Periodontal Attachment Research Articles

Effect of Periodontal Serial Therapy Combined with Orthodontics on Periodontal Parameters in Patients with Periodontitis

Objective: To investigate the clinical efficacy of periodontal sequence in combination with orthodontic treatment of patients with periodontitis. Methods: Retrospective analysis of periodontitis patients (54 cases) treated at our hospital between February 2018 and June 2019. The clinical data of all the enrolled participants were subjected to periodontal serial combined orthodontic treatment, and all the registered participants were observed at the initial consultation, periodontal serial treatment1 Periodontal parameters at the end of months and at the end of orthodontic treatment, serial periodontal treatment and orthodontic treatment for all enrolled individuals, x-rays and Oral examinations were performed, and the results were analyzed. Results: Compared to the initial visit, all enrolled individuals had a higher plaque index (PLI) after 1 month of periodontal treatment and at the end of orthodontic treatment. Bleeding index (BI), periodontal probe depth (PD), and periodontal attachment loss (CAL) levels were all lower than those detected at the initial visit. The difference was statistically significant (P < 0.05); after serial periodontal treatment and orthodontic treatment, the x-ray results showed that the patients' Alveolar bone resorption or regeneration ceased; The results of the oral examination showed that the patient's occlusal relationship improved significantly and basically returned to normal. Status, a masticatory function was significantly improved, and individual tooth loosening due to occlusal trauma was improved considerably. Conclusion: The combination of periodontal sequence and orthodontic treatment of patients with periodontitis is beneficial to enhance periodontal parameters, improve occlusal relationships, and improve masticatory function.

Changes in clinical and microbiological parameters of the periodontium during initial stages of orthodontic movement in patients with treated severe periodontitis: A longitudinal site-level analysis.

Applying orthodontic braces makes oral hygiene difficult and increases plaque accumulation, frequently resulting in gingival inflammation. In patients with previous severe periodontitis, this inflammation overlaps with the pre-existing inflammatory challenge and can lead to further progression of periodontal attachment loss. The aim of this study was to assess longitudinal site-level changes as mirrored by clinical and microbiological parameters during the initial remodeling of alveolar bone and the periodontal ligament, produced as an effect of light orthodontic forces in adult patients with severe periodontal disease that underwent standard (non-surgical and conventional surgical) periodontal therapy. Thirteen patients with previously treated severe generalized periodontitis were given fixed orthodontic appliances for re-alignment of teeth misaligned or displaced during the course of periodontitis. Before insertion of orthodontic appliances and at 2, 4, and 6 months of treatment, periodontal clinical parameters were recorded in the same deepest residual pocket of at least 3 mm in each patient. The same pocket was sampled at baseline and after 6 months of orthodontic treatment for the frequency of positive detection of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tanerella forsythia (Tf), Treponema denticola (Td). An average reduction in Pocket Depth by 0.2 mm at the end of the assessment period was identified. The only clinical parameter with statistically significant improvement was bleeding on probing. The frequency of detection of Aa, Pg, Pi, and Tf was not significantly different between baseline and 6 months of treatment, while a marginally significant increase of Td was found. There were no significant differences in the clinical parameters or microflora in the initial phase of orthodontic treatment in patients with reduced periodontal support. By correlating clinical and microbiological data, we concluded that the presence of periopathogens do not negatively influence periodontal health during orthodontic treatment in adult patients treated for severe periodontitis.

Considerations for Clinical Use of Concentrated Growth Factor in Maxillofacial Regenerative Medicine

Different strategies have been utilized to facilitate mineralized/soft tissues. Concentrated growth factor (CGF) emerges as a promising biomaterial for regenerative therapy due to high levels of platelets, growth factors, and nucleated cells entrapped in the fibrin scaffold. This review aimed to collect extensive studies on CGF used in maxillofacial regenerative medicine, discussing current obstacles, and expressing some considerations of CGF use. Articles were retrieved systematically without time limitation. In total, 27 human studies were included and separated accordingly. In general, CGF has been most evaluated in implant related therapy and maxillofacial bone regeneration where a majority of articles have revealed favorable outcomes. Little studies have supported the effects on improving probing periodontal depth reductions and clinical attachment level gains for intrabony and furcation defect regeneration. Very little data with high-level evidence was available directly to investigate its effects on the soft tissue regeneration and postoperative complications reduction. The evidence supporting the clinical efficacy of CGF in maxillofacial regenerative medicine is limited. Some conflicting results are worrisome. In addition, the characterization of CGF preparation protocols and CGF's components was not performed in most studies. Further studies should make a consensus on standardized end-product of CGF including characterization of protocols and optimal ratio of CGF' components. Defined algorithms and evidence-based protocols for the clinical use of CGF should be also available.

Treatment of chronic generalized periodontitis using miramistin-containing nanomatrix as maintenance therapy: a pilot study and early results

Aim of the study was to evaluate the clinical efficacy of a nanomatrix with Miramistin based on M-Chip (Double White, Russia), which is used subgingivally as an addition to SRP (scaling and root planing) as a combination therapy in patients with chronic generalized periodontitis.Materials and methods. T he s tudy i ncluded 4 5 p atients w ith c hronic g eneralized p eriodontitis (20 f emales a nd 25 males; age span is 35–60 years; mean age 57.87 ± 8.2 years). Patients with a probing depth ≥5 mm were included. Selected patients did not receive antibiotic therapy during the last 6 months of follow-up.Results. The mean clinical parameter values between the M-Chip + SRP treatment group and the SRP control group showed a statistically significant improvement in clinical parameters at 6 months compared to baseline values for the following indicators: plaque index (API), gingival pocket depth at probing, Mühlemann Bleeding Index (BI), the level of clinical attachment.Conclusions. SRP has been shown to be effective in reducing pocket depth, increasing periodontal attachment, and reducing inflammation. However, when SRP was used with the M-Chip, possible additional clinical benefits have been shown.

A systematic review and meta-analysis on the effectiveness of xenograft to prevent periodontal defects after mandibular third molar extraction.

Background To evaluate the use of guided bone regeneration with xenograft to prevent periodontal defect in the distal aspect of the second molar after the surgical removal of the mandibular third molar. Material and Methods Three electronic databases (Pubmed, Cochrane Library and Scopus) were searched in April 2020. Randomized clinical trials in non-smokers and healthy patients, with at least six months follow-up, comparing periodontal probing depth, clinical attachment level, alveolar bone level and adverse events were selected by two independent investigators. The risk of bias assessment of the selected studies was evaluated by means of the Cochrane Collaboration’s Tool. Finally, a meta-analysis of the outcomes of interest was performed. Results Despite 795 articles were found in the initial search, only three randomized controlled clinical trials were included. Pooled results favoured the use of the xenograft plus collagen membrane over the spontaneous healing in terms of periodontal probing depth gain (MD=2.36; 95% CI 0.69 to 4.03; P=0.005) and clinical attachment level gain (MD=2.52; 95% CI 0.96 to 4.09; P=0.002). No other statistically significant differences were found. Conclusions Within the limitations of the present review, the xenograft plus collagen membrane exhibited better periodontal results than spontaneous healing without increasing postoperative complications. However, future well-designed studies with larger samples are required to confirm our results. Key words:Third molar, tooth extraction, bone regeneration, xenograft.

The association of tumor necrosis factor alpha, lymphotoxin alpha, tumor necrosis factor receptor 1 and tumor necrosis factor receptor 2 gene polymorphisms and serum levels with periodontitis and type 2 diabetes in Serbian population

ObjectivesAiming to show that periodontitis (PD) and type 2 diabetes (T2D) are bidirectionally related and potentially linked by inflammatory cytokines, we searched for association between −308 G/A Tumor necrosis factor-alpha (TNFα), +252A/G Lymphotoxin-alpha (LTα), +36A/G Tumor necrosis factor receptor 1 (TNFR1) and +676 T/G tumor necrosis factor receptor 2 (TNFR2) single nucleotide polymorphisms (SNPs) and: risk of PD or PD + T2D; periodontitis parameters in PD and PD + T2D; serum levels of cytokines/their receptors. Relationship between periodontal inflammation and serum cytokine/receptor levels was also assessed. DesignSubjects were stratified as: 57 healthy controls (HC); 58 PD; 65 PD + T2D. Sociodemographic, environmental, behavioral and periodontal clinical data were recorded. SNPs were genotyped using polymerase chain reaction-restriction fragment length polymorphism, while cytokines/receptors levels were quantified by enzyme-linked immunosorbent assay. Impact of periodontal inflammation was measured using periodontal inflamed surface area (PISA). ResultsTNFα AA genotype showed protective effect in T2D + PD compared to PD, even adjusted for behavioral/environmental factors (OR 0.18; 95 %CI 0.037−0.886; p = 0.035). LTα AG heterozygotes had increased risk of PD (OR 3.27; 95 %CI 1.35−7.96; p = 0.016), while TNFR2 TG genotype had protective effect (OR = 0.44; 95 %CI 0.954−0.9794; p = 0.043). TNFR1 AA was predictor of periodontal pocket depth and clinical attachment loss in PD. Correlation between TNFR2 concentration and PISA was negative in PD, positive in PD + T2D. ConclusionsNone of the SNPs showed cross-susceptibility between PD and T2D. + 252A/G LTα and +676 T/G TNFR2 SNPs are associated with PD risk. Periodontal destruction in healthy individuals is influenced by TNFR1 genotype. Impact of periodontal on systemic inflammation is masked by T2D.

Effects of the professional oral care management program on patients with head and neck cancer after radiotherapy: A 12-month follow-up

Background/purposeBecause oral health of patients with head & neck cancer is prone to disease after radiotherapy, effective and long-lasting oral care program is necessary. We aimed to evaluate the effects of the oral care management program, which lasted up to 12 months after radiotherapy for patients with head and neck cancer. Materials and methodsSixty-eight patients who visited a dental clinic prior to the initiation of radiotherapy were recruited and categorized into either a “healthy” or a “vulnerable” group. The vulnerable group was made of patients with dental caries or periodontal attachment loss. Professional oral hygiene care, including tooth brushing instructions, professional mechanical tooth cleaning, and fluoride varnish application, was conducted once every week for a month during radiotherapy and once every 3 months after radiotherapy. Oral health, including dental caries, plaques, gingival index, and periodontal attachment loss, was examined at baseline, 6 months, and 12 months after radiotherapy. Results; Twenty-nine and 16 patients were followed up at 6 and 12 months after radiotherapy, respectively. Oral health indices, such as the number of decayed teeth, amount of plaque, and gingival index, did not significantly change in either group. However, the periodontal pocket depth significantly decreased in both groups at 6 months after baseline, and this decrease continued in the vulnerable group up to 12 months after baseline. ConclusionPeriodic dental visits and professional oral hygiene care during and after radiotherapy were effective in maintaining oral health for over 12 months after radiotherapy in patients with head and neck cancer.

Effect of resveratrol on the progression of experimental periodontitis in an ovariectomized rat model of osteoporosis: Morphometric, immune-enzymatic, and gene expression analysis.

This study aimed to determine the role of resveratrol (RESV) on the progression of experimental periodontitis (EP) in ovariectomy rats (OVT). Estrogen deficiency is the main cause of osteoporosis and is related to higher periodontal attachment loss and reduction of alveolar bone. Zoledronate (ZLD) is an antiresorptive drug used to control osteoporosis but can lead to osteonecrosis of the jaw. RESV, a natural product, can reduce bone loss and control and prevent osteoporosis. Thus, this study aimed at investigating the effect of RESV on the progression of EP in estrogen-deficient rats. The animals were subjected to the OVT or sham surgery to induce estrogen-deficiency and then were divided into the groups: OVT+RESV (n: 10); OVT+PLAC (n: 10): OVT+placebo; OVT+ZLD +PLA (n: 10); OVT+RESV +ZLD (n: 10): OVT+RESV and ZLD; SHAM (n: 10): non-ovariectomized animals+placebo. To induce estrogen deficiency, the rats were subjected to ovariectomy. Experimental periodontitis was induced by the placement of a ligature at the second maxillary molars. Daily administration of the placebo solution, resveratrol (10mg/kg), and ZLD (0.1mg/kg) was carried out for a period 42days prior to initiation of EP, and then for another 28days following ligature placement. After euthanasia, the specimens were processed for micro-CT and morphometric analysis of bone loss (linear measurement), and the gingival tissue surrounding the maxillary second molar was collected for the quantification of inflammatory markers using Luminex/MAGPix, of oxidative stress markers using ELISA assay, and gene expression analysis of bone markers, by real-time PCR. Morphometric and micro-CT analysis showed higher bone loss and lower bone density, respectively, in OVT+PLAC when compared to the other groups (P<.05). ZLD treated groups had lower alveolar bone loss, as well as, higher density and percentage of bone volume, when compared to OVT+RESV and SHAM+PLAC groups (P<.05). IL-4 levels were significantly lower in the OVT+PLAC group versus OVT+ZLD +RESV and SHAM+PLAC (P<.05). NADPH oxidase (nicotinamide adenine dinucleotide phosphate oxidase) levels were significantly lower OVT+RESV group when compared to OVT+PLAC (P<.05). OPG mRNA levels were lower in OVT+PLAC compared with the SHAM+PLAC group (P<.05). It can be concluded that resveratrol modulated alveolar bone loss during experimental periodontitis progression in estrogen-deficient rats by downregulating NADPH oxidase levels.

ROLE OF SOCKET SHIELD TECHNIQUE IN IMMEDIATE IMPLANTS PLACED IN THE ESTHETIC ZONE – A CASE REPORT

Immediate implant is a valuable treatment of choice to replace non restorable teeth in the esthetic zone with a success rate of 87.5 to 100%. It has several advantages like minimizing the total treatment time, cost effective, and psycosocial benefits. In spite of the exceptional success rates, horizontal buccal bone resorption of about 56% and corresponding palatal bone resorption of 30% has been documented with respect to immediate implants (1) . These morphometric changes negatively influence the aesthetic outcome of dental implants. The use of modified surgical procedures such as the flapless technique, various hard tissue augmentation procedures, guided bone regeneration (GBR) and titanium reinforced barriers as well as various bone promoting molecules have been tried for bone preservation, with each method having its own benefits and drawbacks. Recently socket-shield technique (SST) otherwise called partial extraction therapy by Hurzeler et al in 2006 was described where buccal segment of the root is retained as a shield in situ, which aids in preserving periodontal attachment apparatus thus preserving the vascularity of buccal bone when compared to other conventional techniques. Here we present a case of non-restorable tooth in the maxillary aesthetic zone managed with placement of immediate implant using socket shield technique and evaluating the hard tissue health and aesthetic outcome (2).

EVALUATION OF VARIATION IN SLOT SIZE BETWEEN COMMERCIALLY AVAILABLE BRACKET SYSTEMS

Immediate implant is a valuable treatment of choice to replace non restorable teeth in the esthetic zone with a success rate of 87.5 to 100%. It has several advantages like minimizing the total treatment time, cost effective, and psycosocial benefits. In spite of the exceptional success rates, horizontal buccal bone resorption of about 56% and corresponding palatal bone resorption of 30% has been documented with respect to immediate implants (1) . These morphometric changes negatively influence the aesthetic outcome of dental implants. The use of modified surgical procedures such as the flapless technique, various hard tissue augmentation procedures, guided bone regeneration (GBR) and titanium reinforced barriers as well as various bone promoting molecules have been tried for bone preservation, with each method having its own benefits and drawbacks. Recently socket-shield technique (SST) otherwise called partial extraction therapy by Hurzeler et al in 2006 was described where buccal segment of the root is retained as a shield in situ, which aids in preserving periodontal attachment apparatus thus preserving the vascularity of buccal bone when compared to other conventional techniques. Here we present a case of non-restorable tooth in the maxillary aesthetic zone managed with placement of immediate implant using socket shield technique and evaluating the hard tissue health and aesthetic outcome (2).

Uncaria tomentosa reduces osteoclastic bone loss in vivo

BackgroundThe genus Uncaria (Rubiaceae) has several biological properties significant to human health. However, the mechanisms underlying the protective effect of this plant on bone diseases are uncertain. PurposeThe present study investigated the role of Uncaria tomentosa extract (UTE) on alveolar bone loss in rats and on osteoclastogenesis in vitro. MaterialsUTE was characterized by an Acquity UPLC (Waters) system, coupled to an Electrospray Ionization (ESI) interface and Quadrupole/Flight Time (QTOF, Waters) Mass Spectrometry system (MS). The effect of UTE treatment for 11 days on the ligature-induced bone loss was assessed focusing on several aspects: macroscopic and histological analysis of bone loss, neutrophil and osteoclast infiltration, and anabolic effect. The effect of UTE on bone marrow cell differentiation to osteoclasts was assessed in vitro. ResultsThe analysis of UTE by UPLC-ESI-QTOF-MS/MS identified 24 compounds, among pentacyclic or tetracyclic oxindole alkaloids and phenols. The administration of UTE for 11 days on ligature-induced rat attenuated the periodontal attachment loss and alveolar bone resorption. It also diminished neutrophil migration to the gingiva tissue, demonstrated by a lower level of MPO. UTE treatment also decreased the level of RANKL/OPG ratio, the main osteoclast differentiation-related genes, followed by reduced TRAP-positive cell number lining the alveolar bone. Additionally, the level of bone-specific alkaline phosphatase, an anabolic bone marker, was elevated in the plasma of UTE treated rats. Next, we determined a possible direct effect of UTE on osteoclast differentiation in vitro. The incubation of primary osteoclast with UTE decreased RANKL-induced osteoclast differentiation without affecting cell viability. This effect was supported by downregulation of the nuclear factor activated T-cells, cytoplasmic 1 expression, a master regulator of osteoclast differentiation, and other osteoclast-specific activity markers, such as cathepsin K and TRAP. ConclusionUTE exhibited an effective anti-resorptive and anabolic effects, which highlight it as a potential natural product for the treatment of certain osteolytic diseases, such as periodontitis.

PERIODONTAL MICROBIOLOGIC PROFILE OF PATIENTS WITH AMEGAKARYOCYTIC PURPURA POST BONE MARROW TRANSPLANTATION

Two siblings (2 and 4 years old) diagnosed with amegakaryocytic purpura after hematopoietic stem cell transplantation were diagnosed with graft vs host disease (GVHD) in the skin, buccal and gastrointestinal mucosa and lungs. Dental biofilm accumulation and periodontal clinical attachment loss (PCAL) were also observed in the dental evaluation. Samples of dental biofilm were collected for analysis using the Checkerboard DNA-DNA hybridization technique to determine the microbiologic profile. The hypothesis was that PCAL could be associated with the microbial profile compatible with periodontal disease and, therefore, a local treatment would be effective. However, the samples showed normal cell counts of bacterial species compatible with health and low counts of species compatible with the disease (higher in the patient with older age than in younger). We conclude that the observed PCAL was more compatible with a local manifestation of GVHD than with a change in the microbiologic profile.

2,3,5,4'-Tetrahydroxystilbene-2-O-β-d-glucoside promotes the effects of dental pulp stem cells on rebuilding periodontal tissues in experimental periodontal defects.

This study aimed to investigate the regenerative effects of 2,3,5,4'-tetrahydroxystilbene-2-O-β-d-glucoside (THSG)-treated human dental pulp stem cells (DPSC) on the healing of experimental periodontal defects in rats. The maxillary first molars of 30 male Sprague-Dawley rats were extracted, and after healing, bilateral periodontal defects were surgically created mesially in second molars. The defects were treated with Matrigel (as control), DPSC, or DPSC + THSG. After 2weeks, the healed defects were evaluated using microcomputed tomography and through histological and immunohistochemical analyses. In the microcomputed tomography analysis, more new bone formation in the DPSC and DPSC + THSG groups was observed compared with the control group. The periodontal bone supporting ratio in site with DPSC + THSG was significantly higher than that in DPSC. Histologically, an enhanced new bone formation and more significant periodontal attachment were observed in the DPSC + THSG group. The expression levels of proliferating cell nuclear antigen (PCNA), vascular endothelial growth factor (VEGF), and osteopontin (OPN) in the DPSC + THSG group were significantly greater than those in other groups. THSG-revolutionized DPSCs significantly shortened the regenerative period of periodontal defects by enhancing the cell recruitment and possibly the angiogenesis in rat models, which illustrate the critical implications for a clinical application and provide a novel tactic for periodontitis treatment.

IMPLICATION OF PERIO IN FORENSIC ODONTOLOGY

Forensic research pertaining to dentistry has taken several turns and reached a crossroad where every separate branch has an entity to contribute to support identification of the deceased. Periodontics is utilized for identification of individuals through morphology and pathology of periodontium and is also utilized for age estimation studies which include periodontal ligament attachment level, root transparency and root length . The prime focus of this literature is to highlight how a periodontist can contribute to the field of forensic odontology by associating the following parameters of his domain, to unravel a crime scene. This literature aims to summarize the findings of studies that reported periodontal associations or potential associations that could play a role in forensic research.

Guided Tissue Regeneration – A Boon to Surgical Periodontal Therapy

Periodontitis has been a chronic inflammatory disease of the gingiva which eventually result in periodontal pocket formation with loss of the associated periodontal ligament and alveolar bone around teeth. Guided tissue regeneration (GTR), which is often a target for periodontal treatment, has the ability to promote periodontal regeneration. The development of the periodontal attachment is primarily concerned with tissue regeneration.Based on such concept, guided tissue regeneration is being utilized to varying degree of success to restore periodontal defects. In order to remove epithelium as well as gingival corium from the root and/or existing bone walls on the assumption that they interfere with regeneration, barrier techniques have been applied, using elements like expanded polytetrafluoroethylene, polyglactine, polylactic acid, calcium sulfate and collagen.

Een klachtenvrije derde molaar, verwijderen of niet?

Three adult patients, ages 28 (female), 36 (male) and 53 (male), respectively, were referred by their dentists to an orofacial surgeon concerning problems with their third molars. With the woman, teeth 38 and 48 were removed. After the removal of tooth 38, a permanent periodontal attachment loss of the adjoining second molar occurred. With the second patient, retention of tooth 48 caused serious damage to the adjoining second molar, resulting in the loss of the tooth. At the time of removal, there was a question of increased risk of inflammatory complications and nerve damage. With the third patient, removal of his impacted tooth 38 led to osteomyelitis and a fracture of the angle of the mandible. According to the newly published 'Third molar' in the Dutch Clinical Guidelines, the advice is to consider the removal of asymptomatic third molars in 17-year-old patients. In the case of impacted third molars with mesial or horizontal angulation and partial eruption, the risk of pathology is such that preventive removal is advised. An intraoral radiograph (periapical or bitewing) as a first screening is recommended here.

Endpoints of active periodontal therapy.

AimPosition paper on endpoints of active periodontal therapy for designing treatment guidelines. The question was as follows: How are, for an individual patient, commonly applied periodontal probing measures—recorded after active periodontal therapy—related to (a) stability of clinical attachment level, (b) tooth survival, (c) need for re‐treatment or (d) oral health‐related quality of life.MethodsA literature search was conducted in Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations and Daily <1946 to 07 June 2019>.ResultsA total of 94 papers were retrieved. From the literature search, it was found that periodontitis patients with a low proportion of deep residual pockets after active periodontal therapy are more likely to have stability of clinical attachment level over a follow‐up time of ≥1 year. Other supporting literature confirms this finding and additionally reports, at the patient level, that probing pocket depths ≥6 mm and bleeding on probing scores ≥30% are risks for tooth loss. There is lack of evidence that periodontal probing measures after completion of active periodontal treatment are tangible to the patient.ConclusionsBased on literature and biological plausibility, it is reasonable to state that periodontitis patients with a low proportion of residual periodontal pockets and little inflammation are more likely to have stability of clinical attachment levels and less tooth loss over time. Guidelines for periodontal therapy should take into consideration (a) long‐term tangible patient outcomes, (b) that shallow pockets (≤4 mm) without bleeding on probing in patients with <30% bleeding sites are the best guarantee for the patient for stability of his/her periodontal attachment, (c) patient heterogeneity and patient changes in immune response over time, and (d) that treatment strategies include lifestyle changes of the patient. Long‐term large population‐based and practice‐based studies on the efficacy of periodontal therapies including both clinical and patient‐reported outcomes (PROs) need to be initiated, which include the understanding that periodontitis is a complex disease with variation of inflammatory responses due to environment, (epi)genetics, lifestyle and ageing. Involving people living with periodontitis as co‐researchers in the design of these studies would also help to improve their relevance.

Frequency of diagnosis of various periodontal tissue conditions at the dentist's appointment and risk factors

Objective : To calculate the rate of various states and inflammatory diseases among dental patients and to determine risk factors for periodontitis according to the new international classification. Methods: 64 patients aged from 21 to 65 years were examined. The main inclusion criterion was the absence of complaints of periodontal lesions. Dental formula, occlusion, condition of gums and soft tissues of the oral vestibule, the presence of dental plaque, indicators of oral hygiene, bleeding of the gums, loss of periodontal attachment were evaluated. Results : Healthy periodontium was detected in 29.7 % of cases (19 people); healthy reduced periodontium – in 10.9 % of cases (7 people); chronic gingivitis was diagnosed in 15.6 % of patients (10 people); and progressive periodontitis – in 43.8 % of patients (28 people). Conclusions : Healthy periodontium was diagnosed in people of young age without systemic pathologies; healthy reduced periodontium was detected in people of young and middle age who did not have severe systemic diseases and occlusion pathologies.

Is There a Bidirectional Association between Polycystic Ovarian Syndrome and Periodontitis? A Systematic Review and Meta-analysis.

Polycystic ovary syndrome (PCOS) has reproductive and metabolic properties that may be linked to periodontitis (PD). This study aimed to update and render a robust critical assessment on all evidence linking PCOS and PD, and appraising a hypothetical bidirectional association. Five databases (PubMed, Scholar, EMBASE, Web of Science and CENTRAL) were searched up to May 2020. Case-control and cohort studies on the association of PCOS and PD were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Random effects meta-analyses of standardized mean difference (SMD) and risk ratio (RR) were performed. We followed Strength of Recommendation Taxonomy (SORT) to appraise the strength and quality of the evidence. Twelve case-controls fulfilled the inclusion criteria (876 with PCOS and 48170 healthy controls), all scored as having a low risk of bias. Meta-analysis revealed that PCOS females have 28% more risk towards PD, and PD females have 46% more risk to have PCOS. PCOS females with PD had higher gum bleeding, periodontal pocket depth and clinical attachment loss than non-PCOS females with PD. Populations with undefined periodontal status contribute to underestimated results. On the basis of the available evidence, it is possible to assume a bidirectional link between PCOS and PD. That is, PCOS increases by 28% the risk of having PD and in the same fashion, PD increases by 46% the risk of having PCOS. Furthermore, women with PCOS were associated with worsening clinical characteristics and inflammation of PD. These findings suggest that PCOS and PD may be linked. Hence, further prospective and clinical trial studies with nonsurgical periodontal therapy are necessary to clarify the existence of an increased risk of PCOS in women with PD and vice-versa.

Strategies for Managing the Risk of Mucogingival Changes During Impacted Maxillary Canine Treatment.

Gingival recession is a frequent mucogingival defect in the adult population. It affects the esthetics and is related to hypersensitivity and a high risk of periodontal attachment loss. The connection between orthodontic treatment and periodontal health has been debated for a long time. A healthy periodontium can be preserved during safe orthodontic tooth movement even in patients with poor mucogingival anatomy. This article aimed to review the strategies around managing the risks of mucogingival and apical root changes owing to maxillary canine impaction, with a special focus on gingival recession and impacted maxillary canine treatment. Maxillary canines are the second most frequently impacted teeth after the third molars. They can be located in the labial or buccal aspect of the alveolar bone. If interceptive procedures fail, the next step is the challenging and time-consuming comprehensive orthodontic-surgical treatment. Determining the exact impacted canine location, its relation to the adjacent teeth and structures, the least invasive surgical approach, and the best path for traction are all a part of the standard diagnostic process. It has also been suggested that orthodontists should evaluate periodontal risks to achieve the best possible results. Clinical examination and cone beam computed tomography provide valuable information for the treatment plan that yields good results with a healthy periodontium.