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Background: Numerous studies have proposed that periodontitis is a potential risk factor for Alzheimer's disease. However, the association between periodontitis and brain normal cognition in aged and elderly individuals (NCs) is unclear. Such a link could provide clues to Alzheimer's disease development and strategies for early prevention., Objective: To explore the associations between periodontal condition and metrics of both brain structure and function among NCs with the help of multimodal magnetic resonance imaging (MRI)., Methods: High-resolution T1-weighted structural data, resting-state functional-MRI data, and measures of periodontal condition were collected from 40 NCs. Cortical volume, thickness, and area as well as regional homogeneity were calculated with the aid of DPABISurf software. Correlation analyses were then conducted between each imaging metric and periodontal index., Results: Consistent negative correlations were observed between severity of periodontitis (mild, moderate, severe) and cortical volume, area, and thickness, not only in brain regions that took charge of primary function but also in brain regions associated with advanced cognition behavior. Among participants with mild attachment loss (AL) and a shallow periodontal pocket depth (PPD), periodontal index was positively correlated with most measures of brain structure and function, while among participants with severe AL and deep PPD, periodontal index was negatively correlated with measures of brain structure and function (all p < .005 for each hemisphere)., Conclusions: Our results demonstrate that periodontitis is associated with widespread changes in brain structure and function among middle-aged and elderly adults without signs of cognitive decline, which might be a potential risk factor for brain damage., (© 2023 The Authors. Journal of Periodontal Research published by John Wiley & Sons Ltd.)

Objectives: This study aimed to characterize the clinical, radiographic and histopathologic features of early-onset gingivitis (EOG) and periodontitis in cats., Methods: The medical records database was searched for cats diagnosed with histologically confirmed EOG or periodontitis from 1997 to 2022. Information such as medical history, lifestyle factors, clinical presentation, radiographic and histopathologic features were included for 27 client-owned cats. Response to treatment and long-term follow-up was also recorded., Results: Moderate-to-severe periodontal disease was radiographically confirmed in 78% (21/27) of cats with moderate-to-severe EOG, compared with the evidence of periodontal disease noted in 30% (8/27) of cases during awake oral examination. Horizontal bone loss, along with missing teeth, were the predominant radiographic features noted in 89% (24/27) of cases. The predominant histopathologic feature was moderate-to-severe, erosive-to-ulcerative, neutrophilic and lymphoplasmacytic inflammation with varying degrees of epithelial and stromal hyperplasia. Two cats developed feline chronic gingivostomatitis (FCGS)-like lesions, and seven cats exhibited worsening of aggressive periodontitis (AP). Lack of improvement in the severity of gingivitis or clinical signs evident at the first follow-up appointment was significantly associated with progression of disease ( P  = 0.004)., Conclusions and Relevance: The results of this study demonstrate the importance of oral evaluations in cats as early as 6 months of age. For cats exhibiting substantial gingivitis, an anesthetized evaluation, periodontal treatment and long-term monitoring are recommended. Given the high frequency of moderate-to-severe periodontitis encountered in these cats, clients should be informed about the potential need for tooth extractions. EOG may progress to AP. Finally, this study suggests that there could be a link between EOG and FCGS; however, further studies are needed to better characterize this condition and establish any potential link between the two entities.

Aim: To evaluate the correlation between standard clinical findings, radiographic (OPT) and magnetic resonance imaging (MRI) as well as to assess whether MRI is capable of providing additional information related to the severity and extent of periodontal disease., Methods: 42 patients with generalized periodontitis received pre-interventional MRI scans. These were compared to MR images of a periodontal healthy control group (n = 34). The extent of the osseous oedema, detected by MRI, was set in correlation with clinical periodontitis-associated findings., Results: A highly significant correlation between bone oedema and clinical testings such as probing depth (p < 0.0001) and bleeding on probing (p < 0.0001) was revealed. The oedema exceeded the extent of demineralized bone. Patients with a positive BOP test showed a 2.51-fold increase in risk of already having a bone oedema around the respective tooth even if probing depth was ≤3 mm (logistic binary regression analysis, OR 2.51; 95% CI: 1.54-4.11; p < 0.0001)., Conclusion: MRI findings correlated with standard clinical findings, and MRI was able to depict intraosseous changes before any osseous defect had occurred., (© 2021 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

Deepened periodontal pockets exert a significant pathological burden on the host and its immune system, particularly in a patient with generalized moderate to severe periodontitis. This burden is extensive and longitudinal, occurring over decades of disease development. Considerable diagnostic and prognostic successes in this regard have come from efforts to measure the depths of the pockets and their contents, including level of inflammatory mediators, cellular exudates and microbes; however, the current standard of care for measuring these pockets, periodontal probing, is an analog technology in a digital age. Measurements obtained by probing are variable, operator dependent and influenced by site-specific factors. Despite these limitations, manual probing is still the standard of care for periodontal diagnostics globally. However, it is becoming increasingly clear that this technology needs to be updated to be compatible with the digital technologies currently being used to image other orofacial structures, such as maxillary sinuses, alveolar bone, nerve foramina and endodontic canals in 3 dimensions. This review aims to summarize the existing technology, as well as new imaging strategies that could be utilized for accurate evaluation of periodontal pocket dimensions., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Periodontitis, an infective disease caused by oral pathogens and the intrinsic aging process, results in the destruction of periodontal tissues and the loss of alveolar bone. This study investigated whether Boesenbergia pandurata extract (BPE) standardized with panduratin A exerted anti-periodontitis effects, using an aging model representative of naturally occurring periodontitis. In aged rats, the oral administration of BPE (200 mg·kg -1 ·day -1 ) for 8 weeks significantly reduced the mRNA and protein expression of interleukin-1β, nuclear factor-kappa B, matrix metalloproteinase (MMP)-2, and MMP-8 in gingival tissues ( p < 0.01). In alveolar bone, histological analysis with staining and micro-computed tomography revealed the attenuation of alveolar bone resorption in the BPE-treated aged group, which led to a significant reduction in the mRNA and protein expression of nuclear factor of activated T-cells c1 (NFATc1), c-Fos, tartrate-resistant acid phosphatase, and cathepsin K ( p < 0.01). BPE not only increased the expression of osteoblast differentiation markers, such as alkaline phosphate, and collagen type I (COL1A1), but also increased the ratio of osteoprotegerin to RANKL. Collectively, the results strongly suggested that BPE is a natural resource for the prevention or treatment of periodontal diseases.

Aim: The aim of this study was to correlate radiographic examination with the clinical periodontal condition in cases of biologic width invasion by overextending restoration margins in restored premolars and molars., Materials and Methods: The present pilot study involved nine people (mean age 32 years) with biologic width invasion by 21 surfaces overextending restoration margins in restored premolars and molars. Radiographs were made in a standardized unit using the interproximal technique and were evaluated by a single calibrated investigator. The clinical periodontal parameters were analyzed with the use of a computerized periodontal probe. Exploratory analysis and Spearman's correlation were used to perform statistical analyses (SPSS, p < 0.05)., Results: The most prevalent teeth with biologic width invasion were second premolars and first molars. Mean plaque index was 30.76%, and bleeding on probing was 27.0%. The mesial surface was invaded in 47.6% of cases and the distal surface in 52.4%. The 21 sites with biologic width invasion were found in patients with the following periodontal status: periodontal health (11 sites), gingivitis (2 sites), mild periodontitis (7 sites) and moderate periodontitis (1 site). There was a correlation between plaque index and bleeding on probing with the horizontal component of the bone level., Conclusions: There was correlation between the radiographic parameters of biologic width invasion and clinical conditions. The measure of the bone crest level correlated with the gingival recession. The horizontal component of bone defect correlated with plaque index and bleeding on probing., (Copyright© by the International Academy of Periodontology.)

Objectives: Consideration of the causes of unilateral paranasal sinusitis, which frequently occurs in routine medical care and is often associated with odontogenic infection., Study Design: Retrospective data analysis., Methods: A review of the charts of all 190 patients treated for unilateral paranasal sinusitis at our department between 2005 and 2012 was carried out. All patients were diagnosed based on clinical signs, symptoms, and imaging findings, including computed tomography (CT), orthopantomography (OP), and other modalities. Patients were classified in three groups: patients with odontogenic infection involvement (Group A); patients without odontogenic infection involvement (Group B); and patients with inconclusive odontogenic infection involvement (Group C)., Results: The most common cause of unilateral paranasal sinusitis was odontogenic infection, as seen in 138 cases (72.6%), followed by chronic inflammation in 43 cases (22.6%). Among patients diagnosed with odontogenic infection, one patient was also diagnosed with coexistent polyps and mycosis. Based on CT, OP, EPT, and oral examination, final distribution was 138 patients (72.6%) in Group A, 32 (16.8%) in Group B, and 20 (10.5%) in Group C., Conclusions: Odontogenic infection involvement was implicated in approximately 70% cases of unilateral paranasal sinusitis. Odontogenic maxillary sinusitis can be difficult to diagnose, and consideration of imaging performed under various conditions is recommended. In order to determine the most appropriate treatment for unilateral paranasal sinusitis, whether such treatment will be surgery, dental treatment, conservative therapy, or other treatments, collaboration between concerned doctors is essential., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: The periodontal screening index (PSI) is an element of the initial dental examination. The PSI provides information on the periodontal situation and allows a first estimation of the treatment required. The dental panoramic tomography (DPT) indicates the proximal bone loss, thus also allowing conclusions on the periodontal situation. In this study, the results of both methods in determining the periodontal situation are compared., Methods: The clinical examination covered DMF-T, QHI, and PSI scores at four proximal sites per tooth; the examining dentist was unaware of the radiographic finding. Based on the PSI scores, the findings were diagnosed as follows: score 0 - 2 "no periodontitis", score 3 and 4 "periodontitis". Independent of the locality and time of the clinical evaluation, two dentists examined the DPTs of the subjects. The results were classified as follows: no bone loss = "no periodontitis", and bone loss = "periodontitis"., Results: 112 male subjects (age 18 to 58, Ø 37.7 ± 8 years) were examined. Regarding the PSI, 17 subjects were diagnosed "no periodontitis" and 95 subjects "periodontitis". According to the evaluation of the DPTs, 70 subjects were diagnosed "no periodontitis" and 42 "periodontitis". A comparison of both methods revealed that the diagnosis "no periodontitis" corresponded in 17 cases and "periodontitis" in 42 cases (53%). In 47% (53 cases) the results were not congruent. The difference between both methods was statistically significant (p < 0.001; kappa = 0.194)., Conclusion: The present study shows that the initial assessment of the periodontal situation significantly depends on the method of evaluation.

Aim: The aim of this study is first, to examine the prevalence, symmetry and spread of root proximity using the measurement tools and classification as described in part I of the study, and second to examine whether root proximity is a risk marker for periodontal disease., Material and Methods: The radiographs of 227 patients were examined. The study consisted of a study group of 197 patients with advanced periodontal disease with at least one site with bone loss more than one third of the root length and 30 controls without periodontal disease. Every inter-proximal space was assessed on the full-mouth radiographs and a score was assigned according to severity and location. Consequently prevalence of severity and location, symmetry, spread and an odds ratio and relative risk for periodontal disease was calculated., Results: Root proximity is a symmetrical and localized but widespread phenomenon in periodontal patients and to lesser extend in the non-periodontal control group. In periodontal patients root proximity was most often encountered in the coronal and intervening part whereas subjects without periodontal disease had more root proximity in the apical and intervening part where it is less critical. Subjects with bilateral root proximity had a 3.6 times higher chance to have periodontitis., Conclusion: Root proximity must be taken into consideration as a risk marker for periodontal disease.

Hemodynamic indices of blood circulation in gingival tissues in health and parodontal diseases were determined basing on ultrasonic Dopplerography data on linear and volumetric blood circulation flow rate. It is shown that changes in hemodynamics of tissual blood flow in initial inflammatory diseases are moderate (linear and volumetric blood circulation flow rate came down by 22-40%). In more severe inflammation in the parodontium and in cases of parodontosis changes in hemodynamics of tissual blood flow were more pronounced (linear and volumetric blood circulation flow rate came down by 56-80%).

Infantile congenital agranulocytosis or Kostmann syndrome is a rare hereditary kind of severe neutropenia. The typical symptoms, which appear since the first days of life, are abscesses located on various parts of the body: ear, cutis, lung and oral cavity. These abscesses are due to an almost total disimmunity typical of the neutropenia. The aim of this article is to describe the most typical signs of this pathology in the oral cavity, reporting a case observed in our department in Florence, Italy. On the basis of the personally observed case and of the review of the literature, it is possible to consider, as a characteristic finding in Kostmann syndrome, a typical very serious periodontal pathology, which is similar to the prepubertal periodontitis in deciduous dentition. At the age of 19 years the patient showed a dramatic compromise of the masticatory function. It is obvious that the lack of response of the host can obstruct the interaction between the host and the microbic flora, because the lack of neutrophils increases the susceptibility of the patient to every kind of infection, even to periodontitis. A periodontal prophylaxis, since the very first observations, followed by a rigorous maintenance with frequent and regular professional hygienic treatments could be effective in controlling the effects of periodontal disease and could reduce the tragic evolution. We need to recognise that it could be hard to monitor the oral situation correctly in these patients, as they have a continuously poor systemic condition. Finally in these cases the rehabilitative therapy is very problematical.

Between 1994 and 1999, 50 patients were treated with either profound parodontopathy (30) or periimplantitis (20). Half of each of the two groups of patients was treated conventionally, and the other half was treated with laser support. Before the operation, microbiological examinations were carried out, in addition to registering the clinical findings and taking x-rays. These procedures were repeated after the operation, and again after 6, 12, 24, 36, 48, and 60 months. The surgical part of therapy for each half of the patient groups included surface decontamination with diode laser light (1-watt output, maximum of 20 seconds) in addition to conventional procedures. The values of the laser-supported therapy were lower than those specified in the relevant literature. The relapse rate of the two diseases (13% for the periimplantitis and 23% for the parodontopathy group) after 5 years was lower than the comparative values of researched literature where decontamination was not included in the therapy. We think that integrating diode laser light decontamination in the approved treatment schemes for periimplantitis and parodontitis contributes considerably to the success of this therapy.

The aim of the study was to evaluate the periodontal conditions in patients treated more than 10 years ago for advanced periodontal disease and rehabilitated with cross-arch fixed partial dentures (FPDs). Of 50 randomly selected patients, 34 subjects carrying 43 FPDs agreed to participate in a clinical and radiographic follow-up examination. The FPDs were divided into three groups on the basis of prosthesis design (end abutments, unilateral cantilever, and bilateral cantilevers) and amount of supporting tissues at the time of bridge installation. Seventy per cent of the FPDs were found to be unchanged, whereas the rest had been modified due to various complications leading to extraction of one or more of the abutment teeth. Six FPDs (14%) had been partially replaced by FPDs anchored to osseointegrated dental implants. A total of 21 (8%) of the original 274 abutment teeth had been extracted. Longitudinal changes in the amount of periodontal support were minimal over the average of 15 years of follow-up. FPD design or initial amount of supporting tissues was found not to have significant influence on longitudinal changes in periodontal conditions. It was concluded that combined periodontal and prosthodontic treatment of patients with advanced loss of periodontal support may provide a high rate of long-term successful outcome, provided proper adequate periodontal and prosthetic treatment and maintenance care are given.

The maintenance of 172 patients who were treated and then attended a periodontal practice in Sydney, Australia for periods of at least 10 years has been surveyed. The results, expressed as loss of teeth over the maintenance period, have been compared with a 1978 study. Results of the two surveys have been compared for total tooth loss over the maintenance period, loss of individual tooth types, loss of teeth with furca lesions, and tooth loss relative to surgical experience. The comparative analysis is limited by the difference in total number of patients and by the duration of the studies. The proportionate division of patients into three groups according to tooth retention (well maintained, downhill, and extreme downhill) was statistically similar in both surveys. There were very few statistically valid differences in numbers of individual teeth lost between the two studies. Despite these comparable end results of long-term maintenance, the surgical experience was quite different, with the patients in our practice undergoing much more surgical treatment than those in the earlier report. The results appear to support the hypothesis that long-term maintenance is attainable for most periodontal patients, and is consistent with a variety of treatment approaches.

The relative mineral content per unit volume of bone in the alveolar bone crest was determined in 81 bone crests from 25 human autopsy cases by means of contact microradiography and videodensitometry of 100 microns thick sections. Each bone crest was divided in 4 areas: crestal, mesial, distal, and trabecular; and the relative mineral content was determined for each area. The data were analyzed statistically and it was found that the crestal area had a significantly lower mineral content than the other 3 areas. Histologically, the crestal area had a reduced number of Sharpey's fibers and it was speculated that these features lower the probability of restoring the natural crestal shape and the fiber reattachment, increasing the risk of bone loss. No correlation was found between relative mineral content and age or extent of inflammatory infiltration of the periodontal tissues.

Diagnostic radiographs are an invaluable aid to the diagnosis, treatment and monitoring of periodontal disease. However, their usefulness depends very much on minimised distortion of bone and tooth tissue images in an area of the body where the dental radiographer's knowledge, both of the local anatomy and the needs of the clinician, make a tremendous difference. In conclusion, radiographic bite-wings are the most accurate projections to demonstrate periodontal disease of the bone margins relative to the necks of the teeth. However, the roots of the teeth are not demonstrated. The OPG gives the best overall picture of the whole mouth and the film can be shown and explained to the patient. Paralleling projections may be still needed in certain areas of the mouth where greater detail is required. Some periodontologists still prefer full mouth paralleling films for their patients.

We report clinical, radiographic and historical data on a large family with an unusually high prevalence of periodontitis. The proband, a 20-year-old black male, had the classic features of juvenile periodontitis (JP). His father was periodontally normal, while his mother had lost all her teeth at age 27 because of rapidly progressive periodontitis (RP). In addition to the 13 living children the couple had had 2 miscarriages. Of the children, one had RP, five had JP and two had prepubertal periodontitis (PP). Both maternal grandparents of the proband had become edentulous at an early age, presumably because of early-onset periodontitis. Four of 10 siblings of the proband's mother had early-onset periodontitis. In contrast, the paternal grandparents did not have early-onset periodontitis nor was periodontitis unusually prevalent in the siblings of the proband's father. The pedigree for this family is consistent with, but does not prove, an X-linked dominant pattern of genetic transmission. The natural history of early-onset periodontitis and the relationship among PP, JP and RP are not understood. The fact that the mother of the proband had RP and she had offspring with RP, JP and PP indicates a close relationship among these diseases and argues in favor of a common underlying mechanism. JP was not preceded by PP in the proband nor his affected 21-year-old brother, but one sister had PP, and at age 15 manifested JP. In her case, the alveolar bone around the deciduous molars had been destroyed, but it regenerated as the permanent premolars erupted.(ABSTRACT TRUNCATED AT 250 WORDS)

In a total of 20 patients (of these 8 without parodontopathy and 12 with parodontitis marginalis profunda), a quantitative scintigraphy of the jaw bones was carried out after application of 99mTc-methylene diphosphonate with a gamma camera computer system. In 8 patients without parodontopathies, approximately the same metabolic activity in the bone was found in the os occipitale as well as in the mandible and maxilla. The 12 patients with parodontitis marginalis profunda showed in contrast to this an appreciable raised bone metabolism in the region of the affected jaw bone. This finding was in agreement with corresponding alterations in the X-ray of the jaw. The use of bone scintigraphy in marginal parodontopathies thus provides in addition to the radiological finding information on processes of bone transformation and degradation which can be registered quantitatively. Digital analysis enables control of the course of therapie.

The composition of subgingival plaque, from healthy and periodontally diseased regions, as well as the clinical periodontal condition of 6 patients, 17 to 24-years-old suffering from juvenile periodontitis were examined. 6 older patients with rapidly progressive periodontitis served as a control. Samples of subgingival plaque were taken from first molars and central incisors and were analysed morphologically by dark-field microscopy. In the control group in healthy regions the ratio between non-motile and motile bacteria was 27:1 and about 1:1 in deep pockets. In the juvenile periodontitis group in diseased regions, motile bacteria made up only 1/4 of the bacteria present. The results clearly show that our relatively old patients with juvenile periodontitis had a completely different microflora in their periodontally diseased regions than patients with common periodontitis. As regards our observations by dark-field microscopy, one can assume, however, that with increasing age, there might be a shift of the flora associated with juvenile periodontitis lesions from a rather simple composition to a more complex composition very similar to the flora seen in rapidly progressive adult periodontitis lesions.