Deep Pockets Research Articles

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.

Assessment of oral and overall health parameters using the SillHa Oral Wellness System

The study evaluated use of a multipoint saliva analyzer to assess patient wellness in a contemporary dental practice setting. Unstimulated saliva from a diverse 104 patient cohort was analyzed using the SillHa Oral Wellness System. The device measures the following 7 analytes present in the patient's oral rinse: cariogenic bacteria, acidity, buffer capacity, blood, leukocytes, protein, and ammonia. Data obtained were compared with validated clinical assessment data independently provided by credentialed dental professionals. Measured leukocyte and protein levels were higher in patients with periodontal disease and/or deep gingival pockets. Patients with a history of cancer and/or diabetes presented with higher ammonia and lower leukocyte levels. Acidity levels were higher in patients using multiple xerogenic medications and lower in patients with a history of sleep apnea. Sex differences showed female patients exhibiting higher acidity, lower buffer capacity, and lower ammonia than male patients. Increasing age is associated with elevated buffer capacity. Multipoint saliva analyzers such as the one used in this study, along with clinical practice examination and medical history, can provide rapid salivary component analysis that augments treatment planning. A follow-up multisite study would provide the opportunity to test this analyzer in clinical sites with different practice workflows.

Relationships between Solobacterium moorei and Prevotella intermedia in subgingival microbiota of periodontitis patients with halitosis: A preliminary study using qPCR

ObjectiveSolobacterium moorei is suggested to be associated with the production of volatile sulphur compounds (VSCs) and can be found in subgingival plaques of deep periodontal pockets. We examined whether this bacterium’s count was reduced in periodontitis patients with halitosis following non-surgical periodontal treatment, while the bacterial count of Prevotella intermedia was measured simultaneously as a control. Material & methodsThis clinical study included 20 adults with chronic periodontitis who complained of halitosis. The bacterial relationship in the subgingival plaque sample was measured after 8 weeks post-treatment, including the probing pocket depth (PPD). Quantitative real-time PCR (qPCR) was used to measure the proportion of S. moorei, while the concentrations of H2S and CH3SH were determined using oral ChromaTM. ResultsThe presence of S. moorei was consistently observed in participants with periodontitis before and after non-surgical periodontal treatment and consistent showed a significantly lower proportion compared with P. intermedia. Solobacterium moorei showed a strong positive correlation with H2S and CH3SH concentrations, but a negative correlation with deep periodontal pocket measurements. Conversely, reduced P. intermedia may be more associated with a deep pocket, independent of the concentration of CH3SH. ConclusionThe study data showed that the proportion of S. moorei in the subgingival biofilm can be related to halitosis in periodontitis patients.

Periodontal conditions and incident dementia: A nationwide Swedish cohort study.

Periodontal disease has been proposed as a putative etiological factor for dementia. The aim of this investigation was to compare the incidence of dementia in individuals with or without deep probing pocket depths (DPPD), serving as a proxy for periodontitis. In this cohort study, conducted in Sweden, we identified 7992 individuals with DPPD and 29,182 matched individuals without DPPD (non-DPPD), using the Swedish Quality Registry for Caries and Periodontal Diseases (SKaPa). The two groups were followed for incident dementia (mean follow-up time was 7.6 years) based on data from the Swedish Dementia Registry (SveDem). The exposure-outcome relationship was explored by applying the Royston-Parmar (RP) flexible parametric survival model. The incidence of dementia in the two groups was similar. In the DPPD group 137 (1.7%) developed dementia and 470 (1.6%) in the non-DPPD group. The incidence rate of dementia was estimated to be 2.3 per 1000 person-years (95% confidence interval [CI] 1.9 to 2.7) in the DPPD group and 2.1 per 1000 person-years (95% CI 1.9 to 2.3) in the non-DPPD group. The RP model disclosed no association between DPPD and dementia incidence after controlling for potential confounders (the exponentiated coefficient was estimated to 1.13 [95% CI=0.39 to 3.24]). In this sample, no association was revealed between deep probing pocket depths and the incidence of dementia.

Deciphering the molecular mechanisms of selective non-covalency demonstrated differentially by 9-Allylnaphtho[1,8-ef]isoindole-7,8,10(9H)-trione (C11) against fibroblast growth factor receptors 1–4

The specific inhibition of aberrant Fibroblast Growth Factor Receptors (FGFRs) has been identified as a feasible strategy to therapeutically ameliorate their respective carcinogenic involvements. High homology among these proteins has however limited efforts towards the discovery of selective small-molecule compounds due to undesirable effects elicited by pan-FGFR inhibitors. A recent study showed the selective activity of a new compound C11 which was >52 times more potent against FGFR1 than FGFR2 and FGFR3, and 4 times than FGFR4. This C11 selective non-covalency was investigated in this study using computational methods since it has remained unresolved. Structural findings revealed that C11 enhanced structural perturbations in FGFR1 with less prominent effects in other FGFRs. High deviations also characterized the C11-bound active pocket of FGFR1 with notable fluctuations across the constituent P-loop, αC helix, hinge region, catalytic, and activation loops. These induced motions were essential for optimal C11 motion an d positioning of its phenalenone ring and prop-2-en-l-yl moiety at the FGFR1 active pocket to interact stably and strongly with A564FGFR1, L484FGFR1, Y563FGFR1, and E562FGFR1 which as well had high energy contributions. C11 exhibited highly unstable binding in F GFRs2-3 with a more steady interaction with FGFR4. Free binding energy ( ΔGbind ) analyses further estimated the highest interaction energy for C11-FGFR1 with favorable desolvation energy that indicated a deep hydrophobic pocket binding for C11 in FGFR1 compared to other FGFRs. We believe rational insights from this study will contribute to the structure-based design of highly specific FGFR1 inhibitors. Communicated by Ramaswamy H. Sarma

Association Between the Severity of Periodontitis and Osteoarthritis in Middle-Aged and Older Patients With Type 2 Diabetes Mellitus: A Nationwide Population-Based Study.

Periodontitis and osteoarthritis are major public health concerns that result in decreased quality of life among middle-aged and older adults. We sought to examine whether the severity of periodontitis is related to osteoarthritis according to the presence of type 2 diabetes mellitus. This study included 3,527 participants age ≥50 years from the Korean National Health and Nutrition Examination Survey. Periodontitis was assessed using the Community Periodontal Index; severe periodontitis was defined as periodontal tissue forming deep periodontal pockets ≥6-mm depth. Osteoarthritis was defined as Kellgren/Lawrence grade ≥2 on radiographic images of the knee or hip area with joint pain. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for osteoarthritis according to the severity of periodontitis, stratified by type 2 diabetes mellitus, were calculated using multiple logistic regression analyses. Participants with type 2 diabetes mellitus were more likely to have osteoarthritis as the severity of periodontitis increased (nonsevere periodontitis OR 1.23 [95% CI 0.67-2.32]; severe periodontitis OR 3.01 [95% CI 1.51-5.84]) after adjusting for age, sex, body mass index, smoking status, alcohol consumption, regular exercise, education level, household income, hypertension, and frequent tooth-brushing. However, this positive association was not found in individuals without type 2 diabetes mellitus after adjusting for the same covariables. Severe periodontitis was positively and significantly associated with osteoarthritis in middle-aged and older individuals with type 2 diabetes mellitus. Our findings suggest that the oral inflammation manifesting in periodontitis may be at least partly involved in the pathogenesis of osteoarthritis, particularly in patients with type 2 diabetes mellitus.

Association between peri-implantitis and cardiovascular diseases: A case-control study.

This study assesses the association between peri-implantitis and cardiovascular diseases (CVD). One hundred and twenty-eight patients with dental implants were recruited to evaluate the prevalence of peri-implantitis in patients with or without CVD (CVD group, n=82, control group, n=46, respectively). Diagnosis of peri-implantitis followed the 2017 World Workshop guidelines and the severity was defined as mild, moderate, and severe form when the radiographic bone loss (RBL) was<2, 2 to 4, and>4mm. Multivariable logistic regression was performed to test the association between two diseases. A trend of higher prevalence of peri-implantitis defined by detectable RBL beyond the physiologic bone remodeling was found in the CVD group (64.6%) when compared with the controls (56.5%). A significant higher prevalence (48.8%) of moderate to severe peri-implantitis was identified in CVD compared with controls(30.4%) with a significant crude association between moderate to severe peri-implantitis and CVD (odds ratio=2.18, 95% CI, 1.02 to 4.67; P=0.04). The CVD group had a trend of higher prevalence of deep pockets (≥7mm) and higher numbers of sites with bleeding on probing (>66%) when compared with controls (P> 0.05). However, after controlling for multiple confounders including age, hypertension, smoking, family history of heart attack, and periodontitis, the significant association was not found. CVD group had significantly higher prevalence of moderate to severe peri-implantitis (RBL ≥2mm). The association between the two diseases did not exist after controlling multiple confounders for CVD. Future studies with a larger sample size controlling for the patient- and implant-related confounders are needed to better understand the link between peri-implantitis and CVD.

Effect of systemic antibiotic and probiotic therapies as adjuvant treatments of subgingival instrumentation for periodontitis: a randomized controlled clinical study.

Objective:This study assessed the efficacy of two adjunct therapies (antibiotic and probiotic) for periodontal treatment based on clinical and immunological parameters in patients with Stage II and III Grade B periodontitis.Methodology:45 patients were randomly allocated into three groups: control group (CG); antibiotic group (GAtb), in which 500 mg amoxicillin + 400 mg metronidazole were used; and probiotic group (GProb), for which Lactobacillus reuteri was used. Patients received medications after undergoing periodontal debridement. Clinical and immunological parameters were assessed at baseline, 30 days, and 90 days.Results:All therapies reduced bleeding on probing (BoP) in the evaluated periods, and the GAtb had a greater reduction at 90 days (p=0.03). The GProb group showed better results for plaque index (PI) and gingival recession (GR) compared to the GAtb at 90 days (p=0.0014; p=0.006). The area of inflammation (PISA Index) significantly decreased in all therapies in the evaluated periods. Therapies had no significant differences regarding moderate pockets. The GAtb had a greater reduction in probing depth (PD) for deep pockets (p=0.03) at 90 days and in the number of deep pocket sites at 30 days (p=0.04). The occurrence of adverse effects was commonly reported in the GAtb as a percentage per patient. The GAtb had a significant reduction in the concentration of interleukins IL-1β and IL-8 and an increase in IL-10 and TNF-α. The CG had a reduction in IL-6 and IL-1 β, whereas in the GProb there was no difference.Conclusion:After three months, none of the adjuvant therapies provided any additional benefit for subgingival instrumentation.

Prior‐free dynamic allocation under limited liability

A principal seeks to efficiently allocate a productive public resource to a number of possible users. Vickrey–Clarke–Groves (VCG) mechanisms provide a detail‐free way to do so provided users have deep pockets. In practice however, users may have limited resources. We study a dynamic allocation problem in which participants have limited liability: transfers are made ex post, and only if the productive efforts of participants are successful. We show that it is possible to approximate the performance of the pivot VCG mechanism using limited liability detail‐free mechanisms that selectively ignore reports from participants who cannot make their promised payments. A complementary use of cautiousness and forgiveness achieves approximate renegotiation‐proofness. We emphasize the use of prior‐free online optimization techniques to approximate aggregate incentive properties of the pivot mechanism.

Survival Rate of 3-unit Fixed Partial Dentures Replacing First Molars: A Retrospective Cohort Study.

Fixed partial dentures (FPDs) made of 12% Au-Pd alloy are covered under Japan's national health insurance system. The survival rate of such 3-unit fixed FPDs remains unknown, however. The purpose of this retrospective study was to assess their survival rate in the replacement of first molars. A total of 140 FPDs were included, and the endpoint was removal of an FPD. During the observation period, 43 FPDs were removed. The FPD survival rate was 70.2% at 10 yr, 58.2% at 15 yr, and 42.1% at 20 yr according to the Kaplan-Meier method. The estimated mean survival period was 19.4 yr. The main reasons for FPD loss were dental caries (27.9%), separation from the abutment tooth (18.6%), and pulpitis (18.6%). Single factor analysis using the log-rank test showed that two factors influenced FPD survival: a smaller gonial angle and deep pockets around the abutment teeth. This effect was not statistically significant in either case, however (p>0.05). The present results suggest that the prevention of caries and of the separation of the dentures from the abutment teeth are important factors in the long-term survival of FPDs.

Effect of Dental Anxiety on Oral Health among the First-Time Dental Visitors: A Hospital-based Study.

Objective:The objective was to assess dental anxiety and to find its association with oral health status and oral health-related quality of life (OHRQoL) among 20–40-year-old patients visiting Vokkaligara Sangha Dental College and Hospital.Materials and Methods:A single-center, hospital-based cross-sectional study was done among first-time dental visitors in the Department of Oral Medicine and Radiology, Vokkaligara Sangha Dental College and Hospital over a period of 8 months (July 14–February 18). The sample size was determined to be 700. Participants in the age group of 20–40 years were selected based on inclusion and exclusion criteria. Data were collected using Corah's Modified Dental Anxiety Scale, Oral Health Impact Profile-14 (OHIP-14), and clinical examination was done using the WHO oral health assessment form and OHI-S. Data were analyzed using Chi-square test and t-test. The associations found through bivariate analysis were entered as predictor variables into linear and binomial logistic regression models with high dental anxiety as the outcome variable.Results:The results of the study suggested that 56% of the study participants were having dental anxiety. Local anesthetic injection (80%) and fear of tooth drilling (60%) were the most anxiety-provoking stimulus. Analysis of OHIP-14 suggested that respondents perceiving oral health as affecting their life quality (very often/fairly often) in the past year were observed for items such as tension, difficulty to relax, irritability, difficulty in doing usual jobs, and totally unable to function because of oral problems. Dental anxiety was significantly associated with gender (odds ratio [OR] = 1.32), education (OR = 1.43), occupation (OR = 2.07), poor oral hygiene status (OR = 3.15), presence of dental caries (OR = 2.67), bleeding on probing (OR = 1.57), presence of periodontal pockets (OR = 2.64), clinical attachment loss (OR = 1.63), and OHRQoL (OR = 1.76). Stepwise linear regression model of independent variables (<0.05 variables included) explained dental caries as highest predictor (39%), followed by debris (22%), calculus (38%), mean OHIS (27%), mean OHIP-14 (29%), deep pocket (14%), and the least predictor was shallow pocket (9%).Conclusion:Dental anxiety was associated with poor oral health status seeking further attention to modify patients' behavior regarding improvement in oral health status.

Applying nano-HA in addition to scaling and root planing increases clinical attachment gain

PurposeThis study evaluated the efficacy of treating periodontitis using subgingival nano-hydroxyapatite powder with an air abrasion device (NHAPA) combined with scaling and root planing (SRP).MethodsA total of 28 patients with stage III periodontitis (grade B) were included in this study, although 1 was lost during follow-up and 3 used antibiotics. The patients were divided into a test group and a control group. All patients first received whole-mouth SRP using hand instruments, and a split-mouth approach was used for the second treatment. In the test group, the teeth were treated with NHAPA for 15 seconds at 70% power per pocket. Subgingival plaque samples were obtained from the 2 deepest pockets at the test and control sites before treatment (baseline) and 3 months after treatment. The full-mouth plaque index (PI), gingival index (GI), papillary bleeding index (PBI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and at 1- and 3-month post-treatment. Real-time polymerase chain reaction was used to determine the colonisation of Treponema denticola (Td), Porphyromonas gingivalis (Pg), and Aggregatibacter actinomycetemcomitans in the subgingival plaque.ResultsFrom baseline to the first month, the test group showed significantly larger changes in BOP and CAL (43.705%±27.495% and 1.160±0.747 mm, respectively) than the control group (36.311%±27.599% and 0.947±0.635 mm, respectively). Periodontal parameters had improved in both groups at 3 months. The reductions of PI, GI, BOP, PD, and CAL in the test group at 3 months were greater and statistically significant. The total bacterial count and Td and Pg species had decreased significantly by the third month in both groups (P<0.05).ConclusionsApplying NHAPA in addition to SRP improves clinical periodontal parameters more than SRP alone. Subgingival NHAPA may encourage clot adhesion to tooth surfaces by increasing surface wettability.

Reproducibility of Manual Periodontal Probing Following a Comprehensive Standardization and Calibration Training Program.

Background:Clinical standardization and calibration training is recommended to increase the reproducibility of periodontal probing, but its impact on manual periodontal probing outcomes has received little attention. This study examined the reproducibility of manual periodontal probing performed by a periodontist after completion of a comprehensive standardization and calibration training program.Methods:A newly-educated periodontist was subjected to an individualized periodontal probing standardization and calibration training program involving approximately 24 total hours of lecture, bench-top, and clinical instruction/evaluation. Satisfactory completion of each portion of the training program required ≥ 95% intra-examiner agreement within 1 mm between initial and repeat measurements, and a ≥ 90% level of exact agreement with measurements by a “gold standard” examiner. The periodontist then evaluated bleeding on probing (BOP) and performed duplicate measurements of probing depth (PD) and the distance between the cementoenamel junction and gingival margin (CEJ-GM) with a manual periodontal probe on 567 periodontal sites exhibiting ≥ 5 mm PD with BOP in 39 adults. Clinical periodontal attachment level (CAL) was calculated for each site as (PD) - (CEJ-GM).Results:Intra-examiner measurement error (the standard deviation for a single measurement) was found to be 0.21 mm for PD, 0.15 mm for CEJ-GM, and 0.26 mm for CAL. Replicate assessments of PD and CAL yielded excellent exact agreement kappa scores of 0.86 and 0.87, respectively. Greater intra-examiner measurement error was found at periodontal sites with more gingival inflammation as measured by higher BOP index scores.Conclusion:These findings demonstrate that a rigorous periodontal probing standardization and calibration training program facilitates acquisition of highly reproducible PD and CAL assessments in moderate to deep inflamed periodontal pockets with a manual periodontal probe. Similar formal hands-on training should be incorporated into dental education programs and clinical research studies to improve the diagnostic performance of manual periodontal probing of the periodontium.

Recognition of quinolone antibiotics by the multidrug efflux transporter MexB of Pseudomonas aeruginosa.

The drug/proton antiporter MexB is the engine of the major efflux pump MexAB-OprM in Pseudomonas aeruginosa. This protein is known to transport a large variety of compounds, including antibiotics, thus conferring a multi-drug resistance phenotype. Due to the difficulty of producing co-crystals, only two X-ray structures of MexB in a complex with ligands are available to date, and mechanistic aspects are largely hypothesized based on the body of data collected for the homologous protein AcrB of Escherichia coli. In particular, a recent study (Ornik-Cha, Wilhelm, Kobylka et al., Nat. Commun., 2021, 12, 6919) reported a co-crystal structure of AcrB in a complex with levofloxacin, an antibiotic belonging to the important class of (fluoro)-quinolones. In this work, we performed a systematic ensemble docking campaign coupled to the cluster analysis and molecular-mechanics optimization of docking poses to study the interaction between 36 quinolone antibiotics and MexB. We additionally investigated surface complementarity between each molecule and the transporter and thoroughly assessed the computational protocol adopted against the known experimental data. Our study reveals different binding preferences of the investigated compounds towards the sub-sites of the large deep binding pocket of MexB, supporting the hypothesis that MexB substrates oscillate between different binding modes with similar affinity. Interestingly, small changes in the molecular structure translate into significant differences in MexB–quinolone interactions. All the predicted binding modes are available for download and visualization at the following link: https://www.dsf.unica.it/dock/mexb/quinolones.

Comparative evaluation of 5% Moringa oleifera and 0.2% Chlorhexidine subgingival irrigation as a supplement to non-surgical pocket therapy in Stage I and Stage II Periodontitis: A Clinical study

Background: Although scaling and root planing (SRP) are the gold standard in nonsurgical periodontal treatment, it does not ensure complete eradication of all putative periodontal pathogens. So, subgingival irrigation is performed in addition to non-surgical debridement for removing periodontal pathogens by both mechanical and chemical action. The goal of the present study was to assess and compare the clinical efficacy of two episodes of subgingival irrigation using 0.2 percent chlorhexidine and 5% moringa oleifera combined with SRP. Materials and Methods: Totally 15 patients with less than or equal to 4 mm of attachment loss as seen in Stage I and Stage II Periodontitis were recruited. From each patient, 2 periodontal pockets that are not adjacent and have a probing depth of minimum 6 mm were selected. Each patient's two deep periodontal pockets were given irrigation treatments, one with CHX digluconate 0.2 percent (control group) and the other with Moringa oleifera 5 percent (test group) in two episodes. Pre-irrigation (day 0), days 7, and 28 post-irrigation measurements of the plaque index (PI), gingival index (GI), probing pocket depth (PD), and clinical attachment level (CAL) were recorded. Results: Following irrigation, the mean PI and GI scores decreased for both groups, with the moringa group experiencing a statistically significant greater decrease than the chlorhexidine group. The Moringa group had a greater reduction in PD and CAL than the CHX group. Conclusion: The clinical outcomes of this investigation imply that subgingival irrigation with 5 percent Moringa oleifera may be an effective adjunctive treatment for patients with chronic periodontitis.

Periodontal granulation tissue preservation in surgical periodontal disease treatment: a pilot prospective cohort study.

PurposeThe aim of this study was to evaluate the clinical outcomes of periodontal granulation tissue preservation (PGTP) in access flap periodontal surgery.MethodsTwenty patients (stage III–IV periodontitis) with 42 deep periodontal pockets that did not resolve after non-surgical treatment were consecutively recruited. Access flap periodontal surgery was modified using PGTP. The clinical periodontal parameters were evaluated at 9 months. The differences in the amount of granulation tissue width (GTw) preserved were evaluated and the influence of smoking was analyzed.ResultsGTw >1 mm was observed in 97.6% of interproximal defects, and the granulation tissue extended above the bone peak in 71.4% of defects. At 9 months, probing pocket depth reduction (4.33±1.43 mm) and clinical attachment gain (CAG; 4.10±1.75 mm) were statistically significant (P<0.001). The residual probing depth was 3.2±0.89 mm. When GTw extended above the interproximal bone peak (i.e., the interproximal supra-alveolar granulation tissue thickness [iSUPRA-GT] was greater than 0 mm), a significant CAG was recorded in the supra-alveolar component (1.67±1.32 mm, P<0.001). Interproximal gingival recession (iGR) was significant (P<0.05) only in smokers, with a reduction in the interdental papillary tissue height of 0.93±0.76 mm. In non-smokers, there was no increase in the iGR when the iSUPRA-GT was >0 mm. The clinical results in smokers were significantly worse.ConclusionsPGTP was used to modify access flap periodontal surgery by preserving affected tissues with the potential for recovery. The results show that preserving periodontal granulation tissue is an effective and conservative procedure in the surgical treatment of periodontal disease.

MORPHOLOGICAL CHANGES OF PERIODONTAL COMPONENTS UNDER EXPERIMENTAL LIPOPOLYSACCHARIDE PERIODONTITIS COMBINED WITH HYPERTHYROIDISM.

The aim: Investigate structural changes in the tissues of the periodontal complex under the condition of experimental lipopolysaccharide periodontitis combined with hyper¬thyroidism. Materials and methods: The studies were performed on adult white male rats, which simulated periodontitis combined with hyperthyroidism. Periodontal tissues were subjected to morphological examination on the 22nd day of the experiment. Collection of material for microscopic examinations was performed according to the generally accepted method; histological specimens were studied using a light optical microscope. Results: Morphological studies of the components of the periodontal complex of experimental animals with experimental periodontitis established the reorganization of its structural elements. Damage to the epithelium in the area of attachment of the circular ligament and erosive-ulcerative changes of the gums led to a deepening of the gingival sulcus with the formation of a deep periodontal pocket. Intense hyperkeratosis was observed in the area of the bottom of the periodontal pocket. In the own plate of the mucous membrane of the gums - significant edema, collagen fibers were disorganized, defragmented. There were pronounced destructive-degenerative and inflammatory changes of the epithelial and own plates of all areas of the gums and periodontium, damage to the nuclei and cytoplasm of keratinocytes, fibroblasts, and leukocytes. Conclusions: Experimental periodontitis combined with hyperthyroidism is accompanied by pronounced signs of destructive and inflammatory changes in the soft and dense tissues of the periodontal complex, as well as disruption of stromal-vascular interactions, which progress from reversible to irreversible disruption of periodontal connective tissue.

Debridamento ultrassônico de boca toda no tratamento da periodontite crônica severa em pacientes diabéticos: estudo preliminar

ABSTRACT Objective: The purpose of this study was to clinically evaluate the effect of one-stage full-mouth ultrasonic debridement in the treatment of diabetic subjects with severe chronic periodontitis. Methods: Sixteen patients with uncontrolled diabetes (glycated hemoglobin ≥ 7%) and severe chronic periodontitis (at least 8 teeth with a probing depth and bleeding on probing were selected and randomly assigned to 2 treatment groups: control group (n=7) - quadrant-wise scaling and root planning; test group (n=9) - full-mouth ultrasonic debridement in one session of 45 minutes. The following outcomes were assessed: plaque index, gingival index, bleeding on probing, probing depth, clinical attachment level and gingival margin position. All parameters were assessed at baseline, 1 and 3 months after treatment. Probing depth, clinical attachment level and gingival margin position were analyzed using ANOVA and Tukey test, and the other clinical parameters analysed with the Friedman and Mann-Whitney tests. Results: An improvement in probing depth, clinical attachment level was observed after treatment in both groups, but without statistically significant differences between them. After 3 months, in initially deep pockets, the PD decreased 1.6 mm and 1.7 mm in test and control group, respectively. Clinical attachment level gain ≥ 2 mm was statistically significant at sites in control (10.1%) and test (13,4%) groups in 3 months. Conclusions: One-stage full-mouth ultrasonic debridement promoted similar clinical outcomes to those obtained with the scaling and root planning in the treatment of diabetic subjects with severe chronic periodontitis.

The Effect of Inhaled Corticosteroid Therapy on Periodontal Status in Patients with Asthma

Asthma belongs to a broad group of allergic diseases and is the most common chronic disease found in children and adults up to four decades of age. Already published studies suggest that the use of inhaled anti-asthmatic medications affects both general health and oral health. The study included 120 adult patients aged 18 to 71 divided into three groups: I “PERIO-ASTHMA”—with asthma and periodontitis, II “ASTHMA”—with asthma without periodontitis, and control group III “CONTROL”—without asthma and periodontitis. The patients were monitored for oral health status for six months. Oral health was assessed by dental indices: DMF index, PI, BoP, PD, and CAL at interproximal sites. Significantly deeper pockets in the lateral segments of the dentition were observed in all study groups. In addition, the bronchial-only group had significantly deeper pockets in the lateral sextants than the control group at all time points. There was no significant worsening of periodontal status by CAL and PD in asthma patients treated with inhalation, irrespective of baseline periodontal status. Depending on the severity of asthma, an increase in BOP was observed in the central sextant in patients without periodontitis. The history of asthma and the use of ICS has an impact on the periodontal status of patients.

Design, synthesis and SAR study of Fluorine-containing 3rd-generation taxoids

It has been shown that the incorporation of fluorine or organofluorine groups into pharmaceutical and agricultural drugs often induces desirable pharmacological properties through unique protein-drug interactions involving fluorine. We have reported separately remarkable effects of the 2,2-difluorovinyl (DFV) group at the C3′ position, as well as those of the CF3O and CHF2O groups at the 3-position of the C2-benzoyl moiety of the 2nd- and 3rd-generation taxoids on their potency and pharmacological properties. Thus, it was very natural for us to investigate the combination of these two modifications in the 3rd-generation taxoids and to find out whether these two modifications are cooperative at the binding site in the β-tubulin or not, as well as to see how these effects are reflected in the biological activities of the new 3rd-generation DFV-taxoids. Accordingly, we designed, synthesized and fully characterized 14 new 3rd-generation DFV-taxoids. These new DFV-taxoids exhibited remarkable cytotoxicity against human breast, lung, colon, pancreatic and prostate cancer cell lines. All of these new DFV-taxoids exhibited subnanomolar IC50 values against drug-sensitive cell lines, A549, HT29, Vcap and PC3, as well as CFPAC-1. All of the novel DFV-taxoids exhibited 2–4 orders of magnitude greater potency against extremely drug-resistant cancer cell lines, LCC6-MDR and DLD-1, as compared to paclitaxel, indicating that these new DFV-taxoids can overcome MDR caused by the overexpression of Pgp and other ABC cassette transporters. Dose-response (kill) curve analysis of the new DFV-taxoids in LCC6-MDR and DLD-1 cell lines revealed highly impressive profiles of several new DFV-taxoids. The cooperative effects of the combination of the 3′-DFV group and 3-CF3O/CHF2O-benzoyl moiety at the C2 position were investigated in detail by molecular docking analysis. We found that both the 3′-DFV moiety and the 3-CF3O/3-CHF2O group of the C2-benzoate moiety are nicely accommodated to the deep hydrophobic pocket of the paclitaxel/taxoid binding site in the β-tubulin, enabling an enhanced binding mode through unique attractive interactions between fluorine/CF3O/CHF2O and the protein beyond those of paclitaxel and new-generation taxoids without bearing organofluorine groups, which are reflected in the remarkable potency of the new 3rd-generation DFV-taxoids.