Evaluation of Oxidative Stress before and after Using Laser and Photoactivation Therapy as Adjuvant of Non-Surgical Periodontal Treatment in Patients with Rheumatoid Arthritis

(1) Background: The aim of this split-mouth design study was to analyze the clinical periodontal indexes and oxidative stress markers in gingival crevicular fluid modifications after three periodontal disease treatment possibilities (scaling and root planning-SRP; SRP and diode laser-L; SRP and photodynamic therapy-PDT). (2) Methods: The study was conducted on 52 patients: systemically healthy subjects with periodontal disease-non-RA (n = 26); and test group (n = 26) subjects with rheumatoid arthritis and periodontal disease-RA. Clinical periodontal measurements (probing depth-PD; Löe and Silness gingival index-GI; papillary bleeding index-PBI; and periodontal community index of treatment needs-CPITN) and oxidative stress markers (8-hydroxy-2'-deoxyguanosine (8-OHdG) and 4 hydroxynonenal (4-HNE)) were analyzed at baseline (T0), after three sessions of periodontal treatment (T1), and 6 months after treatment (T2). (3) Results: Periodontal therapy improved clinical periodontal measurements and oxidative stress markers in both analyzed groups, with supplementary benefits for laser- and PDT-treated periodontal pockets. (4) Conclusions: The analyzed oxidative stress markers decreased significantly following non-surgical periodontal therapy in both rheumatoid arthritis and systemically healthy patients. All the periodontal disease treatment possibilities analyzed in this study offered clinical and paraclinical improvements; however, the association of laser with SRP and photodisinfection with SRP yielded the best clinical and paraclinical outcomes when compared to SRP alone.

Optical coherence tomography assessment of gingival epithelium inflammatory status in periodontal - Systemic affected patients

INTRODUCTION

Optical coherence tomography (OCT) is an imaging tool used in various medical fields (ophthalmology, dermatology), which allows the observation of morphological particularities on the surface of tissues or internal constructive details of about 2-3mms in depth. In periodontology, it has been used as an experimental tool for periodontal pocket analysis (depth, calculus deposits) but not for the assessment of periodontal inflammation in the gingival tissues, which has been the subject of our in-vitro study.

MATERIAL AND METHOD

Gingival samples were collected from three types of patients: patients with periodontal disease; patients with periodontal disease and a systemic comorbidity; periodontal and systemic healthy patients. The samples were scanned with an OCT light beam, resulting two-dimensional images of the gingival tissue (full thickness epithelium and partial connective tissue). The images were assessed using dedicated software, which allowed the quantification of pixels on a given segment in the epithelium. The average pixel densities were then calculated for each patient group and statistically analyzed.

RESULTS

The resulted pixel densities were highest for the control group samples, while the lowest pixel densities were found in samples originating from periodontal patients with diabetes mellitus. For the other possible periodontal comorbidity, chronic hepatitis C, image assessment also exhibited lower pixel densities than those of the periodontal group, suggesting that this condition could also have an added effect on the tissular changes induced by periodontal disease.

CONCLUSION

OCT has proven that in an in-vitro environment it can be a useful tool for the assessment of periodontal inflammation in gingival samples of periodontal patients. In terms of inflammatory tissular changes observed by OCT analysis, chronic hepatitis C could be regarded as possible periodontal disease's comorbidity.