The elevation of fibroblast growth factor 21 is associated with generalized periodontitis in patients with treated metabolic syndrome.

BACKGROUND: Fibroblast growth factor 21 (FGF21) is closely associated with metabolic syndrome (MetS). An alteration of FGF21 is possibly affected by periodontitis. The present study aimed to investigate the levels of serum FGF21 in MetS patients with generalized periodontitis and its association with periodontal and metabolic parameters. METHODS: One hundred forty-six MetS patients were recruited from the CORE (Cohort Of patients at a high Risk for Cardiovascular Events) Thailand registry. All participants received general data interviewing, periodontal examination and blood collection for measurement of FGF21 levels and biochemistry parameters. Periodontitis was defined according to the new classification and divided into two groups of localized periodontitis and generalized periodontitis. RESULTS: FGF21 was significantly higher in generalized periodontitis group when compared with localized periodontitis group (p <  0.05). The significant correlation was observed between FGF21 and variables including number of remaining teeth, mean clinical attachment loss, hypertriglyceridemia and low high-density lipoprotein cholesterol. The elevation of serum FGF21 was associated with presence of generalized periodontitis after adjusting of covariate factors (OR = 27.12, p = 0.012). CONCLUSIONS: The elevation of serum FGF21 might be a potential biomarker for MetS patients who have risk of generalized periodontitis.

Comparison of platelet-rich fibrin and cellulose in palatal wounds after graft harvesting.

AIM: The aim of the present study was to compare patient morbidity and healing outcomes of free gingival graft (FGG) harvesting at palatal donor sites and after using platelet-rich fibrin (PRF) and oxidized regenerated cellulose (ORC). FGG harvesting leaves open palatal wounds, which heal by secondary intention. Patients might experience discomfort or pain during the first 2 weeks of healing. METHODS: Eighteen participants requiring two FGG were recruited. The test and control sites were covered with PRF membrane and ORC. The complete epithelialization of the palatal wound, the percentage of wound healing, and postoperative pain were evaluated, 1, 3, and 7 days and 2, 3, and 4 weeks after surgery. RESULTS: Similar wound size reduction at 1 week (test: 36.87%, control: 38.78%) was found. At 2 weeks, the majority of the test group (88.89%) showed complete epithelialization, whereas 66.67% of the control group had complete epithelialization (P = .228). Pain was more prevalent in the control group (27.77%) than in the test group (11.1%) on day 1. None of the participants reported any pain or discomfort at the test sites on day 3. CONCLUSIONS: PRF seems to reduce patient morbidity, but there is no difference in palatal wound healing (P > .05).

Periodontal disease in Thai patients with rheumatoid arthritis.

AIM: To evaluate the prevalence and severity of periodontal disease in patients with rheumatoid arthritis (RA) who attended a rheumatology clinic in a university hospital. METHODS: All consecutive patients with RA who attended the rheumatology clinic between June 2009 and January 2010 were asked to enroll in this study. All participants answered questionnaires, which included demographic data, medical history, medications used and smoking habits. A full mouth periodontal examination, including gingival index, plaque index, probing pocket depth and clinical attachment level was performed. Only cases that had at least 20 teeth were included in this study. Rheumatoid arthritis parameters, including number of tender and swollen joints, erythrocyte sedimentation rate, the presence of rheumatoid factor (RF), hand radiographs, Disease Activity Index (DAS) and health status using the Thai Health Assessment Questionnaire (HAQ), were determined. The association between RA parameters and periodontal condition was examined. RESULTS: There were 196 participants (87.2% female) with a mean age of 51.7 ± 9.70 years, mean disease duration of 9.62 ± 7.0 years and mean DAS score of 4.64 ± 1.25. Eighty-two per cent were RF-positive. Moderate and severe periodontitis were found in 42% and 57%, respectively. Higher age, male gender, previous or current smoking and high level of plaque score were associated with severe periodontal disease. No differences in RA parameters were found between groups of patients who had moderate and severe periodontitis. CONCLUSIONS: We found a high prevalence of periodontitis in Thai patients with RA. However, there was no association between RA parameters and periodontal conditions.

Elevated levels of a disintegrin and metalloproteinase 8 in gingival crevicular fluid of patients with periodontal diseases.

BACKGROUND: A disintegrin and metalloproteinase 8 (ADAM8) is involved in inflammation and is essential for osteoclastogenesis. Elevated ADAM8 levels are detected in human serum and other body fluids in several inflammatory conditions. Therefore, we hypothesized that ADAM8 levels are also raised in gingival crevicular fluid (GCF) of patients with periodontal diseases. METHODS: Forty-five patients with periodontal diseases (n = 15 for each group: the group of patients with gingivitis, the group with aggressive periodontitis [AgP], and the group with chronic periodontitis [CP]) and 15 volunteers who exhibited healthy gingiva were recruited. Four periodontal parameters, gingival index, plaque index, probing depth, and clinical attachment level, were recorded before GCF collection. The presence of ADAM8 in GCF was shown by immunoblotting using anti-human ADAM8 polyclonal antibody against its prodomain, and the ADAM8 levels were measured by an enzyme-linked immunosorbent assay. RESULTS: Four immunoreactive bands at 120, 70, 50, and <30 kDa were detected in the groups of patients with periodontitis, whose intensities were stronger than those in the group of patients with gingivitis, consistent with significantly greater ADAM8 levels in both groups of patients, with either CP or AgP, than those in the group of patients with gingivitis and in the group that was healthy (P <0.001). Moreover, the ADAM8 levels correlated significantly with the four periodontal parameters (P <0.001), indicating that ADAM8 levels are positively associated with the degree of periodontal tissue inflammation and destruction. CONCLUSIONS: The ADAM8 levels are elevated in the GCF of patients with periodontal diseases, including gingivitis, CP, and AgP, in comparison to control participants who are healthy, and they correlate with four clinical parameters that reflect the degree of disease severity.

Aggregatibacter actinomycetemcomitans serotypes, the JP2 clone and cytolethal distending toxin genes in a Thai population.

AIM: To examine the genetic diversity of Aggregatibacter actinomycetemcomitans in Thai adults. MATERIALS AND METHODS: Subgingival plaque samples from 453 subjects were analysed for A. actinomycetemcomitans serotypes, the presence of the high leukotoxin-producing JP2 clone and cytolethal distending toxin genes (cdtABC) using the polymerase chain reaction technique. In subjects who were positive for cdtABC, restriction fragment length polymorphism analysis was used to identify a single nucleotide polymorphism (SNP) in the cdtB gene at amino acid position 281. The extent and severity of periodontal disease were compared between subjects harbouring different A. actinomycetemcomitans genotypes. RESULTS: Eighty six subjects (19%) were positive for A. actinomycetemcomitans. The JP2 clone was not detected. Serotype c was the most prevalent (57%), followed by serotypes a (33%) and b (7%). Among A. actinomycetemcomitans-positive subjects, 27% were positive for cdtABC. All cdtABC-positive subjects possessed the SNP in the cdtB, which is involved with increased toxin activity. The presence of A. actinomycetemcomitans, but not a specific genotype, was significantly related to increased probing depth and periodontal attachment loss. CONCLUSIONS: Our results confirm the previous findings that genotype distribution of A. actinomycetemcomitans varies between ethnic groups. However, no clear relationship between a specific genotype and periodontal conditions was observed.

Relationship between the presence of certain bacterial pathogens and periodontal status of urban Thai adults.

BACKGROUND: The association between Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Tannerella forsythia (previously T. forsythensis) and periodontal disease has been reported in Western populations. However, corresponding data in Asian populations are still lacking. The aim of this study was to determine the prevalence of these three bacteria and their relationship to periodontal status in a group of urban Thai adults. METHODS: The study was conducted in 453 subjects, aged 39 to 59 years. The presence of bacteria in subgingival plaque was analyzed using polymerase chain reaction analysis. Subjects were classified as having chronic periodontitis if they had at least three sites with probing depths > or =5 mm. Logistic regression analysis was used to determine the degree of association between the target bacteria and periodontal status. RESULTS: A. actinomycetemcomitans, P. gingivalis, and T. forsythia were found in 19.0%, 70.9%, and 77.5% of the subjects, respectively. About one-third (36.2%) of subjects had chronic periodontitis. In univariate analysis, age, male gender, current smoking, diabetes, and the presence of A. actinomycetemcomitans or P. gingivalis were positively associated with chronic periodontitis, whereas education and income exhibited inverse associations with chronic periodontitis. In multivariate analysis, education, current smoking, diabetes, and the presence of A. actinomycetemcomitans and P. gingivalis remained significant. The adjusted odds ratios for having chronic periodontitis were 2.5 and 3.4 in subjects positive for A. actinomycetemcomitans and P. gingivalis, respectively. However, no significant association was observed between the presence of T. forsythia and periodontal status. CONCLUSION: The presence of A. actinomycetemcomitans and P. gingivalis, but not T. forsythia, in subgingival plaque was associated with chronic periodontitis in this group of Thai adults.