Gingival Crevicular Fluid Of Patients Research Articles

Placental biomarkers and angiogenic factors in oral fluids of patients with preeclampsia.

The objectives of this study are to explore the feasibility of measuring endothelial and placental biomarkers in saliva and gingival crevicular fluid (GCF) and to determine if patients with preeclampsia (PE) have a different profile of these biomarkers in oral fluids. A case-control study was conducted, including patients with PE (n = 10) and a control group with normal pregnancies randomly selected (n = 20) admitted at the Sótero del Río Hospital in Santiago, Chile. A complete periodontal and obstetric history that involved the collection of oral fluids was performed at the same gestational age. Levels of Cd63(+) extracellular vesicles, placental alkaline phosphatase (PLAP), placental growth factor (PlGF), and sFlt-1 levels were determined by ELISA assays. Data analysis was performed with chi-square or Fisher's exact test, and Mann-Whitney U-test for continuous variables. The association was assessed using a multiple logistic regression model. sFlt-1 concentrations in saliva and GCF were significantly higher in patients with PE (p = 0.045 and p = 0.033 respectively). Concentrations of PLAP were elevated in GCF of patients with PE (p = 0.049). The PLAP/CD63(+) ratio in GCF of patients with PE was significantly higher (p = 0.0008). No differences in PlGF levels were observed. GCF of patients with PE concentrates higher levels of biomarkers related with the PE development. © 2016 John Wiley & Sons, Ltd.

Levels of Interleukin‐18 in Saliva and Gingival Crevicular Fluid in Patients with Chronic Periodontitis and Healthy Subjects

Levels of Interleukin‐18 in Saliva and Gingival Crevicular Fluid in Patients with Chronic Periodontitis and Healthy Subjects

The effect of smoking on myeloid-related protein-8 and myeloid-related protein-14.

The aim of this study was to determine the myeloid-related protein-8 and myeloid-related protein-14 levels in the gingival crevicular fluid of smoker patients with generalized aggressive periodontitis (SAgP), smoker patients with chronic periodontitis (SCP), smoker patients with gingivitis (SG-smoker control), non-smoker patients with generalized aggressive periodontitis (AgP), non-smoker patients with chronic periodontitis (CP), and non-smoker patients with gingivitis (G-non-smoker control). The periodontal statuses of the patients were determined by periodontal clinical measurements and radiographical evaluations. The levels of myeloid-related protein-8 and myeloid-related protein-14 in the gingival crevicular fluid were assessed using enzyme-linked immuno sorbent assay. The myeloid-related protein-8 and myeloid-related protein-14 levels in the gingival crevicular fluid of patients with generalized aggressive periodontitis (non-smoker and smoker) were found to be statistically higher than patients with chronic periodontitis (non-smoker and smoker) and patients with gingivitis (non-smoker and smoker). Myeloid-related protein-8 and myeloid-related protein-14 levels of non-smokers were significantly higher than smokers in all types of periodontitis and gingivitis. The decreased myeloid-related protein-8 and myeloid-related protein-14 level could have prevented the haemostasis of calcium which plays a significant role in the migration of neutrophiles. Smoking affects myeloid-related protein-8 and myeloid-related protein-14 levels and may inhibit the antimicrobial efficiency against microorganisms. Due to these reasons smoker generalized aggressive periodontitis patients need to be treated in detail and their maintenance durations should be shortened.

IL-18 and Anti- <i>P. gingivalis</i> Antibodies in Patients with Diabetes and Chronic Periodontitis

Periodontitis is an important complication in patients with diabetes mellitus. Chronic periodontitis is caused mostly by <i>Porphyromonas gingivalis</i> in Mexico, and by proinflammatory cytokines like IL-1, IL-6, TNFa, and IL-18. The aim of our study was to quantify IL-18 and to detect antibodies against <i>P. gingivalis</i> in gingival crevicular fluid of type 2 diabetes mellitus (T2DM) patients with chronic periodontal disease (PD). We studied a total of 40 patients divided in four groups: group 1 T2DM patients with PD, group 2 T2DM patients without PD, group 3 non-diabetic patients with PD, and a control group of healthy individuals. IL-18 was quantified using a commercial ELISA kit. Detection of IgG and IgM antibodies in gingival crevicular fluid was carried out through ELISA using <i>P. gingivalis</i> semi-purified proteins. Our results showed T2DM patients with chronic PD had low levels of IL-18, whereas non-diabetic patients with chronic PD had the highest. IgM antibodies were detected in diabetic and non-diabetic with chronic PD. IgG antibodies were detected in patients with T2DM and chronic PD, non-diabetic patients with chronic PD, and healthy individuals. In conclusion, IL-18 was detected in low concentrations in gingival crevicular fluid of patients with T2DM and chronic PD. This could be due to a dysregulation of immune-inflammatory responses secondary to diabetes, or by the presence of IL-18 binding protein in gingival fluid. Low levels of IgG antibodies in T2DM patients with PD could be due to the formation of immune complexes, which would explain the greater periodontal damage these patients present.

Smoking and gingivitis: focus on inducible nitric oxide synthase, nitric oxide and basic fibroblast growth factor.

Periodontal disease pathogenesis has been associated with smoking. Gingivitis is a mild and reversible form of periodontal disease and it tends to progress to periodontitis only in susceptible individuals. In the present study, we aimed to examine the impact of smoking on host responses in gingivitis and to evaluate and compare the inducible nitric oxide synthase (iNOS) activity in gingival tissue and NO and basic fibroblast growth factor (bFGF) levels in the gingival crevicular fluid of patients with gingivitis and healthy individuals. Forty-one participants were assigned to the gingivitis-smoker (n = 13), gingivitis (n = 13), healthy-smoker (n = 7) and healthy groups (n = 8). Clinical indices were recorded; gingival biopsy and gingival crevicular fluid samples were obtained from papillary regions. iNOS expression was evaluated by immunohistochemical staining. The immunoreactive cells were semiquantitatively assessed. For the quantitative determination of nitrite and nitrate in gingival crevicular fluid, the NO assay kit was used. The amount of bFGF in gingival crevicular fluid was determined by enzyme-linked immunosorbent assay. The gingivitis-smoker group demonstrated a stronger iNOS expression than the non-smoker gingivitis group. iNOS expression intensity was lower in the non-smoker healthy group compared to that in healthy-smokers. No significant gingival crevicular fluid NO and bFGF level changes were observed between groups. Among patients with gingivitis, a positive correlation was detected between gingival crevicular fluid NO and bFGF levels (r = 0.806, p = 0.001). Our data suggest that smoking has significant effects on iNOS expression but not on gingival crevicular fluid NO or bFGF levels in healthy and patients with gingivitis. However, our results suggest that bFGF might be involved in the regulation of NO production via iNOS.

Gingival crevicular fluid levels of protease‐activated receptors type 1 and type 2 in diabetic patients with periodontitis

Protease activated receptor type 1 (PAR1 ) seems to play a role in periodontal repair, while PAR2 is associated with periodontal inflammation. As diabetes is a known risk factor for periodontal disease, the aim of this study was to evaluate the influence of type 2 diabetes on PAR1 and PAR2 mRNA expression in the gingival crevicular fluid of patients with chronic periodontitis before and after non-surgical periodontal treatment. Gingival crevicular fluid samples and clinical parameters consisting of measuring probing depth, clinical attachment level, bleeding on probing and plaque index were collected from systemically healthy patients and patients with type 2 diabetes and chronic periodontitis, at baseline and after non-surgical periodontal therapy. PAR1 and PAR2 , as well as the presence of the proteases RgpB gingipain and neutrophil proteinase-3 were assessed by quantitative polymerase chain reaction in the gingival crevicular fluid. The periodontal clinical parameters significantly improved after periodontal therapy (p<0.01). Diabetes led to increased expression of PAR1 in gingival crevicular fluid, and in the presence of chronic periodontitis, it significantly decreased the expression of PAR1 and PAR2 (p<0.05). Moreover, non-surgical periodontal treatment in diabetics resulted in increased expression of PAR1 and PAR2 (p<0.05), and decreased expression of RgpB gingipain and proteinase-3 (p<0.05). The present data demonstrated that diabetes was associated with an altered expression of PAR1 and PAR2 in the gingival crevicular fluid cells of subjects with chronic periodontitis. Future studies are necessary to elucidate the effects of PAR1 upregulation in periodontally healthy sites and PAR2 downregulation in chronic periodontitis sites on the increased susceptibility and severity of periodontitis in diabetes.

Antibodies produced in vitro in the detection of periodontal bacteria by using surface plasmon resonance analysis.

Porphyromonas gingivalis (P. gingivalis) is a major etiological agent associated with periodontitis. This study aims to develop antibodies to P. gingivalis in vitro for real‐time detection of bacteria in clinical samples. Lymphocytes were isolated from whole blood of patient treated for periodontitis and were stimulated with P. gingivalis ATCC 33277. B‐cell maturation to long‐living antibody secreting‐plasma cells was studied using flow cytometry and immunofluorescence staining. The antibodies developed in vitro were immobilized onto a CM‐5 sensor chip of a biosensor to detect the presence of P. gingivalis in the gingival crevicular fluid of patients with periodontitis compared to periodontally healthy controls (n = 30). Surface plasmon resonance (SPR) analysis was performed to evaluate specific interactions of bacteria in samples with the immobilized antibodies. The results of SPR analysis were compared to the detection of P. gingivalis in the samples using DNA–DNA checkerboard hybridization technique. A clear and distinct change in lymphocyte morphology upon stimulation with P. gingivalis was observed. Anti‐P. gingivalis antibodies secreted by CD38+ plasma cells showed the presence of all the four IgG subclasses. The results of DNA–DNA checkerboard analysis were in agreement with that of SPR analysis for the detection of P. gingivalis in patient samples. Furthermore, incubation with anti‐P. gingivalis attenuated the bacterial response in SPR. The in vitro method for antibody production developed during this study could be used for an efficient real‐time detection of periodontitis, and the attenuating effects of in vitro antibodies suggest their role in passive immunization to prevent periodontitis and their associated risk factors.

Niveles locales de marcadores de inflamación en fluido crevicular gingival en diabéticos tipo 2 de recién diagnóstico con periodontitis crónica

El sistema inmune del sujeto diabético sufre alteraciones debido a la enfermedad, repercutiendo en los tejidos periodontales. El objetivo fue evaluar los marcadores de inflamación de interleucina (IL)-2, IL-6 e IL-8 en fluido crevicular gingival de pacientes con diabetes mellitus tipo 2 (DMT2). Los participantes se agruparon en cuatro grupos: 1) sanos (n = 20), 2) con periodontitis (PCM, n = 20), 3) con diabetes ≤1 año y periodontitis (DMT2≤1+PCM, n = 20) y 4) con diabetes de ≥10 años con periodontitis (DMT2≥10+PCM, n = 20). Los marcadores se cuantificaron por citometría de flujo. Como resultado, el grupo de DMT2≥10+PCM mostró niveles mayores de IL-2 con relación a los demás grupos, al igual que niveles elevados de IL-6 con respecto del PCM. Los niveles de IL-8 resultaron mayores en el grupo de sanos frente a los demás grupos. Se concluye que los sujetos con DMT2≥10+PCM mostraron una respuesta inmune adaptativa-destructiva del tejido periodontal en comparación con DMT2≤1+PCM que muestran una alteración inmunológica.

Evaluation of non-surgical therapy on glutathione levels in chronic periodontitis.

Objective:To compare the levels of glutathione (GSH), both oxidized and reduced forms in patients with and without chronic periodontitis in gingival crevicular fluid (GCF).Materials and Methods:Twenty GCF samples from maxillary quadrants were collected using capillary micropipettes from the chronic periodontitis patients (test group) at baseline before treatment, at 1-month, 3 months, and 6 months after scaling and root planing and samples from 20 patients without chronic periodontitis (control group) from maxillary quadrants were also collected. GSH, oxidized glutathione (GSSG) levels and GSH: GSSG ratios were determined using the spectrophotometric method.Statistical Analysis:Results were concluded for the test over control groups using paired Student's t-test.Results:Lower concentrations of GSH (P < 0.001) and GSSG (P < 0.001) were detected in GCF in patients with chronic periodontitis (test group) than patients without chronic periodontitis (control group) at baseline. Treatment had a significant effect in improving the GSH and reducing GSSG levels postscaling and root planing at 1-month and 3 months but not significant effect at 6 months. Scaling and root planing increased the GSH: GSSG ratio (P < 0.001) in the test group as compared to the control group (P < 0.001).Conclusions:The concentrations of GSH within GCF are reduced in chronic periodontitis patients. Scaling and root planing (nonsurgical therapy) restores GSH concentration in GCF post 1-month and 3 months along with redox balance (GSH: GSSG ratio), but at 6 months the balance is not maintained. Adjunctive use of micronutritional supplements to boost antioxidant concentration in tissues by preserving GSH or by elevating its level at the inflamed sites is recommended, as nonsurgical periodontal therapy alone is not able to maintain redox balance for longer duration.

Interaction Between Fibronectin Fragments and Immunoglobulin G in Gingival Crevicular Fluid of Patients with Periodontal Disease/ Kompleksi fibronektinskih fragmenata i imunoglobulina G u gingivalnoj tečnosti osoba obolelih od parodontopatije

SUMMARYIntroduction Fibronectin (FN) can interact with immunoglobulin G (IgG) molecules affecting the process of physiological elimination and causing abnormal deposition of immune complexes. The aim of the study was to analyze interaction between FN fragments and IgG molecules with different glycosylation profiles in gingival crevicular fluid (GCF) of patients with periodontal disease and healthy controls.Material and Methods The study included 30 patients with moderate and advanced periodontitis and 22 healthy subjects. IgG and FN content in GCF were measured as well as the presence of FN and galactose expression on IgG molecules.Results IgG content in GCF was five times higher in patients with moderate (p&lt;0.01) and eight time higher in patients with advanced periodontitis (p&lt;0.001) compared to healthy subjects. Also, hypogalactosylated forms of IgG were found in higher concentration in GCF of patients with advanced periodontitis compared to moderate periodontitis and healthy subjects (p&lt;0.05). FN fragments of molecular mass 48 - 53 kDa were the most commonly found fragments in all three groups. Furthermore, in patients with advanced periodontitis, fibronectin fragments were attached to IgG molecules.Conclusion IgG and FN fragments form complexes in GCF in patients with periodontal disease and healthy subjects

Changes in Transforming Growth Factor-β1 in Gingival Crevicular Fluid of Patients with Chronic Periodontitis Following Periodontal Flap Surgery.

The aim of the study was to assess changes in Transforming Growth Factor- β1 (TGF-β1) levels in gingival crevicular fluid (GCF) and examine correlation of TGF-β1 levels and periodontal parameters: probing pocket depth (PPD) and clinical attachment level (CAL) in sites with chronic periodontitis at various time intervals before and after periodontal surgery. The effects of non-surgical and surgical therapy on periodontal parameters and GCF TGF-β1 levels in 18 sites affected with chronic periodontitis were assessed upto 6 weeks post conventional flap surgery. GCF was collected and PPD, CAL recorded at Baseline. GCF was collected and PPD, CAL recorded at Pre-surgery and flap surgery performed. GCF was collected from all sites at Two Weeks Post-surgery. GCF was collected and PPD, CAL recorded at Six Weeks Post-surgery. The concentration of TGF-β1 in GCF was determined using a human TGF-β1 enzyme immunometric assay kit. Mean TGF-β1 concentrations were significantly reduced at Pre-surgery, at Two Weeks Post-surgery and at Six Weeks Post-surgery (p<0.05) when compared to Baseline TGF-β1 values. There was a statistically significant reduction in PPD and gain in CAL following non-surgical and surgical therapy when compared to baseline (p<0.05). RESULTS indicate that TGF-β1 may play a role in the pathogenesis and diagnosis of periodontal disease and could be considered as a disease predictive biomarker.

Association Between Gingival Crevicular Fluid Leptin Levels and Periodontal Status - A Biochemical Study on Indian Patients.

The present study was carried out to evaluate and compare the gingival crevicular fluid (GCF) concentrations of leptin in periodontally healthy and diseased subjects, to compare GCF leptin levels with respect to Body Mass Index (BMI) among the study groups and essentially to obtain an insight into leptin's possible role in the initiation and progression of periodontal disease. A total of 60 subjects; both males and females, based on their body mass index were selected for the study. They were categorized into three groups of 20 subjects each, based on their periodontal status, as follows: Group I (clinically healthy periodontium); Group II (gingivitis); Group III (chronic periodontitis). GCF samples of 1 μl were collected extra-crevicularly using black color-coded 1-5 μl calibrated volumetric microcapillary pipettes from one site in each person, and samples were analyzed for leptin using a commercially available ELISA kit. The concentration of leptin in GCF of patients in Group I (2272.25 pg/mL) was statistically higher (p < 0.001) than in those of Group II (1421.86 pg/mL) and Group III (1160.67 pg/mL). No statistically significant difference was found when comparing the mean values of leptin between BMI groups in each study group. As periodontal disease progressed, there was a substantial decrease in the gingival crevicular fluid leptin concentration. This suggests a protective role of leptin with regard to periodontal health.

Assessment of periostin levels in serum and gingival crevicular fluid of patients with periodontal disease.

Periostin, a secreted adhesion molecule essential for periodontal tissue integrity, is highly expressed in the periodontal ligament and plays a critical role in tooth and bone development. The purpose of this study was to investigate periostin levels in the gingival crevicular fluid and serum of patients with periodontal disease and compare them with those of healthy individuals. Eighty individuals (41 males and 39 females; age range: 25-48 years) were enrolled in the study. Individuals were divided into three groups following clinical and radiographic examinations: the periodontal-healthy group (n = 20), gingivitis group (n = 30) and chronic periodontitis group (n = 30). Gingival crevicular fluid and serum samples were collected and periostin levels were determined using the enzyme-linked immunosorbent assay. The total amount and concentration of periostin decreased in gingival crevicular fluid with the progression and severity of the disease from healthy controls to gingivitis and to chronic periodontitis groups and differed significantly (p < 0.05). However, there was no significant difference in serum periostin concentration within all groups (p > 0.05). Periostin in gingival crevicular fluid negatively correlated with the gingival index in the periodontal disease groups, whereas it is inversely correlated with the clinical attachment level only in the periodontitis group (p < 0.05). When all the clinical groups were examined together, the periostin concentration negatively correlated with clinical attachment level and gingival index; moreover, total periostin positively correlated with periostin concentration and clinical attachment level (p < 0.05). The periostin levels in gingival crevicular fluid decreased proportionally with the progression and severity of periodontal disease, and negatively correlated with the clinical parameters. Within the limits of the study, the periostin level in gingival crevicular fluid can be considered a reliable marker in the evaluation of periodontal disease susceptibility and activity.

Effects of Photodynamic Therapy on Clinical and Gingival Crevicular Fluid Inflammatory Biomarkers in Chronic Periodontitis: A Split‐Mouth Randomized Clinical Trial

There are limited clinical experiments addressing the effects of photodynamic therapy (PDT) as an adjunct to conventional scaling and root planing (SRP) on clinical and biologic features of periodontitis. This trial compares the clinical parameters and cytokine profiles in gingival crevicular fluid of patients with moderate-to-severe chronic periodontitis (CP) who have been treated using SRP alone or SRP + PDT. Twenty-two patients with two contralateral teeth affected with moderate-to-severe CP were selected. After SRP, the participants' teeth were randomized to receive either no further treatment or a single application of PDT using a 638-nm laser and toluidine blue. Although the change in probing depth was the primary outcome, bleeding on probing, clinical attachment level, gingival recession, interleukin-1β, tumor necrosis factor (TNF)-α, and matrix metalloproteinase 8 and 9 were also evaluated at baseline and 3 months postintervention. An oral rinse assay was also performed to determine the total levels of oral polymorphonuclear cells (PMNs) before and 3 months after the treatments. Within each group, significant improvements (P <0.001) were found for all variables in 3-month follow-up compared with baseline. Only TNF-α was significantly improved in the PDT + SRP versus SRP group. Total levels of PMNs were reduced for all patients compared with baseline levels (P <0.001). In patients with CP, a single application of PDT (using a 638-nm laser and toluidine blue) did not provide any additional benefit to SRP in terms of clinical parameters or inflammatory markers 3 months following the intervention.

The Role of Factors Associated With Apoptosis in Assessing Periodontal Disease Status

Little is known about the release of apoptotic proteins during periodontal breakdown. This pilot study investigates the presence of factors associated with apoptosis in serum, saliva, and gingival crevicular fluid (GCF) and their association with periodontal disease severity and activity. GCF, whole saliva, and serum were obtained from 47 adult patients with chronic periodontitis (CP) and 10 healthy controls. Clinical measurements, including probing depth (PD), clinical attachment level (CAL), and radiographs, were used to classify patients into healthy, mild, and moderate/severe CP groups. Enzyme-linked immunosorbent assays were used to measure apoptosis or DNA fragmentation in GCF and active caspase-3, soluble Fas (sFas), and sFas ligand (sFasL) in saliva and serum. Western immunoblotting was used to detect Fas, FasL, sFasL, and caspase-3 expression in GCF. DNA fragmentation was positively correlated with PD and CAL regardless of patient disease status (P <0.001). sFas and sFasL were present in saliva and serum, but there were no differences between groups. In GCF, the greater odds of detecting Fas, sFasL, and caspase-3 increased with increasing PD and CAL (P <0.05). In addition, sites with inflammation and PD ≥5 mm had significantly greater odds of exhibiting Fas, sFasL, and caspase-3 expression compared with sites without inflammation and PD <5 mm (P <0.05). Caspase-3 was not detected in saliva or serum. At the patient level, only FasL and disease status were significantly correlated (P <0.05). Factors associated with apoptosis were detected in GCF in patients with CP.

Cytokines and chemokines are differentially expressed in patients with periodontitis: Possible role for TGF-β1 as a marker for disease progression

Periodontitis is a chronic inflammatory disease characterized by destruction of periodontal tissue ultimately leading to bone destruction and has been associated with other inflammatory diseases, such as atherosclerosis. Attachment loss of periodontal tissue is primarily caused by host cell-derived immune responses against subgingival biofilm. The aim of the present study was to determine the cytokine profile in serum, saliva and gingival crevicular fluid (GCF) patients with periodontitis and healthy controls. We show that periodontitis patients exhibit higher numbers of periodontal pathogens and their immune responses are significantly altered. The levels of IL-6 in saliva and GCF were significantly suppressed, and while CXCL8 was not altered in serum, its expression levels were significantly suppressed in saliva and elevated in GCF. The T-cell-derived cytokine IL-2 did not differ between patients and controls in serum and saliva, but there was a significant suppression in GCF of patients. Interestingly, TGF-β1 levels were significantly elevated in serum, saliva and GCF in patients compared to controls. Furthermore, by using cultured gingival fibroblasts stimulated with wild type and proteinase mutant strains of Porphyromonas gingivalis, we show that the suppression of CXCL8 and IL-6, and the induction of TGF-β1 is primarily mediated by the proteolytic activity of lysine-specific proteinases. These results indicate that P. gingivalis is a major contributor to the altered immune responses and the pathology of periodontitis. Furthermore, the ease of sampling and analyzing cytokine expression profiles, including TGF-β1, in saliva and GCF may serve to predict the progression of periodontitis and associated systemic inflammatory diseases.

Nuclear factor-kappa B ligand and osteoprotegerin levels in serum and gingival crevicular fluid in patients with bone metastases treated with zoledronic acid

Bone metastases are frequently observed in patients with certain types of cancer and are significant cause of morbidity. Zoledronic acid (ZA) is routinely prescribed for patients with bone metastases by affecting osteoclast function. We aimed to assess the effect of ZA over time in patients with bone metastases by analyzing novel bone turnover marker levels including receptor activator of nuclear factor-k B ligand (RANKL) and osteoprotegerin (OPG) in serum and gingival crevicular fluid (GCF). Also, associations between these bone turnover markers with hematological and biochemistry dysregulation were studied. The study enrolled patients with bone metastases including 32 patients diagnosed with solid tumors and 15 patients with multiple myeloma. In these patients, GCF and serum RANKL and OPG levels were measured and compared with measures of hematological and biochemical parameters before and after 3 months of ZA therapy. Mean subject age was 54 years old with a range of 28-80 years. Skeletal-related events were observed in 8.5% of all patients. After the 3-month treatment of ZA therapy, no significant differences were found in serum and GCF levels of RANKL and OPG when compared with before treatment levels. GCF RANKL levels at baseline and following 3 months of ZA therapy were significantly higher in patients with solid tumors when compared patients diagnosed with multiple myeloma (p=0.001; p<0.001, respectively). GCF OPG levels after the entire course of ZA therapy were greater in patients with 5 or more bone metastases (p=0.04). For patients with multiple myeloma, control GCF OPG was negatively correlated with control platelet and WBC counts (p=0.018 and p=0.027, respectively). A negative correlation was observed between control serum RANKL and control serum OPG levels in myeloma patients (p=0.001). After 3 months of ZA therapy, no significant differences were observed in GCF and serum RANKL and OPG levels when compared with baseline. A negative correlation was observed between serum control RANKL and OPG levels in myeloma patients. OPG levels were greater in patients with 5 or more bone metastases. In patients diagnosed with multiple myeloma, GCF OPG levels were negatively associated with WBC and platelet counts.

Vitamin d-binding protein levels in plasma and gingival crevicular fluid of patients with generalized aggressive periodontitis.

Vitamin D-binding protein (DBP) is the main transport protein of vitamin D and plays an important role in the immune system and host defenses. The purpose of this study was to measure DBP levels in plasma and gingival crevicular fluid (GCF) of patients with generalized aggressive periodontitis (GAgP), in comparison to healthy controls, with the goal of elucidating the relationship between DBP and GAgP. Fifty-nine GAgP patients and 58 healthy controls were recruited for the study; clinical parameters of probing depths (PD), bleeding index, and attachment loss (AL) were recorded. DBP levels were measured by enzyme-linked immunosorbent assay. From the results, GAgP patients had higher plasma DBP concentrations (P < 0.001) but lower GCF DBP concentrations (P < 0.001) than healthy controls. In GAgP group, after controlling the potential confounders of age, gender, smoking status, and BMI index, GCF DBP concentrations correlated negatively with PD (P < 0.001) and AL (P = 0.009). Within the limits of the study, we concluded that decreased GCF DBP level and increased plasma DBP level are associated with periodontitis.

The Effect of Nutritional Supplementation with Fish Oil on Rankl/Opg Ratio in Gingival Crevicular Fluid of Patients Suffering From Chronic Periodontitis. A Randomized Controlled Trial

Fish oil, which is rich in omega-3 polyunsaturated fatty acids, has been shown to exert anti inflammatory influence in animal models and in many inflammatory diseases. The present study was designed to study the effect of nutritional supplementation with fish oil on RANKL/OPG ratio in gingival crevicular fluid of patients suffering from chronic periodontitis A total 60 subjects participated in the study and were randomly divided into experimental and control group consisting 30 each. The experimental group received nutritional supplementation with 300 mg of fish oil capsule containing 30 mg of DHA (Docosahexanoic acid) 20 mg of EPA (Eicosapentanoic acid). The control group received placebo consisting gelatin capsule and starch. GCF samples were harvested from all the subjects and samples were stored and analyzed for RANKL and OPG levels using commercially. Our investigation revealed that the baseline RANKL/OPG ratio between the two groups was almost same. In both the groups after 6 weeks follow up there was a statistically significant decrease in the RANKL/OPG ratio. Comparing their mean RANKL/OPG ratio after 6 weeks there was a difference in their means with greater reduction in the experimental group. However this difference was not statistically significant. Fish oil may play a role as an inflammatory in periodontal diseases.

The Adjunctive Effect of Tenoxicam During Non-Surgical Periodontal Treatment on Clinical Parameters and Gingival Crevicular Fluid Levels of MMP-8 and TNF-α in Patients with Chronic Periodontitis – Randomized, Double-Blind Clinical Trial

Matrix metalloproteinases (MMPs) and cytokines play a role of extracellular matrix degradation and remodelling, and are significantly involved in the course of periodontal disease. The purpose of this study was to evaluate the adjunctive effect of administering an oxicam non-steroidal anti-inflammatory drug (NSAID), tenoxicam, during non-surgical (phase 1) periodontal treatment on clinical parameters and gingival crevicular fluid (GCF) levels of MMP-8 and TNF-α in subjects with chronic periodontitis. A total of 32 subjects with chronic periodontitis were randomized into two groups: 1) phase I periodontal treatment + NSAID and 2) phase I periodontal treatment + placebo. Phase I periodontal therapy consisted of scaling and root planning (SPR), which was provided by a single therapist masked with respect to group assignment. Patients in group 1 received a systemic NSAID (20 mg tenoxicam tablet once daily for 10 days). Clinical measures and GCF samples were obtained immediately prior to periodontal treatment and 30 days afterwards from all subjects. Clinical measures included a plaque index, gingival index, gingival bleeding time index, probing depth, and clinical attachment level. The MMP-8 and TNF-α levels in the GCF were assayed using an enzyme-linked immunosorbent assay. With the exception of clinical attachment level, all clinical measures showed a significant (p < 0.05) improvement following non-surgical treatment in both the NSAID and placebo groups. A significant decrease in MMP-8 levels (p < 0.05) was observed at post-treatment in the NSAID group but not in the placebo group (p > 0.05). Treatment exhibited no effect on TNF-α levels (p > 0.05). There was also no statistically significant difference in clinical measurements after treatment between the two groups (p > 0.05). Moreover, the post treatment MMP-8 level in group 1 was statistically significant higher than the placebo group (p < 0.05). The adjunctive administration of tenoxicam during phase I periodontal treatment decreases MMP-8 levels in gingival crevicular fluid in patients with chronic periodontitis. But no benefits were observed.