Proposed protocol for treatment of severe periodontitis without platelet transfusion in patients with aplastic anemia: a case report

Abstract Background Aplastic anemia is an intractable disease characterized by pancytopenia, susceptibility to infection, and difficulty in achieving hemostasis. In patients with severe periodontal disease and aplastic anemia, spontaneous bleeding from the gingival tissue due to thrombocytopenia and during brushing is common, which may further exacerbate dental issues. Comprehensive periodontal treatment for patients with aplastic anemia is highly challenging and requires collaboration with a hematologist. Here, we discuss the case of a patient with aplastic anemia and severe periodontitis who was successfully treated in collaboration with our hematology department. Case presentation A 36-year-old Japanese woman with chief complaints of spontaneous gingival bleeding, pain, and increasing tooth mobility consulted our department. She had developed pancytopenia at age 11 years and was later diagnosed with aplastic anemia, making her susceptible to infection due to leukopenia. The results of the initial periodontal examination led to a diagnosis of severe generalized periodontitis (generalized stage IV grade C periodontitis) caused by leukopenia and poor oral hygiene. We adopted a comprehensive treatment plan, including invasive dental procedures. The patient exhibited no postoperative bleeding due to aplastic anemia-induced thrombocytopenia and experienced a good outcome. Conclusions Both physicians and dentists should be aware that immunocompromised patients with aplastic anemia are at risk of developing severe periodontitis with severe alveolar bone resorption if the condition is combined with poor oral hygiene. Even in the presence of aplastic anemia, patients with severe periodontitis can undergo comprehensive dental treatment, including dental extraction and periodontal surgery, if bleeding and susceptibility to infection are controlled. This requires the cooperation of the patient and hematologists and can ultimately contribute to improving the patient’s quality of life.

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COMPREHENSIVE TREATMENT FOR CHILDREN 6 YEARS OLD WITH EARLY CHILDHOOD CARIES

Jurnal Ilmiah dan Teknologi Kedokteran Gigi ◽

10.32509/jitekgi.v16i2.1043 ◽

2021 ◽

Vol 16 (2) ◽

pp. 57-66

Author(s):

Fidya Kemala Putri

Keyword(s):

Early Childhood ◽

Dental Caries ◽

Oral Hygiene ◽

Primary Schools ◽

Early Childhood Caries ◽

Rapid Development ◽

Comprehensive Treatment ◽

Poor Oral Hygiene ◽

Space Management ◽

Childhood Caries

Background : Dental caries is still one of the most common problems in Indonesia, not only in adults but also in children. The prevalence of dental caries in Indonesian primary schools is almost 60-80%. Caries is a multifactorial disease caused by host (teeth), microorganism, carbohydrates, and time. Early childhood caries (ECC) is one of the most prevalent diseases in children worldwide. ECC driven by oral microorganism which is mainly caused by sugar rich-foods. In addition, poor oral hygiene and removal of dental plaque leads to the rapid development of ECC.The goal of this treatment is to prevent malocclusion of the teeth and maintain the growth and development of the child. Case report : A6-year-old girl with ECC and poor oral hygiene is given comperhensive treatment, such as restoration, endodontic treatment, extraction and space management. Conclusion: Comperhensive treatment was successful and both patient and parent were satisfied with the treatment.This can be seen from the plaque control of the child before and after the toothbrush during the visit and the space available for replacement teeth is sufficient. The pre-toothbrush control at the February 2020 visit was 25% and then the toothbrush 19%, which were 75% and 35.5% previously.

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Novel and Accurate Predictive Model of Peri-implantitis for Implant Prosthesis in Managing Patients With Chronic Periodontitis

10.21203/rs.3.rs-256187/v1 ◽

2021 ◽

Author(s):

Jiaping Lu ◽

Naizheng Zhang ◽

Wenhao Qian

Keyword(s):

Logistic Regression ◽

Predictive Model ◽

Influencing Factors ◽

Oral Hygiene ◽

Chronic Periodontitis ◽

Poor Oral Hygiene ◽

Related Factors ◽

Severe Periodontitis ◽

Implant Prosthesis

Abstract The aim of this study was to identify the influencing factors of peri-implantitis for implant prosthesis and to establish a predictive model of occurrence in managing patients with chronic periodontitis. 430 patients (a total of 686 implants) with 5 years follow-up were included in the study. The demographic and clinical characteristics independent variables were including patient related factors (age, gender, duration of symptoms, smoking, diabetes, severity of periodontitis, bone mineral density, oral hygiene) and implants related factors (position, implant diameter, implant length, additional operations, probing depth, gingival index, plaque index, load-bearing time). Univariate analysis identified the influencing factors, the statistically significant factors were further analyzed by multivariate logistic regression, and the predictive model was established. After 5 years of follow-up, peri-implantitis occurred in 95 of 686 implants (13.8%). Multiple linear regression indicated that smoking (p = 0.011), diabetes (p < 0.001), severe periodontitis (p = 0.023), lager implant diameter (p < 0.001) and poor oral hygiene (p < 0.001) increased the odds of occurrence of peri-implantitis. There were no significant differences in other factors. (p > 0.05) Logistic regression drew the equation: occurrence of peri-implantitis = [1 + e (16.172+5.395*smoking+4.807*diabetes +8.109*severe periodontitis+5.569*lager implant diameter+11.138*poor oral hygiene)]−1. The sensitivity of predictive factors was 91.77%, 88.43%, 82.64%, 85.21% and 92.02%, respectively. The specificity 45.65%, 49.17%, 66.23%, 42.39% and 65.41%, respectively. The AUC was 0.721, 0.620, 0.453, 0.651 and 0.826, respectively. Hosmer-Lemeshow test showed a good fitting of the predictive model with an overall accuracy of 87.2%. Smoking, diabetes, severe periodontitis, lager implant diameter and poor oral hygiene are important risk factors of peri-implantitis. We also established a novel and accurate predictive model for the occurrence of peri-implantitis in managing patients with chronic periodontitis. The use of these parameters, in the form of a predictive model, has the potential to improve decision-making in the application of the treatment plan.

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Effects of drug abuse and mental disorders on oral health: a case report

Journal of the Pakistan Medical Association ◽

10.47391/jpma.2050 ◽

2022 ◽

Vol 71 (12) ◽

Author(s):

Marine Ortiz Magdaleno ◽

Gabriel Romo Ramirez

Keyword(s):

Mental Health ◽

Case Report ◽

Oral Hygiene ◽

Treatment Plan ◽

Psychological State ◽

Health Issues ◽

Poor Oral Hygiene ◽

Invasive Treatment ◽

Negative Effect ◽

Oral Conditions

Substance use disorders, related to mental health issues can lead to oral pathologies. The purpose of this case report was to identify the oral conditions and manifestations in a 28-year-old male narco-dependent schizophrenic who smoked tobacco and marijuana. In intra-oral clinical exploration, poor oral hygiene, excessive tartar formation and dental plaque were observed, and the diagnosis of severe chronic periodontitis was established. The choice of a treatment plan in such patients is complex because the consequences of an invasive treatment can aggravate the psychological state and emotional stability leading to a negative effect on behaviour and mental health due to edentulism. The effects of excessive drug consumption related to schizophrenia can cause poor oral hygiene habits leading to oral pathologies and the loss of teeth. Keywords: drugs, schizophrenia, oral manifestations, mental health, oral pathologies.

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Association between Oral Hygiene and Metabolic Syndrome: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10132873 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2873

Author(s):

Cornelia Melinda Adi Santoso ◽

Fera Ketti ◽

Taufan Bramantoro ◽

Judit Zsuga ◽

Attila Nagy

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

Oral Hygiene ◽

Reference Lists ◽

Meta Analysis ◽

Tooth Brushing ◽

Inclusion Criteria ◽

Poor Oral Hygiene ◽

Dental Visits ◽

Substantial Heterogeneity

Emerging evidence has linked poor oral hygiene to metabolic syndrome (MetS), but previously, no summary of evidence has been conducted on the topic. This systematic review and meta-analysis aims to evaluate the associations of oral hygiene status and care with MetS. A systematic search of the PubMed and Web of Science databases from inception to March 17, 2021, and examination of reference lists was conducted to identify eligible observational studies. A random-effects model was applied to pool the effects of oral hygiene status and care on MetS. Thirteen studies met the inclusion criteria and had sufficient methodological quality. Good oral hygiene status (OR = 0.30 (0.13–0.66); I2 = 91%), frequent tooth brushing (OR = 0.68 (0.58–0.80); I2 = 89%), and frequent interdental cleaning (OR = 0.89 (0.81–0.99); I2 = 27%) were associated with a lower risk of MetS. Only one study examined the association between dental visits and MetS (OR = 1.10 (0.77–1.55)). Our findings suggested that there might be inverse associations of oral hygiene status, tooth-brushing frequency, and interdental cleaning with MetS. However, substantial heterogeneity for tooth-brushing frequency and inconsistent results for oral hygiene status in subgroup analyses were observed. There was insufficient evidence for the association between dental visits and MetS. Further longitudinal studies are needed to investigate these associations.

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Prevalence and Correlates of Poor Oral Hygiene among School-Going Students in Mongolia

Dentistry Journal ◽

10.3390/dj9020012 ◽

2021 ◽

Vol 9 (2) ◽

pp. 12

Author(s):

Javzan Badarch ◽

Suvd Batbaatar ◽

Edit Paulik

Keyword(s):

Health Promotion ◽

Oral Hygiene ◽

Fast Food ◽

Vegetable Intake ◽

Soft Drink ◽

Health Promotion Program ◽

Second Hand Smoke ◽

Oral Diseases ◽

Poor Oral Hygiene ◽

Oral Health Promotion

Brushing at least twice a day is one of the most effective methods for the prevention of dental caries and oral diseases. The aim of the present study was to determine the prevalence and correlates of poor oral hygiene in Mongolian school-going students. A secondary analysis of nationally representative data from the 2013 Mongolian Global School-based Health Survey (GSHS) was performed. In the survey, a questionnaire was completed by 5393 students aged 12–16 years old. The prevalence of poor oral hygiene and its association with some independent variables were analyzed by frequency distribution, chi-squared test, and logistic regression. The overall prevalence of poor oral hygiene was 33%. In the multivariate analysis, male students, inadequate fruit and vegetable intake, parents’ smoking, being exposed to second-hand smoke, poor parental supervision and connectedness, physical inactivity, and sedentary behavior were significantly associated with poor oral hygiene. Meanwhile, students who ate fast food and drank carbonated soft drink were found to be less likely to be poor tooth-brushers in 2013. Various determinants were identified in connection with poor oral hygiene. Based on these findings, it is recommended that an oral health promotion program should be combined with general health promotion and lifestyle intervention programs for this target population.

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Evaluation of clinical performance and survival rate of Straumann dental implants in Saudi Population based on cross-sectional study

Scientific Reports ◽

10.1038/s41598-021-89112-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Reham AL Jasser ◽

Mohammed AlSarhan ◽

Dalal Alotaibi ◽

Saleh Aloraini ◽

Pradeep Koppolu ◽

...

Keyword(s):

Oral Hygiene ◽

Strong Association ◽

Tissue Level ◽

Cross Sectional Study ◽

Titanium Implants ◽

Risk Indicators ◽

Sectional Study ◽

Poor Oral Hygiene ◽

Cross Sectional ◽

Keratinized Tissue

AbstractRisk indicators of peri-implantitis is still contradictory and somehow unclear in present literature therefore efforts should be done for better understanding of the exact etiology of peri-implant disease progression. The present study aimed to assess risk indicators associated with peri-implantitis by observing the changes in several periodontal parameters after implant placement. This cross-sectional study included 213 female and 271 male patients aged 26–87 years, who received 484 titanium implants (Straumann, Switzerland) at King Saud University’s Dental College, Saudi Arabia. Patients were called for dental visits. During these visits; full clinical and radiographic assessment of implants were done. The periodontal pocket depth (PPD) was greater around implants placed at grafted sites than non-grafted sites and around bone-level implants than tissue-level implants. The plaque index (PI) was associated with poor oral hygiene. There was a strong association between graft (yes/no) and bleeding on probing (BOP). Patients with good oral hygiene showed high radiographic bone stability. Keratinized tissue width < 2 mm was associated with a higher PPD, higher PI, higher BOP, more edematous gingiva, and more exposed implant threads on radiography. In patients receiving implants, poor oral hygiene status and inadequate keratinized tissue level can be proposed as risk indicators for developing periimplantitis due to strong association found between them and developments of peri-implantitis.

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Febuxostat Attenuates the Progression of Periodontitis in Rats

Pharmacology ◽

10.1159/000513034 ◽

2021 ◽

pp. 1-11

Author(s):

Naseratun Nessa ◽

Miyuki Kobara ◽

Hiroe Toba ◽

Tetsuya Adachi ◽

Toshiro Yamamoto ◽

...

Keyword(s):

Oxidative Stress ◽

Blood Pressure ◽

Bone Resorption ◽

Alveolar Bone ◽

Alveolar Bone Loss ◽

Gingival Tissue ◽

Systemic Effects ◽

Rt Pcr ◽

Tnf Α ◽

And Oxidative Stress

Introduction: Periodontitis is a lifestyle-related disease that is characterized by chronic inflammation in gingival tissue. Febuxostat, a xanthine oxidase inhibitor, exerts anti-inflammatory and antioxidant effects. Objective: The present study investigated the effects of febuxostat on periodontitis in a rat model. Methods: Male Wistar rats were divided into 3 groups: control, periodontitis, and febuxostat-treated periodontitis groups. Periodontitis was induced by placing a ligature wire around the 2nd maxillary molar and the administration of febuxostat (5 mg/kg/day) was then initiated. After 4 weeks, alveolar bone loss was assessed by micro-computed tomography and methylene blue staining. The expression of osteoprotegerin (OPG), a bone resorption inhibitor, was detected by quantitative RT-PCR and immunological staining, and the number of osteoclasts in gingival tissue was assessed by tartrate-resistant acid phosphatase staining. The mRNA and protein expression levels of the proinflammatory cytokines, tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β), in gingival tissue were measured using quantitative RT-PCR and immunological staining. Oxidative stress in gingival tissue was evaluated by the expression of 4-hydroxy-2-nonenal (4-HNE), and 8-hydroxy-2-deoxyguanosine (8-OHdG). To clarify the systemic effects of periodontitis, blood pressure and glucose tolerance were examined. Results: In rats with periodontitis, alveolar bone resorption was associated with reductions in OPG and increases in osteoclast numbers. The gingival expression of TNF-α, IL-1β, 4-HNE, and 8-OHdG was up-regulated in rats with periodontitis. Febuxostat significantly reduced alveolar bone loss, proinflammatory cytokine levels, and oxidative stress. It also attenuated periodontitis-induced glucose intolerance and blood pressure elevations. Conclusion: Febuxostat prevented the progression of periodontitis and associated systemic effects by inhibiting proinflammatory mediators and oxidative stress.

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Association between infection with Campylobacter species, poor oral health and environmental risk factors on esophageal cancer: a hospital-based case–control study in Thailand

European Journal of Medical Research ◽

10.1186/s40001-021-00561-3 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Arisara Poosari ◽

Thitima Nutravong ◽

Prakasit Sa-ngiamwibool ◽

Wises Namwat ◽

Supaporn Chatrchaiwiwatana ◽

...

Keyword(s):

Risk Factors ◽

Esophageal Cancer ◽

Oral Hygiene ◽

Case Control Study ◽

Significant Risk ◽

Case Control ◽

Poor Oral Hygiene ◽

History Of ◽

Control Study ◽

History Of Cancer

Abstract Background Previous studies have shown the association between Campylobacter species infection and that environmental factors, poor oral hygiene in particular, are linked to an increased risk of esophageal cancer (EC). However, no study has reported on these factors in Thailand. Thus, this study’s objective was to evaluate the impact of the relationship between Campylobacter infection and environmental factors on EC incidence in the population of Thailand. Methods Data from a case–control study were collected from 105 newly diagnosed EC cases and 105 controls recruited from 2007 to 2017. Infection with Campylobacter spp. was detected in the formalin-fixed paraffin-embedded (FFPE) tissue of EC taken from gastroesophageal biopsy specimens obtained from the participants, and evaluated using TaqMan® real-time PCR. Multivariable logistic regression was performed to calculate the odds ratios (ORs) and perform data analysis. Results Smoking, alcohol use, a family history of cancer, history of gastroesophageal reflux disease, poor oral hygiene and Campylobacter spp. infection were shown to be significant risk factors for EC (p < 0.05). The combination of poor oral hygiene and infection with Campylobacter spp. constituted significant risk for EC (p < 0.001). In addition, the risk of EC in subjects co-infected with C. rectus and C. concisus that practiced poor oral hygiene was even higher and was significant (ORadj = 4.7; 95% CI 2.41–9.98; p = 0.003). Conclusions In Thailand, the major risk factors for EC are smoking status, alcohol drinking, family history of cancer, GERD, poor oral hygiene and Campylobacter spp. infection. This study found Campylobacter spp. prevalence to be associated with EC and appears to be enhanced by poor oral hygiene, suggesting that a combination of poor oral hygiene and Campylobacter species infection may together act as an important etiological risk factor for EC.

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Salivary antioxidants and periodontal disease status

Proceedings of The Nutrition Society ◽

10.1079/pns2001141 ◽

2002 ◽

Vol 61 (1) ◽

pp. 137-143 ◽

Cited By ~ 112

Author(s):

Dean V. Sculley ◽

Simon C. Langley-Evans

Keyword(s):

Periodontal Disease ◽

Antioxidant Status ◽

Alveolar Bone ◽

Disease Status ◽

Gingival Tissue ◽

Root Area ◽

Nutritional Strategy ◽

Dietary Antioxidant ◽

Factor Α ◽

High Degree

Periodontal disease is a common chronic adult condition. The bacteriumPorphyromonas gingivalishas been implicated in the aetiology of this disease, which causes destruction of the connective tissue and bone around the root area of the tooth. It has been observed that invadingP. gingivalisbacteria trigger the release of cytokines such as interleukin 8 and tumour necrosis factor α, leading to elevated numbers and activity of polymorphonucleocytes (PMN). As a result of stimulation by bacterial antigens, PMN produce the reactive oxygen species (ROS) superoxide via the respiratory burst as part of the host response to infection. Patients with periodontal disease display increased PMN number and activity. It has been suggested that this proliferation results in a high degree of ROS release, culminating in heightened oxidative damage to gingival tissue, periodontal ligament and alveolar bone. Antioxidant constituents in plasma have been well-documented, being chiefly ascorbate, albumin and urate, and these are known to display sensitivity to dietary antioxidant intakes. The concentration of antioxidants in saliva does not appear to mirror those of plasma. The extent of dietary influence upon salivary antioxidant status is unclear. Urate is the predominant salivary antioxidant, with albumin and ascorbate providing minor contributions. Previous research has found reduced salivary antioxidant activity in patients suffering from periodontal disease. An improved understanding of the role antioxidants play in periodontitis, and the influence of nutrition on antioxidant status, may lead to a possible nutritional strategy for the treatment of periodontal disease.

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Capnocytophaga gingivalis Bacteremia After Upper Gastrointestinal Bleeding in Immunocompromised Patient

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211020672 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110206

Author(s):

Folake J. Lawal ◽

Stephanie L. Baer

Keyword(s):

Gastrointestinal Bleeding ◽

Oral Hygiene ◽

Upper Gastrointestinal Bleeding ◽

Immunocompromised Patient ◽

Periodontal Diseases ◽

Oral Care ◽

Chronic Obstructive ◽

Poor Oral Hygiene ◽

Oral Flora ◽

Upper Gastrointestinal

Odontogenic bacteremia, most commonly involving gram-positive oral flora, can result from daily self-care practices or professional dental procedures. Though usually transient and quickly cleared by the immune system, the presence of periodontal disease increases the frequency of exposure and risk of persistence of oral-systemic infections. Comorbidities such as asplenia, alcoholism, and immunocompromise increase the risk of complications of hematogenous spread and severe systemic illness. Capnocytophaga is a genus of anaerobic fastidious gram-negative bacilli, which is a common member of human oral flora, and its density is proportional to mass of dental plaques and periodontal diseases. Capnocytophaga spp that colonize humans are less virulent and are uncommon causes of bacteremia when compared with the Capnocytophaga typical of canines. C gingivalis has been rarely reported as a cause of disease in immunocompromised or immunocompetent hosts. In this article, we present a case of an immunocompromised 70-year-old man with poor oral hygiene, on methotrexate and prednisone for rheumatoid arthritis and sarcoidosis, who was admitted for chronic obstructive pulmonary disease exacerbation and developed C gingivalis bacteremia and septic shock after an episode of upper gastrointestinal bleeding. Poor oral hygiene in our patient is believed to have increased his risk as an immunocompromised patient to developing C gingivalis bacteremia. This case highlights the importance of oral care in immunocompromised patients especially while hospitalized, and those about to receive transplant, chemotherapy, or on immune modulators.

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