Gingival crevicular fluid prostaglandin E(2) and thiobarbituric acid reactive substance levels in smokers and non-smokers with chronic periodontitis following phase I periodontal therapy and adjunctive use of flurbiprofen

BACKGROUND: It has been established that smoking is an important risk factor for the initiation and progression of chronic periodontitis (CP). This study investigates the effects of phase I periodontal therapy and adjunctive flurbiprofen administration on prostaglandin E(2) (PGE(2)) and thiobarbituric acid reactive substance (TBARS) levels in gingival crevicular fluid (GCF) samples from smoker and non-smoker patients with CP. METHODS: Twenty-one non-smoker and 21 smoker patients with CP were divided into four groups according to treatment modalities. Group 1 (non-smokers with CP) and group 3 (smokers with CP) patients received daily 100-mg flurbiprofen tablets in a 2 x 1 regimen for 10 days together with scaling and root planing (SRP). Patients in group 2 (non-smokers with CP) and group 4 (smokers with CP) received placebo tablets in a 2 x 1 regimen for 10 days together with SRP. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) measurements were recorded and GCF samples were collected at baseline and on day 10 of drug intake from each sampling area by a single examiner who was unaware of the treatment modality. Assays for GCF PGE(2) and TBARS were carried out by an enzyme-linked immunosorbent assay and fluorometric method, respectively. RESULTS: All groups showed statistically significant reductions in PI and GI scores following the phase I periodontal treatment on day 10 (P <0.05), but no statistical differences were observed in PD and CAL scores after the therapy. In groups 1 and 2, the reduction of GCF PGE(2) and TBARS levels were not significant after the therapy compared to baseline levels. In group 3, GCF PGE(2) and TBARS levels exhibited a statistically significant decrease (P <0.05) after the therapy. Group 4 showed significant reductions (P <0.05) in GCF PGE(2) levels after the therapy. No statistically significant reductions were observed in group 4 with regard to GCF TBARS levels. When groups 1 and 3 were compared according to GCF TBARS levels after the therapy, a more statistically significant reduction was observed in group 3 (P = 0.001). CONCLUSION: These results suggest that additional flurbiprofen administration may have more inhibitory effects on GCF levels of PGE(2) and TBARS in the groups of smokers compared to non-smokers with CP.     

The resolvin D1 levels before and after periodontal therapy in periodontitis patients

Clinical Oral Investigations - The aim of this study was to determine the levels of resolvin D1 (RVD1) in the gingival crevicular fluid (GCF) and saliva in the patients with periodontitis and...     

Effect of periodontal therapy on crevicular fluid interleukin-1beta and interleukin-10 levels in chronic periodontitis

OBJECTIVES: This study aimed to analyse the levels of the proinflammatory cytokine IL-1beta and the anti-inflammatory cytokine IL-10 in gingival crevicular fluid (GCF) of patients with chronic periodontitis prior to, and following, periodontal therapy for a period of 32 weeks. MATERIAL AND METHODS: GCF samples were obtained from 24 non-diseased and 72 diseased sites of 12 periodontal patients prior to as well as at 6, 16 and 32 weeks post-periodontal therapy. All sites received conventional periodontal treatment and IL-1beta and IL-10 levels (concentration and total amount) were determined by enzyme linked immunosorbent assay (ELISA). Additionally, probing pocket depth (PD), clinical attachment loss (CAL), gingival (GI) and plaque (PII) indices were evaluated pre-and post-therapy. RESULTS: IL-1beta was detected in 382 out of 384 samples, while IL-10 was detected in 337 out of 384 samples. The total amount of IL-1beta was significantly higher at diseased compared to non-diseased sites (p<0.01). Following therapy, IL-1beta total amounts were reduced, while IL-1beta concentration gradually increased. IL-10 total amounts (per 30 s sample) were similar in diseased and non-diseased sites, and following therapy they remained almost unchanged. By contrast, IL-10 concentration was significantly higher in non-diseased sites (p<0.01) and displayed a significant increase post-therapy. Moreover, IL-1beta concentration and total amount were significantly greater in smokers following therapy, while IL-10 total amount was significantly higher in non-smokers both prior to and following therapy. Total IL-1beta amounts were positively correlated with GI and Pll. A weak negative correlation between IL-1beta and IL-10 levels was noted (p<0.05). CONCLUSIONS: The data suggest that the total amount rather than the concentration of IL-1beta in GCF seemed to be closely associated with periodontal disease severity. Moreover, smoking status influenced IL-1beta and IL-10 levels. An inverse relationship between IL-1beta and IL-10 was evident.     

Effect of phase I periodontal therapy on anti-cardiolipin antibodies in patients with acute myocardial infarction associated with chronic periodontitis

Background: Serum anti‐cardiolipin (aCL) antibodies are prevalent in patients with periodontal diseases. These increased aCL concentrations were identified to play a modulating role in cardiovascular diseases. The present study aims to explore the effect of phase I periodontal therapy on immunoglobulin (Ig)M and IgG aCL antibodies in patients with acute myocardial infarction (AMI) associated with chronic periodontitis. Methods: A cross‐sectional randomized clinical study was conducted within two groups comprising a sample size of 72 patients (n = 36 each). Group 1 had clinical features of AMI, and group 2 had clinical features of AMI associated with chronic periodontitis. After a thorough clinical and oral examination, the plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (AL) were recorded. Serum sample collection by venipuncture was done for estimation of serum IgM and IgG aCL concentration by using an enzyme‐linked immunosorbent assay method. In group 2, phase I periodontal therapy was performed, and clinical and biochemical parameters were reanalyzed after 1 month. Results: In group 2, the mean PI, GI, PD, clinical AL, and serum IgM and IgG aCL antibody levels were significantly higher than in group 1 patients. In addition, study results showed significant alterations in concentrations of serum IgM (P = 0.008) and IgG (P <0.001) aCL along with periodontal parameters after phase I periodontal therapy. Conclusion: The phase I periodontal therapy altered levels of serum IgG and IgM aCL antibodies in patients with AMI associated with chronic periodontitis.     

Endothelial dysfunction in patients with chronic periodontitis and its improvement after initial periodontal therapy

BACKGROUND: Recent epidemiological data suggested that there is a relationship between periodontal health and atherosclerotic coronary heart disease. Although hypothetical models were proposed, the exact mechanism of this association has not been clarified. The aim of this study is to investigate whether there is an endothelial dysfunction in patients with chronic periodontitis and, if present, whether recovery is possible with therapy. METHODS: The study groups consisted of 28 patients (mean age: 45.5 +/- 8.6 years) with chronic periodontitis and without any atherosclerotic vascular disease, and 26 healthy controls (mean age: 43.7 +/- 6.8 years). Cardiovascular risk factors were investigated in both groups. Brachial artery responses to reactive hyperemia (endothelium-dependent dilatation [EDD]) and sublingual nitroglycerin (endothelium-independent dilatation [EID]) were measured using high-resolution vascular ultrasound in both groups. Measurements were taken before and after initial periodontal therapy in the periodontal patients. RESULTS: There was no significant difference between the groups with regard to cardiovascular risk factors. In the baseline measurements, EDD and EID were significantly impaired in patients with chronic periodontitis when compared with the controls (8.4% +/- 4.0% versus 19.4% +/- 8.1%, P<0.0001; 13.3% +/- 6.3% versus 29.5% +/- 10.0%, P<0.0001 for EDD and EID, respectively). After non-surgical periodontal therapy, EDD and EID improved significantly (from 8.4% +/- 4.0% to 17.7% +/- 5.7%, P<0.0001; and from 13.3% +/- 6.3% to 24.9% +/- 7.3%, P<0.0001 for FMD and EID, respectively). The EDD and EID changes in the controls were insignificant. CONCLUSION: This study showed that endothelial functions were impaired in patients with chronic periodontitis and that they improve following initial periodontal therapy.     

Proinflammatory cytokine levels in hyperlipidemic patients with periodontitis after periodontal treatment

Oral Diseases (2012) 18 , 299–306 Objective: The aim of this study was to evaluate the effects of periodontal treatment on serum and gingival crevicular fluid (GCF) proinflammatory cytokine levels in hyperlipidemic patients with periodontitis. Materials and Methods: Fifty‐two patients with hyperlipidemia and periodontitis and 28 systemically healthy controls with periodontitis (C) were included in the study. Hyperlipidemic groups were divided into two groups as suggested diet (HD) and prescribed statin (HS). The clinical periodontal parameters, fasting venous blood, and GCF samples were obtained, and serum tumor necrosis factor‐alpha (TNF‐α), interleukin (IL) 1‐beta, and IL‐6 levels were evaluated at baseline and at 3 months follow‐up (3MFU) after the completion of the non‐surgical periodontal treatment that included scaling and root planning. Results: Percentage of bleeding on probing was significantly higher in the HS group than both the HD and C groups. In the HD and HS groups, there were significant decreases in serum IL‐6 and GCF TNF‐α levels between the 3MFU and baseline. A significant decrease was also found in GCF IL‐6 at the end of the study period in the HS group. Conclusion: The combination of the periodontal therapy and antilipemic treatment may provide beneficial effects on the metabolic and inflammatory control of hyperlipidemia.     

Effect of MMP-1 promoter polymorphisms on GCF MMP-1 levels and outcome of periodontal therapy in patients with severe chronic periodontitis

Aims: The aims of this study were to investigate (1) the matrix metalloproteinase‐1 (MMP‐1) promoter polymorphisms in severe chronic periodontitis (CP), (2) the relationship of periodontal therapy outcome with these genotypes, and (3) the gingival crevicular fluid (GCF) MMP‐1 levels–MMP‐1 genotype correlation. Material and Methods: Genomic DNA was obtained from the peripheral blood of 102 patients with severe CP and 98 periodontally healthy subjects. MMP‐1 ?519A/G and ?1607 1G/2G polymorphisms were determined by the polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) method. Fifty‐eight CP patients received non‐surgical periodontal therapy and were followed for 6 months. Clinical periodontal parameters and GCF samples were collected at baseline and at 6 months. GCF MMP‐1 levels were analysed by enzyme‐linked immunosorbent assay (ELISA). Results: The distribution of MMP‐1 genotypes did not significantly differ between the study groups. On the other hand, the ?1607 2G allele frequency of severe CP patients was higher than that of healthy subjects. MMP‐1 ?519G allele carriers had higher GCF MMP‐1 levels and percentage of sites with 4–6 mm clinical attachment level (CAL) compared with AA genotypes after non‐surgical periodontal therapy (p<0.05). Conclusions: These data suggest that the ?1607 2G polymorphic allele of the MMP‐1 gene could be associated with susceptibility to severe CP in the Turkish population. It seems that ?519AG and GG genotypes could play a role in the outcome of periodontal therapy.     

伴糖尿病的慢性牙周炎牙周基础治疗疗效观察二例

牙周炎和糖尿病(diabetes mellitus)都是严重危害人类健康的常见病,许多研究已经证实两者可以相互影响.目前,非手术治疗仍是牙周炎最基础、最有效的治疗方法.以控制菌斑为主的牙周基础治疗对伴有糖尿病的牙周炎患者能否取得同样的疗效,目前尚无明确结论.笔者在临床中曾收治两例伴糖尿病的慢性牙周炎患者,现报道如下,以期对牙周基础治疗对伴糖尿病的牙周炎患者牙周炎症及代谢改善的作用进行探讨.     

Correlation between periodontal status and biting force in patients with chronic periodontitis during the maintenance phase of therapy

Aim: The association between periodontal status and biting force is unclear. The aim of this study was to investigate the relation between periodontal status and biting force in patients with chronic periodontitis during the maintenance phase of periodontal treatment. Material and Methods: A total of 198 patients, who had entered a periodontal maintenance programme, were examined for the presence of restorations on the occlusal surface, probing pocket depth, clinical attachment loss (CAL), bleeding on probing, and mobility of teeth. Quantitative analysis of total biting force, occlusal contact area and biting pressure (defined by biting force per 1 mm² of occlusal contact area) was performed using microcapsular pressure‐sensitive sheets. Results: A multiple stepwise regression analysis showed that total biting force and occlusal contact area were positively associated with the number of present teeth and negatively associated with female gender, mean CAL and mean probing pocket depth. Biting pressure was positively associated with CAL. Conclusions: Reduced periodontal support was found to be associated with decreased total biting force and with increased biting pressure (defined as force per 1 mm² of occlusal contact area).     

Interleukin-17 and interleukin-18 levels in saliva and plasma of patients with chronic periodontitis

Özçaka Ö, Nalbantsoy A, Buduneli N. Interleukin‐17 and interleukin‐18 levels in saliva and plasma of patients with chronic periodontitis. J Periodont Res 2011; 46: 592–598. © 2011 John Wiley & Sons A/S Background and Objective: This study was planned to investigate whether patients with chronic periodontitis exhibit different salivary and/or plasma concentrations of interleukin (IL)‐17 and IL‐18 compared with clinically healthy subjects. Material and Methods: Whole saliva and blood samples, together with full‐mouth clinical periodontal recordings, were obtained from 22 otherwise healthy untreated nonsmokers with chronic periodontitis and from 21 systemically and periodontally healthy control subjects. The concentrations of IL‐17 and IL‐18 in saliva and plasma were determined using ELISAs. Results: The healthy control group exhibited significantly lower values in all clinical periodontal measurements (p < 0.001). The salivary concentration of IL‐17 was significantly lower, and that of IL‐18 significantly higher, in patients from the chronic periodontitis group compared with healthy control subjects (p = 0.025 and p = 0.009, respectively). Plasma IL‐17 and IL‐18 concentrations were similar in the two study groups (p > 0.05). Conclusion: Within the limits of the present study, it may be suggested that an elevated salivary IL‐18 level in untreated nonsmoker chronic periodontitis patients has the potential to be a biomarker for periodontal tissue destruction.     

Salivary enzyme levels after scaling and interleukin-1 genotypes in Japanese patients with chronic periodontitis

BACKGROUND: Saliva has been used as a diagnostic fluid in medicine and dentistry. It is easy to collect using non-invasive methods. The intracellular enzymes present in saliva have been studied as markers of periodontal disease. The purpose of this study was to determine the salivary enzyme levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) after scaling and to clarify the influence of interleukin (IL)-1 genotypes on these enzyme levels. METHODS: Forty-nine Japanese patients with chronic periodontitis (24 men and 25 women; mean age: 55.1 years) were enrolled in this study. Measurements of clinical parameters including probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) and collections of stimulated whole mixed saliva were performed at baseline and 4 weeks after scaling. After evaluation of salivary AST, ALT, and LDH levels, DNA was extracted from various cells in whole saliva. IL-1A+4845 G/T genotype was determined by polymerase chain reaction amplification, followed by enzyme digestion and electrophoresis. Statistical analysis was performed by the Wilcoxon signed-rank and Mann-Whitney U tests. A significant difference was set at P <0.05. RESULTS: Mean PD, CAL, and BOP values significantly decreased after scaling (mean +/- SE: 3.2 +/- 0.1 mm to 2.6 +/- 0.1 mm in PD; 3.9 +/- 0.2 mm to 3.3 +/- 0.2 mm in CAL; and 41% +/- 4% to 18% +/- 3% in BOP) (P <0.001). The values of AST, ALT, and LDH were 77.0 +/- 7.5, 43.9 +/- 5.5, and 753.4 +/- 96.5 (units per liter [U/l]) at baseline, and significantly decreased to 55.5 +/- 6.5, 30.0 +/- 5.5, and 394.7 +/- 34.0 (U/l) after scaling, respectively (P = 0.01, P = 0.006, and P <0.001). The carriage rate of the IL-1A+4845 allele 2 was 24.5%. No difference was noted in the decrease in PD, CAL, and BOP after scaling between the carriers (N = 12) and non-carriers (N = 37) of IL-1A+4845 allele 2. However, the IL-1A allele 2 non-carriers displayed a significant decrease in salivary AST and ALT levels (P <0.001), in contrast to the carriers who did not show any changes in the salivary levels of the enzymes after scaling. CONCLUSIONS: These results documented that salivary AST, ALT, and LDH levels reflect inflammation and destruction of periodontal tissue, suggesting clinically useful markers following periodontal therapy. In addition, although IL-1A+4845 alleles may not influence clinical parameters, they may influence post-scaling values of salivary AST and ALT.     

吸烟和非吸烟慢性牙周炎患者基础治疗后龈沟液肝细胞生长因子水平的变化

目的研究吸烟和非吸烟的慢性牙周炎患者牙周基础治疗前后龈沟液（GCF）中肝细胞生长因子（HGF）的水平变化。了解吸烟和基础治疗对GCF中HGF的水平的影响。方法将研究对象分为吸烟慢性牙周炎组和非吸烟慢性牙周炎组,每组患者各15例,实验牙各30颗,用滤纸条法在龈沟袋内获取牙周基础治疗前后的GCF样本．采用酶联免疫吸附试验（ELISA）测定其中的HGF水平。结果基础治疗后慢性牙周炎患者非吸烟组与吸烟组相比,GCF中HGF水平降低更明显（P〈0．01）。结论吸烟和GCF中HGF水平变化有关系。     

Interleukin-1beta, interleukin-12 and interleukin-18 levels in gingival fluid and serum of patients with gingivitis and periodontitis

INTRODUCTION: Cytokines are of major importance in periodontal disease progression. Interleukin-12 (IL-12) stimulates interferon-gamma production by T helper type 1 (Th1) cells while IL-18 induces Th1 responses when present with IL-12 but Th2 responses in the absence of IL-12. IL-1beta has been correlated with periodontal disease destruction. This study determined the local concentrations of these cytokines in sites of gingivitis and periodontitis. METHODS: Gingival crevicular fluid was collected from two sites in each of 10 gingivitis patients and from two gingivitis sites and two periodontitis sites from each of 10 periodontitis patients. Serum samples were also collected. IL-1beta, biologically active IL-12 p70, the IL-12 p40 subunit and IL-18 concentrations were determined by enzyme-linked immunoabsorbent assay. RESULTS: IL-1beta and IL-18 concentrations were higher in the gingival crevicular fluid from periodontitis patients than in that from gingivitis patients; IL-18 concentrations were higher than those of IL-1beta. Very little IL-12, either p40 or p70, was detected in the gingival crevicular fluid samples. In the serum, very low levels of cytokines were found. The level of serum IL-12 p40, however, was higher than in the fluid from periodontitis sites of periodontitis patients. CONCLUSION: The local production of IL-1beta and IL-18 in the gingival crevicular fluid increased with increasing inflammation and IL-18 was the predominant cytokine at both gingivitis and periodontitis sites. Very little IL-12 was detected with levels decreasing with increasing inflammation. These results suggest that there is an association between severity of periodontal disease and levels of IL-1, IL-12 and IL-18.     

牙周炎患者基础治疗后牙龈卟啉单胞菌的定植研究

目的 通过对牙周炎患者龈下菌斑中牙龈卟啉单胞菌(Porphyromonas gingivalu,Pg)的检测,探讨慢性牙周炎(chronic periodontitis,CP)和侵袭性牙周炎(aggressive periodontitis,AgP)患者牙周基础治疗后Pg的定植规律.方法 选取90例CP患者和90例AgP患者,在牙周基础治疗前、治疗后6周、12周共采集龈下菌斑样本1620个,运用AmpliFluor终末点定量聚合酶链反应方法 检测Pg含量.结果 治疗后6周CP和AgP组Pg活动位点分别为61(22.6%)和66(24.4%)个,两者差异无统计学意义(P>0.05);治疗后6周Pg活动位点在治疗前检测的牙周临床指数高于Pg静止位点.治疗后12周两组Pg活动位点分别为96(35.6%)和18(6.7%)个,差异有统计学意义(P<0.05);治疗后12周Pg活动位点在治疗后6周时检测的牙周临床指数高于Pg静止位点.结论 在牙周基础治疗后6周时,CP和AgP患者Pg定植均已开始,仉是两组定植规律存在一定差异.在牙周基础治疗后,治疗前牙周组织炎性反应严重的龈下位点Pg易于定植.     

The effects of periodontal therapy on serum and salivary leptin levels in chronic periodontitis patients with normal body mass index

Abstract

Summary. Leptin concentrations are altered in favour of pro health after periodontal therapy. Background. Leptin, a non-glycosylated peptide hormone, not only maintains fat stores, but is also an integral part of host defense repertoire. Leptin levels have been found to be altered in an array of inflammatory diseases including chronic periodontitis (CP), but the role of non-surgical periodontal therapy (NSPT) in altering the leptin concentrations in saliva and serum of CP patients is yet to be ascertained. The aim of the present study is to quantify leptin levels in CP patients having normal body mass index (BMI) pre-therapy as compared to periodontally healthy controls and to address whether successful NSPT alters leptin concentration in serum and saliva. Materials and methods. Twenty-two saliva (modified draining method) and serum samples (by venipuncture) were collected from CP patients with normal BMI (n = 22), before and at 4 and 12 weeks after completion of NSPT, and periodontally healthy, age- and gender-matched controls (n = 22). Leptin levels were estimated using enzyme linked immunosorbent assay kits. Results. At baseline, CP patients had significantly different periodontal clinical parameters and the leptin concentrations in saliva of CP patients were found to be significantly lower than periodontally healthy volunteers (4710.10 ± 1133.21 vs 8721.10 ± 1019.58 pg/ml) (p < 0.05), whereas in serum the leptin concentrations were significantly higher than healthy controls (10749 ± 2062.24 vs 8085.00 ± 2859.68 pg/ml). Significant improvement in periodontal parameters, serum and salivary leptin levels were observed in CP patients at 4 and 12 weeks post-therapy (p < 0.01). Conclusion. Altered concentrations of leptin in serum and saliva are observed in CP patients which can be restored in favor of health after periodontal therapy.     

Interleukin-1 beta (IL-1 beta) levels in gingival crevicular fluid from adults with previous evidence of destructive periodontitis. A cross sectional study.

We have estimated the levels of Interleukin-1 beta (IL-1 beta) by ELISA in gingival crevicular fluid (GCF) at 58 sites from 37 patients with adult periodontitis. GCF was collected for 5 s on filter papers and a 2nd sample was collected for 30 s 1 min later. 68/116 strips yielded detectable levels of IL-1 beta. IL-1 beta was present in both the 1st and 2nd samples at 28 sites, in the 1st only at 4 sites and in the 2nd only at 8 sites; 18 sites were below the level of detection for the assay. When the concentrations of IL-1 beta were calculated in the original volume of GCF on each strip, the mean value for positive strips was 34.16 +/- 29.45 (SD) pg/microliters with a range from 1.75 to 97.13 pg/microliters. There were no statistically significant correlations with the plaque index, bleeding index or probable crevice depth (pocket depth). The results indicate that IL-1 is present in the GCF from a proportion of sites with evidence of previous periodontal destruction.     

白细胞介素-1基因多态性与侵袭性牙周炎的关系

目的：研究中国人群中白细胞介素-1（IL-1）基因多态性与侵袭性牙周炎（AgP）之间的关系。方法：提取122例AgP患者和95例健康对照者外周静脉血基因组DNA,采用聚合酶链反应（PCR）分析IL-1A＋4845、IL-1B＋3954位点的单核苷酸多态性（SNP）及IL-1RN第二内含子中的可变数目重复序列（VNTR）多态性,采用多因素Logistic回归模型,进行两组之间基因型、等位基因分布差异的比较。结果：在IL-1A＋4845位点,AgP组男性患者A2^＋基因型的频率较男性健康组显著升高（P〈0．05=0．039）,等位基因A2的携带率也显著升高（P〈0．05=0．049）;未发现IL-1B＋3954位点和IL-1RN VNTR的多态性与AgP关联;未发现IL-1各复合基因型与AgP存在明显关联性。结论：IL-1A＋4845位点的SNP可能与中国人群中男性个体的AgP易感性有关。