Comparing serum levels of cardiac biomarkers in cancer patients receiving chemotherapy and subjects with chronic periodontitis.

BACKGROUND: Chronic periodontitis (CP) is a chronic inflammation associated with elevations of several inflammatory and cardiac markers. Studies implicated CP as one of the etiologies in coronary heart disease (CHD). Cardiotoxicity is a major complication of anticancer drugs, including anthracyclines and 5-fluorouracil (5FU). The most severe cardiac complications are heart failure, arrhythmia and coronary heart disease (CHD). In this study, we compared the level of inflammatory factors and cardiac markers between chronic periodontitis patients and cancer patients receiving chemotherapy. METHODS: 108 blood samples of periodontally healthy subjects were obtained on random from Hong Kong Red Cross, and these represented the controlled population. Forty-four patients diagnosed with chronic periodontitis were recruited from the West China Hospital of Stomatology, Sichuan University. They have received scaling and root planning with mean pocket depths of 6.05 mm. Thirty breast cancer patients diagnosed with invasive ductal carcinoma from UNIMED Medical Institute, Hong Kong gave consent to participate in this study. They received 4 cycles of 500mg/m2 5-fluorouracil, 75 mg/m2 epirubicin and 500mg/m2 cyclophosphamide at a 3-week interval between each cycle. Peripheral venous blood from each group was taken for measurement of blood cells, inflammatory marker (P-selectin, high sensitvity C-reactive protein) and cardiac markers (troponin T; troponin I; N-terminal pro brain natriuretic peptide (Nt-proBNP) and Lactate dehydrogenase (LDH). RESULTS: The lymphocyte count was higher (p < 0.05) in periodontitis patients than the other two groups, and more neutrophils (p < 0.05) were seen in cancer patients receiving chemotherapy. The two test groups demonstrated higher levels (p < 0.01) of inflammatory and cardiac markers than the control group. CONCLUSIONS: The elevated cardiac markers found in periodontitis patients suggested that they may carry potential risks in developing cardiac lesions. Troponin T, troponin I, pro-BNP, LDH and high sensitvity C-reactive protein may be used as markers to monitor cardiac lesions in chronic inflammatory patients.

Gene polymorphism and protein of human pro- and anti-inflammatory cytokines in Chinese healthy subjects and chronic periodontitis patients.

BACKGROUND: Periodontal disease is thought to arise from the interaction of various factors, including the susceptibility of the host, the presence of pathogenic organisms, and the absence of beneficial species. The genetic factors may play a significant role in the risk of periodontal diseases. Cytokines initiate, mediate and control immune and inflammatory responses. The aim of this study is to compare genotypes and soluble protein of pro and anti-inflammatory cytokines (IL-1α, IL-1ß, IL-6, IFN-γ, IL-10, TNF-α and IL-4) in subjects with or free of chronic periodontitis. METHODS: A total of 1,290 Chinese subjects were recruited to this clinical trial: 850 periodontally healthy controls and 440 periodontal patients. All subjects were free of systemic diseases. Oral examinations were performed, and the following parameters were recorded for each subject: supragingival/subgingival calculus, gingival recession, bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), gingival recession and tooth mobility. The peripheral blood samples were collected for genetic and enzyme linked immunosorbent assay (ELISA) analysis. Restriction enzymes were used for digestion of amplified fragments of IL-1α, IL-1ß, IL-6, IFN-γ, IL-10, TNF-α and IL-4. RESULTS: The protein expressions of patient and control samples for IL-1α, IL-1ß, IL-6, TNF-α, IFN-γ, IL-10, and IL-4 measured by ELISA confirmed a statistically significant difference (p < 0.001). The digestion of fragments of various genes showed that the pro-inflammatory cytokines IL-1α and TNF-α, and the anti-inflammatory cytokines IL-4 and IL-10 demonstrated a correlation with chronic inflammation in patients (X2: p < 0.001). The remaining genes investigated in patients and healthy subjects (IL-1ß, IL-6, IFN-γ and IL-10) did not show any significant difference. CONCLUSIONS: The cytokine gene polymorphisms may be used as a marker for periodontitis susceptibility, clinical behaviour and severity. This detection offers early diagnosis and induction of prophylaxis to other family members against disease progression.

Clinical application of human ß-defensin and CD14 gene polymorphism in evaluating the status of chronic inflammation.

BACKGROUND: Periodontitis is a common disease that affects the periodontal tissue supporting the teeth. This disease is attributed to multiple risk factors, including diabetes, cigarette smoking, alcohol, pathogenic microorganisms, genetics and others. Human beta-defensin-1 (hBD-1) is a cationic antimicrobial peptide with cysteine-rich ß-sheets and broad-spectrum antimicrobial activity. CD14 is a protein involved in the detection of bacterial lipopolysaccharide (LPS) and has also been associated with periodontitis. This study investigates the single nucleotide polymorphic (SNP) region, -1654(V38I), of the human beta-defensin-1 (hBD-1) gene as well as the -159 region of the CD14 gene in subjects with chronic periodontitis. METHODS: Blood samples from periodontally healthy subjects and periodontitis patients were obtained. DNA was extracted from the blood and was used to perform restriction digest at the polymorphic G1654A site of DEFB1 with the enzyme HincII. The polymorphic site 159TT of CD14 was digested with the enzyme AvaII. Enzyme-linked immunosorbent assay (ELISA) was performed on soluble samples to determine the protein expressions. RESULTS: The control and patient groups expressed 35% and 38% 1654 A/A genotype of DEFB1, respectively. The A allele frequency of the control group was 40%, while the patient blood group was 54%. The mean hBD-1 protein levels of the control and patient samples were 102.83 pg/mL and 252.09 pg/mL, respectively. The genotype distribution of CD14 in healthy subjects was 16% for C/C, 26% for T/T and 58% for C/T. The genotype frequencies of CD14 in periodontitis patients were 10% for C/C, 43% for T/T and 47% for C/T. The CD14 protein expression determined by ELISA showed a mean protein level of the control samples at 76.28ng/mL and the patient blood samples at 179.27ng/mL with a p value of 0.001.Our study demonstrated that patients suffering from chronic periodontitis present more commonly with the 1654A/A genotype on the DEFB1 gene and the 159T/T genotype on the CD14 gene. CONCLUSIONS: This study purely investigated the association between periodontitis and one polymorphic site on both DEFB1 and CD14 gene, with the purpose of expanding knowledge for the future development in diagnostic markers or therapeutic interventions to combat this disease.

Association of matrix metalloproteinase (MMP)-1, 3, 9, interleukin (IL)-2, 8 and cyclooxygenase (COX)-2 gene polymorphisms with chronic periodontitis in a Chinese population.

Chronic periodontitis (CPs) could result in damage of periodontal tissues, loss of teeth and impose troublesome hindrance to restore teeth satisfyingly as well. Functional gene polymorphisms of matrix metalloproteinases, cytokines and cyclooxygenase-2 have been found to play important roles in periodontitis. This study was to investigate the association between MMP-1-1067, MMP-3-1171, MMP-9-1562, IL-2-330, IL-8-251, COX-2-765 polymorphisms, and the susceptibility to CP in a Chinese population. A total of 122 patients with CP were evaluated for MMP-1, MMP-3, MMP-9, IL-2, IL-8 and COX-2 genetic polymorphisms and were compared with 532 healthy control subjects using PCR-RFLP analysis. Clinical periodontal parameters were recorded. Serum levels of MMP-1, MMP-3, MMP-9, IL-2, IL-8 and COX-2 were measured by ELISA. The data were analyzed by chi-square, logistic regression and Mann-Whitney-U-tests and t test. There were significant differences between CP patients and healthy subjects in the genotype distribution and allele frequency of MMP-3-1171, MMP-9-1562, IL-2-330, IL-8-251 and COX-2-765 genetic polymorphisms. Significant difference between patients and controls were also observed for MMP-1-1067 genotype frequency, but not for allele frequency. Differences between rare allele carriage rates of CP and healthy groups regarding all the genetic polymorphisms in our study were significant (p<0.05). Serum levels of all the cytokines were higher in the CP patients compared to healthy subjects. These data show that MMP-1-1067, MMP-3-1171, MMP-9-1562 and IL-8-251 polymorphisms are associated with susceptibility to CP. MMP-1-1067 2G, MMP-3-1171 6A, MMP-9-1562 T and IL-8-251 A allele are associated with decreased susceptibility to CP in Chinese population.

Changes of occlusal plane inclination after orthodontic treatment in different dentoskeletal frames.

BACKGROUND: The inclination of the occlusal plane (OP) is related to facial types and experiences physiological growth-related changes. The aims of this research were to determine if there were any differences in the inclination of OP in subjects with three types of skeletal malocclusion and to investigate the characteristics and differences of functional occlusal plane (FOP) compared to bisected occlusal plane (BOP). METHODS: A sample of 90 Caucasians patients was skeletal-classified into three (n = 30), and pre- and post-treatment cephalograms were digitized. Six linear and 8 angular cephalometric measurements were selected. The changes of OP inclination within each group and the differences among the three groups pre- and post-treatment were compared with paired t test and ANOVA test, respectively. The comparison and correlation between BOP and FOP were analyzed with paired t test and coefficient of correlation, respectively. RESULTS: The BOP angle increased in all of the three groups but only had statistically significant differences in skeletal class II patients in a mean of 1.51° (p < 0.05). The FOP-SN angle showed stability (p > 0.05) in all three groups. The inclination of FOP was closely related to that of BOP (p < 0.001) but revealed discrepancies in each group. CONCLUSIONS: BOP and FOP were statistically significantly steeper in class II subjects compared to the other two groups both before and after treatment. The BOP angle statistically significantly increased by 1.51° in skeletal class II patients. BOP was a more reproducible reference plane compared to FOP during cephalometric tracing process, while FOP showed stability in orthodontically treated patients with all three skeletal patterns.

Update on cone beam technology and orthodontic analysis.

Orthodontics and cone beam computed tomography technology have evolved tremendously in the last 10 years. The technology has evolved from a predominantly diagnostic entity to a true clinical and translational product. One can believe that this technology is here to stay and it has a real role to revolutionize the efficiency and effectiveness of orthodontic care. This article discusses the current advancements and use of cone beam computed tomography.

Association of cytokines, high sensitive C-reactive protein, VEGF and beta-defensin-1 gene polymorphisms and their protein expressions with chronic periodontitis in the Chinese population.

PURPOSES: This study aimed at investigating the association between interleukin-6 (IL-6), interleukin-12 (IL-12), C-reactive protein (CRP), vascular endothelial growth factor (VEGF) and ß-defensin-1 polymorphisms and the susceptibility to periodontitis in the Chinese population. METHODS: DNA was extracted from the blood samples of 532 healthy individuals and 122 chronic periodontitis (CP) patients enrolled in the study. The genes encoding IL-6, IL-12, CRP, VEGF and ß-defensin-1 were amplified using PCR and digested with restriction enzymes. The protein expression of the abovementioned genes was determined by ELISA. Differences in the allele/genotype frequencies were assessed with the chi-square test. RESULTS: The frequencies of the C/C genotypes of IL-6, IL-12, and VEGF were higher in CP patients than healthy controls (66.3% vs 25.9%; 27.8% vs 19.9%; and 64.8% vs 52.1%, respectively). In the patients' group we also recorded frequencies of the A/A genotypes of CRP and VEGF higher than in healthy controls (63.1% vs 58.1% and 64.8% vs 35.2%, respectively). Protein production evaluated by ELISA demonstrated significant differences between CP patients and healthy controls for IL-6, IL-12, CRP, VEGF and ß-defensin-1. CONCLUSIONS: The genotypes of IL-6, IL-12, VEGF and ß-defensin-1 and their protein productions were associated with CP in a Chinese population. Genotypes and serum levels of CRP were associated with CP, but alleles frequency showed no difference between CP patients and healthy controls.

Application of interleukin-1 genes and proteins to monitor the status of chronic periodontitis.

It has been widely reported that periodontitis may lead to bone tissue and teeth loss and result in failure of prosthodontics or implants. Interleukin-1 (IL-1) is a potent proinflammatory cytokine that plays an essential role during the pathogenesis of periodontitis. However, the gene polymorphisms of IL-1α, IL-1ß and IL-1RN and the relationship between these protein expressions in healthy people and patients with chronic periodontitis (CP) in China have not been fully elucidated. We investigated the gene polymorphisms and protein expression of IL-1α, IL-1ß and IL-1RN in healthy subjects and CP patients, and our data suggest that these gene polymorphisms are associated with CP. The frequency of the C/C genotype of IL-1α was 55% in CP patients, while in the control group it was 20% (p<0.0001). The C/C genotype of IL-1ß was also higher in CP patients (51%) than in controls (21%) (p<0.0001). For the 2/2 genotype of IL-1RN, CP patients showed a 30% frequency, while in controls this was 15% (p<0.0001). Protein levels evaluated by enzyme-linked immunosorbent assay demonstrated a significant difference in secretion between patients and controls for IL-1α and IL-1ß. These results indicate that genotype and protein production of IL-1α, IL-1ß and IL-1RN are associated with CP in a Chinese population, and might be putative risk indicators for chronic periodontitis.

Comparative evaluation of cytokines in gingival crevicular fluid and saliva of patients with aggressive periodontitis.

OBJECTIVES: This study aims to evaluate and compare cytokines in gingival crevicular fluid (GCF) and saliva of patients with aggressive periodontitis (AP) before and after treatment. METHODS: Forty AP patients and 40 healthy volunteers were enrolled in this study. Clinical parameters included probing depth and sulcus bleeding index. GCF and saliva were collected from both groups. The levels of IL-1ß, IL-2, IL-4, IL-6, IFN-γ and TNF-α were measured using ELISA. RESULTS: The probing depth in AP patients was significantly deeper before treatment than after treatment. The concentrations of cytokines in GCF and saliva were significantly higher in AP patients than in the control group and decreased after periodontal treatment. Positive relationships were found between cytokine levels in GCF and clinical parameters. The reliability of cytokines in GCF and saliva was assessed by Cronbach's alpha analysis, which could be considered satisfactory. CONCLUSION: Cytokine levels in GCF and saliva correlated well with clinical parameters and AP. Measurements of cytokines in saliva may be regarded as a noninvasive and quick method for monitoring periodontal disease activity.

[Morphological and failure mode study of different fiber posts luted with different adhesive systems to root dentin].

OBJECTIVE: To investigate the correlation of morphological characteristics and failure modes of two types of glass-fiber posts luted with self-adhesive resin cement and etch-and-rinse adhesive system. METHODS: Thirty-six intact single-rooted premolars were collected and removed the crown. After root canal therapy, teeth were randomly divided into 4 groups. Group A: Self-adhesive with POPO fiber post. Group B: Etch-and-rinse with POPO fiber posts. Group C: Self-adhesive with Para Post. Group D: Etch-and-rinse with Para Post. Each root was sectioned into six 1 mm-thick serial slices and a push-out test was performed. The dentin-cement-post adhesive interface of each specimen and failure modes after fracture were evaluated by stereomicroscope observation. RESULTS: Interface morphology observe indicated that voids present in group B (64.2%) and D (66.7%) were significantly higher than group A (5.8%) and C (13.7%) (P < 0.001). Interface gaps appeared at the resin-dentine interface in group D (41.2%) were significantly higher than group A (13.5%) and C (11.8%) (P < 0.0083), and the failure modes in each group were significantly different (P < 0.0083) except for group A and B (P = 0.69). CONCLUSION: Voids present in cement layer were associated with the luting agent involved. Morphological characteristics of the fiber post-resin luting agent-root dentin adhesive interface were discrepant with failure modes in different root region. There were interaction between adhesive systems and fiber posts.