Investigating the diagnostic potential of IL-1ß, IL-10, and IL-36γ in gingival crevicular fluid in patients with different periodontal conditions.

BACKGROUND: The study aimed to analyze cytokine levels, including interleukin (IL)-1ß, IL-10, and IL-36γ, to investigate the link between pro- and anti-inflammatory responses in periodontal conditions and assess their potential as diagnostic biomarkers for distinguishing between different types of periodontal conditions. METHODS: 80 systemically healthy non-smokers (25 periodontally healthy, 25 with gingivitis, 30 with periodontitis) were included. Clinical periodontal parameters were recorded, and gingival crevicular fluid (GCF) samples were obtained. Receiver operating characteristic (ROC) curve analysis was applied to determine the diagnostic value of cytokines. RESULTS: IL-36γ had the highest sensitivity for diagnosing periodontitis, although its specificity for identifying those without periodontitis was relatively low. The combination of IL-1ß and IL-36γ was the most effective in differentiating periodontitis from periodontal health. IL-10 was found to be an acceptable discriminator for distinguishing gingivitis from healthy conditions. However, its sensitivity and specificity for identifying gingivitis were lower. The combination of the three cytokines showed the highest ability to distinguish between periodontitis and gingivitis. CONCLUSION: The levels of IL-1ß, IL-10, and IL-36γ in GCF may provide insights into periodontal health and disease status. Further studies are needed to validate these results and explore the potential of these cytokines in periodontal disease management.

All three of these cytokines exhibit exceptional diagnostic accuracy, particularly in distinguishing between chronic periodontitis and periodontal health.Moreover, the combination of IL-1ß and IL-36γ stands out as the most accurate diagnostic indicator for periodontitis. This combination could serve as a robust biomarker panel for the early detection and monitoring of periodontal disease, potentially allowing for timely interventions to prevent disease progression.

Compatibility of digital and analog methods in assessment of gingival zeniths.

OBJECTIVE: The compatibility of digital and analog methods assessing the positions of gingival zenith (GZ) points has not been evaluated before. Therefore, the aim of this study was to investigate the accuracy of a digital scanner and a three-dimensional (3D) measuring tool in specifying positions of GZs by comparing it to the conventional method, an analog plaster cast and a caliper. MATERIALS AND METHODS: Both analog and digital impressions were obtained from 32 individuals. Following measurements were conducted in the anterior maxillary region from canine to canine on both the plaster casts and 3D images: (1) The distance from GZ to the corresponding vertical midline in each tooth (GZVM), (2) The distance from GZ of lateral incisor to the corresponding tangent that connects GZs of central incisor and canine (GZLI). RESULTS: The intraclass correlation coefficients (ICC) of GZVM in each tooth varied between 0.366 and 0.755, demonstrating moderate to good compatibility between the two methods. The ICC of analog and digital GZLI for the right and left lateral incisors was 0.788 and 0.395, respectively. CONCLUSION: The digital and analog methods used in this study are compatible in determining the positions of GZs. Therefore, within the limitations of the present study, the choice of method can be based on the available equipment, time, comfort, and personal preference of the researcher. CLINICAL SIGNIFICANCE: Both digital and analog methods have the capability of determining the positions of GZs in compatible way.

Ozone application as adjunctive therapy in chronic periodontitis: Clinical, microbiological and biochemical aspects.

BACKGROUND/PURPOSE: The application of ozone as an adjunctive treatment represents a new approach in the management of chronic periodontitis. The purpose of this study was to evaluate the clinical, biochemical and microbiological efficacy of ozone treatment as an adjunct to scaling and root planing (SRP) in generalized chronic periodontitis (GCP) patients. MATERIALS AND METHODS: Eighteen patients (9 males and 9 females; aged from 28 to 47 years, mean age of 40 ± 6.51 years) with GCP were recruited in the study. In a split mouth design, two quadrants in each patient were randomly allocated to SRP-alone or SRP-ozone therapy (SRP + OT) groups by coin toss method. Subgingival plaque and gingival crevicular fluid (GCF) samples were collected at baseline, following 1st and 3rd months. The clinical parameters were monitored at baseline and after 3 months. Microbiological parameters were analyzed by quantitative-PCR and GCF biomarkers were determined by ELISA. Results were analyzed statistically. RESULTS: Statistically significant improvements in all clinical parameters were accompanied by a reduction in microbiological and biochemical parameters in both treatment groups. SRP treatment resulted in a significant reduction of Porphyromonas gingivalis (Pg) at 1st month and Tannerella forsythia (Tf) and Prevotella intermedia (Pi) at 3 months. Following SRP treatment the interleukin (IL)-8 levels were significantly reduced at month 1. There were no significant differences between two treatments for any of the parameters. CONCLUSION: Within the limitations of this study, adjunctive ozone therapy did not provide additional benefits to clinical, microbiological and biochemical parameters over SRP in chronic periodontitis patients.

Soft Tissue Reconstruction with Free Gingival Graft Technique following Excision of a Fibroma.

Background. Oral fibromas are benign, asymptomatic, smooth surfaced, firm structured tumoral lesions that originate from gingival connective tissue or periodontal ligament. Histologically, they are nodular masses characterized by a dense connective tissue, surrounded by stratified squamous epithelium. Case Report. This case report includes the clinical, radiographical, and histological findings and periodontal treatment of a 38-year-old female patient having painless swelling on the gingiva. Intraoral examination revealed a fibrotic, sessile, smooth surfaced gingival overgrowth interdentally between the teeth #13 and #14. Radiographical findings were normal. Initial periodontal treatment (IPT) was applied including oral hygiene instructions, scaling, and root planing. Following IPT, the lesion (0.7 × 0.6 × 0.4 cm) was excised and examined histopathologically. Subsequently, flap operation was performed to have an access to alveolar bone. Surgical site was reconstructed with free gingival graft obtained from hard palate. Hematoxylin-eosin stained sections revealed a nodular mass composed by dense collagen fibers in lamina propria covered by a stratified squamous epithelium, which were consistent with fibroma. Gingival healing was uneventful and without any recurrence during the 12-month follow-up. Conclusions. In order to achieve optimal functional and aesthetical outcomes, free gingival graft can be used for the reconstruction of the wound site after the excision of the fibroma.

Histologic and histomorphometric assessment of eggshell-derived bone graft substitutes on bone healing in rats.

OBJECTIVE: The objective of this study was to histologically and histomorphometrically evaluate the efficacy of the new formulations of eggshell-derived calcium carbonate in rats. STUDY DESIGN: The study was conducted on 30 adult male rats. Four standardized and circular intrabony defects were created in the both maxilla and mandibula of each animal. Three different graft materials were prepared as follows: 1) Material A: Eggshell-derived calcium carbonate combined with carrageenan gel, 2) Material B: Eggshell-derived calcium carbonate combined with xanthan gum gel, and 3) Material C: Eggshell-derived calcium carbonate powder. The right mandibular defect sites were grafted with Material A in all animals, and defects on the left were grafted with Material B. Defects on the right side of maxilla were received Material C in all animals, and all left maxillary defects were remained untreated as controls. The animals were sacrificed either postoperatively on the 15th day, postoperatively on the 30th day or postoperatively on the 45th day. Histomorphometric measurements were made of the areas of newly formed bone, necrotic bone, fibrous tissue and residual graft material. RESULTS: Material A exhibited the highest level of osteoid formation followed by Material B and Material C on the 45th day. In terms of osteoid formation, statistically significant differences were observed between graft materials and controls at 45th day compared to 15th and 30th day (p<0.05). CONCLUSIONS: Eggshell-derived graft substitutes in both gel and powder forms are biocompatible materials which may have the potential to enhance the new bone formation. Key words:Bone graft material, bone defects, eggshell, histopathological evaluation, rat.

Lactoferrin in Gingival Crevicular Fluid and Peripheral Blood during Experimental Gingivitis.

OBJECTIVES: Lactoferrin (LF) is an iron binding protein and stored in the specific granules of granulocytes. It is released by degranulation following granulocyte activation. A positive correlation was previously reported between periodontitis and LF titers of gingival crevicular fluid (GCF) and blood. The purpose of this study was to examine alterations of GCF and blood levels of LF (LF-GCF and LF-BL, respectively), employing the experimental gingivitis model. METHODS: Twelve systemically healthy volunteers, aged 19-21, were selected. Pre-experimental phase of hygiene was followed by a 14-day experimental gingivitis phase in which subjects refrained from all oral hygiene procedures. After that subjects resumed optimal plaque control for 21 days of recovery period. At days 0 (baseline), 14 and 35 gingival crevicular fluid (GCF) and blood samples were collected and plaque index (PI), gingival index (GI), bleeding on probing (BOP) and probing pocket depth scores were recorded. LF levels were measured with commercial enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: PI, GI, BOP and LF-GCF increased significantly after 14 days of experimental gingivitis period and decreased significantly after reinstitution of oral hygiene measures (P<.05). LF-BL appeared to follow the same pattern. Significant negative correlation was detected between the level of LF-BL and BOP at day 14 (P<.05), whereas significant positive correlation was noticed between LF-BL and clinical scores PI, GI and BOP at day 35 (P<.05). CONCLUSIONS: LF-BL followed the same pattern with LF-GCF and clinical scores during the experimental gingivitis and recovery periods, although alterations of the LF-BL appeared statistically insignificant.

Clinical and radiographic evaluations of chitosan gel in periodontal intraosseous defects: a pilot study.

Periodontitis is a chronic infection in the supportive tissue of the teeth which eventually leads to tooth loss. Various grafting materials and barrier membranes have been used to repair periodontal intraosseous lesions. Chitosan is a derivative of chitin, a natural biopolymer, which is biologically safe, biodegradable, and nontoxic and has been applied in a variety of forms in dentistry. It also exerts bioactive properties such as wound healing, antimicrobial, tissue regeneration, and hemostatic activities. The aim of this study was to evaluate effects of chitosan on periodontal regeneration. Twenty chronic periodontitis patients were recruited. Following initial therapy, the patients were divided into four groups: group A, receiving chitosan gel (1% w/v); group B, receiving chitosan gel + demineralize bone matrix; group C: receiving chitosan gel + collagenous membrane; and group D, receiving flap only (control group). Clinical and radiographic measurements were recorded at baseline, day 90 (3rd month), and day 180 (6th month) after surgery. For clinical data, no significant differences were obtained among the treatment groups. However, radiographic data revealed that except control group, all the other groups showed statistically significant bone fills when compared with baseline indicating that chitosan gel alone or its combination with demineralize bone matrix/collagenous membrane is promising for periodontal regeneration.

The effect of smoking on epithelial proliferation in healthy and periodontally diseased marginal gingival epithelium.

BACKGROUND: Smoking causes an increase in the thickness of gingival epithelium, which is the outcome of increased keratinocyte proliferation or loss. Smoking-related changes in the proliferative activity of the gingival epithelium are largely uncharacterized for periodontal diseases. The aim of the present study was to determine the effects of smoking on the proliferation of the epithelium in periodontally diseased marginal gingiva by comparing the expression patterns of two different proliferation markers. METHODS: Gingival biopsies (N=60) were obtained from smokers who had clinically healthy gingiva (n=10), smokers with gingivitis (n=10), smokers with periodontitis (n=10), non-smokers with clinically healthy gingiva (n=10), non-smokers with gingivitis (n=10), and non-smokers with periodontitis (n=10). The quantitative measurement of maximum epithelial thickness was performed on hematoxylin and eosin-stained sections. The expression patterns for proliferating cell nuclear antigen (PCNA) and Ki67 were evaluated immunohistochemically. RESULTS: The percentage of PCNA-positive cells was higher than the percentage of Ki67-positive cells in all groups (P<0.001). When the mean values of PCNA and Ki67 were compared in each group, a statistically significant difference was observed only in the healthy smoker group (P=0.003). Significant differences in PCNA proliferation indices were only found between the smoker group and the non-smoker healthy group (P=0.015). CONCLUSIONS: Smoking had an affect on the proliferation of cells in the oral gingival epithelium, regardless of periodontal status. The increase in thickness of the epithelium was not associated with smoking; periodontal status and inflammation seemed to be more important factors. Smoking induced the replication activity of gingival epithelium and induced DNA repair.

Effects of phase I periodontal treatment on gingival crevicular fluid levels of matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1.

OBJECTIVES: The aim of this study was to evaluate the effects of phase I periodontal treatment on gingival crevicular fluid (GCF) levels of matrix metalloproteinase (MMP)-3 and tissue inhibitors of metalloproteinase (TIMP)-1. METHODS: Plaque index, gingival index, pocket depth and clinical attachment loss were recorded and GCF samples were collected from 20 chronic periodontitis (CP) patients and 20 periodontally healthy controls (C) before treatment. CP patients received phase I periodontal treatment and all clinical parameters were recorded and GCF samples were collected once more after treatment. Assays were performed by an enzyme-linked immunosorbent assay. RESULTS: All of the clinical parameters improved significantly after the therapy (p<0.05). Baseline GCF levels of MMP-3 were significantly higher than C and that level was reduced significantly by treatment compared with baseline levels (p<0.05). Baseline GCF levels of TIMP-1 were lower than post-treatment levels and C (p<0.05). GCF levels of TIMP-1 increased significantly by treatment compared with baseline levels (p<0.05). CONCLUSION: This study shows that the clinical improvements after phase I periodontal therapy are accompanied by reduction in MMP-3 and increasing in TIMP-1 GCF levels.