David Palombo, Andrea Dobos, Mercedes Lopez Duran, Javier Sanz Esporrin, Mariano Sanz
BackgroundThis randomized controlled trial with two parallel arms and a 1:1 allocation ratio aimed to compare early microvascular healing (primary outcome), surgical times, and patient‐reported outcomes (PROM) after harvesting palatal epithelialized gingival grafts (EGG), where hemostasis was achieved with sutures and hemostatic sponges (control) or with a sutureless approach (test).MethodsFrom a total of 33 patients, 34 EGG were harvested. Thirty‐two were randomized to the test/control group (n = 16) and two were excluded. Early palatal microvascular healing was assessed at 7, 14, and 30 days with laser speckle contrast imaging (LSCI). Postoperative bleeding, pain, discomfort, and analgesic consumption were assessed over 2 weeks with a dedicated questionnaire.ResultsA faster onset and resolution of postharvest hyperemia was observed in the test group where peak blood flow was reached at 7 days. No significant blood flow differences were observed between the groups at any of the evaluated timepoints. The mean surgical time was 13 min shorter in the test (p = 0.00). No significant differences were observed for postoperative bleeding and analgesic consumption at any timepoint.ConclusionsThe tested approach represents a viable alternative to the standard one, providing no relevant differences in microvascular, clinical, and patient‐related results, but with significantly shorter surgical times.
{"title":"Harvest of epithelialized gingival grafts without application of hemostatic sutures: A randomized clinical trial using laser speckle contrast imaging","authors":"David Palombo, Andrea Dobos, Mercedes Lopez Duran, Javier Sanz Esporrin, Mariano Sanz","doi":"10.1002/jper.23-0620","DOIUrl":"https://doi.org/10.1002/jper.23-0620","url":null,"abstract":"BackgroundThis randomized controlled trial with two parallel arms and a 1:1 allocation ratio aimed to compare early microvascular healing (primary outcome), surgical times, and patient‐reported outcomes (PROM) after harvesting palatal epithelialized gingival grafts (EGG), where hemostasis was achieved with sutures and hemostatic sponges (control) or with a sutureless approach (test).MethodsFrom a total of 33 patients, 34 EGG were harvested. Thirty‐two were randomized to the test/control group (<jats:italic>n</jats:italic> = 16) and two were excluded. Early palatal microvascular healing was assessed at 7, 14, and 30 days with laser speckle contrast imaging (LSCI). Postoperative bleeding, pain, discomfort, and analgesic consumption were assessed over 2 weeks with a dedicated questionnaire.ResultsA faster onset and resolution of postharvest hyperemia was observed in the test group where peak blood flow was reached at 7 days. No significant blood flow differences were observed between the groups at any of the evaluated timepoints. The mean surgical time was 13 min shorter in the test (<jats:italic>p</jats:italic> = 0.00). No significant differences were observed for postoperative bleeding and analgesic consumption at any timepoint.ConclusionsThe tested approach represents a viable alternative to the standard one, providing no relevant differences in microvascular, clinical, and patient‐related results, but with significantly shorter surgical times.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"10 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141462809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundDiabetes is one of the major inflammatory comorbidities of periodontitis via 2‐way interactions. Cystathionine γ‐lyase (CTH) is a pivotal endogenous enzyme synthesizing hydrogen sulfide (H2S), and CTH/H2S is crucially implicated in modulating inflammation in various diseases. This study aimed to explore the potential role of CTH in experimental periodontitis under a hyperglycemic condition.MethodsCTH‐silenced and normal human periodontal ligament cells (hPDLCs) were cultured in a high glucose and Porphyromonas gingivalis lipopolysaccharide (P.g‐LPS) condition. The effects of CTH on hPDLCs were assessed by Cell Counting Kit 8 (CCK8), real‐time quantitative polymerase chain reaction (RT‐qPCR), and enzyme‐linked immunosorbent assay (ELISA). The model of experimental periodontitis under hyperglycemia was established on both Cth−/− and wild‐type (WT) mice, and the extent of periodontal destruction was assessed by micro‐CT, histology, RNA‐Seq, Western blot, tartrate‐resistant acid phosphatase (TRAP) staining and immunostaining.ResultsCTH mRNA expression increased in hPDLCs in response to increasing concentration of P.g‐LPS stimulation in a high glucose medium. With reference to WT mice, Cth−/− mice with experimental periodontitis under hyperglycemia exhibited reduced bone loss, decreased leukocyte infiltration and hindered osteoclast formation, along with reduced expression of proinflammatory cytokines interleukin‐6 (IL‐6) and tumor necrosis factor alpha (TNF‐α) in periodontal tissue. RNA‐seq‐enriched altered NF‐κB pathway signaling in healthy murine gingiva with experimental periodontitis mice under hyperglycemia. Accordingly, phosphorylation of p65 (P‐p65) was alleviated in CTH‐silenced hPDLCs, leading to decreased expression of IL6 and TNF. CTH knockdown inhibited activation of nuclear factor kappa‐B (NF‐κB) pathway and decreased production of proinflammatory cytokines under high glucose and P.g‐LPS treatment.ConclusionThe present findings suggest the potential of CTH as a therapeutic target for tackling periodontitis in diabetic patients.
{"title":"Cystathionine γ‐lyase contributes to exacerbation of periodontal destruction in experimental periodontitis under hyperglycemia","authors":"Danni Song, Jiangfeng He, Tianfan Cheng, Lijian Jin, Sijin Li, Beibei Chen, Yongming Li, Chongshan Liao","doi":"10.1002/jper.23-0811","DOIUrl":"https://doi.org/10.1002/jper.23-0811","url":null,"abstract":"BackgroundDiabetes is one of the major inflammatory comorbidities of periodontitis via 2‐way interactions. Cystathionine γ‐lyase (CTH) is a pivotal endogenous enzyme synthesizing hydrogen sulfide (H<jats:sub>2</jats:sub>S), and CTH/H<jats:sub>2</jats:sub>S is crucially implicated in modulating inflammation in various diseases. This study aimed to explore the potential role of CTH in experimental periodontitis under a hyperglycemic condition.MethodsCTH‐silenced and normal human periodontal ligament cells (hPDLCs) were cultured in a high glucose and <jats:italic>Porphyromonas gingivalis</jats:italic> lipopolysaccharide (<jats:italic>P.g</jats:italic>‐LPS) condition. The effects of CTH on hPDLCs were assessed by Cell Counting Kit 8 (CCK8), real‐time quantitative polymerase chain reaction (RT‐qPCR), and enzyme‐linked immunosorbent assay (ELISA). The model of experimental periodontitis under hyperglycemia was established on both <jats:italic>Cth</jats:italic><jats:sup>−/−</jats:sup> and wild‐type (WT) mice, and the extent of periodontal destruction was assessed by micro‐CT, histology, RNA‐Seq, Western blot, tartrate‐resistant acid phosphatase (TRAP) staining and immunostaining.Results<jats:italic>CTH</jats:italic> mRNA expression increased in hPDLCs in response to increasing concentration of <jats:italic>P.g</jats:italic>‐LPS stimulation in a high glucose medium. With reference to WT mice<jats:italic>, Cth</jats:italic><jats:sup>−/−</jats:sup> mice with experimental periodontitis under hyperglycemia exhibited reduced bone loss, decreased leukocyte infiltration and hindered osteoclast formation, along with reduced expression of proinflammatory cytokines interleukin‐6 (IL‐6) and tumor necrosis factor alpha (TNF‐α) in periodontal tissue. RNA‐seq‐enriched altered NF‐κB pathway signaling in healthy murine gingiva with experimental periodontitis mice under hyperglycemia. Accordingly, phosphorylation of p65 (P‐p65) was alleviated in <jats:italic>CTH</jats:italic>‐silenced hPDLCs, leading to decreased expression of <jats:italic>IL6</jats:italic> and <jats:italic>TNF</jats:italic>. <jats:italic>CTH</jats:italic> knockdown inhibited activation of nuclear factor kappa‐B (NF‐κB) pathway and decreased production of proinflammatory cytokines under high glucose and <jats:italic>P.g</jats:italic>‐LPS treatment.ConclusionThe present findings suggest the potential of CTH as a therapeutic target for tackling periodontitis in diabetic patients.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"7 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141463085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Huang, Xiangying Ouyang, Bei Liu, Jianru Liu, Wenyi Liu, Ying Xie
BackgroundThe composite outcome measure (COM) more comprehensively assesses the clinical efficacy of regenerative surgery than a single probing measurement. We aimed to assess long‐term success defined by the COM (clinical attachment level [CAL] gain of ≥3 mm and postsurgery probing pocket depth [PPD] ≤ 4 mm) and influencing factors of regenerative surgery using bone substitutes and resorbable collagen membrane (RM) for intra‐bony defects (IBDs).MethodsWe retrospectively collected data from patients who underwent regenerative surgery using deproteinized bovine bone mineral (DBBM) and RM for IBDs. CAL and PPD values were compared at baseline (preoperative), 1 year (short‐term), and at the last follow‐up (5–10 years). Multivariate logistic regressions were performed to identify factors influencing COM‐based long‐term success.ResultsEighty‐one defects in 75 teeth of 33 patients who completed follow‐up (6.5 ± 1.4 years) were included. One tooth was lost. All defects with complete follow‐up exhibited long‐term average CAL gain (3.00 ± 2.00 mm, 95% confidence interval [CI]: 2.56–3.44 mm, p < 0.001) and PPD reduction (2.06 ± 1.91 mm, 95% CI: 1.64–2.49 mm, p < 0.001). Long‐term success was achieved in 38.8% of IBDs. CAL and PPD values were comparable between 1 year and the last follow‐up. Logistic regression analyses revealed that male sex (odds ratio [OR] = 0.23, 95% CI: 0.07–0.75) and bleeding on probing (BOP) during supportive periodontal therapy (OR = 0.96, 95% CI: 0.94–0.99) were risk factors for long‐term success.ConclusionsRegenerative surgery with DBBM and RM for IBDs can achieve some degree of long‐term success defined by COM. However, within this study's limitations, male sex and higher BOP incidence postoperatively are negatively associated with optimal long‐term success.Clinical trial numberChiCTR2300069016.
{"title":"Long‐term success and influencing factors of regenerative surgery for intra‐bony defects: A retrospective cohort study","authors":"Yan Huang, Xiangying Ouyang, Bei Liu, Jianru Liu, Wenyi Liu, Ying Xie","doi":"10.1002/jper.23-0701","DOIUrl":"https://doi.org/10.1002/jper.23-0701","url":null,"abstract":"BackgroundThe composite outcome measure (COM) more comprehensively assesses the clinical efficacy of regenerative surgery than a single probing measurement. We aimed to assess long‐term success defined by the COM (clinical attachment level [CAL] gain of ≥3 mm and postsurgery probing pocket depth [PPD] ≤ 4 mm) and influencing factors of regenerative surgery using bone substitutes and resorbable collagen membrane (RM) for intra‐bony defects (IBDs).MethodsWe retrospectively collected data from patients who underwent regenerative surgery using deproteinized bovine bone mineral (DBBM) and RM for IBDs. CAL and PPD values were compared at baseline (preoperative), 1 year (short‐term), and at the last follow‐up (5–10 years). Multivariate logistic regressions were performed to identify factors influencing COM‐based long‐term success.ResultsEighty‐one defects in 75 teeth of 33 patients who completed follow‐up (6.5 ± 1.4 years) were included. One tooth was lost. All defects with complete follow‐up exhibited long‐term average CAL gain (3.00 ± 2.00 mm, 95% confidence interval [CI]: 2.56–3.44 mm, <jats:italic>p </jats:italic>< 0.001) and PPD reduction (2.06 ± 1.91 mm, 95% CI: 1.64–2.49 mm, <jats:italic>p </jats:italic>< 0.001). Long‐term success was achieved in 38.8% of IBDs. CAL and PPD values were comparable between 1 year and the last follow‐up. Logistic regression analyses revealed that male sex (odds ratio [OR] = 0.23, 95% CI: 0.07–0.75) and bleeding on probing (BOP) during supportive periodontal therapy (OR = 0.96, 95% CI: 0.94–0.99) were risk factors for long‐term success.ConclusionsRegenerative surgery with DBBM and RM for IBDs can achieve some degree of long‐term success defined by COM. However, within this study's limitations, male sex and higher BOP incidence postoperatively are negatively associated with optimal long‐term success.Clinical trial numberChiCTR2300069016.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"18 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141462904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}