The Role of Macrophage Death in Periodontitis: A Review.

Periodontitis, an infectious inflammatory disease influenced by various factors, disrupts the delicate balance between the host microbiota and immunity. The resulting excessive immune response exacerbates the progressive destruction of the supporting periodontal tissue. Macrophages are essential elements of the host innate immune system. They are pivotal components in the periodontal immune microenvironment and actively participate in both physiological and pathological processes of periodontal tissue. When confronted with periodontitis-related irritant factors, macrophages may differentiate to pro- or anti-inflammatory subtypes that affect tissue homeostasis. Additionally, macrophages may die in response to bacterial infections, potentially affecting the severity of periodontitis. This article reviews the typical mechanisms underlying macrophage death and its effects on periodontitis. We describe five forms of macrophage death in periodontitis: apoptosis, pyroptosis, necroptosis, ferroptosis, and ETosis. Our review of macrophage death in the pathophysiology of periodontitis enhances comprehension of the pathogenesis of periodontitis that will be useful for clinical practice. Although our review elucidates the complex mechanisms by which macrophage death and inflammatory pathways perpetuate periodontitis, unresolved issues remain, necessitating further research.

The dimension and morphology of alveolar bone at maxillary anterior teeth in periodontitis: a retrospective analysis-using CBCT.

The morphology of the alveolar bone at the maxillary anterior teeth in periodontitis patients was evaluated by cone-beam computed tomography (CBCT) to investigate the distribution of alveolar defects and provide guidance for clinical practice. Ninety periodontitis patients and 30 periodontally healthy individuals were selected to determine the morphology of the alveolar bone at the maxillary anterior teeth according to the degree of bone loss, tooth type, sex and age. The differences in the dimensions between periodontitis patients and healthy individuals were compared, and the distribution of alveolar bone defects was analyzed. A classification system was established regarding the sagittal positions and angulations of the teeth. The buccal residual bone was thicker and the lingual bone was thinner in the periodontitis patients than in the periodontally healthy individuals, and there were differences between the different tooth types, sexes and age subgroups. The buccal undercut was close to the alveolar ridge, while fenestration was reduced and the apical bone height was higher in periodontitis patients than in periodontally healthy individuals. The apical bone height increased with the aggravation of bone loss and age. The proportions of different sagittal positions changed with the aggravation of bone loss. Moreover, the teeth moved more buccally regarding the positions of the maxillary anterior teeth. The morphology of the alveolar bone at the maxillary anterior teeth differed between periodontitis patients and healthy individuals, and the differences were related to the degree of bone loss, tooth type, sex and age.

The mediating role of general self-efficacy in the association between perceived social support and oral health-related quality of life after initial periodontal therapy.

BACKGROUND: Although initial periodontal therapy can ease some physical and psychological discomforts from periodontitis and improve patients' oral health-related quality of life (OHRQoL), it is also vital to find positive resources from psychological and social aspects to promote the overall OHRQoL. This study aims to explore the associations of perceived social support (PSS) and general self-efficacy with OHRQoL and the mediating role of general self-efficacy in PSS-OHRQoL association after initial periodontal therapy. METHODS: A prospective case series study was conducted among consecutive outpatients with chronic periodontitis during the period of July 2014-April 2015. A total of 145 eligible patients responded to OHRQoL questionnaire and periodontal examination at baseline. About 4 to 5 weeks after initial periodontal therapy, 120 patients completed the second OHRQoL measurement and periodontal examination, along with PSS and general self-efficacy measurement. The Wilcoxon matched-pairs signed-rank test was used to determine the difference between baseline and post-treatment OHRQoL scores and periodontal parameters. Hierarchical linear regression analysis was used to explore the associations of PSS and general self-efficacy with post-treatment OHRQoL after adjusting for some demographic and periodontal variables. Asymptotic and resampling strategies were performed to explore the mediating role of general self-efficacy. RESULTS: Initial periodontal therapy resulted in a significant improvement in the mean total score and all domains of OHRQoL and all periodontal parameters measured. In hierarchical linear regression analysis, clinical attachment loss (CAL) was significantly and positively associated with post-treatment OHRQoL score (ß = 0.265, p < 0.01), while PSS (ß = -0.303, p < 0.01) and general self-efficacy (ß = -0.221, p < 0.01) were significantly and negatively associated with post-treatment OHRQL score, respectively. A significant mediating role of general self-efficacy (a*b = -0.139, BCa 95 % CI: -0.298, -0.011) in the association between PSS and post-treatment OHRQoL was revealed, and the proportion of the mediating role of general self-efficacy was 31.4 %. CONCLUSIONS: Initial periodontal therapy could significantly improve all aspects of OHRQoL. PSS and general self-efficacy could be the positive resources for improving OHRQoL after initial periodontal therapy among patients with periodontitis. General self-efficacy partly mediated the association between PSS and post-treatment OHRQoL.