Gingivitis Patients Research Articles

RANKL and MMP8 levels in Gingival Crevicular Fluid (GCF) as oral biomarker for periodontal condition

Objective: We assessed the diagnostic potential of RANKL and MMP8 in gingivitis and periodontitis patients. Material and Methods: Sixty Seven otherwise gingivitis and periodontitis patient were enrolled at Faculty of Dentistry Universitas Brawijaya and Janti Health Service Malang. Gingival crevicular fluid was sampled modified gingival index include normal (n= 26), mild inflammation (n= 25), moderate (n=10), and severe inflammation (n=6). For periodontitis parameter, GCF was sampled pocket depth such as pocket depth 0-3,5 mm (n= 49), pocket depth 3,6-5,5 mm (n=11), pocket depth >5,5 mm (n=7). RANKL and MMP8 were determined by ELISA (Enzyme-linked immunosorbent assay). Then, One Way ANOVA analysis was used. Results: RANKL showed significantly difference in gingivitis patient (p<0.05), but not periodontitis patient (p>0.05). However MMP8 did not show any significant difference (p>0.05) between gingivitis and periodontitis. RANKL showed a good discrimination performance. RANKL and MMP8 present in the identification of periodontal disease. Conclusion: RANKL presented more accurate diagnostic marker for periodontitis than gingivitis.

Molecular detection of Entamoeba gingivalis among periodontitis and gingivitis patients by singleplex polymerase chain reaction

Abstract Background: Periodontal disease is classically characterized by progressive destruction of the soft and hard tissues of the periodontal complex, mediated by an interplay between dysbiotic microbial communities and aberrant immune responses within gingival and periodontal tissues. It is being recorded as public health problems. Objective: The aim of study is to detect Entamoeba gingivalis parasite in the oral cavity of patients with periodontitis and gingivitis by using molecular technique with singleplex polymerase chain reaction (PCR). Materials and Methods: A total of 100 patients with periodontal diseases (periodontitis and gingivitis) were enrolled in the current study. Samples of dental plaque were collected from each patient and stained with Giemsa stain and studied under a microscope. Six samples were selected to be examined by using singleplex PCR technique for the detection of 18S-the small subunit of ribosomal RNA gene (SSU rDNA) gene with 203 bp and comparing the results. Results: This result showed a high significant prevalence of E. gingivalis in dental plaque samples in patients with periodontitis and gingivitis. About 46 (46%) samples were positive by microscope examination. In comparison, six positive samples (3 men and 3 women) were selected for parasitic investigation by singleplex PCR and the results of PCR with specific primers designed for the detection of 18S SSU rDNA gene of (203 bp) showed positive results for the six samples. Conclusion: It was concluded that E. gingivalis had a prevalence among male patients than female patients. In addition, singleplex PCR is the technique of choice for the detection of the target sequence of DNA.

Comparison of Oral Health and Salivary Biomarkers in Children with Juvenile Idiopathic Arthritis and Healthy Individuals.

This study examines the effects of juvenile idiopathic arthritis (JIA) on the oral health and detectability of inflammatory biomarkers IL-17, tumour necrosis factor-alpha (TNF-α) and total antioxidant status (TAS) in the saliva of children with JIA. This study included 117 participants (39 patients with JIA and 78 systemically healthy subjects aged 8-12 years). Demographic data, responses to an oral health-related questionnaire, saliva samples, periodontal parameters [plaque index (PI), gingival index (GI) and bleeding on probing (BOP)] and dental recordings [facial profile (FP) and dental occlusion relationship (DOR)] were obtained. Enzyme-linked immunosorbent assays were used to determine the levels of salivary IL-17, TNF-α and TAS. The Caries Assessment Spectrum and Treatment (CAST) index, FP and DOR distributions did not change between groups (P > 0.05). JIA patients had more temporomandibular joint (TMJ) discomfort than gingivitis patients and healthy subjects (P < 0.05). JIA patients had greater salivary IL-17 levels than healthy subjects (P < 0.05). The healthy group's TAS was higher than that of the JIA and gingivitis groups (P < 0.05). Saliva TNF-α levels were similar between groups (P > 0.05). PI, GI, BOP and TNF-α were positively associated with salivary IL-17 (P < 0.001). Elevated salivary IL-17 and TAS levels could be used as biological markers for discriminating the clinical health status of children with JIA and gingivitis.

Antimicrobial photodynamic therapy for the management of gingivitis and white spot lesions in fixed orthodontic patients: A systematic review

We conducted this review to evaluate the safety and efficacy of antimicrobial photodynamic therapy (aPDT) for the management of gingivitis and white spot lesions (WSLs) in fixed orthodontic patients. The PubMed/MEDLINE, Cochrane Library, Scopus, and Google Scholar databases were searched for randomized controlled trials and clinical trials assessing the clinical effectiveness of aPDT for the management of gingivitis and WSLs in fixed orthodontic patients without time limitation. Primary outcomes were the changes in clinical parameters such as DIAGNOdent, plaque index (PI), bleeding on probing (BOP), and gingival index (GI). Secondary outcomes included measurements of microbial and inflammatory factors, such as cytokine levels (tumor necrosis factor alpha [TNF-α], interleukin-1 beta [IL-1β], and interleukin-6 [IL-6]), and bacterial counts. Our search yielded a total of 12 studies that met the inclusion criteria. Among the 11 studies that evaluated gingivitis, the majority employed a diode laser (670nm, 150 mW, 22J/cm2, 60seconds) as the light source and methylene blue at a concentration of 0.0005% (applied for 3minutes) as the photosensitizer in a single treatment session. The included studies reported positive effects of aPDT on gingivitis management, with more improvements observed in PI, BOP, and GI following aPDT treatment. Additionally, aPDT was found to reduce the counts of periopathogens such as Porphyromonas gingivalis, as well as inflammatory factors (TNF-α, IL-1β, and IL-6). Two studies demonstrated that aPDT, particularly when administered in multiple sessions, effectively controlled the extent of WSLs during orthodontic treatment and yielded favorable outcomes that persisted for several months after treatment. Based on the available evidence, aPDT appears to be a safe and effective treatment option for managing WSLs and gingivitis in patients with fixed orthodontic appliances. However, further high-quality RCTs are necessary to investigate the impact of potential confounding factors on the efficacy of aPDT.

Periodontal disease and visfatin level: A systematic review and meta-analysis.

Visfatin is considered an inflammatory biomarker in periodontal disease (PD). In this meta-analysis, we aimed to evaluate the relationship between Visfatin biomarker level with PD. In this study, Medline, Scopus, Web of Science, and Google Scholar were searched. We included studies that examined visfatin levels in samples from healthy people and periodontal disease until March 2023. The quality of the selected articles was evaluated using the Newcastle-Ottawa assessment scale. Depending on heterogeneity of studies, random-effects or fixed-effect models were used to pool results and report the standardized mean difference (SMD). After screening the retrieved papers, the related data were extracted. A total of 159 studies were identified, and 16 studies were included in the meta-analysis. In 9 studies, the SMD of visfatin level of gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP) and healthy individuals was 4.32 (p<0.001). In 6 studies, the SMD of salivary visfatin level in patients with CP and healthy individuals was 2.95 (p = 0.004). In addition, in five studies, the SMD of serum visfatin level in patients with CP and healthy individuals was 7.87 (p<0.001). Therefore, Visfatin levels in serum, saliva, and GCF of patients with CP were increased in comparison to healthy individuals. Comparison of visfatin levels in saliva of gingivitis patients and healthy individuals showed a significant increase of visfatin in gingivitis patients (SMD:0.57, P = 0.018), but no significant difference was observed in the mean GCF visfatin level of gingivitis patients and healthy individuals (SMD:2.60, P = 0.090). In addition, the results suggested that there is no difference between gingivitis cases compared to CP patients (SMD:3.59, P = 0.217). Visfatin levels in GCF, serum, and saliva have the potential to be used as a diagnostic biomarker of periodontitis.

Isolation and identification of some predominant bacteria and assessment of TNF-α level in serum of patients with gingivitis

This study was conducted to diagnose the aerobic bacterial species causing gingivitis, reveal the antibiotic susceptibility pattern and assess the level of tumor necrosis factor-alpha (TNF-α) in serum of patients with gingivitis. In total, 110 samples (including patient group and control group) were collected during the period from November 2021 until March 2022. Of which, 80 samples were collected by using oral swabs from patients attending the College of Dentistry at Tikrit University and outpatient clinics of both gender with different age groups. While the remaining 30 samples were collected from healthy individuals representing the control group. Identification of bacterial isolates was performed depending on micro and macroscopic cultural characteristics and biochemical tests. In addition to assessing the biochemical characteristics of the isolates, a VITKE2 compact system was used to ensure the identification of species level. The TNF-α concentrations in the serum were determined using an enzyme-linked immunosorbent assay known as a sandwich ELISA. Out of 80 samples, 60 (75%) samples showed positive bacterial growth cultures, while 20 (25%) samples showed no bacterial growth. The most common isolated bacteria species was Streptococcus mutans (18%), followed by Streptococcus mitis (13%), Staphylococcus aureus (12%) Streptococcus salivarius, Streptococcus pyogenes (8%) Staphylococcus epidermidis, Enterococcus feacalis, Escherichia coli, Klebsilla pneumoniae (6%), Rothia dentocariosa, Pseudomonas aeruginosa (4%), and Streptococcus pneumonia, Kocuria kristinae, Granulicatella adiacens (3%). The sensitivity of the bacterial isolates under study was tested to 11 antibiotics. Different species of bacteria showed various sensitivity patterns to several kinds of antibiotics. The study recorded a high significant difference (P=0.0007) between the patients (56.54 + 9.32 pg/ml) and the control group (31.88 + 7.44 pg/ml) concerning the level of TNF-α. In conclusion, the predominant bacteria identified from gingivitis patients were S. mutans and S. mitis. In addition, the levels of TNF-α in gingivitis patients were significantly higher than in the control group.

Metabolomics analysis in saliva from periodontally healthy, gingivitis and periodontitis patients.

The aim of this study was to investigate metabolomics markers in the saliva of patients with periodontal health, gingivitis and periodontitis. The use of metabolomics for diagnosing and monitoring periodontitis is promising. Although several metabolites have been reported to be altered by inflammation, few studies have examined metabolomics in saliva collected from patients with different periodontal phenotypes. Saliva samples collected from a total of 63 patients were analysed by nuclear magnetic resonance (NMR) followed by ELISA for interleukin (IL)-1β. The patient sample, well-characterised clinically, included periodontal health (n = 8), gingivitis (n = 19) and periodontitis (n = 36) cases, all non-smokers and not diabetic. Periodontal diagnosis (healthy/gingivitis/periodontitis) was not associated with any salivary metabolites in this exploratory study. Periodontal staging showed nominal associations with acetoin (p = .030) and citrulline (p = .047). Among other investigated variables, the use of systemic antibiotics in the previous 3 months was associated with higher values of the amino acids taurine, glycine and ornithine (p = .002, p = .05 and p = .005, respectively, at linear regression adjusted for age, gender, ethnicity, body mass index and staging). While periodontal staging was marginally associated with some salivary metabolites, other factors such as systemic antibiotic use may have a much more profound effect on the microbial metabolites in saliva. Metabolomics in periodontal disease is still an underresearched area that requires further observational studies on large cohorts of patients, aiming to obtain data to be used for clinical translation.

Molecular detection of oral Trichomonas tenax in periodontal disease patients by polymerase chain reaction -based 18S rRNA gene.

Trichomonas tenax, an oral flagellated protozoon found in humans, potentially associated with the inflammation of periodontal tissues and decreased immunity that causes the tissue damage and tooth loss from chronic infection. Currently, there is a lack of data regarding the prevalence of T. tenax infection in Thailand. Therefore, this study aimed to measure prevalence of T. tenax in periodontal disease patients by using polymerase chain reaction (PCR) to amplify the 18S ribosomal RNA (18S rRNA) gene and to determine the factors associated with the presence of this protozoan. A cross-sectional descriptive study was conducted among 230 patients with periodontal disease, who visited the oral health center of Suranaree University of Technology Hospital, Thailand from 2021 to 2022. Dental plaque specimens were collected and examined to identify the presence of T. tenax using the PCR-based 18S rRNA gene. The occurrence of factors associated with T. tenax infection was analyzed by the chi-square test and binary logistic regression. The prevalence of T. tenax infection was 13.48% (31/230), in patients, including 96.77% (30/31) and 3.23% (1/31) in periodontitis and gingivitis patients, respectively. The presence of T. tenax was associated with periodontal disease (p<0.001) and the Periodontal Screening and Record (PSR) index (p=0.001). The significant risk factors for T. tenax infection were periodontitis (ORadj=239.89, 95% CI=23.801-2417.746), no-underlying disease (ORadj=0.31, 95% CI=0.099-0.942), and male sex (ORadj=0.25, 95% CI=0.062-0.981). Dentists should be concerned about this oral protozoan in periodontitis patients. Furthermore, epidemiologic studies of T. tenax are still needed to investigate the mechanism of pathogenesis from T. tenax infection.

Clinical and oral microbiome pattern of halitosis patients with periodontitis and gingivitis.

Halitosis is caused by a bacterial proteolytic process that induces the production of volatile sulfur compounds, odor-causing gases. The aim of this study was to determine the clinical oral hygiene state and oral microbiome pattern of halitosis patients with periodontitis and gingivitis. The oral hygiene state of halitosis patients with periodontitis and gingivitis was assessed using the oral hygiene index simplified (OHI-S), decay missing filled teeth (DMFT), and tongue biofilm. The dorsum of the tongue and subgingival swabs were cultured for bacteria, and bacterial morphology was evaluated using Gram staining. Evaluation of the bacterial genus using the Bergey's systematic bacteriology diagram as a guide. A total of ten patients with periodontitis and gingivitis were included. Our data indicated that the scores of OHI-S and DMFT were different significantly between halitosis patients with periodontitis and gingivitis (both had p<0.001) while tongue biofilm score was not different between groups. On the dorsum of the tongue, periodontitis patients had a significant higher oral microbiome population (85.65x106 CFU/mL) compared to those with gingivitis (0.047x106 CFU/mL) with p=0.002. In contrast, the number of microbiomes in the subgingival had no significant different between periodontitis and gingivitis. On the dorsum of the tongue, six bacterial genera were isolated from periodontitis cases and seven genera were detected from gingivitis patients. On subgingival, 10 and 15 genera were identified from periodontitis and gingivitis, respectively. Fusobacterium, Propionibacterium, Eubacterium and Lactobacillus were the most prevalent among periodontitis cases while Porphyromonas was the most prevalent in gingivitis patients. In conclusion, although OHI-S and DMFT are different between periodontitis and gingivitis, overlapping of bacterial genera was detected between periodontitis and gingivitis cases.

Investigation of volatile sulfur compound level and halitosis in patients with gingivitis and periodontitis

This study aimed to measure the levels of volatile sulfur compounds and investigate the occurrence of halitosis in patients with gingivitis and periodontitis. Additionally, the incidence rates of gingivitis and periodontitis in patients with halitosis were investigated. Through various statistical analyses, we attempted to determine the relationship between periodontal disease and halitosis. One-hundred-and-four participants (52 females and 52 males, mean age: 46.49 ± 16.03 years) were enrolled in this cross-sectional study, comprising 33 healthy controls, 43 patients with gingivitis, and 28 patients with periodontitis. Gas chromatography was used to measure hydrogen sulfide (H2S) and methyl mercaptan (CH3SH), which are representative VSCs. The VSC cut-off values for diagnosing halitosis were 65.79 ppb for women and 79.94 ppb for men. Total VSC level was significantly higher in the gingivitis than the healthy control group (186.72 ± 374.83 ppb vs. 19.80 ± 40.19 ppb, p = 0.035). There was no significant difference between the gingivitis and periodontitis (153.79 ± 278.51 ppb) groups. H2S level was significantly higher in the gingivitis (100.51 ± 183.69 ppb) and periodontitis (91.57 ± 132.06 ppb) groups than in healthy controls (14.97 ± 31.22 ppb), and CH3SH level was significantly higher in gingivitis group (29.31 ± 59.16 ppb) than in the healthy control (5.73 ± 14.10 ppb) (all p < 0.05). Halitosis was found in 3% of healthy controls and 39.5% and 42.9% of patients with gingivitis and periodontitis patients, respectively, making it significantly higher in the gingivitis and periodontitis groups than the healthy controls (p = 0.005). Conversely, among participants with halitosis, 53.1% had gingivitis, 37.5% had periodontitis, and 90.6 incidence had periodontal disease. Multivariate logistic regression analysis to predict the presence of halitosis, found periodontal disease was a significant predictor of halitosis (OR = 3.607, 95% CI 1.023–12.718, p = 0.046). Considering area under curve value for halitosis, the cut-off value of healthy control (H2S:61.5 ppb, CH3SH:3.5 ppb), gingivitis (H2S:50.0 ppb, CH3SH:6 ppb), and periodontitis (H2S:62.0 ppb, CH3SH:3.5 ppb) were (all p < 0.05). Our results emphasize the close and strong relationship between periodontal disease and halitosis through human clinical evidence based on the high co-occurrence rate of mutual diseases. Additionally, the presence of periodontal disease increased the probability of halitosis by 3.607 times. These results suggest that H2S can be used as a biomarker of halitosis in patients with periodontal disease.

Oil Pulling and Polyphenols: Treatment of Gingivitis Patients with 'Itri Extra-Virgin Olive Oil'.

The aim of the study was to evaluate the effectiveness of extra virgin olive (EVO) oil and fruity oil for the treatment of gingivitis. A sample of 75 patients over 18 years of age with gingivitis induced by plaque bacteria was divided into three groups: study group A, with extra virgin olive oil; study group B, with fruity oil; and control group C. In the two study groups, EVO oil was administered as a mouthwash to patients with gingival inflammation. The protocol included a daily application of the product for 30 days, with three recalls 15 days apart. Clinical parameters of plaque formation and gingivitis, including plaque index (PI) and bleeding index (BI), were assessed at each recall and scored on a specific periodontal chart. The control group received no mouthwash treatment in addition to normal daily oral hygiene procedures, and the same clinical parameters as the study group were evaluated. Data were evaluated using SPSS 27.0 software for Windows (SPSS Inc., Chicago, IL, USA). Then, the pre- and post-treatment values of the groups were compared using Student's t-test, setting p < 0.05 as the significance level. Comparison of the three groups showed that extra-virgin olive oil was an adjuvant in the treatment of gingival inflammation, improving PI and BI. In group A, the mean plaque index showed a 48% reduction, and the bleeding index showed a 64% reduction after 30 days. In group B, the mean plaque index showed a 35% reduction and a bleeding index reduction of 43% after 30 days. The collected data showed significant improvements in the formation of bacterial plaque and gingivitis. The exact mechanism of such treatment is still to be elucidated. As a result of this, further studies with a different sample of patients than those used and a comparison with other products need to be addressed to verify and demonstrate the antibacterial and anti-inflammatory effects of the components of this natural product.

Periodontal Disease Markers among Patients with Long COVID: A Case-control Study

Background: Long-COVID affects approximately 32-87% of COVID-19 patients and causes persistent symptoms that last more than 4 weeks after initial infection. Long COVID is associated with a notable cytokine triad, namely IL-1β, IL-6, and TNF-α. Periodontal disease also involves proinflammatory cytokines production, including IL-1β, IL-6, and TNF-α. Consequently, long-COVID, which has an impact on proinflammatory cytokine release, could have an impact on periodontal status. Objective: This study aims to see whether long COVID affects periodontal status severity based on proinflammatory cytokines levels involved in both diseases, namely IL-1β, IL-6, and TNF-α. Methods: Patients were divided into periodontitis or gingivitis patients and then were further divided into two groups, previous COVID-19 patients and non-COVID-19 patients (controls). Gingival sulcus fluids were obtained from each patient using paper points inserted in the patients’ sulcus, and ELISA tests were carried out to measure IL-1β, IL-6, and TNF-α levels. Results: Levene Test indicated that there were no substantial differences between IL-1β, IL-6, and TNF-α levels (0.057, 0.135, and 0.341, respectively) in COVID-19 patients with gingivitis in comparison to the control group with gingivitis, with average IL-1β, IL-6 and TNF-α levels seen higher in the control group compared to COVID-19 patients. There were also no substantial differences between IL-1β, IL-6, and TNF-α levels (1.00, 0.567, and 0.666, respectively) between COVID-19 patients with periodontitis and the control group with periodontitis. Although higher levels of IL-6 and TNF-α were found higher in COVID-19 patients in comparison to the control group. Conclusion: Levels of IL-6 and TNF-α in periodontitis patients with long COVID were higher than controls. But despite that, higher IL-1β, IL-6, and TNF-α levels were not found in long COVID subjects with gingivitis, as well as IL-β levels in the periodontitis group. Further studies with more subjects are needed to determine the connection between these two diseases further. Clinical Trial Registration No: The clinical trial registration of this research is 014/S3/KEPK/FKG/10/2021.

Comparison of the Efficacy of Two Different Mouthwashes in Gingivitis Patients: A Clinical Study

INTRODUCTION: Adequate plaque control becomes essential for reducing the progression of periodontal disease. Plaque management consists several mechanical procedures and chemical agents that retard the formation of plaque. AIM: To compare clinical outcomes of chlorhexidine gluconate mouthwash and Hiora herbal mouthwash in gingivitis patients. MATERIALS AND METHOD: The study was conducted among 30 patients. Patients were randomly divided into two groups, Group I used Chlorhexidine mouthwash and Group II received Hiora mouthwash. Clinical parameters such as Plaque Index (PI), Gingival Index (GI), Probing depth (PD) and Clinical Attachment Loss (LA) were recorded just before initiation of oral prophylaxis. After completion of oral prophylaxis, patients were advised to use mouthwash and were recalled after two weeks for further recording of clinical parameters. The collected data was thus statistically analysed to arrive at the results using SPSS version 24.0 and applying the student's t-test. RESULTS: Both the groups reported significant improvement in clinical parameters. When two mouthwashes were compared, a statistically significant difference in the mean value of PI (0.02) and GI (0.01), CAL and PD between the two experimental groups whereas no significant differences were observed before and after therapeutic interventions. CONCLUSION: The study concluded that herbal mouthwash are comparably effective in comparison to other conventional mouthwash in controlling dental biofilm

Interactions of Fibroblast Subtypes Influence Osteoclastogenesis and Alveolar Bone Destruction in Periodontitis.

To analyze the fibroblasts subtypes in the gingival tissues of healthy controls, gingivitis and periodontitis patients, as well as the effects of interaction between subtypes on alveolar bone destruction. Gingival tissues were divided into three groups according to clinical and radiographic examination, and the immunostaining of EDA+FN was assessed. Fibroblasts from gingiva developed colony formation units (CFUs) and induced Trap+MNCs. The expression of osteoclastogenesis-related genes was assessed by real-time PCR. Variances in the gene profiles of CFUs were identified by principal component analysis, and cluster analysis divided CFUs into subtypes. The induction of Trap+MNCs and gene expression were compared among individual or cocultured subtypes. The fibroblast subtypes exerted critical effect on Trap+MNCs formation were selected and edited by CRISPR/Cas to investigate the influence on osteoclastogenesis in the periodontitis in mice. Most periodontitis samples exhibited intensive EDA+FN staining (P < 0.05), and these fibroblasts also induced most Trap+MNCs among three groups; consistently, fibroblasts from periodontitis highly expressed genes facilitating osteoclastogenesis. According to gene profiles and osteoclastogenic induction, four clusters of CFUs were identified. The proportion of clusters was significantly different (P < 0.05) among three groups, and their interaction influenced osteoclastogenic induction. Although Cluster 4 induced less osteoclasts, it enhanced the effects of Clusters 1 and 3 on Trap+MNCs formation (P < 0.05). EDA knockout in Cluster 4 abrogated this promotion (P < 0.05), and decreased osteoclasts and alveolar bone destruction in experimental periodontitis (P < 0.05). Heterogeneous fibroblast subtypes affect the switch or development of periodontitis. A subtype (Cluster 4) played important role during alveolar bone destruction, by regulating other subtypes via EDA+FN paracrine.

TNF-αand OSX mRNA of salivary small extracellular vesicles in periodontitis: a pilot study.

This cross-sectional study explored extracellular vesicle (EV)-derived gene expression of markers for bone turnover and pro-inflammatory cytokines in periodontal disease. Whole unstimulated saliva was collected from fifty-two participants (18 healthy, 13 gingivitis and 21 stages III/IV periodontitis), from which small extracellular vesicles (sEVs) were enriched using the size-exclusion chromatography (SEC) method, and characterised by morphology, EV-protein, and size distribution, using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), and Nanoparticle Tracking Analysis (NTA), respectively. Bone turnover markers and pro-inflammatory cytokines in salivary sEVs were evaluated using RT-qPCR. Salivary sEVs morphology, mode, size distribution and particle concentration were comparable between healthy, gingivitis, and periodontitis patients. A CD9+ subpopulation was significantly higher in periodontitis-derived salivary sEVs compared to healthy. The detection of sEVs mRNA for osterix (OSX) and tumour necrosis factor-alpha (TNFα) was significantly decreased and increased, respectively, in periodontitis compared to healthy controls, with good discriminatory power for periodontitis diagnosis [area under the curve (AUC) >0.72]. Our study demonstrated that salivary sEVs mRNAs may serve as a potential non-invasive biomarker source for periodontitis diagnosis.

DESCRIPTION OF SALIVA MELATONIN LEVELS IN GINGIVITIS PATIENTS AT RSGM UNJANI CIMAHI INDONESIA

Periodontal disease is a dental and oral disease that often occurs in Indonesian society. According to Riskesdas in 2018, the Prevalence of dental and oral diseases in Indonesia was 57.6%, with most cases being dental caries and periodontal disease, while according to Purwakarta Health Profile in 2017, the periodontal disease prevalence in West Java was 85.6%. One of the most common periodontal diseases in Indonesia is Gingivitis. According to Riskesdas, in 2018, the Prevalence of Gingivitis in Indonesia reaches 74%. Gingivitis is an inflammatory process in the gum tissue of the oral cavity. The body has a hormone that acts as an anti-inflammatory and antioxidant in periodontal diseases, namely melatonin. melatonin hormoneill decrease if there is inflammation in the body, increased free radicals, bone damage, immune system disorders, oxidative stress, and circadian rhythm disorders. This study aimed to describe the melatonin level in gingivitis patients' saliva. This study used cross-sectional quantitative descriptive research as its methodology. The level of melatonin in the saliva is low if &lt;2 pg/ml, normal: 2-4pg/ml, and high: &gt;4pg/ml. The results showed that the mean melatonin level in the saliva of gingivitis patients at RSGM Unjani was 13.8 pg/ml, with a minimum melatonin level of 6.9 pg/ml and a maximum of 48.5 pg/ml. The results of the research and data analysis concluded that the level of melatonin in the saliva of patients with Gingivitis at RSGM Unjani is elevated, which is caused by various factors that affect melatonin levels.

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment: a systematic review and meta-analysis

BackgroundMouthwashes were convenient adjuncts to mechanical cleaning procedures. This review aimed to evaluate the efficacy of mouthwashes on oral microorganisms and gingivitis in orthodontic patients.MethodsBy April 16, 2022, multiple databases and grey literature were searched based on the PICOS strategy. Randomized controlled trials in orthodontic patients evaluating the efficacy of mouthwashes with at least one microbial parameter and/or plaque- and/or gingival inflammation-related index were included. Relevant data were extracted, and the risk of bias was evaluated using Cochrane's tool. Individual mean and standard deviation of the outcomes in mouthwashes and placebos/blank controls were pooled to estimate the weighted mean differences (WMDs) and 95% confidence intervals (95%CIs). Sensitivity analysis, and certainty of evidence were evaluated.ResultsOf 1684 articles, 32 studies satisfied the eligibility criteria, and nine were included for meta-analysis. Missing outcome data was the primary source of bias. Compared to blank controls, the short-term application of fluoride mouthwashes significantly reduced the colony counts of Mutans streptococci (MS), while the long-term application may not be effective. Compared to placebos or blank controls, Chlorhexidine mouthwashes significantly reduced the colony counts of multiple microorganisms in the short-term. Compared to placebos or blank controls, herbal mouthwashes showed the inhibitory effect of MS in the short-term, with some results lacking statistical significance. After meta-analysis, significant lower plaque- and gingival inflammation-related indexes were observed in the Chlorhexidine mouthwashes groups [Gingival Index: WMD = -0.45, 95%CI = -0.70 to -0.20 (placebos as control); WMD = -0.54, 95%CI = -0.96 to -0.13 (blank controls); Plaque Index: WMD = -0.70, 95%CI = -1.12 to -0.27 (blank controls)]. Significant lower gingival inflammation-related indexes were observed in the herbal mouthwashes groups [Gingival Index: WMD = -0.20, 95%CI = -0.32 to -0.09 (blank controls)].ConclusionsThe short-term application of fluoride mouthwashes may reduce the colony counts of cariogenic bacteria, but the long-term effect is not evident. Chlorhexidine may reduce the colony counts of multiple microorganisms in the short-term. Short-term application Chlorhexidine and herbal mouthwashes may effectively reduce plaque- and gingival inflammation-related indexes. However, the risk of bias, inconsistency, and imprecision in the included studies may reduce the certainty of the evidence.

Association between Chronic Gingivitis and Cancer: A Retrospective Cohort Study of 19,782 Outpatients from the United Kingdom.

Purpose: Recent data argue for the involvement of inflammatory and infectious diseases in cancer development. However, clinical data on the association between chronic gingivitis and cancer have been less conclusive. Here, we systematically evaluated the cancer incidence in a population-based cohort of outpatients with chronic gingivitis from the United Kingdom. Methods: 9891 patients with chronic gingivitis and an identical number of people without gingivitis matched by age, gender, index year, and the Charlson Comorbidity Index were identified from the Disease Analyzer database (IQVIA) between January 2000 and December 2016. Cox regression models were used to study the association between gingivitis and cancer. Results: The probability of cancer was significantly higher among patients with diagnosed chronic gingivitis compared to non-gingivitis individuals (HR = 1.36, 95% CI = 1.15-1.62). In cancer site-stratified analyses, we observed a trend towards higher rates of cancer in almost all cancers (breast cancer, lymphoid system cancer, digestive tract cancers, skin cancer); however, a significant association was only observed for prostate cancer (HR: 3.38; 95% CI: 1.57-7.27). Notably, the largest increase in cancer rates was observed in male patients (HR: 1.46, 95% CI: 1.13-1.89) between 41 and 60 years old (HR: 1.74, 95% CI: 1.30-2.32). Conclusions: Our data suggest that chronic gingivitis represents an important risk factor for the development of cancer. Therefore, in the context of patient dental care, awareness should be raised to refer gingivitis patients to existing screening programs, especially for prostate cancer. Moreover, the consistent treatment of gingivitis could potentially have a positive impact on the morbidity of certain cancers.

Complicated clinical variants of mucoperiodontal lesions: desquamative gingivitis

Objective. To study the frequency, clinical and topographic features, risk factors for development, quality of primary diagnosis and treatment of desquamative gingivitis in patients with chronic pathology of the oral mucosa.&#x0D; Materials and methods. A cohort cross-sectional clinical study with elements of sociological analysis of patients (n = 314; 99 males and 215 females aged 18 to 62 years), who visited the medical advisory center for oral mucosal diseases (OMD) was conducted. According to the results of clinical and laboratory studies, the diagnosis of the main oral mucosal disease was formulated, and patients with desquamative gingivitis were isolated into a separate group. Hygienic (OHI-S) and periodontal (PMA, BoP, PBI, CPITN) indices were evaluated, and impact of oral pathology on the patients quality of life using OHIP-49-RU index was assessed for objectification of periodontal status.&#x0D; Results. High (17.8 %) incidence of desquamative gingivitis was found in patients with chronic oral mucosal diseases of predominantly autoimmune origin (lichen planus, pemphigus vulgaris, erythema multiforme, psoriasis). Desquamative gingivitis develops significantly more often (60.7 %) in women and affects the vestibular surfaces of the anterior-upper dentogingival segment, manifests clinically apparent edema, pain, hemorrhagic and sensory-paresthetic symptoms, which limit the functionality of the patient (chewing, speech, oral hygiene, social communication and professional realization), that significantly reduces the key parameters of patients quality of life.&#x0D; Conclusions. The main reasons for chronization of desquamative gingivitis and low effectiveness of its treatment are the following: low level of polyclinic diagnostics, problems of differential diagnosis, the predominant use of irrational, pathogenetically unjustified means and methods of treatment, as well as the lack of interdisciplinary approaches to the planning of complex therapy.

Relationship between Diet Quality and Periodontal Disease in South Korean Adults Aged ≥40 Years.

The purpose of this study was to investigate the relationship between diet quality and periodontal disease, in adults aged ≥40 years, using data from the 7th (2016-2018) Korea National Health and Nutrition Survey (KNHANES), representing South Koreans. The subjects of this study were 7935 people aged ≥40 years, who responded to the items in the Korea Healthy Eating Index (KHEI) and underwent periodontal examination. Complex sample univariate and multivariate logistic regression analyses were conducted, to analyze the relationship between the diet quality and periodontal disease. The group with a low diet quality for energy intake balance, showed a higher risk of periodontal disease than the group with a high diet quality for energy intake balance, and it was confirmed that the diet quality in adults aged ≥40 years was related to periodontal disease. Therefore, regular diet evaluations, and the counseling of gingivitis and periodontitis patients by dental experts, will have a positive effect on the restoration and improvement of periodontal health in adults.