Differences in Periodontal Severity Between Perimenopausal and Postmenopausal Women with Chronic Periodontitis

Background: Postmenopausal women exhibit reduced bone mineralization, which causes bone resorption, including that of alveolar bone. Parathyroid hormone has been shown to play a role in alveolar bone resorption. Objective: This study aims to analyze relationships between parathyroid hormone and other factors that may contribute to alveolar bone resorption in postmenopausal women. Methods: This cross-sectional study included 82 postmenopausal women aged 50–74 years, who resided in Central and East Jakarta, Indonesia. Subjects' data were obtained through questionnaires, dental examinations, and blood collection for the examination of parathyroid hormone levels by enzyme-linked immunosorbent assay and using panoramic radiography to measure bone resorption. Results: Spearman correlation analysis showed a significant correlation between parathyroid hormone level (p = 0.005) and extent of alveolar bone resorption, but age (p = 0.292), menopausal duration (p = 0.244), and number of missing teeth (p = 0.517) were not significantly correlated with the extent of alveolar bone resorption. Conclusion: Various factors play a role in the mechanism of bone resorption, so knowing the role of each factor is expected to reduce the effects of alveolar bone resorption that occurs in postmenopause. Among the factors investigated in this study, the parathyroid hormone was the sole factor correlated with postmenopausal alveolar bone resorption.

Periodontal tissue destruction can cause complaints for sufferers. Inflammatory conditions of the gingiva, bleeding gums, and even tooth loss are clinical features of the destruction of the periodontal tissues. Periodontitis is an inflammatory disease involving the periodontal tissues. The prevalence of periodontium destruction increases with aging. Changes in innate and adaptive immunity that occur in the elderly also play a role in the severity of periodontitis. “Inflammaging” is a chronic inflammatory state associated with old age in humans. Periodontitis contributes to inflammaging since periodontitis in the elderly is associated with increased markers of systemic inflammation. Age-related changes also affect neutrophil function, especially antimicrobial activity, so neutrophils may become more pathological. After infiltration into the tissue, neutrophils are equipped with several antimicrobial strategies to reduce the number of antigens. Phagocytosis is the ability of neutrophils to engulf and kill microbes, but neutrophil phagocytosis is weakened in the elderly. Age-related changes affecting neutrophils, macrophages, and T cells appear to promote pathogenic immune responses and contribute to the increased prevalence of periodontal disease in aging individuals. Proper regulation of the host immune response is critical in maintaining periodontal health. This paper aims to describe the aging process and its relation to periodontal conditions.

Objectives This study aimed to determine the role of stress in recurrent aphthous stomatitis. Stress was examined with the Perceived Stress Scale and cortisol levels; meanwhile, recurrent aphthous stomatitis was assessed with the duration of the lesion. Materials and Methods This was a cross-sectional analytical study conducted at Oral Medicine Installation, Universitas Sumatera Utara Dental Hospital, and Prodia Laboratory, Medan. The subjects were 50 patients with minor recurrent aphthous stomatitis, without systemic disease, who did not take systemic drugs or use orthodontic appliances. The diagnosis of recurrent aphthous stomatitis was established with anamnesis and clinical examination. Stress was examined by filling out the Perceived Stress Scale questionnaire and blood tests for serum cortisol levels. Statistical analysis The data were analyzed using the Fisher test and Mann–Whitney U test. Results This study showed no significant relationship between the Perceived Stress Scale category and recurrent aphthous stomatitis, with a p-value of 0.392. This study also showed no significant relationship between blood cortisol level and recurrent aphthous stomatitis with a p-value of 1.000. Conclusion Stress may play an important role in recurrent aphthous stomatitis. However, this study did not show any difference in stress examined through the Perceived Stress Scale and cortisol levels based on the duration of recurrent aphthous stomatitis.

Objective: the study aimed to investigate the effectiveness of the combined application freeze-dried platelet-rich plasma (FD-PRP) and hyaluronic acid (HA) in healing after periodontal surgery. Material and Methods: This is an experimental laboratory research with a design pre and post-test only control group design. Freeze-dried platelet-rich plasma and HA were applied at periodontal surgical sites in periodontitis induced Wistar rats’ mandibulary incisors. Bleeding on probing (BOP) was observed as a clinical aspect. Porphyromonas gingivalis was examined and counted. Meanwhile, the healing process was seen by examining fibroblasts and Platelet-Derived Growth Factor-BB (PDGF-BB) in histology and immunohistochemistry. In this study, BOP decreased faster after applying FD-PRP and HA. Data were processed by ANOVA and Kruskal-Wallis test. Results: Clinical examination by measuring BOP level showed better inflammation resolution at 14th day (p=0.007). Porphyromonas gingivalis (P. gingivalis) count was also reduced in the treatment group (p=0.001 at 3rd and 14th day). The histology aspect by measuring fibroblast count (p=0.025 at 3rd day and p=0.001 at 14th day) and immunohistochemistry by measuring PDGF-BB expression (p=0.014 at 3rd day and p=0.030 at 14th day) showed better tissue healing. Conclusion: combination of FD-PRP and HA has accelerated the healing of periodontal surgical wounds. KEYWORDS Fibroblast; Hyaluronic acid; Periodontitis; Platelet-rich plasma; Porphyromonas gingivalis.