The relationships of inflammatory blood markers with maternal periodontal and dental states and their effects on preterm membrane rupture development.

BACKGROUND: The influence of maternal oral and dental health on the occurrence of Preterm Premature Rupture of Membranes (P-PROM) and its underlying mechanisms remain uncertain. This research seeks to investigate the impact of maternal oral and dental health on the incidence of P-PROM and its association with inflammatory markers in the blood. METHODS: This study adopts a prospective case-control design methodology. The study involved 70 women diagnosed with P-PROM and delivered by an obstetrician and 79 women who had healthy deliveries with no prenatal complications. The values for DMFT (Number of decayed, missing and filled teeth) index, Gingival Index (GI), Plaque index (PI), Pocket depth (PD), Clinical attachment loss (CAL) and medical history were recorded. Mann-Whitney U test and hierarchical binomial logistic regression analysis were applied. It was considered statistically significant at p < 0.05. RESULTS: The case group's DMFT, PI, GI, PD values were statistically significantly higher than the control group (p < 0.001). There was no relationship between DMFT, GI, PD, CAL and inflammatory blood markers (p > 0.05). In the regression analysis for possible risk factors that may be effective in P-PROM, oral and dental health parameters were the most effective. CONCLUSIONS: Oral and dental health of women with P-PROM was found to be worse than that of the control group. Oral and dental health may be a potential risk factor that may contribute to adverse pregnancy outcomes associated with P-PROM.

Serum and salivary ferritin and Hepcidin levels in patients with chronic periodontitis and type 2 diabetes mellitus.

BACKGROUND: Iron disorder and abnormal expression of hepcidin play important roles in many diseases, but it is still unclear in chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). We aimed to assess ferritin and hepcidin levels in serum and saliva of CP patients with or without T2DM. METHODS: Serum and unstimulated whole saliva samples were collected from 88 participants, who were categorized into 4 groups based on the presence or absence of CP or T2DM. Demographics and general health parameters were recorded. Full-mouth clinical periodontal parameters including probing pocket depth, clinical attachment loss, bleeding index, and plaque index were recorded. Chemiluminescence microparticle immunoassay and enzyme-linked immunosorbent assay were used to detect ferritin and hepcidin concentrations, respectively, in serum and saliva. RESULTS: Serum ferritin and hepcidin levels in the CP and CP with T2DM groups were higher than in the control group (P < 0.05). Serum hepcidin and serum ferritin are linear correlated (P < 0.001). Serum hepcidin/ferritin values in the CP with T2DM group were significantly lower than those in the T2DM and control groups. Moreover, salivary ferritin levels in the CP and T2DM groups were higher than those in the control group (P < 0.05). There was positively correlation between salivary ferritin and serum ferritin (P = 0.017). Hepcidin concentrations were relatively low in saliva. CONCLUSIONS: These results suggest that iron overload and hepcidin inadequacy existed in CP with T2DM patients. Salivary ferritin might provide a reference for body iron load. TRIAL REGISTRATION: ChiCTR-ROC-17012780.

Total and Differential Leukocyte Counts in the Peripheral Blood of Patients with Generalised Aggressive Periodontitis.

PURPOSE: To compare the total and differential leukocyte counts in the peripheral blood of generalised aggressive periodontitis patients with that of periodontally healthy subjects in a central Indian population. MATERIALS AND METHODS: Seventy-five patients with generalised aggressive periodontitis and 63 periodontally healthy subjects were enrolled for the purpose of the study. All participants received a full-mouth periodontal examination in which probing depth and clinical attachment level were recorded. The haematological variables analysed included total leukocyte count, neutrophil count, lymphocyte count, monocyte count, neutrophil percentage, lymphocyte percentage, monocyte percentage and platelet count. RESULTS: The patient group showed a significantly higher total leukocyte count (7.62 ± 1.70 x 109 cells/l, p = 0.008), neutrophil count (5.06 ± 1.47x109 cells/l, p < 0.001) and neutrophil percentage (70.61 ± 8.73, p < 0.001), as well as a significantly lower lymphocyte count (1.82 ± 0.65 x 109 cells/l, p = 0.002) and lymphocyte percentage (26.55 ± 8.05, p < 0.001) compared to the control group. Logistic regression analyses showed significant associations between aggressive periodontitis and elevated total leukocyte (p = 0.012) and neutrophil counts (p = 0.001). CONCLUSION: The findings of the present study suggest that patients with generalised aggressive periodontitis might also demonstrate a systemic inflammatory response, as evidenced by increased leukocyte counts. This systemic inflammatory response observed in patients with generalised aggressive periodontitis may be associated with an increased risk for cardiovascular diseases.

Low serum level of 1,25(OH)2 D is associated with chronic periodontitis.

BACKGROUND AND OBJECTIVES: Vitamin D has been studied primarily for its involvement in calcium and phosphate absorption and bone metabolism. The active form of vitamin D-1,25(OH)2 D-has also been investigated for its immune modulatory properties. We explored associations between serum levels of 25(OH)D and 1,25(OH)2 D and periodontal health. SUBJECTS AND METHODS: This case-control study included 55 subjects with chronic periodontitis (cases) and 30 periodontally healthy subjects (controls). Their serum levels of 25(OH)D, 1,25(OH)2 D, ultrasensitive C-reactive protein and high-density lipoprotein cholesterol were determined. Associations between vitamin D and periodontal health status were studied using logistic regression analysis. RESULTS: A statistically significant association was found between serum 1,25(OH)2 D level and periodontal health status; in that subjects with a low 1,25(OH)2 D were more likely to belong to the periodontitis group (OR = 0.97, 95% CI = 0.95-1.00). There was practically no association between 25(OH)D level and periodontal health status. CONCLUSION: In this case-control study low serum 1,25(OH)2 D level appeared to be associated with periodontitis, which was in line with the previously reported associations between serum 1,25(OH)2 D levels and other inflammatory diseases. Whether this association is causal in nature, remains to be confirmed in future studies.

Effect of non-surgical periodontal therapy on plasma homocysteine levels in Indian population with chronic periodontitis: a pilot study.

AIM: Homocysteine (Hcy) is implicated in the development of cardiovascular diseases (CVD). The effect of periodontal disease and periodontal therapy on plasma Hcy remains controversial. Hence, in this pilot study we assessed the effect of periodontal disease and non-surgical periodontal therapy (NSPT) on plasma Hcy in systemically healthy Indian subjects. MATERIALS AND METHODS: Forty participants (30 to 39 years) were enrolled in the study and were divided into two groups based on gingival index, probing depth, and clinical attachment level (CAL): Healthy (control group; n = 20) and Chronic Periodontitis (test group; n = 20). Plasma samples were collected and quantified at baseline and 12 weeks after scaling and root planing (SRP) for Hcy using High Performance Liquid Chromatography with fluorescent detection (HPLC-fld). RESULTS: Plasma Hcy levels of chronic periodontitis (17.87 ± 1.21 µmol/l) subjects was significantly higher than healthy subjects (9.09 ± 2.11 µmol/l). Post-therapy, the plasma Hcy concentration reduced significantly (11.34 ± 1.87 µmol/l) (p < 0.05). CONCLUSION: The rise and descent of plasma Hcy levels with periodontal inflammation and therapy, respectively, indicate a direct relationship of Hcy with chronic periodontitis. NSPT may be employed as an adjunctive Hcy Lowering Therapy, contributing towards primary prevention against CVD's.

Local and serum levels of adipokines in patients with obesity after periodontal therapy: one-year follow-up.

AIM: This study evaluated the effects of scaling and root planing (SRP) on gingival crevicular fluid (GCF) and serum levels of adipokines in patients with chronic periodontitis (CP) with or without obesity. METHODS: Twenty patients with obesity and 20 patients without obesity, all with CP, received SRP. Serum and GCF levels of resistin, adiponectin, leptin, tumour necrosis factor [TNF]-α and interleukin [IL]-6 were evaluated by enzyme-linked immunosorbent assay at baseline, 3, 6 and 12 months post-therapy. RESULTS: SRP reduced the amounts of TNF-α in deep sites and increased the concentration of adiponectin in shallow sites of non-obese patients (p < 0.05). SRP increased the concentrations of TNF-α and leptin in patients with obesity (p < 0.05). GCF levels of TNF-α were higher in patients with obesity than in patients without obesity at all time-points (p < 0.05). There were no changes in serum levels of any adipokines for any group after therapy (p > 0.05). Patients with obesity exhibited higher serum levels of leptin at all time-points and IL-6 at 3 months post-therapy (p < 0.05). CONCLUSIONS: Obesity may modulate systemic and periodontal levels of adipokines in favour of pro-inflammation, independently of periodontal therapy. SRP did not affect the circulating levels of adipokines in patients with or without obesity.

The effects of periodontal therapy on serum and salivary leptin levels in chronic periodontitis patients with normal body mass index.

SUMMARY: Leptin concentrations are altered in favour of pro health after periodontal therapy. BACKGROUND: Leptin, a non-glycosylated peptide hormone, not only maintains fat stores, but is also an integral part of host defense repertoire. Leptin levels have been found to be altered in an array of inflammatory diseases including chronic periodontitis (CP), but the role of non-surgical periodontal therapy (NSPT) in altering the leptin concentrations in saliva and serum of CP patients is yet to be ascertained. The aim of the present study is to quantify leptin levels in CP patients having normal body mass index (BMI) pre-therapy as compared to periodontally healthy controls and to address whether successful NSPT alters leptin concentration in serum and saliva. MATERIALS AND METHODS: Twenty-two saliva (modified draining method) and serum samples (by venipuncture) were collected from CP patients with normal BMI (n = 22), before and at 4 and 12 weeks after completion of NSPT, and periodontally healthy, age- and gender-matched controls (n = 22). Leptin levels were estimated using enzyme linked immunosorbent assay kits. RESULTS: At baseline, CP patients had significantly different periodontal clinical parameters and the leptin concentrations in saliva of CP patients were found to be significantly lower than periodontally healthy volunteers (4710.10 ± 1133.21 vs 8721.10 ± 1019.58 pg/ml) (p < 0.05), whereas in serum the leptin concentrations were significantly higher than healthy controls (10749 ± 2062.24 vs 8085.00 ± 2859.68 pg/ml). Significant improvement in periodontal parameters, serum and salivary leptin levels were observed in CP patients at 4 and 12 weeks post-therapy (p < 0.01). CONCLUSION: Altered concentrations of leptin in serum and saliva are observed in CP patients which can be restored in favor of health after periodontal therapy.

Association of aggressive periodontitis with reduced erythrocyte counts and reduced hemoglobin levels.

BACKGROUND AND OBJECTIVE: Studies have shown that erythrocyte counts and hemoglobin levels are reduced in patients with chronic periodontitis, suggesting that this condition may be associated with anemia of chronic disease. Although increased leukocyte counts have been reported in aggressive periodontitis, very little is known about the effects of aggressive periodontitis on erythrocyte counts. The present study was undertaken to determine whether generalized aggressive periodontitis is associated with reduced erythrocyte counts and reduced hemoglobin levels. MATERIAL AND METHODS: The present study was conducted as a case-control study in which 64 patients with generalized aggressive periodontitis were categorized as cases and 58 periodontally healthy individuals were categorized as controls. Erythrocyte parameters (such as erythrocyte count, hemoglobin concentration, and hematocrit and erythrocyte indices) and clinical parameters (such as gingival index, plaque index, probing depth, clinical attachment level and percentage of severe sites) were recorded. RESULTS: Significant differences were observed between cases and controls in mean erythrocyte count (4.45 ± 0.6 × 10(6) erythrocytes/µL and 4.78 ± 0.56 × 10(6) erythrocytes/µL respectively, p = 0.002) and hemoglobin level (12.43 ± 1.83 g/dL and 13.53 ± 1.64 g/dL, respectively, p = 0.001). Other erythrocyte parameters, such as hematocrit, mean corpuscular volume and mean corpuscular hemoglobin, were also significantly lower among cases compared with controls. Logistic regression analyses showed that generalized aggressive periodontitis was significantly associated with lower erythrocyte counts ( p = 0.032) and a lower hemoglobin concentration ( p = 0.017). CONCLUSION: The findings of the present study suggest that patients with generalized aggressive periodontitis tend to have lower erythrocyte counts and lower hemoglobin levels compared with periodontally healthy controls. This suggests that generalized aggressive periodontitis, like chronic periodontitis, may be associated with a risk for anemia of chronic disease.

The impact of non-surgical periodontal treatment on serum levels of long chain-polyunsaturated fatty acids: a pilot randomized clinical trial.

BACKGROUND AND OBJECTIVE: Our group recently found higher levels of serum long chain-polyunsaturated fatty acids (LC-PUFAs) in patients with chronic periodontitis compared to controls. However, the effect of periodontal treatment on LC-PUFA serum levels has not been investigated. The primary aim of the present study was to investigate the impact of periodontal treatment on LC-PUFA serum levels. A secondary aim was to assess the effect of dietary ω-3 supplementation on clinical outcome. MATERIAL AND METHODS: The test group was composed of 10 patients with generalized chronic periodontitis (mean age 44 ± 6.4 years) treated with scaling and root planing associated with 4 mo of ω-3 supplementation eicosapetaenoic acid (EPA) plus docosahexaenoic acid (DHA), 3 g/d. The placebo group was composed of 11 patients (47.9 ± 10.5 years) that received scaling and root planing plus placebo. The periodontal examination included probing depth, clinical attachment level, bleeding on probing and visible plaque index. Docosapentaenoic acid (DPA), EPA, DHA and arachidonic acid (AA) were detected using gas chromatograph. RESULTS: In the placebo group, all LC-PUFAs levels reduced significantly (DHA, DPA and AA, p = 0.004; EPA, p = 0.008). In the test group, only DPA and AA showed a significant reduction (p = 0.005). Moreover, a significant decrease in the ratios AA/EPA and AA/DHA (p = 0.005) was observed in the test group. CONCLUSION: Non-surgical periodontal treatment reduced significantly the serum levels of all analyzed LC-PUFAs except those presented in the supplementation. The ω-3 dietary supplementation had no effect on clinical outcome of treatment.

Is obesity a possible modifier of periodontal disease as a chronic inflammatory process? A case-control study.

BACKGROUND AND OBJECTIVE: This cross-sectional case-control study was conducted to provide a comparative evaluation of clinical periodontal measurements, together with serum levels of certain bioactive peptides and inflammatory cytokines, in relation to obesity. For this purpose, clinical periodontal measurements and the levels of serum leptin, adiponectin, interleukin-6 (IL-6), C-reactive protein and soluble intercellular adhesion molecule-1 of obese female individuals and their nonobese counterparts were compared. MATERIAL AND METHODS: Sixty obese (body mass index (BMI) > 30) and 31 nonobese (BMI < 30) female subjects were recruited for the present study. Before any periodontal intervention, serum samples were obtained and full-mouth clinical periodontal measurements were recorded at six sites per tooth. ELISA was used for the biochemical analysis. Data were tested statistically. RESULTS: Clinical attachment level was significantly higher in the obese group compared with the nonobese control group (p < 0.05). Serum levels of leptin and IL-6 were significantly higher in the obese group (p < 0.05). BMI correlated with the serum levels of inflammatory molecules (p < 0.05), but not with clinical periodontal parameters, in the obese group. CONCLUSION: In conclusion, obesity does not seem to have a prominent effect on clinical periodontal parameters but it does have many correlations with circulating inflammatory molecules. As suggested in the literature, increased levels of leptin and IL-6 in the obese group might be one explanation for a possible relationship between obesity and periodontal disease. A prospective study is warranted to clarify, in greater detail, the effects of obesity on periodontal health.

Role of cytokines in development of pre-eclampsia associated with periodontal disease - Cohort Study.

AIM: The present study was designed to find any association of cytokines in women with periodontal disease and development of pre-eclampsia in North Indian population. MATERIALS AND METHODS: A total of 504 consecutively registered primigravida with a single live pregnancy were recruited at 14-18 weeks of gestation from antenatal clinic of Maulana Azad Medical College & associated Lok Nayak Hospital and Maulana Azad Institute of Dental Sciences, New Delhi. One periodontist performed oral health examination of all patients at inclusion into study. Blood samples were collected to measure the level of cytokines IL-4, IL-10, TNF-α and IFN-γ. RESULTS: The profile of blood levels of cytokines from women with periodontal disease was observed. The log serum levels of TNF-α & IL-4 at 16-18 weeks of gestation were significantly higher in women with periodontal disease (4.13 ± 2.06; 0.47 ± 1.56 pg/ml respectively) than in women with healthy gums (2.16 ± 1.51; 0.02 ± 1.84 pg/ml respectively, p < 0.001). Periodontal disease is associated with log serum TNF-α levels at cut-off ≥14.43 pg/ml at sensitivity 71.2% and specificity 62% (OR = 4.04; 95%CI = 2.77-5.87). Woman with periodontal disease who later developed pre-eclampsia had lower levels of TNF-α (3.72 ± 1.33 pg/ml) than those with periodontal disease who did not develop pre-eclampsia (4.20 ± 2.15 pg/ml, p ≥ 0.05). CONCLUSION: Reduced TNF-α level secretion in the early second trimester in women with periodontal disease appears to be associated with the development of pre-eclampsia.

Periodontal status and serum biomarkers levels in haemodialysis patients.

AIM: To investigate the association between periodontal status and serum biomarkers levels in haemodialysis patients. METHODS: This cross-sectional study included 96 haemodialysis patients. The periodontal evaluation was realized using clinical attachment level (CAL), probing depth (PD), gingival bleeding index (GBI), visible plaque index (VPI) and gingival index (GI). Biochemical and haematological data - serum albumin, phosphorus, creatinine, transferrin, ferritin, iron, alkaline phosphatase, calcium, potassium and haemoglobin - were collected from the medical records. The subject was diagnosed with periodontitis if he/she had at least two inter-proximal sites in different teeth with CAL ≥4 mm and/or at least two inter-proximal sites in separate teeth with PD ≥5 mm. RESULTS: The study population consisted of 45 men and 51 women, with mean time under haemodialysis of 45.6 ± 33.1 months. Periodontitis was observed in 59.4% of the subjects. The periodontitis group had albumin (p = 0.021) and phosphorus (p = 0.024) serum levels lower than the no periodontitis group. Thus, there was a positive association of periodontitis with hypoalbuminaemia (OR = 9.10, p = 0.006) and a negative association with hyperphosphataemia (OR = 0.21, p = 0.010). CONCLUSIONS: These findings suggest that periodontitis is associated with albumin and phosphorus serum levels in haemodialysis patients.

Evaluation of the effects of periodontal treatment on levels of ascorbic acid in smokers.

Smokers consistently have lower levels of vitamin C, which is important for optimal healing, especially following invasive procedures. Some studies demonstrated that patients undergoing surgery experience significant reductions in systemic vitamin C levels, presumably due to higher metabolic utilization of existing vitamin pools. However, there appear to be no studies evaluating the effect of non-surgical periodontal therapy on plasma levels of vitamin C. The aim of this study was to evaluate if non-surgical periodontal therapy is able to reduce the plasmatic level of ascorbic acid (AA) in smokers. Twenty-six systemically healthy adult (> 40 years) smokers (10 cigarettes/day for > 5 years) who needed scaling and root planing (SRP) for chronic periodontitis were recruited. The sessions of SRP (per quadrant) were scheduled 7 days apart from each other. Blood was collected by venipuncture before the first session of SRP and at the end of the periodontal treatment. The ascorbate concentrations in plasma were assessed according to a published protocol. A paired t-test (p < 0.05) evaluated the statistical significance of differences between the mean values obtained pre- and post-treatment. In general, there was no significant change in levels of AA; however, in 38% of patients, increased levels of AA in plasma were observed after SRP. In 15% of the patients, no change was noted, while 47% of patients showed a reduction in levels of AA after SRP. It can be concluded that although almost half of individuals presented with reduced levels of ascorbic acid after treatment, SRP did not significantly change the levels of AA in smokers.

Elevation of vitamin D-binding protein levels in the plasma of patients with generalized aggressive periodontitis.

BACKGROUND AND OBJECTIVE: Vitamin D-binding protein (DBP) is a multifunctional and highly expressed plasma protein. Among its diverse roles, including those in the immune and inflammatory responses, it is the primary carrier of vitamin D, which has been implicated in periodontitis. We hypothesized that there is a correlation between systemic DBP levels and generalized aggressive periodontitis (GAgP). MATERIAL AND METHODS: Forty-four patients with GAgP and 32 healthy controls were recruited. Clinical parameters were examined, including the mean bleeding index, probing depth, attachment loss and percentage of severely affected sites. Blood chemistry analyses were performed for each subject. Plasma levels of DBP, interleukin-6 (IL-6) and procalcitonin (PCT) were measured using ELISAs, and plasma levels of 25-hydroxy-vitamin D(3) (25(OH)D(3)) were detected using a radioimmunoassay. RESULTS: Significantly higher levels of plasma DBP, IL-6, PCT and 25(OH)D(3), as well as leukocyte counts, neutrophil counts and neutrophil percentages were found in patients with GAgP compared with healthy controls (p < 0.05 for all). Multiple linear regression analysis showed that the plasma DBP levels were significantly correlated with GAgP, plasma PCT levels and smoking status (p < 0.05 for all). In the GAgP group, the plasma DBP levels in smokers were significantly higher than those in nonsmokers (p < 0.001). CONCLUSION: Elevated plasma vitamin DBP levels are associated with GAgP.

Serum osteoprotegerin and periodontal destruction in subjects with type 1 diabetes mellitus.

AIM: Besides their role in bone metabolism, receptor activator of nuclear factor-kappaB ligand (RANKL) and osteoprotegerin (OPG) are also known to be associated with inflammation. We explored associations between the extent/severity of periodontitis and circulating levels of sRANKL and OPG and their ratio using a cross-sectional study design. SUBJECTS & METHODS: The extent of periodontal inflammation and tissue destruction and the serum levels of sRANKL (pg/ml) and OPG (pg/ml) were determined in 80 subjects with type 1 diabetes mellitus (T1DM). Plaque-, age-, gender-, smoking-, HbA1c- and body mass index-adjusted associations between periodontal parameters and serum sRANKL, OPG and their ratio were studied using multiple linear regression analysis. RESULTS: Adjusted regression analyses of all the subjects indicated a significant positive association between AL ≥ 4 mm and severity of periodontitis and the level of serum OPG. A major drop in the strength and statistical significance of the above association was observed when the analyses included only non-smokers. Serum sRANKL level and sRANKL/OPG ratio were not associated with periodontitis. CONCLUSION: Our observations suggest that serum OPG may be an indicator of periodontal tissue destruction in T1DM.

[Effects of dental health awareness and behaviours on the glycemic metabolic characteristics and periodontal disease of patients with type 2 diabetic].

OBJECTIVE: To analyze the effects of dental health awareness and behaviours on the relationship between glycemic metabolic characteristics and periodontal disease of type 2 diabetic patients. METHODS: In the study, 83 subjects with type 2 diabetes mellitus were recruited. The clinical periodontal indexes, such as pocket probing depth (PPD), attachment loss (AL), modified bleeding index (mBI), plaque index (PLI) were obtained with a Williams type periodontal probe; Laboratory examinations including glycosylated haemoglobin A1(HbA1C) were made, glucose assay tested, and the structured questionnaire interview conducted evaluationg the knowledge, attitude and practice (KAP) about periodontal health. RESULTS: The prevalence of moderate and severe periodontitis was 67.5%, compared with mild periodontitis, whose severities were affected by the higher level of HbA1C (≥8.0%) (OR 54.1-143.1), followed by using glycemic drug (OR=12.9-44.6), stress (OR=16.9-29.6), and the dissatisfaction with diabetic therapy (OR=16.9-18.0) et al. Meanwhile the attachment loss conditions were also correlated with the poor periodontal knowledge level(OR=3.4),older age(OR=1.1),and misjudgement of gingival inflammation (OR=13.3) et al. On the other hand, individuals with moderate and severe periodontitis, having bad teeth brushing effects and knowing about dental plaque inadequately, had a significantly higher risk for the poorly controlled glycemic results (HbA1C≥8.0%), and the OR was 8.61, 8.07, and 7.49 respectively. CONCLUSION: In patients with type 2 diabetes the severity of periodontal disease and the glycemic metabolic level (HbA1C) have a definite bidirectional adverse interrelationship, which is affected by the dental health awareness and behaviours.

Comparison of the serum immunoglobulin IgM level in diabetic and nondiabetic patients with chronic periodontitis.

AIM: To evaluate and compare the serum IgM level in diabetic and nondiabetic patients with chronic periodontitis. MATERIALS AND METHODS: A total of 60 patients were selected for the study and divided into four groups, diabetic with periodontitis, diabetic without periodontitis, nondiabetic with periodontitis and nondiabetic without periodontitis (control) were analyzed for the quantitative estimation of serum immunoglobulins M by turbidimetric immunoassay. The serum of the diabetic and nondiabetic patients was evaluated and turbidimetric method was used for immunological assay by using Quantia IgM turbidimetric immunoassay for estimation of immunoglobulin IgM in human serum. The data for the level of immunoglobulin thus obtained were compared with clinically healthy patient taken as control. Sugar level was estimated the by checking the random blood sugar level by glucose test kit based on end point and kinetic assay and compared with the HbA1c percentage of the patients, by using NycoCard Reader. RESULT: The group A patients having diabetes with periodontitis showed nonsignifcant increase in serum IgM level as compared to controls and other groups. Group B showed signifcance of p = 0.074. Group C showed signifcance of p = 0.982 and group D showed signifcance of p = 0.520. There was signifcant increase in HbA1c with an increase percentage serum IgM. CONCLUSION: In the present study, significantly high concentrations of the IgM in serum of diabetic and nondiabetic patients were found as compared to the healthy subjects who had neither diabetes nor periodontitis. CLINICAL SIGNIFCANCE: By this study, we can emphasize on the fact of the importance of the immune system and its correlation with glycemic control, especially in patients diagnosed with periodontitis, also suggests that the alteration in immune response in poorly controlled diabetic patients may contribute to the pathogenesis of periodontitis and is the cause of increased incidence of periodontitis in patients with diabetes.

Serum cytokine levels and periodontal parameters in ankylosing spondylitis.

BACKGROUND AND OBJECTIVE: Multiple studies support the role of periodontal disease in contributing to the chronic systemic inflammatory burden in a variety of diseases, including ankylosing spondylitis (AS), in the progression which the inflammatory process plays an important role. We assume that patients with AS are more likely to have periodontal disease than healthy individuals. The aim of this study was to determine the possible relationship between inflammatory periodontal diseases and AS by evaluating clinical periodontal parameters and serum cytokine levels. MATERIAL AND METHODS: Forty-eight adults with AS (35 women and 13 men; age range 18-56 years; mean age 34.27 years) and 48 age- and sex-matched systemically healthy control subjects participated in the study. The clinical periodontal parameters, venous blood and Bath Ankylosing Spondylitis Disease Activity Score were obtained, and serum C-reactive protein, tumour necrosis factor-α and interleukin-6 (IL-6) levels were evaluated. RESULTS: There was statistically no significant difference in the frequency of periodontitis between AS patients and the control group. Furthermore, there was no significant difference in probing depth, clinical attachment level and plaque index, and the only significant clinical difference between groups was in levels of bleeding on probing (p < 0.001). Serum concentrations of IL-6, tumour necrosis factor-α and C-reactive protein in the AS group were significantly higher than those in the control group (p < 0.001). In the AS group, there was a correlation between serum IL-6 levels and clinical attachment level (p < 0.001). CONCLUSION: The results of present study suggest that bleeding on probing was the only different periodontal parameter between the AS and the control group, and the periodontal status of patients with AS may be affected by IL-6 levels.

The formation of immune complexes is involved in the acute phase of periodontal destruction in rats.

BACKGROUND AND OBJECTIVE: Loss of clinical attachment and alveolar bone destruction are major symptoms of periodontitis, caused by not only the destructive effect of periodontopathic bacteria but also the overactive response of the host immune system against periodontal pathogens. The details of the participation of the immune system in the onset and progression of periodontitis are unclear. In this study, we attempted to determine whether the host immune system, and in particular the formation of immune complexes, is involved in the periodontal destruction. MATERIAL AND METHODS: We applied ovalbumin or lipopolysaccharide (LPS) as antigens and their specific immunoglobulin G (IgG) antibodies purified from rat serum to rat gingival sulcus alternately. Loss of attachment, alveolar bone destruction and the numbers of inflammatory cells infiltrating the periodontal tissue and osteoclasts on the alveolar bone surface were investigated histometrically. The formation of immune complex was confirmed by immunohistological staining of complement C1qB. RESULTS: Loss of attachment and the presence of C1qB were observed histopathologically in both experimental groups. The group that had been treated with LPS and anti-LPS IgG showed greater loss of attachment. The number of inflammatory cells in the periodontal tissue was increased in both experimental groups, while osteoclasts at the alveolar bone crest were observed only in the group that had been treated with LPS and anti-LPS IgG. CONCLUSION: In the present study, we showed that the formation of immune complex appears to be involved in the acute phase of periodontal destruction and that the biological activity of antigens is also important.

Association between the insulin-like growth factor axis in serum and periodontitis in the Study of Health in Pomerania: an exploratory study.

AIM: To evaluate the association of Insulin-like Growth Factor (IGF) I-related variables with periodontitis in the population-based Study of Health in Pomerania (SHIP). MATERIAL AND METHODS: From the cross-sectional SHIP, 2293 subjects with clinical attachment loss (CAL) data and 2398 subjects with tooth count data aged 20-59 years were analysed. Serum IGF-I and IGF-binding protein (BP)-3 levels were determined by chemiluminescence immunoassays. Linear and logistic regressions with fractional polynomials were used to study associations between IGF-related variables and mean CAL or high tooth loss. For non-linear relations between IGFBP-3 and mean CAL, graphical presentations of fractional polynomials were used to deduce knots for linear splines. RESULTS: In fully adjusted models, for serum IGFBP-3 values ≤1200 ng/ml, mean CAL increased significantly for decreasing serum IGFBP-3 levels [B = -0.027 (95% CI, -0.049; -0.005), p = 0.02]. The odds for high tooth loss decreased significantly for high serum IGFBP-3 values [OR = 0.97 (0.95; 0.99), p = 0.02]. Serum IGF-I levels and the IGF-I/IGFBP-3 ratio were not related to mean CAL or tooth loss after full adjustment. CONCLUSIONS: Low serum IGFBP-3 levels might be associated with higher levels of periodontal disease. Neither serum IGF-I nor IGF-I/IGFBP-3 ratios were associated with periodontitis.