Flattening of the articular eminence is associated with the loss of occlusal support: radiological study.

BACKGROUND: Degenerative changes in the temporomandibular joint might be associated with ageing and/or with the loss of occlusal support. OBJECTIVE: The aim of the study was to evaluate whether the inclination of the posterior slope of the articular eminence changes in association with: (i) ageing in patients with maintained occlusal support zones (OSZs); and (ii) the loss of OSZs in elders. METHODS: In this retrospective radiological study, selected orthopantomograms were allocated into the following groups: I-age 18-35, maintained OSZs, II-age 36-60, maintained OSZs, III-age >60, at least one OSZ per side maintained, IV-age >60, loss of all OSZs. The inclination of the articular eminence was measured relative to the Frankfort plane. RESULTS: The mean values of the inclination of the slope of the articular eminence amounted 34.05° ± 5.17°, 36.68° ± 5.65°, 34.86° ± 6.26° and 26.31° ± 5.12° for group I, II, III and IV respectively. There were no significant differences between the groups I to III. Group IV differed significantly from each of the previous groups. CONCLUSIONS: Flattening of the articular eminence is associated with the loss of OSZs rather than ageing.

HDAC3 Regulates Gingival Fibroblast Inflammatory Responses in Periodontitis.

Histone deacetylases (HDACs) are important regulators of gene expression that are aberrantly regulated in several inflammatory and infectious diseases. HDAC inhibitors (HDACi) suppress inflammatory activation of various cell types through epigenetic and non-epigenetic mechanisms, and ameliorate pathology in a mouse model of periodontitis. Activation of gingival fibroblasts (GFs) significantly contributes to the development of periodontitis and the anaerobic bacterium Porphyromonas gingivalis plays a key role in driving chronic inflammation. Here, we analyzed the role of HDACs in inflammatory responses of GFs. Pan-HDACi suberoylanilide hydroxamic acid (SAHA) and/or ITF2357 (givinostat) significantly reduced TNFα- and P. gingivalis-inducible expression and/or production of a cluster of inflammatory mediators in healthy donor GFs (IL1B, CCL2, CCL5, CXCL10, COX2, and MMP3) without affecting cell viability. Selective inhibition of HDAC3/6, but not specific HDAC1, HDAC6, or HDAC8 inhibition, reproduced the suppressive effects of pan-HDACi on the inflammatory gene expression profile induced by TNFα and P. gingivalis, suggesting a critical role for HDAC3 in GF inflammatory activation. Consistently, silencing of HDAC3 expression with siRNA largely recapitulated the effects of HDAC3/6i on mRNA levels of inflammatory mediators in P. gingivalis-infected GFs. In contrast, P. gingivalis internalization and intracellular survival in GFs remained unaffected by HDACi. Activation of mitogen-activated protein kinases and NFκB signaling was unaffected by global or HDAC3/6-selective HDACi, and new protein synthesis was not required for gene suppression by HDACi. Finally, pan-HDACi and HDAC3/6i suppressed P. gingivalis-induced expression of IL1B, CCL2, CCL5, CXCL10, MMP1, and MMP3 in GFs from patients with periodontitis. Our results identify HDAC3 as an important regulator of inflammatory gene expression in GFs and suggest that therapeutic targeting of HDAC activity, in particular HDAC3, may be clinically beneficial in suppressing inflammation in periodontal disease.

Therapeutic effect of exogenous ghrelin in the healing of gingival ulcers is mediated by the release of endogenous growth hormone and insulin-like growth factor-1.

Ghrelin, an acylated 28-amino acid polypeptide, was primary isolated from the stomach, and the stomach is a main source of circulating ghrelin. Ghrelin strongly and dose-dependently stimulates release of growth hormone from the anterior pituitary, as well as increases food intake and fat deposition. Previous studies showed that ghrelin exhibits protective and therapeutic effect in different parts of the gastrointestinal system, including the oral cavity. The aim of present study was to examine the role of growth hormone and insulin-like growth factor-1 (IGF-1) in the healing of gingival ulcers. Studies were performed on rats with the intact pituitary gland and hypophysectomized rats. In anesthetized rats, chronic ulcers of the gum were induced by acetic acid. Rats were treated intraperitoneally twice a day with saline or ghrelin (4, 8 or 16 nmol/kg/dose) for six days. In pituitary-intact rats, administration of ghrelin significantly increased serum concentration of growth hormone and IGF-1 and this effect was associated with a significant increase in the healing rate of gingival ulcers. Moreover, treatment with ghrelin increased mucosal blood flow and DNA synthesis in the gum, while a local inflammation was decreased what was observed as a reduction in mucosal concentration of pro-inflammatory interleukin-1ß. Hypophysectomy decreased serum level of growth hormone below a detection limit; whereas serum concentration of IGF-1 was reduced by 90%. On the other hand, removal of the pituitary gland was without any significant effect on the healing rate of gingival ulcers or on the ulcer-induced increase in DNA synthesis and concentration of pro-inflammatory interleukin-1ß in gingival mucosa. Administration of ghrelin failed to affect serum level of growth hormone and IGF-1 in hypophysectomized rats, and was without any effect on the healing rate of gingival ulcers, mucosal blood flow, DNA synthesis or concentration of interleukin-1ß in gingival mucosa. Neither induction of gingival ulcers nor hypophysectomy nor administration of ghrelin significantly affected serum concentration of pro-inflammatory interleukin-1ß. We concluded that endogenous growth hormone and IGF-1 were involved in the therapeutic effect of exogenous ghrelin in the healing of gingival mucosa damage.

Salivary oxidative status in patients with oral lichen planus.

Reactive oxygen species (ROS) are involved in the pathogenesis of many inflammatory diseases, including oral lichen planus. Therefore, determining the salivary markers of oxidative stress is an excellent alternative approach to diagnosing oral cavity diseases. The objective of our study was to provide preliminary validation and determination of the salivary markers of oxidative stress in both patients with reticular and erosive forms of oral lichen planus as well as in healthy individuals without any oral lesions. In total, 62 patients with oral lichen planus (OLP) were enrolled in the study, including 31 with the reticular form of lichen planus (44.63 ± 11.05 years) and 31 with erosive forms (40.43 ± 10.05 years), who had never been treated for their disease. The control group comprised 30 individuals without any oral lesions (42.12 ± 12.22 years). We determined the saliva levels in glutathione (GSH), total antioxidant capacity (TAC), and thiobarbituric acid reactive substances (TBARS). The mean saliva levels of GSH and TAC were significantly lower (P < 0.01) in OLP patients compared to the control group. The mean levels of salivary TBARS were higher in both OLP groups (reticular and erosive) compared to the control group (P = 0.01). The lower saliva levels of GSH and TAC in patients with OLP indicate that free radicals and the resulting oxidative damage may play an important role in the pathogenesis of OLP lesions. In conclusion, monitoring the oxidant-antioxidant status of saliva may serve as an efficient and less intrusive marker for determining stages of disease development in patients with OLP.

A systematic review of the recurrence rate for keratocystic odontogenic tumour in relation to treatment modalities.

This systematic review was undertaken to determine the overall and detailed recurrence rate of keratocystic odontogenic tumour in relation to specific treatment methods. Online electronic databases were searched to identify articles published in English language from 1956 to 2010. Articles were independently appraised by two reviewers in three separate rounds. Any disagreement was settled by discussion with a third judge. Of 1568 potentially relevant articles, 168 articles related to the treatment of keratocystic odontogenic tumour/parakeratinised type of odontogenic keratocyst and its recurrence rate entered the second round for evaluation. Fourteen papers entered the third round for critical appraisal. Two retrospective reviews entered the final analysis. One hundred eight lesions were found in the material analysed. Six treatment modalities were identified. The recurrence rates were 0% for resection, 0% for enucleation with peripheral ostectomy and Carnoy's solution, 18.18% for enucleation with peripheral ostectomy, 26.09% for enucleation alone, 40% for marsupialisation, and 50% for enucleation with Carnoy's solution. The overall recurrence rate was 23.15%. The present review discusses the methodological weaknesses of many of the studies analysed. No high quality evidence was obtained to evaluate recurrence rates related to treatment modalities of keratocystic odontogenic tumour.

Preemptive effect of ketoprofen on postoperative pain following third molar surgery. A prospective, randomized, double-blinded clinical trial.

The authors examined whether ketoprofen administered 60 min before surgical extraction of the lower wisdom teeth provides effective postsurgical analgesia and reduces rescue analgesic intake compared with ketoprofen administered 60 min after surgery or placebo. The 96 patients were placed into three groups: pre-group (ketoprofen 60 min preoperatively); post-group (ketoprofen 60 min postoperatively); and no-group (placebo). Study interventions had a significant effect on pain sensations in the 12 h after surgery. The initial onset of pain was significantly delayed only in the post-group. Pain intensity at the first onset of pain was significantly lower only in the post-group. Patients in the pre- and post-groups required significantly less rescue analgesic than those in the no-group. Ketoprofen administered after third molar surgery provides more effective pain control than ketoprofen administered before the surgery or placebo.

Single-dose and multi-dose clindamycin therapy fails to demonstrate efficacy in preventing infectious and inflammatory complications in third molar surgery.

The goal of this study was to evaluate the efficacy of single- and multi-dose (5-day) clindamycin therapy for the prevention of inflammatory complications in patients undergoing lower third molar surgical extraction with bone removal. Patients who qualified for the prospective, randomized, double-masked, placebo-controlled trial were randomly divided into three groups: (1) single dose of oral clindamycin administered preoperatively (single-dose group); (2) clindamycin administered preoperatively with continued therapy for 5 days (5-day group); and (3) a placebo group. The following parameters were evaluated on the first, second and seventh days postsurgery: trismus, facial swelling, body temperature, lymphadenopathy, alveolar osteitis and subjective pain sensations. There were 86 patients (31 in the single-dose group, 28 in the 5-day group and 27 in the placebo group) enrolled in the study. There were no statistically significant differences in postoperative inflammatory complications in patients during the first and second days postsurgery. A statistically significant variation in body temperature was reported on the seventh day. Analysis of the postoperative analgesic intake did not show statistically significant differences between examined groups. Clindamycin applied in a single preoperative dose of 600 mg with or without subsequent 5-day therapy does not demonstrate efficacy in prophylaxis for postoperative inflammatory complications after third molar surgery.