Presence of Porphyromonas gingivalis in gingival squamous cell carcinoma

Periodontal disease has been recently linked to a variety of systemic conditions such as diabetes, cardiovascular disease, preterm delivery, and oral cancer. The most common bacteria associated with periodontal disease, Porphyromonas gingivalis (P. gingivalis) has not yet been studied in the malignant gingival tissues. The objective of this study was to investigate the presence of P. gingivalis in specimens from squamous cell carcinoma patients. We have performed immunohistochemical staining to investigate the presence of P. gingivalis and Streptococcus gordonii (S. gordonii), a non invasive oral bacteria, in paraffin embedded samples of gingival squamous cell carcinoma (n = 10) and normal gingiva (n = 5). Staining for P. gingivalis revealed the presence of the bacteria in normal gingival tissues and gingival carcinoma, with higher levels (more than 33%, P < 0.05) detected in the carcinoma samples. The staining intensity was also significantly enhanced in the malignant tissue by 2 folds (P < 0.023) compared to specimens stained for the non-invasive S. gordonii. P. gingivalis is abundantly present in malignant oral epithelium suggesting a potential association of the bacteria with gingival squamous cell carcinoma.

Association between periodontal pockets and elevated cholesterol and low density lipoprotein cholesterol levels

BACKGROUND

Periodontitis is associated with increased prevalence of cardiovascular morbidity and mortality; however, the nature of this association is unclear. There is a rationale that indicates that the presence of periodontal pockets which can harbor pathogenic microorganisms and evoke a host response could elicit a systemic effect. The hypothesis of this study is that periodontal pockets may be associated with elevated blood lipid levels, a known risk factor for atherosclerotic disease.

METHODS

The periodontal health of 10,590 Israeli military service men and women was assessed using the Community Periodontal Index of Treatment Needs (CPITN). The relationship of blood lipids and periodontal disease and CPITN index was tested, controlling for factors that are related to elevated cholesterol levels, including high body mass index (BMI), age, diastolic blood pressure, and smoking.

RESULTS

The presence of periodontal pockets was positively associated with higher cholesterol and low density lipoprotein (LDL) cholesterol blood levels in men. No significant association was found in women.

CONCLUSIONS

In this large cohort study, the presence of periodontal pockets as measured by CPITN was positively associated with total cholesterol and LDL-cholesterol. The findings of the study support the reports linking increased prevalence of cardiovascular mortality among patients with periodontal disease.

Expression of the receptor of advanced glycation end products in gingival tissues of type 2 diabetes patients with chronic periodontal disease: a study utilizing immunohistochemistry and RT-PCR

OBJECTIVES

Relationship between diabetes and periodontal disease is well established. It has been shown that advanced glycation end-products (AGEs) might exert noxious effects on gingival tissues through its receptor. Evidence for the role of receptors of AGE (RAGE) in periodontal disease was verified in a murine model for diabetes. However, the presence of RAGE in human gingival tissues has not been demonstrated previously. In this study we demonstrate the presence of RAGE in human periodontium in patients with chronic periodontitis with and without type 2 diabetes.

MATERIAL AND METHODS

Gingival biopsies from eight patients with both type 2 diabetes and chronic periodontitis and 14 healthy control subjects with chronic periodontitis were immunohistochemically stained for RAGE. Five samples from the study groups and four controls were subjected to reverse transcriptase coupled to polymerase chain reaction (RT-PCR) for quantitative determination of mRNA for RAGE.

RESULTS

On immunohistochemistry, positive staining for RAGE was seen in the endothelium and the basal and spinous layer of the inflamed gingival epithelium in both type 2 diabetes and non-diabetes tissue with no statistically significant difference between both groups. RT-PCR, however, showed a 50% increase in mRNA for RAGE in the gingiva of diabetic patients when compared with controls (p<0.05).

CONCLUSIONS

Although there was no change in the staining intensity for RAGE between both groups, the increase in the mRNA for RAGE in the type 2 diabetes gingival epithelium may indicate a possible involvement of this receptor in the periodontal destruction in type 2 diabetes.

Localization of P. gingivalis in preterm delivery placenta

Increasing evidence suggests an association between periodontal disease and adverse pregnancy outcomes. Although infection is considered as a risk factor for preterm delivery, the localization of oral bacteria or their antigens in chorioamnionitis placental tissue has never been demonstrated. This study was devised to test the hypothesis that periodontal pathogens may be present and affect human placenta in cases of chorioamnionitis. Using immunocytochemistry, we have identified the presence of Porphyromonas gingivalis antigens in placental tissues. The antigens were detected in the placental syncytiotrophoblasts, chorionic trophoblasts, decidual cells, and amniotic epithelial cells, as well as the vascular cells. There was a substantial increase in immunostaining intensity of the tissues sectioned from women with chorioamnionitis compared to those experiencing normalterm pregnancy, p < 0.019 (Mann-Whitney test). These results suggest that P. gingivalis may commonly colonize placental tissue, and that the presence of the organism may contribute to preterm delivery.

On the association between hypercholesterolemia, cardiovascular disease and severe periodontal disease

BACKGROUND

Premature death in men is known to be significantly associated with coronary heart disease (CHD). More and more studies are pointing toward a possible association between periodontal disease and increased risk of cardiovascular disease. The association of poor oral hygiene and atherosclerosis can be explained by the effect of chronic inflammatory disease on blood rheology. The purpose of the present study was to assess the relationship between CHD and periodontal disease.

PATIENTS AND METHODS

The study population included 1094 Israeli army service men aged 26-53 years (mean: 39+/-5 years). The study group comprised 151 subjects classified as having coronary heart disease CHD, i.e., myocardial infarction, and or anginal syndrome with angiographic evidence of significant coronary disease, or suffer from atherosclerotic risk factors, i.e., diabetes (fasting glucose) and HTN according to strict, well-established criteria. Blood levels of cholesterol and triglycerides were also determined. The severity of periodontal disease was assessed by the aid of CPITN. The control group comprised 943 healthy subjects. Statistical analysis was performed with chi2 test.

RESULTS

Statistical analysis showed a significant association of CPITN score 4 with hypercholesterolemia and a possible association with CHD.

CONCLUSIONS

The generation of higher cholesterol blood levels is proposed as a possible link between chronic periodontal inflammation and atherosclerosis.

Human leukocyte antigen (HLA) DR4. Positive association with rapidly progressing periodontitis

The relationship between human leukocyte antigens (HLA) determinants and periodontitis has been examined by several authors without showing any particular pattern. However, no study has investigated the HLA-D determinants, which are generally associated with immune disorders, and rapidly progressive periodontitis (RPP). The HLA profile of 10 RPP patients was compared with that of a healthy control population (n = 120). Although no significant difference was found for HLA-A, HLA-B, and HLA-C, HLA-DR4 of the HLA-D group was found in 80% of patients but only in 38.3% of controls. A high frequency of HLA-DR4 has been reported in rheumatoid arthritis (RA) patients. This finding may be significant in light of previous reports highlighting similarities between RA and periodontal disease.

Genetic polymorphisms and other risk factors associated with bisphosphonate induced osteonecrosis of the jaw

Bisphosphonate induced osteonecrosis of the jaw (BONJ) is a complication in patients taking bisphosphonate (BP) that affects their quality of life and compliance. In this cohort study, patients with multiple myeloma (MM) on intravenous BP therapy were enrolled over 1 year. Demographic and clinical data and genotyping of 10 single nucleotide polymorphisms (SNPs) from seven candidate genes associated with drug or bone metabolism were determined. Of the 78 patients enrolled, 12 had BONJ. The median time to developing BONJ was 28 months. Univariate and multivariate analysis revealed a significant association between BONJ and smoking (p=0.048) and type of BP treatment (p=0.03). A trend for higher odds for BONJ was found for SNPs in five genes: COL1A1 (rs1800012), RANK (rs12458117), MMP2 (rs243865), OPG (rs2073618) and OPN (rs11730582). Considering all five SNPs together, patients with genotype scores ≥ 5 had a BONJ event rate of 57%; those with scores < 5 had a rate of 10%. The adjusted odds ratio was 11.2 (95% confidence interval of 1.8-69.9; p value 0.0097). Smoking, type of BP and combined genotype score of COL1A1, RANK, MMP2, OPG and OPN were significantly associated with BONJ in MM patients undergoing BP therapy.

Receptor for advanced glycation end product (RAGE) upregulation in human gingival fibroblasts incubated with nornicotine

BACKGROUND

Clinical and epidemiological data strongly support a link between smoking and periodontal disease. The mechanism by which smoking contributes to the destruction of periodontal tissue is not clear and cannot be attributed solely to the vasoconstrictive effects of nicotine. Our hypothesis is that nornicotine, a metabolite of nicotine, upregulates the expression of the receptor for the advanced glycation end products (RAGE) in the gingiva of smokers and triggers the proinflammatory effects of AGE by stimulating the secretion of cytokines and reactive oxygen species which directly cause destruction of the periodontal apparatus.

METHODS

Human gingival cells grown in tissue culture were exposed to 1 microM nornicotine for 72 hours. Following the nornicotine pretreatment, some of the cells were also treated with AGE that was generated with nornicotine for 48 hours and another group was continued on nornicotine only for 48 hours. Control cells that were not exposed to either nornicotine or AGE were also cultured. The cells were harvested and RNA was extracted for reverse transcription-polymerase chain reaction (RT-PCR) and RAGE mRNA was amplified.

RESULTS

The nornicotine-treated cells increased their expression of RAGE by approximately 4-fold (P <0.05, Student t test). These data suggest that nornicotine, a byproduct of cigarette smoke, can induce RAGE expression in gingival tissues. Therefore, our data support the hypothesis that RAGE potentially plays a significant role in the progression of periodontal disease exacerbated by smoking.

CONCLUSION

Nornicotine, AGE, and upregulation of RAGE may be involved in the pathogenesis of periodontal disease associated with smoking.

Oral signs and symptoms in relation to disease activity and site of involvement in patients with inflammatory bowel disease

OBJECTIVE

An assessment of oral symptoms and signs in patients with inflammatory bowel disease (IBD).

METHODS

Fifty-four patients with IBD, 34 with Crohn's disease (CD) and 20 with ulcerative colitis (UC) participated in the study. Forty-two patients without gastrointestinal disease or complaints attending the orthopedic clinic served as controls. Each patient completed a written questionnaire and was subjected to an oral examination.

RESULTS

The main findings of this study were the higher prevalence of halitosis (50% vs 10% P < 0.0008), nausea (30% vs 7%, P < 0.017) and reflux (regurgitation) (45% vs 17%, P < 0.017) in patients with UC, and nausea (50% vs 7%, P < 0.026), dry mouth and halitosis (29% vs 10%, P < 0.026) and vomiting (41% vs 5%, P = 0.01) in patients with CD, compared with controls. Patients with active CD had a higher prevalence of dry mouth, nausea and vomiting compared with controls (46, 69 and 54% vs 10, 7 and 5%, respectively, P < 0.001) and of reflux compared with non-active CD (46% vs 5%, P < 0.001). Patients with active UC had a higher prevalence of halitosis and regurgitation (50 and 60% vs 10 and 17%, P < 0.001) compared with controls.

CONCLUSIONS

The present study demonstrates increased frequency of oral signs and symptoms in patients with IBD. Patients with active CD had more oral signs compared with non-active CD patients. Manifestations such as nausea, vomiting, regurgitation and dry mouth may have detrimental effects on teeth and soft tissues of the oral cavity. Communication between gastroenterologists and dentists is imperative for success of the overall treatment of their patients.

Increased risk for COVID-19 in patients with vitamin D deficiency

OBJECTIVE

The 2019 coronavirus disease (COVID-19) pandemic has disproportionally affected a variety of patients with underlying risk factors such as respiratory and cardiovascular diseases, diabetes, obesity, and black race. Vitamin D deficiency, which can result in a compromised immune response, has been also linked to increased risk and increased morbidities associated with COVID-19. In the absence of large-scale longitudinal studies to determine the strength of association between vitamin deficiency and COVID-19, cross-sectional studies of large patient cohorts can be used.

METHODS

We used the i2b2 patient's registry platform at the University of Florida Health Center to generate a count of patients using the international classification of diseases (ICD)-10 diagnosis codes for the period of October 1, 2015, through June 30, 2020. Logistic regression of the aggregates was used for the analysis.

RESULTS

Patients with vitamin D deficiency were 4.6 times more likely to be positive for COVID-19 (indicated by the ICD-10 diagnostic code COVID19) than patients with no deficiency (P < 0.001). The association decreased slightly after adjusting for sex (odds ratio [OR] = 4.58; P < 0.001) and malabsorption (OR = 4.46; P < 0.001), respectively. The association decreased significantly but remained robust (P < 0.001) after adjusting for race (OR = 3.76; P < 0.001), periodontal disease status (OR = 3.64; P < 0.001), diabetes (OR = 3.28; P < 0.001), and obesity (OR = 2.27; P < 0.001), respectively. In addition, patients with vitamin D deficiency were 5 times more likely to be infected with COVID-19 than patients with no deficiency after adjusting for age groups (OR = 5.155; P < 0.001).

CONCLUSIONS

Vitamin D deficiency is significantly associated with increased risk for COVID-19.

Prevention of recurrent aphthous stomatitis with colchicine: an open trial

BACKGROUND

Recurrent aphthous stomatitis (RAS) is a common disorder with hitherto unsatisfactory drug therapy.

OBJECTIVE

Our purpose was to evaluate the prophylactic effect of colchicine in the treatment of RAS.

METHODS

An open, prospective, 4-month study was conducted in 20 patients with RAS who served as their own controls. During the first 2 months of the study no medications were given and in the last 2 months colchicine, 1.5 mg/day, was prescribed.

RESULTS

The mean number of aphthae per week and the subjective daily pain scores were reduced by 71% and 77%, respectively, during colchicine treatment as compared with the previous period (p < 0.001 for both). No serious side effects of colchicine were noted.

CONCLUSION

These findings suggest a role for continuous colchicine therapy in the prevention of RAS.

Expression of the receptor of advanced glycation end products in the gingival tissue of smokers with generalized periodontal disease and after nornicotine induction in primary gingival epithelial cells

BACKGROUND

The association between smoking and periodontal disease is well established; however, the mechanism by which smoking augments the destruction of periodontal tissue is not clear. We hypothesize that smoking is related to an increased expression of receptor of advanced glycation end products (RAGE) in gingival tissues of smokers.

METHODS

Gingival biopsies from five smokers and five age- and gender-matched non-smokers were examined. In addition, gingival epithelial cells (GECs) were reacted with 1 muM nornicotine for 4, 16, 24, and 48 hours for mRNA for RAGE and an additional 72 hours for protein expression. RAGE mRNA was amplified by reverse transcriptase-polymerase chain reaction (RT-PCR), and expression of RAGE at the protein level in GECs was studied with Western blots.

RESULTS

In the gingival biopsies from all 10 subjects, RT-PCR with RAGE-specific primers produced a band of the predicted size. For all pairs, the smoker biopsies expressed a greater level of RAGE compared to the matched non-smokers. When viewed as groups, analysis of the band intensity indicated that RAGE mRNA in smokers was approximately 1.4-fold of the expression in non-smokers (Wilcoxon test; P = 0.031). In GECs treated with nornicotine, there was a time-dependent increase in RAGE expression up to two-fold at 48 hours. RAGE protein levels initially were reduced but increased to 1.4-fold after 48 hours.

CONCLUSION

The ability of nornicotine to elevate RAGE expression in GECs, along with increased RAGE expression in inflamed gingival tissue from smokers, indicates that RAGE may be associated with periodontal disease linked to smoking.

Stafne's bone cavity in the anterior mandible: a possible diagnostic challenge

Stafne was the first to report the presence of "bone cavities" in the angle of 35 mandibles. Such cavities generally appear in the area between the mandibular first molar and the mandibular angle, and are not considered rare. One of their primary radiological diagnostic features is the characteristic location below the mandibular canal. Stafne's bone cavity is relatively rare in the anterior mandible. The mandibular canal is not present in the anterior mandible. As a result, diagnosis in the anterior mandible may be missed. Needless treatment modalities such as endodontic treatment, bone trephining, and bone exploration may be conducted. The purpose of the present report is to describe a new case of Stafne's bone cavity in the anterior mandible and discuss the differential diagnosis process. The dental computerized tomography scan is suggested as the most suitable noninvasive diagnostic and follow-up modality for this bony configuration in the anterior mandible.

Herpes simplex and herpes zoster viruses in COVID-19 patients

BACKGROUND

Reactivation of herpes family viruses in immunocompromised patients may result in detrimental outcomes for the hosts; therefore, herpes simplex virus-1 and varicella zoster virus infections in the context of COVID-19 may have clinical and prognostic implications. Several reports associated this human herpes virus with COVID-19 infection and have claimed that it can be an indicator for latent COVID-19 infection. However, since most of these were case reports, it is impossible to assess the prevalence of these associations.

METHODS

The University of Florida patient registry i2b2 with ICD-10 diagnosis codes was used for retrieval of patients with diagnosis of COVID-19 and each of the other viruses over the period of October 2015-June 2020.

RESULTS

The prevalence of the herpes simplex-1 occurrence in the COVID-19 group was 2.81% compared to 0.77% in the hospital population odds ratio of 5.27. When adjusted for gender, race, and age, the odds were 5.18, 4.48, and 4.61, respectively. After adjustment for respiratory disease, endocrine disease, obesity, diabetes, circulatory disease, and smoking, the odds were 1.94, 3.18, 1.37, 3.54, 3.7, and 5.1, respectively. The prevalence of the varicella zoster virus in COVID-19 patients was 1.8% compared to 0.43% in the hospital population, odds ratio of 5.26 before adjustment, and 5.2, 5.47, and 4.76 after adjusting for gender, age, and race, respectively. When adjusted for respiratory disease, endocrine disease, obesity, diabetes, and circulatory and neurological diseases, the odds were 1.3, 2.2, 1.48, 2.33, 2.85, and 2.6, respectively.

CONCLUSION

Herpes simplex-1 and varicella zoster viruses are strongly associated with COVID-19 infection.

CIP2A expression and localization in oral carcinoma and dysplasia

AIMS

Oral squamous cell carcinoma (OSCC) is the most prevalent malignancy of the oral cavity resulting in severe morbidity and mortality. To date only few proteins have been suggested as potential biomarkers or targets for this type of cancer. Cancerous inhibitor of PP2A (CIP2A) is a protein expressed in epithelial tissues that stabilizes the oncogene c-Myc and causes cell transformation. This study was designed to investigate the expression of CIP2A in OSCC cell lines and tissues representing human normal, dysplasia and OSCC.

METHODS

Using quantitative real time PCR, mRNA quantification for CIP2A was performed in a primary gingival cell line and OSCCs CAL 27 and SCC-25. Paraffin embedded human specimen classified as normal, dysplastic or OSCC were immunohistochemically stained for CIP2A expression. EGFR and CIP2A were also stained by immunofluorescence for co-localization. Samples of human normal oral tissue and OSCC were studied by PCR for mRNA expression of CIP2A.

RESULTS

CIP2A was significantly increased in the human carcinoma cell lines compared to the primary gingival cell line. CIP2A was overexpressed in the human oral dysplasia and OSCC tissues compared to normal oral tissues. CIP2A was also preferentially localized in the dysplastic and OSCC epithelial areas compared to EGFR that was expressed mainly in areas of relatively normal epithelium and in dysplastic tissues above the basal layers.

CONCLUSIONS

CIP2A may play a significant role in oral malignant transformation and therefore, it may be a potential target for chemotherapy of OSCC.

Elevated blood glucose levels in patients with severe periodontal disease

BACKGROUND, AIMS

The rôle of diabetes mellitus in various forms of periodontal disease was investigated intensively in the past; some studies have also indicated an impact of periodontal inflammation on diabetic balance. The purpose of this study was to evaluate the reciprocal relationship between abnormal serum glucose levels and elevated CPITN scores in non-diabetic patients.

MATERIAL AND METHODS

10,590 subjects were analyzed for normal and abnormal (higher than 120 mg/dl) serum glucose levels, their periodontal status reflected as CPITN was correlated with their glucose level category.

RESULTS

The results of the present study reflect a significant association between elevated blood glucose levels (higher than 120 mg/dl) and CPITN scores of 4.5 with an odds ratio of 2.46.

CONCLUSION

A strong association exists between abnormal serum glucose level and periodontal disease as manifested by CPITN score.

Lichen planus evoked by periodontal surgery

A case of Lichen Planus (LP) following periodontal surgery in a patient previously free of the disease is described. Genetic predisposition and lymphokine secretion stimulated by local trauma are suggested as a possible mechanism of the phenomenon. It is recommended that LP patients, especially those suffering from the erosive type, should be treated as conservatively as possible, minimizing the possibility of trauma to the oral tissues where local immunity may have been altered by a pathological process.

Peripheral T lymphocyte subsets in rapidly progressive periodontitis

The peripheral blood lymphocyte subsets of 10 patients with rapidly progressive periodontitis were investigated with monoclonal antibody. In 4 patients, the T helper/T suppressor ratio was increased. 5 others had a slightly reduced T helper/T suppressor ratio as compared to control group. These findings may indicate a possible cellular immune response in the pathogenesis of rapidly progressive periodontitis.

Burning mouth sensation associated with fusospirochetal infection in edentulous patients

Six middle-aged and elderly edentulous, systemically ill patients complaining of burning mouth sensation had a fusospirochetal infection of the oral mucosa. Metronidazole was successful in the treatment of three of these patients.

Increased odds ratio for erectile dysfunction in COVID-19 patients

PURPOSE

Erectile dysfunction and COVID-19 share similar risk factors, including vascular disruption of integrity, cytokine release, cardiovascular disease, diabetes and obesity. The aim of this study was to investigate the association between erectile dysfunction and COVID-19 patients.

METHODS

Odds ratio for erectile dysfunction in patients with a history of COVID-19 with and without comorbidities were calculated using a patients' registry platform i2b2. ICD-10 diagnoses codes were accessed for queries and data were analyzed using logistic regression.

RESULTS

Patients with COVID-19 were 3.3 times more likely to have erectile dysfunction with 95% CI (2.8, 3.8). The association became stronger with odds ratio 4.8 (95% CI (4.1, 5.7)) after adjusting for age groups. The odds ratio remained the same after adjusting for smoking status with 3.5 (95% CI (3.0, 4.1)). After adjusting for race, COVID-19 patients were 2.6 (95% CI (2.2, 3.1)) times more likely to have erectile dysfunction. The odds ratio were 1.6, 1.8, 1.9 and 2.3 after adjusting for respiratory disease, obesity, circulatory disease and diabetes, respectively.

CONCLUSION

COVID-19 and erectile dysfunction are strongly associated even after adjustment for known risk factors and demographics.

Prevalence of Periapical Lesions in Patients with Osteoporosis

INTRODUCTION

Osteoporosis is a major systemic disease that can significantly deteriorate the quality of life of the affected individuals. It is more common in women, particularly after menopause. Osteoporosis may be associated with alterations in oral health. Treatment of osteoporotic patients mainly involves the administration of bisphosphonates (BPs). Nitrogen-containing BPs are more potent therapeutically and more commonly used. The purpose of this study was to assess the prevalence of periapical lesions in patients with osteoporosis and to evaluate the difference in the prevalence of periapical lesions in patients treated with alendronate and risedronate, 2 nitrogen-containing types of BPs.

METHODS

Integrated data of hospital patients were used. Data from the corresponding diagnosis codes for osteoporosis and periapical periodontitis were retrieved by searching the appropriate query in the database. The odds ratio (OR) of periapical lesions, its association with osteoporosis, and the use of 2 BP medications were calculated and analyzed statistically.

RESULTS

Of 1,644,953 hospital patients, 8715 presented with periapical lesions. A total of 42,292 patients were diagnosed with osteoporosis. A total of 754 patients diagnosed with osteoporosis presented with periapical lesions. The prevalence of periapical lesions in patients with osteoporosis was 1.78% compared with 0.52% in the general patient population of the hospital. The OR for the prevalence of periapical lesions in patients with osteoporosis was 3.36 and was statistically significant (P < .0001). Patients with osteoporosis treated with any type of BPs showed a prevalence of periapical lesions in 1.25% of cases compared with 0.52% in the general patient population of the hospital. The difference in the OR was statistically significant (P < .0001). The OR for the presence of periapical lesions in the osteoporosis group treated with BPs was 2.35 compared with 3.52 in the osteoporosis group not treated with BP. The difference in the OR was statistically significant (P < .0001). Patients treated with alendronate showed an OR of 1.6 for the prevalence of periapical lesions, and the difference in the OR was statistically significant (P < .0001). Patients treated with risedronate showed an OR of 1.34 for the prevalence of periapical lesions, and the difference in the OR was not statistically significant (P = .3502).

CONCLUSIONS

Under the conditions of this study, it appears that the prevalence of periapical lesions is significantly higher in osteoporotic patients. Osteoporotic patients treated with BPs showed a marked reduction in the prevalence of periapical lesions, especially when risedronate was used.

Receptor of advanced glycation end product (RAGE) expression in the minor salivary glands of patients with Sjögren's syndrome: a preliminary study

OBJECTIVE

Receptor for advanced glycation end product (RAGE) is a cell-surface receptor with ligands capable of inducing proinflammatory responses in autoimmunity. We investigated the immunohistochemical expression and immunoblotting of RAGE in labial salivary glands from Sjögren's syndrome (SS) patients.

MATERIAL AND METHODS

Ten minor salivary glands from SS and 15 from normal salivary tissue adjacent to mucocele were stained immunohistochemically using an antibody to RAGE. Immunoblotting was performed on four SS biopsies and four controls from normal gland.

RESULTS

Immunohistochemistry showed all sections positive for RAGE. The SS sections did not statistically differ from controls. In immunoblotting, SS samples expressed approximately 100% more RAGE than controls [probability (p)<0.03, Student's t-test].

CONCLUSIONS

RAGE is present in the labial salivary glands of both normal and SS patients, with preliminary data suggesting over-expression in SS tissues. The role of RAGE in the pathogenesis of SS has yet to be determined.

Vigabatrin-induced gingival overgrowth

Vigabatrin is a relatively new medication used in the treatment of epilepsia. The present report concerns the use of vigabatrin by a 19-year-old woman. The patient manifested marked gingival overgrowth compatible clinically and histologically with the overgrowth induced by phenytoin, cyclosporine and calcium channel blockers. This is the 1st report of vigabatrin-induced gingival overgrowth. Clinicians should be aware of similar lesions in patients using new anticonvulsants.

Cytokines and growth factors modulate cell growth and insulin-like growth factor binding protein secretion by the human salivary cell line (HSG)

The human salivary cell line (HSG) was investigated for the effect of various growth factors and cytokines on cellular proliferation and on the production of insulin-like growth factor binding proteins (IGFBPs). IGF-I increased cell growth by approximately 25%, and induced the appearances of three distinct protein bands on ligand blot of the cell culture. Two bands with molecular weights of 43 and 45 Kda, respectively, proved to be IGFBP-3 using a specific antibody, and the third was a 24 Kda species (probably, IGFBP-4). Similar IGFBPs were released by the cells following stimulation by EGF and insulin as well as following incubation with the IGF-I receptor antibody alpha IR3. Retinoic acid had an inhibitory effect (50%) on IGF-I-induced cellular proliferation and an attenuative effect on the 24 Kda band when it was combined with IGF-I, and to a lesser effect EGF; however, it enhanced IGFBP-3 production when incubated with IGF-I. The IGF-I receptor antibody had an agonistic effect on IGFBPs production when applied alone or together with IGF-I. TNF-alpha and INF-gamma had minimal effects on cell growth when added alone but when applied in combination, a marked inhibition of cellular proliferation was noted. These cytokines caused increased accumulation of IGFBP-3, -4, and -5. Addition of IGF-I to these cytokines enhanced the expression of these bands. These data demonstrate that growth factors and cytokines which modulate HSG cell growth, induce specific IGFBPs which may play a role in their effects on cell growth.

Periodontal status by CPITN, and associated variables in an Israeli permanent force military population

AIMS

The objectives were to determine periodontal treatment needs using the CPITN index, of Israeli permanent force military personnel.

METHODS

The study population consisted of 1300 military personnel aged 25-44 years (mean age 33.8 +/- 5.4), who attended obligatory routine medical and dental examinations. Clinical examinations were conducted by 3 calibrated examiners, employing flat dental mirrors, the specially designed WHO periodontal probes (FDI probes) and following CPITN criteria. The frequency distributions were studied with regard to age groups, gender and education, as well as differences in the severity of the disease. Also, the mean number of sextants affected per person by age was assessed.

RESULTS

Only 1.19% of the subjects demonstrated healthy periodontal tissue. Shallow pockets were similarly found among all age groups, and the number of persons with deep pockets increased with age. Deep pockets were found almost 3 x more among males (18.66%) in comparison with females (6.19%). Persons with higher education (> 12 years), had less deep pockets and bleeding than individuals with less than 12 years of education (p<0.05).

CONCLUSIONS

Compared with data from other countries reported by the WHO, this periodontal status indicates a relatively high level of treatment needs. This survey provides a substantial contribution to the national oral health data bank concerning the adult working population in Israel.