Mobile Application-Based Support for Periodontal Treatment Improves Clinical, Cognitive, and Psychomotor Outcomes: A Randomized Controlled Trial Study.

This study aims to evaluate the clinical, cognitive, and psychomotor changes that emerged among patients with gingivitis and patients with periodontitis via mobile application assistance. Forty subjects were randomly and evenly distributed into test and control groups and were administered a professional mechanical plaque removal (PMPR) procedure. The clinical parameters examined were bleeding on probing (BoP), probing pocket depth (PPD), and the oral hygiene index (OHI-S). The test group was administered a mobile application intervention, namely PerioUICare, which provided users with continuous education and motivation and served as a daily dental hygiene reminder. The comparative results of the mean values of all parameters between the groups (inter-group) and within the groups (intra-group) after one- and three-month evaluations were analyzed. A one-month inter-group evaluation uncovered significant differences in the BoP, PPD, cognitive, and psychomotor scores of subjects with gingivitis and the BoP, OHI-S, cognitive, and psychomotor scores of subjects with periodontitis. A three-month inter-group evaluation revealed significant differences across all parameters except for PPD in subjects with periodontitis. The results of the intra-group comparison demonstrated statistically significant differences in all parameters in the test group but no significant differences in the cognitive and psychomotor scores of the control group. This study revealed that mobile application-based support for periodontal treatment can be considered effective.

Osteoclastogenesis Inhibitor and Antioxidant Properties of Konjac Glucomannan in a Periodontitis Mice Model: An In Vivo Study.

Background: Periodontitis is an inflammatory disease caused by specific microorganisms that gradually damage the periodontal and tooth-supporting tissues, thereby reducing a person's quality of life. Periodontal disease is closely associated with high reactive oxygen species (ROS) levels, with a high receptor activator of nuclear factor kß ligand (RANKL)/osteoprotegerin (OPG) ratio. Konjac glucomannan (KGM) is produced from the porang root, which has several properties. For example, it can reduce oxidative stress. The current study analyzed the osteoclastogenesis inhibitory and antioxidant properties of KGM based on histomorphometric findings, RANKL/OPG ratio, and ROS levels in the Swiss Webster mouse periodontitis model. Methods: Eight-week-old male Swiss Webster mice were divided into the nonligation, nonligation + KGM, ligation + Porphyromonas gingivalis, and ligation + P. gingivalis + KGM groups. KGM suspension was administered for 14 days. Periodontitis induction was performed from 7th to 14th day. On the 14th day, maxillae, gingival, and gingival crevicular fluid samples were collected to assess the histomorphometry of bone damage, gene expression ratio of RANKL/OPG, and ROS protein levels. Results: The periodontitis group pretreated with KGM presented with significantly reduced alveolar bone damage, RANKL/OPG ratio, and ROS level than without KGM group. KGM treatment had no harmful/toxic effects in mice. Conclusion: Administration of KGM could act as an adjunctive in periodontal therapy by suppressing periodontal disease via osteoclastogenesis inhibitory and antioxidant properties.

Changes in Interleukin-1ß, Tumor Necrosis Factor-α, and Interleukin-10 Cytokines in Older People with Periodontitis.

Aging can change the ability to respond to various stimuli and physical conditions. A decreased immune response is a form of deterioration of function in older people, who then become more vulnerable when exposed to pathogens. Periodontitis is an inflammatory disease of the periodontal tissues that often occurs in older people. This study aimed to clinically analyze the periodontal status and cytokine levels of IL-1ß, TNF-α, and IL-10 in older people and adults with periodontitis. This clinical study examined 20 persons in a group of older people and 20 persons in a group of adults. The clinical measurements of periodontal status included the Simplified Oral Hygiene Index (OHI-S), Plaque Index (PlI), and Papilla Bleeding Index (PBI). The cytokine levels in gingival crevicular fluid (GCF) were quantified by using ELISA kits. The OHI-S, PlI, and PBI were found to be higher in the older group. The mean values of cytokines were higher in the older group than in adults, although no statistically significant differences were found. A strong correlation was found between the clinical measurements and the cytokine levels in the GCF. There was an increasing tendency of pro-inflammatory and anti-inflammatory cytokines in the older group compared to the adult group.

The Red and Orange Complex Subgingival Microbiome of Cognitive Impairment and Cognitively Normal Elderly with Periodontitis.

Increasing evidence has shown an association between periodontitis and cognitive impairment. Subgingival microbiota play a great role in periodontitis pathogenesis. However, the correlation between the subgingival microbiome and cognitive impairment remains unclear. This study aimed to evaluate the red and orange complex subgingival microbiome of cognitively impaired and cognitively normal elderly Indonesian subjects with periodontitis. Twenty-eight elderly subjects diagnosed with periodontitis underwent two cognitive examinations using the Hopkins Verbal Learning Test and the Mini-Mental State Examination. Gingival crevicular fluid taken from the periodontal pocket, at a depth between 5 and 7 mm, using a paper point was used as the subgingival samples. The subgingival microbiome in the cognitive impairment group (n = 14) and cognitively normal group (n = 14) was compared using the 16S rRNA Metagenomic iSeq™ 100 Sequencing System. There was ß-diversity in the subgingival microbiota between the cognitively impaired and cognitively normal subjects. The metagenomic analysis showed a higher abundance of Porphyromonas and Treponema bacteria in the cognitive impairment group than in the normal cognitive group (p < 0.05). The abundance of Porphyromonas gingivalis and Treponema denticola was higher in the cognitively impaired elderly subjects. The role of P. gingivalis and T. denticola in the pathogenesis of cognitive impairment needs further investigation.

Immunoglobulin G Levels in the Gingival Crevicular Fluid of Menopausal Patients with Periodontitis

Abstract Objective: To measure the level of immunoglobulin G (IgG) in the gingival crevicular fluid (GCF). Material and Methods: A total of 158 patients aged >45 years were examined for periodontitis and interviewed regarding their menopausal status. The non-menopause group entailed female patients with periodontitis without menopause (n=23). The menopause group included females who stopped menstruating since >1 year, had a pocket depth of 4-5 mm, and did not have other systemic conditions (n=40). Samples were selected based on periodontal and menopausal status. In total, 63 samples of GCF were collected from the participants and tested using an enzyme-linked immunosorbent assay kit for IgG. Results: The median level of IgG in the menopause group was 39.50 (g/mL, whereas that of the non-menopause group was 41.08 (g/mL. There was a positive correlation between the plaque index and IgG level in both groups. In contrast, there was a negative correlation between age and IgG level. However, there was no correlation between plaque index and age regarding the IgG level in both groups (p>0.05). Conclusion: The IgG levels in the menopause group were lower than those in the non-menopause group. As such, menopausal females should take great care of their overall health, including the periodontium.

Differences in Periodontal Severity Between Perimenopausal and Postmenopausal Women with Chronic Periodontitis

Abstract Objective: To analyze the differences in periodontal severity between perimenopausal and postmenopausal women with chronic periodontitis. Material and Methods: A cross-sectional study with 63 subjects, comprising 27 perimenopausal and 36 postmenopausal women, aged 45-59 years, was conducted in East Jakarta. The women were interviewed regarding their perimenopausal and postmenopausal status; they underwent a periodontal examination for periodontal pockets, attachment loss, gingival recession, plaque index, debris index, calculus index, oral hygiene index, papilla bleeding index, and tooth mobility. Independent T-test and Mann-Whitney U test were used for bivariate analysis Results: There were significant differences (p<0.05) in age between perimenopausal and postmenopausal women (p=0.01); however, no significant differences (p>0.05) in gingival recession (p=0.33) or tooth mobility (p=0.84) were observed. Independent t-test revealed no significant differences in pocket depth (p=0.95), attachment loss (p=0.71), plaque index (p=0.89), debris index (p=0.52), calculus index (p=0.46), oral hygiene index (p=0.48), or papilla bleeding index (p=0.63) between perimenopausal and postmenopausal women Conclusion: There was no difference in periodontal severity between perimenopausal and postmenopausal women; however, the current study obtained valuable information regarding periodontal severity in perimenopausal and postmenopausal women.