Genetic dysbiosis: the role of microbial insults in chronic inflammatory diseases

This review was undertaken at UCL, which received a proportion of funding from the Department of Health’s National Institute of Health Research (NIHR) Biomedical Research Centres funding scheme

Principles of Periodontology

Periodontal diseases are among the most common diseases affecting humans. Dental biofilm is a contributor to the etiology of most periodontal diseases. It is also widely accepted that immunological and inflammatory responses to biofilm components are manifested by signs and symptoms of periodontal disease. The outcome of such interaction is modulated by risk factors (modifiers), either inherent (genetic) or acquired (environmental), significantly affecting the initiation and progression of different periodontal disease phenotypes. While definitive genetic determinants responsible for either susceptibility or resistance to periodontal disease have yet to be identified, many factors affecting the pathogenesis have been described, including smoking, diabetes, obesity, medications, and nutrition. Currently, periodontal diseases are classified based upon clinical disease traits using radiographs and clinical examination. Advances in genomics, molecular biology, and personalized medicine may result in new guidelines for unambiguous disease definition and diagnosis in the future. Recent studies have implied relationships between periodontal diseases and systemic conditions. Answering critical questions regarding host‐parasite interactions in periodontal diseases may provide new insight in the pathogenesis of other biomedical disorders. Therapeutic efforts have focused on the microbial nature of the infection, as active treatment centers on biofilm disruption by non‐surgical mechanical debridement with antimicrobial and sometimes anti‐inflammatory adjuncts. The surgical treatment aims at gaining access to periodontal lesions and correcting unfavorable gingival/osseous contours to achieve a periodontal architecture that will provide for more effective oral hygiene and periodontal maintenance. In addition, advances in tissue engineering have provided innovative means to regenerate/repair periodontal defects, based upon principles of guided tissue regeneration and utilization of growth factors/biologic mediators. To maintain periodontal stability, these treatments need to be supplemented with long‐term maintenance (supportive periodontal therapy) programs

Dexamethasone and Basic‐Fibroblast Growth Factor Regulate Markers of Mineralization in Cementoblasts In Vitro

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142252/1/jper1550.pd

Treatment of Peri‐Implant Defects With Combination Growth Factor Cement

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141685/1/jper0008.pd

The prevalence of advanced loss of periodontal attachment in two New Mexico populations

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65430/1/j.1600-0765.1987.tb01550.x.pd

The effects of subgingival application of ozonated olive oil gel in patient with localized aggressive periodontitis. A clinical and bacteriological study

AbstractThis study evaluates the effect of subgingival application of ozonated olive oil gel as an adjunct to scaling and root planing (SRP) in aggressive periodontitis.Material & methodsThirty patients were randomly selected and equally divided into: Group I received SRP only, group II received SRP and ozonated olive oil gel (Oxactiv). Subgingival application of ozone gel was performed following initial SRP and at 7, 14 and 21 days. Clinical measurements included pocket depth (PD), plaque index (PI), gingival index (GI), bleeding on probing (BOP) and clinical attachment level (CAL). Real time PCR was carried out to determine the effect of the treatment on both Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg). Clinical measurements and Plaque samples for PCR were recorded at baseline, one, three and six months after treatment.ResultsThe results showed improvement in all clinical parameters in (group II) which was maintained up to six months (P < 0.05). However, this improvement was best following one month but gradually decrease at 3 and 6 months. Whereas SRP alone resulted in a significant improvement only up to one month for BOP, PPD and CAL parameters and up to three months for the PI and GI scores as compared to baseline values.Microbiological resultsRevealed significant reduction of the mean Pg and Aa DNA copies at 1 and 3 months for (groupII), whereas group I resulted in slight reduction up to 1 month only followed by gradual increase reaching baseline values. There was no significant difference between groups at three and six months regarding Pg DNA copies. There was a significant difference between groups at the one and three months periods in term of number of Aa copies (P < 0.001, P < 0.05 respectively).ConclusionThe study concluded that (Oxactiv) gel could be a promising adjunct to SRP in the treatment of aggressive periodontitis

Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study

The study examined the relationship between oral health status (periodontal disease and carious pulpal exposure (CPE)) and preterm low-birth-weight (PTLBW) infant deliveries among Tanzanian-African mothers at Muhimbili National Hospital (MNH), Tanzania. A retrospective case-control study was conducted, involving 373 postpartum mothers aged 14-44 years (PTLBW--150 cases) and at term normal-birth-weight (TNBW)--223 controls), using structured questionnaire and full-mouth examination for periodontal and dentition status. The mean number of sites with gingival bleeding was higher in PTLBW than in TNBW (P = 0.026). No significant differences were observed for sites with plaque, calculus, teeth with decay, missing, filling (DMFT) between PTLBW and TNBW. Controlling for known risk factors in all post-partum (n = 373), and primiparaous (n = 206) mothers, no significant differences were found regarding periodontal disease diagnosis threshold (PDT) (four sites or more that had probing periodontal pocket depth 4+mm and gingival bleeding > or = 30% sites), and CPE between cases and controls. Significant risk factors for PTLBW among primi- and multiparous mothers together were age < or = 19 years (adjusted Odds Ratio (aOR) = 2.09, 95% Confidence interval (95% CI): 1.18-3.67, P = 0.011), hypertension (aOR = 2.44, (95% CI): 1.20-4.93, P = 0.013) and being un-married (aOR = 1.59, (95% CI): 1.00-2.53, P = 0.049). For primiparous mothers significant risk factors for PTLBW were age < or = 19 years (aOR = 2.07, 95% CI: 1.13 - 3.81, P = 0.019), and being un-married (aOR = 2.58, 95% CI: 1.42-4.67, P = 0.002). These clinical findings show no evidence for periodontal disease or carious pulpal exposure being significant risk factors in PTLBW infant delivery among Tanzanian-Africans mothers at MNH, except for young age, hypertension, and being unmarried. Further research incorporating periodontal pathogens is recommended

Surgical treatment of gingival overgrowth with 10 years of follow-up

<p>Abstract</p> <p>Background</p> <p>In some pathological conditions, gingivitis caused by plaque accumulation can be more severe, with the result of an overgrowth. Nevertheless, the overgrowth involves the gingival margin with extension to the inter-dental papilla. The lesion may involve the inter-proximal spaces, and become so extensive that the teeth are displaced and their crowns covered. Severe overgrowth may lead to impairment in aesthetic and masticatory functions, requiring surgical excision of the excessive tissue. Aim of this study is to describe an operative protocol for the surgical treatment of localized gingival overgrowth analyzing the surgical technique, times and follow-up.</p> <p>Methods</p> <p>A total of 20 patients were enrolled and underwent initial, non surgical, periodontal treatment and training sessions on home oral hygiene training. The treatment plan involved radical exeresis of the mass followed by positioning of an autograft of connective tissue and keratinized gingiva.</p> <p>Results</p> <p>During 10 years of follow-up, all the grafts appeared well vascularized, aesthetically satisfactory, and without relapse.</p> <p>Conclusions</p> <p>Periodontal examinations, surgical procedures, and dental hygiene with follow-up are an essential part of the treatment protocol. However, additional effort is needed from the patient. Hopefully, the final treatment result makes it all worthwhile.</p