Role of IL-6 and STAT3 signaling in dihydropyridine-induced gingival overgrowth fibroblasts.

OBJECTIVES: This study analyzed the role of the interleukin (IL)-6/signal transducer and activator of transcription 3 (STAT3) pathway in dihydropyridine-induced gingival overgrowth (DIGO) fibroblasts. MATERIALS AND METHODS: Tissue samples were obtained through surgical dissection from five DIGO patients and five healthy individuals. Cell cultures were conditioned with nifedipine (Nif) (0.34 µM) and stimulated with IL-1ß (10 ng/ml) to clarify whether IL-6 upregulates extracellular matrix overproduction or has an impact on the cell proliferation rate of DIGO fibroblasts. STAT3 was knocked down using short hairpin (sh)RNA to determine its role in collagen (Col) type I alpha 1 (Colα1(I)) synthesis. RESULTS: Results showed that phosphorylated (p)STAT3 nuclear translocation was activated by a simulated autocrine concentration (50 ng/ml) of IL-6, and application of an anti-IL-6 antibody significantly decreased the pSTAT3/STAT3 ratio in DIGO fibroblasts. STAT3 knockdown significantly decreased STAT3 and Colα1(I) expressions in DIGO cells. DIGO tissues presented stronger proliferating cell nuclear antigen (PCNA) expression than did healthy individuals under the effect of IL-1ß/Nif treatment. CONCLUSIONS: Gingival inflammation (e.g., IL-1ß) and taking dihydropyridine (e.g., Nif) may additively stimulate Col overproduction through the IL-6-STAT3-Colα1(I) cascade in DIGO cells. IL-6-STAT3 signaling may be considered a target for the control of DIGO.

Recommendations for treating stage I-III periodontitis in the Taiwanese population: A consensus report from the Taiwan Academy of Periodontology.

BACKGROUND/PURPOSE: Based on the fundamental of the S3-level clinical practice guideline (CPG) for treating stage I-III periodontitis developed by the European Federation of Periodontology (EFP), this consensus report aimed to develop treatment recommendations for treating periodontitis in the Taiwanese population. METHODS: The report was constructed by experts from the Taiwan Academy of Periodontology. The following topics were reviewed: (a) the prevalence of periodontitis in Asia and current status of treatment in Taiwan; (b) specific anatomical considerations for treating periodontitis in Asians; (d) educational and preventive interventions and supragingival plaque control; (d) subgingival instrumentation and adjunctive treatment; (e) surgical periodontal therapy; and (f) maintenance and supportive periodontal care. Recommendations were made according to the evidences from the EFP CPG, the published literature and clinical studies in Asians, and the expert opinions. RESULTS: The treatment recommendations for the Taiwanese population were generally in parallel with the EFP CPG, and extra cautions during treatment and maintenance phases were advised due to the anatomical variations, such as shorter root trunk, higher prevalence of supernumerary distolingual root and lingual bony concavity in mandibular posteriors, and thinner anterior labial plate, of the Asian population. CONCLUSION: The EFP CPG could be adopted for treating periodontitis and maintaining periodontal health of the Taiwanese population, and anatomical variations should be cautious when the treatment is delivered.

Outcomes of autotransplanted teeth with complete root formation: a systematic review and meta-analysis.

AIM: In this review, we assessed clinical outcomes of autotransplanted teeth with complete root formation and the effects of various influencing factors. MATERIALS AND METHODS: Pubmed, Scopus, Google scholar and a hand search were used to identify prospective and retrospective cohort studies and case series till February 2013. Using multilevel Poisson regression, the annual failure rate (FR), 1-year and 5-year survival rates (SRs), infection-related root resorption rate (RR), ankylosis rate (AR), the influences of systemic antibiotics (SAs), endodontic and splinting modalities and donor tooth morphology were analysed. Failure was defined as a transplant being lost during follow-up. RESULTS: Twenty-six studies were included. The estimated FR, RR, AR, 1- and 5-year SRs were 2.0%, 2.1%, 1.2%, 98.0% and 90.5%, respectively. The estimated FR was higher in the absence of SA, suture splinting, wire splinting ≤14 days and posterior donors. The estimated RR was higher in the absence of SA, endodontic treatment within post-operative 14 days and anterior/premolar donors. The estimated AR was higher with wire splinting and premolar donors. CONCLUSIONS: Tooth autotransplantation with complete root formation is a favourable treatment with rare FR, RR and AR. However, SAs, endodontic and splinting modalities and tooth morphology seemed to influence the outcomes.

Systematic review of treatment modalities for gingival depigmentation: a random-effects poisson regression analysis.

OBJECTIVE: Repigmentation variably occurs with different treatment methods in patients with gingival pigmentation. A systemic review was conducted of various treatment modalities for eliminating melanin pigmentation of the gingiva, comprising bur abrasion, scalpel surgery, cryosurgery, electrosurgery, gingival grafts, and laser techniques, to compare the recurrence rates (Rrs) of these treatment procedures. MATERIAL AND METHODS: Electronic databases, including PubMed, Web of Science, Google, and Medline were comprehensively searched, and manual searches were conducted for studies published from January 1951 to June 2013. After applying inclusion and exclusion criteria, the final list of articles was reviewed in depth to achieve the objectives of this review. A Poisson regression was used to analyze the outcome of depigmentation using the various treatment methods. RESULTS: The systematic review was based on case reports mainly. In total, 61 eligible publications met the defined criteria. The various therapeutic procedures showed variable clinical results with a wide range of Rrs. A random-effects Poisson regression showed that cryosurgery (Rr = 0.32%), electrosurgery (Rr = 0.74%), and laser depigmentation (Rr = 1.16%) yielded superior result, whereas bur abrasion yielded the highest Rr (8.89%). CONCLUSIONS: Within the limit of the sampling level, the present evidence-based results show that cryosurgery exhibits the optimal predictability for depigmentation of the gingiva among all procedures examined, followed by electrosurgery and laser techniques. CLINICAL SIGNIFICANCE: It is possible to treat melanin pigmentation of the gingiva with various methods and prevent repigmentation. Among those treatment modalities, cryosurgery, electrosurgery, and laser surgery appear to be the best choices for treating gingival pigmentation.

Plumbagin Induces Reactive Oxygen Species and Endoplasmic Reticulum Stress-related Cell Apoptosis in Human Oral Squamous Cell Carcinoma.

BACKGROUND/AIM: Oral squamous cell carcinoma (OSCC), a major malignancy in Taiwan, is an invasive epithelial neoplasm resulting in a low survival rate. Current treatments do not prevent OSCC progression, and antitumor therapies should be improved. Plumbagin, a natural compound extracted from Plumbago zeylanica L., appears to have antitumor effects in various tumors. The antitumor mechanism of plumbagin in OSCC is still unclear. This study investigated the molecular mechanism through which plumbagin induces apoptosis. MATERIALS AND METHODS: To investigate the antiproliferative and pro-apoptotic effects of Plumbagin on OSCC cells and explore its underlying mechanism, cell counting kit-8, cell cycle analysis, and annexin V/PI assay were conducted. The functions of plumbagin on endoplasmic reticulum (ER) stress, reactive oxygen species (ROS) production, and mitochondrial membrane potential (MMP) deficiency were analyzed using flow cytometric analysis. Plumbagin-induced apoptosis-associated proteins were detected using western blotting. RESULTS: Plumbagin induced apoptosis in OSCC cells by suppressing tumor cell proliferation through ROS production, ER stress, mitochondrial dysfunction, and caspases activation. CONCLUSION: Plumbagin is a promising antitumor candidate targeting human OSCC.

Expression of epithelial-mesenchymal transition-associated proteins and proliferating cell nuclear antigen in dihydropyridine-induced gingival overgrowth fibroblasts: A preliminary study.

Background/purpose: The clinical features of dihydropyridine-induced gingival overgrowth (DIGO), including extracellular matrix accumulation and cell hyperplasia, are regulated by inflammatory factors (e.g., Interleukin-1ß [IL-1ß]) in combination with calcium channel blockers (e.g., nifedipine [Nif]). We speculated that IL-1ß and Nif (IL-1ß/Nif) may be the main factor modulating the proliferative potential and turnover of fibroblasts in DIGO. Materials and methods: We cultured four DIGO fibroblast strains and analysed the possible effects of IL-1ß/Nif treatments on epithelial-mesenchymal transition (EMT)-associated proteins. We developed short hairpin ribonucleic acids (shRNAs) and used them to explore the role of IL-1ß/Nif in regulating proliferating cell nuclear antigen (PCNA) levels in DIGO tissues. Results: Our results revealed that compared with control cells, DIGO cells stimulated with IL-1ß/Nif had higher levels of the EMT-associated proteins Snail, Slug, and Twist. Moreover, both drugs enhanced androgen receptor (AR), Slug, and PCNA expression. Conclusion: Taken together, our data indicate that proinflammatory cytokines in combination with calcium channel blockers can regulate the expression of EMT-associated proteins and increase the proliferative potential of DIGO fibroblasts.

Expression of advanced glycation end products and receptors in gingival tissues of patients with noninsulin-dependent diabetes mellitus-associated periodontitis.

Background/purpose: Advanced glycation end products (AGEs) are known to accumulate in the periodontal tissues of patients with diabetes mellitus (DM). Through this study, we aimed to investigate the distribution of AGEs and the receptor of AGEs (RAGE) in the gingival tissues of patients with chronic periodontitis with and without non-insulin-dependent diabetes mellitus (NIDDM). Materials and methods: Gingival biopsy samples from 13 patients with both NIDDM and periodontitis and 6 patients with both non-DM (NDM) and periodontitis were collected. The tissue sections were processed using immunohistochemical (IHC) staining to detect the distributions of AGEs and RAGE. Spearman correlation coefficients of all samples were calculated (P < 0.05) for the AGE and RAGE rankings of the following clinical parameters: plaque score (PI), probing depth (PD), bleeding on probing (BOP), and tooth loss (TL). Results: IHC analysis revealed that AGEs among patients with NIDDM had a significantly higher ranking than those of the NDM group (P < 0.05). Positive staining for RAGE was observed in both groups but was not significantly different (P > 0.05). A positive correlation between AGE ranking and TL was observed in the NIDDM group, but not between AGE ranking and PI, PD, or BOP. The distribution of RAGE was not correlated with PI, PD, BOP, or TL. Conclusion: AGEs were particularly distributed in the highly inflamed gingiva of patients with NIDDM-associated periodontitis and was statistically correlated with the long-term parameter TL.

A Bayesian network meta-analysis on comparisons of enamel matrix derivatives, guided tissue regeneration and their combination therapies.

AIMS: Guided tissue regeneration (GTR) and enamel matrix derivatives (EMD) are two popular regenerative treatments for periodontal infrabony lesions. Both have been used in conjunction with other regenerative materials. We conducted a Bayesian network meta-analysis of randomized controlled trials on treatment effects of GTR, EMD and their combination therapies. MATERIAL AND METHODS: A systematic literature search was conducted using the Medline, EMBASE, LILACS and CENTRAL databases up to and including June 2011. Treatment outcomes were changes in probing pocket depth (PPD), clinical attachment level (CAL) and infrabony defect depth. Different types of bone grafts were treated as one group and so were barrier membranes. RESULTS: A total of 53 studies were included in this review, and we found small differences between regenerative therapies which were non-significant statistically and clinically. GTR and GTR-related combination therapies achieved greater PPD reduction than EMD and EMD-related combination therapies. Combination therapies achieved slightly greater CAL gain than the use of EMD or GTR alone. GTR with BG achieved greatest defect fill. CONCLUSION: Combination therapies performed better than single therapies, but the additional benefits were small. Bayesian network meta-analysis is a promising technique to compare multiple treatments. Further analysis of methodological characteristics will be required prior to clinical recommendations.

Non-surgical periodontal therapy with and without subgingival minocycline administration in patients with poorly controlled type II diabetes: a randomized controlled clinical trial.

The aim of this study was to evaluate changes in clinical parameters and levels of inflammatory biomarkers in plasma in periodontal patients with poorly controlled type 2 diabetes mellitus (T2DM) after non-surgical periodontal therapy. Twenty-eight poorly controlled T2DM patients were randomly assigned to treatment with scaling and root planning (SRP) and SRP + subgingival minocycline administration. Clinical parameters, including the probing depth (PD), bleeding on probing (BOP), plaque score (PS), clinical attachment level (CAL), and plasma interleukin (IL)-6, soluble receptor of advanced glycation end products (sRAGE), chronic reactive protein (CRP), and hemoglobin A1c (HbA1c) were measured before and after a 6-month treatment period. Significant changes in PD, BOP, PS, and CAL were found in both groups. The latent growth curve model showed an overall reduction in the log HbA1c level in the SRP group (-0.082, p = 0.033). Small changes in the log sRAGE level and log CRP level in plasma were found in both groups. IL-6 in the plasma increased in the SRP group, but slightly decreased in the SRP+minocycline group (0.469 pg/ml, p = 0.172). Non-surgical periodontal therapy with or without subgingival minocycline application may achieve significant periodontal improvement and moderate improvement in HbA1c, but had no significant effect on plasma levels of IL-6, CRP, or sRAGE in patients with poorly controlled T2DM. For patients with both periodontal diseases and diabetes, non-surgical periodontal treatments may be helpful in their diabetic control.

Effects of Periodontal Treatment in Patients with Periodontitis and Kidney Failure: A Pilot Study.

Periodontitis and chronic kidney disease are both chronic inflammatory diseases and share some common risk factors. This 3-month pilot study aimed to clarify whether non-surgical periodontal therapy is beneficial in clinical, biochemical, and microbiological conditions in patients with periodontitis and kidney failure. Kidney failure patients with moderate to severe periodontitis were recruited from two hospitals. Treatment group received non-surgical periodontal therapy, and control group received oral hygiene instruction only. Outcome assessments were conducted 1 and 3 months after treatment. Non-parametric tests were used to analyze the patient-level data. Periodontal site-level assessments were analyzed by Student t-test and paired t-test. Statistical significance was set at p-value < 0.05. A total of 11 subjects completed the study. There was no significant difference between groups in all-cause mortality, cardiovascular events, infection events, systemic parameters, and serum biomarkers. Comparing to control group, clinical periodontal parameters, gingival crevicular fluid interleukin-1ß (IL-1ß) level and periodontal pathogens showed significant improvement in the treatment group. Non-surgical periodontal treatment did not change systemic outcomes in kidney failure patients, but changed the local micro-environment.

Evidence-based clinical decision making for the management of patients with periodontal osseous defect after impacted third molar extraction: A systematic review and meta-analysis.

BACKGROUND/PURPOSE: Extraction of impacted mandibular third molar (MTM) is one of the most common procedures in clinical dental treatment; building a decision tree to perform MTM extraction can be prudent in alleviating periodontal diseases. This study is to review the latest research on the management of periodontal osseous defect (POD) after MTM extraction and rebuild a new clinical decision tree. MATERIALS AND METHODS: Current study was conducted according to PRISMA statement. Medline, Embase, Scopus, and Google Scholar were searched concerning treatment of MTM extraction up to Oct.2019. Three focused questions revolving around asymptomatic versus disease site, age, and necessity of ridge preservation after >6 months follow up will be answered. RESULTS: A total of 7 studies were included for meta-analysis. Evidences were inadequate in regards to asymptomatic vs disease site of MTM extraction in the long-term follow-up. For patients with age <25 years, postoperative probing depth (PD) always remained at < 4 mm. However, for patients with age >25 years with initial PD > 7 mm, residual pockets still remained at 5 mm. For ridge preservation, significant positive effect in reduction of second molar distal site PD was observed, regardless of different biomaterials being placed (z = 4.69, p < 0.00001). CONCLUSION: Age is of utmost importance in preoperative evaluation during impacted MTM extraction. The timing for ridge preservation is essential determinant for achieving optimal treatment outcome. The clinical decision tree as proposed could serve as guidance when dealing with POD after impacted MTM extraction.

Meta-regression analysis of the initial bone height for predicting implant survival rates of two sinus elevation procedures.

AIM: To undertake a systematic review for the association between the initial alveolar bone height and the success of dental implants with sinus elevation procedures. MATERIALS AND METHODS: An online search was performed using the following electronic databases: PubMed, Medline, Science Direct, and Blackwell synergy. Two investigators independently assessed publications for inclusion and extracted data. Meta-regression analyses were used to test the associations between the initial alveolar bone height and implant survival with lateral window or osteotome sinus elevation procedures. RESULTS: Of 635 studies, 21 were included for analysis. A quadratic curve-fitting meta-regression showed an increasing trend of implant survival rate with greater initial bone height for the lateral window technique (p<0.0001, adjusted R(2)=0.97). The result of the meta-regression for hazard rates showed a decreasing trend (p=0.0041, adjusted R(2)=0.89). No association was found for the osteotome technique. CONCLUSIONS: For the lateral window technique, meta-regression analysis suggested a positive association between the initial alveolar bone height and implant survival rates. No relationship was found between the initial alveolar bone height and implant survival rate for the osteotome technique due to a lack of data below 4 mm of initial bone height.

Quantitative analysis of Miller mobility index for the diagnosis of moderate to severe periodontitis - A cross-sectional study.

BACKGROUND/PURPOSE: We assessed the mobility of single-root teeth by using Miller's mobility index (MMI) and to analyze the validity of MMI for the diagnosis of periodontitis. MATERIALS AND METHODS: A total of 30 patients were included and the Spearman correlation coefficient was used to assess the correlation between MMI, clinical attachment level (CAL), and probing depth (PD). The validity of MMI for the diagnosis of the severity of periodontitis was evaluated using the receiver operating characteristic (ROC) curve, area under curve (AUC) value, positive predictive value (PPV). RESULTS: Strong correlations were observed between MMI and CAL (r = 0.92) and between MMI and PD (r = 0.76). When the CAL = 3-4 mm and CAL ≥5 mm groups were pooled together, the AUC value was 0.81. The AUC was 0.86 for diagnosis with MMI in the CAL ≥5 mm group. A PPV of 100% was achieved for all grades when MMI >1. When the teeth with PD ≥ 5 to <7 mm and PD ≥ 7 mm groups were pooled together, the AUC value for MMI was 0.80. The PPV was 98.8%, 99%, and 100% for MMI Grade 1, Grade 2, and Grade 3, respectively. When PD ≥ 7 mm was defined as severe periodontitis, the AUC value for MMI was 0.72. CONCLUSION: MMI may provide valuable information for the diagnosis of moderate and severe periodontitis when CAL is not obtainable during routine practice.

A comprehensive periodontal treatment project: The periodontal status, compliance rates, and risk factors.

BACKGROUND/PURPOSE: The comprehensive periodontal treatment project (CPTP) is being implemented in Taiwan since 2010. This retrospective study compared the periodontal status, compliance rates, and influence of risk factors for periodontal recurrence and tooth loss among groups of patients who accepted CPTP and conventional periodontal treatment (CPT). MATERIALS AND METHODS: A total of 161 patients who received periodontal therapy were investigated and divided into compliant (n = 94) and noncompliant (n = 67) groups. Patients in the compliant group were further assigned to two subgroups: CPT with a postcard recall (PR) system (CPT + PR, n = 48) and CPTP with a PR system (CPTP + PR, n = 46). Demographic characteristics and periodontal parameters, including the probing pocket depth (PPD), bleeding on probing (BOP), and plaque control record (PCR), were collected for comparison between the subgroups. The risk factors for periodontal recurrence and tooth loss were statistically analyzed. RESULTS: The 161 patients were followed-up for a mean of 3.8 years. The patients in the CPTP + PR subgroup exhibited shallower PPD, less BOP, improved PCR, and fewer tooth loss. Age, smoking, PPD ≥7 mm, and PCR ≥30% were associated with periodontal recurrence, whereas age, diabetes, BOP ≥30%, and duration of the follow-up period were correlated with tooth loss. PR apparently increased the compliance rate of patients (27.3% vs. 77.7%). CONCLUSION: CPTP with PR led to an optimal and stable periodontal status in patients. Compliant patients maintained a significantly improved periodontal status as compared with noncompliant patients.

Effect of glutaraldehyde on the humoral immunogenicity and structure of porcine dermal collagen membranes.

OBJECTIVES: Our previous studies showed that the biodegradation rate of cross-linked porcine dermal collagen membrane (PDCM) could be retarded without changing its biocompatible character. The purpose of this study was to assay the humoral immune response of PDCM reconstitute with glutaraldehyde (GA) and observe their surface architectures. METHODS: PDCM reconstituted with GA (0, 0.01, 0.05, and 3%) was implanted in 30 Sprague-Dawley rats. Sample sera were collected 3, 6, and 9 weeks after surgery and assayed with ELISA. The architectures of PDCMs were observed under SEM (100x). RESULTS: The study showed that non cross-linked PDCM induced the highest immune response than any other cross-linked PDCMs (by optical density (OD) values, P<0.05). It also possessed the most active cross-reactivity to the serum of rats from any other PDCMs groups (by Sheffe test, P<0.05). The surface architectures observed under SEM presented four structures: fibrillar, porous, channeled, and sheet-like structures as PDCM was conditioned with 0, 0.01, 0.05, and 3% GA, respectively. CONCLUSIONS: Resulting from the study are that changing the concentration of GA can modulate the surface characters of PDCMs and change their immunogenicity. Reconstitution of PDCM may not change the conformation of antigenic determinants of PDCM but rather hinder the epitopes by changing the surface stereo structure of this collagen.

Comparison of Th1/Th2 cytokine profiles of initial wound healing of rats induced by PDCM and e-PTFE.

Because periodontal regeneration is vital in the modern treatment of periodontal defects, artificial membranes have become a key component for predictable outcomes. Herein a new ranking system to analyze the expression of different cytokines around regenerative membranes is introduced. Porcine dermal collagen membranes (PDCMs) and GORE-TEX (e-PTFE) membranes were used for implantation in a Sprague Dawley rat model. Tissue samples were harvested at three time intervals (7, 10, and 14 days); then an immunohistochemical ranking process was conducted to determine the intensity of the selected Th1/Th2 cytokines [Th1: interleukin-2 (IL-2) and interferone-gamma (IFN-gamma); Th2: IL-4, IL-10, and IL-13]. The results show that the intensities of IL-2 cytokine in PDCM groups were slightly higher than those of e-PTFE groups but without statistical significance. The level of interferon-gamma in PDCM groups was lower than that of e-PTFE groups, but also without significant differences. However, expressions of Th2 cytokines (IL-4, IL-10, and IL-13) induced by e-PTFE were generally higher than those of PDCM and control groups at all times (Mann-Whitney U test, p < 0.05). In a comparison of the mean ratio of IL-2/IL-4 with the use of the Mann-Whitney U test, data for the PDCM group were generally higher than those of the e-PTFE group, with statistical significance at all time intervals (p < 0.05). A descending order of the intensity ratio of IL-2/IL-4 was PDCM groups > control groups > e-PTFE groups. These findings indicate that the cytokine profiles of PDCM, in connection with the GTR technique, demonstrate a higher trend toward Th1-dominated responses and may protect against periodontal tissue destruction, as compared to the Th2-dominated responses of e-PTFE.

Cross-sectional analysis of different variables of patients with non-insulin dependent diabetes and their periodontal status.

The periodontal condition of 72 non-insulin dependent diabetes patients was compared with that of 92 nondiabetic individuals. Plaque Index (PII), Calculus Index (CI), Gingival Index (GI), and attachment loss (AL) were measured on four surfaces of six teeth in each subject. All four parameters were significantly higher in the diabetic group. No significant difference in the frequency of toothbrushing was found between the groups. For all age groups, GI and AL were higher in the diabetic group. In each group, GI was not changed with age, while AL increased with age. Classification of the groups based on PII showed that the diabetic group's GI was higher than the nondiabetic group for low, medium, or high PII values. The diabetic group showed higher AL for only the medium and high PII groups. Classification by CI revealed that the diabetic group's GI and AL were significantly higher than those of the nondiabetic group for subjects with low, medium, or high values of CI. Multiple regression analysis revealed that the main factor affecting GI was the presence or absence of diabetes. PII and CI both showed a significant relationship with GI; age was the second most significant factor. The most significant factors influencing AL were CI and the presence or absence of diabetes; age was the second most significant factor. Patients who had had diabetes for more than 10 years had a higher AL than those who had suffered from diabetes for less than 10 years. Patients with average HbA1c values > or = 10% had more serious mean GI values than those with HbA1c values < 10%. In patients with diabetes, age, plaque accumulation, and calculus formation have more detrimental effects on the periodontal apparatus than in healthy individuals.

Efficacy of subgingivally applied minocycline in the treatment of chronic periodontitis.

BACKGROUND: The use of adjunctive minocycline with mechanical debridement in treating periodontitis has been widely studied using different methods. However, the results from these studies are equivocal. OBJECTIVE: The purpose of this study was to clarify the efficacy of the adjunctive use of subgingival minocycline application plus scaling/root planing as compared with the results of one episode of scaling/root planing in the treatment of chronic periodontitis. METHODS: Fifteen patients were enrolled in this split-mouth clinical trial. Probing depth, clinical attachment loss, gingival index, and bleeding on probing were evaluated at the baseline before scaling/root planing and 6, 10, 14, and 18 weeks later according to a single-blind protocol. The amount of interleukin-1beta (interleukin-1beta pg/site) at each lesion was also simultaneously measured in gingival crevicular fluid in a parallel comparison design. After full-mouth baseline measurements and scaling/root planing, 78 lesions with a residual mean probing depth of 5 mm at anterior teeth were selected and equally distributed in either right or left sites based on a split-mouth symmetrical design and randomly assigned to one of two treatment groups (with or without minocycline administration, n = 39 for each group). RESULTS: Probing depth significantly decreased from the baseline (week 0) to week 6 after scaling/root planing (p < 0.05) in both groups, but there was no statistically significant difference between the two groups (p > 0.05). However, at weeks 10, 14, and 18, the experimental group showed significantly greater improvement in pocket reduction than the control group (p < 0.05). Similarly, both groups also showed significant decreases in gingival index scores from weeks 0-6 (p < 0.05), but gingival index reductions at weeks 10, 14, and 18 were statistically significant in favor of the experimental group (p < 0.05). The experimental group had more attachment gain than the control group at weeks 14 and 18 (p < 0.05). Values of interleukin-1beta (pg/site) at the experimental sites were significantly reduced at weeks 10, 14, and 18, as compared to values at control sites (p < 0.01). Finally, the incidence of bleeding on probing showed no differences between the two groups for any time interval (p > 0.05). CONCLUSIONS: In this 18-week clinical trial, the results suggested that scaling/root planing with adjunctive subgingival administration of minocycline ointment has a significantly better and prolonged effect compared to scaling/root planing alone on the reduction of probing depth, clinical attachment loss, gingival index, and interleukin-1beta content, but not on bleeding on probing.

Measurement of gp130 cytokines oncostatin M and IL-6 in gingival crevicular fluid of patients with chronic periodontitis.

Several proinflammatory cytokines can induce periodontal tissue destruction and are thought to be useful indicators or diagnostic markers for periodontitis. Here, we aimed to investigate whether oncostatin M (OSM) was present in gingival crevicular fluid (GCF) and to clarify the correlation of GCF OSM and interleukin-6 (IL-6) levels with the severity of periodontitis. Sixty-two sites in 14 patients were divided into 4 groups based on probing depth (PD) and bleeding on probing (BOP). GCF was collected using paper strips from clinically health sites (PD < or = 3 mm, CAL: 1-3 mm, without BOP, n = 31), mildly diseased sites (PD < or = 3 mm, CAL: 3-5 mm, with BOP, n = 11), moderately diseased sites (PD = 4-6 mm, CAL: 5-8 mm, with BOP, n = 11), and severely diseased sites (PD > 6 mm, CAL: 8-12 mm, with BOP, n = 9). IL-6 and OSM in GCF were quantified by enzyme-linked immunosorbent assay and are expressed as concentrations (pg/ml) and total amounts (pg/site). Correlations of OSM and IL-6 levels with the severity of periodontitis in all groups were determined using Spearman rank correlation (r(s)). Our results showed that OSM and IL-6 were detected in most GCF samples. The total amounts of OSM and IL-6 were significantly positive correlated with severity of diseased sites (OSM: r(s) = 0.526, p < 0.01; IL-6: r(s) = 0.729, p < 0.01). No correlations of OSM or IL-6 concentration in GCF were found with disease severity. OSM and IL-6 levels in GCF were positively correlated to each other when expressed as either concentrations or total amounts (concentrations: r = 0.485, p < 0.01; total amounts r = 0.490, p < 0.01). In conclusion, our findings suggest that IL-6 and OSM may play a role in modulating the inflammatory cascade of chronic periodontitis.