Relationship Between Low Education and Poor Periodontal Status among Mexican Adults Aged ≥50 Years.

PURPOSE: To examine the association between educational level and the presence of periodontal disease in adults ages ≥ 50 years in Mexico. MATERIALS AND METHODS: A cross-sectional study was conducted on 2098 Mexican adults, using data from the annual reports of the Epidemiological Monitoring System for Oral Pathologies from 2019-2022. Data were collected on sociodemographic characteristics such as gender, age, educational level, oral hygiene, and diabetes. Periodontal status was evaluated using the Community Periodontal Index (CPI) and was classified into: CPI = 0 (healthy); CPI = 1 (bleeding on probing); CPI = 2 (calculus); and CPI = 3 or 4 (pocket depth ≥ 4 mm). A multinomial regression model was used to estimate the odds ratio (OR) and the 95% confidence intervals (CI), using periodontal status as the result. RESULTS: 39.9% of subjects presented periodontal pockets of ≥ 4 mm, 20.8% presented calculus, and 12.8% presented bleeding, while only 26.4% were classified as healthy. A low level of education (≤ 9 years) (OR = 4.84; p 0.001), age ≥ 65 years (OR = 1.33; p = 0.025), poor oral hygiene (OR = 6.86; p 0.001), smoking (OR = 1.51; p = 0.025), and diabetes (OR = 1.73; p 0.001) were statistically significantly associated with the presence of periodontal pockets ≥ 4 mm. CONCLUSIONS: A low level of education is associated with worse periodontal status in adults aged 50 years or more. These findings reiterate the importance of implementing effective strategies and the incorporation of interventions for improving the access to and quality of services targeted at aging communities.

The effectiveness of photodynamic therapy as a complementary therapy to mechanical instrumentation on residual periodontal pocket clinical parameters: A clinical split-mouth test.

The purpose of this study was to evaluate the effectiveness of photodynamic therapy as complementary therapy to mechanical instrumentation on periodontal residual pockets. This longitudinal, prospective, double-blind and controlled split-mouth clinical trial included one hundred and fourteen residual periodontal sites with probing depth ≥ 4 mm and bleeding on probing, which were distributed into two groups: 57 in the test group (SRP + aPDT) - using a low power laser application Therapy XT (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 110 mW for 15s, and 57 in the control group (SRP). Oral hygiene conditions were evaluated, through the Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI), as well as periodontal clinical outcomes, comprising the Bleeding on Probing (BOP), Probing Depth (PD) and Clinical Attachment Level (CAL) at baseline and after 3 months. Decrease of 17.74% was observed for the VPI after 3 months of follow-up, while the GBI was reduced by 19.91%, thus indicating statistically significant decreases for both parameters (p < 0.001). Decreases in VPI per site, BOP and PD and CAL gain between T0 and T3 in both treatment groups (p < 0.001) were observed, but no statistically significant intergroup differences were found (p > 0.05). Within the parameters used in this study, adjuvant aPDT to SRP did not lead additional benefits regarding the assessed clinical parameters after three months.

Antimicrobial Photodynamic Therapy Using a Chloro-Aluminum Phthalocyanine Adjuvant to Nonsurgical Periodontal Treatment Does Not Improve Clinical Parameters in Patients with Chronic Periodontitis.

Background and objective: To evaluate the effects of antimicrobial photodynamic therapy (aPDT) with chloro-aluminum phthalocyanine (AlClFc) adjuvant to scaling and root planing (SRP) on periodontal clinical parameters of patients with chronic periodontitis. Materials and methods: Fifty-four periodontal sites were randomly distributed into two groups: 27 in the test group (SRP+aPDT)-using a low-power laser application Photon Lase III (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 100 mW for 15 sec, and 27 in the control group (SRP). SRP was performed in a single session and the periodontal clinical parameters such as visible plaque index, bleeding on probing (BOP), probing depth (PD), and clinical attachment level were assessed at the baseline (T0) and 3 months after aPDT (T3). Results: Regarding BOP, a decrease in both treatment groups, the test group (p = 0.003) and control group (p = 0.001), was reported between T0 and T3. A reduction in PD and clinical insertion gain for both treatment groups (p < 0.05) after 3 months of therapy was observed, although nonsignificant (p > 0.05) in intergroup comparison. Conclusions: aPDT with AlClFc adjuvant to SRP did not provide additional benefits in reducing PD and clinical insertion gain.

Photobiomodulation for the treatment of periodontal pockets in patients with type 2 diabetes: 1-year results of a randomized clinical trial.

This study investigated the local effect of photobiomodulation (PBM) for the treatment of periodontal pockets in patients with periodontitis and type 2 diabetes. Thirty-eight periodontal pockets presenting probing depth (PD) and clinical attachment level (CAL) ≥ 5 mm were selected from 19 patients (two pockets/patient). The selected periodontal pockets were randomly assigned to receive mechanical debridement only (control group) or mechanical debridement with PBM (PBM group). Clinical measures, such as PD, CAL, bleeding on probing (BoP), and presence of supragingival biofilm (PI), were collected and compared at baseline, 3, 6, and 12 months. After 12 months, no statistically difference was observed for mean PD and mean CAL when control and PBM groups were compared. The frequency of pockets with PD 5-6 mm was significantly lower for the PBM group at 6 months when compared to the control group. Pockets with PD ≥ 7 mm changed significantly between baseline and 3, 6, and 12 months for the PBM group, while for the control group, statistical significance was only observed between baseline and 6 months. The PBM protocol used in this study did not provide significant changes for PD and CAL in periodontal pockets when compared to mechanical therapy only. However, PBM was more effective in reducing the percentage of moderate periodontal pockets at 6 months in patients with type 2 DM.

Staphylococcus spp. en bolsas periodontales de un grupo de pacientes que acuden a un Centro Odontológico del Municipio San Diego, Estado Carabobo / Staphylococcus spp. in periodontal pockets from a group of patients attending a dental center in the Municipality of San Diego, Carabobo State

Algunos microorganismos inusuales han sido aislados en muestras de cavidad bucal de pacientes con enfermedad periodontal. El objetivo de esta investigación fue determinar la frecuencia de Staphylococcus spp. en bolsas periodontales basado en las características epidemiológicas de pacientes que acuden a un centro odontológico en el Municipio San Diego, Edo Carabobo. Se estudiaron muestras provenientes de bolsas periodontales de 50 pacientes que asistieron al centro odontológico. Las cepas aisladas se identificaron mediante pruebas bioquímicas, y finalmente se determinó el perfil de susceptibilidad antimicrobiana. Se obtuvo que la frecuencia de pacientes portadores de Staphylococcus spp. fue de 32%, 16 pacientes. Se aisló con mayor frecuencia Staphylococcus Coagulasa Negativa (SCN) en 10 pacientes, seguido de S. aureus en 6. Con respecto al perfil de susceptibilidad antimicrobiana se determinó que de las 6 cepas aisladas de Staphylococcus aureus, 2 resultaron ser Meticilino-resistentes. La presencia de Staphylococcus spp en bolsas periodontales es de baja frecuencia; sin embargo en este estudio, se demostró la presencia de dichos microorganismos en 32% del total de los pacientes estudiados, lo que significa que estos pacientes están más colonizados de lo que se cree.

Some unusual microorganisms have been isolated from samples of patients with oral cavity periodontal disease. The objective of this research was to determine the frequency of Staphylococcus spp. in periodontal pockets based on the epidemiological characteristics of patients attending a dental center in the municipality of San Diego, Carabobo state. Samples from periodontal pockets of 50 patients attending the dental center were studied. The isolated strains were identified by biochemical tests and finally the profile of antimicrobial susceptibility was determined. It was found that the frequency of patients with Staphylococcus spp. was 32%, 16 patients. Staphylococcus Coagulase Negative (SCN) was isolated in 10 patients, followed by S. aureus in 6. Regarding to antimicrobial susceptibility profile, it was determined that of the 6 isolated strains of Staphylococcus aureus, 2 proved to be Methicillin-resistant. The presence of Staphylococcus spp. in periodontal pockets is low frequency; however in this study, the presence of said microorganism was determined in 32% of the patients studied, which means that these patients are more colonized than what is believed.

Presentación de un paciente con regeneración de defectos óseos periodontales y con plasma rico en plaquetas / Presentation of a Patient with Regeneration of Periodontal Bone Defects and Platelet-Rich Plasma

Las periodontitis implican pérdida de inserción clínica y destrucción ósea visible en las radiografías. Se consideran las enfermedades más comunes entre las que afectan al periodonto de inserción. Su prevalencia aumenta con la edad hasta alcanzar alrededor del 80% a los 50 años. Con el objetivo de demostrar la regeneración ósea periodontal con plasma rico en plaquetas, se presentó este caso clínico, paciente de 19 años de edad que acudió en búsqueda de atención estomatológica, la cual fue diagnosticada con una periodontitis juvenil. Como conclusión se comprobó que el plasma rico en plaquetas es una posibilidad válida para regenerar o reconstruir el tejido óseo.

Periodontitis involve clinical attachment loss and bone destruction visible on radiographs. They are considered the most common diseases among those affecting the periodontal insertion. Its prevalence increases with age up to about 80% at 50 years. In order to demonstrate the periodontal bone regeneration with platelet-rich plasma, a patient of 19 years old who came for dental care, which was diagnosed as a periodontitis in young people. The author concluded that the platelet-rich plasma is a valid possibility to regenerate or reconstruct the bone tissue

Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: a randomized controlled clinical trial.

AIM: A randomized controlled clinical trial was designed to evaluate the efficacy of the photodynamic therapy (PDT) in the treatment of residual pockets of chronic periodontitis patients. MATERIAL AND METHODS: Thirty-four patients with at least four residual periodontal pockets undergoing maintenance care were included and randomly assigned to test group (PDT, n = 18) or control group (sham procedure, n = 16). The intervention was performed at baseline, 3, 6 and 12 months. Clinical parameters such as pocket probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP) and plaque index (PI) were measured before intervention and after 3, 6 and 12 months. Subgingival samples were obtained at baseline, and after 7 days, 3, 6 and 12 months to quantify Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia by real-time polimerase chain reaction (PCR). RESULTS: All clinical variables showed significant improvement during the study, but there was no significant difference between test and control groups. The microbiological analyses showed no differences between groups at any time during the study. CONCLUSION: Within the limits of this clinical trial and considering the laser and photosensitizer protocol used, PDT failed to demonstrate additional clinical and bacteriological benefits in residual pockets treatment.

Prevalence of Staphylococcus spp and Candida spp in the oral cavity and periodontal pockets of periodontal disease patients

The oral cavity can act as a reservoir of certain pathogens that can cause systemic infections. The periodontal pocket is an ecological niche appropriate for hosting microorganisms that could act as opportunistic pathogens. The ability of Staphylococcus spp and Candida spp to form a biofilm and live within certain niches allows them to develop mechanisms that increase persistence, such as the evasion of host defenses and antibiotic efficacy. These microorganisms can easily be or become resistant to antibiotics and lead to superinfection. The aims of this study were to assess the presence of Staphylococcus aureus and Staphylococcus spp in biofilm in subgingival plaque and oral cavity of individuals with gingival-periodontal disease, to identify isolates and the relationship with Candida spp. The study included eighty-two patients, aged 18-70 years with periodontal disease and at least two sites with probing depth ≥3 mm. Participants’ data were evaluated individually. Subgingival biofilm samples were obtained using Gracey curettes 7/8, after supragingival biofilm removal, and a sample from the oral cavity (buccal mucosa, tongue and cheek mucosa) by sterile swab. Of all the patients studied, 42.7% exhibited Staphylococcus spp in the periodontal pocket and 69.5% in the oral cavity while 25.6% exhibited Candida spp in the periodontal pocket and 42.7% in the oral cavity. However, 13.4% had both microorganisms in the periodontal pocket and 36.6% in the oral cavity. The prevalence of Staphylococcus aureus was 13.4% in the periodontal pocket and 15.8% in the oral cavity. Candida albicans was the most prevalent yeast in the periodontal pocket (76.2%) and in the oral cavity (63.0%).

La cavidad bucal puede actuar como reservorio de ciertos patógenos que pueden producir infecciones sistémicas. La bolsa periodontal es un nicho ecológico propicio para albergar microorganismos que podrian actuar como patógenos oportunistas. La posibilidad que Staphylococcus spp y Candida spp puedan formar un biofilm o biopelícula y vivir dentro de ciertos nichos les permite a estos microorganismos desarrollar ciertos mecanismos que aumentan su persistencia como ser la capacidad de eludir las defensas del huésped y la terapia antimicrobiana. Estos microorganismos pueden ser o fácilmente convertirse en resistentes a los antibióticos y dar origen a una supeinfección. El propósito de este estudio fue evaluar la presencia de Staphylococcus aureus y Staphylococcus spp en biofilm placa subgingival y en cavidad oral en sujetos con enfermedad gingivoperiodontal, identificar los microorganismos aislados y su relación con la portación de Candida spp. El estudio incluyo ochenta y dos pacientes, de edades entre 18 a 70 anos de edad, con enfermedad periodontal, y al menos dos sitios con la profundidad de sondaje ≥ 3 mm. Se evaluaron los datos individuales. Las muestras de biofilm subgingival fueron obtenidas con cureta tipo Gracey 7/8, previa remoción del biofilm supragingival y una muestra de cavidad oral (mucosa, lengua y carrillo) mediante hisopo estéril. Del total de los pacientes estudiados, el 42,7% mostraron Staphylococcus spp en la bolsa y el 69,5% en la cavidad oral, mientras que 25,6% mostraron Candida spp en la bolsa y 42,7% en la cavidad oral. Sin embargo, el 13,4% tenían ambos microorganismos en la bolsa y el 36,6% en la cavidad oral. La prevalencia de Staphylococcus aureus en la bolsa periodontal fue de 13,4% y 15,8% en la cavidad oral. Candida albicans fue la levadura más frecuente en la bolsa periodontal (76,2%) y en la cavidad oral (63,0%).

Reproducibility of Probing Depth Measurements Using a Constant-Force Electronic Probe: Analysis of Inter- and Intraexaminer Variability.

BACKGROUND: Probing depth (PD) is a commonly used method to determine periodontal disease severity in both treating and evaluating disease progression. Agreement among examiners collecting data in scientific investigations is necessary to establish reliable criteria for determining levels of periodontal attachment loss. The objective of our study was to evaluate inter- and intraexaminer variability of PD measurements among study examiners using a constant force periodontal probe, and to compare the variability of tooth-mean and quadrant-mean. METHODS: Three examiners, who had been previously trained and calibrated, performed measurements on 20 volunteers. Intraand interexaminer variability of sites was determined by means of standard error of measurement (SE). Data analysis included determination of error for both quadrant mean and tooth mean. RESULTS: PD measurements for the quadrant-mean were used to calculate the intraexaminer variability, resulting in a mean (SD) value for an SE of 0.40 mm (± 0.02). Interexaminer variability for quadrant mean was 0.16 mm (± 0.02). For tooth-mean SE, the intraexaminer variability values were equal to 0.38 mm (± 0.07), and interexaminer variability equal to 0.24 mm (± 0.05). CONCLUSIONS: All three examiners participating in our study were able to obtain reliable measurements for PD, using the constant force electronic probe. Reproducibility did not vary appreciably when using the whole quadrant mean compared to the tooth mean. These trained examiners were able to provide reproducible measures under 0.5 mm. J Periodontol 2003;74:1736-1740.