Although the present study cannot ascertain causal association, it provides substantial evidence that poor periodontal health is associated with obstructive lung disease.
Background:
Growth of scientific evidence suggests an exquisite association between oral infection and systemic diseases. Though etiologies of periodontitis and rheumatoid arthritis (RA) are separate, their underlying pathological processes are sufficient to warrant consideration of hypothesis that individuals at risk of developing RA may also be at the risk of developing periodontitis and vice versa.
Materials and Methods:
To test their relationship, a study was carried out on 80 individuals. Part A: Forty subjects having rheumatoid arthritis (RA group) were compared to 40 controls without arthritis (NRA group). Their periodontal indices rheumatoid arthritis clinical laboratory parameters were also correlated with periodontitis in group. Part B: Omplete periodontal treatment was done for 10 patients of group suffering from periodontitis. All parameters of periodontal indices were measured pre-operatively and weeks after completion of periodontal treatment.
Results:
(1) There was high prevalence of mild (12.5%) to moderate (75%) periodontitis in group. (2) Extent severity of periodontal disease rheumatoid arthritis were positively correlated. (3) Statistically significant differences were present in periodontal parameters of RA group compared to NRA group. (4) There was statistically, significant reduction in parameters postoperatively with concomitant decrease in periodontal parameters in RA group.
Conclusion:
Thus, an association exists between periodontal disease with an underlying dysregulation of the molecular pathways in the inflammatory response. Also, there are significant management implications in the future as new host modifying medications are developed.
Periodontal destruction is initiated by bacteria that stimulate host responses leading to excess production of cytokines. Anticytokine therapy for periodontal diseases especially targets proinflammatory cytokines, that is, TNF-α, IL-1, and IL-6, because these are essential for the initiation of the inflammatory immune reaction and are produced for prolonged periods in periodontitis. This therapy aims to bind the cytokines with the receptors present on target cells such as the fibroblasts. The three basic treatment strategies are: (1) neutralization of cytokines, (2) blockage of cytokine receptors, and (3) activation of anti-inflammatory pathways, such as, immune-suppressive pathways.This new therapy can act as a host response modulator in the control of inflammatory diseases of gums and may provide the basis for new molecular therapeutic approaches to the treatment of periodontitis.
Gingival recession is defined as displacement of gingival margin apical to cementoenamel junction. Over the years gingival recession has been treated by a number of surgical techniques. Conventional mucogingival procedures such as the laterally positioned flap, free gingival graft, connective tissue graft and coronally positioned flap have been shown to be relatively successful in achieving root coverage. Gingival tissue regeneration (GTR) based root coverage has emerged as an alternative treatment because it demonstrates histologically new attachment formation. The aim of this study was to compare coronally positioned flap procedures in gingival recession defects with or without using a collagen barrier membrane.
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