Prevalence and Progression of Gingivitis in Domestic Cats in Subtropical Mexico.

With the objective to characterize the gingival index (GI) and its progression, 218 domestic cats in a subtropical region of Mexico were studied. All teeth of each cat were examined with a periodontal probe to determine the GI; in addition, the absence of teeth was recorded. Six months later, the teeth of the 38 cats were again examined to assess any progression of the GI and loss of teeth. From the 218 cats, 33.0% of them develop some degree of gingival inflammation; from those, 61.5% were classified as GI 1. Age, sex, and neutered status were associated with tooth affections. Missed teeth were observed in 35% of the cats, particularly for molars 109 and 209 in both sexes. After six months, the number of teeth with GI 1 decreased to 20%. The gingival problems in cats have not been well studied, particularly at the speed they progress and how this can affect the loss of teeth; under the conditions of this study, a high frequency of gingival inflammation even at early age was demonstrated, with a rapid tooth loss. Although young males were more prone to develop gingivitis, females tend to loss more teeth. Non-neutered cats tended to develop more dental affections.

Evaluation of the Local Synergistic Effect of a Dexketoprofen and Chlorhexidine Combination in the Formalin Test.

OBJECTIVE: Evidence supports the local application of non-steroidal antiinflammatory drugs such as dexketoprofen trometamol (DXT) for pain management, but little is known about the potential antinociceptive effect of chlorhexidine gluconate (CHX) and its possible synergistic effect when combined with DXT. The aim of this study was to evaluate the local effect of a DXT-CHX combination using isobolographic analysis in a formalin pain model in rats. MATERIALS AND METHODS: Briefly, 60 female Wistar rats were used for the formalin test. Individual dose effect curves were obtained using linear regression. For each drug, the percentage of antinociception and median effective dose (ED50; 50% of antinociception) were calculated, and drug combinations were prepared using the ED50s for DXT (phase 2) and CHX (phase 1). The ED50 of the DXT-CHX combination was determined, and an isobolographic analysis was performed for both phases. RESULTS: The ED50 of local DXT was 5.3867 mg/mL in phase 2 and for CHX was 3.9233 mg/mL in phase 1. When the combination was evaluated, phase 1 showed an interaction index (II) of less than 1, indicating synergism but without statistical significance. For phase 2, the II was 0.3112, with a reduction of 68.88% in the amounts of both drugs to obtain the ED50; this interaction was statistically significant (P < .05). CONCLUSION: DXT and CHX had a local antinociceptive effect and exhibited synergistic behavior when combined in phase 2 of the formalin model.

Use of Ionized Monocalcium phosphate and enameline derivatives to reduce dentin hypersensitivity after periondontal therapy / Uso de Fostato Monocálcio y derivados en Enamelina para reducir la hipersensibilidad dentaria después de terapia periodontal

Abstract This study aimed to evaluate the effectiveness of using an ionized monocalcium phosphate and enamelin derivatives (IMP+ED) based mouthwash for the treatment of dentin hypersensitivity (DH) after scaling and root planing (SRP). 47 patients who reported DH after SRP treatment were included in this prospective cohort study. The Schiff Cold Air Sensitivity Scale (SCASS) was applied to classify their degree of pain in mild, moderate or intense at two times: after SRP (T0), and after one month of using a IMP+ED-based mouthwash (T1). The McNemar-Bowker test was used to compare the correlated proportions between both times (p<0.05). After the SRP therapy (T0), all the sample members reported pain distributed in the following manner: 12.8% were mild, 27.6% moderate, and 59.6% intense. At one month since treatment and with the use of the IMP+ED-based mouthwash (T1), the distribution of pain levels changed to 83% mild, 12.8% moderate, and 4.3% intense, this change was statistically significant (p<0.001). IMP+ED-based mouthwash produces a positive effect in reducing painful responses caused by exposure of the dentin tubules to the oral environment after SRP therapy.

Resumen El objetivo de este estudio fue evaluar la efectividad de un enjuague bucal a base de fosfato monocálcico ionizado y derivados de enamelina (FCI+DE) para el tratamiento de hipersensibilidad dentinaria (HD) posterior al tratamiento de raspado y alisado radicular (RAR). 47 pacientes que reportaron tener HD posterior al tratamiento de RAR fueron incluidos en este estudio prospectivo de cohorte. Con el fin de clasificar la HD de los pacientes en leve, moderada o intensa se utilizó la Escala de Sensiblidad al Aire Frío de Schiff (ESAFS). Los pacientes fueron evaluados después del tratamiento de RAR (T0) y posterior al uso de un enjuague bucal basado en FCI+DE (T1). Para comparar las proporciones correlacionadas se utilizó la prueba de McNemar-Bowker (p<0.05). La distribución del dolor de los pacientes posterior al tratamiento de RAR (T0) fue la siguiente: 12.8% fueron leves, 27.6% moderado, and 59.6% intenso. Un mes después del uso del enjuague buccal basado en FCI+DE (T1) la distribución en los niveles de dolor cambio a 83% leve, 12.8% moderado, and 4.3% intenso, este cambio fue estadísticamente significativo (p<0.001). El uso del enjuague bucal basado en FCI+DE produce una reducción significativa a la respuesta de dolor causada por la exposición de la dentina al ambiente oral como consecuencia del tratamiento de RAR.

Neutrophil N1 and N2 Subsets and Their Possible Association with Periodontitis: A Scoping Review.

Periodontitis is a chronic non-communicable disease caused by dysbiotic changes that affect the subgingival microbiota. During periodontitis, neutrophils play a central role in the initial recognition of bacteria, and their number increases with the appearance of the first signs of periodontal inflammation. Recent evidence has led to the proposition that neutrophils can also functionally polarize, determining selective activity patterns related to different diseases. Two well-defined neutrophil phenotypes have been described, the pro-inflammatory N1 subset and the suppressor N2 subset. To date, it has not been established whether these different neutrophil subtypes play a role in the pathogenesis of periodontitis. Thus, this scoping review aimed to determine whether there was evidence to suggest that the neutrophils present in periodontal tissues can be associated with certain phenotypes. The research question, population, concept, and context sought to identify original articles, in humans, that detected the presence of neutrophils in the periodontal tissues of people affected by periodontitis. Based on the search strategy, we found 3658 studies. After removing the papers with abstracts not related to the outcome measures and eligibility criteria, 16 articles were included for qualitative analysis. Several studies identified the presence of different neutrophil subsets, specifically, the naive, pro- and para-inflammatory, hyper-reactive and hyper-active, and high- and low-responder phenotypes. The existing evidence demonstrates the presence of pro-inflammatory, hyper-reactive and high-responder neutrophils in periodontal tissues affected with periodontitis. There is no evidence demonstrating the presence of the N1 or N2 phenotypes in periodontal tissues during periodontitis. However, the existence of pro-inflammatory phenotypes, which increase NETosis and degranulation, and increase the production of pro-inflammatory cytokines, could be suggestive of the N1 phenotypes.

Quantification of Osteoprotegerin Plasma Levels in Patients with Periodontitis.

OBJECTIVE: Periodontitis (POD) is an infectious process directed at the structures supporting the teeth. Destruction of alveolar bone is considered one of the main causes of tooth loss in humans and is mediated by the host immune response. Osteoprotegerin (OPG), a protein that inhibits bone resorption by binding to the RANK ligand (RANKL), prevents osteoclastic differentiation. The aim of the study was to determine the plasma levels of OPG in patients with POD. METHODS: a case-control study with forty-nine patients with POD and 49 healthy controls were included in the study. OPG levels were determined by an ELISA test in plasma samples. RESULTS: OPG values (1.6203 ng/mL) were higher in the POD group compared with control group (1.2824 ng/mL). Among the studied groups, we detected significant differences in age, glycosylated haemoglobin (HbA1C), and plasma concentration of OPG (p < 0.05). CONCLUSION: plasma OPG levels are associated with bone formation and destruction processes, suggesting that OPG acts in a protective manner.

Quantification of sphingosine-1-phosphate (S1P) in patients with periodontitis stage II grade B / Cuantificación de esfingosina 1 fosfato en pacientes con periodontitis estadío II grado B

Abstract The aim of this study was the quantification of Sphingosine-1-phosphate (S1P) in periodontal pockets of patients with periodontitis. This is an observational, descriptive, case-control study. Thirty subjects were selected: 15 controls and 15 cases. A periodontal study was conducted following the parameters of AAP 2017 for the diagnosis of periodontal diseases. A sample of saliva and gingival crevicular fluid was obtained from each subject and then analyzed with the Human S1P Elisa kit (MyBioSource #MBS2516132) accordingly to the manufacturer's instructions, in order to verify the presence of S1P and quantify it´s concentration when founded. Results showed a significant difference (p=0.05) between cases and controls. In the case of saliva samples, the concentration of S1P was higher than the ones found in the control group (72.94 ng/mL and 45.12 ng/mL). For GCF, a higher amount of S1P was found in patients with POD (20.09 ng/mL and 15.20 ng/mL). This work raises a possible route of bone metabolism, inflammatory process, and identification of periodontitis through oral quantification of S1P, however, future studies are needed.

Resumen El propósito de este estudio fue la cuantificación de Esfingosina-1-Fosfato (S1P) en las bolsas periodontales de pacientes con periodontitis. Estudio observacional, descriptivo de casos y controles. 30 sujetos fueron seleccionados de los cuales 15 controles y 15 casos. Se realizó un estudio periodontal completo siguiendo los parámetros establecidos por la AAP en 2017 para el diagnóstico de las enfermedades periodontales. Se tomaron muestras de saliva y de líquido crevicular gingival de cada sujeto estudiado y se analizaron con el ELISA kit humano para S1P (MyBiosource #MBS2516132) y de acuerdo con las instrucciones del fabricante, se realizó para cuantificar la presencia d S1P en las muestras estudiadas. Los resultados mostraron diferencia significativa (p=0.05) entre casos y controles. En el caso de las muestras de saliva, la concentración de S1P en controles fue mayor (72.94 ng/mL y 45.12 ng/mL). Para Líquido crevicular gingival, se encontró mayor cantidad de S1P en los pacientes con periodontitis (20.09 ng/mL y 15.20 ng/mL). Este estudio plantea una posible ruta de metabolismo óseo, proceso inflamatorio e identificación de la Periodontitis a través de la cuantificación oral de S1P, sin embargo se necesitan estudios futuros.

Gingival crevicular fluid as Biomarker's source for alzheimer's disease / Fluido crevicular gingival como biomarcador de enfermedad de Alzheimer

Abstract Periodontitis is a low-grade inflammatory disease caused by a subgingival dysbiotic microbiota. Multiple studies have determined the higher prevalence of tooth loss and poor oral hygiene in patients with Alzheimer's disease (AD). However, the periodontal diagnosis, periodontal bacteria or mediators has not been measured to date. Aim: To determine the periodontal status, the pro-inflammatory mediators, Porphyromonas gingivalis load, and Apoliporpotein E (ApoE) in patients with AD. A complete dental examination was performed on 30 patients, and cognitive status was determined by the Montreal Cognitive Assessment (MoCA). Subgingival microbiota and GCF samples were then taken from all patients from the deepest sites. Total DNA was isolated from the microbiota samples for the quantification of the 16S ribosomal subunit. Pro-inflammatory mediators and ApoE were quantified from the gingival crevicular fluid (GCF). Patients with AD had periodontitis stage III-IV in 80%, a higher concentration of pro-inflammatory and ApoE mediators, and a higher P. gingivalis load compared to healthy subjects. The pro-inflammatory mediators, P. gingivalis load had a negative correlation with the MoCA test scores. Finally, a ROC curve was performed to assess the specificity and sensitivity of ApoE levels, detecting an area of 84.9%. In AD patients, we found a more severe periodontitis, a higher levels of pro-inflammatory mediators, and higher bacterial load. In addition, there is an increase in ApoE that allows to clearly determine patients with health, periodontitis and periodontitis and AD.

Resumen La periodontitis es una enfermedad crónica no transmisible que se caracteriza por generar una inflamación sistémica de bajo grado causada por una microbiota disbiótica subgingival. Múltiples estudios han determinado la mayor prevalencia de pérdida de dientes y mala higiene bucal en pacientes con enfermedad de Alzheimer (EA). Sin embargo, el diagnóstico periodontal, bacterias periodontales o mediadores pro-inflamatorio no se ha medido hasta la fecha. Determinar el estado periodontal, los mediadores pro-inflamatorios, la carga de Porphyromonas gingivalis y la apoliporpoteína E (ApoE) en pacientes con EA. Se realizó un examen odontológico completo en 30 pacientes y el estado cognitivo se determinó mediante la Evaluación Cognitiva de Montreal (MoCA). Luego, se tomaron muestras de microbiota subgingival y FCG de todos los pacientes de los sitios más profundos. Se aisló el DNA total de las muestras de microbiota para la cuantificación de la subunidad ribosómica 16S. Los mediadores pro-inflamatorios y la ApoE se cuantificaron a partir del líquido crevicular gingival (GCF). Los pacientes con EA tenían periodontitis en estadio III-IV en 80%, una mayor concentración de mediadores pro-inflamatorios y ApoE, y una mayor carga de P. gingivalis en comparación con los sujetos sanos. Los mediadores pro-inflamatorios y la carga de P. gingivalis tuvieron una correlación negativa con las puntuaciones de la prueba MoCA. Finalmente, se realizó una curva ROC para evaluar la especificidad y sensibilidad de los niveles de ApoE, detectando un área del 84,9%. En los pacientes con EA encontramos una periodontitis más severa, mayores niveles de mediadores pro-inflamatorios y mayor carga bacteriana. Además, un aumento de ApoE que permite determinar claramente a los pacientes con salud, periodontitis y periodontitis y EA.

Antimicrobial effect of Casiopeinas® copper- and ruthenium-based compounds on Aggregatibacter actinomycetemcomitans and in vitro cell viability onto osteoblasts cells.

OBJECTIVES: The present study aims to evaluate the antimicrobial property of Casiopeinas® copper- and ruthenium-based compounds against Aggregatibacter actinomycetemcomitans serotype b (ATCC® 43,718™), as well as the cytotoxicity on an osteoblasts cell line of both compounds. MATERIAL AND METHODS: The antibacterial effect of the copper-based compounds (CasII-gly, CasIII-ia) and the ruthenium-based compound (RuN-6) at four different concentrations was evaluated as the inhibition ratio of the bacterial growth after 48 h under anaerobic conditions, and the cell viability was measured through resazurin assay. RESULTS: The copper- and ruthenium-based compounds used for this assay were (CasII-gly, CasIII-ia, and RuN-6), showing inhibitory activity between 39 and 62% compared to the antibiotic employed as control 66%. Cell viability was established between 61 and 96%. CONCLUSIONS: Casiopeinas® and ruthenium showed dose and time dependent, inhibitory activity on A. actinomycetemcomitans, and low toxicity on cells (osteoblast) underexposure. The compound CasII-gly showed the best antimicrobial effect, and it could be considered a possible antimicrobial agent in periodontal therapy.

Oral-Gut-Brain Axis in Experimental Models of Periodontitis: Associating Gut Dysbiosis With Neurodegenerative Diseases.

Periodontitis is considered a non-communicable chronic disease caused by a dysbiotic microbiota, which generates a low-grade systemic inflammation that chronically damages the organism. Several studies have associated periodontitis with other chronic non-communicable diseases, such as cardiovascular or neurodegenerative diseases. Besides, the oral bacteria considered a keystone pathogen, Porphyromonas gingivalis, has been detected in the hippocampus and brain cortex. Likewise, gut microbiota dysbiosis triggers a low-grade systemic inflammation, which also favors the risk for both cardiovascular and neurodegenerative diseases. Recently, the existence of an axis of Oral-Gut communication has been proposed, whose possible involvement in the development of neurodegenerative diseases has not been uncovered yet. The present review aims to compile evidence that the dysbiosis of the oral microbiota triggers changes in the gut microbiota, which creates a higher predisposition for the development of neuroinflammatory or neurodegenerative diseases.The Oral-Gut-Brain axis could be defined based on anatomical communications, where the mouth and the intestine are in constant communication. The oral-brain axis is mainly established from the trigeminal nerve and the gut-brain axis from the vagus nerve. The oral-gut communication is defined from an anatomical relation and the constant swallowing of oral bacteria. The gut-brain communication is more complex and due to bacteria-cells, immune and nervous system interactions. Thus, the gut-brain and oral-brain axis are in a bi-directional relationship. Through the qualitative analysis of the selected papers, we conclude that experimental periodontitis could produce both neurodegenerative pathologies and intestinal dysbiosis, and that periodontitis is likely to induce both conditions simultaneously. The severity of the neurodegenerative disease could depend, at least in part, on the effects of periodontitis in the gut microbiota, which could strengthen the immune response and create an injurious inflammatory and dysbiotic cycle. Thus, dementias would have their onset in dysbiotic phenomena that affect the oral cavity or the intestine. The selected studies allow us to speculate that oral-gut-brain communication exists, and bacteria probably get to the brain via trigeminal and vagus nerves.

Levels of Myeloperoxidase and Metalloproteinase-9 in Gingival Crevicular Fluid from Diabetic Subjects with and without Stage 2, Grade B Periodontitis.

OBJECTIVE: The present study aimed to compare levels of matrix metalloproteinase-9 (MMP-9) and myeloperoxidase (MPO) in gingival crevicular fluid (GCF) from subjects with controlled and noncontrolled Type 2 Diabetes Mellitus (T2D), with and without stage 2 grade B periodontitis (POD2B) versus healthy (H) subjects. METHODS: The levels of both enzymes, from 80 GCF samples collected with PerioPaper strips, were analyzed by a Multiplex/Luminex assay. Five groups were formed, all current patients at the Institutional Dentistry Service, and distributed as follows: two groups of diabetics (one controlled and one poorly controlled); two groups with the previous conditions and diagnosed with POD2B; and one H group. RESULTS: The highest concentration of MMP-9 corresponded to the H group, while the lowest corresponded to the T2D controlled group. Regarding MPO levels, the highest levels were associated with the T2D controlled with POD2B group and the lowest with the T2D controlled group. CONCLUSIONS: No apparent relationship between the elevation of MMP-9 and MPO levels was observed among subjects with T2D, with and without POD2B, compared to H subjects.

Quantification of TNF-α in Patients with Periodontitis and Type 2 Diabetes.

OBJECTIVE: The present study aimed to compare variations in quantified tumor necrosis factor-alpha (TNF-α) levels in patients with periodontitis stage 2 grade B (POD2B) and/or type 2 diabetes (T2D) and to identify any relationships between this cytokine and these diseases. METHODS: Levels of the cytokine TNF-α in gingival crevicular fluid in patients with POD2B and/or T2D were evaluated. A total of 160 subjects were distributed into four groups: those with POD2B (n=44); those with T2D (n=37); those with POD2B/T2D (n=40); and healthy subjects (n=39). Glycosylated hemoglobin (HbA1c) and blood glucose (BG) levels were quantified in each subject. Data were collected on body mass index (BMI), loss of insertion (LI), and probe depth (PD). Gingival crevicular fluid samples were collected from the most acutely affected periodontal pocket and gingival sulcus in each subject, and TNF-α was quantified by multiplex analysis. RESULTS: Kruskal Wallis tests was used to identify differences in TNF-α levels, LI, PD, BMI, BG, and HbA1c by group. Differences (p<0.001) were found for LI, PD, BG, and HbA1c. A Spearman test was used to calculate possible correlations between TNF-α levels and LI or PD identified a weak but significant negative correlation of TNF-α with LI (Rho=-0199; p=0.012), and a moderately positive correlation of LI with PD (Rho=0.509; p < 0.001). CONCLUSIONS: No variation was found between TNF-α levels and the presence of POD2B, POD2B/T2D, or T2D, suggesting the absence of any direct relationship between progression of these diseases and TNF-α levels. However, a correlation was present between low TNF-α concentrations and greater LI.

Aggressive Periodontitis and its Multidisciplinary Focus: Review of the Literature

he purpose of this review is to have a current prospect of periodontal diseases and, in particular, aggressive periodontitis. To know its classification and clinical characteristics, such as the extent and age group affected, as well as its distribution in the population, etiology, genetic variations, among other factors that could affect the development of this disease. Also, reference is made to different diagnostic options and, likewise, the current treatment options.

l propósito de esta revisión es tener un panorama actual de las enfermedades periodontales y, en particular, de la periodontitis agresiva. Conocer su clasificación y características clínicas, como la extensión y grupo etario afectado, así como su distribución en la población, etiología, variaciones genéticas, entre otros factores que pudiesen afectar el desarrollo de dicha enfermedad. Así mismo, se hace referencia a distintas opciones de diagnóstico y, de igual forma, las opciones de tratamiento actuales.

Cuantificación de la quimiocina CCL5 en pacientes con diabetes mellitus tipo 2 y/o periodontitis cronica: Estudio preliminar

l propósito del presente estudio fue cuantificar la presencia de la quimiocina CCL5 (RANTES) en Líquido Crevicular Gingival (LCG) de pacientes con Periodontitis Crónica (PC) y/o Diabetes Mellitus tipo 2 (DM2). Se realizó un estudio comparativo, transversal en 40 pacientes. Se tomó LCG de bolsas periodontales y surcos gingivales de 4 grupos de pacientes (10 por grupo de estudio), se excluyó a los pacientes que recibieron tratamiento periodontal, antibiótico y antiinflamatorio 6 meses anteriores al estudio o cursaron con alguna enfermedad sistémica distinta a DM2. Las concentraciones de CCL5 se determinaron mediante ensayos LUMINEX de selección magnética. Se realizó estadística descriptiva, prueba ANOVA de una vía, T de student y correlación de Pearson. La cuantificación de CCL5 fue mayor en los pacientes que presentaron ambas enfermedades, seguidos del grupo con solo PC, los sanos y el grupo con solo DM2. No se encontró diferencia significativa entre los grupos y no hubo correlación entre las cuantificaciones y los indicadores glicémicos. A pesar de que las diferencias no fueron significativas, el grupo de pacientes con ambas enfermedades presentó la mayor cuantificación de CCL5. La expresión de CCL5 en LGC debe considerarse un potencial inductor de destrucción periodontal, su determinación podría ser útil para monitoreo de la salud/enfermedad de los tejidos periodontales.

he purpose of the present study was to quantify the presence of chemokine CCL5 (RANTES) in gingival crevicular fluid (LCG) in patients with chronic periodontitis (PC) and / or type 2 diabetes mellitus (DM2). A comparative cross-sectional study was conducted in 40 patients. LCG was taken from periodontal pockets and gingival grooves from 4 patient groups (10 per study group); patients who received periodontal, antibiotic and anti-inflammatory treatment 6 months prior to the study or who had systemic disease other than DM2 were excluded. Concentrations of CCL5 were determined by LUMINEX® assays. Descriptive statistics, one-way ANOVA, Student's T, and Pearson's correlation were performed. The quantification of CCL5 was higher in the patients who presented both diseases, followed by the group with only PC, healthy and the group with only DM2. No significant difference was found between groups and there was no correlation between quantifications and glycemic indicators. Although the differences were not significant, the group of patients with both diseases had the highest CCL5 quantification. The expression of CCL5 in LGC should be considered as a potential inducer of periodontal destruction, its determination could be useful for monitoring the health/disease of periodontal tissues.