Periodontal treatment outcomes in post menopausal women receiving hormone replacement therapy.

PURPOSE: To evaluate the effect of hormone replacement therapy(HRT) on periodontal treatment outcomes in a group of postmenopausal women with periodontitis. MATERIALS AND METHODS: 23 post-menopausal chronic periodontitis patients were included in this study. The test group(n=11) consisted of women who started HRT with this study and received conjugated estrogen and medroxyprogesteron. The control group(n=12) was women not taking any HRT or supplement therapy. Study groups received the same periodontal treatment. All subjects examiend by recording the following: plaque index (PI), sulcus bleeding index (SBI), periodontal pocket depth (PD) and relative attachment level (RAL) from 6 sites in each tooth. Measurements were recorded at the baseline, 1 month, 3 months, and 6 months following periodontal treatment. Serum estrogene level and bone mineral density was recorded at baseline and 6 months following periodontal treatment. RESULTS: The GI change was greater in the control group. There wasn't significant difference by means of PD, the attachment gain was significantly greater in the HRT receiving group. CONCLUSION: HRT seems to have a positive effect on periodontal treatment outcomes.

The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment.

BACKGROUND: The aim of this study is to evaluate the effect of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal therapy of smoking and non-smoking patients with moderate to advanced chronic periodontitis. METHODS: All 36 systemically healthy patients who were included in the study initially received non-surgical periodontal therapy. The LLLT group (n = 18) received GaAlAs diode laser therapy as an adjunct to non-surgical periodontal therapy. A diode laser with a wavelength of 808 nm was used for the LLLT. Energy density of 4 J/cm(2) was applied to the gingival surface after periodontal treatment on the first, second, and seventh days. Each of the LLLT and control groups was divided into two groups as smoking and non-smoking patients to investigate the effect of smoking on treatment. Gingival crevicular fluid samples were collected from all patients and clinical parameters were recorded on baseline, the first, third, and sixth months after treatment. Matrix metalloproteinase-1, tissue inhibitor matrix metalloproteinase-1, transforming growth factor-ß1, and basic-fibroblast growth factor levels in the collected gingival crevicular fluid were measured. RESULTS: The primary outcome variable in this study was change in gingival bleeding and inflammation. At all time points, the LLLT group showed significantly more improvement in sulcus bleeding index (SBI), clinical attachment level, and probing depth (PD) levels compared to the control group (P <0.001). There were clinically significant improvements in the laser-applied smokers' PD and SBI levels compared to smokers to whom a laser was not applied, between the baseline and all time points (P <0.001) (SBI score: control group 1.12, LLLT group 1.49; PD: control group 1.21 mm, LLLT group 1.46 mm, between baseline and 6 months). Transforming growth factor-ß1 levels and the ratio of matrix metalloproteinase-1 to tissue inhibitor matrix metalloproteinase-1 decreased significantly in both groups at 1, 3, and 6 months after periodontal therapy (P <0.001). Basic-fibroblast growth factor levels significantly decreased in both groups in the first month after the treatment, then increased in the third and sixth months (P <0.005). No marker level change showed significant differences between the groups (P <0.05). CONCLUSION: LLLT as an adjunctive therapy to non-surgical periodontal treatment improves periodontal healing.

Detection of implant crevicular fluid prostaglandin E2 levels for the assessment of peri-implant health: a pilot study.

Inflammatory changes in the peri-implant tissues may lead to peri-implantitis and bone loss. Prostaglandin E2 has been shown to have proinflammatory effects on peri-implant tissues, including mediation of bone resorption. The aim of this study was to assess prostaglandin E2 levels in implant crevicular fluid and the possibility of using this method in diagnosing peri-implant mucositis. Twenty-four dental implants with 3 mm or greater probing depths comprised the test group and another 24 implants with probing depths less than 3 mm served as the control group. Plaque index (PI), gingival index (GI), and probing pocket depths (PPD) were recorded. Implant crevicular fluid was obtained by collection onto periopapers. Then, prostaglandin E2 levels were evaluated using a commercially available enzyme immuno-assay kit. PI, GI, PPD, and implant crevicular fluid (ICF) levels of prostaglandin E2 were found to be statistically significantly higher in the test group (P < 0.05). In the test group, gingival index and probing depths were found to be statistically significantly related with ICF prostaglandin E2 levels (P < 0.05). In the control group, there was no statistically significant positive correlation between clinical parameters and ICF prostaglandin E2 levels (P > 0.05). It may be speculated that biochemical tests, such as the detection of prostaglandin E2 levels in the crevicular fluid are useful diagnostic methods for the maintenance of functional dental implants.

The effects of periodontal therapy on intracrevicular prostaglandin E2 concentrations and clinical parameters in pregnancy.

BACKGROUND: The increase in circulating levels of progesterone during pregnancy stimulates production of prostaglandins, especially prostaglandin E2, possibly resulting in pregnancy gingivitis. The purpose of this study is to evaluate the influence of prostaglandin E2 concentrations on gingival tissues in pregnancy and to assess its relationship to clinical parameters. METHODS: This study evaluates the effects of periodontal treatment on clinical indices including plaque index, gingival index, probing depth, and gingival crevicular fluid prostaglandin E2 levels of 22 pregnant women in their first, second, and third trimesters. Initial periodontal therapy consisting of scaling, root planing, and oral hygiene instruction was performed at the beginning of the first trimester and repeated each trimester. Prostaglandin E2 concentrations in gingival crevicular fluid were determined using a commercially available enzyme immunoassay kit. The statistical tests used were paired sample test and correlation analysis. RESULTS: The results of the study show that periodontal therapy has resulted in an improvement in clinical parameters (P<0.05). There is also a statistically significant decrease in levels of prostaglandin E2 at the second and third trimesters following periodontal therapy (P <0.001). The correlation between prostaglandin E2 concentrations and clinical parameters is found to be non-significant (P >0.05). CONCLUSIONS: Our data indicate that levels of prostaglandin E2 in gingival crevicular fluid may be used as a marker of gingival inflammation in order to determine the effects of periodontal therapy in pregnancy. Periodontal therapy that is performed throughout the entire pregnancy period may help prevent the threat of pregnancy gingivitis.

The effect of sociocultural status on periodontal conditions in pregnancy.

BACKGROUND: The effects of sociocultural status on periodontal conditions in pregnant women have been reported by a number of researchers and there have been speculations about the effects of hormonal changes, patients' systemic health, and socio-cultural characteristics on periodontal health during pregnancy. METHODS: This study evaluates the periodontal condition of 61 pregnant women at their first, second, and third trimesters, and the relation between the demographic (age, professional level, education) and clinical variables (previous periodontal care, frequency of tooth brushing). The clinical indices, including plaque index, gingival index, and probing depth measurements were repeated at the first, second, and third trimesters. The statistical tests used were stepwise analysis and paired sample test. RESULTS: The results of the study showed that the plaque index, gingival index, and probing depth scores increased gradually in the first, second, and third trimesters, although oral hygiene instructions were given to the entire study population. The level of statistical significance was established at P <0.05. When the clinical parameters and demographic variables were compared, only educational level and periodontal care seemed to be statistically significant (P<0.05). CONCLUSIONS: Our clinical index scores were related to the educational level of the study population. When the educational level of the study group decreased, the plaque, gingival index, and probing depth scores contrarily increased. Also non-attendance for previous periodontal care increased the scores of plaque index and probing depth. In view of the results of our study, it might be suggested that simple preventive oral hygiene programs may help maintain healthy gingiva during pregnancy.