scholarly journals Clinical and Radiographic Characteristics of Endoperiodontitis in Patients with Chronic Generalized Periodontitis

2017 ◽  
pp. 13-20
Author(s):  
L.N. Dedova ◽  
Yu.L. Denisova ◽  
N.I. Rossenik

The article presents modern data on the priority clinical and radiographic signs of endoperiodontitis in patients with chronic generalized periodontitis. The aim of the research was to determine the complex of clinical and radiographic methods for diagnosing the patients with chronic generalized periodontitis in conjunction with a localized complex endoperiodontitis. Objects and methods. The research included the clinical and radiographic examination of 100 almost healthy patients aged 35-44 years. The study group consisted of 50 patients with chronic generalized periodontitis of moderate severity in conjunction with a localized complex endoperiodontitis (100 teeth). The control group was represented by 50 patients without periodontal pathology. The diagnosis endoperiodontitis was made according to the classification of professor L.N. Dedova (2012). Result and discussion. Clinical studies revealed chronic localized endoperiodontitis which led to 13.6 times decrease of pulp vitality and increase in the probing depth of the periodontal pocket by 4.84 ± 1,34 mm. CBCT was characterized by greater than IOR and OPG sensitivity (98%), 96% specificity, with a total accuracy of 97% and 24.5 times higher prognostic significance. Conclusion. The main methods of diagnosing localized complex endoperiodontitis are the electric pulp test and probing the periodontal pockets that has 4.2 times higher prognostic significance compared to gingival index, bleeding on probing, suppuration from periodontal pockets, migration of teeth, positive percussion, tooth mobility, furcation involvement and formation of acute periodontal abscesses. The additional method of diagnosing the localized complex endoperiodontitis is cone-beam computed tomography that has the diagnostic efficacy 96‒98% compared to intraoral radiography (42‒44%) and orthopantomography (52‒66%).

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Holger F. R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick

Abstract Background This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. Clinical relevance The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL.


2020 ◽  
Author(s):  
Holger F.R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods:Forty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21). They were analyzed for the clinical variables BOP (primary outcome at six month), probing depth (PD), attachment level (AL), four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions:Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5mm when compared with subgingival instrumentation only. Clinical relevanceThe adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery.


2020 ◽  
Author(s):  
Holger F.R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods: Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21). They were analyzed for the clinical variables BOP (primary outcome at six month), probing depth (PD), attachment level (AL), four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions: Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5mm when compared with subgingival instrumentation only. Clinical relevance: The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration: The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId =trial.HTML&TRIAL


2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Ayse Caygur

Objectives:  This study was performed to investigate the efficacy of using glycine powder air-polishing (GPAP) or  antiseptics (CHX) adjunctively to scaling and  root planing (SRP) in the treatment of periodontitis. Methods: In this trial, ninety patients (between 28-80 years old) who had at least three teeth with 3 to 7- mm periodontal pockets, were ıncluded from the Department of Periodontology. The patients were divided into three groups randomly. In the control group ultrasonic instrumentation was performed with distilled water and hand instrumentation, in the CHX group ultrasonic instrumentation was performed with CHX and hand instrumentation, in the GPAP group in addition to SRP with ultrasonic performed with distilled water and hand instrumentation, GPAP was performed for 10 seconds per periodontal pocket using a Perio-Flow device.  All treatments were performed in one session.  Resuls: The scores of  plaque index(PI),gingival index (GI), probing depth (PD), bleeding on probing (BOP) and clinical attachement level (CAL) were decreased in all groups after 1 month and the results were statistically significant in intergoup comparisions. PI and CAL scores were statistically significant in intragroup comparisions in GPAP group. Altough GI, PD and BOP scores were lower in the GPAP group than CHX and control group, the differences after 1 month were not statistically significant.  Conclusion: Within the limits of this study, it was seen that SRP was effective alone in the treatment of periodontitis. However, using a CHX with ultrasonic devices has little beneficial effects on periodontal parameters when compared with control and GPAP groups. GPAP groups was found more effectively in PI and CAL scores.


2020 ◽  
Author(s):  
Holger F.R. Jentsch ◽  
Christian Flechsig ◽  
Benjamin Kette ◽  
Sigrun Eick

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods: Fourty-two individuals with periodontitis receiving nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21) were analyzed for clinical variables, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group but not in the controls. There was no further significant difference of any clinical and non-clinical variable between both groups at three and six months after SI. Conclusions: Subgingival instrumentation with adjunctive erythritol air-polishing powder may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. Clinical relevanceThe adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI. Trial registration: The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId =trial.HTML&TRIAL


2014 ◽  
Vol 34 (3) ◽  
pp. 237-240
Author(s):  
Chia-Jen Hsu ◽  
Shu-Li Lin ◽  
Wei-Jen Chang ◽  
Eisner Salamanca ◽  
Sheng-Wei Feng ◽  
...  

Abstract Guided tissue regeneration (GTR) in the management of the periodontal furcation invasion is effective. Recent studies showed significant clinical improvement with different materials. The purpose of this study is to provide clinical evaluations of the bone repair potential of GTR combined with a novel porcine collagen membrane in the treatment of human molar Class II furcations. Fifty-one patients, 33 males and 18 females, with no systemic disease and a mean age of 49.1 years, participated in this study after phase I periodontal therapy. Probing depth, attachment loss and radiographic examination were recorded and analyzed before and after GTR therapy with collagen membrane. In the soft tissue measurement, the periodontal pocket (PD) depth was 5.283±0.283 mm before the surgery and improved to 2.631±0.147 mm at 9 months after surgery (p<0.05). Attachment loss also showed similar results. The attachment level was 5.547±0.3 mm before the surgery, and 2.911±0.188 mm at 9 months after surgery (p<0.05). According to the measurements the attachment gain was 2.636±0.168 mm after GTR surgery with porcine collagen membrane. According to this study, the porcine collagen membrane can perform with exceptional results in attachment level gain for the Class II periodontal furcation involvement.


2020 ◽  
Vol 28 (3) ◽  
pp. 290-299
Author(s):  
Kira A. Ageeva ◽  
Evgenii V. Filippov

Aim. To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods. 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.94.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.63.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р0.05). The distance walked by the patients with CHF in 6 minutes was 488.2390.84 m, which was significantly less than in the control group (815.6053.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.83.0% and 48.05.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.15.0% in the group of CHF and 40.05.0% in the control group, р=0.014), palpitation (29.04.6% and 20.04.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO2 trend was recorded in CHF group in 58.31.0% of cases (the difference with the control group with р=0.046), the trend of heart rate in 18.80.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, 6MWT distance, desaturation, PB during 6MWT.


Author(s):  
Babaeva T.N. ◽  
Seregina O.B. ◽  
Pospelova T.I.

At present, the serum ferritin level is not included in the list of prognostic factors; however, it is known that its increased serum level in patients with malignant neoplasms relates with the tumor burden, the degree of disease activity and correlates with a worse prognosis in patients with hematologic malignancies.The normalization of serum ferritin level during remission period confirms the involving of hyperferritinemia in mechanisms of tumor progression and may testify for clinical importance of measurement of serum ferritin level in patients, including those with malignant lymphomas. Objective:The aim of this study was to assess of the prognostic significance of high ferritin levels at the onset of the disease in patients with malignant lymphomas. Materials and methods:98 patients with malignant lymphomaswere enrolled in this study, including 72 patients (73.5%) with non-Hodgkins lymphomas (NHL) and 26 patients (26.5%) with Hodgkin’s lymphoma (HL). The increased serum ferritin level (more than 350 ng/ml) was found in 53 (54.2%) patients with malignant lymphomas at the onset of disease and its average concentration was 587,62±131,6 ng/ml (8.3 times higher values of control group, p<0.001).Also the positive statistical correlationsbetween increased ferritin level and increased level of LDH (r=0.47, p<0.001, n=98) and C-reactive protein (r=0.41, p<0.001, n=98) as well as the presence of B-symptomswere found. The median OS was significantly shorter in the group of patients with increased ferritin level (more than 350 ng/ml) at the onset of disease in comparison with group of patients with normal ferritin level, where the median OS was not reach during the observation period. Patients with increased ferritin level before starting chemotherapy also showed worse results of overall survival and increased mortality risk (OR 8.122; 95% CI, 1.764-37.396;р<0.05) compare with a group of patients with ferritin level ˂350 hg/ml at the onset of disease. Conclusion:These results make it possible to include lymphomas’s patients with increased ferritin level at the onset of disease in the group with poor prognosis and lower OS, while the increased ferritin level in patients without previous blood transfusions should be considered as a significant prognostic factor.


2019 ◽  
Vol 20 (10) ◽  
pp. 781-784 ◽  
Author(s):  
Meizhen Zhao ◽  
Li Juanjuan ◽  
Fan Weijia ◽  
Xie Jing ◽  
Huang Qiuhua ◽  
...  

Background: This study aimed to investigate the expression levels of microRNA (miRNA)-125b in serum exosomes and its diagnostic efficacy for asthma severity. Methods: The study included 80 patients with untreated asthma and 80 healthy volunteers. The patients were divided into 4 groups according to disease severity: 20 with the intermittent state, 20 with the mildly persistent state, 20 with the moderately persistent state, and 20 with the severely persistent state. The expression levels of miRNA-125b in serum exosomes of each group were detected using a quantitative polymerase chain reaction and compared. The Spearman correlation analysis was used to study the correlation between the expression levels of miRNA-125b in serum exosomes and asthma severity. The diagnostic efficacy of the expression levels of miRNA-125b in exosomes for asthma severity was evaluated using the Receiver Operating Characteristic (ROC) curve. Results: The expression levels of miRNA-125b in serum exosomes of patients with intermittent, mildly persistent, moderately persistent, and severely persistent asthma were all higher than those in the healthy control group, with statistically significant differences. The expression levels of miRNA-125b were also statistically significantly different among patients in each group. The Spearman correlation analysis showed a positive correlation of the relative expression of miRNA-125b in serum exosomes with asthma severity. The area under the ROC curve of the diagnostic efficacy of miRNA-125b in serum exosomes for patients with intermittent, mildly, moderately, and severely persistent asthma was 0.7770, 0.8573, 0.9111, and 0.9995, respectively. Conclusion: The expression levels of miRNA-125b in serum exosomes had a high diagnostic efficacy and might serve as a noninvasive diagnostic marker for asthma severity.


Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1615
Author(s):  
Ines P. Nearchou ◽  
Hideki Ueno ◽  
Yoshiki Kajiwara ◽  
Kate Lillard ◽  
Satsuki Mochizuki ◽  
...  

The categorisation of desmoplastic reaction (DR) present at the colorectal cancer (CRC) invasive front into mature, intermediate or immature type has been previously shown to have high prognostic significance. However, the lack of an objective and reproducible assessment methodology for the assessment of DR has been a major hurdle to its clinical translation. In this study, a deep learning algorithm was trained to automatically classify immature DR on haematoxylin and eosin digitised slides of stage II and III CRC cases (n = 41). When assessing the classifier’s performance on a test set of patient samples (n = 40), a Dice score of 0.87 for the segmentation of myxoid stroma was reported. The classifier was then applied to the full cohort of 528 stage II and III CRC cases, which was then divided into a training (n = 396) and a test set (n = 132). Automatically classed DR was shown to have superior prognostic significance over the manually classed DR in both the training and test cohorts. The findings demonstrated that deep learning algorithms could be applied to assist pathologists in the detection and classification of DR in CRC in an objective, standardised and reproducible manner.


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