Effects of low-level laser therapy (685 nm) at different doses in osteogenic cell cultures.

The present in vitro study evaluated parameters of osteogenesis under the influence of low-level laser therapy (LLLT) at different doses. Osteogenic cells originated from rat calvaria were cultivated in polystyrene plates and exposed to a laser irradiation using an indium-gallium-aluminum phosphide therapeutic laser (InGaAIP), at wavelength of 685 nm, power of 35 mW, 600-µm-diameter optical fiber, and continuous wave. In the attempt of observing the existence of a dose response and its effects, laser irradiation was performed at 25, 77, and 130 J/cm(2) (7, 22, and 37 s, respectively). The following parameters were assessed: growth curve (4, 7, and 11 days), cell viability (24 h), and nodular formation of mineralized matrix (14 days). The results did not show significant differences related to the growth curve (4, 7, and 11 days) and cell viability (24 h). Within 14 days, osteogenic cultures showed nodular areas with well-defined calcified matrix. The total area stained with Alizarin Red did not show any differences between doses of 25 and 130 J/cm(2). However, the percentage of stained area was significantly higher in the 25 J/cm(2) group when compared to the group of 77 J/cm(2) (Kruskal-Wallis test, p < 0.05). It was possible to conclude that the 685-nm laser irradiation (at 25, 77, and 130 J/cm(2)) did not influence cell growth and proliferation, although the extracellular mineralization process may have its pattern altered by the LLLT on osteogenic cell cultures.

The effect of smoking on gingival crevicular fluid volume during the treatment of gingivitis.

Smoking is detrimental to periodontal tissues, and periodontal destruction is greater among smokers. Paradoxically, smokers seem to have less gingival bleeding than never-smokers with comparable supragingival plaque. There is scarce information about the impact of smoking on gingival crevicular fluid (GCF) volume. This single-arm study clinical trial assessed the effect of smoking on GCF volume during the treatment of gingivitis. The sample included 24 never-smokers (47.3 +/-6.7years old, 41.7% males) and 21 smokers (45.8 +/- 5.1 years old; 55% males; 19.6 +/- 11.8 cigarettes/day; 24.1 +/- 8.7 years of smoking) with gingivitis and chronic periodontitis. After baseline supragingival scaling, patients received oral hygiene instructions weekly for 180 days. Particqants were examined at baseline, 30, 90 and 180 days, and gingival bleeding index (GBI), bleeding on prob-ing (BOP), periodontal probing depth (PPD) and GCF volume were recorded. Statistical analysis was performed using linear models (Wald test, p<0.05%). Smokers had significantly smaller GCF volumes than never-smokers. This finding was not attributed to GBI, BOP or PPD. Higher volumes of GCF were significantly associated with deeper pockets. GCF was significantly reduced throughout the study for both smokers and never-smokers, and the largest reductions were seen at 30 days. Smoking affected the GCF crevicular fluid volume independently of the presence of gingival bleeding, BOP and PPD. Smoking status and PPD should be taken into account when GCG volume and components are under investigation.

Short-term clinical and immunologic effects of scaling and root planing with Er:YAG laser in chronic periodontitis.

BACKGROUND: Recently, the erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser has been used for periodontal therapy. This study compared Er:YAG laser irradiation (100 mJ/pulse, 10 Hz, 12.9 J/cm(2)) with or without conventional scaling and root planing (SRP) to SRP only for the treatment of periodontal pockets affected with chronic periodontitis. METHODS: Twenty-one subjects with pockets from 5 to 9 mm in non-adjacent sites were studied. In a split-mouth design, each site was randomly allocated to a treatment group: SRP and laser (SRPL), laser only (L), SRP only (SRP), or no treatment (C). The plaque index (PI), gingival index (GI), bleeding on probing (BOP), and interleukin (IL)-1beta levels in crevicular fluid were evaluated at baseline and at 12 and 30 days postoperatively, whereas probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were evaluated at baseline and 30 days after treatment. A statistical analysis was conducted (P <0.05). RESULTS: Twelve days postoperatively, the PI decreased for SRPL and SRP groups (P <0.05); the GI increased for L, SRP, and C groups but decreased for the SRPL group (P <0.05); and BOP decreased for SRPL, L, and SRP groups (P <0.01). Thirty days postoperatively, BOP decreased for treated groups and was lower than the C group (P <0.05). PD decreased in treated groups (P <0.001), and differences were found between SRPL and C groups (P <0.05). CAL gain was significant only for the SRP group (P <0.01). GR increased for SRPL and L groups (P <0.05). No difference in IL-1beta was detected among groups and periods. CONCLUSION: Er:YAG laser irradiation may be used as an adjunctive aid for the treatment of periodontal pockets, although a significant CAL gain was observed with SRP alone and not with laser treatment.

Systemic administration of strontium ranelate to enhance the osseointegration of implants: systematic review of animal studies.

The literature states that Strontium (Sr) is able to simultaneously stimulate bone formation and suppress bone resorption. Recent animal studies suggest that the systemic administration of Sr, in the form of strontium ranelate (SRAN), would enhance the osseointegration of implants. The purpose of the present study was to undertake a systematic review on animal studies evaluating the systemic administration of Sr to enhance the osseointegration of titanium implants and the remodeling of bone grafts. The MEDLINE (PubMed) and Scopus bibliographic databases were searched from 1950 to October 2017 for reports on the use of systemic and non-radioactive Sr to enhance the osseointegration of titanium implants and the remodeling of bone grafts in animals. The search strategy was restricted to English language publications using the combined terms: "strontium" and "implant or graft or biomaterial or bone substitute". Five studies were included, all related to the systemic administration of Sr in the form SRAN, and its effects on osseointegration of titanium implants. No studies on the use of SRAN-based therapy to enhance the remodeling of bone grafts were found. The studies differed notably with respect to the study population (healthy female rats, healthy male rats, and female rats with induced osteoporosis) and SRAN dose (ranging from 500 to 1000 mg/kg/day). Results were diverse, but a tendency suggesting positive influence of systemic SRAN administration on the osseointegration of titanium implants was observed. No major side-effects due to strontium administration were reported. Systemic Sr administration, in the form of SRAN, seems to enhance peri-implant bone quality and implant osseointegration in animals, however, at a moderate extent. Further studies, evaluating both the effects of this drug on implant osseointegration and the risk/benefit of its use, are needed to provide a rationale of this therapeutic approach.

The relationship of oral malodor in patients with or without periodontal disease.

BACKGROUND: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSC) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal area and the dorsum of the tongue. The aim of this study was to determine whether there is some relationship between the presence of N-benzoyl-DL-arginine-2-napthylamide (BANA)-positive species Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus and clinical and oral malodor parameters. METHODS: Twenty-one subjects (21 to 59 years old) with probing depths (PD) > 3.0 mm and 20 subjects (21 to 63 years old) with PD < or = 3.0 mm (controls) participated. The quality of the mouth air was assessed organoleptically, and a portable sulfide monitor was used to measure the concentration of VSC. Clinical parameters, plaque index (PI) and gingival index (GI), were obtained from 6 teeth. Samples for BANA test were taken from the dorsal surface of the tongue, saliva, and the 6 reference teeth. RESULTS: The scores of PI, GI, subgingival samples that tested positive for BANA hydrolyzing species, organoleptic ratings, and VSC values were significantly higher in the subjects with PD > 3.0 mm (P < 0.01, Mann-Whitney U test). There was a correlation between BANA hydrolysis by subgingival plaque bacteria and VSC values (r = 0.55, P < 0.01), and between GI and VSC values (r = 0.48, P < 0.05) in patients with PD > 3.0 mm. There was no significant correlation between these parameters in the control group. CONCLUSION: These results confirm that the BANA hydrolyzing bacteria in the subgingival plaque are an important source of malodor production in the oral cavity.

Use of aspartate aminotransferase in diagnosing periodontal disease: a comparative study of clinical and microbiological parameters.

The objective of this study was to assess the association between the levels of enzyme aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) with the BANA hydrolysis microbiological test (Perioscan) and clinical periodontal diagnostic measurements, such as bleeding on probing, plaque index, gingival index, probing depth, and attachment level in patients with chronic periodontitis using an enzymatic test (PocketWatch). One hundred and forty-seven sites were evaluated in 22 patients with a probing depth of > or = 5 mm at selected sites. AST and BANA enzymatic tests were carried out, and clinical parameters recorded. Pearson's chi-square and Fisher's exact tests were used for statistical analysis. There was no statistical correlation between AST levels and any of the analyzed parameters. The lack of any association between the factors studied does not indicate, however, that the latter cannot be used in diagnosing the actual periodontal condition of patients and/or sites. However, more research should be carried out to evaluate the true relationship between AST and periodontal disease.

Interleukin-1ß and interleukin-6 expression and gene polymorphisms in subjects with peri-implant disease.

BACKGROUND: Polymorphisms found in the IL-1 family genes have been associated with susceptibility of periodontal disease. However, very little is known about the relationship between polymorphisms on inflammatory mediators' genes and peri-implant disease. PURPOSE: The aim of the present study was to evaluate interleukin-1ß (IL-1ß) and interleukin-6 (IL-6) concentration in the crevicular fluid, and the impact of gene polymorphisms on healthy and diseased implants in comparison with healthy teeth. MATERIALS AND METHODS: We examined 47 implants and teeth in 47 patients grouped as: 31 healthy implants, 16 implants with peri-implantitis, 31 healthy teeth from patients with healthy implants, and 16 healthy teeth from patients with peri-implantitis. Clinical parameters were recorded from all implants and teeth. Gingival crevicular fluid was collected to evaluate the concentration of IL-1ß and IL-6. Cells from buccal mucosa were collected and their genomic DNA extracted for identification of the following polymorphisms: IL1B+3954, IL1B-511, and IL6-174. RESULTS: Clinical evaluation demonstrated that implants with peri-implantitis had less favorable indexes for probing depth (PD), relative clinical attachment level (CAL), bleeding on probing, and suppuration when compared with healthy implants and, for PD and CAL when compared with healthy teeth. There was no significant difference in the concentration of IL-1ß and IL-6 detected between groups. There were no statistically significant differences between alleles and polymorphisms distribution on the studied population. CONCLUSIONS: There was no correlation between the concentration of IL-1ß and IL-6 in the crevicular sulcular fluid present in healthy or diseased osseointegrated implants in comparison with healthy teeth. The studied gene polymorphisms had no influence on peri-implant disease.

Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study.

BACKGROUND: Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated. OBJECTIVE: The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and Tannerella forsythia, and to evaluate the ability of periodontal treatment to reduce these pathogens. DESIGN: Patients with generalized chronic periodontitis were selected by recording clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Subgingival samples from 30 diseased nonadjacent sites (CAL≥5 mm, PD between 5 and 7 mm and positive BOP) and 30 healthy nonadjacent sites (PD≤3 mm and negative BOP) were collected and subjected to microbial analysis by quantitative polymerase chain reaction (qPCR) The variables of age, PD, CAL and BOP of all individuals were analyzed using the paired t-test (GrapPad Prism5(®)). Data of bacteria quantification were subjected to a normality test (D'Agostino-Pearson Test). For bacterial correlation analysis, the Spearman correlation was used. RESULTS: Our results showed that diseased sites had significantly higher levels of P. endodontalis compared to healthy sites, similar to the results obtained for P. gingivalis and T. forsythia. The numbers of all bacterial species were reduced significantly after mechanical periodontal treatment. P. endodontalis was significantly correlated with the presence of T. forsythia and P. gingivalis in the diseased group. CONCLUSION: Our results suggest that there is a high prevalence of P. endodontalis, P. gingivalis and T. forsythia in periodontitis sites and that mechanical periodontal treatment is effective at reducing the pathogens studied.

Different Molecular Weight Chitosan-Based Membranes for Tissue Regeneration.

Natural polymers, such as chitosan, obtained from chitin, are been widely studied for use in the tissue regeneration field. This study established a protocol to attain membranes made from this biopolymer, consisting of high or low molecular weight chitosan. The biocompatibility of these membranes was histologically evaluated, comparing them to collagen membrane surgically implanted in rat subcutaneous tissue. Fifteen Holtzmann rats were divided in three experimental groups: High and Low Molecular Weight Chitosan membranes (HMWC and LMWC) and Collagen membranes (C-control group); each of them with three experimental periods: 7, 15 and 30 days. As a result, after the seven days evaluation, the membranes were present and associated with a variable degree of inflammation, and after the 15 and 30 days evaluations, the membranes were absent in all groups. It is concluded that the chitosan-based membranes were successfully attained and presented comparable resorption times to collagen membranes.

The effect of smoking on gingival crevicular fluid volume during the treatment of gingivitis / Efeito do tabagismo sobre o volume de fluido crevicular gingival durante o tratamento da gengivite

Smoking is detrimental to periodontal tissues, and periodontal destruction is greater among smokers. Paradoxically, smokers seem to have less gingival bleeding than never-smokers with comparable supragingival plaque. There is scarce information about the impactof smoking on gingival crevicular fluid (GCF) volume. This singlearm study clinical trial assessed the effect of smoking on GCF volume during the treatment of gingivitis. The sample included 24 never-smokers (47.3 ± 6.7 years old, 41.7% males) and 21 smokers (45.8 ± 5.1 years old; 55% males; 19.6 ± 11.8 cigarettes/day; 24.1 ± 8.7 years of smoking) with gingivitis and chronic periodontitis. After baselinesupragingival scaling, patients received oral hygiene instructions weekly for 180 days. Participants were examined at baseline, 30, 90 and 180 days, and gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PPD) and GCF volume wererecorded. Statistical analysis was performed using linear models (Wald test, p<0.05%). Smokers had significantly smaller GCF volumes than never-smokers. This finding was not attributed to GBI, BOP or PPD. Higher volumes of GCF were significantly associated with deeper pockets. GCF was significantly reduced throughout thestudy for both smokers and never-smokers, and the largest reductionswere seen at 30 days. Smoking affected the GCF crevicular fluid volumeindependently of the presence of gingival bleeding, BOP and PPD. Smoking status and PPD should be taken into account when GCG volume and components are under investigation.

O tabagismo é capaz de alterar a resposta periodontal determinando maior expressão de destruição periodontal em pacientes fumantes. Paradoxalmente, estes pacientes apresentam menos sangramento gengival frente a uma quantidade semelhante de biofilme dental, quando comparados a pacientes que nuncafumaram. Por outro lado, existe pouca informação sobre o impacto do tabagismo sobre o volume de fluido crevicular gengival (FCG). O presente ensaio clínico de braço único teve comoobjetivo avaliar o efeito do tabagismo sobre o volume de FCG durante o tratamento da gengivite. A amostra foi composta por 24 pacientes que nunca fumaram (47.3 ± 6.7 anos, 41.7% homens) e 21 fumantes (45.8 ± 5.1 anos; 55% homens; 19.6 ± 11.8cigarros por dia; 24.1 ± 8.7 anos de exposição ao tabaco), com diagnóstico de gengivite e periodontite crônica. Os exames periodontais: Índice de Placa Visível (IPV), Índice de SangramentoGengival (ISG), Sangramento à Sondagem (SS) e Profundidade de Sondagem (PS) e a coleta de FCG foram realizados nos dias 0, 30, 90 e 180. Após a raspagem supragengival realizada no dia zero (dia 0), os pacientes receberam instrução de higienebucal semanalmente, até o dia 180. A análise estatística utilizou modelos lineares (Teste de Wald, p<0.05%). Os fumantes apresentaram um volume significativamente menor de FCG. Esteresultado não esteve associado ao ISG, SS ou PS. Sítios com maiores valores de PS apresentaram maior volume de FCG.Durante o tratamento, uma redução significante do volume de FCG foi observada em fumantes e pacientes que nunca fumaram. Conclui-se que o tabagismo influenciou o volume de FCG independente da presença de sinais inflamatórios clínicos e que o hábito de tabagismo e a PS devem ser observados quando o volume de FCG e seus componentes estiverem sob investigação.

The effect of smoking on gingival crevicular fluid volume during the treatment of gingivitis / Efeito do tabagismo sobre o volume de fluido crevicular gingival durante o tratamento da gengivite

Smoking is detrimental to periodontal tissues, and periodontal destruction is greater among smokers. Paradoxically, smokers seem to have less gingival bleeding than never-smokers with comparable supragingival plaque. There is scarce information about the impactof smoking on gingival crevicular fluid (GCF) volume. This singlearm study clinical trial assessed the effect of smoking on GCF volume during the treatment of gingivitis. The sample included 24 never-smokers (47.3 ± 6.7 years old, 41.7% males) and 21 smokers (45.8 ± 5.1 years old; 55% males; 19.6 ± 11.8 cigarettes/day; 24.1 ± 8.7 years of smoking) with gingivitis and chronic periodontitis. After baselinesupragingival scaling, patients received oral hygiene instructions weekly for 180 days. Participants were examined at baseline, 30, 90 and 180 days, and gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PPD) and GCF volume wererecorded. Statistical analysis was performed using linear models (Wald test, p<0.05%). Smokers had significantly smaller GCF volumes than never-smokers. This finding was not attributed to GBI, BOP or PPD. Higher volumes of GCF were significantly associated with deeper pockets. GCF was significantly reduced throughout thestudy for both smokers and never-smokers, and the largest reductionswere seen at 30 days. Smoking affected the GCF crevicular fluid volumeindependently of the presence of gingival bleeding, BOP and PPD. Smoking status and PPD should be taken into account when GCG volume and components are under investigation.(AU)

O tabagismo é capaz de alterar a resposta periodontal determinando maior expressÒo de destruiþÒo periodontal em pacientes fumantes. Paradoxalmente, estes pacientes apresentam menos sangramento gengival frente a uma quantidade semelhante de biofilme dental, quando comparados a pacientes que nuncafumaram. Por outro lado, existe pouca informaþÒo sobre o impacto do tabagismo sobre o volume de fluido crevicular gengival (FCG). O presente ensaio clínico de braþo único teve comoobjetivo avaliar o efeito do tabagismo sobre o volume de FCG durante o tratamento da gengivite. A amostra foi composta por 24 pacientes que nunca fumaram (47.3 ± 6.7 anos, 41.7% homens) e 21 fumantes (45.8 ± 5.1 anos; 55% homens; 19.6 ± 11.8cigarros por dia; 24.1 ± 8.7 anos de exposiþÒo ao tabaco), com diagnóstico de gengivite e periodontite cr¶nica. Os exames periodontais: Indice de Placa Visível (IPV), Indice de SangramentoGengival (ISG), Sangramento O Sondagem (SS) e Profundidade de Sondagem (PS) e a coleta de FCG foram realizados nos dias 0, 30, 90 e 180. Após a raspagem supragengival realizada no dia zero (dia 0), os pacientes receberam instruþÒo de higienebucal semanalmente, até o dia 180. A análise estatística utilizou modelos lineares (Teste de Wald, p<0.05%). Os fumantes apresentaram um volume significativamente menor de FCG. Esteresultado nÒo esteve associado ao ISG, SS ou PS. Sítios com maiores valores de PS apresentaram maior volume de FCG.Durante o tratamento, uma reduþÒo significante do volume de FCG foi observada em fumantes e pacientes que nunca fumaram. Conclui-se que o tabagismo influenciou o volume de FCG independente da presenþa de sinais inflamatórios clínicos e que o hábito de tabagismo e a PS devem ser observados quando o volume de FCG e seus componentes estiverem sob investigaþÒo.(AU)

The Relationship of Oral Malodor in Patients With or Without Periodontal Disease / O relacionamento do malodor oral em pacientes com ou sem doenças periodontais

Background: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSC) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal area and the dorsum of the tongue. The aim of this study was to determine whether there is some relationship between the presence of N-benzoyl-DL-arginine-2-napthylamide (BANA)-positive species Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus and clinical and oral malodor parameters. Methods: Twenty-one subjects (21 to 59 years old) with probing depths (PD) >3.0 mm and 20 subjects (21 to 63 years old) with PD =3.0 mm (controls) participated. The quality of the mouth air was assessed organoleptically, and a portable sulfide monitor was used to measure the concentration of VSC. Clinical parameters, plaque index (PI) and gingival index (GI), were obtained from 6 teeth. Samples for BANA test were taken from the dorsal surface of the tongue, saliva, and the 6 reference teeth. Results: The scores of PI, GI, subgingival samples that tested positive for BANA hydrolyzing species, organoleptic ratings, and VSC values were significantly higher in the subjects with PD >3.0 mm (P <0.01, Mann-Whitney U test). There was a correlation between BANA hydrolysis by subgingival plaque bacteria and VSC values (r = 0.55, P <0.01), and between GI and VSC values (r = 0.48, P <0.05) in patients with PD >3.0 mm. There was no significant correlation between these parameters in the control group. Conclusion: These results confirm that the BANA hydrolyzing bacteria in the subgingival plaque are an important source of malodor production in the oral cavity