Research progress on metabonomic studies in periodontitis / 口腔疾病防治

@#Metabolomics reflects the endogenous metabolite changes in organisms through qualitative and quantitative detection of small molecules in biological samples, revealing the metabolic changes during disease development. Metabolomic studies of periodontitis further elucidate the etiology, diagnosis and predictive markers of periodontitis at the levels of metabolites and metabolic pathways. In this paper, the concept and research methods of metabonomics were summarized, and the current status of the metabonomics of saliva and gingival crevicular fluid in the study of periodontitis was reviewed. Previous studies have shown that metabolites such as short-chain fatty acids and amino acids and metabolic pathways such as glutamic acid and pyrimidine metabolism might promote the occurrence of periodontitis, and it was suggested that lactic acid, γ-amino-butyrate, butyric acid and lysophosphatidic acid might be potential diagnostic markers of periodontitis. The metabolomics study of periodontitis still faces challenges such as high heterogeneity of results and fluctuation of metabolites. In the future, its study could be optimized through multicenter prospective studies to provide fresh approaches for the etiology and diagnosis of periodontitis.

Evaluation of Serum and Gingival Crevicular Fluid Levels of Vitamin D Binding Protein in Subjects with Clinically Healthy Periodontium and Chronic Periodontitis: A Clinico Bio-Chemical Study

Background: Advances in oral and periodontal disease diagnostic research are moving towards methods wherein periodontal risk can be identified and quantified by objective measures such as bio?markers. Given the roles of vitamin D binding protein (DBP) in modulating the immune response and in the transport of vitamin D, it is hypothesised that quantitative changes of vitamin DBP are associated with periodontal disease. Aim: The aim of the current study is to measure DBP levels in serum and gingival crevicular fluid (GCF) of patients with generalised chronic periodontitis, in comparison to healthy controls. Materials and Methods: The present cross?sectional clinico?bio?chemical study includes 30 systemically healthy subjects with 15 periodontally healthy and 15 chronic periodontitis subjects who were recruited from the out?patient Department of Periodontics. GCF and blood samples were collected from all the patients. DBP estimation was performed in both the samples using a commercially available ELISA kit. Results: Serum and GCF DBP levels in chronic periodontitis subjects were significantly higher when compared to the periodontally healthy group. There were no significant correlations found among serum and GCF DBP levels with gender and increasing age in both the groups. An increase in disease severity measured by the increase in probing pocket depth and clinical attachment loss did not show correlation with the GCF and serum DBP levels in the chronic periodontitis group. Conclusion: Based on the findings of the present study, increased serum and GCF DBP levels in chronic periodontitis seem to be a probable marker for identifying ongoing periodontal destruction.

Quantification of sphingosine-1-phosphate (S1P) in patients with periodontitis stage II grade B / Cuantificación de esfingosina 1 fosfato en pacientes con periodontitis estadío II grado B

Abstract The aim of this study was the quantification of Sphingosine-1-phosphate (S1P) in periodontal pockets of patients with periodontitis. This is an observational, descriptive, case-control study. Thirty subjects were selected: 15 controls and 15 cases. A periodontal study was conducted following the parameters of AAP 2017 for the diagnosis of periodontal diseases. A sample of saliva and gingival crevicular fluid was obtained from each subject and then analyzed with the Human S1P Elisa kit (MyBioSource #MBS2516132) accordingly to the manufacturer's instructions, in order to verify the presence of S1P and quantify it´s concentration when founded. Results showed a significant difference (p=0.05) between cases and controls. In the case of saliva samples, the concentration of S1P was higher than the ones found in the control group (72.94 ng/mL and 45.12 ng/mL). For GCF, a higher amount of S1P was found in patients with POD (20.09 ng/mL and 15.20 ng/mL). This work raises a possible route of bone metabolism, inflammatory process, and identification of periodontitis through oral quantification of S1P, however, future studies are needed.

Resumen El propósito de este estudio fue la cuantificación de Esfingosina-1-Fosfato (S1P) en las bolsas periodontales de pacientes con periodontitis. Estudio observacional, descriptivo de casos y controles. 30 sujetos fueron seleccionados de los cuales 15 controles y 15 casos. Se realizó un estudio periodontal completo siguiendo los parámetros establecidos por la AAP en 2017 para el diagnóstico de las enfermedades periodontales. Se tomaron muestras de saliva y de líquido crevicular gingival de cada sujeto estudiado y se analizaron con el ELISA kit humano para S1P (MyBiosource #MBS2516132) y de acuerdo con las instrucciones del fabricante, se realizó para cuantificar la presencia d S1P en las muestras estudiadas. Los resultados mostraron diferencia significativa (p=0.05) entre casos y controles. En el caso de las muestras de saliva, la concentración de S1P en controles fue mayor (72.94 ng/mL y 45.12 ng/mL). Para Líquido crevicular gingival, se encontró mayor cantidad de S1P en los pacientes con periodontitis (20.09 ng/mL y 15.20 ng/mL). Este estudio plantea una posible ruta de metabolismo óseo, proceso inflamatorio e identificación de la Periodontitis a través de la cuantificación oral de S1P, sin embargo se necesitan estudios futuros.

Levels of DKK-1, MIP-1α and IL-17 in gingival crevicular fluid and serum of patients with chronic periodontitis and their clinical significance / 中国医师杂志

Objective:To investigate the level of gingival crevicular fluid and serum gingival sulcus fluid Dickkopf-1 (DKK-1), macrophage inflammatory protein-1α (MIP-1α) and interleukin (IL)-17 in patients with chronic periodontitis and their clinical significance.Methods:80 patients with chronic periodontitis (observation group) and 40 healthy periodontal subjects (control group) were prospectively selected. The gingival index (GI), bleeding index (BI), probe depth (PD), loss of attachment (AL) levels were compared between the two groups. The IL-6, IL-8, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), DKK1, MIP-1α and IL-17 levels in the gingival sulcus fluid and serum of the two groups were compared, and the correlation of DKK-1, MIP-1α and IL-17 levels with periodontal indexes and inflammatory factors in the observation group were analyzed. The DKK-1, MIP-1α and IL-17 levels in the gingival crevicular fluid and serum before and after treatment were compared among the patients with different disease degrees.Results:The levels of GI, BI, PD and AL in the observation group [(2.11±0.36)points, (3.76±0.65)points, (4.56±0.78)mm, (4.06±0.49)mm, respectively] were higher than those of the control group [(0.53±0.08)points, (1.61±0.33)points, (2.13±0.29)mm, 0 mm, respectively] (all P<0.05). The levels of IL-6, IL-8, TNF-α, DKK-1, MIP-1α and IL-17 in gingival crevicular fluid of the observation group [(65.23±9.30)ng/L, (310.19±42.95)ng/L, (40.46±9.70)ng/L, (13.70±3.62)μg/L, (19.67±8.14)μg/L, (315.84±53.76)pg/μl] were higher than those of the control group [(36.81±5.61)ng/L, (178.21±25.73)ng/L, (26.43±5.76)ng/L, (7.41±2.02)μg/L, (6.23±1.99)μg/L, (266.64±46.27)pg/μl, respectively] (all P<0.05). The serum levels of IL-8, TNF-α, DKK-1, MIP-1α and IL-17 in the observation group were also higher than those in the control group (all P<0.05). In the observation group, the levels of DKK-1, MIP-1α and IL-17 in gingival crevicular fluid and serum were positively correlated with eriodontal indexes (GI, BI, PD, AL) and the IL-8 and TNF-α levels (all P<0.05). In the observation group, the levels of DKK-1, MIP-1α and IL-17 in gingival crevicular fluid and serum of mild patients were lower than those of moderate to severe patients, and the levels of DKK-1, MIP-1α and IL-17 in mild and moderate to severe patients after treatment were also lower than those before treatment, with statistically significant difference (all P<0.05). Conclusions:The levels of DKK-1, MIP-1α and IL-17 in gingival crevicular fluid and serum of patients with chronic periodontitis are increased, which are closely related to the occurrence and development of chronic periodontitis. Detection of these indicators has certain significance for the diagnosis and treatment of the disease.

Comparison of the effects of different orthodontic techniques on the levels of inflammatory factors in gingival crevicular fluid of orthodontic adolescents / 中国基层医药

Objective:To investigate the effects of bracket-free invisible orthodontic technique versus traditional fixed orthodontic technique on the levels of inflammatory factors in the gingival crevicular fluid of orthodontic adolescents. Methods:A total of 67 orthodontic patients who received their first orthodontic treatment in Huzhou Central Hospital from June to September 2020 were included in this study. They were randomly divided into an observation group ( n = 34) and a control group ( n = 33). The control group was treated with traditional fixed orthodontic treatment. The observation group was treated with invisible orthodontic treatment without brackets. At 0, 1, 2, 4, and 6 months of treatment, the level of inflammatory factors and periodontal index were compared. Results:At 0 and 1 month of treatment, there were no significant differences in the levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the gingival crevicular fluid between the observation and control groups (all P > 0.05). At 2, 4, and 6 months of treatment, the levels of IL-1β, IL-6, and TNF-α in the observation group were significantly lower than those in the control group (IL-1β: t2 months = 5.56, P = 0.042; t4 months = 8.14, P = 0.019; t6 months = 9.87, P = 0.002. IL-6: t2 months = 7.15, P = 0.029; t4 months = 7.94, P = 0.021; t6 months = 9.16, P = 0.007. TNF-α: t2 months = 6.87, P = 0.039; t4 months = 7.65, P = 0.026: t6 months = 9.89, P = 0.001). In each group, gingival index (GI), sulcus bleeding index (SBI), probing depth (PD), and plaque index (PLI) increased significantly after treatment. At 0 and 1 month of treatment, there were no significant differences in GI, SBI, PD, and PLI between the two groups (all P > 0.05). At 2, 4, and 6 months of treatment, GI, SBI, PD, and PLI in the observation group were significantly lower than those in the control group (GI: t2 months = 3.62, P = 0.073; t4 months = 8.16, P = 0.018; t6 months = 8.54, P = 0.016. SBI: t2 months = 5.65, P = 0.042; t4 months = 7.56, P = 0.027; t6 months = 8.15, P = 0.019. PD: t2 months = 5.652, P = 0.042; t4 months = 7.56, P = 0.027, t6 months = 8.15, P = 0.019. PLI: t2 months = 9.57, P = 0.006; t4 months = 9.98, P = 0.002. t6 months = 9.94, P = 0.010). In addition, at 1 month of treatment, PLI in the observation group was significantly lower than that in the control group ( t = 9.99, P = 0.001). Conclusion:Bracket-free invisible orthodontic treatment provides better protection on periodontal tissue and has less impact on periodontal health than traditional fixed orthodontic treatment.

Effects of McLaughlin Bennett Treriri straight wire technique on the content of periostin in gingival crevicular fluid of the maxillary first molar / 中国基层医药

Objective:To investigate the effects of McLaughlin Bennett Treriri (MBT) straight wire technique on the content of periostin in gingival crevicular fluid of the maxillary first molar.Methods:Ninety patients with malocclusion who were treated with MBT straight wire technique in Jiaxing Hospital of Traditional Chinese Medicine from February to September 2021 were included in this study. The patients were divided into group A (13-18 years old) and group B (30-35 years old) according to age, with 45 patients in each group. According to the random number table method, patients in group A were divided into 100 g subgroup (group A1, n = 22) and 150 g subgroup (group A2, n = 23), and patients in group B were divided into 100 g subgroup (group B1, n = 22) and 150 g sub group (group B2, n = 23). Effects of age on the content of periostin in gingival crevicular fluid and bite force were observed. The antagonistic effect of periostin in gingival crevicular fluid during the application of different corrective forces was evaluated based on the changes in bite force, bone mineral density and height of the jaw after the application of force. The incidence of complications was calculated. Results:The level of periostin and bite force in group A were (1 249.38 ± 89.29) pmol/L and (1 038.37 ± 79.54) N, respectively, which were significantly higher than (831.54 ± 76.38) pmol /L and (921.45 ± 81.36) N in group B ( t = 23.86, 6.89, both P < 0.05). After 1 and 3 months of treatment, the amplitude of improvement in bite force, jaw bone density, and jaw height in group A2 were greater than those in group A2 ( t = 2.92, 6.39, 0.64, 1.30, 1.07, 2.48, all P < 0.05). After 7 and 14 days of treatment, the level of periostin was increased in both group B1 and B2 and its level in group B2 was significantly higher than that in group B1 ( t = 0.59, 1.89, both P < 0.05). After 1 month of treatment, there were no significant differences in bite force, jaw bone density and jaw height between groups B1 and B2 (all P > 0.05). After 3 months of treatment, the amplitude of improvement in bite force, jaw bone density and jaw height were greater in group B2 than those in group B1 ( t = 0.27, 4.02, 3.07, 1.52, 0.06, 1.57, P < 0.05). There were 3 patients with loose teeth, 2 patients with pulp reaction, 1 patient with mucosal ulcer, and 2 patients with secondary dental caries during treatment. The incidence of complications was 8.89%. Conclusion:MBT straight wire technique is effective and safe in the treatment of patients with dental deformities. The level of periostin in gingival crevicular fluid of the maxillary first molar and bite force decrease with age. The corrective force can increase and activate the expression of periostin, thereby promoting periodontal wound healing and regeneration, and increasing patients' bite force, jaw bone density and height.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) in subjects with different stages of periodontitis according to the new classification

Abstract Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a multifunctional cytokine that regulates inflammatory responses in various autoimmune and inflammatory disorders. Objective: The purpose of this study was to analyze the gingival crevicular fluid (GCF) for GM-CSF, interleukin-1 beta (IL-1β), and macrophage inflammatory protein-1 alpha (MIP-1α) levels in patients with stage I, stage II, stage III, and stage IV periodontitis (SI-P, SII-P, SIII-P, and SIV-P). Methodology: A total of 126 individuals were recruited for this study, including 21 periodontal healthy (PH), 21 gingivitis (G), 21 SI-P, 21 SII-P, 21 SIII-P, and 21 SIV-P patients. Plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), probing depth (PD), and attachment loss (AL) were used during the clinical periodontal assessment. GCF samples were obtained and analyzed by an enzyme-linked immunosorbent assay (ELISA). Results: GCF GM-CSF, MIP-1α, and IL-1β were significantly higher in SII-P and SIII-P groups than in PH, G, and SI-P groups (p<0.05). There was no significant difference among the PH, G, and SI-P groups in IL-1β, GM-CSF, and MIP-1α levels (p>0.05). Conclusions: These results show that GM-CSF expression was increased in SII-P, SIII-P, and SIV-P. Furthermore, GM-CSF levels may have some potential to discriminate between early and advanced stages of periodontitis.

The Effect of Periodontal and Peri-Implanter Health on IL-1 and TNF- Levels in Gingival Crevicular and Peri-Implanter Sulcus Fluid: a Cross-Sectional Study / El efecto de la salud periodontal y peri-implantar en niveles de IL-1ß y TNF-α en el fluido crevicular y sulcus peri-implantador: un estudio transversal

Abstract: It is stated that peri-implanter diseases have destructive effects similar to periodontal diseases. This study aims to compare IL-1β and TNF-α levels in healthy and diseased areas. Forty non-smokers systemically health individuals (40 implants/40 teeth) (age:38-67) were included in the study. In clinical and radiographic examinations; plaque index (PIn), gingival index (GI), periodontal pocket depth (PPD), clinical attachment level (CAL) and marginal bone loss (MBL) values were recorded. The gingival crevicular fluid (GCF) and peri-implanter sulcus fluids (PISF) of the patients were collected, and IL-1β and TNF-α levels were measured by ELISA in the samples. The collected data were analyzed with the help of SPSS v.22 package program. Sample PPD score showed a statistically significant difference between the diseased and healthy groups and also sample CAL showed statistically significant higher in Periodontitis(P) compared to periodontally heathy(H) and Gingivitis(G) (p>0.05). IL-1beta and TNF-α levels in GCF/PISF; In the P and Peri-implantitis (PI) group, it was found statistically significantly higher than the H, Healthy-Implant (HI), besides P showed higher levels compared to G (p<0.05). Within the limitations of our study, it can be said that IL-1β and TNF-α among inflammatory cytokines in GCF/PISF will increase in periodontal and peri-implanter diseases, it can also be said that this increase in cytokines may indicate that periodontal and peri-implanter diseases have similar immunological structure. Peri-implant mucositis without periodontitis history has similarity to peri-implantitis and periodontitis in terms of IL-1β and TNF-α levels in GCF/PISF.

Resumen: Se afirma que las enfermedades peri-implantarias tienen efectos destructivos similares a los de las enfermedades periodontales. Este estudio tiene como objetivo comparar los niveles de IL-1β y TNF-α en zonas sanas y enfermas. Cuarenta individuos no fumadores con salud sistémica (40 implantes/40 dientes) (edad:38-67) fueron incluidos en el estudio. En los exámenes clínicos y radiográficos se registraron los valores de índice de placa (PIn), índice gingival (GI), profundidad de la bolsa periodontal (PPD), nivel de fijación clínica (CAL) y pérdida de hueso marginal (MBL). Se recogieron los fluidos creviculares gingivales (GCF) y los fluidos del surco peri-implantario (PISF) de los pacientes, y se midieron los niveles de IL-1β y TNF-α mediante ELISA en las muestras. Los datos recogidos fueron analizados con la ayuda del programa de paquete SPSS v.22. La puntuación PPD de la muestra mostró una diferencia estadísticamente significativa entre los grupos enfermos y sanos y también la muestra CAL mostró estadísticamente significativa más alta en la Periodontitis (P) en comparación con la salud periodontal (H) y la Gingivitis (G) (p>0.05). Los niveles de IL-1beta y TNF-α en GCF/PISF. En el grupo de P y Peri-implantitis (PI), se encontró estadísticamente significativo más alto que el H, implante sano (HI), además P mostró niveles más altos en comparación con G (p<0.05). Dentro de las limitaciones de nuestro estudio, se puede decir que IL-1β y TNF-α entre las citoquinas inflamatorias en GCF/PISF aumentarán en las enfermedades periodontales y peri-implantarias. También se puede decir que este aumento de citoquinas puede indicar que las enfermedades periodontales y peri-implantarias tienen una estructura inmunológica similar. La mucositis peri-implantaria sin antecedentes de periodontitis tiene similitudes con la peri-implantitis y la periodontitis en cuanto a los niveles de IL-1β y TNF-α en la GCF/PISF.

Desfechos periodontais e qualidade de vida relacionada à saúde bucal em indivíduos de transplante de células tronco hematopoiéticas, fígado e rim: um estudo transversal comparativo / Periodontal outcomes and quality of life related to oral health in hematopoietic stem, liver and kidney transplant individuals: a comparative cross-sectional study

Esse estudo observacional transversal comparativo teve como objetivos avaliar os parâmetros clínicos periodontais, índice gengival modificado (IGM), índice de placa visível (IPV), crescimento gengival induzido por drogas (CGID), mensurar volume e fluxo do fluido crevicular gengival (FCG), perda dentária bem como o impacto da saúde bucal auto-relatada na qualidade de vida, em pacientes pré e pós-transplante de células tronco hematopoiéticas (TCTH), fígado (TX-fígado), rim (Tx-rim), comparados a indivíduos sem doença sistêmica diagnosticada. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais (UFMG) (CAAE-18019619.1.0000.5149). A amostra foi recrutada dentre usuários da Faculdade de Odontologia da UFMG, de março a dezembro de 2019. Foram registrados: IGM, IPV, profundidade à sondagem (PS), sangramento à sondagem (SS), nível de inserção clínico (NIC), recessão gengival (RG), CGID, fluxo e volume do FCG e número de dentes presentes. O instrumento Oral Health Impact Profile (OHIP-14) foi aplicado para avaliar a Qualidade de Vida Relacionada à Saúde Bucal (QVRSB). O grupo controle incluiu pacientes sem doença sistêmica diagnosticada, pareados por sexo e idade. Os dados foram analisados pelo programa SPSS versão 25. Análises descritivas e comparativas foram realizadas usando os testes de Wilcoxon, Mann Whitney e Kruskal-Wallis seguido de Dunn-Bonferroni. Modelos de regressão logística binária condicional estimaram a Odds-Ratio, considerando como desfechos presença de periodontite e prevalência de alto impacto na QVRSB. Em todos os testes, o nível de significância de 5% foi adotado. As frequências de periodontite foram maiores em indivíduos em condição de transplante que no grupo controle, na fase pré-transplante e nos pacientes Tx-fígado. O diagnóstico mais frequentemente encontrado foi a periodontite estágio I localizada. As medianas de IPV, PS, NIC, volume e fluxo do FCG foram maiores em pacientes de transplante comparados aos controles (p<0,05). Comparados aos respectivos controles, os grupos Tx-fígado e Tx-rim apresentaram medianas de IPV e PS significativamente maiores. O número de dentes presentes foi menor no grupo Tx fígado que no Tx rim (p=0,027). No modelo ajustado final, nenhuma variável mostrou associação com a presença de periodontite (p>0,05). Pacientes de transplante tiveram pior percepção do impacto na QVRSB que os indivíduos controle (p=0,015). Os grupos TCTH (p=0,008) e Tx-fígado (p=0,033) foram mais impactados que seus controles. Na regressão logística, a variável transplante não afetou a frequência de alto impacto na QVRSB. No modelo final ajustado, a escolaridade e o número de dentes presentes permaneceram como fatores preditores do impacto da saúde bucal na qualidade de vida auto-relatada. Indivíduos com menor escolaridade (OR = 3,590; 1,021-12,622) e com menor número de dentes (OR = 4,991; IC95% 1,386-17,970) tiveram maior impacto na QVRSB. Concluiu-se, que as frequências de periodontite foram maiores em indivíduos em condição de transplante, na fase pré e em pacientes Tx-fígado. A periodontite estágio I localizada foi o diagnóstico mais frequente. A condição de transplante não afetou a presença de periodontite. O número de dentes presentes e a escolaridade tiveram impacto na QVRSB dos indivíduos em condição transplante, e estes demonstram uma pior percepção que os controles.

This cross-sectional observational study aimed to assess periodontal clinical parameters, modified gingival index (MGI), visible plaque index (VPI), drug-induced gingival overgrowth (DIGO), measuring gingival crevicular fluid (GCF) volume and flow , tooth loss as well as the impact of self-reported oral health on quality of life, in patients before and after hematopoietic stem cell (HSCT), liver (Tx-liver), kidney (Tx-kidney) transplantation compared to individuals without diagnosed systemic disease. The study was approved by the Research Ethics Committee of the Federal University of Minas Gerais (UFMG) (CAAE-18019619.1.0000.5149). The sample was recruited from users of the Faculty of Dentistry at UFMG, from March to December 2019. The outcomes MGI, VPI, probing depth (PD), bleeding on probing (BoP), clinical attachment level (CAL), gingival recession (GR), DIGO, flow and volume of GCF and number of teeth present were recorded. The Oral Health Impact Profile instrument (OHIP-14) was applied to assess the Oral Health Related Quality of Life (HRQoL). The control group included patients without diagnosed systemic disease, matched for sex and age. The data were analyzed using the SPSS software version 25. Descriptive and comparative analyzes were performed using the Wilcoxon, Mann-Whitney and KruskalWallis followed by Dunn-Bonferroni tests. To estimate the Odds-Ratio, conditional binary logistic regression models were used, considering as outcomes presence of periodontites and prevalence of hight impact on OHRQoL. In all tests, the significance level of 5% was adopted. The frequency of periodontitis was higher in individuals undergoing transplantation than in the control group, in the pre-transplant phase and in Tx-liver patients. The most frequently found diagnosis was localized stage I periodontitis. The medians of VPI, PD, CAL, GCF volume and flow were higher in transplant patients compared to controls (p <0.05). The Tx-liver and Tx-kidney groups had significantly higher VPI and PD medians than their respectives controls. Comparing the transplant groups, the number of teeth present was lower in Tx-liver than in Tx-kidney (p = 0.027). In the final adjusted model, no variable was associated with the presence of periodontitis (p> 0.05). Transplant patients had a worse perception of the impact on OHRQoL than control subjects (p = 0.015). The groups HSCT (p = 0.008) and Tx-liver (p = 0.033) were more impacted than their controls. In logistic regression, the transplant variable did not affect the frequency of high impact on OHRQoL. In the final adjusted model, schooling and the number of teeth present remained as predictors of the impact of oral health on self-reported quality of life. Individuals with less education (OR = 3.590; 1.021-12.622) and with fewer teeth (OR = 4.991; 95% CI 1.386-17.970) had a greater impact on HRQoL. It was concluded that the frequencies of periodontitis were higher in individuals in a transplant condition, in the pre-transplantation phase and in Tx-liver patients. Localized stage I periodontitis was the most frequent diagnosis. The transplant condition did not affect the presence of periodontitis. The number of teeth present and education had an impact on the HRQoL of transplantation individuals, and these demonstrate a worse perception than the controls.

Changes and clinical significance of four biomarkers in gingival crevicular fluid after nonsurgical periodontal therapy / 口腔疾病防治

Objective@# To study the changes in levels of interleukin (IL)-6, IL-10, tumor necrosis factor-alpha (TNF-α), and alkaline phosphatase (ALP) in the gingival crevicular fluid (GCF) of patients with severe chronic periodontitis before and after nonsurgical periodontal therapy and to explore the relationship among the levels of these four biomarkers in GCF, their periodontal status and their clinical significance to evaluate the effect of nonsurgical periodontal therapy and periodontitis activity.@*Methods@# In total, 30 patients with severe chronic periodontitis were enrolled in a 1-year longitudinal pilot study (Chinese Clinical Trial Registry: ChiCTR-OCH-13004679). At baseline and 1, 3, 6, and 12 months after nonsurgical therapy, the periodontal clinical indicators plaque index (PLI), probing depth (PD), clinical attachment loss (CAL), sulcus bleeding index (SBI) were recorded. Filter paper strips were used to collect two deep-pocket (probing depth ≥ 6 mm) and two shallow-pocket (probing depth ≤ 4 mm) periodontal sites for each patient and weighed. The levels of interleukin IL-6, IL-10, TNF-α, and ALP in GCF were assessed using enzyme-linked immunosorbent assay. Meanwhile, 30 healthy sites of 15 subjects with healthy periodontium were used as the baseline controls for patients with severe chronic periodontitis.@*Results @#At the baseline, the TNF-α, ALP and IL-6 levels in GCF of the disease sites of patients with periodontitis were significantly higher than those in healthy periodontal sites of the control group (P < 0.001), and the levels of IL-10 were significantly lower than those in the control group (P < 0.001). In patients with severe chronic periodontitis, the levels of TNF-α, ALP and IL-6 in GCF at deep-pocket sites were significantly higher than those at shallow-pocket sites (P <0.001), and the IL-10 levels were significantly lower than those at shallow-pocket sites (P < 0.001). 1, 3, 6, and 12 months after nonsurgical treatment, the levels of TNF-α and ALP in GCF at the shallow- and deep-pocket sites in patients with chronic periodontitis significantly decreased, the level of IL-10 significantly increased (P < 0.005), and the level of IL-6 in GCF at the deep-pocket sites significantly decreased (P < 0.005). However, there was no significant difference in IL-6 level at shallow-pocket sites (P > 0.05). 1, 3, 6, and 12 months after nonsurgical treatment, the periodontal clinical indicators were improved compared with the baseline. In addition, there was a significant correlation between the levels of these four biomarkers and the periodontal clinical parameters (P < 0.05). During the two follow-up visits after nonsurgical periodontal therapy, the sites with more than 2-mm increase in attachment loss had significant differences in the levels of the four biomarkers in the GCF compared with the previous visit time (P < 0.005).@*Conclusion@#The detection of the levels of these four biomarkers in GCF has strong clinical significance for assessing the severity of periodontitis and the efficacy of nonsurgical periodontal therapy. Increased levels of TNF-α, ALP, and IL-6 and decreased IL-10 levels in GCF may indicate periodontitis progression at this site.

The level of antimicrobial peptides in gingival crevicular fluid and its correlation with periodontal clinical indexes in elderly patients with type 2 diabetic periodontitis / 口腔疾病防治

Objective@#To investigate the changes and significance of human beta-defensin-2 (HBD-2) and LL-37 in the gingival crevicular fluid of patients with periodontitis and type 2 diabetes mellitus (T2DM).@*Methods@#This study was conducted among 45- to 85-year-old patients in the Department of Stomatology and Internal Medicine of Shenzhen Center for Chronic Disease Control, including a healthy control group of 22 people, a systemically healthy control group of 19 people with periodontitis, a T2DM periodontal health group of 15 people, and a T2DM group of 21 people with periodontitis. The Florida periodontal probe was used for periodontal examination, and the clinical indexes, including probing depth (PD), clinical attachment level (CAL) and probing on bleeding (BOP), were recorded. The concentrations of HBD-2 and Ll-37 in gingival crevicular fluid were determined by ELISA. The differences in HBD-2, LL-37 and periodontal clinical indexes between the groups were compared, and correlation analysis was conducted.@*Results@#The PD values in T2DM with the periodontitis group were higher than those of the systemically healthy controls with periodontitis group (P < 0.05); the levels of HBD-2 and LL-37 in gingival crevicular fluid in systemically healthy controls with periodontitis group were significantly higher than those in the healthy control group (P < 0.05), the level of HBD-2 in gingival crevicular fluid in systemically healthy controls with periodontitis group was significantly higher than that in T2DM with periodontitis group (P < 0.05); and the antimicrobial peptides HBD-2 and LL-37 in gingival crevicular fluid were significantly positively correlated with the PD and CAL in systemically healthy controls with periodontitis group (P < 0.05), and there was no significant correlation between the antimicrobial peptides HBD-2, LL-37 in gingival crevicular fluid and PD, CAL in T2DM with periodontitis group (P > 0.05).@*Conclusion@#The levels of antimicrobial peptides HBD-2 and LL-37 in gingival crevicular fluid of middle-aged and elderly patients with T2DM periodontitis were lower, and there was no significant correlation with PD and CAL in periodontal clinical indicators.

Estimation of interleukin-17 levels in gingival crevicular fluid from healthy individuals, chronic gingivitis and chronic periodontitis patients using enzyme linked immunosorbent assay

Background: Chronic Periodontitis (CP) is an infectious disease resulting in inflammation of supporting tissues of the teeth. A number of pro-inflammatory cytokines are formed against periodontopathogenic microorganisms. Interleukin-17 (IL-17) is a pro-inflammatory cytokine, implicated in numerous inflammatory and autoimmune conditions.Methods: A total of 25 periodontally healthy subjects (Group 1), 25 patients with gingivitis (Group 2) and 25 patients with CP (Group 3) were included for the study based on clinical examination. Gingival index, probing pocket depth and clinical attachment loss were recorded in all subjects.Results: The levels of IL-17 increased from healthy to gingivitis to periodontitis patients. A positive correlation was found with the IL-17 and the clinical parameters like gingival index, probing pocket depth and clinical attachment loss.Conclusions: There is a strong association between the levels of IL-17 with periodontal disease as well as with its severity and its possible use as a biomarker for inflammatory periodontal disease.

Lymphocyte B and Th17 chemotactic cytokine levels in peri-implant crevicular fluid of patients with healthy, peri-mucositis, and peri-implantitis implants / Niveles de citoquinas quimiotácticas de linfocitos B y Th17 en el fluido crevicular periimplantario de pacientes con implantes sanos, perimucositis y periimplantitis

Peri-implantitis is one of the leading causes of implant failure and loss, and its early diagnosis is not currently feasible due to the low sensitivity of currents methods. In the current exploratory cross-sectional study, we explored the diagnostic potential of lymphocyte B and Th17-chemotactic cytokine levels in peri-implant crevicular fluid (PICF) in 54 patients with healthy, peri-mucositis, or peri-implantitis implants. Peri-implant crevicular fluid was collected, and the levels of the molecules under study were quantified by Luminex assay. The concentrations of CCL-20 MIP-3 alpha, BAFF/BLYS, RANKL and OPG concentration in PICF were analyzed in the context of patient and clinical variables (smoking status, history of periodontitis, periodontal diagnosis, implant survival, suppuration, bleeding on probing, periodontal probing depth, clinical attachment level, mean of implant probing depth, and plaque index). Patients with peri-implantitis, appear to have an overregulation of the RANKL/BAFF-BLyS axis. This phenomenon needs to be investigated in depth in further studies with a larger sample size.

La periimplantitis es una de las principales causas de falla y pérdida del implante, y su diagnóstico temprano no es factible debido a la baja sensibilidad de los métodos actuales. En este estudio transversal exploratorio, se estudió el potencial diagnóstico de los niveles de citocinas quimiotácticas de linfocitos B y Th17 en el líquido crevicular periimplantario (LCPI) en 54 pacientes con implantes sanos, peri-mucositis o periimplantitis. Se recogió líquido crevicular periimplantario y se cuantificaron los niveles de las moléculas estudiadas mediante Luminex assay. Las concentraciones de CCL-20 MIP-3 alfa, BAFF/BLYS, RANKL y la concentración de OPG en LCPI se analizaron en el contexto de las variables clínicas y del paciente (tabaquismo, antecedentes de periodontitis, diagnóstico periodontal, supervivencia del implante, supuración, sangrado al sondaje, profundidad de sondeo periodontal, nivel de inserción clínica, media de la profundidad de sondeo del implante e índice de placa). Los pacientes con periimplantitis parecen tener una sobrerregulación del eje RANKL/BAFF-BLyS. Este fenómeno debe investigarse en profundidad en futuros estudios con un tamaño de muestra mayor.

Influência de laminados cerâmicos cimentados sobre dentes naturais sem término cervical na microbiota do fluido gengival crevicular: estudo clínico, prospectivo e longitudinal usando PCR em tempo real / Influence of laminate veneers cemented over natural teeth without finish line on the microbiota of gingival crevicular fluid: clinical, prospective and longitudinal study using real-time PCR

Objetivo: quantificar bactérias colonizadoras do sulco gengival em paralelo à verificação do comportamento clínico periodontal e da adaptação marginal de laminados cerâmicos cimentados sobre dentes sem término cervical. Métodos: 73 laminados cerâmicos em dissilicato de lítio monolítico foram cimentados sobre dentes naturais sem término cervical e com a margem cervical posicionada cerca de 0,5mm no interior do sulco gengival. Para todos os dentes foi feita a coleta do fluido gengival crevicular (FGC) previamente à cimentação da restauração (baseline) e em 7, 180 e 365 dias após a cimentação para quantificação das bactérias S. mitis, P. intermedia e P. gingivalis através de PCR em tempo real. Clinicamente foram avaliados os parâmetros índice de placa visível (IPV), sangramento à sondagem (SS), profundidade de sondagem (PS), perda de inserção clínica (PIC), recessão gengival (RG) e a adaptação marginal da restauração em baseline, 7, 15, 30, 60, 180 e 365 dias. Foram obtidas réplicas da região cervical para análise da adaptação marginal por microscopia eletrônica de varredura (MEV). Resultados: Não houve diferença estatisticamente significante para o IPV, PS, SS em todos os períodos analisados (Anova, p>0,05). Não houve registro de PIC e RG. Houve diferença estatisticamente significante para S. mitis na comparação entre 180 e 365 dias (Dunn, p=0,03). Não foi detectado P. intermedia em nenhum dos sítios e não houve diferença estatisticamente significante para P. gingivalis em todos os tempos do estudo (Friedman, p>0,05). Todas as restaurações receberam o conceito alfa para a adaptação marginal nas análises clínica e microscópica. Conclusões: o sobrecontorno causado pelo laminado cerâmico não contribuiu para o acúmulo de placa na região cervical e para alterações no comportamento clínico periodontal, microbiológico e microscópico em relação aos mesmos dentes antes do tratamento restaurador(AU)

Purpose: quantify colonizing bacteria of the gingival sulcus, in parallel to the verify of the periodontal clinical behavior and the marginal adaptation of natural teeth restored with ceramic veneers without finish line. Methods: 73 ceramic veneers in monolithic lithium disilicate were cemented onto natural teeth without finish line and with the cervical margin positioned about 0.5mm inside the gingival sulcus. Gingival crevicular fluid (GCF) was collected for all teeth prior to cementation of the restoration (baseline) and 7, 180 and 365 days after cementation to quantify the bacteria S. mitis, P. intermedia and P. gingivalis through of real-time PCR. Clinically, visible plaque index (PIV), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival recession (GR) and marginal adaptation were evaluated at baseline, 7, 15, 30, 60, 180 and 365 days. Replicas of the cervical region were obtained for analysis of marginal adaptation by scanning electron microscopy (SEM). Results: There was no statistically significant difference for PIV, PD, BOP in all periods analyzed (Anova, p>0.05). There were no records of CAL and RG. There was a statistically significant difference for S. mitis in the comparison between 180 and 365 days (Dunn, p=0.03). P. intermedia was not detected in any of the analyzed samples. There was no statistically significant difference for P. gingivalis at all study times (Friedman, p>0.05). All restorations had an alpha concept for marginal adaptation in clinical and SEM analysis. Conclusions: the overcontouring caused by ceramic veneers did not contribute to the accumulation of plaque in the cervical region and to changes in the clinical, microbiological and microscopic behavior in relation to the same teeth before the restorative treatment(AU)

Comparison of TNF-α and IL-1ß Concentrations in Gingival Crevicular Fluid During Early Alignment Stage of Orthodontic Treatment in Adults and Adolescents

Abstract Objective: To compare the levels of TNF-α and IL-1β in the gingival crevicular fluid (GCF) during early leveling stage of orthodontic treatment. Material and Methods: This study was carried out on 20 orthodontic patients, including 10 teenagers and 10 adults. Before bonding, GCF was collected with a paper strip in gingival sulcus of maxillary right central incisor on the disto labial aspect for 60 seconds, followed by bonding and insertion of initial 14 NiTi archwire. GCF collection was repeated 24 hours, 7 days, and 28 days after bonding. Measurement of TNF-α and IL-1β levels was done utilizing Enzyme-Linked Immunosorbent Assay (ELISA). Data were analyzed in SPSS using repeated measurement test. Results: Concentration of TNF-α and IL-1β increased after treatment. There was no significant relationship between TNF-α and IL-1β concentrations subsequent to bonding in comparison to the baseline. There was no significant relationship in TNF-α and IL-1β level changes in the two age groups and between males and females. Conclusion: Concentration of TNF-α and IL-1β increased after treatment. Age and sex had no statically significant effect on the concentration of TNF-α and IL-1β.

Comparison of protein profiles of the pellicle, gingival crevicular fluid, and saliva: possible origin of pellicle proteins

BACKGROUND: The pellicle, the acellular organic material deposited on the surface of tooth enamel, has been thought to be derived from saliva. In this study, protein compositions of the pellicle, gingival crevicular fluid, and saliva collected from healthy adults were compared to elucidate the origin of pellicle proteins. RESULTS: The pellicle, gingival crevicular fluid, and saliva from the parotid gland or mixed gland were collected; subsequently, protein expression in samples from the respective individual was compared by SDS-PAGE and mass spectrometry. Following SDS-PAGE, proteins in the major bands were identified by mass spectrometry. The band pattern of pellicle proteins appeared different from those of gingival crevicular fluid, or saliva samples. Using mass spectrometry, 13 proteins in these samples were identified. The relative abundance of the proteins was quantitatively analyzed using mass spectrometry coupled with stable isotope labeling and by western blot. Cystatin S and α-amylase detected in pellicle were enriched in saliva samples, but not in gingival crevicular fluid, by western blot, and their abundance ratios were high in saliva and low in gingival crevicular fluid when analyzed by stable isotope labeling. Serotransferrin, however, was found only in the pellicle and gingival crevicular fluid by western blot and its abundance ratio was low in saliva. CONCLUSIONS: Our study revealed that the gingival crevicular fluid appears to contribute to pellicle formation in addition to saliva.

Systematic review of the effect of probiotics on experimental gingivitis in humans

Abstract: Probiotic therapy is a viable alternative to chlorhexidine, a widely used antiseptic in dentistry that produces significant adverse effects. This systematic review aimed to analyze the effects of probiotics on experimental gingivitis in humans. Two independent reviewers conducted a comprehensive literature search until March 2019. Randomized clinical trials and controlled clinical trials were selected. Outcome data were extracted and critically analyzed. A total of five articles were included in the qualitative synthesis. No meta-analysis could be conducted due to the heterogeneity of the selected studies. The use of probiotics showed a slight improvement in clinical parameters. Changes in gingival crevicular fluid volume were lower in the presence of the probiotic than in the placebo group. All the studies showed that the immediate, positive effects of probiotics during the period of discontinued mechanical oral hygiene were due to the modulation of the host response, not the anti-plaque effect. Investigators should conduct randomized clinical trials to elucidate the mechanisms of probiotic action and develop improved delivery systems.

Role of B cell activating factor in the development of periodontitis / 口腔疾病防治

@#B cell activating factor (BAFF) is the key regulator of B cells and is considered as a potential therapeutic target for immune inflammatory diseases. Periodontitis can promote local and systemic BAFF factor expression, whereas BAFF aggravates B cell immune responses and tissue destruction in periodontitis. In addition, BAFF also stimulates CD4+T cell response and inhibits regulatory T cell and M2 macrophage responses, thus changing the pathogenesis of a variety of immune inflammatory diseases. However, whether the biological effect mentioned above is an important mechanism by which BAFF aggravates periodontitis still lacks direct evidence and should be confirmed in future research. To provide a theoretical basis for the study of the pathogenic mechanism of BAFF, the expression and role of BAFF in periodontitis is reviewed in this article.

Effect of orthodontic forces on levels of enzymes in gingival crevicular fluid (GCF): A systematic review

Abstract Objective: Orthodontic force application releases multiple enzymes in gingival crevicular fluid (GCF) for activation, resorption, reversal, deposition of osseous elements and extracellular matrix degradation. The current systematic review critically evaluated all existing evidence on enzymes in orthodontic tooth movement. Methods: Literature was searched with predetermined search strategy on electronic databases (PubMed, Scopus, Embase), along with hand search. Results: Initial search identified 652 studies, shortlisted to 52 studies based on PRISMA. Quality assessment further led to final inclusion of 48 studies (13 moderately and 35 highly sensitive studies). Primary outcomes are significant upregulation in GCF levels of enzymes-aspartate aminotransferase (AST), alkaline phosphatase (ALP), matrix metalloproteinases (MMPs), lactate dehydrogenase (LDH), β-glucuronidase (βG), tartrate resistant acid phosphatase (TRAP), acid phosphatase (ACP) and down regulation in cathepsin B (Cb). Site specificity is shown by ALP, TRAP, AST, LDH, MMP9 with levels at compression site increasing earlier and in higher quantities compared with tension site. ALP levels are higher at tension site only in retention. A positive correlation of LDH, ALP and AST is also observed with increasing orthodontic force magnitude. Conclusions: A strong evidence of variation in enzymes (ALP, AST, ACP TRAP, LDH, MMPs, Cb) in GCF is found in association with different magnitude, stages and sites of orthodontic force application.

Resumo Objetivo: a aplicação da força ortodôntica libera múltiplas enzimas no fluído crevicular gengival (FCG), desencadeando a ativação, reabsorção, reversão, deposição de elementos ósseos e degradação da matriz extracelular. A presente revisão sistemática avaliou criticamente toda a evidência disponível sobre os níveis de enzimas durante a movimentação ortodôntica. Métodos: utilizando-se estratégias predeterminadas, foram realizadas buscas em bases de dados eletrônicas (PubMed, Scopus, Embase), sendo também feitas buscas manuais. Resultados: a busca inicial identificou 652 estudos e, com base nas diretrizes do PRISMA, foram selecionados 52 estudos. A avaliação qualitativa resultou na inclusão final de 48 estudos (13 estudos com moderada sensibilidade e 35 com alto nível de sensibilidade). Os desfechos primários foram o aumento significativo dos níveis no FCG das enzimas aspartato aminotransferase (AST), fosfatase alcalina (FA), metaloproteinases de matriz (MMPs), lactato desidrogenase (LDH), β-glucuronidase (βG), fosfatase ácido-resistente ao tartarato (TRAP), fosfatase ácida (FAC) e baixa regulação de catepsina B (Cb). Especificidade quanto ao local foi mostrada para FA, TRAP, AST, LDH e MMP9 com os níveis no lado de compressão aumentando mais rápido e em maiores quantidades, quando comparado ao lado de tensão. Os níveis de FA foram maiores no lado de tensão somente no período de contenção. Uma correlação positiva de LDH, FA e AST também foi observada à medida que a magnitude de força ortodôntica aumentou. Conclusões: há fortes evidências indicando que as variações nas enzimas (FA, AST, FAC, TRAP, LDH, MMPs, Cb) presentes no FCG estão associadas a diferentes magnitudes, estágios e locais de aplicação da força ortodôntica.

Asociación de sialometría, fosfato y calcio en saliva total bajo estímulo y en líquido crevicular gingival con caries dental en escolares / Sialometry and concentration of phosphate and calcium in stimulated whole saliva and gingival crevicular fluid and its association with dental caries in schoolchildren

Resumen Introducción. La capacidad de la saliva para la remineralización contribuye a mantener la integridad fisicoquímica de la estructura mineral de los dientes, lo cual los protege de la aparición y evolución de la caries dentaria. Objetivo. Establecer la relación de la sialometría, la capacidad amortiguadora, la concentración de calcio y fosfato en la saliva total estimulada y en el líquido crevicular gingival, con la gravedad y la actividad de las caries en escolares. Materiales y métodos. Se seleccionaron 36 escolares de 6 años, 18 con caries (International Caries Detection and Assessment System, ICDAS, código 2 o mayor) y 18 sin caries (ICDAS, código 0). En la dentición primaria, se evaluaron la gravedad y la actividad de la caries dentaria en la superficie de oclusión de los molares y en la vestibular de los dientes anteriores, y se codificaron mediante el ICDAS-II. Resultados. Se evidenció una mayor gravedad de las caries en la superficie de oclusión que en la vestibular. Las concentraciones de calcio en la saliva y de fosfato en el líquido crevicular gingival de los dientes sanos, fueron mayores en el grupo con un código ICDAS de 2 o mayor. La concentración de calcio en el líquido crevicular gingival fue mayor en el grupo con código ICDAS 0 que en los dientes cariados del grupo con código ICDAS de 2 o mayor. Se encontró una asociación estadísticamente significativa entre la frecuencia de caries activas y la concentración de fosfato en el líquido crevicular gingival de los dientes afectados, como también entre la gravedad de las caries y la capacidad amortiguadora, por una parte, y la concentración de fosfato en el líquido crevicular gingival de los dientes afectados, por la otra. Conclusión. Se evidenció una asociación entre la caries dental, la capacidad amortiguadora y la química bucal del calcio y el fosfato.

Abstract Introduction: The remineralizing properties of saliva contribute to maintain the physical and chemical integrity of the mineral structure of teeth, which protects it from the installation and evolution of dental caries. Objective: To relate sialometry, buffering capacity, calcium and phosphate concentration in whole stimulated saliva, and in gingival crevicular fluid with school children caries severity and activity. Materials and methods: We selected 36 schoolchildren aged 6 years: 18 with caries (International Caries Detection and Assessment System, ICDAS>1 group) and 18 without caries (ICDAS=0 group). The severity and activity of dental caries were diagnosed in the primary dentition: in the occlusal surface of molars and in the vestibular of the anterior teeth by ICDAS-II. Results: Caries in occlusal surface were more severe than in vestibular surface. The concentration of calcium in saliva and phosphate in healthy teeth gingival crevicular fluid were higher in the ICDAS>1 group. The concentration of calcium in gingival crevicular fluid was higher in the ICDAS=0 group than in the decayed teeth of the ICDAS>1 group. We found a statistically significant association between the frequency of active caries andthe concentration of phosphate in gingival crevicular fluid of teeth with caries, as well as between the severity of caries with buffering capacity and the concentration of phosphate in the gingival crevicular fluid of teeth with caries. Conclusion: We found an association between dental caries with buffering capacity and buccal calcium and phosphate.