Generalized Chronic Periodontitis Research Articles

The Effect of Selenase on Inflammatory and Cytoprotective Markers in Experimental Chronic Generalized Periodontitis

Epidemiological studies in recent decades have revealed a significant increase in the number of patients with periodontal diseases leading to tooth loss. Modern realities require improvement of drug treatment of periodontitis. The antioxidant Selenase, selenium derivative, is an interesting treatment strategy for periodontitis. The study was carried out with the aim to evaluate the healing effectiveness of Selenase in rats with chronic generalized periodontitis (CGP) by its effect on markers of inflammation and cytoprotection. Experimental CGP was modulated in Wistar rats by a calcium-deficient diet with the inclusion of a prooxidant. Selenase (50 mcg/kg) and Mexidol (ethylmethylhydroxypyridine succinate, 250 mg/kg) were administered intragastrically for 30 days. Levels of IL-1β, HIF-1α, HSP70, and TNF-α were determined in the blood after treatment using the enzyme immunoassay method. Experimental CGP was characterized by the development of hyperemia, swelling, and bleeding of the gums; mobility of teeth; and gingival pockets up to 8 mm against the background of increased inflammatory markers (IL-1β, TNF-α), and molecular markers of cytoprotection (HIF-1α, HSP70) in the blood, indicating a homeostatic response of the periodontium in response to inflammation and subsequent hypoxia. Administration of Selenase to rats with CGP produced pronounced healing effects: the reduction in the depth of periodontal pockets by 42.55 %, cessation of bleeding, and disappearance of swelling against the background of a decrease of inflammatory markers: IL-1β – by 44.6 %, and TNF-α – by 65.9 % (p < 0.05). HIF-1α increased by 36.8 %, and HSP70 – by 71.1 % compared to those of the control group, which was not given the treatment (p < 0.05). The results obtained suggest a significant influence of Selenase on HSP70-dependent mechanisms of endogenous cytoprotection. The results of the study found that the use of Selenase in experimental CGP is more effective than Mexidol.

Peculiarities of oral microbiota in patients with small and medium-sized dental defects and chronic periodontitis of moderate severity

BACKGROUND: Сhronic generalised periodontitis is one of the most widespread pathologies of the dento-mandibular system. To date, even if there is evidence of bacterial etiology, no biological markers have been developed to qualitatively assess the possibility of inflammation of periodontal tissues or its pathomorphosis to a more severe stage. AIMS: Study of peculiarities of oral microbiota in patients with acquired defects of dental rows in chronic generalised periodontitis of medium severity. MATERIALS AND METHODS: The study participants were 88 people with small/medium dental defects with no clinical signs of periodontal tissue inflammation (the first group) and chronic generalised periodontitis of medium severity (the second group). In order to assess the dental status, an index assessment of periodontal tissues and the intensity of tooth decay was carried out, and the degree of tooth mobility was determined. Using microbiological methods, biomaterial from the mucous membrane of the denture bed tissues was studied with determination of microorganisms composition. DNA of periodontal pathogens was detected and quantified by polymerase-chain reaction. Statistical analysis was performed using the Shapiro-Wilk criterion, t-criterion and χ2 criterion. RESULTS: The mean values of CFE and PMA indices in group 2 patients were 1.5 and 5.7 times higher, respectively, than in group 1. When analysing the composition of microorganisms in biological material from patients with chronic generalised periodontitis of moderate severity, Neisseria spp. were statistically significantly more common (p=0.002), Candida spp. (p=0.035), Enterobacterales (p=0.001), Enterococcus spp. (p=0.03) and statistically significantly lower Corynebacterium spp. (p=0.001) and S. salivarius (p=0.001). In the presence of partial defects of tooth rows in patients, the stated microorganisms formed persistent communities, the nature of symbiotic relations in which determined the clinical manifestations of inflammatory changes in the soft tissues of the periodontium. CONCLUSIONS: The increased incidence of Candida spp. and Enterobacterales in patients with acquired dental defects and periodontal soft tissue inflammation, as well as the formation of persistent relationships between them and antagonistic effects on oral autochthonous bacteria, is of interest for the development of targeted antimicrobial therapy in preparation for dental prosthetic treatment.

Evaluation of Salivary Parameters and Oral Health Status in Periodontally Healthy Subjects and Chronic Periodontitis Subjects

Introduction: Periodontal disease is a chronic disease of the oral cavity that consists of a group of inflammatory disorders affecting the supporting structures of the dentition. Saliva can be used to predict the early onset of periodontitis. Several investigations have been carried out to evaluate the salivary chemical compounds that lead to the destruction and/or protection of periodontal tissues. The present study aimed to assess and compare salivary parameters and oral health status in periodontally healthy and chronic generalised periodontitis patients. Materials and Methods: This is an in vivo study designed to compare salivary parameters (albumin, urea, total proteins, amylase, glucose and pH) of unstimulated saliva and oral health status of periodontally healthy subjects (n = 65) and chronic generalised periodontitis subjects (n = 65). Human whole unstimulated saliva was collected by spitting method with the subject seated in an upright position after refraining from oral intake for 2 h before saliva collection. Approximately 5 mL of saliva was collected and stored in graduated saliva-collecting vials and refrigerated at 4°C for 1 h. The samples were centrifuged at 2800 rpm for 10 min, and the supernatant was separated from the substrate and stored at 20°C. Next, the sample was defrosted at room temperature and centrifuged at 3000 rpm. The supernatant was separated again to determine the concentrations of glucose, amylase, urea, total protein and albumin using the respective kits and analysed using an automated analyser. Salivary pH was estimated electrometrically with the help of a pH meter. Results: A significant association was found between salivary parameters (amylase and albumin total proteins) and clinical parameters (plaque index [PI], gingival index) [GI], probing depth and calculus index in generalised chronic periodontitis subjects when compared to periodontally healthy subjects. Conclusion: The increase in salivary parameters (amylase, total proteins and albumin) was statistically significant except for salivary glucose and urea (statistically non-significant) in generalised chronic periodontitis subjects compared to the healthy subjects. As the clinical parameters (probing depth, loss of attachment, PI, GI, calculus index and decay missing filled teeth) in periodontitis subjects increased, the salivary parameters also increased, suggesting a linear relationship between the generalised chronic periodontitis and salivary parameters (total proteins, albumin and amylase).

Short-term, nonsurgical periodontal therapy boosts interleukin-12 levels and reduces oral cancer risk.

Cytokines, including interleukin-12 (IL-12), are proteins that regulate cell survival, proliferation, differentiation, and function. IL-12 is a heterodimeric proinflammatory cytokine. It possesses tumoricidal properties and promotes M1 macrophage polarization and IFN-γ production by T helper (Th1) cells, which in turn stimulates the antitumor cytotoxic cluster of eight positive (CD8+) and natural killer cells, therefore activating an effector immune response against tumor cells. Herein, the IL-2 levels of 60 patients with generalized chronic periodontitis (GCP) were assessed. Plaque index, gingival index, pocket probing depth, bleeding on probing percentage (BOP %), and clinical attachment loss were the clinical indicators reported. Patients with GCP in the pretreatment group had substantially lower mean IL-12 levels than those in the post-treatment group. Short-term, nonsurgical treatment (NST) considerably improved periodontal indices and increased IL-12 levels, thereby reducing oral cancer risk. NST is a cost-effective and accessible cancer prevention procedure for general dentists.

FUNCTIONAL ACTIVITY OF PLATELETS FOR THE PATIENTS WITH CHRONICAL GENERELIZED PERIODONTITIS AND CORRECTION OF THE HYPERAGREGATIONAL CHANGES IN THE COMPLEX TREATMENT BY THE GINKGO BILOBA EXTRACT

The presented results determine the functional activity of platelets in 35 patients diagnosed with chronic generalized periodontitis (CGP). Dystrophic changes in the periodontium were assessed by measuring pathological periodontal pockets and the Ramfjord index. The level of inflammation in periodontal tissues was determined by PMA and PBI indices.
 The evaluation of platelet functional activity in patients with CGP was conducted before and after combined treatment, including the administration of "Tanakan" (orally 120mg/day for 1 month). It was observed that an increase in adhesive-aggregational platelet function is typical for periodontal patients (degree of aggregation% and rate of aggregation%). Additionally, the parallel investigation of coagulation hemostasis in this patient group showed no significant changes in clotting time of plasma citrate. It was found that the prescribed "Tanakan" medication promotes inhibition of platelet aggregational activity, thus improving microcirculation in periodontal pathology.

Clorhexidina y Morinda citrifolia como enjuague bucal profiláctico previo al raspado ultrasónico: un ensayo clínico aleatorizado

Background: Aerosols released during ultrasonic scaling can cause cross-contaminations. Infections like hepatitis and SARS-CoV-2 can spread through these aerosols. Preprocedural rinse is a cost-effective method to reduce aerosol contami-nation produced during ultrasonic scaling. Materials and Methods: This was a double-blinded randomised trial on 105 subjects diagnosed with chronic generalised periodontitis which was randomly allocated into three groups: Group I received 0.12% chlorhexidine (CHX), Group II received 5% Morinda citrifolia (noni) mouthrinse, Group III received distilled water. Participants were advised to mouthrinse for 60 seconds just before the start of ultrasonic scaling. The aerosols released during ultrasonic scaling were gathered on blood agar plates placed at three locations. Colony forming units (CFUs) were counted after 48 hours of incubation. Results: The highest CFU values were observed in the distilled water group and the lowest in chlorhexidine group (p<0.05). Patient chest area has the highest number of CFU than doctors’ and assistant chest area (p<0.05). Conclusions: Preprocedural rinsing with noni mouthwash can be used as an effective method of reducing aerosol contamination during ultrasonic scaling. Keywords: Aerosols; Chlorhexidine; Morinda citrifolia; mouthwashes; Dental prophylaxis; Dental scaling.

Клинико-цитологическая оценка состояния пародонта пациентов с хроническим генерализованным пародонтитом при подготовке к ортопедическому лечению

Literature data and own observations indicate that the risk of periodontal complications at various stages of dental prosthetics is associated with the clinical and functional state of the periodontal complex. After basic therapy in patients with chronic generalized periodontitis (CGP), an analysis of the clinical and morphofunctional state of the periodontium was performed. Cell differentiation index (CDI) and inflammatory-destructive (VDI) index, as well as the degree of microbial contamination (CIGP) were determined. The clinical condition of the periodontium of patients was assessed using periodontal and hygienic indices. The results of monitoring (3, 7, 14 and 21 days after surgical debridement of periodontal pockets) showed that the relief of the inflammatory process in the periodontium is observed as early as 14 days, according to the PMA 10,3 1,2 index (p2 0,05). The data of a cytological study of smears-imprints of the marginal epithelium of the periodontium indicate that the stabilization of inflammation and the reparative process in the integumentary epithelium becomes pronounced after 14 days, and the values of CDI (630,6 1,1) and VDI (3,5 1,2) reach the limits of the norm only by 21 days after curettage of periodontal pocket. Thus, in order to minimize the risk of periodontal complications, when planning the timing and scope of prosthodontic treatment for patients with CGP, it is recommended to use, among other things, a cytomorphological method that reflects an objective picture of the periodontal condition

Clinical assessment of the periodontal tissues during complex treatment of patients with chronic generalized periodontitis using herbal rinse

BACKGROUND: Preserving the effect of periodontal disease treatment and choosing an individual oral care program are urgent issues in dentistry.
 AIM: To examine the clinical dynamics and index indicators of the state of the oral cavity in patients with mild but chronic generalized periodontitis (CGP) before and after complex treatment using a mouthwash (“Art-Dental Expert”; LLC “KorolevPharm”).
 MATERIALS AND METHODS: The study was conducted in the main (using “Art-Dental Expert” mouthwash) and control (using 0.05% solution of chlorhexidine bigluconate) groups of patients with mild CGP. The state of periodontal tissues was assessed using a simplified hygiene index (OHI-S, Green–Vermillion), probing bleeding index (BOP), papillary–marginal–alveolar index (PMA), and the index of the need for periodontal disease treatment (CPITN).
 RESULTS: The main group showed positive dynamics of changes in the indices characterizing the state of the periodontium, with a significant difference in indicators when compared with the control group.
 CONCLUSION: The use of “Art-Dental Expert” mouthwash for the treatment of patients with mild CGP has a fast and stable prolonged clinical effect with normalization of qualitative and quantitative indicators of the state of periodontal tissues. The “Art-Dental Expert” mouthwash can be recommended for long-term use.

Effect of non surgical periodontal therapy and vitamin C supplementation on total antioxidant capacity in patients with chronic generalised periodontitis - A randomised controlled trial.

Periodontal inflammation are inflammation of supporting tissues of periodontium. The microbial factor can cause infection which is polymicrobial in origin and causes dysbiosis and shift in oxidative stress with compromised antioxidant capacity. This study focused at determination of the effect of nonsurgical periodontal therapy (NSPT) and vitamin C supplementation on total antioxidant capacity (TAOC) in chronic periodontitis patients (ChP). A total of 70 ChPand 35 periodontally healthy subjects (control) were recruited in this study. Further, ChP group was subdivided into ChP1 group (n=35) which received NSPT only and ChP 2 group (n=35) which received NSPT with vitamin C 500mg once daily for 3 months. Serum and saliva samples were taken at baseline and at 3 months postNSPT for measurement of TAOC. Clinical parameters measured were measured at 1-, 3-, 6- and 12-month interval. Lower levels of serum and salivary TAOC levels were observed in ChP patients than healthy subjects (p<0.05). Improvement in Clinical parameters was observed in both the groups ChP1 and ChP 2 group post therapy (p<0.05). The periodontal treatment showed insignificant changes in serum and salivary TAOC levels (p>0.05). The supplemental dose of vitamin C didn't have any additional benefits (p>0.05). There lies an association of oxidative stress with periodontitis, low serum and salivary TAOC levels were seen in chronic periodontitis patients. NSPT improved the periodontal inflammatory status. However, benefits of vitamin C as an adjunct to NSPT remains inconclusive and needs to be further explored by multicentre longitudinal studies.

The effectiveness of on-line monitoring of oral cavity changes in patients with non-alcoholic fatty liver disease

Objective — to assess the effectiveness of using an on‑line format for dental monitoring of patients with non‑alcoholic fatty liver disease&#x0D; Materials and methods. A two‑time dental questionnaire survey was conducted on 41 patients with a combined course of chronic generalized periodontitis (CP) and non‑alcoholic fatty liver disease (NAFLD), and their physically healthy spouses. All patients selected for the study underwent treatment of periodontal tissues, individual training in hygienic care of the oral cavity with the selection of tooth brushing techniques, hygiene objects and products. Control survey to assess knowledge and skills of oral care was conducted after 12 months with the use of on‑line questionnaires.&#x0D; Results. It has been proven that most married couples were sufficiently motivated to implement the provided recommendations. Thus, if at the beginning of the study there were almost 71% of married couples where both spouses preferred the use of easily digestible carbohydrates, then after the individual classes, their number decreased almost in 5 times. Similarly, the frequency of positive answers to questions about the consumption of sweet fizzy drinks decreased. A significant number of family couples denied smoking at the endpoint of the study, and the number of positive responses to questions related to full‑fledged oral hygiene (brushing teeth twice, using additional items for individual oral hygiene) increased in more than 1.5 times compared to the initial visit. For most patients, non‑observance of a healthy diet, tobacco smoking, failure to perform full‑fledged oral hygiene was established to be a habitual lifestyle, affecting the course of both CP and NAFLD as a result of entering of the genetic material of pathogenic microorganisms, endotoxins, pro‑inflammatory cytokines etc., in the systemic circulation.&#x0D; Conclusions. The use of questionnaires in the on‑line format makes it possible to find out the usual way of life and conduct a comparative analysis of the presence or absence of negative habits’ correction in the process of therapy of comorbid pathology, which is very relevant in the conditions of martial law. Questionnaire surveys of both spouses proved to be important, it promotes the motivation to correct negative habits and increase the effectiveness of treatment and preventive measures.&#x0D;

МОЛЕКУЛЯРНО-ГЕНЕТИЧЕСКАЯ ХАРАКТЕРИСТИКА МИКРОБИОТЫ ПАРОДОНТАЛЬНЫХ КАРМАНОВ У ПАЦИЕНТОВ С ХРОНИЧЕСКИМ ГЕНЕРАЛИЗОВАННЫМ ПАРОДОНТИТОМ, ПЕРЕНЕСШИХ COVID-19

The aim of the study was to study the frequency of periodontal pathogens in patients with chronic forms of periodontitis who underwent COVID-19.&#x0D; Material and methods of research. Clinical and laboratory studies were conducted in a comparative aspect, depending on the presence/absence of a history of a new coronavirus infection. All patients who sought dental care for exacerbation of chronic generalized periodontitis (CGP) of mild and moderate severity were divided into 2 groups: 1 main group – 30 patients with CGP after a new coronavirus infection (after 4 months).&#x0D; Comparison group 2 – 30 patients with CGP who do not have a history of COVID-19, Patients of the compared observation groups (60 people) underwent a real-time PCR study of the contents of periodontal pockets.&#x0D; The results of the study. According to the results of molecular genetic screening, the DNA of six periodontal pathogenic bacteria was found in the contents of the periodontal pockets of the examined patients. Detection of bacteria associated with periodontitis (Porphyromonas endodontalis, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Fusobacterium nucleatum, Tannerella forsythia) showed no statistically significant differences in the prevalence of the studied bacteria in patients of the first and second groups. At the same time, the detected community of microorganisms Porphyromonas gingivalis and Porphyromonas endodontalis, characteristic of the most severe manifestations of periodontitis, was 17% more common among the examined patients who underwent COVID-19 than in patients without COVID-19.&#x0D; Thus, as a result of research, the presence of a relationship between the species composition of the microbiota of periodontal pockets and the presence of COVID-19 in the anamnesis has been shown.

Evaluating Salivary Apelin Level among Chronic Periodontitis Patients, with and without Type 2 Diabetes Mellitus utilizing Enzyme‑Linked Immunosorbent Assay: A Comparative Study

Background: Periodontitis is a chronic inflammatory disorder mainly due to a decrease in the immune system caused by periodontal pathogens. The relationship of apelin among chronic generalized periodontitis (CGP) and type 2 diabetes mellitus (T2DM) has been reported. This study intends to assess the level of apelin in saliva from patients of healthy individuals, individuals with CGP, and CGP + T2DM, and evaluate the role of apelin adipokine in inflammation and insulin resistance. New treatment modalities can be invented using apelin in host modulation therapies. Methods: The study comprised 300 patients that were enrolled according to their clinical findings and were divided into three groups chronic periodontitis (n=100), chronic periodontitis with T2DM (n=100), and healthy controls (n=100). Probing pocket depth (PPD), clinical attachment level (CAL), and salivary Apelin (AP) were obtained. With the help of the enzyme-linked immunosorbent assay (ELISA) kit, the salivary apelin level was measured. A statistical software package was used for the surveying of collected data. Results: Group three[CGP+DM] shows the highest salivary apelin level compared to CGP patients without DM. It was 15.43±2.05ng/dl in CGP and 24.08 ± 3.60ng/dl in CGP with DM. All three groups found a statistically significant difference in mean Apelin Level, PPD, and CAL. Conclusion: This study indicated a possible role of adipokines in inflammation and glucose level regulation in patients with T2DM and CGP. In the coming era, apelin levels in saliva can be used for screening objectives in large populations to assure the risk of destructive periodontal disease. Bangladesh Journal of Medical Science Vol. 22 No. 02 April’23 Page : 305-315

Periodontal pathogens and antibiotic resistance genes in individuals with chronic generalized periodontitis

Relevance. Considering the role of personalized medicine in dental practice, the accumulation of knowledge about the genetic determinants of bacterial resistance and the use of antibacterial drugs, the learning of periodontal microbiota, sensitivity to antimicrobial drugs, the identification of key periodontal pathogens will allow predicting the development mechanisms of inflammatory periodontal diseases and monitoring and prescribing effective antibacterial therapy.Aim. The study aimed to determine the prevalence of pathogens and the occurrence of antibiotic resistance genes in individuals with chronic generalized periodontitis (CGP).Materials and methods. Clinical and laboratory examinations studied 163 subjects aged 18 to 45 years, of which there were 100 patients with inflammatory periodontal diseases and 63 subjects with intact periodontium. The study obtained periodontal pocket and gingival crevice swabs. The real-time PCR isolated marker bacteria and resistance genes to glycopeptide and β-lactam antibiotics.Results. The patients with chronic periodontitis demonstrated a periodontal pathogen detection rate of 96.4 %. Among the isolated periodontal pathogens, bacteria of the red complex were the most common: T. forsythia (81%; p &lt; 0.001), T. denticola (63%; p = 0.054) and P. gingivalis (69%; p &lt; 0.001). In healthy individuals with intact periodontium, P. gingivalis (12.7%), T. denticola (47.62%), and T. forsythia (36.51%) prevailed in the studied material, i.e., gingival fluid. The mean ratio of bone loss in relation to the root length (the Fuchs Index) was 0.83 ± 0.03 in patients with mild CGP and 0.71 ± 0.05 with moderate CGP. The β-lactam antibiotic resistance genes appeared to occur frequently (%). So, TEM and SHV genes were in 72% and 26%. The control group demonstrated the TEM gene in 41.27% (p &lt; 0.001) and the SHV gene in 4.76% (p &lt; 0.001).The group with CGP appeared to have resistance genetic markers: MecA to cephalosporins (15%) and OXA-51 to carbapenems (9%). The control group detected MecA (6.35%; p = 0.0948), while OXA-51 markers were absent (p = 0.014). Both groups did not show resistance genes to other antibiotic groups (AB).Conclusion. The "red complex" microorganisms T. forsythia, T. denticola and P. gingivalis, which were the most frequent during the progression of bone destruction, appeared to play the leading role in the onset and progression of inflammatory periodontal diseases.The oral microbiome can serve as a reservoir for the transfer of resistance genes: the study results indicate a high incidence rate (%) of β-lactam antibiotic resistance genes in the group of patients with chronic periodontitis. The group with chronic periodontitis revealed TEM and SHV genes in 72% and 26%, respectively. The group with intact periodontium also demonstrated a high occurrence rate of the TEM gene in 58.3 % of cases.

Association of Oral Squamous Cell Carcinoma and Human Papilloma Virus Status in Chronic Periodontitis Patients: A Cross-sectional Study

Introduction: Apart from the alcohol and tobacco which are considered as an important cause for carcinogenesis, periodontal infections have also been considered equally important cause for it. Infections are increasingly considered as potential trigger for carcinogenesis apart from alcohol and tobacco. The role of the Human Papilloma Virus (HPV) in causing Oral Squamous Cell Carcinoma (OSCC), highlights the significance of the oral infections in the development of the OSCC. Aim: To detect the relationship between Chronic Periodontitis, HPV, and OSCC. Materials and Methods: This was a cross-sectional study conducted on 15 chronic generalised periodontitis patients with OSCC affecting alveoli and gingiva. DNA was extracted from the biopsy of the tissue sample for the detection of HPV by Polymerase chain reaction (PCR). The parameters assessed were the Clinical Attachment Loss (CAL), Tumor Node Metastsis (TNM ) staging of OSCC, HPV status and the presence of the periodontal marker bacteria. Chi-square test and spearman correlation were used to find association and correlation between the parameters. Results: A total of 15 cases of chronic generalised periodontitis patients with oral squamous cell carcinoma were included in the study (7 males and 8 female patients, with a mean age of 50.8 years). Of these, HPV was found in 4 patients only. On comparison between Chronic Generalised Periodontitis (CGP) and OSCC, a non-significant association and a negative correlation was found. Similar analysis was observed between CGP and HPV. When comparison was done between HPV and OSCC, non-significant association (p-value 0.774) and a negative correlation(r- value= -0. 169) was found. Conclusion: This study did not yield a significant association and correlation between these three parameters. Further prospective studies should be conducted which may help in the prevention of periodontitis and subsequently decreasing the incidences of OSCC.

Vicious circles in chronic generalized periodontitis pathogenesis

Relevance. The high prevalence of periodontal diseases, late presentation of patients, especially at the early stages, the ineffectiveness of the provided treatment, and complex still-not-fully-understood mechanisms of the pathogenesis of periodontal diseases render chronic generalized periodontitis (CGP) a socio-medical problem.The study aims to consider the pathogenic mechanisms which characterize the development of CGP.Materials and methods. The study conducted a systematic literature search, which included publications from 2005 to 2022. The studies were found by searching electronic databases PubMed and Google Search.Results. The dental plaque microbiota is a common cause contributing to the initiation of the inflammatory process in the periodontal tissues. But its presence alone is not enough for the manifestation of all periodontal pathological reactions. The principal role in regulating the phases of the inflammation belongs to cytokines and other mediators, the imbalance of which causes the chronification of the process. Microvascular blood flow disorders, which determine the clinical manifestations, are an important part of the pathogenesis at all stages of CGP. Cellular reactions that occur during CGP as a response to the periodontal pathogen invasion protect periodontal tissues and simultaneously induce their destruction, thereby increasing bacterial contamination.Conclusion. The formation of intricately related several key vicious circles, including cytokine, vascular, leukocyte and reparative, is one of the most important particularities of CGP pathogenesis.

The nature of changes in cell renewal and apoptosis of gingival epithelium in postmenopausal patients with chronic generalized periodontitis

Objective: to identify the nature of proliferation and apoptosis process disorders in the gingival epithelium in postmenopausal women with varying degrees of bone mineralization for early diagnosis and optimization of combination therapy. Materials and Methods. We examined 80 women aged 55–60 years with chronic generalized periodontitis (CGP) and reduced bone mineral density (BMD). All patients underwent a standard dental examination, including an index assessment of periodontal tissues. BMD was quantified via a densitometric analysis of the bone tissue condition. The investigation of periodontal epithelial cell renewal was performed using immunohistochemical studies. Results. We discovered that in postmenopausal patients with CGP and BMD disorders, there was a reduction in the proliferation of gingival epithelial cells with activation of their apoptosis (Iapt=0.73±0.03%, Iki-67=11.77±0.27%) vs. the patients with intact periodontium (Iapt 0.29±0.04%, Iki-67=9.88±0.09%), p=0.04. Conclusion. We discovered that CGP in postmenopausal women occurs with enlarged activity of apoptosis of gingival epithelial cells against the background of their reduced proliferation. The activity of inflammatory destructive processes in periodontal tissues is higher in patients with osteopenia vs. those without BMD impairment.

Сlinical characteristics and diagnosis of chronic generalized periodontitis in patients with connective tissue dysplasia

BACKGROUND: At present, the detection of periodontal pathology is not very difficult, especially in unfolding disease stages. Moreover, determining the clinical course and differentiating the diagnosis of nosological forms, prognosis of disease development, its interrelation with the general condition of the patient and the bone system as a whole are more complicated tasks that require further close study. The bone is an active metabolic system that is constantly self-renewed by the processes of resorption and formation. This study focused on the peculiarities of the course of generalized periodontitis (GP) in 104 patients with differentiated and undifferentiated connective tissue dysplasia (UCTD).&#x0D; AIM: To diagnose and study the clinical course of chronic GP (CGP) in patients with CTD.&#x0D; MATERIAL AND METHODS: This study analyzed retrospective and prospective data obtained in 20162020 as a result of monitoring patients with different severities of CTD: differentiated CTD (DCTD) + CGP (group 1, n=56), undifferentiated (UCTD) + CGP (group 2, n=48), and control group (CG, n=34) with CGP but without signs of musculoskeletal dysplasia. The study included a total of 137 patients aged 1837 years.&#x0D; RESULTS: In group 1, the average caries intensity was 18.20.5; non-carious dental lesions, 9.00.4; periodontal tissue pathology, 90.60.6. In group 2, the corresponding values were 16.70.8, 4.50.3, and 85.50.8, respectively. In CG, the incidence of these pathologies as 20% to two times less. By sex groups, a more severe form of periodontal tissue inflammation was noted in women, and after age 45 years and onset of menopause, it increased to 66.6%. The minimal thickness of the cortical layer was recorded in patients with decreased bone mineral density (BMD) of the jaw bones, with 5.80.4 mm in group 1, 5.20.6 mm (p 0.001) in group 2, and 2.80.3 mm (p 0.001) in СG.&#x0D; CONCLUSIONS: Thus, in groups 1 and 2, the state of hard tissues against the background of reduced BMD is characterized by high rates of extracted teeth. In addition, specific changes in periodontal tissues were noted, i.e., aggressive disease course, deterioration of all periodontal indexes, increased attachment loss, and higher degree of bone tissue resorption, which are characteristic of severe periodontal pathologies. In addition, an imbalance in the calcium-regulating hormone system was noted in middle-age adults in groups 1 and 2 of both sexes. In our opinion, the cause was a disorder of the bone remodeling cycle in the presence of an imbalance in calcium-regulating hormones.

Decreased beta-defensin-2 level in the gingival crevicular fluid as a potential predictor for developing inflammatory periodontal diseases

-defensin-2 (HBD-2) is a peptide of innate immunity that provides the first defenсe line in the oral mucosa against invading pathobionts. Under inflammatory conditions, epithelial cells and gingival fibroblasts produce HBD-2. The defective defensin secretion may play a crucial role in the development of inflammatory periodontal diseases. The study was aimed at comparing HBD-2 levels in the gingival fluid and/or periodontal pockets in patients with dental plaque-induced gingivitis (PG), aggressive periodontitis (AgP), chronic generalized periodontitis (CP) and in the periodontally healthy subjects (Control). We examined 142 patients (45.01.03 years) residing in Moscow, including 11 patients with PG (35.73.69 years), 43 patients with AgP (35.40.84 years), 71 patients with CP (54.40.86 years) and 17 controls (36.12.92 years). We assessed the periodontal tissue condition in all patients during the periodontal and X-ray examination. The samples of the gingival crevicular fluid and periodontal pocket contents were collected from the gingival sulcus and periodontal pockets at 8 teeth of both jaws by paper points. The concentration (C) of -defensin-2 was determined by enzyme immunoassay (ELISA Kit for Defensin Beta 2, Cloud-Clone Corp., USA). MannWhitney U-test (U), the KruskalWallis test (H) and the DwassSteelCritchlowFligner post hoc test (W) analyzed a difference significance between the parameters. We estimated the parameter relationship and its power by using the Spearmanʼs rank correlation coefficient (rS). The critical significance level was p 0.05. The current study showed that the progression of the periodontal inflammation is accompanied by sharply decreased HBD-2 concentration in patient samples (H = 42.8, df = 3, р 0.001). Thus, the concentration of HBD-2 in the gingival crevicular fluid of the periodontally healthy subjects (control group) ranged from 225 to 1720 pg/ml (C = 738 [477; 1114] pg/ml). In patients with PG, the median value of peptide concentration was 242 [42.5; 610] pg/ml (Cmin = 19 pg/ml, Cmax = 1000 pg/ml). In patients with periodontitis, it declined to critically low levels: CAgP = 54 [3; 195] pg/ml (Cmin = 0, Cmax = 478 pg/ml) and ССP = 25.5 [0; 125] pg/ml (Cmin = 0, Cmax = 298 pg/ml). Thus, we can consider the level of HBD-2 in the gingival crevicular fluid as a potential predictor for developing inflammatory periodontal diseases.

The effectiveness of post-prosthetic rehabilitation measures with the use of platelet autoplasm in patients with periodontal diseases and disorders of carbohydrate metabolism

Periodontal diseases and disorders of carbohydrate metabolism are comorbid conditions that aggravate each other. There are a number of practical recommendations aimed at preserving the positive results achieved by a dentist as a result of oral sanitation, periodontal and prosthetic treatment. However, they do not fully take into account the features of examination, treatment and rehabilitation of patients suffering from periodontal diseases for a long time, but denying the presence of somatic diseases.The purpose of the study. To evaluate the effectiveness of a complex of post-prosthetic rehabilitation measures using PRP therapy in patients with periodontal diseases and disorders of carbohydrate metabolism.Material and methods. In the period from 2016 to 2021, 441 patients aged 35-55 years who applied to a dental clinic were examined. All patients suffered from chronic generalized periodontitis (CGP), but denied the presence of somatic pathology. As a result of an additional examination in somatic medical organizations (CFOs), 205 patients suffering from CGP were found to have cardiometabolic disorders (impaired glucose tolerance, type 2 diabetes mellitus, arterial hypertension). Prosthetic treatment was performed in 195 patients who were stratified into two groups. Group 1 (120 people) included patients who underwent correction of identified metabolic disorders, group 2 (75 people) – persons who refused further observation by a clinician. By randomization, subgroups were formed in each group: patients of subgroups 1a and 2a received standard post-prosthetic rehabilitation (professional oral hygiene, periodontal treatment), patients of subgroups 1b and 2b additionally underwent local immunocorrection with platelet-enriched autoplasm – PRP (Platelet-rich plasma) therapy. The article presents the results of post-prosthetic rehabilitation of patients with CGP according to clinical (PMA, PI, BOP, OHI-S indices) and immunological (IL-10, IL-8, IL-1ß, TNF-α, sIg A, LDH in oral fluid) indicators obtained after oral sanitation, rehabilitation course, after 3 and 6 months of follow-up.Conclusions. The team approach of dentists and clinicians and the use of periodontal PRP therapy can improve the effectiveness of post-prosthetic rehabilitation measures in periodontal patients with identified comorbid somatic pathology.

Evaluation of the reactive oxygen metabolite levels in plasma, gingival crevicular fluid, and saliva in generalized chronic periodontitis patients before and after nonsurgical periodontal therapy: A case-control and interventional study.

Background:Reactive oxygen metabolites (ROMs) produced in periodontitis could contribute to excessive tissue damage. Thus, treatment of chronic periodontitis may decrease the ROM levels. The aim of this study is to evaluate the ROM levels in plasma, saliva, and gingival crevicular fluid (GCF) in generalized chronic periodontitis (GCP) patients before and after nonsurgical periodontal treatment.Materials and Methods:Two groups were included in this study. Group I consisted of 30 healthy controls (C) and Group II consisted of 30 subjects with GCP. Plaque index (PI), papillary bleeding index, Probing Depth (PD), and clinical attachment level were recorded. GCF, saliva, and plasma samples were collected from both groups. ROM levels were assessed. A baseline comparison was made between the two groups. Nonsurgical periodontal treatment was carried out for Group II subjects. Two months posttreatment, the clinical parameters and ROM levels in GCF, saliva, and plasma were reassessed in Group II, and the data were compared with their baseline values. Statistical analysis was done using SPSS 20 software and results were derived.Results:Two months posttreatment, Group II exhibited significant reduction in ROM levels in plasma, saliva, and GCF with significant decrease in PI, bleeding on probing, probing depth, and attachment loss.Conclusion:Thus, significant oxidative stress may occur in chronic periodontitis and nonsurgical periodontal therapy may be regarded as an effective treatment modality to treat the diseased periodontium, thereby preventing possible systemic diseases in future.