Aggressive Periodontitis Group Research Articles

Integrated analysis of the salivary microbiome and metabolome in chronic and aggressive periodontitis: A pilot study.

This pilot study was designed to identify the salivary microbial community and metabolic characteristics in patients with generalized periodontitis. A total of 36 saliva samples were collected from 13 patients with aggressive periodontitis (AgP), 13 patients with chronic periodontitis (ChP), and 10 subjects with periodontal health (PH). The microbiome was evaluated using 16S rRNA gene high-throughput sequencing, and the metabolome was accessed using gas chromatography-mass spectrometry. The correlation between microbiomes and metabolomics was analyzed by Spearman’s correlation method. Our results revealed that the salivary microbial community and metabolite composition differed significantly between patients with periodontitis and healthy controls. Striking differences were found in the composition of salivary metabolites between AgP and ChP. The genera Treponema, Peptococcus, Catonella, Desulfobulbus, Peptostreptococcaceae_[XI] ([G-2], [G-3] [G-4], [G-6], and [G-9]), Bacteroidetes_[G-5], TM7_[G-5], Dialister, Eikenella, Fretibacterium, and Filifactor were present in higher levels in patients with periodontitis than in the healthy participants. The biochemical pathways that were significantly different between ChP and AgP included pyrimidine metabolism; alanine, aspartate, and glutamate metabolism; beta-alanine metabolism; citrate cycle; and arginine and proline metabolism. The differential metabolites between ChP and AgP groups, such as urea, beta-alanine, 3-aminoisobutyric acid, and thymine, showed the most significant correlations with the genera. These differential microorganisms and metabolites may be used as potential biomarkers to monitor the occurrence and development of periodontitis through the utilization of non-invasive and convenient saliva samples. This study reveals the integration of salivary microbial data and metabolomic data, which provides a foundation to further explore the potential mechanism of periodontitis.

Genetic polymorphism of interleukin-12β (rs7709212) in chronic and aggressive periodontitis in a group of the Bengali population of India

Objectives: The genetic basis of periodontitis was demonstrated by formal genetic studies which were focused on a range of various candidate genes selected for their roles in the immune system like genes of the interleukins (IL). Bone proresorptive cytokines such as IL-1 and tumor necrosis factor-α are primarily regulated by a network of other T-cell derived cytokines, including IL-12 family. Specific objective of this study was to find out any association between IL-12β 3΄ untranslated region (UTR) (rs7709212) gene polymorphism and chronic as well as aggressive periodontitis (AgP) in Bengali population of West Bengal, India. Materials and Methods: A total of 88 Bengali participants of both sexes were recruited and were divided into three groups: Group A (chronic periodontitis [CP] group), Group B (AgP group), and Group C (healthy control). DNA extraction from collected peripheral venous blood was performed by phenol chloroform method and ethanol precipitation. Genotyping of extracted DNA samples was carried out for locus IL-12β 3΄UTR (rs7709212) by real time-polymerase chain reaction. Association between genotypes and cases was examined by the odds ratio with 95% confidence interval and chi-square analysis using R statistical software. Statistical significance was defined as P < 0.05. Results: On analysis of the minor allele frequencies of total periodontitis cases and control, the results were found to be statistically significant with the P = 0.03045. Conclusion: The present study suggested a strong association of single nucleotide polymorphism of IL-12β (rs7709212) with total periodontitis cases (both CP and AgP) in the present study cohort.

Study of the correlation between the clinical manifestations of the inflammatory periodontal diseases and the microbiome of periodontal pathogenic microflora in young representatives of a mixed population of the European region

The age of inflammatory periodontal disease (PD) manifestations has tended to decrease over the past decades. The study of the range of periodontal pathogens in young people and their influence on the PD manifestation contributes to the predictor identification for the early prevention of this pathology.The aim was to study the correlation between the range of periodontal pathogens in the dentoalveolar sulcus/periodontal pocket (DS/PC) contents and the clinical PD manifestations in young people.We examined 28 patients (23.1 ± 0.93 years) with dental biofilm-induced gingivitis (BG), 24 patients (30.7 ± 0.6 years) with aggressive periodontitis (AgP), and 87 clinically periodontally healthy patients (21.1 ± 0.49 years) (Control). The hygiene index and the periodontal status were determined in all patients. DNA of five periodontal pathogens was identified by PCR in the DS/PC contents. The statistical analysis was performed in Statistica 13.3. The critical significance level was p ≤ 0.05.DNA was not observed in 60.9 % of the control group samples and 7.1 % of the BG group samples. In other cases, the bacteria were found separately and as part of bacterial complexes. P.g. and T.f. were most often detected in all groups. P.g. (U = 474, р < 0.01) and A.a. (U = 209, р >< 0.05) significantly contributed to the plaque formation in the control group, T.d. – in BG and AgP groups (U = 37.5, р >< 0.05 and U = 34, р >< 0.05, respectively). In the AgP group, purulent discharge was more often recorded if T.d. was detected in the PC contents (χ2 = 5.53, р >< 0.05). T.f. + P.i. and P.g. + T.f. + P.i. complexes were exclusively associated with PD. Complexes of four bacteria were found only in the AgP group. The association of periodontal pathogens and their complexes with different PD forms was revealed.>< 0.01) and A.a. (U = 209, р <0.05) significantly contributed to the plaque formation in the control group, T.d. – in BG and AgP groups (U = 37.5, р <0.05 and U = 34, р <0.05, respectively). In the AgP group, purulent discharge was more often recorded if T.d. was detected in the PC contents (χ2 = 5.53, р <0.05). T.f. + P.i. and P.g. + T.f. + P.i. complexes were exclusively associated with PD. Complexes of four bacteria were found only in the AgP group.The association of periodontal pathogens and their complexes with different PD forms was revealed.

Evaluation of genetic polymorphism of interleukin-1β (rs16944) in chronic and aggressive periodontitis in a group of the Bengali population of West Bengal, India

Objectives: The genetic basis of periodontitis was demonstrated by formal genetic studies which were focused on a range of various candidate genes selected for their roles in the immune system like genes of the interleukins (ILs) which regulate the intensity of host immunity-inflammatory response. This regulation of host response may be associated with the genetic polymorphisms, specific single-nucleotide polymorphisms of the genes of various ILs. Interleukin-1 (IL-1) is a principal mediator of inflammatory responses acting on many cell types and is itself produced by many different cells, including macrophages, endothelial cells, B cells, fibroblasts, epithelial cells, astrocytes, and osteoblasts in response to microorganisms, bacterial toxins, and complement components. In the present study, an attempt has been made to explore the role of IL-1β-511 (rs16944) genetic polymorphism in chronic as well as aggressive periodontitis in a group of the Bengali population of West Bengal, India. Materials and Methods: A total of 88 Bengali patients of both sexes were recruited in this study and they were divided into three groups: Group A (chronic periodontitis group), Group B (aggressive periodontitis group), and Group C (healthy control). The clinical parameters taken into consideration in the assessment of chronic and aggressive periodontitis were plaque index, calculus index, gingival index, probing pocket depth (PPD), and clinical attachment loss (CAL). A 3 ml of peripheral venous blood was collected from each selected participant and transferred to 3% EDTA containing serum vial and stored at −20°C for DNA extraction. DNA extraction was performed by the phenol chloroform method and ethanol precipitation. Genotyping of extracting DNA samples was carried out for locus IL-1β-511 (rs16944) by real-time polymerase chain reaction. Hardy–Weinberg equilibrium was tested for the gene polymorphism and association between genotypes and cases was examined by odds ratio with 95% confidence interval (CI) and Chi-square analysis using R programming software. Allelic frequencies were calculated according to the number of different alleles observed and the total number of alleles examined. Statistical significance was defined as P < 0.05. Results: On analysis of minor allele frequencies of total periodontitis cases and control, the results were found to be statistically insignificant with P = 0.9799. Minor allele frequency of overall periodontitis cases and controls was 0.405 and 0.403, respectively; the odds ratio was 1.008 and 95% CI ranges from 0.53 to 1.88. Conclusion: The present study suggested no association of single-nucleotide polymorphism of IL-1β-511 (rs16944) with total periodontitis cases (both chronic periodontitis and aggressive periodontitis) in the present study cohort.

Annually and Cumulative Radiographic Alveolar Bone Loss Rates using Digital Scanning Image for the Periodontal Disease Groups before and after Periodontal Treatment

The aim of the present study was to assess the cumulative radiographic alveolar bone loss (CRABL) and yearly radiographic periodontal attachment loss (YRABL) of periodontal disease groups over 5 years or more. A total of 53 subjects, who had taken two sets of full-mouth standardized paralleling radiographs with separated periods of 5 years or more in Kaohsiung Medical University Hospital during 1981-2001, were collected for the past 20 years.
 The radiographic alveolar bone levels at mesial and distal aspects of teeth were assessed by measuring the distance between cemento-enamel junction and alveolar bone crest using an electronic digimatic caliper (EDC) under a 3.5X magnified radiographs.
 The results revealed that 1) patients with a periodic recall (3-4 times/yr.) showed a significantly lower loss rate than patients without periodic recalls; 2) mean CRPAL was highest in the generalized aggressive periodontitis (GAgP) group (5.52±3.27mm), then the chronic periodontitis (CP) group (4.82±3.47mm), and the localized aggressive periodontitis (LAgP) group (4.47±3.47mm) followed, and lowest in the periodontal healthy (PH) group (1.05±0.59mm); 3) mean YRPAL was the highest in the LAgP group (0.26±0.25mm/yr.), then the GAgP group (0.20±0.13 mm/yr.), and the CP group (0.12±0.09 mm/yr.) followed, and lowest in the periodontal healthy group (0.07±0.06 mm/yr.).
 It was concluded that: 1) sites with more advanced alveolar bone loss are more likely to undergo further breakdown; 2) patients with a periodic recall showed a significantly lower alveolar bone loss rate and bone gain, irrespective disease groups; 3) mean CPBLs was highest in the GAgP group; mean YRABLs was highest in the LAgP.

IL-13 gene polymorphisms (-1112 C/T and -1512 A/C) in patients with chronic and aggressive periodontitis: Effects on GCF and outcome of periodontal therapy.

IL-13 is the key cytokine in the regulation of inflammatory with an autoimmune disease and has an anti-inflammatory effect. This study aimed to compare IL-13 (-1112 C/T and -1512 A/C) gene polymorphisms in patients with aggressive periodontitis (AgP), chronic periodontitis (CP), and periodontally healthy group (C) and evaluate the effect of nonsurgical periodontal therapy on gingival crevicular fluid (GCF) IL-13 levels in patients. One hundred thirty patients with AgP, 120 patients with CP, and 70 periodontally healthy subjects were included in this study. Clinical parameters were recorded (plaque and gingival index, probing pocket depth, clinical attachment level), and GCF and blood samples were taken at baseline and 6-week. Nonsurgical periodontal therapy was performed in patients with periodontitis. Gene analyses (IL-13 - 1112C/T (rs1800925) and - 1512 A/C (rs1881457) were performed with real-time polymerase chain reaction (PCR) and cytokine levels were determined by an enzyme-linked immunosorbent assay method. AgP and CP patients showed significant improvement in clinical parameters after periodontal therapy (P < 0.05). According to results, genotype distributions and allele frequencies in IL-13 variants - 1112C/T and - 1512 A/C were found similarly in all groups (P > 0.05). In the AgP group, GCF IL-13 cytokine level is statistically significant and increased in 6 weeks; however, in the CP group, there is no statistically significant difference between baseline and 6 week. In the AgP group, baseline GCF IL-13 cytokine level is lower than those of the CP group and C group (P < 0.05). Within the limits of this study, IL-13 -1112 and -1512 gene polymorphisms have not been associated with AgP and CP, and GCF IL-13 cytokine level is increased after treatment in the AgP group.

IL29 expression in gingival tissues of chronic periodontitis and aggressive periodontitis patients: An immunohistochemical analysis

Interleukin-29 (IL-29) is one of the cytokines which has immunomodulatory properties and might play a role in the pathogenesis of periodontal diseases. The aim of this study was an immunohistochemical analysis of IL-29 in gingival tissues of chronic and aggressive periodontitis. In this cross-sectional study based on clinical evaluation and inclusion and exclusion criteria, 20 patients with generalized chronic periodontitis, 13 patients with generalized aggressive periodontitis, and 20 periodontally healthy individuals were enrolled. Gingival tissue samples were obtained during periodontal flap and crown lengthening surgery in periodontal patients and healthy individuals, respectively. Tissue samples were examined to determine the level of IL-29 expression by immunohistochemistry. The data were analyzed using SPSS and paired t-test, ANOVA test, and Tukey's test (P < 0.05). A total of 53 participants (34 females and 19 males) were enrolled in this study. IL-29 expression in the connective tissue of the patient groups was more than the healthy one (P < 0.001). In the aggressive periodontitis group, there was a significant increase of IL-29 expression compared to the other two groups, but there was no significant difference between the chronic periodontitis and healthy groups. According to the results of this study, IL-29 expression was increased in the gingival tissue of aggressive and chronic periodontitis. IL-29 local expression in aggressive periodontitis is higher than the chronic periodontitis and healthy groups, which could suggest the role of IL-29 in the etiopathogenesis of aggressive periodontitis.

Possible Protective Role of NLRC4 Inflammasome in Periodontal Diseases: A Preliminary Study

Introduction: Inflammasomes are multiprotein complexes, which regulate proinflammatory cytokines, Interleukin-18 (IL-18), and Interleukin-1β (IL-1β) that are associated with periodontal breakdown. This study investigated the expression of NOD-like receptor pyrin domain-containing-3 (NLRP3) and NOD-like receptor family CARD domain-containing protein 4 (NLRC4) inflammasomes in different periodontal diseases in humans and their potential association with IL-18 release in gingival crevicular fluid (GCF). Materials and Methods: A total of 45 participants (21 males and 24 females) divided into four groups; periodontally healthy (H), gingivitis (G), chronic periodontitis (CP), and aggressive periodontitis (AgP) based on periodontal examination. NLRC4 and NLRP3 expression were detected by immunohistochemistry in gingival tissue samples for all groups. Expression percentage (%) and staining intensity distribution score (SID) were calculated for both NLRC4 and NLRP3. IL-18 was measured in GCF via enzyme linked immunosorbent assay (ELISA). Results: Positive immunoreactivity was seen for NLRC4 and NLRP3 across groups. No differences were found for NLRC4 expression %, but SID scores were slightly higher in G and AgP compared to other groups (P > 0.05). Results showed a significant increase of NRLP3 expression % in group CP compared to group H (P < 0.05) without affecting SID scores (P > 0.05). IL-18 levels were significantly higher in AgP and CP groups compared to H and G groups (P < 0.05). IL-18 significantly and positively correlated with clinical attachment levels across groups. Conclusion: Within the limitations of this preliminary study, we suggest that the NLRC4 platform may have a protective role contrary to the NLRP3 platform influencing IL-18 release and associated periodontal tissue breakdown.

Comparison of subgingival microbial profile of aggressive periodontitis, chronic periodontitis and periodontally healthy individuals

Objective: To compare the subgingival microbiota of subjects from patients with aggressive periodontitis (AgP), chronic periodontitis (CP) and periodontally healthy (PH) individuals, respectively. Methods: Volunteers were recruited from the Nangjing Stomatological Hospital, Medical School of Nanjing University during December 2013 to December 2014. Ten individuals were included in each of three groups. Preliminary estimation of sampling sites was chosen based on the X-ray and intraoral examination. Then the subgingival plaque samples were collected, the periodontal clinical indices were recorded, genes were extracted and amplified by PCR, and subsequently a DNA library was constructed for 16S rDNA sequencing. The library that can be successfully constructed and sequenced includes: 18 samples from 8 AgP group patients, 31 samples from 10 CP group patients and 10 samples from 8 PH group volunteers. Finally, we analyzed and compared the α-diversity, β-diversity and microbial compositions of samples in each group. Pearson correlation analysis was adopted to evaluate the correlation between the relative abundance of microorganisms and the probing depth (PD). Results: The α-diversity of subgingival flora in AgP group was significantly lower than that in PH group and CP group, respectively (P<0.05). On the phylum level, the abundance of Bacteroides [(36.8±7.4)%] and Spirochetes [(16.0±5.4)%] in AgP group and the abundance of Bacteroides [(37.2±6.3)%] and Spirochetes [(11.8±3.6)%] in CP group were significantly higher than those in PH group [(27.5±11.2)%, (5.2±4.4)%, respectively, P<0.05]. While the relative abundance of Actinomycetes and Proteobacteria [(4.2±3.3)%, (12.9±5.1)%, respectively] in AgP group and that of CP group [(6.1±2.6)%, (12.1±4.0)%, respectively] were significantly higher than PH group [(19.3±13.1)%, (23.0±10.1)%, respectively, P<0.01). The abundance of Spirochetes and Tenericutes in AgP group [(16.0±5.4)%, (1.7±1.2)%, respectively] were significantly higher than that in CP group [(11.8±3.6)%, (0.7±0.6)%, respectively, P<0.05]. At the genus level, Corynebacterium, Actinomycete, Saccharibacteria_norank, Selenomonas and Oribacterium in the subgingival flora of AgP group were significantly lower than that of CP group, while the relative abundance of Actinomycetes, Lentimicrobiaceae_norank, Defluvitaleaceae_UCG_011, Family_XI_unclassified were significantly higher than that of CP group (P<0.05). Principal coordinate analysis showed that samples of each group clustered separately from each other. Linear discriminant analysis revealed that the bacteria enriched in AgP group included Spirochetes, while in CP group included Bacteroidaceae. The result of correlation analysis showed that the abundance of the following genera in AgP group were positively correlated with PD: Treponema_2, Defluitaleaceaeae_UCG_011, Mycoplasma, Catonella, Fretibacterium (r=0.525-0.750, P<0.05). While the relative abundance of Comamonadaceae_unclassified, Streptococcus, Capnocytophaga, Neisseria, Prevotella, Peptococcus, Ralstonia, Bergenia and Actinomycetes were negatively associated with PD (r=-0.617--0.490, P<0.05). In the CP group, the abundance of Dialister, Family_XI_unclassified, Catonella, Peptococcus, Pelospora and Rikenella_RC9_gut group were positively correlated with PD (r=0.430-0.533, P<0.05). Conclusions: There is a clear difference between the subgingival flora of periodontal patients and that of PH individuals. Besides, subgingival flora of AgP and CP are also different, suggesting that these could be two different diseases.

Occurrence and quantification of Anelloviruses and Herpesviruses in gingival tissue in Chinese Shanghai sub-population

BackgroundHerpesviruses and bacteria and their interplay have long been believed to play important roles in the pathogenesis of periodontitis, but other microbial entities in the oral environment might also be involved. Anelloviruses are commonly detected in human, including in oral samples. The aim of the present study was to explore the occurrence and co-occurrence of human cytomegalovirus (HCMV), Epstein–Barr virus (EBV), and human anelloviruses (HTTVs) in gingival tissue samples collected from participants recruited in Shanghai, China.MethodsGingival tissues were collected from 159 participants (57 with aggressive periodontitis (AP), 59 with chronic periodontitis (CP) and 43 with healthy periodontal status). The presence of HCMV, EBV, torque teno virus (TTV), torque teno mini virus (TTMV) and torque teno midi virus (TTMDV) DNA was detected by nested-PCR. The virus loads were quantified by real-time PCR.ResultsThe detection rates of EBV, TTV, TTMV and TTMDV were significantly higher in the AP and CP groups compared to the healthy group (all P < 0.01). A statistically significant association was found between EBV, TTV and TTMV virus load and periodontitis (all P < 0.05). Participants infected with EBV showed significantly higher infection rates and higher virus loads of TTV and TTMV than the EBV-negative group (all P < 0.05). The coexistence rates of EBV and anelloviruses and the coexistence of three HTTVs were significantly higher in AP and CP groups (all P < 0.01).ConclusionsCollectively, results obtained in this study suggest that HTTVs and the coexistence of EBV and HTTVs in particular, may be associated with periodontitis. Possible mechanisms of the interaction between herpesviruses and anelloviruses in the context of periodontitis require further investigation.

Expression of mast cell in aggressive periodontitis.

Aggressive periodontitis is a progressive disease that can cause tooth loss within a short period of time. Mast cells are found in tissues with various allergic and inflammatory conditions including periodontal disease through the release of cytokines, chemokines, and proteolytic enzymes. Given the findings of some studies on the related role of mast cells, this study was conducted to determine the number of mast cells in aggressive periodontitis. This study was conducted on 30 participants divided into two groups visiting the Faculty of Dentistry of University of Medical Sciences. A total of 15 participants with aggressive periodontitis and 15 healthy participants were investigated. For counting mast cells, toluidine blue staining was used. The percentage of mast cells and demographic factors were evaluated in the two groups and the results were analyzed in SPSS using descriptive statistics and independent t-tests. A P value <0.05 was considered significant. The mean percentage of mast cells in the aggressive periodontitis group was 27.1±8.9 which was significantly higher than that of the healthy group, i.e. 12.6±5.1 (P<0.001). In general, the results of the study showed that the percentage of mast cells in the aggressive periodontitis group was more than two times higher than that of the healthy group, which is indicative of an increase in the number of mast cells in aggressive periodontitis disease.

Comparative evaluation of expression of VEGF (vascular endothelial growth factors) in periodontal tissues of healthy, chronic and aggressive periodontitis patients: an immunohistochemical study

Periodontitis is a chronic inflammatory disease of the vascularized supporting tissues of the teeth. Angiogenesis (neovascularization) is the budding of new capillaries and is thought to be an essential process in the development of chronic inflammatory diseases. Inflamed tissues (such as gingiva coincident in periodontal disease) have evidence of enhanced expression of inflammatory mediators, many of which can promote angiogenesis. Of the various cytokines and growth factors that are involved in angiogenesis, the most potent agent that acts specifically on vascular epithelium is Vascular Endothelial Growth Factor. Even though angiogenesis is a prominent feature of both inflammation and healing, information about its role in periodontal lesions is limited. Hence the aim of the present study was the immunohistochemical evaluation of the expression of VEGF in the gingival tissues of chronic and aggressive periodontitis patients compared to the healthy controls. The present study was carried out in a total of 45 subjects with age range of 18-55 years, reporting to the Department of Periodontology, Rajarajeswari Dental College and Hospital, Bangalore. Gingival tissue samples were collected from all the 45 subjects and categorized into three groups based on their clinical findings as follows: Group 1 (Healthy), Group II (Chronic Periodontitis), Group III (Aggressive Periodontitis). Following sample collection, immunohistochemical staining of tissues was carried out and evaluation was done to compare the grades of expression of VEGF in the three groups. The expression of VEGF in blood vessels was also quantitatively evaluated. The results were statistically analyzed using Kruskal Wallis ANOVA and Mann Whitney test. There was a statistically significant higher expression of VEGF in both chronic periodontitis and aggressive periodontitis group as compared to the control group. Aggressive periodontitis cases showed higher grades of expression of VEGF compared to the chronic periodontitis cases and healthy controls. However, the difference in expression of VEGF was not statistically significant between the two forms of periodontitis. The presence of VEGF in both chronic and aggressive periodontitis clearly indicates the potent role played by VEGF as an inflammatory agent in the initiation and progression of periodontal diseases. Thus, VEGF might be used as a potential vascular marker for the assessment of severity and inflammatory status in periodontal disease.

Gingival recession after scaling and root planing with or without systemic metronidazole and amoxicillin: a re-review.

Gingival recessions inevitably occur during healing after scaling and root planing, but synoptic data on this topic is still lacking. This review compared the recession formation with and without the administration of systemic antibiotics. To evaluate the formation of recession with and without the administration of antibiotics during the healing after scaling and root planing. This study re-analyzed publications that reported clinical attachment levels (CAL) and probing pocket depths (PD) up to January 2019, including the pivotal review by Zandbergen and co-workers (2013). Whereas these studies traditionally focused on PD and CAL, the present analysis compared recession formation (ΔREC) after adjunctive systemic administration of amoxicillin (amx) and metronidazole (met) during scaling and root planing (SRP) and SRP alone. The mean increase in ΔREC, if not reported, was calculated from CAL and PD values and statistically analyzed. Recession formation was compared after 3 and 6months after therapy. Results were separately reported for chronic periodontitis (CP) as well as aggressive periodontitis (AP) cases. Recessions increased consistently between baseline and follow-up. In the AP group, median ΔREC was 0.20mm after 3months, irrespective of whether antibiotics were administered or not. After 6months, median ΔREC increased to 0.35mm after AB and remained stable at 0.20mm with SRP alone. In the CP group, after 3months with and without antibiotics, median ΔREC accounted for 0.30mm and 0.14mm, respectively. After 6months, median ΔREC accounted for 0.28mm (with AB) and 0.20mm (without AB). The quantitative assessment by meta-analyses also yielded small values (≤ 0.25mm) for the estimated differences in recession formation between AB and noAB; however, none of them reached statistical significance. Although a slight tendency towards higher recession formation after SRP in combination with AB could be observed in many studies, quantitative meta-analyses showed no clinically relevant difference in recession formation due to the administration of AB. In general, the description and discussion of recessions in the literature seems not to be a major focus so far. Since the preservation of gingival tissues is important by preventive and therapeutic means, e.g., when avoiding postoperative root sensitivity or performing regenerative surgery, these aspects should not be neglected. We thus suggest to report REC measurements along with PD and CAL values for more direct recession formation (ΔREC) assessments in the future.

Triclosan toothpaste as an adjunct therapy to plaque control in children from periodontitis families: a crossover clinical trial.

Studies have demonstrated that children from aggressive periodontitis (AgP) parents presented precocious alterations in their periodontal condition, and the use of chemical agents in association to plaque control could be useful to control these alterations. This study aimed to evaluate the effect of Triclosan toothpaste to modulate the clinical and subgingival condition in children from AgP parents. Fifteen children from AgP parents and 15 from periodontally healthy parents were included in this crossover placebo study. Children were randomly allocated into triclosan or placebo therapy, using selected toothpaste for 45 days. After 15 days of wash-out, groups were crossed, changing the used toothpaste. Clinical examination and saliva, crevicular gingival fluid (GCF), and subgingival biofilm collection were performed at baseline and 45 days of each phase. GCF cytokines' levels were analyzed by Luminex/MAGpix platform and subgingival and salivary periodontal pathogens' levels by qPCR. At baseline, AgP group presented higher plaque index (PI), gingival index (GI), and bleeding on probing (BoP), higher Aggregatibacter actinomycetemcomitans (Aa) abundance in saliva and subgingival biofilm, and lower levels of INF-ɣ, IL-4, and IL-17 in GCF. Placebo therapy only reduced PI in both groups. Triclosan toothpaste reduced PI and GI in both groups. Triclosan promoted reduction of BoP and probing depth (PD), Aa salivary, and IL-1β levels in AgP group. In health group, triclosan reduced INF-ɣ and IL-4 concentration. Triclosan toothpaste demonstrated to be more effective than placebo toothpaste to control the periodontal condition in children from AgP parents, by reducing the BoP, PD, salivary Aa, and IL-1β. Triclosan toothpaste can improve oral conditions in higher-risk population for AgP. This study was registered at ClinicalTrials.gov with the identifier NCT03642353.

Clinical and Microbiological Profiles of Aggressive and Chronic Periodontitis in Congolese Patients: A Cross-sectional Study.

ABSTRACTBackground:Chronic and aggressive periodontitis were the main forms of periodontitis according to the 1999 classification of periodontal diseases and conditions. Their profile in Congolese patients is still undescribed.Aim:The aim of this study was to compare the profile of chronic periodontitis (ChP) with that of aggressive periodontitis (AgP) in Congolese patients.Materials and Methods:Thirty-two patients with ChP and 20 with AgP who consulted the dental services at any of the four medical centers in Kinshasa, from April 2017 to April 2018, were enrolled in the cross-sectional study. All patients underwent a full mouth examination, including assessment of the probing pocket depth and clinical attachment level at six sites per tooth. Microbial samples were collected in the deepest pocket in the maxilla and the deepest pocket in the mandible. A deoxyribonucleic acid (DNA) analysis was performed using DNA strip technology. Fisher exact test, the chi-square test, the t test, and the Mann–Whitney test were used for the statistical analysis.Results:Patients with AgP were significantly younger than those with ChP (P < 0.001). There was no significant difference in the prevalence of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, or Prevotella intermedia between the AgP and ChP groups (P > 0.05). Aggregatibacter actinomycetemcomitans was detected in 10% of cases in the AgP group and in none of those in the ChP group (P = 0.143).Conclusion:This study shows that the clinical profiles of ChP and AgP are similar in Congolese patients. There were no microbiological differences between these two forms of periodontitis.

Immunohistochemical evaluation of CD117 in mast cell of aggressive periodontitis.

Context:Aggressive periodontitis is a type of inflammatory response in periodontal tissues that is differentiated from chronic by its earlier onset, its high rate of progression, subgingival microbial composition, the difference in the host's immune response, and family history of the disease. Mast cells live in tissues and contribute to the various allergic and inflammatory conditions, including periodontal diseases, through the release of cytokines, chemokines, and proteolytic enzymes. CD117, the receptor of the stem cell factor expressed by the mast cells, is the hallmark of mast cell development. This study aimed to determine the expression level of CD117 in the mast cells of aggressive periodontitis using immunohistochemistry.Aims:This study aimed to determine the expression level of CD117 in the mast cells of aggressive periodontitis using immunohistochemistry.Subjects and Methods:The study was conducted on tissue samples from 15 patients with aggressive periodontitis and 15 patients with healthy gingival tissue. Samples were stained for CD117 markers using immunohistochemistry. After the microscopic examination of samples, all data were entered into SPSS 20 and analyzed.Statistical Analysis Used:Statistical data were analyzed using Kolmogorov–Smirnov test and independent t-test.Results:According to the results, the mean expression levels of CD117 in the aggressive periodontitis and normal gingival groups were 19.08 ± 6.9 and 18.2 ± 8.1, respectively, which were not statistically significant (P = 0.75). The Kolmogorov–Smirnov test verified the normality of distribution of CD117 expression level. Given the normal distribution of the scores, the independent t-test was used to compare the CD117 expression level in the two study groups.Conclusions:There was no significant difference in the level of CD117 expression between the control and aggressive periodontitis groups.

Is sialic acid a promising marker for periodontal diseases?

Periodontal diseases are inflammatory chronic infections. Sialic acid (SA) is an acute phase reactant by itself. The aim of this study is to investigate the relationship between salivary and serum SA levels and clinical parameters in different forms of periodontal diseases. Systemically healthy subjects were included in the study; patients with chronic gingivitis (CG) (n = 10), chronic periodontitis (CP) (n = 10), and aggressive periodontitis (AgP) (n = 10), and ten volunteers with healthy periodontium as the control group. Total SA levels were determined by Warren's thiobarbituric acid method in whole saliva, parotis saliva, and serum samples of subjects before and 3 months after nonsurgical periodontal treatment. Full mouth clinical parameters including plaque index, gingival index, probing depth, and bleeding on probing were also recorded. Before treatment, in both periodontitis groups salivary and serum SA levels were higher than those of controls (P = 0.001). Both salivary and serum SA levels decreased significantly in the patient groups after treatment (P < 0.001). Multiple comparisons of baseline clinical parameters in all groups revealed significant differences (P = 0.001) and these parameters decreased significantly on the 90th day (P < 0.01). There were positive correlations between SA levels and periodontal indices of the CG, CP, and AgP groups (P < 0.05). Our results suggest that SA level in both saliva and serum may be a potentially useful marker to determine inflammatory changes and investigate different forms of periodontal diseases.

The Association Between Some Macro and Trace Elements in Saliva and Periodontal Status.

Changes in the macro and trace element composition of saliva might be indicative for pathological changes in periodontal tissues. However, there is a lack of evidence in the literature showing associations between mineral elements and periodontal status. The aim of this study was to determine whether such associations occur. Totally, 190 systemically healthy non-smoker participants (mean age 32.2 ± 6.02; 50 periodontally healthy, 50 gingivitis, 50 chronic periodontitis, and 40 aggressive periodontitis individuals) were included in this cross-sectional study. Salivary levels of some macro and trace elements were measured by using inductively coupled plasma mass spectrometry (ICP-MS). Kruskal-Wallis's test was used for statistical analysis. Statistically significant differences were found in sodium (Na), magnesium (Mg), potassium (K), calcium (Ca), vanadium (V), chromium Cr), manganese (Mn), iron (Fe), rubidium (Rb), strontium (Sr), and selenium (Se) concentrations among the groups. Significant increases in the essential minerals Na, Mg, K, Ca, Fe, and Se occurred in both periodontitis groups when compared to the gingivitis and periodontally healthy groups. Lower Se, Sr, Fe, Mn, and V concentrations were found in the aggressive periodontitis group than in the chronic periodontitis group. The results of this study demonstrated that assessment of mineral element concentrations in saliva might be useful in assessing periodontal health and disease. However, further studies are required to determine whether the change in a specific mineral element is the result of periodontal disease or is involved in its pathogenesis.

Differential expression of inflammasome regulatory transcripts in periodontal disease

The inflammasome modulates the release of key proinflammatory cytokines associated with periodontal disease pathogenesis. The aim of this study was to evaluate the expression of proteins that regulate the inflammasome, namely pyrin domain-only proteins (POPs), caspase activation recruitment domain (CARD)-only proteins, and tripartite motif-containing (TRIM) proteins, in periodontal diseases. A total of 68 participants (34 males and 34 females) were divided into four groups, including periodontal health (H), gingivitis (G), chronic periodontitis (CP), and aggressive periodontitis (AgP) based on clinical parameters. Gingival tissue samples were obtained from all participants for reverse transcription polymerase chain reaction (RT-PCR)-based gene expression analyses of molecules that regulate the inflammasome, including apoptosis-associated speck-like protein (ASC) containing CARD, caspase-1, interleukin-1β (IL-1β), interleukin-18 (IL-18), nucleotide-binding domain, leucine rich family (NLR) pyrin domain containing 3 (NLRP3), NLR family pyrin domain containing 2 (NLRP2), AIM2 (absent in melanoma 2), POP1, POP2, CARD16, CARD18, TRIM16, and TRIM20 by RT-PCR. NLRP3 and IL-1β were upregulated in the G, CP, and AgP groups compared with group H (P<0.05). AIM2 was downregulated in the CP group compared with the H, G, and AgP groups (P<0.05). TRIM20, TRIM16, and CARD18 were downregulated in the G, CP, and AgP groups compared with the H group (P<0.05). POP1 and POP2 were downregulated in the CP and AgP, and AgP and G groups, respectively (P<0.05). Active periodontal disease may result in downregulation of inflammasome regulators that may increase the activity of NLRP3 and IL-1β in periodontal disease.

Human leukocyte antigen-G polymorphisms in periodontitis

Objective: This study evaluated human leucocyte antigen-G gene polymorphisms in patients with periodontitis and healthy controls.Material and methods: The insertion/deletion polymorphism of 14 bp and a single nucleotide polymorphism (SNP) C > G on the position +3142 of the 3′ untranslated region of the gene were analyzed in chronic periodontitis (n = 62), aggressive periodontitis (n = 24) patients and healthy individuals (n = 47).Results: Considering the 14 bp insertion/deletion, a significant deviation from Hardy-Weinberg expectations in the chronic periodontitis group was observed, but not in the other groups. No significant deviations were observed in patients and control groups considering the +3142 C > G SNP. A significant increased frequency of homozygotes for the 14 bp deletion allele was observed in the chronic periodontitis group as compared to controls. This group also presented a higher frequency of the deletion allele, which was marginally not significant. Concerning this polymorphism, no significant differences were observed between the aggressive periodontitis and healthy control groups. In addition, no significant differences were seen amongst patients and controls when considering the +3142 C > G frequencies.Conclusion: No differences were found amongst patients and controls when considering the +3142 C > G SNP haplotypes frequencies, but a significant increased frequency of homozygotes for the 14 bp deletion allele was observed in chronic periodontitis patients compared to healthy controls, suggesting a susceptibility role of this polymorphism in the pathogenesis of this condition.