Effect of non-surgical periodontal therapy on risk markers of cardiovascular disease: a systematic review and meta-analysis.

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality in the world. Patients with periodontitis have a higher risk of CVD, although a causal relationship between these conditions remains unclear. Non-surgical periodontal therapy (NSPT) is able to control inflammation at local and systemic levels. This study aimed to analyze the effect of NSPT on CVD risk markers. METHODS: Four electronic databases were searched from their inception to April 1, 2023, to identify and select articles without any language restrictions. Eleven CVD-related markers (e.g., C-reactive protein [CRP], Interleukin-6 [IL-6]) were selected. Meta-analyses were performed using random and fixed effect models. The differences were expressed as weighted mean differences (WMD) and 95% confidence interval (95% CI). RESULTS: From 1353 studies, twenty-one randomized controlled clinical trials were included in the meta-analysis. Results showed a significant decrease in CRP, IL-6, and systolic blood pressure (SBP) after NSPT. CONCLUSION: Moderate certainty evidence shows that NSPT has a positive effect on the reduction of IL-6 and SBP in patients with periodontitis, while low certainty evidence shows that NSPT is effective for reduction of CRP. Moderate certainty evidence showed that NSPT did not show a positive effect on low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC) and triglycerides (TG), and low certainty evidence showed that NSPT did not show a positive effect on Interleukin-1ß (IL-1ß), tumor necrosis factor-alpha (TNF-α), diastolic blood pressure (DBP), and flow-mediated dilatation (FMD). PROTOCOL REGISTRATION: The protocol was registered in the PROSPERO (International Prospective Register of Systematic Reviews), number CRD42022377565.

Regulatory effect of 17ß-estradiol on the expression of ß-defensin-2 and proinflammatory cytokines in human oral epithelial cells.

BACKGROUND: Although estrogen deficiency has been proposed as a risk factor for oral mucosal inflammatory diseases in post-menopausal women, the mechanisms involved remain unclear. This study aimed to investigate the effect of 17ß-estradiol (E2) on the inflammatory response stimulated by interleukin-1 beta (IL-1ß) in human oral mucosal epithelial cells (hOMECs) and its possible mechanism. METHODS: Primary hOMECs were obtained from female infants and cultured in keratinocyte growth medium. The hOMECs at second passage were collected and stimulated by 10-7  mol/L ICI182,780 or 10-7  mol/L G1 for 1 hour, E2 (10-7  mol/L, 10-8  mol/L, 10-9  mol/L) for 36 hour, 100 ng/mL IL-1ß for 12 hours, respectively. Human beta-2 defensin (hBD-2), tumor necrosis factor-alpha (TNF)-α, IL-6, IL-8, estrogen receptor-alpha (ERα), estrogen receptor-beta (ERß), and G protein-coupled receptor 30 (GPR30) mRNA levels and protein levels were measured by real-time quantitative polymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), and Western Blot (WB), respectively. RESULTS: Expression of hBD-2 and inflammatory cytokines increased after IL-1ß stimulation, which was down-regulated by E2 pre-treatment. With ICI182,780, the suppression of E2 on hBD-2 mRNA was attenuated. With G1, the mRNA expression and protein expression of hBD-2 were reduced. CONCLUSION: Pre-treatment of hOMECs with E2 at physiological concentrations inhibited the IL-1ß-induced expression of hBD-2 and inflammatory cytokines. The protective effects of E2 suggest its potential use treating oral inflammatory diseases in clinical practice.

[Evaluation of the cavity cleaning of ultrasonic instruments and slow-speed handpiece in posterior teeth root-end preparation].

PURPOSE: To compare the cleanliness of root end preparations by using ultrasonic instrumentation and slow-speed handpiece. METHODS: Thirty-two mesial roots of the first mandibular molars with two canals and mature root apices were assigned randomly to 2 groups, each group had 16 teeth. The root-end preparations were made respectively using ultrasonic diamond tip Berutti and NiTi tip RE2 and slow-speed handpiece with No.2 round bur. Root end cavities were examined under scanning electron microscope for further evaluation of the superficial debris and smear layer of the root end preparations. SPSS 13.0 software package was used for Kruskal Wallis test. RESULTS: Ultrasonic preparation had significantly less superficial debris and smear layer than slow-speed handpiece preparation (P<0.05). CONCLUSIONS: Ultrasonic instrument creates cleaner surfaces for root end cavities than slow-speed handpiece preparation in posterior teeth root end preparation.

[Effects of different instruments in root-end preparation: scanning electron microscopic evaluation].

PURPOSE: To evaluate the effects of retrograde preparation between ultrasonic retrotips and traditional slow-speed handpiece. METHODS: 27 maxillary second bicuspid teeth with two canals and one isthmus were divided randomly into 3 groups with 9 in each. The root-end preparations were made respectively using ultrasonic diamond tip Berutti and NiTi tip RE2, ultrasonic #40K file and slow-speed handpiece with NO.2 round bur. The postoperative epoxy resin replicas were examined under scanning electron microscope for further evaluating the number and type of the micro-cracks, the quality of cavity margin. SPSS13.0 software package was used for Kruskal-Wallis test. RESULTS: The number of micro-crack of ultrasonic instruments were significantly less than that of slow-speed handpiece(P=0.002).The type of micro-cracks has no significant difference between the two techniques(P=0.657). On the quality of cavity margin, the slow-speed handpiece group had significant inferior to the ultrasonic #40K file group(P=0.039); there was no significantly difference between the ultrasonic Berutti and RE2 group and the slow-speed handpiece group (P=0.136); there was no significant difference between the two ultrasonic groups (P=0.637). CONCLUSION: Ultrasonic instrument is feasible in the root-end preparation.