The immune and infectious alterations occurring in periodontitis have been shown to alter the development and severity of cardiovascular disease. One of these relationships is the translocation of ...oral bacteria to atheroma plaques, thereby promoting plaque development. Thus, the aim of this study was to assess, by 16s cloning and sequencing, the microbial diversity of the subgingival environment and atheroma plaques of patients concomitantly suffering from periodontitis and obstructive coronary artery atherosclerosis (OCAA).
Subgingival biofilm and coronary balloons used in percutaneous transluminal coronary angioplasty were collected from 18 subjects presenting with generalized moderate to severe periodontitis and OCAA. DNA was extracted and the gene 16S was amplified, cloned and sequenced.
Significant differences in microbial diversity were observed between both environments. While subgingival samples mostly contained the phylum Firmicutes, in coronary balloons, Proteobacteria (p<0.05) was predominant. In addition, the most commonly detected genera in coronary balloons were Acinetobacter, Alloprevotella, Pseudomonas, Enterobacter, Sphingomonas and Moraxella, while in subgingival samples Porphyromonas, Filifactor, Veillonella, Aggregatibacter and Treponema (p<0.05) were found. Interestingly, 17 identical phylotypes were found in atheroma and subgingival samples, indicating possible bacterial translocation between periodontal pockets and coronary arteries.
Periodontal pockets and atheromatous plaques of cardiovascular disease patients can present similarities in the microbial diversity.
Propolis has been used in folk medicine since ancient times and it presented inhibitory effect on neutrophil recruitment previously. However, its effect on macrophage obtained from mice remains ...unclear.
To demonstrate BRP effects on LPS activated peritoneal macrophage.
Peritoneal macrophages, obtained from C57BL6 mice and activated with LPS, were treated with 50–80µg/mL of crude extract of Brazilian red propolis (BRP) during 48h. Cell viability, levels of NO, 20 cytokines and expression of 360 genes were evaluated.
BRP 60µg/mL reduced NO production by 65% without affecting the cell viability and decreased production IL1α, IL1β, IL4, IL6, IL12p40, Il12p70, IL13, MCP1 and GM-CSF. Molecular mechanism beyond the anti-inflammatory activity may be due to BRP-effects on decreasing expression of Mmp7, Egfr, Adm, Gata3, Wnt2b, Txn1, Herpud1, Axin2, Car9, Id1, Vegfa, Hes1, Hes5, Icam1, Wnt3a, Pcna, Wnt5a, Tnfsf10, Ccl5, Il1b, Akt1, Mapk1, Noxa1 and Cdkn1b and increasing expression of Cav1, Wnt6, Calm1, Tnf, Rb1, Socs3 and Dab2.
Therefore, BRP has anti-inflammatory effects on macrophage activity by reducing NO levels and diminished release and expression of pro-inflammatory cytokine and genes, respectively.
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Purpose
To evaluate the antineoplastic therapy (AT) as a risk factor for dental caries lesions independent of other risk factors such as income, family education, stimulated salivary flow rate, ...hygiene habits, frequency of sugar intake, and microbiota in childhood cancer (CC) patients.
Methods
72 individuals were divided into CC patients (
n
=36) and healthy individuals (control group - CT
n
=36). Demographic data, hygiene habits, frequency of sugar intake, CC type, and AT were collected. Stimulated salivary flow rate was measured and the presence and concentration of
Streptococcus mutans
were assessed using a real-time polymerase chain reaction (qPCR) technique. Clinical evaluations included plaque index (PI) and decayed-missing-filled-teeth index (dmft/DMFT). Descriptive statistics,
T
-test, Mann-Whitney test, chi-square test, Fisher’s exact test, and two-way analysis of variance were used for data analysis (
p
<0.05).
Results
At the time of oral evaluation, both groups exhibited similar ages with means of 12.0±3.9 years old for CC and 12.0±4.0 years old for CT patients. All CC patients underwent chemotherapy with nine also undergoing radiotherapy. Significant differences were observed between the groups in terms of color/race, income, family education, and hygiene habits. However, no statistically significant differences were found between groups regarding the frequency of sugar intake, stimulated salivary flow rate, or the concentration of
Streptococcus mutans
(qPCR technique). For clinical parameters, the DMF (CC:1.80, CT: 0.75), decayed (CC: 0.88, CT: 0.19), missing (CC: 0.25, CT:0), and PI (CC: 30.5%, CT: 22.6%) were higher in the CC group (
p
<0.05).
Conclusion
Childhood cancer (CC) patients undergoing antineoplastic therapy (AT) exhibit a higher prevalence of dental caries, regardless of income/education, frequency of sugar intake, stimulated salivary flow rate, and microbiota.
This study evaluated the effects of Bifidobacterium animalis subsp. lactis HN019 (B. lactis HN019) in the development of periodontitis (PE), associated or not with metabolic syndrome, (MS) in rats.
...Ninety-six rats were grouped according to a food protocol: high-fat diet for induction of MS or standard diet for the control groups (C). They were subdivided into groups with (+) and without (-) PE, receiving (*) or not (**) probiotic (PROB): C-**, CP-*, PE+**, PEP+*, MS- MSP-*, MSPE+**, and MSPEP+*. PROB administration started on the eighth week of the study and PE was induced on the 14th week by placing ligature on the animals' lower first molars. Euthanasia occurred in the 16th week. Biomolecular analyzes, immunoenzymatic assays, and microtomographic analyses were performed. The data obtained were analyzed statistically (P < 0.05).
The PEP and MSPEP groups showed lower levels of alveolar bone loss when compared with the PE and MSPE groups, respectively (P < 0.05). The immunoenzymatic analysis showed higher levels of interleukin (IL)-1β and a higher receptor activator of NF-kappaB ligand (RANKL)/osteoprotegerin (OPG) ratio in the MSPE group when compared with the MSPEP group (P < 0.05). The PEP group showed lower levels of tumor necrosis factor (TNF)-α and IL-6 when compared with the PE group. The use of PROB attenuated dyslipidemia parameters in animals with MS, with or without PE.
B. lactis HN019 reduced more significantly the severity of PE in rats with MS, modulating both systemic metabolic and immunoinflammatory parameters in periodontal tissues.
Objectives
To analyze the association between systemic inflammatory burden of cardiovascular disease (CVD) risk and periodontitis in adolescents, including mediating pathways triggered by their ...common risk factors.
Materials and methods
Using a population-based sample study (
n
= 405) of Brazilian adolescents (17–18 years old), direct and mediation pathways triggered by “Socioeconomic Status,” “Adiposity,” Smoking, and “Blood Pressure” were modelled for the association between the “Systemic Circulating Inflammatory Burden of CVD Risk” (IL-1β, IL-6, IL-8, TNF-α) and the “Initial Periodontitis” (bleeding on probing (BoP), probing depth (PD) ≥ 4 mm, clinical attachment loss (CAL) ≥ 4 mm), both as continuous latent variables, using structural equation modeling. Sensitivity analysis was performed for the outcomes “Gingivitis” (visible plaque; BoP); “Moderate Periodontitis” (PD ≥ 5 mm and CAL ≥ 5 mm) and periodontitis (CDC-AAP case definition).
Results
Higher “Systemic Circulating Inflammatory Burden of CVD Risk” was directly associated with higher “Initial Periodontitis” (standardized coefficient SC = 0.178,
P
value < 0.001). Lower “Socioeconomic Status” (SC = − 0.022,
P
value = 0.015) and Smoking (SC = 0.030,
P
value = 0.021) triggered the “Initial Periodontitis”, mediated by “Systemic Circulating Inflammatory Burden of CVD Risk”. Sensitivity analysis showed a dose-response relationship between “Systemic Circulating Inflammatory Burden of CVD Risk” and “Moderate Periodontitis” (SC = 0.323,
P
value = 0.021).
Conclusions
“Systemic Circulating Inflammatory Burden of CVD Risk” appeared as an underlying mechanism of early periodontal breakdown in adolescents, also triggered by social vulnerability and smoking.
Clinical relevance
The association between periodontitis and CVD in adulthood seems to establish much earlier in life than had been previously studied, giving impetus to preventive approaches focused on their common risk factors.
Grade C, Stage 3-4 Periodontitis (Perio4C) is a rapidly destructive disease caused by an unequilibrated immune response that starts after the primary contact of the periodontopathogens with the ...gingival tissue. However, it is still unclear how this imbalanced response initiates and what is the role of the connective tissue cells in the progression of this disease. Thus, this study aims to assess the local immune response of Perio4C patients through the exposure of primary gingival fibroblast cells (GFs) with Aggregatibacter actinomycetemcomitans protein extract (AaPE) and the quantification of the inflammatory cytokines interleukin (IL)-4, IL-17, tumor necrosis factor (TNF)-α, IL-1β, interferon (IFN)-γ, and IL-10 super-family members (IL-10, IL-19, and IL-24) secreted by them.
Gingival biopsies from nine periodontally health (PH) and eight Perio4C patients were harvested, and the primary culture of GFs was obtained. The cells were exposed to AaPE (5 and 20 μg/ml) and 12-myristate 13-phorbol acetate and ionomycin - calcium salt (PMA). The supernatant was collected after 1.5 and 3 h, and a cytokine panel was evaluated.
Clustering analysis indicated dissimilar and stimuli-dependent cytokine production between Perio4C and PH subjects. Perio4C GFs presented lower production of IL-4, TNF-α, IFN-γ, IL-17, IL-10, IL-24, and IL-19, while IL-1β levels were similar to the PH group, leading to a disruption in the pro-/anti-inflammatory cytokine ratio (p < 0.05). IL-1β and IL-10 super-family were the most discriminative representants for PH and Perio4C, respectively.
GFs from individuals with Perio4C tended to hypo-respond to stimulation with AaPE, producing lower concentrations of some pro- and anti-inflammatory molecules, trending to develop a pro-inflammatory extracellular environment.
Aim
This randomized placebo‐controlled clinical trial evaluated the effects of multispecies probiotic containing Lactobacillus rhamnosus HN001™, Lactobacillus paracasei Lpc‐37®, and Bifidobacterium ...animalis subsp lactis HN019™ as an adjunct to mechanical debridement (MD) on changes in bleeding on probing (BOP) in edentulous patients with peri‐implant mucositis (PiM).
Materials and Methods
Patients were randomly assigned to test (probiotic) or control (placebo) groups. All sites with PiM received MD and topical gel application (probiotic or placebo) at baseline and 12 weeks. After initial MD, patients consumed probiotic or placebo capsules twice a day for 12 weeks. Clinical (modified sulcus bleeding index mSBI; modified plaque index mPI; probing depth PD; and BOP) and immunological parameters were collected at baseline and after 12 and 24 weeks. Data were statistically analysed (p < .05).
Results
Thirty‐six patients with PiM were recruited. The test group presented higher prevalence (p < .05) of cases of restored peri‐implant health at 24 weeks than did the control group (72.2% and 33.3%, respectively). No significant difference was observed between test (n = 18) and control (n = 18) groups for mPI and PD. mSBI %—score 0 was higher in the test group than in the control group at 24 weeks (p < .05). When compared with baseline, both groups presented reduced BOP at 12 and 24 weeks (p < .05). BOP was lower in the test group than in the control group at 12 (mean difference = −14.54%; 95% confidence interval CI = −28.87 to 0.22; p = .0163) and 24 (mean difference = −12.56%; 95% CI = −26.51 to 1.37; p = .0090) weeks. At 24 weeks, only the test group presented lower levels of interleukin (IL)‐1β, IL‐6, IL‐8, and tumour necrosis factor (TNF)‐α than those at baseline (p < .05).
Conclusions
The multispecies probiotic (administered locally and systemically) containing L. rhamnosus HN001™, L. paracasei Lpc‐37®, and B. lactis HN019™ as an adjunct to repeated MD promotes additional clinical and immunological benefits in the treatment of PiM in edentulous patients (ClinicalTrials.gov NCT04187222).
Objective
To evaluate clinical and radiographic characteristics in peri‐implant marginal tissues in patients with a history of chronic periodontitis, rehabilitated using tissue‐level or bone‐level ...implants.
Material and Methods
Using a split‐mouth design, 20 patients with a history of chronic periodontitis were selected and received two different implants, tissue‐level group (n = 20) and the bone‐level group (n = 20). Peri‐implant probing depth, relative peri‐implant mucosal margin position, relative peri‐implant clinical attachment level, peri‐implant plaque index and peri‐implant bleeding on probing were evaluated at prosthesis installation, 1, 3, 6, 12 and 24 months after implant loading. Radiographic marginal bone level was evaluated at implant insertion, prosthesis installation, 6 and 24 months after implant loading.
Results
The mean difference of peri‐implant marginal bone resorption from implant installation to 24 months in function was 0.75 ± 1.12 mm for the tissue‐level group and 0.70 ± 0.72 mm for the bone‐level group. No statistically significant difference was found between groups at all assessment periods for clinical and radiographic peri‐implant evaluation.
Conclusion
Under a rigid supportive therapy, both approaches performed likewise regarding clinical and radiographic parameters for rehabilitation of patients with a history of chronic periodontitis.
The aim of this study was to evaluate the effect of active oxygen-releasing gel as an adjuvant, with and without antimicrobial photodynamic therapy (aPDT), in the treatment of residual pockets in ...periodontal patients with type 2 diabetes mellitus (DM2).
Patients with residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BOP) were divided into the following groups: SI (n = 17)-subgingival instrumentation in a single session; BM (n = 17)-SI followed by local application of active oxygen-releasing gel inside the periodontal pocket for 3 min; BM + aPDT (n = 17)-SI followed by application of BM for 3 min and pocket irrigation with methylene blue, and 660-nm diode laser irradiation at 100 mW for 50 s. The periodontal clinical parameters, serum levels of glycated hemoglobin, and immunological analysis of crevicular fluid were evaluated. All data were submitted to statistical analysis (α = 5%).
A significant reduction in BOP was verified at 90 and 180 days in the BM + aPDT group. The percentage of sites with PD ≥ 4 mm was significantly reduced at 90 days in BM + aPDT and BM, whereas after 180 days only BM showed a significant reduction. In the BM + aPDT group, there was a significant reduction in tumor necrosis factor α levels at 90 days. There were no differences between the treatments.
The use of adjuvant active oxygen-releasing gel, with or without aPDT, resulted in the same clinical benefits as SI in the treatment of residual pockets in poorly controlled DM2 patients.
Residual pockets are challenging sites that require additional periodontal therapy. The aim of this study was to evaluate the effect of a single photodynamic therapy (PDT) as an adjunct to scaling ...and root planning (SRP) in residual pockets in single-rooted teeth. A blind, split-mouth, randomized controlled clinical trial was conducted in systemically healthy subjects presenting at least two residual pockets (probing pocket depth (PPD) ≥5 mm with bleeding on probing (BoP)) in single root teeth in supportive periodontal therapy. The selected sites were assigned to receive (1) PDT + SRP or (2) SRP. In sites treated by PDT as adjunctive to SRP, the laser system included a handheld battery-operated diode laser with a wavelength of 660 nm, a power output of 60 mW, and energy density of 129 J/cm
2
, together with methylene blue as a photosensitizer (10 mg/ml). Clinical parameters were assessed at baseline and 3 months post-therapies. Clinical parameters improved significantly after both therapies (
p
< 0.05), whereas higher probing pocket depth reduction and clinical attachment level gain were observed in the PDT + SRP group at 3 months (
p
< 0.05). In addition, sites treated by the combined approach yielded a significant reduction in the number of sites with PPD <5 mm without BoP after 3 months compared to sites treated by conventional SRP alone (
p
< 0.05). PDT as an adjunctive to mechanical debridement demonstrated additional clinical benefits for residual pockets in single-rooted teeth and may be an alternative therapeutic strategy in supportive periodontal maintenance.
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