Periodontal Tissues Research Articles

Insertion axis in removable prosthesis: a preliminary report.

Removable partial denture (RPD) is still a widely used prosthesis today to solve non-implant cases, despite its aesthetic contraindications. The aim of the following work is to evaluate how much the communication and explanation to the patient of the insertion axis of the removable partial prosthesis in the periodontium and teeth has an impact on his degree of acceptance of the aesthetic limits of this prosthesis. For this study, 150 patients were examined from 10 dentists, 5 in Lombardy and 5 in Sicily, using inclusion criteria and exclusion criteria. All selected patients required removable partial dentures. The data was obtained by completing 2 questionnaires, at three different times, at prosthesis delivery, at 6 and 12 months. Questionnaires highlighted overlapping data in the two regions and a total absence of communication of the insertion axis by the dental technician laboratories was highlighted with a percentage of 100%. 28% of the patients complained of pain during the insertion of the prosthesis at 12 months and 39.33% of patients had mobility of remaining teeth with clasps at 12 months. All patients experienced no discomfort, and no important data were reported at the first 6-month follow-up. For mobile partial dentures, respecting the insertion axis can improve the predictability of the periodontal tissue and the resistance of the remaining teeth with clasps. The drawing of an arrow in the model shows the insertion axis of the prosthesis. It would be desirable to include information regarding the insertion axis and advice for the management of the removable partial denture in the first days of use in the declaration of conformity given to the doctor and to thepatient, in the indications section. It can be said that correct insertion of the removable partial denture, helped by verbal and written instructions from the doctor, can reduce possible periodontal alterations of the remaining teeth, by eliminating spurious stresses during insertion and removal of the prosthesis.

Research Progress on the Application of Injectable Hydrogel in Oral Tissue Regeneration.

Oral and maxillofacial tissue defects resulting from factors such as trauma or infection, can significantly impact both facial function and aesthetics. Additionally, the complex anatomical structure of the face often increases the difficulty of treatment. With the advantages of controlled release, targeted delivery, and enhanced mechanical properties, injectable hydrogels have been investigated for the treatment of oral and maxillofacial diseases. In the field of regeneration, injectable hydrogels have a structure similar to the extracellular matrix (ECM) and are biocompatible, which can be used as scaffolds for tissue regeneration. This review aims to summarize the literature on the current status and limitations of injectable hydrogels in the field of oral tissue regeneration. We searched Pubmed and Web of Science databases to find and summarize the articles on the application of injectable hydrogels in tissue regeneration. This review focuses on the current status and limitations of injectable hydrogels in the field of tissue regeneration (periodontal tissue, dentin-pulp complex, bone and cartilage, salivary gland regeneration, and mucosal repair). Although fully studied in animal models, there are still challenges in clinical transformation of injectable hydrogels in promoting tissue regeneration.

The Effect of Corticotomy-Assisted Orthodontic Therapy (CAOT) or Periodontally Accelerated Osteogenic Orthodontics (PAOO) on Bone Remodeling and the Health of Periodontium: A Systematic Review of Systematic Reviews.

Background: Orthodontic treatment involves moving teeth within the alveolar ridge. Bone remodeling is associated with the activity of osteoblasts and osteoclasts. Procedures such as corticotomy-assisted orthodontic therapy (CAOT) or periodontally accelerated osteogenic orthodontics (PAOO) are intended to reduce bone density and negative stress on the grip side and therefore limit bone resorption during orthodontic movement or add bone substitute material so that the tooth does not cross the vestibular plate. Methods: The study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The study design was defined in the PICO format-Population (P): patients with full permanent dentition, both adolescents and adults; Intervention (I): orthodontic treatment with fixed appliances using additional supportive treatments such as CAOT or PAOO; Comparison (C): assessment of the impact of additional treatments during orthodontic treatment on the remodeling of the alveolar bone and the condition of the periodontium; Result (O): statistically significant/non-significant differences in the condition of the alveolar bone before and after orthodontic treatment. Search filters include the time of publication of the article, systematic reviews from the last five years, and publications that appeared in English. The information provided in the abstracts of systematic reviews that describe the effects of additional procedures during orthodontic treatment such as CAOT or PAOO on the health of periodontium was analyzed. Articles unrelated to the subject of the planned study and those in which tooth movement acceleration was analyzed were excluded. Results: Eight articles were selected in which a total number of 835 subjects took part. The changes in bone density and effects on periodontium were different after CAOT and PAOO. Conclusions: The validity of CAOT and PAOO procedures remains controversial. Better results are obtained when combined with tissue augmentation or thickening of the gingival phenotype rather than as stand-alone procedures, as their uses to protect periodontal tissues are limited.

Dual role of Sfrp4 in bone remodelling during orthodontic tooth movement.

The objective of this study was to determine changes in gene expression by establishing an orthodontic tooth movement (OTM) rat model with appropriate and excessive orthodontic force. Using a closed coil nickel-titanium spring, the OTM was carried out to apply a mesial force of 50 or 100 g to the maxillary first molars. Micro-CT, histological and immunohistochemical staining were used to evaluate the bone formation at the tension site and the bone resorption and bone formation at pressure site. Then RNA sequencing and bioinformatic analysis were performed. According to the results of the Mirco-CT scan of OTM rat models, both the 50 g group and the 100 g group showed variable degrees of reduction in alveolar bone density on the tension and pressure sides. The results of histological and immunohistochemical staining demonstrated that the periodontal tissue and osteogenic ability of the 50 g group were restored at the 14 days, while the 100 g group caused severe periodontal tissue damage. The GO and KEGG analysis results, as well as the number of differentially expressed genes (DEGs), varied depending on the loading time and value of appliance, according to the results of the RNA sequencing. And the immunohistochemical staining results showed that Sfrp4 functioned by efficiently influencing both bone formation and bone absorption. Appropriate orthodontic force value could cause appropriate movement of teeth in rats without adverse periodontal damage. Simultaneously, distinct gene expression patterns were observed at various force levels and time intervals.

High glucose promotes lipopolysaccharide-induced macrophage pyroptosis through GSDME O-GlcNAcylation.

The high glucose (HG) environment in diabetic periodontitis aggravates the damage of periodontal tissue. Pyroptosis has been shown to be positively correlated with the severity of periodontitis, including macrophage pyroptosis. O-GlcNAcylation is a posttranslational modification that is involved in the pathogenesis of periodontitis. However, whether HG regulates macrophage pyroptosis through O-GlcNAcylation remains uncertain. This study aimed to investigate the effect of HG on the O-GlcNAcylation level of a pyroptosis regulator GSDME in macrophages to further probe the mechanisms of diabetic periodontitis. Blood samples were collected from patients with diabetic periodontitis. THP-1 monocytes were induced to differentiate into macrophages by phorbol 12-myristate 13-acetate and then treated with HG to simulate periodontitis invitro. GSDME expression of blood samples and macrophages was measured by quantitative real-time PCR. Pyroptosis was assessed by propidium iodide staining, measurement of cell viability, cytotoxicity, protein levels of inflammation factors, and pyroptosis-related proteins. O-GlcNAcylation of GSDME was analyzed using co-immunoprecipitation (co-IP), IP, and western blot. The results showed that GSDME expression was elevated in patients with periodontitis and HG-treated macrophages. HG inhibited cell viability but increased LDH content, levels of IL-1β, IL-18, TNF-α, NLRP3, GSDMD, and Caspase-1, indicating that HG promoted pyroptosis of macrophages, which was reversed by GSDME knockdown. HG treatment increased O-GlcNAcylation in macrophages. Mechanically, GSDME interacted with OGT, and OGT knockdown suppressed O-GlcNAcylation of GSDME at Ser (S)339 site. Knockdown of OGT inhibited pyroptosis in HG-treated macrophages, while GSDME overexpression partially reversed this inhibition. HG treatment enhanced OGT-mediated GSDME O-GlcNAcylation, thereby augmenting pyroptosis in LPS-induced macrophages. These results may provide a novel sight for the treatment of periodontitis.

Inflammation indices in association with periodontitis and cancer.

Inflammation is a complex physiological process that plays a pivotal role in many if not all pathological conditions, including infectious as well as inflammatory diseases, like periodontitis and autoimmune disorders. Inflammatory response to periodontal biofilms and tissue destruction in periodontitis is associated with the release of inflammatory mediators. Chronic inflammation can promote the development of cancer. Persistence of inflammatory mediators plays a crucial role in this process. Quantification and monitoring of the severity of inflammation in relation to cancer is essential. Periodontitis is mainly quantified based on the severity and extent of attachment loss and/or pocket probing depth, in addition with bleeding on probing. In recent years, studies started to investigate inflammation indices in association with periodontal diseases. To date, only few reviews have been published focusing on the relationship between blood cell count, inflammation indices, and periodontitis. This review presents a comprehensive overview of different systemic inflammation indices, their methods of measurement, and the clinical applications in relation to periodontitis and cancer. This review outlines the physiological basis of inflammation and the underlying cellular and molecular mechanisms of the parameters described. Key inflammation indices are commonly utilized in periodontology such as the neutrophil to lymphocyte ratio. Inflammation indices like the platelet to lymphocyte ratio, platelet distribution width, plateletcrit, red blood cell distribution width, lymphocyte to monocyte ratio, delta neutrophil index, and the systemic immune inflammation index are also used in hospital settings and will be discussed. The clinical roles and limitations, relationship to systemic diseases as well as their association to periodontitis and treatment response are described.

Bmi‐1 alleviates alveolar bone resorption through the regulation of autophagy

AbstractBackgroundB‐cell‑specific Moloney MLV insertion site‐1(Bmi‐1)is a crucial osteopenic target molecule. The aim of this study is to explore the effects of Bmi‐1 on alveolar bone resorption and the underlying mechanisms in vitro and vivo.MethodsA Bmi‐1‐knockout (Bmi‐1−/−) mouse model was used to investigate the effect of Bmi‐1 on alveolar bone metabolism, with micro‐computed tomography imaging, histology, and immunohistochemistry staining. Furthermore, we utilized a ligature‐induced experimental periodontitis model to examine the impact of Bmi‐1‐knockdown (Bmi‐1±) on inflammatory alveolar bone resorption. Finally, we stimulated human periodontal ligament stem cells (hPDLSCs) with lipopolysaccharide (LPS) to explore the potential mechanism of Bmi‐1 overexpression in the process of osteogenesis.ResultsCompared with wild‐type mice, Bmi‐1−/− mice demonstrated more alveolar bone resorption by inhibiting osteogenesis, which was characterized by decreases in Runt‐related transcription factor 2 and type 1 collagen formation. In addition, Bmi‐1−/− mice had lower levels of autophagy markers such as Parkin and LC3, but higher levels of inflammation‐related factors such as interleukin (IL)‐6 and IL‐1β in periodontal tissues. In addition, Bmi‐1‐knockdown aggravated ligature‐induced alveolar bone loss. Under in vitro inflammatory conditions, Bmi‐1 overexpression stimulated osteoblast differentiation and inhibited the production of inflammatory factors, as well as the autophagy and apoptosis in hPDLSCs stimulated with LPS. When 3‐methyladenine (3‐MA), an autophagy inhibitor, was added, the osteogenic effect of Bmi‐1 was further enhanced.ConclusionsBmi‐1 alleviates alveolar bone resorption by regulating autophagy, indicating that it could be a potential target for periodontitis prevention and treatment.Plain Language SummaryPeriodontitis is a chronic inflammatory disease, which leads to progressive destruction of periodontal tissues, manifested as periodontal pocket formation, loss of periodontal attachment and alveolar bone resorption. Currently, there is a lack of effective treatments to regenerate damaged periodontal tissues. Therefore, it is of great clinical significance to explore new mechanisms of periodontitis and effective intervention targets. B‐cell‑specific Moloney MLV insertion site‐1 (Bmi‐1) is involved in the regulation of the cell cycle, DNA damage repair, autophagy, bone metabolism, tumor, and other physiopathological processes. Autophagy, as an important mechanism of intracellular self‐regulation, plays an indispensable role in the destruction and repair of periodontal tissues. The aim of this study was to investigate the role of Bmi‐1 on periodontal tissues and its intrinsic mechanism. The results revealed that Bmi‐1 regulates autophagy to protect periodontal tissues, suggesting that it may be a potential target for the prevention and treatment of periodontitis.

Serum vitamin D concentration is inversely associated with matrix metalloproteinase‐9 level in periodontal diseases

AbstractBackgroundThe aim of this study was to investigate the potential association between vitamin D deficiency and matrix metalloproteinase‐9 (MMP‐9) levels in gingival crevicular fluid (GCF) across various periodontal health and disease statuses.MethodsA total of 200 volunteers were divided into two groups according to serum vitamin D concentration (25(OH)D < 10 ng/mL and 25(OH)D ≥ 10 ng/mL). Periodontal health status was determined based on a full‐mouth periodontal examination and radiographic evaluation. Participants in both groups were categorized according to periodontal diagnoses, encompassing periodontal health, gingivitis, and periodontitis. Following sampling, the MMP‐9 levels in GCF were determined by the enzyme‐linked immunosorbent assay (ELISA) method.ResultsThe GCF MMP‐9 levels were found to be higher in individuals with serum 25(OH)D < 10 ng/mL, in both the healthy and gingivitis and periodontitis groups, compared to those with 25(OH)D ≥ 10 ng/mL. Nevertheless, a statistically significant distinction was observed exclusively within the gingivitis and periodontitis groups. Correlation analysis and robust regression analyses provided additional evidence supporting the predictive role of periodontal disease status and vitamin D concentration in local MMP‐9 levels. These associations remained significant after adjusting for age and sex in robust regression analysis (p = 0.002). Furthermore, the inclusion of periodontal clinical parameters in the regression analysis revealed notable associations of clinical attachment loss with local MMP‐9 levels, along with periodontal disease status and serum vitamin D concentration (p < 0.001).ConclusionThe findings of our study suggest a potential mechanistic relationship between serum vitamin D levels and periodontitis.PLAIN LANGUAGE SUMMARYVitamin D deficiency is a widespread issue globally due to urban living, less outdoor time, seasonal changes, aging, and sunscreen use, leading to inadequate sun exposure. Low vitamin D levels are linked to several health problems, including hypertension, diabetes, heart diseases, and periodontal diseases, which affect the gums and bones around teeth and can cause tooth loss if untreated. Although the link between vitamin D and periodontal disease is unclear, it may involve the enzyme matrix metalloproteinase‐9 (MMP‐9). Our study examined 200 people, dividing them into two groups based on vitamin D levels. We assessed their gum health and measured MMP‐9 levels in their gingival crevicular fluid, a liquid that seeps out from the tiny space between gums and teeth. We found that people with lower vitamin D levels had higher MMP‐9 levels, especially those with gum disease. Our analysis showed that both vitamin D levels and gum health significantly impact MMP‐9 levels, with gum health being the more influential factor. Maintaining good gum health and adequate vitamin D levels is crucial for managing MMP‐9, an enzyme critical for tissue remodeling during healing and inflammation. However, excessive MMP may rapidly destroy periodontal tissues.

Immediate and Successful Management of Avulsed Teeth: A Case Reports

Avulsion and midroot fractures of teeth present significant challenges in dental trauma management. These case reports outlines the successful management of avulsed after a lapse of 2hrs in 1st case report and 24hrs in 2nd case report and midroot fractured tooth, focusing on immediate steps, long-term strategies, and clinical considerations. Midroot fractures often present with compromised structural integrity, necessitating stabilization and protection of the tooth to prevent further damage. Splinting techniques stabilize the tooth and promote healing of periodontal tissues. However, careful monitoring is crucial to assess for potential complications such as inflammatory root resorption and external root resorption. In both the cases extraoral root canal treatment was done for avulsed tooth and then reimplanted into the socket and stabilisation was done using splinting. Followup up was done at regular intervals of one and 3 months which showed no resorption or perapical changes, lack of clinical symptoms In conclusion, the management of avulsed and midroot fractured teeth requires long-term treatment strategies. Favorable outcomes can be achieved, preserving tooth function, and esthetics in patients with traumatic dental injuries.

ANXA2 promotes osteogenic differentiation and inhibits cellular senescence of periodontal ligament cells (PDLCs) in high glucose conditions.

Periodontal ligament cells (PDLCs) are a major component of the periodontal ligament and have an important role in the regeneration of periodontal tissue and maintenance of homeostasis. High glucose can affect the activity and function of PDLCs in a variety of ways; therefore, it is particularly important to find ways to alleviate the effects of high glucose on PDLCs. Annexin A2 (ANXA2) is a calcium- and phospholipid-binding protein involved in a variety of cellular functions and processes, including cellular cytokinesis, cytophagy, migration, and proliferation. The aim of this study was to exploring whether ANXA2 attenuates the deleterious effects of high glucose on PDLCs and promotes osteogenic differentiation capacity. Osteogenic differentiation potential, cellular senescence, oxidative stress, and cellular autophagy were detected. Culturing PDLCs with medium containing different glucose concentrations (CTRL, 8 mM, 10 mM, 25 mM, and 40mM) revealed that high glucose decreased the protein expression of ANXA2 (p<0.0001). In addition, high glucose decreased the osteogenic differentiation potential of PDLCs as evidenced by decreased calcium deposition (p=0.0003), lowered ALP activity (p=0.0010), and a decline in the expression of osteogenesis-related genes (p=0.0008). Moreover, β-Galactosidase staining and expression of p16, p21 and p53 genes showed that it increased cellular senescence in PDLCs (p<0.0001). Meanwhile high glucose increased oxidative stress in PDLCs as shown by ROS (p<0.0001). However, these damages caused by high glucose were inhibited after the addition of 1 µM recombinant ANXA2 (rANXA2), and we found that rANXA2 enhanced autophagy in PDLCs under high glucose conditions. Therefore, our present study demonstrates that alterations in ANXA2 under high glucose conditions may be a factor in the decreased osteogenic differentiation potential of PDLCs. Meanwhile, ANXA2 is associated with autophagy, oxidative stress, and cellular senescence under high glucose conditions.

Assessment of Risk Factors and Prognostic Predictors for Endo-Perio Lesions in Indian Cohorts: An Observational Study.

Endodontic and periodontal tissues exhibit a significant interrelationship, whereby pathologies affecting one tissue can precipitate the involvement of the other. The primary objective of this study was to assess the risk factors associated with endo-perio lesions (EPLs). The secondary objective was to assess the prognostic predictors for such lesions and the prevalence rate of EPLs involving both pulpal and periodontal tissues in Indian cohorts. A prospective observational study was conducted on 2170 teeth with EPLs in Indian adults aged > 18 years. A detailed history of smoking, tobacco chewing, and the development of EPLs was obtained from all patients. Detailed periodontal and endodontic examinations were conducted by two calibrated examiners. Intraoral periapical radiographs (IOPAs) were obtained to diagnose EPLs. The chi-square test of association was used to analyze the association between independent and dependent variables, and the strength of association was presented by Pearsoncontingency coefficient (r). Logistic regression analysis was performed to identify reliable factors for diagnosing EPLs. A statistical significance threshold of 0.05 was established. The prevalence of EPLs involving pulpal and periodontal tissues was 29.49%. Type 1 lesions (EPLs involving only pulpal tissue) were most commonly seen at 41-45 years of age, type 2 lesions (EPLs involving primary pulpal and secondary periodontal tissue), and type 3 lesions (EPLs involving only periodontal tissue) at 26-30 years of age, and type 4 lesions (EPLs involving primary periodontal and secondary pulpal tissue) at 31-35 years of age. The pulp was found to be non-vital in all cases of type 3 lesions, and faulty restoration or improper root canal treatment (RCT) was the main risk factor for such lesions. Occupational trauma was found to be the most common risk factor for type 3 and type 4 lesions. Smoking, age, tooth type, occlusal trauma, faulty restorations and RCT, presence of caries, periapical pathology, periodontitis, bone loss, and pulp vitality were significantly associated with EPLs. Pulp vitality and bone loss were two prognostic predictors of EPLs.

Basic principles of treatment and follow-up of children with acute odontogenic infection and insulin-dependent diabetes mellitus

The purpose of the study is to substantiate the basic principles of treatment and clinical dental observation of children with acute odontogenic inflammatory disease and insulin-dependent diabetes mellitus as an accompanying disease. Material and methods. A medical examination was conducted for 213 children who were treated at the St. Petersburg city children’s hospital of K.A. Raukhus of. The dental status of children with insulin-dependent diabetes mellitus and children of the control group without concomitant diseases was assessed using the Fedorov-Volodkina index, the KPU index and analysis of the caries intensity according to the T.F. Vinogradova table, periodontal conditions according to the PMA index (papillary-marginal-alveolar). The state of microhemocirculation of periodontal tissues was also assessed using Doppler ultrasound and the use of a reflex cold test. In children diagnosed with “Acute odontogenic osteomyelitis of the jaws,” laboratory blood parameters, the composition of the microbial flora of wound discharge, and the length of hospitalization were studied. Results. Based on the data obtained, an algorithm for treatment and dispensary dental observation of children with diabetes was presented. The detection of diabetes mellitus in children of any age should be accompanied by increased attention to the dental health of these patients. If teeth affected by caries are identified during a preventive examination, immediate treatment is required. It is necessary to ensure constant follow-up of the child by an endocrinologist. Doppler examination of the microhemocirculatory bed vessels of the mucosa of the alveolar process of the jaw revealed that an adequate response to a reflex cold test was detected only in the control group patients, those who do not have insulin-dependent diabetes mellitus. With the development of acute odontogenic osteomyelitis of the jaw in children suffering from insulin-dependent diabetes mellitus, hospitalization is necessary when the first clinical symptoms of the inflammatory process appear. Immediately after hospitalization and immediate surgical sanitation of a purulent focus of infection in the oral cavity, drug therapy should be started: antibacterial, infusion, symptomatic, as well as insulin therapy. The results of this study are especially relevant in the treatment of children with a duration of insulin-dependent diabetes mellitus of more than 5 years and a decompensated course of endocrine disease. Conclusions. The results of the study allowed us to expand our understanding of the impact of diabetes on the oral health of children, to establish risk factors for the development of acute odontogenic osteomyelitis of the jaws in children of different age categories with insulin-dependent diabetes mellitus, as well as the characteristics of the course of odontogenic osteomyelitis of the jaws in each of the cases. Based on the identified features, the principles of diagnosis and treatment of acute odontogenic osteomyelitis of the jaws in children with insulin-dependent diabetes mellitus have been formulated.

Understanding the hierarchical structure of collagen fibers of the human periodontal ligament: Implications for biomechanical characteristics

The periodontal ligament (PDL) is a unique fibrous connective tissue that regulates periodontal homeostasis mechanisms. Its biomechanical properties primarily reside in the hierarchical and non-uniform collagenous network. This study aimed to investigate the region-specific structure and composition of collagen fibers in the PDL at various scales and to explore their relationship with mechanical properties in a split-mouth design. Fresh human cadaver transverse PDL specimens of maxillary anterior teeth were categorized into cervical, middle, and apical groups. These specimens were analyzed via Masson’s trichrome staining, scanning electron microscopy, picrosirius red (PSR) staining, three-dimensional (3D) reconstruction, Raman spectroscopy, and uniaxial tensile test. Statistical analyses were performed to compare the structural, compositional, and tensile properties among the groups. Notably, the middle PDL samples exhibited superior tensile strength and higher fiber area fraction than the other two transverse sections. Despite a higher mineral-to-matrix ratio and a different collagen secondary structure, the apical PDL demonstrated a relatively weaker tensile strength, possibly associated with its discovered sparser collagen fiber areal fraction. The cervical region, characterized by a mediocre fiber areal fraction, displayed diminished tensile strength. The 3D reconstructed collagenous network model and PSR staining exposed the fiber interaction and the micropores. Microscale porosity and variations in collagen secondary structure, particularly in the apical region, suggest adaptive mechanisms for accommodating compressive forces and maintaining functional integrity. Variance in the tensile properties of samples in different force directions indicated the significant influence of fiber orientation and root level on tissue mechanics. Statement of significanceThis study provides critical insights into the biomechanical and structural properties of the human periodontal ligament (PDL), particularly focusing on the underexplored anterior teeth. Through advanced techniques like SEM, histological staining, 3D reconstruction, Raman spectroscopy, and tensile testing, we reveal significant regional variations in PDL collagen organization, composition, and biomechanical properties. Our findings address a crucial knowledge gap concerning the material mechanics of the PDL, offering a foundational understanding for future periodontal tissue engineering and biomimetic material development. This multi-scale analysis underscores the importance of both mesoscale structural characteristics and nanoscale molecular structures in maintaining PDL mechanical integrity.

Effects of Platelet-Rich Plasma Injections on Periodontal Health During Accelerated Orthodontic Tooth Movement.

The interplay between orthodontics and periodontics is crucial for successful orthodontic treatment. Accelerating orthodontic tooth movement (OTM) can enhance treatment efficiency, but it is important to assess the impact of such methods on periodontal health. Platelet-rich plasma (PRP) has emerged as a promising adjunct in accelerating OTM, but its effects on periodontal health require further investigation. This study aimed to evaluate the impact of PRP injections on periodontal health during accelerated OTM by comparing clinical and biochemical parameters between a PRP-enhanced orthodontic treatment group and a conventional orthodontic treatment group. In this randomized controlled trial, 40 participants with anterior teeth crowding were divided into two groups: the PRP group (n = 20), which received standard orthodontic treatment with PRP injections, and the control group (n = 20), which received standard orthodontic treatment alone. Periodontal parameters, including periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and gingival recession (GR), were recorded at baseline, four, eight, and 12 weeks. Salivary aspartate aminotransferase (AST) levels were measured at baseline, one hour, 24 hours, seven days, and 14 days post treatment. No statistically significant differences were found between the PRP and control groups regarding periodontal parameters (PPD, CAL, BOP, and GR) and AST enzyme levels throughout the study period. Both groups exhibited slight increases in PPD, CAL, GR, and BOP over time, consistent with typical orthodontic effects. AST levels showed fluctuations but no significant differences between the groups. PRP injections did not demonstrate significant advantages over conventional orthodontic treatment in terms of periodontal health or AST enzyme levels. This suggests that PRP is a safe and non-inferior method for accelerating OTM without adversely affecting periodontal tissues. Further research with larger sample sizes and longer follow-ups is recommended to validate these findings and explore the long-term effects of PRP.

Scaffolds in periodontal regeneration- A brief review

The periodontium constitutes the supportive framework of a tooth, comprising the integration of the periodontal ligament, cementum, gingiva, and alveolar bone. The periodontium's health is compromised by the infiltration of bacteria due to local or systemic factors. Untreated periodontal disease can lead to the loss of attachment and eventual tooth loss, necessitating effective therapy. Tissue engineering is a multidisciplinary approach that combines engineering techniques with life sciences principles to generate biological substitutes for damaged tissues, aiming to restore, maintain, or enhance their function. In recent years, various scaffolding technologies have emerged, transitioning from monophasic to multi-phasic/bioactive scaffold systems, with the goal of three-dimensional regeneration of periodontal tissue rather than mere promotion of healing. This review discusses tissue engineering principles, materials, and recent advancements in scaffold design for periodontal tissue regeneration, along with their efficacy tested both in vitro and in vivo.

DIABETES MELLITUS AND ITS IMPACT ON THE STATE OF THE ORAL CAVITY IN CHILDREN

Today, the number of people with diabetes is growing in all age groups both in our country and around the world. Diabetes is one of the most serious diseases in terms of its course and complications. It is known that diabetes destroys all types of metabolism, changes cellular and humoral immunity, is characterized by persistent hemorrhagic and neuromodulatory disorders, and slows down regenerative and reparative processes. The development of diabetic complications is associated with hyperglycemia and pathological changes in the vascular and peripheral nervous system. Studies by Ukrainian and foreign scientists have repeatedly shown that the child's body is an integral system and that endocrine disorders are accompanied by changes in various organs and systems, including the dentition. Although periodontal tissues are the main affected organ, other dental lesions, such as caries, inflammatory and infectious diseases of the oral mucosa and salivary glands. They are more common in diabetic patients than in children without somatic lesions. The first and most common symptoms in diabetic patients are dry mouth (xerostomia) and dry lips due to dehydration with polyuria, which is especially noticeable in children with worsening diabetes. Inflammatory periodontal diseases and inflammatory-dystrophic periodontal diseases occupy a special place among the symptoms of diabetes in the oral cavity in diabetic children. Vascular damage is of prime importance in the development of periodontal tissue inflammation in diabetic patients. Microangiopathy in diabetes mellitus enhances the process of bone resorption. The analysis of scientific material shows that there are significant pathological changes in the oral cavity of children with diabetes mellitus, which increase the dynamics of the disease and worsen its course. Therefore, the planning of dental treatment of patients with diabetes at each clinical stage should be based on a clear understanding of all etiological relationships, manifestations of various forms of diabetes in the oral cavity and their relationship with the corrected state of carbohydrate metabolism. A literature search was conducted using the databases Web of Science, Scopus, The Cochrane Library, MedLine, EMBASE and Global Health.

THE IMMUNOMODULATORY ROLE OF CYTOKINES IN THE PATHOGENESIS OF PERIODONTAL DISEASE

Background:Inflammatory periodontal diseases are one of the most acute problems of modern dentistry, which is associated with their widespread prevalence in the world. In the structure of periodontal diseases, periodontitis a leading place in the age group of 40-50 years. Many factors play a role in the etiology of periodontitis, the most important of which are the local microbiota and the host immune response. Cytokines play an extremely important role. Cytokines are key modulators of both homeostasis and inflammatory processes, acting in the first wave of responses against pathogens, stimuli at barrier sites and linking tissue cells to lymphocytes and additional cell populations. Objective:The aim of the study was to analyze modern literature on the role of cytokines in the etiology and pathogenesis of inflammatory periodontal diseases. Materials and methods:Data Extraction: A comprehensive electronic literature search was performed in the following databases:PubMed, Scopus,Web of Scienc, Google Scholar, EBSCO host from 2000 to 2024 terms: periodontitis, infection, inflammation, immunity, cytokines, interleukin. 124 articles were found and 50 full-text articles of high methodological quality were selected according to the review method used, the PRISMA. Inclusion criteria:included clinical trials, considered randomized controlled trials, cross-sectional studies, casecontrol studies, and cohort studies in human subjects that evaluated the current literature on the periodontitis, infection, inflammation, immunity, cytokines, interleukin written in English articles.There was no limitation on minimal quality, minimal sample size, or the number of patients. Exclusion criteria were:original primary studies, due to language limitations , abstracts, letters to the editor, book chapters, case reports, conference abstracts, duplicate publications, and in vitro and in vivo animal experimental studies. Result:Many factors of general and local origin are involved in the development and progression of inflammatory periodontal diseases. Microorganisms and their products cause activation of the host immune system, which results in the release of cytokines and other proinflammatory biomarkers that cause tissue damage. The inflammatory process in periodontal tissues progresses through various stages, beginning with the infiltration of immune cells into the gingival tissue. Immune cells secrete proinflammatory cytokines such as interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α),which further promote inflammation and tissue destruction. The interaction between bacterial biofilm and the immune response, which is mainly controlled by cytokines, determines the course of periodontal disease. Conclusion:The etiology and pathogenesis of periodontal disease is quite complex, diverse and not yet fully disclosed. Cytokines are control and modulate the immune response in periodontitis

The expression of signal regulatory protein alpha (SIRPα) in periodontal cells and tissue.

Signal regulatory protein alpha (SIRPα) is mainly expressed by cells of myeloid origin. This membrane glycoprotein is shown to be involved in regulation of different inflammatory conditions, such as colitis and arthritis. However, SIRPα has not been investigated in relationship to periodontitis, an inflammatory condition affecting the tooth supporting tissues. We aim to investigate if resident cells in the periodontium express SIRPα and whether a possible expression is affected by inflammatory conditions. Primary human keratinocytes, fibroblasts, periodontal ligament cells, and osteoblasts were cultured with or without the pro-inflammatory cytokines tumor necrosis factor alpha (TNF-α) or interleukin-1-beta (IL-1β). All different periodontal cell types showed a basal mRNA expression of SIRPα. Pro-inflammatory cytokines induced a 2-3-fold significant increase in SIRPα expression in both cultured human gingival fibroblasts and osteoblasts but neither in keratinocytes nor in periodontal ligament cells. Tissue sections from human gingival tissue biopsies were histochemically stained for SIRPα. Epithelial keratinocytes and gingival fibroblasts stained positive in sections from periodontally healthy as well as in sections from periodontitis. In periodontitis sections, infiltrating leukocytes stained positive for SIRPα. We highlight our finding that oral keratinocytes, gingival fibroblasts, and periodontal ligament cells do express SIRPα, as this has not been presented before. The fact that inflammatory stimulation of gingival fibroblasts increased the expression of SIRPα, while an increased expression by gingival fibroblasts in periodontitis tissue in situ could not be detected, is indeed contradictory.

M2 macrophage-derived exosomes enable osteogenic differentiation and inhibit inflammation in human periodontal ligament stem cells through promotion of CXCL12 expression

BackgroundPeriodontitis is a dental disease characterized by inflammation of periodontal tissues and loss of the periodontal ligaments and alveolar bone. Exosomes are a class of extracellular vesicles that are involved in a variety of diseases by releasing active substances. In this study, we aimed to investigate the effect and mechanism of exosomes from M2 polarized macrophages (M2-exos) on osteogenic differentiation in human periodontal ligament stem cells (hPDLSCs).MethodsM2-exos were isolated from IL-4-induced RAW264.7 cells (M2 macrophages) and then treated on hPDLSCs. Osteogenic differentiation was assessed by alkaline phosphatase (ALP) staining, alizarin red S (ARS) staining, measurement of osteogenic differentiation-related genes and proteins, and inflammation was evaluated by measuring the levels of inflammatory factors. The mechanism of M2-exo was confirmed through qPCR, western blot, ALP and ARS staining.ResultsResults suggested that M2-exo improved osteogenic differentiation and inhibited inflammation in LPS-induced hPDLSCs. CXCL12 expression was elevated in M2 macrophages, but decreased in LPS-induced hPDLSCs. Moreover, the effect of M2-exo on osteogenic differentiation and inflammation in LPS-induced hPDLSCs was reversed by CXCL12 knockdown.ConclusionWe demonstrated that M2-exo facilitated osteogenic differentiation and suppressed inflammation in LPS-induced hPDLSCs through promotion of CXCL12 expression. These results suggested the potential of M2-exo in the treatment of periodontitis, which may provide a new theoretical basis for M2-exo treatment of periodontitis.

A hierarchical Bilayered scaffold for periodontal complex structure regeneration.

The periodontal tissue comprises alveolar bone, cementum, and periodontal ligament (PDL), forming a highly hierarchical architecture. Although current therapies could regenerate the hard tissue well, the simultaneous reconstruction of hard and soft tissue remains a great clinical challenge with the major difficulty in highly orientated PDL regeneration. Using the unidirectional freeze-casting method and biomimetic mineralization technique, we construct a hierarchical bilayer scaffold with the aligned chitosan scaffold with ZIF-8 resembling PDL, and intrafibrillarly mineralized collagen resembling alveolar bone. The hierarchical bilayer scaffold exhibits different geomorphic clues and chemical microenvironments to realize a perfect simulation of the natural periodontal hierarchical architecture. The aligned scaffold with ZIF-8 could induce the fibrogenic differentiation of bone mesenchymal stromal cells (BMSCs), and the mineralized scaffold could induce osteogenic differentiation of BMSCs. The hierarchical bilayer scaffold could simulate periodontal complex tissue, exhibiting great promise for synchronized multi-tissue regeneration of periodontal tissue.