Association between oral malodour and periodontal disease-related parameters in the general population

Abstract

Aim. To determine the association between halitosis detection and periodontal status in systemically healthy non-smokers and to assess whether halitosis was related to quantities of Fusobacterium nucleatum and Porphyromonas gingivalis on the tongue dorsum. Methods. Periodontal examinations, tongue coating determination, Halimeter® readings and organoleptic assessments of mouth odour were performed in 28 chronic periodontitis patients, 23 chronic gingivitis patients and 27 healthy individuals. The quantities of P. gingivalis and F. nucleatum were determined in tongue specimens by real-time PCR. Results. Halitosis was more likely to be detected in patients with periodontitis (OR = 9.2) and gingivitis (OR = 4.6) than in healthy subjects. The posterior tongue odour was similar for all groups; had the highest score of all organoleptic assessments and was significantly correlated with Halimeter® scores and the odour of the whole mouth air. Periodontitis patients harboured significantly greater amounts of P. gingivalis on their tongue, yet similar quantities of F. nucleatum compared to gingivitis patients and healthy subjects. The amount of P. gingivalis residing on the tongue dorsum of periodontitis patients was significantly associated with halitosis recordings, while the amount of F. nucleatum was related to tongue coating in healthy controls, which corroborates its role in biofilm formation. Conclusions. Patients with periodontal disease were at higher risk for halitosis detection than healthy individuals. The posterior portion of the tongue dorsum seems to be an important source of odourous compounds, regardless of periodontal condition. P. gingivalis residing on the tongue of periodontitis patients may play a key role in oral malodour production.     

Cellular death but not genetic damage in oral mucosa cells after exposure to digital lateral radiography

The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis, and karyorrhexis) in exfoliated buccal mucosa cells from individuals following digital lateral radiography. A total of 30 healthy patients (15 men and 15 women) indicated to the orthodontic therapy were submitted to digital lateral X-ray. Exfoliated oral mucosa cells were collected immediately before the X-ray exposure and after 10 days. The results pointed out no significant statistically differences (p > 0.05) of micronucleated oral mucosa cells. On the other hand, X-ray was able to increase other nuclear alterations closely related to cytotoxicity such as karyorrhexis, pyknosis, and karyolysis. In summary, these data indicate that exposure to digital lateral radiography may not be a factor that induced chromosomal damage, but it is able to promote cytotoxicity.     

Raised chondroitin sulphate WF6 epitope levels in gingival crevicular fluid in chronic periodontitis

Aim: To determine the levels of chondroitin sulphate (CS) WF6 epitope, recognized by WF6 monoclonal antibody, in gingival crevicular fluid (GCF) from different stages of periodontal disease and healthy periodontium, and to correlate those levels with clinical parameters. Material and Methods: GCF samples, collected from 389 sites, were analysed for the WF6 epitope levels by the competitive enzyme‐linked immunosorbent assay. Results: The median WF6 epitope level was significantly higher in chronic periodontitis sites (n=185) than in healthy and gingivitis sites (n=204) (p<0.001), whereas the median levels did not significantly differ between healthy (n=65) and gingivitis sites (n=139). The median level in severe periodontitis sites (n=60) was significantly higher than that in moderate periodontitis sites (n=63) (p=0.019). Similarly, the median level in moderate periodontitis sites was significantly higher than that in slight periodontitis sites (n=62) (p=0.001). The WF6 epitope levels significantly correlated with probing depth (r=0.777, p=0.001) and loss of clinical attachment level (r=0.814, p=0.001). Conclusion: Elevated CS WF6 epitope levels in GCF are associated with severity of periodontitis. The WF6 antibody may therefore be clinically applied to monitor disease severity and progression.     

Monocytic TNFα secretion patterns in IDDM patients with periodontal diseases*

Abstract The aim of the present study was to identify whether monocytic TNFα secretion patterns could serve as a potential phenotypic discriminator for periodontal disease susceptibility within insulin-dependent diabetes mellitus (IDDM) patients. In 32 IDDM individuals the lipopolysaccharide (LPS) stimulated monocytic TNFα secretion dose-response characteristics were analyzed and related to two different periodontal status categories. Diabetics were divided into group A (gingivitis or mild periodontal disease) and group B (moderate to severe periodontal disease). In addition, 17 non-diabetic individuals with various degrees of periodontal disease served as control patients. Diabetics as a group had a significantly higher monocytic TNFα production in response to increasing Porphyromonas gingivalis A 7436 lipopolysaccharide concentrations (0, 0.003, 0.03, 0.3 and 3.0 μg/ml) as compared to non-diabetic patients with gingivitis or adult periodontitis (p <0.05). A significant difference in the dose response was also noted in the level of TNFα secreted as a function of P. gingivalis LPS concentrations between group A and B diabetics, as determined by two-way repeated measurements ANOVA (p <0.05). Furthermore, there was no significant difference in the mean HbA_1C between the two diabetic groups, and the TNFα level was not significantly associated with the HbA_1C level within diabetic patients. These data suggest that the diabetic state results in an upregulated monocytic TNFα secretion phenotype (4.6-fold increase) which, in the presence of Gram-negative bacterial challenge, is associated with a more severe periodontal disease expression. In addition, approximately 40% (10 of 24) IDDM periodontitis patients in group B demonstrated a 62-fold elevation in TNFα secretion relative to non-diabetic gingivitis or periodontitis patients and a 13.5-fold increase relative to IDDM group A (gingivitis or mild periodontitis) patients.     

A novel application of the buccal micronucleus cytome assay in oral lichen planus: a pilot study

Background

The most important complication of oral lichen planus is malignancy transformation.

Objective

The aim of this study was to assess cellular and nuclear morphology in a group of patients with oral lichen planus measured by means of buccal micronucleus cytome assay.

Study design

This study included thirty patients with a clinicopathological diagnosis of oral lichen planus (all with atrophic–erosive clinical forms of OLP) and thirty healthy control subjects. Both samples were similar in age and gender. The buccal micronucleus cytome assay protocol consisted of: cell collection from both cheeks with a cytobrush; cell centrifuge; slide preparation, fixation and staining followed by fluorescent microscope analysis. 2 × 10⁶ exfoliated cells were screened for nuclear abnormalities: micronuclei, nuclear buds, binucleation, basal and differentiated cells, condensed chromatin, karyorrhectic cells, pyknosis and karyolytic cells.

Results

Patients with oral lichen planus showed significantly higher frequencies of micronuclei (p < 0.001), nuclear buds (p < 0.001), binucleated cells (p < 0.021) than the control group.

Conclusions

This method is an easy way for clinicians to assess DNA damage, proliferative potential of basal cells and cell death in buccal cells in cases of oral lichen planus.     

Apoptosis of periodontium cells in streptozototocin- and ligature-induced experimental diabetic periodontitis in rats

Abstract

Objective. The aim of this study was to investigate the presence of apoptosis of periodontium cells in streptozototocin- and ligature-induced experimental diabetic periodontitis in rats. Materials and methods. Sixty-two 6-week-old male Sprague-Dawley (SD) rats were randomly divided into three groups: the diabetic periodontitis group (group DP; n = 22), periodontitis group (group P; n = 20) and normal control group (group N; n = 20). Diabetes was induced by intraperitoneal injection of streptozototocin (STZ). Periodontitis was initiated by ligating floss around maxillary second molars. The animals were sacrificed at 3 and 6 weeks after ligature placement in the P and DP groups. Maxillary dentoalveolar segments were isolated and were prepared for morphometric analysis of alveolar bone loss (ABL) and for histological analysis. Results. ABL was significantly increased in group DP compared with group P (p < 0.05). The number of PDL fibroblasts, osteoblasts and osteocytes in group DP was decreased compared with group P (p < 0.05). Inter-group analysis revealed higher osteoclast numbers in the inflammatory area of group DP and group P when compared with group N (p < 0.05). Also, compared with group P, group DP had more higher osteoclast numbers (p < 0.05). Periodontitis and diabetic periodontitis also increased apoptosis of fibroblasts, osteoblasts and osteocytes. The percentage of these apoptotic cells was ～ 2-fold higher in group DP vs group P. Conclusions. The results of these studies suggest that diabetes may have a negative effect on the periodontium by increasing the formation of osteoclasts and enhancing apoptosis of fibroblasts, osteoblasts and osteocytes in the periodontal tissue.     

Root caries and risk profiles using the Cariogram in different periodontal disease severity groups

Abstract

Objectives. To study root caries and risk profiles using the Cariogram in relation to periodontal disease severity and to analyse indicators associated with high caries risk. Material and methods. A cross-sectional examination was carried out on 112 patients with periodontal disease from two government clinics in Saudi Arabia. The investigation comprised a questionnaire, bitewing radiographs, measurement of salivary secretion rate, buffering capacity and cariogenic microorganisms, and registration of periodontal status, plaque amount and coronal and root caries/fillings (DFT and RDFT). The data were then entered into the Cariogram pedagogic model to illustrate the caries risk profiles. Results. Patients were grouped according to periodontal disease severity into one of three groups: (1) gingivitis (n = 44); (2) mild-to-moderate periodontitis (n = 33); and (3) severe periodontitis (n = 35). The prevalence of RDFT in the total sample was 17%. There were no statistically significant differences between the three groups in number of root lesions or mean ‘Actual Chance to Avoid New Cavities’ (Chance-AC) according to the Cariogram. Of the total sample, 22% displayed high caries risk (Chance-AC ≤40%). The most significant risk indicators in high caries risk patients were infrequent use of fluoride and unfavourable salivary and microbial parameters. Conclusions. Root surface lesions and high caries risk were present in about one-fifth of the patients referred for periodontal treatment. A combination of risk indicators rather than a single one contributed to the increased risk. Caries and risk profiles were not significantly correlated with periodontal disease severity.     

Frequency of periodontal pathogens in equivalent peri-implant and periodontal clinical statuses

ObjectivesThis study tested the hypotheses that there is: (1) higher bacterial frequency in peri-implantitis/periodontitis, followed by mucositis/gingivitis and peri-implant/periodontal health; (2) similar bacterial frequency between comparable peri-implant and periodontal clinical statuses.Design of studyThe presence of Porphyromonas gingivalis, Tannerella forsythia, Campylobacter rectus, Prevotella intermedia, Treponema denticola and Aggregatibacter actinomycetemcomitans was evaluated in peri-implant (n = 53) and periodontal (n = 53) health; mucositis (n = 50), gingivitis (n = 50), peri-implantitis (n = 50) and periodontitis (n = 50).ResultsThe pattern of peri-implant bacterial frequency was not as expected (peri-implantitis > mucositis > health). Except for P. intermedia (p > 0.05), bacterial frequency was higher in peri-implantitis than health (p < 0.05). The frequency of P.gingivalis and red complex species were higher in peri-implantitis than mucositis (p < 0.05). In periodontal samples, T. forsythia and T. denticola showed the expected pattern of frequency (periodontitis > gingivitis > health). The frequencies of C. rectus and T. forsythia were higher in healthy teeth/gingivitis than healthy implants/mucositis, respectively (p < 0.05). The frequency of P. gingivalis and A. actinomycetemcomitans were similar between periodontitis and peri-implantitis (p > 0.05) while all other species occurrences were higher in periodontitis than peri-implantitis (p < 0.05).ConclusionsBacterial frequency increased from peri-implant/periodontal health to peri-implantitis/periodontitis but not from mucositis/gingivitis to peri-implantitis/periodontitis. There was a trend towards higher bacterial frequency in teeth than implants.     

Ex vivo studies of polymorphonuclear neutrophils from patients with early-onset forms of periodontitis (I).

Abstract The polymorphonuclear neutrophil (PMN) appears lo be an important cell in the protection of the host from pathogenic periodontal microorganisms and, despite some reports to the contrary, it is generally assumed that early-onset forms of periodontal disease including both juvenile and rapidly progressing periodontitis are associated with a defect in PMN chemotactic behaviour. The purpose of the present study was to examine the peripheral PMN chemotactic behaviour, using the under agarose method, in 4 groups, namely healthy periodontium group (n= 7), gingivitis group (n= 8), early-onset periodontitis group (n= 17) and adult periodontitis group (n= 8). PMN from early-onset periodontitis patients showed normal random and chemotactic locomotory behaviour when compared with those of PMN from subjects of the other groups. No statistically significant difference could be found among the 4 studied groups, with regard to spontaneous and oriented migration.     

Immunohistochemical analysis of the gingiva with periodontitis of type I plasminogen deficiency compared to gingiva with gingivitis and periodontitis and healthy gingiva

ObjectiveType I plasminogen deficiency (Plgdef) is an uncommon chronic inflammation of mucous membranes. Gingival enlargements usually proceed with progressive periodontal destruction and tooth-loss. Plasmin(ogen)-independent enzymatic mechanisms for fibrin clearance have already been discussed in the literature.Our primary objective was to verify, immunohistochemically, the occurrence of different enzymatic factors involved in tissue breakdown of inflamed compared to healthy gingiva.Secondly, we tried to find out, if these patients have a similar microbiological profile to the patients with known gingivitis and periodontitis.Materials and methodsImmunohistochemical analysis of enzymes elastase, plasminogen (plg), cathepsin G, matrix-metalloproteinase (MMP)-3 and MMP-7 and of glycoprotein fibrinogen were performed with gingival tissues from 3 healthy controls, 8 patients with Plgdef and 3 patients with gingivitis and periodontitis. Furthermore, plaque from 5 patients with plasminogen deficiency were also obtained to determine the microbiological profile.ResultsSignificantly high numbers of elastase positive leukocytes were detected in all samples. Staining for MMP-3 and MMP-7 was seen in samples with gingivitis and periodontitis with a stronger staining in samples with periodontitis by Plgdef. Fibrinogen was detectable in all samples. Staining for plg was stronger in samples with periodontitis than in other samples. Staining for cathepsin G was weak in gingivitis and periodontitis. Subgingival microbial flora showed elevated colony forming units of Prevotella intermedia/nigrescens, Fusobacterium spp., Eikenella corrodens, Porphyromonas gingivalis and viridans streptococci.ConclusionStrong staining of elastase, MMP-3 and MMP-7 and weak staining of plg in Plgdef samples supports the plasmin(ogen) – independent fibrin clearance. Similar subgingival microbiological flora was observed in periodontitis with Plgdef as in other periodontal diseases. Further investigations should determine the exact pathomechanism and focus on effective treatment methods of this entity.     

Macrophage activating factor: A potential biomarker of periodontal health status

ObjectiveIn periodontitis, activated macrophages not only initiate immune responses to periodontal-pathogen infections, but also damage the periodontal tissues by releasing a series of inflammatory cytokines. Macrophage-activating factor (MAF) and macrophage-chemotactic factor (MCF) are two important mediators involved in macrophage accumulation, activation and function. This study analyzed the levels of salivary MAF and MCF in healthy individuals and those with different periodontal diseases, and assessed the usefulness of salivary MAF and MCF as diagnostic biomarkers in periodontal tissue health status.DesignNinety-five saliva specimens were collected from healthy individuals (n = 19), and patients with gingivitis (n = 19), mild periodontitis (n = 17), moderate periodontitis (n = 20), and severe periodontitis (n = 20). Pocket probing depth (PPD) and alveolar bone loss (ABL) were recorded via periodontal probing and dental radiography, respectively. Salivary MAF and MCF concentrations were assayed using enzyme-linked immunosorbent assays.ResultsMAF level tended to increase in saliva as periodontal diseases progressed (healthy periodontium < gingivitis < mild periodontitis < moderate periodontitis < severe periodontitis). The concentration of salivary MAF in periodontitis correlated positively with ABL (r = 0.758) and PPD (r = 0.779). In contrast, salivary MCF levels increased significantly only in periodontitis.ConclusionsSalivary MAF levels correlate positively with tissue destruction in periodontal diseases. It is a potential valuable biomarker that could be used to assess periodontal health status.     

In vivo determination of multiple indices of periodontal inflammation by optical spectroscopy

Background and Objective: Visible, near‐infrared (optical) spectroscopy can be used to measure regional tissue hemodynamics and edema and therefore may represent an ideal tool with which to study periodontal inflammation in a noninvasive manner. The study objective was to evaluate the ability of optical spectroscopy to determine simultaneously multiple inflammatory indices (tissue oxygenation, total tissue hemoglobin, deoxyhemoglobin, oxygenated hemoglobin and tissue edema) in periodontal tissues in vivo. Material and Methods: Spectra were obtained, processed and evaluated from healthy, gingivitis and periodontitis sites (n = 133) using a portable optical, near‐infrared spectrometer. A modified Beer–Lambert unmixing model that incorporates a nonparametric scattering loss function was used to determine the relative contribution of each inflammatory component to the overall spectrum. Results: Optical spectroscopy was harnessed to generate complex inflammatory profiles of periodontal tissues. Tissue oxygenation at periodontitis sites was significantly decreased (p < 0.05) compared to sites with gingivitis and healthy controls. This was largely the result of an increase in deoxyhemoglobin in the periodontitis sites compared with healthy (p < 0.01) and gingivitis (p = 0.05) sites. Tissue water content per se showed no significant difference between the sites, but a water index associated with tissue electrolyte levels and temperature differed significantly between periodontitis sites and both healthy and gingivitis sites (p < 0.03). Conclusion: This study established that optical spectroscopy can simultaneously determine multiple inflammatory indices directly in the periodontal tissues in vivo. Visible, near‐infrared spectroscopy has the potential to be developed into a simple, reagent‐free, user‐friendly, chairside, site‐specific, diagnostic and prognostic test for periodontitis.     

Deep sequencing salivary proteins for periodontitis using proteomics

Objectives

Saliva is a bodily fluid transuded from gingival crevice fluid and blood and contains many proteins. Proteins in saliva have been studied as markers for periodontal diseases. Mass spectrometric analysis is applied to investigate biomarker proteins that are related to periodontitis.

Material and methods

Saliva samples were collected from 207 participants including 36 pairs matched for age, sex, and smoking who joined Yangpyeong health cohort. Periodontitis was defined by 2005 5th European guideline. Shotgun proteomics was applied to detect proteins from saliva samples. Principal component analysis and Ingenuity Pathway Analysis for canonical pathway and protein pathway were applied. Protein-protein interaction was also applied. Enzyme-linked immunosorbent assay (ELISA) was used to verify the candidate protein markers among another matched participants (n = 80).

Results

Shotgun proteomics indicated that salivary S100A8 and S100A9 were candidate biomarkers for periodontitis. ELISA confirmed that both salivary S100A8 and S100A9 were higher in those with periodontitis compared to those without periodontitis (paired-t test, p < 0.05).

Conclusion

Our proteomics data showed that S100A8 and S100A9 in saliva could be candidate biomarkers for periodontitis. The rapid-test-kit using salivary S100A8 and S100A9 will be a practical tool for reducing the risk of periodontitis and promotion of periodontal health.

Clinical relevance

A rapid-test-kit using salivary biomarkers, S100A8 and S100A9, could be utilized by clinicians and individuals for screening periodontitis, which might reduce the morbidity of periodontitis and promote periodontal health.

     

Antibody responses of Porphyromonas gingivalis infected gingivitis and periodontitis subjects

Porphyrornonas gingivalis demonstrates a strong association with adult periodontitis although some individuals with the infection do not experience attachment loss. Therefore differences in the immune response to this organism may be of importance to the outcome of the disease. OBJECTIVE: The aim of this study was to determine whether P. gingivalis positive subjects with and without periodontal breakdown, reacted differently to P. gingivolis antigens as assessed by the pattern of serum antibody reactivity. MATERIALS AND METHODS: Two highly defined groups Of subjects were chosen for this study. Both demOnstrated p gingivalis in their plaque and both had responded to P. gingivolis as shown by the presence of serum antibodies_* The two groups differed only in their apparent clinical susceptibility to periodontal breakd?wn. Western blots of P. gingivolis membrane antigens were probed with sera from the two groups to determine their reactivity to specific antigens. RESULTS: Analysis Of the immunoblots showed that there were no differences in either the total numbers of bands, Or bands recognized by the majority Of subjects in the gingivitis and adult periodontitis groups. There were however, four bands recognized by the majority of the gingivitis group and not by the majority Of the adult periodontitis group, there being a significant difference (P = 0.03) in the recognition of the 91.4-kDa antigen band_* A further five antigens Of lower molecular weight were seen by the majority of the adult periodontitis group and not by the majority of the gingivitis group. When sera were tested against purified p_*gingivalis Lps, the results indicated that the five antigens seen by the majority Of the adult periodontitis group had molecular weights which were in the range exhibited by the Lps antigens. CONCLUSION: These results suggest that gingivitis and adult periodontitis subjects with P. gingivalis infection, may recognize different P. gingivalis antigens.     

Ex vivo studies of polymorphonuclear neutrophils from patients with early-onset-periodontitis (II). Chemiluminescence response analysis

Abstract Previous studies have indicated that oxygen-free radicals may cause damage to the periodontal tissues. This study compared the luminol-dependant chemiluminescence response (after stimulation with either opsonized zymosan or Phorbol myristate acetate (PMA)) of peripheral blood polymorphonuclear leukocytes (PMN) isolated from human subjects with a healthy periodontium (n=7), gingivitis (n=8), adult periodontitis (n=8), or early-onset periodontitis (n=17). These results were also compared with those obtained in a larger reference group which consists of 50 subjects without infection or inflammation, selected on the basis of laboratory investigations. An enhanced response was defined as being 2 standard deviations above the reference group mean; a reduced response was. defined as being 2 standard deviations below this mean. Although PMN from patients with either gingivitis or periodontitis were often functionally activated (when compared to the PMN from the reference group), no significant differences could be found between the 4 groups, with regard to the chemiluminescence response means obtained in a basal state or after stimulation.     

Evaluation and comparison of serum vitamin D and calcium levels in periodontally healthy,chronic gingivitis and chronic periodontitis in patients with and without diabetes mellitus – a cross-sectional study

Objective: Limited data are available with respect to the relation of vitamin D and calcium with periodontal infections and type-2 diabetes mellitus (T2DM). The aim of this cross-sectional study was to evaluate the levels of vitamin D and calcium in serum of periodontally healthy, chronic gingivitis and chronic periodontitis patients with and without T2DM.

Material and methods: The study evaluated 100 patients equally divided into five groups (Group I to Group V) according to the inclusion criteria. Clinical parameters and serum 25-hydroxyvitamin D level were assessed. Other laboratory investigations comprised of random blood sugar, glycated haemoglobin and serum calcium.

Results: The probing pocket depth and clinical attachment loss were found to be greater in chronic periodontitis and chronic periodontitis with diabetes mellitus, while the vitamin D and calcium levels were found to be least in these groups. When vitamin D and calcium levels were compared between periodontal disease with diabetes to that of non-diabetics, statistically significant difference were found between the two with p-value of .001 indicating decrease in levels of vitamin D and calcium with increase in RBS and HbA1c values.

Conclusion: Vitamin D and calcium levels are inversely correlated with random blood sugar and glycated haemoglobin and also probing pocket depth and clinical attachment loss, thus contributing towards increase in periodontal disease severity.     

Duration of Una Synthesis in the Gingival Epithelial Cells of Marmosets

Abstract

Objective. Gingival inflammation may affect the composition of the dental pellicle and initial acquisition of bacteria, which in turn could affect the healing of the periodontal pocket. The aim of this study was to examine the dental pellicle and early supragingival biofilms in periodontitis patients with an established subgingival infiltrate before and after surgical pocket elimination. Materials and methods. Eleven patients with remaining pockets were selected. Samples were taken before and after surgical pocket elimination and after subsequent experimental gingivitis. Pellicle proteins were analyzed by SDS-PAGE, immunoblotting and image analysis and 4-h supragingival plaque by culturing. Results. The inflammatory status affected to a greater extent the concentration of plasma proteins than salivary proteins in the dental pellicle. The highest plasma protein concentrations were observed at remaining periodontal pockets where also the highest bacterial counts were found. The TVC was reduced on the gingival tooth surfaces (p < 0.05) after pocket elimination and increased slightly during experimental gingivitis. The finding of streptococci was highest on the incisal tooth surfaces and increased after surgery. Gram-negative anaerobes were sparse but seen more often before than after pocket elimination and on gingival than on incisal surfaces. Conclusions. This study suggests that increased amounts of plasma proteins in the pellicle formed in the presence of remaining periodontal pockets may foster the acquisition of bacteria, including proteolytic Gram-negative species. This, in turn, results in an increased de novo plaque formation rate.     

Arginine–Nitric Oxide–Polyamine Metabolism in Periodontal Disease

Background: Arginine is converted to nitric oxide (NO) via NO synthase and to ornithine via arginase. Ornithine decarboxylase (ODC) catalyzes the conversion of ornithine to polyamines. Arginase can inhibit NO production, and NO can inhibit ODC activity as part of an early inflammatory response. This study examines the arginine‐NO‐polyamine pathway alteration in saliva and gingival biopsy samples of patients with gingivitis or periodontitis and healthy controls and evaluates the response to periodontal treatment. Methods: This study includes nine gingivitis patients, 15 chronic periodontitis patients, and 11 healthy age‐matched controls. Periodontal clinical measurements, gingival biopsies, and saliva samples were obtained before treatment (BT) and 1 month after periodontal treatment (AT). Arginase and ODC activities and NO levels were determined spectrophotometrically. Results: The BT salivary and gingival NO levels were found to be highest in the gingivitis group, followed by the healthy and the periodontitis groups, respectively. Salivary NO levels significantly increased in the periodontitis group and decreased in the gingivitis group AT (P <0.05). Gingival NO levels decreased significantly in the periodontitis and the gingivitis groups AT (P <0.05). Arginase levels were detected highest in the gingivitis group and lowest in the periodontitis group, both in saliva and gingiva. Only gingival arginase levels significantly increased AT (P <0.05). ODC activity was highest in saliva, and lowest in the gingiva of the periodontitis patients BT. It was found to be significantly higher in the periodontitis group AT (P <0.05). Conclusions: In this study, regarding arginine‐NO‐polyamine metabolism, gingival tissue seems to be more informative about periodontal pathogenesis than saliva. At early phase of periodontal inflammation, NO arginase and ODC levels were measured as higher than at an established lesion of periodontitis.     

Mutagenicity and cytotoxicity in patients submitted to ionizing radiation: A comparison between cone beam computed tomography and radiographs for orthodontic treatment

Objectives:To evaluate and compare mutagenicity (micronucleus) and cytotoxicity (karyorrhexis, pyknosis, and karyolysis) in exfoliated buccal mucosa cells of children following cone beam computed tomography (CBCT) or conventional radiograph exposure necessary for orthodontic planning.Materials and Methods:A total of 49 healthy children were submitted to CBCT or a conventional orthodontic radiographic protocol; they were divided into two groups based on exam: CBCT (n  =  24) and Radiographic Set (n  =  25) groups. The micronucleus test in the exfoliated buccal mucosa cells was applied.Results:There was not a statistically significant difference (P > .05) found between the number of micronucleated buccal mucosa cells (MNC) before and after exposure to radiation in either group, showing that neither group experienced a mutagenic effect. However, radiation did cause other nuclear alterations closely related to cytotoxicity, including karyorrhexis, pyknosis, and karyolysis, in both groups (P < .05). The CBCT group presented a greater increase in cell death than was noted in the Radiographic Set group (P < .044).Conclusion:According to the micronucleus test, mutagenicity was not induced by the CBCT or the conventional radiographs, but cytotoxicity was verified after these exams, especially after CBCT. That might have happened once the CBCT group received a greater radiation dose than the Radiographic Set group as a result of the protocols used in orthodontic planning for this study.     

Correction to: Clinical and microbiological effects of non-surgical periodontal treatment in individuals with rheumatoid arthritis: a controlled clinical trial

The effect of periodontal treatment on clinical, microbiological and serological parameters of patients with rheumatoid arthritis (RA) are scarce and controversial. The aim of this study was to investigate the influence of non-surgical periodontal treatment on clinical periodontal status, subgingival bacterial levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and RA activity through a controlled clinical trial on individuals with RA and periodontitis (PE). From a convenience sample, 107 individuals were considered eligible and consecutively allocated in four groups: (1) individuals without PE and RA (− PE-RA, n = 30); (2) individuals without PE and with RA (− PE + RA, n = 23); (3) individuals with PE and RA (+ PE + RA, n = 24); and (4) individuals with PE and without RA (+ PE-RA, n = 30). Full-mouth periodontal clinical examinations, microbiological analysis and Disease Activity Score (DAS-28) evaluations were performed at baseline (T1) and 45 days after non-surgical periodontal treatment (T2). At T1, individuals + PE + RA showed greater severity of PE than + PE-RA individuals. At T2, significant reductions were observed in all periodontal clinical parameters in both groups (p < 0.001) with a significant reduction in DAS-28 in + PE + RA (p = 0.011). Individuals + PE-RA and + PE-RA showed significant reductions for all bacteria (p < 0.001). Additionally, P. gingivalis demonstrated an expressively significant reduction in + PE + RA (p < 0.001). Non-surgical periodontal treatment was effective on improving the clinical periodontal condition, improving the RA clinical status and reducing the presence of periodontal pathogens. Brazilian Registry of Clinical Trials (ReBEC) protocol #RBR-8g2bc8 (https://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/).