Results of this study favour combination therapy using CHX chip as an adjunct to SRP due to greater improvements in BI and PPD compared to those obtained by SRP alone in the treatment of chronic periodontitis.
Introduction.Epulis is a change in gingival tissue that occurs under the influence of chronic irritation. Histologically, there are several different types of epulis. Fibrous epulis is benign tumor of gingiva that most often occurs in interdental papilla area as a result of local irritation (inadequate restorative fillings, carious teeth, subgingival deposits or the combination of them). The aim of this paper is to present a clinical case of fibrous epulis. Case report.A 25-year-old girl reported to the Specialist Center for Dentistry in Foca. Clinical examination revealed a gingival tissue enlargement in the area of the upper jaw central incisors with speech and chewing function disturbances. Intraoral examination revealed a change above the level of gingiva, reddish-pink in color with smooth surface texture and soft consistency. The size of the change was 1 x 1.5 cm. It was connected to the interdental gingiva between teeth 12 and 21 by a narrower base. Clinically, a significant amount of soft and hard dental deposits surrounded the remaining teeth. Remaining gingiva was swollen, red, bleeding on provocation. The anamnesis did not confirm the presence of other acute and chronic diseases. The patient was not pregnant. She was informed about clinical condition assessment, as well as possible therapeutic procedures. Our patient was treated with non-surgical periodontal therapy and surgical excision of the enlargement. After histopathological examination of the removed tissue, the diagnosis was made: "Fibrous epulis cum ulceration". Conclusion.Clinical examination is insufficient for definite diagnosis. Therefore, a histopathological examination of the tissue is mandatory for fibrous epulis definite diagnosis. Treatment of choice is surgical excision of the enlargement and removal of predisposing factors to avoid recurrence.
Although a strong relationship between periodontal disease (PD) and atherosclerosis was shown in adults, little data are published in younger PD patients. Therefore, this study aimed to investigate and correlate clinical parameters of PD, pro- and immunoregulatory cytokines in gingival crevicular fluid (GCF) and serum, biochemical and hematological parameters associated with atherosclerosis risk, and carotid intima-media thickness (IMT) in our younger study participants (n = 78) (mean age 35.92 ± 3.36 years) who were divided into two equal groups: subjects with and without PD. PD patients had higher values of IMT, hs-CRP, triglycerides, total cholesterol, and LDL; most proinflammatory and Th1/Th17-associated cytokines in GCF; and IL-8, IL-12, IL-18, and IL-17A in serum compared to subjects without PD. These cytokines in GCF positively correlated with most clinical periodontal parameters. Clinical periodontal parameters, TNF-α and IL-8 in GCF and IL-17A, hs-CRP, and LDL in serum, had more significant predictive roles in developing subclinical atherosclerosis (IMT ≥ 0.75 mm) in comparison with other cytokines, fibrinogen, and other lipid status parameters. Hs-CRP correlated better with the proinflammatory cytokines than the parameters of lipid status. Except for serum IL-17A, there was no significant association of clinical and immunological PD parameters with lipid status. Overall, these results suggest that dyslipidemia and PD status seem to be independent risk factors for subclinical atherosclerosis in our younger PD population.
Introduction. Decreased salivary flow is frequently associated with numerous diseases such as diabetes mellitus and may lead to numerous oral diseases. The aim of this study was to compare salivary flow rate and oral health status in type 2 diabetics and healthy controls. Material and methods. The study involved 90 patients, divided into the three groups: 30 with well controlled (HbA1c<9%), 30 will poorly controlled (HbA1c?9%) diabetes and 30 healthy subjects. The following clinical parameters were determined: decayed, missing and filled teeth (DMFT); plaque index (PI), sulcus bleeding index (SBI), probing pocket depth (PPD) and clinical attachment level (CAL). Culture of Candida spp. specimens were obtained from tongue dorsum and inoculated into Sabouraud Dextrose Agar. Saliva was collected using ?a spit technique?. Results. Highest mean of unstimulated salivary flow was in healthy subjects; however significant difference between groups was not observed. Stimulated salivary flow results indicate significant reduction in diabetics as well as significant relation between metabolic control and salivary flow. Unstimulated and stimulated salivary flows were negatively and significantly correlated with periodontal parameters and DMFT. Conclusion. The present findings indicate that decreased salivary flow rate could have a significant impact on oral health status in type 2 diabetics.
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