Locally produced anti-phosphorylcholine and anti-oxidized low-density lipoprotein antibodies in gingival crevicular fluid from aggressive periodontitis patients

BACKGROUND: Sera from patients with periodontal attachment loss contain higher concentrations of IgG anti-phosphorylcholine (anti-PC) than sera from healthy subjects. Furthermore, a large proportion of plaque bacteria bear PC-containing surface antigens, implicating the oral flora as a source of immunogen for anti-PC. Additionally, anti-PC is cross-reactive with a variety of oral bacterial antigens and human antigens such as oxidized low-density lipoprotein (oxLDL). We hypothesized that, if the oral flora is a source of PC antigens, then we should be able to detect local anti-PC and anti-oxLDL production in gingival crevicular fluid (GCF). METHODS: To test this, we collected 66 GCF samples from 15 patients with aggressive periodontitis and examined both the GCF samples and serum samples for their content of IgG anti-PC, IgG anti-LDL, and IgG anti-oxLDL by enzyme-linked immunosorbent assay. We also determined levels of anti-tetanus toxoid (anti-TT) as a non-oral antigen control. Serum and GCF concentrations of serum albumin (HSA) were also determined for use as a dilution marker. A conservative GCF:serum antibody ratio of greater than 1.5 was considered to be evidence of local antibody production. RESULTS: For the non-oral antigen TT, only one out of 62 samples contained locally produced antibody. Eight out of 64 samples (7 from a single subject) demonstrated local production of anti-LDL. In contrast, 28 out of 66 samples demonstrated local production of anti-PC, and 47 out of 66 samples contained locally produced anti-oxLDL. It was observed that A. actinomycetemcomitans strains containing or devoid of PC could absorb anti-oxLDL from human sera. Although there was a correlation between the ratios of anti-PC and anti-oxLDL (Spearman's rho = 0.35, P = 0.0037), local production of both antibodies was found in only 17 out of 65 samples, indicating that these antibodies are not always reflective of reactivity to the same antigens. CONCLUSION: The local production of anti-PC and anti-oxLDL further implicates the oral flora as a source of antigen that may mediate immune reactions of relevance to cardiovascular and other systemic diseases.     

Safety of dental amalgam

This Critical Appraisal is a departure from our usual format. Usually, contributors review several articles about a specific topic. Instead, we have asked Dr. Osborne to review several topics related to a specific issue, the safety of dental amalgam. Despite the increasing use of tooth‐colored restorative materials, amalgam remains a widely used and important part of the dentist's armamentarium. This article provides the practicing dentist with essential information regarding the safety of amalgam. We hope that you will find this helpful as you discuss safety issues with concerned patients.     

The release of interleukin-1β, tumor necrosis factor-α and i nterferon-γ by cultured peripheral blood mononuclear cells from patient swith periodontitis

The extracellular release of IL-1 beta by cultured peripheral blood monocytes from 26 periodontitis patients and 26 control subjects was measured by radioimmunoassay. Unstimulated monocytes from periodontitis patients released significantly more IL-1 beta than controls during 24 h of culture; there was a wide variation in the amount of IL-1 beta released (0.45-13.00 ng/ml per 10(6) cells) which did not correlate with either the degree of bone loss or pocket formation observed clinically. When stimulated with lipopolysaccharide (LPS; Actinobacillus actinomycetemcomitans; 5 micrograms/ml) monocytes from periodontitis patients produced significantly more IL-1 beta than those from control subjects. Monocyte culture supernatants from another 10 periodontitis patients and 10 control subjects were also assayed for both IL-1 beta and TNF-alpha by enzyme-linked immunosorbent assays. Spontaneous and LPS-stimulated (Bacteroides gingivalis; 5 micrograms/ml) IL-1 beta release were again significantly higher for periodontitis patients. TNF-alpha was detected in the periodontitis cultures (0-765 pg/ml per 10(6) cells), but the mean value was not significantly different from controls. LPS-stimulated TNF-alpha release, however, was significantly higher than for control subjects, and there was a strong correlation between spontaneous IL-1 beta and TNF-alpha release by monocytes from the periodontitis group. Measurement of interferon-gamma (IFN-gamma) in lymphocyte cultures from these patients by immunoradiometric assay showed that IFN-gamma levels in periodontitis cultures were consistently low, but not significantly so when compared to controls; both groups responded equally to concanavalin-A (5 micrograms/ml). Although the precise roles of IL-1 beta and TNF-alpha in periodontitis remain unclear, these data provide evidence that both cytokines may participate in the pathogenesis of the disease.     

Histological evaluation of oral implants inserted with different surgical techniques into the trabecular bone of goats

OBJECTIVE: The aim of this study was to investigate the influence of implant surface topography and surgical technique on bone response. MATERIAL AND METHODS: For the experiment, 48 screw-designed implants were used with two different surface finishes, i.e. machined and 'blasted, etched'. The implants were inserted into the left and right medial femoral condyle of eight goats using three different surgical approaches: press-fit (implant diameter=implant bed diamete(r), undersized (implant bed diameter相似文献   

Influence of the size of the microgap on crestal bone levels in non-submerged dental implants: a radiographic study in the canine mandible

BACKGROUND: Accumulating evidence suggests that alveolar crestal bone resorption occurs as a result of the microgap that is present between the implant-abutment interface in dental implants. The objective of this longitudinal radiographic study was to determine whether the size of the interface or the microgap between the implant and abutment influences the amount of crestal bone loss in unloaded non-submerged implants. METHODS: Sixty titanium implants having sandblasted with large grit, acid-etched (SLA) endosseous surfaces were placed in edentulous mandibular areas of 5 American fox hounds. Implant groups A, B, and C had a microgap between the implant-abutment connection of <10 microm, 50 microm, or 100 microm, respectively, as did groups D, E, and F, respectively. Abutments were either welded (1 -piece) in groups A, B, and C or non-welded (2-piece screwed) in D, E, and F. All abutment interfaces were placed 1 mm above the alveolar crest. Radiographic assessment was undertaken to evaluate peri-implant crestal bone levels at baseline and at 1, 2, and 3 months after implant placement whereupon all animals were sacrificed. RESULTS: The size of the microgap at the abutment/implant interface had no significant effect upon crestal bone loss. At 1 month, most implants developed crestal bone loss compared with baseline levels. However, during this early healing period, the non-welded group (D, E, and F) showed significantly greater crestal bone loss from baseline to one month (P <0.04) and 2 months (P < 0.02) compared with the welded group (A, B, and C). No significant differences were observed between these 2 groups at 3 months (P > 0.70). CONCLUSIONS: Crestal bone loss was an early manifestation of wound healing occurring after 1 month of implant placement. However, the size of the microgap at the implant-abutment interface had no significant effect upon crestal bone resorption. Thus, 2-piece non-welded implants showed significantly greater crestal bone loss compared with 1-piece welded implants after 1 and 2 months suggesting that the stability of the implant/abutment interface may have an important early role to play in determining crestal bone levels. At 3 months, this influence followed a similar trend but was not observed to be statistically significant. This finding implies that implant configurations incorporating interfaces will be associated with biological changes regardless of interface size and that mobility between components may have an early influence on wound healing around the implant.     

In vitro biofilm formation on the surface of resin-based dentine adhesives

Prevention of root caries on exposed root surfaces in the aging population is a significant challenge. Bonding resins can be applied to exposed root surfaces as sealants; however, minimal data exists regarding biofilm formation on the surface of these resins. We hypothesized that an antibacterial dentine-bonding resin containing methacryloxydodecyl-pyridiniumbromide (MDPB) may reduce biofilm formation. Biofilms were produced in pooled stimulated natural whole saliva, supplemented with 1% sucrose, on the surface of 5 dentine-bonding resins (Clearfil SE, OptiBond Solo, Protect Bond, Protect Bond Primer, and Xeno III) using untreated root surfaces as controls. Biofilms were stained using the Live:Dead Baclight bacterial viability stain, viewed with confocal microscopy, and analyzed using ImageJ image-analysis software. Resin surfaces encouraged attachment of live bacteria compared with root surfaces. All resins showed similar bacterial colonization in sections adjacent to the resin surface, but in the central and outer portions of biofilms, Xeno III and Protect Bond Primer showed a viable bacterial load similar to that of the root surface. Fluoride-releasing resins (OptiBond Solo/Protect Bond) did not show reduced biofilm formation. Thus, antibacterial agents within the resins have a minimal effect on biofilm formation, particularly when directly adjacent to the root surface.     

Effect of two-step adhesive systems on inhibition of secondary caries around fluoride-releasing resin composite restorations in root dentine

OBJECTIVE: The purpose of this study was to investigate the effect of two-step adhesive systems on secondary caries inhibition around fluoride-releasing materials in vitro. METHODS: Two self-etching primer systems, Clearfil SE Bond (SE) and UniFil Bond (UB), and two one-bottle systems with a total-etch wet-bonding technique, Single Bond (SB) and One-Step (OS), were used prior to placement of resin composites either with (Reactmer) or without (Z100) fluoride release. Class V cavities prepared in extracted human premolars were restored with various combinations of materials: Reactmer/SE, Reactmer/UB, Reactmer/SB, Reactmer/OS, Z100/SE, Z100/UB, Z100/SB and Z100/OS. After storage for 14 days, the restored teeth were incubated in bacterial medium containing sucrose with Streptoccus mutans for 2 weeks. Water sorption and desorption of the adhesives and fluoride release from the resins either coated with adhesive or uncoated were also determined. RESULTS: The one-bottle groups showed higher water sorption and desorption than the self-etching primer groups. Although fluoride release from the Reactmer specimens was suppressed by the adhesive coating, the one-bottle groups allowed significantly higher fluoride release than the self-etching primer groups. On microradiographs, the radio-opaque layers adjacent to the Reactmer restorations were thick and clear, while the layers adjacent to the Z100 restorations were thin and unclear. For the Reactmer restorations, the radio-opaque layers associated with the one-bottle groups were significantly thicker than for the self-etching primer groups. CONCLUSIONS: These results indicated that the use of one-bottle wet-bonding systems for bonding of fluoride-releasing resin composites to dentine may contribute to inhibit secondary caries compared to self-etching primer systems.     

The use of Ormocer as an alternative material for bonding orthodontic brackets

As new adhesives, composite resins, and bonding techniques were introduced, orthodontists adopted some of these innovations and added them to their armamentarium. The purpose of this study was to compare the shear bond strength (SBS) of two adhesive materials; one with an organically modified ceramic matrix, Admira (Voco, Cuxhaven, Germany) and another that contains the traditional Bis GMA matrix namely Transbond XT (3M Unitek, Monrovia, Calif). The new materials have a lower wear rate and are more biocompatible than traditional composites. Forty molar teeth were randomly divided into two groups: 20 teeth bonded with the Transbond adhesive system and the other 20 teeth with the Admira bonding system. Student's t-test was used to compare the SBS of the two adhesives. Significance was predetermined at P < or = .05. The results of the t-test comparisons (t = 0.489) of the SBS indicated that there was no significant (P = .628) difference between the two adhesives tested. The mean SBS for Admira was 5.1 +/- 3.3 MPa and that for Transbond XT was 4.6 +/- 3.2 MPa. It was concluded that the new material, Ormocer, which is an organically modified ceramic restorative material can potentially have orthodontic applications if available in a more flowable paste. These new materials are more biocompatible and have lower wear rate including bonding orthodontic brackets to teeth.     

Periodontal repair in dogs: evaluation of a bioresorbable calcium phosphate cement (Ceredex) as a carrier for rhBMP-2

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been shown to induce clinically relevant bone formation for orthopedic, craniofacial, and oral indications. It appears critical, in particular for onlay indications, that the associated carrier technology exhibits structural integrity to offset compressive forces in support of rhBMP-2-induced bone formation. The objective of this study was to evaluate a calcium phosphate (CP) cement, Ceredex, as a candidate carrier for rhBMP-2 in a defect model with limited osteogenic potential. MATERIALS: Bilateral, critical size, 6-mm, supra-alveolar, periodontal defects were created in six, adult, male, Hound Labrador mongrels. Three animals received rhBMP-2/Ceredex (rhBMP-2 at 0.20 and 0.40 mg/ml) in contralateral defect sites (implant volume/defect approximately 1 ml). One defect site in each of the three remaining animals received Ceredex without rhBMP-2 (control). The animals were euthanized at 12 weeks postsurgery for histologic and histometric analysis. RESULTS: Mean induced bone height exceeded 80% of the defect height for supra-alveolar periodontal defects receiving rhBMP-2/Ceredex without major differences between rhBMP-2 concentrations compared with approximately 40% for the control. The newly formed bone, a mixture of lamellar and woven bone in fibrovascular tissue, circumscribed relatively large portions of the residual Ceredex biomaterial. Inflammatory lesions were associated with limited bone formation in some sites. From a periodontal perspective, sites receiving rhBMP-2/Ceredex exhibited increased cementum formation compared with control, but without a functionally oriented periodontal ligament, and increased ankylosis and root resorption. Control sites exhibited early wound failure and exposure, loss of the Ceredex biomaterial, and limited bone formation. CONCLUSIONS: The Ceredex CP cement appears a potentially promising carrier technology for rhBMP-2 onlay indications. However, a slow resorption rate may prevent its wider use. This study does not support use of the rhBMP-2/Ceredex combination for periodontal indications.     

The effects of a calorie-reduced diet on periodontal inflammation and disease in a non-human primate model

BACKGROUND: Low-calorie diets are commonplace for reducing body weight. However, no information is available on the effects of a reduced-calorie diet on periodontal inflammation and disease. The purpose of this study was to evaluate the clinical effects of a long-term calorie-restriction (CR) diet on periodontitis in an animal model of periodontitis. METHODS: Periodontitis was induced in 55 young, healthy, adult rhesus monkeys (Macaca mulatta) by tying 2.0 silk ligatures at the gingival margins of maxillary premolar/molar teeth. Animals on a CR diet (30% CR; N = 23) were compared to ad libitum diet controls (N = 32). Clinical measures, including the plaque index (PI), probing depth (PD), clinical attachment level (CAL), modified gingival index (GI), and bleeding on probing (BOP) were recorded at baseline and 1, 2, and 3 months after ligature placement. RESULTS: Significant effects of CR were observed on the development of inflammation and the progression of periodontal destruction in this model. Compared to controls, CR resulted in a significant reduction in ligature-induced GI (P <0.0001), BOP (P <0.0015), PD (P <0.0016), and CAL (P <0.0038). Periodontal destruction, as measured by CAL, progressed significantly more slowly in the CR animals than in the controls (P <0.001). CONCLUSIONS: These clinical findings are consistent with available evidence that CR has anti-inflammatory effects. Moreover, these experimental findings are the first observations, to the best of our knowledge, that CR dampens the inflammatory response and reduces active periodontal breakdown associated with an acute microbial challenge.