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Lumbikananda S, Srithanyarat SS, Mattheos N, Osathanon T. Oral Fluid Biomarkers for Peri-Implantitis: A Scoping Review. Int Dent J 2024; 74:387-402. [PMID: 38065782 PMCID: PMC11123564 DOI: 10.1016/j.identj.2023.11.005] [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: 08/06/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 05/18/2024] Open
Abstract
Peri-implantitis, a prevalent complication in dental implant therapy, poses a significant threat to long-term implant success. The identification of reliable biomarkers for the early detection and monitoring of peri-implantitis is crucial for timely intervention and improved treatment outcomes. Salivary and peri-implant sulcular fluid (PISF) biomarkers have become promising diagnostic tools in the field of implant dentistry. This scoping review aims to explore current studies in the literature on salivary and PISF biomarkers for peri-implantitis. A systematic search was conducted on 2 databases (PubMed and Scopus) to identify relevant studies published up to January 2023. A total of 86 articles were included, which underwent data extraction and analysis. Several biomarkers have been investigated in salivary and PISF samples for association with peri-implantitis. Investigations included a wide range of biomarkers, including inflammatory markers, matrix metalloproteinases and bone loss markers. The findings suggested that certain salivary and PISF biomarkers demonstrated potential in distinguishing healthy peri-implant conditions from peri-implantitis. Elevated levels of proinflammatory cytokines, such as interleukin-1β (IL-1β) and interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), and matrix metalloproteinases, have been consistently associated with peri-implantitis. Additionally, alterations in bone loss markers have shown potential as indicators of disease progression and treatment response. In conclusion, this scoping review provides an overview of current knowledge on salivary and PISF biomarkers for peri-implantitis. The identified biomarkers are promising as noninvasive diagnostic tools for early detection, monitoring, and personalised management of peri-implantitis. Future studies should focus on establishing standardised protocols and conducting well-designed clinical trials to validate the diagnostic accuracy and clinical relevance of these biomarkers.
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Affiliation(s)
- Supanat Lumbikananda
- Center of Excellence for Dental Stem Cell Biology and Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Supreda Suphanantachat Srithanyarat
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Center of Excellence for Periodontology and Dental Implants, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Thanaphum Osathanon
- Center of Excellence for Dental Stem Cell Biology and Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Alpaslan NZ, Altindal D, Akbal D, Talmac AC, Keskin Tunc S, Ertugrul AS. Evaluation of the effect of Er,Cr:YSGG laser application on peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand and osteoprotegerin levels in the non-surgical treatment of peri-implantitis: A randomized clinical trial. J Periodontol 2024. [PMID: 38375939 DOI: 10.1002/jper.23-0540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND This study aimed to investigate the effect of erbium, chromium doped:yttrium,scandium,gallium,garnet (Er,Cr:YSGG) laser application combined with non-surgical mechanical debridement (MD) on clinical parameters and peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG) levels in the treatment of peri-implantitis. METHODS A total of 49 patients who underwent non-surgical treatment of peri-implantitis were randomly divided into two groups. The control group (n = 26) received MD alone, while the laser group (n = 23) received MD+Er,Cr:YSGG. The clinical parameters (bleeding on probing [BoP], gingival index [GI], plaque index [PI], probing depth [PD]), marginal bone loss (MBL), and biochemical parameters (RANKL and OPG) were measured at baseline (T0) and 6 months after treatment (T1). RESULTS There was a statistically significant decrease in all the clinical parameters in both groups at T1 compared to T0 (p < 0.05). The BoP, PD, MBL, and RANKL reductions were significantly higher in the laser group than in the control group (p = 0.046, p = 0.014, p = 0.047, p = 0.045, respectively). The OPG levels significantly increased at T1 in the laser group (p = 0.01). The OPG/RANKL ratio increased significantly in both groups at T1, which favored the laser group (p = 0.034). CONCLUSIONS Although both treatment methods were influential in treating peri-implantitis, the laser group (MD+Er,Cr:YSGG) yielded more favorable results by reducing clinical inflammation and improving biochemical parameters. Based on these findings, Er,Cr:YSGG laser may be a beneficial adjunctive treatment in this patient group.
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Affiliation(s)
- Nazli Zeynep Alpaslan
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | - Dicle Altindal
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | | | - Ahmet Cemil Talmac
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | - Serap Keskin Tunc
- Hamidiye Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, University of Health Sciences, Istanbul, Turkey
| | - Abdullah Seckin Ertugrul
- Faculty of Dentistry, Department of Periodontology, Izmir Katip Celebi University, Izmir, Turkey
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Virdee SS, Bashir NZ, Krstic M, Camilleri J, Grant MM, Cooper PR, Tomson PL. Periradicular tissue fluid-derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross-sectional study. Int Endod J 2023; 56:1222-1240. [PMID: 37464545 DOI: 10.1111/iej.13956] [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: 03/15/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Periradicular tissue fluid (PTF) offers a source of diagnostic, prognostic and predictive biomarkers for endodontic disease. AIMS (1) To optimize basic parameters for PTF paper point sampling in vitro for subsequent in vivo application. (2) To compare proteomes of PTF from teeth with normal apical tissues (NAT) and asymptomatic apical periodontitis (AAP) using high-throughput panels. METHODOLOGY (1) To assess volume absorbance, paper points (n = 20) of multiple brands, sizes and sampling durations were inserted into PBS/1%BSA at several depths. Wetted lengths (mm) were measured against standard curves to determine volume absorbance (μL). To assess analyte recovery, paper points (n = 6) loaded with 2 μL recombinant IL-1β (15.6 ng/mL) were eluted into 250 μL: (i) PBS; (ii) PBS/1% BSA; (iii) PBS/0.1% Tween20; (iv) PBS/0.25 M NaCl. These then underwent: (i) vortexing; (ii) vortexing/centrifugation; (iii) centrifugation; (iv) incubation/vortexing/centrifugation. Sandwich-ELISAs determined analyte recovery (%) against positive controls. (2) Using optimized protocols, PTF was retrieved from permanent teeth with NAT or AAP after accessing root canals. Samples, normalized to total fluid volume (TFV), were analysed to determine proteomic profiles (pg/TFV) of NAT and AAP via O-link Target-48 panel. Correlations between AAP and diagnostic accuracy were explored using principal-component analysis (PCA) and area under receive-operating-characteristic curves (AUC [95% CI]), respectively. Statistical comparisons were made using Mann-Whitney U, anova and post hoc Bonferonni tests (α < .01). RESULTS (1) UnoDent's 'Classic' points facilitated maximum volume absorbance (p < .05), with no significant differences after 60 s (1.6 μL [1.30-1.73]), 1 mm depth and up to 40/0.02 (2.2 μL [1.98-2.20]). For elution, vortexing (89.3%) and PBS/1% BSA (86.9%) yielded the largest IL-1β recovery (p < .05). (2) 41 (NAT: 13; AAP: 31) PTF samples proceeded to analysis. The panel detected 18 analytes (CCL-2, -3, -4; CSF-1; CXCL-8, -9; HGF; IL-1β, -6, -17A, -18; MMP-1, -12; OLR-1; OSM; TNFSF-10, -12; VEGF-A) in ≥75% of AAP samples at statistically higher concentrations (p < .01). CXCL-8, IL-1β, OLR-1, OSM and TNFSF-12 were strongly correlated to AAP. 'Excellent' diagnostic performance was observed for TNFSF-12 (AUC: 0.94 [95% CI: 0.86-1.00]) and the PCA-derived cluster (AUC: 0.96 [95% CI: 0.89-1.00]). CONCLUSIONS Optimized PTF sampling parameters were identified in this study. When applied clinically, high-throughput proteomic analyses revealed complex interconnected networks of potential biomarkers. TNFSF-12 discriminated periradicular disease from health the greatest; however, clustering analytes further improved diagnostic accuracy. Additional independent investigations are required to validate these findings.
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Affiliation(s)
- Satnam S Virdee
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | | | - Milan Krstic
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Josette Camilleri
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Melissa M Grant
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Paul R Cooper
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Phillip L Tomson
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
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Gür B, Afacan B, Çevik Ö, Köse T, Emingil G. Gingival crevicular fluid periodontal ligament-associated protein-1, sclerostin, and tumor necrosis factor-alpha levels in periodontitis. J Periodontol 2023; 94:1166-1175. [PMID: 37006132 DOI: 10.1002/jper.22-0750] [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: 12/30/2022] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND In periodontitis, the equilibrium between bone formation and resorption skews in favor of bone loss. Periodontal ligament-associated protein-1 (PLAP-1) and sclerostin play a significant role in the suppression of bone formation. Tumor necrosis factor-alpha (TNF-α) is a central proinflammatory cytokine related to periodontal bone loss. This study aims to assess gingival crevicular fluid (GCF) PLAP-1, sclerostin, and TNF-α levels in individuals with periodontal disease. METHODS Seventy-one individuals diagnosed with generalized stage III grade C periodontitis (n = 23), gingivitis (n = 24), and periodontal health (n = 24) were included in the study. Full-mouth clinical periodontal measurements were performed. PLAP-1, sclerostin, and TNF-α total amounts in GCF were quantified by ELISA. Nonparametric methods were used for the data analyses. RESULTS Periodontitis group exhibited significantly higher GCF PLAP-1, sclerostin and TNF-α levels compared with gingivitis and periodontally healthy groups (p < 0.05). GCF PLAP-1 and TNF-α levels of gingivitis group were higher than healthy controls (p < 0.05) whereas GCF sclerostin levels were similar in two groups (p > 0.05). Significant positive correlations were found between GCF PLAP-1, sclerostin and TNF-α levels and all clinical parameters (p < 0.01). CONCLUSIONS To our knowledge, this is the first study showing GCF PLAP-1 levels in periodontal health and disease. Increased GCF PLAP-1 and sclerostin levels and their correlations with TNF-α in periodontitis imply that those molecules might be involved in the pathogenesis of periodontal disease. Further studies in larger mixed cohorts are needed to enlighten the possible role of PLAP-1 and sclerostin in periodontal bone loss.
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Affiliation(s)
- Berkay Gür
- Department of Periodontology, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey
| | - Beral Afacan
- Department of Periodontology, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey
| | - Özge Çevik
- Department of Biochemistry, School of Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, İzmir Ege University, İzmir, Turkey
| | - Gülnur Emingil
- Department of Periodontology, Faculty of Dentistry, İzmir Ege University, İzmir, Turkey
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Oliveira JA, de Oliveira Alves R, Nascimento IM, Hidalgo MAR, Scarel-Caminaga RM, Cristina Pigossi S. Pro- and anti-inflammatory cytokines and osteoclastogenesis-related factors in peri-implant diseases: systematic review and meta-analysis. BMC Oral Health 2023; 23:420. [PMID: 37355561 PMCID: PMC10290807 DOI: 10.1186/s12903-023-03072-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/23/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Pro- and anti-inflammatory cytokines are acknowledged, during inflammatory bone destruction, as key regulators of osteoclast and osteoblast differentiation and activity. However, evidence regarding the exact role of pro- and anti-inflammatory cytokines and osteoclastogenesis-related factors in peri-implant diseases is unclear. We aimed to execute a systematic review and meta-analysis about the pro- and anti-inflammatory cytokines and osteoclastogenesis-related factors levels in peri-implant diseases. METHODS The focused question was elaborated to summarize the levels of pro-and anti-inflammatory cytokines and osteoclastogenesis-related factors in tissue samples (mRNA) and biofluids (protein levels) of patients with/without peri-implant diseases. Electronic searches of the PubMed, Cochrane Controlled Trials Registry, Web of Science, EMBASE, Scopus and Google scholar databases were conducted for publications up to March 2023. Meta-analysis evaluating the mediator´s levels (protein levels by ELISA) in peri-implant crevicular fluid (PICF) were made. The effect size was estimated and reported as the mean difference. The 95% confidence interval was estimated for each mediator, and the pooled effect was determined significant if two-sided p-values < 0.05 were obtained. RESULTS Twenty-two publications were included in the systematic review (qualitative analysis), with nine of these subjected to meta-analyses (quantitative analysis). In the qualitative analysis, higher pro-inflammatory cytokines [Interleukin (IL)-1β, IL-6] and pro-osteoclastogenic mediator [Receptor Activator of Nuclear Factor-Kappa B ligand (RANKL)] levels were observed in PICF of individuals with peri-implant diseases in comparison to healthy individuals. Higher RANKL/osteoprotegerin (OPG) ratios were observed in PICF from individuals with peri-implant diseases in comparison to healthy individuals. Meta-analysis showed higher RANKL levels in diseased groups compared to controls. CONCLUSIONS The results showed that the levels of IL-1β, IL-6, IL-10, and RANKL/OPG are not balanced in peri-implant disease, suggesting that these mediators are involved in the host osteo-immunoinflammatory response related to peri-implantitis.
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Affiliation(s)
- Jovânia Alves Oliveira
- School of Dentistry, Alfenas Federal University (Unifal-MG), Alfenas, Minas Gerais Brazil
| | - Roberta de Oliveira Alves
- Department of Periodontology, School of Dentistry, School of Dentistry, Federal University of Uberlândia - UFU, Umuarama Campus, Bloco UMU4L, Pará Avenue, Uberlândia, Minas Gerais 1720, 38405-320 Brazil
| | | | - Marco Antonio Rimachi Hidalgo
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, (FOAr/UNESP), UNESP- São Paulo State University, Araraquara, São Paulo, Brazil
| | - Raquel Mantuaneli Scarel-Caminaga
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, (FOAr/UNESP), UNESP- São Paulo State University, Araraquara, São Paulo, Brazil
| | - Suzane Cristina Pigossi
- Department of Periodontology, School of Dentistry, School of Dentistry, Federal University of Uberlândia - UFU, Umuarama Campus, Bloco UMU4L, Pará Avenue, Uberlândia, Minas Gerais 1720, 38405-320 Brazil
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Ashifa N, Viswanathan K, Srinivasan S, Kumar S, Sundaram R, Pavithran VK. Assessment of sclerostin levels in the gingival crevicular fluid of patients with periodontitis: A clinico-biochemical crosssectional study. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2023; 15:3-9. [PMID: 37645545 PMCID: PMC10460775 DOI: 10.34172/japid.2023.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/17/2023] [Indexed: 08/31/2023]
Abstract
Background Sclerostin, a glycoprotein, plays a key role in regulating bone mass. In this study, sclerostin levels in the gingival crevicular fluid (GCF) were assessed in patients with Stage III Grade C generalized periodontitis (SIII-GC) and Stage III Grade B generalized periodontitis (SIII-GB). Methods This cross-sectional study included 30 participants divided equally into three groups: group I (gingival health), group II (SIII-GC), and group III (SIII-GB). Clinical periodontal parameters like plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PD), and clinical attachment level (CAL) were recorded. A sandwich ELISA was used to determine the sclerostin levels in GCF samples. One-way ANOVA and post hoc Tukey tests were used to analyze the clinical parameters and GCF sclerostin levels. The association between GCF sclerostin levels and periodontal parameters was assessed using Pearson's correlation coefficient (r). Results Patients in groups II and III had much higher sclerostin levels in their GCF than in group I (P≤0.05). In contrast, no significant difference in sclerostin levels was observed between the two diseased conditions (P=0.841). Concerning periodontal parameters, a statistically significant difference was observed between the three groups. There was a positive correlation between the periodontal clinical parameters and the expression levels of sclerostin in GCF (P≤0.05). Conclusion Increased expression of sclerostin in GCF in patients with periodontitis indicated that it could be considered a reliable biomarker of periodontal disease activity.
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Affiliation(s)
- Nisha Ashifa
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Krishnan Viswanathan
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Sivapragasam Srinivasan
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Senthil Kumar
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Rajasekar Sundaram
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Varsha K Pavithran
- Department of Public Health Dentistry, Rajah Muthiah Dental College & Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
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Fragkioudakis I, Kallis A, Kesidou E, Damianidou O, Sakellari D, Vouros I. Surgical Treatment of Peri-Implantitis Using a Combined Nd: YAG and Er: YAG Laser Approach: Investigation of Clinical and Bone Loss Biomarkers. Dent J (Basel) 2023; 11:dj11030061. [PMID: 36975558 PMCID: PMC10046921 DOI: 10.3390/dj11030061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/13/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023] Open
Abstract
The current study aimed to investigate the effect of the combined Nd-Er: YAG laser on the surgical treatment of peri-implantitis by evaluating clinical markers and biomarkers of bone loss (RANKL/OPG). Twenty (20) patients having at least 1 implant diagnosed with peri-implantitis were randomly assigned to two groups for surgical treatment. In the test group (n = 10), Er: YAG laser was used for granulation tissue removal and implant surface decontamination, while Nd: YAG laser was employed for deep tissue decontamination and biomodulation. In the control group (n = 10), an access flap was applied, and mechanical instrumentation of the implant surface was performed by using titanium curettes. The following clinical parameters were evaluated at baseline and six months after treatment: Full-mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Probing Attachment Levels (PAL), recession (REC), and Bleeding on probing (BoP). Peri-implant crevicular fluid (PICF) was collected at baseline and six months for the evaluation of soluble RANKL and OPG utilizing enzyme-linked immunosorbent assay (ELISA). Baseline clinical values were similar for both groups, with no statistical differences between them. The study results indicated statistically significant improvements in the clinical parameters during the 6-month observation period in both groups. More specifically, PPD, PAL, and REC were improved in the test and control groups with no differences in the between-groups comparisons. However, a greater reduction in the BoP-positive sites was noted for the laser group (Mean change 22.05 ± 33.92 vs. 55.00 ± 30.48, p = 0.037). The baseline and six-month comparisons of sRANKL and OPG revealed no statistically significant differences between the two groups. The combined Nd: YAG—Er: YAG laser surgical therapy of peri-implantitis seemed to lead to more favorable improvements in regard to bleeding on probing six months after treatment compared to the conventional mechanical decontamination of the implant surface. None of the methods was found superior in the modification of bone loss biomarkers (RANKL, OPG) six months after treatment.
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Affiliation(s)
- Ioannis Fragkioudakis
- Department of Preventive Dentistry Periodontology and Implant Biology, Dental Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: (I.F.); (I.V.)
| | - Antonios Kallis
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Thivon 2 Str., Goudi, 11527 Athens, Greece
| | - Evangelia Kesidou
- 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Olympia Damianidou
- 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry Periodontology and Implant Biology, Dental Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis Vouros
- Department of Preventive Dentistry Periodontology and Implant Biology, Dental Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: (I.F.); (I.V.)
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Banu Raza F, Vijayaragavalu S, Kandasamy R, Krishnaswami V, Kumar V A. Microbiome and the inflammatory pathway in peri-implant health and disease with an updated review on treatment strategies. J Oral Biol Craniofac Res 2023; 13:84-91. [PMID: 36504486 PMCID: PMC9730223 DOI: 10.1016/j.jobcr.2022.11.005] [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: 03/12/2022] [Revised: 08/30/2022] [Accepted: 11/25/2022] [Indexed: 12/04/2022] Open
Abstract
Crestal bone preservation around the dental implant for aesthetic and functional success is widely researched and documented over a decade. Several etiological factors were put forth for crestal bone loss; of which biofilm plays a major role. Biofilm is formed by the colonization of wide spectra of bacteria inhabited around dental implants. Bacterial adherence affects the regulators of bone growth and an early intervention preserves the peri-implant bone. Primary modes of therapy stated in early literature were either prevention or treatment of infection caused by biofilm. This narrative review overviews the microbiome during different stages of peri-implant health, the mechanism of bone destruction, and the expression of the biomarkers at each stage. Microbial contamination and the associated biomarkers varied depending on the stage of peri-implant infection. The comprehensive review helps in formulating a research plan, both in diagnostics and treatment aspects in improving peri-implant health.
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Key Words
- Antibiotics
- Biomarkers
- CD14, Cluster of Differentiation 14
- CSF, Colony-Stimulating Factor
- Gene expression
- IL, Interleukins
- MMP 8, Matrix MetalloProteinase 8
- Microbiota
- OPG, Osteoprotegerin
- PSMB 2, Proteasome subunit beta type-2
- Peri-implant
- RANK, Receptor Activator of Nuclear factor Kappa-Β
- RANKL, Receptor Activator of Nuclear factor Kappa-ΒLigand
- TIMP, Tissue inhibitor of Metalloproteinase
- TNF, Tumor Necrosis Factor
- TWEAK, TNF-related weak inducer of apoptosis
- VEGF, Vascular Endothelial Growth Factor
- sRANKL, soluble Receptor Activator of Nuclear Factor-κB Ligand
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Affiliation(s)
- Fathima Banu Raza
- Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | | | - Ruckmani Kandasamy
- Centre for Excellence in Nanobio Translational REsearch (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
| | - Venkateshwaran Krishnaswami
- Centre for Excellence in Nanobio Translational REsearch (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
| | - Anand Kumar V
- Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
- Corresponding author. Department of Prosthodontics, Faculty of Dental Sciences, SRIHER (DU), Porur, Chennai, Tamil Nadu, India.
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Muacevic A, Adler JR, Eguia A. On Peri-Implant Bone Loss Theories: Trying To Piece Together the Jigsaw. Cureus 2023; 15:e33237. [PMID: 36733558 PMCID: PMC9890078 DOI: 10.7759/cureus.33237] [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] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
This review aims to explore the plausibility of new theories on the etiopathogenesis of marginal bone loss (MBL) and peri-implantitis (PI) and to discuss possible underlying pathogenic mechanisms. The former concept of osteointegration of dental implants can now be conceptualized as a foreign body response histologically characterized by a bony demarcation in combination with chronic inflammation. Different risk factors can provoke additional inflammation and, therefore, pro-inflammatory cytokine release in soft tissues and bone, leading to an overpass of the threshold of peri-implant bone defensive and regenerative capacity. Progressive bone loss observed in MBL and PI is ultimately due to a localized imbalance in the receptor activator of nuclear factor kappaB ligand (RANKL)/Receptor activator of nuclear factor κ B (RANK)/osteoprotegerin (OPG) pathway in favor of increased catabolic activity. The genetic background and the severity and duration of the risk factors could explain differences between individuals in the threshold needed to reach an imbalanced scenario. MBL and PI pathogenesis could be better explained by the "inflammation-immunological balance" theory rather than a solely "infectious disease" conception. The link between the effect of biofilm and other risk factors leading to an imbalanced foreign body response lies in osteoclast differentiation and activation pathways (over)stimulation.
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Yilmaz M, Demir E, Gürsoy M, Firatli E, Gürsoy UK. Baseline interleukin-10, CD163, and tumor necrosis factor-like weak inducer of apoptosis (TWEAK) gingival tissue levels in relation to clinical periodontal treatment outcomes: A 12-week follow-up study. J Periodontol 2023; 94:141-154. [PMID: 35819128 PMCID: PMC10087717 DOI: 10.1002/jper.22-0242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/09/2022] [Accepted: 07/05/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study was to examine the relationship between healing response after non-surgical periodontal treatment and baseline gingival tissue levels of M2 macrophage activation-related proteins CD163, interleukin (IL)-10, interferon (IFN)-γ, and tumor necrosis factor-like weak inducer of apoptosis (TWEAK), and the CD163/TWEAK ratio. METHODS Eighty-eight gingival tissue samples from 44 Stage III/IV, Grade C periodontitis patients (18 smokers) and 41 tissue samples from 41 periodontally healthy participants (18 smokers) were evaluated. Clinical parameters were recorded in periodontally healthy individuals at baseline and in periodontitis patients at pre-treatment and 2, 6, and 12 weeks following therapy. IL-10, IFN-γ, CD163, and TWEAK levels were analyzed with Luminex technique. RESULTS Tissue levels (median, 1st -3rd quartile) of IL-10 (pg/ng protein), CD163 (pg/μg protein) and TWEAK (pg/μg protein) were as follows: IL-10 periodontitis: 2.08, 0.86-5.32 and periodontally healthy: 5.22, 3.20-10.25; CD163 periodontitis: 8.85, 4.92-14.06 and periodontally healthy: 18.36, 12.51-34.02; TWEAK periodontitis: 0.08, 0.05-0.11 and periodontally healthy: 0.16, 0.12-0.21. IL-10, CD163, and TWEAK levels were higher (P < 0.001) in periodontally healthy tissues than in periodontitis tissues. Pocket closure at 12 weeks was associated with elevated baseline gingival CD163 levels (P = 0.047) and CD163/TWEAK ratio (P = 0.001). Elevated baseline gingival CD163/TWEAK ratio was associated with pocket reduction at 6 (P = 0.022) and 12 weeks (P = 0.002). CONCLUSION Associations of pocket closure with pre-treatment gingival tissue CD163 levels and CD163/TWEAK ratio indicate that baseline M2 macrophage activation profile may play a role in periodontal wound healing.
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Affiliation(s)
- Mustafa Yilmaz
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland.,Department of Periodontology, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Esra Demir
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Mervi Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland.,Oral Health Care, Welfare Division, City of Turku, Turku, Finland
| | - Erhan Firatli
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Ulvi Kahraman Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
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11
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Molecular Biomarkers in Peri-Implant Health and Disease: A Cross-Sectional Pilot Study. Int J Mol Sci 2022; 23:ijms23179802. [PMID: 36077204 PMCID: PMC9456434 DOI: 10.3390/ijms23179802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of this feasibility study was to investigate the concentration level of CCL-20/MIP-3α, BAFF/BLyS, IL-23, RANKL, and Osteoprotegerin in the Peri-Implant Crevicular Fluid (PICF), from patients diagnosed with peri-implant mucositis and peri-implantitis, and to compare them with PICF from patients with healthy implants. Methods: Participants with at least one dental implant with healthy peri-implant tissues, peri-implant mucositis, or peri-implantitis were included. PICF was collected using paper strips from healthy and diseased peri-implant sites (n = 19). Biomarker levels were analyzed using a custom Multiplex ELISA Assay Kit. Results: In comparison to peri-implant health, the peri-implant mucositis group showed an increased concentration of CCL-20 MIP-3α, BAFF/BLyS, IL-23, RANKL, and Osteoprotegerin. The peri-implantitis group had the lowest median concentration of Osteoprotegerin (1963 ng/mL); this group had a similar concentration of RANKL (640.84 ng/mL) when compared to the peri-implant health group. BAFF/BLyS (17.06 ng/mL) showed the highest concentration in the peri-implantitis group. Conclusions: This feasibility study suggests that IL-23 and RANKL may help to elucidate the pathogenesis during the conversion from peri-implant health to peri-implantitis. Further research is required in BAFF/BLyS for the early diagnosis of peri-implantitis.
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12
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Liao C, Liang S, Wang Y, Zhong T, Liu X. Sclerostin is a promising therapeutic target for oral inflammation and regenerative dentistry. J Transl Med 2022; 20:221. [PMID: 35562828 PMCID: PMC9102262 DOI: 10.1186/s12967-022-03417-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
Sclerostin is the protein product of the SOST gene and is known for its inhibitory effects on bone formation. The monoclonal antibody against sclerostin has been approved as a novel treatment method for osteoporosis. Oral health is one of the essential aspects of general human health. Hereditary bone dysplasia syndrome caused by sclerostin deficiency is often accompanied by some dental malformations, inspiring the therapeutic exploration of sclerostin in the oral and dental fields. Recent studies have found that sclerostin is expressed in several functional cell types in oral tissues, and the expression level of sclerostin is altered in pathological conditions. Sclerostin not only exerts similar negative outcomes on the formation of alveolar bone and bone-like tissues, including dentin and cementum, but also participates in the development of oral inflammatory diseases such as periodontitis, pulpitis, and peri-implantitis. This review aims to highlight related research progress of sclerostin in oral cavity, propose necessary further research in this field, and discuss its potential as a therapeutic target for dental indications and regenerative dentistry.
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Affiliation(s)
- Chufang Liao
- School of Stomatology, Jinan University, Guangzhou, China.,Clinical Research Platform for Interdiscipline of Stomatology, Jinan University, Guangzhou, China.,Department of Stomatology Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shanshan Liang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Prosthodontics, Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yining Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Prosthodontics, Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Ting Zhong
- School of Stomatology, Jinan University, Guangzhou, China.,Clinical Research Platform for Interdiscipline of Stomatology, Jinan University, Guangzhou, China.,Department of Stomatology Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiangning Liu
- School of Stomatology, Jinan University, Guangzhou, China. .,Clinical Research Platform for Interdiscipline of Stomatology, Jinan University, Guangzhou, China. .,Department of Stomatology Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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13
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Yiğit U, Kırzıoğlu FY, Özmen Ö. Effects of low dose doxycycline and caffeic acid phenethyl ester on sclerostin and bone morphogenic protein-2 expressions in experimental periodontitis. Biotech Histochem 2022; 97:567-575. [PMID: 35135409 DOI: 10.1080/10520295.2022.2036370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
We investigated the effects of caffeic acid phenethyl ester (CAPE) and low-dose doxycycline (LDD) on sclerostin and bone morphogenic protein (BMP)-2 expression in experimental periodontitis. We used male rats in groups as follows: control group (C), periodontitis + CAPE group (PC), periodontitis + LDD group (PD), periodontitis + LDD + CAPE group (PCD) and periodontitis group (P). We administered 10 µmol/kg/day CAPE by an intraperitoneal (i.p.) injection and 10 mg/kg/day LDD by oral gavage. Histopathological changes among groups were evaluated and compared. Sclerostin and BMP-2 expression was analyzed using immunohistochemistry. LDD and/or CAPE treatment ameliorated pathology. The highest sclerostin and lowest BMP-2 expressions were found in P group. Group PC exhibited the highest BMP-2 expression scores and the most significant improvement among the treatment groups. The lowest sclerostin expression was observed in the PD group. We found that preventing sclerostin activity may be a useful treatment alternative for bone resorption, especially in cases of periodontitis and peri-implantitis. We found that CAPE and/or LDD may act as anti-sclerostin agents.
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Affiliation(s)
- Umut Yiğit
- Department of Periodontology, Faculty of Dentistry, Uşak University, Uşak, Turkey
| | - Fatma Yeşim Kırzıoğlu
- Department of Periodontogy, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
| | - Özlem Özmen
- Department of Pathology, Faculty of Veterinary Medicine, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
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14
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Gur AT, Guncu GN, Akman AC, Pinar A, Karabulut E, Nohutcu RM. Evaluation of GCF IL-17, IL-10, TWEAK and sclerostin levels after SRP and adjunctive use of diode laser application in periodontitis patients. J Periodontol 2021; 93:1161-1172. [PMID: 34962665 DOI: 10.1002/jper.21-0494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/23/2021] [Accepted: 12/19/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate the clinical efficacy of the diode laser as an adjunct to scaling and root planing (SRP) and also determine the biochemical profile by evaluating the gingival crevicular fluid (GCF) levels of interleukin (IL)-17, IL-10, TNF-related weak inducer of apoptosis (TWEAK) and sclerostin. METHODS A total of 40 systemically healthy, stage III periodontitis patients were included in this randomized controlled study. Participants were randomly divided into two groups as scaling root planning (SRP) + diode laser(L) (0.80W power, 940nm wavelength and 0.80J/s energy level) and only SRP group. Recording of periodontal parameters and collecting GCF samples were performed at baseline, 1st and 3rd months. Biomarker levels in GCF were measured with ELISA . RESULTS At baseline, no significant difference was detected between groups in terms of both clinical and biochemical parameters. All biochemical parameters (except for IL-10 in control group), presented a statistically significant difference for 3 months study period in both groups. When laser and control groups were compared, significant differences were not observed, except the lower GCF IL-17 levels (p = 0.025), bleeding on probing (p = 0.028) and clinical attachment level (CAL) (p = 0.0002) values in laser group at 3rd , 1st and 3rd months, respectively. Statistically significant correlations were also noted between biochemical parameters and clinical parameters. CONCLUSION The GCF IL-17, TWEAK and sclerostin levels may be useful for monitoring response to SRP+L therapy. However, long-term studies on higher populations are needed to evaluate the effectiveness of adjunctive use of diode laser application to SRP. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ali Tugrul Gur
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Guliz N Guncu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Abdullah C Akman
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Asli Pinar
- Department of Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rahime M Nohutcu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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15
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WNT-5a and SOST Levels in Gingival Crevicular Fluid Depend on the Inflammatory and Osteoclastogenic Activities of Periodontal Tissues. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57080788. [PMID: 34440994 PMCID: PMC8399934 DOI: 10.3390/medicina57080788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 12/15/2022]
Abstract
Background and Objectives: Wnt signaling leads to stimulation of osteoblasts and it reduces osteoclastogenesis and bone resorption via the regulation of the osteprotegrin and receptor activator of nuclear factor kappa-Β ligan (RANKL). Wnt signaling pathways are regulated by their physiological antagonists such as sclerostin (SOST) as well as WNT-5a. The aim of this study was to determine the total amount of Sclerostin and WNT-5a in the gingival crevicular fluid (GCF) in sites with a continuum from a healthy to diseased periodontium. Materials and Methods: In this cross-sectional study, a total of 20 patients with generalized periodontitis, 10 subjects with gingivitis as well as 14 individuals with a healthy periodontium were recruited upon clinical and radiographic periodontal examination. In patients diagnosed with periodontitis, GCF samples were collected from periodontitis, gingivitis and healthy sites, while gingivitis patients provided samples from gingivitis and healthy sites. In healthy patients, only healthy sites were sampled. Protein total amount of SOST and WNT-5a were quantified by sandwich enzyme-linked immunosorbent assay (ELISA). Results: A total of 108 GCF samples were collected from a total of 44 individuals. When all periodontitis (n = 51), gingivitis (n = 12) and healthy (n = 45) sites were analyzed regardless of the patient diagnosis, periodontitis sites demonstrated significantly elevated WNT-5a total amounts (p = 0.03) when compared to gingivitis sites. Gingivitis sites demonstrated a trend of more total SOST (p = 0.09) when compared to periodontitis and healthy sites. Within each patient diagnostic category, sites showed similar SOST and WNT-5a total amounts (p > 0.05). Conclusions: WNT-5a levels in GCF depend on the stage of periodontitis sites. SOST trended higher in the GCF of gingivitis sites but similar in chronic periodontitis and healthy sites. WNT-5a and SOST play a crucial role in periodontal tissue remodeling and depend on the inflammatory and osteoclastogenic activities.
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16
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Theodoridis C, Doulkeridou C, Menexes G, Vouros I. Comparison of RANKL and OPG levels in peri-implant crevicular fluid between healthy and diseased peri-implant tissues. A systematic review and meta-analysis. Clin Oral Investig 2021; 26:823-836. [PMID: 34264378 DOI: 10.1007/s00784-021-04061-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/28/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To assess RANKL and OPG levels, as well as RANKL/OPG ratio, in peri-implant crevicular fluid (PICF), in dental implants presenting peri-implantitis (PI) in comparison to healthy implants (H) and to implants with peri-implant mucositis (MU). MATERIALS AND METHODS An electronic search based on the PICO framework, supplemented by hand searching, was conducted in MEDLINE and EMBASE, using the Ovid interface from 1996 up to and including the 17th of December 2019 in order to identify relevant clinical studies. A combination of MeSH terms and text words was utilized for this purpose. Sequential screenings at the title, abstract, and full-text levels were performed independently and in duplicate. A random-effects meta-analysis was conducted and mean value standardized differences, between PI and H groups, were utilized as effect sizes. RESULTS Out of 1961 titles, which were revealed by the search strategy, 11 articles fulfilled the inclusion criteria and were incorporated in the systematic review. Meta-analytical processing was performed for RANKL (4 articles), OPG (5 articles), and RANKL/OPG ratio (5 articles) in PI and H groups. The total effect for RANKL mean differences between PI and H groups indicated a tendency but not a statistical significance (P = 0.078) in favor of the PI group, while no statistically significant differences were found for OPG and the ratio levels in the examined groups. CONCLUSIONS There is limited evidence that levels of the examined biomarkers, RANKL, and OPG as well as the RANKL/OPG ratio, in PICF, may be considered strong indicators for distinguishing between healthy and inflamed peri-implant sites. CLINICAL RELEVANCE Biomarker identification in PICF, which could differentiate between healthy and diseased dental implants, might represent a valuable non-invasive method suitable for implant pathology and implant therapy prognosis.
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Affiliation(s)
- C Theodoridis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.,Cretan District Health Directorate, Agia Foteini Health Center, Rethymnon, Greece
| | - C Doulkeridou
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - G Menexes
- Laboratory of Agronomy, School of Agriculture, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Vouros
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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17
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Systematic review of ratios between disease /health periodontitis modulators and meta-analysis of their levels in gingival tissue and biological fluids. Arch Oral Biol 2021; 127:105147. [PMID: 34044319 DOI: 10.1016/j.archoralbio.2021.105147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/03/2021] [Accepted: 05/08/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The ratio between molecules which acts towards the diseased or healthy phenotype determine whether the periodontitis lesions will progress or stabilize. Considering gingival tissue and biofluids, we aimed to present a systematic review (qualitative analysis) on the ratios between disease/health periodontitis modulators, and a meta-analysis (quantitative analysis) of their levels in individuals with periodontitis compared to controls. DESIGN Electronic searches of the PubMed, Scopus, EMBASE and Web of Science databases were conducted for publications up to May 2020. RESULTS A total of 53 publications were included in the systematic review, being 22 of them focusing on the ratios between Interleukin [IL]-1/IL-10, IL-6/IL-10, IL-1/IL-1RA and RANKL/OPG. Twenty-one publications were eligible for meta-analyses. The ratios of IL-1, IL-6 and RANKL mRNA levels were significantly higher in diseased gingival tissue, as well as their protein levels in gingival crevicular fluid (GCF) of periodontitis individuals. Considering the saliva levels, the RANKL/OPG ratio was higher in periodontitis subjects in comparison to controls. Meta-analyses showed higher IL-1β, IL-1α, IL-6 and IL-10 gene expressions in gingival tissue and protein levels in GCF, while RANKL was higher in GCF of periodontitis individuals in comparison to controls. CONCLUSIONS Both the ratios and meta-analyses showed higher levels of modulators in gingival tissue and GCF of diseased individuals.
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18
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Ashifa N, Viswanathan K, Sundaram R, Srinivasan S. Sclerostin and its role as a bone modifying agent in periodontal disease. J Oral Biosci 2021; 63:104-110. [PMID: 33878470 DOI: 10.1016/j.job.2021.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Periodontitis is a highly prevalent inflammatory disease affecting the periodontium that results from an imbalance between periodontopathogens and host mechanisms. Continuous progression of the disease may lead to tissue and bone destruction, eventually resulting in tooth loss. The extent of bone loss depends on the dysregulated host immune response. Various host-elicited molecules play a major role in disease progression. The discovery of the glycoprotein sclerostin and its role as a regulator of bone mass has led to a better understanding of bone metabolism. HIGHLIGHT Sclerostin, which is primarily expressed by osteocytes, is a negative regulator of bone formation. It is a potent antagonist of the canonical Wingless-related integration site (Wnt) pathway, which is actively involved in bone homeostasis. Sclerostin is known to stimulate bone resorption by altering the osteoprotegerin (OPG)/receptor activator of nuclear factor kappa- β ligand (RANKL) balance. Additionally, in periodontitis, activation of the inflammatory cascade also increases the synthesis of sclerostin. CONCLUSION The recently discovered sclerostin antibody has emerged as a positive therapeutic tool for the treatment of metabolic bone diseases. It has been reported to improve bone strength, bone formation, osseointegration around implants and lower the risk of bone fractures in various animal and human models. This review describes the properties and action of sclerostin, its role in periodontal diseases, and the advent and efficacy of sclerostin antibodies.
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Affiliation(s)
- Nisha Ashifa
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Annamalai Nagar, Chidambaram, 608002, Tamil Nadu, India.
| | - Krishnan Viswanathan
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Annamalai Nagar, Chidambaram, 608002, Tamil Nadu, India.
| | - Rajasekar Sundaram
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Annamalai Nagar, Chidambaram, 608002, Tamil Nadu, India.
| | - Sivapragasam Srinivasan
- Department of Periodontology, Rajah Muthiah Dental College & Hospital, Annamalai University, Annamalai Nagar, Chidambaram, 608002, Tamil Nadu, India.
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Jansson L, Lundmark A, Modin C, Abadji D, Yucel-Lindberg T. Intra-individual cytokine profile in peri-implantitis and periodontitis: A cross-sectional study. Clin Oral Implants Res 2021; 32:559-568. [PMID: 33595852 DOI: 10.1111/clr.13725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 12/27/2020] [Accepted: 01/27/2021] [Indexed: 12/19/2022]
Abstract
AIM To study cytokine profiles and intra-individual correlations in crevicular fluid samples at periodontitis, peri-implantitis, and healthy sites. MATERIALS AND METHODS Samples from gingival crevicular fluid (GCF) and peri-implant crevicular fluid (PICF) were collected from healthy and diseased sites in patients who had had dental implants for a minimum of 10 years. Cytokine levels were analyzed using the Bio-Plex Pro Human inflammation kit, which included biomarkers for the tumor necrosis factor-α (TNF-α) superfamily, regulatory T Cell (Treg) cytokines, and interferon (IFN) proteins. RESULTS Gingival crevicular fluid/PICF cytokine levels, determined in samples from 163 patients, were frequently lower for healthy tooth and implant sites compared to sites with periodontitis or peri-implantitis. In contrast, there were no significant differences in cytokine levels between peri-implant sites and periodontitis sites. Intra-individual correlations between cytokines at peri-implant sites were frequently significant. In addition, the cytokines IFN-λ1 and TNFSF12 were significantly correlated with the presence of peri-implantitis. CONCLUSION Within the limits of this study, the intra-individual cytokine profile did not differ between sites diagnosed with periodontitis and those diagnosed with peri-implantitis, but did differ between healthy tooth and healthy implant sites. Studying intra-individual cytokine profiles is a method to elucidate possible differences between the etiopathogeneses of periodontitis and peri-implantitis, since it is well known that immune responses to dysbiosis vary between individuals according to host factors. Thus, the findings of the present study are potentially relevant to the advancement of knowledge in this field.
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Affiliation(s)
- Leif Jansson
- Department of Periodontology, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Lundmark
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carolina Modin
- Department of Periodontology, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Denise Abadji
- Department of Periodontology, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden
| | - Tülay Yucel-Lindberg
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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20
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Kensara A, Hefni E, Williams MA, Saito H, Mongodin E, Masri R. Microbiological Profile and Human Immune Response Associated with Peri-Implantitis: A Systematic Review. J Prosthodont 2020; 30:210-234. [PMID: 33016381 DOI: 10.1111/jopr.13270] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate and synthesize the existing evidence on the microbiological and human immune response associated with peri-implantitis in comparison to healthy implants. MATERIALS AND METHODS Three electronic databases (MEDLINE, Embase, and Cochrane Library) were searched in October 2019 to identify clinical studies evaluating the microbiota and the immune response associated with peri-implantitis. Two reviewers independently screened the studies and used the full text to extract the data. A qualitative synthesis was performed on the extracted data and summary tables were prepared. Due to clinical and methodological heterogeneity among included studies, no meta-analysis was performed. RESULTS Forty studies were included in this review. Of these, 20 studies compared the microbiological profile of peri-implantitis with healthy implants. Nineteen studies focused on the immune response associated with peri-implantitis in comparison to healthy implants. Three studies focus on gene polymorphism associated with peri-implantitis. The most commonly reported bacteria associated with peri-implantitis were obligate anaerobe Gram-negative bacteria (OAGNB), asaccharolytic anaerobic Gram-positive rods (AAGPRs), and other Gram-positive species. In regard to immune response, the most frequently reported pro-inflammatory mediators associated with peri-implantitis were IL-1β, IL-6, IL-17, TNF-α. Osteolytic mediator, e.g., RANK, RANKL, Wnt5a and proteinase enzymes, MMP-2, MMP-9, and Cathepsin-K were also expressed at higher level in peri-implantitis sites compared to control. CONCLUSIONS Peri-implantitis is associated with complex and different microbiota than healthy implants including bacteria, archaea, fungi, and virus. This difference in the microbiota could provoke higher inflammatory response and osteolytic activity. All of this could contribute to the physiopathology of peri-implantitis.
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Affiliation(s)
- Anmar Kensara
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD.,Department of Restorative Dentistry, College of Dentistry, Umm Al Qura University, Makkah, Saudi Arabia.,Institute for Genome Sciences, School of Medicine, University of Maryland, Baltimore, MD
| | - Eman Hefni
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD.,Department of Basic and Clinical Oral Sciences, College of Dentistry, Umm Al Qura University, Makkah, Saudi Arabia
| | - Mary Ann Williams
- Health Sciences & Human Services Library, School of Dentistry, University of Maryland, Baltimore, MD
| | - Hanae Saito
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD
| | - Emmanuel Mongodin
- Institute for Genome Sciences, School of Medicine, University of Maryland, Baltimore, MD
| | - Radi Masri
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD
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Effects of orthodontic forces on bone turnover biomarkers in peri-miniscrew crevicular fluid: A systematic review. Int Orthod 2020; 18:403-411. [DOI: 10.1016/j.ortho.2020.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 11/19/2022]
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Zhong W, Peng Y, Yue E, Huang B, Zhang W, Zhao Z, Jiang J, Wang Q, Zhao H. Gingival crevicular fluid levels of SLIT3 are increased in periodontal disease. Oral Dis 2019; 26:182-192. [PMID: 31696592 DOI: 10.1111/odi.13227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 12/01/2022]
Abstract
This study aims to investigate the levels of SLIT3 in gingival crevicular fluid (GCF) of healthy and periodontal disease subjects, and their correlations to periodontal disease. A total of 45 periodontal patients and 45 periodontally healthy volunteers were enrolled. The clinical parameters, radiographic bone loss and the levels of SLIT3, receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) in GCF were measured. The prevalences of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in subgingival plaque were also analyzed. The expression of SLIT3 and RANKL was detected in the periodontium of experimental periodontitis in rats and lipopolysaccharide (LPS)-induced mouse macrophage. The total amounts and concentrations of SLIT3 and RANKL were significantly higher in periodontitis than those in healthy, while the level of OPG was significantly lower (p < .05). Significant positive correlations were observed between the level of GCF SLIT3 and clinical attachment level and radiographic bone loss (p < .05). There existed a significant positive correlation between SLIT3 and RANKL (p < .05). Increased expression of SLIT3 and RANKL was observed in the periodontium of periodontal rats. SLIT3 expression was induced by LPS stimulation in macrophages. These results suggest that SLIT3 may act as a diagnostic indicator of periodontal disease and should be further investigated.
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Affiliation(s)
- Wei Zhong
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Youmei Peng
- Henan Key Laboratory for Pharmacology of Liver Diseases, Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Erli Yue
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bin Huang
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Zhang
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhe Zhao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinhua Jiang
- Henan Key Laboratory for Pharmacology of Liver Diseases, Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Qingduan Wang
- Henan Key Laboratory for Pharmacology of Liver Diseases, Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Hongyu Zhao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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de Vries TJ, Huesa C. The Osteocyte as a Novel Key Player in Understanding Periodontitis Through its Expression of RANKL and Sclerostin: a Review. Curr Osteoporos Rep 2019; 17:116-121. [PMID: 30924022 PMCID: PMC6491659 DOI: 10.1007/s11914-019-00509-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Periodontitis is the inflammation-associated bone loss disease of the alveolar bone that surrounds teeth. Classically, the emphasis on the etiology of periodontitis has been on the products of periodontal pathogens that lead to an inflammatory response of the soft tissues of the periodontium, eventually leading to activation of osteoclasts that degrade the alveolar bone. Until recently, the response of osteocytes that populate the alveolar bone, and that are known for their regulatory role in bone anabolism and catabolism, has not been addressed. RECENT FINDINGS This review demonstrates that osteocytes play a key contributing role in periodontitis progression in various experimental mouse and rat periodontitis models. Osteocytes are the key expressing cells of both osteoclast differentiation factor RANKL as well as osteoblast activity regulator sclerostin. Targeted deletion of RANKL in osteocytes prevents osteoclast formation, thereby impairing periodontitis, despite the pressure of periodontitis-associated bacteria. Antibodies against the osteocyte-derived protein sclerostin inhibit and partially revert periodontitis by stimulating bone formation. Experimental mouse and rat periodontitis models strongly indicate a key role for the bone-encapsulated osteocyte in understanding periodontitis etiology.
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Affiliation(s)
- Teun J de Vries
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Carmen Huesa
- Centre for Reproductive Health, Queen Margaret Research Institute, University of Edinburgh, Edinburgh, Little France Crescent, EH16 4TJ, UK
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