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.

RANKL (receptor activator of nuclear factor kappa-β ligand) and OPG (osteoprotegerin) are two proteins involved in bone remodelling. During the active phase of periodontal disease, an imbalance between the ratios of the two elements can be noticed. While the expression of RANKL is elevated compared with that of OPG, the RANKL is available to bond with RANK (receptor activator of nuclear factor kappa-β). This study was conducted on 41 patients: 19 with generalized aggressive periodontitis, 18 with severe chronic periodontitis, and 4 periodontal healthy subjects. For each patient included, we determined the salivary levels of RANKL and OPG with the help of two Human ELISA kits. The results show that the patients affected by periodontitis, either aggressive or chronic, have significant higher values of RANKL and RANKL/OPG ratio. This values correlate with the local inflammation status.

Periodontal disease is an oral infectious and inflammatory disease caused by microorganisms that determine the host-mediated destruction of soft and hard periodontal tissues, which ultimately leads to tooth loss. Periodontitis affects a large part of the population, with various degrees of severity. Treatment consists of etiologic therapy: the removal of biofilm through mechanical debridement plus microbial elimination by supplementary measures. Antibiotic administration, either systemically or through local delivery, has been shown to improve clinical outcomes after mechanical periodontal treatment. Clindamycin is a lincosamide with a broad spectrum, being active against aerobic, anaerobic, and β-lactamase-producing bacteria. This antibiotic offers several advantages and some disadvantages and has been used in periodontal treatment both systemically and locally with various degrees of success. Among the properties that recommend it for periodontal treatment is the bacteriostatic effect, the inhibition of bacterial proteins synthesis, the enhancement of neutrophil chemotaxis, phagocytosis and the oxidative burst–oxidative stress storm. Furthermore, it is easily absorbed at the level of oral tissues in a considerable amount. This substantial tissue penetration, especially inside the bone, is synergistic with a stimulating effect on the host immune system. The aim of this review is to explore the applicability of this antibiotic agent and to evaluate its antimicrobial potential and limitations at the level of the oral biofilm associated with periodontal disease.

SummaryAim: The aim of the study was to evaluate the impact of oral health education and non-surgical periodontal therapy on the quality of life for a group of patients with type I diabetes mellitus, in Iasi, Romania.Materials and Method: The study was conducted on 21 patients with type 1 diabetes mellitus which also presented a form of periodontitis. We examined: the degree of glycaemic control (by measuring the glycated haemoglobin), the periodontal and oral hygiene parameters at the baseline and after 4 weeks, 6 months and 12 months after the periodontal treatment which consisted in scaling and root planing. The patients also filled an OHIP-14 questionnaire at baseline and 6 month after the periodontal therapy to assess the quality of life.Results and Discussion: We observed a rapid recurrence of the deep periodontal pockets after 12 months in subjects with poor glycaemic control. At baseline, the highest scores for the OHIP-14 were in the sub-domains of pain, discomfort on chewing and self-consciousness.Conclusions: The prolonged poor control of glycaemia is closely related with its complications. The periodontal therapy improved (lower values) the domain codes and final score of the OHIP-14 questionnaire, proving that periodontal health has an impact on the diabetic patients’ quality of life.

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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 study assessed whether the increased production of interleukin-1α (IL-1α) and interleukin-1β (IL-1β), as a result of chronic hepatic inflammation, could be the expression of the negative impact on periodontal disease. The study included chronic periodontitis patients who were systemically healthy, chronic periodontitis patients suffering from chronic hepatitis C, as well as control patients, being systemically and periodontally healthy. After periodontal examination and the assessment of certain periodontal parameters, gingival crevicular fluid was collected from all participating patients. By using the enzyme-linked immunosorbent assay method, a quantitative assessment of IL-1α and IL-1β levels was possible. The immunologic results were correlated to the clinical periodontal data. The gingival fluid levels of cytokines were higher for periodontitis patients with chronic hepatitis C than for the systemically healthy periodontitis patients (1.8-fold higher for IL-1α and 2.1-fold higher for IL-1β). In addition, the gingival fluid cytokine levels were significantly higher for the periodontal patients (with/without chronic hepatitis C) than for the control group. Positive correlations were found between gingival fluid IL-1α and IL-1β levels and certain clinical periodontal parameters or the age of the viral hepatitis C diagnosis, in periodontitis patients with chronic hepatitis C. The chronic hepatic inflammation may have an important additional negative impact on the periodontal status, as both inflammatory reactions seem to be promoted by common pro-inflammatory cytokines.

(1) Background: Metalloproteinase-8 (MMP-8) and metalloproteinase-9 (MMP-9) are members of a family of proteases of major importance during orthodontic tooth movement. Their levels increase during orthodontic therapy and in periodontally affected tissues. Orthodontic fixed appliances retain dental plaque and can cause gingival inflammation. When gingival inflammation is present, the forces produced during orthodontic tooth movement can aggravate tissue reaction and cause the destruction of supportive periodontal tissue. This study aimed to identify biomarkers that facilitate the assessment of periodontal status during orthodontic treatment. (2) Methods: Our study was conducted on 111 patients who were about to receive fixed orthodontic treatment. We determined the salivary levels of MMP-8 and MMP-9 and bleeding on probing (BOP) before applying the orthodontic fixed appliance (T1), one week after appliance placement (T2), and during orthodontic treatment, one month after non-surgical periodontal treatment (T3). (3) Results: Patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement (T2) and a decrease in these parameters one month after periodontal treatment (T3). Statistically significant correlations were found between MMP-8 levels and BOP values at T1, T2, and T3. (4) Conclusion: In our study patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement and a decrease in these parameters one month after periodontal treatment. Strong positive statistically significant correlations were found between MMP-8 levels and BOP and medium positive statistically significant correlations between MMP-9 and BOP values before and after orthodontic treatment and periodontal treatment. MMP-8, MMP-9, and BOP could be used to assess the periodontal status of orthodontic patients.