Oral health-related quality of life in subjects with hidradenitis suppurativa suffering from periodontitis.

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder affecting the pilosebaceous unit in intertriginous body areas, and recent research suggests an association with periodontitis. Aim: To assess oral health-related quality of life (OHRQoL) in patients with HS diagnosed additionally with periodontitis and to compare it to patients with periodontitis alone. Material and methods: The study involved 55 HS patients, with 25 in the HS + P group (both HS and periodontitis) and matched controls in the periodontitis-only group (P group). Outcomes were assessed using the Oral Health Impact Profile (OHIP-14) questionnaire. Results: No significant difference was observed in the mean OHIP-14 total score between the HS + P group and the P group. Patients with HS + P were less likely to undergo the dental evaluation and floss their teeth less frequently compared to the P group. Conclusions: The findings reveal that the coexistence of HS in patients with periodontitis does not significantly influence OHRQoL. Lower dental evaluation frequency and less frequent flossing in HS+P patients suggest reduced attention to oral health practices.

Enzymatic antioxidants activity in gingival crevicular fluid and saliva in advanced periodontitis.

AIM: Enzymatic antioxidants are the primary line of defense against oxidative and nitrosative stress. However, their involvement in the progression of periodontitis is still not well understood. The study aimed to determine the activity of enzymatic antioxidants in the gingival crevicular fluid (GCF) and saliva of patients with periodontitis. MATERIALS AND METHODS: The study group of 56 patients with periodontitis (stage III and IV) and 28 healthy controls were involved. The modified plaque index, probing depth, the clinical attachment level, the percentage of sites with bleeding on probing, papilla bleeding index, and maximum value of tooth mobility (Periotest®) were tested. Saliva (stimulated and non-stimulated) and GCF were collected from the participants, and activity of peroxidase, catalase, superoxide dismutase, and glutathione reductase were determined colorimetrically. RESULTS: Lower activity of peroxidase (p < 0.0001), catalase (p < 0.0001), superoxide dismutase (p = 0.0188), and glutathione reductase (p < 0.0001) was noted in non-stimulated saliva of patients with periodontitis compared to healthy subjects. Peroxidase (p < 0.0001), catalase (p < 0.0001) and superoxide dismutase (p < 0.0001) showed lower activity in stimulated saliva of patients with periodontitis compared to healthy subjects. The peroxidase (p < 0.0029), catalase (p < 0.0001), and glutathione reductase (p = 0.0028) activity in GCF of stage III + IV were significantly higher compared to healthy controls. Superoxide dismutase (p < 0.0001) showed lower activity in GCF of patients with periodontitis. CONCLUSIONS: The demonstrated decrease in activity of all analyzed enzymatic antioxidants in non-stimulated saliva may result from long-lasting periodontitis and exhaustion of the safeguard mechanism against reactive oxygen species.

In Vivo Evaluation of Periodontal Phenotypes Using Cone-Beam Computed Tomography, Intraoral Scanning by Computer-Aided Design, and Prosthetic-Driven Implant Planning Technology.

BACKGROUND Two clinical parameters, the gingival thickness (GT) and the width of keratinized tissue (WKT), describe the gingival phenotype, which is defined as the 3-dimensional volume of the gingiva. The periodontal phenotype additionally includes the thickness of the labial plate of the alveolar crest (TLPAC). MATERIAL AND METHODS Thirty patients with healthy periodontium on the upper canines and incisors underwent measurements for crestal, supracrestal, free gingival thickness (FGT), the alveolar crest-gingival margin (AC-GM), alveolar crest-cementoenamel junction distance, and the TLPAC at 2, 4, and 8 mm apically from the edge of the alveolar crest using cone-beam computed tomography (CBCT) with computer-aided design and prosthetic-driven implant planning technology. For each tooth, the gingival and periodontal phenotype was evaluated on the basis of the gingival thickness, width of keratinized tissue (WKT), and TLPAC measurements. Each patient's periodontal phenotype was evaluated according to the coronal width/length ratio of both the upper central incisors. RESULTS The dentogingival units had varying average values for the 3 periodontal phenotypes (thin phenotype: FGT 0.65±0.06 mm, WKT 4.85±1.18 mm, AC-GM 3.17±0.64 mm, TLPAC2 0.66±0.28 mm; medium phenotype: FGT 0.87±0.07 mm, WKT 5.49±1.23 mm, AC-GM 3.36±0.65 mm, TLPAC2 0.76±0.37 mm; and thick phenotype: FGT 1.20 mm, WKT 6.00 mm, AC-GM 3.90 mm, TLPAC2 0.90 mm). Positive correlations were seen among WKT, FGT, AC-GM, and TLPAC2. CONCLUSIONS Positive correlations between the FGT and WKT, and the AC-GM distance confirm that measurements using CBCT with computer-aided design and prosthetic-driven implant planning technology can evaluate the gingival phenotype and TLPAC2 for the periodontal phenotype.

Reasons and risk indicators tor tooth loss in the Polish cross-sectional gerodontological study

INTRODUCTION: The number of teeth in the elderly is the most essential epidemiological data in gerodontological studies. It depends mainly on two medical causes in the form of caries and periodontitis, as well as many risk factors and indicators for tooth preservation and loss. The goals of the cross-sectional study among the residents of Wroclaw and Olawa aged 65-74 have been to assess the number of preserved teeth, severe tooth loss and edentulism in a 30-year trend and in relation to current European regional data. In addition, the most important risk indicators for tooth preservation and loss in the assessed population will be determined. MATERIAL AND METHODS: After applying the two-tier stratification method from a group of 1,200 people, 387 volunteered for the study. The examination was conducted in dental offices in Wroclaw and Olawa, it consisted from clinical and anamnestic parts. The average number of preserved teeth in the entire group was 13.07 (median 15), there were 21.2% persons with functional dentition, 21.4% with severe tooth loss and 14.2% with edentulism. The main direct reason of tooth loss was caries and its complications, which concerned 81.9% of the teeth removed, on average over 12 teeth in the examined person. RESULTS: Referring the results of the obtained study to previous observations can be seen, that in the 30-year trend for Wroclaw in people aged 65 to 74 years, the average number of teeth as well as the percentage of edentulism have improved, but they are still worse than the results of regional European studies. The main risk indicators of earlier loss of teeth by seniors in Lower Silesia are low income, past incorrect pro-health behaviours towards the oral cavity as well as current smoking and history of cardiovascular incidence.

Effectiveness of orthodontic miniscrew implants in anchorage reinforcement during en-masse retraction: A systematic review and meta-analysis.

INTRODUCTION: The aim of this systematic review was to compare the effectiveness of orthodontic miniscrew implants-temporary intraoral skeletal anchorage devices (TISADs)-in anchorage reinforcement during en-masse retraction in relation to conventional methods of anchorage. METHODS: A search of PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science was performed. The keywords were orthodontic, mini-implants, miniscrews, miniplates, and temporary anchorage device. Relevant articles were assessed for quality according to Cochrane guidelines and the data extracted for statistical analysis. A meta-analysis of raw mean differences concerning anchorage loss, tipping of molars, retraction of incisors, tipping of incisors, and treatment duration was carried out. RESULTS: Initially, we retrieved 10,038 articles. The selection process finally resulted in 14 articles including 616 patients (451 female, 165 male) for detailed analysis. Quality of the included studies was assessed as moderate. Meta-analysis showed that use of TISADs facilitates better anchorage reinforcement compared with conventional methods. On average, TISADs enabled 1.86 mm more anchorage preservation than did conventional methods (P <0.001). CONCLUSIONS: The results of the meta-analysis showed that TISADs are more effective than conventional methods of anchorage reinforcement. The average difference of 2 mm seems not only statistically but also clinically significant. However, the results should be interpreted with caution because of the moderate quality of the included studies. More high-quality studies on this issue are necessary to enable drawing more reliable conclusions.

Periodontal status and selected parameters of oral condition of Poles aged 65 to 74 years.

INTRODUCTION: The goal of this study was the evaluation of the periodontal health by means of CPI score in inhabitants of big and small cities in the age range from 65 to 74 and making comparison with previous Polish and European studies from XXI century. Also an average number of natural teeth, the edentulous persons percentage, the percentage of people with oral function maintenance and prevalence of oral mucosal diseases were evaluated. There were also attempts to evaluate essential behaviours related to the oral health and the percentage of people that are treated with use of non-reimbursed or reimbursed services. MATERIAL AND METHODS: Studies were conducted in 5 big cities: Warszawa, Szczecin, Wroclaw, Bialystok and Torun, as well as in 4 towns, such as Olawa, Police, Lobez and Elk. From sampling 7400 people aged from 65 to 74 years for the study reported only 807 people. In the mouth evaluated CPI score, number of natural teeth and prevalence of pathological lesions on cavity mucosa. Answers for questions on selected attitudes and health-seeking behaviours related to the oral health and the range of dental treatment were also analysed. RESULTS: Distribution of values of CPI codes in the whole group was as follows: CPI0-1.2%, CPI1-9.4%, CPI2-16.6%, CPI3-21.8%, CPI4-19.7% and the number of people excluded from examinations (1 tooth in the sextant or edentulous 31.3%). The state of the periodontium was worse in big cities and in men. An average number of teeth was 13.7 and was higher in big cities and in men. The percentage of edentulous persons was 28.9% and was higher in towns and in woman. The percentage of people with oral function maintenance was 25.15% and was higher in big cities and in men. The most three common pathologies of the oral cavity were leukoplakia and leukokeratosis that were found in 10.5% of examined people, candidiasis 5.82% and lichen planus 2.2%. CONCLUSION: The state of the periodontium of Poles at the age from 65 to 74 has not been improved in XXI century, but also does not significantly differ from an average European level. An average number of remaining teeth of Poles at this age has increased, but remains under a European average; also the prevalence of edentulism has decreased, but still remains one of the highest in Europe. The percentage of people with oral function maintenance is very low, thus needs for prosthetic treatment and rehabilitation of masticatory ability remain high. Precancerous lesions in the oral cavity are quite common in this age group. Health-seeking behaviours related to the oral health of older Poles are inadequate and result from a low level of knowledge on dental prophylaxis.

[Plastic bag suffocation in material collected by Department of Forensic Medicine in Krakow]. / Uduszenie workiem foliowym w materiale Zakladu Medycyny Sadowej w Krakowie.

Cases of death resulting from placing a plastic bag on the victim's head are very rare. In the last 20 years, in the Department of Forensic Medicine in Krakow, there were fourteen such cases examined. Their number is, however, noticeably growing, amounting to as many as few cases per year. Death resulting from this mechanism is difficult from the diagnostic point of view and often the only indicative evidence is a presence of a plastic bag on the head.

Technological Aspects and Evaluation Methods for Polymer Matrices as Dental Drug Carriers.

The development of polymer matrices as dental drug carriers takes into account the following technological aspects of the developed formulations: the composition and the technology used to manufacture them, which affect the properties of the carriers, as well as the testing methods for assessing their behavior at application sites. The first part of this paper characterizes the methods for fabricating dental drug carriers, i.e., the solvent-casting method (SCM), lyophilization method (LM), electrospinning (ES) and 3D printing (3DP), describing the selection of technological parameters and pointing out both the advantages of using the mentioned methods and their limitations. The second part of this paper describes testing methods to study the formulation properties, including their physical and chemical, pharmaceutical, biological and in vivo evaluation. Comprehensive in vitro evaluation of carrier properties permits optimization of formulation parameters to achieve prolonged retention time in the dynamic oral environment and is essential for explaining carrier behavior during clinical evaluation, consequently enabling the selection of the optimal formulation for oral application.

The mRNA expression of genes encoding selected antioxidant enzymes and thioredoxin, and the concentrations of their protein products in gingival crevicular fluid and saliva during periodontitis.

BACKGROUND: The activity of antioxidant enzymes in periodontitis is reduced, but results vary between studies and are subject to bias. In turn, the expression of genes encoding antioxidant factors has not been examined yet. OBJECTIVES: This is the first study to evaluate the expression of genes encoding superoxide dismutase 1 (SOD1), glutathione peroxidase 1 (GPX1) and thioredoxin 1 (TXN1) in the saliva and gingival tissue of patients with periodontitis. The activity of the antioxidant enzyme protein products in the unstimulated and stimulated saliva and the gingival crevicular fluid (GCF) of patients with periodontitis was also investigated. MATERIAL AND METHODS: The prospective study involved 65 patients with periodontitis, who were divided into groups depending on the disease stage, and a control group of 31 ageand gender-matched healthy patients. RESULTS: We demonstrated that the expression of genes encoding GPX1 and TXN1 in saliva was significantly higher, and the expression of genes encoding SOD1, GPX1 and TXN1 in the gingival tissue was significantly lower in periodontitis patients as compared to the control group. We noted a lower activity of GPX1 in unstimulated saliva, of SOD1 in stimulated saliva and of both antioxidant enzymes in GCF in patients with periodontitis. CONCLUSIONS: The GPX1 transcriptome and its activity in the salivary and GCF proteome appear to be dependent on the oxidative stress related to the destructive inflammatory changes in periodontitis.

The Composition of Subgingival Microbiome in Hidradenitis Suppurativa and Periodontitis Patients.

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of the pilosebaceous unit of the intertriginous body areas. Recent findings have suggested the association between periodontitis and HS. This investigation aimed to characterize and compare the composition of subgingival microbiome between HS, periodontitis, and control patients. The nine crucial perio-pathogenic species and total bacteria were analyzed using RT-PCR based tests in samples collected from 30 patients with periodontitis, 30 patients with HS and 30 controls. Patients with HS were excluded if they had periodontitis and patients with periodontitis were excluded if they had HS. The mean total bacteria count was significantly higher in HS and periodontitis samples than in control samples (p < 0.05). The majority of perio-pathogens tested were more frequently detected in HS and periodontitis groups than among controls. Treponema denticola was the most common pathogen in individuals with HS (70%) and periodontitis (86.7%), while among controls Capnocytophyga gingivalis was the most frequently detected isolate (33.2%). The results of the present investigation demonstrated that HS and periodontitis patients share some similarities in their subgingival microbiome composition.

The characteristics of autonomic nervous system disorders in burning mouth syndrome and Parkinson disease.

AIMS: To conduct a clinical electrophysiologic evaluation of autonomic nervous system functions in patients with burning mouth syndrome and Parkinson disease and estimate the type and intensity of the autonomic dysfunction. METHODS: The study involved 83 subjects-33 with burning mouth syndrome, 20 with Parkinson disease, and 30 controls. The BMS group included 27 women and 6 men (median age, 60.0 years), and the Parkinson disease group included 15 women and 5 men (median age, 66.5 years). In the control group, there were 20 women and 10 men (median age, 59.0 years). All patients were subjected to autonomic nervous system testing. In addition to the Low autonomic disorder questionnaire, heart rate variability (HRV), deep breathing (exhalation/inspiration [E/I] ratio), and sympathetic skin response (SSR) tests were performed in all cases. Parametric and nonparametric tests (ANOVA, Kruskal-Wallis, and Scheffe tests) were used in the statistical analysis. RESULTS: The mean values for HRV and E/I ratios were significantly lower in the burning mouth syndrome and Parkinson disease groups. Significant prolongation of SSR latency in the foot was revealed in both burning mouth syndrome and Parkinson disease patients, and lowering of the SSR amplitude occurred in only the Parkinson disease group. The autonomic questionnaire score was significantly higher in burning mouth syndrome and Parkinson disease patients than in the control subjects, with the Parkinson disease group having the highest scores. CONCLUSION: In patients with burning mouth syndrome, a significant impairment of both the sympathetic and parasympathetic nervous systems was found but sympathetic/parasympathetic balance was preserved. The incidence and intensity of autonomic nervous system dysfunction was similar in patients with burning mouth syndrome and Parkinson disease, which may suggest some similarity in their pathogeneses.

Periodontitis and risk of preterm birth and low birthweight--a meta-analysis.

INTRODUCTION: Periodontitis and prematurity are social diseases with common risk factors. In 1996 periodontitis was proven to be a possible significant and independent risk factor of preterm birth of newborns with low body weight. Numerous studies on the influence of periodontitis on the time of birth and/or birth weight of newborns have been conducted throughout the world since, including several ones in Poland, but their results have been inconsistent. Work objective: A meta-analysis of case-control, prospective and cohort studies on the influence of periodontitis on preterm birth and low birth weight. METHODS: The international and Polish bibliography bases were searched for essays on the relationship between periodontitis and preterm birth and/or low birth weight published between 1996 and 2010. All essays qualified for the meta-analysis were subjected to qualitative evaluation. The calculation of the overall odds ratio used both, fixed-effects and random-effects models (DerSimonian-Liard method). The heterogeneity of the included studies and effect of publication bias were also subjected to evaluation. RESULTS: The meta-analysis included 15 case-control studies, 1 cross-sectional study and 6 cohort studies. The essays came from 4 continents: 8 from Europe (including 2 from Poland), 7 from South America, 4 from North America, and 3 from Asia. The total analysis covered 12047 pregnant women. The overall odds ratio of giving premature birth to a child with low weight for mothers with periodontitis in the model of random effects amounted to 2.35 (1.88-2.93, p < 0.0001). For low birth weight, the overall OR was 1.5 (95% Cl: 1.26-1.79, p = 0.001) for premature births--2.73 (95% CI: 2.06-3.6, p < 0.0001). A significant heterogeneity of the studies included in the meta-analysis was observed, and a significant publication bias was also demonstrated. CONCLUSIONS: The hypothesis of periodontitis as an independent risk factor of preterm birth and/or low birth weight needs further verification. In order to achieve that, it is necessary to conduct more methodologically well-planned cohort and intervention studies. The need of dental care for pregnant women as an integral component of the prenatal care program remains to be an important issue.

Comparison of Clonazepam and Tongue Protector in the Treatment of Burning Mouth Syndrome.

BACKGROUND: BMS is a chronic pain syndrome affecting the oral mucosa. It consists of experiencing a burning or dysesthetic sensation. BMS prevalence varies, with up to 15% among women. An effective treatment is still unattainable. MATERIAL AND METHODS: A total of 60 patients with BMS qualified for a randomised trial, divided in two groups: the clonazepam-treated and tongue protector group. Treatment was provided for 4 weeks in both groups. In the former, the oral dosage of clonazepam 0.5 mg; in the latter, a tongue protector was used. Clinical oral examination was performed, and the presence of taste disorder and pain intensity, on the visual analogues scale, were recorded. Psychological domains were explored with the Beck depression inventory (depression), Athens insomnia scale (insomnia), Eyesenck personality questionnaire-revised (personality traits), and WHO quality of life questionnaire (quality of life). RESULTS: Complete recovery was observed in three patients after clonazepam and one patient after tongue guard treatment. A greater improvement in the VAS scores, from baseline to the control values, was demonstrated in the clonazepam group, and it was statistically significant. In women, the level of depression significantly correlated with all domains of quality of life. CONCLUSIONS: BMS is an ongoing multi-specialist challenge. The development of new pathophysiological concepts of BMS offers hope for more effective treatment. Considering the influence of BMS on the quality of life and mental disorders in most patients, further research on the possibilities of therapy seems to be very important.

Gingival fluid and saliva concentrations of selected non-enzymatic antioxidants in periodontitis.

BACKGROUND: Due to their low specificity, non-enzymatic antioxidants play a significant role in the protection of organisms against free radicals. They are normally sourced from the diet, and independently react with oxidizing molecules and their products. OBJECTIVES: The study aimed to determine the concentrations of selected non-enzymatic antioxidants (uric acid (UA), reduced glutathione (GSH) and polyphenols) in the gingival fluid and saliva of patients diagnosed with periodontitis according to the current criteria. MATERIAL AND METHODS: This prospective case-control study included 50 patients with periodontitis, who were divided into 2 groups depending on disease severity, along with 25 healthy controls. Unstimulated saliva, stimulated saliva and gingival crevicular fluid (GCF) were collected from all subjects, and nonenzymatic antioxidant concentrations were determined. RESULTS: Significantly lower concentrations of all tested non-enzymatic antioxidants were observed in the gingival fluid as well as in the unstimulated and stimulated saliva of patients with periodontitis (p < 0.05). Moreover, the concentration of GSH was a parameter that differentiated the various degrees of periodontitis (p < 0.05). A significantly lower concentration of GSH was found in the stimulated saliva of patients with moderate progression as compared to those with fast progression of the disease (p < 0.05). CONCLUSIONS: The continuation of research on the GSH concentrations in the gingival fluid and saliva may be useful in the context of biomarkers for periodontitis progression.

The Prevalence of Periodontitis and Assessment of Oral Micro-Biota in Patients with Hidradenitis Suppurativa: A Descriptive Cross-Sectional Study.

Periodontitis has been causally connected with the development of other immune-mediated inflammatory disorders previously. Nevertheless, the current literature does not provide knowledge on oral health in hidradenitis suppurativa (HS) individuals. The aim of this study was to assess the prevalence of periodontitis and characterize an oral microbiome in HS patients. Fifty-five patients with HS and fifty-five healthy controls were enlisted in the study. The incidence of periodontitis was assessed in all patients during the periodontal evaluation. RT-PCR tests were used to quantification of bacterial content and assess the number and composition of nine crucial periodontal pathogens. HS patients had a significantly higher prevalence of periodontitis than healthy controls (45.5% versus 14.5%). Significantly higher values of average copy-count numbers of total bacteria were found in HS patients. The majority of periodontal pathogens were more frequently isolated in patients with HS than among controls. The most frequently detected pathogen in the HS group was Treponema denticola (70.9%), whereas among controls Capnocytophaga gingivalis (34.5%) was the most common isolate. There was no correlation between HS severity and the number of DNA copies of periodontal bacteria. The findings of this research suggest that periodontitis may contribute to the development of HS.

A Comparison of Clinical Efficiency of Photodynamic Therapy and Topical Corticosteroid in Treatment of Oral Lichen Planus: A Split-Mouth Randomised Controlled Study.

BACKGROUND: The aim of the study was to compare the effectiveness of photodynamic therapy (PDT) to steroid therapy in the treatment of oral lichen planus (OLP). Due to the lack of commercially available drug carriers, innovative proprietary solutions were used for both the photosensitiser and the steroid carrier-in the first case to shorten and in the second to extend the contact of the active substance with the mucosa. METHODS: A prospective, randomised, single-blind, 12-week full contralateral split-mouth clinical trial of 30 patients with bilateral oral lichen planus was conducted. The prepared matrices were incorporated with active substances methylene blue 5% and 0,05% triamcinolone. The size of lesions, Thongprasom, ABISIS, and VAS scale were evaluated. RESULTS: Relatively high rates of complete remission of lichen were demonstrated: immediately after treatment, 33.3% with PDT and 22.2% with triamcinolone (TA), and after 3 months, 54.2% with PDT and 62.9% with TA. After 3 months of treatment, a reduction in the area of evaluated lesions of 52.7% for PDT and 41.7% for TA was achieved. CONCLUSION: In situations of topical or general contraindications to oral corticosteroids, resistance to them, or the need for repeated treatment in a short period of time, PDT appears to be a very promising treatment option.

Fractal Dimension and Texture Analysis of Lesion Autofluorescence in the Evaluation of Oral Lichen Planus Treatment Effectiveness.

BACKGROUND: Oral Lichen planus (OLP) is a chronic inflammatory disease. Topical steroids are used as the treatment of choice. The alternative is photodynamic therapy (PDT). The study aimed to fabricate optimal biodegradable matrices for methylene blue or triamcinolone acetonide because of a lack of currently commercially available carriers that could adhere to the mucous. METHODS: The study was designed as a 12-week single-blind prospective randomized clinical trial with 30 patients, full contralateral split-mouth design. Matrices for steroid and photosensitizer and laser device were fabricated. Fractal and texture analysis of photographs, taken in 405, 450, 405 + 450 nm wavelength, of lesions was performed to increase the objectivity of the assessment of treatment. RESULTS: We achieved two total responses for treatment in case of steroid therapy and one in the case of PDT. Partial response was noted in 17 lesions treated using local steroid therapy and 21 in the case of PDT. No statistically significant differences were found between the effectiveness of both used methods. Statistically significant differences in fractal dimension before and after treatment were observed only in the analysis of photographs taken in 405 + 450 nm wavelength. CONCLUSIONS: Photodynamic therapy and topical steroid therapy are effective methods for treating OLP. Using a carrier offers the possibility of a more predictable and effective method of drug delivery into the mucous membrane. Autofluorescence enables the detection of lesions especially at the early stage of their development.

Periodontitis and risk for preeclampsia - a systematic review.

OBJECTIVES: The aim of the study is to review systematic cohort and randomized trials on the relationship between periodontitis and preeclampsia. Periodontitis is an independent risk factor for preeclampsia (PE), and periodontal treatment could play a significant role in the prevention of this pregnancy complication. MATERIAL AND METHODS: A total of 821 items (published until March 2019), thematically related to the relationship between periodontitis, its treatment and the incidence of preeclampsia, were collected from the databases of PubMed, Scopus, Google Scholar and the Polish Database of Medical Bibliography and analyzed. In the end, 6 cohort studies and 3 randomized controlled trials (from the years 2003-2016) were deemed eligible for the review. The main exclusion criteria were as follows: case-control and cross-sectional studies, medical and dental conditions. RESULTS: A significant relationship between periodontitis and the risk for developing preeclampsia was demonstrated in 5 cohort trials, which was not confirmed by only 1 study. A total of 2724 pregnant women, including 195 (7.16%) with PE, were analyzed. In 3 randomized trials which assessed the impact of non-surgical treatment (scaling and root planing = SRP) on the occurrence of preeclampsia, the preventive effects of the implemented treatment was not confirmed. A total of 116 women from the group of 1825 pregnant subjects undergoing the non-surgical treatment (SRP) and 116 women from the control group of 1827 pregnant women were subsequently diagnosed with PE, which amounted to 6.30% and 6.35%, respectively. CONCLUSIONS: The cohort studies indicated that periodontitis may result in an increased risk for developing PE. A more detailed analysis regarding the impact of potential risk factors and modification of further studies (clarification of how periodontitis and preeclampsia should be defined in observations, consideration of disease severity, earlier at 12-16 weeks of gestation - implementation of the non-surgical treatment, modification and extension of the classical protocol of the non-surgical treatment of periodontal diseases, as well as conducting European studies), are necessary due to considerable discrepancies in the available literature sources (cohort and randomized observations).

Impact of periodontitis on the Oral Health Impact Profile: A systematic review and meta-analysis.

BACKGROUND: Periodontitis, being a chronic and multifactorial disease, affects oral health, and consequently, the patient's quality of life (QoL). The assessment of the oral health-related quality of life (OHRQoL) is possible with the Oral Health Impact Profile-14 (OHIP-14) questionnaire comprising 7 subdomains: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. OBJECTIVES: The aim of this study was to conduct a systematic review of cross-sectional or case-control studies concerning the impact of periodontitis on QoL measured with OHIP-14. The outcomes of the studies were subjected to a meta-analysis. MATERIAL AND METHODS: On the basis of a survey of databases (MEDLINE, Scopus, Google Scholar, and Polish Medical Bibliography - PBL), 1,346 titles related thematically to the impact of periodontitis on QoL were obtained and analyzed. Ten studies were considered eligible for evaluation (8 cross-sectional ones and 2 case-control ones). RESULTS: All studies indicated a significant influence of periodontitis on the deterioration of the OHIP-14 values. This relationship was shown to be directly modified in proportion to the degree of the advancement of the periodontal disease and to the extent of periodontal tissue damage. Our own meta-analysis confirmed the correlation between the prevalence of periodontitis and increased OHIP-14 scores with a cumulative odds ratio (OR) of 1.33, demonstrated a moderately significant deterioration of the OHIP-14 scores by 4.2 points in the group with periodontitis as compared to the control group, and assessed the probability of OHIP-14 deterioration to be 3.5 times greater in severe periodontitis. CONCLUSIONS: The impact of periodontitis on the deterioration of OHRQoL is quite clearly explained by the clinical symptoms of periodontitis. According to patients, the most important problems that periodontitis may cause include psychological discomfort, stress, problems in interpersonal relations, or even difficulties in daily activities. This indicates the need for more of a holistic approach in planning the goals of the periodontal therapy, taking into account the psychological and social aspects of the patient's perception of the disease.

Nitrosative Stress Biomarkers in the Non-Stimulated and Stimulated Saliva, as well as Gingival Crevicular Fluid of Patients with Periodontitis: Review and Clinical Study.

Diagnosis of periodontopathy is complex and includes defining the cause, type, stage, and grade of periodontitis. Therefore, alternative diagnostic methods are sought to indicate the progression of inflammation or to determine the effectiveness of therapy. Gingival crevicular fluid (GCF) biomarkers can be particularly useful because they most likely reflect the disease process of the periodontal tissues. However, the difficulty of collecting GCF for testing is the reason for the limited use in diagnostics. Because periodontitis is the primary source of nitrogen free radicals in the oral cavity, the aim of the study was to evaluate the biomarkers of nitrosative stress (nitric oxide, peroxynitrite, and S-nitrosothiols) in GCF, non-stimulated and stimulated saliva of 90 patients with periodontitis. The study group was divided into two subgroups, depending on the stage of the disease severity. We showed a significantly higher concentration of all assessed biomarkers in the non-stimulated and stimulated saliva of patients with periodontitis. However, significant changes in GCF has been shown only for peroxynitrite. The studied biomarkers did not correlate with clinical periodontal status, which probably results from their short-duration activity and the impact on a few factors in the oral cavity. Saliva and gingival fluid are not very useful in the differential diagnosis of periodontitis.