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

STATISTICAL STUDY ON THE PREVALENCE OF GINGIVAL RECESSION IN YOUNG ADULTS

Gingival recession represents a serious problem, for both patient and physician, especially when exposure of the radicular surface is related to the deterioration of the aesthetic aspect and to a more pronounced dental hyper‐ sensitivity. Scope of the study: to determine the preva‐ lence and severity of recessions in young adults, correlated with the local dental, as well as socio‐economic and cultu‐ ral conditions. Materials and method: A number of 85 persons, having addressed the Department of Perio‐ dontology, Faculty of Dental Medicine of Iasi, between February‐May 2011, were examined. The following para‐ meters were recorded: sex, education level, total number of gingival recessions at the level of the oral cavity, type of brush employed, frequency of dental brushing, amount of attached gingiva, existence of labial phrenum, type of occlusion, presence of certain complications induced by the manifestation of recessions, such as hypersensitivity. Results and discussion: Analysis and correlation of data showed that the most important role in the occurrence of recessions was played by the local factors, which intensi‐ fied the action of the determining element, the bacterial plaque. Thus, the nature of periodontal recessions is of inflammatory type, those with traumatic causes being sta‐ tistically non‐significant. The type of periodontium influ‐ enced the development of recessions, so that, for a delicate periodontium, 10.4 recessions/patient have been discove‐ red, while, in a thick periodontium, only 7 recessions/ patient. In cases of phrenectomies with insertion in the vicinity of the gingival margin, recessions of various sizes have been always present. In cases of dental occlusion, the obtained data suggest that the occurrence of recessions is not considerably influenced by the type of occlusion, the values being quite close. As to their sizes, most of the reces‐ sions were situated at a level of 2‐3 mm, a significant decre‐ ase being observed at levels exceeding 4 or 5 mm. A complication accompanying recessions in 39.96% of the affected teeth was hypersensitivity. Conclusions. Recessi‐ ons represent a complex pathology, with multiple etiology, sometimes difficult to identify, with special implications in the establishment of a therapeutical plan. Monitoriza‐ tion of the young adult, alongwith a precocious identifica‐ tion of the lesions and of their etiology may be therefore a starting point for the preservation of a healthy periodontal status

EVALUATION OF THE PREVALENCE OF THE PERIODONTAL DISEASE VERSUS SYSTEMIC AND LOCAL RISK FACTORS

Introduction: The periodontal disease represents a malady characterized by an extremely high incidence. The manifestations and evolution of the periodontal diseases vary for each form in part, being influenced by systemic and local risk factors. Scope of the study: To evaluate the periodontal status on a group of patients, versus the syste‐ mic and local factors. Materials and method: The study was performed on a group of 170 patients, whose odonto‐periodontal status was evaluated by strict clinical and paraclinical examinations, on establishing the inflammation indices and the periodontal diagnosis. Results: The main cause of the analysis was gingival ble‐ eding; an increased number of smokers was registered among the patients. Out of the local factors, especially important were edentations and malocclusions. Also, a higher number of aggressive generalized periodontites has been noticed. Discussion: The forms of the periodontal diseases are obviously influenced by the systemic context, while the forms of localized chronic periodontitis associa‐ ted with generalized chronic gingivitis reflect the role pla‐ yed by the local risk factors. Conclusions: Stress and smoking represent significant risk factors in the installation of periodontal pathology, with a really alarming preva‐ lence. The aggressive forms of periodontitis showed a higher frequency than that recorded in literature

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

THE RESULTS ANALYSIS OF AN ECONOMIC ENTITY OF WATER DISTRIBUTION

The authors of this study aim to carry out a dynamic and structural analysis of the revenues and expenses of an economic entity supplying drinking water, for the period 2021-2022, to highlight their evolution as a result of the increase in the water tariff. For the profitability of the activity of the analyzed economic entity, it is particularly important to know the expenses caused by the performance of the specific activity and, respectively, to identify the best ways to improve its performance. As is known, the correlated analysis of expenses and the management of financial, material, and human resources is the basis of the managerial decision-making process of an economic entity. The objective of this research is to develop an analysis of expenses related to incomes in order to highlight their evolution, as well as the factors that influence their size. The research focused on the study of specialized literature, complemented by a case study comprising the vertical analysis of the profit and loss account, as well as the dynamic and structural analysis of the expenses and revenues of a company in the targeted field. The obtained result resides in the observation that, for the analyzed entity, the revenues adversely influence the efficiency of the total expenses. The article ends with the authors’ conclusions regarding how the expenses related to the analyzed entity’s revenues evolved during the mentioned period and the effect over time of the resulting variations

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

The Complex Relationship of Periodontal Disease and Rheumatoid Arthritis

The relationship between periodontitis and systemic diseases is an important part of clinical periodontal research, which has been growing steadily. Even though the etiologies of periodontal disease and rheumatoid arthritis (RA) differ, these pathologies have many common features, both being multifactorial diseases characterized by localized chronic inflammatory reactions, which are fuelled by an analogous set of cytokines (among many, the most prominent being Tumour Necrosis Factor (TNF), Interleukin (IL) 6 and 17), leading to high systemic circulating concentrations of inflammatory markers such as C-reactive protein (CRP). It was not until the discovery of peptidylarginine deiminase (PAD) mediated citrullination of proteins by Porphyromonas gingivalis that the link between the two diseases was purely speculative. This citrullination initiates a series of events which culminate in the production of anti-citrullinated protein antibodies (ACPA) and, finally, in the clinical manifestation of rheumatoid arthritis. Another common denominator is the bone destruction caused by proinflammatory cytokines secreted by T 17 helper cells (TH17) which is the pathological hallmark of both diseases. Other notable common areas are shared risk factors such as environmental and genetic risk factors. Regarding treatment, neither pathologies have a definitive cure, however, several strategies are employed, some of which are common, such as diet and lifestyle changes, and immunomodulating medication applied locally or systemically

Periodontal Tissue Reaction Consecutive Implantation of Endodontic Materials and Subsequent Integration of Complex Oral Rehabilitation Treatments

Oral rehabilitation is a main branch of dentistry focused on diagnosing the patient’s problem and creating a treatment plan to restore aesthetics, recondition morphologically all components, and recover the functionality of the oral cavity. Biological compatibility of the materials used has a major importance, due to the direct contact with essential tissues, such as the soft and hard tissue of the periodontium and the potential influence on the outcome of the treatment. The present material aims to assess the inflammatory response after subcutaneous implantation of three materials frequently used in endodontics (Mineral Trioxide Aggregate—MTA, DiaRoot BioAggregate, and Sealapex). The evaluation of the reparative tissue reaction after 7, 30, and 60 days, respectively, subsequent to in vivo implantation, was carried out through electron microscopy imaging. Moreover, evaluation of the dynamics of the osteogenesis process was an indicator for the maintenance of internal homeostasis in the context of complex intraoral rehabilitation treatments that include fixed prosthodontics correlated with the particular periodontal-aesthetic aspects and completed by cranio-mandibular repositioning. Our study showed increased absolute values of alkaline phosphatase in all material-implanted cases (more pronounced in MTA and Bio Aggregate), highlighting that this enzyme could be an effective indicator of bone formation, which takes place after the material implantation, with the most significant elevated values at 30 days postoperatively