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Abstract This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon inflammation. Available evidence shows the relationship among osteoporosis, AR agents, periodontitis and implant therapy in relation to the incidence of MRONJ. Uncontrolled periodontitis may lead to tooth loss and to the need to replace teeth with dental implants. Tooth extraction and surgical dental procedures are recognized as the main risk factors for developing MRONJ in individuals taking AR therapy for osteometabolic conditions. Although the incidence of MRONJ in osteometabolic patients taking AR therapy may be as low as 0.9%, the increasing prevalence of osteoporosis and the high prevalence of periodontitis suggest that this potential complication should not be overlooked. Good clinical practice (GCP) guidelines are proposed that aim at a more integrated approach (prescriber, dentist, periodontist and dental hygienist) in the management of periodontitis patients undergoing AR therapy for osteometabolic disorders to reduce the risk of MRONJ. Dental professional and prescribers should educate patients regarding the potential risk associated with the long-term use of AR therapy and oral health behavior.

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Inflammatory periodontal and peri-implant diseases follow dysbiotic shifts in a susceptible host. A well-established tool for microbial sample collection is the use of paper points. The purpose of this pilot study was to evaluate the use of interdental brushes compared to paper points. Biofilm samples were collected with paper points and later interdental brushes from ten patients. Five patients were represented with a community periodontal index of treatment needs (CPITN) of 0–2 around the teeth and an implant with PPD ≤ 5 mm and no radiological bone loss. The remaining five patients had a CPITN ≥ 3 and one implant with peri-implantitis. Microbial samples were analyzed with quantitative polymerase chain reaction (qPCR) and next-generation sequencing (NGS). The results showed higher amounts of DNA in samples taken by interdental brushes but also higher Ct values. Both methods detected Filifactor alocis, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola in the majority of samples, while Aggregatibacter actinomycetemcomitans was rarely found. A microbial dysbiosis index showed comparable or higher values in sites with no periodontitis/peri-implantitis with interdental brushes. The results of this pilot study indicate that interdental brushes might be a valid technique for microbial sampling and particularly advantageous in the early detection of dysbiotic shifts around teeth and implants. Larger studies with more participants are needed to validate the proposed microbial sampling method with interdental brushes.

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Inflammatory periodontal and peri-implant diseases follow dysbiotic shifts in a susceptible host. A well-established tool for microbial sample collection is the use of paper points. The purpose of this pilot study was to evaluate the use of interdental brushes compared to paper points. Biofilm samples were collected with paper points and later interdental brushes from ten patients. Five patients were represented with a community periodontal index of treatment needs (CPITN) of 0–2 around the teeth and an implant with PPD ≤ 5 mm and no radiological bone loss. The remaining five patients had a CPITN ≥ 3 and one implant with peri-implantitis. Microbial samples were analyzed with quantitative polymerase chain reaction (qPCR) and next-generation sequencing (NGS). The results showed higher amounts of DNA in samples taken by interdental brushes but also higher Ct values. Both methods detected Filifactor alocis, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola in the majority of samples, while Aggregatibacter actinomycetemcomitans was rarely found. A microbial dysbiosis index showed comparable or higher values in sites with no periodontitis/peri-implantitis with interdental brushes. The results of this pilot study indicate that interdental brushes might be a valid technique for microbial sampling and particularly advantageous in the early detection of dysbiotic shifts around teeth and implants. Larger studies with more participants are needed to validate the proposed microbial sampling method with interdental brushes. [ABSTRACT FROM AUTHOR]

Developing disposable paper-based devices has positively impacted analytical science, particularly in developing countries. Some benefits of those devices include their versatility, affordability, environmentally friendly, and the possibility of being integrated with portable electrochemical or colorimetric detectors. Paper-based analytical devices (PADs) comprising circular zones and microfluidic networks have been successfully employed in the analytical chemistry reign. However, the combination of the stencil-printing method and alternative binder has not been satisfactorily explored for fabricating colorimetric paper devices. We developed PADs exploring the stencil printing approach and glass varnish as the hydrophobic chemical agent. As a proof-of-concept, the colorimetric assay of salivary α-amylase (sAA) was performed in saliva samples. Through the scanning electron microscopy measurements, it was possible to indicate satisfactory definitions between native fibers and barrier, and that the measured values for the channel width revealed suitable fidelity (R2 = 0.99) with the nominal widths (ranging from 400 to 5000 μm). The proposed hydrophobic barrier exhibited excellent chemical resistance. The analytical applicability for detecting sAA revealed linear behavior in the range from 2 to 12 U mL−1 (R2 = 0.99), limit of detection of 0.75 U mL−1, reproducibility (RSD ≤2.4%), recovery experiments ranged from 89 to 108% and AGREE response (0.86). In addition, the colorimetric analysis of sAA in four different saliva samples demonstrated levels ranging from 202 to 2080 U mL−1, which enabled monitoring the absence and presence of periodontitis. This report has presented the first use of a self-adhesive mask and glass varnish for creating circular zones and microfluidic architectures on paper without using thermic or UV curing treatments. Also, the proposed analytical methodology for detecting sAA exhibited suitable ecological impact considering the AGREE tool. We believe the proposed fabrication of paper devices emerges as a novel, simple, high-fidelity microfluidic channel and portable analytical approach for colorimetric sensing. [Display omitted] • Paper-based analytical devices (PADs) comprising circular zones and microfluidic networks have been manufactured. • The stencil printing approach and glass varnish as the hydrophobic agent were utilized. • The proposed hydrophobic barrier presented suitable chemical resistance. • Colorimetric detection of salivary α-amylase in saliva samples was performed. [ABSTRACT FROM AUTHOR]

Featured Application: Sialic acid is a critical membrane constituent required to maintain mucosal integrity. This investigation describes the biochemical quantitation of salivary sialic acid as a rapid measure of oral health that corresponds with the clinical status of the patient. The test can be utilized widely including in remote facilities with limited resources. A rapid, low-cost, visual test for sialic acid using commonly available reagents complements the biochemical assessment. The test can be applied for screening large populations, monitoring oral health status, amenable to digital health and can advance patient engagement to manage their oral health. Objective: Sialic acid [SA] represents a critical mucosal membrane component maintaining mucosal integrity. This investigation stratified adult subjects based on clinical parameters of periodontal health to examine salivary sialic acid [SA] as a health measure and develop a corresponding rapid visual chair-side assay. Methods: Adults [n = 90] were enrolled and clinically stratified into healthy [n = 30], gingivitis [n = 29] or periodontitis [n = 31] groups. Saliva from subjects was evaluated for SA using the Ninhydrin method. A novel rapid SA spot test was developed utilizing filter paper discs soaked in a sialidase substrate. Substrate-laden disks were incubated at room temperature with saliva produced a blue color with increasing color intensities due to higher sialidase activity. Subjects were recalled weekly for clinical and salivary assessments. Results: Average baseline salivary SA in healthy, gingivitis and periodontal disease groups were 64, 95 and 102 µg/mL, respectively with significant differences (<0.05). Differences in SA concentrations among control and test groups were maintained throughout the study. Similarly, the differences in the color intensities in the rapid visual chair side spot test were also observed during the entire study period. Conclusions: Increasing levels of salivary SA were observed from healthy to periodontal disease with these differences remaining consistent over the study. These results corresponded with the chair-side visual assay, which is suitable for patient education or monitoring. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: This study aimed to elucidate the connection between osteoclastic forkhead transcription factor O1 (FoxO1) and periodontitis and explore the underlying mechanism by which FoxO1 knockdown regulates osteoclast formation. Materials and Methods: A conventional ligature‐induced periodontitis model was constructed to reveal the alterations in the proportion of osteoclastic FoxO1 in periodontitis via immunofluorescence staining. Additionally, RNA sequencing (RNA‐seq) was performed to explore the underlying mechanisms of FoxO1 knockdown‐mediated osteoclastogenesis, followed by western blotting, quantitative polymerase chain reaction, and enzyme‐linked immunosorbent assay. Results: FoxO1+ osteoclasts were enriched in the alveolar bone in experimental periodontitis. Moreover, FoxO1 knockdown led to impaired osteoclastogenesis with low expression of osteoclast differentiation‐related genes, accompanied by an insufficient osteoclast maturation phenotype. Mechanistically, RNA‐seq revealed that the nuclear factor kappa B (NF‐κB) and nucleotide‐binding oligomerization domain‐like receptor family pyrin domain containing 3 (NLRP3) inflammasome signaling pathways were inhibited in FoxO1‐knockdown osteoclasts. Consistent with this, MCC950, an effective inhibitor of the NLRP3 inflammasome, substantially attenuated osteoclast formation. Conclusions: FoxO1 knockdown contributed to the inhibition of osteoclastogenesis by effectively suppressing NF‐κB signaling and NLRP3 inflammasome activation. This prospective study reveals the role of FoxO1 in mediating osteoclastogenesis and provides a viable therapeutic target for periodontitis treatment. [ABSTRACT FROM AUTHOR]

Microfluidic paper-based devices (μPADs) and wearable devices have been highly studied to be used as diagnostic tools due to their advantages such as simplicity and ability to provide instrument-free fast results. Diseases such as periodontitis and diabetes mellitus can potentially be detected through these devices by the detection of important biomarkers. This study describes the development of μPADs through craft cutter printing for glucose and nitrite salivary diagnostics. In addition, the use of μPADs integrated into a mouthguard as a wearable sensor for glucose monitoring is also presented. μPADs were designed to contain two detection zones for glucose and nitrite assays and a sampling zone interconnected by microfluidic channels. Initially, the analytical performance of the proposed μPADs was investigated and it provided linear behavior (r2 ≥ 0.994) in the concentration ranges between 0 to 2.0 mmol L−1 and 0 to 400 μmol L−1 for glucose and nitrite, respectively. Under the optimized conditions, the limits of detection achieved for glucose and nitrite were 27 μmol L−1 and 7 μmol L−1, respectively. Human saliva samples were collected from healthy individuals and patients previously diagnosed with periodontitis or diabetes and then analyzed on the proposed μPADs. The results found using μPADs revealed higher glucose concentration values in saliva collected from patients diagnosed with diabetes mellitus and greater nitrite concentrations in saliva collected from patients diagnosed with periodontitis, as expected. The results obtained on μPADs did not differ statistically from those measured by spectrophotometry. With the aim of developing paper-based wearable sensors, μPADs were integrated, for the first time, into a silicone mouthguard using a 3D-printed holder. The proof of concept was successfully demonstrated through the monitoring of the glucose concentration in saliva after the ingestion of chocolate. According to the results reported herein, paper-based microfluidic devices offer great potential for salivary diagnostics, making their integration into a silicone mouthguard possible, generating simple, low-cost, instrument-free, and powerful wearable sensors. [ABSTRACT FROM AUTHOR]

The present study compared the recovery of six periodontal pathogens by paper point samples from two different aspects of periodontal lesions by quantitative real-time polymerase chain reaction (PCR). Twenty patients with untreated chronic periodontitis were randomized into two groups. Before subgingival instrumentation and after 10 weeks samples in group A were taken first with a paper point half length (HP) of the probing depth, then with a paper point full length (FP) at the same site. In group B sampling sequence was reversed. Analysis by real-time PCR enabled quantification of six bacteria as well as total bacterial count (TBC). Statistical analysis included t test, Kappa, and Spearman's correlations. Higher TBC could be harvested by use of FP than by HP (mean of differences of ln-transformed counts before therapy: −0.791, CI [−1.515, −0.068], SD 0.770, p = 0.034; after therapy: −0.563, CI [−1.151, 0.024], SD 0.625, p = 0.059). The plaque composition regarding total target pathogens was similar for both samples. Both, for TBC as well as for single target bacteria a strong positive correlation was found between HP and FP (Kappa, Spearman correlation: Aggregatibacter actinomycetemcomitans 0.807, 0.778; Fusobacterium nucleatum 0.573, 0.772; Porphyromonas gingivalis 0.733, 0.824; Prevotella intermedia 0.480, 0.756; Treponema denticola 0.807, 0.814; and Tannerella forsythia 0.692, 0.695). The recovery of target pathogens was similar following sampling at various depths of the periodontal lesion. [ABSTRACT FROM AUTHOR]

This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon inflammation. Available evidence shows the relationship among osteoporosis, AR agents, periodontitis and implant therapy in relation to the incidence of MRONJ. Uncontrolled periodontitis may lead to tooth loss and to the need to replace teeth with dental implants. Tooth extraction and surgical dental procedures are recognized as the main risk factors for developing MRONJ in individuals taking AR therapy for osteometabolic conditions. Although the incidence of MRONJ in osteometabolic patients taking AR therapy may be as low as 0.9%, the increasing prevalence of osteoporosis and the high prevalence of periodontitis suggest that this potential complication should not be overlooked. Good clinical practice (GCP) guidelines are proposed that aim at a more integrated approach (prescriber, dentist, periodontist and dental hygienist) in the management of periodontitis patients undergoing AR therapy for osteometabolic disorders to reduce the risk of MRONJ. Dental professional and prescribers should educate patients regarding the potential risk associated with the long-term use of AR therapy and oral health behavior. Highlights: AR drugs such as bisphosphonates (BPs), denosumab (DNB) and romosozumab (RMB) are very effective in the treatment of osteoporosis and in the prevention of fragility bone fractures. Periodontitis is a widespread infective inflammatory disease that is the major cause of tooth loss, and it is strongly connected with other systemic diseases, including osteoporosis. MRONJ is a serious and rare complication associated with the use of AR drugs in osteoporotic patients. The reported incidence is rather low and ranges between 0.01 and 0.9%, but may be higher in the presence of comorbidities. Periodontitis and MRONJ share some risk factors, such as diabetes, smoking, steroids, cardiovascular diseases and rheumatoid arthritis. The risk of developing MRONJ in a case of successfully treated periodontitis is much lower than the risk of fragility fracture in a high-risk person such as one with a previous fracture. Oral and periodontal conditions should be assessed before starting an AR therapy, and local intra-oral inflammation should be brought under control. Periodontal therapy is effective at reducing the risk of teeth extraction and therefore the need for major bone reconstructive intervention and implant placement. Control of periodontal inflammation should be achieved and maintained over time in osteoporosis-affected patients treated with AR. Peri-implant diseases rather than dental implant placement may be considered a trigger for MRONJ; for this reason, periodontitis and peri-implant inflammatory disease control and the inclusion of patients in a supportive periodontal program are critical. AR therapy should not be discontinued or deferred by the dentist unless done in accordance with the prescriber. The suspension of BP therapy is not recommended on a routine basis, as BP binds to the skeletal sites and continue to be released for months or years after treatment, with a long tail effect on bone metabolism. DNB administration should not be withdrawn because the rebound effect may increase the risk of bone fractures. A therapeutic window in which to perform dento-alveolar surgical procedures is suggested. It is advisable to calibrate the timing of dental extraction and surgical procedures between the dentist and prescribers according to the oral condition, the general health condition, and the time and type of AR drugs used. A more integrated approach between prescriber, dentist, periodontist and dental hygienist should be encouraged, particularly in the management of periodontitis-affected patients who are taking AR drugs for osteometabolic disorders. Prescribers and dentists must educate patients regarding the potential risk associated with long-term use of AR therapy. [ABSTRACT FROM AUTHOR]

Paper points are widely established for the collection of subgingival plaque or other oral samples to analyze the microbiota, especially the presence of peri-odontal pathogenic bacteria such as Actinobacillus actinomycetemcomitans or Porphyromonas gingivalis. In contrast to the high frequency of usage of paper points in oral sampling, very few data are available about the parameters influ-encing the sampling process. Therefore, in four different in vitro experiments (6-9 repeats), we inoculated paper points with standardized suspensions (2X10[sup9] colony- forming units/ml) of A. actinomycetemcomitans and P. gingivalis to test the influence of the origin (kind) of paper point ("manufacturer"), size (according to the International Organization for Standardization ISO 25-80), sampling time (5 to 60 s), and elution time (5 to 60 s). Sampled bacteria were detected and (semi-) quantified using 16S rRNA/DNA-directed oligonucleotide probes. The bacterial load was categorized and calculations performed with index values ranging be-tween 0 (below the detection limit of 10[sup2] to 10[sup3] colony-forming units) and 9 (>10[sup6] colony-forming units). We found statistically significant differences in the efficiency of bacterial sampling between the 5 paper point manufacturers tested, expressed in a mean bacterial index between 4.4 and 7.8. ISO 45 Paper points were statistically proven to work most efficiently. According to our results, a sampling time of 60 s seems to be optimum. However, shorter times between 5 and 30 s did not significantly reduce the sampling efficiency. We found an interval of 20 s best to elute bacteria from the paper points by vortexing. The evaluation of basic parameters for subgingival plaque sampling by paper points might help to optimize microbiologically based diagnostics in periodontal diseases. [ABSTRACT FROM AUTHOR]

The present clinical study aimed to investigate if there are differences in microbiological outcomes dependent on the subgingival biofilm collection method. Subgingival biofilm samples were collected from the four deepest pockets (>5 mm) of 17 patients with aggressive periodontitis (AgP) and 33 patients with chronic periodontitis ( CP), first by paper point and thereafter by curette. Samples obtained with the same method were pooled together from each patient and forwarded for molecular microbiological analysis by a commercially available assay ( IAI Pado Test 4.5) that estimates total bacterial load and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans. Data analysis included frequency of detection, quantification and correlation of detection levels between the two sampling methods. P. gingivalis, T. forsythia and T. denticola were detected in >90% of the samples, and their detection levels exhibited a strong correlation between sampling methods. The detection consistency of A. actinomycetemcomitans was 56% between the two sampling methods. A. actinomycetemcomitans was more readily detected by paper point compared with curette collection with a stronger correlation between the two methods in AgP. Subgingival biofilm sampling by curette or paper point does not yield differences in the detection of the three 'red complex' species. However, A. actinomycetemcomitans was more consistently detected by means of paper point collection, which can be crucial in the decision to administer antibiotics as an adjunctive periodontal treatment. [ABSTRACT FROM AUTHOR]

Periodontitis is a major cause of tooth loss in adults that initially results from dental plaque. Subgingival plaque pathogenesis is affected by both community composition and plaque structures, although limited data are available concerning the latter. To bridge this knowledge gap, subgingival plaques were obtained using filter paper (the fourth layer) and curette (the first‐third layers) sequentially and the phylogenetic differences between the first–third layers and the fourth layer were characterized by sequencing the V3–V4 regions of 16S rRNA. A total of 11 phyla, 148 genera, and 308 species were obtained by bioinformatic analysis, and no significant differences between the operational taxonomic unit numbers were observed for these groups. In both groups, the most abundant species were Porphyromonas gingivalis and Fusobacterium nucleatum. Actinomyces naeslundii, Streptococcus intermedius, and Prevotella intermedia possessed relatively high proportions in the first–third layers; while in the fourth layer, both traditional pathogens (Treponema denticola and Campylobacter rectus) and novel pathobionts (Eubacterium saphenum, Filifactor alocis, Treponema sp. HOT238) were prominent. Network analysis showed that either of them exhibited a scale‐free property and was constructed by two negatively correlated components (the pathogen component and the nonpathogen component), while the synergy in the nonpathogen component was lower in the first–third layers than that in the fourth layer. After merging these two parts into a whole plaque group, the negative/positive correlation ratio increased. With potential connections, the first–third layers and the fourth layer showed characteristic key nodes in bacterial networks. [ABSTRACT FROM AUTHOR]

This review gives an update on recent epidemiologic data on periodontal diseases and a description of current periodontal services in Europe. A Medline search of articles published within the last decade with the keywords epidemiology, prevalence, periodontitis, tooth loss, and Europe was performed. Data on provision of dental services originated from international databases. Epidemiologic data on the prevalence of edentulism, the number of missing teeth, the prevalence of probing depth (Community Periodontal Index – CPI ≥ 3 or Pocket Depth – PD ≥ 4 mm), and clinical attachment loss (CAL ≥ 4 mm) displayed a fragmentary picture within Europe. With respect to the limited data on periodontal health, Spain, Sweden, and Switzerland ranked as the healthiest among European countries in contrast to Germany where increased tooth loss and the highest prevalence of CAL ≥ 4 mm were reported. The role of dental auxiliaries especially of dental hygienists and/or the medico-legal framework in which they work, appears to be an important factor in provision of effective periodontal care. Actual epidemiologic data on periodontal diseases are non-homogeneous and absent from several European countries. This emphasises the need for more national representative epidemiological studies with a uniform design to permit comparability between different nations. Merging actual epidemiologic data with former data on provision of periodontal care may help to explain differences in periodontal parameters on a population basis and to define future provision of dental care. [ABSTRACT FROM AUTHOR]

The microbial compositions from concurrent peri-implant and periodontal lesions were compared, since the results reported in the literature on the etiological relationship between these oral pathologies are contradictory. Microbial compositions from nine patients were evaluated using Illumina MiSeq sequencing of 16S rRNA gene amplicons and Principal Components Analysis. Comparisons between the use of curettes or paper points as collection methods and between bacterial composition in both pathologies were performed. Paper points allowed the recovery of a higher number of bacterial genera. A higher bacterial diversity was found in peri-implantitis compared to periodontal samples from the same patient, while a greater number of operational taxonomic units (OTUs) were present in the corresponding periodontal samples. A higher abundance of oral pathogens, such as Porphyromonas or Treponema, was found in peri-implantitis sites. The opposite trend was observed for Aggregatibacter abundance, which was higher in periodontal than in peri-implantitis lesions, suggesting that both oral pathologies could be considered different but related diseases. Although the analysis of a higher number of samples would be needed, the differences regarding the microbial composition provide a basis for further understating the pathogenesis of peri-implant infections. [ABSTRACT FROM AUTHOR]

Background: The collection of subgingival plaque samples with paper points is time-consuming and accident-sensitive. However, the collection of saliva is simple and contains pathogens of all intraoral surfaces. The aim of this study is to investigate whether a sampling strategy with mouthrinse (mouthrinse sample [MSP]; test) leads to results comparable with standard sampling method (multiple site test from the deepest pocket of each quadrant [MT4]; control).Methods: In 50 patients with periodontitis, subgingival plaque was sampled from the deepest pocket of each quadrant by using paper points and by gaining saliva with saline mouthrinse. Analysis was performed using a commercially available polymerase chain reaction test for 11 periodontal pathogens.Results: Detection frequency of Aggregatibacter actinomycetemcomitans (MT4/MSP: 42%/36%), Porphyromonas gingivalis (78%/66%), Tannerella forsythia (98%/84%), Treponema denticola (94%/74%), Parvimonas micra (86%/62%), Campylobacter rectus (90%/76%), Eubacterium nodatum (64%/30%), Prevotella intermedia (58%/54%), and Eikenella corrodens (90%/82%) was higher with MT4 than MSP. For Fusobacterium nucleatum (100%/100%), there was no difference between test and control. Only detection frequency of Capnocytophaga species (68%/74%) was higher with MSP than MT4. Differences were significant for P. gingivalis, T. forsythia, T. denticola, P. micra, C. rectus, and E. nodatum.Conclusions: There is no significant difference between MT4 and MSP for detection frequency of key pathogen A. actinomycetemcomitans. Key pathogens P. gingivalis, T. forsythia, T. denticola, P. micra, C. rectus, and E. nodatum show statistically higher detection frequencies with MT4. [ABSTRACT FROM AUTHOR]

Background/Objectives: Electronic cigarettes (e-cigarettes) are commonly used by former smokers as an alternative product to conventional cigarettes and also by young adults and adolescents to deliver nicotine. E-cigarettes are thought to be a less harmful and more socially acceptable alternative to tobacco smoking; however, their long-term effects on health, including oral health, are currently unknown. Methods: A literature search for relevant papers indexed in the literature from 2016 to 2023 was conducted using the PubMed, Scopus, and Google Scholar databases. In our paper, we included clinical trials and both in vivo and in vitro research concerning the impact of e-cigarettes on oral health. Results: E-cigarettes impact the oral cavity, which is directly exposed to inhaled chemicals present in e-cigarette aerosols. The use of e-cigarettes has been linked to teeth discoloration and dental caries, promoting the development of periodontal diseases and causing oral mucosa lesions, including oral cancer. E-cigarette aerosols might also negatively affect the oral microbiome by suppressing the growth of commensal bacteria and increasing the population of bacteria responsible for developing numerous oral disorders. E-cigarettes also impact saliva composition and its properties, including reducing saliva's antibacterial and antioxidant properties, which may subsequently lead to the promotion of oral diseases. Conclusions: The outcomes suggest that e-cigarette usage may cause the development of oral diseases, however further longitudinal studies of a larger and homogenous group of e-cigarette users are required. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review considers possible etiologic factors and definitions of peri-implantitis as reported in the recent literature. Materials and Methods: An electronic search of databases plus a hand search of the most relevant journals published between January 2005 and September 2012 were performed. Results: The electronic and manual searches yielded 640 and 14 titles, respectively. From the independent double-check of the titles and abstracts, 24 full texts were downloaded (18 clinical studies and 6 animal studies). After reading the full texts, 10 articles (4 clinical studies and 6 animal studies) were included in this review. None of the human articles selected provided sufficient evidence to address the research question, and no human clinical evidence is available to support a cause-effect relationship between peri-implantitis and bacterial accumulation and/or occlusal overload. The animal literature is also not unanimous regarding a specific peri-implantitis etiology. However, a correlation between periodontitis and smoking histories was cited as contributing to a higher incidence of peri-implantitis. Conclusion: The available scientific literature is characterized by an absence of a unanimous consensus regarding the etiology of peri-implantitis and its specific relationship to periodontitis. Furthermore, both the choice of the term peri-implantitis and its definition remain controversial. [ABSTRACT FROM AUTHOR]

Background and Aims: Periodontitis is irreversible plaque-mediated damage to gums and its supporting structures. Plaque is a niche of complex organisms forming biological associations for their attachment and sustenance, forming the basis for periodontal diseases. There is a vast diversity in oral microbiota, depending on the site. Dentition creates natural surfaces and barriers for the diversification of bacteria. For instance, periodontal bacteria differ between supra and subgingival tissues. The plaque mounted on the subgingival area chiefly houses gram-negative anaerobes such as Treponema denticola, Tannerella forsythia, and Porphyromonas gingivalis. The current study aims to compare and contrast the antimicrobial potential of Terminalia arjuna with commercially available mouth rinses against clinical isolates of periodontal bacteria based on the well-diffusion method. Materials and Methods: Preparation of Terminalia arjuna bark extract was done. For the detection of periodontal bacteria, Porphyromonas gingivalis, and Treponema denticola, polymerase chain reaction (PCR) was used. The well-diffusion method was used to test the antimicrobial activity. Results: The aqueous extract of Terminalia arjuna showed minimum zone of inhibition of 23.33 ± 0.577 for Porphyromonas gingivalis and 24.33 ± 0.577 for Treponema denticola while the commercially available mouthwashes M1, M2, M3showed 29.33 ± 0.577, 29.33 ± 0.577, 24.33 ± 0.577, respectively towards Porphyromonas gingivalis and 29.66 ± 0.577, 27.33 ± 0.577, 25.66 ± 0.577, respectively towards Treponema denticola The results depicted nearly equal efficacy of Terminalia arjuna aqueous extract similar to those of commercial mouthwashes against the test bacteria. Conclusion: Antibacterial tests of Terminalia arjuna bark extracts showed promising results even at low concentrations. Hence, it can be an alternative to commercially available mouthwashes, which suffer from having numerous drawbacks ranging from burning sensation while in use to yellowing of teeth surfaces. Herbal medicines are considered to be much safer than other synthetic formulations and possess wide acceptance by people. Hence, this study forms a basis for future studies in this area.

Background: The outcome of microbiological diagnostics may depend on the sampling technique. It was the aim of the present study to compare two widely used sampling techniques for subgingival bacteria using quantitative real-time polymerase chain reaction. Methods: Twenty patients with chronic periodontitis were randomized into two groups. [n group A, samples were taken first with a paper point and then with a curet at the same site (single-rooted teeth with probing depth >5 mm) before scaling and root planing and after 10 weeks. The sampling sequence was reversed in group B. The analysis enabled the quantification of Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivaIis, Prevotella intermedia, Treponema denticola, and Tannerella forsythensis and total bacteria! counts (TBCs). Statistical analysis included t test, kappa, and Spearman correlation. Results: Higher TBC was harvested with curets than by paper points (P = 0.008). The plaque composition with regard to total target pathogens was similar for both sampling techniques. A strong positive correlation was found between curet and paper point samples for TBC and single target bacteria. Conclusions: Overall, there was a relatively good agreement for the results of paper point and curet sampling. Thus. both techniques seem to be suitable for microbiological diagnostics. [ABSTRACT FROM AUTHOR]

Abstract: In the oral cavity, we can find a complex mixture of microorganisms, commensals, and pathogens. The studies of normal oral microbiota, as well as the studies of much oral pathology (e.g., caries, periodontitis), involve the isolation and cultivation of these microorganisms and their molecular analysis. The aim of this study was to validate a quick, easy, efficient, and inexpensive DNA extraction method for the recovery of genomic DNA from gram-positive and gram-negative oral bacteria to be used in polymerase chain reaction amplification. This method worked great with all samples analyzed, providing an approach to extract DNA for different microorganisms. [Copyright &y& Elsevier]

Background: Aging has been implicated in many chronic inflammatory diseases, including periodontitis. Periodontitis is an inflammatory disease caused by longterm irritation of the periodontal tissues by the plaque biofilm on the surface of the teeth. However, only a few bibliometric analyses have systematically studied this field to date. This work sought to visualize research hot spots and trends in aging associated with periodontitis from 2002 to 2023 through bibliometric approaches. Methods: Graphpad prism v8.0.2 was used to analyse and plot annual papers, national publication trends and national publication heat maps. In addition, CtieSpace (6.1.6R (64-bit) Advanced Edition) and VOSviewer (version 1.6.18) were used to analyse these data and visualize the scientific knowledge graph. Results: The number of documents related to aging associated with periodontitis has steadily increased over 21 years. With six of the top ten institutions in terms of publications coming from the US, the US is a major driver of research in this area. journal of periodontology is the most published journal in the field. Tonetti MS is the most prolific authors and co-cited authors in the field. Journal of Periodontology and Journal of Clinical Periodontology are the most popular journals in the field with the largest literature. Periodontitis, Alzheimer's disease, and peri-implantitis are current hot topics and trends in the field. Inflammation, biomarkers, oxidative stress cytokines are current research hotspots in this field. Conclusion: Our research found that global publications regarding research on aging associated with periodontitis increased dramatically and were expected to continue increasing. Inflammation and aging, and the relationship between periodontitis and systemic diseases, are topics worthy of attention. [ABSTRACT FROM AUTHOR]

Enterococcus faecalis is one of the bacteria that is commonly found in infected root canals, necrotic pulp and failure of root canal treatment, while Phorphyromonas gingivalis play a role in inducing periodontitis. Both bacteria can enter the blood circulation and lead to risk factors for systemic disease such as atherosclerosis. ChKM is the most widely used root canal sterilization, and also 0.2 % chlorhexidine mouthwash for long-term usage. It can destroy a potent cell and is allergenic. Developing an alternative material for root canal sterilization and mouthwash for plaque control is necessary. One of the alternative natural products that is predicted to have antibacterial effect is robusta coffee husk peels. This research aimed to investigate the antibacterial activity of robusta coffee (Coffea canephora) husk extract on E. faecalis and P. gingivalis. The robusta coffee husk was extracted using the maceration process with 96 % ethanol as the solvent. This research is an experimental laboratory, was tested by disk diffusion methods (Kirby-Baurer) using Gram-positive E. faecalis ATCC 29212 and Gram-negative P. gingivalis ATCC 33277 consisted of 6 groups: Aquadest as a negative control group, ChKM (for E.facecalis) and 0.2 % chlorhexidine (for P. gingivalis) as positive control, 4 treatment groups of coffee robusta husk extract with different concentrations there were 250, 250, 500, 750 and 1,000 mg/mL. The antibacterial effect was examined by measuring the clear zone around the disk paper. The results of this study proved the presence of antibacterial activity of coffee robusta husk extract against E. faecalis and P. gingivalis. The higher concentrations followed with a greater antibacterial effect. [ABSTRACT FROM AUTHOR]

Background: The analysis of samplings from periodontal pockets is important in the diagnosis and therapy of periodontitis. In this study, three different sampling techniques were compared to determine whether one method yielded samples suitable for the reproducible and simultaneous determination of bacterial load, cytokines, neutrophil elastase, and arginine-specific gingipains (Rgps). Rgps are an important virulence factor of Porphyromonas gingivalis, the exact concentration of which in gingival crevicular fluid (GCF) has not been quantified. Methods: GCF was sampled from four sites per patient (one sample per quadrant using two samples per method) in 36 patients with chronic periodontitis. One week later, the procedure was repeated with alternative methods. Variables determined were loads of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) and P. gingivalis, levels of interleukin-6 and -8, activity of neutrophil elastase, and level of Rgps. Results: The detected cytokine levels were higher using paper strips compared to paper points. Bacteria were found in similar loads from paper strips and paper points. Rgps were only detectable in high quantities by washing the periodontal pocket. The level of Rgps correlated with the load of P. gingivalis. Conclusions: The use of paper strips was suitable for the simultaneous determination of microbial and immunologi parameters. Obtaining GCF by washing can be useful for special purposes. The gingipain concentration in periodonta pockets was directly determined to be ≤1.5 µM. This value indicated that most of the substrates of these proteases by in vitro assays identified until now can be easily degraded in P. gingivalis-infected sites. [ABSTRACT FROM AUTHOR]

This systematic review assessed to evaluate the potential correlation between oral health and air pollution. To the best of the authors' knowledge, this is the first systematic review endeavoring to compare air pollution and oral health. A systematic search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement and employed the PICO(S) approach (Patient or Population, Intervention, Control or Comparison, Outcome, and Study types). The search was limited to English-language articles, and publications within a 15-year timeframe were included in the electronic search. A comprehensive search was conducted across PubMed, Scopus, Embase, and Web of Science databases, spanning the years 2008 to 2023, resulting in a total of 4983 scientific articles. A final selection of 11 scientific papers was made based on their study type and the specific air pollutants examined. The selected papers analyzed various air pollutants associated with health-related diseases, including Ozone, Nitrogen Dioxide, Nitrogen Monoxide, Carbon Monoxide, sulfur dioxide, and particulate matter. Three out of eleven of the reviewed studies assert a strong correlation between air pollutants and oral diseases, specifically periodontitis. However, the exact biological mechanisms underlying this correlation do not seem to be fully understood, indicating the need for further comprehensive investigation in this regard. Dentists can contribute to the collective effort by educating their patients about the oral health implications of air pollution, thereby supporting initiatives aimed at promoting environmental and health sustainability. [ABSTRACT FROM AUTHOR]

This study investigated the impact of tobacco exposure, specifically through heating and burning, on periodontopathogens in the subgingival microbiome among clinically healthy individuals and those diagnosed with periodontitis. The sample comprised 66 subjects (26–56 years, median 38 yrs; 64% females) classified as non-smokers, classic cigarette smokers, and tobacco heating system (THS) smokers (each N = 22). Full-mouth periodontal examination was performed, and 330 paper-point samples from periodontal pockets were collected. Next-generation sequencing of 16S rRNA genes was conducted to identify the composition of subgingival microbiome. Periodontitis prevalence among the groups was ranked as THS (41%) < non-smokers (44%) < cigarette smokers (68%), without statistically significant differences between the groups. The number of perio-pathogenic species was higher in subjects with periodontitis compared to those without (median 7 vs. 6 species; p = 0.005) but without significant differences between exposure groups: non-smokers (6) = smokers (6) < THS (6.5). When combining exposure and periodontal status, each smoker group had more perio-pathogenic species than non-smokers: non-smokers without periodontitis (5) < smokers without periodontitis (5.5) < THS without periodontitis (6); non-smokers with periodontitis (6.5) < THS with periodontitis (7) = smokers with periodontitis (7). Multiple linear regression indicated periodontitis as the sole predictor of perio-pathogenic species quantity, irrespective of the type of tobacco consumption, sex, age, or oral hygiene (R2 = 0.163; p = 0.005). In conclusion, the quantity of perio-pathogenic species in the subgingival microbiome was more influenced by periodontitis than by exposure to tobacco smoke, regardless of whether it was heated or burned. [ABSTRACT FROM AUTHOR]

Periodontal disease is a highly prevalent disease worldwide that seriously affects people's oral health, including gingivitis and periodontitis. Although the current treatment of periodontal disease can achieve good control of inflammation, it is difficult to regenerate the periodontal supporting tissues to achieve a satisfactory therapeutic effect. In recent years, due to the good tissue regeneration ability, the research on Mesenchymal stromal/stem cells (MSCs) and MSC-derived exosomes has been gradually deepened, especially its ability to interact with the microenvironment of the body in the complex immunoregulatory network, which has led to many new perspectives on the therapeutic strategies for many diseases. This paper systematically reviews the immunomodulatory (including bone immunomodulation) properties of MSCs and their role in the periodontal inflammatory microenvironment, summarizes the pathways and mechanisms by which MSCs and MSC-EVs have promoted periodontal regeneration in recent years, lists potential areas for future research, and describes the issues that should be considered in future basic research and the direction of development of "cell-free therapies" for periodontal regeneration. [ABSTRACT FROM AUTHOR]

Periodontal ligament fibroblasts (PDLFs) play a crucial role in the etiology of periodontitis and periodontal tissue regeneration. In healthy periodontal tissues, PDLFs maintain the homeostasis of periodontal soft and hard tissues as well as the local immune microenvironment. PDLFs also have the potential for multidirectional transdifferentiation and are involved in periodontal tissue regeneration. On the other hand, PDLFs can become dysfunctional and acquire an inflammatory phenotype to secret various inflammatory cytokines when affected by pathological factors. These cytokines further trigger immune and inflammatory events, and lead to destruction of periodontal soft and hard tissues as well as damage to the regenerative potential of PDLFs. This review summarizes the physiological functions of PDLFs. Meanwhile, this review also highlights recent insights into the pathological mechanisms driving the development of periodontitis through dysfunctional PDLFs and the negative impact on periodontal tissue regeneration. Additionally, this paper summarizes strategies for targeting PDLFs to treat periodontitis, involving blocking multiple stages of the inflammatory response induced by PDLFs and promoting the multidirectional transdifferentiation of PDLFs. Future research directions are proposed to address important questions that have not yet been answered in this field. This article provides a reference for understanding the important role of PDLFs in the pathological mechanisms of periodontitis and for developing new strategies for targeting PDLFs in periodontitis treatment. [ABSTRACT FROM AUTHOR]

Background/Objectives: This narrative review paper highlights the multifaceted influence of dysbiotic biofilm, genetic background, host response, and environmental factors on periodontitis. It explores the roles of type I and II diabetes mellitus, gestational diabetes, and metabolic syndrome in the progression of periodontitis, drawing insights from various empirical studies and theoretical perspectives. Methods: Relevant articles were sourced using keywords in databases like PubMed/Medline, Science Direct, Scopus, and Google Scholar. Additionally, this review examines the relationship between aMMP-8 levels and increased glycemic states, as well as varying degrees of periodontitis severity. Results: The biomarker active-matrix metalloproteinase-8 (aMMP-8), produced by polymorphonuclear leukocytes (PMN), is highlighted as a reliable indicator of ongoing connective tissue degradation. Dysfunctions in PMN activity, accumulation of advanced glycation end products (AGE), and oxidative stress aggravate the periodontal inflammatory response and complications of diabetes. Traditional diagnostics of periodontitis do not provide sufficient information about the current or future disease initiation or activity of periodontitis. Conclusions: The implications of this review point to the need for monitoring periodontal health by utilizing innovative strategies like aMMP-8 point-of-care testing, using oral rinse for screening and treatment monitoring, and harnessing the potential of supportive treatments like low-dose doxycycline and light-activated mouth rinses for restoring periodontal health. Its expression in oral fluids is a promising diagnostic tool to differentiate periodontitis from gingivitis and healthy periodontium, especially when associated with systemic diseases, fostering greater collaboration among healthcare professionals. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Periodontitis is a slow progressing infection and has profound systemic implications. The influence of various therapeutic drugs to inhibit inflammation and promote bone regeneration has been studied. Introduction of newer congeners of older drugs necessitates testing the efficacy of newer drugs for the said use. Aim: The aim was to determine the effectiveness of newer nitroimidazoles and fluoroquinolones for controlling and eliminating periodontal pathology by binding to the targets. Methods and Material: A total of 12 drugs were selected, and the chemical structure drugs used were retrieved form PubChem and development of 2d and 3d structures was done using chem draw software. Targets used were Gingipain K, FimA, Interleukin-1β, and Estrogen Receptor β. AutoDock version 4 software was used for in silico docking simulations. The binding free energy, inhibition constant, electrostatic energy, intermolecular energy, and total interaction surface are all provided by the docking tool. In this paper, the optimal docking pose for each target is chosen and presented. Results: From the results of the study, it can be observed that gatifloxacin and ciprofloxacin have more affinity and interactions with all four targets were analyzed. Conclusions: This study has effectively tested nitroimidazoles and fluoroquinolones comparatively and proposed that fluoroquinolones are more effective for blocking periodontitis. [ABSTRACT FROM AUTHOR]