Evaluation of the Change in Halitosis with the Improvement in Oral Health in Cleft Lip and Palate Patients.

AIM: This study aimed to assess the effects of hygiene education on periodontal health and mouth/nasal halitosis in patients with cleft. MATERIALS AND METHODS: 39 patients with cleft who were accepted for orthodontic treatment divided into two groups as with (Group1; n = 24) and without braces (Group2; n = 15). Plaque Index (PI), Gingival Index (GI), and Tongue coating Index (TCI) values were recorded. The BANA test microbiological kit, was used to determine the amount of anaerobic bacteria. Values of volatile sulfur components (VSC) for the measurement of oral and nasal halitosis were measured with a Halimeter device. After the initial measurements, oral hygiene instructions were given to eliminate the plaque production on teeth, periodontal structure, tongue and palate. All measurements were repeated 4 weeks after the hygiene instructions. Wilcoxon and Mann-Whitney U test were used for statistical analysis. RESULTS: In both groups, the PI, GI, values were significantly decreased (P < .05). Tongue coating area, thickness and TCI were significantly reduced (P < .05). Oral halitosis values decreased significantly (P < .05). The PI values decreased significantly more in the Group 1 (P < .05). Non significant difference was detected in nasal halitosis in both groups. In unilateral cleft lip and palate cases cases (n = 23), no significant difference was found in nasal halitosis values between the cleft and the healthy sides (P > 0.05). CONCLUSION: In patients with clet cases, periodontal health was improved and oral halitosis was reduced by the given hygiene education; brushing the teeth, especially the tongue and palate. However, hygiene education did not have a significant effect on nasal halitosis. Key Words: Cleft lip and palate, Halitosis, BANA test, Periodontal index.

Effects of smoking on the salivary and GCF levels of IL-17 and IL-35 in periodontitis.

Periodontitis progression is associated with a host response in which anti-inflammatory and pro-inflammatory cytokine networks play a key role. Smoking is involved in the production of various mediators. The study aims to evaluate the levels of IL-17 and IL-35 in saliva and gingival crevicular fluid (GCF), to investigate the effects of smoking on these cytokines in smoker and non-smoker periodontitis patients. 19 smokers with periodontitis, 20 non-smokers with periodontitis, and 18 periodontally healthy subjects were included in the study. Periodontal clinical indexes were recorded and the levels of IL-17 and IL-35 in saliva and GCF were analyzed. No significant difference was detected among the groups in terms of salivary IL-17 and IL-35 levels. GCF IL-17 and IL-35 concentration levels in the non-smoker periodontitis group were significantly lower than the others (p < 0.05). Total levels of GCF IL-17 were significantly higher in both periodontitis groups than the control group; and total levels of GCF IL-35 were significantly higher in non-smoker periodontitis group than the others (p < 0.05). A positive correlation was detected between the salivary IL-17 and IL-35 levels (r = 0.884), GCF IL-17 and IL-35 concentrations (r = 0.854), and total GCF IL-17 and IL-35 (r = 0.973) levels (p < 0.01). The present study revealed a positive correlation between the IL-35 and IL-17 levels both in saliva and GCF. IL-17 and IL-35 can be considered as one of the cytokines that play a role in periodontal health and periodontitis; and smoking may be among the factors that affect the levels of these cytokines in GCF and saliva.

Oral manifestations in SARS-CoV-2 infection

Background: We aimed to evaluate the prevalence of predisposing factors and oral manifestations in SARS-CoV-2infection.Material and Methods: 204 SARS-CoV-2 positive patients were included in the study. Questions regarding thesystemic, periodontal health, oral hygiene habits, common symptoms and, oral manifestations of COVID-19 suchas oral lesions, and dry mouth were included in the survey. The Visual Analogue Scale (VAS) was used.Results: 47.5% of individuals had various systemic diseases. Dry mouth (44.2%) and oral lesions (22.4%) werethe most common oral manifestations in COVID-19 patients. Also, dry mouth had the highest VAS score. Themost common oral lesion locations were buccal mucosa (15.2%) and tongue (10.8%). The majority of participants(142 patients) were affected by taste disorders. Patients who received periodontal treatment before SARS-CoV-2infection reported fewer oral complaint and manifestations than those who did not receive periodontal therapy(p=0.032). There was no statistically significant difference between males and females on the presence of any oralmanifestations, and taste disorders.Conclusions: Our results showed that SARS-CoV-2 could cause oral manifestations. However various predisposing factors may be part of the etiology and promote oral findings. (AU)

Effects of smoking on the bone alkaline phosphatase in peri-implant crevicular fluid and implant stability quotient around implants before loading.

We aimed to examine the implant stability quotient (ISQ), alveolar bone level measurements (ABL), and bone alkaline phosphatase (BALP) in peri-implant crevicular fluid (PICF) around implants in smokers and non-smokers before loading in 3 months. 44 dental implants were placed into smoker and non-smoker patients equally. ISQ was measured at baseline and 3 months after surgery. The levels of PICF BALP and alveolar bone were measured. ISQ values significantly increased in smokers and non-smokers in the 3rd month (p < 0.05). ABL measurements were lower at 3 months compared to baseline in both groups (p < 0.05). Although ISQ and ABL values were higher in non-smokers than smokers at 3 months, the difference between the groups did not show any statistical significance. The PICF BALP levels in the 3rd month changed in both groups. But, these differences were insignificant. Although some of the measurements presented differences between the groups during the assessment periods, they were not indicative of the hazardous effects of smoking on bone healing around implants after surgery till functional loading in 3 months. However, smoking is an important factor to be considered for osseo-integration outcomes. Further studies are needed to clarify the influence of smoking on osseo-integration.

Effect of topical ozonetherapy on gingival wound healing in pigs: histological and immuno-histochemical analysis

Abstract In this study, the effects of ozonetherapy on secondary wound healing were evaluated histologically and immuno-histochemically. Material and Methods: 8 healthy pigs were used in this study. Six wounds with 10 mm in diameter were created through the punch technique on the palatinal gingiva of each pig. Ozone gas was applied on only 3 wounds (test group) and the remaining 3 were left to natural healing (control group). Biopsy samples were taken from one of the wounds in each group on the third day, from another wound of each group on the seventh day, and from another one on the tenth day. Routine histological analysis and immuno-histochemical staining were performed to investigate transforming growth factor-beta (TGF-β) and (VEGF) expressions. Results: No statistical difference was found between the test and control groups in terms of collagen fibers, epithelial formation and inflammation scores. A VEGF expression found in the test group was statistically higher than control group samples taken on the 3rd and 7th day. There was no statistical difference between the test and control groups in terms of TGF-β expression on any of the sampling days. Conclusion: The topical application of ozone gas could be effective in the early stages of wound healing by increasing the amount of VEGF expression. Clinical Relevance: Topical application of ozone gas may be effective in the early stages of oral wound healing.

Effect of topical ozonetherapy on gingival wound healing in pigs: histological and immuno-histochemical analysis.

OBJECTIVES: In this study, the effects of ozonetherapy on secondary wound healing were evaluated histologically and immuno-histochemically. MATERIAL AND METHODS: Material and Methods: 8 healthy pigs were used in this study. Six wounds with 10 mm in diameter were created through the punch technique on the palatinal gingiva of each pig. Ozone gas was applied on only 3 wounds (test group) and the remaining 3 were left to natural healing (control group). Biopsy samples were taken from one of the wounds in each group on the third day, from another wound of each group on the seventh day, and from another one on the tenth day. Routine histological analysis and immuno-histochemical staining were performed to investigate transforming growth factor-beta (TGF-ß) and (VEGF) expressions. RESULTS: Results: No statistical difference was found between the test and control groups in terms of collagen fibers, epithelial formation and inflammation scores. A VEGF expression found in the test group was statistically higher than control group samples taken on the 3rd and 7th day. There was no statistical difference between the test and control groups in terms of TGF-ß expression on any of the sampling days. CONCLUSIONS: Conclusion: The topical application of ozone gas could be effective in the early stages of wound healing by increasing the amount of VEGF expression. Clinical Relevance: Topical application of ozone gas may be effective in the early stages of oral wound healing.

Evaluation of peri-implant crevicular fluid prostaglandin E2 levels in augmented extraction sockets by different biomaterials.

OBJECTIVES: This study compares peri-implant crevicular fluid (PICF) prostaglandin E2 (PGE2) levels, clinical parameters and implant stability quotient (ISQ) values around implants placed in augmented extraction sockets. MATERIALS AND METHODS: The sockets (24 in total) were randomly augmented using either EMD or Bio-Oss Collagen. Implant placements were performed after three months of healing. ISQ readings were evaluated at three points: at the time of surgery, at the first month and at the third month. PICF was collected for PGE2 evaluation after the first and the third months of implant surgery. RESULTS: After the first month, a higher level of PICF PGE2 was observed in the EMD group than in the Bio-Oss Collagen group, and this increase was of statistical significance; however, at the third month there was no statistically significant difference in PICF PGE2 levels between the two groups. For implants placed in EMD sites, ISQ values were statistically higher at the third month than at the first month, while no significant differences in ISQ value were detected between the first and third months in Bio-Oss Collagen sites. CONCLUSIONS: The results of this research suggest that both EMD and Bio-Oss Collagen are effective treatment modalities for stimulating the formation of new bone at extraction sites prior to implant surgery.

Osteocalcin and osteonectin expression after double application of platelet-rich plasma in rabbits.

PURPOSE: Platelet-rich plasma (PRP) is a novel method for transferring autogenous growth factors to the wound area. The aim of this study was to evaluate the efficacy of double-application of PRP (DA-PRP) on bone healing in rabbit cranial defects by examining osteonectin (ON) and osteocalcin (OC) expression. MATERIALS AND METHODS: Twenty-eight rabbits, each with two surgically prepared calvarial bone defects, were included in this study and divided into six groups: The defects (N=56) were treated with either a single-application of PRP (SA-PRP) (n=10), a combination of SA-PRP and betatricalciumphosphate (SA-PRP+ß-TCP) (n=10), only DAPRP (n=8), both DA-PRP and beta-tricalciumphosphate (DA-PRP+ß-TCP) (n=8), only beta-tricalciumphosphate (ß-TCP) (n=10), or controls (n=10). The animals were sacrificed at 30th day postoperatively and samples were immunohistochemically examined for ON and OC expressions. RESULTS: It was determined that DA-PRP did not significantly improve the ON and OC percentages achieved by SA-PRP or the controls. The three groups treated with ß-TCP showed a higher percentage of ON than those treated without ß-TCP (p<0.05). The ß-TCP treated groups and SA-PRP group demonstrated higher OC percentage than DA-PRP and control groups (p<0.05). CONCLUSION: The present findings suggest that DAPRP did not have a significant effect on the healing of non-critical size rabbit cranial bone defects.

Evaluation of Clinical Parameters and Levels of Proinflammatory Cytokines in the Crevicular Fluid Around Dental Implants in Patients with Type 2 Diabetes Mellitus.

PURPOSE: Diabetes mellitus is considered a relative contraindication for dental implant therapy, depending on levels of glycemic control. The purpose of this research was to evaluate the peri-implant conditions and measure the levels of interleukin 1 beta (IL-1ß) and tumor necrosis factor alpha (TNF-α) in the peri-implant crevicular fluid (PICF) in patients with glycemic-controlled type 2 diabetes (T2DM). MATERIALS AND METHODS: Thirteen patients with well-controlled T2DM and seven systemically healthy patients were recruited for this study. Clinical measurements were recorded, and samples of gingival crevicular fluid (GCF) and PICF were collected from the sulci of both adjacent teeth and implants at baseline (after implant placement), 1 month, 4 months, and 7 months. Levels of IL-1ß and TNF-α in the GCF and PICF were analyzed by enzyme-linked immunosorbent assay. Standardized intraoral radiographs were taken at baseline (after implant placement), 4 months, and 7 months. Implant stability was assessed by resonance frequency analysis at baseline, at 1 month, and at 4 months. RESULTS: Glycosylated hemoglobin levels in the T2DM group were significantly increased at 7 months compared to baseline levels. Implant stability quotient levels at 4 months were increased significantly compared to baseline in both groups. Alveolar bone levels around implants were statistically lower at 4 and 7 months compared to baseline and statistically decreased at 7 months compared to 4 months in the T2DM group. There were no significant differences between groups in bone levels around implants, and no significant differences were found in levels of IL-1ß and TNF-α at either teeth or implants or between the groups. CONCLUSION: The results suggest that dental implant therapy can be offered to patients with well-controlled T2DM, as there were no significant differences between control and diabetic patients in terms of clinical parameters or GCF and PICF cytokine levels.

Short term effects of non-surgical periodontal treatment on gingival crevicular fluid levels of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 2 (PAI-2) in patients with chronic and aggressive periodontitis.

OBJECTIVE: The purpose of this study was to evaluate the gingival crevicular fluid (GCF) levels of tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor 2 (PAI-2) in aggressive periodontitis (AgP), chronic periodontitis (CP) and periodontally healthy control subjects, before (BT) and after (AT) the non-surgical periodontal treatment. DESIGN: Systemically healthy 12 CP and 13 AgP patients and 20 control subjects were included in this study. Plaque index, gingival index, probing depth and clinical attachment levels were recorded and GCF samples were collected BT and AT. Assays for GCF t-PA and PAI-2 levels were carried out by an enzyme linked immunosorbent assay (ELISA). The χ(2), Wilcoxon and Mann-Whitney U tests and Spearman correlation coefficient were used for data analyses. RESULTS: Statistically significant reductions in clinical index scores were noted in both periodontitis groups after treatment. No significant differences were detected in GCF levels of t-PA and PAI-2 between CP and AgP groups at either BT or AT. There was a statistically significant decrease in GCF PAI-2 levels in CP after therapy (p<0.01). GCF t-PA levels in CP and AgP groups exhibited significant correlations with PD and CAL measurements at both BT and AT (p<0.01). CONCLUSION: Significant decrease was detected for GCF PAI-2 levels in CP and clinical parameters in both CP and AgP by non-surgical periodontal treatment.

Effects of low-dose doxycycline and bisphosphonate clodronate on alveolar bone loss and gingival levels of matrix metalloproteinase-9 and interleukin-1ß in rats with diabetes: a histomorphometric and immunohistochemical study.

BACKGROUND: Bisphosphonates (BPs) and low-dose doxycycline (LDD) have been shown to inhibit bone resorption and to improve the levels of proinflammatory mediators and destructive enzymes in gingival tissues, respectively. The purpose of this study is to evaluate the effect of mono and combined BP clodronate and LDD therapies in reducing gingival levels of matrix metalloproteinase-9 (MMP-9), interleukin-1ß (IL-1ß), and alveolar bone loss in rats with diabetes. METHODS: Fifty adult Wistar rats were divided into five study groups as follows: 1) group 1 = diabetes control; 2) group 2 = diabetes + periodontitis; 3) group 3 = diabetes + periodontitis + LDD; 4) group 4 = diabetes + periodontitis + clodronate; and 5) group 5 = diabetes + periodontitis + LDD + clodronate. LDD and clodronate were given as a single agent or as combination therapy during the 7 days of the post-experimental periodontitis period. On day 7, the rats were sacrificed, the mobility of the tooth was recorded, and block biopsies were removed. The gingival tissues were analyzed histologically and immunohistochemically for expression of MMP-9 and IL-1ß. Alveolar bone loss was evaluated morphometrically under a light microscope. Data analysis was performed statistically by Kruskal-Wallis and post hoc Tukey and Spearman correlation tests. RESULTS: Alveolar bone loss was significantly greater in groups 2 through 5 than group 1 (P <0.05) but was not significantly different among groups 2 through 5 (P >0.05). Animals with periodontitis (group 2) expressed significantly higher levels of MMP-9 and IL-1ß compared with those without periodontitis (group 1) (P <0.05). MMP-9 expression was significantly lower in group 3 than groups 1, 2, and 5 (P <0.05). IL-1ß expression was significantly lower in the groups 1, 3, 4, and 5 than 2 (P <0.01) but was not significantly different among groups 1, 3, 4, and 5. Positive correlations were found between alveolar bone loss and density of inflammation (ρ = 0.319, P = 0.021) and between MMP-9 and IL-1ß (ρ = 0.418, P = 0.002), respectively. CONCLUSION: Our findings suggest that ligature-induced periodontitis in animals with diabetes results in significantly higher levels of MMP-9 and IL-1ß expression in gingiva. The use of mono and combined clodronate and LDD administrations may significantly reduce levels of MMP-9 and IL-1ß expression. However, drug administration did not affect alveolar bone levels during the study period.

Double-application of platelet-rich plasma on bone healing in rabbits

Objective: Platelet-rich plasma (PRP) is considered to enhance bone formation especially at early stages of wound healing, depending on the limited and short life-span of platelets and growth factors. The aim of this study was to evaluate efficacy of double-application of PRP (DA-PRP) on bone healing in a rabbit calvarial defect model. Study design: Twenty-eight rabbits, each had two surgically prepared calvarial bone defects (10mm diameter),were included in this study and randomly divided into six groups. Defects (n=56) were treated with single-application of PRP (SA-PRP)(n=10), SA-PRP and beta-tricalciumphosphate (SA-PRP+TCP)(n=10), DA-PRP (n=8),DA-PRP and beta-tricalcium phosphate (DA-PRP+TCP)(n=8), beta-tricalcium phosphate (TCP)(n=10) or left empty(Control)(n=10). Animals were sacrificed at 30 days postoperatively. Results: The new bone (NB%) and defect fill (DF%) percentages were calculated from histological slides by image-analyzer software and statistically analysed. All test groups showed higher NB% than control, but differences among all groups were insignificant. The TCP treated groups had significantly higher DF% than groups treated without TCP, however the DF% differences between control, SA-PRP and DA-PRP or TCP, SA-PRP+TC Por DA-PRP+TCP were insignificant. Conclusion: Although new bone formation was histomorphologically remarkable at double-application PRP groups, statistical analyses of the histomorphometric data revealed no significant difference (AU)

Double-application of platelet-rich plasma on bone healing in rabbits.

OBJECTIVE: Platelet-rich plasma (PRP) is considered to enhance bone formation especially at early stages of wound healing, depending on the limited and short life-span of platelets and growth factors. The aim of this study was to evaluate efficacy of double-application of PRP (DA-PRP) on bone healing in a rabbit calvarial defect model. STUDY DESIGN: Twenty-eight rabbits, each had two surgically prepared calvarial bone defects (10mm diameter), were included in this study and randomly divided into six groups. Defects (n=56) were treated with single-application of PRP (SA-PRP)(n=10), SA-PRP and beta-tricalciumphosphate (SA-PRP+TCP)(n=10), DA-PRP (n=8), DA-PRP and beta-tricalciumphosphate (DA-PRP+TCP)(n=8), beta-tricalciumphosphate (TCP)(n=10) or left empty (Control)(n=10). Animals were sacrificed at 30 days postoperatively. RESULTS: The new bone (NB%) and defect fill (DF%) percentages were calculated from histological slides by image-analyzer software and statistically analysed. All test groups showed higher NB% than control, but differences among all groups were insignificant. The TCP treated groups had significantly higher DF% than groups treated without TCP, however the DF% differences between control, SA-PRP and DA-PRP or TCP, SA-PRP+TCP or DA-PRP+TCP were insignificant. CONCLUSION: Although new bone formation was histomorphologically remarkable at double-application PRP groups, statistical analyses of the histomorphometric data revealed no significant difference.

Effects of scaling and root planing and subantimicrobial dose doxycycline on gingival crevicular fluid levels of matrix metalloproteinase-8, -13 and serum levels of HsCRP in patients with chronic periodontitis.

BACKGROUND: This study evaluates the efficacy of subantimicrobial dose doxycycline (SDD) in conjunction with scaling and root planing (SRP) on gingival crevicular fluid (GCF) levels of matrix metalloproteinase (MMP)-8 and -13 and on serum levels of high-sensitivity C-reactive protein (HsCRP) in patients with chronic periodontitis (CP). METHODS: A total of 41 patients with CP and 17 healthy individuals were included in this randomized controlled trial. CP patients were randomly distributed into two groups. Study groups were established as Group I with SRP+placebo, Group II with SRP+SDD, and Group III as control. All CP patients received two regimens of SRP and Group II patients also received SDD for 6 weeks. At baseline and 6 weeks, GCF and blood were collected and clinical indices were recorded. The HsCRP level was assayed in the plasma on a nephelometer. The GCF levels of MMPs were assayed by an enzyme-linked immunosorbent assay. RESULTS: Statistically significant differences in plaque index, gingival index (GI), probing depth (PD), GCF volumes, GCF MMP levels, and serum levels of HsCRP between pre-treatment and post-treatment were noted in both groups. Between groups there was a statistically significant decrease in PD, GI, and GCF levels of MMP-8 favoring the group receiving SDD adjunctive to SRP (P <0.05). CONCLUSION: In this study, greater improvement was detected for PD, GI, and GCF levels of MMP-8 when using SRP+SDD compared to SRP+placebo.

Evaluation of gingival crevicular fluid and serum levels of high-sensitivity C-reactive protein in chronic periodontitis patients with or without coronary artery disease.

BACKGROUND: Most studies have evaluated serum C-reactive protein (CRP) levels in chronic periodontitis (CP) patients, and a few investigations have examined gingival crevicular fluid (GCF) CRP levels. The aims of this study were to determine GCF and serum levels of high-sensitivity CRP (HsCRP) in CP patients with or without coronary artery disease (CAD) and to investigate the relationship between the GCF and serum HsCRP levels in CP patients with and without CAD. METHODS: Thirty CP patients with angiographically proven CAD, 20 CP patients, and 17 healthy individuals were included in the study. Clinical parameters were recorded, and serum and GCF samples were collected. The level of HsCRP in GCF was assayed by a high-sensitivity enzyme-linked immunosorbent assay. The HsCRP level was assayed in the plasma on a nephelometer. RESULTS: The serum HsCRP levels were significantly higher in CP patients with or without CAD than in the control group, and there was a correlation between serum HsCRP levels and clinical parameters and between serum HsCRP levels and GCF volume. There was no statistically significant difference in GCF HsCRP levels between the groups. There was no correlation between GCF HsCRP levels and clinical parameters, GCF volume, or serum HsCRP levels. CONCLUSIONS: Patients with CP and CP + CAD had statistically significant elevations in serum HsCRP levels compared to healthy subjects. However, HsCRP levels of GCF did not differ from those of the control and CP groups or the control and CP + CAD groups. Further studies are needed to clarify the relationship between GCF CRP levels and periodontal diseases.

Effects of scaling and root planing and sub-antimicrobial dose doxycycline on oral and systemic biomarkers of disease in patients with both chronic periodontitis and coronary artery disease.

OBJECTIVES: This study evaluated the effects of scaling and root planing (SRP) +/- sub-antimicrobial dose doxycycline (SDD) on gingival crevicular fluid (GCF) levels of matrix metalloproteinase (MMP) -1, -8, -13 and on serum levels of high-sensitivity C-reactive protein (HsCRP) and lipid fractions in patients with both chronic periodontitis (CP) and coronary artery disease (CAD). MATERIAL AND METHODS: Thirty-six patients were randomly distributed into two groups (Placebo or SDD; 6 weeks) and both received two regimens of SRP. At baseline and 6 weeks, GCF and blood were collected and clinical indices were recorded. MMPs, HsCRP and lipid fractions were assayed. RESULTS: There were statistically significant improvements for all clinical parameters, GCF volumes, GCF MMPs and serum levels of HsCRP, apolipoprotein-A (APO-A), high-density lipoprotein (HDL) and lipoprotein-a between pre- and post-treatment in both groups. Between groups, there were statistically significant greater improvements in pocket depth (PD), gingival index (GI), APO-A and HDL, favouring the group receiving SDD adjunctive to SRP (p < 0.05). CONCLUSION: Greater improvement was detected for PD and GI, and for serum levels of APO-A and HDL cholesterol when using SRP+SDD compared with SRP+placebo in this study. An investigation with larger numbers of patients and a longer duration of drug treatment is needed to confirm these preliminary findings.

Gingival crevicular fluid prostaglandin E(2) and thiobarbituric acid reactive substance levels in smokers and non-smokers with chronic periodontitis following phase I periodontal therapy and adjunctive use of flurbiprofen.

BACKGROUND: It has been established that smoking is an important risk factor for the initiation and progression of chronic periodontitis (CP). This study investigates the effects of phase I periodontal therapy and adjunctive flurbiprofen administration on prostaglandin E(2) (PGE(2)) and thiobarbituric acid reactive substance (TBARS) levels in gingival crevicular fluid (GCF) samples from smoker and non-smoker patients with CP. METHODS: Twenty-one non-smoker and 21 smoker patients with CP were divided into four groups according to treatment modalities. Group 1 (non-smokers with CP) and group 3 (smokers with CP) patients received daily 100-mg flurbiprofen tablets in a 2 x 1 regimen for 10 days together with scaling and root planing (SRP). Patients in group 2 (non-smokers with CP) and group 4 (smokers with CP) received placebo tablets in a 2 x 1 regimen for 10 days together with SRP. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) measurements were recorded and GCF samples were collected at baseline and on day 10 of drug intake from each sampling area by a single examiner who was unaware of the treatment modality. Assays for GCF PGE(2) and TBARS were carried out by an enzyme-linked immunosorbent assay and fluorometric method, respectively. RESULTS: All groups showed statistically significant reductions in PI and GI scores following the phase I periodontal treatment on day 10 (P <0.05), but no statistical differences were observed in PD and CAL scores after the therapy. In groups 1 and 2, the reduction of GCF PGE(2) and TBARS levels were not significant after the therapy compared to baseline levels. In group 3, GCF PGE(2) and TBARS levels exhibited a statistically significant decrease (P <0.05) after the therapy. Group 4 showed significant reductions (P <0.05) in GCF PGE(2) levels after the therapy. No statistically significant reductions were observed in group 4 with regard to GCF TBARS levels. When groups 1 and 3 were compared according to GCF TBARS levels after the therapy, a more statistically significant reduction was observed in group 3 (P = 0.001). CONCLUSION: These results suggest that additional flurbiprofen administration may have more inhibitory effects on GCF levels of PGE(2) and TBARS in the groups of smokers compared to non-smokers with CP.

Gingival Crevicular Fluid Prostaglandin E2 and Thiobarbituric Acid Reactive Substance Levels in Smokers and Non-Smokers With Chronic Periodontitis Following Phase I Periodontal Therapy and Adjunctive Use of Flurbiprofen.

BACKGROUND: It has been established that smoking is an important risk factor for the initiation and progression of chronic periodontitis (CP). This study investigates the effects of phase I periodontal therapy and adjunctive flurbiprofen administration on prostaglandin E2 (PGE2 ) and thiobarbituric acid reactive substance (TBARS) levels in gingival crevicular fluid (GCF) samples from smoker and non-smoker patients with CP. METHODS: Twenty-one non-smoker and 21 smoker patients with CP were divided into four groups according to treatment modalities. Group 1 (non-smokers with CP) and group 3 (smokers with CP) patients received daily 100-mg flurbiprofen tablets in a 2 × 1 regimen for 10 days together with scaling and root planing (SRP). Patients in group 2 (non-smokers with CP) and group 4 (smokers with CP) received placebo tablets in a 2 × 1 regimen for 10 days together with SRP. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) measurements were recorded and GCF samples were collected at baseline and on day 10 of drug intake from each sampling area by a single examiner who was unaware of the treatment modality. Assays for GCF PGE2 and TBARS were carried out by an enzyme-linked immunosorbent assay and fluorometric method, respectively. RESULTS: All groups showed statistically significant reductions in PI and GI scores following the phase I periodontal treatment on day 10 (P <0.05), but no statistical differences were observed in PD and CAL scores after the therapy. In groups 1 and 2, the reduction of GCF PGE2 and TBARS levels were not significant after the therapy compared to baseline levels. In group 3, GCF PGE2 and TBARS levels exhibited a statistically significant decrease (P <0.05) after the therapy. Group 4 showed significant reductions (P <0.05) in GCF PGE2 levels after the therapy. No statistically significant reductions were observed in group 4 with regard to GCF TBARS levels. When groups 1 and 3 were compared according to GCF TBARS levels after the therapy, a more statistically significant reduction was observed in group 3 (P = 0.001). CONCLUSION: These results suggest that additional flurbiprofen administration may have more inhibitory effects on GCF levels of PGE2 and TBARS in the groups of smokers compared to non-smokers with CP.

The immunoglobulin A1 proteinase from Streptococcus pneumoniae is inhibited by tetracycline compounds.

Streptococcus pneumoniae produces a zinc-dependent proteinase that cleaves human immunoglobulin (Ig) A1 in the hinge region. This metalloproteinase is hypothesized to act as a virulence factor by allowing S. pneumoniae to evade the protection provided by IgA1, thus enhancing its ability to colonize the human nasopharyngeal region. No biologically compatible inhibitors of this enzyme have been identified. We determined that doxycycline and a chemically modified tetracycline inhibit this enzyme in vitro at low micromolar concentrations.

Gingival crevicular fluid levels of monocyte chemoattractant protein-1 and tumor necrosis factor-alpha in patients with chronic and aggressive periodontitis.

BACKGROUND: Monocyte chemoattractant protein-1 (MCP-1) is a well-known chemotactic cytokine that regulates mononuclear inflammatory cell recruitment. This recruitment has particular importance in the oral cavity because inflammatory cells will be challenged with periodontopathogenic bacteria during infections. Tumor necrosis factor-alpha (TNF-alpha) is a cytokine that induces bone resorption by stimulating proliferation and differentiation of osteoclasts' progenitors and also stimulates MCP-1 expression. The aims of this study were to investigate the presence of MCP-1 in gingival crevicular fluid (GCF) samples from patients with chronic periodontitis (CP) and aggressive periodontitis (AgP) and to examine the possible correlations between the GCF levels of MCP-1 and TNF-alpha. METHODS: Twenty-five CP, 20 AgP, and 20 healthy control (C) patients were selected for the study. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) measurements were recorded from each sampling area. Assays for GCF MCP-1 and TNF-alpha were carried out by an enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The concentration (nanograms per microliters) and total MCP-1 and TNF-alpha (nanograms per site) were not statistically significant between CP and AgP groups, but total MCP-1 and TNF-alpha was statistically different between CP and C and between AgP and C groups (P <0.001). All clinical parameters were statistically different between CP and C and between AgP and C groups (P <0.001). A positive statistical correlation was detected between the levels of MCP-1 and TNF-alpha, and there was also a positive correlation between all clinical parameters and total MCP-1 and TNF-alpha levels. CONCLUSIONS: These results suggest that MCP-1 could have an important role in the activation and recruitment of inflammatory and immune cells in periodontal diseases, and both AgP and CP patients may have the same pattern of MCP-1 expression. A strong positive correlation between the GCF levels of MCP-1 and TNF-alpha may account for the mechanism of amplification of inflammatory events in gingival inflammation.