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Aim Matrix metalloproteinases ( MMPs) play a key role in the tissue destruction characteristic of chronic periodontitis. The purpose of this study was to investigate the association of MMP and TIMP polymorphisms with chronic periodontitis in two populations. Material and Methods A total of 34 polymorphisms spanning 12 MMP and 2 TIMP genes were genotyped in 401 individuals from Brazil (99 cases with chronic periodontitis and 302 controls), and 274 individuals from the US (70 cases and 204 controls). Individuals were considered cases if presenting at least three teeth exhibiting sites of clinical attachment loss ≥5 mm in two different quadrants. Controls were characterized by absence of clinical attachment loss and no sites with probing depth >3 mm. MMP3 and TIMP1 mRNA expression was evaluated in healthy and diseased periodontal tissues. Results TIMP1 showed association with chronic periodontitis in the Brazilian population (for rs5906435, p = 0.0004), whereas MMP3 showed association in the US population (for rs679620, p = 0.0003; and rs650108, p = 0.002) and in the Brazilian population (for rs639752, p = 0.005). MMP3 and TIMP1 mRNA expression was significantly higher in diseased tissues when compared to control tissues. Conclusions Our results further support a role for variations in MMP3 in chronic periodontitis and report a novel association with TIMP1. These genes may be considered additional candidate genes for chronic periodontitis. [ABSTRACT FROM AUTHOR]

Aim The aim of this 5-years longitudinal study was to investigate the pattern and rate of periodontal attachment loss ( PAL) progression in an urban population in South Brazil. Methods In 2001, a multistage probability sampling strategy was used to derive a representative sample of 1,465 dentate individuals from Porto Alegre, Brazil. Five years later, 697 dentate individuals (294 M/403 F, mean age: 37.9 ± 13.3) were available for follow-up. PAL was assessed by calibrated examiners using a full-mouth protocol. Estimates of proximal PAL progression and standard errors ( SE) are reported. Results Fifty-six per cent ( SE: 1.9) and 36% ( SE: 1.8) of subjects showed PAL progression ≥3 mm affecting ≥2 and ≥4 teeth respectively. PAL progression ≥3 mm was mostly localized affecting 3.8 ( SE: 0.2) teeth and 5.7 ( SE: 0.3) sites. Annual PAL progression was, on average, 0.3 mm ( SE: 0.01). Significant differences in PAL progression were observed according to age, gender, race and socioeconomic status. PAL progression increased with age reaching the highest progression rate in the 40-49 years cohort, and then decreased in older age groups. PAL progression was consistently higher among males and non-Whites than females and whites. Conclusion A large proportion of this urban Brazilian sample was affected by PAL progression underscoring the need for health promotion initiatives aiming at preventing progression of destructive periodontal disease. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the clinical efficacy of subgingival ultrasonic instrumentation irrigated with essential oils (EOs) of residual periodontal pockets. Material and methods: Sixty-four individuals with chronic periodontitis were invited to participate in this randomized, double-blind, parallel, and placebo-controlled clinical trial. All subjects received non-surgical periodontal therapy. After reevaluation (baseline), residual pockets (pocket depth ≥5 mm) received test (ultrasonic instrumentation irrigated with EOs) or control therapy (ultrasonic instrumentation irrigated with negative control). Probing pocket depth (PPD), gingival recession (R), clinical attachment level (CAL), bleeding on probing (BOP), and plaque were assessed at baseline and after 4, 12, and 24 weeks. Differences between groups and changes over the course of time were analysed according to a generalized linear model. Results: There was a significant reduction in PPD and BOP, as well as a significant CAL gain in the two groups (p<0.001). Nevertheless, there were no differences between the groups at any time of the study. When only initially deep pockets (PPD ≥7 mm) were analysed, a significantly greater CAL gain (p=0.03) and PPD reduction (p=0.01) was observed in the test group. Conclusion: The adjunctive use of EOs may promote significant CAL gain and PPD reduction in deep residual pockets. [ABSTRACT FROM AUTHOR]

Aim: The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in non-surgical periodontal therapy of subjects with severe chronic periodontitis. Materials and methods: Of the 201 subjects enrolled from a smoking cessation clinic, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every 3 months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. Results: Of the 93 eligible subjects, 52 remained in the study after 1 year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After 1 year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between the groups regarding clinical attachment level, probing depth, bleeding on probing and plaque index after 1 year (p>0.05). Conclusion: Smoking cessation promoted clinical attachment gain in chronic periodontitis subjects from a smoking cessation clinic after 1 year of follow-up. [ABSTRACT FROM AUTHOR]

Aim: To describe the distribution of clinical attachment loss (CAL) and to study risk indicators for chronic periodontitis in a large population-based sample of adolescents and young adults from south Brazil. Material and methods: This cross-sectional study used a subset of data from a larger survey representative of Porto Alegre, Brazil. The sample consisted of 612 individuals (291 males/321 females) aged 14-29 years. Full-mouth, six sites per tooth clinical examinations were performed by calibrated periodontists. Chronic periodontitis was defined as CAL ≥ 3 mm affecting two or more teeth. Aggressive periodontitis cases were excluded from the analysis. Results: CAL ≥ 3 and ≥ 5 mm affected 50.4% and 17.4% of subjects and 9.7% and 1.1% of teeth, respectively. Prevalence of chronic periodontitis ranged between 18.2% and 72.0% among subjects 14--19 and 24--29 years old, respectively. In the multivariable logistic regression analysis, older age [odds ratio (OR)52.6, 95% confidence interval (CI)51.7-3.9 and OR = 7.2, 95% CI = 3.7-14.0 for 20-24 and 25-29 years old, respectively], low socioeconomic status (OR = 1.9, 95% CI = 1.4-- 2.7), heavy smoking (OR = 1.7, 95% CI = 1.1-2.7) and larger amounts of calculus (OR = 2.0, 95% CI = 1.2-3.2) were significantly associated with chronic periodontitis. Conclusion: This population of adolescents and young adults had a high prevalence of chronic periodontitis, and its presence was associated with age, socioeconomic status, smoking and calculus. [ABSTRACT FROM AUTHOR]

Aim: This study compared the levels of tumour necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-4, IL-17 and IL-23 in the gingival crevicular fluid (GCF) from well-controlled and poorly controlled type 2 diabetic subjects with chronic periodontitis, before and after periodontal therapy. Material and Methods: Eighteen well-controlled (glycated haemoglobin levels 48%) and 20 poorly controlled (glycated haemoglobin levels 48%) diabetic subjects were enrolled in this study. All subjects were submitted to non-surgical periodontal therapy. GCF sampling and clinical periodontal parameters were assessed before, 3 and 6 months post-therapy. Total amounts and concentrations of TNF-α, IFN-γ, IL-4, IL-17 and IL-23 in the GCF were analysed by enzyme-linked immunosorbent assay (ELISA). Results: The levels of IL-17 were higher in poorly than in well-controlled subjects (p<0.05), whereas the levels of IFN-γ were increased in well- compared with poorly controlled subjects at all experimental groups (p<0.05). In addition, IL-4 levels were lower in well- than poorly controlled diabetic subjects at baseline (p<0.05). There were no differences between groups for TNF-α and IL-23 at any time points (p>0.05). Conclusion: These results indicate a predominance of pro-inflammatory T-helper type 1 (Th1)- or Th17-cytokines in sites of chronic periodontitis from type 2 diabetic subjects, according to their glycaemic control. [ABSTRACT FROM AUTHOR]