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Background: Diabetes and periodontal diseases are often associated. Both have highly inflammatory components, but the role played by distinct phlogistic mediators in their pathogenesis is not fully understood and remains controversial. The purpose of this study is to evaluate whether type 2 diabetes alters the expression of inflammatory mediators in sites with chronic periodontitis (CP) or peri-implantitis (P-IM)., Methods: The expression of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6 and -8, and monocyte chemotactic protein (MCP)-1 plus key CC chemokine receptors (CCR1 through 5) and CXC chemokine receptors (CXCR1 through 3) was quantified by real-time polymerase chain reaction (PCR) in gingival or peri-implant biopsies from 135 patients with well-controlled or poorly controlled diabetes and periodontal disease, 65 patients with periodontal disease but otherwise healthy, and 90 systematically and periodontally healthy subjects. Western blots were performed., Results: Relative to controls, in patients without diabetes and patients with well-controlled diabetes, TNF-alpha, CCR5, and CXCR3 expression was exclusively higher in sites with P-IM (P <0.01), whereas IL-6 and -8 were overexpressed in sites with CP and, even more, in sites with P-IM (P <0.01). In patients with poor glycemic control, TNF-alpha, CCR5, and CXCR3 mRNAs were increased in sites with CP (P <0.01). A statistically significant higher IL-6 and -8 expression from patients without diabetes and patients with well-controlled diabetes was observed compared to patients with poorly controlled diabetes. Regardless of metabolic/glycemic status, MCP-1 and CCR2 and 4 were markedly higher in both of the oral pathologies examined (P <0.01). At the protein levels, Western blot experiments confirmed the real-time PCR results., Conclusions: These findings showed that: 1) in subjects without diabetes and patients with well-controlled diabetes, TNF-alpha, CCR5, and CXCR3 may constitute distinctive biomarkers of P-IM; 2) poor glycemic control abolished the differences between CP and P-IM regarding the expression of these mediators; and 3) type 2 diabetes affected the expression of TNF-alpha, IL-6 and -8, CCR5, and CXCR3.

Background: Endosseous dental titanium implants have revolutionized restorative dentistry and have made a significant impact on improved patient care. The aim of this study was to compare and evaluate the influence of the placement technique on periodontal health., Methods: A baseline examination was performed in patients with submerged and non-submerged titanium implants, including an evaluation of plaque index (PI), gingival index (GI), periodontal probing depth (PD), clinical attachment level (CAL), and bone level, as well as histamine and arachidonic acid metabolite concentrations, in the peri-implant crevicular fluid. Examinations were repeated after 12, 24, and 36 months., Results: Bone loss was significantly higher in the submerged group relative to the non-submerged group at 3 years (P <0.01), with a slight increase at 24 months. All clinical parameters were significantly higher in the submerged group relative to the non-submerged group at 24 and 36 months (P <0.05 for PI; P <0.01 for GI, PD, and CAL). The mean levels of histamine and other inflammatory mediators were significantly higher, whereas 15(S)-hydroxy-5,8,11,13-eicosatetraenoic acid concentrations were significantly reduced in the submerged group, with a high correlation with periodontal indices at 24 and 36 months (P <0.001)., Conclusion: This longitudinal study suggested that submerged implants present a number of risks for periodontal complications compared to non-submerged implants, which can be evidenced by inflammatory mediator variations in the peri-implant crevicular fluid.

Background: Some previous investigations underscored the role of histamine in periodontal disease, especially in diabetic patients, but the behavior of this inflammatory mediator in the early phases of periodontal involvement remains unclear. The aim of the present study was to correlate the presence of histamine in saliva with clinical parameters in healthy, periodontitis-affected, and diabetic subjects to ascertain whether this amine may serve as a predictive index of periodontal risk., Methods: For this purpose, subjects were selected as follows: 1) with newly diagnosed type 2 diabetes mellitus; 2) with neither diabetes nor periodontitis; 3) with no diabetes but with chronic, untreated periodontal disease. Histamine salivary levels were measured at the initial time (T0) and after 6, 12, and 24 months using high-performance liquid chromatography. The main periodontal indexes were recorded at the same time intervals., Results: At T0, a very typical shape of the histamine chromatogram was found for all patients of the three groups; at this time, the salivary histamine levels of diabetic patients were increased and comparable to those of healthy patients with periodontal disease, whereas healthy subjects with no periodontitis showed reduced histamine levels. Further controls at 6, 12, and 24 months showed a statistically significant correlation between the increase of salivary histamine and the worsening of the periodontal indexes in diabetic and non-diabetic subjects., Conclusion: These results suggest that salivary histamine may serve as a predictive index in the prevention of periodontal disease.