Interdisciplinary approach for the treatment of periodontally compromised malpositioned anterior teeth: a case report

Today many adult patients with periodontal disease demonstrate positioning of teeth that comprise their ability for proper mechanical tooth cleaning of approximal tooth surfaces. With adequate combined periodontal-orthodontic treatment it is possible to re-establish a healthy and well-functioning dentition. However, while orthodontic treatment can realign periodontally affected teeth, esthetic appearance may be compromised by gingival recession due to alveolar bone dehiscences or fenestrations in combination with a thin gingival biotype. This article reports an interdisciplinary (periodontic, orthodontic, restorative) approach for the treatment of a periodontally compromised patient with anterior dental malalignment. Periodontal therapy, including periodontal plastic surgery to obtain root coverage as well as orthodontic treatment by means of a miniscrew implant anchorage were used to achieve stable periodontal conditions and successful esthetic and functional final results

Flapless application of enamel matrix derivative in periodontal retreatment: a multicenter randomized feasibility trial

AIM: To investigate the potential benefit of enamel matrix derivative (EMD) as adjunct to re-instrumentation of residual pockets persisting after steps 1 and 2 of periodontal therapy.MATERIAL & METHODS: 44 adult patients participated in a multicenter feasibility randomized clinical trial with split-mouth design. They had presented at re-evaluation after initial non-surgical periodontal therapy (steps 1 and 2 of periodontal therapy) for generalized periodontitis with at least 2 teeth with residual probing pocket depths (PPD) ≥ 5 and ≤ 8 mm, with bleeding on probing (BOP). Two teeth with similar PPD were randomized to receive re-instrumentation either with (test) or without (control) adjunctive flapless administration of EMD. Differences in the changes of PPD and BOP from baseline to 6 and 12 months were analyzed, and the frequencies of pocket closure (PPD ≤ 4 mm and no BOP) compared.RESULTS: For the primary outcome "change of mean PPD after 6 months" a significant additional benefit of 0.79 ± 1.3 mm (p < 0.0001) could be observed for the test group. At 12 months, this difference could be maintained (0.85 ± 1.1 mm; p < 0.0001). The frequency of pocket closure in the test group was 69% at 6 and 80% at 12 months and significantly higher than in the control group with 34% and 42%, respectively (p < 0.01).CONCLUSION: The results of the present feasibility study indicate a benefit of adjunctive EMD during non-surgical retreatment (step 3 of periodontal therapy) of residual deep pockets

Chronic periodontitis and its possible association with oral squamous cell carcinoma – a retrospective case control study

Introduction: Different inflammatory processes may trigger the development of malignancies. Therefore, the aim of the present study was to evaluate a potential association between radiological determined chronic periodontitis (CPA) and oral squamous cell carcinoma (OSCC). Methods: In a retrospective study, OSCC-patients and a control group without malignant tumors were radiographically examined for bone loss. Via telephone survey and questionnaire, general clinical data on the individual oral hygiene and concomitant diseases together with tobacco and alcohol use were assessed and data were compared between the groups. Results: 178 OSCC-patients and 123 controls were included. In univariate analysis, a statistically relevant higher mean bone loss was seen in the OSCC group (4.3 mm (SD: 1.8; 95% confidence interval (CI): 4-4.6) vs. 2.9 mm (SD: 0.7; 95% CI: 2.8-3); p < 0.001)). This was confirmed in a multivariate regression model (OR: 2.4, 95% CI: 1.5-3.8; p < 0.001). A history of periodontal treatment was associated with significantly reduced OSCC risk (p < 0.001; OR: 0.2, CI: 0.1-0.5). Conclusions: CPA is a common disease and the monitoring as well as the treatment of such a chronic oral inflammation may be beneficial in reducing one potential cause of OSCC. Therefore, further clinical studies on oral neoplasms should consider clinical periodontal parameters as well

Дослідження впливу фосфатів на біопродуктивність Chlorella vulgaris

Підвищений вміст фосфору у водоймах є основною причиною їхньої евтрофікації. Евтрофікація – процес зростання водної рослинності, який відбувається внаслідок перевищення балансу поживних речовин. Він супроводжується надмірним розвитком водоростей, особливо зелених, синьо-зелених і діатомових, переважанням небажаних видів планктону, порушенням життєдіяльності риб. Продукти метаболізму водоростей дають воді неприємний запах, можуть викликати шкірні алергічні реакції і шлунково-кишкові захворювання у людей і тварин. Після відмирання водорості виділяють у воду поліпептиди, аміак і проміжні продукти білкового розпаду. Це може призводити до підвищення вмісту фенолів, які мають канцерогенні властивості

Periodontal Disease Status of Pregnant Women with Diabetes Mellitus

The aim of the present study was to evaluate the association between type I diabetes mellitus (DM) and periodontal disease in pregnant women. Fifty-two pregnant women aged 27.9±6.9 years with type I DM participated in the present study. Forty-two non-pregnant type I female diabetics (mean age: 27.9±6.1 years) and 121 healthy non-pregnant women (mean age: 29.1±5.7 years) without diabetes formed the control group. All subjects were given a clinical periodontal examination including probing pocket depth (PPD), probing attachment level (PAL), assessment of plaque and gingivitis scores (SBI). Blood parameters included levels of hemoglobin, glycosylated hemoglobin, total cholesterol, triglyceride and leukocytes. The pregnant diabetic subjects showed despite a good metabolic control significantly higher values for the SBI compared to the controls. Pregnant diabetic subjects displayed a significant correlation between the dose of insulin per day and PPD (p0.05) as well as the PAL (p0.05). In conclusion, the results of the study indicate that pregnant diabetics demonstrate a higher degree of periodontal inflammation and destruction compared to non-pregnant diabetics and healthy non-pregnant patients

Modulation of Osteogenic Cell Morphology by ECM Ligands and Enamel Matrix Derivative

Preduvjet za uspješnu regeneraciju parodontnog tkiva jest odgovarajuća aktivacija populacije za to odgovornih stanica, poput osteoblasta. U tom su slučaju stanična adhezija i sazrijevanje usko povezani s morfologijom stanica i f-aktinskom organizacijom citoskeleta. Mogućnost pojačavanja parodontalnog cijeljenja pomoću pojedinih komponenti izvanstaničnog matriksa (ECM) i derivata caklinskog matriksa dobro je dokumentirana u literaturi. Svrha rada: Svrha ovog istraživanja bila je testirati učinak ECM-bjelančevina, kolagena tipa I, laminina-1 te komercijalnog proizvoda EMD-a na morfološku i citoskeletnu organizaciju osteogenih stanica. Ispitanici i postupci: Tijekom promatranja analizirano je ukupno 2450 osteogenih stanica iz pet različitih staničnih linija (četiri primarnih i jedne komercijalne) kultiviranih na pojedinim supstratima, a analizirali su ih tri neovisna promatrača. Nakon bojenja za f-aktin staničnog citoskeleta i automatizirane CLSM-vizualizacije, stanice su podijeljene u tri skupine ovisno o njihovim morfološkim svojstvima (nezrele, prijelazne i zrele). Osim deskriptivne analize obavljena je bila i multivarijantna logička regresija radi identificiranja odgovarajućih parametara koji utječu na staničnu morfologiju i organizaciju citoskeleta. Rabljeni pojedinačni ligandi kolagena i laminina te posebice EMD poticali su stvaranje zrelog osteogenog fenotipa, premda su bile uočene i određene razlike među korištenim staničnim linijama. Rezultati: Analiza morfologije i citoskeleta pouzdan je način skupljanja prvih podataka o biokompatibilnosti i bioaktivaciji stanica na različitim supstratima. Naši rezultati upućuju na mogući potencijal istraživanih liganada u pojačavanju osteogenoga staničnog pričvrstka i sazrijevanju te time i pomaganju cijeljenja parodontnog tkiva.The precondition for successful periodontal regeneration is adequate activation of relevant cell populations like osteogenic cells. Here, cell adhesion and maturation are closely associated with cell morphology and f-actin cytoskeletal organisation. The potential of solitaire extracellular matrix (ECM) components as well as enamel matrix derivative (EMD) to enhance periodontal healing is well documented. Objective: The aim of the study was to test the impact of the ECM proteins collagen type 1 and laminin-1 as well as commercially available EMD on osteogenic cell morphology and cytoskeletal organisation. Material and methods: In an observational study, a total of 2450 osteogenic cells of 5 different cell lines (4 primary ones and 1 commercial one) cultivated on the respective substrates were analysed by 3 independent observers. After staining for the f-actin cytoskeleton and automated CLSM visualisation, cells were assigned to 3 different categories depending on morphological cell attributes (immature vs. intermediate vs. mature). Besides descriptive analysis, a multivariate logistic regression was performed to identify relevant influence parameters on cell morphology and cytoskeletal organisation. Results: The applied solitaire ligands collagen and laminin and especially EMD promoted a mature osteogenic phenotype. Nevertheless, considerable differences between the investigated cell lines could be identified as well. Analysis of cell morphology and cytoskeletal organisation offers a reliable method of acquiring the first hints of biocompatibility and bio-activation on different substrates. Conclusion: Our results highlight the potential of the investigated ligands to support periodontal regeneration by enhancing osteogenic cell attachment and maturation

In vitro proliferation of human osteogenic cells in presence of different commercial bone substitute materials combined with enamel matrix derivatives

<p>Abstract</p> <p>Background</p> <p>Cellular reactions to alloplastic bone substitute materials (BSM) are a subject of interest in basic research. In regenerative dentistry, these bone grafting materials are routinely combined with enamel matrix derivatives (EMD) in order to additionally enhance tissue regeneration.</p> <p>Materials and methods</p> <p>The aim of this study was to evaluate the proliferative activity of human osteogenic cells after incubation over a period of seven days with commercial BSM of various origin and chemical composition. Special focus was placed on the potential additional benefit of EMD on cellular proliferation.</p> <p>Results</p> <p>Except for PerioGlas^®, osteogenic cell proliferation was significantly promoted by the investigated BSM. The application of EMD alone also resulted in significantly increased cellular proliferation. However, a combination of BSM and EMD resulted in only a moderate additional enhancement of osteogenic cell proliferation.</p> <p>Conclusion</p> <p>The application of most BSM, as well as the exclusive application of EMD demonstrated a positive impact on the proliferation of human osteogenic cells <it>in vitro</it>. In order to increase the benefit from substrate combination (BSM + EMD), further studies on the interactions between BSM and EMD are needed.</p

In vitro evaluation of various bioabsorbable and nonresorbable barrier membranes for guided tissue regeneration

<p>Abstract</p> <p>Background</p> <p>Different types of bioabsorbable and nonresorbable membranes have been widely used for guided tissue regeneration (GTR) with its ultimate goal of regenerating lost periodontal structures. The purpose of the present study was to evaluate the biological effects of various bioabsorbable and nonresorbable membranes in cultures of primary human gingival fibroblasts (HGF), periodontal ligament fibroblasts (PDLF) and human osteoblast-like (HOB) cells <it>in vitro</it>.</p> <p>Methods</p> <p>Three commercially available collagen membranes [TutoDent^®(TD), Resodont^®(RD) and BioGide^®(BG)] as well as three nonresorbable polytetrafluoroethylene (PTFE) membranes [ACE (AC), Cytoplast^®(CT) and TefGen-FD^®(TG)] were tested. Cells plated on culture dishes (CD) served as positive controls. The effect of the barrier membranes on HGF, PDLF as well as HOB cells was assessed by the Alamar Blue fluorometric proliferation assay after 1, 2.5, 4, 24 and 48 h time periods. The structural and morphological properties of the membranes were evaluated by scanning electron microscopy (SEM).</p> <p>Results</p> <p>The results showed that of the six barriers tested, TD and RD demonstrated the highest rate of HGF proliferation at both earlier (1 h) and later (48 h) time periods (<it>P </it>< 0.001) compared to all other tested barriers and CD. Similarly, TD, RD and BG had significantly higher numbers of cells at all time periods when compared with the positive control in PDLF culture (<it>P </it>≤ 0.001). In HOB cell culture, the highest rate of cell proliferation was also calculated for TD at all time periods (<it>P </it>< 0.001). SEM observations demonstrated a microporous structure of all collagen membranes, with a compact top surface and a porous bottom surface, whereas the nonresorbable PTFE membranes demonstrated a homogenous structure with a symmetric dense skin layer.</p> <p>Conclusion</p> <p>Results from the present study suggested that GTR membrane materials, per se, may influence cell proliferation in the process of periodontal tissue/bone regeneration. Among the six membranes examined, the bioabsorbable membranes demonstrated to be more suitable to stimulate cellular proliferation compared to nonresorbable PTFE membranes.</p

Gender specific quality of life in patients with oral squamous cell carcinomas

<p>Abstract</p> <p>Background</p> <p>The goal of this study was to evaluate the somatic and psychological effects by means of QUALITY OF LIFE (QOL) of surgical treatment of patients with oral squamous cell carcinoma. The factors gender, age, nicotine consumption, and tumour stage were taken into consideration.</p> <p>Methods</p> <p>54 patients after surgical resection of oral squamous cell carcinomas (OSCC) were analysed from 01.09.2005 to 31.05.2008. Inclusion criteria for the study were: age at least 18 years, no indication or treatment of synchronous and metachronous tumours.</p> <p>German translations of the EORTC H&N-35 and EORTC QLQ-C-30 questionnaires, as well as a general socioeconomic patient history were used as measuring instruments. The questionnaires were completed independently by the patients. The answers were translated into scale values for statistical evaluation using appropriate algorithms.</p> <p>Results</p> <p>Analysis of the EORTC-QLQ-C-30 questionnaires demonstrated a tendency of more negative assessment of emotional function among the female participants, and a more negative evaluation of social function among the male participants. Greater tumour sizes showed significantly lower bodily function (p = 0.018). While a smaller tumour size was significantly associated with lower cognitive functioning (p = 0.031). Other cofactors such as age, nicotine consumption, and tumour stage only showed a tendency to influence the quality of sleep and daily life.</p> <p>Conclusions</p> <p>The data obtained within this investigation demonstrated that gender had the most significant power on the subjectively perceived postoperative quality of life. This factor is important e.g. in preoperative decision making regarding immediate microvascular reconstruction after e.g. mandibular resection and therefore QOL assessment should become integral component of the care of patients with OSCC.</p