Differential molecular profiles and associated functionalities characterize connective tissue grafts obtained at different locations and depths in the human palate / 国际口腔科学杂志·英文版

The present study aimed to assess the molecular profiles of subepithelial connective tissue grafts (CTGs) obtained at different locations and depths in the human palate. Sixty-four CTGs belonging to anterior deep (AD), anterior superficial (AS), posterior deep (PD), and posterior superficial (PS) groups were subjected to RNA-Sequencing and their transcriptomes were analyzed computationally. Functional correlations characterizing the CTG groups were validated by cell biological experiments using primary human palatal fibroblasts (HPFs) extracted from the CTGs. A clearly more pronounced location-dependent than depth-dependent difference between the grafts, with a minimal number of genes (4) showing no dependence on the location, was revealed. Epithelial, endothelial, and monocytic cell migration was strongly (P < 0.001) potentiated by AD- and PS-HPFs. Moreover, significantly increased expression of genes encoding C-C and C-X-C motif chemokine ligands as well as significantly (P < 0.01) activated p38 signaling suggested immunomodulatory phenotype for AD- and PS-HPFs. Increased growth factor gene expression and significantly activated (P < 0.001) Erk and Akt signaling in HPFs originating from A-CTGs implied their involvement in cell survival, proliferation, and motility. Prominent collagen-rich expression profile contributing to high mechanical stability, increased osteogenesis-related gene expression, and strongly activated (P < 0.001) Smad1/5/8 signaling characterized HPFs originating from P-CTGs. The present data indicate that in humans, differences between palatal CTGs harvested from different locations and depths appear to be location- rather than depth-dependent. Our findings provide the basis for future personalization of the therapeutic strategy by selecting an optimal graft type depending on the clinical indications.

A thermosensitive gel with an active hyaluronic acid ingredient that contains an octenidine preservation system as an adjunct to scaling and root planning: a randomized prospective clinical study.

OBJECTIVES: To evaluate the adjunctive effect of a thermosensitive gel formulation that contains 0.8% oligo hyaluronic acid (HA) combined with a preservation system of octenidine HCl 0.625% and phenoxyethanol to scaling and root planing (SRP) as compared with SRP alone in the treatment of residual pockets of patients with stage 3 periodontitis. MATERIALS AND METHODS: Thirty-four patients (21 males and 13 females) aged 29-78 years (51.3 ± 13.1) with stage 3 periodontitis were recruited to participate in the present split-mouth study. None of the patients has been previously treated for periodontitis. Plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were evaluated at baseline and at 3 and 6 months post treatment. Full-mouth SRP was performed in all residual pockets ≥ 5 mm. Treatment was performed by means of ultrasonic and hand instruments and lasted 45-60 min. The gel was applied subgingivally in the test sites immediately after SRP (baseline) and 1 month later. The paired t-test for two means was applied to test the statistical significance of the change from baseline within each arm and determine the difference between groups. The level of significance was set at 0.05 for all tests. RESULTS: Mean PD reductions between baseline and 3 and 6 months were 1.98 mm and 2.79 mm for the test and 1.22 mm and 1.50 mm for the control group, respectively. Comparisons between the test and control groups revealed that SRP + gel yielded statistically significantly higher PD reductions compared to SRP alone (p < 0.0001). Compared to baseline, CAL and BOP values improved statistically significantly in both groups, although the test group presented statistically significantly higher CAL gains and BOP reductions than the control group (P < 0.0001). CONCLUSION: In residual pockets of stage 3 periodontitis patients, the local application of a thermosensitive gel with an active HA ingredient and a preservation system of octenidine HCl 0.625% in conjunction with SRP may additionally improve the clinical outcomes obtained with SRP alone. CLINICAL RELEVANCE: A novel HA and octenidine containing thermosensitive gel effectively improved the clinical parameters in stage 3 periodontitis patients over a 6-month period.

Caffeic acid phenethyl ester protects against oxidative stress and dampens inflammation via heme oxygenase 1 / 国际口腔科学杂志·英文版

Periodontal disease is associated with chronic oxidative stress and inflammation. Caffeic acid phenethyl ester (CAPE), which is a potent inducer of heme oxygenase 1 (HO1), is a central active component of propolis, and the application of propolis improves periodontal status in diabetic patients. Here, primary murine macrophages were exposed to CAPE. Target gene expression was assessed by whole-genome microarray, RT-PCR and Western blotting. The antioxidative and anti-inflammatory activities of CAPE were examined by exposure of the cells to hydrogen peroxide, saliva and periodontal pathogens. The involvement of HO1 was investigated with the HO1 inhibitor tin protoporphyrin (SnPP) and knockout mice for Nrf2, which is a transcription factor for detoxifying enzymes. CAPE increased HO1 and other heat shock proteins in murine macrophages. A p38 MAPK inhibitor and Nrf2 knockout attenuated CAPE-induced HO1 expression in macrophages. CAPE exerted strong antioxidative activity. Additionally, CAPE reduced the inflammatory response to saliva and periodontal pathogens. Blocking HO1 decreased the antioxidative activity and attenuated the anti-inflammatory activity of CAPE. In conclusion, CAPE exerted its antioxidative effects through the Nrf2-mediated HO1 pathway and its anti-inflammatory effects through NF-κB inhibition. However, preclinical models evaluating the use of CAPE in periodontal inflammation are necessary in future studies.

[Experience with the clinical use of beta-tri-calcium phosphate (Cerasorb) as a bone replacement graft material in human periodontal osseous defects]. / A beta tri-calcium phosphate (Cerasorb) klinikai alkalmazásával nyert tapasztalatok humán parodontális csonthiányok pótlásában.

Various bone replacement graft materials have been used in attempting to restore periodontal bone structure lost as a result of periodontal inflammation. The pure beta-tricalcium phosphate has been successfully used in oral surgery for replacing lost bone but the periodontal data available are very limited. The major objective of the present clinical trial is to evaluate the regenerative-reparative potential of beta-tricalcium phosphate (CERASORB) in the treatment of two-three-wall vertical periodontal bony defect. 21 patients with advanced intrabony defects were selected for this study. Parameters used for assessment: Bleeding on probing, Clinical Probing Depths (CPD), Clinical Attachment Loss (CAL), Clinical Gingival Recession (CGR) and Radiological evaluation on standardized periapical radiographs. Following local anesthesia, intracervicular incisions is placed and a full thickness mucoperiosteal flap is raised vestibularly and lingually. The granulation tissue was completely removed from the defects and the roots were thoroughly scaled and planed using hand and ultrasonic instruments. Osseous recontouring was not performed. Following defect debridement, the CERASORB bone-grafting material was carefully applied and gently condensed in the bone crater then the flaps were repositioned in a coronal position and closed with vertical or horizontal mattress sutures. Six months after surgery CPD, CAL and CGR parameters were also measured and compared to baseline data. Bone defects treated with beta-TCP bone grafting materials showed a great variation in healing tendency. The best radiological results (bone fill) were obtained in three wall defects. Even using the most thorough suturing technique substantial part of the bone grafting material was lost during the first post-surgical week. If no sequestration occurred substantial bone fill and clinical attachment gain occurred especially in the three wall defects one year after grafting. The use of biological barrier membranes are recommended.