Investigations on the changes of plasma lipid levels and periodontal disease status

Rezumat. Introducere: Recent, s-a demonstrat că subiecţii cu hipercolesterolemie şi boală cardio-vasculară au o condiţie parodontală semnificativ agravată. Mai mult, gradul de alterare parodontală a fost corelat pozitiv cu nivelele plasmatice ale colesterolului (Pohl si col. 1995). Scop: În studiul prezent, am măsurat timpul de metabolizare a lipidelor plasmatice, ca şi glicemia la pacienţii non-diabetici cu boala parodontală şi în lotul de control. Material şi metodă: Pentru acest studiu au fost selectaţi 39 de pacienţi cu boală parodontală (20 femei şi 19 barbati, cu vârsta între 50-60 de ani, media de 54.4±3.1) şi 40 de pacienţi în lotul de control (25 femei şi 14 barbaţi, cu vârsta între 50-60 de ani, media 54.4±2.8). După înscrierea în grupul de studiu cu parodontită, precum şi subiecţilor din lotul de control li s-a cerut să discute cu medicul de familie pentru măsurarea lipidelor plasmatice à jeun precum şi concentraţiile de glucoză din sânge. Măsurătorile au fost efectuate într-un laborator de biochimie folosind metode enzimatice de rutină. Rezultate: Nivelele medii plasmatice de colesterol şi nivelurile de LDL colesterol la subiecţii parodontită au fost în mod semnificativ mai mari cu aproximativ 8% şi 13% în comparaţie cu subiecţii de control. De asemenea, valorile trigliceridelor plasmatice au fost mai mari la pacienţi decât la subiecţii de control (+39%), dar nici o diferenţă nu a fost observată pentru colesterolul HDL. Concluzii: Modificările pro-aterogenice ale lipidelor plasmatic şi a glucozei sanguine care au fost observate la pacienţii cu boală parodontală pot furniza dovezi ulterioare ale unei asocieri strânse între boala parodontală şi boala cardiovasculară.Totuşi, nu este încă sigur dacă modificările observate în metabolismul glucozei şi cel lipidic sunt o cauză sau o consecinţă a bolii parodontale.Summary: Introduction: Recently, it was shown that subjects with hypercholesterolemia and cardiovascular disease have a significantly increased periodontal condition. More, the degree of periodontal deterioration was positively correlated with serum cholesterol levels (Pohl and cervix. 1995). Purpose: In the present study, we measured plasma lipid metabolism and level of glucose in non-diabetic patients with periodontal disease and control group. Methods: For this study were selected 39 patients with periodontal disease (20 women and 19 men aged 50-60 years, mean 54.4 ± 3.1) and 40 patients in the control group (25 women and 14 men, aged between 50-60 years, mean 54.4 ± 2.8). After enrollment in the study group with periodontitis and control group subjects were asked to discuss with their doctor to measure fasting plasma lipids and blood glucose. Measurements were performed in a biochemistry laboratory using routine enzymatic methods. Results: The mean plasma levels of cholesterol and LDL cholesterol levels in periodontitis subjects were significantly higher about 8% and 13% compared with control subjects. Also, plasma triglyceride levels were higher in patients than control subjects (39%), but no difference was not observed for HDL cholesterol. Conclusions: Changes pro-atherogenic plasma lipids and blood glucose were observed in patients with periodontal disease may provide further evidence of a close association between periodontal disease and cardiovasculare disease. Evan that, is still uncertain whether the observed changes in glucidic metabolism and in the lipidic one is a cause or a consequence of periodontal disease

Clinic and microbiological changes in subgingival microflora after periodontal therapy

Summary Objective: To investigate (1) reduction in the number of microorganisms obtained directly after subgingival instrumentation, (2) rate of bacterial re-colonization during 2 weeks, under subgingival plaque-free conditions. Materials and Methods: Effects of subgingival instrumentation were measured at one deep pocket in 22 patients (11 smokers and 11 non-smokers). Immediately after initial therapy, experimental sites, under strict plaque control, were instrumented subgingivally. Microbiological evaluation was performed at pre-instrumentation, immediate post-instrumentation and 1 and 2 weeks post-instrumentation. Results: Mean total anaerobic clolony forming units (CFUs) dropped from 3.9 _ 106 before to 0.09 _ 106 immediately following instrumentation. Significant reductions were found for Tannerella forsythia, Micromonas micros, Fusobacterium nucleatum and spirochetes. Significant reductions were not observed for Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia and Campylobacter rectus. Except for spirochetes, no reduction in prevalence of specific periodontal bacteria was found immediately after instrumentation. During follow-up, mean total CFU tended to increase. Prevalence of periodontal bacteria further reduced. No effect of smoking was found. Conclusion: Results indicate that subgingival mechanical cleaning in itself, has a limited effect, in actually removing bacteria. The subsequent reduction in prevalence of specific periodontal bacteria shows that it is apparently difficult for these species to survive in treated pockets.Rezumat Obiective: De a investiga reducerea numărului microorganismelor obţinute direct sub instrumentare subgingivală şi viteza recolonizării bacteriene timp de două săptămâni, după îndepărtarea plăcii subgingivale. Materiale şi metode: Efectele instrumentării subgingivale au fost măsurate la o pungă de adâncime într-un număr de 22 pacienţi (11 fumători şi 11 nefumători). Imediat după tratamentul iniţial, siturile experimentale, sub control strict al plăcii, au fost instrumentate subgingival. Evaluarea microbiologică a fost derulată la pre-instrumentare, post-intrumentare imediată şi post-instrumentarea de la 1 săptămână şi de la 2 săptămâni. Rezultate: Unităţile formatoare de colonie (UFC) anaerobă totale medii au scăzut de la 3,9 x 106 înainte de instrumentare la 0,09 x 106 imediat după instrumentare. Reduceri semnificative au fost identificate pentru Tannerella forsythia, Micromonas mciros, Fusobacterium nucleatum şi spirochete. Nu s-au observat reduceri semnificative pentru Actinobacillus actinonomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia şi Campylobacter rectus. Cu excepţia spirochetelor, nu s-a observat, imediat după instrumentare, o reducere a prevalenţei unei anume bacterii parodontale. La urmărirea longitudinală, UFC total mediu a prezentat tendinţa de creştere. Prevalenţa bacteriilor parodontale a continuat să se reducă. Nu s-a identificat un efect al fumatului. Concluzii: Rezultatele indică faptul că procesul de debridare mecanică subgingivală prin el însuşi are un efect limitat în îndepărtarea reală a bacteriilor. Reducerea subsecventă arătată a prevalenţei bacteriilor parodontale este aparentă fiind dificil pentru aceste specii să supravieţuiască în pungile tratate prin terapie mecanică parodontală

Primary herpetic gingivostomatitis in young children

Summary Primary herpetic gingivostomatitis is a vesicular lesion of the oral cavity which is easily transmitted when it enters in direct contact with mucosa or skin. The number of lesions or the degree of discomfort varies from child to child. Among all infectious diseases of childhood, the rate of HSV-1 is increased in young children who go to medical care centers. Most cases of primary herpetic gingivostomatitis are diagnosed on the bases of clinical symptoms. The antiviral therapy with systemic Acyclovir is recommended in the treatment of primary herpetic gingivostomatitis. The medical care for pain and fever takes part in the management of the process.Rezumat Gingivostomatita herpetica primara este o leziune veziculară a cavităţii orale, care se transmite uşor atunci când intră în contact direct cu mucoasa sau pielea. Numărul leziunilor şi gradul de disconfort diferă de la copil la copil. Dintre toate bolile infecţioase ale copilăriei, rata HSV-1 este crescută la copiii tineri care merg în centre de îngrijire medicala. Majoritatea cazurilor de GSHP sunt diagnosticate pe baza simptomelor clinice. Terapia antivirală cu Aciclovir sistemic este recomandată în tratamentul GSHP. Grija medicală pentru durere şi febra face parte din managementul procesului

The role of smoking in the pathogenesis of the periodontal disease

Summary Smoking is usually associated with a greater loss of the alveolar bone at younger ages, manifested through more frequent vertical defects and a greater loss in the proximal areas. There do not seems to be differences between different ways of administrating nicotine, the severity of the periodontal disease being generally correlated with the number of cigarettes, if there is a genetic predisposition which allows smoking to accentuate the evolution of the disease. The mechanisms of smoking in the pathogenesis of the periodontal disease is based on the unbalance of cytokines IL-4, IL8, TGF-(3, alteration of oxido-reduction in favour of anaerobic bacteria, changes of neutrophils chemotactism, reduced potential for resolution of the inflammation through prolonged vasoconstriction, selection of a pathogenic flora which may persist even after conservative therapy.Rezumat Fumatul se asociază în general cu o pierdere mai mare a osului alveolar, la vârste mai tinere, manifestată prin defecte verticale mai frecvente şi o pierdere mai mare în zonele aproximale. Nu par să existe diferenţe între diferitele tipuri de administrare a nicotinei, severitatea bolii parodontale fiind corelată în general cu numărul de ţigarete, dacă există şi o predispoziţie genetică ce permite fumatului să accentueze evoluţia bolii. Mecanismele fumatului în patogenia bolii parodontale se bazează pe dezechilibrarea balanţei citokinelor IL-4, IL-8, TGF-(3, alterarea oxido-reducerii în favoarea bacteriilor anaerobe, modificarea chemotactismului neutrofilelor, potenţial mai redus de rezoluţie a inflamaţie prin vasoconstricţia prelungită, selectarea unei flore patogene ce poate persista şi după terapia conservatoare

Oral Rehabilitation Therapies in A Patient with Facial Dysmorphia and Psychiatric Profile - Clinical Case Report

This article describes rehabilitation of one case, complex psychiatric treatment, facial asimetry, with mandibular and maxilla missing teeth and dental disharmony, with a fixed and also removable hybrid prosthesis. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is irregular deformities and unfavorable biomechanics encountered at the prosthetic field for complex rehabilitation.In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance</em

Clinical Aspects Of Measles Virus Implications In Gingival Pathology

Introduction: Although the role of viruses in the pathology of gingival and periodontal lesions was recently found (Contreras, 2000), periodontal literature, typically, does not include measles virus infection in the differential diagnosis of adult gingivitis and periocoronaritis associated with systemic diseases. The mechanism by which measles virus induces inflammation around coronary part of the tooth is still unclear. As herpetic viruses, may reduce periodontal defence by initiating or promoting cytotoxic events pathogenic which promote the growth of subgingivale bacteria capable of producing gum lesions (Contreras, 1999). Aim: Because of the infectious potential of this eruptive diseases ( chicken pox is an infectiousness potential of 80-85% from exposed contacts ), the dentist has to identify any of these cases from the patients requiring for dental assistance. This clinico-statistical study aimed at the total assessment of oral manifestations caused by measles virus infection in line with the general clinical picture, results of laboratory examinations, and general demographic characteristics. Material and method: We selected a group for the study consisting of 32 persons with the diagnosis of measles from the Clinical Hospital of Infectious Diseases of Iasi, between January 2005 and December 2007. From the total number of 32 patients of the study group, 16 were male and 16 sex female. Results and Discussion: Most cases of measles (59.4%) did not show obvious signs of clinical damage of oral mucous membrane (this is explained by the probability of the hospitalization for a large number of days from onset of the disease). From the clinical examination of the patients, we noticed the presence of intraoral manifestations in 8 cases (25.0%) which had very eritematous gingival mucous membrane (even in the absence of specific factors for gingival pathology as local irritation – called ” gingival measles ” )

The Effects Of Periodontal Therapy On Biochemical Inflammatory Markers On Renal Dysfunction Patients

Introduction Recent studies have shown an association between high levels of C-Reactive Protein (CRP), Interleukin-6 (IL-6) and chronic periodontitis, association which is diminished after the periodontal treatment. Due to this association, chronic periodontitis was recently considered as a risk factor for chronic kidney disease. The aim of the study The purpose of this study was to demonstrate that the inflammatory chronic response observed on patients with chronic kidney disease is influenced by the chronic periodontitis that induces high levels of expression of inflammatory markers, such as IL-6 and CRP. Materials and methods The patients in the study were divided in two groups (a group of patients with CKD that were submitted to conservative periodontal treatment and a control group of patients without any systemic disease with moderate to severe chronic periodontitis). The periodontal therapy included root planning and debridement. After the periodontal treatment completion the patients were recalled at 15, 30, 60 and 90 days. We determined the levels of IL-6 and CRP initially and at 3 months after therapy. Results IL-6 and CRP levels have significantly decreased after the periodontal treatment in both groups. Additionally, significantly higher levels of haemoglobin and ferritin were observed in the control group patients, associated with the periodontal treatment. Conclusions Our results demonstrate that chronic periodontitis is more severe on chronic kidney disease patients, inducing a systemic inflammatory response. The periodontal therapy reduces the inflammatory component and decreases the levels of the serum markers, indicating an important interventional therapy on patients with chronic kidney disease

INVOLVEMENT OF “TYPE-1 HERPES SIMPLEX” IN THE ETIOPATHOGENY OF THE GINGIVAL-PERIODONTAL DISEASES

Scope of the study: The present clinico-statistical study aimed at evaluating the oral manifestations determined by viral infections, especially herpes virusi, in correlation with some general symptoms and demographic characteristics. Materials and method: 68 cases of herpetic gingivo-stomatitis treated in the Clinical Hospital of Infectious Diseases of Ia[i have been investigated between January 1, 2010 – December 31, 2010. The oral clinical investigations, developed in the Clinics of Infectious Diseases and in the Department of Periodontology, aimed at evaluating the occurrence and evolution of the oral manifestations characteristic to this type of viral infections. Results and discussion: The oral manifestations observed within the experimental group had a polymorphous character. At group level, a relatively high number of patients (40.2%) showed no oral lesions in the moment of the clinical examination, the remaining cases (49.8%) evidencing more or less specific oral manifestations for the viral pathology involved in the debut and evolution of the disease under consideration. 13 cases (representing 9.0% of the total group) evidenced oral lesions of ulceration and vesicle type, and 25 cases (13.6%) showed lesion elements of exclusively vesicle type. Conclusions: The clinical-statistical study on the incidence and characteristics of the oral manifestations of the viral infection with type-1 herpes virus, clinically manifested, as well, at the level of the gingival mucous membrane, evidenced the constant presence of a higher incidence of this type of virusi in the population, as well as the polymorphous character of the oral lesions

REHABILITATION OF PATIENTS WITH PERIODONTALLY-AFFECTED BONE SUPPORT BY THE MINI-INVASIVE APPLICATION OF DENTAL IMPLANTS

Introduction. Nowadays, oral implantology came to represent an indispensable part of modern stomatology. Obtention and maintenance of implants’ osteointegration, alongwith “conservation” of the bone level of the periimplantary alveolar apophyies crest are especially important in implantological treatments. Scope and objectives Scope of the study: to optimize the rehabilitation process in patients with periodontally-afected bone support by minimum invasive application of dental endo-oseous implants. Materials and method. The study was developed on 112 persons – 48 men and 64 women, with ages between 22 and 71 years, divided into 2 groups, as follows: the former (control) group included 54 persons, in whom the Alpha-BIO, ADIN and MIS implants had been applied by the standard method, namely flap surgery, while the latter (experimental) group was formed of 58 patients, whose implants had been inserted without using flaps. The modifications produced at the level of the periimplantary cortical bone, along the healing stage, in the patients of both groups, prior and post implant, were appreciated by the difference between the distance from the apex of the implant up to the alveolar crest, determined on the first dental panoramic X-ray-OPG1 immediately after the surgery, and on the second dental panoramic X-ray-OPG2, prior to their discovery. Results. The OPG measurements made on the mandible demonstrated that resorption of the periimplantary cortical bone in the control group is more frequently occurring and more significant, varying between 0.00 and –2.82 mm. In the anterior part of the implants, its mean value is of –0.75 ± 0.09 while, in the posterior one – of –0.59 ± 0.09. In the experimental group, the modifications produced in the periimplantary cortical bone were also varying – namely, between +0.81 (aposition) and –1.39. In the anterior part of the implants, the mean value of the resorption degree is of –0.22 ± 0.08 mm while, in the posterior one, of –0.14 ± 0.07mm. Conclusions. The osteointegration ratio of the implants inserted in two surgical times, without flaps’ departure (97.92%), is not different from that of osteointegration in cases of their installation with flaps’ departure (98.05%). The secondary stability of the installed implants, without the creation of mucoperiostal flaps, even if insignificant (p > 0.05), exceeds the one of the implants installed by standard methods. Consequently, implants’ osteointegration may be successfully obtained even by their insertion through a mini-invasive method – involving two surgical times, with no departure of the mucoperiostal flaps

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