Clinical attachment loss and molecular profile of inflamed sites before treatment

Simple periodontal therapy combined with periodontal orthodontics improves the curative effect and reduces the inflammatory response in the treatment of PD

Objective To analyze the efficacy of simple periodontal therapy combined with periodontal orthodontics in the treatment of periodontal diseases (PD) and its effect on serum inflammatory factors. Methods The case data of 113 patients with PD admitted to the North China University of Science and Technology Affiliated Hospital between July 2019 and July 2021 were retrospectively analyzed. According to the treatment plans, patients were divided into the control group (56 cases undergoing simple periodontal treatment), and the observation group (57 cases undergoing orthodontic treatment combined with simple periodontal treatment). Treatment efficacy, gingival index (GI), plaque index (PI), clinical attachment loss (CAL), periodontal pocket depth (PPD), anterior tooth coverage distance and alveolar bone reconstruction distance before and after treatment were evaluated and compared between the two groups. The post-treatment tooth function and tooth mobility were also compared. Finally, serum inflammatory factors in both groups before and after treatment were detected and compared. Results The effective rate in the observation group was markedly higher than that in the control group (P<0.05). Before treatment, there was no marked difference regarding GI, PI and CAL, PPD, anterior tooth coverage distance and alveolar bone reconstruction between the two groups before treatment. While each of the indexes improved significantly in both groups after treatment, there was more significant improvement in the observation group (P<0.05). After treatment, tooth function and tooth mobility of the observation group were better as compared with the control group (P<0.05). In addition, serum inflammatory factors of both groups improved after treatment, with more obvious alleviation in the observation group (P<0.05). Conclusion Simple periodontal treatment combined with orthodontic treatment can effectively reduce inflammation in PD patients, improve their periodontal condition, promote periodontal tissue regeneration and repair, reduce tooth loosening, and improve masticatory function and aesthetics; moreover, it is beneficial for patients to maintain good oral hygiene for a long time, which is worthy of clinical application.

Osteoprotegerin/receptor activator of nuclear factor‑κB ligand are involved in periodontitis‑promoted vascular calcification

The present study explored the potential role of osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/receptor activator of nuclear factor-κB ligand (RANKL) in promoting vascular calcification by periodontitis. Thirty-six male Wistar rats were randomly assigned to four groups to establish animal models as follows: the sham group (group C), vascular calcification group (group VDN), periodontitis group (group CP), and test group (group CP+VDN). After eight weeks, all the rats were sacrificed. The periodontal and vascular calcification indices were detected. Quantitative polymerase chain reaction (qPCR), immunohistochemistry, western blot analysis, and enzyme-linked immunosorbent assay (ELISA) were used to quantify OPG/RANK/RANKL expression in vascular tissue and serum. Protein expression analyses revealed the expression of OPG and RANKL in the vascular tissues of the four groups. The expression of OPG in group C was the highest, which was similar to group CP+VDN, and the expression of OPG in groups CP and VDN were lower. However, the expression of RANKL was inversely correlated with OPG, and the ratio of RANKL/OPG was also higher in groups CP and VDN than that in groups C and CP+VDN. In conclusion, OPG/RANK/RANKL may play an essential role in the promotion of vascular calcification by periodontitis. However, the expression levels of OPG and RANKL were not simply superimposed when periodontitis and vascular calcification co-existed.

The role of bone-specific biomarkers in chronic periodontitis diagnosis and treatment outcomes - a systematic review

Background The biomarkers of bone turnover may be vital for early detection of bone destruction in chronic periodontitis (CP). Lately, several new biochemical markers have been applied to estimate bone homeostasis.Objective The current review aims to evaluate the role of bone biomarkers in diagnosis and treatment outcomes of CP.Methods Literature search was conducted in databases like Medline (PubMed) and Scopus to include original research articles related to the role of bone biomarkers in CP. About 914 documents were identified through primary search, of which 11 original research articles were included.Results The most common bone biomarker applied in periodontal diagnosis was RANKL. Certain newer biomarkers like ICTP were also found to be useful in early detection of progressive CP.Conclusion The bone turnover biomarkers may serve as an adjunct to the traditional methods of periodontal diagnosis. They are vital in identifying the subjects at risk for future periodontal breakdown as well as in determining the therapeutic outcomes. Their applications in periodontal diagnosis is still in the developing stage and requires further investigation. With this background, the current systematic review evaluated the role of bone-specific biomarkers in CP diagnosis and treatment outcomes.

Periodontitis and diabetes mellitus co-morbidity: A molecular dialogue

BACKGROUND

Type 2 diabetes mellitus (T2DM) and periodontitis are two biologically linked diseases that often coexist in complex interaction. While periodontitis may lead to insulin receptor desensitization, diabetes may increase the expression of inflammatory cytokines, such as Tumor Necrosis Factor-α (TNF-α) and Interleukin 6 (IL-6), in the gingival crevicular fluid and activate osteoclasts via Receptor activator of nuclear factor kappa-Β ligand (RANK-L) production, leading to bone resorption. However, the association between the two diseases processes, where one may exacerbate the progression of the other, is unclear. In addition, both diseases have similar mechanistic themes, such as chronic inflammation and oxidative stress. This review aimed to investigate the pathophysiological and molecular mechanisms underlying T2DM and periodontitis.

HIGHLIGHT

Uncontrolled diabetes is often associated with severe periodontitis, measured by clinical attachment loss. Alteration in the oral microbiome composition, which may activate the host inflammatory response and lead to irreversible oxidative stress, is a common finding in both diseases. An understanding of the molecular crosstalk between the two disease processes is crucial for developing therapeutic targets that inhibit bone resorption and halt the progression of periodontitis in patients with diabetes.

CONCLUSION

The Oral microbiome composition in T2DM and periodontitis shifts toward dysbiosis, favoring bacterial pathogens, such as Fusobacteria and Porphyromonas species. Both conditions are marked by pro-inflammatory immune activity via the activation of Interleukin 17 (IL-17), Interleukin 1 (IL-1), TNF-α, and Nuclear Factor Kappa Beta (NF-κB). Common molecular crosstalk signaling appears to involve advanced glycation end products (AGEs) and oxidative stress. Thus, future drug targets are multifactorial, ranging from modulatory of host inflammatory response to preventing the accumulation of AGEs and oxidative free radicals.

Influence of Doxycycline and InGaAlP Diode Laser at 660 nm Wavelength in the Treatment of Periodontitis Induced in Rats: In Vivo Study

This study evaluated the influence of Doxycycline (DOX) and Low-Intensity Laser (LIL) (InGaAlP diode laser) as scaling and root planing (SRP) adjuvants in the treatment of periodontitis induced in rats. The rats received periodontal disease induction, and after 7 days, the ligature was removed, and the animals were divided into groups/treatments: NT-receive no treatment; SRP-submitted only to SRP; DOX-submitted to SRP and DOX irrigation; LIL-submitted to SRP and LIL irradiation; and DOX + LIL-submitted to SRP treatments, DOX irrigation and LIL irradiation. The animals were sacrificed at 7, 15 and 30 days, and then, the analyses were performed. A lower concentration of Alpha-glycoprotein acid and Complement 3 was observed in the DOX + LIL group compared to all the other groups in all the periods, and for Complement 4 at 15 and 30 days (P < 0.01). A lower bone loss (BL) was observed in the DOX + LIL group compared to all the other groups in all the periods (P < 0.01). It can be concluded that LIL was effective in the reduction of proteins, and its association with DOX was effective in the reduction of proteins and BL, in the treatment of periodontal induction in rats.

Diagnostic Accuracy of Oral Fluids Biomarker Profile to Determine the Current and Future Status of Periodontal and Peri-Implant Diseases

Severe periodontitis is ranked as the sixth most prevalent disease affecting humankind, with an estimated 740 million people affected worldwide. The diagnosis of periodontal diseases mainly relies upon assessment of conventional clinical parameters. However, these parameters reflect past, rather than current, clinical status or future disease progression and, likely, outcome of periodontal treatment. Specific and sensitive biomarkers for periodontal diseases have been examined widely to address these issues and some biomarkers have been translated as point-of-care (PoC) tests. The aim of this review was to provide an update on PoC tests for use in the diagnosis and management of periodontal diseases. Among the PoC tests developed so far, active matrix metalloproteinase-8 has shown promising results in terms of diagnostic and prognostic values. However, further studies are required to increase the sensitivity and specificity via combining more than one biomarker and merging these test kits with periodontal risk assessment tools. Furthermore, the validity of these test kits needs to be investigated by applying the results in further independent studies and the impact on these test kits', together with the results of risk factors for periodontal diseases, such as diabetes and smoking, also needs to be examined.

Efficacy of photodynamic therapy and periodontal treatment in patients with gingivitis and fixed orthodontic appliances: Protocol of randomized, controlled, double-blind study

It is known that the presence of orthodontic brackets predisposes for a change in the biofilm, facilitating the development of gingivits. The sites are difficult to access with a toothbrush and periodontal curette, worsening inflammation, in addition, a gingival hyperplasia is associated with poor hygiene. The objective of this study is to evaluate the impact of photodinamyc therapy (PDT) as an adjuvant treatment, considering clinical immunoregulatory and microbiological parameters. This randomized, controlled, double-blind clinical study will include 34 patients, both genders, having used fixed appliance for more than 12 months, with gingivitis. Participants will be divided into two groups: G1 (n = 17)- Scaling and Root Planing + PDT placebo and G2 (n = 17)- Scaling and Root Planing + PDT. In G2 the following dosimetric parameters will be used: methylene blue 0.005%, λ= 660 nanometers (nm), 9 Joules (J) per site, irradiance= 3.5Watts (W)/ centimeters (cm), radiant exposure= 318J/cm. All participants will receive oral hygiene guidance prior the curetes scaling. The clinical periodontal data to be analyzed are plaque index, gingival index and probing depth. Crevicular fluid, from 4 pre-determined sites and saliva, will be collected and analysed for IL-6, IL-1β, IL-8, TNF-α and IL-10 cytokines using ELISA (Enzyme immunoabsorption assay) method. Total Bacteria count will also be performed, by qPCR and Universal16SrRNA gene. All analysis will be realized using in the baseline (T0), 7 (T1) and 21 (T2) days after treatment. Oral health-related quality of life will be assessed using the OHIP-14 questionnaire at times T0 and T2. If sample distribution is normal, the Student T-test will be applied if it is not normal, the Mann-Whitney test will be used. The data will be presented in terms of ± PD and The significance level will be set at p < 0.05. Our results may improve quality of life and add data to establish a therapeutic alternative for gingivitis during the orthodontic treatment. Registration: clinicaltrials.gov NCT04037709. https://clinicaltrials.gov/ct2/show/NCT04037709 - Registered in July 2019.

Impact of non-surgical periodontal treatment on salivary expression of cytokines related to bone metabolism

We aimed to evaluate the impact of non-surgical periodontal treatment on the salivary expression of leptin, TNF-α, sclerostin, parathyroid hormone, osteoprotegerin, osteopontin, osteocalcin, IL-6, IL-1β and fibroblast growth factor 23 in patients with chronic periodontitis after 1 year of follow-up. Fifteen patients with chronic periodontitis (56.0 ± SD 9.6 years) and 15 subjects with gingivitis (39.7 ± SD 4.4 years) were included in the study. Clinical periodontal parameters, such as probing pocket depth (PPD), clinical attachment level (CAL), % of plaque and bleeding on probing (BOP) were evaluated, and non-stimulated whole saliva was collected from all patients before periodontal treatment and after 1 year of follow-up. A bead-based multiplex assay measured cytokines. In the chronic periodontitis group, periodontal treatment significantly improved clinical parameters and reduced the salivary levels of IL-1β, leptin and TNF-α (p = 0.002, 0.007 and 0.015, respectively). In the gingivitis group, there were also significant improvements in the mean patient %BOP, % Plaque, CAL and PPD. However, there were no significant changes in the cytokine's salivary levels. In conclusion, chronic periodontitis patients showed a significant reduction in the salivary levels of leptin, TNF-α and IL-1β 1 year after periodontal treatment and a significant improvement in their clinical periodontal parameters suggesting that periodontal treatment alone can downregulate important cytokines associated with bone metabolism.