IL-10 In Gingival Crevicular Fluid Research Articles

Effect of Plant-Based Mouthwash (Morinda citrifolia and Ocimum sanctum) on TNF-α, IL-α, IL-β, IL-2, and IL-6 in Gingival Crevicular Fluid and Plaque Scores of Patients Undergoing Fixed Orthodontic Treatment.

Background and Objectives: To investigate the antiplaque properties of two plant-based mouthwashes, Morinda citrifolia (MC) and Ocimum sanctum (OS), and their effect on TNF-α, IL-α, IL-β, IL-2, and IL-6 in gingival crevicular fluid (GCF) of patients undergoing fixed orthodontic treatment. Materials and Methods: Seventy-five individuals were recruited according to defined inclusion and exclusion criteria. This study was structured into two distinct phases. Phase I was a combination of toothbrushing using toothpaste containing fluoride (Protocol A), while Phase II toothbrushing included fluoride toothpaste and use of a mouthwash (Protocol B). For Phase II, individuals participating in this study were allocated into different groups through a randomization process: Group 1-0.12% CHX, Group 2-5% MC, and Group 3-4% OS. Each individual's Phase I and Phase II scores were assessed. GCF was measured in three phases to determine the level of inflammatory biomarkers. The paired t-test evaluated the disparities between the pre- and post-plaque index. Categorical data were subjected to crosstab analysis to assess qualitative variables. The mean values of cytokine levels were presented. An unpaired t-test was employed to assess the levels of cytokines between individuals in Phase I and Phase II. Results: Toothbrushing, fluoride toothpaste, and the supplementary use of mouthwash (Phase II) resulted in mean plaque scores significantly lower than group A (p < 0.001). Cytokines TNF-α, IL-α, and IL-β demonstrated a significant downward trend in herbal mouthwash users. Conclusions: In conjunction with fluoridated toothpaste and brushing, OS and MC can serve as a viable alternative to conventional synthetic mouthwash CHX. This combination demonstrates reducing mean plaque scores and diminishing the levels of cytokines TNF-α, IL-α, and IL-β.

Effect of non-surgical periodontal treatment on cytokines/adipocytokines levels among periodontitis patients with or without obesity: a systematic review and meta-analysis

BackgroundThe objective of this systematic review and meta-analysis was to evaluate the effects of non-surgical periodontal therapy (NSPT) on inflammatory-related cytokines/adipocytokines in periodontitis patients with or without obesity.MethodsWe followed the preferred reporting items for systematic reviews and meta-analyses statement and registered the study (CRD42022375331) in the Prospective International Register of Systematic Reviews. We screened randomized-controlled trials and controlled clinical trials from six databases up to December 2022. Quality assessment was performed with RoB-2 and ROBINS-I tools for randomized trials and non-randomized trials, respectively. Meta-analysis was carried out using a random-effect model.ResultsWe included seventeen references in the systematic analysis, and sixteen in the meta-analysis. Baseline results of pro-inflammatory biomarkers, including serum interleukin (IL)-6, serum and gingival crevicular fluid (GCF), tumor necrosis factor (TNF)-a, serum C-reactive protein (CRP)/hs-CRP, and serum and GCF resistin, were higher in obesity subjects than in normal weight subjects. The effect of NSPT with respect to levels of cytokines/adipocytokines, including IL-6, TNF-a, CRP/hs-CRP, resistin, adiponectin, leptin and retinol binding protein 4 (RBP4), were then analyzed in the systematic and meta-analysis. After three months of NSPT, serum (MD = -0.54, CI = -0.62 – -0.46), and GCF (MD = -2.70, CI = -4.77 – -0.63) levels of IL-6, along with the serum RBP4 (MD = -0.39, CI = -0.68–0.10) decreased in periodontitis individuals with obesity. NSPT also improved GCF adiponectin levels after three months (MD = 2.37, CI = 0.29 – 4.45) in periodontitis individuals without obesity.ConclusionsObese status altered the baseline levels of cytokines/adipocytokines (serum IL-6, serum and GCF TNF-a, serum CRP/hs-CRP, and serum and GCF resistin). Then NSPT can shift the levels of specific pro-inflammatory mediators and anti-inflammatory mediators in biological fluids, both in obesity and non-obesity individuals. NSPT can reduce serum and GCF IL-6 levels together with serum RBP4 level in individuals with obesity after 3 months, besides, there is no sufficient evidence to prove that obese patients have a statistically significant decrease in the levels of other cytokines compared to patients with normal weight. NSPT can also increase GCF adiponectin level in normal weight individuals after 3 months. Our findings imply the potential ideal follow-up intervals and sensitive biomarkers for clinical bioanalysis in personalized decision-making of effect of NSPT due to patients’ BMI value.

IL 6 levels in Periodontitis Induced Rabbits after Treatment with Neem Bark Extract

Background: IL-6 has crucial role in the response to microbial insults. It acts as pro-inflammatory and anti-inflammatory agent. Hence IL 6 is an important inflammatory marker of periodontal disease. Levels of IL6 in Gingival crevicular fluid strongly indicate presence of periodontal disease which ultimately results in many health hazards. Aims: To measure levels of IL 6 in periodontitis induced rabbits after treating animals with neem bark extract and amoxicillin at doses of 500mg/kg and 20mg/kg and to see anti-inflammatory effects of neem bark extract. Methods: Forty eight white New Zealand rabbits were divided in four groups A, B, C and D. Group A was healthy control. Group B was disease group. Group C was neem treated. Group D was amoxicillin treated. Periodontitis was induced and rabbits were given treatment with neem bark extract and amoxicillin for 10 days. Samples were obtained with the help of periopaper absorbent strip and marginal auricular vein and analyzed in laboratory. ELISA test was performed to find levels of IL 6 in all four groups. Practical implication: To gain the evidence that neem can be used in maintenance of oral hygiene and prevention of oral diseases. Results: Treatment with neem bark extract and amoxicillin equally reduced IL 6 levels among group c and D after treatment (0.033±0.003) in gingival crevicular fluid when compared with diseased group B (0.089±0.007).P value was less than 0.001. Conclusion: Neem bark extract has significant effects on reduction of IL 6 levels in gingival crevicular fluid of periodontitis induced rabbits Neem bark extract possess anti-inflammatory and anti-microbial action. Keywords: IL6, Periodontitis, GCF, Inflammation, Neem

Interaction between hypertension and periodontitis.

The possible association between hypertension and periodontitis and the effect of hypertension on periodontal treatment were investigated by evaluating salivary and gingival crevicular fluid (GCF) interleukin (IL)-6 and C reactive protein (CRP) levels. Forty-two healthy individuals without any previously diagnosed systemic disease [10 periodontally healthy (control) and 10 periodontitis (CP)] and subjects with hypertension [13 periodontally healthy (HP) and 9 with periodontitis (CP + HP)] participated in the study. GCF and saliva samples were obtained at baseline and 4 weeks after Phase I periodontal treatment. Biochemical parameters were analyzed using ELISA. Before the periodontal treatment, significantly higher GCF IL-6 and CRP levels were detected in CP + HP and CP groups compared to HP and control groups (p < 0.01). Salivary CRP level in CP + HP group was found to be higher than the control group (p < 0.05). Statistically significant gingival and plaque index measurements (p < 0.01) might suggest a possible effect of hypertension on periodontal status. Periodontal treatment significantly improved the clinical indices; however, biochemical parameters did not change after the treatment. The association of hypertension with periodontitis through local salivary and GCF inflammatory mediators might be possible in disease process.

Effect of Low-Level Laser Therapy on Early Wound Healing and Levels of Inflammatory Mediators in Gingival Crevicular Fluid Following Open Flap Debridement.

Introduction Low-level laser therapy (LLLT) has a beneficial effect on pain relief and wound healing. This study aims at a clinical evaluation of early wound healing and a biochemical evaluation of inflammatory mediators in gingival crevicular fluid (GCF) following LLLT with an open flap debridement (OFD) in periodontal therapy. Material and methods This randomized controlled trial included 40 chronic periodontitis patients with bilateral attachment loss, pocket depths of 5 mm affecting at least two quadrants, and radiographic evidence of horizontal bone loss. 120 control sites were randomly selected to receive OFD, and contralateral 120 test sites received bio-stimulation with a diode laser (890 nm) after OFD.The wound healing index was recorded at the 1stand 2ndweeks, and clinical parameters such as the plaque index, gingival index, pocket probing depth, clinical attachment level, and GCF inflammatory mediators were evaluated at baseline, 3, and 6 months. Results From the start of the study to 6 months later, there was astatistically significant dropin plaque index, gingival index, probing pocket depth, and gain clinical attachment levels in both groups. However, when the two groups were compared, there were no significant differences at any time intervals. GCFinflammatory mediators tumor necrosis factor (TNF) alpha and matrixmetalloproteinases (MMP-8) decrease, and osteoprotegerin (OPG)levels increase in both the test group and control group from baseline to 3 months and 6 months. In intergroup comparisons, there was a statistically significant reduction in the test group as compared to the control group at 6 months. There was a decline in gingivalcrevicular fluid- interleukin-6 (GCF IL-6) levels from baseline to 3 months and 6 months in both the groups but when analysed statistically, the results were not significant on intergroup and intragroup comparison at any time interval.The Landry Wound Healing Index values in the 1st and2nd weeks were showing statistically significant improved healing in the test group as compared to the control group. There was significantly better wound healing at sites where a diode laser was used. Conclusion LLLT increases early wound healing after periodontal surgical procedures.

Evaluation of periodontal status and cytokine response in children with familial Mediterranean fever or systemic juvenile idiopathic arthritis.

Familial Mediterranean fever (FMF) and systemic juvenile idiopathic arthritis (sJIA) are chronic inflammatory diseases and anti-inflammatory agents are used in their treatment. This study evaluates the periodontal status and cytokine response in pediatric patients with FMF or sJIA. Forty-eight FMF/sJIA patients were under treatment/control and in attack-free period; 20 systemically healthy children participated in the study. FMF/sJIA patients were divided into two subgroups based on the treatment they received: receiving anti-IL-1 therapy (anti-IL-1 ( +)) and not receiving anti-IL-1 therapy (anti-IL-1 ( -)). The clinical periodontal indices were recorded. Gingival crevicular fluid (GCF) and serum samples were collected. Cytokine levels (IL-1β, IL-1α, TNF-α, IL-6, IL-8, IL-10, IL-17, IL-33) in GCF and serum were measured using ELISA kits. There was no significant difference between the groups in terms of GCF IL-1β and IL-1α levels although, BoP and GI were significantly lower in the anti-IL-1 ( +) group compared to the control group. GCF IL-10 level was higher in the anti-IL-1 ( -) group than in the control group; GCF IL-8 levels were lower in both FMF/sJIA subgroups versus controls. There was no significant difference between serum cytokine levels of FMF/sJIA subgroups. Considering the significant decrease in GI, BoP, and GCF IL-8 levels in the anti-IL-1 ( +) group, it can be concluded that anti-IL-1 medications may suppress periodontal inflammation clinically and immunologically. Anti-IL agents are not currently used in periodontal therapy. However, this study demonstrated the positive effect of anti-IL-1 medications on periodontal inflammation in pediatric patients with FMF or sJIA.

The neutrophil elastase-upregulated placenta growth factor promotes the pathogenesis and progression of periodontal disease.

Periodontal disease is a chronic inflammatory disease. Given its high prevalence, especially in aging population, the detailed mechanisms about pathogenesis of periodontal disease are important issues for study. Neutrophil firstly infiltrates to periodontal disease-associated pathogen loci and amplifies the inflammatory response for host defense. However, excessive neutrophil-secreted neutrophil elastase (NE) damages the affected gingival. In lung and esophageal epithelium, NE had been proved to upregulate several growth factors including placenta growth factor (PGF). PGF is an angiogenic factor with proinflammatory properties, which mediates the progression of inflammatory disease. Therefore, we hypothesize excessive NE upregulates PGF and participates in the pathogenesis and progression of periodontal disease. In gingival epithelial cells (GEC), growth factors array demonstrated NE-increased growth factors and further be corroborated by Western blot assay and ELISA. The GEC inflammation was evaluated by ELISA. In mice, the immunohistochemistry results demonstrated ligature implantation-induced neutrophil infiltration and growth factor upregulation. By multiplex assay, the ligature-induced proinflammatory cytokines level in gingival crevicular fluid (GCF) were evaluated. Finally, alveolar bone absorption was analyzed by micro-CT images and H &amp; E staining. NE upregulated PGF expression and secretion in GEC. PGF promoted GEC to secret IL-1β, IL-6, and TNF-α in GCF In periodontal disease animal model, ligature implantation triggered NE infiltration and PGF expression. Blockade of PGF attenuated the ligature implantation-induced IL-1β, IL-6, TNF-α and MIP-2 secretion and ameliorated the alveolar bone loss in mice. In conclusion, the NE-induced PGF triggers gingival epithelium inflammation and promotes the pathogenesis and progression of periodontal disease.

Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis.

BACKGROUNDSevere periodontitis is a major oral health concern today as it can lead to loss of teeth. Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIMTo investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β (IL-1β) and IL-10 in gingival crevicular fluid (GCF) in patients with severe periodontitis.METHODSEighty-six patients with severe periodontitis were randomly divided into a research group (n = 43) and a control group (n = 43). The control group was treated with simple periodontal therapy, and the research group was treated with dental pulp periodontal therapy. The total effective rates of the treatments; periodontal status before and after treatment through the measurement of the periodontal pocket probing depth (PPD), gingival sulcus bleeding index (SBI), mobility (MD), and plaque index (PLI); the levels of inflammatory factors IL-1β and IL-10 in the GCF; and the incidence of complications were calculated for both groups and compared using the Student’s t test and the χ2 test.RESULTSThe total effective rate of treatment in the study group (93.02%) was higher than that in the control group (76.74%; P < 0.05). While before treatment, there was no significant difference in the PLI, MD, SBI, or PPD between the two groups, the post-treatment values of PLI, MD, SBI, and PPD (4.71 ± 0.16 mm, 0.61 ± 0.09 mm, 0.96 ± 0.17 mm, and 0.76 ± 0.26 mm, respectively) were significantly lower (P < 0.05) in the research group than in the control group (5.35 ± 0.24 mm, 0.93 ± 0.15 mm, 1.35 ± 0.30 mm, and 1.04 ± 0.41 mm, respectively). There was no significant difference in the level of IL-1β or IL-10 in the GCF before treatment between the two groups; after treatment, the IL-1β level in the research group (139.04 ± 15.54 pg/mL) was significantly lower than that in the control group (156.35 ± 18.10 pg/mL), and the level of IL-10 in the research group (7.98 ± 1.01 ug/L) was higher than that in the control group (5.56 ± 0.96 ug/L) (P < 0.05). The incidence of complications in the study group (4.65%) was significantly lower than that of the control group (18.60%; P < 0.05). CONCLUSIONEndodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction. In addition, it can improve the periodontal condition and the overall treatment effect, reduce the risk of complications, and ensure the safety of treatment.

English

BACKGROUND The present study was conducted to compare clinical outcomes and gingival crevicular fluid (GCF) interleukin (IL)-6 cytokine levels in microsurgical and conventional open flap debridement procedure. METHODS Thirty sites in chronic periodontitis patients were randomly assigned into Group I (microsurgical) and Group II (conventional) open flap debridement in a split-mouth design. Gingival bleeding index (GBI), probing pocket depth (PPD), relative attachment level (RAL) were recorded at baseline and 3 months. GCF IL-6 cytokine levels were assessed at baseline and on 3rd day postoperatively. Pain perception using visual analog score (VAS) and soft tissue healing using early healing index (EHI) were assessed after on 7th day post-surgery. RESULTS There was a significant reduction in gingival bleeding index, probing pocket depth, relative attachment level within both the groups. Intergroup gingival bleeding index scores were statistically significant at the end of 3 months. The difference in visual analog scores between the two groups was found to be statistically insignificant whereas early healing index scores between the groups was found to be statistically significant. Group I showed lower levels of IL-6 on 3rd day postoperatively. It was also found that there was positive correlation of IL-6 levels with clinical parameters such as PPD and RAL. CONCLUSIONS Open flap debridement using microsurgical approach can substantially improve clinical parameters and wound healing compared with conventional macrosurgical approach. IL-6 levels were lower in microsurgical group indicating less invasive surgical approach. KEY WORDS Open Flap Debridement, Periodontal Microsurgery, Wound Healing, IL-6, Cytokine, GCF.

Effects of non-surgical periodontal therapy on the cytokine profile in gingival crevicular fluid of breast cancer patients with periodontitis undergoing chemotherapy.

This study evaluated the effect of non-surgical periodontal therapy (NSPT) on the cytokine profile in gingival crevicular fluid (GCF) in patients with breast cancer and periodontitis. Forty patients were allocated into the periodontitis group (P) (n = 20) and breast cancer with periodontitis group (BC/P) (n = 20). Two days before the removal of infectious foci from the oral cavity and NSPT, as well as periodontal reevaluations, C-reactive protein, neutrophils (103μL), and platelets (103μL), were evaluated. The following cytokines in GCF, interleukin (IL)-4, IL-10, IL-2, IL-6, IL-1β, tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), and transforming growth factor-β (TGF-β) were evaluated by the Luminex assay at baseline, and 45 and 180 days after therapy. Cytokine levels were analyzed for correlations with the clinical parameters: clinical attachment level (CAL), probing depth (PD), bleeding on probing (BOP), and plaque index (PI). After NSPT, IL-2, TNF-α, and TGF-β were downregulated (p<0.05) in the BC/P. In the P group, INF-γ, IL-2, and TNF-α were downregulated (p<0.05), and TGF-β was increased (p<0.05). At 180 days, IL-6 in GCF was significantly positively correlated with PD and CAL (r=0.45, r=0.56) in the BC/P (p<0.05). In the P group, IL-1β in GCF was positively correlated with PD and CAL (r=0.56, r=0.59) at 45 days (p<0.05). NSPT, before the start of chemotherapy, helps to reduce the inflammatory markers associated with the activity of periodontal disease, favoring a less inflammatory pattern, to avoid the exacerbation of periodontitis.

Use of amnion-derived cellular cytokine solution for the treatment of gingivitis: A 2-week safety, dose-ranging, proof-of-principle randomized trial.

BackgroundA 6‐week Phase I clinical trial was performed to primarily evaluate the safety and secondarily determine the preliminary efficacy of a novel biological solution, ST266, comprised of a mixture of cytokines, growth factors, nucleic acids, and lipids secreted by cultured amnion‐derived multipotent progenitor cells on gingival inflammation.MethodsFifty‐four adults with gingivitis/periodontitis were randomly assigned to 1X ST266 or diluted 0.3X ST266 or saline topically applied on facial/lingual gingiva (20 µL/tooth). Safety was assessed through oral soft/hard tissue exam, adverse events, and routine laboratory tests. Efficacy was assessed by modified gingival index (MGI), bleeding on probing, plaque index, probing depth (PD), and clinical attachment level (CAL). Assessments were performed on day 0, 8, 12, and 42. ST266 and saline applied daily starting at day 0 through day 12 except weekend days. Plasma was analyzed for safety and proinflammatory cytokines, interleukin (IL)‐1β, IL‐6, tumor necrosis factor‐alpha, and interferon gamma. Gingival crevicular fluid (GCF) was analyzed for the same cytokines. Subgingival plaque was primarily analyzed by checkerboard DNA‐DNA hybridization. Comparisons with saline were modeled through a generalized estimating equations method adjusting for baseline.ResultsNo safety concern was found related to ST266. Statistically significant reduction in MGI was noted at day 42 by 1X ST266 compared with saline (P = 0.044). PD and CAL were reduced by both doses of ST266 at day 42 (P <0.01) and by 1X ST266 at day 12 (P <0.05). GCF IL‐1β and IL‐6 levels were reduced by both doses of ST266 at day 12 (P <0.05, P <0.01, respectively). IL‐6 was also significantly reduced in plasma of both ST266 groups (P <0.05). Significant reductions in red complex bacteria were detected in both ST266 doses.ConclusionsIn this “first in human oral cavity” study, topical ST266 was safe and effective in reducing gingival inflammation in 6 weeks. Longitudinal studies with large sample sizes are warranted to assess the therapeutic value of this novel host modulatory compound in the treatment of periodontal diseases.

Influence of Ceramic Lumineers on Inflammatory Periodontal Parameters and Gingival Crevicular Fluid IL-6 and TNF-α Levels—A Clinical Trial

The aim was to evaluate the effect of ceramic lumineers on inflammatory periodontal parameters, gingival crevicular fluid (GCF) flow rate and cytokine profile. Patients were provided with lumineers using standardized technique including minimal to no preparation. Ceramic lumineers were etched with hydrofluoric acid and teeth with phosphoric acid followed by adhesive cementation. Periodontal parameters (Plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), and clinical attachment loss (CAL)) were recorded at baseline and after 4, 12, and 24 weeks of lumineer cementation. Assessment of GCF flow rate and levels of IL-6 and TNF-α was made using enzyme linked immunosorbent assay (ELISA). The statistical significance was determined by the t-test, analysis of variance and post hoc Tukey’s test. It was found that PI, BOP, PPD, and CAL at baseline and 24 weeks were comparable (p &gt; 0.05). The GCF volume at baseline was comparable to the GCF at week 24 (p &gt; 0.05). The IL-6 levels at baseline (5.4 ± 3.6) were similar to those at 24 week (7.4 ± 5.2) (p &gt; 0.05). The TNF-α at week 4 (65.3 ± 16.2), 12 (25 ± 10.2), and 24 (21.3 ± 7.6) was higher than the baseline (13.7 ± 5.8) (p &lt; 0.05). Clinical periodontal parameters and GCF volume among patients treated with ceramic lumineers at baseline and twenty-four week follow-up were comparable. The GCF TNF-α levels significantly increased after ceramic lumineer cementation at 24-week follow-up.

Periodontal inflammation and distinct inflammatory profiles in saliva and gingival crevicular fluid compared with serum and joints in rheumatoid arthritis patients.

The association of periodontitis and Porphyromonas gingivalis (Pg) with rheumatoid arthritis (RA) is incompletely understood. To gain further insights, we evaluated periodontal status, oral, serum and joint inflammatory profiles, and Pg biomarkers in RA patients. In this cross-sectional study, we evaluated 33 patients with predominantly untreated new-onset RA, 20 healthy individuals (HIs), and 20 non-RA chronic periodontitis patients. Thirteen mediators (IFN-γ, IL-10, IL-17A, IL-6, IL-8, CXCL10, TNF-α, CXCL13, IL-23, MMP-1, MMP-3, MMP-8, MMP-9) were measured in serum, synovial fluid, saliva and gingival crevicular fluid (GCF) by multiplex immunoassay. Serum Pg IgG antibodies and subgingival Pg DNA were determined. Most RA patients (91%) received routine dental care; only one currently smoked. Ten (30.3%) had periodontal health, 13 (39.4%) had gingivitis, and 10 (30.3%) had periodontitis. Th1 and innate immune responses predominated in serum. Many mediators were concentrated in joints, particularly IL-6, IL-8, and CXCL10. However, salivary and GCF profiles were more restricted, emphasizing neutrophilic inflammation (IL-8, MMP-8) and MMP-9. Compared with HI, most RA patients, regardless of periodontal status, had significantly elevated oral fluid levels of these mediators, with suppression of GCF IL-10, a pattern similar to non-RA periodontitis patients. Pg antibodies or DNA however were primarily associated with clinical periodontitis. Despite routine dental care, RA patients often had inflammation in oral fluids, but inflammatory profiles differed from serum and joints. Neutrophilic inflammatory profiles in oral fluids, regardless of periodontal status, suggests that gingival tissues are a common, and often unrecognized, site of extra-articular inflammation in RA.

Photobiomodulation with 940 nm laser diode: effect on the interleukin 6 expression after orthodontic initial archwire activation

To evaluate the effect of photobiomodulation (PBM) during the initial stage of orthodontic treatment, measuring levels of IL-6 in gingival crevicular fluid (GCF), and comparing to a control group of teeth. Forty-four first premolars were orthodontically treated with passive self-ligation Damon Q (Ormco, Orange, CA, USA) brackets and 0.014 CuNiTi archwires. Sides were randomly assigned to a non-irradiated control group and experimental group (n = 22) treated with 940 nm, 0.1 W, and 2 J for 20s/surface. Gingival crevicular fluid was obtained before treatment and 24 h after; a third sample was obtained immediately after a second laser irradiation. IL-6 concentration was measured by enzymatic immunoassay. The basal concentration of IL-6 in the control group (3.194 ± 0.71 pg/μl) was higher than in the experimental group (2.923 ± 0.48 pg/μl) and was reduced 24 h after the initial archwire placement. In the experimental group of teeth, 24 h after and after the first laser application, the levels were lower. However, the values obtained following the second laser application, evaluating immediate effect, presented a mild increment. The difference between control and experimental groups after 24 h was significant. PBM with 940 nm, 0.1 W, 4 J, 21.05 J/cm2, and 40 s per tooth is not able to produce statistically significant changes in the concentration of IL-6 in GCF, immediately or after 24 h of its application, during initial orthodontic treatment with light forces.

The effect of dental caries and restorative biomaterials on IL-1 β and TNF-α levels in the gingival crevicular fluid

Background/Aim. In the spirit of personalized medicine, determining caries biomarkers in the saliva and gingival crevicular fluid (GCF) attracts great attention in the current dental re-search. The concentration of GCF cytokines is illustrative in depicting the processes in tooth structures. Their relevance must be inspected with aspects of tooth position and caries lesion level. Different impacts of dental restoration materials on GCF IL-1? and TNF-? could be used as a parameter for estimating local inflammation. This paper aimed to estimate the concentrations of the proinflammatory cytokines (IL-1? and TNF-?) in the GCF and to correlate them with caries extension, tooth position, and different restorative biomaterials. Methods. GCF samples were collected from 90 periodontally healthy patients demonstrating at least one tooth with proximal caries and one intact tooth, at the baseline, 7 and 30-days post-treatment. The biomarkers? profile was investigated in relation to different levels of caries extension (superficial, pulpitis, gangrenous, root affection), defect size, and restorative biomaterial. Results. Before therapy, caries level was significantly associated with GCF IL-1? concentration, demonstrating the lowest level in gangrenous (C4) and superficial caries (C2). Thirty days after therapy, root affection (C5) was characterized by the highest IL-1? concentration. Different dental fillings showed various GCF cytokine changes. CPC induced a significant IL-1? increase in more than 70% of treated patients. Caries lesion size was insignificantly associated with GCF levels of these proinflammatory cytokines, where larger defects were followed by an average cytokine increase. Considering the tooth position be-fore therapy, IL-1? had the highest level in GCF samples from caries-affected canines and second molars, while TNF-? showed the highest levels from canines GCF. Dental restoration induced cytokine increase in canines (IL-1? and TNF-?), 1st and 2nd molars GCF (IL-1?). Conclusion. Inflammation intensity of tooth structures was directly reflected in IL-1? and TNF-? concentrations. Dental restoration significantly affects IL-1? and TNF-? levels, depending on the used dental filling-type material. The profile of these cytokines varied in GCF samples of the tooth with different anatomical positions, where canines and molars demonstrated the highest level. An increase of these proinflammatory cytokines in the absence of any symptomatic manifestation of the inflammatory response can be considered as a possible tooth reparation parameter.

Efficacy of a novel post-foaming dental gel on gingival inflammation: A randomized controlled clinical trial.

A pilot randomized controlled clinical trial was performed to evaluate the efficacy of a post-foaming dental gel containing cetylpridinium chloride (CPC), hydrogen peroxide (H2 O2 ), sodium bicarbonate, and antioxidants on periodontal/oral health. Individuals with gingivitis or mild-moderate periodontitis (n=36) were included and randomly assigned to Group 1 and 2 with foaming gel loaded on a mouthpiece with a light source and controlled warming heat built-in unit or on a toothbrush, respectively, in addition to regular twice-daily brushing. Group 3 served as control with twice daily brushing and further assigned split-mouth to Group 3a-un-flossed and Group 3b-flossed. Gingival index (GI) and bleeding on probing (BOP) were evaluated in addition to plaque index (PI), pocket depth, and clinical attachment level at days 14, 28, 42 (treatment), and 60 (maintenance). Subgingival plaque microbial profiles and gingival crevicular fluid (GCF) cytokine levels were determined by DNA-DNA hybridization and multiplexing assays, respectively. Exploratory analyses included esthetic outcomes: changes in tooth color and levels of volatile sulfur compounds in breath. Statistical analyses were conducted using ANOVA with a post hoc analysis of Fisher's LSD. Use of post-foaming gel in both test groups resulted in significant changes in GI and BOP at Day 42 compared to control and un-flossed control (P<0.05). Device-enhanced foaming gel significantly reduced the PI in Group 1 at Day 42 compared to control and un-flossed control (P=0.02; P=0.007, respectively). GCF IL-6 and TNF-α levels were significantly reduced in Group 2 compared to control (PIL-6 =0.01, PTNF-α =0.02). Post-foaming gel resulted in greater reductions in periodontopathogens, whereas health-associated species remained stable. Despite cessation of adjunct treatments, Group 1 and 2 continued having reduced levels of GI, BOP, and PI at Day 60 (P<0.05). The novel post-foaming dental gel improves oral health by reducing gingival inflammation at the local site in addition to better esthetic outcomes.

Six-month clinical outcomes of non-surgical periodontal treatment with antibiotics on apoptosis markers in aggressive periodontitis.

Extrinsic and intrinsic pathways of apoptosis are involved in generalized aggressive periodontitis (GAgP). The aim of this study was to evaluate 6-month clinical outcomes relative to apoptosis of one-stage full-mouth disinfection (OSFMD) and systemic antibiotics (SA) in the treatment of GAgP. Twenty-six patients with GAgP were included in this prospective follow-up intervention study. Gingival crevicular fluid (GCF) was collected from patients at baseline and 3 and 6months after periodontal therapy, which consisted of OSFMD and SA (amoxicillin and metronidazole, 500mg each for 7days). The levels of p53, caspase-3, TNF-α, TRAIL, IL-1β, and IL-10 in GCF were measured via ELISA. Periodontal parameters were improved at 3 and 6months compared to baseline (p<0.05). p53 was decreased up to 6months (p<0.05). TRAIL, TNF-α, and IL-10 were similar at baseline and 3 and 6months. Caspase-3 and IL-1β were decreased at 3months (p<0.05), but similar at 6months compared to baseline (p>0.05). Although OSFMD plus SA improves clinical periodontal parameters up to 6months, this treatment protocol differentially regulates the apoptosis markers caspase-3 at 3months and p53 at 6months without influencing TRAIL in GCF.

Protein and mRNA detection of classic cytokines in corresponding samples of serum, gingival tissue and gingival crevicular fluid from subjects with periodontitis.

Little is known about the correspondence of cytokines detected among the different biological matrices used in periodontal research and whether locally-detected cytokine mRNA can also be identified at the translated protein level. The aims of this study were to compare: (a) the detection of classic cytokines at protein level in corresponding samples of serum, gingival tissue and gingival crevicular fluid (GCF) in subjects with periodontitis and (b) the detection of cytokines at protein level in GCF and tissue with their detection at mRNA level in tissue. Protein concentrations of IL-1β, IL-6 and TNF-α were measured in corresponding samples of GCF, gingival tissue and serum from 125 subjects with chronic periodontitis by multiplex immunoassay. The mRNA levels of these cytokines were evaluated in the same gingival tissue by qPCR. The mean protein concentrations of IL-1ß and TNF-α were higher in tissue and GCF than in serum (P<0.05). The mean protein concentration of IL-6 was higher in tissue, followed by serum and GCF, respectively (P<0.05). Using serum as the gold standard, detection of IL-1ß in GCF and IL-6 in tissue had the highest sensitivity (100%), while detection of IL-6 in the GCF had the lowest sensitivity (77.9%). Using tissue as the gold standard, the detection sensitivities of IL-1ß, IL-6 and TNF-α were 93.6%, 78.4% and 94.2%, respectively, in GCF. Using mRNA as the gold standard, the detection of IL-1ß and IL-6 at the protein level in tissue (100.0%) had the highest sensitivity, while the detection of IL-6 in GCF (77.9%) had the lowest sensitivity. Tissue and GCF exhibited overall higher protein concentrations of cytokines than serum. GCF presented good reliability for identifying the target cytokines at protein level, when compared with detecting tissue cytokines at protein level. GCF and tissue presented high sensitivities for detecting cytokines at the protein level, when compared with detecting tissue cytokines at the mRNA level. The sensitivity for the identification of cytokines in the GCF depended on the target cytokine, where IL-6 was the least likely cytokine to be detected in this matrix.

Association between Oral Contraceptive Use and Interleukin-6 Levels and Periodontal Health

Background and aims. Changes in the balance of sexual hormones during pregnancy decrease gingival crevicular fluid levels of interleukin-6 and the resistance of gingival tissue against inflammations. Hormonal contraceptives are agents that are based on the effects of gestational hormones and simulate a state of pregnancy; therefore, they prevent ovulation. This study evaluates the effect of these drugs on periodontal tissues and levels of IL-6 in gingival crevicular fluid. Materials and methods. Twenty-five patients who had not used oral contraceptives (control) and 35 patients using oral contraceptives (case) were examined clinically and their medical history, dosage and duration of oral contraceptives use were recorded. Periodontal indices such as bleeding on probing, plaque index, probing pocket depth, clinical attachment loss and levels of IL-6 in gingival crevicular fluid were measured. Student’s t-test and Mann-Whitney test were used to analyze data. Results. Mann-Whitney test showed a statistically significant difference in the mean of bleeding on probing in the case and control groups (P&lt;0.05). Student’s t-test showed a statistically significant difference in the mean of IL-6 levels (P&lt;0.05), probing pocket depth (P&lt;0.05) and clinical attachment loss between the case and control groups (P&lt;0.05) but no statistically significant differences were found between the plaque index of the case and control groups (P&gt;0.05). Conclusion. It seems that use of oral contraceptives may affect the periodontal health status of patients, leading to more gingival inflammation. Therefore, patients must have a strict oral hygiene care.

Effect of non-surgical periodontal therapy on the degree of gingival inflammation and stress markers related to pregnancy.

ObjectivesThe purpose of this study was to determine the impact of nonsurgical periodontal therapy considering the salivary stress-related hormone and cytokine levels in the gingival crevicular fluid (GCF) on pregnant and nonpregnant women.Material and MethodsThirty non-pregnant (control group) and 30 pregnant women (test group) that met the study inclusion criteria were chosen. Only participants with gingivitis were included. Clinical data and samples of GCF and saliva were collected at baseline and after periodontal therapy. The levels of interleukin-1 beta (Κ-1β) and IL-10, and concentration of salivary chromogranin A (CgA) hormone were analyzed by enzyme-linked immunosorbent assay (ELISA). The repeated measures analysis of variance was used for intragroup and intergroup analyses.ResultsA major decrease in the gingival inflammation was observed in both groups after periodontal therapy (p<0.05). Periodontal treatment decreased the level of IL-1β in GCF (p<0.05) in control group, but no statistical difference was determined for GCF IL-1β in the test group. However, after periodontal therapy, the CgA hormone concentration was reduced in both groups (p<0.05). However, there was no difference in salivary CgA concentration, GCF IL-10 levels, and perceived stress scale (PSS)-10 between the groups (p>0.05).ConclusionsWithin the limitations of this study, periodontal therapy significantly improved the periodontal status and stress level. In addition, the severity of the gingival inflammation during pregnancy was related to stress. However, further studies will be needed to substantiate these early findings.