Eosinophilic Granuloma in Jaw Bone: A Pare Pediatric Case Report

Background

Eosinophilic granuloma (EG), one of the three clinical forms of Langerhans cell histiocytosis (LCH), is a benign inflammatory reaction to an unknown etiologic agent. It most commonly occurs in children and young adults. The most frequently involved bones are the skull, the ribs and the femurs. Alongside the cranium, the maxilla and mandible can also be affected.

Case Details

Herein, we report a case of eosinophilic granuloma in a ten years old boy involving posterior quadrants upper and lower jaws as a destructive lesion involving gingiva, periodontium and alveolar bone. Involvement of other bones is ruled out by nucleotide imaging study.

Conclusion

EG should be considered as a differential diagnosis whenever there is a bony destructive lesion involving alveolar bone of the Jaws. Early diagnosis and surgical intervention will resolve the lesion.

Periodontal Diseases and Diabetes Mellitus: A Systematic Review

Introduction

Although the fact that the association of the periodontitis and the diabetes mellitus is well accepted, the literature has inconsistent findings regarding this connection. The motive in conducting this systematic review was to define whether poorly controlled diabetes was linked to the development or progression of periodontitis.

Materials and Methods

Databases from PubMed, Scopus, and Embase were searched electronically. All included articles' reference lists were manually searched. Google Scholar was used to research gray literature. For this review, longitudinal studies (prospective) on the association between periodontitis and diabetes were taken into consideration. Studies have to have included at least two parameters of the evolution of health of the periodontium throughout time. The study's design, as well as unadjusted and adjusted estimates, was recorded. This study calculated the combined impact of diabetes-related hyperglycemia on the start or progression of periodontitis using meta-analysis. To look into possible sources of study heterogeneity, subgroup analyses and meta-regression were used.

Results

With 49,262 participants from 13 studies that met the inclusion criteria, 3197 of whom had been diagnosed with diabetes. Diabetes augmented the likelihood of developing or progressing into periodontitis by 86%, according to meta-analyses of adjusted estimates (RR 1.86; 95% CI 1.3-2.8). On the association between periodontitis and diabetes, there is little data, nonetheless.

Conclusions

This study provides proof that persons with diabetes have an increased risk of developing periodontitis. Methodological limitations mentioned in this study should be overcome in upcoming prospective longitudinal investigations.

Efficacy of surgical periodontal treatment with and without photobiomodulation in the treatment of severe periodontitis: An evaluation of periodontal, microbiological, and cytokine levels

AIM

To compare the efficacy of surgical periodontal treatment (SPT) alone and PDT-assisted surgery in participants with severe periodontitis MATERIAL AND METHODS: The present clinical trial was completed by 64 participants (n=32 each). The selection was made according to predefined inclusion and exclusion criteria. Patients in group A were treated with SPT only and participants in group B were treated with SPT adjunct to PDT. Microbiological assessment of P.Gingivalis; T. Forsythia and T.Denticola were evaluated using cultural analysis and periodontal parameters plaque score (PSc), bleeding on probing (BoP) periodontal depth (PD), and clinical attachment loss (CAL) at baseline and post-treatment at 6 months and 12 months were performed. The gingival crevicular fluid (GCF) was collected for the estimation of IL-1β and tumor necrosis factor-alpha (TNF-α) using an enzyme-linked immunosorbent assay (ELISA). For intra-group comparison and post hoc correction, Student's t-test along with Bonferroni was used. For the difference between follow-ups, an analysis of variance (ANOVA) multiple rank tests were incorporated.

RESULTS

The mean age of participants in the SPT group was 55.25±4.6yrs. Whereas, participants treated with PDT adjunct to SPT were 54.88±3.6yrs. Periodontal parameters (BoP, PD, PSc, CAL) showed no significant difference at baseline. At 6 months and 12 months follow-up, a significant difference in all parameters (BoP, PD, PSc, and CAL) was found in participants treated with SPT alone and PDT adjunct to SPT (p<0.05). Inflammatory biomarkers at 6-month and 12-month follow-ups, a statistically significant difference in the level of biomarkers (IL-1β and TNF-α) were observed in both groups from baseline (p<0.05). However, at baseline, no significant difference was noted in both groups (p> 0.05). The microbiological assessment showed a significant drop in the bacterial count in participants treated with both regimes i.e., SPT alone and PDT adjunct to SPT.

CONCLUSION

Photodynamic therapy (PDT) adjunct to surgical periodontal treatment (SPT) in severe periodontitis improves microbiological and periodontal parameters and lowers the level of proinflammatory cytokines.

Periodontal Disease and Smoking: Systematic Review

Introduction

Tobacco has been linked multiple times to many health implications. The relationship between periodontitis and tobacco was thoroughly investigated in this systemic review to evaluate if tobacco specifically smoking impacts the progression of periodontal through impairing vascular and immunity mediators processes.

Materials and Methods

The manual and electronic literature searches up to 2020 in the databanks of the EMBASE, MEDLINE, PUBMED, and SCOPUS were conducted. The search terms were "periodontitis," "periodontitis diseases," "smoking," "tobacco use," "tobacco," and "cigarette, pipe, and cigar." The types of studies included were restricted to the original studies and human trials. Analyses of subgroups and meta-regression were used to calculate the heterogeneity.

Results

15 papers total were considered in the review, however only 14 of them provided information that could be used in the meta-analysis. Smoking raises the incidence of periodontitis by 85% according to pooled adjusted risk ratios (risk ratio 1.845, CI (95%) =1.5, 2.2). The results of a meta-regression analysis showed that age, follow-up intervals, periodontal disease, the severity of periodontitis, criteria used to determine periodontal status, and loss to follow-up accounted for 54.2%, 10.7%, 13.5%, and 2.1% of the variation in study results.

Conclusion

Smoking has an undesirable impact on periodontal incidence and development. Therefore, when taking the history of the patients at the initial visits the information about the habit of smoking has to be thoroughly noted.

Periodontal Diseases and Heart Diseases: A Systemic Review

Introduction

Up to 50% of people worldwide are affected by periodontal disease (PD); cardiovascular diseases are a serious concern for the major portion of the world's population. Observational data have shown a connection between PD and CVD. The current systemic review investigates the incidence of the CVD in individuals with PD through various designs of the previous research.

Materials and Methods

An extensive online search in the various databanks of EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were: "PD, CVD, myocardial infarction, coronary heart disease (CHD), and stroke; technique of diagnosis and the degree of PD were assessed clinically or by self-report." The studies selected were longitudinal research design and randomized trials. To ascertain the risk of mortality due to cardiac issues in periodontal diseases, meta-analysis, and meta-regression were carried out. The diagnosis techniques for periodontal diseases, severity, and impact of gender, were also examined.

Results

After full-text screening, 32 longitudinal cohort studies were included. PD patients had a significantly greater risk of CVD than non-PD patients (RR: 1.20). Clinical and self-reported PD diagnoses did not differ in CVD risk (RR = 0.97). Men were at increased risk for both severe PD (RR: 1.25), and CVD (RR: 1.16). The risk of stroke was the highest among all forms of CVD (RR = 1.24), and the risk of CHD was significantly elevated (RR = 1.14).

Conclusion

Current review showed that populations with PD consistently and modestly have an elevated risk of CVD. Men and those with severe PD are at higher CVD risk, which suggests population-targeted therapies may be helpful.

Assessment of the Peri-Implant Conditions for the Primary and the Repeated Abutment Placements: An Original Research

Introduction

Recurrent abutment substitutions may physically irritate the mucosal (soft tissue) barrier, which may cause additional toxic irritants and germs to enter the mucosal implant barrier and weaken the tissues surrounding implant. The creation of a "definitive abutment" may lessen the likelihood of tissue losses around the implant. Determining the characters of the peri-implant tissue after the placement of the definitive abutments and multiple abutment replacement was the goal of this study.

Materials and Procedures

Forty missing teeth were replaced with implants in matched subjects. Parameters assessed were "distance of cement enamel junction to alveolar crest and distance of CEJ to gingival margin; bleeding on probing, Sulcus probing depth, and peri-implant marginal bone loss." Subjects were randomly assigned for the two groups of intervention. All the measurements were documented at designated timelines and compared for the statistical variance where P < 0.05 was considered as significant.

Results

In the control and test groups, the peri-implant marginal bone level rose from baseline to 3 months. There were no appreciable differences between the CEJ-AC and CEJ-GM groups when the clinical and radiographic parameters of each group were evaluated. Throughout all of the time points, the soft tissue borders in both groups remained comparably steady.

Conclusion

The study's findings suggest that using implants with definite abutments is more advantageous for obtaining better maintenance in terms of the health of the tissues that surround the implants.

Estimation of the Mechanical Properties of PRF in the Implant Surgery: An Original Research

Introduction

In many oral procedures that involve the implants, hair implantations, "Platelet-Rich Fibrin Membrane (PRF)" is commonly applied. The advantages are many. In this study, the mechanical resistance of PRF under resistance pull on a longitudinal axis was assessed and compared.

Material and Methods

For the current in vitro study, 60 volunteers donated each 10 ml of their blood and hence a total volume of 600 ml of blood was procured that was analyzed for the current study. The total volume was grouped to three groups where they receive three resistance centrifugation forces of "F-200,600,800 m/s²." In each group, 20 samples were tested for each level of the G-resistance. Each group was further divided as two subgroups of different times of wait, where they were centrifuged at baseline time and after a stand of 30 minutes. On universal testing equipment, the PRF membranes were mechanically tensioned in order to determine each membrane's resistance force. These values were compared for any statistical variance using appropriate statistical tools keeping P < 0.05.

Results

Any applied force had no statistically significant effect on the centrifugation duration for membrane resistance. When the resistance was applied for the PRP samples immediately after they were procured, no significant variation was seen at all the grades of the centrifugation forces; consequently, the T30 group showed a statistically significant variance for the centrifugation forces applied (P = 0.04), with the highest value when the greatest force was applied. According to the results, the centrifugation waiting period could be determined based on the application requirement.

Conclusion

For immediate membrane usage, the centrifugation had no effect on resistance; however, after 30 minutes, a membrane with greater resistance was produced by applying more force.

Role of Bisphosphonates in Periodontal Diseases: Systematic Review

Introduction

The chief aim in managing periodontal diseases is the elimination of causative factors that may vary from pathogens to physical parameters. In the current systematic review, the effectiveness of "Bisphosphonate Therapy" as a supplement to "Scaling and Root Planing (SRP)" in the management of periodontitis is calibrated from the previous studies.

Materials and Methods

An extensive online search in the various databanks of EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were "Probing depth (PD)" which was the main endpoint, and variations in "Clinical Attachment Level (CAL)" and/or "Bone Defect (BD) fill" were the secondary variants that were searched for in the current study. The data collected were tabulated and compared using the means and the standard deviations. Using the random effect method the mean variations and the confidence intervals (95%) of the parameters were assessed.

Results

Eight studies were finalized. Alendronate was utilized as a supplement to SRP in seven studies, four of which employed topical administration and three of which used oral alendronate. A substantial grade of heterogeneity for Probing depth (P < 0.0001), Clinical Attachment Level (P = 0.007), and Bone Defect fill (P < 0.0001) was observed amongst groups when comparing the properties of adjunctive BT to SRP alone. In comparison to SRP alone, SRP with bisphosphonate treatment significantly reduced PD (P = 0.002), increased CAL (P = 0.008), and filled BD (P < 0.001).

Conclusions

Although BT as an adjunct appears to be successful in treating periodontitis, its practical applicability is questionable due to the possibility of developing jaw osteonecrosis and the short-range follow-up of the research.