Journal of Indian Society of Periodontology最新文献

Background: Porphyromonas gingivalis, highly virulent bacteria, is said to play an important role in the pathogenesis of periodontal disease and rheumatoid arthritis (RA). Chronic periodontitis (CP) is a microbial-induced inflammatory disease leading to tooth loss if undetected and untreated. RA is a systemic inflammatory disease affecting the joints with subsequent morbidity and mortality. These two diseases share a common pathobiology. Although the presence of P. gingivalis has been investigated as a bridging link between these two diseases, its quantification has not been fully elicited. Hence, this case-control study primarily aimed at quantifying P. gingivalis using real-time quantitative polymerase chain reaction (qPCR) and secondarily assess the influence of age and gender on the clinical and biochemical parameters of these two diseases.

Materials and methods: The study population consisted of 51 patients divided into two age groups, i.e., 35-55 and 55-76 years. Twenty-five patients belonged to the test group (RA with CP) and 26 to the control group (CP without RA). Both the groups were analyzed for quantification of P. gingivalis using the qPCR technique along with periodontal and biochemical parameters. The study also analyzed the influence of age and gender on clinical characteristics.

Results: P. gingivalis count was exponentially raised in younger females having CP with RA. Age had no effect on clinical variables in CP patients with and without RA. However, gender comparison revealed RA factor and erythrocyte sedimentation rate to be more sensitive for females with significant relationship.

Conclusion: P. gingivalis count increased exponentially in CP patients with RA compared to those without RA. Younger females harbored more P. gingivalis.

Background: The influence of periodontal phenotype (PP) has been documented in the outcomes of various surgical periodontal interventions such as crown lengthening, mucogingival surgery, implant restoration, and open flap debridement. Previous studies with smaller sample sizes have assessed the role of PP on the outcome of nonsurgical periodontal therapy with inconsistent results.

Aim: The aim of the current interventional study is to estimate the influence of PP on the outcome of subgingival instrumentation in Stage II and III, Grade A and B periodontitis.

Materials and methods: Fifty-two patients (n = 27 thick PP and n = 25 thin PP) underwent subgingival instrumentation using ultrasonic scalers and curettes under local anesthesia in a single sitting, and periodontal parameters were recorded at baseline, 2, 4, and 6 months. The McNemar and Chi-square tests were applied for categorical data, whereas the Wilcoxon signed-rank test and Mann-Whitney U-test were applied for continuous data in intra- and intergroup comparisons, respectively.

Results: Significantly better improvements in deeper pockets (>5 mm) with thick PP were observed. Loss of attachment was found in thin, bleeding on probing (BOP)-negative sites with an initial probing depth of ≤3 mm. However, BOP-positive sites belonging to both groups exhibited higher improvements in terms of clinical parameters.

Conclusion: Probing depth, PP, and periodontal inflammation recorded in terms of BOP influence the gain in clinical attachment following subgingival instrumentation.

Background: This cross-sectional study compared the nutritional status of chronic periodontitis (CP) patients who presented with various degrees of severity with systemically healthy individuals using the Mini Nutritional Assessment (MNA^®) tool along with laboratory analysis of macro- and micronutrients.

Materials and methods: This research enrolled a total of 84 participants, of which 63 belonged to the CP group while 21 served as healthy controls. The CP patients were divided into three groups of 21 each, based on severity as mild, moderate, and severe. Clinical periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment level/loss, total number of teeth present [NOT-P], furcation involvement, pathological migration, and tooth mobility), biochemical parameters (lipid, protein, iron profiles, and Vitamin D₃ and B₁₂), and the MNA^® tool were used to assess the nutritional status of all the participants. The results were analyzed statistically.

Results: NOT-P, MNA score, lipid profile (except very-low-density lipoprotein), iron profile (except total iron-binding capacity), and Vitamin D₃ showed high significant differences (P < 0.001) among the groups. However, Vitamin B₁₂ and protein profile except for total protein revealed significant differences (P < 0.05).

Conclusion: CP can be a contributing risk factor for the development of malnutrition. MNA^® tool can be used for assessing the nutritional status of CP patients.

Plasmacytoid mucositis is a rare form of periodontal disease characterized by the infiltration of plasma cells into the gingival tissues. This case report highlights a unique case of plasmacytoid mucositis with periodontal involvement in a young woman. A 32-year-old female presented with gingival hyperplasia and cheilitis. The clinical examination revealed the presence of deep periodontal pockets, severe gingival inflammation, and bone loss. The patient was treated with a combination of nonsurgical periodontal therapy, systemic antibiotics, and oral hygiene instructions. After 2 months of the treatment, the patient showed significant improvement in the clinical parameters. This case report adds to the existing literature on this condition, emphasizing the importance of early diagnosis and prompt treatment. It highlights the need for a multidisciplinary approach involving periodontists, histopathologists, and microbiologists. The lesson to be learned from this case report is that plasmacytoid periodontitis should be considered and a biopsy should be performed to confirm the diagnosis.

Background: In the last quarter of the 20^th century, dedicated efforts have been made to use phytochemicals in the prevention of periodontal diseases, but the darker side of the coin is that we have hardly encountered studies with a scientific basis to prove the specific role of phytochemicals against dental plaque.

Objective: This study aimed to assess the antiplaque activity of Curcuma longa, Spilanthes acmella, and Quercus infectoria and to determine the antigingivitis activity of the extract, which shows high antiplaque potential.

Materials and methods: Sixteen volunteers were selected as subjects in this biphasic study. In the first phase, 10 volunteers were subjected to topical application of aqueous ethanolic extract (1%) of C. longa, Q. infectoria, and S. acmella on the labial/buccal and lingual/palatal surfaces of 28 teeth. In the second phase, the extract showing the highest efficacy was selected to assess its antigingivitis activity on all the surfaces of six mandibular anterior teeth of six gingivitis patients. The percentage plaque reduction was calculated by dividing the difference of the base and end scores by the baseline scores.

Results: C. longa demonstrated superior results as it showed the maximum reduction in plaque formation. Antigingivitis activity of long-term topical application of 1% C. longa was depicted in independent clusters in different volunteers selected for the study. Only after 2 weeks, the treatment score was found to be statistically significant to depict optimal results.

Conclusion: C. longa can be considered the best at reducing plaque. The antigingivitis activity of C. longa ranked reasonably satisfactory and comparable to the existing data for commercially available drugs.

Background: A 10-year survival analysis was performed to assess the predictive validity of the periodontal risk score (formerly known as Miller-McEntire Periodontal Prognostic Index [MMPPI]) to predict long-term survival of periodontally diseased molars in a longitudinally assessed cohort.

Materials and methods: The MMPPI scores were computed at baseline by summarizing scores allocated for individual factors. The cohort was treated, followed up, and placed under regular periodontal maintenance. Molar survival data collected up to 10 years of follow-up were analyzed. Cox proportional regression was performed, and hazards ratio (HR) were computed for each prognostic factor and the MMPPI score. To estimate the predictive value of MMPPI, a receiver operating curve (ROC) curve analysis was performed.

Results: From 1032 molars, 155 molars were extracted over the 10-year follow-up duration. Cox proportional hazard analysis showed significant hazard ratios for tooth loss for the component variables significant HR was noted for age: 4.92 (3.34:7.27), smoking: 1.74 (1.38-2.22), diabetes: 1.66 (1.49-1.86), molar type: 1.39 (1.15-1.67), probing depth: 2.00 (1.63-2.46), furcation: 2.64 (2.30-3.03), mobility: 3.45 (2.98-4.01), and total MMPPI score: 1.98 (1.85-2.12). ROC curve analysis showed an area under the curve value of 0.94 for the MMPPI index as a predictor of molar loss at 8 years, and the Youden index was maximized at the optimal cutoff point score of 7.

Conclusions: All component scores of MMPPI showed significant hazard ratios at 10 years. These findings support the previous results from the 5-year analysis of this university-based cohort and warrant validation in independent cohorts.

Background: Periodontitis is a multifactorial, polymicrobial oral inflammatory illness brought on by oral pathogens. Porphyromonas gingivalis is a Gram-negative, obligatory anaerobic, black-pigmented coccobacillus and is regarded as a primary etiological factor in the progression of periodontitis. Rapid, highly senstitive and specific detection methods are emerging. The present study aimed to evaluate the loop-mediated isothermal amplification (LAMP) technique for efficiently detecting P. gingivalis from subgingival plaque samples of chronic periodontitis patients.

Materials and methods: This study included 50 subgingival plaque samples from patients suffering from chronic periodontitis. The DNA (Deoxyribonucleic acid) was extracted by the "modified proteinase K" method. A set of six primers, targeting the pepO gene of P. gingivalis, was used for conducting LAMP. The amplification was visualized by naked-eye detection and agarose electrophoresis. Conventional polymerase chain reaction (PCR) and real-time qantitative PCR (qPCR) were carried out by targeting the 16SrRNA (16S ribosomal ribonucleic acid) gene of P. gingivalis.

Results: The results showed that LAMP detected P. gingivalis in 40 out of 50 samples (80%). Whereas, qPCR and conventional PCR technique detected P. gingivalis in 38 (76%) and 33 (66%) samples respectively. The sensitivity and specificity of the LAMP method were 94.87% and 90.90%, respectively. With qPCR, the sensitivity and specificity were found to be 92.30% and 81.81%, respectively, whereas, with conventional PCR, it was found to be 76.92% and 72.72%, respectively.

Conclusion: LAMP is an efficient technique for quick, accurate, and reliable identification of P. gingivalis from subgingival plaque samples. The technique needs to be validated analytically, and further studies can be conducted by taking saliva and/or gingival crevicular fluid samples from periodontitis patients.

Innovations in surgical techniques have improved the esthetic outcome and predictability of root coverage procedures in recent years. A free gingival graft (FGG) augments the attached gingiva, but the compromised blood supply precludes its use in root coverage. In the surgical technique described in this case report, the FGG kept over a laterally placed periosteal flap enhanced the outcome. A laterally flipped periosteal flap was adapted over the root surface using resorbable sutures. The free graft was secured at the recipient site with cyanoacrylate adhesive, and adaptation was ensured with suspensory sutures. Satisfactory root coverage was appreciated and maintained at 6 months with excellent functional outcomes. Adequate width of the attached gingiva and vestibular depth were also noticed at the recipient site. The patient was highly satisfied with the obtained results, which were maintained until the 1-year postoperative period.

Objective: The objective is to compare and evaluate the hard and soft tissue parameters by using short and standard long implants with sinus lifting in the posterior maxilla.

Materials and methods: Eleven patients with complaints of missing upper back teeth were enrolled in the study for implant-supported rehabilitation and were categorized into two groups: Group long (GL): longer implant (>8 mm) placement, preceded by Sinus Augmentation. Group short (GS): short implant (≤8 mm) placement, without sinus augmentation. The primary outcome measured was cumulative survival rate (CSR) in the compromised partial edentulous posterior maxilla. Secondary outcomes measured were implant stability (IS), marginal bone level alterations (MBL), pocket probing depth (PPD), crown-to-implant ratio, and any complications.

Results: The difference in CSR between the groups was not statistically significant (P = 0.317). High stability was achieved immediately after the placement of the implants, in both groups (GS: 64 ± 4.07, GL: 65.58 ± 9.75); this difference in the mean ISQ (IS quotients) values was not found to be statistically significant at implant placement (P = 0.7). The mean MBL reported in the study at the end of 12 months of prosthesis function was - 0.762 ± 0.48 mm and - 0.7 ± 0.34 mm for GS and GL, respectively. The mean PPD measurements in GS and GL groups were 1.917 ± 0.68 mm and 1.833 ± 0.38 mm, respectively, and it was not statistically significant (P = 0.8).

Conclusion: Within the limitations of the present study, the obtained results indicate that short implants provided a similar clinical and radiographic performance compared to long implants placed in combination with a sinus augmentation procedure (lateral window) up to 12 months after prosthetic loading.