The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels.

Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels

Abstract Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

Relação entre doença periodontal e anemia / Relationship between periodontal diseases and anemia

Doença Periodontal é um grupo de doenças inflamatórias de origem infecciosa que afetam os tecidos de proteção e sustentação do dente. A perpetuação da resposta do hospedeiro devido à infecção bacteriana persistente interrompe os mecanismos homeostáticos e resulta na liberação de citocinas pró-inflamatórias, proteases e prostanóides, que podem promover destruição da matriz extracelular na gengiva e estimular a reabsorção óssea, além de estimular a produção de proteínas de fase aguda, sendo a IL-6 seu principal indutor. Dentre as proteínas de fase aguda cuja produção é intensamente aumentada durante a infecção e inflamação está a hepcidina que é predominantemente produzida pelo fígado, tendo como principal função a regulação homeostática do metabolismo de ferro, a modulação da defesa orgânica e contribuindo para a patogênese de anemias de causas diversas. O objetivo do estudo foi realizar uma revisão da literatura utilizando uma consulta às bases de dados Cochrane, Bireme e MedLine, tendo como eixo as seguintes palavras-chaves em associação: periodontite crônica, Inflamação e hemoglobina. Foram encontradas 101 publicações científicas por meio de busca eletrônica, sendo 9 da Bireme, 21 do Pubmed e 71 da Cochrane, além de títulos oriundos de referências de outros artigos. Concluiu-se que há indícios que hepcidina esteja associada ao processo inflamatório sendo responsável pela homeostase do ferro e, desta forma, contribuindo para processo patológico da anemia da inflamação crônica. Constatou-se ainda a escassez de artigos que investiguem a possível associação entre a doença periodontal e a anemia

Periodontal diseases can be defined as inflammatory disease from infectious origin that affect the protection and support tooth tissues. The host response perpetuation due to persistent bacterial infection disrupts the homeostatic mechanisms and results in releasing of the proinflammatory cytokines, proteases and prostanoids that can promote the destruction of extracellular matrix in the gingiva and cause bone resorption, also stimulate the production of acute phase proteins, being the IL-6 the main inductor. Among the acute phase proteins whose production is widely increased during infection and inflammation, there is hepcidin which is predominantly produced by the liver, having as main function the homeostatic regulation of iron metabolism, organic defense modulation and contributing to the pathogenesis of various causes of anemias. The aim of the study was to perform a literature review by using databases Cochrane, Bireme and MedLine, and the following keywords in combination: chronic periodontitis, inflammation and hemoglobin. A total of 101 scientific publications was found by electronic search, 9 from Bireme, 21 from PubMed and 71 from Cochrane, also titles from references by other articles. It was concluded that the hepcidin is associated to inflammatory process and it is responsible for the iron homeostasis therefore leading is associated to the pathologic process of the chronic disease anemia. Also, it was noted the lack of manuscripts that investigate the possible association between periodontal diseases and anemia.

Effect of substrate and adhesive system type on composite resin restorations

Introduction: Although it is possible to obtain a reliable bond between enamel and composite resin, the ideal bonding method of composite resin to dentin still needs to be developed. Variables such as the type of adhesive system used and type of dentin substrate can influence on the adhesion. Objective: The purpose of this study was to compare the shear bond strength of composite resin restorations to human and bovine dentin using three adhesive systems. Material and methods: Fifteen human third molars sectioned into two halves and 30 bovine incisors were cut into blocks (4x4mm), embedded in acrylic resin and ground flat to expose the dentin. The specimens were randomly divided into six groups (n = 10): group 1 - human dentin using Scotchbond Multi-Purpose; group 2 - human dentin using Adper Single Bond 2; group 3 - human dentin using Adper Prompt L-Pop; group 4 - bovine dentin using Scotchbond Multi-Purpose; group 5 - bovine dentin using Adper Single Bond 2; group 6 - bovine dentin using Adper Prompt L-Pop. After composite resin restoration procedure, the specimens were stored into distilled water for 24h at 37ºC and then submitted to the shear test using a universal testing machine. The failure patterns were examined microscopically and classified as adhesive, cohesive in resin, cohesive in dentin or both, and mixed. The ANOVA (two-way) and Tukey's post hoc were used. Chi-square test for independence was used for analysis of failure mode. The significance level was set at 5%. Results: A significant difference in shear bond strength was observed among adhesive systems (p = 0.031), with higher values for one-bottle adhesive (8.87±2.72) and lower for self-etching (6.38±3.15), and between the two types of substrate (p = 0.018), with higher values for human dentin. However, there was no significant difference for the adhesive system/substrate interaction (p = 0.11). Adhesive failure was the predominant failure mode for all adhesive systems and for the two substrates. Conclusion: Shear bond strength was different between human and bovine substrates and for the adhesive system used.