: The purpose of the present study was to evaluate the prevalence of oral mucosal lesions and conditions in a population in Ljubljana, capital of Slovenia. A total 1609 subjects represented the study ...population in the survey about the periodontal treatment needs in a population in Ljubljana, conducted from 1983 to 1987. Ten years later the same 1609 subjects were invited to the second examination. Altogether, 555 (34.5%) of the invited subjects in the age range 25–75 years came for an interview and clinical examination at the Department of Oral Medicine and Periodontology of the Dental Clinic in Ljubljana. Oral mucosal lesions and conditions were evaluated according to the WHO Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases and Conditions. The results showed the presence of one or more mucosal lesions in 61.6% of the population. Fordyce’s condition was observed the most frequently (49.7%) followed by: fissured tongue (21.1%), varices (16.2%), history of herpes labialis (16.0%), history of recurrent aphthae (9.7%), denture stomatitis (4.3%), leukoplakia (3.1%), cheek biting (2.7%), lichen planus (2.3%), frictional keratosis (2.2%), geographic tongue (2.2%), geographic and fissured tongue together (1.1%), mucocele (0.9%), smoker’s palate (0.5%) and angular chelitis (0.4%). In the population examined, no oral malignancies were observed. Mucosal lesions like whitish lesions, denture related lesions, fissured tongue, varices and mucocele were more prevalent with increasing age. Tobacco‐related lesions (leukoplakia and smoker’s palate together) were significantly more prevalent among men than among women (P<0.05), while lichen planus, denture stomatitis and herpes labialis occured more frequently in the female population.
Abstract Objectives Expression of neuronal neuropeptides in inflammatory conditions is altered. The changes in expression of substance P (SP) and calcitonin gene-related peptide (CGRP) in ipsilateral ...and contralateral trigeminal ganglion (TG) neurons were investigated by immunohistochemistry one week after unilateral ligature-induced periodontitis in rats. Design A retrograde nerve tracer Fluorogold (FG) was applied into the gingival sulcus of the second maxillary molar to identify the neurons in TG that specifically innervate the inflamed gingivomucosa. In addition, neurons from the corresponding maxillary and the adjacent mandibular–ophthalmic regions in TG were analysed. Results Statistically significantly higher frequencies of CGRP-positive neurons, regardless of their size, were found in TG ipsilateral to the periodontitis (83% and 73% in FG-labelled and maxillary regions, respectively) than in the control group without periodontitis (52% and 42% in FG-labelled and maxillary regions, respectively). The frequency of small FG-labelled SP-positive neurons in the ipsilateral TG (60%) was significantly higher than in the control TG (25%). In the contralateral TG the frequency of CGRP-positive neurons in maxillary region (66%) was significantly higher than in the control group. Surprisingly, the number of SP-positive neurons in all regions of contralateral TG decreased when compared to control and ipsilateral TGs. Conclusions Taken together, these results implicate a role of neurogenic component in the pathogenesis of periodontitis. The contralateral response in the TG could be mediated through the transmedian neurological pathways crossing in the trigeminal nuclear complex or through the systemic inflammatory reaction and the activation of the so called “neuro-immune axis”.
Bacterial plaque associated periodontal disease is the most common chronic infection in man and dogs. In man, there is an association between periodontal disease and myocardial infarction and stroke, ...while in dogs it has also been associated with changes in internal organs. Inflamed periodontal tissues present a ‘periodontal disease burden’ to the host and the extent of this inflammatory disease burden is likely to affect the degree of associated pathological change in distant organs. This hypothesis was investigated in dogs with naturally occurring periodontal disease. Post-mortem investigations including periodontal assessment, standard necropsy, and organ histology were performed on 44 mature toy and miniature Poodles (related, periodontitis predisposed breeds) that died naturally or were euthanized based on clinical disease. Animals with gross primary organ pathology were excluded. The periodontal disease burden was estimated from the total surface area of periodontal pocket epithelium using six measurements of probing depth for each tooth and the tooth circumferences. Ordinal logistic regression (OR) analysis established that for each square centimeter of periodontal disease burden there was a 1.4-times higher likelihood of greater changes being present in the left atrio-ventricular valves (OR = 1.43), plus 1.2 and 1.4 times higher likelihood for greater liver and kidney pathology (OR = 1.21; OR = 1.42), respectively. The results show that there is a link between the estimated ‘periodontal disease burden’ resulting from plaque-bacteria associated periodontal disease and the level of internal pathology in this population, implying that periodontitis might contribute to the development of systemic pathology in dogs.
Abstract Objective Nitric oxide synthase (NOS) inhibitors are reported to protect against the local tissue damage in gingivitis and periodontal disease by reducing nitroxidative stress during ...inflammation, but their systemic effects are not well investigated. Design NOS inhibitors systemic effects were investigated in a murine chronic oral inoculation model using live Porphyromonas gingivalis ATCC 33277 (0.3 ml; 109 cfu/ml) or sterile broth (0.3 ml). Organ nitric oxide (NO) and plasma nitrite/nitrate (NOx) were determined in mice treated with non-selective NOS inhibitor l -NAME (50 mg/kg/24 h i.p.) or selective iNOS inhibitor 1400W (10 mg/kg/6 h i.p.) for the last 5 days of the experiment. Differences between groups were evaluated by nonparametric Wilcoxon's rank-sum one-sided two-sample test and the results compared to those obtained from sham-treated (sterile broth) sham-inoculated animals (water for injection i.p./6 h). Results Repeated ingestion of P. gingivalis resulted in generalized production of NO in organs and NOx in plasma, the levels of both typically being reduced in P. gingivalis -inoculated-1400W-treated mice, whilst the use of l -NAME was largerly ineffective, even promoting NO/NOx formation. Application of either inhibitor to sham-inoculated animals enhanced NO/NOx formation, due only in part to the repeated i.p. injections. Conclusions The systemic use of 1400W or l -NAME differently affects systemic nitric oxide formation in mice orally challenged with P. gingivalis , but the sequelae of such an intervention should be evaluated further.
Background, aims: The purpose of this study was to evaluate the influence of oxygen free radical scavengers on periodontal inflammation and healing process.
Method: Experimental periodontitis was ...induced by elastic ligatures around premolares (P2, P3, P4) and 1st molares (M1) in the upper and lower jaws of 15 beagle dogs. 9 months after the beginning of the experiment, the ligatures were removed. After 3 weeks of stabilization period, all teeth were supragingivally scaled. The animals were divided into 3 groups of 5 dogs. The 1st group received a liposome‐encapsulated superoxide dismutase (SOD), the 2nd group a liposome‐encapsulated catalase (CAT) and the 3rd group received both enzymes encapsulated in liposomes. 4 treatment modalities were tested in each group; i.e., supragingival scaling only (1), supragingival scaling and enzymes (2), supra‐ and sub‐gingival scaling and root planing (3) and supra‐ and sub‐gingival scaling and root planing with subgingival application of enzymes (4). Enzymes were delivered subgingivally on a daily basis for a period of 6 weeks. Gingival index (GI), probing depth (PD), clinical attachment level (CAL), radiographic analysis and the histological evaluation were performed.
Results: Around the teeth with scaling and root planing followed by the application of SOD, the greatest suppression of gingival inflammation (GI=1.8±0.1 before versus GI=1.2±0.2 after treatment) (p<0.003), the smallest size of connective tissue infiltrate (5.5±4.3%) (p<0.01), the greatest reduction of PD (PD=3.2±1.0 mm before versus 2.0±0.7 mm after treatment) (p<0.001), and gain of CAL (CAL=3.0±1.7 mm before versus CAL=2.4±1.1 mm after treatment) (p<0.001) were observed. In addition, radiographic analysis showed the greatest alveolar bone apposition in the group of teeth treated with scaling and root planing followed by subgingival application of SOD or both enzymes (p<0.001).
Conclusion: In conclusion, we demonstrated that scaling and root planing with subgingival application of liposome‐encapsulated SOD suppress peridontal inflammation on experimentally induced periodontitis in beagle dogs.
Background: To search for a possible source of hepatitis C virus (HCV) in saliva, the presence and shedding patterns of HCV in gingival crevicular fluid (GCF) and saliva of HCV viremic patients were ...assessed based on clinical, biochemical, histological, virological, and oral health parameters.
Methods: Saliva and GCF samples of 50 HCV viremic patients were collected to detect HCV RNA by a modified commercial polymerase chain reaction (PCR) assay. Clinical oral examination was performed and periodontal status at the collection sites was monitored. The results were correlated to specified parameters.
Results: HCV RNA was detected in 59% (29/49) of the GCF specimens and in 35% (17/48) of the saliva specimens. In saliva specimens, HCV RNA was detected only in cases which also had detectable HCV RNA in the GCF samples (P = 0.00002) and was significantly related to the presence of blood in saliva (P = 0.03). Higher, but not significant, values of oral clinical parameters at the sites of fluid collection were found in GCF specimens harboring HCV RNA. In GCF specimens with no blood detected, HCV RNA was more often present in cases with higher plasma viral load (P = 0.05).
Conclusions: The results suggest that besides blood, the other most probable source of HCV in saliva is GCF. Unknown endogenous HCV inhibitory mechanisms in the oral cavity may explain the discrepancies in HCV appearance between saliva and GCF. The results provide a biologic basis for further investigation of the role of HCV in the pathogenesis of periodontal disease. J Periodontol 2001;72:11‐16.
Proinflammatory cytokine tumor necrosis factor alpha (TNF‐α) was found in inflamed periodontal tissues and many studies pointed to its significant role in development of periodontal disease. In this ...study, the influence of subcutaneously administered recombinant human TNF‐α (rhTNF‐α) on inflammatory reaction and periodontal breakdown in rats was analyzed during experimental periodontitis, induced by placing silk ligatures around the maxillary right second molar tooth. The rats were divided into two groups with five animals in each; the first group was infused subcutaneously with rhTNF‐α via osmotic pumps for 2 weeks and the second group was infused with phosphate‐buffered saline (PBS) in the same manner. Inflammatory reaction and periodontal breakdown was evaluated morphometrically on hematoxylin and eosin stained sections. Serum ionized calcium and inorganic phosphates were monitored colorimetrically. Serum calcium and phosphate levels were similar in rats receiving rhTNF‐α and PBS. Ligation resulted in accelerated periodontal breakdown, while subcutaneous rhTNF‐α administration by itself had no significant effect. Combined effect of subcutaneous rhTNF‐α administration and ligation resulted in a significantly greater inflammatory reaction and periodontal breakdown then either treatment alone. We concluded that the subcutaneous administration of rhTNF‐α accelerates the progression of experimental periodontitis in rats.
Few longitudinal studies on changes of decayed, missing, or filled teeth (DMFT) counts in a population have been reported. This study aimed to evaluate the changes in DMFT counts in Ljubljana ...citizens in a 30-year period.
238 dentate subjects that attended the third epidemiological study were invited. Ninety 45-95-year-old subjects (37.8%) responded to our invitation. Two (2.2%) edentulous subjects were excluded. Among the dentate subjects there were 28 men and 60 women. They were divided in six age groups with mean age of 45, 55, 65, 75, 85, and 95 years. The number of subjects in each age group was: 29, 12, 21, 18, 7, and 1, respectively. For evaluation of the state of teeth we used the DMFT index.
The average DMFT value for 45-95-year-old population was 19.3. Mean DMFT counts in all comparable age groups (45-, 55- and 65-years) decreased in 30 years. In 45 year olds they decreased from 17.5 to 15.7, in 55-year-olds they decreased from 20.4 to 19.2, and in 65 year olds they decreased from 22.5 to 20.7. An increase of the average number of present teeth (for 6.4 teeth in average) from the first to the fourth study in subjects of the same age was seen.
Dental health in Slovenia has improved in 30 years. Average DMFT counts in subjects of the same age (45-, 55- and 65-years) have decreased. Ljubljana citizens have less decayed, less missing and more filled teeth than 30 years ago.
Background: Periodontitis, activated by oral bacteria and orchestrated by innate immune response, is regulated by primary nociceptive neurons, which are generally considered to have small‐ to ...medium‐sized perikaryons. Bacterial byproducts (e.g., lipopolysaccharides) activate primary nociceptive neurons directly through Toll‐like receptors (TLRs). Therefore, this study aims to morphometrically characterize rat trigeminal neurons, which express TLR4, and to investigate the changes in the TLR4 expression in neurons during periodontal inflammation.
Methods: Trigeminal neurons innervating gingivomucosa were identified by application of the retrograde tracer hydroxystilbamidine into the gingival sulcus of the maxillary molar in 14 rats. Periodontitis was induced by ligature around the same molar in seven rats. TLR4 expression was investigated by immunohistochemistry on paraffin sections of the trigeminal ganglia (TG). Semiquantitative method was used to identify the intensity of TLR4 expression.
Results: In the control group without the ligatures, TLR4 was detected in 19% of the neurons in the maxillary region of TG and in 29% of neurons innervating gingivomucosa. Expression of TLR4 was more frequent and intensive in small‐ to medium‐sized neurons than in large‐sized neurons. One week after ligature‐induced periodontitis, the percentage of TLR4‐positive neurons in the maxillary region and among the neurons innervating inflamed gingivomucosa significantly increased statistically to 32% and 41%, respectively.
Conclusions: TLR4 is predominantly, but not exclusively, expressed in smaller trigeminal nociceptive neurons in the rat. Experimental periodontitis upregulates TLR4 expression in the trigeminal neurons. The hypothesis that bacterial byproducts regulate the pathogenesis of periodontitis by activation of trigeminal nociceptors through TLR4 should be explored.
Background: In vitro studies demonstrated that proinflammatory cytokine tumor necrosis factor alpha (TNF‐α) modulates bone metabolism.
Objective: The aim of our study was to confirm the ability of ...TNF‐α to induce osteoclastogenesis and bone resorption in an in vivo experiment, with the use of calvarial model in mice.
Materials and methods: Twenty C57‐Black mice were divided into four groups with five animals in each. The first group was infused subcutaneously on their back with recombinant mouse (rm) TNF‐α via osmotic minipumps for 3 d, the second group was similarly infused with phosphate‐buffered saline (PBS), the third group was infused with rmTNF‐α to the region above the parietal bone and the fourth group with PBS in the same manner. Number of osteoclasts on parietal bone was determined morphometrically. Serum calcium and phosphates were monitored colorimetrically.
Results: Serum calcium level and number of osteoclasts on parietal bone were significantly greater after infusion of rmTNF‐α above the parietal bone, whereas after subcutaneous delivery these parameters were similar to the control group.
Conclusion: We are concluding that TNF‐α has the ability to change the bone metabolism in a paracrine manner only.
