Prevalence of HIV-related oral manifestations and their association with HAART and CD4+ T cell count: a review.

HIV infection is one of the major health problem of the last decades. This disease causes a chronic infection that can lead to acquired immunodeficiency syndrome (AIDS). According to the Global AIDS update, released in 2016 by HIV department of World Health Organization (WHO) and by the Joint United Nations Program on HIV/AIDS (UNAIDS), at the end of 2015, 36.7 million people were infected by HIV: 34.9 million of these were adults and 1.8 million were children under 15 years of age. The same report shows that during 2015, 2.1 million of new infection cases have occurred all over the world and about 1.1 million people have died for HIV. The aim of this short review is to up-date of the main HIV-related oral manifestations and their correlation with HAART (Highly Active Antiretroviral Therapy) and CD4+ T-cell count. Despite that more than 20 years have elapsed, this classification still remains valid: even today, group 1 lesions are found in the majority of HIV-positive patients with oral manifestations. Group 1 includes the following conditions: oral candidiasis (pseudomembranous candidiasis, erythematous candidiasis, angle cheilitis), oral hairy leukoplakia, periodontal diseases (necrotizing gingivitis, necrotizing periodontitis, linear gingival erythema), Kaposi’s sarcoma, and non-Hodgkin’s lymphoma. Melanotic hyperpigmentation, HSV infection and HPV infection, which are included in group 2, are also common. Oral candidiasis, oral hairy leukoplakia, Kaposi’s sarcoma and HSV infection are the lesions that have seen the major drop in their incidence after the HAART introduction. The increase in CD4+ T-cell count is not significantly correlated to the decrease of every type of oral lesions, but it is statistically significant only in relation to oral candidiasis (p-value less than 0.001). Oral lesions are an important sign of immunodepression and with the introduction of HAART their incidence has strongly decreased, particularly in urban areas. Nevertheless, developing countries still have a high prevalence of these manifestations because of the persistence of many risk factors, like the difficulty to access treatment, poor oral hygiene, low socioeconomic status and late diagnosis.

Pre-treatment with berberine enhances effect of 5-fluorouracil and cisplatin in HEP2 laryngeal cancer cell line.

Larynx squamous cell carcinoma represents one of the most common head and neck cancers in the world. Herbal drugs are popularly emerging as complementary and alternative therapies in cancer because of their cost effectiveness and minimal side effects. The present study was undertaken to explore the anti-tumor potential of berberine, an isoquinolone present in the extract of Tinospora cordifolia in HEP2 human laryngeal cancer cell line. Besides, it was aimed to investigate whether berberine could enhance the anti-cancer effect of 5-fluorouracil and cisplatin in HEP2. Our data seem to support a role for berberine in decreasing the expression of genes usually seen overexpressed in larynx squamous cell carcinoma and involved in pathways such as those of cell cycle and regulation, differentiation, and epithelial-mesenchymal transition. Moreover, a down regulation of these genes caused by cisplatin or 5-fluorouracil, treatment of election in laryngeal cancers was enhanced by a 4h pre-treatment with berberine.

Peri-implant test is a proposal of a new procedure to prevent peri-implantitis and forensic claims.

Implant dentistry has become one of the most successful techniques for oral rehabilitation over the last 20 years. The success rate of implant oral rehabilitation is above 80% while peri-implant disease (PID) is the most important complication of implant dentistry. The main cause of PID is considered bacterial leakage at the implant-abutment connection of a two-piece implant system. Prevention and control of bacterial leakage at the implant-abutment connection is mandatory for reducing inflammation process around implants neck and achieving bone stability. Since bacteria leakage at implant-abutment connection level is the main cause of PID, a microbiological test should be important to identify bacteria that cause PID. According with the conclusion of workshop of the European Federation on Periodontology, a test that detects the most frequent bacterial species involved in the onset of PID (Actinobacillus actinomycetecomitans, Porphyromonas gengivalis, Tannnerella forsythia, Treponema denticola) should be used in clinical practice. In fact, PID progression depends on the typology, quantity and composition of bacterial flora in peri-implant pockets, so controlling PID onset and progression, is a keystone for preventing implant failures and consequently forensic conflicts. The effort to prevent PID and consequently assurance or forensic conflicts have become one of the main focal points of all dental professionals. Behind these efforts lie, above all, ethical but also economic reasons, as well as a desire to prevent PID, improving implant care quality and increasing the legal security of health care professionals themselves. Since the legal decisions in our society influence how we practice dentistry, especially in the fast-evolving field of implant dentistry, using diagnostic tools that will allow dentists to demonstrate that they have acted correctly in accordance with the knowledge of modern medicine, it is of great importance to defend themselves in the case of legal-legal disputes.

The role of zinc plus octenidine in the regulation of gene expression: an in vitro study.

Zinc was known in ancient times, and is diffused in the environment. The potential benefits offered by zinc supplementary therapy have been demonstrated in numerous clinical trials using oral or topical zinc products. The benefit of zinc can be in principle increased through association with other actives. The aim of this study is to evaluate the effect on primary human gingival fibroblast cell of a new formulation containing zinc and octenidine cations. Human gingival fibroblast cells were obtained from three healthy patients (14-year-old man, 15-year-old woman and 20-year-old man) during extraction of teeth. The gene expression of 14 genes (ELANE, FN1, FBN, ITGA1, HAS1, ELN, DSP, ITGB1, HYAL1,TGFB1, TGFB2, TGFB3, TGFBR1 and TGFBR2) was investigated in HGF cell culture treated with 80µm of Octenidine, 1000µm of Zinc, 80µm Octenidine + Zinc solution and the medium alone at 30 min. Prestoblue™ data showed that as the active concentration increases (Octenidine, Zinc and Octenidine + Zinc) the percentage of cell vitality compared to that of untreated cells decrease. In this study, no statistically significant gene expression was observed between cells, treated with difference substances, and control cells. Our results points out that zinc plus octenidine shows a positive potential in periodontal disease treatment.

Zinc plus octenidine: a new formulation for treating periodontal pathogens. A single blind study.

Periodontal treatment has the aim to reduce oral infection, and prevent the progression of the disease. The potential benefits of new chemical devices for periodontal therapy, include improved patient compliance, an easier access to periodontal pocket and a lower dosage of antimicrobial agent. The objective of this study was to explore the efficacy of a chemical device containing zinc and octenidine in the treatment of chronic periodontitis in adult patients. Ten patients with a diagnosis of chronic periodontitis (20 localized chronic periodontitis sites) in the age group of 35 to 55 were selected. None of these patients received any surgical or non-surgical periodontal therapy and demonstrated radiographic evidence of moderate bone loss. The chemical device zinc plus octenedine was used by each patient after daily oral hygiene. Microbial analysis were analyzed at baseline and on the 15th day. After the treatment, a remarkable decrease in bacteria amount, both for some species and for the total count was observed in the study group. Specifically T. Forsythia and T. Denticola were eradicated whereas Total Bacteria Loading and Fusobacterium Nucleatum showed a reduction of 38% and 55%, respectively. Our study demonstrated the efficacy of the new chemical device containing zinc and octenidine in a sustained release drug delivery system in the management of moderate to severe chronic periodontitis.

Human Papilloma Virus associated with oral cancer and preventive strategies: the role of vaccines.

The aim of this paper is to describe the efficacy of Human Papilloma Virus (HPV) vaccines for preventing oral cancer. A systematic review of the literature was conducted to describe the state of the art about HPV vaccines for preventing oral cancer. The aspects of prevention and control of infection by administering vaccines and the diffusion of sexual education campaigns are discussed also. In recent years there has been a growing interest in HPV in dentistry, suggesting a role of such a family of viruses in the development of oral cancers as well as of the uterine cervix. Even if the mass media have increasingly faced the problem, causing frequent alarming among patients, the dentist therefore needs a complete and up-to-date knowledge of this infectious condition that is one of the most common causes of sexually transmitted mucous membrane infections (eg genital, anal and oral). Recent studies about HPV infection are a basic requirement in order to promote the HPV vaccinations and patient’s health.

HPV acting on E-cadherin, p53 and p16: literature review.

In addition to tobacco and alcohol consumption, the two main risk factors for oral squamous cell carcinoma (OSCC), recent studies have revealed infections with human papilloma virus (HPV) as an additional risk factor for OSCC development. In the field of head and neck malignancies, the prevalence of HPV infections in oropharyngeal cancer (OC) ranges in different studies up to 84%. While HPV infection is discussed as an independent risk factor in this region, its distinguished role in carcinogenesis of tumours localized to the oral cavity remains uncertain. A systematic literature search was performed using PubMed, Cochrane library, Science Direct, and the Internet search, with language restricted to English. The search included published studies which dealt with detection methods of HPV-related oral and oropharyngeal cancers and biomolecular studies, particularly regarding the compromising of p53 p16 and e-cadherin’s. P53 Tumour suppressor protein p53 has several functions that are related to maintaining genomic stability and inhibiting cell proliferation in response to DNA damage. For preventing neoplasia to occur, the most important of these functions are cessation of cell growth and induction of either apoptosis or senescence. P16 is a cellular protein involved in cell cycle regulation. It is a cyclin-dependent kinase 4 (CDK4) inhibitor, and is integral to Rb mediated regulation of G1-S phase of the cell cycle. P16 is expressed at a very low level in normal cell as Rb inhibits transcription of p16. Various detection methods ranging from immunohistochemistry (IHC) to molecular techniques have been used to determine the HPV status of HNSCC. E-cadherin, a 120 kDa Type I classical cadherin, is expressed primarily on epithelial cells. It is found on the surface of keratinocytesand Langerhans cells (LC) and E-cadherin mediated adhesion between these cell types is required for LC retention in the epidermis. It is also an important tumour suppressor protein: its loss or inactivation is associated with epithelial-to-mesenchymal transition (EMT), a process involving dedifferentiation, infiltration and metastasis of tumours. Oral carcinogenesis is a multi-factorial process involving socioeconomic, environmental and microbial factors leading to multistep changes. Smoking and tobacco exposure seems to modify the survival and recurrence of HPV positive tumours and should be considered in future trials for risk stratification of HPV positive patients. HPV associated oropharynx cancer represents a distinct clinical and biologic entity with many unresolved issues that will be investigated in future translational, clinical research. We need to further explore and understand why the disease occurs predominantly in males, and whether the natural history of oral HPV infection differences in men and women.

Human papilloma virus in the tonsillar microbiota of an Afghan population group.

Cancer of the oral cavity is known to have a diverse aetiology that includes infectious agents. Human papilloma virus has been found to be associated with several types of human cancer, inclusive of cervical, vulvar, vaginal, penile, anal, and cancer of tonsil. The aim of this manuscript is to investigate the presence of human papilloma virus in tonsillar microbiota of an Afghan population group. A sample of the tonsillar microbiota was collected by oral swab paper stick from 80 healthy donors. The sample was investigated for the presence of high-risk human papillomavirus types 16, 18, 31 and 45 by real time PCR. Eight samples produced some positive endpoint signals for human papillomaviruses. The human papillomavirus 31 was the unique papillomavirus detected; its calculated prevalence rate was 0.10 (C.I. 0.05-0.19). However, the viral load was always very low, in the order of 10-3 viral genomes per cell. The high prevalence of high-risk human papillomavirus in healthy population suggest a need for further investigation on virus spreading and supports the development of vaccination strategies.

Effect of biostimulation on oral fibroblast: a pilot study.

Bio-stimulation is a technique in aesthetic medicine in which different drugs such as nucleotides, antioxidants and glucosaminoglycans precursors are injected in the dermis to improving the anabolic function of dermal fibroblasts, i.e., protein synthesis, replication and production of extracellular matrix components. It can be achieved with multiple intra-dermal injections, using two protocols: 1) Polydeoxyribonucleotide (PDRN) plus glucosamine sulphate (Gluc); 2) N-acetylcysteine (NAC) and amino acids (Aa) (named Bio- NAC procedure). Since the role of drugs used in biostimulation on human dermal fibroblasts is not completely understood, the aim of this study is to evaluate the effect of these substances in primary cell cultures by using RT-PCR and a panel of specific genes (ELN, DSP, FN1, FBN1, ITGA1, ITGA2, ITGA5, ITGB1, COL1A1,COL3A1) to detect their effect on cell metabolism and extracellular matrix components. Both the treatments were responsible for Elastine and Desmoplakin genes activation. Only NAC plus Aa treatment enhance the expression of other genes related to tissue growth and elasticity like FBN1, ITGA1 and ITGB1. All the other genes investigated (FN1, ITGA5, ITGA2, COL1A1, COL3A1) were down-regulated by both treatments. Since the precise role of these proteins in tissue integrity and aging is not known, this study confirms the usefulness of biostimulation therapies in enhancing some of the genes responsible of cellular wellbeing. This study could be useful to consider the possibility of injective biostimulation in oral cavity, clinical applications in oral healing and in gingival atrophy as well.

Biorevitalization: an in vitro study on gingival fibroblast.

Bio-revitalization is a therapy commonly used in aesthetic medicine to improve skin quality by di¬rectly integrating hyaluronic acid alone or added to other molecules (i.e. vitamins) through intradermal injections. These injections are not aimed to fill roughness but to achieve extracellular matrix optimi¬zation. The injective medical devices used in aesthetic medicine differ for hyaluronic acid content and for the presence of additional molecules that characterize the formulation of a particular company. The aim of the present study is to compare HA with different compounds in regard to their effects on cultured fibroblasts over time by using RT-PCR and a panel of genes (ELN, DSP, FN1, FBN1, ITGA1, ITGA2, ITGA5, ITGB1, COL1A1, COL3A1) involved in connective integrity. Bio-revitalization is able to activate genes involved in tissue integrity. The reported data add new insight in the comprehension of molecular mechanism related to BR. These preliminary data have to be developed through additional experiments. However, an injective therapy seems to be effective in gingival fibroblast stimulation.

Bidirectional flux of fluids and microbiota at implant-abutment connection of FMD Storm implant system: an in vitro stud y using RT-PCR.

The purpose of the present microbiological study was to evaluate bacterial leakage at implant-abutment connection level of a new type of implant (Storm implant (FMD, Falappa Medical Devices®, Rome, Italy) using Real-Time Polymerase Chain Reaction (RT-PCR). This implant presents a polygonal external implantabutment connection with a geometry that provides a hex on which engage complementary abutments. To identify the capability of the implant to protect the internal space from the external environment, the passage of genetically modified Escherichia coli across implant-abutment interface was evaluated. Four Storm implants (FMD, Falappa Medical Devices®, Rome, Italy) were immerged in a bacterial culture for 24 h and bacteria amount was measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 15% for P. gingivalis and 14% for T. forsythia. Our results are similar to those reported in the English literature. Additional studies are needed to explore the relationship in terms of microbiota between the internal implant and implant-prosthetic connection. In addition, the dynamics of internal colonization needs to be thoroughly documented in longitudinal in vivo studies. As a result, microbial leakage along the implant abutment interface was acceptable and considered the most probable explanation for peri-implantitis.

Bacterial colonization of the implant-abutment interface of conical connection with an internal octagon: an in vitro study using real-time PCR.

Bacterial leakage at the implant-abutment connection of a two-piece implant system is considered the main cause of peri-implantitis. Prevention of bacterial leakage at the implant-abutment connection is mandatory for reducing inflammation process around implant neck and achieving bone stability. Micro-cavities at implant-abutment connection level can favour bacterial leakage, even in modern two-piece implant systems. The conical connection with an internal octagon (CCIO) is considered to be more stable mechanically and allows a more tight link between implant and abutment. As P. gingivalis and T. forsythia penetration might have clinical relevance, it was the purpose of this investigation to evaluate molecular leakage of these two bacteria in a new two-implant system with an internal conical implant-abutment connection with internal octagon (Shiner XT, FMD Falappa Medical Devices S.p.A. Rome, Italy). To verify the ability of the implant in protecting the internal space from the external environment, the passage of genetically modified Escherichia c oli across implant-abutment interface was evaluated. Four Shiner XT implants (FMD, Falappa Medical Devices®, Rome, Italy) were immerged in a bacterial culture for 24 h and bacteria amount was measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 6% for P. gingivalis and 5% for T. forsythia. Other comparable studies about the tightness of the tested implant system reported similar results. The gap size at the implant-abutment connection of CCIOs was measured by other authors discovering a gap size of 1­2µm of the AstraTech system and of 4µm for the Ankylos system. Bacterial leakage along implant-abutment connection of cylindrical and tapered implants, Shiner XT, (FMD Falappa Medical Devices S.p.A. Rome, Italy) showed better results compared to other implants. Additional studies are needed to explore the relationship in terms of microbiota of the CCIO. In addition, the dynamics of internal colonization needs to be thoroughly documented in longitudinal in vivo studies.

Genetic effects of BIOPAD® on fibroblast primary culture.

BIOPAD® is an ivory-white soft sponge, made exclusively of lyophilized type I native heterologous collagen extracted from horse flexor tendon, gelatine free, that keeps its native structure specific to the body's skin tissue. BIOPAD® is an active dressing, playing an active role in all stages of wound healing process, stimulating granulation tissue growth and enhancing regeneration tissues. It ensures balance between absorption and humidity at wound surface, gaseous exchange of soft tissues during healing process, barrier to prevent bacterial infections and it is completely non-adherent. The use of BIOPAD® is painless for the patient and does not require removal or change of dressing. In this work, we evaluated the effect of BIOPAD® on fibroblasts behavior in term of cell viability, survival and growth and collagen production. The expression levels of some adhesion and traction-resistance related genes (ELN, DSP, FN1, FBN1, ITGB1, ITGA1, ITGA5, ITGA2, COL1A1, COL3A1) were analyzed using real time Reverse Transcription-Polymerase Chain Reaction (real time RT-PCR). All genes, except for ELN, DSP, ITGB1 and ITGA1 are up-regulated after 48 h of treatment. Altogether, our results point out the good potential of BIOPAD® as a biocompatible and regenerative tool in medicine.

Cone-morse implant connection system significantly reduces bacterial leakage between implant and abutment: an in vitro study.

Osseointegrated implants are very popular dental treatments today in the world. In osseointegrated implants, the occlusal forces are transmitted from prosthesis through an abutment to a dental implant. The abutment is connected to the implant by mean of a screw. A screw is the most used mean for connecting an implant to an abutment. Frequently the screws break and are lost. There is an alternative to screw retained abutment systems: the cone-morse connection (CMC). The CMC, thanks to the absence of the abutment screw, guarantees no micro-gaps, no micro-movements, and a reduction of bacterial leakage between implant and abutment. As P. gingivalis and T. forsythia penetration might have clinical relevance, it was the purpose of this investigation to evaluate molecular leakage of these two bacteria in a new CMC implants systems (Leone Spa®, Florence, Italy). To identify the capability of the implant to protect the internal space from the external environment, the passage of genetically modified Escherichia coli across implant-abutment interface was evaluated. Four cone-morse Leone implants (Leone® Spa, Florence, Italy) were immerged in a bacterial culture for 24 h and bacteria amount was then measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 3% for P. gingivalis and 4% for T. forsythia. Cone-morse connection implant system has very low bacterial leakage percentage and is similar to one-piece implants.

Genetic effects of Vicryl® on fibroblast primary culture.

Vicryl® (polyglactin 910) is an absorbable, synthetic, usually braided suture, indicated for soft tissue approximation and ligation. Vicryl® has a special coating for minimizing friction, easing passage through tissue and easy knot tie down. It is synthetic for minimal tissue reaction. Fibroblasts are the main cells of connective tissue that synthesize extracellular matrix. In this work, we tried to judge the action of Vicryl® on fibroblasts behaviour. We evaluated the expression levels of some adhesion and traction-resistance related genes (ELN, DSP, FN1, FBN1, ITGB1, ITGA1, ITGA5, ITGA2, COL1A1, COL3A1) by using real time Reverse Transcription-Polymerase Chain Reaction (real time RT-PCR). All but 2 genes resulted up-regulated after 48 h of treatment. Our preliminary results point out the potential of Vicryl® as a biocompatible and regenerative tool in medicine.

Effect of platelet reach plasma on fibroblast primary culture: gene expression evaluation.

To correct skin imperfections, aesthetic medicine today makes use of injectable dermal fillers that allow filling skin by increasing the volume of soft tissue. Currently, there are many fillers usable for their excellent biocompatibility and low allergic reactions that ensure good results and good compliance. Among these, the most widely used filler is Human Plasma, obtained by centrifugation from patient blood and processed through cycles of centrifugation and heating, until it becomes a gel. In this work, we evaluated the effect of the Plasma on fibroblasts behavior in terms of cell viability, survival, growth and collagen production. To this aim, the expression levels of some adhesion and traction-resistance related genes (COL11A1, ELN, GDF6, IGF1, DSP, ELANE, HAS1, HYAL1, COL1A1 and COL3A1) were analyzed using real time Reverse Transcription-Polymerase Chain Reaction (real time RT-PCR). All genes, except for COL1A1, COL3A1 and COL11A1, were up-regulated after 24 h of treatment. Altogether, our results point out the good potential of Plasma. In particular, we appreciated an up-regulation in some of the most important genes involved in bio-revitalization, such as elastin and hyaluronic acid.

Helicobacter pylori in periodontal pockets and saliva: a possible role in gastric infection relapses.

It has been a long time since the scientific community started to speculate upon the presence of Helicobacter pylori (HP) in periodontal pockets as an extra-gastric reservoir responsible for gastric relapses after eradication therapy. The aim of this study is to evaluate the presence of oral HP in a group of patients who underwent examination for gastric infection. Sixty patients were enrolled in the current study, subdivided into two groups: 30 patients with a positive result for HP gastric infection with C-Breath Test Urea examination, and 30 patients with a negative result for HP gastric infection. Crevicular fluid and salivary samples were collected in a sterile tube and then sent to the laboratory for evaluation. Specimens were processed to quantify the levels of HP and bacterial load by real time PCR technique. Even though there was no statistically significant difference among the two groups (A vs B) with regard to the total amount of HP in saliva or in periodontal tissues, this study demonstrates that the oral cavity is an extra-gastric reservoir of HP when it is affected by periodontal disease, and that periodontal disease is correlated to gastric HP infection.

Evaluation of light-emitting diode (LED-835 NM) application over human gingival fibroblast: an in vitro study.

Since the laser and photomodulation were discovered over 50 years, they have been used for many applications in medicine and in dentistry also. In particular, light-emitting diodes therapy (LT) achieved a great success in medical treatment and photo-therapy. In the decades, LT has been used for several therapeutic purposes. Many beneficial effects have been demonstrated in vitro and in vivo, including antibacterial, antiviral, antitumor, cell differentiation, immune potentiating and tissue repair activities. Beneficial effects of LT have also been observed in clinical settings. Although there are lots of cell culture studies in low-level laser therapy, there are only a few cell culture studies in LT that have similar characteristics. The aim of this study was to investigate the effects of LT on primary human gingival fibroblast cells (HGF) on elastin (ELN) gene activation using Real Time PCR. ELN gene activation is directly connected with elastin protein production and HGF functionality. Human gingival tissue biopsies were obtained from three healthy patients during tooth extraction. The gingival specimens were fragmented with a scalpel and transferred in culture dishes containing Dulbecco’s modified Eagle medium supplemented with 20% fetal calf serum (FBS) and antibiotics, i.e. penicillin 100U/ml and streptomycin 100µg/ml. Cells were incubated in a humidified atmosphere of 5% CO2 at 37C. The medium was changed the next day and twice a week. After 15 days, the samples of gingival tissue were removed from the culture dishes. Cells were harvested after an additional 24 h incubation. Human gingival fibroblasts at the second passage were seeded on multiple 6-well plates. The cells stimulation was performed with a light-emitting diodes (LEDs) medical device type E-Light. The LED irradiation seems to be directly correlated with the elastin (ELN) gene activation. Interestingly, ELN gene expression in the cultured human gingival fibroblasts seems to be inversely related to the patients’ age; in fact, its expression tends to decrease with aging. In summary, the result of the present study shows that LED irradiation promoted ELN gene expression more in elderly than in younger adults.

Infectogenomics: lack of association between VDR, IL6, IL10 polymorphisms and “red complex” bacterial load in a group of Italian adults with chronic periodontal disease.

Periodontitis is a multifactorial disease that, if untreated, may cause teeth loss. Clinicians and researchers have reported that genetic factors influence the clinical manifestations of periodontal disease (PD), modulating both inflammation of the mucous membranes and loss of alveolar bone. The acquisition of new nowledge about genetic susceptibility of PD, would directly impact on prognosis and treatment of the disease. In addition, a better understanding of PD pathogenesis could improve the diagnostic tools for the prevention and therapies for modulation of immune responses and treatment of PD. In this study, we evaluated genetic polymorphisms of VRD, IL6 and IL10 and amounts of periodontal pathogens in Italian adults affected by PD. We included 326 cases classified according the criteria of the American Academy of Periodontology. No significant differences in bacterial load were found in patients carrying PD susceptibility alleles of IL6, IL10 and VDR genes. In conclusion, no interaction between genetic factors and amount of periodontal pathogens in periodontal pockets were found in PD patients.

Non-ablative radio-frequency rejuvenation: a histological and bio-molecular report.

Radiofrequency machines for medical use are known to produce moderate clinical improvement of skin laxity without invasive procedures. Numerous equipment with different characteristics have been proposed after the introduction in 2002 of the first FDA approved device. This report is aimed to test if RF treatment is effective when performed at low frequency and low energy level. Two RF treatments were performed unilaterally 7 and 2 days before a planned eyebrow lifting surgery, with a radiofrequency device with 0.52 to 0.7 MHz frequencies, maximum energy of 200 W, used at 40% of its power. A bipolar handpiece with a diameter of 30 mm and a maximum power of 9-9.5 W was massaged along the temporal area for 10 min. Skin samples of treated and untreated sides were collected during surgery and processed for histologic examination and RT-PCR analysis, to test differences in gene activation in a panel of proteins that are relevant in extracellular matrix of dermal connective tissue. The histological examination of the samples showed that the treatment induced a loss of the typical oriented structure in the reticular dermis. The study through RT-PCR evidenced that ELN, the gene codifying for Elastine was strongly enhanced. Some collagen-tested genes (COL1A1, COL3A1 and COL9A1) were inhibited by the treatment, whereas COL2A1 and COL11 were activated. The genes responsible for Metallo-proteases (MMP) 2, 3 and 13 were depressed, while the MMP9 was stimulated. Gene codifying for Hyaluronic synthase 1 (HAS1), Hyluronidase 1 (HYAL1), Neutrophyl elastase (Elane), Desmoplakin (DSP) and GDF6 were inhibited. Insulin like growth factor (IGF1) gene activity was enhanced. RF treatment, with the tested non-ablative equipment, produced histological effects and change in DNA expression of some extracellular matrix related genes, confirming the biostimulatory role of this procedure.