OBJECTIVE: To compare the clinical efficacy of initial periodontal therapy in periodontitis patients with or without type 2 diabetes mellitus and its correlation with white blood cell counts. METHODS: In this study, 32 chronic periodontitis patients without systemic disease (CP group) and 27 chronic periodontitis patients with type 2 diabetes mellitus (CP+DM group) were enrolled. At admission, all the patients went through periodontal examination and fasting blood examination(baseline). Probing depth (PD), attachment loss (AL), bleeding index (BI), plaque index (PLI), white blood cells (WBC) counts and fasting blood glucose (FBG) were recorded respectively, while hemoglobin A1c (HbA1c) was recorded only in CP+DM group. After that, initial periodontal therapy was performed. All the tests were repeated 3 and 6 months after treatment. The changes of periodontal clinical indexes and WBC levels were compared between the two groups before and after treatment, and the correlation between WBC and periodontal clinical indexes and glucose metabolism indexes were analyzed by generalized linear mixed model. RESULTS: At baseline, the periodontal inflammation and destruction were similar in CP and CP+DM group, but the WBC level was significantly higher in CP+DM groups [(6.01±1.26)×10⁹/L vs. (7.14±1.99)×10⁹/L, P=0.01]. After 3 and 6 months of initial periodontal therapy, the mean PD, AL, BI, and PLI in CP+DM and CP groups were significantly lower than the baseline, and the PD in CP+DM group was further decreased by 6 months compared with 3 months [(3.33±0.62) mm vs. (3.61±0.60) mm, P < 0.05]. However, none of these periodontal indexes showed significant difference between the two groups by 3 or 6 months. In CP+DM group, HbA1c at 3 months and 6 months were significantly lower than the baseline [(7.09±0.79)% vs. (7.64±1.16)%, P < 0.05; (7.06±0.78)% vs. (7.64±1.16)%, P < 0.05], and FBG was significantly lower than the baseline by 6 months [(7.35±1.14) mmol/L vs. (8.40±1.43) mmol/L, P < 0.05]. The WBC level in CP group was significantly lower than the baseline level by 3 months [(5.35±1.37)×10⁹/L vs. (6.01±1.26)×10⁹/L, P < 0.05], while that in CP+DM group was significantly lower than the baseline level by 6 months [(6.00±1.37)×10⁹/L vs. (7.14±1.99)×10⁹/L, P < 0.05]. The analysis of genera-lized linear mixed model showed that WBC level was significantly positively correlated with PD and FBG (P < 0.05). CONCLUSION Initial periodontal therapy can effectively improve the periodontal clinical status of patients with or without type 2 diabetes mellitus, and have benefits on glycemic control in diabetic patients. However, the response of periodontal indexes and WBC level to initial therapy were relatively delayed in diabetic patients. WBC plays an important role in the correlation between diabetes mellitus and periodontitis.
Chronic Periodontitis/therapy* ; Diabetes Mellitus, Type 2/complications* ; Glycated Hemoglobin A/analysis* ; Humans ; Leukocytes/chemistry* ; Periodontal Index

OBJECTIVE: To compare the clinical efficacy of combined application of glycine powder air-polishing and mechanical submucosal debridement in non-surgical treatment of peri-implant diseases. METHODS: A randomized controlled clinical study was carried out on patients diagnosed with peri-implant diseases in the Department of Periodontology, Peking University School and Hospital of Stomatology, between May of 2020 and June of 2021.Twenty-eight patients with totally sixty-two implants were enrolled.The patients were randomly divided into the test group and control group. The patients in the test group (13 subjects/32 implants) received mechanical submucosal debridement using titanium curettes combined with application of glycine powder air-polishing, while the control group (15 subjects/30 implants) received mechanical submucosal debridement using titanium only. Clinical parameters, such as plaque index (PLI), pocket probing depth (PPD), bleeding index (BI) and the percentage of suppuration on probing on implants' level (SoP%) were measured at baseline and 8 weeks after non-surgical intervention. Changes and group differences of clinical parameters of the implants before and 8 weeks after non-surgical intervention were compared. RESULTS: Mean PLI, PPD, BI of both the test group and control group significantly reduced 8 weeks after non-surgical intervention (P < 0.05). Compared with the control group, the test group achieved lower BI (2.7±0.8 vs. 2.2±0.7, P < 0.05), more reduction of BI (0.6±0.7 vs. 1.1±0.6, P < 0.01) and more reduction of SoP% (21.9% vs. 10%, P < 0.05) after non-surgical intervention. Both the control and test groups exhibited comparable PLI and PPD reductions (P>0.05). For the implants diagnosed with peri-implant mucositis, the test group revealed more signi-ficant reduction in BI and SoP% than the control group (1.0±0.7 vs. 0.4±0.7, P=0.02; 6.3% vs. 0, P=0.012). There was no significant difference existing in PLI and PD improvement between the control group and test group (P>0.05). For the implants diagnosed with peri-implantitis, there was no significant difference existing in PLI, PPD, BI and SoP% improvement values between the test and control groups (P>0.05). No complications or discomforts were reported during the study. CONCLUSION Both treatment procedures could relieve the inflammation of peri-implant soft tissue. Non-surgical mechanical submucosal debridement combined application of glycine powder air-polishing is associated with significant reduction of soft tissue bleeding and suppuration on probing especially in the implants diagnosed with peri-implant mucositis.
Dental Implants ; Glycine ; Humans ; Peri-Implantitis/therapy* ; Periodontal Index ; Periodontics ; Powders ; Treatment Outcome

Considering the adverse effects of nonimpacted third molars (N-M3s) on the periodontal health of adjacent second molars (M2s), the removal of N-M3s may be beneficial to the periodontal health of their neighbors. This study aimed to investigate the clinical, immunological, and microbiological changes of the periodontal condition around M2s following removal of neighboring N-M3s across a 6-month period. Subjects with at least one quadrant containing an intact first molar (M1), M2, and N-M3 were screened and those who met the inclusion criteria and decided to receive N-M3 extraction were recruited in the following investigation. M2 periodontal condition was interrogated before M3 extraction (baseline) and at 3 and 6 months postoperatively. Improvements in clinical periodontal indexes of M2s in response to their adjacent N-M3 removal, along with changes in inflammatory biomarkers among gingival crevicular fluid (GCF) and the composition of subgingival plaque collected from the distal sites of the M2s of the targeted quadrant were parallelly analyzed. Complete data of 26 tooth extraction patients across the follow-up period were successfully obtained and subsequently applied for statistical analysis. Compared to the baseline, the periodontal condition of M2s was significantly changed 6 months after N-M3 removal; specifically, the probing depth of M2s significantly reduced (P < 0.001), the matrix metalloproteinase (MMP)-8 concentration involved in GCF significantly decreased (P = 0.025), and the abundance of the pathogenic genera unidentified Prevotellaceae and Streptococcus significantly decreased (P < 0.001 and P = 0.009, respectively). We concluded that N-M3 removal was associated with superior clinical indexes, decreased GCF inflammatory biomarkers, and reduced pathogenic microbiome distribution within the subgingival plaque. Although the retention or removal of N-M3s continues to be controversial, our findings provide additional evidence that medical decisions should be made as early as possible or at least before the neighboring teeth are irretrievably damaged.
Humans ; Molar/surgery* ; Molar, Third/surgery* ; Periodontal Diseases ; Periodontal Index ; Tooth Extraction

OBJECTIVES: This study aimed to investigate the association between periodontal indexes and biomarkers in gingival crevicular fluid (GCF) and preterm birth (PTB) in pregnancy, as well as to assess the clinical value of these indexes as predictors of PTB. METHODS: A nested case-control study was conducted. A total of 300 systematically healthy pregnant women were selected within 36 weeks of gestation and grouped according to the enrolled weeks. Periodontal indexes, including probing depth (PD), bleeding index (BI), gingival index (GI), and five biomarkers in GCF, including interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α), prostaglandin E2 (PGE2), and 8-hydroxy-2-deoxyguanosine (8-OHdG) were measured at the enrolled date. The detailed birth outcome was recorded. RESULTS: Only women at 24-28 weeks of gestation per PTB case (four full-term births) were selected as controls subjects, PTB displayed significantly greater GI, BI, and 8-OHdG ( CONCLUSIONS Increased BI and 8-OHdG at 24-28 weeks of gestation are risk factors for PTB. Their combined detection may have some value in the prediction of PTB, but further studies with a larger sample size are needed to explore it and thus provide experiment evidence for establishing an early warning system for PTB in pregnant women with periodontal disease.
Biomarkers ; Case-Control Studies ; Female ; Gingival Crevicular Fluid ; Humans ; Infant, Newborn ; Periodontal Index ; Pregnancy ; Premature Birth

OBJECTIVE: To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis. METHODS: Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded. RESULTS: The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P<0.05), but no significant difference in BOP was found between the two groups. The decrease in PD, BOP in group B2 was more obvious than those in group A2 (P<0.000 1), and the GR values in group B2 were more than those in group A2 (P<0.000 1). But the improvement of AL showed no statistical difference between the two groups (P=0.296 8). In group C1, no significant difference in PD, AL, and GR was observed after endoscopy-assisted therapy, but it was more effective for BOP (P<0.000 1). In group C2, the improvement in PD and AL was significantly different from the improvement in SRP alone (P=0.000 5, P=0.000 2) and was accompanied by more GR (P=0.000 5). CONCLUSIONS In non-surgical treatment of severe and generalized periodontitis, SRP can achieve good therapeutic effect on sites with 4<
PD≤6 mm. For sites with PD>6 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.
Dental Scaling ; Endoscopes ; Follow-Up Studies ; Gingival Hemorrhage ; Humans ; Periodontal Attachment Loss ; Periodontal Index ; Periodontal Pocket ; Periodontitis ; Root Planing ; Treatment Outcome

OBJECTIVE: To evaluate the clinical efficacy of clarithromycin (CLM) in the adjuvant treatment of chronic periodontitis systematically, obtain reasonable conclusions through evidence-based medicine, and provide guidance for clinical rational drug use. METHODS: Literature about CLM in the adjuvant treatment of chronic periodontitis was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect, and Embase databases from inception to February 2019 using a computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after two independent reviewers screened the literature, evaluated the quality of the study, extracted the data, and evaluated the risk of bias in the included studies. RESULTS: Six randomized controlled trials were included in 316 subjects. The meta-analysis showed that compared with the scaling and root planning (SRP) group, the probing depth (PD) was reduced in patients with CLM and SRP [MD=-1.00, 95%CI (-1.55, -0.45), P=0.000 04]. Clinical attachment loss was obtained [MD=-0.03, 95%CI (0.43, 0.65), P<0.000 01], and the difference between the groups was statistically significant. The modified sulcus bleeding index (mSBI) was reduced [MD=-0.01, 95%CI (-0.14, 0.19), P=0.66]. No significant difference was observed between the groups, but the decrease in mSBI was more significant in CLM combined with SRP group. CONCLUSIONS CLM combined with subgingival SRP can achieve remarkable results in treating chronic periodontitist.
Anti-Bacterial Agents ; therapeutic use ; Chronic Periodontitis ; drug therapy ; Clarithromycin ; Dental Scaling ; Humans ; Periodontal Index ; Root Planing ; Treatment Outcome

OBJECTIVES: In order to aid the development of practical oral health improvement programs for adults, this study examined whether a correlation exists between oral health indices assessed by experts and self-perceived oral health status. METHODS: Raw data from the second year (2013–2015) of the sixth Korea National Health and Nutrition Examination Survey were analyzed. Among those surveyed, adults over the age of 19 were designated as research subjects. RESULTS: The DT indices, prosthetics indices, and Community Periodontal indices were higher when the subjective oral health status was “Bad.” CONCLUSIONS: The results of this study demonstrated the consistency between subjective and objective oral health status. Thus, self-perceived oral health status is a reliable index to evaluate adult oral health projects for improving the quality of life of adults, improving their oral health, and evaluating future oral health services.
Adult ; Dental Caries ; Dental Prosthesis ; Humans ; Korea ; Nutrition Surveys ; Oral Health ; Periodontal Index ; Quality of Life ; Research Subjects

BACKGROUND: The development of sarcopenia and periodontitis is multifactorial, and several factors that play a role in periodontitis are thought to contribute to sarcopenia. This study evaluated the association between periodontitis and sarcopenia using data from the 2008–2009 Korea National Examination Survey.METHODS: We used the data of 2,340 Korean adults aged more than 65 years from the 2008–2009 Korean National Health and Nutrition Examination Survey. Sarcopenia was defined as the appendicular skeletal muscle mass divided by weight (kg/kg) <2 deviations less than the sex-specific mean for young adults. Periodontal health .was measured using the Community Periodontal Index (CPI), and periodontitis was defined as a CPI score of 3 or 4.RESULTS: Analysis using the chi-square test and linear logistic regression showed that the prevalence of periodontitis increased significantly. The odds ratio (OR) (95% confidence interval [CI]) for sarcopenia was 2.498 (1.366–4.569). After adjusting for age and sex, the OR (95% CI) was 2.430 (1.323–4.465). The OR (95% CI) after adjusting for age, sex, diabetes mellitus, osteoarthritis, osteoporosis, and cancer was 2.168 (1.160–4.051).CONCLUSION: Sarcopenia is a representative lifestyle disease associated with periodontitis. In addition, sarcopenia is related to poor quality of life, especially mobility and usual activity. Therefore, greater attention must be paid to patients with periodontitis and they must be evaluated for sarcopenia to prevent and improve poor quality of life.
Adult ; Aging ; Diabetes Mellitus ; Humans ; Korea ; Life Style ; Logistic Models ; Muscle, Skeletal ; Nutrition Surveys ; Odds Ratio ; Osteoarthritis ; Osteoporosis ; Periodontal Index ; Periodontitis ; Prevalence ; Quality of Life ; Sarcopenia ; Young Adult

BACKGROUND: Sleep disorder is a precursor to depression, which is one of the psychological factors associated with periodontal disease that, in turn, affects general and periodontal health. This study aimed to investigate the relationship between sleep duration, depression, and periodontitis in older people aged over 65 years. METHODS: A total of 2,002 older adults aged 65 years or older were included in the study. Their general and health aspects, including smoking, drinking, diabetes, hypertension, and depression, were investigated. Periodontitis was examined using the Community Periodontal Index (CPI). Data were analyzed through a complex sampling design method. Frequency and crossover analyses were conducted to investigate the relationship between depression and periodontitis. To investigate the effect of depression on periodontitis, a logistic regression analysis was performed. RESULTS: Regarding depression and participants' general characteristics, statistically significant differences were found in sex, economic activity, smoking habit, and CPI (p<0.05). In the presence of depression, the odds ratio for periodontitis was 1.84, and the adjusted odds ratio for age, sex, economic activity, residence type, household income, education level, smoking habit, drinking, hypertension, and diabetes was 1.72, representing a significant difference (p<0.05). CONCLUSION: This study examined the relationship between depression and periodontitis in older persons and confirmed a significant correlation. As the population of older adults increases, we should pay attention to their mental and oral health as well as systemic diseases. Various programs for the health promotion of older persons need to be implemented to improve the quality of life of older people.
Adult ; Depression ; Drinking ; Education ; Family Characteristics ; Health Promotion ; Humans ; Hypertension ; Logistic Models ; Methods ; Odds Ratio ; Oral Health ; Periodontal Diseases ; Periodontal Index ; Periodontitis ; Psychology ; Quality of Life ; Sleep Wake Disorders ; Smoke ; Smoking

OBJECTIVES: The purpose of this study was to investigate the correlation of periodontitis with metabolic syndromes and menopause status. METHODS: The 2013 Korea National Health and Nutrition Examination Survey data of 645 postmenopausal and 663 premenopausal women were analyzed using the Pearson's chi-squared test and multiple regression analysis with the Statistical Package for the Social Sciences (PASW statistics) software version 21.0. Metabolic syndromes and community periodontal index (CPI) were analyzed. RESULTS: CPI 3, CPI 4 (P<0.001), and the prevalence of periodontal disease were significantly higher in the postmenopausal group (P<0.001). Periodontal disease was significantly higher (P<0.001) in postmenopausal women not using dental floss (2.69 times), hypertensive postmenopausal women (1.60 times), and premenopausal women with high blood glucose levels (1.67 times). In the multiple logistic regression analysis, after adjusting for age, smoking habit, and alcohol consumption, significant risk factors for periodontal disease were the lack of dental floss use (odds ratio [OR]: 1.83; 95% confidence interval [CI]: 1.26–2.67), menopause (OR: 1.71; 95% CI: 1.22–2.41), and number of metabolic syndromes (when 1 or 2, OR: 2.22 and 95% CI: 1.50–3.29; when 3 or more, OR: 2.22 and 95% CI: 1.58–3.13). CONCLUSIONS: In summary, menopause status is associated with periodontal disease. Therefore, oral health programs for middle-aged women with menopause and metabolic syndromes should be conducted to improve their oral health-related quality of life.
Alcohol Drinking ; Blood Glucose ; Dental Devices, Home Care ; Female ; Humans ; Korea ; Logistic Models ; Menopause ; Nutrition Surveys ; Oral Health ; Periodontal Diseases ; Periodontal Index ; Periodontitis ; Prevalence ; Quality of Life ; Risk Factors ; Smoke ; Smoking ; Social Sciences