Generalized Periodontitis Research Articles

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).

Does Full-Mouth Disinfection Influence the Size of the Periodontal Inflammatory Burden and the Level of hsCRP?

To investigate the effect of full-mouth disinfection on the sizes of the periodontal wound and periodontal inflammatory burden and whether it leads to a decrease in C-reactive protein (CRP) levels. The study included 20 systemically healthy subjects (11 women and 9 men) 30 to 68 years old with localised or generalised periodontitis (stage III, grade C). The sizes of the periodontal wound and periodontal inflammatory burden were measured with the web application "Periodontalwound", which is based on measurements of average tooth cervices, as well as probing depths and bleeding on probing assessed at six sites around each tooth present in the oral cavity. The levels of hsCRP (high-sensitivity CRP) were measured with an immunochemical method. All three parameters were measured before initial treatment and 3 months after therapy. Full-mouth disinfection included removal of plaque and calculus with ultrasonic and hand instruments in one session. The results showed a statistically significant decrease in the size of the periodontal wound (p < 0.001), a statistically significant decrease in the size of periodontal inflammatory burden (p < 0.001), and a decrease in hsCRP levels 3 months after therapy. Full-mouth disinfection leads to a decrease in the periodontal wound and periodontal inflammatory burden size, as well as a decrease in the levels of hsCRP in patients with localised or generalised periodontitis (stage III, grade C).

Periodontal disease severity in patients with long COVID and non-COVID-19

Background: Previous research studies have found the persistence of various COVID-19 symptoms even after the patient tested negative on a PCR test; this incident is now known as long COVID. These long COVID symptoms are reported to appear in the oral cavity including long COVID effects on periodontal disease, as both long COVID and periodontal disease release similar proinflammatory cytokines such as Acute phase proteins, CRP, TNF-α, IL-1β, IL-2, IL-6, and IFN-g. Purpose: This study aims to show periodontal-disease severity-frequency distribution in COVID-19 survivors with long COVID and in non-COVID-19 patients. Methods: Patients’ secondary data in the Periodontics Clinic Faculty of Dentistry at Trisakti University Dental Hospital (n=40) consisted of 20 samples from COVID-19 survivors who experienced long COVID and 20 samples from the non-COVID-19 group selected according to the inclusion criteria. Afterward, the data was recapitulated and processed into a research report. Results: The distribution percentage of generalized gingivitis was highest in non-COVID-19 patients, while generalized periodontitis was highest in COVID-19 survivors with long COVID. Based on periodontitis staging and grading methods, it is not proven that long COVID increases the severity of the periodontitis. Conclusion: This research shows that the distribution of gingivitis in COVID-19 survivors with long COVID has not increased. Meanwhile, the distribution of general periodontitis increased in survivors with long COVID. However, there was no increased severity of periodontitis based on the staging and grading method of periodontitis in the COVID-19 survivors with long COVID.

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&lt;0.05). Patient chest area has the highest number of CFU than doctors’ and assistant chest area (p&lt;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.

Medication correction of the main clinical symptoms of generalized periodontitis in patients with different blood groups

The article presents the results of treatment of 106 patients with generalized periodontitis (GP) depending on blood type. We determined the effectiveness of treatment by the frequency of detection of the main clinical symptoms (dental plaque, tartar, bleeding, tenderness, gingival hyperemia, serous-purulent discharge, periodontal pockets, pathological tooth mobility, radiological changes in the alveolar membranes) of GP. As a result of applying our proposed therapy, it was found that on day 3–5 after treatment only in patients with blood group 0 (I) of the main group the number of patients with clinical symptoms of GP was significantly less than in the control group (13.58±3.39% of patients vs. 25.69±6.42% of patients, p&amp;lt;0.01, respectively). At 1 month after treatment, there was a significant difference in the presence of clinical symptoms of GP in patients with blood group 0 (I) of the main and control groups (6.17±1.53% vs. 21.58±5.40%, p&amp;lt;0.05, respectively) and with blood group B (III) (8.33±2.08% vs. 22.22±5.56%, p&amp;lt;0.05, respectively). In patients with A (II) and AB (IV) blood groups, the number of patients with symptoms of GP in the study groups did not differ from each other during this follow-up period, p&amp;gt;0.05. After 6–12 months of study, in patients with GP, regardless of blood group, the number of patients in the main group with clinical symptoms of GP was significantly lower than in the control group, p&amp;lt;0.01. The improvement of clinical symptoms in patients with generalized periodontitis indicates a positive effect on the periodontal tissue the medicines we have prescribed.

Dental anxiety and oral health-related quality of life before and after non-surgical periodontal treatment.

To (1) investigate dental anxiety (DA) and oral health-related quality of life (OHRQOL) before and after non-surgical periodontal treatment (NSPT) and (2) determine correlations between these patient-reported measures. Demographics, smoking habits, dental pain, Modified Corah's Dental Anxiety Scale (MDAS), and Oral Health Impact Profile (OHIP-14) were assessed in eighty-two participants. Mean age was 48.3years ± 11.5. At baseline, 8.5% reported being active smokers. Of non-smokers, 11% reported being an ex-smoker. After NSPT, 11.0% reported smoking. Patients' maximal pain in the last month decreased after therapy. Before treatment, participants reported higher DA. Extreme DA was observed in 8.5% of participants before therapy. Afterwards, 2.4% of participants reported extreme DA. Fear of having a foreign object in the mouth decreased after NSPT. All OHIP-14 scores, except functional limitation, improved post-treatment. Higher DA was associated with worse OHRQoL before treatment. After treatment, total MDAS score was associated with OHIP-14 global score, physical pain, psychological disability, and social disability. Worse MDAS sub-scores were associated with a higher OHIP-14 global score. Individuals with "normal/slight anxiety" had a significant improvement in OHRQoL, whereas people in the "moderate and extreme anxiety" group did not report a significant improvement. Patients diagnosed with generalized periodontitis (GP) stage III grade B and GP stage IV grade B reported less anxiety after NSPT. Associations of MDAS subcategories with OHIP-14 domain scores were found before and after therapy. DA decreases and OHRQoL enhances after NSPT in patients with "normal/slight" anxiety to dental treatment. Dental practitioners should plan strategies to cope with anxiety to dental treatment and prevent decreases in OHRQoL. Within the limitations of this study, DA and OHRQoL were positively correlated in patients with periodontitis, before and after NSPT, using the MDAS and OHIP-14 questionnaires. The results of our study suggest that treatment is effective in terms of alleviating DA and improving oral health, along with quality of life, in patients that report "normal/slight" anxiety to dental treatment. Nonetheless, results must be interpreted with caution since patients are generally anxious before any type of dental treatment. DA may not just be confined to NSPT per se. According to our results, evaluation of both outcomes should be an integral part of routine periodontal clinical evaluation and periodontal reevaluation of initial therapy. It is important that clinicians learn to identify patients that suffer from anxiety and take time to explain the treatment procedures to the patient, to strive for patient's emotional well-being before, during, and after dental care services. The use of specific questionnaires for both DA and OHRQoL may be more appropriate to demonstrate the psychological and quality of life differences due to periodontal disease and NSPT.

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.

Influence of electronic cigarettes and tobacco heating systems on the periodontal condition in patients of different age and gender

Objective: to compare the characteristics of the periodontal condition in three categories of patients: smokers of electronic cigarettes, smokers of tobacco heating systems and non-smokers, taking into account age and gender. Material and methods. A comprehensive analysis of 1754 patient-smoker records was carried out: 1122 — electronic cigarettes (ES), 632 —tobacco heating systems (SNT). Data from 566 non-smokers were used as a control group (GC). Patients of all groups were divided into subgroups depending on age and gender. The clinical condition of the periodontium was assessed by dental indices and indicators. Statistical data analysis was performed using Microsoft Excel and Statistica 64 ver. 20.0 programs. Results. Gingivitis prevailed in the groups of persons with ES, SNT and GS. The frequency of gingivitis in the ES group decreases with age, while in the SNT group it increases. Among HS patients, gingivitis was recorded in all age groups. The frequency of acute periodontitis was highest in patients of the ES and SNT groups aged 35-39 years. In the Civil Code — at the age of 30-34 years. The frequency of gingivitis and acute periodontitis in persons of the SNT and ES group is more pronounced in women. In GS, these figures are almost equal. The frequency of registration of chronic localized periodontitis in persons of the SNT group is more pronounced in women, in the ES group these figures are higher in men. The frequency of registration of chronic general periodontitis in persons of all groups is more pronounced in women. Conclusion. The results of the study proved that the use of ES and SNT is a negative factor causing the occurrence of periodontal diseases.

DYNAMIC CHANGES IN PARACLINICAL INDICES FOLLOWING THE COMPLETION OF TREATMENT FOR GENERALIZED PERIODONTITIS IN PATIENTS WITH METABOLIC SYNDROME

The purpose of this study is to assess the dynamic changes in paraclinical indices following the completion of the treatment for generalized periodontitis in patients with metabolic syndrome. 80 patients with metabolic syndrome assigned to receive the integrated treatment for generalized periodontitis (GP) were divided into 2 groups. The main group (40 people) included 15 patients (37.5%) with primary I degree GP, 15 patients (37.5 %) with II degree GP and 10 people (25%) with III degree GP who received the treatment according to the elaborated therapeutic and preventive algorithm. The control group (40 people) received the treatment according to the protocol of the Ministry of Health of Ukraine (dental care provision in the specialty "Therapeutic Dentistry). The number of patients with primary I degree, II and III degrees of GP was identical to that in the main group.&#x0D; Results. Based on the results obtained, the subjects of the main group, who received pathogenetically based treatment, demonstrated a pronounced tendency to improve index values over all time intervals. Before the treatment, the mean values of the paraclicical index in the both groups did not differ and indicated severe GP. In the main group, in 1 month after the beginning of GP treatment, a significant decrease in index scores for periodontitis of moderate severity was observed. After 12 months, the PI index in the patients of the main group continued to show the average GP severity and was 1.5 times lower than before the treatment, p&lt;0.01.&#x0D; Before the GP treatment, the values of the PMA index in patients of the main and control groups showed the upper margin of moderate gingivitis trenching upon severe gingivitis. 1 month after the pathogenetic treatment, there was a significant decrease in the PMA index in the patients of the main group reaching the upper limit of mild gingivitis. 12 months after the receiving treatment-prophylactic algorithm, the patients of the main group showed the digital indicator of the PMA index was 39.87 ± 5.46%, i.e. 1.4-fold lower than the values before the treatment, p&lt;0.01. In the patients of the control group, the PMA index scores of 54.89 ± 8.69% approached the initial level. The effectiveness of the elaborated treatment-prophylactic algorithm was also confirmed by the positive dynamics of the Green-Vermillion hygienic index in the patients of the main group over all observation periods.&#x0D; Conclusion. The subjects of the main group, who received pathogenetically based treatment, demonstrated a pronounced tendency towards the improvement of index values over all treatment intervals. Across all stages of observation, there has been observed the cessation of exudation and suppuration from periodontal pockets, the reduction of granulations and hyperaemia, thus, the elimination of the inflammatory-dystrophic process has been clinically proved. It can be suggested that the proposed therapeutic and preventive algorithm enables to reduce the preparatory period before the surgical stages of periodontal treatment and ensure a favourable post-operative course. The treatment according to the traditional protocol has been found as less ineffective and leads to the deterioration of periodontal tissues in the control group.

Expression of trefoil factor 2 and 3 and adrenomedullin in chronic periodontitis subjects with coronary heart disease.

The current study aims to determine the expression of trefoil factor 2 (TFF2), trefoil factor 3 (TFF3), and adrenomedullin (ADM) in salivary samples of periodontitis patients with and without coronary heart disease (CHD). A total of 75 patients were selected based on the inclusion and exclusion criteria and divided into three groups of 25 patients each: generalized periodontitis (GP) only; GP+CHD; and CHD only. Demographic, periodontal, and cardiac parameters were recorded, and unstimulated saliva samples were collected and analyzed for the expression of TFF2, TFF3, and ADM. Among the demographic variables, the means for age, weight, and body mass index were significantly different between the groups on statistical analysis. Plaque index, bleeding on probing, probing pocket depth, clinical attachment level, and the expression of TFF2 were highest in the GP+CHD group, and ADM was highest in the CHD group, with P valuesof <0.01 as compared to the other groups. TFF2, TFF3, and ADM were also correlated with the demographic and periodontal parameters. The study demonstrates significantly elevated levels of TFF2 in CHD and GP patients, and a higher expression of ADM in CHD patients only, suggesting the possibility of an underlying inflammatory mechanism.

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.

Porphyromonas gingivalis and non-alcoholic fatty liver disease as combined factors of periodontitis

Purpose: This study is to determine the quantitative level of Porphyromonas gingivalis (P. gingivalis) in the periodontal pocket and its gingipain virulence factor in patients with non-alcoholic fatty liver disease (NAFLD). Methods: Dental status, composition of P. gingivalis, and levels of gingipain and blood endotoxin were studied in patients with NAFLD and in a control group. The quantitative composition of P. gingivalis was determined by the real-time quantitative polymerase chain reaction method (qRT-PCR). Gingipain K concentration in oral fluid was determined by an immunoenzymatic method. Results: The level of individual oral hygiene in the NAFLD patients was found to be unsatisfactory. Structurally, periodontal pathology was represented mainly by chronic grade B periodontitis. When analysing the correlation interaction, a positive dynamic was found between P. gingivalis and the presence of generalized periodontitis (GP) (r=0.652; p=0.000) and between gingipain and GP (r=0.510; p=0.006). The endotoxemia value correlated positively with the quantitative index of P. gingivalis (r=0.695; p=0.004), which is explained by the fact that periodontopathogen endotoxin (LPS), when entering the vascular bed, increases the systemic endotoxin level in general. Inflammation-causing cytokines and LPS in NAFLD contribute to the formation of an anaerobic environment in the periodontium that favours the quantitative growth of P. gingivalis. Conclusion: The highest levels of P. gingivalis and gingipain were recorded in patients with NAFLD, which is consistent with a background of decreased periodontal adaptive capabilities. The P. gingivalis/gingipain correlation ratio can allow the dentist to monitor the treatment of periodontal patients.

DETERMINATION OF THE NEED FOR SURGICAL TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS BY THE METHOD OF FLAP OPERATIONS

Aim: to study of the need and justification for flap operations in the complex treatment of patients with generalized periodontitis (GP).&#x0D; Materials and methods. 280 people with GP were examined. Patients were divided into the following age groups: Group I - 136 (48.6%) patients aged 30-44 years and Group II - 144 (51.4%) patients aged 45-60 years. The initial state of oral hygiene was assessed using the OHI-S index (Oral Hygiene Index Simplified). In order to determine the degree of disease development and the need for the use of surgical methods of treatment, the depth of periodontal pockets (PC), levels of epithelial attachment loss and gum recession (classification according to P.D. Miller) were determined. The degree of multirooted teeth furcations damage in the horizontal direction was studied according to the Hamp classification (1975). The degree of tooth mobility was determined according to Entin. The obtained data during the examination of patients were entered into specially developed periodontological maps. The diagnosis was made on the basis of a clinical and radiological examination, according to the classification of Danylevsky M.F. (1994).&#x0D; Results. Initial -1st degree of development of GP was diagnosed in 73 (53.7%) examined persons aged 30-44 years and in 59 (41.0%) persons aged 45-60 years. Such patients do not require surgical interventions, therefore conservative treatment was prescribed to them.&#x0D; In the 1st age group, 38 (27.9%) patients were diagnosed with GP of the II degree of development, II-III degree of development – in 25 (18.4 %) patients. In the 2nd age group, 40 (27.8%) people were diagnosed with GP of the 2nd degree of development, 45 (31.3%) of the 2nd-3rd degree of development. The average value of the depth of periodontal pockets , as well as the level of epithelial attachment loss differed in age groups and was higher in patients older than 45 years. Gum recession was observed in all patients with II, II-III stage of development of GP. At the II stage of the development of GP, the average value of the recession of the gums varied between 1.49 ± 0.23 mm in the I age group and 1.98 ± 0.25 mm in the II group, which corresponds to a light degree of recession. With GP II-III stage of development, the average value of recessions was 2.20 ± 0.46 mm in the I age group and 2.43 ± 0.50 mm in the II age group, which also corresponds to a mild degree of gum recession. Class III and IV recessions, which have an unfavorable treatment prognosis, were more often observed in patients of the II age group. Involvement of multirooted teeth furcations in the pathological process was observed in patients with II-III degree of development of GP. In the majority of patients with II, II-III degree of GP, I-II degree of tooth mobility was registered. III degree of mobility was diagnosed in 5 (20%) patients of the I age group and in 12 (26.7%) patients of the II age group.&#x0D; Conclusions. According to the results of our research, the peculiarities of the clinical picture in patients with generalized periodontitis I, II and II-III stages of development aged 30-44 and 45-60 years were established. In particular, the indicators of the OHI-S hygiene index indicate the unsatisfactory state of oral hygiene of the examinees, and the criteria for surgical interventions in complex treatment are the depth of periodontal pockets, the level of loss of epithelial attachment and the type of gum recession.&#x0D; We established that 17.1% of the examined patients require surgical treatment by the method of flap operations, of which 14.0% of patients in the I age group (30-44 years) and 20.1% of the II age group (45-60 years).

THE EFFECT OF CONVERGENCE ANGLE OF TOOTH PREPARATION IN PATIENTS WITH GENERAL PERIODONTITIS ACCORDING FINITE ELEMENT ANALYSIS

Purpose of the research. To study the character of displacement and stress distribution after prosthetics of the lower central incisor with the metal-ceramic crown, depending on the convergence angle of preparation and the degree of resorption of alveolar septa using finite element analysis. Research methods. The computer models have been studied using the calculated software complex “Lira 9.6” to reproduce intact (before preparation) and treated teeth, taking into account subsequent imposition of a metal-ceramic crown. Calculations have been made for different convergence angles, from 20 to the maximum possible, for four types of loads (constant from own weight; vertical from food biting off; at an angle of 300 to vertical; at an angle of 450 to vertical) and for different degrees of preservation of alveolar septa: 100 %, 75 % and 50 %. Scientific novelty. It has been established that in the calculated model the increase of the convergence angle of tooth surfaces, as well as the decrease in alveolar septa height, cause the increase in displacements in the biomechanical system “crown – tooth – alveolar bone”, the maximum of which are localized in the neck area of the tooth on its lingual surface. The increase in the angle of preparation causes the increase in stresses in the same area, while the increase in the degree of resorption of alveolar septa results with the displacement of the maximum stress zone from the tooth neck to the apical part of the root. Conclusions. The obtained results indicate the need for tooth preparation with the minimum convergence angle of surfaces in patients with general periodontitis. It could prevent the risks of the progression of the pathological process in periodontal tissues due to the increase of stresses and displacements.

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.

Action of enamel matrix proteins on human osteogenous progenitor bone marrow cells, an experimental study

Complex treatment of moderate and severe generalized periodontitis includes surgical phase of treatment in aim to provide regeneration and long-term disease remission. The obtained results confirm presence of osteoinductive properties in enamel matrix proteins, this data may be useful during surgical procedures on periodontal tissues.

The Gaseous Ozone Therapy as a Promising Antiseptic Adjuvant of Periodontal Treatment: A Randomized Controlled Clinical Trial.

Background: the establishment of periodontitis is regulated by the primary etiological factor and several individual conditions including the immune response mechanism of the host and individual genetic factors. It results when the oral homeostasis is interrupted, and biological reactions favor the development and progression of periodontal tissues damage. Different strategies have been explored for reinforcing the therapeutic effect of non-surgical periodontal treatment of periodontal tissue damage. Gaseous ozone therapy has been recognized as a promising antiseptic adjuvant, because of its immunostimulating, antimicrobial, antihypoxic, and biosynthetic effects. Then, we hypothesized that the adjunct of gaseous ozone therapy to standard periodontal treatment may be leveraged to promote the tissue healing response. Methods: to test this hypothesis, we conducted a prospective randomized study comparing non-surgical periodontal treatment plus gaseous ozone therapy to standard therapy. A total of 90 healthy individuals with moderate or severe generalized periodontitis were involved in the study. The trial was conducted from September 2019 to October 2020. Forty-five patients were randomized to receive scaling and root-planning (SRP) used as conventional non-surgical periodontal therapy plus gaseous ozone therapy (GROUP A); forty-five were allocated to standard treatment (GROUP B). The endpoint was defined as the periodontal response rate after the application of the ozone therapy at 3 months and 6 months, defined as no longer meeting the criteria for active periodontitis. Statistical analysis was performed employing SPSS v.18 Chicago: SPSS Inc. Results: periodontal parameters differed significantly between patients treated with the two distinct procedures at 3 months (p ≤ 0.005); a statistically significant difference between groups was observed from baseline in the CAL (p ≤ 0.0001), PPD (p ≤ 0.0001) and BOP (p ≤ 0.0001) scores. Conclusions: The present study suggests that SRP combined with ozone therapy in the treatment of periodontitis revealed an improved outcome than SRP alone.

Oral Hygiene Considerations in Adult Patients with Leukemia during a Cycle of Chemotherapy.

The oral cavity is the place where the first symptoms of systemic diseases may appear. Leukemia is the malignancy of the hematopoietic system in which abnormal leukocytes are produced in the bone marrow and these cells spread to the peripheral blood. It is classified clinically on the basis of the duration and nature of the disease (acute or chronic), the type of cell involved (myeloid, lymphoid, or monocytes), and a rise in the number of abnormal cells in the blood. The study aimed to assess and compare the oral hygiene and periodontium status based on the indices in leukemic patients before and after one cycle of chemotherapy and whether the therapy had an impact on the change of these parameters. Dental indices used in clinical diagnostics were calculated: API (approximal plaque index), SBI (sulcus bleeding index), and CPI (community periodontal index). The research project was conducted at the Clinic of Hematooncology and Bone Marrow Transplantation of the Independent Public Clinical Hospital No. 1 in Lublin. The target population consisted of 102 adults with leukemia who were over 18 years of age. The time since diagnosis of the disease ranged from 1 to 10 years. The data were evaluated in the Statistica 12 software with the respective tests. In the majority of patients, both before and after chemotherapy, improper oral hygiene and severe generalized periodontitis were confirmed. The cycle of chemotherapy that was used did not correlate with the change of patients’ oral hygiene and periodontium state. Unsatisfactory oral hygiene and periodontal health has to be addressed with urgent dental treatment to avoid systemic complications in leukemic patients.

ОЦІНКА ПОКАЗНИКІВ ЛІПІДНОГО ОБМІНУ У ПАЦІЄНТІВ З ІШЕМІЧНОЮ ХВОРОБОЮ СЕРЦЯ ТА ГЕНЕРАЛІЗОВАНИМ ПАРОДОНТИТОМ

Introduction. It has been assumed that generalized periodontitis (GP) adversely affects the qualitative and quantitative composition of plasma lipids and lipoproteins. On the other hand, periodontal treatment and reduction of general periodontal pocket infection in patients with GP are associated with a decrease in total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C) and triglycerides (TG). The aim of the study was to conduct a comparative assessment of the state of lipid metabolism in patients with coronary artery disease (CAD) depending on the GP severity. Methods. The study included 101 patients (mean±SD age - 58.2 ± 8.3 years) with CAD and GP, 58 men (57.4%) and 43 women (42.6%). According to the severity of GP, study participants were divided into 3 groups: group I - patients with CAD and GP stage I (initial periodontitis), group II - patients with CAD and GP stage II (moderate periodontitis) and group III - patients with CAD and GP stage III and IV (severe periodontitis). The control group included 9 patients with CAD and clinical gingival health on an intact periodontium (mean±SD age - 56.3 ± 6.1 years), 5 men (55.6%) and 4 women (44.4%). The diagnosis of CAD and the results of lipid metabolism were obtained by analyzing the inpatient medical records. Results. It was revealed that the values of TC, LDL-C, very low-density lipoprotein-cholesterol (VLDL-C), TG and atherogenic coefficient (AC) were lower in the group of patients with CAD and clinical gingival health compared to the level of the corresponding indicators in the groups of patients with CAD and GP (p&lt;0.05). In the analysis of lipid profile in patients with CAD and GP of varying severity, it was found that the average levels of TC, LDL-C, and AC in the subjects of group I were significantly lower compared to the corresponding indicators of groups II and III (p&lt;0.05). There was no statistical difference in the values of lipid metabolism in groups II and III (p&gt;0.05). No significant difference was found in high-density lipoprotein-cholesterol (HDL-C) levels between the comparison groups including the patients with CAD and clinical gingival health (p&gt;0.05), as well as the gender characteristics of the analyzed indicators in the examined patients. Conclusions. Average levels of TC, LDL-C, and AC in patients with CAD and GP increase with increasing destructive-inflammatory changes in periodontal tissues, therefore, with the severity of GP indicating the progression of atherogenesis along with the increased inflammatory process in the periodontium