Interaction between hypertension and periodontitis.

OBJECTIVE: The possible association between hypertension and periodontitis and the effect of hypertension on periodontal treatment were investigated by evaluating salivary and gingival crevicular fluid (GCF) interleukin (IL)-6 and C reactive protein (CRP) levels. METHODS: Forty-two healthy individuals without any previously diagnosed systemic disease [10 periodontally healthy (control) and 10 periodontitis (CP)] and subjects with hypertension [13 periodontally healthy (HP) and 9 with periodontitis (CP + HP)] participated in the study. GCF and saliva samples were obtained at baseline and 4 weeks after Phase I periodontal treatment. Biochemical parameters were analyzed using ELISA. RESULTS: Before the periodontal treatment, significantly higher GCF IL-6 and CRP levels were detected in CP + HP and CP groups compared to HP and control groups (p < 0.01). Salivary CRP level in CP + HP group was found to be higher than the control group (p < 0.05). Statistically significant gingival and plaque index measurements (p < 0.01) might suggest a possible effect of hypertension on periodontal status. Periodontal treatment significantly improved the clinical indices; however, biochemical parameters did not change after the treatment. CONCLUSION: The association of hypertension with periodontitis through local salivary and GCF inflammatory mediators might be possible in disease process.

Gingival crevicular fluid levels of osteoprotegerin (OPG) in premenopausal and postmenopausal women with or without chronic periodontitis.

OBJECTIVES: Systemic conditions may affect host susceptibility, disease progression and severity as well as treatment response. Previously, low oestrogen (E(2)) levels were associated with increased bone resorption, due to increased osteoclastogenesis and decreased osteoclast apoptosis. Osteoprotegerin (OPG) is an essential cytokine for osteoclastogenesis. The aim of this study was to evaluate gingival crevicular fluid (GCF) OPG levels in menopausal and premenopausal patients with or without periodontitis, and effects of phase I periodontal therapy on GCF OPG levels. METHODS: Forty-four systemically healthy premenopausal and menopausal patients were recruited and divided into subgroups of periodontitis and control. Bone mineral density (BMD) and serum E(2) levels were measured. Before and after phase I periodontal therapy clinical indices, including clinical attachment levels (CAL) were recorded, and GCF samples were collected. GCF OPG levels were detected by enzyme-linked immunosorbent assay. Repeated measurement ANOVA and Spearman correlation tests were used. RESULTS: All clinical indices improved significantly after treatment(p<0.001), except Pre-M/C groups CAL reduction(p>0.05). Periodontitis groups' OPG levels were lower than gingivitis groups(p>0.05). Following periodontal phase I therapy, GCF OPG levels increased markedly in all groups, however this alteration was found statistically insignificant (p>0.05). CONCLUSIONS: The current data revealed that GCF OPG levels were lower in periodontitis patients and phase I therapy resulted with increased GCF OPG levels, however those alterations were statistically insignificant. In addition, present data suggested that menopause do not seem to have a significant effect on periodontal status or response to phase I treatment, within the limits of this study.

Arginine-nitric oxide-polyamine metabolism in periodontal disease.

BACKGROUND: Arginine is converted to nitric oxide (NO) via NO synthase and to ornithine via arginase. Ornithine decarboxylase (ODC) catalyzes the conversion of ornithine to polyamines. Arginase can inhibit NO production, and NO can inhibit ODC activity as part of an early inflammatory response. This study examines the arginine-NO-polyamine pathway alteration in saliva and gingival biopsy samples of patients with gingivitis or periodontitis and healthy controls and evaluates the response to periodontal treatment. METHODS: This study includes nine gingivitis patients, 15 chronic periodontitis patients, and 11 healthy age-matched controls. Periodontal clinical measurements, gingival biopsies, and saliva samples were obtained before treatment (BT) and 1 month after periodontal treatment (AT). Arginase and ODC activities and NO levels were determined spectrophotometrically. RESULTS: The BT salivary and gingival NO levels were found to be highest in the gingivitis group, followed by the healthy and the periodontitis groups, respectively. Salivary NO levels significantly increased in the periodontitis group and decreased in the gingivitis group AT (P <0.05). Gingival NO levels decreased significantly in the periodontitis and the gingivitis groups AT (P <0.05). Arginase levels were detected highest in the gingivitis group and lowest in the periodontitis group, both in saliva and gingiva. Only gingival arginase levels significantly increased AT (P <0.05). ODC activity was highest in saliva, and lowest in the gingiva of the periodontitis patients BT. It was found to be significantly higher in the periodontitis group AT (P <0.05). CONCLUSIONS: In this study, regarding arginine-NO-polyamine metabolism, gingival tissue seems to be more informative about periodontal pathogenesis than saliva. At early phase of periodontal inflammation, NO arginase and ODC levels were measured as higher than at an established lesion of periodontitis.