RESUMEN

AIM: To compare individuals with a periodontitis background (Grade C, stage III/IV-formerly generalized aggressive periodontitis) (H-GAP) with periodontally healthy subjects (H-Health) in terms of molecular changes (immunological/microbiological) accompanying experimental peri-implant mucositis and gingivitis. MATERIALS AND METHODS: H-GAP and control (H-Health) subjects were recruited, and experimental mucositis/gingivitis was induced around a single screw-retained implant and one contralateral tooth. Participants refrained from oral hygiene for 21 days in the selected areas, followed by professional prophylaxis and hygiene instructions for 21 days. Clinical parameters, immunological markers (multiplex analysis) and microbial data (16S rRNA gene sequencing) were collected at baseline, during induction (7, 14 and 21 days) and following remission (42 days). RESULTS: Clinically, no significant differences were observed between the groups (n = 10/each group) (H-GAP vs. H-Health) (p > .05, Mann-Whitney test) and the type of site (tooth vs. implant) (p > .05, Wilcoxon test) at the time of onset and resolution, or severity of gingival/mucosal inflammation. H-GAP displayed lower concentrations of the cytokines interleukin (IL)-1B, IL-4, IL-17, tumor necrosis factor-α and interferon-γ around implants than H-Health at baseline and during induction of mucositis (p < .05, Mann-Whitney test). In both groups, implants showed significantly higher inflammatory background at baseline and all subsequent visits when compared with teeth (p < .05, Wilcoxon test). Alpha and ß-diversity metrics showed a significant shift in the microbiome composition and abundances of core species during induction and resolution of peri-implant mucositis and gingivitis (p < .05, restricted maximum likelihood method of Shannon and Bray-Curtis indices, respectively). Differences were not significant for these parameters between the H-Health and H-GAP groups when the periodontal and peri-implant microbiomes were compared separately; however, at each time point, the peri-implant microbiome differed significantly from the periodontal microbiome. CONCLUSIONS: Within the limitations of this pilot study (e.g. low power), it can be concluded that different microbial shifts contribute to the onset and progression of inflammatory responses around teeth and implants and that history of periodontal disease experience plays an additional role in modulating the immune response of peri-implant and periodontal tissues to biofilm accumulation.

Asunto(s)

Periodontitis Agresiva , Implantes Dentales , Gingivitis , Mucositis , Periimplantitis , Humanos , Mucositis/etiología , Proyectos Piloto , ARN Ribosómico 16S/genética , Implantes Dentales/efectos adversos , Implantes Dentales/microbiología , Periimplantitis/microbiología , Gingivitis/microbiología

RESUMEN

OBJECTIVES: To investigate the effect of antineoplastic therapy (AT) in the periodontal tissues of childhood cancer (CC) patients. MATERIALS AND METHODS: Seventy-two individuals were divided into CC (n=36) and healthy individuals (control group-CG, n=36). Demographics, hygiene habits, CC type, and AT were collected. Salivary flow and the presence and concentration of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Fusobacterium nucleatum were analyzed. Clinical evaluation included plaque (PI) and gingival indexes (GI), periodontal probing depth (PPD), and clinical attachment level (CAL). Patients were classified into periodontal health, gingivitis, or periodontitis. Descriptive statistics, T test, Mann-Whitney test, chi-square, Fisher's exact test, and two-way analysis of variance were used (p<0.05). RESULTS: The mean age of the patients was similar (CC 12.0±3.9 years and CG 12.0±4.0 years). In the CC group, all patients underwent chemotherapy and nine radiotherapy. Color/race, income, and family education showed significant differences between groups. There was no difference between groups in salivary flow. Higher levels of Fusobacterium nucleatum were seen in CC (p=0.02). Significant difference between groups was found for PI (CC: 30.5%, CG: 22.6%), GI (CC: 28.8%, CG: 17.3%), PPD (CC: 1.77 mm, CG: 1.61 mm), and CAL (CC: 1.77 mm, CG: 1.57 mm), periodontal health (CC: 3, CG: 7), gingivitis (CC: 16, CG: 24), or periodontitis (CC: 17, CG: 5). CONCLUSION: AT in CC patients presents a negative impact in the periodontal and microbiological parameters. CLINICAL RELEVANCE: Childhood cancer individuals showed worse periodontal parameters and higher levels of Fusobacterium nucleatum in the saliva when compared to healthy individuals.

Asunto(s)

Antineoplásicos , Gingivitis , Neoplasias , Periodontitis , Humanos , Niño , Adolescente , Estudios de Cohortes , Bolsa Periodontal/microbiología , Neoplasias/tratamiento farmacológico , Periodontitis/microbiología , Porphyromonas gingivalis , Gingivitis/microbiología , Fusobacterium nucleatum , Antineoplásicos/farmacología , Aggregatibacter actinomycetemcomitans

RESUMEN

PURPOSE: In this work, we identified human and bacterial proteomes in the saliva from volunteers with gingivitis or healthy. EXPERIMENTAL DESIGN: The reported population consisted of 18 volunteers (six with gingivitis and 12 healthy controls). Proteomics characterization was performed using a quantitative mass spectrometry method. RESULTS: A total of 74 human and 116 bacterial proteins were identified in saliva. The major functional category that was modified in the human proteome was the immune response, followed by transport and protease inhibition. In the bacterial proteome, most of the proteins identified were from the Fusobacteria phylum, followed by Chlamydiae and Spirochaetes. CONCLUSIONS AND CLINICAL RELEVANCE: We observed statistically relevant differences in the data between the groups. The 15 most important human proteins affecting the variation between case and control groups included cystatin S, alpha amylase, lactotransferrin, and negative elongation factor E. We found that bacterial proteins from Porphyromonas gingivalis and Fusobacterium nucleatum subsp. nucleatum related to the red and orange complexes were closely correlated with the occurrence of periodontal diseases.

Asunto(s)

Gingivitis , Saliva , Humanos , Saliva/microbiología , Proteoma/análisis , Proteómica , Fusobacterium nucleatum/metabolismo , Brasil , Gingivitis/microbiología , Proteínas Bacterianas/metabolismo

RESUMEN

This systematic review evaluated the features of the progression of experimentally induced gingivitis and peri-implant mucositis in humans. Included were studies that evaluated clinical, immunological, or microbiological responses between experimentally induced gingivitis and peri-implant mucositis in periodontally healthy patients. A total of 887 articles were initially identified, but only 12 were included in the final analysis. Implants accumulate less biofilm and suffer the most heterogeneous alterations in the microbiota, in the abstinence of oral hygiene, compared with the tooth. Interestingly, although dental implants presented less biofilm accumulation, the peri-implant mucosa showed a more exacerbated clinical response than the gingival tissue. The risk of bias of the selected studies was moderate to low, with one study presenting serious risk. The progression events of peri-implant mucositis were similar to those of experimental gingivitis but led to a different host response. This review was registered in the PROSPERO database CRD420201 123360.

Asunto(s)

Implantes Dentales , Gingivitis , Mucositis , Periimplantitis , Humanos , Mucositis/microbiología , Biopelículas , Periimplantitis/microbiología , Gingivitis/microbiología , Implantes Dentales/efectos adversos

RESUMEN

BACKGROUND: The objective of this systematic review and meta-analysis (SRM) was to assess the evidence between the association of oral lichen planus and periodontal disease, evaluating the periodontal clinical parameters and biomarkers levels. METHODS: This systematic review and meta-analysis followed PRISMA and was registered in PROSPERO (CRD42020181513). Searches were accomplished in databases for articles published until June 2021. The meta-analysis was performed with the variables: plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (CAL). The mean difference was applied with a 95% confidence interval. RESULTS: Six articles were included. Qualitative analysis showed the levels of biomarkers (matrix metalloproteinases, interleukins, and periodontal microbiological profile) are increased in subjects with periodontal disease and oral lichen planus. In the meta-analysis, these subjects also presented increases in all periodontal clinical parameters evaluated: GI-gingivitis 0.22 [0.14, 0.31] p < 0.0001 and periodontitis 0.12 [0.06, 0.19] p = 0.0003; PI-gingivitis 0.22 [0.12, 0.31] p < 0.0001 and periodontitis 0.15 [0.08, 0.23] p < 0.0001; PD-gingivitis 0.27 [0.06; 0.48] p = 0.0107 and periodontitis 0.11 [0.01; 0.21] p = 0.0299; and CA-periodontitis 0.06 [0.01, 0.12] p = 0.0176. CONCLUSIONS: Evidence suggests a significant relationship between the severity of periodontal disease and the presence of oral lichen planus. Although the association is biologically plausible, further studies are needed using populations and well-defined biochemical and clinical outcomes with consideration of potential confounding factors. CLINICAL RELEVANCE: This SRM provides information on the interaction between OLP and periodontal disease and guides clinicians to make evidence-based decisions and suggests recommendations for further high-quality studies.

Asunto(s)

Gingivitis , Liquen Plano Oral , Enfermedades Periodontales , Periodontitis , Gingivitis/microbiología , Humanos , Liquen Plano Oral/complicaciones , Enfermedades Periodontales/complicaciones , Índice Periodontal

RESUMEN

OBJECTIVES: This study aims to describe the oral microbiome diversity and prevalence of ARGs in periodontal health and disease. BACKGROUND: The human oral cavity harbors a complex microbial community known as the oral microbiome. These organisms are regularly exposed to selective pressures, such as the usage of antibiotics, which drive evolution and acquisition of antibiotic resistance genes (ARGs). Resistance among oral bacteria jeopardizes not only antibiotic therapy for oral infections, but also extra-oral infections caused by bacterial translocation. METHODS: We carried out a cross-sectional investigation. Saliva and subgingival plaque samples were collected during a clinical exam. 16S rRNA gene sequencing was performed to assess microbial diversity. Resistance genes were identified through PCR assays. RESULTS: Of the 110 participants, only 22.7% had healthy periodontium, while the majority was diagnosed with gingivitis (55.4%) and chronic periodontitis (21.8%). The composition of the oral microbiota differed from healthy and diseased samples, being Streptococcus spp. and Rothia spp. predominant in periodontal disease. Regarding ARGs, 80 (72.7%) samples were positive for at least one of genes screened, erm being the most frequent variant (58.2%), followed by blaTEM (16.4%), mecA (2.7%), pbp2b and aac(6 ') (1.8%). Neither genes coding resistance to carbapenems nor metronidazole were detected. CONCLUSIONS: Our findings indicate that there are no significant differences in terms of taxonomic enrichment between healthy and diseased oral microbiomes. However, samples retrieved from healthy patients had a more diverse microbial community, whereas diseased samples have lower taxonomic diversity. We have also identified clinically relevant ARGs, providing baseline information to guide antibiotic prescription in dentistry.

Asunto(s)

Bacterias/aislamiento & purificación , Farmacorresistencia Bacteriana/genética , Microbiota , Boca/microbiología , Adolescente , Adulto , Bacterias/genética , Proteínas Bacterianas/genética , Estudios Transversales , Placa Dental/microbiología , Placa Dental/patología , Femenino , Gingivitis/diagnóstico , Gingivitis/microbiología , Humanos , Masculino , Persona de Mediana Edad , Periodontitis/diagnóstico , Periodontitis/microbiología , Periodoncio/patología , ARN Ribosómico 16S/química , ARN Ribosómico 16S/metabolismo , Saliva/microbiología , Streptococcus/genética , Streptococcus/aislamiento & purificación , Adulto Joven

RESUMEN

It is known that the presence of orthodontic brackets predisposes for a change in the biofilm, facilitating the development of gingivits. The sites are difficult to access with a toothbrush and periodontal curette, worsening inflammation, in addition, a gingival hyperplasia is associated with poor hygiene. The objective of this study is to evaluate the impact of photodinamyc therapy (PDT) as an adjuvant treatment, considering clinical immunoregulatory and microbiological parameters. This randomized, controlled, double-blind clinical study will include 34 patients, both genders, having used fixed appliance for more than 12 months, with gingivitis. Participants will be divided into two groups: G1 (n = 17)- Scaling and Root Planing + PDT placebo and G2 (n = 17)- Scaling and Root Planing + PDT. In G2 the following dosimetric parameters will be used: methylene blue 0.005%, λ= 660 nanometers (nm), 9 Joules (J) per site, irradiance= 3.5Watts (W)/ centimeters (cm), radiant exposure= 318J/cm. All participants will receive oral hygiene guidance prior the curetes scaling. The clinical periodontal data to be analyzed are plaque index, gingival index and probing depth. Crevicular fluid, from 4 pre-determined sites and saliva, will be collected and analysed for IL-6, IL-1ß, IL-8, TNF-α and IL-10 cytokines using ELISA (Enzyme immunoabsorption assay) method. Total Bacteria count will also be performed, by qPCR and Universal16SrRNA gene. All analysis will be realized using in the baseline (T0), 7 (T1) and 21 (T2) days after treatment. Oral health-related quality of life will be assessed using the OHIP-14 questionnaire at times T0 and T2. If sample distribution is normal, the Student T-test will be applied if it is not normal, the Mann-Whitney test will be used. The data will be presented in terms of ±â€ŠPD and The significance level will be set at p < 0.05. Our results may improve quality of life and add data to establish a therapeutic alternative for gingivitis during the orthodontic treatment. Registration: clinicaltrials.gov NCT04037709. https://clinicaltrials.gov/ct2/show/NCT04037709 - Registered in July 2019.

Asunto(s)

Gingivitis/terapia , Mediadores de Inflamación/metabolismo , Azul de Metileno/uso terapéutico , Aparatos Ortodóncicos Fijos , Fotoquimioterapia/métodos , Adolescente , Adulto , Niño , Terapia Combinada , Raspado Dental/métodos , Método Doble Ciego , Ensayo de Inmunoadsorción Enzimática , Femenino , Gingivitis/tratamiento farmacológico , Gingivitis/microbiología , Humanos , Masculino , Índice Periodontal , Calidad de Vida , Adulto Joven

RESUMEN

BACKGROUND: The oral flagellated protozoan Trichomonas tenax has been associated with patients with periodontal disease. However, no recent studies have been conducted on the prevalence of T. tenax in Chile. The aim of this study was to determine the presence of T. tenax in patients with periodontal disease, admitted to the Dental Clinic of the University of Antofagasta, Chile, through Polymerase Chain Reaction (PCR) amplification of the beta-tubulin gene. METHODS: An observational, cross-sectional study was conducted on 50 patients diagnosed with periodontal disease, 20 of them with gingivitis and 30 with periodontitis. T. tenax was identified by PCR amplification of the beta-tubulin gene. Associations between the protozoan and periodontal disease or the presence of risk factors to establish T. tenax infection were determined using the chi-square test and binary logistic regression analysis. RESULTS: T. tenax was present in 28 out of 50 (56%) of patients with periodontal disease, and was more prevalent when associated with periodontitis (21 out of 30; 70%) than dental plaque-induced gingivitis (7 out of 20; 35%). Non-statistically-significant associations were observed between the presence of T. tenax and age, gender, smoking habit or diabetes. Statistically significant associations were observed between the presence of T. tenax and periodontal disease, and between T. tenax and the Periodontal Screening and Recording (PSR) index. CONCLUSION: T. tenax showed a high presence in patients with progressive states of periodontal diseases. Consequently, T. tenax detection is strongly recommended in patients with periodontal disease diagnosis and with a PSR index greater than 3.

Asunto(s)

Gingivitis/microbiología , Enfermedades Periodontales/microbiología , Tricomoniasis/diagnóstico , Trichomonas/aislamiento & purificación , Tubulina (Proteína)/genética , Adulto , Anciano , Anciano de 80 o más Años , Chile/epidemiología , Estudios Transversales , Clínicas Odontológicas , Femenino , Amplificación de Genes , Gingivitis/diagnóstico , Gingivitis/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Periodontales/diagnóstico , Enfermedades Periodontales/epidemiología , Reacción en Cadena de la Polimerasa , Prevalencia , Universidades

RESUMEN

The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1ß, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1ß levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1ß and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1ß, IL-6 and IL-8.

Asunto(s)

Biomarcadores/análisis , Parálisis Cerebral/complicaciones , Gingivitis/complicaciones , Gingivitis/rehabilitación , Periodontitis/terapia , Saliva/química , Adolescente , Niño , Citocinas/análisis , Profilaxis Dental/métodos , Femenino , Gingivitis/microbiología , Humanos , Interleucina-10 , Interleucina-1beta/análisis , Interleucina-6/análisis , Masculino , Concentración Osmolar , Índice Periodontal , Distribución de Poisson , Saliva/inmunología , Saliva/microbiología , Factor de Necrosis Tumoral alfa/análisis

RESUMEN

Periodontal disease has been associated with rheumatic diseases; however, few studies have evaluated the association with systemic lupus erythematosus (SLE), and its impact on the local inflammatory and microbial profiles. Therefore, this study evaluated the levels of several cytokines in gingival crevicular fluid (GCF) and serum from juvenile SLE (jSLE) patients with gingival inflammation, compared with controls. In addition, we assessed their subgingival microbial profile. Thirty jSLE patients and 29 systemically healthy individuals were recruited. Participants were rheumatologically and periodontally examined, and GCF, serum and intrasulcular biofilm were collected. Cytokines were analysed by bead-based multiplex assays and the bacterial profile by checkerboard DNA-DNA hybridization. jSLE patients presented higher percentages of dental plaque and bleeding than controls, as well as increased mean probing depth and attachment loss. After adjustment for multiple comparisons, GCF levels of interleukin (IL)-1ß, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon-γ and monocyte chemoattractant protein-1 were significantly higher, whereas the levels of granulocyte-macrophage colony-stimulating factor were significantly lower in jSLE patients. In serum, G-CSF levels tended to be higher in jSLE patients (adjusted p-value = 0.06). Intrasulcular counts of Aggregatibacter actinomycetemcomitans were significantly higher in jSLE patients as compared with controls. We conclude that patients with jSLE present a worse periodontal condition associated with altered levels of pro-inflammatory cytokines in GCF and increased counts of A. actinomycetemcomitans in the intrasulcular biofilm.

Asunto(s)

Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Citocinas/análisis , Gingivitis/inmunología , Gingivitis/microbiología , Lupus Eritematoso Sistémico/inmunología , Lupus Eritematoso Sistémico/microbiología , Adolescente , Biopelículas , Brasil , Estudios de Casos y Controles , Placa Dental/microbiología , Femenino , Líquido del Surco Gingival/química , Gingivitis/complicaciones , Humanos , Lupus Eritematoso Sistémico/complicaciones , Masculino

RESUMEN

Abstract The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1β, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1β levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1β and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1β, IL-6 and IL-8.

Asunto(s)

Humanos , Masculino , Femenino , Niño , Adolescente , Periodontitis/terapia , Saliva/química , Biomarcadores/análisis , Parálisis Cerebral/complicaciones , Gingivitis/complicaciones , Gingivitis/rehabilitación , Concentración Osmolar , Saliva/inmunología , Saliva/microbiología , Distribución de Poisson , Índice Periodontal , Citocinas/análisis , Interleucina-6/análisis , Factor de Necrosis Tumoral alfa/análisis , Interleucina-10 , Profilaxis Dental/métodos , Interleucina-1beta/análisis , Gingivitis/microbiología

RESUMEN

Silver tungstate (α-Ag2WO4) microcrystals have shown encouraging results regarding their antimicrobial activity. However, in addition to the promising outcomes in fighting oral disease, cytotoxic tests are mandatory for screening new materials for biological applications. Here, we developed a better understanding of the effects of microcrystals on the behavior of both human gingival fibroblast (HGF) cells and three-dimensional (3D) collagen matrices. To perform these experiments, the lowest concentration of α-Ag2WO4 capable of preventing the visible growth of Candida albicans (C. albicans) planktonic cells was defined as the test concentration, and it ranged from 0.781 (C1) to 7.81 (C2) to 78.1 (C3) µg/mL. Complete medium and lysis buffer (LB) served as negative (C-) and positive (C+) controls, respectively. The effect of the microcrystal concentration on the morphology, remodeling and proliferation of HGF cells was evaluated by different approaches. Quantitative and qualitative assessments demonstrated that α-Ag2WO4 did not affect the mitochondrial enzymatic activity of HGF cells cultured in a monolayer or the cell viability within 3D collagen matrices. These experiments showed that α-Ag2WO4 at the C2 concentration did not damage the genomic DNA. The development of new materials is attractive for the possible treatment of diseases and for avoiding indiscriminate prescribing of antibiotics. These findings provide information on the effect of α-Ag2WO4 on cell behavior and reveal that these microcrystals are non-cytotoxic against human gingival cells over a sufficient period to measure the hazard potential.

Asunto(s)

Colágeno/química , Fibroblastos/efectos de los fármacos , Gingivitis/tratamiento farmacológico , Nanopartículas del Metal/química , Plata/farmacología , Compuestos de Tungsteno/farmacología , Antibacterianos/química , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Encía/citología , Encía/microbiología , Gingivitis/microbiología , Gingivitis/patología , Humanos , Modelos Moleculares , Tamaño de la Partícula , Especies Reactivas de Oxígeno/metabolismo , Plata/química , Plata/uso terapéutico , Propiedades de Superficie , Compuestos de Tungsteno/química , Compuestos de Tungsteno/uso terapéutico

RESUMEN

Os objetivos desse estudo foram avaliar a expressão de citocinas no soro e fluido gengival, a produção de arginina-peptidil-deiminase (anti-PPAD) e o perfil microbiológico de pacientes com lúpus eritematoso sistêmico juvenil (LESj) e comparar com indivíduos saudáveis sistemicamente. Como objetivo secundário, avaliamos o impacto do tratamento da inflamação gengival sobre a expressão das citocinas e dos níveis de anti-PPAD. Participaram do estudo 30 pacientes com LESj (idade média: 16,2 ± 1,5 anos) e 29 sem doença sistêmica (idade média 15,5 ± 2,3 anos), ambos com gengivite. Foram coletados dados reumatológicos, periodontais, sangue, fluido gengival e biofilme intrassulcular. As citocinas foram analisadas pelo multiensaio multiplex; anti-PPAD pelo ensaio de imunoabsorção enzimática (ELISA) e níveis bacterianos pelo checkerboard DNA-DNA hybridization. Para avaliar variáveis categóricas foi utilizado o teste Qui-quadrado de Pearson; para as numéricas, o teste U de Mann-Whitney e para as correlações a estatística tau-b de Kendall. No estudo longitudinal, foi utilizado o teste de McNemar para dados qualitativos, e o de Wilcoxon para dados numéricos. No estudo transversal, o grupo teste apresentou maiores níveis de profundidade de bolsa à sondagem (PBS), nível de inserção clínica (NIC), % de placa e sangramento do que o controle. Na análise do soro, G-CSF foi significativamente maior e TNF-α significativamente menor no grupo teste. Na análise do fluido gengival, IL-1ß, IL-7, IL-8, IL-13, G-CSF, IFN-γ e MCP-1 foram significativamente maiores e IL-4, IL-12(p70) e GM-CSF significativamente menores no grupo teste. Não houve diferença significativa nos níveis de anti-PPAD entre os grupos. S. constellatus, A. actinomycetencomytans, E. saburreum, V. parvula, S. intermedius, C. showae e F. nucleatum foram significantemente mais numerosas no grupo teste e A. gerencseriae e T. denticola no grupo controle. Após o tratamento da inflamação gengival, o SLEDAI, %NIC 1-2 e NIC reduziram significantemente. Já os valores de PBS e %NIC 0 aumentaram. No soro, houve diminuição significativa da IL-4 e IL-5 e aumento significativo dos níveis de anti-PPAD após o tratamento. Já no fluido gengival, houve diminuição significativa da IL-1ß, IL-10 e MCP-1 e aumento significativo da IL-4, IL-12(p70), IL-17, GM-CSF e INF-α. Sendo assim, podemos concluir que pacientes com LESj apresentaram piores condições periodontais, PBS, NIC, % de placa e sangramento do que pacientes saudáveis sistemicamente. A análise de citocinas mostrou um aumento do G-CSF e TNF-α no soro e de IL-1ß, IL-7, IL-8, IL-13, G-CSF, IFN-γ e MCP-1 no fluido gengival dos pacientes com LESj. Foram identificados anticorpos anti-PPAD nos pacientes com LESj, o que pode servir como gatilho para a quebra da tolerância imunológica. O estudo longitudinal intervencionista demonstrou que o tratamento da inflamação gengival melhorou significantemente os parâmetros %NIC 1-2 e NIC. Houve uma pequena, porém significante, piora na PBS, a qual acreditamos não ter relevância clínica. Observamos também uma melhora significante no SLEDAI e dos níveis de IL-4 e IL-5 no soro e um aumento das citocinas IL-12, IL-17 e GM-CSF no fluido gengival. Já em relação ao anticorpo anti-PPAD, observamos um aumento significativo após o tratamento da inflamação gengival.

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The objectives of this study were to evaluate the expression of cytokines in serum and gingival fluid, the production of arginine-peptidyl-deiminase (anti-PPAD) and the microbiological profile of patients with juvenile systemic lupus erythematosus (jSLE) and compare with systemically healthy individuals. As a secondary objective, we evaluated the impact of treatment of gingival inflammation on cytokine expression and anti-PPAD levels. Thirty patients with jSLE (mean age: 16.2 ± 1.5 years) and 29 without systemic disease (mean age 15.5 ± 2.3 years), both with gingivitis, participated in the study. Rheumatological and periodontal data, blood, gingival fluid and intrassulcular biofilm were collected. Cytokines were analyzed by multiplex multi-assay; anti-PPAD by enzyme-linked immunosorbent assay (ELISA) and bacterial levels by checkerboard DNA-DNA hybridization. Pearson's Chi-square test was used to evaluate categorical variables; Mann-Whitney U test for numerical variables and Kendall's tau-b statistic for correlations. In longitudinal study, McNemar test was used for qualitative data, and Wilcoxon test for numerical data. In cross-sectional study, test group presented higher levels of probing depth (PD), clinical attachment level (CAL), % of plaque and bleeding than control group. In serum analysis, G-CSF were significantly higher and TNF-α significantly lower in test group. In analysis of gingival fluid, IL-1ß, IL-7, IL-8, IL-13, G-CSF, IFN-γ and MCP-1 were significantly higher and IL-4, IL-12(p70) and GM-CSF were significantly lower in test group. There was no significant difference in anti-PPAD levels between groups. S. constellatus, A. actinomycetencomytans, E. saburreum, V. parvula, S. intermedius, C. showae and F. nucleatum were significantly more numerous in test group and A. gerencseriae and T. denticola in control group. After treatment of gingival inflammation, SLEDAI, % CAL 1-2 and CAL decreased significantly. Already the values of PD and % CAL 0 increased. In serum, there was a significant decrease in IL-4 and IL-5 and a significant increase in anti-PPAD levels after treatment. In gingival fluid, there was a significant decrease in IL-1ß, IL-10 and MCP-1 and significant increase in IL-4, IL-12 (p70), IL-17, GM-CSF and INF-α. Thus, we can conclude that patients with jSLE presented worse periodontal conditions, PBS, NIC, % plaque and bleeding than systemically healthy patients. Cytokine analysis showed an increase in serum G-CSF and TNF-α and IL-1ß, IL-7, IL-8, IL-13, G-CSF, IFN-γ and MCP-1 in gingival fluid of patients with jSLE. Anti-PPAD antibodies have been identified in patients with jSLE, which may serve as a trigger for impaired immune tolerance. Longitudinal interventional study demonstrated that treatment of gingival inflammation significantly improved % CAL 1-2 and CAL parameters. There was a small, but significant worsening in PBS, which we believe has no clinical relevance. We also observed a significant improvement in SLEDAI and levels of IL-4 and IL-5 in serum and an increase in cytokines IL-12, IL-17 and GM-CSF in gingival fluid. Regarding the anti-PPAD antibody, we observed a significant increase after the treatment of gingival inflammation.

Asunto(s)

Humanos , Masculino , Femenino , Adolescente , Citocinas , Disbiosis , Gingivitis/terapia , Lupus Eritematoso Sistémico , Anticuerpos , Ensayo de Inmunoadsorción Enzimática , Índice Periodontal , Estadísticas no Paramétricas , Gingivitis/inmunología , Gingivitis/microbiología , Lupus Eritematoso Sistémico/inmunología , Lupus Eritematoso Sistémico/microbiología

Asunto(s)

Humanos , Gingivitis/diagnóstico , Gingivitis/etiología , Gingivitis/microbiología , Gingivitis/epidemiología , Gingivitis/prevención & control

RESUMEN

OBJECTIVE: The aim of this study was to compare the prevalence of periodontal pathogens, systemic inflammatory mediators and lipid profiles in type 1 diabetes children (DM) with those observed in children without diabetes (NDM), both with gingivitis. MATERIAL AND METHODS: Twenty-four DM children and twenty-seven NDM controls were evaluated. The periodontal status, glycemic and lipid profiles were determined for both groups. Subgingival samples of periodontal sites were collected to determine the prevalence of periodontal microorganisms by PCR. Blood samples were collected for IL-1-ß, TNF-α and IL-6 analysis using ELISA kits. RESULTS: Periodontal conditions of DM and NDM patients were similar, without statistical differences in periodontal indices. When considering patients with gingivitis, all lipid parameters evaluated were highest in the DM group; Capnocytophaga sputigena and Capnocytophaga ochracea were more prevalent in the periodontal sites of DM children. "Red complex" bacteria were detected in few sites of DM and NDM groups. Fusobacterium nucleatum and Campylobacter rectus were frequently found in both groups. Similar levels of IL-1-ß, TNF-α and IL-6 were detected in DM and NDM children. CONCLUSION: Clinical and immunological profiles are similar between DM and NDM children. The presence of Capnocytophaga sputigena and Capnocytophaga ochracea were associated with gingivitis in DM children.

Asunto(s)

Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 1/microbiología , Gingivitis/epidemiología , Gingivitis/microbiología , Periodoncio/microbiología , Adolescente , Brasil/epidemiología , Capnocytophaga/aislamiento & purificación , Niño , Colesterol/sangre , Dentición Permanente , Diabetes Mellitus Tipo 1/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Gingivitis/inmunología , Humanos , Interleucina-1beta/sangre , Interleucina-6/sangre , Masculino , Índice Periodontal , Reacción en Cadena de la Polimerasa , Estadísticas no Paramétricas , Diente Primario/microbiología , Triglicéridos/sangre , Factor de Necrosis Tumoral alfa/sangre

RESUMEN

Abstract Objective The aim of this study was to compare the prevalence of periodontal pathogens, systemic inflammatory mediators and lipid profiles in type 1 diabetes children (DM) with those observed in children without diabetes (NDM), both with gingivitis. Material and methods Twenty-four DM children and twenty-seven NDM controls were evaluated. The periodontal status, glycemic and lipid profiles were determined for both groups. Subgingival samples of periodontal sites were collected to determine the prevalence of periodontal microorganisms by PCR. Blood samples were collected for IL-1-β, TNF-α and IL-6 analysis using ELISA kits. Results Periodontal conditions of DM and NDM patients were similar, without statistical differences in periodontal indices. When considering patients with gingivitis, all lipid parameters evaluated were highest in the DM group; Capnocytophaga sputigena and Capnocytophaga ochracea were more prevalent in the periodontal sites of DM children. “Red complex” bacteria were detected in few sites of DM and NDM groups. Fusobacterium nucleatum and Campylobacter rectus were frequently found in both groups. Similar levels of IL-1-β, TNF-α and IL-6 were detected in DM and NDM children. Conclusion Clinical and immunological profiles are similar between DM and NDM children. The presence of Capnocytophaga sputigena and Capnocytophaga ochracea were associated with gingivitis in DM children.

Asunto(s)

Humanos , Masculino , Femenino , Niño , Adolescente , Periodoncio/microbiología , Diabetes Mellitus Tipo 1/microbiología , Diabetes Mellitus Tipo 1/epidemiología , Gingivitis/microbiología , Gingivitis/epidemiología , Diente Primario/microbiología , Triglicéridos/sangre , Brasil/epidemiología , Capnocytophaga/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática , Índice Periodontal , Reacción en Cadena de la Polimerasa , Colesterol/sangre , Interleucina-6/sangre , Factor de Necrosis Tumoral alfa/sangre , Estadísticas no Paramétricas , Dentición Permanente , Diabetes Mellitus Tipo 1/inmunología , Interleucina-1beta/sangre , Gingivitis/inmunología

RESUMEN

The aim of this study was to evaluate the relationship among nutritional status, gingival health and the composition of oral microbiota in children of a public school from a very poor area of San Miguel de Tucuman. Forty-five children ranging in age from 6 to 14 years old, 13 males and 32 females were studied. Twenty of these children were undernourished (Lejarraga-Morasso Table) and twenty-five were eutrophic. A clinical study that included DMF and dmf indexes, Löe Silness Plaque Index and bleeding on probing was performed. For microbiological study, saliva samples without stimulation were taken; aliquots of them were immediately placed in TAE buffer pH 7.6, adding NaOH (N and keeping at -70 °C until processed by checkerboard DNA-DNA hybridization method to check the presence of 40 oral microorganism species. Positive bleeding on probing was present in more than 80% of children, without significant differences between eutrophic and undernourished groups. Same result were obtain for the other clinical indexes (p > 0.05, Two Way ANOVA). Significant differences were found for some oral microorganism species, with a higher percentage of undernourished children harboring them. That was the case of S. gordonii (p < 0.05), Capnocitophaga gingivalis and C. ochraceae (p < 0.01 and p < 0.10, respectively), F. nucleatum ss nucleatum (p < 0.05), P. nigrescens (p < 0.10), Campylobacter gracilis (p < 0,05), and T. denticola (p < 0.10, multiple logistic regression). Significant differences were also found between children groups for E. saborreum (p < 0.001), P. acnes (p < 0.10), G. morbillorum (p < 0.05) and L. buccalis (p < 0.10). Gingivitis and bleeding on probing would not be related to nutritional status in the groups of children studied. There were significant differences for the presence of some of the main periodontal pathogen species between eutrophic and undernourished children. It would be important to study the meaning of significant differences found for the other microorganisms more deeply.

Asunto(s)

ADN Bacteriano/genética , Encía/microbiología , Gingivitis/microbiología , Desnutrición/microbiología , Microbiota/genética , Adolescente , Aggregatibacter actinomycetemcomitans/clasificación , Aggregatibacter actinomycetemcomitans/genética , Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Argentina , Bacteroides/clasificación , Bacteroides/genética , Bacteroides/aislamiento & purificación , Campylobacter/clasificación , Campylobacter/genética , Campylobacter/aislamiento & purificación , Capnocytophaga/clasificación , Capnocytophaga/genética , Capnocytophaga/aislamiento & purificación , Estudios de Casos y Controles , Niño , Femenino , Fusobacterium nucleatum/clasificación , Fusobacterium nucleatum/genética , Fusobacterium nucleatum/aislamiento & purificación , Gingivitis/fisiopatología , Humanos , Masculino , Desnutrición/fisiopatología , Hibridación de Ácido Nucleico , Peptostreptococcus/clasificación , Peptostreptococcus/genética , Peptostreptococcus/aislamiento & purificación , Porphyromonas gingivalis/clasificación , Porphyromonas gingivalis/genética , Porphyromonas gingivalis/aislamiento & purificación , Saliva/microbiología

RESUMEN

Las características de los tejidos gingivales y periodontales son diferentes en niños y adolescentes. La clasificación actual de enfermedades gingivales incluye a las gingivitis producidas por el biofilm y a las no producidas por el biofilm de placa. Las gingivitis son reversibles. Las condiciones de riesgo individuales, de origen externo o de origen sistémico, influyen en el agravamiento. La prevención de la gingivitis está enfocada en el control de los factores de riesgo.

Asunto(s)

Masculino , Femenino , Humanos , Adolescente , Niño , Enfermedades de las Encías/clasificación , Gingivitis/etiología , Gingivitis/prevención & control , Factores de Riesgo , Factores de Edad , Placa Dental/prevención & control , Encía/anatomía & histología , Enfermedades de las Encías/epidemiología , Gingivitis/microbiología , Higiene Bucal/educación , Pubertad , Factores Socioeconómicos

RESUMEN

INTRODUCTION: Oral-derived bacteremia may occur after several dental procedures and routine daily activities. Some conditions of the oral cavity may favor episodes of bacteremia. This would be the case of patients with diabetes mellitus and periodontitis, who exhibit exacerbated gingival inflammation and may be more prone to developing oral-derived bacteremia.  OBJECTIVE: To compare the effectiveness of an independent culture method (quantitative real-time PCR- qCR) and the most commonly used method (BacT-ALERT 3D®) for the diagnosis of bacteremia.  MATERIALS AND METHODS: Blood samples were drawn from subjects with type 2 diabetes mellitus and chronic periodontitis before and after apple chewing. Samples were processed by an automated blood culture system (BacT-ALERT 3D®) monitored for 15 days with suitable subculture of positive cultures. In parallel, whole DNA from blood samples was purified using a commercial kit and screened by qPCR using a universal primer set of16S rDNA for bacteria detection.  RESULTS: Blood cultures taken before apple chewing were shown to be negative by the two diagnostic methods. After chewing, two samples (11%) showed bacterial growth by BacT-ALERT 3D® whereas qPCR did not detect the presence of bacteria in any sample.  CONCLUSIONS: qPCR did not show greater effectiveness than the BacT-ALERT 3D® in the detection of bacteremia of oral origin.

Asunto(s)

Bacteriemia/diagnóstico , Periodontitis Crónica/complicaciones , Colorimetría/métodos , Técnicas de Cultivo , Diabetes Mellitus Tipo 2/complicaciones , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Anciano , Bacteriemia/etiología , Bacteriemia/microbiología , Bacterias/aislamiento & purificación , Bacterias/metabolismo , Biopelículas , Dióxido de Carbono/análisis , Periodontitis Crónica/microbiología , Colorimetría/instrumentación , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/microbiología , Susceptibilidad a Enfermedades , Femenino , Gingivitis/complicaciones , Gingivitis/microbiología , Humanos , Masculino , Masticación , Persona de Mediana Edad , Boca/microbiología

RESUMEN

OBJECTIVE: The present study assessed the effect of smoking on clinical, microbiological and immunological parameters in an experimental gingivitis model. MATERIAL AND METHODS: Twenty-four healthy dental students were divided into two groups: smokers (n = 10); and nonsmokers (n = 14). Stents were used to prevent biofilm removal during brushing. Visible plaque index (VPI) and gingival bleeding index (GBI) were determined 5- on day -7 (running phase), baseline, 21 d (experimental gingivitis) and 28 d (resolution phase). Supragingival biofilm and gingival crevicular fluid were collected and assayed by checkerboard DNA-DNA hybridization and a multiplex analysis, respectively. Intragroup comparison was performed by Friedman and Dunn's multiple comparison tests, whereas the Mann-Whitney U-test was applied for intergroup analyses. RESULTS: Cessation of oral hygiene resulted in a significant increase in VPI, GBI and gingival crevicular fluid volume in both groups, which returned to baseline levels 7 d after oral hygiene was resumed. Smokers presented lower GBI than did nonsmokers (p < 0.05) at day 21. Smokers had higher total bacterial counts and higher proportions of red- and orange complex bacteria, as well as lower proportions of Actinomyces spp., and of purple- and yellow-complex bacteria (p < 0.05). Furthermore, the levels of key immune-regulatory cytokines, including interleukin (IL)-8, IL-17 and interferon-γ, were higher in smokers than in nonsmokers (p < 0.05). CONCLUSION: Smokers and nonsmokers developed gingival inflammation after supragingival biofilm accumulation, but smokers had less bleeding, higher proportions of periodontal pathogens and distinct host-response patterns during the course of experimental gingivitis.

Asunto(s)

Gingivitis/etiología , Fumar/efectos adversos , Biopelículas/crecimiento & desarrollo , Estudios de Casos y Controles , Citocinas/análisis , Índice de Placa Dental , Femenino , Líquido del Surco Gingival/química , Gingivitis/inmunología , Gingivitis/microbiología , Humanos , Masculino , Índice Periodontal , Estudios Prospectivos , Adulto Joven