Our objective was to investigate immunological changes that occur in saliva of subjects with type 2 diabetes mellitus (T2DM) without signs of periodontal disease and to establish if salivary inflammatory cytokines are a possible link between diabetes mellitus and periodontal breakdown.
Material and methods. Twenty T2DM subjects with no periodontal disease and twenty healthy controls were registered for the present study. TNF-α and IL-6 level from saliva and serum were measured. Periodontal tissue samples were histologically examined.
Results: TNF-α and IL-6 levels were higher in T2DM subjects compared to controls, with an extremely significant difference in saliva (p<0.001). Significant inflammation, affecting both epithelial and connective tissues was present in periodontal biopsies.
Conclusions: The subjects showed an increased TNF-α and IL-6 levels, both in serum and -mostly in -saliva of diabetics without signs of periodontal disease, confirming the hypothesis of immunological implication, as a correlation between periodontal disease incidence and diabetes mellitus. Histologic alterations, suggesting a local inflammatory state, were present in periodontal tissue of diabetics, confirming the above hypothesis. The study reveals that saliva analysis is a quite efficient method in testing the periodontal breakdown progression in the subjects with T2DM.
Bacterial plaque has the primary etiologic role in triggering the pathological changes of periodontal disease. A major goal of periodontal therapy is supraand subgingival bacterial flora reduction through scaling and root planning, through local and general antimicrobial treatment. The aim of our study was to evaluate the effectiveness of the mechanical treatment of scaling and root planning in reducing or suppressing bacterial species from the periodontal pockets. In order to conduct this study we collected and analyzed subgingival plaque samples taken from the 50 periodontal pockets with a depth of about 5mm, from 50 subjects with diagnosis of generalized chronic periodontitis, before and after scaling and root planning. The usage of API 20A test allows a quick and easy identification of anaerobic bacteria based on biochemical properties. Additional complementary tests were used, such as examining the culture and the morpho-tinctorial features to confirm and complete the identification. The microbial flora that we were able to isolate from the periodontal pockets before scaling and root planning was very rich. After scaling and root planning the subjects showed clinical improvement in the periodontal status, and the microbiological analysis of the periodontal pockets mostly showed a quantitative and qualitative reduction of bacterial species. A local or general antimicrobial treatment is recommended to assure improved effectiveness because mechanical treatment alone cannot completely suppress bacterial flora.
Objective: The objective of our work is to examine the presence of the much-discussed golden proportion provided by Levin, and of the golden percentage (Snow), on the widths of maxillary anterior teeth, by measurements made on digital images.
Material and method: The material of this study consists of digital photographs taken of subjects with natural and esthetic teeth. We took photos of 68 subjects (35 women and 33 men), between 19 and 26 years. Using a computer program, we made the necesarry measurements, then we made the appropriate calculations of the above theories.
Results: The golden proportion between the lateral and central incisor occurs in a higher proportion than between the canine and the lateral incisor. The values obtained by analyzing the golden proportion differ slightly from those proposed by Snow.
Conclusions: The frequency of the golden proportion is not significant for the groups of teeth mentioned. With small modifications and taking into consideration ethnic differences, Snow's golden percentage is more valid and applicable than Levin's golden proportion is.
Orthodontically induced external apical root resorption (OIEARR) is a major concern regarding periodontal status after nonsurgical orthodontic treatment. The aim of this study was to assess this sequel by a systematic review of published data. For assessment, we performed an electronic search of one database for comprehensive data, using keywords in different combinations: “root resorption”, “periodontics” and “nonsurgical orthodontic treatment”. We supplemented the results searching by hand in published journals and we cross-referenced with the accessed articles. Patients included in the results presented a good general health status, with no previous history of OIEARR and no other associated pathologies. Finally, twenty-three studies were selected and included in this review. A high prevalence (69–98%) and moderate severity of OIEARR (<5 mm and <1/3 from original root length) were reported. No difference in root resorption was found regarding the sex of the patients. A moderate positive correlation between treatment duration and root resorption was found. Also, a mild correlation regarding antero-posterior apical displacement and root resorption was found.
Introduction: According to last years' research, periodontopathogens may have a negative impact on treatment options in patients with periodontal lesions. However, not all infected sites suffer periodontal destructions, which can be explained on the assumption that only a limited number of pathogens present in a sufficient amount, are capable of affecting the periodontal tissue. Thermal cycling polymerase chain reaction (PCR) is a new technique used for the identification and quantification of periodontopathogenic bacteria. The aim of our study was to confirm the presence of periodontal pathogens, and to evaluate the amount of microbacterial pathogens in the periodontal pockets of patients undergoing orthodontic treatment for a more predictable result.
Material and methods: A total amount of 32 subgingival samples were collected from periodontal pockets ≥6 mm in 8 patients. Clinical examinations, periapical radiographs and periodontal screenings were performed. Only patients undergoing orthodontic treatment with fixed appliances were included in the study. PCR and DNA hybridization-based identification were performed by paper-point sampling using a micro-IDent plus, Hain Lifescience Germany kit.
Results and Discussions: Results showed that bacterial load may be connected to disease progression. The prevalence of the periodontopathogenic bacteria Actinobacillus a. was established in 42.8% of cases, P. Gingivalis in 71.42%, P. Intermedia 57.14%, Bacteroides F. was found in 85.71% of cases, Treponema D. in 100% of cases. Extremely high bacterial loads were recorded for Actinobacillus a., Bacteroides F. and Prevotella I.
Developmental disabilities exist in children and adolescents, enabling them to live an independent and self-governing life, requiring special health related services. We are intended to inform dental professionals in planning and implementing a dental treatment for people with developmental disabilities. Cerebral palsy is defined as being a group of motor abnormalities and functional impairments that affect muscle coordination, and characterized by uncontrolled body movements, intellectual disabilities, balance-related abnormalities or seizure disorders. These patients can be successfully treated in normal dental practices, but because they have problems with movements, care must be tailored accordingly. Down syndrome, a very common genetic disorder, is usually associated with different physical and medical problems, intellectual disabilities, and a developmental delay. These patients can be treated with success in dental offices, this way making a difference in the medical care for people with special needs. Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication and by restricted and repetitive behavior. Self-injurious behavior, obsessive routines and unpredictable body movements can influence dental care. Because of the coexisting conditions (epilepsy or intellectual disability), one can find this people among the most challenging to treat. There is a need of greater awareness, focus and education in the field of the unique and complex oral health care that people with disabilities need. Making a difference their oral health positively influences an already challenged existence. According to the ethical principles, patients with developmental disabilities should be treated equitably depending on their necessities.
Recent studies have shown that systemic inflammation caused by periodontal disease (PD) can determine important changes in the coronary arteries, favoring atherosclerosis progression and the development of acute coronary syndromes (ACS). The aim of the ATHERODENT study (Protocol Record Number CM0117-ATD) is to assess the interrelation between PD, inflammation, and the progression of coronary atherosclerosis in patients with ACS.
Material and methods: This case-control observational study will enroll 100 patients (group 1 – ACS and associated PD, and group 2 – ACS and no PD), in whom the following data will be collected: (1) demographic and clinical data; (2) cardiovascular risk factors; (3) full characterization of PD markers; (4) systemic inflammatory biomarkers; (5) imaging biomarkers derived from transthoracic echocardiography, computed tomography, coronary angiography, optical coherence tomography, and intravascular ultrasound; and (6) assessment of the presence of specific oral bacteria in samples of coronary plaques collected by coronary atherectomy, which will be performed during percutaneous revascularization interventions, when indicated in selected cases, in the atherectomy sub-study. The follow-up will be performed at 1, 3, 6, 12, 15, 18, and 24 months. The primary endpoint of the study will be represented by the rate of major adverse cardiovascular events (MACE) in PD vs. non-PD patients and in correlation with: (1) the level of systemic inflammation triggered by PD and/or by ACS at baseline; (2) the vulnerability degree of atheromatous plaques in the coronary tree (culprit and non-culprit lesions); and (3) the presence and burden of oral bacteria in atheromatous plaques. Secondary endpoints will be represented by: (1) the rate of progression of vulnerability degree of non-culprit coronary plaques; (2) the rate of progression of atheromatous burden and calcium scoring of the coronary tree; and (3) the rate of occurrence of left ventricular remodeling and post-infarction heart failure. The ATHERODENT study has been registered in clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT03395041).