Ultrastructure of the gingiva in cardiac patients treated with or without calcium channel blockers

Mitochondrial DNA Efflux Maintained in Gingival Fibroblasts of Patients with Periodontitis through ROS/mPTP Pathway

Mitochondria have their own mitochondrial DNA (mtDNA). Aberrant mtDNA is associated with inflammatory diseases. mtDNA is believed to induce inflammation via the abnormal mtDNA release. Periodontitis is an infectious, oral inflammatory disease. Human gingival fibroblasts (HGFs) from patients with chronic periodontitis (CP) have shown to generate higher reactive oxygen species (ROS) that cause oxidative stress and have decreased mtDNA copy number. Firstly, cell-free mtDNA was identified in plasma from CP mice through qRT-PCR. Next, we investigated whether mtDNA efflux was maintained in primary cultures of HGFs from CP patients and the possible underlying mechanisms using adenovirus-mediated transduction live cell imaging and qRT-PCR analysis. Here, we reported that mtDNA was increased in plasma from the CP mice. Additionally, we confirmed that CP HGFs had significant mtDNA efflux from mitochondria compared with healthy HGFs. Furthermore, lipopolysaccharide (LPS) from Porphyromonas gingivalis can also cause mtDNA release in healthy HGFs. Mechanistically, LPS upregulated ROS levels and mitochondrial permeability transition pore (mPTP) opening by inhibition of pyruvate dehydrogenase kinase (PDK)2 expression, resulting in mtDNA release. Importantly, mtDNA efflux was even persistent in HGFs after LPS was removed and cells were passaged to the next three generations, indicating that mtDNA abnormalities were retained in HGFs in vitro, similar to the primary hosts. Taken together, our results elucidate that mtDNA efflux was maintained in HGFs from periodontitis patients through abnormal ROS/mPTP activity. Therefore, our work indicates that persistent mtDNA efflux may be a possible diagnostic and therapeutic target for patients with periodontitis.

Mandibular regeneration after immediate load dental implant in a periodontitis patient: A clinical and ultrastructural case report

RATIONALE

In this case study, we characterized from radiographic, morphological and elemental point of view the mandibular reconstruction that occur in patients affects by periodontitis after application of endosseous titanium implants. In particular, we verified that the bone load applied by titanium implant was able to induce the mandibular osteogenic reconstruction.

PATIENT CONCERN

A 57-year-old female active smoker with no contraindications for dental implants and 3 unstable dental prostheses, underwent open surgery for the application of endosseous titanium implants (BANP IMPLANT S.R.L., Milan, MI, Italy) with Immediate load dental implant technique. At the time of presentation, patient was under treatment β- beta-adrenergic agents.

DIAGNOSES

Patient was affected by grade II periodontitis according to Armitage classification.

INTERVENTATION

Patient underwent open surgery for the application of endosseous titanium implants (BANP IMPLANT S.R.L., Milan, MI, Italy) with Immediate load dental implant technique. Implant placement was performed under local anesthesia after premedication with diazepam (0.2 mg/kg), given orally 30 minutes before surgery. After crestal incision, a meticulous cleaning of the oral cavity was carried out. We removed necrotic tissues and all inflammatory residues. Then, the bone cavity was extended gradually, according to the intended implant diameter. Inserted titanium implants were placed 8-12 mm subcrestally.

OUTCOMES

We demonstrated that the bone load applied by titanium implant was able to induce the mandibular osteogenic reconstruction in a periodontitis patient.

LESSONS

This case study can lay the foundation to improve understanding of the relationship between the immediate load dental implant and the mandibular regeneration.

Role of Lipids in the Onset, Progression and Treatment of Periodontal Disease. A Systematic Review of Studies in Humans

The risk of different oral problems (root caries, tooth mobility, and tooth loss) can be increased by the presence of periodontal disease, which has also been associated with a growing list of systemic diseases. The presence of some bacteria is the primary etiology of this disease; a susceptible host is also necessary for disease initiation. In this respect, the progression of periodontal disease and healing of the periodontal tissues can be modulated by nutritional status. To clarify the role of lipids in the establishment, progression, and/or treatment of this pathology, a systematic review was conducted of English-written literature in PubMed until May 2016, which included research on the relationship of these dietary components with the onset and progression of periodontal disease. According to publication type, randomized-controlled trials, cohort, case-control and cross-sectional studies were included. Among all the analyzed components, those that have any effect on oxidative stress and/or inflammation seem to be the most interesting according to current evidence. On one hand, there is quite a lot of information in favor of a positive role of n-3 fatty acids, due to their antioxidant and immunomodulatory effects. On the other hand, saturated fat-rich diets increase oxidative stress as well the as intensity and duration of inflammatory processes, so they must be avoided.

Clinical indicators of periodontal disease in patients with coronary heart disease: a 10 years longitudinal study

OBJECTIVES

There is evidence about a possible relationship existing between periodontal diseases and coronary heart disease. The aim of the present longitudinal study was to investigate the changes in periodontal evolution after etiological periodontal treatment, comparing a healthy control group with another having coronary heart disease.

STUDY DESIGN

The study included initially 55 patients of which 44 finished it. They were placed into two groups: Healthy Control Group (HCG) n =9, and Coronary Heart Disease Group (CHDG) n=35. The gingival level (GL), probing depth (PD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BOP) were measured to compare the periodontal status in both groups. The patients were examined and etiological periodontal treatment was performed and they were then examined at the end of 1 and 10 years.

STATISTICAL METHOD

A one way-ANOVA and a MR-ANOVA were established; significance p<0.05.

RESULTS

No significant differences between both groups were detected on the first visit (p>0.5). However, at the second visit the CHDG presented a significantly higher PD (p<0.05) and PI (p<0.01). CHDG patients gradually increase PD through time and in comparison to the control group (p<0.041). CHDG patients present a significantly higher CAL loss (p<0.0385) and a significant increase in PI (p<0.0041) at the end of one year, while on the third visit no significant differences were detected in any of these indices. Likewise, a similar fact can be observed on evaluating BOP at the end of ten years causal treatment, a smaller decrease in the cardiac group was observed in regards to the initial values (p<0.001).

CONCLUSION

Patients with coronary heart disease showed a worse evolution of periodontal indices than healthy ones, when referring to probing depth, plaque index and bleeding on probing index.

Diltiazem did not induce gingival overgrowth in rats: a clinical, histological and histometric analysis

The administration of calcium channel blockers has been associated with gingival overgrowth. However, there are few studies in humans or animals that evaluated the effect of diltiazem on gingival tissues. The present study assessed the influence of diltiazem, at different dosages and treatment duration, on gingival tissues of rats, using clinical, histological and histometric analyses. Eighty young male rats were separated into eight groups according to the dosage and duration of treatment. Rats were treated for 20 or 40 days with a daily subcutaneous injection of 5, 20 or 50 mg/kg of body weight of diltiazem. The results confirmed that diltiazem did not induce gingival overgrowth in rats. For all animals, the evaluation did not show gingival alterations regardless of the dosages and periods of treatment. The histometric analysis showed no significant change in the area of epithelium and connective tissues, although after 40 days of treatment a decrease in the area of connective tissue was observed, without statistically significant difference from control groups. Within the limits of this study, we suggest that diltiazem did not induce gingival overgrowth.

Relationship between maternal periodontal disease and low-birth-weight pre-term infants

OBJECTIVES

The purpose of this study was to determine the influence of periodontal status on low-birth-weight pre-term delivery.

MATERIAL AND METHODS

Ninety-six pregnant women were examined in their first, second and third trimester to record plaque scores, clinically assessed gingival inflammation and probing depth (mean depth and percentage of sites with depth of >3 mm). Binary logistic regression analyses were performed using SUDAAN 7.5 program. The type 1 (alpha) error established at 0.05 and an (alpha) error of 0.05-0.1 were considered nearly significant.

RESULTS

The 96 women delivered 89 newborns: 16 were pre-term and seven of these were of low birth weight. There were seven miscarriages, all in the second trimester. No statistically significant association was found between gestational age and periodontal parameters. No significant relationship was found between low-weight delivery and plaque index measurements, although the association with gingival index was close to significant. A relationship was observed between low-weight birth and probing depth measurements, especially the percentage of sites of >3 mm depth, which was statistically significant (p=0.0038) even when gestational age was controlled for.

CONCLUSIONS

According to these results, periodontal disease is a significant risk factor for low birth weight but not for pre-term delivery.

The effect of Cyclosporine A chronic administration on the antioxidant pattern of rat liver mitochondria: structural and functional consequences

Cyclosporine A (CsA) plays a pivotal role in controlling Ca2+ movement in the cell modulating also the mitochondrial permeability transition pore. We investigated if chronic administration of CsA may have some effects on the lipophilic and hydrophilic antioxidant pattern of rat liver mitochondria and on their morphological structure. It seems that CsA administration does not statistically affect the redox status of the antioxidants investigated and their amounts (vitamin E, CoQ9, CoQ10, glutathione, uric acid and ascorbic acid) despite the variety of effects that this treatment produces at physiological and morphological levels. However, some kind of derangement could occur in the liver biochemical machinery since CsA treatment induces a markedly increased variability in antioxidant contents.