Evaluation of the effects of periodontal status according to 2017 classifications on oral health-related quality of life and quality of life-related to general health: A cross-sectional study.

BACKGROUND: In patients with periodontal disease, various symptoms are observed along with inflammation. The impact of local and systemic inflammation on periodontal tissue is well-known; however, the impact of periodontal disease on the individual's quality of life is unclear. This study aimed to assess oral health-related and general health-related quality of life in patients undergoing maintenance treatment following treatment for periodontitis (RP-CPH), patients with gingivitis (G) and patients with Stage I periodontitis (SI-P) and to compare this with individuals with clinical periodontal health (IP-CPH). METHOD: This study was comprised of cross-sectional periodontal assessment along with questionnaires. Oral health-related quality of life and general health-related quality of life were assessed using, respectively, the Oral Health Impact Profile-14 (OHIP-14) and Short-Form-36 (SF-36) questionnaires. Study participants were classified according to the classification of periodontal and peri-implant diseases and conditions established by the 2017 World Workshop. RESULTS: The OHIP-14 total scores for the 166 study participants (age range: 22-57) of the G (11.61 ± 3.21) and SI-P (13.03 ± 3.47) groups were significantly higher than the OHIP-14 total scores of the IP-CPH (1.09 ± 1.58) and RP-CPH (2.95 ± 2.58) groups. SF-36 scores were found to be significantly lower in the SI-P group in all subgroups compared to the G and IP-CPH groups. CONCLUSIONS: A correlation was found between early-stage periodontal disease and low levels of OHRQoL and GHRQoL. The health of periodontal tissues may have a positive effect on the quality of life.

Gingival crevicular fluid CSF-1 and IL-34 levels in patients with stage III grade C periodontitis and uncontrolled type 2 diabetes mellitus.

PURPOSE: Periodontal diseases are inflammatory conditions that alter the host's response to microbial pathogens. Type 2 diabetes mellitus (T2DM) is a complex disease that affects the incidence and severity of periodontal diseases. This study investigated the gingival crevicular fluid (GCF) levels of colony-stimulating factor-1 (CSF-1) and interleukin-34 (IL-34) in patients with stage III grade C periodontitis (SIII-GC-P) and stage III grade C periodontitis with uncontrolled type 2 diabetes (SIII-GC-PD). METHODS: In total, 72 individuals, including 24 periodontally healthy (PH), 24 SIII-GC-P, and 24 SIII-GC-PD patients, were recruited for this study. Periodontitis patients (stage III) had interdental attachment loss (AL) of 5 mm or more, probing depth (PD) of 6 mm or more, radiographic bone loss advancing to the middle or apical part of the root, and tooth loss (<5) due to periodontal disease. Radiographic bone loss in the teeth was also evaluated; grade C periodontitis was defined as a ratio of the percentage of root bone loss to age greater than 1.0. The plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), PD, and clinical AL were used for clinical periodontal assessments. GCF samples were obtained and analyzed using an enzyme-linked immunosorbent assay. RESULTS: All clinical parameters-PD, AL, GI, BOP, and PI-were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups for both the full mouth and each sampling site (P<0.05). The total IL-34 and CSF-1 levels were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups (P<0.05), and there were significant differences between the periodontitis groups (P<0.05). CONCLUSIONS: These findings suggest that IL-34 and CSF-1 expression increases in patients with SIII-GC-PD. CSF-1 was associated with the inflammatory status of periodontal tissues and T2DM, while IL-34 was associated only with T2DM. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04891627.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) in subjects with different stages of periodontitis according to the new classification.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a multifunctional cytokine that regulates inflammatory responses in various autoimmune and inflammatory disorders. OBJECTIVE: The purpose of this study was to analyze the gingival crevicular fluid (GCF) for GM-CSF, interleukin-1 beta (IL-1ß), and macrophage inflammatory protein-1 alpha (MIP-1α) levels in patients with stage I, stage II, stage III, and stage IV periodontitis (SI-P, SII-P, SIII-P, and SIV-P). METHODOLOGY: A total of 126 individuals were recruited for this study, including 21 periodontal healthy (PH), 21 gingivitis (G), 21 SI-P, 21 SII-P, 21 SIII-P, and 21 SIV-P patients. Plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), probing depth (PD), and attachment loss (AL) were used during the clinical periodontal assessment. GCF samples were obtained and analyzed by an enzyme-linked immunosorbent assay (ELISA). RESULTS: GCF GM-CSF, MIP-1α, and IL-1ß were significantly higher in SII-P and SIII-P groups than in PH, G, and SI-P groups (p<0.05). There was no significant difference among the PH, G, and SI-P groups in IL-1ß, GM-CSF, and MIP-1α levels (p>0.05). CONCLUSIONS: These results show that GM-CSF expression was increased in SII-P, SIII-P, and SIV-P. Furthermore, GM-CSF levels may have some potential to discriminate between early and advanced stages of periodontitis.

Effect of single-dose locally applied lactoferrin on autograft healing in peri-implant bone in rat models.

Immediate dental implant installation into fresh extraction sockets has become a common surgical technique and yields successful clinical results. In addition, complete contact may not be possible with this procedure cause of defects between the bone wall and the implant surface. Therefore, different graft materials have been used in the literature to increase the peri­implant bone volume. The aim of the present study was to evaluate the effect of single-dose and locally applied lactoferrin on autograft healing in peri­implant area and bone implant contact value. Twenty-four Sprague-Dawley rats were included in this study. Firstly, a trephine drill was used for creating a cylindrical bony defects (6.5 mm in diameter and 3 mm in depth) under sterile saline irrigation in the lateral side of the femur. Subsequently, implant beds -2.5 mm diameter and 6 mm depth - were prepared in the middle of each defect with special implant drills. All of the implants were installed and primary stability was achieved. Rats were randomly divided into 3 groups (n = 8 each): Group-1 had empty defects, Group-2 had defects filled with autograft, and Group-3 had defects filled with autograft and lactoferrin solution (100 µg/ml) combination. All of the rats were sacrificed at postoperative 4th week and samples were analyzed with micro-computed tomography, histomorphometry and immunohistochemistry respectively. It was found that Group 3 had the least area of fibrous tissue (6.75±0.83mm2) according to the other 2 groups (p<0.001). On the other hand, Group 3 had the highest osteoblast number (25.50±3.29), osteoclast number (21.25±1.03), newly formed bone area (20.50±1.30 mm2), total healing area (22.62±0.93 mm2), defect closure rate (80.37±1.40%), bone implant contact value (23.2%±0.6%), and percentage bone volume (18.2%±0.3%) (p<0.001). Matrix metalloproteinase-3 expression was found to be highest in Group 3 by immunohistochemistry analysis. In this study it was observed that the results of the different analysis techniques supported each other. According to these findings it can be stated that a single-dose and locally applied lactoferrin solution plays an important role in the autograft healing in peri­implant area and increasing bone implant contact value. These findings will shed light on further clinical studies of implant osseointegration.

Are there correlations between radiographic grade levels and modified grade levels of periodontitis?

BACKGROUND: At the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions, periodontitis was reclassified according to a multidimensional staging and grading system. Grading takes variabilities in the rate of disease progression into account, relying on recognized progression risk factors, and is based on the assessment of bone loss at the worst-affected tooth in the dentition as a function of age, which is then modified by factors such as smoking and diabetes mellitus. In this context, the aim of this study was to determine whether there are correlations between radiographically calculated grades and grades modified by the presence of smoking or diabetes. MATERIALS AND METHODS: In this descriptive study, individuals diagnosed with periodontitis according to the 2017 classifications were examined. The grade of periodontitis was measured using periapical radiography. A modified-grade level was assigned to the patients according to their glycated hemoglobin levels (in diabetics) or their smoking status. RESULTS: The study included 341 individuals. No statistically significant relationship was revealed by Chi-square testing (P > 0.05) or in the kappa agreement index between the modified grades and the radiographic grades. CONCLUSIONS: Although there was no correlation between radiographic grade and modified grade in smokers and diabetic individuals, increasing the grade score in these individuals in accordance with the 2017 classification provides clinicians the opportunity to develop a risk-based treatment plan, commensurate with the severity of periodontal disease and the level of risk.

The association between stage-grade of periodontitis and sleep quality and oral health-related quality of life.

BACKGROUND: Inadequate sleep increases inflammatory and proinflammatory markers among many other influences. Due to its potential to influence inflammation and oxidative stress, which are the main pathogenetic mechanisms actually recognized in the periodontal damage, poor sleep quality could be a factor for periodontitis and quality of life (QoL). In this context, the aim of this study is to investigate the association of stage-grade of periodontitis with sleep quality. and the effect of periodontitis on QoL. METHODS: The study consisted of clinical examination and a questionnaire. The questionnaire was based on demographic information, Oral Health Impact Profile-14 (OHIP-14), and Pittsburgh Sleep Quality Index (PSQI). Patients were diagnosed according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Clinical examination included probing depth (PD) and clinical attachment loss (AL). RESULTS: The mean age of 99 participants was 30.27 ± 5.80 years ranging from 18 to 40-years. The mean clinical values of the patients in this study included AL, 4.03 ± 2.46 mm, and PD, 4.27 ± 1.55 mm. The mean of the global OHIP-14 score was 13.43 ± 6.23 and the mean PSQI global score was 6.57 ± 3.53. CONCLUSIONS: Stage-grade of periodontitis was associated with short sleep duration, low-sleep quality, and low oral health-related quality of life.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) in subjects with different stages of periodontitis according to the new classification

Abstract Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a multifunctional cytokine that regulates inflammatory responses in various autoimmune and inflammatory disorders. Objective: The purpose of this study was to analyze the gingival crevicular fluid (GCF) for GM-CSF, interleukin-1 beta (IL-1β), and macrophage inflammatory protein-1 alpha (MIP-1α) levels in patients with stage I, stage II, stage III, and stage IV periodontitis (SI-P, SII-P, SIII-P, and SIV-P). Methodology: A total of 126 individuals were recruited for this study, including 21 periodontal healthy (PH), 21 gingivitis (G), 21 SI-P, 21 SII-P, 21 SIII-P, and 21 SIV-P patients. Plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), probing depth (PD), and attachment loss (AL) were used during the clinical periodontal assessment. GCF samples were obtained and analyzed by an enzyme-linked immunosorbent assay (ELISA). Results: GCF GM-CSF, MIP-1α, and IL-1β were significantly higher in SII-P and SIII-P groups than in PH, G, and SI-P groups (p<0.05). There was no significant difference among the PH, G, and SI-P groups in IL-1β, GM-CSF, and MIP-1α levels (p>0.05). Conclusions: These results show that GM-CSF expression was increased in SII-P, SIII-P, and SIV-P. Furthermore, GM-CSF levels may have some potential to discriminate between early and advanced stages of periodontitis.