RESUMEN
Alveolar ridge preservation maintains ridge dimensions and bone quality for implant placement. The aim of this randomized controlled clinical study is to compare the use of a human amnion-chorion membrane to a collagen membrane in an exposed-barrier ridge preservation technique. Furthermore, this study will determine if intentional membrane exposure compromises ridge dimensions and bone vitality. Forty-three patients requiring extraction and delayed implant placement were randomly assigned into either the experimental or control group. Twenty-one participants received human amnion-chorion membrane (test) during ridge preservation while 22 participants received the collagen membrane (control). In both groups, demineralized freeze-dried bone allografts were used to graft the socket and primary closure was not achieved. The patients underwent implant placement after an average healing period of 19.5 weeks, and 2.7 × 8-mm core bone specimens were obtained for histomorphometric analyses. The clinical ridge dimensions were measured after extraction and at the time of delayed implant placement. No significant difference was observed in the mean vital bone formation between the experimental (51.72 ± 8.46%) and control (49.96 ± 8.31%; P > .05) groups. The bone height and width did not differ, as determined by clinical measurements (P > .05). Using either a human amnion-chorion membrane or type 1 bovine collagen as the open barrier did not change healing, compromise ridge dimensions, or affect bone vitality between the 2 groups.
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Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Proceso Alveolar , Amnios , Animales , Trasplante Óseo , Bovinos , Corion , Colágeno , Colágeno Tipo I , Humanos , Membranas Artificiales , Extracción Dental , Alveolo Dental/cirugíaRESUMEN
AIM: To investigate the role of Epstein-Barr virus (EBV), cytomegalovirus (CMV), and anaerobic bacteria in the progression of periodontitis. METHODS: Eighty-one adults with generalized moderate to severe periodontitis were randomly assigned to: oral hygiene or scaling and root planning ± placebo or polyunsaturated fatty acids fish oil. Subgingival plaque samples collected from three healthy and three disease sites at weeks 0, 16, and 28 and from sites demonstrating disease progression were analysed for EBV, CMV, P. gingivalis (Pg), T. forsythia (Tf), and T. denticola (Td) DNA using quantitative polymerase chain reaction. RESULTS: Cytomegalovirus was detected in 0.3% (4/1454) sites. EBV was present in 12.2% of healthy sites (89/728) and 27.6% disease sites (201/726; p < .0001), but was in low copy number. Disease progression occurred in 28.4% of participants (23/81) and developed predominantly at sites identified as diseased (75/78; 96.2%). CMV and EBV were not associated with disease progression (p = .13) regardless of treatment. In contrast, disease sites were associated with higher levels of Pg, Td, Tf, and total bacteria, and sites that exhibited disease progression were associated with an abundance of Td and Tf (p < .04). CONCLUSION: Disease progression was associated with Gram-negative anaerobic bacteria; not EBV or CMV.
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Herpesviridae , Periodontitis , Adulto , Citomegalovirus , Progresión de la Enfermedad , Herpesvirus Humano 4 , HumanosRESUMEN
OBJECTIVE: To investigate biological markers of peri-implantitis (PIP) in crevicular fluid before and after surgical and antimicrobial therapy. MATERIAL AND METHODS: Forty-eight participants (24 healthy implants and 24 PIP) were clinically evaluated, and peri-implant crevicular fluid (PICF) samples were collected at baseline for both groups, and at 3-months after surgical and antimicrobial treatment (ie, n = 21 PIP completers). Samples were analyzed for interleukin-1ß (IL-1ß), matrix metalloproteinase-8 (MMP-8), and macrophage inflammatory protein-1α (MIP-1α) using immunoassay and the results compared between groups. RESULTS: Peri-implantitis sites at baseline demonstrated significantly higher mean periodontal probing depths, percentage bleeding on probing (P ≤ 0.001), and mean IL-1ß concentration in PICF compared to healthy implant sites (17.9 vs 1.7 pg/µL; P = 0.02). Three months after treatment, periodontal probing depths, bleeding on probing, suppuration (P < 0.05), and the mean concentration of MMP-8 decreased significantly compared with baseline (12.1 vs 6.7 ng/µL, P = 0.04). MIP-1α concentrations showed no differences between the groups. CONCLUSION: Elevated concentrations of IL-1ß in PICF were consistent with PIP. A decrease in MMP-8 concentration in PICF at three months after treatment is consistent with a healing biological response.
Asunto(s)
Implantes Dentales , Líquido del Surco Gingival/química , Periimplantitis/diagnóstico , Proteínas Adaptadoras Transductoras de Señales/análisis , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/química , Estudios de Casos y Controles , Femenino , Humanos , Interleucina-1beta/análisis , Masculino , Metaloproteinasa 8 de la Matriz/análisis , Persona de Mediana EdadRESUMEN
New strategies are critically needed to counter uncontrolled periodontal infection and inflammation in obesity-associated type 2 diabetes (T2D). However, mechanisms that explain the relationship between periodontitis (PD) and T2D remain poorly understood. Several lines of evidence indicate that destructive immune responses potentiate periodontitis (PD) in T2D. B cells are abundant in periodontal lesions, and our data show that B cells are required for PD in obese/insulin resistant but not lean/normoglycemic mice. In mice and in people, T2D-primed B cells supported Th17 cytokine profiles, but B cells had a modest effect on T-cell function in samples from normoglycemic individuals. Given the recently appreciated importance of Th17 cells in PD outside a T2D milieu, our data raise the possibility that B cells indirectly promote T2D-potentiated PD through support of Th17 cells, which in turn directly promote PD.Data herein thereby suggest unexpected mechanisms that explain the clinical observation that T2D potentiates PD.
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Diabetes Mellitus Tipo 2 , Periodontitis , Células Th17 , Animales , Diabetes Mellitus Tipo 2/complicaciones , Inflamación , Ratones , Obesidad/fisiopatología , Periodontitis/complicaciones , Periodontitis/patología , Células Th17/citologíaRESUMEN
Dietary supplementation has traditionally consisted of adding vitamins and/or minerals to correct or prevent a nutritional deficiency. When supplementing the diet with other inflammatory mediators, such as essential fatty acids, there is an adjunctive benefit to the standard therapies used in the control of chronic inflammatory diseases such as Crohn's disease or rheumatoid arthritis. This review focuses on the strategies utilized for therapeutic modulation of the inflammatory cascade through dietary supplementation with specific biomolecules. Examples of how these biomolecules affect local and systemic immune responses to chronic inflammation are examined. In particular, an overview of the literature identifying the potential to modify the host response to chronic periodontitis is provided.
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Periodontitis Crónica/tratamiento farmacológico , Dieta , Suplementos Dietéticos , Micronutrientes/uso terapéutico , Periodontitis Crónica/inmunología , Ácidos Grasos Omega-3/uso terapéutico , Humanos , Factores Inmunológicos/uso terapéutico , Inflamación/inmunología , Mediadores de Inflamación/uso terapéutico , Oligoelementos/uso terapéuticoRESUMEN
During the last two to three decades our understanding of the immunobiology of periodontal disease has increased exponentially, both with respect to the microbial agents triggering the disease process and the molecular mechanisms of the host engagement maintaining homeostasis or leading to collateral tissue damage. These foundational scientific findings have laid the groundwork for translating cell phenotype, receptor engagement, intracellular signaling pathways and effector functions into a 'picture' of the periodontium as the host responds to the 'danger signals' of the microbial ecology to maintain homeostasis or succumb to a disease process. These findings implicate the chronicity of the local response in attempting to manage the microbial challenge, creating a 'Double Indemnity' in some patients that does not 'insure' health for the periodontium. As importantly, in reflecting the title of this volume of Periodontology 2000, this review attempts to inform the community of how the science of periodontal immunology gestated, how continual probing of the biology of the disease has led to an evolution in our knowledge base and how more recent studies in the postgenomic era are revolutionizing our understanding of disease initiation, progression and resolution. Thus, there has been substantial progress in our understanding of the molecular mechanisms of host-bacteria interactions that result in the clinical presentation and outcomes of destructive periodontitis. The science has embarked from observations of variations in responses related to disease expression with a focus for utilization of the responses in diagnosis and therapeutic outcomes, to current investigations using cutting-edge fundamental biological processes to attempt to model the initiation and progression of soft- and hard-tissue destruction of the periodontium. As importantly, the next era in the immunobiology of periodontal disease will need to engage more sophisticated experimental designs for clinical studies to enable robust translation of basic biologic processes that are in action early in the transition from health to disease, those which stimulate microenvironmental changes that select for a more pathogenic microbial ecology and those that represent a rebalancing of the complex host responses and a resolution of inflammatory tissue destruction.
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Interacciones Huésped-Patógeno/inmunología , Enfermedades Periodontales/inmunología , Inmunidad Adaptativa/inmunología , Biopelículas , Citocinas/inmunología , Humanos , Inmunidad Innata/inmunología , Inmunidad Mucosa/inmunología , Interacciones Microbianas/inmunología , Microbiota/inmunología , Enfermedades Periodontales/microbiologíaRESUMEN
BACKGROUND: Salivary biomarkers of periodontitis were assessed longitudinally to determine response to therapy. METHODS: A 6-month case-controlled study of adults with chronic periodontitis was performed, with 33 participants receiving oral hygiene instructions (OHI) alone and 35 with scaling and root planing (SRP) combined with OHI. Saliva samples collected at week 0, 16 and 28 were analysed for interleukin (IL)-1ß, IL-8, macrophage inflammatory protein (MIP)-1α, matrix metalloproteinase-8 (MMP-8), osteoprotegerin (OPG), and tumour necrosis factor-α (TNF)-α. Clinical measures of periodontal disease were recorded at each visit. RESULTS: All parameters of periodontal health improved significantly in both groups by week 16 (p<0.0001) with the SRP group demonstrating greater benefit at week 16 and 28. Baseline OPG and TNF-α levels changed significantly at both follow-up visits (p<0.03), regardless of treatment group. IL-1ß and MMP-8 levels decreased significantly from baseline (p<0.04) in the SRP group only. OPG, MMP-8, and MIP-1α were significantly reduced in responders compared with non-responders (p=0.04, 0.01, 0.05, respectively). In receiver-operating characteristic analyses, MMP-8 produced the highest area under the curve (0.7; p=0.01). CONCLUSION: Salivary levels of IL-1ß, MMP-8, OPG, and MIP-1α reflected disease severity and response to therapy suggesting their potential utility for monitoring periodontal disease status.
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Periodontitis Crónica/metabolismo , Profilaxis Dental/métodos , Higiene Bucal/métodos , Saliva/metabolismo , Proteínas y Péptidos Salivales , Adulto , Anciano , Análisis de Varianza , Biomarcadores/metabolismo , Estudios de Casos y Controles , Quimiocina CCL3/metabolismo , Periodontitis Crónica/inmunología , Periodontitis Crónica/terapia , Femenino , Humanos , Interleucina-1beta/metabolismo , Interleucina-8/metabolismo , Estudios Longitudinales , Masculino , Metaloproteinasa 8 de la Matriz/metabolismo , Persona de Mediana Edad , Osteoprotegerina/metabolismo , Índice Periodontal , Curva ROC , Saliva/inmunología , Proteínas y Péptidos Salivales/metabolismo , Índice de Severidad de la Enfermedad , Método Simple Ciego , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
AIM: To test the hypothesis that rheumatoid arthritis (RA) influenced levels of salivary biomarkers of periodontal disease. METHODS: Medical assessments, periodontal examinations and pain ratings were obtained from 35 RA, 35 chronic periodontitis and 35 age- and gender-matched healthy controls in a cross-sectional, case-controlled study. Unstimulated whole saliva samples were analysed for interleukin-1ß (IL-1ß), matrix metalloproteinase-8 (MMP-8) and tumour necrosis factor-α (TNF-α) concentrations. RESULTS: The arthritis and healthy groups had significantly less oral disease than the periodontitis group (P<0.0001), with the arthritis group having significantly more sites bleeding on probing (BOP) than matched controls (P=0.012). Salivary levels of MMP-8 and IL-1ß were significantly elevated in the periodontal disease group (P<0.002), and IL-1ß was the only biomarker with significantly higher levels in the arthritis group compared with controls (P=0.002). Arthritis patients receiving anti-TNF-α antibody therapy had significantly lower IL-1ß and TNF-α levels compared with arthritis patients not on anti-TNF-α therapy (P=0.016, 0.024) and healthy controls (P<0.001, P=0.011), respectively. CONCLUSION: RA patients have higher levels of periodontal inflammation than healthy controls, i.e., an increased BOP. Systemic inflammation appears to influence levels of select salivary biomarkers of periodontal disease, and anti-TNF-α antibody-based disease-modifying therapy significantly lowers salivary IL-1ß and TNF-α levels in RA.
Asunto(s)
Artritis Reumatoide/metabolismo , Periodontitis Crónica/metabolismo , Saliva/química , Adulto , Pérdida de Hueso Alveolar/metabolismo , Anticuerpos Monoclonales/uso terapéutico , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Biomarcadores/análisis , Estudios de Casos y Controles , Estudios Transversales , Índice de Placa Dental , Femenino , Hemorragia Gingival/metabolismo , Humanos , Interleucina-1beta/análisis , Interleucina-1beta/efectos de los fármacos , Masculino , Metaloproteinasa 8 de la Matriz/análisis , Metaloproteinasa 8 de la Matriz/efectos de los fármacos , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/metabolismo , Índice Periodontal , Bolsa Periodontal/metabolismo , Radiografía de Mordida Lateral , Factor de Necrosis Tumoral alfa/análisis , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adulto JovenRESUMEN
OBJECTIVE: Dietary caloric restriction (CR) has been found to reduce systemic markers of inflammation and may attenuate the effects of chronic inflammatory conditions. The purpose of this study was to examine the effects of long-term CR on naturally occurring chronic inflammatory periodontal disease in a nonhuman primate model. METHODS: The effects of long-term CR on extent and severity of naturally occurring chronic periodontal disease, local inflammatory and immune responses, and periodontal microbiology, were evaluated in a cohort of 81 (35 female and 46 male; 13-40 y of age) rhesus monkeys (Macaca mulatta) with no previous exposure to routine oral hygiene. CR monkeys had been subjected to 30% CR for 13-17 y relative to control-fed (CON) animals starting at 3-5 y of age. RESULTS: Same sex CR and CON monkeys exhibited similar levels of plaque, calculus, and bleeding on probing. Among CON animals, males showed significantly greater periodontal breakdown, as reflected by higher mean clinical attachment level and periodontal probing depth scores, than females. CR males exhibited significantly less periodontal pocketing, lower IgG antibody response, and lower IL-8 and ss-glucuronidase levels compared to CON males, whereas CR females showed a lower IgG antibody response but comparable clinical parameters and inflammatory marker levels relative to CON females. Long-term CR had no demonstrable effect on the periodontal microbiota. CONCLUSION: Males demonstrated greater risk for naturally occurring periodontal disease than females. Long-term CR may differentially reduce the production of local inflammatory mediators and risk for inflammatory periodontal disease among males but not females.
Asunto(s)
Restricción Calórica , Placa Dental/epidemiología , Hemorragia Gingival/epidemiología , Pérdida de la Inserción Periodontal/epidemiología , Enfermedades Periodontales/epidemiología , Animales , Placa Dental/patología , Índice de Placa Dental , Modelos Animales de Enfermedad , Femenino , Hemorragia Gingival/patología , Macaca mulatta , Masculino , Pérdida de la Inserción Periodontal/patología , Enfermedades Periodontales/patología , Índice Periodontal , Bolsa Periodontal , Distribución Aleatoria , Factores Sexuales , Factores de TiempoRESUMEN
BACKGROUND: Detection of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in plaque from patients with periodontal disease provides support for the theory that these viruses play a role in the pathogenesis of periodontitis. This study sought to further define this relationship by determining the prevalence of these viruses at individual disease and healthy sites of patients with periodontal disease and to determine whether the presence and amount of viral DNA correlate with disease severity. METHODS: Subgingival plaque from three healthy and three disease sites of 65 patients who had chronic periodontitis were evaluated for the presence and amount of EBV, CMV, and Fusobacterium nucleatum DNA using real-time polymerase chain reaction. Patient serum was evaluated for antibodies against EBV and CMV using enzyme-linked immunosorbent assays. RESULTS: EBV DNA was detected in 18.5% of subgingival plaque samples (72/390) and in at least one of the six plaque samples in 44.6% (29/65) of the patients. CMV DNA was detected in one plaque sample (0.3%). EBV was significantly more prevalent in disease sites (28.2%; 55/195) than in healthy sites (8.7%; 17/195; P = 0.002). However, neither EBV prevalence nor its amount correlated with increased probing depth >5 mm or attachment loss >2 mm, whereas the amount of F. nucleatum DNA did. Sites positive for EBV had a median copy number of eight. Antibodies against EBV and CMV were detected in 85.7% and 78.6% of persons evaluated, respectively. CONCLUSION: EBV was infrequent and CMV was rarely present in individual subgingival sites affected by chronic periodontitis.
Asunto(s)
Periodontitis Crónica/virología , Citomegalovirus/inmunología , Placa Dental/virología , Encía/virología , Herpesvirus Humano 4/inmunología , Adulto , Anciano , Anticuerpos Antivirales/sangre , Estudios de Casos y Controles , Periodontitis Crónica/sangre , Periodontitis Crónica/inmunología , Periodontitis Crónica/microbiología , Citomegalovirus/genética , ADN Bacteriano/análisis , ADN Viral/análisis , Placa Dental/inmunología , Femenino , Fusobacterium nucleatum/genética , Fusobacterium nucleatum/aislamiento & purificación , Encía/microbiología , Herpesvirus Humano 4/genética , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Curva ROC , Valores de Referencia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Índice de Severidad de la EnfermedadRESUMEN
Soft and hard tissue engineering has expanded the frontiers of oral/maxillofacial augmentation. Soft tissue grafting enhancements include improving flap prevascularization and using stem cells and other cells to create not only the graft, but also the vascularization and soft tissue scaffolding for the graft. Hard tissue grafts have been enhanced by osteoinductive factors, such as bone morphogenic proteins, that have allowed the elimination of harvesting autogenous bone and thus decrease the need for other surgical sites. Advancements in bone graft scaffolds have developed via seeding with stem cells and improvement of the silica/calcium/phosphate composite to improve graft characteristics and healing.
Asunto(s)
Trasplante Óseo , Ingeniería de Tejidos , Humanos , Colgajos Quirúrgicos , Andamios del TejidoRESUMEN
BACKGROUND: Previous studies showed that host modulation therapy (HMT) or topical antimicrobial therapy (TAT) provided significant adjunctive benefits to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). The purpose of this study was to evaluate a combination therapy involving SRP, HMT, and TAT in the treatment of moderate to severe CP. METHODS: A 6-month, randomized, multicenter, placebo-controlled, examiner-masked study was undertaken to evaluate the clinical usefulness of a combination treatment of systemically delivered doxycycline hyclate (HMT; 20 mg, twice a day) plus locally delivered doxycycline hyclate gel (TAT; 10%, in pockets > or =5 mm) in combination with SRP versus SRP plus placebo. Clinical outcomes included mean changes in probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and gingival index (GI) at baseline and at 3 and 6 months. RESULTS: In 171 subjects, combination therapy provided significantly greater clinical benefits than control therapy for all clinical measures at 3 and 6 months. In moderate CP (PD of 4 to 6 mm), combination therapy provided significant benefits over control for PD (3 and 6 months: P <0.01), CAL (3 months: P <0.01; 6 months: P <0.03), BOP (3 months: P <0.02; 6 months: P <0.05), and GI (3 months: P <0.01; 6 months: P <0.03). In severe CP (PD > or =7 mm), combination therapy provided significant benefits over control for PD (3 and 6 months: P <0.01), CAL (3 months: P <0.01; 6 months: P <0.02), BOP (3 months: P <0.01; 6 months: P >0.05), and GI (3 months: P <0.01; 6 months: P <0.01). CONCLUSION: Combination therapy, including SRP, HMT, and TAT, provided significantly greater clinical benefits than SRP alone in the treatment of moderate to severe CP.
Asunto(s)
Antibacterianos/administración & dosificación , Raspado Dental , Doxiciclina/administración & dosificación , Periodontitis/terapia , Aplanamiento de la Raíz , Administración Oral , Administración Tópica , Adolescente , Adulto , Anciano , Enfermedad Crónica , Terapia Combinada , Femenino , Estudios de Seguimiento , Hemorragia Gingival/tratamiento farmacológico , Hemorragia Gingival/terapia , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/tratamiento farmacológico , Pérdida de la Inserción Periodontal/terapia , Índice Periodontal , Bolsa Periodontal/tratamiento farmacológico , Bolsa Periodontal/terapia , Periodontitis/tratamiento farmacológico , Placebos , Método Simple Ciego , Resultado del TratamientoRESUMEN
BACKGROUND: Previous studies showed that adjunctive subantimicrobial dose doxycycline (SDD; 20 mg, twice daily) provides significant clinical benefits to scaling and root planing (SRP). A modified-release SDD formulation containing 40 mg doxycycline (SDD-40) to be taken once daily has been developed. The aim of this study was to investigate the efficacy of SDD-40 when used as an adjunct to SRP for the treatment of periodontitis. METHODS: A 9-month, double-masked, randomized, placebo-controlled, multicenter study was conducted to test the efficacy of adjunctive SDD-40 in 266 subjects with periodontitis. Subjects were treated by SRP and randomized to receive SDD-40 or placebo for 9 months with evaluations at 3, 6, and 9 months. RESULTS: Adjunctive SDD-40 provided significantly greater clinical benefits than placebo at all time points. At month 9, at sites with baseline probing depths (PD) > or =6 mm, 72% to 76% of sites in the SDD-40 group demonstrated clinically significant PD reductions and clinical attachment level (CAL) gains > or =2 mm compared to 56% to 58% of sites in the placebo group (P <0.0001); 48% to 52% of sites in the SDD-40 group demonstrated PD reductions and CAL gains > or =3 mm compared to 32% of sites in the placebo group (P <0.0001). In moderate sites (baseline PD 4 to 6 mm), adjunctive SDD-40 provided significant clinical benefits compared to placebo for mean CAL (all time points: P <0.05), PD (3 months: P = 0.002; 6 and 9 months: P = 0.001), and bleeding on probing (BOP) (3 months: P <0.01; 6 months: P <0.02; 9 months: P <0.05). In deep sites (baseline PD > or =7 mm), SDD-40 provided significant benefits over control for mean CAL (3 months: P <0.05; 6 and 9 months: P <0.01), PD (all time points: P <0.001), and BOP (3 months: P <0.05; 6 months: not statistically significant; 9 months: P <0.05). Compliance with study medication was high (>92%) with no significant differences in adverse events between groups and no evidence of microbiologically significant changes or development of antibiotic resistance in the subgingival flora in either group. CONCLUSION: SDD-40 used as an adjunct to SRP resulted in significantly greater clinical benefits than SRP alone in the treatment of periodontitis.
Asunto(s)
Antibacterianos/administración & dosificación , Raspado Dental , Doxiciclina/administración & dosificación , Periodontitis/tratamiento farmacológico , Periodontitis/terapia , Administración Tópica , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Bacterias Anaerobias/aislamiento & purificación , Recuento de Colonia Microbiana , Terapia Combinada , Placa Dental/microbiología , Método Doble Ciego , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Índice Periodontal , Estadísticas no ParamétricasRESUMEN
BACKGROUND: Low-calorie diets are commonplace for reducing body weight. However, no information is available on the effects of a reduced-calorie diet on periodontal inflammation and disease. The purpose of this study was to evaluate the clinical effects of a long-term calorie-restriction (CR) diet on periodontitis in an animal model of periodontitis. METHODS: Periodontitis was induced in 55 young, healthy, adult rhesus monkeys (Macaca mulatta) by tying 2.0 silk ligatures at the gingival margins of maxillary premolar/molar teeth. Animals on a CR diet (30% CR; N = 23) were compared to ad libitum diet controls (N = 32). Clinical measures, including the plaque index (PI), probing depth (PD), clinical attachment level (CAL), modified gingival index (GI), and bleeding on probing (BOP) were recorded at baseline and 1, 2, and 3 months after ligature placement. RESULTS: Significant effects of CR were observed on the development of inflammation and the progression of periodontal destruction in this model. Compared to controls, CR resulted in a significant reduction in ligature-induced GI (P <0.0001), BOP (P <0.0015), PD (P <0.0016), and CAL (P <0.0038). Periodontal destruction, as measured by CAL, progressed significantly more slowly in the CR animals than in the controls (P <0.001). CONCLUSIONS: These clinical findings are consistent with available evidence that CR has anti-inflammatory effects. Moreover, these experimental findings are the first observations, to the best of our knowledge, that CR dampens the inflammatory response and reduces active periodontal breakdown associated with an acute microbial challenge.
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Restricción Calórica , Enfermedades Periodontales/fisiopatología , Periodontitis/fisiopatología , Animales , Diente Premolar/patología , Índice de Placa Dental , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Femenino , Hemorragia Gingival/fisiopatología , Gingivitis/fisiopatología , Macaca mulatta , Masculino , Diente Molar/patología , Pérdida de la Inserción Periodontal/fisiopatología , Índice Periodontal , Bolsa Periodontal/fisiopatología , Factores de TiempoRESUMEN
OBJECTIVES: The authors hypothesized that women with a history of gestational diabetes mellitus (GDM) during pregnancy would exhibit more severe periodontal disease than controls without a history of diabetes during pregnancy. METHODS: Data from NHANES Ill provided information for 4,244 women ages 20-59. One hundred and thirteen had a history of GDM (GDM+), while 4,131 had no history of diabetes before or during their pregnancies (GDM-). Women were further classified by the presence or absence of diabetes mellitus (DM+ or DM-) at the time of their NHANES Ill examination. Periodontal disease (PD) was defined as one or more teeth with one or more sites with probing depth > or = 4mm, loss of attachment > or = 2mm, and bleeding on probing. RESULTS: The PD prevalence among women who were GDM+DM- was 9.0% and 4.8% for those who were GDM-DM-. PD prevalence for women who were GDM+DM+ was 30.5% and 11.6% for GDM-DM+ subjects, respectively. A logistic regression model, controlling for age, calculus, smoking, and income estimated women who were GDM+DM+ were more likely to have periodontal disease than women who were GDM-DM- and women who were GDM-DM+. The GDM+DM- group also tended to be more likely to have PD than the GDM-DM- and GDM-DM+ groups. However, the odds ratios were not statistically significant. CONCLUSIONS: These results support the hypothesis that women with gestational diabetes mellitus (GDM) during pregnancy may be at greater risk for developing more severe periodontal disease than pregnant women without GDM.
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Diabetes Gestacional/epidemiología , Periodontitis/epidemiología , Adulto , Cálculos Dentales/complicaciones , Métodos Epidemiológicos , Femenino , Humanos , Persona de Mediana Edad , Encuestas Nutricionales , Embarazo , Prevalencia , Fumar/efectos adversos , Fumar/epidemiologíaRESUMEN
Dental implants are an important treatment option for patients interested in replacing lost or missing teeth. Although a robust body of literature has reviewed risk factors for tooth loss, the evidence for risk factors associated with dental implants is less well defined. This article focuses on key systemic risk factors relating to dental implant failure, as well as on perimucositis and peri-implantitis.
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Implantes Dentales/efectos adversos , Fracaso de la Restauración Dental/clasificación , Biopelículas , Enfermedad Crónica , Placa Dental/microbiología , Humanos , Periimplantitis/etiología , Factores de Riesgo , Estomatitis/etiologíaRESUMEN
OBJECTIVE: The aim was to evaluate three primer-probe sets and real-time polymerase chain reaction (PCR) for the detection of human cytomegalovirus (HCMV) in dental plaque from individual periodontal sites. STUDY DESIGN: Fifty subgingival plaque specimens from 13 healthy subjects (on average at least 2 healthy and 2 periodontal disease sites per subject) and 50 saliva specimens from 24 subjects, including 16 controls, were assessed using 3 primer-probe sets (polymerase [POL], glycoprotein B [gB], and US14) and real-time PCR. Kappa statistics were performed to measure agreement between the primer-probe sets. RESULTS: There was excellent agreement between the gB and POL primers in the detection of HCMV (kappa statistic = 0.85 [95% confidence interval 0.71-0.99]), yielding a prevalence of 4% (2 out of 50) at individual periodontal disease sites and a similar rate of 8.8% (3 out of 34) in saliva. CONCLUSION: Human cytomegalovirus was infrequently detected in dental plaque. Of 3 primer-probe sets evaluated, those targeting the POL and gB genes were more accurate in the detection of HCMV than that targeting US14.