Pacauskienė, Ingrida Marija

In recent years, increasing attention has been given to adjunctive therapies aimed at improving clinical outcomes in periodontal treatment. Among these, antimicrobial photodynamic therapy (aPDT) using the photosensitizer indocyanine green (ICG) has shown great promise. Objective: This narrative review seeks to summarize the existing evidence from randomized controlled trials, systematic reviews, and in vitro and in vivo studies on the use of antimicrobial photodynamic therapy with indocyanine green (ICG) as a photosensitizer, as well as the emerging approach of double-light aPDT with ICG, in the treatment of periodontitis. Materials and Methods: PubMed, Web of Science, and Cochrane Library databases were searched to find relevant articles regarding the topic. The articles were published in English between the years 2015 and 2025. The search used keywords such as (“indocyanine green” AND “antimicrobial photodynamic therapy” AND (“efficiency” OR “efficacy” OR “effect”) AND (“periodont*” OR “gingivitis” OR “gingival” OR “gum”). The articles chosen were required to evaluate the treatment outcomes of periodontitis with ICG-aPDT. Conclusions: ICG-aPDT represents an effective adjunct treatment in periodontal therapy. It can non-invasively target biofilms and minimize systemic action. It makes this technique an attractive adjunct in modern periodontology practice. This narrative review shows that ICG-aPDT can be integrated into comprehensive periodontal care as an adjunct measure promoting tissue healing. However, more high-quality clinical trials are needed to develop standardized protocols and demonstrate long-lasting benefits.

Background: Dental calculus, biofilm, chronic irritation, and periodontitis are some of the aetiological factors that can trigger various active processes in oral mucosa, such as pyogenic granuloma. We present the clinical results of a 52-year-old male patient with severe periodontal disease (stage IV and grade B) and huge pyogenic granuloma successfully treated by conservative subgingival mechanical cleaning and comprehensive full-mouth rehabilitation.

Description of the procedure: At the initial appointment an intraoral examination, orthopantomogram, treatment planning, professional oral hygiene, and oral hygiene instructions were conducted. Teeth with a poor prognosis were extracted, and tooth 47 underwent endodontic retreatment. After 2 weeks the mechanical subgingival cleaning was performed. Teeth with mobility levels of II-III degrees were splinted. Missing teeth were restored with removable partial dentures. Follow-up visits with a periodontist occurred at 12, 24, 36 weeks, and 12 months, where the periodontal condition was assessed clinically and radiographically. Conservative supragingival and subgingival treatment were performed, and individualised oral hygiene instructions were reinforced.

Outcomes: This case demonstrated improvement in bleeding on probing (BoP) and plaque index (PI) at each follow-up. The patient experienced a reduction in pocket depth (PD) of 5–7 mm and significant improvement in radiographic bone level at 24 weeks post-treatment. The pyogenic granuloma between teeth 11 and 21 diminished following the initial conservative treatment and completely resolved by 36 months. No deterioration in periodontal condition was observed, and after 12 months, the pyogenic granuloma had not recurred, with the periodontal condition remaining stable.

Conclusions: This 1-year follow-up case highlights the success of a one-stage treatment approach in promoting periodontal healing through full-mouth periodontal therapy. Stage IV periodontitis and pyogenic granuloma can be effectively managed non-surgically in some cases. The success of this approach relies on eliminating aetiological factors, comprehensive full-mouth rehabilitation, and strong patient motivation.

Background: Antibacterial photodynamic therapy (aPDT) and antibacterial blue light (aBL) are emerging as new adjunctive solutions to attack dental biofilm. In recent years, the development of LED has enabled aPDT to be used repeatedly and practically at home. We present the clinical results of three patients with severe periodontal disease (stage III and grade B) treated by conservative mechanical cleaning with daily use of dual-light aPDT technology at home.

Description of the procedure: Professional oral hygiene and oral hygiene instructions were performed at the first appointment. At this point, Lumoral dual-light aPDT treatment was started to support the oral hygiene regimen at home. The second visit to the dentist was after 4 weeks. Again, the periodontal status remained unstable. Mechanical subgingival cleaning was performed. The patient continued to use the Lumoral device. The third visit to the periodontist was after 24 weeks, the condition of the periodontium was assessed clinically and radiographically.

Outcomes: All three patients showed improved bleeding on probing (BoP) and plaque index (PI) 4 weeks and 24 weeks after the procedure and use of the ‘Lumoral’ device. Also, all three patients had a reduction in pocket depth (PD) after 6 months of treatment. A significant positive change in radiographic bone level following treatment was observed in some sites. The third patient had only two infected pockets left, and the clinical attachment level was significantly improved. None of the patients showed deterioration of the periodontal condition in any aspect. The device use was easy, according to the patients. No adverse events were observed.

Conclusions: Conservative periodontal treatment and repeated aPDT treatment at home eventually improve oral hygiene and periodontal outcomes. More research is needed to confirm and extend the current results.

Periodontitis can disrupt oral and gut microbiota, leading to dysbiosis that affects overall systemic health. Besides the spread of periodontal pathogens by the hematogenous route, they can also be translocated into the gastrointestinal tract, possibly intervening in the neoplastic process in the gastrointestinal tract. This manuscript reviews the relationship between oral and gut microbiota due to periodontitis, discussing systemic health implications and potential links to gastrointestinal cancer. This article highlights the significance and effect of dysbiosis in the gut, emphasizing the importance of maintaining oral health to prevent systemic diseases. Lastly, it will go through therapeutic innovations such as probiotics and oral microbiota analysis tools for systemic disease detection. These findings will mark the integration of oral health management in clinical practice to lower systemic disease risk and improve overall patient outcomes. Aim of work: This manuscript aims to unravel the pathological interaction between oral and gut microbiota and their bidirectional effect on systemic diseases. Materials and methods: The review was performed using the MEDLINE and ScienceDirect databases. Reviewed articles were published in English between the year 2015 and 2024. The search used keywords such as (“oral microbiota” AND “periodontal disease”) OR (“oral microbiota” AND “gastrointestinal cancer”) OR (“Porphyromonas gingivalis” AND “periodontal disease”) OR (“Helicobacter pylori” AND “gastric cancer”) OR (“gut microbiome” AND “inflammatory bowel disease”) OR (“oral microbiome” AND “systemic diseases”). Conclusions: The dysbiotic change in the oral cavity due to periodontitis is linked directly and indirectly to systemic diseases such as IBS, neurodegenerative diseases, muscle joint diseases, respiratory infections, and gastrointestinal cancer; this underscores the importance of maintaining oral hygiene for prophylaxis of oral diseases and the prevention of systemic diseases. A better understanding of the interconnections between oral health and systemic diseases will integrate oral health management to offer new prevention, diagnostic, and treatment opportunities to improve overall patient outcomes.

Burnos gleivinės pažeidimai ir ligos nėra labai dažnai aptariami studentų odontologų klinikinės praktikos metu. Tad būsimiesiems gydytojams sunku juos išmokti pažinti, skirti fiziologinę normą nuo patologijos ir laiku siųsti specializuotai konsultacijai. Leidinyje pateikti LSMU Dantų ir burnos ligų klinikoje konsultuotų pacientų klinikiniai atvejai, iliustruoti nuotraukomis, aprašyta trumpa ligos anamnezė, atlikti tyrimai, diferencinė diagnostika. Mokomoji knyga yra skirta Odontologijos fakulteto studentams, gydytojams rezidentams.

To evaluate and compare the associations of VEGFA serum levels and SNPs (rs1570360, rs699947, rs3025033, and rs2146323) with periodontitis in study participants grouped by gender.

Introduction With 10% of adults worldwide suffering from the severe form of periodontitis, it is also the sixth most common chronic disease in the world. It is a bacterial-driven, chronic inflammation with adverse consequences on chewing ability and quality of life that, if left untreated, eventually results in tooth loss due to the progressive deterioration of the tooth-supporting apparatus. Interestingly, periodontitis has a documented higher prevalence in men (~57%) compared to women (~39%), signifying a possible sex bias in disease pathogenesis. Aim This study aimed to assess and compare the relationships between periodontitis and SNPs (rs1570360,rs699947, rs3025033, and rs2146323) in study participants divided by gender. Methods Patients were subjected to a periodontal examination and radiographic analysis to confirm the diagnosis of periodontitis. Blood samples were taken, and DNA was extracted from peripheral venous blood using the salting-out procedure. The associations between haplotypes and periodontitis were evaluated using logistic regression with OR and a 95% confidence interval. When p<0.05, statistically significant differences were discovered. Statistically significant differences were identified when p<0.0125 after Bonferroni adjustment. Results 261 individuals with periodontitis were enrolled in the study: 107 males and 154 females. There were no statistically significant differences in the genotype and allele distribution of the VEGFA SNPs (rs1570360, rs699947, rs3025033, and rs2146323) in both gender groups. After Bonferroni correction (p>0.05/4), the binary logistic regression analysis used to assess the effects of VEGFA (rs1570360, rs699947, rs3025033,and rs2146323) on the development of periodontitis in males and in females failed to produce any statistically significant findings. Conclusions In this study, VEGFA SNPs (rs1570360, rs699947, rs3025033, and rs2146323) had no association with the gender of periodontitis patients.

Background: The aim of this work was to evaluate the efficacy of proanthocyanidins (PACNs) as an adjunctive periodontal therapy in patients with periodontitis. Methods: Patients with periodontitis (stage III-IV) were included in this randomised clinical study. Patients with periodontitis received 2 different treatment modalities: minimally invasive nonsurgical therapy only (MINST group) or minimally invasive nonsurgical therapy and subgingival application of collagen hydrogels with PACNs (MINST + PACNs group). Clinical periodontal parameters, that is, pocket probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), were evaluated before treatment and after 8 weeks. Concentrations of immunologic markers, matrix metalloproteinase-3 (MMP-3), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in saliva were assessed at baseline and at 8-week follow-up. Results: Forty-six patients diagnosed with periodontitis were randomised into 2 groups: 23 patients in the MINST group and 23 patients in the MINST + PACNs group received the intended treatment. PACNs combined with MINST resulted in additional statistically significant PPD reduction and CAL gain in moderate periodontal pockets by 0.5 mm (P < .05) on average compared to MINST alone. Additional use of PACNs did not result in additional statistically significant improvement of BOP or PI values. Application of PACNs showed significant reduction of MMP-3 levels in saliva after 8 weeks (P < .05).Conclusions: Adjunctive use of PACNs in MINST resulted in better clinical outcomes for moderate pockets. Additional use of PACNs improved MMP-3 concentration in saliva more than MINST alone. Biochemical analysis revealed that MMP-3 concentration in saliva reflected the periodontal health state.

Pirmą kartą šis vadovėlis išleistas 2005 m. 2010 m. pakartotas antrasis pataisytas vadovėlio leidimas. Paaiškėjo, kad vadovėlis, kurį parengė anatomai ir klinicistai: odontologai, veido ir žandikaulių chirurgijos specialistai, remdamiesi naujausia literatūra, kasdienio darbo patirtimi, labai naudingas ne tik studentams, kurie mokydamiesi anatomijos ir histologijos studijuoja dantų sandarą, normalų sąkandį, bet ir odontologams, pradedantiems dantų pažeidimų ir ligų studijas Dantų ir burnos ligų klinikoje. Labai didelių pokyčių šioje anatomijos mosklo srityje neįvyko, tačiau dėl vadovėlio poreikio nusprendėme išleisti trečią šiek tiek pataisytą leidimą. Per šį laikotarpį netekome trijų iškilių asmenybių, vadoėlio bendraautorių Vytauto Leono Gedrimo (1944-2021), Edmundo Burneckio (1935-2018), Aušros Burkauskienė (1959-2020).Vadovėlyje aprašoma histologinė danties audinių sandara, dantų formavimasis, dažnos anomalijos, apibūdinami žandikauliniai dantų segmentai, pateikiamas dantų vardynas (tarptautinė nomenklatūra), apibrėžiamos dantų dalys, danties ertmė, minkštimas (pulpa), dantų formulės, simetriškų dantų grupių požymiai, aprašomi pastovieji ir pieniniai dantys. Atskirai apibūdinamas sąkandis ir jo pobūdį lemiantys veiksniai.Dėl glaudaus ryšio tarp burnos, sisteminės ir psichologinės sveikatos būtina burnos sveikatą atsakingai vertinti kaip sveikatos priežiūros dalį. Vadovėlyje glaustai pateikiami būsimam odontologui būtiniausi bendrieji dantų susiformavimo, pastoviųjų ir pieninių dantų išorinės ir vidinės sandaros duomenys, šiuolaikinė dantų nomenklatūra, apibūdinamas dantų sąlytis idealaus ir fiziologinio sąkandžio metu. Lentelėse glaustai pateikiami kiekvieno danties bei kai kurių viršutinių ir apatinių atitinkamų dantų palyginamieji duomenys.

Background and Objectives: Periodontitis is a multifactorial inflammatory disease associated with biofilm dysbiosis and is defined by progressive periodontium destruction. Genes largely regulate this entire process. SIRTs are a group of histone deacetylases (HDACs) intimately involved in cell metabolism and are responsible for altering and regulating numerous cell functions. Understanding SIRTs and their functions in periodontitis may be useful for therapeutic treatment strategies in the future. The aim of our study was to investigate the associations amid SIRT1 single-gene nucleotide polymorphisms (rs3818292, rs3758391, and rs7895833) and SIRT1 serum levels for patients affected by periodontitis in the Caucasian population. Materials and Methods: The study included 201 patients affected by periodontitis and 500 healthy controls. DNA extraction from peripheral leukocytes was carried out using commercial kits. The real-time PCR method was selected for the determination of the genotype of the periodontitis patients and the control group. The ELISA method was used to measure the SIRT1 concentration. A statistical data analysis was performed using “BM SPSS Statistics 27.0” software. Results: The SIRT1 rs3818292 AG genotype was associated with a 2-fold and 1.9-fold increase in the development of periodontitis under the codominant and overdominant models (OR=1.959; CI=1.239–3.098; p=0.004; and OR=1.944; CI=1.230–3.073; p=0.004, respectively). The serum SIRT1 levels were not statistically significantly different between subjects in the periodontitis and control groups (0.984 (5.159) ng/mL vs. 0.514 (7.705) ng/mL, p=0.792). Conclusions: in our study, the genotypes and alleles of SIRT1 rs3818292, rs3758391, and rs7895833 statistically significantly differed between the periodontitis and control groups, exclusively in the male population and subjects older than 60 years.