Chronic Periodontitis Research Articles

Retrospective analysis and clinical features of periapical tissue regeneration

Background: Chronic periodontitis is associated with changes in periapical tissues. Untimely diagnosis and lack of appropriate mechanical treatment increase the incidence of chronic periodontitis. Periodontitis that causes destructive changes due to long-term inflammation of periapical tissues is of particular concern. Thus, the treatment of destructive periodontal diseases is a pressing issue in modern dentistry. Aim: To assess periapical tissue regeneration following treatment in chronic periodontitis patients. Materials and Methods: A retrospective analysis of the destruction and regeneration of periapical tissues before and after treatment during 3–6 months was performed in 20 patients. Results: A retrospective analysis of X-ray findings in 20 patients revealed bone destruction of varying degrees. Low-quality root canal preparation was due to various factors, primarily the anatomy and topography of root canals. Of the 20 patients who required treatment for chronic periodontitis with varying degrees of destruction, 16 came back for follow-up appointments and received endodontic treatment. Following treatment, X-ray findings were used to identify taper root canal preparation and assess the quality of obturation up to the root apex. X-ray examination was performed after 3 months in patients with clinical signs of periodontitis and after 6 months in patients without clinical signs of periodontitis. After 3 months, X-ray findings showed a reduction in bone destruction in the causative tooth area, indicating an improvement. Conclusion: The study of periapical tissue regeneration following treatment in chronic periodontitis patients revealed that effective apical preparation, as well as appropriate irrigation and root canal filling, promote regeneration in periodontitis. Healing of periapical tissues is essential for effective root canal treatment.

Gender differences in periodontal pocket microflora in patients with chronic generalized periodontitis

Background: Periodontal disease, the primary cause of tooth loss, is a critical public health concern with a considerable impact on quality of life. It is of interest to explore gender differences in the course of inflammatory periodontal diseases, as well as the prospects of their personalized treatment and prevention in males and females. Aim: To assess the dental health and quantitative composition of periodontal pocket microflora in periodontitis patients, taking into account gender differences. Materials and Methods: The study included 39 patients with moderate chronic generalized periodontitis aged 40–60 years. The diagnosis was made using both primary and secondary dental diagnostic tools. The study had two groups: males (41%, n=16) and females (59%, n=23). The following parameters were assessed: oral hygiene index (OHI-S), severity of gingival inflammation (PMA), and quantitative composition of periodontal pocket microflora (DENTOSCREEN, “Lytech” Co. Ltd., Russia), taking into account gender differences. The study findings were statistically processed using Microsoft Office Excel 2016 with Data Analysis and AtteStat 12.0.5 add-ins. The Shapiro–Wilk test was used. The data are presented as median and interquartile range: Me [Q1; Q3]. The frequency of microorganisms is presented as percentage of the mean and standard error of the mean. The confidence interval was calculated using the Wald method, according to the formula for proportions and frequencies. For small values, the Wald method with Agresti–Coull correction was used. Samples were compared using the following tests: the Mann–Whitney U test was used for quantitative data and Fisher’s angular transformation (φ*emp) for frequency (nominal) attributes. Significant differences were defined as a probability 95% (p 0.05). Results: The quantitative composition of periodontal pocket microflora in patients with moderate periodontitis revealed significant gender differences, as demonstrated by an increase in the count of Fusobacterium nucleatum and Prevotella intermedia, as well as the frequency of Porphyromonas gingivalis, in males compared to females (φ*emp=1.736; p 0.05). Dental health indices confirmed the hypothesis of significant differences between males and females in terms of plaque index (OHI-S) and РМА. In males, poor oral hygiene was reported in 93.7% cases, which was significantly higher (φ*emp=2.04; p 0.05) than in females (69.6%). Moderate gingival inflammation was more prevalent in males, while mild gingival inflammation was more prevalent in females (p 0.05). Conclusion: The study findings emphasize the importance of oral hygiene in the prevention of chronic periodontitis and can be used to improve complex treatment algorithms for patients with periodontal diseases. This includes more frequent dental check-ups and professional oral care sessions, as well as oral hygiene training and monitoring, in males compared to females. Diagnosis by polymerase chain reaction allows for the identification and quantitative determination of DNA from periodontopathogenic bacteria at low concentrations, as well as the justification of treatment algorithms and prediction of treatment outcomes.

Assessment of Serum Adiponectin and Leptin in Chronic Preiodontitis Over Healthy Individuals

ABSTRACT Objective: The objective of the research was to ascertain whether serum levels of the biochemical markers adiponectin and leptin are related to clinical periodontal characteristics. Materials and Method: For the study, 20 people with chronic periodontitis (Group A) and 20 healthy people (Group B) were enrolled. Assessments were conducted on periodontal markers, including bleeding on probing (POP), gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL). An enzyme-linked immunosorbent assay (ELISA) test was used to assess the levels of adiponectin and leptin in serum samples. Result: There was significant elevation in average level of leptin in chronic periodontitis in association to that in healthy group. On the other hand, there was considerable decrease in serum adiponectin in group A in association to healthy group. The ratio of leptin\adiponectin was appreciably greater amongst periodontitis group compared to healthy group. Conclusion: The current investigation leads us to the conclusion that the pathophysiology of periodontitis is significantly influenced by serum levels of adiponectin and leptin.

The Effect of Platelet-Rich Fibrin (PRF) in Accelerating Periodontal Regeneration: A Randomized Controlled Clinical Trial

ABSTRACT Background: Regeneration of periodontal tissues is an essential component in treating periodontal disease, and there is an increasing focus on biological agents that might improve the healing process. Materials and Methods: The randomized controlled clinical study included a cohort of 60 individuals diagnosed with chronic periodontitis. Each participant was randomly allocated to one of two groups: the experimental group (n = 30), which underwent PRF in combination with traditional open flap debridement (OFD), and the control group (n = 30), which received OFD alone. Clinical criteria such as probing pocket depth (PPD), clinical attachment level (CAL), and bone fill percentage were assessed at baseline and after 6 months. Furthermore, cone-beam computed tomography (CBCT) was used to evaluate bone regrowth radiographically. Results: Following a period of 6 months, the experimental group had a notable decrease in postpartum depression (mean decrease of 4.2 mm) and an increase in central artery ligation (mean increase of 3.5 mm) compared to the control group, which had a mean decrease in postpartum depression of 2.8 mm and a mean increase in central artery ligation of 2.1 mm. The test group had a notably greater proportion of bone fill (45%) in comparison to the control group (30%). Further radiographic study verified enhanced bone regeneration in the areas treated with PRF. Conclusion: The use of Platelet-Rich Fibrin (PRF) in combination with traditional periodontal surgery greatly expedites the process of periodontal regeneration, as shown by notable enhancements in clinical indicators and bone regeneration.

Influence of dental prostheses materials on the condition of oral mucosa local homeostasis

Objective. To study the influence of base materials used in the manufacture of removable dentures on the immune homeostasis of the oral mucosa, and, as a consequence, on the clinical condition of the oral mucosa and periodontium of supporting teeth. To create fundamental principles for the development of a pathogenetically substantiated choice of basic dental materials of various chemical natures for removable prosthetics based on the analysis of the parameters of immune homeostasis of the oral mucosa. Materials and methods. 154 patients aged 40 to 85 using dentures based on acrylic, polyurethane plastics and thermoplastics for 6 months, participated in the study. Indicators of immune homeostasis and the identified clinical manifestations of the influence of the prosthesis material such as chronic periodontitis and gingivitis were compared using the statistical method of conjugate multifield tables. Results. The indicators CD4+/CD8+, CD11/CD303, CD68, CD204, CD163, Ki-67 phenotypic markers were determined in gingival biopsies of the prosthetic bed of patients using dentures based on acrylic, polyurethane and thermoplastic for 6 months. Analysis of the statistical significance of differences proved the influence of the prosthesis material on indicators of cellular immune homeostasis, with a shift of homeostasis towards the pro-inflammatory phenotype, and the suppression of the anti-inflammatory factor in circulating monocytes. Conclusions. The study shows that, although each type of removable dentures has its own advantages and disadvantages, the response of the cellular immunity of the oral mucosa to polyurethane dentures is less than to acrylic and thermoplastic ones in relation to the control group. The use of polyurethane prostheses is reasonable as temporary ones during the healing stage of surgical interventions in the oral cavity, in particular tooth extraction and implantation. This type of prosthesis can be recommended as a permanent one for patients with a severe allergic reaction, especially to polymer compounds and dyes.

IDENTIFICATION OF PERIODONTAL PATHOGENS IN PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS DEPENDING ON THE SEVERITY OF INFLAMMATION

Introduction. The progression of chronic generalized periodontitis is associated with gram-negative anaerobic bacteria. Microbiological diagnostics of periodontal disease provides an opportunity for selecting the most effective therapeutic approach for both local and systemic conditions in patients. Aim of this study is to conduct a qualitative assessment of the presence of pathogenic microorganisms in the periodontal pockets of patients, based on the severity of inflammation. Materials and methods. The presence of five key pathogenic microorganisms in the periodontal pocket contents of 90 individuals aged 25-60 years (45 with grade I severity and 45 with grade II) was assessed using real-time polymerase chain reaction (PCR). The analysis was conducted with the CFX96™ Real-Time PCR Detection System (BIO-RAD) and the PeriodontScreen Real-TM reagent kit (Sacace Biotechnologies Srl, Italy). Non-parametric correlation statistical analysis was performed to calculate Kendall’s Tau and Gamma coefficients. In 27 patients (60%) with grade I severity, bacteria of a single species were identified. Two types of periodontal pathogens were detected in 13 patients (28.9%), with the most common combination being Tannerella forsythia and Aggregatibacter actinomycetemcomitans, found in 5 patients (11.1%); 5 patients (11.1%) showed the presence of three microbial species: Tannerella forsythia, Treponema denticola, and Porphyromonas gingivalis. Among the patients with grade II severity, 8 patients (17.8%) had bacteria of one species, specifically Prevotella intermedia. Two microbial species were identified in 9 patients (20%), while three species were present in 15 patients (33.3%). The most frequent combination included Prevotella intermedia, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans, found in 5 patients (11.1%). Four types of microbes were detected in 13 patients (28.9%), with the predominant combination being Tannerella forsythia, Porphyromonas gingivalis, Treponema denticola, and Aggregatibacter actinomycetemcomitans (17.8%). None of the patients with grade II severity had all five periodontopathogenic agents. The correlation analysis confirmed that chronic periodontitis is strongly associated with the presence of Tannerella forsythia within microbial associations. Conclusions. The spectrum of periodontal pathogens affects the severity of inflammation in the periodontium. In grade II inflammation, associations of periodontal pathogens were detected by 82.2% of cases, while in grade I by in 40%. Tannerella forsythia was detected in 42.2% of patients with grade I inflammation, 15.6% of them as a mono-infection; in patients with grade II inflammation in 71.1%, in associations with Treponema denticola in 48.9%. Determining the spectrum of periodontal pathogens, taking into account their characteristics and associated virulence factors, is necessary for choosing the effective differentiated treatment approach.

Postobturation Pain of three Novel Calcium Silicate-based sealers with asymptomatic irreversible pulpitis or necrotic pulp with chronic apical periodontitis: prospective clinical trial

BackgroundBioceramic-based root canal sealers are increasingly important in root canal treatment because of their biocompatible properties. This study aimed to evaluate postobturation pain incidence and intensity after root canal obturation with NeoSealer Flo, MTA-Bioseal, and GuttaFlow bioseal calcium silicate-based sealers and AH Plus epoxy resin-based sealer in patients with asymptomatic irreversible pulpitis or necrotic pulp with chronic apical periodontitis.MethodsA total of 120 participants with single-rooted teeth were included and randomly divided into four groups according to the root canal sealer used (n = 30). The patients were subsequently categorised based on the pulp vitality (vital or nonvital) in each group (n = 15) and all teeth were obturated in a single-visit. The postobturation pain scores were recorded on a visual analogue scale (VAS) at 6 h, 24 h, 48 h, 72 h, 7 d and 30 d. Moreover, analgesic intake was also noted at 24 h and 48 h. The Mann–Whitney U test, Kruskal‒Wallis H test, Friedman test, and Spearman’s correlation test were used, and a p value < 0.05 was considered significant.ResultsVAS scores were highest for the 6 h > 24 h > 48 h ≈ 72 h ≈ 7 d ≈ 30 d time intervals for both pulp status in each root canal sealer. A significant decrease in the VAS score was observed for all sealers from 6 h to 48 h (p 0.05). Nonvital cases had lower VAS scores at all time intervals. Analgesic intake was greater in the first 24 h (p < 0.05) in vital cases (p < 0.05) and also in females than males.ConclusionThe level of pain experienced after obturation was similar in patients with different pulp status for all the root canal sealers. Analgesic intake was greater in vital cases and females within 24 h.Trial registrationClinicalTrial.gov, NCT06515756, record date: 2024-07-17, retrospectively registered.

Neutrophil extracellular traps in the cross-talk between periodontitis and chronic kidney disease

BackgroundThe objective was to evaluate the level of neutrophil extracellular traps (NETs) in patients with chronic kidney disease (CKD) and periodontitis, and to explore the relationship between NETs and both diseases.Methods63 CKD and 40 non-CKD participants were recruited and underwent periodontal examination, among which 35 early CKD patients underwent periodontal therapy. The concentrations of NETs were determined by dsDNA assay in gingival crevicular fluid (GCF) and plasma, and by flow cytometry or immunofluorescence assay in blood and gingival tissues. The correlations between NETs and clinical parameters were analyzed. The influence of periodontal therapy on periodontitis, CKD and NETs concentrations was also evaluated.ResultsCKD patients had higher concentrations of NETs in plasma than non-CKD patients, and NETs concentrations were also increased in both GCF and plasma of patients with periodontitis than that of periodontally healthy patients. NETs concentrations were positively correlated with increased clinical parameters of CKD and periodontitis. The positive correlation between CKD and periodontitis was demonstrated. Moreover, periodontal therapy ameliorated periodontitis and CKD, and reduced NETs concentrations in GCF of patients.ConclusionsThis study revealed that NETs might be a possible bridge between periodontitis and CKD, and suggested the potential target for therapy.

Relationship Between Tooth Loss Due to Chronic Periodontitis and Lower Urinary Tract Symptoms

Relationship Between Tooth Loss Due to Chronic Periodontitis and Lower Urinary Tract Symptoms

Efficacy of Chlorhexidine Chips as Local Drug Delivery in Nonsurgical Management of Chronic Periodontitis: A Systematic Review

Efficacy of Chlorhexidine Chips as Local Drug Delivery in Nonsurgical Management of Chronic Periodontitis: A Systematic Review

The comorbid pathology in patients with chronic apical periodontitis

The purpose of this study was to study the relationship between teeth after endodontic treatment and/or with apical periodontitis, in patients with a number of systemic diseases and smokers among the adult population of Yaroslavl.Materials and methods of research. Medical history data were collected, including age, gender, presence of cardiovascular diseases, diabetes mellitus, allergies, smoking habits and data on endodontic dental treatment of 421 patients (10,540 teeth). The prevalence of depulpated teeth and the periodontal condition were assessed by orthopantomograms. The periapical status was classified according to the periapical Index PAI (PAI), chronic apical periodontitis was defined as PAI-score ≥3. The statistical analysis was carried out using the Stata/MP v. program.17.0 (StataCorp LLC, Texas 77845-4512, USA) using chi-square tests, odds ratio and confidence intervals (95%).The results and their discussion. The overall prevalence of chronic apical periodontitis and the prevalence of teeth after endodontic treatment was 2.2 and 4.2%, respectively. The high prevalence of depulpated teeth increased the likelihood of chronic apical periodontitis (p&lt;0.0001). In the group of men, there was a higher percentage of teeth with chronic apical periodontitis (p&lt;0.0001), a lower percentage of teeth after endodontic treatment (p=0.05) and a greater number of residual roots (with complete destruction of the crown of the tooth) (2.3%). Smokers were more likely to have teeth with chronic apical periodontitis (p=0.002) and the prevalence of teeth after endodontic treatment (p=0.045). A positive correlation was observed between the prevalence of teeth after endodontic treatment and diabetes mellitus (p=0.040).Conclusion. A higher prevalence of chronic apical periodontitis and/or teeth after endodontic treatment in smokers and patients with diabetes mellitus may indicate a relationship between the condition of the oral cavity and a number of systemic diseases.

Association of ABO phenotype, rhesus factor, platelet count and hemoglobin level with oral hygiene status and severity of chronic periodontitis

BackgroundThe development of periodontal diseases has multifactorial causes including genetic factors. Limited investigations have been conducted to explore the association between ABO blood groups and the development and progression of periodontal diseases. AimTo evaluate and assess the association of ABO Phenotype and Rhesus factor with oral hygiene status, severity of chronic periodontitis and blood parameters like hemoglobin level and Platelet count in localized and generalized chronic periodontitis. Material and methodsStudy was carried out on 100 patients, out of which 80 patients of Generalized Chronic Periodontitis and 20 patients of Localized Chronic Periodontitis. Patients were categorized into Mild, Moderate and Severe Periodontitis. ResultA highly significant association was found between severity of periodontitis and blood groups with blood group B and O were found to be at a greater risk to develop moderate to severe form of chronic periodontitis. Also subjects with blood group B and O showed worst oral hygiene among all the blood groups. Also patients suffering from chronic periodontitis showed a general trend towards lower limit of both hemoglobin level and platelet. ConclusionGenetic factors such as ABO blood group antigens may act as a risk influencer that plays a role in progression and severity of the chronic periodontitis, with blood group B and O being worst affected. Another observation was that a long standing case of chronic periodontitis can lead to anemia thus having systemic implications.

D-mannose alleviates chronic periodontitis in rats by regulating the functions of neutrophils

BackgroundPeriodontitis is a chronic inflammatory disease characterized by the destruction of the components of the periodontium. It significantly impacts oral health and has been linked to systemic conditions like cardiovascular disease and diabetes. The critical role of neutrophils in the occurrence and development of chronic periodontitis has been paid increasing attention. The study aimed to explore the protective effects of D-mannose on chronic periodontitis and determine whether its underlying mechanisms is related to neutrophils.MethodsTo explore the protective effects of D-mannose on chronic periodontitis, the eight-week-old Sprague Dawley rat model of lipopolysaccharide (LPS)-induced periodontitis was established, followed by D-mannose treatment by oral gavage. To evaluate the protective effects of D-mannose against periodontal bone loss, methylene blue staining, hematoxylin and eosin (H&E) staining, and micro-CT scanning were utilized. Then, immunofluorescence (IF), Western Blot, and RT-PCR were applied to assess the expression levels of pro-inflammatory cytokines (IL-1β, IL-6, and IL-17), anti-inflammatory cytokine (IL-10), tumor necrosis factor-alpha (TNF-α), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), ten-eleven translocation 2 (TET2), and key glycolytic enzymes (HK1, HK2, PFKFB3), and to examine D-mannose’s impact on the recruitment and activation of neutrophils in the gingiva. Additionally, neutrophils isolated from the peripheral blood of healthy rats were treated with LPS and D-mannose, and changes in the expression levels of myeloperoxidase (MPO), IL-1β, IL-6, IL-17, IL-10, and TET2 were observed via IF.ResultsIn vivo, D-mannose inhibited LPS-induced alveolar bone resorption in rats. After D-mannose treatment, the expression levels of IL-17 (p<0.01) and TET2 (p<0.01) were suppressed by IF, and the expression levels of IL-1β (p<0.05), IL-17 (p<0.05) and TET2 (p<0.01) were downregulated by WB. The results of qPCR showed that D-mannose reduced the expression levels of IL-1β (p<0.05), IL-6 (p<0.01), IL-17 (p<0.01), TNF-α (p<0.01), G-CSF (p<0.01), GM-CSF (p<0.01), TET2 (p<0.01), HK1 (p<0.01), HK2 (p<0.01), and PFKFB3 (p<0.01). D-mannose also inhibited the recruitment and activation of neutrophils in LPS-treated rat gingival tissues. In vitro, the results of IF showed that D-mannose inhibited the activation of neutrophils stimulated by LPS, downregulated the expression of IL-1β (p < 0.05), IL-6, IL-17 (p < 0.01), and TET2 (p < 0.01), and upregulated the expression of IL-10 (p < 0.01).ConclusionsD-mannose can alleviate chronic periodontitis in rats by regulating the functions of neutrophils, potentially associated with the expression of TET2 and glycolysis, providing new insights into the potential application of D-mannose to chronic periodontitis.

Periapical cemento-osseous dysplasia masquerading as asymptomatic chronic apical periodontitis in a Chinese woman: A case report.

Cemento-osseous dysplasia (COD) belongs to a group of fibrous osseous disorders that can masquerade as periapical inflammatory conditions in the jawbones. We present a rare case of COD occurring in a patient who also had periapical periodontitis concurrently. When faced with a patient exhibiting no symptoms, diagnosis may be challenging. COD is a fibrous osseous disorder similar to periapical chronic inflammatory conditions and other cysts in the jaw bones on the radiograph. There is a rare case of COD occurring in a 49-year-old Chinese woman who also had chronic periapical periodontitis concurrently. The lesions were incidentally discovered in the mandibular anterior tooth region during the patient's imaging examination. The patient exhibited no symptoms, and diagnosing the conditions may be challenging due to the confusingly similar radiological features that present as a radiolucent lesion in the periapical region. The final diagnosis was made through pulp vitality tests, cone beam computed tomography (CBCT), and clinical examinations. The COD was recommended for annual follow-up. Root canal therapy has been performed for chronic apical periodontitis. According to the diagnostic process of COD, a thorough history check, multiple clinical examinations, and imaging studies should be emphasized to prevent misdiagnosis and avoid unnecessary or inappropriate therapies. The patient was followed up for 6 years. The recovery of chronic apical periodontitis in tooth #31 and the transformation of osteolytic and osteogenesis of COD had been observed in CBCT.

Exosomal miR-155-5p promote the occurrence of carotid atherosclerosis.

Periodontitis is a significant independent risk factor for atherosclerosis. Yet, the exact mechanism of action is still not fully understood. In this study, we investigated the effect of exosomes-miR-155-5p derived from periodontal endothelial cells on atherosclerosis invitro and invivo. Higher expression of miR-155-5p was detected in the plasma exosomes of patients with chronic periodontitis (CP) and carotid atherosclerosis (CAS) compared to patients with CP. Also, the expression level of miR-155-5p was associated with the severity of CP. miR-155-5p-enriched exosomes from HUVECs increased the angiogenesis and permeability of HAECs and promoted the expression of angiogenesis, permeability, and inflammation genes. Along with the overexpression or inhibition of miR-155-5p, the biological effect of HUVECs-derived exosomes on HAECs changed correspondingly. In ApoE-/- mouse models, miR-155-5p-enriched exosomes promoted the occurrence of carotid atherosclerosis by increasing permeable and angiogenic activity. Collectively, these findings highlight a molecular mechanism of periodontitis in CAS, uncovering exosomal miR-155-5p derived periodontitis affecting carotid endothelial cells in an 'exosomecrine' manner. Exosomal miR-155-5p may be used as a biomarker and target for clinical intervention to control this intractable disease in future, and the graphic abstract was shown in FigureS1.

Applications Of Photodynamic Therapy In Periodontal Diseases

Background: According to A. Marcacci et al (1888), when many reports emerged on light absorbing properties and of fluorescence of various dyes, it became clear that dye excitation by light exerts destructive action in biological systems. This so-called photodynamic action was described as a process in which light, after being absorbed by dyes sensitizes organisms for visible light inducing cell damage. The supra- and subgingival plaque biofilm on tooth surfaces should easily be accessible for flushing with the dye and for activating them by light. Thus, periodontal diseases are promising applications of Photodynamic Therapy. Introduction: Chronic periodontitis is the most common periodontal disease which is related to the chronic accumulation of bacterial plaque. Since mechanical methods are not sufficient in the treatment of this disease, administration of local/systemic antibiotic is recommended following mechanical debridement. However, side effects of antibiotics such as microbial resistance and patient allergy led to development of alternative methods. One of these suggested methods is the antimicrobial photodynamic therapy (aPDT). PDT is a local noninvasive treatment modality without the side effects caused by antibiotics. Objectives: In this review, the mechanism of action of PDT and its application in the treatment of various periodontal conditions along with its future trends are discussed. Conclusion: Even though PDT is still in experimental stages of development and testing, the method may be an adjunct to conventional antibacterial measures in periodontology and Implant related perspectives.

Expression of CCL2 signaling pathway genes in patients with periodontitis and atherosclerosis.

Periodontitis and atherosclerosis are chronic inflammatory diseases characterized by leukocyte infiltration. We investigated the expression of CCL4, CCR5, c-Jun, c-Fos, NF-κB, and CCL2 as well as the possible mechanism involved in the regulation of CCL2 in human periodontitis tissues and atherosclerotic aorta based on previous research on the CCL4/CCR5/c-Jun and c-Fos/CCL2 pathway leading to CCL2 expression in collagen-induced arthritis (CIA) rat. Sixty-five volunteers were recruited and the condition of their gingiva and coronary arteries were assessed. The subjects were divided into four groups: healthy control, chronic periodontitis (CP), coronary artery diseases (CAD), and noncoronary artery diseases (non-CAD). Total RNA was isolated from gingiva in periodontitis patients and control populations and from the aorta in patients with and without CAD. PCR was used to examine CCL4, CCR5, c-Jun, c-Fos, NF-κB, and CCL2 levels. The production of CCL2 in the gingiva and aorta was analyzed by immunostaining. PCR revealed that CCL4, CCR5, and CCL2 mRNA levels were increased in CP patients' gingivae and aortas from coronary artery bypass grafting (CABG) patients. Marked c-Jun, c-Fos, and NF-κB gene productions were detected in CP patients' gingivae but did not show statistical differences between the CAD and non-CAD groups. Stronger immunoreactivity against CCL2 was observed in periodontitis gingiva and aorta from CABG patients. Our findings suggest that the CCL4/CCR5/c-Jun and c-Fos/CCL2 pathways may be involved in CCL2 expression in periodontitis. CCL4, CCR5, and CCL2 might act as possible nodes to link the presence of periodontitis and atherosclerosis.

Beyond The Usual Suspects: A Challenging Case Of Radix Entomolaris With Endodontic-Periodontal Lesion: A Case Report

The purpose of this case report is to present an unusual endodontic periodontal lesion along with radix entomolaris in tooth 46 in a 31-year-old female patient with intermittent pain and sensitivity to hot and cold stimuli. Clinical examination revealed deep dentinal caries and periodontal pocket depth of 5mm in tooth #46.The radiographic examination revealed an extra distal root with a periapical radiolucency in tooth #46. patient was diagnosed with irreversible pulpitis and chronic apical periodontitis, with secondary periodontal involvement due to an endodontic-periodontal lesion. Non-surgical root canal treatment was performed, followed by canal obturation with resin-based sealer and final restoration with a porcelain fused to metal crown. After a 3-month follow-up, the patient remained asymptomatic, radiographs showed bone reposition, and periodontal probing depth decreased, indicating successful treatment.

Periodontal pathogens in the appearance and progression of chronic periodontitis

Periodontal diseases are considered a public health problem due to their high prevalence worldwide, so the authors set out to describe the role of periodontal pathogens in the onset and progression of chronic periodontitis. The documentary analysis method was used and a total of 18 bibliographies were reviewed. Current scientific evidence supports the association between periodontal pathogens and the development of periodontitis, demonstrating that bacteria such as Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola play a crucial role in the pathogenesis of periodontal disease by triggering inflammatory responses and promoting the destruction of tooth-supporting tissues.

Primary endodontic infections - key issue in pathogenesis of chronic apical periodontitis

Primary endodontic infections - key issue in pathogenesis of chronic apical periodontitis