Denture characteristics, oral hygiene practice and periodontal changes of partial denture wearers and non-denture wearers in a Teaching Hospital- A comparative study

Background: There can be localized periodontal inflammation around abutment teeth of dentures as a result of plaque accumulation. This study assessed the periodontal changes of removable partial denture wearers compared to that of non-denture wearers. Methodology: Participants were recruited from the prosthodontic and restorative outpatient clinics of Lagos University Teaching Hospital. The self-administered questionnaire was used to collect information on socio-demographics, denture characteristics, periodontal changes and oral hygiene practice of participants. Periodontal status assessed included gingival inflammation, plaque accumulation and tooth mobility. Data was analyzed using SPSS version 20 (IBM SPSS Armonk, New York) and presented as frequencies and percentages. Test for significance was done using Chi-square statistics, and the level of statistical significance was set at P < 0.05. Results: A total of 96 participants between age 16 and 74years were recruited with mean age of 40±14.5years. There were 56 females and 40 males (F:M; 1.4:1). Fifty-four denture wearers and forty-two non-denture wearers were recruited into the study. Among participants wearing partial denture, 49(90.7%) had gingival inflammation; 45(91.8%) had mild inflammation compared to 4.8% participants who are non-denture wearers. 29(53.7%) denture wearers had fair oral hygiene while most 31(73.8%) non-denture wearers had excellent oral hygiene. Abutment teeth in denture wearers had tooth recession; mostly on the upper arch and also posteriorly. Conclusion: The periodontal inflammation, tooth recession and mobility in denture wearers were worse compared to non-denture wearers. Thus, they need to be motivated for more adequate oral hygiene practices and have regular recall system to monitor their periodontal health.

Site-specific adaptation mechanisms of an oral pathobiont in the oral and gut mucosae

Periodontal inflammation leads to oral dysbiosis with the expansion of oral pathobionts. Besides the pathogenic role of oral pathobionts during periodontal inflammation, studies have revealed that oral pathobionts contribute to diseases in distant organs beyond the oral mucosa. For example, the oral pathobiont Klebsiella aerogenes, which accumulates in the oral mucosa during periodontitis in mice, can exacerbate colitis when it ectopically colonizes the gastrointestinal tract. However, the precise mechanisms by which oral pathobionts establish their colonization in extra-oral mucosal sites remains incompletely understood. We performed high-throughput in vivo genetic screening to identify fitness genes required for the adaptation of the oral pathobiont K. aerogenes to different mucosal sites – the oral and gut mucosae – in the steady state and during inflammation. In addition, the global transcriptome of K. aerogenes in different environments was analyzed. We determined that K. aerogenes employs genes related to iron acquisition and chaperone usher pili, which are encoded on a newly identified genomic locus named “locus of colonization in the inflamed gut” (LIG), for adaptation in the gut mucosa, particularly during inflammation. In contrast, the LIG virulence factors are not required for K. aerogenes to adapt to the oral mucosa. Thus, oral pathobionts likely exploit distinct adaptation mechanisms in their ectopically colonized intestinal niche as compared to their original niche.

Estimation of periodontal pocket surface area in small to medium dogs: a proof-of-concept study

Background Periodontal disease is the most common dental disease in dogs. Although the systemic effects of periodontal disease have not been clarified in veterinary science, it is necessary to evaluate the effects of periodontal disease in clinical trials in the future. There have been a few clinical attempts made, however, to assess the severity of periodontal inflammation and its impact on the systemic health of dogs. Meanwhile, in the field of dentistry for humans, the periodontal inflamed surface area (PISA) and periodontal epithelial surface area (PESA) have been used to quantitatively assess the degree of periodontal disease affecting a single tooth as well as the overall extent of periodontitis. Recent studies have also suggested the use of these assessments to examine the relationship between periodontal inflammation and systemic health. Results The estimation formula for a dog’s periodontal pocket surface area (PPSA), an alternative to PISA and PESA in humans, was established using body weight and periodontal pocket depth. Actual values were measured using extracted teeth from various dog breeds and sizes (2.3–25.0 kg of body weight) to obtain universal regression equations for PPSA. Altogether, 625 teeth from 73 dogs of 16 breeds were extracted and subsequently analyzed for morphological information. PPSA was measured in 61 dogs of 10 breeds with periodontal disease using the established estimation formulas, and the correlation between PPSA and preoperative blood chemistry data was analyzed accordingly. A strong correlation was found between PPSA and serum globulin (r = 0.71) while moderate correlations were found for C-reactive protein (r = 0.54) and serum albumin (r = -0.51). Conclusions Estimation formulas using body weight and the 6-point probing depth were established for determining PPSA. Direct correlations between PPSA and several blood test results were observed in the study sample. Taken together, these results suggest that PPSA could be useful for evaluating the effects of periodontitis on systemic conditions in dogs.

Retrospective Study Regarding Orthodontic Retention Complications in Clinical Practice

At the end of any orthodontic treatment, retention is a necessary phase. Unfortunately, the current retention devices and the lack of proper oral hygiene on the part of patients lead to the accumulation of dental plaque, periodontal inflammation, and gingival retraction. Our retrospective study included 116 adult patients wearing various types of orthodontic retainers. To quantitatively determine the accumulation of dental plaque, we used the Quigley–Hein plaque index modified by Turesky and the Navy plaque index modified by Rustogi. Another studied parameter was related to the gingival recession associated with retention devices. We had investigated the correctness of patients’ dental hygiene, their preferences for auxiliary means of oral hygiene, the consistency with which they wear the mobile retainers, and respect the orthodontist’s instructions; we also investigated the inconveniences and the accidents that may occur during the retention period. Statistical analysis showed that plaque accumulation is significantly lower in the case of mobile retainer than fixed retainer wearers; the exception was the Hawley plate, where the interdental plaque was more than in all the other studied retainers. Periodontal recessions were more frequent in the case of fixed retainer wearing. Flossing was the most commonly used auxiliary mean for oral hygiene. The compliance of women in wearing vacuum-formed retainers was better than that of men. Patients with a class III history had more plaque accumulation, and class II/1 had the most problems related to detachment/damage of fixed retainers. Mobile retainers proved better results for oral hygiene, but fixed retainers cannot be waved.

Systemic Antibiotics Influence Periodontal Parameters and Oral Microbiota, But Not Serological Markers

The use of systemic antibiotics may influence the oral microbiota composition. Our aim was to investigate in this retrospective study whether the use of prescribed antibiotics associate with periodontal status, oral microbiota, and antibodies against the periodontal pathogens. The Social Insurance Institution of Finland Data provided the data on the use of systemic antibiotics by record linkage to purchased medications and entitled reimbursements up to 1 year before the oral examination and sampling. Six different classes of antibiotics were considered. The Parogene cohort included 505 subjects undergoing coronary angiography with the mean (SD) age of 63.4 (9.2) years and 65% of males. Subgingival plaque samples were analysed using the checkerboard DNA-DNA hybridisation. Serum and saliva antibody levels to periodontal pathogens were analysed with immunoassays and lipopolysaccharide (LPS) activity with the LAL assay. Systemic antibiotics were prescribed for 261 (51.7%) patients during the preceding year. The mean number of prescriptions among them was 2.13 (range 1–12), and 29.4% of the prescriptions were cephalosporins, 25.7% penicillins, 14.3% quinolones, 12.7% macrolides or lincomycin, 12.0% tetracycline, and 5.8% trimethoprim or sulphonamides. In linear regression models adjusted for age, sex, current smoking, and diabetes, number of antibiotic courses associated significantly with low periodontal inflammation burden index (PIBI, p &lt; 0.001), bleeding on probing (BOP, p = 0.006), and alveolar bone loss (ABL, p = 0.042). Cephalosporins associated with all the parameters. The phyla mainly affected by the antibiotics were Bacteroidetes and Spirochaetes. Their levels were inversely associated with the number of prescriptions (p = 0.010 and p &lt; 0.001) and directly associated with the time since the last prescription (p = 0.019 and p &lt; 0.001). Significant inverse associations were observed between the number of prescriptions and saliva concentrations of Prevotella intermedia, Tannerella forsythia, and Treponema denticola and subgingival bacterial amounts of Porphyromonas gingivalis, P. intermedia, T. forsythia, and T. denticola. Saliva or serum antibody levels did not present an association with the use of antibiotics. Both serum (p = 0.031) and saliva (p = 0.032) LPS activity was lower in patients having any antibiotic course less than 1 month before sampling. Systemic antibiotics have effects on periodontal inflammation and oral microbiota composition, whereas the effects on host immune responses against the periodontal biomarker species seem unchanged.

Gingival hyperplasia treatment using diode laser gingivectomy in a child with cerebral palsy: case report

Gingival hyperplasia is associated with several factors, such as chronic inflammation due to the large accumulation of biofilm and medications including anticonvulsants. The aim of this study is to report a clinical case of a 4-year-old spastic quadriplegic cerebral palsy patient with gingival hyperplasia in the palatal region of the upper teeth induced by the use of high doses of anticonvulsant medications. The patient attended the Dental Assistance Center for People with Disabilities, with fibrotic gingival hyperplasia in the upper posterior region, covering the dental crowns on the palatal and occlusal surfaces. Oral hygiene instructions were previously carried out using chlorhexidine gluconate solution (0.12%) on the teeth with the aid of a cotton swab, twice a day for seven days, to reduce bacterial plaque levels and control periodontal inflammation. Gingivectomy was performed using a gallium aluminum arsenide diode laser (GaAlAs; 808±10 nm, 2.5 W output power, continuous mode). Following the surgical procedures, photobiomodulation therapy was performed with a low-level aluminum gallium indium phosphide diode laser (InGaAlP; 660±10 nm, 100 mW, 3 J) at three points (anterior, middle and posterior region of surgical wound). The patient returned at 7 and 30 days after surgery presenting accelerated wound healing. It was concluded that the high-level diode laser associated with photobiomodulation therapy were effective for performing a conservative and safe procedure in a patient with severe neurological disorder.

Role of Pentraxin-3 in Periodontal Inflammation - A Comprehensive Review

Acute phase reactants like C-reactive protein (CRP), and pentraxin 3 (PTX3) are increased with inflammation and tissue injury. PTX3 is an acute phase protein and a member of the long pentraxin family. CRP is synthesized in the liver but PTX3 is generated locally at the inflammatory site. It is a fluid-phase pattern-recognition molecule that regulates antimicrobial immunity and inflammation by interfering with selectin-dependent neutrophil recruitment and regulating the complement cascade. Hence, PTX3 could be used as a potential biomarker to identify inflammatory response in both acute and chronic diseases. In this review, we discuss the role of PTX3 in periodontal inflammation.

Oral Mucositis Association with Periodontal Status: A Retrospective Analysis of 496 Patients Undergoing Hematopoietic Stem Cell Transplantation

Background: Hematopoietic stem cell transplantation (HSCT) can induce serious oral complications, including oral mucositis (OM). The presence of periodontal inflammation before HSCT is believed to be associated with OM. The aim of our study was to determine the prevalence and severity of OM in patients undergoing HSCT and its relation to periodontal status. Patients and methods: This is a retrospective study of patients who underwent HSCT and a detailed dental examination between 2007 and 2015. The dental and periodontal status of all patients was evaluated by clinical and radiographic examination prior to HSCT. Oral health was assessed with the gingival index, the the community periodontal index, presence of plaque-related gingivitis, and marginal periodontitis. During the HSCT period, patients were examined daily for the presence of OM, which was graded according to World Health Organization (WHO) classification if present. The patients were assigned to the groups according to type of transplantation: autologous HSCT, myeloablative allogeneic HSCT, and non-myeloablative allogeneic HSCT. Results: A total of 496 patients were included in the study. OM was present in 314 of 496 patients (63.3%): 184/251 (73.3%) in the autologous group, 100/151 (66.2%) in the myeloablative allogeneic group, and 30/94 (31.9%) in the nonmyeloablative allogeneic group. Significantly more patients suffered from OM in the autologous and myeloablative groups versus the nonmyeloablative conditioning group (p < 0.001). The presence of periodontal inflammation did not significantly differ among the groups. There was only a borderline trend for the higher prevalence of OM in the non-myeloablative allogeneic nonmyeloablative group when periodontal inflammation was present (0.073939). Conclusions: Oral mucositis prevalence and severity after stem cell transplantation is not widely affected by the oral hygiene and periodontal disease presence before HSCT. We confirmed the wide-known connection of the conditioning regimen intensity to the prevalence of OM.

Braided Glass Fiber Reinforced Composite Resin Bridge - An Alternative Treatment for Management of Missing Anterior Tooth: A Case Report

Missing anterior teeth is of great concern during a patient's lifetime in many communities. A variety of treatment options, from implants to traditional bridges are often used in order to replace missing anterior tooth. However, it is often accompanied by variety of barriers such as an increased number of chairside visits and better costs. Fibre-reinforced composites (FRCs) have gained increasing and great acceptance in mainstream prosthodontics as viable alternatives to alloy-based restorations recently. In compaison to other restorative systems this is often a conservative approach that carries a minimum risk of pulp exposure or sensitivity and periodontal inflammation, which maintains the health of supporting tissues. Therefore the aim of this case report was to present a clinical case of a congenitally missing mandibular central incisors bilaterally which were replaced by means of a FRC bridge wherein, we employed a semi-direct (direct and indirect) technique. This technique provides a conservative, esthetic, and noninvasive treatment, economically more acceptable, nonirritating, and noniatrogenic. FRC bridges can therefore be considered as a permanent treatment modality.

DECREASE OF β-DEFENSIN-2 LEVEL IN THE GINGIVAL CREVICULAR FLUID AS A POTENTIAL PREDICTOR OF THE DEVELOPMENT OF INFLAMMATORY PERIODONTAL DISEASES

β-defensin-2 (HBD-2) is a peptide of innate immunity that provides the first line of defenсe of the oral mucosa from the introduction of the pathobionts. Under inflammatory conditions epithelial cells and gingival fibroblasts produce HBD-2. The defective defensin secretion may play a crucial role in the development of inflammatory periodontal diseases. The study aimed to compare the levels of HBD-2 in the gingival fluid and/or the content of the periodontal pockets in patients with dental plaque-induced gingivitis (PG), aggressive periodontitis (AgP), chronic generalized periodontitis (CP) and in the periodontally healthy subjects (Control). We examined 142 patients (45.0 ± 1.03 years) from Moscow, including 11 patients with PG (35.7 ± 3.69 years), 43 patients with AgP (35.4 ± 0.84 years), 71 patients with CP (54.4 ± 0.86 years) and 17 controls (36.1 ± 2.92 years). We determined the periodontal tissues condition in all patients during the periodontal and X-ray examination. The samples of the gingival crevicular fluid and periodontal pocket content were collected by paper points from the gingival sulcus and periodontal pockets at 8 teeth of both jaws. The concentration (C) of β-defensin-2 was determined by enzyme immunoassay (ELISA Kit for Defensin Beta 2, Cloud-Clone Corp., USA). Mann-Whitney U-test (U), the Kruskal-Wallis test (H) and the Dwass-Steel-Critchlow-Fligner post hoc test (W) determined the difference significance between the parameters. We estimated the parameter relationship and its strength using the Spearmanʼs rank correlation coefficient (rS). The critical significance level was p ≤ 0.05.The present study showed that the progression of the periodontal inflammation is accompanied by a sharp decrease in the concentration of HBD-2 in patients’ samples (H = 42.8, df =3, p < 0.001). Thus, the concentration of HBD-2 in the gingival crevicular fluid of the periodontally healthy subjects (control group) ranged from 225 to 1720 pg/ml (C = 738 [477; 1114] pg/ml). In patients with PG the median value of the peptide concentration was 242 [42.5; 610] pg/ml (Cmin = 19 pg/ml, Cmax = 1000 pg/ml). In patients with periodontitis it dropped to critically low levels: CAgP = 54 [3; 195] pg/ml (Cmin = 0, Cmax = 478 pg/ml) and ССP = 25.5 [0; 125] pg/ml (Cmin = 0, Cmax = 298 pg/ml). Thus, we can consider the level of HBD-2 in the gingival crevicular fluid – a potential predictor of the development of inflammatory periodontal diseases.