Salivary spinability and periodontal disease progression in an elderly population

OBJECTIVE: To explore the relationship between the spinability of stimulated whole saliva and periodontal disease progression over 12 months in an elderly population. METHODS: Three hundred and thirty-two subjects aged 76 years at baseline were studied. Attachment loss was calculated on a site-by-site basis, and periodontal disease progression was defined as an attachment loss of >/=3mm. Stimulated whole saliva was collected and salivary spinability (SS) was measured. A multiple linear regression analysis was performed to assess the relationship between periodontal disease progression and SS after controlling for other covariates. The independent variables were selected from those which had significant relationships with disease progression in the bivariate analyses. RESULTS: Mean SS was 1.94+/-0.42mm in males and 1.88+/-0.32mm in females; this difference was not significant. Simple linear regression analysis showed a significant positive relationship between periodontal disease progression and SS (P=0.026), whereas there was no significant relationship between periodontal disease progression and salivary flow rate. Multiple regression analysis revealed a significant positive relationship between periodontal disease progression and SS (P=0.024) after controlling for the number of remaining teeth and baseline periodontal conditions. The model explained 15.5% of the variance in the percentage of sites where the disease had progressed. CONCLUSIONS: These findings suggest that elderly subjects with viscous saliva are prone to periodontal disease progression.     

Beta-glucuronidase activity in saliva: relationship to clinical periodontal parameters

BACKGROUND: Beta-glucuronidase (betaG) in gingival crevicular fluid (GCF), a marker of neutrophil influx into the crevicular environment, has previously been shown to be correlated with periodontal clinical parameters at individual sites (probing depth and clinical attachment level). Furthermore, elevated levels of betaG were found to be a risk factor for periodontal attachment loss. Analysis of betaG in saliva may be a measure of crevicular neutrophil influx for the whole mouth. The purpose of this cross-sectional study was to evaluate the relationship between betaG activity in saliva and periodontal clinical parameters in subjects demonstrating various levels of periodontal disease. METHODS: The study population consisted of 380 subjects (108 males and 272 females). A sample of unstimulated whole saliva and a venous blood sample were obtained from each subject, and a periodontal examination, which included measurement of probing depth (PD), attachment level (AL), and gingival index (GI) was performed. The unmodified saliva samples were frozen at -20 degrees C and analyzed for betaG activity. The blood samples were analyzed for number of white blood cells, neutrophils, monocytes, lymphocytes, and platelets. Statistical analysis was conducted to determine the association between salivary betaG activity and the whole-mouth clinical periodontal parameters, complete blood count, smoking status, and age. RESULTS: Highly significant correlations between salivary betaG activity and mean probing depth (MPD), mean gingival index (MGI), and the number of sites with probing depth > or = 5 mm were found. When subjects were divided into tertiles based on their MPD and MGI, elevated salivary betaG activity was detected in subjects in the 2 upper tertiles. Logistic regression modeling was used to determine which of the clinical or laboratory parameters were able to identify patients with at least 4 sites with PD > or = 5 mm. Salivary betaG activity > or = 100 produced an odds ratio (OR) of 3.77. In comparison, current and former smokers had an OR of 3.15 and 2.29, respectively. CONLCUSIONS: The results suggest that a significant association exists between periodontal clinical parameters and salivary betaG activity. Due to the non-invasive and simple nature of saliva collection, this association should be studied to determine its usefulness as a screening test for periodontitis, and a means of monitoring the response to treatment.     

The extent of periodontal disease and the IL-6 -174 genotype as determinants of serum IL-6 level

AIM: To study the extent of periodontal disease and the IL-6(-174) genotype as determinants of serum and mouthwash IL-6 concentration in subjects with moderate to severe periodontal disease. MATERIAL AND METHODS: Fifty-two generally healthy subjects volunteered to participate. Probing pocket depth (PD) and periodontal attachment level (AL) were clinically examined and alveolar bone level (BL) was measured on orthopantomographs. IL-6 concentrations in mouthwash, collected by rinsing with 3 ml saline for 30 s and in serum, obtained by venipuncture, were measured using ELISA. IL-6(-174) polymorphism was studied using a polymerase chain reaction. RESULTS: Eleven subjects carried the GG genotype, and 41 subjects, carried the CG/CC genotype. The mean (+/- SD) concentration of IL-6 in serum was 1.6 (+/- 1.5) pg/ml and, 2.8 (+/- 5.04) pg/ml in mouthwash. The serum concentration of IL-6 was higher in subjects with the GG genotype than with the CG/CC genotype. In regression analyses the percentages of sites with PD> or =6 mm, AL> or =6 mm and BL> or =8 mm, the IL-6(-174) genotype, body mass index and gender associated significantly with serum IL-6 concentration. CONCLUSIONS: The extent of moderate to severe periodontal disease and the IL-6(-174) genotype contribute significantly to serum IL-6 concentration.     

Oral health condition and saliva flow in southern Chinese with Sjögren's syndrome

Objective : To investigate the oral health condition and saliva flow of southern Chinese patients with Sjögren's syndrome (SS). Method : 51 SS patients (26 primary and 25 secondary cases) and 29 controls took part in this cross‐sectional study. Stimulated whole and parotid saliva flow rates, pH, and buffer capacity, and xerostomia, oral mucosal lesions, oral hygiene status, dental and periodontal conditions, prosthetic status were assessed and compared between groups. Results : Stimulated whole saliva (SWS) flow was reduced in primary and secondary SS cases (p<0.001), pH and buffer capacity were also reduced in the primary SS group (p<0.05). SS patients had a greater prevalence of xerostomia than controls (p<0.001). Primary SS patients had a higher mean DMFT, more missing teeth, and more prostheses than secondary SS cases and controls (p<0.05). SWS flow correlated negatively with the number of filled teeth in both SS groups (p<0.05) and the number of decayed teeth in the primary SS group (p<0.05). Conclusion : Despite good oral hygiene and regular dental checkups, the oral health of southern Chinese with primary SS was significantly compromised compared with secondary SS cases and controls, most probably due to the combined effect of impaired salivary gland function and poorer saliva buffer capacity.     

内窥镜辅助下微创牙周基础治疗的临床疗效评价

目的 探讨牙周内窥镜辅助下超声龈下刮治及根面平整(subgingival scaling and root planning,SRP)对重度牙周炎治疗的临床疗效.方法 选取2017年6月至2019年1月于南京大学医学院附属口腔医院就诊的Ⅲ-Ⅳ期牙周炎患者19例,随机分为内窥镜组及对照组.内窥镜组在龈上洁治术1周后,牙周...     

Salivary and Serum Leptin Concentrations in Patients With Chronic Periodontitis

Background: The discovery of leptin has led to the elucidation of a robust physiologic system that not only maintains fat stores but is also an integral part of the host defense mechanism. However, leptin concentrations in the saliva of patients with chronic periodontitis (CP) has not been explored despite the potential role of salivary biomarkers in determining the presence, risk, and progression of periodontal disease. Methods: Eighty‐four participants (44 with generalized severe CP and 40 without periodontitis) were enrolled. For each patient, the values of periodontal parameters were recorded, such as plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (AL), and percentage of sites with bleeding on probing (BOP) and clinical AL ≥5 mm. Saliva and serum samples were collected to estimate the leptin concentrations using enzyme‐linked immunosorbent assay kits. Statistical analysis was performed using software. Results: Participants with CP demonstrated significantly higher BOP, PI, GI, and percentage of sites with clinical AL >5 mm (P <0.05). Leptin was detectable in all the clinical samples. Salivary leptin concentrations in patients with CP were significantly lower than in healthy volunteers (6,200.61 ± 2,322.11 versus 8,799.60 ± 901.70 pg/mL), whereas serum leptin concentrations were significantly higher in patients with CP than in healthy volunteers (11,600.00 ± 1,705.01 versus 7,616.62 ± 1,169.83 pg/mL). In addition, the results reflected a significant negative correlation of salivary leptin and a positive correlation of serum leptin with PD (P <0.05). Conclusion: The results suggest that leptin concentrations in saliva and serum are significantly altered in CP and relate closely to current disease activity; however, further studies are needed to confirm the findings.     

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.     

Scaling and root planing, systemic metronidazole and professional plaque removal in the treatment of chronic periodontitis in a Brazilian population. I. clinical results

OBJECTIVE: The current investigation evaluated the clinical effects of scaling and root planing (SRP) alone or in combination with systemic metronidazole and/or repeated professional removal of supragingival plaque in subjects with chronic periodontitis. METHODS: Fourty-four adult subjects (mean age: 45+/-6 years) with periodontitis were randomly assigned to four treatment groups; a control (C, n=10) that received SRP and placebo and three test groups treated as follows: Test 1 (T1) (n=12) received SRP and metronidazole (400 mg t.i.d., M) for 10 days; Test 2 (T2) (n=12) received SRP, weekly professional supragingival plaque removal for three months (professional cleaning (PC)) and placebo; and Test 3 (T3) (n=10) received SRP, M and PC. Pocket depth (PD), attachment level (AL), bleeding on probing (BOP) and presence of visible plaque and suppuration were measured at six sites per tooth at baseline and at 90 days post-therapy. Significance of differences over time was determined using the Wilcoxon test, and among groups using ancova. RESULTS: A reduction in full-mouth mean clinical parameters was observed at 90 days after all therapies. Sites with baseline PD<4 mm showed an increase in mean PD in the control group and in mean AL in all treatment groups. Sites with baseline PD of 4-6 mm in subjects who received PC as part of therapy (T2, T3) showed a marked reduction in PD, AL and in the % of sites with BOP. Subjects who received metronidazole (T1 and T3) showed the best clinical response at sites with an initial PD of >6 mm. The major clinical benefit occurred when the combination of SRP, M and PC was used. Group T3 showed the least attachment loss in initially shallow pockets. This group also exhibited the greatest reduction in the % of sites with BOP and suppuration as well as in mean PD and AL at sites with baseline PD>4 mm. CONCLUSION: The data suggest a significant clinical benefit in combining SRP, systemic metronidazole and weekly professional supragingival plaque removal for the treatment of chronic periodontitis.     

Relationship between markers of metabolic control and inflammation on severity of periodontal disease in patients with diabetes mellitus

AIM: The aim of this study was to investigate the relationship between markers of metabolic control and inflammation and periodontal disease parameters in patients with diabetes. MATERIAL & METHODS: One hundred and eighty one adult patients with diabetes attending treatment at two diabetes centres were invited to participate in the study. Periodontal examination included full-mouth assessment for probing depths and bleeding on probing (BOP). Blood analyses were carried out for glycated haemoglobin, (HbA1c), high-sensitivity C reactive protein, (hsCRP) and lipid profile comprising total cholesterol, low-density lipoprotein cholesterol (LDL chol), high-density lipoprotein cholesterol (HDL chol) and triglycerides. RESULTS: Upon multivariate analysis, periodontal disease severity in terms of increased percentage of BOP and mean percentage of sites with probing depths > or = 5 mm were found to be associated with inadequate glycaemic control as measured by HbA1c (p<0.01). HsCRP was also found to be a significant predictor for mean percentage of sites with probing depths > or = 5 mm (p<0.05). After controlling for age, gender, smoking habits and number of teeth, positive correlations were found between HbA1c and percentage sites with probing depths > or = 5 mm, percentage sites BOP, total cholesterol, LDL chol and triglycerides (p<0.05). Using the adjusted differences, subjects with acceptable glycaemic control (HbA1c < 8%) showed a lower percentage of sites with BOP and probing depths > or = 5 mm (p<0.05) when compared with those having inadequate glycaemic control. There was also a trend towards lower blood cholesterol in the well-controlled group. CONCLUSION: The level of glycaemic control as measured by HbA1c emerged as the most consistent risk factor associated with the extent and severity of periodontal disease in this study cohort.     

Bone remodeling biomarkers of periodontal disease in saliva

BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha), C-telopeptide pyridinoline cross-links of type I collagen (ICTP), and receptor activator of nuclear factor-kappa B ligand (RANKL) have been associated with bone remodeling and periodontal tissue destruction. This study evaluated the level of these biomarkers in saliva with respect to periodontal disease status. METHODS: Levels of TNF-alpha in unstimulated whole saliva of 74 adults (35 subjects with moderate to severe periodontal disease and 39 healthy controls) and salivary levels of RANKL and ICTP of a subset of 21 subjects and 21 matched controls were examined using enzyme immunosorbent assays in a case-control clinical study. RESULTS: Salivary levels of TNF-alpha were detected in all subjects, whereas levels of ICTP and RANKL were detected in only a minority of subjects. Mean salivary levels of TNF-alpha were significantly higher in individuals with periodontal disease (mean: 4.33 pg/ml) than in controls (mean: 2.03 pg/ml; P = 0.02), with a maximum level (27.96 pg/ml) observed in periodontitis. Subjects with salivary TNF-alpha levels above a threshold of 5.75 pg/ml (i.e., two standard deviations above the mean of the controls) had significantly more sites with bleeding on probing, probing depths >/=4 mm, and attachment loss > or =2 mm (P < or =0.01). CONCLUSION: Salivary levels of TNF-alpha were elevated in patients who had clinical indicators of periodontitis, suggesting that this biomarker may serve in a panel of salivary biomarkers that could facilitate the screening, diagnosis, and management of periodontal disease.     

Non-surgical periodontal treatment with a new ultrasonic device (Vector-ultrasonic system) or hand instruments

OBJECTIVES: The aim of this prospective, randomized, controlled clinical study was to compare the effectiveness of a newly developed ultrasonic device to that of scaling and root planing for non-surgical periodontal treatment. MATERIAL AND METHODS: Thirty-eight patients with moderate to advanced chronic periodontal disease were treated according to an "one-stage procedure" with either a newly developed ultrasonic device (VUS) (Vector-ultrasonic system) or scaling and root planing (SRP) using hand instruments. Clinical assessments by plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made prior to and at 6 months after treatment. Differences in clinical parameters were analyzed using the Wilcoxon signed ranks test and Mann and Whitney U-test. RESULTS: No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the VUS group from 32% at baseline to 20% after 6 months (p<0.001) and in the SRP group from 30% at baseline to 18% after 6 months (p<0.001).The results have shown that at moderately deep sites (initial PD 4-5 mm) mean CAL changed in the test group from 4.6+/-1.2 to 4.2+/-1.6 mm (p< 0.001) and in the control group from 4.8+/-1.3 to 4.4+/-1.5 mm (p<0.001). At deep sites (initial PD>6 mm) mean CAL changed in the test group from 8.5+/-1.9 to 7.9+/-2.4 mm (p<0.001) and in the control group from 7.9+/-1.6 to 7.2+/-2.2 mm (p<0.001). No statistically significant differences in any of the investigated parameters were found between the two groups. CONCLUSION: Non-surgical periodontal therapy with the tested ultrasonic device may lead to clinical improvements comparable to those obtained with conventional hand instruments.     

Periodontal Health in Women With Early‐Stage Postmenopausal Breast Cancer Newly on Aromatase Inhibitors: A Pilot Study

Background: Aromatase inhibitor (AI) use results in low estrogen levels, which in turn affect bone mineral density (BMD). Periodontitis, alveolar bone loss, and tooth loss are associated with low BMD. The goal of this study is to assess the prevalence of periodontitis and perceived oral health and evaluate salivary biomarkers in postmenopausal women who are survivors of early‐stage (I to IIIA) breast cancer (BCa) and receive adjuvant AI therapy. Methods: Participants included 58 postmenopausal women: 29 with BCa on AIs and 29 controls without BCa diagnoses. Baseline periodontal status was assessed with: 1) periodontal probing depth (PD); 2) bleeding on probing (BOP); and 3) attachment loss (AL). Demographic and dental utilization information was gathered by questionnaire. Linear regression modeling was used to analyze the outcomes. Results: No differences were found in mean PD or number of teeth. The AI group had significantly more sites with BOP (27.8 versus 16.7; P = 0.02), higher worst‐site AL (5.2 versus 4.0 mm; P <0.01), and more sites with dental calculus (18.2 versus 6.4; P <0.001) than controls. Linear regression adjusted for income, tobacco use, dental insurance, and previous radiation and chemotherapy exposure demonstrated that AI use increased AL by >2 mm (95% confidence interval, 0.46 to 3.92). Median salivary osteocalcin and tumor necrosis factor‐α levels were significantly higher in the AI group than the control group. Conclusion: This first investigation of the periodontal status of women initiating adjuvant AI therapy identifies this population as having an increased risk for periodontitis.     

Longitudinal evaluation of prostaglandin E2 (PGE2) and periodontal status in HIV+ patients

The study aim was to determine whether prostaglandin E(2) (PGE(2)) in gingival crevicular fluid (GCF) could serve as a risk factor for periodontitis in human immunodeficiency virus-positive (HIV(+)) patients. Clinical measurements, including gingival index (GI), plaque index, bleeding index, probing depth (PD), attachment loss (AL) and GCF samples were taken from two healthy sites (including sites with gingival recession, GI=0; PD< or =3 mm; AL< or =2 mm), three gingivitis sites (GI>0; PD< or =3 mm; AL=0) and three periodontitis sites (GI>0; PD> or =5 mm; AL> or =3 mm) of each of the 30 patients at baseline and 6-month visits. GCF samples were also taken by means of paper strips. GCF PGE(2) levels were determined by a sandwich ELISA. The progressing site was defined as a site which had 2 mm or more attachment loss during the 6-month study period. The mean amounts of PGE(2) were significantly higher in gingivitis and periodontitis sites than in healthy sites (p<0.0001). GCF levels of PGE(2) were significantly correlated with probing depth, attachment loss, CD4(+) cells, viral load, age and smoking pack-years at baseline and 6-month visits (0.0001相似文献   

Attachment loss in rural Chinese children over a 3-year period

OBJECTIVES: The periodontal condition of 84 children (9-14 years old, 38 males and 46 females) in a rural area of China was monitored over a 3-year period in order to determine the clinical parameters that act as risk factors for attachment loss. METHODS: Plaque and calculus accumulation (PSS and CI), modified gingival index (MGI), pocket depth (PD) and attachment level (AL) of two quadrants of each child were examined in 1993 and 1996. Following calculation of the mean of each of these parameters and statistical analysis of the change in each of the clinical parameters over the 3-year period, the relationship between attachment loss and clinical parameters was analyzed using multiple regression analysis. RESULTS: At the beginning of this study, the mean values for males and females were 3.66 and 3.58 for PSS, 1.22 and 1.17 for MGI, 1.07 and 0.90 for CI, 2.21 and 2.22 for PD, and both 0.02 for AL respectively. No significant difference between males and females was observed. After 3 years, all except mean PSS had increased significantly. Multiple regression analysis indicated that AL correlated only to age (P<0.01). In 1993, although the AL was > or =1 mm for at least one site in 21 children, none had an AL> or =3 mm. In 1996, the number of children with an AL> or =1 mm had increased to 63, and nine of these children exhibited 3 mm AL (one to six sites per child). No other significant differences were observed between the clinical data of these nine children and those of the other children. CONCLUSION: Although attachment loss tended to increase with age, no clinical parameters correlated with attachment loss in children.     

Matrix metalloproteinase‐8 concentration in shallow crevices associated with the extent of periodontal disease

Objective: The aim of this study was to analyse the association between matrix metalloproteinase‐8 (MMP‐8) concentration in shallow, mostly non‐bleeding gingival crevices, and the extent of periodontal disease. Material and Methods: Plaque, bleeding on probing (BOP), probing pocket depth (PPD) and attachment level (AL) were assessed clinically in 48 patients with chronic periodontitis. MMP‐8 concentrations in gingival crevicular fluid (GCF) from four shallow (PPD3 mm), and four diseased sites and in serum, were measured by enzyme‐linked immunosorbent assay. Results: The mean concentration of MMP‐8 in GCF from shallow crevices was 11.8 ± 12.8 ng/ml and from diseased sites was 150.1 ± 91.8 ng/ml. In subjects with moderate to high plaque scores, a statistically significant association was found between MMP‐8 concentration from shallow crevices and the extent of AL4 mm (p=0.028) and AL6 mm (p<0.001). Conclusion: The above association between MMP‐8 concentration in shallow crevices and attachment loss provides a new aspect to future studies of MMP‐8 as a prognostic marker for periodontal disease.     

s-IgA and cytokine levels in whole saliva of Sjögren's syndrome patients before and after oral pilocarpine hydrochloride administration: a pilot study

Previous investigations have found elevated levels of s-IgA in the parotid saliva and normal levels in submandibular saliva of patients with Sjögren's syndrome (SS). Fox et al. also found elevated levels of cytokines (i.e., IL-2 and IL-6) in serum, salivary epithelial cells and parotid saliva of patients with SS. The oral administration of pilocarpine hydrochloride stimulates whole and parotid salivary flow. The purpose of this study was to determine the levels of s-IgA and IL-2 and IL-6 in whole saliva before and after administration of pilocarpine hydrochloride in SS subjects. Ten definitively diagnosed SS subjects were enrolled in the study, as were ten controls (C). The mean age was 57.2 years and all subjects were female. Whole unstimulated saliva (WUS) was collected by standard techniques for 5 min, after which the volume and flow rate were determined (mean WUS: SS = 0.047 vs C = 0.480 ml/min). Samples were centrifuged and the immunoglobulin analysis performed on the supernatants by immunoreactivity in a double-sandwich technique as previously described by Rudney et al. Cytokine analysis was performed similarly utilizing commercially available kits from R&;D Systems. The results as analyzed by pairwise t-tests revealed comparable levels of s-IgA in the saliva of the SS patients, as compared to controls at baseline (means±SEM: SS-IgA = 348.1±82.0 vs C-IgA = 284.0±65.1 μg/ml; NS ). Whole salivary flow was significantly increased (328%) in the SS subject group 60 min after the administration of 5 mg pilocarpine hydrochloride (means±SEM: 0.0472±0.017 vs 0.1546±0.054 ml/min; P<0.01). There was no significant change in the concentration of s-IgA in the SS subject group following the pilocarpine dose (means±SEM: SS-IgA = 439.9±121.2 μl/ml; P = NS). There were elevated levels of IL-2 in the saliva of four out of the ten and IL-6 in two out of the ten SS patients, as compared to controls (means±SEM: SS-IL-2 = 127.8±11.4 vs C-IL-2 = 30.8±1.6 pg/ml and SS-IL-6 = 41.4±7.1 vs C-11.6 ± 2.8 pg/ml). There was also a significant decrease in the concentration of IL-2 in the same four out of ten SS subjects following the pilocarpine dose (means±SEM: SS-IL-2 = 32.4±10.3; P<0.01). These preliminary results indicate that s-IgA levels do not change with increased salivary flow following the administration of pilocarpine hydrochloride in patients with Sjögren's syndrome. While cytokines are elevated in the whole saliva of some SS patients, a decrease in IL-2 concentration may occur with increased salivary flow.     

The association between smoking cessation and periodontal status and salivary proteinase levels

BACKGROUND: Little information is available about the effects of the cessation of cigarette smoking on oral health, although cigarette smoking has been shown to be associated with a variety of oral diseases. The aim of this study was to compare periodontal status, salivary proteolytic activity, especially collagenase-2 (MMP-8) levels, and oral mucosal status in individuals who had quit smoking for at least 6 months (mean 3.5, SD 1.3 years) and in regular smokers. METHODS: The subjects were 409 white male smokers aged 55 to 74 years with 15 or more remaining teeth. They had participated in a major cancer prevention study (ATBC Study). Eighty-two of the men had given up smoking and 327 were smokers. The subjects were examined clinically to determine the prevalence of periodontal pockets, gingival bleeding (BOP) and suppuration, and prevalence of keratotic oral mucosal lesions. The loss of alveolar bone was determined radiographically. Candida albicans was cultivated, and lesions showing leukoplakia were examined histopathologically. General proteolytic activity and collagenase-2 or matrix metalloproteinase-8 (MMP-8) levels in saliva, salivary pH, and buffering capacity were measured. Linear regression, logistic regression, or Fisher's exact test were used in statistical analysis. RESULTS: Salivary general proteolytic activity and MMP-8 levels were lower in current smokers than in ex-smokers (P <0.05 and P <0.05, respectively). The prevalence of > or = 4 mm deep pockets, gingival suppuration, and loss of crestal bone were statistically significantly lower (P = 0.003, P<0.001, and P<0.05, respectively) and salivary buffering capacity higher (P <0.05) in those who had quit smoking compared to current smokers; there was no difference in BOP. The prevalence of oral leukoplakia did not differ significantly between smokers and quitters, but was higher in those who smoked >15 cigarettes per day compared to quitters (odds ratio 3.5, 95% CI, 0.8 to 15.3). CONCLUSIONS: These data suggest that periodontal status and oral mucosal health are better in those who have quit cigarette smoking compared to current smokers. However, the data further suggest that smoking may significantly lower both general proteolytic enzyme activity and MMP-8 levels in saliva. Thus, care should be taken in interpreting results revealing salivary/mouthrinse proteinases as diagnostic markers for oral/periodontal disease activity.     

Clinical effects of scaling and root planing with an adjunctive periodontal endoscope for residual pockets: a randomized controlled clinical study

目的 比较牙周内窥镜辅助龈下刮治和根面平整（SRP）与传统SRP对慢性牙周炎患者基础治疗后残留牙周袋的临床疗效。方法 将牙周基础治疗后口内每个区至少有1个位点探诊深度（PD）≥5 mm的患者纳入研究,随机分为内窥镜组和SRP组,分别对残留牙周袋位点进行内窥镜辅助SRP治疗和传统SRP治疗。在治疗前（基线）、治疗后3、6个月检查PD、探诊出血（BOP）和附着丧失（AL）,采用SPSS 20.0统计学软件对数据进行统计分析。结果 与基线相比,治疗后3、6个月内窥镜组及SRP组PD≥5 mm位点百分比、PD、AL、BOP阳性位点百分比均降低（P<0.05）。治疗后6个月与3个月相比,内窥镜组PD≥5 mm位点百分比、PD、AL、BOP阳性位点百分比均降低（P<0.05）,而SRP组差异无统计学意义（P>0.05）。与SRP组相比,内窥镜组治疗后3及6个月PD≥5 mm位点百分比、PD均降低,治疗后6个月AL、BOP阳性位点百分比降低（P<0.05）。结论 牙周内窥镜辅助SRP对于基础治疗后的残留牙周袋（PD≥5 mm）的临床疗效优于传统SRP,尤其具有更好的远期预后。     

Relationship between Campylobacter rectus and periodontal status during pregnancy

INTRODUCTION: In a previous study, we showed that the growth of Campylobacter rectus is stimulated by the presence of female sex hormones in the culture medium. In the present study, we examined the relationship between C. rectus levels in the saliva and the periodontal status of pregnant women. METHODS: Unstimulated whole saliva was collected from 22 pregnant and 15 non-pregnant women. Periodontal pocket depth (PD) and bleeding on probing (BOP) were recorded. A quantitative real-time polymerase chain reaction was performed to determine the concentrations of suspected periodontopathogenic bacteria in the saliva samples. In addition, the concentration of estradiol in the saliva samples was measured by enzyme immunoassay. RESULTS: The average age, number of teeth, and total number of bacteria in the saliva of subjects in both groups were similar. The percentage of sites with a PD = 4 mm and the salivary estradiol concentrations were significantly higher in pregnant women than in non-pregnant women. In addition, the percentage of BOP sites and the C. rectus levels in the saliva of the pregnant women tended to be higher than in non-pregnant women, although these differences were not statistically significant. There were positive correlations between C. rectus levels and estradiol concentrations, and between C. rectus levels and the percentage of sites with PD = 4 mm in the pregnant women. CONCLUSION: These results indicate that C. rectus levels are higher in the oral flora of pregnant women and that this may be associated with increased salivary estradiol concentrations. This may contribute to periodontal disease progression during pregnancy.     

难治性牙周炎患者血清中瘦素(LEP)水平及其与牙周临床指数关系分析

目的: 探讨难治性牙周炎患者的血清瘦素水平以及其与牙周临床指数之间的关系。方法: 本文随机选取健康组、慢性牙周炎组以及难治性牙周炎组患者各40例,记录所有接受检测者的牙周炎临床指标牙周袋探诊深度(PD)、菌斑指数(PLI)、牙周附着水平(AL)以及探诊出血(BOP)的相关变化情况;然后采用高效液相关层析法检测所有接受检查患者的糖化血红蛋白(HBALC)以及空腹血糖(FPG)指标变化情况,并且同时使用酶联免疫吸附法(ELISA)检测患者血清中瘦素(LEP)表达水平变化情况。结果: 难治性牙周炎组中患者的血清中HBALC(10.902±2.129)%、FPG(9.783±2.109) mmoL/L、LEP(1.347±0.658) μg/L的浓度明显高于慢性牙周炎组和健康组HBALC(5.601±0.375)%、(5.142±0.319)%、FPG(5.689±0.712)、(5.432±0.467) mmoL/L、LEP(0.912±0.256)、(0.462±0.119) ng/mL(P<0.05);所有受试者的血清瘦素指标与PD、AL、PLI以及BOP指标值都呈正相关,R值依次分别为0.497、0.534、0.509和0.571(P<0.05)。结论: 难治性牙周炎患者血清中瘦素水平会逐渐升高,血清瘦素水平与PD、AL、PLI以及BOP指标呈正相关的关系。