Periodontal disease and visfatin level: A systematic review and meta-analysis.

Visfatin is considered an inflammatory biomarker in periodontal disease (PD). In this meta-analysis, we aimed to evaluate the relationship between Visfatin biomarker level with PD. In this study, Medline, Scopus, Web of Science, and Google Scholar were searched. We included studies that examined visfatin levels in samples from healthy people and periodontal disease until March 2023. The quality of the selected articles was evaluated using the Newcastle-Ottawa assessment scale. Depending on heterogeneity of studies, random-effects or fixed-effect models were used to pool results and report the standardized mean difference (SMD). After screening the retrieved papers, the related data were extracted. A total of 159 studies were identified, and 16 studies were included in the meta-analysis. In 9 studies, the SMD of visfatin level of gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP) and healthy individuals was 4.32 (p<0.001). In 6 studies, the SMD of salivary visfatin level in patients with CP and healthy individuals was 2.95 (p = 0.004). In addition, in five studies, the SMD of serum visfatin level in patients with CP and healthy individuals was 7.87 (p<0.001). Therefore, Visfatin levels in serum, saliva, and GCF of patients with CP were increased in comparison to healthy individuals. Comparison of visfatin levels in saliva of gingivitis patients and healthy individuals showed a significant increase of visfatin in gingivitis patients (SMD:0.57, P = 0.018), but no significant difference was observed in the mean GCF visfatin level of gingivitis patients and healthy individuals (SMD:2.60, P = 0.090). In addition, the results suggested that there is no difference between gingivitis cases compared to CP patients (SMD:3.59, P = 0.217). Visfatin levels in GCF, serum, and saliva have the potential to be used as a diagnostic biomarker of periodontitis.

A pro-inflammatory diet is associated with an increased odds of periodontitis: finding from a case-control study.

OBJECTIVE: This study aimed to evaluate the inflammatory effect of diet using the dietary Inflammatory Index (DII) on the odds of periodontitis. We hypothesized that a diet with high DII scores (a pro-inflammatory diet) is associated with high chronic and systematic inflammation resulting in periodontitis. Periodontitis is one of the most common inflammatory diseases that affect the tissues around the tooth and results from the interaction of bacterial infection and the host immune response. The DII shows the association between different food components and the level of specific inflammatory biomarkers. METHOD: The food intake of 87 cases with diagnosed periodontitis and 87 control was assessed using a 163-item valid food frequency questionnaire (FFQ). The DII was calculated based on the FFQ data. Logistic and linear regression models adjusting for multivariable confounders were used to investigate the odds ratio (OR) and 95% confidence intervals (CI) of developing periodontitis. RESULTS: There was a significant difference between the mean intake of micronutrients and food groups, including saturated fatty acids (SFAs), iron, magnesium, manganese, vitamin C, crude fiber, selenium, chromium, whole fiber, caffeine, dairy, and meat, between patients with periodontitis and the control group (p-value˂0.05). DII scores in this study ranged from -3.13 to + 0.99. However, the periodontitis OR in the raw and multivariable-adjusted models was not statistically significant (multivariable-adjusted OR tertiles 1 vs. tertiles 3 = 2.00, 95%CI: 0.4-90.42, p-value = 0.08). A similar result was also observed in the continuous model of DII (multivariable-adjusted OR DII continuous = 1.93, 95%CI: 0.30-98.79, p-value = 0.05). CONCLUSION: Although the OR was not statistically significant in crude models, a significant trend was found in multivariable-adjusted models. The results were promising since this is the first study to examine the association between diet-induced inflammation and dental disease. It is advisable to conduct additional studies with high sample sizes and other designs, such as prospective studies.

Maternal saliva visfatin level in term and preterm labor: A case control study.

Visfatin, a colony-enhancing factor (pre-B-cell), is an inflammatory biomarker that is secreted from a different number of cells and appears to have some proinflammatory or immune-regulating effects. The aim of this study was to compare maternal saliva visfatin levels in women with preterm and term delivery. In This case-control study, women in labor before 37 weeks of gestation were the case group (n = 40) and women in labor after 37 weeks of gestation were in control group (n = 40). The saliva of the participants was sampled and maternal saliva visfatin level was measured by ELISA test. In this study, 80 pregnant women were studied in case and control groups. The mean age of case and control group was 29.1±6.9 and 30.55±5.3 years, respectively. The results revealed that the mean maternal saliva visfatin level in the preterm group (4.75±2.2) is significantly (p = 0.001) lower than that in term birth group (6.7±3.1). The results of adjusted logistic regression revealed that after adjusting for GDM, preeclampsia, pre pregnancy BMI and weight gain, the mean of maternal saliva visfatin level in the preterm group is significantly lower than that in the term group (p = 0.026). Considering that during the term pregnancy visfatin levels increase and visfatin may play a role in initiating labor, in our study due to the high visfatin level in case group although the level of maternal saliva visfatin was lower than the control group but high levels of visfatin in the case group can represent the role of visfatin in initiating labor and due to this issue can be use the role of this adipokine for early diagnosis of preterm delivery can be used to prevent, treat and improve the prognosis of this disease. Also, this study is the first study to compare the maternal saliva visfatin level between SGA and AGA group and there is no difference between these groups.

Periostin level in gingival crevicular fluid in periodontal disease: a systematic review and meta-analysis.

BACKGROUND: Periostin, a secreted adhesion molecule, is a matricellular protein secreted most in periodontal ligament and periosteum. Periostin is also needed for integrity and maturation of periodontal tissue. This meta-analysis was conducted to compare the gingival crevicular fluid (GCF) periostin levels in subjects having periodontal disease and healthy periodontium. METHODS: In this meta-analysis, three international database including PubMed, Scopus and Web of Science were searched and 207 studies retrieved. Also, the Google Scholar was searched to find more related studies (two studies were found). To assess the risk of bias of included studies, the Newcastle-Ottawa assessment scale adapted for case-control was used. Finally, required data was extracted and included into analysis. All statistical analysis were done using Stata software. RESULTS: Eight studies were included in this meta-analysis. Results showed that GCF periostin level is significant lower in chronic periodontitis group compare to healthy people (the standardized mean difference (SMD) = -3.15, 95% CI = -4.45, -1.85, p < 0.001). The syntheses of studies shown a significant decrease in the periostin level of chronic periodontitis patients compared to the gingivitis patients (SMD = -1.50, 95%CI = -2.52, -0.49, P = 0.003), while the mean level of periostin between the gingivitis patients and healthy group has no significant difference (SMD = -0.88, 95%CI = -2.14, 0.38, P = 0.173). CONCLUSION: The mean concentration of GCF periostin in people with chronic periodontitis significantly decreased compared to people with gingivitis and also compared to healthy people, while no significant difference was observed between the two groups with gingivitis and healthy people. Therefore, this marker may be used as a diagnostic criterion for the disease, which requires further studies.

Bacterial biofilm prevalence in dental unit waterlines: a systematic review and meta-analysis.

BACKGROUNDS: Numerous studies have shown that dental unit water lines (DUWLs) are often contaminated by a wide range of micro-organisms (bacteria, fungi, protozoa) and various prevalence have been reported for it in previous studies. Therefore, this review study aims to describe the prevalence of bacterial biofilm contamination of DUWLs. METHODS: This is a systematic review and meta-analysis in which the related keywords in different international databases, including Medline (via PubMed) and Scopus were searched. The retrieved studies were screened and the required data were extracted from the included studies. Three standard methods including American Dental Association (ADA), The Center for Disease Control and Prevention (CDC) and contaminated > 100 CFU/ml(C-100) standards were used to assess the bacterial biofilm contamination of DUWLs. All studies that calculated the prevalence of bacterial biofilm contamination of DUWLs, and English full-text studies were included in the meta-analysis. Studies that did not have relevant data or used unusual laboratory methods were excluded. Methodological risk of bias was assessed by a related checklist and finally, the data were pooled by fixed or random-effect models. RESULTS: Seven hundred and thirty-six studies were identified and screened and 26 related studies were included in the meta-analysis. The oldest included study was published in 1976 and the most recent study was published in 2020. According to the ADA, CDC and C-100 standards, the prevalence of bacterial contamination was estimated to be 85.0% (95% confidence interval (CI): 66.0-94.0%), 77.0% (95%CI: 66.0-85.0%) and 69.0% (95%CI: 67.0-71.0%), respectively. The prevalence of Legionella Pneumophila and Pseudomonas Aeruginosa in DUWLs was estimated to be 12.0% (95%CI: 10.0-14.0%) and 8.0% (95%CI: 2.0-24.0%), respectively. CONCLUSION: The results of this review study suggested a high prevalence of bacterial biofilm in DUWLs; therefore, the use of appropriate disinfecting protocol is recommended to reduce the prevalence of contamination and reduce the probable cross-infection.

Evaluation of the effectiveness of Lactuca Sativa syrup in controlling pain after periodontal flap surgery: a split-mouth, randomized, double-blind placebo-controlled trial.

OBJECTIVES: Effective pain control after oral surgeries including periodontal flap surgery is one of the biggest problems in the periodontology field. The use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) to reduce pain after periodontal flap surgery is common, but these have some adverse side effects such as impaired platelet function and causing digestive problems. Today, the tendency to use omedicinal plants is more than synthetic drugs due to their safety. Therefore, we designed a split-mouth randomized controlled clinical trial to evaluate the effects of Lactuca Sativa (L. Sativa) syrup as an adjunct therapy in reducing pain after periodontal flap surgery. METHODS: This split-mouth, randomized, double-blind, placebo-controlled trial was performed on 26 subjects. Patients were assigned for two surgery. Primary surgery was performed on the right maxilla and after 30 days, secondary surgery was performed on the left maxilla. In primary surgery, patients consumed L. Sativa syrup (3 times a day for 72 h) and in secondary surgery, patients consumed placebo syrup (3 times a day for 72 h). Pain intensity was measured at 6, 12, 24, 48, and 72 h after a periodontal flap surgery in both surgeries using the Visual Analogue Scale (VAS). All patients received their routine drugs, including analgesics. The number of analgesics used after surgery was recorded. Statistical analysis of t-test was used to compare the results of the two surgery. RESULTS: The results showed that the mean pain based on VAS score at 6, 12, 24, 48 and 72 h after primary periodontal flap surgery was significantly reduced compared to the secondary periodontal flap surgery (p<0.001). The results also showed that the use of analgesics after 72 h of surgery was significantly reduced in the primary periodontal flap surgery compared to the secondary periodontal flap surgery (p<0.001). CONCLUSIONS: According to the results of this study, L.Sativa syrup can be effective as adjuvant therapy in reducing pain after periodontal flap surgery.

Correlation between alveolar cleft volume and alveolar bone quality in patients with unilateral cleft lip and palate: A cone-beam computed tomography study.

OBJECTIVES: This study aimed to determine the correlation between alveolar cleft volume and fenestration and dehiscence in the adjacent alveolar bone in patients with unilateral cleft lip and palate (UCLP) using cone-beam computed tomography (CBCT) sections. MATERIALS AND METHODS: In this descriptive, cross-sectional study, CBCT scans of 68 non-syndromic patients with UCLP aged between 6 and14 years were selected. All patients were treated in Iran and had undergone lip and palate repair surgery within the first 3 to 18 months after birth. CBCT scans had been taken after orthodontic expansion and prior to alveolar bone grafting surgery. Cleft volume, fenestration and dehiscence were assessed using Mimics software. Data were analyzed using independent t-test, Kruskal-Wallis test, Spearman's correlation coefficient and logistic regression model. RESULTS: The mean alveolar cleft volume was 628.66±172.84 mm3. There was a significant negative correlation between cleft volume and fenestration (P<0.001). Also, there was a significant positive correlation between cleft volume and dehiscence (P<0.001) in the adjacent bone. CONCLUSION: The Mimics software can be successfully used to estimate the cleft volume prior to surgical procedures in UCLP patients. The results suggest that the alveolar cleft volume can be used as an aid to assess the periodontal condition of adjacent teeth. The cleft volume has a negative and positive correlation with fenestration and dehiscence respectively.

Evaluation of periostin levels in gingival crevicular fluid in association between coronary heart disease and chronic periodontitis.

BACKGROUND: Periostin is a protein, which is essential for periodontal tissue integrity, development and maturity. The aim of this study was to evaluate the role of gingival crevicular fluid (GCF) periostin levels in the association between coronary heart disease (CHD) and chronic periodontitis (CP). MATERIALS AND METHODS: This matched case-control study was conducted on 116 participants. The participants were matched for age, gender, and body mass index and divided into four groups as follows: (1) 29 patients with CHD and sever CP (CHD-CP), (2) 29 patients with CHD and without CP (CHD-H), (3) 29 patients without CHD and with sever CP (H-CP), and (4) 29 healthy participants (H-H). The GCF periostin was collected and evaluated using the enzyme-linked immunosorbent assay (ELASA). Finally, the data were analyzed by analysis of variance using the stata software. Significance was assigned at P < 0.05. RESULTS: The results showed that there was a significant difference in the GCF periostin levels in the four groups (P < 0.05). Moreover, according to the results of the Bonferroni's test, differences in the mean periostin levels were significant (P < 0.001) between CHD-CP and CHD-H, CHD-CP and H-CP, CHD-CP and H-H, CHD-H and H-H, and also between H-CP and H-H. CONCLUSION: The periostin levels reduced in the CHD patients, especially in the CHD-CP group. The findings reveal a probable role of periostin in the association between CHD and CP.

Quantitative and qualitative assessment of microbial aerosols in different indoor environments of a dental school clinic.

In the indoor environment of dental clinics, dental staff and patients are exposed to various types of infectious agents transported by aerosols and particles, generated during dental procedures, promoting an increased risk of cross-infection. The aim of this study was to determine the levels and diversity of microbial aerosol in relation to particle load in five different departments of a dental school clinic. The air samples were collected by an active single-stage Andersen sampler during the treatment procedure. The mean concentrations of airborne bacteria were in the range of 52-1030 and 8-844 CFU/m3 at the distances of 0.5 and 2 m, respectively. Bacterial aerosols in pediatric, endodontics, and restorative wards and fungal aerosols in all the sampling wards were significantly higher at the distances of 0.5 m. The dominant bacteria and fungi were identified as Micrococcus, Bacillus, Streptococcus, Staphylococcus, Penicillium, Cladosporium, Aspergillus, Rhizopus, and Alternaria. The positive associations were also obtained between bacteria and fungi levels and particulate matter (PM) concentrations.

Gingival crevicular fluid levels of visfatin in patients with chronic periodontitis and polycystic ovary syndrome.

OBJECTIVE: Recently, the association between periodontal diseases and polycystic ovary syndrome (PCOS) has been established, and it has been revealed that visfatin levels increase in chronic periodontitis (CP) and PCOS. However, there was no study comparing the mean visfatin levels between advanced CP and PCOS. Therefore, the probable role of visfatin linking these diseases remains unknown, and this study was conducted to address this gap. METHODS: In this age- and weight-matched case-control study (cases with PCOS disease and controls without it), 110 female participants were divided into 4 groups based on clinical findings. The 1st group participants had both PCOS and advanced CP (n=30), 2nd group participants had only PCOS (n=25), 3rd group participants had only advanced CP (n=23), and 4th group comprised of healthy participants (n=32). Enzyme-linked immunosorbent assay was used to investigate visfatin levels in the gingival crevicular fluid (GCF). Data were collected and analyzed using Stata software (version 11). RESULTS: The results revealed the significant effect of both PCOS and advanced CP on visfatin levels in the GCF (P<0.05). CONCLUSION: According to the results of this study, the visfatin level in the GCF could be the probable link of association between PCOS and advanced CP.

The comparison of visfatin levels of gingival crevicular fluid in systemic lupus erythematosus and chronic periodontitis patients with healthy subjects.

BACKGROUND: Visfatin is an adipokine and has a crucial role in pro-inflammatory response. The aim of this study was investigating the visfatin levels of gingival crevicular fluid (GCF) in patients with systemic lupus erythematosus (SLE) and chronic periodontitis and healthy subjects. MATERIALS AND METHODS: Sixty non-obese females were selected based on their clinical parameters into four groups: 15 healthy subjects (H-H), 15 systemically healthy individuals with chronic periodontitis (H-CP), 15 SLE patient with CP (SLE-CP), and 15 SLE patients without CP (SLE-H). GCF samples were collected to estimate the levels of visfatin using enzyme-linked immunosorbent assay (ELISA). RESULTS: Investigating the amount of visfatin in the GCF showed that there is a significant difference between visfatin amount of GCF in SLE patients and chronic periodontitis (L-CP) in comparison with other groups (P < 0.001). CONCLUSION: Visfatin levels have correlated positively with all the clinical periodontal parameters and its levels in (L-CP) group are highest in comparative with other groups. This finding suggests visfatin has a possible role in association between these two inflammatory conditions. Key Point • Visfatin in systemic lupus erythematosus.

A Comparison of 940 nm Diode Laser and Cryosurgery With Liquid Nitrogen in the Treatment of Gingival Physiologic Hyperpigmentation Using Split Mouth Technique: 12 Months Follow Up.

Introduction: Gingival hyperpigmentation is excessive deposition of melanin pigments in the epithelium of gingiva which affects facial esthetics. Various surgical methods for gingival depigmentation have been used to treat the darkened color of pigmented gingiva. This study compared the use of 940 nm diode laser and liquid nitrogen cryosurgery in the treatment of gingival physiologic hyperpigmentation in terms of gingival depigmentation, postoperative pain, healing duration, pigmentation recurrence, and patients' satisfaction. Methods: Fifteen systemically healthy patients (11 females and 4 males; 17-35 years of age) with bilateral gingival physiologic hyperpigmentation were enrolled in this split-mouth randomized study. Maxillary anterior labial gingiva of each patient was divided into left and right halves, and each half was randomly depigmented by either laser or cryosurgery. Patients were given questionnaires to evaluate the procedures and were followed up in 3, 7, 10, 17 and 21 days postoperatively for the assessment of gingival healing and 1, 3, 6 and 12 months after the treatments to detect any sign of pigmentation recurrence. Results: The severity of post-op pain measured by visual analogue scale (VAS) was mild to average and showed no significant difference between the 2 modalities (P>0.05). There was no considerable swelling or hemorrhage after the treatment procedures and the healing duration was significantly shorter in laser (P<0.05). The degree of pigmentation in all gingival sites treated by laser reached and remained at zero until the last follow up (1 year) and reached zero in 9 out of 15 cryosurgerytreated sites. All patients were completely satisfied with the laser, and 9 out of 15 were completely satisfied with cryosurgery. No pigmentation recurrence was observed during any follow-up periods. Conclusion: Removal of gingival physiologic hyperpigmentation by laser therapy and cryotherapy was effective and safe. The efficiency of the laser was better than cryotherapy.

Dental implant in a multiple myeloma patient undergoing bisphosphonate therapy: A case report.

Dental implant placement in patients with multiple myeloma undergoing bisphosphonates therapy could be accomplished; however, it can turn into a successful treatment for edentulous area and functionally stabilized for many years. But a meticulous case selection, proper medical consultation with physician, minimally invasive surgery, and other cautions must be considered.

Maxillary sinus floor augmentation and simultaneous dental implant placement in a patient with Guillain-Barre syndrome: A case report.

Dental implant placement in patients with Guillain-Barre syndrome could be accomplished, and it may turn into a successful treatment for edentulous sites and functionally stabilized for long life. However, a proper patient selection, accurate medical consultation with physician, atraumatic surgery, and other important cautions should be considered.

Possible interaction between visfatin, periodontal infection, and other systemic diseases: A brief review of literature.

Gingivitis and periodontitis are common bacterial infections caused by a variety of microorganisms. Despite the microorganisms' roles as etiologic agents, inflammation-induced substances also have crucial parts in the loss of connective tissue and the supporting alveolar bone. Visfatin is a pleiotropic mediator, which acts as growth factor, cytokine, and pre-B-cell colony-enhancing factor. A positive correlation was detected between the serum/plasma levels of visfatin and inflammatory disorders such as diabetes mellitus and cardiovascular disease. In addition, the visfatin level was higher in saliva and the gingival crevicular fluid (GCF) of subjects with periodontal disease. This review defined current, predictable patterns of possible interaction of visfatin with periodontal infection and other systemic diseases, using PubMed and Medline databases searching for articles written in English. Peer-reviewed articles were targeted using the following keywords: "visfatin," "periodontal disease," "inflammatory mediator," and "biomarker." Available full-text articles were read, and related articles were also scrutinized, while a hand search was also performed. Search was confined to human studies, and articles written in English and published between 1985 and 2016 were selected. It was concluded that periodontal infection and other systemic diseases could be related to the levels of visfatin in GCF, saliva, and serum as a biomarker of these diseases.

Evaluation of Salivary Leptin Levels in Healthy Subjects and Patients with Advanced Periodontitis.

OBJECTIVES: Leptin is a hormone-like protein produced by the adipose tissue. It plays an important role in protection of host against inflammation and infection. Some studies have reported changes in leptin levels in the gingival crevicular fluid (GCF), saliva and blood serum of patients with periodontal disease compared to healthy individuals. The aim of the present study was to compare the salivary leptin levels in patients with advanced periodontitis and healthy individuals. MATERIALS AND METHODS: In this case-control study, the salivary samples of healthy individuals and patients with advanced periodontitis with clinical attachment loss >5mm were obtained using a standardized method and the leptin levels were measured in the salivary samples by means of ELISA. The effects of the periodontal status and sex on the salivary leptin levels of both groups were statistically analyzed by two-way ANOVA. RESULTS: The means ± standard deviation (SD) of salivary leptin levels in healthy subjects and patients with advanced periodontitis were 34.27±6.88 and 17.87±5.89 pg/mL, respectively. Statistical analysis showed that the effect of sex on the salivary leptin levels was not significant (P=0.91), while the effect of advanced periodontitis on the salivary leptin levels was significant compared to healthy individuals (P<0.0001). CONCLUSIONS: In patients with advanced periodontitis, the salivary leptin levels were significantly lower compared to healthy individuals. Thus, assessment of salivary leptin can be done as a non-invasive and simple method to determine the susceptibility of patients to advanced periodontitis.

Cementogenesis in Patients with Localized Aggressive Periodontitis.

OBJECTIVES: The aim of this study was to determine the cementum thickness in the first molars of patients with localized aggressive periodontitis (LAP) compared to healthy individuals. MATERIALS AND METHODS: This case-control study compared eight first molar teeth affected by LAP with eight third molar teeth of healthy individuals. The teeth were disinfected by immersion in 10% buffered formalin solution for three days and were then sectioned. External mesial root surfaces (middle one-third) were evaluated under a stereomicroscope by a blinded pathologist to determine the mean thickness of cementum. SPSS software (version 16.0) and t-test were used for statistical analysis. RESULTS: Histological examination revealed a significant difference between the two groups in terms of the amount of cementogenesis (P<0.001) .The thickness of cementum was higher in the control group (105.16±11.5 µm) than in LAP patients (86.44±7.3 µm). CONCLUSION: This study demonstrated the presence of cementum hypoplasia in mesial root surfaces of first molars affected by LAP.

Comparison of salivary epidermal growth factor levels in patients with gingivitis and advanced periodontitis and healthy subjects.

OBJECTIVE: Epidermal growth factor (EGF) is a polypeptide molecule, with important functions in epithelial growth and wound repair. It exerts its effects on cells by binding to receptors on the cell surface. The aim of this study was to evaluate and compare salivary EGF levels in patients with gingivitis and advanced periodontitis as well as in healthy controls. MATERIAL AND METHODS: Unstimulated salivary samples were collected from patients with gingivitis and advanced periodontitis and healthy individuals. The clinical parameters of plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL) were measured and recorded using a Williams probe. The enzyme-linked immunosorbent assay (ELISA) was used to determine salivary levels of EGF. One-way ANOVA was used for data analysis. RESULTS: The mean salivary level of EGF in healthy individuals (99.27) was significantly higher than that in patients with gingivitis (61.53). This value in patients with gingivitis (61.53) was also significantly higher than that in subjects with periodontitis (36.14) (P<0.001). CONCLUSION: The reduction in salivary level of EGF in patients with periodontal disease may be related to the pathogenesis of periodontitis.