Cause Of Tooth Loss Research Articles

Curry Leaf Triggers Cell Death of P. gingivalis with Membrane Blebbing.

Periodontal disease has become a serious public health problem, as indicated by accumulating evidence that periodontal disease is not only a major cause of tooth loss but is also associated with various systemic diseases. The present study assessed the anti-bacterial activities of three herbal products (curry leaf, clove, and cinnamon) against Porphyomonas gingivalis, a keystone pathogen for periodontal diseases. The curry leaf extract (CLE) showed the strongest growth inhibitory activity among them, and the activity was maintained even after extensive heat treatment. Of note, while clove and cinnamon extracts at sub-minimum inhibitory concentrations (sub-MICs) significantly enhanced the biofilm formation of P. gingivalis, CLE at sub-MIC did not have any effect on the biofilm formation. The MIC of CLE against P. gingivalis was higher than those against a wide range of other oral bacterial species. P. gingivalis cells were completely killed within 30 min after treatment with CLE. Spatiotemporal analysis using high-speed atomic force microscopy revealed that CLE immediately triggered aberrant membrane vesicle formation on the bacterial surface. Bacterial membrane potential assay revealed that CLE induced depolarization of the bacterial membrane. Taken together, these findings suggest the mechanism behind early bactericidal activity of CLE and its therapeutic applicability in patients with periodontal diseases.

Tooth Elongation of Maxillary Second Premolars and Mandibular Third Molars and Associated Periodontal Disease in Horses: A Retrospective Study.

Periodontal disease has been identified in horses and donkeys through the millennia at a prevalence of up to 75% and is a leading cause of tooth loss in horses. We hypothesize that there is a correlation between tooth elongations and periodontal disease. Dental records of all client owned horses examined by a single AVDC/equine board certified practitioner in 2016-2018 were analyzed. Inclusion criteria consisted of the examination finding of tooth elongation of one of the following teeth pairs 106/107, 206/207, 310/311, or 410-411. The included cases were then examined for the finding of periodontal disease in Stages 1-4 (PD 1-4). Bayesian correlation analysis revealed significant positive correlations of elongations and periodontal disease existed between PD1 and proximal tooth pairs 106-107 and 206-207, PD2 and PD4 with all four tooth pairs, and PD3 with 106-107. Clinically, early diagnosis and treatment of newly formed elongations, or prevention of their formation altogether through diligent dental prophylaxis could prove key in preservation of teeth through prevention of the associated development of periodontal disease in the horse.

Periodontal disease-related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral-liver axis.

Periodontal disease, a chronic inflammatory disease of the periodontal tissues, is not only a major cause of tooth loss, but it is also known to exacerbate/be associated with various metabolic disorders, such as obesity, diabetes, dyslipidemia, and cardiovascular disease. Recently, growing evidence has suggested that periodontal disease has adverse effects on the pathophysiology of liver disease. In particular, nonalcoholic fatty liver disease, a hepatic manifestation of metabolic syndrome, has been associated with periodontal disease. Nonalcoholic fatty liver disease is characterized by hepatic fat deposition in the absence of a habitual drinking history, viral infections, or autoimmune diseases. A subset of nonalcoholic fatty liver diseases can develop into more severe and progressive forms, namely nonalcoholic steatohepatitis. The latter can lead to cirrhosis and hepatocellular carcinoma, which are end‐stage liver diseases. Extensive research has provided plausible mechanisms to explain how periodontal disease can negatively affect nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, namely via hematogenous or enteral routes. During periodontitis, the liver is under constant exposure to various pathogenic factors that diffuse systemically from the oral cavity, such as bacteria and their by‐products, inflammatory cytokines, and reactive oxygen species, and these can be involved in disease promotion of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Also, gut microbiome dysbiosis induced by enteral translocation of periodontopathic bacteria may impair gut wall barrier function and promote the transfer of hepatotoxins and enterobacteria to the liver through the enterohepatic circulation. Moreover, in a population with metabolic syndrome, the interaction between periodontitis and systemic conditions related to insulin resistance further strengthens the association with nonalcoholic fatty liver disease. However, most of the pathologic links between periodontitis and nonalcoholic fatty liver disease in humans are provided by epidemiologic observational studies, with the causal relationship not yet being established. Several systematic and meta‐analysis studies also show conflicting results. In addition, the effect of periodontal treatment on nonalcoholic fatty liver disease has hardly been studied. Despite these limitations, the global burden of periodontal disease combined with the recent nonalcoholic fatty liver disease epidemic has important clinical and public health implications. Emerging evidence suggests an association between periodontal disease and liver diseases, and thus we propose the term periodontal disease–related nonalcoholic fatty liver disease or periodontal disease–related nonalcoholic steatohepatitis. Continued efforts in this area will pave the way for new diagnostic and therapeutic approaches based on a periodontologic viewpoint to address this life‐threatening liver disease.

3-D tooth movement adjacent to single anterior implants and esthetic outcome. A 14- to 20-year follow-up study.

To report three-dimensional (3-D) movement of teeth adjacent to single-implant crowns (SICs) in the anterior maxilla and to relate the findings to patient characteristics and esthetic outcome. 3-D movements of teeth adjacent to anterior maxillary SICs were measured in 30 patients with original SICs in function after 14-20years. The movements were related to facial type, lower anterior facial height (LAFH), age at crown delivery, sex, the position of the implant, implant occlusion, cause of tooth loss, follow-up period, orthodontic treatment prior to implant placement, and marginal bone-level changes. The esthetic outcome and quality were assessed using Visual Analog scale (VAS) and California Dental Association (CDA) index. 3-D movement of adjacent teeth between 0 and 2.5mm was observed at follow-up with incisal and palatal movement being most pronounced. Incisal tooth movement of >1mm was observed in 30% of the patients and was significantly associated with LAFH ≥70mm. VAS rating associated poorly between patients and clinicians with scores of >80% in 63% and 20%, respectively. The CDA rating was assessed as satisfactory in 87% of the patients. Significantly more extensive infraposition was observed in patients with SICs without occlusion, other causes of tooth loss than trauma, implant in lateral incisor and canine position, and a LAFH of ≥70mm. Although infraposition occurs, patients are highly satisfied with the esthetics of their implants and the esthetic results are valued as higher by patients than dentists.

Galectin-7 promotes proliferation and wound healing capacities in periodontal ligament fibroblasts by activating ERK signaling

Periodontitis is a progressive inflammation condition and a primary cause of tooth loss in adults. As one of the abundant cell types in the periodontium, periodontal ligament fibroblasts (PDLFs) play an integral role in the maintenance and regeneration of periodontal tissue. Our previous work has shown that the application of Er:YAG laser increased the cell proliferation and migratory capacity of PDLFs via induction of galectin-7. In the present study, we aimed to evaluate if the forced expression of galectin-7 directly affected the cellular phenotypes of PDLFs. Our results showed that the cell proliferation, transwell migration, invasion, and wound healing capacities were all upregulated in PDLFs with the ectopic expression of galectin-7. These results suggest that therapeutic approaches to enhance the expression of galectin-7 in periodontium may accelerate tissue regeneration by recruiting more PDLFs to the injured site.

Treatment Of Inflammatory Bone Loss in Periodontitis By Stem Cell-Derived Exosomes

Periodontitis is the primary cause of tooth loss, but there is no effective treatment to repair inflammatory bone loss in periodontitis. Exosomes emerge as essential paracrine factors of mesenchymal stem cells (MSCs) that mediated tissue regeneration. Here, we investigated the potential of exosomes secreted by periodontal ligament stem cells (PDLSCs) as therapeutics for the bone defect in periodontitis. Exosomes secreted from PDLSCs derived from healthy periodontal ligaments (h-PDLSCs) and their function were evaluated on PDLSCs isolated from the inflammatory periodontal ligament of periodontitis patients (i-PDLSCs). Treatment of exosomes of h-PDLSCs led to an increase in the formation of mineralized nodules and the expressions of osteogenic genes and proteins in i-PDLSCs. Mechanistically, h-PDLSCs-exosomes suppressed the over-activation of canonical Wnt signaling to recover the osteogenic differentiation capacity of i-PDLSCs. To evaluate the therapeutic of exosomes on inflammatory bone loss, h-PDLSCs-exosomes loaded with Matrigel or β-TCP were employed to repair bone defects in rat models of periodontitis. Compared to the vehicle-treated control group, h-PDLSCs-exosomes-treated rats resulted in more bone formation in the defect of alveolar bone. In conclusion, these results demonstrated that exosomes derived from healthy PDLSCs could rescue the osteogenesis capacity of endogenous stem cells under an inflammatory environment and promote regeneration of alveolar bone. Our findings suggest that MSCs-derived exosome is an effective and practical cell-free MSC therapeutic for the treatment of periodontitis.

Study Of Awareness Of Pupils About Methods For Preventing Dental Caries

Caries is the leading cause of tooth loss in the adult population. The terminology of the early stage of caries is rather contradictory and is designated as “initial caries”, “enamel caries”, “focal demineralization of enamel”, “caries in the stain stage”, “chalky spots” [2,7,9]. Caries is currently being interpreted as a chronic infectious disease. It has been proven that the initial forms of carious lesions can be cured by non-surgical methods [10,18,20]. Therefore, the optimization of the activities of a pediatric dentist in a school stationary dental office is an urgent task, it brings the provision of the primary level of specialized dental care as close as possible to the territory of compact residence of children, improves the availability, timeliness of treatment and prevention of dental caries. Thus, timely diagnosis and treatment of early forms of caries is an urgent problem in dentistry, especially in pediatric dentistry.

A Porphyromonas gingivalis Capsule-Conjugate Vaccine Protects From Experimental Oral Bone Loss.

Periodontal diseases are chronic inflammatory diseases of the periodontium that result in progressive destruction of the soft and hard tissues supporting the teeth, and it is the most common cause of tooth loss among adults. In the US alone, over 100 million individuals are estimated to have periodontal disease. Subgingival bacteria initiate and sustain inflammation, and, although several bacteria have been associated with periodontitis, Porphyromonas gingivalis has emerged as the key etiological organism significantly contributing to the disease. Currently, intensive clinical maintenance strategies are deployed to mitigate the further progression of disease in afflicted individuals; however, these treatments often fail to stop disease progression, and, as such, the development of an effective vaccine for periodontal disease is highly desirable. We generated a conjugate vaccine, comprising of the purified capsular polysaccharide of P. gingivalis conjugated to eCRM®, a proprietary and enhanced version of the CRM197 carrier protein with predetermined conjugation sites (Pg-CV). Mice immunized with alum adjuvanted Pg-CV developed robust serum levels of whole organism-specific IgG in comparison to animals immunized with unconjugated capsular polysaccharide alone. Using the murine oral bone loss model, we observed that mice immunized with the capsule-conjugate vaccine were significantly protected from the effects of P. gingivalis-elicited oral bone loss. Employing a preclinical model of infection-elicited oral bone loss, our data support that a conjugate vaccine incorporating capsular polysaccharide antigen is effective in reducing the main clinical endpoint of periodontal disease—oral bone destruction. Further development of a P. gingivalis capsule-based conjugate vaccine for preventing periodontal diseases is supported.

Research hotspots and trends of microRNA in periodontology and dental implantology: a bibliometric analysis

BackgroundPeriodontal disease is a leading cause of tooth loss, and microRNA (miRNA) has been shown to regulate various biological processes. This study aimed to quantitatively analyze the literature related to miRNA in periodontology and dental implantology and summarize the research hotspots and trends in this field.MethodsLiterature records from 1985 to 2020 were obtained from the Web of Science Core Collection database. After manual selection, the data was used for cooperative network analysis, keyword co-occurrence analysis, and reference co-citation analysis and visualized by CiteSpace.ResultsA total of 287 papers were analyzed between 2007 and 2020, and more than 95% of them were published in the past decade. The largest number of publications were from China, followed by the USA and Japan. The direct cooperation among the productive institutions was not close. At present, most of the research belongs to the discipline of dentistry, oral surgery, cell biology, and molecular biology. Literature clusters generated by reference co-citation analysis and keyword co-occurrence network showed that previous studies mainly focused on four hotspots: periodontal ligament stem cells (PDLSCs), the pathological process of periodontitis, osteogenic differentiation/bone regeneration, and the competing endogenous RNA (ceRNA) network.ConclusionsThe therapeutic potential of miRNA in promoting bone formation and how the ceRNA network contributes to miRNA regulation at a deeper level have become the two main research trends of this field.

Gold Standards in Periodontics: A Review

The field of dentistry has evolved where people expect the best oral health care from specialists. Periodontics is that specialty of dentistry which deals with prevention, diagnosis, and treatment of diseases of the supporting tissues of the teeth. Almost half of the world's population is suffering from periodontal diseases. Periodontitis is the sixth most common chronic diseases in the world and along with dental caries, the most common cause of tooth loss. Through the effort of various professional organisations and research, various reliable products and treatment modalities have been developed. A gold standard is a benchmark which has been thoroughly tested and has reputation as a reliable modality. Some of established gold standards in periodontics include: periodontal probing, measurement of clinical attachment loss, bone loss, cone beam computed tomography, quantitative polymerase chain reaction tests, biopsies as investigative techniques; periodontal debridement, subepithelial connective tissue graft for recession coverage, lasers, autogenous bone in alveolar ridge augmentation prior to oral implantation, dental implant as reconstruction of missing dentition, and chlorhexidine mouth wash as treatment options. The objective of the review is to provide critical evaluation of the data available from existing studies in Periodontics which can help identify potential research areas to explore.

The feasibility of phage therapy for periodontitis.

Periodontitis, a chronic progressive inflammation caused by plaque biofilm, is the main cause of tooth loss in adults. For certain refractory periodontitis cases, it is difficult to achieve a good curative effect using the existing periodontal treatment approaches, which may be due to periodontal pathogenic mechanism in the affected periodontal tissue that the host cannot resist and eliminate. Various pieces of evidence collectively revealed that most studies are focusing on phages in periodontal disease. Several studies have reported periodontitis treatment using phage therapy, highlighting its features including specificity, rapid propagation, and effectiveness on bacteriophage biofilms. In this study, we focus on these reports, aiming to lay the foundation for improved periodontal treatment approaches.

Dental injuries in paediatric mandibular fracture patients

PurposeDental injuries (DIs) are associated with facial fractures, particularly mandibular fractures. As paediatric mandibular fractures have special features, we sought to clarify the occurrence and types of DIs among this patient group. We assessed how age, injury type, and fracture location affects the occurrence of DIs and thereby defined which patients are most susceptible.MethodsThis retrospective study included patients < 18 years with a recent mandibular fracture. Predictor variables were gender, age group, mechanism of injury, type of mandibular fracture, and other associated facial fracture(s). Types and locations of DIs and tooth loss due to injury were also reported.ResultsDIs were detected in 34.7% (n = 41) out of 118 patients. Patients with tooth injury had on average 3.5 injured teeth. A total of 16.2% of injured teeth were lost, typically at the time of the injury. Loss of at least one tooth was seen in approximately 10% of patients. Avulsion was the most common cause of tooth loss (52.2%). Non-complicated crown fracture (50.7%) was the most common DI type. Statistically significant associations between studied variables and DIs were not detected.ConclusionDIs are common and often multiple in paediatric mandibular fracture patients regardless of background factors. DIs often lead to tooth loss. Prompt replantation of an avulsed tooth, early detection of DIs, and prevention of tooth loss whenever possible are important to avoid permanent tooth defects.

Противовоспалительная cистемная фармакотерапия пародонтита (обзор литературы)

Проведен поиск в базах данных Scopus, Web of Science, MedLine, The Cochrane Library. Заболевания пародонта — основная причина потери зубов. Пародонтит — воспалительное заболевание, которое вызывается специфической микрофлорой и приводит к прогрессирующему разрушению связочного аппарата зуба и альвеолярной кости. Это сопровождается образованием рецессии десны, формированием пародонтальных карманов как отдельно, так и обоюдно. Пародонтит отмечается у 9–85 % детей, 70–90 % подростков, более чем у половины взрослых людей. Активация воспаления в пародонте неразрывно связана с системными процессами в организме, сопровождающимися воспалительным ответом, и потому пародонтит является сопутствующим фактором при ишемической болезни сердца и цереброваскулярных заболеваниях/ишемическом инсульте, негативно влияет на пищеварительную, сердечно-сосудистую, эндокринную и другие системы организма. Неконтролируемый воспалительный ответ организма в условиях микробной биопленки, которая плотно прилегает к поверхности зуба, приводит к разрушению тканей пародонта, потере костной ткани. Если острое воспаление своевременно стихает, предотвращая деструкцию, но не происходит полного восстановления гомеостаза тканей, это приводит к повреждениям, вызванным нейтрофилами, и хроническому воспалению. Системная противо-воспалительная терапия с использованием неселективных нестероидных противовоспалительных лекарственных средств является важным направлением терапии пародонтита, что обеспечивает снижение интенсивности воспаления, минимизирует разрушение тканей пародонта, ограничивает ресурс питательных веществ для патогенных микроорганизмов, предупреждает резорбцию альвеолярной кости. Для профилактики гастропатии целесообразно в комплексе терапии применять синтетический аналог простагландина E2 мизопростол. Менеджмент взаимодействия лекарственных средств целесообразно проводить в случае назначения нестероидных противовоспалительных лекарственных средств пациенту, который принимает производные сульфонилмочевины, варфарин, антигипертензивные лекарственные средства и др.

PLGA hybrid porous microspheres as human periodontal ligament stem cell delivery carriers for periodontal regeneration

Periodontitis, a widespread disease, is the main cause of tooth loss in adults, and there is no ideal clinical therapy for patients with severe alveolar bone defects. Research investigating the potential of polymer porous microspheres (PMs) as stem cells delivery carriers has been a hot-spot topic for tissue engineering in recent years. However, to date, it remains largely unknown regarding application of PMs in periodontal regeneration with satisfied cell seeding efficiency. In this study, PLGA PMs and corresponding silk fibroin (SF) or / and hydroxyapatite (HA) modified PLGA counterparts were synthesized by double emulsion-solvent evaporation, desolvation and biomineralization. Then, human periodontal ligament stem cells (hPDLSCs) were seeded into these carriers with a specific “cell perfusion” technique. Cell viability and migration, proliferation as well as osteogenic differentiation properties of the hPDLSCs were evaluated in vitro. In vivo experiment examining the impact of hPDLSCs suspension group and four cell delivery carriers groups on rat periodontal tissue regeneration further suggested that the HA-SF-PLGA group displayed superior tissue repairing efficacy due to SF-dependent high adhesion and HA-dependent osteogenesis induction. This novel tissue regeneration strategy based on PLGA hybrid PMs combined with a specific “cell perfusion” technique present promising potential of local stem cell delivery for effective clinical periodontitis therapy development, which is also applicable to tissue regeneration in other body parts.

Predictive Periodontitis: The Most Promising Salivary Biomarkers for Early Diagnosis of Periodontitis.

The primary cause of tooth loss in the industrialized world is periodontitis, a bacterial anaerobic infection whose pathogenesis is characterized by composite immune response. At present, the diagnose of periodontitis is made by a complete status check of the patient’s periodontal health; full-mouth plaque score, full-mouth bleeding score, probing depth, clinical attachment level, bleeding on probing, recessions, mobility, and migration are evaluated in order to provides a clear picture of the periodontal conditions of a single patient. Chair-side diagnostic tests based on whole saliva could be routinely used by periodontists for a very early diagnosis of periodontitis, monitoring, prognosis, and management of periodontal patients by biomarker detection, whose diagnostic validity is related to sensitivity and specificity. Recent paper reviews and meta-analyses have focused on five promising host derived biomarkers as candidate for early diagnosis of periodontitis: MMP-8 (Metalloproteinase-8), MIP-1α (Macrophage inflammatory protein-1 alpha), IL-1 β (Interleukin-1 beta), IL-6 (Interleukin-6), and HB (Hemoglobin), and their combinations. Chair-side Lab-on-a-chip (LOC) technology may soon become an important part of efforts to detect such biomarkers in saliva medium to improve worldwide periodontal health in developed nations as well as in underserved communities and poor countries. Their applications in preventive and predictive medicine is now fundamental, and is aimed at the early detection of risk factors or the presence or evolution of the disease, and in personalized medicine, which aims to identify tailor-made treatments for individual patients. The aim of the present paper is to be informative about host derived periodontal biomarkers and, in particular, we intend to report information about the most important immune response derived biomarkers and Hemoglobin as candidates to be routinely utilized in order to obtain a chair-side early diagnosis of periodontal disease.

IN VITRO ANALYSIS OF UNIVERSALLY UTILIZED IMPLANT RESTORATIVE DENTAL MATERIAL’S IMPACT ON THE ARCHITECTURAL STABILITY OF GINGIVAL FIBROBLASTS IN THE PRESENCE OF A COMMON ENDOTOXIN

Dental implants have been utilized in the last several decades to replace missing teeth. Various factors may result in the loss of teeth. The most common causes of tooth loss are often caries or periodontal disease. The use of a dental implant restored with a porcelain fused to metal crown is often the standard. The purpose of this study was to assess the architectural integrity of gingival fibroblasts at the cellular level when exposed to universally utilized restorative dental material; porcelain, in the presence of a periodontal pathogen, Porphyromonas gingivalis lipopolysaccharide (LPS-PG). Human gingival fibroblasts were exposed to Porcelain (.1 g) in combination with LPS-PG (10 μL), at 24, 48, and 72 hour durations. When assessing for cellular metabolic activity and viability, no significant differences were noted between the control and experimental groups. Contrastingly, when assessing for oxidative stress, the experimental groups were statistically significantly different from the control at the 48 and 72 hour phases (P&lt;0.001). H&amp;E staining of the experimental groups showed irregular shaped cells with loss of density, vacuolization, coarse cytoplasm, and hyperchromatic nuclei.

Analysis of Periodontitis Biomarker Expression in Gingival Crevicular Fluids

Background: Periodontal disease, also known as gum disease, is a major dental inflammatory disease with a very high prevalence; it is the main cause of tooth loss. Therefore, diagnostic biomarkers that can monitor gum inflammation are important for oral healthcare. Since the gingival crevicular fluid (GCF) adequately reflects changes in the periodontal environment, they have become a target for the development of effective diagnostic biomarkers for periodontitis. In the present study, the level of the target molecules suggested as diagnostic biomarkers for periodontitis were analyzed in GCF samples collected from healthy individuals and periodontitis patients. In addition, useful targets for the diagnosis of periodontitis were evaluated. Methods: GCF samples were collected from healthy individuals and periodontitis patients using absorbent paper points. SDS-PAGE and Coomassie staining were performed for protein analysis. The protein concentrations of GCF specimens were determined using the Bradford method. The levels of the target molecules appropriate for diagnosing periodontal disease were measured by ELISA, according to the manufacturer’s protocol. Results: The protein concentration of GCF collected from periodontitis patients was 3.72 fold higher than that in an equal volume of GCF collected from healthy individuals. ELISA analysis showed that the level of interukin-6 (IL-6), IL-8, metalloproteinases 2 (MMP-2), MMP-9, tumor necrosis factor-alpha (TNF-α), azurocidin, and odontogenic ameloblast-associated protein (ODAM) were higher in the GCF samples from the periodontitis patients than in those from the healthy individuals. However, the level of IL-6 and TNF-α were relatively low (＞ 5 pg/ml). The prostaglandin E2 (PGE2) levels were not significantly different between the two GCF samples. Conclusion: These results indicate that IL-8, MMP-2, MMP-9, azurocidin, and ODAM are potentially useful diagnostic biomarkers for periodontitis; combining multiple biomarkers will improve the diagnostic accuracy of periodontitis.

Tooth loss in complying and non-complying periodontitis patients with different periodontal risk levels during supportive periodontal care

ObjectivesTo evaluate yearly tooth loss rate (TLR) in periodontitis patients with different periodontal risk levels who had complied or not complied with supportive periodontal care (SPC).Materials and methodsData from 168 periodontitis patients enrolled in a SPC program based on a 3-month suggested recall interval for at least 3.5 years were analyzed. For patients with a mean recall interval within 2–4 months (“compliers”) or > 4 months (“non-compliers”) with different PerioRisk levels (Trombelli et al. 2009), TLR (irrespective of the cause for tooth loss) was calculated. TLR values were considered in relation to meaningful TLR benchmarks from the literature for periodontitis patients either under SPC (0.15 teeth/year; positive benchmark) or irregularly complying with SPC (0.36 teeth/year; negative benchmark).ResultsIn both compliers and non-compliers, TLR was significantly below or similar to the positive benchmark in PerioRisk level 3 (0.08 and 0.03 teeth/year, respectively) and PerioRisk level 4 (0.12 and 0.18 teeth/year, respectively). Although marked and clinically relevant in non-compliers, the difference between TLR of compliers (0.32 teeth/year) and non-compliers (0.52 teeth/year) with PerioRisk level 5 and the negative benchmark was not significant.ConclusionA SPC protocol based on a 3- to 6-month recall interval may effectively limit long-term tooth loss in periodontitis patients with PerioRisk levels 3 and 4. A fully complied 3-month SPC protocol seems ineffective when applied to PerioRisk level 5 patients.Clinical relevancePerioRisk seems to represent a valid tool to inform the SPC recall interval as well as the intensity of active treatment prior to SPC enrollment.

Standard of periodontal examination and evaluation during oral diagnosis and treatment

Report of the fourth national oral health survey showed that the prevalence of gingivitis and periodontitis stayed at a high level in Chinese population and the periodontitis was the most common cause of tooth loss in Chinese adults. Therefore, the examination of periodontal health status, disease condition and risk assessment are particularly important. The Society of Periodontology of the Chinese Stomatological Association organized experts of related disciplines to formulate the standard of basic periodontal examination and evaluation during oral diagnosis and treatment, aiming to emphasize the necessity and importance of periodontal health and to improve dental clinicians' abilities in understanding, diagnosis and treatment planning of periodontal disease. As a national and professional standard, it will play an important and practically significant role in conservation of natural teeth and improvement of people's oral health in China.

Polydopamine functionalized mesoporous silica as ROS-sensitive drug delivery vehicles for periodontitis treatment by modulating macrophage polarization

Periodontitis is recognized as the major cause of tooth loss in adults, posing an adverse impact on systemic health. In periodontitis, excessive production of reactive oxygen species (ROS) at the inflamed site culminates in periodontal destruction. In this study, a novel ROS-responsive drug delivery system based on polydopamine (PDA) functionalized mesoporous silica nanoparticles was developed for delivering minocycline hydrochloride (MH) to treat periodontitis. The outer PDA layer and the inner MH of the nanoparticles acted as ROS scavengers and anti-inflammatory agents, respectively. Under the synergistic action of PDA and MH, macrophages were polarized from the pro-inflammatory M1 to the anti-inflammatory M2 phenotype. The in vitro experiments provided convincing evidence that PDA could scavenge ROS effectively, and the expression of pro-inflammatory cytokines was attenuated and the secretion of anti-inflammatory cytokines was enhanced through M1 to M2 polarization of macrophages with the cooperation of MH. In addition, the results obtained from the periodontitis rat models demonstrated that the synergetic effect of PDA and MH prevented alveolar bone loss without causing any adverse effect. Taken together, the results from the present investigation provide a new strategy to remodel the inflammatory microenvironment by inducing the polarization of macrophages from M1 toward M2 state for the treatment of periodontitis.