Risk Factor For Periodontitis Research Articles

IL-17F Gene rs763780 and IL-17A rs2275913 Polymorphisms in Patients with Periodontitis.

Background: Periodontitis (PD) is a chronic inflammatory disease that can eventually lead to tooth loss. Genetic and environmental factors such as smoking are involved in the pathogenesis of PD. The development of PD is potentiated by various pathogens that induce an immune response leading to the production of cytokines, such as interleukin (IL)-17. The synthesis of IL-17 is influenced genetically. The polymorphisms in IL-17 gene may affect the synthesis of IL-17. The aim of this study was to examine the association between the IL-17F rs763780 and IL-17A rs2275913 polymorphisms and PD in non-smoking and smoking patients to check if these polymorphisms could be a risk factor for PD. Methods: The study enrolled 200 patients with PD (130 non-smokers and 70 smokers) and 160 control subjects (126 non-smokers and 34 smokers). Periodontitis was diagnosed on the basis of 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. All samples were genotyped using allelic discrimination assays with TaqMan® probes on a Real-Time PCR Detection System. Results: There were no statistically significant differences in the distribution of the IL-17F rs763780 and IL-17A rs2275913 genotypes and alleles between patients with PD and control subjects, between smoking patients with PD and smoking control subjects, and between non-smoking patients with PD and non-smoking control subjects. Conclusions: The results of this study suggest a lack of statistically significant associations between IL-17F rs763780 and IL-17A rs2275913 polymorphisms and PD in Polish population.

Comparison of Diagnosed Depression and Self-Reported Depression Symptom as a Risk Factor of Periodontitis: Analysis of 2016-2018 Korean National Health and Nutrition Examination Survey Data.

Depression causes damage to the immune defense mechanism, and it can worsen periodontitis due to the accumulation of periodontitis pathogens. This study was conducted in order to explore the association of diagnosed depression and self-reported depression symptom with periodontitis by using the Korean National Health and Nutrition Examination Survey 7th (KNHANES VII) data. A total of 12,689 participants aged over 19 received a periodontal examination among the 24,269 participants of KNHANES VII. Diagnosed depression and self-reported depression symptom were the two terms used for depression. Periodontitis was defined as the presence of teeth with periodontal pockets of 4 mm or deeper. The age, sex, marital status, education, region, basic livelihood protection, private health insurance, type of housing, health insurance coverage, household income, sleeping hours, subjective health condition, stress perception, drinking status, obesity, and current smoking status of the participants were examined. Chi-square tests and two-tailed analyses were used. The association of depression and periodontitis was tested by using logistic regression models adjusted for socio-demographic and behavioral variables. Diagnosed depression was associated with periodontitis, as the odds ratio of diagnosed depression for periodontitis was 1.772 (95% confidence interval = 1.328–2.364). However, the association between self-reported depression symptom and periodontitis was not statistically significant. This study revealed that diagnosed depression, not self-reported depression symptom, could be a risk factor for periodontitis. Therefore, it is necessary to take a closer look into diagnosed depression in order to manage and prevent periodontitis.

Effect of Switching to the Tobacco Heating System Versus Continued Cigarette Smoking on Chronic Generalized Periodontitis Treatment Outcome: Protocol for a Randomized Controlled Multicenter Study.

BackgroundSmoking is a significant risk factor for periodontal disease and tooth loss, as shown in several clinical studies comparing smokers and nonsmokers. Although only a few longitudinal studies have assessed the outcome of periodontal disease after smoking cessation, they indicated that recovery after nonsurgical treatment was more successful in those who had quit smoking. As part of tobacco harm reduction strategies, substituting cigarettes with alternative, less harmful tobacco products is an approach complementary to cessation for smokers who would otherwise continue to smoke. The Tobacco Heating System (THS), developed by Philip Morris International (commercialized as IQOS), is part of the heat-not-burn product category. The IQOS device electrically heats tobacco instead of burning it, at much lower temperatures than cigarettes, thereby producing substantially lower levels of harmful and potentially harmful constituents, while providing the nicotine, taste, ritual, and a sensory experience that closely parallel those of cigarettes. Phillip Morris International has published the results from a broad clinical assessment program, which was established to scientifically substantiate the harm reduction potential of the THS among adult healthy smokers switching to the THS. The program is now progressing toward including adult smokers with smoking-related diseases.ObjectiveThe goal of this study is to demonstrate favorable changes of periodontal endpoints in response to mechanical periodontal therapy in patients with generalized chronic periodontitis who completely switched to THS use compared with continued cigarette smoking.MethodsThis is a randomized controlled two-arm parallel-group multicenter Japanese study conducted in patients with chronic generalized periodontitis who switch from cigarettes to THS compared with smokers continuing to smoke cigarettes for 6 months. The patients were treated with mechanical periodontal therapy as per standard of care in Japan. The primary objective of the study is to demonstrate the beneficial effect of switching to THS use compared with continued cigarette smoking on pocket depth (PD) reduction in all sites with an initial PD≥4 mm. The secondary objectives include evaluation of other periodontal parameters (eg, clinical attachment level or gingival inflammation) and overall oral health status upon switching to THS. Safety was monitored throughout the study.ResultsIn total, 172 subjects were randomized to the cigarette (n=86) or THS (n=86) groups, and all 172 completed the study. The conduct phase of the study is completed, while data cleaning and analyses are ongoing.ConclusionsThis study is the first to test a heat-not-burn tobacco product in smokers with an already established disease. The results should further strengthen the evidence that switching to THS can significantly reduce the risk of smoking-related diseases if favorable changes in the evolution of chronic generalized periodontitis after mechanical therapy are found when compared with continued cigarette smoking.Trial RegistrationClinicalTrials.gov NCT03364751; https://clinicaltrials.gov/ct2/show/NCT03364751International Registered Report Identifier (IRRID)DERR1-10.2196/15350

The impact of smoking different tobacco types on the subgingival microbiome and periodontal health: a pilot study

Smoking is a risk factor for periodontal disease, and a cause of oral microbiome dysbiosis. While this has been evaluated for traditional cigarette smoking, there is limited research on the effect of other tobacco types on the oral microbiome. This study investigates subgingival microbiome composition in smokers of different tobacco types and their effect on periodontal health. Subgingival plaques were collected from 40 individuals, including smokers of either cigarettes, medwakh, or shisha, and non-smokers seeking dental treatment at the University Dental Hospital in Sharjah, United Arab Emirates. The entire (~ 1500 bp) 16S rRNA bacterial gene was fully amplified and sequenced using Oxford Nanopore technology. Subjects were compared for the relative abundance and diversity of subgingival microbiota, considering smoking and periodontal condition. The relative abundances of several pathogens were significantly higher among smokers, such as Prevotella denticola and Treponema sp. OMZ 838 in medwakh smokers, Streptococcus mutans and Veillonella dispar in cigarette smokers, Streptococcus sanguinis and Tannerella forsythia in shisha smokers. Subgingival microbiome of smokers was altered even in subjects with no or mild periodontitis, probably making them more prone to severe periodontal diseases. Microbiome profiling can be a useful tool for periodontal risk assessment. Further studies are recommended to investigate the impact of tobacco cessation on periodontal disease progression and oral microbiome.

RESOURCES TO IMPROVE THE EFFECTIVENESS OF PERIODONTAL TREATMENT IN PATIENTS WITH DIABETES MELLITUS

The aim: Is to characterize the «Medico-sociological map» developed by us to identify systemic and local risk factors for periodontal disease in patients with type I and II diabetes mellitus as a resource to improve the treatment of generalized periodontitis. Materials and methods: We have developed a Medic-sociological map to identify systemic and local risk factors for periodontal disease in patients with type I and type II diabetes mellitus. Methods of accumulation of primary dental and endocrinological information, review and analytical methods. Statistical methods for comparing empirical data and their generalization. Results: Thanks to the «Medico-sociological map» developed by us, systemic and local risk factors for the development of periodontal tissue diseases in patients with type I and II diabetes mellitus have been identified. Factors for improving the well-being of patients in the treatment of periodontal diseases have been comprehensively studied. Patients with type 1 and type 2 diabetes mellitus have been shown to give up healthy habits (cigarette smoking) and lead a healthy lifestyle and reduce the health risks that can be caused by generalized periodontitis in combination with diabetes mellitus. Conclusions: It has been demonstrated that resources to improve the effectiveness of periodontitis treatment in patients with diabetes mellitus include not only cooperation with endocrinologists, but also our «Medico-sociological map» to identify systemic and local risk factors for periodontal disease in patients with type I and II diabetes mellitus.

Comparison of stem cell markers on Gingival mesenchymal stem cells among diabetic and healthy individuals. An Ex Vivo Pilot study

Aim: Diabetes mellitus (DM), being a risk factor for periodontal disease, affects various cellular functions, and it plays an important role in periodontal regeneration. However, the effect of hyperglycemia on Gingival mesenchymal stem cells (GMSCs) is unclear. We aim at investigating the effect of hyperglycemia on stem cell markers of GMSCs compared with normoglycemic conditions. Materials and Methods: An ex vivo pilot study was conducted by obtaining primary gingival tissues from subjects. Subjects from the outpatient department of periodontology were randomly selected according to the criteria. Three subjects with an HbA1c of >6.5 were selected as the test group, and three subjects with an HbA1c <6 served as controls. The tissue was enzymatically digested in 0.5 mg/mL collagenase (Sigma-Aldrich) and cultured in Knockout Dulbecco‘s Modified Eagles Medium (DMEM - KO medium, Life Technologies). MSC-like cells isolated were examined under a microscope and investigated for specific cell surface antigens CD73, CD90, CD105, CD34, CD45, HLA ABC, and HLA DR by using flow cytometry. Data were analyzed by a two-tailed non-parametric Mann–Whitney U test using SPS software. P < 0.05 was considered statistically significant. Results: The immunophenotype characterization in both test and control exhibited positive expression of CD73 (94.95%,95.93%), CD90 (98.05%, 88.53%), CD105 (73.97%, 73.88%), and HLA ABC (98.83%,98.16%) and negative expression of CD34 (0.02%,0.10%), CD45(0.57%,1.72%), and HLA DR (0.64%, 2.57%). Statistical analysis by the nonparametric Mann–Whitney U test did not reveal any statistically significant difference in the expression. Conclusion: GMSCs from the hyperglycemic environment retained their stem cell characteristics by positive expression of CD73, CD90, CD105, and HLA ABC, and negative expression of CD34, CD45, and HLA DR.

Behavioral risk factors and periodontal disease in Malang, Indonesia

ObjectiveThis study aimed to analyze the relationship of behavioral risk factors for periodontal disease among 19–64 age group in Malang City. MethodA non-experimental quantitative analytic with a cross sectional study approach was used in this study. The respondents were 331 patients who visited the dental clinics of the Health Centers in Malang City. A cluster random sampling technique was used in this study. The instrument used was questionnaire. The data analysis was done through multivariate analyses use logistic-regression. ResultsThe Wald test results on logistic-regression models showed there is no significant effect of smoking habits and consumption patterns on periodontal disease. There is a significant effect of systemic disease on periodontal disease with a significance value of 0.000 (p<0.05). ConclusionsThere was a significant relationship and effect between systemic disease and periodontal disease in this study.

Obstructive sleep apnea and periodontitis: A cross-sectional study.

(1) To assess the risk of Obstructive Sleep Apnea (OSA) using a pre-designed questionnaire; (2) To assess the periodontal parameters like pocket probing depth (PPD) and clinical attachment loss (CAL) in the study subjects and (3) To determine the association between the shared risk factors of OSA and periodontitis. Periodontitis is a microbially associated, host-mediated inflammatory disease that results in the loss of periodontal attachment. It has multifactorial etiology and has been linked to an array of systemic diseases. Though both periodontitis and obstructive sleep apnoea (OSA) share some common risk factors, the insight into the hypothetical speculative link remains vague. This study intended to probe into the association between periodontitis and OSA. A cross-sectional study was conducted on 250 subjects. The subjects were explained the nature of the study and written informed consent was obtained for participation in the study. The patients were administered a STOP-BANG questionnaire following which the periodontal parameters were recorded. The data obtained was analyzed by descriptive and inferential statistics. A statistically significant increase in PPD and CAL scores were seen with the increase in OSA scores. A significant moderate positive correlation was found between OSA scores and PPD [r = 0.58, P < 0.001] and CAL [r = 0.55, P = 0.001]. Males were at increased risk for OSA and periodontitis. Age, hypertension and BMI which are the risk factors for periodontitis were also significantly higher in subjects at high risk for OSA. This study found a moderate positive association between periodontitis and OSA.

Oral Hygiene as a Risk Factor in Periodontitis

Dental plaque is the etiological factor for initiation of periodontal disease due to secretion of toxins andproteolytic enzymes by the microbial accumulation in the cervical region of teeth &amp; sub gingival area.Gingival inflammation will progress into the continuing destruction of supporting tissues like resorptionof alveolar bone Joss of attachment increase pocket depth if we don’t remove the microbial dental plaque,by daily oral hygiene practice through mechanical tooth brushing of the person himself &amp;periodic clinicalexamination to remove the plaque .calculus &amp;other retentive factors to maintain the oral hygiene in a goodmanner.The oral hygiene is considered as a risk factor in the prevention or progression of periodontal diseasedepending on daily removing of dental plaque by the person &amp; professional recalling system clinically.

Influence of Psychological Stress on Periodontal Diseases

Introduction: The association between periodontal disease and stress has been questioned for a almost a century, however, it still represents an unexplored field of research with several orphaned questions of conclusive answers. Objective: To evaluate the relationship between periodontal disease and stress. Methodology: Searches were performed with descriptors related to periodontal diseases and psychological factors in the following databases: Pubmed, Embase, Lilacs. Were identified and included studies that deal with the relationship between stress and periodontal disease and /or that emphasize the role of this psychosocial factor in the progression of periodontal disease. Conclusion: Most studies have shown a positive relationship between periodontal disease and stress, however, further research needs to be developed to confirm stress as a risk factor for periodontal disease

The impact of vaping on periodontitis: A systematic review.

Background and objectiveWhile tobacco cigarette smoking has been proven to be a risk factor for periodontitis, limited information is available regarding vaping, a new alternative to smoking that has been branded as less harmful. Several important in vitro studies have shown that vaping has a similarly damaging effect as cigarette smoking on the health of the periodontium. However, a comprehensive review is lacking in this field. Therefore, we aimed to systematically review the literature about the impact of vaping on periodontitis.MethodsThe research question was created using the PICOs format. A systematic search of the following electronic databases was performed up to March 2020: Medline, Embase, PubMed, Cochrane, and grey literature. Human studies that assessed periodontal status (plaque index, bleeding on probing, clinical attachment loss, marginal bone loss, and probing depth) in e‐cigarette users compared to non‐smokers (control group) were assessed based on an estimate of fixed effects. The weights of the studies were calculated based on their risks of bias.ResultsAfter duplicates were removed, 1,659 studies were screened and 8 case–control studies that investigated the relationship between vaping and periodontal parameters in humans were selected after their risk of bias assessment. Estimated effects of vaping after weighting results based on their standard deviation showed increased plaque, marginal bone loss, clinical attachment loss, pocket depth, and reduced bleeding on probing.ConclusionThis study concluded that there is not enough evidence to fully characterize the impacts of vaping on periodontitis. However, within the limitations of our review and the selected included studies, the available results point to increased destruction of the periodontium leading to the development of the disease.

Low education is associated with poor periodontal status in patients with type 2 diabetes mellitus: A cross-sectional study.

ObjectivesCardiovascular disease remains the most common cause of death in patients with type 2 diabetes mellitus. Because periodontitis is a risk factor of cardiovascular disease, identification of risk factors of periodontitis is valuable to control periodontitis effectively. The purpose of this study was to examine the association of education and household income with periodontal status in patients with type 2 diabetes mellitus.MethodsParticipants were 2,436 patients (59.8% male, aged 29–93 years) with type 2 diabetes mellitus from 27 medical clinics. Participants' medical records and information about education, household income, general health status, and health behaviors were collected. Periodontal status was assessed in a nearby dental office. Multiple linear regression analyses and ordered logistic regression analyses were conducted to examine the association of periodontal parameters with education and household income after adjusting for age, sex, general health status, and health behaviors.ResultsMultiple linear regression analysis showed that mean probing pocket depth was not significantly associated with education and household income. Ordered logistic regression analyses showed statistically significant odds ratios (ORs) of junior high school (reference: university) for the tertiles of the percentage of sites with bleeding on probing (OR: 1.42; 95% confidence interval [CI]: 1.11–1.81), percentage of mobile teeth (OR: 1.58; 95% CI: 1.24–2.03), and number of teeth present (OR: 0.51; 95% CI: 0.39–0.65), and statistically significant odds ratios of high school (reference: university) for the tertiles of the percentage of mobile teeth (OR: 1.27; 95% CI: 1.06–1.51) and number of teeth present (OR: 0.74; 95% CI: 0.62–0.88), but not household income.ConclusionsThese results suggest that low education is one of the important predictors of poor periodontal status in patients with type 2 diabetes mellitus. It is important to provide targeted interventions including periodontal education in junior high school.

Periodontal Health and Systemic Conditions.

According to the new classification proposed by the recent 2017 World Workshop on Periodontal and Peri-implant Diseases and Conditions, periodontitis, necrotizing periodontal diseases, periodontitis as a manifestation of systemic diseases, and systemic diseases or conditions affecting the periodontal supporting tissues, are considered as separate entities. Scientific evidence has demonstrated that periodontal diseases are not just simple bacterial infections but rather complex diseases of multifactorial complexity that interplay with the subgingival microbes, the host immune, and inflammatory responses. Despite dental plaque biofilm being considered the primary risk factor for periodontitis in the vast majority of patients that dentists encounter on a daily basis, there are other factors that can also contribute and/or accelerate pathologic progressive attachment loss. In this article, the authors aim to briefly review and discuss the present evidence regarding the association between periodontal diseases and systemic diseases and conditions.

The impact of smoking on non-surgical periodontal therapy: A systematic review and meta-analysis.

Smoking is a risk factor for periodontitis. This study aimed to evaluate the impact of smoking on clinical outcomes of non-surgical periodontal therapy. Electronic databases were searched to screen studies published before May 2020. The included studies had to have two groups: smokers (S) and non-smokers (NS) with periodontitis. The outcomes evaluated were differences between groups in probing depth (PD) reduction and clinical attachment level (CAL) gain after non-surgical periodontal therapy. Meta-regressions were conducted to evaluate correlations between outcomes and other contributing factors. Seventeen studies were included. The post-treatment PD reduction in the S group was smaller than in the NS group (weighted mean difference in PD reduction: -0.33mm, 95% confidence interval (CI): [-0.49, -0.17], p<.01). The CAL gain in the S group was also smaller than in the NS group (weighted mean difference in CAL gain: -0.20mm, CI: [-0.39, -0.02], p<.01). Additionally, baseline PD significantly affected the difference in PD reduction between two groups. Smoking negatively impacts clinical responses to non-surgical periodontal therapy. Smokers with periodontitis have significantly less PD reduction and CAL gain than non-smokers.

The prevalence of fimA genotypes of Porphyromonas gingivalis in patients with chronic periodontitis: A meta-analysis.

FimA is an important virulence factor of Porphyromonas gingivalis (P. gingivalis). According to its DNA sequence, the fimA genotype of P. gingivalis can be divided into six categories (I, Ib, Ⅱ, III, IV, V). The fimA gene may be a key factor in the diversity of virulence found in P. gingivalis. Moreover, the role fimA plays in the pathogenesis of P. gingivalis is closely associated with periodontitis, making it an important factor of study for disease prevention and treatment. In this study, the prevalence of fimA genotypes of P. gingivalis in patients with periodontal diseases was evaluated by meta-analysis. The Embase and PubMed databases were searched for articles from 1999 to 2019 using the following search terms: Porphyromonas gingivalis or P. gingivalis; periodontitis or chronic periodontal disease; fimA or fimA genotype. The reference lists of relevant published articles were searched manually. A total of 17 studies were included in this report. A statistical software package (Stata, version 11.0/mp, StataCorp) was utilized to calculate and analyze the P. gingivalis fimA genotypes for each combined incidence estimate. The pooled rates of fimA Ⅰ, fimA Ib, fimA Ⅱ, fimA Ⅲ, fimA Ⅳ and fimA Ⅴ genotypes of P. gingivalis were 8.4% (95% CI: 5.7-11.1), 11.7% (95% CI: 7.4-16), 42.9% (95% CI: 34.2-51.7), 6.5% (95% CI: 5.1-7.9), 17.8% (95% CI: 9.0-26.5), and 3.2% (95% CI: 1.6-4.9), respectively. This study showed that the fimA Ⅱ and fimA Ⅳ genotypes of P. gingivalis are highly present in patients with periodontal disease. Therefore, these two genotypes may be related to the pathogenesis and progress of periodontal disease, one of the main risk factors of periodontitis.

Diagnostic Accuracy of Oral Fluids Biomarker Profile to Determine the Current and Future Status of Periodontal and Peri-Implant Diseases.

Severe periodontitis is ranked as the sixth most prevalent disease affecting humankind, with an estimated 740 million people affected worldwide. The diagnosis of periodontal diseases mainly relies upon assessment of conventional clinical parameters. However, these parameters reflect past, rather than current, clinical status or future disease progression and, likely, outcome of periodontal treatment. Specific and sensitive biomarkers for periodontal diseases have been examined widely to address these issues and some biomarkers have been translated as point-of-care (PoC) tests. The aim of this review was to provide an update on PoC tests for use in the diagnosis and management of periodontal diseases. Among the PoC tests developed so far, active matrix metalloproteinase-8 has shown promising results in terms of diagnostic and prognostic values. However, further studies are required to increase the sensitivity and specificity via combining more than one biomarker and merging these test kits with periodontal risk assessment tools. Furthermore, the validity of these test kits needs to be investigated by applying the results in further independent studies and the impact on these test kits’, together with the results of risk factors for periodontal diseases, such as diabetes and smoking, also needs to be examined.

Early pregnancy levels of gingival crevicular fluid matrix metalloproteinases-8 and -9 are associated with the severity of periodontitis and the development of gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) is increasing worldwide and women with a history of GDM are at risk of developing type 2 diabetes which is a risk factor for periodontitis. The aim of this study was to explore the association between the concentrations of matrix metalloproteinase (MMP)-8 and -9 in gingival crevicular fluid (GCF) during early pregnancy with the periodontal diagnosis and the risk of GDM development. A prospective cohort study, including 314 women, enrolled at 11 to 14weeks of pregnancy was conducted. A complete maternal/obstetric and periodontal exam was performed, and GCF samples were obtained for the MMP-8 and -9 determination by Multiplex Elisa Assays. Mann-Whitney test; Spearman's correlation and log-binomial regression model estimated the association between MMPs concentration in GCF and GDM. Fourteen percent of the pregnancies were diagnosed with GDM. An increase in the concentration of MMP-8 and -9 in women with periodontitis stage III and IV compared to periodontitis stage I was observed (99.31ng/mL [IQR: 85.32] versus 71.95ng/mL [IQR: 54.04], and 262.4ng/mL [IQR: 312.55] versus 114.1ng/mL [IQR: 184.94], respectively). Women who developed GDM showed increased concentrations of MMP-8 and -9 in GCF since the beginning of pregnancy (P=0.0381; P=0.0302, respectively). MMP-8 concentration in GCF was associated with GDM (RR: 1.19; P=0.045; CI 95% 1.00 to 1.40; and RR: 1.20; P=0.063; CI 95% 0.99 to 1.45 in the adjusted model). GCF concentrations of MMP-8 and -9 at early of pregnancy are increased in women with severe periodontitis and associated with the GDM development.

EVALUATION OF A CORRELATION BETWEEN SLEEP HOURS, SLEEP QUALITY AND SALIVARY LEVELS OF 8-HYDROXY-2'-DEOXYGUANOSINE IN CHRONIC PERIODONTITIS PATIENTS- AN OBSERVATIONAL STUDY

Aims: To determine if there was a correlation between sleep hours, sleep quality with the salivary levels of 8-hydroxy-2’-deoxyguanosine in chronic periodontitis patients, and to decide its relationship with the established clinical periodontal parameters. Settings and Design: Observational analytical study with 100 patients based on the inclusion criteria, who visited the Department of Periodontology of a tertiary care setting. Methods and Material: Bleeding on probing, pocket depth, clinical attachment loss, plaque index score were recorded. Sleep behaviour longer than a month time stretch was surveyed by Pittsburgh Sleep Quality Index, a validated questionnaire. 8-OHdG levels in un-stimulated saliva of all subjects were examined by ELISA. Statistical analysis used: Sleep-hour correlations with sleep quality at salivary 8-OHdG levels as well as clinical periodontal parameters were assessed using the Pearson correlation coefficient. All statistical analysis was performed using SPSS software version 17.0. Results: Salivary 8-OHdG levels and clinical parameters (PPD, CAL, PI) were significantly higher among sleep deprived individuals. On comparison, subjects with a poor quality of sleep (PSQI score&gt;5) showed a significantly higher 8-OHdG levels. Conclusions: Short sleep durations and poor sleep quality can instigate inflammation and oxidative stress and could be a risk factor for periodontitis.

DENTAL FLUOROSIS AND PERIODONTAL DISEASE: AN OVERVIEW

Aim: The aim of this review is to discuss various effects of fluoride on hard and soft tissues of the periodontium and its importance in human life. Background : Fluoride is an essential element for life and is one of the trace elements normally present in the body. It is abundant in the environment and the main source of fluoride to humans is drinking water. Fluoride gets accumulated in hard tissues of the body and has been known to play an important role in mineralization of bone and teeth. The behaviourof fluoride ions in the human organism can be regarded as that of double-edged sword. In small amounts, it is known to have beneficial effects on dental health. On the other hand, excessive chronic intakes can result in adverse effects including the development of dental fluorosis in children and/or skeletal fluorosis in both children and adults. Although effect of fluoride on caries has been discussed in painstaking details through various studies but the effect of fluorosis on the periodontium yet remains in shadow. Review Results : Dental fluorosis is a developmental disturbance of dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. Even after continuing with the age old logic of structural changes that take place in mottled enamel it can be said with scientific plausibility that this factor of surface roughness can or must influence some of the variables in this multifactorial disease of periodontitis. This surface roughness is conducive for the bacteria to survive as well as make it difficult for scaling and root planing in fluorosed teeth. This could also jeopardize the effectiveness of the regular oral hygiene procedures. Conclusion : Dental fluorosis is not only a cosmetic problem that impairs social well-being but also affects the oral health related quality of life. Fluorosis continues to be an important problem, both for the affected individuals and for public health. More and more areas are being discovered regularly that are affected by fluorosis in different parts of the country. But ultimate solution for this fluoride menace remains to be the principal of Precaution is better than cure. Clinical Significance : Considering the role of fluorosis on hard and soft tissues and all the risk factors of periodontitis, fluorosis can be recommended strongly as an environmental risk factor for periodontitis. To be defined as one of the etiological (environmental) agent of periodontal disease requires further research studies with greater sample size from varying areas globally.

Kostmann Sendromu ve Ağız İçi Bulguları

Bu derlemede Kostmann Sendromu tanısı konulurken diş hekimlerinin öneminin sunulması amaçlandı. Nötrofiller akut enflamatuar yanıtta ve bakteriyel enfeksiyonlara karşı konak savunmasında kritik bir rol oynayan ve fagositoz yapan hücrelerdir. Nötropeni mutlak nötrofil sayısının 1500 / mm3’ün altına inmesi durumunda kullanılan terimdir. Mutlak nötrofil sayısı < 200 / mm3 olduğunda Kostmann sendromu olarak tanımlanır. Periferik yaymada monositoz ve eozinofili gözlenir. Kemik iliği incelemesinde promyelosit veya myelosit aşamasında ‘maturasyon arresti’ tanı koydurucudur. Prevalansı 12 / 1000000, kadın/erkek görülme oranı eşittir. Genellikle otozomal resesif geçiş göstermekle birlikte otozomal dominant geçiş veya spontan mutasyonların bir sonucu olarak da kalıtılabilir. Sitogenetik değişikliklerin varlığında ise bu hastalarda myelodisplastik sendrom (MDS) ve akut myeloid lösemi (AML) görülme riski vardır. Ciddi konjenital nötropeni periodontal hastalıklar için risk faktörüdür, hastalığın şiddeti arttıkça periodonsiyumdaki yıkımın şiddeti de artar. Kostmann sendromunda her iki dentisyonda görülen şiddetli ve yaygın diş eti iltihabı, diş eti çekilmesi, apikal abse, dişlerde mobilite, alveoler kemik kaybı ve erken diş kaybı gibi oral belirtilerle sık karşılaşılır. Enflamasyon belirtisi olmadan beyaz ya da grimsi yüzeyli, tekrarlayan, ağrılı oral ülserasyonlar yaygın olarak gözlenebilmekte hatta hastalığın tek major belirtisi olabilmektedir. Ayrıca bu hastalarda geçirilen ciddi enfeksiyonların sebep olduğu generalize mine hipoplazisi de görülebilir. Ağız-diş ve çevre dokularında görülen ve nedeni açıklanamayan patolojik durumlar, ciddi konjenital nötropenisi olan hastalarda sıklıkla gözlenir hatta ortaya çıkan ilk belirtiler olabilir bu yüzden dikkat gösterilmelidir. Nötrofil ile ilişkili hastalıkların tanısında diş hekimlerinin önemli bir rolü olduğu açıktır.