Periodontitis in young individuals: Important factors for disease progression.

AIM: To investigate the progression of periodontitis in young individuals and identify factors that contribute to progression rate and whether periodontitis stage and grade have an impact on disease progression. MATERIALS AND METHODS: This retrospective cohort study was based on patients younger than 36 years at two periodontal clinics between 2003 and 2009. At least 10 years later, a clinical and radiographic examination was performed on 215 patients. The marginal bone loss between baseline and follow-up for the tooth with the most severe bone loss at follow-up was estimated by radiographic measurements. Linear regression analysis was used to investigate the influence of potential risk indicators on periodontitis progression. RESULTS: Most patients (83%) were classified as periodontitis stage III at baseline. At follow-up, 70% of these patients remained in stage III. The frequency of patients with grade C decreased from 79% to 17% at follow-up. The median (Q25%; Q75%) of the longitudinal marginal bone loss was 0.5 mm (0.0; 2.0). High bleeding on probing (BOP) index at baseline, smoking and interruption of periodontal treatment were found to significantly increase longitudinal bone loss. CONCLUSIONS: High levels of BOP at baseline, smoking and interruption of periodontal treatment increased the risk of marginal bone loss. The stage and grade at baseline had no significant impact on disease progression.

Higher expression of Th1/Th2-related cytokines in the intestine of Wistar rats with ligature-induced periodontitis.

OBJECTIVE: This study aimed to investigate the impact of ligature-induced periodontitis (LIP) on histopathological and immunological outcomes in the colon of Wistar rats. BACKGROUND: It has been repeatedly shown that inflammatory bowel disease (IBD) patients are at higher risk of developing periodontitis and presenting worse oral health than non-IBD patients. However, whether the chronic inflammatory process around teeth contributes to the pathophysiology of IBD needs to be further explored. MATERIALS AND METHODS: Thirteen Wistar rats were allocated into LIP (n = 7) and controls (n = 6). Half of the colon was processed for histopathological analyses and immunohistochemical (CD45); the other half was homogenized for immunological analyses. Periodontal destruction was confirmed by measuring the distance from the cementum-enamel junction to the mandible's apical position of the mesial interproximal bone. The immunological analyses were performed with the Bio-Plex Th1/Th2 assay. RESULTS: There was a significantly higher interproximal bone loss in LIP compared to controls. The LIP group showed a moderate infiltrate of inflammatory cells, predominantly mononucleated cells in the intestinal tissues. There was significantly higher expression of GM-CSF, IFN-γ, IL-1α, IL-1ß, IL-2, IL-4, IL-5, IL-10, IL-12 (p70), IL-13, and TNF-α in the intestinal tissues of LIP group compared to controls. CONCLUSION: Ligature-induced periodontitis was associated with an overexpression of Th1/Th2-related cytokines in the colon of Wistar rats.

Colitis induced by dextran sulphate sodium causes histopathological and immunological changes in the periodontal tissues of Wistar rats.

OBJECTIVE: This study investigated the impact of colitis induced by dextran sulphate sodium (DSS)-induced colitis (DIC) on histopathological and immunological outcomes in the periodontal tissues of Wistar rats. BACKGROUND: Inflammatory bowel diseases (IBD) and periodontitis have been reported to present a bidirectional relationship. However, the inflammatory pathway that connects both diseases needs further investigation. MATERIAL AND METHODS: Twenty-five male Wistar rats were allocated in four groups: unilateral ligature-induced periodontitis for 14 days: LIP (n = 7); dextran sulphate sodium-induced colitis only: DIC (n = 6); DIC + LIP (n = 6) and controls (n = 6). Digital images were obtained from the histological sections. In order to assess the attachment loss (AL), the linear distance between the cementoenamel junction (CEJ) and the alveolar bone crest was measured on the mesial root using histological photomicrography's ImageJ software. Immunological analyses of gingival tissues and plasma were performed by Bio-Plex Th1/Th2 Assay. RESULTS: The DIC group showed inflammatory cells extending to the periodontal connective tissues, which contained significantly elevated expressions of IL-1α, IL-1ß, IL-2, IL-6, IL-12, IL-13, GM-CSF, IFN-γ and TNF-α compared to controls. There was no significant difference in bone loss between controls and DIC. There were no significant histopathological differences between DIC + LIP and LIP. However, DIC + LIP presented a significantly lower IL-2 and IL-5 than the LIP group. There was no bone loss difference between LIP+DIC and LIP groups. DIC + LIP group presented significantly higher levels of GM-CSF in plasma. CONCLUSION: DSS-induced colitis was associated with an overexpression of Th1/Th2- related cytokines in the gingival tissue.

MMP-12 and S100s in saliva reflect different aspects of periodontal inflammation.

Matrix metalloproteinase (MMP)-12, S100A8/A9, and S100A12 are involved in innate immune responses. We addressed whether different aspects of oral health and non-disease-related covariates influence their levels in saliva. 436 participants were clinically examined, completed a health questionnaire, and provided stimulated saliva. Salivary levels of MMP-12, S100A8/A9, and S100A12 were determined by enzyme-linked immunosorbent assays. Lower MMP-12 levels were observed in individuals 40-64 years old (yo) compared to < 40 yo, and higher S100A8/A9 levels were found in individuals > 64 yo compared to 40-64 yo. Smokers exhibited lower MMP-12 and S100A12 levels compared to non-smokers. All three proteins were elevated in individuals with bleeding on probing (BOP) > 20% compared to those with BOP ≤ 20%, and the S100A8/A9 levels were higher in individuals having ≥ 10% gingival pocket depths (PPD) ≥ 4 mm compared to the ones with shallow pockets < 4 mm. The extent of alveolar bone loss or presence of manifest caries did not alter any of the markers. MMP-12, S100A8/A9, and S100A12 levels were higher in participants with high periodontal inflammatory burden. All three proteins correlated positively to BOP, PPD, and to several inflammatory mediators. The explanatory variables for MMP-12 in saliva were age, smoking, presence of any tumor, and percentage of PPD ≥ 4 mm. The determinant of salivary S100A8/A9 was percentage of BOP, while S100A12 levels were associated with percentage of BOP and presence of any tumor. Taken together, MMP-12 and the S100/calgranulin levels in saliva reflect different aspects of periodontal inflammation. Smoking and age should be taken into account in further investigation of these proteins as biomarker candidates of periodontal disease.

Polyhexamethylene guanidine phosphate irrigation as an adjunctive to scaling and root planing in the treatment of chronic periodontitis.

OBJECTIVE: To evaluate the efficacy of adjunctive polyhexamethylene guanidine (PHMG) phosphate irrigation in periodontal treatment. MATERIALS AND METHODS: The subjects comprised 59 patients with severe chronic periodontitis. Plaque index, bleeding on probing (BOP) and pocket probing depths (PPD) were recorded. The subjects were randomly allocated to one of three groups for scaling and root planning, with different adjunctive irrigants: 1% PHMG phosphate (19 subjects), 0.2% chlorhexidine (21 subjects) and distilled water (19 subjects). Patients were recalled after two weeks, one month and then after 4, 6 and 12 months. RESULTS: In all groups, treatment resulted in considerable improvement of the observed clinical parameters. There were no intergroup differences in plaque index and BOP at any time point, but significant differences in PPD at one, four and six months. By the end of the study no intergroup differences in PPDs persisted. While post study surgical treatment needs decreased in all three groups, no intergroup differences were observed in the number of deep periodontal pockets. CONCLUSIONS: Irrigation with PHMG phosphate significantly reduces PPDs in the short-term, but has no significant long-term effect on the mean pocket depth.

Attitudes and lifestyle factors in relation to oral health and dental care in Sweden: a cross-sectional study.

OBJECTIVE: The aim of the present study was to investigate attitudes to and perceptions of dental treatment and costs, self-assessed personal oral health status and dental self-care in an adult Swedish population, with special reference to potential associations between these factors and periodontal status. MATERIAL AND METHODS: The study population comprised 1577 subjects who had undergone radiographic dental examination. The subjects were grouped by severity of periodontitis, based on extent of bone loss, as none, mild/moderate or severe. Subjects answered a questionnaire about socioeconomic factors, oral care habits and attitudes to dental treatment. Other questions covered medical history, smoking and other life style factors. Associations were tested using the Chi-squared test and a logistic regression model. RESULTS: Compared to subjects with no periodontitis, those with mild/moderate or severe periodontitis were less likely to afford (p < .001), more often refrained from treatment due to costs (p < .001) and in the past year had experienced dental problems for which they had not sought treatment (p < .001). They also reported more anxiety in relation to dental appointments (p = .001). Regarding caries prevention, the severe periodontitis group used least fluoride products (p = .002). CONCLUSIONS: Swedish adults regard their oral health as important, those with periodontitis have a more negative perception of their oral health and are less prone to seek help. These discouraging findings suggest the need for targeted measures, which focus on improving the care of this group of patients.

Chemical effects of chewing sticks made of Salvadora persica.

OBJECTIVE: The chewing sticks are widely used in many regions of Asia and Africa as a traditional tool to maintain oral hygiene. Salvadora persica L. (S. persica), also known as Arak or Miswak, a member of the salvadoraceae family. Chewing sticks, made up from S. persica, have chemical antibacterial properties and mechanical effects. The study aimed to investigate possible chemical effects of S. persica on dental plaque, sub-gingival microbiota and gingival inflammation. In order to achieve this, we inactivated some sticks through boiling to be used as inactive, but mechanically comparable control sticks. METHODS: In a double-blinded crossover trial, 24 patients with mild-to-moderate periodontitis were randomly allocated to use either fresh activated Miswak or inactivated Miswak for 3-week period. Plaque index (PI), gingival index (GI), visual plaque index (VPI) and bleeding on probing (BOP) were evaluated before and immediately following the experimental period. Sub-gingival plaque samples were analysed using DNA-DNA hybridization technique. The study was repeated with the participants switching the type of Miswak they used after a 7-week of "washout" period. RESULTS: There were no significant differences in the microflora after using active and inactive Miswak. Sixteen species of bacteria showed an increase (P < 0.05) after the usage of inactive Miswak, as compared to pretreatment values. No species showed a similar change after the use of active Miswak. There were no significant differences between active and inactive Miswak regarding the registered clinical variables. CONCLUSION: This study has not shown any clinical effect of the chemically active Miswak, but there was a tendency towards an effect on the microflora.

Periodontitis Increases the Risk of a First Myocardial Infarction: A Report From the PAROKRANK Study.

BACKGROUND: The relationship between periodontitis (PD) and cardiovascular disease is debated. PD is common in patients with cardiovascular disease. It has been postulated that PD could be causally related to the risk for cardiovascular disease, a hypothesis tested in the Periodontitis and Its Relation to Coronary Artery Disease (PAROKRANK) study. METHODS AND RESULTS: Eight hundred five patients (<75 years of age) with a first myocardial infarction (MI) and 805 age- (mean 62±8), sex- (male 81%), and area-matched controls without MI underwent standardized dental examination including panoramic x-ray. The periodontal status was defined as healthy (≥80% remaining bone) or as mild-moderate (from 79% to 66%) or severe PD (<66%). Great efforts were made to collect information on possibly related confounders (≈100 variables). Statistical comparisons included the Student pairwise t test and the McNemar test in 2×2 contingency tables. Contingency tables exceeding 2×2 with ranked alternatives were tested by Wilcoxon signed rank test. Odds ratios (95% confidence intervals) were calculated by conditional logistic regression. PD was more common (43%) in patients than in controls (33%; P<0.001). There was an increased risk for MI among those with PD (odds ratio, 1.49; 95% confidence interval, 1.21-1.83), which remained significant (odds ratio, 1.28; 95% confidence interval, 1.03-1.60) after adjusting for variables that differed between patients and controls (smoking habits, diabetes mellitus, years of education, and marital status). CONCLUSIONS: In this large case-control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confounding factors. These findings strengthen the possibility of an independent relationship between PD and MI.

Saliva and plasma levels of cardiac-related biomarkers in post-myocardial infarction patients.

AIM: To relate cardiac biomarkers, such as cystatin C and growth differentiation factor-15 (GDF-15) in saliva to myocardial infarction (MI) and to periodontal status, and to investigate the relation between salivary and plasma cardiac biomarkers. MATERIALS AND METHODS: Two hundred patients with MI admitted to coronary care units and 200 matched controls without MI were included. Dental examination and collection of blood and saliva samples was performed 6-10 weeks after the MI for patients and in close proximity thereafter for controls. Analysing methods: ARCHITECT i4000SR, Immulite 2000 XPi or ELISA. RESULTS: The mean age was 62 ± 8 years and 84% were male. Total probing pocket depth, fibrinogen, white blood cell counts and HbA1c were higher in patients than controls. GDF-15 levels correlated with most of the included clinical variables in both study groups. No correlation was found between plasma and saliva levels of cystatin C or GDF-15. CONCLUSION: Salivary cystatin C and GDF-15 could not differentiate between MI patients and controls.

Effects of polyhexamethylene guanidine phosphate on human gingival fibroblasts.

OBJECTIVE: Polyhexamethylene guanidine phosphate (PHMG-P) was compared to chlorhexidine (CHX) in order to determine potential cytotoxic and immune-modulatory effects on human gingival fibroblasts. MATERIALS AND METHODS: Cytotoxic effects of PHMG-P and CHX on human gingival fibroblasts were assessed using cell viability assay at various time points and concentrations. The effects of PHMG-P and CHX on the secretion of prostaglandin (PG) E2, interleukin (IL)-6, IL-8 and matrix metalloproteinase (MMP)-1 by non-stimulated or IL-1ß stimulated fibroblasts were evaluated by enzyme-linked immunosorbent assays. RESULTS: PHMG-P concentration 0.00009% led to the total loss of fibroblast viability within 24 h, whereas inhibition of fibroblast viability by CHX occurred at significantly higher concentrations of 0.0009% (p < .001). Short-term exposure to 0.005% PHMG-P led to loss of fibroblast viability after 5 min, whilst cells exposed to 0.005% CHX survived 30 min of treatment (p < .001). IL-1ß stimulation induced an inflammatory response with a significant increase in the secretion of PGE2, IL-6, IL-8 and MMP-1. Treatment of IL-1ß stimulated fibroblasts in combination with PHMG-P or CHX at concentrations of 0.000045 or 0.0.00009% resulted in significantly decreased PGE2, IL-6, IL-8 and MMP-1 levels. PHMG-P or CHX alone did not affect the baseline secretion of PGE2, IL-6, IL-8 or MMP-1 by gingival fibroblasts. CONCLUSIONS: Cytotoxic effects on gingival fibroblasts were triggered by both PHMG-P and CHX at concentrations below those used in clinical practice. The tested antiseptics did not cause inflammation and reduced IL-1ß-induced secretion of inflammatory mediators and collagenase by gingival fibroblasts, which suggests anti-inflammatory properties.

Association of periodontitis with persistent, pro-atherogenic antibody responses.

AIM: To study antibody responses associated with molecular mimicry in periodontitis. MATERIAL & METHODS: Fifty-four periodontitis cases (mean age 54.0 years) and 44 controls (53.6 years) were examined, after which cases received periodontal treatment. Established immunoassays were used to analyse levels of antibodies against two pathogens, Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg), heat shock proteins (Hsp), Hsp60, Hsp65, and Hsp70, and epitopes of oxidized low-density lipoprotein (oxLDL) (CuOx-LDL and MDA-LDL) in plasma samples that were collected at baseline and after 3 (n = 48) and 6 (n = 30) months. RESULTS: When age, sex, smoking habit, and the number of teeth were considered in multivariate logistic regressions, Aa and Pg IgG, Hsp65-IgA, CuOx-LDL-IgG and -IgM, and MDA-LDL-IgG antibody levels were associated with periodontitis, whereas Hsp60-IgG2 antibody levels were inversely associated. The Aa antibody levels significantly correlated with the levels of IgA antibodies to Hsp65 and Hsp70, and both OxLDL IgA antibody levels. The levels of antibodies to Pg correlated with IgG antibodies to Hsp60, Hsp70, and both oxLDL antibody epitopes. None of the antibody levels changed significantly after treatment. CONCLUSIONS: Periodontitis is associated with persistently high levels of circulating antibodies that are reactive with pathogen- and host-derived antigens.

Caries correlates strongly to salivary levels of matrix metalloproteinase-8.

The caries process in dentin involves the degradation of both mineral and organic matrix. The demineralization has been demonstrated to be caused by bacterial acids. However, the collagen degradation is considered to be initiated by endogenous proteolytic enzymes, mainly collagenolytic matrix metalloproteinases (MMPs). This paper aims to relate salivary MMP-8 (or salivary collagenase-2) and tissue inhibitor of MMP (TIMP-1) levels to manifest caries in a large number of subjects. A random sample of 451 adults (aged 18-87 years) living in the south of Sweden was included in this study. Standard clinical examinations were performed, and stimulated saliva was collected and analyzed for concentrations of MMP-8, TIMP-1 and total protein, using an immunofluorometric assay, an enzyme-linked immunosorbent assay and the Bradford assay, respectively. Salivary numbers of mutans streptococci and lactobacilli were determined using a chair-side kit. Subjects with manifest caries lesions presented with elevated levels of MMP-8 (p < 0.001) as well as total protein, MMP-8/TIMP-1 ratio, bleeding on probing and plaque index (p = 0.05) compared with subjects without manifest caries. Multiple linear regression analysis with caries as the dependent variable revealed MMP-8 as the only significant explanatory variable (p < 0.001). TIMP-1 was not significant in any case. Using MMP-8 as the dependent variable revealed total protein concentration, caries lesions (p ≤ 0.001) and salivary secretion rate (p = 0.05) as explanatory variables. In conclusion, our data reveal that subjects with manifest caries lesions have elevated levels of salivary MMP-8 relative to subjects with no caries lesions.

Significance of scaling and root planing with and without adjunctive use of a water-cooled pulsed Nd:YAG laser for the treatment of periodontal inflammation.

The aim was to assess the significance of scaling and root planing (SRP) with adjunctive use of a water-cooled pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of periodontal inflammation. Thirty-nine patients were equally divided into three groups. In group 1, the upper jaw was treated with Nd:YAG laser application; whereas in groups 2 and 3, the upper jaw was treated with SRP alone and Nd:YAG laser application immediately after SRP, respectively. In each group, probing pocket depth (PPD), plaque index (PI), and gingival index (GI) were measured and gingival crevicular fluid (GCF) volume was determined after using at 1 week and after 3 months. Three-month follow-up results showed that PPD, PI, GI, and GCF volume were significantly reduced in group 3 compared to groups 1 and 2. In short term, SRP with a single application of a water-cooled pulsed Nd:YAG laser reduced PI, GI, PPD, and GCF volume more significantly compared to when Nd:YAG laser and SRP are used alone to treat periodontal inflammation.

Inhibition of microsomal prostaglandin E synthase-1 by aminothiazoles decreases prostaglandin E2 synthesis in vitro and ameliorates experimental periodontitis in vivo.

The potent inflammatory mediator prostaglandin E2 (PGE2) is implicated in the pathogenesis of several chronic inflammatory conditions, including periodontitis. The inducible enzyme microsomal prostaglandin E synthase-1 (mPGES-1), catalyzing the terminal step of PGE2 biosynthesis, is an attractive target for selective PGE2 inhibition. To identify mPGES-1 inhibitors, we investigated the effect of aminothiazoles on inflammation-induced PGE2 synthesis in vitro, using human gingival fibroblasts stimulated with the cytokine IL-1ß and a cell-free mPGES-1 activity assay, as well as on inflammation-induced bone resorption in vivo, using ligature-induced experimental periodontitis in Sprague-Dawley rats. Aminothiazoles 4-([4-(2-naphthyl)-1,3-thiazol-2-yl]amino)phenol (TH-848) and 4-(3-fluoro-4-methoxyphenyl)-N-(4-phenoxyphenyl)-1,3-thiazol-2-amine (TH-644) reduced IL-1ß-induced PGE2 production in fibroblasts (IC50 1.1 and 1.5 µM, respectively) as well as recombinant mPGES-1 activity, without affecting activity or expression of the upstream enzyme cyclooxygenase-2. In ligature-induced experimental periodontitis, alveolar bone loss, assessed by X-ray imaging, was reduced by 46% by local treatment with TH-848, compared to vehicle, without any systemic effects on PGE2, 6-keto PGF1α, LTB4 or cytokine levels. In summary, these results demonstrate that the aminothiazoles represent novel mPGES-1 inhibitors for inhibition of PGE2 production and reduction of bone resorption in experimental periodontitis, and may be used as potential anti-inflammatory drugs for treatment of chronic inflammatory diseases, including periodontitis.

Smoking and inflammation: evidence for a synergistic role in chronic disease.

Tobacco smoking is the most important preventable risk factor for periodontitis; however, the underlying biological mechanisms responsible for the detrimental effects of smoking on periodontal health remain largely unclear. It is also well established that smoking has a negative impact on several inflammatory diseases, including rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease. The aim of this paper was to review smoking-related changes in local and systemic host responses with a focus on cellular and molecular effects that could explain a hyperinflammatory response leading to periodontal destruction. Biological mechanisms that may be common to periodontal disease and other chronic inflammatory diseases were also explored, together with gene-smoking interactions. An epidemiologic perspective on the burden of smoking on periodontal health and the potential for smoking cessation is also presented. Tobacco smoking seems to induce changes ranging from decreased leukocyte chemotaxis to decreased production of immunoglobulins. Smoking also seems to cause a stronger inflammatory reaction with an increased release of potentially tissue-destructive substances (e.g. reactive oxygen species, collagenase, serine proteases and proinflammatory cytokines). These findings support a hypothesis that periodontitis is a hyperinflammatory condition rather than a hypo-inflammatory condition.

[Periodontitis - an often neglected risk factor for several other diseases]. / Parodontit ­ en ofta förbisedd riskfaktor för en rad sjukdomar.

Periodontitis is a chronic inflammatory disease that degrades dental supporting tissues, including the alveolar bone. The global prevalence is 19%, in Sweden it is 11%. Left untreated, periodontitis can cause loss of teeth. The initial clinical manifestations of periodontitis usually start between 35 and 45 years of age. The underlying pathological mechanism is an aberrant inflammatory response to the bacteria colonizing the gingival crevice. Periodontitis has been associated with several other diseases, most prominently diabetes. The relation between periodontitis and diabetes is bidirectional in the sense that diabetes increases the risk for periodontitis and vice versa. Periodontitis also increases the risk for cardiovascular disease and cancer.

[Diabetes and periodontitis - common, important but often neglected]. / Diabetes och parodontit ­ viktig aspekt av diabetesvården.

Diabetes and periodontitis are two global epidemics. There is a two-way relationship between diabetes and periodontitis. Diabetes increases the risk of periodontitis and periodontitis increases the risk for deteriorating glucose levels, having undetected diabetes, and for future diabetes. A recent Cochrane report summarized that there is moderate-certainty evidence that periodontal treatment improves glycaemic control in people with both periodontitis and diabetes. The recent PAROKRANK study found that undetected dysglycaemia was independently associated to both myocardial infarction and to periodontitis. To increase awareness of oral health in people with diabetes this article summarizes recent evidence.

The effects of periodontal treatment on pregnancy outcomes.

BACKGROUND: Preterm infants are at greater risk than term infants for physical and developmental disorders. Morbidity and mortality increases as gestational age at delivery decreases. Observational studies indicate an association between poor periodontal health and risk for preterm birth or low birthweight, making periodontitis a potentially modifiable risk factor for prematurity. AIM: To identify randomized controlled trials (RCTs) published between January 2011 and July 2012 and discuss all published RCTs testing whether periodontal therapy reduces rates of preterm birth and low birthweight. METHODS: Search of databases including PubMed, ISI Web of Science and Cochrane Library. RESULTS: The single RCT identified showed no significant effect of periodontal treatment on birth outcomes. DISCUSSION: All published trials included non-surgical periodontal therapy; only two included systemic antimicrobials as part of test therapy. The trials varied substantially in terms of sample size, obstetric histories of subjects, study preterm birth rates and the periodontal treatment response. The largest trials - also judged to be high-quality and at low risk of bias - have yielded consistent results, and indicate that treatment does not alter rates of adverse pregnancy outcomes. CONCLUSION: Non-surgical periodontal therapy, scaling and root planing, does not improve birth outcomes in pregnant women with periodontitis.

Salivary biomarkers of oral health: a cross-sectional study.

AIM: Saliva is a useful diagnostic fluid for oral-related diseases. Monitoring salivary biomarkers for oral and systemic diseases could become an important complement to clinical examinations in epidemiological surveys. Recent findings indicate that it is possible to detect biomarkers for oral diseases within saliva samples. The aim of this study was to investigate if known salivary biomarkers could be used for epidemiological studies for detection of periodontitis. MATERIALS AND METHODS: A randomly selected sample of adults (20-89 years) living in Southern Sweden were invited to participate. Four hundred and fifty-one individuals were examined clinically using standard examination procedures. Stimulated saliva samples were collected and analysed for concentrations of IL-1ß, -6, -8, lysozyme, matrix metalloproteinases (MMP)-8 and tissue inhibitor of metalloproteinase (TIMP)-1 using ELISA, immunofluorometric assay or Luminex assays. RESULTS: Patients with severe periodontitis presented with elevated salivary concentrations of IL-1ß (p < 0.001) and MMP-8 (p < 0.001). In addition, the MMP-8/TIMP-1 ratio was significantly higher in the severe periodontitis group (p < 0.001). Smokers compared with non-smokers showed slightly lower concentrations of IL-8 (p < 0.05) and MMP-8 (p = 0.052). CONCLUSION: This investigation shows that IL-1ß, MMP-8 and the ratio of MMP-8/TIMP-1 could be used as markers of periodontal disease in larger patient populations.

The Resolution of Periodontal Inflammation Promotes Changes in Cytokine Expression in the Intestine and Gingival Tissues of Aged Rats with DSS-Induced Colitis.

Our research aimed to explore how resolving periodontal inflammation impacts cytokine expression in the colons of aged Wistar rats. Research studies involving animals have been conducted to investigate the two-way relationship between periodontitis and inflammatory bowel disease (IBD), where chronic inflammation in either the mouth or intestines can negatively affect the other. We allocated seventeen male Wistar rats aged between 8 and 11 months to one of four groups: (1) ligature-induced periodontitis (LIP) without the resolution of periodontal inflammation (RPI) (LIP; n = 4), (2) LIP + RPI (n = 4), (3) LIP + dextran-sulphate-sodium-induced colitis (DIC) without RPI (n = 4), and LIP + DIC + RPI (n = 5). We performed histopathological and immunological analyses on periodontal and intestinal tissues and analysed cytokine expressions using a Rat Cytokine 23-Plex Immunoassay. Our findings showed that animals with and without DIC who underwent RPI showed significantly lower levels of IL-2, IL-4, IL-5, IL-10, IL-13, IL-17, IL-18, and TNF-α in the intestine compared to those without treatment. The RPI effectively reduced the number of inflammatory cells in the lamina propria and restored the epithelial barrier in the intestine in animals with DIC. The resolution of periodontal inflammation significantly reduced the levels of pro-inflammatory cytokines and chemokines in the intestines of aged rats with and without DSS-induced colitis.