Presence Of Chronic Periodontitis Research Articles

Comparative Evaluation and Correlation of Periodontal Status With Inflammatory Markers in Pregnant Women With or Without Chronic Periodontitis: A Clinico-Hematological Study.

Background The research delves into the intricate relationship between periodontal health and specific blood biomarkers in pregnant women during their second trimester. It specifically focuses on the levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), and C-reactive protein (CRP) in those suffering from chronic periodontitis compared to healthy controls. Methodology A detailed approach was taken involving 60 pregnant women categorized into two groups based on the presence or absence of chronic periodontitis. Out of 60 pregnant women, 30 had chronic periodontitis, while the other 30 served as controls selected from the regular patient population of the college. The study utilized blood sample analysis and advanced statistical tools for data analysis, ensuring precise and reliable results. Levels of IL-6, LDH, and CRP in those suffering from chronic periodontitis compared to healthy controls were checked. Results The findings revealed a notable variance in IL-6, LDH, and CRP levels between the two groups. Women with chronic periodontitis exhibited significantly higher levels of these biomarkers. The statistical analysis reinforced the validity of these differences, highlighting their significance. Conclusions The study underscored a clear link between higher levels of IL-6, LDH, and CRP and the presence of chronic periodontitis in pregnant women. These biomarkers emerge as potential indicators for early detection and monitoring of periodontal health in this demographic.

Studying the relationship between oral lichen planus and periodontal disease: Value on periodontal pathogens and oral hygiene

BACKGROUND: Oral lichen planus is a chronic inflammatory condition of the oral mucosa characterized by white, lacy lesions. The etiology of oral lichen planus is complex and remains unclear, but it is thought to be a T-cell mediated autoimmune disease. Several factors have been implicated in the pathogenesis of oral lichen planus, including genetic predisposition, dental materials, iatrogenic factors, infections, autoimmunity, and bowel disease. The microflora of the oral cavity plays an important role in maintaining oral health and preventing disease. However, its role in the development and progression of oral lichen planus is not yet totally understood. Some studies have shown that there are differences in the microflora of oral lichen planus patients compared to healthy controls. These differences may be related to the inflammatory process in oral lichen planus, or they may be a contributing factor to the disease.
 AIM: Identify the prevalence of the detection of periodontopathogenic microorganisms in oral lichen planus patients and compare their prevalence in healthy non-oral lichen planus patients.
 MATERIALS AND METHODS: A cross-sectional, single-center study was conducted. A total of 75 patients were recruited, 45 with oral lichen planus and 30 healthy controls. The groups were formed by simple random sampling. The diagnosis of oral lichen planus was confirmed histologically in the main group. The forms and localization of oral lichen planus were determined in the main group based on clinical examination. In the control group, patients were divided into two subgroups depending on the presence of chronic periodontitis or gingivitis. The prevalence of periodontal pathogens was assessed based on the analysis of culture results. Among the 48 bacteria isolated from the oral mucosa of the affected site in the main and control groups, we focused on the microbiota of only periodontal bacteria to study their role and assess their impact on disease progression.
 RESULTS: Among the 45 patients with a clinical diagnosis of oral lichen planus, there were 10 (22.22%) men and 35 (77.78%) women, with a mean age of 55.3±13.4 years. The control group included 30 healthy volunteers, 8 (26.67%) men and 22 (73.33%) women, with a mean age of 54.8±12.7 years. In patients with oral lichen planus regardless of their periodontal status the percentage of seropositivity for A. actinomycetemcomitans, V. parvula, P. gingivalis, T. denticola is higher compared to their healthy counterparts with gingivitis and periodontitis.
 CONCLUSION: The study found an increased frequency of detection of pathogenic microorganisms, such as A. actinomycetemcomitans, V. parvula, P. gingivalis, and T. denticola, in patients with oral lichen planus, regardless of the presence of periodontitis. These periodontopathogens may be associated with oral lichen planus. However, further studies are needed to clarify their role in the pathogenesis of the disease.

The Oral Manifestation of Hepatitis Patients Visiting Tertiary Care Clinics of Karachi

Background: The present study aimed to find out the most frequent Oral lesions in hepatitis B and C patients in the local population and correlate it with age and gender. Materials and Methods: A retrospective study was designed at Sindh Institute of Oral Health Sciences at the department of Oral medicine. We studied the records of patients coming to OPD from 2016 till 2021 diagnosed with hepatitis B and C for treatment. Convenience sampling was done. Incomplete forms and data of the patients with comorbid conditions such as Diabetes, Rheumatoid Arthritis or Hypertension were removed as a part of the protocol. Results: Data of sixty-seven patients was included in the study. Data analysis was done through SPSS ver.18. Frequency of the oral lesions in hepatitis B and C was assessed and the relationship between hepatitis and oral lesions was also explored by applying t-test. Male to female ratio was 1: 1.5. The most frequent lesion in both hepatitis B and C was Periodontitis followed by gingivitis and oral lichen planus. Also, the relationship between hepatitis C and oral lesions was significant at the level of p-value of 0.05% while for hepatitis B and effect on the treatment of hepatitis was no significant. Conclusion: The findings of the study show that the Hepatitis C has a significant relationship with oral lesions and presence of chronic periodontitis or gingivitis and oral lichen planus requires further testing for HCV and HBV status which would result in early diagnosis and treatment decreasing the chances of complications such as liver cirrhosis in long term and spread of infection. Keywords: Periodontitis, Oral lesions, Hepatitis B, Hepatitis C, Gingivitis.

Proinflammatory (CD14+CD16++) monocytes in type 2 diabetes mellitus patients with/without chronic periodontitis

Until date, the proportion of nonclassic monocytes in type 2 diabetic mellitus patients with and without chronic periodontitis has not been evaluated based on glycemic control. The objective of this study was to compare the proportion of CD14+CD16++ monocytes in type 2 diabetic patients with and without chronic periodontitis. In this cross sectional study A total of sixty individuals with type 2 diabetes mellitus (n = 15/group) were recruited. Individuals were grouped based on glycosylated hemoglobin A (HbA 1c) values and the presence of chronic periodontitis; Group 1 (diabetes mellitus with good glycemic control), Group 2 (diabetes mellitus with poor glycemic control), Group 3 (diabetic mellitus with chronic periodontitis and good glycemic control), Group 4 (diabetic mellitus with chronic periodontitis and poor glycemic control). Fluorochrome-conjugated monoclonal antibodies against CD14, CD16, and human leukocyte antigen-antigen D related was used to analyze the proportion of nonclassic monocytes by flow cytometry. One-way ANOVA with Tukey's post-hoc test was used to assess the significant differences in monocyte subpopulations. The Pearson's correlation test was used to assess the relationship between hemoglobin A1c values and percentage of nonclassical monocytes. In both the above statistical tools, the value of P < 0.05 is considered as significant level. Group 4 had the highest percentage of CD14+CD16++ monocytes 14.67% + 4.70%, followed by Group 3-9.73% + 0.60%, Group 2-9.32% + 2.03% and Group 1-5.92% + 0.63% (P < 0.001). Further, a statistically significant positive correlation between HbA (1c) levels and the proportion of CD14+CD16++ monocytes was observed. In the present study, we observed type 2 diabetes mellitus patients with poor glycemic control and chronic periodontitis showed more than two-fold increase in the proportion of nonclassic monocytes compared to type 2 diabetes mellitus patients with good glycemic control.

Connection Between Genetic Polymorphism of Interleukin -1Beta With Chronic Periodontitis in Peruvian Adults

. To determine the connection between polymorphism IL-1B C(+3953/4)T and chronic periodontitis in adults. . Case and control study. Individuals between 18 and 64 years of age were included; they were recruited through healthcare campaigns carried out in 2012 in different areas of the city of Lima with similar socio-economic characteristics. Dentists specialized in periodontics performed the diagnosis of the periodontal state of participants; genotyping was made through the PCR-RFLP technique. The data were analyzed by logistic regression. . The factors associated with chronic periodontitis were: age over 46 years (OR: 7.50, CI 95%: 1.85-6.37), higher education level achieved (OR: 0.43, CI 95%: 0.27-0.98), the presence of allele 2 in the polymorphism of IL-1B. The positive genotype (2-2) was associated with the presence of chronic periodontitis (OR: 2.06, CI 95%: 1.01-4.21). . The presence of allele 2 in the polymorphism of IL-1B and the positive genotype (2-2) confers greater risk for the development of chronic periodontitis in the population of Peruvian adults under study.

The Biochemical Effects of Non-surgical Periodontal Therapy in Patients with and without Chronic Renal Disease

Recent studies have shown an association between high levels of biomarkers and periodontitis, association which decreases after the periodontal treatment. Because of this association with systemic inflammatory response, chronic periodontitis was recently included as a risk factor for chronic renale disease. Specifically, in this study we hypothesized that a part of chronic inflammatory response observed in patients with chronic renale disease is due to physiopathological reactions caused by the presence of chronic periodontitis, which, during the course of its evolution, induces an increase in the expression of inflammatory markers. Patients were divided into two groups: the first group consisted of patients with chronic renale disease and periodontal disease who were undergoing periodontal treatment (test group) and the second group, control group, composed of patients without any systemic disease, but who experienced moderate to severe chronic periodontitis, also periodontal treated. Blood samples were taken for biochemical analysis at baseline and at 3 months after periodontal therapy. Venous blood was collected in vacuum tubes between 7:00 am and 9:00 am after 12 hours after the last meal. A tube containing EDTA was analyzed for blood following parameters: albumin, uric acid, creatinin, urea. An association between periodontal disease and renale disease is often found in studies using a population where the renale disease is already diagnosed. In these cases, duration of renal end stage and type of topical and systemic treatment administered to patients significantly affect the association. Therefore, we have shown that periodontitis may promote any detectable changes in renal function. Thus, by analogy, in this study the test groups and control groups were compared not only with each other but also comparative analyzes were performed based on the reference values of markers of renal dysfunction. We think it could be plausible existence of a causal link between periodontal disease and chronic renal disease both by glomerular invasion by periodontal pathogens, directly and indirectly through systemic inflammatory effect caused by chronic periodontitis. Success of periodontal therapy reduce systemic inflammatory response and decreases levels of biochemicals markers indicating that this may be an important intervention therapy in patients with chronic renale disease.

Niveles de hemoglobina glicosilada en pacientes con periodontitis crónica

Objetivo: Evaluar si existe relación entre el nivel de hemoglobina glicosilada y la presencia de periodon-titis crónica. Materiales y método: se evaluaron 77 pacientes, agrupados en función a si presentaban o no periodontitis crónica. Los datos fueron recolectados en una ficha donde se consideró edad, género, índice de masa corporal (IMC) y antecedentes de dislipidemias, se llenaron los periodontogramas para establecer al grupo de pertenencia de los pacientes, se les envió a laboratorio clínico para recabar y pro-cesar las pruebas de hemoglobina glicosilada. Todos firmaron el consentimiento informado. Resultado: se obtuvo un 5,58% de HbA1c para el grupo con periodontitis crónica (38 pacientes), y un 5,31% para el grupo sin periodontitis (39 pacientes), valores sin ajustar, se determinó una diferencia significativa (P=0,000), al realizar el estudio de las variables de riesgo, se obtuvo que no hay influencia estadística del género ni del IMC. Considerando estos factores la diferencia sigue siendo significativa (P=0,001). No se halló diferencia significativa (P=0,921) entre varones (5,58%) y mujeres (5,60%) con periodontitis crónica. Tampoco hubo diferencia significativa (P=0,230) entre varones (5,33%) y mujeres (5,29%) sin periodontitis crónica. Conclusiones: existe diferencia significativa en el porcentaje de hemoglobina glicosilada y la presencia de periodontitis crónica. No existe diferencia significativa en los pacientes en función al género, en los grupos con y sin periodontitis crónica. El análisis de factores de riesgo, mostró que los niveles elevados de Hemoglobina Glicosilada se deben a periodontitis crónica, edad del paciente y presencia de dislipidemias, más no del género y el IMC.

Chronic periodontitis can affect the levels of potential oral cancer salivary mRNA biomarkers.

More than 100 salivary constituents have been found to show levels significantly different in patients with oral squamous cell carcinoma (OSCC) from those found in healthy controls, and therefore have been suggested to be potential salivary biomarkers for OSCC detection. However, many of these potential OSCC salivary biomarkers are also involved in chronic inflammation, and whether the levels of these biomarkers could be affected by the presence of chronic periodontitis was not known. The objective of this pilot study was therefore to measure the levels of seven previously reported potential OSCC salivary mRNA biomarkers in patients with chronic periodontitis and compare them to levels found in patients with OSCC and healthy controls. The seven salivary mRNAs were interleukin (IL)-8, IL-1β, dual specificity phosphatase 1, H3 histone family 3A, ornithine decarboxylase antizyme 1, S100 calcium-binding protein P (S100P) and spermidine/spermine N1-acetyltransferase 1. Unstimulated whole saliva samples were collected from a total of 105 human subjects from the following four study groups: OSCC; CPNS (chronic periodontitis, moderate to severe degree, non-smokers); CPS (chronic periodontitis, moderate to severe degree, smokers); and healthy controls. Levels of each mRNA in patient groups (OSCC or chronic periodontitis) relative to the healthy controls were determined by a pre-amplification reverse transcription-quantitative polymerase chain reaction approach with nested gene-specific primers. Results were recorded and analyzed by the Bio-Rad CFX96 Real-Time System. Mean fold changes between each pair of patient vs. control groups were analyzed by the Mann-Whitney U-test with Bonferroni corrections. Only S100P showed significantly higher levels in patients with OSCC compared to both patients with CPNS (p = 0.003) and CPS (p = 0.007). The difference in S100P levels between patients with OSCC and healthy controls was also marginally significant (p = 0.009). There was no significant difference in the levels of salivary IL-8, IL-1β and dual specificity phosphatase 1 mRNAs between patients with OSCC and patients with CPNS (p = 0.510, 0.058 and 0.078, respectively); no significant difference in levels of salivary ornithine decarboxylase antizyme 1 and spermine N1-acetyltransferase mRNAs between patients with OSCC and patients with CPS (p = 0.318 and 0.764, respectively); and no significant difference in levels of the H3 histone family 3A mRNA between patients with OSCC and either CPS (p = 0.449) or healthy controls (p = 0.107). Salivary S100P mRNA could be a reliable biomarker for OSCC detection, regardless of the presence of chronic periodontitis. The presence of chronic periodontitis could significantly affect the levels of the other six mRNAs, and negatively influence reliability for using them as biomarkers for oral cancer detection.

Gingival crevicular fluid levels of protease‐activated receptors type 1 and type 2 in diabetic patients with periodontitis

Protease activated receptor type 1 (PAR1 ) seems to play a role in periodontal repair, while PAR2 is associated with periodontal inflammation. As diabetes is a known risk factor for periodontal disease, the aim of this study was to evaluate the influence of type 2 diabetes on PAR1 and PAR2 mRNA expression in the gingival crevicular fluid of patients with chronic periodontitis before and after non-surgical periodontal treatment. Gingival crevicular fluid samples and clinical parameters consisting of measuring probing depth, clinical attachment level, bleeding on probing and plaque index were collected from systemically healthy patients and patients with type 2 diabetes and chronic periodontitis, at baseline and after non-surgical periodontal therapy. PAR1 and PAR2 , as well as the presence of the proteases RgpB gingipain and neutrophil proteinase-3 were assessed by quantitative polymerase chain reaction in the gingival crevicular fluid. The periodontal clinical parameters significantly improved after periodontal therapy (p<0.01). Diabetes led to increased expression of PAR1 in gingival crevicular fluid, and in the presence of chronic periodontitis, it significantly decreased the expression of PAR1 and PAR2 (p<0.05). Moreover, non-surgical periodontal treatment in diabetics resulted in increased expression of PAR1 and PAR2 (p<0.05), and decreased expression of RgpB gingipain and proteinase-3 (p<0.05). The present data demonstrated that diabetes was associated with an altered expression of PAR1 and PAR2 in the gingival crevicular fluid cells of subjects with chronic periodontitis. Future studies are necessary to elucidate the effects of PAR1 upregulation in periodontally healthy sites and PAR2 downregulation in chronic periodontitis sites on the increased susceptibility and severity of periodontitis in diabetes.

The association between the RAGE G82S polymorphism, sRAGE and chronic periodontitis in Taiwanese individuals with and without diabetes

The present study investigated the association between the RAGE G82S polymorphism, the plasma levels of sRAGE and chronic periodontitis in subjects with and without diabetes mellitus (DM). A total of 230 patients with DM and 264 non-DM participants were recruited for this study. Genotyping of the RAGE G82S polymorphism was accomplished using polymerase chain reaction-restriction fragment length polymorphism, and associations were analyzed with the chi-squared test and logistic regression analysis. In the non-DM group, the chi-squared test showed that the frequency distributions of the G82S polymorphism were significantly different between chronic periodontitis and non-chronic periodontitis subjects (χ(2) = 8.39, p = 0.02). A multivariate logistic regression model showed that the (G82S + S82S) genotypes were associated with a significantly increased risk of chronic periodontitis development compared to the G82G genotype (adjusted odds ratio = 2.06, 95% confidence interval: 1.08-4.07). In the DM group, there was no association between the G82S polymorphism and chronic periodontitis development when a multivariate logistic regression was performed. Plasma levels of sRAGE were significantly higher in subjects with the G82G genotype compared to those with the (G82S + S82S) genotypes in both the non-DM (856.6 ± 332.0 vs. 720.4 ± 311.4 pg/mL, p = 0.003) and DM groups (915.3 ± 497.1 vs. 603.5 ± 298.3 pg/mL, p < 0.0001). However, there was no difference in plasma sRAGE levels between chronic periodontitis and non-chronic periodontitis subjects in both the DM and non-DM groups. Moreover, when the subjects were further sub-divided by the G82S polymorphism, the difference in plasma levels of sRAGE between chronic periodontitis and non-chronic periodontitis subjects in the DM and non-DM groups remained statistically insignificant. The present study revealed that the RAGE G82S polymorphism was associated with chronic periodontitis in the non-DM group but not in the DM group. Our results also showed that the plasma levels of sRAGE were significantly higher in subjects with the RAGE G82G genotype, and this correlation was not affected by the presence of chronic periodontitis in the DM and non-DM groups.

Laser Apicoectomy with ER:YAG and Bone Xenograft Bio-Oss Collagen®. A Case Report

Main problem in apicoectomy procedures is the choice of access and flap, which determines the prognosis of the affected tooth. An additional complication is the presence of chronic periodontitis and increased tooth mobility. In such cases it is important to maintain the free marginal tissues and to do minimal trauma. Aim: To show the possibilities of the Er:YAG laser for treatment of apical lesions in a tooth with chronic periodontitis. Materials and Methods: Patient age 35 with moderate to severe chronic periodontitis, and a persistent cyst at tooth 22 was examined. After performing nonsurgical periodontal treatment apicoectomy was scheduled. A semilunar flap with vertical incisions was elevated 3mm from the gingival margin with a blade. All other procedures were performed with the help of Er:YAG laser in modes (release incision, bone remodeling, granulation tissue ablation, apex cutting). No retrograde filling was done. The cyst cavity was filled with Bio-Oss collagen® (Geistlich®, USA). Results: In the post treatment period a flap dehiscence occurred due to: loose sutures, necrosis, infection. After a period of one year the X-ray showed complete bone filling of the defect with light lucidity at the sight of the dehiscence, which might be merited to the epithelial tissue proliferation towards the defect which resulted in forming bone with lesser density. After one year the tooth is preserved with mobility grade 1. Discussion: The apicoectomy technique performed with Er:YAG is reliable and kept the soft tissues intact and also the tooth in spite of the severity of the chronic periodontitis. The technique can be recommended in similar cases.

Prevalence and quantification of the uncommon Archaea phylotype Thermoplasmata in chronic periodontitis

ObjectiveChronic periodontitis is a chronic inflammatory disease of the periodontal tissues and is caused by invasion of certain types of bacteria and Archaea, with Methanobrevibacter oralis as the predominant archaeon. In this study, we investigated the prevalence and quantity of the newly discovered Archaea phylotype Thermoplasmata in patients with chronic periodontitis. MethodsSubgingival plaque samples were obtained from 49 patients with chronic periodontitis and 45 periodontally healthy subjects. Qualitative analyses of Archaea and class Thermoplasmata were carried out by amplification of 16S rRNA genes in DNA extracts from plaque samples, and all the samples were quantitatively analyzed by real-time polymerase chain reaction (PCR). ResultsThe prevalence of Archaea in patients with chronic periodontitis was 69.4% according to the conventional PCR results, but was 87.8% according to real-time PCR. In the control group, three samples were detected as positive, but none of these were confirmed in qualitative analyses. The prevalence of class Thermoplasmata was 18.4% by nested PCR and 24.5% by quantitative PCR in the chronic periodontitis group. The prevalence of Thermoplasmata was significantly lower than that of total Archaea. The relative abundances of Archaea and Thermoplasmata varied among samples. Thermoplasmata were not the predominant archaeons in the subgingival dental plaque. Among the clinical parameters of patients with periodontitis, probing depth was positively associated with Archaea detection. ConclusionsThe existence of Archaea was correlated closely with the presence of chronic periodontitis. Thermoplasmata represented a minor archaeon in periodontal infection.

Chronic Periodontitis and Erectile Dysfunction

We read the article by Oguz et al. [1] with great interest. The cited study is an interesting contribution to the literature. The relationship between erectile dysfunction (ED) and periodontal disease is explored. The cited authors conclude that an association exists between clinical periodontal parameters and ED. Further, they suggest that periodontal disease should be considered when it is sought to understand the etiology of ED in young adults. However, we suggest that these findings should be viewed with caution because some necessary data are lacking. First, the mean International Index of Erectile Function (IIEF) scores of participants were not reported. It is well known that IIEF scores can be used to grade ED severity as absent, mild, moderate, or severe [2]. Why did the authors not subdivide their group I patients in terms of the severity of ED? Had they done so, it would have been possible to draw a firm conclusion as to the existence of any correlation between ED and the presence of chronic periodontitis (CP). We would make another technical point. The possibility that some cases of ED were psychological in terms of etiology should have been explored in more detail [3]. The exclusion criteria were the presence of a systemic disease (including diabetes mellitus, heart disease, and hypertension); such conditions can affect periodontal health and ED. It was shown in the literature with a rat model that experimental model of periodontitis may cause ED [4]. Also, the authors argue that CP is an organic cause of ED, because CP may induce systemic vascular disease by triggering endothelial dysfunction, but in the study no psychological exclusion criterion was listed. It would have been possible to identify appropriate exclusion criteria had patients been asked about the presence of nocturnal erections, or had a nocturnal penile tumescence and rigidity test been performed.

The short-term effects of non-surgical periodontal therapy on the circulating levels of interleukin-6 and C-reactive protein in patients with chronic periodontitis.

Background:Recent epidemiological studies have shown that periodontal infection is a risk factor for a number of systemic diseases and conditions. In addition to the conventional risk factors, chronic infection and the subsequent generation of a systemic inflammatory response may be associated with this increased risk.Aims:This study was conducted to determine whether the presence of chronic periodontitis and subsequent non-surgical periodontal therapy could influence the serum levels of interleukin-6 and C-reactive protein (CRP) in patients with severe chronic generalized periodontitis.Settings and Design:Participants were selected from subjects who attended the Department of Periodontics and Oral Implantololgy, Government Dental College, Thiruvananthapuram.Materials and Methods:Sera were obtained from 25 patients with periodontitis for baseline examination and reassessment after completion of treatment. As a control, sera were also obtained from 20 subjects without periodontitis. Interleukin-6 was determined by sensitive enzyme-linked immunosorbent assay, and high-sensitivity CRP (hsCRP) was measured using latex turbidometric immunoassay.Statistical Analysis:Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS) version 10.Results:The level of interleukin-6 and hsCRP in the sera of periodontitis patients was seen to be higher than those of healthy controls. Interleukin-6 level tended to decrease with improvement of the periodontal condition following treatment and approached that of control subjects, and this decline was statistically significant. The hsCRP levels also showed a decreasing trend following periodontal treatment.Conclusions:In this study, we were able to show that periodontal disease significantly affects the serum levels of systemic inflammatory markers and that non-surgical periodontal therapy could bring about a decrease in the levels of these inflammatory markers.

Associação entre saúde bucal e doença arterial coronária aterosclerótica em pacientes submetidos a cineangiocoronariografia: estudo transversal controlado

INTRODUÇÃO: Doenças cardiovasculares e periodontais são condições inflamatórias comuns na população. Na aterosclerose, a condição inflamatória tem papel contínuo no desenvolvimento, desestabilização e ruptura da placa do ateroma. Existe evidência científica controversa em relação à associação entre periodontite crônica e doença arterial coronária (DAC). O objetivo do estudo foi verificar a associação entre periodontite crônica e DAC em nosso meio. MÉTODOS: Estudo transversal controlado, com amostra de 206 pacientes sem DAC prévia e com indicação clínica de cineangiocoronariografia, submetidos a anamnese, exame físico e coleta de sangue para verificação de glicemia, perfil lipídico e proteína C-reativa. A presença de periodontite crônica foi determinada por exame clínico realizado por periodontista, buscando avaliar quantidade de placa bacteriana, cálculos gengivais, sangramento, exsudato e sinais clássicos de inflamação. RESULTADOS: A média de idade foi de 60,3 ± 10,1 anos e 60,2% eram do sexo masculino. DAC esteve presente em 126 pacientes (61,2%). Houve associação da presença de DAC com gênero [sexo masculino, odds ratio (OR) 2,18; P = 0,0075], idade (61-70 anos, OR 5,63; P = 0,0007) e escolaridade (ensino superior, OR 2,08; P = 0,02). Os biomarcadores inflamatórios não diferiram entre os grupos com e sem DAC. Sinais inflamatórios e placa bacteriana ocorreram em 88% dos pacientes com DAC, índice ligeiramente superior ao observado naqueles sem DAC. Má saúde bucal, representada por perda de dentes, foi mais prevalente nos pacientes com DAC. O número de dentes faltantes foi de 14 ± 6,4 e de 11,9 ± 6,7 (P = 0,04) nos pacientes com e sem DAC, respectivamente. CONCLUSÕES: Há associação entre saúde bucal comprometida e DAC.

The Association between Oral Health and Atherosclerotic Coronary Artery Disease in Patients submitted to Coronary Angiography: a Controlled Cross-Sectional Study

ABSTRACT Background Cardiovascular and periodontal diseases are common inflammatory conditions. In atherosclerosis, inflammation plays a continuous role in the development, destabilization, and rupture of atheromas. There is controversial scientific evidence regarding the association between chronic periodontitis and coronary artery disease (CAD). The objective of this study was to assess the association between chronic periodontitis and CAD in this practice. Methods This was a cross-sectional controlled study of 206 patients with no prior CAD and for whom coronary angiography was indicated; the data included clinical history, physical examination and blood sample collection to test for blood glucose, lipid profile, and C-reactive protein levels. The presence of chronic periodontitis was determined by clinical examination performed by a periodontist. The levels of bacterial plaque, gingival calculus, bleeding, exudate, and classical signs of inflammation were recorded. Results The mean age was 60.3 ± 10.1 years, and 60.2% of the subjects were male. CAD was present in 126 patients (61.2%). There was an association between CAD and gender [male gender, odds ratio (OR) 2.18; P = 0.0075], age (61–70 years, OR 5.63; P = 0.0007), and educational level (higher educational level, OR 2.08; P = 0.02). Inflammatory biomarkers did not differ between the groups with and without CAD. Signs of inflammation and bacterial plaque were present in 88% of patients with CAD, slightly higher than the rate observed in patients without CAD. Poor oral health, as indicated by the loss of teeth, was more prevalent in patients with CAD. The number of missing teeth was 14 ± 6.4 and 11.9 ± 6.7 (P = 0.04) in patients with and without CAD, respectively. Conclusions There is an association between poor oral health and CAD.

Effect of periodontal treatment on the C‐reactive protein and proinflammatory cytokine levels in Japanese periodontitis patients

Recent epidemiological studies have shown that individuals with periodontitis have a significantly increased risk of developing coronary heart disease. In addition to conventional risk factors, chronic infection and subsequent production of systemic inflammatory markers may be associated with this increased risk. The aim of the present study was to determine whether the presence of chronic periodontitis and subsequent periodontal treatment could influence the serum levels of C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-alpha (TNF-alpha) in a Japanese population. Sera were obtained from 24 patients with moderate to advanced periodontitis at the baseline examination and at reassessment after completion of treatment. As a control, sera were also obtained from 21 subjects without periodontitis. High-sensitivity CRP (hs-CRP) was measured using nephelometry with a latex particle-enhanced immunoassay and interleukin-6 and TNF-alpha were determined by sensitive enzyme-linked immunosorbent assay. The levels of hs-CRP and interleukin-6 in the sera of this Japanese population seemed to be much lower than those reported in other populations. TNF-alpha on the other hand, demonstrated similar levels between this Japanese and other populations. Periodontal status demonstrated a significant improvement in all patients following treatment. There was a trend toward higher hs-CRP levels in patients at baseline compared with control subjects. Hs-CRP level tended to decrease with improvement of the periodontal condition following treatment and approached that of control subjects, although this decline was not statistically significant. interleukin-6 and TNF-alpha levels did not change following periodontal treatment. Furthermore, there was no difference in the serum levels of these inflammatory cytokines between patients either at baseline or at reassessment and control subjects. In this pilot study, we were unable to show that periodontal disease significantly affects the serum levels of systemic inflammatory markers. However, this does not necessarily mean that periodontitis does not contribute to the total burden of inflammation as there was a tendency for hs-CRP to decrease following successful periodontal treatment. Large-scale studies are clearly needed to determine the impact of periodontal disease on systemic inflammation.

The role for butyrate and propionate in mediating HeLa-cells growth inhibition by human dental plaque fluid from adult periodontal disease

To determine to what extent propionate and butyrate, secreted in vitro by various oral bacteria, account for the growth-inhibiting activity of plaque fluid in gingivitis in the absence or presence of chronic periodontitis, the fluid phase of plaque from each of these disease forms was obtained by homogenizing the bacteria with 0.13 M NaCl, centrifuging the mixture and Millipore-filter-sterilizing the plaque-fluid-extract supernatant. Toxins were detected and measured by growth inhibition of HeLa cells grown in minimal Eagle medium supplemented with calf serum and antibiotics. Samples of butyrate, propionate or plaque-fluid extract were added and inhibition of growth was determined relative to control cultures. The toxins in each extract were characterized by their stability to heat, freeze-drying and elution on gel filtration. Butyrate and propionate contents were measured with a Hewlett-Packard S880A gas chromatograph. The plaque-fluid extracts from each group had similar contents of butyrate, but most of the activity was due to heat-sensitive high mol. wt components. Butyrate and propionate accounted for only 5 to 15 per cent of the total activity. High mol. wt exotoxins, rather than butyrate or propionate, were the most prominent and freeze-drying-stable tissue-destructive agents in the plaque fluid from subjects with or without periodontitis.