A Retrospective Clinical Trial Regarding Oral Rehabilitation Diagnosis Strategies Based on Stomatognathic System Pathology.

INTRODUCTION: Orofacial pain is a common occurrence in daily dental practice; it is frequently attributed to temporomandibular dysfunction, one of its major causes, followed by pathology of the salivary glands, without avoiding interference at the level of the pain pathways caused by complications of periodontal pathology. The main objective of this study is to identify an important cause of pain in the oral-maxillofacial territory by quantifying the changes at the salivary glandular level using stereological methods. The secondary objective of the present research is to identify the implications of periodontal changes as a consequence of salivary quantitative and qualitative changes, quantified using periodontal indices, on the balance of the temporomandibular joint, dysfunction of it being an important cause of facial pain and having a profound impact on the complex oral rehabilitation algorithm of each clinical case, a condition evaluated with the analysis of the results of the Souleroy questionnaire. MATERIAL AND METHODS: In a retrospective study, we evaluated the clinical results obtained after applying complex rehabilitation treatment to 35 subjects, 20 women and 15 men with salivary and TMJ dysfunctions, selected between 2020 and 2021 from the Clinic of Maxillofacial Surgery, Iasi. RESULTS AND DISCUSSION: The most common symptoms of temporomandibular disorders (TMDs) that were identified through the Souleroy questionnaire were pain and different types of damage to the masticatory muscles. The most significant changes in elders are reported in the case of serous cells, which reduced their percentage volume from 46.7% to 37.4%. CONCLUSION: As regards stereological analysis in conjunction with histological images, there were significant changes in diameters, perimeters, and longitudinal axes in the adult patients as opposed to the elderly patients, which were also influenced by the type of pathology at this level. The scores recorded on the diagnostic Souleroy scale indicated a large number of patients with low efficiency and maximum stress levels: 20.0% in level 1, 25.7% in level 2, and 25.7% in level 3.

Research Regarding Dental Mobility Phenomena in the Clinical Recognition Diagnosis of Temporomandibular Disorders.

The main objective of this study is to quantify the implications of the complications of periodontal pathology and dental mobility on the pathology of dysfunctional algo syndrome, a clinical entity with profound implications for the patient's quality of life. METHODOLOGY: Clinical and laboratory evaluation was conducted in the 2018-2022 period, on a group of 110 women and 130 men, aged between 20-69, selected from our practice venue, Policlinica Stomatologica nr. 1 Iasi, Clinical Base of Dentistry Education "Mihail Kogalniceanu" Iasi, "Grigore T. Popa" University of Medicine and Pharmacy Iasi and "Apollonia" University Iasi. Overall, 125 subjects were diagnosed with periodontal disease with complications and TMJ disorders and followed periodontal therapy in the context of oral complex rehabilitation treatments (study group); the results of their clinical evaluation were compared with the results of the evaluation of the control group, made from the other 115 patients). RESULTS: Dental mobility and gingival recession were identified as more frequent in the study sample compared with the control sample, the differences being statistically significant in both cases. In total, 26.7% of patients had different types of TMJ disorders and 22.9% of patients had occlusal changes; the percentages are slightly increased in the study sample compared with the control one, but the recorded differences are not statistically significant. CONCLUSIONS: Dental mobility, most of the time, is a negative consequence of periodontal disease, leading to the alteration of the mandibular-cranial relations, materializing in an important proportion as an etiopathogenic factor of the dysfunctional syndrome of the stomatognathic system.

Host Response Modulation Therapy in the Diabetes Mellitus-Periodontitis Conjuncture: A Narrative Review.

The inflammatory response of the host in periodontitis is the phenomenon that underlies the onset and evolution of periodontal destructive phenomena. A number of systemic factors, such as diabetes mellitus (DM), can negatively affect the patient with periodontitis, just as the periodontal disease can aggravate the status of the DM patient. Host response modulation therapy involves the use of anti-inflammatory and anti-oxidant products aimed at resolving inflammation, stopping destructive processes, and promoting periodontal healing, all important aspects in patients with high tissue loss rates, such as diabetic patients. This paper reviews the data available in the literature on the relationship between DM and periodontitis, the main substances modulating the inflammatory response (nonsteroidal anti-inflammatory drugs, sub-antimicrobial doses of doxycycline, or omega-3 fatty acids and their products, specialized pro-resolving mediators), as well as their application in diabetic patients.

The Effects of 810 nm Diode Laser and Indocyanine Green on Periodontal Parameters and HbA1c in Patients with Periodontitis and Type II Diabetes Mellitus: A Randomized Controlled Study.

The aim of this study was to investigate the effects of adjunctive periodontal therapy of 5 mg/mL indocyanine green irradiation by an 810 nm diode laser (aPDT), supplementary to scaling and root planing (SRP) in patients with periodontitis and type II diabetes mellitus (DM) compared to the SRP alone, on periodontal clinical parameters and glycated hemoglobin A1c (HbA1c). The study was conducted on 49 subjects with type II DM and periodontitis, divided into two groups: the SRP group (n = 25), who followed SRP alone, and the SRP + aPDT group (n = 24), who followed SRP and four weekly sessions of indocyanine green irradiation by an 810 nm diode laser. Plaque Index (PI), Bleeding on Probing Index (BOP), probing depth (PD), clinical attachment loss (CAL) and HbA1c were investigated at baseline and after 6 months. At 6 months, both SRP alone and SRP + aPDT generated significant reductions in all the investigated parameters; SRP + aPDT produced more significant reductions for BOP, PD and CAL (p < 0.001) but not for PI and HbA1c, than SRP alone. aPDT with indocyanine green therapy was well tolerated, with two subjects reporting slight discomfort. Therefore, aPDT with indocyanine green might represent a good adjunctive periodontal treatment option for SRP in patients with type II DM and periodontitis.

Curcumin as a Natural Approach of Periodontal Adjunctive Treatment and Its Immunological Implications: A Narrative Review.

Scaling and root planing represent the gold standard in the treatment of periodontal disease, but these therapeutic methods cannot eliminate the remaining periodontopathogenic bacteria in cement, tubules, and periodontal soft tissue. Thus, a number of additional therapeutic means have been adopted, including local and systemic antibiotic therapy, as well as the use of photodynamic therapy techniques. Recently, special attention has been paid to potential phytotherapeutic means in the treatment of periodontal disease. In this review, we aim to present the effects generated by the extract of Curcuma longa, the various forms of application of turmeric as an additional therapeutic means, as well as the aspects related to its biotolerance.

Assessment of Salivary Levels of RANKL and OPG in Aggressive versus Chronic Periodontitis.

RANKL (receptor activator of nuclear factor kappa-ß ligand) and OPG (osteoprotegerin) are two proteins involved in bone remodelling. During the active phase of periodontal disease, an imbalance between the ratios of the two elements can be noticed. While the expression of RANKL is elevated compared with that of OPG, the RANKL is available to bond with RANK (receptor activator of nuclear factor kappa-ß). This study was conducted on 41 patients: 19 with generalized aggressive periodontitis, 18 with severe chronic periodontitis, and 4 periodontal healthy subjects. For each patient included, we determined the salivary levels of RANKL and OPG with the help of two Human ELISA kits. The results show that the patients affected by periodontitis, either aggressive or chronic, have significant higher values of RANKL and RANKL/OPG ratio. This values correlate with the local inflammation status.

Evaluation of serum and gingival crevicular fluid C-reactive protein and IL-6 levels in patients with periodontitis and transient ischemic attacks.

BACKGROUND: Recent advances have suggested that periodontitis (PD), the paradigm of chronic infection in dental pathology, shares several pathogenic pathways with cardio- and cerebro-vascular disorders (CVD), based on inflammatory mediators including IL-1, IL-6, TNF-α. AIM: To assess pro-inflammatory biomarkers (C-reactive protein - CRP, IL-6) in serum and gingival crevicular fluid (GCF) in patients with PD and with transient ischemic attacks (TIAs). MATERIALS AND METHODS: Prospective observational study on 143 patients classified as follows: 40 healthy subjects (group A), 50 PD patients (group B) and 53 PD-TIAs patients (group C). The predefined assessment protocol has included: current medical data, risk factors for CRP changes, periodontal status (clinical, orthopantomography, Schei Ruler technique), inflammatory biomarkers (CRP, IL-6). RESULTS: High serum CRP and IL-6 have been reported in both TIAs and PD, while statistically significant increase in GCF CRP only in PD-TIAs (p<0.05). Moreover, both generalized and localized chronic PD may be at higher risk for CVD, since CRP level was higher in these subgroups. However, no significant differences were reported in serum IL-6 between generalized and localized PD. A score function was demonstrated, including bone loss degree, bleeding index, collection site depth, serum and GCF IL-6 and CRP, tooth loss, allowing the classification of PD based on risk for developing TIAs. CONCLUSIONS: CRP and IL-6 are commonly involved in the pathways of PD and TIAs. Interdisciplinary assessment should be promoted in order to implement the stratification of PD patients according to the risk for TIAs as suggested by the proposed algorithm.

[The contribution of CT imaging in the diagnosis of periodontal disease]. / Aportul explorarilor imagistice CT in diagnosticul bolii parodontale.

UNLABELLED: Generally, the routine clinical and radiographic examination in periodontology are nor enough for establishing a global and individual diagnosis that allow to establish the exact location of alveolar bone loss, their type (vertical or horizontal) as well as the presence of furcation involvement. In the six clinical cases explored with the dental CT it was possible to appreciate the alveolar bone quality (in Hounsfield units), the tridimensional morphology of intrabony defects, the number of vertical bone walls, as well as the architecture of the furcation defects. This dental CT examination is very close to the results obtained during periodontal surgery. However, this fact has permitted for four patients, from the beginning and not intraoperatively, the choice of the regenerative therapeutic procedure in the case of eight intrabony lesions as well as the extraction of three molars with Class II furcations associated with deep periodontal pockets. For the last two patients there were not obtained with the CT exam any more data. CONCLUSION: The CT exam that uses the Dental CT program allows the dental practitioner to obtain important data in cases with complexes infrabony pockets.

[The influence of restorations on periodontal health]. / Influenta terapiei restaurative asupra parodontiului marginal.

UNLABELLED: Dental caries and restorations in proximal tooth surfaces often impinge upon the periodontal biological health.This study examines whether these factors may contribute to risk for alveolar bone loss. METHODS: Approximal tooth surfaces of 96 teeth in 40 patients were evaluated on panoramic radiographs for alveolar bone loss, restorations and caries. RESULTS: Higher values of alveolar bone loss were observed in molars and on the right side of patients. Where a caries/restorative event had occurred in the inter-proximal tooth surface bone loss at the corresponding teeth was approximately twice more than in the omologous non-treated tooth. Increased number of furcations was also observed in molars with caries/restorations. CONCLUSIONS: Site-specific periodontal bone loss due to dental caries or restorative events occurs in adults.

Is it an association between body appreciation, self-criticism, oral health status and oral health-related behaviors?

OBJECTIVES: Our aim was to investigate whether body appreciation and self-criticism are associated with self-reported oral health status and oral-health-related behaviors were associated. METHODS: The present study sample consisted of 178 first year medical students. The questionnaire included information about socio-demographic factors, behavioral variables, self-reported oral health status, self-criticism and body appreciation. RESULTS: Significant differences were found on body appreciation and self-criticism scales according to several variables: gender, anxiety, stress, depression, smoking status, perceived dental health status, current extracted teeth, satisfaction by appearance of own teeth, self-reported gingival condition. When oral health behaviours were analysed we observed that toothbrushing frequency once a day or less was reported mainly in persons with low-levels of body appreciation (P < 0.01) and comparative self-criticism (P < 0.05). Moreover, individuals who visit their dentist mainly when treatment is needed or when in pain were compared with persons who visit their dentist mainly for check-up or for tooth cleaning and scaling; they showed lower levels of body appreciation (P = 0.005), as well as higher levels of comparative self-criticism (P < 0.05), internalized self-criticism (P < 0.05) and total self-criticism (P = 0.009). Multiple linear regression analyses revealed that anxiety in everyday life, body appreciation and comparative self-criticism scales were significantly positively associated with oral health status (r2 = 0.144; F = 3.436, P = 0.001), while body appreciation was related also to gingival health-related status (r2 = 0.087; F = 1.943, P = 0.057). When oral health behaviors were evaluated, it was shown that gender and body appreciation scale were positively associated with toothbrushing frequency (P < 0.0001). CONCLUSIONS: The results suggest that there is an increased risk for impaired dental health status and behaviour among subjects with low levels of body appreciation and high levels of self-criticism.

Metabolic syndrome and periodontal diseases.

The metabolic syndrome (also known as syndrome X, insulin resistance syndrome, dysmetabolic syndrome, deadly quartet and plurimetabolic syndrome) is a cluster of factors associated with increased risk of developing coronary heart disease and/or type 2 diabetes. Several recent studies reviewed in the present paper have indicated an association between the metabolic syndrome and periodontitis, and suggest that people exhibiting several components of metabolic syndrome should be encouraged to undergo a periodontal examination. Further investigations are required to clarify the mechanisms of the relationship between metabolic syndrome and periodontal disease in men, and to determine whether oral health care in individuals exhibiting metabolic syndrome has the potential to reduce the incidence of various systemic diseases.