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Tarrad NAF, Shaker OG, Elbanna RMH, AbdelKawy M. "Outcome of non-surgical periodontal treatment on Gal-1 and Gal-3 GCF levels in periodontitis patients: a case-control study". Clin Oral Investig 2024; 28:309. [PMID: 38743248 PMCID: PMC11093871 DOI: 10.1007/s00784-024-05688-1] [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: 10/11/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This study aimed to explore the effect of nonsurgical periodontal treatment on Galectin-1 and -3 GCF levels in gingivitis and periodontitis stage III compared to periodontally healthy individuals, to determine whether they could serve as diagnostic markers / therapeutic targets for periodontitis and revealing their possible role in periodontal disease. MATERIALS AND METHODS Forty-five systemically healthy participants were included and equally subdivided into three groups: gingivitis, periodontitis (stage III), and a periodontally healthy control group. The clinical parameters were recorded. Galectin-1 and -3 GCF levels were evaluated (before and after non-surgical treatment for periodontitis) using an enzyme linked immune-sorbent assay (ELISA) kit. Receiver operating characteristic (ROC) curve was performed to reveal sensitivity, specificity, predictive value, and diagnostic accuracy of both markers. RESULTS The study showed statistical significance between different groups regarding Galectin-3 with higher values in periodontitis and the lowest values in healthy control. Also, Galectin-1 was significantly higher in the periodontitis/gingivitis groups than in the control group. Moreover, non-surgical periodontal treatment in periodontitis patients caused a statistical reduction in clinical parameters and biomarkers. ROC analysis revealed excellent diagnostic ability of both biomarkers in discriminating periodontitis/gingivitis against healthy individuals (100% diagnostic accuracy for Galectin-1 and 93% for Galectin-3, AUC > 0.9) and acceptable diagnostic ability between periodontitis participants against gingivitis (73% diagnostic accuracy for Gal-1 and 80% for Gal-3, AUC > 0.7). CONCLUSIONS Both Galectin-1 and Galectin-3 seem to have outstanding diagnostic accuracy for the identification of periodontal disease, an acceptable ability to measure periodontal disease activity and the severity of inflammatory status. Additionally, they could serve as therapeutic targets to monitor treatment efficiency. CLINICALTRIAL GOV REGISTRATION NUMBER: (NCT06038812).
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Affiliation(s)
| | - Olfat Gamil Shaker
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Maha AbdelKawy
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt
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Hsu YT, Chang AM, Daubert D, Roberts F, Chen D, Trivedi HM, Gomez J, Darveau RP. Inflammation and tissue remodeling mediator expression during gingivitis: A comparison between experimental, naturally occurring gingivitis, and periodontal health. J Periodontol 2024. [PMID: 38708772 DOI: 10.1002/jper.23-0692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND The aim of this study is to evaluate the immune regulation and tissue remodeling responses during experimental gingivitis (EG) and naturally occurring gingivitis (NG) to provide a comprehensive analysis of host responses. Gingival crevicular fluid (GCF) was obtained from 2 human studies conducted in university settings. METHODS The EG study enrolling 26 volunteers provided controls for the baseline (Day 0) from healthy disease-free participants, while Day 21 (the end of EG induction of the same group) was used to represent EG. Twenty-six NG participants age-matched with those of the EG group were recruited. GCF samples were analyzed for 39 mediators of inflammatory/immune responses and tissue remodeling using commercially available bead-based multiplex immunoassays. The differences in GI and mediator expression among groups were determined at a 95% confidence level (p ≤ 0.05) by a 2-way analysis of variance (ANOVA) with a post-hoc Tukey's test. RESULTS Our findings showed that EG had a greater gingival index than NG and was healthy (p < 0.01 of all comparisons). Furthermore, EG showed significantly higher levels of MPO (p < 0.001), CCL3 (p < 0.05), and IL-1B (p < 0.001) than NG. In contrast, NG had increased levels of MIF (p < 0.05), Fractalkine (p < 0.001), angiogenin (p < 0.05), C3a (p < 0.001), BMP-2 (p < 0.001), OPN (p < 0.05), RANKL (p < 0.001), and MMP-13 (p < 0.001) than EG. CONCLUSIONS Consistent with the findings from chronic (NG) versus acute (EG) inflammatory lesions, these data reveal that NG displays greater immune regulation, angiogenesis, and bone remodeling compared to EG.
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Affiliation(s)
- Yung-Ting Hsu
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Ana M Chang
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, Washington, USA
| | - Diane Daubert
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Frank Roberts
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Dandan Chen
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Harsh M Trivedi
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Juliana Gomez
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Rich P Darveau
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
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Han C, Wu D, Yu F, Wang Q, Yang Y, Li Y, Qin R, Chen Y, Xu L, He D. No genetic causal association between periodontitis and ankylosing spondylitis: a bidirectional two-sample mendelian randomization analysis. BMC Med Genomics 2024; 17:118. [PMID: 38698441 PMCID: PMC11067206 DOI: 10.1186/s12920-024-01845-3] [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: 10/15/2023] [Accepted: 03/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Observational studies that reveal an association between periodontitis (PD) and ankylosing spondylitis (AS) exist. However, observational research is prone to reverse causality and confounding factors, which make it challenging to infer cause-and-effect relationships. We conducted a two-sample Mendelian randomization (MR) study to examine the causal relationship between the genetic prediction of PD and AS. METHODS In our study, single-nucleotide polymorphisms (SNPs) were defined as instrumental variables (IVs). The genetic association with PD came from the Gene-Lifestyle Interactions and Dental Endpoints (GLIDE) consortium, wherein 17353 cases of European ancestry and 28210 controls of European ancestry were included in this study. The genetic association with AS from the Neale Laboratory Consortium included 337,159 individuals from the United Kingdom, with 968 cases and 336,191 controls. MR analysis was mainly performed using the inverse-variance weighted (IVW) method. In addition, the robustness of the study findings was assessed using sensitivity, pleiotropy, and heterogeneity analyses. RESULTS Eighteen independent SNPs with P-values significantly smaller than 1 × 10- 5 were used as IV SNPs for PD, while 39 independent SNPs with P-values significantly smaller than 1 × 10- 5 were used as IV SNPs for AS. The results of the IVW method revealed no causal association between PD and AS (odds ratio = 1.00, 95% confidence interval: 0.99953 to 1.00067, P = 0.72). The MR-Egger method did not support the causal association between PD and AS. It is unlikely that horizontal pleiotropy distorts causal estimates based on sensitivity analysis. No significant heterogeneity was observed in the Q test. The ''leave-one-out'' analysis demonstrated that the robustness of our results was unaffected by eliminating any of the IVs. Likewise, no significant causative effect for AS on PD was observed in the inverse MR analysis. CONCLUSIONS The study results do not support shared heritability or a causal association between PD and AS.
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Affiliation(s)
- Chong Han
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Dongchao Wu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Feiyan Yu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Qianqian Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Yang Yang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Yi Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Rao Qin
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Yue Chen
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Linkun Xu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China
| | - Dongning He
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China.
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, China.
- Department of Implantology, Shanxi Medical University School and Hospital of Stomatology, No. 63, New South Road, Yingze District, 030001, Taiyuan, Shanxi, P.R. China.
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Butera A, Pascadopoli M, Nardi MG, Ogliari C, Chiesa A, Preda C, Perego G, Scribante A. Clinical Use of Paraprobiotics for Pregnant Women with Periodontitis: Randomized Clinical Trial. Dent J (Basel) 2024; 12:116. [PMID: 38668028 PMCID: PMC11049446 DOI: 10.3390/dj12040116] [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: 01/25/2024] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Periodontal disease is very common in pregnant women. Paraprobiotics are a subset of probiotics. They can be defined as inactivated microbial cells providing health benefits to the host and are considered particularly safe. The aim of this study was to compare the periodontal health of pregnant women and puerperae after 6 months of home use of paraprobiotics. A total of 30 pregnant women were enrolled and divided into two groups: the test group, who had to use a paraprobiotic-based toothpaste (Biorepair Peribioma Pro, Coswell S.p.A., Funo di Argelato, BO, Italy) and mousse (Mousse Mouthwash Biorepair Peribioma, Coswell S.p.A.) twice a day, and the control group, who had to use only the paraprobiotic-based toothpaste. The time frames of the study were: 1 month (T1), 3 months (T2) and 6 months (T3), and data were collected during pregnancy and in the period immediately following delivery. The following indices were evaluated at T0, T1, T2 and T3: clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), plaque control record (PCR), modified marginal gingival index (mMGI), papillary marginal gingival index (PMGI) and recessions (R). All data were subjected to statistical analysis. PCR decreased significantly from T0 to T1 in the control group and from T0 to T2 and from T0 to T3 in the test group. BOP tended to decrease in both groups, but a significant reduction was observed only in the test group. CAL, PPD, PMGI and mMGI tended to decrease gradually in both groups without significant differences between or within groups. The combination of the paraprobiotic-based toothpaste and the paraprobiotic-based mousse significantly reduced BoP and plaque control over time, although there were no significant differences with the use of the paraprobiotic-based toothpaste alone. In addition, the combination of the two products promoted a trend towards the better stabilization of recessions.
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Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maria Gloria Nardi
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | | | - Alessandro Chiesa
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Camilla Preda
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Giulia Perego
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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5
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Sindhusha VB, Rajasekar A. Assessment of Clinical and Patient-Centered Outcomes in Nonsurgical Periodontal Therapy. Cureus 2024; 16:e56464. [PMID: 38638755 PMCID: PMC11024879 DOI: 10.7759/cureus.56464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Aim The study was conducted to assess the clinical and patient-centered outcomes among the patients who had undergone nonsurgical periodontal therapy (NSPT). Methodology The participants for this study were 40 individuals with generalized chronic periodontitis. Numerous clinical parameters including clinical attachment level (CAL), probing pocket depth (PPD), plaque index (PI), and gingival index (GI) were evaluated along with the administration of a customized questionnaire before and after three months of therapy to evaluate patient-centered outcomes. Results Clinical parameters showed significant (p < 0.05) improvement post-NSPT. There was 100% satisfaction in few patient-centered outcomes such as bleeding gums, bad breath, food entrapment, and mobility. Conclusion A significant improvement in the clinical parameters does not guarantee improvement in patient-centered outcomes. Achieving the improvement in patient-centered outcomes can improve the overall quality of life (QOL), marking this a holistic treatment.
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Affiliation(s)
- Vyshnavi B Sindhusha
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Arvina Rajasekar
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Huang Y, Ge R, Qian J, Lu J, Qiao D, Chen R, Jiang H, Cui D, Zhang T, Wang N, He S, Wang M, Yan F. Lacticaseibacillus rhamnosus GG Improves Periodontal Bone Repair via Gut-Blood Axis in Hyperlipidemia. J Dent Res 2024; 103:253-262. [PMID: 38197171 DOI: 10.1177/00220345231217402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Periodontal bone regeneration remains a clinical challenge, and hyperlipidemia can aggravate alveolar bone resorption. Probiotics have recently been reported to improve bone mass. We aimed to determine the role of Lacticaseibacillus rhamnosus GG (LGG) in periodontal bone regeneration improvement within the context of periodontitis with hyperlipidemia. A Sprague Dawley rat model for periodontitis, hyperlipidemia, and periodontal fenestration defect was constructed (n = 36) and administered LGG gavage for 6 wk (the rats were subsequently sacrificed). Fecal microbiota from donor rats 3 wk after LGG gavage was transplanted into recipient rats to evaluate the role of LGG-modulated gut microbiota in periodontal bone regeneration. Regenerated bone mass was detected using micro-computerized tomography and hematoxylin and eosin stain. Gut microbiota was analyzed using 16S ribosomal RNA sequencing. Serum metabolites were detected by liquid chromatography-mass spectrometry (6 wk after LGG gavage). The pro-osteogenic effects of screened serum metabolite were verified in vitro on bone marrow mesenchymal stem cells (BMMSCs). We found that the bone mineral density, bone volume (BV), trabecular bone volume fraction (BV/TV), and trabecular thickness of the regenerated periodontal bone increased after LGG gavage (P < 0.05) but had little effect on oral flora. After LGG gavage, Staphylococcus, Corynebacterium, and Collinsella in the gut of donors were significantly changed, and these differences were maintained in recipients, who also showed increased trabecular thickness of the regenerated periodontal bone (P < 0.05). These key genera were correlated with BV/TV and BV (P < 0.05). In addition, LGG gavage significantly regulated bone-related blood metabolites, of which selenomethionine promoted BMMSC osteogenesis. Notably, selenomethionine was associated with key gut genera (P < 0.05). Collectively, LGG improved periodontal bone regeneration in the context of periodontitis with hyperlipidemia by modulating gut microbiota and increasing pro-osteogenic metabolites in the blood. These results reveal new insights into the use of probiotics to promote periodontal bone regeneration via the gut-blood-bone axis.
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Affiliation(s)
- Y Huang
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Periodontology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - R Ge
- School of Stomatology, Zunyi Medical University, Zunyi, China
| | - J Qian
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - J Lu
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - D Qiao
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - R Chen
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - H Jiang
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Stomatology, Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, China
| | - D Cui
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - T Zhang
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - N Wang
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - S He
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - M Wang
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - F Yan
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
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7
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Mathangi R, Shyamsundar V, Meenakshi A, Aravindha Babu N, Vashum Y, Shila S. Influence of type 2 diabetes on immunohistochemical detection of TRAF6, cFos and NFATC1 in the gingiva in cases of chronic periodontitis. Biotech Histochem 2023; 98:492-500. [PMID: 37486267 DOI: 10.1080/10520295.2023.2236543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Type 2 diabetes (T2D) and chronic periodontitis (CP) are common diseases worldwide. Although T2D increases the severity of CP and alveolar bone loss, the mechanism of this is not well understood. We investigated using immunohistochemistry the expression of three osteoclast proteins, TRAF6, cFos and NFATc1, in gingival tissues. Gingival tissues were obtained from three groups: HC group, healthy controls; CP group, patients with CP; T2D + CP group, patients with both T2D and CP. Strong immunostaining for TRAF6, cFos and NFATc1 was observed in the gingival epithelium as well as in inflammatory cells in the CP and T2D + CP groups. Immunostaining was most intense in the T2D + CP group. We found strong up-regulation of TRAF6, cFos and NFATC1 in gingiva tissue of subjects with both T2D and CP, which corroborates our hypothesis that T2D potentiates osteoclastogenesis in CP.
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Affiliation(s)
- R Mathangi
- Research and Development Centre, Bharathiar University, Coimbatore, India
- Department of Biochemistry, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, India
| | - Vidyarani Shyamsundar
- Department of Oral Pathology and Microbiology, Centre of Oral Cancer Prevention and Research, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, India
| | - A Meenakshi
- Department of Periodontics, Sri Venkateshwara Dental College and Hospital, Chennai, India
| | - N Aravindha Babu
- Department of Oral Pathology and Microbiology, Centre of Oral Cancer Prevention and Research, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, India
| | - Yaongamphi Vashum
- Department of Biochemistry, Armed Forces Medical College, Pune, India
| | - S Shila
- VRR Institute of Biomedical Science, Affiliated to University of Madras, Chennai, India
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8
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Ravindran MP, Geetha A, Rajendran S, Mahendra J, Jyothi M, Namasivayam A. Correlation of Serum and Gingival Crevicular Fluid Levels of Caspase-3 and Milk Fat Globule-Epidermal Growth Factor 8 on Gingival Health. Indian J Dent Res 2023; 34:359-364. [PMID: 38739812 DOI: 10.4103/ijdr.ijdr_62_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 09/08/2023] [Indexed: 05/16/2024] Open
Abstract
AIM This study aimed to estimate and correlate the serum and gingival crevicular fluid (GCF) levels of caspase-3 and milk fat globule-epidermal growth factor 8 (MFG-E8) in healthy, gingivitis and generalised chronic periodontitis subjects. MATERIALS AND METHODS A total of 24 subjects were selected and divided into three groups. After recording the periodontal parameters (plaque index (PI), modified gingival index (MGI), probing depth (PD) and clinical attachment level (CAL)), the serum and GCF samples were collected and the levels of caspase-3 and MFG-E8 were estimated using enzyme-linked immunoassay (ELISA). RESULTS The mean values of PI, MGI, PD and CALs were significantly higher in group III when compared to group II and group I. The mean value of serum and GCF caspase-3 increased with increasing disease severity, whereas the mean serum and GCF values of MFG-E8 decreased with increasing severity of disease. Spearman's correlation showed a strong positive correlation between the serum and GCF levels of caspase-3 and periodontal parameters, whereas serum and GCF levels of MFG-E8 showed a strong negative correlation with the periodontal parameters. CONCLUSION The findings of this study are suggestive that the serum and GCF levels of caspase-3 and MFG-E8 could serve as a potential biomarker for the role of apoptosis in periodontal disease. However, further studies are required to explore the mechanism and understand the relationship between these apoptotic markers and periodontitis.
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Affiliation(s)
- Manonmani Pavithra Ravindran
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, Tamil Nadu, India
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Zhang L, Sheng M, Cao H, Zhang L, Shao W. Decoding the role of long non-coding RNAs in periodontitis: A comprehensive review. Biomed Pharmacother 2023; 166:115357. [PMID: 37619483 DOI: 10.1016/j.biopha.2023.115357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/13/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023] Open
Abstract
Periodontitis is an inflammatory disease characterized by the pathological loss of alveolar bone and the adjacent periodontal ligament. It is considered a disease that imposes a substantial health burden, with an incidence rate of 20-50%. The etiology of periodontitis is multifactorial, with genetic factors accounting for approximately half of severe cases. Studies have revealed that long non-coding RNAs (lncRNAs) play a pivotal role in periodontitis pathogenesis. Accumulating evidence suggests that lncRNAs have distinct regulatory mechanisms, enabling them to control numerous vital processes in periodontal cells, including osteogenic differentiation, inflammation, proliferation, apoptosis, and autophagy. In this review, we summarize the diverse roles of lncRNAs in the pathogenesis of periodontitis, shedding light on the underlying mechanisms of disease development. By highlighting the potential of lncRNAs as biomarkers and therapeutic targets, this review offers a new perspective on the diagnosis and treatment of periodontitis, paving the way for further investigation into the field of lncRNA-based therapeutics.
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Affiliation(s)
- Lizhi Zhang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China; First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Mengfei Sheng
- Department of Microbiology and Parasitology, Anhui Provincial Laboratory of Pathogen Biology, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, Anhui, China
| | - Huake Cao
- First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Lei Zhang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China.
| | - Wei Shao
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China; Department of Microbiology and Parasitology, Anhui Provincial Laboratory of Pathogen Biology, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, Anhui, China.
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10
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Thankappan P, Gopalakrishnan D, Manandhar S. Emerging role of photodynamic therapy as an adjunct to nonsurgical periodontal therapy on periodontal status and glycemic control in patients with type 2 diabetes: A clinical study. J Indian Soc Periodontol 2023; 27:508-514. [PMID: 37781335 PMCID: PMC10538516 DOI: 10.4103/jisp.jisp_7_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 10/03/2023] Open
Abstract
Background Periodontal disease is considered to be the sixth most common complication of diabetes mellitus (DM). Antibiotics (systemic and local) enhance the outcome of conventional mechanical debridement but frequent use of antimicrobials may develop resistance to microorganisms. To overcome this complicacy, the current study assessed the effectiveness of photodynamic therapy (PDT) in chronic periodontitis patients with type 2 diabetes when used as a combination therapy to standard periodontal therapy by assessing the various clinical and glycemic parameters. Materials and Methods A total of 16 known cases of chronic Periodontitis patients who were suffering from type 2 DM were allocated into two groups. The test group (n = 8) was treated with standard scaling and root planing (SRP) along with PDT while the control group was treated with SRP alone. Various clinical parameters assessed were plaque index, gingival index, pocket probing depth, clinical attachment level, and Glycated hemoglobin level at baseline and 90 days after therapy. Results At the end of the study, both the groups showed improvements with regard to all clinical and glycemic parameters compared to baseline. However, the test group presented statistically significant favorable results (all P < 0.05). Conclusion Conventional periodontal treatment aided with PDT proved to be a beneficial therapeutic measure and effective alternative in patients with chronic periodontitis with diabetes when compared with standard periodontal therapy alone.
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Affiliation(s)
- Prasanth Thankappan
- Department of Periodontology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Dharmarajan Gopalakrishnan
- Department of Periodontology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Sumita Manandhar
- Department of Periodontology, Armed Forces Medical Colleges, Pune, Maharashtra, India
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Shindo S, Pierrelus R, Ikeda A, Nakamura S, Heidari A, Pastore MR, Leon E, Ruiz S, Chheda H, Khatiwala R, Kumagai T, Tolson G, Elderbashy I, Ouhara K, Han X, Hernandez M, Vardar-Sengul S, Shiba H, Kawai T. Extracellular Release of Citrullinated Vimentin Directly Acts on Osteoclasts to Promote Bone Resorption in a Mouse Model of Periodontitis. Cells 2023; 12:1109. [PMID: 37190018 PMCID: PMC10136503 DOI: 10.3390/cells12081109] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 05/17/2023] Open
Abstract
Elevated osteoclast (OC)-mediated bone resorption, a common pathological feature between periodontitis and rheumatoid arthritis (RA), implicates a possible mutually shared pathogenesis. The autoantibody to citrullinated vimentin (CV), a representative biomarker of RA, is reported to promote osteoclastogenesis (OC-genesis). However, its effect on OC-genesis in the context of periodontitis remains to be elucidated. In an in vitro experiment, the addition of exogenous CV upregulated the development of Tartrate-resistant acid phosphatase (TRAP)-positive multinuclear OCs from mouse bone marrow cells and increased the formation of resorption pits. However, Cl-amidine, an irreversible pan-peptidyl arginine deiminase (PAD) inhibitor, suppressed the production and secretion of CV from RANKL-stimulated OC precursors, suggesting that the citrullination of vimentin occurs in OC precursors. On the other hand, the anti-vimentin neutralizing antibody suppressed in vitro Receptor activator of nuclear factor kappa-Β ligand (RANKL)-induced OC-genesis. The CV-induced upregulation of OC-genesis was abrogated by the Protein kinase C (PKC)-δ inhibitor Rottlerin, accompanied by the downmodulation of OC-genesis-related genes, including Osteoclast stimulatory transmembrane protein (OC-STAMP), TRAP and Matrix Metallopeptidase 9 (MMP9) as well as extracellular signal-regulated kinase (ERK) mitogen-activated protein (MAP)-kinase phosphorylation. Elevated levels of soluble CV and vimentin-bearing mononuclear cells were found in the bone resorption lesions of periodontitis induced in mice in the absence of an anti-CV antibody. Finally, local injection of anti-vimentin neutralizing antibody suppressed the periodontal bone loss induced in mice. Collectively, these results indicated that the extracellular release of CV promoted OC-genesis and bone resorption in periodontitis.
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Affiliation(s)
- Satoru Shindo
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Roodelyne Pierrelus
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Atsushi Ikeda
- Department of Periodontics and Endodontics, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8525, Japan
| | - Shin Nakamura
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Alireza Heidari
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Maria Rita Pastore
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Elizabeth Leon
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Sunniva Ruiz
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Harsh Chheda
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Rhea Khatiwala
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Tomoki Kumagai
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - George Tolson
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Islam Elderbashy
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Kazuhisa Ouhara
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Xiaozhe Han
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Maria Hernandez
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Saynur Vardar-Sengul
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
| | - Hideki Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Toshihisa Kawai
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, USA
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12
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Li J, Liu Y, Lai W, Song L, Deng J, Li C, Jiang S. MicroRNA-126 regulates macrophage polarization to prevent the resorption of alveolar bone in diabetic periodontitis. Arch Oral Biol 2023; 150:105686. [PMID: 36947912 DOI: 10.1016/j.archoralbio.2023.105686] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVE This study aims to investigate the effects of microRNA-126 (miR-126) on the macrophage polarization in vitro and alveolar bone resorption in vivo. DESIGN The relationship between miR-126 and MEK/ERK kinase 2 (MEKK2) was confirmed by dual-luciferase reporter assay. Real-time quantitative polymerase chain reaction, enzyme-linked immunosorbent assay or Western blot was used to detect the changes of miR-126, inducible nitric oxide synthase (iNOS), arginase-1 (Arg-1), tumor necrosis factor (TNF)-α, interleukin (IL)-10, MEKK2 and MEKK2-related pathways: mitogen-activated protein kinase (MAPK) and nuclear factor kappa-B (NF-κB) in RAW264.7 macrophages challenged with Porphyromonas gingivalis (P. gingivalis) lipopolysaccharide (LPS) and/or high glucose and/or miR-126 mimic. In mice with diabetic periodontitis, the expressions of iNOS and Arg-1 in gingiva, and alveolar bone level were detected after miR-126 mimic injection. RESULTS MiR-126 could directly bind with MEKK2 3'-untranslated region (UTR). MEKK2, phosphorylation of NF-κB and MAPK signaling proteins, TNF-α and iNOS increased (P < 0.05), while miR-126, Arg-1 and IL-10 were inhibited (P < 0.05) in macrophage challenged with high glucose and/or P. gingivalis LPS, however, miR-126 mimic reversed these effects (P < 0.05). The expressions of iNOS in gingiva and alveolar bone resorption were elevated (P < 0.05), the expression of Arg-1 in gingiva decreased (P < 0.05) in mice with diabetic periodontitis, which could be inhibited by miR-126 mimic. CONCLUSIONS miR-126 might prevent alveolar bone resorption in diabetic periodontitis and inhibit macrophage M1 polarization via regulating MEKK2 signaling pathway.
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Affiliation(s)
- Jiajun Li
- School of Dentistry, Tianjin Medical University, 300070 Tianjin, People's Republic of China
| | - Yue Liu
- School of Stomatology, Zunyi Medical University, Zunyi 563000, Guizhou, People's Republic of China; Stomatological Center, Peking University Shenzhen Hospital, Shenzhen 5180036, Guangdong, People's Republic of China; Guangdong Provincial High-level Clinical Key Specialty, Shenzhen 5180036, Guangdong, People's Republic of China; Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen 5180036, Guangdong, People's Republic of China
| | - Wen Lai
- School of Dentistry, Tianjin Medical University, 300070 Tianjin, People's Republic of China
| | - Liting Song
- School of Dentistry, Tianjin Medical University, 300070 Tianjin, People's Republic of China
| | - Jiayin Deng
- School of Dentistry, Tianjin Medical University, 300070 Tianjin, People's Republic of China
| | - Changyi Li
- School of Dentistry, Tianjin Medical University, 300070 Tianjin, People's Republic of China.
| | - Shaoyun Jiang
- Stomatological Center, Peking University Shenzhen Hospital, Shenzhen 5180036, Guangdong, People's Republic of China; Guangdong Provincial High-level Clinical Key Specialty, Shenzhen 5180036, Guangdong, People's Republic of China; Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen 5180036, Guangdong, People's Republic of China.
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13
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Sun H, Zheng M, Liu J, Fan W, He H, Huang F. Melatonin promoted osteogenesis of human periodontal ligament cells by regulating mitochondrial functions through the translocase of the outer mitochondrial membrane 20. J Periodontal Res 2023; 58:53-69. [PMID: 36373245 DOI: 10.1111/jre.13068] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 10/08/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVE Melatonin plays an important role in various beneficial functions, including promoting differentiation. However, effects on osteogenic differentiation, especially in human periodontal cells (hPDLCs), still remain inconclusive. Mitochondria are highly dynamic organelles that play an important role in various biological processes in cells, including energy metabolism and oxidative stress reaction. Furthermore, the translocase of the outer mitochondrial membrane 20 (TOM20) is responsible for recognizing and transporting precursor proteins. Thus, the objective of this study was to evaluate the functionality of melatonin on osteogenesis in human periodontal cells and to explore the involved mechanism of mitochondria. METHODS The hPDLCs were extracted and identified by flow cytometry and multilineage differentiation. We divided hPDLCs into control group, osteogenic induction group, and osteogenesis with melatonin treatment group (100, 10, and 1 μM). Then we used a specific siRNA to achieve interference of TOM20. Alizarin red and Alkaline phosphatase staining and activity assays were performed to evaluate osteogenic differentiation. Osteogenesis-related genes and proteins were measured by qPCR and western blot. Mitochondrial functions were tested using ATP, NAD+/NADH, JC-1, and Seahorse Mito Stress Test kits. Finally, TOM20 and mitochondrial dynamics-related molecules expression were also assessed by qPCR and western blot. RESULTS Our results showed that melatonin-treated hPDLCs had higher calcification and ALP activity as well as upregulated OCN and Runx2 expression at mRNA and protein levels, which was the most obvious in 1 μM melatonin-treated group. Meanwhile, melatonin supplement elevated intracellular ATP production and mitochondrial membrane potential by increasing mitochondrial oxidative metabolism, hence causing a lower NAD+ /NADH ratio. In addition, we also found that melatonin treatment raised TOM20 level and osteogenesis and mitochondrial functions were both suppressed after knocking down TOM20. CONCLUSION We found that melatonin promoted osteogenesis of hPDLCs and 1 μM melatonin had the most remarkable effect. Melatonin treatment can reinforce mitochondrial functions by upregulating TOM20.
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Affiliation(s)
- Haoyun Sun
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Miaomiao Zheng
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Jiawei Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Wenguo Fan
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Hongwen He
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Fang Huang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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14
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Ebadi M, Miresmaeili A, Shojaei S, Farhadi S, Rajabi S. Isolation and characterization of apical papilla cells from root end of human third molar and their differentiation into cementoblast cells: an in vitro study. Biol Proced Online 2023; 25:2. [PMID: 36690939 PMCID: PMC9869574 DOI: 10.1186/s12575-023-00190-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/11/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Periodontal regeneration, treatment of periodontal-related diseases and improving the function of implants are global therapeutic challenges. The differentiation of human stem cells from apical papilla into cementoblasts may provide a strategy for periodontitis treatment. This study aimed to evaluate the differentiation of primary human stem cells apical papilla (hSCAPs) to cementoblast cells. MATERIAL AND METHODS SCAPs cells were isolated from human third molar and then incubated for 21 days in a differentiation microenvironment. Alkaline phosphatase (ALP) and Alizarin red S staining assays were performed to evaluate the calcium deposition and formation of hydroxyapatite in the cultured hSCAPs microenvironment. Real-time polymerase chain reaction (RT-PCR) assay was performed for cementum protein 1 (CEMP1), collagen type I (COL1), F-Spondin (SPON1), osteocalcin (OCN), and osteopontin (OPN) as specific markers of cementoblasts and their progenitors. RESULTS ALP phosphatase activity in day 21 of treatment demonstrated a significant increase in ALP compared to the control. Alizarin red S staining assay showed that the differentiated hSCAPs offered a great amount of calcium deposition nodules compared to the control. The increased expression level of CEMP1, OCN, OPN, COL1 and Spon1 was observed in days 7, 14 and 21 compared to the control, while greatest expression level was observed in day 21. CONCLUSION In conclusion, the differentiation microenviroment is convenient and useful for promoting the differentiation of hSCAPs into cementoblast.
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Affiliation(s)
- Morvarid Ebadi
- grid.411463.50000 0001 0706 2472Department of Biomedical Engineering, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Amirfarhang Miresmaeili
- grid.411950.80000 0004 0611 9280Orthodontic Department of Hamadan University of Medical Sciences and Hamadan Dental Research Centre, Hamadan, Iran
| | - Shahrokh Shojaei
- grid.411463.50000 0001 0706 2472Department of Biomedical Engineering, Central Tehran Branch, Islamic Azad University, Tehran, Iran ,grid.411463.50000 0001 0706 2472Stem Cells Research Center, Tissue Engineering and Regenerative Medicine Institute, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Sareh Farhadi
- grid.411463.50000 0001 0706 2472Department of Oral & Maxillofacial Pathology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sarah Rajabi
- grid.419336.a0000 0004 0612 4397Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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15
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Cai R, Wang L, Zhang W, Liu B, Wu Y, Pang J, Ma C. The role of extracellular vesicles in periodontitis: pathogenesis, diagnosis, and therapy. Front Immunol 2023; 14:1151322. [PMID: 37114060 PMCID: PMC10126335 DOI: 10.3389/fimmu.2023.1151322] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Periodontitis is a prevalent disease and one of the leading causes of tooth loss. Biofilms are initiating factor of periodontitis, which can destroy periodontal tissue by producing virulence factors. The overactivated host immune response is the primary cause of periodontitis. The clinical examination of periodontal tissues and the patient's medical history are the mainstays of periodontitis diagnosis. However, there is a lack of molecular biomarkers that can be used to identify and predict periodontitis activity precisely. Non-surgical and surgical treatments are currently available for periodontitis, although both have drawbacks. In clinical practice, achieving the ideal therapeutic effect remains a challenge. Studies have revealed that bacteria produce extracellular vesicles (EVs) to export virulence proteins to host cells. Meanwhile, periodontal tissue cells and immune cells produce EVs that have pro- or anti-inflammatory effects. Accordingly, EVs play a critical role in the pathogenesis of periodontitis. Recent studies have also presented that the content and composition of EVs in saliva and gingival crevicular fluid (GCF) can serve as possible periodontitis diagnostic indicators. In addition, studies have indicated that stem cell EVs may encourage periodontal regeneration. In this article, we mainly review the role of EVs in the pathogenesis of periodontitis and discuss their diagnostic and therapeutic potential.
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Affiliation(s)
- Rong Cai
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
| | - Lu Wang
- Department of Critical Care Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhang
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
| | - Bing Liu
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
| | - Yiqi Wu
- Department of Critical Care Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jianliang Pang
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
- *Correspondence: Chufan Ma, ; Jianliang Pang,
| | - Chufan Ma
- Department of Stomatology, Air Force Medical Center, The Fourth Military Medical University, Beijing, China
- *Correspondence: Chufan Ma, ; Jianliang Pang,
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16
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Wang C, Wang L, Wang X, Cao Z. Beneficial Effects of Melatonin on Periodontitis Management: Far More Than Oral Cavity. Int J Mol Sci 2022; 23:ijms232314541. [PMID: 36498871 PMCID: PMC9739298 DOI: 10.3390/ijms232314541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
Periodontitis as a highly prevalent chronic infection/inflammatory disease can eventually lead to tooth loss and masticatory dysfunction. It also has a negative impact on general health and largely impairs quality of life. The tissue destruction during periodontitis is mainly caused by the excessive immune-inflammatory response; hence, how to modulate the host's reaction is of profound importance for effective periodontal treatment and tissue protection. Melatonin, as an endogenous hormone exhibiting multiple biological functions such as circadian rhythm regulation, antioxidant, and anti-inflammation, has been widely used in general healthcare. Notably, the past few years have witnessed increasing evidence for the application of melatonin as an adjunctive approach in the treatment of periodontitis and periodontitis-related systemic comorbidities. The detailed underlying mechanisms and more verification from clinical practice are still lacking, however, and further investigations are highly required. Importantly, it is essential to establish standard guidelines in the near future for the clinical administration of melatonin for periodontal health and general wellbeing.
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Affiliation(s)
- Chuan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Leilei Wang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaoxuan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Zhengguo Cao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Correspondence:
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17
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Ablinger I, Dressel K, Rott T, Lauer AA, Tiemann M, Batista JP, Taddey T, Grimm HS, Grimm MOW. Interdisciplinary Approaches to Deal with Alzheimer's Disease-From Bench to Bedside: What Feasible Options Do Already Exist Today? Biomedicines 2022; 10:2922. [PMID: 36428494 PMCID: PMC9687885 DOI: 10.3390/biomedicines10112922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Alzheimer's disease is one of the most common neurodegenerative diseases in the western population. The incidence of this disease increases with age. Rising life expectancy and the resulting increase in the ratio of elderly in the population are likely to exacerbate socioeconomic problems. Alzheimer's disease is a multifactorial disease. In addition to amyloidogenic processing leading to plaques, and tau pathology, but also other molecular causes such as oxidative stress or inflammation play a crucial role. We summarize the molecular mechanisms leading to Alzheimer's disease and which potential interventions are known to interfere with these mechanisms, focusing on nutritional approaches and physical activity but also the beneficial effects of cognition-oriented treatments with a focus on language and communication. Interestingly, recent findings also suggest a causal link between oral conditions, such as periodontitis or edentulism, and Alzheimer's disease, raising the question of whether dental intervention in Alzheimer's patients can be beneficial as well. Unfortunately, all previous single-domain interventions have been shown to have limited benefit to patients. However, the latest studies indicate that combining these efforts into multidomain approaches may have increased preventive or therapeutic potential. Therefore, as another emphasis in this review, we provide an overview of current literature dealing with studies combining the above-mentioned approaches and discuss potential advantages compared to monotherapies. Considering current literature and intervention options, we also propose a multidomain interdisciplinary approach for the treatment of Alzheimer's disease patients that synergistically links the individual approaches. In conclusion, this review highlights the need to combine different approaches in an interdisciplinary manner, to address the future challenges of Alzheimer's disease.
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Affiliation(s)
- Irene Ablinger
- Speech and Language Therapy, Campus Bonn, SRH University of Applied Health Sciences, 53111 Bonn, Germany
| | - Katharina Dressel
- Speech and Language Therapy, Campus Düsseldorf, SRH University of Applied Health Sciences, 40210 Düsseldorf, Germany
| | - Thea Rott
- Interdisciplinary Periodontology and Prevention, Campus Rheinland, SRH University of Applied Health Sciences, 51377 Leverkusen, Germany
| | - Anna Andrea Lauer
- Nutrition Therapy and Counseling, Campus Rheinland, SRH University of Applied Health Sciences, 51377 Leverkusen, Germany
- Experimental Neurology, Saarland University, 66424 Homburg, Germany
| | - Michael Tiemann
- Sport Science, Campus Rheinland, SRH University of Applied Health Sciences, 51377 Leverkusen, Germany
| | - João Pedro Batista
- Sport Science and Physiotherapy, Campus Rheinland, SRH University of Applied Health Sciences, 51377 Leverkusen, Germany
| | - Tim Taddey
- Physiotherapy, Campus Rheinland, SRH University of Applied Health Sciences, 51377 Leverkusen, Germany
| | - Heike Sabine Grimm
- Nutrition Therapy and Counseling, Campus Rheinland, SRH University of Applied Health Sciences, 51377 Leverkusen, Germany
- Experimental Neurology, Saarland University, 66424 Homburg, Germany
| | - Marcus Otto Walter Grimm
- Nutrition Therapy and Counseling, Campus Rheinland, SRH University of Applied Health Sciences, 51377 Leverkusen, Germany
- Experimental Neurology, Saarland University, 66424 Homburg, Germany
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Brodzikowska A, Górski B, Bogusławska-Kapała A. Association between IL-1 Gene Polymorphisms and Stage III Grade B Periodontitis in Polish Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14687. [PMID: 36429405 PMCID: PMC9690736 DOI: 10.3390/ijerph192214687] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Periodontitis is a chronic multifactorial inflammatory disease originating from microbial, environmental and genetic factors. The present study aimed to find an association of genetic polymorphisms at IL-1A-889 and IL-1B+3953 loci in Polish patients with stage III grade B periodontitis and periodontally healthy subjects. Fifty patients with stage III grade B periodontitis (tests) and thirty-five periodontally healthy controls were included in the study. To determine IL-1A and IL-1B gene polymorphisms, buccal swab-derived DNA obtained by means of the GenoType PST test was used. There were no statistically significant differences regarding the prevalence of IL-1A-889 or IL-1B+3953 alleles between groups. The frequencies of different IL-1A-889 genotypes did not differ significantly between groups. The IL-1B+3953 C/T genotype was significantly more predominant in periodontitis patients than in controls, whereas C/C genotype prevalence was significantly lower in the test group. Complex genotypes consisting of at least one IL-1A-889 and IL-1B+3953 T allele occurred significantly more frequently in subjects with periodontitis. Stage III grade B periodontitis may be associated with the IL-1B+3953 T allele and composite IL-1 polymorphism. Reduced susceptibility to periodontal disease was present in IL-1A-889 and IL-1B+3953 C/C homozygotic patients.
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Affiliation(s)
- Aniela Brodzikowska
- Department of Conservative Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Bartłomiej Górski
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland
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Domokos Z, Uhrin E, Szabó B, Czumbel ML, Dembrovszky F, Kerémi B, Varga G, Hegyi P, Hermann P, Németh O. Patients with inflammatory bowel disease have a higher chance of developing periodontitis: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:1020126. [PMID: 36425101 PMCID: PMC9679143 DOI: 10.3389/fmed.2022.1020126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/21/2022] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Periodontitis affects up to one billion people worldwide, and has been proven to be associated with several systemic inflammatory conditions. This study investigates the specific relationship between two multifactorial diseases: Inflammatory bowel disease (IBD) and periodontitis. To thoroughly explore this issue, we investigated separately whether IBD patients have a higher chance of developing periodontitis, and equally, whether patients with periodontitis have a higher chance of developing IBD. METHODS The systematic search was performed in three databases: MEDLINE, Cochrane Trials, and Embase, up to 26 October 2021. The protocol was registered in PROSPERO. All eligible studies investigating the association between IBD and periodontitis from either direction were included. The Newcastle-Ottawa Scale was used to assess the risk of bias. As a primary outcome, we investigated the prevalence of IBD and periodontitis, and calculated the odds ratio (OR). Our secondary outcomes involved comparing the clinical periodontal outcomes of IBD patients to those of IBD-free patients. RESULTS The systematic search resulted in 1,715 records, 14 of which were eligible for qualitative synthesis and 8 for quantitative synthesis. On the basis of the results of the primary outcome, IBD diagnosis was associated with significantly higher odds of periodontitis: OR = 2.65 (CI: 2.09-3.36, I 2 = 0 (CI: 0-0.75)). For subgroup analysis, we investigated separately the odds in Crohn's disease (CD) patients: OR = 2.22 (CI: 1.49-3.31, I 2 = 0.05 (CI: 0-0.76)) and in ulcerative colitis (UC) patients: OR = 3.52 (CI: 2.56 to 4.83, I 2 = 0 (CI: 0-0.75)); the odds were significantly higher in all cases. Two studies investigated whether patients with periodontitis were more susceptible to IBD, and both found that periodontitis was significantly associated with the risk of subsequent UC, but not with subsequent CD. However, more studies are needed to prove an association. CONCLUSION Our analysis confirmed that IBD patients have a higher chance of developing periodontitis, and are a higher risk population in dentistry. Both dentists and gastroenterologists should be aware of this relationship and should emphasize the importance of prevention even more than in the healthy population. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021286161].
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Affiliation(s)
- Zsuzsanna Domokos
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eszter Uhrin
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Márk László Czumbel
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Fanni Dembrovszky
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Beáta Kerémi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Amato M, Santonocito S, Viglianisi G, Tatullo M, Isola G. Impact of Oral Mesenchymal Stem Cells Applications as a Promising Therapeutic Target in the Therapy of Periodontal Disease. Int J Mol Sci 2022; 23:ijms232113419. [PMID: 36362206 PMCID: PMC9658889 DOI: 10.3390/ijms232113419] [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: 09/30/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Periodontal disease is a chronic inflammatory condition affecting about 20–50% of people, worldwide, and manifesting clinically through the detection of gingival inflammation, clinical attachment loss, radiographically assessed resorption of alveolar bone, gingival bleeding upon probing, teeth mobility and their potential loss at advanced stages. It is characterized by a multifactorial etiology, including an imbalance of the oral microbiota, mechanical stress and systemic diseases such as diabetes mellitus. The current standard treatments for periodontitis include eliminating the microbial pathogens and applying biomaterials to treat the bone defects. However, periodontal tissue regeneration via a process consistent with the natural tissue formation process has not yet been achieved. Developmental biology studies state that periodontal tissue is composed of neural crest-derived ectomesenchyme. The aim of this review is to discuss the clinical utility of stem cells in periodontal regeneration by reviewing the relevant literature that assesses the periodontal-regenerative potential of stem cells.
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Affiliation(s)
- Mariacristina Amato
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
- Correspondence: (S.S.); (G.I.); Tel.: +39-0953782638 (S.S. & G.I.)
| | - Gaia Viglianisi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Marco Tatullo
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70122 Bari, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
- Correspondence: (S.S.); (G.I.); Tel.: +39-0953782638 (S.S. & G.I.)
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21
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Lu J, Zhang S, Huang Y, Qian J, Tan B, Qian X, Zhuang J, Zou X, Li Y, Yan F. Periodontitis-related salivary microbiota aggravates Alzheimer's disease via gut-brain axis crosstalk. Gut Microbes 2022; 14:2126272. [PMID: 36175166 PMCID: PMC9542625 DOI: 10.1080/19490976.2022.2126272] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The oral cavity is the initial chamber of digestive tract; the saliva swallowed daily contains an estimated 1.5 × 1012 oral bacteria. Increasing evidence indicates that periodontal pathogens and subsequent inflammatory responses to them contribute to the pathogenesis of Alzheimer's disease (AD). The intestine and central nervous system jointly engage in crosstalk; microbiota-mediated immunity significantly impacts AD via the gut-brain axis. However, the exact mechanism linking periodontitis to AD remains unclear. In this study, we explored the influence of periodontitis-related salivary microbiota on AD based on the gut-brain crosstalk in APPswe/PS1ΔE9 (PAP) transgenic mice. Saliva samples were collected from patients with periodontitis and healthy individuals. The salivary microbiota was gavaged into PAP mice for two months. Continuous gavage of periodontitis-related salivary microbiota in PAP mice impaired cognitive function and increased β-amyloid accumulation and neuroinflammation. Moreover, these AD-related pathologies were consistent with gut microbial dysbiosis, intestinal pro-inflammatory responses, intestinal barrier impairment, and subsequent exacerbation of systemic inflammation, suggesting that the periodontitis-related salivary microbiota may aggravate AD pathogenesis through crosstalk of the gut-brain axis. In this study, we demonstrated that periodontitis might participate in the pathogenesis of AD by swallowing salivary microbiota, verifying the role of periodontitis in AD progression and providing a novel perspective on the etiology and intervention strategies of AD.
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Affiliation(s)
- Jiangyue Lu
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Shuang Zhang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yuezhen Huang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jun Qian
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Baochun Tan
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xueshen Qian
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jia Zhuang
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xihong Zou
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yanfen Li
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China,CONTACT Fuhua Yan
| | - Fuhua Yan
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China,Yanfen Li Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, China
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22
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Gottumukkala SNVS, A. C, Venkata RKS, Penmetsa GS, Koneru S, Pasupuleti S. Estimation of Salivary Neopterin Levels in Aggressive and Chronic Periodontitis After Nonsurgical Periodontal Therapy: A Cohort Study. JOURNAL OF ADVANCED ORAL RESEARCH 2022. [DOI: 10.1177/23202068221116749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: Neopterin is a marker associated with cell-mediated immunity produced by interferon-Ɣ-stimulated macrophages. The levels of neopterin in body fluids are elevated in infections, autoimmune diseases, malignancies, and allograft rejections. Recently, it was shown to be associated with the initiation and progression of periodontal disease. This investigation was designed to explore the use of salivary neopterin in predicting the outcome of nonsurgical periodontal therapy (NSPT) in aggressive and chronic periodontitis patients. Materials and Methods: This case-control study with stratified sampling comprised 45 subjects divided into three groups: a control group of 15 periodontally healthy participants, a test Group A of 15 participants with chronic periodontitis, and a test Group B of 15 participants with aggressive periodontitis. Periodontal parameters, including plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL), were recorded at baseline and three months after scaling and root planing (SRP). An enzyme-linked immunosorbent assay (ELISA) analysis was performed to measure neopterin levels in saliva in study groups before and after SRP. Kruskal–Wallis analysis of variance and Mann–Whitney U tests were done for intra- and intergroup comparisons. The correlation between salivary neopterin levels with clinical parameters was done by Karl Pearson’s correlation coefficient. Results: Baseline salivary neopterin levels were least in the control group (5 62 nmol/L), higher in test Group A (9.30 nmol/L), and highest in test Group B (9.76 nmol/L). Three months after SRP, there was a significant reduction in all the clinical parameters, and the reduction in mean salivary neopterin levels were 2.79 and 2.57 in test Group A and test Group B, respectively; the difference was not statistically significant. Conclusion: Salivary neopterin levels have the potential to be utilized as a diagnostic tool for detecting the presence, activity of the disease, and the course of the lesions. It cannot, however, be utilized to distinguish between chronic and aggressive periodontitis.
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Affiliation(s)
| | - Chaitanya A.
- Department of Periodontics, Vishnu Dental College, Bhimavaram, West Godavari, Andhra Pradesh, India
| | | | - Gautami S. Penmetsa
- Department of Periodontics, Vishnu Dental College, Bhimavaram, West Godavari, Andhra Pradesh, India
| | - Suneetha Koneru
- Department of Periodontics, Sudha Nageswara Rao Dental College, Gannavaram Mandal, Andhra Pradesh, India
| | - Swetha Pasupuleti
- Department of Oral Pathology, Vishnu Dental College, Bhimavaram, West Godavari, Andhra Pradesh, India
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23
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Gene Correlation Network Analysis to Identify Biomarkers of Peri-Implantitis. Medicina (B Aires) 2022; 58:medicina58081124. [PMID: 36013591 PMCID: PMC9416455 DOI: 10.3390/medicina58081124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/01/2022] [Accepted: 08/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives: The histopathological and clinical conditions for transforming peri-implant mucositis into peri-implantitis (PI) are not fully clarified. We aim to uncover molecular mechanisms and new potential biomarkers of PI. Materials and Methods: Raw GSE33774 and GSE57631 datasets were obtained from the Gene Expression Omnibus (GEO) database. The linear models for microarray data (LIMMA) package in R software completes differentially expressed genes (DEGs). We conducted a weighted gene co-expression network analysis (WGCNA) on the top 25% of altered genes and identified the key modules associated with the clinical features of PI. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed using the R software. We constructed a protein–protein interaction (PPI) network through the STRING database. After that we used Cytohubba plug-ins of Cytoscape to screen out the potential hub genes, which were subsequently verified via receiver operating characteristic (ROC) curves in another dataset, GSE178351, and revalidation of genes through the DisGeNET database. Results: We discovered 632 DEGs (570 upregulated genes and 62 downregulated genes). A total of eight modules were screened by WGCNA, among which the turquoise module was most correlated with PI. The Cytohubba plug-ins were used for filtering hub genes, which are highly linked with PI development, from the candidate genes in the protein–protein interaction (PPI) network. Conclusions: We found five key genes from PI using WGCNA. Among them, ICAM1, CXCL1, and JUN are worthy of further study of new target genes, providing the theoretical basis for further exploration of the occurrence and development mechanism of PI.
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Li W, He Y, Zheng Q, Deng X. The causal effect of life‐course adiposity on periodontitis: a mendelian randomization study. J Periodontol 2022; 94:256-262. [PMID: 37163583 DOI: 10.1002/jper.21-0632] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 06/16/2022] [Accepted: 07/06/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND To establish whether life course adiposity, including birth weight (BW), childhood and adulthood body mass index (BMI), waist-hip ratio (WHR), and body fat percentage (BF%), has a causal influence on periodontitis. METHODS We used single-nucleotide polymorphisms with significant associations with life course adiposity as instrumental variables. We examined their association with periodontitis risk in a genome-wide association study involving periodontitis cases (n = 17,353) and healthy controls (n = 28,210) using a two-sample Mendelian randomization (MR) strategy. The association of life course adiposity with periodontitis risk was estimated with inverse-variance weighting with random effects. We performed sensitivity analyses using MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO), weighted median, and MR-Egger methods. We calculated the odds ratios (ORs) for one standard deviation (SD) increase per risk factor to estimate the effect on the risk of periodontitis. RESULTS After correction for multiple testing, there was an association between each SD increase in gene-predicted adulthood BMI with a higher periodontitis risk (OR = 1.15, 95% confidence interval [CI]: 1.06-1.23, p = 3.1 × 10-4), with a similar influence for BF% on periodontitis risk (OR = 1.29, 95% CI: 1.12-1.49, p = 3.3 × 10-4). No causal association was detected for gene-predicted BW, childhood BMI, or WHR with periodontitis risk. CONCLUSION We present new proof supporting a causal function of greater adiposity, especially high BMI and BF%, being associated with higher periodontitis risk. We recommend that future studies focus on periodontitis from a life course perspective.
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Affiliation(s)
- Wenjing Li
- Beijing Laboratory of Biomedical Materials Department of Geriatric Dentistry Peking University School and Hospital of Stomatology Beijing 100081 P. R. China
- CAS Key Laboratory of Genomic and Precision Medicine Beijing Institute of Genomics Chinese Academy of Sciences Beijing 100081 P. R. China
| | - Ying He
- Beijing Laboratory of Biomedical Materials Department of Geriatric Dentistry Peking University School and Hospital of Stomatology Beijing 100081 P. R. China
| | - Qiwen Zheng
- Institute of Medical Technology Peking University School of Stomatology Department of Geriatric Dentistry Beijing China
- Qiwen Zheng China National Center for Bioinformation Beijing 100081 P. R. China
| | - Xuliang Deng
- Beijing Laboratory of Biomedical Materials Department of Geriatric Dentistry Peking University School and Hospital of Stomatology Beijing 100081 P. R. China
- Key Laboratory of Dental Material National Medical Products Administration Beijing 100081 P. R. China
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25
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Evaluation of Common Factors of Periodontitis and Cardiovascular Disease in Patients with the Acute Coronary Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138139. [PMID: 35805797 PMCID: PMC9265665 DOI: 10.3390/ijerph19138139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 02/01/2023]
Abstract
Periodontitis is a multifactorial disease causing inflammatory destruction of supporting structures of the dentition and eventually leading to its loss. This study was designed to evaluate common risk factors for periodontitis and acute coronary syndrome in the study population and demonstrate the systemic impact of periodontitis on the occurrence of acute coronary syndrome. A total of 160 patients (35 female and 125 male) were enrolled in the study. Considering the age range, the largest group of patients (118 patients) was between 55 and 65 years, which accounted for 73.8% of the total study population. There were 35 patients (21.9%) in the age group of 45 to 54 years, while the youngest age group of 35 to 44 years had as many as seven patients. Medical history and physical examination, including periodontal status, were performed. API, PD, CAL, and CPITN were evaluated. Common risk factors for periodontitis and acute coronary syndrome were assessed. The study assessed risk factors such as hypertension, diabetes, dyslipidemia, general health, smoking, height, weight, and hip circumference. In light of the above-described etiopathogenesis of atherosclerotic disease and its association with periodontal disease, it is important to emphasize preventing and treating periodontitis, especially in patients in the so-called high-risk group for cardiovascular disease. Dentists’ introduction of an appropriate prophylactic and therapeutic plan may constitute both primary and secondary prevention of cardiovascular diseases.
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26
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Fu Z, Zhuang Y, Cui J, Sheng R, Tomás H, Rodrigues J, Zhao B, Wang X, Lin K. Development and challenges of cells- and materials-based tooth regeneration. ENGINEERED REGENERATION 2022. [DOI: 10.1016/j.engreg.2022.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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27
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Huang Y, Liu L, Liu Q, Huo F, Hu X, Guo S, Tian W. Dental follicle cells derived small extracellular vesicles inhibit pathogenicity of Porphyromonas gingivalis. Oral Dis 2022. [PMID: 35509129 DOI: 10.1111/odi.14239] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 04/10/2022] [Accepted: 04/29/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE It aims to explore the effect of dental follicle cells derived small extracellular vesicles (D-sEV) with or without lipopolysaccharides (LPS) pretreating on the pathogenicity of Porphyromonas gingivalis (P. gingivalis). METHODS The antibacterial effects of D-sEV were evaluated by measuring the growth, biofilm formation, gingipains and type IX secretion system (T9SS) expression of P. gingivalis. And the influence of D-sEV on P. gingivalis adhesion, invasion, cytotoxicity, and host immune response was examined in gingival epithelial cells (GECs). Then P. gingivalis treated with D-sEV was applied to investigate the pathogenicity in experimental periodontitis of mice. RESULTS It showed that both D-sEV and P. gingivalis LPS pretreated D-sEV (L-D-sEV) could target P. gingivalis, inhibit their growth and biofilm formation, and hinder the attachment and invasion in GECs, therefore remarkably decreasing P. gingivalis cytotoxicity and the expression of IL-1β and IL-6 in GECs. In addition, they significantly reduced the expression of P. gingivalis virulence factors (gingipains and T9SS). In vivo, it showed that the bacteria in the gingiva were significantly decreased after sEV treatment. Meanwhile, less bone loss and fewer inflammatory cells infiltration and osteoclast formation in D-sEV and L-D-sEV groups. CONCLUSION Both D-sEV and L-D-sEV were proven to inhibit the pathogenicity of P.gingivalis and thus prevented the development of periodontitis.
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Affiliation(s)
- Yanli Huang
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Oral Regenerative Medicine, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Engineering Research Center of Oral Translational Medicine, Ministry of Education, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Li Liu
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Oral Regenerative Medicine, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Engineering Research Center of Oral Translational Medicine, Ministry of Education, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Qian Liu
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Oral Regenerative Medicine, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Engineering Research Center of Oral Translational Medicine, Ministry of Education, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Fangjun Huo
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Oral Regenerative Medicine, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Engineering Research Center of Oral Translational Medicine, Ministry of Education, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China
| | - Xingyu Hu
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Oral Regenerative Medicine, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Engineering Research Center of Oral Translational Medicine, Ministry of Education, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Shujuan Guo
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Oral Regenerative Medicine, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Engineering Research Center of Oral Translational Medicine, Ministry of Education, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Weidong Tian
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Oral Regenerative Medicine, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Engineering Research Center of Oral Translational Medicine, Ministry of Education, School of Stomatology, Sichuan University, West China, Chengdu, People's Republic of China.,Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People's Republic of China
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KUNDAK K, YARAT A, DOĞAN B, KURU L. Effect of Non-surgical Periodontal Therapy on Salivary Melatonin Levels. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1053211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: Melatonin, a hormone secreted predominantly by pineal gland in a circadian manner, has antioxidant and anti-inflammatory effects. The current research is conducted to explore the influence of non-surgical periodontal therapy (NSPT) on levels of salivary melatonin in subjects with gingivitis and periodontitis. Methods: Sixty systemically healthy participants were included in this study; the groups are as follows: gingivitis (G), chronic periodontitis (CP), generalized aggressive periodontitis (GAP) and periodontally healthy (H). NSPT was applied to G group patients for 2 sessions, to CP and GAP group patients for 4 sessions. Plaque and gingival indices, probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL) were documented at baseline and 3 months post – treatment and early morning salivary samples were collected. ELISA was used to detect melatonin levels in saliva. Pittsburgh Sleep Quality Index (PSQI) questionnaire was performed to evaluate of sleep quality of patients. Results: At baseline, significant difference in gingival index, PD, BOP and CAL values was detected among all groups (p
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Affiliation(s)
- Kübra KUNDAK
- MARMARA UNIVERSITY, INSTITUTE OF HEALTH SCIENCES
| | - Ayşen YARAT
- MARMARA ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ
| | - Başak DOĞAN
- MARMARA ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ
| | - Leyla KURU
- MARMARA ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ
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29
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Polymorphisms in Genes Involved in Inflammation and Periodontitis: A Narrative Review. Biomolecules 2022; 12:biom12040552. [PMID: 35454140 PMCID: PMC9030004 DOI: 10.3390/biom12040552] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/02/2022] [Accepted: 04/05/2022] [Indexed: 12/14/2022] Open
Abstract
Current evidence pinpoints that the variability in periodontitis traits in humans may be attributable to genetic factors. Different allelic variants can result in alterations in tissue structure, antibody responses and inflammatory mediators. Consequently, genetic variations may act as protective or risk factors for periodontal diseases. A number of features of the inflammatory and immune response that seem to play a role in the development of periodontitis have a clearly established genetic basis. Identifying genes that contribute to the pathogenesis of periodontitis may be utilized for risk assessment in both aggressive and chronic periodontitis. The aim of this narrative review is to summarize the role of polymorphisms in genes involved in inflammation and periodontitis, including cellular receptors, tissue compatibility antigens, antibodies and cytokines.
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30
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Wang J, Liu Y, Wang W, Ma J, Zhang M, Lu X, Liu J, Kou Y. The rationale and potential for using Lactobacillus in the management of periodontitis. JOURNAL OF MICROBIOLOGY (SEOUL, KOREA) 2022; 60:355-363. [PMID: 35344188 DOI: 10.1007/s12275-022-1514-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 01/13/2023]
Abstract
Periodontitis refers to a wide range of the inflammatory conditions of supporting dental structures. For some patients with periodontitis, antibacterial agents are needed as an adjuvant to mechanical debridement treatments and oral hygiene maintenance. However, the widespread use of broad-spectrum antibiotics for the prophylaxis and treatment of periodontal infections results in the emergence of resistant pathogens. Therefore, probiotics have become markedly interesting to researchers as a potentially safe alternative to periodontal treatment and maintenance. Probiotics have been used in medicine for decades and extensively applied to the treatment of inflammatory diseases through the modulation of microbial synergy and other mechanisms. A growing amount of evidence has shown that using Lactobacillus strains for oral cavity maintenance could improve periodontal health. In this study, we reviewed studies showing proof of the inhibitory effects of Lactobacillus species on periodontal inflammation. We also explored the rationale and potential for using Lactobacillus species in the management of periodontitis.
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Affiliation(s)
- Jiaqi Wang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Yingman Liu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Weiru Wang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Jiaojiao Ma
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Manman Zhang
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Xiaoying Lu
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Jie Liu
- Science Experiment Center, China Medical University, Shenyang, 110122, P. R. China
| | - Yurong Kou
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China. .,Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China.
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Yilmaz D, Yilmaz N, Polat R, Nissilä V, Aydın EG, Rautava J, Gürsoy M, Gürsoy UK. Salivary levels of hBDs in children and adolescents with type 1 diabetes mellitus and gingivitis. Clin Oral Investig 2022; 26:4897-4904. [PMID: 35313357 DOI: 10.1007/s00784-022-04457-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Type 1 diabetes mellitus (T1DM), a chronic autoimmune disease characterized by insulin deficiency, is related to periodontal diseases in children and adolescents. Our aim was to profile salivary human beta-defensin (hBD)-2 and hBD-3 concentrations in relation to periodontal and T1DM status in children and adolescent populations. MATERIAL AND METHODS Unstimulated saliva samples were collected from 66 participants including periodontally healthy T1DM patients (T1DM + C; n = 18), T1DM patients with gingivitis (T1DM + G; n = 20), systemically and periodontally healthy individuals (SH + C: n = 15), and systemically healthy gingivitis patients (SH + G; n = 13). Full mouth plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded. Salivary hBD-2 and hBD-3 concentrations were evaluated by sandwich ELISA method. A p value of < 0.05 was considered statistically significant. RESULTS Salivary hBD-3 concentrations were lower in T1DM groups in comparison to systemically healthy counterparts (SH + G vs. T1DM + G; p < 0.001 and SH + C vs. T1DM + C; p < 0.001). Salivary hBD-2 levels did not differ between related groups. The difference in hBD-3 concentrations between T1DM and control groups was still significant (p = 0.008) after being adjusted for PI%, BOP%, and age. CONCLUSION In the limits of study, T1DM patients were found to have decreased salivary hBD-3 concentrations, regardless of their gingival inflammatory status. CLINICAL RELEVANCE Altered salivary hBD-3 concentration can partly explain why diabetic children are more prone to periodontal diseases.
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Affiliation(s)
- Dogukan Yilmaz
- Department of Periodontology, Faculty of Dentistry, Sakarya University, Sakarya, Turkey.
| | - Neslihan Yilmaz
- Department of Pediatric Dentistry, Faculty of Dentistry, Sakarya University, Sakarya, Turkey.,Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Recep Polat
- Department of Pediatric Endocrinology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Verneri Nissilä
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Elif Gül Aydın
- Department of Pediatric Dentistry, Faculty of Dentistry, Sakarya University, Sakarya, Turkey
| | - Jaana Rautava
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, ClinicumHelsinki, Finland.,Department of Pathology, Faculty of Medicine, University of Helsinki, HUS Diagnostic Center, HUSLAB, Helsinki University Hospital, MedicumHelsinki, Finland
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Ulvi Kahraman Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
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Dolińska E, Milewski R, Pietruska MJ, Gumińska K, Prysak N, Tarasewicz T, Janica M, Pietruska M. Periodontitis-Related Knowledge and Its Relationship with Oral Health Behavior among Adult Patients Seeking Professional Periodontal Care. J Clin Med 2022; 11:jcm11061517. [PMID: 35329843 PMCID: PMC8949077 DOI: 10.3390/jcm11061517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Periodontitis is a chronic inflammatory disease that not only damages the stomatognathic system, but may also adversely influence other systems and organs. Patients with low oral health literacy levels are more prone to gingivitis/periodontitis and have a more severe disease course. Methods: A written questionnaire was carried out to assess the knowledge of patients of the Outpatient Clinic of Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, Poland. The questions concerned knowledge regarding the causes of periodontal disease, its risk factors, and the connection between periodontal disease and general health status. To analyze the population, patients were divided according to gender, age and if they were first-time or regular outpatients. Results: Written questionnaires were completed by a total of 302 patients. In the studied population, we noted knowledge deficits, particularly related to weaker periodontal disease risk factors (stress, diabetes, osteoporosis, obesity) and the genetic factor, which is the determinant of periodontitis. The patients’ awareness of the role of plaque bacteria and the effect of smoking on the periodontium was at a relatively high level. The respondents were also aware of the impact of periodontal disease on general health as well as the role of oral hygiene in preventing the disease. At the same time, few of them (26%) used interdental brushes or an irrigator (8%). Conclusions: We demonstrated that patients have an insufficient level of knowledge related to risk factors as well as the prevention of periodontal disease. Awareness of the extent of oral health literacy among patients will help to identify key issues connected with health education interventions
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Affiliation(s)
- Ewa Dolińska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland;
- Correspondence: ; Tel.: +48-85-748-59-05
| | - Robert Milewski
- Department of Statistics and Medical Informatics, Medical University of Bialystok, ul. Szpitalna 37, 15-295 Bialystok, Poland;
| | - Maria Julia Pietruska
- Student’s Research Group, Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (M.J.P.); (K.G.); (N.P.); (T.T.)
| | - Katarzyna Gumińska
- Student’s Research Group, Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (M.J.P.); (K.G.); (N.P.); (T.T.)
| | - Natalia Prysak
- Student’s Research Group, Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (M.J.P.); (K.G.); (N.P.); (T.T.)
| | - Tomasz Tarasewicz
- Student’s Research Group, Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (M.J.P.); (K.G.); (N.P.); (T.T.)
| | - Maciej Janica
- Student’s Research Group, Department of Statistics and Medical Informatics, Medical University of Bialystok, ul. Szpitalna 37, 15-295 Bialystok, Poland;
| | - Małgorzata Pietruska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland;
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Hashimoto H, Hashimoto S, Shimazaki Y. Functional Impairment and Periodontitis in Rheumatoid Arthritis. Int Dent J 2022; 72:641-647. [PMID: 35241287 PMCID: PMC9485534 DOI: 10.1016/j.identj.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 01/24/2023] Open
Abstract
Background This study explored the association of functional impairment due to rheumatoid arthritis (RA) and RA disease activity with periodontal disease in patients with RA. Methods Ninety-three patients with RA were included. Their RA functional status was assessed using the Steinbrocker classification. The serum level of matrix metalloproteinase-3 (MMP-3) was used as an indicator of RA disease activity. Probing depth (PD) and clinical attachment level (CAL) were used as indicators of periodontal status. We examined the association of RA severity and MMP-3 levels with periodontal status using a generalised linear model (GLM). Results In a multivariate GLM, the coefficient for the mean PD was significantly positive in those with RA severity classes III or IV (reference: class I; β = 0.14; 95% confidence interval [CI], 0.03–0.25; P = .02) independent of other confounding variables. In multivariate GLM using the mean CAL as the dependent variable, the coefficient was significant in patients with high MMP-3 levels (10 ng/mL; β = 0.005; 95% CI, 0.001–0.008; P = .02). Conclusions Functional impairment due to RA may affect PD, and high serum levels of MMP-3 may affect CAL.
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Affiliation(s)
- Hiroko Hashimoto
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | | | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
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Olszewska-Czyz I, Kralik K, Tota M, Prpic J. The Influence of Hyaluronic Acid Adjunctive Therapy of Periodontitis on Salivary Markers of Oxidative Stress: Randomized, Controlled Clinical Trial. Antioxidants (Basel) 2022; 11:antiox11010135. [PMID: 35052639 PMCID: PMC8773125 DOI: 10.3390/antiox11010135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 02/04/2023] Open
Abstract
Periodontitis is a common oral disease affecting the tooth-supporting tissues. Bacteria have been long viewed as the main causative factor in its development; however, many investigations have proved that aberrant immune and inflammatory response and the resulting misbalance between the damage caused by reactive oxygen species and the antioxidant capacity of tissues may be an underlying factor in disease progression that reduces healing potential. The objective of the current trial is to assess the outcomes of the addition of hyaluronic acid (HA) to standard non-surgical periodontal therapy (NST) on some major oxidative stress markers in saliva. HA-based gel designed for dental application was used and the measurements were taken after 3 months. HA adjunctive therapy had a significantly greater increase in markers with antioxidant properties as well as total antioxidant capacity compared to standard NST alone. Furthermore, clinically measured levels of gingival inflammation (bleeding on probing-BOP) and periodontal destruction (clinical attachment loss-CAL) were significantly correlated with these markers, and the correlation was negative. This investigation demonstrates that HA may indeed express antioxidant properties and improve the antioxidant capacity of periodontal tissues, thus improving the prognosis for the teeth and the results of periodontal therapy. Further investigations will be necessary to determine the duration of these effects over time.
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Affiliation(s)
- Iwona Olszewska-Czyz
- Department of Periodontology, Prophylaxis and Oral Pathology, Dental Institute, Medical Faculty, Jagiellonian University, 31155 Krakow, Poland
- Correspondence:
| | - Kristina Kralik
- Department of Medical Statistics and Medical Informatics, Medical Faculty Osijek, University Josip Juraj Strossmayer of Osijek, 31000 Osijek, Croatia;
| | - Marin Tota
- Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Medical Faculty, University of Rijeka, 51000 Rijeka, Croatia;
| | - Jelena Prpic
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia;
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Ou Y, Yan M, Gao G, Wang W, Lu Q, Chen J. Cinnamaldehyde protect against ligature-induced periodontitis through inhibitions of microbial accumulation and inflammatory responses of host immune cells. Food Funct 2022; 13:8091-8106. [PMID: 35792680 DOI: 10.1039/d2fo00963c] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cinnamaldehyde (CA), the main active ingredient of cinnamon, is proved to be a potential candidate of controlling inflammation, but few evidences are demonstrated on its role in periodontitis. The aim...
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Affiliation(s)
- Yanjing Ou
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, 350002, PR China.
| | - Mingdong Yan
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, 350002, PR China
| | - Guanglin Gao
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, 350002, PR China
| | - Wenjie Wang
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, 350002, PR China
| | - Qiaoqiao Lu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, 350002, PR China.
| | - Jiang Chen
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, 350002, PR China.
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Singhi A, Sharma A, Nath J, Sharma S, Marri R, Ekka R. A comparative clinical study to assess the role of antibiotics in periodontal flap surgery. J Pharm Bioallied Sci 2022; 14:S841-S844. [PMID: 36110722 PMCID: PMC9469438 DOI: 10.4103/jpbs.jpbs_16_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 11/04/2022] Open
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Zhang X, Wang P, Ma L, Guo R, Zhang Y, Wang P, Zhao J, Liu J. Differences in the oral and intestinal microbiotas in pregnant women varying in periodontitis and gestational diabetes mellitus conditions. J Oral Microbiol 2021; 13:1883382. [PMID: 34925709 PMCID: PMC8676621 DOI: 10.1080/20002297.2021.1883382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background: The present study aimed to investigate the potential association between oral and intestinal microbiotas of pregnant women with periodontitis and/or gestational diabetes mellitus (GDM) in the second trimester.Methods: Four groups were defined: periodontitis (n = 28), GDM (n = 7), periodontitis + GDM (n = 7), and periodontitis- and GDM-free controls (n = 27). The oral and intestinal microbiomes were analyzed using the 16S rRNA sequencing technique.Results: Periodontitis alone significantly decreased the oral microbial diversity (by Shannon index, p = 0.003) and changed the structure of the oral microbial community (by AMOVA, p 0.001). GDM alone significantly increased the oral microbial diversity (by Shannon index, p = 0.049), and when combined with periodontitis, GDM significantly decreased the intestinal microbial richness (by observed species, p = 0.018) and influenced the structure of intestinal microbial community (by AMOVA, p = 0.043). The differentially abundant microbial taxa among different groups in both oral and intestinal samples were identified by LEfSe analysis, and limited taxa showed consistent trends. The numbers and ratios of oral-intestinal shared operational taxonomical units were the least in the periodontitis + GDM group.Conclusions: A close relationship between the oral microbiota and pregnant periodontitis was shown. Significant changes occur in both the oral and intestinal microbiomes when periodontitis was coupled with GDM. A separate influence of periodontitis and GDM on the oral and intestinal microbiotas may be indicated.
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Affiliation(s)
- Xin Zhang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Pei Wang
- Department of gynaecology and obstetrics, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing China
| | - Liangkun Ma
- Department of gynaecology and obstetrics, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Rongjun Guo
- Novogene Bioinformatics Technology Co., Ltd., Tianjin, China
| | - Yongjing Zhang
- Novogene Bioinformatics Technology Co., Ltd., Tianjin, China
| | - Peng Wang
- Novogene Bioinformatics Technology Co., Ltd., Tianjin, China
| | - Jizhi Zhao
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Juntao Liu
- Department of gynaecology and obstetrics, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Abstract
Periodontitis is a common disorder affecting >40% of adults in the United States. Globally, the severe form of the disease has a prevalence of 11%. In advanced cases, periodontitis leads to tooth loss and reduced quality of life. The aetiology of periodontitis is multifactorial. Subgingival dental biofilm elicits a host inflammatory and immune response, ultimately leading to irreversible destruction of the periodontium (i.e. alveolar bone and periodontal ligament) in a susceptible host. In order to successfully manage periodontitis, dental professionals must understand the pathogenesis, primary aetiology, risk factors, contributing factors and treatment protocols. Careful diagnosis, elimination of the causes and reduction of modifiable risk factors are paramount for successful prevention and treatment of periodontitis. Initial non-surgical periodontal therapy primarily consists of home care review and scaling and root planing. For residual sites with active periodontitis at periodontal re-evaluation, a contemporary regenerative or traditional resective surgical therapy can be utilised. Thereafter, periodontal maintenance therapy at a regular interval and long-term follow-ups are also crucial to the success of the treatment and long-term retention of teeth. The aim of this review is to provide current concepts of diagnosis, prevention and treatment of periodontitis. Both clinical and biological rationales will be discussed.
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Affiliation(s)
| | - Ira B Lamster
- Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Faramarzi M, Shirmohammadi A, Khorramdel A, Sadighi M, Bargahi E. Effect of non-surgical periodontal therapy on serum ferritin levels in postmenopausal women with chronic periodontitis. J Dent Res Dent Clin Dent Prospects 2021; 15:178-182. [PMID: 34712408 PMCID: PMC8538142 DOI: 10.34172/joddd.2021.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background. Ferritin is a positive acute phase protein (APP) in inflammation and chronic infections, including chronic periodontitis. Two key factors that can regulate ferritin expression are iron and pro-inflammatory cytokines. Serum ferritin levels increase after menopause, affecting women’s health. This study aimed to evaluate serum ferritin levels in postmenopausal women upon undertaking non-surgical periodontal treatment.
Methods. In this cross-sectional study, blood samples of 38 postmenopausal women with chronic periodontitis were collected before any treatment. The serum ferritin levels and periodontal parameters, probing depth (PD), clinical attachment level (CAL), and gingival index (GI) were recorded at baseline and three months after non-surgical periodontal therapy. Wilcoxon test was used to compare serum ferritin levels before and after treatment. T-test was used for comparison of periodontal parameters, with a P value of ≤0.05 considered significant.
Results. A decrease was observed in the serum ferritin level (from 108.55 mcg/L to 98.28 mcg/L) after treatment compared to baseline (P < 0.001). Also, significant improvements in periodontal parameters were observed compared to the baseline (P < 0.001).
Conclusion. Based on the results, it can be concluded that non-surgical periodontal treatment significantly reduces serum ferritin levels in postmenopausal women with chronic periodontitis.
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Affiliation(s)
- Masoumeh Faramarzi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Adileh Shirmohammadi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Azin Khorramdel
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Mehrnoosh Sadighi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
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Kedlaya MN, Ramesh A, Hosmane GB, Bhandary R, Sajna HR, Thomas B. Comparative evaluation of serum cotinine levels in chronic periodontitis and chronic obstructive pulmonary disease. J Indian Soc Periodontol 2021; 25:405-410. [PMID: 34667383 PMCID: PMC8452176 DOI: 10.4103/jisp.jisp_546_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 03/14/2021] [Accepted: 05/08/2021] [Indexed: 11/16/2022] Open
Abstract
Context: Periodontitis and chronic obstructive pulmonary disease (COPD) are chronic progressive inflammatory conditions. Smoking has been associated with both chronic periodontitis and COPD. Hence, the present study was designed to correlate serum levels of cotinine with the severity of periodontal disease with or without COPD. Settings and Design: A total of eighty patients, twenty healthy individuals, twenty patients with chronic generalized periodontitis without smoking and without COPD, twenty patients who are smokers with chronic periodontitis without COPD and twenty patients who are smokers with chronic periodontitis and COPD in the age range of 43–65 years were selected for the study. Subjects and Methods: Serum cotinine level assessment, smoking history, and periodontal examination were done in all the patients and the data obtained were statistically analyzed. Results: The mean serum cotinine level was highest in smokers with chronic periodontitis and COPD (93.642 ± 14.727) and it differed significantly between the four groups (P < 0.001). There is a significant positive correlation between the number of cigarettes and serum cotinine levels in both groups involving smoking. There was no significant correlation between serum cotinine level and clinical attachment loss in chronic periodontitis smokers with or without COPD. Conclusions: The result of this study indicates that increased smoking with COPD causes a higher chance of progression of periodontal destruction but it is not statistically significant. Furthermore, this study indicates that the assessment of serum cotinine levels is a reliable method to evaluate smoking exposure.
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Affiliation(s)
- Madhurya Nagaraj Kedlaya
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Amitha Ramesh
- Department of Periodontics, A B Shetty Memorial Institute of Dental Sciences, Nitte deemed to be University, Mangalore, Karnataka, India
| | - Giridhar Belur Hosmane
- Department of Pulmonary Medicine, K S Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Rahul Bhandary
- Department of Periodontics, A B Shetty Memorial Institute of Dental Sciences, Nitte deemed to be University, Mangalore, Karnataka, India
| | | | - Biju Thomas
- Department of Periodontics, A B Shetty Memorial Institute of Dental Sciences, Nitte deemed to be University, Mangalore, Karnataka, India
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Sattari M, Taheri RA, ArefNezhad R, Motedayyen H. The expression levels of MicroRNA-146a, RANKL and OPG after non-surgical periodontal treatment. BMC Oral Health 2021; 21:523. [PMID: 34645448 PMCID: PMC8515652 DOI: 10.1186/s12903-021-01883-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/05/2021] [Indexed: 11/20/2022] Open
Abstract
Objective MicroRNA-146a (miR-146a) is a regulator of inflammatory response. Periodontitis is a disease with immune pathophysiology of the periodontium in which the inflammation results in the destruction of the soft tissues and alveolar bone. Therefore, the aim of this study was to investigate the expressions of miR-146a, OPG, and RANKL in diseased and healthy periodontal tissues to understand whether miR-146a expression level may associate with OPG and RANKL mRNA levels and OPG/RANKL ratio after non-surgical periodontal treatment. Methods The levels of miR-146a, RANKL, and OPG in gingival tissues from patients with generalized periodontitis stages II and III and grades A and B (n = 15, group A), patients with generalized periodontitis stages III and IV and grade C (n = 15, group B), and healthy individuals (n = 10) were determined by real-time PCR. The associations of miR-146a expression with OPG and RANKL levels were evaluated. Results The levels of miR-146a in two subgroups within periodontitis patients were significantly higher than healthy subjects (P < 0.0001). MiR-146a showed the increased level in group A of patients compared with group B (P < 0.05). Clinical parameters such as probing depth (PD) and clinical attachment loss (CAL) were significantly higher in patients than control group (P < 0.05). The levels of OPG and RANKL were increased in patients compared with healthy subjects, although the elevated levels were not statistically significant. MiR-146a was not associated with OPG and RANKL levels and OPG/RANKL ratio. Conclusions The results of this study failed to show the associations of miR-146a level with OPG and RANKL levels and OPG/RANKL ratio in periodontitis after non-surgical periodontal treatment.
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Affiliation(s)
- Mandana Sattari
- Department of Immunology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ramezan Ali Taheri
- Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Reza ArefNezhad
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Motedayyen
- Autoimmune Diseases Research Center, Shahid Beheshti Hospital, Kashan University of Medical Sciences, 5th Kilometer of Ravand Road, Kashan, Iran.
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Prevalence of Dental Caries and Periodontal Disease of High School Students Aged 15 to 18 Years in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199967. [PMID: 34639272 PMCID: PMC8508362 DOI: 10.3390/ijerph18199967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to assess the prevalence and distribution of dental caries and periodontal disease in Taiwanese high school students aged 15–18. A total of 1069 Taiwanese students participated in a cross-sectional nationwide dental survey. By using a stratified method based on the National Health Insurance administration regions, 24 high schools were randomly sampled in different areas of Taiwan. The participants were examined with dental mirrors and community periodontal index (CPI) probes without using radiographs, to measure dental caries and periodontal status. Demographic information and other relevant risk indicators for the two diseases were gathered via a self-report questionnaire. In this study population, the weighted mean decayed, missing and filled teeth (DMFT) scores for ages 15 to 18 were 5.2, 6.1, 6.1, and 5.7. The weighted mean decayed, missing and filled surfaces (DMFS) scores were 9.0, 12.0, 13.1, and 11.2 at ages 15, 16, 17, and 18, respectively. Additionally, 88.2% of the subjects had periodontal disease, with calculus as the most prevalent type. Moreover, 5.2% of these students showed loss of attachment. There was no significant association between dental caries and periodontal disease. Dental caries and periodontal disease were prevalent among Taiwanese high school students in this national dental survey.
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Omer-Cihangir R, Baser U, Kucukgergin C, Aykol-Sahin G, Huck O, Yalcin F. Impact of Smoking on Neutrophil Enzyme Levels in Gingivitis: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158075. [PMID: 34360367 PMCID: PMC8345369 DOI: 10.3390/ijerph18158075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 01/22/2023]
Abstract
Background: The determination of the impact of risk factors such as smoking in periodontal disease development is of importance to better characterize the disease. However, its impact on host response remains unclear. This study aimed to evaluate the effects of tobacco smoking on GCF levels of neutrophil enzymes (myeloperoxidase (MPO), beta-glucuronidase (BGD), neutrophil elastase (NE) and periodontal parameters in healthy young adults with dental plaque biofilm-induced gingivitis. Methods: The study population consisted of 60 systemically healthy young adults (39 smokers (Sm) and 21 non-smokers (n-Sm)) diagnosed with plaque-induced gingivitis. The periodontal examination consisted of a plaque index (PI); gingival index (GI); probing depth (PD); bleeding on probing (BoP), and clinical attachment level (CAL). GCF MPO, BGD, and NE levels were determined by means of an enzyme-linked immunosorbent assay (ELISA). Results: PI, GI, and BoP were significantly increased in the Sm group (p < 0.05). PD and CAL showed no significant difference between Sm and n-Sm groups (p > 0.05). In GCF, MPO, BGD, and NE levels were significantly increased in Sm group (p < 0.05). NE levels showed a significant correlation with GI and BoP (p < 0.05 for both). Moreover, a positive correlation between BGD and NE levels (p < 0.05) was measured. Conclusions: It may be concluded that, even in young patients, tobacco consumption affects the host’s immune response related to gingival inflammation. It is, therefore, mandatory to inform young patients about the risk related to tobacco consumption for their gingival health.
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Affiliation(s)
- Rumeysa Omer-Cihangir
- Periodontology Department, Faculty of Dentistry, University of Istanbul, Istanbul 34093, Turkey;
- Correspondence: (R.O.-C.); (U.B.); Tel.: +90-505-369-8644 (U.B.)
| | - Ulku Baser
- Periodontology Department, Faculty of Dentistry, University of Istanbul, Istanbul 34093, Turkey;
- Correspondence: (R.O.-C.); (U.B.); Tel.: +90-505-369-8644 (U.B.)
| | - Canan Kucukgergin
- Department of Medical Biochemistry, Istanbul Faculty of Medicine, University of Istanbul, Istanbul 34093, Turkey;
| | - Gokce Aykol-Sahin
- Periodontology Department, Faculty of Dentistry, Istanbul Okan University, Istanbul 34959, Turkey;
| | - Olivier Huck
- Department of Periodontology, Dental Faculty, University of Strasbourg, 67081 Strasbourg, France;
- INSERM, UMR 1260 Osteoarticular and Dental Regenerative Nanomedicine, 67000 Strasbourg, France
- Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France
| | - Funda Yalcin
- Periodontology Department, Faculty of Dentistry, University of Istanbul, Istanbul 34093, Turkey;
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[Periodontitis-therapy of a widespread disease]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:931-940. [PMID: 34236451 PMCID: PMC8264996 DOI: 10.1007/s00103-021-03373-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/08/2021] [Indexed: 01/19/2023]
Abstract
Parodontitis ist eine chronisch entzündliche nichtübertragbare Erkrankung, die alle Anteile des Zahnhalteapparates (Parodonts) betrifft und dort weitgehend irreversible Schäden verursacht. Schätzungen legen nahe, dass in Deutschland ca. 10 Mio. Menschen an einer schweren Parodontitis erkrankt sind. Parodontitis zeigt über viele Jahre zumeist wenige oder nur milde Symptome, die von den Patienten oft nicht wahrgenommen oder richtig eingeordnet werden. Fehlendes Bewusstsein kann dazu führen, dass zahnärztliche Behandlung erst in einem fortgeschrittenen Erkrankungsverlauf in Anspruch genommen wird, wenn umfangreiche Therapiemaßnahmen notwendig geworden sind und sich die Prognose für den Erhalt der Zähne verschlechtert hat. Der parodontale Screeningindex (PSI) ist ein einfaches und schnelles Instrument, mit dem die Notwendigkeit weiterführender diagnostischer Maßnahmen beurteilt werden kann. Der Index wird mittlerweile bei vielen Patienten durchgeführt. Trotzdem bleiben die Versorgungszahlen niedrig und hinter dem zurück, was für das Absenken der bestehenden Parodontitislast notwendig wäre. Jede Zahnarztpraxis muss in der Lage sein, Parodontitistherapie umzusetzen. Fachzahnärzte oder Spezialisten können die allgemeinzahnärztlichen Kollegen wesentlich bei der Behandlung von schweren Formen von Parodontitis unterstützen. Dazu ist eine Aufwertung des Faches in der universitären Ausbildung erforderlich, aber auch die zunehmende postgraduale Ausdifferenzierung von Spezialisten oder Fachzahnärzten für Parodontologie. Die neuen Behandlungsrichtlinien für die Parodontaltherapie (PAR-Therapie) erlauben die Versorgung der parodontal erkrankten Patienten auf Basis international anerkannter wissenschaftlicher Standards und verbessern damit die Rahmenbedingungen für die Parodontitistherapie in der zahnärztlichen Praxis.
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Vacaras S, Baciut G, Gheban D, Bran S, Colosi H, Toader S, Opris D, Kretschmer W, Manea A, Armencea G, Baciut M, Opris H, Mitre I, Hedesiu M, Dinu C. Engaging a polylactide copolymer in oral tissue regeneration: first validation of Suprathel ® for guided epithelial and osseous healing. J Med Life 2021; 14:181-197. [PMID: 34104241 PMCID: PMC8169152 DOI: 10.25122/jml-2021-0083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The present study investigated the capacity of Suprathel® (a copolymer membrane, so far validated for skin regeneration) to also regenerate oral tissue – mucosa and bone, by comparing this biomaterial, in a split-mouth rabbit model, to Mucoderm®, a xenogeneic collagen matrix certified for keratinized oral mucosa healing. The clinical reason behind this experimental animal model was to determine whether the benefits of this advanced skin regeneration product (Suprathel®) could be conveyed for future evaluation in clinical trials of oral tissue regeneration in humans. The outcomes of this study validated the use of Suprathel®, a terpolymer of polylactide with trimethylene carbonate and ε-caprolactone, for stimulation of oral epithelium and alveolar bone regeneration in rabbits. Both Suprathel® and Mucoderm® exhibited comparable results and the null hypothesis stating a comparable regenerating effect of these two materials could not be rejected.
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Affiliation(s)
- Sergiu Vacaras
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dan Gheban
- Department of Morphological Sciences, Division of Pathoanatomy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Colosi
- Department of Medical Education, Division of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Septimiu Toader
- Center for Experimental Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daiana Opris
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Winfried Kretschmer
- Klinik fur Mund-, Kiefer- und Plastische Gesichtschirurgie, Alb Fils Kliniken GmbH, Goppingen, Baden-Wurttemberg, Germany
| | - Avram Manea
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horia Opris
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ileana Mitre
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Radiology, Division of Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Espíndola LCP, Picão RC, Mançano SMCN, Martins do Souto R, Colombo APV. Prevalence and antimicrobial susceptibility of Gram-negative bacilli in subgingival biofilm associated with periodontal diseases. J Periodontol 2021; 93:69-79. [PMID: 33955542 DOI: 10.1002/jper.20-0829] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/08/2021] [Accepted: 04/26/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND This cross-sectional study aimed to determine the prevalence and antimicrobial susceptibility of Gram-negative bacilli (GNB) isolated from subgingival biofilm of individuals with different periodontal conditions. METHODS Subgingival biofilm was obtained from 362 individuals with periodontal health (PH) (n = 83), gingivitis (n = 74), and periodontitis (n = 205), cultivated in broth and selective media. Isolated strains were identified by mass spectrometry. Antimicrobial susceptibility was determined by the Clinical and Laboratory Standards Institute disk diffusion guidelines. Production of extended-spectrum beta-lactamase (ESBL) and carbapenemases were evaluated by double disk synergy test and spectrophotometric detection of imipenem hydrolysis, respectively. ESBL and carbapenemase encoding genes were surveyed by Polymerase chain reaction (PCR). Differences among groups were examined by Chi-square, Kruskal-Wallis or Mann-Whitney tests. RESULTS GNB were isolated from 36.2% of all subgingival biofilm samples, with a significantly greater prevalence and species diversity (P < 0.001) in patients with periodontitis (45.9%) compared with individuals with PH (24.1%) and gingivitis (22.9%). Pseudomonas aeruginosa (27.5%), Enterobacter cloacae (16.8%), and Enterobacter asburiae (10.7%) were the most predominant species. Resistance/reduced sensitivity to at least 1 antimicrobial was detected in 60% of the strains, but only 4.6% were multidrug resistant. Serratia marcescens, E. cloacae, and Enterobacter kobei presented high rates of intrinsic resistance (>40%) to amoxicillin-clavulanate and first/second-generations of cephalosporins. One strain of Klebsiella pneumoniae isolated from periodontitis was resistant to imipenem, but no ESBL encoding genes or ESBL phenotype was detected. CONCLUSION High prevalence and diversity of GNB, with low susceptibility to β-lactams are observed in the subgingival microbiota associated with periodontitis.
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Affiliation(s)
- Laís Christina Pontes Espíndola
- School of Dentistry, Department of Clinics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Institute of Microbiology, Department of Medical Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renata Cristina Picão
- Institute of Microbiology, Department of Medical Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Renata Martins do Souto
- Institute of Microbiology, Department of Medical Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Paula Vieira Colombo
- School of Dentistry, Department of Clinics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Institute of Microbiology, Department of Medical Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Palheiros BR, Cunha FA, Abreu LG, Esteves Lima RP. Pain assessment and analgesic consumption after nonsurgical periodontal therapy. J Indian Soc Periodontol 2021; 25:237-241. [PMID: 34158691 PMCID: PMC8177178 DOI: 10.4103/jisp.jisp_309_20] [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: 04/29/2020] [Revised: 08/18/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022] Open
Abstract
Background: The aim of this cross-sectional study was to assess the analgesic consumption and the frequency and intensity of pain after nonsurgical periodontal therapy, as well as to associate these factors with the extent and severity of periodontitis and with the degree of anxiety before the procedure. Materials and Methods: Fifty-one patients with chronic periodontitis were recruited. The degree of previous anxiety was assessed with the dental anxiety scale questionnaire. Periodontal data were obtained by means of clinical examination and circumferential probing performed by undergraduate students, supervised by a clinical lecturer. The teeth submitted to treatment in the session were registered. Analgesic consumption was recorded 7 days after periodontal intervention. To measure pain, a visual analog scale was used. The patient was instructed to record the pain intensity at 2, 4, 8, 24, and 48 h after subgingival scaling. Differences in pain intensity between periods after nonsurgical periodontal therapy were performed using Anova test. P < 0.05 was statistically significant. Results: There was no relevant difference between groups in all variables used in the study (P > 0.05). The use of analgesics was significantly more frequent among individuals who had reported higher levels of pain. The degree of anxiety before treatment was similar among groups (P > 0.05). Most individuals reported no pain or mild pain (P < 0.05). Conclusion: Nonsurgical periodontal therapy is associated with low pain or absent pain.
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Affiliation(s)
- Beatriz Ribeiro Palheiros
- Department of Clinical, Pathology and Dental Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fabiano Araújo Cunha
- Department of Clinical, Pathology and Dental Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rafael Paschoal Esteves Lima
- Department of Clinical, Pathology and Dental Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Yang D, Jiang C, Ning B, Kong W, Shi Y. The PorX/PorY system is a virulence factor of Porphyromonas gingivalis and mediates the activation of the type IX secretion system. J Biol Chem 2021; 296:100574. [PMID: 33757767 PMCID: PMC8050853 DOI: 10.1016/j.jbc.2021.100574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/13/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022] Open
Abstract
PorX/PorY is a two-component system (TCS) of Porphyromonas gingivalis that governs transcription of numerous genes including those encoding a type IX secretion system (T9SS) for gingipain secretion and heme accumulation. Here, an in vitro analysis showed that the response regulator PorX specifically bound to two regions in the promoter of porT, a known PorX-regulated T9SS gene, thus demonstrating that PorX/PorY can directly regulate specific target genes. A truncated PorX protein containing the N-terminal receiver and effector domains retained a wild-type ability in both transcription regulation and heme accumulation, ruling out the role of the C-terminal ALP domain in gene regulation. The PorX/PorY system was the only TCS essential for heme accumulation and concomitantly responded to hemin to stimulate transcription of several known PorX-dependent genes in a concentration-dependent manner. We found that PorX/PorY activated the sigH gene, which encodes a sigma factor known for P. gingivalis adaptation to hydrogen peroxide (H2O2). Consistently, both ΔporX and ΔsigH mutants were susceptible to H2O2, suggesting a PorX/PorY-σH regulatory cascade to confer resistance to oxidative stress. Furthermore, the ΔporX mutant became susceptible to high hemin levels that could induce oxidative stress. Therefore, a possible reason why hemin activates PorX/PorY is to confer resistance to hemin-induced oxidative stress. We also demonstrated that PorX/PorY was essential for P. gingivalis virulence because the ΔporX mutant was avirulent in a mouse model. Specifically, this TCS was required for the repression of proinflammatory cytokines secreted by dendritic cells and T cells in the P. gingivalis–infected mice.
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Affiliation(s)
- Dezhi Yang
- The School of Life Sciences, Arizona State University, Tempe, Arizona, USA; Biodesign Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, Arizona, USA
| | - Chizhou Jiang
- The School of Life Sciences, Arizona State University, Tempe, Arizona, USA; Biodesign Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, Arizona, USA
| | - Bo Ning
- The Center for Cellular and Molecular Diagnostics, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Wei Kong
- Biodesign Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, Arizona, USA.
| | - Yixin Shi
- The School of Life Sciences, Arizona State University, Tempe, Arizona, USA; Biodesign Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, Arizona, USA.
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Hashimoto H, Hashimoto S, Shimazaki Y. Association Between the Extent of Periodontal Inflammation and the Severity of Rheumatoid Arthritis in Japanese Patients With Rheumatoid Arthritis. Int Dent J 2021; 71:429-437. [PMID: 33741141 PMCID: PMC9275163 DOI: 10.1016/j.identj.2020.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective Periodontal inflammation can affect the progression of rheumatoid arthritis (RA), and RA drugs may influence the periodontal condition of patients with RA. We examined whether the association between periodontal inflammation and the severity of RA is influenced by RA medication. Methods This cross-sectional study recruited 98 Japanese patients with RA from an orthopaedic clinic. We assessed the severity of RA using the Steinbrocker class and stage. The periodontal inflamed surface area (PISA) was used as an indicator of periodontal status. We obtained data on RA medications from medical records. We examined the associations among periodontal tissue inflammation, RA medications, and RA severity using multinomial logistic regression analyses. Results In univariate multinomial logistic regression analyses, no significant association between PISA score and RA severity was observed. There was no significant association between PISA score and RA severity in multivariate analyses not including variables about RA drugs as independent variables. However, in multivariate analyses adjusted for RA drugs and other confounding variables, patients with a PISA >550 mm2 had significantly higher odds ratios (ORs) for Steinbrocker class III-IV and stage III-IV (OR, 20.24; 95% confidence interval [CI], 1.78-229.85 and OR, 12.42; 95% CI, 1.79-86.49, respectively) compared to patients with PISA score ≤550 mm2. Conclusion The extent of periodontal inflammation is associated with the severity of RA independent of RA medications.
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Affiliation(s)
- Hiroko Hashimoto
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | | | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
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Yamamoto M, Aizawa R. Maintaining a protective state for human periodontal tissue. Periodontol 2000 2021; 86:142-156. [PMID: 33690927 DOI: 10.1111/prd.12367] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Periodontitis, caused by infection with periodontal pathogens, is primarily characterized by inflammatory bone resorption and destruction of connective tissue. Simply describing periodontitis as a specific bacterial infection cannot completely explain the various periodontal tissue destruction patterns observed. Periodontal tissue damage is thought to be caused by various factors. In recent years, research goals for periodontal pathogens have shifted from searching for specific pathogens to investigating mechanisms that damage periodontal tissues. Bacteria interact directly with the host in several ways, influencing expression and activity of molecules that evade host defenses, and destroying local tissues and inhibiting their repair. The host's innate and acquired immune systems are important defense mechanisms that protect periodontal tissues from attack and invasion of periodontal pathogens, thus preventing infection. Innate and acquired immunity have evolved to confront the microbial challenge, forming a seamless defense network in periodontal tissues. In the innate immune response, host cells quickly detect, via specialized receptors, macromolecules and nucleic acids present on bacterial cell walls, and this triggers a protective, inflammatory response. The work of this subsystem of host immunity is performed mainly by phagocytes, beta-defensin, and the complement system. In addition, the first line of defense in oral innate immunity is the junctional epithelium, which acts as a physical barrier to the entry of oral bacteria and other nonself substances. In the presence of a normal flora, junctional epithelial cells differentiate actively and proliferate apically, with concomitant increase in chemotactic factor expression recruiting neutrophils. These immune cells play an important role in maintaining homeostasis and the protective state in periodontal tissue because they eliminate unwanted bacteria over time. Previous studies indicate a mechanism for attracting immune cells to periodontal tissue with the purpose of maintaining a protective state; although this mechanism can function without bacteria, it is enhanced by the normal flora. A better understanding of the relationship between the protective state and its disruption in periodontal disease could lead to the development of new treatment strategies for periodontal disease.
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Affiliation(s)
- Matsuo Yamamoto
- Department of Periodontology, School of Dentistry, Showa University, Tokyo, Japan
| | - Ryo Aizawa
- Department of Periodontology, School of Dentistry, Showa University, Tokyo, Japan
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