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Influence of residual pockets on periodontal tooth loss: A retrospective analysis 残留牙周袋对牙周牙齿脱落的影响:回顾性分析。
IF 4.3 2区 医学 Q1 Dentistry Pub Date : 2023-12-19 DOI: 10.1002/JPER.23-0448
Muhammad H. A. Saleh, Debora R. Dias, Obada Mandil, Ricardo P. de Oliveira, Abdusalam Alrmali, Maurício G. Araújo, Hom-Lay Wang, Zoltan Barath, Istvan A. Urban

Background

Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined “threshold” at which a patient's profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk.

Methods

Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc ≥ 5 mm or ≥6 mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model.

Results

Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5 mm (90.8%) or ≥6 mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5 mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4 mm/grade A. Grading exhibited the best discrimination and model fit.

Conclusion

Patients with RPc ≥5 mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5 mm displayed very good predictive capability of TLP.

背景:接受支持性牙周治疗(SPT)的患者仍有可能因牙周炎(TLP)而导致牙齿脱落。关于残余牙周袋(RPc)的影响以及将患者的情况设定为 TLP 高风险的 "阈值",文献中的证据很有限。因此,本研究旨在评估RPc对TLP的影响,并确定RPc与牙周炎分期和分级相比对TLP风险的预后效果:这项回顾性研究评估了168名牙周炎患者(3869颗牙齿)接受SPT治疗至少10年的临床数据。收集了每位患者的TLP和RPc≥5毫米或≥6毫米的部位百分比。采用多层次考克斯比例危险回归模型将RPc的预后表现与TLP的疾病分期和分级进行比较:在中位 25 年的随访中,13.7% 的牙齿脱落,其中 4.6% 是由于牙周炎造成的。大多数TLP患者有≥1个部位的RPc≥5毫米(90.8%)或≥6毫米(77.6%)。多变量多层次Cox回归显示,与RPc≤4毫米/A级相比,RPc≥5毫米的部位>15%的患者的危险比为2.34,C级的TLP危险比为4.6:结论:RPc≥5 mm的患者,>15%的部位有牙齿脱落的风险。分级和 RPc ≥5 mm 对 TLP 有很好的预测能力。
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引用次数: 0
Human gingival fibroblasts are a source of B cell-activating factor during periodontal inflammation 人牙龈成纤维细胞是牙周炎症期间 B 细胞活化因子的来源之一
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-12-13 DOI: 10.1002/JPER.23-0543
Ahed Dyab, Ava Emnegard, Magnus Wänman, Filippa Sjöström, Elin Kindstedt

Background

Host-modulating therapy is a possible treatment for individuals that respond poorly to conventional periodontal therapy. B cells, abundant in periodontitis lesions, require the cytokines B cell-activating factor (BAFF) and A proliferation-inducing ligand (APRIL) for survival and maturation. Although mRNA levels of BAFF and APRIL are increased in tissue from periodontitis lesions, it is unknown if periodontal resident cells express BAFF and/or APRIL during periodontal inflammation. In this study, we aim to analyze the expression of BAFF and APRIL in human gingival fibroblasts after stimulation with proinflammatory cytokines. Furthermore, we perform protein analysis in tissues and serum from periodontitis patients and healthy controls.

Methods

Human gingival fibroblasts were cultured and stimulated with the proinflammatory cytokines’ tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β). The mRNA expression of BAFF and APRIL was analyzed by real-time quantitative polymerase chain reaction (qPCR), and the protein was detected in tissue sections using immune staining. Serum levels of BAFF were analyzed with enzyme-linked immunosorbent assay (ELISA).

Results

In gingival fibroblasts, TNF-α upregulated BAFF mRNA, but APRIL was unaffected. IL-1β affected neither BAFF nor APRIL expression. BAFF protein was detected in the oral epithelium and in cells of the underlying connective tissue in periodontitis tissue, and BAFF protein was increased in the serum of periodontitis patients.

Conclusion

Periodontal resident cells express BAFF during periodontal inflammation and participate in providing a favorable milieu for the survival and action of B cells.

宿主调节疗法是对常规牙周治疗反应差的个体的一种可能的治疗方法。在牙周炎病变中大量存在的B细胞需要细胞因子B细胞活化因子(BAFF)和A增殖诱导配体(APRIL)来存活和成熟。虽然在牙周炎病变组织中BAFF和APRIL的mRNA水平升高,但尚不清楚牙周驻留细胞是否在牙周炎症期间表达BAFF和/或APRIL。本研究旨在分析促炎因子刺激后人牙龈成纤维细胞中BAFF和APRIL的表达情况。此外,我们在牙周炎患者和健康对照者的组织和血清中进行蛋白质分析。
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引用次数: 0
Harvest graft substitute for soft tissue volume augmentation around existing implants: A randomized, controlled and blinded multicenter trial 用于现有种植体周围软组织体积增大的收获移植替代物:随机、对照和盲法多中心试验
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-12-09 DOI: 10.1002/JPER.23-0305
Donald S. Clem, Pamela K. McClain, Michael K. McGuire, Chris R. Richardson, Greg A. Santarelli, Rachel A. Schallhorn, E. Todd Scheyer, John C. Gunsolley, Thiago Morelli

Background

Using a single-blind, randomized, controlled, multicenter, practice-based clinical trial, a volume-stable collagen matrix (VCMX) was compared with connective tissue graft (CTG) for soft tissue augmentation around existing dental implants.

Methods

Sixty patients (31 VCMX and 31 CTG) were included. The primary outcome was a soft tissue thickness change 3 mm below the gingival margin (GM). Secondary outcomes included clinical measures, such as keratinized tissue widths (KTw), probing pocket depths, and pink esthetic scores, and patient-reported outcomes (PRO).

Results

There were no significant differences between test and control patient demographics or clinical measures throughout the 1-year study. VCMX “grafts” were by design larger than CTG, and surgery time was less (27% less, p = 0.0005). Three millimeters below the GM (primary endpoint), tissue thickness increase was noninferior for VCMX compared with CTG (0.93 ± 0.80 mm vs. 1.10 ± 0.51 mm, respectively), inferior (by 0.25 mm) at 1 mm, and noninferior at 5 mm. Postoperative pain was significantly less for VCMX patients (p < 0.0001), but all other PRO measures, including esthetics and satisfaction, improved similarly for both therapies.

Conclusions

Given the inclusion criteria for this study, namely soft tissue augmentation around existing implants with some evidence of KTw and minimal recession, VCMX provided soft tissue thickness and volume increases similar (noninferior) to CTG. Clinical measures and PRO were similar between therapies—site sensitivity and esthetics improved similarly for both therapies—but surgery time and pain following surgery were significantly less for VCMX.

通过一项单盲、随机、对照、多中心、基于实践的临床试验,比较了体积稳定胶原基质(VCMX)和结缔组织移植(CTG)在现有牙科种植体周围软组织增量方面的效果。
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引用次数: 0
Melatonin supports nonsurgical periodontal treatment in patients with Type 2 diabetes mellitus and periodontitis: A randomized clinical trial 褪黑素支持2型糖尿病和牙周炎患者的非手术牙周治疗:一项随机临床试验
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-12-06 DOI: 10.1002/JPER.23-0335
Yagmur Sarac Gul, Oguz Kose, Ahmet Altin, Hatice Yemenoglu, Hatice Arslan, Kerimali Akyildiz, Adnan Yilmaz

Background

Diabetes mellitus (DM)-associated hyperinflammatory host response significantly provokes periodontal tissue destruction. In this context, the support of nonsurgical periodontal therapy in diabetics with host modulation agents is a current field of study. This clinical study aims to investigate the clinical efficacy of melatonin supplementation and discuss its possible biological mechanisms in nonsurgical periodontal treatment in patients with DM and periodontitis through some fundamental markers.

Methods

In this randomized controlled and single-blind study, 27 of 55 diabetic patients with periodontitis (stage III/IV and grade C) underwent full-mouth scaling and root planing (fmSRP) alone and 28 patients underwent melatonin administration (6 mg daily, 30 days) in addition to fmSRP (full-mouth scaling and root planing plus melatonin, fmSRP-mel). The potential therapeutic contribution of melatonin was evaluated clinically and biochemically (gingival crevicular fluid RANKL, OPG, MMP-8, and serum IL-1β levels) at 3rd and 6th months.

Results

Melatonin (tablet, 6 mg daily, 30 days) did not cause any local or systemic side effects. fmSRP alone resulted in significant reduction in serum IL-1β levels, pocket depths, gingival inflammation, and gingival crevicular fluid RANKL and MMP-8 levels (p < 0.05). Moreover, melatonin supplementation resulted in a more significant decrease in bleeding and pocket depth scores at probing, especially at 3 months (p < 0.05). Furthermore, RANKL and MMP-8 levels were significantly lower at 3 months and IL-1β levels at 6 months compared to the control group (p < 0.05). However, OPG levels were not affected significantly by the treatments (p > 0.05).

Conclusion

Melatonin, as a host modulation agent, significantly increases the clinical efficacy of fmSRP. The reduction in periodontal inflammation and pocket depths may be a result of marked suppression of RANKL-associated osteoclastogenesis and extracellular matrix damage by melatonin.

背景:糖尿病(DM)相关的高炎症宿主反应显著地引起牙周组织破坏。在这种情况下,支持使用宿主调节剂对糖尿病患者进行非手术牙周治疗是当前研究的一个领域。本临床研究旨在通过一些基础标志物探讨褪黑素在糖尿病合并牙周炎患者非手术牙周治疗中的临床疗效,并探讨其可能的生物学机制。方法:在这项随机对照单盲研究中,55名患有牙周炎的糖尿病患者(III/IV期和C级)中有27名患者单独接受了全口洗牙和牙根刨平(fmSRP)治疗,28名患者在fmSRP(全口洗牙和牙根刨平加褪黑素,fmSRP-mel)治疗的基础上接受了褪黑素治疗(每天6 mg, 30天)。在第3个月和第6个月对褪黑素的潜在治疗作用进行临床和生化评估(龈沟液RANKL、OPG、MMP-8和血清IL-1β水平)。结果:褪黑素(片剂,每日6毫克,30天)未引起任何局部或全身副作用。单用fmSRP可显著降低血清IL-1β水平、龈袋深度、牙龈炎症、龈沟液RANKL和MMP-8水平(p 0.05)。结论:褪黑素作为宿主调节剂,可显著提高fmSRP的临床疗效。牙周炎症和牙袋深度的减少可能是褪黑素显著抑制rankl相关的破骨细胞生成和细胞外基质损伤的结果。
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引用次数: 0
Resolution of peri-implant mucositis following standard treatment: A prospective split-mouth study 标准治疗后种植体周围粘膜炎的解决:一项前瞻性裂口研究。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-12-02 DOI: 10.1002/JPER.23-0507
Mia Rakic, Zoran Tatic, Sandro Radovanovic, Aleksandra Petkovic-Curcin, Danilo Vojvodic, Alberto Monje

Background

Peri-implant mucositis (PIM) is a pathological precursor of peri-implantitis, but its pattern of conversion to peri-implantitis is unclear and complicated to diagnose clinically, while none of the available protocols yield complete disease resolution. The aim of this study was the evaluation of PIM responsiveness to standard anti-infective mechanical treatment (AIMT) at clinical and biomarker levels, and estimation of the diagnostic capacity of bone markers as surrogate endpoints and predictors.

Methods

Systemically healthy outpatients presenting one implant exhibiting clinical signs of inflammation confined within the soft tissue (PIM) and one healthy control (HC) implant at a non-adjacent position were included. Clinical parameters and peri-implant crevicular fluid samples were collected baseline and 6 months following mechanical therapy, to assess the levels of RANKL, OPG, and IGFBP2. PIM clustering was performed using machine learning algorithms.

Results

Overall, 38 patients met the inclusion criteria. Therapy resulted in the reduction of all clinical and biological indicators, but respective values remained significantly higher compared to HC. Clinical examination noted 30% disease resolution at the 6-month follow-up, while 43% showed no active bone resorption. OPG showed positive prognostic value for treatment outcome, while the clustering based on active bone resorption did not differ in terms of therapeutic effectiveness.

Conclusion

AIMT is effective in reducing the clinical and biological indicators of PIM, but complete clinical resolution was achieved in only 30% of the cases. Around one third of PIM patients exhibited active bone resorption bellow clinical detectability that was not associated with disease progression and poor treatment responsiveness.

背景:种植体周围粘膜炎(PIM)是种植体周围炎的病理前兆,但其转化为种植体周围炎的模式尚不清楚,临床上诊断复杂,而现有的方案均不能完全解决疾病。本研究的目的是在临床和生物标志物水平上评估PIM对标准抗感染机械治疗(AIMT)的反应性,并评估骨标志物作为替代终点和预测因子的诊断能力。方法:纳入系统健康门诊患者,其中一个种植体表现出软组织内炎症的临床症状(PIM),另一个健康对照(HC)种植体位于非邻近位置。基线和机械治疗后6个月收集临床参数和种植体周围沟液样本,评估RANKL、OPG和IGFBP2水平。使用机器学习算法进行PIM聚类。结果:38例患者符合纳入标准。治疗导致所有临床和生物学指标降低,但与HC相比,各自的值仍显着较高。临床检查显示,在6个月的随访中,30%的疾病消退,而43%的患者骨吸收不活跃。OPG对治疗结果有积极的预后价值,而基于主动骨吸收的聚类在治疗效果方面没有差异。结论:AIMT能有效降低PIM的临床及生物学指标,但临床完全缓解的病例仅占30%。大约三分之一的PIM患者表现出活跃的骨吸收低于临床可检测性,这与疾病进展和治疗反应性差无关。
{"title":"Resolution of peri-implant mucositis following standard treatment: A prospective split-mouth study","authors":"Mia Rakic,&nbsp;Zoran Tatic,&nbsp;Sandro Radovanovic,&nbsp;Aleksandra Petkovic-Curcin,&nbsp;Danilo Vojvodic,&nbsp;Alberto Monje","doi":"10.1002/JPER.23-0507","DOIUrl":"10.1002/JPER.23-0507","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peri-implant mucositis (PIM) is a pathological precursor of peri-implantitis, but its pattern of conversion to peri-implantitis is unclear and complicated to diagnose clinically, while none of the available protocols yield complete disease resolution. The aim of this study was the evaluation of PIM responsiveness to standard anti-infective mechanical treatment (AIMT) at clinical and biomarker levels, and estimation of the diagnostic capacity of bone markers as surrogate endpoints and predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systemically healthy outpatients presenting one implant exhibiting clinical signs of inflammation confined within the soft tissue (PIM) and one healthy control (HC) implant at a non-adjacent position were included. Clinical parameters and peri-implant crevicular fluid samples were collected baseline and 6 months following mechanical therapy, to assess the levels of RANKL, OPG, and IGFBP2. PIM clustering was performed using machine learning algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 38 patients met the inclusion criteria. Therapy resulted in the reduction of all clinical and biological indicators, but respective values remained significantly higher compared to HC. Clinical examination noted 30% disease resolution at the 6-month follow-up, while 43% showed no active bone resorption. OPG showed positive prognostic value for treatment outcome, while the clustering based on active bone resorption did not differ in terms of therapeutic effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AIMT is effective in reducing the clinical and biological indicators of PIM, but complete clinical resolution was achieved in only 30% of the cases. Around one third of PIM patients exhibited active bone resorption bellow clinical detectability that was not associated with disease progression and poor treatment responsiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/JPER.23-0507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of bone defect morphology for the adjunctive use of bone grafting combined with enamel matrix derivative: A 3-year cohort study 牙釉质基质衍生物联合植骨辅助使用的骨缺损形态学评估:一项为期3年的队列研究
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-29 DOI: 10.1002/JPER.23-0538
Takanori Matsuura, Risako Mikami, Koji Mizutani, Hidehiro Shioyama, Norio Aoyama, Tomonari Suda, Yukako Kusunoki, Kohei Takeda, Yuichi Izumi, Jun Aida, Akira Aoki, Takanori Iwata

Background

There have been limited studies with statistically sufficient sample sizes for assessment of suitable bone defect morphology for combination therapy with enamel matrix derivative (EMD) and bone grafting. The aim of this study was to investigate the appropriate feature of intrabony defects, such as bone defect angle (DA) and the containment by bony wall, for yielding the additional benefit of bone grafting in combination with periodontal regenerative therapy using EMD.

Methods

Following periodontal regenerative therapy using EMD with or without autologous bone grafting, 282 intrabony defects of 177 participants were maintained for 3 years. Multilevel linear regression analysis was performed to evaluate the radiographic bony defect depth (RBD) reduction after adjusting for confounders.

Results

The baseline parameters, except for the proportion of contained bony defects and tooth mobility, did not differ significantly between the groups with and without bone grafts. There was no significant difference in the improvement of clinical parameters between the groups. The 1- and 3-year reduction of RBD showed significant inverse correlations with preoperative DA only in the group without bone graft. Furthermore, multivariate analysis showed a significant interaction between DA at baseline ≥40° and adjunctive bone grafting in the reduction of RBD, regardless of the number of bony walls.

Conclusion

Adjunctive autologous bone grafting with enamel matrix derivative might be significantly beneficial for defect depth improvement in the case of DA at baseline ≥40°.

在评估牙釉质基质衍生物(EMD)和骨移植联合治疗的合适骨缺损形态方面,有统计学上足够样本量的有限研究。本研究的目的是探讨骨内缺损的适当特征,如骨缺损角(DA)和骨壁的遏制,以获得骨移植结合EMD牙周再生治疗的额外好处。
{"title":"Assessment of bone defect morphology for the adjunctive use of bone grafting combined with enamel matrix derivative: A 3-year cohort study","authors":"Takanori Matsuura,&nbsp;Risako Mikami,&nbsp;Koji Mizutani,&nbsp;Hidehiro Shioyama,&nbsp;Norio Aoyama,&nbsp;Tomonari Suda,&nbsp;Yukako Kusunoki,&nbsp;Kohei Takeda,&nbsp;Yuichi Izumi,&nbsp;Jun Aida,&nbsp;Akira Aoki,&nbsp;Takanori Iwata","doi":"10.1002/JPER.23-0538","DOIUrl":"10.1002/JPER.23-0538","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There have been limited studies with statistically sufficient sample sizes for assessment of suitable bone defect morphology for combination therapy with enamel matrix derivative (EMD) and bone grafting. The aim of this study was to investigate the appropriate feature of intrabony defects, such as bone defect angle (DA) and the containment by bony wall, for yielding the additional benefit of bone grafting in combination with periodontal regenerative therapy using EMD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following periodontal regenerative therapy using EMD with or without autologous bone grafting, 282 intrabony defects of 177 participants were maintained for 3 years. Multilevel linear regression analysis was performed to evaluate the radiographic bony defect depth (RBD) reduction after adjusting for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The baseline parameters, except for the proportion of contained bony defects and tooth mobility, did not differ significantly between the groups with and without bone grafts. There was no significant difference in the improvement of clinical parameters between the groups. The 1- and 3-year reduction of RBD showed significant inverse correlations with preoperative DA only in the group without bone graft. Furthermore, multivariate analysis showed a significant interaction between DA at baseline ≥40° and adjunctive bone grafting in the reduction of RBD, regardless of the number of bony walls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adjunctive autologous bone grafting with enamel matrix derivative might be significantly beneficial for defect depth improvement in the case of DA at baseline ≥40°.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138455889","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}
引用次数: 0
Enhanced periodontal tissue healing via vascular endothelial growth factor expression following low-level erbium-doped: yttrium, aluminum, and garnet laser irradiation: In vitro and in vivo studies 低水平掺铒:钇、铝和石榴石激光照射后通过血管内皮生长因子表达增强牙周组织愈合:体外和体内研究
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-27 DOI: 10.1002/JPER.23-0458
Shu Takemura, Koji Mizutani, Risako Mikami, Keita Nakagawa, Masahiro Hakariya, Eri Sakaniwa, Natsumi Saito, Hiromi Kominato, Daisuke Kido, Kohei Takeda, Akira Aoki, Takanori Iwata

Background

This study aimed to investigate the effects of low-level erbium-doped: yttrium, aluminum, and garnet (Er:YAG) laser irradiation on periodontal tissue healing and regeneration through angiogenesis in vivo and in vitro studies.

Methods

Intrabony defects were surgically created in the bilateral maxilla molar of rats. The defects were treated by open flap debridement (OFD) with Er:YAG laser, including low-level laser irradiation (LLLI) to bone and blood clot surfaces, or conventional procedures. The mRNA expression of vascular endothelial growth factor (VEGF) in the surgical sites was quantified using real-time polymerase chain reaction. The decalcified specimens were prepared for histometric analysis. Also, LLLI was performed on human umbilical vein endothelial cells to evaluate the effects on angiogenesis. Cell proliferation, VEGF expression, and tube formation were assessed. In addition, capsazepine (CPZ), a selective inhibitor of transient receptor potential vanilloid 1 (TRPV1), treatment was performed before LLLI for the same assays.

Results

OFD using Er:YAG laser did not generate thermal damage on bone or root surfaces. LLLI accelerated hemostasis by coagulation of the superficial layers of blood clots in the laser-treated group. Postoperative healing was sound in all animals in both groups. VEGF expression and bone formation were significantly increased in the laser-treated group compared to those in the conventional treatment group. In vitro, cell proliferation and VEGF expression were significantly increased in the LLLI group compared to the control group. Tube-formation assays showed that LLLI significantly promoted angiogenesis. CPZ treatment significantly suppressed VEGF expression and tube formation following LLLI.

Conclusions

This study suggests that Er:YAG laser irradiation may promote periodontal tissue healing by enhancing angiogenetic effect of endothelial cells via TRPV1.

背景:本研究旨在探讨低水平掺铒:钇,铝和石榴石(Er:YAG)激光照射对牙周组织血管生成愈合和再生的影响。方法:对大鼠双侧上颌磨牙进行骨内缺损手术修复。缺损采用Er:YAG激光开瓣清创(OFD)治疗,包括低水平激光照射(LLLI)骨和血凝块表面,或常规手术。采用实时聚合酶链反应定量检测手术部位血管内皮生长因子(VEGF) mRNA表达。制备脱钙标本进行组织计量学分析。并对人脐静脉内皮细胞进行了LLLI实验,以评估其对血管生成的影响。评估细胞增殖、VEGF表达和管形成情况。此外,辣椒素(CPZ)是一种瞬时受体电位香草素1 (TRPV1)的选择性抑制剂,在LLLI之前进行了同样的检测。结果:Er:YAG激光OFD对骨和根表面均无热损伤。在激光治疗组中,LLLI通过凝固血凝块的浅层来加速止血。两组动物术后愈合良好。与常规治疗组相比,激光治疗组VEGF表达和骨形成明显增加。在体外,与对照组相比,LLLI组细胞增殖和VEGF表达明显增加。成管实验表明,LLLI显著促进血管生成。CPZ处理显著抑制血管内皮生长因子的表达和LLLI后的小管形成。结论:Er:YAG激光照射可能通过增强内皮细胞TRPV1血管生成作用促进牙周组织愈合。
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引用次数: 0
Possible role of annexin A1/FPR2 pathway in COX2/NLRP3 inflammasome regulation in alveolar bone cells of estrogen-deficient female rats with diabetes mellitus 膜联蛋白A1/FPR2通路在雌激素缺乏雌性糖尿病大鼠牙槽骨细胞COX2/NLRP3炎性体调控中的可能作用
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-21 DOI: 10.1002/JPER.23-0530
Gisela Rodrigues Da Silva Sasso, Paulo Sérgio Cerri, Estela Sasso-Cerri, Manuel Jesus Simões, Cristiane Damas Gil, Rinaldo Florencio-Silva

Background

Annexin A1 (ANXA1) and the NOD-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome play important roles in bone remodeling. However, expression profiles of these factors in bone cells under diabetes mellitus (DM) and estrogen-deficient conditions are poorly understood. This study investigated the immunoexpression of ANXA1 and its formyl peptide receptor 2 (FPR2), as well as NLRP3 inflammasome mediators, during remodeling of the alveolar process in diabetic and estrogen-deficient rats.

Methods

Twenty adult female Wistar rats were divided into four groups (n = 5): Sham-operated (SHAM) and ovariectomized (OVX) rats received a vehicle solution, and SHAM and OVX rats were intraperitoneally administered 60 mg/kg/body weight (BW) of streptozotocin (STZ) to induce DM (SHAM-Di and OVX-Di groups). After 7 weeks, the rats were euthanized and their maxillae were fixed in phosphate-buffered 4% formaldehyde and embedded in paraffin. Sections were stained with hematoxylin/eosin (H&E) and picrosirius red or subjected to immunohistochemical detection of ANXA1, FPR2, NLRP3, interleukin-1β (IL-1β), and cyclooxygenase-2 (COX2).

Results

Estrogen deficiency and DM were associated with deleterious effects in bone tissue, as evidenced by a lower number of osteocytes and higher number of empty lacunae in the SHAM-Di and OVX-Di groups compared to the nondiabetic groups. Both diabetic groups showed a smaller vascular area and weaker collagen fiber birefringence intensity in alveolar bone tissue. A significantly higher number of ANXA1/FPR2-positive osteoblasts, osteocytes, and osteoclasts was accompanied by a significantly higher number of these cells immunolabeled for COX2, NLRP3, and IL-1β in the diabetic and OVX groups, especially in both estrogen-deficient and diabetic rats.

Conclusion

These results indicate a possible role for the ANXA1/FPR2 pathway as a fine-tuning/anti-inflammatory regulator to counterbalance exacerbated COX2/NLRP3/IL-1β activation in bone cells during bone remodeling under estrogen deficiency and DM.

背景:膜联蛋白A1 (ANXA1)和nod样受体家族pyrin结构域蛋白3 (NLRP3)炎性体在骨重塑中发挥重要作用。然而,在糖尿病(DM)和雌激素缺乏的情况下,这些因子在骨细胞中的表达谱知之甚少。本研究研究了糖尿病和雌激素缺乏大鼠肺泡过程重构过程中ANXA1及其甲酰基肽受体2 (FPR2)以及NLRP3炎症小体介质的免疫表达。方法:将20只成年雌性Wistar大鼠分为4组(n = 5):假手术(SHAM)和去卵巢(OVX)大鼠给予载药液,假手术(SHAM)和去卵巢(OVX)大鼠分别腹腔注射链脲佐菌素(STZ) 60 mg/kg/体重(BW)诱导DM (SHAM- di组和OVX- di组)。7周后处死大鼠,用4%甲醛磷酸盐缓冲液固定上颌骨,石蜡包埋。切片采用苏木精/伊红(H&E)和小红染色或免疫组化检测ANXA1、FPR2、NLRP3、白细胞介素-1β (IL-1β)和环氧化酶-2 (COX2)。结果:雌激素缺乏和糖尿病与骨组织的有害影响有关,与非糖尿病组相比,SHAM-Di和OVX-Di组骨细胞数量减少,空腔隙数量增加。两组患者牙槽骨组织血管面积减小,胶原纤维双折射强度减弱。在糖尿病和OVX组中,尤其是在雌激素缺乏和糖尿病大鼠中,ANXA1/ fpr2阳性的成骨细胞、骨细胞和破骨细胞数量显著增加,同时这些细胞免疫标记为COX2、NLRP3和IL-1β的数量显著增加。结论:这些结果表明,在雌激素缺乏和糖尿病的骨重塑过程中,ANXA1/FPR2通路可能作为一种微调/抗炎调节剂,抵消骨细胞中COX2/NLRP3/IL-1β活化的加剧。
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引用次数: 0
Association of environmental polycyclic aromatic hydrocarbons exposure with periodontitis in NHANES 2009–2014: A mixtures approach NHANES 2009-2014中环境多环芳烃暴露与牙周炎的关系:混合方法。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-11-21 DOI: 10.1002/JPER.23-0428
Jinqiu Sun, Feifei Guo, Lin Wang, Fulei Han, Jia Yang, Shengli Gao

Background

Polycyclic aromatic hydrocarbons (PAHs) can invade and cause harm to the human body through various pathways, but there is currently little research on the relationship between mixed-PAHs exposure and periodontitis. The purpose of this study was to examine the effects of mixed-urinary PAHs exposure on periodontitis in adults in the United States.

Methods

The cross-sectional study included 2749 subjects selected from the National Health and Nutrition Examination Survey (NHANES) 2009–2014 cycles. A professional examination of the periodontal status was conducted to distinguish between periodontitis and non-periodontitis based on the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) case definition. Laboratory testing of urine samples was performed to obtain the levels of urinary PAHs. Pearson correlation coefficients were utilized to determine the degree of correlation between urinary PAHs, while weighted binary logistic regression and Bayesian kernel machine regression (BKMR) were employed to evaluate the relationship between urinary PAHs and periodontitis.

Results

In a single-exposure model, 3-hydroxyfluorene (OH-3F), 2-hydroxyfluorene (OH-2F), 1-hydroxyphenanthrene (OH-1Ph), and 2-hydroxyphenanthrene and 3-hydroxyphenanthrene (OH-2,3Ph) were positively associated with periodontitis risk. In the mixed-exposure model, BKMR analysis demonstrated that mixed exposure to urinary PAHs was positively associated with periodontitis, with OH-2F being the most critical factor for the overall mixed effects (posterior inclusion probability [PIP] = 0.98). Univariate exposure–response function and univariate effects analysis revealed a positive correlation between urinary OH-2F levels and periodontitis.

Conclusions

The study reveals a significant positive correlation between exposure to mixed PAHs and periodontitis, with a particular emphasis on the pivotal role of OH-2F. Mitigating PAHs in the environment may serve as a preventive measure against periodontitis and alleviate its global public health burden.

背景:多环芳烃(Polycyclic aromatic hydrocarbons, PAHs)可通过多种途径侵入人体并对其造成危害,但目前关于混合PAHs暴露与牙周炎之间关系的研究很少。本研究的目的是检查混合尿多环芳烃暴露对美国成人牙周炎的影响。方法:横断面研究纳入2009-2014年全国健康与营养检查调查(NHANES)周期的2749名受试者。根据疾病控制和预防中心/美国牙周病学会(CDC/AAP)的病例定义,对牙周状况进行专业检查,以区分牙周炎和非牙周炎。对尿液样本进行了实验室检测,以获得尿液中多环芳烃的水平。采用Pearson相关系数确定尿中多环芳烃与牙周炎的相关程度,采用加权二元logistic回归和贝叶斯核机回归(BKMR)评估尿中多环芳烃与牙周炎的关系。结果:在单次暴露模型中,3 -羟基芴(OH-3F)、2-羟基芴(OH-2F)、1-羟基菲(OH-1Ph)、2-羟基菲和3-羟基菲(oh - 2,3ph)与牙周炎风险呈正相关。在混合暴露模型中,BKMR分析表明,混合暴露于尿液多环芳烃与牙周炎呈正相关,OH-2F是整体混合效应的最关键因素(后验包含概率[PIP] = 0.98)。单因素暴露-反应函数和单因素效应分析显示尿OH-2F水平与牙周炎呈正相关。结论:本研究揭示了混合多环芳烃暴露与牙周炎之间的显著正相关,并特别强调了OH-2F的关键作用。减少环境中的多环芳烃可作为预防牙周炎和减轻其全球公共卫生负担的措施。
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引用次数: 0
Mediating role of systemic inflammation in the association between heavy metals exposure and periodontitis risk 全身炎症在重金属暴露与牙周炎风险之间的中介作用。
IF 4.3 2区 医学 Q1 Dentistry Pub Date : 2023-11-21 DOI: 10.1002/JPER.23-0079
Mi Du, Ke Deng, Qingqing Cai, Shixian Hu, Yuntao Chen, Shulan Xu, Geerten-Has E. Tjakkes, Shaohua Ge, Minghua Ge, An Li

Background

This study evaluated the mediating role of systemic inflammation in the association between exposure to heavy metals and periodontitis in a nationwide sample of adults.

Methods

Pooled cross-sectional data from the National Health and Nutrition Examination Survey (NHANES 2009-2014) were used (n = 8993). Periodontitis was defined by a full-mouth examination and classified as no/mild and moderate/severe (mod/sev) groups. Blood and urinary heavy metal levels were investigated, including cadmium (Cd), lead (Pb), and mercury (Hg). In addition, systemic inflammation was assessed using circulatory leukocyte counts and C-reactive protein (CRP) levels.

Results

Multivariable logistic regression analysis revealed the positive associations of blood and urinary levels of Cd and Pb with mod/sev periodontitis. In contrast,blood Hg levels did not show a significant association. The odds of having periodontitis were 1.233 and 1.311 times higher for each one-unit increment in Ln-transformed blood Cd (95% confidence interval [CI]: 1.109–1.371) and Pb (95% CI: 1.170-1.470), respectively. Mediation analysis suggested a 6.3% to 11.5% contribution of leucocyte counts in the association of blood Cd and Pb levels with periodontitis. Sensitivity analyses for urinary Cd levels yielded consistent mediating effects. However, no significant mediating effect of CRP was detected.

Conclusion

Higher exposures to Cd and Pb were positively associated with periodontitis risk. These associations might be partially mediated by the elevated levels of leukocytes rather than CRP. Further longitudinal studies are needed to elucidate the discordant results of the systemic inflammatory biomarkers.

背景:本研究在全国成人样本中评估了全身炎症在重金属暴露和牙周炎之间的中介作用。方法:采用国家健康与营养检查调查(NHANES 2009-2014)的汇总横截面数据(n = 8993)。通过全口检查确定牙周炎,并将其分为无/轻度和中度/重度(mod/sev)组。研究了血液和尿液中的重金属水平,包括镉(Cd)、铅(Pb)和汞(Hg)。此外,使用循环白细胞计数和c反应蛋白(CRP)水平评估全身炎症。结果:多变量logistic回归分析显示血、尿Cd、Pb水平与modv /sev牙周炎呈正相关。相比之下,血液中汞含量没有显示出显著的关联。ln转化血Cd(95%可信区间[CI]: 1.109-1.371)和Pb(95%可信区间:1.170-1.470)每增加一个单位,患牙周炎的几率分别高出1.233倍和1.311倍。中介分析表明,白细胞计数在血液Cd和Pb水平与牙周炎的关系中起6.3%至11.5%的作用。尿中Cd水平的敏感性分析得出了一致的中介效应。而CRP未见明显的介导作用。结论:较高的镉、铅暴露与牙周炎风险呈正相关。这些关联可能部分是由白细胞水平升高介导的,而不是CRP。需要进一步的纵向研究来阐明系统性炎症生物标志物的不一致结果。
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引用次数: 0
期刊
Journal of periodontology
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