Interleukin-1 beta levels in gingival crevicular fluid in type 2 diabetes mellitus and adult periodontitis.

Interleukin-1 beta (IL-1beta) is a potent bone-resorptive cytokine that also mediates soft-tissue destruction by stimulating prostaglandin production and inducing collagenase and other protease activity. The literature suggests that this substance may be an important mediator of attachment loss in human periodontitis, and indicates that IL-1beta may be useful for locating sites of periodontal disease activity. There is some evidence that IL-1beta is produced by cells of the periodontium, and that it can be detected in gingival crevicular fluid (GCF). Many factors are known to contribute to the destruction of periodontal tissue. One of the most important is immune deficiency in diabetes. The aim of this study was to measure and compare the concentration of IL-1beta in the GCF of patients with non-insulin-dependent diabetes mellitus (Type 2 DM), otherwise healthy adults with periodontitis, and individuals with no periodontal disease in order to assess whether diabetes alters IL-1beta levels. We also examined relationships between GCF levels and the clinical parameters of pocket depth, plaque index, and bleeding index in each group. Seventeen patients with Type 2 DM, 17 adult periodontitis patients (AP), and 17 healthy controls were selected. The levels of IL-1beta in the GCF were quantified by ELISA. The mean IL-1beta concentrations in the Type 2 DM, AP, and control groups were 200.1 +/- 65.34 pg/microl, 131.35 +/- 67.66 pg/microl, and 80.0 +/- 36.08 pg/microl, respectively. The levels in the diabetic patients were significantly higher than those in the AP and control subjects. There were no significant correlations between IL-1beta level and any of the clinical data parameters for each group. We believe that the macrophages may over produce IL-beta in Type 2 DM and increased IL-1beta levels in diabetic patients could be linked to altered immune function.

IL-6 levels in gingival crevicular fluid (GCF) from patients with non-insulin dependent diabetes mellitus (NIDDM), adult periodontitis and healthy subjects.

Cytokines play an important role in the pathology associated with chronic inflammatory diseases. One of these cytokines, interleukin 6 (IL-6) is a major mediator of the host response to tissue injury, infection and bone resorption. In the present study, gingival crevicular fluid (GCF) level of IL-6 was determined in patients with non-insulin dependent diabetes mellitus (NIDDM) with periodontitis, adult periodontitis, and healthy controls by use of an enzyme linked immunosorbent assay (ELISA). Twenty-four NIDDM patients with periodontitis, twenty-four adult periodontitis and twenty-four healthy controls were selected for the study. GCF sampling was performed on the vestibular aspects of maxillary incisors and canine teeth. Plaque index (PI), gingival index (GI), gingival bleeding time index (GBTI), probing depth (PD) and probing attachment levels (PAL) were recorded from each sampling area and also the entire dentition. NIDDM and adult periodontitis patients had numerous sites with radiographic evidence of alveolar bone resorption, loss of attachment and pocket depth greater than 3 mm. The mean GCF IL-6 level was 2.43 +/- 0.97 ng/ml in NIDDM patients, 1.31 +/- 0.92 ng/ml in adult periodontitis and 0.62 +/- 0.58 ng/ml in healthy subjects, respectively (p < 0.05). GCF IL-6 levels were markedly higher in NIDDM and adult periodontitis groups compared to the healthy controls. No correlation was found between GCF IL-6 levels and all clinical parameters. These findings suggested that GCF IL-6 levels were significantly higher in the area of inflammation and periodontal destruction locally. The high IL-6 levels in NIDDM patients might be due to different microbial flora in periodontal pockets and altered immune system. Future studies are needed to evaluate the complex interaction among IL-6 GCF levels, host response and local microbial environment in the NIDDM patients.

Comparison of the antibacterial effects on subgingival microflora of two different resorbable base materials containing doxycycline.

A study was conducted to evaluate the effects of local drug delivery on subgingival plaque flora using hydroxypropylmethylcellulose (HPMC) and methylcellulose (MC) base material containing 40% doxycycline (DOXY). Eleven patients who had at least four pockets exceeding 5 mm in depth associated with a single rooted tooth were selected from volunteers after an initial examination. Two of the pockets were chosen at random for insertion of the HPMC and MC strips twice a week for 6 w. One pocket received no treatment, and the other was debrided and root-planed only. Baseline and follow-up measurements at 0, 1, 3, 6, and 10w included probing depth, gingival shrinkage, bleeding on probing and crevicular fluid flow. Subgingival bacterial samples were also taken for dark-field microscopy. In vitro drug release from the HPMC strips was greater than that from MC. Significant improvements in many clinical parameters occurred in the pockets treated with HPMC or MC strips, or mechanical debridement. There was a marked decrease in the relative proportions of motile organisms during and after treatment.

Use of membranes containing 20% chlorhexidine and 40% doxycycline for treatment of chronic periodontal pockets.

A study was carried out to compare the effects of subgingival applications of resorbable hydroxypropylmethylcellulose (HPMC) membranes containing 20% chlorhexidine (CHx) and 40% doxycycline (DOXY) placed subgingivally in periodontal pockets greater than 5 mm in depth. Each of 11 patients had at least four pockets. HPMC strips containing CHx and DOXY were inserted into each pocket twice a week for 6 w. One pocket was kept as a control and the other received subgingival scaling and root planing at 0, 1, 3 and 6 w. The microbial flora of 44 pockets from the 11 patients was examined using dark-field microscopy at the baseline and at 1, 3, 6 and 10 w. Clinical parameters including probing depth, crevicular fluid flow, bleeding on probing and gingival shrinkage were also recorded. The CHx and DOXY-administered or root-planed pockets showed marked reduction of both pocket depth and the number of motile organisms. Less bleeding was also observed in CHx and DOXY-inserted pockets.

Blood flow to human gingiva measured by the 133Xe clearance technique.

Blood flow to the maxillary and mandibular gingivae was determined in 9 subjects under both normal conditions and in inflammation using the 133Xe clearance technique. A total of 36 sites (18 healthy and 18 inflamed) were selected for 133Xe injection. The clearance of radioactivity was monitored by a gamma camera. The calculated mean blood flows were 51.1 +/- 11.4 and 48.7 +/- 6.7 ml/100 g/min to the normal maxillary and mandibular gingivae, respectively. In inflamed gingiva, the corresponding mean blood flows were 55.0 +/- 13.0 and 54.7 +/- 11.7 ml/100 g/min, respectively. A statistical comparison of the healthy and diseased sites was done according to the paired t and Student's t tests. The difference between the sites was not significant (p > 0.05) in the maxilla, but significant (p < 0.05) in the mandible. There was no significant difference (p > 0.05) when the total healthy and diseased sites were compared.

[A clinical study to evaluate the anticalculus effect of a dentifrice on calculus formation]. / Anti-kalkulus özellikli bir dismacununun distasi olusumuna etkisinin klinik degerlendirilmesi.

Calculus plays an important role in chronic inflammatory periodontal diseases. Currently, there is much interest in dentifrices that have the capacity to reduce the formation of calculus. Recent clinical studies have indicated that dentifrices containing soluble pyrophosphate and sodium fluoride can reduce the formation of supragingival calculus. The purpose of this study was to compare the effect on supragingival calculus of a dentifrice containing soluble pyrophosphate and 0.24% sodium fluoride to a placebo dentifrice. Thirty five subjects were stratified into balanced groups based on initial calculus scores. They then received an oral prophylaxis and were assigned to the use of either the placebo or soluble pyrophosphate/sodium fluoride dentifrice for the next 3 months. The results from the 3-month examinations indicated that the dentifrice containing the soluble pyrophosphate and sodium fluoride did not significantly reduce supragingival calculus as compared to the placebo dentifrice. However, both dentifrices reduced the calculus significantly.

[Investigation into the effect of citric and phosphoric acids on planed root surfaces using S.E.M]. / Küretaj uygulanmis kök yüzeylerinde sitrik ve fosforik asit etkisinin tarama elektron mikroskopta (SEM) incelenmesi.

The aim of the present study was to evaluate the effect of citric and phosphoric acid conditioning the diseased root surface on periodontally extracted teeth. Citric acid pH1 and 50 per cent phosphoric acid were topically applied to thoroughly scaled and planed root surfaces for one to three minutes. The specimens were then processed for scanning electron microscopy (S.E.M.) Root surfaces that had received acid treatment after root planing exhibited no smear layer and the overall surface appeared to have an undulating morphology. Whereas, examination of nonacid-treated specimens showed the presence of a smear layer. Furthermore, phosphoric acid treated surfaces demonstrated more irregularity with increasing application time.