Inflammatory Disease Of Gums Research Articles

Anti-gingivitis natural products: Aloe vera gel, tea tree oil mouthwash, turmeric gel, myrrh extract/mouthwash

Gingivitis is an inflammatory gum disease which occurs around the cervical portion of the gum and is classified by its clinical appearance. Gingivitis is very common, and anyone can be affected including but not limited to poor oral care habits. This paper reviews the potential of Aloe Vera, Tea Tree Oil Mouthwash, Turmeric Gel, and Myrrh Extract/Mouthwash. The study also assessed the knowledge and opinions of first-year pharmacy students. The survey part of the study included 5 knowledge-based and 5 opinion-based questions, focusing on the four herbal remedies. The knowledge-based questions showed a 65.7% correct response rate, with the question on turmeric receiving the highest accuracy (94.3%), while the question surveying the participants’ knowledge about the source of information for herbal products received the lowest correct answer rate at 31.4%. Opinion-based questions revealed a positive attitude towards herbal remedies, with about 67.6% to 94.3% strongly agreeing, or agreeing with the potential benefits of the products. The highest agreement rate at 94.3% was obtained for the statement that myrrh can help reduce inflammation in the gums and inhibit the growth of bacteria, thus assisting in the management of gingivitis. Disagreement of opinions was minimal, ranging from 5.7% to 32.3%, indicating a widespread inclination towards positive agreement.

The effect of curcumin and nanocurcumin in improving periodontal lesions in patients with diabetes: (A systematic review)

Introduction: Inflammatory gum disease is a complication of diabetes that can impact blood sugar control. Current treatments for diabetic patients, such as scaling and gum surgery, are invasive. The present study aimed to review the effectiveness of curcumin in improving periodontal lesions in diabetic patients. Method: Four databases of Scopus, PubMed, Web of Science, and Google Scholar were searched for relevant studies without any time or language limitations. MeSH keywords and text words related to "curcumin," "periodontal lesions," and "diabetes" were used to search in the title-abstract field. The titles, abstracts, and full text of the studies were reviewed to identify eligible studies. The present study followed PRISMA guidelines for implementation and reporting. Results: Finally, 10 studies were included in the review. The results showed that curcumin can reduce free radicals and inflammatory factors, improving inflammation. Gums in diabetic patients should be scaled alone or with invasive methods. Conclusion: It seems curcumin may effectively reduce gum inflammation and bone loss in diabetic patients. However, to reach a reliable conclusion, further human studies are required in this field.

Characterization of fumarate reduction by Klebsiella pneumoniae isolated from patients with chronic periodontitis

Chronic periodontitis is oral inflammatory gum disease which affects the tissues that support the teeth. It is caused by formation of bacterial plaque consisting of bacterial species that produces various virulence factors. Oral bacterial species from the periodontitis patients include species of Fusobacterium, Porphyromonas, Prevotella, Tannerella, etc. In the present study, we isolated the Klebsiella pneumoniae strain 9A from the pockets of patients suffering from chronic periodontitis. The strain was isolated on enriched tryptic soya media containing 10 mM fumarate and identified based on Gram staining, 16S rRNA gene sequencing, biochemical tests and ability to reduce fumarate. Our study is the first report of anaerobic fumarate reduction capabilities of Klebsiella spp. isolated from chronic periodontitis patients, which may help in growth and survival of species in periodontal pockets leading to progression of the disease. In addition, experimental evidence is provided through reduction, growth, and inhibitor assays for the presence of fumarate reductase (Frd) activities. Furthermore, we detected a 400 bp frdA gene fragment in Klebsiella pneumoniae strain 9A using degenerate PCR. This fragment show similarity to fumarate reductases flavoprotein subunit (FrdA). Our findings suggest that the FrdA subunit is responsible for anaerobic fumarate respiration in Klebsiella spp. to be important in the survival of bacteria in oxygen-deprived environments in humans such as periodontal pockets, thus contributing to its pathogenicity.

Comparative Evaluation of Metformin Gel and Chlorhexidine Gel as Adjunct to Scaling and Root Planning in the Treatment of Chronic Periodontitis: A Clinical Study

Introduction: Pyorrhoea is an inflammatory gum disease in which destruction of tooth supporting tissues that results ultimate tooth mobility and exfoliation. In local drug delivery (LDD), which includes the delivery of therapeutic agents like Irrigating systems, fibers, gels, strips, films, microparticles, nanoparticles and low dose antimicrobial agents via systemic and local route as an adjunct to mechanical therapy which has beneficial for periodontal therapy. Aim: To evaluate and compare the efficacy of subgingivally delivered 1% Metformin gel and Chlorhexidine gel as an adjunct to scaling and root planing in the management of patients with chronic periodontitis. Materials and Method: Twenty systemically healthy patients with the age group of 20-60 years irrespective of gender suffering from generalized chronic periodontitis were selected, in which fourty sites were randomized at split mouth level and divided into two groups: (Group A -SRP+1% Metformin gel and Group B - SRP+ 0.2% Chlorhexidine gel). Parameters such as, Plaque index (PI), Modified gingival index (MGI), Probing pocket depth (PPD), and Relative clinical attachment level (R-CAL) were measured at baseline and after 1 month and 3 months. The significance of difference within and between the groups was evaluated with paired and unpaired t-tests. Result: In our study, the mean Plaque index (PI), Modified gingival index (MGI), Probing pocket depth (PPD), and Relative clinical attachment level (R-CAL) showed a statistically significant difference from baseline to 1 month and 3 months (p≤0.05) in both Group A and Group B. But, Mean PPD reduction and mean R-CAL gain was found to be greater in Group-A than Group B at 1 month and 3 months. Conclusion: Both Metformin and 0.2% Chlorhexidine gel can be considered as effective as a LDD agent adjunct to scaling and root planning (SRP) in the management of chronic periodontitis. But, 1% Metformin gel was more effective as a LDD adjunct to SRP in curative of chronic periodontitis patient than Chlorhexidine gel (Cevitec gel).

Medicinal Plants Used as an Alternative to Treat Gingivitis and Periodontitis.

For various ailments, natural remedies have been traditionally used. To defend against common disorders, medicinal plants are progressively used as nutritional supplements. Gingivitis and periodontitis are widespread and can affect most of the world's population. Gingivitis is a very common, nondestructive inflammatory disease of gums that causes redness and irritation of the gingiva (gums), but periodontitis causes permanent damage to teeth' subsidiary structures. Herbal medicines are getting popular for the treatment of such types of disorders due to being economical with their medicinal effectiveness, compatibility, and nontoxicity. Traditional chemical therapies can cause cell toxicity along with their disease-curing effects. In this article, we discussed the medicinal plants that can be used as an alternative for the treatment of gingivitis (early-stage gum disease) and periodontitis (chronic-stage gum disease).

Application of antiseptic composition based on polyaminopropyl biguanide in the chronic catarrhal gingivitis treatment

Inflammatory gum disease occupies a large proportion of oral diseases. Among the most honest complaints are concerns about bleeding gums, pain when eating. Gingivitis is an inflammation of the soft tissues surrounding the tooth without disturbing the gingival junction. Currently, the search for the most effective and comfortable therapy for the treatment of gingivitis remains a topical issue in medicine.Materials and methods. A group of patients with a diagnosis of K05.1 – chronic simple marginal gingivitis (chronic catarrhal gingivitis) was selected for the study. All patients underwent examination and index assessment of the condition of the marginal periodontium. Half of the patients were prescribed an antiseptic composition based on 0.2% polyaminopropyl biguanide as an auxiliary antiseptic treatment of the oral cavity. Examination and re-examination of patients was carried out on the 4th, 7th, 10th day.Results. According to the results of the examination, the diagnosis of K05.1 – chronic simple marginal gingivitis (chronic catarrhal gingivitis) was established in 77 patients aged 18 to 25 years. During the inspection on the 4th, 7th, 10th day, there were differences in the course of the disease and the values of the indices.Conclusions. The study demonstrated the effectiveness of the use of an antiseptic composition based on 0.2% polyaminopropyl biguanide in the complex therapy of chronic catarrhal gingivitis.

Gastrodin attenuates lipopolysaccharide-induced inflammation and oxidative stress, and promotes the osteogenic differentiation of human periodontal ligament stem cells through enhancing sirtuin3 expression.

Periodontitis is a common inflammatory gum disease that destroys the periodontal tissue. Gastrodin (GAS) is the predominant bioactive component of Gastrodia elata Blume and exhibits anti-inflammatory, anti-apoptotic and antioxidant effects in various diseases, including bone-related diseases. The aim of the present study was to investigate whether GAS could protect lipopolysaccharide (LPS)-treated human periodontal ligament stem cells (hPDLSCs) against injury and inflammation, and to determine the potential underlying mechanisms. hPDLSCs were treated with LPS and GAS, alone or in combination, and cell viability, inflammation, oxidative stress levels and apoptosis were analyzed using a Cell Counting Kit-8 assay, ELISA assay, western blotting and flow cytometry, respectively. The osteogenic differentiation capacity was evaluated using an alkaline phosphatase (ALP) assay and Alizarin Red S staining. Sirtuin 3 (SIRT3) was silenced in cells treated with LPS and GAS to verify the involvement of SIRT3 in the effects of GAS. The results demonstrated that LPS-induced decrease in cell viability was rescued by treatment with 1, 10 or 50 µM GAS. The LPS-induced production of proinflammatory cytokines and increased level of oxidative stress were also inhibited following treatment with 50 µM GAS. Furthermore, GAS significantly promoted ALP activity, increased the number of mineralized nodules and increased the expression of proteins involved in osteogenic differentiation, including ALP, Runx2, osteocalcin and osteopontin, after osteoinduction, which were all downregulated following LPS stimulation. In addition, GAS prevented LPS-induced cell apoptosis and restored the imbalance of anti-apoptotic and proapoptotic proteins in hPDLSCs. In addition, SIRT3 knockdown significantly inhibited the protective effect of GAS on LPS-induced hPDLSC injury. In summary, the findings form the present study suggested that GAS may protect hPDLSCs from LPS-induced inflammation, apoptosis and oxidative stress, as well as promote their osteogenic differentiation. The effect of GAS on the osteogenic differentiation of hPDLSCs may therefore depend on the upregulated expression of SIRT3.

Blood Biomarkers and Serologic Immunological Profiles Related to Periodontitis in Abdominal Aortic Aneurysm Patients.

BackgroundPeriodontitis is a chronic inflammatory gum disease associated with systemic diseases such as cardiovascular diseases.AimTo investigate the association of systemic blood biomarkers, C-reactive protein (CRP), levels of lipopolysaccharide (LPS), and IgG levels against periodontal pathogens Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) with the stability, based on the aortic diameter, the growth rate and the eligibility for surgical intervention, of patients with abdominal aortic aneurysm (AAA).MethodsPatients with stable AAA (n = 30) and unstable AAA (n = 31) were recruited. The anti-A. actinomycetemcomitans and anti-P. gingivalis IgG levels were analyzed by ELISA, the LPS analysis was performed by using the limulus amebocyte lysate (LAL) test, and plasma levels of CRP were determined using an immune turbidimetric method. The association between these blood systemic biomarkers, AAA features, periodontal clinical parameters and oral microbial profiles were explored. Regression models were used to test the relationship between variables.ResultsThe presence of antibodies against Pg and Aa, LPS and high CRP concentrations were found in all AAA patients. The IgG levels were similar in patients with stable and unstable AAA (both for Aa and Pg). Among investigated blood biomarkers, only CRP was associated with AAA stability. The amount of LPS in saliva, supra, and subgingival plaque were significantly associated with the systemic LPS (p <0.05).ConclusionsThis post-hoc study emphasizes the presence of antibodies against Pg and Aa, LPS and high CRP concentrations in all AAA patients. The presence of Pg in saliva and subgingival plaque was significantly associated with the blood LPS levels. For further studies investigating periodontitis and systemic diseases, specific predictive blood biomarkers should be considered instead of the use of antibodies alone.

SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges.

The novel corona virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and the disease it causes, COVID-19 (Coronavirus Disease-2019) have had multi-faceted effects on a number of lives on a global scale both directly and indirectly. A growing body of evidence suggest that COVID-19 patients experience several oral health problems such as dry mouth, mucosal blistering, mouth rash, lip necrosis, and loss of taste and smell. Periodontal disease (PD), a severe inflammatory gum disease, may worsen the symptoms associated with COVID-19. Routine dental and periodontal treatment may help decrease the symptoms of COVID-19. PD is more prevalent among patients experiencing metabolic diseases such as obesity, diabetes mellitus and cardiovascular risk. Studies have shown that these patients are highly susceptible for SARS-CoV-2 infection. Pro-inflammatory cytokines and oxidative stress known to contribute to the development of PD and other metabolic diseases are highly elevated among COVID-19 patients. Periodontal health may help to determine the severity of COVID-19 infection. Accumulating evidence shows that African-Americans (AAs) and vulnerable populations are disproportionately susceptible to PD, metabolic diseases and COVID-19 compared to other ethnicities in the United States. Dentistry and dental healthcare professionals are particularly susceptible to this virus due to the transferability via the oral cavity and the use of aerosol creating instruments that are ubiquitous in this field. In this review, we attempt to provide a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the various effects it has had on the dental profession and patients visits to dental clinics. Finally, this review is a valuable resource for the management of oral hygiene and reduction of the severity of infection.

Salivary Levels of IL-6 and IL-17 Could Be an Indicator of Disease Severity in Patients with Calculus Associated Chronic Periodontitis.

Background/Purpose. Chronic periodontitis is an inflammatory disease of gums that causes loss of supporting structures of teeth, that is, gingiva, periodontal ligament, cementum, and alveolar bone. Levels of various cytokines in the serum, gingival tissues, and gingival crevicular fluid in patients with chronic periodontitis have been studied, but limited data are available on the level of cytokines in saliva. Therefore, a study was designed to determine levels of salivary IL-6 and IL-17 in patients with calculus associated chronic periodontitis. Materials and Methods. It was a comparative, cross-sectional study that is comprised of 41 healthy controls and 41 calculus associated chronic periodontitis patients (CP patients). According to the degree of attachment loss, CP patients were subcategorized as mild (CAL 1-2 mm), moderate (CAL 3-4 mm), and severe (CAL > 5 mm) forms of periodontitis. Salivary levels of IL-6 and IL-17 were determined using enzyme-linked immunosorbent assay (ELISA) technique. Data was analyzed using SPSS 20.0. Results. Between healthy controls and CP patients (moderate and severe disease), a statistically significant difference was observed in the concentrations of IL-6 and IL-17. In CP patients, the highest mean ± SD of salivary IL-6 and IL-17 was observed in severe CP, followed by moderate and mild CP. Regarding level of IL-6, a statistically significant difference was observed between mild and severe disease and between moderate and severe subcategories of CP patients. Similarly, statistically significant difference was observed in the level of IL-17 between mild and moderate, mild and severe disease, and moderate and severe disease. Conclusion. The levels of salivary IL-6 and IL-17 were increased significantly in calculus associated CP patients as compared to healthy controls and these levels increased with the progression of CP. Clinical Significance. Salivary levels of IL-6 and IL-17 may help in the subcategorization of CP.

PREVALENCE OF GINGIVITIS IN ONCOLOGY PEDIATRIC PATIENTS

Many side effects of oncology treatment and reduction in self-respect can compromise the quality of oral hygiene of pediatric patients, affecting their periodontal healthy status. The aim of this research was to determine the prevalence of inflammatory gum disease in a pediatric population under cancer treatment.

Antimicrobial and Attractant Roles for Chemerin in the Oral Cavity during Inflammatory Gum Disease.

Periodontal inflammation is one of the most common chronic inflammatory conditions in humans. Despite recent advances in identifying and characterizing oral microbiota dysbiosis in the pathogenesis of gum disease, just how host factors maintain a healthy homeostatic oral microbial community or prevent the development of a pathogenic oral microbiota remains poorly understood. An important determinant of microbiota fate is local antimicrobial proteins. Here, we report that chemoattractant protein chemerin, which we recently identified as a potent endogenous antimicrobial agent in body barriers such as the skin, is present in the oral cavity under homeostatic and inflammatory conditions. Chemerin and a chemerin-derived antimicrobial peptide are bactericidal against select bacteria strategically positioned in dental biofilm. Gingival crevicular samples from patients with gingivitis but not periodontitis contain abundant bioactive chemerin capable of inducing CMKLR1-dependent leukocyte migration. Gingipains secreted by the periodontopathogen P. gingivalis inactivate chemerin. Together, these data suggest that as an antimicrobial agent and leukocyte chemoattractant, chemerin likely contributes to antimicrobial immune defense in the oral cavity.

Development and Characterization of Novel Medicated Nanofibers Against Periodontitis.

Periodontitis is an inflammatory disease of gums involving degeneration of periodontal ligaments, creation of periodontal pocket and resorption of alveolar bone, thus disrupting the support structure of teeth causing their loosening and finally removal. Since this disease is mainly confined to the periodontal pocket, so site specific drug delivery of an antibiotic is the best suitable option. This also eradicates the demerits of oral dosing like low drug concentration reaching the target site and the various systemic side effects. In the present work, an efficient and easy technique of electrospinning has been used to develop non-woven drug loaded and biodegradable nanofiber patch with inbuilt property of high surface area to volume ratio. Hyaluronic acid (HA) has been used specifically as the polymer since it possesses remarkable properties like providing an extracellular matrix supporting tissue regeneration, anti-inflammation and mucoadhesion. A blend of this natural polymer with another polymer (Polyvinyl alcohol) has been tried since HA alone cannot be electrospun efficiently as it shows very high viscosity at very low polymer concentration. The developed formulation presented controlled release behavior with good mucoadhesive strength. The in vivo studies confirmed the maintenance of minimum inhibitory concentration (MIC) over an extended period of time in addition to a significant antiinflammatory effect. All these observations suggested that the above formulation forms a stable intra periodontal pocket drug delivery system.

Epigenetic changes of TIMP-3, GSTP-1 and 14-3-3 sigma genes as indication of status of chronic inflammation and cancer.

This study aimed to compare the epigenetic changes via hypermethylation status of TIMP-3, GSTP-1 and 14-3-3σ genes, between healthy subjects and patients with reversible chronic inflammatory disease, and between healthy subjects and patients with irreversible malignant disease, to highlight the genetic changes that occur in the progression from an inflammatory condition to irreversible genetic changes commonly observed in cancer patients. DNA was extracted from the blood of 680 healthy subjects, and tissues and blood of 110 patients with chronic inflammation disease of the gums, as well as neoplastic tissues of 108 breast cancer patients. Methylation-specific polymerase chain reaction (PCR) for TIMP-3, GSTP-1 and 14-3-3σ was performed, and hypermethylation status was analyzed and compared between the 3 groups. The hypermethylation frequencies of TIMP-3 and GSTP-1 of reversible chronic inflammatory gum disease and the control group were similar, but both were significantly lower than those for malignant disease patients (p<0.0001). The methylation frequency of 14-3-3σ in chronic inflammatory gum disease was higher than in the cancer and control groups (p<0.0001). The methylation of CpG islands in TIMP-3 and GSTP-1 in chronic inflammation patients occurred as frequently as in the control group, but less frequently than in breast cancer patients. However, the epigenetic silencing of 14-3-3σ occurred more frequently in the chronic inflammation group than in cancer patients and healthy controls. The epigenetic silencing of 14-3-3σ might be essential for chronic inflammatory gum disease. The epigenetic changes presented in chronic inflammation patients might demonstrate an irreversible destruction in the tissues or organs similar to cancer.

Immune response of macrophages from young and aged mice to the oral pathogenic bacterium Porphyromonas gingivalis

Periodontal disease is a chronic inflammatory gum disease that in severe cases leads to tooth loss. Porphyromonas gingivalis (Pg) is a bacterium closely associated with generalized forms of periodontal disease. Clinical onset of generalized periodontal disease commonly presents in individuals over the age of 40. Little is known regarding the effect of aging on inflammation associated with periodontal disease. In the present study we examined the immune response of bone marrow derived macrophages (BMM) from young (2-months) and aged (1-year and 2-years) mice to Pg strain 381. Pg induced robust expression of cytokines; tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10, chemokines; neutrophil chemoattractant protein (KC), macrophage colony stimulating factor (MCP)-1, macrophage inflammatory protein (MIP)-1α and regulated upon activation normal T cell expressed and secreted (RANTES), as well as nitric oxide (NO, measured as nitrite), and prostaglandin E2 (PGE2) from BMM of young mice. BMM from the 2-year age group produced significantly less TNF-α, IL-6 and NO in response to Pg as compared with BMM from 2-months and 1-year of age. We did not observe any difference in the levels of IL-1β, IL-10 and PGE2 produced by BMM in response to Pg. BMM from 2-months and 1-year of age produced similar levels of all chemokines measured with the exception of MCP-1, which was reduced in BMM from 1-year of age. BMM from the 2-year group produced significantly less MCP-1 and MIP-1α compared with 2-months and 1-year age groups. No difference in RANTES production was observed between age groups. Employing a Pg attenuated mutant, deficient in major fimbriae (Pg DPG3), we observed reduced ability of the mutant to stimulate inflammatory mediator expression from BMMs as compared to Pg 381, irrespective of age. Taken together these results support senescence as an important facet of the reduced immunological response observed by BMM of aged host to the periodontal pathogen Pg.

Subpar Utilization of Dental Care Among Americans With a History of Stroke

Persons with poor oral hygiene are prone to periodontitis, an inflammatory gum disease independently linked to stroke. Regular dental examinations allow for early detection and treatment of oral conditions associated with the risk of further vascular events. Little is known about patterns of dental care among persons at risk for stroke. We assessed the prevalence and independent predictors of at least one visit to the dentist within the preceding 12 months among stroke survivors in the United States using data from the National Health Interview Survey (NHIS) 2006 survey. The 24,275 adults who completed the survey self-reported a total of 706 strokes, for an incidence of 3%. The rate of at least one visit to the dentist over the previous year among stroke survivors (mean age, 67 ± 15 years) was 46%. Factors independently associated with visiting the dentist were female sex (odds ratio [OR], 1.83; 95% confidence interval [CI], 1.31-2.57), being married (OR, 1.95; 95% CI, 1.37-2.77), having a high school or greater education (OR, 2.11; 95% CI, 1.51-2.93), and having contact with a primary care doctor in the previous year (OR, 1.74; 95% CI, 1.04-2.93). Factors independently associated with not visiting the dentist were black race (OR, 0.63; 95% CI, 0.43-0.92) and the presence of a significant medical comorbidity (OR, 0.69; 95% CI, 0.48-0.97). In 2006, less than half of stroke survivors in the United States received dental care, leaving substantial room for improvement. Stroke survivors need education about the importance of regular dental care, particularly minority groups.