Non-Surgical Periodontal Therapy Decreases Periodontal Pocket Depth and Clinical Attachment Loss of Rheumatoid Arthritis Patients

2021 ◽  
Vol 15 (11) ◽  
pp. 3376-3377
Author(s):  
Marryam Riaz ◽  
Sohaib Shujaat ◽  
Ayesha Fahim ◽  
Shamail Zafar ◽  
Mariyah Javed ◽  
...  

Objective: The objective of the present study was to determine the effect of non-surgical periodontal therapy on the disease severity in rheumatoid arthritis patients. Methods: Five hundred and twenty arthritis patients were included in the study, using consecutive non-probability sampling from the outpatient department of various public and private hospitals of Pakistan. Patients with periodontitis along with systemic Rheumatoid Arthritis (RA) were included in the study. Clinical parameters taken for the severity of periodontitis were the Gingival recession (GV), Periodontal Pocket Depth (PPD) and Clinical Attachment Loss (CAL). Independent sample t-test was used for significance before and after non-surgical periodontal therapy. Data was presented with mean (standard deviation). Results: The PPD and CAL of Rheumatoid Arthritis patients were found to be decreased significantly following non-surgical periodontal treatment (p value < 0.05), unlike the gingival recession, which did not decrease significantly (p value > 0.05). Conclusion: The PPD and CAL values of periodontal patients with rheumatoid arthritis were significantly reduced after giving non-surgical Periotherapy along with oral hygiene instruction. Keywords: arthritis; gingiva; periodontitis; periodontal pocket

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseph Fokam ◽  
Buolikeze Kuoh Nji Geh ◽  
Samuel Martin Sosso ◽  
Desire Takou ◽  
Ezechiel Semengue Ngufack ◽  
...  

Abstract Background HIV infection is associated to different oral manifestations (including periodontal diseases), which have decreased with the advent of antiretroviral therapy (ART). Yet, the occurrence of periodontitis is still consistent among patients with HIV living in sub Saharan-Africa, with limited evidence on the driven factors and mitigating measures in these settings. We aimed at evaluating the occurrence of periodontitis and its associated immunological and virological factors in patients with HIV living in Yaoundé, Cameroon. Methods We included 165 (44 ART-naïve and 121 ART-experienced) patients > 18 years old attending the Yaoundé Central Hospital and the Chantal BIYA International Reference Centre, from January-April 2018. The periodontal status was assessed by measuring the clinical attachment loss, periodontal pocket depth, plaques index and gingival bleeding index. CD4+/CD8+ cells and viremia were measured using the fluorescence-activated cell sorting method (FACS Calibur) and the Abbott m2000 RT HIV-1 RNA kit respectively. A standard-questionnaire concerning participants’ medical records and oral hygiene methods was filled. Data was analyzed and p < 0.05 considered statistically significant. Results There was a significantly high prevalence of periodontitis in the ART-naïve (53.2%) compared to the ART-experienced group (37.3%), with a twofold increased risk of the ART-naïve population presenting with periodontitis than the ART-experienced population (OR 2.06, p = 0.03). More importantly, ART-naïve, patients with CD4 < 200 cells presented with higher risk of having periodontitis compared to those with higher CD4-values, with a threefold difference (OR 3.21). Worth noting, males presented with a higher risk of having clinical attachment loss (OR 6.07). There was no significant association between the occurrence of periodontitis and the CD8 (p = 0.45) or viremia (p = 0.10). Conclusion In the Cameroonian context, a considerable number of adults infected with HIV suffer from periodontitis regardless of their treatment profile. Nonetheless, ART-naïve patients have a higher risk, indicating the protective role of ART. Interestingly, severely immune-compromised patients and men are vulnerable to periodontitis, thereby highlighting the need for clinicians to refer patients for regular periodontal screening especially male patients and those with low CD4. Such measures could greatly improve the quality of life of the population living with HIV in Cameroon.


2018 ◽  
Vol 21 (8) ◽  
pp. 544-549 ◽  
Author(s):  
Mahmure A. Tayman ◽  
Canan Önder ◽  
Şivge Kurgan ◽  
Muhittin A. Serdar ◽  
Meral Günhan

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.


2017 ◽  
Vol 68 (7) ◽  
pp. 1660-1664
Author(s):  
Cristina Iordache ◽  
Rodica Chirieac ◽  
Eugen Ancuta ◽  
Cristina Pomirleanu ◽  
Codrina Ancuta

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.


2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Wan Majdiah Wan Mohamad ◽  
◽  
Noor Rashidah Saad ◽  
Siti Lailatul Akmar Zainuddin ◽  
Haslina Taib ◽  
...  

Anti-cardiolipin (anti-CL) antibodies are autoantibodies which are directed against cell membrane phospholipids. A significant number of periodontitis patients showed positive for anti-CL antibody. Objective: This study aimed to determine the periodontal parameters and anti-CL antibodies levels before and after non-surgical periodontal therapy in chronic periodontitis. Methods: This cross-sectional study had been carried out at Periodontal Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Thirty five chronic periodontitis (CP) and 39 non-periodontitis (NP) patients underwent clinical periodontal examination at baseline. Plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), and clinical attachment loss (CAL) were measured. Scaling and polishing was performed and blood samples were taken for IgG and IgM anti-CL antibodies analysis. Re-evaluation was performed four weeks after initial therapy. CP patients were re-examined, all periodontal parameters were recorded and blood samples were taken for reassessment of IgG and IgM anti-CL antibodies. Results: Significant difference means of PI (p=0.001), GI (p=0.000), PPD (p=0.000) and, CAL (p=0.000) were found between CP and NP groups. All periodontal parameters were significantly reduced (p≤0.05) after four weeks of therapy. The mean levels of IgG and IgM anti-CL antibodies at baseline were significantly higher in CP than NP group (IgG=4.46 vs 3.22, p=0.002; IgM=3.28 vs 2.57, p=0.019). No significant difference of the median levels of IgG (p=0.82) and IgM anti-CL antibodies (p=0.35) following therapy. Conclusion: All periodontal parameters were significantly reduced following periodontal therapy. Higher level of Anti-CL antibodies in CP indicates stimulation of autoantibodies production by periodontal infection. Nonetheless no significant changes of this anti-CL antibodies levels despite significant reduction of the clinical parameters after periodontal therapy


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 524.1-524
Author(s):  
R. Dos-Santos ◽  
F. Otero ◽  
E. Perez-Pampín ◽  
A. Mera Varela

Background:Periodontal disease (PD) has been widely studied in the pathogenesis of rheumatoid arthritis (RA). As well, its relationship with severity and disease activity, has also been investigated with ambiguous results. It has been suggested that the improvement of oral health could enhance disease activity scores.1 PD prevalence worldwide stands around 60% in older adults (>65 years) and its frequency increases with aging.2Objectives:To asses oral health in RA patients and to identify predictors of PD in this population.Methods:Patients diagnosed of RA at treatment with biological, classical or targeted synthetic disease modifying anti-rheumatic drugs (b/cs/tsDMARDs) in the aforementioned hospital during 2020 performed a dental review with a specialized periodontal odontologist. Oral health patterns were given for all patients, following criteria of American Academy of Periodontology, and reevaluation of disease activity was made 2 months later.Clinical, demographic and treatment data were collected from participants.Univariable logistic regression was performed to identify predictors of PD. Variables with p<0.20 were selected for multivariable analysis.Stata 15.1 was used to perform statistical analysis.Results:81 patients were recruited. 82.72% were female. Mean age was 56.17 years (SD 14.15) and mean time since diagnosis was 15.58 years (SD 8.17). 25% were current or past smokers. 21 patients had comorbidities (arterial hypertension the most frequent). 66.67% were rheumatoid factor (RF) positive and 72.73% anti-citrullinated peptide autoantibody (ACPA) positive. Median erythrocyte sedimentation rate (ESR) was 12 mm (IQR 6;23) and mean C-reactive protein (CRP) was 0.48 mg/dl (SD 1.18). Mean disease activity score (DAS28-VSG) at the testing time was 2.62 (SD 1.21) and after 2 months was 2.39 (SD 0.97). 96.30% of patients were at treatment with csDMARDs, 64.20% with glucocorticoids, 96.30% with bDMARDs and 6 patients with tsDMARDs.Univariable analysis identified higher age, at least one autoantibody positive and ESR/CRP as potential predictors of medium/severe PD (p<0.20). Multivariable testing including these variables pointed out higher age, lower ESR and at least one autoantibody positive (OR 1.09 [CI95% 1.04-1.14] p=0.001, OR 0.18 [CI95% 0.04-0.95] p=0.044 and OR 0.94 [CI95% 0.88-1.00] p=0.042, respectively) as predictors of medium or severe PD (≥3 mm interdental clinical attachment loss).Univariable analysis identified higher age, the presence of any comorbidity and anti tumour-necrosis factor alpha treatment (anti-TNF) as potential predictors of severe PD (p<0.20). Multivariable testing including these variables pointed out higher age (OR 1.15 [CI95%1.02-1.30] p=0.026) as predictor of severe PD (≥5 mm interdental clinical attachment loss).Conclusion:Periodontal disease is still an extended health problem among the entire population. Its prevalence in RA is increased, therefore higher age and RF or ACPA positive are risk factors for developing severe PD. This analysis might suggest that an aggressive management of PD could implement better responses in DAS28. Also anti-TNF treatment could delimit a “penumbra” group of patients at risk of developing severe PD, where intensive manage could modify the final outcome.References:[1]C O Bingham, M Moni. Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions. Curr Opin Rheumatol. 2013;25(3):345-353.[2]P Carvajal. Periodontal disease as a public health problem: the challenge for primary health care. Rev Clin Periodoncia inplantol. 2016;9(2):177-183.Disclosure of Interests:None declared


Author(s):  
Tae Yeon Lee ◽  
Sung Eun Yang ◽  
Hye Min Kim ◽  
Min Joo Kye

Abstract Objectives The purpose of this study was to analyze and to compare retrospectively the characteristics, the treatment process, and the prognosis of cracked teeth by comparing recent data with data from 10 years ago. Materials and Methods Sixty-eight cracked teeth from March 2009 to June 2010 (2009 data) and 185 cracked teeth from March 2019 to June 2020 (2019 data) were analyzed. The characteristics of cracked teeth and the treatment method depending on probing depth, caries, and symptoms, and prognosis depending on pocket depth and apical lesions were analyzed using R version 3.3.3 (R Foundation for Statistical Computing, Vienna, Austria) and T&F version 3.0 (YooJin BioSoft, Korea). To compare proportions, the two-sample proportion test was performed. The distribution of proportions within the samples from 2009 and 2019 data was analyzed using the Chi-square test or binomial test. A p-value <0.05 was considered to indicate statistical significance. Results Significantly fewer cracked teeth received root canal treatment before crown in 2019 than in 2009 (p = 0.032). In both 2009 and 2019, symptomatic cracked teeth and those with deep periodontal pockets (>6 mm) were significantly more likely to receive root canal treatment. In both years, cracked teeth with a probing depth less than 6 mm or without an apical lesion were significantly more likely to be asymptomatic at 3-month and 6-month follow-ups (p < 0.001). Conclusion Cracked teeth with a deep periodontal pocket or symptoms had a higher likelihood of endodontic treatment, and the presence of a deep periodontal pocket or apical lesion was associated with a higher risk of persistent symptoms. Therefore, clinicians should consider these factors when planning treatment and predicting patients’ prognosis.


Author(s):  
Muhtada Ahmad ◽  
Zafar Ali Khan ◽  
Tahir Ullah Khan ◽  
Montaser N. Alqutub ◽  
Sameer A. Mokeem ◽  
...  

The aim of the study was to assess the influence of flap designs (Envelope flap (EF) and Szmyd flap (SF)) for impacted mandibular third molar extraction, on periodontal pocket depth (PPD), clinical attachment loss (CAL) and bone levels (BL) of second molar. Sixty patients indicated for third molar extractions with healthy second molars were allocated into two groups: EF and SF (n = 30). Third molars were assessed for angulation, root patterns, depth of impactions and relation with ramus (Pell and Gregory classification). Extraction of third molars was performed and PPD, CAL and BL around second molars at 0, 3 and 6 month (mon) follow-ups (FU) were assessed clinically and radiographically. ANOVA, Chi-square and Fisher’s exact test were employed to compare periodontal factors between EF and SF groups, considering p ≤ 0.05 as significant. Sixty participants with a mean age of 23.22 ± 3.17 were included in the study. Based on angulation, the most common impaction in the EF and SF groups was mesio-angular (EF, 50%; SF, 36.7%). Buccal and distal PPD showed a significant increase (p < 0.001) in both EF and SF patients from baseline to 6 mon. EF patients showed significantly higher distal and buccal CAL (6.67 ± 0.18 mm; 6.91 ± 0.17 mm) and BL (7.64 ± 0.16 mm; 7.90 ± 0.15 mm) as compared to SF patients (CAL, 6.76 ± 0.26 mm; 6.91 ± 0.17 mm-BL, 7.42 ± 0.38 mm; 7.34 ± 0.34 mm) at 6 mon FU. SF showed better soft tissue attachment (PPD and CAL) and bone stability (less bone loss) around second molars compared to EF after third molar extractions regardless of the patient, tooth and operator factors.


Author(s):  
Shreeya Aryal ◽  
Ameena Pradhan ◽  
Shilu Shrestha ◽  
Surendra Man Shrestha

Introduction: Obesity is regarded as unnecessary body fat in ratio to lean body mass. Besides being an established risk factor for cardiovascular and other systemic diseases, obesity has been suggested to be a potential threat for periodontitis as well. Objective: The objective of the study was to learn relationship between body mass index (BMI) and periodontal disease. Methods: This analytical cross-sectional study was conducted at People’s Dental College from February 16 to April 15, 2021 after ethical approval. Seventy-two participants were selected conveniently who, on the basis of calculation of weight and height were allocated into two groups: Group A: participants with normal BMI, Group B: Obese/ overweight individuals. Plaque index, gingival index, periodontal pocket, and clinical attachment loss were recorded in both the groups to assess the periodontal disease status. On basis of findings, the two groups were statistically compared. Results: The result showed clinical attachment loss was significantly higher (P <0.001) in overweight/obese group than in normal BMI group (P =0 .001). Conclusion: The findings of this study suggest that obesity and overweight can be a possible predisposing factor for periodontal disease.


2018 ◽  
Vol 12 (04) ◽  
pp. 528-531 ◽  
Author(s):  
Lubaba A. Abdul Ameer ◽  
Zainab J. Raheem ◽  
Saif Saadedeen Abdulrazaq ◽  
Basima Gh. Ali ◽  
Maysaa Mahdi Nasser ◽  
...  

ABSTRACT Objective: Chronic periodontitis (CP) is a common inflammatory disease that causes destruction to the supporting tissues of the teeth. Many treatment modalities tried to stop the disease progression. Platelet-rich plasma (PRP) is one of the regenerative methods that used in adjunct to conventional periodontal treatment. The aim of this study was to evaluate the anti-inflammatory effect of PRP by monitoring the lymphocyte count before and after its application to the periodontal pocket. Materials and Methods: Twenty patients, with CP and a pocket depth equal to or deeper than 4 mm, subjected to scaling, root planing, and PRP injection into the pocket. The lymphocyte count measured before and after 1 month from PRP application. Clinical periodontal parameters were taken during two visits (1 month apart), with customized stent fabrication. Results: All clinical periodontal parameters showed a reduction in their value following 1 month of PRP application. . There was a noticeable reduction in lymphocyte count from (mean 2.47 ± 0.91) to (mean 1.94 ± 0.77). Conclusion: In addition to its traditional uses, PRP has a great role in the periodontal treatment by its anti-inflammatory effect.


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