periodontal tissues
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Biagio Rapone ◽  
Elisabetta Ferrara ◽  
Luigi Santacroce ◽  
Skender Topi ◽  
Antonio Gnoni ◽  

Background: the establishment of periodontitis is regulated by the primary etiological factor and several individual conditions including the immune response mechanism of the host and individual genetic factors. It results when the oral homeostasis is interrupted, and biological reactions favor the development and progression of periodontal tissues damage. Different strategies have been explored for reinforcing the therapeutic effect of non-surgical periodontal treatment of periodontal tissue damage. Gaseous ozone therapy has been recognized as a promising antiseptic adjuvant, because of its immunostimulating, antimicrobial, antihypoxic, and biosynthetic effects. Then, we hypothesized that the adjunct of gaseous ozone therapy to standard periodontal treatment may be leveraged to promote the tissue healing response. Methods: to test this hypothesis, we conducted a prospective randomized study comparing non-surgical periodontal treatment plus gaseous ozone therapy to standard therapy. A total of 90 healthy individuals with moderate or severe generalized periodontitis were involved in the study. The trial was conducted from September 2019 to October 2020. Forty-five patients were randomized to receive scaling and root-planning (SRP) used as conventional non-surgical periodontal therapy plus gaseous ozone therapy (GROUP A); forty-five were allocated to standard treatment (GROUP B). The endpoint was defined as the periodontal response rate after the application of the ozone therapy at 3 months and 6 months, defined as no longer meeting the criteria for active periodontitis. Statistical analysis was performed employing SPSS v.18 Chicago: SPSS Inc. Results: periodontal parameters differed significantly between patients treated with the two distinct procedures at 3 months (p ≤ 0.005); a statistically significant difference between groups was observed from baseline in the CAL (p ≤ 0.0001), PPD (p ≤ 0.0001) and BOP (p ≤ 0.0001) scores. Conclusions: The present study suggests that SRP combined with ozone therapy in the treatment of periodontitis revealed an improved outcome than SRP alone.

2022 ◽  
Vol 23 (2) ◽  
pp. 962
Xingzhi Wang ◽  
Nitesh Tewari ◽  
Fuyuki Sato ◽  
Keiji Tanimoto ◽  
Lakshmi Thangavelu ◽  

Sodium fluoride (NaF) is widely used in clinical dentistry. However, the administration of high or low concentrations of NaF has various functions in different tissues. Understanding the mechanisms of the different effects of NaF will help to optimize its use in clinical applications. Studies of NaF and epithelial cells, osteoblasts, osteoclasts, and periodontal cells have suggested the significant roles of fluoride treatment. In this review, we summarize recent studies on the biphasic functions of NaF that are related to both soft and hard periodontal tissues, multiple diseases, and clinical dentistry.

Antioxidants ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 135
Iwona Olszewska-Czyz ◽  
Kristina Kralik ◽  
Marin Tota ◽  
Jelena Prpic

Periodontitis is a common oral disease affecting the tooth-supporting tissues. Bacteria have been long viewed as the main causative factor in its development; however, many investigations have proved that aberrant immune and inflammatory response and the resulting misbalance between the damage caused by reactive oxygen species and the antioxidant capacity of tissues may be an underlying factor in disease progression that reduces healing potential. The objective of the current trial is to assess the outcomes of the addition of hyaluronic acid (HA) to standard non-surgical periodontal therapy (NST) on some major oxidative stress markers in saliva. HA-based gel designed for dental application was used and the measurements were taken after 3 months. HA adjunctive therapy had a significantly greater increase in markers with antioxidant properties as well as total antioxidant capacity compared to standard NST alone. Furthermore, clinically measured levels of gingival inflammation (bleeding on probing-BOP) and periodontal destruction (clinical attachment loss-CAL) were significantly correlated with these markers, and the correlation was negative. This investigation demonstrates that HA may indeed express antioxidant properties and improve the antioxidant capacity of periodontal tissues, thus improving the prognosis for the teeth and the results of periodontal therapy. Further investigations will be necessary to determine the duration of these effects over time.

Andreas Grigoriadis ◽  
Ismo T. Räisänen ◽  
Pirjo Pärnänen ◽  
Taina Tervahartiala ◽  
Timo Sorsa ◽  

AbstractThe coronavirus disease-2019 (COVID-19) pandemic greatly affected human well-being, social behavior, global economy, and healthcare systems. Everyday clinical practice in dentistry has been adjusted to the increased hazards of aerosol production by routine dental procedures. The objective of this study was to assess the existing literature to determine possible mechanisms of a relationship between COVID-19 and periodontitis, as well as describe findings from relevant epidemiological studies.Scarce data exist in the literature that directly addresses the relationship between the two diseases. However, several data describe the role of the oral cavity and periodontal tissues as portals of entry of severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2), and the contribution of cytokines known to be produced in periodontal disease to severe forms of COVID-19. It is also suggested from the current literature that periodontal disease, shown to be associated with systemic diseases such as diabetes mellitus, cardiovascular and respiratory diseases, shares common risk factors with—especially—severe forms of COVID-19.Further clinical studies are required to establish the relationship between these diseases. Oral hygiene performance and intact periodontal tissues can assist in mitigating the pandemic, and it is suggested that dental practitioners can contribute to identifying at-risk patients.

Dorota Satala ◽  
Miriam Gonzalez-Gonzalez ◽  
Magdalena Smolarz ◽  
Magdalena Surowiec ◽  
Kamila Kulig ◽  

Periodontal disease depends on the presence of different microorganisms in the oral cavity that during the colonization of periodontal tissues form a multispecies biofilm community, thus allowing them to survive under adverse conditions or facilitate further colonization of host tissues. Not only numerous bacterial species participate in the development of biofilm complex structure but also fungi, especially Candida albicans, that often commensally inhabits the oral cavity. C. albicans employs an extensive armory of various virulence factors supporting its coexistence with bacteria resulting in successful host colonization and propagation of infection. In this article, we highlight various aspects of individual fungal virulence factors that may facilitate the collaboration with the associated bacterial representatives of the early colonizers of the oral cavity, the bridging species, and the late colonizers directly involved in the development of periodontitis, including the “red complex” species. In particular, we discuss the involvement of candidal cell surface proteins—typical fungal adhesins as well as originally cytosolic “moonlighting” proteins that perform a new function on the cell surface and are also present within the biofilm structures. Another group of virulence factors considered includes secreted aspartic proteases (Sap) and other secreted hydrolytic enzymes. The specific structure of the candidal cell wall, dynamically changing during morphological transitions of the fungus that favor the biofilm formation, is equally important and discussed. The non-protein biofilm-composing factors also show dynamic variability upon the contact with bacteria, and their biosynthesis processes could be involved in the stability of mixed biofilms. Biofilm-associated changes in the microbe communication system using different quorum sensing molecules of both fungal and bacterial cells are also emphasized in this review. All discussed virulence factors involved in the formation of mixed biofilm pose new challenges and influence the successful design of new diagnostic methods and the application of appropriate therapies in periodontal diseases.

2021 ◽  
pp. 20-26
I. A. Voronkina ◽  
V. F. Dyachenko ◽  
A. M. Maryuschenko ◽  
E. S. Serdechna ◽  
V. G. Rusanova

The problem of the purulent inflammatory disorders of periodontal tissues (PIDPT) at the present time is extremely prevalent. According to the World Health Organization (WHO), around 80% of people suffer from periodontal diseases, and the disease incidence among young people increases significantly and reaches up to 80-95 %. The aim of the present research was to study the composition of microflora of gingival pockets in patients with purulent inflammatory periodontal diseases (PIDPT) in order to establish the specific weight of the determined microbial associations. Materials and methods. Microbiological researches included isolation and identification of bacteria that were present in the gingival pockets of patients with different types of PIDPT. Identification of anaerobic microorganisms and associated microflora was carried out with the help of commonly used classical bacteriological methods, with determination of biochemical properties of the microorganisms cultures using APІ and ANAEROtest 23. Results. There were 192 patients studied in total, all aged older than 20 with diagnoses acute and chronical periodontitis, aggressive periodontitis, hypertrophic pulpitis, granulating periodontitis, parodontopathy, and local periodontitis with a presence of fistula. During the analysis of composition of the microflora isolated from periodontal tissue in patients with PIDPT, the following pathogens were isolated most frequently during the bacteriological research: Streptococcus spp., Staphylococcus spp., Neisseria spp., Stomatococcus spp., and Enterococcus spp. (58%). The quantity of periodontally pathogenic microorganisms was constituted 19,3% from the total quantity of isolated streains (81 isolates). The most numerous group was determined to be the “orange” complex (59,3%) – isolates of Prevotella melaninogenica, Fusobacterium nucleatum, Parvimonas micra. The least numerous was the group of “green” complex - (2,5 %) – Streptococcus mitis. Periodontally pathogenic representatives of microbiota in all cases were isolated as a part of associations with other bacteria. The presented materials signified that the periodontally pathogenic agents of the “red” and “orange” complexes were isolated together with representatives of Streptococcus spp - 33 (56,0 %) associations; Staphylococcus spp - 11(18,6%) – associations. Also in 13 cases (22,1 %) of associations the associated flora was represented by Candida spp. fungi. Conclusions. In course of the research, 4 species of “red” and “orange” complexes were identified, and the quantity of different associations there were present in was significant. There were 22 associations determined. The obtained date concerning microbial associates in the content of gingival pockets in PIDPT show the necessity of individual approach during treatent of this patient group, with taking into account the microbial diversity.

2021 ◽  
pp. 72-75
M. M. Rozhko ◽  
M. V. Pavlyshyn ◽  
A. I. Grybyk

The aim of the research is to increase the effectiveness of treatment of patients with chronic catarrhal gingivitis living in ecologically favorable conditions and in ecologically polluted regions of Precarpathian, by adding to the complex therapy of quercetin and chlorhexidine dent. The results of research by a number of scientists indicate that the use of quercetin in complex therapy helps to restore the antioxidant system, improve oxygen uptake by tissues and peripheral circulation, improve the rheological properties of the patient's blood. These properties of the drug were used by us in the research. We studied changes in periodontal tissues in children living in ecologically favorable conditions and in ecologically polluted regions of Precarpathian, conducted a comparative characterization of changes in periodontium and proposed a treatment plan for patients with chronic catarrhal gingivitis, supplemented with chlorhexidine dent and quercetin. We examined 60 children with chronic catarrhal gingivitis living in the contaminated areas of Precarpathian (Burshtyn) and 15 people with intact periodontium living in environmentally stable conditions. All patients underwent a full range of treatment measures, taking into account the removal of dental plaque and rehabilitation of the oral cavity. In 1 group of patients (30 people) patients were treated with chlorhexidine, calendula and chamomile infusion and 1% mefenamine paste. Patients of group 2 (30 people) - the drug quercetin on the mucous membrane of the gums under the individual gingival cap and chlorhexidine dent in the form of oral baths. In order to compare the two groups, an index assessment of the condition of periodontal tissues and a study of rheographic parameters of periodontal tissues were performed. The results of the research did not show a significant difference between clinical and laboratory parameters in patients 1 and 2 groups before treatment (p> 0.05), but they differed significantly from those in the comparison group (p <0.05), which indicates the fact that unfavorable environmental living conditions have an impact on the course of periodontal disease in children. We obtained a significant difference in the blood supply to periodontal tissues in patients with chronic catarrhal gingivitis compared with (p <0.05). The results of the research showed that the use of quercetin and 0.12% chlorhexidine solution in the complex treatment of patients with chronic catarrhal gingivitis provided a significant improvement in clinical parameters and laboratory characteristics of periodontal tissues in children living in different environmental conditions, and provided stabilization of these indicators in long-term observation. The use of the proposed scheme of treatment of patients with chronic catarrhal gingivitis stimulates metabolic processes in periodontal tissues, reduces cyanosis, edema of periodontal tissues according to the results of rheography of periodontal tissues. After treatment, we observe the normalization of the rheological characteristics of the gums, which indicates an improvement in blood circulation in the periodontal tissues in these patients (normalization of qualitative and quantitative characteristics of rheograms).

2021 ◽  
Vol 23 (1) ◽  
pp. 372
Mariane Beatriz Sordi ◽  
Ricardo de Souza Magini ◽  
Layla Panahipour ◽  
Reinhard Gruber

Pyroptosis is a caspase-dependent process relevant to the understanding of beneficial host responses and medical conditions for which inflammation is central to the pathophysiology of the disease. Pyroptosis has been recently suggested as one of the pathways of exacerbated inflammation of periodontal tissues. Hence, this focused review aims to discuss pyroptosis as a pathological mechanism in the cause of periodontitis. The included articles presented similarities regarding methods, type of cells applied, and cell stimulation, as the outcomes also point to the same direction considering the cellular events. The collected data indicate that virulence factors present in the diseased periodontal tissues initiate the inflammasome route of tissue destruction with caspase activation, cleavage of gasdermin D, and secretion of interleukins IL-1β and IL-18. Consequently, removing periopathogens’ virulence factors, triggering pyroptosis, is a potential strategy to combat periodontal disease and regain tissue homeostasis.

2021 ◽  
pp. 80-84
I.P. Mazur ◽  
V.A. Habal ◽  
M.S. Drohomyretska ◽  
K.M. Lykhota

The purpose of this review was to analyze and summarize the available literature data on changes of oral tissues in menopausal/postmenopausal women. We searched for the relevant references in Pubmed database using appropriate key words. We had revealed about 3,500 references on these topics and analyzed the most relevant. Postmenopausal women have an increased risk of the decrease of bone mineral density due to estrogen deficiency. Estrogens induce osteoclast apoptosis and intensity of this protective mechanism decreases after the cessation of menstruation. Most cross-sectional radiographic studies have confirmed an association between age-related osteoporosis and decreased alveolar bone height. It has been established that postmenopausal women with generalized chronic periodontitis are characterized by severe destruction of the periodontium, which progresses in parallel to a decrease in bone mineral density. Sex hormones maintaining bone integrity and strength, involved in regulating the proliferation, differentiation, and growth of keratinocytes and fibroblasts of the gums. The effect of low estrogen levels on keratinization of the gum epithelium and decreased salivation can lead to menopausal gingivostomatitis. Estrogen deficiency also adversely affects the microenvironment of gingival sulcus, including the composition and circulation of crevicular fluid. Postmenopausal women have lower salivary pH and lower salivation, which is associated with deterioration of periodontal tissues. In addition, the postmenopausal period is characterized by the changes in the microbial composition of the oral cavity, IgG decreases in the crevicular fluid and prooxidant changes of saliva. Conclusions. The oral cavity status in menopausal and postmenopausal women undergoes significant changes: a decrease in bone mineral density, dryness of mucous membranes, microbiome changes, and activation of oxidative and immune processes. These changes necessitate regular examinations, timely treatment and application of all measures of preventive dentistry. There is also a need for randomized clinical trials and create standardized guidelines for the management of postmenopausal patients with periodontal disease.

Aleksandra Ciesielska ◽  
Aida Kusiak ◽  
Agata Ossowska ◽  
Magdalena Emilia Grzybowska

Oral health awareness during the menopausal period is essential to minimize the inevitable inconveniences which may occur due to hormonal changes. The decrease in estrogen hormone concentration impacts the oral mucosa in a similar way to the vaginal mucosa due to the presence of estrogen receptors in both of these structures. An estrogen deficiency also affects the maturation process of the oral mucosal epithelium and can lead to its thinning and atrophy, making it more susceptible to local mechanical injuries, causing a change in pain tolerance and problems in the use of removable prosthetic restorations. Mucosal epithelium during the menopausal period is more vulnerable to infections, candidiasis, burning mouth syndrome, oral lichen planus (OLP), or idiopathic neuropathy. Moreover, salivary glands are also hormone-dependent which leads to changes in saliva secretion and its consistency. In consequence, it may affect teeth and periodontal tissues, resulting in an increased risk of caries and periodontal disease in menopausal women. Due to the large variety of complaints and symptoms occurring in the oral cavity, menopausal women constitute a significant group of patients who should receive special preventive and therapeutic care from doctors and dentists in this particular period.

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