Berberine promotes osteogenic differentiation of mesenchymal stem cells with therapeutic potential in periodontal regeneration.

Periodontal disease is a bacterial infection-associated disease of the periodontal tissues characterized by the destruction of tooth-supporting structures, including alveolar bone. The ideal goal of periodontal therapy is the complete regeneration of alveolar bone in a healthy microenvironment free of infection. In this study, we found that berberine, a benzylisoquinoline plant alkaloid from Coptidis Rhizoma, strongly inhibited the growth of Porphyromonas gingivalis. Gingipain is the most important virulence factor of Porphyromonas gingivalis in the process of periodontal tissue destruction. Berberine also had an inhibitory effect on gingipain activity in a concentration dependent manner. Remarkably, berberine restored the downregulation of osteogenesis-related genes expression in bone mesenchymal stem cells (BMSCs) induced by Porphyromonas gingivalis infection, and significantly increased the expression of osteogenesis-related genes such as OSX, COLI, ALP, OCN and OPN compared to the control group. This results suggested that berberine may directly promote osteogenesis. Further in-vitro studies demonstrated that berberine statistically significantly promoted the osteogenic differentiation of BMSCs at concentrations of 1-10 µM. In the research on the mechanisms, we found that both total ß-catenin and nuclear ß-catenin accumulation were statistically significantly increased by berberine. And the transcriptional activity of ß-catenin/TCF was about 2 folds higher than the control group. Furthermore, Wnt signalling specific inhibitor DKK-1 blocked the above effects of berberine. These demonstrated that Wnt/ß-catenin signalling pathway was involved in the osteogenic differentiation induced by berberine. The antibacterial actions in combination with the promotion role in osteogenic differentiation position berberine as a prospective drug for periodontal tissue regeneration.

Retrieval of a periodontally compromised tooth by allogeneic grafting of mesenchymal stem cells from dental pulp: A case report.

Objective To report a case of successful allogeneic grafting of mesenchymal dental pulp stem cells (DPSCs) as preliminary findings in a patient with periodontal disease enrolled into clinical trial ISRCTN12831118. Methods Mesenchymal stem cells from the dental pulp of a deciduous tooth from a 7-year-old donor were separated from the pulp chamber and processed via enzymatic digestion and centrifugation. DPSCs were passaged and cultured on a 35 × 13 mm culture dish in minimum essential medium-alpha, without supplementation. After reaching 80% confluency, 5 x 106 allogeneic DPSCs in 250 µl phosphate buffered saline were seeded onto a dry scaffold of lyophilized collagen-polyvinylpyrrolidone sponge placed in the left lower premolar area of a 61-year-old patient with periodontal disease. Surgical access to the lower premolar area was achieved using the flap technique. Results At 3 and 6 months following allogeneic graft, the patient showed no sign of rejection and exhibited decreases in tooth mobility, periodontal pocket depth and bone defect area. Bone mineral density had increased at the graft site. Conclusions Regenerative periodontal therapy using DPSCs of allogeneic origin may be a promising treatment for periodontal disease-induced bone defects.

The Role of Nutrition in Periodontal Health: An Update.

Periodontal health is influenced by a number of factors such as oral hygiene, genetic and epigenetic factors, systemic health, and nutrition. Many studies have observed that a balanced diet has an essential role in maintaining periodontal health. Additionally, the influences of nutritional supplements and dietary components have been known to affect healing after periodontal surgery. Studies have attempted to find a correlation between tooth loss, periodontal health, and nutrition. Moreover, bone formation and periodontal regeneration are also affected by numerous vitamins, minerals, and trace elements. The aim of this review is to critically appraise the currently available data on diet and maintenance of periodontal health and periodontal healing. The effects of nutritional intervention studies to improve the quality of life and well-being of patients with periodontal disease have been discussed.

Manifesto for a paradigm shift: periodontal health for a better life.

This article outlines the European Federation of Periodontology's (EFP) manifesto Periodontal Health for a Better Life which was informed by the first joint EFP/American Academy of Periodontology workshop on periodontitis and systemic health. The EFP manifesto calls upon the dental profession to engage in screening and providing preventive advice to patients who are at risk of common chronic diseases and conditions such as cardiovascular disease, diabetes and cancer. In particular, the article emphasises the dental team's role in promoting behaviour change in their patients aimed at reducing smoking and obesity levels, by promoting healthy nutrition and exercise. The chairman of the National Association of Primary Care Medicine, Dr Charles Alessi, has strongly endorsed this model and highlighted the important opportunities offered by a capitation-based new contract for the dental team to engage fully in preventive medicine in support of medical colleagues and in the best interests of public health and patients across England.

Influence of periodontal disease on systemic disease: inversion of a paradigm: a review.

Medicine and dentistry interface at many levels. For example, the focal infection theory, popular at the outset of the 1900s, suggested that systemic ailments could be traced to dental infections, which, in those days, were common, chronic, and often untreated. With the advent of modern dental and medical treatment, particularly antibiotics, this relationship was largely forgotten. Until recently, the discovery of relationships between periodontal disease and heart ailments, maternal oral health and prematurity of offspring, bidirectional interrelationships between diabetes and periodontal diseases, relationship of oral infections and chronic respiratory diseases and relationship between skeletal and oral bone mineral density, has brought a shift in the perspective. Research is now focused on the potential impact of periodontal diseases on systemic health. Thus, the impact of oral infection in systemic health defined a novel branch in Periodontology termed Periodontal medicine.

The oral-systemic personalized medicine model at Marshfield Clinic.

Periodontal disease and diabetes, two diseases that have achieved epidemic status, share a bidirectional relationship driven by micro-inflammatory processes. The present review frames the current understanding of the pathological processes that appear to link these diseases and advances the hypothesis that reversal of the epidemic is possible through application of interdisciplinary intervention and advancement of oral-systemic personalized medicine. An overview of how Marshfield Clinic's unique clinical, informatics and bio-repository resources and infrastructures are being aligned to advance oral-systemic personalized medicine is presented as an interventional model with the potential to reverse the epidemic trends seen for these two chronic diseases over the past several decades. The overall vision is to engineer a transformational shift in paradigm from 'personalized medicine' to 'personalized health'.

Laser phototherapy in the treatment of periodontal disease. A review.

Many studies in the literature address the effect of low-power lasers in the management of pathologies related to periodontal tissues. Due to the lack of standardized information and the absence of a consensus, this review presents the current status of laser phototherapy (LPT) in periodontics and discusses its benefits and limits in the treatment of periodontal disease. The literature was searched for reviews and original research articles relating to LPT and periodontal disease. The articles were selected using either electronic search engines or manual tracing of the references cited in key papers. The literature search retrieved references on wound and bone healing, analgesia, hypersensitivity, inflammatory process and antimicrobial photodynamic therapy. Each topic is individually addressed in this review. The current literature suggests that LPT is effective in modulating different periodontal disease aspects in vitro, in animals, and in simple clinical models. Further development of this therapy is now dependent on new clinical trials with more complex study designs.

Attitudes and practices of dentists with respect to nutrition and periodontal health.

OBJECTIVE: To determine the opinions and attitudes of general dental practitioners and hygienists towards the role of nutrition in periodontal health. SETTING: The study was completed by general dental practitioners and dental hygienists throughout the UK. METHOD: A questionnaire was sent out with the British Dental Journal and BDA News together with explanatory information about the study. Postage was pre-paid for replies. RESULTS: Eight hundred and seventy-nine questionnaires were completed. Sixty-six percent of respondents believed nutrition plays a role in periodontal health. Dietary factors that were considered most important were vitamin C (70%), fruit and vegetables (64%) and antioxidant vitamins (45%). Forty-four percent had recommended nutrition supplements to their patients, with multivitamin and mineral supplements (37%) and vitamin C (30%) the most popular. Eighty-two percent of respondents sourced information from dental journals. Qualitative data highlighted uncertainty amongst respondents about the evidence base around nutrition and periodontal health and a lack of training opportunities. CONCLUSIONS: A majority of dentists consider that nutrition and dietary factors play a role in maintaining periodontal health. However, there was a need to increase awareness of the current state of the evidence for a role of nutrition in maintaining periodontal health. Concern regarding lack of an evidence base for the role of nutrition in the treatment of periodontal diseases suggests a need for further research into the therapeutic role of nutrition in periodontal disease management.

N-3 polyunsaturated fatty acid effect in periodontal disease: state of art and possible mechanisms involved.

Anti-inflammatory properties have been widely reported for n-3 polyunsaturated fatty acids (PUFAs) and some studies have been focalized on their possible role in the modulation of gingivitis and alveolar bone resorption in periodontal disease (PD). Increased formation of arachidonic acid-derived inflammatory eicosanoids and augmented oxidative stress are two molecular mechanisms pathogenetically involved in the progression of PD and known to be inhibited by n-3 PUFAs in PD setting. The present review will focus also on other molecular pathways and factors known to be altered in the development of PD and known to be subject to n-3 PUFA modulation in other pathological settings different from PD. Overall, the available findings strongly encourage further experimental studies on animals subject to experimental PD and treated with n-3 PUFAs, long term n-3 PUFA intervention studies on PD patients and molecular studies to identify additional potential molecular routes of n-3 PUFA action in PD.

Topical application of Garcinia mangostana L. pericarp gel as an adjunct to periodontal treatment.

OBJECTIVE: To evaluate the effects of gel containing Garcinia mangostana L. pericarp extract (GM gel) applied topically as an adjunct to periodontal treatment. DESIGN: Subjects who had periodontal pockets on their single-rooted teeth were randomized into the test or control group. Subjects in the test group received periodontal treatment consisting of scaling, root planing and subgingival application of GM gel while those in the control group received scaling and root planing without GM gel application. SETTING: Mahidol University, Faculty of Dentistry, Thailand. MAIN OUTCOME MEASURES: Clinical parameters included probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), Gingival Index (GI) and Plaque Index (PI). Microbiological parameter included subgingival microbial composition as examined by phase contrast microscopy. RESULTS: Clinical improvement compared to baseline was found in both groups (P < 0.05). The test group exhibited significantly higher reduction in mean PPD, GI and BOP than the control group at the 3rd month after treatment (P < 0.05). Subgingival microbial composition changed from diseased state to that compatible with health after treatment in both groups. However, significant differences between groups were found only in the mean percentage of cocci at the 1st and 3rd month after treatment (P < 0.05). CONCLUSIONS: GM gel could enhance the clinical effects of periodontal treatment.

GMP-grade preparation of biomimetic scaffolds with osteo-differentiated autologous mesenchymal stromal cells for the treatment of alveolar bone resorption in periodontal disease.

BACKGROUND: Periodontal disease is a degenerative illness that leads to resorption of the alveolar bone. Mesenchymal stromal cells (MSC) represent a novel tool for the production of biologic constructs for the treatment of degenerative bone diseases. The preparation of MSC differentiated into osteogenic lineage for clinical use requires the fulfillment of strict good manufacturing practice (GMP) procedures. METHODS: MSC were isolated from BM samples and then cultured under GMP conditions. MSC were characterized phenotypically and for their differentiative potential. Cells were seeded onto collagen scaffolds (Gingistat) and induced to differentiate into osteogenic lineages using clinical grade drugs compared with standard osteogenic supplements. Alizarin Red S stain was used to test the deposition of the mineral matrix. Standard microbiologic analysis was performed to verify the product sterility. RESULTS: The resulting MSC were negative for CD33, CD34 and HLA-DR but showed high expression of CD90, CD105 and HLA-ABC (average expressions of 94.3%, 75.8% and 94.2%, respectively). Chondrogenic, osteogenic and adipogenic differentiation potential was demonstrated. The MSC retained their ability to differentiate into osteogenic lineage when seeded onto collagen scaffolds after exposure to a clinical grade medium. Cell numbers and cell viability were adequate for clinical use, and microbiologic assays demonstrated the absence of any contamination. DISCUSSION: In the specific context of a degenerative bone disease with limited involvement of skeletal tissue, the combined use of MSC, exposed to an osteogenic clinical grade medium, and biomimetic biodegradable scaffolds offers the possibility of producing adequate numbers of biologic tissue-engineered cell-based constructs for use in clinical trials.

Psychoneuroimmunology: new avenues of research for the twenty-first century.

Psychoneuroimmunology (PNI) investigates the relations between the psychophysiological and immunophysiological dimensions of living beings. PNI brings together researchers in a number of scientific and medical disciplines, including psychology, the neurosciences, immunology, physiology, pharmacology, psychiatry, behavioral medicine, infectious diseases, and rheumatology. All are scientists with profound interest in interactions between the nervous and immune systems, and the relation between behavior and health. Despite the variety in domains and approaches to research, the outcome common to all research endeavors is the discovery of new information, of uncovered facts, of novel evidence, which contributes to the continuing generation of knowledge. In this paper we discuss psychoneuroimmune aspects of some conditions that are not routinely immediately associated with immunity, such as the condition of being the caregiver of somebody suffering from dementia; the effect on the brain-body modulations of aluminum, a metal that is not a component of the human body; and insomnia, a fairly common but disturbing disease, that even today lacks an effectual treatment.

The effects of extracts of chewing sticks (Salvadora persica) on healthy and periodontally involved human dentine: a SEM study.

The popularity and availability of chewing sticks (Salvadora persica) in the Asia, Middle East and Africa make them a commonly used oral hygiene tool in those societies. Salvador persica chewing stick called miswak is frequently used in Saudi Arabia. The antimicrobial effects of miswak has been well documented. The aim of this study is to find our the effect of aqueous extracts of miswak on healthy and periodontally involved human dentine with Scanning Electron Microscopy (SEM) in vitro. 25% aqueous extract of freshly prepared miswak solution was used for the study. Twelve human premolars teeth (6 healthy and 6 with periodontal disease) recently extracted for orthodontic and periodontal reasons were used. 24 SEM specimens were prepared and treated with miswak extract with different conditions e.g. soaking and burnishing with miswak extract. Soaking the healthy and periodontally diseased root dentine in miswak extract resulted in partial removal of smear layer and occlusion of dentinal tubules was observed in dentine specimens burnished with miswak solution. Further research is needed to evaluate the effect of aqueous extract of miswak on etched human dentine at higher concentrations.

Periodontal repair in dogs: effect of transforming growth factor-beta 1 on alveolar bone and cementum regeneration.

BACKGROUND: Transforming growth factor-beta (TGF-beta) represents a family of growth-modulating proteins with fundamental roles in connective tissue and bone development. The objective of this study was to evaluate the potential for regeneration of alveolar bone and cementum following surgical implantation of recombinant human TGF-beta 1 (rhTGF-beta 1). METHOD: Bilateral, critical size, supra-alveolar periodontal defects in 5 beagle dogs were surgically implanted with rhTGF-beta 1 in a calcium carbonate carrier (CaCO3) or with carrier alone. The animals were euthanized at 4 weeks postsurgery and block-biopsies of the defects were processed for histologic and histometric analysis. RESULTS: Surgical implantation of rhTGF-beta 1 resulted in minimal, if any, stimulation of alveolar bone or cementum regeneration. Linear bone and cementum regeneration in rhTGF-beta 1-treated defects was 1.2+/-0.6 and 0.01+0.01 mm, respectively. Corresponding values for the controls were 1.0+/-0.6 and 0.01+/-0.03 mm. CONCLUSIONS: The results suggest that, under the conditions (dose, carrier, defect type) evaluated here, treatment of periodontal defects in beagle dogs with rhTGF-beta 1 may be of limited clinical benefit.

[The effect of magnetotherapy on the immunobiochemical indices of subjects with diseases of the periodontal tissues and joints]. / Vliianie magnitoterapii na immunobiokhimicheskie pokazateli u lits s zabolevaniiami tkanei parodonta i sustavov.

Kept under medical surveillance in a health resort setting were 52 patients with disorders of the parodontium and large joints. All patients were given a complex therapy involving dietotherapy, therapeutic exercise, hydrotherapy, mud-treatment. Those patients having parodontium diseases were also prescribed topical treatment (chloride-sodium mouth baths and mud applications to the gingiva area). The main group subjects were also exposed to VMF using the unit for low-frequency therapy "Gradient-1". Laboratory means were also made use of, as a complex of biochemical tests characterizing changes in lipid metabolism. The level of the natural bodily resistance was determined by nitroblue tetrazolium test (NBT-test). The condition of the parodontium was evaluated by the Loë-Silness index. Adaptive reactions were studied by the lymphocytes-to-segmented neutrophils ratio. Adoption of therapy involving physiobalneofactors in patients with afflictions of the parodontium tissues and large joints makes for development of favourable in prognostic respect adaptive reactions.

The natural history of periodontal disease. The correlation of selected microbiological parameters with disease severity in Sri Lankan tea workers.

The purpose of this study was to assess the prevalence of A. actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia, and their association with periodontal disease states in a population sample from Sri Lanka. Based on clinical parameters, a total of 536 sites in 268 male Sri Lankan tea workers were categorized as healthy, or showing gingivitis only, moderate or advanced periodontitis. Bacterial samples were obtained from all sites and the three target bacteria identified by indirect immunofluorescence. P. intermedia, P. gingivalis and A. actinomycetemcomitans were found in 76%, 40% and 15% of the subjects, respectively. Of the 536 periodontal sites, 10.5% were categorized with "no disease", 14% "gingivitis only": 59% with moderate and 16% with advanced periodontitis. The prevalence of P. gingivalis and P. intermedia was significantly higher in sites with moderate and advanced periodontitis than in sites with no disease or gingivitis only. A. actinomycetemcomitans was not found in healthy sites, but occurred with equal frequency in sites with gingivitis, moderate and advanced periodontitis. The association between these three bacteria and periodontal diseases in Sri Lankan tea laborers was similar to that described for other non-industrialized and industrialized countries.