Journal of Advanced Periodontology and Implant Dentistry
Volume:4 Issue: 1, May 2012

Considering the importance and prevalence of cardiovascular disease and periodontal disease, the aim of this study was to compare the amount of periodontal destruction in patients with coronary heart disease (CHD) and healthy controls, using panoramic radiography. Fifty-four individuals (27 patients with CHD and 27 patients without CHD) participated in this study; the subjects had undergone angiography procedures for the diagnosis of CHD during the previous year. After patient consent was obtained, panoramic radiographs were taken; then the amount of alveolar bone loss and number of missed teeth were evaluated. This study showed that the amount of average bone loss in patients with CHD and the average number of extracted teeth were significantly higher than those in healthy subjects (P< 0.001). The average amount of bone loss according to the number of involved vessels was 4.71 mm in patients with 1 involved vessel, 4.63 mm in patients with 2 involved vessels and 5.14 mm in patients with 3 involved vessels; however, these differences were not statistically significant (P=0.333).This study suggested an association between poor oral condition and CHD, and provided evidence that the improvement of periodontal condition might influence the systemic, inflammatory and haemostatic situation.

Previous data have demonstrated that berberine, a barberry plant alkaloid, possesses various therapeutic properties. This study histologically evaluated the clinical efficacy of a berberine-derived topical gel on periodontal inflammation in patients requiring surgery. This randomized clinical trial was performed on 14 patient (11 females, 3 males) presenting with moderate to severe periodontitis (pocket depth >4 mm). Plaque indices (PI) and gingival indices (GI) were recorded at baseline and scaling and root planing were carried out. One week later, PI and GI values were recorded again in patients treated on respective sides of the jaw with either berberine gel or a placebo gel control at night for two weeks. PI and GI were again measured prior to periodontal surgery (three weeks after the initial visit). Specimens collected from both sides of the jaw were evaluated histologically and PI and GI scores compared for statistical differences. GI and PI scores were significantly different between baseline and follow-up examinations but no significant differences were observed between the groups. No differences in the nature of the inflammatory cell types, degree of angiogenesis, integrity of collagen fibers and the levels of edema were observed between the groups; however, barberry gel-treated tissues presented with reduced levels of inflammatory cell infiltrates compared to placebo controls. Tissues treated with barberry gel extract had reduced numbers of inflammatory cells at the time of surgery. However, the GI and PI scores were not significantly different between the groups.

Different clinical studies have reported high survival rates in immediate implant placement in extraction sockets with periapical lesions. The aim of this study was to investigate the effect of Er:YAG laser irradiation on success rate of immediate implant placement in tooth extraction sockets with chronic periapical lesions. Thirty patients requiring a single-root tooth extraction with chronic periapical lesions were included in this prospective, randomized, clinical trial and divided into control (n=15) and test (n=15) groups. After tooth extraction, the implant were placed with guided bone regeneration in the control group after periapical curettage and socket irrigation and in the test group, irrigation of the periapical region was accompanied with Er:YAG laser for 1 min at 100 mJ, 10 Hz, 12.73 J/cm2. Radiographic (using standard long-cone parallel) and clinical parameters (plaque index [PI], modified bleeding index [mBI], probing depth [PD], keratinized mucosa [KM], Periotest values [PTV]) were assessed at baseline and 1, 3 and 6 months after implant placement. Data was analyzed with t-test and chi-squared test. The level of significance was set at 5%.A survival rate of 100% was observed for all the implants placed at the sixth-month follow-up, with no significant differences between clinical and radiographic parameters of the control and test groups at different time intervals (P>0.05). At 6-month follow-up, there were no complications in soft and hard tissue healing processes after immediate placement of implants into fresh extraction sockets with chronic periapical lesions, regardless of Er:YAG laser irradiation.

Recent reports suggest that some of the risk factors for periodontal disease are similar to those of certain systemic diseases, and that periodontal disease itself may be a risk factor for some systemic diseases. Therefore, the present study investigated the association of markers of metabolic control and systemic inflammation in diabetics with the extent and severity of periodontal disease; in addition, the relative cardiovascular risk was evaluated in such patients. A total of 50 known diabetic subjects participated in the study. Periodontal examination included a full-mouth assessment for bleeding on probing using sulcus bleeding index (SBI) and probing depths (PD). Blood analyses were carried out for glycosylated hemoglobin, (HbA1c), C-reactive protein (CRP) and lipid profile. Periodontal disease severity, in terms of SBI scores and PD, was found to be associated with inadequate glycemic control as measured by HbA1c. Similarly, increased probing depths were associated with increased CRP levels, total cholesterol, low-density lipoproteins, and triglycerides (P< 0.05). The results suggest that patients with poorer glycemic control are at increased risk for periodontitis with an associated risk for cardiovascular disease.

The aim of this study was to evaluate the effect of right/left handedness on the ability of patients to remove dental plaque in various quadrants of the mouth. This double-blind cross-sectional study was conducted in two phases with a two-week time interval, on 40 subjects. During the two visits, the subjects were requested to brush their teeth for 3 minutes with a soft toothbrush without a dentifrice using the Bass technique. Pre- and post-brushing plaque indexes (PI) were measured for all the dental surfaces in various quadrants of the mouth. Following plaque removal at the end of the first phase, RH subjects had higher average of PI in upper left quadrants compared to upper right quadrants (P=0.044), whereas lower right quadrants had higher average of PI compared to lower left quadrants (P=0.387). This study indicates that LH subjects have better ability to access the right quadrants of the mouth to perform oral hygiene procedures, whereas RH subjects are more successful in plaque control of the left quadrants.