Periodontitis is a periodontal tissue infectious disease and the most common cause for tooth loss in adults. It has been linked to many systemic disorders, such as coronary artery disease, stroke, and diabetes. At present, there is no ideal therapeutic approach to cure periodontitis and achieve optimal periodontal tissue regeneration. In this study, we explored the potential of using autologous periodontal ligament stem cells (PDLSCs) to treat periodontal defects in a porcine model of periodontitis. The periodontal lesion was generated in the first molars area of miniature pigs by the surgical removal of bone and subsequent silk ligament suture around the cervical portion of the tooth. Autologous PDLSCs were obtained from extracted teeth of the miniature pigs and then expanded ex vivo to enrich PDLSC numbers. When transplanted into the surgically created periodontal defect areas, PDLSCs were capable of regenerating periodontal tissues, leading to a favorable treatment for periodontitis. This study demonstrates the feasibility of using stem cell-mediated tissue engineering to treat periodontal diseases.

https://stemcellsjournals.onlinelibrary.wiley.com/doi/epdf/10.1634/stemcells.2007-0734

Periodontal ligament stem cell-mediated treatment for periodontitis in miniature swine.

Infection and diabetes: The case for glucose control

Interrelationship between diabetes and periodontitis: Role of hyperlipidemia

Background: African Americans have a disproportionate burden of diabetes. Gullah African Americans are the most genetically homogeneous population of African descent in the United States, with an estimated European admixture of only 3.5%. This study assessed the previously unknown prevalence of periodontal disease among a sample of Gullah African Americans with diabetes and investigated the association between diabetes control and the presence of periodontal disease.Methods: Two hundred thirty-five Gullah African Americans with type 2 diabetes were included. Diabetes control was assessed by percentage of glycosylated hemoglobin (HbA1c) and divided into three categories: well controlled, 8.5%. Participants were categorized as healthy (no clinical attachment loss [AL] or bleeding on probing) or as having early periodontitis (clinical AL ≥1 mm in at least two teeth), moderate periodontitis (three sites with clinical AL ≥4 mm and at least two sit...

Periodontal disease status in gullah african americans with type 2 diabetes living in South Carolina.

The oral cavity of elderly patients in diabetes

Introduction: Over the past decade, there has been an emerging interest in the inter- relationship between systemic conditions and oral health. Diabetes is perhaps one of the best documented conditions that have been closely linked with periodontal disease. This paper reviews the role of diabetes as a risk factor in periodontal disease. The treatment implications in the management of periodontal disease as an integral component of diabetes care is also discussed in light of the current understanding of the pathogenesis of these 2 chronic conditions. Materials and Methods: Epidemiological, clinical and laboratory studies examining the relationship between diabetes and periodontal diseases were selected from both medical and dental journals. Results: The severity of periodontal destruction has been shown to be related to the direct and indirect effects of glycaemic control, with other factors also being implicated. Although some studies have pointed towards a bi-directional relationship between glycaemic control and periodontal health, it is still not clear if improvement in periodontal health could lead to improved metabolic control. Conclusion: Diabetes and periodontal disease are closely related in many ways, though the effect of periodontal disease on diabetes control remain to be determined, with larger intervention studies. In light of the increasing evidence of the relationship between diabetes and periodontal disease, management of oral health should form an integral part of diabetes management. Ann Acad Med Singapore 2006;35:571-81

https://annals.edu.sg/PDF/35VolNo8Aug2006/V35N8p571.pdf

Diabetes as a risk factor for periodontal disease: current status and future considerations

Objectives: The objectives of this systematic review were to assess the survival rate of grafts and implants placed with sinus floor elevation. Material and Methods: An electronic search was conducted to identify studies on sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. Results: The search provided 839 titles. Full-text analysis was performed for 175 articles resulting in 48 studies that met the inclusion criteria, reporting on 12,020 implants. Metaanalysis indicated an estimated annual failure rate of 3.48% [95% confidence interval (CI): 2.48%‐4.88%] translating into a 3-year implant survival of 90.1% (95% CI: 86.4%‐ 92.8%). However, when failure rates was analyzed on the subject level, the estimated annual failure was 6.04% (95% CI: 3.87%‐9.43%) translating into 16.6% (95% CI: 10.9%‐24.6%) of the subjects experiencing implant loss over 3 years. Conclusion: The insertion of dental implants in combination with maxillary sinus floor elevation is a predictable treatment method showing high implant survival rates and low incidences of surgical complications. The best results (98.3% implant survival after 3 years) were obtained using rough surface implants with membrane coverage of the lateral window.

Asystematicreviewofthesuccess ofsinusfloorelevationandsurvival ofimplantsinsertedincombination

This case report illustrates the diagnosis, treatment and long-term follow-up of a patient with ciclosporin- and nifedipine-associated gingival enlargement. The patient was treated successfully without changing his medications. The main aim of the treatment was to reduce the extent of the gingival enlargement, thus restoring dental health, function and aesthetics. Following initial periodontal therapy, a surgical phase was performed. The patient was followed for two years with no recurrence of his gingival enlargement.

Wah Ching Tan

Papers

Diabetes as a risk factor for periodontal disease: current status and future considerations

Asystematicreviewofthesuccess ofsinusfloorelevationandsurvival ofimplantsinsertedincombination

Diagnosis, treatment and long-term maintenance of a patient with drug-associated gingival enlargement