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Correlation between gingivain/gingipain and bacterial dipeptidyl peptidase activity in gingival crevicular fluid and periodontal attachment loss in chronic periodontitis patients. A 2-year longitudinal study.

The aim of this study is to determine whether either gingival crevicular fluid (GCF) bacterial gingivain/gingipain or dipeptidyl peptidase (DPP) levels, total activity (TA) and concentration (EC), predict progressive attachment loss (AL) in 75 patients with moderate periodontitis. GCF was collected from 16 molar and premolar mesiobuccal sites and then clinical attachment level (CAL) and probing depth (PD) were measured with an electronic constant pressure probe. Lastly, gingival, gingival bleeding, and plaque indices were scored. Prior to the baseline visit, patients were given basic periodontal treatment after which the above procedures were repeated. In addition, carefully localized radiographs were taken of the test teeth and repeated annually. Patients were then seen every 3 months for 2 years and the clinical measurements repeated at each visit. In 48 patients, 124 AL sites, 91 rapid AL (RAL), and 33 gradual AL (GAL) were detected. Gingivain/gingipain and bacterial DPP levels (TA and EC) at RAL sites were significantly higher (P < or = 0.0001) than at paired control sites at the attachment loss time (ALT) and prediction time (PT). Mean levels over the study period of both proteases (TA and EC) at GAL sites were significantly higher (P < or = 0.0001) than those at paired control sites. The GCF levels of gingivain/gingipain were always higher than those of DPP. Critical values (CV) of 5 microU/30 seconds (TA) and 30 microU/microL (EC) for both proteases showed high sensitivity and specificity values for TA and EC, which were the same at both ALT and PT. The positive predictive values were higher for gingivain/ gingipain. Mean site levels, over the course of the study, of both proteases (TA and EC) were significantly higher (P < or = 0.0001) at AL, RAL, and GAL sites than non-attachment loss (NAL) sites in AL patients and mean patient levels were significantly higher (P < or = 0.0001) in AL, RAL, and GAL patients than NAL patients. These results indicate that both of these bacterial proteases in GCF may be predictors of periodontal attachment loss.

Adhesins, Bacterial↗

[The levels of interleukin 8 in gingival crevicular fluids of chronic periodontitis].

OBJECTIVE: To study the changes of IL-8 levels in chronic periodontitis progress and correlation with clinical parameters. METHODS: The concentrations and total amounts of IL-8 cytokine in gingival crevicular fluids by double antibody sandwich ABC ELISA in chronic periodontitis (before and after treatment) and healthy control group were determined. Clinical parameters were measured and analysed. RESULTS: In the chronic periodontitis, IL-8 cytokine was detected,significantly higher than the healthy group. The total amounts of IL-8 and GCF had significant differences between the diseased and healthy groups, as well as between the groups before and after treatment (P<0.01, P<0.05, respectively), but no significant difference was found between these groups in the concentration of IL-8 (P>0.05). There was positive correlation between the total amounts of IL-8 and clinical parameters, between GCF volume and clinical parameters (P<0.01). CONCLUSION: These data indicated that the total amounts of IL-8 exhibited dynamic changes upon progress of chronic periodontitis. The levels of IL-8 in GCF are valuable in judging the degree of chronic periodontitis and in guiding clinical treatment.

English Abstract↗

Periodontal pathogens in subgingival plaque of HIV-positive subjects with chronic periodontitis.

Many putative periodontal pathogens associated with periodontal disease in human immunodeficiency virus (HIV)-infected patients also occur in non-HIV-infected individuals. This study examined the prevalence of eight periodontal pathogens in HIV-positive and HIV-negative patients with chronic periodontitis using the 16s RNA polymerase chain reaction technique. The results showed a significant prevalence of Porphyromonas gingivalis and Treponema denticola among HIV-negative patients compared to HIV-positive patients. Sixty percent of the patients in both groups were colonized by five to six species. Odds ratio analysis revealed a statistically significant positive association between three of the 28 possible combinations in the HIV-positive group. They included Prevotella nigrescens/Campylobacter rectus, P. nigrescens/P. gingivalis and P. nigrescens/T. denticola. Although the prevalence of periodontal pathogens is similar in both the groups, the combination of certain periodontal pathogens may be responsible for chronic periodontitis seen in HIV-infected adults.

Adult↗

The relationship between gingival crevicular fluid cathepsin B activity and periodontal attachment loss in chronic periodontitis patients: a 2-year longitudinal study.

This study aims to determine whether gingival crevicular fluid (GCF) cathepsin B levels, total activity (TA) and concentration (EC) predict progressive attachment loss (AL). Seventy-five previously untreated patients with moderate periodontitis were recruited. GCF was collected from 16 molar and premolar mesiobuccal sites and probing attachment level (PAL) and probing depth (PPD) were measured with an electronic probe. Gingival, gingival bleeding and plaque indices were then scored. Prior to baseline patients were given basic periodontal treatment after which the above procedures were repeated. Carefully localized radiographs were taken of the test teeth and repeated annually. Patients were seen 3-monthly for 2 yr and the procedures were repeated. One hundred and twenty-one AL sites, 90 rapid AL (RAL) and 31 gradual AL (GAL), in 49 patients were detected. Cathepsin B levels (TA & EC) at RAL sites were significantly higher (p < 0.0001) than paired control sites at the attachment loss time (ALT) and prediction time (PT). Mean levels (TA & EC) over the study period at GAL sites were significantly higher (p < 0.0001) than paired control sites. Using a critical value (CV) of 7.5 microU/30 s (TA) and 30 microU/microL (EC) showed a sensitivity of 100% and specificity of 99.83% (TA) and 100% and 99.75%(EC) at both ALT & PT. Mean cathepsin B levels (TA & EC) were significantly higher (p < 0.0001) at RAL and GAL sites than non-attachment loss (NAL) sites in AL patients in intrapatient comparisons and mean patient levels were significantly higher (p < 0.0001) in AL patients than NAL patients in interpatient comparisons. These results indicate that GCF cathepsin B may serve as a predictor of attachment loss.

Adult↗

Cathepsin B/L-, elastase-, tryptase-, trypsin- and dipeptidyl peptidase IV-like activities in gingival crevicular fluid: correlation with clinical parameters in untreated chronic periodontitis patients.

20 untreated chronic periodontitis patients were given a full periodontal examination, including measurements of probing depth (PD), clinical attachment loss (CAL), gingival index (GI), bleeding index (BI) and plaque index (Pl.I.). At a second visit, gingival crevicular fluid (GCF) was collected on filter paper strips from the deepest accessible probing site of each tooth. GCF volumes were determined and the samples eluted into buffer. Protease activities in the resulting eluates were assayed with peptidyl derivatives of 7-amino-4-trifluoromethyl coumarin (AFC). Cathepsin B/L-like activity was determined with Bz-Val-Lys-Lys-Arg-AFC, elastase-like activity with MeOSuc-Ala-Ala-Pro-Val-AFC, tryptase-like activity with Z-Ala-Ala-Lys-AFC, trypsin-like activity with Z-Gly-Gly-Arg-AFC and dipeptidyl peptidase (DPP) IV-like activity with Ala-Pro-AFC. Total enzyme activities and enzyme concentrations both correlated positively with all clinical parameters in linear regression analysis. This was true on both a patient level, using mean patient values, and a site level, using either individual patient or pooled patient data. Most of these correlations were statistically significant, although the proportion was greater for total enzyme activity than concentration. With total activities, correlations with different enzymes and parameters generally followed the order: cathepsin B/L-greater than elastase- greater than DPP IV- greater than trypsin- greater than tryptase-like activity and PD greater than CAL greater than GI greater than BI greater than Pl.I respectively. Total enzyme activities had good diagnostic specificity and sensitivity as predictors of clinical parameters in this cross-sectional study, suggesting that GCF proteases might provide useful information on the periodontal condition.

Adult↗

Maintenance of periodontal attachment levels in prosthetically treated patients with gingivitis or moderate chronic periodontitis 5-17 years post therapy.

OBJECTIVES: The present retrospective analysis was performed to evaluate the long-term results of initial periodontal and fixed prosthodontic treatment in patients with gingivitis or moderate chronic periodontitis during post-therapeutic irregular maintenance of 5-17 years. MATERIAL AND METHODS: Thirty-four patients participated in the study. Baseline data were taken from the patients' records when the periodontal and the prosthetic treatment was finished. A follow-up examination was performed in conjunction with the radiographic examination including assessment of plaque, bleeding on probing, probing pocket depth, recession and probing attachment loss. Information regarding the oral hygiene habits of the subjects as well as the amount of dental and initial therapy received between the observation time was obtained from the patients' records. RESULTS: The results from the clinical trial revealed that during the mean examination period of 11 years only 31 teeth were lost. The remaining restored and non-restored teeth did not show any significant differences in attachment loss (from 2.9 mm to 3.0 mm) in spite of a higher plaque value at the follow-up examination (from 42% to 48%). The BoP remained stable in the same time period and scored 31% to 28%. CONCLUSIONS: The periodontal attachment levels were maintained during a prolonged period despite irregular maintenance care. This indicates that in a population of obviously decreased susceptibility to chronic periodontitis, it is possible that fixed reconstructions will not - even under suboptimal supportive care - jeopardize the periodontal status.

Adolescent↗

Polymorphisms in the +252(A/G) lymphotoxin-alpha and the -308(A/G) tumor necrosis factor-alpha genes and susceptibility to chronic periodontitis in a Czech population.

BACKGROUND: Periodontitis is an inflammatory disease that leads to irreversible attachment loss, bone destruction and eventually tooth loss. Tumor necrosis factor (TNF), a pluripotent proinflammatory cytokine that is able to induce tissue destruction and bone resorption, has been implicated in the pathogenesis of periodontal disease. METHODS: In this study, we investigated an association between chronic periodontitis and two previously described bi-allelic polymorphisms in the TNF locus: a G to A transition at position -308 in the 5'promoter region of the TNF-alpha gene and an NcoI restriction fragment length polymorphism (RFLP) in the first intron (position +252A/G) of the lymphotoxin alpha (LT-alpha) gene. Genomic DNA was obtained from 132 patients with chronic periodontitis together with 114 age- and gender-matched unrelated control subjects. RESULTS: The TNF-alpha (-308G/A) polymorphism itself showed no association with chronic periodontitis, whereas the frequency distribution of the LT-alpha (+252A/G) genotypes showed statistically significant differences between patients and the reference group. The proportion of individuals carrying the LT-alpha 1/1 genotype was significantly lower in the group of patients with chronic periodontitis (0.8%) than in the control group (8.8%) (P < 0.0094, Pcorr < 0.05). However, the significant differences in the frequencies of the combined genotypes (TNF-alpha and LT-alpha) between the control and the patient groups were found using a simulation by applying the Monte-Carlo method (P < 0.01). CONCLUSION: Our data suggest that combined genotypes composed of the TNF-alpha and LT-alpha gene polymorphisms may influence the susceptibility to chronic periodontitis. We also showed that, comparing the two genes, the 1/1 genotype of the NcoI polymorphism in the first intron of the LT-alpha gene is a more informative marker and it may be one of the protective genetic factors against chronic periodontitis in our population.

Adenine↗

Anaerobes and short-chain fatty acids in crevicular fluid from adults with chronic periodontitis.

Pathogeny of adult chronic periodontitis is still unclear. Bacteriological and chemical analysis of crevicular fluid have shown, in active sites of the disease, a simultaneous presence of anaerobes and their major by-product: short-chain fatty acids. The last can decrease "in vitro" the neutrophil intracellular pH, whenever these cells are incubated in an acid medium. Clinical investigations are scarce which hold out data useful to attempt verifying this possible physiopathological mechanism. This work shows the presence of anaerobes in the active periodontal pockets, together with the presence of short-chain fatty acids likely to reach a concentration level comparable to that used for inhibiting neutrophils "in vitro". Forthcoming studies should investigate about a possible intracellular pH drop in the neutrophils and other cells of the inflamed periodontium.

Adult↗

[The distribution of fimA genotype of Porphyromonas gingivalis in chronic periodontitis patients].

OBJECTIVE: To investigate the distribution of fimA genotype of P. gingivalis in chronic periodontitis patients. METHODS: Subgingival plaque samples were collected from 101 chronic periodontitis patients. P. gingivalis was detected by both culture method and P. gingivalis 16S rRNA PCR. fimA type-specific primer were designed, and the distribution of fimA genotype of P. gingivalis in periodontitis patients were detected by PCR. RESULTS: The detective ratio of P. gingivalis was 88.1%. Among them, a single fimA genotype was detected in most subgingival plaque samples (65.1%), and the distribution of five fimA genotypes among P. gingivalis positive patients was as follows: type I, 24.7%; type II, 43.8%; type III, 15.7%; type IV, 40.4%; type V, 3.4%; respectively. CONCLUSION: P. gingivalis with various fimA genotypes were present in subgingival plaque samples from chronic periodontitis patients, and P. gingivalis with type II fimA and IV fimA were more predominant in chronic periodontitis patients, and they may be associated with the development of periodontitis.

Adult↗

Lifestyle and psychosocial factors associated with chronic periodontitis in Taiwanese adults.

BACKGROUND: The development of chronic periodontitis (CP) is a multifactorial process and variation in severity cannot be explained by just a few risk factors. The aims of this study were: 1) to explore the lifestyle and psychosocial factors of CP patients and 2) to estimate the proportion of total CP cases attributable to one or more risk factors considered. METHODS: A case-control study of 250 cases of CP patients and 250 controls were matched by age (within 3 years) and gender. Complete dental examinations were performed based on the clinical criteria for CP for both groups. Structured questionnaires were conducted to collect lifestyle and psychosocial factors. Multivariate logistic regression was applied to assess the association between risk factors and chronic periodontitis. RESULTS: Conditional multivariable logistic regression analysis showed that toothbrushing frequency (odds ratio [OR]: 5.77, if rarely; OR: 3.50, if once a day), mental illness (OR: 5.32, if Chinese Health Questionnaire scores were > or = 6), and smoking (OR: 3.93, if pack years smoked was > 21) are significantly and independently associated with chronic periodontitis. In addition, all these variables reflected a dose-response effect (P trend = <0.001, 0.004, and 0.005, respectively). CONCLUSIONS: For Taiwanese adults, 36.10% of CP cases were presumably attributable to toothbrushing frequency, mental illness, and smoking. These three factors should be the first priorities in establishing a preventive program to improve the periodontal health status.

Adult↗

[Changes of circulating IFN-gamma, IL-4 in patients with chronic periodontitis before and after periodontal initial therapy].

PURPOSE: To investigate the effect of periodontal initial therapy on circulating blood serum interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) in patients with chronic periodontitis. METHODS: 15 patients with chronic periodontitis and 15 healthy people were selected. Circulating blood serum IFN-gamma and IL-4 were measured using double antibody sandwich ELISA; Student's t test was used for comparing sulcus bleeding index (SBI), probing depth (PD), and circulating IFN-gamma, IL-4 in patients with chronic periodontitis that were assessed respectively before and 4 to 6 weeks after periodontal initial therapy. RESULTS: The level of blood serum IFN-gamma, IL-4 in patients with chronic periodontitis was significantly higher than the control group (P<0.01); After periodontal initial therapy, SBI, PD, and circulating IFN-gamma concentration were reduced significantly (P<0.01); IL-4 concentration had no significant difference (P>0.05). CONCLUSIONS: Blood serum IFN-gamma, IL-4 were associated with chronic periodontitis; The control of gingival infection may reduce blood serum IFN-gamma concentration; IL-4 concentration was not reduced with the control of gingival infection. Periodontal initial therapy.

Chronic Periodontitis↗

Genetic variations in the matrix metalloproteinase-1 promoter and risk of susceptibility and/or severity of chronic periodontitis in the Czech population.

OBJECTIVES: Matrix metalloproteinase-1 (MMP-1) is a potent enzyme degrading extracellular matrix that was implicated in the pathogenesis of chronic periodontitis. Therefore, the aim of our study was to examine the association between three promoter polymorphisms of the MMP-1 gene and chronic periodontitis susceptibility and/or severity in a Czech population. MATERIALS AND METHODS: A total of 329 Caucasian subjects were enrolled in this study. They were 133 patients with mild to severe chronic periodontitis and 196 unrelated control subjects. MMP-1 promoter polymorphisms (-1607 1G/2G, -519A/G, and -422A/T) were genotyped using standard polymerase chain reaction-restriction fragment length product methods. RESULTS: Genotype analysis of the three single nucleotide polymorphisms across 27 different combinations showed significant association with chronic periodontitis (p<0.05). Analyses of individual polymorphisms showed no differences in distribution of the -519A/G and -422A/T variants between periodontitis and control groups. However, a trend to increased frequency of the -1607 1G allele was observed in patients with chronic periodontitis compared with the controls (p=0.054). When the groups were further stratified by smoking status, the 1G allele was associated with chronic periodontitis among non-smokers but not among smokers (p=0.033). On the contrary, the distribution of genotype frequencies of the MMP-1 -422A/T polymorphism was different between the patient and control smokers with respect to heterozygotes (73.91% versus 50.91%; p=0.017). CONCLUSIONS: Our results demonstrate that the polymorphisms in the MMP-1 promoter may have only a small effect on the etiopathogenesis of chronic periodontitis.

Adult↗

Oral lactobacilli in chronic periodontitis and periodontal health: species composition and antimicrobial activity.

BACKGROUND/AIMS: Lactobacilli are known to play an important role in the maintenance of health by stimulating natural immunity and contributing to the balance of microflora. However, their role in chronic periodontitis is unclear. We aimed to identify oral lactobacilli in chronic periodontitis and periodontally healthy subjects, and to determine their antimicrobial activity against putative oral pathogens. METHODS: A total of 238 Lactobacillus isolates from the saliva and subgingival sites of 20 chronic periodontitis and 15 healthy subjects were collected. In all, 115 strains were identified using rapid amplified ribosomal DNA restriction analysis. Antimicrobial activity against Streptococcus mutans, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia was assessed. RESULTS: Lactobacilli belonging to 10 species were identified. The most prevalent strains in healthy persons were Lactobacillus gasseri and Lactobacillus fermentum and in chronic periodontitis patients, Lactobacillus plantarum. Obligately homofermentatives, particularly L. gasseri, were less prevalent in chronic periodontitis patients compared with healthy subjects (8% vs. 64% for L. gasseri, P < 0.01). Sixty-nine percent of tested lactobacilli inhibited S. mutans, 88% A. actinomycetemcomitans, 82% P. gingivalis and 65% P. intermedia. The strongest antimicrobial activity was associated with Lactobacillus paracasei, L. plantarum, Lactobacillus rhamnosus, and Lactobacillus salivarius. The strains from periodontally healthy patients showed a lower antimicrobial activity against S. mutans than the strains from chronic periodontitis patients. CONCLUSION: The composition of oral lactoflora in chronic periodontitis and healthy subjects differs, with a higher prevalence of homofermentative lactobacilli, particularly L. gasseri, in the latter group. Both homo- and heterofermentative oral lactobacilli suppress the growth of periodontal pathogens, but the antimicrobial properties are strain, species and origin specific.

Adult↗

[Interferon-gamma and neopterin in blood serum of patients with chronic periodontitis after autograft operations].

The aim of the study was to compare the serum levels of interferon-gamma (INF-gamma) and neopterin (NPT) in 10 patients with mild form of chronic periodontitis before and after operations. Overall objective of these operations is the elimination of periodontal and osseous pockets. 10 blood donors were included in the control group. The serum levels of INF-gamma and NPT were measured using enzyme immunoassay technique. INF-gamma and neopterin in patients with chronic periodontitis were assessed before and 4 to 6 weeks after the operation. The mean serum INF-gamma in patients with mild form of chronic periodontitis (n=10) was 13,2+/-4,03 pg/mL. The mean serum INF-gamma level in patients with mild form of chronic periodontitis (n=10) after the operations was 10,05+/-3,12 pg/mL. Serum levels of INF-gamma in patients with mild form chronic periodontitis were significantly higher than those in the control group. There was no significant difference in serum levels of INF-gamma in patients with mild form before and after operations. The mean serum level of NPT in the control was 5,3+/-2,39 nmol/L. The mean serum NPT level in patients (n=10) with mild form chronic parodontitis was 14,4+/-10,05 nmol/L. After operations NPT concentration were reduced (6,9+/-3,39 nmol/L). Serum levels of NTP in patients with mild form chronic periodontitis were significantly higher than those in the control group. Significant difference was observed in serum levels of NPT in patients with mild form of chronic periodontitis before and after operations. Obtained data allow specifying the mechanism of positive influence of autograft operations on the pathogenesis of chronic periodontitis.

Adult↗

[The association between infection of Epstein-Barr virus and chronic periodontitis].

OBJECTIVE: To investigate the relationship between Epstein-Barr virus (EBV) infection and chronic periodontitis. METHODS: In 62 chronic periodontitis patients, subgingival plaque samples were collected from active periodontitis site, quiescent periodontitis site, and initial gingivitis sites of each subject. The nested polymerase chain reaction (nested-PCR) was used to determine the presence of EBV. RESULTS: The EBV was detected in 58.0% of the samples from active periodontitis sites, which was significantly higher than that from quiescent periodontitis sites (58.0% vs 22.6%, P < 0.01) and from initial gingivitis sites (58.0% vs 19.4%, P < 0.01). CONCLUSION: The results suggest that EBV infection is associated with the activity of chronic periodontitis.

Adult↗

Immunoglobulin G subclass antibody profiles in Porphyromonas gingivalis-associated aggressive and chronic periodontitis patients.

BACKGROUND/AIMS: The immunoglobulin G (IgG) antibody response is considered to be protective and beneficial for the control of periodontal lesions. This study analysed IgG subclass antibody levels of Porphyromonas gingivalis in patients with both aggressive periodontitis (AgP) and chronic periodontitis (CP). METHODS: Subgingival plaque and peripheral blood samples were collected from patients with localized AgP (n = 13), generalized AgP (n = 28) and generalized CP (n = 27) and from 14 periodontally healthy controls. P. gingivalis was identified in subgingival pockets using a polymerase chain reaction. Simultaneously, serum IgG subclass antibody against P. gingivalis whole cells/P. gingivalis fimbriae were measured using enzyme-linked immunosorbent assay. RESULTS: P. gingivalis was frequently detected in periodontitis patients. Anti-P. gingivalis whole cell IgG1 was elevated in all P. gingivalis-positive patients in the three periodontitis groups. Although increased anti-P. gingivalis IgG1 was also observed in the bacterium-positive healthy controls, the level was lower than that found in the three periodontitis groups. Levels of IgG1, IgG2, IgG3 and IgG4 to P. gingivalis did not differ among bacterium-positive patients in the three periodontitis groups; a significant increase of IgG2 level was not observed in localized AgP. Anti-fimbriae IgG subclass levels of IgG1, IgG2 and IgG4 did not differ among bacterium-positive subjects in all groups, while the anti-fimbriae IgG3 level in generalized CP was significantly higher than that in localized and generalized AgP. CONCLUSIONS: P. gingivalis infection elicited an IgG subclass antibody response in both periodontitis patients and healthy subjects, while higher anti-P. gingivalis IgG1 levels were found in the three periodontitis groups compared with the healthy control group.

Acute Disease↗

Candida yeasts in chronic periodontitis tissues and subgingival microbial biofilms in vivo.

The frequency of Candida infection in periodontal tissues of chronic periodontitis (CP) patients and the extent of candidal penetration into gingival tissues was studied. Tissue specimens collected from 25 CP patients during periodontal flap operations of initial periodontal therapy were examined by immunohistochemistry using Candida albicans-specific antibodies. Sections were also stained with periodic acid-Schiff (PAS) and subgingival plaque samples from 17 patients were cultured. Immunoreactivity for Candida was present in four of the 25 CP specimens (16%). Only one yeast-positive specimen was found when PAS-staining was used (4%) and two yeast-positive specimens were found with plaque culture (8%). Hyphal formation seemed essential and candidal hyphae were found to extend into the periodontal connective tissue. The degree and type of inflammation adjacent to the hyphae varied from a site and a patient to another. The sensitivity of specific antibodies was superior to PAS-stain or plaque culture in detection of Candida in tissues.

Biofilms↗

Effect of meloxicam on gingival crevicular fluid IL-1beta and IL1 receptor antagonist levels in subjects with chronic periodontitis, and its effects on clinical parameters.

The aim of the present study was to determine the effects of meloxicam after initial periodontal treatment on interleukin-1beta (IL-1beta) and IL-1 receptor antagonist (IL-1ra) in gingival crevicular fluid (GCF) and clinical parameters in the chronic periodontitis patients. Data were obtained from 30 patients with chronic periodontitis. Fifteen chronic periodontitis patients received 7.5 mg meloxicam, and 15 patients received placebo tablets in a 1x1 regimen for 1 month. All subjects were nonsmokers and had not received any periodontal therapy. The plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded. The GCF was collected using a paper strip: eluted and enzyme-linked immunoabsorbent assays (ELISAs) were performed to determine the cytokine levels. The clinical data and GCF samples were obtained after periodontal therapy and 1 month after periodontal therapy. The PI, GI, PD, and GCF IL-1ra decreased significantly (p<0.05) in meloxicam group at first month when comparing the initial levels. While decrease of the PI was statistically significant in control group (p<0.05), statistically significant changes were not determined in the other clinical parameters and GCF cytokine levels (p>0.05). There were no significant differences between two groups in any of the investigated parameters. Our observations did not reveal any influence of meloxicam on levels of IL-1beta and IL-1ra in chronic periodontitis. Additional clinical studies are advisable to determine whether COX-2 selective drugs alter periodontal disease outcome with greater safety.

Adult↗