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OBJECTIVE: To verify a possible association between periodontitis and low-birth-weight babies. MATERIAL AND METHODS: One hundred and fifty-one mothers were examined. The case group included 76 mothers (mean age 25.6 years), whose babies at birth weighed <2500 g and had a gestational age (GA) <37 weeks, while 75 mothers (mean age 24.4 years), whose babies were born with a weight of >2500 g and with a GA>37 weeks, were the control group. Data from the mothers and the babies were collected from the Hospital registration records and during an interview with the mother. The periodontal examination included measurements of probing pocket depth (PPD) and clinical attachment loss (CAL) in six sites from all existing teeth, except for third molars. Mothers with periodontitis had at least four sites with PPD> or =4 and CAL> or =3 mm, while healthy mothers had PPD< or =3 mm and CAL< or =1 mm. RESULTS: The median number of sites with PPD> or =4 and CAL> or =3 mm was eight in the case group, and four in the control group. The significant associations with low birth weight (LBW) babies were periodontitis (odds ratio (OR)=3.48, 95% confidence interval (CI): 1.17; 10.36), arterial hypertension (OR=9.65, 95% CI: 2.22; 41.91), haemorrhage during pregnancy (OR=10.88, 95% CI: 1.95; 60.53), number of pre-natal examinations (OR=0.10, 95% CI: 0.02; 0.43) and genitourinary infection (OR=3.21, 95% CI: 1.25; 8.20). CONCLUSION: Periodontitis was considered a risk indicator for LBW in this sample, similar to other risk factors already recognized by obstetricians. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Our aim was to compare the periodontal conditions in a group of juvenile idiopathic arthritis (JIA) patients with those in a control group of healthy subjects (CTR). MATERIAL AND METHODS: Thirty-two patients with JIA and 24 controls were selected. The measurements used to diagnose periodontal disease included plaque and bleeding scores, probing depths (PDs) and clinical attachment loss (CAL). Laboratory indicators of JIA activity included the erythrocyte sedimentation rate (ESR) and capsule-reactive protein (CRP). The Mann-Whitney test was used to evaluate the data (alpha = 0.05). RESULTS: The mean ages were 15.9 (+/- 2.7) years and 14.7 (+/- 2.3) years for groups JIA and CTR, respectively. The median ESR was 42 mm/h 13 mm/h in the CTR group (p = 0.032) and the median CRP was 1.9 and 0.4 mg/l, respectively (p = 0.001). The prevalence of patients with a proximal attachment loss of 2mm or more in the JIA group was 25% and in controls it was 4.2%. The mean percentages of visible plaque and marginal bleeding were similar in the JIA (54 +/- 22 and 30 +/- 16, respectively) and CTR groups (44 +/- 18 and 29 +/- 11, respectively). The mean percentages of sites with PD > or = 4 mm were significantly higher in the JIA group (3 +/- 4.7) than in the CTR group (0.4 +/- 1.7) (p = 0.012). The mean percentages of sites with proximal CAL > or = 2 mm were 0.7 (+/- 1.4) in the JIA group and 0.001 (+/- 0.2) in the CTR group (p = 0.022). CONCLUSION: Adolescents with JIA present more periodontal attachment loss than healthy controls, in spite of similar plaque and marginal bleeding levels. [ABSTRACT FROM AUTHOR]

Background: Identifying patients with a strong pro-inflammatory phenotype may allow clinicians to underpin high-risk individuals based on early inflammatory marker profiles and to personalize approaches to preventative treatments. Aim: The objective of this systematic review is to synthesize the results of previous studies on osseointegration to show which pro-inflammatory cytokines and chemokines have been detected and quantified during the initial phase of osseointegration. Material and methods: PubMed, Embase, Scopus, ISI Web of Science, and Cochrane Library were searched for articles published until August 2024. A descriptive summary was produced to explain study variations, including patients' characteristics and results. The methodological quality of each included study was assessed based on Downs and Black's checklist. Results: 30 studies were selected for inclusion. In total, 710 patients received 1329 implants (an average of 1.87 implants per participant). A total of 32 biomarkers were analyzed. The overall trend observed in levels of pro-inflammatory cytokines and chemokines appears to be an early peak, followed by a progressive reduction in levels throughout the observation periods. Conclusions: The available evidence suggests that a strong expression of pro-inflammatory biomarkers is a feature of osseointegration, and an over- or underexpression of certain biomarkers could have an effect on early marginal bone levels. Several of these markers are mechanistically implicated with implant pathology; however, the prognostic value of early cytokine expression and correlation with long-term clinical outcomes requires further research.

Our study examined how different titanium alloy Ti6Al4V (Ti64) and zirconia (ZrO 2 ) surfaces, ranging from rough to very smooth, affect the expression of elastase (NE), matrix metalloproteinase (MMP)-8, MMP-9, and extracellular traps (NETs) by neutrophils. Discs of Ti64 and ZrO 2 , 10 mm in diameter and 1.5 mm thick, were created using diamond-impregnated polishing burs and paste to produce rough (Ra > 3 µm), smooth (Ra ≥ 1 to 1.5 µm), and very smooth (Ra < 0.1 µm) surfaces. Neutrophils from Wistar rats were cultured on these surfaces, and the culture supernatants were then examined for NE, MMP-8, and MMP-9 using ELISA. At the same time, NET formation was demonstrated immunohistochemically by staining neutrophils with CD16b and DNA with DAPI. Overall, the expressions of NE and MMP-8 were significantly higher from neutrophil culture on Ti64 and ZrO 2 rough surfaces compared to the very smooth surface (R > S > VS) after 2 h and 4 h of culture. The expression of MMP-9 also increased with culture time; however, no significant surface effects on expression were observed. Similarly, rough Ti64 and ZrO 2 surfaces (R & S) also showed significantly larger NET formation compared to the very smooth surface (VS) after 4 h and 8 h cultures. Our findings suggest that increasing surface roughness on Ti64 and ZrO 2 triggers higher NE, MMP-8, and NET formation secretion.

Background/Objectives: Periodontitis (P), a chronic inflammatory condition that affects the supportive tissues around the teeth, is three to four times more prevalent in individuals with diabetes mellitus (DM), with a direct correlation between its severity and the levels of glycosylated hemoglobin (HbA1c). This study aimed to evaluate the periodontal clinical parameters following non-surgical periodontal treatment (NSPT) in P patients with or without type 2 DM. Methods : Forty patients with P were divided into two groups: Group DM/P and Group P. All the patients were assessed at baseline and at 90 and 180 days after receiving NSPT. The parameters evaluated included the HbA1c level, plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BoP). A statistical analysis was performed with a significance level set at α = 5%. Results : There were significant differences in the HbA1c levels between the DM/P and P groups at baseline, 90, and 180 days, as expected. Importantly, the HbA1c levels did not change after NSPT. Group P showed a significant reduction in both the PI and the BoP values at 90 and 180 days ( p < 0.05). In contrast, Group DM/P demonstrated a significant increase in the percentage of sites with a PPD ≥ 5 mm at 180 days ( p < 0.05). Additionally, Group P exhibited an increase in sites with a PPD ≤ 4 mm and a decrease in sites with a PPD ≥ 5 mm at both 90 and 180 days ( p < 0.05). Conclusions: Our findings suggest that DM may compromise the effectiveness of NSPT, potentially hindering favorable outcomes during the follow-up period.

We sought to evaluate the effects of non-surgical periodontal treatment (NSPT) on periodontal clinical parameters, systemic blood pressure (BP), and plasma levels of systemic inflammation markers in patients with combined refractory arterial hypertension (RAH) and stage III grade B periodontitis. Twenty-seven participants with RAH and periodontitis received NSPT. The analyzed clinical parameters were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). An assessment was performed for systemic BP, complete blood count, coagulogram, creatinine measurement, C-reactive protein (CRP), glycated hemoglobin, cholesterol, glutamic oxaloacetic transaminase, glutamate pyruvic transaminase, waist-hip ratio, and body mass index. In the follow-up period, twenty-two patients were evaluated at baseline and after 90 and 180 days. The data were submitted for statistical analysis (α = 0.05%). As expected, the clinical results showed a significant improvement in the percentages of PI, BOP, PD, and CAL, which were statistically significant at 90 and 180 days ( p < 0.0001). Importantly, NSPT significantly reduced the blood level of CRP ( p < 0.02). However, no significant reduction in BP parameters was noted in the evaluated follow-up periods. NSPT, despite the benefits in periodontal clinical parameters, reduced the plasma level of CRP but not the BP in patients with combined RAH and periodontitis.

The purpose of this in vitro study is to evaluate the effectiveness of incorporating a new irrigation system into a surgical guide and monitor its effect on heat generation during implant bed preparation. A total of 48 surgically guided osteotomies were performed on 12 bovine ribs divided into 4 groups, using different irrigation techniques: Group A (test) had entry and exit channels incorporated into the guide; Group B had a similar design with an entry channel only; Group C had conventional external irrigation; and Group D (control) had no irrigation. Heat generation during the osteotomies was measured using thermocouples placed at a depth of 2 mm and 6 mm. The lowest mean temperature was observed in Group A (22.1 °C at 2 mm and 21.4 °C at 6 mm), which was statistically significant when compared with Groups C and D ( p < 0.001). Group A showed a lower mean temperature compared with Group B as well; however, it was statistically significant only at 6 mm depth ( p < 0.05). In conclusion, the proposed surgical guide has significantly reduced heat generation during implant osteotomy compared to conventional external irrigation. The integration of an exit cooling channel can resolve limitations found in previously designed surgical guides such as debris blockage and can be easily incorporated into computer designing and 3D printing software.

Objectives: This systematic review aimed to assess in vitro studies that evaluated neutrophil interactions with different roughness levels in titanium and zirconia implant surfaces., Material and Methods: An electronic search for literature was conducted on PubMed, Embase, Scopus, and Web of Science and a total of 14 studies were included. Neutrophil responses were assessed based on adhesion, cell number, surface coverage, cell structure, cytokine secretion, reactive oxygen species (ROS) production, neutrophil activation, receptor expression, and neutrophil extracellular traps (NETs) release. The method of assessing the risk of bias was done using the toxicological data reliability assessment tool (TOXRTOOL)., Results: Ten studies have identified a significant increase in neutrophil functions, such as surface coverage, cell adhesion, ROS production, and NETs released when interacting with rough titanium surfaces. Moreover, neutrophil interaction with rough-hydrophilic surfaces seems to produce less proinflammatory cytokines and ROS when compared to naive smooth and rough titanium surfaces. Regarding membrane receptor expression, two studies have reported that the FcγIII receptor (CD16) is responsible for initial neutrophil adhesion to hydrophilic titanium surfaces. Only one study compared neutrophil interaction with titanium alloy and zirconia toughened alumina surfaces and reported no significant differences in neutrophil cell count, activation, receptor expression, and death., Conclusions: There are not enough studies to conclude neutrophil interactions with titanium and zirconia surfaces. However, different topographic modifications such as roughness and hydrophilicity might influence neutrophil interactions with titanium implant surfaces., (© 2022 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Background: This study aimed to compare the effectiveness of non-surgical periodontal treatment in improving periodontal status and reducing gingival crevicular fluid (GCF) levels of interleukin (IL)-1β and IL-18, elastase activity, and matrix metalloproteinase (MMP)--8 and --9 in periodontitis patients with and without type 2 diabetes mellitus (T2DM)., Methods: Twenty-three patients with T2DM (diabetes group) and 26 systemically healthy subjects (control group) with chronic periodontitis participated in this study. The clinical examination included visible plaque index, gingival bleeding index, probing depth, clinical attachment level, and bleeding on probing. GCF samples were collected from five or six deep sites to evaluate the levels of IL-1β and -18, elastase, and MMP-8 and -9. Shallow sites were analyzed for IL-1β and elastase. The glycemic control was analyzed by the concentration of glycated hemoglobin (HbA1c). The subjects received non-surgical periodontal treatment and were reexamined 90 days later., Results: All clinical parameters showed a significant improvement after treatment, which was accompanied by a significant reduction in IL-1β, elastase activity, and MMP-8 and -9 levels in deep sites. The shallow sites also showed significant reductions in IL-1β and elastase activity levels. Treatment did not significantly reduce HbA1c concentrations in patients with T2DM., Conclusions: Non-surgical periodontal treatment was effective in reducing the levels of IL-1β, elastase activity, and MMP-8 and -9 in GCF from diabetes and control groups. Patients with T2DM showed less reduction only in elastase activity in shallow sites compared to controls. This reduction was associated with improvement of the clinical periodontal status., (© 2008 American Academy of Periodontology.)

Background: The primary aim of this study was to compare the inflammatory activity in the gingival crevicular fluid (GCF) in a group of patients with rheumatoid arthritis (RA) and a group of matched controls. Secondarily, we aimed to evaluate the effect of rheumatologic treatment on periodontal inflammation., Methods: Seventeen individuals with RA with a mean duration of disease of 12.1 (± 9.9) years and the same number of systemically healthy individuals matched for age, gender, periodontal status, and tobacco use were selected. Medication data were registered, and GCF was collected by means of an intracrevicular washing method. Besides clinical registrations, periodontal inflammation was assessed by analysis of the cytokines interleukin (IL)-1β and -18 and of elastase activity., Results: Amounts of IL-1β and total elastase were significantly lower in the patient group. IL-1β and total elastase had a significant and strong correlation in the RA group (r s = 0.883). This correlation was not observed in the control group., Conclusion: The anti-inflammatory treatment taken by RA patients might influence the periodontal inflammation status represented by IL-1β and elastase in the GCF., (© 2007 American Academy of Periodontology.)

Background: The levels of interleukin-1β (IL-1β) have been reported to be higher in sites with periodontitis than in healthy controls. This may be the result of a more severe inflammation and/or constitutional differences in IL-1β production. Our aim was to test the hypothesis that the level of IL-1β in gingival crevicular fluid (GCF) is a characteristic trait of periodontitis, regardless of the degree of tissue destruction. As a secondary aim, we investigated the correlation between IL-1β and neutrophil elastase. An untreated population was used., Methods: GCF samples from inflamed sites in 13 patients with gingivitis (GG), and from inflamed sites with shallow (GP) and deep (PP) pockets in 18 patients with periodontitis were collected. Interleukin-1β, elastase-α-1-antitrypsin complex (E-A1AT), α-1-antitrypsin (A1AT), and α-2-macroglobulin (A2MG) were measured with ELISA. Elastase activity was measured with a specific substrate., Results: The concentration of IL-1β was significantly higher in PP than in GG, but no significant differences were detected between PP and GP. A weak positive correlation between the elastase activity and IL-1β was also observed. The elastase activity had a tendency to be higher in PP, although no significant difference was found among the 3 groups. The concentrations of E-A1AT, A1AT, and A2MG were similar in the 3 types of sites., Conclusions: The levels of IL-1β in GCF were increased in samples from periodontitis patients, regardless of the severity of disease at the sampled site, suggesting that the levels of IL-1β are typical of a given patient. J Periodontol 1999;70:1457-1463., (© 1999 American Academy of Periodontology.)