• Title/Summary/Keyword: Severe periodontal disease

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Diagnosis and treatment of teeth with primary endodontic lesions mimicking periodontal disease: three cases with long-term follow ups

  • Lim, Jae-Hyung;Lee, Ji-Hyun;Shin, Su-Jung
    • Restorative Dentistry and Endodontics
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    • v.39 no.1
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    • pp.56-62
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    • 2014
  • A tooth with primary endodontic disease that demonstrates a periodontal defect might be extracted because of misdiagnosis as severe periodontal disease or a vertical root fracture. The aim of this case report was to demonstrate the long-term survival of endodontically treated teeth, which had been initially considered unsavable. With meticulous evaluation including the patient's dental history, clinical and radiographic examinations, teeth with primary endodontic lesions could be differentiated and saved after proper root canal treatment. Pain history, vitality test, and radiographic examinations, as well as a general periodontal condition check with periodontal probing on an affected tooth, might be the key methods to differentiate endodontic pathosis from that of periodontal disease.

ALVEOLAR BONE RESORPTION IN PERIODONTAL DISEASE (치주질환에서의 치조골흡수)

  • Jo, Mu-Hyeon;Choe, Geun-Bae
    • The Journal of the Korean dental association
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    • v.19 no.3 s.142
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    • pp.279-282
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    • 1981
  • The authors observed the degree of alveolar bone resorption on the intraoral roentgenogram of 105 patients who were affected by periodontal disease, and following results were obtained. That is, the alveolar bone resorption due to the periodontal disease showed increased tendency as aging, and severe degree on the mandible in comparison with the maxilla, and revealed sere destruction on the area of mandibular incisors and maxillary molars.

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Low serum 25-hydroxyvitamin D levels, tooth loss, and the prevalence of severe periodontitis in Koreans aged 50 years and older

  • Kim, Hyunju;Shin, Min-Ho;Yoon, Suk-Ja;Kweon, Sun-Seog;Lee, Young-Hoon;Choi, Chang-Kyun;Kim, OkJoon;Kim, Young-Joon;Chung, HyunJu;Kim, Ok-Su
    • Journal of Periodontal and Implant Science
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    • v.50 no.6
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    • pp.368-378
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    • 2020
  • Purpose: Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss. Methods: Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008-2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions. Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed. Results: Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis. Conclusions: This population-based cross-sectional study indicates that low serum 25(OH) D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.

Healing pattern of the mucous membrane after tooth extraction in the maxillary sinus

  • Yoo, Ji-Young;Pi, Sung-Hee;Kim, Yun-Sang;Jeong, Seong-Nyum;You, Hyung-Keun
    • Journal of Periodontal and Implant Science
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    • v.41 no.1
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    • pp.23-29
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    • 2011
  • Purpose: To investigate the healing pattern of the mucous membrane after tooth extraction necessitated by periodontal disease in the maxillary sinus. Methods: One hundred and three patients with 119 maxillary sinuses were investigated. Before implant placement, cone-beam computed tomography (CT) scanning was performed. The causes of extraction, the time elapsed since extraction, smoking, periodontal disease in adjacent teeth, and gender were recorded. In addition, the thickness of the mucous membrane of the maxillary sinus and the height of residual alveolar bone at the extracted area were calculated from CT images. Results: The thickness of the mucous membrane in the periodontal disease group ($3.05{\pm}2.71\;mm$) was greater than that of the pulp disease group ($1.92{\pm}1.78\;mm$) and the tooth fracture group ($1.35{\pm}0.55\;mm$; P<0.05). The causes of extraction, the time elapsed since extraction, and gender had relationships with a thickening of the mucous membrane of the maxillary sinus (P<0.05). In contrast, the height of the residual alveolar bone at the extracted area, periodontal disease in adjacent teeth, and smoking did not show any relation to the thickening of the mucous membrane of the maxillary sinus. Conclusions: The present study revealed distinct differences in healing patterns according to the causes of extraction in the maxillary sinus, especially periodontal disease, which resulted in more severe thickening of the mucous membrane.

Charlson comorbidity index as a predictor of periodontal disease in elderly participants

  • Lee, Jae-Hong;Choi, Jung-Kyu;Jeong, Seong-Nyum;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.48 no.2
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    • pp.92-102
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    • 2018
  • Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

Recent Advances of Therapeutic Targets for the Treatment of Periodontal Disease

  • Kim, Woo Jin;Soh, Yunjo;Heo, Seok-Mo
    • Biomolecules & Therapeutics
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    • v.29 no.3
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    • pp.263-267
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    • 2021
  • Periodontal disease is primarily associated with bacterial infection such as dental plaque. Dental plaque, an oral biofilm harboring a complex microbial community, can cause various inflammatory reactions in periodontal tissue. In many cases, the local bacterial invasion and host-mediated immune responses lead to severe alveolar bone destruction. To date, plaque control, non-surgical, and surgical interventions have been the conventional periodontal treatment modalities. Although adjuvant therapies including antibiotics or supplements have accompanied these procedures, their usage has been limited by antibiotic resistance, as well as their partial effectiveness. Therefore, new strategies are needed to control local inflammation in the periodontium and host immune responses. In recent years, target molecules that modulate microbial signaling mechanisms, host inflammatory substances, and bone immune responses have received considerable attention by researchers. In this review, we introduce three approaches that suggest a way forward for the development of new treatments for periodontal disease; (1) quorum quenching using quorum sensing inhibitors, (2) inflammasome targeting, and (3) use of FDA-approved anabolic agents, including Teriparatide and sclerostin antibody.

Case Studies of Repair of Pathological Mandibular Fracture due to Periodontal Disease in Dogs (개에서 치주질환과 연관된 하악골절의 치료)

  • Shim, Kyung-Mi;Kim, Se-Eun;Yoo, Kyeong-Hoon;Bae, Chun-Sik;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.653-657
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    • 2007
  • A 12-year-old, intact female Toy Poodle and a 10-year-old, intact male Yorkshire terrier were referred with bilateral mandibular fractures, severe periodontal disease and teeth loss. In the second case, mandibular fractures were repaired with periodontal disease treatment. After a fallow-up period of 1 year, fracture healing was successful in the second case, however in the first case, bone healing was not satisfactory because mandibular fractures were repaired without the treatment of diseased teeth within the fracture line. Nonunion and inflammation of fracture sites, oral malodor confirmed in the first case and normal union of fracture sites observed in the second case. It suggests that the treatment of diseased teeth within the fracture line is mandatory for successful fracture healing.

ORTHOPANTOMOGRAPH STUDY OF THE ALVEOLAR BONE LEVEL ON PERIODONTAL DISEASE. (ORTHOPANTOMOGRAPH에 의한 치주병환자의 치조골흡수에 관한 연구)

  • Lee Ki Sik
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.2 no.1
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    • pp.41-46
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    • 1972
  • The author had measured the alveolar bone level of periodontal disease on 50 cases of orthopantomogram to detect the degree of alveolar bone resorption of both sexes of Korean. The results were obtained as follows; 1. Alveolar bone resorption of mesial and distal portion was similiar in same patient. 2. The order of alveolar bone resorption was mandibular anterior region, posterior region, canine and premolar region of both jaws. 3. The degree of alveolar bone destruction was severe in shorter root length than longer. 4. The degree of alveolar bone resorption was severe in forth decades.

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Relationship between Periodontal Disease and Chronic Kidney Disease: A Systematic Review of Cohort Studies (치주질환과 만성신장질환의 연관성: 코호트 연구에 대한 체계적 고찰)

  • Lee, Eun-Sun;Do, Kyung-Yi
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.160-167
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    • 2017
  • The purpose of this systematic review was to investigate the association between periodontal disease and chronic kidney disease. A search of Embase, PubMed and The Cochrane Library databases was performed up to April 17, 2016. Article selection was based on cohort study design and the study subjects were patients with periodontal disease or severe periodontal disease. The final result was development of chronic kidney disease and kidney function decrease based on the estimated glomerular filtration rate values. The quantitative synthesis of the final selected articles was assessed using Review Manager statistical analysis software. A fixed-effects model meta-analysis was performed to estimate the degree of association between periodontal disease and chronic kidney disease. The search strategy identified 3,018 potentially eligible articles, of these, four studies were finally selected for meta-analysis, revealing that periodontal disease was significantly associated with the risk of developing chronic kidney disease (odds ratio, 1.65; 95% confidence interval, 1.44~1.90; p<0.001). In order to prevent the development of chronic kidney disease and kidney function decrease it is important to prevent periodontal disease, as well as minimizing the traditional risk factors known to reduce the quality of life of patients and increase disease burden.

Associations of periodontal status in periodontitis and rheumatoid arthritis patients

  • Rovas, Adomas;Puriene, Alina;Punceviciene, Egle;Butrimiene, Irena;Stuopelyte, Kristina;Jarmalaite, Sonata
    • Journal of Periodontal and Implant Science
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    • v.51 no.2
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    • pp.124-134
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    • 2021
  • Purpose: The aim of this study was to assess the association between the clinical status of rheumatoid arthritis (RA) and periodontitis (PD) in patients diagnosed with PD and to evaluate the impact of RA treatment on the severity of PD. Methods: The study included 148 participants with PD, of whom 64 were also diagnosed with RA (PD+RA group), while 84 age-matched participants were rheumatologically healthy (PD-only group). PD severity was assessed by the following periodontal parameters: clinical attachment loss, probing pocket depth (PPD), bleeding on probing (BOP), alveolar bone loss, and number of missing teeth. RA disease characteristics and impact of disease were evaluated by the Disease Activity Score 28 using C-reactive protein, disease duration, RA treatment, the RA Impact of Disease tool, and the Health Assessment Questionnaire. Outcome variables were compared using parametric and non-parametric tests and associations were evaluated using regression analysis with the calculation of odds ratios (ORs). Results: Participants in the PD+RA group had higher mean PPD values (2.81 ± 0.59 mm vs. 2.58 ± 0.49 mm, P=0.009) and number of missing teeth (6.27±4.79 vs. 3.93±4.08, P=0.001) than those in the PD-only group. A significant association was found between mean PPD and RA (OR, 2.22; 95% CI, 1.16-4.31; P=0.016). Within the PD+RA group, moderate to severe periodontal disease was significantly more prevalent among participants with higher RA disease activity (P=0.042). The use of biologic disease-modifying antirheumatic drugs (bDMARDs) was associated with a lower BOP percentage (P=0.016). Conclusions: In patients with PD, RA was associated with a higher mean PPD and number of missing teeth. The severity of PD was affected by the RA disease clinical activity and by treatment with bDMARDs, which were associated with a significantly lower mean BOP percentage.