Browsing by Subject "Periodontitis"
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- PublicationOpen AccessAn adverse effect of Ocrelizumab treatment in a patient with multiple sclerosis: a case report of necrotizing periodontitis(Gavin Publishers, 2023-04-04) Montoya-Carralero, José María; Sánchez-Pérez, Arturo; Jornet-García, Alfonso; Moya Villaescusa, María José; Dermatología, Estomatología, Radiología y Medicina FísicaMultiple Sclerosis (MS) and Necrotizing Periodontitis (NP) are two diseases whose aetiologies and pathophysiologies do not appear to have a common link; however, treating MS with monoclonal antibodies and the decrease in humoral immunity that this entails can be a trigger or an aggravation in patients who present with quiescent NP. We describe a clinical case of NP, including clinical manifestations, treatment, and evolution during therapy with ocrelizumab and to review risk factors. A rapid progression of NP was evidenced. During the patient’s evolution, she suffered bilateral pneumonia due to coronavirus disease 2019, requiring treatment with corticosteroids and antibiotics, which led to clinical relief of her NP. Based on this case, we believe that regulated dental monitoring of patients with MS before, during, and after the administration of monoclonal antibodies may help prevent periodontal deterioration.
- PublicationOpen AccessAn objective and subjective evaluation of masticatory efficiency in periodontal patients before and after basic periodontal therapy: a case series study(MDPI, 2025-04-12) Moya Villaescusa, María José; López-Lisón, Claudia; Montoya-Carralero, José María; Jornet García, Alfonso; Sánchez Pérez, Arturo; Dermatología, Estomatología, Radiología y Medicina FísicaAbstract: Background: Periodontal disease is a multifactorial infectious pathology that affects dental supporting tissues, impacting the health and quality of life of patients. Assessing chewing efficiency before and after periodontal therapy is crucial to better understand its impact on the quality of life of periodontal patients. Thus, the aim of this case series study was to determine whether basic periodontal therapy improves masticatory ability and efficiency in patients with mild to moderate periodontitis. Methods: A prospective, longitudinal, case series study was carried out in 42 periodontal patients treated at the University Odontology Clinic. Masticatory efficiency before and after basic periodontal treatment was assessed using both objective (HueCheck Gum test) and subjective (Quality of Masticatory Function Questionnaire: QMFQ) methods. Results: Significant improvements (p = 0.0001) were observed in periodontal variables such as hygiene index (HI), probing depth (PD), and clinical attachment level (CAL), as well as in the initial and final QMFQ total score (p = 0.045). In addition, significant differences were found in posttreatment QMFQ scores related to parafunctional habits (p = 0.046) and facial patterns, especially in meat consumption (p = 0.042) fruit and vegetable consumption (p = 0.007, p = 0.044). The initial mean HueCheck Gum test values were 0.59 ± 0.09 and the final values were 0.61 ± 0.11. These differences were not statistically significant. Conclusions: Basic periodontal treatment does not objectively improve the masticatory efficiency of patients with mild–moderate periodontitis, evaluated by means of the test of mixing two chewing gums, but it does offer subjective improvements.
- PublicationOpen AccessApical approach in periodontal reconstructive surgery with enamel matrix derivate and enamel matrix derivate plus bone substitutes: a randomized, controlled clinical trial(Springer, 2021-11-17) Moreno Rodríguez, José Antonio; Ortiz Ruiz, Antonio José; Dermatología, Estomatología, Radiología y Medicina FísicaObjectives This parallel, randomized controlled clinical trial evaluated the influence of bone substitutes (BS) on the efficacy of the non-incised papillae surgical approach (NIPSA) with enamel matrix derivate (EMD) in resolving deep, isolated, combined non-contained intrabony and supra-alveolar periodontal defects, preserving the soft tissue. Material and methods Twenty-four patients were randomized to treatment with NIPSA and EMD or NIPSA plus EMD and BS. Bleeding on probing (BoP), interproximal clinical attachment level (CAL), interproximal probing depth (PD), recession (REC), location of the tip of the papilla (TP), and width of the keratinized tissue (KT) were evaluated before surgery and at 1 year post-surgery (primary outcomes). Wound closure was assessed at 1 week post‐surgery, and supra‐alveolar attachment gain (SUPRA-AG) was recorded at 1 year post‐surgery. Results At 1 week, 87.5% of cases registered complete wound closure and there were no cases of necrosis, without differences between groups (p > .05). At 1 year, all cases showed negative BoP. A significant PD reduction (NIPSA + EMD 8.25 ± 2.70 mm vs. NIPSA + EMD + BS 6.83 ± 0.81 mm) and CAL gain (NIPSA + EMD 8.33 ± 2.74 mm vs. NIPSA + EMD + BS 7.08 ± 2.68 mm) were observed (p < .001) in both groups, without significant between-group differences (p > .05). The residual PD was < 5 mm in all defects (NIPSA + EMD 2.50 ± 0.67 mm vs. NIPSA + EMD + BS 2.67 ± 0.78 mm). Soft tissues were preserved without significant between-group differences (REC: NIPSA + EMD 0.25 ± 0.45 mm vs. NIPSA + EMD + BS 0.17 ± 0.58 mm, p > .05; KT: 0.00 ± 0.43 mm vs. 0.08 ± 0.67 mm, p > .05). There were improvements in the papilla in both groups (TP: NIPSA + EMD 0.33 ± 0.49 mm vs. NIPSA + EMD + BS 0.45 ± 0.52 mm, p > .05), which was only significant in the NIPSA EMD + BS group (0.45 ± 0.52 mm; p < .05). In both groups, CAL gain was recorded in the supra-alveolar component, showing full resolution of the intrabony component of the defect in all cases (SUPRA-AG: NIPSA + EMD 1.83 ± 1.11 mm vs. NIPSA + EMD + BS 2.00 ± 1.76 mm, p > .05). Conclusions NIPSA and EMD with or without BS seem to be a valid surgical approach in the treatment of isolated, deep non-contained periodontal defects. In our study, both treatments resulted in significant PD reduction and CAL gain, that extended in the supra-alveolar component, without differences with the use of BS. Both treatments resulted in soft tissue preservation. However, the addition of BS may improve interdental papillary tissue. Clinical relevance NIPSA, with or without bone substitutes, resulted in significant periodontal improvement, with soft tissue preservation in isolated, deep non-contained periodontal defects. The application of bone substitutes may provide interproximal soft tissue gain.
- PublicationOpen AccessChemoprevention of Experimental Periodontitis in Diabetic Rats with Silk Fibroin Nanoparticles Loaded with Resveratrol(MDPI, 2020-01-19) Giménez-Siurana, Ana; Gomez Garcia, Francisco; Pagan Bernabeu, Ana; Lozano-Pérez, Abel; Aznar-Cervantes, Salvador; Cenis, Luis; Lopez Jornet, Pia; Dermatología, Estomatología, Radiología y Medicina FísicaObjective: the objective of the present work is to study the e ectiveness of treatment with silk fibroin nanoparticles loaded with resveratrol in experimental periodontitis in a diabetic rat model. Introduction: Periodontitis is an inflammatory pathology highly related to other diseases, such as type II diabetes. Both diseases have a specific inflammatory condition, with Interleukin (IL)-6, IL-1 and Transforming Grow Factor (TGF)-1 being the most relevant proinflammatory factors. Silk fibroin (SF) nanoparticles loaded with resveratrol (Res-SFN) are a new alternative as a treatment. Methods: 40 diabetic Sprague Dawley male rats were used and periodontitis was induced by ligation. The animals were divided into 5 treatment groups, and 1 mL of treatment was administered once a day for 4 weeks. The groups were: I: Carboxymethyl cellulose (CMC) 0.8%, II: CMC 0.8% + SF 1%, III: CMC 0.8% + RES-SFN 3 mg/mL, IV: CMC 0.8% + SF 1% + RES-SFN 3 mg/mL, V: Water. A peripheral blood sample was taken every week to quantify the inflammatory profile by ELISA (IL-6, IL-1 and TGF-1 ). After 4 weeks the sacrifice was carried out and biopsies of the gum were taken. Results: Treatment with SF and RES-SFN reduced the amount of chemical inflammation mediators (with the exception of IL-1 in comparisons I-IV and II-IV (p > 0.05)), as well as the anatomopathological variables linked to it, in a significant way (p < 0.05). Conclusion: treatment with RES-SFN has reduced local inflammation in this experimental periodontitis model
- PublicationOpen AccessChronic atrophic gastritis aggravate chronic periodontitis with Helicobacter pylori infection and CD4+Th cytokines infiltration(Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2020) Luo, Wei; Li, Yaqiang; Luo, Zhenhua; Xu, BaohongObjective. To investigate the potential effect of chronic atrophic gastritis on chronic periodontitis and further explore the possible mechanism. Methods. Local periodontal lesions were collected from periodontitis tissues of 30 CAG patients and 35 control adults without CAG (non-CAG). Clinical periodontal parameters were recorded, and the expression levels of distinct CD4+ Th specific cytokines at local periodontitis lesions were evaluated by real time PCR (RT-PCR). Helicobacter pylori (H. pylori) detection was carried out in both gastric and periodontitis lesions of CAG and non CAG patients. Results. Clinical parameters analysis showed that the level of clinical attachment loss in periodontitis lesions of CAG group was significantly higher than non-CAG group. It was observed that the infection rate of H. pylori in the CAG group was higher than non-CAG group. Further cytokine analysis showed that Th17 associated cytokines IL-17, IL-21 and IL-23 were increased in periodontal lesions of CAG patients when compared with non-CAG patients. However, Th1, Th2, Th9 and Treg cells specific cytokines were not significantly increased in CAG group when compared with non-CAG group. Conclusions. Patients with CAG demonstrated that significant elevated attachment loss in periodontitis lesions, while elevated Th17 cytokines IL-17, IL-21 and IL-23 participate in immunopathogenesis of both diseases
- PublicationOpen AccessExpression of CCL2 signaling pathway genes in patients with periodontitis and atherosclerosis(Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2024) Zhao, Yuxia; Wang, Lianqun; Dong, Rui; Cheng, Xuejun; Jia, Liqun; Qu, Dan; Zhang, LinObjective. Periodontitis and atherosclerosis are chronic inflammatory diseases characterized by leukocyte infiltration. We investigated the expression of CCL4, CCR5, c-Jun, c-Fos, NF-κB, and CCL2 as well as the possible mechanism involved in the regulation of CCL2 in human periodontitis tissues and atherosclerotic aorta based on previous research on the CCL4/CCR5/c-Jun and c-Fos/CCL2 pathway leading to CCL2 expression in collagen-induced arthritis (CIA) rat. Methods. Sixty-five volunteers were recruited and the condition of their gingiva and coronary arteries were assessed. The subjects were divided into four groups: healthy control, chronic periodontitis (CP), coronary artery diseases (CAD), and noncoronary artery diseases (non-CAD). Total RNA was isolated from gingiva in periodontitis patients and control populations and from the aorta in patients with and without CAD. PCR was used to examine CCL4, CCR5, c-Jun, c-Fos, NF-κB, and CCL2 levels. The production of CCL2 in the gingiva and aorta was analyzed by immunostaining. Results. PCR revealed that CCL4, CCR5, and CCL2 mRNA levels were increased in CP patients' gingivae and aortas from coronary artery bypass grafting (CABG) patients. Marked c-Jun, c-Fos, and NF-κB gene productions were detected in CP patients’ gingivae but did not show statistical differences between the CAD and non-CAD groups. Stronger immunoreactivity against CCL2 was observed in periodontitis gingiva and aorta from CABG patients. Conclusions. Our findings suggest that the CCL4/CCR5/c-Jun and c-Fos/CCL2 pathways may be involved in CCL2 expression in periodontitis. CCL4, CCR5, and CCL2 might act as possible nodes to link the presence of periodontitis and atherosclerosis.
- PublicationOpen AccessHistopathological and clinical expression of periodontal disease related to the systemic inflammatory response(Universidad de Murcia. Departamento de Biología Celular e Histología, 2017) Ionel, Anca; Lucaciu, Ondine; Tăbăran, Flaviu; Berce, Cristian; Toader, Septimiu; Hurubeanu, Lucia; Bondor, Cosmina; Câmpian, Radu S.Periodontal disease with its systemic implications is highly prevalent among the population, and this correlation could have an impact on the quality lives of many humans. The purpose of this study was to assess the clinical and histopathological changes of the periodontium correlated with the systemic inflammatory response in periodontal disease. An experimental study was performed on male Wistar rats which were subjected to a procedure of periodontitis induction through placing silk thread ligatures around the lower incisors, under general anesthesia. Clinically, the changes of the periodontal tissue induced by the periodontitis progression were daily assessed. Two blood samples were obtained from each animal, at baseline and on completion of the experiment. The plasma level of the cytokine IL-6 and haematological parameters such as leukocytes, neutrophils, lymphocytes, monocytes, and platelets were determined. After seven days the animals were sacrificed, and samples were prepared for histological evaluation. Clinical manifestations such as changes in the color, contour and consistency of the gingival tissue and the bleeding on probing were registered. Histopathological analysis showed an intense inflammatory cell infiltration, the presence of osteoclasts and an obvious bone resorption activity. A significant increase in IL-6 values during the progression of periodontitis in rats (p<0.001) was also observed. The results of this research demonstrated that the clinical and histological changes in the rat’s periodontium are correlated with a notable systemic inflammatory response. Therefore, periodontitis control can be inserted as part of the programs of systemic disorders prevention, in clinical practice.
- PublicationOpen AccessNon-Incised papilla surgical approach and leukocyte platelet-rich fibrin in periodontal reconstruction of deep Intrabony defects: a case series(MDPI, 2021-03-03) Pardo Zamora, Guillermo; Moreno Rodríguez, José Antonio; Ortiz Ruiz, Antonio José; Dermatología, Estomatología, Radiología y Medicina FísicaWe present the preliminary results of the treatment of teeth with a deep, non-contained periodontal residual defect, vestibular bone dehiscence, and soft tissue recession, by combining an apical non-incised papilla surgical approach (NIPSA) to the defect and leukocyte platelet-rich fibrin (L-PRF) in the vestibular aspect. Four patients (upper left first premolar, upper left central incisor, upper right central incisor and upper right lateral incisor) have been treated. At one year of follow up, all cases showed a considerable reduction in the periodontal pocket depth, a gain in clinical attachment and no bleeding on probing, as well as an improvement in the marginal soft tissue minimizing soft tissue contraction (recession and/or loss of papilla) and improving soft tissue architecture. NIPSA plus L-PRF seem to improve clinical outcomes in deep non-contained intrabony defects associated with soft tissue recession.
- PublicationEmbargoPapilla preservation periodontal surgery in periodontal reconstruction for deep combined intra-suprabony defects. Retrospective analysis of a registry-based cohort(Medicina Oral S.L., 2021-08-01) Moreno Rodríguez, José Antonio; Ortiz Ruiz, Antonio José; Dermatología, Estomatología, Radiología y Medicina FísicaBackground: Suprabony defects are the most prevalent defects and there is very little evidence on their treatment. This study aims to assess the effectiveness of papilla preservation periodontal surgery in the periodontal reconstruction of combined deep intra-suprabony defects. Material and Methods: 20 patients with combined intrabony and supra-alveolar deep periodontal defects treated by papilla preservation periodontal surgery were analyzed. Defects were treated with enamel matrix derivate plus xenograft. Clinical recordings made before surgery and at 12 months. Results: Papilla preservation periodontal surgery showed significant PPD reduction (4.4 ± 1.46 mm; p<0.001), clinical attachment gain (3.35 ± 1.6 mm; p<0.001), increased REC (1.05 ± 0.94; p<0.001), papilla apical displacement (0.85 ± 1.31 mm; p<0.005) and KT reduction (0.5 ± 0.76 mm; p<0.05). At one week, there was incomplete wound closure and necrosis in 40% and 30% of the treated sites, respectively. At one year, the intrabony component filling was 73.65 ± 27.6 % and the supra-alveolar attachment gain indicated an incomplete intrabony defect resolution (-0.15 ± 1.56 mm). Conclusions: Periodontal pocket was significantly reduced and the level of clinical attachment increased. However, there was significant recession of the gingival margin and the papilla and a trend to incomplete resolution of the intrabony component.
- PublicationOpen AccessPeriodontal reconstructive surgery of deep intraosseous defects using an apical approach. Non-incised papillae surgical approach (NIPSA): A retrospective cohort study(Wiley, 2019-05-11) Moreno Rodríguez, José Antonio; Ortiz Ruiz, Antonio José; Caffesse, Raúl G.; Dermatología, Estomatología, Radiología y Medicina FísicaBackground The objective of this study was to compare a minimally-invasive surgical technique (MIST) and a non-incised papilla surgical approach (NIPSA) in periodontal reconstructive surgery of deep intraosseous defects. Methods Data on 30 patients with a deep intraosseous defect treated with MIST (n = 15) or NIPSA (n = 15) were analyzed retrospectively. All patients met the same inclusion criteria and were treated following the same protocol, except for the surgical management of soft tissue (MIST versus NIPSA). Clinical parameters at baseline and at 1-year post-surgery, early healing at 1 week, and postoperative pain were assessed. Results NIPSA and MIST resulted in significant clinical attachment gain (CAG) (P < 0.001) and probing depth reduction (PDr) (P < 0.001) at 1-year post-surgery. However, NIPSA resulted in significantly lower recession of the tip of the interdental papilla compared with MIST (P < 0.001). Smoking negatively influenced early healing in both techniques (P < 0.05). Conclusions NIPSA and MIST both resulted in significant improvements in clinical parameters. NIPSA showed significant soft tissue preservation. NIPSA may represent a promising papillae preservation technique in the treatment of intraosseous periodontal defects.
- PublicationOpen AccessT cell regulation of the immune response to infection in periodontal diseases(Murcia : F. Hernández, 2003) Yamazaki, K.; Yoshie, H.; Seymour, G.J.Although T cells have been implicated in the pathogenesis and are considered to be central both in progression and control of the chronic inflammatory periodontal diseases, the precise contribution of T cells to the regulation of tissue destruction has not been fully elucidated. Current dogma suggests that immunity to infection is controlled by distinct T helper 1 (Th1) and T helper 2 (Th2) subsets of T cells classified on the basis of their cytokine profile. Further, a subset of T cells with immunosuppressive function and cytokine profile distinct from Th1 or Th2 has been described and designated as regulatory T cells. Although these regulatory T cells have been considered to maintain selftolerance resulting in the suppression of auto-immune responses, recent data suggest that these cells may also play a role in preventing infection-induced immunopathology. In this review, the role of functional and regulatory T cells in chronic inflammatory periodontal diseases will be summarized. This should not only provide an insight into the relationship between the immune response to periodontopathic bacteria and disease but should also highlight areas of development for potentially new therapeutic modalities.