Cytokine levels in the gingival crevicular fluid and their association with periodontal status of down syndrome patients: a cross-sectional study.

OBJECTIVE: To evaluate cytokine levels of interleukin (IL)-1ß, IL-4, IL-6, IL-17a, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ in the gingival crevicular fluid (GCF) of periodontal sites in individuals with Down syndrome (DS) and analyze their relationship with clinical periodontal parameters. MATERIALS AND METHODS: A cross-sectional study was conducted with 49 DS patients and 32 individuals without DS (non-DS group). Periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP), and visible plaque index (VPI) were evaluated. The periodontal sites were classified as shallow, moderate, and deep. GCF was collected in all shallow sites and, when present, in moderate and deep sites for the analysis of cytokine levels. The cytokines, IL-1ß, IL-4, IL-6, IL-17a, TNF-α, and IFN-γ, were quantified using the Luminex® automatic analyzer system. RESULTS: The DS group presented greater severity of periodontitis compared to the non-DS group (P = 0.005). The DS group showed a significant direct correlation of IL-1ß and an inverse correlation of IFN-γ and IL-14 with all periodontal variables. In the analysis stratified by periodontal pocket depth, we observed a higher level of IFN-γ, IL-17a, IL-1ß, and IL-6 in the shallow sites, and IL-17a, IL-1ß, and IL-6 in deep pockets of DS group individuals. Multivariate models showed that higher levels of IL-1ß, IL-4, IL-6, and IL-17a were associated with Down syndrome even after adjusting for periodontal status, sex, and age. CONCLUSION: The findings suggest that people with DS have greater periodontal impairment and higher levels of cytokines in GCF, even in sites having clinical periodontal parameters similar to those of individuals without DS. These data reiterate the concept of an altered and less effective immune response in the population with DS in the face of a periodontal microbial challenge. CLINICAL RELEVANCE: Elevated periodontal inflammation burden can be observed with higher cytokine levels in the gingival crevicular fluid of people with Down syndrome, especially IL-1, IL-4, IL-6, and IL-17, regardless of the stage of periodontitis.

Identifying metabolic parameters related to severity and extent of periodontitis in down syndrome patients.

BACKGROUND AND OBJECTIVE: Systemic metabolic status and periodontitis can be related in patients with Down syndrome (DS). The objective of this study was to identify metabolic indicators (anthropometric measurements, blood pressure, and serum markers) related to severity and extent of periodontitis in DS patients. METHODS: A cross-sectional study was conducted with 49 patients with DS. Periodontal evaluation included the periodontal probing depth (PPD), clinical attachment level (CAL), gingival bleeding index (GBI), and visible plaque index (VPI). Periodontitis severity was classified by the stages system. The extent of periodontitis was assessed as the percentage of sites with CAL ≥3 mm, CAL ≥4 mm, PPD ≥4 mm, and PPD ≥5 mm. The metabolic condition of the participants was determined by analyzing anthropometric parameters, blood pressure, and serum markers. Data were analyzed using the Mann-Whitney test, Spearman's correlation coefficient, and multivariate regression analysis. RESULTS: Periodontitis stage 3/4 was detected in 32.7% of patients, with high values of VPI (54.6 ± 35.8) and GBI (42.4 ± 33.3). The severity of periodontitis was related to higher mean corpuscular hemoglobin (ß = .291, p = .028) and mean corpuscular volume values (ß = .293, p = .046). Arm circumference measurements were inversely related to CAL ≥3 mm (ß = -.408, p = .023), PPD ≥4 mm (ß = -.475, p = .006), and PPD ≥5 mm (ß = -.443, p = .010). CONCLUSIONS: The findings suggest that the severity and extent of periodontitis may be related to some metabolic parameters in DS patients.

Oral and maxillofacial biopsied lesions in Brazilian pediatric patients: a 16-year retrospective study / Biópsias de lesões orais e maxilo-faciais em pacientes pediatricos brasileiros: estudo retrospectivo de 16 anos

PURPOSE: To survey oral and maxillofacial lesions biopsied in a Brazilian pediatric hospital. METHODS: Biopsy records over a 16-year period (1992-2008) were retrieved from the files of the Anatomy and Pathology Service, Hospital Presidente Dutra, Federal University of Maranhão, Brazil. Pediatric cases patients aged 16 years old or younger were selected. Oral and maxillofacial diagnoses were grouped into 10 categories, and lesions were evaluated for age, gender, anatomic location and pathological diagnosis. Data were analyzed using descriptive statistics. RESULTS: Of a total of 3,550 pediatric biopsies, 88 cases (2.48 percent) were located in oral or maxillofacial sites. Similar incidence rates were observed between the genders and the prevalence of lesions was highest in the permanent dentition period (>12-16 years old). Maxilla was the most commonly affected anatomic location. As regards the diagnostic categories, the highest number of lesions was in the hyperplastic/reactive category. The most frequently encountered lesions were inflammatory fibrous hyperplasia and mucocele. Malignant lesions were rarely described. CONCLUSION: This study shows a similar trend to that reported in previous studies on the most frequent oral and maxillofacial lesions found in the pediatric population. The majority of lesions detected were benign, and malignant lesions were diagnosed in a very low number of patients.

OBJETIVO: Realizar levantamento das lesões orais e maxilo-faciais biopsiadas em um hospital pediátrico brasileiro. METODOLOGIA: Biópsias registradas ao longo de um período de 16 anos (1992-2008) foram recuperadas dos arquivos do Serviço de Anatomia e Patologia do Hospital Presidente Dutra, Universidade Federal do Maranhão, Brasil. Pacientes com até 16 anos de idade foram selecionados. Os diagnósticos de lesões orais e maxilo-faciais foram agrupados em 10 categorias e as lesões foram avaliadas quanto a idade, sexo, localização anatômica e diagnóstico. Os dados foram analisados usando estatística descritiva. RESULTADOS: De um total de 3.550 biópsias registradas, 88 casos (2,48 por cento) estavam localizadas na região oral ou maxilo-facial. Taxas de incidência similares foram observadas entre os sexos e a prevalência de lesões foi maior na dentição permanente (> 12-16 anos). A maxila foi a localização anatômica mais acometida. Quanto às categorias de diagnóstico, o maior número de lesões foi encontrado na hiperplásica/reativo. As lesões mais freqüentemente encontradas foram a hiperplasia fibrosa inflamatória e mucocele. Lesões malignas foram raramente descritas. CONCLUSÃO: Este estudo mostra uma tendência semelhante à relatada em estudos anteriores sobre as lesões mais freqüentes na região oral e maxilo-facial na população pediátrica. A maioria das lesões detectadas foram benignas, enquanto as malignas foram diagnosticadas em um número muito reduzido de pacientes.