Evaluation of the Effect of Occlusal Calibration in Periodontitis Patients with Occlusal Trauma Using T-Scan.

BACKGROUND: High occlusal forces in patients with untreated periodontitis may reflect occlusal trauma-associated periodontal conditions. Occlusal analysis using T-scan might provide the distribution of occlusal loading forces in periodontitis patients. The study aimed to evaluate the effect of occlusal trauma in periodontitis patients and occlusal calibration using a T-scan. MATERIALS AND METHODS: A total of 30 periodontitis patients were recruited for the study. Patients were categorized into two groups: Group I: scaling and root planing followed by T-scan recording and no occlusal calibration; Group II: scaling and root planing followed by occlusal calibration using T-scan. Clinical parameters, orthopantomogram (OPG) and T-scan evaluation were evaluated at baseline, 3-month and 6-month intervals. RESULTS: Significant improvements in clinical parameters were noted at different time intervals after occlusal calibration using T-scan. At 3-month intervals, mean pocket depth showed statistically significant difference among the test group in the right (upper and lower) and left lower quadrant at P = 0.01, 0.002 and 0.005, respectively. Mean clinical attachment level (CAL) showed statistically significant difference among the test group in the right upper, right lower and left lower quadrants at P = 0.02, 0.001 and 0.009, respectively, at 3 months. The comparison of the mean gingival index (GI) at 6 months showed statistically significant difference among test and control groups at 6 months in different study quadrants (P = 1 in right upper, 0.009 in right lower, <0.001 in left upper and <0.001 in left lower). Mean pocket depth at the 6-month follow-up showed statistically significant difference among the test group in all the study quadrants (P = <0.001 in right upper, <0.001 in right lower, 0.003 in left upper and 0.005 in left lower). Mean CAL showed statistically significant difference among the test group in all the study quadrants at 6-month intervals (P = 0.02 in right upper, <0.001 in right lower, 0.01 in left upper and 0.04 in left lower). The bone defect height showed a statistically significant difference only in the right upper quadrant among both the test groups at the 6-month follow-up (P = 0.02). Comparing the mean percentage of force on both sides of the jaw showed a statistically significant difference among the test group at 6 months (P = 0.001 on the left side and 0.001 on the right side). CONCLUSION: The occlusal correction using T-scan showed a positive association between probing pocket depth (PPD) and CAL at different time intervals from baseline to 6 months when these parameters were compared after occlusal adjustments.

Efficacy and Viability of Subgingival Application of Probiotics as an Adjunct to Scaling and Root Planing in Periodontitis.

AIM: This study aimed to compare the efficacy of subgingivally applied probiotics as an adjunct to scaling and root planing (SRP) vs SRP alone in patients with periodontitis. MATERIALS AND METHODS: Patients diagnosed with periodontitis, with probing pocket depth (PPD) of 5-7 mm on at least two teeth on contralateral sites, were selected for the study and randomly allocated to the test group (n = 31) who underwent SRP along with subgingival application of probiotic paste and the control group (n = 31) who underwent only SRP. Clinical parameters were evaluated in both groups at baseline and after 12 weeks. The viability of probiotic bacteria was evaluated in the test group at baseline, day 4 and day 8. RESULTS: All clinical parameters showed a statistically significant difference between baseline and 12 weeks on intragroup and intergroup comparison, with a greater improvement in the test group. Microbiological evaluation showed that the mean colony-forming units (CFUs) in the test group were 38.39 ± 7.76, 7.25 ± 2.72 and 1.57 ± 1.29 at baseline, day 4 and day 8, respectively. The mean CFUs significantly reduced with an increase in time from baseline to 8-day time interval. CONCLUSION: It was seen that the probiotic bacteria remained viable in the periodontal pocket for up to 8 days after placement, but stable improvements were seen in all clinical parameters even at 12 weeks, indicating its prolonged efficacy. Thus, commercially available probiotics can prove to be an inexpensive method to treat periodontitis when combined with SRP.

Role of diet in primary and secondary prevention of periodontitis and non-specific inflammatory bowel diseases. Part II.

INTRODUCTION AND OBJECTIVE: Both periodontitis and non-specific bowel diseases (IBD) are complex chronic diseases, and the elements connecting them are the dysregulated microbiota and abnormal immune response of the host. In turn, in the etiology of these diseases, the common environmental risk factor is improper mode of nutrition. The aim of the study is to review nutritional interventions and effective nutritional protocols applied in periodontitis and IBD. The result of the review will be identification of dietary recommendations exerting a beneficial effect on the reduction of the risk of development and alleviation of the severity of both diseases. At the same time, non-recommended dietary choices will be indicated. REVIEW METHODS: A review of literature was carried out using the databases PubMed, Google Scholar, and Web of Science. Publications were analyzed by a non-systematic literature review aimed at making a brief synthesis of the collected information. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: Diets recommended to patients with both periodontitis and IBD included the Mediterranean diet, DASH diet and vegetarian diet; excluding veganism, raw foodism and fruitarianism. For patients with IBD, special dietary recommendations were elaborated on the recommendations of the International Organization for Research into Inflammatory Bowel Diseases (IOIBD), and specific diets, i.e. specific carbohydrate diet (SCD), and Groningen anti-inflammatory diet (GrAID). In the process of treatment of oral and intestinal dysbiosis, probiotic therapy is beneficial in both diseases, specified as the Western diet. Non-conventional diets are not recommended. SUMMARY: Diet therapy for inflammatory periodontal diseases and IBD requires extensive individualization; nevertheless, a universal principle is avoidance of highly processed food, and implementation of easily digestible meals based on natural, ecological products. Proper nutrition plays a crucial role in primary prevention of both diseases analyzed, whereas in secondary prevention, diet therapy is a valuable supplementation of pharmacotherapy.

Galectin-3 inhibition alleviated LPS-induced periodontal inflammation in gingival fibroblasts and experimental periodontitis mice.

OBJECTIVES: Clinical studies have confirmed that galectin-3 (Gal-3) levels are significantly elevated in periodontitis patients. The present study aimed to explore the effects of Gal-3 inhibition on periodontal inflammation in vitro and in vivo. METHODS: Human gingival fibroblasts (HGFs) with or without Gal-3 knockdown were stimulated by lipopolysaccharide (LPS), and a ligation-induced mouse periodontitis model treated with a Gal-3 inhibitor was established. Hematoxylin-eosin (H&E) and immunohistochemistry (IHC) staining were used to evaluate Gal-3 levels in gingival tissues. Quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) were used to detect Gal-3, interleukin (IL)-6, IL-8, and C-C motif ligand 2 (CCL2) expression. Immunofluorescence and western blotting were used to detect NF-κB and ERK signaling pathway activation. Micro-computed tomography was used to analyse the degree of bone loss. RESULTS: Gal-3 was significantly up-regulated in inflamed gingival tissues and LPS-induced HGFs. Gal-3 knockdown markedly decreased LPS-induced IL-6, IL-8, and CCL2 expression and blocked NF-κB and ERK signaling pathway activation in HGFs. In the mouse periodontitis model, Gal-3 inhibition significantly alleviated IL-1ß and IL-6 infiltration in gingival tissue and mitigated periodontal bone loss. CONCLUSIONS: Gal-3 inhibition notably alleviated periodontal inflammation partly through blocking NF-κB and ERK signaling pathway activation.

Glycemic Control and Oral Health Outcomes in Patients With Diabetes: Insights From a Nationwide Korean Survey.

BACKGROUND: Diabetes is recognized as a risk factor for various inflammatory conditions, including periodontitis. There exists a bidirectional relationship between glycemic control and oral health in individuals with diabetes. This study aimed to analyze the link between glycemic control and oral health status among Korean patients with diabetes. METHODS: Using data from a population-based nationwide survey conducted between 2007 and 2019, we identified 70,554 adults with diabetes-related information. The study population included 9,090 individuals diagnosed with diabetes and 61,164 healthy controls. The association between glycemic control, defined by mean glycated hemoglobin (HbA1c) values, and various oral health measures, such as tooth brushing frequency, periodontitis, denture wearing, Decayed, Missing, and Filled Teeth (DMFT) index, number of remaining teeth, and past-year dental clinic visits, was evaluated using multivariate logistic regression analyses. RESULTS: Compared to the control group, patients with diabetes exhibited a higher prevalence of periodontitis (88.6% vs. 73.3%), complete dentures (5.0% vs. 1.5%), and elevated DMFT index (33.2% vs. 26.7%) (all P < 0.001). Multivariate analyses revealed significant associations between diabetes and several oral health factors: denture status (No denture: adjusted odds ratio [aOR], 0.784; 95% confidence interval [CI], 0.627-0.979), and having fewer permanent teeth (0-19) (aOR, 1.474; 95% CI, 1.085-2.003). Additionally, a positive correlation was found between higher HbA1c levels and the risk of having fewer remaining teeth (0-19) (HbA1c < 6.5%: aOR, 1.129; 95% CI, 0.766-1.663; 6.5% ≤ HbA1c < 8.0%: aOR, 1.590; 95% CI, 1.117-2.262; HbA1c ≥ 8%: aOR, 1.910; 95% CI, 1.145-3.186) (P for trends = 0.041). CONCLUSION: We found a positive association between diabetes and poor oral health, as well as a noteworthy relationship between reduced permanent teeth (≤ 19) and glycemic control. These insights emphasize the critical role of oral health management in diabetic care and underscore the importance of maintaining effective glycemic control strategies for overall health and well-being in patients with diabetes.

The association between periodontitis and the impact of oral health on the quality of life of individuals with psoriasis and psoriatic arthritis.

OBJECTIVE: To evaluate the association between psoriasis (PSO), psoriatic arthritis (PsA) and periodontitis (PE), and the Oral Health-Related Quality of Life (OHRQoL) impacts on individuals with psoriatic disease's daily activities compared to the non-psoriatic ones. MATERIALS & METHODS: 296 individuals with psoriatic disease (PSO n = 210, APS n = 86) (cases) and 359 without these diseases (controls) were included. Complete periodontal examinations and collection of variables of interest were performed. The Brazilian version of the Oral Impacts on Daily Performance (OIDP) instrument was applied. RESULTS: The prevalence of PE was higher in PsA (57.0%; OR = 2.67 95%CI 1.65-4.32; p<0.001) than in PSO (34.3%; OR = 1.05 95% CI 0.73-1.51; p<0.001) compared to controls (33.1%). Both PsA and PSO groups showed more sites and teeth with 4-6mm probing depth (PD) and had higher OIDP scores than controls (p<0.001), thus indicating worse self-reported quality of life. PE, PSO+PE and consumption of alcohol/anxiolytics significantly influenced OHRQoL (p<0.05). The influence of periodontal parameters on OHRQoL was observed for the presence of PE; PD >6 mm; clinical attachment level >6 mm; higher plaque index, % sites and teeth with bleeding on probing (p<0.05). CONCLUSION: Negative impacts of PE on the OHRQoL were demonstrated. The ones having PSO and especially PsA and PE presented significantly worse indicators.

The association between cystic fibrosis-related diabetes and periodontitis in adults: A pilot cross-sectional study.

OBJECTIVES: Periodontitis is a highly prevalent complication of diabetes. However, the association between cystic fibrosis-related diabetes (CFRD) and periodontitis has not yet been evaluated. The objective of this study was to assess if: 1) CFRD is associated with periodontitis among adults with CF, and 2) periodontitis prevalence differs by CF and diabetes status. METHODS: This was a pilot cross-sectional study of the association between CFRD and periodontitis in adults with cystic fibrosis (CF) (N = 32). Historical non-CF controls (N = 57) from the U.S. National Health and Nutrition Examination Survey (NHANES) dataset were frequency matched to participants with CF on age, sex, diabetes status, and insulin use. We defined periodontitis using the U.S. Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) case definition, as the presence of two or more interproximal sites with CAL ≥3 mm and two or more interproximal sites with PD ≥4 mm (not on the same tooth) or one site with PD ≥5 mm. Because NHANES periodontal data were only available for adults ages ≥30 years, our analysis that included non-CF controls focused on this age group (CF N = 19, non-CF N = 57). Based on CF and diabetes status, we formed four groups: CFRD, CF and no diabetes, non-CF with diabetes, and non-CF and no diabetes (healthy). We used the Fisher's exact test for hypotheses testing. RESULTS: There was no association between CFRD and periodontitis for participants with CF ages 22-63 years (CFRD 67% vs. CF no diabetes 53%, P = 0.49), this was also true for those ages ≥30 years (CFRD 78% vs. CF no diabetes 60%, P = 0.63). For the two CF groups, the prevalence of periodontitis was significantly higher than for healthy controls (CFRD 78% vs. healthy 7%, P<0.001; CF no diabetes 60% vs. healthy 7%, P = 0.001) and not significantly different than the prevalence for non-CF controls with diabetes (CFRD 78% vs. non-CF with diabetes 56%, P = 0.43; CF no diabetes 60% vs. non-CF with diabetes 56%, P = 0.99). CONCLUSION: Among participants with CF, CFRD was not associated with periodontitis. However, regardless of diabetes status, participants with CF had increased prevalence of periodontitis compared to healthy controls.

An update on periodontal inflammation and bone loss.

Periodontal disease is a chronic inflammatory condition that affects the supporting structures of the teeth, including the periodontal ligament and alveolar bone. Periodontal disease is due to an immune response that stimulates gingivitis and periodontitis, and its systemic consequences. This immune response is triggered by bacteria and may be modulated by environmental conditions such as smoking or systemic disease. Recent advances in single cell RNA-seq (scRNA-seq) and in vivo animal studies have provided new insight into the immune response triggered by bacteria that causes periodontitis and gingivitis. Dysbiosis, which constitutes a change in the bacterial composition of the microbiome, is a key factor in the initiation and progression of periodontitis. The host immune response to dysbiosis involves the activation of various cell types, including keratinocytes, stromal cells, neutrophils, monocytes/macrophages, dendritic cells and several lymphocyte subsets, which release pro-inflammatory cytokines and chemokines. Periodontal disease has been implicated in contributing to the pathogenesis of several systemic conditions, including diabetes, rheumatoid arthritis, cardiovascular disease and Alzheimer's disease. Understanding the complex interplay between the oral microbiome and the host immune response is critical for the development of new therapeutic strategies for the prevention and treatment of periodontitis and its systemic consequences.

The Bloody Crossroads: Interactions between Periodontitis and Hematologic Diseases.

Periodontitis is a common oral condition that can have a significant impact on the overall health of the body. In recent years, attention has been paid to potential relationships between periodontitis and various hematological disorders. This publication aims to present information available in the literature on this relationship, focusing on examples of red blood cell disorders (such as aplastic anemia and sickle cell anemia) and white blood cell disorders (such as cyclic neutropenia, maladaptive trained immunity, clonal hematopoiesis, leukemia, and multiple myeloma). Understanding these associations can help physicians and dentists better diagnose, monitor, and treat patients associated with both groups of conditions, highlighting the need for interdisciplinary care for patients with oral disorders and hematologic diseases.

Streptococcus gordonii Supragingival Bacterium Oral Infection-Induced Periodontitis and Robust miRNA Expression Kinetics.

Streptococcus gordonii (S. gordonii, Sg) is one of the early colonizing, supragingival commensal bacterium normally associated with oral health in human dental plaque. MicroRNAs (miRNAs) play an important role in the inflammation-mediated pathways and are involved in periodontal disease (PD) pathogenesis. PD is a polymicrobial dysbiotic immune-inflammatory disease initiated by microbes in the gingival sulcus/pockets. The objective of this study is to determine the global miRNA expression kinetics in S. gordonii DL1-infected C57BL/6J mice. All mice were randomly divided into four groups (n = 10 mice/group; 5 males and 5 females). Bacterial infection was performed in mice at 8 weeks and 16 weeks, mice were euthanized, and tissues harvested for analysis. We analyzed differentially expressed (DE) miRNAs in the mandibles of S. gordonii-infected mice. Gingival colonization/infection by S. gordonii and alveolar bone resorption (ABR) was confirmed. All the S. gordonii-infected mice at two specific time points showed bacterial colonization (100%) in the gingival surface, and a significant increase in mandible and maxilla ABR (p < 0.0001). miRNA profiling revealed 191 upregulated miRNAs (miR-375, miR-34b-5p) and 22 downregulated miRNAs (miR-133, miR-1224) in the mandibles of S. gordonii-infected mice at the 8-week mark. Conversely, at 16 weeks post-infection, 10 miRNAs (miR-1902, miR-203) were upregulated and 32 miRNAs (miR-1937c, miR-720) were downregulated. Two miRNAs, miR-210 and miR-423-5p, were commonly upregulated, and miR-2135 and miR-145 were commonly downregulated in both 8- and 16-week-infected mice mandibles. Furthermore, we employed five machine learning (ML) algorithms to assess how the number of miRNA copies correlates with S. gordonii infections in mice. In the ML analyses, miR-22 and miR-30c (8-week), miR-720 and miR-339-5p (16-week), and miR-720, miR-22, and miR-339-5p (combined 8- and 16-week) emerged as the most influential miRNAs.

Combined Periodontal-Orthodontic Treatment with Periodontal Corticotomy Regenerative Surgery in an Adult Patient Suffering from Periodontitis and Skeletal Class II Malocclusion: A Case Report with 5-Year Longitudinal Observation.

A thick periodontal phenotype with thick gingiva and alveolar bone volume is required for safe orthodontic tooth movement and long-term stability. A high incidence of dehiscence and fenestration in the labial aspect of mandibular anterior teeth may limit the correction of deformity and orthodontic treatment, especially when the lower anterior teeth are needed to have a large range of movement. This study reports a combination of periodontal therapy and orthodontic therapy with periodontal corticotomy regenerative surgery (PCRS) in a 25-year-old patient suffering from skeletal Class II malocclusion and periodontitis. The patient received periodontal therapy 5 years ago and commenced orthodontic treatment 4.5 years ago. During the 4 years of follow-up for PCRS, the clinical and radiographic evaluations revealed significant improvements in the periodontal phenotype of the mandibular anterior region. The periodontal phenotypes in the mandibular incisors region were all modified from thin to thick. Supplementing orthodontic treatment with labial PCRS could be a promising treatment strategy to maintain long-term periodontal health in adult patients with alveolar deficiency and thin gingiva tissue.

Periodontal status and mandibular biomechanics in rats subjected to hyposalivation and periodontitis.

Xerostomia emerges as a consequence of salivary gland hypofunction, and seriously compromises the integrity of hard and soft oral tissues, whileperiodontitis is an infectious disease characterized by biofilm accumulation, inflammation and alveolar bone resorption. AIM: The aim this study was to compare the deleterious effects caused by experimental hyposalivation, periodontitis, and the combination of both on periodontal tissues and mandibular biomechanics in rats. MATERIALS AND METHOD: Hyposalivation (group H) was induced through bilateral submandibulectomy. Periodontitis (group EP) was induced by injecting LPS (1 mg/ml) into the gingiva of the first lower molars. A third group was subjected to both conditions (group H+EP). Alveolar bone loss was evaluated by micro-computed tomography and histomorphometric analysis, and gingival inflammatory mediators were assessed by specific techniques. Biomechanical properties were evaluated in mandible. RESULTS: Alveolar bone loss increased similarly in groups H, EP and H+EP compared to control. Metalloproteinase (MMP2 and MMP9) activity was similar in H and control, but higher in groups EP and H+EP (MMP2: C 9644+2214, EP 34441+3336, H 5818+1532, H+EP 42673+3184; MMP9: C 5792+961, EP 14807+861, H 9295+520, H+EP 4838+1531). The rest of the inflammatory mediators evaluated increased in groups H, EP and H+EP to a greater or lesser extent with respect to the control, although in most cases, they were higher in groups EP and H+EP than in group H. The biomechanical properties of the mandible increased in group H compared to the other three groups. CONCLUSIONS: Both hyposalivation and periodontitis cause periodontal damage, but hyposalivation also produces biomechanical alterations, causing more extensive deleterious effects than periodontitis.

La xerostomía surge como consecuencia de la hipofunción de las glándulas salivales y compromete seriamente la integridad de los tejidos orales duros y blandos, mientras que la periodontitis es una enfermedad infecciosa caracterizada por la acumulación de biofilm, inflamación y reabsorción ósea alveolar. OBJETIVO: El objetivo del presente estudio fue comparar los efectos deletéreos causados por la hiposalivación y la periodontitis experimental, y la combinación de ambas sobre los tejidos periodontales y la biomecánica mandibular en ratas. MATERIALES Y MÉTODOS: La hiposalivación (H) se indujo mediante una submandibulectomía bilateral. Por otra parte, la periodontitis (PE) se indujo mediante la inyección de LPS (1 mg/ml) en la encía de los primeros molares inferiores. Otro grupo se sometió a ambas condiciones (H+PE). La pérdida ósea alveolar se evaluó mediante tomografia microcomputarizada y análisis histomorfométrico, mientras que los mediadores inflamatorios gingivales fueron determinados mediante técnicas específicas. Se evaluaron las propiedades biomecánicas en la mandíbula. RESULTADOS: La hiposalivación aumentó la pérdida ósea alveolar en comparación con el control de forma similar a la PE y H+PE. La actividad de las metaloproteinasas (MMP2 y MMP9) fue similar en los grupos H y control, pero resultó mayor en los grupos PE y H+PE (MMP2: C 9644+2214, PE 34441+3336, H 5818+1532, H+PE 42673+3184; MMP9: C 5792+961, PE 14807+861, H 9295+520, H+PE 24838+1531). El resto de los mediadores inflamatorios evaluados aumentaron en mayor o menor medida en los grupos H, PE y H+PE respecto al control, aunque en la mayoría de los casos fueron superiores en los grupos PE y H+PE respecto al grupo H. Sin embargo, las propiedades biomecánicas de la mandíbula aumentaron en el grupo H con respecto a los otros grupos. CONCLUSIONES: Tanto la hiposalivación como la periodontitis causan daño periodontal, pero la hiposalivación también produce alteraciones biomecánicas, provocando efectos deletéreos más extensos que la periodontitis.

Recent advances in injectable hydrogel therapies for periodontitis.

Periodontitis is an immune-inflammatory disease caused by dental plaque, and deteriorates the periodontal ligament, causes alveolar bone loss, and may lead to tooth loss. To treat periodontitis, antibacterial and anti-inflammation approaches are required to reduce bone loss. Thus, appropriate drug administration methods are significant. Due to their "syringeability", biocompatibility, and convenience, injectable hydrogels and associated methods have been extensively studied and used for periodontitis therapy. Such hydrogels are made from natural and synthetic polymer materials using physical and/or chemical cross-linking approaches. Interestingly, some injectable hydrogels are stimuli-responsive hydrogels, which respond to the local microenvironment and form hydrogels that release drugs. Therefore, as injectable hydrogels are different and highly varied, we systematically reviewed the periodontal treatment field from three perspectives: raw material sources, cross-linking methods, and stimuli-responsive methods. We then discussed current challenges and opportunities for the translation of hydrogels to clinic, which may guide further injectable hydrogel designs for periodontitis.

Key periodontal pathogens may mediate potential pathogenic relationships between periodontitis and crohn's disease.

BACKGROUND: Crohn's disease (CD)-associated periodontitis is common. However, the role of periodontal pathogens in the Coexistence of CD and periodontal disease remains unclear. METHODS: To investigate the potential relationship mediated by periodontal pathogens between periodontitis and CD, we collected salivary samples from healthy participants (H group, n = 12), patients with CD (Ch group, n = 10), patients with periodontitis (Ps group, n = 12), and patients with Coexistence of CD and periodontal disease (Cp group, n = 12) and analyzed them by 16 S rRNA sequencing. RESULTS: Patients with Coexistence of CD and periodontal disease had increased levels of Fusobacterium, Actinomyces, Leptotrichia, and Prevotella, which correlated with the severity of periodontitis. Conversely, the levels of Streptococcus, Neisseria, Haemophilus, and Gemella, which decreased in Coexistence of CD and periodontal disease, were negatively correlated with the severity of periodontitis. To further investigate the role of periodontal pathogens in CD development, representative periodontal pathogens causing periodontitis, Porphyromonas gingivalis and Fusobacterium nucleatum, were administered to mice. These pathogens migrate to, and colonize, the gut, accelerating CD progression and aggravating colitis, and even systemic inflammation. In vitro experiments using a Caco-2/periodontal pathogen coculture revealed that P. gingivalis and F. nucleatum increased intestinal permeability by directly disrupting the tight junctions of intestinal epithelial cells. CONCLUSION: Our findings strongly suggest that periodontal pathogens play a role in the relationship between periodontitis and CD. These results provide a basis for understanding the pathogenesis of Coexistence of CD and periodontal disease and may lead to the development of novel therapeutic strategies.

Moderate to advanced periodontitis contributes to increased oxidative stress in cats: a case-control study.

BACKGROUND: Periodontal diseases are the most frequently diagnosed problem in cats. It has been well-established that periodontal diseases could not only cause various oral health issues but could also contribute to systemic diseases. Oxidative stress is a possible link between systemic diseases and periodontitis. Our study aimed to illustrate the influence of periodontitis on oxidative stress development in cats. Furthermore, the changes in the bacterial flora of the gums were investigated. METHODS: Based on the clinical and laboratory examinations, fifty cats were divided into two groups normal (n = 25) and moderate to advanced periodontitis (n = 25). Serum total antioxidant capacity (TAC), total oxidant status (TOS), reduced (GSH) and oxidized glutathione (GSSG) were measured. In addition, samples were taken from the subgingival plaques of all cats for bacterial culture. RESULTS: Serum TOS, GSSG, GSSG to GSH ratio, and oxidative stress index (OSI), calculated as the ratio of TOS to TAC in cats with periodontal disease were significantly higher, and TAC was significantly lower (p < 0.05) compared with controls. The results of bacterial culture indicated that the number of isolated bacterial colonies is higher in patients than in the control group. Additionally, the analysis of these data showed a positive association between periodontal index and oxidative stress. CONCLUSIONS: Our results revealed that periodontitis in cats is related to a main oxidative stress. Furthermore, oxidant factors such as TOS and OSI, compared to antioxidant factors, may better indicate the presence of oxidative stress conditions in patients with periodontitis.

Effect of Oral Care on Endothelial Dysfunction in Patients with Acute Coronary Syndrome.

Periodontitis is a common chronic infection and is associated with cardiovascular disease. This study evaluated whether basic oral care for periodontal disease could improve endothelial function in patients with acute coronary syndrome (ACS).This study enrolled 54 patients with acute coronary syndrome admitted to Kagoshima City Hospital and who had undergone percutaneous coronary intervention. Flow-mediated endothelium-dependent dilatation (FMD) was measured before discharge (initial FMD) and at 8 months after percutaneous coronary intervention (follow-up FMD). The following periodontal characteristics were measured: periodontal pocket depth (PPD, mm), plaque control record (%), and bleeding on probing (%). All patients received basic oral care instructions from dentists. The oral health condition was generally poor in the participants and there were 24 patients (44.4%) who had severe PPD. Despite the intervention of basic oral care, the periodontal characteristics did not improve during the study period; initial FMD and follow-up FMD did not significantly differ (4.38 ± 2.74% versus 4.56 ± 2.51%, P = 0.562). However, the follow-up FMD was significantly lower in patients with severe PPD (≥ 6.0 mm, n = 24) than in patients without severe PPD (≤ 5.0 mm, n = 30) (FMD: 3.58 ± 1.91% versus 5.37 ± 2.67%, P = 0.007). FMD tended to be worse in patients with severe PPD than in patients without severe PPD (ΔFMD: -0.55 ± 2.12 versus 0.81 ± 2.77 %, P = 0.055). In conclusion, during the use of basic oral care, endothelial function improved in patients without severe PPD, while it worsened in patients with severe PPD.

Early periodontal wound healing after chlorhexidine rinsing: a randomized clinical trial.

OBJECTIVES: This single-center randomized, parallel design, clinical trial with a 2-week follow-up involved patients affected by periodontitis undergoing periodontal surgery. The aim was to evaluate periodontal surgical wound healing with the use of chlorhexidine-based mouth rinses versus an untreated control group. MATERIALS AND METHODS: Periodontal surgery was performed following a standardized protocol. Patients were randomly prescribed i) chlorhexidine (CHX) + anti-discoloration system (ADS) + hyaluronic acid (HA), ii) CHX + ADS or iii) no treatment (control group). Plaque score, gingival inflammation, and Early Healing Index (EHI), assessing the degree of wound closure and the presence of fibrin and necrosis, were evaluated at 3, 7 and 14 days after surgery. RESULTS: In total, 33 patients were enrolled. Patients were comparable at baseline for all measured clinical parameters. At 3-days wound healing was significantly improved in all patients treated with CHX + ADS-based mouth rinses with a lower EHI score at the interdental papillae compared with control group (p < 0.01). CHX + ADS + HA group presented improved healing across all time points in terms of EHI, plaque containment, and gingival inflammation when compared to control group (p < 0.01). CONCLUSIONS: The usage of CHX-ADS following periodontal surgery improved early wound healing, reduced plaque accumulation and gingival inflammation. During the early post-operative period the adjunct of HA further improved soft tissue closure. CLINICAL RELEVANCE: This study aims at evaluating the response of gingival tissues to mouth rinsing with chlorhexidine and anti-discoloration system (CHX + ADS) or CHX + ADS + hyaluronic acid (CHX + ADS + HA) versus no rinse in terms of healing of the periodontal surgical wound. CHX + ADS mouth rinses enhanced early soft tissue closure after periodontal surgery and contributed to the reduction in plaque accumulation and gingival inflammation. The adjunct of HA may be beneficial especially in the early post-operative period. CHX + ADS administration following periodontal surgery may improve soft tissue healing in the first two post-operative weeks.

Association between weight-adjusted waist index and periodontitis: A population-based study.

OBJECTIVE: This study aims to examine the association between the Weight-adjusted Waist Circumference Index (WWI) and the prevalence of periodontitis, providing novel evidence on the link between central obesity and periodontal health. METHODS: A cross-sectional study was conducted with 10,289 participants enrolled from NHANES 2009 to 2014. WWI was calculated by dividing waist circumference by the square root of weight. We employed a multivariate logistic regression model and smoothed curve fitting method to evaluate the relationship between WWI and periodontitis. We also compared different subgroups and analyzed the interaction effects. RESULTS: A significant positive association between WWI and periodontitis was observed in 10,289 participants aged ≥30 (OR: 1.20, 95% CI: 1.12-1.28). Upon categorizing WWI into quartiles, the top quartile group exhibited a 27% increased prevalence of periodontitis compared to the bottom quartile (OR: 1.27, 95% CI: 1.10-1.46; P for trend = 0.001). Among individuals aged 30 to 60, the strength of this positive correlation is more pronounced than in those aged 60 and above. CONCLUSIONS: WWI demonstrates a positive correlation with periodontitis with a particularly pronounced impact on moderate periodontitis, suggesting its potential to improve periodontitis prevention in a broad population.

Physical training minimizes immunological dysfunction, oxidative stress and tissue destruction on experimental periodontitis in rats.

The objective of this study is to investigate the effects of a moderate intensity physical training protocol, on alveolar bone morphology of rats submitted to ligature-induced periodontitis. Twenty-eight male Wistar rats were divided into four groups, considering the presence/absence of periodontitis and presence/absence of training. The training protocol was performed on a treadmill, 30 min/day, 5 days a week, for 4 weeks. In the experimental periodontal breakdown, with/without training, ligatures were placed on the lower first molars on the 14th day of the experiment, and were followed until the end of the protocol. At the end of the experiment, animals were euthanized and samples of plasma and mandibles were collected for immunoenzymatic evaluation of interleukins (IL)-1ß, IL-6, TNF-α and IL-10, evaluation of serum concentrations of C-reactive protein, analysis of lipid peroxidation (LPO) and reduced glutathione, histological and microtomographic analyses were performed. Physical training resulted in a reduced levels of IL-1ß, IL-6, TNF-α C-reactive protein and LPO and an increase in the levels of IL-10 in rats with periodontitis (p<0.05); a reduction in the inflammatory infiltrate and decreased fiber degradation was identified in histological analysis. Additionally, it was shown a decrease in vertical bone loss and an increase in the bone volume/trabecular volume ratio was identified in periodontitis+physical training group (p<0.05). Based on the results, the practice of frequent physical exercise, at moderate intensity, can contribute to the reduction of damage related to the disproportionate inflammatory response in periodontitis.

The Role of Pericyte Migration and Osteogenesis in Periodontitis.

A ligature-induced periodontitis model was established in wild-type and CD146CreERT2; RosatdTomato mice to explore the function of pericytes in alveolar bone formation. We found that during periodontitis progression and periodontal wound healing, CD146+/NG2+ pericytes were enriched in the periodontal tissue areas, which could migrate to the alveolar bone surface and colocalize with ALP+/OCN+ osteoblasts. Chemokine C-X-C motif receptor 4 (CXCR4) inhibition using AMD3100 blocked CD146-Cre+ pericyte migration and osteogenesis, as well as further exacerbated periodontitis-associated bone loss. Next, primary pericytes were sorted out by magnetic-activated cell sorting and demonstrated that C-X-C motif chemokine ligand 12 (CXCL12) promotes pericyte migration and osteogenesis via CXCL12-CXCR4-Rac1 signaling. Finally, the local administration of an adeno-associated virus for Rac1 overexpression in NG2+ pericytes promotes osteoblast differentiation of pericytes and increases alveolar bone volume in periodontitis. Thus, our results provided the evidence that pericytes may migrate and osteogenesis via the CXCL12-CXCR4-Rac1 axis during the pathological process of periodontitis.