Association of MTHFR gene C677T mutation with recurrent aphthous stomatitis and number of oral ulcers

Objectives

Recurrent aphthous stomatitis (RAS) is a common ulcerative disease of the oral mucosa. Methylenetetrahydrofolate reductase (MTHFR) gene variants are associated with thrombophilia and vasculopathy that may result in oral ulceration. Oral ulcers are also the most common feature of Behcet’s disease (BD). Association of MTHFR gene C677T mutation with BD has been reported in different populations. The aim of the present study was to investigate the possible association between MTHFR gene C677T mutation and RAS and evaluate if there was an association with clinical features in a relatively large cohort of Turkish patients.

Materials and methods

The study included 188 patients affected by RAS and 200 healthy controls. Genomic DNA was isolated and genotyped using polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) assay for the MTHFR gene C677T mutation.

Results

The genotype and allele frequencies of C677T mutation showed statistically significant differences between RAS patients and controls (p?=?0.002 and p?=?0.0004, respectively). After stratifying RAS patients according to clinical characteristics of oral ulcers, a significant association was observed between C677T mutation and number of oral ulcers of RAS patients (p?=?0.006).

Conclusions

As a result, a high association between MTHFR gene C677T mutation and RAS was observed in the present study. Also number of oral ulcers was found to be associated with MTHFR C677T mutation in RAS patients.

Clinical Relevance

If our observation can be substantiated with further studies, evaluation for MTHFR mutations and perhaps folate supplementation may become necessary in selected patients.     

Levels of salivary IgA in patients with minor recurrent aphthous stomatitis: a matched case–control study

Objectives

Recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease. Despite plenty of studies on aetiopathogenesis of RAS, a definite cause is not clear. The objective of this study was to determine the potential changes of salivary IgA and salivary flow rate in patients affected with minor form of RAS.

Materials and methods

Levels of salivary IgA in 33 patients with acute RAS (minor form) and 33 matched healthy controls were determined using enzyme-linked immunosorbent assay. Resting salivary flow rates were determined too. Both measurements, levels of salivary IgA and resting salivary flow rate, were performed again for each RAS patient in remission phase.

Results

Levels of salivary IgA were significantly increased in acute phase of RAS [median (interquartile range)—124.94 μg/mL (106.22–136.31)] in comparison with the levels in healthy controls [88.92 μg/mL (76.85–93.91; P?<?0.001)] and with the levels in remission phase [102.4 μg/mL (84.6–120.16; P?=?0.01)]. Even in the disease-free period (remission phase), levels of salivary IgA remained significantly higher in comparison with the levels in healthy controls (P?=?0.01). Salivary flow rates, on the other side, were not influenced by the disease state (RAS vs. healthy), phase (acute vs. remission) or even gender (males vs. females).

Conclusion

Marked increase of salivary IgA in acute and remission phases of the minor RAS may suggest a potential role for this immunoglobulin in pathogenesis of the disease.

Clinical relevance

Salivary IgA may be an important aetiological agent in the pathogenesis of RAS, and hence, its immunomodulation may help prevent the disease.     

Evaluation of serum zinc levels in patients with recurrent aphthous stomatitis (RAS)

Background

Recurrent aphthous stomatitis (RAS) is an ulcerative disease of the oral mucosa without a clearly defined etiology. The aim of the study was to evaluate the serum zinc levels in patients with RAS in comparison to healthy controls and to validate the association between zinc levels and the course of RAS.

Methods

Seventy-five patients with RAS and 72 controls underwent full dental examination. Serum zinc levels were determined by flame atomic absorption spectroscopy (F AAS). The results were statistically analyzed with Kruskal-Wallis, Mann-Whitney, chi-square tests and the test of difference between the two rates of structure with p?<?0.05 as a significance level (Statistica 10, StatSoft®).

Results

No statistically significant differences were detected in serum zinc levels between RAS patients and healthy controls. The mean serum zinc concentration was found to be 84.2 μg/dL in RAS group and 83.9 μd/dL in controls, within the accepted norms. Zinc deficiency was observed in 10.7% patients from the RAS group and in 6.9% controls. No significant differences in serum zinc levels were found between patients when the course of the disease was considered.

Conclusions

Serum zinc concentrations did not differ significantly in RAS patients and in healthy controls and it did not influence the course of the disease. Therefore, zinc does not appear to be an important modifying factor in the development of RAS.

     

Association between recurrent aphthous stomatitis and Helicobacter pylori infection: a meta-analysis

Objectives

Several studies have shown the possible involvement of Helicobacter pylori infection in individuals with recurrent aphthous stomatitis (RAS), but the relationship remains controversial. This meta-analysis was performed to validate the association between RAS and H. pylori infection.

Materials and methods

The PubMed database was searched up to January 25, 2013 to select studies on the prevalence of H. pylori infection between RAS patients and control subjects. Studies were included if they evaluated and clearly defined exposure to RAS, reported the incidence of H. pylori infection, or provided data for their estimation. For subgroup analyses, studies were separated by region, publication year, and source of controls to screen the potential factors against the results. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Summary odds ratio (OR) estimates with 95 % confidence intervals (CIs) were calculated using the fixed-effects model.

Results

Seven case-control studies containing 339 cases and 271 controls were eventually selected for analysis. A total of 100 (29.50 %) RAS patients had H. pylori infection, which was significantly greater than the 54 (19.93 %) non-RAS controls with H. pylori infection (OR?=?1.85, 95 % CI: 1.24–2.74, P?=?0.002). This result persisted in a hospital-based control subgroup (OR?=?2.72, 95 % CI: 1.57–4.72).

Conclusions

Based on our meta-analysis, H. pylori infection is associated with an increased risk of RAS.

Clinical relevance

The eradication of H. pylori in the stomach may promote relief of RAS symptoms and healing of oral ulcers, and even prevent the occurrence of RAS.     

Oxidative damage of rat liver induced by ligature-induced periodontitis and chronic ethanol consumption

Objective

Oxidative stress plays a central role in the initiation and progression of liver disease. Chronic ethanol consumption induces oxidative damage of the liver. Using a rat model, we previously showed that chronic administration of lipopolysaccharide and proteases to gingival sulcus induced both periodontal inflammation and liver injury. Periodontitis and ethanol consumption may have an additional effect on hepatic oxidative damage. The present study investigated the effects of periodontitis on ethanol-induced oxidative damage of the liver using a rat model.

Design

Male Wistar rats were divided into four groups (six rats/group). During the experimental period of eight weeks, two groups were fed an ethanol-containing liquid diet, and two groups were on a pair-fed control diet. Four weeks prior to the end of the experimental period, one group from each dietary treatment was ligated to induce periodontitis, while the other group was left unligated. In order to evaluate hepatic oxidative damage, the level of hexanoyl-lysine and the ratio of reduced form glutathione/oxidized form glutathione (GSH/GSSG) was determined. The concentration of blood hexanoyl-lysine was also measured as an index of circulating lipid peroxide.

Results

Ligature-induced periodontitis increased plasma levels of hexanoyl-lysine. In the liver, periodontitis decreased the GSH/GSSG ratio, and the combination of periodontitis and ethanol consumption induced a significant increase in hexanoyl-lysine level compared to ethanol consumption alone.

Conclusion

In the rat model, ligature-induced periodontitis increased plasma lipid peroxide, decreased the hepatic GSH/GSSG ratio and augmented ethanol-induced lipid peroxidation in the liver.     

Investigation of trefoil factor expression in saliva and oral mucosal tissues of patients with oral squamous cell carcinoma

Objectives

The aims of our study were to determine levels of trefoil factor (TFF) peptides in saliva and oral mucosal tissues from patients with oral squamous cell carcinoma (OSCC), and to evaluate whether individual members of TFFs (TFF1, TFF2, and TFF3) might act as biomarkers of disease.

Materials and methods

Saliva samples were from 23 healthy subjects and 23 OSCC patients. Tissue samples were collected from 32 normal oral mucosa (NOM) and 32 OSCC biopsy specimens. ELISA and immunohistochemical methods were used to evaluate the expression of TFF1, TFF2, and TFF3 in saliva and oral mucosal tissues, respectively.

Results

Expression of TFF2 and TFF3 in oral mucosal tissues of OSCC patients was strongly downregulated when compared to healthy subjects (p?<?0.001 and p?=?0.002, respectively). However, there were no differences in levels of salivary TFF concentrations between OSCC patients and healthy subjects.

Conclusions

The present study extends previous observations, demonstrating the reduction of TFF2 and TFF3 expression in oral mucosal tissues of OSCC patients.

Clinical relevance

These findings suggest the clinical significance of TFF2 and TFF3 molecules as negative markers of tumor progression in OSCC. Quantification of TFF levels in saliva may not be optimal in terms of diagnostic or predictive value for OSCC derived from oral mucosa.     

Levels of potential oral cancer salivary mRNA biomarkers in oral cancer patients in remission and oral lichen planus patients

Objectives

To gather preliminary data concerning the feasibility of using seven salivary mRNAs—IL-8; IL-1β; dual specificity phosphatase 1 (DUSP1); H3 histone family 3A (H3F3A); ornithin decarboxylase antizyme 1 (OAZ1); S100 calcium-binding protein P (S100P); and spermidine/spermine N1-acetyltransferase 1 (SAT1)—for detecting development of oral squamous cell carcinoma (OSCC) in oral lichen planus (OLP) patients and OSCC patients whose disease was in remission.

Materials and methods

Saliva samples were collected from five study groups (25 subjects/group): newly diagnosed OSCC, OSCC-in-remission, disease-active OLP, disease-inactive OLP, and normal controls. The salivary mRNA levels were determined by a pre-amplification RT-qPCR approach with nested gene-specific primers. Mean fold changes between each pair of study groups were analyzed by the Mann–Whitney U test.

Results

Salivary levels of OAZ1, S100P, and DUSP1 mRNAs were significantly higher in newly diagnosed OSCC patients, compared to: (1) normal controls (p?=?0.003; p?=?0.003; and p?<?0.001, respectively); (2) OSCC-in-remission (p?<?0.001; p?=?0.001; and p?<?0.001, respectively); (3) disease-active OLP (p?<?0.001; p?=?0.016; and p?<?0.001, respectively); and (4) disease-inactive OLP (p?=?0.043; p?<?0.001; and p?<?0.001, respectively). No significant differences were found in the levels of salivary IL-8, IL-1β, H3F3A, and SAT1 mRNAs between newly diagnosed OSCC patients and the normal controls (p?=?0.093, 0.327, 0.764, and 0.560, respectively).

Conclusion

Salivary OAZ1, S100P, and DUSP1 mRNAs are candidate biomarkers for detecting OSCC development in OSCC patients in remission and in OLP patients.

Clinical relevance

The results of this study serve as the basis for a further large-scale study which may lead to a non-invasive screening method for early detection of OSCC.     

Prognostic and predictive value of serum vascular endothelial growth factor (VEGF) in squamous cell carcinoma of the head and neck

Introduction

This study aimed to investigate the prognostic and predictive value of serum vascular endothelial growth factor (VEGF) in head and neck squamous cell carcinoma (HNSCC).

Method

Preoperative and 6-month postoperative serum VEGF levels were measured using a quantitative sandwich enzyme immunoassay technique in 55 consecutive patients with HNSCC and two control groups. The first control group included normal, healthy, age- and sex-matched individuals (n?=?20), while the second control group included the patients who had history of HNSCC and were free of disease for at least 5 years (n?=?25).

Results

The mean baseline serum VEGF concentrations of the 55 patients with HNSCC and the first and the second control groups were 437.86, 42.56, and 48.03 pg/ml, respectively (P?<?0.001). After a median follow-up of 75 months, 15 patients of the study group developed recurrent disease and 40 patients remained free of disease. The mean preoperative and 6-month postoperative serum VEGF levels for the 40 patients who did not have recurrent disease were respectively 327.69 and 153.50 pg/ml compared to 731.72 and 692.96 pg/ml for the 15 patients with recurrent disease (P?<?0.001). High (≥540 pg/ml) serum VEGF level was associated with poor overall survival (P?<?0.001). Moreover, multivariate analysis showed node stage (P?<?0.001) and preoperative serum VEGF level (P?=?0.020) as significant, independent prognostic factors for overall survival.

Conclusion

Preoperative or postoperative elevated serum levels of VEGF are highly predictive for disease recurrence and are associated with poor disease-free and overall survival of patients with HNSCC.     

Salivary level of interleukin-8 in oral precancer and oral squamous cell carcinoma

Background

Interleukin 8 (IL-8) is a pro-angiogenic, pro-inflammatory mediator that belongs to the family of chemokines. Due to its pro-angiogenic characteristic, it may play a vital role in tumour angiogenesis and progression.

Objectives

This study was designed to estimate the levels of salivary IL-8 in oral precancer and oral squamous cell carcinoma (OSCC) patients and compare them with healthy controls. The aim was to evaluate its efficacy as a potential biomarker for these diseases.

Materials and methods

Each group comprised 25 individuals. The salivary IL-8 levels were determined by enzyme-linked immunosorbent assay.

Results

The levels of salivary IL-8 were found to be significantly elevated in patients with OSCC as compared to the precancer group (p?<?0.0001) and healthy controls (p?<?0.0001). However, the difference in salivary IL-8 concentrations among the precancer group and controls was statistically non-significant (p?=?0.738).

Conclusions

Our results suggested that salivary IL-8 can be utilised as a potential biomarker for OSCC. Salivary IL-8 was found to be non-conclusive for oral premalignancy in this preliminary study. Hence, its possible role in transition from premalignancy to malignancy needs further research with larger sample sizes.

Clinical relevance

Saliva as a diagnostic biofluid offers a number of advantages over blood-based testing. The role of IL-8 in oral cancer if validated further by future research can provide an easy diagnostic test as well as a prognostic indicator for patients undergoing treatment. Therefore, if it’s role in tumourigenesis can be sufficiently assessed, it could open up new avenues to find out novel treatment modalities for oral cancer.     

Evaluation of the quality of different endodontic obturation techniques by digital radiography

Objectives

This study was aimed to evaluate different endodontic obturation techniques (Thermafil, lateral condensation, and Tagger’s hybrid technique) regarding the homogeneity of the obturation radiopacity.

Materials and methods

Seventy roots of human upper central incisors were filled using the Thermafil system, lateral condensation. and Tagger’s hybrid technique. Radiopacity of the filling was evaluated based on mean of grey levels, and its homogeneity was assessed by the coefficient of variation (CV), analyzing the histograms obtained of digitized and digital radiographs.

Results

The increase in mean grey levels (p?<?0.001) and reduction in the CV (p?<?0.05) were higher for Tagger’s hybrid technique compared with other methods.

Conclusions

Tagger’s hybrid technique provided better homogeneity of the obturation radiopacity and better apical sealing compared with lateral condensation technique.

Clinical relevance

The results suggest that Tagger’s hybrid technique provided the best compaction of the root canal filling material, an important factor for the sealing of obturations and, consequently, for the effectiveness of treatment.     

Oral lichen planus may enhance the expression of Th17-associated cytokines in local lesions of chronic periodontitis

Objectives

This study aims to compare the expression levels of interleukin (IL)-17 and IL-23 in local periodontal tissues from patients with both chronic periodontitis and oral lichen planus (CP-OLP), patients with chronic periodontitis (CP) only, patients with oral lichen planus (OLP) only, and healthy controls (HC).

Materials and methods

The periodontal tissues were collected from 15 CP-OLP patients, 15 CP patients, 15 OLP patients, and 10 healthy controls. Immunohistochemistry (IHC) and real-time quantitative PCR (qPCR) was performed to investigate the protein and mRNA expression level of IL-17 and IL-23 in periodontal lesions from these four groups.

Results

IHC statistical analysis showed that the expression level of IL-17- and IL-23p19-positive cells significantly increased in CP-OLP group compared with that in CP (P?<?0.01) and OLP groups (P?<?0.05), showing intense staining reaction in local lamina propria lesions. Meanwhile, qPCR result showed higher IL-17 mRNA level in CP-OLP compared with that in CP and OLP groups and demonstrated a significant increase than OLP group (P?<?0.05). Moreover, it was found that IL-17 mRNA expression level in erosive CP-OLP patients was significantly correlated with probing depth and attachment loss (P?<?0.05).

Conclusions

This study indicated that there was an increased expression level of IL-17 and IL-23 in periodontal tissues from periodontitis patients with oral lichen planus, which might aggravate the inflammatory response in local lesions.

Clinical relevance

Oral lichen planus and chronic periodontitis may have interaction in disease pathogenesis, while IL-17 detection in local lesions may be helpful in identifying the disease severity in periodontitis patients with oral lichen planus.     

Apical periodontitis and periodontal disease increase serum IL-17 levels in normoglycemic and diabetic rats

Objectives

This study aimed to evaluate the influence of apical periodontitis (AP) and/or periodontal disease (PD) on serum interleukin-17 (IL-17) levels in a rat model of diabetes mellitus (DM).

Methods

Eighty male Wistar rats were divided into eight groups of ten animals each: normoglycemic, AP, PD, AP+PD, DM, DM+AP, DM+PD, and DM+AP+PD. DM was induced using streptozotocin, AP by dental pulp exposure to the oral environment, and PD by periodontal ligature. The animals were sacrificed after 30 days, and venous blood samples were collected via cardiac puncture to determine the serum IL-17 and neutrophil levels. The maxillae were dissected and processed for radiographic analysis. The periapical lesion areas were quantified in pixels. The total assessed values were tabulated according to each experimental group and were statistically analyzed using Spearman’s correlation and Kruskal-Wallis test (p?Results A significant difference in the serum IL-17 levels was observed between the groups without oral infections and the groups with AP+PD-associated lesions, regardless of the presence of DM (p?p?p?Conclusion The combination of AP and PD increased the serum IL-17 levels in DM and normoglycemic rats and increased the neutrophil levels in DM rats. Diabetes increased the neutrophil levels and bone resorption in rats.

Clinical significance

AP is capable of potentiating systemic inflammatory changes when associated with PD, and increases in blood glucose can accelerate the pathogenesis of oral infections.     

T helper cells from aggressive periodontitis patients produce higher levels of interleukin-1 beta and interleukin-6 in interaction with Porphyromonas gingivalis

Objective

In this study, we analyzed the production of Interleukin-1 beta (IL-1β) and IL-6 by activated CD4+ cells obtained from aggressive periodontitis (AgP) patients in comparison with healthy subjects (HC).

Materials and methods

CD4+ cells were automatically separated from lymphocytes obtained from peripheral blood of patients with AgP and healthy controls. Cells were activated for 4, 8, and 24 h with three different stimuli: anti-CD3/anti-CD28, phytohemagglutinin (PHA), and Porphyromonas gingivalis (P. gingivalis) outer membrane protein (OMP). Protein levels were measured in supernatants of activated CD4+ cells by a bead-based immunoassay (CBA). In addition, serum antibodies against P. gingivalis were determined. Data were analyzed using U test (p?Results T helper cells of AgP patients activated with P. gingivalis OMP produced higher levels of IL-1β and IL-6 in comparison with healthy controls (p?P. gingivalis.

Conclusion

In view of these results, it is possible to conclude that P. gingivalis contributes to the pathogenesis of AgP by inducing high levels of pro-inflammatory cytokines such as IL-1β and IL-6 by peripheral CD4+ T helper cells.

Clinical relevance

In accordance with the clinical parameters and the immunological data, we suggest that full-mouth disinfection with adjunctive systemic antibiotics might be the anti-infectious non-surgical periodontal treatment of choice in this type of patients. Microbiological analyses at the beginning and at the end of the periodontal treatment are recommended. However, it is necessary to verify these data in longitudinal clinical studies.     

Relationship between bone mineral density and trabecular bone pattern in postmenopausal osteoporotic Brazilian women

Objectives

The aim of this study is to evaluate the relative efficacy of the mandibular trabecular bone in detecting osteoporotic-associated bone changes in Brazilian women.

Materials and methods

Seventy-three digital panoramic radiographs of healthy and osteoporotic postmenopausal women were used. Regions of interest were selected in the mandibular angle and body of the panoramic images, which were analyzed for fractal dimension (FD) and pixel intensity (PI). Statistical analysis evaluated the distribution pattern, compared normal with osteoporotic patients and the right with the left mandible, and assessed the relationship between FD and PI. The significance level was set at 0.05.

Results

FD and PI values were significantly different (p?<?0.05) between normal and osteoporotic patients for the right and left mandibular angle and for the left mandibular body. There was no significant difference (p?>?0.05) between the right and left mandibular angle for FD and PI, but a significant difference (p?<?0.05) was observed on the mandibular body for PI values. FD and PI values presented positive correlation.

Conclusions

The mandibular trabecular bone was effective in detecting osteoporotic changes, with the exception of the right mandibular body.

Clinical relevance

Mandibular trabecular bone shows a promising attempt of accurate detection of osteoporotic changes in some regions of the jaws. Fractal analysis and pixel intensity had strong positive correlation.     

Radiologic bone loss in patients with bisphosphonate-associated osteonecrosis of the jaws: a case–control study

Objectives

Most patients with bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) report a previous tooth extraction at the necrosis site before the diagnosis was made. At older ages, most teeth are extracted due to periodontal disease, which is per se another BP-ONJ trigger factor. The aim of this study was to evaluate the periodontal status of BP-ONJ patients using panoramic radiographs compared to a control.

Materials and methods

All patients treated for BP-ONJ up to January 1, 2010 comprised the study. The very first panoramic radiograph was analyzed. The number of remaining teeth and the radiographic bone loss from the cemento-enamel junction to the crestal bone were measured. For each patient, one control was analyzed (matching for gender and age).

Results

One hundred twenty-nine BP-ONJ panoramic radiographs and 129 controls were analyzed (68 women, 61 men; 67.3?±?9.7 years; osteoporosis [n?=?11], breast cancer [n?=?33], multiple myeloma [n?=?61], prostate cancer [n?=?24]). The average number of remaining teeth was 12.9?±?8.4 for BP-ONJ and 16.4?±?9.4 for the control (p?=?0.02). The average radiographic bone loss was 5.5?±?2.3 mm for BP-ONJ and 3.1?±?1.1 mm for the control (p?<?0.001); 96.6 % of BP-ONJ and 77.5 % had radiographic bone loss of more than 5 mm. Radiographic bone loss in the molar region was the highest for both groups (BP-ONJ 6.0?±?2.3 mm; control 3.6?±?1.4 mm).

Conclusion

Prevalence and severity of periodontal disease in patients with BP-ONJ is higher compared to healthy controls.

Clinical relevance

Patients with periodontal disease might be at a higher risk of developing BP-ONJ; therefore, periodontal disease therapy in patients who are about to receive bisphosphonates should be undertaken.     

Assessment of smoking behaviour in a dental setting: a 1-year follow-up study using self-reported questionnaire data and exhaled carbon monoxide levels

Objectives

This study analyses the changes in smoking habits over the course of 1 year in a group of patients referred to an oral medicine unit.

Materials and methods

Smoking history and behaviour were analysed at baseline and after 1 year based on a self-reported questionnaire and on exhaled carbon monoxide levels [in parts per million (ppm)]. During the initial examination, all smokers underwent tobacco use prevention and cessation counselling.

Results

Of the initial group of 121 patients, 98 were examined at the follow-up visit. At the baseline examination, 33 patients (33.67 %) indicated that they were current smokers. One year later, 14 patients (42.24 % out of the 33 smokers of the initial examination) indicated that they had attempted to stop smoking at least once over the follow-up period and 15.15 % (5 patients) had quit smoking. The mean number of cigarettes smoked per day by current smokers decreased from 13.10 to 12.18 (p?=?0.04). The exhaled CO level measurements showed very good correlation with a Spearman's coefficient 0.9880 for the initial visit, and 0.9909 for the follow-up examination. For current smokers, the consumption of one additional cigarette per day elevated the CO measurements by 0.77 ppm (p?<?0.0001) at the baseline examination and by 0.84 ppm (p?<?0.0001) at the 1-year follow-up.

Conclusions

In oral health care, where smoking cessation is an important aspect of the treatment strategy, the measurement of exhaled carbon monoxide shows a very good correlation with a self-reported smoking habit.

Clinical relevance

Measurement of exhaled carbon monoxide is a non-invasive, simple and objective measurement technique for documenting and monitoring smoking cessation and reduction.     

The association of chronic apical periodontitis and endodontic therapy with atherosclerosis

Objectives

Chronic apical periodontitis (CAP) appears to be a risk factor for coronary heart disease. The aims of the study were to estimate the significance of AP for the atherosclerotic burden and to examine the potential effect of endodontic treatment.

Materials and methods

The whole-body computed tomography (CT) examinations of 531 patients with a mean age of 50?±?15.7 years were evaluated retrospectively. The atherosclerotic burden of the abdominal aorta was quantified using a calcium scoring method. The parameters of periodontitis were measured using the CT scan.

Results

The patients had a total of 11,191 teeth. The volume of the aortic atherosclerotic burden for patients with at least one CAP lesion was 0.32?±?0.92 ml, higher than for patients with no CAP (0.17?±?0.51 ml; p?p?p?Conclusions CAP correlated positively with the aortic atherosclerotic burden. In regression models, CAP without endodontic treatment was found to be an important factor, not however apical radiolucencies in teeth with endodontic treatment.

Clinical relevance

Further research is needed to clarify the possible clinical significance of these associations.     

Effects of orthodontic treatment on human alveolar bone density distribution

Objectives

The objective of this study was to examine if non-invasive clinical cone beam computed tomography (CBCT)-based degree of bone mineralization (DBM) measurement can be used to detect the different results from orthodontic treatment between the maxilla and mandible in human patients.

Materials and methods

CBCT images were taken before and after orthodontic treatment from 43 patients (19 males and 24 females, 14.36?±?1.50 years). A histogram of computed tomography (CT) attenuation value, which is equivalent to the DBM, was obtained from the alveolar cortical (AC), trabecular (AT), and enamel (E) regions of each image. Mean, standard deviation (SD), and coefficient of variation (COV) of the CT attenuation values were computed. The regional variations and percentage (%) differences between the E and alveolar regions of the CT attenuation parameters at the maxilla and mandible were analyzed before and after orthodontic treatment.

Results

The AC had higher mean and variability (SD and COV) than the AT before and after treatment (p?<?0.001). The variability was higher in the mandibular AC than in the maxillar AC (p?<?0.01) independent of orthodontic treatment. The percentage (%) difference of variability of CT attenuation values changed for both AT and AC in the maxilla after orthodontic treatment, while that changed for only the AT (p?<?0.02), but not for AC, in the mandible (p?>?0.16).

Conclusions

The alveolar cortical region of the mandible responded differently to orthodontic treatment compared with other alveolar regions.

Clinical relevance

The CBCT-based DBM analysis can be used clinically to assess alveolar bone quality changes induced by orthodontic treatment to improve treatment planning and result evaluation.     

Effect of nonsurgical periodontal therapy (with or without oral doxycycline delivery) on glycemic status and clinical periodontal parameters in patients with prediabetes: a short-term longitudinal randomized case–control study

Objective

The aim of the present short-term longitudinal randomized case–control study was to assess the effect of nonsurgical periodontal therapy (NSPT) (with and without oral doxycycline delivery) on glycemic status and clinical periodontal parameters in patients with prediabetes.

Material and methods

Sixty-six patients with prediabetes and periodontal disease were included. Characteristics of the study cohort (age, gender, socioeconomic status [SES] education status, duration of prediabetes, and type of treatment adopted for prediabetes management) were recorded. Patients were randomly divided into two groups (33 patients/group). In group 1, scaling and root planing (SRP) was performed, and in group-2, patients underwent SRP and oral doxycycline (100 mg) administration once daily for 15 days. In each group, the following parameters were investigated at baseline and after 3 months: (a) fasting blood glucose level (FBGL), (b) hemoglobin A1c (HbA1c), and (c) periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], and clinical attachment loss [AL]). Statistical analysis was performed using Student’s t test.

Results

There was no significant difference in age, gender, SES, education status, and duration and treatment of prediabetes among individuals in groups 1 and 2. Three months post-NSPT, FBGL and HbA1c were significantly reduced among patients in group 1 (P?P?P?P?P?P?P?Conclusion NSPT (with and without oral doxycycline delivery) reduces hyperglycemia and periodontal inflammation in patients with prediabetes.     

The short-term treatment effects on the microbiota at the dorsum of the tongue in intra-oral halitosis patients—a randomized clinical trial

Objectives

This study aims to assess the effects of rinsing with zinc- and chlorhexidine-containing mouth rinse with or without adjunct tongue scraping on volatile sulfur compounds (VSCs) in breath air, and the microbiota at the dorsum of the tongue.

Material and methods

A randomized single-masked controlled clinical trial with a cross-over study design over 14 days including 21 subjects was performed. Bacterial samples from the dorsum of the tongue were assayed by checkerboard DNA–DNA hybridization.

Results

No halitosis (identified by VSC assessments) at day 14 was identified in 12/21 subjects with active rinse alone, in 10/21with adjunct use of tongue scraper, in 1/21 for negative control rinse alone, and in 3/21 in the control and tongue scraping sequence. At day 14, significantly lower counts were identified only in the active rinse sequence (p?<?0.001) for 15/78 species including, Fusobacterium sp., Porphyromonas gingivalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Tannerella forsythia. A decrease in bacteria from baseline to day 14 was found in successfully treated subjects for 9/74 species including: P. gingivalis, Prevotella melaninogenica, S. aureus, and Treponema denticola. Baseline VSC scores were correlated with several bacterial species. The use of a tongue scraper combined with active rinse did not change the levels of VSC compared to rinsing alone.

Conclusions

VSC scores were not associated with bacterial counts in samples taken from the dorsum of the tongue. The active rinse alone containing zinc and chlorhexidine had effects on intra-oral halitosis and reduced bacterial counts of species associated with malodor. Tongue scraping provided no beneficial effects on the microbiota studied.

Clinical relevance

Periodontally healthy subjects with intra-oral halitosis benefit from daily rinsing with zinc- and chlorhexidine-containing mouth rinse.