Therapeutic efficacy of clindamycin gel as an adjunct to scaling and root planing therapy in chronic periodontal disease.

Clindamycin, a lincosamide antibiotic, has been under-recognized as an antimicrobial agent for use in dentistry. The aim of the present work was to evaluate clinical efficacy of 2% clindamycin gel in addition to the basic mechanical periodontal therapy. At baseline, scaling and root planing (SRP) was performed at all 50 subjects (control group and test group). Clindamycin gel was applied after SRP only in the test group. Clinical measurements including periodontal pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI) were done at baseline, and at 3 and 6 months after treatment. Compared to baseline, the PPD and CAL values significantly decreased in the test group (p < 0.05) and were statistically lower (p < 0.05) compared to control group. PPD reduction of 2.42 mm was obtained in the test group and could be generally considered as clinically significant. A PPD reduction greater than 2 mm indicated that clindamycin gel could be used efficiently as an adjunct to SRP. Also, between-group difference in BOP and PI scores was statistically significant 6 months after treatment. In conclusion, the application of clindamycin gel in combination with SRP enhanced the efficacy of non surgical periodontal therapy in reducing pocket depth and improving attachment levels in chronic periodontitis subjects and had additional benefits over mechanical therapy alone.

Effect of periodontal treatment in renal transplant recipients.

OBJECTIVE: To evaluate the effect of periodontal treatment on gingival overgrowth in a group of renal transplant patients. SUBJECTS AND METHODS: Twenty-five renal transplant recipients receiving immunosuppressive therapy with cyclosporine A (CsA) were randomly assigned to 2 groups. Group 1 (n = 15) included patients who had been specifically referred to a dental clinic to prevent gingival overgrowth and were given full periodontal therapy. Group 2 (n = 10) was comprised of patients who did not receive any professional periodontal cleaning. Patients from both groups were examined to determine their periodontal status before and after 3, 6 and 12 months in terms of their plaque index, gingival index and gingival overgrowth. During the examination, their overall health was stable. RESULTS: For group 1, the scores were 1.89 (baseline), 0.98 (6 months) and 0.56 (12 months), and hence there were significant reductions (p = 0.0001). The gingival indices were 1.71 (baseline), 0.76 (6 months) and 0.35 (12 months), and the reductions were also significant (p = 0.0001). A significant association was observed between poor oral hygiene and the degree of gingival overgrowth. The 1-year post-treatment follow-up showed that patients in group 1 did not develop gingival overgrowth due to the use of CsA as group 2 did without prior periodontal therapy. CONCLUSION: Oral hygiene status was the most important variable related to the development and degree of gingival overgrowth due to the use of CsA.

[Association between chronic periodontitis and serum lipid levels].

BACKGROUND/AIM: Periodontitis is a local inflammatory process mediating destruction of periodontal tissues triggered by bacterial insult. However, this disease is also characterized by systemic inflammatory host responses that may contrbute, in part, to the recently reported increased risk for systemic diseases, including an altered lipid metabolism. On the other hand, many people in the world are affected by hyperlipidemia, which is a known risk faktor for atherosclerosis. The aim of this study was to determine the relationship between periodontal disease and blood lipid levels. METHODS: A total of 50 patients with periodontitis included in this study had no documented history of recent acute coronary events. The healthy, non-periodontal subjects (comparison group) comprised 25 subjects. All the patients were periodontology examined and completed a medical history. Dental plaque index, probing depth, gingival index bleeding on probing and clinical attechment levels were recorded. Blood samples were taken on admission for measurements of serum total cholesterol, triglycerides, hight density lipoprotein cholesterol (HDL-cholesterol), and low density lipoprotein cholesterol (LDL-cholesterol). RESULTS: The obtained results showed that mean levels of cholesterol (6.09 +/- 1.61 mmol/L), triglycerdes (2.19 +/- 1.67 mmol/l) and LDL cholesterol (4.09 +/- 1.40 mmol/L) in individuals with periodontitis were higer, and levels od HDL (1.43 +/- 0.51 mmol/L) was lower than those of individuals without periodontitis (4.86 +/- 1.37; 1.14 +/- 0.71; 3.18 +/- 0.64; 1.53 +/- 0.32 mmol/L, respectively). CONCLUSION: This study confirms a significant relationship between periodontal disease, regardless its intensity, and blood lipid levels in the studied population. The results imply that periodontitis may be a risk factor and may contribute to the pathogenesis of atherosclerosis and cardiovascular diseases (CVD). However, future prospective randomized studies have to determine whether periodontal disease is a risk factor for the occurence of CVD.

Effect of periodontal treatment on lipoproteins levels in plasma in patients with periodontitis.

OBJECTIVES: Recent epidemiological studies have shown that individuals with periodontitis have a significantly increased risk of developing coronary heart disease. In addition to conventional risk factors, dyslipidemia may be associated with this increased risk. METHODS: We measured concentration of lipids in patients with moderate to severe periodontitis before and 3, 6 and 12 months after local periodontal treatment. A total of 50 participants with periodontitis and 25 participants without periodontitis were included in the analyses. Lipoproteins were measured by using serological analyses of the Central Biochemical Laboratory in Clinical Center in Nis. Periodontal health indicators included the plaque index, gingival bleeding index, and periodontal disease status (defined by pocket depth and attachment loss). Patients were non-surgically treated with mechanical debridement of calculus once a week for 1 month. RESULTS: The results show a significant relation between indicators of poor periodontal status and serum level lipoproteins. Periodontal therapy resulted in a significant reduction of local inflammation and tissue destruction as reflected in reduced pocket depth and reduced bleeding indices. The levels of lipoproteins after therapy seemed to be lower than those reported before treatment in patients with periodontitis compared with healthy ones. Lipoproteins were significantly decreased after treatment (P < 0.005) except high-density lipoprotein cholesterol which was not significantly reduced (P > 0.05). CONCLUSION: This pilot study shows that periodontal disease significantly affects the serum levels of lipoproteins and suggests that following successful periodontal treatment decreases serum lipid concentration. This study suggests also that lipoproteins are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.

White blood cell count in different stages of chronic periodontitis.

Periodontal disease is considered to be an inflammatory disorder that is related to the accumulation of oral microbial biofilm and the host response to this accumulation. The host reaction to gingival microorganisms is characterized in part by increase in the polymorphonuclear leukocyte counts, which is one of the most important steps in host defense. Exaggerated leukocytes and neutrophils of host response are a very important component in the pathogenesis of periodontal disease. The purpose of this study was to investigate the relationship between white blood cell count and periodontal disease in subjects with moderate and severe periodontitis and in control subjects with healthy periodontal tissues. Leukocytes for the present study were obtained from peripheral venous blood of 50 patients with moderate periodontitis, 50 patients with severe periodontitis and 25 healthy subjects. The clinical parameters of periodontitis including plaque index, bleeding on probing and gingival index were determined in all study subjects. In both moderate and severe periodontitis, the results indicated a significantly higher count ofneutrophils (P < 0.001), as well as of both lymphocytes and total leukocytes (P < 0.05). The values of clinical parameters (plaque index, gingival index and bleeding on probing) also showed significant between-group differences (P < 0.005 and P < 0.001, respectively). It is possible that there is a significant relationship between total leukocyte count, neutrophil count and different forms of periodontal disease.