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Objective The microinflammatory state can influence the occurrence of dialysis-related complications in dialysis patients. Chronic periodontitis (CP), in which plaque biofilm is considered to be the initiating factor, is a chronic infectious disease in the oral cavity. It is still uncertain whether CP affects the microinflammatory state in peritoneal dialysis (PD) and the occurrence of dialysis-related complications. The purpose of this study was to investigate the correlation between the periodontal index and clinical parameters in peritoneal dialysis patients with CP and dialysis-related complications, including peritoneal dialysis-associated peritonitis (PDAP) and cardiovascular and cerebrovascular events (CCEs). Methods This was a retrospective cohort study, and 76 patients undergoing PD were enrolled. Clinical parameters, the occurrence of PD-related complications and periodontitis-related indicators, including the gingival index (GI), plaque index (PLI), probing depth (PPD) and clinical attachment loss (CAL), were collected. Correlation analysis was used to explore the correlation between periodontal or clinical parameters and the occurrence of PD-related complications. Results All the patients had different degrees of periodontitis (mild 9.2%, moderate 72.4%, severe 18.4%); PPD was inversely related to serum albumin (r = − 0.235, p = 0.041); CAL has a positive correlation with serum C-reactive protein (rs = 0.242, p = 0.035); PLI was positively correlated with serum calcium (r = 0.314, p = 0.006). ANOVA, multivariate logistic regression analysis and Kaplan-Meier Survival curve suggested that CAL was a risk factor for the occurrence of PDAP. There was no correlation between periodontal parameters and CCEs or poor prognosis. Conclusion CP is universally present in PD patients, and the presentation of periodontitis influences the systemic inflammatory state in PD patients. CP is a risk factor for PDAP.

ObjectiveThis study was to investigate whether the width of the interdental papillae could contribute to clinical and aesthetic outcomes of the modified coronally advanced tunnel technique (MCAT).Materials and MethodsA total of 28 patients with 70 class RT1 single and multiple gingival recessions (GRs) were treated by MCAT between March 2017 and March 2021. The apex angle of the mesial and distal papillae adjacent to the involved tooth were recorded at baseline. Clinical outcomes (mean root coverage (mRC) and complete root coverage (CRC)) were recorded at 12 months after surgery. Periodontal clinical parameters (keratinized tissue width (KTW), gingival index (GI), plaque index (PLI), periodontal probing depth (PPD), and clinical attachment loss (CAL)) were recorded at baseline and 12 months after surgery. Aesthetic evaluation was carried out using the root coverage esthetic score (RES) and patients’ visual analogue scale (VAS). The possible relationship between papilla width and clinical and/or aesthetic outcomes was discerned by multiple linear regression and logistic regression.ResultsThe mean width of papilla ranged from 22.6° to 74.65° with a median of 42.32° (IQR: 16.98°). For single GRs, the papilla width was not significantly correlated to mRC, RES, CRC, VAS gain, CAL gain, and KTW gain. The RES and CRC were only associated with papilla width in multiple GRs (P = 0.012). At 12 months, 95.79 ± 10.17% and 92.94 ± 10.64% of mRC were obtained for multiple GRs and single GRs, respectively. Better results in terms of CRC were obtained from multiple GRs compared with single GRs (78.94% vs. 66.67%). For aesthetic outcomes, 8.84 ± 1.54 and 9.16 ± 1.53 of RES were observed at single and multiple GR defects.ConclusionsThe CRC and RES of multiple GRs following MCAT is significantly correlated to papillae width. Relatively wide gingival papillae tend to have a greater chance to achieve complete root surface coverage.Clinical relevance:The width of the gingival papilla helps to speculate on the clinical outcome of root surface coverage. Although the findings are not yet highly predictable, the MCAT can yield better results in the wider gingival papilla area.

Background Mucosal neuroma (MN) is a benign neural tumor of peripheral nerves histologically characterized by irregular tortuous bundles of nerve cells with prominent perineurium that lie scattered throughout the submucosa. The tumor is usually associated with the multiple endocrine neoplasia type 2B (MEN 2B) but rarely occurs without the other components of MEN 2B. We present a case of solitary MN without MEN 2B that occurs in the maxillary incisor gingival papilla that has not been reported yet and review the literature. Case presentation: A 29-year-old woman presented to our outpatient department with an upper anterior teeth gingiva painless mass for 2-year. Intraoral examination revealed a small, tough, basal wide, well-defined mass in the labial gingival papilla between maxillary central incisor. Excisional biopsy showed that it was characterized by nerve bundles in various sizes surrounded by normal connective tissue in the submucosa under HE staining; Immunohistochemically, the mass showed strongly positive staining of S-100 protein, NSE,NF and weakly positive of EMA. The Laboratory examination and ultrasonography showed no signs of MEN 2B. In the first 6 months of follow-up, there was no evidence of recurrence and other components of MEN 2B. The patient was asymptomatic and she is still being followed up every 6 months. Based on these features, the lesion was finally diagnosed as a solitary gingival MN. Conclusions This study showed a rare solitary MN in the gingiva papilla without MEN 2B that has not been reported yet. The histopathological evaluation can be helpful in the differential diagnosis of MN. It is hoped that a greater understanding of solitary MN without MEN 2B in the oral cavity will avoid potential misdiagnosis, and contribute to determining the correct management, which appears to be complete surgical excision with close follow-up for recurrence and other components of MEN 2B surveillance.

Background: Increasing evidence suggests a causal link between periodontitis and Alzheimer’s disease (AD). Systemic inflammation initiated by periodontitis may mediate the development of AD. Our study aims to investigate the effect of ligature-induced periodontitis on cognitive function and the role of STAT3 in this process.Materials and Methods: Ligature-induced periodontitis was established, and the rats were treated intraperitoneally with/without the pSTAT3 inhibitor cryptotanshinone (CTS, 5 mg/kg). Alveolar bone resorption and periodontal inflammation were detected by micro-computed tomography (micro-CT) analysis and histopathological evaluation. The expression of cytokines (IL-1β, IL-6, IL-8, IL-21) in the periphery was evaluated by RT-PCR and ELISA. Locomotor activity and cognitive function were evaluated by the open field test and the Morris water maze test, respectively. The activation of microglia and astrocytes was assessed by immunohistochemistry. In the cortex, the cytokines mentioned above were also detected, while the activation of the STAT3 signalling pathway (JAK2, STAT3, and pSTAT3) was assessed by Western blotting. The expression of amyloid precursor protein (APP) and its key secretase enzymes was evaluated by RT-PCR, while the total Aβ and the ratio of Aβ1-40/1-42 were measured via ELISA.Results: In periodontal ligature rats, significant alveolar bone resorption and local inflammatory cell infiltration were present. Apparent increases in inflammatory cytokines (IL-1β, IL-6, IL-8 and IL-21) were detected; this change was relieved by the pSTAT3 inhibitor CTS. Additionally, spatial learning and memory function was impaired, while locomotor activity was not affected. Activated microglia and astrocytes were found in the cortex and hippocampus. In the cortex, these inflammatory cytokines showed similar changes when the STAT3 signalling pathway was activated. The processing of APP by β- and γ-secretases was promoted, and both the total Aβ and the ratio of Aβ1-40/1-42 were upregulated. Changes in the brain were also attenuated by CTS.Conclusions: Ligature-induced periodontitis in rats resulted in systemic inflammation and further impairments in cognitive function, leading to AD-like pathology. The activation of the STAT3 signalling pathway may play an important role in this process by increasing inflammatory load in both the periphery and brain, promoting neuroinflammation and modulating APP processing. This study may provide novel insights into periodontal intervention strategies and potential targets for AD prevention.