Severe Periodontal Conditions Research Articles

Assessment of Knowledge, Attitude, and Practices among General Population Toward Utilizing ChatGPT: A Cross-Sectional Study

ChatGPT is a chatbot developed by OpenAI and launched on November 30, 2022. Based on a large language model, it enables users to refine and steer a conversation towards a desired length, format, style, level of detail, and language. Many, customers in a variety of fields have utilised ChatGPT, an artificial intelligence-based programme.The purpose of this study was to ascertain the general public's awareness, attitudes, and usage habits regarding ChatGPT. Materials and Methods: For the study, we sent an invitation to everyone living in Chennai, Tamil Nadu, between March and June of 2023.The survey evaluated the general public's knowledge, attitudes, and habits with ChatGPT. For the study, we were able to enlist participants. The participant’s average age was 27.7 ±0.46 According to the findings, individuals, or76.2%, have experience using ChatGPT. Results:Fifty-one percent of the participants thought that using ChatGPT could potentially impair their cognitive abilities, even though 51.4% of them did not use it frequently. However, a sizable portion of users (40.0%) expressed no worries about running into privacy or security problems when utilising ChatGPT. While gender and education level were statistically significant indicators, age and occupation had no significant impact on ChatGPT behaviors. Conclusion:The survey concludes that the majority of participants were aware of ChatGPT and trusted it to understand and respond to user inquiries. They also shown a moderate degree of trust by saying they were confident in ChatGPT's veracity of the material. It's noteworthy to notice that several users expressed concerns about ChatGPT usage potentially impairing cognitive abilities.

Oral health status of pregnant women in the Republic of Kiribati

Prenatal dental examinations were performed from June 2012 to May 2013 in the Republic of Kiribati as a Japan International Cooperation Agency support program. We analyzed the examination data and compared it with Japanese data retrospectively to clarify the oral health condition of pregnant women in the Republic of Kiribati. We recorded the DMF index, gingival status, and calculus attachment, analyzed data of 512 pregnant women. We also compared the city and the rural group data. The average number of present teeth, decayed teeth, missing teeth and filled teeth was 26.9, 2.5, 1.1, 0.2, respectively. Pregnant Kiribati women had significantly more decayed teeth and fewer filled teeth, more severe periodontal condition, more calculus deposition, and more severe gingival swelling than pregnant Japanese women. No significant difference was found in missing and filled teeth, but pregnant women in the city group had significantly more decayed teeth and tooth stumps than those in the rural group. Our findings indicate that pregnant women in Kiribati have more decayed teeth, more missing teeth, fewer filled teeth, and more severe periodontal problems than their counterparts in Japan. Additionally, the oral health status of pregnant women in Kiribati could be subject to regional variations. J. Med. Invest. 70 : 110-114, February, 2023.

Quantitative Assessment of Periodontal Bacteria Using a Cell-Based Immunoassay with Functionalized Quartz Crystal Microbalance

Periodontal disease is an inflammatory disorder that is triggered by bacterial plaque and causes the destruction of the tooth-supporting tissues leading to tooth loss. Several bacteria species, including Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, are considered to be associated with severe periodontal conditions. In this study, we demonstrated a quartz crystal microbalance (QCM) immunoassay for quantitative assessment of the periodontal bacteria, A. actinomycetemcomitans. An immunosensor was constructed using a self-assembled monolayer of 11-mercaptoundecanoic acid (11-MUA) on the gold surface of a QCM chip. The 11-MUA layer was evaluated using a cyclic voltammetry technique to determine its mass and packing density. Next, a monoclonal antibody was covalently linked to 11-MUA using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide to act as the biorecognition element. The specificity of the monoclonal antibody was confirmed by an enzyme-linked immunosorbent assay. A calibration curve, for the relationship between the frequency shifts and number of bacteria, was used to calculate the number of A. actinomycetemcomitans bacteria in a test sample. Based on a regression equation, the lower detection limit was 800 cells, with a dynamic range up to 2.32 × 106 cells. Thus, the QCM biosensor in this study provides a sensitive and label-free method for quantitative analysis of periodontal bacteria. The method can be used in various biosensing assays for practical application and routine detection of periodontitis pathogens.

Association of periodontitis and diabetic macular edema in various stages of diabetic retinopathy

ObjectivesPeriodontitis and diabetes are known to have a bidirectional relationship. Diabetic macular edema is a complication of diabetes that is strongly influenced by inflammatory pathways. However, it remains to be established whether inflammation at other locations, such as periodontitis, affects diabetic macular edema. Here, we investigated the prevalence of periodontitis in patients treated for diabetic macular edema.Materials and methodsPatients with diabetic macular edema were recruited for this cross-sectional study at the Medical University of Graz. Macular edema was documented by optical coherence tomography. Periodontal status was assessed by computerized periodontal probing and panoramic X-ray imaging. Bleeding on probing, clinical attachment level, probing pocket depth, and plaque index were compared between different stages of diabetic retinopathy.ResultsEighty-three eyes of 45 patients with diabetic macular edema were enrolled. Forty-four eyes (53.0%) had early stages of diabetic retinopathy (mild and moderate), and 39 eyes (47.0%) had late stages (severe and proliferative). Patients with mild or moderate DR were more likely to have more severe periodontal conditions than patients with severe or proliferative DR. Fourteen patients with mild DR (82.4%), 7 patients with moderate DR (87.5%), 4 patients with severe DR (100.0%), and 15 patients with proliferative DR (93.8%) had some degree of PD. The periodontal inflamed surface areas and the percentages of tooth sites that bled on probing were significantly higher in patients with early stages of diabetic retinopathy than in those with late stages of the disease (p < 0.05). Patients with periodontal inflamed surface areas of more than 500 mm2 required significantly more intravitreal injections in the last year than those with milder forms of periodontitis (n = 6.9 ± 3.1 versus n = 5.0 ± 3.5, p = 0.03).ConclusionIn patients with diabetic macular edema, periodontitis is more prevalent in early stages of diabetic retinopathy. We suggest regular dental check-ups for diabetic patients, especially when diabetic macular edema is already present.Clinical relevancePatients with diabetic macular edema should be screened for periodontitis and vice versa, particularly early in the course of diabetes.

The optimal orthodontic displacement of clear aligner for mild, moderate and severe periodontal conditions: an in vitro study in a periodontally compromised individual using the finite element model

BackgroundPathologic tooth migration (PTM) is a common complication of mild to severe periodontitis and proper orthodontic treatment is helpful to alleviate periodontal diseases. The goal of this study is to explore an optimal orthodontic displacement of clear aligner using a three-dimensional (3D) finite element model (FEM).MethodsThe cone beam computed tomography (CBCT) data of a patient received invisible orthodontics without diabetes and other systemic diseases were collected. Based on the new classification scheme for periodontal diseases in 2017 (stage I: mild periodontitis, [M1]; stage II: moderate periodontitis, [M2]; stage III: severe periodontitis, [M3]), 3D-FEMs of mandible were established using MIMICS 10.0 and ABAQUS 6.5 softwares. The 3D stress distribution diagrams and stress value of the teeth (left lower incisor, left lower central incisor, right lower lateral incisor, and right lower central incisor) under three different periodontal conditions (M1, M2, and M3) with axial inclination 90° and 100° were obtained by ABAQUS 6.5.ResultsThe stress of anterior teeth was concentrated in the teeth neck, and became greater when the periodontal condition was worse. The stress value of anterior teeth and the strain at the top of the alveolar crest are greater as the displacement increasing. The stress value of anterior teeth and the strain at the top of the alveolar crest in axial inclination 100° are relatively great compared to those of axial inclination 90°. For patients with excessively inclined anterior teeth (such as 100°), the optimal orthodontic displacement is 0.18 mm. In order to ensure that alveolar ridge crest is not deformed, the displacement is less than 0.18 mm (strain for 0.165 mm), 0.15 mm (strain for 0.167 mm) and 0.10 mm (strain for 0.117 mm) respectively when alveolar bone is normal, resorption 1/3 or 1/3–1/2.ConclusionsThe optimal orthodontic displacement for patients (M1, M2, and M3) with excessively inclined anterior teeth (axial inclination 100°) is 0.18 mm. To avoid the strain at the top of the alveolar crest, the optimal displacements for M1, M2 and M3 periodontal disease patients are less than 0.18 mm, 0.15 mm and 0.10 mm, respectively.

Study on the Effects of Melatonin on Glycemic Control and Periodontal Parameters in Patients with Type II Diabetes Mellitus and Periodontal Disease.

Background and Objectives: There is evidence that melatonin could improve the periodontal status and also glycemic control of patients with diabetes mellitus. Therefore, the aim of this study was to assess the effects of scaling and root planing plus adjunctive systemic treatment with melatonin on periodontal parameters and glycemic control in patients with type 2 diabetes and chronic periodontitis. Materials and Methods: The study was conducted on 54 subjects with periodontitis and diabetes mellitus randomly assigned to the study group (n = 27, subjects with scaling and root planing + melatonin) or control group (n = 27, subjects with scaling and root planing + placebo). Periodontal parameters (probing depth—PD; clinical attachment loss—CAL; bleeding on probing—BOP; and hygiene level) and glycated hemoglobin (HbA1c) were assessed at baseline and 8 weeks after. Results: At baseline, there were no significant differences between groups, but at the second evaluation 8 weeks later the association of melatonin with the non-surgical periodontal therapy exerted statistically significant improvements, both in periodontal parameters, with a significant decrease in periodontal disease severity, and glycated hemoglobin when compared to the control subjects. Conclusions: In our study, combined non-surgical periodontal treatment and systemic treatment with melatonin provided additional improvements to severe periodontal condition and the glycemic control of patients with diabetes type 2 when compared to non-surgical periodontal treatment alone.

Association of type 2 diabetes mellitus and periodontal disease susceptibility with genome-wide association-identified risk variants in a Southeastern Brazilian population.

Genome-wide association studies (GWAS) and literature have identified polymorphisms in the KCNJ11, HNF1A, IRS1, TCF7L2, CDKAL1, CDKN2B, RPSAP52, GPR45 HHEX, IL18, and RUNX2 genes associated with type 2 diabetes mellitus (T2DM) and/or periodontitis (P) in diverse populations, and we sought to evaluate them as genetic risk variants for these diseases in the Brazilian population. Periodontal, glycemic, and lipid data were obtained from 931 individuals divided into: control (n = 334), periodontitis (P; n = 358), and periodontitis associated with T2DM (P + T2DM; n = 239). After genotyping, associations between polymorphisms and pathologies were tested by multiple logistic and linear regressions, adjusting for age, sex, and smoking habits. Considering the studied subjects, the increased risk to develop periodontitis in the periodontitis P + T2DM group was found for HNF1A-rs7957197-TA, CDKAL1-rs7754840-CG, RPSAP52-rs1531343-GC, TCF7L2-rs7903146-TT, and CDKN2B-rs7018475-GG. The association of these genetic variants for TCF7L2 and CDKN2B was confirmed for female, never smokers, and poorly controlled P + T2DM. CDKN2B-rs7018475 was associated with worse glycemic condition and periodontal parameters. These five reported genetic variants were associated in the studied Southeastern Brazilian population as genetic risk variants of periodontitis and T2DM associated to periodontitis as comorbidity. Gene-phenotype associations with sex and smoking habits and the CDKN2B-rs7018475 with the poor glycemic control and more severe periodontal conditions should be further investigated. Polymorphisms in the CDKAL1-rs7754840, HNF1A-rs7957197, RPSAP52-rs1531343, TCF7L2-rs7903146, and CDKN2B-rs7018475 might predispose to periodontitis and T2DM associated with periodontitis. These findings may be useful in public health genomics and future advanced clinical practice, since genetic carriage can be measured before disease onset, being of potential great benefit for treatment planning and prognosis in early disease stages.

Periodontal diseases- A brief review

Periodontal diseases consists of a wide range of inflammatory conditions which causes degeneration of Periodontium and affects all supporting structures of teeth such as gingiva, periodontal ligament, cementum and alveolar bone etc. followed by teeth loss. WHO had reported about 10-15% of the world population is suffering from severe periodontal condition. It is complex infectious disease caused by aggressive microbial growth on teeth. The main aim of this study is to provide systemic update on periodontal disease regarding its stages, occurrence, pathophysiology, diagnosis, treatment and management. The pathophysiology of periodontal disease is associated with dental plaque, microbial biofilm formation and immunogenicity of the host cell. The severity of this disease depends upon risk factors and chronological stages. Prevention is attained by daily maintenance of oral hygiene. Various surgical and non-surgical treatments are available to control the formation of microbial biofilm. Daily maintenance and periodic management of this disease control worsening of condition and shows definite improvement in oral health.

Periodontal complications with obesity.

The purpose of this paper was to identify and summarize current evidence describing periodontal complications associated with obesity. Electronic searches supplemented with manual searches were carried out to identify relevant systematic reviews. Identification, screening, eligibility, and inclusion of studies were performed independently by two reviewers. A MeaSurement Tool to Assess systematic Reviews (AMSTAR) was used to assess the quality and risk of bias of the included reviews. From 430 titles and abstracts screened, 14 systematic reviews were considered as eligible for inclusion in this meta-review. Eight reviews reported on cross-sectional studies investigating the association of obesity and periodontal diseases, 4 included longitudinal studies, 5 addressed response to periodontal therapy, 5 reported on studies investigating biomarkers, and only 2 were related to pediatric population samples. Systematic review summaries in the various study design domains (cross-sectional, longitudinal and experimental) report that obese individuals are more likely to have periodontal diseases, with more severe periodontal conditions, than nonobese individuals, with cross-sectional evidence congruent with longitudinal studies showing that obesity or weight gain increases the risk of periodontitis onset and progression. Published research on the effect of obesity on responses to periodontal therapy, or systemic or local biomarkers of inflammation, is variable and therefore inconclusive based on the evidence currently available, which suggests that overweight/obesity contributes to periodontal complications independently of other risk factors, such as age, gender, smoking, or ethnicity. This evidence supports the need for risk assessments for individual patients to facilitate personalized approaches in order to prevent and treat periodontal diseases.

Using Evidence-Based Dentistry in the Clinical Management of Combined Periodontal Conditions

ObjectiveThis report proposes a framework to integrate evidence-based dentistry (EBD) in a systematic approach in the clinical management of a patient diagnosed with drug-induced gingival hyperplasia combined with generalized aggressive periodontitis.This report illustrates the case of a 37-year-old female who presented to the Department of Periodontology at Tufts University School of Dental Medicine with enlarged, tender, bleeding gums, and loose teeth combined with a history of uncontrolled hypertension treated with calcium channel blockers. MethodsIncorporating the EBD process, a new 5-step framework is proposed: ask the clinical question, acquire and appraise the evidence, apply it in the clinical setting, and assess the subjective and objective outcomes. Articles on aggressive periodontitis and/or gingival enlargement were sought using the assistance of an expert librarian. The search was conducted on the PubMed, Embase, and Scopus databases. ResultsInitial literature search identified 34 publications. Articles were reviewed by 2 clinicians, and 31 relevant articles were selected. Twenty-six of the references matched the levels of evidence initially agreed upon. Based on the scientific evidence, patient's chief complaint, and clinical expertise, a decision tree highlighting treatment options was compiled. The outcomes of the clinical management revealed that combined conditions can be successfully treated with nonsurgical therapy before proceeding with surgical therapy. ConclusionWithin the limitations of this study, integrating EBD concepts was a reliable method to treat an atypical case, where 2 severe periodontal conditions were combined: drug-induced gingival enlargement and generalized aggressive periodontitis.

Periodontal Referral Patterns in Australia: 2000 Versus 2015.

A previous study investigated differences in the severity of periodontal disease on referral for specialist care between 1980 and 2000 across the United States. The present study finds patients referred in 2000 had greater severity of periodontal disease than those referred 20 years ago. A retrospective analysis of 384 charts was completed from three periodontal practices across the east coast of Australia. Two time periods were investigated: 2000 to 2001 and 2015 to 2016. From these charts, the following data were recorded: 1) age; 2) sex; 3) smoking status; 4) number of missing teeth; and 5) number of teeth planned for extraction as part of a treatment plan at initial examination. Additionally, degree of periodontal severity was determined and recorded. The classification system was based on that used by the previous study, wherein case Types I to IV defined increasing severity of periodontal disease, and Type V defined referrals for needs other than periodontal disease (e.g., crown lengthening and implants). Overall, patients seen in 2015 presented with a greater percentage of Type IV and Type V cases. Smoking prevalence reduced significantly across the three locations between the two time periods. No consistent or noteworthy trends were identified with regard to number of missing teeth or number of teeth planned for extraction. Consistent with the results of a similar previous study, there appears to be a trend for more severe periodontal conditions being referred to periodontists. This is concerning given that more severe periodontal conditions tend to be more difficult to manage conservatively and reliably.

PENGARUH STRES PADA KESEHATAN JARINGAN PERIODONTAL

Stress is a psycho-physiological reactions to various stimuli emotionally or physically interfere with homeostasis, and can exacerbate diseases result from bacterial and viral infections in animals and humans. Psychological stress or psychosomatic conditions encourage the immunological changes. Namely stress hormone CRH, ACTH and glucocorticoids can affect the immune response resulting in bone loss, tissue damage, loss of attachment, and can inhibit wound healing. One of the periodontal pathogenic bacterial species is Porphyromonas gingivalis. Porphyromonas gingivalis bacteria found in dental plaque and bacteria that cause periodontal tissue pathological changes with the activation of the immune and inflammatory response of the host, and directly affects the cells of the periodontium. The high level of stress is accompanied by a lack of oral health can lead to more severe periodontal conditions. Keywords: stress, periodontal, Porphyromonas gingivalis

Relation between oral health and socioeconomic variables among schoolchildren aged 12 in the City of Manaus - AM

Studies have shown that the age of 12 was determined as the age of global monitoring of caries for international comparisons and monitoring of disease trends. The aimed was to evaluate the prevalence of dental caries, fluorosis and periodontal condition and their relation with socioeconomic factors among schoolchildren aged twelve in the city of Manaus, AM. This study with a probabilistic sample of 661 children was conducted, 609 from public and 52 from private schools, in 2008. Dental caries, periodontal condition and dental fluorosis were evaluated. In order to obtain the socioeconomic classification of each child (high, upper middle, middle, lower middle, low and lower low socioeconomic classes), the guardians were given a questionnaire. The mean decayed teeth, missing teeth, and filled teeth (DMFT) found at age twelve was 1.89. It was observed that the presence of dental calculus was the most severe periodontal condition detected in 39.48%. In relation to dental fluorosis, there was a low prevalence in the children examined, i.e., the more pronounced lines of opacity only occasionally merge, forming small white areas. The study showed a significant association of 5% among social class with dental caries and periodontal condition. In schoolchildren of Manaus there are low mean of DMFT and fluorosis, but a high occurrence of gingival bleeding.

Anabolic steroids affect human periodontal health and microbiota

This study aims to evaluate periodontal microbiological differences between systemically healthy nonsmoker males taking anabolic androgenic steroids (AASs) and non-AAS users and to find associations between disease severity and AAS use. Ninety-two men practicing bodybuilding were included in the study. They were divided into AAS users and a matched control nonuser group and subgrouped based on their most severe periodontal condition. Pooled subgingival samples from each individual were cultured to evaluate specific periodontopathogen infection. AAS users had significantly higher prevalence of severe periodontitis. AAS users had greater gingival inflammation and clinical attachment loss of ≥ 3 mm than nonusers (odds ratio (OR) = 2.4; p = 0.09; 95 % confidence interval (CI) 0.8-6.4). AAS users were 4.9 times more likely to be infected with Prevotella intermedia than AAS nonusers (OR = 4.9; p = 0.003; 95 % CI 1.6-14.7). The OR of presenting subgingival Aggregatibacter actinomycetemcomitans was 8.2 times higher in AAS users (OR = 8.2; p = 0.03; 95 % CI 0.9-70.8). AAS users were 5.6 times more likely to present subgingival Candida spp. than nonusers (OR = 5.6; p = 0.02; 95 % CI 1.1-27.1). AAS users were 14.8 times more likely to present subgingival Candida parapsilosis than nonusers (OR = 14.8; p < 0.0001; 95 % CI 3.1-69.2). The likelihood of AAS users presenting subgingival Candida tropicalis was 4.3 times higher than nonusers (OR = 4.3; p = 0.03; 95 % CI 1.1-16.9). A. actinomycetemcomitans was mostly isolated in individuals with severe periodontitis and was associated with subgingival Porphyromonas gingivalis, P. intermedia, and Candida spp. AAS use may increase the risk for severe periodontitis and may cause a subgingival selection of certain Candida species. Specific periodontopathogens, such as Candida dubliniensis and Candida albicans, seem to be negatively affected by AAS use. The higher risk for disease progression in AAS users may be explained by the significantly higher proportions of A. actinomycetemcomitans, P. gingivalis, P. intermedia, and Candida species as compared to controls. Data on the influence of AAS on subgingival periodontopathogens and disease progression are scarce. Higher proportions of specific periodontopathogens are plausible in AAS users. AAS users had a higher prevalence of severe periodontitis, gingival inflammation, and clinical attachment loss. Men taking AAS are at greater risk of periodontitis and specific periodontopathogen infection.

Papillon–Lefèvre syndrome mimicking psoriasis – A rare case report

Papillon–Lefèvre syndrome is a rare disease characterized by skin lesions caused by palmar-plantar hyperkeratosis and severe periodontal destruction involving both the primary and permanent dentitions. It is transmitted as an autosomal recessive condition and consanguinity of parents is evident in about one third of the cases. This paper reports a unique case of a patient with Papillon–Lefèvre syndrome (PLS) that was earlier mistaken for psoriasis. The examination revealed severe hyperkeratosis on the hands and feet with associated severe periodontal conditions. The patient was diagnosed with Papillon–Lefèvre syndrome and suitable treatment was initiated.

Pre-diabetes and diabetes: Medical risk factors and periodontal conditions

Objective. The aim of this study was to evaluate the difference between subjects with pre-diabetes, well or poorly controlled diabetes mellitus type 2 (T2D) and non-diabetes concerning such medical risk factors as hemoglobin A1c, body mass index (BMI) and waist circumference (WC) with periodontal conditions. Materials and methods. BMI, WC, PI, BOP, PD and marginal bone level (MBL) were recorded. Hemoglobin A1c (HbA1c) level and random blood glucose level (RBGL) were analyzed. Results. Forty-five subjects were pre-diabetics, 64 subjects had poorly controlled T2D, 28 subjects had well controlled T2D and 76 subjects were non-diabetics. Non-diabetics, pre-diabetics as well as subjects with T2D were overweight. Females in all groups had increased mean levels of WC. Number of PD ≥ 6 mm were increased in subjects with poorly controlled T2D compared to non-diabetics and pre-diabetics (p < 0.05). Conclusions. Pre-diabetic subjects showed the same periodontal conditions as non-diabetic subjects. Forty-five of the subjects reporting to have no diabetes were pre-diabetics. Non-diabetic, pre-diabetic and diabetic subjects were overweight. Subjects with poorly controlled T2D had severe periodontal conditions.

Peri‐implant conditions and their relationship with periodontal conditions in Chinese patients: a cross‐sectional study

To analyze the relationships between peri-implant conditions and periodontal conditions in Chinese patients with dental implants in place for at least 1year. Seventy-six patients (mean age, 41±10years; range, 21-69years) who received placement of 120 dental implants (Straumann(®) ), (mean 1.6 implants per subject; range, 1-5 implants per subject) after a mean period of 25months (range, 12-66months) responded to recall. Clinical examinations were performed around the implants and natural teeth. Periapical radiographs were taken by the long cone technique for implants, and radiographic bone level (BL) was measured. Comparisons of the peri-implant conditions were performed between the patients with different periodontal conditions by t-test and chi-square test. The relative risk of periodontal condition as a risk factor for peri-implant conditions was analyzed by logistic regression. Subjects who presented with ≥5% sites with probing depth (PD)≥4mm and ≥30% sites with bleeding on probing (BoP) in the dentition showed significantly poorer peri-implant conditions (58% vs. 18% subjects who had maximum modified gingival index (mGI) 2 or 3, P=0.003; 94% vs. 62% subjects who had maximum PD≥4mm, P=0.008; 100% vs. 79% subjects who had BoP, P=0.044; mean PD 3.36±0.66 vs. 2.75±0.66mm, P=0.002; and sites% with BoP 68±23% vs. 36±31%, P<0.001), as compared with those who had <5% sites with PD≥4mm and <30% sites with BoP on the remaining teeth. The relative risk for subjects with the more severe and extensive periodontal conditions compared to those with better periodontal conditions to have PD≥5mm with BoP at peri-implant sites was 23.3 (P=0.003, 95% CI, 2.8-192.3. The peri-implant conditions were significantly related to the periodontal conditions around the remaining natural teeth, which implies that control of periodontal disease is essential for successful implant treatment.

Periodontal diseases in children and adolescents: a clinician's perspective part 2

The general dental practitioner and paediatric dentist are in a unique position to identify and distinguish between a seemingly innocuous condition that may be a normal physiological aberration or an early sign of severe destructive periodontal disease. Although severe destructive periodontal conditions are uncommon in children, it is essential that children receive a periodontal screening as part of their regular dental examination. Early diagnosis ensures a high likelihood of a successful therapeutic outcome, primarily by reduction of aetiologic factors, remedial therapy and development of an effective maintenance protocol. This prevents the recurrence and progression of disease and reduces the incidence of tooth loss. In the first article, we discussed the classification, plaque-induced and non plaque-induced gingival diseases, localized and generalized forms of chronic as well as aggressive periodontitis. In this second article, we discuss periodontitis as a manifestation of systemic disease, necrotizing periodontal diseases, periodontal screening and basic periodontal examination, and treatment of periodontal diseases in children and adolescents. Incorporation of periodontal screening in regular dental examination by dentists can help in early diagnosis and treatment of periodontal diseases. This could prevent further progression of disease and reduce the frequency of tooth loss.

The Impact of Oral Contraceptives on Women's Periodontal Health and the Subgingival Occurrence of Aggressive Periodontopathogens and Candida Species

The purpose of this study is to evaluate the influence of oral contraceptive (OC) use on the subgingival occurrence of specific periodontopathogens and the host's periodontal status. Ninety-two females aged 19 to 40 years were included in the study. They were divided into two groups, OC users and non-users, and subgrouped according to the most severe periodontal condition and duration of OC usage. A pooled subgingival sample from each subject was cultured to investigate the presence of Candida species, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), and Prevotella intermedia. OC users, particularly smokers, show a statistically significant increase in the prevalence of severe periodontitis. OC users had deeper probing depths (>or=5 mm) than non-users. Moreover, OC users had higher gingival index scores and clinical attachment loss, >or=2 and >or=5 mm, respectively, than non-users (P <0.01). Patients taking OCs had significantly higher numbers of cultures positive for Candida. Seven Candida species were isolated. Subgingival Candida was associated with P. gingivalis and P. intermedia in 82.9% and 85.4%, respectively, in patients taking OCs. A. actinomycetemcomitans was isolated in patients with moderate and severe periodontitis and was associated with subgingival P. gingivalis, P. intermedia, and Candida. OC use may increase the risk of severe periodontitis and seems to cause a selection of certain Candida species in periodontal pockets. OC users showed a higher prevalence of P. gingivalis, P. intermedia, and A. actinomycetemcomitans compared to non-users. C. albicans, C. parapsilosis, C. krusei, C. tropicalis, and C. glabrata were the species with the ability to survive in the conditions created by the sex hormones after 3 years.

Periodontal conditions and treatment in urban and rural population of West Bengal, India

Objective To search adequate epidemiological data on periodontal conditions for the planning of oral health programs in Indian population, and to determine the prevalence of periodontal diseases, in regards to age and gender of urban and rural population in West Bengal, India. Methods 22 542 subjects aged 15 years onwards, representative of rural and urban areas of West Bengal were examined for their periodontal conditions using the community periodontal index (CPI). Results Supra and/or sub gingival calculus dominated as the most frequent score (score 2) among males (76.51%) and females (76.58%), which was least affected in young age group and higher in rural population. Severity of highest score were significant ( P < 0.001) according to their gender, age group and habitation and had independent effects ( P<0.001) on it. Mean number of sextants affected by scores 1, 2, 3, & 4 were more in the rural areas. Assessed treatment needed was predominantly type II (Scaling and improved oral hygiene). Conclusions The severe periodontal condition (Score 2, 3 and 4) is observed among rural males in older age group more than its urban counterparts of West Bengal, India.