the major providers of health services and will be responsible for public oral health promotion. It could help in reformation of the oral health education program. The results of this research indicate that it is necessary to educate preclinical students to solve oral health issues.

Choosing the Right Essential Oil for a Mouthwash: Chemical, Antimicrobial and Cytotoxic Studies.

Thirteen commercial essential oils were assessed for their possible inclusion in a mouthwash formulation based on their inhibitory effect against potentially pathogenic anaerobic oral bacterial isolates from subgingival plaque, and their cytotoxicity towards gingival cells. The essential oils, originating from species belonging to seven major aromatic plant families, were chosen to provide the necessary diversity in chemical composition that was analyzed in detail by GC and GC/MS. Multivariate statistical analysis, performed using the in vitro microbiological/toxicological assays and compositional data, revealed that the major components of the essential oils were probably not the main carriers of the activities observed. A formulation of 'designer' mouthwashes is proposed based on the selective action of certain essential oils towards specific bacterial isolates (e. g., Citrus bergamia vs. Parvimonas micra), and non-toxicity to gingival cells at antimicrobially active concentrations.

Comparative analysis of smoking influence on periodontal tissue in subjects with periodontal disease.

THE AIM OF THE STUDY: The aim of the study was clinical and cytological examination of gingival changes in smokers and non-smokers. Further, specific goals of this study were health promotion in patient, particularly in smokers. METHODS: The anamnesis was taken and clinical examination was conducted on the patients who came on Dental Clinic. During the clinical examination, plaque index (Pl)(16), gingival index Löe-Silness (Gi) and the community periodontal index of treatment needs (CPITN)(17) were done. After diagnosis was established, participants divided into group I -smokers, and group II - non-smokers. The gingival smears were taken for cytological analysis, dried on air, and stained by haematoxylin-eosin method. RESULTS: The values of gingival index (GI)- Löe-Silness and periodontal index (CPITN) were higher in the group of smokers, but plaque index was also higher with statistically significant difference of their values between examined group, with maximum level of significance (p<0,001). The size of nucleus (area, Ferret's diameter and perimeter) was higher in the group of smokers, but differences were not statistically significant. In the group of non-smokers density of nucleus was higher than in non-smokers group, but difference was not statistically significant. CONCLUSION: The values of examined indices showed higher values in smokers group. This finding could show that the level of oral hygiene is higher in the non smokers group. The size of nucleus (area, Ferret's diameter and perimeter) was higher in the group of smokers, but differences were not statistically significant. Teamwork of many different speciality experts is required for better periodontal health of smokers.

RP-HPLC assay of doxycycline in human saliva and gingival crevicular fluid in patients with chronic periodontal disease.

A reversed-phased HPLC method with fluorescence detection was optimized and validated for determination of DOXY in human saliva and gingival crevicular fluid (GCF) with tetracycline as internal standard. Single step extraction with acetonitrile for both types of samples was performed. The separation was achieved at Zorbax Extend-C18 analytical column at 30°C. Mobile phase was consisted of an aqueous phase containing magnesium acetate, ammonium acetate, Na2EDTA, triethyl-ammonium acetate buffered to pH 7.5 with ammonium hydroxide solution and acetonitrile. The volume ratio of the buffered water mixture of salts and acetonitrile was 86:14. Fluorescence detector was set at λex=380 nm and λem=520 nm. Under the optimized experimental conditions, good linearity was found in the range of 5.0-250.0 ng/mL for GCF with LOD of 1.63 ng/mL and LOQ of 4.93 ng/mL and 20.0-500.0 ng/mL for saliva with LOD of 6.36 ng/mL and LOQ of 19.28 ng/mL. This method was successfully applied for determination of DOXY in saliva and GCF obtained from patients with chronic periodontal disease.

A histological evaluation of a low-level laser therapy as an adjunct to periodontal therapy in patients with diabetes mellitus.

Diabetes mellitus (DM) and chronic periodontitis are common chronic diseases in adults in the world population. DM has a strong influence on the oral cavity and represents a risk factor for gingivitis and periodontitis. Low-level laser therapy (LLLT) has proven effective in the reduction of inflammation and swelling. The aim of the present study was to evaluate the efficacy of LLLT in diabetic periodontitis through histological analysis. A total of 300 diabetics with chronic periodontal disease and teeth indicated for extraction were assigned into six equal groups. In the groups 1 and 4, indicated teeth were extracted before treatment, and in the rest of the groups upon completion of the entire treatment. All patients received oral hygiene instructions and full-mouth conservative periodontal treatment. In groups 3 and 6, LLLT was applied (670 nm, 5 mW, 2 J/cm(2), 16 min, 5 days). Histologic findings of gingival tissue treated with LLLT showed expressed healing, as is evident by the absence of inflammatory cells. Tissue edema could not be seen, and the number of blood vessels was reduced. In the gingival lamina, propria pronounced collagenization and homogenization were present. It can be concluded that LLLT has shown efficacy in the treatment of periodontitis in diabetics. Because of more pronounced alterations of periodontium in diabetics, the use of LLLT is of particular importance.

Low-level lasers as an adjunct in periodontal therapy in patients with diabetes mellitus.

BACKGROUND: Diabetes mellitus (DM) increases the risk of periodontitis, and severe periodontitis often coexists with severe DM. The proposed dual pathway of tissue destruction suggests that control of chronic periodontal infection and gingival inflammation is essential for achieving long-term control of DM. The purpose this study is to evaluate the effects of low-level laser therapy (LLLT) by exfoliative cytology in patients with DM and gingival inflammation. SUBJECTS AND METHODS: Three hundred patients were divided in three equal groups: Group 1 consisted of patients with periodontitis and type 1 DM, Group 2 of patients with periodontitis and type 2 DM, and Group 3 of patients with periodontitis (control group). After oral examination, smears were taken from gingival tissue, and afterward all of the patients received oral hygiene instructions, removal of dental plaque, and full-mouth scaling and root planing. A split-mouth design was applied; on the right side of jaws GaAlAs LLLT (670 nm, 5 mW, 14 min/day) (model Mils 94; Optica Laser, Sofia, Bulgaria) was applied for five consecutive days. After the therapy was completed, smears from both sides of jaws were taken. The morphometric analysis was done using the National Institutes of Health Image software program and a model NU2 microscope (Carl Zeiss, Jena, Germany). RESULTS: Investigated parameters were significantly lower after therapy compared with values before therapy. After therapy on the side subjected to LLLT, there was no significantly difference between patients with DM and the control group. CONCLUSIONS: It can be concluded that LLLT as an adjunct in periodontal therapy reduces gingival inflammation in patients with DM and periodontitis.

[Low power laser efficacy in the therapy of inflamed gingive in diabetics with parodontopathy].

BACKGROUND/AIM: There is clear evidence on direct relationship between periodontal disease and diabetes mellitus. Many investigations point out greater prevalence and severity of periodontal disease among diabetic patients. During last decade, low level laser therapy has been used in periodontal therapy. It has biostimulative effect, accelerates wound healing, minimizes pain and swelling, and there is almost no contraindication for its usage. The aim of the paper was to investigate the efficiency of low level laser therapy as adjuvant tool in reduction of gingival inflammation in diabetic patients. METHODS: The study incuded 150 participants divided into three groups: group I (50 participants with diabetes mellitus type 1 and periodontal disease), group II (50 participants with diabetes mellitus type 2 and periodontal disease), group III (nondiabetic participants with periodontal disease). Gingival health evaluation was done using gingival index Löe-Silness. Soft and hard deposits were removed, periodontal pockets cleaned and GaA1As low level laser therapy (5 mW) applied five consecutive days. In each patient, low level laser therapy was not applied on the left side of the jaw in order to compare the effects of the applied therapy. After the first, third and fifth therapy and one month after the last visit gingival index was evaluated. Before the first and after the fifth therapy exfoliative cytology of gingiva was done and nuclei areal was analyzed morphometrically. RESULTS: After all investigated periods, gingival index and nuclei areal were significantly decreased comparing to values before the therapy, at both jaw sides (p < 0.001). After the 1st, 3rd and 5th therapy, the t-test showed a significantly decreased gingival index at the lased side of jaw comparing to non-lased side. CONCLUSION: Low level laser therapy is efficient in gingival inflammation elimination and can be proposed as an adjuvant tool in basic periodontal therapy of diabetic patients.

The effects of low level laser irradiation on gingival inflammation.

OBJECTIVE: The goal of this study was to analyze the effects of low level laser irradiation treatment and conservative treatment on gingival inflammation. BACKGROUND: It is widely accepted today that the primary etiological factor for the onset of periodontitis is dental plaque, although the exact mechanism of damage remains unknown. Inflammation is a basic response of periodontal tissue to damage and serves as a fast first line of defense against damage and infections. The treatment of gingivitis and periodontitis has gone through various stages: from the simplest, classical treatment methods, through improved radical interventions, to a new era marked by laser technology. Low level laser irradiation has an anti-inflammatory effect, both general and local. MATERIALS AND METHODS: The research was done on patients who had chronic periodontal disease (mild periodontitis) with expressed clinical symptoms of gingival inflammation. All patients in the study underwent conservative treatment. After conservative therapy, the patients from the experimental group were subjected to 10 low level laser treatment sessions. Both groups underwent regular follow-up visits 1, 3, and 6 months after treatment, which involved only clinical examination using plaque index (PI), gingival index (GI), and bleeding on probing index (BOP index). RESULTS: A considerable decrease in all three indexes after the application of both therapies was noticed. The follow-up visits revealed the difference in index values. With laser therapy, the values of indexes decreased steadily, whereas with conservative therapy they increased up to a certain point, but did not reach the pre-therapy values. CONCLUSIONS: A general conclusion can be drawn that low level laser irradiation (semiconductor, 670 nm) can be used as a successful physical adjuvant method of treatment, which, together with traditional periodontal therapy, leads to better and longer-lasting therapeutic results.

Dentinal hypersensitivity following scaling and root planing: comparison of low-level laser and topical fluoride treatment.

The aim of this study is to compare the effectiveness of low-level laser irradiation to traditional topical fluoride treatment for treatment choices of dentinal hypersensitivity following scaling and root planing. The experimental group (15 patients) was treated with low-energy-level diode laser at each site of dentinal hypersensitivity following scaling and root planning. The control group (15 patients) received topical fluoride treatment (protective varnish for desensitization). All the patients were treated at baseline visit, and then at day 2 and 4 after the initial treatment; the pain was subjectively assessed by the patients as strong, medium, medium low, low, or no pain. Total absence of the dental hypersensitivity was reported in 26.66% of the examined group even after the second visit, compared to the control group where complete resolution of the hypersensitivity was not present after the second visit in any of the treated cases. Complete absence of pain was achieved in 86.6% of patients treated with laser and only in 26.6% in the fluoride treated group, after the third visit. Based on our findings, we conclude that low-energy biostimulative laser treatment can be successfully used for treatment of dental hypersensitivity following scaling and root planing.

Incidence and treatment outcome of oral lichen planus in southeast Serbia in a 10-year period (1997-2007).

BACKGROUND/AIM: Lichen planus is a chronic, immunologic, mucocutaneous disease with a wide range of clinical manifestations. The aim of this retrospective study was to evaluate the most common forms of oral lichen planus (OLP) and its symptoms and to describe treatment responses in patients during 10-year period. METHODS: The study was conduced on 163 OLP patients who came in the Department of Oral medicine and Periodontology between 1997 and September 2007. Each case was classified into one of four clinical subtypes: reticular, atrophic, erosive-ulcerative, bullous. RESULTS: There was no significant difference in patients age. Women were found to be significantly more likely to have OLP (p < 0.001). Corticosteroids were effective in reducing symptoms, erythema and healing ulcers. Improvement was shown over a long term in 61.35% patients. Over the long term 38.65% patients maintained the same type of OLP or it became a more severe type. Two patients (1.22%) developed oral carcinoma during the follow-up period. CONCLUSION: The response of patients with erosive OLP to a short course of systemic corticosteroids often was quite remarkable. However, symptoms and signs tended to recur after this treatment. Periodic examinations, patient education, medical treatment, monitoring of side-effects as well as follow-up biopsies are necessary for management of OLP patients.

Influence of low-level laser therapy on biomaterial osseointegration: a mini-review.

The aim of this paper is to provide an overview of the available literature on low-level laser therapy (LLLT) and its influence on bone repair and the osseointegration of biomaterials. Extensive studies of alveolar bone repair, a common problem in periodontal therapy, have been conduced worldwide. The utility of LLLT in biomaterial osseointegration is still unanswered, due to lack of literature and poorly understood mechanisms. It is still difficult for one to compare studies about the action of LLLT on the osseointegration of biomaterials because the experimental models and duration of treatments are very distinct. However, it could be concluded that LLLT may offer advantages in terms of periodontal and bone functional recovery and biomaterial osseointegration.

[Diabetes mellitus and periodontal disease].

INTRODUCTION: This review highlights the relations between diabetes mellitus and periodontal disease, as well as the pathogenic mechanisms which are still the subject of investigations. The possible pathogenic mechanisms important for developing periodontal disease in the diabetics are: vascular gingival changes, the disorders in the metabolism of the collagen, disorders in the function of the polimorphonuclear leukocytes and specific microbial flora in the parodontal pockets. CONCLUSION: It is clear that adequate early recognition and good treatment are very important and significant for treatment of diabetic periodontal disease.