IL-1β In Gingival Crevicular Fluid Research Articles

Gingival Crevicular Fluid and Plasma Acute‐Phase Cytokine Levels in Different Periodontal Diseases

The aim of the present study is to investigate gingival crevicular fluid (GCF) and plasma acute-phase cytokines, interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-11 (IL-11), oncostatin M (OSM), and leukemia inhibitory factor (LIF) levels in patients with different periodontal diseases. Eighty individuals were included in this study; 20 with chronic periodontitis (CP), 20 with generalized aggressive periodontitis (GAgP), 20 with gingivitis, and 20 classified as healthy (H). Probing depth, clinical attachment level, plaque index, and papilla bleeding index were recorded. Plasma and GCF IL-1β, IL-6, IL-11, OSM, and LIF levels were analyzed by enzyme-linked immunosorbent assay. CP and GAgP groups had significantly higher GCF IL-1β, IL-6, and IL-11 levels when compared with the H group (P <0.05). Conversely, GCF LIF levels of the CP and GAgP groups were lower than those of the H group (P <0.05). GCF OSM levels did not differ significantly among study groups. Plasma levels of all the cytokines studied were not significantly different among the study groups. Based on the present data, elevated IL-1β, IL-6, and IL-11 GCF levels, but not plasma levels, are suggested as reliable inflammatory biomarkers in periodontal diseases. Decreased LIF levels in diseased groups might reflect the possible beneficial effects of LIF in the modulation of inflammatory response in gingiva.

Effect of nonsurgical periodontal therapy on serum and gingival crevicular fluid cytokine levels during pregnancy and postpartum

A low-grade systemic inflammatory status originating from periodontal infection has been proposed to explain the association between periodontal disease and systemic conditions, including adverse obstetric outcomes. The aim of this study was to evaluate the effect of periodontal therapy during pregnancy on the gingival crevicular fluid and serum levels of six cytokines associated with periodontal disease and preterm birth. A subsample of 60 women (18-35 years of age) up to 20 gestational weeks, previously enrolled in a larger randomized clinical trial, was recruited for the present study. Participants were randomly allocated to receive either comprehensive nonsurgical periodontal therapy before 24 gestational weeks (n = 30, test group) or only one appointment for supragingival calculus removal (n = 30, control group). Clinical data, and samples of blood and gingival crevicular fluid, were collected at baseline, at 26-28 gestational weeks and 30 d after delivery. The levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70 and tumor necrosis factor-α were analyzed by flow cytometry. After treatment, a major reduction in periodontal inflammation was observed in the test group, with bleeding on probing decreasing from 49.62% of sites to 11.66% of sites (p < 0.001). Periodontal therapy significantly reduced the levels of IL-1β and IL-8 in gingival crevicular fluid (p < 0.001). However, no significant effect of therapy was observed on serum cytokine levels. After delivery, the levels of IL-1β in the gingival crevicular fluid of the test group were significantly lower than were those in the control group (p < 0.001), but there were no significant differences between test and control groups regarding serum cytokine levels. Although periodontal therapy during pregnancy successfully reduced periodontal inflammation and gingival crevicular fluid cytokine levels, it did not have a significant impact on serum biomarkers.

Short-term clinical and osteoimmunological effects of scaling and root planing complemented by simple or repeated laser phototherapy in chronic periodontitis

The aim of this study was to evaluate the clinical, anti-inflammatory, and osteoimmunological benefits of the single (PT) and repeated laser phototherapy (rPT) as an adjunctive treatment of inflamed periodontal tissue. Twenty-seven patients with chronic periodontitis were randomly divided into three groups of nine patients each in order to undergo scaling and root planing (SRP), SRP followed by one session of adjunctive PT (Day 1; SRP + PT), or SRP followed by adjunctive repeated PT five times in 2 weeks (Days 1, 2, 4, 7, and 11; SRP + rPT). For phototherapy session, a diode laser (λ = 670 nm, 200 mW, 60 s/tooth) was applied into the sulcus. Clinical parameters, including full-mouth plaque score, full-mouth bleeding score, probing pocket depth, and clinical attachment level were recorded. Samples of gingival crevicular fluid (GCF) were taken at baseline, 4, and 8 weeks after treatment. Interleukin 1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), receptor activator of nuclear factor κΒ ligand (RANKL), and osteoprotegerin (OPG) levels in the collected GCF were measured. PT used in a single or repeated doses, does not produce a significant reduction in the clinical parameters essayed (p > 0.05). Levels of IL-1β in GCF were significantly reduced in SRP + PT and SRP + rPT groups compared with the SRP group (p < 0.05). However, the SRP + rPT group showed a significant reduction of pro-inflammatory cytokine TNF-α and RANKL/OPG ratio at 4 weeks post-treatment compared with the SRP + PT and SRP groups (p < 0.05). SRP + PT group also showed a significant reduction in TNF-α and RANKL/OPG ratio at 8 weeks post-treatment compared with the SRP group (p < 0.05). PT exerts a biostimulative effect on the periodontal tissue. Multiple sessions of PT showed a faster and greater tendency to reduce proinflammatory mediators and RANKL/OPG ratio.

Influence of smoking on interleukin‐1beta level, oxidant status and antioxidant status in gingival crevicular fluid from chronic periodontitis patients before and after periodontal treatment

The aim of this study was to evaluate the impact of smoking on the relationship between interleukin-1 (IL-1β) and oxidation in patients with periodontitis and response to nonsurgical periodontal therapy. Data were obtained from 30 patients with generalized chronic periodontitis (15 smokers and 15 nonsmokers) and from 10 periodontally healthy controls. IL-1β level, total oxidant status (TOS) and total antioxidant status (TAS) were recorded in gingival crevicular fluid. Probing depth, clinical attachment level, gingival and plaque indices and bleeding on probing were also measured. The gingival crevicular fluid and clinical parameters were recorded at baseline and 6 wk after periodontal treatment. The study showed statistically significant improvement of clinical parameters in both smokers and nonsmokers after periodontal treatment. Moreover, the baseline IL-1β levels were significantly higher in smokers compared with nonsmokers (p < 0.05). After periodontal treatment, the IL-1β levels were significantly reduced in both smokers and nonsmokers (p < 0.05). There were no significant differences in TOS and TAS between periodontitis patients and healthy controls at baseline and 6 wk after periodontal treatment. The level of IL-1β in gingival crevicular fluid was positively correlated with TOS in both smokers and nonsmokers. Periodontal treatment improved the clinical parameters in both smokers and nonsmokers. The results confirm that periodontal therapy has an effect on IL-1β levels in gingival crevicular fluid, but not on TOS and TAS.

Interleukin-1 gene polymorphisms and periodontal status in a Spanish population

The aim of this study was to investigate the possible association between interleukin (IL)-1A (+4845) and/or IL-1B (+3954) gene polymorphisms and the onset and progression of chronic periodontal disease (PD), an issue that remains controversial. The relationship between IL-1β concentration in the gingival crevicular fluid (GCF) and disease activity was also evaluated. The study was performed on 25 individuals with no gingivitis or PD and on 25 subjects with active chronic PD. Two samples of GCF were obtained from each subject and IL-1β was determined by enzyme-linked immunoabsorbent assay. Blood samples (10 ml) were drawn from each subject to detect polymorphisms in IL-1A (+4845) and IL-1B (+3954) by polymerase chain reaction. Mean GCF IL-1β concentrations were higher in patients with active chronic PD compared to the control group. No significant association was found in either group between GCF IL-1β concentration and the presence of polymorphisms in IL-1A (+4845), IL-1B (+3954) or both genotypes. No significant difference was found in either group with regard to the presence of polymorphisms in IL-1A (+4845), IL-1B (+3954) or both genotypes (p=0.556). The concentration of IL-1β in GCF was almost 2-fold higher in patients with chronic PD than in the healthy individuals. The presence of polymorphisms in IL-1A (+4845) and/or IL-1B (+3954) genotypes is not associated with IL-1β overproduction in GCF and is not a risk factor for chronic PD. IL-1β is considered a suitable marker of the severity and progression of chronic PD. The presence of IL-1A (+4845) and/or IL-1B +3954 gene polymorphisms does not appear to be a risk factor for chronic PD. Therefore, the IL-1A (+4845) and/or IL-1B +3954 gene polymorphisms cannot be considered genetic markers of chronic PD. Moreover, these polymorphisms do not indicate an overproduction of IL-1β in GCF.

Correlations between pentraxin 3 or cytokine levels in gingival crevicular fluid and clinical parameters of chronic periodontitis

The gingival crevicular fluid (GCF) contains various biomarkers, such as interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α (TNF-α), and IL-10, among others. These cytokines have been reported to correlate with gingival inflammation and periodontal status. Therefore, the analysis of GCF may be useful for the diagnosis of periodontal status. Pentraxin 3 (PTX3) is the first identified long pentraxin, and is released by several cell types in response to proinflammatory signals. The aim of this study was to determine the levels of IL-1β, IL-6, IL-8, TNF-α, IL-10 and PTX3 in GCF from diseased and healthy sites in patients with chronic periodontitis. Cross-sectional clinical data were obtained from 50 patients with chronic periodontitis. GCF samples were collected with paper strips from one periodontal diseased site and one periodontally healthy site per subject. The levels of IL-1β, IL-6, IL-8, IL-10 and TNF-α were determined using a multiplexed bead immunoassay, and the PTX3 level was measured using an enzyme-linked immunosorbent assay. Mean clinical parameters were significantly higher at diseased sites (P < 0.01) as compared to healthy sites, and the mean levels of PTX3, IL-1β, IL-6, IL-8, IL-10 and TNF-α were higher in diseased sites (P < 0.01) than in healthy sites. There were strong correlations between PTX3 or IL-1β and periodontal status. These results suggest that GCF PTX3 levels might be useful as a diagnostic marker for periodontal disease.

Mutations in the ELANE Gene are Associated with Development of Periodontitis in Patients with Severe Congenital Neutropenia

BackgroundPatients with severe congenital neutropenia (SCN) often develop periodontitis despite standard medical and dental care. In light of previous findings that mutations in the neutrophil elastase gene, ELANE, are associated with more severe neutropenic phenotypes, we hypothesized an association between the genotype of SCN and development of periodontitis.MethodsFourteen Swedish patients with SCN or cyclic neutropenia harboring different genetic backgrounds were recruited for periodontal examination. Peripheral blood, gingival crevicular fluid (GCF), and subgingival bacterial samples were collected. The levels of cytokines and antibacterial peptides were determined in GCF and plasma by multiplex immunoassay and immunoblotting, respectively. Subgingival bacterial samples were analyzed using 16S rDNA pyrosequencing.Results ELANE mutations correlated with more severe periodontal status than the HAX1 or unknown mutations in patients with SCN. The subjects with mutant ELANE had higher levels of IL-1β in GCF. Using principal coordinate analysis of the subgingival microbiota, patients with ELANE mutations and reference subjects with periodontitis tended to cluster differently from patients with HAX1 or unknown mutations and non-periodontitis reference subjects.ConclusionThis study demonstrates an association between ELANE mutations in SCN and the development of periodontitis with skewed subgingival microbiota, indicating a potential role of ELANE mutations in the pathogenesis of periodontitis.

Effect of 1,064-nm Nd:YAG laser therapy on GCF IL-1β and MMP-8 levels in patients with chronic periodontitis

The aim of this study was to evaluate the long-term effects of a combined periodontal treatment of scaling and root planing (SRP) and Nd:YAG laser (NDL) in chronic periodontitis (CP) patients. This was accomplished by determining the periodontal indices and the interleukin-1beta (IL-1β) and matrix metalloproteinase-8 (MMP-8) levels of the gingival crevicular fluid (GCF). This study was performed according to a random split-mouth-design, controlled clinical trial for sulcular debridement on 40 teeth from 20 patients with generalized moderate chronic periodontitis. The periodontal healing outcomes were compared after periodontal treatment with either SRP + NDL at 1 W (test side) or SRP (control side). Plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded, and samples of gingival crevicular fluid (GCF) were taken at baseline and post-therapy (3 and 9months after treatment). The GCF samples were analyzed for IL-1β and MMP-8. There was postoperative improvement of all clinical parameters in both groups, but test side GI, PPD, and CAL recovery was higher than that of the control side (p < 0.05). Although levels of IL-1β and MMP-8 in GCF after treatment were lower in the test side than the control side, there was not a statistically significant difference (p > 0.05). In the long term, we found that SRP + NDL treatment of periodontal pockets was more effective than SRP alone in reducing PPD, CAL, GI, and GCF values.

T-helper-related cytokines in gingival crevicular fluid from adolescents with Down syndrome

Subjects with Down syndrome have a high prevalence of periodontal disease. The aim was to investigate the level of Th1-, Th2- and Th17-related cytokines in the gingival crevicular fluid (GCF) of subjects with Down syndrome. Subjects with Down syndrome (n = 24) and controls (n = 29) with a mean age of 16.4 years were clinically examined with respect to periodontal probing depth (PD) and gingival inflammation in terms of bleeding on probing (BOP%). The controls were matched to subjects with Down syndrome regarding age and gingival inflammation (BOP%). All subjects answered a questionnaire regarding oral hygiene, medical history and socioeconomic background. GCF was collected and the concentration of the cytokines, IFN-γ, TNF-α, IL-1β, IL-4, IL-6, IL-10, IL-12 and IL-17 were determined using Bio-Plex cytokine multiplex assays. The volume of GCF (microliters) was significantly higher in subjects with Down syndrome (P < 0.001) compared with controls. The mean concentrations (picogrammes per millilitre) of IL-1β (P < 0.001), IL-4 (P = 0.002), IL-6 (P = 0.005), IL-10 (P = 0.001), IL-12 (P = 0.003), IFN-γ (P = 0.002), and TNF-α (P = 0.002) in GCF, respectively, were significantly higher in subjects with Down syndrome compared with controls. The regression line of the relationship between IFN-γ and IL-4 in GCF differed significantly (P = 0.006) in subjects with Down syndrome compared to controls. Subjects with Down syndrome demonstrated higher concentration of Th1-, Th2- and Th17-related cytokines with an altered relationship between Th1 cytokine, IFN-γ and Th2 cytokine, IL-4, in volume GCF compared to controls.

A clinical, microbiological and immunological comparison between subgingival irrigation with Dentol™ and chlorhexidine in advanced periodontitis

IntroductionThe purpose of this study was to compare the clinical, microbiological and immunological effects of subgingival irrigation with Dentol™ and 0.2% chlorhexidine in human advanced periodontitis.Material and methodsTwenty cases of advanced periodontitis patients were randomly treated either with Dentol™ (as test) or 0.2% chlorhexidine (as control) every other day for 29 days after primary scaling, root planing and oral hygiene instruction. Pocket depth (PD), bleeding on probing (BOP) and plaque index (PI) were considered as clinical parameters. Total counts of aerobic and anaerobic bacteria were measured in subgingival plaque. At the end, concentrations of TNF-α and IL-1β in gingival crevicular fluid were measured as inflammatory markers.ResultsPD and BOP decreased in both groups on the 29th day and two weeks afterward. PI did not show any statistical difference either within or among groups (p > 0.05). Results indicate that both chlorhexidine and Dentol™ diminished total count of subgingival anaerobic bacteria significantly (p < 0.05). Total count of subgingival aerobic bacteria increased in both groups, but the differences between the two groups were statistically significant in favour of Dentol™ (p < 0.05). The level of IL-1β in the crevicular fluid was reduced in both groups but it was more significant in the test group (p < 0.05). The TNF-a level decreased in both groups but the statistical difference between the two groups was negligible (p > 0.05).ConclusionsSubgingivally irrigation with Dentol™, containing 0.02% carvacrol, every other day for 29 days is equally or more effective than 0.2% chlorhexidine in reducing clinical and immunological inflammatory indices.

Correlation of Levels of Interleukin-1β in Gingival Crevicular Fluid to the Clinical Parameters of Chronic Periodontitis

IL-1β is a potent stimulator of bone resorption and has been implicated in the pathogenesis of periodontal destruction. Therefore, this study was designed to compare the levels of IL-1β of chronic periodontitis patients with the healthy subjects. Another objective of this study was to correlate IL-1β levels with the clinical parameters of the periodontal disease progression. For this study, total 60 subjects were chosen (30- healthy and 30-chronic periodontitis). Simplified oral hygiene index (OHI-S), gingival index (GI), periodontal disease index (PDI), probing depth (PD), tooth mobility, bleeding on probing (BOP) were recorded for all the subject. Gingival crevicular fluid (GCF) was collected and subjected for ELISA for estimation of IL-1β. At the periodontal diseased sites, the IL-1β levels increased at least 2-fold as compared with healthy subjects. This increase was highly significant (p = 0.0000). Within the test group, IL-1β levels correlated positively and significantly with PDI, PD, BOP and tooth mobility. The correlations of IL-1β with PD (p = 0.000) and IL-1β with BOP (p = 0.0004) were highly significant. These data suggest that amount of GCF IL-1β is closely associated with periodontal status. This relationship may be valuable in monitoring periodontal disease activity. It could be stated from this study on IL- 1β that there seem to be a strong correlation between periodontal tissue destruction and IL-1β. Furthermore IL-1β level could also differentiate between active and inactive periodontal lesions.

Diabetes mellitus-associated periodontitis: differences between type 1 and type 2 diabetes mellitus

Although many studies have appeared about diabetes mellitus-associated periodontitis, few have compared periodontitis inflammatory markers between type 1 (T1DM) and type 2 diabetes mellitus (T2DM), and information regarding this issue is scarce and contradictory. We evaluated the levels of plasma C-reactive protein and of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in gingival crevicular fluid in two groups of subjects affected by T1DM and T2DM, in order to identify possible differences between the two classes in the inflammatory mechanisms of diabetes mellitus-associated periodontitis. Plasma C-reactive protein and gingival crevicular fluid IL-1β, IL-6 and TNF-α were measured in periodontitis patients affected by type 1 (P-T1DM, n = 24) and type 2 diabetes mellitus (P-T2DM, n = 24). Gingival crevicular fluid levels of IL-1β and TNF-α in P-T1DM subjects were significantly higher than in P-T2DM subjects. In P-T1DM subjects, we found significant negative correlations between the duration of diabetes mellitus and IL-1β and between the duration of diabetes mellitus and TNF-α. This study shows that IL-1β and TNF-α levels in periodontitis patients with T1DM are affected by the duration of diabetes mellitus.

Pro-inflammatory cytokine levels in association between periodontal disease and hyperlipidaemia

The aim of this study was to evaluate serum and gingival crevicular fluid (GCF) pro-inflammatory cytokine levels in association between periodontal disease and hyperlipidaemia. One hundred and twenty-three subjects with hyperlipidaemia and 68 systemically healthy controls (C) were included in the study. Hyperlipidaemic groups were divided into two groups as suggested diet (HD) and prescribed statin (HS). Both groups were divided into three subgroups as healthy (h), gingivitis (g) and periodontitis (p). The clinical periodontal parameters, fasting venous blood and GCF samples were obtained, and serum tumour necrosis factor-alpha (TNF-α), interleukin (IL)-1β (IL-1β) and IL-6 levels were evaluated. The ratio of total cholesterol to high-density lipoprotein (TC/HDL) was associated with gingival index and percentage of bleeding on probing (BOP%) in both hyperlipidaemic groups. In HS group, GCF and serum IL-6 were positively correlated with BOP% and TC/HDL. GCF TNF-α was positively associated with probing pocket depth and clinical attachment level, whereas serum TNF-α was associated with BOP% in the HD group. Serum and GCF TNF-α and IL-1β were significantly associated with TC/HDL in the HD group. Serum pro-inflammatory cytokines may play an important role in the association between periodontal disease and hyperlipidaemia.

Interleukin-1 levels, pain intensity, and tooth movement using two different magnitudes of continuous orthodontic force

This study aimed to determine the optimum orthodontic force from a broader perspective. Interleukin (IL)-1β levels in human gingival crevicular fluid (GCF), pain intensity, and the amount of tooth movement were measured during canine retraction using different magnitudes of continuous orthodontic force. Sixteen subjects (two males and 14 females), aged 18-24 years, diagnosed with Class I bimaxillary protrusion and treated with first premolar extractions participated in this study. The upper canines were retracted with continuous forces of 50 or 150 g using nickel-titanium coil springs on segmented archwires. One of the lower canines was used as a control. GCF was collected from the distal site of each tooth at specific time points. IL-1β concentrations, pain intensity, using the visual analogue scale (VAS), and the amount of tooth movement were evaluated. One-way analysis of variance, Friedman, and paired t-tests were used for comparisons of IL-1β in GCF, the plaque and gingival indices, and the efficiency of tooth movement on pain perception, respectively. IL-1β concentration in the 150 g group showed the highest level at 24 hours and 2 months with significant differences compared with the control group (P < 0.05). The mean VAS score of pain intensity from the 150 g force was significantly greater than from the 50 g force at 24 hours (P < 0.01). However, no significant difference in the amount of tooth movement was found between these two different magnitudes of continuous force at 2 months. A 50 g force could effectively induce tooth movement similar to 150 g with less pain and less inflammation.

Clinical findings and gingival crevicular fluid prostaglandin E2 and interleukin-1-beta levels following initial periodontal treatment and short-term meloxicam administration

Objective: To evaluate the effects of adjunctive meloxicam administration on clinical periodontal measurements and gingival crevicular fluid (GCF) prostaglandin E2 (PGE2) and interleukin-1-beta (IL-1β) levels in chronic periodontitis.Methods: Forty chronic periodontitis patients were randomized to receive either meloxicam 7.5 mg or placebo tablets for 10 days with scaling and root planing (SRP). GCF levels of PGE2 and IL-1β at baseline, day 10 of drug intake and 4 weeks after SRP were determined by enzyme-linked immunosorbent assay. Demographic, clinical periodontal data were analyzed using a repeated measures ANOVA and Bonferroni analysis. GCF PGE2 and IL-1β levels were compared between different evaluation times using the Friedman test. The Mann–Whitney test was used to compare biochemical data between the study groups. Pearson correlation analysis was used to relate clinical and biochemical data.Results: Study groups showed significant reductions in all clinical periodontal measurements and GCF volume (p < 0.05). In both groups, IL-1β was reduced significantly on day 10 and at week 4 compared with baseline (p < 0.01) without significant changes in PGE2 levels (p > 0.05). No significant differences were found between study groups in GCF IL-1β or PGE2 levels (p > 0.05).Conclusion: Adjunctive meloxicam does not seem to provide additional improvement in clinical parameters or GCF PGE2 and IL-1β levels. Larger-scale studies may better clarify potential usage of anti-inflammatory agents in periodontal therapy.

Association of Gingival Crevicular Fluid Biomarkers During Periodontal Maintenance With Subsequent Progressive Periodontitis

The analysis of biomarkers in gingival crevicular fluid (GCF) may be helpful in forecasting patient vulnerability to future attachment loss. The purpose of this study is to correlate GCF biomarkers of inflammation and bone resorption with subsequent periodontal attachment and bone loss in a longitudinal trial of a matrix metalloproteinase (MMP) inhibitor. GCF was collected from two periodontal pockets (mean +/- SD: 5.1 +/- 1.0 mm) at baseline and annually in postmenopausal females with moderate to advanced periodontitis undergoing periodontal maintenance every 3 to 4 months during a 2-year double-masked, placebo-controlled, randomized clinical trial of subantimicrobial dose doxycycline (SDD; 20 mg two times a day). Subjects were randomized to SDD (n = 64) or a placebo (n = 64). GCF was analyzed for the inflammation markers interleukin (IL)-1beta (using enzyme-linked immunosorbent assay), total collagenase activity (using hydrolysis of a synthetic octapeptide), and MMP-8 (using a Western blot) and the bone-resorption marker carboxyterminal telopeptide cross-link fragment of type I collagen (ICTP) (using a radioimmunoassay). Generalized estimating equations were used to associate these biomarkers, categorized into tertiles, with subsequent clinical attachment (using an automated disk probe) or interproximal bone loss (using radiography). Odds ratio (OR) values compared highest to lowest tertile groups. Increases in GCF IL-1beta and MMP-8 during the first year of periodontal maintenance were associated with increased odds of subsequent (year 2) periodontal attachment loss (OR = 1.67; P = 0.01 and OR = 1.50; P = 0.02, respectively) driven by the placebo group. Elevated baseline ICTP was also associated with increased odds of 1- and 2-year loss of alveolar bone density (OR = 1.98; P = 0.0001) in the placebo group, not the SDD group, and a loss of bone height (OR = 1.38; P = 0.06), again driven by the placebo group. These data support the hypothesis that elevated GCF biomarkers of inflammation and bone resorption from a small number of moderate/deep sites have the potential to identify patients who are vulnerable to progressive periodontitis, and SDD may modify that risk.

Biomarkers of periodontal inflammation in the Australian adult population

Several inflammatory biomarkers are implicated in the pathogenesis of periodontitis including interleukin-1beta (IL-1beta) and C-reactive protein (CRP). This study investigated the presence of these factors in gingival crevicular fluid (GCF) and their relationship to clinical and social determinants of periodontitis in the Australian population. Equal numbers of periodontitis cases and non-cases were sampled during oral epidemiologic examination in the National Survey of Adult Oral Health. GCF was sampled from four sites where probing pocket depth (PPD) and recession were recorded. From these, IL-1beta and CRP were quantified by ELISA and the log amount of GCF IL-1beta (pg) per person and the proportion of adults with detectable CRP was computed. Periodontitis cases (n = 511) had significantly higher levels of IL-1beta and CRP than non-cases (n = 562). PPD, clinical attachment loss, plaque and gingivitis indices were positively associated with elevated levels of both biomarkers. Levels of both were positively associated with age, low socio-economic position and non-Australian birth. The presence of IL-1beta and CRP in GCF are associated with periodontal disease parameters within the Australian population. The levels of both biomarkers are influenced by age, education and eligibility for public dental care.

Prognostic significance of tumor-infiltrating cytotoxic T-cells in colorectal cancer

Limited evidence exists regarding the role of scaling and root planning (SRP) with adjunct neodymium yttrium aluminum garnet (Nd:YAG) laser therapy in reducing periodontal parameters (plaque index [PI], bleeding on probing [BOP] and probing pocket depth [PPD]) and levels of proinflammatory cytokines in the gingival crevicular fluid (GCF) among patients with periodontal disease (PD). The aim was to assess the effect of SRP with and without adjunct Nd:YAG laser therapy on clinical periodontal parameters and GCF interleukin 1-beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) levels among patients with PD.Demographic data was collected using a questionnaire. Mandibular right and left quadrants were randomly divided into test- (SRP + Nd:YAG laser) and control-sites (SRP alone). PI, BOP and PPD were assessed and GCF IL-1β and TNF-α levels were measured at baseline and at 3- and 6-month follow-up. Level of significance was set at P < 0.05.Twenty-eight male patients with PD were included. At 3- and 6-month follow-up, PI (P < 0.01), BOP (P < 0.01) and PPD (P < 0.01) were significantly higher in the control-sites than test-sites. In the test-sites, PI, BOP and PPD and GCF IL-1β and TNF-α levels were comparable at 3- and 6-month follow-up. At 6-month follow-up, IL-1β (P < 0.05) and TNF-α (P < 0.05) levels were significantly higher in control-sites than test-sites at 3- and 6-month follow-up.At 3- and 6-month follow-up, SRP + Nd:YAG therapy was more effective in reducing periodontal inflammatory parameters and GCF IL-1β and TNF-α levels compared with SRP alone.

The Evaluation of Cystatin C, IL-1β, and TNF-α Levels in Total Saliva and Gingival Crevicular Fluid From 11- to 16-Year-Old Children.

The aim of this study was to evaluate the levels of cystatin C, interleukin-1β (IL-1β), and tumor necrosis factor-alpha (TNF-α) in the total saliva and gingival crevicular fluid (GCF) of periodontally healthy children (PHC) and children with gingivitis (CG) who were between 11 and 16 years old. The study was carried out with 10 PHC and 25 CG. Unstimulated total saliva and GCF samples were obtained. Clinical parameters, including probing depth (PD), clinical attachment loss (CAL), plaque index (PI), gingival index (GI), and gingival bleeding index (GBI), were assessed. GCF samples were collected from four maxillary upper incisors. After sampling, biochemical analyses were performed using latex particle-enhanced turbidimetric immunoassay for cystatin C and enzyme-linked immunosorbent assay for IL-1β and TNF-α. The multivariate analysis of variance test was used for statistical evaluation. In total saliva, cystatin C and TNF-α levels were higher in PHC, and IL-1β levels were higher in CG, but the differences were not statistically significant. In GCF, cystatin C levels were higher in PHC (P >0.05), whereas TNF-α and IL-1β levels were higher in CG (P >0.05). In the CG group, there were positive correlations between the GCF cystatin C level and the PI of the sampled site (r = 0.488; P <0.05); also, GCF IL-1β (r = 0.603; P <0.05) and TNF-α (r = 0.456; P <0.05) levels were positively correlated with PD and CAL. For the whole mouth and the sampled sites, PI, GI, GBI, PD, and CAL values were higher in CG (P <0.05), but no significant differences were detected between GCF volumes of the two groups. To the best of our knowledge, this study represents the first evaluation of cystatin C in the gingival disease mechanism in children. Our results showed that total saliva and GCF cystatin C levels were higher in PHC (P >0.05), but there was no correlation between cystatin C levels and IL-1β or TNF-α levels in total saliva or GCF.

Risk Markers for Changes in Periodontal Pathology in the Third Molar and Non-Third Molar Regions

Identify risk markers at baseline associated with changes in periodontal probing depth (PD) over time for the 3rd molar region and non-3rd molars in young adults. The data were from healthy subjects with four asymptomatic 3rd molars, enrolled in an IRB-approved longitudinal trial. Demographic and oral health data were collected at baseline. Gingival crevicular fluid (GCF) samples were taken from the mesial of all 1st molars and distal of all 2nd molars. GCF samples were independently analyzed by ELISA for levels of IL-1β and PGE2 as a measure of oral inflammation. A pooled patient mediator level was then calculated as the mean of the eight site values. Subgingival biofilm samples were taken from the distal of all 2nd molars prior to periodontal probing. The presence and levels of periodontal pathogens were determined using whole chromosomal DNA probes and checkerboard DNA-DNA hybridization. Baseline subject levels of periodontal pathogens were chosen to determine the level of periodontal pathogens in subjects’ biofilm. Gingival crevicular fluid (GCF) inflammatory mediators were chosen to assess subjects’ immune response to the pathogens. Full mouth PD, six sites per tooth, was conducted to determine periodontal status at baseline and at longest follow-up. The 3rd molar region was defined as the PD for 6 sites around the 3rd molars and the 2 sites on the distal of the 2nd molars. The non-3rd molar region was defined as the remainder of the PD sites in the mouth. A PD >4mm was considered indicative of periodontal pathology. The primary outcome measures for this study were the occurrence at longest follow-up of a PD in the 3rd molar region and in non-3rd molars in study subjects, dichotomized by PD<, >4mm. Predictor variables at baseline were subjects: 3rd molar region PD, levels of “orange cluster” and “red cluster” periodontal pathogens, and levels of GCF IL-1β and PGE2. Changes from enrollment to longest follow-up were compared by the McNemar’s Test. Level of significance was 0.05. Data from 195 subjects were available with a median follow-up of 5.9 years (IQ 4.6-6.9y). Median age at enrollment was 26.2 years (IQ 22-34y); 52% were female, 84% Caucasian and 10% African American. If at least one PD >4mm was detected in the 3rd molar region at baseline, 64% subjects had at least one PD >4mm in the 3rd molar region at follow-up and 18% at least four PD >4mm compared to baseline PD <4mm, 15% and 5%, respectively. Non-3rd molar region PD >4mm was also significantly more likely. The extent of 3rd molar periodontal pathology at baseline predicted the extent of 3rd molar and non-3rd molar periodontal pathology at longest follow-up. If at least four PD >4mm were detected in the 3rd molar region at follow-up, median number PD >4mm was 7 (IQ 5-12). If subjects had at least four PD >4mm in non-3rd molars at follow-up, median number PD >4mm was 11 (IQ 7-18.5). Baseline subject levels of GCF IL-1β were significant predictors of periodontal pathology at follow-up in the 3rd molar region and non-3rd molar region. If baseline levels of GCF IL-1β were above the median 432.0 ng/m/L (IQ 196.5-869.7), 73% of subjects had at least one PD >4mm in the 3rd molar region at follow-up vs. 54% below the median, and 58% of subjects had at least one PD >4mm in the non-3rd molar region at follow-up vs. 39%. Baseline levels of “orange” or “red” cluster pathogens significantly predicted follow-up 3rd molar region PD >4mm, but not non-3rd molar PD >4mm. The presence of risk markers for oral inflammation were associated with worsening 3rd molar and non-3rd molar periodontal pathology.