Periodontal Therapy In Patients Research Articles

Genetic analysis of impaired healing responses after periodontal therapy in type 2 diabetes: Clinical and invivo studies.

This study aims to investigate the mechanisms underlying the impaired healing response by diabetes after periodontal therapy. Outcomes of periodontal therapy in patients with diabetes are impaired compared with those in patients without diabetes. However, the mechanisms underlying impaired healing response to periodontal therapy have not been sufficiently investigated. Zucker diabetic fatty (ZDF) and lean (ZL) rats underwent experimental periodontitis by ligating the mandibular molars for one week. The gingiva at the ligated sites was harvested one day after ligature removal, and gene expression was comprehensively analyzed using RNA-Seq. In patients with and without type 2 diabetes (T2D), the corresponding gene expression was quantified in the gingiva of the shallow sulcus and residual periodontal pocket after non-surgical periodontal therapy. Ligation-induced bone resorption and its recovery after ligature removal were significantly impaired in the ZDF group than in the ZL group. The RNA-Seq analysis revealed 252 differentially expressed genes. Pathway analysis demonstrated the enrichment of downregulated genes involved in the peroxisome proliferator-activated receptor (PPAR) signaling pathway. PPARα and PPARγ were decreased in mRNA level and immunohistochemistry in the ZDF group than in the ZL group. In clinical, probing depth reduction was significantly less in the T2D group than control. Significantly downregulated expression of PPARα and PPARγ were detected in the residual periodontal pocket of the T2D group compared with those of the control group, but not in the shallow sulcus between the groups. Downregulated PPAR subtypes expression may involve the impaired healing of periodontal tissues by diabetes.

Phytic acid effect on periodontal ligament fibroblast: An in-vitro study

Objectives This study evaluated phytic acid (IP6) effect on the viability, alkaline phosphatase (ALP) activity and calcium release of human periodontal ligament (HPDL) cells in optimal (OGL) and elevated glucose level (EGL) in cell culture media. Materials and methods Cells were seeded in OGL (1000mg/L) or EGL (4500 mg/L) media. IP6 was added at 0.005%, 0.01% or 0.02% concentrations for 24 or 48h, and XTT assay was performed. Cell differentiation and calcium release in presence of 0.02% IP6 in OGL or EGL in non-osteogenic or osteogenic media were analyzed using ALP assay and alizarin red staining, respectively. Results In OGL, IP6 enhanced the viability of the cells at both exposure times (P<0.05). However, IP6 lowered the viability of the cells with the presence of EGL compared to the control at both exposure times, except for 0.02% IP6 which showed comparable viability to the control at 48 h. In OGL and EGL, ALP activity of the cells was not affected by the presence of IP6 in non-osteogenic media; however, in osteogenic media IP6 lowered the ALP activity. Meanwhile, calcium release was the highest with IP6 within osteogenic media of EGL. Conclusions IP6 effects on the HPDL cells were dependent on IP6 concentration, time of exposure, glucose levels and the osteogenic condition of the media. Clinical relevance This study gives insights on the potential therapeutic effect of IP6 as adjunctive periodontal therapy in patients with diabetes.

Evaluation of the clinical parameters and volumetric analysis of gingival crevicular fluid for chlohexidine vying silver nanoparticle mouthwash the avant garde for chronic periodontitis

BACKGROUND: Oral cavity ecosystem represents a dynamic pattern. Scaling and root planing (SRP) is the gold standard approach for treatment of chronic periodontitis but used alone it may not be effective in removing periodontal pathogens from sites where access is poor. Although chlorhexidine is the most effective mouthwash against oral microorganisms, the side effects of long- term use suggest the need for an alternative. Hence, this study has been undertaken to know effectiveness of silver nanoparticle mouthwash with chlorhexidine mouthwash which is effective on common microorganisms of oral cavity. OBJECTIVE: To evaluate and compare the clinical and biochemical outcome of chlorhexidine (CHX) and silver nanoparticle as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis. METHODS: Ninety- two patients with generalized moderate to severe chronic periodontitis from the Dept. of Periodontology who fulfilled the inclusion and exclusion criteria were recruited for the study. In the experimental clinical trial, the clinical parameters likewise; Plaque index (PI), Gingival index (GI), probing depth (PD), clinical attachment loss (CAL) were assessed. The volumetric analysis of gingival crevicular fluid (GCF) levels were assessed at baseline and follow up visits. The IBM SPSS Statistics for Windows software, v. 20.0 (IBM Corp., Armonk, USA), was used. The data was numerically coded and entered into the program. Both the descriptive statistics and the inferential statistics were analyzed to compare the responses between the groups. RESULTS: The statistical analysis was carried out by descriptive as well as inferential statistics and both groups demonstrated significant intragroup reduction in PI, GI, PPD, CAL, GCF from baseline to 3 months follow-up. There were statistically significant intragroup differences between both the groups for all of the parameters. CONCLUSION: Silver nanoparticle mouthwash can be an alternative adjunct for non-surgical periodontal therapy in patients with chronic periodontitis. Results of this study indicated that both the mouth rinse demonstrated an equal range of effectiveness. These conclusions were supported by the clinical parameters and biochemical outcomes.

Effect of psychosocial stress and coping strategies on non-surgical periodontal therapy in patients with generalized stage III/IV periodontitis: a longitudinal intervention study

ObjectivesThe aim of this longitudinal intervention study was to assess the impact of psychosocial stress and coping response strategies on the clinical outcomes in periodontitis patients treated with non-surgical periodontal therapy (NSPT).Materials and methodsAfter the administration of psychological questionnaires, patients diagnosed with generalized stage III–IV periodontitis were categorized into different groups depending on their stress levels (10-item perceived stress level (PSS-10)) and coping response strategies (coping responses inventory (CRI)). Clinical data were collected 1 week before and 3 months after the completion of NSPT.ResultsOf the 90 patients included at baseline, 27 presented major and 63 minor stress levels, while 40 had avoidance and 50 approach coping behavior. All clinical parameters were similar at the baseline across different categories. At re-evaluation, full-mouth bleeding score (FMBS), mean probing pocket depth (PPD), and number of residual pathological pockets were significantly superior in groups with higher stress levels (p <0.001, p =0.001, and p =0.020, respectively), while higher full-mouth plaque scores (FMPS) and FMBS were found in patients with avoidance coping strategies (p =0.009 and p <0.001, respectively). When jointly evaluated, an added detrimental effect of coping styles on allostatic load was observed. Multivariate analysis confirmed a significant effect of stress levels and coping strategies on final FMBS, but not of coping on mean PPD.ConclusionPsychosocial stress and avoidance coping strategy seem to negatively influence the clinical outcomes of NSPT at short term (NCT04739475; 9/1/2017).Practical implicationsBased on these findings, patients reflecting these psychological profiles should be considered at greater risk for poor NSPT response and may benefit from complementary stress management strategies.

Cardiovascular Diseases and Their Relationship to Periodontal Disease

Many studies reveal the relationship between periodontal disease [PD] and cardiovascular diseases [CVD], but their outcome is heterogeneous. This review article is designed to update the basis of understanding the role of periodontal disease in causing cardiovascular events. Studies have investigated a possible link between periodontal diseases and distinctive systemic diseases. Periodontitis is a constant implicit source of infection and has been considered a discrete risk factor for some outcomes like cardiovascular diseases, cerebrovascular diseases, diabetes mellitus complications, chronic obstructive pulmonary disease, pregnancy complications, and osteoporosis, etc. A concise overview has been entailed for atherosclerosis [ATH] its pathophysiology, and the association of periodontal infections as a risk factor for causing atherosclerosis, as the development of ATH is associated with chronic low-grade inflammation moreover, it has been set prior to the development of ischemic heart disease [IHD] and provides a contributing mechanism that ATH may singly contribute or in prime concern with other risk factors to develop ischemic heart disease. Finally, this report summarizes the evidence from epidemiological studies that focus on links that feasibly exist between PD and its role as a risk factor in triggering cardiovascular events and complications of periodontal therapy in patients on anti-thrombotic therapy

The use of shear wave elastography to monitor changes in gingival elasticity associated with initial periodontal therapy in patients with advanced periodontitis: A prospective pilot study

Background/purposeGingival tissue firmness cannot be objectively assessed or monitored in real-time in existing examinations. This study was designed to examine the potential utility of shear wave elastography (SWE) as a means of evaluating and monitoring gingival inflammation in an effort to assess the effects of initial periodontal therapy in patients with advanced periodontitis. Materials and methodsThis pilot study included analyses of 66 sites in 6 advanced periodontitis patients. Patients underwent the SWE examination of the gingiva at the mid-labial and interdental papillae at baseline and at 2, 4, and 6 weeks following initial periodontal therapy. Measured periodontal parameters in these patients include Plaque index (PI), Gingival bleeding index (GBI), Probing depth (PD), and Clinical attachment loss (CAL). ResultsRespective baseline SWE values at the mid-labial gingiva and interdental papilla 25.68 ± 6.82 kPa and 26.78 ± 6.20 kPa, with no significant differences between these two measures. A significant negative correlation between SWE and both PI (r = −0.350, P = 0.004) and GBI (r = −0.287, P = 0.020) was observed at baseline. Initial periodontal therapy contributed to significantly higher SWE values and tougher gingiva, particularly during the first two weeks. Postoperative changes in SWE were negatively correlated with SWE values at baseline (r = −0.710, P < 0.001). ConclusionThese results establish SWE as a sensitive noninvasive approach to quantitatively assessing changes in gingival elasticity in real-time.

Effects of omega-3 supplementation as an adjunct to non-surgical periodontal therapy on periodontal parameters in periodontitis patients: a randomized clinical trial

ObjectivesThis study aimed to assess the effects of omega-3 fatty acid supplementation as an adjunct to non-surgical periodontal therapy in patients with periodontitis.Materials and methodsThis randomized clinical trial was conducted on 30 patients with periodontitis. All patients received standard non-surgical periodontal therapy, and were randomly divided into two groups of intervention and control by a table of random numbers (n = 15). The intervention group consumed 1000 mg natural fish oil soft-gels daily (300 mg Omega-3 marine triglycerides, 180 mg Eicosapentaenoic acid and 120 mg Docosahexaenoic acid) while the control group used soft-gels contained only some soybean oil for 3 months. Clinical attachment loss (CAL), probing depth (PD), and bleeding index (BI) were recorded at baseline (before the intervention) and after 3 months. The two groups were compared regarding the clinical parameters by t-test (alpha = 0.05).ResultsAll three clinical parameters decreased in both groups at 3 months compared with baseline (P = 0.001). The improvement in PD and CAL in the intervention group was significantly greater than that in the control group (P = 0.001); however, the difference in BI was not significant between the two groups (P = 0.283).ConclusionOmega-3 supplementation as an adjunct to non-surgical periodontal therapy significantly improved the clinical parameters in periodontitis patients compared to soybean oil supplements.

Identification of Key Gene Targets for Periodontitis Treatment by Bioinformatics Analysis.

Background Periodontitis is considered to be the leading cause of tooth loss in adults, and it interacts with some serious systemic diseases. Periodontal basic therapy is the cornerstone of periodontal disease treatment and long-term maintenance and has a positive impact on the treatment of systemic diseases. Aim To explore the potential gene targets of periodontitis therapies by bioinformatics method. Methods We analyzed the expression database (GSE6751) downloaded from the Gene Expression Omnibus (GEO) with weighted gene coexpression network analysis (WGCNA) to confirm the functional gene modules. Pathway enrichment network analyses the key genes in functional modules and verified the candidate genes from the samples in peripheral blood sources of GSE43525. Moreover, we confirmed the expression of target protein in the periodontal tissues of experimental periodontitis-afflicted mice using western blotting. Results The functional gene modules were found to have biological processes, and ARRB2, BIRC3, CD14, DYNLL1, FCER1G, FCGR1A, FCGR2B, FGR, HCK, and PRKCD were screened as candidates' genes in functional modules. The 921 DEG from GSE43525 and 418 DEG is from the green module of GSE6751 and identified AMICA1, KDELR1, DHRS7B, LMNB1, CTSA, S100A12, and FCGR1A as target genes. Finally, FCGR1A (CD64) was confirmed as the key gene that affects periodontal treatment. Western blot analysis showed an increasing trend in the expression level of FCGR1A protein in the periodontal tissues of experimental periodontitis mice compared to normal mice. Conclusions FCGR1A (CD64) may be a key gene target for periodontal therapy in patients with periodontitis and other systemic diseases.

Efficacy of Proanthocyanidins in Nonsurgical Periodontal Therapy

BackgroundThe aim of this work was to evaluate the efficacy of proanthocyanidins (PACNs) as an adjunctive periodontal therapy in patients with periodontitis. MethodsPatients with periodontitis (stage III–IV) were included in this randomised clinical study. Patients with periodontitis received 2 different treatment modalities: minimally invasive nonsurgical therapy only (MINST group) or minimally invasive nonsurgical therapy and subgingival application of collagen hydrogels with PACNs (MINST + PACNs group). Clinical periodontal parameters, that is, pocket probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), were evaluated before treatment and after 8 weeks. Concentrations of immunologic markers, matrix metalloproteinase-3 (MMP-3), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in saliva were assessed at baseline and at 8-week follow-up. ResultsForty-six patients diagnosed with periodontitis were randomised into 2 groups: 23 patients in the MINST group and 23 patients in the MINST + PACNs group received the intended treatment. PACNs combined with MINST resulted in additional statistically significant PPD reduction and CAL gain in moderate periodontal pockets by 0.5 mm (P < .05) on average compared to MINST alone. Additional use of PACNs did not result in additional statistically significant improvement of BOP or PI values. Application of PACNs showed significant reduction of MMP-3 levels in saliva after 8 weeks (P < .05). ConclusionsAdjunctive use of PACNs in MINST resulted in better clinical outcomes for moderate pockets. Additional use of PACNs improved MMP-3 concentration in saliva more than MINST alone. Biochemical analysis revealed that MMP-3 concentration in saliva reflected the periodontal health state.

Estimation of Oral Neutrophil Counts Following Periodontal Therapy in Patients with Chronic Periodontal Disease Utilizing a Standardized Oral Rinse - Interventional Study

Background: Orogranulocytic Migratory Rate (OMR) is defined as the amount of neutrophils move into the oral cavity, through the gingival sulcus. When inflammatory changes occur in the oral cavity, there is an increase in the level of orogranulocytic migratory rate. The oral neutrophil count may be an indicator of the periodontal health status and also it correlates with the severity of periodontal disease. The aim of the study was to assess the relationship of oral neutrophil counts with severity of chronic periodontal diseases and to estimate their levels in response to phase 1 periodontal therapy. Materials and Methods: A total of 66 subjects were selected from the Departments of Periodontics, Annoor Dental College and Hospital, Kerala, India. The subjects were divided into three groups of 22 subjects in each group with two visits. The groups were diagnosed on the basis of gingival index and the number of periodontal pockets. Oral rinse samples of subjects were taken before and 4 weeks after periodontal treatment ((phase 1). Acridine orange was used to stain the cells in the rinse samples. A fluorescence microscope and hemocytometer was used to count neutrophils. Results: There was significant difference in mean value of oral neutrophils before and after treatment for control, moderate periodontitis and severe periodontitis groups. Conclusion: The oral rinse assay was capable to identify a major decrease in oral neutrophil counts in patients who reacted to periodontal treatment (phase 1 therapy). This method is safe, easy, reliable and noninvasive method of quantification of oral neutrophils.

ПРИМЕНЕНИЕ НЕСТЕРОИДНЫХ ПРОТИВОВОСПАЛИТЕЛЬНЫХ ПРЕПАРАТОВ ПРИ ПАРОДОНТАЛЬНОЙ ТЕРАПИИ ПАЦИЕНТОВ С КОМОРБИДНОЙ ПАТОЛОГИЕЙ

Subject. This paper covers the main aspects of non-steroidal anti-inflammatory drugs (NSAIDs) used on periodontal therapy in patients with cormobid pathology.&#x0D; Objectives. A domestic and foreign literature review on effects of NSAIDs on periodontal therapy in patients with cormobid pathology.&#x0D; Methodology. The literature review is based on the source literature available over the past five years starting 2015 by PubMed keywords in order to summarize the subject information.&#x0D; Conclusion. NSAIDs, therefore, remain the most essential medications on etiotropic, pathogenetic and symptomatic therapy of dental disorders. NSAIDs can help manage pain syndrome, control inflammation responses and regeneration with indulating inflammation-induced tissue destruction, prevent unnecessary complications during basic and supportive periodontal therapy including invasive techniques. Systemic and localized use of NSAIDs in the complex periodontal therapy based on the rational choice of the drug and the appropriate dose selection considering patient’s comorbidities must be necessarily supported by the dentist’s knowledge of pharmacodynamics and NSAIDs classifications with Clinical Guidance on rational use of NSAIDs (2015, revised 2018) and Clinical Guidance on comorbid pathology (2019) taken as the basis. These, therefore, will ensure the personified approach, efficacy and safety of NSAID use in patients.

Low-level laser periodontal therapy in diabetic patients: a randomized controlled clinical trial - pilot study

Objectives We aimed to evaluate the effects of low-level laser therapy as an adjunct to non-surgical periodontal therapy in patients with periodontitis and compare the effect on periodontal healing in diabetes mellitus and non-diabetes mellitus patients. Methodology Ten patients with periodontitis stage II grade B were divided into two groups; Group 1 included 5 non-diabetes mellitus patients with periodontitis, and Group 2 included 5 type2 diabetes mellitus patients with periodontitis. A 13 mW low-level laser was used in a continuous wave and non-contact mode as an adjunct to scaling and root planning (SRP) in a split-mouth study design “OPTODAN” (Scientific Development and Production Center, Saratov, Russia). The clinical parameters; plaque and gingival index, probing depth, and relative clinical attachment level of the test and control sides of both groups were analyzed at baseline and 1-month post-therapy. Visual analogue scale was used to determine patient discomfort intraoperatively and after 1 week. Results Statistically, significant improvement was evident in the gingival index, probing depth, and relative clinical attachment level when comparing test and control sides in all patients 1-month post-therapy. There was improvement in gingival index amongst type 2 diabetes mellitus patients in the test group. However, non-diabetes mellitus patients demonstrated superior results especially in probing depth and relative clinical attachment level. Conclusion The use of low-level laser therapy as an adjunct in periodontal therapy showed overall improvement in gingival inflammation, probing depth, and clinical attachment level. In comparison to non-diabetes mellitus patients, type 2 diabetes mellitus patients demonstrated significant improvement in gingival inflammation with low-level laser therapy.

Two-year outcomes following the adjunctive use of InGaAsP and Er,Cr:YSGG lasers in nonsurgical periodontal therapy in patients with stages III and IV periodontitis.

To evaluate the clinical outcomes 2 years after the adjunctive use of an InGaAsP diode and Er,Cr:YSGG laser for nonsurgical treatment of severe periodontitis. Forty-two patients (45.31 ± 9.78 years old, n = 22 females, n = 23 smokers) with stage III or IV grade B periodontitis were randomly treated either with laser (InGaAsP + Er,Cr:YSGG) adjunctive to subgingival debridement (test group, n = 21) or with subgingival debridement alone (control group, n = 21). Subjects in the test group received a second laser treatment in residual sites 2 months after the initial laser therapy. At baseline, and at 12 and 24 months after therapy, periodontal clinical parameters were evaluated. The primary outcome variable was the number of residual deep sites at 12 months (probing depth [PD] ≥ 6 mm). One and two years after nonsurgical periodontal treatment, both groups yielded statistically significant clinical improvements. The adjunctive use of InGaAsP and Er,Cr:YSGG laser to mechanical debridement resulted in statistically significantly higher clinical (PD, clinical attachment level, bleeding on probing, number of sites with PD ≥ 5 mm, PD ≥ 6 mm, PD ≥ 7 mm) improvements (P < .05) compared to subgingival debridement alone both at 12 and 24 months after therapy. In patients with stage III or IV grade B periodontitis, InGaAsP and Er,Cr:YSGG used adjunctively to subgingival debridement may additionally improve the clinical outcomes compared to mechanical debridement alone over a period of 24 months.

Use and Effectiveness of Propolis on Chronic Periodontitis: a Systematic Review

The aim of this study was to determine the effect of propolis on non-surgical periodontal therapy in patients with chronic periodontitis (CP) as it appears in the recent literature. Propolis is a natural and biocompatible resinous substance that has shown, by means of several scientific studies, to possess medicinal properties such as antimicrobial, healing, anesthetic, anti-inflammatory, and analgesic, among others. There are several studies that have reported the use of propolis as a non-surgical treatment of CP, its comparison with other antimicrobials, and the improvement of clinical and microbiological parameters with scaling and root planing (SRP). A bibliographic search was conducted in the PubMed, Google Scholar, Web of Science, and Science Direct databases up to 2021. The results showed that there are very few reports focused on clinical studies; however, according to the analyzed data, propolis could be a good adjuvant for the treatment of patients with chronic periodontitis compared to the conventional treatment (SRP).

Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

This review investigated whether the adjunctive use of antioxidants with periodontal therapy improves periodontal parameters in patients with type 2 diabetes. A systematic and extensive literature search for randomized controlled trials (RCTs) conducted before April 2021 was performed on the PubMed, Cochrane Library, and Web of Science databases. The risk of bias was assessed using the Cochrane risk-of-bias tool. A meta-analysis was performed to quantitatively evaluate the clinical outcomes following periodontal therapy. After independent screening of 137 initial records, nine records from eight RCTs were included. The risk-of-bias assessment revealed that all RCTs had methodological weaknesses regarding selective bias, although other risk factors for bias were not evident. This meta-analysis of two RCTs showed that periodontal pocket depths were significantly reduced in the groups treated with combined non-surgical periodontal therapy and melatonin than in those treated with non-surgical periodontal therapy alone. The present systematic review and meta-analysis suggest that the adjunctive use of melatonin, resveratrol, omega-3 fatty acids with cranberry juice, propolis, and aloe vera gel with periodontal therapy significantly improves periodontal disease parameters in patients with type 2 diabetes, and melatonin application combined with non-surgical periodontal therapy might significantly reduce periodontal pocket depth. However, there are still limited studies of melatonin in combination with non-surgical periodontal therapy in Type 2 diabetic patients, and more well-designed RCTs are required to be further investigated.

Changes in Salivary Melatonin Levels by Scaling and Root Planing in Patients with Chronic Periodontitis

Background: Periodontitis is a chronic inflammatory disease that causes tissue destruction due to the imbalance in the oxidant-antioxidant system. Melatonin has anti-inflammatory, antioxidant, and immune-modulatory properties and is considered to be a biomarker and diagnostic/therapeutic agent in the pathogenesis of periodontitis. Objectives: The present study aimed to evaluate the salivary melatonin level and its changes following non-surgical periodontal therapy in patients with periodontitis. Methods: In total, 90 salivary samples were collected from 60 patients, including 30 from patients with moderate chronic periodontitis (before periodontal treatment), and 30 from the same patients one month after the non-surgical periodontal therapy, and 30 from periodontally healthy subjects (control). Salivary melatonin levels were measured using the competitive immunoassay of the human melatonin ELISA kit. Results: The highest melatonin concentration was observed in the control group (79.55 ± 59.22; P &lt; 0.05), while the lowest concentration was observed in the pre-treatment group (P &lt; 0.05). In addition, salivary melatonin concentration in the post-treatment group (56.58 ± 46.48) was significantly higher compared to the pre-treatment group (17.25 ± 5.79; P &lt; 0.05). Conclusions: According to the results, salivary melatonin levels improved after non-surgical periodontal therapy, which suggests the involvement of melatonin in the pathogenesis of periodontitis. However, the exact role of melatonin requires further investigation.

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study.

Background: periodontal therapy has been suggested to have systemic effects. However, studies of periodontal therapy in rheumatoid arthritis patients have produced controversial results.Aim: To compare the effects of nonsurgical periodontal therapy on biochemical markers of rheumatoid arthritis and periodontal parameters in patients with and without rheumatoid arthritis.Methods: a prospective before-and-after study was conducted that included 21 participants without and 29 participants with rheumatoid arthritis. Periodontal parameters, Porphyromonas gingivalis detection, C-reactive protein, rheumatoid factor and anti-citrullinated protein antibodies were measured at baseline and three months after nonsurgical periodontal therapy and the changes were statistically assessed.Results: In general, both groups presented statistically significant improvement in periodontal parameters (p<0.05). There was an increase in the counts of P. gingivalis in both groups at three months. In addition, there was a reduction in levels of anti-citrullinated protein antibodies and rheumatoid factor in participants with rheumatoid arthritis. In contrast, C-reactive protein levels increased in both groups but were higher in the rheumatoid arthritis group. Periodontal parameters in rheumatoid arthritis participants under disease-modifying antirheumatic drugs presented a slightly higher improvement (p <0.05).Conclusions: Nonsurgical periodontal therapy has similar improvements in periodontal parameters in patients with and without rheumatoid arthritis. In addition, nonsurgical periodontal therapy may benefit serum levels of anti-citrullinated protein antibodies and rheumatoid factors in patients with rheumatoid arthritis. NCT04658615.

Impact of stress on clinical outcomes of non-surgical periodontal therapy in patients with severe generalized periodontitis

Relevance.Aim – to assess the impact of psychosocial stress on the clinical outcomes in severe periodontitis patients treated with Nonsurgical Periodontal Therapy (NPT).Materials and methods.Patients received 2 psychological questionnaires to score their stress levels, while clinical data were obtained 1 week before and six weeks after the completion of NPT.Results.A total of 55 patients were consecutively included in the study and subsequently categorized into different stress levels (low stress level n = 22 and moderate/high stress level n = 33). All clinical parameters were found to be comparable at baseline between groups. While reduction in full-mouth bleeding scores was found to be statistically significantly lower in group with higher stress levels, a similar improvement in the other clinical parameters was observed at the completion of NPT.Conclusion.Psychosocial stress seems to influence negatively the results of NPT and highly stressed patients may represent a risk category for disease progression.

Role of probiotics in adjunct to non-surgical periodontal therapy in patients with chronic periodontitis: a systematic review and meta-analysis.

The objective of this study was to establish the significance of probiotic usage, both as a preventive as well as a therapeutic strategy for the management of periodontal disease. It also substantiates the existing studies of single/combined bacterial strain for exhibiting variable ecological impact on oral bacteria. Data sources included literature searches of PubMed (MEDLINE), Scopus, Embase, CENTRAL and Web of science databases for placebo controlled randomized clinical trials of SRP with orally administered probiotics in any form as an adjunct. Data extraction was conducted and information from the included studies was tabulated according to the study designs, form of drug delivery, main outcomes, and clinical parameters. Data collected were based on the focused question outlined for the present systematic review. The reviewers cross-checked all extracted data. CAL and PD were assessed as the primary outcome to compare the effectiveness of adjunctive probiotic therapy in addition to SRP. Fourteen clinical studies were included and demonstrated efficacy in reducing periodontal probing depth (PPD) and gaining clinical attachment level (CAL), between probiotics and SRP/placebo. Adjunctive probiotic therapy in addition to SRP leads to decrease in probing depth and clinical attachment gain in chronic periodontitis patients. However, further high-quality randomized clinical trials with microbiological outcomes are required to fortify the conclusion.

Effects of periodontitis on postoperative pneumonia in patients with lung and esophageal cancer.

BackgroundFew studies have been conducted on the relationship between chronic periodontitis and postoperative pneumonia (POP) in patients with lung and esophageal cancer. Furthermore, it remains controversial as to whether improving the periodontal condition of patients with lung and esophageal cancer before surgery reduces the incidence of POP. This retrospective study was conducted to assess the effects of periodontal therapy in patients with lung and esophageal cancer to prevent POP.MethodsA total of 265 patients with lung or esophageal cancer complicated with chronic periodontitis who underwent open thoracotomy between July 2015 and June 2019 were selected and given the choice of being in the experimental or control group. A total of 141 participants in the experimental group received periodontal therapy, and 124 participants in the control group did not receive periodontal therapy. All clinical data of participants in both groups were retrospectively studied to determine the incidence of POP on the 30th day after discharge from hospital.ResultsEight patients in the experimental and six in the control group, respectively, were excluded from the study. It was found that four of the 133 patients suffered from POP in the experimental group (incidence: 3.01%). A total of 18 of 118 patients in the control group had a pulmonary infection (incidence: 15.25%). POP incidence in the experimental group was significantly lower than that in the control group, and in the level analysis of different types of periodontitis, surgical methods, and diseases (p < 0.05).ConclusionsPeriodontal treatment is associated with a lower incidence of POP following lung and esophageal cancer surgery. Improving the periodontal condition of patients helps prevent POP. The presence of periodontitis is an important predisposing factor for POP in patients after open thoracotomy. Periodontal examination and therapy are recommended before the surgical treatment of lung or esophageal cancer.