Effects of a cyclic NSAID regimen on levels of gingival crevicular fluid prostaglandin E2and Interleukin-1ß: A 6-month randomized controlled clinical trial.

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for inflammation control and pain relief. However, while the adjunct use of NSAIDs is avoided for periodontal therapy because of related side effects, cyclic administration of NSAIDs may reduce or eliminate these effects. We evaluated the effect of a cyclic diclofenac potassium (DP) regimen on clinical parameters and levels of prostaglandin E2 (PGE2) and interleukin-1ß (IL-1ß) in the gingival crevicular fluid (GCF) of individuals with periodontitis. MATERIALS AND METHODS: The study protocol was approved by the Ethics Committee (2000/071). Forty-one individuals with chronic periodontitis (33 men, 8 women) were divided into two groups (test and control) after initial periodontal therapy. During this 6-month, randomized, double-blind, placebo-controlled study, test (n = 28) and control (n = 13) groups were administered a cyclic regimen of DP (50 mg, twice daily) or placebo. Clinical measurements and GCF sample collections were made at baseline, 2, 4, and 6 months. GCF levels of PGE2and IL-1ß were determined using enzyme immunoassay and enzyme-linked immunoassay kits, respectively. RESULTS: At baseline, no significant differences existed between groups for plaque indices, gingival indices, bleeding on probing, probing depth (PD), or attachment levels (P > 0.05). Compared with the control group, cyclic regimen in the test group suppressed increased levels of PGE2found in GCF at the end of the study (P < 0.05). Significant differences for PD and relative attachment gain were also noted in favor of the test group (P < 0.05). CONCLUSIONS: These results suggest that a cyclic regimen of DP may be efficacious in the management of chronic periodontitis in adults.

Posterior segmental osteotomy of maxillary edentulous ridge: an alternative to vertical reduction.

The posterior segmental maxillary osteotomy (PSMO) can be used as an alternative procedure to vertical reduction of the edentulous posterior maxilla. Surgical intrusion of the segment resulted in an adequate interarch space for prosthetic restoration without cortical bone loss and widening of the edentulous ridge and the mobilized keratinized mucosa as would be the case if vertical alveolar reduction had been performed.

Effect of systemic doxycycline administration on the subgingival microbial flora: a dark-field microscopy study.

The effect of systemically administered doxycycline hydrochloride on subgingival microbial plaque morphotypes was evaluated using dark-field microscopy. After 1 week of drug administration, while the percentage of coccoid bacteria showed a significant increase, the percentages of spirochetes, motile rods and non-motile rods tended to decrease. Since spirochetes and/or motile rods are considered to be associated with the pathogenesis of periodontal disease, the significant decrease in the proportions of these bacteria are considered to be important. Therefore, it is suggested that doxycycline may be beneficial for the treatment of periodontal disease as an adjunct to traditional therapeutic methods.

Interleukin-1beta and tumour necrosis factor-alpha levels in periapical exudates.

AIM: The aim of this study was to determine IL-1beta and TNF-alpha levels in periapical exudates and to evaluate their relationship with clinical and radiological findings. METHODOLOGY: Periapical exudates were collected from root canals of 35 single-rooted teeth using absorbent paper points. IL-1beta and TNF-alpha levels were determined by enzyme-linked immunosorbent assays. The samples were divided into two groups according to the presence or absence of clinical signs including swelling and/or fistula, pain on palpation and/or percussion, and pus discharge from canals. Periapical exudate samples were divided into two groups according to size of periapical radiolucent area. RESULTS: The mean concentration of IL-1beta (72.79 ng mL-1) in periapical exudates was approximately 12-fold higher than TNF-alpha(6.17 ng mL-1). There was no significant correlation between these cytokines (P > 0.05). IL-1beta levels in canals with larger radiolucent areas (long axis > or =1 cm) were significantly higher than those with small areas (P < 0.05). There was a tendency toward higher levels of IL-1beta in groups with clinical signs, but the differences were not significant (P > 0.05). CONCLUSIONS: Periapical exudate levels of both cytokines failed to reflect periapical disease state.