A point-of-care test of active matrix metalloproteinase-8 predicts triggering receptor expressed on myeloid cells-1 (TREM-1) levels in saliva.

BACKGROUND: This cross-sectional study aims to investigate if a point-of-care (PoC) test of active matrix metalloproteinase-8 (aMMP-8) predicts levels of inflammation amplifier triggering receptor expressed on myeloid cells-1 (TREM-1) and its putative ligand the neutrophil peptidoglycan recognition protein 1 (PGLYRP1) in saliva. METHODS: Forty-seven adolescents, aged 15 to 17 years, were tested with aMMP-8 PoC test, which was followed by a full-mouth clinical examination of the assessment of periodontal, mucosal, and oral health. TREM-1 and PGLYRP1 levels were analyzed by ELISA. The immunofluorometric assay (IFMA) specific for aMMP-8 was used as the reference method. RESULTS: Fourteen saliva samples out of a total of 47 showed positivity for aMMP-8 PoC test. Both the TREM-1 and the aMMP-8 (IFMA) levels were significantly elevated among the aMMP-8 PoC test positives compared with the PoC test negatives (P < 0.05). Moreover, aMMP-8 levels assessed by IFMA showed a strong positive correlation with TREM-1 levels in saliva (r = 0.777, P < 0.001). The number of sites with a probing depth of ≥4 mm was significantly lower among the adolescents that had a negative aMMP-8 PoC test result, and TREM-1 levels < 75 pg/mL (P < 0.05). In contrast, adolescents with a positive aMMP-8 PoC test result (i.e., elevated aMMP-8 levels) together with elevated TREM-1 levels had a significantly higher number of periodontal pockets with ≥4 mm (P < 0.001). CONCLUSION: The present study validated usability of aMMP-8 PoC test for predicting "proinflammatory" salivary profile and periodontal health status in adolescents.

High salivary estrogen and risk of developing pregnancy gingivitis.

BACKGROUND: Estrogen regulates the cellular functions of several tissues that may disturb the host response against bacteria. The present aim is to evaluate the contribution of estrogen to the severity of gingival inflammation during pregnancy. METHODS: Salivary estrogen levels from 30 pregnant and 24 non-pregnant females were related to their periodontal health parameters, including visible plaque index (VPI) and bleeding on probing (BOP) from six sites per tooth. The pregnant group was examined three times during pregnancy and twice during postpartum, and the non-pregnant group was examined three times, once per subsequent month. RESULTS: Salivary estrogen levels increased significantly during the second (P <0.01) and third (P <0.05) trimesters. In both participant groups, BOP scores correlated significantly with VPI scores (r = 0.498 to 0.870) but not with estrogen levels. In all trimesters and postpartum, the individuals with both high estrogen and high VPI levels had the highest frequency of pregnancy gingivitis. During the second and third trimesters, simultaneously enhanced estrogen levels and VPI scores brought an additional risk of developing gingivitis compared with a high VPI score alone. CONCLUSION: The present findings suggest that, during pregnancy, the estrogen level determines the magnitude of gingival inflammation developed against microbial plaque at the gingival margin.

Effect of teenage smoking on the prevalence of periodontal bacteria.

The aim of our study was to investigate how teenage smoking affects the prevalence of periodontal bacteria and periodontal health with the hypothesis that smoking increases the prevalence of the bacteria. Oral health of 264 adolescents (15- to 16-year-olds) was clinically examined, and their smoking history was recorded. The participants also filled in a structured questionnaire recording their general health and health habits. Pooled subgingival plaque samples were taken for polymerase chain reaction analysis of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens, and Treponema denticola. The prevalence of P. intermedia (21% vs. 4%, p = 0.01) and T. forsythia and T. denticola (23% vs. 8%, p < 0.05, for both) was higher among female smokers than among non-smokers. T. forsythia and T. denticola were more often associated with bleeding on probing (29% vs. 12%; 25% vs. 10%, respectively) and deep pockets (25% vs. 15%; 23% vs. 10%, respectively) with smokers than non-smokers. Among the girls, a significant association was found between pack-years and the prevalence of P. nigrescens (p < 0.007). In both genders, A. actinomycetemcomitans and P. gingivalis were rare in this study. To conclude, periodontal bacteria were associated with higher periodontal index scores among all teenage smokers. Smoking girls harbored more frequently certain periodontal bacteria than non-smokers, but this was not seen in boys. Hence, our study hypothesis was only partly confirmed.

Periodontal status and neutrophilic enzyme levels in gingival crevicular fluid during pregnancy and postpartum.

BACKGROUND: Pregnancy induces or enhances susceptibility to gingivitis; however, the presence and role of neutrophilic enzymes in pregnancy-related gingivitis are not well known. The present study demonstrates the relationship between neutrophilic enzymes in gingival crevicular fluid (GCF) and periodontal status during pregnancy and postpartum. METHODS: At baseline, 30 periodontally healthy pregnant women (Pr group) and 24 non-pregnant women (N-Pr group) as their controls participated in the study. The Pr group was examined once per each trimester and twice during postpartum and the N-Pr group three times (on successive months). During each visit, GCF samples were collected from all first molars, and clinical measurements (visible plaque index, bleeding on probing [BOP], probing depth [PD], and clinical attachment level) were recorded. The samples were analyzed for matrix metalloproteinase (MMP)-8, polymorphonuclear neutrophil (PMN) elastase, myeloperoxidase (MPO), and tissue inhibitor of matrix metalloproteinase (TIMP)-1. Their levels were compared to the periodontal status at the collection site. RESULTS: In the Pr group, BOP and PD scores significantly increased between the first and second trimester, indicating pregnancy gingivitis. This increased inflammation was not reflected by the enzymes examined in GCF; the amounts of PMN elastase decreased continuously during the follow-up period, and those of MPO and MMP-8 did not increase until delivery, whereas TIMP-1 amounts remained stable throughout the follow-up period. In the N-Pr group, all parameters remained steady. CONCLUSION: Despite an increased susceptibility to gingivitis during mid-pregnancy, the host response does not seem to activate its own degradative enzymes.

The effect of smoking on periodontal health of 15- to 16-year-old adolescents.

BACKGROUND: Smoking is a severe risk factor for periodontal health in adults, but data on the effect of smoking on periodontal health in teenage populations are sparse. The aim of this study was to investigate the effect of duration and quantity of smoking on periodontal health in teenagers and possible differences between genders. METHODS: The oral health of 501 adolescents (15- to 16-year-old boys [n = 258] and girls [n = 243]) was examined. A structured questionnaire about self-reported smoking and health habits was filled out, and bitewing x-rays were taken. Clinical examinations included measuring periodontal indexes, such as visible plaque index, bleeding on probing, root calculus (RC), probing depth, and attachment loss. Results were analyzed by generalized linear logistic regression. RESULTS: Twenty-five percent of boys and 27% of girls were smokers. The boys and girls who smoked had higher RC values than non-smokers (P <0.001). The adjusted scores for smoking boys and girls were 17.3 (95% confidence interval [CI]: 8.6 to 31.7) and 13.6 (95% CI: 5.5 to 29.7), respectively. The adjusted scores for non-smokers were 10.4 (95% CI: 5.7 to 18.3) and 7.7 (95% CI: 3.3 to 17.3), respectively. Smoking boys and girls also had more periodontal pockets > or =4 mm than non-smokers: the score for boys was 4.6 (95% CI: 2.2 to 9.1), and the score for girls was 5.4 (95% CI: 1.1 to 23.2; P <0.001). CONCLUSION: Smoking significantly impaired periodontal health in teenagers.

Clinical changes in periodontium during pregnancy and post-partum.

BACKGROUND AND AIM: Pregnancy has been presented to increase susceptibility to gingival inflammation. It is unclear whether pregnancy gingivitis exposes or proceeds to periodontitis. We examined longitudinally the severity of periodontal changes during pregnancy and post-partum, and compared the findings with an age-matched group of non-pregnant women. MATERIAL AND METHODS: Thirty generally healthy, non-smoking women at an early phase of their pregnancy and 24 non-pregnant women as controls were recruited. The pregnant group was examined three times during pregnancy and twice during post-partum, and the non-pregnant group three times, once per subsequent month. At each visit, visible plaque index (VPI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were measured from six sites per tooth. RESULTS: In the pregnant group, BOP and PPD increased simultaneously without relation to plaque between the first and second trimesters, and thereafter decreased during subsequent visits. No changes were detected in CAL during the study period. In the non-pregnant group, BOP stayed invariable during the follow-up and correlated with the amount of plaque. Neither periodontal pocket formation nor significant changes in attachment levels were observed. CONCLUSION: Based on this study, changes in clinical parameters during pregnancy are reversible, indicating that pregnancy gingivitis does not predispose or proceed to periodontitis.