Mean Periodontal Pocket Depth Research Articles

Assessment of the relationship between oral health and adenoid hypertrophy in children aged 8 to 15 years

Background: The oral health of children is adversely affected by mouth breathing. One of the main reasons for mouth breathing in children is adenoid hypertrophy. Consequently, this study aimed to assess the relationship between oral health and adenoid hypertrophy among children aged 8–15 years in the city of Babol. Methods: This case-control study was conducted on 100 children. The case group included 50 children with adenoid hypertrophy. An Ear, Nose, and Throat (ENT) specialist examined the children clinically and referred them to the oral and maxillofacial radiology clinic. The study control group included 50 healthy children. To assess the size of the adenoidal tissues and the dimensions of the upper airways, we assessed the linear cephalometric measurement Ptm-ad2 . The evaluations consisted of the decayed, missing, and filled teeth (DMFT and dmft for permanent and primary teeth, respectively) index, mean periodontal pocket depth, plaque index (PI), and papillary marginal attached (PMA) index. Results: Fifty samples had adenoid hypertrophy. The prevalence of dental caries was significantly higher in children with adenoid hypertrophy compared to healthy children (DMFT was 4.10±2.09 and 2.06±0.97, and dmft was 3.52±3.34 and 1.48±1.24, in the case and control groups, respectively). Furthermore, the periodontal indices of the case group were significantly greater than those of the control group (periodontal pocket depth was 2.93±0.35 and 1.98±0.23, PI was 2.73±0.26 and 1.13±0.29, and the PMA index was 5.71±0.82 and 2.55±0.48, in the case and control groups, respectively). Conclusion: In the case group, there was a statistically higher prevalence of dental caries and gingival inflammation than in the control group. Therefore, periodical dental visits and preventive dental procedures are recommended for children with adenoid hypertrophy.

The relationship of dietary flavonoids and periodontitis in US population: a cross-sectional NHANES analysis.

We investigated the association between dietary flavonoids intake and periodontitis. This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey 2009-2010 on 3025 participants aged between 30 and 80 years who had full-mouth periodontal examination and dietary flavonoids intake data. This study used periodontal pocket depth (PPD) and clinical attachment loss (CAL) as periodontitis markers. Data were analyzed using multivariate linear regression. After adjusting confounders, the middle tertile of total dietary flavonoids was associated with decreased mean PPD (0.06mm, P = 0.016) and mean CAL (0.13mm, P = 0.001) and the top tertile of total dietary flavonoids was significantly associated with decreases in mean PPD (0.05mm, P = 0.029) and mean CAL (0.11mm, P = 0.010). Both the middle and top tertiles of total flavonoids intake were significantly related with decreased mean CAL in females, those flossing 0 days/week, overweight and non-diabetic population but not in males, smokers, those flossing 1-6 days/week and diabetic population. Higher anthocyanidins, flavones and flavonols intake was significantly associated with decreased mean PPD and mean CAL while higher flavanones intake was only significantly associated with decreased mean CAL. Higher anthocyanidins intake was particularly related with greatest decreases in mean CAL (top tertile: 0.22mm, middle tertile: 0.17mm, both P < 0.010). However, no significant associations were found between isoflavones and flavan_3_ols intake and mean CAL. Higher dietary flavonoids intake may be beneficial for periodontal health. Additional anthocyanidins, flavanones, flavones and flavonols intake was associated with improved periodontal health.

Correlation Between the Severity of Chronic Periodontitis and Coronary Artery Stenosis Involvement in Coronary Heart Disease (CHD) Patients

Periodontitis is independently related to coronary heart disease and significantly impacts the quality of human life. The aim of this study was to investigate the relationship between the severity of chronic periodontitis and the severity of coronary artery stenosis in CHD patients. A total of 75 subjects were recruited for this study. The severity of the coronary artery was measured by coronary angiography. Quantitative coronary angiography (QCA) was conducted to determine 1 vessel disease (VD), 2 VD, and 3 VD, followed by stenosis. The severity of chronic periodontitis was determined based on the mean periodontal pocket depth (Mean PPD). The &lt; 4 mm and 4 mm scores were categorized as mild and moderate-severe, respectively. Statistical analysis was conducted to determine the relationship between periodontitis and coronary artery by chi-square and followed by multivariate analysis using an ordinal regression test with a 95% confidence interval. P value &lt; 0.05 was considered statistically significant. The proportion of moderate-severe periodontitis was more dominant than mild periodontitis. 79.20% and 20.80% of subjects were categorized as moderate-severe periodontitis and mild periodontitis in the 3 VD group. In groups 1 and 2 VD, the proportion of mild periodontitis was higher than moderate-severe periodontitis (61.30% vs. 38.7%) and (70% vs. 30%), based on bivariate analysis of the involvement of the coronary artery. Multivariate analysis showed chronic periodontitis and dyslipidemia had estimates of 1.084 (95% CI range 0.162 - 2.006) and 1.141 (95% CI range 0.217 - 2.066) for the severity of coronary artery involvement with p-values of 0.021 and 0.016, respectively. Gender, age, smoking, DM, hypertension, and obesity were not statistically significant. A significant relationship between moderate-severe chronic periodontitis was found, followed by an increase in the severity of coronary artery compared to mild chronic periodontitis.

Evaluation of different local drug delivery systems in the management of chronic periodontitis: A comparative study

Periodontal disease is an immune-inflammatory disease affecting the soft tissues and alveolar bone and surrounding periodontal tissues. The standard treatment involves scaling and root planing (SRP) which removes the sub gingival microbial deposits effectively and the gingival health is maintained. Sometimes the treated areas may show regrowth of the microorganisms and the non-surgical periodontal treatment alone cannot eliminate the micro-organisms in mild periodontitis cases due to the difficulty in reaching the subgingival areas which are deeper and in complex root morphologies. So now a days the non-surgical periodontal treatment combined with the use of systemic antimicrobial agents and host modulating agents has shown to use effectively in the treatment of periodontal diseases.All the patients who were diagnosed with chronic periodontitis underwent initial therapy i.e., full-mouth scaling and root planing. Then the oral hygiene instructions were given to the patients and were recalled after 1 week (baseline visit). A total of 20 patients who met the inclusion criteria and showed satisfactory condition after the initial therapy with persistent periodontal pockets were included in this study. They were randomly assigned into two groups i.e., Group-A: metronidazole gel (metrogyl) and Group B: tetracycline fibre groups with 10 patients in each group. The periodontal clinical parameters like plaque index (PI), gingival index (GI) and periodontal pocket depth (PPD) were evaluated at the baseline visit before the application of local drug delivery and 15 and 30 days after the local drug delivery application.The mean plaque scores were reduced from 1.41±0.04 at baseline to 1.04±0.14 at 30 days. Likewise in Group-B the mean PI scores reduced from 1.50±0.10 at baseline to 1.25±0.18 at 30 days. The mean gingival index scores reduced from 1.41±0.04 at baseline to 1.01±0.04 at 30 days. Likewise in Group-B mean GI Scores reduced from 1.36±0.03 at baseline to 0.99±0.06 at 30 days. The mean PPD scores were reduced from 5.65±0.12 at baseline to 3.15±0.10 at 30 days in Group-A. Likewise in Group-B mean PPD scores reduced from 5.68±0.06 at baseline to 3.26±0.10 at 30 days. This study demonstrated that although thorough SRP is an effective treatment method for elimination of chronic periodontal pockets, improved results can be obtained by adjunctive use of locally administered metronidazole gel and tetracycline fibers.

Clinical outcomes of diode laser as an adjunct to nonsurgical periodontal therapy for residual periodontal pockets in mandibular second molars-a randomized controlled clinical trial.

The aim of this study was to evaluate the clinical outcomes of diode laser as an adjunct to nonsurgical periodontal therapy (NSPT) for residual periodontal pockets in mandibular second molars. Sixty-seven mandibular second molars (154 residual periodontal pockets) were recruited into the study and randomly assigned to the Laser + NSPT group and the NSPT group. The Laser + NSPT group underwent NSPT adjunct with diode laser radiation (wavelength: 810nm, power: 1.5 W, 40s maximum), while the NSPT group underwent nonsurgical periodontal therapy alone. Clinical parameters were measured at baseline (T0) and 4(T1), 12(T2), and 24(T3), weeks after treatment. Periodontal pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP) in both groups showed significant improvements at the end of study compared to baseline. The reductions of PPD, CAL, and BOP in the Laser + NSPT group were significantly greater than NSPT group. At T3, the Laser + NSPT group had a mean PPD of 3.06 ± 0.86mm, CAL of 2.58 ± 0.94mm and BOP of 15.49%, while the NSPT group had a mean PPD of 4.46 ± 1.57mm, CAL of 3.03 ± 1.25mm and BOP of 64.29%. The diode laser as an adjunct to nonsurgical periodontal therapy may contribute to clinical outcomes for residual periodontal pockets. However, the approach may cause reductionof keratinized tissue width. This study was registered in the Chinese Clinical Trial Registry ChiCTR2200061194. Diode laser as an adjunct to nonsurgical periodontal therapy may contribute to the clinical outcomes for residual periodontal pockets in mandibular second molars.

Periodontal Pocket Therapy Using a Class IV Dental Diode Laser in Dogs: A Retrospective Analysis.

Class IV dental diode lasers have been introduced as a nonsurgical therapy for periodontal pockets in veterinary and human dentistry. This retrospective case series evaluates the use of Class IV dental diode laser therapy for abnormal periodontal pockets in a specialty veterinary dental practice. A hypothesis that the Class IV diode dental laser is a useful adjuvant modality in canine periodontal pocket therapy in the reduction of clinical pocket depth was made. This article discusses and demonstrates diode laser use in periodontal pocket therapy in a specialty veterinary dental practice and reviews the current literature. Inclusion in this study was limited to client-owned dogs with noted periodontal pocketing on any tooth type between 3 and 6 mm, which were treated with closed root planing (RP/C) and laser therapy who returned in 6 to 7 months for recheck of the pockets from the years 2017 to 2020. Twelve patients met the inclusion criteria. A total of 128 periodontal pockets were included in the study. Each periodontal pocket was a case receiving therapy. The mean periodontal pocket depth before the treatment is measured as 3.35 mm. The mean pocket depth of the periodontal pockets following treatment was 0.59 mm. The mean improvement in periodontal pocket depths after diode laser therapy when considering patient and tooth number using linear mixed-effects modeling was 2.63 mm (95% confidence interval [CI]: 1.81-3.46, P < .0001). No statistically significant results were observed for pocket type, as P values were greater than .05.

Salivary cytokine expression after non-surgical periodontal therapy in smokers: 12-month follow-up.

Diverse smoking trajectories may influence cytokine expression after non-surgical periodontal therapy and supportive periodontal care. Thus, we aimed to describe cytokine profiles in periodontal healing after periodontal therapy in smokers. A smoking cessation program and non-surgical periodontal therapy were offered to 80 smokers with periodontitis. Smoking trajectories (quitters/light, moderate, heavy) were observed. The association of salivary interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α) with smoking trajectories and periodontal outcomes was determined using mixed-effects linear regression. Among quitters/light smokers, IL-1β was associated with an increase in mean periodontal pocket depth (PPD) and mean clinical attachment level (CAL). IL-6 was associated with a decrease in mean PPD and CAL in heavy smokers, whereas IL-8 was associated with a decrease in PPD among moderate smokers. TNFα was associated with a reduction in mean PPD and CAL among quitters/light smokers, while among moderate smokers, TNFα was associated with an increase in mean PPD and CAL. IL-12 and IL-13 were associated with a decrease in mean PPD in moderate smokers. Our findings suggest that distinctive smoking exposures induce differential cytokine expression, which, in turn, seems to influence periodontal repair.

Comparison of Non Surgical Periodontal Treatment Outcome and Clinician's Comfort Levels using LM ErgoMax over Hu-Friedy Hand Instruments-A Randomised Clinical Trial

Introduction: Non surgical periodontal therapy by scaling is done by using different sets of hand and motor driven instruments. The best instrument for non surgical periodontal therapy has to be identified, so that, it will benefit the clinicians in point of ergonomics and for patients in terms of less discomfort caused during scaling. Aim: To compare the effectiveness of Linear Monolithic (LM) instruments to Hu-Friedy instruments in non surgical periodontal treatment. Materials and Methods: The split-mouth randomised clinical trial study comprised 50 patients, who were selected from those attending the Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India, and who were classified with gingivitis or moderate to severe periodontitis according to American Academy of Periodontology (AAP) standards from 1999 and had not undergone any periodontal therapy in the previous six months to one year. The study was conducted from September 2021 to February 2022. Periodontal treatment outcomes were evaluated by plaque index, bleeding index, probing pocket depths, gingival index, and clinical attachment level. Clinicians comfort levels and handling characteristics of two sets of hand instruments (Test: LM instruments to control: Hu-Friedy instruments) were assessed by questionnaire consisting of 10 closed ended questions immediately after the non surgical therapy. The unpaired t-test was used for intergroup analysis and one-way ANOVA was used for intragroup analysis. Results: The mean gingival index scores for test and control sites at baseline were (1.65 and 1.72), at one week were (0.89 and 0.64) and at one month were (0.46 and 0.31). The mean periodontal pocket depth for test and control sites at baseline were (3.93 and 3.79), at one week were (3.40 and 3.25) and at one month were (3.18 and 2.42). A statistically significant difference seen in gingival index (p=0.001), sulcus bleeding index (p&lt;0.001), periodontal probing depths (p&lt;0.001) and clinical attachment level (p&lt;0.001) at one-month interval. Conclusion: The findings demonstrate that LM instruments have higher handling features and cutting efficiency than HuFriedy instruments, althou gh there is no significant difference in plaque index, gingival index, probing depth reduction, sulcus bleeding index, or clinical attachment level.

In Vivo Evaluation of the Efficacy of a Nisin-Biogel as a New Approach for Canine Periodontal Disease Control.

Periodontal disease (PD) is a common oral disease in dogs. Recent in vitro research revealed that nisin−biogel is a promising compound for canine PD control. In this work, a clinical trial was developed to assess the in vivo efficacy of nisin−biogel in dogs by determining the dental plaque index (DPI), gingivitis index (GI), and periodontal pocket depth (PPD) after dental administration. The biogel’s influence on aerobic bacteria counts was also evaluated, as well as its acceptance/adverse effects in dogs. Twenty animals were allocated to one of two groups: a treatment group (TG) subjected to a dental topical application of nisin−biogel for 90 days and a control group (CG) with no treatment. Besides daily monitoring, on day 1 (T0) and at the end of the assay (T90), animals were subjected to blood analysis, periodontal evaluation, dental plaque sampling, scaling, and polishing. Statistical analysis with mixed models showed a significant reduction in mean PPD (estimate = −0.371, p-value < 0.001) and DPI (estimate = −0.146, p-value < 0.05) in the TG animals at T90. A reduction in the GI (estimate = −0.056, p-value > 0.05) was also observed but with no statistical significance. No influence on total bacterial counts was observed, and no adverse effects were detected. The nisin−biogel was revealed to be a promising compound for canine PD control.

Evaluation of the Correlation between Systemic Osteoporosis and Periodontal Status in Menopausal Women

Introduction: Periodontitis is one of the most common periodontal diseases, characterized by destruction of connective tissue and supporting structure of the tooth. Osteoporosis is a systemic disease of skeletal tissue characterized by a decrease in bone mass and leads to the destruction of bone structure. The aim of this study was to evaluate the correlation between systemic osteoporosis and periodontal status in menopausal women referred to the bone density measurement center in Gorgan.&#x0D; Materials &amp; Methods: In this case-control study, 56 menopausal women aged 45-65 years participated. Among the participants, 28 individuals had osteoporosis and 28 women were healthy. Periodontal pocket depth (PPD), clinical attachment level (CAL), plaque index (PI) and gingivitis index (GI) were measured for each patient. Finally, the data were analyzed using 95% confidence level.&#x0D; Results: A total of 56 menopausal women were included in the study. The mean GI in the osteoporotic group was 0.74 ± 1.43 and in the non-osteoporotic group was 0.77 ± 1.32 (p value = 0.280). The mean periodontal pocket depth in the osteoporotic group (0.63 ± 3.73) was more than the non- osteoporotic group 0.57 ± 3.66 (p value = 0.363). PI mean in the osteoporotic and non-osteoporotic groups were 37.11 ± 15 and 37.39 ± 15, respectively (p value = 0.363).&#x0D; Conclusion: The mean clinical attachment level in menopausal women with osteoporosis was significantly higher than normal menopausal women. On the other hand, there was no significant difference in other indices of periodontal disease such as PPD, PI, GI.

Clinical and bacterial outcomes of photodynamic therapy in the treatment of chronic necrotizing ulcerative periodontitis

AimTo assess the clinical periodontal and microbiological parameters in patients having chronic necrotizing ulcerative periodontitis (NUP) after the administration of adjunctive photodynamic therapy and non-surgical periodontal therapy in smokers, mal-nutrition and HIV positive individuals. Materials and MethodsA total of 30 individuals with NUP were selected for the present clinical trial, where both Group I and Group II had equal number of patients, respectively (15 each). The groups were divided on the basis of provision of treatment where patients in Group I underwent scaling and root planing (SRP). Furthermore, Group II patients were subjected to adjunctive phtotodynamic therapy and SRP (aPDT + SRP). Full mouth plaque scores (fmpS), full mouth bleeding on probing (fmBOP), periodontal pocket depth (PPD) and clinical attachment levels (CAL) were the clinical periodontal parameters that were carefully evaluated. Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg) and Tannerella forsythia (Tf) were the bacteria species which were evaluated. The assessments were done at baseline, three (3) months and six (6) months, respectively. ResultsAll periodontal parameters including fmpS, fmBOP, PPD and CAL significantly improved in both Group I and Group II, respectively. Group II patients subjected to aPDT + SRP reported higher reduction in mean PPD in comparison to Group I patients at follow up (p < 0.05). At follow-up, similar results were also reported for CAL gain where Group II (aPDT +SRP) patients reported higher CAL gain in comparison to patients who underwent SRP only (p < 0.05). From baseline to follow-up, all the bacterial levels exhibited reduction in both study groups i.e Group I (SRP) and Group II (aPDT + SRP), respectively (p < 0.05). However, Group II patients prominent reduction in the counts of Aa and Tf at the three-month interval, whereas Aa seem to reduce in HIV and smoking individuals at the six-month interval. Moreover, the levels of Pg and Tf significantly reduced at 3 months and only Aa at 6 months in patients with mal-nutrition, respectively (p < 0.05). ConclusionThe use of photodynamic treatment as an adjunct to scaling and root planing enhanced clinical periodontal results and reduced bacterial content in patients having NUP.

POTENTIAL ROLE OF OSTEOCALCIN AND OSTEOPROTEGRIN IN DETERMINING THE CONNECTION BETWEEN RHEUMATOID ARTHRITIS AND PERIODONTITIS: PERSPECTIVE CASE STUDY FROM LOCAL POPULATION OF PUNJAB, PAKISTAN

Objective: The aim of this study was to determine the association between Rheumatoid Arthritis and Periodontitis with the help of biomarkers Osteocalcin and Osteoprotegerin. Materials and Methods: One hundred and twenty subjects were enrolled using consecutive nonprobability sampling for four groups, i.e., controls, clinically diagnosed cases of Rheumatoid Arthritis and Periodontitis, and both after informed consent (attached in the end). Serum Osteocalcin and Osteoprotegerin were measured along with Anti-CCP antibodies and clinical measures of severity of Periodontitis with the help of bleeding on probing (BOP), clinical attachment loss (CAL) and periodontal pocket depth (PPD). ANOVA and post hoc analysis were used to determine the difference of mean in different groups using SPSS 21. Results: Mean Osteocalcin and Osteoprotegerin were equally distributed among all four groups, although showing trends of increase and decrease in mean plots, respectively (using ANOVA, p value= 0.711, 0.15, respectively). Anti-CCP antibodies, mean CAL, mean BOP, mean PPD, and age were significantly different in four groups (p-value &lt; 0.05 for all). Gender and RA factor were homogenous in all groups (p-value &gt; 0.05 for both), i.e., there was the same number of males and females in each group, and the Rheumatoid factor was equally distributed in patients of all four groups. This proves the fact that the RA factor is just a sensitive test and not a specific test for the diagnosis of Rheumatoid Arthritis. Conclusion: It is concluded that at the current sample size of 120 subjects, i.e., 30 controls and 30 patients each in with either Rheumatoid Arthritis or Periodontitis or both, there is no difference in mean Osteocalcin and Osteoprotegerin levels.

Impact of tooth-related factors on photodynamic therapy effectiveness during active periodontal therapy: A 6-months split-mouth randomized clinical trial.

The persistence of periodontal pockets > 5 mm after periodontal treatments increases the risk of periodontitis recurrence and the need of periodontal surgery. This study evaluated the impact of tooth-related factors on the effectiveness of adjunctive photodynamic treatment (PDT) in the reduction of pockets > 5 mm during active periodontal treatment. Thirty-six patients suffering from severe chronic periodontitis were evaluated in a 6-months split-mouth randomized clinical trial. Each quadrant was assigned to test (scaling and root planing (SRP) + PDT) or control (SRP alone) group. PDT was conducted using the toluidine blue O and a light-emitting diode (LED) with a red spectrum. PDT applications were performed immediately after SRP, 7 days later and at 3 months. Plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline, 3 and 6 months. Multilevel analysis showed a significant reduction of pockets > 5 mm in test group in comparison with control group at 3 (OR = 0.69) and 6 months (OR = 0.77). This effect was mainly observed at 6 months in initially deep sites (PPD > 6 mm) with BOP (OR = 0.57). At sites exhibiting PI > 1 no PDT effect was observed. A more moderate PDT effect was observed on mean PPD and BOP reductions at 3 months only. Repeated applications of PDT significantly improved SRP outcomes, reducing by more than 40% residual pockets > 5 mm in initially deep and bleeding on probing periodontal sites. PDT effect was negatively influenced by dental plaque accumulation.

No evidence to support benefit of 14-day courses of amoxicillin-plus-metronidazole as adjunct to non-surgical periodontal treatment at three months.

Data sources Databases including Embase, MEDLINE, The Cochrane Central Register of Controlled Trials and the WHO International Clinical Trial Register Platform were screened by two reviewers. A manual search has been performed in references from included articles and relevant reviews.Study selection Blinded, placebo-controlled, randomised clinical trials (RCTs) with a minimum follow-up of three months were included. Primary outcomes were periodontal pocket depth (PD) and clinical attachment level (CAL) changes after non-surgical periodontal treatment with adjunctive use of amoxicillin/metronidazole vs placebo in periodontitis patients. Secondary outcomes were adverse events and compliance.Data extraction and synthesis Data were extracted and compiled in a spreadsheet. Studies were grouped according to duration (seven days or fourteen days) and dose of amoxicillin/metronidazole regimen (lower dose (mg): 250/200, 375/250, 375/500, 500/250 and higher dose (mg): 500/400, 500/500). Meta-analyses were performed using inverse-variance method. Random-effect models were applied and weighted mean differences were estimated for PD reduction and CAL changes at three months. Risk of bias was assessed using the Cochrane Collaboration tool.Results Eighteen studies were identified and included in the systematic review. Among them, 15 were pooled for meta-analysis. The use of a wide range of antibiotics concentrations (amoxicillin (from 250 to 500 mg) and metronidazole (from 200 to 500 mg)) was reported and the duration of antibiotic administration ranged from three to 14 days. Eleven studies were performed in chronic periodontitis patients and six in aggressive periodontitis patients. No significant differences were found regarding mean PD and mean CAL changes according to the duration or dose of administered antibiotics (Table 1). Risk differences for adverse events in the higher dose and longer duration groups were minimally greater (0.04 and 0.05 respectively).Conclusions Longer courses (14 days) of antibiotics adjuvant to non-surgical therapy do not appear to provide better results in terms of PD reduction or CAL gain at three months. No differences were found between high and low dose groups. In this context, 400/500 mg or 500/500 mg of amoxicillin/metronidazole three times per day should be recommended for seven days.

Relationship between periodontal inflammation and calcium channel blockers induced gingival overgrowth-a cross-sectional study in a Japanese population.

Periodontal inflammation is regarded as a risk factor for drug-induced gingival overgrowth (DIGO). In order to elucidate the involvement of periodontal inflammation in DIGO, the periodontal status of subjects who do not develop DIGO despite receiving causative drugs (non-responders) needs to be examined. Therefore, the aim of the present study which was a pilot study was to assess periodontal inflammatory variables in responders (calcium channel blocker induced-GO patients), non-responders, and patients who did not receive causative drugs (non-consumers). The following parameters were measured: (1) existence of gingival overgrowth, (2) number of teeth, (3) mean periodontal pocket depth (PPD), and (4) percentage of positive sites for bleeding on probing (BOP). The periodontal inflamed surface area (PISA) and periodontal epithelial surface area (PESA) and the PISA/PESA ratio which indicated the degree of periodontal inflammation in each patient were also used to evaluate periodontal inflammation. Thirteen responders, 32 non-responders, and 83 non-consumers were included in the analyses. The mean PPD, percentage of BOP, PESA, and PISA, and the PISA/PESA ratio were significantly higher in responders than in non-responders and non-consumers (p < 0.01). The BOP, PISA, and PISA/PESA ratio were significantly lower in non-responders than in non-consumers (p < 0.05). A positive correlation was found between PPD and age in non-consumers. On the other hand, a negative correlation was noted between PPD and age in non-responders. Periodontal inflammation may be associated with the initiation of DIGO. It could be speculated that periodontal therapy before the administration of calcium channel blockers may prevent the development of gingival overgrowth.

Relationship between BMI ≥25 and periodontal status: A case‒ control study.

Background Obesity is an important subject in both developed and developing countries. Obesity is a risk factor for many diseases, including cardiovascular diseases, hypertension and osteoarthritis. Periodontitis is a prevalent, chronic disease and multiple factors have been proposed to contribute to its progression. we aimed to compare the periodontal status of normalweight and obese individuals. Methods In this study, we consecutively selected 100 patients (50 obese and overweight as the case group, based on body mass index [BMI], and 50 others with normal weight, as the control group) referred to the Periodontology Department of Mashhad Dental School. The demographic data of the participants were recorded, including age, gender, height and weight. The following periodontal parameters were assessed: periodontal pocket depth (PPD), clinical attachment level (CAL) and plaque index. Kolmogorov-Smirnov test, chi-squared test and independent t-test, as well as ANCOVA, were used to analyze data. Results We found that the mean PPD was similar in the test and control groups (P=0.168). Moreover, CAL was not significantly different between the two groups (P=0.494). Conclusion Our findings indicated that obesity and overweight do not seem to have an association with periodontal parameters such as periodontal pocket depth and clinical attachment loss. Further research is needed to evaluate this relationship.

Association between Helicobacter pylori gastritis and dental diseases: A cross-sectional, hospital-based study in Eastern Saudi Arabia.

There is inconsistent evidence about the association between Helicobacter pylori (H.pylori) and dental diseases with possible effect of environmental factors. The aims of the study were to assess (1) the association between gastric and oral H.pylori colonization and (2) the association between oral colonization of H.pylori and dental diseases. A cross-sectional study was conducted in King Fahad University hospital in Khobar, Eastern Saudi Arabia in 2017. Patients admitted to the Endoscopy Unit were recruited and clinically examined for plaque, decayed teeth (D), filled teeth (F), missing teeth (M), periodontal pocket depth (PPD), attachment loss (AL), and gingival bleeding in addition to assessing their age, gender, education, tooth brushing, flossing, and tobacco use with a questionnaire. Pooled dental plaque samples were collected and analyzed using nested polymerase chain reaction PCR to detect oral H.pylori. Gastroscopy was used to extract biopsies to assess gastritis and the presence of gastric H.pylori using Giemsa stain. Regression analysis was used to assess differences between patients with and without gastritis, oral H. pylori and gastric H. pylori in the percentage of sites with gingival bleeding, PPD, CAL, D, M, and F with adjustment for confounders. One hundred twenty patients were included. Most of them brushed daily (82.6%) and had university education (45.7%). Of these, 34.2% had gastric H.pylori and 5% had oral H.pylori. No significant association was observed between the percentage of sites with gingival bleeding, mean PPD, AL, F, and either gastritis, the presence of oral or gastric H.pylori. Patients with gastritis had significantly higher number of D and M than patients without gastritis (P= 0.03). In this study, the presence of gastric and oral H.pylori in patients with good oral hygiene and moderate socioeconomic status is not significantly associated with periodontal diseases. Patients with gastritis tend to have a higher number of decayed and missing teeth.

Influence of lack of posterior occlusal support on cognitive decline among 80-year-old Japanese people in a 3-year prospective study.

Previous studies have reported significant associations between tooth loss or periodontal status and cognitive function; however, animal experimental studies have shown that occlusion might be a more important factor in cognitive decline. The purpose of the present study was to investigate the influence of a lack of posterior occlusal support by residual teeth on the decline of cognitive function over a 3-year period among 80-year-old Japanese people. Participants were community-dwelling older adults (n = 515, age 79-81 years). Cognitive function was measured using the Japanese version of the Montreal Cognitive Assessment. At baseline, participants were divided into two groups: those with and without posterior occlusal support. Participants whose Japanese version of the Montreal Cognitive Assessment score decreased by ≥3 points over the 3-year period were defined as the declined group. Logistic regression was carried out for the decline in Japanese version of the Montreal Cognitive Assessment scores, including dental status and possible risk factors as independent variables. More participants without posterior occlusal support tended to be in the cognitive decline group (49.4%) than in the maintained group (38.5%; χ2 -test, P = 0.02). Logistic regression analysis showed that a lack of posterior occlusal support was a significant variable (odds ratio 1.55, P = 0.03) for cognitive decline, even after adjusting for other risk factors. However, the number of teeth or mean periodontal pocket depth was not significantly correlated with cognitive decline. The present findings suggest that a lack of posterior occlusal support predicted the incidence of cognitive decline, even after adjusting for possible risk factors in community-dwelling old-old people. Geriatr Gerontol Int 2018; 18: 1439-1446.

Retrospective study of combined splinting restorations in the aesthetic zone of periodontal patients.

This retrospective study evaluated the clinical performance of combining a fiber-reinforced, composite-resin (FRC) bonded splint; bridge; fiber post; and/or resin veneer for the restoration of periodontally-involved anterior teeth. Sixty-three patients with periodontally-involved anterior teeth each received one of the following splinting restorations: FRC-bonded splint-bridges (SB), a combination of an FRC-bonded splint and resin veneer (SV), or FRC-bonded splints (S). Six patients with healthy periodontal teeth received orthodontic retainers with FRC-bonded splints (OS) as a control. Modified USPHS criteria were used to evaluate the effects of rehabilitation, and the periodontal pocket depth (PPD) and clinical attachment level (CAL) of the natural teeth were measured. All restorations resulted in good aesthetic outcomes. SV, S in combination with fiber posts and OS all resulted in 100% acceptable ratings for each category that was directly evaluated at each follow-up. The mean PPD was 3.5 ± 1.0 mm at baseline, decreased to 3.3 ± 1.0 mm after one year (p <0.05), and subsequently increased to 3.5±1.0 mm again after four years (p >0.05). These changes were similar to those in the mean CAL. A combination of a FRC-bonded splint, bridge, fiber post and/or resin veneer for minimally invasive prosthodontic treatment in the aesthetic zone is a good choice for periodontal patients.

The relationship between recurrent aphthous stomatitis, and periodontal disease and Helicobacter Pylori infection.

Recurrent aphthous stomatitis (RAS) is a common oral mucosal disease with unknown etiology. This cross-sectional study aimed to test the hypothesis that Helicobacter pylori and periodontal disease might play an etiological role in RAS. Dental plaque samples obtained from 38 patients with RAS and 43 healthy individuals via periodontal examinations were examined for H. pylori colonization. H. pylori was identified using the rapid urease test (RUT). The periodontal status of the patients and controls was based on the following periodontal parameters: periodontal pocket depth (PPD), the plaque index (PI), the gingival index (GI), and clinical attachment loss (CAL). RUT results were positive in 34 (89.5%) of the 38 patients and 24 (55.8%) of the 43 controls (P = 0.002). There were not any significant differences in mean PPD, PI, GI, or CAL between the patient and control groups (P > 0.05). Mean PPD, PI, GI, and CAL were higher in the RUT-positive RAS patients than in the RUT-negative patients (P > 0.05, for all). The present findings show that H. pylori might have played an etiological role in RAS and might have caused periodontal disease, but RAS was not associated with any of the periodontal parameters examined in this study. The present study indicates that H. pylori plays a role in the development of RAS, but periodontal diseases have no effect on it. Eradicating H. pylori might be useful to prevent RAS.