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PubMedDate not supplied

Periodontal diseases and diabetes.

Inflammatory periodontal diseases are common in the United States. The incidence of gingivitis and periodontitis appears to be the same for persons with controlled diabetes as for those in the nondiabetic population. For patients with uncontrolled diabetes, however, periodontal diseases progress more rapidly than in their controlled counterparts. In addition, once a person with diabetes has periodontitis, the disease is usually more aggressive than in nondiabetic controls. These differences may be due to microangiopathy, altered polymorphonuclear leukocyte chemotaxis, increased dental plaque formation, or other causes. Patients with diabetes should be counseled to have a periodontal screening, which must include the use of a probe to measure the depth of the periodontal pockets. When problems are found, they should be treated and the patient should be placed in maintenance therapy.

Diabetes Complications↗
PubMed1991

[Insulin-dependent diabetes and periodontal disease in young patients].

Periodontal disease is one of the well-documented complications of diabetes mellitus in adulthood. The effects of diabetes mellitus on periodontal tissues in children and teenagers have been studied only in more recent years. Although clinical studies have demonstrated a few cases of severe periodontal disease in patients with "historical" diabetes mellitus, in the overwhelming majority of cases periodontal lesions seem comparable in young subjects with and without diabetes mellitus. However, reports on this topic published both in France and in the United States fail to give a clear picture of the existence, prevalence and severity of peridontal disease in youngsters with diabetes mellitus. Consequently, an epidemiologic study was undertaken at the Herold Hospital (Paris) and at the Association of Young Diabetics. Eighty-five young patients with diabetes mellitus and 38 controls were included. The purpose of the study was to determine whether periodontal disease is only a former or still a current complication of diabetes mellitus.

Adolescent↗
PubMed1990

Classification of periodontal diseases.

The classification of periodontal diseases used and taught in the Department of Periodontology at The University of Sarajevo, Yugoslavia is presented and explained. The classification is the result of nearly 20 years' work. It is based on the inflammatory process and a combination of topography, morphology, pathology and aetiology of periodontal diseases.

Adolescent↗
PubMed2006

The diagnosis of periodontal disease in private practice.

BACKGROUND: Periodontal disease is an inflammatory reaction to the bacteria in dental plaque. The present study compared the prevalence of periodontal disease in patients using as a diagnostic either probing depth measurements, an inflammatory marker such as numbers of white blood cells in plaque samples, or microbiological markers such as the microscopic count and the benzoyl-DL-arginine naphthylamide (BANA) test. METHODS: Teeth with the most inflammation and/or deepest pockets in each quadrant were probed and subgingival plaque was sampled from 1,043 consecutive new patients enrolled in a private practice. Multivariate "diagnostic" models were developed based upon the probing depth (general linear models), percentage of white blood cell-positive and percentage of BANA-positive plaques (logistic regression models) to determine the prevalence of patients with periodontal disease. RESULTS: Plaque samples were removed from 3,694 sites. Fifty-two percent of sampled pockets were >4 mm; 49% of sites were inflamed, using the presence of white blood cells, and 28% were infected using the BANA test. Diagnostic models were highly significant at P<0.0001. The white blood cell model was the most parsimonious as demonstrated by the lowest Akaike information criteria statistic and had the highest receiver operator characteristic (ROC) curve relative to the probing depth and BANA models. CONCLUSIONS: Periodontal disease can be diagnosed chairside by the presence of white blood cells in plaque samples, a finding that reflects the inflammatory nature of the disease process. This approach would reduce the misclassification of subjects as having periodontal disease (130 patients in the present study who had pockets) but minimal evidence of an inflammatory response.

Benzoylarginine-2-Naphthylamide↗
PubMed2004

Team care for periodontal disease: a model for patient rights.

Periodontal diseases are a chronic, widespread disease problem. Treating periodontal diseases requires a team care approach. It also requires thorough examination, diagnosis, and treatment planning followed by disease-control therapy, periodontal-maintenance therapy, adjunctive therapy as needed, and referral to the periodontist if control of the disease is not established in the general dental practice. Only with collaboration and communication can a highly effective level of disease control be achieved. This disease control has a significant impact on the maintenance of the dentition and potentially on systemic health. This paper reports on a treatment model for diabetes adapted to the treatment of periodontal diseases. This model, which incorporates elements of the AAP's Rights and Responsibilities of Patients, provides a framework and foundation for improving the well being of patients with periodontal diseases.

Dental Care for Chronically Ill↗
PubMed1994

Current concepts in periodontal disease testing.

Tests for periodontal disease fall into four categories. The test may identify putative periodontopathic plaque bacteria, the susceptible host, metabolic changes associated with inflammation, tissue damage or death or anatomic changes including periodontal probing and radiographs. The current understanding of tests for periodontal disease is reviewed within a framework for understanding the rationale for such tests.

DNA Probes↗
PubMed2004

Periodontal diseases as bacterial infection.

The periodontal disease is conformed by a group of illnesses affecting the gums and dental support structures. They are caused by certain bacteria found in the bacterial plaque. These bacteria are essential to the onset of illness; however, there are predisposing factors in both the host and the microorganisms that will have an effect on the pathogenesis of the illness. Periodontopathogenic bacterial microbiota is needed, but by itself, it is not enough to cause the illness, requiring the presence of a susceptible host. These diseases have been classified as gingivitis, when limited to the gums, and periodontitis, when they spread to deeper tissues. Classification of periodontal disease has varied over the years. The one used in this work was approved at the International Workshop for a Classification of Periodontal Diseases and Conditions, held in 1999. This study is an overview of the different periodontal disease syndromes. Later, the systematic use of antibiotic treatment consisting of amoxicillin, amoxicillin-clavulanic acid, and metronidazole as first line coadjuvant treatment of these illnesses will be reviewed.

Anti-Bacterial Agents↗
PubMed1991

Periodontal disease and the family physician.

Periodontal disease can be divided into two categories: gingivitis (inflammation of the soft tissue) and periodontitis (destruction of the alveolar bone). Swelling, erythema, bleeding and gingival recession are common signs of gingivitis. However, most patients with gingivitis are asymptomatic. When patients complain of tooth pain and mobility, they already have severe periodontal disease. Dental loss secondary to periodontal disease may result in inadequate mastication, impaired phonetics and loss of self-esteem. Patients should be counseled that good oral hygiene and regular dental examinations can prevent periodontal disease.

Family Practice↗
PubMed1989

Periodontal condition and microbiology of healthy and diseased periodontal pockets in type 1 diabetes mellitus patients.

On the basis of glycosylated hemoglobin (HbA1c) values, 22 type 1 (insulin-dependent) diabetic adults were grouped into patients with near normal (HbA1c less than or equal to 7.7%) and poor (HbA1c greater than or equal to 9.9%) metabolic control. A total of 44 subgingival sites were examined for Actinobacillus actinomycetemcomitans, black-pigmented Bacteroides species and Capnocytophaga species. No significant difference could be demonstrated between patients in the 2 test groups with regard to periodontal condition. Neither age of diabetic patients nor duration of diabetes mellitus influenced the periodontal parameters. In both test groups, pocket depth of 4 mm or more (greater than or equal to 4 mm) was found to be significantly associated with increased swelling, bleeding after probing and amount of marginal plaque. Proportionally high %s of cultivable A. actinomycetemcomitans (mean 4.3%; range 2.8-5.8%), Bacteroides gingivalis (33.2% and 34.6%) and Bacteroides intermedius (mean 4.2%; range 0.001-13.5%) were isolated from diseased periodontal pockets. In diabetic patients with poor metabolic control, B. intermedius was isolated from diseased periodontal pockets with a mean % of 7.2%, range 0.3-12.5%. Independent of the degree of metabolic control, low %s of Capnocytophaga species were isolated from diseased and healthy periodontal pockets, mean 0.9% (range 0.003-3.9%) and mean 1.4% (range 0.04-4.9%), respectively. It was concluded from this study that metabolic control seems to have no direct effect on the periodontium. Furthermore, the rôle of Capnocytophaga species in the pathogenesis of infectious periodontal disease in type 1 diabetic patients seems to be overestimated.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinobacillus↗
PubMed1986

Topical antimicrobial therapy and diagnosis of subgingival bacteria in the management of inflammatory periodontal disease.

Bacterial specificity in human periodontal diseases suggests the possibility of diagnosing and treating periodontitis as specific infections and using microbiological diagnostic means to evaluate the efficacy of periodontal therapy. In a series of clinical trials, the usefulness of topical antimicrobial agents in combination with surgical and non-surgical conventional periodontal therapy were tested. The healing result was estimated by monitoring probing attachment levels (PAL). The usefulness of clinical and microbiological parameters to evaluate post-treatment healing result was tested. 9 of the patients exhibiting sites with recurrent periodontal disease were then evaluated for clinical and microbiological parameters to define accurate means to differentiate between active and inactive periodontal disease. The results showed that the frequency of periodontal lesions with significant loss of PAL after treatment was less in patients treated with antimicrobial agent. Specific microbiological parameters showed stronger correlation than clinical parameters with gain and/or loss of PAL post-treatment. Thus Actinobacillus actinomycetemcomitans and Bacteroides gingivalis occurred in periodontal lesions with progressing disease after treatment, but were rarely detected in samples from pockets of the same depths which did not exhibit further loss of PAL over a study period of 1 year. This study points to the usefulness of topical antimicrobial agent as an adjunct to mechanical subgingival debridement in the treatment of periodontitis in adults. The results also indicate the utility of diagnostic microbiology in the assessment of periodontal disease activity post-treatment.

Acetrizoic Acid↗
PubMed2003

Patterns of chemokines and chemokine receptors expression in different forms of human periodontal disease.

Current knowledge states that periodontal diseases are chronic inflammatory reactions raised in response to periodontopathogens. Many cell types and mediators, including Th1 and Th2 lymphocytes, cytokines and chemokines, appear to be involved in the immunopathogenesis of periodontal diseases. Chemokines, a family of chemotactic cytokines, bind to specific receptors and selectively attract different cell subsets to the inflammatory site. They can also interact with classical cytokines and modulate the local immune response. In order to study the role of chemokines in periodontal diseases, we examined the expression of chemokines, chemokine receptors and cytokines by means of reverse transcription-polymerase chain reaction (RT-PCR) techniques. Characteristic patterns of such factors' expression were found in gingival biopsies from patients presenting with aggressive periodontitis and chronic periodontitis. The expression of the chemokines macrophage inflammatory protein-1 alpha (MIP-1alpha) and interferon-gamma inducible protein 10 (IP-10) and of their respective receptors, CCR5 and CXCR3, were more prevalent and higher in aggressive periodontitis, and associated with higher interferon-gamma (IFN-gamma) expression and lower interleukin-10 (IL-10) expression. In contrast, chronic periodontitis patients exhibited a more frequent and higher expression of monocyte chemoattractant protein-1 (MCP-1) and its receptor CCR4, and higher expression of IL-10. It is possible that chemokines, in addition to the classical cytokines, are involved in the immunopathogenesis of periodontal disease, driving the migration and the maintenance of several inflammatory cell types such as polymorphonuclear leukocytes, dendritic cells (DCs), natural killer cells, macrophages, and subsets of lymphocytes in the gingival tissues. These cells are thought to participate in the inflammatory and immune reaction that takes place in periodontal disease, killing pathogens, presenting antigens, and producing cytokines. The selective recruitment of polarized lymphocyte subsets could result in differential cytokine production at the site of response, which is supposed to determine the stable or progressive nature of the lesion. Besides, the role of chemokines as activators and chemoattracts of osteclasts may be involved in the determination of disease severity.

Adult↗
PubMed1990

Problems associated with the management of periodontal disease in clinical practice.

Periodontal disease is caused by poor oral hygiene. It is the most common cause of oral infection and tooth loss in dogs. Simple periodontal therapy such as repeated root planing at strategic intervals can prevent many serious problems. This chapter presents the origin, clinical presentation, and treatment of periodontal disease in a format that is directly applicable to clinical practice.

Age Factors↗
PubMed1979

The epidemiology of dental caries and periodontal disease.

Dental caries and periodontal disease are common in industrialized countries and caries is increasing in non-industrialized countries. The predominant method of coping with the disease problem has been to treat rather than prevent the diseases, an approach which has obviously failed to cope with the problem as shown by the results of the International Collaborative Study of Dental Manpower Systems (58). Epidemiological evidence suggests that a food policy directed at lowering the refined sugar consumption level to about 10 kg per person per year in conjunction with fluoride supplementation of the diet would virtually eliminate dental caries in industrialized countries. Health education to improve the effectiveness of toothbrushing will reduce the progression of periodontal disease to a rate compatible with keeping teeth for a life-time.

Adolescent↗
PubMed1999

Periodontitis in the house musk shrew (Suncus murinus): a potential animal model for human periodontal disease.

BACKGROUND: Our understanding of periodontal diseases has been facilitated greatly by the use of animal models. However, no animal model has been identified that truly reflects the disease seen in humans. Suncus murinus, a rat-sized laboratory house musk shrew, has received attention as a valuable animal model due to ease of handling. In the studies described here, periodontal conditions in Suncus murinus were evaluated to determine the usefulness of the shrew as an experimental model for understanding various aspects of periodontal diseases. METHODS: Periodontal tissues of 34 Suncus murinus (18 to 430 days old) were examined macroscopically, morphometrically, histologically, and ultrastructurally. RESULTS: Dentition pattern is I3/1, C1/1, P2/1, M3/3. Spontaneous gingival swelling with accumulation of plaque was observed in more than two-thirds of animals older than 200 days. Morphometric analysis of alveolar bone demonstrated a pattern of bone loss that correlated closely with animal age. Histologically, periodontal lesions varying from gingivitis to periodontitis, similar to those observed in humans, were noted. Marked infiltration of lymphocytes and plasma cells in the connective tissue was noted, usually not seen in periodontal lesions of rodents. Although osteoclastic alveolar bone resorption was noted, active bone resorption was not a frequent feature in specimens obtained from chronic inflammatory lesions. Ultrastructurally, degradation of collagen fibers in the inflamed area and ingestion of collagen fibrils by fibroblasts in the deeper connective tissue were often seen. CONCLUSIONS: These results indicate the potential utility of Suncus murinus as a model to study periodontal disease; e.g., chronic nature of the inflammatory periodontal lesions, similar to those in humans, as well as other advantages including size and ease of handling and housing of these animals.

Age Factors↗
PubMed1984

Chemotherapy and periodontal disease--a review.

Periodontal diseases are common, inflammatory infections of the mouth of microbiological etiology. Therapy traditionally focuses on professional tooth cleaning and debridement. Recent research has investigated the efficacy of antibiotic therapy, as well as the use of various other agents. Although protocols still are being developed, pharmacists can expect increasing use of these medications by dentists in the future.

Adult↗
PubMed1988

[Introduction of a method of promoting periodontal disease awareness].

In periodontal diseases, due to lack of subjective symptoms, disease awareness and professional consultations are often dismissed even by subjects with already established periodontal lesions. The purpose of this study was to gain data concerning the relationship between bleeding induced by interdental stimulating and some of the clinical indices used in routine periodontal examinations in order to consider if wooden interdental cleaners, which are available to patients themselves, could be used as a means of arousing disease awareness. Furthermore, the buccolingual insertion of interdental cleaners was confirmed together with reconsiderations on its role as a means of proximal plaque control. 180 interdental sites of 30 new out-patients suspected of gingivitis or periodontitis consisted the material. As comparative indices to interdental stimulating, Bleeding on Probing (BOP), Probing Depth (PD), Gingival Index (GI) and Gingival Crevicular Fluid (GCF) measurement were selected. The interdental cleaning efficiency was reconsidered by assessment of interproximal plaque removal. As a result, bleeding was induced both by interdental stimulating and probing in 106 of the 180 experimental sites and was the majority. In relation to PD, concerning pockets less than 1.5 mm, bleeding was not induced by interdental stimulating. 58.8% of 3 mm pockets and all of the pockets deeper than 5 mm bled on interdental stimulating. Concerning the relationship with the GI, no site evaluated GI. 0 bled on interdental stimulating. 12.9% of sites evaluates GI. 1, 73.3% of sites evaluated GI. 2, and all of the sites evaluated GI. 3 bled on interdental stimulating. 39.0% of sites with GCF measurement of 0-21, 51.9% of sites with GCF measurement of 21-40 and 96.8% of sites with GCF measurement of over 81 showed bleeding on interdental stimulating.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Devices, Home Care↗