Inflammatory Periodontal Disease Research Articles

Mapping of DNA methylation-sensitive cellular processes in gingival and periodontal ligament fibroblasts in the context of periodontal tissue homeostasis.

Interactions between gingival fibroblasts (GFs) and oral pathogens contribute to the chronicity of inflammation in periodontitis. Epigenetic changes in DNA methylation are involved in periodontitis pathogenesis, and recent studies indicate that DNA methyltransferase (DNMT) inhibitors may protect against epithelial barrier disruption and bone resorption. To assess the impact of DNMT inhibition on GFs, cells were cultured with decitabine (5-aza-2'-deoxycytidine, DAC) for 12 days to induce DNA hypomethylation. We observed several potentially detrimental effects of DAC on GF biological functions. First, extended treatment with DAC reduced GF proliferation and induced necrotic cell death. Second, DAC amplified Porphyromonas gingivalis- and cytokine-induced expression and secretion of the chemokine CCL20 and several matrix metalloproteinases (MMPs), including MMP1, MMP9, and MMP13. Similar pro-inflammatory effects of DAC were observed in periodontal ligament fibroblasts. Third, DAC upregulated intercellular adhesion molecule-1 (ICAM-1), which was associated with increased P. gingivalis adherence to GFs and may contribute to bacterial dissemination. Finally, analysis of DAC-induced genes identified by RNA sequencing revealed increased expression of CCL20, CCL5, CCL8, CCL13, TNF, IL1A, IL18, IL33, and CSF3, and showed that the most affected processes were related to immune and inflammatory responses. In contrast, the genes downregulated by DAC were associated with extracellular matrix and collagen fibril organization. Our observations demonstrate that studies of DNMT inhibitors provide important insights into the role of DNA methylation in cells involved in periodontitis pathogenesis. However, the therapeutic potential of hypomethylating agents in periodontal disease may be limited due to their cytotoxic effects on fibroblast populations and stimulation of pro-inflammatory pathways.

Immune infiltration and diagnostic value of immune-related genes in periodontitis using bioinformatics analysis.

Periodontitis, which is a chronic inflammatory periodontal disease resulting in destroyed periodontal tissue, is the leading cause of tooth loss in adults. Many studies have found that inflammatory immune responses are involved in the risk of periodontal tissue damage. Therefore, we analyzed the association between immunity and periodontitis using bioinformatics methods to further understand this disease. First, the expression profiles of periodontitis and healthy samples were downloaded from the GEO database, including a training dataset GSE16134 and an external validation dataset GSE10334. Then, differentially expressed genes were identified using the limma package. Subsequently, immune cell infiltration was calculated by using the CIBERSORT algorithm. We further identified genes linking periodontitis and immunity from the ImmPort and DisGeNet databases. In addition, some of them were selected to construct a diagnostic model via a logistic stepwise regression analysis. Two hundred sixty differentially expressed genes were identified and found to be involved in responses to bacterial and immune-related processes. Subsequently, immune cell infiltration analysis demonstrates significant differences in the abundance of most immune cells between periodontitis and healthy samples, especially in plasma cells. These results suggested that immunity doses play a non-negligible role in periodontitis. Twenty-one genes linking periodontitis and immunity were further identified. And nine hub genes of them were identified that may be key genes involved in the development of periodontitis. Gene ontology analyses showed that these genes are involved in response to molecules of bacterial origin, cell chemotaxis, and response to chemokines. In addition, three genes of them were selected to construct a diagnostic model. And its good diagnostic performance was demonstrated by the receiver operating characteristic curves, with an area under the curve of 0.9424 for the training dataset and 0.9244 for the external validation dataset.

Magnolia kobus Extract Inhibits Periodontitis-Inducing Mediators in Porphyromonas gingivalis Lipopolysaccharide-Activated RAW 264.7 Cells.

Periodontitis, a disease caused by inflammation of oral bacteria, contributes to the loss of alveolar bone and destruction of connective tissues. Porphyromonas gingivalis, a Gram-negative bacterium, is known to possess important pathogenic factors for periodontal disease. In this study, we investigated the anti-periodontitis effects of Magnolia kobus extract (MKE) and magnolin as a component of Magnolia kobus (MK) in murine macrophage RAW 264.7 cells stimulated with Porphyromonas gingivalis lipopolysaccharide (LPS). Effects of MKE and magnolin on the mechanism of RAW 264.7 cellular inflammation were determined by analyzing nitric oxide (NO) production and Western blot protein expression (n = 3). MKE/magnolin inhibited NO production without affecting cell survival. MKE/magnolin treatment inhibited LPS-induced pro-inflammatory cytokines, expression levels of matrix metalloproteinases (MMPs such as MMP-1, 3, 8, 9, and 13), and protein levels of inflammatory mediators (such as TNF-α, IL-1β, and mPGES-1). MKE/magnolin also suppressed NF-κB activation by inhibiting the TLR4 signaling pathway. These findings suggest that MKE has a therapeutic effect on inflammatory periodontal disease caused by oral bacterium P. gingivalis and that magnolin is a major functional component in the anti-inflammatory effect of MKE.

Syringeable atorvastatin loaded eugenol enriched PEGylated cubosomes in-situ gel for the intra-pocket treatment of periodontitis: statistical optimization and clinical assessment

Atorvastatin calcium (ATV) is a well-known anti-hyperlipidemic drug currently being recognized for possessing an anti-inflammatory effect. Introducing it as a novel remedy for periodontitis treatment necessitates developing a syringeable modified delivery system capable of targeting inflammation within the periodontal pockets. Thus, a 33 Box-Behnken design was used to generate eugenol enriched PEGylated cubosomes. Based on the desirability function, the optimized formulation (OEEPC) was selected exhibiting a solubilization efficiency (SE%) of 97.71 ± 0.49%, particle size (PS) of 135.20 ± 1.11 nm, polydispersity index (PDI) of 0.09 ± 0.006, zeta potential (ZP) of −28.30 ± 1.84 mV and showing a sustained drug release over 12 h. It displayed a cubic structure under the transmission electron microscope, furthermore, it was stable upon storage for up to 30 days. Hence, it was loaded into an optimum syringeable in-situ gel (ISG) which displayed the desired periodontal gelation temperature (34 ± 0.70 °C) and an adequate gelation time (46 ± 2.82 sec), it also released approximately 75% of the drug within 72 h. Clinical evaluation of the ISG showed a promising percentage reduction of about 58.33% in probing depth, 90% in the bleeding index, 81.81% in the plaque index, and 70.21% in gingival levels of transforming growth factor–β1. This proved that the formulated syringeable intra-pocket delivery system of ATV is an efficient candidate for diminishing inflammation in periodontitis.

Correlation of marker periodontopathogenic bacteria with the immune component sCD14 secretion level in inflammatory periodontal diseases.

Lipopolysaccharide of the cell wall of gram-negative bacteria is a highly active biological substance: its interaction with toll-like receptors-4 (TLR-4) of myeloid cells leads to the activation of a cascade of inflammatory reactions, which is accompanied by the release of the soluble CD14 receptor (sCD14), which can be considered not only as a marker of cell activation by endotoxin, but also as a marker of microbial translocation. The aim of the work was to assess the prognostic significance of the sCD14 level in the samples of the periodontal pocket in inflammatory periodontal diseases and the relationship of its secretion with marker periodontopathogens. For the study, washes were obtained from the periodontal pocket (88 samples in total) from patients with chronic periodontitis and intact periodontium. The sCD14 content was determined by ELISA; during real-time PCR, the marker periodontopathogens Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, and Candida albicans were isolated. The study revealed differences in the level of sCD14 secretion by groups: in chronic periodontitis, its content was 8,5 times higher than in the control group and amounted to 17,2±4,06 ng/ml (p=0,006). The frequency of detecting genes of periodontal pathogenic bacteria was 89,3% in patients with periodontitis and 31,25% in the group with intact periodontium. An interesting dependence of the detection of periodontal pathogenic bacteria in the group of patients with chronic periodontitis was established depending on the content of sCD14. Thus, at high concentrations of soluble coreceptor, a greater number of periodontopathogenic bacteria of the I and II orders were released. Thus, in inflammatory periodontal diseases, the processes of sCD14 synthesis change, which is probably due to the colonization of periodontal pathogenic bacteria and the action of their toxins and aggression factors. The relationship of marker periodontopathogens with the level of secretion of the immune component sCD14 and its effect on the structure of the periodontal index reflect shifts in the processes of reparative regeneration of the oral mucosa and the regulation of local immunity in response to microbial invasion.

CONDITION OF PERIODONTAL TISSUES ON THE BACKGROUND OF HELICOBACTER INVASION: THE CONCEPT OF PATHOGENESIS.

The aim: To analyze the state of periodontal tissues against the background of Helicobacter pylori invasion in dynamics and to propose a possible mechanism of development of inflammatory periodontal diseases in patients with Helicobacter pylori-associated pathology of the gastrointestinal tract. Materials and methods: We examined 43 patients with Helicobacter pylori-associated gastrointestinal pathology and 42 patients of the same age without somatic pathology, including without gastrointestinal pathology associated with Helicobacter pylori. Clinical and laboratory research methods (clinical, instru-mental, biochemical, histological methods) were used. Results: Comparing the data of clinical observations and the results of laboratory studies of patients with inflammatory periodontal disease on the background of Helicobacter pylori-associated gastrointestinal pathology, obtained in different observation periods, we can assume that basic dental treatment of periodontal disease in such patients undergoing eradication therapy does not provide stable anti-inflammatory, antimicrobial and antioxidant effect, which leads to reduced periods of remission and recurrence of periodontal disease, where oral dysbiosis plays a crucial role. Conclusions: Comparing the data of clinical observations and the results of laboratory studies of patients with chronic gingivitis on the background of Helicobacter pylori-associated gastrointestinal pathology, obtained in different observation periods, we can say that they correlate with each other and suggest that the basic dental treatment of chronic gingivatis on the background of H.pylori-associated pathology of the gastrointestinal tract, which is currently undergoing a course of eradication, does not give a stable anti-inflammatory, antimicrobial and antioxidant effect, which leads to recurrence of periodontal disease and shortening remission periods, where oral dysbiosis plays a crucial role.

Knowledge and Perception of Bidirectional Relationship Between Periodontal Disease and Type 1 Diabetes Mellitus: A Questionnaire Study.

The bidirectional relationship between type 1 diabetes mellitus (T1DM) and inflammatory periodontal disease (PD) is globally recognized. However, oral health components are often given lower priority, and studies related to knowledge and the bidirectional association are limited. This study assesses the knowledge and perceptions of PD and its associated risk factors among T1DM patients and/or their parents. Patients under 18 with T1DM at Universiti Teknologi MARA and Universiti Malaya were invited to participate. Structured interviews were conducted to assess participants' knowledge and perceptions of T1DM, and statistical analysis was performed to examine their associations using Pearson's chi-squared test and Fisher's exact test. A total of 113 T1DM patients, with a mean age of 11.4 ± 4, completed the interviews. Poor knowledge was observed among parents and T1DM patients (P-value = 0.007) and those who exercised regularly (P-value = 0.047). A significant association with good perception was found among individuals with uncontrolled HbA1c levels (P-value = 0.0018) and those experiencing bleeding symptoms (P-value = 0.021). The study highlights the importance of increasing awareness, a key factor in improving oral health knowledge. Interestingly, despite poor control of clinical parameters, the population displayed good perception, suggesting a potential lack of understanding regarding disease control.

ОСОБЕННОСТИ ПРОФИЛАКТИКИ СТОМАТОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ У ПАЦИЕНТОВ C САХАРНЫМ ДИАБЕТОМ

We consider interrelation of diabetes mellitus and dental health. Knowledge of dentists and dental patients about diabetes is insufficient. The role of a dentist in the early diagnosis of diabetes mellitus and the features of the treatment of dental diseases in diabetic patients are discussed. Diabetes mellitus is one of the diseases receiving much attention in modern scientific and medical societies. It is easy to explain such a high interest: diabetes mellitus ranks third among the direct causes of death after cardiovascular and oncological diseases, therefore, the solution of issues related to diabetes mellitus is put at the state level in many countries. According to various sources, there are from 120 to 180 million diabetic patients in the world, which is 2-3 % of the total population of the planet. The incidence of diabetes mellitus seemed to become endemic and a crisis in the health sector - according to forecasts of the World Health Organization, by 2025 the number of diabetic patients in the world will increase to 333 million people. Along with the increase in the number of patients with diabetes mellitus, the number of patients suffering from complications of this serious disease increases, which leads to rapid disability. The objective of this study was to increase the effectiveness of prevention and treatment of inflammatory periodontal diseases in patients with diabetes mellitus.

Dental gel Cholisal at the stage of conservative treatment of inflammatory periodontal diseases

To study the effectiveness of using the drug Cholisal as part of the conservative treatment of chronic periodontitis. We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute phase with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of CGP, patients were divided into two groups of 50 people. In the main group, in addition to standard treatment, the dental gel Cholisal was used, and in the control group, therapy was standard. 10 days after professional hygiene, patients in both groups were examined and underwent an index assessment of the condition of periodontal tissues and adherence to treatment. In patients of the control group, 10 days from the start of treatment, the depth of periodontal pockets in the control group decreased slightly from 4.7±0.28 mm to 4.2±0.21 mm (p=0.074), and the Green-Vermillion hygiene index decreased by 25.3±1.79% (p=0.041), Silnesse-Loe plaque index by 59.1±2.16% (p<0.001), PMA index by 51.5±1.92% (p<0.001) and Muhlemann-Cowell bleeding index by 42.2±1.75% (p<0.001). In the main group, the effectiveness of treatment of chronic periodontitis with conservative therapy using Cholisal was higher. There was a statistically significant decrease in the depth of periodontal pockets from 4.8±0.23 mm to 3.5±0.19 mm (p=0.043), the Green-Vermillion hygiene index decreased by 47.6±2.13% (p=0.0003), Silnesse-Loe plaque index by 78.2±3.05% (p<0.001), PMA index by 69.4±2.74% (p<0.001) and Muhlemann-Cowell bleeding index by 66.9±1.62% (p<0.001). The use of the drug Cholisal in the conservative treatment of chronic periodontitis has shown convincing positive dynamics in both subjective and objective assessments, which suggests its effective use.

Особенности течения воспалительных заболеваний пародонта в сочетании с новой коронавирусной инфекцией. Систематичеcкий обзор

Особенности течения воспалительных заболеваний пародонта в сочетании с новой коронавирусной инфекцией. Систематичеcкий обзор

ПРОБЛЕМА АНТИБИОТИКОРЕЗИСТЕНТНОСТИ В СТОМАТОЛОГИИ (ПАРАДОНТОЛОГИИ) НА СОВРЕМЕННОМ ЭТАПЕ (ОБЗОР ЛИТЕРАТУРЫ)

The problem of antibiotic resistance has become the main one in solving the problems of treatment of chronic generalized periodontitis, in the etiology of which periodontopathogenic microflora and its pathogenicity factors, including the formation of biofilms that transmit resistance genes, play an important role. The aim of the work is to analyze the literature data on the feasibility and effectiveness of antibiotics in terms of the genetic aspects of the etiology and pathogenesis of the emergence of microbiota antibiotic resistance in chronic inflammatory periodontal diseases.

The use of carboxytherapy in the complex treatment of periodontal diseases

Relevance. Today, inflammatory periodontal diseases are one of the most common pathologies seen at dental appointments. During the treatment of these diseases, the main goal of the therapy is to reduce the intensity of inflammatory manifestations.Materials and methods. The article presents the results of the application of the original method of carboxytherapy to reduce the inflammatory component at the initial phase of the treatment of inflammatory periodontal diseases.The technique suggests the injection of 0.5–1.0 ml of medical carbon dioxide into the vestibular mucobuccal fold and the dental papillae region with a special injector. The study was conducted at the department of prosthodontics of Samara State Medical University. The study divided the patients into two groups. The control group underwent professional oral hygiene, and the main-group patients had an additional carboxytherapy treatment developed by the authors. The study evaluated the effectiveness of the treatment using the OHI-S, PMA, and Muhllemann indices and the restoration of blood filling using the periodontal bloo d flow assessment method.Results. After the treatment, the main group showed a statistically significant decrease in the assessed indices and blood circulation restoration in the periodontium, which indicates a significant effect of the method used. Allergic and toxic effects on the mucous membrane did not manifest in the carboxytherapy group during the observation period. Patients did not complain about pain and discomfort.Conclusion. So, based on the conducted studies, we can conclude that the method of carboxytherapy is highly effective as one of the elements of the c omplex treatment of periodontal diseases.

Review of extended-release drug delivery systems for non-surgical treatment of inflammatory periodontal diseases

Relevance. The onset of periodontal pathogen resistance to systemic antibiotics revealed a new direction in periodontics. The characteristics of local drug delivery systems allow for a prolonged impact on periodontal pocket microbiota.Materials and methods. The non-interventional study was carried out by an analytical review of Russian and international scientific publications of independent clinical and laboratory research databases PubMed, ResearchGate, ScienceDirect, and eLIBRARY.RU for the last decade. The search was performed using the keywords: "periochip", "periodontal treatment", "the matrix", "tissue engineering", and "bioactive cryogels". The review included randomized controlled studies, controlled clinical trials, prospective and retrospective comparative cohort studies of drug delivery systems and systematic reviews.Results. In contrast to systemic drug administration, biodegradable local drug delivery systems provide long-lasting and effective treatment at the lesion site at much lower doses and in a shorter period of time. The prolonged drug activity time combined with non-surgical treatment of inflammatory periodontal diseases results in faster soft tissue regeneration. Gels, foams, fibres, bioactive cryogels, micro- and nanoparticles, and chips may be biodegradable matrices for the extended-release drug delivery system. The basic polymer for all these forms can be of natural origin (proteins, collagen), semi-synthetic (cellulose derivatives) or synthetic.Conclusion. Films, chips and bioactive cryogel are nowadays more common forms. Due to its unique structure, the bioactive drug cryogel can serve as a controlled and multifunctional system for drug delivery to the periodontal tissues, which determines its importance in periodontics and high interest f or further research.

INCREASING THE EFFICIENCY OF THE TREATMENT OF ENDOPARODONTAL LESIONS

Chronic inflammation in the periodontium, pulp and periodontium, through the pocket of which the infection can spread towards the root apex and cause a retrograde development of the inflammatory process in the pulp and periapical tissues, is considered as an odontogenic focus.&#x0D; Aim: to study the state of periodontal tissues, periodontitis in the presence of a periapical focus of infection and the dynamics of its change in complex treatment.&#x0D; Material and methods. 150 medical records of a dental patient were studied, among them a randomized controlled study of 100 patients with combined endodontic and periodontal lesions and 50 individuals not burdened by this pathology was also conducted. At the next stage a study of 41 patients with EPL was conducted. The patients were divided into two groups depending on the treatment algorithm: I – with a diagnosis of EPL20 patients of the main group, who, along with standard treatment, received additional therapy with decontamination of CC and laser curettage with a dental diode laser (Picasso Life); II with a diagnosis of EPL 21 patients in the control group with traditional treatment. Evaluation of the effectiveness of traditional and proposed methods of treatment of endoperiodontal lesions was carried out by assessing the degree of gingival bleeding (SBI index (Muhlemann H.R. modified by Cowell I., 1975)) and probing depth (PD).&#x0D; Results. The age indicators for patients of two groups most often varied within 40-49 years. The second most frequent was the age of the subjects, which amounted to 50-59 years. When studying the influence degree of industrial environment factors with irritating and general toxic properties on the frequency of occurrence of EPl, it was found that in the main group 14.0% of patients with this pathology have been working in such conditions for a long time. In addition, in the control group, the number of persons professionally burdened with inflammatory periodontal diseases without signs of apical periodontitis was 16.0%. In the course of further analysis of the obtained anamnestic data, it was revealed that alcohol abuse occurred in the main group in 36.0% of cases, in the control group in 24.0%. Abuse of tobacco products, against the background of which there is inflammation of the gums in the form of hyperemia, edema, bleeding, was noted by half of the patients in the control group and almost the same number of patients in the main group 48.0%, in whom pathological changes in the periapical region were detected in parallel.&#x0D; Conclusion. At certain periods of observation, statistically significant distinguishing intergroup signs were clearly expressed 6 months after the completion of therapeutic and preventive measures, and this trend in a sharp and significant decrease in gum bleeding and periodontal pocket depth continued by the end of observations in the main group when using a laser.

Periodontal ligament cells from patients with treated stable periodontitis: Characterization and osteogenic differentiationpotential.

Periodontal ligament progenitor cells (PDL cells) isolated from patients with inflammatory periodontitis have impaired regenerative capacity, but it is unknown whether this capacity can be recovered upon treatment and stabilization of the periodontal condition. The study aimed to investigate the expression of surface markers and the proliferation and osteogenic potential of PDL cells isolated from patients with treated stable periodontitis (S-PDL cells), periodontally healthy individuals (H-PDL cells), and patients with inflammatory periodontitis (I-PDL cells). H-PDL, I-PDL, and S-PDL cells were isolated from the extracted teeth of individuals who (1) were periodontally healthy, (2) had inflammatory periodontitis, and (3) had treated stable periodontitis, respectively. The expression levels of surface markers and the proliferative and osteogenic capacities of the PDL cells were assessed. PDL cells derived from all three sources exhibited mesenchymal stem cell (MSC) characteristics. They were positive for MSC-related markers and negative for a hematopoiesis-related marker. However, S-PDL cells had higher proliferation rates, higher expression levels of osteogenic markers, higher alkaline phosphatase activity, and more calcium nodules than I-PDL cells. But all of these parameters remained lower in S-PDL cells than in H-PDL cells. S-PDL cells proliferated faster and had greater osteogenic potential than I-PDL cells, although these values remained lower than those in H-PDL cells.

Features of mucosal immunity in the development of periodontal diseases in patients with type II diabetes mellitus

Chronic generalized periodontitis takes one of the leading places in the structure of dental diseases. Inflammatory periodontal disease is one of the most common complications of diabetes. An important role in the progression of periodontitis in type II diabetes mellitus (T2DM) belongs to disorders of the immune system that affect the supportive/retaining complex of the tooth. Inflammation of periodontal tissues which occurs in the patients with carbohydrate metabolism disorders is characterized by a more severe course, which worsens the condition and quality of life of patients with T2DM thus leading to tooth loss. In this regard, the immunological aspects of developing periodontal pathology under conditions of carbohydrate metabolism disorders are of great interest. Purpose of our study included comparative assessment of local TNF, TNF, IFN, IL-1, IL- 12, IL-17A levels in patients with periodontitis with and without carbohydrate metabolism disorders (type II diabetes mellitus), as well as in patients with type II diabetes mellitus without signs of periodontitis.&#x0D; 127 patients were examined, aged 30 to 59 years. The patients were divided into 3 groups, i.e., group I included patients suffering from periodontitis of varying severity without known comorbidities (47 persons); Group II consisted of patients with T2DM and periodontitis of varying severity (49 persons); Group III included patients with T2DM without symptoms of periodontitis (30 persons). The control group consisted of 30 practically healthy volunteers, matched to the patients for age and sex. Saliva specimens were used for laboratory studies. The levels of TNF, TNF, IFN, IL-1, IL-12, IL-17А were determined by ELISA sandwich technique, with specific reagents purchased from RD Diagnostics Inc (USA).&#x0D; A significant increase in the IL-1, TNF, IFN and IL-17A levels was found in patients of all groups compared with controls. At the same time, the increased concentrations of IFN, IL-1, IL-17A correlated with increase in periodontitis severity in the patients of both groups. Decreased TNF levels in saliva samples were revealed in the patients from almost all groups, regardless of the periodontitis severity. Significantly increased levels of IL-12 (p40 subunit) were recorded in saliva of the persons from group II and III when compared with controls and the group without diabetes mellitus.

Changes in mucosal immunity of oral cavity upon tooth loss in patients with periodontal diseases

Partial or complete loss of teeth occurs in elderly and senile people, caused, mainly, by chronic generalized periodontitis. At the same time, the impact of presence or absence of persisting teeth and periodontium, is practically not covered in the literature as a factor of balance in the oral cavity, including local immunity of the mucous membranes. Our work concerned the changes in local immunity of the oral cavity occuring with the loss of natural teeth. We have observed 45 elderly people who were divided into 3 study groups, i.e., without inflammatory periodontal pathology (1), with periodontitis (2) and with chronic periapical inflammatory processes in the absence of periodontal inflammation (3). In order to sanitize oral cavity before the upcoming dental prosthetics, the patients of study groups 2 and 3 underwent extraction of all teeth in the upper and lower jaws. Indices of local immunity of the oral cavity in the salivary fluid of patients were assessed before surgical sanitation of the oral cavity (before the teeth extraction) and 30-35 days after removal of the last tooth. We have measured the salivary levels of secretory immunoglobulin A (sIgA) as well as pro-inflammatory cytokines, i.e., interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor- (TNF), and anti-inflammatory cytokines, e.g., receptor antagonist of interleukin-1 (RAIL), interleukin-4 (IL-4), interleukin-10 (IL-10)), as well as contents of antimicrobial peptides in saliva (catelicidin LL-37 and alphadefensins 1-3 (HNP1-3). We have found that the development of inflammation in severe inflammatory periodontal diseases, in particular, chronic generalized periodontitis requiring tooth extraction for oral cavity sanitation is characterized by functional insufficiency of secretory immunity of the oral mucosa associated with decreased secretion of secretory immunoglobulin A and antimicrobial peptides of neutrophilic origin, as well as a shift in the salivary cytokine balance towards increased production of pro-inflammatory cytokines. Removal of teeth, as the main source of inflammation and the basis for maintenance of dysbiotic microbiome biofilm leads to elimination of inflammation and the restoration of immune balance in the oral cavity.

Study of the clinical efficacy of the crystalline form of the immunomodulatory drug based on antimicrobial peptides and cytokines complex in the treatment of patients with inflammatory periodontal diseases

On the basis of clinical periodontal indices of Muhlemann, RMA and Silness-Loe, the effectiveness of a new water-soluble form of the immunomodulatory drug Superlimf L in the treatment of inflammatory periodontal diseases was studied.&#x0D; Material and methods. 2 groups of patients with moderate periodontitis were formed: the experimental group (Group A) and the control group (Group B) (30 patients in each group). Before the start of treatment, all patients were taught the rules of correct brushing. Piezon-Master-400 and polishing the surfaces of the roots of the teeth in patients of the experimental group (A) were introduced into the periodontal pockets on cotton turundas with a solution of Superlimf® L. Previously, the pulvis of the Superlimf® L was dissolved in 5 ml of distilled water. Cotton turundas soaked in the preparation solution were introduced into periodontal pockets and soaked swabs were applied to the surfaces of gum — for 40 minutes. The procedures were carried out daily for 2 weeks. In the control group, the intervention was limited to the removal of dental deposits and subsequent controlled brushing of the teeth once every 3 days. The duration of the study was 2 weeks. An index assessment of the periodontal condition in patients of both groups was performed before treatment and, 3, 7 and 14 days after treatment.&#x0D; Treatment results. Clinically visible improvement in the condition of periodontal tissues after mechanical treatment occurred in patients of both groups after 3 days. The dynamics of the Silness-Loe index was very demonstrative in patients of both groups. Being initially almost equally high (2.35±0.45 units), after 3 days these values decreased by more than half. However, the difference in the decrease in the value of the Muhlemann index and PMA in patients of groups A and B was very significant. If in the control group (group B) after 3 days the intensity of bleeding during a probe test decreased by no more than 20%, then in patients in group A it decreased by almost half. In subsequent periods of observation, the decrease in inflammation and bleeding indices was also almost 3 times more intense in patients in group A than in patients in the control group. It is characteristic that the Silness-Loe plaque index already on the 7th day in patients in group B was significantly higher than in patients in group A. By the end of the study, both clinically and according to the index assessment of the condition of the periodontium in patients who received Superlimf® L, the condition of periodontal tissues was significantly better than in patients in the control group (Group B).&#x0D; Conclusion. Pronounced efficacy, the absence of adverse effects when using the product, good organoleptic indicators — all of the above allows specialists to use the powder form of the new drug Superlimf® L for the treatment of inflammatory periodontal diseases both in the conditions of dental units, as well as recommend to patients after their preliminary instruction and training apply the remedy at home.

The role of vitamin D in periodontal health and disease.

Vitamin D plays an essential role in calcium and bone metabolism, immune regulation and possesses profound anti-inflammatory effects. Evidence suggests that low serum vitamin D is associated with increased severity of periodontitis, a chronic inflammatory condition characterised by destruction of the supporting tissues surrounding the tooth, which has several shared risk factors with other chronic non-communicable diseases. The biological functions of vitamin D are mediated by its strong anti-microbial, anti-inflammatory, and host modulatory properties. Experimental periodontitis models involving targeted deletion of 1α-hydroxylase, the enzyme responsible for the conversion of inactive substrate to active 1,25(OH)2 D3 (calcitriol), showed augmented alveolar bone loss and gingival inflammation. Vitamin D receptor (VDR) gene polymorphisms have also been associated with increased severity of periodontitis. Thus, the involvement of vitamin D in the pathogenesis of periodontitis is biological plausible. Clinical studies have consistently demonstrated an inverse relationship between serum 25OHD3 and periodontal disease inflammation. However, due to the paucity of well-designed longitudinal studies, there is less support for the impact of vitamin D status on periodontal disease progression and tooth loss. The evidence emphasises the importance of maintaining vitamin D sufficiency in supporting periodontal health. This review aims to first examine the biological mechanisms by which vitamin D might influence the pathogenesis of periodontal disease and second, discuss the clinical evidence which implicate the role of vitamin D in periodontal disease.

Exosomal miR-205-5p derived from periodontal ligament stem cells attenuates the inflammation of chronic periodontitis via targeting XBP1.

Chronic periodontitis (CP) is an inflammatory periodontal disease with high incidence and complex pathology. This research is aimed to investigate the function of exosomal miR-205-5p (Exo-miR-205-5p) in CP and the underlying molecular mechanisms. Exo-miR-205-5p was isolated from miR-205-5p mimics-transfected periodontal ligament stem cells (PDLSCs), and subsequently cocultured with lipopolysaccharide (LPS)-induced cells or injected into LPS-treated rats. The mRNA expression of inflammatory factors and Th17/Treg-related factors were measured by quantitative real-time PCR. The contents of inflammatory factors and the percentages of Th17/Treg cells were measured by enzyme-linked immunosorbent assayand flow cytometry, respectively. Besides, the target relation between miR-205-5p and X-box binding protein 1 (XBP1) was explored. MiR-205-5p was downregulated in LPS-induced PDLSCs and corresponding exosomes. Exo-miR-205-5p inhibited inflammatory cell infiltration, decreased the production of TNF-α, IL-1β, and IL-6, and decreased the percentage of Th17 cells in LPS-treated rats. In addition, XBP1 was a target of miR-205-5p. Overexpression of XBP1 weakened the effects of Exo-miR-205-5p on inhibiting inflammation and regulating Treg/Th17 balance in LPS-induced cells. Exo-miR-205-5p derived from PDLSCs relieves the inflammation and balances the Th17/Treg cells in CP through targeting XBP1.