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To discover and validate differential protein biomarker expression in saliva and gingival crevicular fluid (GCF) to discriminate objectively between periodontal health and plaque-induced periodontal disease states.One-hundred and ninety participants were recruited from two centres (Birmingham and Newcastle upon Tyne, UK) comprising healthy, gingivitis, periodontitis, and edentulous donors. Samples from the Birmingham cohort were analysed by quantitative mass spectrometry proteomics for biomarker discovery. Shortlisted candidate proteins were then verified by enzyme-linked immunosorbent assay in both cohorts. Leave-one-out cross validation logistic regression analysis was used to identify the best performing biomarker panels.Ninety-five proteins were identified in both GCF and saliva samples, and 15 candidate proteins were selected based upon differences discovered between the donor groups. The best performing panels to distinguish between: health or gingivitis and periodontitis contained matrix metalloproteinase-9 (MMP9), S100A8, alpha-1-acid glycoprotein (A1AGP), pyruvate kinase, and age (area under the curve [AUC] 0.970); health and gingivitis contained MMP9, S100A8, A1AGP, and pyruvate kinase, but not age (AUC 0.768); and mild to moderate and advanced periodontitis contained MMP9, S100A8, A1AGP, pyruvate kinase, and age (AUC 0.789).Biomarker panels containing four proteins with and without age as a further parameter can distinguish between periodontal health and disease states.

Objectives: The objective of this study was to systematically review the epidemiological evidence for an association between periodontitis (PD) and incident atherosclerotic cardiovascular disease (ACVD), including coronary heart disease (CHD), cerebrovascular disease and peripheral arterial disease. Methods: Systematic review of cohort and case-control studies on the association of clinically or radiographically diagnosed PD and ACVD. Results: Overall, 12 studies were included in this study (six studies on CHD, three studies on cerebrovascular disease, two studies on both coronary heart and cerebrovascular disease mortality and one study on peripheral arterial disease). All but one study reported positive associations between various periodontal disease measures and the incidence of ACVD, at least in specific subgroups. The association was stronger in younger adults and there was no evidence for an association between PD and incident CHD in subjects older than 65 years. Only one study evaluated the association between PD and secondary cardiovascular events. Conclusions: There is evidence for an increased risk of ACVD in patients with PD compared to patients without. However, this may not apply to all groups of the population. There is insufficient evidence for an association between PD and the incidence of secondary cardiovascular events.

Introduction: The classic manifestations of vitamin D deficiency include rickets and osteomalacia. Here we demonstrate a case of vitamin D deficiency presenting as radiologic bone loss around the apical and marginal periodontal tissues, consistent with periapical cemental dysplasia. Potential mechanisms for this are explored and the importance of dentists in managing such cases is discussed.Case Presentation: An 18-year-old female patient was referred with marginal periodontal bone loss. Radiology revealed marginal bone loss and multiple asymptomatic periapical radiolucencies associated with teeth that responded positively to pulp testing. The patient was of Southern Asian descent, wore a headscarf and occlusive clothing for cultural reasons, and was visibly malnourished, reporting a poor diet. A diagnosis of severe vitamin D deficiency was confirmed by serum biochemistry. The patient underwent vitamin D supplementation, after which the radiolucent areas resolved.Conclusions: The prevalence of vitamin D d...

Periodontitis is a prevalent chronic inflammatory disease, a major cause of tooth loss and associates with systemic morbidity and mortality. Biologically, it associates with reduced local and systemic antioxidant defences and elevated levels of oxidative stress secondary to a hyper-inflammatory neutrophil host response to plaque bacteria. This randomised, placebo-controlled, double-blind trial, aimed to assess whether adjunctive benefit could be detected with Juice Plus+® supplementation during and after standard non-surgical periodontal therapy. Primary outcomes were reduction in periodontal pocket depth (PPD) and gain in connective tissue attachment level (CAL) to teeth, 2-months posttherapy. Test interventions were fruit/vegetable (FV, n=16) and FV/berry (FVB, n=15) verses placebo (PL, n=17). Statistical analysis employed 2-tailed ANCOVA (baseline PPD and CAL as covariates) and interim data on 48 never smokers are reported. Non-surgical therapy produced significant improvements in PPD (FV = 0.86±0.4mm; FVB = 0.88±0.4mm; PL = 0.81±0.5mm) and for CAL (p