Optical coherence tomography assessment of gingival epithelium inflammatory status in periodontal - Systemic affected patients.

INTRODUCTION: Optical coherence tomography (OCT) is an imaging tool used in various medical fields (ophthalmology, dermatology), which allows the observation of morphological particularities on the surface of tissues or internal constructive details of about 2-3mms in depth. In periodontology, it has been used as an experimental tool for periodontal pocket analysis (depth, calculus deposits) but not for the assessment of periodontal inflammation in the gingival tissues, which has been the subject of our in-vitro study. MATERIAL AND METHOD: Gingival samples were collected from three types of patients: patients with periodontal disease; patients with periodontal disease and a systemic comorbidity; periodontal and systemic healthy patients. The samples were scanned with an OCT light beam, resulting two-dimensional images of the gingival tissue (full thickness epithelium and partial connective tissue). The images were assessed using dedicated software, which allowed the quantification of pixels on a given segment in the epithelium. The average pixel densities were then calculated for each patient group and statistically analyzed. RESULTS: The resulted pixel densities were highest for the control group samples, while the lowest pixel densities were found in samples originating from periodontal patients with diabetes mellitus. For the other possible periodontal comorbidity, chronic hepatitis C, image assessment also exhibited lower pixel densities than those of the periodontal group, suggesting that this condition could also have an added effect on the tissular changes induced by periodontal disease. CONCLUSION: OCT has proven that in an in-vitro environment it can be a useful tool for the assessment of periodontal inflammation in gingival samples of periodontal patients. In terms of inflammatory tissular changes observed by OCT analysis, chronic hepatitis C could be regarded as possible periodontal disease's comorbidity.

Hepatitis C Infection and Periodontal Disease: Is there a Common Immunological Link?

Hepatitis C virus (HCV) infections could have an important impact on the oral health status of patients, favoring conditions such as periodontal disease and oral cancer. The review of the existing scientific literature written in English was performed, searching for oral and periodontal manifestations of HCV infection and its impact on the oral fluids. HCV infection can determine direct extrahepatic manifestations at the oral and periodontal level including oral lichen planus, Sjögren-like sialadenitis, and oral cancer. The changes caused by the infection in the subjects' immune system, diet, and lifestyle can facilitate the development of oral conditions such as periodontal disease. Important changes also occur in the composition of the infected patients' saliva and gingival fluid. HCV-infected patients need to be carefully monitored in terms of oral health since the infection with the virus can result in oral complications. The cellular and molecular particularities of the gingival fluid of HCV-infected patients can answer some questions regarding its impact upon periodontium impairment and whether this refers to a possible bidirectional relationship, with hepatic biomarker adjustments being induced by the periodontal patients' inflammatory status.