Intact Periodontium Research Articles

Features of effect of low-intensity laser irradiation on prokaryotic and eukaryotic cells

Objective. To study the possibility of using LED blue, red, and green radiations of a new apparatus to eliminate prokaryotic cells and maintain human cell viability. Currently, laser technologies are widely used in medical practice. However, there are relatively few studies on the effect of laser radiation with similar parameters on the viability of prokaryotic and eukaryotic cells.
 Materials and methods. As a radiation generator, the LFDT-02 diode medical laser of a new type from the Perm Scientific and Production Instrument-Making Company was used. Staphylococcus aureus 66G cultures were irradiated with a different wavelengths laser (exposure time 2 min, power 22 mV). After that, the viability of microorganisms was evaluated by direct seeding on nutrient media. To study the effect of laser radiation on macroorganism cells, fasting samples of buccal epithelium were obtained in 17 practically healthy volunteers aged 2025 years with an intact periodontium and dentition, without somatic pathology. To assess cell viability, a vital dye was used 0.1 % trypan blue solution. The exposure time and power do not differ from those for the studied S. aureus strain. To assess the morphological changes of epithelial cells, preparations were prepared for microscopy, which, after fixation, were stained according to the Romanovsky-Giemsa method.
 Results. When evaluating the effect of laser radiation, especially in a clinical setting, it is necessary to take into account its possible effect not only on cells of conditionally pathogenic microorganisms, but also on human cells. In the present study, it was shown that laser radiation with a power of 22 mV allows one to achieve a bacteriostatic effect against S. aureus but it also significantly reduces the viability of buccal epithelial cells, that can be considered, on the one hand, as a side effect of laser radiation and, on the other hand, the removal of dying cells filled with microorganisms, can enhance the effect of ongoing therapy.
 Conclusions. Based on the results obtained, it can be concluded that the laser radiation of a diode laser with a wavelength of 405 nm (blue) and 650 nm (red) has a pronounced bacteriostatic effect. However, a significant damaging effect of red radiation on macroorganism cells was found.

Prognosis of progression of chronic generalised periodontitis in patients with bronchiectatic disease

Aim. To analyse the parameters of dental indices and the level of markers of infl ammation and oxidative stress in patients with chronic generalised periodontitis (CGP) with bronchiectatic disease and to develop a mathematical model for assessing the risk of CGP progression in patients with bronchiectatic disease.Materials and methods. A total of 70 patients with mild and moderate CGP were examined, which were divided into the following groups: patients with CGP without general somatic pathology (n = 33), and patients with CGP and bronchiectatic disease (n = 37). The control group consisted of somatically healthy individuals with intact periodontium (n = 40). Dental indices (PMA, PI, Muhlemann, OHI-s), infl ammatory markers (transforming growth factor beta 1 (TGFβ-1), lactoferrin (LF), interleukin-8 (IL-8), C — reactive protein (CRP)), and oxidative stress markers (malondialdehyde (MDA), as well as advanced oxidation protein products (AOPPs), and total superoxide dismutase (SOD)) were analysed in all patients included in the study. The method of binary logical regression was used to create a mathematical model for assessing the risk of CGP progression in patients with bronchiectatic disease.Results. Dental indices and the level of markers of infl ammation and oxidative stress were statistically signifi cantly higher in all patients with CGP as compared to somatically healthy individuals, as well as in patients with CGP and bronchiectatic disease as compared to patients with CGP without general somatic pathology. Positive correlations of different strength between the studied markers of infl ammation and oxidative stress and dental indices were revealed. Based on the results of the correlation matrix data and using the binary logistic regression method, a mathematical model was developed that can be applied for assessing the risk of CGP progression in patients with bronchiectatic disease. The predictors of progression included in the mathematical model were: PI, TGFβ-1 and AOPPs. Conclusion. The data obtained indicate a greater severity of infl ammation and oxidative stress in CGP patients with comorbid pathology in the form of bronchiectatic disease and the infl uence of these processes on the periodontal condition. The proposed mathematical model for assessing the risk of CGP progression in patients with bronchiectatic disease is characterized by a high level of sensitivity and prognostic signifi cance, thus being applicable for use in clinical practice.

ОЦЕНКА СОСТОЯНИЯ ТКАНЕЙ ПАРОДОНТА У РАБОТНИКОВ ПРОМЫШЛЕННЫХ ПРЕДПРИЯТИЙ

Subject. The results of a clinical examination of workers of the special economic zone "Alabuga" of the Republic of Tatarstan and JSC "Chemical Plant named after L.Ya. Karpova ”(Mendeleevsk), including a comparative analysis of data on the prevalence of inflammatory periodontal diseases.
 The goal is a comparative assessment of the prevalence of inflammatory periodontal diseases among workers in the Alabuga Special Economic Zone of the Republic of Tatarstan and JSC "Chemical Plant named after L.Ya. Karpova"(Mendeleevsk).
 Methodology. Dental status was evaluated using WHO methods and criteria. The clinical study was conducted through a comprehensive dental examination of 370 employees of the special economic zone “Alabuga” of the Republic of Tatarstan (the main group) and 297 employees of JSC “Chemical Plant named after L.Ya. Karpova ”(Mendeleevsk) (comparison group).
 Results. According to the results of our clinical diagnostic examination of the oral cavity in the main group and the comparison group of workers of industrial enterprises, certain differences were revealed. In the main group, an intact periodontium without signs and with signs of inflammatory periodontal lesions was diagnosed in 39.2 and 60.8 % of cases, in the comparison group — in 53.2 and 46.8 %, respectively. An analysis of the hygiene index in the main group showed that 62.4 % of the subjects showed poor oral hygiene, 19.7 % had poor hygiene, and in the comparison group 32.3 and 3.03 %, respectively.
 Conclusions. Thus, the data obtained justify the need and relevance of the proposal and the introduction of organizational principles for providing industrial workers with high-quality dental care. It is necessary to reform the dental service in order to increase priority, quality and preventive orientation when servicing workers directly at the factory.

The Level of Oxidative Stress Markers in Generalised Periodontitis in the Setting of Bronchiectasis

Aim. To analyse the level of oxidative stress markers and the value of dental indices characterising the state of periodontal tissue in patients with generalised periodontitis (GP) both without somatic pathology and with bronchiectasis.Materials and methods. Over the period from 2015 to 2017, a total of 90 GP patients were examined, including 40 patients without somatic pathology and 50 patients with bronchiectasis. The control group consisted of somatically healthy individuals with intact periodontium (n=40). The following indices were calculated for all examined individuals: PMA, PI, Muhlemann and OHI-s. The level of oxidative stress markers in oral fl uid was determined: total superoxide dismutase (SOD) of all three types (Cu/Zn-SOD + Mn-SOD + Fe-SOD), products of advanced protein oxidation and malondialdehyde.Results. The study established the intensifi cation of oxidative stress in GP patients without somatic pathology and with bronchiectasis. Patients with comorbid pathologies demonstrated a greater severity of oxidative stress. The analysis revealed a significant correlation between the values of dental indices (PMA, PI, Muhlemann, OHI-s) and the level of oxidative stress markers both in GP patients without somatic pathology and with bronchiectasis. Furthermore, this correlation is stronger in patients with comorbid pathologies.Conclusion. The presence of comorbid pulmonary pathologies in the form of bronchiectasis in patients with generalised periodontitis can act as an aggravating factor in the development of periodontal lesions.

Correlation between Cone Beam CT Data and the Levels of Inflammatory Markers in Odontogenic Respiratory Comorbidity

Aim. In this study, the authors set out to find the correlation between the data of cone beam computed tomography (CBCT) and the levels of inflammatory markers in patients with chronic generalised periodontitis (CGP), both without somatic pathology and with bronchiectasis.Materials and methods. The study included 90 CGP patients and 40 somatically healthy individuals with intact periodontium. CGP patients were divided into two groups: CGP patients without somatic pathology (n = 40) and CGP patients with bronchiectasis (n = 50). Using ELISA, the authors determined the level of the following inflammatory markers in oral fluid: transforming growth factor beta 1 (Tgfß-1), interleukin -8 (IL-8), lactoferrin (LF) and C-reactive protein (CRP).Results. The analysis of CBCT data and the levels of inflammatory markers (Tgfß-1, LF, IL-8 and CRP) revealed that more pronounced changes in their values were observed in CGP patients with bronchiectasis. In addition, the revealed correlations between CBCT data and the levels of inflammatory markers in CGP patients without somatic pathology and CGP patients with bronchiectasis indicate a relation between the severity of inflammatory reaction and the clinical manifestations of CGP. Furthermore, this correlation is stronger in CGP patients with comorbid pathology than in CGP patients without somatic pathology.Conclusion. The presence of comorbid pathology in the form of bronchiectasis in CGP patients has a negative impact on the periodontium, which should be considered when managing patients.

INDICATORS OF LASER CONVERSION DIAGNOSTICS OF THE PERIODONTAL STATE IN NORMAL AND PATHOLOGY

Diagnosis of periodontal conditions is diverse and includes an index assessment of inflammation, microcirculation analysis, determination of microflora of periodontal pockets, radiography. A new method for assessing inflammation is proposed - laser conversion diagnostics using the InSpektr M instrument. In 30 patients, indicators of LCD with intact periodontium and indicators in patients with chronic generalized periodontitis of moderate severity were revealed. Measurements are differentiated by localization: keratinized, non-keratized gums, marginal margin. It was shown that laser conversion diagnostics (fluorescent component) of the state of the gum tissue using the InSpektr M device can serve as an objective method for detecting inflammatory changes in periodontal disease; obtained indicators of conversion diagnostics of intact periodontium.

Finite element analysis of the dental pulp under orthodontic forces.

To evaluate the stress at the apical third of the pulp and neurovascular bundle (NVB) during 5 types of orthodontic movement at different levels of bone loss. Furthermore, correlations among bone loss, orthodontic appliances, and stress increase were assessed. Based on cone-beam computed tomography datasets, 10 models of the mandibular second premolar were created. Each of these models was subjected to a gradual horizontal bone loss simulation (0-8mm). Orthodontic forces of 20g, 60g, and 120g were applied during the finite element analysis (FEA). For each bone loss level, stress values were evaluated with the use of Abaqus at the apical third of the pulp and the NVB. The stress manifested at the apical third of the pulp was smaller than that at the NVB. The highest apical NVB stress was found for rotation (0.000546N/mm2 for 8mm bone loss) whereas the lowest stress resulted after translational movements (2.35E-04 MPa for 8mm bone loss). The FEA showed that Proffit's indicated orthodontic forces did not significantly disturb the pulpal blood flow and damage the apical NVB. Up to a doubling of the NVB stress, bone loss correlated with the force reduction to obtain similar stress levels compared with teeth with no bone loss. The present findings indicate that the stress manifested at the apical third of the pulp is smaller than that at NVB. Rotational movements induce the highest stress and translational forces develop the lowest stress related to the physiologic capillary blood pressure. Furthermore, in situations with reduced periodontium, lower forces are needed to reach the maximum tolerable stress compared with teeth with intact periodontium.

Periodontally accelerated osteogenic orthodontics: A boon in a severe periodontally compromised Class II division 1 malocclusion patient

Periodontally accelerated osteogenic orthodontics (PAOO) is a combination of a selective decortication facilitated orthodontic technique and alveolar augmentation. With this technique, one is no longer at the mercy of the preexisting alveolar volume, and teeth can be moved two to three times further than required for traditional orthodontic therapy. It is used to treat moderate-to-severe malocclusions in both adolescents and adults. PAOO technique increases alveolar volume which can provide a more intact periodontium, inturn decreases need for extractions, increases a degree of facial reshaping. This technique also increases the bony support for both the teeth and the overlying soft tissues. Here is a case report which highlights the above-mentioned uses with PAOO technique in a severe periodontally compromised Class II division1 malocclusion patient treated with nonextraction line of orthodontic treatment.

Комплаєнтність як предиктор ефективності лікувально-профілактичних заходів у хворих на генералізовані захворювання пародонта, афілійовані з нервовою анорексією

Summary. To plan the treatment of GPD in patients with anorexia nervosa, the format of a personal assessment of the level of compliance was verified.Materials and research methods. The research involved 58 patients with GPD, suffering from AN, restrictive form, and 62 patients with GPD without signs of anorexia at the age of 18–25 years. The control group was represented by 30 healthy people with normal weight and clinically intact periodontium. Clinical-radiological and medical-psychological methods were used.Results and its discussion. Low level of emotional (E), social (S), behavioral (B) and general (G) compliance with a frequency of 70–75, 61–65, 40–65 and 60–70 % respectively has been established in patients with GPD afiliated with AN, which may indicate the complexity of achieving sustained and long-term remission and the effectiveness of preventative measures for GPD. A high level of all components of compliance in patients with GPD afiliated with AN was identified in only 6, 10, 11–27.5 and 10–20 % of the surveyed patients, respectively. Among patients with GPD without signs of AN. The average level of all components of compliance (E, S, B, G) with frequency of 45–76, 46,6–73,3, 70–73,3 and 30–63.3 %, respectively, was prevalent.Conclusions: the low level of all components of compliance (E, S, B, G) in patients with GPD suffering from AN, indicates the potential complexity of promising treatment and leads to the involvement of related profile specialists; patients with AN can be attributed to the risk of satisfactory, sustainable, long-term and predictable outcome of treatment for GPD; taking into account the determination of the level of compliance in patients with GPD afiliated with AN is an important factor in ensuring the effectiveness of the comprehensive treatment and prevention process.Key words: anorexia nervosa, generalized parodontal diseases, behavioral compliance, emotional compliance, motivation, social compliance.

Assessment of the effectiveness of differential management of patients in the early postoperative period following the dental implant surgery

Development of the modern dental implantology as a science is rapidly advancing, making impressive gains. Despite the undoubted achievements, an important issue of the dental implantation is the risk of inflammatory post-surgical complications. Aim of the study. To assess the effectiveness of the proposed differential medicamentous therapy after dental implant surgery based on the results of clinical picture dynamic monitoring in the early postoperative period (up to 3 months). Materials and methods. 124 somatically healthy people (54 men and 70 women) aged from 18 to 34 years were examined, among them: 25 patients with intact periodontium, 35 patients with chronic catarrhal gingivitis (CCG), 30 patients with generalized periodontitis (GP) of the initial, initial-І degrees of severity, 34 patients with GP of the І and ІІІ degree of severity. Patients were divided into 2 equal study groups: the proposed differential therapy was used for the experimental group (62 patients) in the early post-surgical period depending on the determined initial oral hygienic status; the traditional medicamentous treatment was applied for the control group (62 patients). Since the special medicamentous therapy was not advisable for the patients with healthy periodontium (25 patients) after the implant surgery, they made up the comparison group. Immunomodulating monotherapy (6 “Imudon” lozenges per day for 2 weeks) was prescribed to patients with CCG in the postoperative period. Immunomodulating therapy (“Imudon” by the same scheme) combined with a universal broad-spectrum antimicrobial drug “Miramistin” was prescribed to patients with GP of the initial, initial-I, І and І–ІІ degrees of severity for 2 weeks. Control examinations were performed one week after removing the stitches, then weekly for 3 months before the second stage of surgery. Results . One week after removing the stitches a significantly better oral hygienic status was observed in the main group of patients with CCG compared to the control (P < 0.05). When assessing the mucosa state above the intraosseous element in CCG patients, cases of peri-implantitis were detected neither in the main nor in the control group in the postoperative period. In the main group of patients with GP of the initial, initial-I degrees of severity the oral cavity hygienic status was significantly better in all periods of observation, starting from the first week after removing the stitches and after 3 months compared with the control (P < 0.05). When assessing the mucosa state above the intraosseous element in patients with GP of the initial, initial-I degree of severity in the postoperative period, one case of peri-implantitis was revealed in the control group. It manifested as hyperemia and edema of the mucosa above the intraosseous element during the 1st week after removing the stitches and granulation tissue growth during the 2nd week. The main group of patients with GP of the I, I–II degrees of severity were characterized by significantly better oral hygienic status – 1.90 times on average (P < 0.05), compared with the control, from the 1st week after removing the stitches and over the follow-up period up to 3 months. When assessing the mucosa state above the intraosseous element in patients with GP of the I, I–II degrees of severity in the postoperative period, one case of peri-implantitis was revealed in the control, similarly to patients with GP of the initial, initial-I degrees of severity. Conclusions. Analysis of the clinical parameters dynamics in the patients after dental implant surgery suggests the effectiveness of the proposed methods in addition to the traditional maintenance therapy in the early period of 1 week after removing the stitches to 3 months. The obtained results allow to recommend the proposed methods of differential medicamentous therapy in the early postoperative period following the dental implant surgery for a wide application in dental practice.

Improving the efficiency of treatment of inflammatory periodontal diseases in professional athletes

Aim. Evaluation of the effectiveness of the medication «Pomegranate balm» in the treatment of inflammatory periodontal diseases in professional athletes. Methods. Among 475 professional athletes the prevalence of periodontal diseases was studied using the Community Periodontal Index of Treatment Needs. Silness-Löe plaque index, periodontal index, Muhlemann sulcus bleeding index modified by I. Cowell and biochemical analyses were determined in 51 freestyle and classical style wrestlers divided into three groups: group 1 - 20 athletes with intact periodontium, group 2 - 16 athletes with chronic catarrhal gingivitis, group 3 - 15 wrestlers with the signs of mild periodontitis. Sialometry was performed, the concentration of secretory immunoglobulin A and interleukin-8 in oral fluid was measured by the method of enzyme linked immunosorbant assay (ELISA). Results. The maximum values of gingival bleeding were recorded in groups 1 and 2 of the examined athletes - 20.9±3.79 and 34.5±3.21%, respectively. The incidence of moderate and severe periodontal diseases in the age group of 24-32 years was in average 14.1±2.35 and 5.5±1.53%, respectively. Use of the drug sharply increased the rate of basic salivation (from 1.98±0.031 to 2.23±0.023 ml/min, p &lt;0.001), and by the end of the investigation, in most of the athletes the earlier observed signs of hyposalivation resolved, and the analysis of laboratory data revealed markedly increased level of secretory immunoglobulin A from 260.2±1.47 to 544.0±6.33 mg×mg-1 protein and decreased levels of interleukin-8 from 2829.6±15.8 to 1224.2±18.0 pg×mg-1 protein (p &lt;0.001). Conclusion. Effective and biologically active preparation based on propolis «Pomegranate balm» can significantly improve the dental status of professional athletes against the background of improving the state of factors of local oral immunity.

Features of cellular mechanisms affecting the pathogenesis and course of chronic catarrhal gingivitis

Aim. To investigate the cellular mechanisms of chronic catarrhal gingivitis to develop the appropriate treatment schemes based on the analysis of obtained data. Methods. 57 patients aged 16 to 22 years were observed and divided into the control group (18 subjects with the intact periodontium with no orthopedic constructions) and the study group of patients with chronic catarrhal gingivitis (39 subjects, group 1). The degree of gingival inflammation was evaluated by papillo-marginal alveolar index as well as by gingival bleeding index. In addition, laboratory parameters were measured: spontaneous nitroblue tetrazolium test and zymosan-stimulated nitroblue tetrazolium test. Leukocyte-modulating activity of oral fluid was determined by measurement of luminol-dependent chemiluminescence. The activity of lysosomal enzymes - acid deoxyribonuclease and acid phosphatase - was determined in whole oral fluid, supernatant fraction of oral fluid and in sediment, obtained by centrifugation. Antioxidant activity was determined in whole oral fluid by biochemiluminescent method with hydrogen peroxide. Results. The performed investigations demonstrated that the development of chronic catarrhal gingivitis is accompanied by a sharp increase of the number of neutrophils and macrophages with a significant increase of their functional activity. At the same time, more than two-fold increase of the activity of lysosomal enzymes, lysosomal membrane labilization and release of enzymes outside the organelles and cells were observed, that indicated the increase of destructive potential in chronic catarrhal gingivitis. Use of indometacin in the complex treatment of chronic catarrhal gingivitis contributed to normalization of clinical parameters, increased neutrophil functional activity and enhanced their functional reserve, reduced the activity of phlogogenic factors and normalized the antioxidant activity of oral fluid. Pro- and anti-inflammatory factors secreted into the oral cavity during inflammatory periodontal diseases collectively have leukocyte-modulating activity. Conclusion. The obtained data indicate the important role of both high oxygen-dependent and oxygen-independent biocidal activity of neutrophils and macrophages in the pathogenesis and clinical course of chronic catarrhal gingivitis.

Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions.

Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm-induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable "periodontitis patient" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a "case" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.

Plaque‐induced gingivitis: Case definition and diagnostic considerations

Clinical gingival inflammation is a well-defined site-specific condition for which several measurement systems have been proposed and validated, and epidemiological studies consistently indicate its high prevalence globally. However, it is clear that defining and grading a gingival inflammatory condition at a site level (i.e. a "gingivitis site") is completely different from defining and grading a "gingivitis case" (GC) (i.e. a patient affected by gingivitis), and that a "gingivitis site" does not necessarily mean a "GC". The purpose of the present review is to summarize the evidence on clinical, biochemical, microbiologic, genetic markers as well as symptoms associated with plaque-induced gingivitis and to propose a set of criteria to define GC. A universally accepted case definition for gingivitis would provide the necessary information to enable oral health professionals to assess the effectiveness of their prevention strategies and treatment regimens; help set priorities for therapeutic actions/programs by health care providers; and undertake surveillance. Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score>30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4mm in depth.

Plaque-induced gingivitis: Case definition and diagnostic considerations.

Clinical gingival inflammation is a well-defined site-specific condition for which several measurement systems have been proposed and validated, and epidemiological studies consistently indicate its high prevalence globally. However, it is clear that defining and grading a gingival inflammatory condition at a site level (i.e. a "gingivitis site") is completely different from defining and grading a "gingivitis case" (GC) (i.e. a patient affected by gingivitis), and that a "gingivitis site" does not necessarily mean a "GC". The purpose of the present review is to summarize the evidence on clinical, biochemical, microbiologic, genetic markers as well as symptoms associated with plaque-induced gingivitis and to propose a set of criteria to define GC. A universally accepted case definition for gingivitis would provide the necessary information to enable oral health professionals to assess the effectiveness of their prevention strategies and treatment regimens; help set priorities for therapeutic actions/programs by health care providers; and undertake surveillance. Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score>30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4mm in depth.

Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions.

Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm-induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable "periodontitis patient" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a "case" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.

THE PREVALENCE OF PERIODONTAL TISSUE DISEASES IN YOUNG INDIVIDUALS ON THE BACKGROUND OF CROWDED TEETH

The abnormalities of maxillodental system take one of the leading places among diseases of the maxillofacial area. Thus, they are diagnosed more than in 50% cases among the younger population and in 30% cases among the adult population. &#x0D; Most often, there are prerequisites for the incorrect position of individual teeth: anomalies are formed at the genetic level because of heredity of pathologies of size, amount, shape of teeth and size of the jaw bones of the facial skeleton. If the position of the teeth is incorrect, the periodontium retains the occlusal load of the functional injury.&#x0D; Therefore, the aim of our research was to study the prevalence of periodontal tissue diseases in young individuals on the background of crowded teeth.&#x0D; The material and research methods. The study was conducted on the base of Dental Center of Danylo Galytsky Lviv National Medical University during 2015−2017 years. 1146 people at the age from 18 to 44 years were examined. Every participant of research underwent general dental examination, as well as a special examination aimed at clarification of orthodontic treatment. The diagnosis of periodontal tissue diseases was made according to the classification of N. F. Danilevskyi and was determined using paraclinical indicators. The obtained results were worked out statistically using functions of MS Excel and Statistica 6.&#x0D; Results of the research and their discussion. The total number of the examined with orthodontic pathology was found on average in 77.24% of patients (885 people). At the same time, abnormalities of dental jaw system were not detected in about 261 (22.76%) of the examined.&#x0D; As a result of the conducted studies we found that among the examined without dental jaw abnormalities 38.89±.,32% of patients had intact periodontium, that was 1.6 times more for data in individuals with crowding − 23.73±2.00, p&lt;0.01. At the same time, in patients of the main group the prevalence of periodontal tissue diseases was 1.2 times higher than in the examined of the comparative group (76.27±2.00% against 61.11±3.32%, respectively, p&lt;0.01).&#x0D; It should be noted, that with the increase of the age of patients the prevalence of periodontal tissue diseases increased in both study groups, but in patients with crowded teeth this tendency was more pronounced. So, in the younger age group in patients with crowding the prevalence of periodontal diseases was 1.5 times higher in relation to the data of their peers from the comparison group (71.37±3.00% vs. 46.99±5.48%, p&lt;0.01). In 27−35-year-old patients the prevalence of periodontal tissue diseases amounted to 72.38±4.03% of the examined of the main group and 65.62±5.94% of the examined of the comparison group, but the obtained data were not statistically significant, p&gt;0.05. At the same time, in the patients of the main group aged 36−44 years the prevalence of periodontal tissue diseases was maximal and exceeded the value of their peers in the comparison group by 1.2 times (92.08±2.69% vs. 73.91±5.29%, respectively, p&lt;0.01).&#x0D; The analysis of the obtained data allowed to assert that on average crowding of teeth on the upper jaw was found in 237 patients (52.55%) and on the lower jaw in 214 patients (47.45%).&#x0D; Thus, the maximum frequency of crowded teeth on the upper jaw was observed in the examined in the age range of 27−35 years, 60.16±4.41% of patients, with the minimum prevalence of this pathology in the youngest group (18−26 years), 49.34±4, 72%.&#x0D; The analysis of diagnostic structure of periodontal tissue diseases showed that inflammatory diseases of periodontal tissues (gingivitis, localized periodontitis) were found in patients with crowded teeth, on average 1.2 times more often than in patients without orthodontic pathology (42.42±1.88% vs. 36.33±3.54%, respectively, p&lt;0.05).&#x0D; Conclusions. Thus, as a result of the conducted studies, higher prevalence of periodontal tissue diseases was proved in patients with crowding of teeth, which made progress in increasing the age of the examined than in patients without orthodontic pathology.

A Wnt-Responsive PDL Population Effectuates Extraction Socket Healing

Stem cells residing in the periodontal ligament (PDL) support the homeostasis of the periodontium, but their in vivo identity, source(s), and function(s) remain poorly understood. Here, using a lineage-tracing mouse strain, we identified a quiescent Wnt-responsive population in the PDL that became activated in response to tooth extraction. The Wnt-responsive population expanded by proliferation, then migrated from the PDL remnants that remained attached to bundle bone, into the socket. Once there, the Wnt-responsive progeny upregulated osteogenic protein expression, differentiated into osteoblasts, and generated the new bone that healed the socket. Using a liposomal WNT3A protein therapeutic, we showed that a single application at the time of extraction was sufficient to accelerate extraction socket healing 2-fold. Collectively, these data identify a new stem cell population in the intact periodontium that is directly responsible for alveolar bone healing after tooth removal.

CLINICO-BIOCHEMICAL AND MORPHOLOGICAL CHARACTERISTICS OF PERIODONTAL DISEASE IN INDIVIDUALS OF THE CONTROL GROUP

Periodontal diseases are widespread all over the world. In this connection, the questions relating to the prevalence of these diseases, and the subtle mechanisms occurring in tissues in norm at the subcellular level it is important to investigate for a correct assessment of biochemical changes occurring in the pathology ofperiodontitis. The article analyzes the biochemical changes in the periodontal tissues with intact tooth rows and periodontium. Material for biochemical analysis obtained from 36 patients, while removing the first premolars with the aim of orthodontic treatment.

Поширеність та структура захворювань тканин пародонта у дітей із надмірною масою тіла

Epidemiological studies in recent years have shown a high prevalence of periodontal tissue diseases in children and adolescents in the world and in Ukraine in particular. One of the main general factors in the development of periodontal tissue diseases is the presence of concomitant pathology, one of which is an excessive body weight.The aim of the study – to learn the prevalence, structure and peculiarities of the clinical course of periodontal tissue diseases in overweight children.Materials and Methods. 278 children with overweight (the main group) were examined. The comparison group was made of 292 children with normal body weight. The study was conducted in age groups of 7, 12, 15 years old. The state of the periodontal tissues of the examined persons was objectified according to the classification of Danylevskyi (1994) and by using of the periodontal indices of PMA, CPI and hygienic index OHI-S. On the basis of the anthropometric examinations, the body mass index (BMI) was calculated.Results and Discussion. The results of the dental examination showed that the number of overweight children with intact periodontium was significantly lower (32.01 ± 2.8 %) compared with children with normal body mass (53.08 ± 2.92 %) (p &lt;0.01). On the other hand, the inflammatory process in the tissues of periodontium in overweight children, on average, was 67.99 ± 2.80 %, which was much higher in relation to children with normal body mass – 46.92 ± 2.92 % (p &lt;0.01).Conclusions. The results of the examination of periodontal tissues in overweight children indicate a high incidence and severity of inflammatory processes in periodontal tissues compared with normal weight children.