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

OBJECTIVETo investigate the accuracy of probing depth measurements of undergraduate students in department of periodontology and analyze the cause of measurement errors.

METHODSThirty-eight dental students from Peking Universty School and Hospital of Stomatology who began their periodontal clinical practice for the first time were recruited. According to principle of clinical teaching, after the students recorded the probing depth of 1-2 periodontitis patients using Williams periodontol probe, an experienced teacher checked the probing depth. The measurements of interproximal sites of Ramfjord index teeth (6 14 41 6) were used as the data of this study. According to the probing depth discrepancies between teacher and the students, all the probing sites were divided in three levels: absolutely consistent sites (probing depth measured by teacher and by student was completely consistent), almost consistent sites (the depth discrepancy between teacher and student was 1 mm), inconsistent sites (the depth discrepancies between teacher and student ≥ 2 mm).

RESULTSThe accuracy of probing depth measurements of students decreased with the deepening of probing depth, and the accuracy of probing depth measurements in molar teeth was significantly lower than incisor teeth [58.8% (261/444) vs.73.1% (339/464), P < 0.01]. The main factor associated with the accuracy of probing depth measurements in interproximal sites was the probe's inability to get into gingival col, which accounted for 70.7% (87/123) of the total inconsistent sites.

CONCLUSIONSThe correct angle of insertion of the probe in interproximal sites should be reinforced during the course of pre-clinical education of periodontal probing. More attention should be paid to check the probing depth of deep pockets and molar teeth during the clinical practice of undergraduate students.

Bicuspid ; pathology ; Chronic Periodontitis ; pathology ; Clinical Competence ; Dental Instruments ; Humans ; Incisor ; pathology ; Molar ; pathology ; Periodontal Index ; Periodontal Pocket ; pathology ; Students, Dental

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

OBJECTIVETo investigate the relationship between chronic periodontitis and the genetic polymorphisms of vitamin D receptor gene and estrogen receptor gene.

METHODSClinical parameters including probing depth, clinical attachment loss, sulcus bleeding index and tooth movement were measured by fluoride probe. Genomic DNA from peripheral venous blood was extracted with saturant sodium chloride, and PCR-restriction fragment length polymorphism was applied to examine the Apa I, Bsm I, Taq I polymorphisms of the vitamin D receptor genes and the Xba I and Pvu II polymorphisms of the estrogen receptor genes. The results were analyzed by Z-score test and mean square analysis.

RESULTSForty-three point four percent of chronic periodontitis patients took vitamin D receptor BB genotype, the rate in healthy controls was 30.0%. 39.6% of chronic periodontitis patients took estrogen receptor XX genotype, the rate in healthy controls was 20.0%. The people who took BBXX genotype had the worst periodontal conditions among all chronic periodontitis patients.

CONCLUSIONSVitamin D receptor allele B and estrogen receptor allele X are susceptible alleles for chronic periodontitis. The synergistic effects of the two receptor susceptible alleles may promote chronic periodontitis.

Adult ; Alleles ; Case-Control Studies ; Chronic Periodontitis ; genetics ; pathology ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Receptors, Calcitriol ; genetics ; Receptors, Estrogen ; genetics ; Young Adult

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

OBJECTIVETo investigate the effect of tooth extraction with antibiotics on atherosclerosis, and to examine the expression of serum interleukin 6(IL-6) and the pathological changes of the carotid artery in chronic periodontitis(CP) rats with or without atherosclerosis(As).

METHODSA total of 44 SD rats were randomly divided into four groups, group A(normal control), group B(As), group C(CP), group D(CP+As). After model establishment, group C and group D were randomly divided into group C1/D1 (tooth extraction) and group C2/D2(tooth extraction with antibiotics) according to random number table and received the corresponding oral intervention treatment respectively. Serum IL-6 levels were determined by enzyme linked immunosorbent assay(ELISA) respectively one week before the intervention, one week after the first intervention, one, three, five weeks after the second intervention. The pathological changes of the carotid artery were accessed under light microscope.

RESULTSAt all sampling time points, the levels of serum IL-6 in group B, C, D were higher than that of group A, with group D1 being increased most obviously, significantly higher than that of group A(P< 0.001). One week after the second intervention, the content of IL-6 in group C and group D peaked[C1(127.0 ± 29.9) ng/L, C2: (120.6 ± 23.1) ng/L, D1: (175.1 ± 50.8) ng/L, D2: (160.5 ± 37.7) ng/L], and was significantly higher than that of group B[B: (43.4 ± 7.5) ng/L,P<0.001]. Then they all had varying degrees of decline, 5 weeks after the second intervention, group C1 and D1 were still higher than that of group B, but group C2 and D2 were lower than that of group B. At all sampling time points, the levels of serum IL- 6 in group C2/D2 were lower than those in group C1/D1, 5 weeks after the second intervention the difference was most obvious and statistically significant(P<0.001). Pathology showed that the carotid artery wall in group A was normal. The carotid artery wall was thickened in group B, inflammatory cells and foam cells could be seen, and elastic fibers disordered. The carotid artery wall in group C1 was uneven, foam cells and a small amount of inflammatory cells were visible, and elastic fiber disordered. Obvious thickening was not seen in the carotid artery wall of group C2, a small amount of foam cells and inflammatory cells were found, and elastic fiber mildly disordered. The carotid artery wall in group D1 was obviously uneven, calcium salt deposits were visible in the artery wall, a large amount of inflammatory cells and foam cells could be found, and elastic fiber disordered. Obvious thickening was not seen in the carotid artery wall of group D2, a small amount of inflammatory cells and a large amount of foam cells could be seen, and elastic fiber disordered.

CONCLUSIONSPeriodontitis and hyperlipidemia could increase the level of serum IL- 6 and the risk of the As. In chronic periodontitis rats with or without atherosclerosis, when periodontal inflammation was not controlled, tooth extraction may increase the risk of the As. At the time of tooth extraction, giving the anti-inflammatory treatment can reduce the risk to a certain extent.

Animals ; Anti-Bacterial Agents ; pharmacology ; Aorta ; chemistry ; pathology ; Atherosclerosis ; blood ; complications ; Carotid Arteries ; drug effects ; metabolism ; pathology ; Chronic Periodontitis ; blood ; complications ; Foam Cells ; pathology ; Humans ; Hyperlipidemias ; blood ; Interleukin-6 ; blood ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tooth Extraction ; adverse effects

OBJECTIVETo investigate the possible correlation between atherosclerosis and chronic periodontitis by establishing an animal model of chronic periodontitis and atherosclerosis in Wistar rat.

METHODSSixty male Wistar rats were divided into four groups: A (control group), B (chronic periodontitis group), C (atherosclerosis group), D (chronic periodontitis accompany with atherosclerosis group). Every group was accepted the corresponding treatment. Animals were sacrificed after 12 weeks. The periodontal index, levels of serum total cholesterol (TC) and low-density lipoprotein (LDL), the concentration of TNF-alpha and matrix metalloproteinase (MMP-3) were examined. The severity of chronic periodontitis and atherosclerosis was quantified by histopathology. The date were statistically analyzed.

RESULTSThrough detection of periodontal tissue of experimental teeth, serum and histopathology, animal models were successful. Histopathologic observation revealed:obvious inflammation of periodontal tissue was observed in group B and D. Attachment loss level in group B [(137.86 +/- 28.39) microm] and D [(162.36 +/- 22.69) microm] was higher than that in group A [(4.26 +/- 1.07) microm] and C [(68.07 +/- 18.25) microm] (P < 0.05), and that in group C was higher than group A (P < 0.05). Atherosclerotic lesions of abdominal aorta were formed in group C and D. The level of TC, LDL in group C and D was higher than that in group A and B (P < 0.05), and that in group D was higher than group C (P < 0.05). Animals in group B and D showed higher level of TNF-alpha, MMP-3 in serum than that in group A and C (P < 0.05). There was no correlation between the level of MMP-3 and TC (P = 0.971) or LDL (P = 0.604).

CONCLUSIONSChronic periodontitis may be a risk factor and contribute to the pathogenesis of atherosclerosis. MMP-3 may be an independent risk factor of atherosclerosis exclude TC and LDL.

Animals ; Aorta, Abdominal ; Aortic Diseases ; etiology ; pathology ; Atherosclerosis ; etiology ; pathology ; Cholesterol ; blood ; Chronic Periodontitis ; complications ; pathology ; Disease Models, Animal ; Drugs, Chinese Herbal ; Lipoproteins, LDL ; blood ; Male ; Matrix Metalloproteinase 3 ; blood ; Periodontal Index ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo determine the level of high-density lipoprotein cholesterol (HDL-C), serum C-reactive protein (CRP) and inflammation cytokines and investigate the concentration between periodontal disease and coronary heart disease (CHD).

METHODSSixty-six patients with CHD and chronic periodontitis [(C+P) group], forty-four with only CHD (C group), fifty-six with only chronic periodontitis (C group), and forty-three healthy controls (H group) were included in this study. The diagnosis of chronic periodontitis and CHD was based on accepted clinical criteria. Serum levels of HDL-C, CRP, IL-6, tumor necrosis factor (TNF)-alpha and IL-1beta were tested in all patients and controls.

RESULTSThe periodontal conditions of these four groups were significantly different (P<0.05). The clinical periodontal parameters [probing depth (PD), attachment loss (AL), and bleeding on probing (BOP)] in patients with (C+P) group, P group, C group and H group were [(4.55+/-0.85) mm, (3.78+/-0.34) mm, 69.6%], [(4.06+/-0.61) mm, (3.05+/-0.44) mm, 63.6%], [(1.85+/-0.67) mm, (1.26+/-0.39) mm, 20.5%], [(1.12+/-0.33) mm, (0.42+/-0.83) mm, 4.6%], respectively. The levels of HDL-C in H group, C group, P group and (C+P) group were (1.42+/-0.21), (1.22+/-0.18), (1.24+/-0.21) and (1.04+/-0.22) mmol/L, respectively. T compare with other three groups, the level of HDL-C in (C+P) group is the lowest. The levels of CRP, IL-6, TNF-alpha and IL-1beta in (C+P) group were significantly higher than other groups (P<0.05).

CONCLUSIONSHDL-C, CRP, IL-6, TNF-alpha and IL-1beta may be associated with the pathogenesis of periodontitis and CHD. There may be a relationship between the two diseases.

C-Reactive Protein ; metabolism ; Cholesterol, HDL ; blood ; Chronic Periodontitis ; blood ; complications ; pathology ; Coronary Disease ; blood ; complications ; Female ; Humans ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Periodontal Attachment Loss ; blood ; Periodontal Index ; Tumor Necrosis Factor-alpha ; blood