Teeth electroexcitability in periodontitis

Electroodontometric study of 756 intact teeth in 209 patients 18-65 years of age with normal periodontium and different stages of periodontal disease (periodontitis) showed that 96.8% of teeth in patients with mild periodontitis retained normal sensitivity, 68.4% -- with moderate periodontitis and 55% -- with severe periodontitis. Decreased pain threshold was detected in 3.2% of teeth of patients with mild periodontitis, 22.6% -- with moderate periodontitis and 12% -- with severe periodontitis. Increased pain threshold was not detected in teeth of patients with mild periodontitis, but in 9% with moderate periodontitis and in 29% with severe periodontitis it was obvious.     

Recent epidemiologic trends in periodontitis in the USA

The most important development in the epidemiology of periodontitis in the USA during the last decade is the result of improvements in survey methodologies and statistical modeling of periodontitis in adults. Most of these advancements have occurred as the direct outcome of work by the joint initiative known as the Periodontal Disease Surveillance Project by the Centers for Disease Control and Prevention and the American Academy of Periodontology that was established in 2006. This report summarizes some of the key findings of this important initiative and its impact on our knowledge of the epidemiology of periodontitis in US adults. This initiative first suggested new periodontitis case definitions for surveillance in 2007 and revised them slightly in 2012. This classification is now regarded as the global standard for periodontitis surveillance and is used worldwide. First, application of such a standard in reporting finally enables results from different researchers in different countries to be meaningfully compared. Second, this initiative tackled the concern that prior national surveys, which used partial-mouth periodontal examination protocols, grossly underestimated the prevalence of periodontitis of potentially more than 50%. Consequently, because previous national surveys significantly underestimated the true prevalence of periodontitis, it is not possible to extrapolate any trend in periodontitis prevalence in the USA over time. Any difference calculated may not represent any actual change in periodontitis prevalence, but rather is a consequence of using different periodontal examination protocols. Finally, the initiative addressed the gap in the need for state and local data on periodontitis prevalence. Through the direct efforts of the Centers for Disease Control and Prevention and the American Academy of Periodontology initiative, full-mouth periodontal probing at six sites around all nonthird molar teeth was included in the 6 years of National Health and Nutrition Examination Surveys from 2009-2014, yielding complete data for 10 683 dentate community-dwelling US adults aged 30 to 79 years. Applying the 2012 periodontitis case definitions to the 2009-2014 National Health and Nutrition Examination Surveys data, the periodontitis prevalence turned out to be much greater than previously estimated, namely affecting 42.2% of the population with 7.8% of people experiencing severe periodontitis. It was also discovered that only the moderate type of periodontitis is driving the increase in periodontitis prevalence with age, not the mild or the severe types whose prevalence do not increase consistently with age, but remain ~ 10%-15% in all age groups of 40 years and older. The greatest risk for having periodontitis of any type was seen in older people, in males, in minority race/ethnic groups, in poorer and less educated groups, and especially in cigarette smokers. The Centers for Disease Control and Prevention and the American Academy of Periodontology initiative reported, for the first time, the periodontitis prevalence estimated at both local and state levels, in addition to the national level. Also, this initiative developed and validated in field studies a set of eight items for self-reported periodontitis for use in direct survey estimates of periodontitis prevalence in existing state-based surveys. These items were also included in the 2009-2014 National Health and Nutrition Examination Surveys for validation against clinically determined cases of periodontitis. Another novel result of this initiative is that, for the first time, the geographic distribution of practicing periodontists in relation to the geographic distribution of people with severe periodontitis is illustrated. In summary, the precise periodontitis prevalence and distribution among subgroups in the dentate US noninstitutionalized population aged 30-79 years is better understood because of application of valid periodontitis case definitions to full-mouth periodontal examination, in combination with reliable information on demographic and health-related measures. We now can monitor the trend of periodontitis prevalence over time as well as guide public health preventive and intervention initiatives for the betterment of the health of the adult US population.     

轻，中、重度慢性牙周炎多种等位基因的检测

目的：探讨轻度慢性牙周炎个体和中、重度慢性牙周炎个体携带不同数目牙周炎易感基因的差异。方法：对纳入的慢性牙周炎个体和健康对照组进行牙周临床检查,并抽取外周静脉血,提取基因组DNA,应用限制性内切酶,采用聚合酶链反应限制性片段长度多态性的方法检测HLA-DRB1＊1501、TNF-A-308、IL-1B＋3953、雌激素受体、维生素D受体5种基因的多态性。结果：中、重度慢性牙周炎个体携带3种以上易感等位基因的百分比为56.6%,轻度慢性牙周炎个体携带3种以上易感等位基因的百分比为12.5%,健康对照组携带3种以上易感等位基因的个体百分比为7.5%,经方差分析中、重度慢性牙周炎组与轻度慢性牙周炎组和健康对照组间差异具有统计学意义（P〈0.01）,轻度慢性牙周炎组与健康对照组间差异不具有统计学意义。中、重度慢性牙周炎组携带VDR-TT、ER-XX基因型的个体临床附着丧失重于携带VDR-tt和ER-xx基因型的个体,经t检验二组差异具有显著性（P〈0.01）。结论：多种等位基因的共同携带有助于慢性牙周炎的进展;VDR-TT和ER-XX基因型可能是牙周骨组织丧失的危险因素。     

Distribution of genotypes of Porphyromonas gingivalis in type 2 diabetic patients with periodontitis in Mexico

OBJECTIVE: To determine and compare the distribution of Porphyromonas gingivalis fimA genotypes in type 2 diabetes mellitus (T2DM) patients affected by periodontitis, using non-diabetic subjects with and without periodontitis as control groups. MATERIAL AND METHODS: This study involved 75 subjects divided into three groups of 25 subjects each: Group 1 (non-T2DM without periodontitis), Group 2 (non-T2DM with periodontitis) and Group 3 (T2DM with periodontitis). The outcome variable was periodontitis, and explanatory variables were age, sex, T2DM and specific P. gingivalis fimA genotypes. RESULTS: In non-T2DM subjects with healthy periodontal tissues, type I fimA was the most frequently detected individually (40%) or in combinations (40%). In non-T2DM subjects with periodontitis, the most frequently detected type was Ib individually (20%) or in combinations (36%). In T2DM patients with periodontitis, the most frequently detected types were types I (20%) and III (20%), but there was no statistical difference (p>0.05) with non-T2DM periodontitis subjects. CONCLUSIONS: Type I genotype was more frequently detected in periodontally healthy sites from non-T2DM subjects than in periodontitis sites from either subjects with or without T2DM. However, in sites affected by periodontitis from T2DM subjects the predominating types were I and III, which are less virulent strains of P. gingivalis.     

老年人牙周炎牙龈组织内抗原提呈细胞的免疫组织化学研究

利用抗T6及HLA-DR二种单克隆抗体对12例老年9例成人牙周炎患者牙龈组织内Langerhan's细胞及巨噬细胞进行免疫组化染色观察。发现Langerhan's细胞位于上皮棘细胞及基底胞层,而巨噬细胞位于结缔组织靠近上皮处。老年人与成人牙周炎之间的Langerhan's细胞和巨噬细胞数差异显著。作者认为:巨噬细胞在老年人牙周炎免疫调节中起重要作用。     

趋化因子受体CXCR7在牙周炎中的表达及其作用机制

目的:探讨CXCR7在牙周炎中的表达、分布及SDF-1/CXCR7生物学轴在牙周炎中的作用。方法:运用免疫组化的方法检测SDF-1、CXCR4、CXCR7在15例正常的牙龈组织和15例牙周炎组织中的表达,同时运用PCR方法检测15例正常的牙龈组织和15例牙周炎组织中的表达情况。结果:免疫组化和PCR的结果均显示SDF-1、CXCR4、CXCR7在牙周炎组织中表达增高,高于正常牙龈组织(P<0.05)。SDF-1与CXCR7呈正相关关系(γ=0.533,P=0.041)。CXCR4和CXCR7的表达呈正相关关系(γ=0.533,P=0.041)。结论:CXCR7在牙周炎微环境中的不同细胞群过表达,在牙周炎的病理过程中发挥作用,可能是治疗牙周炎的一个新的作用靶点。     

No alteration in bone mineral density in patients with periodontitis

Alveolar bone destruction can be magnified in the presence of generalized skeletal disorders. We questioned whether severe generalized periodontitis patients display signs of bone metabolism disturbances. Our objective was to assess skeletal bone mineral density (BMD) and biochemical bone parameters in premenopausal women with periodontitis. Forty-five patients and 40 control individuals were included in the study. We measured BMD by dual-energy x-ray absorptiometry. The results showed no difference in BMD values between the periodontitis and control groups (p > 0.05). A positive relationship between the clinical attachment level and Body Mass Index (BMI) scores was observed (p = 0.03). Increased serum creatinine levels were noted in the periodontitis group (p = 0.04). Analysis of the data suggests that there is no evidence for an association between skeletal BMD and severe periodontitis in premenopausal women. There may be a link between elevated creatinine levels and periodontitis. The persons with high BMI scores seemed to be at risk for periodontitis.     

sclerostin在2型糖尿病伴牙周炎大鼠牙槽骨骨重建过程中的表达及意义

目的： 观察2型糖尿病（T2DM）伴牙周炎大鼠牙槽骨骨重建过程中骨硬化蛋白（sclerostin）的表达。方法： 将54只SD大鼠随机分为健康组、牙周炎组、T2DM伴牙周炎组,每组各18只。牙周炎组建立牙周炎大鼠模型,T2DM伴牙周炎组先建立T2DM模型,再建立牙周炎模型。腹腔注射STZ后1、5、10 d,检测糖代谢指标。结扎后8周,检测牙周指标。建模成功后1、3、6个月,免疫组织化学染色检测牙槽骨组织中sclerostin的表达。采用SPSS 21.0软件包对数据进行统计学分析。结果： 与未建模大鼠相比,T2DM建模大鼠腹腔注射STZ后1、5、10 d空腹血糖（FBG）,腹腔注射STZ后10 d空腹胰岛素（FINS）及胰岛素抵抗指数（HOMA-IR）均显著升高（P<0.05）。与未建模大鼠相比,牙周炎建模大鼠牙龈出血指数（SBI）、菌斑指数（PLI）、探针深度（PD）均显著增加（P<0.05）。与健康组相比,牙周炎组、T2DM伴牙周炎组建模成功后1、3、6个月牙槽骨组织中sclerostin表达显著增加（P<0.05）,且T2DM伴牙周炎组显著高于牙周炎组（P<0.05）。与建模成功后1个月相比,牙周炎组、T2DM伴牙周炎组建模成功后3、6个月牙槽骨组织中sclerostin表达显著增加（P<0.05）。与建模成功后3个月相比,牙周炎组、T2DM伴牙周炎组建模成功后6个月牙槽骨组织中sclerostin表达显著减少（P<0.05）。结论： sclerostin在牙周炎中表达增加,且合并T2DM进一步上调sclerostin的表达,但在骨重建过程中逐渐下调。     

Trauma and progression of marginal periodontitis in squirrel monkeys

This investigation was designed to test the co-destructive factor hypothesis that a traumatic lesion subjacent to marginal periodontitis alters the progression of the periodontitis and produces angular bony defects. Marginal periodontitis was produced around 28 mandibular teeth in 7 squirrel monkeys by tying a silk ligature at the gingival margin to facilitate plaque accumulation. Six months after inducing periodontitis a severe traumatic lesion was produced subjacent to the marginal periodontitis in 15 of these teeth by thermal injury via the root canal. These specimens (Group I) were analyzed from 3 days to 6 months after injury subjacent to the periodontitis. The duration of periodontitis in the remaining 13 teeth (Group II) was the same as Group I allowing a comparison between the groups. It was concluded that the presence of a severe traumatic lesion and its sequelae subjacent to a marginal periodontitis did affect the progression of the periodontitis when evaluated by apical migration of the junctional epithelium and loss of alveolar bone. Angular bony defects occurred only when periodontitis was induced around isolated tooth surfaces and were related to the presence or absence of the traumatic lesion. Angular defects may be related more to location of etiologic agent than a combination of co-destructive factors.     

牙周炎患者血清超敏C反应蛋白的相关性研究

目的检测伴心血管因素的牙周炎患者及单纯牙周炎患者的血清超敏C反应蛋白,研究分析牙周炎与心血管疾病的相关关系。方法将92例牙周炎患者分为1组：51例伴心血管因素牙周炎组,2组：41例单纯牙周炎组。对照组：51例牙龈炎组。利用BNProspec特种蛋白免疫分析仪进行血清超敏C反应蛋白水平测定。结果两组牙周炎患者血清hs CRP水平明显高于牙龈炎对照组,差异有统计学意义（P〈0.05）。1组的血清hs CRP水平明显高于2组,差异有统计学意义（P〈0.05）。2组中、重度牙周炎患者的血清hs CRP水平明显高于轻度牙周炎患者,与附着丧失呈正相关关系,差异有统计学意义（P〈0.05）。1组轻、中、重度牙周炎患者血清hs CRP水平的差异无统计学意义（P〉0.05）,但中、重度牙周炎患者较轻度牙周炎患者多。1组的中、高度心血管疾病风险人数较2组的中、高度心血管疾病风险人数多,差异有统计学意义（P〈0.05）。结论伴心血管因素患者的牙周炎症程度较单纯牙周炎患者的重,血清hs CRP水平也较高。心血管疾病受牙周炎的影响,可使血清CRP进一步升高,并有可能加重牙周炎。两者之间可能相互影响。     

Plasma antibody levels in periodontitis patients and controls

BACKGROUND: A major aspect of the adaptive host response in periodontitis is the production of antibodies. Several risk and susceptibility factors for periodontitis, including smoking, age and composition of the subgingival microflora, have also been suggested to influence antibody production. AIM: The present study was conducted to investigate plasma levels of immunoglobulin (Ig) G, A and M antibodies in periodontitis patients of Caucasian European heritage in relation to disease severity, smoking, diagnosis and prevalence of periodontopathogens. METHODS: In this study, 29 patients with severe periodontitis, 51 with moderate periodontitis and 55 controls without periodontal destruction were enrolled. From the total of 80 patients, 18 were diagnosed with aggressive periodontitis and 62 with chronic periodontitis. Total IgG, IgA and IgM as well as IgG isotypes were analyzed in plasma samples. RESULTS: Levels of total IgG, IgA and IgM were not different between patients and controls; however, in periodontitis, higher levels of IgG1 and IgG2 were observed. Smoking appeared to be significantly and inversely related to antibody levels in periodontitis, in particular for total IgG and IgG2. The absence of an elevated total IgG and IgG2 in smoking patients was irrespective of severity, prevalence of periodontal pathogens and diagnosis. The elevation of total IgG and IgG1 and IgG2 in non-smoker periodontitis patients was observed in patients with moderate periodontitis and even greater in patients with severe periodontitis, but was independent whether patients were infected with Actinobacillus actinomycetemcomitans or Porphyromonas gingivalis and independent of diagnosis. Clinically, it was observed that patients who smoked had more periodontal bone loss; the current findings on antibody levels may be one of several mechanisms related to more extensive periodontal breakdown in smoker patients. CONCLUSION: The current study shows that non-smoker periodontitis patients have higher levels of total IgG and IgG2 than smoker periodontitis patients.     

实验性糖尿病牙周炎诱导成骨细胞凋亡的研究

目的观察糖尿病牙周炎条件下成骨细胞的凋亡情况。方法选用SD大鼠62只,随机分为糖尿病牙周炎组（DP）、单纯牙周炎组（P）以及空白对照组（N）。采用一次性腹腔注射链脲佐菌素（STZ）的方法诱导大鼠糖尿病模型,采用丝线结扎联合口内接种细菌的方法建立牙周炎模型。各组动物分别于DP组、P组丝线结扎后第3、6周时分批处死,取标本进行组织学检测,并计算各组成骨细胞凋亡百分率。结果丝线结扎后3、6周时,成骨细胞凋亡百分率由高至低依次为DP组、P组、N组,组间两两比较均有统计学意义（P＜0.05）。在丝线结扎后3周和6周时,DP组成骨细胞凋亡百分率均达到P组的2倍。结论糖尿病可促进牙周炎条件下牙周组织中成骨细胞的凋亡。     

Periodontitis prevalence and severity in Indonesians with type 2 diabetes

Background: The prevalence of diabetes mellitus type 2 (DM2) in Indonesia is high and still rising. Periodontitis is associated with DM2. No study has investigated this association in Indonesia, nor has any study investigated this association using a variety of methods to operationalize periodontitis. The present study compares prevalence and severity of periodontitis in patients with DM2 to healthy controls, using different methods to operationalize periodontitis. Methods: A total of 78 subjects with DM2 and 65 healthy control subjects underwent a full‐mouth periodontal screening assessing probing depth, gingival recession, plaque index, and bleeding on probing. Using these measurements, the prevalence and severity of periodontitis was operationalized in various ways. Differences in the prevalence and severity of periodontitis between subjects with DM2 and healthy subjects were analyzed using univariate analyses. In regression analyses, the prevalence and severity of periodontitis were predicted on the basis of DM2 presence, controlling for confounders and effect modification. Results: Prevalence of periodontitis was significantly higher in subjects with DM2 compared to healthy subjects, showing odds ratios of 5.0 and 6.1. Likewise, periodontitis severity was significantly higher in subjects with DM2. Conclusion: Indonesian subjects with DM2 had more prevalent and more severe periodontitis than healthy Indonesian subjects, independent of confounding factors or the methods used to operationalize periodontitis.     

Calcitonin gene-related peptide in gingival crevicular fluid in periodontal health and disease

The aims of the present study were to investigate whether calcitonin gene-related peptide (CGRP) was present in gingival crevicular fluid in both periodontal health and disease and to study the relationship with periodontal inflammation. Gingival crevicular fluid (GCF) was collected from a healthy, a gingivitis and a periodontitis site in 18 subjects with periodontitis and from a healthy site in 19 subjects without periodontitis. The volume of GCF was measured and each sample subsequently analysed for CGRP by radioimmunoassay. In subjects with periodontitis, CGRP immunoreactivity (CGRP-IR) was not detected in any periodontitis sites, nor in 67% of gingivitis and 28% of periodontally-healthy sites. The total amount of CGRP-IR was significantly elevated in periodontally healthy (p=0.0015) and gingivitis (p=0.027) compared with periodontitis sites. CGRP-IR was present in 89% of the healthy sites sampled in control subjects at comparable levels to those in healthy sites in periodontitis subjects. It is concluded that in periodontal inflammation, particularly in deep pockets, constituents of GCF process and degrade CGRP.     

Increased interleukin-18 in gingival crevicular fluid from periodontitis patients

INTRODUCTION: This study aimed to measure the levels of interleukin-18 (IL-18) in inflamed shallow sites and inflamed deep sites in patients with periodontitis and to compare the data with results from inflamed shallow sites in patients with gingivitis. A secondary aim was to examine the composition of the subgingival microbiota in the sampled sites. METHODS: Gingival crevicular fluid was collected from five gingivitis sites and five periodontitis sites from 18 patients with chronic periodontitis, and from five gingivitis sites from 15 patients with gingivitis. Samples from each site category were pooled and IL-18 levels were measured using an enzyme-linked immunosorbent assay. The subgingival microbiota was analyzed by checkerboard DNA-DNA hybridization. RESULTS: All clinical parameters and gingival crevicular fluid volumes were higher in periodontitis sites compared with gingivitis sites from patients with periodontitis and gingivitis. The total amount of IL-18 was higher in periodontitis sites than gingivitis sites in both periodontitis (P = 0.018) and gingivitis (P = 0.002) patients and was higher in gingivitis sites from periodontitis patients than in those from gingivitis patients (P = 0.015). There were higher levels of Tannerella forsythia, Porphyromonas gingivalis, and Treponema denticola (red complex species) in periodontitis sites compared with gingivitis sites in both the periodontitis and gingivitis patients (P < 0.001). CONCLUSION: Levels of IL-18 were higher in patients with chronic periodontitis compared with patients with gingivitis, even at sites with similar pocket depths. The presence of similar levels of red complex species in gingivitis sites from periodontitis patients and from gingivitis patients suggested that the higher levels of IL-18 were not associated with a different microbial challenge.     

Periodontal diseases in the child and adolescent

BACKGROUND: Periodontal diseases are among the most frequent diseases affecting children and adolescents. These include gingivitis, localized or generalized aggressive periodontitis (a.k.a., early onset periodontitis which includes generalized or localized prepubertal periodontitis and juvenile periodontitis) and periodontal diseases associated with systemic disorders. The best approach to managing periodontal diseases is prevention, followed by early detection and treatment. METHODS: This paper reviews the current literature concerning the most common periodontal diseases affecting children: chronic gingivitis (or dental plaque-induced gingival diseases) and early onset periodontitis (or aggressive periodontitis), including prepubertal and juvenile periodontitis. In addition, systemic diseases that affect the periodontium and oral lesions commonly found in young children are addressed. The prevalence, diagnostic characteristics, microbiology, host-related factors, and therapeutic management of each of these disease entities are thoroughly discussed.     

Microbiological study of localized juvenile periodontitis in Panama

The occurrence of subgingival Actinobacillus actinomycetemcomitans and Capnocytophaga in 12 localized juvenile periodontitis and 10 gingivitis patients from Panama was determined using selective culture techniques. A actinomycetemcomitans was present in all localized juvenile periodontitis lesions studied and was, on average, recovered in hundred-fold-higher numbers from localized juvenile periodontitis lesions than from gingivitis lesions. Capnocytophaga was only recovered in approximately threefold-higher numbers from localized juvenile periodontitis than from gingivitis. The study confirms and extends previous data indicating a close relationship between A actinomycetemcomitans and localized juvenile periodontitis. It is proposed that identification of A actinomycetemcomitans may be a valuable adjunct in the diagnosis of localized juvenile periodontitis.     

不同牙周状态正畸力诱导IL-23在牙周组织表达的实验研究

目的 研究不同牙周状态正畸力作用下IL-23在牙周组织的表达变化,为牙周病正畸治疗提供参考.方法 建立大鼠牙周炎静止期、牙周炎活动期模型,以50克力移动牙周正常组、牙周炎静止期组、牙周炎活动期组的上颌磨牙.分别于牙齿移动的第3和7天处死大鼠.采用免疫组化和实时荧光定量PCR定性定量分析各组IL-23在牙周组织的表达.结果 正常牙周移动组IL-23mRNA的表达较正常对照组差异无显著性（P＞0.05）.静止期牙齿移动组IL-23mRNA在牙周组织的表达较正常牙周移动组增高,差异有显著性（P＜0.05）;较活动期移动组显著减小（P＜0.01）.牙周炎活动期牙齿移动组IL-23mRNA的表达较其他各组均高,且差异有高度显著性（P＜0.01）.结论 IL-23参与调节牙周炎正畸牙齿移动.牙周炎静止期正畸治疗不会导致IL-23的过度高表达,但要密切控制牙周易感因素.     

牙周炎患者龈沟液中P物质和降钙素基因相关肽的变化

目的：测定正常人和重度牙周炎患者龈沟液中神经肽P物质和降钙素基因相关肽，以了解两种神经肽与牙周炎的关系。方法：应用放射免疫技术测定正常对照组、广泛型重度牙周炎、局限型重度牙周炎患者正常部位、牙周炎部位龈沟液中神经肽P物质和降钙素基因相关肽的含量，并计算出其浓度。结果：龈沟液中P物质的含量和浓度在四组间均有显著差异，而牙周炎部位的降钙素基因相关肽与牙周健康部位相比，检出率明显下降，有统计学意义。结论：神经肽如P物质、降钙素基因相关肽与牙周炎的发生及发展可能有一定的关系。     

Aberrant neutrophil reactions in periodontitis

BACKGROUND: The aim of this study was to compare the activity of neutrophilic granulocytes in patients with severe periodontitis and patients with gingivitis alone. METHODS: The study population comprised 22 patients with gingivitis and 44 with periodontitis. Samples of gingival crevicular fluid (GCF) were collected from untreated patients with gingivitis and from shallow and deep pockets in untreated patients with periodontitis. GCF samples were analyzed for lactoferrin, elastase, matrix metalloproteinase-8 and -9, and collagenolytic activity. RESULTS: The free elastase activity and the neutrophil activity, estimated as the ratio between elastase and lactoferrin, were significantly higher in the samples from the periodontitis patients. These differences were also observed in shallow pockets in periodontitis patients compared to similar pockets in patients with gingivitis. CONCLUSION: This study shows higher levels of free elastase in untreated patients with periodontitis, relative to inflammation-matched controls, which may explain the tissue destruction seen in periodontitis.