Association of thalassemia major and gingival inflammation: A pilot study

Evaluation of salivary melatonin and MMP-9 levels in periodontal diseases

OBJECTIVE

The aim of this study was to evaluate salivary matrix metalloproteinase-9 (MMP-9) and melatonin levels in individuals with periodontal health, gingivitis, and periodontitis.

DESIGN

A total of 170 participants were enrolled in this study. They included 57 periodontally healthy individuals, 58 gingivitis patients, and 55 periodontitis patients. Saliva samples were collected by passive drool technique. The levels of MMP-9 and melatonin in saliva were measured biochemically using the ELISA method.

RESULTS

Salivary MMP-9 levels in the periodontitis group were significantly higher than those in the gingivitis and periodontally healthy groups, while salivary melatonin levels were significantly lower (p<0.001). A positive correlation was observed between clinical periodontal parameters and salivary MMP-9 levels, while salivary melatonin levels were negatively correlated (p<0.001). A negative correlation was also observed between salivary MMP-9 levels and salivary melatonin levels (p<0.001).

CONCLUSION

This study shows that the level of melatonin in saliva is associated with periodontal disease and with the level of MMP-9 in saliva, which plays a role in this disease.

Comparison of Analgesic and Anti-Inflammatory Effects of Kale Extract Versus Ibuprofen After Impacted Mandibular Third Molar Surgery: A Randomized, Double-Blind Split-Mouth Clinical Trial

BACKGROUND/OBJECTIVE

We assessed the analgesic and anti-inflammatory effects of kale extract (500 mg anthocyanin equivalent) in patients after mandibular molar surgery.

METHODS

In our randomized clinical trial, postoperative subjects (n = 20) aged 18-25 years old took kale extract or ibuprofen (400 mg) capsules for 7 days, or vice versa, after surgical removal of each impacted tooth. Their pain intensity was then assessed using a visual analogue scale (VAS). Moreover, salivary α-amylase (AA) activity, matrix metalloproteinase 9 (MMP-9) and transforming growth factor beta2 (TGF-β2) concentrations were measured. Levels of VAS and AA decreased 7 days after the first and second molar extractions in the two treatment groups.

RESULTS

The kale extract was more effective than ibuprofen. MMP-9 and TGF-β2 levels were reduced on days 4 and 7 following the two extractions in the kale group, whereas they were reduced on days 4 and 7 following the first extraction in the ibuprofen group. There was a positive correlation between MMP-9 and TGF-β2. Thus, the consumption of the kale extract exerted analgesic and anti-inflammatory effects during the postoperative period in patients who had undergone molar extractions. In conclusion, anthocyanin-abundant kale extract is preferable when administered in a postoperative course and could reduce the need for a prescription of ibuprofen.

Plasma proteome profiling combined with clinical and genetic features reveals the pathophysiological characteristics of β-thalassemia

The phenotype of β-thalassemia underlies multigene interactions, making clinical stratification complicated. An increasing number of genetic modifiers affecting the disease severity have been identified, but are still unable to meet the demand of precision diagnosis. Here, we systematically conducted a comparative plasma proteomic profiling on patients with β-thalassemia and healthy controls. Among 246 dysregulated proteins, 13 core protein signatures with excellent biomarker potential are proposed. The combination of proteome and patients' clinical data revealed patients with codons 41/42 -TTCT mutations have an elevated risk of higher iron burden, dysplasia, and osteoporosis than patients with other genotypes. Notably, 85 proteins correlating to fetal hemoglobin (Hb F) were identified, among which the abundance of 27 proteins may affect the transfusion burden in patients with β-thalassemia. The current study thus provides protein signatures as potential diagnostic biomarkers or therapeutic clues for β-thalassemia.

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246 dysregulated proteins are detected in plasma of patients with β-thalassemia

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13 potential biomarkers and 27 proteins related to disease progression are found

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Variations in plasma proteome reveal the disease pathophysiological characteristics

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Codons 41/42 -TTCT carriers have higher ferritin levels compared to non-carriers

Periodontal condition of patients with Thalassemia Major: A systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review was to evaluate the existing evidence on the association between Thalassemia major (TM) and periodontal condition.

MATERIALS & METHODS

MEDLINE via OVID, EMBASE, and The Cochrane Database (including the Central Register of Controlled Trials (CENTER)), were searched up to September 2018 to identify observational studies eligible for systematic review and meta-analyses. Newcastle-Ottawa Scale (NOS) was used for quality assessment.

RESULTS

The initial search resulted in 172 articles, and of these, 16 articles were included and a qualitative synthesis was carried out. Based on the quantitative data from 14 studies, significant differences were found in gingival index (GI) (p < 0.001), bleeding on probing (p = 0.02) as well as plaque index (PI) (p < 0.01) measures between TM and systemically healthy controls. Additional analyses (young vs. adult) for GI and PI revealed that such significant differences were only observed in adults, even though overall analysis showed no subgroup effect. The majority of the studies qualified as "intermediate quality".

CONCLUSION

Patients with TM had significantly higher gingival inflammation scores compared to controls. Therefore, routine comprehensive periodontal screening in TM is recommended in order to prevent occurrence of periodontal diseases and eventually reduce the complexity of the oral health care. Also, conduction of further well-designed observational studies is recommended to contribute to this topic.

Sociodemographic profile and oral health status of thalassemic patients attending the National Thalassaemia Centre, Kurunegala, Sri Lanka

AIM

The aim of the present study was to investigate the sociodemographic profile and oral health status (Decayed, Missing, Filled Teeth [DMFT] and periodontal health) of thalassemic patients compared to healthy individuals.

METHODS

The data were collected by means of an interviewer-administered, pretested, and validated questionnaire, followed by oral examination. Patients attending the outpatient department, who were age and sex matched, but without any diagnosed or suspected long-term illnesses, were considered for the control group. Both groups were compared in terms of facial profile, skeletal pattern, facial angles, DMFT, and periodontal health (plaque index, bleeding on probing, and probing pocket depth).

RESULTS

The association of convex facial profile and class II skeletal pattern with Thalassemic status was statistically significant when compared to healthy individuals. Decayed, missing, and filled teeth in the permanent and deciduous dentition, plaque index, and probing pocket depths of the control group were significantly higher compared with the thalassemic group. Surprisingly, 67.8% of thalassemic patients did not show bleeding on probing.

CONCLUSION

Families of the thalassemic patients attending the National Thalassaemia Centre are from a low socioeconomic background. Their DMFT and periodontal health are significantly better than those of healthy individuals.