RESUMEN

Dental therapists encounter patients with various systemic diseases of which cardiovascular disease (CVD) patients form a significant segment. Relation between oral health and cardiac diseases has been well established. Common cardiac disorders encountered in a dental practice include arterial hypertension, heart failure, ischemic heart disease, cardiac arrhythmias, infective endocarditis, stroke, and cardiac pacemaker. Patients with CVDs pose a significant challenge to dental therapy. These patients need special considerations and an adequate understanding of the underlying cardiovascular condition to provide safe and effective dental treatment. Based on the cardiac condition, an appropriate modification in dental care is crucial. A multidisciplinary approach including the patient's cardiologist can potentially reduce complications and improve dental treatment results. This review aims at unfolding the risks associated with the dental management of a cardiac patient and outlines the measures to be undertaken for optimum dental treatment.

RESUMEN

The vestibular incision subperiosteal tunnel access (VISTA) technique, a minimally invasive procedure, achieves multitooth recession coverage with only a single access incision. Use of fetal membranes such as the amnion and chorion has become increasingly popular in the field of dentistry due to their lack of immunogenicity and added advantage of growth factors. The present case series aimed to provide information regarding the potential advantage of placing a chorionic membrane in combination with the VISTA technique to achieve recession coverage. Eight healthy adult patients presenting with 24 Miller Class I multitooth gingival recession defects were surgically treated with the VISTA technique and a chorionic membrane. The clinical parameters measured at baseline and 1, 3, and 6 months postoperatively were probing depth, clinical attachment level, width of keratinized gingiva, thickness of attached gingiva, and height of gingival recession. A repeated-measures analysis of variance with a post hoc Bonferroni test was carried out to compare the baseline values with the 1-, 3-, and 6-month postoperative values. The mean (SD) height of gingival recession was significantly reduced from 2.04 (0.67) mm at baseline to 0.71 (0.71) mm at 6 months (P < 0.001). In addition, there were statistically significant gains in the clinical attachment level, width of keratinized gingiva, and thickness of attached gingiva from baseline to 6 months postoperatively (P < 0.001). The probing depth remained the same at all measurement times. The VISTA technique provided good results in terms of recession coverage. Although there was an improvement in the gingival biotype, the placement of a chorionic membrane did not provide any advantage in terms of percentage of root coverage.

Asunto(s)

Recesión Gingival/cirugía , Adulto , Aloinjertos , Corion/cirugía , Tejido Conectivo , Estudios de Seguimiento , Encía , Humanos , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento

RESUMEN

CONTEXT: Diabetes has become an endemic throughout the world. Periodontitis is associated with diabetes, and it has been regarded as the sixth complication of diabetes. However, the role of diabetes on periodontopathic microbiota such as Porphyromonas gingivalis remains unclear. AIMS: To compare the total number of different genotypes of P. gingivalis in chronic periodontitis patients with and without diabetes by using arbitrarily primed-polymerase chain reaction (AP-PCR) and heteroduplex-PCR. SETTINGS AND DESIGN: This is a single-center comparative study. MATERIALS AND METHODS: A total of 100 patients were included in this study. Patients were divided into two groups: Group A - patients having chronic periodontitis without diabetes (50) and Group B - patients having chronic periodontitis with diabetes (50). Subgingival plaque samples were collected from both groups of patients. Plaque samples were cultured for P. gingivalis. Positive culture samples and extracted DNA from samples by proteinase-K method were collected. Part of DNA samples were checked by AP-PCR using OPA-13 primer, and part of the DNA were checked using heteroduplex-PCR using P. gingivalis-specific Pg8 primer. Results were analyzed by polyacrylamide gel electrophoresis procedure. STATISTICAL ANALYSIS USED: Independent t-test and Chi-square test (SPSS 16) were used. RESULTS: Thirty-four out of fifty samples of Group B patients were found positive for P. gingivalis, whereas 21 out of 50 samples in Group A were found positive for P. gingivalis. AP-PCR showed nine different genotypes in Group B and six different genotypes in Group A. Heteroduplex-PCR showed a total of seven different genotypes in Group B and five different genotypes in Group A. CONCLUSIONS: Results of this study show that, in diabetic condition, P. gingivalis shows increased variations in genotypes.