Chronic Periodontitis ; complications ; Diabetes Mellitus, Type 2 ; complications ; pathology ; Humans

The purpose of this study was to observe histopathologically the influence of advanced periodontitis on pulp tissue, and to conclude the correlation between the results with clinical madifestations. The samples were teeth with over 7mm pocket depth and over 50% radiographic bone loss. These were diagnosed to have very poor prognosis and thus planned to be extracted. Those with any of following conditions were excluded from the samples, loss of vitality, periapical pathology, restoration or prosthesis, dental caries, and attrition or abrasion. It was because these conditions could affect pulp without any correlation with periodontal disease. For the experiment, 17 teeth from 11 patients were selected. Average age of patient was 47. Each tooth was examined for following categoris; pocket depth, gingival recession, electric pulp test, mobility, percussion test, sensitivity test. The extracted teeth were fixed buffered neutral formalin solution. It was decalcified using 4% nitric acid. Sliced histological samples observed using light microscope, for pulp status, and severeity of inflammation. 4 samples were excluded due to histologic sample discrepency. Thus 13 samples were subject to observation. 4 showed normal conditions. Focal reversable pulpitis was shown in 5 samples. Chronic pulpitis was observed 1 samples. Pulpal abscess observed in 3 samples.
Abscess ; Adult* ; Chronic Periodontitis* ; Dental Prosthesis ; Formaldehyde ; Gingival Recession ; Humans ; Inflammation ; Nitric Acid ; Pathology ; Percussion ; Periodontal Diseases ; Periodontitis ; Prognosis ; Pulpitis ; Tooth

Chronic Disease ; Cone-Beam Computed Tomography ; Humans ; Periapical Abscess ; pathology ; Periapical Granuloma ; pathology ; Periapical Periodontitis ; diagnostic imaging ; pathology ; Problem Solving ; Prognosis ; Radicular Cyst ; diagnostic imaging ; pathology

BACKGROUNDReceptor activator of nuclear factor kappa B (NF-κB) ligand (RANKL) and osteoprotegerin (OPG) have been recently shown to play important roles in bone resorption. The aim of this study was to investigate the possible association between the expression of bone resorption regulators (RANKL and OPG) and inflammatory cell infiltration in chronic apical periodontitis.

METHODSThe samples of chronic periapical lesions (n = 40) and healthy periapical tissues (n = 10) were examined for immunohistochemical analysis of RANKL and OPG. Lesion samples were further analyzed for the inflammatory infiltration condition. The inflammatory cell infiltration was scored in relation to immunohistochemical reactivity for CD3, CD20 and CD68.

RESULTSThe number of RANKL-positive cells and the ratio of RANKL/OPG in chronic apical periodontitis were significantly higher than those in healthy periapical tissues (P < 0.001). The number of RANKL-positive cells was higher in lesions with severe inflammatory infiltration than in those with light inflammatory infiltration (P < 0.05). Significantly increased RANKL expression was found with T lymphocytes (CD3(+)), macrophages (CD68(+)) and B lymphocytes (CD20(+)) infiltration (P < 0.05). No association was found between the ratio of RANKL/OPG and inflammatory cell infiltration.

CONCLUSIONSRANKL expression was increased with T, B lymphocytes and macrophages infiltration, respectively in chronic periapical lesions. RANKL appears to be closely related to periapical inflammatory infiltrates. The relative ratio of RANKL/OPG may be a key determinant of RANKL-mediated bone resorption.

Adolescent ; Adult ; Chronic Periodontitis ; immunology ; pathology ; Female ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Inflammation ; metabolism ; Male ; Middle Aged ; Osteoprotegerin ; metabolism ; RANK Ligand ; metabolism ; Young Adult

OBJECTIVE: To investigate the relationship between periodontal disease and subclinical atherosclerosis in middle-aged and older adults in Shijingshan community of Beijing. METHODS: In 2005-2010, a total of 830 middle-aged and older adults were recruited from Shijingshan community of Beijing, who were divided into two groups by severity of periodontitis. A questionnaire, periodontal examination, blood biochemical examination, carotid intima-media thickness (CIMT), including common carotid artery (CCA-IMT), internal carotid artery (ICA-IMT) and carotid bifurcation (CB-IMT), were measured of each subject. The associations of periodontitis with CIMT was evaluated by multivariable Logistic regression analysis and analysis of covariance, adjusted for age, gender, education level, hypertension, hyperlipidemia, obesity, smoking, drinking, and diabetes. And then anther definition of periodontitis (mild periodontitis: percentage of AL≥3 mm <10%; moderate periodontitis: percentage of AL≥3 mm 10%-30%; severe periodontitis: percentage of AL≥3 mm ≥30%) was used to investigate the hypotheses that different classification of periodontitis would affect results. RESULTS: The subjects with moderate-severe periodontitis were characterized by significantly higher levels of CCA-IMT, ICA-IMT, CB-IMT and mean CIMT than the mild group. In the univariate analysis, moderate-severe periodontitis was associated with an increased risk of ICA-IMT>0.9 mm (adjusted OR=1.230, 95% CI: 1.058-1.452, P=0.031). Furthermore, moderate periodontitis was associated with an increased risk of CB-IMT>0.9 mm (adjusted OR: 1.297, 95%CI: 1.117-1.753, P=0.011) and severe periodontitis was associated with an increased risk of CB-IMT>0.9 mm (adjusted OR=1.771, 95%CI: 1.176-3.503, P=0.042) according to another classification of periodontitis. CONCLUSION Our data provided evidence that periodontitis was associated with CIMT among middle-aged and older adults in Shijingshan community of Beijing and different periodontitis classification would affect the results.
Aged ; Atherosclerosis/complications* ; Beijing ; Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, Internal ; Carotid Intima-Media Thickness ; Chronic Periodontitis/pathology* ; Diabetes Mellitus ; Humans ; Middle Aged ; Risk Factors

Acute Disease ; Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Disinfectants ; therapeutic use ; Humans ; Periapical Abscess ; diagnosis ; therapy ; Periapical Granuloma ; diagnosis ; therapy ; Periapical Periodontitis ; classification ; diagnosis ; pathology ; therapy ; Problem Solving ; Prognosis ; Root Canal Irrigants ; therapeutic use ; Root Canal Therapy

BACKGROUNDThe association between the infection of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Treponema denticola in chronic periodontitis (CP) and the severity of periodontal disease remains to be elucidated. The aim of this study was to investigate the subgingival infection frequencies of three periodontopathic bacteria in Chinese CP patients and to evaluate the correlations between infection by these bacteria and periodontal destruction.

METHODSA multiple PCR assay using primers derived from 16SrDNA genes of P. gingivalis, A. actinomycetemcomitans and T. denticola was established to measure simultaneously the presence of the three microbes in 162 subgingival samples from 81 Chinese CP patients.

RESULTSThe positive rates of P. gingivalis, A. actinomycetemcomitans and T. denticola in the subgingival samples were 84.6%, 83.3% and 88.3%, respectively. Of the subgingival samples, 68% revealed the coinfection of all the three microbes. The infection rates with P. gingivalis, A. actinomycetemcomitans or T. denticola alone was 5.9% (1/17), 17.6% (3/17) and 76.5% (13/17), respectively. A close association was present between the A. actinomycetemcomitans infection and gingival index (GI) (P < 0.01), but not between P. gingivalis or T. denticola infection and GI (P > 0.05). P. gingivalis and A. actinomycetemcomitans were more frequently detectable in middle and deep pockets than in shallow ones (P < 0.01), while T. denticola was found remarkably often in deep pockets (P < 0.05). The coinfection rate of the three microbes was significantly higher in sites with severe periodontitis than in those with mild periodontitis (P < 0.01).

CONCLUSIONSThe multiple PCR established in this study can be used as a sensitive and specific method to simultaneously detect all three microbes in subgingival samples. A. actinomycetemcomitans infection may be associated with CP and play an important role in the periodontal tissue destruction. The coinfection of P. gingivalis, A. actinomycetemcomitans and T. denticola can cause more serious periodontal destruction than infection of any one or two of the three microbes.

Adult ; Aged ; Aggregatibacter actinomycetemcomitans ; genetics ; isolation & purification ; Chronic Disease ; DNA, Ribosomal ; analysis ; Dental Plaque ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Periodontitis ; microbiology ; pathology ; Periodontium ; pathology ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; genetics ; isolation & purification ; RNA, Ribosomal, 16S ; genetics ; Treponema denticola ; genetics ; isolation & purification