The gingiva as an indicator of general disease.
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BACKGROUND: The prevalence of periodontal diseases, gingivitis and periodontitis, is higher in diabetic patients and can have severe functional and esthetic consequences early in their lives. AIM: To evaluate the prevalence of periodontal disease in type 1 diabetics, aged between 18 and 30 years old, living in Santiago de Chile. SUBJECTS AND METHODS: One hundred male and female type 1 diabetics were examined. Glycated hemoglobin A1c, microalbuminuria, and fundoscopy were assessed in a sample of 52 subjects, separated in two groups according to the presence of periodontal disease. RESULTS: The prevalence of gingivitis was 22%, periodontitis 41%. Only 37% of subjects were free of periodontal disease. When compared with patients without periodontal disease, in the group of patients with the disease there was a higher proportion of subjects with diabetes lasting more than 10 years (28 and 55% respectively) and a higher proportion of patients with chronic complications of diabetes (42 and 58% respectively). CONCLUSIONS: A high prevalence of periodontal diseases was observed in this sample of diabetic patients. A long history of diabetes and the presence of chronic complications were risk factors for these diseases in the analyzed sample.
Gingival disease is very common in young population. The diagnosis of gingival and periodontal breakdown in children and adolescents, strongly needs an effective "screening" type of examination that can be employed by any pediatric dentist or general practitioner. The aim of this study was to demonstrate the clinical value of the PSR system in early detection of periodontal disease in children and adolescents and that there is a significant difference between PSR probe and William's probe in the time of probing and behavioral rating. A total of 26 patients from 3 to 20 years of age participated in the study that was taken in 2 sessions: PSR scoring system was used on the first session, on the second a Standard Evaluation. Time and acceptability were recorded in both sessions. The results showed a good clinical application of PSR in screening young patients, and no differences were seen between PSR and William's in diagnosis and clinical management. PSR took less time and was better accepted by the patients.
One hundred and twenty-four gingival crevicular fluid (GCF) samples were harvested from 13 healthy and 111 diseased gingival sites in 10 patients with periodontitis. The total amount and concentration of interleukin-1 beta (IL-1 beta) in each sample was measured by the enzyme-linked immunosorbent assay (ELISA) technique using an ELISA Kit specific for this cytokine. The IL-1 beta was undetectable in 23% of the GCF from clinically non-inflamed sites (three out of 13), while it could mostly be identified in diseased sites (109/111). The amount of IL-1 beta varied from 4.03 to 511.12 pg/site in diseased GCF samples. The average IL-1 beta amount from diseased sites was three-fold that from non-inflamed sites. Total IL-1 beta amount and the GCF volume were significantly increased with elevated gingival index (GI) score and deeper probing depth (PD). However, no significant difference of crevicular IL-1 beta concentration (pg/microL) could be found among groups with different clinical parameters. Our results indicate that IL-1 beta was present in the GCF of most clinically non-inflamed gingiva and almost all diseased pockets. The significant elevation of total IL-1 beta amount and GCF volume in diseased sulci suggests that it is closely associated with the severity of periodontal disease.
Recent studies have raised the possibility that natural killer (NK) cell activity may play a role in tissue destruction in chronic inflammatory periodontal disease (CIPD). This study aimed to locate and identify these cells in healthy and diseased gingival tissue. Leu 4, Leu 7, and Leu 11 monoclonal antibodies were used to characterize lesions of CIPD and to identify NK cells. Gingival tissue from three patient groups was examined. Group 1 subjects participated in a 21-day experimental gingivitis study. Group 2 subjects were children aged less than 8 years who had gingivitis associated with deciduous teeth. Group 3 consisted of patients with CIPD undergoing periodontal surgery. In group 1, NK cells were absent in health (Day 0) and gradually increased in number with increasing inflammation up to Day 21. The number and distribution of NK cells in Group 2 subjects resembled those seen after a 21-day experimental gingivitis study. In Group 3 subjects, lesions of CIPD which contained greater than 90% Leu 4+ cells ("T cell" lesions) contained few Leu 7+ cells and no Leu 11+ cells. The greatest number of NK cells were found in the "B cell" lesions (less than 60% Leu 4+ cells). The absence of NK cells in gingival health and their presence in diseased gingiva suggests that these cells are involved in the immune response to the accumulation of plaque.
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This paper is the transcription of the course of Dr. Jens Pindborg, from Denmark, on the Ateneo Argentino de Odontología, November 1988. The author provides current information on AIDS, epidemiologic factors, etiology, clinical and oral manifestations, associated diseases and treatment. Special emphasis are made in candidiasis lesions, gingival disease, oral viral Hairy leukoplakia and Kaposi's sarcoma.
There has been an effort by the dental profession working in the field of gingival and periodontal disease to find a method of recording the extent and degree of pathological change in tissues leading from gingivitis to periodontitis and to measure reversible as well as irreversible changes. It is obvious that some form of index is required and it should have the following well-defined criteria: (1) Simplicity, (2) Accuracy, (3) Quantitativeness, (4) Reproducibility, (5) Speed, (6) Objectivity, and (7) Amenability to statistical analysis. Indices, as well as determining the prevalence of disease in the group under investigation at a given period in time, must also provide information on incidence of disease, i.e. at different periods of time. Indices must also give data that make it possible to verify the nature, severity and aetiology of the disease process and to evaluate therapeutic measures. Indices yield information about the success or failure of control and prevention of disease, affecting the gingivae and the periodontal tissues. A review of methods of assessing and recording gingival and periodontal disease is presented starting from the early investigations of the century. It is shown that subsequently many variations evolved, often with the same inherent difficulties of interpretation or application. Usually the initial stages of inflammation of the gingivae are more difficult to recognize than established disease. Present methods of recording as objectively and as quickly as possible the gingival state in population groups are discussed with emphasis upon the necessity for providing effective preventive measures based upon assessment of schoolchildren.
The Population of 12-15 years is a key age group for oral health because the permanent dentition and periodontal tissues are almost complete at this stage. The purpose of this study was to evaluate oral health status and to develop an effective school dental health program for junior high schools students. The survey was performed on 527 persons aged 12-13 at 2 junior high schools in the suburbs of Chiba city. Periodontal disease was evaluated on the basis of the CPITN, and analyzed for severity and region of periodontal disease. Gingivitis was examined with PMA index, using color photo slides taken of anterior dentition at the time of inspection. At the same time, caries experience and oral hygiene index were also estimated. The results were as follows: (1) The mean DMFT was 3.89. Caries prevalence in females was higher than males. Ratio of treated teeth rate was 77.03%; that of untreated teeth rate was 22.65%. Females revealed less treatment for caries than males. Oral hygiene index showed significant difference between males and females. Labial and buccal parts of the maxillary and molar region on the mandibular showed remarkable plaque deposition. Calculus accumulation in this population was greatest on the lower incisor. (2) The mean PMA index was 7.36. Gingivitis was highly prevalent in both sexes, although it was more severe in males. There was correlations between PMA index and OHI. (3) From the results of CPITN, 10.6% of the subjects showed no signs of periodontal disease (Code 0), and 5.7% exhibited gingival bleeding (Code 1).(ABSTRACT TRUNCATED AT 250 WORDS)
Improved dental hygiene has decreased the incidence of dental caries and focused attention on periodontal diseases. Gingivitis is the inflammation and/or ulceration of gingival tissue caused by anaerobic bacteria. Ionizing radiation produces a variety of oxygen species from the water in our tissues; each is highly toxic for anaerobic. The hypothesis is: low dose irradiation should be an effective treatment for gingivitis.
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In this study, the gingival condition of patients with neutrophil dysfunction has been evaluated. The data demonstrate increased gingival disease as well as oral ulcerations in patients with neutrophil dysfunction syndromes and are consistent with a critical role of neutrophils in oral health.
The gingival crevicular fluid of a patient(s) with marginal periodontal disease contained an activity inhibitory to interleukin-1 (IL-1). The inhibitory activity could be detected after the depletion of IL-1 alpha by the use of a specific antibody (anti-human recombinant IL-1 alpha monoclonal antibody)-conjugated Sepharose column. The inhibitory activity was not due to a toxic effect on the thymocytes since IL-1 alpha-depleted gingival crevicular fluid did not affect the incorporation of [3H]thymidine in either the presence or absence of concanavalin A. The inhibitory activity was exerted against both IL-1 alpha and IL-1 beta. The inhibitory factor did not have any effect on IL-2-induced proliferation of concanavalin A-activated spleen cells. The inhibitor was heat labile. Gel filtration on a Superose 12 column revealed the IL-1 inhibitor to have two major peaks, one in the molecular size range of 12 to 14 kDa and the other below a molecular size of 10 kDa.