慢性牙周炎龈沟液中白细胞介素-8与硫化物的相关关系

目的：探讨慢性牙周炎龈沟液（gingival crevicular fluid，GCF）中白细胞介素-8（interleukin-8，IL-8）与硫化物（suleus sulphide level，SUL）的关系。方法：采用双抗体夹心ELISA法、金刚牙周诊断仪对龈沟液中IL-8和硫化物的含量和临床指标进行测定。23个牙周健康牙作正常对照组（C），12个慢性牙周炎健康牙作实验组1（T1），30个慢性牙周炎患牙作实验组2（T2）。用标准化滤纸条采集观察牙位GCF样本，记录相应位点30’硫化物浓度，同时记录龈沟出血指数（SBI）、牙周袋探诊深度（PPD）、牙周附着丧失水平（CAL）。结果：①受检位点龈沟液中IL-8总量存在显著性差别，其中慢性牙周炎炎症牙位组IL-8总量高于健康牙位组、正常对照组（p〈0.05），但龈沟液中IL-8浓度无显著性差别。龈沟液中IL-8总量与SBI、PPD、CAL之间有明显相关关系（P〈0.05），但IL-8的浓度与临床指标间相关关系不明显。②慢性牙周炎炎症牙位组的硫化物浓度与健康牙位组、正常牙位组之间均有显著性差别（P〈0.05），慢性牙周炎健康牙位组与正常牙位组之间无显著性差别。③慢性牙周炎炎症牙位组硫化物浓度与临床指标间具正相关关系（P〈0.05），而健康牙位组和正常对照组硫化物浓度与临床指标间无相关关系。GCF中慢性牙周炎炎症牙位组的硫化物浓度与IL-8总量具负相关关系（P〈0．05），而慢性牙周炎健康牙位组和正常对照组的硫化物浓度与IL-8总量之间无相关关系。结论：慢性牙周炎患牙龈沟液中IL-8和硫化物的含量与临床指标之间有相关性。龈沟液中细菌代谢产物所产生的硫化物对IL-8的含量存在一定抑制作用。     

广泛型侵袭性牙周炎患者龈沟液中白介素-17的检测

目的 比较广泛型侵袭性牙周炎患者与健康人龈沟液中白介素-17(IL-17)的表达水平及与临床指标的关系。方法 选择广泛型侵袭性牙周炎患者18例和健康人16例,共68颗牙,记录临床牙周检查指标,用滤纸条法收集龈沟液。采用抗体夹心ELISA法测定广泛型侵袭性牙周炎患者治疗前、治疗后3个月及健康对照者龈沟液中IL-17总量和浓度。结果 广泛型侵袭性牙周炎患牙治疗前龈沟液中IL-17的总量和浓度高于牙周健康牙,基础治疗3个月后广泛型侵袭性牙周炎患牙龈沟液中IL-17的总量和浓度较治疗前下降。广泛型侵袭性牙周炎患牙龈沟液中IL-17浓度与探诊深度、附着丧失和出血指数呈正相关关系,而IL-17总量仅与探诊深度呈正相关关系。结论 龈沟液中IL-17浓度可能与广泛型侵袭性牙周炎牙周破坏及炎症的严重程度相关。?     

牙龈卟啉单胞菌与龈沟液中白细胞介素8关系的研究

目的:探讨龈沟液(GCF)中白细胞介素8(IL -8)在慢性牙周炎病程中的变化、IL- 8与牙周临床检测指标以及同龈下菌斑中细菌含量的相关关系。方法: 5名非牙周炎患者的10颗牙周健康牙和30名慢性牙周炎(CP)患者的70颗牙(其中10颗为健康牙, 60颗为牙周炎患牙)纳入本研究。采集观察牙的GCF样本、龈下菌斑样本,同时记录所有牙的牙龈指数(GI)、牙周袋探诊深度(PPD)、临床附着丧失水平(CAL)。用ELISA法检测样本中IL -8的水平,用厌氧菌培养技术培养菌斑标本,用PCR法检测菌斑中的牙龈卟啉单胞菌(Pg),结果:慢性牙周炎组的GCF中IL -8的总量高于临床牙周健康组,而IL -8的质量浓度在各组中无差异。GCF中IL- 8浓度与GI、PPD、CAL无相关关系,而IL -8的总量与GI、PPD、CAL呈正相关关系。龈下菌斑中Pg的检出量与GCF中IL- 8的含量间未发现有相关关系。结论:慢性牙周炎患者龈沟液中IL- -8量增加与龈沟液分泌增加有关而与牙龈卟啉单胞菌检出CFU无关。     

维族绝经妇女龈沟液IL-6、血清雌二醇水平与牙周炎的关系

目的:探讨维吾尔族绝经早期的牙周炎患者龈沟液IL-6及血清雌二醇(E2)水平与牙周炎的关系。方法:共79例绝经年限均≤5a的妇女纳入本研究。采集30颗牙周健康牙和49颗牙周炎患牙的龈沟液(GCF),记录牙周临床观察指标。采集慢性牙周炎患者的血样本。应用放射免疫分析法检测GCF中IL-6和血清中E2的浓度。结果:牙周健康组GCF中IL-6浓度为(1088.10±102.33)pg/ml;慢性牙周炎组GCF中IL-6浓度明显高于牙周健康牙组(P<0.005);慢性牙周炎患牙GCF中IL-6浓度与GI、PPD、CAL均呈正相关(r=0.564,P<0.005;r=0.335,P<0.05;r=0.324,P<0.05)。血清E2≤30pg/ml组的妇女牙周炎患牙牙周临床指标、GCFIL-6浓度与E2>30pg/ml组无显著差异(P>0.05)。结论:健康牙GCF中含有微量IL-6。牙周炎患牙GCF中IL-6的水平反映了牙周炎症的严重程度,可以尝试作为判断维族妇女牙周病变程度的一个指标。绝经早期患慢性牙周炎的维族妇女,血清E2水平与牙周炎患牙的病变程度及GCF中IL-6的水平无关。     

侵袭性牙周炎龈沟液中硫化物的检测

目的:检测侵袭性牙周炎(AgP)龈沟液中硫化物浓度水平变化并探讨其与牙周临床指标的关系。方法:采用金刚牙周诊断仪进行龈沟液硫化物和牙周临床指标测定。选定实验组(T)16例侵袭性牙周炎病人,56个牙,共336个位点。其中健康牙(T1)16个,位点96个;炎症牙(T2)40个,位点240。对照组(C):全身、牙周健康者10例,20个牙,共120个位点。测定所选位点龈沟液(gingival crevicu lar flu id,GCF)中硫化物水平(su lcus su lph ide level,SUL),牙周袋探诊深度(pocket prob ing depth,PPD),牙周临床附着丧失水平(c lin i-cal attachm ent level,CAL),龈沟出血指数(su lcus b leed ing index,SB I)。结果:①3组受检牙龈沟液中硫化物浓度不同。侵袭性牙周炎炎症牙位组GCF中硫化物浓度(0.2210±0.0415)×10-6mol/L高于健康牙位组(P<0.05)、正常对照组;健康牙位组GCF中硫化物浓度(0.1025±0.0198)×10-6mol/L高于正常对照组(0.0523±0.0044)×10-6mol/L。②经相关性分析,侵袭性牙周炎炎症牙位组(T1)GCF中硫化物的浓度均值与PD、SB I和CAL均呈正相关关系,健康牙位组(T1)、正常对照组(C)GCF中硫化物浓度均值与PD、SB I及CAL无相关性。结论:侵袭性牙周炎病人龈沟液中的硫化物是参与牙周炎症反应的重要调节因子,其水平变化可反映牙周组织的炎症状态。     

慢性牙周炎患者IL-8和弹性蛋白酶水平的研究

目的：探讨IL-8、弹性蛋白酶在慢性牙周炎患者龈沟液中的表达。方法：采用ELISA检测慢性牙周炎患者30名和健康对照组20名龈沟液中IL-8的总量和浓度，采用底物法检测相同人群龈沟液中细胞外弹性蛋白酶、总弹性蛋白酶的浓度和总量。采用SPSS11．0软件分析其差异性及相关性。结果：慢性牙周炎患者龈沟液中的IL-8浓度明显低于健康对照组（P〈0．01），而IL-8总量略高于健康对照组但无显著性差异（P〉0．05）；IL-8和细胞外弹性蛋白酶的浓度和总量在重度牙周炎组明显高于轻、中度牙周炎组（P〈0．01）。结论：不同浓度的IL-8和弹性蛋白酶参与了慢性牙周炎的炎症过程，二者的协同作用将加重慢性牙周炎的病情。     

活动期与静止期牙周炎患牙龈沟液中IL-10和IFN-Y的含量测定

目的：探讨IFN-γ和白细胞介素10（IL-10）与牙周炎活动期和静止期的关系。方法：应用ELISA免疫夹心法检测牙周炎活动期30个患牙和静止期30个患牙龈沟液（GCF）中IFN—γ和IL-10的含量。结果：活动期忠牙组龈沟液中IFN-γ的浓度（14．25±2．35ng／ml）显著高于静止期患牙组（4．36±0．41ng／ml,p〈0．05）,活动期患牙组龈沟液中IL-10的浓度（3．64±0．56ng／ml）显著低于静止期患牙组（11．26±3．05ng／ml,p〈0．05）。结论：作为Th1家族的细胞因子IFN-γ在牙周病灶区是占优势的,而Th2的代表性细胞因子IL-10则和牙周炎的缓解有关,IL-10／IFN-γ的高比值意味着牙周状况的改善。     

侵袭性牙周炎治疗前后龈沟液CRP、sICAM-1含量测定

目的：测定侵袭性牙周炎龈沟液中C反应蛋白、可溶性细胞间黏附分子1的含量及牙周非手术治疗对其水平的影响,方法：16例侵袭性牙周炎病例,进行非手术治疗,收集治疗前后龈沟液,用酶联免疫吸附法（ELISA法）测定C反应蛋白（CRP）、可溶性细胞间黏附分子1（sICAM—1）水平,并和正常对照组比较。结果：侵袭性牙周炎患者龈沟液中CRP、sICAM-1水平增高,和对照组比较,p〈0．05;牙周非手术治疗后,牙周临床指标明显改善,龈沟液中CRP、sICAM-1水平下降,且接近牙周正常水平。结论：侵袭性牙周炎龈沟液CRP、sICAM-1的水平升高,牙周非手术治疗能有效降低CRP、siCAM-1在龈沟液中的表达。     

盐酸米诺四环素软膏对慢性牙周炎龈沟液中硫化物的影响

目的：分析慢性牙周炎病人局部应用盐酸米诺四环素（minocycline HCl，MINO）后，不同牙周状态下龈沟液（GCF）中硫化物（suleus sulphide level，SUL）浓度变化及其与临床指标的关系。方法：采用金刚牙周探测仪对盐酸米诺四环素治疗前后龈沟液中硫化物浓度及其临床指标进行测定。随机单盲法选择慢性牙周炎病人21例，61个患牙。用药组（T）34个患牙，204个位点，基础治疗后将盐酸米诺四环素软膏置牙周袋内；对照组（C）卯个患牙，162个位点，以单纯基础治疗为主。于基线前两周完成全口龈上洁治、口腔卫生宣教。基线时测定相应位点龈沟液中硫化物浓度，龈沟出血指数（SBI），牙周袋探诊深度（PPD），牙周临床附着丧失水平（CAL）；然后行龈下刮治术，用药组龈沟内放药，对照侧不放药。第2周各项指标检查同上。结果：用药组（T）龈沟液中硫化物浓度与其基线时和对照组相比明显下降（P〈0．05），其临床指标用药组（T）与对照组（C）相比改善明显（P〈0．05），龈沟液中硫化物的浓度与临床指标间具有相关性。结论：盐酸米诺四环素软膏（MINO）辅助治疗牙周炎，能有效降低龈沟液中硫化物浓度，改善牙周组织状况；椅旁龈沟液硫化物浓度变化可间接反映对牙周袋内细菌的杀灭、抑制作用。     

糖尿病对牙周炎病人龈沟液白介素-1β、前列腺素E2水平的影响

目的：探讨Ⅱ型糖尿病对牙周炎病人龈沟液白介素-1β（IL-1β）、前列腺素E2（PGE2）水平的影响及其与糖脂代谢情况的关系。方法：选择Ⅱ型糖尿病伴发牙周炎病人18例（DM组）、单纯牙周炎病人18例（PD组）和全身、牙周健康者18例（H组）为研究对象。分别测定各组糖化血红蛋白（HbA1C）、血脂水平以及龈沟液（gingival cervicular fluid GCF）中IL-1β、PGE2水平,并同时测定牙周龈沟出血指数、探诊深度、附着丧失等指标。结果：DM、PD组龈沟出血指数（SBI）、探诊深度（PD）、附着丧失（AL）、龈沟液PGE2水平明显高于H组（P〈0．05）,DM与PD组无明显差异;DM组病人糖化血红蛋白、龈沟液IL-1B指标均明显高于PD、H组（P〈0．05）;龈沟液IL-1β水平与HbA1C含量正相关。结论：糖尿病伴发牙周炎病人龈沟液IL-1β水平升高可能受全身因素影响,进一步促进牙周病变发展。     

侵袭性牙周炎患者龈沟液中有机酸的研究

检测侵袭性牙周炎(aggressive periodontitis,AgP)患者龈沟液中7种有机酸的浓度,探讨其与AgP的关系.方法应用高效毛细管电泳技术,检测38例AgP患者152个位点和14名牙周健康对照者56个位点龈沟液中甲酸、琥珀酸、乙酸、乳酸、丙酸、丁酸和异戊酸的浓度,比较AgP组和健康对照组之间、AgP患者不同袋深组之间龈沟液中有机酸浓度的差别,分析出血指数(bleedingindex,BI)、探诊深度(probing depth,PD)和附着丧失(attachment loss,AL)与有机酸浓度的相关关系.结果 AgP组龈沟液中琥珀酸(1.00 mmoL/L)、乙酸(24.13 mmol/L)、乳酸(8.33 mmoL/L)、丙酸(4.37 mmoL/L)、丁酸(2.33 mmol/L)和异戊酸(2.63 mmol/L)的浓度均显著高于健康对照组(依次为0.33、11.35、3.88、2.07、0.00、0.00 mmoL/L,P<0.05),甲酸浓度(7.08 mmoL/L)显著低于健康对照组(14.03 mmoL/L,P<0.05);除乳酸外其余6种有机酸在不同袋深组间浓度差异均有统计学意义(P<0.05);AgP组甲酸浓度与BI、PD和AL呈负相关,BI与琥珀酸、乙酸、乳酸、丙酸和丁酸浓度呈正相关,PD和AL与琥珀酸、乙酸、丙酸、丁酸和异戊酸浓度呈正相关.结论 AgP的病变状况町能与龈沟液中琥珀酸、乙酸、丙酸、丁酸和异戊酸浓度升高而甲酸浓度降低有关.     

The influence of diabetes on gingival crevicular fluid beta-glucuronidase and interleukin-8

OBJECTIVES: Polymorphonuclear neutrophil (PMN) dysfunction is associated with diabetes. We examined the gingival crevicular fluid (GCF) beta-glucuronidase (BG) and interleukin-8 (IL-8) levels of periodontitis patients with and without type 2 diabetes mellitus (DM). MATERIAL AND METHODS: Forty five adults with type 2 DM and 32 adults without DM, both with chronic periodontitis were enrolled. GCF was collected from eight posterior sites in each quadrant, and periodontal parameters were recorded. GCF was assayed for IL-8 by ELISA and BG by a fluorometric assay. RESULTS: GCF IL-8 was positively correlated with probing depth (PD), and GCF BG but not clinical attachment level (CAL), bleeding on probing (BOP), or plaque index (PI). In contrast, GCF BG was strongly correlated with each of the clinical measures of periodontal disease. Subjects with DM significantly lower levels of both BG (73.0+/-44.8 versus 121.9+/-84.6 pg/sample; p=0.002) and IL-8 (32.1+/-33.1 versus 90.8+/-83.2 pg/sample; p<0.0001) even after adjustments for age, gender, PD, CAL, BOP, and PI. Neither BG nor IL-8 was correlated with HbA1c levels in subjects with DM. CONCLUSION: These data suggest that an inadequate local response by PMN, partially explained by an altered chemokine gradient, may contribute to periodontal disease in patients with type 2 DM.     

Gingival crevicular fluid levels of interleukin-1beta and glycemic control in patients with chronic periodontitis and type 2 diabetes

BACKGROUND: Patients with diabetes have increased incidence and severity of periodontal disease not accounted for by differences in the subgingival microbial infection. Poor glycemic control has been consistently associated with periodontal disease severity. Also, recent evidence suggests that hyperglycemia may induce inflammatory cytokine production. Few studies, however, have examined local biochemical measures of periodontal inflammation in patients with type 2 diabetes. The aim of this study was to determine whether glycemic control was related to gingival crevicular fluid (GCF) levels of interleukin-1beta (IL-1beta). METHODs: GCF samples were collected from 45 patients with type 2 diabetes and untreated chronic periodontitis. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), and attachment level (AL) were recorded at six sites per tooth. IL-1beta levels were determined from individual GCF samples by enzyme-linked immunoabsorbent assay (ELISA). Individual site and mean patient values were calculated. Glycated hemoglobin (HbA1c) levels were measured from anticoagulated whole blood using an automated affinity chromatography system. Serum glucose was also determined. RESULTS: Clinical periodontal measures (PD, AL, BOP) and measures of glycemic control (HbA1c, random glucose) were significantly correlated with GCF IL-1beta. Patients with greater than 8% HbA1c had significantly higher mean GCF IL-1beta levels than patients with less than 8% HbA1c. In a multivariate model adjusting for age, gender, PD, AL, BOP, and PI, HbA1c and random glucose were independent predictors of high GCF IL-1beta. CONCLUSIONS: Poor glycemic control is associated with elevated GCF IL-1beta. These data are consistent with the hypothesis that hyperglycemia contributes to an heightened inflammatory response, and suggests a mechanism to account for the association between poor glycemic control and periodontal destruction.     

Identification of the osteoprotegerin/receptor activator of nuclear factor-kappa B ligand system in gingival crevicular fluid and tissue of patients with chronic periodontitis

BACKGROUND AND OBJECTIVE: Recent findings have suggested that osteoclastogenesis is directly regulated by receptor activator of nuclear factor-kappa B ligand (RANKL) and its decoy receptor, osteoprotegerin (OPG). However, no studies have described interactions of OPG/RANKL and the gp130 cytokine family in periodontal disease. This study aimed to identify and quantify OPG/RANKL in the gingival crevicular fluid (GCF) and connective tissue of patients with periodontitis, and to clarify possible correlations with disease severity and interleukin-6 (IL-6) cytokines. MATERIAL AND METHODS: Ninety-five sites in 20 patients with generalized chronic periodontitis were divided into four groups by site based on probing depth (PD) and bleeding on probing (BOP). In periodontitis patients, GCF was obtained using sterile paper strips from clinically healthy sites (PD 6 mm with BOP, n = 27). Fourteen clinically healthy sites from four periodontally healthy individuals were used as the control group. The levels of OPG, RANKL and two gp130 cytokines - IL-6 and oncostatin M (OSM) - in the GCF were determined by an enzyme-linked immunosorbent assay (ELISA) and are expressed as total amounts (pg/site). Immunohistochemical localization of OPG- and RANKL-positive cells was also performed on gingival connective tissues harvested from patients with periodontitis (inflammatory group, n = 8 biopsies) and from non-diseased individuals (healthy group, n = 8 biopsies). RESULTS: GCF RANKL, but not OPG, was elevated in diseased sites of patients with periodontitis. However, the expressions of OPG and RANKL showed no correlation with disease severity (r = 0.174 and 0.056, respectively), but the content of RANKL in the GCF was significantly positively correlated with those of IL-6 (r = 0.207) and OSM (r = 0.231) (p < 0.01). Immunohistochemical staining showed that RANKL-positive cells were significantly distributed in the inflammatory connective tissue zone of diseased gingiva, compared with those of samples from non-diseased persons (p < 0.01). However, few OPG-positive cells were found in connective tissue zones of either the diseased gingiva or healthy biopsies. CONCLUSION: These findings imply that in this cross-sectional study of GCF, RANKL, IL-6 and OSM were all prominent in periodontitis sites, whereas OPG was inconsistently found in a few samples of diseased sites but was undetectable in any of the control sites. The results also imply that the expression of RANKL was positively correlated with IL-6 and OSM in the GCF.     

TNF-alpha and IL-4 levels in generalized aggressive periodontitis subjects

Objectives:  The aim of this study was to evaluate tumor necrosis factor (TNF)-α and interleukin (IL)-4 levels in healthy sites and sites exhibiting signs of moderate and advanced generalized aggressive periodontitis (GAgP) in the same subject.
Methods:  The following sites were selected for crevicular fluid sampling in the same AgP subject ( n  = 14): Healthy sites (HS): no marginal bleeding or bleeding on probing (BOP) and probing depth (PD) ≤ 3 mm; Moderate sites (MS): BOP and PD between 4 and 6 mm; Advanced sites (AS): BOP and PD ≥ 7 mm. One site from periodontally healthy subjects ( n  = 13) was sampled for use as a control. TNF-α and IL-4 levels were measured using ELISA.
Results:  The total amount of TNF-α was lower for control sites, while there were no differences among healthy and diseased sites from GAgP subjects ( P  < 0.05). The concentration of TNF-α was higher in HS, in relation to the other sites ( P  < 0.05). There were no significant differences among the groups regarding total amounts of IL-4 ( P  > 0.05), while IL-4 concentration was significantly higher in control sites, when compared with sites from GAgP subjects ( P  < 0.05).
Conclusion:  In conclusion, high levels of TNF-α and low levels of IL-4 were observed in both healthy and diseased sites within the same generalized AgP individuals.     

Biomarker levels in gingival crevicular fluid of subjects with different periodontal conditions: A cross-sectional study

ObjectiveTo compare five biomarker levels in gingival crevicular fluid (GCF) in different tooth-sites of subjects with healthy periodontium, aggressive periodontitis and severe chronic periodontitis, and to evaluate the value of these biomarker levels for diagnosis of the type and activity of periodontitis.Materials and methodsPrior to therapy, GCF samples were collected using filter paper strip at different tooth-sites of 10 subjects with healthy periodontium (H), 15 with severe chronic periodontitis (CP) and 15 with aggressive periodontitis (AgP). The strips were weighed and the periodontal clinical parameters were recorded. Levels of interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and alkaline phosphatase (ALP) in GCF were assessed by enzyme-linked immunosorbent assay (ELISA).ResultsThe volumes of the GCF samples obtained in CP and AgP subjects were significantly higher than those from subjects with healthy periodontium (P < 0.05). Levels of IL-6, TNF-α, CRP and ALP were significantly higher in the untreated disease sites in the CP and AgP groups compared to those in control sites in the H group, while IL-10 levels were lower in the CP and AgP groups than those in the control sites in the H group. However, the levels of all five biomarker levels showed significant correlation with the clinical parameters.ConclusionThe measurement of five biomarker levels in GCF may facilitate overall screening of periodontitis patients in epidemiological studies and allow estimation of periodontitis activity.     

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??Objective    To investigate the influence of Porphyromonas gingivalis??Pg?? and Treponema denticola??Td?? in gingival crevicular fluid ??GCF?? of patients with aggressive periodantitis??AgP?? on organic acid. Methods    Forty cases of AgP and 40 healthy volunteers in our hospital were selected and GCF was collected. GCF in booth of same quadrant of patients was collected??and plaque index ??PLI????sampling location??probing depth??PD????sulcus beeding index??SBI?? and attachment loss??AL?? were recorded. CE was used to detect the concentration of organic acid??PCR was used to detect Pg and Td. The gray value of amplification entry stripe??which was detected positive??was given quantitative analysis??amplification target bars and brightness ratio showed the relative volune of target gene??which was PCR product quantity. Results    PLI??PD??AL??concentration of acid??Pg/Td detection rate and Pg/Td product quantity of AgP group were higher than those of healthy group ??P??0.05????Pg butyric acid concentration at positive detection point of AgP group was higher than that at negative detection point??P??0.05????organic acid concentration at Td positive detection point was higher than that at negative group??P??0.05??. Conclusion    Organic acid concentration in GCF of AgP patients shows product quantity of Pg and Td??which plays a certain guiding role in organic acid concentration of AgP.     

Adjunctive Non‐Surgical Therapy of Inflamed Periodontal Pockets During Maintenance Therapy Using Diode Laser: A Randomized Clinical Trial

Background: Numerous studies have documented the clinical outcomes of laser therapy for untreated periodontitis, but very few have reported on lasers treating inflamed pockets during maintenance therapy. The aim of this study is to compare the effectiveness of scaling and root planing (SRP) plus the adjunctive use of diode laser therapy to SRP alone on changes in the clinical parameters of disease and on the gingival crevicular fluid (GCF) inflammatory mediator interleukin‐1β (IL‐1β) in patients receiving regular periodontal maintenance therapy. Methods: This single‐masked and randomized, controlled, prospective study includes 22 patients receiving regular periodontal maintenance therapy who had one or more periodontal sites with a probing depth (PD) ≥5 mm with bleeding on probing (BOP). Fifty‐six sites were treated with SRP and adjunctive laser therapy (SRP + L). Fifty‐eight sites were treated with SRP alone. Clinical parameters, including PD, clinical attachment level (CAL), and BOP, and GCF IL‐1β levels were measured immediately before treatment (baseline) and 3 months after treatment. Results: Sites treated with SRP + L and SRP alone resulted in statistically significant reductions in PD and BOP and gains in CAL. These changes were not significantly different between the two therapies. Similarly, differences in GCF IL‐1β levels between SRP + L and SRP alone were not statistically significant. Conclusion: In periodontal maintenance patients, SRP + L did not enhance clinical outcomes compared to SRP alone in the treatment of inflamed sites with ≥5 mm PD.     

Effect of locally delivered minocycline microspheres on markers of bone resorption

BACKGROUND: Gingival crevicular fluid (GCF) biomarkers associated with bone resorption may be useful to determine periodontal disease status and response to therapy. The pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), a bone-specific degradation product, and interleukin 1-beta (IL-1), a potent bone-resorptive cytokine, have both been associated with periodontal disease activity. Minocycline is a tetracycline derivative possessing antimicrobial effects on periodontal pathogens and inhibitory properties on matrix metalloproteinases (MMPs) associated with tissue destruction. The aim of this study was to evaluate the effect of periodontal treatment in the form of scaling and root planing (SRP) and locally administered minocycline microspheres on the GCF levels of ICTP and IL-1. METHODS: Forty-eight chronic periodontitis patients were randomly assigned to 2 groups (SRP plus subgingival application of vehicle control [SRP + V], or SRP plus subgingival application of minocycline microspheres [SRP + M]) and monitored at 8 sites per subject at baseline and 1, 3, and 6 months. Four shallow (PD < or = 3 mm) and 4 deep (PD > or = 5 mm) sites were evaluated for both marker levels and for probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). Eight periodontally healthy control subjects with no probing depths >3 mm and no loss of attachment were also monitored at the same time intervals. GCF levels of ICTP and IL-1 were determined using radioimmunoassay and enzyme-linked immunosorbent assay techniques, respectively. RESULTS: Significant differences (P<0.001) in GCF levels of ICTP and IL-1 were found between deep and shallow sites at all time points in both treatment groups. In addition, healthy subjects demonstrated significantly reduced levels of both markers compared to both shallow and deep sites in periodontitis patients (P <0.001). Only the SRP + M treated patients exhibited significant reductions (P <0.05) in both ICTP and IL-1 levels 1 month after treatment. Furthermore, the SRP + M group demonstrated significantly lower IL-1 levels (P <0.02) at 1 month compared to the SRP + V group. CONCLUSIONS: Results of this study indicate that GCF levels of ICTP and IL-1 correlate with clinical measures of periodontal disease and may aid in assessing disease status and response to periodontal therapy. Furthermore, local administration of minocycline microspheres led to a potent short-term reduction in GCF IL-1 levels. Additional studies are needed to address whether repeated administration of scaling and root planing along with minocycline microspheres will achieve long-term reductions in GCF ICTP and IL-1 levels.