CLINICAL ASSESSMENT OF THE CONDITION OF PERIODONTAL TISSUES IN PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS CLASS II

Introduction. Inflammatory diseases of periodontal tissue are one of the most prevalent worldwide. This pathology has a complex aetiology and ambiguous views on pathogenetic mechanisms; therefore, the approach to the assessment of periodontitis should be integrated. The aim of the study was to assess the state of periodontal tissues in patients with chronic generalized periodontitis class II and absent or compensated somatic pathology. Materials and methods. We examined 20 patients aged 35 to 45 years having a diagnosis of chronic generalized periodontitis class II who had no somatic pathologies or compensated somatic pathology. The patients underwent the assessment of their hygienic, gingival and periodontal indices, measuring the depth of periodontal pockets, the level of the gingival margin, loss of clinical attachment and bleeding during probing. Results. The average value of the Green-Vermillion hygienic index among the study group was 2.16, the papillary-marginal-alveolar index was 56%, and the periodontal Russell index was 3.4scores. The mean value of the depth of periodontal pockets was 3.75, and the loss of clinical attachment was 4.12. The average index of Müllemann's bleeding gums in the surveyed was 4.1. Conclusions. Аn integrated approach to assessing the state of periodontal tissues contributes to a better understanding of the epidemiology, characteristics of the course and predicting the consequences of chronic generalized periodontitis class II.

FEATURES OF THE CLINICAL STATE OF PERIODONTAL TISSUES IN YOUNG PEOPLE

Relevance of the research topic. The authors found that various risk factors play a leading role in changing the clinical state of periodontal tissues. The aim is a comparative assessment of the clinical condition of periodontal tissues based on the correlation of hygienic and periodontal indices depending on age. Material and methods. A comprehensive clinical examination of 765 young people was conducted. The main group consisted of 70 (66.6%) patients with diagnosed chronic gingivitis and 145 (33.35%) patients with mild initial periodontitis due to the presence of conditionally pathogenic and periodontopathogenic types of microorganisms in the microbial biofilm. The control group was formed by 83 patients whose index evaluation revealed the condition of periodontal tissues in the form of clinically healthy gums with intact periodontal and clinically healthy gums with periodontal tissue loss, respectively, in 61.4 and 38.6% of cases of observations. Study results. In 61.4% of persons forming groups with clinically healthy gums, hygienic and periodontal indices are within normal values, in 38.6% of cases of persons there is a tendency to change them from the norm. In 47.7% and 52.3% of cases of individuals with gingivitis and in 48.3% and 51.7% of individuals with initial periodontitis, the OHI-S index correlates with the indicators of PMA, GI and SBI (p < 0.001, p = 0.315). Conclusions. Thus, the revealed changes in the indicators of hygienic and periodontal indices (the Chuprov conjugacy coefficient is 0.64 (p = 0.012), the Kraskel-Wallis criterion (H = 7.89, p < 0.05) makes it possible to clearly determine the clinical condition of periodontal tissues corresponding to modern European criteria.

THE IMPORTANCE OF CYTOKINES OF ORAL FLUID AND PERIODONTOPATHOGENIC MICROBIOTA IN THE DEVELOPMENT OF GINGIVITIS AGAINST THE BACKGROUND OF PSYCHOEMOTIONAL STRESS IN CADETS OF THE DEPARTMENTAL INSTITUTE

Subject. Such a cytokine as transforming factor β (TFRß) deserves special attention in stress-induced gingivitis, since there are observations indicating its ability to stimulate the differentiation of myofibroblasts, which results in an increase in collagen production, the development of fibrous changes in the gum, which ultimately lead to tooth loss. Goal. The aim is to determine the relationship between the development of signs of depression, the frequency of detection of periodontal pathogenic bacteria and the spectrum of cytokines that play a likely role in the pathogenesis of gingivitis in cadets of the departmental institute under conditions of psychoemotional stress. Methodology. Psychological testing, clinical dental and laboratory examinations of 71 cadets of the departmental institute (41 women, 30 men) aged from 18 to 23 years were conducted. The detection of depression was carried out using the A. Beck scale, reactive and personal anxiety — Ch. Spielberger — Y.L. Khanin. To assess the periodontal condition, traditional hygienic and periodontal indices (OHI-s, RNR, PMA) were used. Identification of the marker DNA of periodontal pathogenic bacteria was carried out using a polymerase chain reaction using a test kit "Multident-5" manufactured by NPF GenLab (Russia). The content of cytokines in saliva was determined by solid-phase enzyme immunoassay. For the detection of IL-1β, IL-4, IL-10, IL-12, IFNu, TNFa, sets of NPO "Vector Best" (Russia) were used, for the cytokine TFRß — from Biosource (Canada). Results. It was found that the development of depression and gingivitis is accompanied by changes in the cytokine status, the main pathogenetic significance is IL-1β and TFRß, and the auxiliary is IL-12 and TNFa. At the same time, the cytokines IL-1β and TNFa are associated with the severity of the course of gingivitis. Conclusions. A correlation was established for the cytokines IL-1β, TNFa and TFRß with the first-order periodontopathogenic species A actinomycetemcomitans and T. forsythia.

EVALUATION OF AN ELECTRONIC PERIODONTAL PROBE VERSUS A MANUAL PROBE IN THE PERIODONTAL DIAGNOSIS OF CHILDREN AGED 12-14 YEARS

Objective: The purpose of the trial is to comparatively analyze an electronic, pressure-calibrated probe third generation Parometer (Orange) and a standard, manual measurement probe WHO 621 (C type) in the context of taking periodontal variables when assessing periodontal status in childhood. Materials and methods: The subject of the study were 28 children aged between 12 and 14 years (12 boys and 16 girls). All patients were clinically examined, and the data were recorded on a specially prepared card. The recorded clinical variables contain: Assessment of oral hygiene habits (type of toothbrush, frequency of brushing); OHI as per Green Vermillion; Registration of dental status; Depth of gingival sulcus (on all teeth) with both types of probes; BOP (bleeding on probing), percentage of bleeding units with both types of probes; Taking into account the complete time needed to take the findings and the sensation of pain experienced by a digital rank scale during probing. Results and conclusion: The average depth of gingival sulcus measured with a mechanical periodontal probe was 1.62 mm, and with an electronic one - 1.38 mm (p <0.05). Values ​​for BOP with both types of probes showed an average of 0.30 ± 0.29, which is 30% of all bleeding units examined (p> 0.05). The time for recording the periodontal indices with both probes is, on average, 10 minutes. In both probes, the discomfort of about grade 4 was observed according to the ranking scale used to read sensitivity (p <0.05). There is a more pronounced sensitivity when using an electronic periodontal probe.

The Potential of Aloe vera as an Active Ingredient in Toothpaste Formulations: A Narrative Review

Context: Tooth brushing is a primary method to prevent the onset of oral diseases. Aloe vera is commonly used in dentistry as an herbal alternative due to its anti-inflammatory and anti-microbial actions; recently, it has been used in toothpaste formulations as an active agent. This review aimed to investigate the clinical effects of A. vera as an active ingredient in toothpaste formulations. Materials and Methods: The data used in this review was extracted from articles published until 2020. We searched official databases, including Scopus, PubMed, Google Scholar, Embase, and Science Direct, using the “Aloe vera”, “dentifrice”, and “toothpaste” keywords. After screening titles and abstracts, relevant studies were used for full-text review. Results: Although conflicting results have been reported on the usage of A. vera toothpaste in different studies, the majority of findings suggest that A. vera effectively reduces periodontal indices and removes different organisms, including Streptococcus mutans. However, the overall effects of this herbal toothpaste were found to be equal to those of other commercial toothpaste. Conclusions: Aloe vera toothpaste is as beneficial as other kinds of toothpaste. Therefore, it can be used as an adjunct agent in toothpaste due to its established effects on improving periodontal problems and reducing different oral cavity micro-organisms.

Perio-Prosthodontics Considerations in Removable Partial Denture: The Role of the Prosthodontist

OBJECTIVE: To review the periodontal considerations associated with removable partial denture therapy. METHODOLOGY: Using a MEDLINE search, for "removable partial dentures periodontal", a total of 712 papers from peer-reviewed journals came in results. The MEDLINE search was made more specific by applying filters to the key phrase with other key words such as "periodontal evaluation"(140), "direct retainers"(77), "non-surgical periodontal"(8), "surgical periodontal"(180), "plaque"(249), "periodontal indices"(112), "tooth mobility,"(180) "periodontal maintenance,"(60) "splinting,"(198) and "split major connector"(2). Both in vivo and in vitro studies on the Perio-prosthodontic aspects of RPD treatment were included in the study pool whereas case Series and case reports were excluded. RESULT: A total of 1206 studies were collected from the search engine. After applying the exclusion criteria and filtering the duplicates a total of 95 studies were included for the narrative review. CONCLUSIONS: Out of all the factors, recall and oral and denture hygiene have the utmost importance. KEYWORDS: Perio-prosthodontics, removable partial denture, periodontal indices.

CLINICAL-STATISTICAL STUDY ON THE FREQUENCY AND ETIOLOGICAL FACTORS OF GINGIVAL HYPERPLASIA

Introduction. Gum hyperplasia is clinically translated by growth in gum size, edema and bleeding (over-normal bags). The gum may be thin or fibrous, firm (in pseudotumor forms). In the absence of proper treatment, it will be associated with the bone resorption of the alveolar process, leading to different degrees of dental mobility. Purpose. Through this clinical-statistical study, we aim to analyze patients diagnosed with gum hyperplasia by age, gender, type of gum hyperplasia, etiology and localization. Also, by observing in surgical practice more and more cases of gum hyperplasia in patients with orthodontic treatment, through this clinical-statistical study, we aim to quantify the incidence of gingival hyperplasia in orthodontic treatments carriers and its distribution by gender. Material and method. The study is retrospective type, performed on 172 patients with the diagnosis of gum hyperplasia (K06.1), treated in the Oro-maxillo-facial surgery Clinic in Targu Mures, during Jan.2015-march 2021. Hypocrate concept 3 was used to access patient observation sheets. Results and discussions. Analyzing the descriptive statistical data of this retrospective clinical-statistical study, it is observed that the average age of the subjects is 58 years, the distribution by sex favors the female gender (59%), generally occurs in adults, has affinity for the right hemimaxilla, approx. 25% of patients have gingival hyperplastic lesions caused by orthodontic appliances and mobile/mobilizable prostheses. These types of lesions represent a ratio of 2/1 in favor of females, which indicates that the aesthetic requirements for females are much higher compared to males. Also, interpreting, from a medical point of view, the statistical conclusions of this study, we find that the patient's gender does not influence the location and appearance of the hyperplasic lesion, instead the age of the patients influences the occurrence of the hyperplastic lesion. Conclusion. Orthodontic therapy should be indicated after a correct evaluation of periodontal tissues, quantification of periodontal indices and detection of risk factors.

CORRELATION BETWEEN PERIODONTAL INDICES [PLAQUE INDEX (PI), GINGIVAL INDEX (GI)] AND GLYCATED HEMOGLOBIN (HBA1C), IN TYPE 2 DIABETES MELLITUS.

Objectives:The objective was to find out Correlation between the clinical (periodontal indices) and metabolic changes (glycated hemoglobin) following non-surgical periodontal treatment (pre and post),in diabetic (Type 2) patients. Material and methods: Forty type 2 diabetic patients with generalized chronic periodontitis were selected. Subjects were randomly assigned into two groups. Data collection: st rd Periodontal indices [Plaque index (PI), gingival index (GI)], were recorded at baseline, 1 and 3 st rd months. glycated hemoglobin (HbA1c), was analyzed at baseline, 1 and 3 months following the non surgical periodontal therapy. The treatment group received scaling and root planning whereas the control group received no periodontal treatment. Results:The results showed significant Correlation between periodontal indices and,levels of HbA in Type 2 diabetes 1c mellitus patients. Summary and conclusions: Non surgical periodontal therapy is associated with improved glycemic control in Type 2 diabetes mellitus patients.

Improving of treatment of periodontal diseases in workers of the woodworking industry of the Chernivtsi region

Goal. Improving the scheme of treatment and prevention of periodontal diseases in workers of the woodworking industry of Chernivtsi region, who in the process of professional activity have long-term contact with unfavorable factors of the production environment. Materials and methods. 70 workers of the woodworking industry with diagnosed chronic generalized periodontitis of the I degree were treated (35 people – the main group (A); 35 people – comparison group (B)), age – from 25 to 45 years. To compare the results of laboratory studies, an additional survey of 25 healthy individuals of the same age with an intact periodontium were conducted. They formed the control group (C). Clinical examination of patients was performed according to standart methods: subjective (complaints, medical history, life history) and objective (examination, periodontal indices, determination of the level of gingival attachment). Laboratory methods of research included determination of urease and lysozyme activity in saliva, degree of dysbiosis of oral cavity. As maintenance therapy, patients of the main group were prescribed the proposed composition DEPE. Results. After the treatment, a significant improvement in the hygienic status of patients in both groups was observed, but difference between groups A and B in the indicators of oral hygiene after treatment was no statistically significant (pA2–B2 > 0.05). There was a significant improvement in periodontal indices after treatment in patients of both groups (PMA index according to C. Parma, bleeding index according to Muhlemann in Cowell I. modification, Russell periodontal index, PSR-test), but the indicators in patients of the main group were significantly better – pA2–B2 < 0.05. In patients of the main group (A) the level of attachment loss decreased by 1.83 times, comparison group (B) – by 1.71 times. The difference in levels of attachment loss after treatment between groups A and B is statistically significant (pA2–B2 < 0.05). The activity of the enzyme urease in patients of the main group (A) and comparison group (B) after treatment was significantly reduced (pA1–A2 < 0.001, pB1–B2 < 0.001), but only in the main group it reached the level in the control group (C) (pA2–C > 0.05). The level of lysozyme after treatment was significantly increased in patients of both observation groups (pA1–A2 < 0.001, pB1–B2 < 0.001), and reached the level of lysozyme in patients of the control group (C) (pA2–C > 0.05, pB2–C > 0.05). The degree of oral dysbiosis in patients of the main group (A) was significantly reduced by 5.43 times (pA1–A2 < 0.001), and its difference from the degree of dysbiosis in patients of the control group (C) is statistically insignificant (pA2–C > 0.05 ). The degree of oral dysbiosis in patients of the comparison group (B) was significantly reduced by 3.04 times (pB1–B2 < 0.001), but still remained significantly different from oral dysbiosis in patients of the control group (C) (pB2–C < 0.05). Conclusion. The proposed pharmacological composition DEPE is an effective antiseptic solution and can be used in the phase of maintenance therapy to improve the treatment and prevention of periodontal disease in workers of woodworking industry. Key words: decamethoxine, propolis, ethonium, generalized periodontitis, woodworking industry.