Candida albicans and Candida dubliniensis in Periodontitis in Adolescents and Young Adults

Aim. This study aims to evaluate the association of Candida albicans and Candida dubliniensis with periodontitis in adolescents and young adults in a Moroccan population. Methods. 426 subjects aged between 12 and 25 years were recruited for the study. A pool of plaque sample was taken. Samples were cultured on Sabouraud Chloramphenicol medium at 37°C for 24–48 hours and then identified by the Vitek 2 YST system. Clinical data and presence of Candida albicans and Candida dubliniensis were analyzed using Jamovi (Version 1.8). Results. Candida albicans was observed in 25 subjects among 68 diseased patients (37%) and in 60 subjects among 358 healthy patients (17%). It can be reported that under normal yeast conditions, there is a statistically significant difference between these two groups ( P < 0.001 ). Candida dubliniensis was more prevalent in periodontitis than in healthy subjects ( P = 0.026 ). Regarding clinical variables, subgroups of periodontitis subjects showed significant statistical differences for periodontal probing depth, clinical attachment loss, and number of decayed teeth in advanced periodontitis in comparison with initial or mild periodontitis. The results also indicate that the presence of the two species of Candida is not related to gender or age ( P > 0.05 ) nor related to the severity of the periodontal disease in this population. Conclusion. Within the limits of our study, Candida albicans is more frequently associated with periodontitis. The potential role of C. albicans in periodontitis pathogenesis is very complex. More studies on biofilm associated with different forms of periodontitis are necessary. It is also important to assess the coexistence of periodontitis and caries and the associated biofilms.

The Influence of Hyaluronic Acid Adjunctive Therapy of Periodontitis on Salivary Markers of Oxidative Stress: Randomized, Controlled Clinical Trial

Periodontitis is a common oral disease affecting the tooth-supporting tissues. Bacteria have been long viewed as the main causative factor in its development; however, many investigations have proved that aberrant immune and inflammatory response and the resulting misbalance between the damage caused by reactive oxygen species and the antioxidant capacity of tissues may be an underlying factor in disease progression that reduces healing potential. The objective of the current trial is to assess the outcomes of the addition of hyaluronic acid (HA) to standard non-surgical periodontal therapy (NST) on some major oxidative stress markers in saliva. HA-based gel designed for dental application was used and the measurements were taken after 3 months. HA adjunctive therapy had a significantly greater increase in markers with antioxidant properties as well as total antioxidant capacity compared to standard NST alone. Furthermore, clinically measured levels of gingival inflammation (bleeding on probing-BOP) and periodontal destruction (clinical attachment loss-CAL) were significantly correlated with these markers, and the correlation was negative. This investigation demonstrates that HA may indeed express antioxidant properties and improve the antioxidant capacity of periodontal tissues, thus improving the prognosis for the teeth and the results of periodontal therapy. Further investigations will be necessary to determine the duration of these effects over time.

Impact of Impaired Glucose Metabolism on Periodontitis Progression over Three Years

We evaluated the relationship between glucose abnormalities and periodontitis in overweight/obese individuals. Eight hundred and seventy (870) diabetes-free participants aged 40–65 years completed the three-year follow-up in the San Juan Overweight Adults Longitudinal Study. The ADA thresholds for fasting and 2-h post-load glucose and HbA1c were used to define prediabetes. The NHANES methods were used to assess periodontitis. Multivariable linear regression was used to evaluate the relationship between baseline glucose metabolism measures and periodontitis at follow-up, adjusting for potential confounders. There was no association between impaired glucose measures and mean pocket depth (PD), mean clinical attachment loss (CAL), or mean percent of sites ≥5 mm PD. Impaired glucose tolerance (IGT) was associated with a lower mean percent of sites ≥5 mm CAL (β = −1.6, p = 0.037). Prediabetes and impaired fasting glucose (IFG) were associated with improvement in mean percent of sites ≥5 mm PD (β = −1.4, p = 0.022; β = −1.6, p = 0.032; respectively). IFG and IGT were associated with improvement in mean percent of sites with ≥5 mm CAL (β = −1.6, p = 0.038; β = −1.9, p = 0.020; respectively). In conclusion, there were no consistent associations between baseline prediabetes or insulin resistance and periodontitis progression over a three-year period.

Serum Alkaline Phosphatase and Calcium in Relation to Periodontal Status among Perimenopausal and Postmenopausal Women

Background: Menopause is a physiological phenomenon that occurs in aging women. Periodontal disease is associated with menopausal status. Alkaline phosphatase (ALP) plays a role in general and periodontal bone turnover. Calcium is essential for the maintenance of bone and teeth, and serum ALP and calcium are specific bone markers related to the acceleration of bone mass loss in elderly women and periodontitis. Objectives: The aim of this study was to correlate the levels of serum ALP and calcium with periodontal status in perimenopausal and postmenopausal women with periodontitis. Methods: A total of 22 perimenopausal and 49 postmenopausal women underwent a full periodontal examination assessing the pocket depth, number of teeth lost, clinical attachment loss, plaque index, calculus index, and papillary bleeding index. Using these measurements, the subjects were divided according to periodontal severity. Serum ALP and calcium were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method. A correlation between serum ALP and calcium to periodontal status was investigated. Results: Serum ALP was significantly correlated with the severity of periodontitis, clinical attachment loss, and the number of teeth lost among perimenopausal and postmenopausal women (p < 0.05). Serum calcium levels were not correlated with periodontal status. Conclusion: Postmenopausal women tended to have more periodontal breakdown, and the level of serum ALP was increased in severe periodontitis.

Clinical benefits and adverse effects of siwak (S. persica) use on periodontal health: a scoping review of literature

Background Siwak is a chewing stick used as an oral hygiene aid associated with Muslim communities across the globe since more than 1500 years ago. Used either exclusively or in conjunction with a regular toothbrush, there is evidence supporting its clinical effectiveness in plaque control, but adverse effects on periodontal health remains inconclusive. Objective This study aims to systematically review the wide range of data and literatures related to siwak practice and its effect on periodontal health. Method The review was conducted based on scoping review techniques, searching literature in EBSCOHOST, PubMed, SCOPUS and Google scholar databases using the following search terms: “siwak’ or ‘miswak’ or ‘chewing stick” for intervention, and “periodontium or ‘periodontal’ or ‘periodontal health’ or ‘periodontal disease” for outcome. Articles published between January 1990 to March 2021 and written in English language were included. Results A total of 721 articles collected from the search and 21 of them were eligible for the final analysis. Results of this study was described based on clinical and antibacterial reporting of siwak, method of siwak practice and its adverse effect on oral health. Siwak was found effective at removing dental plaque and improving periodontal health over time although its effect on subgingival microbiota was inconclusive. Presence of gingival recession and clinical attachment loss were much more commonly reported in siwak users, attributable to variations in the methods employed for tooth cleaning using the siwak. Conclusion There is substantial evidence that the lack of standardised reporting for effective siwak use may have resulted in contradictory findings about its oral hygiene benefits and adverse effects. As such, future work on safe and effective siwak practice is to be advocated among its users.

Association between schizophrenia and periodontal disease in relation to cortisol levels: an ELISA-based descriptive analysis

Background Schizophrenia is a chronic psychosis marked by multiple bioenvironmental and immunological dysregulation with its intricate role in etiopathogenesis of periodontal disease remaining unclear. Hence, the aim of this study is to determine the association between periodontal disease and schizophrenia in relation with cortisol levels. Methods The study is in descriptive design comprised of 40 subjects randomly selected (20 schizophrenic patients as Group A and 20 healthy volunteers as group B). All the study participants underwent complete periodontal examination including scoring of gingival index (GI), plaque index (PI), Probing depths (PD) and clinical attachment loss (CAL). Salivary cortisol levels are estimated using ELISA. Link between schizophrenia and periodontal disease is described in relation to cortisol levels with elimination of other shared risk factors, such as tobacco smoking and xerostomia. Results Significant higher values of periodontal parameters are observed in Group A with schizophrenic patients (GI 2.467 ± 0.528; PI 2.402 ± 0.526; PD 2.854 ± 0.865; CAL 1.726 ± 3.096) than Group B with healthy subjects (GI 0.355 ± 0.561; PI 0.475 ± 0.678; PD 1.493 ± 0.744; CAL 0.108 ± 0.254). However, cortisol levels are lower in schizophrenic group (0.190 ± 0.059) than non-schizophrenic group (0.590 ± 0.228) ruling out the possible role of cortisol in periodontal disease severity associated with schizophrenic patients. Conclusion Findings of this study, provides ground evidence for consideration of schizophrenia as a risk factor for periodontitis and demands greater emphasis on management of schizophrenic patients in dental setting similar to other comorbid disorders such as diabetes mellitus and also incorporating periodontal care measures in the clinical guidelines for schizophrenia management.

Non-Surgical Periodontal Therapy Decreases Periodontal Pocket Depth and Clinical Attachment Loss of Rheumatoid Arthritis Patients

Objective: The objective of the present study was to determine the effect of non-surgical periodontal therapy on the disease severity in rheumatoid arthritis patients. Methods: Five hundred and twenty arthritis patients were included in the study, using consecutive non-probability sampling from the outpatient department of various public and private hospitals of Pakistan. Patients with periodontitis along with systemic Rheumatoid Arthritis (RA) were included in the study. Clinical parameters taken for the severity of periodontitis were the Gingival recession (GV), Periodontal Pocket Depth (PPD) and Clinical Attachment Loss (CAL). Independent sample t-test was used for significance before and after non-surgical periodontal therapy. Data was presented with mean (standard deviation). Results: The PPD and CAL of Rheumatoid Arthritis patients were found to be decreased significantly following non-surgical periodontal treatment (p value < 0.05), unlike the gingival recession, which did not decrease significantly (p value > 0.05). Conclusion: The PPD and CAL values of periodontal patients with rheumatoid arthritis were significantly reduced after giving non-surgical Periotherapy along with oral hygiene instruction. Keywords: arthritis; gingiva; periodontitis; periodontal pocket

Interferon-Gamma (IFNg) +874A/T Polymorphism Does Not Significantly Affect the Severity of Periodontitis

Objectives Interferon-gamma (IFNg) is an immune-regulatory cytokine with a role in host responses to periodontitis. Genetic factors have been reported to modify the corresponding protein expression. The objective of this study was to evaluate the association and role of IFNg polymorphisms, such as IFNg +874 A/T, and the susceptibility to periodontitis. Materials and Methods A total of 100 unrelated subjects were included in the present study. Genomic deoxyribonucleic acid (DNA) was obtained from peripheral blood of 43 patients with mild periodontitis and 57 patients with severe periodontitis. The determined clinical parameters of periodontitis included probing depth, clinical attachment loss, and papilla bleeding index. The oral hygiene indicators were also assessed. The level of IFNg was determined from the gingival crevicular fluid by enzyme-linked immunosorbent assay technique. The IFNg +874 A/T polymorphisms were analyzed from peripheral blood by the method of restriction fragment length polymorphism-polymerase chain reaction. Statistical Analysis Statistical analysis of the results was conducted using chi-squared testing for categorical data. Independent t-tests and Mann–Whitney U tests were used for numeric data. Kruskal–Wallis testing was used to compare genotypes concerning for IFNg +874 A/T polymorphism. A p-value < 0.05 was assumed for statistical significance. Results Analysis of the IFNg +874 A/T polymorphism showed no significant differences with the level of IFNg. No significant differences were observed either in IFNg +874 A/T polymorphism between the subjects with mild periodontitis and those with severe periodontitis (p > 0.05). The subjects with severe periodontitis showed marginally but not significantly higher levels of IFNg compared with subjects with mild periodontitis (p > 0.05). Conclusion The polymorphism of IFNg +874 A/T was not associated with the level of IFNg nor with the risk of periodontitis in this study.

Investigation of the Expression of Inflammatory Markers in Oral Biofilm Samples in Patients with Systemic Scleroderma and the Association with Clinical Periodontal Parameters—A Preliminary Study

Background: Systemic scleroderma (SSc) has multiple orofacial effects. The aim of this study was to analyze the expression of inflammatory mediators in biofilm samples. It was hypothesized that different expression levels and clinical associations might be drawn. Methods: A total of 39 biofilm samples from group 1 = SSc and group 2 = healthy control were examined for the expression levels of interleukin (IL)-2,-6, and -10; matrix metalloprotease (MMP)-9; and surface antigens CD90 and CD34 by quantitative real-time PCR and clinical parameters. Relative quantitative (RQ) gene expression was determined using the ∆∆CT method. Results: The mean bleeding on probing values (p = 0.006), clinical attachment loss (CAL) (p = 0.009), gingival recession (p = 0.020), limited mouth opening (p = 0.001) and cervical tooth defects (p = 0.011) were significantly higher in group 1. RQ expressions of IL-2 and CD34 were significantly lower, IL-6, MMP-9, and CD90 were significantly higher. There was a significant positive correlation of IL-6/MMP-9 and negative correlation of mouth opening/CAL and IL-6/CAL. Conclusion: Different expression levels of IL-2, IL-6, MMP-9, CD34 and CD90 were detected in biofilm samples from patients with SSc compared to control. An immunological correlation to the clinical parameters of mouth opening and CAL was shown; thus, we conclude that SSc might have an impact on periodontal tissues.

Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases

Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.