The impact of Resolvin E1 on bone regeneration in critical-sized calvarial defects of rat model-A gene expression and micro-CT analysis

OBJECTIVE

To investigate, in vivo, the effect of local application of Resolvin E1 (RvE1) on the bone regeneration of critical-size defects (CSDs) in Wistar rats utilizing gene expression and micro-computed tomographic (micro-CT) analysis.

BACKGROUND

The inflammation-resolving actions of RvE1 are well established. The molecular mechanism of its bone-regenerative actions has been of significant interest in recent years; however, there is limited information regarding the same.

MATERIALS AND METHODS

Thirty Wistar rats with a 5 mm induced critical-size calvarial defect were randomly allocated into four groups: no treatment/negative control (n = 5), treatment using bovine bone grafts/positive control (n = 5), treatment using local delivery of RvE1 (n = 11) and treatment using RvE1 mixed with bovine bone graft (n = 9). After 4 weeks, RNA isolation, complementary DNA synthesis and real-time polymerase chain reaction were used for genetic expression of alkaline phosphatase (ALP), osteocalcin (OCN) and osteopontin (OPN). The rats were sacrificed after 12 weeks and micro-CT imaging was performed to analyse the characteristics of the newly formed bone (NFB). The data were analysed using ANOVA and the least significant difference tests (α ≤ .05).

RESULTS

The RvE1 + bovine graft group had statistically highest mean NFB (20.75 ± 2.67 mm3 ) compared to other groups (p < .001). Similarly, RvE1 + bovine graft group also demonstrated statistically highest mean genetic expression of ALP (31.71 ± 2.97; p = .008) and OPN (34.78 ± 3.62; p < .001) compared to negative control and RvE1 groups.

CONCLUSION

Resolvin E1 with adjunct bovine bone graft demonstrated an enhanced bone regeneration compared to RvE1 or bovine graft alone in the calvarial defect of Wistar rats.

Self-perceived halitosis and its social impact on females: A cross-sectional study

Halitosis refers to socially unacceptable levels of breath odors. This affects the social life and psychological well-being of individuals. The purpose of this study was to evaluate the prevalence of self-perceived halitosis (SPH) among females and its effect on social life. This was a cross-sectional study. A previously validated questionnaire was distributed electronically through a secure link. The questionnaire consisted of 5 different parts that collected information on sociodemographic, medical history, oral hygiene and other health habits. It also included questions related to participant's knowledge and perception of halitosis and its social impact. All females who were at least 18 years were invited to participate. Data were transferred for analysis using the Statistical Package for Social Sciences program for Windows (IBM SPSS Statistics Version 26, Chicago, IL). Simple descriptive statistics such as frequency distributions and percentages were calculated for the study variables. The relationship between the variables and SPH was also evaluated using the chi-squared test of independence at 95% confidence (P ≤ .05). In total, 1089 subjects completed the questionnaire. The SPH prevalence was 62% among females. The correlation between SPH and sinusitis, gastrointestinal tract disorders, periodontal diseases were significant (P < .05). In addition, subjects with good tooth brushing habits reported no halitosis (91.6%) compared to subjects with poor tooth brushing habits who reported no halitosis (8.9%), and the difference was statistically significant (P < .001). Not using floss and tounge cleaners daily was significantly related to self-reported halitosis (P < .001). Females who reported SPH indicated that they were hesitant to talk to others (68.1%), uncomfortable around others (80.5%), did not like meeting others (44.2%), avoided by others (15%), and that halitosis affected their personal life (31.9%). This association was statistically significant for all variables of social life (P < .001). The prevalence of SPH is high and can have an incapacitating effect on females social lives. The management of halitosis includes active involvement of dental professionals and the incorporation of psychological support.

Relationship between Hormonal Changes and Self-Perceived Halitosis in Females: A Cross-Sectional Study

Halitosis is a growing concern for patients seeking dental treatment. Women experience hormonal changes throughout different phases of their life. These changes may affect volatile organic compound (VOC) production and can be linked to halitosis. The aim of this study was to evaluate the effect of hormonal changes on self-perceived halitosis in a sample of females using a self-administered questionnaire. This study used a cross-sectional observational design. The questionnaire was distributed electronically through Google forms. A total of 1089 participants completed the questionnaire. Almost 50% of participants were below the age of 25; and 12% were of menopausal age (defined as 45 years and older). Most participants reported having regular menstrual cycles (63.5%) while only 20% reported having hormonal disturbances. Almost 62% of the sample reported that they notice halitosis on themselves with 27.6% indicating their perception of halitosis occurred at different times of the month. Around 12% of the sample thought that a relationship between halitosis and their menstrual cycle existed with 4.6% reporting halitosis during menstruation. The present study found that regularity of menstrual cycle and hormonal disturbances can affect females' self-perceived halitosis and the prevalence of oral health symptoms.

Effects of ginger (Zingiber officinale) on gingival fibroblasts: An in vitro study

OBJECTIVES

Ginger, the powdered rhizome of the herb Zingiber officinale, is commonly used as a traditional medicine in many areas around the world. Anti-inflammatory actions of its extract have been previously reported. The aim of this study was to investigate the effect of ginger extract on matrix metalloproteinase (MMP) and interleukin (IL) expression from human gingival fibroblasts (HGFs) in vitro.

MATERIAL AND METHODS

HGFs were obtained from subcultures of biopsies from clinically healthy gingival tissues of 10 patients. Ginger extract was prepared from commercial powder of rhizome of Z. officinale (GZO) and its effect on cell viability was assessed using the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide cytotoxicity assay. Cells were then incubated and treated (except for the control samples) with either GZO, lipopolysaccharides (LPS), and GZO before or after LPS stimulation. Culture supernatants of all five samples were collected for the Milliplex analysis to measure MMP-1, MMP-2, MMP-8, MMP-9, IL-1β, and IL-8. One-way analysis of variance and Duncan multiple range tests were used to compare the mean values of all groups.

RESULTS

The gingerextract showed minimal cytotoxicity to HGFs even with the maximum tested concentration. Compared to the control group, GZO treatment alone caused little or no effect on the levels of expression of MMP-1, MMP-2, MMP-8, MMP-9, IL-1β, and IL-8. While GZO treatment after LPS stimulation significantly reduced the expression of MMP-1, MMP-2, MMP-8, MMP-9, and IL-8 when compared to LPS alone. Comparing the control to LPS stimulation after GZO treatment, significant differences were detected for all tested MMPs and cytokines.

CONCLUSIONS

These findings suggest a potential role for ginger extract in inhibiting MMP and IL HGFs' expression in inflamed gingival tissues.

Postoperative Analgesic and Anti-inflammatory Effectiveness of Ginger (Zingiber officinale) and NSAIDs as Adjuncts to Nonsurgical Periodontal Therapy for the Management of Periodontitis

PURPOSE

The authors hypothesize that ginger (Zingiber officinale) tablets and non-steroidal anti-inflammatory drugs (NSAIDs) are effective in reducing postoperative self-rated pain and periodontal parameters (plaque index [PI], gingival index [GI], and probing depth [PD], clinical attachment loss [AL] and marginal bone loss) following non-surgical periodontal therapy (NSPT) in patients with periodontitis. The aim was to compare the postoperative analgesic and anti-inflammatory effectiveness of ginger tablets and NSAIDs as adjuncts to nonsurgical periodontal therapy for the management of periodontitis. Materials and Methods: Patients with periodontitis were included. All patients underwent NSPT. In groups 1 and 2, patients received postoperative ginger (400 mg) and non-steroidal anti-inflammatory drugs (400 mg), respectively. Demographic data were collected, and full-mouth periodontal parameters (PI, GI, PD and CAL) were evaluated at baseline and at 7, 14 and 21 days. Self-rated pain scores were assessed at baseline, and at 24 h, 3 and 7 days of follow-up. In both groups, self-rated pain was assessed pre- and postoperatively using the numeric rating scale (NRS). Power analysis was performed on data from a pilot investigation and group comparisons were done. Statistical significance was set at p < 0.01.

RESULTS

Baseline mean NRS scores in groups 1 and 2 were 4.19 ± 0.12 and 4.13 ± 0.08, respectively. All participants had stage II/grade B periodontitis. At baseline, self-rated pain scores were significantly higher among patients in groups 1 and 2 at 24 h (p < 0.01) and 3 days (p < 0.01) of follow-up. In groups 1 (p < 0.01) and 2 (p < 0.01), self-rated pain scores were significantly higher at 24 h compared with 3 days of follow-up. In both groups, there was a significant reduction in PI (p < 0.01), GI (p < 0.01) and PD (p < 0.01) at 7, 14 and 21 days of follow-up compared with baseline.

CONCLUSION

Ginger and traditional NSAIDs are effective in reducing postoperative pain and inflammation following NSPT in patients with moderate periodontitis.

Wound Fluid Cytokine Profile Following Bone Regeneration Procedures

Clinical parameters available to evaluate early healing phases of bone regeneration procedures are limited. This study explores wound fluid (WF) content for molecular markers to differentiate wound healing responses in the early postoperative period after bone graft placement. Fifteen patients (50 ± 5 years old; 8 men) scheduled to receive tooth extraction and bone graft placement at maxillary nonmolar single-tooth sites were recruited. Primary wound closure was not intended at time of surgery. Gingival crevicular fluid from adjacent teeth or WF from surgical wound edges were collected (30 seconds) at baseline, at 3, 6, and 9 days, and at 1 and 4 months. Multiplex protein assay was used to determine concentration of various wound healing mediators. Immediately after surgery, 87% of surgical sites exhibited open wound. At day 9, mean wound exposure was 4.8 ± 0.4 mm. At 1 month, all wounds were clinically closed. The WF tripled in volume at day 3 and day 6 (P ≤ .05), compared with baseline gingival crevicular fluid, and gradually decreased as wounds closed. The WF concentrations of interleukin (IL)-6, placental growth factor, plasminogen activator inhibitor 1, insulin-like growth factor binding protein 1, and soluble cluster determinant 40 ligand were increased during early healing days, generally with peak concentration at day 6 (P ≤ .004). Conversely, WF concentrations of IL-18 and epidermal growth factor were decreased after surgery, generally not reaching baseline values until wound closure (P ≤ .008). In general, WF cytokine expression kinetics were concordant with wound closure dynamics (P ≤ .04). These results suggest that WF molecular markers such as IL-6, and to a lesser extent placental growth factor and IL-18, might help differentiate wound healing responses after bone regeneration procedures.

Gingival Perfusion and Tissue Biomarkers During Early Healing of Postextraction Regenerative Procedures: A Prospective Case Series

BACKGROUND

Postextraction alveolar bone loss, mostly affecting the buccal plate, occurs despite regenerative procedures. To better understand possible determinants, this prospective case series assesses gingival blood perfusion and tissue molecular responses in relation to postextraction regenerative outcomes.

METHODS

Adults scheduled to receive bone grafting in maxillary, non-molar, single-tooth extraction sites were recruited. Clinical documentation included the following: 1) probing depth (PD); 2) keratinized tissue width (KT); 3) tissue biotype (TB); and 4) plaque level. Wound closure was clinically evaluated. Gingival blood perfusion was measured by laser Doppler flowmetry (LDF). Wound fluid (WF) and gingival biopsies were analyzed for protein levels and gene expression, respectively, of relevant molecular markers. Bone healing outcomes were determined radiographically (cone-beam computed tomography). Healing was followed for 4 months.

RESULTS

Data from 15 patients are reported. Postoperatively, neither complications nor changes in PD, KT, or TB were observed. LDF revealed decreased perfusion followed by hyperemia that persisted for 1 month (P ≤0.05). WF levels of angiopoietin-2, interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), and vascular endothelial growth factor peaked on day 6 (P ≤0.05) and decreased thereafter. Only IL-8 and TNF-α exhibited increased gene expression. Linear bone changes were negligible. Volumetric bone changes were minimal but statistically significant, with more bone loss when membrane was used (P = 0.05).

CONCLUSIONS

Gingival blood perfusion after postextraction bone regenerative procedures follows an ischemia-reperfusion model. Transient increases in angiogenic factor levels and prolonged hyperemia characterize the soft tissue response. These soft tissue responses do not determine radiographic bone changes.