Gingival Crevicular Fluid Concentrations Research Articles

Effect of non-surgical periodontal therapy on salivary and gingival crevicular fluid concentration of visfatin in periodontal health and disease

Background and objectiveVisfatin, a pleotropic mediator mostly produced by visceral fat, is crucial in controlling the immunological and defensive systems. It serves the roles of a cytokine, an enzyme involved in energy metabolism, and a growth factor. The objective of the present study was to assess the impact of non-surgical periodontal therapy (scaling and root planing) on visfatin concentrations in saliva and gingival crevicular fluid in individuals with Periodontitis (stage-II grade-A) Materials and methods54 individuals were divided into Group A (Periodontally Healthy) and Group B1(Periodontitis baseline) based on periodontal parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and radiographic parameters. After NSPT (SRP), Group B1 patients were recalled after 4 weeks, constituting Group B2 (post NSPT group B1). At baseline and 4 weeks after non-surgical periodontal therapy (SRP), all clinical parameters, salivary and GCF samples were recorded. An ELISA kit was used to measure the levels of visfatin. Using the paired t-test, unpaired t-test, and Pearson's correlation coefficient, data were analysed using SPSS 15. ResultsAfter non-surgical periodontal treatment (SRP), the mean salivary and gingival crevicular fluid concentration of visfatin considerably decreased to a level comparable to periodontal health. In all groups, GCF visfatin concentration was higher than salivary concentration of visfatin. In periodontitis patients, visfatin concentration in GCF was 1.5 times higher than in saliva. ConclusionThe results of this investigation suggest a direct correlation between salivary and gingival crevicular fluid visfatin concentration and periodontal tissue inflammation and disease activity.

Relationship between gingival and peri-implant sulcular fluid active matrix metalloproteinase-8 concentration and clinical indices in healthy and diseased conditions

Aim: The study was to evaluate the active matrix metalloproteinase-8 (aMMP-8) concentration in gingival crevicular fluid (GCF) and in peri-implant sulcular fluid (PISF) in healthy and diseased conditions, before and after non-surgical treatment, and to compare it with the various clinical parameters used to estimate the gingival and peri-implant inflammation. Methods: Plaque index/modified PI (PI/mPI), gingival index/simplified GI (GI/sGI), probing depth (PD), bleeding on probing index/modified BOPI (BOPI/mBOPI), radiographic bone loss/radiographic marginal bone loss (rBL/rMBL), and GCF/PISF samples were evaluated, before and 3 months after non-surgical treatment, GCF/PISF samples were analyzed by a chair-side mouth-rinse test (ImplantSafe®) in combination with a digital reader (ORALyzer®). Results: In all groups, aMMP-8 median levels were statistically higher in the PISF than in GCF and they did not change after treatment. Moreover, it was statistically higher in Group 3 (periodontitis/peri-implantitis) compared to the other groups. A positive correlation of the GCF/PISF and aMMP-8 median concentration was seen with increasing PD and BOPI/mBOPI values. A higher covariation of aMMP-8 mean levels in GCF with PD was found when compared to PISF levels. aMMP-8 mean levels in PISF expressed a higher covariation with increasing grades of sGI, rMBL, and BOPI while aMMP-8 GCF concentration established a better covariation with PD and PI. Conclusions: PISF of sites with peri-implant mucositis and peri-implantitis showed higher levels of aMMP-8 compared to sites with gingivitis and periodontitis. Compared to clinical indices, aMMP-8 concentration in GCF/PISF can be a beneficial adjunctive diagnostic tool for early identification and screening of the risk of peri-implant diseases. After non-surgical therapy, PISF aMMP-8 concentration remained mostly unchanged, while the GCF concentration of aMMP-8 significantly decreased.

Immunological Biomarkers IL-34, MCP-1, and MIP-1α: Age and Sex Associations in Periodontitis Patients

Periodontitis is a common osteolytic disease and the leading cause of adult tooth loss. The disease's susceptibility can be influenced by systemic factors, with age and sex being significant factors. The current study assessed the correlations between interleukins and age and sex in periodontitis patients. A total of 85 periodontitis patients and 40 healthy individuals aged between 18 and 67 years were included to examine statistical correlations between interleukins and age/sex in periodontitis. Using ELISA techniques, levels of IL-34, MCP-1, and MIP-1α in serum and gingival crevicular fluid (GCF) were assessed. Statistical analyses, including the Kruskal-Wallis Test, Mann-Whitney Test, and Chi-square Test, were conducted to ascertain relationships among immunological markers, age, and sex, with significance set at P≤0.05. The results revealed significant age correlations with IL-34 concentrations in serum and GCF, notably increasing in patients aged 40-54. Conversely, no substantial age-based variances were observed in MCP-1 or MIP-1α levels within the patient group. Sex effect on IL-34 production, demonstrating higher levels in patients compared to healthy individuals. Conversely, MCP-1 and MIP-1α levels showed no significant sex-related variations within patients. In conclusion, this study underscores a positive association between age and IL-34 levels in serum and GCF among periodontitis patients. Additionally, it underscores the sex impact on IL-34 production. These findings contribute to comprehending the immunological mechanisms of periodontitis and the role of age and sex in disease susceptibility. Further exploration is needed to assess these findings' implications in tailoring personalized treatment approaches for periodontitis.

Comparative Evaluation of Sclerostin Levels in Gingival Crevicular Fluid of Periodontal Health and Disease before and after Nonsurgical Periodontal Therapy

Abstract Aim: The purpose of this study was to measure the concentration of sclerostin in the gingival crevicular fluid (GCF) before and after 1, 3, and 6 weeks of nonsurgical periodontal therapy (NSPT) in subjects with and without chronic periodontitis. Materials and Methods: An interventional study was conducted among 35 subjects of the age groups of 30–50 years. Subjects were divided into three groups: Group I (10 healthy individuals), Group II (10 gingivitis), and Group III (15 chronic periodontitis only). Clinical parameters assessed were gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL). The GCF samples were collected from all the groups at baseline and in Group III at baseline and 1, 3, and 6 weeks after NSPT using micropipettes. Results: Although the mean sclerostin concentration in GCF (ng/ml) was highest in Group III at baseline (5.41 ± 0.68) and lowest in Group I (4.98 ± 0.46), there was no statistically significant difference (P < 0.05) when intergroup comparison was done. PPD and CAL measured for Group III were 6.93 ± 1.2 and 7.67 ± 1.2, respectively. PI (2.52 ± 0.25) and GI (2.52 ± 0.17) were measured highest in Group III. Conclusion: There was a substantial decrease in the concentration of sclerostin in the GCF of chronic periodontitis patients after 1, 3, and 6 weeks after NSPT. This proves sclerostin to be a responsive measure of inflammation in periodontal destruction.

Soluble Receptor Activator of Nuclear Factor Ligand and Osteoprotegerin Levels in Gingival Crevicular Fluid among Cigarette Smokers and Non-smokers with and without Periodontitis.

This study aimed to measure and compare the levels of soluble receptor activator of nuclear factor ligand (RANKL) and osteoprotegerin (OPG) in the gingival crevicular fluid (GCF), as well as their ratio, in smokers and nonsmokers with periodontitis. Gingival crevicular fluid samples were collected using PerioPaper strips, from 150 individuals, who were categorized into three groups: current smokers with periodontitis stage III grades C and B (n = 50), nonsmokers with periodontitis stages I and II grade A (n = 50), and control healthy individuals (n = 50). The concentrations (pg/mL) of sRANKL and OPG in the GCF were measured by enzyme-linked immunesorbent assays (ELISA). The smokers' group exhibited the highest sRANKL (pg/mL) concentration as a subsequent lead to a higher sRANKL/OPG ratio. The healthy control group exhibited higher OPG and lower sRANKL concentration, subsequently, the sRANKL/OPG ratio was reduced compared with the other study groups. However, there was no statistical significance of sRANKL and its relative ratio between periodontitis stage III grades C and B, periodontitis stages I and II grade A, and healthy control individuals. There was a statistically significant positive moderate correlation between smoking duration (years) and the sRANKL (pg/mL) concentration and a statistically significant negative moderate correlation between OPG (pg/mL) concentration and cigarettes smoked per day. As a result, compared to the other research groups, smokers with periodontitis stage III grades C and B had greater GCF concentrations of sRANKL, lower OPG, and a higher sRANKL/OPG ratio. The difference in OPG (pg/mL) level was statistically significant. However, there was no statistically significant difference in sRANKL (pg/mL) or its relative ratio, sRANKL/OPG, across the groups. A characteristic that sets periodontitis apart is alveolar bone loss. Resorption is induced by RANKL and inhibited by OPG, resulting in a relative ratio. In light of this, the levels of RANKL and OPG may be helpful indicators for monitoring the activity of periodontal disease in both smokers and nonsmokers with and without periodontitis.

Positive correlational shift between crevicular antimicrobial peptide LL-37, pain and periodontal status following non-surgical periodontal therapy. A pilot study

BackgroundPeriodontitis has a high prevalence and uncertain recurrence. Unlike the pro-inflammatory cytokine profile, little is known about the anti-inflammatory cytokine and antimicrobial peptide overview following treatment. The present study aimed to evaluate if any of the antimicrobial peptide LL-37, interleukin (IL) 4, 10 and 6 together with the volume of gingival crevicular fluid (GCF) and total protein concentration in GCF could be used as correlative biomarkers for the severity in periodontitis as well as prognostic factors in the management of the disease.MethodsForty-five participants were recruited and allocated to the healthy (15), Stage I-II (15) or Stage III-IV periodontitis (15) group. Along with periodontal examination, GCF samples were obtained at baseline and 4–6 weeks following scaling and root planing (SRP) for the periodontitis groups. GCF samples were analyzed by ELISA kits to quantify LL-37 and IL-4, -6 and − 10. One-way ANOVA followed by Dunnett’s test was used to determine differences among the three groups at baseline. Two-way ANOVA followed by Sidak’s post-hoc test was used to compare between pre- and post-SRP in the two periodontitis groups.ResultsThe amount of GCF volume was significantly correlated to the severity of periodontitis and decreased following SRP, particularly in the Stage III-IV group (p < 0.01). The levels of LL-37, IL-6, and pain and periodontal clinical parameters were significantly correlated to the severity of periodontitis. IL-4 and IL-10 in the periodontitis groups were significantly lower than the healthy group (p < 0.0001) and barely improved following SRP up to the level of the healthy group.ConclusionsWith the limitations of this study, crevicular LL-37 may be a candidate for a biomarker of periodontitis and the associated pain upon probing.Trial registrationThe study was registered in clinical trials.gov, with number NCT04404335, dated 27/05/2020.

A randomized, double-blind pilot study of analgesic and anti-inflammatory effects of naproxen sodium and acetaminophen following dental implant placement surgery.

Introduction: Post-surgical pain following dental implant placement surgery is typically managed with non-opioid analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. However, the comparative analgesic efficacy of over-the-counter doses of non-steroidal anti-inflammatory drugs and acetaminophen in implant patients is unknown. Therefore, we compared the analgesic and anti-inflammatory effects of naproxen sodium and acetaminophen after surgical placement of one or two dental implants. Methods: Adult patients were treated with naproxen sodium (440mg loading dose +220mg q8h, n = 15) or acetaminophen (1,000mg q6h-max daily dose 3,000mg, n = 15) for 3days after implant placement in a randomized, double-blind design. Pain was assessed on a 0-10 scale every 20min for 6h after study medication treatment. Tramadol (50mg) was available as a rescue medication. Plasma and gingival crevicular fluid (GCF) were collected prior to the surgery and 0, 1, 2, 4, 6, 24, and 72h after surgery for quantification of interleukin (IL)-6, IL-8, and IL-1β levels. Results: Pain scores were significantly lower in patients treated with naproxen sodium compared to those treated with acetaminophen. Inflammatory mediator levels in plasma and gingival crevicular fluid increased after surgery and returned to near baseline levels by 72h. Plasma IL-6 levels were significantly lower 6h after surgery in patients treated with naproxen sodium compared to acetaminophen. No differences in inflammatory mediator concentrations in gingival crevicular fluid were observed between the treatment groups. The number of implants placed and body mass index (BMI) influenced inflammatory mediator concentrations in plasma and gingival crevicular fluid, respectively. Discussion: Naproxen sodium was more effective than acetaminophen in reducing post-operative pain and systemic inflammation following surgical placement of one or two dental implants. Further studies are needed to determine whether these findings are applicable to more complex implant cases and how they affect clinical outcomes following implant placement. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT04694300.

The Influence of Fixed Dental Prostheses on the Expression of Inflammatory Markers and Periodontal Status-Narrative Review.

A dental prosthesis will only be successful if the restoration lasts for a long period and does not cause any illness. The presence of permanent prosthetic restorations has been linked to an increased risk of periodontal infections, according to a large body of research that has been gathered. When chronic inflammation is brought on by fixed prosthetic constructions, both cellular and noncellular immunity are activated as adaptive immune mechanisms. It has previously been stated that both clinically adequate and inadequate restorations might cause gingival inflammation. Areas surrounding the abutment teeth presented periodontal pockets, attachment loss, congestion, bleeding on probing, and gingival hyperplasia after fixed restorations were removed. The depth of pockets, bleeding on probing, and bone loss are all closely correlated with disease's severity and IL-1β concentration in gingival crevicular fluid; IL-1β shows higher values in disease sites than in healthy ones. hs-CRP and TNF-α blood levels showed a considerable reduction one day after fixed restorations were applied, in comparison with the pre-treatment values. Collaboration between prosthodontists and periodontists is essential for a good treatment outcome since it will increase the restoration's lifespan, enhance periodontal health, and improve the quality of life for dental patients.

Cytokine profile of gingival crevicular fluid in children with impaired immunological surveillance system

Aim. To study the cytokine profile of the gingival crevicular fluid (GCF) in children with a juvenile rheumatoid arthritis (JRA).Materials and methods. We examined 20 children with JRA and 10 patients without somatic pathology aged 6 to 16 years old. The condition of periodontal tissues was assessed by periodontal indices – gingival index GI (Loe, Silness, 1963) and gingival bleeding index GBI. Biomaterial sampling from the gingival sulcus was carried out using special endodontic absorbent paper points. Enzyme immunoassay for IL-18, IL-10, IL-1ß, IL-1RA, MCP-1, VEGFs in the GCF was performed using the test kits of Vector-Best LLC (Novosibirsk, Russia).Results. Mean GI index in the JRA group was 0.31 ± 0.10 and in the control group – 0.20 ± 0.05 (p &lt; 0.05), mean GBI index – 19.90 ± 3.14 and 10.80 ± 2.60 respectively (p &lt; 0.05), which was accompanied by a more pronounced degree of inflammation of periodontal tissues. The GCF concentration of IL-18 in the JRA group was 6.70 (4.97–7.92) pg/ml, in the control group – 11.25 (8.70–13.10) pg/ml (p &lt; 0.05), while the concentration of IL-1ß was 15.30 (13.79–17.18) pg/ml in the JRA group and 5.36 (5.32–5.54) pg/ml in the control group.The IL-10 concentration in the JRA group was 3.60 (2.89–4.45) pg/ml, which was comparable to the values of the control group. The concentration of IL-1RA was lower in the JRA group than in the control group: 3638.5 (2397.5–4133.5) pg/ml and 4951.0 (4303.0–5455.0) pg/ml respectively. The total GCF chemokine concentration for MCP-1 was determined at the level of 15.65 (14.15–17.39) pg/ml and 15.50 (12.80–21.20) pg/ml for the main and control groups and for VEGF – 49.60 (41.95–54.50) pg/ml in the JRA group and 12.00 (11.00–13.00) pg/ml in control group.Conclusion. In children with juvenile rheumatoid arthritis, an imbalance of pro- and anti-inflammatory cytokines in GCF plays a role in the development of gingivitis: an increased of IL-1ß concentration – a triggering factor of pro-inflammatory chains, a decreased concentration of IL-1RA – an anti-inflammatory cytokine, an increased concentration of VEGF – a marker of hypoxia.

Metformin gel in the treatment of generalized aggressive periodontitis

ObjectivesThe aim of this study was to assess the adjunctive regenerative effect of metformin (MF) gel in the treatment of stage II grade C periodontitis utilizing β-TCP bone graft in the control group, and β-TCP bone graft mixed with 1% MF gel in the test group on clinical, radiographic, and biochemical parameters.Patients and methodsThirty intrabony defects were selected in seven patients who met the inclusion criteria. Patients were randomly distributed in the two study groups and treated with β-TCP bone graft plus collagen membrane in the control group and β-TCP bone graft mixed with 1% MF gel plus collagen membrane in the test group. Clinically, evaluation was carried out by clinical parameters (bleeding on probing, pocket depth, and clinical attachment loss) at 3, 6, and 9 months posttreatment. Biochemically, gingival crevicular fluid concentration of receptor activator of nuclear factor-κB ligand (RANKL) and Osteoprotegerin (OPG) at baseline and 9 months posttreatment were evaluated and RANKL/OPG ratio was calculated. Radiographically, quantitative digital subtraction radiography was used to evaluate bone gain and bone mineral density at 9 months posttreatment follow up period.ResultsThe intragroup comparison in the two studied groups demonstrated statistically significant improvement in all clinical parameters (bleeding on probing, pocket depth, and clinical attachment loss) after 3, 6, and 9 months when they were compared to their corresponding values at baseline, while, the intergroup comparison showed that there is no statistically significant difference regarding all clinical parameters at 3, 6, and 9 months posttreatment except pocket depth which differs statistically significant at 3 months posttreatment. The intragroup comparison of RANKL and OPG was statistically significant between baseline and 9 months posttreatment in the two groups but intergroup comparison revealed that there is no statistically significant difference. Regarding RANKL/OPG ratio, the intragroup analysis revealed that there was a statistically significant change in this ratio from baseline to 9 months posttreatment in the test and control group. Additionally, the intergroup analysis revealed that there was no statistically significant difference in RANKL/OPG ratio between the test and control group at baseline and at 9 month posttreatment. The intragroup quantitative digital subtraction radiography analysis demonstrated statistically significant bone gain and increase in bone mineral density in the two studied groups. Also, the intergroup comparison revealed that no statistically significant increase in bone level in the two groups although increase in bone density was statistically significant.ConclusionThe present study demonstrated that guided tissue regeneration utilizing 1% MF gel combined with β-TCP bone graft showed better radiographic results, when compared with guided tissue regeneration utilizing β-TCP bone graft alone. The adjunctive regenerative action of MF is promising material for periodontal regeneration.

Neopterin Levels in Periodontitis and after Nonsurgical Periodontal Therapy: Evaluation of Gingival Crevicular Fluid, Oral Fluid, Serum and Urinary Samples-A Case-Control Study.

Periodontitis is a chronic inflammatory disease that leads to the destruction of the tooth-supporting tissues with complex immune response. Neopterin (Np), secreted via activated macrophages, is considered a biomarker of cellular immunity. The aim of this study was to evaluate the impact of periodontitis and nonsurgical periodontal therapy. Np gingival crevicular fluid (GCF), oral fluid, serum and urine levels were compared in subjects with periodontitis before periodontal treatment, three months after and in a healthy control. Np GCF concentrations in the study group after treatment were significantly higher than the control group (p = 0.038). The GCF total amount (amount of substance) was significantly higher in the study group before periodontal treatment than in the control group (p = 0.001) and higher than the levels taken after treatment collection (p = 0.024). The oral fluid Np concentrations in the study group after treatment were significantly increased compared to the before treatment concentrations (p = 0.020). The same trend was observed in the urine samples. Significant correlation was found between the serum and oral fluid Np concentrations (p = 0.001, ρ = 0.40). Our results confirm the impact of cellular immunity and macrophages on periodontitis and on the resolution of periodontal inflammation. The presence of neopterin in oral fluid most likely originates in the serum.

The Correlation between Periodontal Parameters and Cell-Free DNA in the Gingival Crevicular Fluid, Saliva, and Plasma in Chinese Patients: A Cross-Sectional Study.

Purpose: To investigate the correlation between periodontal parameters and cell-free DNA (cfDNA) concentrations in gingival crevicular fluid (GCF), saliva, and plasma. Methods: Full mouth periodontal parameters, including probing depth (PD), bleeding on probing (BOP), and plaque index (PI) were recorded from 25 healthy volunteers, 31 patients with untreated gingivitis, and 25 patients with untreated periodontitis. GCF, saliva, and plasma samples were collected from all subjects. Extraction and quantification assays were undertaken to determine cfDNA concentrations of each sample. Results: GCF and salivary cfDNA levels were increased with aggravation of periodontal inflammation (GCF p < 0.0001; saliva p < 0.001). Plasma cfDNA concentrations in patients with periodontitis were significantly higher than those in healthy volunteers and patients with gingivitis. GCF and salivary cfDNA were positively correlated with mean PD, max PD, BOP, and mean PI (p < 0.0001), whereas plasma cfDNA was not correlated with BOP (p = 0.099). Conclusion: GCF, saliva, and plasma concentrations of cfDNA were significantly elevated in patients with periodontal disease. There were also positive correlations between cfDNA levels in GCF and saliva and periodontal parameters.

Suppression of Tumorigenicity 2 Pro-Inflammatory Biomarker Linking Diabetes Mellitus and Periodontitis: A Pilot Study.

BACKGROUND Suppression of tumorigenicity 2 (ST2) is a member of the interleukin (IL)-1 family and has 2 isoforms: ST2L, a transmembrane form, and ST2, a soluble form. IL-33 can act as an immune system alarm signal when released by damaged cells, which in turn activates other cells expressing the ST2 receptor. This can cause inflammatory cytokines to be released and produced, as well as trigger osteoclastogenesis. This study aimed to investigate the levels of soluble ST2 in gingival samples. MATERIAL AND METHODS The study population consisted of 30 individuals. The participants were divided into 3 groups: healthy participants, patients with periodontitis, and patients with periodontitis and diabetes mellitus. Periodontitis was determined using probing depth, clinical attachment loss, and gingival index. Patients with stage 2 to 4 periodontitis met the inclusion criteria. Gingival crevicular fluid (GCF) was collected for quantification of samples for ST2 levels by using an enzyme immunoassay. RESULTS The mean±standard deviation of ST2 GCF concentrations was relatively high (558.87±68.99) in the group with periodontitis and diabetes mellitus, compared with that of the periodontitis group (452.06±54.18) and healthy group (252.82±87.9). CONCLUSIONS GCF ST2 values were found to be a marker of inflammatory activities. Thus, GCF ST2 could be a potential biomarker for the diagnosis of periodontitis as well as systemic diseases, such as diabetes mellitus. This pilot study was limited by a small number of participants. To confirm the associations, more large-scale investigations should be conducted.

Effectiveness of periodontal intervention on the levels of N-terminal pro-brain natriuretic peptide in chronic periodontitis patients.

Background: N-terminal-pro-brain natriuretic peptide (NT-proBNP) is an inactive hormone that is seen during inflammation and is a known biomarker of cardiovascular disease (CVD). Evidence suggests that periodontitis has a bidirectional relationship with CVD and NT-proBNP has a potential role in periodontal disease. However, there is no evidence on the impact of nonsurgical periodontal therapy (NSPT) on the levels of NT-proBNP in gingival crevicular fluid (GCF) and serum in patients with chronic periodontitis. Hence, the aim of this study was to compare the levels of NT-proBNP in GCF and serum in patients with chronic generalized periodontitis. Materials and methods: GCF and serum samples were collected in 19 patients with chronic periodontitis before and after NSPT after 6 weeks and the cumulative or reduction in values of NT-proBNP in GCF and serum was assessed. NT-proBNP levels in GCF and serum were determined by enzyme-linked immunosorbent assay. Results: The concentrations of NT-proBNP were significantly reduced in GCF and serum after NSPT. Statistically significant difference of NT-proBNP concentration between pre- and postgroups in GCF was apparent (p &lt; 0.0001), whereas statistically nonsignificant results in NT-proBNP serum levels when compared at baseline to postoperative state with mean of 61.77 (22.6 standard deviation [SD]) preoperatively and 72.67 (51.86 SD) postoperatively (p = 0.0007) was observed. Conclusion: Significant reduction of NT-proBNP concentrations in GCF and serum in patients with chronic periodontitis subjected to NSPT was observed. This may account for a significant relation between periodontal disease, bacteremia, and CVD.

Calprotectin and N-telopeptide of Type I Collagen (NTx) as Gingival Crevicular Fluid (GCF) Biomarker in Peri-Implantitis Patients

Introduction: Formulation of various preventive and therapeutic strategies is possible only by a better understanding of the immune-inflammatory profile of peri-implant diseases. For understanding the changes and turnover of bone, various markers have been used in the past literature, out of which, N-telopeptide of Type I Collagen (NTx) is acknowledged to be the most reliable marker.Aims and objectives: Assessment of calprotectin and NTx concentration in gingival crevicular fluid (GCF) around the implant sites in subjects suffering from peri-implantitis.Materials and methods: In total, 70 healthy individuals were included in the present study. These patients had opted for dental implants within the last decade. After collecting the peri-implant crevicular fluid (PICF) and GCF, various examinations were carried out. PICF samples were obtained with the help of sterile paper available in the form of strips. The enzyme-linked immunosorbent assay (ELISA) technique was used for measuring the calprotectin and NTx. All the readings were obtained in nanograms per microliter of PICF. All the results were recorded and analyzed.Results: The overall mean calprotectin and NTx values were observed to be in a significantly higher range within the sites suffering from peri-implantitis when compared with healthy locations. The calprotectin values and NTx levels were positively correlated with the mean values of periodontal parameters observed clinically.Conclusion: Both calprotectin and NTx could be used as a biomarker signifying the presence of inflammation as well as bone resorption in patients suffering from peri-implantitis.

Effects of a 980 nm Diode Laser as an Adjunct to Nonsurgical Periodontal Therapy on Periodontal Status and Inflammatory Markers in Patients After Myocardial Infarction: A Randomized Controlled Trial.

Objective: The aim of this study was to evaluate the efficacy of diode laser (DL) therapy as an adjunct to nonsurgical periodontal therapy in the treatment of periodontitis in patients after myocardial infarction (MI). Methods: After given permission by Ethics Commission of the Pomeranian Medical University (KB-0012/06/12), 36 patients <65 years of age (mean: 56.3 ± 7.9) with periodontitis, 6 weeks to 6 months after MI were enrolled for the study. The control group (n = 18) received nonsurgical periodontal therapy, whereas the test group (n = 18) received nonsurgical periodontal therapy followed by laser therapy of the periodontal pockets with 980 nm DL, 1 W, continuous wave mode, and 20 sec per tooth side. Procedures were repeated twice at 5-7 day intervals. Clinical periodontal parameters and inflammatory markers in gingival crevicular fluid (GCF) [elastase, aspartate transaminase (AST), alanine transaminase (ALT) and interleukin (IL)-6, proteins], bloodstream [fibrinogen, high-sensitivity CRP (hs-CRP), IL-6, AST and ALT], and lipid fractions (triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol) were measured before treatment, 2 weeks, and 3 months after treatment. Results: The difference between groups in the reduction of periodontal pocket depth (PPD) in pockets ≥7 mm was found to be significant in the test group (p < 0.05). There was also a statistically significant reduction in the volume of GCF and hs-CRP concentration in blood 2 weeks after the completion of treatment in the test group (p < 0.05). Conclusions: Within the limits of this study, it can be concluded that in the nonsurgical treatment of periodontitis with patients after MI, the additional use of DL enables greater reduction of PPD in pockets ≥7 mm. In addition, a faster reduction of GCF volume and hs-CRP was noted in the laser group.

The resolvin D1 levels before and after periodontal therapy in periodontitis patients.

The aim of this study was to determine the levels of resolvin D1 (RVD1) in the gingival crevicular fluid (GCF) and saliva in the patients with periodontitis and healthy subjects, and also to evaluate the effects of non-surgical periodontal treatments (NSPTs) on RVD1 levels. Fifteen patients with Stage III Grade B periodontitis (P) and 11 periodontally healthy individuals (H) were included in this study. Clinical periodontal measurements, GCF, and saliva samples were collected from each individual at baseline and 6weeks after NSPTs in periodontitis group. GCF and saliva levels of RVD1 were analyzed by enzyme-linked immunosorbent assay. GCF total and concentration levels of RVD1 were significantly lower in the periodontitis group than in the healthy group and significantly increased after NSPTs in periodontitis (p < 0.001). There was no statistically significant difference in saliva RVD1 levels between healthy and periodontitis group and also before and after NSPTs in periodontitis (p > 0.05). Significant negative correlations were found between all periodontal clinical parameters and GCF volume with both GCF total amount and concentrations of RVD1 (p < 0.01). There was a positive correlation between GCF total amount and concentrations of RVD1 (r = 0.762, p < 0.01). GCF levels of RVD1 might be promising biomarkers for monitoring the susceptibility to periodontitis and predicting periodontal status. RVD1 may be valuable biomarker to observe the healing process after periodontal treatment as increased GCF levels might project clinical improvements post-treatment. Accordingly, observing GCF RVD1 levels might be helpful to determine individuals require further periodontal treatment.

Protective Effect of Iron Oxide Nanoparticles on Periodontal Injury in Rats by Inhibiting Collagenase-1 and Alkaline Phosphatase Expression

This study intends to assess whether iron oxide nanoparticles affect periodontal injury and collagenase-1 (COL-1), and alkaline phosphatase (ALP) in rats. In this study, the ALP activity and Col-1 concentration in rats with periodontal injury were determined.We detected the periodontal histopathological changes and expression of periodontal pocket depth (PD) and attachment loss (AL) by Hematoxylin and eosin (HE) staining.We also detected Col-1 and ALP proteins in periodontal tissues by Western blot. Real-time reverse transcription-polymerase chain reaction (RT-PCR) detected Col-1 and ALP mRNA level in periodontal tissues of rats in each group, while ALP activity and Col-1 concentration in gingival crevicular fluid in model group increased compared to sham group (P < 0.05). After intervention by iron oxide nanoparticles, ALP activity and Col-1 concentration in the gingival crevicular fluid of model rats decreased greatly (P < 0.05). The gingival atrophy was more serious in model group, and many inflammatory cells infiltrated into the tissue and destroyed the alveolar tissue. Meanwhile, the periodontal tissue from rats in intervention group was greatly improved, and the degree of alveolar bone destruction was also significantly reduced, while the PD and AL periodontal indexes were significantly inhibited (P < 0.05). The protein and relative expression showed that the protein and mRNA expressions of ALP and Col-1 in periodontal tissue from model group were lower than those in sham group (P < 0.05). After intervention by iron oxide nanoparticles, the protein and mRNA expressions of ALP and Col-1 in the periodontal tissues in intervention group increased (P < 0.05). Iron oxide nanoparticles can thus inhibit the expression of ALP and COL-1 in periodontal injury rats, and improve the periodontal injury tissue.

To estimate the levels of gingival crevicular fluid YKL-40 in patients with chronic periodontitis and rheumatoid arthritis with chronic periodontitis - a clinico-biochemical study

Background and objectives: YKL-40, a C-reactive protein belongs to the positive acute-phase protein. It is also known as Human chitinase-3-like protein 1(HCI3L1) and is closely related to both acute and chronic inflammation. The present study aimed to detect and estimate the levels of YKL-40 in gingival crevicular fluid (GCF) in patients with healthy periodontium, chronic periodontitis, and rheumatoid arthritis with chronic periodontitis. Materials and methods: Forty-five patients in the age range of 25-55years were included in the study. Patients were divided into three groups: Group I-15 Periodontal healthy patients, Group II-15 Chronic Periodontitis patients, and Group III-15 Rheumatoid arthritis with chronic periodontitis patients. Clinical parameters recorded were Plaque index, Gingival index, Gingival bleeding index, probing depth, and Relative attachment level. GCF samples were analyzed using ELISA. p - value &lt; 0.05 was considered statistically significant. Results: The highest mean YKL-40 concentration in GCF was observed in rheumatoid arthritis with Chronic periodontitis. The mean concentration of YKL-40 in GCF showed a three to four folds increase in its levels when compared to healthy controls (p &lt; 0.001). Contrary, GCF YKL-40 levels between Group II and Group III were not significant. Conclusion: With the increase in severity of periodontal destruction from healthy periodontium to chronic periodontitis, there was a substantial increase in the concentration of YKL-40 in GCF. Correlation of GCF YKL-40 with clinical parameters demonstrated increased severity of the diseases increased its levels

Effect of nonsurgical periodontal therapy on gingival crevicular fluid levels of Interleukin-35 in patients with periodontitis

ObjectiveInterleukin (IL)-35 is a comparatively novel immunosuppressive cytokine produced by T-regulatory cells, the purpose of which in periodontal well being and disease still eludes the researchers. This study intends to measure and compare the levels of IL-35 in gingival crevicular fluid (GCF) taken from periodontitis patients before and at first, second and third week post non-surgical periodontal therapy. Methodologyology: Twenty patients having generalized chronic periodontitis (mean age of 36.25 ± 5.12 years) with moderate to severe disease were assessed clinically for the following parameters: plaque index, gingival index, probing pocket depth, and clinical attachment loss. GCF samples were collected from deepest pockets before performing a full mouth non-surgical periodontal therapy. GCF samples were again collected at 1st, 2nd, and 3rd week after non-surgical periodontal therapy and, IL-35 levels in the GCF samples were measured using an ELISA kit. ResultsAll the clinical parameters improved significantly over time from baseline to 3rd week. The results for plaque index, gingival index, and probing pocket depth were highly significant (p < 0.001) and significant (p < 0.05) for clinical attachment loss. The IL-35 concentration in GCF increased post periodontal therapy from baseline till third week and results were statistically highly significant (p < 0.001). A significant negative correlation (p < 0.001) was found between clinical parameters and IL-35 levels. ConclusionsWith the healing of the previously diseased periodontal tissues, the levels of IL-35 in GCF increases significantly. Therefore, IL-35 can be considered as potential inflammatory marker of periodontal health and disease.