[Combination therapy of periodontal intrabony defects with demineralized freeze-dried bone powder and platelet-rich plasma].

OBJECTIVE: To evaluate the effect of decalcified freeze-dried bone allograft (DFDBA) and DFDBA with platelet-rich plasma (PRP) in the treatment of periodontal infrabony defects. METHODS: Fifteen periodontal infrabony defects (30 sites) in 12 patients with periodontitis (9 patients with chronic periodontitis and 3 patients with aggressive periodontitis) were selected. Three months after initial therapy, they were assigned to either the DFDBA group (10 defects with 20 sites) or the DFDBA with PRP group (5 defects with 10 sites). The patients were evaluated for plaque index (PI), bleeding index (BI), probing depths (PD) and clinical attachment loss (CAL) before the treatment and at 6 months after periodontal bone graft surgery. RESULTS: The PI, BI, PD and CAL in the DFDBA group were 1.7, 2.7, 6.0 mm and 7.0 mm at baseline; 1.5, 1.8, 3.9 mm and 4.4 mm at the 6 months after periodontal surgery. The PD, CAL and BI in DFDBA with PRP group at baseline were 6.2 mm, 7.1 mm and 2.9; 3.2 mm, 3.6 mm and 1.7 at the 6 months after periodontal surgery. The PI did not change significantly after surgery in both groups. While both groups showed significant improvement (P<0.01) in BI, PD and CAL, the improvement in the DFDBA with PRP group was significant greater than in the DFDBA group (P<0.05). CONCLUSION: DFDBA is an effective therapy for periodontal intrabony defects. DFDBA with PRP can significantly improve the clinical effect of periodontal infrabony defects.

[Detection of periodental pathogens in atherosclerotic lesions in patients].

OBJECTIVE: To detect periodontopathic bacterial DNA in atherosclerotic vascular lesions in a group of Chinese patients by using polymerase chain reaction (PCR) techniques. METHODS: Ten human specimens of atherosclerotic plaque were obtained sterilely. The sclerotic lesions were blade into fine pieces and DNA was isolated from the samples. To detect Porphyromonas gingivalis(Pg), Tannerella forsythia(Tf), Aggregatibacter actinomycetemcomitans(Aa), Prevotella intermedia(Pi), Prevotella nigrescens(Pn), Treponema denticola(Td), Campylobacter rectus(Cr), PCR amplification of bacterial 16S ribosomal DNA (rDNA) was carried out. RESULTS: PCR assays for bacterial 16S rDNA indicated the presence of periodontal pathogens in 3 out of 10 surgical specimens. DNA of Pg were found in 3 samples, Tf was found only in one among the 3 samples and Pn was found in another sample among the 3 samples. CONCLUSION: The data confirm that DNA of periodontal pathogens present in atherosclerotic plaques. Pg, Tf, Pn may play a role in the development and progression of atherosclerosis in these Chinese patients. Further studies with large size samples are needed.

[Evaluation of the in vitro quantitative measurement of II degree furcation involvements in mandibular molars by cone-beam computed tomography].

OBJECTIVE: To evaluate the accuracy of measurement of II degree furcation involvements in molars of dry mandibles by cone-beam computed tomography (CBCT). METHODS: Twenty molars with II degree furcation involvements in dry mandibles were examined directly and measured by CBCT. Eight parameters were selected to describe the exact appearance of each II degree furcation involvements, including vertical defect dimensions, horizontal defect dimensions and furcation entrance dimensions. The results were compared with the corresponding data obtained by probing and periapical radiograph. RESULTS: All furcation involvements could be correctly classified by CBCT. For 5 of 8 parameters, no significant difference was found between the data obtained by CBCT and probing measurements (P>0.05). The distances from furcation entrance to alveolar crest, to bottom of bone pocket, and to the deepest site of horizontal bone defect measured by CBCT were less than those probed directly (P<0.05), but the differences were less than 0.5 mm (0.21, 0.24, 0.35 mm, respectively). The localization of furcation entrance may cause the differences. Two out of 20 furcation involvements could not be detected on periapical radiographs, and only 2 of 8 parameters could be measured on periapical radiographs. CONCLUSION: CBCT could provide precise and detailed 3D images of II degree furcation involvements in vitro.

[Effect of periodontal initial therapy on the serum level of lipid in the patients with both periodontitis and hyperlipidemia].

OBJECTIVE: To observe the effect of periodontal initial therapy on the serum level of lipid in the patients with both periodontitis and hyperlipidemia. METHODS: Twenty patients with both hyperlipidemia and moderate to severe chronic periodontitis were enrolled in this study. Periodontal parameters [plaque index (PLI), bleeding on probing (BOP), bleeding index (BI), probing depth (PD) and attachment level (AL)] were evaluated prior to and 3 months after periodontal initial therapy. Simultaneously, the patients' serum levels of total cholesterol, triglyceride, high-lipoprotein cholesterol, low-lipoprotein cholesterol were also measured. RESULTS: (1) Three months after periodontal therapy, the periodontal infection and inflammation in patients reduced comparing with baseline. The PD, PLI, BI, and BOP decreased significantly (the PD, PLI, BI, and BOP reduced from 3.98+/-0.12 to 2.39+/-0.13, 1.23+/-0.10 to 0.84+/-0.08, 2.63+/-0.14 to 1.48+/-0.08 and 94.26+/-1.84 to 33.57+/-2.06, respectively; P<0.05), and the attachment level increased significantly after periodontal treatment (AL decreased from 5.17+/-0.21 to 3.92+/-0.16, P<0.05). (2) The total cholesterol and triglyceride levels in these patients also reduced significantly (reducing 0.25 mmol/L and 0.20 mmol/L respectively, P<0.05) at 3 month after periodontal therapy comparing with baseline. At the same time, high-lipoprotein cholesterol levels in these patients increased significantly (increasing 0.18 mmol/L, P<0.05). Eight out of 20 patients showed their serum levels of lipid down to the normal levels. CONCLUSION: Our observation indicated that periodontal initial therapy could reduce the serum lipid levels of patients with both periodontitis and hyperlipidemia, which might be helpful for decreasing risk of cardiovascular disease such as coronary heart disease.

[Association of Fc gamma receptors IIIA gene polymorphisms with the susceptibility to periodontitis in Chinese patients].

OBJECTIVE: Fc gamma receptors IIIA (Fc gamma RIIIA) mediates phagocytosis by macrophages, and cytokine production by NK cells and lymphocytes. The Fc gamma R IIIA-158V/F polymorphism may play a role in the pathogenesis of periodontitis. This study was to detect Fc gamma R IIIA-158V/F genotypes in Chinese patients with different forms of periodontitis. METHODS: Thirty aggressive periodontitis (AgP) patients (aged from 9 to 40, 13 males and 17 females), 131 chronic periodontitis (CP) patients (aged from 22 to 63, 76 males and 55 females), and 47 healthy subjects (H) (aged from 22 to 75, 21 males and 26 females) consented to participate in this study. Swabs were taken from each subject by ten strokes on the buccal mucosa. DNA was isolated from each swab by Chelex-100 methods. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)was performed to determine the Fc gamma R IIIA-158 genotypes in each groups of subject. RESULTS: The allele frequency was in Hardy-Weinberg equilibrium in our cohort for the V-158F polymorphism in Fc gamma R IIIA gene (P>0.05). The detected frequency of 158F/F in AgP patients was significantly higher than that in CP patients (16.7% vs 0.8%, P<0.05), and also higher than that in H subjects (16.7% vs 4.3%) but was not statistically significant. No significant difference in distribution of the Fc gamma R IIIA-158V/F genotype was found between CP and H groups (P>0.05). CONCLUSION: The distribution of Fc gamma R IIIA-158F/F genotype might have effects on the phenotypes of periodontitis.