Partial (incomplete) removal of granulation tissue using modified minimally invasive surgical technique in treatment of infrabony defects (randomized control clinical trial).

AIM: This study aims to compare the clinical and radiographic outcomes after complete versus incomplete removal of granulation tissue (GT) during modified minimally invasive surgical technique (M-MIST) for management of periodontitis patients with deep pockets associated with infra-bony defects. METHODOLOGY: Ten patients with a total of 14 deep non-resolving pockets (≥ 5 mm) associated with a vertical infra-bony defect were recruited for this study. They were randomized into 2 groups; a test group with incomplete removal of GT and a control group with complete removal of GT. Clinical parameters of clinical attachment level (CAL), residual probing depth (rPD) and buccal recession (Rec.) were recorded every 3 months. Radiographic periapicals were taken at baseline, 6 and 9 months. The significance level was set to 0.05. RESULTS: None of the results showed statistical significance between the 2 groups (p > 0.05). The test group showed less CAL gain (2 ± 0.87 mm, p = 0.062), more reduction in rPD (3.1 ± 0.96 mm, p = 0.017) and more recession (0.857 ± 0.26 mm, p = 0.017) than control group CAL gain (2.4 ± 0.58 mm, p = 0.009), rPD reduction (2.9 ± 0.3 mm, p = 0.001) and recession (0.5 ± 0.34 mm, p = 0.203) respectively. Control group had linear reduction in depth defect (DD) (0.68 ± 0.287, p = 0.064) compared to an increase in DD in test group (-0.59 ± 0.5, p = 0.914). CONCLUSIONS: No statistical significance were observed in healing parameters between complete removal of GT in M-MIST and incomplete (partial) removal of GT of deep pockets with infra-bony defects both clinically and radiographically. Further studies with larger samples are needed to confirm the results.

Multifunctional human serum albumin-crosslinked and self-assembling nanoparticles for therapy of periodontitis by anti-oxidation, anti-inflammation and osteogenesis.

Periodontitis is a chronic inflammatory disease that can result in the irreversible loss of tooth-supporting tissues and elevate the likelihood and intensity of systemic diseases. The presence of reactive oxygen species (ROS) and associated related oxidative stress is intricately linked to the progression and severity of periodontal inflammation. Targeted removal of local ROS may serve to attenuate inflammation, improve the unfavorable periodontal microenvironment and potentially reverse ensuing pathological cascades. These ROS scavenging nanoparticles, which possess additional characteristics such as anti-inflammation and osteogenic differentiation, are highly sought after for the treatment of periodontitis. In this study, negative charged human serum albumin-crosslinked manganese-doped self-assembling Prussian blue nanoparticles (HSA-MDSPB NPs) were fabricated. These nanoparticles demonstrate the ability to scavenge multiple ROS including superoxide anion, free hydroxyl radicals, singlet oxygen and hydrogen peroxide. Additionally, HSA-MDSPB NPs exhibit the capacity to alleviate inflammation in gingiva and alveolar bone both in vitro and in vivo. Furthermore, HSA-MDSPB NPs have been shown to play a role in promoting the polarization of macrophages from the M1 to M2 phenotype, resulting in reduced production of pro-inflammatory cytokines. More attractively, HSA-MDSPB NPs have been demonstrated to enhance cellular osteogenic differentiation. These properties of HSA-MDSPB NPs contribute to decreased inflammation, extracellular matrix degradation and bone loss in periodontal tissue. In conclusion, the multifunctional nature of HSA-MDSPB NPs provides a promising therapeutic approach for the treatment of periodontitis.

Association between calcium-channel blockers and gingival enlargement: A case-control study.

OBJECTIVES: As reported by the existing literature, calcium-channel blockers (CCB) can lead to gingival enlargement. The aims of this study were to investigate the factors associated with gingival enlargement in patients on CCB and to assess the saliva and gingival crevicular fluid (GCF) profile of patients on CCB with gingival enlargement. METHODS: A total of 131 participants were included. Data were collected from 91 patients taking CCB for treatment of systemic hypertension. The presence of drug-induced gingival enlargement (DIGE) was assessed clinically and associated with patient factors. Patients with DIGE were group-matched for gender and ethnicity with an equal number of consecutive CCB non-DIGE patients (control 1), no-CCB no-DIGE (control 2) and periodontally healthy with no DIGE (control 3) for the saliva and GCF analysis. A bead-based multiplex immunoassay was used to assess a panel of biomarkers. RESULTS: Twenty-two percent of patients on CCB were diagnosed with DIGE. Lack of daily interdental cleaning and self-reported diagnosis of type II diabetes were associated with the diagnosis of DIGE. When analysing patients only on CCB, those with DIGE had higher GCF levels of vascular endolthelial growth factor (VEGF) (p = 0.032), epidermal growth factor (EGF) (p = 0.030) and matrix metalloproteinase-8 (MMP-8) (p = 0.008). Among the salivary markers, only MMP-8 showed a statistically significant difference across groups (p < 0.001). CONCLUSIONS: This is the first study investigating saliva and GCF biomarkers in patients with DIGE and different control groups, suggesting that causes of the overgrowth might involve inflammatory processes, tissue damage pathways, and potentially an impact on growth factors like VEGF. Future research should verify these results in independent populations and explore the underlying pathogenic mechanisms in-depth. CLINICAL SIGNIFICANCE: Calcium-channel blockers (CCB) can lead to gingival enlargement. This study confirms lack of interdental cleaning and type II diabetes as risk factors. Elevated levels of VEGF, EGF, and MMP-8 in gingival crevicular fluid and MMP-8 in saliva suggest inflammatory processes and growth factors might play roles in this condition.

Association between Periodontal Diseases and the Risk of Site-Specific Gastrointestinal Cancers: A Systematic Review and Meta-Analysis.

The association between periodontal diseases and the risk of gastrointestinal cancers, especially site-specific gastrointestinal cancers, remains unclear. Here, we comprehensively searched PubMed, EMBASE, Web of Science, and Google Scholar from inception to April 2024 to identify relevant studies. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. Subgroup analyses and sensitivity analyses were conducted to confirm the robustness of the main findings in different populations. This study was reported according to PRISMA 2020 guidelines. In total, we identified 19 studies, including 16.6 million participants. Individuals with periodontal diseases had an increased risk of overall gastrointestinal cancers compared with those without periodontal diseases (HR 1.31, 95% CI 1.16-1.49). Periodontal diseases significantly increased the risk of esophageal cancer by 39% (HR 1.39, 95% CI 1.15-1.68), gastric cancer by 13% (HR 1.13, 95% CI 1.01-1.26), colorectal cancer by 21% (HR 1.21, 95% CI 1.05-1.39), pancreatic cancer by 35% (HR 1.35, 95% CI 1.00-1.82), and liver cancer by 9% (HR 1.09, 95% CI 1.04-1.13). The risk of gastrointestinal cancers was significantly increased by periodontitis (HR 1.45, 95% CI 1.14-1.85), gingivitis (HR 1.03, 95% CI 1.01-1.04), and periodontitis/gingivitis (HR 1.27, 95% CI 1.07-1.51). Furthermore, severe periodontal diseases showed a significantly increased risk of gastrointestinal cancer (HR 1.79, 95% CI 1.07-2.99). Results of sensitivity analyses for site-specific gastrointestinal cancers were robust with the main findings. In summary, periodontal diseases, especially severe periodontitis, increase the risk of overall and site-specific gastrointestinal cancers. Interventions to prevent and manage periodontal diseases may reduce the risk of developing gastrointestinal cancers.

Combined application of Er:YAG laser and low-level laser in non-surgical treatment of periodontitis.

BACKGROUND: To compare the efficacy of combined treatment of Er:YAG laser (ERL) and low-level laser therapy (LLLT) with single laser applications, and scaling and root planing (SRP) for non-surgical periodontal treatment. METHODS: In a randomized controlled trial, 25 non-smoking Stage II or Stage III periodontitis patients were recruited. The four intraoral quadrants were randomly assigned to four different treatments: (1) combined application with ERL plus SRP plus LLLT; (2) ERL plus SRP; (3) SRP plus LLLT; and (4) SRP. We assessed periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI), along with three cytokines (IL-1ß, TNF-α, IL-10) from gingival crevicular fluid and red complex pathogens from subgingival dental plaque at baseline, 3 months, and 6 months. RESULTS: For initial moderate pockets (4 mm ≤ PD ≤ 6 mm), quadrants treated with ERL+SRP+LLLT, ERL+SRP, and SRP+LLLT exhibited greater PD improvement compared to the control (SRP) quadrants at the 3-month follow-up (1.25 ± 1.06, 1.23 ± 1.12, 1.00 ± 1.21 vs. 0.98 ± 1.21 mm) and the 6-month follow-up (1.35 ± 1.06, 1.23 ± 1.17, 1.35 ± 0.98 vs. 0.98 ± 1.23 mm) (p = 0.002). Quadrants treated with ERL+SRP+LLLT and SRP+LLLT showed more CAL gain means than the control quadrants at the 3-month follow-up (0.96 ± 1.42, 0.61 ± 1.39 vs. 0.55 ± 1.57 mm) and the 6-month follow-up (0.84 ± 1.54, 0.89 ± 1.49 vs. 0.48 ± 1.68 mm) (p = 0.008). For initial deep pockets (PD ≥ 7 mm), the ERL+SRP+LLLT quadrants had more PD improvement and CAL gain compared to the control quadrants at follow-up. There were no significant differences in BI, PLI, inflammatory cytokines, and periodontal pathogens among the four groups. CONCLUSION: The combined application of ERL and LLLT demonstrated potential efficacy in reducing PD, particularly for deep pockets. PLAIN LANGUAGE SUMMARY: To compare the therapy effect of combined use of Er:YAG laser (ERL) and low level laser therapy (LLLT) with single laser applications, and traditional periodontal treatment (SRP). A total of 25 non smoking patients with periodontitis were involved, and their mouths were divided into four sections, each receiving a different treatment: ERL+SRP+LLLT, ERL+SRP, SRP+LLLT, and SRP. Clinical indexes and laboratory indicators were assessed at baseline, 3 months, and 6 months. After six months, for initial moderate pockets, combined laser group and single laser group showed better improvements than traditional group in reducing the depth of periodontal pockets and increasing attachment levels. But for initial deep pockets, only combined laser group showed better improvement than traditional group. There were no significant differences in bleeding, plaque, inflammation, or harmful bacterial levels among the groups. These findings suggest that the integration of Er:YAG laser and low level laser therapy into standard periodontal treatment may enhance the treatment's benefits in reducing pocket depth, especially for severe conditions.

Improvements in Oral Lichen Planus Following Periodontal Treatment in a Patient With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Case Report.

Oral lichen planus (OLP), a chronic inflammatory mucocutaneous disease, is known to be associated with liver disease. Additionally, associations between periodontal disease and metabolic dysfunction-associated steatotic liver disease (MASLD), as well as cardiovascular disease, have been reported. Herein, we report a case of a 68-year-old male who presented at a dental clinic with OLP, which showed signs of improvement after treatment for periodontal disease. The patient had hepatic dysfunction and steatosis, which was complicated by angina pectoris. He was diagnosed with OLP and periodontal disease. Subsequent close examination of his liver led to a diagnosis of MASLD. Treatment for periodontal disease and enhanced oral self-care improved the OLP lesions and liver function values. This case demonstrates that collaboration between different medical disciplines can significantly impact patient health.

Obesity and periodontitis: a comprehensive review of their interconnected pathophysiology and clinical implications.

Obesity and periodontitis are significant health problems with a complex bidirectional relationship. Excess body fat is linked to systemic diseases and can lead to persistent inflammation, potentially harming periodontal health. Periodontitis, a chronic inflammatory condition affecting the supporting structures of teeth, poses substantial health risks. Both conditions share pathological processes such as inflammation and oxidative stress, which aggravate health status and make treatment more challenging. Understanding this interaction is crucial for developing effective management strategies for both diseases. This study explores the multifaceted aspects of obesity and periodontitis and their reciprocal relationship.

An Anaerobic Culture Study to Assess the Prevalence of Porphyromonas gingivalis in Periodontal Disease Incidences Among Adults.

Introduction Periodontitis is a complex condition influenced by various factors involving interactions between the host and bacterial plaque. Porphyromonas gingivalis, an anaerobic gram-negative bacterium, is commonly linked with periodontal disease. Aim This study aimed to examine the occurrence of P. gingivalis in individuals diagnosed with chronic periodontitis (CP) compared to those who show no clinical indications of periodontal disease. Methodology Patients diagnosed with CP (including both severe and moderate cases) and individuals without any signs of periodontal disease were recruited for this study. Samples were collected from the gingival pockets using curettes and were subsequently subjected to anaerobic culturing. Results A group of 30 patients, divided into moderate and severe CP, along with 30 healthy individuals serving as controls, were examined. In individuals with CP, P. gingivalis was found in 23 (78%) of cases, while in healthy individuals, the prevalence was 10 (34%). The presence of P. gingivalis was notably higher in those with periodontal diseases compared to healthy subjects, with rates of 23 (78%) vs. 10 (34%), respectively. Conclusion P. gingivalis is frequently found in individuals with periodontal diseases as well as in those without such conditions, albeit in smaller quantities. Consequently, the existence of P. gingivalis raises the probability of developing periodontal disease and may be regarded as a notable potential contributor to its initiation.

Alveolar bone loss is a significant contributor to tooth loss in dentate HIV+ patients: A retrospective study.

BACKGROUND: The study objectives were to determine tooth loss prevalence and to investigate the relationship between tooth loss and potential risk factors among adult dentate HIV+ patients on newer antiretroviral therapy (ART) regimens. METHODS: Health records of 450 human immunodeficiency virus (HIV)-infected individuals were surveyed. Eighty-eight records of dentate HIV+ individuals with full-mouth periodontal charting and intra-oral periapical radiographs were identified. We collected data on demographics, systemic risk factors, oral health, and HIV disease measures. Caries exposure and alveolar bone loss (ABL) were radiographically assessed. RESULTS: Eighty-eight percent of patients showed tooth loss. Patients with ABL ≥15% had a higher number of missing teeth (p < .01). Stepwise regression analyses indicated that tooth loss was positively associated with age (ß = 0.45, p < .01) and ABL (ß = 0.39, p < .01). By contrast number of years on ART was negatively associated with tooth loss (ß = -0.28, p < .05). CONCLUSIONS: Tooth loss remains prevalent among HIV+ patients, and periodontal disease is a significant contributor. The number of years on ART seem to improve oral health behavior and reduce tooth loss.

Targeted Reprogramming of Pathogenic Fibroblast Genes at the 3'-Untranslated Regions by DNA Nanorobots for Periodontitis.

Periodontitis, with its persistent nature, causes significant distress for most sufferers. Current treatments, such as mechanical cleaning and surgery, often fail to fully address the underlying overactivation of fibroblasts that drives this degradation. Targeting the post-transcriptional regulation of fibroblasts, particularly at the 3'-untranslated regions (3'UTR) of pathogenic genes, offers a therapeutic strategy for periodontitis. Herein, we developed a DNA nanorobot for this purpose. This system uses a dynamic DNA nanoframework to incorporate therapeutic microRNAs through molecular recognition and covalent bonds, facilitated by DNA monomers modified with disulfide bonds. The assembled-DNA nanoframework is encapsulated in a cell membrane embedded with a fibroblast-targeting peptide. By analyzing the 3'UTR regions of pathogenic fibroblast genes FOSB and JUND, we identified the therapeutic microRNA as miR-1-3p and integrated it into this system. As expected, the DNA nanorobot delivered the internal components to fibroblasts by the targeting peptide and outer membrane that responsively releases miR-1-3p under intracellular glutathione. It resulted in a precise reduction of mRNA and suppression of protein function in pathogenic genes, effectively reprogramming fibroblast behavior. Our results confirm that this approach not only mitigates the inflammation but also promotes tissue regeneration in periodontal models, offering a promising therapeutic avenue for periodontitis.

Ten-year changes of periodontitis grading using direct and indirect evidence: a retrospective evaluation.

OBJECTIVE: To evaluate two methods for assessing the changes in periodontitis grading in patients undergoing supportive periodontal therapy (SPT) ten years (T10) after retrospective baseline (BL) grading. MATERIALS AND METHODS: The periodontitis grade of 51 SPT-patients was assessed using indirect evidence as the primary criterion for periodontitis progression at BL and T10 (radiographic bone loss/age index, periodontitis phenotype). Grading at T10 was also performed using the direct evidence for periodontitis progression (clinical attachment loss over the previous five years). The use of indirect evidence for periodontal progression at BL and T10 was defined as method 1 (M1) to assess the changes in periodontitis grading. The use of indirect evidence at BL and direct evidence at T10 was defined as method 2 (M2). Changes in periodontitis grading using M1 and M2 were evaluated (Wilcoxon signed-rank test). Agreement between M1 and M2 was assessed (Cohen's kappa). RESULTS: Indirect BL-grading revealed five grade B and 46 grade C patients. The indirect grading at T10 revealed 17 grade B and 34 grade C patients. The direct T10-grading classified all patients as grade C. M1 led to an overall improvement in periodontitis grading after ten years of SPT (p=0.00297), whereas M2 led to a deterioration (p=0.0369). The comparison between M1 and M2 showed that they lead to different results in terms of grading (Cohen's Kappa=0.116208). CONCLUSIONS: Periodontitis grading may change during SPT. Using indirect or direct evidence as the primary grading criterion during SPT may lead to different results.

Evaluation of Folic Acid-Containing Mouthrinse and Chlorhexidine Mouthrinse as an Adjunct to Scaling and Root Planing in Patients With Periodontal Disease.

BACKGROUND: Periodontal disease is a host-mediated inflammation caused due to microbial challenge. Hence, mechanisms involving the control of host-associated mediators can be a potential target. The conventional nonsurgical periodontal treatment modality includes scaling and root planing (SRP), which is often combined with adjunctive chemical plaque control agents for effective disease control. Chlorhexidine (CHX) is the most common chemical plaque control agent used. Recent research is now being focused on exploring other medicinal substitutes that may benefit control of inflammation and tissue healing. Folic acid is an important nutrient that increases the ability of oral epithelial cells to resist local irritants and inflammation if supplemented either systemically or locally. AIM: The current study aimed to evaluate the effect of folic acid and CHX mouthwash as an adjunct to scaling and root planing for treating patients with chronic periodontitis. METHODOLOGY: In this study, 30 patients with chronic periodontitis were included and assigned to either of the two groups: Group A (receiving folic acid-containing mouthrinse) and Group B (receiving CHX mouthrinse). Periodontal measurements, including plaque index, probing pocket depth, gingival index, and healing index, were evaluated at baseline and again four weeks after scaling and root planing. RESULTS: Significant reduction was detected in all clinical parameters (plaque index, gingival index, probing pocket depth, healing index) for both groups (p<0.05) when evaluated from baseline to four weeks. CONCLUSION: Both mouthrinses were effective when used as an adjunct to scaling and root planing in the treatment of periodontitis. Hence, folic acid-containing mouthrinse can be used in patients with chronic periodontitis.

Comparative Evaluation of Three Different Demineralisation Protocols on the Physicochemical Properties and Biocompatibility of Decellularised Extracellular Matrix for Bone Tissue Engineering Applications.

Background With three-dimensional (3D) bioprinting emerging as the ultimate pinnacle of personalised treatment for achieving predictable regenerative outcomes, the search for tissue-specific bioinks is on. Decellularised extracellular matrix (DECM), which provides the inherent biomimetic cues, has gained considerable attention. The objective of the present study was to compare the efficacy of three different demineralisation protocols to obtain DECM for bone tissue engineering applications.  Methodology Goat femurs were treated using three demineralisation protocols to obtain DECM. Group A was treated with demineralisation solution at 40 rpm for 14 days, Group B with freeze-thaw cycles and 0.05M hydrochloric acid (HCl) and 2.4 mM ethylenediamine tetra-acetic acid (EDTA) at 40 rpm for 60 days, and Group C with 0.1M HCl at 40 rpm for three days. After washing, neutralization, 0.05% trypsin-EDTA treatment for 24 hours, and lyophilisation, DECM was obtained. Assessments included scanning electron microscope (SEM) analysis, energy dispersive X-ray (EDX) analysis, hematoxylin and eosin (H&E) staining, and biocompatibility analysis.  Results On comparative analysis, the protocol followed by Group C revealed good surface properties with patent and well interconnected pores with an average pore size of 218.87µm. Group C also revealed carbon and oxygen as predominant components with trace amounts of calcium, proving adequate demineralisation. Group C further revealed optimal demineralisation and decellularisation under histological analysis while maintaining biocompatibility. DECM obtained in Group C should be further processed for bioprinting applications.  Conclusion The three protocols explored in this study hold potential, with Group C's protocol demonstrating the most promise for DECM-based bioink applications. Further research is needed to evaluate the suitability of the obtained DECM for preparing tissue-specific bioinks for 3D bioprinting.

Association of the severity and progression rate of periodontitis with systemic medication intake.

Background/purpose: Information on the systemic medication profiles of patients with periodontitis is limited. Therefore, this retrospective cross-sectional study aimed to analyze the relationship between the severity and rate of progression of periodontitis and systemic medication intake using a database of patients who attended the Clinic of Periodontics of the Faculty of Dentistry of the University of Costa Rica. Methods: Electronic health records of patients diagnosed with periodontitis based on the Classification of Periodontal and Peri-Implant Diseases and Conditions (2017) were evaluated. Individuals were further categorized based on the severity (stage) and rate of progression (grade). Data extracted from the patient records included age, sex, and self-reported medication intake. Results: In total, 930 records were included. Most of the studied population was middle-aged (36-64 years old); 43.01% were male, and 56.99% were female. Four hundred and fifty-seven patients (49.14%) reported taking at least one systemic medication for a chronic condition. Regarding the periodontal treatment phase, 62.37% underwent steps 1-3, and 37.63% underwent step 4. The most common systemic medications taken were for cardiovascular diseases (42.28%), followed by medications for diabetes (14.46%) and neurologic disorders (14.46%). Most patients (59.35%) were diagnosed with Stage III periodontitis. Grade B (48.28%) was the most prevalent. Calcium channel blockers demonstrated a disease severity-dependent association with the periodontal stage (p = 0.021). In addition, systemic medications for diabetes mellitus were associated with periodontal disease severity and rate of progression (all Ps < 0.05). Conclusions: This study provides indirect evidence of the association between systemic diseases and periodontitis. The positive association between medications used to treat diabetes and the severity and rate of progression of periodontitis may be due to the underlying disease rather than the medications per se.

Association of periodontitis with cardiovascular and all-cause mortality in hypertensive individuals: insights from a NHANES cohort study.

BACKGROUND: The objective of this research is to clarify the impact of periodontitis on overall and cardiovascular-related death rates among hypertensive individuals. METHOD: A total of 5665 individuals with hypertension were included from the National Health and Nutrition Examination Survey (NHANES) data spanning 2001-2004 and 2009-2014. These individuals were divided into two groups based on the presence or absence of periodontitis and further stratified by the severity of periodontitis. We employed weighted multivariate Cox proportional hazards regression and Kaplan-Meier curves (log-rank test) to evaluate the impact of periodontitis on all-cause and cardiovascular mortality. Additional analyses, including adjustments for various covariates, subgroups, and sensitivity analyses, were conducted to ensure the robustness and reliability of our results. RESULT: Over an average follow-up duration of 10.22 years, there were 1,122 all-cause and 297 cardiovascular deaths. Individuals with periodontitis exhibited an elevated risk of all-cause mortality (HR = 1.33, 95% CI 1.18-1.51; p < 0.0001) and cardiovascular mortality (HR = 1.48, 95% CI 1.15-1.89; p = 0.002). Moreover, we observed a progressive increase in both all-cause mortality and cardiovascular mortality (p for trend are both lower than 0.001) and correlating with the severity of periodontitis. These associations remained consistent across various subgroup and sensitivity analyses. CONCLUSION: Our findings suggest a significant association between periodontitis and increased risks of all-cause and cardiovascular mortality among hypertensive individuals. Notably, the severity of periodontitis appears to be a critical factor, with moderate to severe cases exerting a more pronounced impact on all-cause mortality. Additionally, cardiovascular disease mortality significantlly increases in individuals with varying degrees of periodontitis.

Ginsenoside Rb1 ameliorates apical periodontitis via suppressing macrophage pyroptosis.

OBJECTIVES: The objectives of current study were to investigate the role and related mechanism of Ginsenoside Rb1 (GRb1) on regulating apical periodontitis (AP) prognosis. MATERIALS AND METHODS: Clinical specimens were used to determine the involvement of calcium overload-induced macrophage pyroptosis in periapical tissues. Next, a calcium ion-chelating agent (BAPTA-AM) was applied to detect the suppression of intracellular calcium overload in macrophage pyroptosis. Then, network pharmacology, western blot (WB) analysis, and Fluo-4 calcium assay were conducted to explore the role of GRb1 on intracellular calcium overload. To gain a better understanding of GRb1 in calcium overload-induced macrophage pyroptosis linked AP, GRb1-treated AP models were established. RESULTS: We discovered clinically and experimentally that calcium overload-dependent macrophage pyroptosis is involved in AP pathogenesis, and reducing calcium overload greatly decreased macrophage pyroptosis in an AP cell model. Next, based on GRb1's inhibitory role in aberrant intracellular calcium accumulation, we discovered that GRb1 alleviates AP by suppressing calcium-dependent macrophage pyroptosis in both in vitro and in vivo models. CONCLUSIONS: GRb1 is an effective therapeutic strategy to rescue the periapical tissues from inflammation due to its anti-pyroptosis function. Thus, the present study supports further investigation of GRb1 as an adjuvant therapy for AP.

The comprehensive evaluation of oral and fecal microbiota in patients with acromegaly.

PURPOSE: The alteration of the microbiota in the mouth and gut could potentially play a role in the pathogenesis of various diseases, and conversely, these diseases may have an influence on the composition of the gut microbiota. Acromegaly disease can potentially affect physiological processes in the mouth and gut. The present study was designed to investigate the relationship between acromegaly and the oral and gut microbiota, as data on this topic are scarce. METHODS: This was a multicenter, cross-sectional study. Our study included individuals diagnosed with acromegaly (who were treated and followed up, and also as an another group of patients with newly diagnosed acromegaly) and healthy participants. All three groups were assessed and compared based on age, sex, serum IGF-1, body mass index BMI as well as their stool and oral microbiota We collected demographic information from the patients, collected fecal and oral samples, performed DNA isolation followed by 16 S rRNA sequencing, and then performed bioinformatic analysis. We also analyzed the oral and fecal samples with respect to medical and surgical treatment and disease control status, specific treatments received for acromegaly, presence of comorbidities, hypopituitarism status, presence of intestinal polyps. RESULTS: One hundred and three patients with acromegaly, 15 newly diagnosed patients with acromegaly without comorbidities and 34 healthy controls were included in the study. The Firmicutes/Bacteroidetes ratio was significantly lower in patients with acromegaly who received treatment (medical and/or surgical) than in healthy controls. In addition, a significant difference was found in the fecal and oral microbiota of patients with acromegaly with disease control compared to healthy controls. Furthermore, a significant difference was found in the fecal and oral microbiota of patients with acromegaly without disease control. Nevertheless, it was not possible to establish a clear relationship between disease control status, the presence of intestinal polyps, the presence of type 2 diabetes and the composition of the oral and gut microbiota in acromegalic patients who had received different forms of treatment. CONCLUSION: Patients with acromegaly show distinct gut microbiota profiles, and it is evident that factors beyond the GH/IGF-1 axis play a role in shaping the gut microbiota of individuals with acromegaly.

Exploration of the shared diagnostic genes and mechanisms between periodontitis and primary Sjögren's syndrome by integrated comprehensive bioinformatics analysis and machine learning.

BACKGROUND: Accumulating evidence has showed a bidirectional link between periodontitis (PD) and primary Sjögren's syndrome (pSS), but the mechanisms of their occurrence remain unclear. Hence, this study aimed to investigate the shared diagnostic genes and potential mechanisms between PD and pSS using bioinformatics methods. METHODS: Gene expression data for PD and pSS were acquired from the Gene Expression Omnibus (GEO) database. Differential expression genes (DEGs) analysis and weighted gene co-expression network analysis (WGCNA) were utilized to search common genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were conducted to explore biological functions. Three machine learning algorithms (least absolute shrinkage and selection operator (LASSO), support vector machine recursive feature elimination (SVM-RFE), and random forest (RF)) were used to further identify shared diagnostic genes, and these genes were assessed via receiver operating characteristic (ROC) curves in discovery and validation datasets. CIBERSORT was employed for immune cell infiltration analysis. Transcription factors (TFs)-genes and miRNAs-genes regulatory networks were conducted by NetworkAnalyst. Finally, relevant drug targets were predicted by DSigDB. RESULTS: Based on DEGs, 173 overlapping genes were obtained and primarily enriched in immune- and inflammation-related pathways. WGCNA revealed 34 common disease-related genes, which were enriched in similar biological pathways. Intersecting the DEGs with WGCNA results yielded 22 candidate genes. Moreover, three machine learning algorithms identified three shared genes (CSF2RB, CXCR4, and LYN) between PD and pSS, and these genes demonstrated good diagnostic performance (AUC>0.85) in both discovery and validation datasets. The immune cell infiltration analysis showed significant dysregulation in several immune cell populations. Regulatory network analysis highlighted that WRNIP1 and has-mir-155-5p might be pivotal co-regulators of the three shared gene expressions. Finally, the top 10 potential gene-targeted drugs were screened. CONCLUSION: CSF2RB, CXCR4, and LYN may serve as potential biomarkers for the concurrent diagnosis of PD and pSS. Additionally, we identified common molecular mechanisms, TFs, miRNAs, and candidate drugs between PD and pSS, which may provide novel insights and targets for future research on the pathogenesis, diagnosis, and therapy of both diseases.

Epidemiology of Odontogenic Sinusitis.

Odontogenic sinusitis (ODS) is more common than historically thought, representing 25% to 40% of all maxillary sinusitis. Due to a lack of widely accepted diagnostic criteria and a specific international diagnostic code, a true overall prevalence is unknown. ODS may be caused by either a multitude of infectious dental pathologies or complications after dental procedures. The most common dental etiologies causing ODS are apical periodontitis (endodontic) and oroantral communication or fistula after dental extraction. Less commonly, ODS can evolve after dental implant or maxillary sinus bone grafting surgeries, infection of odontogenic cysts, or advanced periodontitis.

Dysregulation of Porphyromonas gingivalis Agmatine Deiminase Expression in Alzheimer's Disease.

BACKGROUND: Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder, with a significant burden on global health. AD is characterized by a progressive cognitive decline and memory loss. Emerging research suggests a potential link between periodontitis, specifically the presence of oral bacteria such as Porphyromonas gingivalis (P. gingivalis), and AD progression. P. gingivalis produces an enzyme, Agmatine deiminase (AgD), which converts agmatine to N-carbamoyl putrescine (NCP), serving as a precursor to essential polyamines. Recent studies have confirmed the correlation between disruptions in polyamine metabolism and cognitive impairment. OBJECTIVE: This study aims to investigate the dysregulation of P. gingivalis Agmatine deiminase (PgAgD) in the context of AD. METHODS: Saliva samples were collected from a total of 54 individuals, including 27 AD patients and 27 healthy controls. The expression of the PgAgD gene was analyzed using quantitative Real-- Time PCR. RESULTS: The results showed a significant decrease in PgAgD gene expression in the saliva samples of AD patients compared to healthy controls. This downregulation was found in AD patients with advanced stages of periodontitis. Additionally, a correlation was observed between the decrease in PgAgD expression and the 30-item Mini-Mental State Examination (MMSE) score. CONCLUSION: These findings suggest that measuring PgAgD expression in saliva could be a noninvasive tool for monitoring AD progression and aid in the early diagnosis of patients with periodontitis. Further research is needed to validate our results and explore the underlying mechanisms linking periodontitis, PgAgD expression, and AD pathophysiology.