Initial attachment, subsequent cell proliferation/viability and gene expression of epithelial cells related to attachment and wound healing in response to different titanium surfaces.

OBJECTIVES: A tight seal between the epithelium and the dental implant surface is required to prevent bacterial inflammation and soft tissue recession and therefore to demonstrate a long-term success. Surface hydrophilicity was recently shown to promote osseointegration. The aim of this study was to investigate the influence of surface hydrophilicity in combination with surface topography of Ti implant surfaces on the behavior and activation/differentiation of epithelial cells using a set of in vitro experiments mimicking the implant-soft tissue contact. METHODS: Hydrophobic acid-etched (A) and coarse-grit-blasted, acid-etched (SLA) surfaces and hydrophilic acid-etched (modA) and modSLA surfaces were produced. The behavior of an oral squamous cell carcinoma cell line (HSC-2) grown on all surfaces was compared through determination of cell attachment and proliferation/viability (CCK-8 and MTT assay), time-lapse microscopy of fluorescence labeled cells and determination of gene expression by real time polymerase chain reaction. RESULTS: Within the surfaces with similar wettability cell spreading and cell movements observed by time-lapse microscopy after one day of incubation were most pronounced on smoother (A and modA) surfaces compared to rougher (SLA and modSLA) surfaces. Within the surfaces with similar roughness the hydrophilic surfaces (modA and modSLA) showed more cell spreading and cell activity compared to the hydrophobic surfaces (A and SLA). The relative gene expressions of cytokeratin14, integrin α6, integrin ß4, vinculin, transforming growth factor (TGF)-ß, TGF-ß1, and TGF-ß3 were decreased in HSC-2 on all four types of Ti surfaces compared to control surfaces (tissue culture polystyrene; p<0.01) and there was no significant difference of gene expression on the four different implant-surfaces. SIGNIFICANCE: We have demonstrated that for proliferation and spreading of HSC-2 cells the smoother and hydrophilic surface is optimal (modA). These results suggest that surface hydrophilicity might positively influence the epithelial seal around dental implants. All tested titanium surfaces downregulate cell attachment, cell proliferation, expression of adhesion promoters, and cytokines involved in wound healing in HSC-2 cells compared to control surfaces.

Anaerobic and microaerophilic pathogens in the biofilm formation on voice prostheses: A pilot study.

OBJECTIVES/HYPOTHESIS: Voice rehabilitation with voice prostheses is a standard therapy in laryngectomized patients. Biofilm formation on the surface of the voice prostheses causes device failure and requires frequent replacements. Studies analyzing the biofilm of voice prostheses have mainly focused on aerobic bacteria. Anaerobic bacteria as an integral part of the biofilms on voice prostheses have not been investigated yet. STUDY DESIGN: Prospective pilot study on the occurrence of anaerobic and microaerophilic pathogens in biofilm formation on voice prostheses. METHODS: Biofilm samples of 15 voice prostheses were analyzed using a polymerase chain reaction-based hybridization method regarding the presence of 11 selected anaerobic and microaerophilic pathogens. RESULTS: In 80% of the voice prostheses, at least one and up to 10 of the tested bacteria could be identified. Fusobacterium nucleatum was the pathogen most often present (73%). Other frequently occurring pathogens were Treponema denticola (40%), Tannerella forsythia (33%), and Eikenella corrodens (33%). There was no correlation between the number of identified bacteria and the indwelling times (mean, 127 days; maximum, 344 days; minimum, 22 days). CONCLUSIONS: For the first time, anaerobic and microaerophilic pathogens have been identified as part of the biofilm formation on the surface of voice prostheses. Those pathogens might be responsible for accelerated biofilm formation and reduced lifetime of the voice prostheses.

Salivary and serum chromogranin A and α-amylase in periodontal health and disease.

BACKGROUND: Salivary stress-related biomarkers in connection with periodontal disease have not been extensively studied. In addition to cortisol as a well-known marker of stress loading, chromogranin A (CgA) and α-amylase (AA) are supposed to link the activity of the neuroendocrine system to local and systemic immune functions and to be related to periodontitis. This study aims to determine CgA and AA in saliva and serum in periodontal health and disease to assess their potential relationship to periodontitis. METHODS: Patients with aggressive (AgP) (n = 24) and chronic periodontitis (CP) (n = 34) as well as healthy control (CO) (n = 30) individuals participated in this study. CgA and AA were determined in saliva and serum with enzyme-linked immunosorbent assay and an adapted clinical amylase test; salivary cortisol was determined using mass spectrometry. Clinical parameters of periodontal disease were evaluated, and their possible correlations with stress-related biomarkers were assessed. RESULTS: Significantly higher CgA levels were found in the saliva of patients with AgP compared with those in patients with CP and CO individuals (P <0.001). Salivary cortisol levels were higher in the AgP group compared with those in patients with CP (P <0.05). No differences in serum CgA levels and salivary and serum AA activities were found among all groups. A positive correlation was revealed between salivary AA activity or salivary CgA levels and the extent of periodontitis (P <0.05). CONCLUSION: The results suggest an association of CgA and cortisol levels as well as AA activity in saliva with periodontitis, especially a significant relationship of salivary CgA and cortisol to AgP.

Effect of enamel matrix derivative on proliferation and differentiation of osteoblast cells grown on the titanium implant surface.

OBJECTIVES: Enamel matrix derivative (EMD) is widely used in promoting periodontal regeneration, but the mechanisms underlying its effects are not entirely clear. In particular, the effect of EMD on osseointegration of dental implants and its application in the treatment of peri-implantitis are still debatable. The purpose of this study was to investigate the effect of EMD on proliferation and differentiation of osteoblasts grown on the Ti implant surface. STUDY DESIGN: Osteoblast-like MG-63 cells were seeded on coarse-grit-blasted and acid-etched surface Ti implant disks and stimulated with various EMD concentrations. Cell proliferation/viability, alkaline phosphatase activity, osteocalcin production, and expression levels of osteoprotegerin (OPG) and receptor activator of nuclear factor κB ligand (RANKL) were determined. RESULTS: EMD inhibited the proliferation/viability of MG-63 cells. Furthermore, EMD significantly increased the alkaline phosphatase activity and osteocalcin production in MG-63 cells grown on Ti surfaces. Finally, EMD enhanced mRNA expression level of OPG and did not influence that of RANKL. CONCLUSION(S): Application of EMD in the dental implantolology may have a positive effect on implant osseointegration, and further studies are required to improve clinical outcome.

Serum cytokine levels in periodontitis patients in relation to the bacterial load.

BACKGROUND: Periodontitis is a local inflammatory disease that also has some systemic effects. We investigated the levels of interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and interleukin (IL)-2, -4, -5, and -10 in the serum of patients with periodontitis in relation to the bacterial load in the dental plaques. METHODS: Serum cytokine levels in patients with generalized periodontitis and healthy control groups were determined using the cytometric bead array kit. Bacterial load in the dental plaque was determined semiquantitatively by real-time polymerase chain reaction. The proportions of different lymphocyte subsets were determined in the peripheral blood of patients with periodontitis by flow cytometry. Finally, relationships between the bacterial load in the subgingival plaques of patients with periodontitis and levels of cytokines and counts of lymphocyte subsets were established. RESULTS: Serum levels of IFN-γ, TNF-α, and IL-10 were significantly increased, whereas those of IL-2 were significantly decreased in patients with periodontitis compared to healthy controls. Increased serum levels of IFN-γ and TNF-α in patients with periodontitis were associated with the enhanced dental plaque load with Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) and Porphyromonas gingivalis, respectively. Finally, as revealed by analysis of lymphocyte populations, the presence of A. actinomycetemcomitans and Trepomena denticola was associated with an increased population of CD3(-)/CD16(+) and CD3(+)/CD8(+) cells, respectively. CONCLUSION: Certain periodontal pathogens could be associated with an increased level of proinflammatory cytokines in the peripheral blood and thus increased risk of systemic diseases.

Effect of cyclosporin A on proliferation and differentiation of human periodontal ligament cells.

OBJECTIVE: Cyclosporin A (CsA) is widely used to prevent rejection after organ transplantation. However, it also causes several side-effects, including gingival overgrowth and bone resorption. Cellular mechanisms underlying the effect of CsA on periodontal tissue remain unclear. In this study, we investigated the effect of CsA on the proliferation and expression of characteristic markers in periodontal ligament cells (PDLs). MATERIAL AND METHODS: The proliferation and viability of PDLs were measured by direct cell counting and 3,4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide assay, respectively. mRNA expression levels of the specific proteins alkaline phosphatase (ALP), osteocalcin (OC) and collagen type 1 (Coll-1) were quantified using real-time polymerase chain reaction. Finally, ALP activity of PDLs was investigated using a specific colorimetric assay. RESULTS: We found that proliferation of PDLs was stimulated by 0.01­0.1 µg/ml CsA and unaffected by 1 µg/ml CsA. The viability of PDLs was increased by 0.1 µg/ml CsA and not affected by 0.01 µg/ml and 1 µg/ml CsA. Furthermore, the mRNA expression levels of ALP, OC and Coll-1 in PDLs were significantly increased upon stimulation with 0.1 µg/ml CsA for 24 h or by stimulation with 0.01 µg/ml CsA for 48 h. In contrast, significantly lower expression levels of all three proteins in PDLs were observed upon stimulation with 1 µg/ml CsA for 48 h. The ALP activity of PDLs exhibited a similar pattern of changes upon CsA stimulation. CONCLUSION: Our data demonstrated that CsA may influence both the proliferation and differentiation of human PDLs, which may play an important role in the homeostasis of periodontal tissue.

Osteogenic properties of hydrophilic and hydrophobic titanium surfaces evaluated with osteoblast-like cells (MG63) in coculture with human umbilical vein endothelial cells (HUVEC).

OBJECTIVES: Osteogenesis on titanium (Ti) surfaces is a complex process involving cell-substrate and cell-cell interaction of osteoblasts and endothelial cells. The aim of this study was to investigate the osteogenic properties of Ti surfaces on osteoblasts in the presence of endothelial cells (ECs). METHODS: Osteoblast-like cells (MG63 cells) and human umbilical vein endothelial cells (HUVECs) were grown in cocultures on four kinds of Ti surfaces: acid-etched (A), coarse-grit-blasted and acid-etched (SLA), hydrophilic A (modA) and hydrophilic SLA (modSLA) surfaces. MG63 cells in single cultures served as controls. Cell ratios and cell types in cocultures were determined and isolated using flow cytometry. Cell numbers were obtained by direct cell counting. In MG63 cells, alkaline phosphatase (ALP) activity was determined and protein levels of osteocalcin (OC) and osteoprotegerin (OPG) were detected with enzyme-linked immunosorbant assay (ELISA). The mRNA levels of ALP, OC and OPG of sorted MG63 cells were determined with real time polymerase chain reaction (PCR). RESULTS: MG63 cells proliferated in the presence of HUVECs, which showed higher cell numbers on Ti surfaces (A, SLA, modSLA) after 72h, and lower cell numbers on Ti surfaces (modA, SLA, modSLA) after 120h in comparison to single cultures. Protein and mRNA levels of ALP and OPG were higher in cocultures than in single cultures, while OC exhibited a lower expression. These three parameters were higher expressed on modA, SLA and modSLA surfaces compared to A surfaces. SIGNIFICANCE: Cocultures of osteoblasts and endothelial cells represent the most recently developed research model for investigating osteogenesis and angiogenesis which play both a major role in bone healing. This paper investigates for the first time the osteogenic properties of titanium surfaces used for dental implants with a coculture system with osteoblast-like cells and endothelial cells: (1) In cocultures with ECs (HUVECs) osteoblast-like cells (MG63 cells) show enhanced expression of early differentiation markers and osteogenic factors on Ti surfaces compared to single cultures of MG63 cells. (2) The differentiation and the expression of an osteogenic phenotype of osteoblast-like cells (MG63 cells) in coculture with ECs (HUVECs) is enhanced by both hydrophilicity and roughness of Ti surfaces.

The proliferation and differentiation of osteoblasts in co-culture with human umbilical vein endothelial cells: An improved analysis using fluorescence-activated cell sorting.

The interaction of osteoblasts and endothelial cells plays a pivotal role in osteogenesis. This interaction has been extensively studied using their direct co-culture in vitro. However, co-culture experiments require clear discrimination between the two different cell types in the mixture, but this was rarely achieved. This study is the first to use fluorescence-activated cell sorting (FACS) for the separation and quantitative analysis of the proliferation and differentiation of MG-63 cells grown in direct co-culture with human umbilical vein endothelial cells (HUVECs). The cells of the MG-63 cell line have properties consistent with the characteristics of normal osteoblasts. We labeled HUVECs with fluorescent antibody against CD31 and used FACS to measure the proportions of each cell type and to separate them based on their different fluorescence intensities. The rate of proliferation of the MG-63 cells was estimated based on a count of the total viable cells and the proportion of MG-63 cells in the mixture. The mRNA expression levels of the osteoblast differentiation markers alkaline phosphatase (ALP), collagen type 1 (Coll-1) and osteocalcin (OC) in the MG-63 cells were measured via real-time PCR after the separation via FACS. We found that HUVECs stimulated the proliferation of the MG-63 cells after 72 h of co-culture, and inhibited it after 120 h of co-culture. The mRNA expression levels of ALP and Coll-1 significantly increased, whereas that of OC significantly decreased in MG-63 after co-culture with HUVECs. Using FACS for the quantitative analysis of the proliferation and differentiation of osteoblasts directly interacting with endothelial cells could have merit for further co-culture research.

Effect of Emdogain on proliferation and migration of different periodontal tissue-associated cells.

OBJECTIVES: Although Emdogain is widely used as a gel in periodontal therapy, the exact mechanisms underlying its regenerative ability still need to be further investigated. Therefore, we tested in vitro the effect of the product Emdogain on proliferation, viability, and migration of various human cell types of periodontium. STUDY DESIGN: Proliferation and viability of alveolar osteoblasts (AOBs), epithelial cell line HSC-2, and human umbilical vein endothelial cells (HUVECs) were measured using [(3)H]-thymidine uptake and 3,4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide (MTT)-assay, respectively. Cell migration was investigated in microchemotaxis chamber. RESULTS: The proliferation and viability of AOB, HSC-2, and HUVECs were significantly stimulated by Emdogain (12.5-250 microg/mL) in direct relationship with the amount of product present in the cell culture medium. Cell migration was stimulated in AOB and HUVECs depending on Emdogain amount. In contrast, in HSC-2 cells the migration was stimulated only by less than 50 microg/mL of Emdogain, whereas at higher amounts this stimulating effect was either diminished or absent. CONCLUSION: Emdogain stimulates proliferation, viability, and migration of AOB, HSC-2, and HUVECs in vitro. This biological versatility of Emdogain could correspond to an essential mechanism underlying its ability to promote periodontal regeneration.

Proliferation, behavior, and cytokine gene expression of human umbilical vascular endothelial cells in response to different titanium surfaces.

Success of dental implantation is initially affected by wound healing of both, hard and soft tissues. Endothelial cells (ECs) are involved as crucial cells in the angiogenesis and inflammation process of wound healing. In the present study, proliferation, mobility, cluster formation, and gene expression of angiogenesis-related molecules of human umbilical vascular endothelial cells (HUVECs) were investigated on titanium surfaces with different roughnesses: acid-etched (A), coarse-grit-blasted and acid-etched (SLA) surfaces, as well as on hydrophilic modified modA and modSLA surfaces. Cell behaviors were analyzed by proliferation assay and time-lapse microscopy, gene expression was analyzed by real time PCR. Results showed that cell proliferation, mobility, and cluster formation were highest on modA surfaces compared with all other surfaces. HUVECs moved slowly and exhibited seldom cell aggregation on SLA and modSLA surfaces during the whole observing period of 120 h. The gene expressions of the angiogenesis-related factors von Willebrand factor, thrombomodulin, endothelial cell protein C receptor, and adhesion molecules intercellular adhesion molecule-1 and E-selectin were most enhanced on modSLA surfaces. These results suggest that modA surface is optimal for proliferation and angiogenic behavior of ECs. However, modSLA surface seems to promote ECs to express angiogenesis-related factor genes, which play essential roles in controlling inflammation and revascularization of wound healing.

Controlled clinical, polysomnographic and psychometric studies on differences between sleep bruxers and controls and acute effects of clonazepam as compared with placebo.

The pathogenesis, pathophysiology, and pharmacotherapy of sleep bruxism (SB) are still not fully understood. We investigated symptomatology, objective and subjective sleep and awakening quality of middle-aged bruxers compared with controls and acute effects of clonazepam 1 mg compared with placebo by polysomnography and psychometry. Twenty-one drug-free bruxers spent 3 nights in the sleep lab, 21 age- and sex-matched controls 2 nights. Clinically, bruxers exhibited deteriorated PSQI, SAS, SDS and IRLSSG measures, polysomnographically impaired sleep maintenance, increased movement time, stage shift index, periodic leg movements (PLM) and arousals and psychometrically deteriorated subjective sleep and awakening quality, evening/morning well-being, drive, mood, drowsiness, attention variability, memory, and fine motor activity. As compared with placebo, clonazepam significantly decreased the SB index in all patients (mean: -42 +/- 15%). Sleep efficiency, maintenance, latency, awakenings and nocturnal wake time, the stage shift index, S1, PLM, the arousal index, subjective sleep and awakening quality, and fine motor activity improved.

Effects of enamel matrix derivative on proliferation/viability, migration, and expression of angiogenic factor and adhesion molecules in endothelial cells in vitro.

BACKGROUND: The aim of this study was to test in vitro the effect of enamel matrix derivative (EMD) on the proliferation/viability, migration, and expression of angiogenic factor and adhesion molecules in human umbilical vein endothelial cells (HUVECs). To date, discussions on angiogenic effects of EMD are rather controversial. METHODS: The effect of EMD on the proliferation/viability of HUVECs after 24 hours was measured using 3,4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide (MTT) assay and direct cell counting. Cell migration was observed in an especially adapted in vitro monolayer wound-healing model. The expression of angiogenic factor angiopoietin-2 (ang-2) and adhesion molecules intercellular adhesion molecule (ICAM)-1 and vascular endothelium-selectin (E-selectin) was quantified with real-time polymerase chain reaction (PCR). RESULTS: The proliferation/viability of HUVECs measured in MTT assay was stimulated by 0.1 microg/ml EMD and inhibited by higher doses (50 to 100 microg/ml), but the total number of cells was not affected. Cell migration in the wound-healing assay was promoted by EMD at doses of 0.1 to 50 microg/ml and inhibited at 100 microg/ml. The highest expression level of all three tested genes (ICAM-1, E-selectin, and ang-2) was observed at 50 microg/ml EMD. CONCLUSION: The results of the present in vitro study show the potential influence of EMD on the angiogenic activity of HUVECs, which may play an important role in periodontal tissue regeneration and wound healing.

Differentiation and cytokine synthesis of human alveolar osteoblasts compared to osteoblast-like cells (MG63) in response to titanium surfaces.

OBJECTIVES: The aim of this study was to investigate the influence of different implant surface topographies and chemistries on the expression of differentiation/proliferation markers on MG63 cells and primary human alveolar osteoblasts. METHODS: Hydrophobic acid-etched (A) and hydrophobic coarse-grit-blasted, acid-etched (SLA) surfaces and hydrophilic acid-etched (modA) and hydrophilic coarse-grit-blasted (modSLA) surfaces were produced. Thereby, modA and modSLA surfaces were rinsed under nitrogen protection and stored in a sealed glass tube containing isotonic NaCl solution at pH 4-6. Tissue culture plates without specimens served as controls. The behavior of MG63 cells and primary human alveolar osteoblasts (AOB) grown on all surfaces was compared through determination of alkaline phosphatase (ALP) activity, cell proliferation ((3)H-thymidin incorporation, MTT colorimetric assay) and expression of osteocalcin (OC), osteoprotegerin (OPG), transforming growth factor-beta1 (TGF-beta(1)) and vascular endothelial growth factor (VEGF), detected with commercial available test kits. RESULTS: Proliferation of MG63 and primary cells was highest on controls, followed by A surfaces, modA and SLA surfaces being almost on the same level and lowest on modSLA surfaces. modSLA surfaces exhibited highest ALP and OC production, followed by SLA, modA and A surfaces. Proliferation and OC production were comparable for MG63 cells and AOB. OPG, TGF-beta(1) and VEGF produced on primary cells showed a slightly different rank order on different surfaces compared to MG63 cells. modSLA still showed the highest production of OPG, TGF-beta(1) and VEGF, but was followed by modA, SLA and A. Statistical significance was checked by ANOVA (p<0.0035). SIGNIFICANCE: MG63 cells and primary human alveolar osteoblasts showed similar proliferation and differentiation characteristics on different titanium surfaces. Only modA surfaces showed enhanced expression of OPG, TGF-beta(1) and VEGF on MG63 cells compared to primary human alveolar osteoblasts. Overall, the lowest proliferation rates and the highest expressions of differentiation markers and growth factor productions were observed on modSLA.

Quantification of bone resorption in the interforaminal region of the atrophic mandible.

PURPOSE: This anatomic study was undertaken to examine the effects of atrophy on bone quantity and quality in the mandibular interforaminal region. MATERIALS AND METHODS: Three sections were made from each jaw studied, and each section was measured by means of a morphometric software program (Artma-Biomed, Vienna, Austria). The mandibular specimens were grouped according to the classification of Cawood and Howell and also according to that of Lekholm and Zarb. RESULTS: The macromorphometric measurements revealed that mandibular atrophy may cause the loss of up to 60% of the original bone mass. As the maximum width remained relatively consistent in all jaw sections, it can be assumed that the reduction in total area of each jaw section results from a reduction in mandibular height. The compact and cancellous bone portions were equally affected by resorption. The assessment of bone quality showed that most mandibles displayed a thick cortical compartment, especially inferiorly and lingually, with variations in the amount of cancellous bone. There was a clear predominance of bone types 2 and 3. DISCUSSION AND CONCLUSION: The interforaminal region of the mandible appears to be the site of choice for implantation, since it can be expected that the bone structure is well suited to provide the necessary stability even in severely atrophic mandibles. As the degree of alveolar ridge resorption does not depend on the patient's age but on the time elapsing postextraction, implants should be placed as soon as possible after tooth loss in order to avoid excessive resorption.

The initial attachment and subsequent behavior regulation of osteoblasts by dental implant surface modification.

The aim of this study was to investigate the influence of hydrophobic acid-etched (A) and coarse-blasted large-grit and acid-etched (SLA) surfaces as well as hydrophilic modified acid-etched (modA) and modified coarse-blasted large-grit and acid-etched (modSLA) surfaces on the behavior of MG63 cells grown on these surfaces through determination of cell attachment and cell proliferation, time-lapse microscopy of fluorescence-labeled cells, and determination of gene expression by reverse transcription-polymerase chain reaction (RT-PCR). No significant difference of cell attachment on various titanium surfaces was found. Increased cell proliferation was observed on the A surface and the SLA surface compared with the modA surface and the modSLA surface. After 2 days of incubation, on modSLA and modA surfaces a tendency of formation of cell clusters has been observed, which was most pronounced on modSLA surface. On the A and the SLA surface, cell cluster formation started after longer incubation periods. The expression level of the bone-associated genes (alkaline phosphatase, osteocalcin, type-I-collagen, osteoprotegerin, and glyceraldehyde-3-phosphate-dehydrogenase) detected by RT-PCR was highest on the modSLA surface. In conclusion it has been demonstrated that the modSLA surface results in an enhanced cluster formation of osteoblasts grown on this surface and in an increased expression of key osteogenic regulatory genes in osteoblasts.

Controlled clinical and psychometric studies on the relation between periodontitis and depressive mood.

BACKGROUND: Depressive mood is considered a risk factor for the development of periodontitis. OBJECTIVES: Investigation of the relationship between periodontitis and psychopathology utilizing psychometry (both observer- and self-rating scales). METHODS: Forty periodontitis patients were compared with 41 age- and sex-matched controls. The percentage of smokers was similar in both groups (30% versus 24.4%). Dental variables included probing depth, clinical attachment loss (CAL), radiographic loss of attachment, papillary bleeding index (PBI) and approximal plaque index (API). Psychometry comprised the Hamilton Depression Scale, the Zung Self-Rating Depression and Anxiety Scales, the von Zerssen Well-being and Complaint Scales, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Quality-of-Life Index, crystallized intelligence and the Freiburg Personality Inventory (FPI). RESULTS: Multifactorial analysis of variance demonstrated increased depression and anxiety scores, reduced well-being, increased somatic complaints, deteriorated quality of life and introversion in periodontitis. Partial correlation analyses between psychometric measures and dental variables revealed positive correlations of periodontal disease severity/CAL with the depression/anxiety, subjective well-being and complaints scores, and a negative correlation with quality of life. The API was negatively correlated with social orientation, and the CAL was positively correlated with somatic complaints and introversion in the FPI. CONCLUSION: Our clinical-psychometric studies confirm depressive mood as a relevant pathogenetic factor for periodontitis.

Interleukin-1beta-induced prostaglandin E2 production by human gingival fibroblasts is upregulated by glycine.

BACKGROUND: Human gingival fibroblasts (GFB) may produce prostaglandin E(2) (PGE(2)) in response to proinflammatory cytokines. Elevated concentrations of glycine were previously found in periodontal pockets and saliva of periodontitis patients and, therefore, we aimed to study the influence of glycine on PGE(2) production. METHODS: Human GFB were cultured in the presence of various concentrations of glycine and/or interleukin (IL)-1beta, tumor necrosis factor (TNF)-alpha, and IL-10 and their influence on PGE(2) production was measured. The expression of cyclooxygenases (COX) was analyzed by Western blot and immunocytochemistry. RESULTS: The PGE(2) production by IL-1beta-stimulated GFB was significantly upregulated by glycine. The effect of glycine on IL- 1beta-induced cell proliferation and PGE(2) production was concentration- dependent, reached a peak at 3 mM, and declined slowly at higher doses. The synthesis of PGE(2) by human GFB cultured in the absence of glycine was significantly inhibited by IL-10 and partially induced in cells cultured with glycine. Glycine had no effect on TNF-alpha-induced PGE(2) production. The IL-1beta-driven PGE(2) synthesis was blocked by indomethacin, a COX-1/COX-2 inhibitor, and by COX-2 inhibitor NS-398. The expression of COX-2 protein was slightly induced by glycine, more evidently by IL-1beta, and mostly enhanced by combined IL-1beta with glycine. CONCLUSION: Since PGE(2) is a potent stimulator of bone resorption, and production of PGE(2) and COX-2 protein is augmented by glycine, our results strongly suggest that glycine may be involved in the pathogenesis of periodontitis.