The Effect of Waterpipe Smoking on Periodontal Health.

PURPOSE: To determine the effect of waterpipe smoking on periodontal health. MATERIALS AND METHODS: The study included 190 participants who were categorised into four groups; cigarette smokers, waterpipe smokers, dual smokers and nonsmokers. Intraoral examination included plaque (PI), gingival (GI) and calculus (CI) indices, probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP). RESULTS: The four groups differed significantly in the prevalence and extent of periodontal disease. Pairwise comparison tests showed that the means of percentages of sites with PPD > 3 mm, PPD > 4 mm, CAL > 1 mm and bleeding on probing were significantly higher among smoking groups compared to the nonsmoking group (p < 0.05). After adjusting for age, cigarette smokers (OR = 4.6), waterpipe smokers (OR = 4.3) and dual smokers (OR = 4.9) were significantly more likely to have periodontal disease compared to nonsmokers. When data were analysed according to the smoking method, no significant differences in the odds of periodontal disease were detected between different smoking groups (p > 0.05). CONCLUSION: Waterpipe tobacco smoking is not an alternative, safe way of smoking considering periodontal disease. Thus, global actions against waterpipe smoking are required.

Long-term bonded retention after closure of maxillary midline diastema.

INTRODUCTION: The objectives of this study were to evaluate fixed bonded palatal surface retainers between the maxillary central incisors that were placed to maintain midline diastema closure and record their longevity, proclivity for damage, and periodontal health of the central incisors in patients 5 or more years after treatment. METHODS: Twenty-nine subjects were contacted and interviewed by phone concerning the status of their bonded retainer and midline diastema. Eleven subjects with intact retainers came for a periodontal health evaluation of the maxillary central incisors. The measures used were the plaque index, the periodontal screening and recording score, and the gingival index. A split-mouth design was used. Statistical analyses of retainer duration, damage probability, and gingival health were performed. RESULTS: Of the 29 subjects, 52% of the initial retainers were in place for an average of 23 years. For the total of 34 bonded retainers, the mean longevity was 17 years. The risk of breakage for any particular year the retainer was in place was 2%. The mean differences in scores between the maxillary central incisors and the control teeth were -0.06 for the plaque index, -0.14 for the periodontal screening and recording score, and -0.11 for the gingival index. Statistical tests on the differences indicated no evidence that the long-term presence of the bonded palatal surface retainer adversely affected the periodontal health of the maxillary central incisors. CONCLUSIONS: The study's sample demonstrated that a bonded retainer for maintaining closure of a maxillary midline diastema can last an average of 17 years or more, with a yearly 2% chance of breakage and with no expected adverse effects on the periodontal health of the maxillary central incisors.

Tooth loss in individuals under periodontal maintenance therapy: 5-year prospective study.

BACKGROUND AND OBJECTIVE: Tooth loss (TL), one of the most visible results of the evolution of periodontitis, causes physiological and psychological impacts on a patient's life. This prospective study aimed to evaluate the incidence, underlying reasons and influence of risk predictors for the occurrence of TL in a program of periodontal maintenance therapy (PMT) over 5 years. METHODS: The sample comprised 212 individuals diagnosed with chronic moderate-severe periodontitis, who had finished active periodontal treatment, were incorporated in a PMT program. Individuals were divided in to two groups: 96 regular compliers (RC) and 116 irregular compliers (IC). Full-mouth periodontal examination was performed. Social, demographic, behavioral and biological variables of interest were collected at all PMT visits. The effect of risk predictors and confounders for TL, as well as the underlying reasons of TL, were assessed by univariate and multivariate analysis. RESULTS: TL was significantly lower among RC (0.12 teeth lost/year) in comparison to IC (0.36 teeth lost/year; p < 0.01). Individuals that were > 55 years old, males and smokers lost significantly more teeth in both groups (with IC > RC). The number of teeth lost due to periodontal reasons was significantly higher than TL for other reasons in both groups (p < 0.01). The final linear and logistic model for TL included: male gender, smoking, probing depth 4-6 mm in up to 10% of sites and irregular compliance. CONCLUSION: IC individuals undergoing PMT presented higher rates of TL when compared to RC individuals. Findings demonstrated the influence of irregular compliance and the importance of monitoring other risk predictors for TL such as smoking, male gender and severity of probing depth during PMT.

The effect of long-term aspirin intake on the outcome of non-surgical periodontal therapy in smokers: a double-blind, randomized pilot study.

OBJECTIVE: The objective of this parallel, double-blind, randomized pilot study was to determine the effect of a daily dose of 325 mg of aspirin (ASA) on the clinical outcomes of scaling and root planing in a selected group of adult smokers. BACKGROUND: The response to periodontal therapy is inferior among smokers compared to non-smokers. Long-term intake of ASA has been shown to exert a positive impact on reducing both the prevalence and severity of periodontitis, among high-risk groups of subjects such as heavy smokers and diabetics. It is reasonable to assume that systemic administration of ASA in conjunction with reduction of the bacterial load by scaling and root planing may improve and prolong the benefits of periodontal therapy. To date, only few prospective interventional clinical studies have specifically addressed the periodontal needs of smokers. METHODS: The study includes 24 smokers. The following clinical parameters were measured preoperatively and at 3, 6, 9 and 12 mo postoperatively: (i) gingival index; (ii) plaque index; (iii) probing depth; (iii) probing attachment level; (iv) gingival recession; and (v) bleeding scores. Study subjects received scaling and root planing over several visits and were randomly assigned into two equal groups; a control group (C), which received a placebo and a test group (T), which took a daily dose of 325 mg ASA. No additional therapy was provided over the 1 year observation period. RESULTS: There were more statistically significant differences (p < 0.05; one- tailed) between pretest and posttest scores in the T group than in the C group. Mean percent increase in sites with probing depth 1-3 mm (T: 8.78; C: 7.21); mean percent reduction in sites with probing depth 4-6 mm (T: -7.25; C: -5.09 not statistically significant, NS); mean percent reduction in sites with probing depth ≥ 7 mm (T: -1.42; C: -02.09); mean percent reduction in sites with probing attachment level 3-4 mm (T: -3.63; C: 0.48 NS); mean percent reduction in sites with bleeding on probing (T: -12.37; C: -2.59 NS) (p < 0.05, NS). CONCLUSIONS: Daily intake of 325 mg of ASA following scaling and root planing improved treatment outcomes in smokers, without an increase in gingival bleeding tendency. ASA promoted a higher incidence of shallow pockets and more gain in attachment level.

Oxidative burst intensity of peripheral phagocytic cells and periodontitis in Down syndrome.

BACKGROUND: This study investigated the oxidative burst function of peripheral phagocytic cells (granulocytes and monocytes) and assessed the relation between oxidative burst and periodontal status in adult individuals with Down syndrome (DS) vs. other groups. METHODS: Of 55 DS individuals (18-56 years old), 74 individuals with mental retardation (MR) and 88 medically healthy controls (HC) participated in the study. The MR and HC groups were age, race and gender matched with the DS group. Gingival index, plaque index, probing depth, attachment level and bleeding on probing were recorded for each subject. Whole blood was collected for granulocyte/monocyte oxidative burst tests. Oxidative burst was determined by flow cytometry in terms of percentage of cells actively involved in oxidative burst, and oxidative intensity (magnitude of ROIs per cell). RESULTS: The basal oxidative burst intensity of DS granulocytes was higher than that of HC and MR granulocytes (p = 0.05). The Escherichia coli stimulated oxidative burst intensity of DS monocytes was higher than that of HC and MR monocytes (p = 0.05). Regression analysis controlling for age, sex, race and plaque levels showed a significant association between monocyte oxidative burst intensity and loss of periodontal attachment in DS subjects (p < 0.01). Regression analysis also showed a significant association between granulocyte oxidative burst intensity and bleeding on probing in all subjects (p < 0.05). CONCLUSIONS: Oxidative burst activity of peripheral monocytes and granulocytes is elevated in DS affected individuals and may contribute to periodontal tissue inflammation and loss of periodontal attachment in this susceptible group.

Oral health of patients under short hospitalization period: observational study.

OBJECTIVE: To assess the impact of hospitalization on the oral health status of individuals hospitalized for a short period of time. MATERIAL AND METHODS: This was an observational study of hospitalized patients. The plaque index (PI), gingival index (GI) was measured at baseline (T0 - first 24 h of hospital admission), and at 3 (T1), 7 (T2), 14 (T3) days. RESULTS: One hundred and sixty-two patients were examined at baseline (T0), 35 examined at 3 days (T1), 23 at 7 days (T2) and 16 at 14 days (T3). The main reason for loss of patients was hospital discharge. The mean PI increased at T1 (0.97-1.21; p < 0.001), at T2 (1.06-1.30; p < 0.007) and at T3 (1.19-1.44; p < 0.03). Gingival index (GI) increased at T2 (0.74-0.96; p < 0.04) and at T3 (0.74-0.96; p < 0.02). CONCLUSION: Oral health, assessed through PI and GI, deteriorates after a short period of hospitalization.

Periodontitis in coronary heart disease patients: strong association between bleeding on probing and systemic biomarkers.

AIM: Few studies have examined the relationship of individual periodontal parameters with individual systemic biomarkers. This study assessed the possible association between specific clinical parameters of periodontitis and systemic biomarkers of coronary heart disease risk in coronary heart disease patients with periodontitis. MATERIALS AND METHODS: Angiographically proven coronary heart disease patients with periodontitis (n = 317), aged >30 years and without other systemic illness were examined. Periodontal clinical parameters of bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) and systemic levels of high-sensitivity C-reactive protein (CRP), fibrinogen (FIB) and white blood cells (WBC) were noted and analyzed to identify associations through linear and stepwise multiple regression analyses. RESULTS: Unadjusted linear regression showed significant associations between periodontal and systemic parameters; the strongest association (r = 0.629; p < 0.001) was found between BOP and CRP levels, the periodontal and systemic inflammation marker, respectively. Stepwise regression analysis models revealed that BOP was a predictor of systemic CRP levels (p < 0.0001). BOP was the only periodontal parameter significantly associated with each systemic parameter (CRP, FIB, and WBC). CONCLUSION: In coronary heart disease patients with periodontitis, BOP is strongly associated with systemic CRP levels; this association possibly reflects the potential significance of the local periodontal inflammatory burden for systemic inflammation.

Levels of HIV-1 in subgingival biofilm of HIV-infected patients.

AIM: The aims of the current study were to compare the levels of HIV-1 in the subgingival biofilm (SHVL) between detectable and undetectable plasmatic HIV-1 viral load (PHVL) in HIV-infected patients as well as to determine the association of SHVL with PHVL and clinical periodontal parameters. MATERIAL AND METHODS: Forty-one HIV-infected individuals were divided into two groups: detectable (21) and undetectable (20) PHVL. Subgingival biofilm samples were obtained for detection and quantification of HIV-1 by real-time RT-PCR. To estimate the effect of co-variables on the outcome undetectable SHVL, the Generalized Estimation Equation (GEE) was employed. RESULTS: Detectable SHVL was observed only in the detectable PHVL group and the detection of the HIV-1 was observed in 40% of these individuals. In the bivariate analysis between co-variables from the individual level and the outcome SHVL, significant difference was observed only for the CD4+ T lymphocytes levels (p = 0.017). The multiple logistic model demonstrated that only CD4+ T lymphocytes levels had a significant effect on the outcome undetectable SHVL [OR 8.85 (CI 3.6-9.2), p = 0.002]. CONCLUSION: HIV-1 can be detected and quantified in the subgingival biofilm of HIV-infected individuals, but these findings are not associated with PHVL and periodontal clinical parameters.

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.

Periodontal findings in individuals with newly identified pre-diabetes or diabetes mellitus.

AIM: To assess the periodontal status and number of missing teeth in patients with newly identified pre-diabetes or diabetes mellitus. METHODS: A total of 1097 subjects with previously undiagnosed diabetes were available for study, and were categorized into normoglycaemic, potentially pre-diabetes or potentially diabetes groups based on a point-of-care (POC) HbA1c test. RESULTS: In fully adjusted models, significant differences were observed between all groups for the per cent of teeth with at least one site with a probing depth of ≥5 mm. For bleeding on probing, there were significant differences between diabetes and pre-diabetes (p = 0.001), and between diabetes and normoglycaemic groups (p = 0.002). For missing teeth, there were significant differences between the pre-diabetes and normoglycaemic groups (p = 0.034), and the diabetes and normoglycaemic groups (p = 0.004). CONCLUSIONS: Individuals with previously unidentified pre-diabetes demonstrate a level of periodontal destruction between that observed for normoglycaemic individuals and persons with diabetes. These data emphasize the association of oral findings to dysglycaemia, and suggest that periodontal disease and tooth loss can be early complications of diabetes mellitus.

Implant- and patient-centred outcomes of guided surgery, a 1-year follow-up: An RCT comparing guided surgery with conventional implant placement.

AIM: To assess, in a randomized study, the implant (clinical and radiological) and patient outcomes of guided implant placement at 1-year follow-up, compared to conventional implant treatment. MATERIAL AND METHODS: A total of 314 were placed in 59 patients, randomly assigned to one of the treatment groups. Radiographic and clinical parameters were recorded at the time of implant placement, prosthesis instalment (baseline) and at 1-year follow-up. Patient satisfaction was measured with the oral health-related quality of life instrument (OHIP-49). RESULTS: No implants were lost. The mean marginal bone loss after the first year of loading was 0.04 mm (SD 0.34) for the guided surgery and 0.01 mm (SD 0.38) for the control groups. In the guided surgery groups, the mean number of surfaces with BOP and plaque at 1-year follow-up was 1.41 (SD 1.25) and 1.10 (SD 1.22), for the control groups this was, respectively, 1.37 (SD 1.25) and 1.77 (SD 1.64). The mean pocket probing depth was 2.81 mm (SD 1.1) for the guided, and 2.50 mm (SD 0.94) for the control groups. For all treatment groups, a significant improvement in quality of life was observed at 1-year follow-up (p ≤ 0.01), no differences between groups were observed. CONCLUSION: Within the limitations of this study, no difference could be found at 1-year follow-up between the implant and patient outcome variables of guided or conventional implant treatment.

Long-term changes in microbiology and clinical periodontal variables after completion of fixed orthodontic appliances.

OBJECTIVES: The aim of this prospective study was to monitor patients' microbiological and clinical periodontal parameters prior and up to 2 years after orthodontic treatment. MATERIAL AND METHODS: Twenty-four adolescents were treated with brackets. Fourteen of them received bands on upper first molars for extra-oral force application before bonding brackets to the remaining teeth. Microbiology, periodontal probing depth, bleeding on probing (BOP), and gingival crevicular fluid (GCF) flow were assessed at baseline (T1), bracket removal (T2), and 2 years post-treatment (T3). A statistical comparison was made over time and between bands and brackets. RESULTS: A significant increase from T1 to T2 and a decrease from T2 to T3 in pathogenicity of plaque were noted. No significant difference was observed concerning supragingival colony-forming units (CFU) ratio (aerobe/anaerobe) between T3 and T1. However, the subgingival CFU ratio (aerobe/anaerobe) at T3 did significantly differ from the ratio at T1. Periodontal probing depth, BOP and GCF flow showed a significant increase between T1 and T2 and a reduction between T2 and T3, resulting in the absence of significant differences between T3 and T1, except for BOP at banded sites. CONCLUSION: Placement of fixed appliances has an impact on periodontal parameters. The results showed that not all parameters were normalized at T3, indicating that the changes are only partially reversible.

IPLA2 mRNA expression by human neutrophils in type 2 diabetes and chronic periodontitis.

Type 2 diabetes mellitus (T2D) is becoming increasingly prevalent worldwide and complications of T2D cause significant systemic and dental morbidity in the susceptible individual. Although T2D has been linked as a significant risk factor for chronic periodontitis (CP), molecular mechanisms explaining the pathogenesis and inflammatory impact of CP in T2D are lacking. iPLA2 is the calcium-independent form of phospholipase A2. In previous studies, we demonstrated that iPLA2 enzyme activity is altered in T2D. The purpose of this study was to elucidate the level of the iPLA2 abnormality in T2D by measuring messenger RNA levels in T2D-associated CP. A total of 53 healthy and T2D subjects with CP were recruited for this study. The clinical periodontal exam included probing pocket depth, clinical attachment levels and bleeding on probing. Peripheral venous blood was collected and neutrophils were isolated. Real time polymerase chain reaction was used to quantify iPLA2 mRNA in neutrophils from healthy controls and people with diabetes. Results revealed that the prevalence of moderate to severe CP was increased in people with T2D. The iPLA, mRNA levels in diabetics with different severity of CP were not significantly different compared to healthy controls; 1.07 vs 0.97 (mild CP), 1.07 vs 0.85 (moderate CP) and 1.07 vs 1.05 (severe CP). Collectively, the data suggest that levels of iPLA2 mRNA in T2D are not different than in health and are not directly influenced by periodontal disease status. The impact of inflammation on iPLA2 regulation is at the level of activation of the enzyme rather than expression at the mRNA level.

Dental caries experience and periodontal treatment needs of 10- to 15-year old children with type 1 diabetes mellitus.

AIM: To investigate experience of dental caries and periodontal treatment needs among children with type I diabetes mellitus. MATERIALS AND METHODS: A cross-sectional study design, in which experience of dental caries and the periodontal treatment needs of 70 children with type 1 diabetes were compared with those of 70 controls matched for age and gender. The diabetic children were recruited from the child care unit of the central Benghazi hospital. The decayed, missing and filled teeth (DMFT) index for dental caries experience and Community Periodontal Index of Treatment Needs (CPITN) index for periodontal treatment needs were calculated according to World Health Organisation criteria in a dental clinic by a calibrated examiner. Scores for decayed, missing and filled teeth and periodontal treatment needs were compared in bivariate analysis. RESULTS: Two groups were compared: diabetic children and controls. Each group consisted of 70 children (45 males and 25 females) aged between 10 years and 15 years; the mean ages were 11.66 ± 1.44 years for diabetic children and 11.63 ± 1.54 years for controls. The diabetic children had higher means for the number of decayed teeth (P = 0.037) and the number of missing teeth (P = 0.028). Professional gingival scaling was the most required periodontal treatment by diabetic children (P = 0.007). There were no gender differences among study subgroups. CONCLUSIONS: The results suggest that children with type 1 diabetes are at higher risk of developing dental caries and periodontal disease. Greater efforts are required to tackle these problem and prevent complications arising from them.

Evaluation of periodontal pathogens of the mandibular third molar pericoronitis by using real time PCR.

OBJECTIVES: The aim of this study was to investigate the mandibular third molar pericoronitis flora by using real-time polymerase chain reaction (PCR). MATERIALS AND METHODS: The quantitative values of Aggregatibacter actinomycetemcomitans (Aa), Campylobacter rectus (Cr), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi) and Tannerella forsythia (Tf) were evaluated in comparison with the healthy third molar flora by using real time PCR. RESULTS: Aa, Cr, Pg, and Pi were not statistically significant but numerically higher than the pericoronitis group. In contrast to samples from control subjects, statistically significant higher numbers of Tf were detected in samples from pericoronitis patients. The study revealed the strong relation between risk of pericoronitis and the presence of Tf. Individuals who have Tf in their samples present with an almost eight times relative risk of pericoronitis as the individuals with an absence of Tf in their samples. CONCLUSION: Tf plays an important role in the development of clinical symptoms related to pericoronitis.

Saliva viscosity as a potential risk factor for oral malodor.

OBJECTIVES: The objective of this study was to assess whether saliva viscosity, measured by a viscometer, was a predictor of oral malodor. MATERIALS AND METHODS: The subjects were 617 patients who visited an oral malodor clinic. The organoleptic test (OT) was used for diagnosis of oral malodor. An oral examination assessed the numbers of teeth present and decayed teeth as well as the presence or absence of dentures. Further, periodontal pocket depths (PD), gingival bleeding, dental plaque and tongue coating were investigated. Unstimulated saliva were collected for 5 min. Saliva viscosity was measured with a viscometer. Logistic regression analysis with oral malodor status by OT as a dependent variable was performed. Possible confounders including age, gender, number of teeth present, number of decayed teeth, number of teeth with PD ≥ 4 mm, number of teeth with bleeding on probing, presence or absence of dentures, plaque index, area of tongue coating, saliva flow rate, saliva pH and saliva viscosity were used as independent variables. RESULTS: Saliva viscosity (p = 0.047) along with the number of teeth with PD ≥4 mm (p = 0.001), plaque index (p = 0.037) and area of tongue coating (p < 0.001) were significant variables for oral malodor. Subjects with a higher number of teeth with PD ≥ 4 mm (OR = 1.32), plaque index (OR = 2.13), area of tongue coating (OR = 3.17) and saliva viscosity (OR = 1.10) were more likely to have oral malodor compared to those with lower values. CONCLUSIONS: The results suggested that high saliva viscosity could be a potential risk factor for oral malodor.

Effect of 2 elastomeric ligatures on microbial flora and periodontal status in orthodontic patients.

INTRODUCTION: The aim of this study was to compare the effects of a nonconventional elastomeric ligature (Slide; Leone, Florence, Italy) with those of a conventional elastomeric ligature (Ormco, Orange, Calif) on microbial flora and periodontal status in orthodontic patients. METHODS: A total of 13 orthodontic patients scheduled for fixed orthodontic treatment were selected for this study. The use of Slide and conventional elastomeric ligatures in fixed orthodontic appliances was tested. Microbial and periodontal records were obtained before bonding and 1 and 5 weeks after bonding. For the statistical analysis and calculations, SPSS software (version 15.0; SPSS, Chicago, Ill) was used. In the statistical decisions, P <0.05 values were accepted as significantly different. RESULTS: No significant differences between Slide and conventional elastomeric ligatures were evident at 1 week or 5 weeks after bonding, with regard to gingival index, plaque index, gingival bleeding index, or pocket depth scores (P >0.05). Similarly, aerobic and anaerobic bacteria counts did not differ significantly on the surface or on the elastics (P >0.05). CONCLUSIONS: Although the Slide ligatures cover the total surface of the bracket, they do not cause significantly more plaque accumulation or periodontal problems than do the conventional elastomeric ligatures.

Saliva versus peri-implant inflammation: quantification of IL-1ß in partially and totally edentulous patients.

The aim of this study was to investigate the potential use of salivary IL1ß in early-stage diagnostics of peri-implant inflammation in partially and totally edentulous patients rehabilitated with dental implants. Patients were classified according to peri-implant probing depth and bleeding upon probing in groups of healthy individuals or in groups of individuals with peri-implant inflammation. Data on plaque index, clinical attachment loss, suppuration, and mobility were also assessed. Saliva was collected without stimulation, and the levels of IL-1ß were determined by ELISA. Healthy groups demonstrated significantly lower levels of IL-1ß compared with the inflammation groups. No difference in IL-1ß levels was observed between partially edentulous or totally edentulous patients. Salivary IL-1ß may be useful for the diagnosis and monitoring of early peri-implant inflammation, particularly in edentulous patients.

The impact of handicap severity on oral and periodontal status of patients with mental retardation.

AIM: Mental retardation (MR) subjects comprise a considerable amount of the community and are susceptible to oral and periodontal problems due to insufficient oral care. The aim of this cross-sectional study was to determine the oral health and periodontal status of MR patients in Turkey with regard to periodontal indices and Decay missed filling teeth (DMFT) scores and compare findings according to severity of the MR. MATERIALS AND METHODS: One hundred and five MR patients were included to the study and divided into 3 groups according to MR severity diagnoses. Demographic variables like age, gender, disabled sibling, BMI, living an institution and clinical parameters like plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), missing teeth and DMFT scores were recorded from all subjects. Appropriate statistical analyses were used to compare the findings. RESULTS: There were no statistically significant differences between groups according to age, gender, disabled sibling, living status and DMFT scores. Clinical periodontal indices and the number of missing teeth were showed a statistically significant increasing trend with the severity of MR (p < 0.05). Correlation analysis showed significant positive correlations between PI and periodontal disease measures like GI, PD, CAL and BOP and also between PI and DMFT (p < 0.05). CONCLUSION: The deteriorated teeth condition and deprived periodontal health of MR patients may be most likely caused by the poor oral hygiene and may be worsen with the severity of the MR. Clinical significance: Knowledge of oral and periodontal status of mental retardation patients has great importance for public health and family education.

Expression of oral secretory leukocyte protease inhibitor in HIV-infected subjects with long-term use of antiretroviral therapy.

BACKGROUND: The objectives of this study were to determine (i) the expression of oral secretory leukocyte protease inhibitor (SLPI) in HIV-infected subjects compared with non-HIV controls, (ii) the oral SLPI expression in HIV-infected subjects with antiretroviral therapy (ART) compared with those without ART, and (iii) factors associated with the expression of oral SLPI. METHODS: Oral tissues and samples of both un-stimulated and stimulated saliva were collected from HIV-infected subjects with and without ART, and non-HIV individuals. The expression of SLPI mRNA in the tissue was determined by quantitative real-time PCR. Salivary SLPI protein was detected using ELISA. Chi-square test and logistic regression analysis were performed to determine the association between HIV/ART status and the expression of oral SLPI. RESULTS: One hundred and fifty-seven HIV-infected subjects were enrolled: 99 on ART (age range, 23-57 years; mean, 39 years), 58 not on ART (age range, 20-59 years; mean, 34 years), and 50 non-HIV controls (age range, 19-59 years; mean, 36 years). The most common ART regimen was 2NRTIs + 1NNRTI. The expression of oral SLPI in stimulated saliva was significantly decreased with HIV infection (P < 0.001). The expression was also significantly different with respect to ART use (P = 0.007). Smoking, CD4(+) cell count, and HIV viral load were the factors associated with the oral SLPI expression. CONCLUSION: The expression of oral SLPI is altered by HIV infection and use of ART. Thus, oral SLPI may be the useful biomarker to identify subjects at risk of infections and malignant transformation due to HIV infection and long-term ART.