Investigating the role of salivary Interleukin-40 levels in diagnosing periodontal diseases.

BACKGROUND: The present study aimed to analyze IL-40, IL-1ß, and MMP-8 levels in periodontitis as well as gingivitis and periodontal health, and to explore potential correlations between these biomarkers and standard clinical parameters. MATERIALS AND METHODS: We collected saliva samples from 120 systemically healthy, non-smoking individuals aged between 18 and 63 years. These individuals were divided into three groups: healthy controls [S], gingivitis [G], and stage III grade B periodontitis [P]. IL-40, IL-1ß, and MMP-8 levels in saliva samples were analyzed by ELISA. RESULTS: We observed significantly elevated salivary IL-40 levels in the G group compared to the S group (p = 0.003). We found significantly higher salivary IL-1ß levels in the P group compared to both the S and G groups (p = 0.000). Salivary MMP-8 levels were significantly higher in the P group than in the S group (p = 0.016). CONCLUSION: Our study suggests that IL-40 and IL-1ß may serve as effective salivary biomarkers for diagnosing gingivitis, while MMP-8 and IL-1ß may be effective for distinguishing periodontitis. Based on our study's findings, it can be stated that IL-40 may serve as a new and effective biomarker for distinguishing individuals with gingivitis from healthy ones.

Immunologic burden links periodontitis to acute coronary syndrome: levels of CD4 + and CD8 + T cells in gingival granulation tissue.

OBJECTIVE: To investigate the proportional variation of macrophage and T-lymphocytes subpopulations in acute coronary syndrome (ACS) patients, its association with periodontitis (P), and to compare with control individuals. SUBJECTS AND METHODS: Three groups of subjects participated: one group consisted of 17 ACS patients with P (ACS + P), another group consisted of 22 no ACS + P patients, and a control group consisted of 23 participants with gingivitis (no ACS + G). Macrophage, CD4 + , and CD8 + T-lymphocytes and CD4 + /CD8 + ratio values in gingival tissue were determined histometrically. RESULTS: Significant differences were found among three groups regarding the mean number of macrophage (no ACS + P > ACS + P > no ACS + G; p < 0.05) and CD8 + T-lymphocytes (no ACS + P > ACS + P > no ACS + G; p < 0.05). Significant variations were observed between the groups both CD4 + T-lymphocytes densities (ACS + P > no ACS + P and ACS + P > no ACS + G; p < 0.05) and CD4 + / CD8 + ratio (no ACS + P < no ACS + G and ACS + P < no ACS + G; p < 0.05). CONCLUSIONS: The increased number of CD8 + T-lymphocytes in both group ACS + P and group no ACS + P resulted in a reduction of the CD4 + /CD8 + ratio in gingival tissue when compared with no ACS + G group. CLINICAL RELEVANCE: The decrease of CD4 + /CD8 + ratio in gingival tissue reflects periodontitis and may be associated with severe adverse outcomes in people with ACS.

Interleukin-38: A crucial player in periodontitis.

BACKGROUND: The objective of this study was to compare the levels of gingival crevicular fluid (GCF), salivary, and serum matrix metalloproteinase-9, interleukin (IL)-17, IL-36γ, and IL-38 in individuals with healthy periodontium, gingivitis, and periodontitis and to evaluate their correlations with clinical periodontal parameters. MATERIALS AND METHODS: Ninety systemically healthy and nonsmoking volunteers divided into a healthy (H) group (n = 30), a gingivitis (G) group (n = 30), and a periodontitis (P) group (n = 30) were included in this study. Clinical periodontal parameters of volunteers were recorded, and GCF, unstimulated saliva, and serum samples were collected. Data analysis was done with enzyme-linked immunosorbent assays. The Kruskal-Wallis test and Bonferroni correction were used for multiple comparisons and post hoc statistical analyses. RESULTS: The group H had significantly lower clinical parameters than the group P (p < 0.001). GCF and salivary IL-36γ and IL-38 levels were significantly higher in the group P than in the H and G groups (p < 0.05). Positive correlations between biochemical findings and clinical periodontal parameters were observed. CONCLUSIONS: IL-36γ and IL-38 levels in GCF, saliva, and serum correlate with clinical periodontal parameters and may play a role in determining the activity of periodontitis.

The effects of non-surgical periodontal therapy on neutrophil elastase and elastase alpha-1 proteinase inhibitor levels in GCF in periodontitis patients with or without acute coronary syndrome.

OBJECTIVE: Periodontitis may contribute to vascular damage, resulting in the destabilization of atherosclerotic plaque leading to acute coronary syndrome (ACS). In this study, we explored the effect of non-surgical periodontal treatment (NSPT) on cardiovascular blood biomarkers and gingival crevicular fluid (GCF) neutrophil elastase (NE) and α1-proteinase inhibitor (α-1PI) levels in periodontitis (P) participants with and without ACS. MATERIALS AND METHODS: Medical and dental examinations were performed to diagnose ACS and periodontitis, respectively. Seventeen patients with diagnosis of ACS and periodontitis were included in this study, as a test group (group ACS). Twenty-six age and sex-matched control patients with periodontitis (group P) were otherwise systemically healthy. Both groups received NSPT. Plasma levels of cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), C-reactive protein (CRP), GCF NE activity, GCF α1-PI levels, and GCF NE/α1-PI rates were measured at baseline, at1st and 3rd months after NSPT. RESULTS: GCF NE activity/time (µU/30s) decreased significantly at 3rd month compared to baseline values in the Group P after NSPT. First and 3rd months after NSPT, in the Group P GCF α1-PI activity/time (pg/30s) was significantly higher than the Group ACS. Moreover GCF NE/α1-PI rates decreased significantly compared to baseline values at 1st and 3rd months after NSPT in the group P. CONCLUSION: NSPT yields decrease in NE/α1-PI rates. NE and its possible interactions with α1-PI may play a crucial role in both periodontitis and ACS. GCF α1PI activity/time (U/30s) can be a potential biomarker in management of periodontitis associated with ACS. CLINICAL RELEVANCE: The GCF α1-PI reduction may alter the immune-inflammatory response in patients with periodontitis and thus increase the risk of ACS. TRIAL REGISTRATION: Thai Clinical Trials.gov (NCT04785235).

Systemic treatment with alpha-tocopherol and/or sodium selenite decreases the progression of experimental periodontitis.

OBJECTIVE: To investigate the effects of sodium selenite (Se) and/or α-tocopherol (αT) applications on the alveolar bone loss (ABL), the number of gingival collagen fibers, inducible nitric oxide synthase (iNOS)+ and CD95+ cell numbers, and serum cytokine concentrations in experimental periodontitis in rats. MATERIALS AND METHODS: Forty Sprague Dawley rats were divided into four groups of ten as follows: group A: Se group, group B: αT group, group C: Se and αT combined group, and group D: control group (intraperitoneal (IP) saline injection applied). Using the image analysis method in the connective tissue under the connective epithelium, the numbers of iNOS, CD95 positive cells, and collagen fibers were counted. ELISA kits were used to test the concentrations of serum interleukin (IL)-1ß, IL-6, and IL-4. RESULTS: The combination of Se and αT (group C) suppressed ABL compared with the control group (group D) (P < 0.05). In group A (Se), the number of iNOS+ cells was smaller than in group D (P < 0.05). CONCLUSION: Se has been concluded to inhibit inflammation of the gum due to iNOS. Se and αT can have a remarkable important role in preventing alveolar bone loss, and particularly in combination. CLINICAL RELEVANCE: Se and/or αT application may be useful in preventing the destruction of periodontal tissue and treatment of periodontal disease.

Methodological evaluation of gingival crevicular fluid volume and neutrophil elastase levels: sequential sampling, length of sampling time and two different sampling methods.

Objectives: The mechanisms underlying the formation and composition of gingival crevicular fluid (GCF) and its flow into and from periodontal pockets are not understood very well. The aim of this study was to evaluate the length of sampling time and sequential sampling of GCF neutrophil elastase (NE) enzyme levels by using intracrevicular and orifice methods.Material and methods: Twenty adults (mean age of 41.8 years, ranged 31-60 years, 18 males and 2 females) with chronic periodontitis were enrolled and all completed the 3-d study. GCF was collected by both intracrevicular and intrasulcular methods, 720 samples of GCF were collected. In first, second and third day, the length of sampling time in seconds (s) and order were '5- 10-30-s'; '10- 30- 5-s' and '30- 5- 10-s,' respectively. GCF elastase levels were determined by hydrolysis of neutrophil specific substrate N-methoxysuccinyl-Ala-Ala-Pro-Val-p-nitroanilide.Results: NE activity (µU) and NE activity/volume (µU/µl) were significantly different for order of sampling (p < .05), but not for the length of sampling time (p>.05).Conclusions: Within the limits of this study, the choice of sampling technique in GCF-profile studies seems to be a critical decision as it has the potential to affect the GCF volume and NE activity.

Can We Determine an Appropriate Timing to Avoid Thermal Pulp Hazard During Gingivectomy Procedure? An In Vitro Study with Diode Laser.

Objective: Diode laser (DL) is a frequently preferred tool for soft tissue incision and ablation in oral surgery. The aim of this study was to find the most effective irradiation time protocol to avoid potential harmful temperature rise in pulp during DL-assisted gingivectomy. Materials and methods: Ninety human freshly extracted teeth (30 anterior, 30 premolar, and 30 molar) were irradiated using a 940 nm DL with power output of 1 and 2 W and exposure time of 10, 20, 30, 40, 50, and 60 sec per specimen. Intrapulpal temperature was evaluated with thermocouple. Additionally, the effect of dark deposits on root surface for intrapulpal temperature rise was investigated. Temperature differences with every 10 sec were evaluated for three different teeth types, and statistical analyses were performed. Results: Anterior and premolar teeth exceeded the threshold values earlier than molar teeth for both 1 and 2 W. Despite the significant differences among the types of teeth, at 10 sec, temperature rise recorded for all types of teeth was below the critical value of 5.6°C, which cause pulp damage. Dark deposits on teeth surface boosted thermal effect of DLs (p < 0.01). Conclusions: Gingivectomy with DLs at 1 W on anterior, premolar, and molar teeth for 20, 40, and 60 sec, respectively, generates acceptable temperature rise; however, it should be <10, 20, and 40 sec at 2 W, respectively. Especially in the anterior teeth, DLs should be performed with caution to avoid pulp damage.

Could We Set a Convenient Irradiation Time to Reduce the Possibility of Thermal Pulp Damage During Diode Laser as an Adjunct to Periodontal Treatment? An In Vitro Analysis.

Background: To identify the most effective time procedure for irradiation to prevent possible harmful pulp temperature rises during diode laser (DL) as an adjunct to scaling and root planning (SRP) treatment. Methods: One hundred fifty freshly extracted human teeth (30 molars, 30 premolars, 30 canines, 30 upper incisors, and 30 lower incisors) were irradiated using a 940-nm DL with a power output at 0.8 W and exposure time of 10, 20, 30, 40, 50, 60 sec per specimen. The thermocouple was used to measure intrapulpal temperature. As an addition, the impact of dark deposits on the root surface was investigated for the intrapulpal temperature rise. The threshold value of 5.6°C is predetermined to damage the pulp. Temperature variations were measured at every 10 sec for five different types of teeth, and statistical analysis was performed. Results: Despite large differences between tooth types, the observed temperature increases for all tooth types were below the threshold of 5.6°C in 20 sec. Dark deposits on the tooth surface reduced the reliable working time of DLs (p < 0.01). Conclusions: DLs as an adjunct to SRP treatment at 0.8 W in molars, premolars, canine, upper incisors, and lower incisors for 42, 37, 38, 27, and 21 sec, respectively, generate acceptable temperature rises for pulp but should be changed as 39, 21, 26, 23, and 13 sec, respectively, in the presence of dark deposits.

Immune responses in women with periodontitis and preterm low birth weight: Levels of CD4+ and CD8+ T cells in gingival granulation tissue.

OBJECTIVE: Preterm Low-Birth-Weight (PLBW) is frequently associated with periodontal disease. However, the mechanism is still unknown. The present study was performed to examine the possible link between periodontal infections and PLBW in post-partum women utilizing clinical parameters and CD4+ and CD8 + T lymphocytes ratio in gingival granulation tissue. MATERIALS: The tissues used in this study consisted of 35 gingival granulation tissue biopsies from 35 mothers of healthy infants (HTBW), 35 biopsies of gingival granulation tissue from 35 mothers of PLBW within one month postpartum and gingival tissue biopsies from 7 control individual with no periodontal disease (HC). CD4+ and CD8 + T lymphocyte ratios in a unit area of the gingival granulation tissue were determined by hystometrically. Statistical analysis was performed by using Kruskal-Wallis and Mann-Whitney U tests. RESULTS: CD8 + T lymphocytes were more prevalent in the PLBW group than in the HTBW and HC group (P < 0.05). The CD4+/CD8+ ratio in the PLBW group was lower than those of the other groups (p < 0.05). There were no statistically significant differences in CD4 + T lymphocytes counts between all groups (P > 0.05). CONCLUSION: Within the limits of this study it can be concluded that CD8 + T lymphocytes in gingival tissue may play important roles in the pathogenesis of periodontitis and PLBW.

Interleukin-1 receptor antagonist levels in gingival crevicular fluid and serum in nonsmoking women with preterm low birth weight and intrauterine growth retardation.

OBJECTIVE: The aim of this study was to evaluate interleukin (IL)-1 ß and IL-1 receptor antagonist (IL-1ra) levels in gingival crevicular fluid (GCF) and serum (S) in nonsmoking women with normal birth (NB), preterm low birth weight (PLBW), and intra-uterine growth retardation (IUGR). MATERIALS AND METHODS: In this unmatched case-control study design, 64 women with NB, 45 women with PLBW, and 47 women with IUGR were recruited within 24 h delivery. Clinical periodontal parameters were recorded. IL-1 ß and IL-1ra levels in GCF (pg/30 s) and serum (pg/ml) of were evaluated using commercial enzyme immunoassay and ELISA kits. RESULTS: Greater pocket depth and clinical attachment loss were observed in PLBW and IUGR women than in NB women (P < 0.05). The total amounts of IL-1ra and IL-ß of GCF were higher levels in NB women than PLBW and IUGR women (P < 0.05). The lowest total amount of IL-1ra of GCF was found in IUGR women (P < 0.05). The concentrations of IL-1ra in serum samples were not statistically significant for any of the study groups (P > 0.05). CONCLUSION: It can be suggested that worse periodontal conditions and the low levels of IL-1ra in GCF may be an important factor in adverse pregnancy outcomes.

Interleukin-1 receptor antagonist gene polymorphism, adverse pregnancy outcome and periodontitis in Turkish women.

OBJECTIVE: The aim of this study was to determine associations between interleukin (IL)-1A (+4845), IL-1B (+3954), and IL-1 receptor antagonist (RN) variable number tandem repeat polymorphisms and adverse pregnancy outcomes and periodontitis in a Turkish women. DESIGN: A total of 156 patients, including 64 women with normal birth outcome (NB) and 92 women with preterm/low birth weight outcome (PLBW) were included in this case-control study. Within 24h after labor, maternal demographic characteristics and clinical periodontal parameters were recorded. The distribution and genotype frequencies of IL-1 were analyzed with polymerase chain reaction-restriction fragment length polymorphism assay. Statistical analyses were carried out for clinical periodontal parameters, genotype frequencies, and to identify explanatory variables for PLBW. RESULTS: PLBW was associated with maternal age (p<0.05), irregular prenatal care (p<0.001), previous PLBW (p<0.05), and antibiotic use during pregnancy (p<0.05). Measurements of probing depth and clinical attachment level (CAL) were significantly higher in the PLBW group than in the NB group (p<0.001). PLBW was associated with IL-1RN allele 2 (p<0.001). Moreover, stepwise logistic regression analysis showed that CAL (OR 1.39, 95% CI: 1.04-1.85) and IL-1RN polymorphism (OR 7.92, 95% CI: 2.76-22.79), previous PLBW (OR 5.01, 95% CI: 1.08-23.17), age (OR 1.22, 95% CI: 1.04-1.44) were predictors found to increase the risk of PLBW (p<0.05). There was a negative association between PLBW and regular prenatal care, total number of births, use an antibiotic during pregnancy period (p<0.05). CONCLUSION: Our study showed that, IL-1RN allele 2, periodontal disease characterized with clinical attachment loss, previous PLBW and age could be an important risk factors for PLBW.