Catechol-Modified and MnO2-Nanozyme-Reinforced Hydrogel with Improved Antioxidant and Antibacterial Capacity for Periodontitis Treatment.

Periodontitis is an inflammatory disease characterized by tooth loss and alveolar bone resorption. Bacteria are the original cause of periodontitis, and excess reactive oxygen species (ROS) encourage and intensify inflammation. In this study, a mussel-inspired and MnO2 NPs-reinforced adhesive hydrogel capable of alleviating periodontitis with improved antibacterial and antioxidant abilities was developed. The hydrogel was created by combining polyvinyl alcohol (PVA), 3,4-dihydroxy-d-phenylalanine (DOPA), and MnO2 nanoparticles (NPs) (named PDMO hydrogel). The hydrogel was demonstrated to be able to scavenge various free radicals (including total ROS─O2•- and OH•) and relieve the hypoxia in an inflammatory microenvironment by scavenging excess ROS and generating O2 due to its superoxide dismutase (SOD)/catalase (CAT)-like activity. Besides, under 808 nm near-infrared (NIR) light, the photothermal performance of the PDMO hydrogel displayed favorable antibacterial and antibiofilm effects toward Escherichia coli, Staphylococcus aureus, and Porphyromonas gingivalis (up to nearly 100% antibacterial rate). Furthermore, the PDMO hydrogel exhibited favorable therapeutic efficacy in alleviating gingivitis in Sprague-Dawley rats, even comparable to or better than the commercial PERIO. In addition, in the periodontitis models, the PDMO2 group showed the height of the residual alveolar bone and the smallest shadow area of low density among other groups, indicating the positive role of the PDMO2 hydrogel in bone regeneration. Finally, the biosafety of the PDMO hydrogel was comprehensively investigated, and the hydrogel was demonstrated to have good biocompatibility. Therefore, the developed PDMO hydrogel provided an effective solution to resolve biofilm recolonization and oxidative stress in periodontitis and could be a superior candidate for local drug delivery system in the clinical management of periodontitis with great potential for future clinical translation.

[Locally delivered macrolides as an adjunct to non-surgical periodontal treatment of chronic periodontitis: a meta analysis].

PURPOSE: The present meta analysis was designed to determine the effects of macrolides group of antibiotics as local drug delivery agents to scaling and root planing (SRP), compared with SRP alone or plus placebo. METHODS: Electronic and manual literature searches were conducted to select randomized controlled trials (RCTs) comparing SRP + macrolides versus SRP alone using the following databases: PubMed, Cochrane Library, Science Direct, EMbase, CNKI, Wanfang database and VIP data until August 2018. Two reviewers independently extracted the data and evaluated the methodological quality of the included studies. RevMan 5.3 was applied for meta analysis. RESULTS: Seven papers were obtained, which included 439 patients with chronic periodontitis.Meta analysis showed that in the two groups, the changes in probing depth（PD）[MD=0.77, 95%CI(0.48-1.05), P<0.00001], clinical attachment loss（CAL）[MD=0.74, 95%CI(0.39-1.10), P<0.0001],plaque index（PI）[MD=0.30, 95% CI(0.17-0.43), P<0.00001]，modified sulcus bleeding index (mSBI)[MD=0.23, 95%CI(0.15-0.32), P<0.00001]at 3 month and 6 month of PD[MD=1.15, 95%CI(0.41-1.89), P=0.002] were significantly different, the difference of CAL[MD=0.92, 95%CI(0.43-1.40), P=0.0002], PI[MD=0.51, 95%CI(0.07-0.95), P=0.02] and mSBI[MD=0.18, 95%CI(0.07-0.29), P=0.002] was also significant (P<0.05). CONCLUSIONS: SRP combined with local macrolides adjuvant treatment for chronic periodontitis is effective in short-term observation.

Association Between Toothbrushing and Behavioral Risk Factors of Non-communicable Diseases: A population Based Survey of 4500 adults in China.

Non-communicable Disease (NCD) related behavioral risk factors (BRF) plays a crucial role in NCD prevention, as does oral hygiene behavior in oral health promotion. We examined the association between NCD BRF and toothbrushing using data from a population-based survey, which recruited 4485 adults aged 18+ years, in Chongqing city, China. Prevalence of five NDC BRF and their clustering within individual were determined by toothbrushing frequency. Ordinal logistic regression examined the association between toothbrushing and BRF clustering. Prevalence of current smoking, insufficient intake of vegetable and fruit, and harmful use of alcohol increased significantly with toothbrushing frequency. Respondents who brushed teeth ≥2 times daily consumed more red meat than those with less frequent toothbrushing. Relative to those with no BRF, the adjusted cumulative odds ratio of brushing teeth less frequently was 2.1 (95% CI: 1.4-3.1) for respondents with 3+ BRF. The adjusted cumulative odds ratio was 1.5 (1.1-2.1) and 1.4 (1.0-1.8) for those who had two BRF and those who had one, respectively. Significant correlation between toothbrushing and NCD BRF implied that integrated intervention strategy involving the both may be beneficial in public health programs targeting at either oral health or NCDs, or both.

[Platelet-rich plasma combined with demineralized freeze-dried bone allografts for periodontal regeneration in the treatment of periodontal defects: a meta-analysis].

PURPOSE: The aim of this meta analysis was to assess the influence of platelet-rich plasma (PRP)combined with demineralized freeze-dried bone allografts(DFDBA) on regeneration of periodontal periodontal defects by means of evaluating clinical and radiographic outcomes in prospective human clinical trials. METHODS: The following databases such as PubMed, The Cochrane Library, EMbase, CNKI, Wanfang data and VIP data were searched on computer from inception to December, 2016. According to the inclusion and exclusion criteria, two reviewers independently extracted the data，assessed the methodological quality of the included studies. RevMan 5.2 was applied for meta analysis. RESULTS: Six papers were obtained reviewed which included 205 periodontal bone defect sites. Six articles showed that there was no significant difference in probing depth decrease between PRP combined with DFDBA and PRP or DFBDA group[MD=0.35, 95%CI（-0.09，0.79), P=0.12], but there was significant difference in clinical attachment loss increase between the two groups［MD= 0.68，95%CI（0.41，0.94），P<0.00001]. Three articles were included for evaluating bone filling, there was significant difference in the distance from the cemento-enamel junction(CEJ) to the vertical bone defect(BD)(CEJ-BD)[MD=0.71，95%CI（0.46，0.95），P<0.00001]between the two groups; there was also significant difference in the distance from the alveolar crest to the vertical bone defect(AC-BD)[MD=0.64，95%CI（0.41，0.87)，P<0.00001]between the two groups. but there was no significant difference in the distance from the cemento-enamel junction(CEJ)to the alveolar crest (AC)(CEJ-AC)[MD=0.03，95%CI（-0.10，0.16），P=0.68] between the two groups. CONCLUSIONS: Within the limitations of this meta analysis, PRP combined with DFDBA is superior to PRP or DFDBA alone in clinical attachment loss and bone filling ,but there was no significant difference in probing depth. However, given the limited sample size and quantity of included studies, the above findings still need to be further proved by conducting more high-quality and large-scale RCTs.

Impact on the upper airway space of different types of orthognathic surgery for the correction of skeletal class III malocclusion: A systematic review and meta-analysis.

OBJECTIVE: This study is aimed at assembling, through a systematic review and meta-analysis, scientific evidence related to the effects of mandibular setback (MdS) surgery and bimaxillary surgery for the correction of Class III malocclusion on the cross-sectional area (CSA) and volume of the upper airway as assessed using CT. METHODS: An electronic search was conducted on Cochrane Library, EMBASE, PubMed, Scopus and Web of Science up to June 20, 2016. The inclusion criteria were prospective or retrospective studies, with the aim of comparing the impact on the upper airway space of orthognathic surgery for the treatment of the skeletal class III malocclusion. The methodological index for non-randomized studies (MINORS) was chosen as the evaluation instrument and Revman5.3 was used for the meta-analysis. RESULTS: A total of 1213 studies were retrieved, of which only 18 met the eligibility criteria. The results of meta-analysis showed that the mean decrease in the upper airway volume after MdS surgery was 3.24 cm3 [95%CI (-5.25,-1.23), p = 0.85]; the mean decrease in minimum CSA after a combined surgery of maxillary advancement with mandibular setback (MdS + MxA) was 27.66 mm2 [95%CI (-52.81,-2.51), p = 0.51], but there was no significant decrease in upper airway volume (mean 0.86 cm3); comparison between MdS + MxA and isolated MdS showed significant differences in the CSA of the posterior nasal spine plane (PNS) and epiglottis plane (EP); statistically significant differences in nasopharynx volume (P < 0.0001) and upper airway total volume (P = 0.002) were observed, but no statistically meaningful variations existed in oropharynx volume (P = 0.08) and hypopharynx volume (P = 0.64). CONCLUSION: The results of this study suggest that bimaxillary surgery promotes less decrease on the upper airway than mandibular setback surgery alone for the correction of the skeletal class III malocclusion.

[Clinical significance of calcitonin gene-related peptide level before and after treatment in patients with chronic periodontitis].

PURPOSE: To explore the clinical significance of calcitonin gene-related peptide (CGRP) levels in patients with chronic periodontitis before and after treatment, and to detect the calcitonin gene-related peptide content in human venous blood. METHODS: Thirty healthy controls and thirty patients with mild, moderate, severe periodontitis were enrolled from August 2014 to June 2015.CGRP level in the patients' peripheral blood was detected by ELISA. Three months after periodontal treatment, CGRP level in mild, moderate, severe periodontitis patients' peripheral blood was re-examined by ELISA. Then the correlation between calcitonin gene-related peptide and inflammation of chronic periodontitis was analyzed with SPSS 22.0 software package. RESULTS: The content of CGRP in healthy controls was significantly higher than that in patients with periodontitis. With the aggravation of periodontal inflammation, blood level of CGRP decreased gradually, and the lowest was in patients with severe periodontitis (P<0.01). Three months after periodontal treatment, CGRP content was significantly higher compared with that before treatment (P<0.05), but no significant difference was found in patients with different degree of periodontitis (P>0.05). CONCLUSIONS: The level of CGRP in venous blood decreased with the increasing severity of chronic periodontitis, and CGRP was negatively correlated with the degree of inflammation of chronic periodontitis. CGRP may be involved in the occurrence and development of chronic periodontitis. CGRP content in serum of patients with chronic periodontitis after treatment was significantly increased, CGRP may be used as the basis for clinical detection of chronic periodontitis.

Porphyromonas gingivalis lipopolysaccharide increases lipid accumulation by affecting CD36 and ATP-binding cassette transporter A1 in macrophages.

Porphyromonas gingivalis lipopolysaccharide (P. gingivalis LPS) promotes macrophage-derived foam cell formation, however, the mechanisms are not well established. In macrophages, lipid uptake is mediated by scavenger receptors including SR-A and CD36, while the cholesterol efflux is mediated by ATP-binding cassette transporter G1 (ABCG1), ABCA1 and SR-BI. We further investigated the mechanisms underlying the dysregulation by P. gingivalis LPS of these regulators resulting in the promotion of lipid accumulation in THP-1-derived macrophages. Our results showed that P. gingivalis LPS exacerbated lipid accumulation in oxidized low-density lipoprotein (oxLDL)-treated macrophages. However, cholesterol efflux was inhibited by P. gingivalis LPS in THP-1-derived macrophages. In oxLDL-untreated macrophages, P. gingivalis LPS treatment caused an increase in CD36 mRNA and protein levels, and a decrease in ABCA1 mRNA and protein levels, while having no effect on SR-A, SR-BI or ABCG1 expression. Upregulation of CD36 by P. gingivalis LPS resulted from activation of c-Jun/AP-1, and this was confirmed by the inhibition of increased CD36 expression after AP-1 inhibition using SP600125. However, the decreased protein stability of ABCA1 by P. gingivalis LPS was a result of increased calpain activity. Moreover, small hairpin RNA (shRNA) targeting heme oxygenase-1 (HO-1) augmented the P. gingivalis LPS-induced atherogenic effects on the expression of c-Jun/AP-1, CD36, ABCA1 and calpain activity. Accordingly, P. gingivalis LPS-regulated promotion of lipid accumulation in foam cells was also exacerbated by HO-1 shRNA. These results indicate that P. gingivalis LPS confers a exacerbation effect on the formation of foam cells by a novel HO-1-dependent mediation of cholesterol efflux and lipid accumulation in macrophages.