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Ren J, Fok MR, Zhang Y, Han B, Lin Y. The role of non-steroidal anti-inflammatory drugs as adjuncts to periodontal treatment and in periodontal regeneration. J Transl Med 2023; 21:149. [PMID: 36829232 PMCID: PMC9960225 DOI: 10.1186/s12967-023-03990-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/14/2023] [Indexed: 02/26/2023] Open
Abstract
Periodontitis is the sixth most prevalent chronic disease globally and places significant burdens on societies and economies worldwide. Behavioral modification, risk factor control, coupled with cause-related therapy have been the "gold standard" treatment for managing periodontitis. Given that host inflammatory and immunological responses play critical roles in the pathogenesis of periodontitis and impact treatment responses, several adjunctive strategies aimed at modulating host responses and improving the results of periodontal therapy and maintenance have been proposed. Of the many pharmacological host modulators, we focused on non-steroidal anti-inflammatory drugs (NSAIDs), due to their long history and extensive use in relieving inflammation and pain and reducing platelet aggregation. NSAIDs have been routinely indicated for treating rheumatic fever and osteoarthritis and utilized for the prevention of cardiovascular events. Although several efforts have been made to incorporate NSAIDs into the treatment of periodontitis, their effects on periodontal health remain poorly characterized, and concerns over the risk-benefit ratio were also raised. Moreover, there is emerging evidence highlighting the potential of NSAIDs, especially aspirin, for use in periodontal regeneration. This review summarizes and discusses the use of NSAIDs in various aspects of periodontal therapy and regeneration, demonstrating that the benefits of NSAIDs as adjuncts to conventional periodontal therapy remain controversial. More recent evidence suggests a promising role for NSAIDs in periodontal tissue engineering and regeneration.
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Affiliation(s)
- Jianhan Ren
- grid.194645.b0000000121742757Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Melissa Rachel Fok
- grid.194645.b0000000121742757Division of Periodontology and Implant Dentistry, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Yunfan Zhang
- grid.11135.370000 0001 2256 9319Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Bing Han
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Yifan Lin
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
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Kowalski J, Nowak M, Górski B, Górska R. What Has Immunology Brought to Periodontal Disease in Recent Years? Arch Immunol Ther Exp (Warsz) 2022; 70:26. [PMID: 36245042 PMCID: PMC9573852 DOI: 10.1007/s00005-022-00662-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
Abstract
Recent decades have shed a new light on the pathomechanism of periodontal inflammation. While classic periodontology concentrates on biofilm control, oral hygiene improvement, professional tooth cleaning and surgical correction of damaged periodontal tissues, new aspects of the destruction mechanisms are being raised. Among them, the greatest attention is paid to the influence of host response on the clinical manifestations of the disease. Numerous studies have proved that the shift from gingivitis to periodontitis is not a simple progress of the disease, but an event occurring only in susceptible individuals. Susceptibility may result from appearance of local factors facilitating biofilm accumulation and/or maturation, or from systemic features, among which over-reaction and prolonged agitation of non-specific component of inflammatory response is crucial. The present paper summarizes the association between periodontology and immunology and updates the knowledge accrued mostly in the recent years. After a brief explanation of advances in understanding of the disease aetiology, the most studied and potentially viable immunological markers of periodontal disease are presented. Possible new therapeutic strategies, exploiting knowledge about the nature of host response—immunomodulation and reduction of chronic oxidative stress—are also presented.
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Affiliation(s)
- Jan Kowalski
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, Warsaw, Poland.
| | - Maciej Nowak
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Bartłomiej Górski
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Renata Górska
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, Warsaw, Poland
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Garzón H, Suárez LJ, Muñoz S, Cardona J, Fontalvo M, Alfonso-Rodríguez CA. Biomaterials Used for Periodontal Disease Treatment: Focusing on Immunomodulatory Properties. Int J Biomater 2022; 2022:7693793. [PMID: 35528847 PMCID: PMC9072036 DOI: 10.1155/2022/7693793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/23/2022] [Accepted: 03/05/2022] [Indexed: 12/25/2022] Open
Abstract
The growing use of biomaterials with different therapeutic purposes increases the need for their physiological understanding as well as to seek its integration with the human body. Chronic inflammatory local pathologies, generally associated with infectious or autoimmunity processes, have been a current therapeutic target due to the difficulty in their treatment. The recent development of biomaterials with immunomodulatory capacity would then become one of the possible strategies for their management in local pathologies, by intervening in situ, without generating alterations in the systemic immune response. The treatment of periodontal disease as an inflammatory entity has involved the use of different approaches and biomaterials. There is no conclusive, high evidence about the use of these biomaterials in the regeneration of periodontitis sequelae, so the profession keeps looking for other different strategies. The use of biomaterials with immunomodulatory properties could be one, with a promising future. This review of the literature summarizes the scientific evidence about biomaterials used in the treatment of periodontal disease.
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Affiliation(s)
- H. Garzón
- Grupo de Investigación en Salud Oral, Departamento de Periodoncia, Universidad Antonio Nariño, Bogotá, Colombia
| | - L. J. Suárez
- Departamento de Ciencias Básicas y Medicina Oral, Universidad Nacional de Colombia, Bogotá, Colombia
| | - S. Muñoz
- Grupo de Investigación en Salud Oral, Departamento de Periodoncia, Universidad Antonio Nariño, Bogotá, Colombia
| | - J. Cardona
- Grupo de Investigación en Salud Oral, Departamento de Periodoncia, Universidad Antonio Nariño, Bogotá, Colombia
| | - M. Fontalvo
- Grupo de Investigación en Salud Oral, Departamento de Periodoncia, Universidad Antonio Nariño, Bogotá, Colombia
| | - C. A. Alfonso-Rodríguez
- Grupo de Investigación en Salud Oral, Departamento de Periodoncia, Universidad Antonio Nariño, Bogotá, Colombia
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Added effect of 1% topical alendronate in intra-bony and inter-radicular defects as part of step II periodontal therapy: a systematic review with meta-analysis and trial sequential analysis. BMC Oral Health 2022; 22:15. [PMID: 35062940 PMCID: PMC8780760 DOI: 10.1186/s12903-022-02044-1] [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: 05/17/2021] [Accepted: 12/28/2021] [Indexed: 01/08/2023] Open
Abstract
Background This systematic review and meta-analysis aimed to investigate the role of alendronate combined with step 2 of periodontal therapy in reducing probing pocket depth, improving clinical attachment level, and reducing bone defect depth in intra-bony and inter-radicular defects. Methods RCTs with more than 6 months follow-up were included in this study. Risk of bias assessment was performed using the Cochrane collaboration tool. In addition, meta-analysis and trial sequential analysis were used to aggregate the available evidence. Results Seven studies met the inclusion criteria and were included in the systematic review. Topical application of alendronate during second step of periodontal therapy significantly improved PD and CAL. Conclusion Local application of alendronate may confer a beneficial effect when applied during step II of periodontal therapy even if long term studies are needed to confirm these results. Clinical relevance Considering the emerging role of host-inflammatory response in treatment of periodontitis and the antiresorptive and osteostimulative properties of bisphosphonates, several studies are focusing on the role of alendronate as an addition to non-surgical periodontal therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02044-1.
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Citterio F, Gualini G, Chang M, Piccoli GM, Giraudi M, Manavella V, Baima G, Mariani GM, Romano F, Aimetti M. Pocket closure and residual pockets after non-surgical periodontal therapy: A systematic review and meta-analysis. J Clin Periodontol 2021; 49:2-14. [PMID: 34517433 PMCID: PMC9298904 DOI: 10.1111/jcpe.13547] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
Aim To analyse the efficacy of non‐surgical therapy (NST) in terms of pocket closure (PC) and changes in percentage and number of pockets. Materials and Methods Three databases (PubMed, EMBASE, and Scopus) were searched up to January 2020. Prospective studies with a minimum follow‐up of 12 months and presenting data in terms of PC or number or percentage of pocket depths (PDs) before and after NST on systemically healthy patients were included. Random‐effect meta‐analyses were performed. Results After screening 4610 titles and abstracts, 27 studies were included. Of these, 63.9% of PC was reported by one study. The percentage of PDs ≤3 mm changed from 39.06% to 64.11% with a weighted mean difference (WMD) of 26.14% (p < .001). This accounted for a relative increase of healthy sites of 64.13%. The mean percentage of PD ≥5 mm was 28.23% and 11.71% before and after treatment, respectively, with a WMD of 15.50% (p < .001). The WMD in the number of PDs ≥5 mm before and after treatment was 24.42 (p = .036). The mean number of residual PPD ≥5 after NST was 14.13. Conclusions NST is able to eradicate the majority of the pockets. However, residual pockets after NST may remain and should be considered cautiously for further treatment planning.
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Affiliation(s)
- Filippo Citterio
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Giacomo Gualini
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Moontaek Chang
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy.,Department of Periodontology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, South Korea.,Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Gian Marco Piccoli
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Marta Giraudi
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Valeria Manavella
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Giacomo Baima
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Giulia Maria Mariani
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Federica Romano
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
| | - Mario Aimetti
- Department of Periodontology, Università di Torino, C.I.R. Dental School, Turin, Italy
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Systematic review and meta-analysis on the adjunctive use of host immune modulators in non-surgical periodontal treatment in healthy and systemically compromised patients. Sci Rep 2021; 11:12125. [PMID: 34108528 PMCID: PMC8190303 DOI: 10.1038/s41598-021-91506-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/10/2021] [Indexed: 01/13/2023] Open
Abstract
Considering the central role of inflammation in the pathogenesis of periodontitis, the combination of NSPT with different agents that can modulate the host immune-inflammatory response has been proposed to enhance the outcomes of NSPT. The aim of this paper is to systematically review the literature on the efficacy of systemic host modulators (HMs) as adjuncts to non-surgical periodontal therapy (NSPT) in improving pocket depth (PD) reduction and clinical attachment level (CAL) gain in healthy and systemically compromised patients. RCTs with ≥ 3 months follow-up were independently searched by two reviewers. Meta-analysis was performed when ≥ 3 studies on the same HM were identified. The quality of the evidence was rated according to the GRADE approach to rate the certainty of evidence. 38 articles were included in the qualitative assessment and 27 of them were included in the meta-analysis. There is low/very low evidence that the adjunctive use of sub-antimicrobial dose of doxycicline, melatonin and the combination of omega-3 and low dose aspirin (in type 2 diabetic patients) to NSPT would improve PD and/or CAL. Conflicting evidence is available on the efficacy of probiotics. Future studies controlling for confounding factors, using composite outcomes to define the endpoint of therapy and considering not only the patient- but also as the site-specific effect of systemic HMs are warranted. The dosage, posology and long-term effect of HMs still need to be clarified, also in association to the presence of systemic conditions potentially affecting the response to HMs administration.
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Donos N, Calciolari E, Brusselaers N, Goldoni M, Bostanci N, Belibasakis GN. The adjunctive use of host modulators in non-surgical periodontal therapy. A systematic review of randomized, placebo-controlled clinical studies. J Clin Periodontol 2021; 47 Suppl 22:199-238. [PMID: 31834951 DOI: 10.1111/jcpe.13232] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/10/2019] [Accepted: 12/01/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Considering the role of the inflammatory host response in the pathogenesis of periodontitis, different host modulators have been proposed to enhance the outcomes of non-surgical periodontal therapy (NSPT), but their efficacy has not been fully clarified. OBJECTIVES This systematic review investigated the efficacy of host modulators combined with NSPT in reducing probing pocket depth (PPD) in periodontitis patients. MATERIALS AND METHODS Placebo-controlled RCTs with ≥6 months follow-up were searched. Meta-analysis was conducted when ≥5 studies using the same host modulator were identified. RESULTS Fifty eight studies met the inclusion criteria. After 6 months, local administration of 1.2% statin gels as adjuncts to NSPT significantly improved PPD reduction (1.83 mm) in infrabony defects and systemic administration of sub-antimicrobial dose doxycycline (SDD) in addition to NSPT improved PPD reduction of deep pockets. Administration of probiotics conferred limited clinical benefits. Local bisphosphonate and metformin gels showed potential for clinical use in infrabony defects, which needs to be confirmed. CONCLUSIONS Local delivery of statins in infrabony defects and systemic SDD for deep pockets may confer additional clinical benefits to NSPT. Their long-term effectiveness and safety need to be confirmed in independent multi-centred studies. Further studies are needed to confirm the benefit of other host modulators.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Barts and The London School of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Barts and The London School of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nele Brusselaers
- Centre of Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Matteo Goldoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Jain P, Mirza MA, Iqbal Z. A 4-D approach for amelioration of periodontitis. Med Hypotheses 2019; 133:109392. [PMID: 31521022 DOI: 10.1016/j.mehy.2019.109392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/02/2019] [Accepted: 09/05/2019] [Indexed: 01/04/2023]
Abstract
Global prevalence of the severe periodontitis is at the alarming stage and its association with the systemic complications is highly evident which cannot be neglected. An insight into the pathophysiology of the periodontitis reveals that the promising amelioration could only be envisaged with the 4-D/multi-pronged approach of combining antibiotic along with the host modulating agents. The complications of the disease itself suggest that the use of antibiotic alone is not able to cater the symptoms completely. There is a need of other host modulatory agents too, such as Cyclo-oxygenase -II (COX II) enzyme inhibitors, Matrix metalloproteinase's (MMPs) inhibitors and osteo-integrating agents. Also, there is an unmet need of singular treatment modality through which all these agents can be sequentially and directly delivered into the periodontal cavity. The current hypothesis takes it a step forward wherein an antibiotic is combined with other three host modulatory agents in a singular drug delivery system. The encapsulation of multiple therapeutic agents with controlled release would therefore allow for reduced drug dose thus minimizing side effects; contributing to enhanced patient compliance and treatment efficacy. Hence this approach can be presented as a 4-D/multi-pronged approach for circumvention of periodontitis.
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Affiliation(s)
- Pooja Jain
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - M Aamir Mirza
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Zeenat Iqbal
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
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Sulijaya B, Takahashi N, Yamazaki K. Host modulation therapy using anti-inflammatory and antioxidant agents in periodontitis: A review to a clinical translation. Arch Oral Biol 2019; 105:72-80. [PMID: 31288144 DOI: 10.1016/j.archoralbio.2019.07.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/26/2019] [Accepted: 07/02/2019] [Indexed: 01/19/2023]
Abstract
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.
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Affiliation(s)
- Benso Sulijaya
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Division of Periodontology, Department of Oral Biological Science, Niigata University Faculty of Dentistry, Niigata, Japan; Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Naoki Takahashi
- Division of Periodontology, Department of Oral Biological Science, Niigata University Faculty of Dentistry, Niigata, Japan; Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuhisa Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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Kats A, Gerasimcik N, Näreoja T, Nederberg J, Grenlöv S, Lagnöhed E, Desai S, Andersson G, Yucel-Lindberg T. Aminothiazoles inhibit osteoclastogenesis and PGE 2 production in LPS-stimulated co-cultures of periodontal ligament and RAW 264.7 cells, and RANKL-mediated osteoclastogenesis and bone resorption in PBMCs. J Cell Mol Med 2018; 23:1152-1163. [PMID: 30506812 PMCID: PMC6349150 DOI: 10.1111/jcmm.14015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/17/2018] [Accepted: 10/09/2018] [Indexed: 12/18/2022] Open
Abstract
Inflammatory mediator prostaglandin E2 (PGE2 ) contributes to bone resorption in several inflammatory conditions including periodontitis. The terminal enzyme, microsomal prostaglandin E synthase-1 (mPGES-1) regulating PGE2 synthesis is a promising therapeutic target to reduce inflammatory bone loss. The aim of this study was to investigate effects of mPGES-1 inhibitors, aminothiazoles TH-848 and TH-644, on PGE2 production and osteoclastogenesis in co-cultures of periodontal ligament (PDL) and osteoclast progenitor cells RAW 264.7, stimulated by lipopolysaccharide (LPS), and bone resorption in RANKL-mediated peripheral blood mononuclear cells (PBMCs). PDL and RAW 264.7 cells were cultured separately or co-cultured and treated with LPS alone or in combination with aminothiazoles. Multinucleated cells stained positively for tartrate-resistant acid phosphatase (TRAP) were scored as osteoclast-like cells. Levels of PGE2 , osteoprotegerin (OPG) and interleukin-6, as well as mRNA expression of mPGES-1, OPG and RANKL were analysed in PDL cells. PBMCs were treated with RANKL alone or in combination with aminothiazoles. TRAP-positive multinucleated cells were analysed and bone resorption was measured by the CTX-I assay. Aminothiazoles reduced LPS-stimulated osteoclast-like cell formation both in co-cultures and in RAW 264.7 cells. Additionally, aminothiazoles inhibited PGE2 production in LPS-stimulated cultures, but did not affect LPS-induced mPGES-1, OPG or RANKL mRNA expression in PDL cells. In PBMCs, inhibitors decreased both osteoclast differentiation and bone resorption. In conclusion, aminothiazoles reduced the formation of osteoclast-like cells and decreased the production of PGE2 in co-cultures as well as single-cell cultures. Furthermore, these compounds inhibited RANKL-induced bone resorption and differentiation of PBMCs, suggesting these inhibitors for future treatment of inflammatory bone loss such as periodontitis.
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Affiliation(s)
- Anna Kats
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Natalija Gerasimcik
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Tuomas Näreoja
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
| | - Jonas Nederberg
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Simon Grenlöv
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Ekaterina Lagnöhed
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
| | - Suchita Desai
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
| | - Göran Andersson
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
| | - Tülay Yucel-Lindberg
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden
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11
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Lopes DEM, Jabr CL, Dejani NN, Saraiva AC, de Aquino SG, Medeiros AI, Rossa Junior C. Inhibition of 5-lipoxygenase attenuates inflammation and BONE resorption in lipopolysaccharide-induced periodontal disease. J Periodontol 2017; 89:235-245. [PMID: 29381190 DOI: 10.1902/jop.2017.170210] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 08/14/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Arachidonate-5-lipoxygenase (5-LO) activity and increased leukotriene B4 (LTB4) production have been implicated in various inflammatory conditions. Increased production of leukotrienes has been associated with periodontal diseases; however, their relative contribution to tissue destruction is unknown. In this study, an orally active specific 5-LO inhibitor is used to assess its role in inflammation and bone resorption in a murine model of lipopolysaccharide (LPS)-induced periodontal disease. METHODS Periodontal disease was induced in Balb/c mice by direct injections of LPS into the palatal gingival tissues adjacent to the maxillary first molars three times per week for 4 weeks. Animals were treated with biochemical inhibitor (2 mg/kg/daily) or the same volume of the vehicle by oral gavage. Microcomputed tomography analysis was used to assess bone resorption. Enzyme immunoassay determined LTB4, and enzyme-linked immunosorbent assays quantified tumor necrosis factor (TNF), interleukin (IL)-12, and IL-10 in gingival tissues. Histologic sections were used for the morphometric analysis (number of neutrophils and mononuclear cells). Osteoclasts were counted in tartrate-resistant acid phosphatase-stained sections. RESULTS Administration of 5-LO inhibitor effectively reduced production of LTB4 (23.7% decrease) and significantly reduced TNF and IL-12 levels in gingival tissues. Moreover, reduction of LTB4 levels in gingival tissues was associated with a significant decrease in bone resorption and a marked reduction in number of osteoclasts and inflammatory cells. CONCLUSION 5-LO activity plays a relevant role in inflammation and bone resorption associated with the LPS model of experimental periodontal disease.
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Affiliation(s)
- Debora E M Lopes
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University, Araraquara, Sao Paulo, Brazil
| | - Camila L Jabr
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University, Araraquara, Sao Paulo, Brazil
| | - Naiara N Dejani
- Department of Biological Sciences, School of Pharmaceutical Sciences, Sao Paulo State University
| | - Amanda C Saraiva
- Department of Biological Sciences, School of Pharmaceutical Sciences, Sao Paulo State University
| | - Sabrina G de Aquino
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University, Araraquara, Sao Paulo, Brazil
- Health Sciences Center, School of Dentistry, Federal University of Paraiba, Joao Pessoa, Paraíba, Brazil
| | - Alexandra I Medeiros
- Department of Biological Sciences, School of Pharmaceutical Sciences, Sao Paulo State University
| | - Carlos Rossa Junior
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University, Araraquara, Sao Paulo, Brazil
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13
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Oliveira GJPLD, Paula LGFD, Souza JACD, Spin-Neto R, Stavropoulos A, Marcantonio RAC. Effects of avocado/soybean unsaponifiables (ASU) on the treatment of ligature-induced periodontitis in rats. Braz Oral Res 2017; 31:e28. [PMID: 28403331 DOI: 10.1590/1807-3107bor-2017.vol31.0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/13/2017] [Indexed: 12/30/2022] Open
Abstract
The purpose of this study is to evaluate the effect of the avocado/soybean unsaponifiables (ASU) on the treatment of induced periodontitis in rats. Periodontitis was induced in 84 rats via ligature placement around the second upper molar, which was removed after 7 days, and scaling and root planning (SRP) was performed at this time. Subsequently, the rats were randomly allocated to four groups with 21 animals each: One SRP group in which saline solution was administered (SS), and three groups in which ASU was administered (0.6 g/kg/day), beginning either 7 days before the induction of periodontitis (SRP/ASU-7), on the day of periodontitis induction (SRP/ASU0), or on the day of treatment (SRP/ASU+7). ASU and SS were administered daily by gavage until the sacrifice of the animals (7, 15, and 30 days after SRP). The % bone in the furcation area was evaluated by histomorphometry and micro-CT. The expression of proteins (TRAP, RANKL, and alkaline phosphatase) and mRNA (IL-1β, TNF-α, IL-6, RANKL, and alkaline phosphatase) were evaluated by immunohistochemistry and qPCR. The SRP/ASU+7 group presented a higher percentage of bone fill in the furcation area and higher expression of alkaline phosphatase than in the SRP group (at 7 and 30 days, respectively). The SRP/ASU0 and SRP/ASU+7 groups presented lower expression levels of RANKL mRNA than the SRP and SRP/ASU-7 groups at 15 days. ASU administration on the day of the SRP treatment of the ligature-induced periodontitis promoted subtle beneficial effects on periodontal repair following the treatment of induced periodontitis within the experimental period of 7 days.
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Affiliation(s)
| | | | | | - Rubens Spin-Neto
- Aarhus University, Department of Dentistry, Section of Oral Radiology, Aarhus, Denmark
| | - Andreas Stavropoulos
- Malmo University, Faculty of Odontology, Department of Periodontology and Community Dentistry, Malmo, Sweden
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Martin-Cabezas R, Davideau JL, Tenenbaum H, Huck O. Clinical efficacy of probiotics as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis: a systematic review and meta-analysis. J Clin Periodontol 2016; 43:520-30. [PMID: 26970230 DOI: 10.1111/jcpe.12545] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 12/18/2022]
Abstract
FOCUSED QUESTION What is the clinical influence of probiotics as an adjunctive therapy of scaling and root planing (SRP) when compared with SRP alone or in combination with placebo in the treatment of chronic periodontitis (CP). METHODS Electronic databases were searched up to July 2015. Randomized controlled trials (RCTs) comparing SRP + probiotic versusSRP were included. PPD reduction and CAL gain were selected as primary outcome variables. RESULTS Independent screening resulted in four eligible publications for the systematic review and three were included in the meta-analysis. Meta-analysis showed a statistically significant CAL gain (-0.42 mm, p = 0.002) and bleeding on probing (BOP) reduction (-14.66, p = 0.003) for SRP + probiotic treatment versusSRP at short-term. Only a tendency (p = 0.06) has been observed in terms of overall PPD reduction, whereas results were significant when stratified for moderate (-0.18, p = 0.001) and deep pockets (-0.67, p < 0.001). CONCLUSION Within the limitations of this study, the findings of this meta-analysis seem to support the adjunctive use of L. reuteri to SRP in CP treatment at short-term, especially in deep pockets. Heterogeneity and limited available data may reduce the impact of these conclusions. Future long-term RCTs evaluating the clinical efficacy of adjunctive probiotics to SRP are needed.
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Affiliation(s)
- Rodrigo Martin-Cabezas
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Jean-Luc Davideau
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France.,INSERM 1109 "Osteoarticular & Dental Regenerative Nanomedicine", Strasbourg, France
| | - Henri Tenenbaum
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France.,INSERM 1109 "Osteoarticular & Dental Regenerative Nanomedicine", Strasbourg, France
| | - Olivier Huck
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France.,INSERM 1109 "Osteoarticular & Dental Regenerative Nanomedicine", Strasbourg, France
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Kats A, Norgård M, Wondimu Z, Koro C, Concha Quezada H, Andersson G, Yucel-Lindberg T. Aminothiazoles inhibit RANKL- and LPS-mediated osteoclastogenesis and PGE2 production in RAW 264.7 cells. J Cell Mol Med 2016; 20:1128-38. [PMID: 26987561 PMCID: PMC4882984 DOI: 10.1111/jcmm.12814] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 01/13/2016] [Indexed: 01/09/2023] Open
Abstract
Periodontitis is characterized by chronic inflammation and osteoclast‐mediated bone loss regulated by the receptor activator of nuclear factor‐κB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG). The aim of this study was to investigate the effect of aminothiazoles targeting prostaglandin E synthase‐1 (mPGES‐1) on RANKL‐ and lipopolysaccharide (LPS)‐mediated osteoclastogenesis and prostaglandin E2 (PGE2) production in vitro using the osteoclast precursor RAW 264.7 cells. RAW 264.7 cells were treated with RANKL or LPS alone or in combination with the aminothiazoles 4‐([4‐(2‐naphthyl)‐1,3‐thiazol‐2‐yl]amino)phenol (TH‐848) or 4‐(3‐fluoro‐4‐methoxyphenyl)‐N‐(4‐phenoxyphenyl)‐1,3‐thiazol‐2‐amine (TH‐644). Aminothiazoles significantly decreased the number of multinucleated tartrate‐resistant acid phosphatase (TRAP)‐positive osteoclast‐like cells in cultures of RANKL‐ and LPS‐stimulated RAW 264.7 cells, as well as reduced the production of PGE2 in culture supernatants. LPS‐treatment induced mPGES‐1 mRNA expression at 16 hrs and the subsequent PGE2 production at 72 hrs. Conversely, RANKL did not affect PGE2 secretion but markedly reduced mPGES‐1 at mRNA level. Furthermore, mRNA expression of TRAP and cathepsin K (CTSK) was reduced by aminothiazoles in RAW 264.7 cells activated by LPS, whereas RANK, OPG or tumour necrosis factor α mRNA expression was not significantly affected. In RANKL‐activated RAW 264.7 cells, TH‐848 and TH‐644 down‐regulated CTSK but not TRAP mRNA expression. Moreover, the inhibitory effect of aminothiazoles on PGE2 production was also confirmed in LPS‐stimulated human peripheral blood mononuclear cell cultures. In conclusion, the aminothiazoles reduced both LPS‐ and RANKL‐mediated osteoclastogenesis and PGE2 production in RAW 264.7 cells, suggesting these compounds as potential inhibitors for treatment of chronic inflammatory bone resorption, such as periodontitis.
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Affiliation(s)
- Anna Kats
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Maria Norgård
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Zenebech Wondimu
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Catalin Koro
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Hernán Concha Quezada
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Göran Andersson
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Tülay Yucel-Lindberg
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Chee B, Park B, Fitzsimmons T, Coates AM, Bartold PM. Omega-3 fatty acids as an adjunct for periodontal therapy-a review. Clin Oral Investig 2016; 20:879-94. [PMID: 26885664 DOI: 10.1007/s00784-016-1750-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/10/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this article is to present an overview of omega-3 fatty acids, their anti-inflammatory properties and potential use as an adjunct for periodontal therapy. MATERIALS AND METHODS A general literature search was conducted to provide an overview of omega-3 fatty acids, their metabolism and anti-inflammatory properties. A more specific literature search of PubMed and EMBASE was conducted to identify articles dealing studies investigating the effects of omega-3 fatty acids in the treatment of periodontitis in animals and humans and included cross-sectional, longitudinal and intervention designs. RESULTS To date, there is good emerging evidence that dietary supplementation with fish oil may be of some benefit and this is enhanced if combined with aspirin. All clinical intervention studies to date have been on small sample sizes, and this indicates there is need for larger and more robust clinical trials to verify these initial findings. CONCLUSIONS Dietary supplementation with fish oil could be a cost-effective adjunctive therapy to the management of periodontal disease. CLINICAL RELEVANCE The host modulatory properties of omega-3 fatty acids warrant further assessment of their use as an adjunct in the management of periodontitis.
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Affiliation(s)
- B Chee
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - B Park
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - T Fitzsimmons
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - A M Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - P M Bartold
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia.
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Abstract
BACKGROUND Several studies have demonstrated the high incidence of periodontal disorders among patients suffering from mental illnesses, probably because of self-care impairment, the difficult financial conditions, and the lack of motivation. The primary aim of this study was to evaluate the impact of depression and alexithymia on periodontal status. Due to the influence of personality traits on behavior in general, the secondary aim of our study was to investigate the possible impact of personality disorders on dental status. METHODS Patients with major depression (DP) referred to our psychiatry unit and healthy individuals (controls) were consecutively enrolled during the period April 2012-September 2012. All the participants to the study underwent a psychiatric evaluation (through questionnaires investigating the presence of depression, anxiety, personality disorders, and alexithymia) and a dental examination through the following indexes: plaque index, gingival index, simplified oral hygiene index, periodontal index. RESULTS Fifty DP (aged 56.7±15.2 years) and 40 controls (aged 56.1±15.9 years) were enrolled in the study. DP showed a worse oral hygiene status. In particular, statistically significant differences were found when comparing DP and controls in terms of plaque index, simplified oral hygiene index, gingival index, periodontal index, and oral health impact profile. In addition, periodontal health was found to be negatively related to the severity of depression and the presence of alexithymia. The strength of association between depression and dental indexes was reduced after adjusting for the other psychiatric variables (alexithymia and personality disorders) and was confirmed only for oral health impact profile. CONCLUSION Psychiatric variables seem to affect the patients' periodontal status; due to the high frequency of dental problems, patients suffering from mental illnesses should be referred to the oral health services for evaluation.
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Affiliation(s)
- Maria Luca
- Department of Medical and Surgery Specialties, Psychiatry Unit, University Hospital "Policlinico-Vittorio Emanuele" of Catania, Sicily, Italy
| | - Antonina Luca
- Department "GF Ingrassia", Section of Neuroscience, University Hospital "Policlinico-Vittorio Emanuele" of Catania, Sicily, Italy
| | | | - Carmela Calandra
- Department of Medical and Surgery Specialties, Psychiatry Unit, University Hospital "Policlinico-Vittorio Emanuele" of Catania, Sicily, Italy
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Prakash G, Umar M, Ajay S, Bali D, Upadhyay R, Gupta KK, Dixit J, Mittal B. COX-2 gene polymorphisms and risk of chronic periodontitis: a case-control study and meta-analysis. Oral Dis 2013; 21:38-45. [PMID: 24267395 DOI: 10.1111/odi.12203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 10/03/2013] [Accepted: 10/21/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Cyclooxygenase-2 (COX-2) enzyme is a major mediator of inflammation in periodontitis, leading to loss of gingival tissues and alveolar bone supporting the teeth. Previous studies have explored the role of COX-2 polymorphisms with the risk of periodontitis in different ethnic groups; however, findings are inconsistent. So, we aimed to investigate the association of COX-2 polymorphisms (rs20417, rs689466, and rs5275) in susceptibility to chronic periodontitis (CP) in northern Indian population. Meta-analysis was also carried out to precisely estimate the effect of COX-2 polymorphisms in CP. MATERIALS AND METHODS Genotyping of COX-2 polymorphisms was carried out through PCR-RFLP in 200 CP cases and 200 controls. For risk estimation, binary logistic regression was applied using SPSS, version 15.0, while meta-analysis was carried using MIX 2.0 software. RESULTS None of the COX-2 polymorphisms independently were associated with the risk of CP. Meta-analysis suggested a significant reduced risk of CP with rs5275+8473 C allele and rs20417 in Chinese population. CONCLUSIONS No association was observed in any of the studied COX-2 polymorphisms with CP in North India. But, the study should be replicated in larger sample size to arrive at a definitive conclusion. Meta-analysis suggested a role of rs5275 COX-2 polymorphisms in susceptibility to overall CP, and on ethnic basis, rs20417 showed reduced risk of CP in Chinese population.
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Affiliation(s)
- G Prakash
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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de Araújo RF, Souza TO, de Moura LM, Torres KP, de Souza LB, Alves MDSCF, Rocha HO, de Araújo AA. Atorvastatin decreases bone loss, inflammation and oxidative stress in experimental periodontitis. PLoS One 2013; 8:e75322. [PMID: 24130702 PMCID: PMC3794930 DOI: 10.1371/journal.pone.0075322] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 08/08/2013] [Indexed: 12/16/2022] Open
Abstract
The aim of this study is to determine the effects of Atorvastatin treatment, an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, in periodontal disease. Male Wistar albino rats were randomly divided into five groups of ten rats each: (1) non-ligated treatment (NL), (2) ligature only (L), (3) ligature plus 1 mg/kg Atorvastatin daily for 10 days, (4) ligature plus 5 mg/kg Atorvastatin daily for 10 days, and (5) ligature plus 10 mg/kg Atorvastatin daily for 10 days. Following the treatment course, the periodontal tissue of the animals was analyzed by Measurement of alveolar bone loss, Histopathology and immunohistochemistry to determine of the expression of COX-2, MMP-2, MMP9, and RANKL/RANK/OPG. ELISA assay was used to quantitate the levels of IL-1β, IL-10, TNF-α, myeloperoxidase, malondialdehyde, and glutathione. The periodontal group treated with 10 mg/kg of Atorvastatin (3.9±0.9 mm; p<0.05) showed reverse the alveolar bone loss caused Experimental Periodontal Disease compared to (L) (7.02±0.17 mm). The periodontal group treated with 10 mg/kg of Atorvastatin showed a significant reduction in MPO and MDA (p<0.05) compared to ligature only group (L). Similarly in this group, the levels of the proinflammatory cytokines IL-1β and TNF-α were significantly decreased (p<0.05). Furthermore, MMP-2, MMP-9, RANKL/RANK, and COX-2 were all downregulated by Atorvastatin treatment, while OPG expression was increased. The findings support a role of Atorvastatin for reducing the bone loss, inflammatory response, oxidative stress, and expression of extracellular matrix proteins, while reducing RANK/RANKL and increase OPG in periodontal disease.
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Affiliation(s)
- Raimundo Fernandes de Araújo
- Postgraduation Program in Functional and Structural Biology/Postgraduation Program Health Science/Department of Morphology, UFRN, Natal, RN, Brazil
| | | | - Lígia Moreno de Moura
- Department of Dentistry/UNP, Postgraduation Program Public Health, UFRN, Natal, RN, Brazil
| | | | | | | | | | - Aurigena Antunes de Araújo
- Postgraduation Program Public Health/Postgraduation Program in Pharmaceutical Science/UFRN, Natal, RN, Brazil
- * E-mail:
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Kayal RA. The role of osteoimmunology in periodontal disease. BIOMED RESEARCH INTERNATIONAL 2013; 2013:639368. [PMID: 24151615 PMCID: PMC3789307 DOI: 10.1155/2013/639368] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 08/15/2013] [Accepted: 08/17/2013] [Indexed: 12/26/2022]
Abstract
Periodontal disease is a pathological condition that involves inflammation of the tooth supporting structures. It occurs in response to the presence of bacterial plaque on the tooth structure. The host defense system, including innate and adaptive immunity, is responsible for combating the pathologic bacteria invading the periodontal tissue. Failure to eradicate the invading pathogens will result in a continuous state of inflammation where inflammatory cells such as lymphocytes, PMNs, and macrophages will continue to produce inflammatory mediators in an effort to destroy the invaders. Unfortunately, these inflammatory mediators have a deleterious effect on the host tissue as well as foreign microbes. One of the effects of these mediators on the host is the induction of matrix degradation and bone resorption through activation of proteases and other inflammatory mediators that activate osteoclasts.
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Affiliation(s)
- Rayyan A. Kayal
- Department of Oral Basic and Clinical Science, King Abdulaziz University Faculty of Dentistry, P.O. Box 3738, Jeddah 21481, Saudi Arabia
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21
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Abstract
Periodontitis is a chronic inflammatory condition of the periodontium involving interactions between bacterial products, numerous cell populations and inflammatory mediators. It is generally accepted that periodontitis is initiated by complex and diverse microbial biofilms which form on the teeth, i.e. dental plaque. Substances released from this biofilm such as lipopolysaccharides, antigens and other virulence factors, gain access to the gingival tissue and initiate an inflammatory and immune response, leading to the activation of host defence cells. As a result of cellular activation, inflammatory mediators, including cytokines, chemokines, arachidonic acid metabolites and proteolytic enzymes collectively contribute to tissue destruction and bone resorption. This review summarises recent studies on the pathogenesis of periodontitis, with the main focus on inflammatory mediators and their role in periodontal disease.
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22
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Araújo AA, Lopes de Souza G, Souza TO, de Castro Brito GA, Sabóia Aragão K, Xavier de Medeiros CA, Lourenço Y, do Socorro Costa Feitosa Alves M, Fernandes de Araújo R. Olmesartan decreases IL-1β and TNF-α levels; downregulates MMP-2, MMP-9, COX-2, and RANKL; and upregulates OPG in experimental periodontitis. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2013; 386:875-84. [DOI: 10.1007/s00210-013-0886-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 05/26/2013] [Indexed: 10/26/2022]
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Shiloah J, Bland PS, Scarbecz M, Patters MR, Stein SH, Tipton DA. The effect of long-term aspirin intake on the outcome of non-surgical periodontal therapy in smokers: a double-blind, randomized pilot study. J Periodontal Res 2013; 49:102-9. [DOI: 10.1111/jre.12085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2013] [Indexed: 01/18/2023]
Affiliation(s)
- Jacob Shiloah
- Department of Periodontology; College of Dentistry; University of Tennessee Health Science Center; Memphis TN USA
| | - Paul S. Bland
- Department of Periodontology; College of Dentistry; University of Tennessee Health Science Center; Memphis TN USA
| | - Mark Scarbecz
- Department of Periodontology; College of Dentistry; University of Tennessee Health Science Center; Memphis TN USA
| | - Mark R. Patters
- Department of Periodontology; College of Dentistry; University of Tennessee Health Science Center; Memphis TN USA
| | - Sydney H. Stein
- Department of Periodontology; College of Dentistry; University of Tennessee Health Science Center; Memphis TN USA
| | - David A. Tipton
- Department of Periodontology; College of Dentistry; University of Tennessee Health Science Center; Memphis TN USA
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Mendes RT, Sordi R, Olchanheski LR, Machado WM, Stanczyk CP, Assreuy J, Santos FA, Fernandes D. Periodontitis increases vascular cyclooxygenase-2: potential effect on vascular tone. J Periodontal Res 2013; 49:85-92. [DOI: 10.1111/jre.12083] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- R. T. Mendes
- Department of Dentistry; Universidade Estadual de Ponta Grossa; Ponta Grossa PR Brazil
| | - R. Sordi
- Department of Pharmacology; Universidade Federal de Santa Catarina; Florianópolis SC Brazil
| | - L. R. Olchanheski
- Department of Pharmaceutical Sciences; Universidade Estadual de Ponta Grossa; Ponta Grossa PR Brazil
| | - W. M. Machado
- Department of Pharmaceutical Sciences; Universidade Estadual de Ponta Grossa; Ponta Grossa PR Brazil
| | - C. P. Stanczyk
- Department of Dentistry; Universidade Estadual de Ponta Grossa; Ponta Grossa PR Brazil
| | - J. Assreuy
- Department of Pharmacology; Universidade Federal de Santa Catarina; Florianópolis SC Brazil
| | - F. A. Santos
- Department of Dentistry; Universidade Estadual de Ponta Grossa; Ponta Grossa PR Brazil
| | - D. Fernandes
- Department of Pharmaceutical Sciences; Universidade Estadual de Ponta Grossa; Ponta Grossa PR Brazil
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Kats A, Båge T, Georgsson P, Jönsson J, Quezada HC, Gustafsson A, Jansson L, Lindberg C, Näsström K, Yucel-Lindberg T. Inhibition of microsomal prostaglandin E synthase-1 by aminothiazoles decreases prostaglandin E2 synthesis in vitro and ameliorates experimental periodontitis in vivo. FASEB J 2013; 27:2328-41. [PMID: 23447581 PMCID: PMC3659347 DOI: 10.1096/fj.12-214445] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The potent inflammatory mediator prostaglandin E2 (PGE2) is implicated in the pathogenesis of several chronic inflammatory conditions, including periodontitis. The inducible enzyme microsomal prostaglandin E synthase-1 (mPGES-1), catalyzing the terminal step of PGE2 biosynthesis, is an attractive target for selective PGE2 inhibition. To identify mPGES-1 inhibitors, we investigated the effect of aminothiazoles on inflammation-induced PGE2 synthesis in vitro, using human gingival fibroblasts stimulated with the cytokine IL-1β and a cell-free mPGES-1 activity assay, as well as on inflammation-induced bone resorption in vivo, using ligature-induced experimental periodontitis in Sprague-Dawley rats. Aminothiazoles 4-([4-(2-naphthyl)-1,3-thiazol-2-yl]amino)phenol (TH-848) and 4-(3-fluoro-4-methoxyphenyl)-N-(4-phenoxyphenyl)-1,3-thiazol-2-amine (TH-644) reduced IL-1β-induced PGE2 production in fibroblasts (IC50 1.1 and 1.5 μM, respectively) as well as recombinant mPGES-1 activity, without affecting activity or expression of the upstream enzyme cyclooxygenase-2. In ligature-induced experimental periodontitis, alveolar bone loss, assessed by X-ray imaging, was reduced by 46% by local treatment with TH-848, compared to vehicle, without any systemic effects on PGE2, 6-keto PGF1α, LTB4 or cytokine levels. In summary, these results demonstrate that the aminothiazoles represent novel mPGES-1 inhibitors for inhibition of PGE2 production and reduction of bone resorption in experimental periodontitis, and may be used as potential anti-inflammatory drugs for treatment of chronic inflammatory diseases, including periodontitis.
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Affiliation(s)
- Anna Kats
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Daing A, Singh SV, Saimbi CS, Khan MA, Rath SK. Cyclooxygenase 2 gene polymorphisms and chronic periodontitis in a North Indian population: a pilot study. J Periodontal Implant Sci 2012. [PMID: 23185695 PMCID: PMC3498299 DOI: 10.5051/jpis.2012.42.5.151] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Cyclooxygenase (COX) enzyme catalyzes the production of prostaglandins, which are important mediators of tissue destruction in periodontitis. Single nucleotide polymorphisms of COX2 enzyme have been associated with increasing susceptibility to inflammatory diseases. The present study evaluates the association of two single nucleotide polymorphisms in COX2 gene (-1195G>A and 8473C>T) with chronic periodontitis in North Indians. METHODS Both SNPs and their haplotypes were used to explore the associations between COX2 polymorphisms and chronic periodontitis in 56 patients and 60 controls. Genotyping was done by polymerase chain reaction followed by restriction fragment length polymorphism. Chi-square test and logistic regression analysis were performed for association analysis. RESULTS By the individual genotype analysis, mutant genotypes (GA and AA) of COX2 -1195 showed more than a two fold risk (odds ratio [OR]>2) and COX2 8473 (TC and CC) showed a reduced risk for the disease, but the findings were not statistically significant. Haplotype analysis showed that the frequency of the haplotype AT was higher in the case group and a significant association was found for haplotype AT (OR, 1.79; 95% confidence interval, 1.03 to 3.11; P=0.0370) indicating an association between the AT haplotype of COX2 gene SNPs and chronic periodontitis. CONCLUSIONS Individual genotypes of both the SNPs were not associated while haplotype AT was found to be associated with chronic periodontitis in North Indians.
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Affiliation(s)
- Anika Daing
- Department of Periodontics, Faculty of Dental Sciences, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India
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Mesa F, Aguilar M, Galindo-Moreno P, Bravo M, O'Valle F. Cyclooxygenase-2 expression in gingival biopsies from periodontal patients is correlated with connective tissue loss. J Periodontol 2012; 83:1538-45. [PMID: 22324469 DOI: 10.1902/jop.2012.110561] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The objective of this study is to compare cyclooxygenase-2 (COX-2) protein expression in gingival biopsies from patients with chronic periodontitis (CP), patients with gingivitis (GV), and individuals with no periodontal disease (control group) and to establish its relationship with clinical variables and connective tissue loss in the lamina propria. METHODS A cross-sectional and analytic study was conducted in 108 gingival biopsies from 52 patients with CP, 39 with GV, and 17 controls. All biopsies were processed for conventional histopathologic study, immunohistochemical determination of COX-2 protein expression, and automatic quantification of connective tissue by image analysis. RESULTS The protein expression of COX-2, mainly produced by plasma cells and monocytes, was significantly related to the presence of periodontal disease, bleeding index, intensity of inflammatory infiltrate, and loss of connective tissue in the lamina propria of gingival biopsies (P <0.01, Spearman test). COX-2 expression was also directly correlated with attachment loss (P <0.05, Spearman test). CONCLUSIONS COX-2 protein expression is higher in patients with GV and CP than in individuals without periodontal disease and is inversely correlated with the amount of connective tissue in the lamina propria as determined by image analysis. This finding suggests that COX-2 participates in mechanisms and pathway signaling related to the destruction of fibrillar support structures of the periodontium.
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Affiliation(s)
- Francisco Mesa
- Department of Periodontology, School of Dentistry, University of Granada, Granada, Spain.
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Båge T, Kats A, Lopez BS, Morgan G, Nilsson G, Burt I, Korotkova M, Corbett L, Knox AJ, Pino L, Jakobsson PJ, Modéer T, Yucel-Lindberg T. Expression of prostaglandin E synthases in periodontitis immunolocalization and cellular regulation. THE AMERICAN JOURNAL OF PATHOLOGY 2011; 178:1676-88. [PMID: 21435451 PMCID: PMC3078457 DOI: 10.1016/j.ajpath.2010.12.048] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 12/10/2010] [Accepted: 12/22/2010] [Indexed: 12/17/2022]
Abstract
The inflammatory mediator prostaglandin E(2) (PGE(2)) is implicated in the pathogenesis of chronic inflammatory diseases including periodontitis; it is synthesized by cyclooxygenases (COX) and the prostaglandin E synthases mPGES-1, mPGES-2, and cPGES. The distribution of PGES in gingival tissue of patients with periodontitis and the contribution of these enzymes to inflammation-induced PGE(2) synthesis in different cell types was investigated. In gingival biopsies, positive staining for PGES was observed in fibroblasts and endothelial, smooth muscle, epithelial, and immune cells. To further explore the contribution of PGES to inflammation-induced PGE(2) production, in vitro cell culture experiments were performed using fibroblasts and endothelial, smooth muscle, and mast cells. All cell types expressed PGES and COX-2, resulting in basal levels of PGE(2) synthesis. In response to tumor necrosis factor (TNF-α), IL-1β, and cocultured lymphocytes, however, mPGES-1 and COX-2 protein expression increased in fibroblasts and smooth muscle cells, accompanied by increased PGE(2), whereas mPGES-2 and cPGES were unaffected. In endothelial cells, TNF-α increased PGE(2) production only via COX-2 expression, whereas in mast cells the cytokines did not affect PGE(2) enzyme expression or PGE(2) production. Furthermore, PGE(2) production was diminished in gingival fibroblasts derived from mPGES-1 knockout mice, compared with wild-type fibroblasts. These results suggest that fibroblasts and smooth muscle cells are important sources of mPGES-1, which may contribute to increased PGE(2) production in the inflammatory condition periodontitis.
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Affiliation(s)
- Tove Båge
- Division of Pediatric Dentistry, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Kats
- Division of Pediatric Dentistry, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Blanca Silva Lopez
- Division of Pediatric Dentistry, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gareth Morgan
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Nilsson
- Clinical Immunology and Allergy Unit, Karolinska Institutet, Stockholm, Sweden
| | - Idil Burt
- Department of Orthodontics, Eastman Institute, Stockholm, Sweden
| | | | - Lisa Corbett
- Division of Respiratory Medicine, City Hospital, University of Nottingham, Nottingham, United Kingdom
| | - Alan J. Knox
- Division of Respiratory Medicine, City Hospital, University of Nottingham, Nottingham, United Kingdom
| | - Leonardo Pino
- Örebro City Council, Postgraduate Dental Education Center, Örebro, Sweden
| | | | - Thomas Modéer
- Division of Pediatric Dentistry, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tülay Yucel-Lindberg
- Division of Pediatric Dentistry, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Treatment of experimental periodontal disease by a selective inhibitor of cyclooxygenase-2 with scaling and root planing (SRP). Inflammopharmacology 2010; 18:293-301. [DOI: 10.1007/s10787-010-0059-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Accepted: 09/21/2010] [Indexed: 11/28/2022]
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Buduneli N, Buduneli E, Çetin EÖ, Kırılmaz L, Kütükçüler N. Clinical findings and gingival crevicular fluid prostaglandin E2 and interleukin-1-beta levels following initial periodontal treatment and short-term meloxicam administration. Expert Opin Pharmacother 2010; 11:1805-12. [DOI: 10.1517/14656566.2010.490555] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Schaefer A, Richter G, Nothnagel M, Laine M, Noack B, Glas J, Schrezenmeir J, Groessner-Schreiber B, Jepsen S, Loos B, Schreiber S. COX-2 Is Associated with Periodontitis in Europeans. J Dent Res 2010; 89:384-8. [DOI: 10.1177/0022034509359575] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
COX-2 plays an important role in periodontitis by mediating inflammatory reactions in periodontal tissues, and the COX-2 polymorphisms rs20417 and rs689466 have been reported to be associated with periodontitis in populations of Taiwanese and Chinese ethnicity. To test whether these variants were associated with periodontitis in populations of European ethnicity, we genotyped the single-nucleotide polymorphisms (SNPs) rs689466 and rs6681231, the latter a haplotype tagging SNP (htSNP) for rs20417 (r2>0.95), in our large-analysis population of individuals with aggressive (n = 532) and chronic periodontitis (n = 1052), and 2873 healthy control individuals. The rare G allele of htSNP rs6681231 was associated with aggressive periodontitis prior to and after adjustment for the covariates smoking, diabetes, and gender, with an odds ratio of 1.57 (95% confidence interval 1.18–2.08; p = 0.002). The validation of the association of rs20417 by the htSNP rs6681231 provides evidence for a general genetic risk of COX-2 variants in the pathogenesis of periodontitis.
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Affiliation(s)
- A.S. Schaefer
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - G.M. Richter
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - M. Nothnagel
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - M.L. Laine
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - B. Noack
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - J. Glas
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - J. Schrezenmeir
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - B. Groessner-Schreiber
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - S. Jepsen
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - B.G. Loos
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
| | - S. Schreiber
- Christian-Albrechts-University, Institute for Clinical Molecular Biology, Schittenhelmstraße 12, 24105 Kiel, Germany
- Christian-Albrechts-University, Institute of Medical Informatics and Statistics, House 31, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Department of Oral Microbiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
- University Medical Center Carl Gustav Carus der Technischen Universität Dresden, Zentrum für Zahn-, Mund- und Kieferheilkunde, Poliklinik für Zahnerhaltung, Fetscherstraße 74, 01307 Dresden, Germany
- Department of Preventive Dentistry and Periodontology, University of Munich, Goethestraße 70, 80336 Munich, Germany
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Xie CJ, Xiao LM, Fan WH, Xuan DY, Zhang JC. Common single nucleotide polymorphisms in cyclooxygenase-2 and risk of severe chronic periodontitis in a Chinese population. J Clin Periodontol 2009; 36:198-203. [DOI: 10.1111/j.1600-051x.2008.01366.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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