Mild Chronic Periodontitis Research Articles

Assessment of cardiovascular risk in patients with chronic periodontitis

Abstract Introduction To effective prevention of cardiovascular morbidity and mortality in populations with an unfavorable cardiovascular profile, it is important to analyze the occurrence and severity of traditional risk factors and the calculated risks of cardiovascular events. Aim Estimation of cardiovascular risk in patients with chronic periodontitis (CP) different severity. Methods We examined 2400 person (65.6% male, aged from 40 to 64 years), of these 466 had health periodontium (HP), 1934 had CP different severity. Considered exclusion criteria were known diabetes and cardiovascular diseases. The 10-year risk of a cardiovascular event was calculated using SCORE (Systematic Coronary Risk Evaluation) and Reynolds Risk Score (RRS). Results There were no differences between the groups with HP and mild CP in the incidence of calculated 10-year risk of a cardiovascular event. Severity of periodontitis was associated with a higher cardiovascular risk on the SCORE. High risk on the SCORE in the group with HP was found in 10.3%, and in patients with moderate and severe CP-in 34.1%, 48.5% respectively. Using the RRS among 538 patients with moderate risk on the SCORE was showed the results: 48 (8.9%) patients were classified as low risk, 258 (48%) - the moderately low risk category (5% to 10%), 192 (35.7%) patients -a moderately high risk (10% to 20%) and 40 (7.4%) - high risk (≥20%). There was an association between SCORE index with the number of missing teeth (Spearman's R=0.591) and the loss of periodontal bone according to panoramic x-ray (R = 0.46). RRS index correlated with the severity of periodontal inflammation: the periodontal index (R=0.43), and the depth of periodontal pockets (R=0.38). Conclusion The relationship between the results of severe CP as missing teeth, loss of periodontal bone and the risk of fatal cardiovascular events is important for clinical use and can be an additional cardiovascular risk marker for patients with CP. Funding Acknowledgement Type of funding source: None

Investigation of the levels of different salivary stress markers in chronic periodontitis patients

Background and aimIn this study, we aimed to determine the salivary levels of cortisol, α-amylase, β-endorphin, and chromogranin (CgA) in saliva and to investigate their relationship with periodontitis. MethodsThirty-seven female and 43 male periodontitis patients who presented to the Periodontology Department of the XXX University Faculty of Dentistry participated in the study. The individuals were divided into three groups: mild, moderate, or severe chronic periodontitis. Plaque index (PI), gingival index (GI), clinical attachment loss (CAL), and probing depth (PD) measurements were recorded for all the participants. All participants underwent the State–Trait Anxiety Inventory test (STAI 1 and 2). Between 09:00 and 11:00 a.m., saliva samples from the participants were collected into tubes within an average of five minutes. ResultsHigher cortisol measurements were detected in the saliva samples of participants with severe chronic periodontitis than in those who had mild chronic periodontitis (P < 0.05). There were statistically significant age differences among patients with mild–moderate, moderate–severe, and mild chronic periodontitis, the severity of the disease increasing with age (P < 0.05). There was also a positive correlation between STAI 1 stress scores and cortisol levels. Similarly, there was a positive correlation between CAL and cortisol levels (P < 0.05). However, a significant difference was found among groups only in terms of salivary cortisol levels (P < 0.05). ConclusionWithin the limitations of this study, there was found to be a relationship between saliva cortisol levels and periodontitis and between salivary cortisol levels and stress.

Evaluation of Osteocalcin Levels in Saliva of Periodontitis Patients and Their Correlation with the Disease Severity: A Cross-Sectional Study.

Objectives The present study aimed to investigate osteocalcin levels in saliva of healthy and periodontitis patients and correlate these levels with periodontitis severity. Materials and Methods This cross-sectional study was conducted in a hospital setup. A total of 95 individuals participated in the study with 46 subjects in group I (healthy individuals) and 49 subjects in group II (mild, moderate, and severe chronic periodontitis patients). A detailed assessment of clinical periodontal parameters and alveolar bone loss was made. Unstimulated saliva samples were collected from all study subjects and osteocalcin levels were quantitatively analyzed by sandwich enzyme-linked immunosorbent essay technique. Statistical Analysis One-way analysis of variance, Spearman’s correlation test, and Pearson’s chi-squared test were applied at a significance level of 95%. p -Values less than 0.05 were considered statistically significant. Results The results showed a significant association of qualification with group II ( p < 0.02). Bone loss scores were also significantly associated with periodontitis severity ( p < 0.01). However, no statistically significant difference was observed between group I and group II in terms of mean salivary osteocalcin levels ( p = 0.68). Also, an insignificant correlation was also observed between osteocalcin levels and periodontitis severity ( p = 0.13). Conclusion The overall study results showed that there was no significant difference between saliva osteocalcin levels of healthy and periodontitis patients. Also, there was a nonsignificant correlation between osteocalcin levels and periodontitis severity. The findings of the present study support the hypothesis that low osteocalcin levels in saliva might be considered as a poor indicator of periodontal disease progression and severity.

Комплексный анализ применения фитопрепарата «пародонтоцид» в консервативном лечении больных хроническим генерализованным пародонтитом легкой степени

A comprehensive clinical and laboratory analysis of the use of the phytoremedy «Parodontocide» in the complex treatment of chronic periodontitis was carried out. «Parodontocide» contains sage oil, peppermint oil, sage oil, clove oil, allantoin, phenyl salicylate and it demonstrates a pronounced anti-inflammatory and repairing effect. It was well tolerated by the majority of patients, practically causing no adverse reactions and complications in comparison with other medications. That's precisely why «Parodontocide» can be used in a comprehensive treatment program for mild chronic periodontitis and in patients with intolerance to synthetic antiseptics as a part of monotherapy.

Associations of impaired glucose metabolism with chronic peridontitis in pre-diabetes patients

Objective To investigate the associations of impaired glucose metabolism and insulin resistance with chronic periodontitis in pre-diabetes patients. Methods A cross-sectional analysis was conducted and we included a total of 171 pre-diabetes patients aged 30-65 years, free of diabetes. pre-diabetes was defined as impaired fasting glucose (IFG) [fasting glucose (FG): 6.1-7.0 mmol/L] and/or impaired glucose tolerance (IGT) [oral glucose tolerance test (OGTT): 7.8-11.0 mmol/L]. Chronic periodontitis was defined according to Centers for Disease Control and Prevention (CDC)/American Academy of Periodontology (AAP) definition and the patients were divided into mild, moderate, and severe chronic periodontitis groups [mild: at least two interproximal sites with clinical attachment loss (CAL) ≥3 mm and at least two interproxima sites with probing depth (PD) ≥4 mm or 1 site with PD≥5 mm; moderate: at least two interproximal sites with CAL ≥4 mm and at least two interproxima sites with at least two interproximal sites with PD ≥5 mm; severe: at least two interproximal sites with CAL ≥6 mm and at least one interproxima site with at least two interproximal sites with PD≥5 mm]. A periodontal examination indexes [plaque index (PLI), PD, CAL, and bleeding on probing (BOP)] and glucose metabolism indexes [FG, OGTT, hemoglobinA1c (HbA1c), fasting insulin and homeostasis model assessments of insulin resistance (HOMA-IR)] were measured. The association of glucose metabolism and chronic periodontitis was investigated by multivariable logistic regression analysis. Results FG in the moderate and severe chronic periodontitis groups was significantly higher compared with mild chronic periodontitis group, HOMA-IR in the moderate and severe chronic periodontitis groups was significantly higher compared with mild chronic periodontitis group, OGTT in the severe chronic periodntitis group was significantly higher compared with mild chronic peridontitis group and moderate chronic periodontitis groups, and there was no significant difference between moderate and mild chronic periodontitis groups. For the insulin and HbA1c, there was no significant difference among mild, moderate and severe chronic periodontitis groups. After multivariable adjustment of age, gender, smoking status, hypertension and body mass index, IFG (OR=1.39, 95%CI: 1.01-1.98) and HOMA-IR (OR=1.36, 95%CI: 1.04-1.76) were associated with moderate periodontitis; IFG (OR=1.64, 95%CI: 1.17-2.40), IGT (OR=1.65, 95%CI: 1.21-2.26), and HOMA-IR (OR=1.72, 95%CI: 1.23-2.41) were significantly associated with severe periodontitis. Conclusion Our data provided evidences that impaired glucose metabolism were associated with chronic periodontitis among pre-diabetes patients.

Prosthetic treatment using a partial denture with self cleaning properties for a patient with generalized mild chronic periodontitis; A case report

Prosthetic treatment using a partial denture with self cleaning properties for a patient with generalized mild chronic periodontitis; A case report

The Role of Porphoromonas Gingivalis in Rheumatoid Arthritis and Periodontitis by Using Subantimicrobial Dose Doxycycline

ABSTRACTPurpose: The current study was directed to estimate the role of porphoromonas gingivalis in the relation between rheumatoid arthritis and periodontitis by using subantimicrobial dose doxycycline.Subjects and methodology: The current study was accomplished on twenty patients who had mild or moderate chronic periodontitis and rheumatoid arthritis they were partitioned into two groups: Group I; ten patients were exposed to mechanical debridement only and Group II: ten patients were exposed to mechanical debridement added to receiving small dose doxycycline (SDD) as a host modulatory agent (20mg twice daily) for three months. Results: group I exhibited a greatly significant improvement in clinical parameter in correlation to group II after three months follow up. Group II showed the statistically significantly lowest percentage decrease in number of bacteria in synovial fluid Conclusion: The adjunct use of doxycycline as host modulatory agent improved the treatment outcomes when used with mechanical debridement in rheumatoid arthritis and patients with periodontitis.KEYWORDS: Rheumatoid Arthritis, Periodontitis, low dose doxycycline, Porphoromonas Gingivalis

Avidity of serum immunoglobulin G antibodies to &lt;i&gt;Porphyromonas gingivalis&lt;/i&gt; in the elderly with chronic periodontitis

The present study aimed at evaluating serum immunoglobulin G (IgG) avidity to Porphyromonas gingivalis in elderly patients with mild and severe chronic periodontitis. The avidity of antibodies against P. gingivalis present in the sera of 18 patients with mild chronic periodontitis and 18 patients with severe chronic periodontitis was evaluated using an ammonium thiocyanate-dissociated enzyme-linked immunosorbent assay (ELISA). The results showed that the mean absorbance value in serum IgG antibody titers was significantly higher in the severe chronic periodontitis group than in the mild chronic periodontitis group (198 ± 35 ELISA unit [EU] vs. 142 ± 32 EU, p < 0.01). However, there was no significant difference between the two groups in antibody avidity (65 ± 57 EU vs. 54 ± 27 EU). These findings suggest that humoral immune responses to P. gingivalis between mild and severe chronic periodontitis in elderly patients are characterized by the differences in the quantity rather than the quality of the antibodies.

Association between hypertension and chronic periodontitis in a Portuguese population

Introduction: Periodontal disease (PD) is an inflammatory disease of the periodontal tissues. Periodontal disease is highly prevalent in adolescents, adults, and elderly, and is a major public health concern [1,2]. Previous studies show a slight superior prevalence of mild forms in young adults [3], and a significant difference in periodontal disease type distribution by gender, with severe generalized chronic periodontitis condition being more prevalent in men [4,5]. Moderate periodontitis is even more common, affecting 40–60% of adults [6,7]. Over the last years, PD have been associated with arterial hypertension [6–8]. Therefore, the aim of this study was to evaluate the possible association between the prevalence of self-reported hypertension and the periodontal status in an adult Portuguese population. Materials and methods: This study was approved by the Egas Moniz Ethical Committee (Ethical Application Ref: 595). This retrospective observational study included patients from the Periodontology Department, that were diagnosed between April 2017 and April 2018. Before clinical examinations, all patients answered a general and oral health questionnaire that included information such as age, gender, smoking status, self-reported general medical history and medication. Periodontitis was defined according to Page & Eke [9]. From a total of 267 patients, 7 were excluded due to incomplete data. Thus, it was gathered a final sample size of 260 patients. Descriptive and inferential statistics methodologies were applied, using IBM SPSS Statistics version 24.0 for Macintosh. Results: From the 260 patients (mean age 56.6 ± 12.4), the majority had severe chronic periodontitis (n =140, 53.8%). Patients with none or mild chronic periodontitis didn’t refer hypertension. The prevalence of self-reported hypertension was 38.61% and 36.43%, in patients with moderate and severe chronic periodontitis respectively. Overall, there was a statistical difference between the prevalence of self-reported hypertension between the severity of chronic periodontitis type (p = 0.004) (Table 1). Discussion and conclusions: The results show a statistical difference in the prevalence of self-reported hypertension according to the chronic periodontitis severity. To minimize potential bias, we tried to overcome the limitation of being a self-reported hypertension information by confirming current medication of the patient. The findings in this sample are according to the previous studies referred overhead.

Chronic periodontitis impairs polymorphonuclear leucocyte-endothelium cell interactions and oxidative stress in humans.

To evaluate the relationship between oxidative stress parameters in polymorphonuclear leucocytes (PMNs) and PMN-endothelial cell interactions in patients with chronic periodontitis (CP) according to different degrees of severity of the disease. For this cross-sectional study, 182 subjects were divided into four groups according to degree of CP: without CP (n=37), mild CP (n=59), moderate CP (n=51), and severe CP (n=35). We determined anthropometric and biochemical variables, periodontal parameters, inflammatory markers, oxidative stress parameters (superoxide and mitochondrial membrane potential), and PMN-endothelium cell interactions (rolling flux, velocity, and adhesion). Systemic inflammatory markers-C-reactive protein, leucocyte count, TNFα, and retinol-binding protein 4-were altered in the group with CP. Total superoxide was augmented in patients with moderate and severe periodontitis, whereas mitochondrial membrane potential did not change. Furthermore, PMNs adhesion and rolling flux were increased in subjects with CP. In a systemic proinflammatory environment, PMNs from patients with CP exhibit hyperactivity and produce higher amounts of superoxide. In parallel with this, an increase in PMNs rolling flux and cell adhesion to the endothelium suggests the presence of alterations of PMN-endothelium interactions in patients with CP that can lead to atherosclerosis and cardiovascular complications.

Evaluation of Hematocrit Level, Red Blood Cells and White Blood Cells Counts in Blood from Patients with Different Severities of Periodontal Diseases

Background: Anemia of chronic disease (ACD) occurs in the presence of chronic infection, inflammatory conditions or neoplastic conditions despite of adequate iron and vitamins storage. Gingivitis is the inflammation of the gingiva, periodontitis is the inflammation in the periodontium that extend deeper with loss of connective tissue attachment and supporting bone. The main pathogenesis of periodontal diseases and ACD is immune activation. Aims of study: Determine and compare the clinical periodontal parameters (plaque index (PLI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL)). Evaluate the hematocrit (Hct) level, red blood cells (RBCs) count and white blood cells (WBCs) count. Assess the correlations between the clinical periodontal parameters and hematological parameters at patients had gingivitis, chronic periodontitis (CP) with different severities (mild, moderate and severe) with healthy periodontium subjects. Materials and Methods: 35-50 years old, 150 male subjects were included in this study. They were divided into three study groups: group of 30 patients with gingivitis, group of 90 patients with CP which subdivided into (Mild CP=30 patients, Moderate CP =30 patients, Severe CP =30 patients) and control group 30 subjects with clinically healthy periodontium. Blood samples were collected then by automated blood analyzer the Hct, RBCs and WBCs were evaluated. Results: Comparisons among groups and subgroups revealed significant differences in Hct and WBCs, while RBCs was non-significant. Means values of RBCs count showed reduction in mild and severe CP subgroups. while, the Hct and WBCs mean values increased in patients with periodontal disease. The correlations between the clinical periodontal parameters with WBCs and RBCs were almost non-significant but, with Hct was mostly significant negative correlations. Conclusion: Inflammatory and immune responses in periodontal diseases caused change in different hematologic parameters which could contribute to the development of anemia of chronic disease.

Severity of chronic periodontitis and risk of gastrointestinal cancers: A population-based follow-up study from Taiwan.

The present study aimed to assess the association between the severity of chronic periodontitis and the risk of gastrointestinal (GI) cancers by investigating whether severe chronic periodontitis (CP), rather than mild CP, correlates with an increased risk of total or individual GI cancers.Adults (≥18 years) with mild and severe CP were identified from a random sample of 2 million insured patients in the National Health Insurance Research Database (2001–2010). After propensity score matching, 25,485 individuals, each with mild or severe CP, were included for comparison. The primary endpoint was the incidence of total or individual GI cancers, including cancers of the esophagus, stomach, small intestine, colon/rectum, and pancreas. Cox proportional hazard models with the robust aggregated sandwich estimator were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for known risk factors.GI cancers occurred in 275 individuals with mild CP and 324 individuals with severe CP. After adjusting for known risk factors, severe CP was not associated with an increased risk of total GI cancer relative to mild CP (HR: 0.99, 95% CI: 0.84–1.16) or individual GI cancers, including esophageal (HR: 1.15, 95% CI: 0.62–2.15), gastric (HR: 1.01, 95% CI: 0.68–1.49), small intestinal (HR: 0.70, 95% CI: 0.22–2.22), colorectal (HR: 0.95, 95% CI: 0.78–1.16), and pancreatic cancers (HR: 0.90, 95% CI: 0.47–1.75).Severe CP was not associated with an increased risk of total or individual GI cancers when compared with mild CP.

Comparative evaluation of efficacy of oral curcumin gel as an adjunct to scaling and root planing in the treatment of chronic periodontitis

Background: A large number of in vitro and in vivo studies in both animals and humans have reported that curcumin has antioxidant, anti-inflammatory, anti-carcinogenic, anti-microbial and anti-parasitic properties. Curcuma longa is also used externally for inflammation of oral mucosa. To overcome the adverse effects caused by the chemical agents, curcumin is proposed as an alternative for the treatment of gingivitis and periodontitis. Aim: This study aimed to evaluate and compare the role of topical application of oral curcumin gel with scaling and root planing (SRP) on chronic periodontitis. Materials and Methods: In this clinical study, forty participants with mild chronic periodontitis were included. Included participants underwent Phase I therapy, after which they were allocated into two groups (20 each), out of which only one group received curcumin gel for topical application. Plaque index (PI), bleeding on probing measured by sulcus bleeding index, probing pocket depth and clinical attachment level (CAL) were recorded at baseline and at the follow-up after 2 months. Results: Both test and control groups showed statistically significant reduction in PI, sulcular bleeding index, pocket probing depth and CAL. Curcumin gel group showed statistically significant difference compared to the control group with respect to PI (<0.001), sulcular bleeding index (<0.001) and pocket probing depth (0.006). Conclusion: Curcumin as an adjunct to SRP showed higher reduction in plaque accumulation, sulcular bleeding and pocket probing depth as compared to SRP alone.

The coinfection between herpesviruses and periodontopathic microbiota in increasing severity of chronic periodontitis

Introduction: Chronic periodontitis is an oral disease and having multiple etiologies. The coinfection between herpesviruses and periodontopathic bacteria might play a crucial role in the increasing severity of the disease. The present study was conducted to find out any specific coinfection which is contributing in increase in the severity of the disease. Materials and Methods: It was a prospective case–control study. A total of 300 cases with chronic periodontitis (100 each from mild, moderate, and severe chronic periodontitis) and 300 age- and sex-matched controls were included. After fulfilling the inclusion and exclusion criteria, a subgingival plaque specimen was collected and processed for detection of herpesviruses and periodontopathic microbiota. Results: Herpesviruses were significantly associated with anaerobes and yeasts as compared to aerobes. In severe chronic periodontitis, association of anaerobes and herpesviruses was found to be statistically significant in the present study. All four studied herpesviruses have shown strong association with Porphyromonas gingivalis. Conclusion: Coinfection helps in the increasing severity of chronic periodontitis when a particular combination of herpesviruses and periodontopathic microbiota is detected from the cases of chronic periodontitis. Herpes simplex virus-2 and P. gingivalis seem to play a crucial role in the increasing severity of chronic periodontitis as compared to other coinfection combinations in the studied populations.

Association of Elevated C-Reactive Protein with Severe Periodontitis in Hypertensive Patients in Lagos, Nigeria: A Pilot Study.

Background:Epidemiological studies have shown that individuals with chronic periodontitis have a significantly higher risk of developing cardiovascular complications, which might be attributed to the increased production of inflammatory cytokines initiated by the complex microbiota in dental biofilm.Aim:The study aims to evaluate the association between chronic periodontitis and C-reactive protein (CRP) levels in a group of hypertensive individuals in Nigeria.Materials and Methods:The investigator enrolled 50 hypertensive patients with chronic periodontitis into the study from the medical outpatient clinic of a teaching hospital in Lagos, Nigeria. Full-mouth periodontal examination was done to assess the participant's periodontal status, with probing depths and clinical attachment levels of six sites on all teeth. The investigator defined periodontitis as at least one interproximal site with probing depth ≥4 mm. Classification of participants into three groups was done based on their severity of periodontitis; mild (n = 16), moderate (n = 27), and severe (n = 7) periodontitis. Their CRP serum levels were measured, and the association with the severity of periodontitis was determined. P was found to be ≤ 0.05.Results:The median CRP levels were 1.0 (0.6, 2.2), 2.4 (1.1, 4.8), and 4.1 mg/L (3.3, 9.4) for mild, moderate, and severe chronic periodontitis, respectively. The association between the serum CRP levels and severity of periodontitis was statistically significant (P = 0.006).Conclusion:There was an association of elevated serum CRP level with increased severity of chronic periodontitis in hypertensive individuals. This preliminary finding among Nigerians suggests that chronic periodontal inflammation may contribute to systemic inflammatory burden in hypertensive patients.

Correlation between interleukin-10 polymorphisms and susceptibility to chronic periodontitis among Uygur adults in the Moyu area

This study aims to investigate the association between interleukin (IL)-10-597 (C/A) single-nucleotide polymorphisms and chronic periodontitis of Moyu Uygur population in Xinjiang Uygur Autonomous Region of China. In accordance with the inclusion and exclusion criteria, the buccal swabs of 300 subjects were randomly selected from the epidemiological investigation of Uygur adults in Moyu county on April and May 2013. The study was conducted on a healthy control group, a mild chronic periodontitis group, and a moderate-to-severe chronic periodontitis group, with each comprising 100 samples. The IL-10-597(C/A) site in the promoter sequences was analyzed using the tetra-primer amplification refractory mutation system-polymerase chain reaction method to test the genotype and allele distributions. Statistical analysis was performed using Chi-squared test and ordinal classification Logistic regression analysis. The genotype and allele frequencies of the IL-10-597(C/A) site in the healthy control group, mild chronic periodontitis group, and moderate-to-severe chronic periodontitis group exhibited no significant difference (P>0.05). The age of all the samples was associated with chronic periodontitis. The risk of chronic periodontitis in the people of 55-65 years old was 25 times in the people under the age of 35 (OR=25.56, P<0.001). The IL-10-597 (C/A) single-nucleotide polymorphisms in the gene promoter are not associated with chronic periodontitis in Uygur adult population.

Simultaneous Detection of Oral Pathogens in Subgingival Plaque and Prostatic Fluid of Men With Periodontal and Prostatic Diseases.

Chronic prostatitis (CPr) and benign prostatic hyperplasia (BPH) are complex inflammatory conditions for which etiologic determinants are still poorly defined. Periodontitis is caused by subgingival colonizing bacteria in the oral cavity. The causal effect of periodontal disease on prostatic inflammation has not been established. The purpose of this study is to isolate oral pathogens from expressed prostatic secretions of patients with periodontal disease and CPr or BPH. Twenty-four men diagnosed with CPr/BPH participated in the study. A complete periodontal examination consisting of probing depth, bleeding on probing, tooth mobility, gingival index, and plaque index was performed on the men, and prostatic secretion was collected for the study. Dental plaque and prostatic secretion samples were used for analysis of bacterial DNA for Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Treponema denticola (Td), and Escherichia coli using reverse transcription-polymerase chain reaction. Six patients were diagnosed with severe, seven with moderate, and four with mild chronic periodontitis. Seventeen of 24 (70.8%) of the prostatic secretion samples showed one or more of the studied oral pathogens. Nine of 10 BPH and eight of 14 patients with CPr had at least one oral pathogen in their prostatic secretions. Pg was found in both prostatic secretion and plaque samples in six of 17 (35.3%) patients, Td was found in both samples in seven of 15 (46.7%) patients, and E. coli was found in both samples in three of 15 (20%) patients. Pi was detected in all dental plaque samples but not in the prostatic secretion. An association between chronic inflammatory prostate and periodontal diseases has been demonstrated by the presence of similar bacterial DNA in both prostatic secretion and subgingival dental plaque from the same individual.

Periodontitis in Chédiak-Higashi Syndrome: An Altered Immunoinflammatory Response.

Chédiak-Higashi syndrome (CHS), a rare autosomal recessive disorder caused by mutations in the lysosomal trafficking regulator gene (LYST), is associated with aggressive periodontitis. It is suggested that LYST mutations affect the toll-like receptor (TLR)-mediated immunoinflammatory response, leading to frequent infections. This study sought to determine the periodontal status of patients with classic (severe) and atypical (milder) forms of CHS and the immunoregulatory functions of gingival fibroblasts in CHS patients. In contrast to aged-matched healthy controls, atypical (n = 4) and classic (n = 3) CHS patients presented with mild chronic periodontitis with no evidence of gingival ulceration, severe tooth mobility, or premature exfoliation of teeth. As a standard of care, all classic CHS patients had undergone bone marrow transplantation (BMT). Primary gingival fibroblasts obtained from atypical and BMT classic CHS patients displayed higher protein expression of TLR-2 (1.81-fold and 1.56-fold, respectively) and decreased expression of TLR-4 (-2.5-fold and -3.85-fold, respectively) at baseline when compared with healthy control gingival fibroblasts. When challenged with whole bacterial extract of Fusobacterium nucleatum, both atypical and classic CHS gingival fibroblasts failed to up-regulate TLR-2 and TLR-4 expression when compared with their respective untreated groups and control cells. Cytokine multiplex analysis following F. nucleatum challenge showed that atypical CHS gingival fibroblasts featured significantly increased cytokine expression (interleukin [IL]-2, IL-4, IL-5, IL-6, IL-10, IL-12, interferon-γ, tumor necrosis factor-α), whereas classic CHS cells featured similar/decreased cytokine expression when compared with treated control cells. Collectively, these results suggest that LYST mutations in CHS patients affect TLR-2 and TLR-4 expression/function, leading to dysregulated immunoinflammatory response, which in turn may influence the periodontal phenotype noted in CHS patients. Furthermore, our results suggest that atypical CHS patients and classic CHS patients who undergo BMT early in life are less susceptible to aggressive periodontitis and that hematopoietic cells play a critical role in mitigating the risk of aggressive periodontitis in CHS. Knowledge Transfer Statement: Results from this study can be used to create awareness among clinicians and researchers that not all CHS patients exhibit historically reported aggressive periodontitis, especially if they have atypical CHS disease or have received bone marrow transplantation. LYST mutations in CHS patients may affect TLR-2 and TLR-4 expression/function leading to dysregulated immunoinflammatory response, which in turn may influence the periodontal phenotype noted in CHS patients.

The prevalence of pathologic tooth migration with respect to the severity of periodontitis.

Aim:Pathologic tooth migration (PTM) has been defined as tooth displacement that occurs when the balance among the factors that maintain physiologic tooth position is disturbed by periodontal disease. The aim of this cross-sectional epidemiological study was to determine the prevalence of pathologic tooth migration among patients with periodontitis.Materials and Methods:Recorded documents of 370 patients (72.4% females, 27.6% males) within the age range of 17 to 70 years (mean 37.77 ± 11.46) were studied. Statistical analysis was carried out using t-test and Chi-square test.Results:Pathologic migration prevalence was 11.4% (35/314 patients), however, there was no pathologic migration in patients with mild chronic periodontitis. The Chi-square test showed that there was no statistically significant difference between males and females.Conclusions:The results of this study confirm that pathologic tooth migration is relatively common among periodontal patients and its prevalence is increased by the severity of periodontal disease.

An Evaluation of Non-Surgical Periodontal Therapy in Patients with Rheumatoid Arthritis.

aim of this study was to evaluate the efficacy of periodontal scaling and oral hygiene instruction for patients with mild chronic periodontitis and rheumatoid arthritis through clinical periodontal parameters and laboratory tests for CRP (C- reactive protein) and ESR (erythrocyte sedimentation rate). Twelve individuals with rheumatoid arthritis and 12 healthy individuals were evaluated, with a mean age of 45.38 and 46.75 respectively, all female and with mild, chronic periodontitis. The participants were evaluated clinically and periapical radiographs were taken (T1), after which periodontal treatment was instituted. After ninety days (T2), new clinical and laboratory data were obtained. Probing depth, bleeding index, and plaque indexes were observed in both groups, and the results demonstrated reductions but no statistical differences. Laboratory tests for CRP and ESR produced higher values for the rheumatoid arthritis group with T1- T2 reductions on the average, but the values were still higher than in the health group. We conclude that periodontal therapy in patients with rheumatoid arthritis and mild chronic periodontitis showed a improvement in the periodontal clinical parameters and laboratory tests that were evaluated.