elham fakhari

Chronic periodontitis is caused by the interaction between plaque biofilm microorganisms and host immune cells. The serum level of some vitamins may play a role in the prevention and control of the disease. This study aimed to determine the relationship between serum vitamin D levels and chronic periodontitis in patients referring to Dental School, Golestan University of Medical Sciences, Gorgan, Iran.

A total of 49 individuals with healthy periodontium (control group) and 49 patients with chronic periodontitis (case group) participated in this case-control study. Blood samples were taken from the participants, and serum vitamin D levels were measured using an enzyme-linked immunosorbent assay. Serum vitamin D levels were compared between the two groups using the Mann-Whitney test. Data were analyzed in SPSS 22 software at a 0.05% confidence level.

A total of 37 (37.8%) males and 61 (62.2%) females were included in the study. Serum vitamin D levels in the control and case groups were 35.61±16.12 ng/ml and 24.98±10.54 ng/ml, respectively (P˂0.001). The odds ratio of periodontitis per unit change in vitamin D level with the removal of confounders was 0.94 (95% confidence interval: 0.90-0.97) (P˂0.001).

Serum vitamin D levels were lower in patients with chronic periodontitis than in healthy individuals. It seems that decreased serum vitamin D levels may increase the chances of developing chronic periodontitis.

Chronic periodontitis (CP) is characterized by an immune response, leading to the destruction of periodontal supporting tissue. The effect of inflammatory and genetic factors on periodontitis has been evaluated previously. The interleukin (IL‑17) as an inflammation regulator seems to play a critical role in periodontitis pathogenesis. Here, in the current study, we aimed to investigate the association of ‑197 G > A (rs2275913) IL‑17 gene promoter polymorphism with generalized severe CP in an Iranian population.

In this case–control study, a total of 54 patients with periodontitis and 118 normals were enrolled. The polymerase chain reaction‑restriction fragment length polymorphism technique was applied to detect IL‑17 promoter rs2275913 genotypes in association with the susceptibility to severe CP. Chi‑square test or Fisher’s exact test was employed to compare genotype frequencies between groups. P < 0.05 were considered statistically significant.

The distribution of genotypes and alleles was in Hardy–Weinberg equilibrium. Although no significant association was observed between the risk of periodontitis and genotype frequencies under any of the inheritance models, the GG genotype was higher in healthy controls, while the AG genotype was more frequently observed in patients under the codominant model ([odd ratio [OR] = 2.14, 95% confidence interval (CI) (1.01–4.53), P = 0.13]). The frequency of AG‑AA genotype was higher in patients under dominant inheritance model ([OR = 1.92, 95% CI (0.94–3.93), P = 0.068]), while GG‑AA and AG genotypes were higher in healthy controls under over dominant model (OR = 0.1.95, 95% CI [0.98‑3.86], P = 0.055).

The results of this study showed that the presence of allele A and AG genotypes could be considered possible factors in increasing the risk of developing CP, although the differences of allele and genotype frequencies were remarkable but not statistically significant between the two groups.

Periodontitis is one of the most common periodontal diseases, characterized by destruction of connective tissue and supporting structure of the tooth. Osteoporosis is a systemic disease of skeletal tissue characterized by a decrease in bone mass and leads to the destruction of bone structure. The aim of this study was to evaluate the correlation between systemic osteoporosis and periodontal status in menopausal women referred to the bone density measurement center in Gorgan.

In this case-control study, 56 menopausal women aged 45-65 years participated. Among the participants, 28 individuals had osteoporosis and 28 women were healthy. Periodontal pocket depth (PPD), clinical attachment level (CAL), plaque index (PI) and gingivitis index (GI) were measured for each patient. Finally, the data were analyzed using 95% confidence level.

A total of 56 menopausal women were included in the study. The mean GI in the osteoporotic group was 0.74 ± 1.43 and in the non-osteoporotic group was 0.77 ± 1.32 (p value = 0.280). The mean periodontal pocket depth in the osteoporotic group (0.63 ± 3.73) was more than the non- osteoporotic group 0.57 ± 3.66 (p value = 0.363). PI mean in the osteoporotic and non-osteoporotic groups were 37.11 ± 15 and 37.39 ± 15, respectively (p value = 0.363).

The mean clinical attachment level in menopausal women with osteoporosis was significantly higher than normal menopausal women. On the other hand, there was no significant difference in other indices of periodontal disease such as PPD, PI, GI.

 The oral cavity has been suggested as a potential reservoir for Helicobacter pylori (H. pylori), which could be a major cause of reinfection after standard systemic therapy. The aim of this study was to evaluate the effect of full-mouth disinfection (FMD) on the recurrence of H. pylori infection.

This randomized clinical trial was conducted on 40 patients with chronic periodontitis and H. pylori infection. Of these, 20 patients received quadruple anti-H. pylori therapy only (group A) and the other 20 patients received quadruple therapy plus FMD (group B). The presence of H. pylori was detected by a 14C-urea breath test (UBT) after 1 and 6 months. Data were analyzed with SPSS 16 using the chi-square test. A value of p<0.05 was considered statistically significant.

Of 40 dyspeptic patients, 15(75%) and 18(90%) of 20 in groups A and B, respectively, had a negative UBT after 4 weeks. Of the patients with successful eradication of H. pylori after 1 month, 8(53.3%) and 6(33.3%) of 15 in group A and 18 in group B, respectively had a positive UBT after 6 months. There were no statistically significant differences between the two groups in the follow-up periods (p>0.05).

Implementation of quadruple therapy plus FMD may reduce recurrence of the infection although further studies are recommended to confirm the results.

Periodontal disease has high prevalence in diabetic patients and the knowledge of them about the relationship between diabetes and periodontal disease is effective in the control of the blood glucose and progression of periodontitis. This study was done to evaluate the knowledge, attitude and practice of diabetic patients about periodontal disease in Gorgan north of Iran.

This descriptive-analytical study was done on 300 type 1 and 2 diabetic patients (136 males & 164 females) whom referred to governmental health centers in Gorgan, northern Iran during 2019. Demographic information, knowledge, attitude and practice were recorded using a questionnaire.

The level of good knowledge, attitude and practice were evaluated 51.7%, 44.3% and 25%, respectively. There was significant association between oral hygiene practice and gender and education (P<0.05). Good practice was observered more in females and in patients.

More than half of diabetic patients had moderate to good knowledge and attitude about periodontal disease but their practice was moderate to poor.

The present study aimed to assess the periodontal condition in the patients with various blood groups referred to the dental school, Golestan University of Medical Sciences, in 2018.

This cross-sectionalstudy was done in 970 patients referred to the dental school, Golestan University of Medical Sciences. Medical history was obtained and blood groups were determined. The assessed periodontal indices, included gingival index (GI), clinical attachment level(CAL), and periodontal pocket depth (PPD), and there were three divided groups of patients based on it: healthy ones, patients with gingivitis, and periodontitis. Then, the probable association between the type of periodontal disease, ABO blood groups andRh factor was analyzedby Chi-squared test. P-value of 0.05 considerations was statistically significant.

Among 970 patients, the most frequent blood groups in healthy individuals, patients with gingivitis and periodontitis were Group A, B, and O, respectively. The AB blood group had the least frequency in all three groups. Rh+ factor was significantly more prevalent in all three groups. Statistically, there was a significant relationship between blood group and Rh factor with periodontal disease(p value < 0.0001, p value = 0.022).

According to the results, the blood groups B and O showed a higher percentage in gingivitis and periodontitis groups respectively, while the blood group AB showed the least percentage of periodontal disease. Statistically, there was a significant relationship between periodontal disease with the blood group and Rh factor.

The combination of chlorhexidine (CHX) and fluoride is believed to enhance the effects of both constituent elements, and reduce their possible side effects. This study aimed to evaluate the effect of CHX containing sodium fluoride on dental plaque, gingival inflammation, and tooth discoloration.

In this double-blind clinical study, 40 patients were selected and randomly divided into two groups. One group was given CHX 0.12%, and the other one was provided with sodium fluoride 0.05%-CHX 0.12% mouthwashes. Plaque index (PI), gingival index (GI), and discoloration index (DI) were measured at the beginning of the study and then after two weeks. Data were analyzed using chisquared and independent t test.

PI and GI were significantly reduced in the group with CHX + sodium fluoride compared to the one with CHX (P<0.001); however, the difference between two groups in terms of DI was not statistically significant (P =0.08). Both groups showed complications, but their differences were not statistically significant (P=0.5).

Mouth wash containing CHX + sodium fluoride was more effective in dental plaque control and gingival inflammation than the one only including CHX, although complications were not statistically significant between the two groups.

Gingival biotype is defined as the faciolingual thickness of keratinized gingiva which plays an important role in periodontal health. Moreover, it affects the periodontal response to physical trauma, the result of periodontal and implant surgery, and restorative and orthodontic treatment. In this regard, the present study aimed to investigate the relationship of gingival biotype with the width of the keratinized gingiva, depth of probe, and height of papilla in the patients who referred to the Dental School at Golestan University of Medical Sciences.

This cross-sectional study was conducted on 130 patients who referred to the Periodontal Department of the Dental School. For the purposes of the study, their clinical parameters were assessed which included the width of keratinized gingiva, depth of the probe, and height of papilla. Finally, the relationship between the gingival biotype and clinical parameters was investigated. It should be noted that a p < /em>-value of 0.05 was considered statistically significant.

Out of 130 participants, 70 and 60 patients had thin and thick gingival biotypes, respectively. Based on the results, the mean values of the keratinized gingiva width, depth of the probe, and height of papilla were 6.23±1.44, 1.12±0.44, and 3.12±0.65 mm, respectively. Moreover, the mean values of keratinized gingiva width, depth of the probe, and height of papilla were 5.27±0.91, 1.07±0.37, and 3.4±0.66 mm in thin gingival biotype, respectively, and 7.35±1.10, 1.19±0.49, and 2.7±0.46 in the thick gingival biotype, respectively.

It can be concluded that the mean value of the keratinized gingiva width of the thin biotype was less than that of thick biotype. However, the height of papilla was more in the thin biotype, compared to the thick biotype. Besides, no significant difference was observed between the depth of probe of these two biotypes.

Rheumatoid arthritis and periodontitis are chronic inflamma-tory diseases with a possible bidirectional relationship. This link may be affected by many factors like drug consumption.

This study was designed to evaluate the periodontal condition in patients with rheumatoid arthritis, considering the effect of disease modifying anti-rheumatic drugs.

This case-control study included 25 newly diagnosed rheumatoid arthritis patients with negative history of taking anti-rheumatic drugs, 25 patients who received anti-rheumatic drugs for more than three years and 50 healthy individuals as a control group. Periodontal indices, including plaque index, gingival index, probing depth, clinical attachment loss, and rheumatologic indices were recorded and compared between these groups.

Rheumatoid arthritis patients were significantly more affected by periodontitis compared with healthy subjects (p= 0.006). There was no significant difference in rheuma-tologic indices between patients with and without periodontitis. Clinical attachment loss in old rheumatoid arthritis patients and gingival index in newly diagnosed ones were signifi-cantly more compared to the control group (p= 0.003 and p< 0.001 respectively). We could not find a linear relationship between the severity of rheumatoid arthritis and chronic peri-odontitis (p= 0.1, r= -0.224).

Periodontitis and clinical attachment loss were more in patients with rheuma-toid arthritis than the healthy group, especially in drug consumers. Gingival index in pa-tients without the history of consuming anti-rheumatic drugs was significantly higher than those who were drug consumers, indicating the effect of the medications on the signs of inflammation.

The purpose of this process was to utilize the flipped classroom for the knowledg and satisfaction improvment of dental students in the preclinical courses of periodontics and pediatric dentistry.
Methods and Materials: Students (n=28 in each course) were divided into two groups randomly . In one group the students were instructed by the traditional method (lecture and demonstration),in the other one the students were asked to watch the prerecorded films and the classroom was converted to a place for discussion.
Evaluation was done using pre-test and post-test in each group. Results have shown that the knowledge of the students was improved in both groups, but there were not statistically differences between them. All of the students preferred flipped classroom to the lecture one, and were satisfied.
This article demonstrates that learners seem to prefer a flipped classroom method. Certainly ,it was rated more positively than the traditional classroom on many different characteristics.

Periodontics is, to a great extent, associated with debridement of periodontal pockets; however, regeneration of periodontal tissues and application of biomaterials have attracted a lot of attention during the recent decades and considerable progress has been achieved in this field. The materials used include bone grafts, membranes and growth factors. The aim of this article was to review biomaterials currently used to treat peri-dental and peri-implant lesions and assess the future needs in this field.Search strategy: All the relevant articles indexed in Pubmed from 1976 to 2013 were searched, using the following key words: guided tissue regeneration, Guided bone regeneration, bone graft, membrane and tissue engineering. Of all the 105 abstracts retrieved, papers were selected that had evaluated the clinical aspects of the use of biomaterials used to treat peri-dental and peri-implant lesions. The use of growth factors, genes and stem cells has been promising and these agents will lay the future foundations of biomaterials. It appears trial-and-error processes determine the best biomaterials for use in periodontal treatment.

It has been stated that the bone allografts from different tissue banks may lead to various amount of bone induction, so the aim of this study was to evaluate bone regeneration of three demineralized allografts both histologically and histomorphometrically in rabbits calvaria bone defects. In this double-blind randomized experimental animal study, 32 critical size defects (11-mm diameter) in the calvaria of 16 male New Zealand white rabbits were randomly fi lled with three demineralized freeze-dried bone allografts (DBM, CENOBONE, DEMBONE), while the nongrafted defect was regarded as control group. After 6 and 12 weeks of healing, the experimental animals were euthanized for specimen preparation. After histological evaluation, histomorphometric analysis was performed to quantify new bone formation and remained graft particles. The data were analyzed by one-way ANOVA with Tukey’s ad-hoc test and t-test. (P < 0.05 was considered to be statistically signifi cant). Mean percentage of bone formation increased between two healing time, but it was not statistically signifi cant in all groups except DBM which the bone formation signifi cantly decreased (P = 0.04). There were not statistically signifi cant differences between three allografts in remained particles and bone formation in both healing times and they could not induce signifi cantly more bone formation than control group. Both test and control groups resulted in successful new bone formation. No difference was noted in bone formation and remained particles between three commercial bone allografts. Further studies in this issue may be needed.

Various methods have been used for the treatment of dentine hypersensitivity such as dentifrices, sealants and different types of lasers. The aim of this study was to evaluate the effect of Neodimium:Yttrium-Aluminium-Garnet (Nd:YAG) laser in association with graphite on the dentin morphologic changes. In this experimental in vitro study, 16 freshly extracted third molars were selected. 5 specimens with the dimensions of 2×2×1 mm from root trunk were prepared. Specimens were randomly divided into five groups: group 1 (control, no laser irradiation). Group 2, 3 irradiated by Nd:YAG laser 0.5 and 1W, output power respectively. Group 4, 5 smeared with graphite and then irradiated by Nd: YAG laser 0.5 and 1W output power. Samples were prepared for scanning electron microscopy. Number and diameter of dentinal tubules were determined in different groups and analyzed with the Kruskal-wallis and Mann-Whitney tests (SPSS 16). The number of tubules had significant difference between all groups (P<0.001), except group 1 in comparison with group 2 (P> 0.05), and group 3 in comparison with group 4 (P> 0.05). Micro-cracks and rupture of melted dentin materials were seen in group 4 and 5. According to the findings of this study, smearing with graphite on dentin surface increase the absorption of Nd:YAG laser energy and reduced the diameter and number of open dentinal tubules.

Polyphenpls are the most common antioxidants in foodstuffs، which have an important role in the prevention of chronic diseases. Periodontitis is a chronic disease of the supporting structures of teeth، which can destroy periodontal structures and result in tooth loss. The aim of this review article was to evaluate the effect of polyphenols on periodontal diseases. Review report: All the relevant articles indexed in the Pubmed from 2002 to 2011 were surveyed. After studying the abstracts of 48 collected articles، 13 irrelevant ones were excluded and full texts of 35 remaining articles were assessed. Regarding the existing articles about polyphenols، it appears consumption of polyphenol-containing products may be effective in plaque control and prevention of periodontal diseases. Therefore، it is suggested that the results of in vitro studies be assessed by clinical trials.