RESUMEN
Although dental implants and bone regenerative procedures are important approaches for the reestablishment of esthetics and function in young patients with a history of generalized aggressive periodontitis (GAP), no predictable outcomes have been reported, and the host osteo-immunoinflammatory response may play a relevant role in this context. In view of the lack of molecular investigations into the bone tissue condition of young patients with periodontitis, the aim of this study was to evaluate the gene expression of bone-related factors in this population. Bone biopsies were obtained from the posterior mandible in 16 individuals previously diagnosed with GAP and on periodontal support therapy and from 17 periodontally healthy (PH) patients. The gene expression of tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-ß, receptor activator of the NF-κB ligand (RANKL), osteoprotegerin (OPG), osteocalcin (OC), bone sialoprotein (BSP), and type I collagen (COL-I), important biomarkers of bone turnover, was evaluated by qRT-PCR. Lower TGF-ß and OPG mRNA levels were observed in GAP patients compared to PH individuals (p ≤ 0.05). There were no between-group differences in levels of TNF-α, BSP, RANKL, OC, or COL-I mRNA (p>0.05). In young adults, a history of periodontal disease can negatively modulate the gene expression of important bone-related factors in alveolar bone tissue. These molecular outcomes may contribute to the future development of therapeutic approaches to benefit bone healing in young patients with history of periodontitis via modulation of osteo-immuno-inflammatory biomarkers.
Asunto(s)
Periodontitis Agresiva/genética , Expresión Génica , Adulto , Periodontitis Agresiva/metabolismo , Proceso Alveolar/química , Biomarcadores , Colágeno Tipo I/análisis , Colágeno Tipo I/genética , Estudios Transversales , Femenino , Humanos , Sialoproteína de Unión a Integrina/análisis , Sialoproteína de Unión a Integrina/genética , Masculino , Osteocalcina/análisis , Osteocalcina/genética , Osteoprotegerina/análisis , Osteoprotegerina/genética , Ligando RANK/análisis , Ligando RANK/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Valores de Referencia , Método Simple Ciego , Estadísticas no Paramétricas , Factor de Crecimiento Transformador beta/análisis , Factor de Crecimiento Transformador beta/genética , Factor de Necrosis Tumoral alfa/análisis , Factor de Necrosis Tumoral alfa/genética , Adulto JovenRESUMEN
Abstract Although dental implants and bone regenerative procedures are important approaches for the reestablishment of esthetics and function in young patients with a history of generalized aggressive periodontitis (GAP), no predictable outcomes have been reported, and the host osteo-immunoinflammatory response may play a relevant role in this context. In view of the lack of molecular investigations into the bone tissue condition of young patients with periodontitis, the aim of this study was to evaluate the gene expression of bone-related factors in this population. Bone biopsies were obtained from the posterior mandible in 16 individuals previously diagnosed with GAP and on periodontal support therapy and from 17 periodontally healthy (PH) patients. The gene expression of tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, receptor activator of the NF-κB ligand (RANKL), osteoprotegerin (OPG), osteocalcin (OC), bone sialoprotein (BSP), and type I collagen (COL-I), important biomarkers of bone turnover, was evaluated by qRT-PCR. Lower TGF-β and OPG mRNA levels were observed in GAP patients compared to PH individuals (p ≤ 0.05). There were no between-group differences in levels of TNF-α, BSP, RANKL, OC, or COL-I mRNA (p>0.05). In young adults, a history of periodontal disease can negatively modulate the gene expression of important bone-related factors in alveolar bone tissue. These molecular outcomes may contribute to the future development of therapeutic approaches to benefit bone healing in young patients with history of periodontitis via modulation of osteo-immuno-inflammatory biomarkers.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Adulto Joven , Periodontitis Agresiva/genética , Expresión Génica , Periodontitis Agresiva/metabolismo , Valores de Referencia , Biomarcadores , Osteocalcina/análisis , Osteocalcina/genética , Método Simple Ciego , Estudios Transversales , Factor de Crecimiento Transformador beta/análisis , Factor de Crecimiento Transformador beta/genética , Factor de Necrosis Tumoral alfa/análisis , Factor de Necrosis Tumoral alfa/genética , Estadísticas no Paramétricas , Colágeno Tipo I/análisis , Colágeno Tipo I/genética , Ligando RANK/análisis , Ligando RANK/genética , Osteoprotegerina/análisis , Osteoprotegerina/genética , Sialoproteína de Unión a Integrina/análisis , Sialoproteína de Unión a Integrina/genética , Proceso Alveolar/química , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
BACKGROUND AND OBJECTIVE: Smoking is a recognized risk factor for peri-implant disease and leads to microbiological changes in mucositis and peri-implantitis. However, there is no knowledge about the impact of smoking in healthy peri-implant tissue. The aim of the study was to evaluate the microbiome in a peri-implant environment in smokers with healthy peri-implant conditions. METHODS: Peri-implant biofilm was collected around single clinically healthy, screwed-retained, teeth-surrounded implants in 12 non-smoker (NSMK) and 12 smoker (SMK) non-periodontitis subjects (no bleeding and probing depth <4 mm). Bacterial DNA was isolated and 16S ribosomal RNA gene libraries were sequenced using pyrosequencing, targeting the V3-V4 region. Datasets were processed using the Quantitative Insights into Microbial Ecology, Greengenes and the Human Oral Microbiome Database databases. RESULTS: An evident difference in the SMK peri-implant microbiome was observed compared to the NSMK microbiome, with a large abundance of species, even with a healthy peri-implant. The SMK core-microbiome showed an abundance of Fusobacterium, Tannerella and Mogibacterium, while the NSMK core revealed an abundance of Actinomyces, Capnocytophaga and Streptococcus, genera that are usually related to periodontal health. The microbiome inter-relationship was shown to be more inter-generic in SMK then in NSMK, indicating different microbiome cohesion. CONCLUSION: Smoking negatively affected the peri-implant microbiome, leading to a disease-associated state, even in clinically healthy individuals.
Asunto(s)
Biopelículas , Implantes Dentales/microbiología , Periimplantitis/etiología , Periimplantitis/microbiología , Fumar/efectos adversos , Actinomyces/genética , Actinomyces/aislamiento & purificación , Adulto , Capnocytophaga/genética , Capnocytophaga/aislamiento & purificación , Estudios de Casos y Controles , ADN Bacteriano/genética , ADN Bacteriano/aislamiento & purificación , Fusobacterium/genética , Fusobacterium/aislamiento & purificación , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Masculino , Microbiota/genética , Persona de Mediana Edad , Periodontitis/microbiología , ARN Ribosómico 16S/genética , Tannerella forsythia/genética , Tannerella forsythia/aislamiento & purificaciónRESUMEN
Este relato descreveu um caso clínico no qual foi realizado um planejamento multidisciplinar priorizando, além do restabelecimento funcional, uma adequada estética ao paciente. Para que tais metas fossem alcançadas, foi importante a implementação de uma visão multidisciplinar do caso, garantindo um planejamento integrado capaz de reunir todos os requisitos para a otimização de resultados satisfatórios, considerando os padrões de estética periodontal e dental. O presente caso clínico descreveu uma abordagem clínica multidisciplinar para reabilitação anterior envolvendo cirurgia plástica periodontal, para aumento de coroa e confecção de facetas em resina composta pela técnica direta para devolução de estética dental, resultando em sucesso clínico e satisfação da paciente.
This report describes a clinical case in which a multidisciplinary planning was performed, prioritizing, in addition to functional restoration, adequate aesthetics to the patient. In order to achieve these goals, it was important to implement an interdisciplinary view of the case, guaranteeing an integrated planning capable of meeting all the requirements for the optimization of satisfactory results, considering the patterns of periodontal and dental aesthetics. The present case report describes a multidisciplinary clinical approach for previous rehabilitation involving periodontal plastic surgery for crown lengthening and direct composite resin veneers to retrieve dental esthetics achieving clinical success and patient satisfaction.
