The Association of Periodontopathic Bacteria Levels in Saliva and Tongue Coating with Oral Malodor in Periodontitis Patients.

PURPOSE: To elucidate the association oral malodor with the levels of periodontopathic bacteria in saliva and tongue coating of periodontitis patients with oral malodor. MATERIALS AND METHODS: In 25 periodontitis patients, the organoleptic test (OLT) was performed, the levels of volatile sulfur compounds (VSCs) were measured, tongue coating (TC) score was determined, and periodontal parameters and the proportions of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Tannerella forsythia and Prevotella intermedia in the saliva and the tongue coating were evaluated. RESULTS: The proportions of T. denticola and T. forsythia in the saliva of patients with an OLT score ≥ 2 were significantly higher than those with OLT scores < 2. The proportion of P. gingivalis in the saliva significantly correlated with periodontal parameters, whereas T. denticola and T. forsythia levels in the tongue coating correlated with VSC levels. However, the five periodontopathic bacteria were found in the tongue coating at levels approximately 12 times lower than in the saliva. CONCLUSIONS: The findings suggest that the levels of T. denticola and T. forsythia in the saliva of periodontitis patients correlate with oral malodor, and that the prevalence of P. gingivalis in the saliva is related to periodontitis. Periodontopathic bacteria in the tongue coating contribute minimally to oral malodor in periodontitis patients.

Effect of surface roughness on initial responses of osteoblast-like cells on two types of zirconia.

The aim of this study was to evaluate the effect of surface roughness on the initial attachment of mouse osteoblast-like cells on ceriastabilized zirconia/alumina nanocomposite (NANOZR) and yttria-stabilized zirconia (3Y-TZP) in comparison to those on pure titanium (Ti) and alumina oxide (AO). Specimens with smooth and rough surfaces were prepared by grinding with diamond paper or by sandblasting, respectively. For four substrates examined, the number of attached cells on the rough surface specimens was significantly higher than that on the smooth surface specimens (p < 0.05). Integrin alpha(5) and beta(1) expression had a greater increase in rough surface specimens than in smooth surface specimens. Actin cytoskeleton organization was, however, similar for both smooth and rough surface specimens. NANOZR and 3Y-TZP produced good cell attachment, similar to Ti and AO. The overall results demonstrated that NANOZR and 3Y-TZP with rough surface could provide good initial cell responses, adequate for future implant usage.

Comparison of injectable calcium phosphate bone cement grafting and open flap debridement in periodontal intrabony defects: a randomized clinical trial.

BACKGROUND: Regeneration of lost periodontium is the ultimate goal of periodontal therapy. Bone grafts, guided tissue regeneration, and application of growth factors are used for periodontal regeneration. This study aimed to evaluate the clinical efficacy of a new, injectable calcium phosphate bone cement (CPC) in human periodontal intrabony defects. METHODS: Thirty subjects (mean age, 53.4 +/- 9.1 years) with periodontitis and narrow intrabony defects were enrolled in the study. Subjects were classified randomly into the CPC graft group (N = 15) or the open flap debridement (OFD) alone group (N = 15). Clinical measurements were performed at baseline and at 3, 6, 9, and 12 months; radiographs were taken at baseline, 2 weeks, and 6 and 12 months after surgery. The Student t test was used for statistical analysis. RESULTS: In the CPC group, six cases showed exposure or loss of the CPC within 12 months, whereas the remaining nine cases (CPC-R group) showed no adverse reaction, including infection or suppuration. Overall, CPC-R and OFD treatment groups exhibited a significant reduction in probing depth and a significant gain in clinical attachment level at 3, 6, 9, and 12 months compared to baseline values. However, there were no significant differences in any of the clinical parameters between the groups. In the CPC-R group, radiographic bone level gain appeared to be greater than in the OFD group. CONCLUSIONS: The present study failed to demonstrate any superior clinical outcomes for the CPC group compared to the OFD group; however, radiographs revealed more favorable results in the CPC-R group. The filling volume and stiffness of CPC may compromise the clinical outcomes for periodontal intrabony defects.

Surface properties and biocompatibility of acid-etched titanium.

The purpose of this study was to evaluate the effects of acid-etched titanium on the biological responses of osteoblast-like MC3T3-E1 cells. Four types of treatments (polishing, sandblasting, concentrated H2SO4 etching, and concentrated H2SO4 etching with vacuum firing) were carried out on the surfaces of commercially pure titanium (cpTi) disks. MC3T3-E1 cells were then cultured on the treated cpTi surfaces. Through surface roughness measurement and SEM analysis, it was found that the acid-etched surfaces showed higher roughness values than the sandblasted ones. Scanning electron microscope analysis showed that the cells on the disks treated with acid-etching and acid-etching with vacuum firing spread as well as the sandblasted ones. There were no significant differences in cell proliferation and collagen production on cpTi among the four different surface treatments. Based on the results of this study, it was concluded that etching with concentrated sulfuric acid was a simple and effective way to roughen the surface of titanium without compromising its biocompatibility.

Isolated vertical infrabony defects treated by orthodontic tooth extrusion.

It has been reported that periodontal disease and traumatic occlusion may cause an isolated vertical infrabony defect. In such cases, the improvement of both inflammation and the occlusion are necessary to ameliorate the defect. We discuss the successful orthodontic treatment of an adult patient with isolated vertical infrabony defects of the maxillary right lateral incisor, left canine, and mandibular left incisor regions. The patient showed an anterior crossbite and one- and two-wall wide isolated vertical infrabony defects. The inflammation was improved by a periodontist; however, the vertical infrabony defects remained. In order to improve the defects, the pulps of the maxillary right lateral incisor, left canine, and mandibular left incisor were extirpated, and temporary crowns were put on those teeth. Next, an edgewise appliance was applied to the maxillary and mandibular teeth. After the anterior crossbite was improved, the incisor edge regions of the temporary crowns were ground, and the maxillary right lateral incisor, left canine, and mandibular left incisor were extruded until they touched antagonistic teeth. The patient's anterior crossbite, traumatic occlusion and gingival esthetics were improved by this treatment. Panoramic and dental radiographs after treatment also showed improvement of the vertical infrabony defects. Thus, tooth extrusion might be effective to improve one- and two-wall wide isolated vertical infrabony defects.

Cleavage of host cytokeratin-6 by lysine-specific gingipain induces gingival inflammation in periodontitis patients.

BACKGROUND/PURPOSE: Lysine-specific gingipain (Kgp) is a virulence factor secreted from Porphyromonas gingivalis (P. gingivalis), a major etiological bacterium of periodontal disease. Keratin intermediate filaments maintain the structural integrity of gingival epithelial cells, but are targeted by Kgp to produce a novel cytokeratin 6 fragment (K6F). We investigated the release of K6F and its induction of cytokine secretion. METHODS: K6F present in the gingival crevicular fluid of periodontal disease patients and in gingipain-treated rat gingival epithelial cell culture supernatants was measured by matrix-assisted laser desorption/ionization time-of-flight mass spectrometer-based rapid quantitative peptide analysis using BLOTCHIP. K6F in gingival tissues was immunostained, and cytokeratin 6 protein was analyzed by immunofluorescence staining and flow cytometry. Activation of MAPK in gingival epithelial cells was evaluated by immunoblotting. ELISA was used to measure K6F and the cytokines release induced by K6F. Human gingival fibroblast migration was assessed using a Matrigel invasion chamber assay. RESULTS: We identified K6F, corresponding to the C-terminus region of human cytokeratin 6 (amino acids 359-378), in the gingival crevicular fluid of periodontal disease patients and in the supernatant from gingival epithelial cells cultured with Kgp. K6F antigen was distributed from the basal to the spinous epithelial layers in gingivae from periodontal disease patients. Cytokeratin 6 on gingival epithelial cells was degraded by Kgp, but not by Arg-gingipain, P. gingivalis lipopolysaccharide or Actinobacillus actinomycetemcomitans lipopolysaccharide. K6F, but not a scrambled K6F peptide, induced human gingival fibroblast migration and secretion of interleukin (IL)-6, IL-8 and monocyte chemoattractant protein-1. These effects of K6F were mediated by activation of p38 MAPK and Jun N-terminal kinase, but not p42/44 MAPK or p-Akt. CONCLUSION: Kgp degrades gingival epithelial cell cytokeratin 6 to K6F that, on release, induces invasion and cytokine secretion by human gingival fibroblasts. Thus, Kgp may contribute to the development of periodontal disease.

Cellular compatibility of a gamma-irradiated modified siloxane-poly(lactic acid)-calcium carbonate hybrid membrane for guided bone regeneration.

A bi-layered silicon-releasable membrane consisting of a siloxane-poly(lactic acid) (PLA)-vaterite hybrid material (Si-PVH) microfiber mesh and a PLA microfiber mesh has been developed by an electrospinning method for guided bone regeneration (GBR) application. The bi-layered membrane was modified to a three-laminar structure by sandwiching an additional PLA microfiber mesh between the Si-PVH and PLA microfiber meshes (Si-PVH/PLA membrane). In this study, the influence of gamma irradiation, used for sterilization, on biological properties of the Si-PVH/PLA membrane was evaluated with osteoblasts and fibroblasts. After gamma irradiation, while the average molecular weight of the Si-PVH/PLA membrane decreased, the Si-PVH/PLA membrane promoted cell proliferation and differentiation (alkaline phosphatase activity and calcification) of osteoblasts, compared with the poly(lactide-co-glycolide) membrane. These results suggest that the gamma-irradiated Si-PVH/PLA membrane is biocompatible with both fibroblasts and osteoblasts, and may have an application for GBR.

Enhanced expression of vascular endothelial growth factor by periodontal pathogens in gingival fibroblasts.

Vascular endothelial growth factor (VEGF) has recently attracted attention as a potent inducer of vascular permeability and angiogenesis. Aberrant angiogenesis is often associated with lesion formation in chronic periodontitis. The aim of the present study was to investigate the properties of VEGF expression in human gingival fibroblasts (HGF) culture. HGF were stimulated with lipopolysaccharide (LPS), vesicle (Ve) and outer membrane protein (OMP) from Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. HGF constitutively produced VEGF and levels were significantly enhanced (P < 0.01) by stimulation with Ve and OMP from A. actinomycetemcomitans and P. gingivalis at concentrations of 10 microg/ml or higher. On the other hand, VEGF levels were not increased by LPS stimulation. VEGF mRNA expression was also observed in Ve- and OMP-stimulated HGF. A vascular permeability enhancement (VPE) assay was performed using guinea pigs to ascertain whether supernatant from cultures of Ve- and OMP-stimulated HGF enhance vascular permeability in vivo. Supernatant from cultures of Ve- and OMP-stimulated HGF strongly induced VPE. This was markedly suppressed upon simultaneous injection of anti-VEGF polyclonal antibodies with the supernatant. Heating and protease treatment of the stimulants reduced the VEGF enhancing levels in Ve and OMP in vitro. These results suggest that Ve and OMP may be crucial heat-labile and protease-sensitive components of periodontal pathogens that enhance VEGF expression. In addition, VEGF might be associated with the etiology of periodontitis in its early stages according to neovascularization stimulated by periodontal pathogens causing swelling and edema.