Clinical Periodontal Parameters Research Articles

Microbiome of periodontitis and peri-implantitis before and after therapy: Long-read 16S rRNA gene amplicon sequencing.

The microbial profiles of peri-implantitis and periodontitis (PT) are inconclusive. The controversies mainly arise from the differences in sampling sites, targeted gene fragment, and microbiome analysis techniques. The objective of this study was to explore the microbiomes of peri-implantitis (PI), control implants (CI), PT and control teeth (CT), and the microbial change of PI after nonsurgical treatment (PIAT). Twenty-two patients diagnosed with both PT and peri-implantitis were recruited. Clinical periodontal parameters and radiographic bone levels were recorded. In each patient, the subgingival and submucosal plaque samples were collected from sites with PI, CI, PT, CT, and PIAT. Microbiome diversity was analyzed by high-throughput amplicon sequencing using full-length of 16S rRNA gene by next generation sequencing. The 16S rRNA gene sequencing analysis revealed 512 OTUs in oral microbiome and 377 OTUs reached strain levels. The PI and PT groups possessed their own unique core microbiome. Treponema denticola was predominant in PI with probing depth of 8-10 mm. Interestingly, Thermovirga lienii DSM 17291 and Dialister invisus DSM 15470 were found to associate with PI. Nonsurgical treatment for peri-implantitis did not significantly alter the microbiome, except Rothia aeria. Our study suggests Treponemas species may play a pivotal role in peri-implantitis. Nonsurgical treatment did not exert a major influence on the peri-implantitis microbiome in short-term follow-up. PT and peri-implantitis possess the unique microbiome profiles, and different therapeutic strategies may be suggested in the future.

Evaluation of Glycosylated Hemoglobin Levels and Effect of Tobacco Smoking in Periodontally Diseased Non-Diabetic Patients

Background and Objective Chronic diseases have progressively increased worldwide, impacting all areas and socioeconomic groups. Periodontal disease is an increasing global concern and contains risk factors similar to other chronic illnesses. The main risk factor for periodontitis is smoking. Smoking not only hastens periodontal disease but also complicates periodontal therapy. Serum glycosylated hemoglobin levels, which are derived from the average life span of an erythrocyte, are a good indicator of glycemic management during the preceding one to three months. This study was undertaken to assess the association between tobacco smoking and periodontal disease by evaluating plaque score, gingival score, extent and severity index (ESI), and glycemic status by estimating serum HbA1c in cigarette smoker patients compared to non-smokers. Methods The study was conducted with 40 patients in the age range of 20–40 years. Patients were divided into two groups: non-smokers (Group I) and cigarette smokers (Group II). Periodontal clinical parameters such as the plaque index (PI), gingival index (GI), and ESI were recorded during the oral cavity examination. The biochemical marker, serum glycosylated hemoglobin, was measured in both groups. All parameters were measured at baseline and three months after periodontal therapy. The statistical tests used were the paired t-test, and Chi-square test for comparison between both groups. Results The mean difference of PI of non-smokers was 0.33 ± 0.30, and smokers were 0.52 ± 0.32, which was statistically significant. The mean difference of GI of non-smokers was 0.34 ± 0.19 and smokers 0.36 ± 0.303, which was statistically significant. The mean difference of extent in non-smokers was 5.33 ± 1.59, 5.52 ± 2.43, and smokers were 0.18 ± 0.17. The mean difference in severity in non-smokers was 0.18 ± 0.17, and smokers were 0.31 ± 0.25, which was statistically significant. The mean difference of HbA1c in non-smokers and smokers was 0.43 ± 0.277 and 0.415 ± 0.230, which shows a higher mean difference in non-smokers, which was statistically non-significant. Conclusion and Global Health Implications This study concluded that each of Group I and Group II showed substantial improvements in all clinical periodontal variables, which include plaque index (PI), gingival index (GI), extent and severity index (ESI), and biochemical marker serum glycosylated hemoglobin. Controlling inflammation with SRP can improve insulin resistance, lower glucose levels, and prevent non-enzymatic glycation of hemoglobin.

Efficacy of Locally Delivered Aloe Vera Hydrogel in Patients With Chronic Periodontitis: A Prospective Clinical Study.

Various herbal and natural products have been used for multiple purposes in medicine due to recent interest and advancements in the field of alternative medicine. For the past few millennia, aloe vera has been used as medicine. Itsanti-inflammatory and antibacterial properties have been proven to reduce periodontal disease. In patients with generalised chronic periodontitis, this study examined the impact of aloe vera hydrogel in conjunction with scaling and root planing (SRP). Sixty patients with generalised chronic periodontitis were enrolled in this study and split into two groups: Group 1 (control) - SRP alone (n=30) and Group 2 (test) - Aloe vera hydrogel with SRP (n=30). Clinical parameters related to periodontal disease, such as plaque index (PI), clinical attachment level (CAL), and probing depth (PD) were measured at baseline and three months after the procedure, and the results were compared using Statistical Product and Service Solutions (SPSS, version 23.0; IBM SPSS Statistics for Windows, Armonk, NY) software.A p-value of <0.05 indicated that the result was statistically significant. When comparing both groups' third-month periodontal clinical parameters to the baseline, there was a significant improvement (p<0.05). In the third month, the test group showedbetter improvement inPD and CAL than the control group (p<0.05). The combination of SRP and aloe vera hydrogel greatly improved periodontal clinical parameters. However, studies with long-term follow-up assessing the efficacy of other modes of delivering aloe vera and also its effect on microbiological and immunological parameters are warranted in the future to substantiate these findings.

Oxidative Stress and FOXO-1 Relationship in Stage III Periodontitis

Objectives8-Hydroxideoxyguanosine (8-OHdG) is a marker of oxidative stress, and Forkhead Box-O1 (FOXO1) is a transcription factor and signaling integrator in cell and tissue homeostasis. This study aims to determine FOXO1 and 8-OHdG levels in serum and saliva samples of periodontitis patients and to evaluate their relationship with clinical periodontal parameters.Materials and MethodsTwenty healthy individuals, twenty generalized Stage III Grade B periodontitis patients, and nineteen generalized Stage III Grade C periodontitis patients were included in the study. Clinical periodontal parameters (plaque index (PI), probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL)) were recorded. Salivary and serum 8-OHdG and FOX-O1 levels were analyzed by enzyme-linked immunosorbent assay (ELISA).ResultsClinical periodontal parameters showed a statistically significant increase in periodontitis groups compared to the control group (p < 0.05). 8-OHdG salivary levels were significantly higher in both periodontitis groups compared to the control group. The salivary FOXO1 levels were significantly lower in both periodontitis groups compared to the control group. Salivary FOXO1 level had a low-grade negative correlation with BOP and salivary 8-OHdG level.ConclusionsWhile reactive oxygen species increase in periodontal inflammation, low expression of FOXO1, an important transcription factor for antioxidant enzymes, supports that this molecule plays a vital role in tissue destruction, and FOXO1 can be seen as a potential immune modulator.Clinical relevanceThe role of FOXO1 in supporting antioxidant defense may suggest that FOXO1 is a candidate target for periodontitis treatment.

Soft tissue augmentation around dental implants by a new laser-aided pouch roll technique.Volumetric and clinical evaluation after 1-year.

The ultimate goal in implantology is to restore the whole tooth-gingival complex in a fashion that cannot be distinguished from the rest of the natural dentition. This study assesses the volumetric and clinical changes of vestibular gingival soft tissues, crucial for satisfactory engraftment and aesthetic results, upon treatment with laser-aided pouch roll augmentation in second-stage surgery for dental implant uncovering. Twelve patients with mild ridge deficiencies in 16 edentulous sites, including distal elements, were enrolled and re-evaluated for up to 1 year. Digital impressions, taken with an intra- oral laser scanner and software, were analyzed before (day 0) and after (month 12) the treatment. The digital STL files were superimposed to assess volumetric and linear dimensional variations in selected peri-implant regions of interest (ROI) by 3D analysis software. Clinical periodontal parameters (probing depth PD, bleeding on probing BoP, plaque index PI) and subjective patient-reported outcomes were also evaluated. In all the patients, the applied technique induced a substantial increase in the volume of the vestibular peri-implant gingiva at 12-month follow-up (range 24-69%, mean 40,4%) in respect to day 0. The gingival mucosa appeared normal at both inspection and evaluation of the periodontal parameters (PD 2.7±1 mm; BoP 0.11±0.2 s; PI 0.19±0). Patients' liking of perceived pain/discomfort and aesthetic outcome was high. These findings indicate that laser-aided pouch roll flap is a safe, patient-liked procedure whose long-term effectiveness has been objectively demonstrated by volumetric and clinical assessment.

Mean platelet volume is associated with periodontitis: a cross-sectional study

BackgroundIt is uncertain if mean platelet volume and periodontitis are related. The objective of this study was to examine the association between levels of mean platelet volume and moderate/severe periodontitis in adult persons who inhabit the U.S.MethodsWe screened 6,809 people from the National Health and Nutrition Examination Survey (NHANES 2009–2012). Mean platelet volume was measured in the Mobile Examination Centers (MECs) using the Beckman Coulter analyzer. The category of periodontitis was defined by the CDC/AAP using clinical periodontal parameters. Multiple logistic regression models were employed to examine the distribution for covariate differences across the various independent groups. Four models were employed to examine the relationship between mean platelet volume level and periodontitis. Smoothed curve fitting was utilized to confirm the linearity of the relationships. To determine the impact of factors on the connection between MPV and periodontitis, subgroup analysis and interaction testing were utilized.ResultsResults from the multiple logistic regression analysis indicate a significant association between moderate/severe periodontitis and the mean platelet level, even after considering any potential confounding variables (OR = 1.090, 95% CI: 1.019–1.166, P-value = 0.01211). Additionally, those in the upper tertile of mean platelet volume levels had a 21.6% higher probability of developing periodontitis when compared with those in the least tertile of mean platelet levels (OR = 1.216, 95% CI:1.052–1.406, P-value = 0.00816). Moreover, it showed a positive correlation between mean platelet volume (MPV) and moderate/severe periodontitis. Subgroup analyses indicated a positive association between the level of mean platelet volume and moderate/severe periodontitis among individuals who were under 60 years of age, had low income, were obese, never smoked, were heavy drinkers, had hypertension, and had no cardiovascular disease (p < 0.05). However, none of the subgroups exhibited significant interactions (p for interaction > 0.05).ConclusionA correlation has been found between mean platelet volume levels and periodontal disease in individuals residing in the United States.

Evaluation of CD44 antigen in type 2 diabetic patients with periodontitis: An immunohistochemical study.

Type 2 diabetes mellitus (DM) is a known systemic risk factor for periodontitis. An increased expression of CD44 has been suggested in type 2 diabetics and periodontitis patients. The present study aimed to assess the expression of CD44 antigen in patients with chronic periodontitis (CP) and type 2 DM in a South Indian urban population. Additionally, the relationships between the expression of CD44 antigen in gingival tissues, periodontal clinical parameters, and the random blood sugar (RBS) and glycated hemoglobin (HbA1c) levels were assessed. A total of 63 subjects were divided into 3 groups: systemically and periodontally healthy controls (group H); CP patients, otherwise healthy (group CP); and CP patients with type 2 DM (group CP+DM). Periodontal parameters were recorded for all groups, and additionally the RBS and HbA1c levels for group CP+DM. Gingival tissue samples were obtained and subjected to immunohistochemical analysis for CD44. The expression of CD44 was significantly higher in the diseased groups. Epithelial CD44 expression was significantly stronger in group CP+DM as compared to groups CP and H (p < 0.001), whereas connective tissue CD44 expression was similar in groups CP and CP+DM (p = 0.657). Furthermore, an inverse relationship was observed between blood glucose parameters and CD44 expression in the epithelium and connective tissue. The expression of CD44 increased with the severity of periodontal disease. Additionally, glycemic control in patients with CP and type 2 DM had an impact on CD44 expression. Our findings indicate a possible destructive role of CD44 in the pathogenesis of periodontal diseases in individuals with type 2 DM.

Impact of circadian clock protein Bmal1 on experimentally-induced periodontitis-associated renal injury.

To investigate the mechanism of circadian clock protein Bmal1 (Bmal1) on renal injury with chronic periodontitis, we established an experimental rat periodontitis model. Twelve male Wistar rats were randomly divided into control and periodontitis groups (n=6, each group). The first maxillary molars on both sides of the upper jaw of rats with periodontitis were ligated by using orthodontic ligature wires, whereas the control group received no intervention measures. After 8 weeks, clinical periodontal parameters, including probing depth, bleeding index, and tooth mobility, were evaluated in both groups. Micro-CT scanning and three-dimensional image reconstruction were performed on the maxillary bones of the rats for the assessment of alveolar bone resorption. Histopatholo-gical observations of periodontal and renal tissues were conducted using hematoxylin-eosin (HE) and periodic acid-Schiff (PAS) staining. Renal function indicators, such as creatinine, albumin, and blood urea nitrogen levels, and oxidative stress markers, including superoxide dismutase, glutathione, and malondialdehyde levels, were measured using biochemical assay kits. MitoSOX red staining was used to detect reactive oxygen species (ROS) content in the kidneys. The gene and protein expression levels of Bmal1, nuclear factor erythroid 2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) in rat renal tissues were assessed using real-time quantitative polymerase chain reaction (RT-qPCR) and immunohistochemical staining. Micro-CT and HE staining results showed significant bone resorption and attachment loss in the maxillary first molar region of the periodontitis group. Histological examination through HE and PAS staining revealed substantial histopathological damage to the renal tissues of the rats in the periodontitis group. The findings of the assessment of renal function and oxidative stress markers indicated that the periodontitis group exhibited abnormal levels of oxidative stress, whereas the renal function levels showed abnormalities without statistical significance. MitoSOX Red staining results showed that the content of ROS in the renal tissue of the periodontitis group was significantly higher than that of the control group, and RT-qPCR and immunohistochemistry results showed that the expression levels of Bmal1, Nrf2, and HO-1 in the renal tissues of the rats in the periodontitis group showed a decreasing trend. Circadian clock protein Bmal1 plays an important role in the oxidative damage process involved in the renal of rats with periodontitis.

Clinical Effectiveness of Salvia officinalis in Periodontitis: A Split-Mouth Randomized Controlled Trial.

Background Periodontitis is a chronic inflammatory condition that destroys the tissues supporting the teeth. Conventional nonsurgical treatments, such as mechanical scaling and root surface debridement (RSD), often require adjunct therapies to enhance outcomes due to their limited efficacy in completely eradicating pathogenic microorganisms. Given the adverse effects of standard adjunctive therapies, including antibiotics and nonsteroidal anti-inflammatory drugs, Salvia officinalis (sage) presents a promising herbal alternative due to its anti-inflammatory and antimicrobial properties. This study aims to assess the local application of Salvia officinalis gel as an adjunctive to scaling and RSD to manage periodontitis. Methods We conducted a randomized, controlled split-mouth clinical trial involving 14 systemically healthy periodontitis patients. We included patients with at least 20 natural teeth, a probing pocket depth (PPD) ≥5 mm, and attachment loss ≥4 mm at a minimum of five sites. Primary outcomes measured were bleeding on probing (BOP), PPD, and relative attachment level (RAL). The Salvia officinalis gel was applied to designated test sites post-RSD, while control sites received no adjunctive treatment. Clinical parameters were recorded at baseline and a one-month follow-up visit. Results The cohort consisted of 10 men and four women, with a mean age of 37.1 ± 5.46 years. At the follow-up visit, the test group demonstrated a significant reduction in mean BOP (P = 0.0004), whereas the control group showed no significant change (P ≥ 0.05). Both groups experienced significant decreases in mean PPD and RAL from baseline to follow-up, with the test group showing greater improvements. Conclusions Salvia officinalis gel, used as an adjunct to scaling and RSD, significantly improves clinical periodontal parameters in patients with periodontitis. Its anti-inflammatory properties likely underpin the observed benefits, offering an effective and safe alternative to traditional chemical pharmaceuticals. Further research is needed to explore the long-term effects and mechanisms underlying the therapeutic benefits of Salvia officinalis in periodontal treatment.

Comparative examination of trabecular bone structure in healthy and diabetic patients with periodontitis using fractal analysis.

Fractal analysis is a numerical method that indicates the structural patterns and complexity of the trabecular bone on radiographs. The aim of this cross-sectional study was to evaluate the trabecular bone structure in systemically healthy patients and diabetes mellitus patients with periodontitis using fractal analysis. The study included 125 mandibular first molars of nonsmoker patients. The subjects were divided into five subgroups: diabetes mellitus patients with mild-moderate periodontitis, diabetes mellitus patients with advanced periodontitis, systemically healthy individuals with mild-moderate periodontitis, systemically healthy individuals with advanced periodontitis, and systemically healthy individuals with gingivitis (control group). Clinical periodontal parameters (pocket depth, bleeding on probing, clinical attachment loss, and bone loss) were recorded. Two specific sites located in the mesial-distal regions (n = 250) of the mandibular first molars were identified using periapical radiographs captured with a parallel technique. Fractal analysis values were calculated using the box-counting method. One-way analysis of variance (ANOVA), and Pearson correlation analysis were used for statistical evaluation. The highest fractal analysis values were observed in systemically healthy with gingivitis patients (mesial fractal analysis: 1.86 ± 0.01; distal fractal analysis: 1.85 ± 0.01). Patients with periodontitis (mesial fractal analysis: 1.78 ± 0.02; distal fractal analysis: 1.79 ± 0.01) exhibited lower fractal analysis values compared to the control group. There was no significant difference in mesial and distal fractal analysis values between all periodontitis groups. No correlation was found between age, sex, clinical attachment loss, bone loss, and fractal analysis (P > .05). Although fractal analysis values were lower in the periodontitis groups compared to the control group, fractal analysis did not demonstrate any periodontitis-associated changes of bone trabeculation in diabetes at any stage of periodontitis. Furthermore, there was no significant association between fractal analysis values and age, sex, clinical attachment, and bone loss.

Entire papilla preservation technique for treatment of periodontal intrabony defects: a series of cases.

Periodontitis is characterized by bone resorption. Vertical bone loss results in an intraosseous defect. Multiple surgical approaches for treating intrabony defects have shown different grades of effectiveness. Recently, the entire papilla preservation technique has been proposed, improving clinical parameters, such as pocket depth and clinical attachment level. This series of cases aimed to describe the use of the entire papilla preservation surgical technique without using biomaterials to regenerate periodontal intrabony defects. The influence on the clinical periodontal parameters and radiographic parameters was measured through CBCT, the latter not described until now, and analyzed the possible postoperative complications. A total of six intrabony periodontal defects associated with at least one periodontal pocket with probing depths equal to or greater than 6 mm were treated with the entire papilla preservation technique. The clinical and radiographic parameters were evaluated at the beginning and 6 months after surgery. The mean probing pocket depth reduction was 4.00 ± 0.63 mm, the mean clinical attachment level gain was 3.67 ± 1.03 mm, and the mean radiographic intrabony filling was 2.41 ± 2.03 mm. Early healing was uneventful; the mean visual analog scale at 7 days was 0. This minimally invasive technique results in an improvement in clinical and radiographic parameters, the latter showing a filling of the bone defect observed during the 6-month evaluation after surgical treatment. These results confirm the importance of clot and flap stability in regenerating intraosseous defects.

Effects of e-cigarette smoking on periodontal health: A scoping review.

Use of electronic cigarettes (ECs), also known as vaping, has gained remarkable popularity globally during the last decade especially among young people. Current evidence suggests that vaping may be associated with health risks. The aim of this study is to evaluate whether vaping increases the risk for initiation and progression of periodontal disease; and to appraise the clinical changes seen in patients using e-cigarettes, and how these changes impact the management of periodontal disease. A comprehensive electronic search was conducted on the PubMed, Scopus and Embase databases using the following search terms: Electronic Cigarettes OR vaping OR electronic nicotine delivery systems OR e-cigarettes AND Periodontitis. The search was limited to studies published from 1st January 2012 to 31st December 2022. A total of 23 clinical studies focusing on the effect of e-cigarette smoking on the periodontal clinical parameters, levels of inflammatory mediators, alteration in periodontal microflora, and response to periodontal treatment were found to be eligible for inclusion in the review. Vaping may be associated with greater clinical attachment loss (CAL) compared to non-smokers. Moreover, ECs are also associated with unfavorable effects on periodontal microbial counts, biomarkers of inflammation and oxidative stress. Vaping may play a role in the initiation and progression of periodontal disease by altering the host response resulting in the release of inflammatory cytokines and periodontal microflora. Clinical studies show deleterious effects of vaping on periodontal health as well as less favourable response to periodontal treatment is observed in e-cigarette users compared to non-smokers. However, compared to cigarette smoking, the effects of vaping are less remarkable.

Evaluation of Salivary Il-38 Levels in Periodontitis: A Cross-Sectional Study.

The goal of the current study was to assess levels of salivary interleukin (IL)-38, IL-1β, and IL-10 in various periodontal clinical conditions. In total, 60 (20 healthy, 20 gingivitis, and 20 stage II-III, grade A-B periodontitis) subjects were included in the study. Demographic and clinical periodontal parameters were recorded. Samples were examined for IL-38, IL-1β, and IL-10 levels by means of enzyme-linked immunosorbent assay. Results demonstrated that the periodontitis group had significantly lower salivary IL-38 levels (P < 0.05) than the healthy group. Salivary IL-10 levels did not differ significantly between the groups (P > 0.05). The salivary IL-1β levels of gingivitis (P < 0.001) and periodontitis groups (P < 0.01) were significantly higher than those of the healthy group. The present study indicated that IL-38 level is decreased in periodontal disease. The results suggested a possible role of IL-38 in the periodontal inflammation process. Clarifying the mechanisms of IL-38 in the inflammatory process may contribute to the development of novel treatment strategies in periodontal diseases.

The periodontal health status of postmenopausal women and its relationship to bone mineral density

The relationship between changes in postmenopausal women and periodontalcondition had been studied in many countries. It has been suggested that estrogendeficiency may play a role in periodontal disease following menopause. The aim ofthis study was to investigate the influence of postmenopausal alteration on the clinicalperiodontal parameters and teeth loss. In addition, to determine the relationshipbetween systemic bone mineral density and periodontal disease in postmenopausal.womenSixty Iraqi women in total were involved in this study, 20 women as a controlgroup of age (35-45) years and forty postmenopausal women divided into two.subgroups: groupl for age (50-60) years and group 2 of age (60-70) years:Questionnaire involved the following periodontal parametersPlaque index (PI), gingival index (GI), bleeding on probing (BOP), pocketdepth (PD), clinical attachment level (CAL). All these parameters were measured andtabulated according to redefined scores, or counts, and the data was analyzed.statistically- Fifteen of forty postmenopausal women, were examined using dual energy xray absorptiometry (DEXA) equipment to measure bone mineral density (BMD) inorder to determine the relationship between (BMD) and any of the above periodontalparameters. The means, Gl, BOP, PD and CAL were found to be significantly higher.)in the postmenopausal group than the control (P&lt;0.05It was found that BMD is negatively associated with Gl, BOP, PD and CALbut the correlation is either of high significant or of slight of difference but notsignificant at (P&lt;0.05). The clinical parameters may increase depending on theexpected negative effects during menopause further, it is concluded that BMD of the.lumbar spine is related to CAL, PD, number of teeth loss and to a lesser extent BOP&#x0D;

Serum levels of antimicrobial peptides (Cathelicidins and Beta Defensins-1) in patients with periodontitis

Background: periodontitis is a multifactorial oral inflammatory disease characterized by the gradual loss of bone and eventual tooth loss. It starts with microbes and is then influenced by the environment. A diverse family of host defense major compounds known as antimicrobial peptides react quickly to combat microbial invasion and challenge. These little cationic peptides are crucial for the development of innate immunity. The goal of this study was to evaluate the blood levels of healthy individuals and patients with periodontitis for cathelicidins and human beta-defensin-1. In this case-control study, 35 healthy volunteers (matched exactly by age and sex to the patients) and 50 periodontitis patients (aged 20 to 59) participated. In this investigation, periodontal parameters such as plaque index, gingival index bleeding on probing, probing pocket depth, and clinical attachment loss were employed. The levels of cathelicidins and human beta-defensin-1 in patients and controls were estimated using ELISA after blood samples from all individuals were taken. The current findings showed that the mean levels of cathelicidin and human beta defensin-1 were significantly higher (P˂0.01) in the patient group compared to the control group, and that there was no significant correlation with all clinical periodontal parameters. These findings support the notion that antimicrobial peptides play a crucial role in periodontitis' inflammatory process.

Association between Gingival Phenotype and Periodontal Disease Severity-A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment.

This longitudinal study aimed to compare the association between gingival phenotype (thin vs. thick) and periodontal disease severity in patients undergoing fixed orthodontic therapy (FOT) and Invisalign treatment over a six-month follow-up period. Clinical periodontal parameters, including full mouth plaque score (FMPS), full mouth bleeding score (FMBS), gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), keratinized tissue width (KTW), transgingival probing, and gingival biotype assessment, were recorded at baseline and 6 months into treatment for both orthodontic groups and a control group. Statistical analysis evaluated differences in parameters between groups and across time points. In the thick phenotype, both Invisalign and FOT groups showed a significant mean reduction in FMPS (baseline to 6 months) by -24.8707 and -12.3489, respectively (p < 0.05). The gingival index decreased significantly for both groups, with Invisalign and FOT showing reductions of -0.83355 and -1.10409, respectively (p < 0.05). FMBS (baseline to 6 months) decreased significantly for Invisalign and FOT, with mean differences of -9.10298 and -12.6579 (p < 0.05). Probing pocket depth (baseline to 6 months) was also significantly reduced for both Invisalign and FOT groups while CAL showed non-significant differences in both groups (p > 0.05). Similar changes were seen in the thin phenotype too. This study highlights the positive influence of both Invisalign and fixed orthodontic therapy on periodontal health, particularly in patients with thin and thick gingival biotypes. These findings, with significant reductions in key periodontal parameters, offer valuable insights to guide orthodontic treatment decisions and enhance patient outcomes.

Effect of non-surgical periodontal therapy on salivary histone deacetylases expression: A prospective clinical study.

To evaluate the effect of non-surgical periodontal therapy (NSPT) on salivary histone deacetylases (HDACs) gene expression in patients with Stage III-IV periodontitis at baseline and at 3 and 6 months post NSPT treatment. Twenty patients completed the study. Periodontitis (as well as the corresponding staging and grading) was diagnosed according to the 2017 World Workshop Classification. Clinical measures were recorded and whole unstimulated saliva was collected at baseline and at 3 and 6 months after NSPT. The expression of 11 HDACs was determined using reverse-transcription PCR, and the respective changes over time were evaluated. Six months after NSPT, significant improvements in all clinical periodontal parameters were observed, concomitant with significant up-regulation of HDAC2, 4, 6, 8, 9 and 11 expressions. Subgroup analyses of non-responders and responders revealed no significant differences in HDACs mRNA expression between groups at any time point. This prospective clinical study identifiedlongitudinal changes in salivary HDACs expression in response to NSPT, which provides new insights into the epigenetic mechanisms underlying the pathobiology of periodontitis and creates avenues for the discovery of novel biomarkers.

Associations between immune-inflammatory markers, age, and periodontal status: a cross-sectional study.

Since periodontal disease is associated with many systemic diseases, it is important to evaluate its effects on host responses in elderly individuals. To this end, this study investigated salivary interleukin (IL)-17, IL-18, toll-like receptor (TLR) 2, TLR4, and tumor necrosis factor-alpha (TNF-α) levels in patient groups with different periodontal health statuses and immunologically evaluated the relationship between age and periodontal health status. A total of 60 individuals aged 18-40years (young individuals) and 60 individuals aged 65years or older (elderly individuals) were included in this study. According to periodontal disease status, the patients were divided into periodontally healthy, gingivitis, and periodontitis subgroups. Clinical periodontal parameters, including probing depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI), were recorded. Saliva samples were collected and analyzed using ELISA to determine the levels of IL-17, IL-18, TLR2, TLR4, and TNF-α. Higher clinical periodontal parameter (PD, CAL, PI, and GI) and inflammatory marker (IL-17, IL-18, TNF-α, TLR2, and TLR4) levels were found in patients with periodontitis than those in periodontally healthy individuals and patients with gingivitis (P < 0.05). Salivary inflammatory marker levels were significantly higher in elderly individuals than those in young individuals in all subgroups (P < 0.05). A positive correlation was found between inflammatory marker levels and clinical periodontal parameters, but there was no correlation between TLR2 and PI or GI. This study suggests a significant increase in host response to periodontal disease as the disease progresses, with the levels of cytokines and TLR expression exhibiting an increasing trend with age. Increased IL-17, IL-18, TLR2, TLR4, and TNF-α levels in elderly individuals in all periodontal health subgroups might suggest the role of these cytokines and TLR pathway in the pathogenesis of periodontal diseases.

Effect of Glycine Subgingival Sandblasting on the Incidence of Peri-Implantitis and Expression of Inflammatory Factors in Gingival Crevicular Fluid in Patients with Titanium-Nickel-Chromium Alloy Porcelain-Fused-To-Metal Crowns

This research was aimed to demonstrate impacts of glycine subgingival sandblasting on peri-implantitis (PI), periodontal clinical parameters, and inflammatory factor expression in gingival crevicular fluid (GCF) in patients with titanium-nickel-chromium (TiNiCr) alloy porcelain-fused-to-metal crown (APC) restorations. A total of 159 patients with TiNiCr APCs were randomly rolled into glycine subgingival sandblasting group (Exp 1 group), erythritol subgingival sandblasting group (Exp 2 group), and conventional scaling and root planing (SRP) treatment group (Con group), with 53 patients in each group. The quantity of oral biofilm was assessed based on plaque staining, and the plaque index (PLI), bleeding index (BI), probing depth (PD), and clinical attachment level (CAL) preoperatively (baseline) and at 3-, 6-, and 12-months postoperatively in various groups were compared. Microbial species and quantities in the GCF were determined using microbial counting, and the incidence of PI postoperatively was calculated in each group. The inflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-6 in the GCF were measured using enzyme-linked immunosorbent assay (ELISA). The results showed that at 3-, 6-, and 12-months postoperatively, the PLI, BI, PD, CAL, TNF-α, IL-1β, and IL-6 in Exp 1 group were dramatically inferior to those in Con group (P &lt; 0.01). The PLI, BI, PD, CAL, bacterial counts (rods, cocci, and spirochetes) in Exp 2 group were inferior to those in Con group (P &lt; 0.05) at the same time points. Furthermore, the PLI, BI, PD, CAL, TNF-α, IL-1β, and IL-6 in Exp 1 group were inferior to those in Exp 2 group (P &lt; 0.05) at 3-, 6-, and 12-months postoperatively. The incidence of PI postoperatively in Exp 1 and Exp 2 groups was 5.66% and 3.77%, respectively, which was dramatically inferior to Con group’s incidence of 9.43% (P &lt; 0.05). These findings indicate that glycine subgingival sandblasting can greatly enhance the periodontal condition of patients undergoing TiNiCr APC restorations, reduce the incidence of PI, and lower the levels of inflammatory factors in the GCF.

Clinical relevance of distolingual roots and periodontal status in mandibular first molars: a cross-sectional study employing CBCT analysis.

OBJECTIVES: Distolingual root of the permanent mandibular first molar (PMFM-DLR) has been frequently reported, which may complicate the treatment of periodontitis. This study aimed to assess the morphological features of PMFM-DLR and investigate the correlation between the morphological features of PMFM-DLR and periodontal status in patients with Eastern Chinese ethnic background. MATERIALS AND METHODS: A total of 836 cone beam computed tomography (CBCT) images with 1497 mandibular first molars were analyzed to observe the prevalence of PMFM-DLR at the patients and tooth levels in Eastern China. Among them, complete periodontal charts were available for 69 Chinese patients with 103 teeth. Correlation and regression analyses were used to evaluate the correlation between the morphological features of DLR, bone loss, and periodontal clinical parameters, including clinical attachment loss (CAL), probing pocket depth (PPD), gingival recession (GR), and furcation involvement (FI). RESULTS: The patient-level prevalence and tooth-level prevalence of DLR in mandibular first molars were 29.4% and 26.3%, respectively. Multiple linear regression analysis suggested that bone loss at the lingual site and CAL were negatively affected by the angle of separation between distolingual and mesial roots in the transverse section, while they were significantly influenced by age and the angle of separation between distobuccal and mesial roots in the coronal section. CONCLUSIONS: The prevalence of PMFM-DLR in Eastern China was relatively high in our cohort. The morphological features of DLR were correlated with the periodontal status of mandibular first molars. This study provides critical information on the morphological features of DLR for improved diagnosis and treatment options of mandibular molars with DLR.