The effect of different cigarette smoking levels on gingival crevicular fluid volume and periodontal clinical parameters in Saudi Arabia

IntroductionPeriodontal disease is a chronic inflammatory condition of the periodontium. It is the main cause of tooth loss and is considered one of the biggest threats to the oral cavity. Tobacco smoking has long been associated with increased risk for periodontal, peri-implant, and other medical diseases.ObjectiveTo evaluate the effect of smoking and its level on periodontal clinical parameters (probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), bleeding on probing (BOP), and the volume of gingival crevicular fluid (GCF)) in healthy and chronic periodontitis individuals.Material and MethodA total of 160 participants were recruited in the present study, who were equally divided into the following five groups: healthy controls (C), healthy smokers (HS), nonsmokers with periodontitis (PNS), light smokers with periodontitis (PLS), and heavy smokers with periodontitis (PHS). GCF volume and periodontal clinical parameters (PD, PI, GI, CAL, and BOP) were assessed for each participant and compared between the study groups.ResultThere was a statistically significant difference in PD, PI, GI, CAL, and BOP between healthy and periodontitis patients (p < 0.001). The mean PI, PD, and CAL were considerably higher in heavy smokers than light smokers and non-smokers (P < 0.001). In contrast, the mean GI and BOP were significantly lower in heavy smokers than in light smokers and non-smokers. There was a statistically significant difference in GCF between healthy and periodontitis patients (p < 0.001). The mean GCF readings were higher in heavy smokers than light smokers or non-smokers (P < 0.001).ConclusionThe present study confirms the influence of smoking on periodontal clinical parameters. Smoking was associated with increased PD, PI, CAL, and GCF readings; however, GI and BOP were decreased in smokers. The number of cigarettes played a key role in the volume of GCF and periodontal clinical parameters.     

Periodontal Status and Hyperlipidemia: Statin Users Versus Non‐Users

Background: The association between serum lipids and periodontal disease has been studied predominantly in patients with chronic periodontitis with limited data available regarding periodontal status of patients with hyperlipidemia. Meanwhile, the impact of statins on the periodontal health of the population also remains largely underexplored. This study aims to assess the periodontal status among patients with hyperlipidemia and users of statins. Methods: In this cross‐sectional study, 94 patients with hyperlipidemia (50 receiving statins and 44 receiving non‐pharmacologic therapy) and 46 control individuals who were normolipidemic underwent periodontal examination (plaque index, gingival index [GI], probing depth [PD], and clinical attachment level [CAL]). Biochemical parameters measured included serum triglyceride (TG), total cholesterol (TC), low‐density lipoprotein (LDL) cholesterol, and high‐density lipoprotein cholesterol levels. Results: PD and GI were significantly higher in patients with hyperlipidemia who were non‐statin users compared with the normolipidemic individuals (P <0.001 [PD] and P <0.05 [GI]) and the statin group (P = 0.001 [PD] and P <0.05 [GI]). Periodontal parameters between statin users and the normolipidemic group did not differ significantly. After adjusting for confounders, positive and significant correlations were observed between PD and TG, and TC and LDL, whereas CAL shared correlation with TC and LDL. GI was correlated with TG and TC. Regression analyses revealed that whereas TC was associated significantly with PD (P <0.001), LDL showed significant association with CAL (P = 0.013). TG showed significant association with GI (P = 0.020). Conclusions: Our findings suggest that relative to the general population, patients with hyperlipidemia are more prone to periodontal disease. Also, within the limits of this study, statins have a positive impact on periodontal health.     

Association of Serum Triglyceride Level and Gemfibrozil Consumption With Periodontal Status

Background: Hyperlipidemia is a major risk factor for cardiovascular diseases. Considering the suggested association between periodontal and cardiovascular diseases, this study sought to assess the association, if any, between serum triglyceride (TG) levels and gemfibrozil consumption with periodontal parameters. Methods: This cross‐sectional study was conducted on 90 participants, including 30 individuals with a normal lipid profile (group H), 30 patients with hypertriglyceridemia and not on medication (group N), and 30 patients with hypertriglyceridemia and taking gemfibrozil over a 3‐month period (group M). Periodontal parameters including probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index were measured at four sites of each tooth. Serum levels of total cholesterol (TC), TG, low‐density lipoprotein, and high‐density lipoprotein were measured. Results: Mean values for PD and CAL in the two hypertriglyceridemic groups were significantly higher than those of the H group (P <0.001). After controlling for confounding variables, significant linear correlations were noted between PD and BOP, PD and TC, PD and TG, and CAL and TG in each group (P <0.01). Conclusions: Patients with hypertriglyceridemia had worse periodontal status than healthy controls. Patients with hypertriglyceridemia who were taking gemfibrozil did not show significant differences in CAL and PD compared with untreated patients with hypertriglyceridemia.     

Effect of eucalyptus extract chewing gum on periodontal health: a double-masked, randomized trial

BACKGROUND: Studies in vitro showed that eucalyptus extracts possess antibacterial activity against cariogenic and periodontopathic bacteria; however, the clinical effects with respect to periodontal health in humans remain unproven. The objective of this study was to evaluate the effect of chewing gum containing eucalyptus extract on periodontal health in a double-masked, randomized, controlled trial. METHODS: Healthy humans with gingivitis but not deep periodontal pockets were randomly assigned to the following groups: high-concentration group (n=32): use of 0.6% eucalyptus extract chewing gum for 12 weeks (90 mg/day); low-concentration group (n=32): use of 0.4% eucalyptus extract chewing gum for 12 weeks (60 mg/day); and placebo group (n=33): use of chewing gum without eucalyptus extract for 12 weeks. Plaque accumulation (PLA), gingival index (GI), bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment level (CAL) were measured at weeks 0, 4, 8, 12, and 14. Significance was analyzed with repeated-measures two-way analysis of variance followed by the Games-Howell pairwise comparison test. RESULTS: The interaction between the effects of eucalyptus extract chewing gum and the intake period was statistically significant for PLA, GI, BOP, and PD but not for CAL. The low- and high-concentration groups exhibited statistically significant (P <0.05) improvements compared to the placebo group for PLA, GI, BOP, and PD. CONCLUSIONS: Eucalyptus extract chewing gum had a significant effect on PLA, GI, BOP, and PD. The use of eucalyptus extract chewing gum may promote periodontal health.     

牙周基础治疗对伴2型糖尿病的中、重度牙周炎患者牙周炎症控制、血清炎症指标及代谢水平影响

目的 探讨牙周基础治疗对伴 2型糖尿病的中、重度牙周炎患者牙周炎症控制、血清炎症指标以及糖代谢水平的影响。方法 将前期临床试验人群中的 56例中、重度牙周炎患者（平均临床附着水平> 3 mm）纳入本研究进行亚组分析,采用重复测量的方差分析比较治疗组和对照组牙周指数（包括平均探诊深度、临床附着水平和探诊出血指数）、超敏 C反应蛋白（ hsCRP）、糖化血红蛋白（ HbA1c）、空腹血糖在基线、 1.5个月、 3个月、 6个月连续 4次的变化。结果 伴2型糖尿病的中、重度牙周炎患者在牙周治疗后平均探诊深度（ F=62.898,P=0.000）、临床附着水平（ F=51.263,P=0.000）和探诊出血指数（ F=75.164,P=0.000）在治疗后逐渐改善,其中平均探诊深度（t=-2.050,P=0.045）和探诊出血指数（ t=-4.538,P=0.000）显著优于对照组;治疗后 hsCRP（F=6.391,P=0.010）、 HbA1c（F=4.536,P=0.011）、空腹血糖（ F=3.073,P=0.031）降低,其中 hsCRP显著低于对照组（ t=-2.261,P=0.028）。结论 牙周基础治疗有助于改善伴 2型糖尿病的中、重度牙周炎患者的牙周炎症和血清炎症指标以及糖代谢水平。     

缓释氯己定凝胶在慢性牙周炎治疗中的应用

目的:观察龈上洁治术、龈下刮治术和根面平整术(scaling and root planing,SRP)结合缓释氯己定凝胶(chlorhexidine,CHX)对慢性牙周炎的治疗作用。方法:选择35～65岁的慢性牙周炎患者36例,将后牙区牙周袋数目较多的单颌设定为实验组,对颌为对照组。实验组采取SRP+CHX治疗,对照组采取SRP治疗。分别于牙周治疗前、中、后3个阶段,记录每个受试牙近颊、颊侧、远颊、近舌、舌侧和远舌位点的牙龈指数(GI)、探诊出血(BOP)、探诊深度(PD)、临床附着水平(CAL)、探诊出血指数(SBI)。结果:BOP、SBI、PD、GI四项指标在治疗后1个月,实验组与对照组之间有显著差异(P<0.05),4个月后则无显著性差异(P>0.05)。CAL在治疗后1个月,两组间无显著(P>0.05),而4个月后差异显著性差异(P<0.05)。无论是实验组还是对照组,治疗前后各项牙周指标后牙区位点对治疗的反应明显不如前牙区,但无显著性差异(P>0.05)。PD>7 mm的深牙周袋,SRP+CHX组与SRP组之间4个月后仍有显著性差异。结论:在慢性牙周炎治疗过程中,SRP+CHX治疗能够改善牙周临床指标,尤其对PD>7 mm的深牙周袋有更好的治疗作用。     

Periodontal Condition of Patients With Autoimmune Diseases and the Effect of Anti‐Tumor Necrosis Factor‐α Therapy

Background: The aim of this study is to evaluate the effect of autoimmune diseases (AIs), as well as anti‐tumor necrosis factor‐α (TNF‐α) therapy on the clinical and immunologic parameters of the periodontium. Methods: Thirty‐six AI patients (12 rheumatoid arthritis [RA], 12 psoriatic arthritis, and 12 systemic sclerosis) were recruited together with 12 healthy (H) and 10 RA patients receiving anti‐TNF‐α therapy (RA+). Periodontal indices including plaque index, gingival index (GI), probing depth (PD), and bleeding on probing (BOP) were measured, and gingival crevicular fluid (GCF) was collected from five deepest pockets using papers strips. The TNF‐α level was analyzed using enzyme‐linked immunosorbent assay. Analysis of variance test was used for statistical comparison between groups, whereas Pearson linear correlation coefficient test was used to examine the association between TNF‐α and periodontal status indices. Results: The three AI subgroups were very similar in clinical and immunologic parameters. GI was greater in the AI patients compared to the H and RA+ groups (1.91 ± 0.54, 1.21 ± 0.67, and 1.45 ± 0.30, respectively, P = 0.0005). AI patients exhibited significantly more BOP than H and RA+ (46.45% ± 17.08%, 30.08% ± 16.86%, and 21.13% ± 9.51%, respectively, P = 0.0002). PD in H and RA+ groups were lower than in the AI (3.47 ± 0.33, 3.22 ± 0.41, and 3.91 ± 0.49 mm, P = 0.0001). Number of sites with PD >4 mm was higher in AI patients compared to H and RA+ (42.44 ± 17.5 versus 24.33 ± 15.62 versus 33.3 ± 6.6, P = 0.0002). GCF TNF‐α was higher among the AI patients (1.67 ± 0.58 ng/site) compared to 1.07 ± 0.33 ng/site for the H group and 0.97 ± 0.52 ng/site for the RA+ group (P = 0.0002). A significant positive correlation was found between PD and TNF‐α levels in the GCF (r = 0.4672, P = 0.0002), BOP (r = 0.7491, P = 0.0001), and GI (r = 0.5420, P = 0.0001). Conclusions: Patients with AI diseases have higher periodontal indices and higher TNF‐α levels in GCF than H controls. Anti‐TNF‐α treatment appears to reverse this phenomenon.     

Clinical evaluation of chlorhexidine and essential oils for adjunctive effects in ultrasonic instrumentation of furcation involvements: a randomized controlled clinical trial

To cite this article:
Int J Dent Hygiene 10 , 2012; 113–117
DOI: 10.1111/j.1601‐5037.2011.00538.x Yilmaz HG, Bayindir H. Clinical evaluation of chlorhexidine and essential oils for adjunctive effects in ultrasonic instrumentation of furcation involvements: a randomized controlled clinical trial. Abstract: Background: The aim of this clinical study was to evaluate and compare the clinical efficacy of subgingival ultrasonic mechanical instrumentation (UMI) irrigated with essential oils (EOs) and chlorhexidine (CHX) at the furcation involvements (FI). Methods: Forty‐five patients (244 FI) who presented with Class II FI were recruited to the study. Patients were randomly assigned to CHX (UMI irrigated with 0.2% CHX), EO (UMI irrigated with EOs) or control (UMI irrigated with distilled water) groups. All treatments were performed in one session. For all groups, plaque index (PI), gingival index (GI), position of gingival margin (PGM), pocket depth (PD), bleeding on probing (BOP), clinical attachment level (CAL) and horizontal attachment level (HAL) scores were recorded at baseline and 1 and 3 months after therapy. Results: In all groups, there were significant reductions in PI, GI, PD and BOP, increase in PGM scores and gain in CAL and HAL scores, at 1 and 3 months compared to baseline. Except in BOP scores, there were no significance differences among the groups at any time point. At 1 and 3 months, there were significant reductions in the BOP scores of the EO group compared with the CHX and control groups. Conclusion: Within the limits of this study, the use of EOs as a cooling liquid of UMI may promote slight adjunctive effects at FI compared to CHX and water.     

Clinical outcome observed in subjects with recurrent periodontal disease following local treatment with 25% metronidazole gel

BACKGROUND: The aim of this study was to evaluate the clinical outcome in patients with recurrent periodontal disease following treatment with 25% metronidazole gel. METHODS: Twenty subjects in a maintenance care program but with recurrent periodontal disease participated. Three months after scaling and root planing, a total of 40 sites, 2 in each patient, with probing depth > or = 5 mm were selected. One site randomly selected was treated with metronidazole gel (test) and the other site with a placebo gel (control). Baseline and follow-up measurements included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). RESULTS: There were no statistically significant differences in PI, GI, BOP, PD, or CAL between test and control sites. CONCLUSION: This study showed that local treatment with 25% metronidazole gel did not seem to influence the clinical healing in this group of subjects with recurrent periodontal disease.     

Adiposity Measurements and Non‐Surgical Periodontal Therapy Outcomes

Background: Obesity is considered a risk factor for periodontitis. However, its influence on periodontal therapy has not been clearly determined. The aim of this case‐control study is to evaluate the association between adiposity measurements, non‐surgical periodontal treatment outcomes, and influencing factors in patients with chronic periodontitis. Methods: Eighteen obese and 18 normal‐weight (NW) patients are included in this study. The waist/hip ratio (WHR), plaque index, bleeding on probing, probing depth (PD), and clinical attachment level (CAL) were measured at baseline and 3 and 6 months after treatment. Univariable and multivariable analyses were used to evaluate the influence of sex, age, baseline percentage of PD >3 mm, WHR, and obesity on periodontal treatment outcomes. Results: Demographic and periodontal characteristics at baseline were similar in both groups. All periodontal parameters were improved during treatment in both groups. PD reduction and CAL gain were 0.88 and 0.84 mm in NW individuals and 0.79 and 0.68 mm in obese individuals. The difference in moderate‐to‐deep pocket (PD >5 mm) percentages between the baseline and 6‐month examinations was 9.1% in NW individuals and 6.08% for obese individuals. Multivariable analysis showed that obesity negatively influenced changes of PD >5 mm percentages. This influence was also observed at 3 months for improving sites (PD decrease >2 mm between examinations) if WHR was also considered in the analysis. Conclusions: A negative association between adiposity measurements and periodontal treatment outcomes was observed mainly for moderate‐to‐deep pockets. Consideration of WHR and other influencing factors amplified the negative effect of obesity on periodontal treatment outcomes.     

Clinical and Biochemical Evaluation of Lozenges Containing Lactobacillus reuteri as an Adjunct to Non‐Surgical Periodontal Therapy in Chronic Periodontitis

Background: This study evaluates the effects on clinical and biochemical parameters of Lactobacillus reuteri–containing probiotic supplementation adjunctive to initial periodontal therapy in patients with chronic periodontitis (CP). Methods: Thirty patients with CP were included and divided into two groups. Every patient had, in each quadrant, ≥2 teeth each with approximal sites with a probing depth (PD) of 5 to 7 mm and gingival index (GI) of ≥2. The test group received scaling and root planing (SRP) and probiotic‐containing lozenges. The control group received SRP and placebo lozenges. Plaque index (PI), GI, bleeding on probing (BOP), PD, and attachment gain were measured. Gingival crevicular fluid (GCF) was sampled for the analysis of matrix metalloproteinase (MMP)‐8 and tissue inhibitor of metalloproteinase (TIMP)‐1 by enzyme‐linked immunosorbent assay. All evaluations were performed at baseline and on days 21, 90, 180, and 360. Results: Differences in intergroup comparisons of PI, GI, BOP, and PD were found to be significant (P <0.05) in favor of the test group at all time points. Decreased GCF MMP‐8 levels and increased TIMP‐1 levels were found to be significant up to day 180 (P <0.05). Mean values of attachment gain were significantly higher in the test group compared with the control group on days 90, 180, and 360. Conclusions: Lozenges containing L. reuteri may be a useful supplement in moderately deep pockets of patients with CP. Low MMP‐8 and high TIMP‐1 levels may indicate the role of the lozenges in reduction of inflammation‐associated markers up to day 180.     

Periodontal Status and High‐Sensitivity C‐Reactive Protein Levels in Polycystic Ovary Syndrome With and Without Medical Treatment

Background: Recently, some studies have revealed the effect of polycystic ovary syndrome (PCOS) on gingival inflammation. This cross‐sectional study attempts to assess the periodontal status and systemic inflammation of women receiving medical treatment for PCOS and women newly diagnosed with PCOS. Methods: A total of 126 participants comprising 41 newly diagnosed patients with PCOS (PCOS‐N), 45 patients with PCOS on medical treatment (PCOS‐MT), and 40 systemically healthy controls (control group [CG]) were examined. Periodontal parameters, anthropometric parameters, and serum levels of high‐sensitivity C‐reactive protein (hsCRP) were recorded. Results: Women with newly diagnosed PCOS had increased sites with bleeding on probing (BOP), probing depth, clinical attachment level (CAL), waist circumference (WC), hsCRP, and prevalence of periodontitis compared with control and PCOS‐MT groups (P ≤0.05). On partial correlation analysis after controlling for confounders, BOP and CAL correlated positively and significantly with hsCRP (P = 0.01 and P = 0.005). Multivariate linear regression analysis revealed that BOP and CAL (dependent variable) (P = 0.009/R² = 0.05 and P = 0.005/R² = 0.07, respectively) had significant association with hsCRP. Furthermore, hsCRP, when considered as outcome, also exhibited association with CAL and WC (P = 0.002/R² = 0.07 and P = 0.04/R² = 0.106). Logistic regression analysis demonstrated that the PCOS‐N group had 2.88 times increased likelihood of having moderate periodontitis (adjusted odds ratio 2.88, 95% confidence interval 1.18 to 6.98). Conclusions: Women with newly diagnosed PCOS may have increased prevalence and likelihood for periodontitis, with higher measures of periodontal inflammation and breakdown than those on medical treatment for PCOS and systemically healthy females. Furthermore, periodontal breakdown might depend on systemic inflammation and vice versa.     

Comparison of Glycated Hemoglobin Levels in Individuals Without Diabetes and With and Without Periodontitis Before and After Non‐Surgical Periodontal Therapy

Background: Only a few studies have examined the association between periodontitis and glycated hemoglobin (HbA1c) levels in individuals without diabetes. The aim of this study is to compare HbA1c levels in individuals without diabetes and with and without periodontitis before and after non‐surgical periodontal therapy. Methods: This comparative study was done on individuals without diabetes who were 35 to 65 years old. Group A consisted of 30 individuals without periodontitis, and group B consisted of 30 individuals with periodontitis. Body mass indices and clinical parameters, including oral hygiene index‐simplified (OHI‐S) score, gingival index (GI), probing depth (PD), clinical attachment level (CAL), and HbA1c level, of all participants were recorded. All participants received non‐surgical periodontal therapy (scaling and root planing). After 3 months, all participants were reexamined, and clinical parameters and HbA1c levels were evaluated and compared to baseline values. Results: There were significant differences between group A and group B in regard to baseline OHI‐S, GI, PD, and HbA1c (P <0.05). There was no clinical attachment loss in group A, either at baseline or after 3 months. At the end of 3 months, group B showed improvement in all clinical parameters (P <0.05) and their HbA1c levels also significantly decreased (P <0.05), although the values never reached those of group A. Conclusion: The HbA1c levels of individuals without diabetes and with periodontitis (group B) were significantly reduced 3 months after non‐surgical periodontal therapy, although they never reached the same levels as those of the individuals without diabetes or periodontitis (group A).     

Short‐Term Effects of 2% Atorvastatin Dentifrice as an Adjunct to Periodontal Therapy: A Randomized Double‐Masked Clinical Trial

Background: The pleiotropic effects of statins, such as immunomodulation and anti‐inflammatory effects, may also improve periodontal conditions. The aim of the present study is to assess the effectiveness of a dentifrice medicated with 2% atorvastatin in improving clinical periodontal parameters as a complement to non‐surgical periodontal treatment (NSPT). Methods: A randomized, double‐masked clinical trial was performed with two parallel groups: 1) atorvastatin group (NSPT plus medicated 2% atorvastatin dentifrice) and 2) placebo group (NSPT plus placebo dentifrice). The effectiveness of these treatments was assessed using periodontal measurements obtained at baseline and 1 month later. The measurements were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), and periodontal inflamed surface area (PISA). Multiple linear regression models were used to compare outcome variables after adjusting for sex, diabetes, and tobacco use. Results: A total of 36 individuals participated in this study (atorvastatin group, n = 18; placebo group, n = 18). Both groups showed improvements in periodontal parameters. The atorvastatin group showed a decrease of 297.63 mm² in PISA (95% confidence interval = 76.04 to 519.23; P = 0.01), which was significantly greater than the reduction observed in the placebo group. There was also a significantly greater reduction in mean PD, percentage of sites with PD ≥5 mm, mean CAL, percentage of sites with CAL ≥5 mm, BOP, and GI in the atorvastatin group compared with the placebo group. Conclusion: NSPT plus 2% atorvastatin medicated dentifrice was more effective in improving clinical periodontal parameters than NSPT plus a placebo dentifrice.     

Correlation Between Gingival Crevicular Fluid Hemoglobin Content and Periodontal Clinical Parameters

Background: Probing depth (PD) and bleeding on probing (BOP) are essential clinical parameters used for periodontal diagnosis. This study investigated whether detection of hemoglobin (Hb) in gingival crevicular fluid (GCF), along with PD and BOP, would improve diagnostic accuracy. Methods: After plaque index (PI) was measured, GCF was collected from the gingival sulci of 401 anterior teeth in the maxilla and mandible from 184 patients who had entered periodontal maintenance therapy. Clinical parameters (gingival index [GI], PD, clinical attachment level [CAL], and BOP) were recorded. Hb values in GCF were assessed by immunochromatography. Moreover, cutoff values for PI, GI, and CAL based on the degree of PD and amount of GCF were created and analyzed. Results: Hb was detected in 64.8% of GCF samples in 105 BOP‐negative (–) sites in the periodontally stable group out of 107 sites that were less than all cutoff values. There were 71 BOP(–) sites in the periodontal‐management‐required group out of 122 sites that were more than all cutoff values, although no improvement in periodontal disease was observed. Hb was detected in 88.7% of GCF samples from these 71 BOP(–) sites. Conclusions: Hb was observed in more than 60% of GCF samples in BOP(–) gingival sulci in both periodontally stable and periodontal‐management‐required groups. These results suggest inspection of Hb derived from microbleeding in gingival sulci may serve as an index for preclinical diagnosis.     

Periodontal disease in gestational and type 1 diabetes mellitus pregnant women

Oral Diseases (2011) 17 , 515–521 Objective: The present study evaluated the relationship between periodontal disease and its clinical variables in Brazilian non‐diabetic pregnant women (C), gestational diabetes mellitus (GDM), or type 1 diabetes mellitus (T1DM). Subjects and methods: A periodontal exam was performed in one hundred and sixty‐one pregnant women (GDM:80; T1DM:31; C:50) by a single‐blinded calibrated examiner who recorded plaque index (PI), gingival index (GI), bleeding index (BI), gingival margin location (GM), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and tooth mobility index (MI). The medical variables were age, pregestational body mass index (pre‐BMI), fasting plasma glucose (FPG), and glycated hemoglobin (HbA _1c ). Results: The GI, GM, PD, CAL, BOP, and MI were significantly higher ( P < 0.01) among GDM and T1DM than for C. The PI was higher in GDM and similar between C and T1DM. The Adjusted Final Model for medical variables to evaluate the effects of groups on periodontal parameters confirmed these results. Conclusions: The presence of periodontal disease was significantly higher in Brazilian diabetic pregnancies (GDM and T1DM) when compared to non‐diabetic pregnant women (C). The degree of periodontal disease was similar between the GDM and T1DM groups. Age, pregestational BMI, and HbA_1c were factors related to CAL development in these two types of diabetes mellitus.     

Clinical usability of aspartate aminotransferase to evaluate the prognosis of periodontal regeneration therapies: prospective,longitudinal study

To evaluate the degree of periodontal tissue destruction, aspartate aminotransferase (AST) levels in the gingival crevicular fluid (GCF) are utilized as a predictor of periodontal therapy. We have previously shown that the usefulness of AST activities [periodontal tissue monitor (PTM) values] using a PTM-kit to evaluate the effects of initial periodontal therapy and periodontal regeneration therapy by enamel matrix derivative (EMD). This prospective, longitudinal study was conducted using 38 healthy and 80 periodontitis sites with probing depth (PD) of 5–10 mm for guided tissue regeneration (GTR) and EMD from 36 patients. GCF samples were used to evaluate PTM values at base line (BL) and after 6 months of surgeries (re-evaluation: RE), and periodontal examinations were performed concurrently. PTM values at BL were statistically improved at RE, accompanied by the improvement of periodontal parameters in both groups. PTM values and PD, and the clinical attachment level (CAL) showed high correlations. PD, CAL and bleeding on probing (BOP) were highly correlated with PTM values in both groups, whereas only PD showed a significant correlation with PTM values at RE in the GTR group. Change in the amounts of PD, CAL and BOP between BL and RE in both groups showed no correlation with PTM values. In the negative PTM value sites at BL in EMD group, the mean PD was significantly reduced at RE compared with positive PTM sites at BL. PTM values are able to be utilized as the biochemical predictor of prognosis after periodontal regeneration therapy.     

无锡市老年人牙周健康状况调查分析

目的:了解无锡市老年人牙周健康状况,为牙周疾病防治提供参考.方法:选择无锡市1156名65～74岁的老年人为调查对象,应用简化口腔卫生指数、牙龈指数、探诊出血、牙周袋探诊深度、临床牙周附着丧失、松动牙数及牙缺失数等,评价牙周健康状况.应用SPSS12.0软件包对数据进行t检验和x2检验.结果:无锡市老年人简化口腔卫生指数(OHI-S)为3.16±1.48,牙龈指数(GI)为1.33+0.54;牙龈探诊出血、牙周袋深度及牙周附着丧失等牙周健康状况未表现出显著的城乡差异.结论:无锡市老年人牙周健康状况不佳,应注重牙周病预防,普及和加强口腔健康教育.     

Periodontal Status and Metabolic Syndrome in Middle‐Aged Japanese

Background: Metabolic syndrome (MetS) increases the risk of various lifestyle‐related diseases. Although some studies have reported a significant relationship between periodontal status and MetS, little information exists about the nature of the relationship between periodontal health status and MetS. Methods: Comprehensive health examinations of 6,421 Japanese individuals (aged 34 to 77 years) were performed. Five components (obesity, high blood pressure, low high‐density lipoprotein cholesterol, hypertriglyceridemia, and high plasma glucose) of MetS were evaluated, and individuals with ≥3 positive components were defined as having MetS. The periodontal parameters were periodontal probing depth (PD) and clinical attachment level (CAL), and each parameter was divided into three categories (none/mild: ≤3 mm; moderate: 4 to 5 mm; and severe: ≥6 mm). Results: When PD and CAL were analyzed separately in multivariate models, both parameters were significantly associated with MetS. In a multivariate logistic regression analysis using a combination of PD and CAL as an independent variable, individuals with severe PD and severe CAL or with moderate PD and moderate CAL had significantly higher odds ratios for MetS, but severe CAL without severe PD was not significantly associated with MetS. Conclusion: The results of this study suggest that periodontal status, particularly in individuals suspected to have untreated periodontal infection indicated by ≥4 mm PD, is significantly associated with MetS.     

The Association Between Periodontal Inflammation and Labor Triggers (Elevated Cytokine Levels) in Preterm Birth: A Cross‐Sectional Study

Background: Periodontitis is considered to be a risk factor for preterm birth. Mechanisms have been proposed for this pathologic relation, but the exact pathologic pattern remains unclear. Therefore, the objective of the present study is to evaluate levels of four major labor triggers, prostaglandin E₂ (PGE₂), interleukin (IL)‐1β, IL‐6, and tumor necrosis factor (TNF)‐α, in gingival crevicular fluid (GCF) and serum samples between women with preterm birth (PTB) and full‐term birth (FTB) and correlate them with periodontal parameters. Methods: PGE₂, IL‐1β, IL‐6, and TNF‐α levels were estimated using enzyme‐linked immunosorbent assays in GCF and serum samples collected 24 to 48 hours after labor from 120 women (60 FTB, 60 PTB). Results: Women with PTB exhibited significantly more periodontitis, worse periodontal parameters, and increased GCF levels of IL‐6 and PGE₂ compared with the FTB group; there were no significant differences in serum levels of measured markers. GCF levels of IL‐1β, IL‐6, and PGE₂ and serum levels of TNF‐α and PGE₂ were significantly higher in women with periodontitis compared with periodontally healthy women. Serum levels of PGE₂ were positively correlated with probing depth (PD) and clinical attachment level (CAL) as well as with GCF levels of TNF‐α in women with PTB. Conclusions: Women with PTB demonstrated worse periodontal parameters and significantly increased GCF levels of IL‐6 and PGE₂ compared with those with FTB. Based on significant correlations among serum PGE₂ and PD, CAL, and GCF TNF‐α in PTB, periodontitis may cause an overall increase of labor triggers and hence contribute to preterm labor onset.