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1.
BMC Oral Health ; 23(1): 60, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36726081

RESUMO

BACKGROUND: Smoking is an established modifying factor for the host immune response of periodontitis patients. However, its exact influence remains unclear. We aimed to compare the cytokine profile of periodontitis patients with and without smoking habits both before and after periodontal therapy to preliminarily explore its influence on the host immune response to periodontitis. METHODS: The protocol of the present meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the code CRD42021255656. Meta-analysis was performed for each cytokine if at least three studies were included. We synthesized the evidence to compare the cytokine profile of periodontitis with and without smoking both in gingival cervical fluid (GCF) and serum to explore the impact of smoking on periodontitis both locally and systemically. Moreover, we also compared the cytokine profile of the two groups of patients after periodontal therapy to explore the effect of smoking on the outcome of periodontal therapy. RESULTS: Fifteen studies were included in this meta-analysis. We found that there was no significant difference between the two groups of patients in the baseline cytokine profile. However, after periodontal therapy, smoking periodontitis patients showed significantly higher IL-1ß levels in their GCF than nonsmoking patients. DISCUSSION: There was no significant difference between smoking and nonsmoking periodontitis patients in the baseline cytokine profile. However, after periodontal therapy, smoking periodontitis patients showed significantly higher IL-1ß levels in their GCF than nonsmoking patients, which indicates that smoking may impair the response of periodontitis to periodontal treatment.


Assuntos
Periodontite , Fumar , Humanos , Fumar/efeitos adversos , Líquido do Sulco Gengival , Revisões Sistemáticas como Assunto , Periodontite/terapia , Citocinas
2.
J Med Case Rep ; 17(1): 19, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36658639

RESUMO

BACKGROUND: Orthodontic treatment involves movement of teeth by compression and resorption of the alveolar bone using orthodontic forces. These movements are closely linked to the interactions between the teeth and the periodontal tissues that support them. Owing to an increase in adults seeking orthodontic treatment, orthodontists increasingly encounter patients with periodontal diseases, in whom orthodontic treatment is contraindicated. In rare cases, periodontitis may develop after treatment initiation. However, no approach for treating periodontitis after the initiation of orthodontic treatment has been established. Here, we present an approach for managing localized severe periodontitis manifesting after initiating orthodontic treatment. CASE PRESENTATION: A 32-year-old Japanese woman was referred to the Department of Dentistry and Oral Surgery by an orthodontist who observed symptoms of acute periodontitis in the maxillary molars that required periodontal examination and treatment. A detailed periodontal examination, including oral bacteriological examination, revealed localized severe periodontitis (stage III, grade B) in the maxillary left first and second molars and in the mandibular right second molar. After consultation with the orthodontist, the orthodontic treatment was suspended based on the results of the bacteriological examination to allow for periodontal treatment. Full-mouth disinfection was performed with adjunctive oral sitafloxacin. Periodontal and bacteriological examinations after treatment revealed regression of the localized periodontitis with bone regeneration. Thereafter, orthodontic treatment was resumed, and good progress was achieved. CONCLUSIONS: Orthodontists should recognize the risk of acute severe periodontitis in young adults. Asymptomatic patients with localized severe periodontitis may clear a screening test before orthodontic treatment but develop acute symptoms with bone resorption during orthodontic treatment. Therefore, patients requiring orthodontic treatment should be examined by their family dentist or a periodontist to rule out periodontal issues that may impede orthodontic treatment. The patients should also be informed of age-related risks. Further, periodontists, family dentists, and orthodontists who treat adults should be informed about periodontitis and the need for interdisciplinary collaboration. In patients who develop periodontitis after orthodontic treatment initiation, temporary interruption of orthodontic treatment and aggressive periodontal intervention may facilitate recovery.


Assuntos
Periodontite , Feminino , Adulto Jovem , Humanos , Adulto , Periodontite/terapia
3.
Compend Contin Educ Dent ; 44(1): 18-24; quiz 25, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36696274

RESUMO

Periodontitis is a chronic, multifactorial inflammatory disease characterized by progressive destruction of the tooth-supporting apparatus. Determining tooth prognosis is of central importance in clinical practice to help both the clinician and patient understand the risks and benefits of treatment while shedding light on the patient's long-term periodontal prognosis and aiding in the development of an individualized treatment plan. Several indexing-type systems have been proposed for determining the prognosis of periodontally involved teeth. The periodontal risk score (PRS) is a simple, evidence-based, motivational tool that can be used in daily clinical practice in both healthy and periodontally involved patients. The PRS incorporates systemic and lifestyle prognostic factors to achieve superior predictive accuracy. With the PRS, patients are encouraged to achieve a target score (representing an "excellent" prognosis) that can be realistically attained through compliance with a periodontal maintenance plan. The purpose of this article is to present to clinicians how to implement this evidence-based tool into their daily practices and thus help patients improve their long-term periodontal prognosis.


Assuntos
Periodontite , Perda de Dente , Humanos , Periodontite/terapia , Prognóstico , Fatores de Risco , Doença Crônica
4.
J Feline Med Surg ; 25(1): 1098612X221148577, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36651926

RESUMO

OBJECTIVES: This study aimed to characterize the clinical, radiographic and histopathologic features of early-onset gingivitis (EOG) and periodontitis in cats. METHODS: The medical records database was searched for cats diagnosed with histologically confirmed EOG or periodontitis from 1997 to 2022. Information such as medical history, lifestyle factors, clinical presentation, radiographic and histopathologic features were included for 27 client-owned cats. Response to treatment and long-term follow-up was also recorded. RESULTS: Moderate-to-severe periodontal disease was radiographically confirmed in 78% (21/27) of cats with moderate-to-severe EOG, compared with the evidence of periodontal disease noted in 30% (8/27) of cases during awake oral examination. Horizontal bone loss, along with missing teeth, were the predominant radiographic features noted in 89% (24/27) of cases. The predominant histopathologic feature was moderate-to-severe, erosive-to-ulcerative, neutrophilic and lymphoplasmacytic inflammation with varying degrees of epithelial and stromal hyperplasia. Two cats developed feline chronic gingivostomatitis (FCGS)-like lesions, and seven cats exhibited worsening of aggressive periodontitis (AP). Lack of improvement in the severity of gingivitis or clinical signs evident at the first follow-up appointment was significantly associated with progression of disease (P = 0.004). CONCLUSIONS AND RELEVANCE: The results of this study demonstrate the importance of oral evaluations in cats as early as 6 months of age. For cats exhibiting substantial gingivitis, an anesthetized evaluation, periodontal treatment and long-term monitoring are recommended. Given the high frequency of moderate-to-severe periodontitis encountered in these cats, clients should be informed about the potential need for tooth extractions. EOG may progress to AP. Finally, this study suggests that there could be a link between EOG and FCGS; however, further studies are needed to better characterize this condition and establish any potential link between the two entities.


Assuntos
Doenças do Gato , Gengivite , Doenças Periodontais , Periodontite , Estomatite , Gatos , Animais , Periodontite/diagnóstico por imagem , Periodontite/terapia , Periodontite/veterinária , Gengivite/veterinária , Doenças Periodontais/veterinária , Estomatite/veterinária , Doenças do Gato/diagnóstico por imagem
5.
Clin Oral Investig ; 27(1): 1-13, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36565370

RESUMO

OBJECTIVE: This systematic review aims to assess the available literature on the clinical efficacy of hand versus power-driven instruments for subgingival instrumentation during surgical periodontal therapy (ST). MATERIALS AND METHODS: A search of the literature was carried out on MEDLINE via Ovid, Embase, Web of Science, the Cochrane Database, LILACS, and Scopus. RCTs comparing the use of powered instruments (test) to hand scalers (control) for subgingival instrumentation in terms of changes in probing pocket depth (PPD) after surgical periodontal treatment were included and screened in duplicate. Descriptive synthesis of the data and risk of bias assessment were undertaken. RESULTS: Four RCTs met the inclusion criteria and were included in this systematic review. ST in all studies was performed by means of open flap debridement. Gracey curettes were the most commonly used hand instruments, while sonic and ultrasonic devices were used in the test group. Sites with initial PPD ≥ 6 mm had pocket reduction ranging from 2.93 to 4.89 mm in the control group and from 2.77 to 3.86 mm in the test group. All studies found no significant difference between the different types of instruments/devices in terms of PPD reduction. CONCLUSIONS: Despite the limited number of studies, both manual and power-driven instruments appear to be effective in reducing PPD after surgical treatment of periodontitis. CLINICAL RELEVANCE: Based on the findings of this systematic review, the clinician may make a decision whether to use manual or powered instruments during ST on a case-by-case basis and considering other factors, such as the risk of creating high concentrations of aerosols.


Assuntos
Periodontite , Terapia por Ultrassom , Humanos , Raspagem Dentária , Periodontite/terapia , Resultado do Tratamento , Ultrassom , Aplainamento Radicular
6.
J Med Case Rep ; 16(1): 463, 2022 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-36522676

RESUMO

BACKGROUND: Felty syndrome is defined by three conditions: neutropenia, rheumatoid arthritis, and splenomegaly. Neutropenia associated with pancytopenia may further affect the dental condition of a patient. Periodontal treatment and surgery in patients with Felty syndrome necessitates cooperation with a hematologist. Here we present a case of a patient with Felty syndrome who was initially referred to the oral surgery hospital attached to the School of Dentistry for extensive periodontitis. She was effectively treated in collaboration with the hematology department. CASE PRESENTATION: A 55-year-old Asian woman visited our department with concerns of worsening tooth mobility, discomfort, and spontaneous gingival bleeding. Initial periodontal examination revealed generalized severe periodontitis (Stage IV Grade C) resulting from leukopenia/neutropenia and poor oral hygiene. A thorough treatment strategy involving comprehensive dental procedures, such as multiple extractions and extensive prosthetic treatment, was implemented. Following the diagnosis of Felty syndrome, the patient was started on treatment with oral prednisolone 40 mg/day, which effectively controlled the disease. Furthermore, there was no recurrence of severe periodontitis after the periodontal treatment. CONCLUSIONS: Dentists and physicians should be aware that immunocompromised individuals with pancytopenia and poor oral hygiene are at risk of developing extensive periodontitis. If their susceptibility to infection and pancytopenia-related bleeding can be managed, such patients can still receive comprehensive dental treatment, including teeth extractions and periodontal therapy. Cooperation among the dentist, hematologist, and patient is necessary to improve treatment outcomes and the patient's quality of life.


Assuntos
Perda do Osso Alveolar , Síndrome de Felty , Neutropenia , Pancitopenia , Periodontite , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome de Felty/complicações , Síndrome de Felty/diagnóstico , Qualidade de Vida , Pancitopenia/complicações , Perda do Osso Alveolar/terapia , Perda do Osso Alveolar/complicações , Periodontite/complicações , Periodontite/diagnóstico , Periodontite/terapia , Neutropenia/complicações
7.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(12): 1195-1201, 2022 Dec 09.
Artigo em Chinês | MEDLINE | ID: mdl-36509518

RESUMO

The S3 level clinical practice guideline for the treatment of stage Ⅳperiodontitis, developed by the European Federation of Periodontology, was published in April 22, 2022 (DOI: 10.1111/jcpe.13639). According to the severity and complexity, stage Ⅳ periodontitis was grouped into four case types, and comprehensive treatment plans were formulated correspondingly in the guideline, including tooth splinting, occlusal adjustment, orthodontic therapy, restorative therapy, and personalized supportive periodontal care as well. The aim of present work is to intensively interpret the key points of the guideline and help the clinicians to understand this guideline better, in order to improve the treatment level of stage Ⅳ periodontitis in China.


Assuntos
Periodontite , Dente , Humanos , Periodontite/terapia , Periodontia , Ajuste Oclusal , China
8.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(12): 1202-1208, 2022 Dec 09.
Artigo em Chinês | MEDLINE | ID: mdl-36509519

RESUMO

2018 international classification of periodontal and implant diseases relates the classifications with the approaches of prevention and treatment based on the stages and grades of disease. European Federation of Periodontology (EFP) evaluated the available evidences following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE), and published the EFP S3 level clinical practice guideline for the treatment of stage Ⅰ-Ⅲ and Ⅳ periodontitis in 2020 and 2022, respectively. The present manuscript gives introduction and interpretation based on the EFP S3 level clinical practice guideline and Chinese national conditions. On the base of the diagnostic key points of staging and grading, it introduces in detail the step treatment procedures of stageⅠ-Ⅲ periodontitis as well as the multi-disciplinary treatment procedures of stage Ⅳ periodontitis, compares the similarities and differences between the step and phase procedures, and then proposes a strategy for determining the recall interval more suitable for Chinese clinicians. The present manuscript aims to help dentists to learn and grasp the key points more quickly and accurately on the clinical application of the guideline and to assist them in making the optimal treatment plans after judging and evaluating the specific clinical circumstances, so as to maximize the chances of favorable outcome.


Assuntos
Doenças Periodontais , Periodontite , Dente , Humanos , Doenças Periodontais/terapia , Periodontia , Periodontite/diagnóstico , Periodontite/terapia
9.
J Nanobiotechnology ; 20(1): 545, 2022 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-36585740

RESUMO

Periodontal tissue is a highly dynamic and frequently stimulated area where homeostasis is easily destroyed, leading to proinflammatory periodontal diseases. Bacteria-bacteria and cell-bacteria interactions play pivotal roles in periodontal homeostasis and disease progression. Several reviews have comprehensively summarized the roles of bacteria and stem cells in periodontal homeostasis. However, they did not describe the roles of extracellular vesicles (EVs) from bacteria and cells. As communication mediators evolutionarily conserved from bacteria to eukaryotic cells, EVs secreted by bacteria or cells can mediate interactions between bacteria and their hosts, thereby offering great promise for the maintenance of periodontal homeostasis. This review offers an overview of EV biogenesis, the effects of EVs on periodontal homeostasis, and recent advances in EV-based periodontal regenerative strategies. Specifically, we document the pathogenic roles of bacteria-derived EVs (BEVs) in periodontal dyshomeostasis, focusing on plaque biofilm formation, immune evasion, inflammatory pathway activation and tissue destruction. Moreover, we summarize recent advancements in cell-derived EVs (CEVs) in periodontal homeostasis, emphasizing the multifunctional biological effects of CEVs on periodontal tissue regeneration. Finally, we discuss future challenges and practical perspectives for the clinical translation of EV-based therapies for periodontitis.


Assuntos
Vesículas Extracelulares , Periodontite , Humanos , Vesículas Extracelulares/metabolismo , Células-Tronco , Periodontite/terapia , Periodontite/metabolismo , Comunicação Celular , Homeostase
10.
Int J Mol Sci ; 23(22)2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36430760

RESUMO

Periodontal diseases are predisposing factors to the development of many systemic disorders, which is often initiated via leukocyte infiltration and vascular inflammation. These diseases could significantly affect human health and quality of life. Hence, it is vital to explore effective therapies to prevent disease progression. Periodontitis, which is characterized by gingival bleeding, disruption of the gingival capillary's integrity, and irreversible destruction of the periodontal supporting bone, appears to be caused by overexpression of selectins in periodontal tissues. Selectins (P-, L-, and E-selectins) are vital members of adhesion molecules regulating inflammatory and immune responses. They are mainly located in platelets, leukocytes, and endothelial cells. Furthermore, selectins are involved in the immunopathogenesis of vascular inflammatory diseases, such as cardiovascular disease, diabetes, cancers, and so on, by mediating leukocyte recruitment, platelet activation, and alteration of endothelial barrier permeability. Therefore, selectins could be new immunotherapeutic targets for periodontal disorders and their associated systemic diseases since they play a crucial role in immune regulation and endothelium dysfunction. However, the research on selectins and their association with periodontal and systemic diseases remains limited. This review aims to discuss the critical roles of selectins in periodontitis and associated systemic disorders and highlights the potential of selectins as therapeutic targets.


Assuntos
Doenças Periodontais , Periodontite , Doenças Vasculares , Humanos , Qualidade de Vida , Células Endoteliais , Selectinas , Doenças Periodontais/terapia , Imunoterapia , Periodontite/terapia , Fatores Imunológicos
11.
Int J Mol Sci ; 23(21)2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36362206

RESUMO

Periodontal disease is a chronic inflammatory condition affecting about 20-50% of people, worldwide, and manifesting clinically through the detection of gingival inflammation, clinical attachment loss, radiographically assessed resorption of alveolar bone, gingival bleeding upon probing, teeth mobility and their potential loss at advanced stages. It is characterized by a multifactorial etiology, including an imbalance of the oral microbiota, mechanical stress and systemic diseases such as diabetes mellitus. The current standard treatments for periodontitis include eliminating the microbial pathogens and applying biomaterials to treat the bone defects. However, periodontal tissue regeneration via a process consistent with the natural tissue formation process has not yet been achieved. Developmental biology studies state that periodontal tissue is composed of neural crest-derived ectomesenchyme. The aim of this review is to discuss the clinical utility of stem cells in periodontal regeneration by reviewing the relevant literature that assesses the periodontal-regenerative potential of stem cells.


Assuntos
Perda do Osso Alveolar , Gengivite , Células-Tronco Mesenquimais , Doenças Periodontais , Periodontite , Humanos , Regeneração Tecidual Guiada Periodontal , Doenças Periodontais/terapia , Periodontite/terapia
12.
Bioelectromagnetics ; 43(7): 426-437, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36310445

RESUMO

Periodontitis is an inflammatory disease resulting from a complex polymicrobial infection that causes tissue destruction in susceptible individuals. Osteoporosis has been associated with greater clinical attachment loss in patients with periodontitis. Experimental studies have shown positive results in the treatment of osteoporosis through pulsed electromagnetic field (PEMF) stimulation. The aim of this study was to evaluate the effects of PEMF in the presence of estrogen deficiency associated with periodontitis, verifying its role in bone metabolism and in the inflammatory response. Sixty rats were divided into four groups: Sham surgery + ligature-induced periodontitis (P); Sham surgery + ligature-induced periodontitis + PEMF therapy (P + PEMF); Ovariectomy surgery + ligature-induced periodontitis (P + OVX); Ovariectomy surgery + ligature-induced periodontitis + PEMF therapy (P + OVX + PEMF). The area of bone loss in the furcation region (BL), connective tissue attachment loss (CTAL) and alveolar bone loss (ABL), BV/TV and BMD were evaluated. In addition to immunohistochemical labelling of RANKL, OPG, and TRAP and the inflammatory response of interleukin (IL)-1b, IL-6, TNF-α, IL-10, and vascular endothelial growth factor. P + OVX showed significant BL in relation to P + PEMF and the greatest CTAL and ABL. P + OVX and P + OVX + PEMF showed a significant reduction in BV/TV (%). P and P + PEMF showed a significantly lesser amount of Tb.Sp (mm) while P + OVX and P + OVX + PEMF showed a lesser of Tb.N. P + PEMF had the greatest BMD. P + OVX presented higher RANKL and lower OPG immunolabeling than other groups. P + PEMF and P + OVX + PEMF showed a reduction on all biomarkers evaluated. The application of PEMF seems to attenuate the effects of bone loss in the presence of periodontitis and ovariectomy. © 2022 Bioelectromagnetics Society.


Assuntos
Campos Eletromagnéticos , Estrogênios , Osteoporose , Periodontite , Animais , Feminino , Ratos , Estrogênios/deficiência , Osteoporose/etiologia , Osteoporose/terapia , Ovariectomia , Periodontite/complicações , Periodontite/terapia
13.
Arch Immunol Ther Exp (Warsz) ; 70(1): 26, 2022 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-36245042

RESUMO

Recent decades have shed a new light on the pathomechanism of periodontal inflammation. While classic periodontology concentrates on biofilm control, oral hygiene improvement, professional tooth cleaning and surgical correction of damaged periodontal tissues, new aspects of the destruction mechanisms are being raised. Among them, the greatest attention is paid to the influence of host response on the clinical manifestations of the disease. Numerous studies have proved that the shift from gingivitis to periodontitis is not a simple progress of the disease, but an event occurring only in susceptible individuals. Susceptibility may result from appearance of local factors facilitating biofilm accumulation and/or maturation, or from systemic features, among which over-reaction and prolonged agitation of non-specific component of inflammatory response is crucial. The present paper summarizes the association between periodontology and immunology and updates the knowledge accrued mostly in the recent years. After a brief explanation of advances in understanding of the disease aetiology, the most studied and potentially viable immunological markers of periodontal disease are presented. Possible new therapeutic strategies, exploiting knowledge about the nature of host response-immunomodulation and reduction of chronic oxidative stress-are also presented.


Assuntos
Gengivite , Doenças Periodontais , Periodontite , Suscetibilidade a Doenças , Humanos , Inflamação , Doenças Periodontais/terapia , Periodontite/terapia
14.
Mol Biol Rep ; 49(12): 12219-12225, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36266554

RESUMO

Periodontitis is the primary cause of irreversible destruction of the periodontium surrounding teeth. Proinflammatory cytokines are secreted by pathogens in the biofilm and destroy the periodontium. Exosomes released into all biological fluids from saliva have enabled many innovations in the early diagnosis and treatment of periodontal diseases. This narrative review describes the role of exosomes in various diseases, and their involvement in periodontal diseases and periodontal regeneration primarily. Since guided tissue regeneration offers unpredictable results that vary according to the case, new developments in periodontal treatment are needed. Exosomes are suitable drug carriers for periodontal regeneration due to their isolation from every biological fluid, biocompatibility, low toxicity and high concentration of drugs reaching the target tissue. Exosomes obtained from mesenchymal stem cells can be used for periodontal regeneration in periodontal flaps, scaffolds, or periodontal defect areas through biomaterials such as drugs and hydrogels. Exosomes are significant in the early diagnosis and development of treatment of many diseases such as cardiovascular, neurodegenerative, diabetes and prognostic markers in cancer. Future studies are needed to elucidate the effects and possible mechanisms of exosomes in periodontitis and periodontal diseases and other systemic diseases, as they have many promises in diagnosis, treatment, and prognosis.


Assuntos
Exossomos , Doenças Periodontais , Periodontite , Humanos , Periodonto , Ligamento Periodontal , Periodontite/terapia , Doenças Periodontais/terapia
15.
Curr Med Sci ; 42(5): 1079-1087, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36255663

RESUMO

OBJECTIVE: The specific objective of this study was to evaluate the effects of atmospheric pressure plasma (APP) in the treatment of experimental periodontitis in Beagle dogs. METHODS: The APP jet was diagnosed using optical emission spectroscopy and laser-induced fluorescence spectroscopy. Six Beagles received stainless steel ligatures to establish experimental periodontitis model. The teeth in the control group were subjected to conventional root surface debridement (RSD) and chlorhexidine irrigation. The APP group also started with RSD and was then subjected to plasma irradiation. Clinical analyses including plaque index, modified sulcus bleeding index, pocket depth and attachment loss (AL), as well as cone-beam computed tomography (CBCT) analysis, were performed at baseline, 4th week, 8th week and 12th week after treatment. RESULTS: The results showed that typical reactive oxygen and nitrogen species were found in the full spectrum and the gas temperature of APP was close to room temperature. The highest concentrations of hydroxide and oxygen were obtained at 5 mm away from the nozzle. In both groups, all values in clinical examinations were significantly lower (P<0.05) at 12th week after treatment than those at baseline. At the 12th week, the AL in clinical examinations and the bone loss in CBCT images in the APP group were significantly lower than those in the control group (P<0.05). The hematoxylin-eosin staining showed more renascent alveolar bone in the APP group than in the control group. CONCLUSION: These findings suggested that APP has profound potential for use as an adjunct approach for periodontitis treatment.


Assuntos
Clorexidina , Periodontite , Cães , Animais , Clorexidina/uso terapêutico , Amarelo de Eosina-(YS)/uso terapêutico , Aço Inoxidável , Hematoxilina/uso terapêutico , Periodontite/diagnóstico por imagem , Periodontite/terapia , Pressão Atmosférica , Oxigênio , Nitrogênio/uso terapêutico
16.
Gen Dent ; 70(6): 52-58, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36288076

RESUMO

Periodontal disease affects 42% of adults in the United States. Both the periodontal microbiome and the host immune inflammatory response may be influenced by overweight/obesity status. This retrospective analysis sought to determine the associations of periodontal disease parameters with body mass index (BMI) and obesity status in patients undergoing periodontal maintenance therapy. The records of 418 patients who were undergoing periodontal maintenance after periodontitis treatment were examined, and the patients' demographic characteristics (sex, age, and race/ethnicity), self-reported BMI, periodontal disease condition, number of sites with probing depth ≥ 4 mm, missing teeth, and sites with bleeding on probing (BOP) were recorded. Patients were determined to have active moderate to severe periodontitis if they presented with 2 or more sites in 2 different quadrants with clinical attachment loss ≥ 5 mm and probing depth ≥ 5 mm. Individuals were also categorized into 3 groups: underweight/normoweight, BMI < 25; overweight, BMI 25 ≤ 30; or obese, BMI ≥ 30. In the study population, BMI ranged from 16.827 to 51.389. The periodontitis status was not significantly associated with a BMI status of overweight (odds ratio [OR] = 1.388 [95% CI, 0.961- 2.006]) or obese (OR = 1.168 [95% CI, 0.77-1.757]). Female sex (OR = 0.561 [95% CI, 0.343-0.918]) and age (OR = 0.983 [95% CI, 0.967-0.999]) were negatively associated with active periodontitis status. Obese patients demonstrated significantly more sites with BOP than either underweight/normoweight or overweight patients, and a BMI indicating obesity was associated with increasing age (P < 0.001) and higher number of missing teeth (P = 0.0064). In a population of patients undergoing periodontal maintenance therapy, BMI was associated with age and missing teeth, and obese status was associated with a significantly higher number of sites with BOP.


Assuntos
Doenças Periodontais , Periodontite , Perda de Dente , Adulto , Humanos , Feminino , Índice de Massa Corporal , Sobrepeso/complicações , Índice Periodontal , Estudos Retrospectivos , Magreza , Periodontite/complicações , Periodontite/terapia , Obesidade/complicações , Doenças Periodontais/complicações , Perda da Inserção Periodontal/complicações , Perda da Inserção Periodontal/epidemiologia
17.
J Leukoc Biol ; 112(5): 1025-1040, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36218054

RESUMO

Periodontitis is one of the most prevalent infectious inflammatory diseases, characterized by irreversible destruction of the supporting tissues of teeth, which is correlated with a greater risk of multiple systemic diseases, thus regarded as a major health concern. Dysregulation between periodontal microbial community and host immunity is considered to be the leading cause of periodontitis. Comprehensive studies have unveiled the double-edged role of immune response in the development of periodontitis. Immune senescence, which is described as age-related alterations in immune system, including a diminished immune response to endogenous and exogenous stimuli, a decline in the efficiency of immune protection, and even failure in immunity build-up after vaccination, leads to the increased susceptibility to infection. Recently, the intimate relationship between immune senescence and periodontitis has come into focus, especially in the aging population. In this review, both periodontal immunity and immune senescence will be fully introduced, especially their roles in the pathology and progression of periodontitis. Furthermore, novel immunotherapies targeting immune senescence are presented to provide potential targets for research and clinical intervention in the future.


Assuntos
Periodontite , Humanos , Idoso , Periodontite/terapia
18.
Artigo em Inglês | MEDLINE | ID: mdl-36305924

RESUMO

This retrospective study evaluated the effect of combined periodontal-orthodontic treatment in terms of clinical, radiographic, and patient-reported outcomes in 40 stage IV periodontitis patients with advanced attachment loss and pathologic migration of anterior teeth. Full-mouth periodontal parameters were recorded at baseline (after diagnosis; T0), at the end of active periodontal therapy (APT; T1), at completion of orthodontic tooth movement (OTM; T2), and at the last supportive periodontal care (SPC) visit (T3). Radiographic analysis was performed at T0, T2, and T3. A total of 115 teeth were lost during APT, including 5 molars at T2 (used as orthodontic anchorage) and 10 premolars at T3 (due to root fracture). All anterior migrated teeth were in function at T3 (mean duration: 9.5 years). Significant mean probing pocket depth reduction (1.5 ± 1.1 mm) and attachment level gain (0.9 ± 1.0 mm) were observed after APT, whereas OTM and SPC were associated with furthering small changes. The alveolar bone level at T3 was slightly increased from T0 values. Patient-reported outcome measurements significantly improved in terms of esthetics and masticatory function. OTM should be considered an essential part of the comprehensive treatment plan to change the prognosis of severely compromised teeth in stage IV periodontitis patients.


Assuntos
Periodontite , Perda de Dente , Dente , Humanos , Estudos Retrospectivos , Periodontite/complicações , Periodontite/diagnóstico por imagem , Periodontite/terapia
19.
Int J Technol Assess Health Care ; 38(1): e73, 2022 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-36169019

RESUMO

OBJECTIVES: To evaluate the cost-effectiveness of the nonsurgical periodontal treatment (NSPT) compared with supragingival therapy in type II diabetics with periodontitis. METHODS: A decision tree analysis was used to estimate the costs and health outcomes of two periodontal therapies in a hypothetical cohort of type II diabetics with periodontitis. The analysis was developed from the perspective of a third-party payer at 1 year and 5 years. Probabilities were derived from two systematic reviews. The costs and resource use were validated by a Delphi expert panel. All costs were expressed in USD, using the 25 May 2021 Colombian pesos market exchange rate (USD 1 = COP 3,350). RESULTS: NSPT was a dominant alternative compared with subsidized supragingival therapy in type II diabetics with periodontitis, generating savings of USD 87 and 400, during the first year or up to 5 years, respectively, and improving dental survival from 32 to 69 percent. CONCLUSIONS: NSPT can generate savings by reducing the complications derived from uncontrolled periodontitis and tooth loss.


Assuntos
Diabetes Mellitus Tipo 2 , Periodontite , Colômbia , Análise Custo-Benefício , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/terapia , Humanos , Periodontite/complicações , Periodontite/terapia
20.
Artigo em Inglês | MEDLINE | ID: mdl-36141577

RESUMO

Halitosis, or bad breath, is an oral health problem characterized by an unpleasant malodor emanating from the oral cavity. This condition can have different origins and causes a negative burden in social interactions, communication and quality of life, and can in uncommon cases be indicative of underlying non-oral non-communicable diseases. Most cases of halitosis are due to inadequate oral hygiene, periodontitis and tongue coating, yet the remaining proportion of cases are due to ear-nose-throat-associated (10%) or gastrointestinal/endocrine (5%) disorders. For this reason, the diagnosis, treatment and clinical management of halitosis often require a multidisciplinary team approach. This comprehensive review revisits the etiology of halitosis as well as standard and novel treatment that may contribute to higher clinical success.


Assuntos
Halitose , Periodontite , Halitose/etiologia , Halitose/terapia , Humanos , Saúde Bucal , Higiene Bucal , Periodontite/complicações , Periodontite/terapia , Qualidade de Vida , Língua
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