Effects of a full-mouth disinfection protocol on the treatment of type-2 diabetic and non-diabetic subjects with mild-to-moderate periodontitis: one-year clinical outcomes.

OBJECTIVES: This study compared the clinical effects of a full-mouth disinfection (FMD) protocol for the treatment of mild-to-moderate periodontitis in type 2 diabetic and non-diabetic subjects for up to 1 year. Secondary aim was to evaluate the effects of this therapy on the salivary levels of periodontal pathogens between diabetics and non-diabetics. MATERIAL AND METHODS: Twenty-six type 2 diabetic subjects and 28 non-diabetic subjects with mild-to-moderate periodontitis received full-mouth scaling and root planing within 24 h, application of chlorhexidine digluconate (CHX) gel in pockets and tongue plus CHX rinses for 14 days. Clinical monitoring was performed at baseline, 3, 6, and 12 months post-therapy. Salivary levels of red complex bacterial species were evaluated at baseline, 6, and 12 months post-therapy by qPCR. RESULTS: Intention-to-treat analyses were performed for seven diabetics and three non-diabetics that did not return for the 12-month evaluation. Most clinical parameters improved significantly at 3, 6, and 12 months post-therapies for both groups (p < 0.05). Overall, there were no significant differences in clinical parameters between groups after therapy (p > 0.05). At 1 year, 39.3% and 50.0% of the non-diabetic and diabetic subjects, respectively, achieved the desired clinical endpoint for treatment (≤ 4 sites with probing depth ≥ 5 mm) (primary outcome variable) (p > 0.05). FMD did not promote changes in the salivary levels of pathogens in either of the groups (p > 0.05). Levels of T. forsythia were lower in diabetic than in non-diabetic subjects at 6 months post-therapy (p < 0.05). CONCLUSIONS: Type 2 diabetic subjects and systemically healthy subjects with mild-to-moderate periodontitis responded similarly to the proposed FMD protocol for up to 1 year. CLINICAL RELEVANCE: There is a general thought that diabetics do not answer as well as non-diabetics to periodontal treatments. However, this study showed that diabetics and non-diabetics respond equally to the FMD protocol. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02643771.

Th2 cells and the ifn-γ R1 subunit in early and advanced experimental periodontitis in rats; an immunohistochemical study

Aim: To evaluate the involvement of Th2 cells in different periods of the active phase of experimental periodontal disease and expression of the R1 subunit of the receptor for IFN-γ during the early and advanced progression of the disease. Methods: Experimental periodontitis was induced in 30 male Wistar rats by placing cotton ligatures around the mandibular first molars. The rats were then randomly assigned into two groups: G1=15 and G2=15, in group G1, ligatures were maintained for 2 days, a period that corresponds to the initial stage of periodontal disease in rats, in G2 ligatures were left for 15 days, a period that corresponds to the advanced stage of periodontal disease. The contra-lateral teeth served as controls (unligated). An immunohistochemical investigation of the gingival tissue was performed to detect the presence of the Th2 specific transcription factor (GATA3). Results Light microscopy analysis revealed a decreased expression of GATA-3-positive cells when bone loss progressed. IFN-γ R1 was detected at an early stage during the active phase of disease, but the expression of positive cells remained unaltered during the remaining period of the study.

Resposta celular Th1/Th2 na doença periodontal experimental, em ratos: um estudo imuo-histoquímico / Cellular reply Th1/Th2 in the experimental periodontal illness, rats: a imuno-histoquímico study

A resposta do hospedeiro tem um importante papel na patogênese periodontal. Mediadores como as citocinas liberadas por células inflamatórias durante a resposta imune, frente a um ataque bacteriano, desempenham papéis antagônicos que podem culminar com a proteção ou não do tecido agredido, o que fundamenta o paradigma da resposta Th1/Th2 na doença periodontal. Na tentativa de esclarecer a participação das células Th2, em diferentes tempos, na fase ativa da doença periodontal, bem como observar se o microambiente encontrava-se preparado para uma resposta Th1, induziu-se doença periodontal experimental em 30 ratos Wistar machos, através da colocação de ligaduras de algodão ao redor dos primeiros molares mandibulares. Os animais foram divididos, aleatoriamente, em dois grupos: Grupo 1(G1=15) e Grupo 2 (G2=15). em G1 as ligaduras foram mantidas por 2 dias, que configurou o estágio inicial da doença periodontal e no G2, as ligaduras foram mantidas por 15 dias, que foi considerado o estágio avançado da doença periodontal. Os dentes...