Radmila Obradovic

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.

Influence of low-level laser therapy on biomaterial osseointegration: a mini-review

The aim of this paper is to provide an overview of the available literature on low-level laser therapy (LLLT) and its influence on bone repair and the osseointegration of biomaterials. Extensive studies of alveolar bone repair, a common problem in periodontal therapy, have been conduced worldwide. The utility of LLLT in biomaterial osseointegration is still unanswered, due to lack of literature and poorly understood mechanisms. It is still difficult for one to compare studies about the action of LLLT on the osseointegration of biomaterials because the experimental models and duration of treatments are very distinct. However, it could be concluded that LLLT may offer advantages in terms of periodontal and bone functional recovery and biomaterial osseointegration.

Dentinal hypersensitivity following scaling and root planing: comparison of low-level laser and topical fluoride treatment

The aim of this study is to compare the effectiveness of low-level laser irradiation to traditional topical fluoride treatment for treatment choices of dentinal hypersensitivity following scaling and root planing. The experimental group (15 patients) was treated with low-energy-level diode laser at each site of dentinal hypersensitivity following scaling and root planning. The control group (15 patients) received topical fluoride treatment (protective varnish for desensitization). All the patients were treated at baseline visit, and then at day 2 and 4 after the initial treatment; the pain was subjectively assessed by the patients as strong, medium, medium low, low, or no pain. Total absence of the dental hypersensitivity was reported in 26.66% of the examined group even after the second visit, compared to the control group where complete resolution of the hypersensitivity was not present after the second visit in any of the treated cases. Complete absence of pain was achieved in 86.6% of patients treated with laser and only in 26.6% in the fluoride treated group, after the third visit. Based on our findings, we conclude that low-energy biostimulative laser treatment can be successfully used for treatment of dental hypersensitivity following scaling and root planing.

Low-level lasers as an adjunct in periodontal therapy in patients with diabetes mellitus.

BACKGROUND Diabetes mellitus (DM) increases the risk of periodontitis, and severe periodontitis often coexists with severe DM. The proposed dual pathway of tissue destruction suggests that control of chronic periodontal infection and gingival inflammation is essential for achieving long-term control of DM. The purpose this study is to evaluate the effects of low-level laser therapy (LLLT) by exfoliative cytology in patients with DM and gingival inflammation. SUBJECTS AND METHODS Three hundred patients were divided in three equal groups: Group 1 consisted of patients with periodontitis and type 1 DM, Group 2 of patients with periodontitis and type 2 DM, and Group 3 of patients with periodontitis (control group). After oral examination, smears were taken from gingival tissue, and afterward all of the patients received oral hygiene instructions, removal of dental plaque, and full-mouth scaling and root planing. A split-mouth design was applied; on the right side of jaws GaAlAs LLLT (670 nm, 5 mW, 14 min/day) (model Mils 94; Optica Laser, Sofia, Bulgaria) was applied for five consecutive days. After the therapy was completed, smears from both sides of jaws were taken. The morphometric analysis was done using the National Institutes of Health Image software program and a model NU2 microscope (Carl Zeiss, Jena, Germany). RESULTS Investigated parameters were significantly lower after therapy compared with values before therapy. After therapy on the side subjected to LLLT, there was no significantly difference between patients with DM and the control group. CONCLUSIONS It can be concluded that LLLT as an adjunct in periodontal therapy reduces gingival inflammation in patients with DM and periodontitis.

RP-HPLC assay of doxycycline in human saliva and gingival crevicular fluid in patients with chronic periodontal disease

A reversed-phased HPLC method with fluorescence detection was optimized and validated for determination of DOXY in human saliva and gingival crevicular fluid (GCF) with tetracycline as internal standard. Single step extraction with acetonitrile for both types of samples was performed. The separation was achieved at Zorbax Extend-C18 analytical column at 30°C. Mobile phase was consisted of an aqueous phase containing magnesium acetate, ammonium acetate, Na₂EDTA, triethyl-ammonium acetate buffered to pH 7.5 with ammonium hydroxide solution and acetonitrile. The volume ratio of the buffered water mixture of salts and acetonitrile was 86:14. Fluorescence detector was set at λex=380 nm and λem=520 nm. Under the optimized experimental conditions, good linearity was found in the range of 5.0-250.0 ng/mL for GCF with LOD of 1.63 ng/mL and LOQ of 4.93 ng/mL and 20.0-500.0 ng/mL for saliva with LOD of 6.36 ng/mL and LOQ of 19.28 ng/mL. This method was successfully applied for determination of DOXY in saliva and GCF obtained from patients with chronic periodontal disease.

Comparative Analysis of Smoking Influence on Periodontal Tissue in Subjects with Periodontal Disease

The aim of the study: The aim of the study was clinical and cytological examination of gingival changes in smokers and non-smokers. Further, specific goals of this study were health promotion in patient, particularly in smokers. Methods: The anamnesis was taken and clinical examination was conducted on the patients who came on Dental Clinic. During the clinical examination, plaque index (Pl)16, gingival index Löe-Silness (Gi) and the community periodontal index of treatment needs (CPITN)17 were done. After diagnosis was established, participants divided into group I –smokers, and group II – non-smokers. The gingival smears were taken for cytological analysis, dried on air, and stained by haematoxylin-eosin method. Results: The values of gingival index (GI)- Löe-Silness and periodontal index (CPITN) were higher in the group of smokers, but plaque index was also higher with statistically significant difference of their values between examined group, with maximum level of significance (p<0,001). The size of nucleus (area, Ferret’s diameter and perimeter) was higher in the group of smokers, but differences were not statistically significant. In the group of non-smokers density of nucleus was higher than in non-smokers group, but difference was not statistically significant. Conclusion: The values of examined indices showed higher values in smokers group. This finding could show that the level of oral hygiene is higher in the non smokers group. The size of nucleus (area, Ferret’s diameter and perimeter) was higher in the group of smokers, but differences were not statistically significant. Teamwork of many different speciality experts is required for better periodontal health of smokers.

False gingival enlargement as a diagnostic problem: a case report.

The aim of the case report was to describe gingival enlargement in a patient who came to the Department of Oral Medicine and Periodontology at Nis Dental Clinic. After anamnesis had been taken, and following clinical examination, laboratory blood analysis, radiological examination and pathological examination, it was established that gingival enlargement was a consequence of medicament injection. We are of the opinion that gingival enlargement was a consequence of sclerotic agent injection.

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.