The Role of Osteoporosis as a Systemic Risk Factor for Periodontal Disease

Periodontal disease is an infectious and inflammatory disease with a high incidence in the global population and an extremely complex etiopathogenesis. Osteoporosis is one of the systemic diseases that can affect the integrity of periodontal tissues. Osteoporosis, as a skeletal disease, causes a reduction in bone mass and microarchitectural changes in the bone. Discussions about the connection between the two diseases affecting the bone began in 1960, but, contrary to the high number of studies, discoveries are still being made regarding the pathophysiological mechanisms that link the two diseases. The chapter proposes a systematized description of data on the influence of osteoporotic disease on the periodontal structures, therapeutic methods to address the patient with periodontal disease and osteoporosis and data on the potential influence of conventional and adjunctive periodontal treatment on systemic parameters in patients with osteoporosis

Advances in Locally Delivered Antimicrobials for Periodontitis Treatment

Periodontal disease represents an inflammatory disease of the tissues supporting the maintenance and functionality of the teeth on the dental arches. The main cause of periodontitis consists in periodontal dysbiosis, which will trigger an inflammatory response, progressively leading to periodontal tissue breakdown. Scaling and root planing represent the gold standard in treating periodontal diseases but, as it was already established, these measures are unable to completely eliminate the subgingival bacterial plaque. Therefore, new adjunctive therapies have emerged, involving systemic and local delivery of various antimicrobial products. This chapter aims to provide current knowledge on the local application of different periodontal supplementary therapies. The chapter focuses on local forms of antimicrobials, such as irrigations, gels or controlled release systems but also on laser/LED-assisted periodontal pocket photodynamic antibacterial therapy (PDT), along with various photosensitizers. Moreover, we present data from current guidelines regarding the recommendations for the main locally delivered antimicrobials

Cytokines’ Involvement in Periodontal Changes

The bacterial challenge on the periodontal tissues triggers an inflammatory reaction, driven by pro-inflammatory cytokines, that eventually leads to the periodontal structures’ damage. The pathogenic mechanisms of this inflammatory reaction are complex and are influenced by the type of host-immune response and certain local and systemic factors. These factors can influence periodontal inflammation, through the action of the various pro-inflammatory cytokines. Periodontal disease and certain systemic conditions can have a mutual association, as the pathogenic mechanisms of these diseases can involve similar molecular and cellular elements. The concept of ‘periodontal medicine’ comprises these pathogenic connections, focusing on the key role that periodontal health has on the general homeostasis and well-being

RETROSPECTIVA ISTORICA SI CONCEPTELE ACTUALE IN ETIOPATOGENIA SI CLASIFICAREA BOLILOR PARODONTALE. DATE DIN LITERATURA

Periodontal diseases are arguably among the most ancient and common infectious diseases affecting humans, leading to permanent destruction of the supporting structures of the dentition and ultimately tooth loss. It has been established that dental biofilm, consisting of many microbial species and their products, is an etiological agent of periodontal disease. It is widely accepted that immunological and inflammatory responses to dental plaque via hostparasite interaction are manifested by clinical signs and symptoms of periodontal diseases. The outcome of this interaction can be modulated by other components known as risk factors (modifiers), either inherent (genetic) or acquired (environmental) in nature, significantly affecting the initiation and progression of periodontal diseases of different types. While definitive genetic factors responsible for either susceptibility or resistance to periodontal diseases await definitive identification and verification. Currently, periodontal diseases are classified based upon clinically observed disease traits using radiographs and clinical examination: gingivitis; chronic periodontitis; aggressive periodontitis; periodontitis as manifestation of systemic diseases; necrotizing ulcerative periodontitis; abscesses of the periodontium; periodontitis associated with endodontic lesions; and developmental or acquired deformities and conditions. Advances in genomics, molecular science, and personalized medicine may result in guidelines for unambiguous disease definition and diagnosis in the future

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

OXIDATIVE STRESS AND PERIODONTAL DISEASE. REVIEW

ROS (reactive oxygen species) have become increasingly worthy of attention because of their central role in the progression of many inflammatory conditions. They are described as oxygen free radicals and any other non-radical oxygen derivative involved in the production of oxygen radicals. ROS are involved in normal cellular metabolism and are continuously generated by cells in most tissues. Another category of substances called antioxidants exist in the cell that can effectively delay or completely inhibit ROS-induced oxidation. Under physiological conditions, ROS production is drastically increased largely due to the immune system cells and the phagocytosis process through the metabolic pathway. Consequently, high levels or increased activities can not be balanced by the antioxidant defense system, which leads to oxidative stress and tissue damage. ROS can directly damage the tissue by their action against DNA, proteins and oxidation of important enzymes. At the same time, they can act as signaling pathways or as mediators of inflammation. In recent years, numerous clinical and experimentional studies have demonstrated a strong association between oxidative stress and periodontitis. A better understanding of this association can lead us to a detailed knowledge of the pathogenic mechanisms of this disease, and so can guide us towards a more structured therapy

Impact of Oral Health Education and a Non-Surgical Periodontal Therapy on the Quality of Life of Patients with Diabetes Mellitus*

Aim: The aim of the study was to evaluate the impact of oral health education and non-surgical periodontal therapy on the quality of life for a group of patients with type I diabetes mellitus, in Iasi, Romania

Digitized Diagnostic Systems Between Challenge And Necessity In Young Dentists’ Clinical Practice

When we start working as a dentist we should keep in mind that all our efforts should be focused on providing the best dental care to our patients but doing that as a young doctor can be sometimes extremely challenging. We all agree on the fact that for a suitable and ethical treatment planning we have to establish a correct diagnosis. Correct diagnosis involves knowledge, good training and adequate diagnostic systems. The aim of this study is to provide an objective overview on the modern diagnostic tools that we can use in order to have a successful practice from the very beginning. This work will present as well the advantages and the limitations of using the X-Ray digitized systems in the private clinic. We tried to emphasize the importance of a correct treatment planning in different specialties using these devices for a predictable clinical result. Last but not least we would like to approach in a critical comparative way the benefits of the digitized diagnostic tools compared to classical devices and to decide if the digital era will replace or rather complete the classical methods of diagnosis

THE ROLE OF IADS AND YDW IN SHAPING THE FUTURE CAREERS OF DENTAL STUDENTS

Dental education has changed a lot in the last decades alone. If ten years students were receiving mainly frontal teaching nowadays they are actively involved in the educational process. Being an educator in the dental field has become more a mission than a job and students should be treated as partners with full rights. The international associations like IADS and YDW have a crucial role in fulfilling the education process of dental students and creating new opinion leaders in the field