Crevicular Fluid Samples Research Articles

Impact of Clear Aligners vs Conventional Brackets on Oxidant and Antioxidant Levels: A Case-Control Study.

BACKGROUND The aim of this study was to identify the changes in the levels of total oxidant status (TOS) and total antioxidant status (TAS) in gingival crevicular fluid (GCF) samples of patients treated with conventional brackets (CBs) and clear aligners (CAs) over a 30-day period. MATERIAL AND METHODS Thirty-four patients who received non-extraction treatment with either CBs or CAs were included in the study. GCF samples were obtained at baseline (T0) and on days 7 (T1) and 30 (T2) following initial phase of treatment. Clinical periodontal parameters were used to determine periodontal conditions of patients. ELISA method was used to determine TAS and TOS levels in GCF samples. RESULTS In the group treated with CAs, TOS levels in GCF were significantly high at T1 but approached T0 after the first month (T2) of treatment. In contrast, the group treated with CBs showed significantly high TOS levels in GCF at both T1 and T2 compared with T0. No significant changes were observed in GCF TAS data at T1 and T2 in either group (CA and CB), compared with T0. When comparing TOS data between the groups at T1 and T2, the CA group had lower TOS levels than the CB group (Mann-Whitney U with Bonferroni correction). Additionally, the CA group had lower periodontal clinical indexes than did the CB group. CONCLUSIONS Oxidative tissue damage during orthodontic teeth movements may be lower with CA treatment. In cases in which higher oxidative stress is anticipated, CA treatment may be preferred over CB treatment.

Encapsulated Chlorhexidine Gel Use in Adolescents Undergoing Orthodontic Treatment: A Randomised Trial

IntroductionThe majority of orthodontic patients present with plaquebiofilm and related manifestations in the early stages of active fixed orthodontic appliance use. AimsTo evaluate the effects of a slow-delivery chlorhexidine:beta-cyclodextrin (Cx:β-Cd) gel compared with those of free Cx free formulations on clinical parameters in patients undergoing treatment with fixed orthodontic appliances. MethodsPatients aged 12-18 years received prophylaxis and scaling and were randomised to treatment groups in a double-blinded manner. They were treated with Cx:β-Cd, Cx, or placebo gel for 15 or 30 days. Bleeding on probing and the visible plaque index were recorded, and gingival crevicular fluid samples were collected for the assessment of cytokine expression. ResultsAt 15 days, the Cx:β-Cd group exhibited significantly less BOP than did the Cx and control groups (P < 0.001; n = 116). At 15 days, notable decreases in tumour necrosis factor-α and interferon-γ expression, as well as a substantial increase in interleukin-10 expression, were observed in the Cx:β-Cd and Cx groups relative to the control group (P < 0.05). The molecular encapsulation gel resulted in greater saliva Cx concentrations than did the free Cx gel released concentrations of 800 ng g−1. ConclusionCx:β-Cd gel is effective for the slow delivery of Cx, improving the gingival health of adolescents undergoing orthodontic treatment. Clinical relevanceA single application of encapsulated Cx gel, was a more effective antiseptic than a free Cx application in fixed orthodontice appliance wearers.

The role of interleukin-20 on inflammatory stress and periodontal tissue destruction in patients with metabolic syndrome and periodontitis

BackgroundThere is an increasing occurrence of periodontitis and metabolic syndrome (MetS), which is resulting in a decline in the overall quality of life. Both disorders can occur together since they are both linked to insulin resistance and systemic inflammation. However, evidence for a role of interleukin (IL)-20 in this comorbidity is very limited. This cross-sectional study aimed to comprehensively investigate, for the first time, the levels of RANKL/OPG, MMP-8 and OSI as well as the role of IL-20 in patients with MetS and periodontitis.MethodsThe study included a total of 80 individuals, divided into four groups: 20 individuals who were healthy both systemically and periodontally, 20 individuals who were systemically healthy but had periodontitis, 20 individuals who had MetS but were periodontally healthy, and 20 individuals who had both MetS and periodontitis. Periodontal clinical parameters (plaque index, gingival index, bleeding on probing, clinical attachment loss, probing pocket depth) were evaluated. Gingival crevicular fluid (GGF) and serum samples were collected and used for biochemical assays. Enzyme-linked immunosorbent assay was used to determine the levels of IL-20, receptor activator of nuclear factor kappa B ligand (RANKL)/osteoprotegerin (OPG), matrix metalloproteinase-8 (MMP-8) and oxidative stress index (OSI).ResultsIL-20 levels measured in serum and GCF were statistically significantly highest in patients with MetS and periodontitis (p = 0.001). Significant positive correlation was observed between serum and GCF IL-20 values and periodontal parameters (p < 0.05). There was a positive correlation between RANKL and RANKL/OPG levels and IL-20 and clinical parameters (p < 0.05). OSI values were found to be increased in the presence of both periodontitis and MetS (p = 0.001) and were positively correlated with serum and GCF IL-20 (p < 0.05).ConclusionsThese data from the study suggest a correlation between IL-20 and both MetS and periodontitis. IL-20 may potentially worsen the condition of periodontal tissue by increasing both the oxidative stress levels, periodontal collagen degredation and the ratio of RANKL to OPG.Trial registrationThis study was registered on ClinicTrials.gov (NCT06092853), 2023-10-10, retrospectively registered.

Effects of Minocycline on Early Wound Healing after Implant Placement: An InVitro and Randomized Clinical Study.

To determine the invitro effects of minocycline on human gingival fibroblasts (HGFs), its clinical impact on early wound healing after implant placement, and its potential mechanism of action. First, we evaluated the invitro proliferation, migration, and collagen production of HGFs treated with different concentrations of minocycline, as well as the underlying mechanism. Subsequently, we conducted a clinical trial and randomly assigned 40 partially edentulous patients to either the test (minocycline hydrochloride treatment) or control (blank control) group immediately after implant surgery. The early wound healing score (EHS), pain index, gingival index (GI), modified sulcus bleeding index (mSBI), and peri-implant crevicular fluid samples were assessed or collected 3 and/or 7 days after surgery. In vitro, 1 μg/mL minocycline promoted the proliferation, migration, and collagen production of HGFs. Minocycline inhibited collagen degradation by downregulating the expression of matrix metalloproteinase-2 (MMP-2) and MMP-14 and upregulating tissue inhibitors of metalloproteinases-2. However, higher concentrations of minocycline, 10 and 100 μg/mL, exhibited adverse effects. In the randomised clinical trial, the test group showed significantly better clinical outcomes compared to the control group, with higher EHS and lower GI, mSBI, concentrations of IL-1β, IL-10, and TNF-α, and relative abundance of Streptococcus and gram-negative anaerobic bacteria. Small doses of minocycline (1 μg/mL) promoted the proliferation and migration of HGFs and inhibited collagen degradation invitro. Locally delivered minocycline after implant surgery improves clinical outcomes by promoting early wound healing, relieving the inflammatory response, and decreasing early colonisation of gram-negative anaerobic bacteria. This clinical trial was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2100044680).

Impact of Long-term Fasting on Breath Volatile Sulphur Compounds, Inflammatory Markers and Saliva Microbiota Composition.

Despite substantial evidence supporting the role of resident bacterial communities in therapeutic fasting outcomes, research has primarily focused on gut microbiota, leaving changes in oral microbiota largely unexplored. The clinical significance of oral health changes during fasting is nonetheless underscored by the documented development of halitosis in fasting individuals. However, no scientific studies have comprehensively examined the interplay between salivary microbiota alterations, inflammatory changes in the gingival crevice, and the production of malodorous volatile compounds. We examined volatile sulphur compounds (VSC) in breath during fasting, cytokine levels in the gingival crevice, and oral microbiota composition of the saliva in a single-arm interventional study involving 36 subjects who fasted for 10 ± 3 days. Participants fasted according to Buchinger fasting guidelines. VSC were evaluated every morning before any food or drink intake using the OralChroma gas chromatography device. Saliva and gingival crevicular fluid (GCF) samples were collected at the clinical site before fasting, at the end of fasting, and at the end of food reintroduction. Follow-up saliva samples were sent to the patients after 1 and 3 months. Saliva samples were processed and analysed by targeted sequencing of 16S rRNA gene amplicons, whereas the expression of 6 inflammatory markers in the GCF were analysed using a multiplex fluorescent bead-based immunoassay. The quantification of volatile compounds in the breath demonstrated a statistically significant increase in dimethylsulfide levels during fasting, which corroborates the occurrence of bad breath as a common side effect of fasting. Salivary microbiota profiling showed a shift in microbial composition, including reduction in the levels of Neisseria, Gemella and Porphyromonas spp., concomitant with an increase in the levels of Megasphaera, Dialister, Prevotella, Veillonella, Bifidobacteria, Leptotrichia, Selenomonas, Alloprevotella, and Atopobium. We further demonstrated a reduction in the levels of the pro-inflammatory cytokine interleukin-8 in the GCF. Dimethylsulfide concentrations in the breath increased during fasting, and this was correlated to changes in the oral microbiota. Future studies are needed to illuminate the possible impact of these changes on oral and general health status.

Clinical and GCF outcomes of Minimally-invasive non-surgical periodontal therapy in teeth with bone loss to the apex. A prospective study

AimsThe aim of this prospective study was to assess the potential benefits of minimally-invasive non-surgical therapy (MINST) in the healing of intrabony defects reaching the apex. MethodsTwenty systemically healthy patients with stage III-IV periodontitis and with at least one tooth with an intrabony defect reaching the apex were included in the study. Step 1 and 2 periodontal therapy including MINST were provided to all patients and patients were then followed up to 12 months post-treatment. Clinical parameters, standardised periapical radiographs and gingival crevicular fluid (GCF) samples were collected at test and control sites. 31 biomarkers were analysed. ResultsThree cases did not have the 12-months review (2 drop-outs and 1 tooth lost due to fracture). Despite significant improvements in clinical and radiographic parameters, the majority of defects still had PPD>5mm at the 12-months reassessment, therefore needing further treatment, including endodontic treatment in some cases. A pattern of increase in GCF biomarkers associated with a senescent secretory phenotype was detected immediately after treatment in test sites, with a decrease up to 12 months. An increase in IL-1β and MMP-3 in particular seems to be associated with increased risk to need endodontic treatment post-MINST. ConclusionsThe treatment of teeth with unfavourable prognosis and bone loss to the apex with MINST leads to PPD reduction, CAL gain and reduction in radiographic defect depth 12 months after treatment. However, MINST alone may not be sufficient in terms of defects resolution in most of these cases. Clinical significanceThe treatment of teeth with unfavorable prognosis and bone loss to the apex (hopeless) using MINST may lead to consistent PPD reduction, CAL gain and radiographic defect depth reduction after 12 months. However, adjunctive therapies may be necessary to achieve endpoints of therapy in these defects. GCF biomarkers may clarify healing patterns.

Levels of matrix metalloproteinase-1 (MMP-1), MMP-2, MMP-3, osteopontin, pentraxin-3, and thymic stromal lymphopoietin in crevicular fluid samples from peri-implantitis, periodontitis, and healthy sites.

Periodontitis and peri-implantitis are chronic inflammatory diseases characterized by the destruction of supporting tissues. Despite some similarities, it is essential to understand the differences in how these diseases elicit unique host responses within the oral tissues, including the production of selected matrix metalloproteinases (MMPs) and inflammatory mediators involved in tissue remodelling. The aim of this study was to evaluate the levels of proteolytic enzymes MMP-1, MMP-2, MMP-3, as well as the inflammatory mediators osteopontin (OPN), pentraxin-3 (PTX3), and thymic stromal lymphopoietin (TSLP) in crevicular fluid samples collected from healthy, periodontitis-affected, and peri-implantitis sites. Gingival crevicular fluid (GCF) and peri-implant crevicular fluid (PICF) samples were collected from healthy and diseased teeth and implant sites of 163 patients. The MMP-1, MMP-2, MMP-3, OPN, PTX3, and TSLP levels were determined using commercially available immunoassays. A linear mixed model procedure was adopted for multilevel analyses, using biomarker levels as the outcome variable to compare two types of sites. The diagnostic accuracy of the biomarkers was evaluated by Youden's index to estimate the sensitivity, specificity and the area under curve (AUC). The levels of MMP-1, MMP-2, MMP-3, OPN, and TSLP were higher at sites with periodontitis and peri-implantitis compared to the levels at sites with healthy teeth and healthy implants. No significant differences were observed in the levels of the measured markers between the sites diagnosed with periodontitis and those diagnosed with peri-implantitis. The highest diagnostic potential at implant sites was found for MMP-2 (AUC = 0.74) and TSLP (AUC = 0.72). The highest AUC (0.82) at tooth sites was found for OPN. The findings indicate that the proteolytic enzyme MMP-2 and the cytokine TSLP might be potential biomarkers for both periodontitis and peri-implantitis, whereas the proinflammatory cytokine OPN may serve as a biomarker for periodontitis. Further studies are required to confirm the utility of these biomarkers and explore their potential clinical applications.

Comparative Evaluation of Soft Tissue Reaction to Titanium and Polyetheretherketone Customized Healing Abutments: a Split-Mouth Randomised Clinical Trial

Aim. This study aimed to evaluate the peri-implant soft tissue response to customized healing abutments (CHAs) made of titanium and polyetheretherketone (PEEK). Methods. Titanium and PEEK CHAs were mounted on bone-level dental implants in bilateral edentulous patients in a randomized split-mouth study design. After a three-week healing period, the clinical parameters of the peri-implant soft tissues were assessed. The value of marginal bone resorption was measured by cone-beam computed tomography. In addition, peri-implant crevicular fluid samples were obtained to identify periodontal pathogenic bacteria, cytokine levels, and active neutrophil collagenase (aMMP-8) concentration. Microcirculation and oxygenation parameters were assessed using laser Doppler flowmetry and optical tissue oximetry. In addition, wavelet analysis was conducted to study blood flow control mechanisms. Results. Out of the 23 participants initially recruited, 20 were assessed after titanium and PEEK CHA installation due to losses to follow-up. The peri-implant soft tissue around 27 titanium and 25 PEEK CHAs was evaluated during follow-ups. No differences were found in the values of marginal bone resorption, cytokine levels, or total bacterial load (p&gt;0.05). PEEK CHAs demonstrated lower bleeding on probing values, less plaque accumulation, and faster relief of ischemia and hypoxia. Although aMMP-8 concentration was higher in the PEEK group, the values were within normal limits. Conclusions. The results of this comparative study showed a positive soft tissue response to PEEK CHAs. However, further studies comparing the effectiveness of different materials for CHAs should be carried out, considering their specific physical properties and processing protocols.

Expression of microRNA-223 and microRNA-214 in gingival crevicular fluid of smoker and nonsmoker periodontitis patients, an observational diagnostic accuracy study

ObjectivePeriodontitis is a multifactorial disease that affects a wide range of populations. However, its pathogenesis remains unclear. miRNAs are now considered potential diagnostic markers for many inflammatory diseases. Thus, the aim of this study was to assess the expression of microRNA-223(miRNA-223) and microRNA-214 (miRNA-214) in gingival crevicular fluid (GCF) of smoker and nonsmoker with periodontitis.Materials and methodsWe conducted a prospective study among 42 participants: 14 healthy controls, 14 nonsmoker periodontitis participants, and 14 smokers with periodontitis. Eligibility criteria for inclusion were consecutive adults, aged 20–60 years, with stage III periodontitis grade B/C and no systemic diseases. All consenting participants had gingival crevicular fluid samples collected after diagnosis to assess miRNA-214 and -223 by quantitative real-time polymerase chain reaction assay.ResultsROC curve analyses for the non-smoker periodontitis group showed that miR-214 as a predictor in comparison to miR-223 had higher sensitivity [92.86%-64.29%], same specificity [100%], and a significantly higher area under the curve [0.974–0.796] respectively (p = 0.036). As for the smoker periodontitis group, a ROC curve with miR-214 as predictor in comparison to miR-223 had higher sensitivity [100%-71.43%], same specificity [100%], and a non-significantly higher area under the curve [1–0.872], respectively (p = 0.059).ConclusionBoth miRNA-214 and 223 are reliable potential diagnostic markers for periodontitis, with miRNA-214 being more accurate for smokers with periodontitis.Clinical relevanceBoth miRNA-214 and 223 could be considered for potential chair-side diagnostics, by simply collecting GCF detecting the disease in its first steps and aid in preventing unrepairable damage.

Expression patterns of interleukin-6 and microRNA-146A during orthodontic relapse in a rat model.

In this study, we established an experimental rat model to simulate orthodontic tooth movement relapse and a human periodontal ligament stem cell (PDLScs) model. Our aim was to explore the relationship between microRNA-146a (miR-146a) expression in periodontal tissue, the inflammatory factor interleukin-6 (IL-6), and orthodontic relapse subsequent to mechanical intervention. In the animal experiment, a total of 30 healthy male Wistar rats were randomly allocated to either the control group (n=6) or the model group (n=24). In the model group, the orthodontic appliance was removed 14 days after force application. Gingival crevicular fluid (GcF) and periodontal tissue samples were collected at intervals of days 0, 7, 14, and 21 following removal of the orthodontic appliance to assess alterations in miR-146a and IL-6 expressions. In the in vitro cell culture study, human premolar tooth tissue was isolated 24 hours following the addition of the transfection reagent to harvest PDLScs. Reverse transcription quantitative polymerase chain reaction was employed to evaluate the expression levels of the miRNA-146a gene, while Western blot analysis was utilized to assess the production of the IL-6 protein. As a result in comparison to the control group, the protein expression of IL-6 notably escalated to its peak value in the model-day 7 group (p<0.05). Subsequently, although experiencing a slight decline, the IL-6 expression in the model-day 14 group remained significantly elevated compared to control group (p<0.05). In the model-day 21 group, the protein expression of IL-6 approached that of the control group, with no significant difference observed (p>0.05). conversely, in relation to the control group, the gene expression of miR-146a drastically decreased to its lowest point in the model-day 7 group (p<0.05). While exhibiting a slight increase, the miR-146a expression in the model-day 14 group remained significantly diminished compared to control group (p<0.05). Following the identification of human periodontal ligament cells (hPDLcs) through immunofluorescence in the in vitro study, a subsequent experiment was conducted to specifically inhibit miR-146a expression. In comparison to the control group, the protein expression of IL-6 demonstrated a significant increase in the anti-miRNA oligodeoxyribonucleotide (AMO) group, where miR-146a expression was effectively suppressed (p<0.05). Throughout the process of orthodontic tooth movement relapse in rats, there was a notable reduction in the gene expression of miR-146a, accompanied by a significant increase in the expression of IL-6.

Application of Nano-Hydroxyapatite Implantation for Periodontitis Treatment and Oral Tissue Regeneration

In this study, the combined application of nano-hydroxyapatite (nHA) implants and root planing was used for the treatment of periodontitis. A total of 80 patients with chronic periodontitis who were admitted to our hospital from January 2020 to March 2023 were selected and randomly divided into the control group (root planing) and observation group (root planing+nHA implants), each consisting of 40 cases. The gingival crevicular fluid samples were collected to detect changes in inflammatory factors before, 6 weeks after, and 12 weeks after operation. Additionally, periodontal indexes such as plaque index (PLI), sulcus bleeding index (SBI), probing depth (PD), and attachment loss (AL) were evaluated. The therapeutic efficacy, aesthetic outcome, and incidence of adverse reactions were analyzed between the two groups. The results indicated that after the operation, both groups exhibited lower levels of periodontal index AL, PD, SBI, PLI, and inflammatory factors compared to pre-operation levels. However, the observation group demonstrated superior outcomes with significantly higher postoperative PES scores and total treatment effective rates. Although adverse reaction incidence was slightly lower in the observation group (7.5%) than in the control group (15%), there was no statistically significant difference between them (P &gt; 0.05). Therefore, it can be inferred that the combined application of nHA implants and root planing in patients with chronic periodontitis yields favorable postoperative recovery and effectively enhances the periodontal condition. Consequently, this approach can serve as an optimal therapeutic strategy for the treatment of chronic periodontitis.

Matrix metalloproteinase 9 level changes in gingival crevicular fluid samples of teeth with acute and chronic apical periodontitis

Matrix metalloproteinase 9 level changes in gingival crevicular fluid samples of teeth with acute and chronic apical periodontitis

Evaluation of the effect of adjunctive diode laser application on peri-implant crevicular fluid biomarker levels: a randomized controlled trial

ObjectivesTo assess both the clinical and immunological effectiveness of diode laser therapy when used as an adjunct to non-surgical mechanical therapy in managing peri-implantitis.Materials and methodsA cohort of 27 participants, comprising 21 females and 6 males, agreed to take part in this investigation. 37 dental implants with peri-implantitis diagnosis were randomly allocated to either the laser group (n = 19) or the control group (n = 18). Evaluation of peri-implant clinical parameters and collection peri-implant crevicular fluid (PICF) samples occurred at baseline, as well as at 3 and 6-month follow-up intervals. The level of various biomarkers (TWEAK, IL-1β, sclerostin, IL-17, RANKL, OPG and IL-10) within the PICF were quantified using enzyme-linked immunosorbent assay.ResultsSignificant time-dependent decreases in clinical and biochemical parameters were detected in both groups compared to the baseline. There were marked differences between the groups in terms of periodontal parameters, except probing depth, and IL-1β, IL-17, sclerostin levels in PICF at 3rd month follow-up. However, no statistically significant difference was detected at 6th month.ConclusionsDiode laser seems to be a reliable tool as an adjunct for supporting the nonsurgical mechanical treatment during the early stages of peri-implantitis. Furthermore, the findings suggest that IL-17, sclerostin and IL-1β may serve as promising biomarkers for assessing efficacy of peri-implantitis treatment.Clinical relevanceBased on these outcomes, clinicians may consider the application of adjunctive use of diode laser to non-surgical peri-implantitis treatment to achieve better clinical and immunological improvements than nonsurgical peri-implantitis therapy alone in just early healing period. However, it should be noted that there was no difference between the two methods in the long term.

Effectiveness of 0.2% Hyaluronic Acid on Clinical, Biomolecular and Microbiological Parameters in Type 2 Diabetes Mellitus Patients with Periodontitis.

This double-blind randomized clinical trial assessed the effectiveness of 0.2% hyaluronic acid (HA) gel as an adjunct to scaling and root planning (SRP) in patients with periodontitis and type 2 diabetes mellitus (DM), focusing on changes in clinical periodontal parameters, the expression of inflammatory mediators, and oral pathogens. The randomized clinical trial involved 36 participants, 18 DM patients, and 18 healthy patients. The participants in each group were randomly assigned to receive placebo or HA gel after SRP. Gingival crevicular fluid and subgingival plaque samples were taken before treatment and at 4-week follow-up. Clinical parameters, interleukin-1β (IL-1β) and IL-10 levels, and proportions of Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) were evaluated at baseline and follow-up. Paired t-test (parametric data) or Wilcoxon signed-rank test (nonparametric data) was used for intragroup comparison between baseline and follow-up, and comparisons between groups one-way analysis of variance test (parametric data) or Kruskal-Wallis test (nonparametric data). At 4 weeks, most of the groups showed statistically significant decreases (p ≤ 0.05) in various clinical and biomolecular parameters. However, there were exceptions: the pocket probing depth (PPD) and clinical attachment loss (CAL) parameter did not significantly decrease for the placebo (p > 0.05) non-DM group, and the IL-10 parameter in the DM HA gel group (p = 0.108). Regarding bacterial proportions, the non-DM and DM placebo group exhibited significant test results for Pg after 4 weeks (p ≤ 0.05). In the case of Fn bacteria proportions, they decreased in all groups, but these results were not statistically significant (p ≥ 0.05). An intergroup analysis revealed no significant differences (p ≤ 0.05) for bleeding on probing (BOP), PPD, and both proinflammatory and anti-inflammatory cytokines. Only clinical attachment loss (CAL) exhibited a statistically significant intergroup difference 0.042. The use of 0.2% HA gel into periodontal pockets alongside SRP, for both diabetic and healthy individuals, showed no statistically significant variances in clinical, biomolecular, and microbiological measures.

Utility of gingival crevicular fluid components for periodontal diagnosis.

Periodontal diseases are highly prevalent chronic diseases, and severe periodontitis creates functional and esthetic problems and decreases self-esteem for a large percentage of the older population worldwide. In many cases of periodontitis, there is no distinct tell-tale pain that motivates a patient to seek treatment, rather the signs become clinically detectable late, and typically when the disease has progressed to a problematic level for the life of the dentition. Early periodontal screening and diagnostics tools will provide early recognition of periodontal diseases and facilitate timely management of the disease to reduce tooth loss. To this goal, gingival crevicular fluid is easily sampled, can be repeatedly and non-invasively collected, and can be tested for potential biomarkers. Moreover, the site specificity of periodontal diseases enhances the usefulness of gingival crevicular fluid sampled from specific sites as a biofluid for diagnosis and longitudinal monitoring of periodontal diseases. The present review aimed to provide up-to-date information on potential diagnostic biomarkers with utility that can be assayed from gingival crevicular fluid samples, focusing on what is new and useful and providing only general historic background textually and in a tabulated format.

The adjunctive use of antimicrobial photodynamic therapy, light-emitting-diode photobiomodulation and ozone therapy in regenerative treatment of stage III/IV grade C periodontitis: a randomized controlled clinical trial

ObjectivesTo assess the short-term efficacy of multiple sessions of antimicrobial photodynamic therapy (aPDT), light-emitting-diode (LED) photobiomodulation, and topical ozone therapy applications following surgical regenerative treatments on clinical parameters, patient-centered outcomes, and mRNA expression levels of VEGF, IL-6, RunX2, Nell-1, and osterix in gingival crevicular fluid samples in patients with stage III/IV, grade C periodontitis.Materials and methodsForty-eight systemically healthy patients were assigned into four groups to receive adjunctive modalities with regenerative periodontal surgical treatment. A 970 ± 15 nm diode laser plus indocyanine-green for aPDT group, a 626 nm LED for photobiomodulation group, and topical gaseous ozone were applied at 0, 1, 3, and 7 postoperative days and compared to control group. The clinical periodontal parameters, early wound healing index (EHI), and postoperative patients’ morbidity were evaluated. The mRNA levels of biomarkers were assessed by real-time polymerase chain reaction.ResultsNo significant difference in the clinical parameters except gingival recession (GR) was identified among the groups. For group-by-time interactions, plaque index (PI) and probing pocket depths (PD) showed significant differences (p = 0.034; p = 0.022). In sites with initial PD > 7 mm, significant differences were observed between control and photobiomodulation groups in PD (p = 0.011), between control and aPDT, and control and photobiomodulation groups in CAL at 6-month follow-up (p = 0.007; p = 0.022). The relative osterix mRNA levels showed a statistically significant difference among the treatment groups (p = 0.014).ConclusionsThe additional applications of aPDT and LED after regenerative treatment of stage III/IV grade C periodontitis exhibited a more pronounced beneficial effect on clinical outcomes in deep periodontal pockets.

Peri-implant phenotype, calprotectin and MMP-8 levels in cases diagnosed with peri-implant disease

ObjectivesThe purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of non-surgical mechanical treatment (NSMT), along with calprotectin (CLP) and MMP-8(matrix metalloproteinase-8) levels.Materials and methods77 implants from 39 patients were included. The implants were categorized Group-1(peri-implant mucositis), Group-2(peri-implantitis).Baseline (0. Month-PrT) clinical parameters (PD, GI, PI, BOP, CAL) and radiographic bone loss were documented, and peri-implant crevicular fluid (PICF) samples were collected. Various intruments and methodologies were employed to assess PPh components (mucosa thickness, supracrestal tissue height, keratinized mucosa) and peri-implant attached mucosa (AM). NSMT was applied to diseased implant sites. All clinical parameters were reassessed again by taking PICF samples at the 6th month-after treatment (PT). In PICF samples obtained from both groups, MMP-8 and CLP levels were evaluated using the ELISA test.ResultsPrT-PD,PrT-GI,PrT-CAL and PrT-BOP percentage values in Group-2 were significantly higher than Group-1.PrT-PD,PrTPI scores are significantly higher in thin biotype implants. All components of the PPh and AM were significantly lower in thin biotype. Intra-group time-dependent changes of MMP-8 and CLP were significant in both groups (p < 0.05). When the relationship between thin and thick biotype and biochemical parameters was evaluated, the change in PrT-PT didn’t show a significant difference (p > 0.05).ConclusionsPPh plays a role in influencing the severity of peri-implant diseases. However, the impact of phenotype on NSMT outcomes was similar in both groups.Clinical relevanceThe PPh should be considered when planning implant surgery.

A Study of the Association between Primary Oral Pathologies (Dental Caries and Periodontal Diseases) Using Synchrotron Molecular FTIR Spectroscopy in View of the Patient's Personalized Clinical Picture (Demographics and Anamnesis).

In this exploratory study, we searched for associations between the two most common diseases of the oral cavity-dental caries and periodontal diseases-taking into account additional factors, such as personalized clinical pictures (the individual risk factors of the patient), based on the method of a multivariate data analysis of the molecular changes in the composition of human gingival crevicular fluid (GCF). For this purpose, a set of synchrotron Fourier-transform infrared spectroscopy (FTIR) spectra of gingival crevicular fluid samples from patients with different demographics, levels of dental caries development and periodontal diseases, and the presence/absence of concomitant chronic diseases were obtained and analyzed. Using a set of techniques (v-, F-, Chi-square tests; a principal component analysis (PCA); and the hierarchical clustering of principal components (HCPCs)) implemented in the R package FactoMineR allowed us to assess the relationship between the principal components (PCs) and characteristics of the respondents. By identifying the features (vibrational modes in the FTIR spectra) that contribute most to the differentiation of the spectral dataset, and by taking into account the interrelationships between the patients' characteristics, we were able to match specific biological markers (specific molecular groups) to the two factors of interest-two types of oral pathologies. The results obtained show that the observed changes in the quantitative and qualitative composition of the modes in the infrared (IR) spectra of the GCF samples from patients with different dental caries developments and periodontal diseases present confirm the difficulty of identifying patient-specific spectral information. At the same time, different periodontal pathologies are more closely associated with other characteristics of the patients than the level of their caries development. The multivariate analysis performed on the spectral dataset indicates the need to take into account not only the co-occurrence of oral diseases, but also some other factors. The lack of this consideration (typical in lots of studies in this area) may lead to misinterpretations and consequently to a loss of data when searching for biological markers of certain oral diseases.

The assessment of glutathione, glutathione peroxidase, glutathione reductase, and oxidized glutathione in patients with periodontitis-A systematic review and meta-analysis.

The present systematic review explored the involvement of enzymatic and nonenzymatic antioxidants in periodontitis, drawing from established literature. The research approach encompassed an extensive electronic search from 2000 to 2023 across databases such as PubMed, Science Direct, and Wiley Online Library and cross-referencing using specific keywords. The initial literature exploration generated a total of 766 articles. After thoroughly examining the abstracts, 693 articles were excluded from consideration due to duplication and lack of relevance to the central research inquiry. Following that, 73 articles were left for in-depth evaluation. Following a qualitative assessment, 35 studies that satisfied the inclusion criteria were chosen, while 38 were removed for not meeting the necessary standards. Within this selection, a meta-analysis was conducted on 11 articles that provided consistent data for quantitative synthesis. Specifically, the analysis of glutathione (GSH) levels in serum samples revealed a standardized mean difference (SMD) of -5.552 µg/mL (CI 95%: -9.078 to -2.026; P-0.002). In contrast, the analysis of glutathione peroxidase (GPx) enzymes in gingival crevicular fluid (GCF) samples displayed an overall SMD of 2.918 ng/µL (CI 95%: 0.372-5.465; P-0.025), while salivary samples exhibited an overall SMD value of 0.709 U/l (95% CI: -1.907-3.325; P-0.596) which is of insignificant. The systematic review findings suggest a notable decrease in antioxidant enzymes across various systemic biological samples among patients with periodontitis, contrasting with the results from gingival tissue samples meta-analysis of GPx enzyme.

The importance of mechanosensitive cell mediated prostaglandin and nitric oxide synthesis in the pathogenesis of apical periodontitis: comparative with chronic periodontitis

ObjectivesMechano-sensitive odontoblast cells, which sense mechanical loading and various stresses in the tooth structure, synthesize early signaling molecules such as prostaglandin E2 (PGE2) and nitric oxide (NO) as an adaptive response. It is thought that these synthesized molecules can be used for the diagnosis and treatment of periodontal and periapical diseases. The aim of this study was to investigate the relationship between the severity of apical periodontitis (AP) and chronic periodontitis (CP) and serum (s) TNF-α, IL-10, PGE2 and NO levels, as well as PGE2 and NO levels in gingival crevicular fluid (GCF) samples.Materials & methodsA total of 185 subjects were divided into three categories: AP group (n = 85), CP group (n = 50) and healthy control group (n = 50). The AP group was divided into 3 subgroups according to abscess scoring (AS-PAI 1, 2 and 3) based on the periapical index. The CP group was divided into 4 subgroups according to the periodontitis staging system (PSS1, 2,3 and 4). After recording the demographic and clinical characteristics of all participants, serum (s) and gingival crevicular fluid (GCF) samples were taken. TNF-α, IL-10, PGE2 and NO levels were measured in these samples.ResultsUnlike serum measurements (sTNF-α, sIL-10, sNO and sPGE2), GCF-NO and GCF-PGE levels of the AP group were significantly higher than the control group in relation to abscess formation (54.4 ± 56.3 vs. 22.5 ± 12.6 µmol/mL, p < 0.001 and 100 ± 98 vs. 41 ± 28 ng/L, p < 0.001, respectively). Confirming this, the GCF-NO and GCF-PGE levels of the AS-PAI 1 group, in which abscesses have not yet formed, were found to be lower than those in AS-PAI 2 and 3, which are characterized by abscess formation [(16.7(3.7-117.8), 32.9(11.8-212.8) and 36.9(4.3-251.6) µmol/mL, p = 0,0131; 46.0(31.4–120.0), 69.6(40.3-424.2) and 74.4(32.1–471.0) ng/L, p = 0,0020, respectively]. Consistent with the increase in PSS, the levels of sTNF [29.8 (8.2-105.5) vs. 16.7(6.3–37.9) pg/mL, p < 0.001], sIL-10 [542(106–1326) vs. 190(69–411) pg/mL, p < 0.001], sNO [182.1(36.3–437) vs. 57.0(15.9–196) µmol/mL, p < 0.001], sPGE2 [344(82-1298) vs. 100(35-1178) ng/L, p < 0.001], GCF-NO [58.9 ± 33.6 vs. 22.5 ± 12.6 ng/L, p < 0.001] and GCF-PGE2 [ 99(37–365) vs. 30(13–119), p < 0.001] in the CP group were higher than the control group. Comparison ROC analysis revealed that the GCF-PGE2 test had the best diagnostic value for both AP and CP (sensitivity: 94.1 and 88.0; specificity: 64.0 and 78.0, respectively; p < 0.001).ConclusionsGCF-PE2 and GCF-NO have high diagnostic value in the determination of AP and CP, and can be selected as targets to guide treatment. In addition, the measurements of PGE2 and NO in GCF can be used as an important predictor of pulpal necrosis leading to abscess in patients with AP.Clinical relevanceIn this article, it is reported that syntheses of early signaling molecules such as PGE2 and NO can be used for the diagnosis and treatment target of periapical and periodontal infections.