Diagnosis Of Chronic Periodontitis Research Articles

Circulating interleukin-27 is associated with the risk of chronic periodontitis and allergic rhinitis: A Mendelian randomization analysis

Background Chronic periodontitis (CP) and allergic rhinitis (AR) have attracted wide attention as global public health problems with high incidence. Recent studies have shown that circulating interleukin-27 (IL-27) is associated with the risk of CP and AR. The aim of this study is to analyze the causal effect between them using Mendelian randomization (MR) Methods Bidirectional MR analyses were performed with the use of publicly available genome-wide association study (GWAS) data. Summary data on circulating IL-27, CP, and AR published in genome-wide association studies were collected. Instrumental variables (IV) were extracted using assumptions of correlation, independence and exclusivity as criteria. Inverse variance weighting (IVW) was used as the main method, combined with weighted median method (WM) and MR-Egger and other MR Analysis methods for causal inference of exposure and outcome. Cochran’s Q and MR-Egger intercept were used for sensitivity analysis Results The IVW study showed a causal effect between increased circulating IL-27 levels and increased risk of CP (OR = 1.14, 95%CI = 1.02–1.26, p = .020). Similarly, the increase of circulating IL-27 level had a causal effect on the decreased risk of AR (OR = 0.88, 95%CI = 0.80–0.97, p = .012). In addition, IVW study found that there was a causal between the increased risk of CP and circulating IL-27 level (OR = 1.05, 95%CI = 1.01–1.10, p = .016). However, there was no significant causal relationship between the risk of AR and circulating IL-27 levels (OR = 0.97, 95%CI = 0.91–1.02, p = .209). no significant heterogeneity or horizontal pleiotropy was found in sensitivity analysis. Conclusions There is a causal effect between circulating IL-27 level and CP, AR, which will help to find new ideas and methods for the diagnosis and treatment of CP and AR.

The Role of Inflammatory Biomarkers of Crevicular Fluid Involved in Modulating of Immune Protection Mechanisms in Chronic Periodontitis

INTRODUCTION: Chronic periodontal inflammation is provoked by persistence of subgingival bacterial flora and is mediated through the production of proinflammatory cytokines that induce the innate immune reactions.
 АIM: To establish the interrelation of secretion of interleukin 1 and immune component of soluble CD14 co-receptor with the main periodontopathogenic microorganisms in patients with chronic generalized periodontitis.
 MATERIALS AND METHODS: A clinical and laboratory examination of patients with chronic generalized periodontitis (n = 100) and individuals with the intact parodontium (n = 63) was conducted. Molecular genetic studies (isolation of periodontal pathogens by polymerase chain reaction in real time), immune enzyme assay (isolation of interleukin 1 and soluble CD14 co-receptor) and statistical analysis of the data obtained were performed.
 RESULTS: The frequency of isolation of periodontopathogenic bacteria in patients with the diagnosis of chronic periodontitis was 96.4% (T. forsythia 81%, р 0.001; P. gingivalis 69%, р 0.001; Tr. denticola 63%, р = 0.054). In 25% of cases, C. Albicans (р 0.001), in 37% Pr. intermedia (р 0.001) and in 30% A. actinomycetemcomitans (р 0.001) were isolated. The average concentrations of soluble CD14 co-receptor were 2.13 [1.89; 2.76] pg/ml in the control group and 20.3 [17.3; 22.5] ng/ml in the group of patients with chronic periodontitis (р 0.001). Concentrations of interleukin 1 were 3.187 [2.356; 4.633] pg/ml in the control group and 33.68 [17.255; 56.915] pg/ml in the group of patients with chronic periodontitis (р 0.001).
 CONCLUSION: Inflammation of periodontal tissues is supported by the factors of aggression and toxins not only of known periodontal pathogens, but also by their associations, which leads to enhancement of virulence factors and increase in secretion of interleukin 1 and soluble CD14 co-receptor, which, in turn, causes destruction of alveolar bone.

Diagnostic potential of miR-200 family members in gingival crevicular fluid for chronic periodontitis: correlation with clinical parameters and therapeutic implications

ObjectiveThe purpose of this study was to evaluate the potential of miR-200 family members in gingival crevicular fluid (GCF) as diagnostic biomarkers for chronic periodontitis (CP), aiming to provide valuable insights for the early detection and management of the disease.MethodsGSE89081 dataset profiled miRNAs in GCF derived from 5 healthy and 5 periodontitis was analyzed by GEO2R. Quantitative real-time PCR was used to quantify the expression levels of miR-200 family members (miR-200a-3p, miR-200a-5p, miR-200b-3p, miR-200b-5p, miR-200c-3p, miR-200c-5p, miR-141-3p, miR-141-5p, and miR-429) in the GCF samples from 103 CP patients and 113 healthy controls. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic potential of miR-200 family members in differentiating CP patients from healthy controls.ResultsBy analyzing the GSE89081 dataset, miR-200a-5p, miR-200b-5p and miR-200c-5p were significantly upregulated in GCF of the CP patients compared to the healthy control. In this study, miR-200a-3p, miR-200a-5p, miR-200b-3p, miR-200b-5p, miR-200c-3p, miR-200c-5p were significantly increased in GCF of CP patients compared to the healthy control, while miR-141 and miR-429 did not show significant differences. MiR-200a, -200b and 200c had good diagnostic value, and when these miRNAs were combined, they demonstrated excellent diagnostic value for CP with an AUC of 0.997, sensitivity of 99.03%, and specificity of 98.23%. MiR-200a, -200b and 200c in GCF showed significant and positive correlation with plaque index (PI), gingival index (GI), bleeding on probing (BOP), clinical attachment level (CAL), and probing pocket depth (PPD).ConclusionMiR-200a, -200b and 200c in GCF may serve as potential biomarkers for the early diagnosis of CP, which was correlated with clinical parameters, being therapeutic targets for CP.

The Comparison of Periostin Levels in Gingival Crevicular Fluid among Patients with Endometrial Cancer and Chronic Periodontitis

Background: Serum periostin in cancer patients and chronic periodontitis (CP) is the lowest and could be linked to the association between CP and endometrial cancer (EC). Periostin is a matricellular protein secreted by fibroblasts associated with cancer and is also secreted in chronic inflammatory conditions such as CP. Objective: The aim of this study is to compare the GCF periostin level among CP, EC, and healthy people and the evaluation of the plausible role of periostin in this association. Methods: This case-control study was conducted on 80 participants including 20 people with both EC and CP (EC-CP), 20 only CP cases (H-CP), 20 only EC cases (EC-H), and 20 healthy people (H-H). Then, the gingival crevicular fluid (GCF) periostin levels for all the participants were measured through enzyme-linked immunosorbent assay (ELISA). Finally, the data were analyzed using Stata software version 11. Results: The mean value of periostin levels was significantly different between groups (p < 0.001) and the lowest and highest mean was observed in EC-CP and H-H groups, respectively. The mean of GCF periostin before treatment in the EC-CP group was 2.14 which was lower than that after treatment; however, this difference was not significant (p = 0.086). Also, the mean of GCF periostin in the H-CP group was 3.96 before non-surgical treatment and after treatment it significantly raised to 6.79 (p = 0.049). Conclusions: Periostin is a potential biomarker for CP diagnosis in EC patients and also can be used to prevent CP. However, further studies are required to confirm this role.

УСОВЕРШЕНСТВОВАНИЯ ПРОТОКОЛА ОПЕРАЦИИ ОДНОМОМЕНТНОЙ ДЕНТАЛЬНОЙ ИМПЛАНТАЦИИ ПАЦИЕНТОВ ПРИ ПОТЕРЕ ЗУБОВ

Subject. The technique of immediate dental implantation, analysis of its results and treatment protocol improvement.
 Aim. To increase the effectiveness of the rehabilitation of patients with chronic periodontitis and traumatic tooth fracture (with indications for extraction) based on the improvement of the protocol for the operation of one-stage dental implantation. 
 Methodology. In the period from 2020 to 2022, on the basis of the Department of Oral Surgery and Maxillofacial surgery department of the RUDN University and Sechenov University, the immediate dental implantation was performed in 20 patients with a diagnosis of Chronic periodontitis and tooth fracture (K.04.5, S02.5 ICD-10) (with indications for their removal ) with the installation of 20 dental implants: Osstem Implant (South Korea) – 10 units (50%), IRIS (Russia) – 10 units (50%). In all cases, the gingival cuff shapers were installed simultaneously. If necessary, osteoplastic materials and gingival autografts were used. The installation of dental implants was carried out with a depth of 2–3 mm, depending on the jaw section, and was displaced orally with a minimum distance to the vestibular cortical plate of 1.5 mm.
 Results. At the end of our study, no complications were identified, 100% integration of implants was obtained, as well as their 100% survival and stability, both according to CBCT data, and according to the results of a follow-up examination 12 months after permanent prosthetics restorations. 
 Conclusion. According to the results of our study, immediate implantation made it possible to carry out a full-fledged rehabilitation of patients if tooth extraction was necessary, to reduce the overall treatment time in the absence of complications in the postoperative period.

Comparison of matrix metalloproteinase-13 and tissue inhibitor of metalloproteinase-1 levels and alveolar bone density in chronic periodontitis before and after scaling and root planning

Periodontitis is typically associated with disorders characterized by compromised tooth-supporting tissue. Damage to periodontal tissue is caused by an imbalance between matrix metalloproteinases and their inhibitors. Decreased tissue inhibitor and elevated matrix metalloproteinase levels result in collagen connective tissue and bone degradation. Several studies have shown that high levels of matrix metalloproteinase-13 (MMP-13) and low levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) are also found in gingival crevicular fluid and saliva of patients with periodontitis. The purpose of this study was to determine the comparison of MMP-13 levels, TIMP-1 levels of saliva and bone density in patients with chronic periodontitis before and after scaling and root planning (SRP). The study samples were selected from patients who came for treatment at the Periodontics Installation of Universitas Sumatera Utara. A total of 16 patients were selected (n = 16) with a diagnosis of chronic periodontitis. The result showed that salivary MMP-13 levels in chronic periodontitis patients before SRP were higher than salivary MMP-13 levels after SRP and the difference was statistically significant (p < 0.05). It was also revealed that salivary TIMP-1 levels and alveolar bone density in chronic periodontitis patients before SRP were lower than that after SRP and the difference was statisticallysignificant (p < 0.05). There was a positive correlation between clinical parameters and salivary MMP-13 levels in patients with chronic periodontitis before and after SRP, but it was not statistically significant (p > 0.05). There was a negative correlation between clinical parameters and salivary TIMP-1 levels in patients with chronic periodontitis before and after SRP, but it was not statistically significant (p > 0.05).

Machine learning models for analysis of biomarkers of chronic periodontitis

Periodontitis is a multifactorial inflammatory chronic disease initiated by dysbiosis of the commensal microbiota of the oral cavity. With the advent of the multi-ohm approach, which creates datasets with multiple features, machine learning algorithms have become an important technique in translational research. The most effective methods for identifying highly specific interactions of biomarkers with clinical parameters and their implementation in interpretable accurate clinical diagnoses are machine learning algorithms. The aim of the study was to evaluate laboratory diagnostic indicators that are significant for predicting the severity of periodontitis using machine learning models. We examined 133 patients aged 22 to 73 years with a diagnosis of chronic periodontitis, as well as 53 people without periodontal pathology. After the examination and assessment of the condition of the periodontium of patients, a biological sample of the periodontal fluid was taken. Real-time PCR was used to evaluate periodontopathogenic microflora and mRNA of pro-inflammatory cytokines. Cells of innate and acquired immunity were evaluated in mixed saliva. Machine learning was performed using logistic regression algorithms, naive Bayes classifier, ‘the Random Forest’ with 25 % training. When trained to 25 %, the naive Bayes classifier showed an accuracy of 23 %, logistic regression – 29 %. ‘The Random Forest’ showed 100 % accuracy and selected the following biomarkers associated with periodontitis severity: Porphyromonas endodontalis; CD 3+, CD 14+, CD 19+5–B 27+ cells; mRNA IL-1β, IL-10, IL-18, GATA3, TNFa, TLR 4. In chronic periodontitis, there is a relationship between local indicators of the immune-inflammatory process, such as mRNA of pro-inflammatory cytokines, cells of the immune system, and the severity of pathology. In the analysis of a multifactorial disease such as chronic periodontitis, a machine learning model optimized for a large heterogeneous data set with a large patient sample should be used.

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis.

There may be an association between periodontitis and cardiovascular disease (CVD); however, the evidence so far has been uncertain about whether periodontal therapy can help prevent CVD in people diagnosed with chronic periodontitis. This is the third update of a review originally published in 2014, and most recently updated in 2019. Although there is a new multidimensional staging and grading system for periodontitis, we have retained the label 'chronic periodontitis' in this version of the review since available studies are based on the previous classification system. To investigate the effects of periodontal therapy for primary or secondary prevention of CVD in people with chronic periodontitis. An information specialist searched five bibliographic databases up to 17 November 2021 and additional search methods were used to identify published, unpublished, and ongoing studies. We also searched the Chinese BioMedical Literature Database, the China National Knowledge Infrastructure, the VIP database, and Sciencepaper Online to March 2022. We included randomised controlled trials (RCTs) that compared active periodontal therapy to no periodontal treatment or a different periodontal treatment. We included studies of participants with a diagnosis of chronic periodontitis, either with CVD (secondary prevention studies) or without CVD (primary prevention studies). Two review authors carried out the study identification, data extraction, and 'Risk of bias' assessment independently and in duplicate. They resolved any discrepancies by discussion, or with a third review author. We adopted a formal pilot-tested data extraction form, and used the Cochrane tool to assess the risk of bias in the studies. We used GRADE criteria to assess the certainty of the evidence. There are no new completed RCTs on this topic since we published our last update in 2019. We included two RCTs in the review. One study focused on the primary prevention of CVD, and the other addressed secondary prevention. We evaluated both as being at high risk of bias. Our primary outcomes of interest were death (all-cause and CVD-related) and all cardiovascular events, measured at one-year follow-up or longer. For primary prevention of CVD in participants with periodontitis and metabolic syndrome, one study (165 participants) provided very low-certainty evidence. There was only one death in the study; we were unable to determine whether scaling and root planning plus amoxicillin and metronidazole could reduce incidence of all-cause death (Peto odds ratio (OR) 7.48, 95% confidence interval (CI) 0.15 to 376.98), or all CVD-related death (Peto OR 7.48, 95% CI 0.15 to 376.98). We could not exclude the possibility that scaling and root planning plus amoxicillin and metronidazole could increase cardiovascular events (Peto OR 7.77, 95% CI 1.07 to 56.1) compared with supragingival scaling measured at 12-month follow-up. For secondary prevention of CVD, one pilot study randomised 303 participants to receive scaling and root planning plus oral hygiene instruction (periodontal treatment) or oral hygiene instruction plus a copy of radiographs and recommendation to follow-up with a dentist (community care). As cardiovascular events had been measured for different time periods of between 6 and 25 months, and only 37 participants were available with at least one-year follow-up, we did not consider the data to be sufficiently robust for inclusion in this review. The study did not evaluate all-cause death and all CVD-related death. We are unable to draw any conclusions about the effects of periodontal therapy on secondary prevention of CVD. For primary prevention of cardiovascular disease (CVD) in people diagnosed with periodontitis and metabolic syndrome, very low-certainty evidence was inconclusive about the effects of scaling and root planning plus antibiotics compared to supragingival scaling. There is no reliable evidence available regarding secondary prevention of CVD in people diagnosed with chronic periodontitis and CVD. Further trials are needed to reach conclusions about whether treatment for periodontal disease can help prevent occurrence or recurrence of CVD.

MicroRNA-28-5p as a potential diagnostic biomarker for chronic periodontitis and its role in cell proliferation and inflammatory response

Background/purposeRecent studies have pointed to the crucial role of microRNAs (miRNAs) in chronic periodontitis (CP). This study investigated the regulation and potential mechanisms of miR-28-5p in CP patients and lipopolysaccharide (LPS)-induced periodontal ligament cells (PDLCs).Materials and methods76 CP patients and 71 periodontally healthy subjects were included. RT-qPCR was employed to examine miR-28-5p and sphingosine kinase −1 (SPHK1) in subjects’ gingival sulcus fluid and PDLCs. The diagnostic performance was evaluated by measuring the area under the curve (AUC) of the receiver operating characteristic (ROC) analysis. Pearson correlation coefficient (r) was adopted to explore the statistical relation between indicators. PDLCs proliferation and inflammation factors were determined by CCK-8 and ELISA assay. The direct target gene was validated by a dual-luciferase reporter assay.ResultsmiR-28-5p was lowly expressed in CP patients and LPS-induced PDLCs (P < 0.05). AUC for miR-28-5p was 0.937, which had certain diagnostic value. Additionally, miR-28-5p was negatively correlated with periodontal clinical indicators and inflammatory factors. Cell proliferation of PDLCs was inhibited and inflammation was promoted under LPS induction, however, elevated miR-28-5p diminished the effect of LPS (P < 0.05). SPHK1 acts as a miR-28-5p target and the elevation of SPHK1 caused by LPS treatment was inhibited by the increased miR-28-5p.ConclusionPresent study revealed that miR-28-5p could be served as a potential diagnostic biomarker for CP. And miR-28-5p may participate in CP progression by targeting SPHK1 to regulate the proliferation and inflammation of PDLCs. This study may offer insights into CP treatment and diagnosis.

Effect of periodontal treatment on the blood parameters of individuals with diabetes mellitus

OBJECTIVE: This study aimed to evaluate diabetic individuals with chronic periodontitis who underwent periodontal treatment using clinical parameters and blood tests for fasting glycemia and glycated hemoglobin. MATERIAL AND METHODS: A total of 146 patients with diabetes were initially evaluated. After adopting the inclusion and exclusion criteria, 63 patients were included in the diabetic group (DG). The control group (CG) consisted of individuals with a similar age group to the DG group, a diagnosis of chronic periodontitis, and without systemic involvement. Periodontal clinical parameters and blood tests for fasting glycemia and glycated hemoglobin were performed before periodontal treatment (T1) and 90 days after (T2) treatment. RESULTS: For plaque index and bleeding index, there was a significant difference between the times in both groups. Significant reduction in the percentage of pockets with PD ≥ 6mm after periodontal therapy in both groups. The blood test showed a significant difference in DG group, for fasting glycemia in T1 mean of 168.8 mg/dl and in T2 of 153.1 mg/dl and glycated hemoglobin in 7.6% in T1 and 7.3% in T2 (p ≤ 0,05). CONCLUSION: Non-surgical periodontal therapy improved blood parameters of fasting glucose and glycated hemoglobin in individuals with type 2 diabetes mellitus after treatment.

Photodynamic Therapy Using 5-Aminolevulinic Acid (Ala) for the Treatment of Chronic Periodontitis: A Prospective Case Series

Aim: The objective of this study was to compare the efficacy of supportive periodontal therapy (i.e., scaling and root planning, SRP) alone versus ALADENT medical device used in association with SRP in the treatment of chronic periodontitis in adult patients. Materials and Methods: A total of 20 patients with a diagnosis of chronic periodontitis (40 localized chronic periodontitis sites) aged between 35 and 55 were selected. None of these patients previously received any surgical or non-surgical periodontal therapy, and they presented radiographic evidence of moderate bone loss. Two non-adjacent sites in different quadrants were identified and observed in each patient, analyzing treatment effectiveness (split-mouth design). Clinical pocket depth, clinical attachment loss, and bleeding on probing were evaluated at time 0 and after 6 months, while microbial analysis (MA) was conducted at baseline and after 15 days. Significant differences were calculated using SPSS program and paired simple statistic t-test. Results: Total bacteria loadings had a statistically significant reduction before and after treatment with SRP (left site) (total average decrease of 27%). The sites treated with SRP plus ALADENT (right) showed a significantly reduced total bacterial loading compared to the untreated sites (right) (total average decrease of 75%). Mean values of CAL/PD and percentages data of BOP, recorded after SRP + ALADENT therapy, showed a higher reduction (CAL = 2.42, PD = 2.87 mm, 90% of sites with no bleeding) than those obtained after SRP treatment (CAL = 4.08 mm, PD = 4.73 mm, 70% of sites with no bleeding). Conclusion: The treatment of moderate and severe chronic periodontitis should include, beside SRP, the use of ALADENT medical device, which has been proved to be a useful adjuvant therapy.

The role of bone-specific biomarkers in chronic periodontitis diagnosis and treatment outcomes - a systematic review.

Background The biomarkers of bone turnover may be vital for early detection of bone destruction in chronic periodontitis (CP). Lately, several new biochemical markers have been applied to estimate bone homeostasis.Objective The current review aims to evaluate the role of bone biomarkers in diagnosis and treatment outcomes of CP.Methods Literature search was conducted in databases like Medline (PubMed) and Scopus to include original research articles related to the role of bone biomarkers in CP. About 914 documents were identified through primary search, of which 11 original research articles were included.Results The most common bone biomarker applied in periodontal diagnosis was RANKL. Certain newer biomarkers like ICTP were also found to be useful in early detection of progressive CP.Conclusion The bone turnover biomarkers may serve as an adjunct to the traditional methods of periodontal diagnosis. They are vital in identifying the subjects at risk for future periodontal breakdown as well as in determining the therapeutic outcomes. Their applications in periodontal diagnosis is still in the developing stage and requires further investigation. With this background, the current systematic review evaluated the role of bone-specific biomarkers in CP diagnosis and treatment outcomes.

A Comparative Evaluation of the Measurement of Interleukin-1β as Salivary Biomarker in Periodontitis Patients with and without Diabetes Mellitus

Introduction: Periodontitis is characterized by inflammatory destruction of connective tissue, loss of periodontal attachment, and resorption of the alveolar bone. Because of its activity as an inflammatory mediator as well as a modulator of the extracellular matrix and bone, the pro-inflammatory cytokine interleukin (IL)-1β.&#x0D; Aim: The study aimed to evaluate Interleukin-1β as a salivary biomarker in periodontitis patients with and without diabetes mellitus.&#x0D; Materials and methods: The study included 30 patients, 15 males and 15 females, ranging in age from 30 to 60 years old. Group A: Clinically healthy, Group B: Periodontitis with diabetes mellitus, and Group C: Periodontitis without diabetes mellitus were the three groups of patients under this investigation. Expectoration into sterile bulbs was used to collect whole unstimulated saliva from all patients. Following that, collected samples are sent to the laboratory, where the amount of IL-1β, as a periodontal disease marker was determined using the ELISA sandwich technique. The data were statistically analysed using One-Way ANOVA. The Newman-Keuls multiple comparison test was used to test the significance at the levels of p&lt;0.05.&#x0D; Results: IL-1β level was found to be significantly higher (p&lt;0.05) in periodontitis with diabetes mellitus (75 ±7 pg/L) when compared with patients with periodontitis only (45.06±7 pg/L) compared with healthy controls (36.37±5.6 pg/L).&#x0D; Conclusion: From the study, it was concluded that IL-1β level was significantly increased with periodontitis patients, and patients with periodontitis and diabetes mellitus, when compared to patients with clinically healthy group. In summary, diabetes mellitus and periodontal diseases are closely associated with each other. Salivary IL-1β level can be used as a biomarker in early diagnosis of chronic periodontitis in patients with diabetes mellitus.

Role of non-resident subpopulations of mucosal and adaptive immune systems in patients with chronic periodontitis

Periodontal bacterial bioflm causes an innate and adaptive immune response of the host mucosa, leading to inflammation and destruction of the tissues supporting the periodontal. The progression of periodontitis depends not only on bacteria, since an inadequate immune response to microorganisms can accelerate the development of periodontitis. However, the exact mechanisms of the development of immune reactions remain unclear. Recent studies emphasize the existence of a typical innate response of resident and extravasated immune cells.Objective. To investigate the quantitative composition of non-resident subpopulations of lymphocytes in salivary fluid and to study the mechanisms of interaction of the cellular link of the innate and adaptive immune system in chronic generalized periodontitis of varying severity.Materials and methods. 49 people aged 26–67 years of both sexes were examined with a diagnosis of chronic periodontitis. The comparison group consisted of 17 people aged 26–44 years with no periodontal diseases. The state of the cellular link of the adaptive and local immune system of the oral cavity was assessed by the following phenotypes: CD3–CD16+56+; CD3+CD16+56+; CD3+; CD3+HLA-DR+; CD19+, CD19+HLA-DR+; CD19+CD5+CD27–; CD19+CD5–СD 27–; CD19+СD5–CD27+.Results. The number of T-NK cells decreased with a mild degree of periodontitis and increased with a severe degree. Similarly, CD3+HLA-DR+ decreased with mild periodontitis [Me = 0.148 cells/µl] and increased with moderate [Me = 0.247 cells/µl] and severe [Me = 0.448 cells/µl]. The number of B-lymphocytes with the CD19+, CD19+CD5+, CD19+CD5–CD27+ phenotype decreased to single cells per microliter during the development of the disease.Conclusion. The imbalance of the immune system caused by pathogenic colonization of the periodontium, at different degrees of severity, is an important factor in the occurrence and development of periodontitis, in which various subsets of B cells of the adaptive immune system play a certain role, closely interacting with the cellular link of the innate mucosal immune system

Indocyanine-mediated antimicrobial photodynamic therapy promotes superior clinical effects in stage III and grade C chronic periodontitis among controlled and uncontrolled diabetes mellitus: A randomized controlled clinical trial

Background: The aim of this randomized controlled clinical trial was to evaluate the efficacy of indocyanine-green mediated antimicrobial photodynamic therapy (ICG-aPDT) in the treatment of stage III grade C periodontitis in terms of clinical, microbiological, and immune-inflammatory parameters in patients with well-controlled and poorly-controlled form of type-2 diabetes mellitus (T2DM). Materials and methods: Subjects with a diagnosis of chronic periodontitis according to the new classification and case definition of periodontitis [probing depth (PD): ≥6 mm, interdental clinical attachment loss (CAL): ≥5 mm and bone loss extending to mid-third of root and beyond (≥3 mm)] were recruited. Subjects were grouped on the basis of well-controlled and poorly-controlled diabetic status. Two subgroups were made according to the treatment modality (RSD versus ICG-aPDT/RSD) in each group. A split-mouth design was used in which one site was designated for control (RSD alone treatment) while the other contralateral site was chosen for test treatment (ICG-aPDT/RSD) in all the patients. Periodontal parameters included the measurement of plaque score (PS), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL) and alveolar bone levels (ABL). Identification of Porphyromonas gingivalis and Tannarella forsythia through PCR was executed using species specific primers. Gingival crevicular fluid samples were then analyzed using enzyme-linked immunosorbent assay for the quantification of interleukin (IL)-17 and interferon (IFN)-γ. All the clinical, microbiological, and immunological parameters were assessed using repeated measure ANOVA for intra and inter-group comparisons. The p-value significance was set at 0.05. Results: The mean age of the 50 patients was 44.7 ± 7.4 years. Systemic parameters suggest no significant change between the times in either HbA1c or serum CRP levels in any of the groups. A statistically significant reduction for BOP was noted for ICG-aPDT group for non-diabetic subjects at 3 months follow up only, while a significant reduction was seen at both 3 months and 6 months among well-controlled and poorly-controlled T2DM subjects (p<0.05). For PD and CAL, a significant improvement was seen for ICG-aPDT group among non-diabetic and well-controlled T2DM subjects at both 3- and 6-months follow up, while a significant reduction was seen at only 3 months among poorly-controlled T2DM subjects. A significant reduction was seen for ICG-aPDT group compared to RSD group for both bacteria in all the three groups at 6 months follow up (p<0.05). Conclusion: ICG-aPDT significantly improved clinical and antimicrobial parameters in well-controlled and poorly-controlled T2DM having stage III and grade C periodontitis. Glycemic status did not have negative impact in the reduction of periodontal parameters in either types of T2DM. Trial registration: The present RCT was registered in the clinicaltrials.gov under the identifier: NCT04857346

Soluble neuropilin-1 in gingival crevicular fluid is associated with rheumatoid arthritis: An exploratory case-control study

BackgroundTo explore the soluble Neuropilin-1 (sNRP-1) concentrations in gingival crevicular fluid (GCF) and the periodontal clinical status of patients with Rheumatoid Arthritis (RA). Materials and methodsWe conducted an exploratory study with 40 study participants, 20 with RA, and 20 healthy controls. Clinical and periodontal data were recorded, and GCF samples were obtained. sNRP-1 levels in GCF were determined by ELISA assay. Descriptive statistics, Mann–Whitney U test, Unpaired t-test, logistic regression model, and Area Under Receiver Operating Characteristic Curve (AUC-ROC) were made to explore the diagnostic performance accuracy. ResultsRA patients had significantly higher levels of sNRP-1 in GCF (p ​= ​0.0447). The median levels of GCF-sNRP-1 were 208.85 ​pg/μl (IQR 131.03) in the RA group compared to 81.46 ​pg/μl (IQR 163.73) in the control group. We observed an association between the GCF-sNRP-1 concentrations and the RA diagnosis (OR:1.009; CI 1.00–1.001; p ​= ​0.047). The diagnosis of chronic periodontitis was also associated with RA (OR: 6.9; CI 1.52–31.37; p ​= ​0.012). Moreover, the AUC-ROC of GCF-sNRP-1 concentrations combined with periodontal clinical parameters such as periodontal probing depth and periodontal inflamed surface area was 0.80. ConclusionThis exploratory case-control study shows that RA patients had significantly higher levels of sNRP-1 in GCF. New longitudinal studies are necessary to evaluate the role of NRP-1 in periodontal tissues and consider it an oral biomarker with clinical value in RA.

Expression of Toll-like receptors 2 and 4 in the saliva of patients with systemic lupus erythematosus and chronic periodontitis.

The aim of this study was to investigate the expression of salivary Toll-like receptors (TRL) 2 and 4 in patients with systemic lupus erythematosus (SLE) and chronic periodontitis (CP). A case-control study was conducted with 77 participants (42 SLE and 35 non-SLE) stratified according to CP diagnosis criteria. Periodontal parameters consisted of clinical attachment level (CAL), probing depth (PD), the visible plaque index (VPI), and the gingival bleeding index (GBI). Salivary TRL 2 and 4 expressions were determined by quantitative real-time polymerase chain reaction (RT-PCR). Statistical analysis included Mann-Whitney U test, Kruskal-Wallis test, Spearman's correlation rank, and multiple linear regression. Patients with isolated SLE or CP had higher TLR 2 and TLR 4 expression in their saliva samples (P < 0.05). The group with both SLE and CP had lower TLR 2 and 4 expressions (P < 0.05). TLR 2 and TLR 4 showed significant negative correlations with PD, CAL, and GBI in SLE patients, and a significant positive correlation with periodontal parameters in non-SLE patients. CP was independently associated with reduction of TLR2 and TLR4 expression, even after adjusting for clinical data and current drug use. Reduced TRL 2 and 4 expression in saliva was associated with the presence of CP in SLE patients. Key Points • Patients affected by isolated CP or SLE had higher TLR2 and TLR4 expression. • TLR under-expression may be associated with a worse periodontal status in SLE. • Abnormalities in TLRs expression may increase the susceptibility to periodontitis.

Total oxidant status and total antioxidant capacity in the saliva of patients with chronic periodontitis

Recently, methods of quantifying total oxidant status (TOS) and total antioxidant capacity (TAOC) were developed to investigate periodontitis. This study was performed to evaluate the salivary TOS and TAOC levels of patients with chronic periodontitis (CP) and investigating the association between periodontal clinical parameters and these oxidative stress biomarkers. 40 participants (23-65 years old) were classified into two groups of 20 each, namely the CP group (participants with CP) and the control group (periodontally healthy controls). Clinical periodontal parameters were monitored, and TOS and TAOC levels were measured using laboratory assays. TOS level increased in the saliva of patients with CP and the salivary TAOC in patients with CP was significantly lower than that of the control group. The TOS had a positive moderate correlation with the plaque index and clinical attachment loss (r=0.32 and 0.37, respectively) while TAOC was negatively and moderately correlated with clinical attachment loss (r=-0.35). Salivary TOS and TAOC were distinguished in healthy and chronic PD patients. Further studies are required to comprehensively evaluate the potential role of these biomarkers in diagnosis and treatment evaluation of CP.

Ретроспективный анализ обращаемости пациентов с хроническим пародонтитом в лечебные учреждения стоматологического профиля г.о. Самара

Subject. Data on the prevalence and epidemiology of chronic periodontitis are presented. The main treatment protocols for this pathology and the most common complications arising from its neglect or inadequate treatment are presented. The goal is to conduct a retrospective analysis of the incidence of chronic generalized periodontitis in the period from 2015 to 2019 in medical institutions of the dental profile of the city of Samara Methodology. During the study 21368 medical records were studied in the period from 2015 to 2019, and errors in filling out 2910 medical records of primary patients were analyzed. The quality of conducting 18458 medical records was assessed in the provision of dental care for patients with a diagnosis of chronic periodontitis. Statistical processing of the material was carried out using the statistical program package “Statistica” for the formation of clear approaches in the diagnosis, treatment methods and prevention of this pathology. Results. An analysis of medical records showed that the highest prevalence of chronic periodontitis was observed in the 55―64-year-old age group (29.82 % of those examined), while 67.5 % of the patients showed a generalized form of chronic periodontitis, and 32.5 % localized. The treatment of such patients was carried out comprehensively and included both conservative methods of treatment, as well as surgical and orthodontic treatment. Stabilization in chronic generalized and localized periodontitis of mild degree occurred in 45 % of patients, in medium ― in 33.4 %, and in severe ― in 8.5 %. Conclusions. The frequency of occurrence of patients with a diagnosis of "chronic periodontitis" by referral to dental clinics is about 86 %. At the same time, the positive outcome of the treatment currently remains at an extremely low level, especially in the treatment of patients with a severe degree of development of chronic periodontitis. This is largely due to the neglect by the dentists of the proposed treatment protocols.

Increased Risk of Chronic Periodontitis in Chronic Rhinosinusitis Patients: A Longitudinal Follow-Up Study Using a National Health-Screening Cohort.

This study compared the risk of chronic periodontitis (CP) between chronic rhinosinusitis (CRS) and non-chronic rhinosinusitis (control) patients using a national cohort dataset from the Korean Health Insurance Review and Assessment Service. CRS (n = 5951) and control participants (n = 23,804) were selected after 1:4 ratio matching for age, sex, income, region of residence, and preoperative CP visits. Postoperative CP visits were measured between 2002 and 2015. The margin of equivalence of the difference between the CRS and control groups was set between −0.5 and 0.5. Statistical significance was noted in the post-index date (ID) of the third, fourth, and fifth year periods. In subgroup analyses according to age and sex, statistical significance was observed in 40–59-year-old males in post-ID third, fourth, and fifth year periods, ≥60-year-old males in post-ID third and fourth year periods, and ≥60-year-old females in post-ID fifth year period (p < 0.05, each). In another subgroup analysis based on the number of pre-ID CP visits, statistical significance was observed for pre-ID CP (0 time) in the third, fourth, and fifth year periods (p < 0.05, each). This study revealed that CRS participants were likely to receive CP diagnosis and treatment.