Microbiological and host factors are involved in promoting the periodontal failure of metaloceramic crowns

Analysis of subgingival microbiota and IL-1β, TNF-α and CX3CL1 levels in gingival crevicular fluid of fixed dental prostheses

Prosthetic biomaterials can affect the composition of the subgingival microbiota and consequently the production of proinflammatory cytokines, causing damage to the periodontium. A total of 40 patients were divided into two groups: 20 with monolithic zirconia (MZ) prostheses and 20 with porcelain fused to metal (PFM) with nickel-chromium (Ni-Cr) alloy prostheses. Subgingival plaque and gingival crevicular fluid samples were taken. The Checkerboard technique for DNA-DNA hybridization and the enzyme-linked immunosorbent assay technique were performed. Teeth with MZ presented a lower percentage of bleeding on probing and tooth mobility compared to teeth with PFM with Ni-Cr alloy. Prosthodontic teeth harbored higher total levels of the 18 bacterial species than non-prosthodontic teeth. There was a higher prevalence of S. gordonii and V. parvula species in PFM with Ni-Cr alloy compared to MZ. There was an increase in IL-1β, TNF-α and CX3CL1 levels in PFM with Ni-Cr alloy compared to MZ. MZ is a candidate biomaterial with fewer negative effects on the periodontium, allowing for longer prostheses longevity in the mouth.

The Influence of Fixed Dental Prostheses on the Expression of Inflammatory Markers and Periodontal Status-Narrative Review

A dental prosthesis will only be successful if the restoration lasts for a long period and does not cause any illness. The presence of permanent prosthetic restorations has been linked to an increased risk of periodontal infections, according to a large body of research that has been gathered. When chronic inflammation is brought on by fixed prosthetic constructions, both cellular and noncellular immunity are activated as adaptive immune mechanisms. It has previously been stated that both clinically adequate and inadequate restorations might cause gingival inflammation. Areas surrounding the abutment teeth presented periodontal pockets, attachment loss, congestion, bleeding on probing, and gingival hyperplasia after fixed restorations were removed. The depth of pockets, bleeding on probing, and bone loss are all closely correlated with disease's severity and IL-1β concentration in gingival crevicular fluid; IL-1β shows higher values in disease sites than in healthy ones. hs-CRP and TNF-α blood levels showed a considerable reduction one day after fixed restorations were applied, in comparison with the pre-treatment values. Collaboration between prosthodontists and periodontists is essential for a good treatment outcome since it will increase the restoration's lifespan, enhance periodontal health, and improve the quality of life for dental patients.

Potential Impact of Prosthetic Biomaterials on the Periodontium: A Comprehensive Review

The success of a prosthetic treatment is closely related to the periodontal health of the individual. The aim of this article was to review and present the importance of prosthetic restorative materials on the condition of the periodontium, the changes that occur in the composition of the subgingival microbiota and the levels of inflammatory markers in gingival crevicular fluid. Articles on the influence of different prosthetic restorative materials on subgingival microbiota and proinflammatory cytokines were searched for using the keywords "prosthetic biomaterials", "fixed prosthesis", "periodontal health", "subgingival microbiota", "periodontal biomarkers" and "gingival crevicular fluid" in PubMed/Medline, Science Direct, Scopus and Google Scholar. The type of material used for prosthesis fabrication together with poor marginal and internal fit can result in changes in the composition of the subgingival microbiota, as well as increased accumulation and retention of dentobacterial plaque, thus favoring the development of periodontal disease and prosthetic treatment failure. Biological markers have helped to understand the inflammatory response of different prosthetic materials on periodontal tissues with the main purpose of improving their clinical application in patients who need them. Metal-free ceramic prostheses induce a lower inflammatory response regardless of the fabrication method; however, the use of CAD/CAM systems is recommended for their fabrication. In addition, it is presumed that metal-ceramic prostheses cause changes in the composition of the subgingival microbiota producing a more dysbiotic biofilm with a higher prevalence of periodontopathogenic bacteria, which may further favor periodontal deterioration.

Antimicrobial Capacity and Surface Alterations Using Photodynamic Therapy and Light Activated Disinfection on Polymer-Infiltrated Ceramic Material Contaminated with Periodontal Bacteria

This study determined the antimicrobial efficiency of light-activated disinfection (LAD) and photodynamic therapy (PDT) on polymer-infiltrated ceramic network (PICN) material contaminated with three periodontal bacteria and explored if PDT and LAD cause PICN surface alterations. Sixty PICN discs were contaminated with Tannerella forsythia, Porphyromonas gingivalis, and Treponema denticola and randomly divided into five groups (n = 12 samples/each) according to the treatment groups: Group PDT-PDT (630 ± 10 nm diode laser) with methylene blue; Group DL-808 nm diode laser in contact mode without photosensitizer; Group MB-methylene blue without light application; Group CHX-0.12% chlorhexidine digluconate solution and; Group NT-no treatment. Each disc was then placed in tubes containing phosphate buffered saline (PBS) and vortexed for 30 s to remove the remaining bacteria from the discs. A total of 10× serial dilutions were performed followed by plating of 30 μL of suspension on Brucella agar plates. The colony forming units (CFU) were calculated after 72 h. PICN discs with the attached biofilms were used for confocal microscopy investigation for live/dead bacterial viability. A random single sample from each group was selected to study the bacterial adherence and topographical alterations on PICN discs under scanning electron microscope (SEM). The PDT group showed higher reduction for each bacterial species and total counts of bacteria assessed followed by the DL group (p < 0.05). When compared with MB group, the two laser groups were significantly superior (p < 0.05). The MB group did not show significant differences for any bacteria when compared to NT. The bacteria with the CHX group and DL groups appeared dead with few areas of surviving green stained bacteria. The PDT group showed the highest dead cell count (p < 0.05). PDT and DL groups indicate no significant changes on the surface compared to the sterile PICN discs on visual assessment. Photodynamic therapy produced superior periodontal bacteria reduction over the surface of PICN surface. PDT group showed higher reduction for each bacterial species and total counts of bacteria assessed followed by the DL group. Both PDT and DL treatment strategies are effective without producing surface alterations on PICN.

Evaluation of microbiota associated with Herpesviruses in active sites of generalized aggressive periodontitis

Aims

The present study aimed to investigate microbial patterns associated with disease progression and coinfection by different Herpesviruses in generalized aggressive periodontitis (GAP).

Methods

Microbiological samples were obtained from active (AS) and non-active (n-AS) sites in 165 subjects affected by GAP and were analyzed for 40 bacterial species by the Checkerboard DNA-DNA Hybridization technique and for Herpes simplex 1 (HSV-1), Human Cytomegalovirus (CMV), and Epstein Bar virus (EBV) by PCR.Common Factor Analysis and Multiple Regression Analysis were applied to disclose specific microbial patterns associated with the three viruses.

Results

Herpesviruses were detected in 37.6% of subjects. Detection of each of the searched viruses was associated with specific patterns of subgingival biofilm in AS. Logistic regression analyses evidenced several virus/bacteria associations: i) EBV with Aggregatibacter actinomycetemcomitans; ii) CMV with A. actinomycetemcomitans, Veillonella parvula, Parvimonas micra and Fusobacterium nucleatum subsp. polymorphum; iii) HSV-1 with Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium periodonticum and Staphylococcus aureus.

Conclusions

Microbiological data suggest that Herpesviruses are probably not mere spectators of disease progression and that specific patterns of subgingival plaque are correlated with the presence of different Herpesviruses.

A double-blind randomised clinical trial of two techniques for gingival displacement

Knowledge about security and the potential damage originated by the gingival displacement techniques has not been described through randomised clinical studies. This crossover, double-blind, randomised clinical trial evaluated clinical and immunological factors related to conventional and cordless gingival displacement (GD) techniques, and patients' perceptions in 12 subjects with the employment of 2 GD techniques: conventional (gingival cord + 25% AlCl3 astringent gel) and cordless (15% AlCl3 astringent-based paste). In each subject, two anterior teeth were treated and a 10-day wash-out period separated the two treatments. Periodontal indices were evaluated before (baseline) and 1 and 10 days after GD. Interleukin 1β, interleukin 6 and tumour necrosis factor α concentrations in gingival crevicular fluid were measured before and 1 day after GD. Subjective parameters (pain, unpleasant taste and stress) were also evaluated. Data were analysed by one-way repeated-measures analysis of variance and Tukey's test (immunological factors), the Friedman test (periodontal parameters) and Fisher's exact or chi-squared test (subjective parameters), with a significance level of 95%. Gingival bleeding index, probing depth and plaque index values did not differ significantly between groups at any timepoint. Neither technique resulted in worse periodontal indices. Both techniques yielded similar results for pain and unpleasant taste, but conventional GD was significantly more stressful than cordless GD for volunteers. Both treatments significantly increased mean concentrations of the three cytokines, with the conventional technique producing the highest cytokine levels. Cordless GD is less stressful for patients and results in lower post-treatment levels of inflammatory cytokines compared with conventional GD.

In vitro adhesion of commensal and pathogenic bacteria to commercial titanium implants with different surfaces

Although dental implants have undergone impressive evolution in recent years, periimplantitis still remains a relevant problem and information on the susceptibility of commercial implants to bacterial colonization is insufficient. This work evaluated the susceptibility of different commercial implants to bacterial colonization, to identify key features for good performances. Twenty-four implants, produced with different technologies, were colonized with 9 bacterial strains following pre-conditioning with culture medium, or saliva or serum proteins and adherent bacteria were enumerated by Real Time quantitative PCR. The studied implants differed significantly for susceptibility to bacterial adhesion. Pre-conditioning of surfaces affected adhesion assays in a species specific manner. Although surface topography influenced bacterial adhesiveness, implants produced by different manufacturers with comparable technologies showed great variability of results. These data demonstrate that susceptibility of implants to bacterial colonization is influenced by productive technologies (in a surface topography proportional manner) and by the productive environment. In choosing an implant the clinician should rely upon specific experimental studies, because surface characteristics alone cannot predict susceptibility to colonization by pathogenic bacteria. Tests should include assays performed in the medium of culture and in the presence of serum proteins.

Corrosion behavior of pure titanium in the presence of Actinomyces naeslundii

It is well known that some microorganisms affect the corrosion of dental metal. Oral bacteria such as Actinomyces naeslundii may alter the corrosion behavior and stability of titanium. In this study, the corrosion behavior of titanium was studied in a nutrient-rich medium both in the presence and the absence of A. naeslundii using scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and electrochemical impedance spectroscopy (EIS). A. naeslundii was able to colonize the surface of titanium and then form a dense biofilm. The SEM images revealed the occurrence of micropitting corrosion on the metal surface after removal of the biofilm. The electrochemical corrosion results from EIS showed a significant decrease in the corrosion resistant (R(p)) value after immersing the metal in A. naeslundii culture for 3 days. Correspondingly, XPS revealed a reduction in the relative levels of titanium and oxygen and an obvious reduction of dominant titanium dioxide (TiO₂) in the surface oxides after immersion of the metal in A. naeslundii culture. These results suggest that the metabolites produced by A. naeslundii can weaken the integrity and stability of the protective TiO₂ in the surface oxides, which in turn decreases the corrosion resistance of titanium, resulting in increased corrosion of titanium immersed in A. naeslundii solution as a function of time.

Clinical, Microbiological and Inflammatory Evidence of the Efficacy of Combination Therapy Including Serratiopeptidase in the Treatment of Periimplantitis

The present study was aimed to evaluate the effect of introducing administration of the proteolytic enzyme serratiopeptidase in the combined mechanical-antibiotic treatment of periimplantitis (PI). Two randomized groups of 64 adults with a diagnosis of PI were studied over a 6-month period. All patients were treated with a combined mechanical and antibiotic protocol for 15 days. The experimental group (EG) was administered antibiotic and serratiopeptidase, while the control group was administered antibiotic alone. To evaluate the effects of the two treatment protocols, clinical and radiographic indices, the concentration of IL-lβ, IL-6 and TNF-α in the gingival crevicular fluid, the amount of total bacteria] DNA and the presence of specific bacteria were assessed at baseline and at 6 months from treatment. Success rates of combined treatments at 6 months were 96.9% and 78.1% for the EG and CG respectively ( P≤0.01). Implants of the EG showed greater enhancement of clinical, microbiological and inflammatory parameters as compared to those of the CG. Microbiological analyses showed that resistance to combined therapy was constantly associated with the isolation of bacterial species that are not common periodontal pathogens (mainly S.aureus and P.aeruginosa). The data demonstrate that the addition of serratiopeptidase to combined mechanical-antibiotic treatment protocols of periimplantitis significantly improves outcomes and suggest that serratiopeptidase acts at different levels during the healing process.