Association of gingival crevicular fluid and serum intracytoplasmic enzyme levels in periodontally healthy homozygous (major) beta-thalassemia patients

The Association Between Thalassemia Major and Periodontal Health

BACKGROUND

The aim of this cross-sectional study is to compare the local and systemic levels of soluble receptor activator of nuclear factor-κB ligand (sRANKL), osteoprotegerin (OPG), a proliferation-inducing ligand (APRIL), B-cell activating factor (BAFF), interleukin (IL)-6, and IL-8 in biofluids of patients with thalassemia major (TM) with or without gingivitis.

METHODS

Seventy-seven patients are included in this study (TM, n = 29; systemically healthy, n = 48). Gingival crevicular fluid (GCF), saliva, and serum levels of IL-6, IL-8, sRANKL, OPG, BAFF, and APRIL were determined by enzyme-linked immunosorbent assay. Data were analyzed by appropriate non-parametric or parametric statistical tests.

RESULTS

Median GCF, serum, and saliva levels for BAFF (P <0.001) and IL-6 and IL-8 (P <0.005) were higher in TM gingivitis than in systemically healthy gingivitis (P <0.001). GCF, serum, and saliva levels for APRIL, sRANKL, IL-6, and IL-8 were higher in TM than in systemically and periodontally healthy comparison groups (P <0.05). Positive correlations were found between bleeding on probing (BOP), plaque index (PI) scores, and GCF APRIL, serum sRANKL, serum OPG, and sRANKL concentrations in TM groups (P <0.05). Several significant positive correlations were found between BOP, PI scores, and biofluid parameters also in systemically healthy groups.

CONCLUSION

TM may have a role in the underlying systemic hematologic condition and potentially affect gingival inflammation via dysregulation of lymphocytes and increased activation of osteoclasts.

Lessons learned and unlearned in periodontal microbiology

Periodontal diseases are initiated by bacterial species living in polymicrobial biofilms at or below the gingival margin and progress largely as a result of the inflammation elicited by specific subgingival species. In the past few decades, efforts to understand the periodontal microbiota have led to an exponential increase in information about biofilms associated with periodontal health and disease. In fact, the oral microbiota is one of the best-characterized microbiomes that colonize the human body. Despite this increased knowledge, one has to ask if our fundamental concepts of the etiology and pathogenesis of periodontal diseases have really changed. In this article we will review how our comprehension of the structure and function of the subgingival microbiota has evolved over the years in search of lessons learned and unlearned in periodontal microbiology. More specifically, this review focuses on: (i) how the data obtained through molecular techniques have impacted our knowledge of the etiology of periodontal infections; (ii) the potential role of viruses in the etiopathogenesis of periodontal diseases; (iii) how concepts of microbial ecology have expanded our understanding of host-microbe interactions that might lead to periodontal diseases; (iv) the role of inflammation in the pathogenesis of periodontal diseases; and (v) the impact of these evolving concepts on therapeutic and preventive strategies to periodontal infections. We will conclude by reviewing how novel systems-biology approaches promise to unravel new details of the pathogenesis of periodontal diseases and hopefully lead to a better understanding of their mechanisms.

Quantification of lactate-dehydrogenase and cell viability in postmortem human dental pulp

Understanding pulp repair and regeneration requires being familiar with this tissue's behavior under extreme conditions, such as postmortem state where an abrupt interruption of tissue blood supply occurs. The purpose of this study was to quantify cell viability and the amount of lactate-dehydrogenase (LDH) expressed in human pulp tissue 6, 12, and 24 hours postmortem to establish how long dental pulp remains viable after death. Pulp samples were obtained from 14 unidentified corpses of people who had received lethal injuries in car accidents or from gunshot wounds; they had at least three caries- and restoration-free incisors. Half of each sample was used for determining cell viability at three different time intervals. The rest of each sample was used for quantifying LDH expression at the same time intervals. Another 14 pulp samples were obtained from live patients' healthy premolars where extraction was indicated for orthodontic reasons to assess normal LDH value in pulp tissue. The results showed cell viability decreasing from 89 to 68 to 41% measured 6, 12, and 24 hours postmortem, respectively. LDH expression in healthy pulps was 246 U/mg pulp weight. Expression increased after death from 249 U/mg at 6 hours to 337 U/mg at 12 hours. LDH expression decreased to 131 U/mg 24 hours postmortem. These findings are valuable in understanding dental pulp survival capability under extreme conditions that may have important clinical significance in terms of repair and regeneration.