Periodontal Implications of Hepatitis C Infection

Periodontal tissues exhibit important vascular, lymphatic, and nervous connections with the rest of the body. Thus, periodontal inflammation caused by the interaction between the subgingival bacterial biofilm and the host immune response has an impact reaching further than the oral cavity. The concept of “periodontal medicine” reunites the bidirectional relationships that exist between periodontal disease and systemic conditions such as diabetes mellitus or cardiovascular disease. The chronic inflammation of hepatic tissues during hepatitis C virus (HCV) infection causes changes in the general homeostasis that can reverberate at periodontal level and influence periodontal inflammation. Various mechanisms such as insulin resistance or pro-inflammatory cytokines production could be the link between the two conditions. In addition, periodontal inflammation could impact HCV transmission, as HCV RNA molecules and antibodies have been found in infected patients’ saliva and gingival fluid. During periodontal inflammation, gingival bleeding is frequent, and the viral molecules could enter oral fluids while being carried by peripheral blood cells. Clinical particularities that suggest the onset of periodontal disease have also been frequently observed in HCV-infected patients. The connections between periodontal disease and hepatitis C need to take into consideration by practitioners of both specialties due to their important implications on clinical manifestations and treatment strategies

Identification of C-Reactive Protein from Gingival Crevicular Fluid in Systemic Disease

Periodontitis is associated with elevated C-reactive protein (CRP) in both serum and gingival crevicular fluid (GCF). Although the liver is the primary source of CRP, extra-hepatic production of CRP has been reported. This study aimed to determine whether CRP in GCF is produced locally in the gingivae. Material and methods Gingivae and GCF were collected from non-periodontitis and periodontitis sites. Presence of CRP in gingivae was assessed by immunohistochemistry. CRP in GCF was measured using ELISA. Gene expression for CRP in gingivae was determined using real-time polymerase chain reaction. Results CRP was found in both the gingivae and GCF. No gingivae had detectable amounts of CRP mRNA. Not all patients with periodontitis had detectable levels of CRP in the GCF. Some non-periodontitis patients had detectable levels of CRP in the GCF. Conclusions CRP in the GCF appears to be of systemic origin, and therefore may be indicative of systemic inflammation from either a periodontal infection or inflammatory disease elsewhere. The correlation between levels of CRP in GCF and serum requires validation in future studies

THE INFLUENCE OF DYSLIPIDEMIA ON THE PERIODONTAL STATUS IN TYPE 2 DIABETES MELLITUS PATIENTS

Introduction Diabetes mellitus and hyperlipidemia are independent risk factors for the periodontal disease; patients with type 2 diabetes mellitus frequently present an impaired lipid profile. Aim of the study We proposed an evaluation of the periodontal status in type 2 diabetic patients, with and without dyslipidemia. Material and methods The study was conducted on 43 patients, divided in two groups: study group (patients with type 2 diabetes mellitus and hyperlipidemia) and the control group (patients with diabetes but without hyperlipidemia). The lipid profile was assessed and every patient was submitted to periodontal clinical examination. Results The study group presented significantly higher values of the periodontal parameters (probing depth, clinical attachment loss, bleeding on probing) than the control group. Discussions Patients with dyslipidemia (already in high risk of periodontal disease due to the presence of diabetes mellitus) can present a significant risk to periodontal tissue breakdown. There is also to be mentioned that a vicious circle becomes existent, the periodontal disease itself enhancing the systemic inflammatory status and predisposing to a poor glycaemic control. Conclusions The patients with diabetes mellitus and hyperlipidemia exerted higher values of the parameters relevant for the periodontal inflammation and tissue loss than the patients without dyslipidemia

THE IMPACT OF KINETO-THERAPY AND OF THERAPEUTICALLY MASSAGES TO IMPROVE LIFE QUALITY OF PATIENTS WITH SDSS

Muscular relaxation offers the opportunity of muscular reconditioning by means of balneotherapy with the establishment of new neural-muscular engrams. Our study aims investigation of two methods of treatment ,through kinetics factors and massage therapy, the assessment of action and efficiency, along with the integration of these methods within a therapeutic algorithm that would finally, lead to stomatognathic system and cephalic musculature homeostasis

ORAL AND SYSTEMIC COMPARATIVE ANALYSIS OF MALONDIALDEHYDE IN PATIENTS WITH DIABETES AND CHRONIC PERIODONTITIS

The effects mediated by free radicals can scan severe destructions toward lethal effects on the cells. The oxidation of polyunsaturated fatty acids is one of the main effects, with the possibility of severe damage through oxidation of cellular enzymes. Objectives. The present clinical and biochemical study was designed to evaluate the role of serum and crevicular fluid (GCF) malondialdehyde (MDA) levels in patients with chronic periodontitis (CP) and diabetes mellitus (DM) as a marker of oxidative stress. Material and methods. The study group consisted of 40 subjects, aged 25-45 years. Subjects were divided into three groups according to clinical signs of periodontal alteration: group 1-control (n = 10) without systemic or periodontal alterations, group 2 (n = 15) with chronic periodontitis without diabetes, group 3 (n = 15 ) with diabetes and periodontal alter. For each patient serum and GCF MDA values have been evaluated. Results. Levels of MDA in both serum and GCF recorded the highest value for group 3, followed by average values in group 2, the lowest being registered in the control group. Conclusions. MDA may be a marker of oxidative stress in CP associated to D

Studies Regarding The Bidirectional Relationship Between The Periodontal Disease And Hyperlipidaemia

Introduction Hyperlipidaemia is influenced by the oral diseases, especially by the periodontal disease. The systemic exposure to infection challenges may have as a result the release of inflammatory cytokines, modifying the lipid metabolism, promoting hyperlipidaemia and atherosclerosis. Aim of the study The present study was conducted in order to assess the levels of cholesterol, low density lipoproteins (LDL), high density lipoproteins (HDL) and triglycerides on subjects with and without periodontal disease. Materials and methods We selected for the study a group of 36 male subjects and 24 female subjects, with the age between 30 and 50 years. We analysed separately the biochemical markers evolution, for a more efficient scientific presentation of the date obtained. Results and discussions The obtained values indicated a strong relation between the lowering of the lipid profile and the periodontal health; we also observed the diminishing of the plasmatic lipidc concentrations. The pathological levels of the triglycerides were around 6.5 times more frequent in periodontitis patients than in control group subjects, while no HDL difference was observed. Conclusions Pro-arteriogenic modifications of plasmatic lipids and blood glucose levels observed in periodontal disease patients may provide further evidence of a tight association between the periodontal disease and cardiovascular disease, with a possible role of hyperlipidaemia in periodontal disease

MAXILLARY GROWTH PATTERNS IN ROMANIAN CHILDREN WITH CLEFT PALATE AGED BETWEEN 0-6 YEARS

A study documenting spontaneous and coordinated growth changes in young Romanian children with cleft palate is developed, for identifying the functional adaptations of oral cavity to the disrupted architecture of palate in children with cleft palate, the 3D analysis of maxillary casts being applied to visualize, evaluate and measure maxillary growth in patients with cleft palate, as well as to identify the reactive morphological pattern that could be imagined from the dimensional changes produced in the first 6 years of life. Two experimental groups were involved in the study, a former one, including 44 patients with cleft palate (16 boys and 28 girls), aged between 2 months and 6 years, operated by the same surgical team in the St.Mary University Children Hospital from Ia[i. The resulting maxillary casts were 3D scanned at Multinr company, in Sf. Gheorghe. The maxillary alveolar arch lines, the 4 Stilmann points (TD, TS, CD, CS) and the maxillary interincisive point were identified and marked by the orthodontist, being reproduced with 6 degrees of tridimensional freedom. The coordinates of this point were transferred to the CAD system, to graphically recreate the computerized three-dimensional alveolar arch. 4 direct measurements have been made, namely: anterior and posterior diameter of the alveolar maxillary arch, length of the alveolar arch and depth of the palate. Student’s t test, both simple and bivariate, performed with SPSS 13.0 soft, showed statistic significance for the dimensional differences of the alveolar maxillary arch in children with cleft palate, comparatively with the healthy control group. Conclusion: Cleft palate patients have narrower and shorter maxillary alveolar arch and a flattened palate

ROLUL MALONDIALDEHIDEI ÎN EVALUAREA STATUSULUI OXIDATIV DIN DEPRECIERILE TERITORIULUI PARODONTAL

Periodontal disease includes multiple and complex mechanisms that simultaneously encapsulate tissue destruction due to bacterial aggression, as well as exaggerated defense mechanisms of the host, which give rise to multiple contradictions in etiopathogenesis and management of the disease, the oxidative status playing a significant role. Objective. Considering the importance of the pro- and antioxidants balance within periodontal condition, we designed a clinical and biochemical study to estimate the levels of a biomarker of oxidative stress, malondialdehyde – MDA in the gingival fluid (GCF). Material and methods. The assessment has been performed in clinically healthy subjects (n=15) and periodontal patients with chronic periodontitis (n=16) versus aggressive periodontitis (n=11). Being a marker of lipid peroxidation, for all individuals malonyldialdehyde gingival fluid levels has been determined from the isolated supernatant, following centrifugation of crevicular fluid, through colorimetry techniques. Results. The separate MDA assessment displayed statistical significance of the values recorded in patients with chronic periodontitis compared to the group of healthy patients (p <0.0001), but also those with the aggressive form of disease (p <0.0001), without statistically significance between the two types of periodontal impairment. Conclusion. Despite the limitations imposed by the small size of the sample, the results obtained may be relevant, MDA being the only biomarker considered for determination. However, measuring other lipid peroxidation products such as conjugated dienes, volatile hydrocarbonates could shed some light upon the dimension of the pro/antioxidant balance in the development of periodontal impairment

EVALUATION OF CLINICAL EFFECTS OF OCCLUSAL TRAUMA ON GINGIVAL RECESSION

Aim of the study The aim of this study was to investigate the occlusal contacts during maximum intercuspation to protrusive, lateroprotrusive and lateral excursive movements and their effects on gingival recession. Material and methods Fourteen subjects having gingival recession aged by 18–53 years old were selected, examined about the location and extent of gingival recession and occlusal wear facets were recorded. The type of occlusion and the nature of occlusal contact in maximum intercuspation and eccentric mandibular movements were also recorded using articulating foil. Results Our results indicated that gingival recession was more frequent in patients with occlusal function group than at patients with occlusal canine protection. At patients with occlusal canine protection gingival recession was located on the labial surface while at patients with function group recession was equally distributed on vestibular surface of the teeth in the anterior and posterior areas. Almost all patients with interference in protrusive, lateroprotrusive movements had teeth with gingival recession. Also abrasion was observed in most teeth with gingival recession. Conclusions These results suggest that occlusal interferences in maximum intercuspation and eccentric movements in one form or the other and absence of mutually protected occlusion can contribute to gingival lesions such as gingival recessions