THE PARTICULARITIES OF THE MAINTENANCE THERAPY IN PERIODONTAL- IMPLANT-PROSTHETIC FIELD FOR THE PERIODONTIC PATIENT

Introduction: The incidence of total edentulous cases became very low and the partial edentation is predominant, therefore, implant overdentures is an important alternative for the treatment plan. Purpose of the study: The purpose of this study was to evaluate in time the changes of the bone tissue surrounding the dental implants inserted for the treatment of partially edentulous patients, in different overdenture types. Materials and methods: The study was conducted on 41 partially edentulous patients, on whom we inserted 245 dental implants, on upper maxilla and mandible, in anterior and posterior areas; the overdentures were conducted in the following situations: dental crown on single implant, implants in dental bridges, overdentures with mixed support (implant and tooth support). We assessed the implant and the prosthetic maintenance. Results and discussions: No difference was observed for the three overdentures situations regarding the bone tissue changes. The bone loss after 6 months was higher for the maxilla than for the mandible. The rate of bone loss in the first 6 months was higher in the following situations: bone dehiscence, when using bone grafts or membranes, ceramic-fused-to-metal prosthetics. Conclusions: The long term prognosis for single crown and bridge overdentures is favorabl

Relation between Chronic Periodontitis and Prevalence of Head-Neck Carcinoma in Association with Quality of Life*

Background and Aim: Substantial evidence supports an association between chronic infections/inflammation, and cancer. The aim of this study was to assess the effect of chronic periodontitis on head and neck squamous-cell carcinoma (HNSCC)

THE EFFECTS OF THE ADJUNCTIVE THERAPY WITH SUBANTIMICROBIAL DOSES OF DOXYCYCLINE IN PATIENTS WITH OSTEOPOROSIS AND CHRONIC PERIODONTITIS

The aim of the study was to analyse the periodontal clinical changes generated by the adjunctive periodontal therapy with sub-antimicrobial doses of doxycycline in patients with chronic periodontitis and osteoporosis. Materials and methods: The study was conducted on 26 subjects with chronic periodontitis and osteoporosis, divided in study group (classical periodontal debridement and sub-antimicrobial doses of doxycycline for 3 months) and the control group (classical debridement only). We analysed the probing depth, clinical attachment level, the PBI and PI indices at baseline, in the last day of medication and at 3 months after the drug therapy. Results and discussions: The reduction of the moderate and profound pockets was higher for the study group when compared to the control group. In the control group, the sites with an initial depth of 0-3mm presented a slight attachment loss at 3 and 6 months, while the same depth sites in the study group presented a slight attachment gain. Conclusions: The therapy with sub-antimicrobial doses of doxycycline generated significant clinical improvement in patients with chronic periodontitis and osteoporosis, an improvement which can reduce the necessity of surgical procedures

ANALYSIS OF POSSIBLE CISPLATIN THERAPY EFFECTS ON THE PERIODONTAL STATUS IN ONCOLOGY PATIENTS

Introduction. Many of the patients that undergo chemotherapy with cisplatin develop systemic and oral side-effects during treatment. Some of these side-effects are linked to various preexisting inflammatory states one of which is periodontal disease. The aim of this study was to analyze the impact cisplatin chemotherapy may have on periodontal tissues and periodontal disease evolution. Material and methods. 15 patients were given an oral hygiene questionnaire and were clinically evaluated before the start of cisplatin chemotherapy and 21 days after the first dose. Results. Both probing depth and clinical attachment loss values were higher after a single dose of chemotherapy with cisplatin. Periodontal disease seemed to progress at an incresed rate. Conclusions. Chemotherapy, and especially chemotherapy with cisplatin, may lead to the modification of periodontal parameters even after a single dose

3D Printed and Bioprinted Membranes and Scaffolds for the Periodontal Tissue Regeneration: A Narrative Review

Numerous technologies and materials were developed with the aim of repairing and reconstructing the tissue loss in patients with periodontitis. Periodontal guided bone regeneration (GBR) and guided tissue regeneration (GTR) involves the use of a membrane which prevents epithelial cell migration, and helps to maintain the space, creating a protected area in which tissue regeneration is favored. Over the time, manufacturing procedures of such barrier membranes followed important improvements. Three-dimensional (3D) printing technology has led to major innovations in periodontal regeneration methods, using technologies such as inkjet printing, light-assisted 3D printing or micro-extrusion. Besides the 3D printing of monophasic and multi-phasic scaffolds, bioprinting and tissue engineering have emerged as innovative technologies which can change the way we see GTR and GBR

Assessment of Salivary Levels of RANKL and OPG in Aggressive versus Chronic Periodontitis

RANKL (receptor activator of nuclear factor kappa-β ligand) and OPG (osteoprotegerin) are two proteins involved in bone remodelling. During the active phase of periodontal disease, an imbalance between the ratios of the two elements can be noticed. While the expression of RANKL is elevated compared with that of OPG, the RANKL is available to bond with RANK (receptor activator of nuclear factor kappa-β). This study was conducted on 41 patients: 19 with generalized aggressive periodontitis, 18 with severe chronic periodontitis, and 4 periodontal healthy subjects. For each patient included, we determined the salivary levels of RANKL and OPG with the help of two Human ELISA kits. The results show that the patients affected by periodontitis, either aggressive or chronic, have significant higher values of RANKL and RANKL/OPG ratio. This values correlate with the local inflammation status

Salivary Metalloproteinase-8 and Metalloproteinase-9 Evaluation in Patients Undergoing Fixed Orthodontic Treatment before and after Periodontal Therapy

(1) Background: Metalloproteinase-8 (MMP-8) and metalloproteinase-9 (MMP-9) are members of a family of proteases of major importance during orthodontic tooth movement. Their levels increase during orthodontic therapy and in periodontally affected tissues. Orthodontic fixed appliances retain dental plaque and can cause gingival inflammation. When gingival inflammation is present, the forces produced during orthodontic tooth movement can aggravate tissue reaction and cause the destruction of supportive periodontal tissue. This study aimed to identify biomarkers that facilitate the assessment of periodontal status during orthodontic treatment. (2) Methods: Our study was conducted on 111 patients who were about to receive fixed orthodontic treatment. We determined the salivary levels of MMP-8 and MMP-9 and bleeding on probing (BOP) before applying the orthodontic fixed appliance (T1), one week after appliance placement (T2), and during orthodontic treatment, one month after non-surgical periodontal treatment (T3). (3) Results: Patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement (T2) and a decrease in these parameters one month after periodontal treatment (T3). Statistically significant correlations were found between MMP-8 levels and BOP values at T1, T2, and T3. (4) Conclusion: In our study patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement and a decrease in these parameters one month after periodontal treatment. Strong positive statistically significant correlations were found between MMP-8 levels and BOP and medium positive statistically significant correlations between MMP-9 and BOP values before and after orthodontic treatment and periodontal treatment. MMP-8, MMP-9, and BOP could be used to assess the periodontal status of orthodontic patients

Finite Element Analysis of Mandibular Anterior Teeth with Healthy, but Reduced Periodontium

Finite element analysis studies have been of interest in the field of orthodontics and this is due to the ability to study the stress in the bone, periodontal ligament (PDL), teeth and the displacement in the bone by using this method. Our study aimed to present a method that determines the effect of applying orthodontic forces in bodily direction on a healthy and reduced periodontium and to demonstrate the utility of finite element analysis. Using the cone-beam computed tomography (CBCT) of a patient with a healthy and reduced periodontium, we modeled the geometric construction of the contour of the elements necessary for the study. Afterwards, we applied a force of 1 N and a force of 0.8 N in order to achieve bodily movement and to analyze the stress in the bone, in the periodontal ligament and the absolute displacement. The analysis of the applied forces showed that a minimal ligament thickness is correlated with the highest value of the maximum stress in the PDL and a decreased displacement. This confirms the results obtained in previous clinical practice, confirming the validity of the simulation. During orthodontic tooth movement, the morphology of the teeth and of the periodontium should be taken into account. The effect of orthodontic forces on a particular anatomy could be studied using FEA, a method that provides real data. This is necessary for proper treatment planning and its particularization depends on the patient’s particular situation