Dimitrije Mirkovic

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.

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.

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.