Vascular endothelial growth factor [VGCF] and insulin-like growth factor [IGF-I] in gingival crevicular fluid of non-insulin dependent diabetic patients with periodontitis

Periodontal disease is one of the major oral problems encountered in patients with diabetes mellitus [DM]. vascular changes, neutrophil dysfunction, altered collagen synthesis, and genetic predisposition observed in DM may contribute to periodontitis and the vascular alterations observed in such patients may depend on vascular endothelial growth factor [VEGF] and insulin-like growth factor I [IGF-I] actions. Few reports are available about the mechanism of neovascularization and the angiogenic factors that contribute to the periodontal pathology. The present study was conducted to determine the role and levels of VEGF and IGF-I in gingival crevicular fluid [GCF] of diabetic and chronic periodontitis patients [CP]. A total of 55 subjects participated in the study and were divided into 15 uncontrolled diabetics [Group I], 15 controlled diabetics [Group II], 15 chronic periodontitis CP patients [Group III] and 10 healthy controls [Group IV]. GCF samples related to areas of greatest attachment loss were taken and immunochemically analyzed using ELISA technique. The results revealed higher GCF VEGF and IGF-I levels in diabetic patients when compared to CP patients. Moreover, uncontrolled diabetic revealed highest levels. There was a correlation between papillary bleeding index [PBI], clinical attachment level [CAL] and VEGF and IGF-I levels. These results indicate the increase of GCF VEGF and IGF-I in diabetic and CP patients may be involved in the immunopathogenesis of both diabetes and chronic periodontitis

Association between C reactive protein serum interlukin 6, and periodontal status as possible risk factors for pre-term labor

Pre-term labor often results in pre-term birth Previous studies have suggested that periodontal disease may be an important risk factor for pre-term low-birth weight. The aim of the present study was to evaluate the association between periodontal clinical parameters, CRP and IL-6 levels in sera of Egyptian pregnant women suffering from pre-term labor. One hundred and twenty-five women were enrolled in this study. Systemic conditions were assessed and serum CRP was evaluated. The women were divided into two groups: group I CRP-positive and group II CRP-negative. Serum IL-6 was also evaluated. Periodontal examination included gingival index [GI], probing depth [PD] and clinical attachment loss [CAL]. Gestational age, parity, gravidity, cervical dilation and cervical length, were also recorded. On comparing both groups , there was a statistical significant increase in GI, PD, CAL and serum IL-6 levels in favor of CRP-positive pregnant women. Positive significant correlations were found between all parameters and CAL. Moreover, there was a positive correlation between age and probing depth in CPR-positive pregnant women. In conclusion, preterm Pre-term labor women with positive CRP revealed worsened periodontal conditions and elevated serum IL-6 levels compared to CRP-negative women. The elevated levels of serum CRP and IL-6 could have affected the maintenance of proper uterine-fetus relationship, resulting in premature uterine contractions

Evaluation of the local application of cholesterol lowering drug [simvastatin] for the management of intrabony defects a clinical, histological and radiographic study

The aim of the present study was to evaluate clinically, radiographically and histologically the adjunctive treatment of periodontal intrabony defects by surgical debridment and local application of a single dose of simvastatin granules. Twenty intraosseous interproximal defects in 10 systemially healthy moderate to severe chronic periodontitis patients constituted the study sample. All patients received initial therapy, then when qualified for surgery defects were randomly divided into 2 groups. Group I defects were treated with surgical debridment and adjunctive use of local application of [2.2 mg] simvastatin granules. Group II defects were treated with surgical debridment alone. At baseline; 6 and 9 months post-surgery clinical and radiographic parameters evaluated included gingival index [GE], probing pocket depth [PPD], clinical attachment level [CAL], radiographic bone density [RBD] and linear radiographic measurement [LRM]. Both groups showed statistical reduction of PPD and gain in CAL after 9 months. Comparing both groups, there was a significant PPD reduction at 9 months and gain in CAL at 6 and 9 months [t= 2.333, 2.910] post operatively in gp I when compared to gp II. Gp I showed a statistical decrease in LRM and RBP at 6 and 9 months, whereas gp II revealed at decrease at 9 months ony. There was a significant decrease of LRM and RBP at nine months when gp I was compared to gp II [2.187, 1.579]. a histological study was carried out to assess the nature of healing 10 critical sized matched bilateral osseous defects were surgically induced at the interproximal area of mandibular 3rd and 4th premolars in 5 dogs, these defects were treated in as similar manner to their human counter parts, the animals were sacrificed at 4, 12 and 24 weeks post-surgery. Gp I revealed formation of a thick layer of new lamellated bone, typical functional orteination of periodontal ligament and enhancement of periodontal regeneration. In conclusion, simvastatin acted as a true osteoinductive material by promotion of new bone formation

Evaluation of the regenerative potential of bisphosphonate gel around immediate dental implants [an experimental study]

Previous studies have demonstrated and increase in bone mass and density with use of alendronate sodium. This agent acts as an inhibitor of osteoclast activity and is thought to result in more net osteoblastic activity. The objective of this study was to determine the effects of locally applied alendronate on guided bone regeneration around dental implants. The study was conducted on seven adult dogs, where bilateral extraction of their mandibular first premolar was performed after the reflection of gingival mucoperiosteal flap and immediate HR-implants [MTM-system] were placed on both sides. Bisphosphonate gel was applied on the right side only around and coating the implant [experimental group], while in the left side the implant was placed without adding the gel [control group]. The animals were sacrificed at one and two months postoperatively. Specimens were evaluated radiographically, histologically and histochemically. Radiographic results showed an increase in radiographic bone density at 1 and 2 months in experimental group. Histologic results revealed early osteoblastic activity; coarse bundles of collagen fibers covering and growing between alendronate gel at 1 month in experimental group. At 2 months, new bone formation and dense mature lamellar bone were observed directed towards implant. Histochemically, results confirmed the histological findings. In conclusion, this study implies that topical delivery of alendronate at surgery increases early bone formation around formation around immediate dental implants

Application of morphologic operations of digitized radiographs to distinguish between periodontally involved and healthy individuals

Objectives to compare between radiograghic images of periodontally involved and healthy individuals by using morphologic operations [MO] with skeletonization and fractal dimension [FD] analysis of digitized images

Methods The participants were divided into two groups; group I [control group]; included 10 , individuals who had either healthy gingiva or gingivitis, group II [periodontal group]; included 10 patients who had moderate chronic periodontits both groups were radiographed by XCP film holder for long cone paralleling techniques processed and digitized under standardized conditions for each 3 to 4 region of interest [ROI] were placed generally within interdental bone. MO were calculated on binary images while FD were calculated on gray level images

Results There was a decrease in mean density values in G II compared to G I after morphological operation analysis with skeletonization. FD also decreased in G II compared to G I after processing of.gray level images. There was a statistical significant difference between GI and Gil in mean densities of binary images MO analysis [t = 10.06 at P< 0.05] and mean of FD measurements [t= 13.610 at P< 0.05]

Conclusion The results of the study indicate that both MO and FD procedures have the potential to differentiate between groups with differing alveolar bone trabecular patterns