Response Of Periodontal Tissues Research Articles

CORM-3 Inhibits the Inflammatory Response of Human Periodontal Ligament Fibroblasts Stimulated by LPS and High Glucose.

Diabetes has been recognized as an independent risk factor for periodontitis. Increasing evidences indicate that hyperglycemia aggravates inflammatory response of human periodontal ligament cells (hPDLCs). Carbon monoxide-releasing molecule-3 (CORM-3) is a water-soluble compound that can release carbon monoxide (CO) in a controllable manner. CORM-3 has been shown the anti-inflammatory effect in different cell lineages. We stimulated periodontal ligament cells with LPS and high glucose. The expression of inflammatory cytokine was detected by ELISA. RT-qPCR, Western blot and immunofluorescence were used to detect the expression of TLR2, TLR4, RAGE and the activation of NF-κB pathway. We performed silencing and overexpression treatment of RAGE targeting the role of RAGE. We performed the immunostaining of paraffin sections of the periodontitis model in diabetes rats. The results showed that CORM-3 significantly inhibited the expression of inflammatory cytokine in hPDLCs stimulated with LPS and high glucose. CORM-3 also inhibited LPS and high glucose-induced expression of RAGE/NF-κB pathway and TLR2/TLR4/NF-κB pathway. Silence of RAGE resulted in significantly decreased expression of proteins above. Overexpression of RAGE significantly enhanced the expression of these factors. CORM-3 abrogated the effect of RAGE partially. In animal model, CORM-3 suppressed the inflammatory response of periodontal tissues in experimental periodontitis of diabetic rats. Our research proved CORM-3 reduced the inflammatory response via RAGE/NF-κB pathway and TLR2/TLR4/NF-κB pathway in the process of high glucose exacerbated periodontitis. These findings demonstrated the role of RAGE in the process of high glucose exacerbated periodontitis and suggested that CORM3 be a potential therapeutic strategy for the treatment of diabetes patients with periodontitis.

Periodontal Tissue Responses to Restorations with and without Cervical Finish Line: A Systematic Review and Meta-analysis.

The purpose of this review was to evaluate the periodontal and peri-implant tissue responses to restorative approaches with and without cervical finish line on teeth and dental implants. An electronic search was performed in PubMed/MEDLINE, Embase, Cochrane Library, LILACS, Web of Science, and Scopus databases, and in the gray literature. Controlled clinical trials and prospective cohort studies were included. Analyzed outcomes included gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival thickness (GT), marginal stability (MS), and marginal bone loss (MBL). A meta-analysis was then performed in two parts: the first compared results of restorations on teeth with and without cervical finish line, and the second compared results of restorations on implant abutments with and without cervical finish line. Regarding the tooth-based restoration analysis, 7 out of 1,388 selected articles were included in the systematic review, and 2 were selected for the meta-analysis. For implantbased restorations on abutments with and without cervical finish line, 6 out of 707 selected articles were included in the systematic review, and 2 in the meta-analysis. No significant differences in periodontal and peri implant indexes were identified between both prosthetic approaches in situations with and without cervical finish lines.

The impact of Thiopeptide antibiotics on inflammatory responses in periodontal tissues through the regulation of the MAPK pathway

Periodontitis is a bacteria-induced inflammatory disease that damages the tissues supporting the teeth, gums, periodontal ligaments, and alveolar bone. Conventional treatments such as surgical procedures, anti-inflammatory drugs, and antibiotics, are somewhat effective; however, these may lead to discomfort and adverse events, thereby affecting patient outcomes. Therefore, this study aimed to find an effective method to prevent the onset of periodontal disease and explore the specific mechanisms of their action.The impact of thiostrepton on Porphyromonas gingivalis and periodontal ligament stem cells was evaluated in an inflammatory microenvironment. In vivo experiments were performed using a mouse periodontitis model to assess the effectiveness of locally applied thiostrepton combined with a silk fibroin hydrogel in impeding periodontitis progression. Thiostrepton exhibited significant antimicrobial effects against Porphyromonas gingivalis and anti-inflammatory properties by regulating the MAPK pathway through DUSP2. Locally applied thiostrepton effectively impeded the progression of periodontitis and reduced tissue damage. Thiostrepton treatment is a promising and tolerable preventive strategy for periodontitis, offering antimicrobial and anti-inflammatory benefits. These findings suggest the potential of thiostrepton as a valuable addition to periodontitis management, warranting further research and clinical exploration to improve patient outcomes.

CHANGES IN THE WIDTH OF THE PERIODONTAL GAP OF RATS WITH SUPRAOCCLUSAL RELATIONSHIPS OF INDIVIDUAL TEETH IN THE AGE ASPECT

Introduction. The dentoalveolar apparatus is a complex of complicated interaction of the jaws, masticatory muscles, teeth, and temporomandibular joints. This connection is carried out by the trigeminal nerve system with sensory and motor nuclei closely connected to the cortical and subcortical centers of the brain. Occlusal trauma is a lesion that develops in the periodontium as a result of forces that exceed the periodontal potential for functional adaptation. Occlusal trauma can be classified as primary or secondary. The first one occurs in the pulp and periodontal ligament when the force of the action on the dental structures is greater than usual, under optimal periodontal support conditions. It includes orthodontic movements, "high" restorations, and parafunctional habits such as bruxism. Secondary occlusal trauma occurs when the teeth with previous supporting tissue changes are subjected to the action of normal and excessive forces with supporting tissue changes caused by periodontal disease or previous trauma. The available evidence has demonstrated that bacterial plaque bioactive substances lead to local inflammatory responses in periodontal tissues which contribute to bone tissue resorption through osteoclasts in periodontitis. Excessive functional stress can initiate inflammatory changes in the periodontium and thus, increase destructive bacterial processes. Traumatic occlusion can expand the space of the periodontal ligament and in this way stimulate apical bacterial migration and proliferation. However, few attempts have been made to investigate the molecular mechanisms that trigger bone tissue resorption in traumatic occlusion. The analysis of publications on the studies of morphological changes in periodontal tissues in individual teeth supraocclusion in the age aspect shows the contradictory data. The aim: to determine the morphometric changes of the periodontal gap as a component of the periodontal complex in rats of different age groups in the supraocclusal relationship of individual teeth in the age aspect. Materials and methods of the study. The scientific experiment was conducted on 60 white laboratory rats aged 4 to 22 months and weighing 90 to 330 g. The rats were divided into control (30 animals) and experimental (30 animals) groups. Each group was divided into 3 subgroups (10 animals each) depending on the age of the rats: young, mature and senile. Young animals included rats aged 3–4 months with a weight of 90–100 g; mature animals - aged 6–8 months with a weight of 150–170 g; senile rats – 20–22 months and weighing 200–220 g. The method of modelling the state of supraocclusal relations of individual teeth is described in the previous publication. For histological examination of dental blocks, the following was performed. Fixation in a 10% solution of neutral formalin for two days, dehydration in alcohols of increasing concentration and embedding in paraffin. After preparation, sections were made on a Shandon Finesse 325 rotary microtome with a section thickness of 4-6 µm. The histological sections were fixed on pre-degreased slides and dried. Van Gieson staining was performed. The width of the periodontal gap was determined using the ZEISS ZEN 3.7 program by Carl Zeiss Microscopy. For statistical data processing, the AtteStat v.12.5 software was used to determine the mean value and its standard error (M±m). The probability of a statistically significant difference between the data obtained was assessed using the Student's parametric test (at a significance level of p ≤ 0.05). All samples were tested for normality using the Gupta test. Results of the study. Statistical differences were observed in rats of all groups, as well as between the indicators of all rats of the control and experimental groups (≤0.05). The width of the periodontal gap increased by 34.1% in young rats, by 25.5% in mature rats, and by 21.1% in senile rats. Conclusions The presence of supraocclusal relationships of individual teeth causes an increase in the periodontal gap in rats of all age groups. The greatest expansion of the periodontal gap has occurred in young rats. The width of the periodontal gap in rats decreases with age.

Resveratrol modulates the inflammatory response in hPDLSCs via the NRF2/HO-1 and NF-κB pathways and promotes osteogenic differentiation.

The purpose of this study was to investigate resveratrol's specific role as an anti-inflammatory and osteogenic differentiation of hPDLSCs in periodontitis and to reveal the mechanisms involved. Numerous studies have shown that inhibiting the inflammatory response of periodontal tissues and promoting the regeneration of alveolar bone are crucial treatments for periodontitis. Resveratrol has been found to have certain anti-inflammatory property. However, the anti-inflammatory mechanism and osteogenic effect of resveratrol in periodontitis are poorly understood. We constructed an invitro periodontitis model by LPS stimulation of hPDLSCs and performed WB, RT-qPCR, and immunofluorescence to analyze inflammatory factors and related pathways. In addition, we explored the osteogenic ability of resveratrol in invitro models. In vitro, resveratrol ameliorated the inflammatory response associated with activation of the NF-κB pathway through activation of the NRF2/HO-1 pathway, characterized by inhibition of p65/p50 nuclear translocation and the proinflammatory cytokines interleukin-1β levels. Resveratrol also has a positive effect on osteogenic differentiation. Observations suggest that resveratrol modulates the inflammatory response in hPDLSCs via the NRF2/HO-1 and NF-κB pathways and promotes osteogenic differentiation.

Effects of G-CSF on hPDLSC proliferation and osteogenic differentiation in the LPS-induced inflammatory microenvironment

BackgroundPeriodontitis is a chronic infectious disease of periodontal support tissue caused by microorganisms in dental plaque, which causes alveolar bone resorption and tooth loss. Periodontitis treatment goals include prevention of alveolar bone resorption and promotion of periodontal regeneration. We previously found that granulocyte colony-stimulating factor (G-CSF) was involved in periodontitis-related alveolar bone resorption through induction of an immune response and subsequent destruction of periodontal tissue. However, the mechanisms underlying the effects of G-CSF on abnormal bone remodeling have not yet been fully elucidated. Human periodontal ligament stem cells (hPDLSCs) are major modulators of osteogenic differentiation in periodontal tissues. Thus, the aim of this study was to investigated whether G-CSF acts effects on hPDLSC proliferation and osteogenic differentiation, as well as periodontal tissue repair.MethodshPDLSCs were cultured and identified by short tandem repeat analysis. The expression patterns and locations of G-CSF receptor (G-CSFR) on hPDLSCs were detected by immunofluorescence analysis. The effects of G-CSF on hPDLSCs in a lipopolysaccharide (LPS)-induced inflammatory microenvironment were investigated. Specifically, Cell-Counting Kit 8 (CCK8) and Alizarin red staining were used to examine hPDLSC proliferation and osteogenic differentiation; reverse transcription-polymerase chain reaction was performed to detect the expression patterns of osteogenesis-related genes (alkaline phosphatase [ALP], runt-related transcription factor 2 [Runx2], and osteocalcin [OCN]) in hPDLSCs; and Western blotting was used to detect the expression patterns of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt) of PI3K/Akt signaling pathway.ResultshPDLSCs exhibited a typical spindle-shaped morphology and good clonogenic ability. G-CSFR was mostly localized on the cell surface membrane. Analyses showed that G-CSF inhibited hPDLSC proliferation. Also, in the LPS-induced inflammatory microenvironment, G-CSF inhibited hPDLSC osteogenic differentiation and reduced the expression levels of osteogenesis-related genes. G-CSF increased the protein expression levels of hPDLSC pathway components p-PI3K and p-Akt.ConclusionsWe found that G-CSFR was expressed on hPDLSCs. Furthermore, G-CSF inhibited hPDLSC osteogenic differentiation in vitro in the LPS-induced inflammatory microenvironment.

Potential Impact of Long COVID-19 on Orthodontic Treatment.

Pooled estimates indicate about 226 million individuals are currently experiencing or have experienced persistent symptoms from COVID-19. Long COVID-19 (LC) has been associated with a prolonged inflammatory and stress responses in affected individuals. Due to common pathways, LC could impact the biological mechanisms of orthodontic tooth movement, orthodontically-induced inflammatory root resorption and periodontal tissue response of patients undergoing orthodontic treatment. The authors of the present report discussed potential biological mechanisms through which LC may influence orthodontic treatment highlighting the need for further research in this area.

Evaluation of the adjuvant effect of topic Bach floral in the clinical response to non-surgical periodontal treatment in patients with type 2 diabetes: pilot study

Objective: To evaluate the clinical response of periodontal tissues after periodontal therapy associated with the use of Bach Flower (Rock Rose gel) in participants with type 2 diabetes mellitus. Methodology: This randomized, doble-blind, split-mouth, single-center, placebo-controlled clinical trial selected 20 participants with moderate, severe, or advanced periodontitis (stage II, III, and IV). They were divided into groups, where group 1 received Floral Rock Rose gel and group 2, saline gel. All groups received conventional periodontal treatment characterized by scaling and root planing before gel application. Clinical evaluation was performed using periodontal clinical parameters: Plaque Index (PI), Gingival Index (GI), probing depth (PPD), gingival recession (GR), and Clinical Insertion Level (CAL). Biometric parameters and hematological parameters were also evaluated. All clinical and laboratory parameters were obtained at baseline and after three months. Results: There was an improvement in periodontal clinical parameters before and after treatment in both groups (P<0.05). There was no statistically significant difference between the intervention, control, and floral groups (P>0.05). Conclusion: The periodontal treatment performed with Rock Rose adjuvant gel (Bach Flower) was safe, efficient, and promoted the improvement of periodontal clinical parameters. However, it did not show superior results to conventional periodontal therapy.

A pilot study on the comparative evaluation of residual periodontal ligament in extracted teeth of chronic periodontitis patients with and without type 2 diabetes - Vital function of an occult dimension.

Periodontitis is the most common type of periodontal condition, primarily affecting middle-aged people and resulting in tooth loss; when combined with diabetes, it becomes a debilitating condition. The aim of this study is to compare the residual periodontal ligament length in periodontitis patients with and without diabetes. The cross-sectional observational study was conducted in the department of periodontics over 5 months. The patients in the study were divided into two groups. Group 1 comprised patients with periodontitis without type 2 diabetes and Group 2 comprised patients with periodontitis with type 2 diabetes. A total of 100 teeth 50 from each group were collected. The teeth were stained, and the Residual Periodontal Ligament (RPL) of all tooth aspects and surfaces to a total of 544 were measured. Two points were identified for measuring the RPL. The first point was from the apex of the tooth and the second point was the highest marking of the stain. The length from these two points was recorded as the RPL. Following which, means from Groups 1 and 2 were calculated to determine the rate of destruction. The average of the values for each tooth was calculated to determine the percentage of RPL in each tooth and surface. The Mann-Whitney test was used to compare the RPL of the teeth surfaces and Group 1 and Group 2 and P < 0.05 was considered statistically significant. The RPL was higher in nondiabetic patients, with a mean value of 23.66 mm, when compared to diabetic patients, with a mean RPL of 17.05 mm, implying that diabetic patients showed greater periodontal destruction. Buccal tooth surfaces displayed a mean RPL of 4.24 mm and 6.00 mm, lingual/palatal tooth surfaces with 4.02 mm and 5.91 mm, mesial tooth surfaces with 3.82 mm and 5.64 mm, and distal tooth surfaces showed 4.14 mm and 5.67 mm (diabetic and nondiabetic, respectively) with (P < 0.001) found to be statistically significant. This study observed that the destruction rate of the periodontal ligament was higher in diabetic teeth than in nondiabetic teeth, implying that patients with metabolic diseases such as type 2 diabetes influence the response of periodontal tissues to periodontitis and that hyperglycemia impacts the periodontal ligament either directly or indirectly.

Clinical and Immunological Efficacy of an Eucalyptus Leaf Preparation in Chronic Periodontitis Treatment: A Randomized Interventional Longitudinal Clinical Study

Background. The prevalence of inflammatory-destructive periodontal diseases remains to be a global problem. Long-term topical application of chlorhexidine bigluconate and metronidazole is known to involve various side effects, thereby requiring widening the spectrum of herbal preparations used for treating chronic periodontitis.Aim. To evaluate the efficacy of Chlorophyllipt in the treatment of chronic generalized periodontitis by studying cytokine concentration dynamics in the gingival fluid.Methods. A randomized controlled clinical study of outcomes achieved in 50 patients with chronic generalized periodontitis treated in Dental Polyclinic No. 3, Krasnodar Кrai, was carried out. The control group included 20 clinically healthy people. Patients diagnosed with chronic generalized periodontitis were divided into the main (n = 25) and comparison (n = 25) groups. The main group received basic therapy and conventional conservative treatment with the addition of Chlorophyllipt. The comparison group received basic therapy and conventional conservative treatment. The therapy efficacy was estimated based on clinical indicators and IL-1β, IL-1Ra, IL-8, and TNF-α cytokine levels in the gingival fluid before treatment and after 14 days, three days, and six months of treatment. Statistical analysis was performed using the SPSS version 15 software (USA).Results. All clinical parameters improved significantly in both chronic periodontitis groups after 14 days, three days, and six months of treatment in comparison with their levels before treatment (p &lt; 0.001). At the same time, the conventional conservative treatment with the addition of Chlorophyllipt reduced inflammatory processes in periodontal tissues and gum bleeding at earlier stages. In the main group IL-1β, cytokine levels after 14 days of treatment were 19% lower than in the comparison group (p = 0.025), while IL-1Ra cytokine levels were 52% higher (p = 0.023). Six months after treatment, IL-1β and TNF-α cytokine levels were 14% and 32% lower than in the control group, respectively (p2 = 0.021 and p2 = 0.008), while IL-1Ra cytokine levels were 39% higher (p =0.019). All these results were statistically significant.Conclusion. Due to the established clinical and immunological efficacy, Chlorophyllipt can be included in the conventional conservative therapy of chronic generalized periodontitis. The determined levels of IL-1β, IL-1Ra, and TNF-α cytokines in chronic periodontitis patients can be used when assessing the response of periodontal tissues towards therapeutic interventions.

Effects of nicotine and lipopolysaccharide stimulation on adhesion molecules in human gingival endothelial cells.

Smoking is a risk factor for periodontitis, and the immune response of periodontal tissues in patients with periodontitis may be strongly affected by smoking. The purpose of this study was to elucidate the bioactivity and signal transduction of human gingival endothelial cells (HGECs) due to nicotinic stimulation using a cultured medium supplemented with lipopolysaccharide (LPS) as a model of periodontitis. HGECs were cultured in medium supplemented with LPS, nicotine, nicotine + LPS, and medium supplemented without nicotine or LPS (control). Cell proliferation was assessed using Alamar blue. Cytotoxicity was assessed by lactate dehydrogenase leakage. The expression of adhesion molecule-1 (ICAM-1, VCAM-1) was assessed by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay. The expression of nicotinic acetylcholine receptor (nAChR) subunits (α3, α5, α7, β2 and β4) was evaluated by RT-PCR. The involvement of p38 mitogen-activated protein kinase (p38MAPK) and protein kinase C (PKC) cell signaling pathways in ICAM-1 and VCAM-1 expression was investigated by RT-qPCR with specific inhibitors. HGECs stimulated with LPS, nicotine and nicotine + LPS showed inhibition of cell proliferation, increase of cell death, and increase of gene and protein expression of ICAM-1. Moreover, HGECs showed the presence of α5 and α7 nAChR subunits. The expression of ICAM-1 in HGECs stimulated with LPS, nicotine, and nicotine + LPS was significantly suppressed by p38MAPK inhibitor, but not by a PKC inhibitor. The nAChR subunits of HGECs are α5 and α7, and that HGECs stimulated with nicotine and LPS express ICAM-1 via p38MAPK pathway.

Association between Periodontitis and Inflammatory Bowel Disease- Review of Current Literature on the Biologic Plausibility

Periodontitis, a chronic inflammatory disease of the supporting tissues of teeth, is etiologically associated with a subset of pathogenic organisms that thrive in the anoxic niche provided by the diseased periodontal pockets. These anaerobic gram-negative organisms resident in plaque biofilm and causing an overwhelming chronic inflammatory response in periodontal tissues have also been associated with other systemic chronic inflammatory diseases like cardiovascular, renal, and adverse pregnancy outcomes as per literature being published for the past twenty years or more. This paper aims to provide an overview on the biological plausibility of a strong association between systemic seeding of pathogenic oral bacteria and chronic bowel diseases like Inflammatory Bowel Diseases by reviewing recent literature from open-source journals on the same topic. Knowledge of the association between oral bacteria and gut inflammatory diseases will help in broadening the preventive and therapeutic options available currently by suggesting measures to suppress the systemic hyper-immune response.

Effective Management of Non-Surgical Periodontal Treatment in a Patient with Severe Gingival Enlargement and Periodontal Bone Loss: A Case Report

The immune-inflammatory response of periodontal tissue can be influenced by various systemic variables such as hormone disorders, hematologic diseases, nutrition, and medications. Inflammatory cytokines released by infected periodontal tissue are implicated in suppressing erythrocyte growth, differentiation, and erythropoiesis inhibition. We present a case of non-surgical periodontal treatment in a 31-year-old female patient with severe gingival enlargement associated with aggressive bone destruction combined with iron deficiency anemia (IDA). The periodontal treatment plan was achieved in collaboration with the hematologist, starting with oral hygiene instruction, scaling and root planning (SRP) by sextants with systemic antibiotic therapy combined with a chemical agent and low-level-laser-therapy (LLLT), and extraction of hopeless teeth. Effective non-surgical periodontal treatment with SRP and LLLT reduces inflammation and gingival enlargements and controls the recolonization of subgingival sites by periodontal pathogens as a crucial factor to proceed with periodontal surgery. Function, aesthetics, and the patient’s social communication are all improved.

Clinical response of doxycycline administration to periodontal tissues of periodontitis patients with type 2 diabetes mellitus: Rapid Review

ABSTRACT Diabetes mellitus is a group of physiological dysfunctions due to insulin resistance and inadequateinsulin secretion characterized by hyperglycemia. Diabetic patients have an increased risk and severity ofperiodontitis. Therefore, additional periodontal treatment is required. Doxycycline is a broad-spectrum antibioticand has the anti collagenase ability to inhibit tissue damage. This study aims to determine the clinical response ofperiodontal tissue in patients with periodontitis with type 2 diabetes mellitus to doxycycline. This rapid review wasconducted online in May-July 2021 on randomized controlled trial articles about systemic doxycycline as anadjunctive periodontal treatment in periodontitis patients with type 2 diabetes mellitus. The search was carried outfrom three electronic databases, Pubmed NCBI, Cochrane Library, and Google Scholar concerning PRISMA analysisguidelines, using PICO strategy and the study quality assessed by SORT. Five articles were selected with goodevidence quality (level 1). Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP),plaque index (PI), gingival index (GI), and gingival recession were evaluated. The result showed a more significantreduction in clinical parameters in periodontitis patients with type 2 diabetes mellitus who received additionalsystemic doxycycline treatment, except gingival recession. Systemic doxycycline as an adjunctive periodontaltreatment in periodontitis patients with type 2 diabetes mellitus gave a positive clinical response, with better resultsthan no other doxycycline treatment group. KEYWORDS: Doxycycline, periodontitis, diabetes mellitus

Periodontal tissue response among subjects with two different Nickel-Titanium fixed retainers during twelve months of retention

Objectives: This study aimed to compare changes in the lower dental arch after bonding two different shapes of Nickel titanium fixed retainers. The study was focused on whether the different shapes and sizes of retainers influence periodontal tissue response during one year of the post-treatment phase. Material and methods: Sixty subjects in total, of age (16-25), were randomly divided into two groups, every 30 subjects, upon finishing orthodontic treatment. Each group was divided into two subgroups according to growth factor (16-19) and (20_25) years old. First group FR was bonded Flat Nickel-titanium Retainer, thickness .010” x .029”, manufactured by Forestadent and to other 30 other subjects was bonded multistranded round Nickel -titanium retainer thickness ø 0.44mm/17”, manufactured by Dentaurum. Subjects had to come for checkups in 3,6,9, and 12 months, where four periodontal parameters were evaluated Plaque Index, Calculus Index, Gingival Index and Probing Depth. Results: There were statistically significant differences for the Plaque Index in favour of the Flat retainer. Also, the Gingival Index was higher in the Round retainer group but only after 12 months of retention. Pocket depth values increased in the first 3 months and then again showed the difference in the 12-month follow-up. Conclusions: Flat retainers showed less periodontal tissue response, lower Plaque Index, Gingival Index and less Pocket Depth compared to the Round retainers used in this study. But again, we found both types of fixed retainers initiate some periodontal response anyway.

Differential gene expression profiles of periodontal soft tissue from rat teeth after immediate and delayed replantation: a pilot study.

PurposeIn dental avulsion, delayed replantation usually has an uncertain prognosis. After tooth replantation, complex inflammatory responses promote a return to periodontal tissue homeostasis. Various types of cytokines are produced in the inflammatory microenvironment, and these cytokines determine the periodontal tissue response. This study aimed to identify the gene expression profiles of replanted teeth and evaluate the functional differences between immediate and delayed replantation.MethodsMaxillary molars from Sprague-Dawley rats were extracted, exposed to a dry environment, and then replanted. The animals were divided into 2 groups according to the extra-oral time: immediate replantation (dry for 5 minutes) and delayed replantation (dry for 60 minutes). Either 3 or 7 days after replantation, the animals were sacrificed. Periodontal soft tissues were harvested for mRNA sequencing. Hallmark gene set enrichment analysis was performed to predict the function of gene-gene interactions. The normalized enrichment score (NES) was calculated to determine functional differences.ResultsThe hallmark gene sets enriched in delayed replantation at 3 days were oxidative phosphorylation (NES=2.82, Q<0.001) and tumor necrosis factor-alpha (TNF-α) signaling via the nuclear factor kappa light chain enhancer of activated B cells (NF-κB) pathway (NES=1.52, Q=0.034). At 7 days after delayed replantation, TNF-α signaling via the NF-κB pathway (NES=–1.82, Q=0.002), angiogenesis (NES=–1.66, Q=0.01), and the transforming growth factor-beta signaling pathway (NES=–1.46, Q=0.051) were negatively highlighted.ConclusionsDifferentially expressed gene profiles were significantly different between immediate and delayed replantation. TNF-α signaling via the NF-κB pathway was marked during the healing process. However, the enrichment score of this pathway changed in a time-dependent manner between immediate and delayed replantation.

EZH2 Regulates Lipopolysaccharide-Induced Periodontal Ligament Stem Cell Proliferation and Osteogenesis through TLR4/MyD88/NF-κB Pathway.

Background Periodontitis induced by bacteria especially Gram-negative bacteria is the most prevalent chronic inflammatory disease worldwide. Emerging evidence supported that EZH2 plays a significant role in the inflammatory response of periodontal tissues. However, little information is available regarding the underlying mechanism of EZH2 in periodontitis. This study is aimed at determining the potential role and underlying mechanism of EZH2 in periodontitis. Methods The protein levels of EZH2, H3K27ME, p-p65, p-IKB, TLR4, MyD88, Runx2, and OCN were examined by western blot assay. Proliferation was evaluated by CCK8 assay. The levels of TNFα, IL1β, and IL6 were detected by ELISA assay. Migration was detected by wound healing assay. The distribution of p65 was detected by immunofluorescence. The formation of mineralized nodules was analyzed using alizarin red staining. Results LPS stimulation significantly promoted EZH2 and H3K27me3 expression in primary human periodontal ligament stem cells (PDLSCs). Targeting EZH2 prevented LPS-induced upregulation of the inflammatory cytokines and inhibition of cell proliferation and migration. Furthermore, EZH2 knockdown attenuated the TLR4/MyD88/NF-κB signaling to facilitate PDLSC osteogenesis. Conclusions Modulation of the NF-κB pathway through the inhibition of EZH2 may offer a new perspective on the treatment of chronic apical periodontitis.

Evaluation of the periodontal status of a patient diagnosed with Sheehan syndrome: A case report

Aim: Some immunological changes occurring in mothers during pregnancy increase their susceptibility to infections, including periodontal infections. Sheehan syndrome (SS) is a disease that occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. The presence of multiple hormonal deficiencies leads to the impairment of bone microarchitecture, which can cause osteopenia and even osteoporosis. Osteoporosis and periodontitis are both chronic diseases characterized by bone loss. Moreover, recent studies have shown that there is a relationship between menopause, osteoporosis, alveolar bone resorption, and tooth loss. This case report aims to evaluate the oral and periodontal status of a patient with SS and to raise awareness about dental and periodontal problems that may occur in such patients.&#x0D; Methodology: A 63-year-old female patient diagnosed with SS in the endocrinology clinic was referred to the periodontology clinic with complaints of multiple tooth loss, mobility in her teeth, and gingival bleeding. In the clinical and radiographic examination of the patient, it was determined that all teeth had horizontal bone resorption; moreover, there was mobility in the mandibular anterior teeth and hemorrhage in the gums. When the patient’s laboratory results were examined, it was seen that the basal plasma levels of free triiodothyronine (T3) and thyroxine (T4), growth hormone (GH), prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and total testosterone values were significantly lower, and the anterior pituitary elevation was significantly decreased in pituitary magnetic resonance (MR) imaging.&#x0D; Conclusion: The periodontium is the target tissue of sex and other hormones. Hormonal changes may affect the inflammatory–immune tissue responses of periodontal tissues. Many studies have shown that thyroid and sex hormones affect oral and especially periodontal tissues. The degradation of hormonal hemostasis may induce a series of pathological events in the oral environment, resulting in inflammatory changes in gingival tissues, periodontal attachment losses, and destruction of the alveolar bone. Systemic diseases that affect hormonal conditions, such as SS, must be considered in the evaluation of oral health. Medical physicians should refer their patients to the dentist for consultation when evaluating patients’ hormonal status and planning their treatment.&#x0D; &#x0D; How to cite this article: Şen SC, Saygun NI, Or Koca A, Özcan E. Evaluation of the periodontal status of a patient diagnosed with Sheehan syndrome: A case report. Int Dent Res 2021;11(Suppl.1):308-11. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.46&#x0D; &#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.&#x0D;

Morphological Assessment of the Effect of Nanosecond Diode Laser Radiation With a Wavelength of 1265 nm on Periodontal Tissue in the Treatment of Apical Periodontitis: An Experimental Study.

Introduction: There is a morphological assessment of the damaged area and the inflammatory response of periodontal tissues after therapy. It seems relevant to evaluate the reaction of the periapical tissues of the teeth of experimental animals after the treatment of simulated apical periodontitis using laser photodynamic therapy (PDT) and non-pigment laser transcanal microablation using morphological research. Methods: The lower incisors of 15 rabbits were used to simulate acute apical periodontitis of pulpal origin. Subsequently, the traditional treatment of teeth canals using mechanical cleaning and irrigation with antiseptic solution started. Then, three groups underwent different therapies - using PDT (n = 5; photosensitizer chlorin e6, [l = 660 nm, 60 mW/cm2 ] for 2 minutes), using a new technology of transcanal laser ablation (n = 5; diode laser [l = 1265 nm, 180 mW/cm2 ] for 3 minutes), and without additional treatment (n = 5). Laser therapy in two groups was carried out for 10 days once in 2 days. The animals were euthanized 10 days after the treatment started, decapitation was performed, and morphological specimens were studied under a microscope. Descriptive analysis (study of inflammatory apical infiltrate, bone regeneration of the alveoli and periodontal ligament) and quantitative analysis were performed. The data were statistically processed using the Kruskal-Wallis test. Results: The group treated with the new laser technology showed the best results with moderate lymph-macrophage infiltration and congested vessels, moderate neoangiogenesis and fibrogenesis. The size of the lesion was 506.4 mm2, compared with the PDT group - 872.0 mm2 (P ≤ 0.05). Conclusion: A decrease in the focus of inflammation, moderate neoangiogenesis and fibrogenesis in the periapical region when using transcanal laser microablation indicate the prospects of using the new technology in clinical practice in the complex therapy of apical periodontitis.

Periodontium in females - A review

Periodontium is physically and anatomically similar for both males and females. However, the response of periodontal tissues to hormones varies in both, due to different hormonal interaction. At different life stages of a female such as puberty, menstruation, pregnancy, menopause and post-menopause, use of contraceptives and hormone replacement therapies; sex hormones like estrogen and progesteron effects periodontal tissues.Sex hormones play significant roles in modulating the periodontal tissue responses, which can be minimized with good plaque control and with hormone replacement.