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"ABSTRACTThe histological outcomes after nonsurgical periodontal treatment with enamel matrix derivatives (EMD) remain controversial. The present study evaluated periodontal wound healing after scaling and root planing (SRP) with subgingival application of EMD for treatment of experimental periodontitis. Periodontal breakdown was induced by applying silk ligatures around mandibular third and fourth premolars of six beagle dogs until radiographic bone loss progressed to approximately half of the root length. Probing pocket depth (PPD) and clinical attachment level (CAL) were proximally measured 2 weeks after ligature removal (baseline). Mesial and distal surfaces of the experimental teeth were subjected to SRP and randomized using a split-mouth design to subgingival application of EMD (test) or normal saline (control). PPD and CAL were re-evaluated at 11 weeks. Animals were sacrificed at 12 weeks for histological analyses. No significant differences were observed in PPD and CAL between both groups at baseline and at 11 weeks. Histologically, test sites exhibited a greater amount of new cementum than that did the control sites (p < 0.01). Moreover, the control sites revealed increased epithelial downgrowth compared with the test sites: (p < 0.05). On the other hand, no intergroup differences were detected in terms of bone position, connective tissue attachment, gingival recession, and planed root length. This study suggested that EMD has an increased potential to support formation of new cementum with decreased epithelial downgrowth when used as an adjunct to nonsurgical periodontal treatment."

"The present study investigated the effect of non-surgical periodontal therapy on serum level of anti-cardiolipin antibodies (aCLA), which are potentially involved in the pathogenesis of cardiovascular diseases in periodontal patients. Twenty volunteers (11 females and 9 males) with the mean age of 40.55 years participated in this study. Generalized chronic periodontitis was diagnosed through clinical periodontal examination at baseline visit. This examination included measuring the probing pocket depth and clinical attachment loss. Plaque index and gingival index were also recorded. After baseline examination, all the subjects received full-mouth non-surgical periodontal treatment. Subjects returned for a final visit 6 weeks after the last session of scaling for reevaluation of the periodontal parameters. At baseline and final visits 2 ml of venous blood was collected from each patient and an available commercially enzyme-linked immunosorbent assay was used for analyzing aCLA (IgM and IgG). The collected data were analyzed using the paired sample t test. Mean levels of both forms of aCLA, before and after treatment, showed statistically significant difference (P = 0.003 for IgM and P = 0.001 for IgG). In addition, study results showed significant reductions in periodontal parameters after non-surgical periodontal therapy (P < 0.001). The results of this study suggested that successful periodontal therapy can improve the serum level of one of the inflammatory biomarkers involved in the cardiovascular problems."

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Pendahuluan: Periodontitis berasal dari hasil interaksi antara biofilm bakteri dan respon imun pejamu. Treponema denticola merupakan salah satu bakteri yang paling banyak terdeteksi pada pasien dengan periodontitis kronis. Matrix metalloproteinase-8 merupakan faktor pejamu yang penting yang terlibat dalam patogenesis penyakit periodontal, yang merupakan MMP kolagenolitik. Tujuan: untuk mengevaluasi proporsi bakteri T. denticola, ekspresi mRNA MMP-8, dan parameter klinis pada pasien periodontitis sebelum dan setelah skeling dan penghalusan akar (SPA) serta korelasi antara perubahan bakteri T. denticola dan ekspresi mRNA MMP-8 dengan parameter klinis.  Metode: Cairan krevikular gingiva dari 6 pasien periodontitis kronis yang tidak dirawat dan 1 subjek sehat diambil untuk menganalisa bakteri T. denticola dan ekspresi mRNA MMP-8 dengan quantitative polymerase chain reaction. Treponema denticola, ekspresi mRNA MMP-8, dan parameter klinis (kedalaman poket, indeks perdarahan gingiva, dan kehilangan perlekatan klinis) diperiksa sebelum dan 1 bulan setelah SPA. Uji Wilcoxon digunakan untuk membandingkan transkripsi mRNA, proporsi bakteri, kedalaman poket, kehilangan perlekatan klinis, dan indeks perdarahan gingiva sebelum dan setelah SPA. Uji Spearman digunakan untuk mengetahui korelasi antara T. denticola dan ekspresi mRNA MMP-8 dengan parameter klinis. Hasil: Pengurangan yang signifikan terlihat pada parameter klinis (P<0,05), meskipun perbedaan T. denticola dan eskprsi mRNA MMP-8 tidak signifikan (P>0,05). Hubungan yang positif terlihat antara perubahan proporsi bakteri T. denticola dengan perubahan indeks perdarahan gingiva (r = 0,029; P>0,05) dan perubahan ekspresi mRNA MMP-8 dengan perubahan indeks perubahan gingiva (r = 0,023; P>0,05). Kesimpulan: Terapi non bedah menghasilkan perbaikan yang signifikan dalam parameter klinis tetapi tidak pada jumlah bakteri T. denticola dan eskpresi mRNA MMP-8 serta korelasi yang tidak signifikan antara T. denticola dan mRNA MMP-8 dengan parameter klinis.  

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Background: Periodontitis results from an outcome of interaction between bacterial biofilms and host immune response. Treponema denticola are one of the most common bacteria detected in patients with chronic periodontitis. Matrix metalloproteinase-8 (MMP-8) is an important host factor involved in the pathogenesis of periodontal diseases, which is the main collagenolytic MMP. Purpose: To evaluate the amount of Treponema denticola, MMP-8 mRNA expression and clinical parameters in periodontitis patient before after scaling and root planning (SRP) and correlation between clinical parameters and proportion of T. denticola and mRNA expression level of MMP-8. Methods: GCF from 6 untreated chronic periodontitis patients and 1 healthy subject were sampled and assessed for the T. denticola, MMP-8 mRNA expression by quantitative polymerase chain reaction (q-PCR). Treponema denticola, MMP-8 mRNA expression and clinical parameters which were pocket depth, papillary bleeding index, and clinical attachment loss were assessed 1 month before and after scaling. Wilcoxon test was used to compare the mRNA transcription level, amount of bacteria, pocket depth, clinical attachment loss and papillary bleeding index before and after SRP. Spearman test was used to correlate clinical parameter and change of proportion of T. denticola and mRNA expression level of MMP-8. Results: A significant reduction in the clinical parameters was noted after SRP than before it (P< 0.05), although the difference of T. denticola and MMP-8 mRNA expression was not significant (P> 0.05). A positive relationship was seen between changes in the proportion of T. denticola bacteria with changes in the gingival bleeding index (r = 0.029; P> 0.05) and changes in MMP-8 mRNA expression with changes in the gingival change index (r = 0.023; P> 0.05). Conclusion: Non-surgical therapy resulted in a significant improvement in clinical parameters but not the proportion of T. denticola and mRNA expression level of MMP-8 and insignificant correlation between T. denticola and MMP-8 mRNA with clinical parameters.

 

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"Latar Belakang: Periodontitis kronis adalah penyakit multifaktorial yang dipengaruhi oleh plak bakteri dan respon inflamasi tubuh dengan matriks metalloproteinase sebagai salah satu molekul inflamasi yang ditemukan meningkat pada penyakit periodontal. Skeling dan penghalusan akar (SPA) telah umum digunakan sebagai pengobatan konvensional atau non-bedah dalam terapi periodontal. Tujuan: Untuk mengevaluasi ekspresi m-RNA matriks metalloproteinase-9 (MMP-9), jumlah Tannerella forsythia (T. forsythia), dan parameter klinis periodontal satu bulan setelah SPA. Metode: Lima puluh gigi dengan poket 4-6 mm dari enam pasien periodontitis kronis dan satu subjek periodontal sehat disertakan dalam penelitian ini. Data penelitian cairan sulkus gingiva diambil dari poket terdalam setiap gigi dengan poket periodontal 4-6 mm untuk mengukur tingkat ekspresi m-RNA MMP-9 dan T.forsythia menggunakan quantitative real time-PCR (qPCR). Kedalaman poket, indeks perdarahan gingiva, dan kehilangan perlekatan klinis diukur pada hari pertama sebagai baseline dan pada hari ke 30. SPA dilakukan pada hari ke-1. Data dianalisis menggunakan program perangkat lunak SPSS 22.0. Hasil: Dibandingkan dengan kontrol, parameter klinis periodontal dan T.forsythia secara signifikan berkurang sementara pengurangan ekspresi m-RNA ­MMP-9 ditemukan tidak signifikan pada hari ke-30 setelah SPA. Kesimpulan: Satu bulan setelah SPA pada periodontitis kronis dengan poket 4-6 mm didapatkan penurunan jumlah T.forsythia dan parameter klinis periodontal secara signifikan dengan ekspresi m-RNA MMP-9 menurun tidak signifikan. Penelitian lebih lanjut dengan periode pengamatan lebih lama diperlukan untuk mengkonfirmasi atau menolak temuan di atas.

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Background: Chronic periodontitis is a multifactorial disease influenced by both bacterial plaque and host inflammatory response with matrix metalloproteinase as one of inflammatory molecules found elevated in periodontal disease. Scaling and root planning (SRP) has been commonly used as conventional or non-surgery treatment in periodontal therapy. Aim: To evaluate m-RNA expression of matrix metalloproteinase-9 (MMP-9), Tannerella forsythia (T. forsythia), and clinical periodontal parameter one month after SRP. Methods: Fifty tooth with pocket 4-6 mm from six CP patients and one periodontally healthy subject was recuited in this study. Gingival crevicular fluid (GCF) were collected from deepest pocket of every tooth with pocket 4-6 mm, the expression level of MMP-9 m-RNA and T.forsythia was measured using quantitative real time-PCR(qPCR). Pocket depth (PD), papilla bleeding index (PBI), and clinical attachment loss (CAL) were measured on day 1 as baseline and on the 30th day. SRP were performed on day 1. Data were analyzed using SPSS 22.0 software program. Results: By comparing to control, the periodontal clinical parameters and T.forsythia were significantly reduced after SRP while the reduction of MMP-9 m-RNA expression was found no significantly after 30th day. Conclusion: Our study show that SRP was clinically effective for CP with 4-6 mm pocket although the expression of MMP-9 m-RNA was not significantly reduced following SRP for one month period. Further studies with longer observation period are needed to confirm or reject the above finding."

"Latar Belakang: Penyakit periodontal tidak hanya mempengaruhi kesehatan mulut, tetapi juga berkontribusi pada berbagai gangguan sistemik termasuk hiperlipidemia yang merupakan salah satu faktor risiko utama dari penyakit kardiovaskular. Mekanisme inflamasi yang mendasari penyakit periodontal diyakini dapat memengaruhi metabolisme lipid, sehingga memperburuk profil lipid pasien. Perawatan periodontal non-bedah telah diusulkan sebagai intervensi potensial untuk dapat mengurangi peradangan sistemik dan memperbaiki profil lipid pada beberbagai studi, tetepi hasil penelitian sebelumnya menunjukkan temuan yang tidak konsisten. Tujuan: Mengetahui pengaruh perawatan periodontal non-bedah pada pasien dengan hiperlipidemia dan periodontitis terhadap kadar biomarker pro-inflamasi TNF-α, IL-1β, IL-6, dan CRP serta profil lipid. Metode: Pencarian studi melalui basis data elektronik menggunakan pedoman Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA). Studi yang sesuai dengan kriteria inklusi dan ekslusi, kemudian dinilai risiko biasnya. Selanjutnya, dilakukan meta-analisis. Hasil: Sintesis kualitatif menunjukkan adanya hasil yang signifikan terhadap pengaruh perawatan periodontal non-bedah pada penurunan kadar TNF-α, IL-1β, dan IL-6 pasca perawatan, tetapi tidak ditemukan adanya penurunan kadar yang signifikan pada biomarker CRP dan profil lipid pasca perawatan. Meta-analisis sebelum dan sesudah perawatan periodontal non-bedah menunjukkan adanya pengaruh yang signifikan secara statistik pada kadar IL-6 dengan perbedaan rerata -0,74 pg/mL (95% CI:[-0.90;-0.57], p<0,00001) dan kadar TC dengan perbedaan rerata -36,19 (95% CI: [-61,00; - 11,38], p = 0,004) serta tidak terdapat pengaruh signifikan terhadap kadar HDL dengan perbedaan rerata 0,12 (95% CI: [-2,28; 2,52], p = 0,92). Kesimpulan: Perawatan periodontal non-bedah pada pasien dengan hiperlipidemia dan periodontitis menunjukkan pengaruh yang signifikan pada kadar TNF-α, IL-1β, dan IL-6, tetapi kadar CRP dan profil lipid tidak menunjukkan padanya pengaruh yang signifikan pasca perawatan pada pasien dengan hipelipidemia dan periodontitis.

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Background: Periodontal disease not only affects oral health but also contributes to a variety of systemic disorders including hyperlipidemia which is one of the major risk factors for cardiovascular disease. The inflammatory mechanisms underlying periodontal disease are believed to affect lipid metabolism, thereby worsening the lipid profile of patients. Non-surgical periodontal treatment has been proposed as a potential intervention to reduce systemic inflammation and improve lipid profiles in various studies, despite previous findings showing inconsistent findings. Objective: To determine the effect of non-surgical periodontal treatment in patients with hyperlipidemia and periodontitis on the levels of pro-inflammatory biomarkers, TNF-α, IL-1β, IL-6, and CRP as well as lipid profile. Methods: Study searches were conducted through electronic databases using the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. Studies that meet the inclusion and exclusion criteria are then assessed for bias risk. Next, a meta-analysis was carried out. Results: Qualitative synthesis showed significant results on the effect of non-surgical periodontal treatment on the reduction of TNF-α, IL-1β, and IL-6 levels after treatment, but no significant reduction in CRP and lipid profile was found after treatment. Meta-analyses before and after non-surgical periodontal treatment showed a statistically significant effect on IL-6 levels with a mean difference of -0.74 pg/mL (95% CI:[-0.90;-0.57], p<0.00001) and TC levels with a mean difference of -36.19 (95% CI: [-61.00; - 11.38], p = 0.004). There is no significant effect on HDL levels with a mean difference of 0.12 (95% CI: [-2.28; 2.52], p = 0.92). Conclusions: Non-surgical periodontal treatment in patients with hyperlipidemia and periodontitis showed a significant effect on TNF-α, IL-1β, and IL-6 levels, but CRP levels and lipid profiles did not show a significant post-treatment effect on patients with hyperlipidemia and periodontitis."

"Periodontitis adalah penyakit inflamasi kronis yang mempengaruhi jaringan pendukung gigi dan memerlukan penanganan yang efektif untuk mencegah kerusakan lebih lanjut. Salah satu metode yang potensial adalah penggunaan local drug delivery film kitosan dengan penambahan glutaraldehid sebagai agen crosslinking untuk meningkatkan sifat mekaniknya. Penelitian ini bertujuan untuk mengevaluasi pengaruh durasi perlakuan uap glutaraldehid terhadap sifat mekanik dan perilaku swelling film kitosan. Film kitosan diproduksi menggunakan metode solvent casting dengan komposisi 1% propolis dan gliserin sebagai plasticizer, kemudian dilakukan crosslinking dengan larutan glutaraldehid 0,5% pada suhu 37°C dengan variasi waktu perlakuan 12 jam, 24 jam, dan 48 jam. Karakterisasi film dilakukan menggunakan Fourier Transform InfraRed (FTIR), Scanning Electron Microscope (SEM), analisis swelling, dan uji tarik. Interaksi kimia antara kitosan dan glutaraldehid ditunjukkan dengan puncak dan shoulder peak pada 1651 cm-1 dalam FTIR, mengindikasikan pembentukan ikatan imina (Schiff base) yang mempengaruhi sifat mekanik dan stabilitas film serta menandakan proses crosslinking berhasil dilakukan. Hasil penelitian swelling menunjukkan peningkatan waktu crosslinking mengurangi derajat swelling film hingga 80,27%, dengan film yang diberi perlakuan glutaraldehid menunjukkan derajat swelling lebih rendah (17,50-12,12%) dibandingkan film tanpa perlakuan. Waktu crosslinking juga meningkatkan sifat mekanik film, dengan kekuatan dan kekakuan meningkat hingga 662,3% (566,7 MPa) pada 12 jam, 725,1% (620,3 MPa) pada 24 jam, dan 1061,2% (907,9 MPa) pada 48 jam, dibandingkan film tanpa glutaraldehid (85,6 MPa). Dengan demikian, durasi perlakuan glutaraldehid optimal untuk film kitosan dalam aplikasi penyembuhan periodontitis adalah 12 jam. Durasi ini menghasilkan film kitosan dengan derajat crosslinking yang optimal, derajat swelling terkontrol, dan peningkatan sifat mekanik yang signifikan, memungkinkan film mudah disisipkan ke dalam kantong periodontal dan memberikan penghantaran obat yang efektif tanpa menyebabkan ketidaknyamanan yang signifikan akibat pembengkakan.

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Periodontitis is a chronic inflammatory disease affecting the supporting tissues of teeth, requiring effective intervention to prevent further damage. One potential method is the use of local drug delivery chitosan films with the addition of glutaraldehyde as a crosslinking agent to enhance their mechanical properties. This study aims to evaluate the influence of glutaraldehyde vapor treatment duration on the mechanical properties and swelling behaviour of chitosan films. Chitosan films were produced using the solvent casting method with a composition of 1% propolis and glycerine as a plasticizer, followed by crosslinking with 0.5% glutaraldehyde solution at 37°C with treatment durations of 12 hours, 24 hours, and 48 hours. The characterization of the films was conducted using Fourier Transform Infrared (FTIR) spectroscopy, Scanning Electron Microscope (SEM), swelling analysis, and tensile testing. Chemical interactions between chitosan and glutaraldehyde were indicated by peaks and shoulder peaks at 1651 cm-1 in the FTIR analysis, suggesting the formation of imine bonds (Schiff base), which affect the mechanical properties and stability of the film, indicating successful crosslinking. The swelling results showed that increasing the crosslinking duration reduced the swelling degree of the film by up to 80.27%, with glutaraldehyde-treated films showing a lower swelling degree (17.50-12.12%) compared to untreated films. Crosslinking time also enhanced the mechanical properties of the film, with strength and stiffness increasing up to 662.3% (566.7 MPa) at 12 hours, 725.1% (620.3 MPa) at 24 hours, and 1061.2% (907.9 MPa) at 48 hours, compared to untreated chitosan films (85.6 MPa). Thus, the optimal glutaraldehyde treatment duration for chitosan films in periodontitis treatment applications is 12 hours. This duration produces chitosan films with optimal crosslinking, controlled swelling, and significant improvements in mechanical properties, allowing the film to be easily inserted into periodontal pockets and provid."

"Latar Belakang: Perbaikan jaringan periodontal pasca splinting dapat ditinjau secara klinis atau radiografis. Evaluasi penyembuhan pada jaringan keras pada penelitian ini dianalisis dengan radiografis periapikal digital. Splinting periodontal adalah terapi pendukung perawatan periodontal untuk melindungi jaringan selama repair dan regenerasi pada terapi periodontal. Tujuan: Analisis kehilangan dan kepadatan tulang alveolar serta keutuhan lamina dura setelah tiga bulan splinting pada gigi anterior mandibula dengan diagnosis periodontitis kronis dan kriteria kehilangan tulang alveolar 2/3 serviks secara radiografis digital. Metode: Delapan puluh empat sisi sampel proksimal (mesial dan distal) dilakukan pengambilan radiografi periapikal digital dan di evaluasi perubahan keadaan tulang alveolarnya setelah di splinting (hari ke 1 dan 91). Hasil: Hasil analisis statistika pada evaluasi setelah tiga bulan splinting untuk perubahan kehilangan-kepadatan tulang alveolar dan keutuhan lamina dura adalah 0,44; 0,256 dan 0,059 (p<0,05). Kesimpulan: Tidak terdapat perubahan kehilangan dan kepadatan tulang alveolar serta keutuhan lamina dura pasca tiga bulan splinting pada gigi anterior mandibula dengan periodontitis kronis yang kehilangan tulangnya sampai 2/3 serviks.

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Background: The healing of periodontal splinting can be detected both with clinical and radiographic examination. In this study, the alveolar bone was evaluated by radiographic digital periapical analysis. Periodontal tooth splinting is periodontal support theraphy used to prevent periodontal injury during repair and regeneration of periodontal theraphy.

Objective: Radiographic digital periapical analysis of alveolar bone in the mandibular anterior region with chronic periodontitis and 2/3 cervical bone loss after three months periodontal splinting.

Methods: Eighty four proximal site (43 mesial and 41 distal) from 16 patients were examined by taking periapical digital radiographic and the bone loss, bone density and utility of lamina dura were detected after splinting (day 1 and 91).

Results: The statistical analysis after three months evaluation using T-test for bone loss, Wilcoxon sign rank test for bone density and utility lamina dura showed no significantly differences(p<0,05)(p=0,44, 0,256 and 0,059).

Conclusion: No radiographic change in bone loss, bone density and utility of lamina dura from chronic periodontitis with 2/3 alveolar bone loss after three months splinting."

"Summary:Practical Periodontal Diagnosis and Treatment Planning offers its readers a step-by-step guide to diagnosing and planning treatment for periodontal patients through the latest evidence-based"

"Growth factor is a general term used to denote a class of naturally occuring proteins that function in the body to promote mitogenesis, directed migration and metabolic activity of cells. Growth factor to mediate repair and regeneration the periodontium. A combination of growth factor may more effectively stimulate these diverse processes of regeneration than single growth factor. Combination PDGF and IGF-I, significant amounts of newly formed bone and new cementum. PDGF and TGF beta are known to be abundant in the alfa granules of platelets. Currently the use of Palatelet Rich Plasma (PRP) into a bone graft combination showed a significant gain in periodontal regeneration. It is probable that it's used to promote periodontal regeneration."

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV; 397-399The purpose of this study was to determine the difference between intercellular adhesion molecule-1 (ICAM-1) cytokine content in gingival crevicular fluid (GCF) on healthy periodontal and chronic periodontitis. It was also determine the treatment effects of hydrogen peroxide as subgingival irrigation in chronic periodontitis. Twenty participants were examined in this study. Gingival fluid collection method was carry out with strip paper technique and analyzed with enzyme-linked immunosorbent assay (ELISA). The result of the study showed that there was a significant difference of ICAM-1 on healthy site and periodontitis site, and there was a significant change of ICAM-1 content after treatment (p<0.05). We concluded that ICAM-1 in GCF is a sensitive indicator to differentiate healthy sites from those with periodontitis."