Ana Pejcic

The effects of low level laser irradiation on gingival inflammation.

OBJECTIVE The goal of this study was to analyze the effects of low level laser irradiation treatment and conservative treatment on gingival inflammation. BACKGROUND It is widely accepted today that the primary etiological factor for the onset of periodontitis is dental plaque, although the exact mechanism of damage remains unknown. Inflammation is a basic response of periodontal tissue to damage and serves as a fast first line of defense against damage and infections. The treatment of gingivitis and periodontitis has gone through various stages: from the simplest, classical treatment methods, through improved radical interventions, to a new era marked by laser technology. Low level laser irradiation has an anti-inflammatory effect, both general and local. MATERIALS AND METHODS The research was done on patients who had chronic periodontal disease (mild periodontitis) with expressed clinical symptoms of gingival inflammation. All patients in the study underwent conservative treatment. After conservative therapy, the patients from the experimental group were subjected to 10 low level laser treatment sessions. Both groups underwent regular follow-up visits 1, 3, and 6 months after treatment, which involved only clinical examination using plaque index (PI), gingival index (GI), and bleeding on probing index (BOP index). RESULTS A considerable decrease in all three indexes after the application of both therapies was noticed. The follow-up visits revealed the difference in index values. With laser therapy, the values of indexes decreased steadily, whereas with conservative therapy they increased up to a certain point, but did not reach the pre-therapy values. CONCLUSIONS A general conclusion can be drawn that low level laser irradiation (semiconductor, 670 nm) can be used as a successful physical adjuvant method of treatment, which, together with traditional periodontal therapy, leads to better and longer-lasting therapeutic results.

Effect of Periodontal Treatment on Lipoproteins Levels in Plasma in Patients with Periodontitis

Objectives: Recent epidemiological studies have shown that individuals with periodontitis have a significantly increased risk of developing coronary heart disease. In addition to conventional risk factors, dyslipidemia may be associated with this increased risk. Methods: We measured concentration of lipids in patients with moderate to severe periodontitis before and 3, 6 and 12 months after local periodontal treatment. A total of 50 participants with periodontitis and 25 participants without periodontitis were included in the analyses. Lipoproteins were measured by using serological analyses of the Central Biochemical Laboratory in Clinical Center in Nis. Periodontal health indicators included the plaque index, gingival bleeding index, and periodontal disease status (defined by pocket depth and attachment loss). Patients were non-surgically treated with mechanical debridement of calculus once a week for 1 month. Results: The results show a significant relation between indicators of poor periodontal status and serum level lipoproteins. Periodontal therapy resulted in a significant reduction of local inflammation and tissue destruction as reflected in reduced pocket depth and reduced bleeding indices. The levels of lipoproteins after therapy seemed to be lower than those reported before treatment in patients with periodontitis compared with healthy ones. Lipoproteins were significantly decreased after treatment (P < 0.005) except high-density lipoprotein cholesterol which was not significantly reduced (P > 0.05). Conclusion: This pilot study shows that periodontal disease significantly affects the serum levels of lipoproteins and suggests that following successful periodontal treatment decreases serum lipid concentration. This study suggests also that lipoproteins are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.

Association between Periodontopathogens and CRP Levels in Patients with Periodontitis in Serbia

Background and aims Recent epidemiological studies have shown that individuals with periodontitis have a significantly higher risk of developing coronary heart disease, which might be attributed to the complex microbiota in the dental plaque. Periodontopathogens have been reported as risk factors for cardiovascular disease. This study evaluated association of chronic periodontitis and periodontopathogens with CRP in systemically healthy Serbian adults. Materials and methods Serum C-reactive protein levels were measured in 24 patients with moderate periodontitis, 26 patients with severe periodontitis, and 25 periodontally healthy subjects. Periodontal health indicators included gingival bleeding on probing and periodontal disease status. Patients with moderate periodontitis had low attachment loss and pocket depths of <4 mm. Patients with severe periodontitis had high AL and pocket depth of >5 mm. The control group with healthy gingiva had gingival sulcus of <2 mm and no attachment loss. Presence of periodontopathogens in subgingival plaque samples was analyzed by polymerase chain reaction. Results The periodontal parameters and CRP levels were significantly higher in the patients with periodontitis. Patients who had both severe and moderate periodontitis had higher mean CRP levels. The percentage of subjects with elevated CRP leves of >5 mol/L was greater in the higher clinical AL group compared to the group with less attachment loss. Presence of periodontopathogens was also associated with elevated CRP levels and poor periodontal status. Conclusion PD and subgingival periodontopathogens are associated with increased CRP levels. These findings suggest that periodontal infection may contribute to systemic inflammatory burden in otherwise healthy individuals.

Effect of Periodontal Treatment in Renal Transplant Recipients

Objective: To evaluate the effect of periodontal treatment on gingival overgrowth in a group of renal transplant patients. Subjects and Methods: Twenty-five renal transplant recipients receiving immunosuppressive therapy with cyclosporine A (CsA) were randomly assigned to 2 groups. Group 1 (n = 15) included patients who had been specifically referred to a dental clinic to prevent gingival overgrowth and were given full periodontal therapy. Group 2 (n = 10) was comprised of patients who did not receive any professional periodontal cleaning. Patients from both groups were examined to determine their periodontal status before and after 3, 6 and 12 months in terms of their plaque index, gingival index and gingival overgrowth. During the examination, their overall health was stable. Results: For group 1, the scores were 1.89 (baseline), 0.98 (6 months) and 0.56 (12 months), and hence there were significant reductions (p = 0.0001). The gingival indices were 1.71 (baseline), 0.76 (6 months) and 0.35 (12 months), and the reductions were also significant (p = 0.0001). A significant association was observed between poor oral hygiene and the degree of gingival overgrowth. The 1-year post-treatment follow-up showed that patients in group 1 did not develop gingival overgrowth due to the use of CsA as group 2 did without prior periodontal therapy. Conclusion: Oral hygiene status was the most important variable related to the development and degree of gingival overgrowth due to the use of CsA.

Histological changes of gingival epithelium in smokers and non-smokers

BackgroundSmoking patients show a reduction of inflammatory clinical signs that might be associated with local vasoconstriction and an increased gingival epithelial thickness. The purpose of this work was to evaluate the S-thickness of the marginal gingival oral epithelium in smokers and non-smokers.MethodsTwelve biopsies were obtained from three different groups. Group I: non-smokers with gingivitis, group II smokers, and group III health persons without any periodontal disease. These biopsies were histologically processed, serially sectioned at 5 µm, and underwent evaluation of the major epithelial thickness, the epithelial base thickness, and the external and internal epithelial perimeters. Differences between the groups were analyzed using ANOVA test. The criteria for statistical significance were at the probablity level p < 0.05.ResultsA greater epithelial thickness was observed in smokers.ConclusionThe increased epithelium thickness can contribute to the reduction of inflammatory clinical signs in the gingival tissue.

Biomaterials in Dentistry—Implantology and Guided Bone Regeneration

The use of biomaterials and implant therapy in dentistry is becoming a more popular and acceptable procedure for the replacement of both single and multiple teeth. Procedures have evolved for maintaining and regenerating bone to provide an optimal environment for subsequent implant placement. Both guided bone regeneration and implantology have applications in dentistry for increasing the width and height of the alveolar ridge in areas with insufficient alveolar bone in jaws, as well as repairing and maintaining bone defects around the teeth. The application of these techniques involves the use of a wide range of materials, including autogenous bone grafts, allografts, xenografts, alloplasts, bone-promoting factors, resorbable/nonresorbable barrier membranes, and implants used either alone or in a variety of combinations. The methods of guided bone regeneration utilize biological materials or synthetic specimens. Furthermore, insight into the future development of membrane fabrication, as well as platelet-rich fibrin membranes, will strongly influence the development of guided bone regeneration. This article describes a series of six patients treated with guided bone regeneration using bovine bone mineral, a resorbable collagen membrane, a growth factor, platelet-rich plasma, and an implant placed with a minimum follow-up period of eighteen months.

The width of the attached gingiva and its variability in people with healthy periodontal status

Uvod: Gingiva je deo sluzokože koja pokriva avleolarne grebene vilica i okružuje vratove zuba. Anatomske karakteristike gingive su veoma važne u planiranju lečenja oboljenja parodonta. Pripojna gingiva je važna za održavanje parodonta u zdravom stanju. Ovom studijom merene su normalne vrednosti širine pripojne gingive kod parodontalno zdravih osoba. Cilj rada bio je procena širinepripojne gingive različitim metodama. Materijal i metode: Širina pripojne gingive merena je korišćenjem parodontalne sonde kod parodontalno zdravih osoba. U zavisnosti od starosti pacijenata, formirane su četiri grupe (I ≤ 14 god; II 15-30 god; III 31-45 god i IV 46-60 god.). Deskriptivna statistička analiza urađena je za određivanje srednjih vrednosti pripojne gingive , koje će predstavljati normalne vrednosti širine pripojne gingive za osobe sa zdravim parodontom. Rezultati: Kod ispitanika starosti od 15-30 godina, nađena je najveća širina pripojne gingive, kao i kod osoba ženskog pola u odnosu na mušku grupu ispitanika. Srednje vrednosti širine pripojne gingive varirale su u zavisnosti od područja usne duplje: najveća širina pripojne gingive zabeležena je u predelu gornjih centralnih sekutića, dok je najmanja širina zabeležena u predelu prvih molara gornje i donje vilice. Zaključak: Širina pripojne gingive varira u odnosu na starost i pol osobe, kao i od mesta u usnoj duplji.

GINGIVAL INFLAMMATION AS A SIGN OF DIABETIC SYSTEMIC CHRONIC COMPLICATIONS

Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder and the high level of blood glucose has profound effects on various systems of the human body. DM increases the risk of periodontal disease and the severe periodontal disease often coexists in diabetic patients with poor glycemic control. The aim of the study was to analyse periodontal health in patients with diabetes mellitus type 2 related to diabetic complications and glycohemoglobin A1c values. Methodology: One hundred patients with periodontitis and type 2 DM participated in the study. According to the glycohemoglobin A1c value they were divided in 4 groups: group 1 (4%-6% normal), group 2 (6.1%-7% good), group 3 (7.1%-8% moderately poor), group 4 (> 8% poor metabolic control). The presence of chronic systemic microvascular diabetic complications (retinopathy, nephropathy and neuropathy) was recorded and periodontal assessments (Plaque, Gingival, Calculus and Periodontal Disease Index) performed. The results were statistically analysed using MS Office Excel, program SPSS, 15.0 version. Results: Gingival index values depended on the level of HbA1c values and higher values of the Gingival and Periodontal Disease Index were noticed as the value of glycohemoglobin A1c was rising (p<0,001). Gingival index values were higher in diabetics with diabetic chronic microvascular complications (p<0.001). Conclusion: It is observed that pronounced gingival inflammation in diabetics is associated with systemic diabetic complications and poor glycemic control.