Interleukin 1 and receptor antagonist levels in gingival crevicular fluid in heavy smokers versus non-smokers

Effect of scaling on levels of interleukin 1-beta and clinical periodontal parameters among e-cigarette users and non-smokers: A prospective study

INTRODUCTION

This cohort study aimed to compare the effect of ultrasonic scaling on the expression of IL-1β in the gingival crevicular fluid (GCF) among ENDS users and non-smokers (NS) with gingivitis.

METHODS

Self-reported current electronic nicotine delivery system (ENDS) users and NS with generalized gingivitis were included in this study. All the patients underwent scaling at the baseline visit (T0). Clinical measures, periodontal parameters [probing depth (PD), plaque index (PI), and bleeding on probing (BOP)], and GCF IL-1β were measured at T0, after 1 week (T1) and after 3 weeks (T2). Wilcoxon signed rank test was used to assess the changes in the periodontal measurements and IL-1β levels at different time points and Mann-Whitney U Test was used to compare the two groups.

RESULTS

A total of 38 individuals (18 NS and 20 ENDS users) participated in the study. The PD was significantly higher in ENDS users than in NS at baseline. However, the PI and BOP were similar in all groups at baseline. At T1, the PI was significantly lower for NS than for ENDS users (p=0.045). At T2, there were no significant differences in any of the parameters assessed between the two groups. For ENDS users, BOP was significantly lower at T1 than at baseline. For NS, the BOP at T1 and T2 and the PI at T1 were significantly lower than at baseline. There was no difference in the GCF IL-1β levels in NS and ENDS users at baseline, T1, and T2. At T2, there was a significant reduction in IL-1β (p<0.05) than at baseline in both groups.

CONCLUSIONS

Both ENDS users and NS with gingivitis responded similarly to scaling. GCF IL-1β levels were significantly higher at baseline (p<0.05) compared with their levels at T1 and T2 for both the groups.

CLINICAL TRIAL REGISTRATION

The study was registered on the official website of ClinicalTrials.gov.

IDENTIFIER

ID NCT05745324.

Smoking and Periodontitis Can Play a Synergistic Role in the Development of Psoriasis: A Nationwide Cohort Study

BACKGROUND

Periodontitis is a chronic inflammatory disorder involving the periodontium. The precise nature of the association between periodontitis and psoriasis has not been determined.

OBJECTIVE

This nationwide population-based study investigated the relationship between periodontitis and the risk of psoriasis.

METHODS

A health screening database, which is a sub-dataset of the Korean National Health Insurance System database, was used in this study. Subjects with (n = 1,063,004) and without (n = 8,655,587) periodontitis who underwent health examinations from January to December 2009 were followed for 9 years.

RESULTS

In multivariable analysis, compared to the non-periodontitis group, periodontitis patients had a significantly higher risk of developing psoriasis (hazard ratio 1.116, 95% confidence interval 1.101-1.13). Non-smokers with periodontitis had an 11% increase in risk of psoriasis and smokers with periodontitis had a 26.5% increase in risk of psoriasis compared to non-smokers without periodontitis.

CONCLUSION

Our study highlights periodontitis as a potential independent risk factor for psoriasis, increasing awareness of the synergistic role of smoking and periodontitis in the pathogenesis of psoriasis.

The impact of smoking on non-surgical periodontal therapy: A systematic review and meta-analysis

AIM

Smoking is a risk factor for periodontitis. This study aimed to evaluate the impact of smoking on clinical outcomes of non-surgical periodontal therapy.

MATERIALS AND METHODS

Electronic databases were searched to screen studies published before May 2020. The included studies had to have two groups: smokers (S) and non-smokers (NS) with periodontitis. The outcomes evaluated were differences between groups in probing depth (PD) reduction and clinical attachment level (CAL) gain after non-surgical periodontal therapy. Meta-regressions were conducted to evaluate correlations between outcomes and other contributing factors.

RESULTS

Seventeen studies were included. The post-treatment PD reduction in the S group was smaller than in the NS group (weighted mean difference in PD reduction: -0.33 mm, 95% confidence interval (CI): [-0.49, -0.17], p < .01). The CAL gain in the S group was also smaller than in the NS group (weighted mean difference in CAL gain: -0.20 mm, CI: [-0.39, -0.02], p < .01). Additionally, baseline PD significantly affected the difference in PD reduction between two groups.

CONCLUSIONS

Smoking negatively impacts clinical responses to non-surgical periodontal therapy. Smokers with periodontitis have significantly less PD reduction and CAL gain than non-smokers.

Effect of Nonsurgical Periodontal Therapy on Serum Levels of Interleukin-1β and Interleukin-8 in Smokers and Nonsmokers with Chronic Periodontitis

Aim:

The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on serum levels of interleukin-1β (IL-1β) and interleukin-8 (IL-8) in smokers and nonsmokers with chronic periodontitis before and after scaling and root planing (SRP).

Materials and Methods:

This was a comparative interventional study including a total of 52 (26 smokers and 26 nonsmokers with chronic periodontitis) subjects. Clinical parameters (gingival index [GI], plaque index [PI], recession, probing pocket depth [PPD], and clinical attachment level [CAL]) were recorded at baseline and 4 weeks after initial periodontal therapy. Initial periodontal therapy included oral hygiene instructions and full mouth SRP. Venous blood sample of 5 mL was collected from each subject at baseline and 4 weeks after initial periodontal therapy to evaluate serum IL-1β and IL-8. These biochemical parameters were assayed using enzyme-linked immunosorbent assay (ELISA) method.

Results:

The periodontal parameters such as PI, GI, recession, PPD, and CAL were reduced after nonsurgical periodontal therapy. Smokers with chronic periodontitis showed statistically significant lower GI and higher PI, gingival recession, PPD, and CAL as compared to nonsmokers with chronic periodontitis. Statistically significant reduction in periodontal parameters was seen in both groups after periodontal therapy. IL-1β and IL-8 were increased in both groups at baseline; after SRP both groups showed statistically significant reduction in IL-1β and smokers with chronic periodontitis showed statistically significant increase in IL-8 after SRP.

Conclusion:

Smokers with chronic periodontitis showed more periodontal destruction and systemic inflammatory markers compared to nonsmokers with chronic periodontitis. After periodontal therapy both groups showed statistically significant improvement in clinical parameters and biochemical parameters excluding IL-8.

T helper 17 cell-related cytokines in serum and saliva during management of periodontitis

AIM

T helper (Th)17 cells are implicated in the pathogenesis of periodontitis. This study investigated the effect of periodontal management on fifteen Th17-related cytokines in serum and saliva in periodontitis patients.

MATERIALS AND METHODS

Periodontal parameters, serum and saliva were collected from 40 healthy controls and 54 periodontitis subjects before treatment, and 3-, 6- and 12-months post-treatment. Cytokine concentrations of IL-1β, IL-4, IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, IFN-γ, sCD40L and TNF-α were determined by Luminex assay.

RESULTS

IL-1β, IL-6, sCD40L and TNF-α in serum, and IL-1β, IL-6, IL-25 and IL-31 in saliva were significantly higher at baseline compared to health and decreased with treatment. In contrast, serum IL-31 was significantly lower at baseline compared to health and increased with treatment. In addition, salivary IL-10, IL-17A, IL-17F, IL-23, IL-33, IFN-γ and TNF-α also displayed treatment-related reduction. Correlation networks showed that cytokines in saliva displayed a higher number of correlations compared to serum in periodontitis.

CONCLUSION

Treatment generally decreased cytokine concentrations except for serum IL-31 which showed a treatment-related increase. Serum cytokine concentrations may not be reflective of salivary cytokines. Saliva may be a better medium for cytokine detection compared to serum. Serum IL-31 and salivary IL-1β, IL-6, IL-10 and TNF-α were significant predictors for mean probing depth and may be potential biomarkers of interest in the pathogenesis of periodontitis.

Collins J, Jones T, Brache M, Toro M, Tumanyan S, Walters C, White S, Elias-Boneta A. The SmoCar Study: A Caribbean-Based Multicenter Study on the Prevalence and Disparities Linked to Smoking and Gingival Health

The aim of the SmoCar (Smoking in the Caribbean) study was to estimate the prevalence of smoking and the disparities in the smoking practices of three regions in the Caribbean: Jamaica, Dominican Republic, and Puerto Rico. The secondary objective was to assess the prevalence and severity of gingivitis in relation to the smoking practices. The study population comprised 1,847 (weighted N = 1,830) individuals (18 years and older) who were volunteer participants from the capitals of Jamaica, Dominican Republic, and Puerto Rico. A structured interview was used to assess the participants’ smoking behaviors. The gingival index was used to determine the extent of gingival inflammation. Polytomous regression was used to estimate the adjusted odds ratios (aORs) for smoking status (current, past, or never), according to risk factors (sex, age-group, education, marital status, tooth-brushing frequency, and city of residence). Logistic regression models were used to assess the associations between different smoking status variables and mild to moderate/severe gingivitis. The majority of the participants were never-smokers, with current smokers being found most commonly in Kingston (33.22%), followed by San Juan (12.76%) and Santo Domingo (8.8%). Both current (aOR = 2.22, 95% confidence interval [1.45, 3.40]) and past (aOR = 1.87, 95% confidence interval [1.19, 2.93]) smoking (vs. never smoking) was strongly associated with severe gingivitis. Smoking was the most prevalent in Jamaicans and the least prevalent in Dominicans. The study population of current smokers was found to have a fourfold increased risk of severe gingivitis and a twofold increased risk of moderate gingivitis.

Temporomandibular disorders in ankylosing spondylitis: a cross-sectional, monocentric study

There are contradictory results in the relevant literature about the relationship between objective determinants of craniocervical posture and temporomandibular disorder (TMD), whereas no study has worked on ankylosing spondylitis (AS) and TMD relationship. We conducted this study to test the predictors of TMD in AS patients and its relationship with craniocervical posture. AS patients aged between 18 and 50 years consecutively admitted to our outpatient clinics were recruited. TMD was diagnosed by 'Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)'. Spinal mobility was assessed by BASMI; disease activity by ASDAS-CRP and neck disability by Neck Disability Index. Craniocervical posture was assessed on lateral cervical X-ray by measuring the craniocervical angle, cervical curvature angle, suboccipital distance, atlas-axis distance, and anterior translation distance. A total of 98 (58.2% female) patients with a mean age of 37.4 ± 8.2 years were enrolled in this study. TMD was diagnosed in 58 (59.2%) patients. Spinal mobility and craniocervical posture measurements were similar among the two groups. Smoking, bruxism (in females), neck disability and AS disease activity (in males) were higher in TMD patients. Multivariate analysis revealed active smoking (aOR 6.9; 95% CI 1.8-25.6; p = 0.004), bruxism in females (aOR 17.9; 95% CI 2.0-159.2; p = 0.01), high ASDAS in males (aOR 11.8; 95% CI 1.2-122.5; p = 0.038) and neck disability (aOR 12.7; 95% CI 3.8-42.9; p < 0.001) as independent risk factors for TMD in AS patients. No relationship between the craniocervical posture measurements and TMD was found in AS patients. Active smoking, high disease activity in males, bruxism in females and neck disability were found as predictors of TMD in AS patients.

Influence of Smoking on Gingival Crevicular Fluid Interleukin 1β and Interleukin-8 in Patients with Severe Chronic Periodontitis among a Rural Population in India

Background and Objective:

Smoking is widely prevalent among rural Indian populations. Smoking is considered a significant risk factor for periodontal diseases. The aim of the present study was to evaluate the influence of smoking on the inflammatory cytokines interleukin (IL) IL-1β and IL-8 in gingival crevicular fluid (GCF) and compare these between smokers and nonsmokers with periodontitis in diseased and healthy sites.

Materials and Methods:

A total of thirty patients with severe chronic periodontitis (15 smokers and 15 nonsmokers) participated in this study. Clinical parameters assessed were gingival index, bleeding on probing, probing depth (PD), and clinical attachment level. One diseased and one healthy site from each of the periodontitis patients were selected for GCF collection and assigned to the following four groups: healthy sites in smoker (SH), diseased sites in smoker (SD), healthy sites in nonsmoker (NH), and diseased sites in nonsmoker (ND) and were analyzed by enzyme-linked immunosorbent assay test (Quantikine^®).

Results:

Intragroup comparisons revealed statistically significant levels of IL-1β in ND sites compared to NH sites (P < 0.005) and SD sites showed statistically significantly higher levels of IL-1β compared to SH sites (P < 0.0001). However, there was no significant difference in IL-8 levels between NH and ND sites as well as between SH and SD sites. Intergroup comparisons revealed that SH sites exhibited significantly lower amounts of IL-8 (P < 0.01) compared to NH sites and SD sites showed significantly lower levels of IL-8 compared to ND sites (P < 0.001). However, the comparison of NH and SH sites as well as ND and SD sites showed no significant difference in the levels of IL-1β.

Conclusions:

Cytokine levels were significantly elevated in periodontitis patients. Smokers exhibited a decrease in IL-8 and increase in IL-1β levels. Hence, this reflects the influence of smoking on immunosuppression and its role in the pathogenesis of periodontal disease.

Tobacco-induced suppression of the vascular response to dental plaque

Cigarette smoking presents oral health professionals with a clinical and research conundrum: reduced periodontal vascular responsiveness to the oral biofilm accompanied by increased susceptibility to destructive periodontal diseases. This presents a significant problem, hampering diagnosis and complicating treatment planning. The aim of this review is to summarize contemporary hypotheses that help to explain mechanistically the phenomenon of a suppressed bleeding response to dysbiotic plaque in the periodontia of smokers. The influence of smoke exposure on angiogenesis, innate cell function, the production of inflammatory mediators including cytokines and proteases, tobacco-bacteria interactions, and potential genetic predisposition are discussed.

A pilot study of the gingival response when smokers switch from smoking to vaping

Introduction Tobacco smoking is one of the most important risk factors for periodontitis as it alters the host response to plaque. Although the prevalence of tobacco smoking has declined in recent years, the use of electronic-cigarettes (vaping) has increased. The effect of vaping on the gingiva is unknown and an evidence-base needs to be established before providing dental advice about the use of these products.Objective To compare the gingival health of a group of established smokers before and after substituting vaping for smoking tobacco.Design Pilot.Setting Guy's Dental Hospital (England) from April-December 2015.Materials and methods Twenty established smokers (all staff members at Guy's Hospital) with mild periodontal disease replaced their regular smoking habits with the use of e-cigarettes for two weeks.Main outcome measure The primary outcome measure of gingival inflammation was bleeding on probing. Levels of selected pro-inflammatory cytokines in GCF, saliva and serum samples were also determined.Results and conclusions There was a statistically significant increase in gingival inflammation when tobacco smokers switched from smoking to vaping for two weeks. However, this result must be interpreted with extreme caution since this is only a pilot study. Nonetheless, this study should provide a stepping stone to encourage further investigation of the effects of vaping on periodontal health.

The Effects of Smoking on Expression of IL-12 and IL-1β in Gingival Tissues of Patients with Chronic Periodontitis

Aim:

The purpose of this study was to compare IL-1β and IL-12 gene expression in the gingival tissue of smokers and non-smokers either with healthy periodontium or with chronic periodontitis.

Materials and Methods:

41 individuals consisting of 21 healthy controls (11 non-smokers and 10 smokers) and 20 chronic periodontitis patients (10 non-smokers and 10 smokers) participated in this study. Samples were collected from papillary regions of targeted areas and cytokines were analyzed using Real Time PCR. Shapiro-Wilk, Mann-Witney and Independent T tests were employed for statistical analysis.

Results:

IL-1β gene expression in gingival tissue of non-smoker group with chronic periodontitis was significantly higher than non-smoker-healthy group (p=0.011). Smoker-chronic periodontitis group showed lower IL-1β gene expression than non-smoker-chronic periodontitis group (p=0.003). IL-12 gene expression was not significantly different between analyzed groups.

Conclusion:

IL-1β gene expression increases in gingival tissue of non-smoker-chronic periodontitis patients due to inflammatory processes but smoking reduces the expression of this cytokine in diseased periodontal tissues. On the other hand periodontal condition and smoking habits do not seem to affect IL-12 gene expressions in gingival tissues. Authors concluded that reduced levels of IL1 and in some extent IL12 in smoking patients are responsible for higher tissue and bone degenerations and less treatment responses in smokers.

The effect of smoking on inflammatory and bone remodeling markers in gingival crevicular fluid and subgingival microbiota following periodontal therapy

BACKGROUND AND OBJECTIVE

Periodontal health is mediated by suppressing microorganisms inducing a local inflammatory host response. Smoking may impair this process. This study compares gingival crevicular fluid levels of inflammatory and bone remodeling markers in heavy smokers and non-smokers following active and supportive periodontal therapy in patients with chronic periodontitis.

MATERIAL AND METHODS

Gingival crevicular fluid and subgingival plaque were collected from the deepest periodontal pocket in 50 patients, 25 smokers and 25 non-smokers, at baseline (T0), following active (T1) and 12 mo of supportive periodontal therapy (T2). Smoking status was validated measuring serum cotinine levels. Gingival crevicular fluid levels of 27 inflammatory and two bone remodeling markers were analyzed using multiplex and singleplex micro-bed immunoassays, and subgingival plaque samples using checkerboard DNA-DNA hybridization. Amounts of markers in smokers and non-smokers were compared calculating the effect size.

RESULTS

Expression of inflammatory and bone-remodeling markers in smokers demonstrated an overall reduced effect size at T0 and T2 (p < 0.001). In particular, proinflammatory markers (p < 0.001), chemokines (p = 0.007) and growth factors (p = 0.003) at T0, osteoprotegerin (p = 0.003) at T1, proinflammatory markers (p = 0.019) and chemokines (p = 0.005) at T2. At T2, interleukin-8 was detected in significantly higher levels in smokers. Ten different markers in non-smokers and none in smokers responded to periodontal therapy (p < 0.05). An overall negative association was revealed between smoking and subgroups of markers at sites presenting ≥ 10⁵ red complex periodontal microbial species.

CONCLUSION

Except for an upregulation of interleukin-8, smokers exhibited reduced gingival crevicular fluid levels of several inflammatory markers at baseline and following active and supportive periodontal therapy. Only inflammatory responses in non-smokers adapted to periodontal therapy. Apparently, there seems to be an immunosuppressant effect of smoking regulating the local inflammatory response and bone remodeling markers captured in gingival crevicular fluid following periodontal therapy.

Chronic periodontitis can affect the levels of potential oral cancer salivary mRNA biomarkers

BACKGROUND AND OBJECTIVE

More than 100 salivary constituents have been found to show levels significantly different in patients with oral squamous cell carcinoma (OSCC) from those found in healthy controls, and therefore have been suggested to be potential salivary biomarkers for OSCC detection. However, many of these potential OSCC salivary biomarkers are also involved in chronic inflammation, and whether the levels of these biomarkers could be affected by the presence of chronic periodontitis was not known. The objective of this pilot study was therefore to measure the levels of seven previously reported potential OSCC salivary mRNA biomarkers in patients with chronic periodontitis and compare them to levels found in patients with OSCC and healthy controls. The seven salivary mRNAs were interleukin (IL)-8, IL-1β, dual specificity phosphatase 1, H3 histone family 3A, ornithine decarboxylase antizyme 1, S100 calcium-binding protein P (S100P) and spermidine/spermine N1-acetyltransferase 1.

MATERIAL AND METHODS

Unstimulated whole saliva samples were collected from a total of 105 human subjects from the following four study groups: OSCC; CPNS (chronic periodontitis, moderate to severe degree, non-smokers); CPS (chronic periodontitis, moderate to severe degree, smokers); and healthy controls. Levels of each mRNA in patient groups (OSCC or chronic periodontitis) relative to the healthy controls were determined by a pre-amplification reverse transcription-quantitative polymerase chain reaction approach with nested gene-specific primers. Results were recorded and analyzed by the Bio-Rad CFX96 Real-Time System. Mean fold changes between each pair of patient vs. control groups were analyzed by the Mann-Whitney U-test with Bonferroni corrections.

RESULTS

Only S100P showed significantly higher levels in patients with OSCC compared to both patients with CPNS (p = 0.003) and CPS (p = 0.007). The difference in S100P levels between patients with OSCC and healthy controls was also marginally significant (p = 0.009). There was no significant difference in the levels of salivary IL-8, IL-1β and dual specificity phosphatase 1 mRNAs between patients with OSCC and patients with CPNS (p = 0.510, 0.058 and 0.078, respectively); no significant difference in levels of salivary ornithine decarboxylase antizyme 1 and spermine N1-acetyltransferase mRNAs between patients with OSCC and patients with CPS (p = 0.318 and 0.764, respectively); and no significant difference in levels of the H3 histone family 3A mRNA between patients with OSCC and either CPS (p = 0.449) or healthy controls (p = 0.107).

CONCLUSIONS

Salivary S100P mRNA could be a reliable biomarker for OSCC detection, regardless of the presence of chronic periodontitis. The presence of chronic periodontitis could significantly affect the levels of the other six mRNAs, and negatively influence reliability for using them as biomarkers for oral cancer detection.

Effects of resveratrol and cigarette smoking onbone healing: histomorphometric evaluation

BACKGROUND/AIM

The aim of the present study is to investigate the effects of cigarette smoke (CS) and simultaneous application of resveratrol on bone healing histomorphometrically and to evaluate the effects of resveratrol on negative effects of CS.

MATERIALS AND METHODS

For 4 weeks, Sprague Dawley rats were exposed to cigarette smoke at the equivalent of 6 cigarettes per day. After this period, monocortical defects were created in femurs by a trephine bur on day 28. Starting from the day of defect creation to the 28th postoperative day, rats were given 20 mg/kg body weight resveratrol. Histomorphometric examination of the number of osteoblasts and osteoclasts, as well as new bone area, was conducted.

RESULTS

Investigations were carried out on 33 rats. Differences between osteoblast numbers in the control and CS groups were significant, and CS caused a reduction in the number of osteoblasts. Areas of new bone formation in the resveratrol and control groups were higher than in the smoking and smoking+resveratrol groups.

CONCLUSION

Smoking appeared to have adverse effects upon bone healing and resveratrol administration helped to reduce these effects.

Impact of a chronic smoking habit on the osteo-immunoinflammatory mediators in the peri-implant fluid of clinically healthy dental implants

OBJECTIVE

The aim of this study was to evaluate the influence of chronic cigarette smoking on the profile of osteo-immunoinflammatory markers in the peri-implant crevicular fluid (PICF) from clinically healthy implants DESIGNS: Twenty-five smokers and 23 non-smoker subjects with a unitary screwed implant-supported crown in the molar or pre-molar region were enrolled in this study. The implants should have been in functioning for at least 12 months, and the peri-implant tissue should be clinically healthy [probing depth (PD)<4mm with no bleeding on probing (BoP) and no evidence of radiographic bone loss beyond bone remodeling]. The levels of interferon (INF)-γ, interleukin (IL)-4, IL-17, IL-1β, IL-10, IL-6, IL-8, tumor necrosis factor (TNF)-α, matrix metalloproteinase (MMP)-2, MMP-9, osteoprotegerin (OPG), soluble receptor activator of nuclear factor-κβ ligand (RANKL), osteocalcin (OC), osteopontin (OPN), transforming growth factor (TGF)-β, and cross-linked telopeptide of type I collagen (ICTP) in the PICF were quantified by a multiplexed bead immunoassay.

RESULTS

The smokers presented reduced levels of IL-4, IL-8, and TNF-α compared with the non-smoker individuals (p<0.05). In addition, although lower OPG levels were detected in the PICF of the smokers, the RANKL/OPG ratio did not show a significant difference (p>0.05). Moreover, higher ICTP concentrations and a higher TH1/TH2 ratio were observed in the PICF of the smoker patients (p<0.05). No differences between the groups were observed for the other markers evaluated (p>0.05).

CONCLUSIONS

Smoking habit modulate peri-implant cytokine profile, leading to reductions in IL-4, -8 TNF-α, and OPG levels and an increased ICTP and TH1/TH2 ratio in peri-implant crevicular fluid.

Relationship between salivary stress biomarker levels and cigarette smoking in healthy young adults: an exploratory analysis

Background

This study investigated the relationships among salivary stress biomarkers, cigarette smoking, and mood states.

Methods

The study population comprised 49 healthy sixth-year dental students at Fukuoka Dental College (39 men, 10 women; age, 23–31 years). Lifetime exposure to smoking was calculated using the Brinkman index (BI). Resting saliva samples were collected, and concentrations of cortisol, secretory immunoglobulin A (SIgA), interleukin (IL)-1β, interleukin-6, and tumor necrosis factor (TNF)-α were determined. Mood states (tension-anxiety, depression-dejection, anger-hostility, fatigue, confusion, and vigor) over the previous week were assessed using the Profile of Mood States - Brief Japanese Version.

Results

Salivary IL-1β levels were significantly higher in smokers than non-smokers (P = 0.044), regardless of the BI or mood state. A significant positive correlation was evident between the TNF-α level and the BI (P = 0.036), and the SIgA level was positively correlated with the BI (P = 0.067) but did not reach statistical significance. In terms of mood states, higher fatigue scores and lower vigor scores were observed in smokers. The TNF-α level and vigor score were negatively correlated (r = –0.229, P = 0.135), but the correlation did not reach statistical significance. However, the SIgA level and fatigue score were significantly positively correlated (r = 0.410, P = 0.005).

Conclusions

The TNF-α and SIgA levels were both positively correlated with the BI. Furthermore, the TNF-α level was negatively correlated with the vigor score, whereas the SIgA level was positively correlated with the fatigue score. Thus, salivary levels of TNF-α and SIgA may be used as biomarkers of mood states in healthy young smokers.

Smoking and inflammation: evidence for a synergistic role in chronic disease

Tobacco smoking is the most important preventable risk factor for periodontitis; however, the underlying biological mechanisms responsible for the detrimental effects of smoking on periodontal health remain largely unclear. It is also well established that smoking has a negative impact on several inflammatory diseases, including rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease. The aim of this paper was to review smoking-related changes in local and systemic host responses with a focus on cellular and molecular effects that could explain a hyperinflammatory response leading to periodontal destruction. Biological mechanisms that may be common to periodontal disease and other chronic inflammatory diseases were also explored, together with gene-smoking interactions. An epidemiologic perspective on the burden of smoking on periodontal health and the potential for smoking cessation is also presented. Tobacco smoking seems to induce changes ranging from decreased leukocyte chemotaxis to decreased production of immunoglobulins. Smoking also seems to cause a stronger inflammatory reaction with an increased release of potentially tissue-destructive substances (e.g. reactive oxygen species, collagenase, serine proteases and proinflammatory cytokines). These findings support a hypothesis that periodontitis is a hyperinflammatory condition rather than a hypo-inflammatory condition.

Polymorphic regions in the interleukin-1 gene and susceptibility to chronic periodontitis: a genetic association study

OBJECTIVE

The objectives of this study were to determine the association between single nucleotide polymorphisms (SNPs) in IL1B (-511, +3954), IL1A (-889, +4845), and the variable number of tandem repeats (VNTRs) polymorphism in the IL-1RN gene with chronic periodontitis susceptibility and to analyze gene-gene interactions in a hospital-based sample population from South India.

SUBJECTS AND METHODS

A total of 400 individuals were recruited for this study; 200 individuals with healthy gingiva and 200 chronic periodontitis patients. Genomic DNA was isolated from peripheral blood samples and genotyping was performed for the above-mentioned single nucleotide and VNTR polymorphisms by polymerase chain reaction, DNA sequencing, and agarose gel electrophoresis.

RESULTS

A higher proportion of the variant alleles were observed in the chronic periodontitis group for all the SNPs examined. The SNP at +3954 (C>T) in the IL1B gene was found to be significantly associated with chronic periodontitis (p=0.007). VNTR genotypes (χ(2) value: 5.163, df=1, p=0.023) and alleles (χ(2) value: 6.818, df=1, p=0.009) were found to have a significant association with chronic periodontitis susceptibility.

CONCLUSION

In the study population examined, the SNP in the IL1B gene (+3954) and VNTR polymorphisms in the IL1RN gene were found to have a significant association with chronic periodontitis susceptibility.

Interleukin-1 receptor antagonist levels in gingival crevicular fluid and serum in nonsmoking women with preterm low birth weight and intrauterine growth retardation

OBJECTIVE

The aim of this study was to evaluate interleukin (IL)-1 β and IL-1 receptor antagonist (IL-1ra) levels in gingival crevicular fluid (GCF) and serum (S) in nonsmoking women with normal birth (NB), preterm low birth weight (PLBW), and intra-uterine growth retardation (IUGR).

MATERIALS AND METHODS

In this unmatched case-control study design, 64 women with NB, 45 women with PLBW, and 47 women with IUGR were recruited within 24 h delivery. Clinical periodontal parameters were recorded. IL-1 β and IL-1ra levels in GCF (pg/30 s) and serum (pg/ml) of were evaluated using commercial enzyme immunoassay and ELISA kits.

RESULTS

Greater pocket depth and clinical attachment loss were observed in PLBW and IUGR women than in NB women (P < 0.05). The total amounts of IL-1ra and IL-β of GCF were higher levels in NB women than PLBW and IUGR women (P < 0.05). The lowest total amount of IL-1ra of GCF was found in IUGR women (P < 0.05). The concentrations of IL-1ra in serum samples were not statistically significant for any of the study groups (P > 0.05).

CONCLUSION

It can be suggested that worse periodontal conditions and the low levels of IL-1ra in GCF may be an important factor in adverse pregnancy outcomes.

Current perspective of the impact of smoking on the progression and treatment of periodontitis

This literature review provides an overview of the current scenario regarding the impact of smoking on the progression and treatment of periodontitis; clinical, microbiological and immunological data from studies from our and other groups are presented. In general, preclinical and clinical data are unanimous in demonstrating that smokers present increased susceptibility, greater severity and faster progression of periodontal disease compared with nonsmokers. The evidence further demonstrates that smokers lose more teeth and have a less favorable response to therapy than do nonsmokers. Although it is well established that smoking significantly impacts on the onset, progression and outcome of periodontal disease, the mechanisms involved remain unclear. More importantly, some of the reported deleterious effects of smoking on periodontal tissues have been reported to be reversible upon participation in smoking-cessation programs. Therefore, clinicians should strongly advise smokers to enroll in cessation strategies, even temporarily, in order to improve the overall outcome.

Comparisons between two biochemical markers in evaluating periodontal disease severity: a cross-sectional study

Background

The purpose of this study was to compare two biochemical markers, which have been previously used to determine the degrees of alveolar bone destruction, in evaluating periodontal disease severity.

Methods

The WF6 epitope of chondroitin sulfate (CS) and the alkaline phosphatase (ALP) levels were determined in gingival crevicular fluid (GCF) samples collected from patients with various degrees of disease severity, including ten patients with gingivitis (50 gingivitis sites) and 33 patients with chronic periodontitis (including gingivitis, slight, moderate, and severe periodontitis sites; n = 50 each), as well as from ten healthy volunteers (50 healthy sites) by Periopaper strips. The levels of CS and ALP were measured by an ELISA and a fluorometric assay, respectively.

Results

The results demonstrated low levels of CS and ALP in non-destructive and slightly destructive periodontitis sites, whereas significantly high levels of these two biomolecules were shown in moderately and severely destructive sites (p < 0.05). Although a significant difference in CS levels was found between moderate and severe periodontitis sites, no difference in ALP levels was found. Stronger correlations were found between CS levels and periodontal parameters, including probing depth, loss of clinical attachment levels, gingival index and plaque index, than between ALP levels and these parameters.

Conclusions

It is suggested that the CS level is a better diagnostic marker than the ALP level for evaluating distinct severity of chronic periodontitis.

The role of smoking and gingival crevicular fluid markers on coronally advanced flap outcomes

BACKGROUND

This study evaluates possible effects of smoking on the following: 1) biochemical content in gingival crevicular fluid (GCF) samples from sites of gingival recession and saliva; and 2) clinical outcomes of coronally advanced flap (CAF) for root coverage.

METHODS

Eighteen defects in 15 patients were included in each of the smoker and non-smoker groups. Baseline cotinine, basic fibroblast growth factor, vascular endothelial growth factor, platelet-derived growth factor, interleukin (IL)-8, IL-10, IL-12, tumor necrosis factor-α, matrix metalloproteinase (MMP)-8, MMP-9, and plasminogen activator inhibitor-1 levels were determined in GCF and saliva samples. CAF with microsurgery technique was applied. Plaque index, papilla bleeding index, recession depth (RD), recession width (RW), and root surface area were evaluated at baseline and postoperative months 1, 3, and 6. Probing depth, clinical attachment level (CAL), and keratinized gingival width (KGW) was recorded at baseline and month 6. Percentage of root coverage and complete root coverage were calculated at postoperative months 1, 3, and 6.

RESULTS

All biochemical parameters were similar in the two groups apart from the definite difference in salivary cotinine concentrations (P = 0.000). Compared with the baseline values, RD, RW, CAL, and root surface area decreased, and KGW increased, with no significant difference between the study groups. CAL gain, percentage of root coverage, and complete root-coverage rates were similar in the study groups.

CONCLUSION

Similar baseline biochemical data and comparably high success rates of root coverage with CAF in systemically and periodontally healthy smokers versus non-smokers suggest lack of adverse effects of smoking on clinical outcomes.

Necessity of keratinized tissues for dental implants: a clinical, immunological, and radiographic study

BACKGROUND

Necessity of keratinized tissues (KTs) for maintaining health around dental implants (DIs) remains as a controversial issue.

PURPOSE

The aim of this study was to investigate the effects of KT width (KTW) on peri-implant tissues by evaluating peri-implant clinical and inflammatory parameters.

MATERIALS AND METHODS

Sixty DIs were included in this 6-month longitudinal study. After classifying DI based on the presence of KTs at the buccal aspect as with adequate/inadequate KTW, DIs were randomly assigned into three study groups. In the first group, while free gingival graft (FGG) was performed, DIs in maintenance (M) group were followed up by standardized maintenance procedures at baseline, first, third, and sixth months as with DI with adequate KTW (Control). Clinical parameters, peri-implant sulcular fluid (PISF) volume, PISF Interleukin 1β concentration, and bone loss were analyzed.

RESULTS

Significant improvements in clinical and immunological parameters were noted only for FGG for the whole study period. Statistical differences detected between the treatment groups (FGG vs M) were for gingival index at all time points and for PISF volume at sixth month. For the other parameters evaluated, while lower values were observed for FGG, statistically no differences were noted between the groups.

CONCLUSIONS

Based on the results of this study, it can be suggested that FGG performed around DIs lacking KT is a reliable method, leading to significant improvements in clinical and inflammatory parameters. Further long-term studies including more DIs are needed to clarify the role of KT on maintenance of DIs.

Neutrophils alter epithelial response to Porphyromonas gingivalis in a gingival crevice model

A gingival crevice model (epithelial cell-Porphyromonas gingivalis-neutrophil) was established and used to profile gingipain, matrix metalloproteinase (MMP), MMP mediators [neutrophil gelatinase-associated lipocalin (NGAL) and tissue inhibitor of metalloproteinases 1 (TIMP-1)] and cytokine networks. Smoking is the primary environmental risk factor for periodontitis. Therefore, the influence of cigarette smoke extract (CSE) was also monitored in the same model. Porphyromonas gingivalis alone induced low levels of interleukin-1β and interleukin-8 from epithelial cells, but high levels of both cytokines were produced on the addition of neutrophils. Exposure to CSE (100 and 1000 ng ml(-1) nicotine equivalency) significantly compromised P. gingivalis-induced cytokine secretion (both P < 0.05). P. gingivalis induced impressive secretion of NGAL (P < 0.05) that was not influenced by CSE. The influence of CSE on gingipain production was strain-specific. Purified gingipains effectively and rapidly degraded both TIMP-1 and MMP-9. Induction of large amounts of NGAL, degradation of TIMP-1, and increased gingipain activity would each be expected to prolong collagen degradation and promote disease progression. However, gingipains also degrade MMP-9. Hence, P. gingivalis exerts a complex influence on the proteolytic balance of a gingival crevice model. Exposure to CSE reduces the proinflammatory cytokine burden, which may be expected to promote P. gingivalis survival. In addition to novel findings that provide mechanistic insight into periodontal disease progression, these results are in keeping with the recognized clinical dogma of decreased inflammation/increased disease in smokers. This straightforward gingival crevice model is established as a suitable vehicle for the elucidation of mechanisms that contribute to susceptibility to periodontitis.

Excess risk of temporomandibular disorder associated with cigarette smoking in young adults

Evidence suggests that the effect of cigarette smoking on chronic pain is stronger in younger than older adults. This case-control study investigated whether age modified an effect of smoking on temporomandibular disorder (TMD) in 299 females aged 18 to 60 years. It also investigated the extent to which this relationship was explained by psychological profile, inflammatory response, and allergy. Cases were defined using the Research Diagnostic Criteria for Temporomandibular Disorders based on clinical examination. Psychological profile was evaluated using standardized instruments. Inflammatory response was evaluated with 11 cytokines isolated in plasma. History of allergy conditions was self-reported. Odds ratios (ORs) for the effect of smoking were calculated using binary logistic regression. Stratified analyses and the likelihood ratio test examined effect modification by smoking. Compared with nonsmokers, ever smokers aged <30 years had higher odds of TMD (OR = 4.14, 95% CI: 1.57, 11.35) than older adults (OR = 1.23, 95% CI: .55, 2.78) (P (effect modification) = .038). Adjustment for psychological profile, cytokines, and history of allergy-like conditions attenuated the effect by 45% to statistical nonsignificance. The main finding was reproduced with secondary analyses of 2 nationally representative surveys of adults conducted in the US and Australia.

PERSPECTIVE

This study showed that smoking was associated with TMD risk in females, but only in young adulthood. It replicated this finding in 2 nationally representative surveys of females in the US and Australia. Findings may alert clinicians to recognize that smoking is a concern for TMD in younger female patients.

The Effect of Bleachıng Systems on the Gingiva and the Levels of IL-1β and IL-10 in Gingival Crevicular Fluid

Home and chemically activated bleaching systems could be considered safer in tooth whitening and maintaining gingival health when compared with a light-activated bleaching system.

The effect of smoking on the mRNA expression of MMPs and TIMP-1 in untreated chronic periodontitis patients: a cross-sectional study

BACKGROUND AND OBJECTIVE

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are important for extracellular matrix. Expression of MMPs has been evaluated in gingiva without studying smoking. The aim of this study was to explore the effect of smoking on mRNA expression of MMP-1, -3, -8, -9 and -13 and TIMP-1 in untreated chronic periodontitis and in periodontal health.

MATERIAL AND METHODS

Gingival samples were harvested from 30 subjects with untreated chronic periodontitis (15 nonsmokers and 15 smokers) and 30 periodontally healthy subjects (15 nonsmokers and 15 smokers). Full-mouth plaque score, gingival index, bleeding on probing, probing depth and clinical attachment level were recorded. Total RNA was isolated, and the mRNA expression of MMPs and TIMP-1 was assessed by RT-PCR.

RESULTS

Periodontitis groups were comparable in clinical measurements. Nonsmoker subjects with periodontitis had statistically significantly higher MMP-1, lower MMP-9 and TIMP-1 expression and higher MMP-1/TIMP-1 ratio than smokers; and higher MMP-8 expression and MMP-8/TIMP-1 and MMP-1/TIMP-1 ratios than healthy nonsmokers. Healthy nonsmokers had statistically significantly higher MMP-13 expression than healthy smokers. Smoker periodontitis and healthy subjects had similar expression levels of MMPs and TIMP-1 and MMPs/TIMP-1 ratios. There was correlation among the MMPs only for smoker periodontitis subjects. Expression of MMP-13 was correlated with mean clinical attachment level.

CONCLUSION

Within its limits, this study demonstrated that smoking affected mRNA expression of MMPs and TIMP-1, MMPs/TIMP-1 ratios and relationships among MMPs in untreated chronic periodontitis and expression of MMPs in health. In the absence of smoking, chronic periodontitis affected expression of MMPs and MMPs/TIMP-1 ratios.

Impact of smoking on inflammation: overview of molecular mechanisms

BACKGROUND

Inflammation is a critical component of normal tissue repair, as well as being fundamental to the body's defense against infection. Environmental factors, such as smoking, have been reported to modify the host response and hence modify inflammation progression, severity and outcome. Therefore, a comprehensive understanding of the molecular mechanisms by which smoking affects inflammation is vital for preventive and therapeutic strategies on a clinical level.

AIM

The purpose of the present article is to review the potential biological mechanisms by which smoking affects inflammation, emphasizing recent developments.

RESULTS

Smoking is reported to effect a number of biological mediators of inflammation through its effect on immune-inflammatory cells, leading to an immunosuppressant state. Recent evidence strongly suggests that the molecular mechanisms behind the modulation of inflammation by smoking mainly involve the nuclear factor-kappa B (NF-kB) family, through the activation of both an inhibitor of IkB kinase (IKK)-dependent and -independent pathway. In addition to NF-kB activation, a number of transcriptional factors including GATA, PAX5 and Smad 3/4, have also been implicated.

CONCLUSION

Multiple mechanisms may be responsible for the association of smoking and inflammation, and the identification of potential therapeutic targets should guide future research.

Influence of smoking on gingival crevicular fluid cytokines in severe chronic periodontitis

AIM

The aim of this study was to compare the expression of 22 chemokines and cytokines in gingival crevicular fluid (GCF) from smokers and non-smokers with periodontitis and periodontally healthy control subjects.

MATERIALS AND METHODS

Forty subjects with generalized severe chronic periodontitis (20 smokers and 20 non-smokers) and 12 periodontally healthy control subjects participated in this study. Four diseased and two healthy sites were selected from each of the periodontitis subjects. GCF samples were collected and cytokines analysed utilizing a multiplexed immunoassay (Luminex(®) ). Statistical analyses employed non-parametric tests including the Mann-Whitney and Wilcoxon matched-pairs signed-rank tests.

RESULTS

Compared with healthy control subjects, GCF in subjects with chronic periodontitis contained significantly higher amounts of interleukin (IL)-1α, IL-1β, IL-6, IL-12(p40) (pro-inflammatory cytokines); IL-8, macrophage chemotactic protein (MCP)-1, macrophage inflammatory protein (MIP)-1α, regulated on activation normal T-cell expressed and secreted (RANTES) (chemokines); IL-2, IFN-γ, IL-3, IL-4 (Th1/Th2 cytokines); IL-15 [regulator of T-cells and natural killer (NK) cells]. Smokers displayed decreased amounts of pro-inflammatory cytokines [IL-1α, IL-6, IL-12(p40)], chemokines (IL-8, MCP-1, MIP-1, RANTES), and regulators of T-cells and NK cells (IL-7, IL-15).

CONCLUSIONS

Periodontitis subjects had significantly elevated cytokine and chemokine profiles. Smokers exhibited a decrease in several pro-inflammatory cytokines and chemokines and certain regulators of T-cells and NK-cells. This reflects the immunosuppressant effects of smoking which may contribute to an enhanced susceptibility to periodontitis.

Interleukin-1 and interleukin-8 in nicotine- and lipopolysaccharide-exposed gingival keratinocyte cultures

BACKGROUND AND OBJECTIVE

Tobacco use is associated with increased periodontal destruction in both cigarette smokers and smokeless tobacco users. Gingival keratinocytes are the first cells in contact with microbial and tobacco components and play a key role in the innate immune response to these agents. The objective of this study was to evaluate the effect of nicotine and bacterial lipopolysaccharide (LPS) alone and in combination on gingival keratinocyte production of interleukin-1 alpha (IL-1 alpha) and interleukin-8 (IL-8).

MATERIAL AND METHODS

Gingival keratinocyte cultures were established from 10 healthy, non-tobacco-using subjects. The cells were stimulated for 24 h with 1 mum or 1 mm nicotine and/or 10 microg/mL Escherichia coli or Porphyromonas gingivalis LPS. Interleukin-1 alpha and IL-8 proteins were quantified using ELISAs.

RESULTS

Compared with untreated cultures, 1 mm nicotine stimulated production of IL-1 alpha (p < 0.001); E. coli and P. gingivalis LPS increased IL-8 production (p = 0.0014 and p = 0.0232, respectively). A combination of nicotine and LPS produced the highest cytokine quantities. Amounts of IL-1 alpha and IL-8 following 1 mm nicotine and LPS exposure were significantly greater than in untreated cultures (p < 0.001). Interleukin-8 was also responsive to 0.1 mum nicotine combined with E. coli or P. gingivalis LPS compared with control cultures (p < 0.0001 and p = 0.0029, respectively). Both cytokines tended to be elevated following the combined treatment relative to nicotine or LPS treatment alone.

CONCLUSION

These results demonstrate that nicotine and LPS differentially regulate IL-1 and IL-8 production by gingival keratinocytes. Combined treatment tended to elevate cytokine production further, which may have implications for the progression of periodontitis in tobacco users.

Destructive effects of smoking on molecular and genetic factors of periodontal disease

Many epidemiological evidences have proven the association between smoking and periodontal disease. The causality can be further established by linking findings of traditional epidemiological studies with the developments in molecular techniques that occurred in the last decade. The present article reviews recent studies that address the effect of smoking on molecular and genetic factors in periodontal disease. Most findings support the fact that tobacco smoking modulates destruction of the periodontium through different pathways: microcirculatory and host immune systems, connective tissue, and bone metabolism. Although smokers experience an increased burden of inflammatory responses to microbial challenges compared to non-smokers, understanding the association between smoking and periodontal diseases involves substantial problems with respect to accuracy of measurements, and particularly, sampling of many subjects. It remains unclear whether genetic susceptibility to periodontal disease is influenced by exposure to smoking or the effect of smoking on periodontal disease is influenced by genetic susceptibility. Employment of molecular techniques may play a key role in further elucidation of mechanisms linking smoking and periodontal destruction, the direct relationship as environmental factors and indirect relationship through genetic factors.

Nicotine and periodontal tissues

Tobacco use has been recognized to be a significant risk factor for the development and progression of periodontal disease. Its use is associated with increased pocket depths, loss of periodontal attachment, alveolar bone and a higher rate of tooth loss. Nicotine, a major component and most pharmacologically active agent in tobacco is likely to be a significant contributing factor for the exacerbation of periodontal diseases. Available literature suggests that nicotine affects gingival blood flow, cytokine production, neutrophil and other immune cell function; connective tissue turnover, which can be the possible mechanisms responsible for overall effects of tobacco on periodontal tissues. Inclusion of tobacco cessation as a part of periodontal therapy encourages dental professionals to become more active in tobacco cessation counseling. This will have far reaching positive effects on our patients' oral and general health.

Interleukin-17, RANKL, and osteoprotegerin levels in gingival crevicular fluid from smoking and non-smoking patients with chronic periodontitis during initial periodontal treatment

BACKGROUND

This study was performed to evaluate the effects of initial periodontal treatment on the gingival crevicular fluid (GCF) levels of interleukin (IL)-17, soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), and osteoprotegerin (OPG) in smoking and non-smoking patients with chronic periodontitis.

METHODS

At baseline, GCF samples were obtained from 10 smoking and 10 non-smoking systemically healthy patients with chronic periodontitis. Initial periodontal treatment, consisting of motivation and instruction for daily plaque control and scaling and root planing (SRP), was performed. GCF sampling and clinical periodontal measurements were repeated 4 weeks after completion of SRP. The data were tested statistically by the Student t and Wilcoxon matched-pairs test and Spearman correlation analysis.

RESULTS

All clinical periodontal measurements had decreased significantly 4 weeks after SRP (P <0.001). GCF volume and the total amount and concentration of OPG decreased in smokers and non-smokers after SRP, whereas the IL-17 concentration increased (P <0.05). sRANKL levels did not differ between groups or with SRP (P >0.05). Significant correlations were found between baseline IL-17 and receptor activator of nuclear factor-kappa B ligand (RANKL) levels and between baseline papilla bleeding index and OPG levels (P <0.001 and P <0.05, respectively).

CONCLUSIONS

Neither smoking nor periodontal inflammation seemed to influence GCF RANKL levels in systemically healthy patients with chronic periodontitis. Smoking and non-smoking patients with chronic periodontitis were not affected differently by the initial periodontal treatment with regard to GCF IL-17 and OPG concentrations.