Oxidative injury and inflammatory periodontal diseases: the challenge of anti-oxidants to free radicals and reactive oxygen species

Efficacy of Lycium barbarum (Goji berry) mouthwash for managing periodontitis: a randomized clinical trial

Background

Removal of the microbial deposits (plaque and calculus) by performing effective scaling and root planing (SRP) is the fundamental step for managing periodontal disease (gingivitis and periodontitis). Various adjuncts in the form of mouthwash, gels, and toothpaste are also being used as adjuncts to SRP for managing periodontitis. Recently, Lycium barbarum ( L. barbarum), commonly known as goji berry or wolfberry, has gained popularity for managing chronic inflammatory and infectious diseases. However, its efficacy in managing periodontitis has never been explored. Hence the present study aims to evaluate the efficacy of goji berry mouthwash compared to chlorhexidine mouthwash for managing periodontitis.

Methods

60 adult participants were divided randomly using computer-generated random sequences into two groups (case group: L. barbarum mouthwash (Males: 16; Female: 14); control group: 0.2% chlorhexidine gluconate mouthwash (Males: 14; Females: 16)). The changes in the gingival index (Gi), plaque index (Pi), bleeding on probing (BOP), clinical attachment loss (CAL), probing pocket depth (PPD), microbial load, and antioxidant levels (protein thiol) in saliva were noted at the baseline, at 15 days and one month.

Results

A significant reduction in the mean PPD, Pi, BOP, and Gi was seen from baseline to one month in both the control (P-value=0.006, 0.027, 0.000, and 0.036 respectively) and test groups (P-value=0.035, 0.000, 0.034, and 0.000 respectively). However, the antioxidant levels (protein thiol) in saliva were significantly increased only in the test group.

Conclusion

Goji berry mouthwash along with SRP reduced the Gi, Pi, BOP, and PPD in patients with periodontitis. However, no statistically significant difference was noted between the use of goji berry and chlorhexidine mouthwash. Goji berry mouthwash was more effective than chlorhexidine in increasing the antioxidant levels in saliva.

Flavonoids attenuate inflammation of HGF and HBMSC while modulating the osteogenic differentiation based on microfluidic chip

BACKGROUND

When inflammation occurs in periodontal tissues, a dynamic cellular crosstalk interacts between gingival fibroblasts and bone marrow mesenchymal stem cells (BMSCs), which plays a crucial role in the biological behaviour and differentiation of the cells. Recently, flavonoids are increasingly recognized for their therapeutic potential in modulating inflammation and osteogenic differentiation. Owing to their varied molecular structures and mechanisms, there are more needs that flavonoid compounds should be identified by extensive screening. However, current drug research mostly relies on static, single-type cell cultures. In this study, an innovative bionic microfluidic chip system tailored for both soft and hard tissues was developed to screen for flavonoids suitable for treating periodontitis.

METHODS

This study developed a microfluidic system that bionically simulates the soft and hard structures of periodontal tissues. Live/dead staining, reactive oxygen species (ROS) staining, and RT-qPCR analysis were employed. These techniques evaluated the effects of flavonoid compounds on the levels of inflammatory factors and ROS contents in HGF and HBMSC under LPS stimulation. Additionally, the impact of these compounds on osteogenic induction in HBMSC and the exploration of the underlying mechanisms were assessed.

RESULTS

The microfluidic chip used in this study features dual chambers separated by a porous membrane, allowing cellular signal communication via bioactive factors secreted by cells in both layers under perfusion. The inflammatory response within the chip under LPS stimulation was lower compared to individual static cultures of HGF and HBMSC. The selected flavonoids-myricetin, catechin, and quercetin-significantly reduced cellular inflammation, decreased ROS levels, and enhanced osteogenic differentiation of BMSCs. Additionally, fisetin, silybin, and icariside II also demonstrated favorable outcomes in reducing inflammation, lowering ROS levels, and promoting osteogenic differentiation through the Wnt/β-catenin pathway.

CONCLUSIONS

The bionic microfluidic chip system provides enhanced capabilities for drug screening and evaluation, delivering a more precise assessment of drug efficacy and safety compared to traditional in vitro methods. This study demonstrates the efficacy of flavonoids in influencing osteogenic processes in BMSCs primarily through the Wnt/β-catenin pathway. These results uncover the potential of flavonoids as therapeutic medicine for treating periodontitis, meriting further research and development.

Assessment of differences in stress markers of edentulous patients rehabilitated with complete dentures

Background

Biomarkers can aid in determining the success of complete denture. Fewer studies evaluated the biomarkers in edentulous patients. This can aid in planning of better qualitative care for edentulous patients. The study compared the quantities of nitric oxide (NO), salivary alpha amylase (SAA) and thiobarbituric acid reactive substances (TBARS) before and after denture insertion in complete denture patients.

Methods

The study involved 25 edentulous patients. The saliva samples were obtained from patients prior, 1 h, and 1 week after denture insertion. Standardized procedure was followed in sample management, transportation and storing. The investigations varied with the biomarkers. SAA was estimated by enzymatic assay. TBARS by lipid peroxidation and NO was assessed by Griess reaction. The obtained data were tabled and statistically analyzed.

Results

The results displayed variation in the level of markers between before and after denture insertion. The mean levels of SAA decreased from 8.26 ± 1.32 nm/ml to 3.44 ± 1.25 nm/ml in following denture insertion. The mean of TBARS and NO increased after denture insertion to 14.33 ± 4.72 nm/ml and NO 22.92 ± 5.79 ng/ml. The results were statistically significant with p < 0.05.

Conclusion

The study concluded that denture insertion decreased the levels of psychological stress marker (SAA) and increased the Oxidative stress marker (TBARS, NO).

Melatonin and oral diseases: possible therapeutic roles based on cellular mechanisms

Oral diseases, including periodontal disorders, oral cancer, periodontitis, and mucositis are the major challenges for both patients and healthcare providers. These conditions often involve inflammation, oxidative stress, and impaired cellular processes, leading to symptoms ranging from discomfort to severe debilitation. Conventional treatments for such oral diseases exhibit constraints, prompting the investigation of innovative therapeutic approaches. Considering the anti-inflammatory, anti-oxidant, and anti-cancer effects of melatonin, this study was carried out to investigate the potential protective effects of melatonin in mitigating the severity of oral diseases. Studies indicate that melatonin influences the differentiation of periodontal stem cells, inhibits oral cancer progression, reduces inflammation associated with periodontitis, and alleviates the severity of oral mucositis. Melatonin has demonstrated potential efficacy in both preclinical and clinical investigations; however, findings are frequently heterogeneous and contingent upon contextual factors. This review provides a comprehensiveoverview of current state of knowledge in this domain, elucidating the multifaceted role that melatonin may assume in combatingoral diseases. Further research should be directed toward determining the most effective dosing, timing, and administration methods for melatonin-based therapies for oral diseases.

The Role of Sulfhydryl (Thiols) Groups in Oral and Periodontal Diseases

AIM

The sulfhydryl (thiols) group of glutathione plays an important role in the neutralization of foreign organic compounds and the reduction in peroxides. The purpose of the study is to evaluate the concentration of sulfhydryl groups in the gingival tissue of healthy individuals and those with gingivitis or periodontitis, and to examine the differences between these groups.

MATERIAL AND METHODS

To assess the concentration of sulfhydryl groups (thiols) in the gingival tissue of healthy individuals and those with gingivitis or periodontitis, we used spectrophotometric analysis using dithionitrobenzoate (DTNB) as a reagent to measure the accessible sulfhydryl groups present in gingival tissue proteins. The sample was divided into three distinct groups: individuals with periodontal health, gingivitis, and periodontitis, and different indices were used to assess the periodontal status of the participants. Next, a statistical analysis was conducted to compare the concentrations of sulfhydryl groups among the different groups of patients.

CONCLUSIONS

The results of this study showed significantly decreased levels of sulfhydryl (thiols) groups in gingival tissue from patients with gingivitis and periodontitis, compared with healthy people (control group). These results confirm the role of sulfhydryl (thiols) groups in defense against free radicals. They share a significant role in detoxification, signal transduction, apoptosis, and various other functions at the molecular level.

Using 8-Hydroxy-2'-Deoxiguanosine (8-OHdG) as a Reliable Biomarker for Assessing Periodontal Disease Associated with Diabetes

In recent years, research has shown that oxidative stress plays a significant role in chronic inflammatory conditions. The alteration of the oxidant/antioxidant balance leads to the appearance of free radicals, important molecules involved in both diabetes mellitus and periodontal disease. Diabetes is considered to be one of the major risk factors of periodontal disease and the inflammation characterizing this condition is associated with oxidative stress, implicitly resulting in oxidative damage to DNA. 8-Hydroxydeoxyguanosine (8-OHdG) is the most common stable product of oxidative DNA damage caused by reactive oxygen species, and its levels have been reported to increase in body fluids and tissues during inflammatory conditions. 8-OHdG emerges as a pivotal biomarker for assessing oxidative DNA damage, demonstrating its relevance across diverse health conditions, including neurodegenerative disorders, cancers, inflammatory conditions, and periodontal disease. Continued research in this field is crucial for developing more precise treatments and understanding the detailed link between oxidative stress and the progression of periodontitis. The use of the 8-OHdG biomarker in assessing and managing chronic periodontitis is an area of increased interest in dental research, with the potential to provide crucial information for diagnosis and treatment.

Advances of Oxidative Stress Impact in Periodontitis: Biomarkers and Effective Targeting Options

Periodontitis is the most common inflammatory oral disease that affects around 15% of adults and contributes to severe periodontal tissue destruction with subsequent tooth loosening and loss. Among the main pathogenic mechanisms underlying periodontitis, excessive reactive oxygen species production and oxidative stress play a predominant role in inducing both local and systemic damage. Current therapeutic approaches have expanded the conventional methods combined with herbal antioxidant compounds to free radical-scavenging nanomaterials and infrared laser therapy, offering promising pre-clinical evidence in periodontitis management. Herein, we review the pathogenic mechanisms of reactive oxygen species tissue damage, along with recent advances in oxidative stress biomarkers and novel targeting options.

Current Advances in Bovine In Vitro Maturation and Embryo Production Using Different Antioxidants: A Review

In vitro maturation (IVM) is one of the most important steps in in vitro embryo production (IVEP). It is a complicated procedure in which nuclear and cytoplasmatic changes in oocytes appear. In order to carry out the in vitro maturation procedure correctly, it is necessary to provide the oocytes with as close to a natural (in vivo) environment as possible. Many factors contribute to the overall poor quality of in vitro-matured oocytes. One important factor may be oxidative stress (OS). The generation of oxidants, such as reactive oxygen species, is common under culture conditions. The solution for OC treatment and prevention is antioxidants. In the last 5 years, many studies have examined different antioxidants and their effects on in vitro maturation of oocytes and embryo production. The aim of this systematic review was to present the achievements of scientific research in the last five years, in which the effects of many antioxidants were tested on bovine oocyte maturation and embryo production.

Effect of non surgical periodontal therapy and vitamin C supplementation on total antioxidant capacity in patients with chronic generalised periodontitis - A randomised controlled trial

Background

Periodontal inflammation are inflammation of supporting tissues of periodontium. The microbial factor can cause infection which is polymicrobial in origin and causes dysbiosis and shift in oxidative stress with compromised antioxidant capacity. This study focused at determination of the effect of nonsurgical periodontal therapy (NSPT) and vitamin C supplementation on total antioxidant capacity (TAOC) in chronic periodontitis patients (ChP).

Material & method

A total of 70 ChPand 35 periodontally healthy subjects (control) were recruited in this study. Further, ChP group was subdivided into ChP1 group (n = 35) which received NSPT only and ChP 2 group (n = 35) which received NSPT with vitamin C 500 mg once daily for 3 months. Serum and saliva samples were taken at baseline and at 3 months postNSPT for measurement of TAOC. Clinical parameters measured were measured at 1-, 3-, 6- and 12-month interval.

Results

Lower levels of serum and salivary TAOC levels were observed in ChP patients than healthy subjects (p < 0.05). Improvement in Clinical parameters was observed in both the groups ChP1 and ChP 2 group post therapy (p < 0.05). The periodontal treatment showed insignificant changes in serum and salivary TAOC levels (p > 0.05). The supplemental dose of vitamin C didn't have any additional benefits (p > 0.05).

Conclusion

There lies an association of oxidative stress with periodontitis, low serum and salivary TAOC levels were seen in chronic periodontitis patients. NSPT improved the periodontal inflammatory status. However, benefits of vitamin C as an adjunct to NSPT remains inconclusive and needs to be further explored by multicentre longitudinal studies.

Assessment of Oxidative Stress by the Estimation of Lipid Peroxidation Marker Malondialdehyde (MDA) in Patients with Chronic Periodontitis: A Systematic Review and Meta-Analysis

OBJECTIVE

The present systematic review and meta-analysis aimed to assess the oxidative stress-mediated lipid peroxidation end product malondialdehyde (MDA) in periodontitis using the available literature.

MATERIALS AND METHODS

An electronic literature search was performed for the published articles from 2000 to 2022 in PubMed (MeSH), Science Direct, Wiley Online library, and cross-reference using specific keywords.

RESULTS

The literature search identified 1,166 articles. After analyzing the abstracts of the obtained articles, the articles were excluded for the following reasons: duplicate studies (n = 395) and not relevant to the research question (n = 726). The remaining 45 articles were chosen for full-text evaluation. Finally, the present qualitative synthesis selected 34 articles that met the inclusion criteria for evaluation and removed the articles which did not meet the required criteria (n = 11). Out of these, 16 articles had coherent data for quantitative synthesis. The meta-analysis used the standardized mean differences method at a 95% confidence interval by random-effects model. The periodontitis group displayed significantly higher MDA levels (P < 0.001) in gingival crevicular fluid, saliva, and serum samples of the studies analyzed than the healthy control.

CONCLUSION

The analyzed studies showed significantly higher MDA levels in various biological samples of patients with periodontitis, supporting the role of elevated oxidative stress and consequent lipid peroxidation in periodontitis.

Green Alternatives as Antimicrobial Agents in Mitigating Periodontal Diseases: A Narrative Review

Periodontal diseases and dental caries are the most common infectious oral diseases impacting oral health globally. Oral cavity health is crucial for enhancing life quality since it serves as the entranceway to general health. The oral microbiome and oral infectious diseases are strongly correlated. Gram-negative anaerobic bacteria have been associated with periodontal diseases. Due to the shortcomings of several antimicrobial medications frequently applied in dentistry, the lack of resources in developing countries, the prevalence of oral inflammatory conditions, and the rise in bacterial antibiotic resistance, there is a need for reliable, efficient, and affordable alternative solutions for the prevention and treatment of periodontal diseases. Several accessible chemical agents can alter the oral microbiota, although these substances also have unfavorable symptoms such as vomiting, diarrhea, and tooth discoloration. Natural phytochemicals generated from plants that have historically been used as medicines are categorized as prospective alternatives due to the ongoing quest for substitute products. This review concentrated on phytochemicals or herbal extracts that impact periodontal diseases by decreasing the formation of dental biofilms and plaques, preventing the proliferation of oral pathogens, and inhibiting bacterial adhesion to surfaces. Investigations examining the effectiveness and safety of plant-based medicines have also been presented, including those conducted over the past decade.

Elucidation of the potential antioxidant compound and mechanism of mung bean using network pharmacology and in vitro anti-oxidative activity

Mung bean is rich in bioactive components, but the main compound and pharmacological mechanism in reducing oxidative and free radical damage are unclear. Network pharmacology and 2,2′-azino-bis-3-ethylbenzthiazoline-6-sulfonic acid (ABTS) radical scavenging activities were employed to uncover the antioxidant mechanism of potentially active compounds, considering the interactions between mung bean targets and oxidative and free radical damage. These key targets were analyzed by protein–protein interactions (PPIs), and key genes were used to find the biological pathway and therapeutic mechanism by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. The results showed that five antioxidant components and 18 mung bean targets were screened. β-carotene and vitexin both played a crucial role in mung bean against oxidative and free radical damage, and the ABTS radical scavenging activities of β-carotene and vitexin were 94.84 and 87.79%, which were equivalent to those of vitamin C. Key targets may be AR, HSP90AA1, MYC, and CASP3 for mung bean to exert antioxidant activity. GO and KEGG indicated that mung bean may mainly act on thyroid hormone signaling pathway, estrogen signaling pathway, p53 signaling pathway, etc. In vitro antioxidant activity tests showed that the bioactive ingredients of mung beans had great antioxidant activity. Network pharmacology analysis also revealed the underlying molecular mechanisms of oxidative and free radical damage. This study provides new insights and evidence to explore the bioactive compounds and biological functions of food cereals and legumes, as well as a reference for the functional evaluation of food ingredients and the development of functional foods.

Periodontitis and implant complications in diabetes

Epidemiologic evidence indicates that periodontitis is more frequent in patients with uncontrolled diabetes mellitus than in healthy controls, suggesting that it could be considered the "sixth complication" of diabetes. Actually, diabetes mellitus and periodontitis are two extraordinarily prevalent chronic diseases that share a number of comorbidities all converging toward an increased risk of cardiovascular disease. Periodontal treatment has recently been shown to have the potential to improve the metabolic control of diabetes, although long-term studies are lacking. Uncontrolled diabetes also seems to affect the response to periodontal treatment, as well as the risk to develop peri-implant diseases. Mechanisms of associations between diabetes mellitus and periodontal disease include the release of advanced glycation end products as a result of hyperglycemia and a range of shared predisposing factors of genetic, microbial, and lifestyle nature. This review discusses the evidence for the risk of periodontal and peri-implant disease in diabetic patients and the potential role of the dental professional in the diabetes-periodontal interface.

Antimicrobial and cytotoxicity properties of Plumeria alba flower extract against oral and periodontal pathogens: A comparative in vitro study

Context:

Plumeria alba, commonly known as frangipani or West Indian jasmine, is a traditional and ancient folklore medicine known for its antimicrobial, anti-inflammatory, and antioxidant properties. The extracts from P. alba obtained from the leaves, bark, and flowers, are commonly used to manage bacterial, fungal, and viral infections such as herpes, scabies, and fungal infections. The constituents of the P. alba plant have shown promising antihelmintic, antipyretic, and antirheumatic properties. Although studies have confirmed that extracts from Plumeria species are effective against microbial infections and cancer, its role in managing oral diseases, particularly the chronic inflammatory disease of the gums (gingivitis and periodontitis), has never been explored. Therefore, the current study aimed to explore the antimicrobial and cytotoxic properties of the P. alba flower extract against oral and periodontal pathogens compared to chlorhexidine and doxycycline.

Settings and Design:

This was an in vitro study.

Materials and Methods:

The ethanolic extract was prepared from the freshly plucked P. alba flowers. The antimicrobial properties of the extract were evaluated by testing the minimal inhibitory concentration, minimal bactericidal concentration, and well-diffusion assay against Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Tannerella forsythia, Streptococcus mutans, Actinomyces viscosus, Streptococcus salivarius, and Candida albicans. The results were compared to chlorhexidine and doxycycline. The cytotoxicity was checked by the against human-derived gingival fibroblast and keratinocytes.

Statistical Analysis Used:

One-way ANOVA for the mean zones of inhibition against all the microorganisms was done.

Results:

P. alba extract inhibited the growth for all the tested oral and periodontal pathogens at 25 μg/ml. The well-diffusion assay of P. alba extract was comparable to chlorhexidine but was not statistically significant compared to doxycycline.

Conclusion:

P. alba can be used as a promising alternative to chlorhexidine for the management of oral and periodontal infections.

Salivary biomarkers of oxidative stress in children with dental caries: Systematic review and meta-analysis

OBJECTIVE

To assess the relationship between salivary biomarkers of oxidative stress and dental caries in children.

METHODS

Studies conducted in children up to 12 years old comparing salivary biomarkers of oxidative stress such as malondialdehyde (MDA), superoxide dismutase (SOD), uric acid, and total antioxidant capacity (TAC), considering children with dental caries lesions and caries-free ones were selected. In addition, salivary parameters such as salivary flow, pH, buffering capacity, calcium and total protein levels were evaluated. A systematic literature review was carried out in 8 databases. The standardized mean difference (SMD) was measured using inverse variance as a statistical method and random effects as an analysis model, corresponding to a 95% confidence interval (CI).

RESULTS

The TAC levels were higher in children affected by dental caries compared to caries-free ones (control group), regardless of age (SMD 2.66, CI 1.33, 3.98), or gender (SMD 0.98, CI 0.56, 1.39). When adjusted for normalized protein, MDA levels were lower in the dental caries group than in the control group (SMD -16.51, CI -29.02, -4.00), and SOD levels were higher in the dental caries group (SMD 5.09, CI 0.01.10.18). The total protein concentration in saliva of children with dental caries was higher than in the control group, regardless of age (SMD 0.98, CI 0.27, 1.69), or gender (SMD 0.77, CI 0.45, 1.10). The salivary parameters assessed had lower levels in children affected by dental caries (p < 0.05).

CONCLUSIONS

The levels of oxidative stress biomarkers and salivary parameters are altered in saliva of children with dental caries.

Effect of CoQ10 Administration to Psoriatic Iraqi Patients on Biological Therapy Upon Severity Index (PASI) and Quality of Life Index (DLQI) Before and After Therapy

Psoriasis is a medical condition in which the skin of the body is affected at a multisytemic level. Patients with moderate to severe psoriasis have a considerably reduced quality of life as a result of their disease. For morphological indicators, the Psoriasis Area Severity Index (PASI) test is one of the methods for indicating the severity of the illness. An imbalance between pro-oxidants and antioxidants in our bodies causes oxidative stress and plays a crucial role in the pathophysiology of chronic inflammatory diseases like psoriasis(1). It has been considered that antioxidant treatment can be an effective therapeutic option. The goal of this clinical investigation was to see if there was a link between the percentage change in quality of life and the clinical severity of psoriasis during a 12-week period among Iraqi psoriatic patients. Over the course of 3 months, 24 psoriatic patients (9 females and 15 males) ranging in age from 17 to 72 years participated in a prospective double-blinded clinical experiment. Two groups of participants were formed. A biological medicine (adalimumab) and a placebo was given to group A (n = 11), whereas group B (n = 13) received 100 mg CoQ10 adjuvant therapy in addition to the biological medication already provided. The Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) were used to examine patients (DLQI). Treatment with both biological and adjuvant CoQ10 therapy showed a substantial association between the PASI and the DLQI (p = 0.000132). After 3 months of therapy, the mean (SD) of the PASI score for all patients was 20.88 7.15, with a 67.48% ± 22.25% improvement change. The mean SD of the DLQI score at baseline was 12.5 ± 4.71, with a change of 56.13% ± 20.15% following treatment. After therapy with a biological medication, there was a favorable association between the PASI and the DLQI (p > 0.05). This indicates that therapy with a biological medication with daily administration of 100 mg CoQ10 supplements to psoriatic patients for 12 weeks improved the correlation between PASI and DLQI.

Are Inflamed Periodontal Tissues Endogenous Source of Advanced Glycation End-Products (AGEs) in Individuals with and without Diabetes Mellitus? A Systematic Review

Advanced glycation end-products (AGEs) are heterogeneous compounds formed when excess sugars condense with the amino groups of nucleic acids and proteins. Increased AGEs are associated with insulin resistance and poor glycemic control. Recently, inflamed periodontal tissues and certain oral bacteria were observed to increase the local and systemic AGE levels in both normoglycemic and hyperglycemic individuals. Although hyperglycemia induced AGE and its effect on the periodontal tissues is known, periodontitis as an endogenous source of AGE formation is not well explored. Hence, this systematic review is aimed to explore, for the first time, whether inflamed periodontal tissues and periodontal pathogens have the capacity to modulate AGE levels in individuals with or without T2DM and how this affects the glycemic load. Six electronic databases were searched using the following keywords: (Periodontitis OR Periodontal disease OR Periodontal Inflammation) AND (Diabetes mellitus OR Hyperglycemia OR Insulin resistance) AND Advanced glycation end products. The results yielded 1140 articles, of which 13 articles were included for the review. The results showed that the mean AGE levels in gingival crevicular fluid was higher in individuals with diabetes mellitus and periodontitis (521.9 pg/mL) compared to healthy individuals with periodontitis (234.84 pg/mL). The serum AGE levels in normoglycemic subjects having periodontitis was higher compared to those without periodontitis (15.91 ng/mL vs. 6.60 ng/mL). Tannerella forsythia, a common gram-negative anaerobe periodontal pathogen in the oral biofilm, was observed to produce methylglyoxal (precursor of AGE) in the gingival tissues. Increased AGE deposition and activate of AGE receptors was noted in the presence of periodontitis in both normoglycemic and hyperglycemic individuals. Hence, it can be concluded that periodontitis can modulate the local and systemic levels of AGE levels even in absence of hyperglycemia. This explains the bidirectional relationship between periodontitis and development of prediabetes, incident diabetes, poor glycemic control, and insulin resistance.

Salivary Antioxidant Capacity and Oral Health Status in Children with Visual Impairments—A Cross-Sectional Study

Background Children with visual impairment are at a higher risk for developing dental disease, and imbalances in the antioxidant levels may play an important role in the development and management of oral diseases.

Aim Our aim was to evaluate and compare the oral health status and salivary total antioxidant capacity (TAC) in children with and without visual impairment.

Methods Oral health was evaluated among 6 to 11 years old children with and without visual impairment (50 each) using World Health Organization oral health assessment form for caries prevalence, gingival health, and oral hygiene levels. Unstimulated saliva was collected and assayed for TAC using the phosphomolybdic method.

Statistical Analysis The data collected were tabulated, and the results, thus, obtained were subjected to statistical analysis using EZR software—version 1.37. The variables between the two groups were compared using the Mann–Whitney U test and Fisher's exact test. A correlation test was done using Spearman's correlation test.

Results The mean TAC levels among children with and without visual impairment were 49.17 (±25.702) and 156.67 (±56.031) µg/mL, respectively, which was statistically significant (p < 0.001). The children with visual impairment showed a significantly higher number of carious lesions compared with the control group (p < 0.001). Oral hygiene status and gingival health status were significantly poorer in children with visual impairments than the children in the control group (p < 0.001).

Conclusions Oral health was significantly poorer, and salivary TAC levels were significantly lower in children with visual impairment. There may be an inverse correlation between salivary TAC and oral health status. Clinical Significance: Since these children have been shown to have poorer oral health status, a baseline assessment of their salivary antioxidant capacity may indicate the need to reinforce oral care efforts and supplement them using an antioxidant-rich diet.

Identification, Quantification and Correlation of Hydrogen Peroxide Present in Saliva to Early Childhood Caries: A Randomized Clinical Trial

Aim

The main objective of the present study was to estimate the production of hydrogen peroxide present in saliva and correlate it to early childhood caries using high-performance liquid chromatography [HPLC] method.

Design

The study was conducted on children aged 3-6 years with a sample size of 20 who had decayed, missing, or filled teeth in accordance to WHO pro forma and were divided into two groups: Study group: Caries active [CA][n = 10] and Control group caries free [CF] [n = 10]. The whole saliva was collected into the vials with a buffer solution and was stored in cold storage. HPLC was done to estimate, detect, and correlate the amount of production of H2O2 in CA and CF groups. To compare age and gender distribution among two groups, Independent student "t" test was used. To compare the mean production of H2O2 levels between two study groups with a significance of p > 0.05 was done using Mann-Whitney U test. Spearman's correlation was done between caries and H2O2.

Results

Comparison of mean H2O2 levels [in ppm] between groups was statistically significant at p = 0.03, which showed as age increases H2O2 production also increases. Age-wise estimation of H2O2 obtained a statistically significant result [p = 0.04]. However, gender-wise comparison of mean H2O2 levels [in ppm] in both the groups showed no difference.

Conclusion

Findings in our study strongly suggested that H2O2 levels are more in children without any caries experience. H2O2 production is the same among males and females but according to age, H2O2 production increases as the child grows with age.

How to cite this article

Thimmegowda U, Belagatta V, Krishnamurthy NH, et al. Identification, Quantification and Correlation of Hydrogen Peroxide Present in Saliva to Early Childhood Caries: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(S-2):S140-S146.

Diabetes Mellitus and Periodontitis Share Intracellular Disorders as the Main Meeting Point

Diabetes and periodontitis are two of the most prevalent diseases worldwide that negatively impact the quality of life of the individual suffering from them. They are part of the chronic inflammatory disease group or, as recently mentioned, non-communicable diseases, with inflammation being the meeting point among them. Inflammation hitherto includes vascular and tissue changes, but new technologies provide data at the intracellular level that could explain how the cells respond to the aggression more clearly. This review aims to emphasize the molecular pathophysiological mechanisms in patients with type 2 diabetes mellitus and periodontitis, which are marked by different impaired central regulators including mitochondrial dysfunction, impaired immune system and autophagy pathways, oxidative stress, and the crosstalk between adenosine monophosphate-activated protein kinase (AMPK) and the renin-angiotensin system (RAS). All of them are the shared background behind both diseases that could explain its relationship. These should be taken in consideration if we would like to improve the treatment outcomes. Currently, the main treatment strategies in diabetes try to reduce glycemia index as the most important aspect, and in periodontitis try to reduce the presence of oral bacteria. We propose to add to the therapeutic guidelines the handling of all the intracellular disorders to try to obtain better treatment success.

The Association between Dietary Habits and Periodontal Disease in Young Adult Women

Dietary habits of middle-aged and elderly individuals affected by periodontal disease (PD) differ from those who are unaffected by it, according to previous reports. However, in young adults, there are only a few reports that show a correlation between nutrient/food intake and PD. Moreover, no report till date has assessed the correlation between dietary habits and PD using a self-administered diet history questionnaire (DHQ). Therefore, we assessed this correlation using a DHQ in young adult women who are likely to develop PD. The participants were enrolled from 2 universities and included 120 female college students a mean age of 20.4 y. The participants were assessed for the presence of PD according to the community periodontal index and were divided into two groups, the PD group and the non-PD group. Their dietary habits were investigated using a DHQ and the level of difficulty in chewing food was assessed. The PD group had a significantly lower nutrient intake of minerals, fat-soluble vitamins, water-soluble vitamins, and dietary fiber than the non-PD group. In terms of food groups, the PD group consumed significantly lesser amounts of green and yellow vegetables (GYV) than the non-PD group. Multivariate analysis revealed that the PD group had significantly lower intakes of vitamin E and GYV than the non-PD group. The PD group consumed significantly lesser amounts of hard foods than the non-PD group. In conclusion, young adult women who were evaluated for PD by a screening test had a significantly lower nutrient/food intake than those without a PD.

Investigating the Antioxidant and Cytocompatibility of Mimusops elengi Linn Extract over Human Gingival Fibroblast Cells

Background-chlorhexidine (CHX) is most commonly used as a chemical plaque control agent. Nevertheless, its adverse effects, including teeth discoloration, taste alteration and calculus build-up, limit its use and divert us to medicinal herbs. The purpose of the study was to evaluate the phytochemical composition, antioxidant potential, and cytotoxic effects of Mimusops elengi Linn extract (ME) over normal human cultured adult gingival fibroblasts (HGFs). Methods-in vitro phytochemical screening, total flavonoid content, antioxidant potential by DPPH and Nitric Oxide (NO) radical scavenging activity, and cytotoxic effects of ME extracts over HGF were explored. The viability of HGF cells was determined using 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT), neutral red uptake, and trypan blue assay after treatment with different concentrations of CHX and ME (0.3125 to 10 µg/mL). Results-ME showed some alkaloids, glycosides, saponins and flavonoids exhibited relatively moderate-to-good antioxidant potential. Increasing the concentration of CHX and ME from 0.3125 to 10 µg/mL reduced cell viability from 29.71% to 1.07% and 96.12% to 56.02%, respectively. At higher concentrations, CHX reduced the viability of cells by 52.36-fold compared to ME, revealed by MTT assay. At 10 µg/mL concentration, the mean cell viability of CHX and ME-treated cells was 2.24% and 57.45%, respectively, revealed by a neutral red assay. The viability of CHX- and ME-treated HGF cells estimated at higher concentrations (10 µg/mL) using trypan blue assay was found to be 2.18% and 47.36%, respectively. A paired t-test showed significance (p < 0.05), and one-way ANOVA difference between the mean cell viability of CHX- and ME-treated cells at different concentrations. One-way ANOVA confirmed the significant difference between the viability of CHX- and ME-treated cells. Conclusions-The cytoprotective and antioxidant effects of ME emphasize its potential benefits. Therefore, it could emerge as a herbal alternative and adjunct to conventional oral hygiene methods, that can diminish periodontal tissue destruction.

Antioxidant effect of caffeic acid phenethyl ester in experimentally induced periodontitis

OBJECTIVES

The aim of the present study was to evaluate the antioxidant effect of systemically administered caffeic acid phenethyl ester (CAPE) in periodontitis.

MATERIALS AND METHODS

Forty rats were randomly divided into four groups: control, lipopolysaccharide-induced experimental periodontitis (LPS), CAPE 5: LPS+5 μmol/kg/day CAPE, and CAPE 10: LPS+10 μmol/kg/day CAPE. Following lipopolysaccharide-induced experimental periodontitis, CAPE was administered intraperitoneally for 28 days. Gingival and serumal total antioxidant status (TAS) and total oxidant status (TOS) were analyzed by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Gingival tissue TAS was significantly higher with CAPE application compared with the LPS group and was highest in the CAPE 10 group (p<0.05). Gingival tissue TOS was highest in the LPS group, and both of the CAPE dosages decreased the gingival tissue TOS, with the highest decrease in the CAPE 10 group (p<0.05). The differences were not significant for serumal TAS or TOS levels (p>0.05).

CONCLUSIONS

The effect of CAPE on increased TAS and decreased TOS levels in inflamed gingival tissue indicates the antioxidant therapeutic potential of CAPE in periodontitis.

CLINICAL RELEVANCE

Within the limitations of this study, CAPE may be suggested as an effective host modulator agent for reducing oxidative stress in gingival tissue and might be considered as an adjunctive therapy in periodontitis.

Insight into the roles of melatonin in bone tissue and bone‑related diseases (Review)

Bone‑related diseases comprise a large group of common diseases, including fractures, osteoporosis and osteoarthritis (OA), which affect a large number of individuals, particularly the elderly. The progressive destruction and loss of alveolar bone caused by periodontitis is a specific type of bone loss, which has a high incidence and markedly reduces the quality of life of patients. With the existing methods of prevention and treatment, the incidence and mortality of bone‑related diseases are still gradually increasing, creating a significant financial burden to societies worldwide. To prevent the occurrence of bone‑related diseases, delay their progression or reverse the injuries they cause, new alternative or complementary treatments need to be developed. Melatonin exerts numerous physiological effects, including inducing anti‑inflammatory and antioxidative functions, resetting circadian rhythms and promoting wound healing and tissue regeneration. Melatonin also participates in the health management of bone and cartilage. In the present review, the potential roles of melatonin in the pathogenesis and progression of bone injury, osteoporosis, OA and periodontitis are summarized. Furthermore, the high efficiency and diversity of the physiological regulatory effects of melatonin are highlighted and the potential benefits of the use of melatonin for the clinical prevention and treatment of bone‑related diseases are discussed.

Oxidative stress cytotoxicity induced by platinum-doped magnesia nanoparticles in cancer cells

The aim of this study was to prepare, characterize, and determine the in vitro anticancer effects of platinum-doped magnesia (Pt/MgO) nanoparticles. The chemical compositions, functional groups, and size of nanoparticles were determined using X-ray diffraction, Fourier transform infrared spectroscopy, energy dispersive X-ray spectroscopy, transmission electron microscopy, and scanning electron microscopy. Pt/MgO nanoparticles were cuboid and in the nanosize range of 30-50 nm. The cytotoxicity of Pt/MgO nanoparticles was determined via the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on the human lung and colonic cancer cells (A549 and HT29 respectively) and normal human lung and colonic fibroblasts cells (MRC-5 and CCD-18Co repectively). The Pt/MgO nanoparticles were relatively innocuous to normal cells. Pt/MgO nanoparticles downregulated Bcl-2 and upregulated Bax and p53 tumor suppressor proteins in the cancer cells. Pt/MgO nanoparticles also induced production of reactive oxygen species, decreased cellular glutathione level, and increased lipid peroxidation. Thus, the anticancer effects of Pt/MgO nanoparticles were attributed to the induction of oxidative stress and apoptosis. The study showed the potential of Pt/MgO nanoparticles as an anti-cancer compound.

Effect of epigallocatechin-3-gallate on tumor necrosis factor-alpha production by human gingival fibroblasts stimulated with bacterial lipopolysaccharide: An in vitro study

Background:

Evidence shows that epigallocatechin-3-gallate (EGCG) in green tea has anti-inflammatory effects.

Aim:

This study assessed the effect of EGCG on the production of tumor necrosis factor-alpha (TNF-α) as an inflammatory cytokine in periodontitis, which produced by human gingival fibroblasts (HGFs) stimulated with lipopolysaccharide (LPS) of Porphyromonas gingivalis.

Materials and Methods:

In this study, HGFs were cultured and subjected to LPS and EGCG. Cell viability of different concentrations of EGCG (10, 25, 50, 75, and 100 μM) and LPS (1, 10, 20, and 50 μg/mL) was assessed using methyl-thiazole-tetrazolium (MTT) assay. Then, the best concentrations of EGCG and P. gingivalis LPS were used simultaneously and separately to assess the production of TNF-α by HGFs using the enzyme-linked immunosorbent assay (ELISA). Assessments were done at 1, 3, and 5 days. Data were read using the ELISA reader and analyzed by the SPSS through two-way ANOVA.

Results:

LPS at 1, 10, and 20 and EGCG at 10.25 and 50 μM showed the least cytotoxicity in MTT assay. ELISA showed EGCG alone decreased the production of TNF-α in all days, except 10 μM on day 1. 1, 10, and 20 μg/mL LPS increased the output of TNF-α on days 1 and 3 while reducing it on day 5. The combination of EGCG and LPS showed a decrease of TNF-α in all days except on day 5 that revealed an increase in the production of TNF-α at 25 and 50 μM EGCG.

Conclusion:

In the combination use of EGCG and LPS, EGCG shows anti-inflammatory effects by decreasing the production of TNF-α by HGFs stimulated with P. gingivalis.

Oral microbiome interactions with gingival gene expression patterns for apoptosis, autophagy and hypoxia pathways in progressing periodontitis

Oral mucosal tissues must react with and respond to microbes comprising the oral microbiome ecology. This study examined the interaction of the microbiome with transcriptomic footprints of apoptosis, autophagy and hypoxia pathways during periodontitis. Adult Macaca mulatta (n = 18; 12-23 years of age) exhibiting a healthy periodontium at baseline were used to induce progressing periodontitis through ligature placement around premolar/molar teeth. Gingival tissue samples collected at baseline, 0·5, 1 and 3 months of disease and at 5 months for disease resolution were analysed via microarray. Bacterial samples were collected at identical sites to the host tissues and analysed using MiSeq. Significant changes in apoptosis and hypoxia gene expression occurred with initiation of disease, while autophagy gene changes generally emerged later in disease progression samples. These interlinked pathways contributing to cellular homeostasis showed significant correlations between altered gene expression profiles in apoptosis, autophagy and hypoxia with groups of genes correlated in different directions across health and disease samples. Bacterial complexes were identified that correlated significantly with profiles of host genes in health, disease and resolution for each pathway. These relationships were more robust in health and resolution samples, with less bacterial complex diversity during disease. Using these pathways as cellular responses to stress in the local periodontal environment, the data are consistent with the concept of dysbiosis at the functional genomics level. It appears that the same bacteria in a healthy microbiome may be interfacing with host cells differently than in a disease lesion site and contributing to the tissue destructive processes.

Development and Evaluation of a Novel Oral Mucoadhesive Ointment Containing Pomegranate Peel Extract as an Adjuvant for Oral Hygiene of Dogs

Herbal therapies are used worldwide to treat a variety of health conditions, including dental conditions in veterinary medicine. In this context, the use of medicinal plant-based formulations as potential therapeutics and preventatives in veterinary dentistry is worth highlighting. The objective of the present study was to develop a mucoadhesive ointment formulation, named orabase, that contained pomegranate extract for use in the oral cavity of dogs, with the aim of improving their oral hygiene. The hydroalcoholic extracts of pomegranate peels was incorporated into the orabase in 3 different concentrations. The formulations were subjected to in vitro microbiological testing by a modified disc-diffusion method to study the susceptibility of microorganisms collected from the oral cavities of the dogs. The samples were taken from the buccal mucosa of dogs having the same management and diet. The most effective formulation was submitted to physicochemical tests to evaluate the functionality of the product, namely pH, swelling index, spreadability, and mechanical properties (hardness, cohesiveness, and adhesiveness). The formulation containing 25.0% w/w of the extract was considered most suitable for the intended use as it showed antiseptic activity and demonstrated a swelling index of approximately 35% in the first 20 minutes of the test, high spreadability, and suitable mechanical properties. The results suggest that the product obtained from pomegranate peel extract is a viable option for use to improve oral hygiene, helping to reduce the bacterial component of dental plaque in dogs.

In vitro activities of Acacia nilotica (L.) Delile bark fractions against Oral Bacteria, Glucosyltransferase and as antioxidant

BACKGROUND

Dental caries and periodontal disease are the most common chronic infectious oral diseases in the world. Acacia nilotica was commonly known in Sudan as Garad or Sunt has a wide range of medicinal uses. In the present study, antibacterial activity of oral bacteria (Streptococcus sobrinus and Porphyromonas gingivalis), inhibitory activity against glucosyltransferase (GTF) enzyme and antioxidant activity were assayed for methanolic crude extract of A. nilotica bark and its fractions.

METHODS

Methanoilc crude extract of A. nilotica bark was applied to a Sephadex LH-20 column and eluted with methanol, aqueous methanol, and finally aqueous acetone to obtain four fractions (Fr1- Fr4). Furthermore, the crude extract and fractions were subjected to analytical high performance liquid chromatography (HPLC). The crude extract and its fractions were assayed for antibacterial activity against S. sobrinus and P. gingivalis using a microplate dilution assay method to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), as well as GTF inhibition and antioxidant activity using ABTS radical scavenging method.

RESULTS

Fractions (Fr1 and Fr2) exhibited MIC values of 0.3 mg/ml against the P. gingivalis. Additionally, Fr2 displayed MBC value of 1 mg/ml against two types of bacteria. Fr4 showed an especially potent GTF inhibitory activity with IC₅₀ value of 3.9 μg/ml. Fr1 displayed the best antioxidant activity with IC₅₀ value of 1.8 μg/ml. The main compound in Fr1 was identified as gallic acid, and Fr2 was mostly a mixture of gallic acid and methyl gallate.

CONCLUSIONS

The results obtained in this study provide some scientific rationale and justify the use of this plant for the treatment of dental diseases in traditional medicine. A. nilotica bark, besides their antibacterial potentiality and GTF inhibitory activity, it may be used as adjuvant antioxidants in mouthwashes. Further studies in the future are required to identify the rest of the active compounds.

Autophagy, One of the Main Steps in Periodontitis Pathogenesis and Evolution

Periodontitis represents a complex inflammatory disease that compromises the integrity of the tooth-supporting tissue through the interaction of specific periodontal pathogens and the host's immune system. Experimental data help to outline the idea that the molecular way towards periodontitis initiation and progression presents four key steps: bacterial infection, inflammation, oxidative stress, and autophagy. The aim of this review is to outline the autophagy involvement in the pathogenesis and evolution of periodontitis from at least three points of view: periodontal pathogen invasion control, innate immune signaling pathways regulation and apoptosis inhibition in periodontal cells. The exact roles played by reactive oxygen species (ROS) inside the molecular mechanisms for autophagy initiation in periodontitis still require further investigation. However, clarifying the role and the mechanism of redox regulation of autophagy in the periodontitis context may be particularly beneficial for the elaboration of new therapeutic strategies.

Obesity and periodontal disease: A review

Periodontal diseases usually refer to inflammatory disorders that are caused by pathogenic bacteria in the subgingival biofilm in association with impaired host immune response and connective tissue breakdown. The bacterial challenge exacerbates the cytokine production by the gingival epithelium, resulting in an uncontrolled inflammation that leads to tooth loss in adults from different populations. The prevalence of these diseases increases with aging, longer retention of teeth, and increased incidence of obesity and diabetes among the population. The prevalence demonstrates an increasing trend and a correlation with numerous comorbidities. Hence, as a family physician one should have the in-depth knowledge regarding the relationship between obesity and periodontitis to create awareness among people to provide primary care. Thus, it is relevant to develop new methods capable of detecting these diseases in the early stages and following up on their progression.

Salivary 8-hydroxyguanosine levels in smokers and non-smokers with chronic periodontitis

This case-controlled clinical trial was performed on the salivary 8-hydroxyguanosine (8-OHdG) levels in smokers and non-smokers with chronic periodontitis after non-surgical periodontal therapy. Subjects (N = 40) with periodontitis (smokers and non-smokers) and with clinically healthy conditions (smokers and non-smokers) were assigned to this study. At baseline, clinical periodontal parameters (plaque index, gingival index, pocket probing depth and clinical attachment levels) were evaluated. Saliva samples were obtained pre- and post-treatment to quantify the 8-OHdG levels using Elisa technique. Subjects diagnosed with chronic periodontitis with smoking habit (CPs) and non-smokers (CPns) received scaling and root planing. In clinically healthy subjects with smoking habit (CHs) and non-smokers (CHns), only oral hygiene tutoring was performed. All clinical measurements and salivary collection were repeated in a 3-month recall interval. Data were analyzed using Anova, Tukey post hoc test and Mann-Whitney 'U' tests (P < 0.05). At baseline, CPs and CPns groups showed significantly higher PI, GI, PD and CAL values than those of CHns and CHs (P < 0.001). Baseline salivary levels of 8-OHdG were significantly higher in CPs group (14.775 pg/mL) (P < 0.001) compared to the other groups. All clinical parameters in chronic periodontitis group improved at the 3rd month recall interval, however, with regards to 8-OHdG values, the CP smoker category still had a higher level compared to CP non-smoker. This study reflects an on-going periodontal destructive status in smokers and salivary 8-OHdG levels could be recognized as an oxidative biomarker for determining periodontal tissue destruction.

Safety and probiotic evaluation of two Bacillus strains producing antioxidant compounds

Bacillus species are becoming increasingly relevant for use as probiotics or feed additives where their heat stability can ensure survival in the food matrix or enable long-term storage at ambient temperature. Some Bacillus species are pigmented and in this study, we have examined two strains, one Bacillus pumilus (pigmented red) and the other Bacillus megaterium (pigmented yellow) for their safety for potential use in humans as dietary supplements. In addition, we have set out to determine if they might confer any potential health benefits. Both strains produce C30 carotenoids while the B. pumilus strain also produced large quantities of riboflavin equivalent to genetically modified Bacillus strains and most probably contributing to this strain’s pigmentation. Riboflavin’s and carotenoids are antioxidants, and we have evaluated the ability of vegetative cells and/or spores to influence populations of Faecalibacterium prausnitzii in the colon of mice. While both strains increased levels of F. prausnitzii, spores of the B. pumilus strain produced a significant increase in F. prausnitzii levels. If found to be reproducible in humans such an effect might, potentially, confer health benefits particularly for those suffering from inflammatory bowel disease.

Host modulation therapy using anti-inflammatory and antioxidant agents in periodontitis: A review to a clinical translation

OBJECTIVE

To highlight the shifting paradigm of periodontitis, describe mechanism of periodontal bone destruction, and propose an updated host modulation therapy (HMT) strategy. To add further clinical relevance, related studies investigating the efficacy of several HMT agents in periodontitis will be discussed.

DESIGN

Literature searches were conducted from articles published in PubMed using keywords "periodontal disease AND periodontitis AND host modulation therapy AND anti-inflammatory AND antioxidant", and then the findings were comprehensively summarized and elaborated.

RESULT

Accumulating evidence indicates that periodontitis is no longer defined solely as a pathogen-induced disease; rather, it is now recognized as a consequence of uncontrolled immune response and oxidative stress leading to periodontal tissue damage. Although periodontopathic bacteria initiate the disease, inflammation and oxidative stress were reported to be the main causes for the severity of tissue destruction. Thus, since the concept of periodontitis has shifted, our approach to its management needs to be adjusted to accommodate the latest paradigm. Nowadays, the modulation of inflammation and oxidative stress is considered a target of HMT. HMT agents, such as probiotics, anti-inflammatory drugs, anti-chemokines, lipid mediators, and bio-active fatty acids, have been extensively investigated for their remarkable functions in modulating the immune response and providing antioxidant effects.

CONCLUSION

Findings from in vitro, in vivo, and human studies frequently demonstrate positive association by the administration of HMT in periodontitis. HMT strategy targeted on anti-inflammatory and antioxidant in periodontitis might serve as an excellent therapeutic approach to reach the level of clinical benefit.

Fibroblasts Collagen Production and Histological Alterations in Hereditary Gingival Fibromatosis

Hereditary gingival fibromatosis is a disorder for which the etiology remains unknown. We aimed to evaluate the fibroblasts and histological alterations to give new clues. A father and a daughter of a family showing gingival hereditary fibromatosis were treated, and gingival biopsies were obtained. A histological study revealed dense fibrous tissue, basal lamina disruption, and epithelial cell migration into the connective tissue. Fibroblasts were cultured from the father and daughter and compared with those from a healthy control patient. The results of the biochemical analysis showed increased collagen synthesis, reduced antioxidant CoQ₁₀ content, and high levels of lipid peroxidation. Additionally, fibroblasts culture incubation with the oxidant H₂O₂ increased collagen levels that have been reduced by the addition of the antioxidant CoQ₁₀. We conclude that some fibroblasts metabolic alterations play a significant role in initiating and maintaining persistent fibrotic tissue. Oxidative stress influences the fibroblasts collagen production and could play a particular role in the pathogenesis of hereditary gingival fibromatosis.

Malondialdehyde as a Marker of Oxidative Stress in Periodontitis Patients

BACKGROUND

Periodontology is a fast-evolving field with newer insights into traditional periodontal diagnosis. Advances in periodontal disease diagnostic research are moving toward methods whereby periodontal risk can be identified and quantified by objective measures such as biomarkers.

OBJECTIVES

The aim of this study was to evaluate malondialdehyde (MDA) levels in whole saliva of patients with chronic periodontitis.

MATERIALS AND METHODS

Whole saliva samples were collected from 85 patients: 30 patients with chronic periodontitis, 25 with gingivitis, and 30 periodontally healthy controls. To determine the clinical condition of each subject, the gingival index and clinical attachment level were measured. The salivary MDA levels were determined spectrophotometrically.

RESULTS

Higher salivary MDA levels (P < 0.005) were detected in patients with periodontitis compared to the healthy controls. There was no statistically significant difference in the salivary MDA levels between patients with gingivitis and healthy controls.

CONCLUSIONS

Higher salivary MDA levels seem to reflect increased oxygen radical activity during periodontal inflammation. Thus, MDA can be used as a marker of oxidative stress in patients with periodontitis.

Intercellular communications-redox interactions in radiation toxicity; potential targets for radiation mitigation

Nowadays, using ionizing radiation (IR) is necessary for clinical, agricultural, nuclear energy or industrial applications. Accidental exposure to IR after a radiation terror or disaster poses a threat to human. In contrast to the old dogma of radiation toxicity, several experiments during the last two recent decades have revealed that intercellular signaling and communications play a key role in this procedure. Elevated level of cytokines and other intercellular signals increase oxidative damage and inflammatory responses via reduction/oxidation interactions (redox system). Intercellular signals induce production of free radicals and inflammatory mediators by some intermediate enzymes such as cyclooxygenase-2 (COX-2), nitric oxide synthase (NOS), NADPH oxidase, and also via triggering mitochondrial ROS. Furthermore, these signals facilitate cell to cell contact and increasing cell toxicity via cohort effect. Nitric oxide is a free radical with ability to act as an intercellular signal that induce DNA damage and changes in some signaling pathways in irradiated as well as non-irradiated adjacent cells. Targeting of these mediators by some anti-inflammatory agents or via antioxidants such as mitochondrial ROS scavengers opens a window to mitigate radiation toxicity after an accidental exposure. Experiments which have been done so far suggests that some cytokines such as IL-1β, TNF-α, TGF-β, IL-4 and IL-13 are some interesting targets that depend on irradiated organs and may help mitigate radiation toxicity. Moreover, animal experiments in recent years indicated that targeting of toll like receptors (TLRs) may be more useful for radioprotection and mitigation. In this review, we aimed to describe the role of intercellular interactions in oxidative injury, inflammation, cell death and killing effects of IR. Moreover, we described evidence on potential mitigation of radiation injury via targeting of these mediators.

Glutathione from recovered glucose as ingredient in antioxidant nanocapsules for triggered flavor delivery

Glucose recovered via enzymatic hydrolysis of rayon fibers was used for glutathione production by S. cerevisiae. Glutathione was used in combination with HSA and silk fibroin for ultrasound assisted nanocapsules production. Triggered release of flavor substances and antioxidant properties of the nanocapsules was demonstrated.

Modulatory Effects of Plant Polyphenols on Bone Remodeling: A Prospective View From the Bench to Bedside

During the past, a more comprehensive knowledge of mechanisms implicated in bone resorption processes has driven researchers to develop a compound library of many small molecules that specifically interfere with the genesis of osteoclast precursors cells. Natural compounds that suppress osteoclast commitment may have therapeutic value in treating pathologies associated with bone resorption like osteoporosis, rheumatoid arthritis, bone metastasis, and periodontal disease. The present review is focused on the current knowledge on the polyphenols derived from plants that could be efficacious in suppressing osteoclast differentiation and bone resorption.

Correlations of inflammatory cytokines, oxidative stress markers, and matrix metalloproteinases in gingival crevicular fluid with peri-implantitis

This study aimed to analyze the correlations of inflammatory cytokines, oxidative stress markers, and matrix metalloproteinases (MMPs) in gingival crevicular fluid (GCF) with peri-implantitis (PI). Forty patients receiving dental implantation were enrolled. There were 52 implants, which were divided into PI group (42 implants) and health implant (HI) group (10 implants). Fifty-two healthy teeth (HT) with the same names with affected teeth in the patients were selected as the control group. The periodontal status was recorded. The GCF was collected and quantified. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), MMP-13, and MMP-8 were detected using enzyme-linked immunosorbent assay (ELISA). Results showed that the probing depth, sulcus bleeding index, GCF volume, and TNF-α, IL-6, hs-CRP, MMP-8, and MMP-13 levels in GCF in PI group were significantly higher than HI and HT groups, respectively ( P < 0.01 or P < 0.05). The SOD and GSH-Px levels in PI group were significantly lower than HI and HT groups, respectively ( P < 0.05). Excepting hs-CRP, there was no significant difference of each index between HI and HT groups ( P > 0.05). In conclusion, TNF-α, IL-6, hs-CRP, SOD, GSH-Px, MMP-8, and MMP-13 are involved in the occurrence of PI, and they may be used as auxiliary indicators to evaluate the degree of PI. In addition, the clinical periodontal index probing depth and sulcus bleeding index are positively correlated with GCF volume, hs-CRP, MMP-8, and MMP-13.

Chitosan/hyaluronan/edaravone membranes for anti-inflammatory wound dressing: In vitro and in vivo evaluation studies

A novel wound healing material composed of chitosan (Ch) and hyaluronan (HA) boosted with edaravone (Ed) as an anti-inflammatory drug was developed. The fabricated membranes were verified using FT-IR, and the thermal properties were estimated employing TGA instrument. Moreover, Physical characterizations of the prepared membranes demonstrated a decrease in the membrane wettability, whereas an increase in membrane roughness was monitored due to the effect of edaravone supplementation. A comparative study of free-radical scavenging activity of edaravone itself was carried out by two in vitro approaches: uninhibited/inhibited hyaluronan degradation and decolorization of ABTS methods in normal and simulated inflammation condition (acidic condition). Accordingly, the scavenging activity of edaravone was significantly diminished to OH and peroxy-/alkoxy-type radicals in acidic conditions in compared to the neutral reactions. The biochemical studies evidenced the haemocompatibility of the examined membranes. The consequence of membranes composed of Ch/HA/Ed on the wound healing of the rat's skin was studied, and the macroscopic and microscopic investigations revealed remarkable healing at 21st day post-surgery compared with injuries treated with cotton gauze as a negative control in addition to Ch/HA membrane without edaravone. For these reasons, the Ch/HA/Ed membrane could be implemented as wound dressing material.

The effect of periodontal therapy on oxidative stress biomarkers: A systematic review

AIM

To systematically review the literature about the effect of periodontal treatment on oxidative stress (OxS) biomarkers.

MATERIAL AND METHODS

Three databases (PubMed, EMBASE, and Scopus) were searched up to February 2018. Clinical trials with a follow-up of at least 6 weeks after mechanical periodontal treatment were included. Due to the high heterogeneity among the units and indices of measurements used in the studies, a meta-analysis was not performed.

RESULTS

Overall, 3,199 studies were retrieved, of which 20 were included. Four studies were randomized clinical trials (RCT), and 16 studies were non-RCTs. The most common OxS biomarkers used were 8-hydroxydeoxiguanosine (8-OHdG), total oxidant status (TOS), and total antioxidant status (TAS). After treatment, most of the studies reported a decrease in 8-OHdG concentration in the gingival crevicular fluid (GCF) and saliva. In addition, the salivary concentration of this biomarker was similar to periodontally healthy patients. Periodontal therapy was effective in reducing TOS in GCF, saliva, and serum in most studies. TAS, however, responded inconsistently to the periodontal intervention.

CONCLUSION

Periodontal therapy reduces the levels of OxS biomarkers, even to values similar to those found in periodontally healthy individuals. Additional RCTs are warranted, as the information is mainly based on nonrandomized studies.