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PubMed2006

Periodontal status and cytoplasmic enzyme activities in gingival crevicular fluid of type 2 diabetic and/or obese patients with chronic periodontitis.

Type 2 diabetes mellitus and obesity are the most common nutritional disorders in developed and developing countries. Increased prevalence of periodontal disease is a well-known complication of type 2 diabetes mellitus (DM). As obesity is generally the first step toward type 2 diabetes mellitus, it is possible to find exacerbated periodontal disease in obese patients, also. The purpose of this cross-sectional study was to investigate the periodontal status and aspartate aminotransferase and lactate dehydrogenase enzyme activities in gingival crevicular fluid (GCF) of type 2 diabetic and/or obese chronic periodontitis patients. A total of 39 chronic periodontitis patients participated in the study. The study population was divided into four groups according to body mass index and type 2 DM status: 1) type 2 DM obese patients, n = 8; 2) type 2 DM patients, n = 12; 3) obese patients, n = 8; 4) systemically healthy control group, n = 11. Enzyme activities in gingival crevicular fluid and periodontal status were evaluated. No significant differences in age, gingival index, plaque index, aspartate aminotransferase and lactate dehydrogenase enzyme activities were observed, but probing depths were significantly higher in the DM groups than in the control group. Obesity did not seem to be a significant factor in any parameters evaluated. The present study showed increased probing depth values for the diabetic groups but failed to show any significant relation between obesity and enzyme activity or periodontal status. However, the slightly increased probing depth values in the obese groups might be a clue to an impaired immune response and predisposition to periodontitis in that patient group.

Adult↗
PubMed2005

[Analysis of volatile fatty acids in gingival crevicular fluid of patients with chronic periodontitis].

OBJECTIVE: To investigate the volatile fatty acids in gingival crevicular fluid (GCF) and to analyze the relationship between the levels of the volatile fatty acids and chronic periodontitis. METHODS: GCF samples taken from 37 patients with chronic periodontitis and 16 volunteers with healthy periodontal status were analyzed by capillary electrophoresis. RESULTS: The detection frequencies and concentrations of succinic acid, butyric acid and valeric acid were significantly higher in GCF of chronic periodontitis than in that of healthy group. The detection frequencies of propionic acid had no statistic difference between the two groups, but the concentrations of it was significantly higher in inflammation group. We also found that the concentrations of succinic acid, propionic acid and butyric acid were significantly lower in shallow pockets than that in deep pockets. CONCLUSIONS: The volatile fatty acids, especially succinic acid, propionic acid, butyric acid and valeric acid were associated significantly with the severity and inflammation of periodontal disease. The levels of succinic acid, propionic acid and butyric acid in GCF were related to pocket depth.

Adult↗
PubMed2005

Genetic variations in the human gelatinase A (matrix metalloproteinase-2) promoter are not associated with susceptibility to, and severity of, chronic periodontitis.

BACKGROUND: Gelatinase A (matrix metalloproteinase-2 [MMP-2]) has been shown to play an important role in the pathogenesis of several disorders, including periodontal diseases. In this study, we test the hypothesis that variations in this gene influence the development and severity of chronic periodontitis. METHODS: Four promoter polymorphisms (-1575G/A, -1306C/T, -790T/G, and -735C/T) were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods in 149 patients with mild to severe chronic periodontitis and 127 age-matched controls in the Czech population. RESULTS: No significant differences in distribution of the -1575G/A, -1306C/T, and -735C/T variants between periodontitis and control groups were detected in our study. However, a trend to decreased frequency of the -790 GG homozygotes was observed in patients with chronic periodontitis compared to healthy controls (P = 0.036, P (corr) >0.05). Haplotype analysis of four single nucleotide polymorphisms (SNP) in the MMP-2 gene showed no significant association of any haplotype with chronic periodontitis. CONCLUSION: Our findings suggest that polymorphisms in the MMP-2 gene promoter do not contribute significantly to the interindividual periodontitis susceptibility and/or severity in European Caucasians, and they are not regulatory variants in this disease.

Adult↗
PubMed2003

Gingival crevicular fluid levels of aspartate amino transferase, sulfide ions and N-benzoyl-DL-arginine-2-naphthylamide in diabetic patients with chronic periodontitis.

BACKGROUND: The aim of this study is to analyze the correlations between plaque index (PlI), gingival index (GI), probable pocket depth (PPD), clinical attachment level (CAL), aspartate aminotransferase (AST), N-benzoyl-DL-arginine-2-naphthylamide (BANA) and sulfide ion activity (SIA) of diabetic patients with chronic periodontitis with regard to disease activity detected by AST levels. MATERIAL AND METHODS: A total of 95 sites from eight diabetic patients with chronic periodontitis and 74 sites from eight systemically healthy patients with chronic periodontitis were enrolled in the study. The patients had no history of periodontal treatment or any antibiotic therapy during the last 6 months and were nonsmokers. All the sites selected for the study had a CAL of at least 2 mm. Gingival crevicular fluid volumes (GCFV) were measured in all sites. RESULTS: According to the result of AST analysis, 45 sites were AST positive and 50 were AST negative in the diabetic group and 36 sites were AST positive and 38 were AST negative in the control group. There was a significant correlation between BANA hydrolysis and PPD in both diabetic and control groups, but no correlation between PPD and AST levels. A significant correlation was observed between AST-positive sites and GI, but not between GI and BANA hydrolysis. In both groups, the correlation between SIA and BANA hydrolysis was significant, but no correlation was revealed between SIA and AST levels in either diabetic or control groups. CONCLUSION: The GCF metabolites had significant correlations with periodontally diseased sites in patients with chronic periodontitis, whether diabetic or systemically healthy, and may help to confirm clinical findings.

Aspartate Aminotransferases↗
PubMed1994

Pathological changes of oxytalan fibers in the human gingiva of chronic periodontitis.

The gingiva samples were obtained from 40 patients with chronic periodontitis after flap operation and 20 cases having healthy gingiva after ectopic wisdom tooth extraction. We investigated the oxytalan fibers by light microscopy (LM), transmission electron microscopy (TEM), and scanning electron microscopy (SEM). The results demonstrated that under normal conditions numerous oxytalan fibers were widely and evenly distributed throughout the periodontal tissues. There was marked degeneration of the oxytalan fibers in chronic peridontitis. The predominant features were disintegration, fragmentation or disappearance of the oxytalan fibers under the basement membrane. Around the blood vessels, the oxytalan fibers decreased in density with fragmentation of the fibers and sometimes they disappeared almost completely. These results indicated that degeneration and destruction of the oxytalan fibers were closely correlated with the chronic periodontitis process, leading to reduced function occlusion of teeth.

Adult↗
PubMed2000

Identification of MRP-8 (calgranulin A) as a major responsive protein in chronic periodontitis.

The purpose of the study was to analyse how the protein composition of the inflammatory exudate associated with chronic periodontitis differed from the exudate in periodontal health. Gingival crevicular fluid (GCF) was collected from sites with chronic periodontal inflammation and from non-diseased sites in healthy control subjects. Microbore HPLC analysis revealed one major difference in GCF protein profiles between healthy controls and periodontitis patients. The protein enhanced in periodontitis patients was identified as migration inhibitory factor-related protein-8 (MRP-8) by a combination of N-terminal amino acid sequencing, mass spectrometry, and SDS-PAGE. Together, these data demonstrate, for the first time, the presence of monomeric MRP-8 in an inflammatory exudate. Whether monomeric MRP-8 is a unique feature of chronic periodontal inflammation is not yet clear, but the chemotactic properties of this peptide support a functional role for MRP-8 in periodontal inflammation.

Adult↗
PubMed2005

[The clinical effect of full-mouth scaling and root planning on chronic periodontitis: a preliminary report].

PURPOSE: To explore the clinical effect of full-mouth scaling and root planning (FM-SRP) on chronic periodontitis with the comparison of quadrant scaling and root planning (Q-SRP). METHODS: 60 patients with chronic periodontitis were randomly divided into 2 groups. The FM-SRP group received full-mouth scaling and root planning completed within the same day, while the Q-SRP group received quadrant scaling and root planning once a week for 4 weeks. Clinical parameters of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD) and attachment loss (AL) were collected at baseline, 3 and 6 months after treatment, as well as the postoperative reaction. The data were analyzed by rank sum test (PI,GI), t test (PD,AL) and Chi square test (BOP), respectively. RESULTS: When compared with the baseline, both therapies resulted in significant improvements in all clinical parameters at the end of 3 and 6 months (P<0.01). However, there were no significant difference between the two groups at any time point (P>0.05). 24 hours after the first treatment, the percentage of patients with postoperative reactions were significantly higher in FM-SRP group than that in Q-SRP group (P<0.05), but the patients could tolerate these reactions. CONCLUSION: Both FM-SRP and Q-SRP are efficacious in treating chronic periodontitis, and the clinician can select the proper treatment modality according to the demand of clinical practice.

Chronic Periodontitis↗
PubMedDate not supplied

Expression of Toll-like receptors 2 and 4 in gingivitis and chronic periodontitis.

Periodontal disease is the major cause of adult tooth loss and is commonly characterized by a chronic inflammation caused by infection by oral bacteria. Members of Toll-like receptor (TLR) family recognize conserved microbial structures, such as bacterial lipopolysaccharides, and activate signaling pathways that result in immune responses against microbial infections. The aim of the present study was to assess the mRNA expression of TLR-2 and TLR-4 in gingivitis and chronic periodontitis. Gingival tissue samples were collected from patients with chronic periodontitis, gingivitis, and healthy controls. Total RNA was extracted and RT-PCR was done for TLR-2 and TLR-4. The results showed that TLR-2 was significantly increased in gingivitis compared to TLR-4 expression and decreased in chronic periodontitis.

Chronic Disease↗
PubMed1984

Slow release metronidazole and a simplified mechanical oral hygiene regimen in the control of chronic periodontitis.

The present study is one of a series aimed at devising practical methods of control of chronic periodontitis that do not depend upon stringent interdental cleaning by the patient. The regime consists of professional and home care components thought to be realistic for general practice. Patients with chronic periodontitis, but without any complicating factor, such as systemic disease, recent antimicrobial therapy or occlusal traumatism were selected. They received an initial thorough scaling, root planing and an instruction in Bass brushing, using a multituft brush and a sodium fluoride toothpaste, but without emphasis on inter-dental cleaning. They were then assigned to one of two groups, one of which received, in addition to the above mechanical oral hygiene regime, low (0.5%) and the other high (40%) dose metronidazole locally in periodontal pockets once a week for 4 weeks. The low dose was supplied in the form of solution inside fine dialysis tubing. The high dose was in the form of metronidazole powder incorporated in acrylic resin. Plaque index, sulcus bleeding index, probeable pocket depth and gingival shrinkage were monitored during this period and for a further 8 weeks. Both groups showed highly significant reductions in (supragingival) plaque and periodontal inflammation, maintained at least 8 weeks after the end of the 4-week chemotherapy period. Reductions in SBI were greatest for the 40% metronidazole group. It was concluded that local metronidazole, even in the form of 0.5% metronidazole in a small portion of dialysis tubing, has a positive rôle in the control of chronic periodontitis.

Chronic Disease↗
PubMed2002

Minocycline microspheres: a complementary medical-mechanical model for the treatment of chronic periodontitis.

Locally delivered antimicrobials represent an expanding class of therapeutics that may complement conventional mechanical treatments for chronic periodontitis. Currently available locally delivered antimicrobials include a tetracycline fiber, chlorhexidine chip, doxycycline gel, and newly approved minocycline microspheres. This last therapeutic is formulated to contain 3 mg polyglycolide-co-dl lactide (PGLA) copolymer and 1 mg of minocycline per unit (pocket) dose. As the polymer microspheres resorb, minocycline is released locally within the periodontal pocket at effective concentrations for at least 14 days. Recently, three phase 3 human clinical trials were conducted to assess the efficacy and safety of minocycline microspheres in patients with moderate-to-advanced chronic periodontitis. Data from an open-label trial involving 173 subjects indicated that minocycline microspheres plus scaling and root planing (SRP) at baseline produced significant improvements in pocket depth (PD) (> or = 1.5 mm) at 1 and 3 months. Retreatment with minocycline microspheres at 3 and 6 months maintained these improvements for 12 months. Two concurrent, blinded studies cumulatively recruited 748 periodontitis subjects who were randomized to SRP plus minocycline microspheres, SRP plus vehicle (placebo), or SRP alone at baseline. Minocycline microspheres or the vehicle were readministered per the randomization at 3 and 6 months. Patients receiving minocycline microspheres plus SRP exhibited significantly greater PD reduction at 1, 3, 6, and 9 months compared to patients receiving SRP plus vehicle or SRP alone. Overall, mean PD reduction with adjunctive minocycline-microsphere treatment increased when patients with more advanced periodontitis (mean PD > or = 6 mm or 7 mm) were considered. Similarly, significant improvements in clinical attachment level and percent bleeding on probing were observed among advanced periodontitis patients treated with SRP plus minocycline microspheres relative to controls. Patients treated with minocycline microspheres plus SRP were 50% more likely to shift to an overall mean PD < 5 mm or to a more maintainable case definition. No increased incidence of adverse events or tetracycline resistance were observed with minocycline-microsphere treatment. The data from these clinical trials indicate that minocycline microspheres plus SRP are safe in patients and more effective than SRP alone in reducting the signs of chronic periodontitis.

Analysis of Variance↗
PubMed2005

Implants in patients treated for generalized aggressive and chronic periodontitis: a 3-year prospective longitudinal study.

BACKGROUND: The aim of the present prospective longitudinal study of periodontally diseased and periodontally healthy patients was a clinical, microbiological, and radiographic comparison of teeth and implants and an assessment of the implant success rate. METHODS: Thirty-nine partially edentulous patients provided with a total of 150 implants were enrolled in the study. Oral rehabilitation was undertaken in 15 patients treated for generalized aggressive periodontitis (GAgP), 12 patients treated for generalized chronic periodontitis (GCP), and 12 periodontally healthy patients. The examinations of the teeth and implants were carried out within the framework of a 3-month recall schedule over a 3-year period. At each session, clinical parameters for probing depth (PD), gingival recession (GR), attachment level (AL), gingival index (GI), and plaque index (PI) were recorded, and the composition of the subgingival microflora determined by dark-field microscopy. In the periodontally diseased patients, Actinobacillus actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), and Prevotella intermedia (P.i.) were detected at teeth and implants by DNA analysis in the first and third years after insertion of the superstructure. Intraoral radiographs of the teeth and implants were taken at baseline, immediately after insertion of the superstructure, and then 1 and 3 years later. RESULTS: The GI and PI at implants and teeth remained below 0.25 and 0.6, respectively, in all patient groups throughout the study period. At the implants and teeth, a slight increase in PD and a continuous attachment loss was recorded in the GAgP patients. The attachment loss was greater at the implants than at the teeth in all groups. The morphological distribution of the microorganisms revealed virtually healthy conditions in all groups. A.a. was detected in two GAgP patients, whereas P.g. and P.i. were found more frequently both in the GAgP and in the GCP patients. Radiographically detected bone loss was higher after 3 years at implants and teeth in the GAgP patients than in the other two groups. The implant success rates recorded were 100% in the periodontally healthy and GCP patients, and 95.7% in the maxilla and 100% in the mandible of the GAgP patients. CONCLUSIONS: The results show that oral rehabilitation can be performed with implants in patients treated for generalized aggressive and chronic periodontitis. However, slight attachment loss and bone loss were registered at the implants and teeth in the patients with aggressive periodontitis.

Acute Disease↗
PubMed2002

[The association of interleukin-1 gene polymorphisms with the susceptibility to chronic periodontitis in Uighur].

OBJECTIVE: To investigate the relationship between interleukin-1 (IL-1) gene polymorphisms and the susceptibility of chronic periodontitis in Uighur minority in Xingjiang province of China. METHODS: The buccal swabs were collected from 41 severe chronic periodontitis (CP) patients, 43 moderate CP patients, 49 mild CP patients and 92 healthy controls. DNA was extracted from these buccal swabs. Genotypes of the IL-1A-889/NcoI and IL-1B+3954/TaqI were determined by sequence specific primers-polymerase chain reaction(SSP-PCR) and PCR-restriction fragment length polymorphism(PCR-RFLP). Then distribution of genotypes for IL-1A-889 and IL-1B+3954 were compared among the different groups. RESULTS: (1) There were no significant differences in the distribution of IL-1A-889 among severe CP patients, moderate CP patients, mild CP patients and healthy controls. (2) Frequencies of allele 2 for IL-1B+3954 were higher in severe CP patients than in healthy controls, and the difference was statistically significant. But there were no such significant differences either between moderate CP patients and healthy controls or between mild CP patients and healthy controls. CONCLUSION: These results suggest that IL-1B+3953 allele 2 may be a risk indicator for the susceptibility to severe chronic periodontitis in Uighur minority in Xingjiang of China.

Adult↗
PubMed2007

Hyperactivity and reactivity of peripheral blood neutrophils in chronic periodontitis.

Some evidence exists that peripheral neutrophils from patients with chronic periodontitis generate higher levels of reactive oxygen species (ROS) after Fcgamma-receptor stimulation than those from healthy controls. We hypothesized that peripheral neutrophils in periodontitis also show both hyper-reactivity to plaque organisms and hyperactivity in terms of baseline, unstimulated generation and release of ROS. Peripheral neutrophils from chronic periodontitis patients and age/sex/smoking-matched healthy controls (18 pairs) were assayed for total ROS generation and extracellular ROS release, with and without stimulation (Fcgamma-receptor and Fusobacterium nucleatum), using luminol and isoluminol chemiluminescence. Assays were performed with and without priming with Escherichia coli lipopolysaccharide (LPS) and granulocyte-macrophage colony-stimulating factor (GM-CSF). Phox gene expression (p22, p47, p67, gp91) was investigated using reverse transcription-polymerase chain reaction (RT-PCR). Neutrophils from patients produced higher mean levels of ROS in all assays. Total generation and extracellular release of ROS by patients' cells were significantly greater than those from controls after FcgammaR-stimulation, with (P = 0.023) and without (P < or = 0.023) priming with GM-CSF. Differences in unstimulated total ROS generation were not significant. By contrast, patients' cells demonstrated greater baseline, extracellular ROS release than those from controls (P = 0.004). This difference was maintained after priming with LPS (P = 0.028) but not GM-CSF (P = 0.217). Phox gene expression was similar in patient and control cells at baseline and stimulation with F. nucleatum (3 h) consistently reduced gp91(PHOX) transcripts. Our data demonstrate that peripheral neutrophils from periodontitis patients exhibit hyper-reactivity following stimulation (Fcgamma-receptor and F. nucleatum) and hyperactivity in terms of excess ROS release in the absence of exogenous stimulation. This hyperactive/-reactive neutrophil phenotype is not associated with elevated phox gene expression.

Adult↗
PubMed2003

Pattern of tooth loss in Nigerian juvenile and plaque-induced chronic periodontitis patients.

The aim of this study was to determine the pattern of tooth loss in chronic periodontitis patients and hence help the clinician to plan preventive treatment against the loss of these teeth. Dental record notes of all the subjects, the periapical radiographs and actual intra-oral examinations of the juvenile periodontitis patients were done to determine the number and types of tooth loss. It was observed that the pattern of tooth loss in both groups of chronic periodontitis (plaque Induced periodontitis (PIP) and juvenile periodontitis (JP) was different as the most frequently lost teeth in PIP was incisors and lower incisor in JP while the least lost in PIP was the upper canines and the lower premolars in JP.

Adolescent↗
PubMed2005

[Study on the expression of IL-10 mRNA and the protein in gingival tissues of patients with chronic periodontitis].

PURPOSE: To investigate the cell type which express IL-10 mRNA and the protein in gingival tissues of patients with chronic periodontitis. METHODS: 12 patients with chronic periodontitis who were undergoing flap operation were randomly chosen as periodontitis group;10 patients undergoing gingivectomy were chosen as gingivitis group;6 patients undergoing extraction of impacted teeth were chosen as control group. Assays of in situ hybridization and immunohistochemistry were used to observe the expression of IL-10 mRNA and the protein in gingival tissues of each group respectively . Wilcoxon test was used to compare the expression of IL-10 of each group at two levels; differences between the two groups were analyzed by one-way ANOVA test. RESULTS: IL-10 mRNA and the protein were all expressed in gingival tissues of periodontium,they were found in lymphocytes, fibroblasts and macrophages. There were no significant differences between two levels of IL-10 expression of periodontitis group and control group (P>0.05) gingivitis group,P<0.05). The IL-10 expression of periodontitis group was significantly higher than gingivitis group and control group (P<0.01); The IL-10 mRNA expression of periodontitis group was significantly higher than control group (P<0.01),but there was no significant difference between the IL-10 mRNA expression of periodontitis group and gingivitis group (P>0.05). CONCLUSION: There is a local secretion mechanism of IL-10 in the periodontal tissues.

Case-Control Studies↗
PubMed1990

The plasma cell at the advancing front of the lesion in chronic periodontitis.

This study analyses the ultrastructure of the plasma cell population of periodontitis-affected soft tissue close to the advancing front of interdental lesions. Biopsies from 20 patients and 3 control volunteers were examined: 5 with treated adult periodontitis (AP), 5 with untreated AP, 5 with treated juvenile or post-juvenile periodontitis (JP) and 5 with untreated JP. Plasma cell (PC) counts increased significantly (p less than 0.05) with lesion severity. They were absent from epithelium and sparse in the clinically healthy control specimens. Degenerate PC tended to be more numerous within JP tissue but differences were not significant (p greater than 0.05) when compared to AP. Intact plasma cells were never seen within JP superficial connective tissue. Russell bodies were small and few in number. The presence of degenerated plasma cells indicated normal formation and release of immunoglobulins within the tissues of AP and JP. Increased counts of degenerate PC and tissue destruction in JP suggested a correlation, possibly attributable to anti-collagen antibody secretion.

Adolescent↗
PubMed2003

Direct evidence of collagenolysis in chronic periodontitis.

BACKGROUND: There is no previous evidence that collagenases in chronic periodontitis excessively cleave collagen fibrils. OBJECTIVES: In this study the eventual presence of neoepitopes produced in such a cleavage were looked for. METHODS: A polyclonal antibody, which recognizes collagenase-cleaved collagen type I 3/4 carboxy-terminal neoepitope (COL1-3/4C), was used in avidin-biotin-peroxidase complex staining. RESULTS: In addition, moderate staining was seen in connective tissue bordering to the sulcular and junctional epithelium, surrounding some of the fibroblasts and in some areas infiltrated by inflammatory mononuclear cells. COL1-3/4C staining in chronic periodontitis was more extensive (6.3 +/- 1.2%, n = 10) and intense than that observed in controls (1.6 +/- 0.7%, n = 10, Unpaired Student's t-test, p < 0.01). CONCLUSIONS: It is concluded that collagenases produced by host cells contribute to periodontal tissue destruction and attachment loss.

Adolescent↗