Salivary and crevicular fluid proinflammatory cytokines and advanced glycation end products in patients with different glycemic levels undergoing fixed orthodontic treatment

OBJECTIVE

To examine whether patients with different blood glycemic levels undergoing fixed orthodontic therapy demonstrate changes in the biochemical profiles of crevicular fluid and salivary advanced glycation end products (AGEs) and proinflammatory cytokine levels in comparison with nondiabetic healthy subjects.

MATERIALS AND METHODS

Prediabetic subjects, subjects with type 2 diabetes mellitus (T2DM), and subjects without a diabetes mellitus diagnosis undergoing fixed orthodontic therapy with MBT prescription brackets (0.022-inch brackets and 0.019 × 0.025-inch stainless steel archwires) were included in the study. The following clinical periodontal parameters were evaluated: (1) plaque score (PS), (2) probing depth (PD), (3) bleeding on probing (BOP), and (4) clinical attachment loss. Crevicular fluid and saliva specimens were collected during regular orthodontic visits. Salivary and crevicular fluid tumor necrosis factor alpha, interleukin-6, ghrelin, resistin, AGEs, and receptor activator of nuclear factor κΒ ligand were evaluated using a human magnetic Luminex multiplex assay.

RESULTS

BOP scores were significantly higher among T2DM subjects (19.2%) than among nondiabetic subjects (11.2%) and prediabetic subjects (15.9%). Comparable values were demonstrated by all three study groups regarding PD scores and PSs. T2DM subjects demonstrated higher scores for gingival crevicular fluid (GCF) chemokines than nondiabetic and prediabetic subjects. A statistically significant difference was found in the levels of AGEs and resistin among the three study groups. The scores revealed for the levels of GCF resistin and AGEs versus periodontal BOP demonstrated a significant positive association by the Pearson correlation test.

CONCLUSIONS

T2DM patients demonstrated significantly higher levels of GCF resistin and AGEs during fixed orthodontic therapy. Chronic hyperglycemic patients undergoing orthodontic therapy demonstrated a proinflammatory response.

Interleukin-1β activity in gingival crevicular fluid of abutment teeth with temporary fixed restorations versus final fixed restorations: Prospective observational study

Objective

To compare the effect of temporary fixed restorations to final fixed restorations on gingival health of abutment tooth by evaluating the level of IL-1β in gingival crevicular fluid (GCF) as an inflammatory biomarker.

Subjects and methods

It was a nonrandomized prospective observational study. Samples of GCF were collected from 24 participants with provisional and permanent definitive full-coverage restorations with subgingival margin placements at three intervals for each participant: Interval 1, after preparation and immediately before cementation of temporary fixed restoration. Interval 2, after two weeks of temporization and before receiving the final fixed restoration. Interval 3, after two weeks of final fixed restorations. GCF were collected from gingival crevice of the abutment tooth by pre-prepared filter paper with dimensions of 2mmx13mm. They were prepared for IL-1β concentration assay by enzyme-linked immuno sorbent assay – analysis (ELIZA).

Results

Were analyzed by SAS® software, Descriptive means and medians were used and the repeated ANVOA test was applied (1st interval) showed the highest level of IL-β (13.587 ± 5.735). In 2nd interval the level of IL-β was significantly reduced (9.602 ± 3.279). While, in 3rd interval the level of IL-β was the lowest (6.293 ± 3.279).

Conclusion

The material and technique of fabrication of both temporary and final fixed restorations are critical for gingival health. PMMA CAD-CAM based temporary restorations showed to be compatible to gingival health by decreasing the level of IL-β level, but the zirconia as a final fixed restoration showed to have optimum compatible effect on gingival health.

Influence of occlusal loading on peri-implant inflammatory cytokines in crevicular fluid: a prospective longitudinal study

Objective

The objective of the study was to evaluate the relation between occlusal loading and peri-implant crevicular fluid cytokine expression in patients with implant-supported complete fixed prostheses in both arches.

Material and methods

A prospective longitudinal clinical study was performed at a university clinic. Fifteen patients were selected and 11 were included. All patients had bimaxillary implant-supported complete fixed ceramo-metallic prostheses loaded at least 12 months before the beginning of the study. Allocation was established for each patient using a computerized occlusal analysis system. The test implant was the maxillary implant closest to the point of highest occlusal loading. The maxillary implant with least loading was the control implant. Occlusal adjustment was performed using a round diamond burr. This occlusal distribution was verified with the occlusal analysis system. Expression of cytokines from peri-implant crevicular fluid (TNF-α, IL-10, IL-6, IL-1β, IL-8) were recorded and analyzed in both test and control implants before (baseline: T0) and 2 (T1) and 12 months (T2) after occlusal adjustment. The Brunner-Langer non-parametric test was performed.

Results

At T0, the expression of IL-10 was significantly higher in the test group implants (p = 0.018). Between T0 and T1, the expression of all the cytokines decreased in the implants of both groups with statistically significant differences, except for TNF (p = 0.271). When comparing both groups at T1, there was no statistically significant difference in any of the analyzed cytokines. At T2, TNF-α suffered when compared with baseline, a statistical decrease in both study and control implants (p < 0,001). At T2, there were no statistically significant differences between groups in any of the cytokines analyzed.

Conclusions

Implants with higher occlusal load presented higher expression of IL-10 in peri-implant crevicular fluid. Occlusal adjustment produced a decrease in the expression of all the analyzed cytokines, both in test and control implants.

Gingival crevicular fluid response to protocols of non-surgical periodontal therapy: A longitudinal evaluation

Context and Aim

Gingival crevicular fluid (GCF) volume reflects the level of periodontal inflammation. This secondary analysis aimed to evaluate the GCF volume in patients submitted to non-surgical periodontal therapies under a split-mouth design.

Materials and Methods

GCF volume of 25 participants (47.24 ± 6.47 years) with moderate-to-severe chronic periodontitis was collected at Days 0, 30, 60, 90, 120, 270, and 450. The participants were submitted to three different non-surgical therapies randomly assigned per quadrant [GI: supragingival control (Supra) as only intervention (one quadrant); GII: Supra plus scaling and root planing (SRP) on Day 0 (two quadrants); GIII: Supra on Day 0 and SRP 30 days later (one quadrant)]. During treatment (0-60 days) and maintenance (90-450 days) participants were submitted to supragingival plaque control reinforcements. GCF volumes were analyzed after logarithmic transformation (log₁₀) and linear models were used for intra- and inter-group comparisons, considering the data dependence.

Results

Baseline GCF volumes were similar between groups (GI: 0.39 ± 0.22 μl; GII: 0.42 ± 0.26 μl; GIII: 0.41 ± 0.14 μl;P > 0.05). At Day 60, GCF volumes were significantly reduced (GI: 0.20 ± 0.13 μl; GII: 0.18 ± 0.11 μl; GIII: 0.22 ± 0.13 μl; P < 0.001), without inter-groups differences. These results were maintained along maintenance period (P > 0.05). Even in sites bleeding on probing (BOP) + the means of GCF volume did not differ between groups (P > 0.05).

Conclusions

All therapies determined reductions on the GCF volume along time. Supragingival plaque control modulated the subgingival area during the study, reinforcing the importance of this control over the subgingival inflammatory response.

Gelatinolytic activity in gingival crevicular fluid and saliva of growing patients with Marfan syndrome: a case-control study

Background

Aim of the study was to evaluate the gelatinolytic activity in the saliva and gingival crevicular fluid from a sample group of subjects with Marfan syndrome.

Methods

Two groups were analyzed in this case-control study. A group of 28 subjects with Marfan syndrome (MG) was recruited from the Centre for Rare Disease, Marfan Clinic of Tor Vergata University Hospital. The second sample, 23 subjects, with the same characteristics and without any syndrome, was the control group (CG). Saliva and gingival crevicular fluid were collected and transferred to a sterile test tube and stored frozen at − 20 °C until analysis at the Medical Chemistry Laboratory. Gelatin substrate zymography was used for the evaluation and characterization of saliva and crevicular fluid proteinases. Correlation test and Student’s t-test have been used to analyze data.

Results

In all samples different gelatin-degrading activities were observed. Two bands, which are related to the molecular weights of pro-MMP-9 and active MMP-9, respectively, were detectable in 100% of Marfan and control samples. MMP-2 activity was higher in Marfan group. Additional bands (55/48 kDa), corresponding to the activated forms of collagenase (MMP-13), were observed in saliva samples of both groups.

Conclusions

The association of an enhanced activity by MMP-13 with an increased amount of active MMP-9 might be an important biomarker for the diagnosis of Marfan syndrome.

The use of crevicular fluid to assess markers of inflammation and angiogenesis, IL-17 and VEGF, in patients with solid tumors receiving zoledronic acid and/or bevacizumab

PURPOSE

Crevicular fluid was used to assess interleukin-17 (IL-17) and vascular endothelial growth factor (VEGF) in cancer patients receiving zoledronic acid and/or bevacizumab. The markers were also assessed in the serum.

METHODS

Twenty-five patients were included and comprised three groups: patients who received zoledronic acid (n = 9), patients who received bevacizumab (n = 9), and patients who received zoledronic acid combined with bevacizumab (n = 5). One patient received zoledronic acid and everolimus and another received zoledronic acid, bevacizumab, and temsirolimus. IL-17 and VEGF were measured by standard quantitative ELISA kits and assessed in two study points.

RESULTS

Twenty-four patients maintained good periodontal health; one had asymptomatic osteonecrosis of the jaw. First assessment: 44 samples were collected; 21 from serum and 23 from crevicular fluid. Second assessment, 6 months later: 11 samples were collected; 6 from serum and 5 from crevicular fluid. IL-17 was detected in all samples, in serum and crevicular fluid, and remained unchanged at both time points. Serum VEGF in patients with bevacizumab alone or combined with zoledronic acid was significantly lower compared with that of patients who received zoledronic acid alone. VEGF was not detected in the crevicular fluid.

CONCLUSIONS

Crevicular fluid might be an easy, non-invasive means to assess IL-17. The stable values of IL-17 in crevicular fluid and serum and the lack of VEGF in the crevicular fluid could be related to the good periodontal health of our patients. Further studies are needed to assess IL-17 and VEGF in the crevicular fluid in patients with and without periodontal disease.