Gingival Crevicular Fluid Volume Research Articles

Influence of vitamin D in orthodontic tooth movement-a systematic review and meta-analysis of randomized controlled trials in humans.

Orchestration of tooth movement necessitates an equilibrium of bone synthesis and resorption. Vitamin D, through receptor-mediated actions, regulates the differentiation and maturation of osteoblasts and also induces osteoclastogenesis, maintaining this equilibrium. To analyze the impact of vitamin D in orthodontic tooth movement (OTM). A comprehensive exploration of the existing literature was conducted by systematic search through seven e-databases. The criteria for inclusion were established using the PICO format: Orthodontic patients treated with fixed appliance (P), administered with vitamin D3 (I), collated with appropriate control groups (C), with tooth movement as the primary outcome and root resorption, anchorage loss, gingival crevicular fluid (GCF) volume, pain perception, and alveolar bone density as the secondary outcome (O). After an extensive database search, 251 articles were obtained. Six articles were chosen following a stringent selection using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The critical appraisal of randomized control trials (RCTs) involved the meticulous application of the RoB 2 tool. The quantitative synthesis incorporated a subset of six articles only. In the meta-analysis investigating the influence of vitamin D on OTM, a notable disparity was evident between the vitamin D and control groups. Specifically, the standardized mean difference (SMD) stood at 1.43, accompanied by a 95% confidence interval (CI) ranging from 0.691 to 2.169 (P = .00154). For root resorption, the SMD was recorded at -0.51, with a 95% CI spanning from -3.051 to 2.031 (P = .11). The rate of tooth movement was enhanced by systemic and local administration of vitamin D. However, the inadequacy of available data is a hindrance in determining conclusively the impact of vitamin D on the extent of root resorption. The resolution of this quandary needs future human studies devoted toward investigating the influence of vitamin D in the realms of OTM and associated root resorption, thereby providing a definitive elucidation. Prospero- CRD42023491783.

Gingival Crevicular Fluid Volume and Protein Concentration: A Biomarker Tool for Predicting Periodontal Diseases Progression and Severity

Gingival Crevicular Fluid Volume and Protein Concentration: A Biomarker Tool for Predicting Periodontal Diseases Progression and Severity

Gingival crevicular fluid levels of TLR-9, AIM-2, and ZBP-1 in periodontal diseases.

Toll-like receptor (TLR)-9, may play a role in periodontal disease inflammation. This study measured TLR-9 and its related molecules, absence in melanoma-2 (AIM-2) and Z-DNA-binding protein-1 (ZBP-1), in gingival crevicular fluid (GCF) from patients with varying stages of periodontal disease to assess the role of pathogen-derived nucleic acids in inflammation. The study comprised 80 participants: 20 with Stage III Grade C periodontitis, 20 with Stage III Grade B periodontitis (P-Stage III-B), 19 with gingivitis, and 21 with periodontal health. Parameters including probing depth (PD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP) were recorded. ELISA was used to analyze TLR-9, AIM-2, and ZBP-1 levels in GCF. Nonparametric tests were used for statistical comparisons. The total amount of TLR-9 was higher in P-Stage III-B than in the healthy group (p < 0.05). Similarly, the gingivitis group exhibited elevated GCF TLR-9 levels compared to the healthy group (p < 0.05). GCF AIM-2 and ZBP-1 levels remained consistent across groups (p > 0.05). Significant correlations were found between GCF TLR-9 and CAL (p < 0.05), BOP (p < 0.05), PI (p < 0.01), and GCF volume (p < 0.001). These findings suggested that the TLR-9-mediated inflammatory process plays a role in periodontal disease, as evidenced by the increased levels of TLR-9 in GCF.

Evaluation of gingival crevicular fluid volume with periopapers in patients who have recovered from COVID-19 infections

Aim: Coronavirus disease 2019 (COVID-19) reportedly affects many body tissues and organs and is detectable in body fluids, such as saliva and gingival crevicular fluid (GCF). Additionally, COVID-19 can cause an increased GCF volume (GCFV). This study investigated GCFV in patients with a history of COVID-19 infection using periopapers. Methodology: This study included 50 patients (25 males and 25 females) aged 21–69 years who were considered periodontally healthy and had a history of COVID-19 infection. GCF was collected from the central incisors’ buccal sites using paper strips, and GCFV was calculated using a Periotron 8000. Results: In patients with a history of COVID-19, the mean GCFV for all patients was 0.5226 ± 0.11 µl. The mean was 0.5208 ± 0.1011 µl in men and 0.5244 ± 0.1261 µl in women. No significant difference was found between the two genders regarding GCFV. Conclusion: Regarding GCFV, no significant difference was found between individuals with a history of COVID-19 infection and those with no history of COVID-19 infection. How to cite this article: Üner DD, İzol BS. Evaluation of gingival crevicular fluid volume with periopapers in patients who have recovered from COVID-19 infections. Int Dent Res 2023;13(3):119-24. https://doi.org/10.5577/intdentres.492 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Ability of gingival crevicular fluid volume, E-cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients.

To determine the potential of gingival crevicular fluid (GCF) volume, E-cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients. NSPT is the gold-standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis-associated tissue destruction is evidenced by the increased level of soluble E-cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of NSPT. Patients with periodontitis (n = 24) were included in this clinical trial and full-mouth periodontal charting was recorded for each patient. GCF samples from periodontal pockets with probing pocket depth (PPD) 4-6 mm from the interproximal surfaces of anterior and premolar teeth were obtained. These sites subsequently received NSPT and were clinically re-evaluated after 1 and 3 months. Levels of GCF E-cadherin and TAC levels were assayed using ELISA. All clinical periodontal parameters were significantly improved 3 months after completion of NSPT. These outcomes were associated with a significant decrease in E-cadherin levels and GCF volume, while TAC levels were significantly increased in samples obtained in follow-up appointments. Binary regression model analysis showed that PPD, GCF volume, E-cadherin, and TAC levels could significantly (p < .05) predict the outcomes of NSPT. The cut-off points for PPD, GCF volume, E-cadherin and TAC were 5 mm, 4 × 10-3, 1267.97 pg/mL and 0.09 μmol/g, respectively. NSPT improved clinical parameters along with increased antioxidants capacity and epithelial pocket lining integrity. Discrimination of favorable/unfavorable responsiveness of periodontally diseased sites to NSPT could be possible by using GCF volume, PPD, E-cadherin and TAC level assessments.

Variation of gingival crevicular fluid volume in early orthodontic tooth movement with clear aligner: A pilot study

Objectives: The objective of this pilot study was to evaluate the crevicular fluid volume (GCF) increase from a quantitative point of view in the first 8 hours of clear aligner treatment. Then, its variation and the amount of Orthodontic Tooth Movement (OTM) obtained with clear aligners was evaluated considering two different protocols, one of 20 h and one of 12 h. Material and Methods: A total of 10 healthy, adult patients were selected to participate in a split-mouth study where an orthodontic treatment with clear aligners was planned. Vestibular crown uncontrolled tipping was planned for upper lateral-posterior sectors. At 0H (baseline), and every hour for the first 8 hours of use, three GCF samples were collected. Then, all patients were asked to wear one random half of the upper aligner for 12 hours per day (Group 1) and the other half for 20 hours per day (Group 2). The GCF samples were measured using the Periotron 8000 device to quantify inflammation. Then, the amount of movement obtained was calculated by considering the FA point shift in mm with Geomagic X Control Software. Results: No differences were found between the extent of inflammation in terms of GCF volume and hours of intermittent force application (group 1 vs group 2). Conclusion: The amount of GCF assessed through Periotron 8000 increases significantly from the moment forces are applied through clear aligners. Considering the limitations of the following pilot study, it would appear that the GCF amount is directly related to the amount of movement obtained.

Inflammatory parameters and color alterations of dental bleaching in patients wearing fixed orthodontic appliance: a randomized clinical trial

BackgroundMany orthodontic patients request dental bleaching during orthodontic treatment to achieve a faster aesthetic resolution, however, no attention has been paid to the inflammatory processes that can occur when both therapies are indicated together. So, this clinical trial evaluated the inflammatory parameters and color alterations associated with dental bleaching in patients wearing a fixed orthodontic appliance.MethodsThirty individuals aged between 18 and 40 years were equally and randomly allocated into three groups: FOA (fixed orthodontic appliance), BLE (dental bleaching), and FOA + BLE (fixed orthodontic appliance + dental bleaching). The orthodontic appliances and the bleaching procedures were performed in the maxillary premolars and molars. For dental bleaching a 35% hydrogen peroxide was used. The gingival crevicular fluid (GCF) and nitric oxide (NO-) levels were evaluated at different time-points. Color evaluation was performed using an Easyshade spectrophotometer at baseline (FOA, FOA + BLE, BLE), one month after (FOA + BLE) and 21 days after appliance removing (FOA + BLE and FOA groups), in each tooth bleached. The ANOVA and Tukey’s tests, with a significance level of 5%, were used for statistical analysis.ResultsThe GCF volume in the FOA + BLE and FOA groups significantly increased at the time points evaluated (p < 0.001); however, this did not occur in the BLE group (p > 0.05). On the other hand, NO- levels significantly decreased during dental bleaching with or without fixed orthodontic appliances (FOA + BLE and BLE groups; p < 0.05), while no significant changes were observed in the FOA group (p > 0.05). Significant changes in color were observed in the FOA + BLE and BLE groups compared to in the FOA group (p < 0.01). However, the presence of fixed orthodontic appliance (FOA + BLE) negatively affected the bleaching efficacy compared to BLE group (p < 0.01).ConclusionsDental bleaching did not increase the inflammatory parameters in patients wearing fixed orthodontic appliance. However, in the presence of orthodontic appliances, the bleaching efficacy was lower than that of bleaching teeth without orthodontic appliances.Trial registrationRBR-3sqsh8 (first trial registration: 09/07/2018).

The effects of low-level laser therapy and photodynamic therapy on oral health of fixed orthodontics patients. A systematic review and meta-analysis

Objective To investigate the effect of low-level laser and photodynamic therapy on the oral health, and periodontal tissue of fixed orthodontic patients and the effect of using photobiomodulation methods compared to routine plaque removal methods and the amount of plaque in fixed orthodontic patients.Method and materials First, the title and summary of related articles were collected by using the search strategy electronic databases PUBMED, EMBASE, Cochrane's CENTRAL, Scopus, ISI and all the articles that were published from the beginning to February 2023 were evaluated. The title, abstracts and full texts of all the relevant studies were reviewed respectively, and those meeting the criteria were entered into our study. Finally, the quality of the studies was examined and the results of the studies were pooled by means of random effects inverse variance meta-analysis.Results Eighteen randomized studies, conducted between 2015 and December 2022, were selected for meta-analysis. Five studies were conducted as split-mouth, twelve as parallel-group, and one as a cross-over design. Among the studies, five examined the effects of low-level laser therapy and twelve assessed the effects of photodynamic therapy. The meta-analysis revealed that photodynamic therapy significantly reduced probing depth compared to scaling (MD=-0.2 mm, P<0.001), though the difference does not seem to be clinically significant. But no significant differences between photodynamic therapy and scaling or low-level laser therapy and control groups in terms of plaque index, or bleeding on probing, gingival crevicular fluid volume, gingival recession, clinical attachment loss, bacterial load and concentrations of inflammatory substances across multiple follow-up periods.Conclusion Moderate evidence indicates that photodynamic therapy (PDT) is comparable to conventional methods in improving oral health, as measured by periodontal indices, inflammatory proteins, bacterial colonies, and white spot lesions, making it a suitable alternative. Limited evidence suggests low-level laser therapy (LLLT) may improve oral health, particularly addressing caries, but further research is needed.

Influence of Nutrition and Physical Activity on Local and Systemic Inflammatory Signs in Experimentally Induced Gingivitis.

Although numerous studies have been published investigating the relationship between various dietary components and inflammatory periodontal disease, it has not yet been possible to clearly distinguish between periodontally healthy and unhealthy diets. This clinical study aimed to assess the association of specific food ingredients and physical activity on local and systemic inflammatory signs in experimentally induced gingivitis. Thirty-nine non-smoking periodontally healthy volunteers (mean age 23.2 ± 3.8 years) refrained from oral hygiene in the right maxilla for 21 days to induce an experimental gingivitis. Clinical examination (baseline and day 21) included plaque index, bleeding on probing (BOP), gingival crevicular fluid volume and high sensitive C-reactive protein levels (blood sample). Accompanying the intervention, volunteers documented with validated questionnaires their physical activity converted into metabolic equivalent (MET) and their nutrition converted into the dietary inflammatory index (DII). Significantly lower BOP (p = 0.039) was found for subjects with a more anti-inflammatory DII than for those with a more pro-inflammatory DII; higher MET values were correlated with lower BOP at day 21 (correlation coefficient -0.36). The results show an influence of nutrition and physical activity on periodontal inflammation signs. The DII may be a suitable parameter to verify the relationship between nutrition and inflammatory periodontal diseases.

Molecular profiling of gingival crevicular fluid fails to distinguish between infrabony and suprabony periodontal defects.

To assess the differential molecular profiling of gingival crevicular fluid (GCF) from infrabony and suprabony periodontal defects compared with healthy sites. Seventy-five samples from 25 patients with untreated periodontitis stage III-IV were included. Clinical and radiological parameters as well as GCF samples were collected from an infrabony defect, a suprabony defect and a periodontally healthy site per patient. A multiplex bead immunoassay was performed to assess the level of 18 biomarkers associated with inflammation, connective tissue degradation and regeneration/repair. GCF volume was higher in periodontal sites compared with healthy sites, with no significant difference between infrabony and suprabony defects. Fourteen biomarkers were elevated in infrabony and suprabony sites compared with healthy sites (p < .05). Only interleukin-1α levels were increased in infrabony compared with suprabony sites, whereas there was no difference in probing pocket depth. Although the GCF molecular profile clearly differentiates periodontally affected sites from healthy sites, the different architecture between infrabony and suprabony defects is not reflected in GCF biomarker changes.

Parkinson's disease is positively associated with periodontal inflammation.

Parkinson's disease (PA) affects 1% of the global population above 60 years. PA pathogenesis involves severe neuroinflammation that impacts systemic and local inflammatory changes. We tested the hypothesis that PA is associated with periodontal tissue inflammation promoting a greater systemic inflammatory burden. We recruited 60 patients with Stage III, Grade B periodontitis (P) with and without PA (n=20 for each). We also included systemically and periodontally healthy individuals as controls (n=20). Clinical periodontal parameters were recorded. Serum, saliva, and gingival crevicular fluid (GCF) samples were collected to measure the inflammatory and neurodegenerative targets (YKL-40, fractalkine, S100B, alpha-synuclein, tau, vascular cell adhesion protein-1 (VCAM-1), brain-derived neurotrophic factor (BDNF), neurofilament light chain (NfL). Parkinson's patients in this study had mild to moderate motor dysfunctions, which did not prevent them from performing optimal oral hygiene control. Periodontal parameters and GCF volume were significantly higher in the P and P+PA groups than in the control group. PA was associated with significantly increased bleeding on probing (BOP) compared to P-alone (p<0.05), while other clinical parameters were similar between P and P+PA groups. In saliva and serum, YKL-40 levels were higher in the P+PA group than in P and C groups (p<0.001). GCF NfL levels from shallow sites were significantly higher in the P+PA group compared to the C group (p=0.0462). GCF S100B levels from deep sites were higher in the P+PA group than in healthy individuals (p=0.0194). The data suggested that PA is highly associated with increased periodontal inflammatory burden-bleeding upon probing and inflammatory markers-in parallel with PA-related neuroinflammation.

Positive correlational shift between crevicular antimicrobial peptide LL-37, pain and periodontal status following non-surgical periodontal therapy. A pilot study

BackgroundPeriodontitis has a high prevalence and uncertain recurrence. Unlike the pro-inflammatory cytokine profile, little is known about the anti-inflammatory cytokine and antimicrobial peptide overview following treatment. The present study aimed to evaluate if any of the antimicrobial peptide LL-37, interleukin (IL) 4, 10 and 6 together with the volume of gingival crevicular fluid (GCF) and total protein concentration in GCF could be used as correlative biomarkers for the severity in periodontitis as well as prognostic factors in the management of the disease.MethodsForty-five participants were recruited and allocated to the healthy (15), Stage I-II (15) or Stage III-IV periodontitis (15) group. Along with periodontal examination, GCF samples were obtained at baseline and 4–6 weeks following scaling and root planing (SRP) for the periodontitis groups. GCF samples were analyzed by ELISA kits to quantify LL-37 and IL-4, -6 and − 10. One-way ANOVA followed by Dunnett’s test was used to determine differences among the three groups at baseline. Two-way ANOVA followed by Sidak’s post-hoc test was used to compare between pre- and post-SRP in the two periodontitis groups.ResultsThe amount of GCF volume was significantly correlated to the severity of periodontitis and decreased following SRP, particularly in the Stage III-IV group (p < 0.01). The levels of LL-37, IL-6, and pain and periodontal clinical parameters were significantly correlated to the severity of periodontitis. IL-4 and IL-10 in the periodontitis groups were significantly lower than the healthy group (p < 0.0001) and barely improved following SRP up to the level of the healthy group.ConclusionsWith the limitations of this study, crevicular LL-37 may be a candidate for a biomarker of periodontitis and the associated pain upon probing.Trial registrationThe study was registered in clinical trials.gov, with number NCT04404335, dated 27/05/2020.

The effect of different cigarette smoking levels on gingival crevicular fluid volume and periodontal clinical parameters in Saudi Arabia

IntroductionPeriodontal disease is a chronic inflammatory condition of the periodontium. It is the main cause of tooth loss and is considered one of the biggest threats to the oral cavity. Tobacco smoking has long been associated with increased risk for periodontal, peri-implant, and other medical diseases. ObjectiveTo evaluate the effect of smoking and its level on periodontal clinical parameters (probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), bleeding on probing (BOP), and the volume of gingival crevicular fluid (GCF)) in healthy and chronic periodontitis individuals. Material and MethodA total of 160 participants were recruited in the present study, who were equally divided into the following five groups: healthy controls (C), healthy smokers (HS), nonsmokers with periodontitis (PNS), light smokers with periodontitis (PLS), and heavy smokers with periodontitis (PHS). GCF volume and periodontal clinical parameters (PD, PI, GI, CAL, and BOP) were assessed for each participant and compared between the study groups. ResultThere was a statistically significant difference in PD, PI, GI, CAL, and BOP between healthy and periodontitis patients (p < 0.001). The mean PI, PD, and CAL were considerably higher in heavy smokers than light smokers and non-smokers (P < 0.001). In contrast, the mean GI and BOP were significantly lower in heavy smokers than in light smokers and non-smokers. There was a statistically significant difference in GCF between healthy and periodontitis patients (p < 0.001). The mean GCF readings were higher in heavy smokers than light smokers or non-smokers (P < 0.001). ConclusionThe present study confirms the influence of smoking on periodontal clinical parameters. Smoking was associated with increased PD, PI, CAL, and GCF readings; however, GI and BOP were decreased in smokers. The number of cigarettes played a key role in the volume of GCF and periodontal clinical parameters.

Utility of a haemoglobin test of gingival crevicular fluid: Amulticentre, observational study.

The purpose of this study was to verify the accuracy and utility of clinical parameters (plaque index, gingival crevicular fluid volume, probing depth, clinical attachment level, bleeding on probing and gingival index) and biochemical parameters (aspartate aminotransferase, protein and haemoglobin) in a longitudinal analysis during the supportive periodontal therapy period. A total of 279 test sites of 128 patients were investigated clinically and biochemically. After the first examination of clinical and biochemical parameters, periodontal support treatments were administered immediately and performed once every three months up to the second examination. All of the clinical and biochemical parameters were significantly lower at the second examination than at the first, except for the plaque index and bleeding on probing. Of these parameters, in particular, aspartate aminotransferase and haemoglobin in the gingival crevicular fluid were significantly reduced compared to those of the first examination in both the ≤4 and ≥5 mm probing depth groups, and they clearly suggested that periodontitis tended to recover. Adding the haemoglobin test to the bleeding on probing test strongly improves the accuracy of measurement of clinical parameters after periodontal treatment.

Effect of Non surgical Periodontal Therapy on Gingival Parameters of Diabetic and Non Diabetic Periodontitis Patients: A Prospective Clinical Study

Introduction: Non Surgical Periodontal Therapy (NSPT) has been an effective treatment for suppression of gingival inflammation and improvement of periodontal health in patients. Periodontitis and diabetes have an inter-relationship with each other. Surgical intervention is not always advisable for periodontitis with patients with diabetes. Hence, assessing the response of non surgical periodontal treatment in diabetic patients can lead to better and non invasive treatment options. Aim: To evaluate the effect of NSPT by observing changes in Gingival Index (GI), Plaque Index (PI), Clinical Attachment Loss (CAL), and volume of Gingival Crevicular Fluid (GCF) in diabetic and systemically healthy periodontitis patients. Materials and Methods: This was a prospective clinical study conducted in the Department of Periodontology, Rural Dental College, Loni, Maharashtra from January 2021 until June 2022. Total of 90 patients were assessed and were divided into three groups. Group A (n=30) included the patients with healthy periodontium and without any systemic disease. Group B (n=30) included the patients with controlled diabetes, with CAL in ranges of 3-4 mm (stage II periodontitis). Group C (n=30) included the patients who are systemically healthy, with CAL in ranges of 3-4 mm (Stage II periodontitis). Clinical parameters including GI, PI, Periodontal Probing Depth (PPD), CAL and volume of GCF were evaluated at baseline. NSPT was performed and parameters were evaluated after three months and then compared with baseline. Statistical analysis was done by descriptive statistics as mean, SD, percentage etc. Results: Total of 90 patients were included, among which 44 were male patients and 46 were females, within the age range of 18- 60 years. Patients were grouped 30 each in all three groups A, B and C with mean age 39.60±7.89, 45.70±10.02 and 43.90±9.64 respectively. The sites of group B showed statistically significant improvement in PPD at three months (1.80±0.76) compared to group C. Sites of group B also showed significant improvement in GI (1.46±0.45). There was no significant difference in the improvements of PI, Volume of GCF and CAL between group B and C at three months. Conclusion: The present study demonstrated marked improvements in the clinical parameters and their outcomes when the systemically healthy periodontitis patients and diabetic patients are treated with NSPT.

Comparison of the inflammatory states of serum and gingival crevicular fluid in periodontitis patients with or without type 2 diabetes mellitus

Background/purpose:There is a two-way relationship between periodontitis and type 2 diabetes mellitus. This study aimed to compare the inflammatory states in serum and gingival crevicular fluid (GCF) in periodontitis patients with or without type 2 diabetes mellitus (T2DM) and healthy subjects. Materials and methods20 subjects were systematic and periodontal healthy (H group), 40 subjects were with periodontitis (CP group), and other 40 were with periodontitis and type 2 diabetes mellitus (DC group). Fasting blood glucose (FBG) and HbA1c was tested. GCF and serum level of interleukin (IL) −17, visfatin, receptor activator of nuclear factor-kappa B (NF-κB) ligand (RANKL)/osteoprotegerin (OPG) ratio were measured. ResultsThe GCF volume, total amount of IL-17, vastatin, RANKL/OPG ratio in GCF and their concentrations in serum were higher (P < 0.05) in CP and DC groups than in H group, which were also higher (P < 0.05) in DC group than in CP group except for visfatin in GCF and IL-17 in serum. At sample sites of PD ≤ 3 mm, GCF volume, IL-17, visfatin and RANKL/OPG ratio in DC and CP groups were higher (P < 0.05) than that in H group, which were also higher in DC group than in CP group either with PD ≤ 3 mm or PD > 3 mm. Inflammatory state in GCF was positively correlated to systemic inflammation, and both of them were positively correlated to FBG. ConclusionModerate and severe periodontitis aggravated systemic inflammation. T2DM together with periodontitis resulted in more severe systemic inflammation. The positive correlation between the periodontal and systemic inflammation and their association with FBG indicated an inflammatory link between periodontitis and T2DM.

Effects of a 980 nm Diode Laser as an Adjunct to Nonsurgical Periodontal Therapy on Periodontal Status and Inflammatory Markers in Patients After Myocardial Infarction: A Randomized Controlled Trial.

Objective: The aim of this study was to evaluate the efficacy of diode laser (DL) therapy as an adjunct to nonsurgical periodontal therapy in the treatment of periodontitis in patients after myocardial infarction (MI). Methods: After given permission by Ethics Commission of the Pomeranian Medical University (KB-0012/06/12), 36 patients <65 years of age (mean: 56.3 ± 7.9) with periodontitis, 6 weeks to 6 months after MI were enrolled for the study. The control group (n = 18) received nonsurgical periodontal therapy, whereas the test group (n = 18) received nonsurgical periodontal therapy followed by laser therapy of the periodontal pockets with 980 nm DL, 1 W, continuous wave mode, and 20 sec per tooth side. Procedures were repeated twice at 5-7 day intervals. Clinical periodontal parameters and inflammatory markers in gingival crevicular fluid (GCF) [elastase, aspartate transaminase (AST), alanine transaminase (ALT) and interleukin (IL)-6, proteins], bloodstream [fibrinogen, high-sensitivity CRP (hs-CRP), IL-6, AST and ALT], and lipid fractions (triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol) were measured before treatment, 2 weeks, and 3 months after treatment. Results: The difference between groups in the reduction of periodontal pocket depth (PPD) in pockets ≥7 mm was found to be significant in the test group (p < 0.05). There was also a statistically significant reduction in the volume of GCF and hs-CRP concentration in blood 2 weeks after the completion of treatment in the test group (p < 0.05). Conclusions: Within the limits of this study, it can be concluded that in the nonsurgical treatment of periodontitis with patients after MI, the additional use of DL enables greater reduction of PPD in pockets ≥7 mm. In addition, a faster reduction of GCF volume and hs-CRP was noted in the laser group.

The resolvin D1 levels before and after periodontal therapy in periodontitis patients.

The aim of this study was to determine the levels of resolvin D1 (RVD1) in the gingival crevicular fluid (GCF) and saliva in the patients with periodontitis and healthy subjects, and also to evaluate the effects of non-surgical periodontal treatments (NSPTs) on RVD1 levels. Fifteen patients with Stage III Grade B periodontitis (P) and 11 periodontally healthy individuals (H) were included in this study. Clinical periodontal measurements, GCF, and saliva samples were collected from each individual at baseline and 6weeks after NSPTs in periodontitis group. GCF and saliva levels of RVD1 were analyzed by enzyme-linked immunosorbent assay. GCF total and concentration levels of RVD1 were significantly lower in the periodontitis group than in the healthy group and significantly increased after NSPTs in periodontitis (p < 0.001). There was no statistically significant difference in saliva RVD1 levels between healthy and periodontitis group and also before and after NSPTs in periodontitis (p > 0.05). Significant negative correlations were found between all periodontal clinical parameters and GCF volume with both GCF total amount and concentrations of RVD1 (p < 0.01). There was a positive correlation between GCF total amount and concentrations of RVD1 (r = 0.762, p < 0.01). GCF levels of RVD1 might be promising biomarkers for monitoring the susceptibility to periodontitis and predicting periodontal status. RVD1 may be valuable biomarker to observe the healing process after periodontal treatment as increased GCF levels might project clinical improvements post-treatment. Accordingly, observing GCF RVD1 levels might be helpful to determine individuals require further periodontal treatment.

The Effect of Flowable Composite Resins on Periodontal Health, Cytokine Levels, and Immunoglobulins.

Objective This study investigated the effects of flowable resin composites (FCR) on the restoration of noncarious cervical lesions (NCCL) and their impact on periodontal tissues. Materials and Methods 30 periodontally healthy patients were assigned into three groups randomly; group VF: self-adhering FCR, group NF: fluoride-releasing FCR, and group SF: microhybrid FCR. Gingival crevicular fluid (GCF) volume levels of osteoprotegerin (OPG), immunoglobulins (IgA, IgM), and interleukins (IL-1, IL-1β, and IL-10) in GCF were analyzed with ELISA tests. Clinical success rates were evaluated using USPHS criteria during the 12-month follow-up. Results The GCF volume was increased mostly in group SF (1.34 ± 0.09 μl). While the titer of interleukin was increased in all groups, higher increases were observed in IL-1 and IL-1β in group NF (170.78 pg/ml and 39.35 pg/ml). Increased IL-10 was observed in group VF (14.33 ± 0.85 pg/ml). IgA levels varied partially among all groups (p > 0.05), and even IgM levels were elevated immediately after the restoration process but returned to normal on the 28th day (p < 0.05). Group NF failed in most of the USPHS criteria, while the material group VF and group SF presented acceptable results except in the marginal adaptation criterion (p < 0.05). Conclusions Clinical efficacy of self-adhering FCR was found the best for restoration of NCCL while fluoride-releasing FCR stimulated the periodontal response and had negative effects on GCF volume, cytokine, and immunoglobulin levels.

Collection, Storage and Protein Extraction Method of Gingival Crevicular Fluid for Proteomic Analysis

Gingival crevicular fluid (GCF) may reflect the events associated with orthodontic tooth movement. Attempts have been conducted to identify biomarkers reflecting optimum orthodontic force, unwanted sequallea (i.e. root resorption) and accelerated tooth movement. The aim of the present study is to find out a standardized GCF collection, storage and total protein extraction method from apparently healthy gingival sites with orthodontics that is compatible with further high-throughput proteomics. Eighteen patients who required extractions of both maxillary first premolars were recruited in this study. These teeth were randomly assigned to either heavy (225g) or light force (25g), and their site specific GCF was collected at baseline and after 1hr, 1day, 7days, 14days, 21days and 28days post force application. Periostrips were used for GCF collection and subsequent phosphate buffered saline (PBS) was used for immediate protein elution with centrifugal speed of 10000rpm for 5min and stored at -80°C. Protein concentration was estimated using Bradford colorimetric assay. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) was carried out to resolve the purity of proteins in the collected samples and the method of collection was validated by western immuno-blotting of alpha amylase salivary enzyme. The current collection, storage and protein extraction protocol showed the best protein recovery and purity with validated collection free of salivary contamination. In conclusion, tiny GCF volume from healthy sites and evaporation issues of such promising non-invasive fluid motivate us to investigate a standardized protocol enabling optimal preservation of GCF sample and the currently followed protocol may serve as a reference for future proteomic studies searching for GCF biomarkers in diagnosing and monitoring orthodontic tooth movement.