Association between Periodontal Disease and Oral Benign, Potentially Malignant, Malignant, and Chronic Immune-Mediated Disorders: A Clinical Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
- medical history (health status, diseases, pregnancy, habits, etc.);
- dental check-up (for the purpose of establishing the general condition of the oral cavity);
- oral hygiene status check using the plaque index of O’Leary;
- instructions regarding and motivation for adoption of the home-modified oral hygiene protocol using sonic toothbrush, brush, and oral cleaner;
- periodontal screening (PSR) to assess periodontal status;
- qualitative microbiological analysis of supra- and subgingival plaque (including sampling of supra- and subgingival plaque with a curette);
- analysis using phase-contrast microscopy, which made it possible to distinguish between compatible bacterial flora (immobile flora), indicative of healthy periodontal pathology, and incompatible bacterial flora (mobile flora), indicative of periodontal pathology;
- Patients presenting incompatible bacterial flora in the analysis by phase-contrast microscopy and who were positive on the PSR screening were referred for periodontal evaluation according to the following:
- completion of the periodontal chart;
- probing depth (PPD);
- presence of gingival recessions;
- bleeding index (BoP);
- evaluation of periodontal radiographic status;
- collection of photographic documentation.
- Patients who met the diagnostic criteria for periodontal disease were given a report with a diagnosis of gingivitis or periodontitis (stage and grade) and were invited to start a protocol of periodontal treatment.
2.2. Operative Protocol of Dye-Free Photodynamic Therapy
- At T1, the patients underwent nonsurgical periodontal therapy of the first and second quadrants (upper arch) according to the GBT protocol (plaque detection, air flow with glycine and erythritol, ultrasonic instrumentation, which leads to an increase in patient compliance, and the removal of the disclosed plaque to more effectively access visible calculus deposits [23,24]) and dye-free photodynamic therapy.
- At T2, one week after T1, the patients underwent nonsurgical periodontal therapy of the third and fourth quadrants (lower arch) according to the GBT protocol and dye-free photodynamic therapy.
- At T3, three weeks after T2, the patients underwent dye-free photodynamic therapy for both the upper arch and the lower arch.
- At T4, three weeks after T3, the patients underwent dye-free photodynamic therapy for both the upper arch and the lower arch.
- At T5, three weeks after T4, the patients underwent dye-free photodynamic therapy for both the upper arch and the lower arch.
- At T6, four weeks after T5, the patients underwent reassessment of their bacterial flora by phase-contrast microscopic analysis and reassessment of their periodontal indices (PI, PPD, gingival recessions, and BoP).
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- improvement in oral hygiene;
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- presence of compatible bacterial flora;
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- improvement and stabilization over time of clinical periodontal parameters (PI, PPD, recessions, and BoP).
2.3. Materials and Tools Used
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- phase-contrast microscope (Leica DM1000, Leica Microsystems GmbH, Wetzlar, Germany) to perform microbiological analysis of plaque;
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- diode laser (Doctor Smile Wiser 3, LAMBDA SpA, Brendola (VI), Italy) to administer non-surgical laser-assisted periodontal therapy.
2.4. Flowchart
2.5. Study Population
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- age (older than 18 years);
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- diagnosis as per biopsy examination;
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- moving flora (incompatible).
2.6. Process of Inclusion and Exclusion
3. Results
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- 12 with leukoplakia;
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- 6 with carcinoma;
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- 4 with papillomas;
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- 6 with lichen planus.
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- 9 with leukoplakia;
- -
- 1 with carcinoma;
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- 5 with papillomas;
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- 4 with lichen planus.
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- 0 with leukoplakia;
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- 3 with carcinoma;
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- 0 with papillomas;
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- 0 with lichen planus.
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- 1 with leukoplakia;
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- 0 with carcinoma;
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- 0 with papillomas;
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- 2 with lichen planus.
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- 0 with leukoplakia;
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- 0 with carcinoma;
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- 1 with papillomas;
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- 2 with lichen planus.
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- 22 with leukoplakia;
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- 10 with carcinoma;
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- 10 with papillomas;
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- 14 with lichen planus.
Preliminary Outcomes of the Sample Search
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- 19 patients with a previous diagnosis of leukoplakia;
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- 8 patients with a previous diagnosis of carcinoma;
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- 5 patients with a previous diagnosis of papillomas;
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- 10 patients with a previous diagnosis of lichen planus.
Patient | Sex | Age (y) | Oral Pathology | Location of the Lesion | Flora Outcome |
---|---|---|---|---|---|
1 | M | 43 | Leucoplakia | Lower lip | Compatible |
2 | M | 51 | Squamous Papilloma | Upper lip | Compatible |
3 | M | 64 | Lichen Planus | Gingival mucosa | Compatible |
4 | F | 74 | Lichen Planus | Buccal mucosa | Compatible |
5 | M | 52 | Leucoplakia | Dorsal tongue | Compatible |
6 | F | 69 | Leucoplakia | Border tongue | Compatible |
7 | M | 48 | Leucoplakia | Gingival mucosa | Compatible |
8 | M | 66 | Leucoplakia | Gingival mucosa | Compatible |
9 | M | 67 | Lichen Planus | Buccal mucosa | Compatible |
10 | M | 56 | Squamous Cell Carcinoma | Ventral tongue | Compatible |
11 | M | 49 | Squamous Papilloma | Gingival mucosa | Incompatible |
12 | F | 64 | Leucoplakia | Dorsal tongue | Compatible |
13 | M | 46 | Leucoplakia | Buccal mucosa | Compatible |
14 | M | 63 | Squamous Cell Carcinoma | Ventral tongue | Compatible |
15 | M | 64 | Lichen Planus | Buccal mucosa | Compatible |
16 | M | 53 | Leucoplakia | Border tongue | Compatible |
17 | F | 47 | Lichen Planus | Buccal mucosa | Compatible |
18 | F | 72 | Leucoplakia | Gingival mucosa | Compatible |
19 | F | 49 | Leucoplakia | Buccal mucosa | Compatible |
20 | F | 55 | Leucoplakia | Buccal mucosa | Compatible |
21 | F | 62 | Lichen Planus | Ventral tongue | Incompatible |
22 | M | 51 | Leucoplakia | Buccal mucosa | Compatible |
23 | F | 69 | Leucoplakia | Buccal mucosa | Compatible |
24 | M | 51 | Lichen Planus | Ventral tongue | Compatible |
25 | M | 47 | Leucoplakia | Lower lip | Compatible |
26 | M | 44 | Squamous Cell Carcinoma | Dorsal tongue | Compatible |
27 | F | 59 | Leucoplakia | Dorsal tongue | Incompatible |
28 | F | 57 | Squamous Cell Carcinoma | Ventral tongue | Compatible |
29 | M | 60 | Squamous Papilloma | Dorsal tongue | Compatible |
30 | M | 39 | Leucoplakia | Lower lip | Compatible |
31 | M | 73 | Leucoplakia | Lower lip | Compatible |
32 | M | 57 | Squamous Papilloma | Buccal mucosa | Compatible |
33 | F | 65 | Leucoplakia | Buccal mucosa | Compatible |
34 | M | 42 | Squamous Cell Carcinoma | Soft palate | Compatible |
35 | F | 39 | Squamous Cell Carcinoma | Ventral tongue | Compatible |
36 | M | 48 | Squamous Cell Carcinoma | Ventral tongue | Compatible |
37 | M | 55 | Leucoplakia | Border tongue | Incompatible |
38 | M | 50 | Squamous Cell Carcinoma | Dorsal tongue | Compatible |
39 | M | 63 | Lichen Planus | Buccal mucosa | Compatible |
40 | F | 48 | Lichen Planus | Ventral tongue | Compatible |
41 | F | 59 | Squamous Papilloma | Gingival mucosa | Compatible |
42 | F | 59 | Lichen Planus | Buccal mucosa | Compatible |
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- 90.5% of the patients (n°38) had compatible flora, while 9.5% of the patients (n°4) had incompatible flora;
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- Thirty-three patients reported that they were advised by a medical pathologist or a dentist to get in touch with a professional oral hygienist and implement a thorough oral hygiene protocol at home;
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- Nine patients reported that they were not followed up with periodically by a dental hygienist and that they were not motivated to implement a proper home oral hygiene protocol.
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient | Staging | Grading | Mean CAL at T0 | Mean PPD at T0 | %BoP at T0 | Mean CAL at T6 | Mean PPD at T6 | %BoP at T6 |
---|---|---|---|---|---|---|---|---|
1 | IV | B | 10 mm | 6 mm | 89% | 9 mm | 5 mm | 25% |
2 | IV | B | 10 mm | 8 mm | 94% | 8 mm | 6 mm | 28% |
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Barbarisi, A.; Cremonini, F.; Lauritano, D.; Visconti, V.; Caccianiga, G.; Ceraulo, S. Association between Periodontal Disease and Oral Benign, Potentially Malignant, Malignant, and Chronic Immune-Mediated Disorders: A Clinical Study. Healthcare 2024, 12, 1999. https://doi.org/10.3390/healthcare12191999
Barbarisi A, Cremonini F, Lauritano D, Visconti V, Caccianiga G, Ceraulo S. Association between Periodontal Disease and Oral Benign, Potentially Malignant, Malignant, and Chronic Immune-Mediated Disorders: A Clinical Study. Healthcare. 2024; 12(19):1999. https://doi.org/10.3390/healthcare12191999
Chicago/Turabian StyleBarbarisi, Antonio, Francesca Cremonini, Dorina Lauritano, Valeria Visconti, Gianluigi Caccianiga, and Saverio Ceraulo. 2024. "Association between Periodontal Disease and Oral Benign, Potentially Malignant, Malignant, and Chronic Immune-Mediated Disorders: A Clinical Study" Healthcare 12, no. 19: 1999. https://doi.org/10.3390/healthcare12191999
APA StyleBarbarisi, A., Cremonini, F., Lauritano, D., Visconti, V., Caccianiga, G., & Ceraulo, S. (2024). Association between Periodontal Disease and Oral Benign, Potentially Malignant, Malignant, and Chronic Immune-Mediated Disorders: A Clinical Study. Healthcare, 12(19), 1999. https://doi.org/10.3390/healthcare12191999