Periodontitis Subject Research Articles

Effect of self-performed mechanical plaque control frequency on gingival health in subjects with a history of periodontitis: A Randomized Clinical Trial.

This randomized clinical trial evaluated the effect of the frequency of self-performed mechanical plaque control (SPC) on gingival health in subjects with a history of periodontitis. Forty-two subjects participating in a routine periodontal maintenance program were randomized to perform SPC at 12-, 24- or 48-hr intervals. Plaque index (PlI) and gingival index (GI) were evaluated at baseline, and days 15, 30 and 90 of study. Probing depths, clinical attachment levels and bleeding on probing were assessed at baseline, days 30 and 90. Mixed linear models were used for the analysis and comparison of experimental groups. Mean GI at baseline remained unchanged throughout study (90days) only in the 12-hr group (0.7±0.1 versus 0.8±0.1; p<.05). At the end of study, mean GI was significantly increased in the 48-hr group over that in the 12- and 24-hr groups. When GI=2 scores were considered, only the 48-hr group failed to maintain gingival health throughout the study (18.8%). SPC performed at a 12- or 24-hr frequency appears sufficient to controlling gingival inflammation whereas this clinical status was not maintained using a 48-hr frequency in subjects with a history of periodontitis subject to a routine periodontal maintenance program (ClinicalTrials.gov: 50208115.9.0000.5346).

Molecular inflammation and oxidative stress are shared mechanisms involved in both myocardial infarction and periodontitis.

Our aims were to improve the understanding of the pathogenic relationship between cardiovascular diseases and periodontitis and to generate new perspectives in the prevention and treatment of acute myocardial infarction (AMI) and periodontitis. The present study evaluates possible differences in inflammation, oxidative stress, and autophagy markers among subject suffering AMI, periodontitis, or both, to explore possible common pathogenic mechanisms. A total of 260 subjects were enrolled in the study: 106 subjects that survived to a first AMI (AMI group) and 154 subjects had no cardiac events in their clinical record (control group). A questionnaire was used to assess age, height, weight, blood pressure, and heart rate. The clinical probing depth, clinical attachment loss, number of remaining teeth, and average number of sites with bleeding on probing were assessed. Lipid peroxidation and protein levels of phosphorylated AMP-activated protein kinase (p-AMPK) and microtubule-associated proteins 1A/1B-light chain 3-II (LC3-II) were determined in isolated peripheral blood mononuclear cells by thiobarbituric acid reactive substances (TBARS) assay and Western blot, respectively. Plasma levels of interleukin-1β were determined using a commercial ELISA kit. All the obtained variables were compared between subjects suffering an AMI with or without periodontitis and control subject periodontal healthy or with periodontitis. A higher proportion of subjects suffering AMI+periodontitis than only AMI (without periodontitis) was found. Higher levels of TBARS were found in subjects with periodontitis than in subjects without periodontitis in both AMI and control subjects. Positive correlations between IL-1β levels and TBARS and between IL-1β levels and LC3-II were found only in control subjects. Results from the present study are consistent with the suggestion of periodontitis as a potential risk factor for AMI. Periodontitis association with circulating lipid peroxides in both AMI and control subjects were found. The absence of differences in IL-1β levels between AMI subjects (only AMI vs AMI+periodontitis) suggests that oxidative stress could be the main pathogenic link between AMI and periodontitis.

Clinical and Biochemical Valuation of Enzymatic and Nonenzymatic Stress Markers Following Full-mouth Disinfection in Aggressive Periodontitis

Assessment of host response to inflammation will throw light on the critical role of antioxidants (AOs) and free radicle damage in the etiology of periodontal disease. The purpose of the study was to assess the level of plasma oxidative stress in those having aggressive periodontal disease before and after full-mouth disinfection. Objectives were to find the influence of full-mouth disinfection analyzing the level of thiobarbituric acid reactive substances (TBARSs), thereby quantifying the lipid peroxidation (LPO) and also the activities of reduced glutathione (GSH), glutathione peroxidase (GPX), and catalase (CAT), valuing the AO defense systems in health and disease. The valuation composed of 30 subjects with aggressive periodontal disease and 30 healthy controls. Clinical assessment included following periodontal parameters: plaque index (PI), papillary bleeding index (PBI), probing pocket depth (PPD), and clinical attachment level (CAL). Levels of bone loss were assessed by taking full-mouth periapical radiographs. Initial periodontal therapy comprises of full-mouth disinfection which includes subgingival scaling and root planing within 24 hours combined with adjunctive chlorhexidine chemotherapy for aggressive periodontitis subject's at sites indicated. The parameters (clinical) were evaluated at the baseline and 8 weeks after initial periodontal therapy at six sites of teeth indicated. Plasma samples were taken and evaluated by standard procedures as defined in the literature. All the values were weighed and related. Strong positive associations were detected among periodontal parameters and TBARS, enzymatic/nonenzymatic AO levels (p < 0.05), and pre- and postperiodontal management. The plasma levels of patients with aggressive periodontitis had high levels of TBARS and displayed a substantial escalation in the activities of GSH and GPX levels in the plasma matched to the healthy individuals (p < 0.05). This paper evaluated ROS activity and AO defense before and after treatment to stimulate added periodontal investigation in this part which will give an insight into the therapeutic options with foreseeable results.

Efficacy of erythrosine and cyanidin-3-glucoside mediated photodynamic therapy on Porphyromonas gingivalis biofilms using green light laser

BackgroundThe purpose of this in vitro study was to evaluate the efficacy of erythrosine and cyanidin-3-glucoside as photosensitizers in PDT for the elimination of Porphyromonas gingivalis (P. gingivalis) biofilms. MethodsP. gingivalis biofilms were prepared from a chronic periodontitis subject. Erythrosine and cyanidin-3-glucoside were prepared and randomly allocated as follows: 110, 220, 330, and 440μM erythrosine; 101, 202, 303, and 404μM anthocyanin; and 440μM erythrosine+404μM cyanidin-3-glucoside. There were 18 PDT experimental groups (non-irradiated/irradiated with a 532-nm green light diode laser at 1.29J/cm2 for 60s). The 3 controls were grouped as follows: biofilms exposed to the photosensitizers alone, biofilms exposed to the laser alone, and biofilms exposed to 0.12% chlorhexidine. All sample groups were cultured at 1, 3 and 6h after PDT and incubated in an anaerobic chamber at 37°C for 4days. The surviving fraction was calculated from the log10 CFU/ml. The 330 and 440μM erythrosine and the 440μM erythrosine+404μM cyanidin-3-glucoside were mixed with spin traps (TEMPO, DMPO), and the electron spin resonance spectra were evaluated. ResultsThe log10 CFU/ml measurements showed that the PDT groups with 330μM or 440μM erythrosine and 440μM erythrosine+404μM cyanidin-3-glucoside had statistically significant differences from the other groups (one-way ANOVA and Bonferroni’s multiple comparison test, p- value≤0.05). ConclusionsPDT using 330μM erythrosine, 440μM erythrosine or 440μM erythrosine+404μM cyanidin-3-glucoside irradiated with the laser more effectively inhibited P. gingivalis in biofilms.

Assessment of tumor necrosis factor- alpha in gingivitis and periodontitis patients

Background: Tumor necrosis factor-α, one of the cytokines, is released in various chronic inflammatory diseases including periodontitis.Aims: To estimate the level of Tumor necrosis factor- alpha (TNF-α) in gingivitis and periodontitis patientsSettings and Design: A cross-sectional study was conducted. A total of 75 patients were recruited by purposive sampling technique among the patients visiting the Department of Periodontology and Oral Implantology during the period one year from August 2014 to July 2015.Material and methods: The recruited samples were divided into gingivitis and periodontitis groups based on clinical attachment level (CAL). A periodontitis subject was defined as having at least 4 sites with pocket depth (PD) &gt;3mm and at least 4 sites with CAL&gt;3 mm, while gingivitis group included the subjects having no CAL measurements greater than 3 mm with signs of inflammation. The TNF-α level was measured using the RayBio Human TNF-alpha ELISA (Enzyme-linked Immunosorbent Assay) kit.Results: The Median TNF-α interquartile range (IQR) (minimum-maximum) in gingivitis and periodontitis was 58.37 (32.63 – 198.77) and 111.89 (39.27 – 215.0) pg/ml, respectively.Conclusion: The level of TNF-α was found to be higher in periodontitis group compared to gingivitis group, although the result was not statistically significant.

Periodontitis subject with failing dentition and management with cross arch bridge and implants

&lt;p class="abstract"&gt;&lt;span lang="EN-US"&gt;Severe periodontal disease often leads to tooth loss, necessitating prosthetic rehabilitation to restore function and aesthetics. The concept of perio-prosthetic treatment using extensive bridges of cross-arch design was introduced approximately 30 years ago. Long term follow-up studies have shown that teeth with reduced periodontal support can be used as abutments for extensive fixed prostheses, provided periodontal disease had been treated successfully and an effective recall program had been instituted to prevent periodontal disease recurrence. Implants along with cross arch bridges in controlled periodontitis subject have never been used together for complete full mouth rehabilitation.&lt;/span&gt;&lt;/p&gt;

Complex Rehabilitation of Advanced Periodontitis Subject with a Staged Approach; Implant Supported Fixed Detachable Prosthesis

Oral rehabilitation for a patient with severe loss of alveolar bone and soft tissue resulting from severe periodontitis presents a challenge to clinicians. The use of dental implants for replacement of teeth has become a routine procedure also in the periodontally compromised patient .The presence of periodontal inflammation and periapical infection often delay the placement of bone grafts as well as dental implants. When transitioning from a failing dentition to complete-arch implant rehabilitation, significant treatment planning is required. In this report a patient with severe chronic periodontitis underwent a full mouth reconstruction with staged approach. The oral function and esthetics was restored with fixed screw retained implant supported prosthesis. However supportive periodontal therapy becomes the most important aspect for survival of complex prosthesis.

Effect of smoking on periodontal health.

The aim of the study was to assess and compare the effect of smoking on mRNA expression of MMP -8 and TIMP-1 in patients with untreated chronic periodontitis and in periodontally healthy subjects and to examine the correlation of MMP-8 and TIMP-1 levels with clinical parameters. Out of 60 subjects, 40 were selected subjects for the study, and were divided into Group I (periodontitis subject) and Group II (healthy subjects). Each group was further subdivided into subgroups I-A (chronic periodontitis smokers CPS), and I-B (chronic periodontitis non-smokers CPN), subgroup II-A (healthy smokers HS) and II B (healthy non-smokers HS). Both the groups underwent periodontal examination and clinical parameters were recorded. Tissue samples from both groups were subjected to the isolation of RNA which was then followed by qRT-PCR and the expression of the mRNA levels of MMP-8 and TIMP-1 were analyzed. The mRNA expression of MMP-8 and TIMP-1 was further compared with the periodontal status of all the four groups. The mRNA expression of MMP-8 was compared between the groups and showed that Group I-A (CPS) had higher expression of MMP-8 compared to group I-B (CPN). Group I-B (CPN) vs Group I-A (CPS) showed statistically significant difference in MMP-8/TIMP-1 with higher values for Group I-A (CPS) than Group I-B (CPN). A positive correlation was found between MMP-8 expression and probing depth and clinical attachment level (CAL) among Group I-B (CPN) and Group I-A (CPS) subjects. A significant correlation was also found between MMP-8 and TIMP-1 expression with probing depth and CAL among Group II B(HN) group subjects. TIMP-1 also showed a positive correlation with gingival index (GI) among group II A (HS) subjects. It is concluded that smoking has an impact on the periodontal status and mRNA expression of MMP-8 and TIMP-1 in chronic periodontitis patients. The earlier evaluation of MMP-8 and TIMP-1, can be used as a biomarker in predicting periodontal disease susceptibility.

A study to evaluate the relationship between periodontitis, cardiovascular disease and serum lipid levels

The search for cellular mechanisms linking periodontitis to changes in systemic health has resulted in the evolution of a new area of lipid research. So far the causality and possible pathways of the association between periodontal disease and cardiovascular disease is obscure. A total of 120 subjects were included in the study with 30 subjects in each of the following groups: healthy group (A), chronic periodontitis group (B), coronary heart disease (CHD + periodontitis group) (C) and CHD - periodontitis group (D). All subjects underwent oral examination and their Gingival Index, Oral Hygiene Index, Periodontal Disease Index scores and attachment loss were recorded. Two millilitres of fasting venous blood sample was drawn and tested for the level of total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglyceride level. The results revealed no significant difference with respect to the lipid profile levels between the four groups. Interpreting the results of the study, periodontal disease did not cause an increase in total CHL, LDL or triglyceride levels or a decrease in the HDL levels in an otherwise systemically healthy individual or in a CHD patient. Periodontitis in a CHD patient did not seem to exacerbate the destruction of periodontal tissue. Higher triglyceride levels did not have any correlation with the severity of attachment loss in a periodontitis subject.

Establishment of peripheral blood and gingival T lymphocyte clones responsive to Porphyromonas gingivalis.

T cells are central to the immune response to infection and studies have indicated a local immunoregulatory imbalance may exist in human periodontal disease. Since Porphyromonas gingivalis is generally recognized as a major periodontopathogen, the aim of this study was to establish T cell lines and clones specific to P. gingivalis from the gingival tissues and peripheral blood of P. gingivalis--infected subjects. Two subjects were selected from two groups of individuals (one from each group) established on the basis of P. gingivalis in their plaque and the presence of serum antibodies which react with P. gingivalis antigens. The two groups differed however in their clinical susceptibility (adult periodontitis) or resistance (gingivitis) to periodontal breakdown. The mean ages +/- standard error of the mean of the two groups were 47.9 +/- 2.2 and 49.6 +/- 3.7, respectively, so that resistance in the gingivitis group was related to the age of the subjects. T cell lines and clones were established from the peripheral blood of one patient from each of the two groups and also from the gingival tissues of the same periodontitis subject. This study has demonstrated the capability of establishing P. gingivalis-specific T cell lines and clones from P. gingivalis-infected subjects and FACS analysis of the T cell receptor variable regions demonstrated that the clones were indeed monoclonal. The CD4:CD8 ratios of the peripheral blood-derived T cell lines were 1.2 and 0.4 for the gingivitis-derived line and the periodontitis-derived line, respectively, thus supporting the clinical differences displayed by the two subjects.