The effects of non-surgical periodontal therapy on neutrophil elastase and elastase alpha-1 proteinase inhibitor levels in GCF in periodontitis patients with or without acute coronary syndrome.

OBJECTIVE: Periodontitis may contribute to vascular damage, resulting in the destabilization of atherosclerotic plaque leading to acute coronary syndrome (ACS). In this study, we explored the effect of non-surgical periodontal treatment (NSPT) on cardiovascular blood biomarkers and gingival crevicular fluid (GCF) neutrophil elastase (NE) and α1-proteinase inhibitor (α-1PI) levels in periodontitis (P) participants with and without ACS. MATERIALS AND METHODS: Medical and dental examinations were performed to diagnose ACS and periodontitis, respectively. Seventeen patients with diagnosis of ACS and periodontitis were included in this study, as a test group (group ACS). Twenty-six age and sex-matched control patients with periodontitis (group P) were otherwise systemically healthy. Both groups received NSPT. Plasma levels of cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), C-reactive protein (CRP), GCF NE activity, GCF α1-PI levels, and GCF NE/α1-PI rates were measured at baseline, at1st and 3rd months after NSPT. RESULTS: GCF NE activity/time (µU/30s) decreased significantly at 3rd month compared to baseline values in the Group P after NSPT. First and 3rd months after NSPT, in the Group P GCF α1-PI activity/time (pg/30s) was significantly higher than the Group ACS. Moreover GCF NE/α1-PI rates decreased significantly compared to baseline values at 1st and 3rd months after NSPT in the group P. CONCLUSION: NSPT yields decrease in NE/α1-PI rates. NE and its possible interactions with α1-PI may play a crucial role in both periodontitis and ACS. GCF α1PI activity/time (U/30s) can be a potential biomarker in management of periodontitis associated with ACS. CLINICAL RELEVANCE: The GCF α1-PI reduction may alter the immune-inflammatory response in patients with periodontitis and thus increase the risk of ACS. TRIAL REGISTRATION: Thai Clinical Trials.gov (NCT04785235).

Systemic treatment with alpha-tocopherol and/or sodium selenite decreases the progression of experimental periodontitis.

OBJECTIVE: To investigate the effects of sodium selenite (Se) and/or α-tocopherol (αT) applications on the alveolar bone loss (ABL), the number of gingival collagen fibers, inducible nitric oxide synthase (iNOS)+ and CD95+ cell numbers, and serum cytokine concentrations in experimental periodontitis in rats. MATERIALS AND METHODS: Forty Sprague Dawley rats were divided into four groups of ten as follows: group A: Se group, group B: αT group, group C: Se and αT combined group, and group D: control group (intraperitoneal (IP) saline injection applied). Using the image analysis method in the connective tissue under the connective epithelium, the numbers of iNOS, CD95 positive cells, and collagen fibers were counted. ELISA kits were used to test the concentrations of serum interleukin (IL)-1ß, IL-6, and IL-4. RESULTS: The combination of Se and αT (group C) suppressed ABL compared with the control group (group D) (P < 0.05). In group A (Se), the number of iNOS+ cells was smaller than in group D (P < 0.05). CONCLUSION: Se has been concluded to inhibit inflammation of the gum due to iNOS. Se and αT can have a remarkable important role in preventing alveolar bone loss, and particularly in combination. CLINICAL RELEVANCE: Se and/or αT application may be useful in preventing the destruction of periodontal tissue and treatment of periodontal disease.

Methodological evaluation of gingival crevicular fluid volume and neutrophil elastase levels: sequential sampling, length of sampling time and two different sampling methods.

Objectives: The mechanisms underlying the formation and composition of gingival crevicular fluid (GCF) and its flow into and from periodontal pockets are not understood very well. The aim of this study was to evaluate the length of sampling time and sequential sampling of GCF neutrophil elastase (NE) enzyme levels by using intracrevicular and orifice methods.Material and methods: Twenty adults (mean age of 41.8 years, ranged 31-60 years, 18 males and 2 females) with chronic periodontitis were enrolled and all completed the 3-d study. GCF was collected by both intracrevicular and intrasulcular methods, 720 samples of GCF were collected. In first, second and third day, the length of sampling time in seconds (s) and order were '5- 10-30-s'; '10- 30- 5-s' and '30- 5- 10-s,' respectively. GCF elastase levels were determined by hydrolysis of neutrophil specific substrate N-methoxysuccinyl-Ala-Ala-Pro-Val-p-nitroanilide.Results: NE activity (µU) and NE activity/volume (µU/µl) were significantly different for order of sampling (p < .05), but not for the length of sampling time (p>.05).Conclusions: Within the limits of this study, the choice of sampling technique in GCF-profile studies seems to be a critical decision as it has the potential to affect the GCF volume and NE activity.

Peri-implant crevicular fluid levels of cathepsin-K, RANKL, and OPG around standard, short, and mini dental implants after prosthodontic loading.

PURPOSE: Despite the high success rates of endosseous dental implants, their placement is restricted according to the height and volume of bone available. The use of short or mini dental implants could be one way to overcome this limitation. Thus, this study aimed to compare standard, short, and mini dental implants with regard to associated clinical parameters and peri-implant crevicular fluid (PICF) levels of cathepsin -K (CTSK), RANK ligand (RANKL), and osteoprotegerin (OPG), after prosthodontic loading. METHODS: A total of 78 non-submerged implants (Euroteknika, Aesthetica(+2), Sallanches, France) were installed in 30 subjects (13 male, 17 female; range, 26-62 years) who visited the clinic of the Periodontology Department, Faculty of Dentistry, Selcuk University. Sampling and measurements were performed on the loading date (baseline) and 2, 14, and 90 days after loading. Assessment of the peri-implant status for the implant sites was performed using the pocket probing depth (PPD), modified plaque index, modified gingival index, modified sulcular bleeding index, and radiographic signs of bone loss. PICF samples collected from each implant were evaluated for CTSK, RANKL, and OPG levels using the ELISA method. Keratinized tissue and marginal bone loss (MBL) were also noted. RESULTS: Clinical parameters statistically significantly increased in each group but did not show statistical differences between groups without PPD. Although implant groups showed a higher MBL in the upper jaw, only the standard dental group demonstrated a statistically significant difference. At 90 days, the OPG: sRANKL ratio and total amounts of CTSK for each group did not differ from baseline. CONCLUSIONS: Within the limitations of this study, both short and mini dental implants were achieving the same outcomes as the standard dental implants in the early period after loading.

Interleukin-1 receptor antagonist levels in gingival crevicular fluid and serum in nonsmoking women with preterm low birth weight and intrauterine growth retardation.

OBJECTIVE: The aim of this study was to evaluate interleukin (IL)-1 ß and IL-1 receptor antagonist (IL-1ra) levels in gingival crevicular fluid (GCF) and serum (S) in nonsmoking women with normal birth (NB), preterm low birth weight (PLBW), and intra-uterine growth retardation (IUGR). MATERIALS AND METHODS: In this unmatched case-control study design, 64 women with NB, 45 women with PLBW, and 47 women with IUGR were recruited within 24 h delivery. Clinical periodontal parameters were recorded. IL-1 ß and IL-1ra levels in GCF (pg/30 s) and serum (pg/ml) of were evaluated using commercial enzyme immunoassay and ELISA kits. RESULTS: Greater pocket depth and clinical attachment loss were observed in PLBW and IUGR women than in NB women (P < 0.05). The total amounts of IL-1ra and IL-ß of GCF were higher levels in NB women than PLBW and IUGR women (P < 0.05). The lowest total amount of IL-1ra of GCF was found in IUGR women (P < 0.05). The concentrations of IL-1ra in serum samples were not statistically significant for any of the study groups (P > 0.05). CONCLUSION: It can be suggested that worse periodontal conditions and the low levels of IL-1ra in GCF may be an important factor in adverse pregnancy outcomes.

Proinflammatory cytokines in temporomandibular joint synovial fluid before and after arthrocentesis.

OBJECTIVE: The aim of this study was to evaluate the levels of interleukin (IL)-1beta, IL-6, IL-8, IL-11, and tumor necrosis factor (TNF)-alpha in temporomandibular joint (TMJ) synovial fluid of the patients with internal derangement before and 2 weeks after arthrocentesis. STUDY DESIGN: Forty TMJs of 35 patients (29 females and 6 males, mean age 22.9 years) were included to the study. TMJs were divided into 2 groups: disc displacement with reduction (Group 1, n = 24) and disc displacement without reduction (Group 2, n = 16). Synovial fluid samples were obtained before and 2 weeks after arthrocentesis. IL-1beta, IL-6, IL-8, IL-11, and TNF-alpha concentrations were measured by using specific kits. RESULTS: Two weeks after the arthrocentesis procedures, all cytokines were found to be significantly decreased (P < .05) both in Group 1 and Group 2. The difference between 2 groups was insignificant (P > .05). CONCLUSION: Arthrocentesis is an effective technique for eliminating the studied cytokines from the TMJ synovial fluid.

The effect of endodontic therapy on periapical exudate neutrophil elastase and prostaglandin-E2 levels.

This study aimed to investigate periapical exudate neutrophil elastase (NE) and prostaglandin E2 (PGE2) levels and their relationships with clinical symptoms, and to determine the changes of their levels following first treatment visit. Periapical exudate samples were collected from the canals of 34 nonvital single-rooted teeth at two sequential treatment visits. Periapical exudate NE and PGE2 levels were found to be higher in the presence of clinical symptoms (pus discharge, swelling) (p < 0.05). The canals of teeth with larger periapical radiolucent area (>or=1 cm) contained more PGE2 levels than with smaller ones (<1 cm) (p < 0.05). Periapical exudate NE levels were significantly correlated with PGE2 levels (p < 0.05), and their levels at first treatment visit did not change following root canal therapy (p > 0.05). The periapical exudate NE and PGE2 levels may regulate periapical disease expression, but the results of this study were unable to reveal this association.

Comparisons of serum somatotropin, 3,5,3'-triiodothyronine, thyroxine, total protein and free fatty acid levels in newborn Sakiz lambs separated from or suckling their dams.

OBJECTIVE: To determine the effects on serum somatotropin, 3,5,3'-triiodothyronine (T(3)), thyroxine (T(4)), free fatty acids (FFAs) and total protein levels of different feedings and age in Sakiz sheep that have a high twin-bearing rate supported by estrous synchronization. METHODS: 20 newborn lambs were used in the study. Lambs were divided into 2 equal groups. The lambs in 1 group were separated from their dams following parturition, and those in other group were kept together with their dams. Separated lambs were fed commercial cow's milk for 2.5 weeks. After that, they were fed a milk substitute, hay and concentrated supplement for 2 months, and from the end of the 2 months they were fed hay and concentrated supplement. The lambs in other group were kept together with their dams only during the day and in addition were fed hay and concentrated supplement. After 2 months, they were maintained feeding only on hay and concentrated supplement. Blood samples were taken from vena jugularis of lambs at 12 and 24-48 h, and 14, 28, 42 and 56-90 days after parturition. Serum samples were analyzed for somatotropin by enzyme immunoassay, for T(3) and T(4) by radioimmunoassay, and for total protein and FFA by a spectrophotometric method. RESULTS: Serum somatotropin levels were insignificantly different between the lambs with and without their dams. Serum T(3) levels were generally lower in the separated lambs than those in other group. Serum T(4) levels were significantly lower in the separated lambs 48 h and 90 days after parturition than those in other group. Serum FFAs were insignificantly different between 2 groups. Serum total protein concentrations were lower in the separated lambs than lambs kept together with their dams (significantly at 12 and 48 h and 14 days). CONCLUSION: Ingestion of colostrum and dam milk markedly affected serum total protein levels, but body weight and serum somatotropin levels were insignificantly affected. Also serum T(3) and T(4) levels markedly decreased with advancing age. Serum FFA levels were not affected by the trial.

Neutrophil elastase levels in periapical exudates of symptomatic and asymptomatic teeth.

The aim of this study was to determine neutrophil elastase levels (NE) in periapical exudates and to evaluate its relationship with clinical signs and symptoms of endodontically involved teeth. A total of 42 teeth with periapical periodontitis of 37 patients were clinically examined and spontaneous pain, swelling, pain on palpation or percussion, sinus tract formation and pus discharge were recorded. Additionally, periapical lesion size was measured on periapical radiographs. Periapical exudate samples were obtained during routine root canal treatment by using paper points. Enzyme levels were determined by spectrophotometric assays using the NE specific substrate N-methoxysuccinil-Ala-Ala-Pro-Val-p-nitroanilide. The teeth with signs and symptoms showed higher NE levels than the teeth without symptoms (p<0.05). The differences were significant when NE levels were presented as total amounts instead of concentration. This study demonstrated that NE in periapical lesions related with clinical symptoms and total enzyme amount may be more reliable mode of data presentation.

Effects of smoking on clinical parameters and the gingival crevicular fluid levels of IL-6 and TNF-alpha in patients with chronic periodontitis.

OBJECTIVE: Smoking is an important environmental risk factor for the initiation and progression of periodontal diseases. The aim of this study was to evaluate the effects of smoking on clinical parameters and the gingival crevicular fluid (GCF) contents of the pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels in patients with chronic periodontitis. MATERIAL AND METHODS: The study base consisted of 41 patients including 22 volunteer current smokers with an age range of 32-59 (44.41+/-7.88) years and 19 volunteer non-smokers with an age range of 36-59 (46.94+/-6.07) years. The first month after non-surgical periodontal therapy was accepted as the baseline of the study. The clinical parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL) were recorded and GCF samples were collected for analysis of GCF contents of IL-6 and TNF-alpha levels. At the 3rd and 6th months, all of these procedures were repeated. RESULTS: In smokers, only CAL was significantly higher at the 3rd month compared with non-smokers (p<0.05). GI and BOP were higher in non-smokers than smokers in both periods (p<0.05). PI showed increases from the initial to the 6th month in smokers (p<0.05). Although the differences between two groups with regard to IL-6 and TNF-alpha were not significant (p>0.05), the total amount of TNF-alpha in GCF decreased from the initial to the 6th month in smokers (p<0.05). There were no significant correlations between the mean total amount of IL-6 and TNF-alpha in GCF and clinical parameters in both evaluation periods in smokers (p>0.05). CONCLUSION: The present study demonstrated that cigarette smoking increases the amount of dental plaque over time in smokers and does not influence GCF contents of IL-6 and TNF-alpha.

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