Mild Periodontitis Research Articles

Clinical efficacy of the new dental gel based on dihydroquercetin in the treatment of patients with inflammatory periodontal diseases

On the basis of periodontal indices, the anti-plaque and anti-inflammatory effect of the gel composition of the new domestic drug, the main active ingredient of which is dihydroquercetin contained in the bark of Siberian larch, which has an antioxidant and antihypoxant effect, was studied. From practically healthy patients aged 18 to 40 years with inflammatory changes in the marginal periodontium (with chronic catarrhal gingivitis and mild periodontitis) without serious concomitant diseases, 2 groups were formed — control (group "A") and experience (group "B"), 30 people in each group. Patients were not separated by gender. At the first stage, patients were taught the rules of brushing their teeth and hygienic care of the oral cavity using demonstration phantoms. Then, after antiseptic treatment of the marginal periodontium and application anesthesia, dental deposits were removed for patients of both groups. At this point, treatment intervention for patients in the control group (Group B) was limited. Patients of group A were additionally prescribed applications of a therapeutic gel. Patients applied the drug to the gums previously dried with a cotton swab from the outer and inner surfaces on their own with a frequency of 3 times a day after demonstrating the rules for the procedure and monitoring by the specialist the correctness of its implementation by the patients themselves.
 The clinical condition of the soft tissues in patients of both groups was monitored before the start of treatment, after 3, 7 and 14 days based on a number of indices: Silness-Loe, PMA and Mulleman).
 The Muhleman Index values in patients before treatment in both groups were 2.4±0.5 and 2.3±0.5 c.u. (conventional unit)., respectively. In subsequent terms, after 3, 7 and 14 days, the index values progressively decreased. 3 days after the removal of dental deposits, the index values significantly decreased: to 1.7±0.5 c.u. in the first and up to 1.9±0.6 c.u. in the second (p<0.05) group of patients. After 7 days, the bleeding index progressively decreased also in both groups, but less intensively. Moreover, the index in patients in group A was 1.1±0.4 and in patients in group B 1.5±0.5 and 0.5±0.1 c.u. Most clearly, the difference in the effect manifested itself on the 14-th day: 0.5±0.3 units. in patients of group A and 1±0.5 c.u. in patients in group B (in all cases p<0,05). The dynamics of the RMA inflammation index turned out to be very comparable with the dynamics of the Muhleman index in patients of both groups.
 The initial training in the rules of brushing the teeth made it possible to achieve an ideal cleansing of the oral cavity in both groups of patients, and the achieved effect was maintained throughout the study period. This confirmed the decrease in the Silness-Loe plaque index to almost zero, despite the fact that before the start of the study its values were the same and reached almost the maximum value: 2,4 c.u. in patients. of both groups. Characteristically, after 3 days, the index value in patients in both groups decreased almost identically to a value of 0.8 c.u., and after 7 and 14 days — almost to zero.
 This fact allowed us to attribute the achieved anti-inflammatory effect not due to more thorough brushing of teeth during the experiment, but precisely due to the therapeutic effect of the applied gel.
 The presented numerical data of clinical indicators were confirmed by the results of statistical processing using the Student's method with the determination of the reliability criterion.
 Examination and questioning of patients made it possible to establish the absence of negative clinical and organoleptic sensations from the use of the gel in patients of both groups.
 The data obtained made it possible to establish a pronounced anti-inflammatory effect of the therapeutic gel "Flamena stom." and to recommend the gel for use in wide clinical practice as part of the complex treatment of patients with inflammatory periodontal diseases.

Clinical efficacy of the new dental gel based on dihydroquercetin in the treatment of patients with inflammatory periodontal diseases

On the basis of periodontal indices, the anti-plaque and anti-inflammatory effect of the gel composition of the new domestic drug, the main active ingredient of which is dihydroquercetin contained in the bark of Siberian larch, which has an antioxidant and antihypoxant effect, was studied. From practically healthy patients aged 18 to 40 years with inflammatory changes in the marginal periodontium (with chronic catarrhal gingivitis and mild periodontitis) without serious concomitant diseases, 2 groups were formed — control (group "A") and experience (group "B"), 30 people in each group. Patients were not separated by gender. At the first stage, patients were taught the rules of brushing their teeth and hygienic care of the oral cavity using demonstration phantoms. Then, after antiseptic treatment of the marginal periodontium and application anesthesia, dental deposits were removed for patients of both groups. At this point, treatment intervention for patients in the control group (Group B) was limited. Patients of group A were additionally prescribed applications of a therapeutic gel. Patients applied the drug to the gums previously dried with a cotton swab from the outer and inner surfaces on their own with a frequency of 3 times a day after demonstrating the rules for the procedure and monitoring by the specialist the correctness of its implementation by the patients themselves.
 The clinical condition of the soft tissues in patients of both groups was monitored before the start of treatment, after 3, 7 and 14 days based on a number of indices: Silness-Loe, PMA and Mulleman).
 The Muhleman Index values in patients before treatment in both groups were 2.4±0.5 and 2.3±0.5 c.u. (conventional unit)., respectively. In subsequent terms, after 3, 7 and 14 days, the index values progressively decreased. 3 days after the removal of dental deposits, the index values significantly decreased: to 1.7±0.5 c.u. in the first and up to 1.9±0.6 c.u. in the second (p<0.05) group of patients. After 7 days, the bleeding index progressively decreased also in both groups, but less intensively. Moreover, the index in patients in group A was 1.1±0.4 and in patients in group B 1.5±0.5 and 0.5±0.1 c.u. Most clearly, the difference in the effect manifested itself on the 14-th day: 0.5±0.3 units. in patients of group A and 1±0.5 c.u. in patients in group B (in all cases p<0,05). The dynamics of the RMA inflammation index turned out to be very comparable with the dynamics of the Muhleman index in patients of both groups.
 The initial training in the rules of brushing the teeth made it possible to achieve an ideal cleansing of the oral cavity in both groups of patients, and the achieved effect was maintained throughout the study period. This confirmed the decrease in the Silness-Loe plaque index to almost zero, despite the fact that before the start of the study its values were the same and reached almost the maximum value: 2,4 c.u. in patients. of both groups. Characteristically, after 3 days, the index value in patients in both groups decreased almost identically to a value of 0.8 c.u., and after 7 and 14 days — almost to zero.
 This fact allowed us to attribute the achieved anti-inflammatory effect not due to more thorough brushing of teeth during the experiment, but precisely due to the therapeutic effect of the applied gel.
 The presented numerical data of clinical indicators were confirmed by the results of statistical processing using the Student's method with the determination of the reliability criterion.
 Examination and questioning of patients made it possible to establish the absence of negative clinical and organoleptic sensations from the use of the gel in patients of both groups.
 The data obtained made it possible to establish a pronounced anti-inflammatory effect of the therapeutic gel "Flamena stom." and to recommend the gel for use in wide clinical practice as part of the complex treatment of patients with inflammatory periodontal diseases.

Assessment of Fasting Blood Glucose in Chronic Periodontitis Patients Visiting a Tertiary Hospital

Introduction: It is well-established that diabetes unfavorably influences periodontal health and results in periodontitis. However, upcoming evidence also shows that periodontitis initiates a chronic state of insulin resistance leading to hyperglycemia. Objectives: We designed this study to assess fasting blood glucose levels in chronic periodontitis patients and also explore the relationship between severity of chronic periodontitis and fasting blood glucose levels with an analysis of their risk factors in adult the population of eastern Nepal. Methods: A cross-sectional hospital-based study was conducted on a total of 141 chronic periodontitis patients aged 30-55 years who were divided into Group A (Mild periodontitis) and Group B (Moderate/ Severe periodontitis) according to the American Academy of Periodontology / Centres for Disease Control (AAP/ CDC) criteria. Fasting blood glucose level was analyzed as normal (<100 mg/dl), impaired fasting (100-125 mg/dl), and diabetic (≥126 mg/dl) based on the American Diabetes Association (ADA) criteria. Results: Among the 141 subjects examined, Group A accounted to be 43.26% and Group B 56.74%. The mean fasting blood glucose level was 121.51 ± 53.67 mg/dl. The Chi-square test showed that severity of periodontitis and body mass index were significantly associated with the categories of fasting blood glucose. Multivariate logistic regression analysis showed that age (OR=1.08), gender (OR=3.48) and body mass index (OR=0.38) were significantly associated with impaired fasting glucose. The risk of acquiring diabetes in mild periodontitis was 0.255 times less likely than in severe periodontitis (OR=0.255, CI 0.065-0.997). Conclusions: The severity of chronic periodontitis showed a significant association with the categories of fasting blood glucose.

Management of the Dental Patient with an Implanted Left Ventricular Assist Device (LVAD), A Case Report and Suggested Guidelines for Care

Background and Overview: Nearly 6 million Americans suffer from heart failure (HF). For patients with advanced HF refractory to medical therapy, Orthotopic Heart Transplantation (OHT) is the therapy of choice, limited primarily by donor availability. A Left Ventricular Assist Device (LVAD) can be used as a “bridge to transplant” while awaiting OHT, or as a “destination therapy”. These devices improve quality of life allowing patients to proceed with the activities of daily living independently, including presenting for routine dental care. There are few existing guidelines available for the care of these complex patients. The purpose of this study is to educate the clinician on the LVAD and to establish guidelines on the care of these patients. Case Description: A 55-year-old male suffering from HF secondary to nonischemic cardiomyopathy, a left ventricular ejection fraction of 15-20%, and severe mitral regurgitation underwent LVAD implantation as a bridge to OHT at NYU Langone Health (NYULH) in December 2017. In September of 2019 he was referred to NYU College of Dentistry for oral health clearance prior to OHT. Evaluation revealed localized chronic mild periodontitis, several teeth requiring endodontic treatment, and several non-restorable teeth requiring extraction to address potential odontogenic infections. Dental treatment was safely completed at the NYU College of Dentistry in cooperation with the patient’s LVAD coordinator for the purpose of receiving an OHT. Conclusions and Practical Implications: Dental patients with LVADs have specific needs due to their implanted cardiac device and their secondary underlying comorbidities. There are few published guidelines for the evaluation and care of the dental patient with an implanted LVAD. DHCP (dental healthcare professionals) should be aware of this cohort of patient as they may present themselves for routine or emergent care to the dental office. Management of the dental patient with an implanted VAD should be done through appropriate close interdisciplinary consultation and coordination.

Effect of Covid and its Treatment Protocols on Chronic Generalized Periodontitis- A Prospective Study

Background: COVID-19 causes an inflammatory response that intensifies and can cause death. Periodontitis is also characterized by an inflammatory response elicited by microbial plaque, which intensifies and inflicts damage to the tissues. To address the effect of immunoinflammatory mechanisms, steroids were used extensively as a lifesaving drug and stayed as the mainstream drug in treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. The present study aimed to investigate the possible impact of COVID-19 treatment protocols in chronic periodontitis patients. Materials and Methods: A total of 103 COVID-19-positive patients with a hospitalization period of at least 5 days with dental records were enrolled in the study. Based on Periodontal Index (PI) values, the subjects were categorized as having mild, moderate, and severe periodontitis. These patients, after undergoing treatment for COVID-19 were recalled after 6 months for periodontal status evaluation. Statistical analysis was made to test for any significant variation in the periodontal status before and after COVID-19 treatments. Results: The mean comparison of Periodontal Index (PI) values before and after COVID were 4.02 and 4.40, with a statistically significant (P ≤ 0.05). PI values of the patients on Dexamethasone pre and post COVID –b 19 were compared and found to be 3.86 and 4.83, respectively. Conclusion: The present study indicates that COVID-19 and its different treatment protocols were strongly associated with elevated periodontal disease worsening in COVID-19 survivors at 6-month follow-up.

Lipid Profile and the Severity of Periodontitis among Tertiary Hospital Patients in a Semi-Urban Population in Southwestern Nigeria

The prevalence of hyperlipidemia among Nigerians is established, while the relationship between it and periodontitis has been studied globally. This study aimed to investigate the relationship between lipid profile and severity of periodontitis among Nigerians. 195 patients were drawn from the family medicine clinic of the Obafemi Awolowo University Teaching Hospital Ile-Ife Osun state Nigeria. Sociodemographic data was obtained using a closed-ended questionnaire, simplified oral hygiene index (OHI), periodontal disease index (PDI), clinical attachment loss (CAL), and periodontal pocket depth (PPD) were also estimated. A full mouth mean CAL ≥0.6mm was considered as periodontitis. Lipid profile was carried out at the chemical pathology department of the same institution by spectrophotometry. Appropriate parameters were determined for descriptive variables. A two-way t-test was done for the mean values of the intraoral and the lipid parameters. Data was exposed to logistic regression to eliminate confounders. Male to female ratio was 1:1.6 with a mean age of 37.42±12.95. High-density lipoproteins (HDL) and triglycerides have a statistically significant relationship with CAL and PPD (p<0.05). Logistic regression showed statistical significance for total cholesterol (p<0.05) in females only. Following the trend with other associated chronic diseases, HDL was higher in the periodontally healthy subjects and those with mild chronic periodontitis, while it was lower in those with moderate and severe chronic periodontitis. This relationship was inverse for low-density lipoproteins (LDL). Increase in LDL/HDL had a linear relationship with the severity of chronic periodontitis from mild to severe. This emphasises the need for oral health education in the community and regular lipid investigations.

Regular dental visits, periodontitis, tooth loss, and atherosclerosis: The Ohasama study.

ObjectiveWe aimed to explore the association between regular dental visits and atherosclerosis and between periodontitis, number of remaining teeth, and atherosclerosis among community dwellers in Japan.BackgroundFew studies have examined the association between regular dental visits, periodontitis, tooth loss, and atherosclerosis in community dwellers in Japan.MethodsThe participants of this cross‐sectional study included community dwellers aged ≥55 years and residing in Ohasama. Exposure variables were regular dental visits; periodontitis, defined as radiographic alveolar bone loss (BL); the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) classification; and number of remaining teeth. The primary outcome was atherosclerosis, defined as maximum carotid intima‐media thickness ≥1.1 mm or confirmation of atheromatous plaque.ResultsOf 602 participants, 117 had atherosclerosis. In the multivariate model, compared to those with regular dental visits, the odds ratio (OR) (95% confidence intervals [CIs]) of atherosclerosis among those with the absence of regular dental visits was 2.16 (1.03–4.49). Regarding BL‐max, compared with those in the first quartile, ORs (95% CIs) of those in the second, third, and fourth quartiles were 1.15 (0.65–2.30), 0.65 (0.32–1.35), and 1.57 (0.81–3.01), respectively. Regarding CDC/AAP classification, compared to those with no or mild periodontitis, ORs (95% CIs) for those with moderate and severe periodontitis were 2.48 (0.61–10.1) and 4.26 (1.01–17.5), respectively. Regarding the number of remaining teeth, compared to those with ≥20 teeth, ORs (95%CIs) for those with 10–19 and 1–9 teeth were 1.77 (1.004–3.12) and 0.96 (0.52–1.80), respectively.ConclusionThe absence of regular dental visits and presence of periodontitis are associated with atherosclerosis among community dwellers in Japan.

EVALUATION OF EFFICACY OF ORAL CURCUMIN GEL AS AN ADJUNCT TO NON-SURGICAL THERAPY IN THE TREATMENT OF PERIODONTITIS

Abstract: Background: Recently, herbal therapy has become interested in research and application in dental treatment. Curcumin gel with extracts from Turmeric has also proven effective in periodontal treatment. The study aimed to evaluate the results of non-surgical periodontitis therapy with the help of topical curcumin gel. Materials and methods: Prospective, clinical intervention study on 30 periodontal pockets in 21 patients with mild and moderate periodontitis (AAP 2014). After the patients received scaling and root planing, curcumin gel was injected into periodontal pockets. The periodontal clinical indices were assessed at baseline and 30 days, 45 days after treatment. Results: All periodontal clinical indexes after 30 days and 45 days of treatment showed statistically significantly reduced compared to those at baseline (p<0.05). The decrease levels on the 30th day were higher than those on the 45th day. Conclusion: The results of non-surgical therapy of mild and moderate periodontitis with curcumin gel showed a significant improvement in periodontal clinical parameters. Key words: periodontitis, non-surgical therapy, curcumin gel

IDF21-0569 Periodontal disease is associated with increased risk of Diabetes and Pre-diabetes

Background: Early diagnosis of diabetes mellitus and pre-diabetes is essential for the timely management of diabetes and its complications as well as the prevention of diabetes in individuals with pre-diabetes. Periodontal disease has also been recognized as the sixth complication of diabetes although this is still under-appreciated by endocrinologists or physicians in general. Since it has been suggested that severe periodontitis might be an early complication of diabetes, therefore periodontal disease may be a useful indicator to screen for the risk of diabetes or pre-diabetes in dental patients who otherwise do not know of their glycemic status. Aim: In this study, HbA1c levels and subsequently the prevalence of diabetes and pre-diabetes in participants with and without periodontitis of various stages were investigated. Method: From 88 mild periodontitis patients, 132 moderate periodontitis patients, 210 severe periodontitis patients and 66 patients without periodontitis (control), HbA1c values were obtained by a finger-prick blood sample taken from each participant which was then tested in a point-of-care HbA1c analyzer. Differences in mean HbA1c values and prevalence of diabetes and pre-diabetes between the different periodontitis and control groups were analyzed. Multivariate analyses were performed, correcting for known risk indicators for diabetes screening. Results: In this cohort of a total of 496 participants, 29(5.8%) and 154 (31.0%) patients were identified with HbA1c levels corresponding to the ADA guideline levels for diabetes (HbA1c > 6.5%) and pre-diabetes (HbA1c 5.7–6.4%), respectively. In addition, the mean HbA1c levels increases as the stage of periodontitis increases from no periodontitis to severe periodontitis. Periodontal disease of all stages have higher proportion of hyperglycaemia as compared to non-periodontitis(control) patients. However, it is the severe periodontitis group that showed a significantly higher percentage of patients with HbA1c values in the diabetes range as compared with the mild/moderate periodontitis group (p < 0.001). The prevalence of pre-diabetes was significantly higher in patients with moderate periodontitis compared with patients without periodontitis or with patients having mild periodontitis. In the severe periodontitis group, 18 (8.6%) patients had HbA1c levels in the diabetes range and 51 (24.3%) patients could be diagnosed with prediabetes according to the ADA-guidelines, whereas in the moderate periodontitis group, 59 (44.7%) subjects had HbA1c levels in the pre-diabetes range and only 2 (1.5%) of them reached HbA1c values for diabetes diagnosis. Discussion: Periodontitis is associated with increased levels of HbA1c and subsequently with an increased prevalence of those at risk for diabetes and pre-diabetes. We suggest that severe periodontal disease may be a useful risk indicator for early diabetes or pre-diabetes. This study also demonstrates the important role that dentists can play in the early referral of their patients who may already have undiagnosed diabetes and pre-diabetes to endocrinologist so as to receive timely medical diagnosis, prevent or delay progression from pre-diabetes to overt diabetes mellitus and intervention to prevent potential diabetes complications which in turn reduces disease burden.

Prevalence of Bone Loss in Mandibular Future Abutment Teeth among Diabetic and Non-Diabetic Patients: A Retrospective Case-Control Study

Objective: This study aimed to compare the prevalence of bone loss in lower permanent premolars and canines, which can serve as abutments for future prostheses, among diabetic and non-diabetic patients. Materials and Methods: In this retrospective case-control study, records of patients who visited the dental clinics of Imam Abdulrahman Bin Faisal University were used. Inclusion criteria were the presence of a complete periodontal chart, full mouth radiographs, and past medical history (presence of DM, hypertension, and/or coronary heart disease). The criteria for exclusion were the reporting of malignancy, pregnancy, breastfeeding, or taking of the medications that affect bone turnover, periodontal surgery within the past year, absence of radiographs with good quality, and antibiotic use within 3 months prior to the dental visit. Demographical data, including gender and age, past medical history (diabetic state), and periodontal diagnosis, were collected. The severity of periodontal disease, radiographic bone loss (RBL), and its pattern were also assessed. Results: Out of 400 records, 363 patient files were included. Of those, almost 36% were males and 64% were females. The patients’ age was ranging from 16 to 82 years. About 34% of the patients were diagnosed with generalized periodontitis while 22% had localized periodontitis. With regards to the severity of the cases, the prevalence was equally distributed between mild (37%) and moderate periodontitis (38%), while 25% were diagnosed with severe periodontitis. A total of 22% of the patients were diabetic, which showed an increase in the severity of bone loss by an average of 31% across the selected teeth (mandibular canines and premolars). The pattern of bone loss was higher in the mandibular incisors, followed by the canines and the premolars. Multiple regression models showed that non-diabetics were significantly less likely to have bone loss in all the selected teeth and the male patients had 2 times the likelihood of having bone loss. Although the mandibular canines have the highest root length in the mandible, they were the most affected by bone loss in diabetic patients with periodontitis. Conclusion: Results of this study suggested that mandibular premolars were the teeth least affected by bone loss in both, diabetic and non-diabetic groups. Therefore, they can be considered the most suitable teeth to be used as abutments for the future prosthesis.

AN T I M I C RO B I AL EFFICACY OF MILD PERIODONTITIS INITIAL THERAPY IN PATIENTS WITH DIABETES MELLITUS TYPE II WITH DIFFERENT DURATION OF ENDOCRINE DISEASE

Endocrine pathology, including diabetes mellitus, significantly affects the immune response characteristics to microbial invasion and, as a result, the microbial balance of the oral cavity in normal conditions and in periodontal diseases. The aim of the study was to evaluate the antimicrobial efficacy of mild periodontitis nonsurgical treatment in patients with type II diabetes mellitus with different duration of endocrine disease. It is shown that before the start of therapy, in dependance of endocrine pathology duration, the bacterial flora of periodontal pockets in the groups was different. The standard therapy also demonstrated varying degrees of effectiveness, and on the background of positive response to the treatment in both groups, the trend to normalization of the microflora in patients with newly diagnosed diabetes mellitus was more evident.

Association between BMI and periodontitis in women living with or at risk for HIV.

Currently, there is no data available assessing the association between body mass index (BMI) and periodontitis among women living with HIV (WLWH). This study aims to investigate this association among WLWH and women at risk for HIV (WRH) in the United States. Data from 351 WLWH and 52 WRH participants from the Women's Interagency HIV Study having pocket depths and clinical periodontal attachment loss assessments in 2003-2004 were included. Multinomial logistic regression analyses in the full sample assessed the relationship between BMI (underweight/normal, overweight, or obese) and periodontitis by severity (mild, moderate, severe), adjusting for study sites, age, education, annual household income, smoking, alcohol consumption, and diabetes. Overall, 75.2% women (76.0% WLWH; 69.0% WRH) had periodontitis. Moreover, 75.0% obese and 75.3% overweight women were affected by periodontitis. In the full sample, adjusted odds ratio (aOR) of having mild, moderate, and severe periodontitis in obese women were: 1.14 (95% confidence interval [CI]: 0.51-2.52), 1.02 (95% CI: 0.46-2.29), and 0.24 (95% CI: 0.06-1.07), respectively, and in overweight women: 0.70 (95% CI: 0.31-1.58), 0.85 (95% CI: 0.38-1.90), and 0.31 (95% CI: 0.08-1.15), respectively. Even with high prevalence of periodontitis among women with or without HIV infection in this cohort, this study does not provide evidence of an association between BMI and periodontitis.

Periodontal disease and preterm delivery: a nationwide population-based cohort study of Taiwan

Preterm delivery of low-birth weight infants is considered a leading cause of morbidity and mortality among neonates. Various studies have reported a positive correlation between periodontal disease (PD) and premature birth (PB) and yet no population-based study has assessed the impact of PD severity and treatments on premature birth. This cohort study used Taiwan’s national medical records (1999–2012, included 1,757,774 pregnant women) to investigate the association between PD severity and PB. Women with PD during the 2-year period prior for giving birth were more likely to have PB (11.38%) than those without PD (10.56%; p < 0.001). After variables adjustment, the advanced PD group had OR of 1.09 (95% CI 1.07–1.11) for PB, the mild PD group had OR of 1.05 (95% CI 1.04–1.06), while no-PD group had OR of 1. Increased PD severity was related to higher risk of PB. When stratified by age, the highest ORs for PB were those aged from 31 to 35 years in both mild PD group (OR = 1.09, 95% CI 1.07–1.11) and advanced PD group (OR = 1.13, 95% CI 1.09–1.17). Improving periodontal health before or during pregnancy may prevent or reduce the occurrence of adverse pregnancy outcomes and therefore maternal and perinatal morbidity and mortality.

Evaluation of serum concentrations of hs-CRP and Hb in varying severities of chronic periodontitis

Context Chronic periodontitis patients exhibit elevations in serum concentrations of c-reactive protein (CRP). Also, periodontitis can potentially contribute to reduced haemoglobin (Hb) levels leading to anaemia of chronic disease (ACD). Objective To determine whether disease severity affect CRP and Hb levels in patients with chronic periodontitis. Material and Methods Based on periodontitis severity, three groups of 50 subjects each were selected, who underwent screening for gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL). Blood samples were taken to estimate the number of erythrocytes, mean corpuscular volume (MCV), packed cell volume (PCV), Hb concentration, mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), and high sensitivity C-reactive protein (hs-CRP) Results Mean hs-CRP levels of 0.796, 2.238, 2.886 were found in mild, moderate, and severe periodontitis groups respectively with significant intergroup differences. The differences in haematological parameters other than MCV were not significant between groups. Conclusion The possible systemic effects of periodontitis might be influenced by its severity, as evidenced by a corresponding change in the levels of systemic inflammatory markers like CRP.

EVALUATION OF THE LONGTERM RESULTS OF PERIODONTAL TREATMENT ON PERIODONTAL INDEX AND HBA1C IN TYPE 2 DIABETES PATIENTS

Background: Diabetes mellitus and periodontitis are common diseases, there is a two-way relationship between oral health and systemic disease. Periodontal treatment improves glycosylated hemoglobin.In contrast, glycaemic control can make periodontal status better. Aim: The aim of the study was to evaluate the long-term results of periodontal treatment on clinical features and HbA1c in type 2 diabetes patients. Materials and Methods: A clinical trials study on 76 type 2 diabetes patients with mild and moderate periodontitis. Patiens were divided into two group. Scaling and root planning with Diode laser (SRP+DL) group: full-mouth SRP with Diode laser and Scaling and root planning (SRP) group: full-mouth SRP. Periodontal index and HbA1c were recorded at baseline and six month after treatment. Results: After 6 months, significant changes in periodontal index (p&lt;0.01). HbA1c levels did not change significantly in both groups (p&gt;0.05). Conclusion: The study shows that non-surgical periodontal treatment with/without diode laser change significantly periodontal health, but long-term result do not change HbA1c in type 2 diabetes patients Key words: type 2 diabetes mellitus, periodontitis, HbA

Candida albicans and Candida dubliniensis in Periodontitis in Adolescents and Young Adults

Aim This study aims to evaluate the association of Candida albicans and Candida dubliniensis with periodontitis in adolescents and young adults in a Moroccan population. Methods 426 subjects aged between 12 and 25 years were recruited for the study. A pool of plaque sample was taken. Samples were cultured on Sabouraud Chloramphenicol medium at 37°C for 24–48 hours and then identified by the Vitek 2 YST system. Clinical data and presence of Candida albicans and Candida dubliniensis were analyzed using Jamovi (Version 1.8). Results Candida albicans was observed in 25 subjects among 68 diseased patients (37%) and in 60 subjects among 358 healthy patients (17%). It can be reported that under normal yeast conditions, there is a statistically significant difference between these two groups (P < 0.001). Candida dubliniensis was more prevalent in periodontitis than in healthy subjects (P=0.026). Regarding clinical variables, subgroups of periodontitis subjects showed significant statistical differences for periodontal probing depth, clinical attachment loss, and number of decayed teeth in advanced periodontitis in comparison with initial or mild periodontitis. The results also indicate that the presence of the two species of Candida is not related to gender or age (P > 0.05) nor related to the severity of the periodontal disease in this population. Conclusion Within the limits of our study, Candida albicans is more frequently associated with periodontitis. The potential role of C. albicans in periodontitis pathogenesis is very complex. More studies on biofilm associated with different forms of periodontitis are necessary. It is also important to assess the coexistence of periodontitis and caries and the associated biofilms.

Possible association between COVID-19 caused stress and periodontal health - a pilot study

Introduction/Objective. Stress is proposed as one of the risk factors linked to periodontal disease. The COVID-19 pandemic has a significant negative impact in population on mental and somatic health. This study aimed to examine the possible association between COVID-19 resultant stress and periodontal health. Methods. An observational pilot study was conducted from March 2020 to October 2021 and included 202 participants. Participants graded their stress level using the Perceived Stress Scale (PSS). Periodontal Disease Index and Clinical Attachment Level were determined. Participants were categorized into following groups: Ia (low stress), IIa (moderate stress), IIIa (high stress) and Ib (healthy parodontium), IIb (mild periodontal disease), IIIb (severe periodontal disease). The cause/effect relationship between stress and health was measured. Results. The results indicated a statistically significant difference between the groups classified according to the stress level concerning values of all the measured parameters. The Poisson regression analysis showed that in both models, crude and adjusted, periodontal health-related covariables were higher in subjects perceiving greater stress (Periodontal Disease Index ? Pradjusted = 1.042, 95% CI [1.030?1.055] and Clinical Attachment Level ? PRadjusted = 1.108, 95% CI [1.094?1.122]). Conslusion. During COVID-19 pandemic increased stress has a negative impact on mental health and may result in the deterioration of the entire oral cavity?s health, including the periodontium.

Epidemiological evaluation of maternal periodontal status in human immunodeficiency virus seropositive pregnant women in India

Background: Human immunodeficiency virus (HIV) infection in pregnancy was the most common complication in some developing countries. This has major implications for the management of pregnancy and birth. Periodontal disease in HIV-infected pregnant women leads to a hyperinflammatory state which may have an impact on developing fetus. Aim: The evaluation of gingival and periodontal health in HIV seropositive pregnant women. Methods: A sample of 432 HIV seropositive pregnant women visiting the antiretroviral therapy center from January 2016–December 2016 were included in the present study. Information concerning demographic profile, medical history, and oral health information was recorded in a case sheet pro forma. Several measures of periodontal health such as bleeding on probing, plaque index, pocket depth (PD), and clinical attachment loss were obtained and analyzed by using Chi-square test of independence and P value (P < 0.05, statistically significant). Results: Three hundred and ninety-six participants (91.6%) had gum bleeding on >1 tooth. In gingivitis, the distributions of mild, moderate, and severe gingivitis were about 64 (14.81%), 192 (44.44%), and 140 (32.41%) participants, respectively. Participants without periodontitis (without a single PD ≥4 mm) were about 202 (46.76%). Two hundred and thirty participants (53.2%) had periodontal pockets (≥4 mm) on ≥1 tooth. In periodontitis, the distributions of mild, moderate, and severe periodontitis were 28.70%, 15.74%, and 8.80%, respectively. Conclusion: Ninety-two percent of HIV pregnant women have shown gingival inflammation. Periodontitis was observed in 51% of HIV pregnant women. This observation strengthens the importance of oral health care in HIV-positive pregnant women.

Self-reported questionnaire on periodontal condition validated for use in Brazil.

There is a current expectation of instruments for periodontal condition surveillance worldwide. The present study aimed to validate the Oral Health Questions Set B (OHQB) for the Brazilian Portuguese and evaluate its temporal stability. This is a sequential mixed-method investigation. After the forward-backward translation process to the Brazilian Portuguese, the OHQB Brazil (OHQB-Br) was applied to 156 participants (39.5 ± 14.14 years; 51.9% males). In sequence, through a full-mouth six-sites/teeth examination and in accordance with the original instrument, the periodontal diagnosis was obtained (March 2020). In January 2021, the OHB-BR was reapplied (n = 71). Ordinal alpha and McDonald's omega tested the internal consistency of the OHQB-Br. Temporal stability was investigated [Spearman correlation, intraclass correlation coefficient (ICC), and the Bland-Altman]. The concurrent validity was also verified, considering the periodontal clinical diagnosis (Kruskal Wallis). The ordinal alpha (0.69) and McDonald's omega (0.73) coefficients showed an adequate internal consistency of the OHQB-Br. The OHQB-Br temporal stability was high, as demonstrated by the Spearman coefficient (0.80) and ICC (0.79) and by the Bland-Altman plot. A concurrent validity showed a direct relationship between the OHQB-Br and the clinical condition of no periodontitis, mild, moderate, and severe periodontitis (p < 0.05). Because the OHQB-Br shows internal validity, temporal stability, and adequately identifies periodontal health and moderate/severe periodontitis, the instrument might represent an important tool, at the public level or other settings, for periodontal surveillance in Brazil.

Association between periodontitis and preterm low birth weight in human immunodeficiency virus seropositive pregnant women in India: A cohort study.

Because of the inflammatory response to human immunodeficiency virus (HIV) infection and periodontitis risk of developing adverse pregnancy outcomes are high. There is a limited number of studies available in the literature regarding the association between periodontitis and adverse pregnancy outcomes, especially in HIV infection. So the main objective of the present study was to assess the risk of preterm low birth weight (PTLBW) associated with periodontitis among HIV seropositive pregnant women. The study sample consists of 216 HIV seropositive pregnant women with complete dental and medical history and the appointment for the follow-up visit was made after the delivery to assess the baby's health.Gingivitis and periodontitis were assessed based on the bleeding on probing and clinical attachment levels at the first visit. In our study, the majority of 96 (44.44%) of the gingivitis cases belong to "moderate gingivitis" and the majority of 62 (28.70%) of the periodontitis cases were found to be in the mild periodontitis category. The relative risk for women with gingivitis or periodontitis having a preterm birth, low birth weight, and PTLBW was not statistically significant. The trend of risk ratios was found to be increased over the severity of periodontitis. This study shows an association between adverse neonatal outcomes with moderate and severe periodontitis. But these results were not statistically significant. This study implicates the importance of oral health care in HIV-positive pregnant women.