Periodontal Status Research Articles

Minimally Invasive Technique for removal of impacted 3rd mandibular molar and periodontal status of 2nd molar. Clinical study.

Minimally Invasive Technique for removal of impacted 3rd mandibular molar and periodontal status of 2nd molar. Clinical study.

Oral Health of the Electronic Cigarette Smokers: A Systematic Review

ABSTRACT Background: This review aimed to evaluate the impact of e-cigarette usage on oral health, given the rising popularity of e-cigarettes and their perceived lower risk compared to traditional smoking. Materials and Methods: Searches were conducted in PubMed, Cochrane, and Scopus databases for studies from January 2014 to December 2023. Eligibility was based on the PICOS criteria. Data extraction was performed by two independent investigators. Studies were assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Results: The review included 31 studies, primarily from the USA and Saudi Arabia: 12 cross-sectional, nine case-control, five prospective observational, and five RCTs. Findings showed that clinical periodontal conditions and pro-inflammatory marker levels in e-cigarette users were similar to non-users and lower than conventional cigarette smokers. Dental issues studied included fractures, pain, decay, sensitivity, and loss. Two studies examined harmful metabolites in e-cigarette users. Most studies had low-quality evidence, relying on self-reported data without considering other influencing factors. Conclusion: E-cigarette users may experience more changes in oral tissues compared to non-smokers and former smokers.

An Immunomodulatory Hydrogel Featuring Antibacterial and Reactive Oxygen Species Scavenging Properties for Treating Periodontitis in Diabetes.

Periodontal disease is a multifactorial, bacterially induced inflammatory disorder characterized by progressive destruction of periodontal tissues. Additionally, diabetes mellitus exacerbates periodontitis, resulting in expedited resorption of periodontal bone. However, methods such as mechanical debridement, anti-inflammatory medications, and surgical approaches often fail to eradicate local infections and inflammation, complicating the reconstruction of periodontal tissue structures. Consequently, there is an urgent need to devise a novel strategy for managing diabetic periodontal conditions. Here, a multifunctional controlled-release drug delivery system (GOE1) is developed by encapsulating self-assembled nanoparticles (consisting of chlorhexidine acetate and epigallocatechin-3-gallate) into a hydrogel matrix composed of gelatin methacryloyl and oxidized hyaluronic acid. In vitro experiments demonstrate that the GOE1 hydrogel possesses good antimicrobial, antioxidant and anti-inflammatory properties, and transgenic sequence genomics further illustrates that IL-17-producing RAW 264.7 macrophages are critical for mediating M1/M2 macrophage transition and provide favorable immune microenvironment. In addition, in vivo experiments reveal that GOE1 significantly ameliorates periodontal tissue inflammation and reduces the loss of alveolar bone by reducing inflammatory infiltration and collagen destruction. Overall, the GOE1 hydrogel offers a promising therapeutic option for managing diabetic periodontitis.

Evaluation of Oral Health Status among Children of Halba Tribe in Bastar Division of Chhattisgarh, India.

The Halba tribe owes its nomenclature term "Hal" which locally means plowing or farming. Bastariya Halba is Dravidian tribe from Warangal. They speak Indo-European language Halbi. There are no population-based studies till date evaluating the oral health status among Halba children in Chhattisgarh. To evaluate the oral health status of Halba tribe children in the Bastar division of Chhattisgarh by assessing the prevalence of dental caries and periodontal conditions. A cross-sectional study was conducted to determine the dental caries and periodontal status in Halba tribe children. Children aged between 6 and 12 years (N = 1,050) were randomly selected from Halba community of Chhattisgarh. Dental caries status was recorded by using the decayed missing filled teeth (DMFT/dmft) index and papillary marginal attached (PMA) index for periodontal status. The statistical software namely Statistical Package for the Social Sciences (SPSS) version 17.0 was used for the analysis of the data. The study population was 1,050 children from the Halba tribal community. Among the subjects, 545 (51.9%) were boys and 505 (48.1%) were girls. The overall mean dmft/DMFT was found to be 2.25 ± 2.71. In this study, boys had significantly higher values for overall dmft/DMFT (2.55 ± 2.74) than girls. It was observed that mild, moderate, and severe gingivitis significantly increased with increasing age. The population examined was characterized by high prevalence of dental caries as well as unmet treatment needs. Factors like poverty, illiteracy, poor awareness, and lack of oral health services may be a reason for poor oral health in these children. Pathivada L, Prabhat SK, Garg N, et al. Evaluation of Oral Health Status among Children of Halba Tribe in Bastar Division of Chhattisgarh, India. Int J Clin Pediatr Dent 2024;17(10):1121-1123.

Association Between Oral Health Status and Oral Health-Related Quality of Life in Individuals With Thyroid Dysfunction: A Cross-Sectional Study.

Background and aim Any alterations in the hormonal regulation system such as thyroid dysfunction may have an impact on oral health status, which in turn may affect their oral health-related quality of life (OHRQoL). The objective of this study was to determine the association of thyroid dysfunction on oral health status and OHRQoL of subjects with thyroid dysfunction. Materials and methods A cross-sectional study was conducted among 150 subjects with thyroid dysfunction and 150 subjects without thyroid dysfunction aged 18-60 years from a government hospital in Bangalore city. Subjects with or without thyroid dysfunction aged 18-60 years were included in the study. Subjects who had other systemic conditions, who were pregnant or lactating, who had tobacco chewing or smoking habits, and who had undergone periodontal therapy in the past six months were excluded. OHRQoL was assessed using a pre-validated Oral Health Impact Profile-14 (OHIP-14) questionnaire. Oral health examination was done using the WHO Oral Health Assessment Form for Adults, 2013. Descriptive and inferential statistics were performed. Results The mean age of the subjects with and without thyroid dysfunction was 43.01±10.9 and 42±9.8, respectively, with female predominance. Most of them had a socioeconomic status of less than the lower middle class. Subjects with thyroid dysfunction showed a higher proportion of dental caries, root caries, gingival bleeding, periodontal pocket, and loss of attachment as compared to the subjects without thyroid dysfunction (p<0.05).Subjects with hyperthyroidism showed poor periodontal condition and a higher proportion of dental caries experience as compared to subjects with hypothyroidism (p>0.05). Oral health indicators showed a significant positive correlation with OHRQoL among subjects with or without thyroid dysfunction. Conclusion There was an association between oral health status and OHRQoL among subjects with thyroid dysfunction when compared to subjects without thyroid dysfunction. Therefore, it is necessary to inform individuals with thyroid dysfunction about the importance of preventive oral care.

The relationship between periodontal status, physical activity, dietary practices, and dental caries

The objective of this study is to evaluate the correlation between dietary patterns, levels of physical activity (PA), and the occurrence of periodontal disease. Many lifestyles have been connected to periodontal disease, but little is known about diet and PA intake. This study included 185 people—62 healthy, 61 gingivitis, and 62 periodontitis. PA, Mediterranean diet score (MDS), and carbohydrate consumption frequency were gathered together with demographics. Clinical and radiographic evaluations calculated decayed, missing, and filled teeth (DMFT) index scores. PA, MDS, carbohydrate consumption, and periodontitis were evaluated. Periodontitis patients had higher DMFT scores, poorer periodontal features, and less daily tooth brushing. More PA overall, more PA in free time, and less sedentary behavior reduced periodontitis rates. Sedentary behavior increased periodontal disease risk in adjusted univariate regression models (OR = 0.235; p = 0.021). Of the study participants, 35 (18.9%) had high MDS. No correlation was established between Mediterranean diet (MD) and periodontitis. Periodontitis and MD, DMFT, and carbohydrate consumption do not seem to be substantially correlated. According to our research, a higher risk of periodontal disease was linked to more sedentary activity. To clarify the extent of the relationship between PA and periodontal disease, more prospective longitudinal research and approaches are required.Clinical Relevance: The periodontal status of individuals can be influenced by their lifestyle.

Birth order, daycare attendance, and childhood socioeconomic status in relation to gingivitis: a cross-sectional study in Turkish young adults

AimBirth order, sibship size, breastfeeding, daycare attendance, and delivery method are known to influence the development of gut microbiota and the immune system, affecting the risk of many infectious diseases. This study aims to explore the impact of these factors, along with socioeconomic background and familial factors, on gingivitis and oral hygiene practices in early adulthood among the Turkish population.Materials and methodsPatients were diagnosed using periodontal clinical and radiographic assessments, adhering to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The study included 18-year-old individuals diagnosed with either generalized gingivitis or clinical gingival health. Data collected included sociodemographic factors, birth order, sibship size, delivery methods, breastfeeding duration, daycare attendance, and oral hygiene behaviors. Binary logistic regression was employed to analyze the associations between these factors and the presence of generalized gingivitis.ResultsA total of 178 individuals were evaluated, including 124 with generalized gingivitis and 54 with clinical gingival health. Daycare attendance was significantly associated with gingival health. Among those with gingival health, 55.6% had attended daycare, whereas only 29% of participants with generalized gingivitis had attended daycare. Conversely, 71% of those with generalized gingivitis did not attend daycare, compared to 44.4% in the gingival health group (p = 0.001). Univariate logistic regression identified a significant association between daycare attendance and a reduced risk of generalized gingivitis (Odds Ratio [OR] = 0.327, p = 0.001). Later birth order was associated with a reduced risk of gingivitis (OR = 0.470, p = 0.037). Sibship size, delivery methods, and breastfeeding duration showed no clear associations with gingivitis (p > 0.05).ConclusionsThe findings indicate a potential association between oral health status in adulthood and early childhood exposures, such as daycare attendance and birth order. Further research is necessary to confirm these associations and elucidate the mechanisms involved, even though these factors may contribute to gingival health in early adulthood. These insights may enhance our understanding of how early-life exposures relate to oral health outcomes and suggest that considering such factors could be beneficial in future oral health management strategies.Trial registrationTrial registration is also available at clinicaltrail.gov.Clinical Trials-ID: NCT06240247.Registration Date: 22.01.2024.

Advancements in Autophagy Modulation for the Management of Oral Disease: A Focus on Drug Targets and Therapeutics.

Autophagy is an intrinsic breakdown system that recycles organelles and macromolecules, which influences metabolic pathways, differentiation, and thereby cell survival. Oral health is an essential component of integrated well-being, and it is critical for developing therapeutic interventions to understand the molecular mechanisms underlying the maintenance of oral homeostasis. However, because of the complex dynamic relationship between autophagy and oral health, associated treatment modalities have not yet been well elucidated. Determining how autophagy affects oral health at the molecular level may enhance the understanding of prevention and treatment of targeted oral diseases. At the molecular level, hard and soft oral tissues develop because of complex interactions between epithelial and mesenchymal cells. Aging contributes to the progression of various oral disorders including periodontitis, oral cancer, and periapical lesions during aging. Autophagy levels decrease with age, thus indicating a possible association between autophagy and oral disorders with aging. In this review, we critically review various aspects of autophagy and their significance in the context of various oral diseases including oral cancer, periapical lesions, periodontal conditions, and candidiasis. A better understanding of autophagy and its underlying mechanisms can guide us to develop new preventative and therapeutic strategies for the management of oral diseases.

Recommendations for Research to Develop a Patient-Centered Clinical Follow-Up Protocol for Oral Epithelial Dysplasia.

Oral epithelial dysplasia (OED) is the primary histological marker for assessing the progression of oral potentially malignant disorders (OPMDs) to cancer. Despite challenges in grading and low inter-pathologist reproducibility, OED severity remains the key predictor of malignant transformation. However, globally accepted guidelines for OED monitoring are lacking, despite calls for individualized management based on host and lesion characteristics. The proposed research protocol involves acquiring high-quality intraoral images, assessing oral hygiene and periodontal status, eliminating chronic mechanical irritation and Candida infections, and applying adjunctive diagnostic methods like toluidine blue staining, optical evaluation, and brush cytology. Tailored follow-up regimens based on individual risk assessments are emphasized, with frequent monitoring for high-grade dysplasia or patients at higher risk of progression. Therefore, effective OED management should consider the patient's immune status, dietary habits, and oral microbiota, aiming to develop personalized treatment strategies that optimize patient-centered care.

GINGIVAL STATUS AND ORAL HYGIENE HABITS IN CHILDREN BETWEEN 10-12 YEARS

Introduction: Children's adolescence is characterized by dynamically changing indicators of periodontal and oral health, related mainly to the eruption of the permanent dentition and stabilization of the periodontal space. This age period is also characterized by an increased incidence of gingival diseases, with the dental biofilm being the main risk factor for the inflammatory process. Aim: The aim of this study is to assess the relationship between gingival status, oral hygiene habits and knowledge on topics related to oral health in children aged 11-13. Material and methods: The subject of the study was 106 children aged 11-13 years. All children overwent a clinical periodontal examination and periodontal risk assessment at 4 levels. An electronic periodontal probe PA ON (Orangedental) with specially designed software was used to assess periodontal and oral hygiene status. The study included a survey method for assessing children's knowledge on topics related to oral health with periodontal focus. The survey consists of 38 questions divided into eight topics. Results: All the children aged 11-13 years had an initial form of gingival inflammation, against the background of plaque accumulation affecting more than 69% of tooth surfaces, unstable and irregular oral hygiene habits, as well as insufficient knowledge of oral/periodontal health. Through appropriate preventive programs, this age is best suited to create consciously motivated behavior for proper oral hygiene and oral health.

Alpha‐Ketoglutarate Alleviates Systemic Lupus Erythematosus–Associated Periodontitis in a Novel Murine Model

ABSTRACTAimTo establish a reproducible experimental animal model for systemic lupus erythematosus (SLE)‐associated periodontitis (PD), investigate the effects of SLE on PD and assess the therapeutic potential of alpha‐ketoglutarate (αKG) for SLE‐PD treatment.Materials and MethodsAn SLE‐PD murine model was established via ligature‐induced PD in MRL‐lpr strain, with MRL/MpJ strain as a non‐SLE control. The periodontal state was assessed using micro‐CT, real‐time PCR, histology, immunofluorescence and flow cytometry assays. αKG levels were analysed, and a thermoresponsive gel was designed as a periodontal dimethyl (DM)‐αKG delivery system. αKG levels were analysed in gingival crevicular fluid (GCF) of PD patients with or without SLE.ResultsSLE significantly increased the periodontal inflammation and bone resorption in the SLE‐PD model. αKG levels in GCF were lower in PD patients with SLE than in PD patients without SLE. Decreased αKG levels in the gingiva and macrophage M1/M2 imbalance were observed in SLE‐PD mice. However, DM‐αKG thermoresponsive gel effectively alleviated the periodontal inflammation, bone resorption and macrophage M1/M2 imbalance in SLE‐PD mice.ConclusionsOur study established, for the first time, a novel SLE‐PD murine model and revealed that SLE increases the severity of PD in vivo. Our findings highlight the therapeutic potential of αKG for SLE‐associated PD.

Salivary Markers of Oxidative Stress and Their Relation to Periodontal and Dental Status Among Children With Down Syndrome.

The current body of literature on oral health in individuals with Down syndrome (SD) presents contradictory information. Individuals with DS often have distinct oral health difficulties that set them apart from the general population. This study aimed to measure malondialdehyde (MDA) and total oxidant status (TOS) levels in the saliva of children diagnosed with DS and explore their association with oral health status. A cross-sectional study enrolled 82 participants aged 7-12, comprising 40 children with DS and 42 controls matched based on age and gender. Diagnosing dental caries relied on the guidelines provided by the World Health Organization. Oral hygiene was examined with the plaque index, and gingival health was estimated using the gingival index (GI). To evaluate oxidative stress, unstimulated whole saliva samples were gathered to measure levels of MDA and TOS. The study data were analyzed using Statistical Package for the Social Sciences version 22 (IBM Corp., Armonk, NY). The p value for parametric variables was obtained using Pearson's chi-square test and Fisher's exact test. In this study, there were no significant differences between the two groups regarding periodontal health and dental decay. However, children with DS displayed significantly elevated GI values compared to the control group (p = 0.05).Children with DS demonstrated significantly higher MDA levels than the control group (p < 0.001). Furthermore, DS children demonstrated a higher prevalence of dental caries in their primary teeth than their permanent teeth. Children with DS have comparable rates of dental caries to non-DS childrenbut show elevated levels of GI values. Furthermore, children with DS exhibit high levels of saliva MDA compared to their peers without DS. Future research should include a wider age range, additional oxidative stress markers, and factors like diet, lifestyle, and antioxidant supplementation. Longitudinal studies and quality-of-life assessments could offer deeper insights into the oral health of individuals with DS.

Correlation of Salivary pH, Incidence of Dental Caries and Periodontal Status among Diabetic and Non-Diabetic Subjects-A Cross Sectional Study

Aim: To evaluate the salivary pH and incidence of dental caries and periodontal status in Diabetes Mellitus and non-diabetic subjects. Materials and methods: A cross-sectional study was conducted which included 40 subjects. 20 Type 2 Diabetic Mellitus subjects and 20 non diabetic subjects. The pH of saliva was determined using a digital pH meter. For dental and periodontal Status, clinical examination was performed and Modified WHO Oral Health Assessment Form for Adults, 2013 was measured. The data collected was statistically analyzed and interpreted. Results: There was a decrease in the mean salivary pH of (6.59±0.10) in diabetic group, compared to that of non diabetic group (7.49±0.24). The mean number of carious teeth in diabetics (7.2±3.61) was significantly higher than in non diabetic subjects (2.55±1.05). Likewise, periodontal health was worse in diabetic subjects, with a higher prevalence of gingival bleeding and pockets of 4-5 mm depth, emphasizing the association between diabetes and increased oral health risks. Conclusion: This study concluded that there was a significant relationship between diabetes mellitus and increased incidence of dental caries and periodontitis. The salivary pH was significantly lower, hence the evaluation of salivary parameters can be a cost effective and a non invasive alternative for screening, diagnosis and monitoring of diabetes.

The Relationship Between Periodontitis, Gingivitis, Smoking, Missing Teeth, Endodontic Infections, Aortic Aneurysm, and Coronary Artery Disease: The 10-Year Results of 25 Patients.

Background Emerging research suggests a correlation between poor oral health and cardiovascular diseases (CVDs), with inflammation being a central mechanism. Periodontitis and gingivitis are chronic inflammatory diseases that can lead to systemic health issues if untreated. It has beenindicated previously that endodontic infections and missing teeth may contribute to elevated cardiovascular risk, and smoking exacerbates both periodontal and cardiovascular conditions. This study expands upon existing research by examining both periodontal and endodontic health factors together and investigating smoking as a potentially amplifying factor. Poor periodontal health may contribute to systemic inflammation, whichis a recognized risk factor for atherosclerosis and cardiovascular events. This study aims to evaluate these relationships over a decade, providing insights into the potential preventive impact of periodontal care on cardiovascular health. Materials and methods This 10-year retrospective study examines the complex relationships among periodontal health factors (including periodontitis, gingivitis, and missing teeth), endodontic infections, smoking, and cardiovascular conditions, specifically coronary artery disease (CAD) and aortic aneurysm. By analyzing data from 25 patients aged 45-75, the study aims to assess whether these oral health indicators correlate with increased cardiovascular risks. The study's methodology included comprehensive dental and cardiovascular evaluations for each patient, with baseline data collected at the study's inception and follow-ups over the next decade. Oral health assessments documented the severity of periodontal diseases and recorded the presence of endodontic infections.Cardiovascular evaluations were conducted to establish the incidence and progression of CAD and aortic aneurysm, while lifestyle factors, particularly smoking, were noted as significant contributors. This approach allowed for an in-depth exploration of the possible causal pathways linking oral health to cardiovascular outcomes. Results Results demonstrated that severe periodontitis, high numbers of missing teeth, and the presence of endodontic infections were significantly associated with higher incidences of CAD and aortic aneurysm. Smoking, as expected, acted as a compounding factor, intensifying the risk of cardiovascular outcomes in patients with poor oral health. Interaction terms further highlighted how smoking combined with advanced periodontitis notably increased CAD risk. The findings align with the hypothesis that severe periodontal disease and endodontic infections contribute to cardiovascular risk, especially among smokers. These results indicate that periodontal disease may serve as a marker for systemic inflammation, which has far-reaching effects beyond oral health alone. Conclusion The 10-year study showed a strong association between periodontal disease, smoking, hypertension,periodontitis and CVDs. This study underscores the importance of maintaining good oral health and cessation of smoking to mitigate cardiovascular risk. The results advocate for a multidisciplinary approach to patient care, integrating dental health with broader cardiovascular risk management. Future research is recommended to confirm these findings in larger, more diverse cohorts and to explore further the underlying mechanisms connecting oral infections and systemic inflammation with cardiovascular health.

Exploring the Link between Periodontal Disease and Systemic Conditions: Implications for Alzheimer’s, Parkinson’s, and Rheumatoid Arthritis

ABSTRACT Background: There is a growing correlation between periodontal disease, a common inflammatory disorder that affects the tissues supporting the teeth, and several systemic diseases. Materials and Methods: Two hundred patients from a tertiary care hospital, ages 50–75, participated in this cross-sectional research. The subjects were split up into four groups: 50 individuals with rheumatoid arthritis, 50 with Alzheimer’s disease, 50 with Parkinson’s disease, and 50 with periodontal disease. To evaluate periodontal condition, including clinical attachment loss and pocket depth, thorough oral exams were performed. Measurements were made of serum biomarkers for inflammation, such as interleukin-6 (IL-6) and C-reactive protein (CRP). Multivariate regression models were used to examine correlations between the severity of periodontal disease and the underlying systemic diseases. Results: In all groups, there were significant relationships between higher levels of indicators of systemic inflammation and the severity of periodontal disease. In comparison to healthy controls (CRP mean value: 2.1 mg/L; IL-6 mean value: 6.4 pg/mL), participants with periodontal disease had higher mean levels of CRP (5.6 mg/L) and IL-6 (mean value: 12.8 pg/mL). Furthermore, compared to those with rheumatoid arthritis, those with Alzheimer’s and Parkinson’s disorders showed higher levels of pocket depth and periodontal attachment loss. Conclusion: In conclusion, the results point to a possible connection between systemic diseases such rheumatoid arthritis, Parkinson’s disease, and Alzheimer’s.

Dental Hygienists' Influence on Oral Health Knowledge, Attitudes and Behavioural of Patients and Effectiveness on Improving Patients' Periodontal Status-Evaluations of a Hospital Based Oral Hygiene Training Program in China.

To evaluate the possibility of integrating dental hygienists (DHs) into the dental field in China, and investigate its effectiveness on improving patients' knowledge, attitudes, self-care behaviours as well as their periodontal status. A hospital-based oral hygiene training program was developed at Sir Run Run Shaw Hospital's (SRRSH) Dental Clinic with the support of two registered DHs from Loma Linda University in California. A questionnaire evaluating oral health knowledge, attitudes and behaviours was conducted in patients who visited SRRSH's Dental Clinic. Scores of oral health knowledge and proportions of positive oral health attitudes and favourable self-care behaviours were estimated between patients treated and not treated by DHs (DH group and NDH group). The improvements in patients' periodontal conditions following non-surgical periodontal therapy (NSPT) administered by DHs at the Dental Clinic of SRRSH, as assessed through the measurement of periodontal pocket depths and the incidence of bleeding upon probing. Patients in DH group exhibited relatively better results in several aspects of oral health knowledge, attitudes and behaviours, compared to those in NDH group. Moreover, NPST performed by DHs significantly improved the periodontal status of the patients, with a remarkably reduction in periodontal pocket depth and bleeding on probing. Integrating DHs into SRRSH's Dental Clinic showed effectiveness in enhancing patients' oral health knowledge, attitudes, behaviours and succeeded in improving patients' periodontal status. This program demonstrated that incorporating DHs into dental care team is not only practical but also enhances the value of the dental workforce in China.

Comparison between Smokers and Non-Smokers receiving Non-Surgical Periodontal Therapy in Male Patients at Rehman Medical Institute, Peshawar

Background: Periodontal disease, a chronic inflammatory ailment, significantly impacts dental stability. Smoking has been identified as a critical risk factor, exacerbating periodontal disease severity and impeding treatment efficacy.Objective: To compare gingival health of non-surgical periodontal therapy between smokers and non-smokers, measuring specific outcomes such as plaque index reduction, bleeding on probing, and clinical attachment level improvements. Materials and Methods: This observational cohort study was carried over six-month duration. A total of 133 male subjects, aged 32- to 51-years, with chronic periodontitis were recruited. They were divided into smokers (n=65) and non-smokers (n=68). The major criterion for selection of both cohorts was a history of cigarette smoking. The study was conducted in three phases: baseline periodontal evaluations and follow-up evaluations at three and six months. Periodontal status was evaluated by measuring critical indicators of periodontal health: the presence of dental plaque, calculus, and gingival bleeding on probing and reduction in clinical attachment levels. Results: Non-smoker experienced a reduction in the plaque index from 2.1 ± 0.5 at baseline to 1.6 ± 0.3 at 6 months, p--0.005. However, smokers 2.4 ± 0.6 to 2.0 ± 0.4 experienced, if verified using this penultimate way it is p-0.018. Similarly, the bleeding index in non-smokers dropped from 2.9±0.6 down to 2.3 ± 0.3 (p-0.005), while smokers experienced this change 3.2±0.7 to 2.7±0.5 (p=0.018). Moreover, loss of attachment became better in non-smokers averaged 3.2±0.7 mm before and 2.7±0.5 mm after treatment (p-0.005), On the other hand an improvement was made while this could only be seen by smoking patients. Conclusion: Smoking significantly impedes the efficacy of non-surgical periodontal therapy. The findings reinforce the need for smoking cessation to enhance treatment outcomes in periodontitis patients.Keywords: Bleeding Index, Loss of Attachment, Non-Surgical Periodontal Therapy, Non-Smokers, Periodontal Disease, Plaque Index, Smoking.

PECULIARITIES OF ORTHODONTIC TREATMENT FOR PATIENTS WITH GENERALIZED PERIODONTITIS AND PREDOMINANCE OF PARASYMPATHETIC NERVOUS SYSTEM ACTIVITY

The use of orthodontic treatment for patients with generalized periodontitis enhances the effectiveness of comprehensive care. However, it is important to consider the reduced capacity for alveolar bone regeneration in these patients. Therefore, as part of the complex treatment of generalized periodontitis, the inclusion of medications to support alveolar bone regeneration is essential. The course of various diseases can be influenced by the state of the patient’s autonomic nervous system. In this study, medications were administered to normalize parasympathetic nervous system activity in patients with generalized periodontitis undergoing orthodontic treatment. The objective of the study was to evaluate the effectiveness of orthodontic treatment in patients with generalized periodontitis, particularly those with a predominance of parasympathetic autonomic nervous system activity. This was assessed by the supplementary use of a combination of drugs designed to stimulate alveolar bone formation and regulate parasympathetic nervous system function. Materials and methods. This study involved 35 young patients (aged 18-35) with generalized periodontitis and a predominance of parasympathetic autonomic nervous system activity, all of whom presented with displacement of the maxillary frontal teeth. These patients underwent orthodontic treatment. To correct the state of the autonomic nervous system over the treatment of generalized periodontitis, patients were prescribed to take a complex of medicines including the preparation “Calcinova” for stimulating osteogenesis. A comprehensive periodontal examination, including the assessment of hygienic indices, was conducted to evaluate periodontal status throughout the treatment. Results. The periodontal examination revealed that almost all patients demonstated an improvement in oral health. Noticeable dynamics in the pathological process were observed as a result of the complex treatment. The analysis of these findings underscores the importance of orthodontic treatment for patients with generalized periodontitis, particularly when combined with methods to correct parasympathetic nervous system activity and promote osteogenesis. This approach was shown to positively affect periodontal tissues and enhance the effectiveness of generalized periodontitis treatment. Conclusions. Correction of parasympathetic autonomic nervous system function enhances the effectiveness of therapy. In this study, a complex of medications was used to improve parasympathetic nervous system activity. The addition of “Calcinova” to stimulate osteogenesis further contributed to achieving more stable treatment outcomes in patients with generalized periodontitis.

Analysis of periodontal status in Polish patients with rheumatoid arthritis treated with biological therapies.

Periodontitis, characterized by inflammation affecting the tooth-supporting tissues, may increase the risk of rheumatoid arthritis (RA) or cardiovascular diseases. The aim of the study was to evaluate the periodontal status in RA patients and its impact on the inflammatory markers and red cell parameters obtained from complete blood laboratory tests to study the risk of cardiovascular disease development. The cross-sectional study included 50 patients with RA treated with biological therapies: tumor necrosis factor inhibitors, interleukin-6 blockers. Rheumatoid arthritis disease activity was assessed with Disease Activity Score with 28-joint count (DAS28). The periodontal indices modified Approximal Periodontal Index, modified Papillary Bleeding Index, and Periodontal Screening Index (PSI) were used to assess patients' periodontal status. Serum levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used as inflammatory markers and a potential cardiovascular risk factor. No statistically significant correlation was found between the periodontal status and RA activity. However, a statistically significant correlation was found between the CRP results and the PSI scores (R = -0.264510, p = 0.048837). Evaluation of the red cell parameters showed statistically significant differences in the markers of inflammation ESR (R = 0.369398, p = 0.008289) and CRP (R = 0.367405, p = 0.008672). Red cell distribution width values were also correlated with RA activity (R = 0.286387, p = 0.043769) and duration of the disease (R = 0.339425, p = 0.015889). A satisfactory periodontal status was found in most of the study group. Increased CRP levels in patients with periodontitis may indicate the negative impact of periodontal status on the general clinical condition of the patient.

Adapting to emergent paradigm shifts: A calibration study among graduating dental students using the new classification of periodontal diseases

IntroductionThe World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions introduced the 2018 Classification. Formulating periodontal diagnosis differs from clinician to clinician and depends on the expertise and competence of the clinician. We aimed to assess calibration levels of periodontal diagnosis based on the 2018 classification among senior-year dental interns at Batterjee Medical College in Saudi Arabia preparing for practice and subsequent graduation. Materials and MethodsIn this preapproved study, 52 senior-year dental students received a two-hour presentation on the 2018 classification by a single teacher, followed by a preliminary exam. One week later, the students were subjected to 12 study cases demonstrating a variety of periodontal and peri-implant disorders with gold standard management, followed by a post-test. Case scenarios with photographs, knowledge cognition, knowledge recall, and case scenarios were the four areas of both exams. Kappa statistics were computed to determine agreement. Statistical significance was set at p < 0.05. ResultsThe total examination score was 12.69 ± 2.74 and 15.12 ± 2.99 (p = 0.001) for the pre- and post-tests, respectively. Furthermore, the difficulty factor and discrimination index increased by 12 % (p = 0.007) and 7 % (p = 0.244), respectively. Finally, the kappa statistic showed moderate agreement at 0.427 (p = 0.002). ConclusionInter-rater agreement with the gold standard increased after training, and this improvement was fairly successful in providing graduating dental students with diagnostic abilities simultaneously with the emergence of a new classification system. A calibration procedure based on a simple feedback approach provided beneficial outcomes.