Evaluation of the effects of 0.05% sodium hypochlorite and 0.12% chlorhexidine gluconate twice daily rinse on periodontal parameters and gingival crevicular fluid HSV1 and CMV levels in patients with chronic periodontitis: a multicentric study

BackgroundMechanical debridement of periodontal pockets remains the mainstay of therapy in all forms of periodontitis. There is 47% greater reduction in plaque amount when sodium hypochlorite (NaOCl) is used as an adjunct when compared with water rinsing. The aim of this study was to evaluate the effects of 0.05% NaOCl and 0.12% chlorhexidine gluconate twice daily rinse on periodontal parameters and gingival crevicular fluid (GCF) HSV1 and CMV levels in chronic periodontitis.MethodsPatients assigned to group A were prescribed 0.05% NaOCl mouthwash for twice daily rinse. Patients in group B were prescribed 0.12% chlorhexidine gluconate mouthwash to be used twice daily. Evaluation of periodontal parameters was done at baseline and after six months following therapy. GCF HSV1 and CMV levels were evaluated using a polymerase chain reaction.ResultsA statistically significant difference was noted in the improvement in periodontal parameters between both groups, when evaluated six months following therapy with greater reduction in group A vis-a-vis group B.ConclusionNaOCl when prescribed as a twice daily mouthwash can be recommended as a part of the home care regime in patients with chronic periodontitis. It is more cost-effective, easily available and can be beneficial to the troops in difficult terrains and extremes of climates, where oral healthcare facilities are not easily accessible.     

Gingival crevicular fluid interleukin-1beta, prostaglandin E2 and periodontal status in a community population

AIM: Interleukin-1 beta (IL-1beta) and prostaglandin E(2) (PGE(2)) are key inflammatory mediators involved in periodontal disease. The purposes of this molecular cross-sectional epidemiological study were to investigate relationships in a community sample between mean concentrations of IL-1beta and PGE(2) in gingival crevicular fluid (GCF) and (1) clinical periodontal signs and (2) risk factors of host inflammatory response and/or periodontal disease. MATERIAL AND METHODS: The sample comprised 6277 community-dwelling adults aged 52-74 years enrolled in the Atherosclerosis Risk in Communities (ARIC) study. IL-1beta and PGE(2) concentrations were measured using enzyme-linked immunosorbent assay. Person-level summary variables were computed for maximum pocket depth (MaxPD), maximum clinical attachment level (MaxCAL) and presence/absence of bleeding on probing (BOP). Mean GCF IL-1beta and PGE(2) concentrations were dependent variables in multiple linear regression models with periodontal measures and covariates as explanatory variables. RESULTS: Both GCF IL-1beta and PGE(2) were positively related to MaxPD and BOP in multiple regression models (p<0.01). Increased levels of IL-1beta and PGE(2) were associated with body mass index >or=30 kg/m(2). CONCLUSION: Higher levels of GCF IL-1beta and PGE(2) were significantly associated with clinical signs of periodontal disease and independently related to patient-based anthropomorphic measures, behaviours and exposures in community-dwelling adults.     

Effect of orthodontic forces on cytokine and receptor levels in gingival crevicular fluid: a systematic review

This systematic review aimed to generate evidence on role of potent markers of inflammation [cytokines, chemokines, their associated receptors and antagonists] following the application of orthodontic forces. Subsequent to registration with PROSPERO, literature search followed a predetermined search strategy to key databases along with hand search (HS). Seventy-seven articles from PubMed (P), 637 from Scopus (S), 51 from Embase (E), and 3 from hand search (HS) were identified. A total of 39 articles were shortlisted that met strict inclusion and exclusion criteria and quality assessment. Each study was evaluated for participant characteristics, study design, oral hygiene regimen, and gingival crevicular fluid (GCF) handling. Among these studies, biomarkers in the order of frequency were interleukin (IL)-1β (N = 21), tumor necrosis factor (TNF)-α (N = 10), IL-8,IL-6(N=8), receptor activator of nuclear factor kappa-B ligand (RANKL) (N = 7), monocyte chemoattractant protein (MCP)-1 (N = 3), IL-2 (N=4), IL-4, IL-10, RANTES (N = 2), IL-1, IL-5, IL-1α, IP-10, osteopontin (OPN) (N = 1) and receptors and their antagonists in the order of osteoprotegerin (OPG) (N = 8), IL-1RA (N = 5), and RANK (N = 1). Results revealed an immediate release of inflammatory bone-resorptive mediators, IL-1β and TNF-α, where IL-1β increased as early as 1 min to 1 h reaching peak at 24 h while TNF-α increased at 1 h or 1 day. This was accompanied by a fall in bone-protective mediator (OPG) levels at 1 h and 24 h after orthodontic force application. Continuous forces were accompanied by a decrease in mediator levels after attaining peak levels (most commonly at 24 h) while repeated activations in interrupted force upregulated their secretion. Significant correlations of IL-1β levels with pain intensity, rate of orthodontic tooth movement (OTM) and of activity index (AI) (IL-1β/IL-1RA) with velocity of tooth movement and growth status of individuals have also been deduced. A greater AI and RANKL/OPG ratio was seen in juveniles as compared to adults or non-growers that were associated with faster rate of OTM in juveniles. None of the studies addressed the effect of estrous cycle in female subjects. Lack of homogeneity in several parameters calls for a better controlled research on the biology of OTM.

Electronic supplementary material

The online version of this article (doi:10.1186/s40510-014-0065-6) contains supplementary material, which is available to authorized users.     

CAD/CAM氧化锆全瓷冠修复体对牙周组织健康状况的影响

目的:探讨计算机辅助设计(CAD)/计算机辅助制作(CAM)氧化锆全瓷冠修复体对牙周组织健康状况的影响.方法:将56例择期进行全冠修复的患者分为两组,每组28例.观察组(32颗牙)采用CAD/CAM氧化锆全瓷冠进行修复.对照组(30颗牙)采用镍铬合金烤瓷冠进行修复.对比两组患者修复前后牙的边缘密合性及牙周组织的炎症反应.结果:观察组修复前后龈沟液(GCF)、肿瘤坏死因子a(TNF-α)、白介素6(IL-6)无明显改变;对照组修复后GCF、TNF-α、IL-6显著高于修复前的水平,且显著高于观察组修复后的水平,差异有统计学意义;观察组修复前后探针深度(PD)、附着丧失(AL)、龈沟出血指数(SBI指数)、菌斑指数(PLT指数)无明显改变;对照组修复后PD、AL、SBI指数、PLT指数显著高于修复前的水平,且显著高于观察组修复后的水平,差异有统计学意义.结论:CAD/CAM氧化锆全瓷冠具有良好的边缘密合性,对牙周组织影响较小,不会引起明显的牙周炎症反应.     

三种牙周炎患者龈沟液中IL—8的检测

目的：探讨ＩＬ－８与不同种类牙周炎的关系，比较三种牙周炎，即青少年牙周炎（ｊｕｖｅｎｉｌｅｐｅｒｉ－ｏｄｏｎｔｉｔｉｓ，ＪＰ），快速进展型牙周炎（ｒａｐｉｄｐｒｏｇｒｅｓｓｉｖｅｐｅｒｉｏｄｏｎｔｉｔｉｓ，ＲＰＰ）和成人牙周炎（ａｄｕｌｔｐｅｒｉｏｄｏｎｔｉｔｉｓ，ＡＰ）龈沟液（ｇｉｎｇｉｖａｌｃｒｅｖｉｃｕｌａｒｆｌｕｉｄ，ＧＣＦ）中ＩＬ－８浓度和检出率。方法：采集ＪＰ、ＲＰＰ和ＡＰ患者ＧＣＦ，用ＥＬＩＳＡ法对ＧＣＦ中ＩＬ－８进行检测。结果：ＡＰ患者ＧＣＦ中ＩＬ－８检出率为６７．８５％，明显高于ＪＰ组、ＲＰＰ组的检出率（分别为３４．４８％、２５％）；ＧＣＦ中ＩＬ－８浓度无明显差别。结论：ＪＰ、ＲＰＰ患牙ＧＣＦ中ＩＬ－８检出率低可能是造成此种牙周炎局部中性粒细胞趋化异常的原因之一。     

Non-antibacterial tetracyclines modulate mediators of periodontitis and atherosclerotic cardiovascular disease: A mechanistic link between local and systemic inflammation

Periodontitis, one of the most common chronic inflammatory diseases afflicting man, is increasingly being recognized as a risk factor for atherosclerotic cardiovascular disease (ASCVD). Non-antimicrobial tetracyclines are known to have inhibitory effects on inflammatory mediators and effector molecules, including cytokines and matrix metalloproteinases (MMPs), associated with both diseases. In this paper, we discuss the evidence that doxycycline and related non-antibiotic chemically modified tetracyclines (e.g., CMT-3) can effectively reduce cytokine (TNF-α, IL-6, and MCP-1) production by human mononuclear inflammatory cells when stimulated either by endotoxin (LPS) or by a complex of C-reactive protein/oxidized LDL cholesterol relevant to the pathogenesis of periodontal disease and ASCVD, respectively. This inhibition by tetracycline compounds appears to be mediated at least in part by a suppression of the phosphorylation/activation of the NFκB cell signaling pathway. We are currently conducting clinical trials on patients who exhibit both diseases, and our preliminary data suggest that virtually all acute coronary syndrome (ACS) patients exhibit moderate-to-severe periodontitis, a higher incidence of this oral inflammatory disease than that seen in the population at large. In other studies, a non-antimicrobial formulation of doxycycline (SDD) has been found to dramatically reduce hsCRP, IL-6 and MMP-9 levels in plasma of ACS patients, and SDD has also been found to significantly increase serum levels of both cardio-protective HDL cholesterol and its core molecule apolipoprotein A-I in ASCVD-vulnerable patients with periodontitis. Our current research suggests that one mechanism involved may be the ability of SDD to inhibit MMP-mediated HDL loss by protecting apolipoprotein A-I from proteinase attack. These pleiotropic mechanisms of non-antimicrobial tetracyclines provide significant therapeutic potential to treat chronic inflammatory diseases including both periodontitis and ASCVD.     

中度儿童龈炎临床指标与龈沟液量的相关性分析

目的：观察中度儿童龈炎的临床指标：菌斑指数（PLI）、出血指数（BI）、牙龈指数（GI）与龈沟液（GcF）的量,探讨GCF量与PLI、BI、GI在儿童龈炎发生发展过程中的变化,分析GCF量与PLI、BI、GI的相关性。方法：选择临床诊断为中度儿童龈炎患者52例156颗牙,在实施治疗措施的第0、3、7、14、21、28天分别对菌斑指数（PLI）、出血指数（BI）、牙龈指数（GI）与龈沟液（GCF）量进行检测与相关性分析。结果：中度牙龈炎儿童治疗后第7、14、21、28天PLI、BI、GI的数值与第一时间点比较,差异均具有统计学意义（P〈0．01）;龈沟液的量治疗后第21天与第一时间点比较,差异有统计学意义,P〈0．05;第28天与第一时间点比较,差异具有统计学意义,P〈0．01;各检查时间GCF量与PLI、BI、GI均呈正相关关系。结论：在儿童龈炎发生过程中,中度牙龈炎的GCF量与PLI、BI、GI间的均呈正相关关系;GCF量与龈炎发生程度密切相关,可作为评价牙龈炎趋向性的动态指标。     

纯钛烤瓷全冠对基牙牙周组织健康的影响

目的:探讨纯钛烤瓷全冠修复对患牙牙周组织的影响.方法:选择临床接受纯钛烤瓷冠修复患者38例,共40颗的上颌前磨牙,以患牙的对侧同名健康牙为对照组.在纯钛烤瓷冠修复前、修复后6个月、12个月时,分别对患牙及对照牙进行临床检查和取龈沟液(gingival crevicular fluid,GCF),进行GCF量和可溶性细胞间粘附分子-1(soluble intercellular adhesion molecule-1,sICAM-l)、肿瘤坏死因子-ɑ(tumor necrosis factor-ɑ,TNF-ɑ)水平的测定.结果:修复后12个月时,纯钛组、对照组龈沟液中sICAM-l、TNF-ɑ水平分别为63.19±21.26(ng/ml)、61.21±20.53(ng/ml)和3.40±3.23(ng/ml)、3.32±2.34(ng/ml),差异均无统计学意义(P ＞0.05).结论:纯钛烤瓷全冠不会对牙周组织健康产生明显不利影响.