Effect of non-surgical periodontal treatment on visfatin and chemerin concentration in the gingival crevicular fluid.

Visfatin, as a novel adipokine, is considered to play a role in periodontal inflammation. Chemerin is another newly identified adipokine that is possible to have a role in periodontitis firstly reported in our previous study. The aim of the current study is to evaluate the gingival crevicular fluid (GCF) levels of visfatin and chemerin in periodontitis and and compare these adipokine levels with before and after non-surgical periodontal treatment. Twenty-nine patients with Stage III Grade B periodontitis and eighteen healthy subjects included in this cross-sectional cohort study. Clinical periodontal parameters and GCF were obtained from all subjects. Eight weeks after the following non-surgical periodontal treatment including scaling and root planning, samples and clinical periodontal parameters were collected again in the periodontitis group. The levels of adipokines were analyzed with standard enzyme-linked immunosorbent assay. The levels of visfatin and chemerin were statistically significantly higher at periodontitis group as compared to healthy group (P < 0.001). Although, no changes were observed in visfatin levels after periodontal treatment (P > 0.05), chemerin levels were significantly decreased (P < 0.001). Also, no differences were observed as compared to the healthy group (P > 0.05). Visfatin and chemerin may play a role in the periodontal disease process. In addition, it can be considered that the decreased chemerin levels after non-surgical periodontal treatment may play an important role for developing host modulation strategies.

Evaluation of adipokines and inflammatory mediator expression levels in patients with periodontitis and peri-implantitis: a cross-sectional study.

OBJECTIVES: The aim of this study was to analyze the mRNA and protein expression of adiponectin, leptin, visfatin, tumor necrosis factor (TNF)-α, and interleukin (IL)-6 levels in periodontitis and peri-implantitis sites in systemically healthy individuals and to investigate the influence of the presence of current periodontitis on their expression levels in peri-implantitis sites. MATERIALS AND METHODS: Soft tissue biopsy samples were collected from 60 systemically healthy patients [15 periodontally healthy patients (group I), 16 patients with periodontitis (group II), 15 patients with peri-implantitis (group III), and 14 patients with peri-implantitis and periodontitis (group IV)]; mRNA expression levels of adiponectin, leptin, visfatin, TNF-α, and IL-6 were measured by quantitative real-time PCR; and their protein levels were assessed by immunohistochemistry. RESULTS: The mRNA expression levels of all biomarkers were significantly higher for group II compared to group I, while significantly higher levels of leptin, TNF-α, and IL-6 were observed in group III in comparison with group I. Group II exhibited significantly higher mRNA expression of adiponectin and TNF-α than group III. Group IV showed significantly higher expression levels of adiponectin, leptin, TNF-α, and IL-6 compared to group III. Regarding the expression of protein levels, which was estimated through quantification of the histoscore, both groups II and III presented higher H-scores than group I for all biomarkers except leptin. CONCLUSIONS: The presence of current periodontitis may enhance expression levels of adiponectin, leptin, TNF-α, and IL-6 in peri-implant soft tissue. CLINICAL RELEVANCE: The presence of periodontitis is an important risk factor for the severity of peri-implant inflammation as well as the onset of peri-implantitis.

Evaluation of chemerin and its receptors, ChemR23 and CCRL2, in gingival tissues with healthy and periodontitis.

Chemerin is a chemoattractant protein that directs inflammatory cells that express its receptor chemokine receptor-like 1 (ChemR23) towards sites of inflammation. C-C chemokine receptor-like 2 (CCRL2), is the other receptor of chemerin, improves the interaction between chemerin and ChemR23. The aim of this study was to evaluate the expression of chemerin and its receptors in gingival tissues with healthy and periodontitis. Tissue biopsy samples were obtained from 20 patients with chronic periodontitis and from the gingiva of 20 healthy individuals undergoing a crown lengthening process. Quantitative real-time PCR (qPCR) was used to examine the mRNA expression of chemerin, ChemR23 and CCRL2. Additionally, protein expression was measured by immunohistochemistry. Both qPCR and immunohistochemistry results revealed that the expression of chemerin and ChemR23 was significantly higher in tissues with periodontitis than in healthy tissues (P = 0.001 and, P = 0.015, respectively). There were no significant differences between healthy tissues and those with periodontitis in terms of mRNA expression of CCRL2, whereas a more intense staining was observed in tissues with periodontitis. The mRNA expression levels of chemerin showed a positive correlation with plaque index, gingival index, probing pocket depth and clinical attachment level (r = 0.448, r = 0.460, r = 0.439 and, r = 0.459, respectively, P < 0.01). To the best of our knowledge, this study is the first to examine the expression of chemerin, ChemR23 and CCRL2 in gingival tissues. Our study suggests that chemerin may play a role in the pathogenesis of periodontitis by causing chemoattraction of immune cells that direct ChemR23 receptors to the site of inflammation.

Increased visfatin expression is associated with nuclear factor-kappa B and phosphatidylinositol 3-kinase in periodontal inflammation.

OBJECTIVE: Visfatin is an adipocytokine that plays a role in regulating periodontal inflammation by as yet identified mechanisms. It has been suggested that visfatin mediates inflammation via activation of the nuclear factor-kappa B (NF-κB) and phosphatidylinositol 3-kinase (PI3k) signaling pathways which play a role in the inhibition of neutrophil apoptosis. The aim of this study was to investigate the expression of visfatin, NF-κB (NF-κB1 and NF-κB2), PI3k, tumor necrosis factor alpha (TNF-α), and interleukin-1 beta (IL-1ß) in the tissue of healthy individuals and patients with periodontitis. MATERIALS AND METHODS: Tissue biopsy samples were obtained from 21 patients with chronic periodontitis and from the gingiva of 19 healthy individuals undergoing crown lengthening. The mRNA expression levels of visfatin, NF-κB, PI3k, TNF-α, and IL-1ß were evaluated by quantitative real-time PCR (qPCR). Also, visfatin protein expression was measured by immunohistochemistry. RESULTS: Both qPCR and immunohistochemistry results revealed that the visfatin expression was higher in the tissues with periodontitis than in healthy tissues (P < 0.01). Similarly, the mRNA expression levels of NF-κB2, PI3k, and IL-1ß were higher in tissues with periodontitis than in healthy gingival tissues (P < 0.01). Visfatin was positively correlated with the levels of NF-κB1 (r = 0.549, P < 0.05), NF-κB2 (r = 0.636, P < 0.05), PI3k (r = 0.682, P < 0.01), TNF-α (r = 0.558, P < 0.05), and IL-1ß (r = 0.686, P < 0.01) in the tissues with periodontitis. CONCLUSIONS: Our results demonstrated that increased visfatin was associated with the expression of NF-κB and PI3k which may play a role in the pathogenesis of periodontitis. We suggest that increased visfatin may contribute to the inhibition of neutrophil apoptosis via the NF-κB and PI3k signaling pathways. CLINICAL RELEVANCE: Understanding the role of visfatin in periodontitis will enable the development of new treatment methods for inflammation.

Effect of Photobiomodulation on Transforming Growth Factor-ß1, Platelet-Derived Growth Factor-BB, and Interleukin-8 Release in Palatal Wounds After Free Gingival Graft Harvesting: A Randomized Clinical Study.

OBJECTIVE: This study evaluated the impact of photobiomodulation (PBM) on the healing of the donor palatal area following free gingival graft (FGG) harvesting by examining changes in transforming growth factor (TGF)-ß1, platelet-derived growth factor (PDGF)-BB, and interleukin (IL)-8 levels in palatal wound fluid (PWF). MATERIAL AND METHODS: Thirty patients were selected and randomly assigned to receive PBM (laser group) or PBM sham (sham group) in the palatine area after FGG harvesting. A neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (1064 nm) was applied to the test sites immediately after surgery and every 24 h thereafter for 4 days. PWF was collected on Days 7 and 12, and PWF TGF-ß1, PDGF-BB, and IL-8 levels were analyzed by enzyme-linked immunosorbent assays (ELISA). RESULTS: PWF TGF-ß1, PDGF-BB, and IL-8 levels were significantly lower on Day 12 than on Day 7 for both groups. PWF TGF-ß1, PDGF-BB, and IL-8 levels of the laser group were significantly higher than those of sham group on Day 7 (p < 0.05). PWF TGF-ß1 levels were also significantly higher in laser group than in the sham group on Day 12; however, differences in PDGF-BB and IL-8 levels between groups on Day 12 were statistically nonsignificant. CONCLUSIONS: Observed increases in PWF TGF-ß1, PDGF-BB, and IL-8 levels suggest that PBM may accelerate wound healing by stimulating production of selected mediators.

Porphyromonas gingivalis and Epstein-Barr Virus Are Associated With Increased Levels of Visfatin in Gingival Crevicular Fluid.

BACKGROUND: There is little clinical information on the relationship between periodontopathogens and visfatin. The purpose of this study is to determine visfatin levels in the gingival crevicular fluid (GCF) of healthy individuals and patients with periodontitis and to investigate the possible relationship between this adipokine and the presence and levels of Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescense, and Epstein-Barr virus (EBV). METHODS: Eighteen healthy individuals and 27 patients with periodontitis were included in this study. GCF and plaque samples were obtained from all individuals. Visfatin levels were analyzed by enzyme-linked immunosorbent assay, and the bacterial numbers were evaluated by the reverse transcription-polymerase chain reaction method. RESULTS: In patients with periodontitis, the visfatin levels in the GCF (mean: 84.29 ng/mL; range: 63.8 to 108.9 ng/mL) were significantly higher compared with those of the healthy individuals (mean: 38.06 ng/mL; range: 13.8 to 89.02 ng/mL) (P <0.01). There was a positive correlation between the visfatin levels and P. gingivalis (r = 0.266, P <0.05), whereas no correlation was found between visfatin levels and other microorganisms. In addition, the visfatin levels were found to be higher in individuals in whom P. gingivalis was detected than for those without P. gingivalis (P <0.01). The visfatin levels were also found to be higher in individuals in whom EBV was detected (P <0.05). CONCLUSIONS: To the best of the authors' knowledge, the present study is the first one to show the correlation of periodontopathogens and GCF visfatin levels. P. gingivalis colonization of the periodontal pockets may increase visfatin secretion. Furthermore, the presence of EBV in the plaque may be another factor that causes an increase in visfatin levels.

Evaluation of the salivary levels of visfatin, chemerin, and progranulin in periodontal inflammation.

OBJECTIVES: In recent years, adipokines have been reported to play an important role in chronic inflammatory diseases. In this study, our aim was to investigate the salivary levels of visfatin, chemerin, and progranulin and their relationship with periodontal health and disease. MATERIALS AND METHODS: A total of 72 patients were included in the study, 23 of which were periodontally healthy, 24 had gingivitis, and 25 had periodontitis. The clinical periodontal parameters including plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment levels (CAL) were recorded. Unstimulated saliva samples were collected, and the concentration of adipokines was evaluated using standard enzyme-linked immunosorbent assay. RESULTS: Salivary visfatin levels were higher in patients with gingivitis and periodontitis compared to those of healthy subjects, while there was no difference between the mean values of gingivitis and periodontitis groups (P > 0.05). There was no difference between the mean values of gingivitis and healthy groups regarding salivary chemerin (P > 0.05), whereas it was detected at higher levels in the periodontitis group compared to the gingivitis and the healthy groups (P < 0.01). Salivary progranulin levels were similar in all groups (P > 0.05). The salivary visfatin level was positively related to PI and GI. The salivary chemerin level was positively related to GI, PD, and CAL. CONCLUSIONS: These results demonstrated that the higher levels of chemerin in the saliva of patients with periodontitis were correlated with the degree of tissue destruction. CLINICAL RELEVANCE: Chemerin may be a novel biomarker in saliva to determine the severity of periodontal disease.

Treatment of complex dentoalveolar injury--avulsion and loss of periodontal tissue: a case report.

Dental avulsion is a common and complex injury which affects multiple oral tissues. In this case report, a 9-year-old girl patient with two traumatically avulsed maxillary central incisors with loss of periodontal tissue was presented. Treatment guidelines for avulsed permanent teeth with open apex were carried out. Bilateral laterally sliding flap procedure was performed, to repair loss of gingival soft tissue. Conventional immobilization was carried out for 6 weeks. Five months follow-up of the patient in whom replantation was performed resulted in positive sensitivity test, no symptoms of infection, pain or any discomfort and good periodontal wound healing. In conclusion, this report presents successful replantation and periodontal treatment of a patient with complex dentoalveolar injury.