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Yang Y, Xu C, Xu S, Li Y, Chen K, Yang T, Bao J, Xu Y, Chen J, Mao C, Chen L, Sun W. Injectable hydrogels activated with copper sulfide nanoparticles for enhancing spatiotemporal sterilization and osteogenesis in periodontal therapy. Biomater Sci 2024. [PMID: 38711336 DOI: 10.1039/d3bm02134c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Developing biomaterials capable of promoting bone regeneration in bacteria-infected sites is of utmost urgency for periodontal disease therapies. Here we produce a hybrid hydrogel by integrating CuS nanoparticles (CuSNPs), which could kill bacteria through photothermal therapy (PTT) triggered by a near infrared (NIR) light, and a gelatin methacryloyl (GelMA) hydrogel, which is injectable and biocompatible. Specifically, CuSNPs were precipitated by chitosan (CS) firstly, then grafted with methacrylic anhydride (MA) to form CuSNP@CS-MA, which was photo-crosslinked with GelMA to synthesize hybrid hydrogels (GelMA/CuSNP). The hybrid hydrogels exhibited a broad-spectrum antibacterial property that could be spatiotemprorally manipulated through applying a NIR light. Their mechanical properties were adjustable by controlling the concentration of CuSNPs, enabling the hydrogels to become more adapted to the oral diseases. Meanwhile, the hybrid hydrogels showed good cytocompatibility in vitro and improved hemostasis in vivo. Moreover, they accelerated alveolar osteogenesis and vascular genesis, successfully treating periodontis in four weeks in a rat model. GelMA/CuSNP hydrogels showed a broad-spectrum sterilization ability via PTT in vitro and outstanding antibacterial property in vivo, suggesting that the hybrid hydrogels could function in the challenging, bacteria-rich, oral environment. Such injectable hybrid hydrogels, capable of achieving both facilitated osteogenesis and NIR-inducible sterilization, represent a new biomaterial for treating periodontitis.
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Affiliation(s)
- Yuting Yang
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, P.R. China.
| | - Chunbin Xu
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, P.R. China.
| | - Shengqian Xu
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, P.R. China.
| | - Yan Li
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, P.R. China.
| | - Ke'er Chen
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, P.R. China.
| | - Tao Yang
- School of Materials Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, 310027, China
| | - Jiaqi Bao
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, P.R. China.
| | - Yajing Xu
- School of Materials Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, 310027, China
| | - Jingyao Chen
- Facility for Histomorphology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310027, China
| | - Chuanbin Mao
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Lili Chen
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, P.R. China.
| | - Weilian Sun
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, P.R. China.
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Rodriguez NM, Loren P, Paez I, Martínez C, Chaparro A, Salazar LA. MicroRNAs: The Missing Link between Hypertension and Periodontitis? Int J Mol Sci 2024; 25:1992. [PMID: 38396672 PMCID: PMC10889313 DOI: 10.3390/ijms25041992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Cardiovascular diseases are the leading cause of death worldwide, and arterial hypertension is a recognized cardiovascular risk factor that is responsible for high morbidity and mortality. Arterial hypertension is the result of an inflammatory process that results in the remodeling and thickening of the vascular walls, which is associated with an immunological response. Previous studies have attempted to demonstrate the relationship between oral disease, inflammation, and the development of systemic diseases. Currently, the existence of an association between periodontitis and hypertension is a controversial issue because the underlying pathophysiological processes and inflammatory mechanisms common to both diseases are unknown. This is due to the fact that periodontitis is a chronic inflammatory disease that affects the interface of teeth and surrounding tissues. However, the most likely explanation for understanding this association is related to low-grade chronic inflammation. An initial path in the study of the relationship between the mentioned pathologies is the possibility of an epigenetic influence, mediated by noncoding RNAs as microRNAs. Thus, in the present review we describe the role of microRNAs related to arterial hypertension and/or periodontitis. In addition, we identified 13 common microRNAs between periodontitis and hypertension. According to the predictions of the DIANA-mirPath program, they can regulate genes involved in 52 signaling pathways.
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Affiliation(s)
- Nelia M Rodriguez
- Doctoral Program in Sciences, Major in Applied Cellular and Molecular Biology, Universidad de La Frontera, Temuco 4811230, Chile
- Center for Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Universidad de La Frontera, Temuco 4811230, Chile
| | - Pía Loren
- Center for Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Universidad de La Frontera, Temuco 4811230, Chile
| | - Isis Paez
- Doctoral Program in Sciences, Major in Applied Cellular and Molecular Biology, Universidad de La Frontera, Temuco 4811230, Chile
- Center for Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Universidad de La Frontera, Temuco 4811230, Chile
| | - Constanza Martínez
- Department of Oral Pathology and Conservative Dentistry, Periodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago 7620001, Chile
| | - Alejandra Chaparro
- Department of Oral Pathology and Conservative Dentistry, Periodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago 7620001, Chile
- Center for Biomedical Research and Innovation (CIIB), Universidad de Los Andes, Santiago 7620001, Chile
| | - Luis A Salazar
- Center for Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Universidad de La Frontera, Temuco 4811230, Chile
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Zhu L, Tang Z, Hu R, Gu M, Yang Y. Ageing and Inflammation: What Happens in Periodontium? Bioengineering (Basel) 2023; 10:1274. [PMID: 38002398 PMCID: PMC10669535 DOI: 10.3390/bioengineering10111274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Periodontitis is a chronic inflammatory disease with a high incidence and severity in the elderly population, making it a significant public health concern. Ageing is a primary risk factor for the development of periodontitis, exacerbating alveolar bone loss and leading to tooth loss in the geriatric population. Despite extensive research, the precise molecular mechanisms underlying the relationship between ageing and periodontitis remain elusive. Understanding the intricate mechanisms that connect ageing and inflammation may help reveal new therapeutic targets and provide valuable options to tackle the challenges encountered by the rapidly expanding global ageing population. In this review, we highlight the latest scientific breakthroughs in the pathways by which inflammaging mediates the decline in periodontal function and triggers the onset of periodontitis. We also provide a comprehensive overview of the latest findings and discuss potential avenues for future research in this critical area of investigation.
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Affiliation(s)
| | | | | | | | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR 999077, China; (L.Z.); (Z.T.); (R.H.); (M.G.)
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Herrera D, van Winkelhoff AJ, Matesanz P, Lauwens K, Teughels W. Europe's contribution to the evaluation of the use of systemic antimicrobials in the treatment of periodontitis. Periodontol 2000 2023. [PMID: 37314038 DOI: 10.1111/prd.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 06/15/2023]
Abstract
This narrative review celebrates Europe's contribution to the current knowledge on systemically administered antimicrobials in periodontal treatment. Periodontitis is the most frequent chronic noncommunicable human disease. It is caused by dysbiotic bacterial biofilms and is commonly treated with subgingival instrumentation. However, some sites/patients do not respond adequately, and its limitations and shortcomings have been recognized. This has led to the development of alternative or adjunctive therapies. One is the use of antimicrobials to target bacteria in subgingival biofilms in the periodontal pocket, which can be targeted directly through the pocket entrance with a locally delivered antibiotic or systemically by oral, intravenous, or intramuscular methods. Since the early 20th century, several studies on systemic antibiotics have been undertaken and published, especially between 1990 and 2010. Europe's latest contribution to this topic is the first European Federation of Periodontology, S3-level Clinical Practice Guideline, which incorporates recommendations related to the use of adjuncts to treat stage I-III periodontitis. Understanding the etiopathogenesis of periodontal diseases, specifically periodontitis, has influenced the use of systemic periodontal antibiotic therapy. Randomized clinical trials and systematic reviews with meta-analyses have demonstrated the clinical advantages of adjunctive systemic antimicrobials. However, current recommendations are restrictive due to concerns about antibiotic misuse and the increase in microbial antibiotic resistance. European researchers have contributed to the use of systemic antimicrobials in the treatment of periodontitis through clinical trials and by providing rational guidelines. Nowadays, European researchers are exploring alternatives and directing clinical practice by providing evidence-based guidelines to limit the use of systemic antimicrobials.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Arie Jan van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Katalina Lauwens
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Seizer L, Schubert C. On the Role of Psychoneuroimmunology in Oral Medicine. Int Dent J 2022; 72:765-772. [DOI: 10.1016/j.identj.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/24/2022] [Accepted: 07/02/2022] [Indexed: 11/05/2022] Open
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Henin D, Fiorin LG, Carmagnola D, Pellegrini G, Toma M, Cristofalo A, Dellavia C. Quantitative Evaluation of Inflammatory Markers in Peri-Implantitis and Periodontitis Tissues: Digital vs. Manual Analysis—A Proof of Concept Study. Medicina (B Aires) 2022; 58:medicina58070867. [PMID: 35888586 PMCID: PMC9318134 DOI: 10.3390/medicina58070867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: In dentistry, the assessment of the histomorphometric features of periodontal (PD) and peri-implant (PI) lesions is important to evaluate their underlying pathogenic mechanism. The present study aimed to compare manual and digital methods of analysis in the evaluation of the inflammatory biomarkers in PI and PD lesions. Materials and Methods: PD and PI inflamed soft tissues were excised and processed for histological and immunohistochemical analyses for CD3+, CD4+, CD8+, CD15+, CD20+, CD68+, and CD138+. The obtained slides were acquired using a digital scanner. For each marker, 4 pictures per sample were extracted and the area fraction of the stained tissue was computed both manually using a 594-point counting grid (MC) and digitally using a dedicated image analysis software (DC). To assess the concordance between MC and DC, two blinded observers analysed a total of 200 pictures either with good quality of staining or with non-specific background noise. The inter and intraobserver concordance was evaluated using the intraclass coefficient and the agreement between MC and DC was assessed using the Bland–Altman plot. The time spent analysing each picture using the two methodologies by both observers was recorded. Further, the amount of each marker was compared between PI and PD with both methodologies. Results: The inter- and intraobserver concordance was excellent, except for images with background noise analysed using DC. MC and DC showed a satisfying concordance. DC was performed in half the time compared to MC. The morphological analysis showed a larger inflammatory infiltrate in PI than PD lesions. The comparison between PI and PD showed differences for CD68+ and CD138+ expression. Conclusions: DC could be used as a reliable and time-saving procedure for the immunohistochemical analysis of PD and PI soft tissues. When non-specific background noise is present, the experience of the pathologist may be still required.
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Affiliation(s)
- Dolaji Henin
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (D.H.); (L.G.F.); (G.P.); (M.T.); (A.C.); (C.D.)
| | - Luiz Guilherme Fiorin
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (D.H.); (L.G.F.); (G.P.); (M.T.); (A.C.); (C.D.)
- Department of Diagnosis and Surgery, Division of Periodontics, School of Dentistry, Sao Paulo State University (UNESP), Aracatuba 16015-050, SP, Brazil
| | - Daniela Carmagnola
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (D.H.); (L.G.F.); (G.P.); (M.T.); (A.C.); (C.D.)
- Correspondence:
| | - Gaia Pellegrini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (D.H.); (L.G.F.); (G.P.); (M.T.); (A.C.); (C.D.)
| | - Marilisa Toma
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (D.H.); (L.G.F.); (G.P.); (M.T.); (A.C.); (C.D.)
| | - Aurora Cristofalo
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (D.H.); (L.G.F.); (G.P.); (M.T.); (A.C.); (C.D.)
| | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy; (D.H.); (L.G.F.); (G.P.); (M.T.); (A.C.); (C.D.)
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Cairo F, Dicembrini I, Serni L, Nieri M, Bettarini G, Caliri M, Pala L, Mannucci E, Barbato L. Periodontitis predicts HbA1c levels and glucose variability in type 1 diabetic patients: the PARODIA Florence Project study. Clin Oral Investig 2022; 26:3585-3591. [DOI: 10.1007/s00784-021-04326-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/29/2021] [Indexed: 11/03/2022]
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Lapo S, Leonardo C, Luigi B, Michele N, Sergio S, Calogero Lino C, Francesco C. Association between chronic kidney disease and periodontitis. A systematic review and metanalysis. Oral Dis 2021; 29:40-50. [PMID: 34726333 DOI: 10.1111/odi.14062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/12/2021] [Accepted: 10/21/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Aims of this SR were to assess the association of Periodontitis (PD) with Chronic Kidney Disease (CKD) and with different CKD stages. MATERIALS AND METHODS MEDLINE, Cochrane Central Register of Trials and EMBASE, up to April 4, 2021 were searched. RCTs, prospective and retrospective cohort studies, case-control studies and cross-sectional studies were considered. JBI's Critical Appraisal Tool for risk of bias assessment was used. The risk of PD was calculated using the Mantel-Haenszel odds ratios (MH-OR); weighted mean difference for clinical attachment level (CAL) and periodontal probing depth (PPD) were also evaluated. RESULTS Out of 1949 titles screened, 142 full texts were evaluated and 17 studies were included. CKD was associated to higher risk of PD (MH-OR = 2.36, [95% C.I. 1.25, 4.44]; p = 0.008), higher mean CAL (WMD = 0.41 mm [95% C.I. 0.22, 0.60]; p < 0.0001) and mean PPD (WMD = 0.25 mm [95% C.I. 0.03, 0.47]; p = 0.02) compared to healthy individuals. Severe CKD (stages 4-5 vs 2-3) resulted at higher risk of PD (MH-OR = 2.21, [95% C.I. 1.07, 4.54]; p = 0.03). Heterogeneity and risk of bias were high. CONCLUSIONS An association between PD and CKD was found. It could be appropriate to consider PD a frequent CKD comorbidity.
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Affiliation(s)
- Serni Lapo
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | | | - Barbato Luigi
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - Nieri Michele
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - Serni Sergio
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | | | - Cairo Francesco
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
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Dicembrini I, Barbato L, Serni L, Caliri M, Pala L, Cairo F, Mannucci E. Glucose variability and periodontal disease in type 1 diabetes: a cross-sectional study-The "PAROdontopatia e DIAbete" (PARODIA) project. Acta Diabetol 2021; 58:1367-1371. [PMID: 33999313 PMCID: PMC8413171 DOI: 10.1007/s00592-021-01720-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/12/2021] [Indexed: 01/04/2023]
Abstract
AIMS Periodontal disease (PD) is a chronic inflammation of periodontal tissue associated with infection from specific anaerobic pathogens contained in dental plaque. Both type 1 and type 2 diabetes are associated with an increased prevalence of PDs. A two-way relationship between diabetes and periodontitis has been proposed, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control. To date, the relationship between PD and glucose variability in type 1 diabetes has not been evaluated. To investigate the prevalence of PD in patients with type 1 diabetes and its association with glycemic control and glucose variability. METHODS In this cross-sectional study, all enrolled patients were scheduled to attend both a diabetologic and a periodontal visit. HbA1c, glucose coefficient of variation (CV), loss of clinical attachment (CAL), and periodontal probing depth (PPD) were collected. RESULTS 136 patients were included in the analysis. The prevalence of PD was 63%. A significant correlation was found between mean CAL and glucose CV (r = 0.31, p = 0.002), but not with HbA1c. Mean PPD was also associated with glucose CV (r = 0.27 and 0.044), but not with HbA1c. In a multiple linear regression model, with mean CAL as dependent variable, age, glucose CV, and smoking habit resulted significantly associated (r = 0.23, p = 0.013; r = 0.33, p = 0.001; r = 0.34, p < 0.001, respectively). Assuming mean PPD as dependent variable, multiple linear regression analysis showed a significant association with glucose CV and smoking habits only. CONCLUSIONS PD is associated with glucose variability in patients with type 1 diabetes also after adjusting for the main confounders.
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Affiliation(s)
- Ilaria Dicembrini
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, viale Morgagni 50, 50134, Florence, Italy
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Luigi Barbato
- Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - Lapo Serni
- Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - Mariasmeralda Caliri
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, viale Morgagni 50, 50134, Florence, Italy
| | - Laura Pala
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - Edoardo Mannucci
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, viale Morgagni 50, 50134, Florence, Italy.
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy.
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Hwang G, Blatz MB, Wolff MS, Steier L. Diagnosis of Biofilm-Associated Peri-Implant Disease Using a Fluorescence-Based Approach. Dent J (Basel) 2021; 9:dj9030024. [PMID: 33673438 PMCID: PMC7996852 DOI: 10.3390/dj9030024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
Dental implants have become a routine component of daily dental practice and the demand for dental implants is expected to increase significantly in the future. Despite the high success rates of dental implants, failures do occur, resulting in discomfort, rampant destruction of the oral health, or painful and costly surgical replacement of a failed implant. Peri-implant diseases are inflammatory conditions affecting the soft/hard tissues surrounding a functional dental implant. Plenty of experimental evidence indicates that the accumulation of dental plaque at the soft tissue-implant interface and the subsequent local inflammatory response seems to be key in the pathogenesis of the peri-implant mucositis. Such peri-implant-soft tissue interface is less effective than natural teeth in resisting bacterial invasion, enhancing vulnerability to subsequent peri-implant disease. Furthermore, in certain individuals, it will progress to peri-implantitis, resulting in alveolar bone loss and implant failure. Although early diagnosis and accurate identification of risk factors are extremely important to effectively prevent peri-implant diseases, current systematic reviews revealed that a uniform classification and diagnostic methodology for peri-implantitis are lacking. Recent progress on fluorescence-based technology enabled rapid diagnosis of the disease and effective removal of plaques. Here, we briefly review biofilm-associated peri-implant diseases and propose a fluorescence-based approach for more accurate and objective diagnoses. A fluorescence-based diagnosis tool through headlights combined with special-filtered dental loupes may serve as a hands-free solution for both precise diagnosis and effective removal of plaque-biofilms.
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Affiliation(s)
- Geelsu Hwang
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (G.H.); (M.B.B.); (M.S.W.)
- Center for Innovation and Precision Dentistry, School of Dental Medicine, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Markus B. Blatz
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (G.H.); (M.B.B.); (M.S.W.)
| | - Mark S. Wolff
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (G.H.); (M.B.B.); (M.S.W.)
| | - Liviu Steier
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (G.H.); (M.B.B.); (M.S.W.)
- Correspondence:
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Dicembrini I, Serni L, Monami M, Caliri M, Barbato L, Cairo F, Mannucci E. Type 1 diabetes and periodontitis: prevalence and periodontal destruction-a systematic review. Acta Diabetol 2020; 57:1405-1412. [PMID: 32318875 DOI: 10.1007/s00592-020-01531-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/27/2020] [Indexed: 12/12/2022]
Abstract
AIMS Data about the association between periodontal disease or periodontitis (PD), diabetes and hyperglycemia have been reported mostly in patients with type 2 diabetes. Conversely, information about PD in type 1 diabetes (T1DM) is relatively scarce. The aim of this meta-analysis is therefore: (1) to assess the prevalence and severity of PD in patients affected by T1DM in comparison with the general population and (2) to verify the association between severity of PD and glycemic control in type 1 diabetics. METHODS An electronic search was performed on MEDLINE, Cochrane Central Register of Trials and EMBASE, up to October 31, 2019. Estimates of prevalence of PD in T1DM were calculated together with Mantel-Haenszel odds ratios (MH-OR) of the risk of PD associated with T1DM; weighed mean difference in CAL between T1DM and control and weighed mean difference in CAL in patients with T1DM and unsatisfactory glycemic control as compared with those in good glycemic control were also evaluated.. RESULTS The prevalence of PD in type 1 diabetes was 18.5 [8.0; 37.1] %; the MH-OR for PD is 2.51 (1.32;4.76) in T1DM patients versus general population (p = 0.005). The weighed mean difference in CAL depth between T1DM patients and controls is 0.506 [0.181; 0.832] mm (p < 0.005), and in T1DM patients with good glycemic control CAL depth is - 0.71 [- 1.00; - 0.42] mm less deep than in subjects with HbA1c > 7%. CONCLUSIONS The present data confirm that T1DM is a relevant risk factor for the development of PD. The proportion of patients affected by PD is more than doubled in subjects with T1DM in comparison with non-diabetic individual, and among patients with T1DM, PD seems to be more severe and the differences appear very wide between subjects in optimal and suboptimal glycemic control.
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Affiliation(s)
- Ilaria Dicembrini
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Lapo Serni
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Matteo Monami
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Mariasmeralda Caliri
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Luigi Barbato
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Edoardo Mannucci
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy.
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Cecoro G, Annunziata M, Iuorio MT, Nastri L, Guida L. Periodontitis, Low-Grade Inflammation and Systemic Health: A Scoping Review. ACTA ACUST UNITED AC 2020; 56:medicina56060272. [PMID: 32486269 PMCID: PMC7353850 DOI: 10.3390/medicina56060272] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023]
Abstract
Background and objectives: Periodontitis is a multifactorial chronic inflammatory infectious disease in which an infection is necessary, but not sufficient, for development of the condition. Individual susceptibility strictly linked to the immune and inflammatory response of the organism must also be present. Low-grade inflammation (LGI) is a systemic status of chronic sub-clinical production of inflammatory factors. This condition represents a risk factor for many chronic diseases including diabetes, cardiovascular disease, cerebrovascular disease, neurodegenerative disease and cancer. This scoping review aims to clarify, summarize and disseminate current knowledge on the possible link between periodontitis, LGI and systemic health. Materials and Methods: PRISMA Extension for Scoping Reviews guidelines were followed. An ad-hoc created keyword string was used to search the electronic databases of PubMed/Medline, Embase, The Cochrane Library and ClinicalTrials.gov. A hand search of specialized journals and their reference lists was also performed. Results: 14 studies that respected eligibility criteria were selected and analyzed. There is emerging evidence of strong links between periodontitis, LGI and systemic health. On the one hand, periodontitis influences the systemic status of LGI and on the other hand, the systemic production of inflammatory factors affects periodontitis with a bidirectional connection. Conclusions: LGI and the subsequent onset of a systemic inflammatory phenotype can be considered the common substrate of many chronic inflammatory diseases including periodontitis, with multiple mutual connections between them. Understanding of the biological principles and mechanisms underlying such a complex interrelationship could lead to significant improvements in the field of personalized diagnostics and therapeutic protocols.
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Mahalakshmi K, Krishnan P, Chandrasekaran SC. Detection of Tannerella forsythia bspA and prtH genotypes among periodontitis patients and healthy subjects-A case-Control study. Arch Oral Biol 2018; 96:178-181. [PMID: 30268559 DOI: 10.1016/j.archoralbio.2018.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 09/05/2018] [Accepted: 09/19/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND T. forsythia a gram negative, anaerobe inhabits the mature biofilm present at sites expressing progressive periodontitis. It is a part of "red complex" group which contributes to the pathogenesis of periodontitis. The BspA protein and prtH gene encoded cysteine protease play a vital role in the virulence of T. forsythia. The present study aims to detect the two genotypes (bspA and prtH) in periodontitis and healthy subjects. MATERIALS & METHOD Subgingival plaque samples were collected from periodontitis patients and healthy subjects (Chronic Periodontitis n = 128, Aggressive Periodontitis n = 72, healthy subjects n = 200). The samples were screened for the presence of T. forsythia 16S rRNA, bspA and prtH genotypes by Polymerase Chain Reaction. The prevalence of the genotypes between periodontitis patients and healthy subjects was compared with Pearson's Chi-square test. A P value of < 0.05 was considered to be statistically significant. RESULTS The prevalence for T. forsythia in Chronic Periodontitis (n = 128), Aggressive Periodontitis (n = 72) and health (n = 200) was 73.4%, 59.7% and 10.5% respectively. The prevalence of T.forsythia bspA/prtH genotypes was 81.90%/43.60%, 88.40%/53.50% and 33.30%/14.3% in Chronic Periodontitis, aggressive Periodontitis and health respectively. Compared to healthy subjects, the odds of detecting T.forsythia 16S rRNA was 18.53 times high in individuals with periodontitis (P = 0.0001). CONCLUSION The high odds ratio of T.forsythia 16S rRNA among periodontitis strongly suggests its role in periodontitis. In addition, the high prevalence of T. forsythia bspA genotype among Chronic Periodontitis signifies it as a useful marker for chronic periodontitis.
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Affiliation(s)
- Krishnan Mahalakshmi
- Department of Microbiology, Research Lab for Oral -Systemic Health, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Velachery, Tambaram Road, Chennai, 600100, Tamilnadu, India.
| | - Padma Krishnan
- Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, 600113, Tamilnadu, India.
| | - S C Chandrasekaran
- Department of Periodontology, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Tamilnadu, India.
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Pinho RCM, Pimentel LB, Bandeira FAF, Dias RSAM, Cimões R. Levels of serum sclerostin, metabolic parameters, and periodontitis in -postmenopausal women with diabetes. SPECIAL CARE IN DENTISTRY 2017; 37:282-289. [PMID: 29194725 DOI: 10.1111/scd.12250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Diabetes mellitus (DM) is a metabolic disease defined by hyperglycemia, which is associated with periodontal disease and exerts an effect on bone metabolism. The aim of this study was to determine serum levels of sclerostin in postmenopausal women with diabetes and determine a possible association with periodontal disease. Sixty-one postmenopausal women (32 with diabetes and 29 without diabetes) were evaluated. Blood was collected for biochemical analysis and the determination of serum sclerostin. The participants were also submitted to a clinical examination for the evaluation of periodontal status. A total of 75.4% of the volunteers had periodontal disease and levels serum sclerostin were altered in 48.7% of the patients with diabetes. In the diabetic population, mean levels of LDL (p = 0.035) and urea (p = 0.032) were higher in the patients without periodontal disease and the plaque index was higher in those with periodontal disease (p = 0.039). The prevalence of periodontal disease and the levels serum sclerostin were high in the postmenopausal women analyzed, but the data do not allow the determination of whether periodontal disease is related to high levels of this peptide.
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Messora MR, Pereira LJ, Foureaux R, Oliveira LFF, Sordi CG, Alves AJN, Napimoga MH, Nagata MJH, Ervolino E, Furlaneto FAC. Favourable effects of Bacillus subtilis and Bacillus licheniformis on experimental periodontitis in rats. Arch Oral Biol 2016; 66:108-19. [PMID: 26945169 DOI: 10.1016/j.archoralbio.2016.02.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 12/10/2015] [Accepted: 02/23/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The purposes of this study were to evaluate, in rats: i) the effects of Bacillus species on the development of experimental periodontitis (EP) via microtomographic, immunological and hematological assays (Experiment 1-E1); ii) the effects of Bacillus species as adjuncts to scaling and root planing (SRP) for the treatment of EP via histomorphometric and immunohistochemical analyses (Experiment 2-E2). METHODS In E1, 24 rats were divided into groups C1 (control), PROB1, EP1 and EP-PROB1. In groups with EP, the mandibular first molar of each animal received a ligature for 14 days. In groups PROB1, animals received Bacillus species for 44 days, starting 30 days before EP induction in Group EP-PROB1. In E2, 24 rats were assigned to groups C2 (control), PROB2, EP-SRP2 and EP-SRP-PROB2. In groups with SRP, EP was induced as described in E1. The ligatures were removed after 14 days and SRP was performed. In groups PROB2, animals received Bacillus species for 15 days, starting after SRP in Group EP-SRP-PROB2. RESULTS In E1, Group EP1 presented bone loss (BL) and eosinophil numbers greater than Group EP-PROB1 (P<0.05). In Group EP-PROB1, the receptor activator of nuclear factor-kB ligand (RANKL)/osteoprotegerin (OPG) ratio was similar to that of groups without EP. In E2, Group EP-SRP-PROB2 presented fewer TRAP-positive osteoclasts, lower immunolabeling pattern for a proinflammatory cytokine and decreased BL and attachment loss than Group EP-SRP2 (P<0.05). CONCLUSIONS Bacillus species supplementation provided a protective effect against BL and enhanced the effects of SRP in the treatment of EP in rats.
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Affiliation(s)
- Michel R Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Av. Café, 14040-904 Ribeirao Preto, SP, Brazil.
| | - Luciano J Pereira
- Physiology and Pharmacology Department, Federal University of Lavras, Av. Doutor Sylvio Menicucci, 1001, 37200-000 Lavras, MG, Brazil
| | - Renata Foureaux
- Physiology and Pharmacology Department, Federal University of Lavras, Av. Doutor Sylvio Menicucci, 1001, 37200-000 Lavras, MG, Brazil
| | - Luiz F F Oliveira
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Av. Café, 14040-904 Ribeirao Preto, SP, Brazil
| | - Caio G Sordi
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Av. Café, 14040-904 Ribeirao Preto, SP, Brazil
| | - Ana J N Alves
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Av. Café, 14040-904 Ribeirao Preto, SP, Brazil
| | - Marcelo H Napimoga
- Laboratory of Immunology and Molecular Biology, Sao Leopoldo Mandic, Street Dr. José Rocha Junqueira, 13, 13045-755 Campinas, SP, Brazil
| | - Maria J H Nagata
- Department of Surgery and Integrated Clinic, Dental School of Aracatuba, UNESP-Univ Estadual Paulista, Street José Bonifácio, 1193, 16015-050 Aracatuba, SP, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, Division of Histology, Dental School of Aracatuba, UNESP-Univ Estadual Paulista, Rodovia Marechal Rondon, km 527, 16021-900 Aracatuba, SP, Brazil
| | - Flávia A C Furlaneto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Av. Café, 14040-904 Ribeirao Preto, SP, Brazil
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Barbato L, Francioni E, Bianchi M, Mascitelli E, Marco LB, Tonelli DP. Periodontitis and bone metabolism. CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2015; 12:174-7. [PMID: 26604945 PMCID: PMC4625776 DOI: 10.11138/ccmbm/2015.12.2.174] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Periodontitis is a plaque induced disease characterized by tissue destruction. The extent of the alveolar bone loss depends on the host response stimulated by bacterial infection. Recently researchers have focused on the role of the immune system, of RANK/RANKL/OPG pathway and of cytokines network. Another recent field of interest is osteoimmunology that try to explain the relationship between immune and bone cells in activating bone resorption. Advances in the understanding of the pathogenic mechanisms allowed a better understanding of the relationship with other diseases like osteoporosis and also to hypothesize new therapies based on modulation of host response (host modulatory therapy - HMT). The purpose of this mini-review is to briefly discuss these topics.
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Affiliation(s)
- Luigi Barbato
- Department of Translational Medicine and Surgery, Section of Dentistry, University of Florence, Italy
| | - Edoardo Francioni
- Department of Translational Medicine and Surgery, Section of Dentistry, University of Florence, Italy
| | - Massimiliano Bianchi
- Department of Translational Medicine and Surgery, Section of Dentistry, University of Florence, Italy
| | - Eleonora Mascitelli
- Department of Translational Medicine and Surgery, Section of Dentistry, University of Florence, Italy
| | - Leila Brancato Marco
- Department of Translational Medicine and Surgery, Section of Dentistry, University of Florence, Italy
| | - Duvina Paolo Tonelli
- Department of Translational Medicine and Surgery, Section of Dentistry, University of Florence, Italy
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Lorenzi T, Niţulescu EA, Zizzi A, Lorenzi M, Paolinelli F, Aspriello SD, Baniţă M, Crăiţoiu Ş, Goteri G, Barbatelli G, Lombardi T, Di Felice R, Marzioni D, Rubini C, Castellucci M. The novel role of HtrA1 in gingivitis, chronic and aggressive periodontitis. PLoS One 2014; 9:e96978. [PMID: 24979214 PMCID: PMC4076180 DOI: 10.1371/journal.pone.0096978] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 04/14/2014] [Indexed: 12/02/2022] Open
Abstract
Proteolytic tissue degradation is a typical phenomenon in inflammatory periodontal diseases. HtrA1 (High temperature requirement A 1) has a serine protease activity and is able to degrade fibronectin whose fragments induce the expression and secretion of several matrix metalloproteinases (MMPs). The aim of this study was to investigate for the first time if HtrA1 has a role in gingivitis and in generalized forms of chronic and aggressive periodontitis. Expression of HtrA1 was investigated in 16 clinically healthy gingiva, 16 gingivitis, 14 generalized chronic periodontitis and 10 generalized aggressive periodontitis by immunohistochemistry and real-time PCR. Statistical comparisons were performed by the Kruskall-Wallis test. Significantly higher levels of HtrA1 mRNA and protein expression were observed in pathological respect to healthy tissues. In particular, we detected an increase of plasma cell HtrA1 immunostaining from gingivitis to chronic and aggressive periodontitis, with the higher intensity in aggressive disease. In addition, we observed the presence of HtrA1 in normal and pathological epithelium, with an increased expression, particularly in its superficial layer, associated with increasingly severe forms of periodontal disease. We can affirm that HtrA1 expression in plasma cells could be correlated with the destruction of pathological periodontal tissue, probably due to its ability to trigger the overproduction of MMPs and to increase the inflammatory mediators TNF-α and IL-1β by inhibition of TGF-β. Moreover, epithelial HtrA1 immunostaining suggests a participation of the molecule in the host inflammatory immune responses necessary for the control of periodontal infection.
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Affiliation(s)
- Teresa Lorenzi
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | | | - Antonio Zizzi
- Pathological Anatomy, Department of Medical Sciences and Public Health, Università Politecnica delle Marche, United Hospitals, Ancona, Italy
| | - Maria Lorenzi
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Francesca Paolinelli
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Simone Domenico Aspriello
- Department of Clinical Specialistic and Dental Sciences, Periodontology, Università Politecnica delle Marche, Ancona, Italy
| | - Monica Baniţă
- Department of Histology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Ştefania Crăiţoiu
- Department of Histology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Gaia Goteri
- Pathological Anatomy, Department of Medical Sciences and Public Health, Università Politecnica delle Marche, United Hospitals, Ancona, Italy
| | - Giorgio Barbatelli
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Tommaso Lombardi
- Laboratory of Oral and Maxillofacial Pathology, Division of Stomatology and Oral Surgery, University of Geneva, Geneva, Switzerland
| | - Roberto Di Felice
- Private Dental Practice, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Daniela Marzioni
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Corrado Rubini
- Pathological Anatomy, Department of Medical Sciences and Public Health, Università Politecnica delle Marche, United Hospitals, Ancona, Italy
| | - Mario Castellucci
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
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Albertini M, López-Cerero L, O'Sullivan MG, Chereguini CF, Ballesta S, Ríos V, Herrero-Climent M, Bullón P. Assessment of periodontal and opportunistic flora in patients with peri-implantitis. Clin Oral Implants Res 2014; 26:937-941. [DOI: 10.1111/clr.12387] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Matteo Albertini
- Department of Periodontology; University of Seville; Seville Spain
| | | | | | | | - Sofia Ballesta
- Department of Microbiology; School of Medicine; Seville Spain
| | - Vicente Ríos
- Department of Periodontology; University of Seville; Seville Spain
| | | | - Pedro Bullón
- Department of Periodontology; University of Seville; Seville Spain
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Teughels W, Durukan A, Ozcelik O, Pauwels M, Quirynen M, Haytac MC. Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study. J Clin Periodontol 2013; 40:1025-35. [PMID: 24164569 PMCID: PMC3908359 DOI: 10.1111/jcpe.12155] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 01/17/2023]
Abstract
AIM The aim of this randomized placebo-controlled clinical trial was to evaluate the effects of Lactobacillus reuteri-containing probiotic lozenges as an adjunct to scaling and root planing (SRP). MATERIAL AND METHODS Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks. RESULTS At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group. CONCLUSIONS The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.
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Affiliation(s)
- Wim Teughels
- Periodontology Section Department of Oral Sciences Faculty of Medicine, Catholic University LeuvenLeuven, Belgium
- Periodontology Section Dentistry, University Hospitals LeuvenLeuven, Belgium
- Fund for Scientific Research Flanders (FWO)Brussels, Belgium
| | - Andaç Durukan
- Department of Periodontology Faculty of Dentistry, Cukurova UniversityAdana, Turkey
| | - Onur Ozcelik
- Department of Periodontology Faculty of Dentistry, Cukurova UniversityAdana, Turkey
| | - Martine Pauwels
- Periodontology Section Department of Oral Sciences Faculty of Medicine, Catholic University LeuvenLeuven, Belgium
| | - Marc Quirynen
- Periodontology Section Department of Oral Sciences Faculty of Medicine, Catholic University LeuvenLeuven, Belgium
- Periodontology Section Dentistry, University Hospitals LeuvenLeuven, Belgium
| | - Mehmet Cenk Haytac
- Department of Periodontology Faculty of Dentistry, Cukurova UniversityAdana, Turkey
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Corbella S, Del Fabbro M, Taschieri S, Francetti L. Periodontal disease and adverse pregnancy outcomes: a systematic review. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.ios.2011.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Albuquerque C, Morinha F, Requicha J, Martins T, Dias I, Guedes-Pinto H, Bastos E, Viegas C. Canine periodontitis: The dog as an important model for periodontal studies. Vet J 2012; 191:299-305. [DOI: 10.1016/j.tvjl.2011.08.017] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 08/04/2011] [Accepted: 08/15/2011] [Indexed: 11/24/2022]
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Garlet GP, Trombone APF, Menezes R, Letra A, Repeke CE, Vieira AE, Martins W, Neves LTD, Campanelli AP, Santos CFD, Vieira AR. The use of chronic gingivitis as reference status increases the power and odds of periodontitis genetic studies: a proposal based in the exposure concept and clearer resistance and susceptibility phenotypes definition. J Clin Periodontol 2012; 39:323-32. [PMID: 22324464 DOI: 10.1111/j.1600-051x.2012.01859.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2012] [Indexed: 11/29/2022]
Abstract
AIM Current literature on chronic periodontitis genetics encompasses numerous single nucleotide polymorphisms-focused case-control studies with inconsistent and controversial results, which typically disregards the exposure concept embraced by case-control definition. Herein, we propose a case-control design reappraisal by clear phenotype selection, where chronic gingivitis represents a genetically resistant phenotype/genotype opposing the susceptible cohort. MATERIAL AND METHODS The hypothesis was tested in healthy, chronic periodontitis and gingivitis groups through Real-time PCR-based allelic discrimination of classic variants IL1B-3954, IL6-174, TNFA-308, IL10-592 and TLR4-299. RESULTS Observed allele/genotype frequencies characterize the healthy group with an intermediate genetic profile between periodontitis and gingivitis cohorts. When comparing genotype/allele frequencies in periodontitis versus healthy and periodontitis versus gingivitis scenarios, the number of positive associations (2-4) and the degree of association (p and odds ratio values) were significantly increased by the new approach proposed (periodontitis versus gingivitis), suggesting the association of IL1B-3954, TNFA-308, IL10-592 and TLR4-299 with periodontitis risk. Power study was also significantly improved by the new study design proposed when compared to the traditional approach. CONCLUSIONS The data presented herein support the use of new case-control study design based on the case-control definition and clear resistance/susceptibility phenotypes selection, which can significantly impact the study power and odds of identification of genetic factors involved in PD.
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Affiliation(s)
- Gustavo Pompermaier Garlet
- Department of Biological Sciences, School of Dentistry of Bauru, São Paulo University (FOB/USP), Bauru, SP, Brazil
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Kraft-Neumärker M, Lorenz K, Koch R, Hoffmann T, Mäntylä P, Sorsa T, Netuschil L. Full-mouth profile of active MMP-8 in periodontitis patients. J Periodontal Res 2011; 47:121-8. [PMID: 21958332 DOI: 10.1111/j.1600-0765.2011.01416.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE MMP-8 in gingival crevicular fluid is considered as a protease with high destructive potential because of its ability to degrade collagen in periodontitis-affected patients. The aim of this study was to investigate whether there was a relationship between clinical diagnostic parameters and the concentration of active MMP-8 (aMMP-8) in gingival crevicular fluid in a site-level full-mouth analysis. Based on these data, the prognostic value of aMMP-8 levels in relation to pocket depth may be evaluated. MATERIAL AND METHODS Clinical measurements of pocket depth, bleeding on probing (BOP), plaque index (PlI) and gingival index (GI), as well as samples of gingival crevicular fluid, were obtained from four sites of each tooth of nine healthy female patients with chronic generalized periodontitis. The aMMP-8 concentration in gingival crevicular fluid was quantified by ELISA using specific monoclonal antibodies. Multiple linear regression models for the single measures of aMMP-8 and pocket depth were calculated with GI and BOP as additional variables. RESULTS Between 92 and 112 recordings were obtained for each parameter in each patient. Mean values of between 31.5 and 88.8% were calculated for pocket depths of ≥ 4 mm. Mean pocket depths ranged from 3.11 to 4.73 mm, the mean BOP values ranged from 34.0 to 96.7% and the mean full-mouth gingival crevicular fluid aMMP-8 concentration ranged from 3.2 to 23.7 ng/mL. CONCLUSION In this sample of female periodontitis patients, a broad range of intra-individual and interindividual aMMP-8 values was found. Although the explained variance was rather weak, a statistically significant relationship between aMMP-8 and pocket depth was proven.
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Affiliation(s)
- M Kraft-Neumärker
- Department of Periodontology, Medical Faculty, University of Technology Dresden, Dresden, Germany
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Periodontal disease as a risk factor for adverse pregnancy outcomes: a systematic review and meta-analysis of case–control studies. Odontology 2011; 100:232-40. [DOI: 10.1007/s10266-011-0036-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 06/09/2011] [Indexed: 11/26/2022]
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Teughels W, Loozen G, Quirynen M. Do probiotics offer opportunities to manipulate the periodontal oral microbiota? J Clin Periodontol 2011; 38 Suppl 11:159-77. [PMID: 21323712 DOI: 10.1111/j.1600-051x.2010.01665.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND As in other fields of healthcare, probiotics have been introduced for prevention and treatment of periodontal diseases. OBJECTIVE This review was initiated to explore whether the use of probiotics can influence the periodontal microbiota and periodontal health. MATERIALS AND METHODS Literature on the mode of action of oral probiotics was reviewed and a systematic review was performed on the microbiological and clinical effects of oral probiotics on periodontal health. RESULTS Three animal and 11 in vivo human studies were retrieved. Six studies reported on microbiological effects whereas eight studies report on clinical effects. Seven studies were performed on healthy or gingivitis patients and four studies on periodontitis patients. Many of the retrieved studies are pilot in nature and with low quality. The high degree of heterogeneity between studies hampered analysis. CONCLUSION Taking into consideration all limitations, the currently available data indicate an effect of probiotics on the oral microbiota and a more limited effect on clinical periodontal outcome measures. However, there is an urgent need for properly conducted clinical trials where probiotics are used as adjuncts to standard periodontal care, similar to antibiotics, using probiotic strains with, at least at an in vitro level, proven periodontal probiotic effects.
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Affiliation(s)
- Wim Teughels
- Department of Periodontology, Research Group for Microbial Adhesion, Catholic University Leuven, Leuven, Belgium.
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da Fonseca DM, Trombone APF, Repeke CE, Avila-Campos MJ, Coelho-Castelo AAM, Silva JS, Campanelli AP, Deperon Bonato VL, Garlet GP. Functional interferences in host inflammatory immune response by airway allergic inflammation restrain experimental periodontitis development in mice. J Clin Periodontol 2010; 38:131-41. [DOI: 10.1111/j.1600-051x.2010.01660.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Trombone AP, Claudino M, Colavite P, de Assis GF, Avila-Campos MJ, Silva JS, Campanelli AP, Ibañez OM, De Franco M, Garlet GP. Periodontitis and arthritis interaction in mice involves a shared hyper-inflammatory genotype and functional immunological interferences. Genes Immun 2010; 11:479-89. [PMID: 20428191 DOI: 10.1038/gene.2010.13] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Periodontitis (PD) and rheumatoid arthritis (RA) have been found to be clinically associated and to share the chronic nature of the inflammatory reaction associated with bone resorption activity. However, the mechanisms underlying such association are unknown. Therefore, we examined the basis of Actinobacillus actinomycetemcomitans- and Porphyromonas gingivalis-induced PD and pristane-induced arthritis (PIA) interaction in mice. Higher severity PD in the genetically inflammation prone acute inflammatory reactivity maximum (AIRmax) mice strain was associated with higher levels of TNF-alpha, IL-1beta, IL-17, matrix metalloproteinase (MMP)-13, and RANKL, whereas PD/PIA co-induction resulted in even higher levels of IL-1beta, IFN-gamma, IL-17, RANKL, and MMP-13 levels. Conversely, PD/PIA co-induction in AIRmin strain did not alter the course of both pathologies. PIA/PD co-induction resulted in altered expression of T-cell subsets transcription factors expression, with T-bet and RORgamma levels being upregulated, whereas GATA-3 levels were unaltered. Interestingly, PIA induction resulted in alveolar bone loss, such response being highly dependent on the presence of commensal oral bacteria. No differences were found in PIA severity parameters by PD co-induction. Our results show that the interaction between experimental PD and arthritis in mice involves a shared hyper-inflammatory genotype and functional interferences in innate and adaptive immune responses.
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Affiliation(s)
- A P Trombone
- Department of Biochemistry and Immunology, School of Medicine of Ribeirão Preto--FMRP/USP, Sao Paulo, Brazil
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Cairo F, Castellani S, Gori AM, Nieri M, Baldelli G, Abbate R, Pini-Prato GP. Severe periodontitis in young adults is associated with sub-clinical atherosclerosis. J Clin Periodontol 2008; 35:465-72. [DOI: 10.1111/j.1600-051x.2008.01228.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Hamlet S, Ganashan N, Cullinan M, Westerman B, Palmer J, Seymour G. A 5-Year Longitudinal Study ofTannerella forsythia prtHGenotype: Association With Loss of Attachment. J Periodontol 2008; 79:144-9. [DOI: 10.1902/jop.2008.070228] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Berdeli A, Emingil G, Han Saygan B, Gürkan A, Atilla G, Köse T, Baylas H. TLR2 Arg753Gly, TLR4 Asp299Gly and Thr399Ile gene polymorphisms are not associated with chronic periodontitis in a Turkish population. J Clin Periodontol 2007; 34:551-7. [PMID: 17555409 DOI: 10.1111/j.1600-051x.2007.01092.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Toll-like receptor (TLR) gene polymorphisms could affect the host's ability to respond to microbial pathogens. In this case-control study, the association of TLR2 and TLR4 gene polymorphisms with chronic periodontitis (CP) was investigated. MATERIALS AND METHODS Genomic DNA was obtained from the peripheral blood of 83 patients with CP and 106 periodontally healthy subjects. The TLR2 Arg753Gly, Arg677Trp and TLR4 Asp299Gly, Thr399Ile gene polymorphisms were genotyped by the polymerase chain reaction-restriction fragment length polymorphism method. The data were analysed by a chi2 test, logistic regression analysis and the Mann-Whitney U test. RESULTS The 753Gln allele was found in 6.1% of the CP patients as compared with 6.6% in the control group (p>0.05). The frequency of the 299Gly and 399Ile allele was 2.4% and 1.8% in CP patients. For the healthy subjects, the frequency was 2.8% for the 299Gly and 2.5% for the 399Ile allele (p>0.05). None of the CP patients or healthy subjects showed homozygosity for the TLR2 and TLR4 alleles. Percentage of sites with bleeding on probing and plaque were significantly higher in 299Gly-positive patients compared with 299Gly-negative patients (p<0.05). CONCLUSION These results showed that the TLR2 and TLR4 gene polymorphisms studied are not associated with susceptibility to CP in Turkish patients.
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Affiliation(s)
- Afig Berdeli
- Molecular Medicine Laboratory, Department of Pediatrics, School of Medicine, Ege University, Izmir, Turkey
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Botero JE, Contreras A, Lafaurie G, Jaramillo A, Betancourt M, Arce RM. Occurrence of Periodontopathic and Superinfecting Bacteria in Chronic and Aggressive Periodontitis Subjects in a Colombian Population. J Periodontol 2007; 78:696-704. [PMID: 17397318 DOI: 10.1902/jop.2007.060129] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Differences in the composition of subgingival microbiota in periodontitis have been observed in different geographic locations. Some of these microbial differences could have clinical significance. This study describes clinical parameters and the composition of the subgingival microbiota in chronic periodontitis (CP) and aggressive periodontitis (AgP) patients in a Colombian population. METHODS Clinical parameters (probing depth, clinical attachment level, bleeding on probing, and plaque index) and plaque samples from 68 CP, 12 AgP, and 30 periodontally healthy subjects were analyzed. Subgingival samples were processed using culture, biochemical tests, and polymerase chain reaction for the detection of periodontal and superinfecting pathogens. The analysis of variance, chi(2), and Kruskal-Wallis tests were used to evaluate differences between groups for clinical parameters and microbiologic composition (P <or=0.05). RESULTS Clinical parameters were significantly increased in CP and AgP patients compared to healthy subjects (P <0.001), but no differences were found between periodontitis groups. Porphyromonas gingivalis, Tannerella forsythensis, and Eikenella corrodens showed higher frequencies in AgP compared to CP and healthy subjects (P <0.05). Extension (localized and generalized) of the periodontal destruction had no effect on the composition of the subgingival microbiota. Gram-negative enteric rods were more frequent in AgP patients (P <0.01). CONCLUSIONS This study demonstrated a high prevalence of P. gingivalis, T. forsythensis, and E. corrodens in AgP patients. Gram-negative enteric rods were frequent in AgP and CP patients. Differences in the composition of subgingival microbiota in periodontitis patients need to be taken into account when considering the best therapeutic approach for each individual, including the use of antibiotics.
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Hamlet SM, Taiyeb-Ali TB, Cullinan MP, Westerman B, Palmer JE, Seymour GJ. Tannerella forsythensis prtHGenotype and Association With Periodontal Status. J Periodontol 2007; 78:344-50. [PMID: 17274725 DOI: 10.1902/jop.2007.060161] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The prtH gene of Tannerella forsythensis encodes for a cysteine protease possessing virulent properties. Subgingival colonization by T. forsythensis with this genotype has been suggested to be a discriminator between periodontal health and disease. This study examined the prevalence of T. forsythensis prtH genotype in subgingival plaque and its association with periodontal disease progression and current disease status. METHODS Subjects harboring T. forsythensis in their subgingival plaque were identified using real-time polymerase chain reaction (PCR). The presence or absence of the prtH genotype was assessed by conventional PCR. Probing depths and relative attachment levels were also assessed. RESULTS The prtH genotype was detected in 13 of 56 (23.2%) subjects harboring T. forsythensis in their subgingival plaque. Periodontal disease progression was defined as two or more sites with > or = 2 mm attachment loss in the previous 2-year period; current disease was defined as four or more sites with probing depths > or = 4 mm. The odds of periodontal disease (progression and/or current disease) were 1.55 times greater in subjects harboring prtH genotype T. forsythensis than in subjects in whom prtH was not detected. The prtH genotype was associated with higher numbers of T. forsythensis. In subjects with high levels of T. forsythensis, prtH genotype was associated with an increased extent of periodontal disease 2 years subsequently. CONCLUSIONS These results show that T. forsythensis prtH genotype is associated with high levels of T. forsythensis. However, further work is needed to determine whether it also is a useful marker of periodontal disease progression in T. forsythensis-infected subjects.
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Affiliation(s)
- Stephen M Hamlet
- School of Dentistry, The University of Queensland, Brisbane, QLD, Australia.
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Emingil G, Kuula H, Pirilä E, Atilla G, Sorsa T. Gingival crevicular fluid laminin-5 gamma2-chain levels in periodontal disease. J Clin Periodontol 2006; 33:462-8. [PMID: 16820033 DOI: 10.1111/j.1600-051x.2006.00933.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIM Our study aimed to examine the molecular forms and gingival crevicular fluid (GCF) levels of laminin-5 gamma2-chain in patients with different periodontal disease, and compare the effects of P.gingivalis trypsin-like proteinase on intact laminin-5 gamma2-chain species. METHODS Eighteen patients with generalized aggressive periodontitis (G-AgP), 29 patients with chronic periodontitis (CP), 20 with gingivitis and 20 periodontally healthy subjects were included. Probing depth, clinical attachment loss, presence of bleeding on probing and plaque were recorded. Molecular forms and GCF laminin-5 gamma2-chain levels and the effects of P. gingivalis trypsin-like proteinase on intact laminin-5 gamma2-chain were analysed by computer-quantitated Western immunoblotting. RESULTS Laminin-5 gamma2-chain 40 and 70 kDa fragments could be detected in all groups, in varying levels. The CP group had elevated GCF laminin-5 gamma2-chain fragment levels compared with the gingivitis and healthy groups (p<0.008). The G-AgP group had GCF laminin-5 gamma2-chain fragment levels similar to the gingivitis and healthy groups (p>0.008). GCF laminin-5 gamma2-chain fragments differed clearly from the multiple lower molecular size fragments of P.gingivalis trypsin-laminin-5 gamma2-chain proteinases. CONCLUSION Increased GCF laminin-5 gamma2-chain fragments in periodontitis sites with deep periodontal pocket suggest that these cleaved 40 and 70 kDa fragments could reflect the extent of the inflammatory reaction in CP.
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Affiliation(s)
- Gülnur Emingil
- Department of Periodontology, Ege University, School of Dentistry, Izmir, Turkey, and Department of Oral and Maxillofacial Diseases, Helsinki University Cnetral Hospital, Finland.
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