The association of osteoprotegerin gene polymorphisms with periodontitis

Background:  It has been demonstrated that genetic variation accounts for approximately half of the variance in periodontitis. The reported association of polymorphisms in the osteoprotegerin (OPG) gene with osteoporosis suggests that the OPG gene may also influence the genetic risk for periodontitis.
Subjects and methods:  We investigated the distribution of OPG gene polymorphisms in 49 patients with aggressive ( n  =   14) or chronic ( n  =   35) periodontitis and 49 control subjects without periodontitis, using polymerase chain reaction (PCR)–restriction fragment length polymorphism and PCR–single strand conformation polymorphism followed by direct sequencing.
Results:  A total of seven known polymorphisms and one new mutation, G373A, were identified. The T950 and G1181 alleles were more common in patients with periodontitis ( P  =   0.028 and P  =   0.047, respectively) than in control subjects. Especially, G1181 allele was associated with patients with aggressive periodontitis.
Conclusion:  The TG haplotype of T950C and G1181C polymorphisms in the OPG gene may be useful genetic markers for the prediction of periodontitis. Further studies in a larger population are required to determine whether these alleles directly contribute to periodontitis susceptibility.     

Vitamin D receptor polymorphism (-1056 Taq-I) interacts with smoking for the presence and progression of periodontitis

Aim: The aim of this analysis was to investigate the relationship between a vitamin D receptor (VDR) polymorphism and the diagnosis and progression of periodontitis.
Material and Methods: Data were derived from two different studies, including 231 subjects with healthy periodontium, 224 aggressive periodontitis and 79 chronic periodontitis (CP) patients in a case–control investigation. Sixty-one of these CP patients also took part in an observational study with a 1-year follow-up, in which progression of periodontitis was determined at the subject level. All 534 subjects provided a blood sample from which genomic DNA was extracted to study VDR −1056 TaqI polymorphism.
Results: The interaction between smoking and VDR polymorphism was associated with the diagnosis of periodontitis in Caucasians [ p =0.001, odds ratio (OR)=1.33, 95% confidence intervals (CI)=1.12–1.57] and all subjects ( p =0.033, OR=1.60, 95% CI=1.04–2.48). In the longitudinal study, subjects were divided into two clusters at 1 year according to the median number of progressing sites (Δcumulative attachment loss >2 mm). Logistic regression analysis revealed that the interaction between VDR Taq-I polymorphism and smoking showed limited evidence of association with the "severe progression" cluster ( p =0.033, OR=15.24, 95% CI=1.24–187.42).
Conclusions: Vitamin D receptor Taq-I TT polymorphism was moderately associated with both the presence and the progression of periodontitis in smokers, while no association was detected in non-smoking individuals. VDR genetic factors may interact with smoking in the pathogenesis of periodontitis.     

Local and systemic biomarkers in gingival crevicular fluid increase odds of periodontitis

Aim: To determine the independent and combined associations of interleukin-1 β (IL-1 β ) and C-reactive protein (CRP) in gingival crevicular fluid (GCF) on periodontitis case status in the Australian population.
Materials and Methods: GCF was collected from 939 subjects selected from the 2004–2006 Australian National Survey of Adult Oral Health: 430 cases had examiner-diagnosed periodontitis, and 509 controls did not. IL-1 β and CRP in GCF were detected by enzyme-linked immunosorbent assays. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated in bivariate and stratified analysis and fully adjusted ORs were estimated using multivariate logistic regression.
Results: Greater odds of having periodontitis was associated with higher amounts of IL-1 β (OR=2.4, 95% CI=1.7–3.4 for highest tertile of IL-1 β relative to lowest tertile) and CRP (OR=1.9, 95% CI=1.5–2.5 for detectable CRP relative to undetectable CRP). In stratified analysis, there was no significant interaction between biomarkers ( p =0.68). In the multivariate analyses that controlled for conventional periodontal risk factors, these relationships remained (IL-1 β OR=1.8, 95% CI=1.1–2.6; CRP OR=1.7, 95% CI=1.3–2.3).
Conclusions:  Elevated odds of clinical periodontitis was associated independently with each biomarker. This suggests that people with elevated biomarkers indicative of either local (IL-1 β ) or systemic (CRP) inflammation are more likely to suffer from periodontal disease.     

Association between type 1 and type 2 diabetes with periodontal disease and tooth loss

Aim: The aim of this study was to determine whether both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) are associated with increased prevalence and extent of periodontal disease and tooth loss compared with non-diabetic subjects within a homogeneous adult study population.
Material and Methods: T1DM, T2DM and non-diabetic subjects were recruited from the population-based Study of Health in Pomerania. Additionally, T1DM subjects were retrieved from a Diabetes Centre. The total study population comprised 145 T1DM and 2647 non-diabetic subjects aged 20–59 years, and 182 T2DM and 1314 non-diabetic subjects aged 50–81 years. Periodontal disease was assessed by attachment loss (AL) and the number of missing teeth.
Results: Multivariable regression revealed an association between T1DM ( p <0.001) and T2DM ( p <0.01) with mean AL after full adjustment. After age stratification ( p =0.04 for interaction), the effect of T2DM was only statistically significant in the 60–69-year-old subjects (B=0.90 (95% confidence intervals [95% CI]; 0.49, 1.31). T1DM was positively associated with tooth loss (adjusted, p <0.001). The association between T2DM and tooth loss was statistically significant only for females (odds ratios=1.60 [95% CI: 1.10, 2.33]).
Conclusions: Our study confirmed an association between both T1DM and T2DM with periodontitis and tooth loss. Therefore, oral health education should be promoted in diabetic subjects.     

Analysis of the interleukin-6 gene promoter polymorphisms in Czech patients with chronic periodontitis

BACKGROUND: Chronic periodontitis is an inflammatory disease, which is a major cause of tooth loss. The proinflammatory cytokines interleukin-1 (IL-1) and interleukin-6 (IL-6) are key regulators of the host response to microbial infection and major modulators of extracellular matrix catabolism and bone resorption. The purpose of this study was to investigate the associations of chronic periodontitis with IL-6 gene polymorphisms (at positions -597 [G/A], -572 [G/C], and -174 [G/C]). METHODS: We analyzed allele, genotype, and haplotype distributions of the IL-6 promoter variants in a case-control study involving 148 patients with chronic periodontitis and 107 unrelated controls. RESULTS: Our results showed significant differences in the distributions of alleles and genotypes of the IL-6 (-572 G/C) polymorphism between patients and the control population (chi2 = 10.393, P= 0.001, P(corr) < 0.01). The difference was due to the underrepresentation of the -572 G/C heterozygotes in patients (6.1%) compared to controls (19.6%). Although no variant "CC" homozygotes were detected in our cases and controls, heterozygosity protected against chronic periodontitis, representing a 73% reduction of risk (odds ratio [OR] = 0.27, 95% confidence interval: 0.12-0.61) compared to wild-type homozygotes. However, there were no significant differences in genotype or allele frequencies between both groups for IL-6 -597 G/A and -174 G/C polymorphisms. CONCLUSION: This study is the first, to our knowledge, suggesting that the -572 G/C polymorphism of the IL-6 gene may be one of the protective factors associated with lower susceptibility to chronic periodontitis.     

白细胞介素6基因-572位点多态性与重度慢性牙周炎易感性的相关分析

目的 研究白细胞介素(IL)6基因-572位点(IL-6-572位点)多态性与重度慢性牙周炎敏感性的关系,以期从基因水平探讨慢性牙周炎的遗传学机制. 方法 用聚合酶链反应-限制性片段长度多态性法检测93例重度慢性牙周炎患者和96名健康对照者的IL-6-572位点基因多态性,比较两组间此位点基因型分布和等位基因频率的差异. 结果 IL-6-572位点CC、CG、GG基因型在牙周炎组和健康对照组的分布频率分别为52.7%、40.9%、6.4%和67.7%、31.3%、1.0%,3种基因型在牙周炎组与对照组的分布差异有统计学意义(P<0.05);等位基因G、C在牙周炎和对照组之间的比例分别为26.9%、73.1%和16.7%、83.3%,其频率分布差异亦有统计学意义(P<0.05).相对于CC基因型,暴露于CG基因型+GG基因型的相对危险度为1.88(95%CI:1.04-3.40,P<0.05). 结论 本组人群患重度慢性牙周炎的易感性与IL-6-572位点基因多态性有关,其风险随等位基因G的增加而显著增加.     

IL-6、IL-6R和IL-4多态性与上海地区汉族人群慢性牙周炎患者的关联研究

目的 研究IL-6、IL-6R和IL-4基因组单核苷酸多态性（single nucleotide polymorphisms,SNPs）与上海地区汉族人群慢性牙周炎患者的相关性。方法 应用TaqMan荧光实时定量PCR方法,对128例牙周正常者和198例中度以上慢性牙周炎患者的IL-6 -572G/C、IL-6R 48892A/C和 IL-4 -590C/T等3个单核苷酸多态性位点进行分析。应用SPSS 17.0软件包对数据进行χ2检验分析。结果 分析显示这3个位点的基因型频率与等位基因频率在牙周正常组和慢性牙周炎组间的分布差异均无显著性。结论 IL-6 -572G/C、IL-6R 48892A/C和 IL-4 -590C/T基因组单核苷酸多态性位点与上海地区汉族人群的慢性牙周炎易感性无显著相关性。     

The impact of the IL-11:IL-17 ratio on the chronic periodontitis pathogenesis: a preliminary report

Objective:  An imbalance in the pro- and anti-inflammatory cytokines may be responsible for periodontal breakdown through immune responses. This study aimed to determine the total amount, concentration and ratio of interleukin (IL)-11 and IL-17 in gingival crevicular fluid (GCF) of chronic periodontitis (CP) patients.
Materials and methods:  Forty CP patients and 20 healthy controls (C) were included. The CP group was divided into two subgroups in line with the probing depth (PD) in GCF-sampling sites (CPa: PD ≥ 5 mm, CPb: PD ≤ 4 mm). For each patient, gingival index, plaque index, gingival bleeding time index, PD, and clinical attachment level values were recorded. IL-11 and IL-17 in GCF were evaluated by enzyme-linked immunosorbent assays.
Results:  The total amount and concentration of IL-11 and IL-17 were significantly lower in the CPa group (P <   0.05). The C group has the highest IL-11:IL-17 ratio, followed by CPb and CPa groups respectively. The ratio was significantly lower in CPa group than the CPb and C groups (P <   0.01).
Conclusion:  Our data confirm that the decreased ratio of IL-11:IL-17 may be a factor, which has shown this imbalance between the cytokines' activities in deeper pockets in our study.     

Effects of smoking on the ex vivo cytokine production in periodontitis

Background and Objective:  Smoking is associated with increased severity of periodontitis. The underlying mechanisms of this phenomenon are not well understood. The purpose of the present study was to compare the monocyte-derived T cell directing (Th1/Th2) response and pro-inflammatory cytokine production in ex vivo whole blood cell cultures (WBCC) of smoking and non-smoking chronic periodontitis patients.
Material and Methods:  Venous blood was collected from 29 periodontitis patients (18 non-smokers and 11 smokers) receiving supportive periodontal treatment, and diluted 10-fold for WBCC. The WBCC were stimulated for 18 h with Neisseria meningitidis lipo-oligosaccharide (LOS) or Porphyromonas gingivalis sonic extract (Pg-SE). The production of the T cell directing cytokines interleukin (IL)-12 p40 and IL-10, as well as the pro-inflammatory cytokines IL-1β, IL-6 and IL-8, was measured in the culture supernatants.
Results:  After LOS stimulation of WBCC, smokers showed a lower IL-12 p40/IL-10 ratio than non-smokers ( P <  0.05). Interleukin-1β production was significantly lower in smokers compared with non-smokers after stimulation with either LOS or Pg-SE ( P <  0.05). Interleukin-6 and IL-8 production was similar in WBCC from both smokers and non-smokers, for both LOS and Pg-SE.
Conclusion:  A more pronounced Th2 response in smoking periodontitis patients may be related to increased severity of the disease.     

The association of interleukin-4 haplotypes with chronic periodontitis in a Czech population

BACKGROUND: Cytokine gene polymorphisms are known to influence the susceptibility and disease course of many chronic disorders. Recently, interleukin (IL)-4 gene polymorphisms were associated with aggressive periodontitis. The aim of this study was to test differences in the distribution of the IL-4 alleles, genotypes, and haplotypes between patients with chronic periodontitis (CP) and healthy controls in a Czech population. METHODS: The association study was conducted using an age- and smoking status-matched case-control design in patients with CP (n = 194) and healthy controls (n = 158) using the polymerase chain reaction-restriction fragment length polymorphism methods for the -590C/T, -33C/T, and intron 3 variable number tandem repeat (VNTR) variants of the IL-4 gene. RESULTS: No significant differences between patients and controls were found in allele and genotype frequencies of all three polymorphisms. Nevertheless, complex analysis revealed significant differences in haplotype frequencies between the groups (P = 0.005). The haplotype T(-590)/T(-33)/allele 2 VNTR (70 base pairs)(2) of the IL-4 gene was significantly more frequent in patients with CP than in controls (17.0% versus 11.0%; odds ratio = 1.85; 95% confidence interval: 1.19 to 2.87). CONCLUSION: The three polymorphisms in the IL-4 gene act in a cooperative fashion and suggest that the high-production IL-4 haplotype was associated with an increased risk for CP in the Czech population.     

白细胞介素-4-590C/T基因多态性与牙周炎易感性的Meta分析

目的 评价白细胞介素-4-590C/T(IL-4-590C/T)基因多态性与牙周炎易感性之间的关系.方法 计算机检索PubMed、Embase、ScienceDirect和Web of Science、CBM、CNKI、WanFang、VIP数据库,搜集国内外有关基因多态性与牙周炎相关性的病例对照研究,经文献筛选、资料提取和质量评价后,采用R 3.3.1软件进行Meta分析,按牙周病分类及人群种族进行亚组分析.结果 Meta分析结果 显示,总体:IL-4-590C/T等位基因频率及各基因型频率与牙周炎间无显著关联:(T vs C:OR=1.19,95%CI=0.811.76,P=0.37).亚组:高加索人种对于携带CC基因型而言,携带TT基因更具牙周炎易感性(TT vs CC:OR=1.75,95%CI=1.10~2.78,P=0.02),差异具有统计学意义,而该基因型在亚洲人种未见显著差异(P=0.63);在慢性牙周炎与侵袭性牙周炎中,均未发现IL-4-590C/T等位基因频率及基因型频率与二者存在易感性(以T vs C.为例,慢性牙周炎:OR=1.20,95%CI=0.75~1.90,P=0.45;侵袭性牙周炎:OR=1.17,95%CI=0.77~1.78,P=0.45).结论 IL-4-590C/T基因多态性与高加索人牙周炎易感性间有一定相关性,与亚洲人牙周炎易感性无关.     

Association of interleukin-10 gene polymorphisms with severe generalized chronic periodontitis

BACKGROUND: Interleukin-10 (IL-10), an anti-inflammatory cytokine, plays a role in periodontal disease by inhibiting synthesis of proinflammatory cytokines and stimulating protective antibody production. Genetic polymorphisms in the IL-10 gene might be useful as a marker to diagnose susceptibility to periodontitis. Therefore, the aim of this study was to investigate the association between IL-10 gene polymorphisms and severe generalized chronic periodontitis (CP) in a Turkish population. METHODS: Samples of venous blood and DNA were obtained from 75 patients with severe generalized CP and 73 healthy subjects. The IL-10 promoter sequences at positions -597 and -824 were amplified by polymerase chain reaction, and polymorphisms were detected by restriction enzyme cleavage. Genotype and allele frequencies were calculated, and data were analyzed using the chi(2) test. Results: There was a statistically significant difference in frequencies of genotypes (AA/CC + CA: P = 0.00007, odds ratio = 12.37, 95% confidence intervals = 2.74 to 7.77; CC/CA + AA: P = 0.001, odds ratio = 3.05, 95% confidence intervals = 1.47 to 6.33) and alleles (P = 0.0002, odds ratio = 2.61, 95% confidence intervals = 1.52 to 4.51) at position -597 C to A between patients with severe generalized CP and healthy controls, whereas there was no significant difference in genotypes and allele frequencies at position -824 C to T between patients with CP and healthy subjects. CONCLUSION: Within the limitations of sample selection and number, the IL-10 gene polymorphism at position -597 seems to be associated with severe generalized CP.     

Physical activity, inflammatory biomarkers in gingival crevicular fluid and periodontitis

Aims: To examine the associations of physical activity with interleukin 1- β (IL-1 β ), C-reactive protein (CRP) and periodontitis and to investigate whether any relationship between physical activity and inflammatory mediators differs between periodontitis cases and non-cases.
Material and Methods: In this population-based case control study of Australians aged 18+ years, dentists conducted oral epidemiologic examinations identifying cases with moderate or severe periodontitis and periodontally healthy controls. Gingival crevicular fluid samples collected during examinations were analysed for inflammatory biomarkers. Subject-completed questionnaires assessed leisure-time physical activity. Exposure odds ratios (ORs) were estimated in multivariable logistic regression models adjusting for periodontitis risk indicators.
Results: Of 751 subjects (359 cases, 392 controls), those meeting a prescribed threshold for leisure-time physical activity had lower adjusted odds of elevated IL-1 β : OR=0.69, (95% CI=0.50–0.94) and detectable CRP: OR=0.70 (0.50–0.98) than less active adults. Physical activity was not associated with periodontitis: OR=1.14 (0.80–1.62). Periodontitis modified the association between levels of physical activity and detectable CRP. Increasing quartiles of physically activity were associated with decreasing probability of detectable CRP, but the effect was limited to periodontitis cases and was not apparent among non-cases.
Conclusion: Leisure-time physical activity may protect against an excessive inflammatory response in periodontitis.     

Lack of short-term adjunctive effect of systemic neridronate in non-surgical periodontal therapy of advanced generalized chronic periodontitis: an open label-randomized clinical trial

Aim: To determine if the adjunctive use of intra-muscular neridronate (NE) during non-surgical periodontal treatment (PT) provides, in patients with generalized chronic periodontitis (GCP), adjunctive benefits as compared with PT alone 3 months after the completion of a 3-month NE therapy.
Material and Methods: Sixty GCP healthy patients were randomly assigned to control (CG) or test group (TG). CG patients received PT only. Thirty subjects in TG also received adjunctive NE (12.5 mg in an i.m. injection/week for 3 months). Clinical parameters were evaluated at baseline, at the end of NE treatment (3 months after PT) and 3 months after the completion of NE treatment (6 months after the beginning of PT).
Results: Groups were balanced at baseline and all clinical parameters showed improvement between baseline and follow-ups. At 6 months improvements from baseline at sites with deep pocket depth (7 mm) were 3.2 mm [95% confidence interval (CI): 2.7–3.9] in CG and 3.0 mm (95% CI: 2.3–3.8) in TG with a non-significant difference of 0.2 mm (95% CI: −1.0–0.5; ancova ; p =0.549) between groups. Secondary outcomes did not show significant differences between groups. No major adverse events were reported.
Conclusions: The adjunctive use of NE during PT did not result in additional short-term improvements in periodontal conditions of GCP patients when compared with PT.     

TLR4 as a risk factor for periodontal disease: a reappraisal

Aim: To determine whether genetic variants of the TLR4 gene are associated with either chronic or aggressive periodontitis.
Methods: A systematic electronic search of literature was conducted to identify all published studies without any language restriction on the association between TLR4 and periodontal diseases, including chronic periodontitis and aggressive periodontitis. All case–control studies evaluating the TLR4 Asp299Gly and Thr399Ile polymorphisms in chronic or aggressive periodontitis were identified. A meta-analysis of the studies that fulfilled the inclusion criteria was performed.
Results: Seven studies comprising 744 chronic periodontitis cases and 855 controls and four studies consisting of a total of 295 aggressive periodontitis cases and 456 controls were included in the meta-analysis. In the pooled analysis, the TLR4 299Gly allele ( TLR4 +896 A>G) appeared to be a genetic risk factor for susceptibility to chronic periodontitis with a random effects and fixed effects odds ratio (OR) of 1.43 [95% confidence interval (CI):1.04–1.97; p =0.03]. On the other hand, the TLR4 399Ile polymorphism ( TLR4 +1196 C>T) showed a protective effect against aggressive periodontitis with a random effects OR of 0.29 (95% CI: 0.13–0.61; p =0.001).
Conclusion: Our results suggest that the alleles 299Gly and 399Ile in TLR4 can be a potential genetic marker for periodontal disease.     

Salivary levels of Epstein-Barr virus DNA correlate with subgingival levels, not severity of periodontitis

Objective:  The aim of this study was to determine the presence and quantity of human cytomegalovirus (CMV) and Epstein-Barr virus (EBV) DNA in the saliva of patients with periodontitis, and investigate the correlation between these factors.
Methods:  Presence and amounts of viral DNA in saliva and subgingival plaque samples, from healthy and disease sites, of 65 adults diagnosed with chronic periodontitis were determined using quantitative real-time polymerase chain reaction.
Results:  Epstein-Barr virus DNA was detected in saliva of 81.5% (53/65) of patients at a median concentration of 4325 copies ml⁻¹. CMV DNA was detected in saliva of one individual (1.5%) at low copy number. Patients who had EBV in saliva were 10 times more likely to have EBV in subgingival plaque than patients lacking EBV in saliva (odds ratio = 10.1, 95% confidence interval = 2.6–39.5; P  = 0.0009). EBV DNA burden in saliva positively correlated with the amounts detected in plaque and with amounts detected in increasing number of affected sites ( P  < 0.0001). EBV DNA presence and quantity in saliva did not correlate with increasing severity of disease as measured by periodontal indices.
Conclusions:  Epstein-Barr virus DNA presence and burden in saliva are associated with its presence and burden in subgingival plaque, but presence and burden in saliva does not correlate with periodontal disease severity.     

VEGF and MVD expression in sinus augmentation with autologous bone and several graft materials

Objective:  The aim of this study was to assess vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) in maxillary sinus augmentation with autogenous bone and different graft materials for evaluating their angiogenic potential.
Methods:  Biopsies were harvested 10 months after sinus augmentation with a combination of autogenous bone and different graft materials: hydroxyapatite (HA, n  =   6 patients), demineralized freeze-dried bone allograft (DFDBA, n  =   5 patients), calcium phosphate (CP, n  =   5 patients), Ricinus communis polymer ( n  =   5 patients) and control group – autogenous bone only ( n  =   13 patients).
Results:  In all the samples, higher intensities of VEGF expression were prevalent in the newly formed bone, while lower intensities of VEGF expression were predominant in the areas of mature bone. The highest intensity of VEGF expression in the newly formed bone was expressed by HA ( P  < 0.001) and CP in relation to control ( P  < 0.01) groups. The lowest intensities of VEGF expression in newly formed bone were shown by DFDBA and polymer groups ( P  <   0.05). When comparing the different grafting materials, higher MVD were found in the newly formed bone around control, HA and CP ( P  <   0.001).
Conclusion:  Various graft materials could be successfully used for sinus floor augmentation; however, the interactions between bone formation and angiogenesis remain to be fully characterized.     

Polymorphic drug metabolizing CYP‐enzymes – a pathogenic factor in oral lichen planus?

Background:  Oral lichen planus (OLP) is a chronic mucosal disease with a characteristic clinical phenotype. Environmental exposures, e.g. drugs have been associated with the pathogenesis.
Objectives:  To test the hypothesis that some OLP lesions have a pharmacological pathogenesis related to polymorphisms of the cytochrome P450 enzymes (CYPs) resulting in poor or intermediate CYP metabolism.
Methods:  One hundred and twenty patients with OLP and 180 gender-matched controls without OLP were genotyped for CYP2C9 , CYP2C19 , and CYP2D6 alleles with absent or reduced function.
Results:  The prevalence of poor or intermediate metabolizers was not higher among the OLPs as compared with the controls; however, there were higher numbers of variant CYP2D6 genotypes among the OLP females ( P  < 0.05). There were no differences between the groups with regard to intake of drugs metabolized by polymorphic CYPs or drug or herbal products inhibiting CYPs. The prevalence of CYP2D6*4 alleles among the OLPs was higher [28%; 95% confidence interval (CI) 20–36%] than previously reported among Danes (19%; 95% CI 17–22%). Fifty per cent of the OLPs had a CYP2D6*4 genotype as compared with 30% in the background population ( P  = 0.0001). The CYP2D6*4 protein has sequence homology with human herpes simplex virus type 1 (HSV1) and Candida albicans , which may result in molecular mimicry.
Conclusion:  It was not possible to substantiate a pharmacological pathogenesis of OLP based on poor or intermediate CYP metabolism. However, molecular mimicry between CYP2D6, in particular CYP2D6*4, and common oral pathogens may be involved in the pathogenesis of OLP.     

The relationship between periodontal condition and serum levels of resistin and adiponectin in elderly Japanese

Background and Objective:  Diabetes and periodontitis are associated with each other. Adipokines, specifically adiponectin and resistin, are secreted from adipocytes and are thought to cause insulin resistance in rodents. Additionally, adiponectin and resistin may play a role in inflammation and immune responses. The aim of this study was to clarify the relationship between serum levels of adipokines and periodontal conditions in elderly Japanese people with and without periodontitis.
Material and Methods:  A total of 158 Japanese men and women (76 years old) with or without periodontitis were selected for the study. Serum adiponectin, resistin, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations were compared between subjects with and without periodontitis.
Results:  Serum resistin levels and total leukocyte counts in subjects with periodontitis were higher than in control subjects. No significant differences were observed in adiponectin, IL-6 and TNF-α levels between subjects with and without periodontitis. Logistic regression analysis showed that periodontitis with at least one tooth that displayed a probing pocket depth of ≥6 mm was significantly associated with higher serum resistin levels (odds ratio, 2.0; 95% confidence interval, 1.0–4.0). When excluding periodontitis subjects with ≤10% of bleeding on probing and excluding control subjects with >10% bleeding on probing, differences between groups and odds ratio increased. Serum adiponectin tended to decrease in patients with periodontitis, albeit not significantly.
Conclusion:  Increased serum resistin levels were significantly associated with periodontal condition, especially when considering bleeding on probing, in elderly Japanese people. There was also a trend, though non-significant, toward decreased levels of adiponectin in subjects with periodontitis.     

Full-mouth treatment concepts for chronic periodontitis: a systematic review

Objectives: To systematically review the effectiveness of full-mouth treatment concepts for chronic periodontitis.
Material and Methods: A search was conducted for randomized, controlled clinical trials including full-mouth scaling with (FMD) or without (FMS) the use of antiseptics and quadrant scaling (control). Data sources included COHG, CENTRAL, MEDLINE and EMBASE. Reviewers independently conducted data abstraction and quality assessment. The primary outcome was tooth loss; secondary outcomes were the reductions of PPD and BOP and a gain of CAL.
Results: Of 216 identified abstracts, seven trials were included. Meta-analysis revealed a weighted mean difference (WMD) for the reduction of PPD between FMD and control of 0.53 mm [95% confidence interval (CI) (0.28, 0.77), p <0.0001] in moderately deep pockets of single-rooted teeth. The WMD for gain in CAL was 0.33 mm [95% CI (0.04, 0.63), p =0.03] in moderately deep pockets of single- and multi-rooted teeth. Comparing FMD and FMS, the WMD for the reduction of CAL amounted to 0.74 mm [95% CI (0.17, 1.31), p =0.01] in deep pockets of multi-rooted teeth in favour of FMS. For BOP a WMD –18.0% [95% CI (−34.30, −1.70), p =0.03] was calculated in deep pockets of single-rooted teeth in favour of FMD.
Conclusions: In adults with chronic periodontitis only minor differences in treatment effects were observed between the treatment strategies.