Pulpal and periodontal diseases increase triglyceride levels in diabetic rats.

OBJECTIVES: The aim of this study was to evaluate triglyceride and cholesterol levels in diabetic rats and their relationship with pulpal and periodontal diseases. METHODS: Eighty male rats (Rattus norvegicus albinus, Wistar) were divided into the following eight groups comprising ten animals each: normal rats (G1), rats with pulpal diseases (G2), rats with periodontal diseases (G3), rats with both pulpal and periodontal diseases (G4), diabetic rats (G5), diabetic rats with pulpal diseases (G6), diabetic rats with periodontal diseases (G7), and diabetic rats with both periodontal and pulpal diseases (G8). Diabetes was induced by injecting streptozotocin, periapical lesions were induced by exposing pulpal tissue to the oral environment, and periodontal diseases were induced by periodontal ligature. The animals were killed after 30 days, and lipid profile was enzymatically measured using Trinder's method. The total assessed values were statistically analyzed by analysis of variance and Tukey test (p < 0.05). RESULTS: The triglyceride levels of diabetic rats with periodontal disease and of diabetic rats with both periodontal and pulpal diseases were significantly higher than those of normal rats and nondiabetic group rats, respectively. The differences in the cholesterol levels among the groups were not significant. CONCLUSIONS: We found that the association of pulpal and periodontal diseases with diabetes increased triglyceride levels in rats. CLINICAL SIGNIFICANCE: Changes in lipid profile may be related to the presence of oral infections and diabetes.

Cytokines as diagnostic markers of pulpal inflammation.

AIM: To measure and compare the levels of the cytokines IL-2, IL-6, IL-8, IL-10, TNF-α and IFN-γ in pulpal blood from irreversible pulpitis, asymptomatic caries exposure and normal pulps. METHODOLOGY: Blood was obtained from pulp exposure sites using cotton pellets. Twenty-five samples were obtained from normal teeth, 40 from asymptomatic caries-exposed pulps and 43 from irreversible pulpitis teeth. Cytokine levels were determined by high-sensitivity ELISA. Data were statistically analysed using Kruskal-Wallis and Mann-Whitney U-tests. RESULTS: Significantly higher levels (P < 0.05) of IL-6, IL-8, IL-10, TNF-α and IFN-γ were detected in caries-exposed pulps and irreversible pulpitis as compared to normal teeth. IL-2 and IL-10 levels were significantly higher (P < 0.05) in caries-exposed pulps as compared to irreversible pulpitis, whilst IL-8 was significantly higher (P < 0.001) in irreversible pulpitis as compared to caries-exposed teeth. Most interestingly, IL-6/IL-10 and IL-8/IL-10 ratios were significantly higher (P < 0.001) in irreversible pulpitis compared with both caries-exposed and normal teeth. CONCLUSION: Levels of IL-8 and the ratios of IL-6/IL-10 and IL-8/IL-10 have the potential to be indicators of pulpal inflammation in caries exposure cases. Cytokine estimation in pulpal blood may help in the diagnosis of pulpal inflammation.

Dental caries related to plasma IgG and alpha1-acid glycoprotein.

This study was aimed at determining whether dental caries is associated with induction of the systemic immune system or cytokine response. For this purpose, 85 children from Den Pasar, Bali, Indonesia, aged 6-7 years, were examined clinically and blood plasma was obtained via finger puncture. The concentrations of the acute-phase protein alpha(1)-acid glycoprotein (AGP), total IgG and the specific IgG and IgM immunoglobulins against Streptococcus mutans were determined. Immunoelectrophoresis was used for the determination of the AGP concentration and ELISA for IgG and IgM detection. The mean dmft of the whole group was 8.8 +/- 2.9, the mean number of infected pulps was 3.9 +/- 2.2 and the mean number of abscesses was 0.5 +/- 0.8. The plasma concentration of AGP ranged between 0.13 and 1.6 mg/ml serum (mean 0.86 +/- 0.26 mg/ml). Stepwise regression analysis revealed that the concentration of IgG against S. mutans (log-transformed) was significantly correlated with dmft (adjusted r(2) = 0.083, standardized beta coefficient = 0.31, p = 0.008). When the concentration AGP was included in the model the correlation improved significantly (for IgG: adjusted r(2) = 0.157, standardised beta coefficient = 0.36, p = 0.002; for AGP: beta coefficient = -0.30, p = 0.009). The results suggest a relationship between caries and systemic parameters of inflammation. On the basis of this, severe caries might have consequences on the general health of the subject.

Quantitative analysis of immunoglobulins and inflammatory factors in human pulpal blood from exposed pulps.

The levels of immunoglobulins (IgG, IgA, and IgM) and inflammatory factors (elastase, prostaglandin E2, interleukin-1 alpha, interleukin-1 beta, interleukin-6, and tumor necrosis factor-alpha) in the blood of human dental pulp were quantified, using enzyme-linked immunosorbent assays. The pulpal blood samples were obtained with nylon fiber pellets from normal and inflamed dental pulp at pulp sites exposed on pulpectomy. Statistically significant differences between normal and inflamed pulp were found in the levels of IgG (p < 0.01), IgA (p < 0.05), IgM (p < 0.01), elastase (p < 0.05), and prostaglandin E2 (p < 0.01). These findings indicate that these factors play an important role in the pathogenesis of pulpal disease, and the sampling methods used in this study are useful for examination of pulpal inflammation.