The effect of chronic periodontitis on dental pulp: A clinical and histopathological study

Background: This human study was carried out to evaluate the possible effects of severe chronic periodontal disease on the different aspect of dental pulp structure. Materials and Methods: A total of 20 permanent teeth with a hopeless prognosis due to severe chronic periodontitis were extracted from systemically healthy adults, with a pocket probing depth of ≥8 mm and a mobility of grade 3. After extraction, the apical 2-3 mm of the roots were immediately sectioned with a fissure bur. Results: Inflammation was usual finding in the samples, however, only 15% of the teeth showed no inflammation. Pulpal necrosis (partial or complete) was seen in different sections, and it was observed that 50% sections had no necrosis. Partial necrosis was a common finding seen when compared to complete necrosis (6.7%). About 60% of samples showed edematous pulp. Only 6.7% of samples showed absence of fibrosis. Pulp with moderate fibrosis was seen commonly seen in many sections. A majority of teeth (70%) also displayed a loss of odontoblastic integrity. In only 25% of samples, pulp stones were detected. Conclusion: Our results revealed that severe chronic periodontitis can affect dental pulp. The cumulative effect of the periodontal disease, as indicated by the factors of calcifications, apposition of calcified tissue, resorption or inflammation from the root caries or from the involved lateral canals, is damaged pulp tissue, but total disintegration is a certainty only when all main apical foramina are involved by bacterial plaque. Proper evaluation and treatment of periodontal-endodontic involvement is recommended

Relationship between periodontal disease and carotid atheromatous plaque: A clinico-ultrasound study

Aim: The aim of this study was to determine the relationship between Carotid atheromatous plaque in carotid artery with periodontal health and disease clinically and ultrasonographically and secondarily whether these relations are dependent on the level of serum high-density lipoprotein (HDL) cholesterol. Materials and Methods : The cross-sectional study was carried out on 60 subjects. Of which 30 subjects with chronic periodontitis and 30 subjects with healthy periodontium were recruited and they underwent ultrasound scanning of common carotid arteries to determine carotid plaque thickness. Clinical parameters measured were probing pocket depth, clinical attachment loss, plaque index, gingival index and biochemical parameters included total cholesterol, triglycerides, and HDL levels. Results : Periodontal disease is positively associated with carotid atherosclerosis. Plaque thickness and prevalence of carotid atheromatous plaque were significantly higher in the test group as compared to the control group. In the test group the mean carotid atheromatous plaque thickness was found to be 2.18 mm whereas in the control group it was found to be 0.14 mm. In test group, there was a positive and highly significant correlation of probing depth (PD) with triglycerides and total cholesterol levels and carotid atheromatous plaque thickness but a negative correlation between PD and HDL, triglycerides and total serum cholesterol levels in healthy subjects. HDL was significantly less in test group when compared with a control group with a P = 0.004. Conclusion: An inter-relationship between periodontal disease and the presence of atheromatous plaque exists. The prevalence of both periodontitis and atherosclerosis is very high. Periodontitis should be diagnosed and treated at its earliest and hence that clinician and public health practitioner can control the epidemic of cardiovascular diseases and reduce mortality

Comparative analysis of salivary sialic acid levels in patients with chronic obstructive pulmonary disease and chronic periodontitis patients: A biochemical study

Aim: Sialic acid plays a central role in the functioning of biological systems, in stabilizing the glycoproteins and cellular membranes, assisting in cell–cell recognition and interaction. The aim of this study is to evaluate and compare the periodontal health status and salivary Sialic acid levels in patients suffering from chronic obstructive pulmonary diseases (COPD) and chronic periodontitis patients. Materials and Methods: Ninety subjects were included in the study, which were divided into the following groups, 30 in each group. Group 1: patients suffering from COPD and chronic periodontitis, Group 2: periodontitis patients without any systemic diseases Group 3: healthy subjects. Unstimulated whole saliva samples were collected around 9–10 AM; 2 h after the subjects had breakfast. The sialic acid content was determined by a combined modification of the thiobarbituric acid method of Skoza and Mohos. Results: The mean salivary sialic acid levels were least in the healthy group followed by the periodontitis group, and it was highest in the COPD group. Conclusions: We can thus conclude that promotion of dental care knowledge is very much essential in the prevention and treatment of COPD. Thus, estimation of levels of salivary sialic acid can be used as an adjunct to diagnose the current periodontal disease status and to assess the treatment outcomes in subjects with COPD and chronic periodontitis