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KAYAALTI M, BOSTANCI V, DOGAN H. THE EFFECT OF MENOPAUSE ON NADPH OXIDASE LEVELS AFTER NON-SURGICAL PERIODONTAL TREATMENTS ON PATIENTS WITH PERIODONTITIS. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1000295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Chen Y, Hu Y. Therapeutic potential of PPARα agonist in ligature-induced experimental periodontitis. J Appl Oral Sci 2022; 30:e20210648. [PMID: 35293424 PMCID: PMC8957283 DOI: 10.1590/1678-7757-2021-0648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/31/2022] [Indexed: 02/18/2023] Open
Abstract
Inflammation-related immune responses and bone metabolism lead to extensive tooth loss in periodontitis.
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State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021; 10:5383. [PMID: 34830663 PMCID: PMC8618619 DOI: 10.3390/jcm10225383&set/a 912874875+940716348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021. [DOI: 10.3390/jcm10225383
expr 893869204 + 932072443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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González-Moles MÁ, Ramos-García P. State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021; 10:5383. [PMID: 34830663 PMCID: PMC8618619 DOI: 10.3390/jcm10225383] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/09/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18010 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18010 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Du Y, Qi YS, Chen H, Shen G. The expression and clinical significance of miR-1226 in patients with periodontitis. BMC Oral Health 2021; 21:487. [PMID: 34592963 PMCID: PMC8485457 DOI: 10.1186/s12903-021-01855-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/13/2021] [Indexed: 02/07/2023] Open
Abstract
Background miR-1226 has been reported to be dysregulated in periodontitis, implying its potential functional role, which needs to be validated. The purpose of this study was to assess the clinical significance of miR-1226 in periodontitis. Methods Gingival crevicular fluid samples were collected from 50 healthy volunteers and 72 periodontitis patients. The expression of miR-1226 in collected samples was detected by RT-qPCR. The concentrations of pro-inflammatory cytokines were analyzed by ELISA. The relationship of miR-1226 expression level with patients’ characteristics was evaluated by the χ2 test and the Pearson correlation test. Results It was found that miR-1226 was downregulated in the gingival crevicular fluid of periodontitis patients compared with healthy volunteers. The downregulation of miR-1226 was negatively correlated with the pocket depth, attachment loss, plaque index, bleeding index, and MMP-8 concentration of patients. miR-1226 showed high sensitivity and specificity to discriminate periodontitis patients from healthy volunteers. Additionally, periodontitis patients had a relatively high concentration of pro-inflammatory cytokines, which is correlated with miR-1226 expression negatively. Conclusions miR-1226 could be an indicator for the diagnosis of periodontitis and has the potential to predict the development and severity of periodontitis.
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Affiliation(s)
- Yimin Du
- Department of Stomatology, Jinshan Hospital Affiliated To Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 200540, China
| | - Yue-Sun Qi
- Department of Stomatology, Jinshan Hospital Affiliated To Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 200540, China
| | - Hui Chen
- Department of Stomatology, Jinshan Hospital Affiliated To Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 200540, China
| | - Guorong Shen
- Department of Stomatology, Jinshan Hospital Affiliated To Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 200540, China.
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The Evaluation of Saliva Oxidative and Antioxidative Markers’ Levels in Adolescents with Gingival Inflammation. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2019-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Periodontal disease is highly prevalent and affects 10%–15% of the world population. Salivary markers of oxidative stress and antioxidant status represent promising tool for research of oral diseases. Given the importance of reactive oxygen species (ROS) in the pathogenesis of periodontal disease, the aim of this study was to determine the association between oxidative stress parameters and periodontal disease gingivitis in adolescents. The study included a consecutive sample of 80 male and female participants referred to the Institute of Dentistry, Kragujevac, Serbia, as a result of periodontal problems or for routine control, aged 18 to 21, with definitive dentition as an inclusion criterion. Patients were divided into three groups depending on their gingival inflammation status. The first group was control group (n=20) with no gingival inflammation, the second group was with mild gingival inflammation (n=19), the third group was with moderate gingival inflammation (n=21) and the fourth group was with severe gingival inflammation (n=20). Oxidative stress parameters were measured in unstimulated whole saliva samples (superoxide anion radical, hydrogen peroxide, nitric oxide, index of lipid peroxidation, reduced gluthatione, catalase and superoxide dismutase). We have found increased levels of hydrogen peroxide and reduced glutathione in the saliva of patients with moderate levels of gingival inflammation, while the other markers were not significantly affected. In conclusion, oxidative stress plays a central role in the pathogenesis and the determination of oxidative and antioxidative levels could be a potent tool in controlling the development of gingivitis.
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Wang Y, Huang X, He F. Mechanism and role of nitric oxide signaling in periodontitis. Exp Ther Med 2019. [PMID: 31641379 DOI: 10.3892/etm.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
The present study investigated the role of the nitric oxide (NO) signaling pathway in the progression of periodontal disease, and explored the related genetic mechanisms. An experimental model of periodontitis was established in Sprague-Dawley rats, then they were divided into normal control, and 2, 4 and 6 weeks post-surgery groups. NO content was determined in the saliva of rats from each group by the Griess reagent method. Pathological changes of the periodontal tissue sections were evaluated with hematoxylin-eosin staining. The periodontal tissue sections were also evaluated by immunohistochemistry to detect the expression of inducible nitric oxide synthase 2 (iNOS2). Significant differences were detected in the iNOS2 expression of the periodontal tissue based on immunohistochemistry. There was a significant time-dependent increase in NO serum levels post-surgery. Two single nucleotide polymorphisms (SNP), rs2297518 in the iNOS gene and rs841 of the GTP cyclohydrolase I gene, were identified to be closely related to alveolar bone resorption, which is associated with the SNP rs1049255 of the cytochrome b-245 α chain gene. The present findings demonstrated that iNOS2 values increased and NO levels increased with the progression of periodontitis. These results are in agreement with the previous literature. It was hypothesized that NO has a role in the occurrence and development of periodontal disease by regulating the action of certain cytokines.
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Affiliation(s)
- Yan Wang
- Department of Stomatology, The East Campus of Beihua University, Jilin, Jilin 132000, P.R. China
| | - Xiangdao Huang
- Department of Stomatology, The East Campus of Beihua University, Jilin, Jilin 132000, P.R. China
| | - Fuming He
- Department of Stomatology, The Affiliated Dental Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China
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Wang Y, Huang X, He F. Mechanism and role of nitric oxide signaling in periodontitis. Exp Ther Med 2019; 18:3929-3935. [PMID: 31641379 PMCID: PMC6796435 DOI: 10.3892/etm.2019.8044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 04/05/2019] [Indexed: 12/13/2022] Open
Abstract
The present study investigated the role of the nitric oxide (NO) signaling pathway in the progression of periodontal disease, and explored the related genetic mechanisms. An experimental model of periodontitis was established in Sprague-Dawley rats, then they were divided into normal control, and 2, 4 and 6 weeks post-surgery groups. NO content was determined in the saliva of rats from each group by the Griess reagent method. Pathological changes of the periodontal tissue sections were evaluated with hematoxylin-eosin staining. The periodontal tissue sections were also evaluated by immunohistochemistry to detect the expression of inducible nitric oxide synthase 2 (iNOS2). Significant differences were detected in the iNOS2 expression of the periodontal tissue based on immunohistochemistry. There was a significant time-dependent increase in NO serum levels post-surgery. Two single nucleotide polymorphisms (SNP), rs2297518 in the iNOS gene and rs841 of the GTP cyclohydrolase I gene, were identified to be closely related to alveolar bone resorption, which is associated with the SNP rs1049255 of the cytochrome b-245 α chain gene. The present findings demonstrated that iNOS2 values increased and NO levels increased with the progression of periodontitis. These results are in agreement with the previous literature. It was hypothesized that NO has a role in the occurrence and development of periodontal disease by regulating the action of certain cytokines.
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Affiliation(s)
- Yan Wang
- Department of Stomatology, The East Campus of Beihua University, Jilin, Jilin 132000, P.R. China
| | - Xiangdao Huang
- Department of Stomatology, The East Campus of Beihua University, Jilin, Jilin 132000, P.R. China
| | - Fuming He
- Department of Stomatology, The Affiliated Dental Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China
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Aithal GC, Nayak UY, Mehta C, Narayan R, Gopalkrishna P, Pandiyan S, Garg S. Localized In Situ Nanoemulgel Drug Delivery System of Quercetin for Periodontitis: Development and Computational Simulations. Molecules 2018; 23:E1363. [PMID: 29882751 PMCID: PMC6099597 DOI: 10.3390/molecules23061363] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 05/31/2018] [Accepted: 06/03/2018] [Indexed: 11/17/2022] Open
Abstract
This study was aimed at formulating a bioabsorbable, controlled-release, nanoemulgel of Quercetin, a potent antimicrobial and anti-inflammatory agent for the treatment of periodontitis that could improve its solubility and bioavailability. Screening of components was carried out based on the solubility studies. Nanoemulsion containing cinnamon oil as the oil phase, tween 80 and Carbitol® as the surfactant-cosurfactant mixture (Smix) and water as the aqueous phase containing 125 µg/200 µL of Quercetin was prepared by using spontaneous emulsification method. Nanoemulgel was prepared using 23% w/v poloxamer 407 as gel base. Comprehensive evaluation of the formulated nanoemulgel was carried out, and the optimized formulation was studied for drug release using Franz vertical diffusion cells. The formulated nanoemulgelexhibited a remarkable release of 92.4% of Quercetin at the end of 6 h, as compared to that of pure Quercetin-loaded gel (<3% release). The viscosity of the prepared nanoemulgel was found to be 30,647 ± 0.32 cPs at 37 °C. Also, molecular dynamics (MD) simulation was utilized to understand the gelation process and role of each component in the formulation. The present study revealed that the developed nanoemulgel of Quercetin could be a potential delivery system for clinical testing in periodontitis.
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Affiliation(s)
- Gururaj C Aithal
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, India.
| | - Usha Yogendra Nayak
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, India.
| | - Chetan Mehta
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, India.
| | - Reema Narayan
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, India.
| | - Pratibha Gopalkrishna
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, India.
| | | | - Sanjay Garg
- School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA 5000, Australia.
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Ebersole JL, Al-Sabbagh M, Gonzalez OA, Dawson DR. Ageing effects on humoral immune responses in chronic periodontitis. J Clin Periodontol 2018; 45:680-692. [PMID: 29476652 PMCID: PMC5992058 DOI: 10.1111/jcpe.12881] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2018] [Indexed: 12/16/2022]
Abstract
Periodontal disease is a dominant global bacterial infection that increases with ageing. AIM This report focuses on host adaptive immune responses in periodontitis. While experimental models and humans diagnosed with periodontitis demonstrate an antigenic specificity for particular oral bacteria, we have a limited understanding of (i) how ageing affects the adaptive immune responses to these bacteria that chronically colonize the oral cavity for decades prior to disease expression and (ii) how the magnitude and specificity of the response interface with pathogens that emerge within the bacterial ecology during exacerbations of disease. MATERIALS AND METHODS Serum antibody levels to a group of pathogenic and commensal oral bacteria were measured in a population of individuals from 21 to 74 years of age, stratified based on clinical status of the periodontium, smoking and sex. RESULTS Clinical parameters were not significantly different within health, gingivitis or periodontitis groups related to age. Antibody to oral pathogens and commensals was similar in different age groups in each of the clinical categories, with no age correlation noted in the periodontitis patients. CONCLUSIONS The adaptive immune responses to oral bacteria that chronically colonize the oral cavity appear generally unaffected by age, but clearly are linked to the extent of disease.
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Affiliation(s)
- Jeffrey L Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Mohanad Al-Sabbagh
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Octavio A Gonzalez
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Dolph R Dawson
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Micó-Martínez P, García-Giménez JL, Seco-Cervera M, López-Roldán A, Almiñana-Pastor PJ, Alpiste-Illueca F, Pallardó FV. miR-1226 detection in GCF as potential biomarker of chronic periodontitis: A pilot study. Med Oral Patol Oral Cir Bucal 2018; 23:e308-e314. [PMID: 29680855 PMCID: PMC5945245 DOI: 10.4317/medoral.22329] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 03/23/2018] [Indexed: 01/18/2023] Open
Abstract
Background The study and identification of new biomarkers for periodontal disease, such as microRNAs (miRNAs), may give us more information about the location and severity of the disease and will serve as a basis for treatment planning and disease-monitoring. miRNAs are a group of small RNAs which are involved in gene regulation by binding to their messenger RNA target (mRNA). In this pilot study, the procedure for purifying miRNAs from gingival crevicular fluid (GCF) was, for the first time, described. In addition, the concentration of miRNAs in GCF was analyzed and compared between patients with moderate or severe chronic periodontitis (CP) and healthy controls. Material and Methods GCF samples were collected from single-rooted teeth of patients with moderate or severe CP (n=9) and of healthy individuals (n=9). miRNAs were isolated from GCF using miRNeasy Serum/Plasma kit (Qiagen, CA. USA). Reverse transcription polymerase chain reaction (qRT-PCR) was used to determine the expression of a series of miRNAs candidates that are related to bone metabolism. The significance of differences in miRNA levels between both groups was determined using Mann-Whitney U test. Results The results from this pilot study indicate that miRNAs can be isolated from GCF. Six different miRNAs were analyzed (miR-671, miR-122, miR-1306, miR-27a, miR-223, miR-1226), but only miR-1226 showed statically significant differences between the CP group and healthy controls (p<0.05). This miRNA was downregulated in patients with CP. Conclusions Within the limitations of the present study, it may be concluded that miR-1226 can be a promising biomarker for periodontal disease, adding relevant information to common clinical parameters used for diagnosis and prognosis of periodontitis. Key words:Small interfering RNA, biomarkers, periodontal diseases, reverse transcriptase polymerase chain reaction.
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Affiliation(s)
- P Micó-Martínez
- Dept. of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag, 1, 46010 Valencia, Spain,
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Interleukin-17 and interleukin-23 levels in gingival crevicular fluid of patients with chronic and aggressive periodontitis. Cent Eur J Immunol 2018; 43:76-80. [PMID: 29736149 PMCID: PMC5927176 DOI: 10.5114/ceji.2018.74876] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 06/21/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction Interleukin-17 is a pro-inflammatory cytokine with a wide range of protective and destructive effects in periodontitis. The role of IL-23 is stabilisation and expansion of Th-17. The aim of this study was to assess whether patients with aggressive and chronic periodontitis exhibit different gingival crevicular fluid (GCF) concentrations of IL-17 and IL-23 compared with clinically healthy subjects. Material and methods GCF samples were obtained from 32 patients: 10 with chronic periodontitis (CP), 12 with aggressive periodontitis (AgP), and 10 healthy controls (HC). IL-23 and IL-17 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Comparison of study groups was performed with ANOVA and Tukey HSD tests. Spearman's correlation coefficient was used to assess correlations between the variables. Results IL-17 concentration was significantly higher in the healthy group compared to the AgP and CP groups (p < 0.001), but there were no significant differences between the CP and AgP groups. IL-23 levels in the healthy group were significantly higher than that in the AgP group (p < 0.001). Cytokine concentrations did not correlate significantly with probing depths and clinical attachment levels. Conclusions Gingival crevicular fluid concentrations of IL-17 and IL-23 were significantly higher in the healthy group compared to periodontitis groups.
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Hernández-Ríos P, Pussinen PJ, Vernal R, Hernández M. Oxidative Stress in the Local and Systemic Events of Apical Periodontitis. Front Physiol 2017; 8:869. [PMID: 29163211 PMCID: PMC5672116 DOI: 10.3389/fphys.2017.00869] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 10/17/2017] [Indexed: 12/13/2022] Open
Abstract
Oxidative stress is involved in the pathogenesis of a variety of inflammatory disorders. Apical periodontitis (AP) usually results in the formation of an osteolytic apical lesion (AL) caused by the immune response to endodontic infection. Reactive oxygen species (ROS) produced by phagocytic cells in response to bacterial challenge represent an important host defense mechanism, but disturbed redox balance results in tissue injury. This mini review focuses on the role of oxidative stress in the local and associated systemic events in chronic apical periodontitis. During endodontic infection, ligation of Toll-like receptors (TLRs) on phagocytes' surface triggers activation, phagocytosis, synthesis of ROS, activation of humoral and cellular responses, and production of inflammatory mediators, such as, cytokines and matrix metalloproteinases (MMPs). The increment in ROS perturbs the normal redox balance and shifts cells into a state of oxidative stress. ROS induce molecular damage and disturbed redox signaling, that result in the loss of bone homeostasis, increased pro-inflammatory mediators, and MMP overexpression and activation, leading to apical tissue breakdown. On the other hand, oxidative stress has been strongly involved in the pathogenesis of atherosclerosis, where a chronic inflammatory process develops in the arterial wall. Chronic AP is associated with an increased risk of cardiovascular diseases (CVD) and especially atherogenesis. The potential mechanisms linking these diseases are also discussed.
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Affiliation(s)
- Patricia Hernández-Ríos
- Department of Conservative Dentistry, School of Dentistry, Universidad de Chile, Santiago, Chile
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Rolando Vernal
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| | - Marcela Hernández
- Laboratory of Periodontal Biology, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
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Romano F, Bongiovanni L, Bianco L, Di Scipio F, Yang Z, Sprio AE, Berta GN, Aimetti M. Biomarker levels in gingival crevicular fluid of generalized aggressive periodontitis patients after non-surgical periodontal treatment. Clin Oral Investig 2017; 22:1083-1092. [PMID: 28918557 DOI: 10.1007/s00784-017-2192-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 08/16/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this study was to assess the effects of non-surgical periodontal treatment on gingival crevicular fluid (GCF) cytokines in patients with generalized aggressive periodontitis (GAgP), in relation to clinical parameters. MATERIALS AND METHODS Data were obtained from 16 GAgP patients and 15 periodontally healthy controls. Periodontal parameters and GCF biomarker levels were evaluated at baseline and repeated 3 and 6 months after treatment for GAgP subjects. Moderate and deep pocket sites were analyzed separately. The amount of interleukin (IL)-1β, IL-9, tumor necrosis factor (TNF)-α, platelet-derived growth factor (PDGF-bb), and vascular endothelial growth factor (VEGF) were measured using a highly specific and sensitive multiplex bead immunoassay. RESULTS At baseline, cytokine levels in the moderate and deep pocket sites of GAgP patients were higher than those of the healthy control sites. In GAgP group, periodontal treatment led to improvement in all examined clinical parameters and resulted in a statistically significant reduction in the total amounts of IL-1β, VEGF, and TNF-α, in comparison to baseline, already 3 months after therapy in both moderate and deep pocket sites and of PDGF-bb in deep sites (p < 0.01). At the concentration level, only IL-1β and VEGF were affected. CONCLUSION Non-surgical treatment of GAgP provided significant clinical benefits leading to a marked decrease in the GCF levels of some pro-inflammatory and pro-angiogenic cytokines, but not of IL-9 and PDGF-bb. CLINICAL RELEVANCE Although the periodontal therapy successfully decreased clinical signs of inflammation, the GCF levels of some inflammatory cytokines were still elevated.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Via Nizza, 230 10126, Turin, Italy
| | - Loretta Bongiovanni
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Via Nizza, 230 10126, Turin, Italy
| | - Laura Bianco
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Via Nizza, 230 10126, Turin, Italy
| | - Federica Di Scipio
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Zhiqian Yang
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Andrea Elio Sprio
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Via Nizza, 230 10126, Turin, Italy.
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Thapa S, Wei F. Association Between High Serum Total Cholesterol and Periodontitis: National Health and Nutrition Examination Survey 2011 to 2012 Study of American Adults. J Periodontol 2016; 87:1286-1294. [PMID: 27452393 DOI: 10.1902/jop.2016.150648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Clinical studies have suggested that lipids increase activity of white blood cells. The objective of this study is to examine whether high serum total cholesterol (STC) is associated with periodontitis. METHODS A total of 1,061 participants from the 2011 to 2012 National Health and Nutrition Examination Survey who underwent both periodontal examination and laboratory test for STC was included. To examine effects of high STC on periodontitis, odds ratios were calculated, adjusting for age, sex, education, income, smoking status, diabetes, body mass index, and calcium levels. RESULTS Statistically significant associations were observed between borderline as well as high STC and periodontitis. Study participants with STC between 200 and 239 mg/dL (borderline) were 1.67 times (95% confidence interval [CI]: 1.13 to 2.47) as likely to have periodontitis as those with normal levels (≤199 mg/dL), and those with STC ≥240 mg/dL (high) were 2.22 times (95% CI: 1.27 to 3.87) as likely to have periodontitis as those with normal levels. CONCLUSIONS Positive significant association was observed between STC and periodontitis. Results of the present study provide insight into potential risk factors for periodontitis. High STC levels could be a potential risk factor for the disease; however, further studies need to be conducted to understand the actual relationship between STC levels and periodontitis and to establish causality and directional association.
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Affiliation(s)
- Susan Thapa
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Feifei Wei
- Department of Biostatistics, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
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17
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Nagarajan R, Miller CS, Dawson D, Al-Sabbagh M, Ebersole JL. Cross-talk between clinical and host-response parameters of periodontitis in smokers. J Periodontal Res 2016; 52:342-352. [PMID: 27431617 DOI: 10.1111/jre.12397] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontal diseases are a major public health concern leading to tooth loss and have also been shown to be associated with several chronic systemic diseases. Smoking is a major risk factor for the development of numerous systemic diseases, as well as periodontitis. While it is clear that smokers have a significantly enhanced risk for developing periodontitis leading to tooth loss, the population varies regarding susceptibility to disease associated with smoking. This investigation focused on identifying differences in four broad sets of variables, consisting of: (i) host-response molecules; (ii) periodontal clinical parameters; (iii) antibody responses to periodontal pathogens and oral commensal bacteria; and (iv) other variables of interest, in a population of smokers with (n = 171) and without (n = 117) periodontitis. MATERIAL AND METHODS Bayesian network structured learning (BNSL) techniques were used to investigate potential associations and cross-talk between the four broad sets of variables. RESULTS BNSL revealed two broad communities with markedly different topology between the populations of smokers, with and without periodontitis. Confidence of the edges in the resulting network also showed marked variations within and between the periodontitis and nonperiodontitis groups. CONCLUSION The results presented validated known associations and discovered new ones with minimal precedence that may warrant further investigation and novel hypothesis generation. Cross-talk between the clinical variables and antibody profiles of bacteria were especially pronounced in the case of periodontitis and were mediated by the antibody response profile to Porphyromonas gingivalis.
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Affiliation(s)
- R Nagarajan
- Division of Biomedical Informatics, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - C S Miller
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.,Department of Oral Health Practice, Division of Oral Medicine, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - D Dawson
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.,Department of Oral Health Practice, Division of Periodontics, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - M Al-Sabbagh
- Department of Oral Health Practice, Division of Periodontics, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - J L Ebersole
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.,Department of Oral Health Practice, Division of Periodontics, College of Dentistry, University of Kentucky, Lexington, KY, USA
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18
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Kaur G, Kathariya R, Bansal S, Singh A, Shahakar D. Dietary antioxidants and their indispensable role in periodontal health. J Food Drug Anal 2016; 24:239-246. [PMID: 28911576 PMCID: PMC9339570 DOI: 10.1016/j.jfda.2015.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 11/03/2015] [Accepted: 11/19/2015] [Indexed: 11/17/2022] Open
Abstract
Periodontitis is an increasing area of interest due to its global prevalence. This inflammatory condition results due to the loss of the critical balance between the virulence factors produced by microorganisms and the inflammatory host response. A number of efforts have been made in the past to address this condition and regain periodontal health. Targeting the root cause by nonsurgical debridement has been considered the gold standard. However, research has shown the possible effects of nutrient deficiency and an imbalanced diet on the periodontium. Therefore, an effort toward the maintenance of optimal conditions as well as improvement of the oral health necessities the introduction of adjunctive nutritional therapy, which can benefit the patients. Antioxidants in the diet have some remarkable benefits and valuable properties that play an irreplaceable role in the maintenance of periodontal health. These have emerged as excellent adjuncts that can enhance the outcomes of conventional periodontal therapy. The aim of this review article is to highlight some of these dietary antioxidants that can make a notable difference by striking a balance between health and disease.
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Affiliation(s)
- Gurbani Kaur
- Department of Periodontology and Oral Implantology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Rahul Kathariya
- Department of Periodontology and Oral Implantology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India.
| | - Shruti Bansal
- Department of Periodontology and Oral Implantology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Archana Singh
- Department of Periodontology and Oral Implantology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Dipti Shahakar
- Department of Periodontology and Oral Implantology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
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Manthena S, Rao MVR, Penubolu LP, Putcha M, Harsha AVNS. Effectiveness of CoQ10 Oral Supplements as an Adjunct to Scaling and Root Planing in Improving Periodontal Health. J Clin Diagn Res 2015; 9:ZC26-8. [PMID: 26436041 DOI: 10.7860/jcdr/2015/13486.6291] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 06/07/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Deficiency of CoQ 10 was found in human inflamed gingiva and has been found to be responsible for periodontal destruction. AIM To evaluate the effectiveness of CoQ 10 supplementation as an adjunct to scaling and rootplaning in reducing gingival inflammation and periodontal pocket depth. MATERIALS AND METHODS The study was a randomized, double-blind, controlled, parallel group design clinical trial. Thirty subjects with plaque induced gingival inflammation and having atleast three nonadjacent interproximal sites with a probing pocket depth ≥ 5mm were included in the study. The subjects were randomly divided into two groups. The test group (n=15) in which patients were given oral CoQ10 supplements after scaling and root planing and the control group (n=15) in which patients were given an oral placebo after scaling and rootplaning. The plaque index, gingival index and probing depth were recorded at baseline, 1 month and 3 months. Statistical analysis done by using Student's paired t-test for intragroup comparison and unpaired t-test for inter-group comparison. RESULTS Both the groups showed marked reduction of afore mentioned periodontal parameters at one month and three months when compared to baseline. Though there was no significant difference in plaque index and probing pocket depth between the two groups at any given time period, test group showed significant difference in gingival inflammation at one month and three months when compared to control group. CONCLUSION In the present study use of Coenzyme Q10 oral supplements as an adjunct to scaling and root planing showed significant reduction in gingival inflammation when compared to scaling and rootplaning alone.
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Affiliation(s)
- Sathish Manthena
- Reader, Department of Periodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences , Chinnoutpalli, India
| | - Mulpuri Venkata Ramoji Rao
- Professor and Head, Department of Periodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences , Chinnoutpalli, India
| | - Lakshmi Preethi Penubolu
- Reader, Department of Periodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences , Chinnoutpalli, India
| | - Madhusudhan Putcha
- Senior Lecturer, Department of Periodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences , Chinnoutpalli, India
| | - Anumolu Venkata Naga Sri Harsha
- Senior Lecturer, Department of Periodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences , Chinnoutpalli, India
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Prasad R, Suchetha A, Lakshmi P, Darshan MB, Apoorva SM, Ashit GB. Interleukin-11 - its role in the vicious cycle of inflammation, periodontitis and diabetes: A clinicobiochemical cross-sectional study. J Indian Soc Periodontol 2015; 19:159-63. [PMID: 26015665 PMCID: PMC4439624 DOI: 10.4103/0972-124x.152108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 12/18/2014] [Indexed: 01/20/2023] Open
Abstract
Context: Interleukin-11 (IL-11) is a multifunctional cytokine with a probable regulatory role in the inflamed periodontal tissue. It has also been shown to inhibit the production of potent proinflammatory cytokines like tumor necrosis factor-alpha, IL-6 and IL-1β in vitro. Type 2 diabetes mellitus, which demonstrates an increase in proinflammatory cytokines, might hypothetically, display a decrease in the levels of IL-11, which down-regulates synthesis of the proinflammatory cytokines. Aims: This clinicobiochemical cross-sectional study was undertaken to try to interpret the link between IL-11, diabetes and periodontitis and to explore the probable protective role of IL-11. Materials and Methods: A total of 90 patients were included in the study and were divided into five groups based on community periodontal index scores and diabetes status. Probing pocket depth and clinical attachment level were measured in all the subjects. Gingival crevicular fluid (GCF) was collected from all the participants using micropipettes and blood samples were collected from subjects in Groups III, IV and V, for analysis of glycated hemoglobin. IL-11 levels were measured in GCF samples by enzyme-linked immunosorbent assay. Statistical Analysis: The data obtained were subjected to statistical analysis. Results: The GCF IL-11 levels decreased from periodontal health to disease and in periodontitis patients with type 2 diabetes with decreasing glycemic control. Conclusions: Interleukin-11 may play an important role in the modulation of immune response via the reduction of proinflammatory cytokine production and periodontal tissue damage. It was seen in this study that IL-11 could be detected in GCF and the levels of IL-11 in GCF decreased progressively from healthy to periodontitis sites. IL-11 levels were significantly lower in chronic periodontitis group when compared to gingivitis group. The decrease in the levels of IL-11 probably indicates that both diabetes and periodontitis may play a synergistic role in the suppression of protective host responses. The potential of IL-11 as a probable biomarker of inflammation in both periodontal disease and diabetes mellitus is indicated by the changeability of IL-11 levels with the change in periodontal disease status and glycemic control. Further longitudinal studies are needed to validate IL-11 as a “biomarker of inflammation” in periodontal disease and diabetes progression and to prove its role in the connecting link between periodontal disease and type 2 diabetes mellitus.
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Affiliation(s)
- Rohit Prasad
- Department of Periodontics, Faculty of Dental Sciences, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Aganashini Suchetha
- Department of Periodontics, D. A. Pandu Memorial R. V. Dental College, Bengaluru, Karnataka, India
| | - Puzhankara Lakshmi
- Department of Periodontics, Amrita School of Dentistry, Kochi, Kerala, India
| | | | | | - Gulabdas Bharwani Ashit
- Department of Periodontics, K. M. Shah Dental College and Hospital, Vadodara, Gujarat, India
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21
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Mechanisms of Bone Resorption in Periodontitis. J Immunol Res 2015; 2015:615486. [PMID: 26065002 PMCID: PMC4433701 DOI: 10.1155/2015/615486] [Citation(s) in RCA: 406] [Impact Index Per Article: 45.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 12/13/2014] [Indexed: 12/18/2022] Open
Abstract
Alveolar bone loss is a hallmark of periodontitis progression and its prevention is a key clinical challenge in periodontal disease treatment. Bone destruction is mediated by the host immune and inflammatory response to the microbial challenge. However, the mechanisms by which the local immune response against periodontopathic bacteria disturbs the homeostatic balance of bone formation and resorption in favour of bone loss remain to be established. The osteoclast, the principal bone resorptive cell, differentiates from monocyte/macrophage precursors under the regulation of the critical cytokines macrophage colony-stimulating factor, RANK ligand, and osteoprotegerin. TNF-α, IL-1, and PGE2 also promote osteoclast activity, particularly in states of inflammatory osteolysis such as those found in periodontitis. The pathogenic processes of destructive inflammatory periodontal diseases are instigated by subgingival plaque microflora and factors such as lipopolysaccharides derived from specific pathogens. These are propagated by host inflammatory and immune cell influences, and the activation of T and B cells initiates the adaptive immune response via regulation of the Th1-Th2-Th17 regulatory axis. In summary, Th1-type T lymphocytes, B cell macrophages, and neutrophils promote bone loss through upregulated production of proinflammatory mediators and activation of the RANK-L expression pathways.
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22
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Thomas B, Rao A, Prasad BR, Kumari S. Serum levels of antioxidants and superoxide dismutase in periodontitis patients with diabetes type 2. J Indian Soc Periodontol 2014; 18:451-5. [PMID: 25210258 PMCID: PMC4158585 DOI: 10.4103/0972-124x.138686] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 12/09/2013] [Indexed: 11/04/2022] Open
Abstract
AIMS AND OBJECTIVES The present study was designed to estimate and compare the superoxide dismutase and total antioxidant capacity levels in the serum of diabetes mellitus - Type 2 patients and healthy individuals with and without periodontal disease. MATERIALS AND METHODS The study was designed as a case-control study comprising of 150 subjects, inclusive of both genders in the age group of 35-65 years. They were divided into three groups of 50 patients each. Patients were categorized into diabetic with chronic periodontitis (DM-CP) and systemically healthy groups with and without periodontitis. Serum samples were collected and sent for biochemical analysis to estimate the total antioxidant capacity (TAOC) and superoxide dismutase (SOD) levels. Results obtained were then statistically analysed using ANOVA test. RESULTS The results showed a higher level of serum TAOC in the systemically healthy group without periodontitis (PH) compared to the other groups. The P value was found to be <0.05. The SOD levels were found to be highest in the DM-CP group. CONCLUSION The results of this study indicate that serum TAOC were found to be highest in the PH group and lowest in the systemically healthy with chronic periodontitis (CP). The serum SOD levels were found to be highest in the DM-CP group. The increased levels of SOD seen in DM patients may be a result of a protective and adaptive mechanism against the oxidative stress developing in the tissue.
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Affiliation(s)
- Biju Thomas
- Department of Periodontics, A. B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Amita Rao
- Department of Periodontics, A. B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | | | - Suchetha Kumari
- Department of Biochemistry, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
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23
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Meeran NA. Biological response at the cellular level within the periodontal ligament on application of orthodontic force - An update. J Orthod Sci 2014; 1:2-10. [PMID: 24987618 PMCID: PMC4072349 DOI: 10.4103/2278-0203.94769] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Orthodontic force elicits a biological response in the tissues surrounding the teeth, resulting in remodeling of the periodontal ligament and the alveolar bone. The force-induced tissue strain result in reorganization of both cellular and extracellular matrix, besides producing changes in the local vascularity. This in turn leads to the synthesis and release of various neurotransmitters, arachidonic acid, growth factors, metabolites, cytokines, colony-stimulating factors, and enzymes like cathepsin K, matrix metalloproteinases, and aspartate aminotransferase. Despite the availability of many studies in the orthodontic and related scientific literature, a concise integration of all data is still lacking. Such a consolidation of the rapidly accumulating scientific information should help in understanding the biological processes that underlie the phenomenon of tooth movement in response to mechanical loading. Therefore, the aim of this review was to describe the biological processes taking place at the molecular level on application of orthodontic force and to provide an update of the current literature.
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Affiliation(s)
- Nazeer Ahmed Meeran
- Departments of Orthodontics and Dentofacial Orthopedics, Priyadarshini Dental College and Hospital, Tamil Nadu, India
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24
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Risk factors of periodontal disease: review of the literature. Int J Dent 2014; 2014:182513. [PMID: 24963294 PMCID: PMC4055151 DOI: 10.1155/2014/182513] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/07/2014] [Indexed: 01/15/2023] Open
Abstract
Objectives. This paper aims to review the evidence on the potential roles of modifiable and nonmodifiable risk factors associated with periodontal disease. Data. Original articles that reported on the risk factors for periodontal disease were included. Sources. MEDLINE (1980 to Jan 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: "periodontal disease," "periodontitis," "risk factors," and "causal." This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. It is important to understand the etiological factors and the pathogenesis of periodontal disease to recognize and appreciate the associated risk factors. As periodontal disease is multifactorial, effective disease management requires a clear understanding of all the associated risk factors.
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25
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Chaudhary S, Gowda TM, Mehta DS, Kumar TAB. Comparative evaluation of plasma ROM levels in chronic periodontitis patients before and after non-surgical and surgical periodontal therapy: A clinical trial. J Indian Soc Periodontol 2014; 18:140-4. [PMID: 24872618 PMCID: PMC4033876 DOI: 10.4103/0972-124x.131303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 10/10/2013] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Chronic periodontitis (CP) is associated with increased levels of blood reactive oxygen species (ROS). So, treatment of CP may lead to decrease in blood ROS. However, not much literature is available comparing the effect of surgical and non-surgical periodontal treatment on blood ROS levels. Reactive oxygen metabolites (ROMs) are a useful measure of blood ROS. The aim of this study was to investigate the effect of periodontal treatment on plasma ROM levels in CP patients. MATERIALS AND METHODS Thirty CP patients and 15 controls were monitored. Plasma samples were collected at baseline and the clinical parameters were recorded. The CP patients were randomly divided into two groups: Scaling and root planing (Group II) and periodontal flap surgery (Group III). Both groups were re-evaluated 1 and 2 months after therapy. Clinical parameters were reviewed, plasma samples collected, and ROM levels were determined using a spectrophotometric technique. RESULTS At baseline, the ROM levels for Group II and Group III were 519.8 ± 62.4 and 513.4 ± 74.7 CARR U, respectively, which were higher than Group I value (282.9 ± 23.9, P < 0.001). Periodontal treatment in CP patients resulted in improvement of clinical parameters and a highly significant reduction in plasma ROM level (P < 0.001) after 2 months. Also, there was a more significant reduction in plasma ROM levels in Group III as compared to Group II (P < 0.05). CONCLUSIONS In CP patients, surgical periodontal treatment was more effective in lowering the plasma ROM levels than when non-surgical periodontal treatment was performed alone and, therefore, may be more beneficial in reducing systemic oxidative stress.
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Affiliation(s)
- Sohini Chaudhary
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Triveni M. Gowda
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Dhoom S. Mehta
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Tarun A. B. Kumar
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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26
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Lee P, Tan KS. Fusobacterium nucleatum activates the immune response through retinoic acid-inducible gene I. J Dent Res 2014; 93:162-8. [PMID: 24334410 DOI: 10.1177/0022034513516346] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Retinoic acid-inducible gene I (RIG-I) is a cytosolic pattern recognition receptor involved in the sensing of RNA viruses and the initiation of antiviral responses. Fusobacterium nucleatum, a Gram-negative anaerobic bacterium associated with periodontal disease, is capable of invading cells. We hypothesized that F. nucleatum's ability to invade cells allows the microorganism to activate the immune response through RIG-I. Bacterial invasion was found to be necessary for F. nucleatum-induced nuclear factor kappa B (NF-κB) activation. Following invasion of the human periodontal ligament fibroblast (PDLF), F. nucleatum was located in the cytosol. F. nucleatum infection led to an 80-fold increase in RIG-I expression. Silencing RIG-I in PDLF by siRNA led to a significant decrease of NF-κB activation and expression of proinflammatory genes. Additionally, F. nucleatum was able to secrete nucleic acids, and introduction of F. nucleatum RNA into PDLF led to a RIG-I-dependent activation of NF-κB. Our findings showed RIG-I to be involved in the recognition of F. nucleatum. The function of RIG-I is likely to be broad and not limited to sensing of viruses only. Hence, this receptor may play an important role in detecting invasive forms of oral pathogens and contribute to inflammation in periodontal tissues.
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Affiliation(s)
- P Lee
- Faculty of Dentistry, National University of Singapore, Singapore
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27
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Irie K, Ekuni D, Tomofuji T, Morita M. Periodontitis and Liver Diseases. STUDIES ON PERIODONTAL DISEASE 2014. [DOI: 10.1007/978-1-4614-9557-4_14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Ebersole JL, Steffen MJ, Thomas MV, Al-Sabbagh M. Smoking-related cotinine levels and host responses in chronic periodontitis. J Periodontal Res 2013; 49:642-51. [PMID: 24283398 DOI: 10.1111/jre.12146] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Smoking has been reported to increase the risk of periodontal disease by disrupting the balance of immune responses and tissue repair processes; however, this risk varies among smokers. Cotinine levels in saliva are routinely used to measure the level of smoking, and reflect the quantity of nicotine, and other smoking-related xenobiotics that challenge host systems. This study delineated characteristics of inflammatory mediators in saliva and serum antibody responses to both periodontal pathogens and commensal bacteria in smokers as they related to cotinine levels. MATERIALS AND METHODS This case-control study (n = 279) examined salivary inflammatory mediator responses [interleukin (IL)-1ß, IL-10, prostaglandin E2, myeloperoxidase and plasminogen activator inhibitor-1], and serum IgG antibody responses to three periodontal pathogens (Aggregatibacter actinomyce-temcomitans, Porphyromonas gingivalis, Treponema denticola) and five commensal oral microorganisms (Veillonella parvula, Streptococcus sanguis, Prevotella loescheii, Actinomyces naeslundii, Capnocytophaga ochracea). RESULTS The patients were stratified into health (n = 30), gingivitis (n = 55) and periodontitis (n = 184); cotinine levels correlated with reported smoking habits in health, less so with gingivitis, and were not correlated in periodontitis. Of the inflammatory mediators/acute phase proteins, only IL-1ß levels were positively associated (p < 0.001) with the pack years and cotinine levels. As might be predicted, patients with periodontitis smoked more (p < 0.001) and had higher levels of cotinine. IL-1ß and antibody to A. actinomycetemcomitans, P. gingivalis and T. denticola were significantly higher in the patients with periodontitis than either patients with gingivitis or who were healthy. CONCLUSIONS Generally, antibody to the pathogens and commensals was lower with decreased cotinine levels. Smoking exacerbated differences in both inflammatory mediators and three antibody in periodontal disease compared to healthy subjects.
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Affiliation(s)
- J L Ebersole
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA; Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, USA
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29
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Sloan AJ, Taylor SY, Smith EL, Roberts JL, Chen L, Wei XQ, Waddington RJ. A novel ex vivo culture model for inflammatory bone destruction. J Dent Res 2013; 92:728-34. [PMID: 23857868 DOI: 10.1177/0022034513495240] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pathological alterations in the balance of bone metabolism are central to the progression of inflammatory bone diseases such as periodontal disease. We have developed and characterized a novel ex vivo murine mandible model of inflammatory bone destruction. Slices of mandible were cultured for 14 days in the presence or absence of P. gingivalis lipopolysaccharide (LPS) or pro-inflammatory cytokines. Following culture, cell viability and tissue histomorphometry were assessed with quantification of matrix proteins, resident osteoclasts, ligament cells, monocytes, macrophages, and neutrophils. In the absence of inflammatory factors, culture viability, osteoclasts, and matrix components were maintained. LPS or TNFα stimulation demonstrated an increase in cellular proliferation, monocyte cells, osteoclast differentiation, and matrix degradation. Pathophysiological bone metabolism can be induced via exposure to LPS and direct influence of TNFα within the model despite the absence of systemic circulation, providing a model for inflammatory bone destruction and investigation of the effects of novel therapeutics.
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Affiliation(s)
- A J Sloan
- Mineralised Tissue Group, Tissue Engineering and Reparative Dentistry, School of Dentistry, Cardiff University, UK.
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30
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Trivedi S, Lal N, Mahdi AA, Mittal M, Singh B, Pandey S. Evaluation of antioxidant enzymes activity and malondialdehyde levels in patients with chronic periodontitis and diabetes mellitus. J Periodontol 2013; 85:713-20. [PMID: 23895253 DOI: 10.1902/jop.2013.130066] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The aim of this study is to investigate the impact of diabetes, a known risk factor for periodontitis, on activities of antioxidant enzymes superoxide dismutase (SOD), glutathione reductase (GR), and catalase (CAT) as well as levels of free radical damage marker malondialdehyde (MDA) in blood and saliva of individuals with chronic periodontitis (CP). METHODS Sixty patients with CP (30 patients with type 2 diabetes mellitus [DMCP] and 30 systemically healthy patients [CP]) and 60 periodontally healthy individuals (30 patients with type 2 diabetes mellitus and 30 systemically healthy patients [PH]) were included in this study. After clinical measurements, blood and saliva samples were collected. SOD, GR, and CAT activities in red blood cell lysate and saliva and MDA levels in plasma and saliva samples were spectrophotometrically assayed. An analysis of variance test followed by a post hoc test was used to compare the intragroup and intergroup variances among the study groups. RESULTS MDA levels in both the periodontitis groups were higher than in the periodontally healthy groups, but the difference between the CP and DMCP groups did not reach statistical significance (P >0.05). There was a highly significant difference between the CP and PH groups for all the enzymes studied except for SOD in blood. Only salivary SOD and GR activities were significantly different in the CP and DMCP groups. CONCLUSIONS This study favors the role of oxidative stress in both diabetes and periodontitis. It shows that the compensatory mechanism of the body is partially collapsed because of excessive production of free radicals during periodontitis and is not able to cope with increased free radical generation attributable to diabetes, thereby worsening the situation.
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Affiliation(s)
- Shilpa Trivedi
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Sundar NM, Krishnan V, Krishnaraj S, Hemalatha VT, Alam MN. Comparison of the salivary and the serum nitric oxide levels in chronic and aggressive periodontitis: a biochemical study. J Clin Diagn Res 2013; 7:1223-7. [PMID: 23905146 PMCID: PMC3708241 DOI: 10.7860/jcdr/2013/5386.3068] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 04/11/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Nitric oxide (NO) is a ubiquitous intercellular messenger molecule with important cardiovascular, neurological, and immune functions. In addition, it has been postulated that the pharmacological inhibition of NO or its actions may be therapeutically valuable in the disease management. The levels of nitric oxide may provide clues about the severity and the state of the underlying disease process. It could be an inflammatory biomarker that may enable clinicians to direct the environmentally based prevention or treatment programmes and to establish whether NO plays a role in the pathogenesis of periodontitis or not. Hence, the aim of the present study was to evaluate the salivary and the serum levels of NO in generalized chronic and aggressive periodontitis. The Study Design: Unstimulated whole saliva and serum samples were collected from a total of 60 subjects who were in the age group of 18-45 years, who participated in this study. They were divided into three equal groups with 20 subjects in each group; group A (healthy controls), group B (chronic periodontitis) and group C (aggressive periodontitis). The clinical parameters were assessed, based on the oral hygiene index simplified (OHI-S), the gingival index (GI), the probing pocket depth and the clinical attachment loss (CAL). A biochemical analysis was performed to evaluate and compare the salivary and the serum nitric oxide levels of the above groups. Statistical Analysis and Results: The statistical comparisons were done under the Griess Reaction. There were statistically significant salivary and serum levels of NO in the groups of periodontitis (group B and C) as compared to those in the healthy controls (group A). A significant positive correlation was found between the values of the salivary and the serum NO levels in chronic and aggressive periodontitis. CONCLUSION Nitric oxide is a potent modulator of the inflammatory disease processes and under pathological conditions, NO has damaging effects. As there is a paucity in the studies which have compared chronic and aggressive periodontitis, this study paved an interest for combining the serum and the salivary analysis in comparing the levels of nitric oxide in chronic and aggressive periodontitis.
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Affiliation(s)
- N Mani Sundar
- Assistant Professor,Department of Periodontics, Sree Balaji Dental College , Chennai, India
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Akpinar A, Toker H, Ozdemir H, Bostanci V, Aydin H. The effects of non-surgical periodontal therapy on oxidant and anti-oxidant status in smokers with chronic periodontitis. Arch Oral Biol 2013; 58:717-23. [DOI: 10.1016/j.archoralbio.2012.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 10/17/2012] [Accepted: 11/13/2012] [Indexed: 11/26/2022]
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Tüter G, Özdemir B, Kurtiş B, Serdar M, Yücel AA, Ayhan E. Short term effects of non-surgical periodontal treatment on gingival crevicular fluid levels of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 2 (PAI-2) in patients with chronic and aggressive periodontitis. Arch Oral Biol 2013; 58:391-6. [DOI: 10.1016/j.archoralbio.2012.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 07/25/2012] [Accepted: 08/10/2012] [Indexed: 01/01/2023]
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Peyyala R, Ebersole JL. Multispecies biofilms and host responses: "discriminating the trees from the forest". Cytokine 2012; 61:15-25. [PMID: 23141757 DOI: 10.1016/j.cyto.2012.10.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 09/28/2012] [Accepted: 10/04/2012] [Indexed: 02/07/2023]
Abstract
Periodontal diseases reflect a tissue destructive process of the hard and soft tissues of the periodontium that are initiated by the accumulation of multispecies bacterial biofilms in the subgingival sulcus. This accumulation, in both quantity and quality of bacteria, results in a chronic immunoinflammatory response of the host to control this noxious challenge, leading to collateral damage of the tissues. As knowledge of the characteristics of the host-bacterial interactions in the oral cavity has expanded, new knowledge has become available on the complexity of the microbial challenge and the repertoire of host responses to this challenge. Recent results from the Human Microbiome Project continue to extend the array of taxa, genera, and species of bacteria that inhabit the multiple niches in the oral cavity; however, there is rather sparse information regarding variations in how host cells discriminate commensal from pathogenic species, as well as how the host response is affected by the three-dimensional architecture and interbacterial interactions that occur in the oral biofilms. This review provides some insights into these processes by including existing literature on the biology of nonoral bacterial biofilms, and the more recent literature just beginning to document how the oral cavity responds to multispecies biofilms.
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Affiliation(s)
- R Peyyala
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY 40536, United States
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Bajaj P, Pradeep AR, Agarwal E, Kumari M, Naik SB. Locally delivered 0.5% clarithromycin, as an adjunct to nonsurgical treatment in chronic periodontitis with well-controlled type 2 diabetes: a randomized controlled clinical trial. ACTA ACUST UNITED AC 2012; 3:276-83. [PMID: 22976782 DOI: 10.1111/j.2041-1626.2012.00168.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 06/30/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Several epidemiologic studies have identified a greater incidence of periodontitis in patients with type 2 diabetes. Recent developments suggest that local delivery of antimicrobials into periodontal pockets improve periodontal health. The present study was designed to investigate the adjunctive effects of subgingivally delivered clarithromycin (CLM) (0.5% concentration) as an adjunct to scaling and root planing for treating chronic periodontitis in patients with well-controlled type 2 diabetes. METHODS Sixty-three patients were categorized into two treatment groups: Group 1, scaling and root planing (SRP) plus 0.5% CLM; Group 2, SRP plus placebo gel. Clinical parameters were recorded at baseline, 1, 2, and 3 months; which included gingival index (GI), sulcus bleeding index (SBI), plaque index (PI), probing depth (PD), and periodontal attachment level (PAL). RESULTS Both therapies resulted in significant improvements. Using a subject-based analysis, patients in Group 1 treated with SRP + CLM showed enhanced reductions in PI, GI, SBI, and PD, and gains in PAL (P < 0.001) over a period of 6 months as compared to Group 2. CONCLUSION Although both treatment strategies seemed to benefit the patients, the adjunctive use of 0.5% CLM as a controlled drug delivery system enhanced the clinical outcome.
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Affiliation(s)
- Pavan Bajaj
- Department of Periodontics, Government Dental College and Research Institute, Bangalore, India
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Ertugrul AS, Sahin H, Dikilitas A, Alpaslan N, Bozoglan A. Comparison of CCL28, interleukin-8, interleukin-1β and tumor necrosis factor-alpha in subjects with gingivitis, chronic periodontitis and generalized aggressive periodontitis. J Periodontal Res 2012; 48:44-51. [PMID: 22812409 DOI: 10.1111/j.1600-0765.2012.01500.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Cytokines produced by various cells are strong local mediators of inflammation. Mucosa-associated epithelial chemokine (CCL28), interleukin-8 (IL-8), interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) are major cytokines that play important roles in the periodontal inflammatory process. In this study we aimed to compare the levels of CCL28, IL-8, IL-1β and TNF-α in the gingival crevicular fluid of both periodontally healthy subjects and in subjects diagnosed with gingivitis, chronic periodontitis and generalized aggressive periodontitis. MATERIAL AND METHODS A total of 84 subjects participated in the study: 21 subjects had gingivitis, 21 subjects had chronic periodontitis, 21 subjects had generalized aggressive periodontitis and 21 were periodontally healthy. The levels of CCL28, IL-8, IL-1β and TNF-α were analyzed using enzyme-linked immune sorbent assay (ELISA). RESULTS The total levels of CCL28 and IL-8 in the gingival crevicular fluid of the generalized aggressive periodontitis group (324.74 ± 42.62 pg/30 s, 487.62 ± 49.21 pg/30 s) were significantly higher than those of the chronic periodontitis group (268.81 ± 28.64 pg/30 s, 423.65 ± 35.24 pg/30 s), the gingivitis group (146.35 ± 17.46 pg/30 s, 310.24 ± 48.20 pg/30 s) and the periodontally healthy group (92.46 ± 22.04 pg/30 s, 148.41 ± 24.64 pg/30 s). Similarly, the total levels of IL-1β and TNF-α in the generalized aggressive periodontitis group (110.23 ± 9.20 pg/30 s, 1284.46 ± 86.32 pg/30 s) were significantly higher than those in the chronic periodontitis group (423.65 ± 35.24 pg/30 s, 82.64 ± 9.12 pg/30 s), the gingivitis group (52.10 ± 7.15 pg/30 s, 824.24 ± 44.68 pg/30 s) and the periodontally healthy group (36.44 ± 8.86 pg/30 s, 628.26 ± 34.61 pg/30 s). CONCLUSION CCL28, IL-8, IL-1β and TNF-α may play key roles in the host response to inflammation in periodontal diseases. As the severity of periodontal diseases increases, destruction of periodontal tissues also increases. Inflammation is one among many factors that trigger periodontal tissue destruction. Identification of the mediators that influence the development and progression of inflammation in periodontal diseases may be very important in understanding the prognoses of periodontal diseases.
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Affiliation(s)
- A S Ertugrul
- Department of Periodontology, Faculty of Dentistry, Yuzuncu Yil University, Van, Turkey.
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Dezerega A, Madrid S, Mundi V, Valenzuela MA, Garrido M, Paredes R, García-Sesnich J, Ortega AV, Gamonal J, Hernández M. Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response. JOURNAL OF INFLAMMATION-LONDON 2012; 9:8. [PMID: 22436166 PMCID: PMC3358239 DOI: 10.1186/1476-9255-9-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 03/21/2012] [Indexed: 01/22/2023]
Abstract
Background Oxidative stress and matrix metalloproteinases -9 and -2 are involved in periodontal breakdown, whereas gingival crevicular fluid has been reported to reflect apical status. The aim of this study was to characterize oxidant balance and activity levels of MMP -2 and -9 in apical lesions and healthy periodontal ligament; and second, to determine whether potential changes in oxidant balance were reflected in gingival crevicular fluid from asymptomatic apical periodontitis (AAP)-affected teeth at baseline and after endodontic treatment. Methods Patients with clinical diagnosis of AAP and healthy volunteers having indication of tooth extraction were recruited. Apical lesions and healthy periodontal ligaments, respectively, were homogenized or processed to obtain histological tissue sections. Matrix metalloproteinase -9 and -2 levels and/or activity were analyzed by Immunowestern blot, zymography and consecutive densitometric analysis, and their tissue localization was confirmed by immunohistochemistry. A second group of patients with AAP and indication of endodontic treatment was recruited. Gingival crevicular fluid was extracted from AAP-affected teeth at baseline, after endodontic treatment and healthy contralateral teeth. Total oxidant and antioxidant status were determined in homogenized tissue and GCF samples. Statistical analysis was performed using STATA v10 software with unpaired t test, Mann-Whitney test and Spearman's correlation. Results Activity of MMP-2 and MMP-9 along with oxidant status were higher in apical lesions (p < 0.05). Total oxidant status correlated positively with matrix metalloproteinase-2 and lesion size (p < 0.05). Gingival crevicular fluid showed significantly lower levels of total antioxidant status in diseased teeth at baseline compared to controls and endodontically-treated groups. Conclusions Apical lesions display an oxidant imbalance along with increased activity of matrix metalloproteinase-2 and -9 and might contribute to AAP progression. Oxidant imbalance can also be reflected in GCF from AAP-affected teeth and was restored to normal levels after conservative endodontic treatment. These mediators might be useful as potential biomarkers for chair-side complementary diagnostic of apical status in GCF.
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Affiliation(s)
- Andrea Dezerega
- Laboratorio de Biología Periodontal, Facultad de Odontología, Avenida Sergio Livingstone 943, Comuna de Independencia, Santiago, Chile.
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Olayanju OA, Rahamon SK, Joseph IO, Arinola OG. Salivary immunoglobulin classes in Nigerians with periodontitis. J Contemp Dent Pract 2012; 13:163-6. [PMID: 22665741 DOI: 10.5005/jp-journals-10024-1114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To provide information on the usefulness of salivary immunoglobulin classes in the diagnosis of periodontitis. MATERIALS AND METHODS About 5 ml of unstimulated saliva was collected from 25 newly diagnosed subjects with periodontitis and 21 sex/age-matched apparently healthy individuals into plain sample bottles. The samples were collected between 9 am and 11 am at least, 1 hour after eating or washing of mouth and levels of salivary immunoglobulin classes (IgA, IgG, IgE and IgM) were determined using enzyme-linked immunosorbent assay (ELISA). RESULTS Only the mean level of IgA was significantly raised (p = 0.05) in the saliva of periodontitis patients compared with controls. The mean levels of IgG, IgM and IgE were not significantly elevated in patients with periodontitis, when compared with controls (p > 0.05). CONCLUSION This study showed that elevated salivary levels of IgA could be used as a screening tool for periodontitis. CLINICAL SIGNIFICANCE Identification of patients at risk and the diagnosis of active phases of periodontal disease remains a challenge due to lack of laboratory test routinely employed in the diagnosis and monitoring of patients with periodontal disease. This study showed that elevated salivary levels of immunoglobulin classes especially, IgA could be used as a screening tool for periodontitis.
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Affiliation(s)
- O A Olayanju
- Department of Chemical Pathology and Immunology, University of Ibadan, Nigeria
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Johansson A. Aggregatibacter actinomycetemcomitans leukotoxin: a powerful tool with capacity to cause imbalance in the host inflammatory response. Toxins (Basel) 2011; 3:242-59. [PMID: 22069708 PMCID: PMC3202821 DOI: 10.3390/toxins3030242] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 03/01/2011] [Accepted: 03/08/2011] [Indexed: 11/21/2022] Open
Abstract
Aggregatibacter actinomycetemcomitans has been described as a member of the indigenous oral microbiota of humans, and is involved in the pathology of periodontitis and various non-oral infections. This bacterium selectively kills human leukocytes through expression of leukotoxin, a large pore-forming protein that belongs to the Repeat in Toxin (RTX) family. The specificity of the toxin is related to its prerequisite for a specific target cell receptor, LFA-1, which is solely expressed on leukocytes. The leukotoxin causes death of different leukocyte populations in a variety of ways. It activates a rapid release of lysosomal enzymes and MMPs from neutrophils and causes apoptosis in lymphocytes. In the monocytes/macrophages, the toxin activates caspase-1, a cysteine proteinase, which causes a proinflammatory response by the activation and secretion of IL-1β and IL-18. A specific clone (JP2) of A. actinomycetemcomitans with enhanced leukotoxin expression significantly correlates to disease onset in infected individuals. Taken together, the mechanisms by which this toxin kills leukocytes are closely related to the pathogenic mechanisms of inflammatory disorders, such as periodontitis. Therapeutic strategies targeting the cellular and molecular inflammatory host response in periodontal diseases might be a future treatment alternative.
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Affiliation(s)
- Anders Johansson
- Department of Odontology, Umea University, SE-901 87 Umea, Sweden.
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Mataftsi M, Skoura L, Sakellari D. HIV infection and periodontal diseases: an overview of the post-HAART era. Oral Dis 2010; 17:13-25. [DOI: 10.1111/j.1601-0825.2010.01727.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Characterization of a novel riboswitch-regulated lysine transporter in Aggregatibacter actinomycetemcomitans. J Bacteriol 2010; 192:6240-50. [PMID: 20889741 DOI: 10.1128/jb.00935-10] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aggregatibacter actinomycetemcomitans is an opportunistic pathogen that resides primarily in the mammalian oral cavity. In this environment, A. actinomycetemcomitans faces numerous host- and microbe-derived stresses, including intense competition for nutrients and exposure to the host immune system. While it is clear that A. actinomycetemcomitans responds to precise cues that allow it to adapt and proliferate in the presence of these stresses, little is currently known about the regulatory mechanisms that underlie these responses. Many bacteria use noncoding regulatory RNAs (ncRNAs) to rapidly alter gene expression in response to environmental stresses. Although no ncRNAs have been reported in A. actinomycetemcomitans, we propose that they are likely important for colonization and persistence in the oral cavity. Using a bioinformatic and experimental approach, we identified three putative metabolite-sensing riboswitches and nine small regulatory RNAs (sRNAs) in A. actinomycetemcomitans during planktonic and biofilm growth. Molecular characterization of one of the riboswitches revealed that it is a lysine riboswitch and that its target gene, lysT, encodes a novel lysine-specific transporter. Finally, we demonstrated that lysT and the lysT lysine riboswitch are conserved in over 40 bacterial species, including the phylogenetically related pathogen Haemophilus influenzae.
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El-Sharkawy H, Aboelsaad N, Eliwa M, Darweesh M, Alshahat M, Kantarci A, Hasturk H, Van Dyke TE. Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 Fatty acids and low-dose aspirin. J Periodontol 2010; 81:1635-43. [PMID: 20572767 DOI: 10.1902/jop.2010.090628] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Host modulatory therapy has been proposed as a treatment for periodontal diseases. Omega-3 (ω-3) polyunsaturated fatty acids (PUFAs), including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), were shown to have therapeutic anti-inflammatory and protective actions in inflammatory diseases including periodontitis. The goal of this study was to test an innovative strategy for periodontal treatment in a clinical experiment. METHODS Eighty healthy subjects (40 in each group) with advanced chronic periodontitis were enrolled in Mansoura, Egypt, in a parallel-design, double-masked clinical study. The control group was treated with scaling and root planing (SRP) and a placebo, whereas the ω-3 group was treated with SRP followed by dietary supplementation of fish oil (900 mg EPA + DHA) and 81 mg aspirin daily. Saliva samples were obtained from all patients at baseline and 3 and 6 months for evaluation of receptor activator of nuclear factor-kappa B ligand (RANKL) and matrix metalloproteinase-8 (MMP-8). Plaque and gingival indices, bleeding on probing, probing depths, and attachment levels were recorded at the same time points. RESULTS Statistical analyses demonstrated a significant reduction in probing depths and a significant attachment gain after 3 and 6 months in the ω-3 group compared to baseline and the control group (P <0.05). Salivary RANKL and MMP-8 levels showed significant reductions in the ω-3 group in response to treatment at 3 and 6 months and compared to the control group at 6 months (P <0.01). Supplementation with ω-3 + aspirin resulted in a significant shift in the frequency of pockets with probing depths <4 mm (P <0.05). CONCLUSION The results of this preliminary clinical study suggest that dietary supplementation with ω-3 PUFAs and 81 mg aspirin may provide a sustainable, low-cost intervention to augment periodontal therapy.
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Affiliation(s)
- Hesham El-Sharkawy
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Effect of matrix metalloproteinase-1 promoter genotype on interleukin-1beta-induced matrix metalloproteinase-1 production in human periodontal ligament cells. J Periodontal Res 2010; 45:109-15. [DOI: 10.1111/j.1600-0765.2009.01208.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bain JL, Lester SR, Henry WD, Bishop CM, Turnage AA, Naftel JP, Johnson RB. Comparative gender differences in local and systemic concentrations of pro-inflammatory cytokines in rats with experimental periodontitis. J Periodontal Res 2009; 44:133-40. [PMID: 19515023 DOI: 10.1111/j.1600-0765.2008.01110.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE There have been few studies of gender differences in response to periodontitis. Thus, we compared gender-specific differences in systemic cytokine concentrations in rats with and without ligature-induced periodontitis. MATERIAL AND METHODS Experimental periodontal disease was initiated in Sprague-Dawley rats by placing a ligature around the crowns of the second right maxillary molar tooth. Sham-operated control groups were also created. Two weeks later, the right and left maxillary quadrants of teeth, liver and serum were collected from all the rats, and uterine horns were collected from the female rats. Liver and uterine samples were ground in phosphate-buffered saline (10 mg of tissue/mL of phosphate-buffered saline + protease inhibitor) containing a protease inhibitor, and cytokine concentrations were determined by enzyme-linked immunosorbent assay. Digital radiographs were made of maxillary quadrants, and the distance from cemento-enamel junction to alveolar crest was measured using image analysis software. Data were compared by factorial analysis of variance and a post-hoc Tukey test. RESULTS Female rats with ligatures had greater, but not significantly different, alveolar bone loss than males with ligatures. However, they had higher serum concentrations of interleukin-6, tumor necrosis factor-alpha and C-reactive protein, and liver C-reactive protein (p < 0.05). These females also had higher interleukin-6, tumor necrosis factor-alpha and vascular endothelial growth factor concentrations within the uterine horn, compared to female controls (p < 0.05). Male animals with ligatures had lower serum concentrations of C-reactive protein and higher interleukin-6 and tumor necrosis factor-alpha concentrations within serum, compared to male controls (p < 0.05). CONCLUSION Our study suggests that females with periodontal disease have a greater risk for inflammatory-based systemic diseases than males.
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Affiliation(s)
- J L Bain
- Department of Periodontics and Preventive Sciences, University of Mississippi, School of Dentistry, Jackson, MS 39216-4505, USA
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Crevicular fluid levels of plasma glutathione peroxidase (eGPx) in periodontal health and disease. Arch Oral Biol 2009; 54:543-8. [DOI: 10.1016/j.archoralbio.2009.02.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 02/02/2009] [Accepted: 02/08/2009] [Indexed: 11/20/2022]
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Abstract
The innate host response system is comprised of various mechanisms for orchestrating host response to microbial infection of the oral cavity. The heterogeneity of the oral cavity and the associated microenvironments that are produced give rise to different chemistries that affect the innate defense system. One focus of this review is on how these spatial differences influence the two major defensive peroxidases of the oral cavity, salivary peroxidase (SPO) and myeloperoxidase (MPO). With hydrogen peroxide (H(2)O(2)) as an oxidant, the defensive peroxidases use inorganic ions to produce antimicrobials that are generally more effective than H(2)O(2) itself. The concentrations of the inorganic substrates are different in saliva vs. gingival crevicular fluid (GCF). Thus, in the supragingival regime, SPO and MPO work in unison for the exclusive production of hypothiocyanite (OSCN(-), a reactive inorganic species), which constantly bathes nascent plaques. In contrast, MPO is introduced to the GCF during inflammatory response, and in that environment it is capable of producing hypochlorite (OCl(-)), a chemically more powerful oxidant that is implicated in host tissue damage. A second focus of this review is on inter-person variation that may contribute to different peroxidase function. Many of these differences are attributed to dietary or smoking practices that alter the concentrations of relevant inorganic species in the oral cavity (e.g.: fluoride, F(-); cyanide, CN(-); cyanate, OCN(-); thiocyanate, SCN(-); and nitrate, NO(3)(-)). Because of the complexity of the host and microflora biology and the associated chemistry, it is difficult to establish the significance of the human peroxidase systems during the pathogenesis of oral diseases. The problem is particularly complex with respect to the gingival sulcus and periodontal pockets (where the very different defensive stratagems of GCF and saliva co-mingle). Despite this complexity, intriguing in vitro and in vivo studies are reviewed here that reveal the interplay between peroxidase function and associated inorganic chemistry.
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Affiliation(s)
- M T Ashby
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK 73019, USA.
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Tzannetou S, Efstratiadis S, Nicolay O, Grbic J, Lamster I. Comparison of levels of inflammatory mediators IL-1beta and betaG in gingival crevicular fluid from molars, premolars, and incisors during rapid palatal expansion. Am J Orthod Dentofacial Orthop 2008; 133:699-707. [PMID: 18456143 DOI: 10.1016/j.ajodo.2006.03.044] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2005] [Revised: 03/01/2006] [Accepted: 03/01/2006] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Previously, we reported fluctuation of the levels of the inflammatory mediators interleukin-1beta (IotaL-1beta) and beta-glucuronidase (betaG) in gingival crevicular fluid (GCF) from the maxillary first molars in adolescents undergoing rapid palatal expansion. In this study, we compared the responses of IL-1beta and betaG in the GCF of the maxillary first molars, first premolars, and central incisors during palatal expansion at the same patients. METHODS Nine patients requiring palatal expansion were selected at the postdoctoral orthodontic clinic at Columbia University College of Dental Medicine. Each patient received periodontal prophylaxis and instructions in proper home care including rinsing with chlorhexidine. Four weeks after periodontal prophylaxis, a modified hyrax appliance was placed. The jackscrew was activated twice daily until the appropriate expansion was achieved. GCF samples were collected before and after periodontal prophylaxis and during passive wearing of the appliance, active orthodontic treatment, and retention. Fluid samples were collected with filter paper strips and analyzed by ELISA and time-dependent fluorometry for IL-1beta and betaG, respectively. The values recorded after periodontal prophylaxis were used as the baseline. Paired t tests were used to compare mediator levels at baseline with the levels obtained at each subsequent observation. RESULTS The results validate that IL-1beta and betaG are present in the GCF of adolescents, and, although their level decreases after a strict regimen of plaque control, it increases during orthodontic or orthopedic movement. Moreover, this study demonstrates that both heavy and light forces evoke increased levels of IL-1beta and betaG, stronger forces cause higher levels of inflammatory mediators, and both IL-1beta and betaG respond to direct and indirect application of mechanical force to teeth. CONCLUSIONS This investigation corroborates previous findings that an inflammatory process occurs during application of mechanical force to teeth. Although this inflammation is considered relatively aseptic, additional inflammation, such as that induced by plaque accumulation, must be avoided during orthodontic or orthopedic treatment.
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Affiliation(s)
- Sappho Tzannetou
- Division of Orthodontics, College of Dental Medicine, Columbia University, New York, NY, USA.
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Novak MJ, Dawson DR, Magnusson I, Karpinia K, Polson A, Polson A, Ryan ME, Ciancio S, Drisko CH, Kinane D, Powala C, Bradshaw M. Combining Host Modulation and Topical Antimicrobial Therapy in the Management of Moderate to Severe Periodontitis: A Randomized Multicenter Trial. J Periodontol 2008; 79:33-41. [DOI: 10.1902/jop.2008.070237] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kesavalu L, Bakthavatchalu V, Rahman MM, Su J, Raghu B, Dawson D, Fernandes G, Ebersole JL. Omega-3 fatty acid regulates inflammatory cytokine/mediator messenger RNA expression in Porphyromonas gingivalis-induced experimental periodontal disease. ACTA ACUST UNITED AC 2007; 22:232-9. [PMID: 17600534 DOI: 10.1111/j.1399-302x.2007.00346.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Porphyromonas gingivalis is strongly implicated in the etiology of adult periodontitis by inducing inflammatory cytokines, resulting in gingival and periodontal tissue inflammation and alveolar bone resorption. This study tested the hypothesis that supplementing the diet with omega-3 fatty acid (omega-3 FA; i.e. fish oil) would exert anti-inflammatory effects in the gingival tissues of P. gingivalis-infected rats. METHODS Rats were fed either fish oil or corn oil diets ad libitum for 22 weeks and infected with P. gingivalis strain 381 or strain A7A1-28. After sacrifice, rat gingival tissues were excised and the RNA was isolated and analyzed for proinflammatory mediators [interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), IL-6], T helper type 1 and type 2 cytokines [interferon-gamma (IFN-gamma), IL-4, IL-10), antioxidant enzymes [catalase (CAT), superoxide dismutase (SOD)], and genes critical for eicosanoid mediator production [cyclo-oxygenase-2 (COX-2), 5-lipoxygenase (5-LO)] by reverse transcription-polymerase chain reaction using rat-specific primers. RESULTS Rats on the omega-3 FA diet exhibited decreased proinflammatory cytokine gene expression (IL-1beta, TNF-alpha) and enhanced IFN-gamma, CAT and SOD messenger RNA expression compared to rats fed a corn oil diet, supporting a diet-induced modulation of host inflammatory reactions. Analyses of alveolar bone resorption in the rats related to gene expression profiles demonstrated significant positive correlations with IL-1beta, IL-6 and COX-2 and negative correlations with CAT and SOD. CONCLUSION These findings suggest that diets enriched for omega-3 FA modulate the local gingival inflammatory milieu of the host following oral P. gingivalis infection, which impacts on alveolar bone resorption in rats.
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Affiliation(s)
- L Kesavalu
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL 32610, USA.
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