scholarly journals ETIOPATHOGENETIC MECHANISMS OF PERIODONTAL DISEASES AGAINST THE BACKGROUND OF VIRAL LIVER DISSEASES

Author(s):  
H.A. Sichkoriz ◽  
O.M. Slaba ◽  
L.Yu. Minko ◽  
Z.O. Bumbar

The article presents a review and analysis of relevant available literature sources on etiopathogenetic mechanisms of periodontal disease and liver diseases of viral aetiology, and, in particular, hepatitis B and C viruses. Significant prevalence, pronounced polymorphism of clinical hepatic and extrahepatic manifestations, the incidence rate of liver cirrhosis and hepatocellular carcinoma allows us to consider hepatitis of viral aetiology as a medical and social challenge. Multi-vector liver dysfunctions can cause oral presentations in this group of patients, and in particular, in their periodontal tissues. Viral liver damage is associated with significant impairment of the microbiocenosis in gingival sulcus and periodontal pockets. Dysbiotic changes are characterized by an increase in the number of opportunistic pathogens and anaerobic periodontal pathogens. Exacerbation of dysbiosis along with deterioration of oral hygiene occurs as a consequence of reduced local resistance and hyposalivation due to the sialotropic properties of hepatitis C virus. Significant pathogenetic role in the development of periodontal disease is played by disorders of metabolic and synthetic functions of the liver, as well as hormonal imbalance, metabolic disorders, immune-mediated damage, induction of autoimmune mechanisms and cytokine imbalance. The formation of hepatogenic osteopenia and osteoporosis enhances the loss of bone mass of the alveolar processes in the jaws and, accordingly, the resorption of bone tissue with the further progression of more aggressive forms of generalized periodontitis.

Author(s):  
Jageer Chinna ◽  
Jannat Sharma

Periodontal diseases are inflammatory and destructive diseases of the dentogingival complex associated with specific periodontal pathogens inhabiting periodontal pockets. Periodontal diseases lead to damage of the periodontal tissues supporting the teeth (bone and connective tissue) and affect the quality of life of the affected individuals: poor alimentation, tooth loss, social and financial problems. Although it is generally considered that the disease has multifactorial etiology, data show that some specific Gram-negative microorganisms in the subgingival plaque biofilm play a major role in the initiation and progression of periodontitis. Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia form a consortium in the subgingival biofilm and are regarded as the principal periodontopathogenic bacteria. Other microorganisms that have been implicated as predominant species in the disease process are: Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, Peptostreptococcus migros, Eikenella corrodens. In periodontitis, the initiation of the disease is the colonization of the tissues by these pathogenic species. The next step is bacterial invasion or invasion by pathogenic products into the periodontal tissues, interactions of bacteria or their substances with host cells, and this directly/indirectly causes degradation of the periodontium, resulting in tissue destruction. Keywords: periodontal disease, periodontal pathogens, microbiology.


Author(s):  
T.A. Hlushchenko

Among dental diseases, periodontal diseases rank one of the leading places and are considered as the most pressing issues of modern dentistry. The presence of concomitant somatic pathology, in particular, cardiovascular, endocrinological, autoimmune diseases is an important factor that considerably determines the course and prognosis of periodontal disease. Metabolic syndrome is regarded as an urgent social and medical issue due to its high prevalence among the general population and its contribution to the development and progression of cardiovascular disease. The number of reports and scientific interest in the metabolic syndrome has grown up significantly in recent years, but despite the significant number of studies, the oral microbiome in patients with periodontal disease and underlying metabolic syndrome is still remaining insufficiently studied. The aim of this work was to investigate the species composition of the microflora in periodontal pockets and the frequency of excretion of certain types of microorganisms in the acute generalized periodontitis in patients with metabolic syndrome. A microbiological study was performed in 30 people with metabolic syndrome and generalized periodontitis, who formed the main group, and in 30 people with generalized periodontitis without endocrinological pathology, who formed a comparison group. The results of microbiological examination indicate pathological changes in the oral microbiome in the patients with metabolic syndrome demonstrating a predominance of periodontal pathogens. It can be assumed that the components of the metabolic syndrome can initiate and support microbial invasion thus resulting in the inflammatory reaction of periodontal tissues. There is a similarity between pathogenetic mechanisms of metabolic syndrome and periodontal disease that lead to the impairment of all types of metabolism: protein, lipid, mineral, carbohydrate. As a consequence, this contributes to the progressive destruction of oral tissues. The obtained data enable to suggest the dependence between the presence of the patient's metabolic syndrome and the development of intensive damage to periodontal tissues.


Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Shotaro Yoshioka

Introduction: Periodontal Gram-negative bacteria and their products can initiate inflammatory responses in periodontal tissues with systemic consequences. They are associated with the pathogenesis of atherosclerosis and ischemic stroke. Local inflammation and oxidative stress play a crucial role in the pathophysiology of intracranial aneurysms (IAs). Under the hypothesis that the severity of periodontal disease is associated with the formation and rupture of IAs we assessed which periodontal pathogens contribute to the pathogenesis of IAs. Methods: We enrolled patients with ruptured- (n=5, age 60±11.9) and unruptured IAs (n=13, age 67±6.1) and controls without IAs (n=7, age 58±8.5); their prior informed consent was obtained. The severity of periodontitis was recorded using the community periodontal index (CPI) of the Treatment Needs code. Subgingival plaques (n=23) were evaluated with the quantitative real-time PCR assay to check for the Gram-negative bacteria Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum, Treponema denticola, Prevotella intermedia (Pi), Tannerella forsythia, and Porphyromonas gingivalis (Pg). Plasma IgG titers of antibody against Pg, Pi, Aa, and Eikenella corrodens were evaluated by ELISA. Results: The CPI was significantly higher in patients with IAs than the controls (2.7 vs 1.9, p<0.05) and their DNA level of subgingival plaques and their plasma IgG titers of Pg were also higher. Periodontal disease was more severe and the plasma IgG titers of Pg were higher in patients with ruptured- than unruptured IAs, suggesting that Pg is associated not only with the formation but also the rupture of IAs. Conclusions: We present evidence that severe periodontal disease and Pg infection may be involved in the pathophysiology of IAs. The management of periodontal diseases may help to prevent the formation and rupture of IAs.


2018 ◽  
Vol 68 (12) ◽  
pp. 2853-2856 ◽  
Author(s):  
Igor Jelihovschi ◽  
Cristian Drochioi ◽  
Aida Corina Badescu ◽  
Raoul Vasile Lupusoru ◽  
Alexandra Elena Munteanu ◽  
...  

The diagnosis of periodontal disease is mainly based on use of clinical and radiographic evidence. In this study we employed a quantitative PCR analysis of Aggregatibacter actinomycetemcomitans and Treponema denticola as species strongly involved in periodontal diseases, burden in periodontal pockets to detect the main sampling factors that interfere with qPCR results. From 22 patients with advanced periodontal disease, subgingival plaque was comparatively collected by paper points and periodontal Gracey curettes. Samples were collected from the same situs in presence of gingival bleeding and absence of bleeding. The concordance and agreement of results between samples were assessed. The present study demonstrates that subgingival plaque sampling with sterile absorbable paper points is often accompanied by gingival bleeding resulting in quantification biases of periodontal pathogens.


Author(s):  
G. A. Loban ◽  
T. O. Petrushanko ◽  
V. V. Chereda ◽  
M. O. Faustova ◽  
M. M. Ananieva ◽  
...  

Background. Periodontal tissues inflammatory diseases are widespread among young people. Objective. This study was aimed at elaborating the method to assess risks of periodontal inflammatory diseases and determining its efficacy depending on the state of dental tissues, gum tissues and sex.          Methods. The study included 182 students (93 men, 89 women) aged 19-29: 22 individuals had no lesions of hard dental tissues and no signs of periodontal disease; 51 individuals were found to have DMF index <6; 52 individuals – DMF index ≥6; 57 individuals were diagnosed with chronic catarrhal gingivitis. Primary groups were formed in autumn; re-examination was carried in spring. The research participants were assessed for detection of risks of periodontal inflammatory disease by the method developes by the authors (Patent UA 54041). Results. The study revealed that the risk of development of preiodontitis increases in individuals with high caries and gingivitis intensity. In spring, more individuals suffer from microbial imbalance in in the composition of gingival sulcus fluid and decrease in the mean stability coefficient value that indicates an increased risk of inflammatory periodontal disease development. Women were less likely to experience seasonal dysbiotic changes in the gingival sulcus fluid composition compared with men. Conclusions. The method suggested for assessment of the risk of periodontal inflammatory diseases is of high informativeness. It allows clinicians detecting early pre-nosological signs of oral microbiocenosis imbalance that enhances the effectiveness of early diagnosis of inflammatory periodontal diseases.


2018 ◽  
pp. 54-59
Author(s):  
N.N. Saveleva ◽  
I.I. Sokolova ◽  
S.I. German ◽  
T.V. Tomilina

The review of the scientific literature is devoted to the topical issues of studying the etiology of periodontal diseases, which are one of the most common and complex pathologies of the maxillofacial region. Analysis of recent studies proves a stable relationship between the development of periodontal diseases and disorders in the immune system, the neurohumoral system, metabolic disorders, genetic predisposition, and so on. The article presents the data obtained in the course of studying the literature on the role of disorders in the functioning of individual organs (gastrointestinal tract, liver, lungs, heart, and urinary system) in the development of chronic periodontal diseases. The article notes that the anatomical and physiological proximity of the periodontal and digestive tract tissues, the generality of innervation and humoral regulation create prerequisites for the involvement of periodontal disease in the pathological process in diseases of the gastrointestinal tract. One of the main etiological factors in the development of inflammatory diseases of the gastrointestinal tract and periodontium is Helicobacter pylori, which is found in the loci of the oral cavity: in the oral and gingival fluid, on the mucous membrane of the tongue and cheeks, and in the periodontal pockets. It is pointed out that the liver also occupies a special place in the development of periodontal diseases, which is explained by the performance of its significant functions for the human body: regulatory, metabolic, antitoxic and other. There is evidence that the pathology of periodontal disease plays a leading role in the structure of dental diseases in patients with chronic obstructive pulmonary diseases, which is clinically manifested by symptoms of generalized periodontitis of the І-ІІ degrees of development and its complications - partial or complete secondary adentia, and with tooth preservation - defects in dental series and violations of occlusion, function, aesthetics. Scientists suggest a general biological mechanism for the development of generalized periodontitis and cardiovascular diseases, linking the development of periodontal diseases in patients with cardiovascular pathology with microcirculatory disorders. The dependence of the severity of inflammatory changes in the periodontal tissues on the disturbances of salt metabolism in urolithiasis is proved. The data obtained indicate that diseases of the internal organs contribute to the structural damage of periodontal tissues and they are a risk factor for periodontal diseases, which necessitate the presence of not only theoretical knowledge and practical skills in dentistry, but also their awareness of the features and clinical manifestations of somatic pathology. An urgent and justified step in the treatment of periodontal diseases is also the involvement in the process of rendering complex dental care to internist doctors capable of quickly and qualitatively assessment the condition of the internal organs and the basic systems of the patient's body.


2019 ◽  
Vol 23 (1-2) ◽  
pp. 17-21
Author(s):  
M. Skrypnyk ◽  
T. Petrushanko ◽  
T. Kryvoruchko ◽  
K. Neporada

Obesity prevalence has significantly increased especially in young adults, which is caused by a particular lifestyle, food quality and dietary behavior. Obesity leads to development of huge array of comorbid conditions such as arterial hypertonia, heart stroke, arthritis and other diseases. We conducted standard clinical examination of oral cavity of 154 young patients (18-21 years old) – all of them were students of Ukrainian Medical Stomatological Academy. It has been determined that the majority of patients with BMI >30 kg/cm2 have aggravated family heredity, in 66,2% cases one parent of obese students had obesity and 32,43% patients have both parents with obesity that is significantly higher compared with persons with normal BMI and overweight. There was a high prevalence of periodontal diseases about 74% and carious lesions of teeth - 97.4% among young people despite the age and contingent of examined patients - medical students. In patients with BMI >30 kg/cm2 prevalence of generalized forms of gingivitis and periodontitis was by three times higher compared with individuals with normal BMI. The values of oral hygienic indexes were poor in all examined groups, but their values were slightly lower in patients with normal BMI than in those with overweight and obesity. The prevalence of inflammatory changes in gums was higher in persons with obesity: all of them had a mild degree of lesions in periodontal tissues. Inflammatory processes in the gums were the most intense in patients with the second degree of obesity. According to the results of the study, the presence of the first and the second degree of obesity should be considered as a risk factor triggering periodontal tissues diseases. For persons with BMI >30 kg/cm2 with periodontal disease measures for the secondary prevention of inflammatory and inflammatory dystrophic periodontal diseases should be carried out and in persons without periodontal disease on the background of obesity measures primary prevention should be done.


2020 ◽  
Vol 9 (1) ◽  
pp. 784-788

Periodontitis is a chronic inflammatory disease of the vascularized supporting tissues of the teeth. Angiogenesis (neovascularization) is the budding of new capillaries and is thought to be an essential process in the development of chronic inflammatory diseases. Inflamed tissues (such as gingiva coincident in periodontal disease) have evidence of enhanced expression of inflammatory mediators, many of which can promote angiogenesis. Of the various cytokines and growth factors that are involved in angiogenesis, the most potent agent that acts specifically on vascular epithelium is Vascular Endothelial Growth Factor. Even though angiogenesis is a prominent feature of both inflammation and healing, information about its role in periodontal lesions is limited. Hence the aim of the present study was the immunohistochemical evaluation of the expression of VEGF in the gingival tissues of chronic and aggressive periodontitis patients compared to the healthy controls. The present study was carried out in a total of 45 subjects with age range of 18-55 years, reporting to the Department of Periodontology, Rajarajeswari Dental College and Hospital, Bangalore. Gingival tissue samples were collected from all the 45 subjects and categorized into three groups based on their clinical findings as follows: Group 1 (Healthy), Group II (Chronic Periodontitis), Group III (Aggressive Periodontitis). Following sample collection, immunohistochemical staining of tissues was carried out and evaluation was done to compare the grades of expression of VEGF in the three groups. The expression of VEGF in blood vessels was also quantitatively evaluated. The results were statistically analyzed using Kruskal Wallis ANOVA and Mann Whitney test. There was a statistically significant higher expression of VEGF in both chronic periodontitis and aggressive periodontitis group as compared to the control group. Aggressive periodontitis cases showed higher grades of expression of VEGF compared to the chronic periodontitis cases and healthy controls. However, the difference in expression of VEGF was not statistically significant between the two forms of periodontitis. The presence of VEGF in both chronic and aggressive periodontitis clearly indicates the potent role played by VEGF as an inflammatory agent in the initiation and progression of periodontal diseases. Thus, VEGF might be used as a potential vascular marker for the assessment of severity and inflammatory status in periodontal disease.


2018 ◽  
Vol 14 (4) ◽  
pp. 54-57
Author(s):  
Н. Чернышева ◽  
N. Chernyshova ◽  
Сергей Чуйкин ◽  
Sergey Chuykin ◽  
Гузель Акмалова ◽  
...  

Background. Periodontal disease is one of the most common and complex pathologies in dentistry. It is known frequently damage to the tissues of the periodontal complex with dermatoses. The most relevant among the dermatoses of the mucous membrane of the mouth and the red border of the lips is oral lichen planus. Among the six clinical forms of red flat oral lichen planus and the red border of the lips, the exudative-hyperemic and erosive-ulcerous forms occur most often. Atypical form is much less common than other forms and is often diagnosed by dentists as an inflammatory periodontal disease. At the same time, the pathogenetic mechanisms of inflammatory processes in the gums, which are different in oral lichen planus, are not taken into account, which, accordingly, complicates adequate treatment. Objectives. The aim of the study was to analyze the periodontal status in patients with exudative-hyperemic, erosive-ulcerative and atypical forms of oral lichen planus. Methods. Under our supervision there were 181 patients with oral lichen planus, in whom a simplified Green-Vermillion hygiene index was determined. To assess the state of periodontal used periodontal index according to Russell. Results. When assessing the hygienic condition of the oral cavity, high values were observed in individuals with severe forms of the disease: erosive-ulcerative, exudative-hyperemic. The highest values of the periodontal index were found in patients with atypical, erosive and ulcerative forms of oral lichen planus. Conclusions. The results of the clinical examination of patients with oral lichen planus dictate, first of all, to include in the scheme of complex treatment of it the sanitization of oral cavity and complex treatment of inflammatory periodontal diseases as well.


Author(s):  
V.O. Kateryniuk

The article presents a retrospective review of professional domestic and foreign literature on modern aspects of treatment of inflammatory periodontal diseases, including vector therapy, plasmalifting, which can be used in various forms of this pathology. Periodontal diseases are one of the most pressing problems of dentistry, which has not only general but also great social significance, due to the high prevalence, intensity of the process, the subsequent formation of chronic odontogenic foci of infection, tooth loss at a young age and adverse effects on the body. Treatment of periodontal disease is a complex and lengthy process that includes general methods of influencing the pathophysiological processes occurring in the body, both local - therapeutic, orthopedic and surgical measures. Before planning treatment, the dentist should determine the patient's medical and dental history, conduct clinical and radiological examinations, determine the degree of loss of the alveolar ridge, functional disorders of the dental system and the possibility of their correction. Depending on this, determine the plan of treatment and rehabilitation measures, the sequence of medical interventions. The main task of periodontal treatment is to optimize the conditions for maintaining a healthy dentition and restoring its physiological functions. The difficulty of treating inflammatory periodontal diseases is that known and standard methods (antibacterial therapy and courses of local therapy) do not always give a positive result and a long period of remission. Therefore, to improve the quality of medical care for patients with periodontal pathology, it is necessary to introduce new innovative methods of treatment in dental practice. Given the patterns of pathophysiological processes occurring in periodontal tissues and bone tissue of the alveolar process, to date, several stages of treatment and rehabilitation measures have been proposed. The first stage is the elimination of the pathogenic action of microbial factors and inflammatory processes in periodontal tissues. Microbial invasion and the inflammatory reaction of periodontal tissues caused by it activate the processes of osteoclastical bone resorption. The task of the second stage of treatment and rehabilitation measures is to restore the physiological structure of gums and bone by normalizing metabolic processes in periodontal tissues, reducing the activity of resorption processes and stimulating reparative osteogenesis in the bone tissue of the alveolar process and the body in general, surgical treatment. At the third stage of treatment and rehabilitation measures, teeth with a significant degree of atrophy of the alveolar process are removed, which cannot be used for prosthetics. To restore the integrity of the dentition, even distribution of masticatory load, appropriate prosthetics are performed. The use of the latest methods contributes to the effective treatment of periodontal disease in the early stages, stabilization of the process at deeper stages, in some cases helps to avoid surgery.


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