• Journal of Periodontal and Implant Science
• /
• 제42권6호
• /
• pp.256-260
• /
• 2012

Purpose: Actinomycosis is an uncommon chronic granulomatous disease that presents as a slowly progressive, indolent, indurated infiltration with multiple abscesses, fistulas, and sinuses. The purpose of this article is to report on a case of actinomycosis with clinical findings similar to periodontitis. Methods: A 46-year-old female presented with recurrent throbbing pain on the right first and second molar of the mandible three weeks after root planing. Exploratory flap surgery was performed, and the bluish-gray tissue fragment found in the interproximal area between the two molars was sent for histopathology. Results: The diagnosis from the biopsy was actinomycosis. The clinical and radiographic manifestations of this case were clinically indistinguishable from periodontitis. The patient did not report any symptoms, and she is scheduled for a follow-up visit. Conclusions: The present study has identified periodontitis-mimicking actinomycosis. Actinomycosis should be included in the differential diagnosis in cases with periodontal pain and inflammation that do not respond to nonsurgical treatment for periodontitis. More routine submissions of tissue removed from the oral cavity for biopsies may be beneficial for differential diagnosis.

• Toxicological Research
• /
• 제20권4호
• /
• pp.299-305
• /
• 2004

Adult periodontitis (AP) is a chronic inflammatory disease whose etiology is not well defined. Some studies suggested that the clinical characteristics of this disease may be in part explained by genetic factors, and some attempts to find genetic markers for this disease were successful. The interleukin-1 (IL-1) gene family as one of genetic factors may influence the expression of adult periodontitis. The aim of present study is to investigate the frequencies of genetic polymorphisms in the IL-1 gene family encoding three genes (IL-1A, IL-1B and IL-1RN) in Korean AP patients and periodontically healthy controls. There were no significant differences in genotype and allele frequencies of these polymorph isms between two groups, respectively. However, -511 polymorphism of IL-1 B gene was significantly associated with mean pocket depth (MPD, mm) value in AP patients (P<0.05). Therefore, our results suggest that -511 polymorphism in the IL-1B gene may be useful as a genetic marker for the severity of AP in Koreans.

• 대한치과의사협회지
• /
• 제54권11호
• /
• pp.897-906
• /
• 2016

Objectives: Periodontitis is multifactorial disease mainly caused by microbial community. Recently, some research has been conducted to find other possible risk factors including stress hormones related to periodontitis. Psychological stress can affect the periodontal health by a variety of biological mechanisms. This study compared the stress hormone levels in healthy subjects and patients with periodontal disease using saliva in order to investigate the association between periodontitis and stress. Methods: The human saliva was collected from 38 periodontally healthy individuals and 34 patients with chronic periodontitis under Institutional Review Board. Their age was 20-60 years ($40.3{\pm}10.45$). From these samples, determination of salivary levels of cortisol and Dehydroepiandrosterone (DHEA) performed by enzyme immunoassay kit (Salimetrics Europe, Suffolk, UK). The independent t-test and Mann-Whitney test for trend was applied using IBM SPSS statistics version 12.0 Program to analyze statistically significant differences. Results: Salivary cortisol levels of periodontitis patients were higher than those levels of healthy subjects (P < 0.001), while salivary DHEA levels of periodontitis patients were not significantly different (P = 0.431). Salivary cortisol/DHEA ratio of periodontitis patients was higher than those levels of healthy subjects (P < 0.001). Conclusions: Our study demonstrates the high levels of cortisol concentrations and cortisol/DHEA ratio in saliva of periodontitis patients than those of healthy subjects. Since cortisol levels and cortisol/DHEA ratio can be significant factors related to the severity of periodontal disease, our study would be helpful for early diagnosis and treatment of periodontal disease.

• 대한지역사회영양학회지
• /
• 제19권1호
• /
• pp.84-94
• /
• 2014

Periodontal disease is one of the most common chronic inflammatory diseases in the oral cavity, and this is the leading cause of loss of teeth. Studies on the association between diet and periodontal diseases are very limited. The purpose of this study was to investigate the association between food and nutrient intakes and the prevalence of periodontitis. Subjects were 13,391 adults participating in the 2008-2010 Korea Health and Nutrition Examination Survey. Periodontitis was diagnosed by dentists using the Community Periodontal Index. Nutrient intakes were estimated by the 24-hour dietary recall. Consumption frequencies of foods were from the food frequency questionnaire. Subjects were categorized into 'smoking' or 'non-smoking' groups. Multiple logistic regression analysis was applied to determine the association between diet and periodontitis. The proportions of subjects having periodontitis were 26% in the non-smoking group and 37.5% in the smoking group. In the nonsmoking group, intakes of fruits, dairy products, green tea, energy and vitamin C were inversely associated with the prevalence of periodontitis, but fish and coffee intakes were positively associated with the prevalence of periodontitis after adjusting for covariates. In the smoking group, protein and retinol intakes were inversely associated with the prevalence of periodontitis after adjusting for covariates. These results suggest that certain food and nutrient intakes such as fruits, dairy products, green tea, vitamin C, protein, or retinol intakes may affect the prevalence of periodontitis among Korean adults. Further studies are required to confirm these findings in other research settings.

• Imaging Science in Dentistry
• /
• 제52권4호
• /
• pp.383-391
• /
• 2022

Purpose: Periodontitis, the most prevalent chronic inflammatory condition affecting teeth-supporting tissues, is diagnosed and classified through clinical and radiographic examinations. The staging of periodontitis using panoramic radiographs provides information for designing computer-assisted diagnostic systems. Performing image segmentation in periodontitis is required for image processing in diagnostic applications. This study evaluated image segmentation for periodontitis staging based on deep learning approaches. Materials and Methods: Multi-Label U-Net and Mask R-CNN models were compared for image segmentation to detect periodontitis using 100 digital panoramic radiographs. Normal conditions and 4 stages of periodontitis were annotated on these panoramic radiographs. A total of 1100 original and augmented images were then randomly divided into a training (75%) dataset to produce segmentation models and a testing (25%) dataset to determine the evaluation metrics of the segmentation models. Results: The performance of the segmentation models against the radiographic diagnosis of periodontitis conducted by a dentist was described by evaluation metrics(i.e., dice coefficient and intersection-over-union [IoU] score). MultiLabel U-Net achieved a dice coefficient of 0.96 and an IoU score of 0.97. Meanwhile, Mask R-CNN attained a dice coefficient of 0.87 and an IoU score of 0.74. U-Net showed the characteristic of semantic segmentation, and Mask R-CNN performed instance segmentation with accuracy, precision, recall, and F1-score values of 95%, 85.6%, 88.2%, and 86.6%, respectively. Conclusion: Multi-Label U-Net produced superior image segmentation to that of Mask R-CNN. The authors recommend integrating it with other techniques to develop hybrid models for automatic periodontitis detection.

• Journal of Periodontal and Implant Science
• /
• 제54권1호
• /
• pp.37-43
• /
• 2024

Purpose: The inflammatory response due to inflammatory cytokines, bacterial pathogens, and the altered lipoprotein metabolism in patients with periodontitis indicates that infection with periodontal anaerobic bacteria may influence atherogenesis in vitro and in vivo. We aimed to explore the effect of periodontitis concerning clinical and ultrasound markers of early atherosclerosis. Methods: In this case-control study, a total of 30 systemically healthy adults (15 with periodontitis and 15 without periodontitis) over 40 years of age were studied. Periodontitis was determined by measuring the clinical attachment level (CAL) and radiographic bone loss (RBL). Conventional cardiovascular risk factors, including body mass index, serum levels of total cholesterol (TCH), triglycerides (TG), and high-density and low-density lipoprotein (HDL and LDL, respectively) cholesterol were evaluated. Carotid artery intima-media thickness (IMT) was measured using ultrasonography. Results: The mean values of the CAL and carotid IMT were 5.02±0.9 mm and 0.084±0.01 cm vs. 1.6±0.61 mm and 0.072±0.02 cm in the periodontitis and healthy groups, respectively, reflecting statistically significant differences (P=0.001 and P=0.037, respectively). There were statistically significant differences in the serum levels of TCH, TG, and LDL between the 2 groups (P=0.017). The CAL and RBL were positively associated with carotid IMT and serum cholesterol levels, except for HDL, whereas tooth loss was not associated with any markers (P<0.05). Compared to the healthy group, participants with periodontitis exhibited 2.09 times higher odds (95% confidence interval, 1.22-3.59) of having subclinical atherosclerosis. Conclusions: The presence of periodontitis increased the risk of atherosclerosis.

• Journal of Periodontal and Implant Science
• /
• 제29권1호
• /
• pp.95-102
• /
• 1999

The purpose of this study was to observe histopathologically the influence of advanced periodontitis on pulp tissue, and to conclude the correlation between the results with clinical manifestations. The samples were teeth with over 7mm pocket depth and over 50% radiographic bone loss. These were diagnosed to have very poor prognosis and thus planned to be extracted. Those with any of following conditions were excluded from the samples, loss of vitality, periapical pathology, restoration or prosthesis, dental caries, and attrition or abrasion. It was because these conditions could affect pulp without any correlation with periodontal disease. For the experiment, 17 teeth from 11 patients were selected. Average age of patient was 47. Each tooth was examined for following categoris; pocket depth, gingival recession, electric pulp test, mobility, percussion test, sensitivity test. The extracted teeth were fixed buffered neutral formalin solution. It was decalcified using 4% nitric acid. Sliced histological samples observed using light microscope, for pulp status, and severeity of inflammation. 4 samples were excluded due to histologic sample discrepency. Thus 13 samples were subject to observation. 4 showed normal conditions. Focal reversable pulpitis was shown in 5 samples. Chronic pulpitis was observed 1 sample. Pulpal abscess was observed in 3 samples.

• Journal of Periodontal and Implant Science
• /
• 제44권1호
• /
• pp.20-24
• /
• 2014

Purpose: The aim of this clinical trial was to explore the impact of intentional passive eruption (IPE) using occlusal reduction on the periodontal parameters of teeth with moderate chronic periodontitis and traumatic occlusion. Methods: This study was performed on 40 teeth from 16 subjects. At baseline, 4 weeks after initial periodontal treatment, and 6 months after IPE, clinical and radiographic examinations were performed. The 20 teeth in the test group underwent IPE using occlusal reduction, whereas the 20 control teeth did not undergone occlusal reduction. Results: All the periodontal parameters were improved by the initial periodontal treatment. The teeth in the test group showed a significantly greater decrease in pocket depth, tooth mobility, and marginal bone loss than did the control group (P<0.05), but there were no significant changes in the attachment level. Significantly greater improvements in all the parameters were observed in the test group after 6 months of IPE compared to 4 weeks after the initial periodontal treatment (P<0.05). Conclusions: Within the limits of this study, performing initial periodontal therapy combined with IPE using occlusal reduction was shown to be very simple and effective. Moreover, IPE would be helpful in improving periodontal parameters.

• 대한구강악안면병리학회지
• /
• 제41권1호
• /
• pp.9-16
• /
• 2017

Porphyromonas gingivalis is a gram-negative bacteria of rod shape, and grown in an anerobic condition. It colonizes in subgingival crevice and is known as a major pathogen causing chronic periodontitis. It possesses an invasive property and replicative potential within various cell types, presumably playing an important role in modulating biological behaviors of oral cancer. However, the pathophysiology of P. gingivalis in the malignant transformation of oral cancer has not been fully understood. In this study, we aimed to investigate molecular changes of oral squamous cell carcinoma cells induced by repetitive P. gingivalis infection that clinically resembles chronic periodontitis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제47권6호
• /
• pp.445-453
• /
• 2021

Objectives: Periodontitis is the most common chronic disease that causes tooth loss and is related to systemic diseases such as cardiovascular disease and diabetes. An objective indicator of the current activity of periodontitis is necessary. Soluble forms of the receptor for advanced glycation end products (sRAGE) are markers that reflect the status of inflammatory diseases. In this study, the relationship between sRAGE and periodontitis was analyzed to determine whether it can be used to diagnose the current state of periodontitis. Patients and Methods: Eighty-four patients without any systemic diseases were diagnosed with periodontitis using three classifications of periodontitis. Demographics and oral examination data such as plaque index (PI), bleeding on probing (BOP) index, and probing pocket depth (PPD) were analyzed according to each classification. In addition, correlation and partial correlation between sRAGE and the values indicating periodontitis were analyzed. Results: In each classification, the level of sRAGE tended to decrease if periodontitis was present or severe, but this change was not statistically significant. sRAGE and periodontitis-related variables exhibited a weak correlation, among which the BOP index showed a relatively strong negative correlation (ρ=-0.20). Based on this, on analyzing the correlation between the BOP index and sRAGE in the group with more severe periodontitis (PPD≥5 mm group, severe group of AAP/CDC [American Academy of Periodontology/Centers for Disease Control and Prevention], periodontitis group of López), the correlation further increased (ρ=-0.23, -0.40, -0.50). Partial correlation analysis of the sRAGE and BOP index showed a stronger negative correlation (ρ=-0.36, -0.55, -0.45). Conclusion: sRAGE demonstrated a tendency to decrease upon increased severity of periodontitis according to the classifications used. Above all, the correlation with the BOP index, which reflects the current state of periodontitis, was higher in the group with severe periodontitis. This indicates that the current status of periodontitis can be diagnosed through sRAGE.