Search

Aim: The purpose of the present study was to assess the association of interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-A) and lymphotoxin alpha (LT-A) gene polymorphisms with the clinical parameters of gingivitis in a large experimental gingivitis trial and with each of two subgroups, "high responder" (HR, n = 24) and "low responder" (LR, n = 24), with distinct susceptibility to gingivitis. Material and Methods: Ninety-six systemically and periodontally healthy non-smokers, 46 males (mean age: 23.9 ± 1.7) and 50 females (mean age: 23.3 ± 1.6), were included in a randomized split-mouth localized 21-day experimental gingivitis trial. Plaque index, gingival index, gingival crevicular fluid volume and angulated bleeding score were recorded. HR and LR subgroups were characterized by substantially different severities of gingival inflammation despite a similar plaque accumulation rate. All subjects were genetically characterized for IL-6 - 174 , IL-6 -597 , TNF-A -308 and LT-A +252 polymorphisms. Results: None of the variants analysed, either as single polymorphisms or as a combined genotype, was associated with the clinical parameters in the overall population. For the polymorphisms studied, genotypic distributions in HR and LR subjects were not significantly different. Conclusions: The present results suggest an absence of association between IL-6, TNF-A and LT-A polymorphisms and subject-based clinical behaviour of the gingiva in response to de novo plaque accumulation.

Objectives: The objective of the present randomized controlled trial was to evaluate the efficacy of a mouthrinse containing a combination of AmF/SnF 2 in controlling supragingival plaque accumulation and gingival inflammation during a 12-week period in patients affected by generalized aggressive periodontitis (GAP). Methods: Eighteen subjects, six males and 12 females, mean age: 32.2 years, were evaluated. One-half of the patients was either prescribed an AmF/SnF 2 -containing mouthrinse (test mouthrinse) or a control mouthrinse in addition to mechanical plaque control for 12 weeks. After a 2-week wash-out period, the patients received the alternative mouthrinse. Before and after treatment plaque index (PII), gingival index (GI), angulated bleeding index (AngBI), tooth stain (GMSI), and tongue stain were recorded. Results: Test mouthrinse resulted in a statistically significant decrease in PII (p = 0.029) and GI (p = 0.017). After treatment, PII was significantly lower in test compared to control mouthrinse (p = 0.027). GMSI significantly increased posttreatment for both mouthrinse regimens (p

Objectives: The purpose of the present parallel-design, controlled clinical trial was to evaluate the treatment outcome of periodontal furcation defects following flap debridement surgery (FDS) procedure in cigarette smokers compared to non-smokers. Materials and Methods: After initial therapy, 31 systemically healthy subjects with moderate to advanced periodontitis, who presented at least one Class I or II molar furcation defect, were selected. Nineteen patients (mean age: 40.3 years, 15 males) were smokers (≥10 cigarettes/day) and 12 patients (mean age: 44.8 years, 3 males) were non-smokers. Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS), probing pocket depth (PPD), vertical clinical attachment level (v-CAL), and horizontal clinical attachment level (h-CAL) were assessed immediately before and 6 months following surgery. Results: Overall, statistically significant v-CAL gain was observed in smokers (1.0 ± 1.3 mm) and non-smokers (1.3±1.1 mm), the difference between groups being statistically significant (p=0.0003). In proximal furcation defects, v-CAL gain amounted to 2.3±0.7 mm in non-smokers as compared to 1.0±1.1 mm in smokers (p=0.0013). At 6 months postsurgery, non-smokers presented a greater h-CAL gain (1.3±1.1 mm) than smokers (0.6±1.0 mm), with a statistically significant difference between groups (p=0.0089). This trend was confirmed in both facial/lingual (1.4±1.0 versus 0.8±0.8 mm) and proximal furcation defects (1.2±1.3 versus 0.5±1.2 mm). The proportion of Class II furcations showing improvement to postsurgery Class I was 27.6% in smokers and 38.5% in non-smokers. After 6 months, 3.4% of presurgery Class I furcation defects in smokers showed complete closure, as compared to 27.8% in non-smokers. Conclusions: The results of the present study indicated that (1) FDS produced clinically and statistically significant PPD reduction, v-CAL gain, and h-CAL gain in Class I/II molar furcation defects, and (2) cigarette smokers exhibited a less favorable healing outcome following surgery in terms of both v-CAL and h-CAL gain.

AimMany studies investigated the role of genetic variants in periodontitis, but few were established as risk factors. We aimed to validate the associations of recent candidate genes in aggressive periodontitis (AgP).Material and MethodsWe analysed 23 genes in 600 German AgP patients and 1441 controls on the Illumina custom genotyping array Immunochip. We tested a suggestive association in a Dutch and German/Austrian AgP case-control sample, and a German chronic periodontitis (CP) case-control sample using Sequenom iPlex assays. We additionally tested the common known risk variant rs1333048 of the gene ANRIL for its association in a Turkish and Italian population.ResultsNone of the analysed genes gave statistical evidence for association. Upon covariate adjustment for smoking and gender, in the pooled German-Austrian AgP sample, IL10 SNP rs6667202 was associated with p = 0.016, OR = 0.77 (95% CI = 0.6-0.95), and in the Dutch AgP sample, adjacent IL10 SNP rs61815643 was associated with p = 0.0009, OR = 2.31 (95% CI = 1.4-3.8). At rs61815643, binding of the transcription factor PPARG was predicted. ANRIL rs1333048 was associated in the Turkish sample (pallelic = 0.026, OR = 1.67 [95% CI = 1.11-2.60]).ConclusionsPrevious candidate genes carry no susceptibility factors for AgP. Association of IL-10 rs61815643 with AgP is suggested. ANRIL is associated with periodontitis across different populations.

Trombelli L, Rizzi A, Simonelli A, Scapoli C, Carrieri A, Farina R. Age-related treatment response following non-surgical periodontal therapy. J Clin Periodontol 2010; 37: 346–352. doi: 10.1111/j.1600-051X.2010.01541.x. Abstract Background: To date, no studies have evaluated the effect of patient age on the treatment response following non-surgical periodontal therapy (NSPT). Aim: To evaluate the outcomes of NSPT in two cohorts of patients with a substantial age difference. Materials and Methods: Two groups of periodontitis patients with a substantial age difference (younger group, Y, and older group, O) were retrospectively selected. The effectiveness of NSPT was assessed by evaluating the changes in the prevalence of sites with different pocket probing depths (PPD) as well as the changes in patient- and site-specific bleeding on probing (BoP) scores. Results: Y group comprised 57 patients, mean age: 34.7 ± 4.4 years, and O group comprised 60 patients, mean age: 58.9 ± 5.3 years (p

AIMS To evaluate the interleukin-1 beta (IL-1 beta) levels in gingival crevicular fluid (GCF) and serum in either naturally occurring (N-O) or experimentally induced (E-I) plaque-associated gingivitis. MATERIAL AND METHODS Thirty-seven periodontally healthy subjects were evaluated in real life conditions (N-O gingivitis) as well as after 21 days of experimental gingivitis trial (E-I gingivitis). During the experimental gingivitis trial, in one maxillary quadrant (test quadrant), gingival inflammation was induced by oral hygiene abstention, while in the contralateral (control) quadrant, oral hygiene was routinely continued. IL-1 beta concentrations in N-O and E-I gingivitis were investigated for IL-1B(+3954) and IL-1B(-511) gene polymorphisms. RESULTS (i) GCF IL-1 beta concentrations in E-I gingivitis were significantly higher compared with N-O gingivitis; (ii) an intra-individual correlation between GCF concentrations of IL-1 beta detected in N-O and E-I gingivitis was observed in control quadrants, but not in test quadrants; (iii) IL-1 beta concentration in GCF was associated with IL-1B(+3954) genotype only at test quadrants; (iv) IL-1 beta was detectable in serum only at low levels in a limited number of subjects, without difference between gingivitis conditions. CONCLUSIONS Aspects of the bacterial challenge to the gingival tissues, such as the amount of plaque deposits and plaque accumulation rate, appear to affect the IL-1 beta levels in GCF in subjects with a specific IL-1B genotype.

Objectives: The purpose of this study was to assess whether identification of subjects with different susceptibility to plaque-induced gingival inflammation is dependent on the length of time of de novo plaque accumulation. Methods: Retrospective analysis of data obtained from a recently reported (J Clin Periodontol 31, 239, 2004) randomized split-mouth localized experimental gingivitis trial involving 96 healthy non-smokers. Gingival and plaque index, gingival crevicular fluid volume (GCF), angulated bleeding score, and the derived parameter cumulative plaque exposure (CPE) were recorded at days 0, 7, 14, and 21. The primary outcome variable to express severity of inflammation was GCF and each subject was a statistical unit. Based on subject distribution of GCF-day 21 residuals after standardization for CPE-day 21, two sub-populations (upper and lower distribution quartiles) were selected. They were, respectively, defined as "high responders" (HR) (n = 24) and "low responders" (LR) (n = 24) and characterized by significantly different severity of gingivitis to similar amounts of plaque deposits. The same analysis was repeated at days 7 and 14. Prevalence of HR and LR was compared between days using the Χ 2 [ML] test. Results: For both day 7 and day 14, the quartile distribution of LR and HR was statistically significant (p = 0.02). Fifty percent of LR and 71% of HR presented a consistent level of susceptibility to plaque-induced gingival inflammation even after only 7 and/or 14 days of plaque accumulation. Conclusions: These findings support the concept that the subject-based susceptibility to plaque-induced gingival inflammation is an individual trait, only partly related to the length of time of exposure to plaque.

AIM The aim of this study was to characterize the gingival inflammatory response to de novo plaque accumulation in subjects treated for aggressive periodontitis (AP). The gingival inflammatory response of the AP subjects was retrospectively compared with that of periodontally healthy individuals (PH) matched for exposure to plaque and of periodontally healthy subjects previously identified as "high responders" (HR) and "low responders" (LR). MATERIALS AND METHODS 13 AP subjects and 26 matched PH subjects participated in a 21-day experimental gingivitis trial. Plaque index (PlI), Gingival index (GI), gingival crevicular fluid volume (GCF) and angulated bleeding score (AngBS) were recorded at days 0, 7, 14 and 21. Cumulative plaque exposure (CPE), i.e. PlI over time, was also calculated. RESULTS GCF was significantly higher in AP compared with PH group at each observation interval (p< or =0.001). In addition, GCF was significantly higher in AP group compared with either LR or HR groups at each observation interval (p

Background: Studies have shown an association between an acute stressful event and gingivitis. However, the possible effects of personality traits associated with stress resistance/susceptibility and current level of stress on the clinical expression of plaque-induced inflammation remain to be examined. The aim of this study was to characterize the subject-based clinical behaviour of the gingiva during experimental gingivitis in relation to personality profile, psychological stress and coping behaviour. Methods: Ninety-six systemically and periodontally healthy subjects (mean age: 23.6±1.7 years), 46 males and 50 females, non-smokers, participated in a randomized, split-mouth, localized experimental gingivitis trial. Prior to the trial, subjects were asked to complete self-administered questionnaires evaluating personality traits (Hardiness scale and Courtauld Emotional Control Scale), subjective stress (Visual Analogue Scale – Total Distress), social support (Multidimensional Scale of Perceived Social Support, MSPSS) and life events (Life Experiences Survey (LES)). The influence of psychosocial factors was investigated in the overall population as well as in two sub-populations with different inflammatory response to plaque accumulation. Results: No significant relationships were found between gingival inflammation variables and psychological measures. No significant differences were detected between subjects with different susceptibilties to plaque-associated gingivitis for any considered psychological variable. A significant association between plaque variables and LES (negative) or MSPSS (positive) was found; however, the variance explained by the model was low. Conclusions: Differences in the current level of stress and psychosocial variables indicative of stress susceptibility do not account for variability in plaque accumulation and gingival inflammation during experimental gingivitis in young adults.

Aim: The aim of the present study was to characterize the subject-based clinical behavior of the gingiva in response to a tooth-cleaning regimen in two subpopulations, “high-responder” (HR) and “low-responder” (LR) groups, presenting a different inflammatory response to plaque accumulation. Material and Methods: The study population comprised of 96 systemically and periodontally healthy subjects, 46 males and 50 females, non-smokers, enrolled in an experimental gingivitis trial. At completion of the experimental gingivitis period (day 21), all subjects were prescribed the same 21-day treatment regimen of amine/stannous fluoride (AmF/SnF2)-containing toothpaste and mouthrinse. Plaque index (PlI), gingival index (GI), gingival crevicular fluid volume (GCF), and angulated bleeding score (AngBS) were recorded on three selected teeth. Treatment efficacy was evaluated in the overall population as well as in HR and LR groups, separately. Results: A statistically significant decrease of PlI was observed after treatment (p

A double-blind, randomized, single-dose clinical trial to evaluate the analgesic efficacy of preoperative ketorolac tromethamine administration on periodontal postoperative pain was designed. One group received 20 mg ketorolac immediately before periodontal flap surgery, and the other group received placebo. Naproxen sodium was allowed post operatively as rescue medication. The visual analog scale was used to estimate pain. Postoperative pain was assessed hourly for the first 10 h on the day of surgery, and 4× daily on the 1st and 2nd postsurgical days. Timing and dose of rescue analgesic remedication were also recorded. Results indicated that preoperative treatment with ketorolac significantly reduced initial pain intensity and delayed the onset of postoperative pain as compared to placebo. Incidence and amount of naproxen consumption was similarly small in both ketorolac- and placebo-treated groups. No adverse reactions related to preoperative medication were observed.