Peridontal Disease Research Articles

Characterization of Etiology and Pattern of Dental Extraction among Patients Presenting to Dental Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Dental extraction is a common curative treatment against pain provided to the patients. A limited number of scientific literature are available that characterizes the reasons for teeth extractions in Nepalese population. The aim of this study is to find out the causes for dental extraction in patients and explore the relationships between demographic variables and loss of teeth in the Nepalese population.Methods: This is a descriptive cross-sectional study performed to assess the predictors and reasons for permanent tooth extraction among the Nepalese patients who visited dental department in a tertiary health care center from 18th June 2022 to 17th June 2023. Ethical approval was obtained from the Institutional Review Committee (Approval No: 52/22). Demographic details were recorded, diagnosis established and the teeth in question were extracted. Descriptive statistical analysis was performed.Results: A total of 465 (42.66%) permanent teeth were extracted from the 1090 patients, out of which 198 (18.16%) were male and 267 (24.49%) were female patients between the age of 10 years to 70 years. Among all the participants, 726 (66.60%) patients were educated while 364 (33.40%) were uneducated, 165 (15.13%) extraction were done due to peridontal disease and 213 (19.54%) of extraction was done due to endodontic disease.Conclusions: Endodontic and periodontal diseases were the most common causes of dental extraction. Permanent molars and incisors were extracted the most.

In Vitro Susceptibility Of Oral Pathogens To Traditional Medicines Used To Treat Gingivitis And Peridontal Infections

Gingivitis and periodontial disease are inflammatory disorders that lead to the progressive destruction of gingival tissues and alveolar bone. The mechanisms underlying the destructive processes involve both direct tissue damage, resulting from periodontal pathogens, and indirect damage through host inflammatory reaction. Invasive pathogenic anerobic bacteria are believed to be responsible for this inflammatory response. Fourteen botanical extracts, used in traditional medicine for oral health, were tested against three of the most important anerobic peridontal pathogens including Porphyromonas gingivalis (PG), Fusobacterium nucleatum (FN) and Streptococcus mutans (SM). Of the 14 extract tested six were active and minimal inhibitory concentrations (MICs) were obtained. 95% EtOH extracts of Punica granatum L. (Punicaceae) peel, Moringa oleifera Lam. (Moringaceae) bark or Aegle marmelos (L.) Correa (Rutaceae) fruit inhibited the growth of PG with an MIC of 64 µg/mL, 128 µg/mL, and 128 µg/mL, respectively; a 95% extract of Chaenomeles speciosa (Sweet) Nak. (Rosaceae) quince fruit inhibited the growth of FN with an MIC of 128 µg/mL. Boesenbergia rotunda (L.) Mansfield (Zingiberaceae) rhizome extract inhibited the growth of FN and PG with an MIC of 128 µg/mL for both. Litsea elliptica Blume (Lauraceae) leaf extract inhibited the growth of inhibited the growth of FN with an MIC of 64 µg/mL and PG with an MIC of 32 µg/mL. None of the extracts inhibited the growth of S. mutans. The results indicate that several botanical extracts used in traditional medicine have activity against anerobic oral pathogens and maybe useful for the treatment of gingivitis or peridontal disease. Acknowledgements: Partial support for this work was made possible by a grant from the Wm. Wrigley Company.

549: Population-based estimation of the peridontal disease rate in malawi and compliance with preventive/ treatment measures

549: Population-based estimation of the peridontal disease rate in malawi and compliance with preventive/ treatment measures

Association of periodontal pathogenesis and cardiovascular diseases: a literature review.

To present a short review of recent literature available on the association of periodontal and cardiovascular diseases (CVD) and the role of peridontal disease as a risk factor to exacerbate CVD. A thorough search of articles was carried out on the databases PUBMED and MEDLINE on the association of periodontal and cardiovascular diseases (CVD). The selected literature included review articles, observational and case-control studies as well as randomised control trials. While selecting articles, priority was placed on papers published within the last 12 years. A brief description of periodontal diseases, atherosclerosis, underlying pathophysiology and oral bacteria has been included. There is growing evidence of the association of periodontal diseases and CVD, as reviewed by the epidemiological studies. The in vitro studies also highlight a potential link between oral bacteria and atherosclerosis. Thus, there is urgent need for proper case controls and efficient interventional trials to analyse how such interventions can produce a positive outcome on cardiovascular diseases. Some recent interventional trials have shown that periodontal treatment can decrease markers of systemic inflammation. The relationship between periodontal diseases and CVD deserves further research because of its consequences for public health.

치주질환자의 구강보건특성과 삶의 질의 관계

Objectives : The purpose of this study was to evaluate the chewing ability, oral-health related quality of life and factors in periodontal disease patients. Methods : Subjects were 111 patients having peridontal disease in 10 dental clinics in Busan and Gyeongsangnamdo. Questionnaire survey was carried out from July to August 2010. Questionnaire consisted of demographic characteristics, oral health factors, chewing ability and quality of life. Data were analyzed by descriptive analysis, t-test, ANOVA, correlation analysis, and multiple regression analysis using SAS(Ver 9.2) set at p<0.05. Results : Chewing ability was <TEX>$44.85{\pm}8.8$</TEX>, and their quality of life was <TEX>$41.7{\pm}8.8$</TEX>. Low level of quality of life was closely related to those factors as education, missing of more than 5 posterior teeth, certain subjective periodontal symptoms including swollen gums, sore gums, drifting gums, bad breath and toothache. The effective factors to the quality of life was chewing ability, bad breath and toothache. Conclusions : Chewing ability and quality of life were closely related each other. To enhance the quality of life, chewing ability should be improved. Proper treatment and effective method of management should also be properly considered to prevent the subjective periodontal symptoms and to minimize tooth loss.

Prolonged Delivery of Ciprofloxacin and Diclofenac Sodium from a Polymeric Fibre Device for the Treatment of Peridontal Disease

In vitro analysis of drug release and antimicrobial activity of the coblended crosslinked polymeric fibre device (PFD) were investigated. The fibre loaded with ciprofloxacin and diclofenac sodium was comprised of alginate and glycerol crosslinked with barium cations. The pH dependent drug release was evident with ciprofloxacin and diclofenac sodium diffusing from the fibre at pH 4.0 compared to pH 6.8, where the fibre swelled and eroded resulting in zero-order drug release. Agar diffusion studies followed by minimum inhibitory assays were conducted to determine the antimicrobial activity of the device against Escherichia coli, Enterococcus faecalis, and Streptococcus mutans. The antimicrobial activity of the PFD was confirmed in both test assays against all test pathogens. The MIC ranges at pH 4.0 for E. coli, E. faecalis, and S. mutans were 0.5–0.8, 0.4–1.1, and 0.7–2.1 μg/mL, respectively. At pH 6.8, similar efficacies (0.3–0.5 μg/mL for E. coli and E. faecalis and 0.6–1.0 μg/mL for S. mutans) were observed. The effect of varying the plasticizer and crosslinking ion concentration on drug release profile of the fibers was further elucidated and conceptualized using molecular mechanics energy relationships (MMER) and by exploring the spatial disposition of geometrically minimized molecular conformations.

Periodontal Disease and Adverse Pregnancy Outcomes: Is There an Association?

Srinivas, S.K.; Sammel, M.D.; Stamilio, D.M.; Clothier, B.; Jeffcoat, M.K.; Parry, S.; Macones, G.A.; Elovitz, M.A.; Metlay, J. Author Information

보육교사의 구강보건교육경험 인지도에 따른 구강보건지식의 관련성

보육교사들의 구강보건경험과 인지도 및 필요성에 따라 구강보건지식정도를 파악하고 관련성이 있는지 조사하고자, 경남지역에 소재한 37개 어린이집에 있는 보육교사 267명을 대상으로 설문조사를 실시하였다. 교육유무에 따른 구강보건지식을 살펴보면 교육경험이 있는 경우가 교육경험이 없는 경우보다 높게 나타났다. 교육장소별에 따른 구강보건지식을 살펴보면 보건소에서 가장 높게 나타났다. 교육필요 요구별에 따른 치주질환, 불소, 자일리톨의 구강보건지식에서 교육이 필요하다고 응답하였다. 교육참석 필요성에 따른 치주질환, 자일리톨의 구강보건지식에서 교육에 참석한다고 응답한 경우가 높게 나타났다. 교육의 필요성과 교육참석 필요성은 높은 상관관계(r=0.874)를 보였고, 치주질환 지식항목과 구강보건교육 참석도는 낮은 상관관계를 나타냈다(r=0.345). 보육교사의 구강보건교육경험과 인지도 및 필요성은 구강보건 지식에 관련성이 있었고, 아이들의 구강 보건을 효과적으로 관리하기 위해서는 보육교사에게 체계적이고 규칙적인 구강보건교육 프로그램이 필요할 것으로 사료되었다. This study was conducted to examine the influence of the experience of childcare teachers about oral health education on oral health knowledge. Questionnaires to be self-filled up on the experience of oral health education were applied to 267 childcare teachers who are working in a nursery schools in Kyoungnam province. The data were analysed using the SPSS 12.0 program. The obtained result were as follows: The oral health knowledge was higher in the case with oral health education than without it. A public health center would provide the highest oral health knowledge to nursery teachers. The educations about peridontal disease, oral health effect of fluorine and Xylitol were the most demanding among the some items. When the education topics are related with peridontal disease and Xylitol, the most respondents are willing to participate in the education course. The high correlation (r=0.874) was shown in the necessity of the education and the necessity of attending the course. Also there was a low correlation (r=0.345) between the knowledge items of peridontal disease and the participation in the oral health education. The relationship of oral health knowledge with experience and recognizance of oral health education appeared. Therefore systematic and regular program for the oral health education would be required.

Periodontal Disease and Adverse Pregnancy Outcomes: Is There an Association?

Some studies have reported an association between peridontal disease and adverse pregnancy outcomes, including preeclampsia (PRE) and preterm birth (PTB), while other studies have found no such association. This multicenter prospective cohort study compared the risk of a composite of adverse pregnancy outcomes and the single pregnancy outcomes of PTB, PRE, fetal growth restriction (FGR), or perinatal death among a population of 786 women with and without peridontal disease. This study, part of the Peridontal Infection and Prematurity Study, recruited the study subjects in 3 urban centers from 2004 to 2007. Peridontal disease was identified early in pregnancy. The comparison group was an observational cohort of women without peridontal disease. All participants were between 6 and 20 weeks' gestation. Peridontal disease was defined as peridontal attachment loss greater than or equal to 3 mm on 3 or more teeth. Multivariable logistic regression was used to control for potential confounding variables. Of the 786 women in the final analysis, 311 had peridontal disease and 475 did not. In unadjusted analyses, no association was found between the presence of peridontal disease and the composite outcome, and individual outcomes of PRE or PTB. Following adjustment for confounding variables, no association was found between peridontal disease and the composite outcome (adjusted odds ratio [aOR], 0.81; 95% confidence interval [CI], 0.58-1.15; P = 0.24), PRE (aOR, 0.71; 95% CI, 0.37-1.36; P = 0.30), or PTB (aAOR, 0.77; 95% CI, 0.49-1.21; P = 0.25). In contrast to several observational studies suggesting an association between peridontal disease and adverse pregnancy outcomes, these findings show no such association.

Gingival crevicular fluid in the diagnosis of periodontal and systemic diseases

Gingival crevicular fluid (GCF) can be found in the physiologic space (gingival sulcus), as well as in the pathological space (gingival pocket or periodontal pocket) between the gums and teeth. In the first case it is a transudate, in the second an exudate. The constituents of GCF originate from serum, gingival tissues, and from both bacterial and host response cells present in the aforementioned spaces and the surrounding tissues. The collection and analysis of GCF are the noninvasive methods for the evaluation of host response in periodontal disease. These analyses mainly focus on inflammatory markers, such as prostaglandin E2, neutrophil elastase and beta-glucuronidase, and on the marker of cellular necrosis-aspartat aminotransferase. Further, the analysis of inflammatory markers in the GCF may assist in defining how certain systemic diseases (e.g., diabetes mellitus) can modify periodontal disease, and how peridontal disease can influence certain systemic disorders (atherosclerosis, preterm delivery, diabetes mellitus and some chronic respiratory diseases). Major factors which influence the results obtained from the analyses of GCF are not only the methods of these analyses, but the method of GCF collection as well. As saliva collection is less technique-sensitive than GCF collection, some constituents of saliva which originate from the GCF can be analysed as more amenable to chairside utilization.

Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London

The aim of this study was to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants. Peridontal disease is associated with an increased risk of adverse pregnancy outcomes. The aim of this study is to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants. A questionnaire designed by the authors was completed by postnatal women within 3 days of delivery. Data collected included past dental attendance, reasons for attendance and information about age, parity and socio-economic group. In total, 206 women completed the questionnaires within 3 days of delivery; 74.2% of the mothers were not born in the UK and 38.3% were Black African. The mean age of was 28.19 +/- 6.07 years. The majority reported good oral hygiene habits such as brushing their teeth twice a day (73.7%) and using mouthwash (51%). However, their dental attendance was poor and the average time since their last visit to a dentist was 1.8 +/- 1.61 years. Over a third of the women questioned did not know about the availability of free dental care during pregnancy and for 12 months after; 33% visited a dentist in pregnancy and half of them needed and received treatment; 15% of mothers had more than one pregnancy and yet were still unaware of free dental care provided during pregnancy and 12 months after birth. Only 36% of questioned women regularly visited a dentist. Pregnancy did little to change their attitudes to dental care. There appears no difference in attitudes to dental care between immigrant and British born pregnant women. Efforts to improve the uptake of dental care should be directed towards immigrant groups in order to promote better maternal health. Further research is required into the provision of dental care during pregnancy, as the high level of non-attendance demonstrated by mothers is undesirable.

The Fcγ receptor III genotype as a risk factor for aggressive periodontitis in Korean patients

Aggressive periodontitis (AgP) represents an inflammatory disease with pathogenic features, such as onset in the juvenile or early adults years and severe and rapid destruction of periodontal tissue. It is now recognized that microbial factors can not solely be held responsible for AgP, although these are important in the initiation of periodontitis. 1 Genetically determined variance in host immune response bacteria has been identified in individuals with AgP. Many AgP (especially those with localized form) patients display defective neutrophil chemotaxis due to changes in chemotactic receptors or activation pathways. 2,31) It was after only the Kormann’s study4 on the genetic polymorphism of interleukin (IL) that many researchers were really being interested in the genetic factors and trying to find the scientific evidences of genetic factors that affect the pathogenesis of periodontitis. Since then, the wide spectrum of genes that might affect the progression of the peridontal disease, such as IL, tumor necrosis factor-α (TNF-α), Fcγ receptor (Fcγ R), vitamine D receptor, Nformyl receptor, matrix metalloproteinase (MMP) promoter, Toll-like receptor 2 (TLR2) and TLR4 have been studied for their role in the various types of periodontitis. Leukocyte receptors for the constant (or Fc-) part of immunoglobulins (FcR) link cellular and humoral branches of the immune systems, which are considered essential for host defense against periodontopathic bacteria. FcR for IgG (FcγR) may play a crucial role in the host defense against periodontopathic bacteria. 6-7 Three receptor

Age, gender, oestrogen therapy and dentition replacement

An increasing number of older people are retaining their teeth in the UK. Edentulism is gradually declining and will increasingly become a feature of social deprivation. This review covers the processes of ageing in teeth, the peridontium, the oral mucosa, muscles of mastication, salivary glands and taste. Diseases of the oral mucosa, in particular cancer, are examined. Tooth decay and peridontal disease are discussed. The relationship between systemic health and oral health status are becoming increasingly important. The effect of diet and tobacco smoking are explored. Finally, the association between peridontal disease and osteoporosis, atherosclerosis, venous thromboembolism are discussed.

Characterization of bone resorbing activity in gingival crevicular fluid from patients with periodontitis.

In attempts to elucidate factors stimulating bone resorption in patients with different inflammatory diseases in the vicinity of the skeleton, e.g., peridontal disease and rheumatoid arthritis, we are investigating the presence of bone-resorbing activity in a variety of inflammatory exudates. The aim of the present study was to characterize the bone-resorbing activity present in patients with periodontitis. Bone-resorbing activity was assessed in gingival crevicular fluids (GCFs) collected from patients with periodontitis and from patients with no signs of gingivitis. Bone-resorbing activity was evaluated by analyzing the capacity of GCFs to stimulate the release of minerals and the breakdown of bone matrix proteins in cultured neonatal mouse calvariae. The concentrations of IL-1alpha, IL-1beta and PGE2 were determined with ELISA and RIA techniques, respectively. GCF eluates from 24 different healthy sites caused a 1.23+/-0.05 fold stimulation of 45Ca release, whereas GCF eluates from 45 different diseased (periodontitis) sites caused a 2.46+/-0.10 fold stimulation. The effect on 45Ca release was time- and concentration-dependent, inhibited by 3 different osteoclast inhibitors and associated with enhanced release of 3H from [3H]-proline-labelled bones. The activity in GCF causing enhanced 45Ca release was unaffected, or in some samples partially reduced, by ultrafiltration using a filter with a molecular weight cut-off of 3000 Daltons. The bone-resorbing activity was temperature sensitive (+90degrees C, 10 min). The concentrations of prostaglandin E2 (PGE2) in the diluted GCF eluates, used in the bone resorption bioassay, were too low to be responsible for the release of 45Ca. Antisera specifically neutralizing human IL-1a inhibited the stimulatory effect of GCF pooled from several diseased sites. The specific, recombinant human IL-1 receptor antagonist completely inhibited the effect of pooled GCFs. GCF eluates from diseased sites contained human IL-1alpha and IL-1beta at concentrations of 1838+/-294 pg/ml and 512+/-91 pg/ml, respectively. These data show that GCF contains activity(ies) stimulating osteoclastic bone resorption in vitro. The factor primarily responsible for this activity seems to be IL-1alpha, but IL-1alpha is not the sole activator of bone resorption in GCF.

An Immunological Evaluation of Type II Diabetic Patients with Periodontal Disease

Peridontal disease is a frequent complication of diabetes, and diabetic subjects often exhibit decreased immune response with increased susceptibility to infection. We evaluated the possible relationship between immune response and periodontal disease in 40 type II diabetic patients, mean (± SD) age 59 ± 8 years and mean disease duration 17 ± 4 years, with good metabolic control (mean fasting plasma glucose, 10.5 ± 3.8 mM/L, mean HbA 1c 8.1 ± 1.66%), and in 40 age and gender-matched controls. Interproximal alveolar bone loss (ABL), as the percentage of bone loss from the cement enamel junction (CEJ) to the apex, was measured with a modified Schei ruler at the deepest point on the mesial/distal surface of the teeth, except third molars, on a panoramic radiograph. Immunological evaluation involved study of NADPH neutrophil superoxide production, neutrophil chemotaxis, lymphocyte subpopulations, immunoglobulins and complement. Diabetic patients showed significant differences compared with controls regarding ABL (30.6 ± 14.7% versus 17.6 ± 4.3%; p < 0.0001) and the T-helper/T-suppressor ratio (2.3 ± 1.0% versus 1.8 ± 0.8%; p < 0.05). Other parameters of cell-mediated immunity and humoral immune response did not show any significant variations. No correlation between immunological and radiographic analysis parameters were found. Further studies are needed to verify the exact role played by immunological factors in type II diabetic patients with periodontal disease.

Anaerobic, gram-positive, pleomorphic rods in human gingival crevice.

Sixty-two strains of anaerobic, gram-positive, pleomorphic rods were isolated from the gingival crevice of individuals clinically free from peridontal disease, and examined for biochemical characteristics, cellular and colonial morphology, and acid end-products from glucose fermentation. None of them produced indole, hydrogen sulfide, or catalase, but all hydrolysed esculin. Seven, 10 and 45 of 62 strains were identified as Bifidobacterium, Actinomyces naeslundii, and Actinomyces israelii, respectively, on the basis of biochemical characteristics.

Book Reviews

Book reviews in this article: PERIDONTAL DISEASE: Basic Phenomena, Clinical Management, and Occlusal and Restorative Interrelationships, by Saul Schluger, Ralph Yuodelis and Roy Page. Salivary Glands in Health and Disease, by D. K. Mason and D. M. Chisholm. A Guide to Dental Radiography: Dental Practitioner Handbook No. 27, by Rita A. Mason.

The Tonsillitis Habit

<i>The Tonsillitis Habit</i>by Osborn and Roydhouse is a small volume (100 pages) with an interesting title. The purpose of this book is to discuss the rationale and value of tonsillectomy and adenoidectomy. The book has several virtues and a number of debits. On the positive side there is an interesting discussion of the physiology and the pathology of "reversible forms" and "irreversible forms" of tonsillitis. The chapter by Holland on anesthesia for adenotonsillectomy presents a worthwhile review of the principles of anesthesia for tonsillectomy and stresses maintenance of the airway. The list of anesthestic agents may not suit every anesthesiologist, however. The chapters describing cow's-milk intolerance, modes of cross infection of infants, and peridontal disease are worth reading, since they are not stressed in most otolaryngology textbooks. On the debit side, however, is a real absence of significant correlation of the pathology of tonsil and adenoid disease to indications

Importance of Actinomyces and certain gram-negative anaerobic organisms in the transformation of lymphocytes from patients with periodontal disease.

Dental plaque deposits are known to be potent stimulants of lymphocyte transformation in patients with periodontal disease but not in normal subjects. Since plaque deposits consist mainly of whole bacteria, the cell walls of the most commonly found organisms in plaque were tested for their capacity to induce lymphocyte transformation. There was a direct correlation between the severity of peridontal disease and the amount of transformation induced by the cell walls of oral bacteria and by solubilized dental plaque. Cord blood leukocytes and lymphocytes from clinically normal people did not respond, which indicates that these stimulants are antigens rather than mitogens. Of the eleven bacteria tested, four members of the family Actinomycetaceae (Actinomyces viscosus, A. israelii, A. naeslundii, and Arachnia propionica), the related Propionibacterium acnes, and an anaerobic gram-negative anaerobic rod (27N). The high prevalence of the former organisms in the mature dental plaque that forms around the gingival crevice area and the potent efficacy with which they stimulate lymphocytes indicates that Actinomyces and certain gram-negative anaerobes may be important etiological agents in chronic periodontal inflammation in man.

Transient Bacteremia Following Dental Manipulation-Reply

To the Editor .—Thank you for the invitation to comment on Dr. Scopp's interesting letter. From Scopp and Orvieto's original paper, 1 in which povidone-iodine (Betadine) mouthwash was used to irrigate the gingival sulci and to wash the oral cavity, and from the studies reported by Jones et al 2 and Cutcher et al, 3 in which a phenolated antiseptic solution was used, it would appear that a reduction in the number of bacteria recoverable from the oral cavity and gingival sulci and a reduction in the incidence of postextraction bacteremia can be obtained with this technique. In Scopp and Orvieto's study, questions might be raised about the exclusion of patients with severe peridontal disease, and one wonders about the quantitation of cultures obtained from the gingivae and gingival sulci at a time when the bactericidal agent was still present in the mouth and likely to be absorbed by