This trial aimed to evaluate the efficacy and safety of vitamin D supplementation on the residual moderate and deep pockets following nonsurgical periodontal therapy.
Malocclusion And Deleterious Oral Habits In South Indian Adolscent Population...DrHeena tiwari
This study evaluated the prevalence of malocclusion and associated oral habits in South Indian adolescents. The researchers assessed 1000 12-15 year olds using the Dental Aesthetic Index and found that 52% had some form of malocclusion. Deleterious oral habits were present in 21.2% of subjects and those with habits were more likely to have malocclusion than those without. Specific habits like tongue thrusting and mouth breathing were correlated with traits like crowding and open bite. The study concludes that malocclusion in this population is directly linked to the presence of oral habits.
Comparative Effects of Chewing Gums in Oral Health: An Original ResearchDrHeena tiwari
This study assessed the effects of sugar-free chewing gum on oral health by comparing plaque index and DMFT scores between patients who chewed gum daily versus a control group. Forty patients were divided into two groups - one using sugar-free gum for 20 minutes daily and a control group. Plaque index and DMFT scores were assessed monthly for both groups. The gum group showed significantly lower plaque accumulation and fewer caries incidents compared to the control group after two months. However, the benefits decreased after longer use, possibly due to decreased compliance. The study concluded that sugar-free gum can improve oral health when used regularly as an adjunct to brushing and flossing by stimulating saliva and reducing plaque and caries risk.
- The document describes three cases of patients with multiple impacted supernumerary teeth. Case 1 involved a patient with bilaterally impacted premolars and one horizontally impacted tooth. Case 2 had numerous impacted supernumerary teeth in both jaws. Case 3 had 6 impacted supernumerary teeth, four in the maxilla and two in the mandible.
- Supernumerary teeth can cause complications like impaction, delayed or ectopic eruption, and cyst formation. Treatment depends on the type, position and complications of each supernumerary tooth.
- The cause of supernumerary teeth is unclear but believed to involve both genetic and environmental factors. They are more common in men and the maxilla.
EVALUATION OF BREAST CANCER AND ITS RELATION WITH PERIODONTAL DISEASES: AN OR...DrHeena tiwari
This study evaluated the association between periodontitis and breast cancer in Brazilian women. 67 cases of breast cancer were compared to 134 age-matched controls. Cases had greater clinical attachment loss than controls. Women diagnosed with periodontitis had 2-3 times higher odds of breast cancer than those without periodontitis after adjusting for covariates. This suggests a significant association between periodontitis and increased risk of breast cancer.
ASTHMA CORRELATES AMONG ADOLESCENCE IN COUNTRY: AN ORIGINAL RESEARCHDrHeena tiwari
The document summarizes a study on asthma correlates among adolescents in a country. The study involved a cross-sectional survey of 1200 children to examine health risks and lifestyle factors. The results found that the prevalence of self-reported asthma was 8.2%. Asthmatic adolescents were more likely to be male, overweight or obese, consume soft drinks and energy drinks more frequently, and less likely to consume milk compared to non-asthmatic adolescents. The study aims to establish how lifestyle factors are associated with increased asthma incidence among adolescents.
Assessment of correlation of periodontitis in teeth adjacent to implant and p...Dr. Anuj S Parihar
Aims: The present study was conducted to determine correlation between peri‑implantitis and periodontitis in adjacent teeth. Materials and Methods: The present study was conducted on 58 patients with 84 dental implants. They were divided into two groups, group I (50) was with peri‑implantitis and group II (34) was without it. In all patients, probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) was calculated around implant, adjacent to implant and on contralateral side. Obtained data were statistically analyzed using statistical software IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp with one‑way analysis of variance. Results: Males were 30 with 52 dental implants and females were 28 with 32 dental implants. CAL was 5.82 ± 0.52 in group I and 3.62 ± 0.63 in group II (P = 0.001) around implants. PD was 4.28 ± 1.26 in group I and 2.20 ± 0.52
in group II around adjacent teeth (P = 0.002). PD around contralateral teeth was significant (P = 0.05) in group I (3.18 ± 1.01) and group II (2.71 ± 0.73). Conclusion: Periodontitis has negative effect on implant success. Teeth adjacent to dental implant plays an important role in deciding the success or failure of implant. Maintenance of periodontal health is of paramount importance for successful implant therapy.
Effectiveness of Low-Level Lasers in the Management of Recurrent Aphthous Sto...DrHeena tiwari
This study assessed the effectiveness of low-level lasers in treating recurrent aphthous stomatitis. 30 subjects with minor, major, or herpetiform aphthae were treated with lasers and their pain was evaluated using VAS scores. For all groups, pain was significantly less after 24 hours and further reduced at 72 hours compared to pre-treatment levels. At 1 week, pain scores were minimal or zero. The results demonstrated that low-level lasers provide effective pain relief and accelerated healing for recurrent aphthous stomatitis lesions.
Malocclusion And Deleterious Oral Habits In South Indian Adolscent Population...DrHeena tiwari
This study evaluated the prevalence of malocclusion and associated oral habits in South Indian adolescents. The researchers assessed 1000 12-15 year olds using the Dental Aesthetic Index and found that 52% had some form of malocclusion. Deleterious oral habits were present in 21.2% of subjects and those with habits were more likely to have malocclusion than those without. Specific habits like tongue thrusting and mouth breathing were correlated with traits like crowding and open bite. The study concludes that malocclusion in this population is directly linked to the presence of oral habits.
Comparative Effects of Chewing Gums in Oral Health: An Original ResearchDrHeena tiwari
This study assessed the effects of sugar-free chewing gum on oral health by comparing plaque index and DMFT scores between patients who chewed gum daily versus a control group. Forty patients were divided into two groups - one using sugar-free gum for 20 minutes daily and a control group. Plaque index and DMFT scores were assessed monthly for both groups. The gum group showed significantly lower plaque accumulation and fewer caries incidents compared to the control group after two months. However, the benefits decreased after longer use, possibly due to decreased compliance. The study concluded that sugar-free gum can improve oral health when used regularly as an adjunct to brushing and flossing by stimulating saliva and reducing plaque and caries risk.
- The document describes three cases of patients with multiple impacted supernumerary teeth. Case 1 involved a patient with bilaterally impacted premolars and one horizontally impacted tooth. Case 2 had numerous impacted supernumerary teeth in both jaws. Case 3 had 6 impacted supernumerary teeth, four in the maxilla and two in the mandible.
- Supernumerary teeth can cause complications like impaction, delayed or ectopic eruption, and cyst formation. Treatment depends on the type, position and complications of each supernumerary tooth.
- The cause of supernumerary teeth is unclear but believed to involve both genetic and environmental factors. They are more common in men and the maxilla.
EVALUATION OF BREAST CANCER AND ITS RELATION WITH PERIODONTAL DISEASES: AN OR...DrHeena tiwari
This study evaluated the association between periodontitis and breast cancer in Brazilian women. 67 cases of breast cancer were compared to 134 age-matched controls. Cases had greater clinical attachment loss than controls. Women diagnosed with periodontitis had 2-3 times higher odds of breast cancer than those without periodontitis after adjusting for covariates. This suggests a significant association between periodontitis and increased risk of breast cancer.
ASTHMA CORRELATES AMONG ADOLESCENCE IN COUNTRY: AN ORIGINAL RESEARCHDrHeena tiwari
The document summarizes a study on asthma correlates among adolescents in a country. The study involved a cross-sectional survey of 1200 children to examine health risks and lifestyle factors. The results found that the prevalence of self-reported asthma was 8.2%. Asthmatic adolescents were more likely to be male, overweight or obese, consume soft drinks and energy drinks more frequently, and less likely to consume milk compared to non-asthmatic adolescents. The study aims to establish how lifestyle factors are associated with increased asthma incidence among adolescents.
Assessment of correlation of periodontitis in teeth adjacent to implant and p...Dr. Anuj S Parihar
Aims: The present study was conducted to determine correlation between peri‑implantitis and periodontitis in adjacent teeth. Materials and Methods: The present study was conducted on 58 patients with 84 dental implants. They were divided into two groups, group I (50) was with peri‑implantitis and group II (34) was without it. In all patients, probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) was calculated around implant, adjacent to implant and on contralateral side. Obtained data were statistically analyzed using statistical software IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp with one‑way analysis of variance. Results: Males were 30 with 52 dental implants and females were 28 with 32 dental implants. CAL was 5.82 ± 0.52 in group I and 3.62 ± 0.63 in group II (P = 0.001) around implants. PD was 4.28 ± 1.26 in group I and 2.20 ± 0.52
in group II around adjacent teeth (P = 0.002). PD around contralateral teeth was significant (P = 0.05) in group I (3.18 ± 1.01) and group II (2.71 ± 0.73). Conclusion: Periodontitis has negative effect on implant success. Teeth adjacent to dental implant plays an important role in deciding the success or failure of implant. Maintenance of periodontal health is of paramount importance for successful implant therapy.
Effectiveness of Low-Level Lasers in the Management of Recurrent Aphthous Sto...DrHeena tiwari
This study assessed the effectiveness of low-level lasers in treating recurrent aphthous stomatitis. 30 subjects with minor, major, or herpetiform aphthae were treated with lasers and their pain was evaluated using VAS scores. For all groups, pain was significantly less after 24 hours and further reduced at 72 hours compared to pre-treatment levels. At 1 week, pain scores were minimal or zero. The results demonstrated that low-level lasers provide effective pain relief and accelerated healing for recurrent aphthous stomatitis lesions.
Modification of Distal Shoe- A Systematic Review & Meta AnalysisDrHeena tiwari
The document summarizes a systematic review of modifications to the distal shoe space maintainer. It analyzes 6 studies on modified distal shoe designs. The studies showed that the modifications provided stability, adjustability, and were well-accepted by patients. However, the quality of the studies was low and conclusions about the efficacy of the modifications were inconclusive due to a lack of clear reporting on outcomes. Further high-quality research is needed to establish the effectiveness of modified distal shoe space maintainers.
This study aimed to determine the prevalence of impacted maxillary canines in the Palestinian population visiting a dental center in Israel between 2006-2013. The researchers examined 4250 patient records and found an overall prevalence of impacted canines to be 3.7%, higher than previous studies. Specifically, the prevalence was 0.8% in males and 1.1% in females, suggesting a higher rate in females. Most impacted canines were palatally positioned. The results differed slightly from other studies, possibly due to differences in sample selection, study methods, and patient populations examined. Accurate assessment of an impacted canine's position is important to determine the appropriate treatment approach.
Dental implants in patients with type 2 diabetesssuser19a491
This document summarizes a clinical study on the outcomes of dental implants in patients with type 2 diabetes mellitus. The study included 41 patients who received a total of 141 dental implants to support overdentures. The success rates after 1 and 5 years were 97.2% and 94.4%, respectively. Most patients reported improved function with the new treatment. A high correlation was found between good mucosal health and improved function, but no correlation was found between failed implants and glucose levels. The results suggest that dental implants can provide satisfactory outcomes for selected patients with well-controlled type 2 diabetes.
EFFICACY OF FIXED VERSUS REMOVAL RETAINER POST ORTHODONTIC TREATMENT: A COMP...DrHeena tiwari
This study compared the efficacy of fixed versus removable retainers for maintaining orthodontic treatment outcomes over 4 years. 48 participants from an original randomized controlled trial were evaluated. Those with fixed retainers had lower irregularity scores on average (0.85mm increase) compared to removable retainers (1.47mm increase). After adjusting for confounding factors, the difference in irregularity between groups was statistically significant, with removable retainers having 1.64mm more irregularity on average. No other significant differences were found between groups for other metrics like inter-canine width. Compliance with removable retainers decreased over time. Fixed retainers maintained their position better, though some required repair. In conclusion, fixed retainers appeared to
This study examined the prevalence of impacted maxillary canines in the Arab population in Israel. The researchers reviewed records of 4250 patients and found 82 cases of impacted canines, a prevalence of 3.7%. Females had a higher prevalence than males, at 1.1% versus 0.8%. Most cases were unilateral, with the left side being more commonly impacted. The results suggest racial and genetic factors may influence canine impaction rates, as this population had a higher prevalence than previous studies in other areas. Early diagnosis and treatment of impacted canines can help guide them into proper alignment and avoid more complex treatment needs.
This systematic review and meta-analysis examined 28 nationally representative surveys from 13 countries on COVID-19 vaccination intentions. The key findings were:
1) Pooled data from March-October found 60% of people anticipated vaccinating and 20% expected to refuse vaccination, with 22% uncertain.
2) Vaccination intentions have declined over time as the pandemic has evolved, while refusal intentions have increased.
3) Demographic factors like being female, younger, lower income/education, and belonging to an ethnic minority were consistently associated with being less likely to intend to vaccinate.
Journal Club On LEVELS OF HIV-1 IN SUBGINGIVAL BIOFILM OF HIV-INFECTED PATIE...Shilpa Shiv
The document summarizes a study that evaluated levels of HIV-1 in the subgingival biofilm of HIV-infected patients. 41 HIV-infected subjects were divided into groups based on having detectable or undetectable levels of HIV-1 in their blood plasma. The study found that detectable HIV-1 was only observed in the subgingival biofilm of patients with detectable plasma viral loads. Detectable HIV-1 in the subgingival biofilm was associated with lower CD4+ T lymphocyte levels. The study suggests monitoring HIV-1 levels in the oral cavity could provide a non-invasive way to monitor viral load and immune status.
An insight into dental evidence as experts witnessLegalSaviour
Kindly Find the presentation presented by Dr. Shanmuganandham, Forensic Odontologist GeneXplore Diagnostics & Research Centre Pvt Ltd, Brazil in the National Webinar conducted on 12.05.2020 by Legal Saviour
Efficacy,and safety of intravenous zoledronic acid in treatment+of+pediatric+...Abdulmoein AlAgha
Zoledronic acid is an effective treatment for pediatric osteoporosis. A 13-year study of 131 children with primary or secondary osteoporosis found that intravenous zoledronic acid significantly reduced fractures, bone pain, and bone turnover markers. While acute side effects like fever and hypocalcemia occurred after the first infusion, no chronic adverse events were reported. Zoledronic acid should be considered as an important treatment for improving outcomes in pediatric osteoporosis.
This case report describes a rare case of non-syndromic oligodontia in a 13-year-old female patient who was missing six permanent teeth excluding third molars. Clinical examination and radiographs revealed agenesis of teeth 1.5, 2.5, 3.4, 3.5, 4.4, and 4.5. The patient had no history of syndrome or systemic disease. Oligodontia can cause significant dental issues and requires a multidisciplinary treatment approach. Genetic factors are known to play a role in tooth agenesis conditions like oligodontia.
Impact of Drains on the Postoperative Sequel Following Third Molar Surgery: A...DrHeena tiwari
This document summarizes a study that assessed the impact of rubber drains on postoperative outcomes following third molar surgery. The study involved 60 patients who underwent bilateral third molar removal, with a drain placed on one side but not the other. Parameters like pain, swelling, trismus and infections were evaluated and compared between sides. The results found no significant differences between sides in any parameter, suggesting drains do not provide benefits. While some past studies found drains reduced sequelae, this study's findings did not support positive effects of drains on postoperative recovery from third molar surgery.
This document provides an overview of potential adverse effects associated with medications used for fracture prevention, discussing whether these adverse effects are clinically relevant. It summarizes evidence related to adverse effects of calcium, vitamin D, bisphosphonates, denosumab, teriparatide, and strontium ranelate from various clinical trials and studies. It concludes with treatment recommendations regarding calcium and vitamin D intake and notes that while bisphosphonates and other antiresorptive medications can have adverse effects like osteonecrosis of the jaw or atypical fractures, their benefits in fracture prevention are still considered to outweigh these risks for most patients.
Regenerative Surgical Treatment of Furcation Journal PresentationDr. B.V.Parvathy
AIM
To evaluate the performance and the added values of surgical regenerative techniques in terms of tooth loss, furcation closure/conversion, horizontal bone level gain and other periodontal parameters of teeth affected by periodontitis-related furcation defects, at least 12 months after surgery.
1. Maxillofacial surgery deals with a wide range of procedures in the head and neck region including dental surgery, diagnosis and treatment of benign and malignant tumors, trauma surgery, and cosmetic surgery.
2. Oral infections are common in immunocompromised patients due to immunosuppression and can sometimes lead to systemic complications through mechanisms such as bacteremia and circulating toxins.
3. Chronic dry mouth is a frequent oral manifestation of immunosuppression and can result from conditions like Sjögren's syndrome or be caused by immunosuppressive drugs used for organ transplantation.
CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC FEMA...Mohamed A. Galal
Mohamed A. Galal ; Mushira A. Dahaba, ; Basma M. Zaki
and Hanaa M. Elshenawy. CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC FEMALES HAVING CHRONIC PERIODONTITIS. Cairo Dental Journal (30)Number (1), 1:10January, 2014.
—Chronic patients of spinal cord injury has been detected severe reduction of bone density. Patients with SCI show mostly osteopenia or osteoporosis of the hip and spine. Vitamin D deficiency may contribute to development of osteoporosis in SCI. So a study was conducted on 100 chronic SCI patients to find out status of correlation of Vitamine D and bone mineral density (BMD). Blood samples were collected and investigated routine biochemistry with serum 25(OH)D. DXA scan of hip and spine was also done. This study observed that 55% patients had suboptimal vitamin D. Positive correlation was found between vitamin D & bone mineral density. It is concluded from this study that monitoring of Serum 25(OH)D levels and annual surveillance of bone mineral density is crucial among persons with chronic SCI to reduce progression of osteoporosis and minimize the risk for further fractures. Keywords: 25(OH)D: 25 Hydroxy Vitamin D, DXA: Dual Energy X-Ray Absorptiometry, BMD: Bone Mineral Density.
Modification of Distal Shoe- A Systematic Review & Meta AnalysisDrHeena tiwari
The document summarizes a systematic review of modifications to the distal shoe space maintainer. It analyzes 6 studies on modified distal shoe designs. The studies showed that the modifications provided stability, adjustability, and were well-accepted by patients. However, the quality of the studies was low and conclusions about the efficacy of the modifications were inconclusive due to a lack of clear reporting on outcomes. Further high-quality research is needed to establish the effectiveness of modified distal shoe space maintainers.
This study aimed to determine the prevalence of impacted maxillary canines in the Palestinian population visiting a dental center in Israel between 2006-2013. The researchers examined 4250 patient records and found an overall prevalence of impacted canines to be 3.7%, higher than previous studies. Specifically, the prevalence was 0.8% in males and 1.1% in females, suggesting a higher rate in females. Most impacted canines were palatally positioned. The results differed slightly from other studies, possibly due to differences in sample selection, study methods, and patient populations examined. Accurate assessment of an impacted canine's position is important to determine the appropriate treatment approach.
Dental implants in patients with type 2 diabetesssuser19a491
This document summarizes a clinical study on the outcomes of dental implants in patients with type 2 diabetes mellitus. The study included 41 patients who received a total of 141 dental implants to support overdentures. The success rates after 1 and 5 years were 97.2% and 94.4%, respectively. Most patients reported improved function with the new treatment. A high correlation was found between good mucosal health and improved function, but no correlation was found between failed implants and glucose levels. The results suggest that dental implants can provide satisfactory outcomes for selected patients with well-controlled type 2 diabetes.
EFFICACY OF FIXED VERSUS REMOVAL RETAINER POST ORTHODONTIC TREATMENT: A COMP...DrHeena tiwari
This study compared the efficacy of fixed versus removable retainers for maintaining orthodontic treatment outcomes over 4 years. 48 participants from an original randomized controlled trial were evaluated. Those with fixed retainers had lower irregularity scores on average (0.85mm increase) compared to removable retainers (1.47mm increase). After adjusting for confounding factors, the difference in irregularity between groups was statistically significant, with removable retainers having 1.64mm more irregularity on average. No other significant differences were found between groups for other metrics like inter-canine width. Compliance with removable retainers decreased over time. Fixed retainers maintained their position better, though some required repair. In conclusion, fixed retainers appeared to
This study examined the prevalence of impacted maxillary canines in the Arab population in Israel. The researchers reviewed records of 4250 patients and found 82 cases of impacted canines, a prevalence of 3.7%. Females had a higher prevalence than males, at 1.1% versus 0.8%. Most cases were unilateral, with the left side being more commonly impacted. The results suggest racial and genetic factors may influence canine impaction rates, as this population had a higher prevalence than previous studies in other areas. Early diagnosis and treatment of impacted canines can help guide them into proper alignment and avoid more complex treatment needs.
This systematic review and meta-analysis examined 28 nationally representative surveys from 13 countries on COVID-19 vaccination intentions. The key findings were:
1) Pooled data from March-October found 60% of people anticipated vaccinating and 20% expected to refuse vaccination, with 22% uncertain.
2) Vaccination intentions have declined over time as the pandemic has evolved, while refusal intentions have increased.
3) Demographic factors like being female, younger, lower income/education, and belonging to an ethnic minority were consistently associated with being less likely to intend to vaccinate.
Journal Club On LEVELS OF HIV-1 IN SUBGINGIVAL BIOFILM OF HIV-INFECTED PATIE...Shilpa Shiv
The document summarizes a study that evaluated levels of HIV-1 in the subgingival biofilm of HIV-infected patients. 41 HIV-infected subjects were divided into groups based on having detectable or undetectable levels of HIV-1 in their blood plasma. The study found that detectable HIV-1 was only observed in the subgingival biofilm of patients with detectable plasma viral loads. Detectable HIV-1 in the subgingival biofilm was associated with lower CD4+ T lymphocyte levels. The study suggests monitoring HIV-1 levels in the oral cavity could provide a non-invasive way to monitor viral load and immune status.
An insight into dental evidence as experts witnessLegalSaviour
Kindly Find the presentation presented by Dr. Shanmuganandham, Forensic Odontologist GeneXplore Diagnostics & Research Centre Pvt Ltd, Brazil in the National Webinar conducted on 12.05.2020 by Legal Saviour
Efficacy,and safety of intravenous zoledronic acid in treatment+of+pediatric+...Abdulmoein AlAgha
Zoledronic acid is an effective treatment for pediatric osteoporosis. A 13-year study of 131 children with primary or secondary osteoporosis found that intravenous zoledronic acid significantly reduced fractures, bone pain, and bone turnover markers. While acute side effects like fever and hypocalcemia occurred after the first infusion, no chronic adverse events were reported. Zoledronic acid should be considered as an important treatment for improving outcomes in pediatric osteoporosis.
This case report describes a rare case of non-syndromic oligodontia in a 13-year-old female patient who was missing six permanent teeth excluding third molars. Clinical examination and radiographs revealed agenesis of teeth 1.5, 2.5, 3.4, 3.5, 4.4, and 4.5. The patient had no history of syndrome or systemic disease. Oligodontia can cause significant dental issues and requires a multidisciplinary treatment approach. Genetic factors are known to play a role in tooth agenesis conditions like oligodontia.
Impact of Drains on the Postoperative Sequel Following Third Molar Surgery: A...DrHeena tiwari
This document summarizes a study that assessed the impact of rubber drains on postoperative outcomes following third molar surgery. The study involved 60 patients who underwent bilateral third molar removal, with a drain placed on one side but not the other. Parameters like pain, swelling, trismus and infections were evaluated and compared between sides. The results found no significant differences between sides in any parameter, suggesting drains do not provide benefits. While some past studies found drains reduced sequelae, this study's findings did not support positive effects of drains on postoperative recovery from third molar surgery.
This document provides an overview of potential adverse effects associated with medications used for fracture prevention, discussing whether these adverse effects are clinically relevant. It summarizes evidence related to adverse effects of calcium, vitamin D, bisphosphonates, denosumab, teriparatide, and strontium ranelate from various clinical trials and studies. It concludes with treatment recommendations regarding calcium and vitamin D intake and notes that while bisphosphonates and other antiresorptive medications can have adverse effects like osteonecrosis of the jaw or atypical fractures, their benefits in fracture prevention are still considered to outweigh these risks for most patients.
Regenerative Surgical Treatment of Furcation Journal PresentationDr. B.V.Parvathy
AIM
To evaluate the performance and the added values of surgical regenerative techniques in terms of tooth loss, furcation closure/conversion, horizontal bone level gain and other periodontal parameters of teeth affected by periodontitis-related furcation defects, at least 12 months after surgery.
1. Maxillofacial surgery deals with a wide range of procedures in the head and neck region including dental surgery, diagnosis and treatment of benign and malignant tumors, trauma surgery, and cosmetic surgery.
2. Oral infections are common in immunocompromised patients due to immunosuppression and can sometimes lead to systemic complications through mechanisms such as bacteremia and circulating toxins.
3. Chronic dry mouth is a frequent oral manifestation of immunosuppression and can result from conditions like Sjögren's syndrome or be caused by immunosuppressive drugs used for organ transplantation.
CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC FEMA...Mohamed A. Galal
Mohamed A. Galal ; Mushira A. Dahaba, ; Basma M. Zaki
and Hanaa M. Elshenawy. CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC FEMALES HAVING CHRONIC PERIODONTITIS. Cairo Dental Journal (30)Number (1), 1:10January, 2014.
—Chronic patients of spinal cord injury has been detected severe reduction of bone density. Patients with SCI show mostly osteopenia or osteoporosis of the hip and spine. Vitamin D deficiency may contribute to development of osteoporosis in SCI. So a study was conducted on 100 chronic SCI patients to find out status of correlation of Vitamine D and bone mineral density (BMD). Blood samples were collected and investigated routine biochemistry with serum 25(OH)D. DXA scan of hip and spine was also done. This study observed that 55% patients had suboptimal vitamin D. Positive correlation was found between vitamin D & bone mineral density. It is concluded from this study that monitoring of Serum 25(OH)D levels and annual surveillance of bone mineral density is crucial among persons with chronic SCI to reduce progression of osteoporosis and minimize the risk for further fractures. Keywords: 25(OH)D: 25 Hydroxy Vitamin D, DXA: Dual Energy X-Ray Absorptiometry, BMD: Bone Mineral Density.
This study evaluated the clinical outcomes and properties of periodontal ligament progenitor cells (PDLPs) for the treatment of periodontitis. Three patients with intrabony periodontal defects were treated by transplantation of autologous PDLPs cultured on a bone graft material. Clinical measurements over 32-72 months showed reduced probing depths and clinical attachment gains, indicating potential therapeutic benefits. In vitro analysis found that PDLPs showed characteristics similar to periodontal ligament stem cells (PDLSCs), including proliferation, mesenchymal surface marker expression, and multipotent differentiation, but lacked expression of the tendon marker scleraxis. This provides preliminary evidence that PDLP transplantation may be an effective and safe approach for periodontitis
This study evaluated the effectiveness of pentoxifylline versus placebo in treating oral submucous fibrosis (OSF). 75 patients with OSF were divided into two groups - group A received placebo and group B received 400 mg of pentoxifylline daily for 7 months. Improvement was measured using symptom and sign scores. Group B showed significantly greater improvement in total scores compared to group A, indicating pentoxifylline was more effective at reducing symptoms and improving mouth opening. Pentoxifylline may help OSF by improving microcirculation and reducing inflammation. The study demonstrates pentoxifylline is superior to placebo for OSF treatment.
Vitamin D And Chronic Periodontitis – A Randomised Double Blinded Placebo Con...inventionjournals
Background: Vitamin D is crucial for a wide variety of organ systems; nevertheless, evidence has demonstrated that vitamin D deficiency may place subjects at risk for not only low mineral bone density /osteoporosis and osteopenia but also infectious and chronic inflammatory diseases Vitamin D also has anti-inflammatory effects by suppressing pro-inflammatory cytokines through its effect on bone and mineral metabolism, innate immunity and several VDR gene polymorphisms, vitamin D has been reported to be associated with periodontal disease. Objectives: To assess anti-inflammatory effect of vitamin D3, when administered as monotherapy in generalised chronic periodontitis. Methods: This study comprises of 56 patients of generalised chronic periodontitis who were screened for their serum vitamin D3 levels. Out of which 30 patients who were vitamin D3 deficient (<20ng /><0.002)><0.000). Conclusion: Vitamin D deficiency may place subjects at risk for not only low bone mineral density/osteoporosis and osteopenia, but also infectious and chronic inflammatory diseases like periodontitis.
Vitamin D And Chronic Periodontitis – A Randomised Double Blinded Placebo Con...inventionjournals
Background: Vitamin D is crucial for a wide variety of organ systems; nevertheless, evidence has demonstrated that vitamin D deficiency may place subjects at risk for not only low mineral bone density /osteoporosis and osteopenia but also infectious and chronic inflammatory diseases Vitamin D also has anti-inflammatory effects by suppressing pro-inflammatory cytokines through its effect on bone and mineral metabolism, innate immunity and several VDR gene polymorphisms, vitamin D has been reported to be associated with periodontal disease. Objectives: To assess anti-inflammatory effect of vitamin D3, when administered as monotherapy in generalised chronic periodontitis. Methods: This study comprises of 56 patients of generalised chronic periodontitis who were screened for their serum vitamin D3 levels. Out of which 30 patients who were vitamin D3 deficient (<20ng /><0.002)><0.000). Conclusion: Vitamin D deficiency may place subjects at risk for not only low bone mineral density/osteoporosis and osteopenia, but also infectious and chronic inflammatory diseases like periodontitis.
This document describes a retrospective study conducted at a tertiary care center that analyzed data on cases of osteomyelitis from 2006 to 2016. The study found that the number of female patients was equal to male patients, and most patients were between 30-45 years old. Unlike typical presentations where the mandible is more commonly affected, this study found that the maxilla was more commonly involved than the mandible. The posterior region of the maxilla was more frequently affected than the anterior region. The study aims to help optimize local treatment protocols by assessing epidemiological data from this specific tertiary care center.
The document discusses risk assessment for dental implant treatment. It finds that poor oral hygiene, a history of periodontitis, and cigarette smoking are strong risk indicators for peri-implant disease based on evidence from experimental and clinical studies. Future prospective studies are still needed to confirm these factors as true risk factors. The review also identifies that probing depth, bleeding on probing, and suppuration should be regularly assessed to diagnose peri-implant diseases, and radiographs are required to evaluate bone levels around implants.
This document summarizes the outcomes of regenerative endodontic procedures. It finds that regenerative endodontic procedures (REPs) are generally more successful at resolving symptoms of apical periodontitis compared to apexification. REPs also typically result in greater increases in root length and thickness compared to apexification. However, the degree of additional root development from REPs can vary significantly depending on factors like the cause of pulp necrosis. Long-term survival rates of teeth treated with REPs or apexification are still unclear due to a lack of large, long-term studies. Return of pulp vitality is achieved in around half of REP cases.
This study investigated the effect of four types of pediatric medications (analgesics, antibiotics, anticonvulsants, multivitamins) on the color stability of two restorative materials (composite resins and glass ionomer cements). Specimens of each material were exposed to solutions of each medication type and color changes were measured. Statistical analysis found significant color changes in both materials exposed to analgesics and anticonvulsants compared to controls. Exposure to antibiotics and multivitamins did not significantly affect color. The study suggests certain pediatric medications can influence the color stability of tooth-colored restorations over time.
Validity of Clinical Attachment Loss for Diagnosis of Osteoporosis in Postmen...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The document summarizes three studies on controlling oral health in diabetic patients with chronic periodontitis. The studies found that regular dental visits, nonsurgical periodontal therapy, and proper oral hygiene care like brushing and flossing can significantly improve oral health conditions and metabolic markers. Compliant patients saw reductions in plaque, probing depths, cholesterol, triglycerides, and HbA1c levels. The document concludes dental hygienists should educate clients on the importance of daily oral hygiene and frequent dental visits to help diabetics better manage their overall health.
This seminar explains various periodontal risk assessment tools at subject, tooth and site level risk assessment. Also, SPT with adjunct use of antimicrobials by professional and to be used by personals. Maintenance care for the implant patients has also been described with different conditions. The role played by dentist and by patient is being explained in flowcharts. And at last complications during SPT is described with references.
Role of Serum Zinc and Copper in Children with Gastroenteritisiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study evaluated the effects of nonsurgical periodontal therapy alone or in combination with diode laser therapy on clinical parameters and tumor necrosis factor-alpha (TNF-α) levels in patients with chronic periodontitis. 22 patients received scaling and root planing either with or without subsequent laser pocket decontamination. Clinical measurements and TNF-α levels from gingival crevicular fluid were assessed at baseline and 1 week, 1 month, and 3 months post-treatment. Both treatments significantly improved clinical parameters from baseline to 3 months. Laser therapy further reduced TNF-α levels at 1 month compared to nonsurgical therapy alone, but this effect was not sustained at 3 months. The study concluded that laser therapy provides additional short-term
This document summarizes several studies that demonstrate the relationship between oral health and overall health. Multiple studies found that tooth loss is associated with atherosclerotic plaque buildup in arteries. Periodontal treatment was shown to improve outcomes for patients with diabetes such as blood sugar control and inflammation. Higher levels of C-reactive protein, a marker for cardiovascular disease, were found in people with periodontal infections or periodontitis. Reducing oral biofilm through practices like brushing, flossing and using xylitol was shown to reduce inflammatory markers and potentially help conditions like COPD. The document advocates for reducing oral biofilm and increasing access to dental hygienists to improve overall health and save on medical costs.
Scaling and root planing (SRP) is a non-surgical treatment for periodontitis that aims to remove dental plaque and calculus from tooth surfaces. It involves scaling to remove deposits and root planing to smooth root surfaces. The goals are to eliminate periodontitis by removing irritants and restoring a healthy environment for tissue healing. The long-term effectiveness depends on factors like patient compliance, disease severity, and anatomical challenges. Overhanging restorations can interfere with cleaning and disturb the ecological balance, allowing disease-causing bacteria to proliferate.
- Epidemiology is the study of the distribution and determinants of health-related states or events, including diseases. Epidemiology of prosthodontics examines topics like edentulism, temporomandibular disorders, alveolar ridge resorption, and their prevalence, etiology, and socio-economic factors.
- The prevalence of edentulism varies globally, from 4.9% in the United States to 21.7% in Mexico. Common causes of tooth loss include caries, periodontal disease, trauma, and socio-economic factors like education and income level. Habits like smoking also increase risk of periodontal disease.
- Alveolar ridge resorption
1) Epidemiology is the study of health and disease in populations and how these states are influenced by various factors such as biology, heredity, environment, and behavior. 2) Advances in research have changed our understanding of periodontal diseases - they are now known to not present as a linear progression and are influenced by host susceptibility and risk factors rather than just being age dependent. 3) Epidemiological studies seek to identify risk factors for periodontal diseases, quantify their strength, and determine if associations are causal to help guide treatment protocols.
CONSCIOUS SEDATION USE ON ANXIETY REDUCTION, AND PATIENT AND SURGEON SATISF...Dr. B.V.Parvathy
EFFECT OF CONSCIOUS
SEDATION USE ON ANXIETY REDUCTION, AND PATIENT
AND SURGEON
SATISFACTION IN DENTAL
IMPLANT SURGERIES: A
SYSTEMATIC REVIEW AND META-ANALYSIS
Orthodontics-Periodontics Relationship
ntroduction
Biological basis for orthodontic therapy
Periodontal tissue response to orthodontic force
Effects of orthodontic tooth movement on the periodontium
Orthodontic tooth movement in adults with periodontal tissue breakdown
Specific factors associated with orthodontic tooth movement
Implants and orthodontic therapy
Systematics of combined ortho – perio treatment
Periodontally Accelerated Osteogenic Orthodontics (PAOO)
Minor periodontal surgery and orthodontic treatment
Review of literature
To evaluate the effects of B. lactis HN019 on clinical periodontal parameters (plaque accumulation and gingival bleeding), on the immunocompetence of gingival tissues [expression of BD-3, Toll-like receptor 4 (TLR4), cluster of differentiation (CD)-57 and CD-4], and on immunological properties of saliva (IgA levels) and adhesion to buccal epithelial cells and antimicrobial properties in non-surgical periodontal therapy in GCP patients.
The document discusses tissue engineering and its application in periodontal regeneration. It describes the key elements of tissue engineering which include progenitor/stem cells, scaffolds, and signaling molecules. It discusses various sources of progenitor cells for periodontal tissues, methods of scaffold fabrication, and growth factors used to enhance regeneration such as PDGF and BMPs. Studies evaluating the efficacy of different scaffold-growth factor combinations for achieving periodontal regeneration are also mentioned.
To evaluate the efficacy of the GPCS for palatal hemostasis during and after the FGG harvesting procedure.
A secondary objective was to evaluate if the placement of the suture improved the operator
visibility thereby reducing the surgical time.
Comparative study of DFDBA and FDBA block grafts.pptxDr. B.V.Parvathy
To evaluate and compare the effectiveness of demineralized freeze dried block graft and freeze dried block graft with chorion membrane as barrier membrane clinically and radiographically for the treatment of residual deep intra bony defects.
Abstract
Focused Clinical Question: Debates and questions related to the newly developed two-vector system
for classification of periodontal diseases have emerged as to how to accurately assign stage and grade
to the periodontitis cases. The aim of the present manuscript is to demonstrate the essential thought
processes that are needed in utilizing the new periodontitis classification system to diagnose two gray
zone cases.
Summary: Clinical case 1 includes an 83-year old patient diagnosed with periodontitis and classified as
Generalized Stage III Grade B periodontitis, while clinical case 2 , a 73-year old male was classified as
presenting Generalized Stage IV Grade B periodontitis. Although clinical and radiographic evaluations
revealed similarities between the cases, the thought process that includes clinical judgement is
described to guide a more accurate diagnosis following the guidelines of the new classification
system.
Conclusion: The two cases demonstrated here offer an opportunity for clinicians to recognize the
essential role of sound clinical judgment in certain cases when applying the new periodontal disease
classification system and also to clarify questions emerging from implementing this classification
system.
Key words: Staging and grading of periodontal diagnosis, Periodontal Diseases, Periodontal Diagnosis,
Abstract
Aim: The aim of this study was to determine whether the combined connective tissue
graft (CTG) with injectable platelet‐rich fibrin (i‐PRF) with coronally advanced flap
(CAF) improved root coverage of deep Miller Class I or II gingival recessions com‐
pared with CTG alone with CAF.
Material and Methods: Seventy‐two patients with Miller class I and II gingival reces‐
sions were enrolled. Thirty‐six patients were randomly assigned to the test group
(CAF+CTG+i‐PRF [700 rpm for 3 min]) or control group (CAF+CTG). Clinical evalua‐
tions were made at 6 months.
Results:At 6months, complete root coveragewas obtained at 88% of the sites treated
with CAF+CTG+i‐PRF and 80% of the sites treated with CAF+CTG. Difference be‐
tween the two groups was not statistically significant. At 6 months, the recession
depth (RD) reduction and increase in keratinized tissue height (KTH) of the test sites
were significantly better compared with the control sites.
Conclusions: According to the results, the addition of i‐PRF to the CAF+CTG treat‐
ment showed further development in terms of increasing the KTH and decreasing
RD. However, this single trial is not sufficient to advocate the true clinical effect of
i‐PRF on recession treatment with CAF+CTG and additional trials are needed.
KEYWORDS
connective tissue graft, injectable platelet‐rich fibrin, root coverage
This document provides an overview of trauma from occlusion including:
- Definitions from various dental organizations
- Etiology and types of occlusal forces that can cause trauma
- Historical perspectives on the study of occlusion and trauma
- Terminologies used to describe occlusal trauma
- Stages of tissue response to excessive occlusal forces
- Signs and symptoms of trauma from occlusion
- Classification systems for trauma from occlusion
- Examination and diagnosis techniques
- Radiographic signs of trauma
- Debate around reversibility of traumatic occlusion
- Considerations for trauma around dental implants
- Treatment approaches including occlusal adjustments and splinting
DEFINITION
INDICATION AND OBJECTIVES
PROCEDURES FOR INCREASING WIDTH OF ATTACHED GINGIVA
PROCEDURES FOR ROOT COVERAGE
TECHNIQUES FOR CORRECTION OF ABERRANT FRENUM
PAPILLA RECONSTRUCTION
RIDGE AUGMENTATION
PROCEDURES FOR INCREASING VESTIBULAR DEPTH
CROWN LENGTHENING PROCEDURES
The Efficacy of Pocket Elimination/Reduction Compared to Access Flap Surgery: A SystematicReview and Meta-analysis
To assess the efficacy and adverse effects of resective
surgery compared to access flap in patients with
periodontitis.
Impact of Different Surgical Protocols on Dimensional Changes of Free Soft Ti...Dr. B.V.Parvathy
To determine if there is a difference in the amount of shrinkage during
healing of free soft tissue autografts (FSTA) using different surgical
techniques—suturing the vestibular flap margin apically to the base of
the recipient bed versus leaving the flap margin free and unsutured.
i-prf &MN in gingival augmentation in thin phenotypeDr. B.V.Parvathy
To evaluate the effect of gingival thickness (GT) and keratinized tissue width (KTW) using injectable platelet rich fibrin (i-PRF) alone and with microneedling (MN) in individuals with thin periodontal phenotypes.
Local Treatment in Periodontal pocket Journal PresentationDr. B.V.Parvathy
It was a systematic review and network meta-analysis aimed to evaluate the efficacy of adjunctive locally delivered antimicrobials, compared to sub gingival instrumentation alone or plus a placebo, on changes in probing pocket depth (PPD) and clinical attachment level (CAL), in patients with residual pockets during supportive periodontal care.
2 Stage Crown Lengthening VS 1 Stage Journal PresentationDr. B.V.Parvathy
This randomized controlled trial aimed to assess the efficacy of a two-
stage crown lengthening intervention (SCL) in the aesthetic zone
compared with a one-stage crown lengthening procedure (CCL).
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Role of Mukta Pishti in the Management of Hyperthyroidism
Vit D Journal Presentation
1.
2. EFFECT OF SHORT-TERM VITAMIN D
SUPPLEMENTATION AFTER NONSURGICAL
PERIODONTAL TREATMENT: A RANDOMIZED,
DOUBLEMASKED, PLACEBO-CONTROLLED
CLINICAL TRIAL
Weimin Gao; Huilin Tang; Danyang Wang; Xuan Zhou;
Yiqing Song; Zuomin Wang
Presented By:
BEENA VIJAYAN PARVATHY
3. This trial aimed to evaluate the efficacy and safety of
vitamin D supplementation on the residual moderate and
deep pockets following nonsurgical periodontal therapy.
4. Periodontitis is one of the most common chronic inflammatory
diseases with an overall prevalence ranging from 10% to 90% in
adults.
If untreated, periodontitis may lead to loss of teeth and ultimately
result in edentulism, which has been shown to have a negative
impact on an individual's quality of life.
Vitamin D is classified as a secosteroid in which one of the rings
has been broken by ultraviolet B (UVB) sunlight and the main
source of vitamin D is de novo synthesis in the skin.
It is well known for its role in calcium homeostasis by
promoting calcium absorption in the intestine and stimulating
osteoblasts to enable normal bone growth and preservation.
5. RATIONALE OF THE STUDY
VITAMIN D AND PERIODONTAL HEALTH
More recent studies showed significant associations between
periodontal health and intake of vitamin D and calcium, and that
dietary supplementation with calcium and vitamin D may
improve periodontal health, increase bone mineral density in the
mandible and inhibit alveolar bone resorption.
In a recently published longitudinal study, Garcia et al reported
that calcium and vitamin D supplementation may reduce the
severity of periodontal disease if used at doses higher than 800-
1,000 IU daily and supported the rational for testing the potential
beneficial role of vitamin D on periodontal disease in randomized
clinical trials.
6. They also noted that vitamin D, in addition to its role in bone and
calcium homeostasis, acts as an anti-inflammatory agent because
it inhibits immune cell cytokine expression and causes
monocyte/macrophages to secrete molecules that have a strong
antibiotic effect. Indeed, vitamin D deficiency may be linked to
increased risk of infectious diseases.
This suggests that vitamin D may be of benefit in the treatment
of periodontitis, not only because of its direct effects on bone
metabolism, but also because it may have antibiotic effects on
periodontopathogens and inhibit inflammatory mediators that
contribute to the periodontal destruction.
7. Recent research indicates that with the help of certain enzymes,
gingival epithelial cells can convert inactive vitamin D (Vitamin
D3) to the active form (25(OH)D) in situ, which could have local
effect on periodontal tissue directly.
Menzel LP et al reported that treatment of gingival epithelial
cells with 25(OH)D inhibited the intracellular growth of P
gingivalis.
Topical application of both vitamin D3 and 25(OH)D to the
gingiva of mice led to rapid inhibition of IL-1α expression, a
prominent pro-inflammatory cytokine associated with
inflammation.
8. Liu K et al found that 25(OH)D concentrations in gingival
crevicular fluid were 300 times higher than those in the plasma of
patients with aggressive periodontitis.
Several observational studies reported that vitamin D levels were
inversely associated with gingivitis and periodontitis.
Additionally, vitamin D and calcium supplementation had a
modest positive effect on periodontal health.
9. STUDY DESIGN
This study was a one-center, randomized placebo-controlled,
double-blind parallel trial with 3 months of follow-up.
This study design included a pre-study phase of 3-month clinical
examination to screen patients and 3 months of interventional
period.
Patients with chronic periodontitis were screened and recruited
from the Department of Stomatology, Beijing Chao-Yang
Hospital, Capital Medical University between December 2014
and June 2015.
10. After 3 months of periodontal examination.
INCLUSION CRITERIA
Age between 30 and 70 years old.
More than 20 teeth remaining in the mouth.
Clinical diagnosis of moderate to severe periodontits.
Not receiving periodontal treatment within last 6 months.
Not taking antibiotic drugs within the previous 3 months.
DIAGNOSTIC CRITERIA
For moderate to severe periodontitis.
At least six sites for all teeth in the mouth with periodontal pocket
depth more than 6 mm, attachment loss(AL) more than 4 mm.
X-ray showing at least six sites with alveolar bone loss more than
one third of the root length.
11. EXCLUSION CRITERIA
Diabetes, thyroid, or parathyroid endocrine-associated diseases.
Severe systemic diseases, such as cancer.
Taking vitamin D and/or calcium drugs during the pre-study
phase.
Taking aspirin, non-steroidal anti-inflammatory drugs, or
steroids.
Pregnant or preparing to become pregnant within the previous
year.
Suffering from hypercalcemia and malabsorption syndrome.
STUDY POPULATION
The number of patients to be enrolled per group was calculated to
be 99. However, taking into account a possible dropout rate of
<20%, the final number of patients included in this trial was 120.
12. CLINICAL PROCEDURES
In the pre-study phase, patients‘ were collected with basic
information, including age, sex, height, weight, smoking history,
and preliminary periodontal status (eg, tartar, plaque, and stain).
All subjects were assigned to receive periodontal therapy
including oral hygiene instruction, supragingival scaling,
subgingival scaling, and root planing.
13. • Periodontal examinations were performed with Williams probe
one week after supragingival scaling to record plaque index (PLI),
probing depth (PD), bleeding index (BI), AL, tooth loss, and tooth
mobility.
•All patients received the same treatment procedures throughout
the study.
•After three months of nonsurgical periodontal therapy, clinical
examination was performed to select eligible patients.
•A total of 360 patients were randomly assigned to receive a
pillpack containing 90 capsules of 2000 IU vitamin D3, 1000 IU
vitamin D3, or placebo.
14. Participants were instructed to take one capsule daily and not to
provide any information to the study personnel about the
treatment assignments.
During the periods of intervention, the subjects were followed
up every month and asked to bring back the pillpacks.
Three months after the intervention, all subjects were followed
up at clinical visits and underwent periodontal examinations.
If the patients’ PD measurements ≥6 mm during follow-up,
periodontal surgery was suggested for those sites.
15. The primary outcome measure was AL, and the secondary
outcome measures included serum 25(OH)D levels, ACH, PD,
BI, and PLI.
Serum 25(OH)D levels were measured by vitamin D Direct Elisa
kit (Immunodiagnostic Systems Limited, IDS). To measure
serum 25(OH)D levels, 3 mL venous blood samples were drawn
by venipuncture after a 12-hours fast. After 1 hour coagulation,
serum was centrifuged and stored at −20°C.
Examinations of PD and AL included six sites on each tooth:
mesial buccal, buccal, distal buccal, mesial lingual, lingual, and
distal lingual.
16. Panoramic radiographs derived from CBCT data were used to
evaluate alveolar crest height (ACH).
The ACH is defined as the mean of the two-dimensional vertical
distance between mesial and distal alveolar crest to apical point.
BI was scored on a 0-5 scale when any visual evidence of
bleeding was noted.
PLI was scored on a 0-3 scale based on the method promoted by
Silness & Löe.
17. Statistical analysis
The normality of data distribution using the KolmogorovSmirnov
goodness-of-fit test, and data were expressed as mean ± standard
deviation (SD) for normally distributed continuous variables.
One-way analysis of variance (ANOVA) and NeumanKeuel test
were carried out to determine difference between groups and
changes during follow-up.
18. The last observation carried forward (LOCF) approach was used
to impute missing efficacy values.
All statistical analysis was performed using SPSS software
(version17.0; SPSS Inc).
A P value of P < .05 was considered statistically significant.
19. RESULTS
Total of 360 randomized patients, 323 patients finished the
therapy regime (vitamin D 2000 IU/d: n = 105; vitamin D 1000
IU/d: n = 110; placebo: n = 108). Thirty-seven patients withdrew,
giving a dropout rate of 10.3%.
There was a slight but significant decrease in AL and PD in both
vitamin D groups compared with placebo group for moderate and
deep pockets.
20. About 2000 IU/d vitamin D3 group, 1000 IU/d vitamin D3
group, and placebo group all decreased the AL for both moderate
pockets (−0.4 mm vs −0.4 mm vs −0.3 mm) and deep pockets
(−1.1 mm vs −1.1 mm vs −1.0 mm) (all P < .05). Similarly, PD
was also decreased in these three groups for both moderate
pockets and deep pockets (all P < .05). In addition, vitamin D
supplementation was well tolerated, and no adverse events were
reported.
21.
22. Baseline characteristics
Baseline characteristics of the participants
2000 IU/d
vitamin D (n
= 120)
1000 IU/d
vitamin D
(n = 120)
Placebo (n
= 120)
P-
value
Age, mean
(sd)
49 (5.4) 51 (6.3) 53 (5.2) 0.233
Gender, N (%)
Male 59 (49.2) 62 (51.6) 57 (47.5) 0.548
Female 61 (50.8) 58 (48.4) 63 (52.5) 0.632
Smoking, N
(%)
Smoker 13 (10.8) 11 (9.2) 9 (7.5) 0.374
Non-smoker 96 (80.0) 102 (85.0) 99 (82.5) 0.628
Past smoker 11(9.2) 7 (5.8) 12 (10.0) 0.541
23. Treatment effects
After 3 months of vitamin D supplementation treatment, there
was a dose-dependent decrease in the AL and PD for moderate
and deep pockets.
Vitamin D 2000 IU/d and 1000 IU/d provided a reduction in AL,
decreased 0.4 mm in both intervention groups on average,
compared with 0.3 mm in placebo group for moderate pockets (P
< .05); 1.1 mm in both intervention groups compared with 1.0
mm in placebo group for deep pockets (P < .05).
24. PD was also significantly decreased: by 0.5 mm and 0.3 mm in
vitamin D intervention groups and 0.2 mm in placebo groups for
moderate pockets (P < .05); 0.6 mm and 0.5 mm in vitamin D
intervention groups and 0.4 mm in placebo group for deep
pockets (P < .05).
The differences between intervention and placebo groups were
0.3 mm and 0.1 mm for moderate pockets; 0.2 mm and 0.1 mm
for deep pockets, which were also statistically significant
although the magnitude was modest.
No significant difference in changes of ACH and BI was
observed between treatment groups. Besides, the differences in
mean changes of PLI were not significant among groups.
25. DISCUSSION
Vitamin D supplementation may improve periodontal health and
may be used for treating moderate or severe periodontitis
adjunctively, which is consistent with several previous studies.
Krall et al found that patients over 65 years old who received
supplementation of 700 IU/d vitamin D and 500 mg/d calcium
for 3 years lost fewer teeth than a placebo group.
Hiremath et al found a dose-dependent anti-inflammatory effect
of vitamin D supplementation on gingivitis.
Vitamin D supplementation is safe and effective anti-
inflammatory agent in doses ranging from 500 IU/d to 2000 IU/d,
with an apparent earlier effect at the highest dose of 2000 IU per
day.
26. CONCLUSION
Although statistically significant differences were observed in
favor to vitamin D supplementation, the magnitude of effect size
tended to be modest with limited clinical relevance and the long-
term efficacy and safety warrant further investigation.
27. REFERENCES
1. Demmer RT, Papapanou PN. Epidemiologic patterns of chronic
and aggressive periodontitis. Periodontol 2000. 2010;53(1):28-
44.
2. Eke PI, Dye BA, Wei L, et al. Prevalence of periodontitis in
adults in the United States: 2009 and 2010. J Dent Res.
2012;91(10): 914-920.
3. Loe H, Anerud A, Boysen H, Smith M. The natural history of
periodontal disease in man. The rate of periodontal destruction
before 40 years of age. J Periodontol. 1978;49:607-620.
4. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal
diseases. Lancet. 2005;366:1809-1820.
28. 5. van Palenstein Helderman WH, Joarder MA, Begum A.
Prevalence and severity of periodontal diseases and dental caries
in Bangladesh. Int Dent J. 1996;46:76-812001;29:195-203.
6. Holtfreter B, Kocher T, Hoffmann T, Desvarieux M, Micheelis
W. Prevalence of periodontal disease and treatment demands
based on a German dental survey (DMS IV). J Clin Periodontol.
2010;37:211-219.
7. Jiang H, Su Y, Xiong X, et al. Prevalence and risk factors of
periodontal disease among pre-conception Chinese women.
Reprod Health. 2016;13:141.
8. Sheiham A, Steele JG, Marcenes W, Tsakos G, Finch S, Walls
AW. Prevalence of impacts of dental and oral disorders and their
effects on eating among older people; a national survey in Great
Britain. Community Dent Oral Epide.
.
29. 9. Strauss RP, Hunt RJ. Understanding the value of teeth to older
adults: influences on the quality of life. J Am Dent Assoc.
1993;124:105-110.
10. Yao SG, Fine JB. A review of vitamin D as it relates to
periodontal disease. Compend Contin Educ Dent. 2012;33:166-
171. miol.
11. Hayes CE, Nashold FE, Spach KM, Pedersen LB. The
immunological functions of the vitamin D endocrine system. Cell
Mol Biol (Noisy-legrand). 2003;49:277-300.
12. Bhalla AK, Amento EP, Serog B, Glimcher LH. 1,25-
Dihydroxyvitamin D3 inhibits antigen-induced T cell activation.
J Immunol. 1984;133:1748-1754.
30. 13. Mathieu C, Adorini L. The coming of age of 1,25-
dihydroxyvitamin D(3) analogs as immunomodulatory agents.
Trends Mol Med. 2002;8:174-179.
14. Rigby WF, Denome S, Fanger MW. Regulation of lymphokine
production and human T lymphocyte activation by 1,25-
dihydroxyvitamin D3. Specific inhibition at the level of
messenger RNA. J Clin Invest. 1987;79:1659-1664.
15. Schleithoff SS, Zittermann A, Tenderich G, Berthold HK,
Stehle P, Koerfer R. Vitamin D supplementation improves
cytokine profiles in patients with congestive heart failure: a
double-blind, randomized, placebo-controlled trial. Am J Clin
Nutr. 2006;83:754-759.
31. 16. Bikle DD. Vitamin D and immune function: understanding
common pathways. Curr Osteoporos Rep. 2009;7:58-63.
17. Kamen DL, Tangpricha V. Vitamin D and molecular actions on
the immune system: modulation of innate and autoimmunity. J
Mol Med (Berl). 2010;88:441-450.
18. Mora JR, Iwata M, von Andrian UH. Vitamin effects on the
immune system: vitamins A and D take centre stage. Nat Rev
Immunol. 2008;8:685-698.
19. Menzel LP, Ruddick W, Chowdhury MH, et al. Activation of
vitamin D in the gingival epithelium and its role in gingival
inflammation and alveolar bone loss. J Periodontal Res.
2019;54:444-452.
32. 20. McMahon L, Schwartz K, Yilmaz O, Brown E, Ryan LK,
Diamond G. Vitamin D-mediated induction of innate immunity
in gingival epithelial cells. Infect Immun. 2011;79:2250-2256.
21. Wang Q, Li H, Xie H, et al. 25-Hydroxyvitamin D3 attenuates
experimental periodontitis through downregulation of TLR4 and
JAK1/STAT3 signaling in diabetic mice. J Steroid Biochem Mol
Biol. 2013;135:43-50.
22. Liu K, Meng H, Tang X, et al. Elevated plasma calcifediol is
associated with aggressive periodontitis. J Periodontol.
2009;80:1114-1120.
23. Liu K, Meng H, Lu R, et al. Initial periodontal therapy reduced
systemic and local 25-hydroxy vitamin D(3) and interleukin-
1beta in patients with aggressive periodontitis. J Periodontol.
2010;81:260-266.
33. 24. Liu K, Meng H, Hou J. Activity of 25-hydroxylase in human
gingival fibroblasts and periodontal ligament cells. PLoS ONE.
2012;7:e52053.
25. Liu K, Meng H, Hou J. Characterization of the
autocrine/paracrine function of vitamin D in human gingival
fibroblasts and periodontal ligament cells. PLoS ONE.
2012;7:e39878.
26. Andrukhov O, Andrukhova O, Hulan U, Tang Y, Bantleon HP,
Rausch-Fan X. Both 25-hydroxyvitamin-D3 and 1,25-
dihydroxyvitamin-D3 reduces inflammatory response in human
periodontal ligament cells. PLoS ONE. 2014;9:e90301.
27. Abreu OJ, Tatakis DN, Elias-Boneta AR, et al. Low vitamin D
status strongly associated with periodontitis in Puerto Rican
adults. BMC Oral Health. 2016;16:89.
34. 28. Joseph R, Nagrale AV, Joseraj MG, Pradeep Kumar KM,
Kaziyarakath JA, Chandini R. Low levels of serum Vitamin D in
chronic periodontitis patients with type 2 diabetes mellitus: a
hospital-based cross-sectional clinical study. J Indian Soc
Periodontol. 2015;19:501-506.
29. Garcia MN, Hildebolt CF, Miley DD, et al. One-year effects of
vitamin D and calcium supplementation on chronic periodontitis.
J Periodontol. 2011;82:25-32.
30. Miley DD, Garcia MN, Hildebolt CF, et al. Cross-sectional
study of vitamin D and calcium supplementation effects on
chronic periodontitis. J Periodontol. 2009;80:1433-1439.
35. 31. Bashutski JD, Eber RM, Kinney JS, et al. The impact of
vitamin D status on periodontal surgery outcomes. J Dent
Res.2011;90:1007-1012.
32. Hiremath VP, Rao CB, Naik V, Prasad KV. Anti-inflammatory
effect of vitamin D on gingivitis: a dose-response randomised
control trial. Oral Health Prev Dent. 2013;11:61-69.
33. Krall EA, Wehler C, Garcia RI, Harris SS, Dawson-Hughes B.
Calcium and vitamin D supplements reduce tooth loss in the
elderly. Am J Med. 2001;111:452-456.
34. Pinto J, Goergen J, Muniz F, Haas AN. Vitamin D levels and
risk for periodontal disease: a systematic review. J Periodontal
Res. 2018;53:298-305.
36. 35. Peric M, Cavalier E, Toma S, Lasserre JF. Serum vitamin
D levels and chronic periodontitis in adult, Caucasian
population-a systematic review. J Periodontal Res.
2018;53:645-656.
36. Ramfjord SP, Caffesse RG, Morrison EC, et al. 4
modalities of periodontal treatment compared over 5 years. J
Clin Periodontol. 1987;14:445-452.
37. Hill RW, Ramfjord SP, Morrison EC, et al. Four types of
periodontal treatment compared over two years. J Periodontol.
1981;52:655-662.
38. Heitz-Mayfield LJ. How effective is surgical therapy compared
with nonsurgical debridement? Periodontol 2000. 2005;37(1):72-
87.
37. 39. Silness J, Loe H. Periodontal disease in pregnancy. II.
correlation between oral hygiene and periodontal condition. Acta
Odontol Scand. 1964;22:121-135.
40. Laky M, Bertl K, Haririan H, et al. Serum levels of 25-
hydroxyvitamin D are associated with periodontal disease. Clin
Oral Investig. 2017;21:1553-1558.
41. Boggess KA, Espinola JA, Moss K, Beck J, Offenbacher S,
Camargo Jr CA. Vitamin D status and periodontal disease among
pregnant women. J Periodontol. 2011;82:195-200.
42. Dietrich T, Joshipura KJ, Dawson-Hughes B, Bischoff-Ferrari
HA. Association between serum concentrations of 25-
hydroxyvitamin D3 and periodontal disease in the US population.
Am J Clin Nutr. 2004;80:108-113.
38. 43. Dietrich T, Nunn M, Dawson-Hughes B, Bischoff-Ferrari HA.
Association between serum concentrations of 25-hydroxyvitamin
D and gingival inflammation. Am J Clin Nutr. 2005;82:575-580.
44. American Geriatrics Society Workgroup on Vitamin D
Supplementation for Older Adults. Recommendations abstracted
from the American geriatrics society consensus statement on
vitamin D for prevention of falls and their consequences. J Am
Geriatr Soc. 2014;62:147-152.
45. EFSA Panel on Dietetic Products Nutrition and Allergies.
Dietary reference values for vitamin D. EFSA J. 2016;14:4547.
46. Anand N, Chandrasekaran SC, Rajput NS. Vitamin D and
periodontal health: current concepts. J Indian Soc Periodontol.
2013;17:302-308.