Chie Fukaya

Effect of Initial Periodontal Therapy on Oral Health–Related Quality of Life in Patients With Periodontitis in Japan

BACKGROUND It is becoming increasingly important for periodontists and dental hygienists to take a biopsychosocial approach to care when considering periodontal interventions. However, information on how patients perceive periodontitis and its treatment is limited. The purpose of the present study is to gain insight into the patient perception of oral health and the impact that periodontitis and treatment have on self-assessed quality of life (QoL). METHODS This was a prospective, two-center, clinical study in Japan. Patients with periodontitis were assessed for their perceptions of oral health by using an instrument for oral health-related QoL (OHRQL) before and after initial periodontal therapy. RESULTS A total of 58 patients (mean age: 53.6 years; 23 male and 35 female) participated in the study and completed initial periodontal therapy. At baseline, 97% of the patients perceived that their oral health status impacted on their QoL in one or more ways. Pain, eating and chewing, and psychologic function were identified as compromised OHRQL domains. More than one-half of the patients rated their overall oral health as poor. Initial periodontal therapy, consisting mainly of oral hygiene instructions and scaling and root planing, significantly improved OHRQL scores (P = 0.0027). The effect size was calculated to be 0.51, indicating a moderate improvement. Compared with baseline, a significantly higher proportion of patients reported rarely or never having a problem regarding OHRQL domains such as pain (P = 0.0049) and eating and chewing (P = 0.0145) after treatment. No significant difference in the OHRQL improvement was found with respect to disease severity. CONCLUSIONS Periodontitis negatively affected QoL in this population of Japanese patients with periodontitis. Conventional non-surgical periodontal therapy has a potential to ameliorate patient perceptions of oral health.

Antibacterial activity of povidone-iodine against an artificial biofilm of Porphyromonas gingivalis and Fusobacterium nucleatum

OBJECTIVE To investigate the antibacterial activity of povidone-iodine (PVP-I) on an artificial dual species biofilm of periodontal pathogens. DESIGN Porphyromonas gingivalis or Fusobacterium nucleatum grown in broth culture was inoculated on polycarbonate membrane (PCM) tissue culture inserts. After incubation for 72 h, PVP-I solutions were applied to the biofilm for the time period ranging from 0.5 to 5 min. After addition of a deactivator, each PCM was removed and the biofilm on the PCM was serially diluted and plated on blood agar plates and cultured anaerobically for 7 days. Then viable bacteria were enumerated. RESULTS In the dual species biofilm model, F. nucleatum showed an approximately 200-fold increase in viable counts when compared with mono-microbial biofilm. In dual species biofilm, PVP-I with concentration equal to or greater than 2% was required to significantly reduce P. gingivalis and F. nucleatum. When the contact time of PVP-I was increased to 1 min or greater, no difference in antibacterial activity of PVP-I was observed in any concentration. CONCLUSION These results suggest that 30s application of 2% PVP-I would be effective in suppressing both P. gingivalis and F. nucleatum in dual-species biofilm, and this provides clinical implication for the control of subgingival biofilm.

Salivary pathogen and serum antibody to assess the progression of chronic periodontitis: a 24-mo prospective multicenter cohort study

BACKGROUND AND OBJECTIVE A diagnosis of periodontitis progression is presently limited to clinical parameters such as attachment loss and radiographic imaging. The aim of this multicenter study was to monitor disease progression in patients with chronic periodontitis during a 24-mo follow-up program and to evaluate the amount of bacteria in saliva and corresponding IgG titers in serum for determining the diagnostic usefulness of each in indicating disease progression and stability. MATERIAL AND METHODS A total of 163 patients with chronic periodontitis who received trimonthly follow-up care were observed for 24 mo. The clinical parameters and salivary content of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans were assessed using the modified Invader PLUS assay, and the corresponding serum IgG titers were measured using ELISA. The changes through 24 mo were analyzed using cut-off values calculated for each factor. One-way ANOVA or Fishers exact test was used to perform between-group comparison for the data collected. Diagnostic values were calculated using Fishers exact test. RESULTS Of the 124 individuals who completed the 24-mo monitoring phase, 62 exhibited periodontitis progression, whereas 62 demonstrated stable disease. Seven patients withdrew because of acute periodontal abscess. The ratio of P. gingivalis to total bacteria and the combination of P. gingivalis counts and IgG titers against P. gingivalis were significantly related to the progression of periodontitis. The combination of P. gingivalis ratio and P. gingivalis IgG titers was significantly associated with the progression of periodontitis (p = 0.001, sensitivity = 0.339, specificity = 0.790). CONCLUSIONS It is suggested that the combination of P. gingivalis ratio in saliva and serum IgG titers against P. gingivalis may be associated with the progression of periodontitis.

Improvement of hydrogelation abilities and handling of photocurable gelatin-based crosslinking materials.

Three types of eosin-derivatized gelatins (eosin-gelatins) with different molecular weights (M(w)) of ca. 15 kDa (low-molecular-weight eosin-gelatin, LEG), ca. 30 kDa (medium-molecular-weight eosin-gelatin, MEG), and ca. 95 kDa (high-molecular-weight eosin-gelatin, HEG) were prepared. All the eosin-gelatins except for HEG dissolved completely in water at 37 degrees C within several hours even at high concentrations of 35 or 40 wt % along with polyamine (poly(N,N-dimethylaminopropylacrylamide)) to produce photo-crosslinkable materials. The materials had appropriate viscosity for in situ molding at 37 degrees C and could be handled as a liquid at low temperatures of up to 25 degrees C. Upon photoirradiation for several tens of seconds, the materials were converted almost completely to hydrogels in the desired form with a microporous network structure by the radical coupling reaction. The mechanical strength of the produced hydrogels could be controlled by selecting a particular molecular weight or concentration of eosin-gelatins. The hydrogels obtained from LEG (40 wt %) or MEG (35 wt %) had elasticity similar to that of goat periodontal tissue. The handling of the photo-crosslinkable materials at room temperature and their photogelation ability were drastically improved by reducing the M(w) of eosin-gelatin. The potential usefulness of the photo-crosslinkable materials to periodontal regeneration has been discussed.

Assessing the progression of chronic periodontitis using subgingival pathogen levels: a 24-month prospective multicenter cohort study

BackgroundThe diagnosis of the progression of periodontitis presently depends on the use of clinical symptoms (such as attachment loss) and radiographic imaging. The aim of the multicenter study described here was to evaluate the diagnostic use of the bacterial content of subgingival plaque recovered from the deepest pockets in assessing disease progression in chronic periodontitis patients.MethodsThis study consisted of a 24-month investigation of a total of 163 patients with chronic periodontitis who received trimonthly follow-up care. Subgingival plaque from the deepest pockets was recovered and assessed for bacterial content of Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans using the modified Invader PLUS assay. The corresponding serum IgG titers were measured using ELISA. Changes in clinical parameters were evaluated over the course of 24 months. The sensitivity, specificity, and prediction values were calculated and used to determine cutoff points for prediction of the progression of chronic periodontitis.ResultsOf the 124 individuals who completed the 24-month monitoring phase, 62 exhibited progression of periodontitis, whereas 62 demonstrated stable disease. The P. gingivalis counts of subgingival plaque from the deepest pockets was significantly associated with the progression of periodontitis (p < 0.001, positive predictive value = 0.708).ConclusionsThe P. gingivalis counts of subgingival plaque from the deepest pockets may be associated with the progression of periodontitis.