Aggregatibacter (Actinobacillus) actimycetemcomitans leukotoxin and human periodontitis - A historic review with emphasis on JP2.

Aggregatibacter (Actinobacillus) actimycetemcomitans (Aa) is a gram-negative bacterium that colonizes the human oral cavity and is causative agent for localized aggressive (juvenile) periodontitis (AgP). In the middle of 1990s, a specific JP2 clone of belonging to the cluster of serotype b strains of Aa with highly leukotoxicity (leukotoxin, LtxA) able to kill human immune cells was isolated. JP2 clone of Aa was strongly associated with in particularly in rapidly progressing forms of aggressive periodontitis. The JP2 clone of Aa is transmitted through close contacts. Therefore, AgP patients need intense monitoring of their periodontal status as the risk for developing severely progressing periodontitis lesions are relatively high. Furthermore, timely periodontal treatment, including periodontal surgery supplemented by the use of antibiotics, is warranted. More importantly, periodontal attachment loss should be prevented by early detection of the JP2 clone of Aa by microbial diagnosis testing and/or preventive means.

Periodontal surgery improves oral health-related quality of life in chronic periodontitis patients in Asian population.

The effect of periodontal surgery on patients' quality of life was investigated. Sixty patients received regenerative surgery or resective osseous surgery. Oral health-related quality of life and health-related quality of life instruments were used to assess the participants' quality of life before surgery and 4 weeks after surgery. Periodontal surgery can improve patients' quality of life by alleviating the physical pain and psychological discomfort. The scores were lower (more favorable) in the regenerative surgery group, and the functional limitations of the regenerative surgery group improved substantially compared with those of the resective osseous surgery group (P = 0.0421). The patients' oral health-related quality of life scores improved significantly after periodontal surgery. Clinicians can take advantage of the positive functional oral health-related quality of life impacts of regenerative surgery.

Compliance with Supportive Periodontal Treatment in Patients with Dental Implants.

PURPOSE: The need for dental implants is increasing, and supportive periodontal treatment can achieve long-term success and prevent peri-implantitis. Contributing factors to noncompliance with long-term scheduled supportive periodontal treatment remain unclear. To investigate whether demographic and clinical characteristics are associated with noncompliance, the authors analyzed data for patients who had received dental implants. MATERIALS AND METHODS: The authors recruited patients participating in a supportive periodontal treatment program after receiving permanent prostheses on implants placed from 2005 to 2013. Demographic data and dental treatment histories were collected. Compliance was defined as a record of participation in a standard supportive periodontal treatment program for at least 1 year. The chi-square test, log-rank test, Kaplan-Meier survival curve, and Cox proportional hazards model were used for statistical analysis. RESULTS: The study included 120 patients (259 implants, 60% compliance). The two groups (compliant and noncompliant) differed significantly in frequency distributions for sex (P = .0017), educational level (P = .0325), and histories of substance use (P = .0016), periodontitis (P = .0005), and root planing or flap surgery (P = .0002). The Kaplan-Meier survival curves and log-rank test showed that increases in cumulative continuation rates were significantly associated with male sex (P = .0025); body mass index ≥ 24 kg/m² (P = .0093); and a history of periodontitis (P < .0001), root planing or flap surgery (P < .0001), and substance use (P = .0026). Multivariate Cox proportional hazards model for supportive periodontal treatment noncompliance showed significantly higher compliance in patients who had received root planing or flap surgery (hazard ratio = 0.26, 95% confidence interval = 0.12 to 0.53, P = .0002). CONCLUSION: These results suggest that in patients who received a permanent prosthesis on implant placement, root planing or flap surgery was the crucial factor in determining compliance with supportive periodontal treatment. However, well-designed large-scale studies with a larger sample size are needed to confirm the findings of this study.

Association between the eruption of the third molar and caries and periodontitis distal to the second molars in elderly patients.

The objective of this study was to verify whether caries and periodontal diseases, when present on the distal surface of the second molars (M2s), are associated with the eruption of the third molars (M3s). In this split-mouth study, we evaluated 70 elderly patients with unilateral maxillary or mandibular M3s who presented to the outpatient clinics of two hospitals. Patients underwent comprehensive oral examinations and radiographical measurements, and we assessed the outcomes of periodontal disease and caries. Periodontal measurements included plaque index, bleeding on probing, and periodontal probing pocket depth (PD). Moreover, caries were assessed through visual-tactile examination and radiography. We performed the χ2 test to determine factors associated with M3 and non-M3 outcomes. Eighty-one unilateral erupted M3s were observed in the study patients. Both the distobuccal region (p<0.0001) and the distolingual region (p=0.006) had a higher PD on the nonextraction side than the extraction side, and the caries rate was significantly higher on the nonextraction side than on the extraction side (p <0.0001 on M2 with caries and p=0.003 on M2 with distal caries). M3 eruption, at the same or different occlusal plane levels of M2, is a risk factor for periodontal diseases and caries in M2s in elderly patients. M3s may continue to negatively impact dental health well into later life.

Association of vitamin D receptor gene polymorphisms and periodontitis in a Taiwanese Han population.

BACKGROUND/PURPOSE: : Genetic polymorphisms in the vitamin D receptor (VDR) gene are related to the immune response and bone metabolism, both of which are implicated in the pathogenesis of periodontitis. This study was to investigate the association between VDR-gene polymorphisms and periodontitis among a Taiwanese Han ethnic population. MATERIALS AND METHODS: Ninety-two aggressive periodontitis (AgP), 385 chronic periodontitis (CP) and 163 healthy controls (HC) were recruited from dental clinics. Demographic characteristics and possible confounding factors were obtained using a self-reported questionnaire. The VDR rs731236 (TaqI), rs7975232 (ApaI), rs1544410 (BsmI), and rs2228570 (FokI) polymorphisms were genotyped using PCR-RFLP methods. Statistical analyses were applied to determine the associations. RESULTS: The individual VDR polymorphisms were not associated with risk of AgP and CP. The f allele of rs2228570 was related to decreased risk for AgP. Subjects with TAbF (adjusted OR = 7.2, 95% CI = 3.2-7.2, p < 0.0001) or TAbf (adjusted OR = 0.17, 95% CI = 0.05-0.48, p = 0.002) combined polymorphisms were significantly associated with AgP. Subjects with Tabf (adjusted OR = 2.6, 95% CI = 1.8-3.8, p < 0.0001), TAbF (adjusted OR = 4.4, 95% CI = 2.6-8.1, p < 0.0001), TabF (adjusted OR = 0.36, 95% CI = 0.2-0.5, p < 0.0001), or TAbf (adjusted OR = 0.45, 95% CI = 0.3-0.7, p = 0.001) combined polymorphisms were significantly associated with CP. CONCLUSION: The study indicates that VDR gene polymorphisms are associated with AgP and CP in a Taiwanese Han population.

Matrix metalloproteinase-2, -9, and tissue inhibitor of MMP-2 gene polymorphisms in Taiwanese periodontitis patients.

BACKGROUND/PURPOSE: Matrix metalloproteinases (MMPs) and tissue inhibitor of MMPs (TIMPs) have been shown to play an important role in the pathogenesis of tissue destruction in periodontitis. The associations between single nucleotide polymorphisms (SNPs) in the promoter regions of MMP-2, MMP-9, and TIMP-2 genes and the risk of aggressive periodontitis (AgP) and chronic periodontitis (CP) were investigated in a Taiwanese population. MATERIALS AND METHODS: MMP-2 C-1306T, C-735T, T-790G, and MMP-9 C-1562T and TIMP-2 G-418C SNPs were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis in 69 patients and 129 patients with AgP and CP, respectively, and 117 periodontal healthy individuals who served as healthy controls (HC). Chi-square test and logistic regression analysis were used to investigate the possible association of genotypes with periodontitis. RESULTS: No significant differences in the distributions of the C-1306T and C-735T variants between periodontitis and HC were detected. Patients with genotype of MMP-2 -790 TT or T allele of MMP-2-790T/G as compared to genotypes of GT + GG genotypes or G allele, were less susceptible to CP [odds ratio (OR) = 0.50, 95% confidence interval (CI) = 0.25-1.00 and OR = 0.52, 95% CI = 0.28-0.96, respectively]. The frequencies of TIMP-2 G-418C gene polymorphisms in nonsmokers were statistically significantly different among AgP, CP, and HC groups (P = 0.024). The nonalcohol drinking participants with C allele of MMP-9 C-1562T as compared to T allele, were less susceptible to AgP (adjusted OR = 0.4; 95% CI, 0.18-0.90). CONCLUSION: It is suggested that MMP-2 T-790G, MMP-9 C-1562T, and TIMP-2 G-418C gene polymorphisms might be associated with periodontitis in the Taiwanese Han population.

Clinical Case Report on Treatment of Generalized Aggressive Periodontitis: 5-Year Follow-up.

Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease associated with considerably more rapid periodontal tissue destruction than chronic periodontitis. This study presents the 5-year follow-up of a patient with GAgP. A 29-year-old man reported experiencing increasing gingival recession. He was treated using cause-related therapy, provisional splints, and flap surgery combined with allograft grafting and was followed up for 5 years. This case study shows that elimination of infectious microorganisms and meticulous long-term maintenance provide an effective treatment modality for aggressive periodontitis cases. This treatment modality can restore the masticatory function and provide the GAgP patient with improved quality of life.

Retrospective study of oral and maxillofacial lesions in older Taiwanese patients.

OBJECTIVE: The aim was to provide information regarding oral and maxillofacial (OMF) lesions in an older Taiwanese population. BACKGROUND: The rate of increase of older people in Taiwan is expected to be rapid. OMF lesions are very frequent in the older population, but no studies have been performed on these lesions in Taiwan. MATERIALS AND METHODS: OMF cases (between 2000 and 2011) in geriatric patients (≥60 years of age) with records of age, sex and histological diagnoses were retrieved from the Oral Pathology Department of our institution. These lesions were classified into four main categories: tumour/tumour-like reactive lesions, cystic/pseudocystic lesions, inflammatory/infective lesions and other miscellaneous lesions. RESULTS: Six thousand seven hundred and twenty-six lesions were collected from a total of 39 503 OMF lesions in older Taiwanese patients in this study. Most of these lesions were distributed in the inflammatory/infective group, followed by tumour/tumour-like reactive lesions. Squamous cell carcinoma was the most common lesion, and, additionally, there was a high frequency of oral potentially malignant disorders. CONCLUSIONS: The present study showed trends similar to previous reports from other countries. However, some detailed information was different, perhaps due to the different criteria and different geographic distribution. Worthy of note, our results indicated that screening for oral potentially malignant disorder and oral malignancy in the older population is essential.

Retrospective study of biopsied head and neck lesions in a cohort of referral Taiwanese patients.

INTRODUCTION: A study of the whole spectrum of biopsied head and neck (HN) diseases in Taiwan has not yet been performed. Therefore, the current study aimed to provide updated information about HN lesions in a cohort of referral Taiwanese patients for histopathological examination. METHODS: HN lesions (2000-2011) in patients with records of age, sex, and histological diagnoses were retrieved from the Oral Pathology Department of the institution. These lesions were classified into four main categories: tumor/tumor-like reactive lesions, cystic/pseudocystic lesions, inflammatory/infective lesions, and others/miscellaneous lesions. RESULTS: A total of 37,210 HN lesions were included in the current study. Most of these lesions were distributed in the group of tumor/tumor-like reactive lesions, followed by the groups of inflammatory/infective lesions, cystic/pseudocystic lesions, and others/miscellaneous lesions. Squamous cell carcinoma was the most common HN lesion, and was also the most frequent malignant lesion among the referral patients. CONCLUSION: It was worthy of note that squamous cell carcinoma and oral potentially malignant disorders comprised high percentages of all HN lesions for the present cohort of referral patients.

Plasma polyunsaturated fatty acids and periodontal recovery in Taiwanese with periodontitis: a significant relationship.

BACKGROUND: Plasma levels of polyunsaturated fatty acids (PUFAs) are different before and after periodontal treatment. Asians and Westerners have significantly different baseline levels of plasma PUFAs. However, no Asian study has reported the effects of nonsurgical treatment on the correlation between periodontal condition and plasma levels of PUFAs. We analyzed whether recovery from periodontitis was correlated with the elevation of plasma fatty acids 3 months after the nonsurgical intervention and with no recommended supplements. DESIGN: Thirty-five Taiwanese patients with periodontitis were recruited. Probing pocket depths (PPDs) and clinical attachment levels (CALs) were measured at baseline and 3 months after the nonsurgical treatment. Plasma levels of fatty acids were determined using gas chromatography. Differences and correlations between plasma fatty acid composition and periodontitis severity at baseline and 3 months after treatment were determined. RESULTS: Twenty-six patients completed the study. At the baseline, PPDs were negatively correlated with plasma n-3 PUFAs (r=-0.52, p<0.01), but at 3 months post intervention, periodontitis severity had declined and the weight percentages of n-3 PUFAs, DPA, and DHA were significantly (p=0.019, 0.005, and 0.037, respectively) higher. The recovery percentages of CALs were positively and significantly correlated with plasma ΔPUFAs and the percentage of Δn-3 PUFAs in ΔPUFAs (r=0.42 and 0.45, respectively; p<0.05 for both). CONCLUSIONS: We conclude that a higher weight percentage of n-3 PUFAs in total PUFAs was related to the recovery of CALs 3 months after the nonsurgical periodontal treatment. However, no such relationship was found for PPDs.

An interdisciplinary treatment approach combining orthodontic forced eruption with immediate implant placement to achieve a satisfactory treatment outcome: a case report.

BACKGROUND: Periodontal disease often results in severely bony defects around the teeth and leads to eventual extraction. Remaining bone morphology often compromises ideally restoration-driven positions and deteriorates the success rates for dental implants. PURPOSE: The present investigation illustrates the clinical outcome of immediately installing an implant following orthodontic forced eruption and atraumatic extraction. MATERIAL AND METHODS: The subject of this study is a 40-year-old Asian female with a right mandibular first molar that had a deep probing depth on the mesial side and mobility. Via the aid of radiographic examination, the tooth that had an angular bony defect and apical lesion was diagnosed as having deep caries and chronic periodontitis with a poor prognosis. After consultation with the patient, we developed a treatment plan incorporating a forced eruption with immediate implantation, intended to augment the alveolar bone volume and increase the width of keratinized gingivae, in a nonsurgical manner. RESULTS: Following 12 months of orthodontic treatment, the tooth was successfully moved occlusally in conjunction with an 8 mm vertical interdental bone augmentation. Because of sufficient volume of bone and satisfactory gingival dimensions, the implant showed adequate initial stability in the correct position to facilitate physiological and aesthetic prerequisites. After 6 months of osteointegration, a customized impression coping was utilized to transfer the established emergence profile to a definitive cast for the fabrication of a customized abutment. The final prosthesis was made using a customized metal abutment and ceramometal crown. CONCLUSION: In the face of difficult clinical challenges, meticulous inspection and a comprehensive treatment plan were crucial. Interdisciplinary treatment through the careful integration of multiple specialists suggests the possibility of optimal results with high predictability.

MMP-8 -799 C>T genetic polymorphism is associated with the susceptibility to chronic and aggressive periodontitis in Taiwanese.

AIM: Matrix metalloproteinase (MMP)-8 is a protease that degrades numerous extracellular molecules and has been implicated in the pathogenesis of periodontitis. Polymorphism in the MMP-8 could affect the susceptibility to disease. Our aim was to evaluate the association between periodontitis and MMP-8 -799 C>T polymorphism. MATERIAL AND METHODS: Genomic DNA was obtained from 361 chronic periodontitis patients (CP), 96 aggressive periodontitis patients (AgP), and 106 periodontally healthy controls (HC). MMP-8 -799 C>T polymorphism was determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: The frequencies of genotypes in diseased groups were similar but were significantly different from those in the HC. Multivariate logistic regression analysis with adjustment for age, gender and smoking indicated that increased risks of AgP and CP were associated with the -799 T allele (in AgP, adjusted OR = 1.99, p = 0.04; in CP, adjusted OR = 1.87, p = 0.007). To avoid the confounded effect of smoking on MMP-8 polymorphism to periodontitis, the analysis was conducted on non-smokers and the associations were significant. CONCLUSIONS: These results suggested that non-smoking Taiwanese with the MMP-8 -799 T allele were associated with the risks of both CP and AgP. Further studies in other ethnic populations are necessary.

The association of Fcgamma receptor IIIb genetic polymorphism and susceptibility to periodontitis in Taiwanese individuals.

AIM: The allelic polymorphism of FcgammaRIIIb, the neutrophil-specific receptor involved in the phagocytosis of immunoglobulin G-opsonized bacteria, has functionally distinct capacities that are important in host defence mediated by neutrophils. The aim of this study was to identify whether the polymorphism of FcgammaRIIIb is associated with periodontitis in Taiwanese individuals. MATERIALS AND METHODS: This case-control study included of 93 aggressive periodontitis (AgP) patients, 372 chronic periodontitis (CP) patients and 158 healthy controls (HC). The FcgammaRIIIb genotypes were determined by PCR using allele-specific primers. The risk for periodontitis associated with genotypes was calculated as the odds ratio (OR). RESULTS: A significant difference was observed in the distribution of the FcgammaRIIIb genotype between either AgP and HC, or AgP and CP, but not between CP and HC. The OR for carriage of the NA2 allele (NA1NA2+NA2NA2 versus NA1NA1) in AgP was 3.27 [95% confidence interval (CI)=1.57-7.51, p=0.0027] and 2.94 (95% CI=1.49-6.48, p=0.0037), as compared with HC and CP. After adjusting for possible confounding factors, the association was still significant. CONCLUSIONS: The results of the present study suggest that subjects carrying at least one copy of the FcgammaRIIIb-NA2 allele might be associated with susceptibility to AgP. However, the clinical implications of the FcgammaRIIIb allelic polymorphism should be determined by further studies.

Cyclooxygenase-2 Gene-765 single nucleotide polymorphism as a protective factor against periodontitis in Taiwanese.

AIM: Prostaglandin E(2) (PGE(2)) is considered to be an important mediator of tissue destruction in periodontitis. The cyclooxygenase (COX) catalyses the production of PGs. COX-2, which is induced in an inflammatory response, is responsible for PGs synthesis at sites of inflammation. A single nucleotide polymorphism of COX-2(-765) has been shown to alter the expression of the COX-2 gene. The purpose of the present study was to evaluate the association of the COX-2(-765) polymorphism and susceptibility to periodontitis in Taiwanese. MATERIAL AND METHODS: Eighty-five cases of aggressive periodontitis (AgP), 343 cases of chronic periodontitis (CP) and 153 cases of healthy controls (HC) were recruited for the study. Genotypes of COX-2(-765) were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The distribution of genotypes among groups was compared by logistic regression analyses. The risk for periodontitis associated with genotypes was calculated as the odds ratio (OR). RESULTS: The prevalence of the GC and CC genotypes was significantly lower in AgP (5%) and in CP (29%) compared with the HC (42%). The ORs for carriage of the -765C allele (GC+CC versus GG) in AgP and CP were 0.068 (95% CI=0.020-0.173, p<0.0001) and 0.571 (95% CI=0.385-0.849, p=0.006), respectively. After adjustment for age, gender and smoking status, the OR was 0.071 (95% CI=0.017-0.219) and 0.552 (95% CI=0.367-0.829) for AgP and CP, respectively. CONCLUSIONS: The results of the study suggest that the -765G to C polymorphism of the COX-2 gene is associated with a decreased risk for periodontitis in Taiwanese, especially in AgP. However, the biological meaning needs further investigation.

New classification of crown forms and gingival characteristics in taiwanese.

OBJECTIVES: The aim of the investigation was to examine the forms of the crowns in the maxillary anterior tooth segment and corresponding gingival characteristics among healthy Taiwanese subjects. MATERIALS AND METHODS: The crown width at the apical third (CW), length (CL), gingival angle (GA) and the interdental papilla height were assessed from the diagnostic stone model using a calibrated periodontal caliper. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. Gingival thickness (GT) and width of keratinized gingiva (WG) were measured clinically. RESULTS: The cluster analysis revealed 3 classifications of crown forms: narrow (N), compound (C) and square (S) types. There was a significant difference among the 3 classifications with respect to CW/CL-ratio, GT, and WG (p < 0.0001). CONCLUSIONS: The results demonstrated varied crown forms and corresponding gingival characteristics in Caucasian and Taiwanese. The new classifications hinted that there was a polymorphism in different races and could be a valuable esthetic guideline and reference for anterior tooth rehabilitation, including various periodontal and restorative treatments and anterior implant placement procedures in Taiwanese.

Characterization of arecoline-induced effects on cytotoxicity in normal human gingival fibroblasts by global gene expression profiling.

Areca nut is the most widely used psychoactive substance and an important environmental risk factor for development of oral premalignant lesions and cancer. Arecoline, the major alkaloid of areca nut, has been known to cause cytotoxicity and genotoxicity in mammalian cells in vivo and in vitro and even contributes to carcinogenicity. However, the susceptible genes accounting for arecoline-induced damage in normal human oral cells are still lacking, which possibly involves in initial molecular damage via alternation of gene expression level on biological pathways. The present study was undertaken to characterize the toxic effects of arecoline in gene expression profiling on normal human gingival fibroblasts (HGF) using cDNA microarray and quantitative real-time reverse transcription PCR. The cytotoxicity of arecoline on HGF-1 cell line was elevated in a dose-dependent manner (p < 0.05) accompanied with distinct morphological change and formation of intracellular vacuoles were observed. At optimum concentration of arecoline determined from dose-response curve of the cytotoxicity, a large number of genes were significantly repressed than induced by arecoline in global gene expression profiling. Five induced- and seven repressed genes including glutathione synthetase were further validated, and their gene expression changes were increased in a dose-dependent manner in a concentration range of 50-150 microg/ml. In conclusion, we proposed a tentative model to explain arecoline-induced effects on contribution of oral pathogenesis. The findings identified that 12 susceptible genes can potentially serve as biomarkers of arecoline-induced damage in betel chewers.

Changes in gingival crevicular fluid interleukin-4 and interferon-gamma in patients with chronic periodontitis before and after periodontal initial therapy.

Cytokines are pivotal to the immune response of chronic periodontitis. The present study investigated the changes of gingival crevicular fluid (GCF) interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) in patients with chronic periodontitis before and after initial nonsurgical periodontal therapy (NSPT). GCF was collected from 17 patients by means of Periopaper at baseline and 1 month after NSPT. IL-4 and IFN-gamma were measured by enzyme-linked immunoabsorbent assay. NSPT resulted in decreased total amount of IFN-gamma, increased concentration of IL-4, and increased ratio of IL-4 to IFN-gamma levels. We suggest that a low ratio of IL-4 to IFN-gamma levels might be involved in the destruction (diseased sites) of periodontal tissue, whereas an increased ratio of IL-4 to IFN-gamma levels could be related to the improvement of clinical periodontal health.

Interleukin-12 and interleukin-16 in periodontal disease.

The immune system plays an important role in the pathological process of periodontitis. Interleukin-12 (IL-12) is produced by monocytes, macrophages and neutrophils. These cells are proinflammatory infiltrates in periodontitis tissues. High IL-12 will contribute to the immune reaction to Th1 type. IL-12 is an inducer of INF-r production. IFN-gamma itself can also activate IL-12 production. Lipopolysaccharides (LPS) of periodontopathogens are also activators of IL-12. Interleukin-16 (IL-16) can cause the high affinity of IL-2 receptors on CD4+ cells and is chemotaxis to Th1 cells and CD4+ T cells. IL-16 can stimulate monocytes to produce proinflammatory cytokines and is highly associated with inflammation including arthritis, enteritis and allergic rhinitis. However, the information on IL-12 and IL-16 in periodontitis is not clear. In this study, 105 GCF samples were collected from 19 periodontal disease patients and 6 healthy ones. The clinical periodontal indices, the habits of cigarette smoking and alcohol drinking were recorded. ELISA was used to determine the levels of IL-12 and IL16 in the GCF. In the non-smoking/non-alcohol-drinking individuals: (1) the total amount of IL-12 (but not IL-16) was significantly higher in chronic periodontitis (CP) sites than gingivitis (G) or healthy (H) sites; (2) the diseased sites (CP + G) had a significantly higher total amount of IL-12 (but not IL-16) than the H sites. Among CP sites, both the concentration and total amount of IL-16 (but not IL-12) were significantly higher in alcohol drinkers/cigarette smokers as compared to the non-drinkers/non-smokers. CP sites of the drinkers/smokers also had significantly deeper probing pocket depth than sites of those without these two habits. IL-12 and IL-16 may be related to the pathogenesis of periodontal disease, but within the periodontitis sites, IL-16 may be related to disease severity in alcohol drinkers/smokers.

The investigation of glutathione peroxidase, lactoferrin, myeloperoxidase and interleukin-1beta in gingival crevicular fluid: implications for oxidative stress in human periodontal diseases.

BACKGROUND: Human periodontal diseases are inflammatory disorders that are the result of complex interactions between periodontopathogens and the host's immune response. Two important and interrelated factors are involved in the pathophysiological progression of periodontal diseases, i.e. the activation of immune system and the production of oxygen radicals and their related metabolites. Increased production of oxygen radicals may contribute to oxidative stress, which is reported to be involved in many diseases, including periodontal diseases. OBJECTIVES: The objective of this study was to investigate glutathione peroxidase, lactoferrin and myeloperoxidase, which play an essential role in free radical production and defenses, and the proinflammatory cytokine interleukin-1beta (IL-1beta), which is important in the regulation of immunological and inflammatory reactions in human periodontal diseases. METHODS: Gingival crevicular fluid (GCF) samples were collected from 27 subjects, 19 periodontitis patients and eight healthy controls, ranging in ages from 24 to 62 years. Clinical parameters were recorded. GCF glutathione peroxidase, lactoferrin, myeloperoxidase and IL-1beta were analyzed by enzyme-linked immunosorbent assays (ELISA). RESULTS: The periodontitis sites exhibited significantly greater total amount of glutathione peroxidase, lactoferrin, myeloperoxidase and IL-1beta than healthy sites. Total amount of glutathione peroxidase, lactoferrin, myeloperoxidase and IL-1beta was positively correlated with plaque index, gingival index, probing depth and probing attachment level (p < 0.05). CONCLUSION: The imbalance between the levels of myeloperoxidase/IL-1beta and glutathione peroxidase/lactoferrin could result in tissue damage of reactive oxygen species (ROS) in periodontitis which is initiated and perpetuated by the chronic insults of periodontopathogens.

Potential role of vascular endothelial growth factor, interleukin-8 and monocyte chemoattractant protein-1 in periodontal diseases.

Host-mediated immunoinflammatory pathways activated by bacteria lead to destruction of the periodontal connective tissues and alveolar bone. The objective of this study was to elucidate the activation of the inflammatory processes in periodontal disease by quantitative assessment of cytokines and periodontopathogens. Gingival crevicular fluids (GCF) and subgingival plaque samples were collected from patients with chronic periodontitis and gingivitis and from periodontally healthy sites. Vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1), and interleukin 8 (IL-8) in GCF were analyzed by enzyme-linked immunosorbent assay. Periodontopathogens, including Bacteroides forsythus, Campylobacter rectus, Porphyromonas gingivalis and Prevotella intermedia, were analyzed by immunofluorescence and dark-field microscopy. There was significantly more VEGF and IL-8 in chronic periodontitis and gingivitis sites than in periodontally healthy sites. There were significant positive correlations between the concentrations and total amounts of VEGF and IL-8 in chronic periodontitis and gingivitis sites, and between the levels of periodontopathogens and the total amounts of VEGF, MCP-1 and IL-8. These data indicate that inflammatory processes induced by periodontopathogens and the activation of certain cytokines (VEGF, MCP-1, IL-8) in periodontal diseases may be relevant to host-mediated destruction in chronic periodontitis.