scholarly journals The Antimicrobial Treatment of Periodontal Disease: Changing the Treatment Paradigm

1999 ◽  
Vol 10 (3) ◽  
pp. 245-275 ◽  
Author(s):  
W.J. Loesche
Keyword(s):  
Periodontal Disease ◽  
Antimicrobial Agents ◽  
Disease Risk ◽  
Antimicrobial Treatment ◽  
Periodontal Pocket ◽  
Gingival Tissue ◽  
Central Feature ◽  
New Paradigm ◽  
Pocket Depth ◽  
Periodontal Infection

Over the last 100 years, methods of surgical periodontal treatment have enjoyed a history of success in improving oral health. The paradigm of care is based on the "non-specific plaque hypothesis"-that is, the overgrowth of bacterial plaques cause periodontal disease, and the suppression of this overgrowth reduces disease risk. The central feature of this approach to care is the removal of inflamed gingival tissue around the teeth to reduce periodontal pocket depth, thereby facilitating plaque removal by the dentist and by the patient at home. Over the last 30 years, with the recognition that periodontal disease(s) is caused by specific bacteria and that specific antimicrobial agents can reduce or eliminate the infection, a second paradigm has developed. This new paradigm, the "specific plaque hypothesis", focuses on reducing the specific bacteria that cause periodontal attachment loss. The contrast between the two paradigms can be succinctly stated as follows: The antimicrobial therapy reduces the cause, while the surgical therapy reduces the result of the periodontal infection. The specific plaque hypothesis has two important implications. First, with the increasing attention to evidence-based models for prevention, treatment, outcome assessment, and reimbursement of care, increasing attention and financial effort will be channeled into effective preventive and treatment methods. Second, the recent observations that periodontal infections increase the risk of specific systemic health problems, such as cardiovascular disease, argue for the prevention and elimination of these periodontal infections. This review highlights some of the evidence for the specific plaque hypothesis, and the questions that should be addressed if antimicrobial agents are to be used responsively and effectively.

scholarly journals A COMPARATIVE STUDY TO ASSES THE EFFICACY OF NANOBIO FUSION GEL AS AN ADJUNCT TO SCALING AND POLISHING IN CHRONIC PERIODONTITIS. - A CLINICAL STUDY

2020 ◽  
pp. 1-3
Author(s):  
Patil A. Veena ◽  
Ansari T. Sobia ◽  
Agarwal Priyanka ◽  
Ayesha Ayesha ◽  
Sultana Shahnaaz
Keyword(s):  
Periodontal Disease ◽  
Chronic Periodontitis ◽  
Antimicrobial Agents ◽  
Test Group ◽  
Controlled Clinical Trial ◽  
Pocket Depth ◽  
Antioxidant Power ◽  
Probing Pocket Depth ◽  
Significant Difference ◽  
And Control

Introduction: Various chemical agents such as nonsteroidal, anti-inflammatory drugs and antimicrobial agents has gained popularity in treatment of periodontal disease but simultaneously lead to condition such as drug resistance and drug allergy. Hence , the topical application of herbal agents such as propolis, aloevera, green tea extracts, Neem reduces the potency and effectiveness to prevent progression of periodontal disease. NanoBioFusion(NBF)gel contains the natural antioxidant power of propolis,vit C,vit E which allows the ultrafine antioxidant to surpase the moist intraoral environment to enter the cells and rejuvenate,revitalize,support,protect and optimize gum and soft oral tissue.Hence the present study is aimed to evaluate the clinical effect of locally delivered NBF gel as an adjunctive therapy to scaling and polishing in the treatment of Periodontitis. Materials and Methods: Chronic Periodontitis patients with 40 sites and probing pocket depth (PD) between 5 and 7 mm were selected in a randomized controlled clinical trial. SRP was performed in both control and test group followed by NBF gel application in 40 sites. The plaque index, gingival index and probing Pocket depth,were recorded at baseline, 6 weeks, and 3 months.The statistical analysis with paired t‑test was used to compare the test and control sites. Results: From baseline to a period of 3 months, a statistically significant difference was seen between both groups for Pocket probing depth and from baseline to 6 weeks the mean GI and PI score have a statistically significant result was obtained(P=0.01& 0.00). Conclusions: Locally delivered NBF gel exhibited a significant improvement compared with SRP alone in chronic periodontitis.

scholarly journals Detection of highly and minimally leukotoxic Actinobacillus actinomycetemcomitans strains in patients with periodontal disease

2003 ◽  
Vol 17 (2) ◽  
pp. 183-188 ◽  
Author(s):  
Sheila Cavalca Cortelli ◽  
Antonio Olavo Cardoso Jorge ◽  
José Roberto Cortelli ◽  
Shawn Francis Jordan ◽  
Violet Ibyola Haraszthy
Keyword(s):  
Periodontal Disease ◽  
Strong Association ◽  
Aggressive Periodontitis ◽  
Actinobacillus Actinomycetemcomitans ◽  
Periodontal Pocket ◽  
Chain Reaction ◽  
Chi Square ◽  
Pocket Depth ◽  
Polymerase Chain ◽  
Brazilian Cohort

This study examined the prevalence of highly and minimally leukotoxic Actinobacillus actinomycetemcomitans in patients with periodontal disease. Pooled subgingival plaque samples from 136 patients with some form of periodontal disease were examined. Subjects were between 14 and 76 years of age. Clinical examinations included periodontal pocket depth (PD), plaque index (PI) and bleeding index (BI). The obtained plaque samples were examined for the presence of highly or minimally leukotoxic A. actinomycetemcomitans strains by the polymerase chain reaction (PCR). Chi-square and logistic regression were performed to evaluate the results. Forty-seven subjects were diagnosed with gingivitis, 70 with chronic periodontitis and 19 with aggressive periodontitis. According to chi-square there was no significant correlation detected between PD (chi2 = 0.73), PI (chi2 = 0.35), BI (chi2 = 0.09) and the presence of the highly leukotoxic A. actinomycetemcomitans. The highly leukotoxic A. actinomycetemcomitans strains were correlated with subjects that were 28 years of age and younger (chi2 = 7.41). There was a significant correlation between highly leukotoxic A. actinomycetemcomitans and aggressive periodontitis (chi2 = 22.06). This study of a Brazilian cohort confirms the strong association between highly leukotoxic A. actinomycetemcomitans strains and the presence of aggressive periodontitis.

scholarly journals Retrieval of a periodontally compromised tooth by allogeneic grafting of mesenchymal stem cells from dental pulp: A case report

2018 ◽  
Vol 46 (7) ◽  
pp. 2983-2993 ◽  
Author(s):  
Beatriz Hernández-Monjaraz ◽  
Edelmiro Santiago-Osorio ◽  
Edgar Ledesma-Martínez ◽  
Andrés Alcauter-Zavala ◽  
Víctor Manuel Mendoza-Núñez
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Periodontal Disease ◽  
Dental Pulp ◽  
Enzymatic Digestion ◽  
Periodontal Pocket ◽  
Mineral Density ◽  
Culture Dish ◽  
Pocket Depth ◽  
Lower Premolar

Objective To report a case of successful allogeneic grafting of mesenchymal dental pulp stem cells (DPSCs) as preliminary findings in a patient with periodontal disease enrolled into clinical trial ISRCTN12831118. Methods Mesenchymal stem cells from the dental pulp of a deciduous tooth from a 7-year-old donor were separated from the pulp chamber and processed via enzymatic digestion and centrifugation. DPSCs were passaged and cultured on a 35 × 13 mm culture dish in minimum essential medium-alpha, without supplementation. After reaching 80% confluency, 5 x 106 allogeneic DPSCs in 250 µl phosphate buffered saline were seeded onto a dry scaffold of lyophilized collagen-polyvinylpyrrolidone sponge placed in the left lower premolar area of a 61-year-old patient with periodontal disease. Surgical access to the lower premolar area was achieved using the flap technique. Results At 3 and 6 months following allogeneic graft, the patient showed no sign of rejection and exhibited decreases in tooth mobility, periodontal pocket depth and bone defect area. Bone mineral density had increased at the graft site. Conclusions Regenerative periodontal therapy using DPSCs of allogeneic origin may be a promising treatment for periodontal disease-induced bone defects.

Canine Periodontal Disease Control Using a Clindamycin Hydrochloride Gel

2011 ◽  
Vol 28 (4) ◽  
pp. 224-229 ◽  
Author(s):  
Thomas P. Johnston ◽  
Pravakar Mondal ◽  
Dhananjay Pal ◽  
Scott MacGee ◽  
Arnold J. Stromberg ◽  
...  
Keyword(s):  
Periodontal Disease ◽  
Fusobacterium Nucleatum ◽  
Positive Influence ◽  
Periodontal Pocket ◽  
Gingival Index ◽  
Pocket Depth ◽  
Cleaning Procedure ◽  
Before And After ◽  
The Matrix ◽  
Gingival Cells

Stabilizing or reducing periodontal pocket depth can have a positive influence on the retention of teeth in dogs. A topical 2 % clindamycin hydrochloride gel (CHgel) was evaluated for the treatment of periodontal disease in dogs. The CHgel formulation provides for the sustained erosion of the matrix, but also flows into the periodontal pocket as a viscous liquid, and then rapidly forms a gel that has mucoadhesive properties and also may function as a physical barrier to the introduction of bacteria. A professional teeth cleaning procedure including scaling and root planing was done in dogs with one group receiving CHgel following treatment. Periodontal health was determined before and after the procedure including measurement of periodontal pocket depth, gingival index, gingival bleeding sites, and number of suppurating sites. There was a statistically significant decrease in periodontal pocket depth (19 %), gingival index (16 %), and the number of bleeding sites (64 %) at 90-days in dogs receiving CHgel. Additionally, the number of suppurating sites was lower (93 %) at 90-days for the group receiving CHgel. The addition of CHgel effectively controlled the bacterial burden (e.g., Fusobacterium nucleatum) at both day 14 and 90. Gingival cells in culture were shown to rapidly incorporate clindamycin and attain saturation in approximately 20-minutes. In summary, a professional teeth cleaning procedure including root planning and the addition of CHgel improves the gingival index and reduces periodontal pocket depth.

scholarly journals Periodontal disease in ideal weight, overweight and obese patients in different gender of a Tertiary Care Hospital in Pakistan.

2019 ◽  
Vol 26 (09) ◽  
pp. 1461-1465
Author(s):  
Zaheer Hussain Chachar ◽  
Gotam Das ◽  
Shabir Ahmed ◽  
Maimuna Khokhar ◽  
Muhammad Ilyas Shaikh ◽  
...  
Keyword(s):  
Periodontal Disease ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Normal Weight ◽  
Periodontal Pocket ◽  
Care Hospital ◽  
Obese Patients ◽  
Ideal Weight ◽  
Pocket Depth ◽  
Female Ratio

Introduction: Chronic periodontitis is the inflammation of the gingiva extending into the supporting structure of teeth. Periodontal disease is characterized by loss of clinical attachment due to destruction of the periodontal ligament and loss of the adjacent supporting bone eventually leading to tooth loss. Obesity is unusual or unnecessary fat deposition that may harm health. A number of hypotheses for biological reactions among obesity and periodontal disease have been anticipated. Objectives: To determine the frequency of ideal weight, overweight and obese patients in dental outdoor of FMH Pakistan. Study Design: Cross-Sectional Study. Setting:  Medical Outdoor at Tertiary Care Hospital in Pakistan. Period: 15th January to 14th July 2017. Material & Methods: A total 100 patients came to the medical outpatients department between 25 to 45 years of age were included. Patients satisfying the inclusion criteria, subjects BMI score were checked by classifying him/her obese, overweight or normal weight. Periodontal pocket depth was observed by WHO probe of one tooth from each male and female patient. Frequency of periodontal disease was seen in subjects. Results: Age range in his study was from 25 to 45 years with mean age of 36.9 ±7.51 years. In 100 patients 66 (66%) were females & 34 (34%) were males and with male to female ratio 1.9:1. Periodontal disease was seen in 47 female patients (71%) and in 24 male patients (70%). Pocket depth was present in over weight and obese patients more than normal weight. Conclusion: current study accomplished that there is positive association of periodontal disease in overweight and obese patients. The incidence of periodontal disease was highest in female obese patients.

scholarly journals Endothelial dysfunction and periodontal hemodynamic disturbances in young patients with nicotine dependence

2012 ◽  
Vol 11 (2) ◽  
pp. 70-75
Author(s):  
A. V. Naumov ◽  
V. A. Vyshivanyuk ◽  
A. L. Vertkin
Keyword(s):  
Endothelial Dysfunction ◽  
Periodontal Disease ◽  
Nicotine Dependence ◽  
Augmentation Index ◽  
Reactive Hyperemia ◽  
Young Patients ◽  
Periodontal Pocket ◽  
Group Differences ◽  
Pocket Depth ◽  
Periodontal Index

Aim.To investigate the association between periodontal hemodynamic disturbances and systemic endothelial dysfunction (ED); to assess the effectiveness of various toothpastes for periodontal disease prevention in patients with nicotine dependence.Material and methods.In total, 120 young individuals aged 22—28 years were divided into 2 groups, according to the presence or absence of nicotine dependence. All participants underwent ED assessment with the EndoPAT device. Microcirculation (MC) was assessed with the high-frequency Doppler ultrasound system MinimaxDoppler-K. Patients with nicotine dependence were divided into 2 subgroups. Subgroup A was recommended to use the R.O.C.S. toothpaste Anti-Tobacco (WDS Laboratories) twice a day, while Subgroup B participants were recommended to use the toothpaste Colgate Advanced Whitening with polishing micro-crystals (ColgatePalmolive Poland) twice a day.Results.Significant between-group differences were observed for reactive hyperemia index and augmentation index. ED severity was higher in smoking participants. Velocity and volume parameters of periodontal MC were lower in smokers. The use of each specialized toothpaste was associated with improved periodontal MC, decreased prevalence of periodontal pathology-related complaints, reduced periodontal pocket depth, and decreased periodontal index values; however, the Anti-Tobacco toothpaste was more effective.Conclusion.Young smokers demonstrated а more severe ED and disturbed periodontal MC, which manifested in a more advanced periodontal disease.

Evaluation of Periodontal Status in the Patients with Various Blood Groups Referred to Dental School, Golestan University of Medical Sciences in 2018

2021 ◽  
Author(s):  
Omid Sheikhi ◽  
Elham Fakhari ◽  
Azizeh Karimian
Keyword(s):  
Periodontal Disease ◽  
Blood Group ◽  
Significant Relationship ◽  
Blood Groups ◽  
Dental School ◽  
Periodontal Pocket ◽  
P Value ◽  
Medical Sciences ◽  
Pocket Depth ◽  
Cross Sectional

Introduction: The present study aimed to assess the periodontal condition in the patients with various blood groups referred to the dental school, Golestan University of Medical Sciences, in 2018. Materials & Methods: This cross-sectional study was done in 970 patients referred to the dental school, Golestan University of Medical Sciences. Medical history was obtained and blood groups were determined. The assessed periodontal indices, included gingival index (GI), clinical attachment level (CAL), and periodontal pocket depth (PPD), and there were three divided groups of patients based on it: healthy ones, patients with gingivitis, and periodontitis. Then, the probable association between the type of periodontal disease, ABO blood groups and Rh factor was analyzed by Chi-squared test. P-value of 0.05 considerations was statistically significant. Results: Among 970 patients, the most frequent blood groups in healthy individuals, patients with gingivitis and periodontitis were Group A, B, and O, respectively. The AB blood group had the least frequency in all three groups. Rh+ factor was significantly more prevalent in all three groups. Statistically, there was a significant relationship between blood group and Rh factor with periodontal disease (p value < 0.0001, p value = 0.022). Conclusion: According to the results, the blood groups B and O showed a higher percentage in gingivitis and periodontitis groups respectively, while the blood group AB showed the least percentage of periodontal disease. Statistically, there was a significant relationship between periodontal disease with the blood group and Rh factor.

A Novel Systemic Indicator of Periodontal Tissue Damage: Ischemia Modified Albumin

2018 ◽  
Vol 21 (8) ◽  
pp. 544-549 ◽  
Author(s):  
Mahmure A. Tayman ◽  
Canan Önder ◽  
Şivge Kurgan ◽  
Muhittin A. Serdar ◽  
Meral Günhan
Keyword(s):  
Periodontal Disease ◽  
Inflammatory Diseases ◽  
Periodontal Therapy ◽  
Periodontal Pocket ◽  
Oxidative Stress Marker ◽  
Pocket Depth ◽  
Ischemia Modified Albumin ◽  
Nonsurgical Periodontal Therapy ◽  
Before And After ◽  
The Impact

Background: Ischemia-modified albumin (IMA) is a systemic indicator of inflammatory diseases and is suggested as an oxidative stress marker. Objective: To determine the IMA and high-sensitivity C-reactive protein (hsCRP) serum levels for patients with chronic periodontitis (CP) and to evaluate the impact of non-surgical periodontal therapy on serum IMA and hsCRP levels. Methods: Twenty one systemically healthy patients with CP and 15 systemically and periodontally healthy controls (C) were enrolled in the study. Periodontal pocket depth (PPD), bleeding on probing (BOP) and attachment loss (AL) were recorded at the time of diagnosis and 6 weeks after the nonsurgical periodontal therapy. Blood samples were obtained before and after treatment from all groups, and serum IMA and hsCRP levels were evaluated by ELISA method. Results: All of the clinical findings were found to be elevated in the CP group in comparison to C group (p<0.05). Levels of IMA and hsCRP were higher in the CP group (p<0.05) and decreased after non-surgical periodontal therapy (p<0.05). Positive correlations were determined between PPD, BOP and hsCRP (p<0.05) as well as between PPD, AL, BOP and IMA levels (p<0.01) before treatment. A significant positive correlation was also observed between hsCRP and IMA (p<0.01) before and after treatment. Conclusion: IMA is a marker indicating systemic inflammation during periodontal disease, and is significantly reduced as a result of non-surgical periodontal therapy. Therefore, IMA might be suggested as a useful indicator of periodontal disease.

Local Drug Delivery Based Treatment Approaches for Effective Management of Periodontitis

2019 ◽  
Vol 14 (2) ◽  
pp. 135-152 ◽  
Author(s):  
Geeta Aggarwal ◽  
Sonia Verma ◽  
Madhu Gupta ◽  
Manju Nagpal
Keyword(s):  
Drug Delivery ◽  
Periodontal Disease ◽  
Antimicrobial Agents ◽  
Delivery Systems ◽  
Local Delivery ◽  
Local Drug Delivery ◽  
Prolonged Treatment ◽  
Effective Management ◽  
Pocket Depth ◽  
Mechanical Removal

Background: Periodontal disease is an immuno-inflammatory condition of tissues that surround and hold the teeth. It is the disease which succeeds in all races, groups and both genders. Almost 10 to15% of the global population gets suffered from severe periodontitis as per WHO reports. Periodontal disease may likely cause other systemic diseases such as cardiovascular disease and pre-term low birth weight infants. Mechanical removal of plaques and calculus deposits from supra and subgingival environment is the backbone of periodontal treatment till date whereas complete elimination of these deleterious agents is quite unrealistic as the pocket depth increases. Recent Approaches: Recently controlled local drug delivery application is more encouraging in comparison to systemic approach as it mainly targets to enhance the therapeutic efficacy by maintaining site-specificity, avoiding first pass metabolism, reduction in gastrointestinal (GI) side effects and decreasing the dose. Several drugs such as antiseptics and antibiotics alongwith various carriers are being formulated as local drug delivery systems for effective management of the disease. Various local delivery systems reported are fibers, films, strips, compacts, injectables, microparticles, vesicular carriers, gels and nanoparticles. These local carriers provide effective prolonged treatment at the site of infection at reduced doses. This review enlightens detailed pathophysiology and various phases of periodontitis, challenges in treatment of disease and various antimicrobial agents (along with their marketed formulations) used. The main emphasis of the review is to cover all carrier systems developed so far for local delivery application in the effective management of periodontitis, as a patient compliant drug therapy.

Periodontal Disease in Patients with Ankylosing Spondylitis: myth or reality?

2017 ◽  
Vol 68 (7) ◽  
pp. 1660-1664
Author(s):  
Cristina Iordache ◽  
Rodica Chirieac ◽  
Eugen Ancuta ◽  
Cristina Pomirleanu ◽  
Codrina Ancuta
Keyword(s):  
Ankylosing Spondylitis ◽  
Periodontal Disease ◽  
Systemic Inflammation ◽  
Periodontal Pocket ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Attachment Loss ◽  
Inflammatory Parameters ◽  
Periodontal Inflammation ◽  
The Impact

Although the relation between periodontitis (PD) and systemic disorders (e.g. cardiovascular diseases, diabetes and rheumatoid arthritis) is widely accepted, the association with ankylosing spondylitis (AS) is inconsistently mentioned. We prospectively examined the relationship between periodontal disease and AS, focusing on the rate and course of PD, factors associated with severity and the impact of anti-TNF-a treatment on inflammatory status. Standard assessments performed twice (week 0, week 24) included an extensive dental evaluation (plaque index, gingival index, bleeding on probing, periodontal pocket depth, clinical attachment loss), inflammatory parameters and AS activity scores (BASDAI, ASDAS-CRP). More than half of AS presented with impaired periodontal health at baseline (mild to moderate PD) meaning increased sites with dental plaque, abnormal bleeding, increased periodontal pocket depth and clinical attachment loss. Significant positive correlation between presence and severity of PD, AS activity and systemic inflammation (CRP) was reported at baseline (p[0.05). A final analysis performed at 24 weeks revealed significant improvement in periodontal status, inflammatory parameters and AS activity, suggesting efficacy of TNF inhibitors directed not only against systemic, but also on local (articular, periodontal) inflammation (p[0.05). Patients with AS are at risk to develop periodontal disease, particularly those with high levels of systemic inflammation. Benefits of anti-TNFa therapy in the particular settings of AS patient and concomitant periodontal disease should be validated through further studies in larger cohorts.

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