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Cheng RHW, Wang M, Tong WM, Gao W, Watt RM, Leung WK. Subgingival microbial changes in Down Syndrome adults with periodontitis after chlorhexidine adjunct non-surgical therapy and monthly recalls-A 12-month case series study. J Dent 2024; 143:104907. [PMID: 38428718 DOI: 10.1016/j.jdent.2024.104907] [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: 01/07/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES Down Syndrome (DS) adults are at risk for periodontitis. Previous reports indicated difficulties in periodontopathogen reduction or eradication in DS individuals after periodontal treatment. This case series follows the subgingival microbial changes in adult DS individuals with periodontitis who received chlorhexidine adjunct non-surgical therapy plus 12-month recalls. METHODS Twenty periodontitis DS participants (7 females; 25.5 ± 5.6 years of age; 3 with generalized periodontitis) partook in a study involving non-surgical mechanical periodontal therapy, twice daily chlorhexidine gel toothbrushing, chlorhexidine mouthwash, and monthly recalls. The subgingival microbiota profile was followed at baseline, 6-, and 12-months post-operation. RESULTS Desulfobulbus, Saccharibacteria (TM7), Tannerella, and Porphyromonas were the major subgingival genera in this DS cohort. Favorable chlorhexidine adjunct non-surgical treatment outcomes were observed, with the relative abundance of Desulfobulbus sp. HMT 041, Saccharibacteria (TM7) [G-1] bacterium HMT 346 or 349, and Tannerella forsythia significantly reduced at the end of the study, but no significant reduction of Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans could be observed. Relative abundance of Desulfobulbus sp. HMT 041 and T. forsythia were also found to be significantly associated with plaque, bleeding on probing, and probing pocket depth (PPD, in mm) at a site level, while the relative abundance of Halomonas pacifica was negatively associated with PPD. CONCLUSIONS Successful chlorhexidine adjunct non-surgical treatment with hygiene care was accompanied by a subgingival microbial shift involving certain periodontopathogenic species, except P. gingivalis and A. actinomycetemcomitans. Further investigations are required to clarify the mechanism underpinning the unchanged relative abundance of the above two pathogens despite favorable clinical responses. CLINICAL SIGNIFICANCE DS adults face challenges achieving optimal home care or hygiene for periodontal healing and disease prevention. Chemical adjunct mechanical periodontal therapy plus regular recalls appeared promising clinically and microbiologically, with subgingival periodontopathogenic species reduction. The persistence of A. actinomycetemcomitans and P. gingivalis in subgingival niches post-treatment warrants further investigation.
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Affiliation(s)
- Ronald H W Cheng
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Miao Wang
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Wai Man Tong
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Wenling Gao
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Rory M Watt
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China.
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Ghaffarpour M, Karami‐Zarandi M, Rahdar HA, Feyisa SG, Taki E. Periodontal disease in down syndrome: Predisposing factors and potential non-surgical therapeutic approaches. J Clin Lab Anal 2024; 38:e25002. [PMID: 38254289 PMCID: PMC10829694 DOI: 10.1002/jcla.25002] [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: 03/18/2023] [Revised: 11/06/2023] [Accepted: 12/31/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Periodontal diseases (PDs) have been documented to be significantly more prevalent and severe in patients with Down syndrome (DS). Different immunological and microbiological factors contributed to predisposing these patients to progressive and recurrent PDs. AIM The aim of this review was to investigate the altered immunological responses and oral microbiota disorders as well as focus on adjunctive non-surgical methods for the treatment of PDs and its applicability in patients with DS. MATERIAL AND METHODS A literature review was conducted addressing the following topics: (1) the altered immunological responses, (2) orofacial disorders related to DS patients, (3) oral microbiota changing, and (4) adjunctive non-surgical treatment and its efficacy in patients with DS. RESULTS Due to the early onset of PDs in children with DS, the need for prompt and effective treatment in these patients is essential. DISCUSSION AND CONCLUSION So, investigating underlying factors may open a new window to better understand the pathology of PDs in DS people and thus, find better strategies for treatment in such group. Although non-surgical treatments such as photodynamic therapy and probiotic consumption represented acceptable outcomes in different examined patients without DS, data about the application of these convenience and no need for local anesthesia methods in patients with DS is limited.
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Affiliation(s)
- Mahdie Ghaffarpour
- Department of Oral Medicine, School of DentistryTehran University of Medical SciencesTehranIran
| | - Morteza Karami‐Zarandi
- Department of Microbiology, School of MedicineZanjan University of Medical SciencesZanjanIran
| | - Hossein Ali Rahdar
- Department of Microbiology, School of MedicineIranshahr University of Medical SciencesIranshahrIran
| | - Seifu Gizaw Feyisa
- Department of Medical LaboratorySalale University College of Health SciencesFicheEthiopia
| | - Elahe Taki
- Department of Microbiology, School of MedicineKermanshah University of Medical SciencesKermanshahIran
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Ahmed N, Arul D. Matrix Metalloproteinase Activity in Gingival Crevicular Fluid and Periodontal Health Status in Down Syndrome Patients: A Comparative Study. Cureus 2023; 15:e40280. [PMID: 37448427 PMCID: PMC10336614 DOI: 10.7759/cureus.40280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Periodontal diseases, caused by gram-negative bacteria, often begin as gingivitis and can progress to periodontitis, characterized by inflammation extending to the periodontal ligament and alveolar bone. Individuals with Down syndrome (DS) commonly exhibit poorer oral hygiene and a higher prevalence of severe chronic periodontitis. This study aimed to identify unregulated risk factors in DS that contribute to increased periodontal breakdown. Materials and methods We conducted a study with 60 age-matched patients, including 20 DS patients from Balavihar Special School and 40 systemically healthy patients with and without periodontitis from Thai Moogambigai Dental College and Hospital. We collected patients' complete case histories and blood samples for evaluating matrix metalloproteinase 8 (MMP8) and matrix metalloproteinase 9 (MMP9) levels. All patients underwent nonsurgical periodontal therapy, and the samples were processed at the Central Research Laboratory at Meenakshi Ammal Dental College and Hospital. We calculated each group's mean and standard deviation and compared them using one-way analysis of variance and Kruskal-Wallis tests, followed by post hoc (Tukey honestly significant difference) multiple group comparisons. Statistical analysis was performed using Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 17.0. (Chicago: SPSS Inc.). Results The mean value of MMP8 in the DS group with chronic periodontitis was -18.1895, which was statistically significant (P<.001) compared to the mean value of -20.3720 in systemically healthy subjects with chronic periodontitis and -21.7120 in systemically healthy controls. Similarly, the mean value of MMP9 in the DS group with chronic periodontitis was 18.6455, which was statistically significant (P<.001) compared to the mean values of 19.8540 in systemically healthy subjects with chronic periodontitis and 25.2505 in systemically healthy controls. These findings indicate that DS subjects exhibit increased levels of pro-inflammatory cytokines MMP8 and MMP9, serving as markers for identifying periodontal disease. The mean differences in MMP8 and MMP9 in the DS group with chronic periodontitis showed highly statistically significant levels compared to both systemically healthy groups. Conclusion This study aimed to identify unregulated risk factors in DS that contribute to increased periodontal breakdown. Our findings revealed elevated MMP8 and MMP9 in DS patients with periodontitis, indicating an increased risk for early development of destructive forms of periodontal disease in this population. Extensive gingival tissue inflammation, bleeding on probing, increasing probing depths, loss of periodontal attachment, and alveolar bone loss are all common symptoms.
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Affiliation(s)
- Nizar Ahmed
- Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Devi Arul
- Periodontology and Implantology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Gul SS, Abdulkareem AA, Sha AM, Rawlinson A. Diagnostic Accuracy of Oral Fluids Biomarker Profile to Determine the Current and Future Status of Periodontal and Peri-Implant Diseases. Diagnostics (Basel) 2020; 10:diagnostics10100838. [PMID: 33081038 PMCID: PMC7603129 DOI: 10.3390/diagnostics10100838] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/10/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023] Open
Abstract
Severe periodontitis is ranked as the sixth most prevalent disease affecting humankind, with an estimated 740 million people affected worldwide. The diagnosis of periodontal diseases mainly relies upon assessment of conventional clinical parameters. However, these parameters reflect past, rather than current, clinical status or future disease progression and, likely, outcome of periodontal treatment. Specific and sensitive biomarkers for periodontal diseases have been examined widely to address these issues and some biomarkers have been translated as point-of-care (PoC) tests. The aim of this review was to provide an update on PoC tests for use in the diagnosis and management of periodontal diseases. Among the PoC tests developed so far, active matrix metalloproteinase-8 has shown promising results in terms of diagnostic and prognostic values. However, further studies are required to increase the sensitivity and specificity via combining more than one biomarker and merging these test kits with periodontal risk assessment tools. Furthermore, the validity of these test kits needs to be investigated by applying the results in further independent studies and the impact on these test kits’, together with the results of risk factors for periodontal diseases, such as diabetes and smoking, also needs to be examined.
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Affiliation(s)
- Sarhang S. Gul
- College of Dentistry, Periodontics Department, University of Sulaimani, Sulaymaniyah 1124–30, Iraq;
- Correspondence: ; Tel.: +964-7701-447-723
| | - Ali A. Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad 10011, Iraq;
| | - Aram M. Sha
- College of Dentistry, Periodontics Department, University of Sulaimani, Sulaymaniyah 1124–30, Iraq;
| | - Andrew Rawlinson
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK;
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Nuernberg MAA, Ivanaga CA, Haas AN, Aranega AM, Casarin RCV, Caminaga RMS, Garcia VG, Theodoro LH. Periodontal status of individuals with Down syndrome: sociodemographic, behavioural and family perception influence. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1181-1192. [PMID: 31062454 DOI: 10.1111/jir.12629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/09/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The aim of the present study was to assess the periodontal condition of individuals with Down syndrome and the association with sociodemographic and behavioural characteristics and family perception of oral health. METHODS This cross-sectional observational study was performed at a referral centre for dental assistance to disabled persons in Araçatuba, Brazil. Parents of the individuals were interviewed, and the visible plaque index, bleeding on probing, probing pocket depth and clinical attachment level were recorded by one periodontist in six sites per tooth of all teeth. The individual was the unit of analysis. The significance level was set at 5%. RESULTS Sixty-four subjects (23.8 ± 8.3 years old) were included. Eighteen (28.1%) were diagnosed with gingivitis and 46 (71.9%) with periodontitis. In the multiple logistic regression final model, age and self-reported oral hygiene practices were associated with the occurrence of periodontitis. The chance of having periodontitis was 4.7 times higher among individuals older than 20 years and approximately 4 times higher in patients whose oral hygiene was performed by themselves and their parents, compared with those who performed oral hygiene alone. Sex, follow-up time in the centre, education, degree of participants' dependence, flossing and family history of periodontal disease were not associated with the occurrence of periodontitis. Higher levels of plaque and bleeding were observed for participants with parents reporting bad gingival health (76.2% and 46.9%) and deficient oral hygiene (79.5% and 47.3%). The perception of parents regarding gingival bleeding was correlated with higher bleeding detected clinically (P = 0.01; 50.1%). CONCLUSIONS The prevalence of periodontitis in individuals with Down syndrome is high and increases with age, even in the face of the parents' perception about their children's oral condition.
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Affiliation(s)
- M A A Nuernberg
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - C A Ivanaga
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - A N Haas
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - A M Aranega
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - R C V Casarin
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - R M S Caminaga
- Department of Morphology, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - V G Garcia
- Post Graduate Program, Latin American Institute of Dental Research and Education (ILAPEO), Curitiba, Brazil
| | - L H Theodoro
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
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Scalioni FAR, Carrada CF, Martins CC, Ribeiro RA, Paiva SM. Periodontal disease in patients with Down syndrome: A systematic review. J Am Dent Assoc 2018; 149:628-639.e11. [PMID: 29779565 DOI: 10.1016/j.adaj.2018.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 02/20/2018] [Accepted: 03/08/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND The authors systematically reviewed the scientific evidence of an association between periodontal disease and Down syndrome (DS). TYPES OF STUDIES REVIEWED In this systematic review, the authors included observational studies in which the investigators assessed the prevalence, incidence, or experience of periodontal disease in patients with DS compared with that in healthy patients. The authors used the Population, Exposure, Comparison, Outcome structure. The population was patients of any age, the exposure was the presence of DS, the comparison was the absence of DS, and the outcome was the presence of periodontal disease. The authors conducted an electronic search in 5 databases through March 2017. Two independent reviewers assessed the risk of bias by using the Fowkes and Fulton scale. The authors performed a meta-analysis to compare periodontal disease among patients with DS and those without DS. The authors calculated a summary effect measure-standard mean difference-when evaluating the means of the oral hygiene index. The authors assessed the strength of evidence from the selected studies by using a modified Grading of Recommendations Assessment, Development and Evaluation system. RESULTS The authors included 23 case-control studies in the systematic review and submitted 3 to meta-analysis. In the qualitative analysis, results from most studies showed that the prevalence of some periodontal parameters was higher among patients with DS than among those without DS. Evaluations of the Fowkes and Fulton scale point to many methodological problems in the studies evaluated. Results of the meta-analysis revealed no differences between groups with regard to the oral hygiene index (standard mean difference, 0.05; 95% confidence interval, -0.55 to 0.65; I2 = 0.0%). CONCLUSIONS AND PRACTICAL IMPLICATIONS Further research is required, in particular well-designed studies that avoid the deficiencies identified in the studies in this review.
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Schmidt J, Guder U, Kreuz M, Löffler M, Kiess W, Hirsch C, Ziebolz D, Haak R. aMMP-8 in correlation to caries and periodontal condition in adolescents-results of the epidemiologic LIFE child study. Clin Oral Investig 2017; 22:449-460. [PMID: 28578462 DOI: 10.1007/s00784-017-2132-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 05/15/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The suitability of a chairside aMMP-8 test in determination of periodontal inflammation and caries in adolescents was assessed. Secondly, the influence of orthodontic treatment on aMMP-8 test result was analyzed. MATERIALS AND METHODS Within the LIFE Child study, 434 adolescents (10 to 18 years) were included. Clinical dental examinations comprised caries experience (DMF/T-Index), signs of periodontal inflammation (probing pocket depth, PPD; community periodontal index of treatment needs; CPITN) at six index teeth and oral hygiene (OH). Information about orthodontic appliances (OA) and socioeconomic status (SES) were obtained by validated questionnaires. Test's sensitivity and specificity to detect periodontal inflammation and carious lesions were evaluated. The influence of OA on the test result was analyzed (multivariate model). RESULTS No associations between age, gender, SES or OH, and test outcome were found (p > 0.05). Positive test results correlated to periodontal findings (CPITN, mean PPD; p < 0.001). However, for the detection of ≥ 1 site(s) with PPD ≥ 4 mm, the test's sensitivity and specificity were found to be 61 and 69%, respectively. Multivariate analysis revealed a higher probability for a positive test result in cases of fixed OA (odds ratio 5.02, 95% confidence interval 1.90-13.19). The test had no diagnostic value considering carious lesions. CONCLUSIONS The chairside aMMP-8 test does not reliably identify adolescents with periodontal inflammation. Positive test results were more frequent in case of OA. CLINICAL RELEVANCE The chairside aMMP-8 test is no appropriate tool to screen children and adolescents neither for periodontal inflammation nor for carious lesions.
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Affiliation(s)
- Jana Schmidt
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany.
| | - Ulrike Guder
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| | - Markus Kreuz
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Härtelstrasse 16-18, 04107, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Härtelstrasse 16-18, 04107, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany.,Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103, Leipzig, Germany
| | - Christian Hirsch
- Department of Pediatric and Preventive Dentistry, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
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Kumar Y, Jain V, Chauhan SS, Bharate V, Koli D, Kumar M. Influence of different forms and materials (zirconia or titanium) of abutments in peri-implant soft-tissue healing using matrix metalloproteinase-8: A randomized pilot study. J Prosthet Dent 2017; 118:475-480. [PMID: 28343676 DOI: 10.1016/j.prosdent.2016.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 11/24/2016] [Accepted: 11/28/2016] [Indexed: 12/19/2022]
Abstract
STATEMENT OF PROBLEM It is unclear how pathogenic bacteria adhere to different implant materials and whether biomarker matrix metalloproteinase-8 (MMP-8) level provides a reliable method of evaluating the connective tissue status of peri-implant tissues. PURPOSE The purpose of this pilot clinical study was to evaluate peri-implant connective tissue response by assessing the MMP-8 levels in peri-implant crevicular fluid around titanium and zirconia abutments. MATERIAL AND METHODS The study was designed as a prospective, within-subject comparison with left-right randomization low. Twelve participants with partial edentulism were selected according to inclusion and exclusion criteria. Peri-implant sulcal fluid sampling and pocket probing depths were assessed at 1, 3, and 12 months after placing the abutments. The MMP-8 protein level of the peri-implant sulcal fluid was determined by MMP-8-specific sandwich enzyme-linked immunosorbent assay system. The independent t test or Wilcoxon test was used to compare MMP-8 levels and probing depth assessment between the zirconia and titanium groups at different time points (1, 3, and 12 months). Repeated measures ANOVA was used for within-group comparison of the MMP-8 levels at 3 time points (α=.05). RESULTS At 1 and 3 months, the titanium abutments showed significantly higher MMP-8 levels and probing depths than the zirconia abutments (P<.05), but no significant differences were found at 12 months for either variable (P>.05). CONCLUSIONS This study suggests the presence of more remodeling and/or inflammatory phenomena around titanium implant abutments than around zirconia abutments of a different design during the early stages but not at 1 year.
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Affiliation(s)
- Yogesh Kumar
- Senior Resident, Department of Prosthodontics, Center for Dental Education and Research, All India Institute of Medical Sciences New Delhi, New Delhi, India
| | - Veena Jain
- Professor, Department of Prosthodontics, Center for Dental Education and Research, All India Institute of Medical Sciences New Delhi, New Delhi, India.
| | - Shyam Singh Chauhan
- Professor, Department of Biochemistry, All India Institute of Medical Sciences New Delhi, New Delhi, India
| | - Vinayak Bharate
- Lecturer, Dr D. Y. Patil Dental College and Hospital Pimpri Pune, Maharashtra, India
| | - Dheeraj Koli
- Assistant Professor, Department of Prosthodontics, Center for Dental Education and Research, All India Institute of Medical Sciences New Delhi, New Delhi, India
| | - Manish Kumar
- Doctoral student, Department of Biochemistry, All India Institute of Medical Sciences New Delhi, New Delhi, India
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Stefanini M, Sangiorgi M, Roncati M, D'Alessandro G, Piana G. Effect on plaque control in children patients with Down syndrome using Digital Brush with or without chlorhexidine: a randomized clinical trial. SPECIAL CARE IN DENTISTRY 2015; 36:66-70. [PMID: 26710753 DOI: 10.1111/scd.12152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate efficacy in children affected by Down syndrome of "Digital Brush" in terms of Plaque Index reduction added to the daily oral hygiene procedures. METHODS A total of 56 patients with Down syndrome were recruited and randomly assigned in two groups: both control and test groups underwent standard hygiene procedures of tooth brushing twice a day followed by the intervention of Digital Brush, TNT gauze impregnated with chlorhexidine 0.12%, for the test group and by sterile gauze soaked in water for the control group. Initial plaque index was measured for all patients (T0), subsequently were instructed to use either Digital Brush or gauze soaked with water for 2 weeks. At last, patients were reevaluated (T1) and the plaque index measured. RESULTS Plaque index improvement from T0 to T1 in control group was 11.7%, while in test group was 24.1%. The mean differences between test and control group was statistically significant (p < 0.001). CONCLUSIONS This study demonstrates how the Digital Brush, added to the daily oral hygiene procedures, obtains significant improvements in supragingival plaque control in children with Down syndrome.
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Affiliation(s)
- Martina Stefanini
- Phd Student, Division of Special Patient Care, Dipartimento di Scienze Biomediche e Neuromotorie, Bologna Univerisity, Italy
| | - Matteo Sangiorgi
- Phd Student, Division of Special Patient Care, Dipartimento di Scienze Biomediche e Neuromotorie, Bologna Univerisity, Italy
| | - Marisa Roncati
- Teaching Professor on Master Degree on Prosthodontics, Bologna Univerisity, Italy
| | - Giovanni D'Alessandro
- Reserch Fellow, Division of Special Patient Care, Dipartimento di Scienze Biomediche e Neuromotorie, Bologna Univerisity, Italy
| | - Gabriela Piana
- Clinical Professor, Chair of Division of Special Patient Care, Dipartimento di Scienze Biomediche e Neuromotorie, Bologna Univerisity, Italy
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Khocht A, Albandar JM. Aggressive forms of periodontitis secondary to systemic disorders. Periodontol 2000 2015; 65:134-48. [PMID: 24738590 DOI: 10.1111/prd.12015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A number of systemic disorders increase a patient's susceptibility to destructive periodontitis and have impacts on periodontal disease progression and severity. The underlying factors are usually genetic and are mainly related to alterations in the immune response and in certain endocrine functions, leading to various syndromes in which periodontitis and/or early tooth loss are secondary manifestations. Neutrophils are important immune defense cells that play a significant role in controlling the spread of microbial plaque infections in the dentogingival region. This review focuses on a selected group of systemic disorders that are associated with alterations in either neutrophil counts (quantitative disorders) or function (qualitative disorders), and defects in the mineralization of bone and dental tissues. In most of these diseases controlling the periodontal disease progression is very challenging. Proper diagnosis is a prerequisite for proper management of the periodontal problem. Future advances in research, including gene targeting and the resolution of enzyme deficiencies, may bring about remedies of the underlying systemic disorders and may significantly improve the outcome of periodontal treatment in these patients.
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The effect of conventional mechanical periodontal treatment on red complex microorganisms and clinical parameters in Down syndrome periodontitis patients: a pilot study. Eur J Clin Microbiol Infect Dis 2014; 34:601-8. [DOI: 10.1007/s10096-014-2268-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/20/2014] [Indexed: 01/18/2023]
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12
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Tsilingaridis G, Yucel-Lindberg T, Concha Quezada H, Modéer T. The relationship between matrix metalloproteinases (MMP-3, -8, -9) in serum and peripheral lymphocytes (CD8+ , CD56+ ) in Down syndrome children with gingivitis. J Periodontal Res 2013; 49:742-50. [PMID: 24372339 DOI: 10.1111/jre.12157] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Altered immune response may be a major contributor to periodontal disease in Down syndrome. This study investigated the relationship between peripheral lymphocytes and matrix metalloproteinases (MMPs) in serum in Down syndrome children with gingivitis. MATERIAL AND METHODS Children with Down syndrome (n = 10) and healthy controls (n = 10) were clinically and radiographically examined during dental treatment under general anaesthesia. Peripheral blood and gingival crevicular fluid were collected from each subject and concentrations were determined: serum MMP-2, -3, -8 and -9; serum tissue inhibitors of metalloproteinases (TIMP) -1, -2 and -3; and gingival crevicular fluid. Leukocytes were isolated from peripheral blood and the relative amounts (%) of the various cell phenotypes were analysed using flow cytometry. In addition, peripheral blood cells were treated with Porphyromonas gingivalis lipopolysaccharide and levels of MMPs and TIMPs measured. RESULTS Concentrations of MMP-3, MMP-8 and TIMP-1 in serum were significantly higher (p < 0.05) in the Down syndrome group compared to the controls. When peripheral blood leukocytes were cultured in the presence or absence of P. gingivalis lipopolysaccharide, MMP-8 levels were significantly (p < 0.05) higher in the Down syndrome group compared to controls. Children with Down syndrome exhibited significant positive correlations between CD8(+) T cells and MMP-8 (r = 0.630; p = 0.050), between CD8(+) T cells and MMP-9 (r = 0.648; p = 0.043), and between CD56(+) NK cells and MMP-3 (r = 0.828; p = 0.003) compared to controls. CONCLUSIONS The positive relationship of serum MMP-3, -8 and -9 with immune cells in children with Down syndrome may facilitate migration of CD8(+) T cells and CD56(+) NK cells into the periodontal tissue, which may contribute to the increased degradation of periodontal tissue in individuals with Down syndrome.
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Affiliation(s)
- G Tsilingaridis
- Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Department of Paediatric Dentistry, Eastmaninstitutet, Stockholm, Sweden
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13
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Tsilingaridis G, Yucel-Lindberg T, Modéer T. Altered relationship between MMP-8 and TIMP-2 in gingival crevicular fluid in adolescents with Down's syndrome. J Periodontal Res 2013; 48:553-62. [DOI: 10.1111/jre.12038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2012] [Indexed: 01/22/2023]
Affiliation(s)
- G. Tsilingaridis
- Division of Paediatric Dentistry; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Department of Paediatric Dentistry; Eastmaninstitutet; Stockholm Sweden
| | - T. Yucel-Lindberg
- Division of Periodontology; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - T. Modéer
- Division of Paediatric Dentistry; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
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Cavalcante LB, Tanaka MH, Pires JR, Henrique Apponi L, Aparecida Giro EM, Roberto Valentini S, Palomari Spolidório DM, Capela MV, Rossa C, Scarel-Caminaga RM. Expression of the Interleukin-10 Signaling Pathway Genes in Individuals With Down Syndrome and Periodontitis. J Periodontol 2012; 83:926-35. [DOI: 10.1902/jop.2011.110056] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kubota M, Tanno-Nakanishi M, Yamada S, Okuda K, Ishihara K. Effect of smoking on subgingival microflora of patients with periodontitis in Japan. BMC Oral Health 2011; 11:1. [PMID: 21208407 PMCID: PMC3020163 DOI: 10.1186/1472-6831-11-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Accepted: 01/05/2011] [Indexed: 11/20/2022] Open
Abstract
Background Smoking is a risk factor for periodontitis. To clarify the contribution of smoking to periodontitis, it is essential to assess the relationship between smoking and the subgingival microflora. The aim of this study was to gain an insight into the influence of smoking on the microflora of Japanese patients with periodontitis. Methods Sixty-seven Japanese patients with chronic periodontitis (19 to 83 years old, 23 women and 44 men) were enrolled in the present study. They consisted of 30 smokers and 37 non-smokers. Periodontal parameters including probing pocket depth (PPD) and bleeding on probing (BOP) and oral hygiene status were recorded. Detection of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum/periodonticum, Treponema denticola and Campylobacter rectus in subgingival plaque samples was performed by polymerase chain reaction. Association between the detection of periodontopathic bacteria and smoking status was analyzed by multiple logistic regression analysis and chi-square test. Results A statistically significant association was found between having a PPD ≥ 4 mm and detection of T. denticola, P. intermedia, T. forsythia, or C. rectus, with odds ratios ranging from 2.17 to 3.54. A significant association was noted between BOP and the detection of C. rectus or P. intermedia, and smoking, with odds ratios ranging from 1.99 to 5.62. Prevalence of C. rectus was higher in smokers than non-smokers, whereas that of A. actinomycetemcomitans was lower in smokers. Conclusions Within limits, the analysis of the subgingival microbial flora in smokers and non-smokers with chronic periodontitis suggests a relevant association between smoking and colonization by the specific periodontal pathogens including C. rectus.
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Affiliation(s)
- Michiya Kubota
- Oral Health Science Center, Tokyo Dental College, Chiba, Japan
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