Frequency and Profile of Severe Periodontitis in Kinshasa Dental Hospitals, DR Congo

Purpose: Severe periodontitis (SP) is the sixth most prevalent disease world-wide. Prevalence and incidence are poorly reported in DR Congo. The aim of this study was to assess the prevalence of SP and to compare its profile with that of mild to moderate periodontitis (MMP). Materials and Methods: Four hundred and four patients from four hospitals of Kinshasa City Capital participated in this study. Probing pocket depth (PPD) at six sites per tooth, bleeding on probing (BoP) and plaque index (PIl) were the main clinical parameters assessed. Results: Out of 404 patients examined in this study, 92 (22.8%) had severe periodontitis and 276 (68.3%) had mild to moderate periodontitis. Among patients with SP, 48 (52%) were female, 44 (48%) were male and 63% of them had a PPD of 6 mm. SP was significantly different from MMP according to patients age, 47.3 ± 18.6 versus 32.87 ± 14.40 years old, p < 0.001;plaque index, 1.153 ± 0.39 versus 0.90 ± 0.39, p < 0.001;BoP, 26.65 versus 17.04, p < 0.001. Conclusion: The Frequency of SP is relatively high in patients attending dental services in Kinshasa City and SP is significantly different from MMP.

Awareness of Patients toward Dental Implants as an Alternative Treatment to Replace Missing Teeth in Kinshasa, D. R. Congo

Background: Dental implant is an artificial root inserted in the jawbone, which restores a lost tooth so that it looks, feels, and is fit like a natural tooth. It is considered to be the best treatment option for single or multiple missing teeth. The aim of this study was to assess the awareness of patients about dental implants as an alternative treatment in Congolese patients. Materials and Methods: A cross-sectional study was conducted in two institutions namely, CBCO Bandal and Ngaliema Clinic, from August to December 2017. A total of 450 respondents have participated in the survey. A printed questionnaire comprised of 20 questions in order to evaluate patients dental awareness was used. Gender, level of education, awareness of dental implant and dental implants therapy, sources of information and the expectation about the sources of information were assessed. The collected data were entered in Microsoft Excel 2010 and analyzed by SPSS (IBM SPSS 20.0, Chicago, IL, USA) software. Results: Out of 450 participants, 14.4% were aware of dental implants. The main disadvantage of dental implant was the high cost. When asked about the anchorage, 86% didn’t know where the dental implant was anchored. Ninety-two percent didn’t know for how long an implant last, 6% thought that dental implant last for a lifetime. When patients were asked about the sources of information, the dentist (5%) and media (5.5%) were the main sources of information. The majority of patients (88.4%) would like to get information about dental implants from their dentist. Conclusion: Dentists should be more involved in the promotion of information about dental implants as a treatment modality to replace missing teeth.

A Case Report of a Peripheral Giant Cell Granuloma in a Patient on Forteo

Peripheral giant cell granuloma (PGCG) is a common reactive gingival lesion that histologically resembles the central giant cell granuloma, and is a central lesion of the jaws. Occasionally, central giant cell granuloma-like lesions may be seen in association with hyperparathyroidism. Rarely, PGCG-like lesions have been described in a background of hyperparathyroidism. We describe the case of a 91-year-old woman taking teriparatide for the treatment of osteoporosis and presented with a peripheral giant cell granuloma of the mandibular posterior area.

Keratocyst Odontogenic Tumor (KCOT): Treatment Methods at the Second Affiliated Hospital of Jiamusi University

Many studies have been done about the treatment of KCOT, but the recurrence rate still remains high despite the combination of surgical techniques used, associated with or without the use chemical solutions such as Carnoy’s solution or Cryosurgery. Currently, there is no consensus concerning the therapeutic choice for the KCOT. The purpose of this study was to evaluate the different treatment methods used for the management of KCOT in the Second Affiliated Hospital of Jiamusi University and the results obtained from those treatment methods. Settings and Design: Clinical study was done at the Second Affiliated Hospital of Jiamusi University. Materials and Methods: Analytical retrospective review of 63 cases treated surgically from 2009 to 2015 at the Maxillofacial and Oral Surgery Department of the Second Affiliated Hospital of Jiamusi University. All cases diagnosed as KCOT and registered in the archives were used. The level of statistical significance was set at P < 0.05. Results: Of the 63 cases, 55.56% were male and 44.44% female. The sex ratio was 1.25 in favor of male and the average age was 42 years. 81% of the lesions were located in the mandible. Of 40 cases treated by enucleation with peripheral ostectomy, curettage and electric cauterization with application of 2% iodine tincture, no recurrence was found. Of 20 cases treated by the same surgical method but without the application of 2% iodine tincture, recurrence was found in 3 cases (4.76%). 3 cases treated by resection had no recurrence. Significant relation between recurrence and type of treatment was found (P < 0.05). Conclusion: In our series, those cases that were treated by combination of surgical methods used with 2% iodine tincture showed an “improvement” in the reduction of recurrence, suggesting a future question to be examined in experimental study is to test the effectiveness of 2% iodine tincture.

Risks Factors of Caries and Periodontal Diseases in the Patients, after 5 Years Use a Partial Removable Denture

Objective: The goal of the removable partial denture is to restore impaired esthetics and masticatory function by replacing missing teeth. The aim of this study was to establish a possible correla-tion between removable partial denture in acrylic resin use after 5 years and dental diseases. Materials and Methods: Partially edentulous patients presenting for removable denture treatment at the Prosthodontics service of the Affiliated Hospital of Kinshasa University, Democratic Republic of Congo were assessed in this study. Patients were randomly assigned into 2 groups: Denture and non-denture group. Caries and periodontal diseases were compared between both groups. Statistical significance was set at p < 0.05. Results: The average age in the denture and non-denture-group was 53.15 (±SD 22.05) and 31.59 (±SD 11.98) years. Out of 160 teeth were decayed, both 110 teeth (68.75%) in the denture-group and 50 teeth (31.25%) in the non-denture group. The DMFT index calculated at start time of the study was 0.2 for both groups, after five years was 7.1 for the denture-group and 2.6 for the non-denture-group. The plaque index in the denture-group had an index of 1 and that of non-denture-group was 0.5. Conclusion: The relationship has been found between patients’ wearers a RPD and dental diseases.

Cytokines Elicited by HSP60 in Periodontitis with and without Coronary Heart Disease

The human 60 kDa and microbial 65 kDa heat shock proteins (HSP) have been implicated in the pathogenesis of chronic periodontitis (CP) and coronary heart disease (CHD). We have studied 100 subjects: Group (a) consisted of patients with gingivitis (n = 25), group (b) were patients with CP (n = 25), group (c) patients with CHD and gingivitis (n = 25) and group (d) patients with CHD and CP (n = 25). PBMCs separated from peripheral blood were stimulated with medium, PMA/ionomycin, human HSP60, microbial HSP65, or no stimulus for 18 hours before intracellular IL-2, IFN-γ, TNF-α, IL-4, IL-5, or IL-17 were detected by flow cytometry. The mean fluorescence intensity (MFLI) for intracellular TNF-α was significantly increased when PBMC were stimulated with human HSP60 amongst the four groups (p = 0.001, ANOVA);pairwise comparisons revealed significant differences in MFLI between the gingivitis group and the CP (p = 0.017);between gingivitis and ging/CHD (p = 0.001) as well;but no significant difference between the CP and CP/CHD (p = 0.442). There was no significant difference in intracellular expression of IL-17, or any of the other cytokines tested;and the MFLI for HSP-stimulated were comparable to unstimulated cultures. When heat-labile human HSP60 was heated, intracellular cellular TNF-α expression was abrogated. In contrast, heat-stable LPS elicited TNF-α expression from monocytes in bulk cultures in all groups. These results suggest that the cytokine expression was dependent on human HSP60 and not LPS. Serum CRP was significantly associated with MFLI of intracellular TNF-α in CP patients (rs = 0.665, p = 0.026) and CP/CHD (rs = 0.699, p = 0.011). We conclude that human HSP60 elicits increased monocytic expression of TNF-α in patients with CP, CP/CHD or ging/CHD compared to patients with gingivitis. Since the marker of inflammation, namely CRP correlates with CP with or without CHD and not with mild chronic gingivitis or ging/CHD, this suggests that human HSP60-induced production of TNF-α is associated with CP and not CHD. There was no significant difference in intracellular expression of IL-17.

Immune Responses to HSP65/60 in Periodontal Disease

Chronic periodontitis (CP) is a chronic inflammatory condition which destroys the supporting tissues of teeth and increases in prevalence with age. Immune responses against heat shock proteins (HSP) can be cross-reactive among bacterial and human antigens. There is evidence that microbial HSP65 and human HSP60 are involved in periodontal disease. The aim of this study is to investigate immune responses to the human HSP60 and microbial HSP65 in patients with CP and relate these to the level of inflammation and smoking status. We collected serum samples from 30 patients with chronic gingivitis (CG) and 30 patients with CP. In each group, eight subjects were current smokers. ELISA was used to determine the levels of serum anti-HSP and C-reactive protein (CRP) in each group. Peripheral blood mononuclear cells were also isolated and stimulated with HSPs. Significant lymphoproliferation was seen in CP when stimulated with human HSP60. CRP and serum anti-human HSP60 IgG were elevated in CP compared to the CG, but not serum anti-microbial HSP 65 IgG. In view of the potential confounding effects of smoking in CP, a group of current smokers (n = 16) was also recruited to investigate whether smoking affects HSP immune responses. There was no significant difference in HSP-induced lymphoproliferation between smokers and non-smokers in either the CG or CP. There was a significant correlation between CRP and lymphoproliferative responses to Human HSP60 irrespective of smoking status. This study shows that serum anti-human HSP60 IgG and serum CRP are raised in untreated CP. In CP, serum CRP levels correlated significantly with human HSP60-induced lymphoproliferation, but not with anti-HSP antibody levels.