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1.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(4): 385-389, 2021 Apr 09.
Artigo em Chinês | MEDLINE | ID: mdl-33832043

RESUMO

Chronic periodontitis is a disease of periodontal supporting tissue infection caused by various causes. It was believed that the oral bacteria were the initiator of chronic periodontitis, and the host immune factors would affect the developing process and outcome of periodontitis, although the specific regulatory mechanism was not completely clear. Extracellular vesicles, subcellular components produced by cell paracrine, may carry a variety of genetic information to mediate intercellular communication. Extracellular vesicles have been found to be closely related to tumors and cardiovascular, cerebrovascular, neurological and immune system diseases and provide a research pathway for the early diagnosis, etiological therapy and vaccine design. Various extracellular vesicles are released from periodontal ligament stem cells, gingival mesenchymal stem cells, bone marrow mesenchymal stem cells, osteoblasts, osteoclasts, immune cells and periodontal pathogenic bacteria. These extracellular vesicles release for mutual communication and regulation, and further affect the pathogenesis of chronic periodontitis. In the present article, the characteristics of extracellular vesicles from periodontal tissues and periodontal pathogenic bacteria were introduced, the research progress of extracellular vesicles involved in the regulation of chronic periodontitis was reviewed and the potential value of extracellular vesicles in the diagnosis and treatment of chronic periodontitis was prospected.


Assuntos
Periodontite Crônica , Vesículas Extracelulares , Células-Tronco Mesenquimais , Periodontite Crônica/diagnóstico , Periodontite Crônica/terapia , Humanos , Ligamento Periodontal , Periodonto
2.
Artigo em Inglês | MEDLINE | ID: mdl-33528456

RESUMO

The aim of the present study was to retrospectively evaluate the longevity of teeth and implants during a long-term period in a cohort of periodontally compromised patients, treated and maintained in a private specialist periodontal practice, and to analyze the associated risk factors. Fifty-eight patients (30 men, 28 women) who had received active periodontal therapy (APT) and regular periodontal maintenance (PM) ≥ 10 years were included and evaluated. The following were evaluated: (1) statistically significant differences of clinical parameters assessed at six tooth or implant sites (plaque scores, bleeding score, periodontal probing depth, bleeding on probing, and gingival recession) and radiographic parameters (mesial and distal bone crest loss) between patients with and without tooth/implant loss during PM; and (2) associations between the number of teeth and implants lost and potential risk factors. During PM, the overall average tooth loss was 0.07 teeth/patient/year (0.04 teeth/patient/year for periodontal reasons), while the overall average implant loss was 0.4 implants/patient/year. The overall implant failure was 10.08%, and the rate of implant failure due to biologic reasons was 9.8%. Incidence of implant failures in patients with vs without recurrent periodontal disease was 83.3% vs 16.7% (P < .05). Results showed that in chronic periodontitis patients, ATP followed by long-term PM is successful in keeping the majority of periodontally compromised teeth. In the same patients, a higher tendency for implant loss than tooth loss was found.


Assuntos
Perda do Osso Alveolar , Periodontite Crônica , Implantes Dentários , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Manutenção , Masculino , Estudos Retrospectivos
3.
Shanghai Kou Qiang Yi Xue ; 29(3): 308-311, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-33043350

RESUMO

PURPOSE: To evaluate the clinical efficacy of erbium-doped yttrium aluminium garnet (Er: YAG) laser in the treatment of degree II bifurcation periodontitis. METHODS: Thirty patients(60 teeth) with grade II bifurcation lesions of chronic periodontitis were enrolled in this study. One week after supergingival scaling with ultrasound, the patients were randomly divided into experimental group: subgingival scaling with ultrasound and hand instruments + Er: YAG laser irradiation in periodontal pocket; control group: the contralateral homonymous teeth were treated with subgingival scaling with ultrasound and hand instruments alone. The changes of gingival index(GI), pocket depth(PD), horizontal probing depth (HPD) and attachment loss(AL) were compared between the two groups 12 and 20 weeks after treatment. SPSS 20.0 software package was used for statistical analysis. RESULTS: Periodontal clinical indexes(GI, PD, HPD, AL) of the experimental group and control group were significantly reduced compared with baseline at 12 and 20 weeks after treatment(P<0.05). At 12 and 20 weeks after treatment, PD in the experimental group was (4.03±0.48) mm and (3.43±0.45) mm, (4.82±0.55) mm and (4.27±0.36) mm in the control group, respectively. The reduction of PD in the experimental group was significantly greater than that in the control group (P<0.05). There was no significant difference in HPD between the two groups at 12 weeks after treatment. Twenty weeks after operation, HPD in the experimental group was found to be (3.01±0.34) mm and (3.78±0.29) mm in the control group. The decrease of HPD in the experimental group was significantly greater than that in the control group (P<0.05). GI and AL of the experimental group at 12 and 20 weeks were lower than those of the control group, but the difference was not statistically significant. CONCLUSIONS: Er: YAG laser is safe and effective in the treatment of chronic periodontitis patients with grade II root bifurcation lesions with significant clinical value.


Assuntos
Periodontite Crônica , Lasers de Estado Sólido , Periodontite Crônica/terapia , Raspagem Dentária , Humanos , Lasers de Estado Sólido/uso terapêutico , Índice Periodontal , Bolsa Periodontal
4.
PLoS One ; 15(9): e0238425, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32960889

RESUMO

OBJECTIVE: To evaluate the effects of Bifidobacterium animalis subsp. lactis HN019 (HN019) on clinical periodontal parameters (plaque accumulation and gingival bleeding), on immunocompetence of gingival tissues [expression of beta-defensin (BD)-3, toll-like receptor 4 (TLR4), cluster of differentiation(CD)-57 and CD-4], and on immunological properties of saliva (IgA levels) in non-surgical periodontal therapy in generalized chronic periodontitis (GCP) patients. Adhesion to buccal epithelial cells (BEC) and the antimicrobial properties of HN019 were also investigated. MATERIALS AND METHODS: Thirty patients were recruited and monitored clinically at baseline (before scaling and root planing-SRP) and after 30 and 90 days. Patients were randomly assigned to Test (SRP+Probiotic, n = 15) or Control (SRP+Placebo, n = 15) group. Probiotic lozenges were used for 30 days. Gingival tissues and saliva were immunologically analyzed. The adhesion of HN019 with or without Porphyromonas gingivalis in BEC and its antimicrobial properties were investigated in in vitro assays. Data were statistically analyzed (p<0.05). RESULTS: Test group presented lower plaque index (30 days) and lower marginal gingival bleeding (90 days) when compared with Control group. Higher BD-3, TLR4 and CD-4 expressions were observed in gingival tissues in Test group than in Control group. HN019 reduced the adhesion of P. gingivalis to BEC and showed antimicrobial potential against periodontopathogens. CONCLUSION: Immunological and antimicrobial properties of B. lactis HN019 make it a potential probiotic to be used in non-surgical periodontal therapy of patients with GCP. CLINICAL RELEVANCE: B. lactis HN019 may be a potential probiotic to improve the effects of non-surgical periodontal therapy. Name of the registry and registration number (ClinicalTrials.gov): "Effects of probiotic therapy in the treatment of periodontitis"-NCT03408548.


Assuntos
Bifidobacterium animalis/imunologia , Periodontite Crônica/terapia , Probióticos/uso terapêutico , Adulto , Aderência Bacteriana/imunologia , Infecções por Bacteroidaceae/imunologia , Infecções por Bacteroidaceae/microbiologia , Infecções por Bacteroidaceae/terapia , Periodontite Crônica/imunologia , Periodontite Crônica/microbiologia , Método Duplo-Cego , Feminino , Interações entre Hospedeiro e Microrganismos/imunologia , Humanos , Imunoglobulina A Secretora/metabolismo , Técnicas In Vitro , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/imunologia , Mucosa Bucal/microbiologia , Porphyromonas gingivalis/patogenicidade , Saliva/imunologia
5.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(5): 723-726, 2020 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-32897208

RESUMO

OBJECTIVE: To evaluate the clinical efficacy of ultrasound subgingival scaling combined with manual root planing for treatment of chronic periodontitis in elderly patients. METHODS: Forty elderly patients with chronic periodontitis were randomly divided into test group for treatment with ultrasound and Gracey subgingival curette for subgingival scaling combined with manual root planing and control group treated with ultrasound subgingival curette scaling (n=20). We compared plaque index (PLI), bleeding index (BI), probing depth (PD), and attachment loss (AL) between the two groups before and at 6 weeks and 12 weeks after the treatment. RESULTS: After periodontal treatment, PLI, BI, PD and AL all decreased significantly in both groups compared with the levels before the treatment (P < 0.05). The patients in the test group showed significantly more obvious decrease of PD and AL than those in the control group (P < 0.05), but the reduction of PLI and BI was comparable between the two groups (P>0.05). CONCLUSIONS: Ultrasound subgingival scaling combined with manual root planing produces better therapeutic effect than ultrasonic subgingival scaling alone for treatment of chronic periodontitis in elderly patients.


Assuntos
Periodontite Crônica , Idoso , Periodontite Crônica/terapia , Raspagem Dentária , Humanos , Aplainamento Radicular , Resultado do Tratamento , Ultrassonografia
6.
J Pathol ; 251(3): 323-335, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32418202

RESUMO

The lymphatic system plays a crucial role in the maintenance of tissue fluid homeostasis and the immunological response to inflammation. The effects of lymphatic drainage dysfunction on periodontitis have not been well studied. Here we show that lymphatic vessel endothelial receptor 1 (LYVE1)+ /podoplanin (PDPN)+ lymphatic vessels (LVs) are increased in the periodontal tissues, with accumulation close to the alveolar bone surface, in two murine periodontitis models: rheumatoid arthritis (RA)-associated periodontitis and ligature-induced periodontitis. Further, PDPN+ /alpha-smooth muscle actin (αSMA)- lymphatic capillaries are increased, whereas PDPN+ /αSMA+ collecting LVs are decreased significantly in the inflamed periodontal tissues. Both mouse models of periodontitis have delayed lymph flow in periodontal tissues, increased TRAP-positive osteoclasts, and significant alveolar bone loss. Importantly, the local administration of adeno-associated virus for vascular endothelial growth factor C, the major growth factor that promotes lymphangiogenesis, increases the area and number of PDPN+ /αSMA+ collecting LVs, promotes local lymphatic drainage, and reduces alveolar bone loss in both models of periodontitis. Lastly, LYVE1+ /αSMA- lymphatic capillaries are increased, whereas LYVE1+ /αSMA+ collecting LVs are decreased significantly in gingival tissues of patients with chronic periodontitis compared with those of clinically healthy controls. Thus, our findings reveal an important role of local lymphatic drainage in periodontal inflammation-mediated alveolar bone loss. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.


Assuntos
Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/metabolismo , Periodontite Crônica/terapia , Terapia Genética , Linfa/metabolismo , Vasos Linfáticos/metabolismo , Maxila/metabolismo , Fator C de Crescimento do Endotélio Vascular/biossíntese , Fator C de Crescimento do Endotélio Vascular/genética , Perda do Osso Alveolar/genética , Perda do Osso Alveolar/metabolismo , Perda do Osso Alveolar/patologia , Processo Alveolar/patologia , Animais , Estudos de Casos e Controles , Periodontite Crônica/genética , Periodontite Crônica/metabolismo , Periodontite Crônica/patologia , Modelos Animais de Doenças , Humanos , Vasos Linfáticos/patologia , Masculino , Maxila/patologia , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Osteoclastos/metabolismo , Osteoclastos/patologia , Fator de Necrose Tumoral alfa/genética
7.
Clin Oral Investig ; 24(6): 1877-1888, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32399735

RESUMO

OBJECTIVE: This systematic review (SR) aimed at assessing the adjunctive clinical effect of ozone therapy (OT) on nonsurgical periodontal treatment. MATERIALS AND METHODS: Articles published prior to September 2019 were electronically searched in four databases without any other date or language restrictions and manually searched in regular journals and in gray literature. This review was performed according to the PICO format. The eligibility criteria comprised randomized controlled trials (RCTs) that analyzed the adjunctive effect of OT on nonsurgical periodontal treatment. RESULTS: Twelve studies published between 2010 and 2019 were included in this SR. A metaanalysis of ten reports showed that there was no statistically significant difference in the periodontal parameters analyzed when scaling and root planing (SRP) plus sulcus irrigation with ozonated water or sulcus insertion of ozonated gas were used when compared to SRP alone. Additionally, there was no significant difference when the effect of SRP plus ozonated water was compared with SRP plus 2% chlorhexidine gluconate (CLX). No studies reported significant microbiological differences when the use of ozone was compared with SRP alone. CONCLUSIONS: The results of this SR do not support the use of OT for nonsurgical periodontal treatment. However, due to the potential heterogeneity across the studies, the presence of confounding factors, and the short follow-up of some included RCTs, these results should not be considered definitive. CLINICAL RELEVANCE: The current evidence indicates that ozone has antimicrobial activity and good biocompatibility with periodontal cells and gingival fibroblasts. However, no evidence was found for a positive effect of OT as an adjunct to scaling and root planing.


Assuntos
Periodontite Crônica , Ozônio , Aplainamento Radicular , Periodontite Crônica/terapia , Terapia Combinada , Raspagem Dentária , Ozônio/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Br Dent J ; 228(7): 537-545, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32277213

RESUMO

Aims To assess the management of chronic periodontitis (CP) in general dental practices based in the West Midlands against the British Society of Periodontology (BSP) guidelines and determine whether this varies between NHS, private and mixed sector practices. To examine general dental practitioners' (GDPs') attitudes towards the management of periodontitis, the implementation of the BSP guidelines and explore their suggestions for improved management of the disease.Materials and methods A semi-structured telephone interview was conducted with eight dentists to construct an online questionnaire. Using the NHS Choices database, the practice managers of 30 dental practices were contacted and asked to distribute the online questionnaire to all GDPs within their practice.Results One hundred and three GDPs completed the questionnaire; several dentists indicated their management would not align with the BSP recommendations. Dentists do not believe the BSP guidelines are easy to implement in NHS practice.Discussion Areas where dentists are falling short of the BSP guidelines include periodontal charting, indications for root surface debridement (RSD) and antimicrobials. These topics should be highlighted to dentists. Dentists would prefer NHS remuneration to reflect the time and effort spent, better access to secondary care and increased awareness of periodontal diseases among patients.Conclusion This study identifies clear areas where dentists are not following the BSP guidelines and provides insight from a GDP's perspective to improve the management of CP in practice.


Assuntos
Periodontite Crônica , Odontólogos , Atitude do Pessoal de Saúde , Periodontite Crônica/terapia , Odontologia Geral , Humanos , Papel Profissional , Inquéritos e Questionários
9.
Med. oral patol. oral cir. bucal (Internet) ; 25(2): e161-e167, mar. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-196245

RESUMO

BACKGROUND: To improve the results of the classic periodontal treatment, probiotics have been suggested recently to decrease the number of bacteria and the expression of mediators of inflammation. This systematic review aimed to assess the literature for the effectiveness of different probiotic strains as adjuvants to non-surgical periodontal therapy. MATERIAL AND METHODS: The electronic database of MEDLINE (via Pubmed) was searched up to December 2017 for randomised clinical trials in English comparing non-surgical periodontal treatment and probiotics versus periodontal treatment and placebo. The primary outcome investigated was reduction in pocket probing depth. Secondary outcomes were bleeding on probing, plaque index reduction and bacteria counts. RESULTS: Nine trials were included. A narrative data synthesis did not result in any major improvement of overall pocket probing depth but moderate pockets from 4 to 6 mm showed larger reductions in study groups, which could decrease the need for surgery. Sites with bleeding on probing and presence of plaque decreased after treatment. For periimplant mucositis, there was a small tendency to better results in the study group. CONCLUSIONS: With the available data, it is concluded that probiotics may provide an additional benefit to manual debridement in chronic periodontitis. More studies are required on dose, route of administration and strains of probiotics used


No disponible


Assuntos
Humanos , Periodontite Crônica/terapia , Probióticos/uso terapêutico , Quimioterapia Adjuvante/métodos , Higiene Bucal/métodos , Raspagem Dentária/métodos , Resultado do Tratamento , Fatores de Tempo , Índice Periodontal , Índice de Placa Dentária
10.
BMC Oral Health ; 20(1): 52, 2020 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-32059714

RESUMO

BACKGROUND: Non-surgical periodontal therapy (NSPT) known as gold standard treatment in managing periodontitis. The aim of this study was to investigate the response of NSPT in periodontitis subjects who were obese. Clinical parameters of periodontitis, changes in serum resistin and periodontal pathogens in subgingival plaque were compared before and after NSPT in periodontitis subjects who were obese and with normal weight. METHODS: A total of 48 periodontitis subjects (obese, n = 18; normal weight, n = 30) were recruited (hereafter will be referred as participants) to participate into a prospective, before and after clinical trial. Obesity status is defined by body mass index (BMI) criteria (obese: ≥30 kg/ m2; normal weight < 25 kg/m2). Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD) and Clinical Attachment Loss (CAL) were recorded; and serum and plaque were collected at baseline and following 12 weeks post-NSPT. Serum resistin level was analyzed using enzyme-linked immune-sorbant assay (ELISA), while detection of periodontal pathogens in dental plaque were carried out using real time PCR (qPCR). RESULTS: Following NSPT, means VPI and GBI showed significant improvement between obese and normal weight groups (p <  0.05), but no difference in means PPD and CAL was observed between groups. Obesity remained as a predictor for VPI and GBI after adjusting for smoking habit. No significant difference was observed in serum resistin level and mean counts for P. gingivalis, T. forsythia, and P. intermedia between obese and normal weight groups following NSPT. CONCLUSIONS: Regardless of obesity status, NSPT has a significant impact on VPI and GBI in periodontitis subjects. However, the impact of NSPT towards serum resistin and periodontal pathogens was non-significant in those with periodontitis. TRIAL REGISTRATION: This study followed the Consolidation Standards of Reporting Trials Statement and retrospectively registered on 26/11/2015 at clinicaltrials.gov (No. NCT02618486).


Assuntos
Periodontite Crônica/terapia , Obesidade/complicações , Resistina/sangue , Periodontite Crônica/complicações , Periodontite Crônica/epidemiologia , Índice de Placa Dentária , Feminino , Humanos , Masculino , Perda da Inserção Periodontal , Estudos Prospectivos
11.
J Biol Regul Homeost Agents ; 34(1 Suppl. 1): 164-174, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32064852

RESUMO

AIM: The objective of this study was to compare the efficacy of supportive periodontal therapy (i.e. scaling and rooth planning, SRP) alone versus a chemical device silica dioxide (SiO2) colloidal solutions (SL) used in association with SRP in the treatment of chronic periodontitis in adult patients. MATERIALS AND METHODS: A total of 20 patients with a diagnosis of chronic periodontitis (40 localized chronic periodontitis sites) in the age group of 35 to 55 were selected. None of these patients have previously received any surgical or non-surgical periodontal therapy and demonstrated radiographic evidence of moderate bone loss. Two non-adjacent sites in separate quadrants were selected in each patient to monitorize treatment efficacy (split mouth design). Clinical pocket depth (PD) and microbial analysis (MA) were analyzed at baseline and 15th day. SPSS program and paired simple statistic T-test were used to detect significant differences. RESULTS: Total bacteria loading, Tannerella Forsitia and Treponema Denticola loading were statistically reduced when SiO2 is locally delivered. CONCLUSIONS: SL gel is an adiuvant therapy which should be added to SRP in the management of moderate to severe chronic periodontitis.


Assuntos
Periodontite Crônica/terapia , Coloides/uso terapêutico , Raspagem Dentária , Aplainamento Radicular , Dióxido de Silício/uso terapêutico , Adulto , Estudos de Casos e Controles , Seguimentos , Humanos , Pessoa de Meia-Idade , Bolsa Periodontal , Resultado do Tratamento
12.
Medicine (Baltimore) ; 99(6): e18854, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028395

RESUMO

BACKGROUND: The elimination of the pathogenic microorganisms of the periodontal pocket is one of the main points for success in periodontal treatment. The objective of this study is to investigate the clinical and antimicrobial effect of papain-mediated photodynamic therapy in the clinical treatment of periodontal disease. METHODS: Twenty patients with chronic periodontitis will be selected. Patients will be randomly divided into 2 groups (n = 10). Group 1 will receive conventional periodontal treatment and group 2 will receive conventional treatment and antimicrobial photodynamic therapy (PACT). Conventional treatment will consist of oral hygiene guidance, with brushing technique instructions and recommendation of daily flossing. The calculus deposits on the teeth will be removed with ultrasound equipment and curettes for scraping and root planning. The PACT will be performed at the end of each periodontal treatment session, at sites with bags ≥4 mm. PapaMblue photosensitizer will be deposited in the periodontal pockets with a syringe and a pre-irradiation time of 1 minute will be adopted. Then, the laser emitting wavelength of 660 nm, with power of 100 mW, for 2 minutes, radiant exposure of 30 J/cm and power density of 250 mW/cm will be applied. Patients will undergo clinical evaluations before treatment (day 1) at 30, 60, and 90 days after the end of treatment; and microbiological evaluations before and immediately after treatment. The distribution of the data within each group and the homogeneity of the variances will be verified. With this information, the most appropriate statistical test in each evaluation will be used. The sample calculation is based on the literature and the significance level of 5% will be adopted. DISCUSSION: The combination of PACT with methylene blue in a papain gel and the conventional treatment may increase the reduction of bacteria in periodontal pockets.


Assuntos
Anti-Infecciosos/uso terapêutico , Periodontite Crônica/terapia , Azul de Metileno/uso terapêutico , Fármacos Fotossensibilizantes/uso terapêutico , Adulto , Anti-Infecciosos/administração & dosagem , Terapia Combinada , Método Duplo-Cego , Feminino , Humanos , Masculino , Azul de Metileno/administração & dosagem , Fotoquimioterapia , Fármacos Fotossensibilizantes/administração & dosagem , Resultado do Tratamento
13.
BMC Oral Health ; 20(1): 18, 2020 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-31969148

RESUMO

BACKGROUND: This systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD). METHODS: Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration's risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. RESULTS: Five RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: - 1.53, 95% confidence interval - 2.95 to - 0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers. CONCLUSIONS: NSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.


Assuntos
Biomarcadores/metabolismo , Periodontite Crônica/terapia , Inflamação/sangue , Interleucina-6/análise , Falência Renal Crônica/sangue , Biomarcadores/análise , Proteína C-Reativa/metabolismo , Periodontite Crônica/metabolismo , Humanos , Inflamação/patologia , Falência Renal Crônica/terapia , Lipídeos/sangue , Diálise Peritoneal , Diálise Renal , Fator de Necrose Tumoral alfa/sangue
14.
PLoS One ; 15(1): e0227757, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31986169

RESUMO

AIM: Alveolar resorption is one of the most important events in periodontitis. Osteoclast activity is regulated by the ratio between receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG). The aim of this study was to evaluate changes in the RANKL/OPG ratio in crevicular fluid after periodontal treatment. MATERIAL AND METHODS: A total of 15 patients with periodontitis were included in the study group. Samples were collected from an area with active periodontitis and a healthy area. The RANKL and OPG levels were measured before and after periodontal scaling and root planing (SRP) treatment. The study group was compared to the control group, which included 10 patients without periodontitis. ID Clinicaltrial.gov: NCT03787875. RESULTS: A decrease in the RANKL level was found in areas with active periodontitis after periodontal treatment, but no change in the OPG level was observed. Therefore, the treatment induced a decrease in the RANKL/OPG ratio in sites with destructive periodontal activity. CONCLUSIONS: Periodontal treatment acts on the RANKL/OPG ratio by decreasing osteoclastogenesis. These results encourage the use of these molecules for periodontal diagnosis, monitoring and treatment. ID CLINICALTRIAL.GOV: NCT03787875.


Assuntos
Perda do Osso Alveolar/prevenção & controle , Periodontite Crônica/terapia , Raspagem Dentária , Líquido do Sulco Gengival/química , Osteoprotegerina/análise , Idoso , Perda do Osso Alveolar/diagnóstico , Perda do Osso Alveolar/etiologia , Estudos de Casos e Controles , Periodontite Crônica/complicações , Periodontite Crônica/diagnóstico , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Osteoclastos/metabolismo , Osteoprotegerina/metabolismo , Índice Periodontal , Estudos Prospectivos , Ligante RANK , Resultado do Tratamento
15.
Artigo em Inglês | MEDLINE | ID: mdl-31948027

RESUMO

Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan-Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.


Assuntos
Periodontite Crônica/terapia , Assistência Odontológica , Pneumonia/prevenção & controle , Adulto , Idoso , Periodontite Crônica/epidemiologia , Estudos de Coortes , Comorbidade , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Pneumonia/epidemiologia , Pontuação de Propensão , Modelos de Riscos Proporcionais , Fatores de Risco , Taiwan/epidemiologia , Adulto Jovem
16.
Oral Dis ; 26(4): 822-829, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31834660

RESUMO

AIM: The present study aimed to monitor the clinical outcomes and the metabolic response of periodontal therapy (non-surgical) in patients with periodontitis (chronic) and uncontrolled diabetes (type 2). METHODS: Eighty-eight subjects with periodontitis (chronic) and uncontrolled diabetes (type 2) were enrolled in this controlled trial and allocated randomly to the test group (44 patients were received immediate periodontal therapy) or the control group (44 patients were received delayed periodontal therapy). The metabolic and clinical evaluations were conducted at baseline and 3 months. This included clinical attachment level, glycated hemoglobin (HbA1c), bleeding on probing, visible plaque, and pocket depth. The periodontal therapy in this study consists of one-stage scaling and root planning, a combination of systemic antibiotics (amoxicillin 500 mg and metronidazole 400 mg), and oral hygiene instructions. RESULTS: Regarding clinical and metabolic parameters at baseline, no statistically significant differences were displayed between the two groups. However, at 3-month follow-up period the patients within the test group demonstrated significantly better clinical and metabolic outcomes than patients in the control group. CONCLUSION: The non-surgical periodontal treatment using a combination of metronidazole and amoxicillin significantly improved the metabolic outcome in addition to periodontal health in diabetic subjects with chronic periodontitis.


Assuntos
Glicemia , Periodontite Crônica/terapia , Raspagem Dentária , Diabetes Mellitus Tipo 2/terapia , Aplainamento Radicular , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Periodontite Crônica/complicações , Diabetes Mellitus Tipo 2/complicações , Hemoglobina A Glicada/análise , Humanos , Metronidazol/uso terapêutico
17.
J Appl Oral Sci ; 28: e20190025, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31778442

RESUMO

INTRODUCTION: Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. OBJECTIVE: This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. METHODOLOGY: Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. RESULTS: Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. CONCLUSION: Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.


Assuntos
Anestesia Dentária/métodos , Anestésicos Locais/administração & dosagem , Raspagem Dentária/efeitos adversos , Géis/administração & dosagem , Dor/prevenção & controle , Aplainamento Radicular/efeitos adversos , Adulto , Idoso , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Método Duplo-Cego , Feminino , Humanos , Lidocaína/administração & dosagem , Combinação Lidocaína e Prilocaína , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Bolsa Periodontal , Placebos , Prilocaína/administração & dosagem , Adulto Jovem
18.
Oral Dis ; 26(1): 166-172, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31587460

RESUMO

OBJECTIVE: To determine the effect of smoking on peptidoglycan recognition protein (PGRP)-1 levels in gingival crevicular fluid (GCF) in smokers and non-smokers with chronic periodontitis (CP) following initial periodontal therapy. SUBJECTS AND METHODS: A total of 40 patients with CP (20 smokers (S + CP) and 20 non-smokers (S-CP)) and 40 subjects with healthy periodontium (20 smokers (S + PH) and 20 non-smokers (S-PH)), comprising 80 subjects, were included in this study. Baseline GCF samples were obtained from all subjects, and clinical periodontal measurements were recorded. In patients who had received initial periodontal therapy, GCF samples were obtained and all clinical periodontal measurements were recorded again during the 6th-8th weeks. GCF PGRP-1 levels were analyzed by enzyme-linked immunosorbent assay. RESULTS: At baseline, GCF PGRP-1 levels were significantly higher in both groups with CP than in both groups with healthy periodontium, whereas these levels were significantly lower in S + CP than in S-CP. GCF PGRP-1 levels decreased significantly in both CP groups after periodontal therapy, and this reduction was significantly greater in non-smokers than in smokers. CONCLUSION: Smoking might have a suppressive effect on GCF PGRP-1 levels in CP. Initial periodontal therapy is effective in decreasing GCF PGRP-1 levels in both smokers and non-smokers with CP.


Assuntos
Periodontite Crônica/metabolismo , Citocinas/metabolismo , Líquido do Sulco Gengival/química , Fumar/efeitos adversos , Adulto , Estudos de Casos e Controles , Periodontite Crônica/terapia , Raspagem Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Aplainamento Radicular , Adulto Jovem
19.
J Formos Med Assoc ; 119(1 Pt 1): 157-163, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30709694

RESUMO

BACKGROUND/PURPOSE: The irradiation of 660-nm light-emitting diodes (LEDs) has exhibited potential to accelerate oral wound healing and prevent periodontal breakdown in rodents. This study was to evaluate the clinical effectiveness of 660-nm LEDs during non-surgical periodontal therapy (NSPT). METHODS: Nineteen patients with at least one periodontitis-involved tooth in three quadrants received NSPT, and three protocols of LED light irradiation, including LED light irradiation from initial clinical assessment (T0) until the completion of scaling and root planning (T1) (LED01), LED light irradiation from T1 until re-evaluation (T2) (LED02), and no LED light irradiation (control treatment), were randomly assigned to respective quadrant. Clinical parameters were assessed at T0 and T2, and such biomarkers as IL-1ß and MMP-8 from gingival crevicular fluid were assessed at T0, T1, and T2. RESULTS: At T2, all examined sites exhibited significantly reduced probing pocket depth (PD), clinical attachment level (CAL), gingival bleeding index, plaque score, and visual analog scale. In the sites with greatest initial PD and CAL, LED01 and LED02 significantly reduced PD and CAL compared with the control treatment. IL-1ß and MMP-8 were reduced in all groups at T1 and T2, and the reduction of MMP-8 was the most notable in LED01. CONCLUSION: LED light irradiation during or after scaling and root planing assisted in the recovery of periodontium and can be used as an adjunct treatment during NSPT, specifically for sites with severe periodontal breakdown.


Assuntos
Biomarcadores/análise , Periodontite Crônica/terapia , Líquido do Sulco Gengival/química , Terapia com Luz de Baixa Intensidade/métodos , Adulto , Idoso , Terapia Combinada , Feminino , Humanos , Interleucina-1beta/análise , Masculino , Metaloproteinase 8 da Matriz/análise , Pessoa de Meia-Idade , Índice Periodontal , Aplainamento Radicular/métodos , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
20.
Lasers Med Sci ; 35(2): 473-485, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31691054

RESUMO

The objective of this study was to evaluate the clinical attachment level (CAL) gain of Er:YAG, Er,Cr; YSGG, Nd:YAG; and diode laser (DL) as monotherapy or adjunctive to scaling and root planing (SRP) of chronic periodontitis by network meta-analysis (NMA). Randomized controlled clinical trials (RCTs) about lasers applied in SRP of chronic periodontitis were searched from PubMed, Cochrane Library, Web of Science, Ovid, Science Direct, Wan Fang, and China National Knowledge Infrastructure (CNKI) databases up to September 2018 and from references of selected full-texts and related reviews. Standard mean differences and 95% confidence intervals were counted for CAL gain. The random effects NMA were performed in STATA software. There were 25 RCTs about CAL gain at 3 and/or 6 months after lasers were applied in SRP. No inconsistency was detected. Er:YAG as monotherapy gained significantly more CAL at 3 months than did SRP; no significant differences were detected among other comparisons. In terms of CAL gain at 3 months, the ranking result from best to worst was as follows: Er:YAG as monotherapy, DL adjunctive to SRP, Er:YAG adjunctive to SRP, Er,Cr;YSGG as monotherapy, Nd:YAG adjunctive to SRP, and SRP. In terms of CAL gain at 6 months, the ranking result from best to worst was as follows: DL adjunctive to SRP, Nd:YAG adjunctive to SRP, SRP, Er:YAG adjunctive to SRP, and Er:YAG as monotherapy. Laser-assisted periodontal treatment could be superior to SRP alone and could serve as a good adjunctive treatment tool.


Assuntos
Periodontite Crônica/terapia , Raspagem Dentária , Lasers Semicondutores/uso terapêutico , Metanálise em Rede , Perda da Inserção Periodontal/terapia , Aplainamento Radicular , China , Terapia Combinada , Humanos , Viés de Publicação , Ensaios Clínicos Controlados Aleatórios como Assunto , Risco , Resultado do Tratamento
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