Effects of a cyclic NSAID regimen on levels of gingival crevicular fluid prostaglandin E2and Interleukin-1ß: A 6-month randomized controlled clinical trial.

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for inflammation control and pain relief. However, while the adjunct use of NSAIDs is avoided for periodontal therapy because of related side effects, cyclic administration of NSAIDs may reduce or eliminate these effects. We evaluated the effect of a cyclic diclofenac potassium (DP) regimen on clinical parameters and levels of prostaglandin E2 (PGE2) and interleukin-1ß (IL-1ß) in the gingival crevicular fluid (GCF) of individuals with periodontitis. MATERIALS AND METHODS: The study protocol was approved by the Ethics Committee (2000/071). Forty-one individuals with chronic periodontitis (33 men, 8 women) were divided into two groups (test and control) after initial periodontal therapy. During this 6-month, randomized, double-blind, placebo-controlled study, test (n = 28) and control (n = 13) groups were administered a cyclic regimen of DP (50 mg, twice daily) or placebo. Clinical measurements and GCF sample collections were made at baseline, 2, 4, and 6 months. GCF levels of PGE2and IL-1ß were determined using enzyme immunoassay and enzyme-linked immunoassay kits, respectively. RESULTS: At baseline, no significant differences existed between groups for plaque indices, gingival indices, bleeding on probing, probing depth (PD), or attachment levels (P > 0.05). Compared with the control group, cyclic regimen in the test group suppressed increased levels of PGE2found in GCF at the end of the study (P < 0.05). Significant differences for PD and relative attachment gain were also noted in favor of the test group (P < 0.05). CONCLUSIONS: These results suggest that a cyclic regimen of DP may be efficacious in the management of chronic periodontitis in adults.

Gingival crevicular fluid levels of monocyte chemoattractant protein-1 in patients with aggressive periodontitis.

OBJECTIVES: The purpose of this study was to investigate the gingival crevicular fluid (GCF) levels of monocyte chemoattractant protein (MCP)-1 in aggressive periodontitis (AgP) and whether GCF MCP-1 levels differ among localized (L) AgP and generalized (G) AgP. MATERIAL AND METHODS: A total of 160 subjects including 80 AgP and 80 age- and gender-matched periodontally healthy (H) controls were recruited in this cross-sectional study (NCT02927704). GCF samples were collected from 160 patients including 50 LAgP, 30 GAgP, and 80 H. Volume of GCF was measured by Periotron 8000® , and enzyme-linked immunosorbent assay was used to assess MCP-1 levels. RESULTS: Compared to H controls, all clinical parameters and total amounts (pg 30 s-1 ) of MCP-1 were significantly higher in subjects with LAgP and GAgP (P < 0.05). Although concentrations of GCF MCP-1 did not differ between LAgP and GAgP (P > 0.05), total amounts of MCP-1 were higher in GAgP than LAgP (P < 0.05). CONCLUSION: It can be concluded that the total amount of MCP-1 level in GCF may be a potential determinant in AgP subjects. Increased MCP-1 levels in line with the degree of periodontal destruction in GAgP patients reveal that MCP-1 can be used to understand the disease pathogenesis of LAgP and GAgP.

Effects of alpha-tocopherol on gingival expression of inducible nitric oxide synthase in the rats with experimental periodontitis and diabetes.

BACKGROUND: The aim of this study was to investigate effects of α-tocopherol and/or insulin on the number of gingival inducible nitric oxide synthase (iNOS) positive cells in rats with experimental periodontitis with or without streptozotocin (STZ)-induced diabetes. MATERIALS AND METHODS: A total of 60 Sprague-Dawley rats were divided into three groups: Group I: The group without diabetes; Group II: The group with STZ-induced diabetes; Group III: The group with STZ-induced diabetes receiving insulin therapy. All animals received anesthesia, and 3/0 silk suture was inserted around the mandibular molar teeth. All groups were divided into subgroups receiving saline (Groups IA, IIA, IIIA) and α-tocopherol injection (Groups IB, IIB, IIIB). After a period of 3 weeks, all rats were sacrificed, and the number of gingival iNOS positive cells was analyzed using image analysis software. RESULTS: Applying α-tocopherol suppressed the number of gingival iNOS positive cells in Groups IB, IIB, and IIIB compared to application of saline (Groups IA, IIA, and IIIA) (P < 0.05). Numbers of gingival iNOS positive cells were found to be similar in the Groups I and III (P > 0.05). CONCLUSIONS: Within limitations of the current study, this is the first study one may suggest that α-tocopherol may reduce oxidative damage in the gingiva of the rats with periodontitis with or without STZ-induced diabetes and increase effects of insulin.

Effects on the clinical indices and gingival crevicular fluid enzyme activities of the cyclical regimen of low-dose doxycycline therapy for adult periodontitis.

The purpose of this study was to determine the effect of cyclic regimen of low dose doxycycline (20 mg) or placebo therapy following scaling and root planing on clinical parameters and crevicular fluid alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and elastase activities. Fifteen adults (13 males, 2 females) with moderate to advanced adult periodontitis were recruited for the study. The LDD-treated group (n = 8 subjects) self administered low dose doxycycline b.i.d. (20 mg, p.o.) from time (treatment) to 2 months and then no drug from 2 to 4 months and finally low-dose doxycycline b.i.d. from 4 to 6 months (i.e. "cyclical" regimen). The placebo-treated group (n = 7 subjects) was asked to take placebo capsules (containing inactive filler; i.e. starchflour) b.i.d. according to the same "cyclical" regimen. No differences were found between LDD- and placebo-treated groups regarding any of the clinical parameters and gingival crevicular fluid enzyme activities. The relative attachment gain was significantly improved in both groups. The "cyclical" regimen of low-dose doxycycline was not found to reduce alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and elastase activities in gingival crevicular fluid of the adult periodontitis patients over a 6-month time period.