Analysis of GLT6D1 and CDKN2BAS gene polymorphisms in Brazilian patients with advanced periodontitis.

Gene polymorphisms can predispose to periodontal disease, as demonstrated by the well-documented association between aggressive periodontitis and single nucleotide polymorphisms (SNPs) such as rs153745 in the GLT6D1 gene and rs3217992 in the CDKN2BAS gene. The purpose of this study was to evaluate the presence of these SNPs in Brazilian patients with advanced periodontitis (stages III/IV, Grade B/C) vs. healthy controls. A total of 100 patients with periodontitis (Group BC) were enrolled. Of these, 51 patients were classified as stage III and 49 patients were classified as stage IV, and 52 were Grade B (Group B) and 48 were Grade C (Group C). The control Group consisted of 61 healthy subjects. DNA samples extracted from buccal epithelial cells were used to genotype the SNPs rs1537415 (GLT6D1) and rs3217992 (CDKN2BAS) by real-time quantitative PCR. No significant differences in polymorphism frequency were found between the control Group and each of the patient groups (BC, B, or C), and Group B did not differ from Group C. In conclusion, the evaluated SNPs had no significant influence on the prevalence of periodontal disease in the sampled Brazilian population.

Analysis of GLT6D1 and CDKN2BAS gene polymorphisms in Brazilian patients with advanced periodontitis

Abstract Gene polymorphisms can predispose to periodontal disease, as demonstrated by the well-documented association between aggressive periodontitis and single nucleotide polymorphisms (SNPs) such as rs153745 in the GLT6D1 gene and rs3217992 in the CDKN2BAS gene. The purpose of this study was to evaluate the presence of these SNPs in Brazilian patients with advanced periodontitis (stages III/IV, Grade B/C) vs. healthy controls. A total of 100 patients with periodontitis (Group BC) were enrolled. Of these, 51 patients were classified as stage III and 49 patients were classified as stage IV, and 52 were Grade B (Group B) and 48 were Grade C (Group C). The control Group consisted of 61 healthy subjects. DNA samples extracted from buccal epithelial cells were used to genotype the SNPs rs1537415 (GLT6D1) and rs3217992 (CDKN2BAS) by real-time quantitative PCR. No significant differences in polymorphism frequency were found between the control Group and each of the patient groups (BC, B, or C), and Group B did not differ from Group C. In conclusion, the evaluated SNPs had no significant influence on the prevalence of periodontal disease in the sampled Brazilian population.

Insights for temporomandibular disorders management: From psychosocial factors to genetics-A case report.

AIMS: This case report aimed to discuss the multifactorial etiology and also the management of temporomandibular disorders (TMD) by addressing important associated psychosocial and biological factors, emphasizing the interaction between these factors and a probable genetic predisposition. METHODS AND RESULTS: A 21-year-old female patient was evaluated according to Research Diagnostic Criteria for TMD and diagnosed with arthralgia, myofascial pain, disc displacement without reduction, and temporomandibular joint (TMJ) degenerative disease. TMJ alterations were confirmed through magnetic resonance imaging and cone-beam computed tomography. Pressure pain threshold of masticatory structures was evaluated using a pressure algometer. Sleep bruxism, poor sleep quality, migraine with aura, mild anxiety, and history of facial trauma were also identified through anamnesis and clinical examination. Following this, genetic analysis was performed to evaluate the presence of single nucleotide polymorphisms (SNPs) already associated with TMD: SNP COMT Val158 Met (rs4680), MMP1-1607 (rs1799750), and tumor necrosis factor alpha-308 (rs1800629), which were all present. A personalized treatment for TMD management was performed, and it included self-management programs, occlusal appliance therapy, pharmacotherapy, anxiety management, and stress control. An 8-year follow-up demonstrated long-term stabilization of TMJ degenerative disease. CONCLUSION: Genetic evaluation, added to anamnesis and clinical examination, could be useful for TMD prognosis and management.

Perda dentária e doença periodontal associada ou não a condições sistêmicas ­ revisão de literatura / Tooth loss and periodontal disease associated or not with systemic conditions - literature review

Associações significativas entre doença periodontal, cárie e perda dentária têm sido relatadas. Este trabalho teve por objetivo analisar a relação entre doença periodontal e perda dentária, associada ou não a alterações sistêmicas através de uma revisão sistematizada da literatura. Para a seleção dos artigos utilizados nesta revisão, foi feita uma busca na base bibliográfica PubMed (www.ncbi.nlm.nih.gov/pubmed), utilizando as palavras-chave: "periodontal disease" ou "periodontitis" em combinação com "tooth loss". Realizou-se um refinamento na pesquisa bibliográfica utilizando como critérios de inclusão: publicações na língua inglesa, estudos clínicos em humanos, longitudinais ou transversais, publicados nos últimos 35 anos. Foram encontrados 1072 resumos. Após a leitura de títulos e resumos,18 artigos que avaliaram a relação da perda dentária com a doença periodontal, associada ou não a condições sistêmicas, foram considerados válidos para a realização desta revisão. Sete estudos abordaram a associação da condição periodontal com a perda dentária em pacientes normossistêmicos e 11 apresentaram relações da perda dentária com a periodontite associada a alterações sistêmicas. A periodontite foi encontrada e classificada como a primeira ou segunda maior causa de perda dentária pelos estudos levantados nesta revisão, tendo ainda sido relatada uma correlação positiva significativa entre perda dentária e níveis de inserção clínica. A diabetes foi associada diretamente a maiores danos nas condições periodontais e, consequentemente, perda dentária. Porém, pacientes diabéticos insulino-controlados apresentaram resultados semelhantes a indivíduos não diabéticos.(AU)

Significant associations between periodontal disease, caries and tooth loss have been reported. The aim of this study was to analyze the relationship between periodontal disease and tooth loss, associated or not to systemic alterations through a systematic review of the literature. We searched the PubMed databases (www.ncbi.nlm.nih.gov/pubmed) for the selection of the articles used in this review, using the keywords "periodontal disease" or "periodontitis" in combination with "tooth loss". A refinement in the bibliographic research was made using as inclusion criteria: publications in the English language, clinical studies in humans, longitudinal or transverse, published in the last 35 years. 1072 abstracts were found. After reading titles and abstracts, 18 articles that assessed the relationship between tooth loss and periodontal disease, associated or not with systemic conditions, were considered valid for this review. Seven studies addressed the association of periodontal condition with tooth loss in normosystemic patients and 11 presented relationships of tooth loss with periodontitis associated with systemic alterations. Periodontitis was found to be the first or second largest cause of tooth loss in studies reviewed in this review, and a significant positive correlation between tooth loss and clinical attachment loss has been reported. Diabetes was directly associated with greater damage in periodontal conditions and, consequently, tooth loss. However, insulin-controlled diabetic patients presented similar results to non-diabetic individuals (AU).

Tratamento da pigmentação melânica gengival ­ revisão sistemática da literatura / Treatment of gingival melanin pigmentation - systematic literature review

A pigmentação oral é uma descoloração que atinge principalmente a gengiva e a mucosa oral, associada a fatores etiológicos endógenos e exógenos. A melanina é um dos pigmentos responsáveis por essa coloração sendo produzida pelos melanossomos presentes nos melanócitos, que estão localizados ao nível da camada basal e suprabasal do epitélio. A pigmentação melânica gengival configura-se como um problema estético. Este trabalho teve por objetivo fazer uma revisão sistematizada da literatura abordando ensaios clínicos que apresentassem técnicas de remoção da pigmentação melânica gengival. Para a seleção dos artigos utilizados foi realizada uma busca online nas bases bibliográficas PubMed (www.ncbi.nlm.nih.gov/pubmed) e Scopus (https://www.scopus.com) compreendendo o período de janeiro de 2006 a abril de 2016, utilizando os descritores: "gingival", "melanin", "pigmentation", "hyperpigmentation" e "depigmentation", em combinação. Realizou-se um refinamento na pesquisa bibliográfica utilizando como critérios de inclusão: publicações na língua inglesa de estudos clínicos de intervenção em humanos. Foram selecionados inicialmente 188 artigos e após a leitura dos títulos e resumos 15 estudos foram considerados válidos para essa revisão. A técnica da desepitelização para remoção da pigmentação melânica gengival com o uso de broca e lâmina de bisturi é considerada padrão ouro, sendo uma alternativa economicamente viável e de fácil execução. Porém, o uso do laser vem sendo indicado como opção ao tratamento. Foram encontrados relatos de recidivas das pigmentações em todas as técnicas apresentadas, com maiores relatos de repigmentações nas técnicas que promovem a remoção do epitélio (AU)

The oral pigmentation is a discoloration that primarily affects the gums and oral mucosa is associated with endogenous and exogenous etiological factors. Melanin is a pigment responsible for this coloring being produced by the present melanosomes in melanocytes, which are located at the level of the basal and suprabasal layer of the epithelium. The gingival melanin pigmentation appears as an aesthetic problem. This study aimed to make a systematic review of the literature regarding clinical trials to submit removal techniques of gingival melanin pigmentation. For the selection of articles used a search online bibliographic databases was conducted in PubMed (www.ncbi.nlm.nih.gov/pubmed) and Scopus (https://www.scopus.com) covering the period from January 2006 to April 2016, using the key words: "gingival" "melanin", "pigmentation", "hyperpigmentation" and "depigmentation" in combination. This was a refinement in the literature search using the following inclusion criteria: clinical intervention studies in humans published in English. They were initially selected 188 articles and after reading the titles and abstracts 15 studies were considered valid for this review. The scalpel technique for removal gingival melanin pigmentation using drill and scalpel blade is considered the gold standard, with an economically viable and easy to perform. However, the use of laser has been recommended as an option for treatment. The recurrence of pigmentations was observed on all the techniques presented with greater repigmentações reports on techniques that promote surgical stripping (AU)

Analysis of polymorphisms in Interleukin 10, NOS2A, and ESR2 genes in chronic and aggressive periodontitis.

The objective of this study was to investigate the association between single nucleotide polymorphisms (SNPs) in the IL10, NOS2A, and ESR2 genes and chronic periodontitis (CP) and aggressive periodontitis (AgP). Three groups of patients underwent periodontal and radiographic evaluations: CP (n = 61), AgP (n = 50), and periodontally healthy (control group=61). Genomic DNA was extracted from oral epithelial cells and used for genotyping by real-time polymerase chain reaction using TaqMan® probes. The investigated SNPs were: -1087G > A, -819C > T and -592C > A in the IL10; +2087G > A in the NOS2A, and +1730G > A in the ESR2 gene. Differences in genotype and allele frequencies of each polymorphism and some individual characteristics were analyzed using the chi-square test and multivariate logistic regression analysis. Analysis of SNPs and haplotypes in the IL10 and SNP in the ESR2 gene did not present any significant association with AgP or CP. The +2087G allele of the NOS2A gene tended to be significantly associated with periodontal disease. Patients carrying the genotype +2087GG in the NOS2A gene were genetically protected against the development of CP (p = 0.05; OR = 0.44; 95%CI = 0.20-0.95). This result showed greater significance when patients with AgP and CP were combined (total PD) (p = 0.03; OR = 0.46; 95%CI = 0.23-0.92). In conclusion, the studied Brazilian population had a significantly higher frequency of the GG genotype for the +2087 SNP in the NOS2A gene in individuals without periodontitis, although statistical significance was not maintained after multiple logistic regression.

Analysis of polymorphisms in Interleukin 10, NOS2A, and ESR2 genes in chronic and aggressive periodontitis

Abstract The objective of this study was to investigate the association between single nucleotide polymorphisms (SNPs) in the IL10, NOS2A, and ESR2 genes and chronic periodontitis (CP) and aggressive periodontitis (AgP). Three groups of patients underwent periodontal and radiographic evaluations: CP (n = 61), AgP (n = 50), and periodontally healthy (control group=61). Genomic DNA was extracted from oral epithelial cells and used for genotyping by real-time polymerase chain reaction using TaqMan® probes. The investigated SNPs were: -1087G > A, -819C > T and -592C > A in the IL10; +2087G > A in the NOS2A, and +1730G > A in the ESR2 gene. Differences in genotype and allele frequencies of each polymorphism and some individual characteristics were analyzed using the chi-square test and multivariate logistic regression analysis. Analysis of SNPs and haplotypes in the IL10 and SNP in the ESR2 gene did not present any significant association with AgP or CP. The +2087G allele of the NOS2A gene tended to be significantly associated with periodontal disease. Patients carrying the genotype +2087GG in the NOS2A gene were genetically protected against the development of CP (p = 0.05; OR = 0.44; 95%CI = 0.20-0.95). This result showed greater significance when patients with AgP and CP were combined (total PD) (p = 0.03; OR = 0.46; 95%CI = 0.23-0.92). In conclusion, the studied Brazilian population had a significantly higher frequency of the GG genotype for the +2087 SNP in the NOS2A gene in individuals without periodontitis, although statistical significance was not maintained after multiple logistic regression.

Leukotoxicity of Aggregatibacter actinomycetemcomitans in generalized aggressive periodontitis in Brazilians and their family members.

OBJECTIVE: The purpose of this study was to examine the leukotoxin promoter types of Aggregatibacter actinomycetemcomitans clones in subjects with generalized aggressive periodontitis (GAgP) and in their family members (FM). MATERIAL AND METHODS: Thirty-five patients with GAgP (33.9±7.1 years), 33 of their FM (22.8±11.4 years), and 41 patients with chronic periodontitis (CP) (44.1±9.4 years) were clinically analyzed using the plaque index, gingival index, probing depth (PD), and clinical attachment level (CAL). Subgingival biofilm samples were collected from four interproximal periodontal sites (>PD and >CAL) of each patient. The presence of A. actinomycetemcomitans and its leukotoxic clone was confirmed by polymerase chain reaction (PCR). RESULTS: A. actinomycetemcomitans was observed in 23 (51.1%) GAgP patients and 16 (30.1%) CP patients. Thirty-seven (94.8%) patients showed minimally leukotoxic strains and 2 (5.1%) showed highly leukotoxic strains. In the FM group, 10 (30.3%) had aggressive periodontitis (AgP), 12 (36.3%) had CP, 11 (33.3%) were periodontally healthy or had gingivitis, and 12.2% were A. actinomycetemcomitans positive. Greater full mouth PD and CAL were observed in GAgP patients positive for the bacteria than those negative for it (p<;0.05), and the presence of A. actinomycetemcomitans positively correlated with GAgP (Odds ratio, 3.1; confidence interval, 1.4-7.0; p=0.009). CONCLUSIONS: The presence of A. actinomycetemcomitans was associated with the clinical condition of GAgP, with most patients exhibiting a generalized form of the disease and minimally leukotoxic clones. Most of the relatives of GAgP patients presented either CP or AgP.

Leukotoxicity of Aggregatibacter actinomycetemcomitans in generalized aggressive periodontitis in Brazilians and their family members

OBJECTIVE: The purpose of this study was to examine the leukotoxin promoter types of Aggregatibacter actinomycetemcomitans clones in subjects with generalized aggressive periodontitis (GAgP) and in their family members (FM). MATERIAL AND METHODS: Thirty-five patients with GAgP (33.9±7.1 years), 33 of their FM (22.8±11.4 years), and 41 patients with chronic periodontitis (CP) (44.1±9.4 years) were clinically analyzed using the plaque index, gingival index, probing depth (PD), and clinical attachment level (CAL). Subgingival biofilm samples were collected from four interproximal periodontal sites (>PD and >CAL) of each patient. The presence of A. actinomycetemcomitans and its leukotoxic clone was confirmed by polymerase chain reaction (PCR). RESULTS: A. actinomycetemcomitans was observed in 23 (51.1%) GAgP patients and 16 (30.1%) CP patients. Thirty-seven (94.8%) patients showed minimally leukotoxic strains and 2 (5.1%) showed highly leukotoxic strains. In the FM group, 10 (30.3%) had aggressive periodontitis (AgP), 12 (36.3%) had CP, 11 (33.3%) were periodontally healthy or had gingivitis, and 12.2% were A. actinomycetemcomitans positive. Greater full mouth PD and CAL were observed in GAgP patients positive for the bacteria than those negative for it (p<;0.05), and the presence of A. actinomycetemcomitans positively correlated with GAgP (Odds ratio, 3.1; confidence interval, 1.4-7.0; p=0.009). CONCLUSIONS: The presence of A. actinomycetemcomitans was associated with the clinical condition of GAgP, with most patients exhibiting a generalized form of the disease and minimally leukotoxic clones. Most of the relatives of GAgP patients presented either CP or AgP. .

Debridamento ultrassônico de boca toda no tratamento da periodontite crônica: uma revisão sistematizada / Full mouth ultrasonic debridement in the treatment of chronic periodontitis: a systematic review

Introdução: O debridamento ultrassônico de boca toda visa a uma instrumentação mais leve e conservadora da superfície radicular, evitando a recolonização da bolsa periodontal. Objetivo: Este trabalho verificou os efeitos do debridamento subgengival com o uso de ultrassom sobre os parâmetros clínicos periodontais no tratamento da periodontite crônica por meio de uma revisão na literatura. Material e Método: A revisão foi realizada nas bases de busca bibliográfica PubMed, Lilacs, Scielo, Medline e Centro de Registro de Ensaios Clínicos Controlados (Biblioteca Cochrane). Foram incluídas publicações na língua inglesa que abordaram estudos clínicos de intervenção em humanos, randomizados e controlados, e que utilizaram o debridamento ultrassônico para o tratamento não cirúrgico da periodontite crônica. Resultado: Inicialmente, foram encontradas 167 referências e, a partir da análise dos títulos e resumos, dez estudos perfizeram as características exigidas e foram considerados válidos para a realização desta revisão. Os estudos mostraram que a abordagem pelo debridamento ultrassônico pode ser terapia favorável ao tratamento da periodontite crônica. Conclusão: O tratamento da periodontite crônica por meio do debridamento ultrassônico periodontal de boca toda produz resultados clínicos semelhantes aos conseguidos na raspagem e no alisamento radicular convencionais.

Introduction: The full-mouth ultrasonic debridement seeks a more conservative instrumentation with light pressure of the root surface, preventing recolonization of periodontal pockets. Objective: This study examined the effects of subgingival debridement through the use of ultrasonic devices on clinical periodontal parameters in the treatment of chronic periodontitis by a review of the literature. Material and Method: Studies were selected on the bibliographic databases PubMed, Lilacs, Scielo, Medline and the Central Registry of Controlled Trials (The Cochrane Library). It was included English language publications with clinical studies of human intervention, randomized controlled trials that used ultrasonic debridement for the nonsurgical treatment of chronic periodontitis. Result: Initially, we found 167 references and analyzing the titles and abstracts totaled ten studies the characteristics required and were considered valid for the completion of this review. Studies have shown that the approach by ultrasonic debridement therapy may be favorable to the treatment of chronic periodontal disease. Conclusion: It can be concluded that the treatment of chronic periodontitis by full mouth periodontal ultrasonic debridement produces similar outcomes to those achieved in conventional scaling and root planing.

Genótipos fimA de porphyromonas gingivalis e periodontite / Porphyromonas gingivalis fimA genotypes and periodontitis

Porphyromonas gingivalis é um dos principais patógenos envolvidos com o início e progressão da doença periodontal. Este microorganismo exibe uma diversidade genotípica e fenotípica que pode resultar em diferenças na capacidade dos clones induzirem destruição periodontal. Variações no potencial patogênico dos distintos genótipos do gene fimA de P. gingivalis foram relacionadas a diferentes doenças periodontais em diversos estudos. Esta revisão teve o objetivo de analisar criticamente os estudos que relacionaram as condições periodontais e os diferentes genótipos fimA de P. gingivalis. Foram incluídas publicações na língua inglesa de estudos clínicos em humanos, que avaliaram a relação entre as condições periodontais e os diferentes genótipos fimA de P. gingivalis. Doze estudos foram considerados válidos para a realização desta revisão. Pôde-se concluir que os genótipos fimA II e IV de P. gingivalis encontram-se frequentemente associados à periodontite crônica

Porphyromonas gingivalis is a major pathogen involved in the initiation and progression of periodontal disease. This microorganism exhibits a genotypic and phenotypic diversity which may result in differences in the ability to induce periodontal destruction of the clones. Variations in the pathogenic potential of different genotypes of fimA gene of P. gingivalis were related to different periodontal diseases in several studies. This systematic review aimed to critically analyze the studies that have linked periodontal conditions and the different fimA genotypes of P. gingivalis. We included English language publications of human clinical studies that evaluated the relationship between periodontal conditions and the different fimA genotypes of P. gingivalis. Twelve studies were considered valid for the completion of this review. It was concluded that fimA genotypes II and IV of P. gingivalis are often associated with chronic periodontitis.

Avaliação da presença de calculo subgengival em fumantes / Evaluation of the presence of subgingival calculus in smokers

O habito de fumar tem sido considerado um dos principais fatores de risco associado com a doença periodontal crônica, por estar associado com um aumento da prevalência e severidade da doença. A exposição ao fumo eleva o risco do desenvolvimento de periodontite podendo exercer um forte impacto sobre o acumulo de calculo subgengival. O objetivo deste estudo foi avaliar a presença do calculo subgengival em fumantes com periodontite crônica. Para tanto foram analisados os prontuarios odontológicos e radiografias de 76 pacientes, 26 fumantes (FUM) e 50 não fumantes(NFUM). Fumantes apresentaram significantemente (p< 0,05) maior percentagem de sítios com profundidade de respectivamente, havendo uma diferença significante entre os grupos. Quando os sítios proximais foram estratificados...

Cigarette smoking has been considered one of the major risk factor associated with chronic periodontal disease, being associated with an increased prevalence and severity of disease. Cigarette smoking exposure increases the risk of developing periodontitis and may have a powerful impact on the accumulation of subgingival calculus. The aim of this study was to evaluate the presence of subgingival calculus in smokers with chronic periodontitis. Therefore, it was examined dental records and radiographs of 76 patients, 26 smokers (SM) and 50 non-smokers (NSM). Smokers had significantly (p< 0.05) higher percentage of sites with probing depth (PD) ¡Ý5 (SM = 32.8%; NSM = 25.7%) as well as lower Gingival lndex (GI) (SM = 21.8%; NSM = 36.2%). ln the analysis of proximal sites with subgingival calculus, SM and NSM showed 37.7% and 30.2% of sites respectively, with a significant difference between groups. When the proximal sites were stratified in relation to PD, this difference was observed only in shallow sites, ¡Ü 4 mm (SM = 31.7%; NSM = 25.4%) but not in the deeper sites, ¡Ý5 mm (SM = 49.9%; NSM= 51.3%). The smokers had a higher amount of subgingival calculus than non-smokers.

Perfil celular e mediadores químicos na doença periodontal associada ao biofilme dental: revisão de literatura / Celular profile and chemical mediating in periodontal disease associated on the dental biofilm: review of the literature

As doenças periodontais resultam da resposta inflamatória às bactérias do biofilme dental que ativam o sistema imunológico do paciente, determinando o resultado final da doença. O presente trabalho se propõe a realizar uma retrospectiva da literatura científica sobre a população celular e os mediadores químicos endógenos que participam no desenvolvimento das gengivites e periodontites associadas ao biofilme dental. Em todas as fases da doença periodontal encontram-se neutrófilos, macrófagos, linfócitosT, linfócitos B e plasmócitos compondo o infiltrado inflamatório, com produção e liberação de mediadores como IL-1,IL-6, IL-8 e TNF-α. Na gengivite estabelecida não se encontra destruição óssea, enquanto na lesão periodontal, além de reabsorção óssea, há tecido conjuntivo com características inflamatórias semelhantes à lesão estabelecida, porém com intensa população de plasmócitos. IL-1 eTNF-α são mediadores de efeito sinérgico e estão envolvidos no processo de reabsorção óssea da periodontite. Sugere-se que nas lesões periodontais estáveis predominamos linfócitos T e nas lesões em progressão os linfócitos B e plasmócitos maduros. O conhecimento das células e mediadores que participam da patogênese da doença periodontal se faz importante para que possamos chegar a métodos terapêuticos mais específicos.

The periodontal diseases results from the inflammatory response to bacteria in the dental biofilm, who active de immunology system, establishing the final result of the disease. This presents review propose to realize a etrospection of the scientific literature about the cellular population and the chemical mediating endogenous that participate to the development of the gingivitis and riodontits associated with the dental biofilm. In all phasesof the periodontal disease are met neutrophils, macrophages, cells-T, cells-B and plasma cells in the inflammatory infiltrate with production and release of IL-1, IL-6, IL-8 and TNF-α. In the established gingivitis have not bone destruction, while in the periodontal lesion shows resorption bone and connective tissue with inflammation characteristics analogous of the established lesion, but there are a intense population of plasma cells. IL-1 and TNF-α are mediating that produced synergistic effects involved in the periodontal bone resorption in the periodontitis. It is suggested that in the stable periodontal lesions predominate the lymphocytes T and in the lesions in progression predominate the lymphocytes B and mature plasma cells. The knowledge of the cells and mediating that participated in the pathogenesis of the periodontal disease is very important. So that we can arriveto the therapy methods more specific.