Immunologic burden links periodontitis to acute coronary syndrome: levels of CD4 + and CD8 + T cells in gingival granulation tissue.

OBJECTIVE: To investigate the proportional variation of macrophage and T-lymphocytes subpopulations in acute coronary syndrome (ACS) patients, its association with periodontitis (P), and to compare with control individuals. SUBJECTS AND METHODS: Three groups of subjects participated: one group consisted of 17 ACS patients with P (ACS + P), another group consisted of 22 no ACS + P patients, and a control group consisted of 23 participants with gingivitis (no ACS + G). Macrophage, CD4 + , and CD8 + T-lymphocytes and CD4 + /CD8 + ratio values in gingival tissue were determined histometrically. RESULTS: Significant differences were found among three groups regarding the mean number of macrophage (no ACS + P > ACS + P > no ACS + G; p < 0.05) and CD8 + T-lymphocytes (no ACS + P > ACS + P > no ACS + G; p < 0.05). Significant variations were observed between the groups both CD4 + T-lymphocytes densities (ACS + P > no ACS + P and ACS + P > no ACS + G; p < 0.05) and CD4 + / CD8 + ratio (no ACS + P < no ACS + G and ACS + P < no ACS + G; p < 0.05). CONCLUSIONS: The increased number of CD8 + T-lymphocytes in both group ACS + P and group no ACS + P resulted in a reduction of the CD4 + /CD8 + ratio in gingival tissue when compared with no ACS + G group. CLINICAL RELEVANCE: The decrease of CD4 + /CD8 + ratio in gingival tissue reflects periodontitis and may be associated with severe adverse outcomes in people with ACS.

Investigating the diagnostic potential of IL-1ß, IL-10, and IL-36γ in gingival crevicular fluid in patients with different periodontal conditions.

BACKGROUND: The study aimed to analyze cytokine levels, including interleukin (IL)-1ß, IL-10, and IL-36γ, to investigate the link between pro- and anti-inflammatory responses in periodontal conditions and assess their potential as diagnostic biomarkers for distinguishing between different types of periodontal conditions. METHODS: 80 systemically healthy non-smokers (25 periodontally healthy, 25 with gingivitis, 30 with periodontitis) were included. Clinical periodontal parameters were recorded, and gingival crevicular fluid (GCF) samples were obtained. Receiver operating characteristic (ROC) curve analysis was applied to determine the diagnostic value of cytokines. RESULTS: IL-36γ had the highest sensitivity for diagnosing periodontitis, although its specificity for identifying those without periodontitis was relatively low. The combination of IL-1ß and IL-36γ was the most effective in differentiating periodontitis from periodontal health. IL-10 was found to be an acceptable discriminator for distinguishing gingivitis from healthy conditions. However, its sensitivity and specificity for identifying gingivitis were lower. The combination of the three cytokines showed the highest ability to distinguish between periodontitis and gingivitis. CONCLUSION: The levels of IL-1ß, IL-10, and IL-36γ in GCF may provide insights into periodontal health and disease status. Further studies are needed to validate these results and explore the potential of these cytokines in periodontal disease management.

All three of these cytokines exhibit exceptional diagnostic accuracy, particularly in distinguishing between chronic periodontitis and periodontal health.Moreover, the combination of IL-1ß and IL-36γ stands out as the most accurate diagnostic indicator for periodontitis. This combination could serve as a robust biomarker panel for the early detection and monitoring of periodontal disease, potentially allowing for timely interventions to prevent disease progression.

Evaluation of long-term effects of diode laser application in periodontal treatment of poorly controlled type 2 diabetic patients with chronic periodontitis.

PURPOSE: This study aimed to investigate the effects of diode laser (DL) in addition to non-surgical periodontal treatment on periodontal parameters, systemic inflammatory response and serum haemoglobin A1c (HbA1c ) level in patients with poorly controlled type 2 diabetes mellitus (T2DM) and chronic periodontitis. METHODS: Thirty-seven patients with poorly controlled T2DM and chronic periodontitis completed this study. The patients were divided into two groups. The individuals in the control group received placebo laser treatment in addition to scaling and root planing (SRP). The individuals in the study group received DL (1 watt) in addition to SRP. Clinical index measurements were performed before treatment (T0), 3 months after treatment (T1) and 6 months after treatment (T2). Plaque index, gingival index, bleeding on probing, clinical attachment level and probing depth were measured to determine periodontal status. HbA1c and C-reactive protein (CRP) levels were also analysed using blood samples. RESULTS: In both groups, clinical and laboratory parameters were significantly improved at T1 and T2 compared to baseline (P < 0.05). Gingival index, bleeding on probing and probing depth were more significantly reduced after treatment in the SRP+DL group than in the SRP group (P < 0.05). The serum CRP and HbA1c levels were similar between the groups (P > 0.05). CONCLUSION: The use of DL in addition to SRP in periodontal treatment of T2DM individuals makes positive contribution to the reduction of local inflammation and to periodontal healing. On the other hand, it has no beneficial effects on systemic inflammatory response and glycaemic control.

Critical steps in electronic volume quantification of gingival crevicular fluid: the potential impact of evaporation, fluid retention, local conditions and repeated measurements.

BACKGROUND AND OBJECTIVES: Various methodological factors may operate during clinical gingival crevicular fluid (GCF) sampling, volume quantification or subsequent laboratory analysis. For precise volume quantification, specific concern for generation and maintenance of a reliable calibration curve, the potential risk of GCF loss as a result of evaporation or fluid retention on actual volume and the impact of local conditions is needed because each of these factors may act as a source of subsequent volumetric distortions. Thus, the present study aimed to analyse the impact of sample transfer time on the rate of evaporation and the possibility of fluid retention, and the impact of local conditions and number of replicated measurements on the reliability of calibration data. MATERIALS AND METHODS: To analyse evaporative errors, standardized Periopaper strips provided with known test volumes (0.1 microl, 0.2 microl, 0.5 microl and 0.6 microl) were transferred to Periotron 8000 with different time intervals (immediately, 5 s, 30 s and 60 s). For fluid retention, after quantifying the actual volume of the strips provided with known volumes (0.1 microl and 0.6 microl) of two test fluids, a second set of measurements was performed using dry strips. To determine the impact of local conditions (temperature and humidity) and the validity of 3, 5 and 20 replications (0.0-0.6 microl with 0.1- microl increments) on device calibration for 20 degrees C and 25 degrees C, electronic readings were obtained from three devices at three different locations. Differences in volumetric data in each experimental design were statistically analysed. RESULTS: No significant fluid loss was observed within 5 s, but evaporation clearly led to volumetric distortions with extending transfer times (30 s or 60 s) (p < 0.05). Measurable amounts of fluid retention were found for both volumes and both test fluids, but not with identical patterns. Local conditions resulted in unique calibration data for each test volume and for each device. Although a 5 degrees C increase generally provided higher readings, this was not observed for all devices at all volumes. Additional replicates (n = 5 or n = 20) did not seem to add any further reliability to the triplicate scores for the given test volumes. CONCLUSION: The findings of the present study confirm the reliability of triplicate readings, and uniqueness of each device and electronic data and the distinct impact of local environmental conditions on the generation/maintenance of calibration scores for each particular device. Furthermore, they underline time-dependent evaporation and fluid retention as additional technical concerns and once again highlight the importance of methodological standardization of the electronic volume quantification process.

Comparison of two different gingivectomy techniques for gingival cleft treatment.

Interdental clefts or invaginations contribute to orthodontic relapse and poor periodontal health in extraction cases. These clefts or invaginations can be removed both by electrosurgical or conventional surgical gingivectomy techniques. This study investigates and compares the efficacy of two different techniques to remove gingival clefts with respect to periodontal health and patient tolerance. Twenty-two patients (mean age, 15.7 years) with bilateral gingival clefts participated in this study. In each patient, the gingival invaginations were removed by gingivectomy using electrosurgery on one side and conventional surgery on the contralateral side. The length and depth of the invaginations, the gingival index of the adjacent teeth, and the changes in visual analogue scale scores were recorded before and after the operation for both groups. Mann-Whitney U-test and Wilcoxon tests were used to analyze the data statistically. The results showed significant improvement in invagination depth and length and gingival index scores for both techniques. There were no statistical differences between the two gingivectomy techniques with respect to gingival health and patient tolerance. Both techniques can be used to remove the gingival invaginations efficiently.

Interleukin-1beta, tumor necrosis factor-alpha levels and neutrophil elastase activity in peri-implant crevicular fluid.

The aim of this study was to determine interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha) levels and neutrophil elastase (NE) activity in peri-implant crevicular fluid (PICF) of smoker and nonsmoker patients, and to investigate their relationships with clinical parameters. A total of 42 endosseous root-form dental implants of 14 patients were clinically examined by modified Plaque index (PI), modified Gingival index (GI) and probing depth (PD). Smoking habits of the patients were recorded. PICF of implants were collected by Periopaper strips and IL-1beta, TNF-alpha levels were determined by enzyme-linked immunosorbent assay (ELISA). NE was analyzed with a neutrophil specific chromogenic substrate, N-methoxysuccinyl-Ala-Ala-Pro-Val-p-nitroanilide. The cytokine and enzyme levels in PICF were expressed as total amount/activity and as concentrations. NE activity in PICF significantly correlated with GI and PD, and IL-1beta levels with GI and PICF volume (P < 0.05). The correlations were stronger when the PICF levels were expressed as total IL-1beta amount and as total NE activity. The implants with inflamed gingiva (GI > 1) had higher levels of IL-1beta and NE activity than implants with noninflamed or slightly inflamed gingiva (GI 3 mm) was greater than the implants with shallow pockets (PD

A rare case of gingival myiasis caused by diptera (Calliphoridae).

Myiasis was first described by Hope in 1840. Since then, many cases of myiasis affecting different human organs have been reported. Oral myiasis is very rare in healthy persons but occurs mainly in the tropics and associated with inadequate public and personal hygiene. In this case report, we present clinical findings gingival myiasis. The patient was 26-year-old farmer and his chief complaint was discomfort and swelling in his maxillary gingiva. The patient's medical and family histories were non-contributory and oral hygiene was not acceptable. The diagnosis was based on the characteristic clinical features and the visual presence of wriggling larvae about 1 cm in size. The larvae were identified as Calliphoridae. Treatment consisted of removal of the maggots from the gingival sulcus, followed by scaling and oral hygiene instruction. One week later, a periodontal flap operation was done. The patient was followed-up for 6 months and healing was uneventful.