Salivary human beta-defensins and cathelicidin levels in relation to periodontitis and type 2 diabetes mellitus.

Objective: Type 2 diabetes mellitus (T2DM) is a well-defined risk factor of periodontitis and it can affect expression of human beta-defensins (hBDs) and cathelicidin (LL-37) as well. The aim of the present study was to evaluate the impact of periodontitis and T2DM on salivary concentrations of these antimicrobial peptides.Material and methods: Unstimulated saliva samples, together with full-mouth periodontal recordings were collected from 92 individuals with periodontitis (63 with T2DM and 21 smokers) and 86 periodontally healthy controls (58 with T2DM and 21 smokers). Salivary hBD-1, -2, -3, LL-37, and advanced glycalization end products (AGE) concentrations were measured by enzyme-linked immunosorbent assay.Results: Among the periodontitis patients, T2DM group demonstrated lower levels of hBD-1 (p = .006), hBD-2 (p < .001) and hBD-3 (p < .001), and higher levels of LL-37 (p < .001) compared to systemically healthy controls. When only periodontally healthy controls were included into the analysis, higher hBD-1 (p = .002) and LL-37 (p < .001) levels were found in T2DM patients in comparison to systemically healthy controls. Salivary LL-37 levels were associated with HbA1c and periodontitis, while hBD-2, hBD-3 and levels associated only with HbA1c.Conclusion: In the limits of this study, hyperglycaemia can be proposed as a regulator of salivary hBD and cathelicidin levels. Periodontitis, on the other hand, affects only salivary LL-37 levels.

Implant-Site Related and Patient-Based Factors With the Potential to Impact Patients' Satisfaction, Quality of Life Measures and Perceptions Toward Dental Implant Treatment.

OBJECTIVES: The present study aimed at evaluating both the implant site-related and patient-based factors with the potential to affect the extent of patients' satisfaction and also their perceptions regarding dental implant treatment. Potential differences between the esthetic evaluations of dental patients and dental specialists were also considered. MATERIALS AND METHODS: Implant-supported fixed prosthesis (n = 164) in 264 anterior esthetic implant sites were included. Patients' satisfaction, esthetic considerations, and perceptions toward dental implants, were evaluated by both Oral Health Impact Profile-14 (OHIP-14) questionnaire and visual analog scale. Pink Esthetic Score/White Esthetic Score were used for the professional esthetic evaluations of dental specialists. RESULTS: Overall patient satisfaction was high (87.42 ± 11.86). Compared with implant supported single-tooth restorations, patients with implant-supported bridges had lower OHIP scores (P = 0.001) and were relatively less satisfied with particular aspects of dental implant treatment (eg, cleanability, phonetics, surgical discomfort, and pretreatment information). Generally, type of prosthesis, history of soft/hard tissue augmentation, and reason for tooth loss had a clear impact on the extent of patients' satisfaction, esthetic considerations regarding treatment outcome, and their perceptions toward dental implant treatment (P < 0.05). CONCLUSIONS: Fixed implant-supported restorations generally provide with high levels of satisfaction and oral health-related quality of life.

Nitrite and nitrate levels of gingival crevicular fluid and saliva in subjects with gingivitis and chronic periodontitis.

OBJECTIVES: Nitrosative stress plays an essential role in the pathogenesis of periodontal disease. The aim of this study is to analyze the gingival crevicular fluid and saliva nitrite and nitrate levels in periodontally healthy and diseased sites. MATERIAL AND METHODS: A total of 60 individuals including, 20 chronic periodontitis and 20 gingivitis patients and 20 periodontally healthy controls participated in the present study. Probing depth, clinical attachment level, bleeding on probing, gingival index and plaque index were assessed, gingival crevicular fluid (GCF) and saliva samples were obtained from the subjects, including 480 GCF samples and 60 unstimulated whole saliva samples. Nitrite and nitrate were analyzed by Griess reagent. RESULTS: Total GCF nitrite levels were higher in gingivitis and periodontitis groups (1.07 [SD 0.62] nmol and 1.08 [SD 0.59] nmol) than the control group (0.83 [SD 0.31] nmol) (P < 0.05) but did not differ significantly between gingivitis and periodontitis groups (P > 0.05). The difference in GCF nitrate level was not significant among the control, gingivitis and periodontitis groups (7.7 [SD 2.71] nmol, 7.51 [SD 4.16] nmol and 7.38 [SD 1.91] nmol). Saliva nitrite and nitrate levels did not differ significantly among three study groups. Saliva nitrate/nitrite ratios were higher in periodontitis and gingivitis groups than the control group. A gradual decrease in nitrate/nitrite ratio in GCF was detected with the presence of inflammation. CONCLUSIONS: It may be suggested that nitrite in gingival crevicular fluid is a better periodontal disease marker than nitrate and may be used as an early detection marker of periodontal inflammation, and that local nitrosative stress markers don't show significant difference between the initial and advanced stages of periodontal disease.

Analysis of daytime variations in gingival crevicular fluid: a circadian periodicity?

BACKGROUND: Volumetric alterations in gingival crevicular fluid (GCF) are widely accepted to be associated with periodontal health/disease. The volume/flow of GCF was shown to be affected by an array of methodological factors. However, relatively limited information is available on whether GCF is subject to circadian rhythm. The main aim of the present study is to assess the possible presence/absence of GCF circadian rhythm. The impact of the sampling technique on daytime volumetric variations is also analyzed. METHODS: The possible daily volumetric variations of GCF with 2-hour intervals (from 08:00 to 18:00 hours) were assessed in 100 tooth sites and 600 GCF samples. Only maxillary incisors were included to eliminate any potential volumetric differences due to tooth dimensions. To analyze the potential impact of sampling technique on GCF volume and daytime variations, at one site modified intracrevicular sampling technique (MIST) was used, whereas the contralateral site was sampled with a deep intracrevicular sampling technique (DIST). Clinical periodontal parameters of the GCF sites were also recorded. RESULTS: No significant daily variations in GCF volume could be detected. Higher volumetric measures were observed in inflamed subgroups compared with healthy subgroups (P <0.05). MIST was equivalent to DIST with regard to mean GCF volumes and the possible daytime volumetric alterations. CONCLUSIONS: Within the limits of the present study, it can be suggested that daytime variations did not have significant impact on GCF volume. The sampling methodology had no apparent impact on the circadian periodicity of GCF.