The Benefits of Non-Surgical Periodontal Treatment in Association with Gastric Eradication

Periodontitis is a chronic degenerative disease which is inflammatory and whose bacteriological aetiology interests the hard and soft tissues supporting the dental elements. A typical characteristic of periodontitis is its correlation with other branches of medicine since periodontal disease is often associated with several other illnesses or systemic conditions which exacerbate or predispose the course of the disease. Amongst the most frequent gastroduodenal diseases are those associated with Helicobacter pylori (Hp) infections such as acute gastritis, chronic atrophic gastritis, gastric atrophy, gastritis ulcers, dysplasia, duodenal ulcer, gastric cancer, gastric MALT-lymphoma. Transmission of the microorganism occurs through iatrogenic pathways (faecal-oral, oral-oral) and through food and water ingestion. From this the possible role of the oral cavity becomes evident as a means of transmitting the microorganism and as an extra-gastric reservoir of Hp which develops inside the oral plaque, the main aetiological agent of periodontal disease. Considering that in a patient affected with periodontal disease the oral cavity presents elevated indices of bacterial plaque in association with infrabony pockets one is brought to ask if it might represent a favourable habitat for Hp colonisation. Furthermore, another query that one might pose is whether the presence of Hp in the oral cavity might be the cause of relapse in gastric infections caused by Hp. Consequently, might non-surgical periodontal treatment, in association with an eradicating gastric therapy, foster decontamination of the microorganism in the oral cavity leading to a better prevention of relapse and re-infection of the gastric cavity? Could non-surgical periodontal treatment thus mean prevention of gastric diseases brought on by Helicobacter pylori? The objective of this study is therefore to evaluate the incidence of periodontal disease and oral Hp infection in patients affected by gastric Hpinfection and to determine the possible benefits of the association of non-surgical periodontal therapy with eradicating gastric therapy compared with treatment that involves just the eradicating gastric therapy in patients who are affected by periodontal disease and Hp infection.

Multidisciplinary non-surgical treatment of advanced periodontitis:A case report

BACKGROUND Patients with severe periodontitis often require multidisciplinary treatment to achieve healthy periodontal tissue,normal occlusion,and optimal aesthetics.In the present study,we aimed to evaluate the efficacy of multidisciplinary non-surgical treatment in a patient with stage IV/grade C periodontitis,malocclusion,and dentition defects.CASE SUMMARY A 47-year-old woman visited our periodontology department due to teeth mobility problems and difficulties chewing food.The patient had no history of drug allergies or systemic disease.Initial therapy involved scaling and root planning with a Gracey scaler and periodontal ultrasonic therapeutic apparatus using a periodontal endoscope(Perioscopy,Zest Dental Solutions,United States)to control the periodontal inflammation prior to treatment.Five months later,orthodontic treatment was then performed to treat occlusion and overall aesthetics.After completion,a Maryland bridge was used to restore Nos.22,31,and 41 teeth.Florida probing(Florida probe,United States)was performed every 2-3 mo to evaluate the periodontal condition throughout treatment.Overall,multidisciplinary non-surgical treatment resulted in satisfactory aesthetic results with healthy periodontal tissue and stable occlusion.CONCLUSION In some patients with stage IV/grade C periodontitis,systematic and sequential non-surgical treatment can provide excellent therapeutic results.

Impact of Non-Surgical Periodontal Therapy on the Salivary Levels of Tissue Inhibitor of Metalloproteinse-1 (TIMP-1) in Patients with Chronic Periodontitis: A Third World Experience

Chronic periodontitis is a disease of public health concern due to its high prevalence globally, especially in the elderly. The aim of this study was to determine the impact of non-surgical periodontal therapy on salivary levels of TIMP-1 among patients with chronic periodontitis in Nigeria. In this experimental study, unstimulated whole saliva (2 mL) was collected from participants in the experimental and control groups, coded (SP1-40 and SH1-40) respectively and assays for salivary TIMP-1as well as clinical measurements such as plaque (PI), probing depths (PD), and CAL were recorded before and 4 weeks after periodontal treatment. Assay was done using Quantikine human TIMP-1 ELISA kit. Data were presented using frequency tables, means and standard deviation. Paired-T Test assessed association between salivary TIMP-1 before and after treatment. Pearson correlation coefficient was used to correlate salivary TIMP-1 levels with clinical parameters of periodontal disease and levels of statistical significance were set at p < 0.05. A total of 80 respondents participated in the study of which 43.80% were females. Age range was 18 - 60 years with a mean of 35.8 ± 12.46 years. Salivary TIMP-1 levels were lower in the case group (13.58 ± 6.53 ng/mL) than the control (15.27 ± 6.10 ng/mL) at baseline but this was not statistically significant (p = 0.13). There was a statistically significant increase in the salivary levels of TIMP-1 in the case group after phase-one periodontal therapy from 13.58 ± 6.53 ng/mL to 17.24 ± 8.44 ng/mL (p = 0.001). Negative correlations were observed between TIMP-1 and clinical parameters of periodontitis. This was not statistically significant. Therefore, TIMP-1 may not be an ideal biomarker for periodontal diagnosis but may be useful in treatment monitoring of the disease.

THERAPEUTIC EFFECT OF NON-SURGICAL TREATMENT OF CHRONIC PERIODONTITIS IN DIABETIC CHINESE

Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese withchronic periodontitis. Methods Moderate to advanced chronic periodontitis ( CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fluctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PlI) , gingival index (GI) , bleeding on probing (BOP) , probing depth (PD) and clinical attachment loss (AL) of all patients were recorded at 6 sites on each tooth at the baseline and 1, 3 and 6 months after oral hygiene instruction (OHI), scaling and root planing. Results It was found that the short-term effect of non-surgical periodon-tal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.

Advances in diagnosis and non-surgical treatment of Bell's palsy

Bell’s palsy is a commonly seen cranial nerve disease and can result in compromised facial appearance and functions. Its etiology, prognosis and treatment are still being debated. This paper is a review of recent development in the understanding of etiology, diagnosis and non-surgical treatment of Bell’s palsy.

Periodontal conditions and treatment in urban and rural population of West Bengal,India

Objective:To search adequate epidemiological data on periodontal conditions for the planning of oral health programs in Indian population,and to determine the prevalence of periodontal diseases,in regards to age and gender of urban and rural population in West Bengal.India. Methods:22 542 subjects aged 15 years onwards,representative of rural and urban areas of West Bengal were examined for their periodontal conditions using the community periodontal index(CPI).Results:Supra and/or sub gingival calculus dominated as the most frequent score (score 2) among males(76.51%) and females(76.58%),which was least affected in young age group and higher in rural population.Severity of highest score were significant(P【0.001) according to their gender,age group and habitation and had independent effects(P【0.001) on it. Mean number of sextants affected by scores 1,2,3,& 4 were more in the rural areas.Assessed treatment needed was predominantly typeⅡ(Scaling and improved oral hygiene).Conclusions: The severe periodontal condition(Score 2,3 and 4) is observed among rural males in older age group more than its urban counterparts of West Bengal,India.

Non-Surgical Orthodontic Treatment of Class III Adult with Posterior Crossbite, Anterior Open Bite and Asymmetric Occlusion, Using TADs and Auxiliary Wires: A Case Report

Class III malocclusion associated with posterior crossbite, anterior open bite pattern with asymmetric occlusion in adults can be a challenging orthodontic problem, especially for the nonsurgical treatment. Skeletal Class III anteroposterior discrepancies in adult patients are generally managed either by surgical-orthodontic treatment or by orthodontic camouflage through dentoalveolar compensation. Although correction with surgery may be the most effective and stable way, many patients refuse surgical treatment plan because of the costs and traumas it may bring. This case report describes the successful use of TADs with expansion auxiliary wire to treat a 24-year-old man with skeletal class III malocclusion, posterior crossbite, anterior open-bite and asymmetric occlusion, mild upper and lower dental spacing and a chief manifestation of anterior crossbite. The patient refused surgery. A treatment plan was formulated consisting of using auxiliary expansion wire to expand the maxillary arch, 8 mm mini-screws between the roots of the mandibular canines and first premolars, preadjusted edgewise brackets to align the teeth, Class III and asymmetric elastics to correct the canines, premolars, and molars relationship and midline deviation, reverse curve of the nickel-titanium wire combined with anterior vertical elastics to intrude molars and correct the anterior open-bite. In this case, without going through surgery, the posterior cross-bite was corrected, and ideal overjet and overbite relationships, midline coincidence and functional occlusion were all achieved. Satisfactory occlusal, functional, esthetic and stable results were obtained.

Non-Surgical Treatment with Chemical Peeling and Subsequent Vitamin C Iontophoresis for Rolling Scars in Acne Vulgaris

A 19-year-old man had atrophic scars on bilateral temple for several years. The atrophic scars were composed of rolling scars (three depressions, 8 × 4 mm in diameter), ice pick scars and boxcar scar. The patient was treated with chemical peeling (CP) using 20% glycolic acid (GA) (pH 3.2) and subsequent iontophoresis with vitamin C derivative at one month’s interval twice. Remarkable improvement was observed;the rolling scars almost disappeared with traces of hypopigmented macule. However, the ice pick scars and boxcar scar did not improve. CP and subsequent vitamin C iontophoresis can be an alternative non-surgical and non-invasive treatment for rolling scar in acne.

Relationship between diabetes and periodontal infection

Periodontal disease is a high prevalent disease.In the United States 47.2% of adults ≥ 30 years old have been diagnosed with some type of periodontitis.Longitudinal studies have demonstrated a two-way relationship between diabetes and periodontitis,with more severe periodontal tissue destruction in diabetic patients and poorer glycemic control in diabetic subjects with periodontal disease.Periodontal treatment can be successful in diabetic patients.Short term effects of periodontal treatment are similar in diabetic patients and healthy population but,more recurrence of periodontal disease can be expected in no well controlled diabetic individuals.However,effects of periodontitis and its treatment on diabetes metabolic control are not clearly defined and results of the studies remain controversial.

Generalized periodontitis treated with periodontal,orthodontic,and prosthodontic therapy:A case report

BACKGROUND Generalized periodontitis is a severe periodontal disease characterized by rapid periodontal destruction in healthy persons.This case report describes the treatment of a severe crowding,large overjet,and occlusal collapse due to the loss of anterior guidance with generalized periodontitis.CASE SUMMARY A 35-year-old female patient with a chief complaint of crowding and maxillary protrusion was diagnosed with generalized periodontitis by clinical and radiographic examinations.To improve crowding and overjet,orthodontic treatment was performed after basic periodontal therapy.Severely damaged upper right lateral incisor and left canine were extracted,and lower right first premolar and left second premolar were also removed to treat severe crowding.After orthodontic treatment,periodontal flap surgery for upper left molars and guided tissue regeneration for the lower left second molar was performed.Then,a dental implant was inserted in the upper left canine legion.The esthetics of the maxillary anterior tooth was improved by prosthetic restorations.The treatment result showed a well-improved occlusion with proper anterior guidance and healthy periodontal tissue after a retention period of 10 years.CONCLUSION Periodontal,orthodontic,and prosthodontic treatments are extremely useful to improve function and stable periodontal tissue for generalized periodontitis.

Non-Invasive management of invasive cervical resorption associated with periodontal pocket: A case report

BACKGROUND Invasive cervical resorption(ICR), a commonly misdiagnosed condition, is an aggressive form of external tooth resorption that contributes to periodontal tissue inflammation and deepening of the periodontal pockets. Herein we report the case of a patient, exhibiting ICR and elaborate the effects of a non-surgical approach in the amelioration of this condition.CASE SUMMARY A 21-year-old female reporting intermittent pain at the upper left side, multiple restorations, no trauma history, and having received orthodontic treatment was studied. Localized erythematous swelling was noted at the buccal interdental papilla between the left maxillary first molar and second premolar. The diseased pulp and tissue in resorption were removed and the root canal system including the defect were sealed using gutta percha/AH Plus and mineral trioxide aggregate(MTA). At the one-year recall, the tooth showed no symptoms and responded normally to percussion and palpation. The surrounding periodontium exhibited a normal color and the probing depth was normal. Radiographic examination showed a restoration of crestal alveolar bone and good adaption to MTA.CONCLUSION Non-surgical root canal treatment in conjunction with resorption defect orthograde repair with MTA was found to be an effective treatment option in the elimination of ICR. Early diagnoses are recommended in order to employ nonsurgical approaches for management of ICR instead of surgical interventions.

三维有限元分析不同工况下牵引上颌埋伏尖牙牙周应力分布

背景:在正畸治疗埋伏尖牙过程中,粘接正畸附件的部位、角度、力值对牵引效果及牙周有较大影响,但目前对合适牵引部位、角度和牵引力值大小的相关研究较少。目的:通过三维有限元分析正畸矫治过程中不同牵引力作用下上颌埋伏尖牙的牙周应力分布。方法:选用1例上颌埋伏尖牙患者的锥形束CT扫描数据,建立包括埋伏尖牙、上颌骨骼及其周围支持结构在内的三维有限元模型,在埋伏尖牙唇侧切1/3、中1/3及颈1/3部位,分别施加与牙齿长轴呈60°,90°,120°角的牵引力(30,60,90 g),分析埋伏尖牙牙周膜Von Mises应力分布。结果与结论:①不同工况下埋伏尖牙的牙周应力分布基本相似:在尖牙切1/3施力时,模型中靠近颈部牙周膜Von Mises应力较小,舌面近颈部牙周膜Von Mises应力较大;在尖牙中1/3施力时,模型中靠近颈部牙周膜Von Mises应力较小,唇面近颈部牙周膜Von Mises应力较大;当在尖牙颈1/3施力时,模型中靠近牙颈部牙周膜Von Mises应力较小,唇面中部牙周膜Von Mises应力较大。②当施力部位、角度相同时,随着施加力的增加,牙周膜最大Von Mises应力呈增加趋势;当施加力大小、角度相同时,尖牙切1/3、中1/3及颈1/3部位牙周膜最大Von Mises应力呈递减趋势。在尖牙切1/3部位施加相同大小的力时,随着施力角度的增加,牙周膜最大和最小Von Mises应力均呈减少趋势;在尖牙颈1/3施加相同大小的力时,随着施力角度的增加,牙周膜最大Von Mises应力呈递增趋势。③结果显示,牵引上颌埋伏尖牙尽量在靠近牙颈部的部位粘接托槽,牵引上颌埋伏尖牙时牵引方向与牵引部位有关,牵引力一般为30-60 g之间。

牙周-正畸联合治疗慢性牙周炎患者的临床疗效及其预后的影响因素

目的探究在牙周基础治疗同时增加正畸治疗对慢性牙周炎患者的临床疗效及其预后的影响因素。方法回顾性分析2021年3月至2023年3月安阳市第六人民医院牙周病科收治的慢性牙周炎患者(146例)的临床资料,按照治疗方法不同分为A组(65例)与B组(81例),A组进行牙周基础治疗,B组进行牙周基础治疗+正畸治疗。对比两组治疗后6个月临床疗效,治疗前及治疗后6个月牙龈指数、牙周袋深度、肿瘤坏死因子-α、白细胞介素-6水平。治疗后6个月根据牙周袋深度将B组患者(81例)分为预后不良组(牙周袋深度≥4 mm,31例)、预后良好组(牙周袋深度<4 mm,50例),分析患者临床资料,将患者临床病历资料信息开展多因素Logistic回归分析,识别并量化影响患者牙周-正畸联合治疗效果及预后的关键因素。结果B组治疗有效率(96.30%)高于A组,差异具有统计学意义(P<0.05);治疗后6个月,两组牙龈指数、牙周袋深度、肿瘤坏死因子-α、白细胞介素-6水平均降低,且B组低于A组,差异均有统计学意义(P<0.05);单因素结果显示,预后不良组患者患牙为下颌牙、前牙、根型态异常占比均高于预后良好组,差异均有统计学意义(P<0.05);经多元Logistic回归分析结果得出,患牙为下颌牙、前牙、根型态异常是影响慢性牙周炎患者牙周-正畸联合治疗预后的影响因素(P<0.05)。结论牙周基础治疗同时增加正畸治疗对慢性牙周炎患者临床效果较好,可改善牙周指数、降低炎症反应。患牙为下颌牙、前牙、根型态异常是影响患者治疗预后不良的影响因素,临床需对以上患者进行密切关注,并采取针对性措施。

Conservative treatment of knee osteoarthritis:A review of the literature

Knee osteoarthritis(KOA)is a common chronic debilitating disease with an estimated prevalence of 23.9%in the general adult population.The condition is characterised by joint pain,functional impairment and significant reduction in quality of life.Management for KOA can generally be divided into conservative(non-operative)and surgical(operative)measures.Conservative management broadly compromises pharmacological and non-pharmacological options and is conventionally the first line treatment to avoid or delay the need for surgical management.The aim of this study is to provide an overview of the current recommendations,efficacy and safety profile of different conservative treatments through a review of the literature.

Prevalence of Enterococcus faecalis in saliva and filled root canals of teeth associated with apical periodontitis

To investigate the prevalence of Enterococcus faecalis in saliva and filled root canals of patients requiring endodontic retreatment for apical periodontitis.Patients with apical periodontitis who were referred for endodontic retreatment were examined.The type and quality of the restoration,symptoms,quality of obturation were recorded.During retreatment,an oral rinse sample and root canal sample were cultured using brain-heart infusion agar and bile esculinazide agar to select for E.faecalis.The 16S rRNA technique was used to identify E.faecalis.A total of 32 women and 22 men（mean age：38 years;s.d.：11 years） and 58 teeth were studied.The prevalence of E.faecalis was 19% in the saliva and 38% in the root canals.The odds that root canals harbored E.faecalis were increased if the saliva habored this bacterium（odds ratio59.7;95% confidence interval51.8-51.6;P,0.05）.Teeth with unsatisfactory root obturation had more cultivable bacterial species in root canals than teeth with satisfactory root obturation（P,0.05）.E.faecalis is more common in root canals of teeth with apical periodontitis than in saliva.The prevalence of E.faecalis in root canals is associated with the presence of E.faecalis in saliva.

Treatment of bilateral granulomatous lobular mastitis during lactation with traditional Chinese medicine: A case report

BACKGROUND Granulomatous lobular mastitis(GLM)is a type of benign chronic inflammatory disease that poses therapeutic challenges to healthcare providers.The diagnosis of GLM relies on tissue biopsy,and incorrect treatment may lead to delayed diagnosis,considerable aesthetic damage,and even mastectomy.CASE SUMMARY We report the case of a 37-year-old Chinese woman who was lactating and had GLM in both breasts.At the time of treatment,the right breast had a mass of approximately 15 cm×11 cm,which was hard and had poor mobility.Multiple skin ulcerations and pus spills were also observed on the surface of the breast.The left breast had a mass of about 13 cm×9 cm,which was hard and had poor mobility.CONCLUSION Herein,we report a case of bilateral GLM in a lactating woman that was successfully treated with traditional Chinese medicine(TCM),without the requirement for surgery or other treatments.Therefore,TCM may have advantages in the nonsurgical treatment of GLM.

Concurrent Multi-Modality Treatment of Keloids (CMTK) Not Manageable by Conventional Postoperative Radiotherapy

Objective: To design and test a treatment regimen which is clinically responsive, readily available, cost effective, and applicable especially to children and women of child bearing age. Design Setting: A prospective cohort study. Setting: Two major postgraduate teaching hospitals: one in Tripoli, Libya and the other in Jeddah, Saudi Arabia. Participants: Fifty-seven patients with 79 keloids, referred from Plastic Surgery Units between April 1996 and January 2005. Main Outcome Measure: Degree of flattening of the keloidal lesion and symptomatic recovery. Results: Result of treatment has been analyzed using unified set criteria. Seventy-seven percent of this cohort had complete response. 19% of cases had partial response, 50% acknowledged the treatment outcome had been “satisfactory” and 44% had an “acceptable” outcome. There was no significant acute or delayed reaction. Conclusion: The technique appears universally adaptable, cost effective, and can safely be prescribed for children and women of child-bearing age. In spite of prolonged treatment course, compliance was excellent.

Tooth loss caused by displaced elastic during simple preprosthetic orthodontic treatment

The use of elastics to close a diastema or correct tooth malpositions can create unintended consequences if not properly controlled. The American Association of Orthodontists recently issued a consumer alert, warning of "a substantial risk for irreparable damage" from a new trend called "do-it-yourself" orthodontics, consisting of patients autonomously using elastics to correct tooth position. The elastics can work their way below the gums and around the roots of the teeth, causing damage to the periodontium and even resulting in tooth loss. The cost of implants to replace these teeth would well exceed the cost of proper orthodontic care. This damage could also occur in a dental office, when a general dentist tries to perform a simplified orthodontic correction of a minor tooth malposition. The present case report describes a case of tooth loss caused by a displaced intraoral elastic, which occurred during a simple preprosthetic orthodontic treatment.

Laser and Its Application in Periodontology: A Review of Literature

Introduction: The use of lasers is an emerging therapy in periodontology, however, controversies regarding its use. Despite the vast amount of literature that is currently available, debates regarding the use of lasers in periodontal therapy continue. This review aims to summarize and clarify the myths surrounding the use of lasers in periodontal therapy, which may offer new hope for the treatment’s future. Methods: A comprehensive computer-based search was done using various databases like PubMed, Medline, and Cochrane Library. Results: Laser therapy has influenced periodontal treatment in many aspects. The advantages of laser over conventional instruments were reported, which include pain relief, inflammation reduction, tissue repair acceleration, wound healing, reduction of scar formation, removal of granulation tissue and epithelial lining, and treatment of periodontal pockets. Today, the laser starts to get more people’s attention. However, an evidence-based approach to using lasers in periodontal treatment must be developed. The potential risks associated with lasers should also be considered. There must be careful and strict safety precautions implemented. Conclusion: Although laser therapy has shown promising results in the treatment of periodontal disease, further research is needed before the clinical use of lasers in evidence-based practice. Further long-term studies and clinical studies in human models are needed to generalize laser therapy in periodontology.