Background and Objectives: There is evidence that melatonin could improve the periodontal status and also glycemic control of patients with diabetes mellitus. Therefore, the aim of this study was to assess the effects of scaling and root planing plus adjunctive systemic treatment with melatonin on periodontal parameters and glycemic control in patients with type 2 diabetes and chronic periodontitis. Materials and Methods: The study was conducted on 54 subjects with periodontitis and diabetes mellitus randomly assigned to the study group (n = 27, subjects with scaling and root planing + melatonin) or control group (n = 27, subjects with scaling and root planing + placebo). Periodontal parameters (probing depth—PD; clinical attachment loss—CAL; bleeding on probing—BOP; and hygiene level) and glycated hemoglobin (HbA1c) were assessed at baseline and 8 weeks after. Results: At baseline, there were no significant differences between groups, but at the second evaluation 8 weeks later the association of melatonin with the non-surgical periodontal therapy exerted statistically significant improvements, both in periodontal parameters, with a significant decrease in periodontal disease severity, and glycated hemoglobin when compared to the control subjects. Conclusions: In our study, combined non-surgical periodontal treatment and systemic treatment with melatonin provided additional improvements to severe periodontal condition and the glycemic control of patients with diabetes type 2 when compared to non-surgical periodontal treatment alone.
Guided tissue regeneration (GTR) and guided bone regeneration (GBR) became common procedures in the corrective phase of periodontal treatment. In order to obtain good quality tissue neo-formation, most techniques require the use of a membrane that will act as a barrier, having as a main purpose the blocking of cell invasion from the gingival epithelium and connective tissue into the newly formed bone structure. Different techniques and materials have been developed, aiming to obtain the perfect barrier membrane. The membranes can be divided according to the biodegradability of the base material into absorbable membranes and non-absorbable membranes. The use of absorbable membranes is extremely widespread due to their advantages, but in clinical situations of significant tissue loss, the use of non-absorbable membranes is often still preferred. This descriptive review presents a synthesis of the types of barrier membranes available and their characteristics, as well as future trends in the development of barrier membranes along with some allergological aspects of membrane use.
Fixed prosthodontic dental restorations can potentially affect the periodontal tissues and vice versa, the periodontium can influence the longevity and esthetic appearance of dental restorations. We proposed an investigation on total bacterial load, specific periodontal pathogens, and periodontal clinical parameters in patients with dental fixed prosthesis and different degrees of periodontal tissue loss that followed photoactivation therapy (PDT) adjunctive to scaling and root planing. The study was conducted on 160 subjects, which were randomly assigned to scaling and root planing (SRP) alone (52 subjects, 256 sites), SRP and chlorhexidine rinsing (58 subjects, 276 sites), and SRP plus PDT (50 subjects, 318 sites). Periodontal parameters (plaque index, bleeding on probing, probing depth, and clinical attachment loss), followed by total bacterial load and specific periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola) were examined in each patient at baseline, one and six months after. PDT exerted significant improvements both in clinical and microbiological load after one month, and these results were maintained 6 months after when compared to chlorhexidine rinsing or SRP alone, especially in severe periodontitis cases. Photoactivation therapy as an adjunctive periodontal therapeutic method was efficient in offering supplementary periodontal improvements in the clinical and microbiological parameters of patients with fixed dental prosthesis, particularly in severe periodontitis cases.
The purpose of this study was to detect bacterial periodontal DNA from subgingival dental plaque and serum in patients affected by rheumatoid arthritis and periodontitis. The study group included 19 patients with periodontitis and refractory rheumatoid arthritis. The patients were clinically examined and diagnosed and the bacterial DNA was detected in the subgingival bacterial plate and serum by PCR. Severe chronic periodontitis was the most commonly diagnosed (42.2%). The DNA of periodontopathogenic bacteria was detected 100% in subgingival plate samples, and in serum samples it was identified in 84.2% of cases. The most commonly found species in subgingival plate samples were P. intermedia (100%), T. denticola (84.2%) and P. gingivalis (78.9%). In serum samples, the most frequently detected species were P. intermedia (89.4% and 73.6% respectively) and P. gingivalis (57.8% and 42.1%, respectively). A. actinomycetemcomitans and P. gingivalis did not show statistically significant differences between samples. This finding suggests that it could be an association because the same bacteria species detected in the serum were present in bacterial plaque samples. Patients with rheumatoid arthritis contain levels of oral pathogens in the serum and subgingival plaque that are common to red complex organisms, namely Porphyromonas gingivalis, Tannerella forsythia and Prevotella intermedia.
The present study aimed to determine the frequency of herpesviruses in gingival fluid samples in patients with periodontitis HIV compared to HIV-negative subjects. Gingival crevicular fluid samples were obtained from 28 patients with HIV-positive periodontitis and from 14 patients with HIV seronegative periodontitis. Herpesviruses have been identified by PCR amplification methods. In HIV-positive patients, the most prevalent herpes virus was HCMV, followed by HHV-6 and HHV-7. In non-HIV-related periodontitis, HCMV was identified in 11 samples and EBV-1 in 8 samples, followed by HSV (7 samples). HIV seropositive samples showed an average of 4.0 herpesviruses and HIV-seronegative individuals averaging 1.4 herpesviruses. EBV-2 and HHV-8 were detected exclusively in subgingival samples from HIV-positive patients. HIV-induced activation of herpes viruses may be a stimulating factor for rapid periodontal destruction. Patients with severe immunosuppression may experience herpesvirus-mediated gingival necrosis. The hypothesis that HIV periodontitis is the result of a combined infection of herpesviruses and bacterial pathogens should be studied further.
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