Relationship between preterm birth and post-partum periodontal maternal status: a hospital-based Romanian study.

PURPOSE: This cross-sectional case-control study of post-partum women aimed to estimate whether maternal periodontitis was a predictive contributor to preterm birth and to identify other risk factors associated with preterm birth in our target population. METHODS: The case group included women who delivered preterm (74 cases) and the control group included women who had a normal term delivery (120 controls). Medical records, a 16-item questionnaire, and a full-mouth periodontal examination were used to collect information about socio-demographic characteristics, general health problems, birth-related information, behavioral factors and periodontal status. Logistic regression analysis was used to estimate the strength of the relationship between predictors and the categorical outcome variable, preterm birth. RESULTS: The bivariate analysis revealed the significant associations between preterm birth and socio-demographic factors (educational level, p = 0.003), antepartum smoking habit (p = 0.001) and birth weight lower than 2500 g (p < 0.001). The multivariate analysis highlighted that the presence of post-partum maternal periodontitis and its severity remained independent risk factors of preterm birth in the presence of antepartum smoking habit and route of delivery [adjusted OR 2.26, 95% CI (1.06; 4.82), respectively, OR 3.46, 95% CI (1.08; 11.15)]. CONCLUSION: Post-partum maternal periodontal disease and its severity might, in part, be considered as contributor to preterm deliveries before 37 weeks of gestation.

Applications of inflammation-derived gingival stem cells for testing the biocompatibility of dental restorative biomaterials.

BACKGROUND: Normal or inflamed gingival tissues are regarded as a source of mesenchymal stem cells (MSCs) abundant and easily accessible through minimally invasive dental procedures. Due to the proximity of dental resin composites to gingival tissues and to the possible local cytotoxic effect of the eluted components, gingiva-derived MSCs could be used to investigate the biocompatibility of dental biomaterials. PURPOSE: The present research aimed to isolate (MSCs) from inflamed and normal gingiva, to fully characterize them and to observe their behavior in relation with some commercial resin composite materials and one experimental material. MATERIAL AND METHODS: Following their isolation, putative MSCs from both gingival sources were grown under the same culture conditions and characterized by immunophenotyping of cell surface antigens by flow-cytometry and transcription factors by immunocytochemical staining. Moreover, stemness gene expression was evaluated by RT-PCR analysis. Multipotent mesenchymal differentiation potential was investigated. Osteogenic and neurogenic differentiated cells were highlighted by immunocytochemical staining, chondrogenic cells by cytochemical staining, and adipocytes by cytochemical staining and spectrophotometry, respectively. Resin composite cytotoxicity was evaluated by cell membrane fluorescent labeling with PKH 26 and MTT assay. The results of PKH labeling were statistically analysed using two-way RM ANOVA with Bonferroni post-tests. For MTT assay, two-way RM ANOVA with Bonferroni post-tests and unpaired t test with Welch's correction were used. RESULTS: A similar expression pattern of surface markers was observed. The cells were positive for CD105, CD73, CD90, CD49e, CD29, CD44 and CD166 and negative for CD45, CD34, CD14, CD79, HLA-DR and CD117 indicating a mesenchymal stem cell phenotype. The qRT-PCR analysis revealed a low gene expression for NOG, BMP4 and Oct3/4 and an increased expression for Nanog in both cells lines. Immunocytochemical analysis highlighted a more intense protein expression for Nanog, Oct3/4 and Sox-2 in MSCs derived from normal gingiva than from inflamed gingiva. Multipotent differentiation capacity of MSCs isolated from both sources was highlighted. The tested materials had no hazardous effect on MSCs as the two cell lines developed well onto resin composite substrates. Cell counting revealed some significant differences in the number of PKH-labeled MSCs at some experimental moments. Also, some differences in cell viability were recorded indicating better developmental conditions offered by some of the tested biomaterials. CONCLUSIONS: The experimental resin composite behaved like the most biocompatible commercial material. Inflamed gingiva-derived MSCs retain their stem cell properties and could be used as a valuable cell line for testing dental biomaterials.

The impact of some behavioral aspects on periodontal disease in a group of Romanian students - an epidemiological survey.

AIMS: To investigate the prevalence of periodontitis in a young population representative for the North-western part of Romania (Transylvania) and to identify possible risk indicators of periodontitis. METHODS: The study is a cross-sectional epidemiological survey. The subjects were students randomly sampled from three universities in Cluj-Napoca and high school students from the neighboring city of Bistrita. The sample size of the population was calculated. Overall, 623 subjects aged 16-35 years were evaluated, of which 488 were university students and 135 high school students. A structured questionnaire was administrated to collect information on socio-behavioral status and oral hygiene habits. Periodontal data was collected using a full-mouth methodology by trained examiners. A recent introduced case definition was used to pick up periodontitis cases. RESULTS: The older the subject, the more frequent toothbrushing, dental visits, and use of interproximal hygiene devices, but also addiction to tobacco and alcohol consumption. The prevalence of periodontitis was 0.96% (n=6). Half of these subjects (n=3, 0.48%) were considered to have aggressive periodontitis (AP). Low frequency of toothbrush changing was identified to influence the development of periodontitis. Smoking and lower socioeconomic level did not seem to correlate with periodontal disease in the present study. CONCLUSIONS: In order to better understand the prevalence of periodontal diseases and identify periodontitis cases as well as to evaluate the impact of specific behavioral factors on the disease development in individual and population levels, further extensive screenings are obviously required. Periodontal prevention programs focusing on oral health behavior are mandatory.

Subepithelial connective tissue graft with or without enamel matrix derivative for the treatment of Miller class I and II gingival recessions: a controlled randomized clinical trial.

BACKGROUND: The aim of this study was to evaluate whether the combination of enamel matrix derivative (EMD) with subepithelial connective tissue graft (SCTG) plus coronally advanced flap (CAF) would improve the treatment outcomes of Miller class I and II gingival recessions when compared with the same technique (SCTG plus CAF) alone. METHODS: The study was designed as a randomized, parallel, controlled, double-blinded clinical trial. Forty-two patients were randomly assigned in the test group (SCTG plus EMD) and in the control group (SCTG). Patients had at least one gingival recession ≥ 2 mm. The clinical parameters were evaluated at baseline and at 14 d, 1, 3, 6 and 12 mo follow-up time points. RESULTS: Forty-two patients, 21 in the test group (SCTG plus EMD) and 21 in the control group (SCTG), aged 21-48 years (mean age 31 ± 8.56) were initially included in the study. Both treatments, STCG plus EMD and SCTG, resulted in a significant final mean root coverage (2.91 ± 0.95mm and 2.91 ± 1.29 mm, respectively) (p < 0.001) and in a high mean percentage of root coverage (82.25 ± 22.20% and 89.75 ± 17.33%, respectively) (p < 0.001), 1 year after surgery. The differences in mean root coverage recorded for the two techniques after 1 year, were not statistically significant (p = 0.19). Complete root coverage was achieved in 56.5% of patients treated with SCTG plus EMD and in 70.6% of patients treated with SCTG (p = 0.275), 1 year after treatment. CONCLUSIONS: The present study failed to demonstrate any additional clinical benefits when EMD was added to SCTG plus CAF.