Citrullination in periodontium is associated with Porphyromonas gingivalis.

OBJECTIVE: To analyse the citrulline level in the periodontium in association with the presence of or antibody levels against Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. DESIGN: Gingival crevicular fluid (GCF), subgingival biofilm and blood serum were sampled from 98 subjects (26 with RA, 72 without RA (NoRA)). GCF was analyzed for the level of citrulline, for interleukin (IL)-1ß, IL-17, IL-10 and monocyte-chemoattractant protein (MCP)-1. Microorganisms were identified in subgingival biofilms. Antibodies againstP. gingivalis, and Aggregatibacter actinomycetemcomitans were quantified in serum. RESULTS: GCF citrulline level was the lowest (by trend) in NoRA group without periodontitis. In NoRA, but not in RA an association between GCF citrulline level and P. gingivalis antibody levels was found and the GCF citrulline levels were higher in P. gingivalis positive samples. Any association of A. actinomycetemcomitans with GCF citrulline level did not exist. A model of univariate variance analysis (p = 0.001) showed a dependence of GCF citrulline level from the number of sites with PD (probing depth) ≥5 mm (p = 0.003) and the GCF MCP-1/CCL2 level (p = 0.019). Compared with NoRA in RA the number of teeth was lower, the number of sites with PD ≥ 5 mm was less, GCF levels of interleukin-17 and MCP-1/CCL2 were higher and those of IL-10 lower. Yeasts were only cultured in 15 RA patients (p < 0.001). CONCLUSION: Citrullination in periodontium might be associated with P. gingivalis supporting the potential role as a trigger in the development of RA. Pathogenesis of periodontal disease in RA patients seems to differ from that in NoRA and should be investigated further.

Activity of taurolidine gels on ex vivo periodontal biofilm.

OBJECTIVES: The purpose of this study is to evaluate the activity of two different taurolidine (TAU) gels in comparison with a 0.2% chlorhexidine (CHX) gel on an ex vivo subgingival biofilm. MATERIAL AND METHODS: Subgingival including supragingival biofilm samples from periodontitis patients were cultured for 10 days, before TAU 1% and TAU 3% gels and CHX gel were applied for 10 min and thereafter diluted with nutrient media to 10% for 50 min. One third of the samples were analyzed for bacterial counts, biofilm quantity, and biofilm metabolic activity. In the two other thirds, 90% of the nutrient media were replaced and biofilms were incubated for 23 h. The second third was analyzed in the same way as before. In the third part, patients' microorganisms were added again and incubated for additional 24 h to allow reformation of biofilm before proceeding to analysis. RESULTS: Decrease of bacterial counts in biofilms was highest following application of TAU 3% after 60 min (0.87 log10 cfu, corresponding 86.5%), 24 and 48 h (reformation of biofilms), respectively. All antimicrobials reduced biofilm quantity after 24 h (each p < 0.05) and following reformation of biofilms (each p < 0.01). Metabolic activity in biofilms was decreased at 60 min (each p < 0.05) and at 24 h (each p < 0.01) after application of TAU gels, while the activity of the reformed biofilm was lower after application of all evaluated antimicrobials (each p < 0.01) than in the control group (e.g., without exposure to antimicrobials). CONCLUSION: The antimicrobial activity of taurolidine gels clearly depends on its taurolidine concentration. A high concentrated taurolidine gel is equally active or even superior to 0.2% chlorhexidine gel. However, the activity of antimicrobials is limited in a complex established biofilm and underlines the pivotal role of mechanical biofilm disruption. CLINICAL RELEVANCE: Within their limits, the data suggest that TAU 3% gel might represent a potential alternative to 0.2% chlorhexidine gel.