Effect of hyperlipidemia on response to nonsurgical periodontal therapy: Statin users versus nonusers

ABSTRACT Objective: To evaluate the response to nonsurgical periodontal therapy among hyperlipidemic subjects and whether statin use by hyperlipidemic subjects influences the response. Materials and Methods: This study was conducted on 107 chronic periodontitis subjects (35 normolipidemic [NL] controls, 36 hyperlipidemics on nonpharmacological therapy and 36 hyperlipidemics on statins). Periodontal (plaque index, gingival index [GI], probing depth [PD], and clinical attachment level [CAL]) and biochemical (plasma triglyceride [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-DL-C [HDL-C] levels) examination was done at baseline and 3 months after nonsurgical periodontal treatment. Results: Both the NL and statin groups exhibited significantly greater improvement in GI as compared to the hyperlipidemic group on nonpharmacological therapy (P = 0.004 and 0.006, respectively). Mean change in PD correlated negatively with baseline TC (r = −0.306) and LDL-C (r = −0.360) while mean change in GI positively correlated with baseline HDL-C (r = 0.219). Regression analyses revealed that mean change in PD was negatively associated with LDL-C (β = −0.358, P < 0.001) while mean change in GI was positively associated with HDL-C (β = 0.219, P = 0.023). Conclusions: While higher baseline lipid levels were somewhat detrimental to the resolution of inflammation postperiodontal treatment, the inclusion of statin therapy among hyperlipidemic subjects seemed to improve clinical response as compared to those devoid of the drug. The findings of the study are suggestive of a possible adjunctive role of statins in periodontal treatment that warrants future studies.

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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy: a randomized clinical trial

BMC Oral Health ◽

10.1186/s12903-020-01363-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Holger F. R. Jentsch ◽

Christian Flechsig ◽

Benjamin Kette ◽

Sigrun Eick

Keyword(s):

Test Group ◽

Nonparametric Tests ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Control Group ◽

Clinical Variables ◽

Air Polishing ◽

Probing Depth ◽

Nonsurgical Periodontal Therapy ◽

Attachment Level

Abstract Background This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. Clinical relevance The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL.

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Aspectos clínicos, microbiológicos e tratamento periodontal em pacientes fumantes portadores de doença periodontal crônica: revisão da literatura

Revista Brasileira de Odontologia ◽

10.18363/rbo.v73n4.p.325 ◽

2016 ◽

Vol 73 (4) ◽

pp. 325

Author(s):

Gabriela Alessandra Da C. Galhardo Camargo ◽

Mariana Gouvea Latini Abreu ◽

Renata Dos Santos ◽

Marcio Alves Crespo ◽

Leticia De Faria Wenderoscky

Keyword(s):

Gingival Recession ◽

Periodontal Therapy ◽

Clinical Aspects ◽

Gingival Index ◽

Periodontal Pathogens ◽

Clinical Attachment Level ◽

Qualitative And Quantitative ◽

Probing Depth ◽

Microbiological Parameters ◽

Attachment Level

Objective: the aim of this study was to evaluate, through literature review, clinical aspects (plaque index, gingival index, probing depth, gingival recession and clinical attachment level) and microbiological (qualitative and quantitative presence of periodontal pathogens) in smokers patients and the response to periodontal therapy. Material and Methods: it was selected scientific articles published between the years 1978 and 2014. We were selected scientific articles from MEDLINE, PUBMED and LILACS databases. Results: there are controversies between tobacco and clinical and microbiological parameters. Conclusion: based on the evaluated studies we can conclude that there are significant clinical and microbiological differences in smoking patients and impaired response to periodontal therapy.

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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy – a randomized clinical trial

10.21203/rs.3.rs-47863/v2 ◽

2020 ◽

Author(s):

Holger F.R. Jentsch ◽

Christian Flechsig ◽

Benjamin Kette ◽

Sigrun Eick

Keyword(s):

Test Group ◽

Nonparametric Tests ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Control Group ◽

Clinical Variables ◽

Air Polishing ◽

Probing Depth ◽

Nonsurgical Periodontal Therapy ◽

Attachment Level

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods:Forty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21). They were analyzed for the clinical variables BOP (primary outcome at six month), probing depth (PD), attachment level (AL), four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions:Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5mm when compared with subgingival instrumentation only. Clinical relevanceThe adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery.

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Genetic Polymorphisms of NLRP3 (rs4612666) and CARD8 (rs2043211) in Periodontitis and Cardiovascular Diseases

Biology ◽

10.3390/biology10070592 ◽

2021 ◽

Vol 10 (7) ◽

pp. 592

Author(s):

Jaideep Mahendra ◽

Abirami Nayaki Rao ◽

Little Mahendra ◽

Hytham N. Fageeh ◽

Hammam Ibrahim Fageeh ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Conventional Polymerase Chain Reaction ◽

Demographic Variables ◽

Clinical Attachment Level ◽

Significant Relationships ◽

Polymerase Chain ◽

Attachment Level

Background: The existing data show that inflammasomes play a role in periodontal disease pathogenesis. However, their role in the pathogenesis of periodontitis and coronary heart disease remains unclear. This study had the objective of assessing NLRP3 (rs4612666) and CARD8 (rs2043211) gene polymorphisms in dental plaque and blood of generalized chronic periodontitis (CP) patients in the presence and absence of coronary heart disease (CHD). Methods: A total of 70 subjects were divided into two groups, including CP and CP + CHD subjects. Demographic variables, periodontal, and cardiac parameters were recorded from both groups. Subgingival plaque and blood samples were obtained from both groups and were subjected to further molecular analysis for NLRP3 (rs4612666) and CARD8 (rs2043211) expression and allele change using conventional polymerase chain reaction (PCR) and gene sequencing (Sanger’s method). Results: Amongst the demographic variables, age, and monthly income were statistically significant between the two groups. Plaque index (PI), clinical attachment level (CAL), high-density lipoprotein (HDL), and low density-lipoprotein (LDL) exhibited statistically significant levels between the two groups. NLRP3 (rs4612666) and CARD8 (rs2043211) genes showed a statistically significant association of allele change (frequency) among the groups. In general, when all of the parameters were compared to the allele change of the genes, statistically significant relationships were found between the two groups. Conclusions: The present study expressed an allele change of the investigated genes which could profoundly affect the pathobiology of the two diseases under investigation.

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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy – a randomized clinical trial

10.21203/rs.3.rs-47863/v3 ◽

2020 ◽

Author(s):

Holger F.R. Jentsch ◽

Christian Flechsig ◽

Benjamin Kette ◽

Sigrun Eick

Keyword(s):

Test Group ◽

Nonparametric Tests ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Control Group ◽

Clinical Variables ◽

Air Polishing ◽

Probing Depth ◽

Nonsurgical Periodontal Therapy ◽

Attachment Level

Abstract Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods: Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n=21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n=21). They were analyzed for the clinical variables BOP (primary outcome at six month), probing depth (PD), attachment level (AL), four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results: In both groups, the clinical variables probing depth (PD), attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5mm was significantly lower in the test group than in the control group after six months. At six months vs. baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions: Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5mm when compared with subgingival instrumentation only. Clinical relevance: The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration: The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId =trial.HTML&TRIAL

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Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No Aggregatibacter actinomycetemcomitans Is Detected—A Randomized Clinical Trial

Antibiotics ◽

10.3390/antibiotics9100686 ◽

2020 ◽

Vol 9 (10) ◽

pp. 686

Author(s):

Holger F. R. Jentsch ◽

Martin Dietrich ◽

Sigrun Eick

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Gingival Crevicular Fluid ◽

Aggregatibacter Actinomycetemcomitans ◽

Periodontal Therapy ◽

Clinical Attachment Level ◽

Probing Depth ◽

Crevicular Fluid ◽

Systemic Antibiotics ◽

Attachment Level

Background: The aim was to compare two different systemic antibiotics regimens adjunctive to non-surgical periodontal therapy when Aggregatibacter actinomycetemcomitans was not detected in the subgingival biofilm. Methods: A total of 58 patients with periodontitis and with no A. actinomycetemcomitans in the subgingival biofilm were treated with full-mouth subgingival instrumentation and either metronidazole (MET; n = 29) or amoxicillin/metronidazole (AMX/MET; n = 29). Probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) were recorded at baseline, as well as after three and six months. Subgingival biofilm and gingival crevicular fluid were collected and analyzed for major periodontopathogens and biomarkers. Results: PD, CAL and BOP improved at 3 and 6 months (each p < 0.001 vs. baseline) with no difference between the groups. Sites with initial PD ≥ 6 mm also improved in both groups after 3 and 6 months (p < 0.001) with a higher reduction of PD in the AMX/MET group (p < 0.05). T. forsythia was lower in the AMX/MET group after 3 months (p < 0.05). MMP-8 and IL-1β were without significant changes and differences between the groups. Conclusion: When A. actinomycetemcomitans was not detected in the subgingival biofilm, the adjunctive systemic use of amoxicillin/metronidazole results in better clinical and microbiological outcomes of non-surgical periodontal therapy when the application of systemic antibiotics is scheduled.

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Antimicrobial or Subantimicrobial Antibiotic Therapy as an Adjunct to the Nonsurgical Periodontal Treatment: A Meta-Analysis

ISRN Dentistry ◽

10.5402/2012/581207 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 7

Author(s):

Ana Patricia Moreno Villagrana ◽

José Francisco Gómez Clavel

Keyword(s):

Chronic Periodontitis ◽

Meta Analysis ◽

Periodontal Treatment ◽

Randomized Controlled Clinical Trials ◽

Probing Depth ◽

Nonsurgical Periodontal Therapy ◽

Post Hoc ◽

Systemic Antibiotics ◽

Periodontal Probing ◽

Attachment Level

The use of antibiotics in nonsurgical periodontal treatment is indicated in cases in which scaling and root planing present important limitations. However, their use is controversial due to the secondary effects associated with them and the disagreements regarding their prescription. The aim of this study is to determine the effectiveness of systemic antibiotics in the management of aggressive and chronic periodontitis. The study was based on a search of randomized, controlled clinical trials. Common data were concentrated and evaluated by means of an analysis of variance (ANOVA), and a meta-analysis of the results was performed. The meta-analysis (, 95% confidence interval, post hoc Bonferroni) determined that the supplementation of nonsurgical periodontal therapy with a systemic antibiotic treatment—amoxicillin with clavulanic acid and metronidazole or subantimicrobial dose doxycycline—provides statistically significant results in patients with aggressive or chronic periodontitis under periodontal treatment, whilst increasing the clinical attachment level of the gingiva and reducing periodontal probing depth.

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Effects of periodontal treatment on serum inflammatory markers and CD4T-lymphocyte cell count in patients with human immunodeficiency virus infection

Medicinski pregled ◽

10.2298/mpns1812355g ◽

2018 ◽

Vol 71 (11-12) ◽

pp. 355-359

Author(s):

Ivana Gusic ◽

Milanko Djuric ◽

Tanja Veljovic ◽

Jelena Mirnic ◽

Duska Blagojevic ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Interleukin 1 ◽

Periodontal Therapy ◽

C Reactive Protein ◽

Clinical Attachment Level ◽

Reactive Protein ◽

Probing Depth ◽

Immunodeficiency Virus ◽

Lymphocyte Cell ◽

Attachment Level

Introduction. Several studies have reported reduction in the serum concentration of systemic inflammatory markers upon completion of periodontal therapy. However, no studies have been conducted on the effects of periodontal therapy on systemic inflammation in human immunodeficiency virus-positive patients. The aim of this study was to investigate the effects of periodontal therapy on the serum levels of systemic inflammatory biomarkers and CD4T-lymphocyte cell count in human immunodeficiency virus-positive patients. Material and Methods. The study included 34 human immunodeficiency viruspositive patients with chronic periodontitis receiving antiretroviral therapy. Periodontal parameters (plaque index, gingival index, papilla bleeding index, probing depth and clinical attachment level) and serum samples, assessed for the levels of interleukin- 1 ?, tumor necrosis factor-?, and C-reactive protein, were evaluated at baseline, 1- and 3-months upon completion of the non-surgical periodontal therapy. The CD4T-lymphocyte count was measured at baseline and three months after treatment completion. Results. Significant reduction in the values of plaque index, gingival index, papilla bleeding index, and probing depth was noted (p < 0.001), whereas the reduction in the median clinical attachment level value did not reach a statistically significant level (F = 1.321; p = 0.261). Local inflammation reduction was accompanied by a significant decrease in serum C-reactive protein (F = 5.765; p = 0.014) and a CD4Tlymphocyte count increase (t = 2.321; p = 0.027). Serum interleukin-1? and tumor necrosis factor-? did not change significantly as a result of periodontal treatment. Conclusion. Periodontal therapy contributes to the reduction of C-reactive protein and improvement of general health in human immunodeficiency virus-positive patients receiving highly active antiretroviral therapy.

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The Role of the Low-Density Lipoprotein Receptor-Related Protein (LRP) in the Plasma Clearance and Liver Uptake of Recombinant Single-chain Urokinase-type Plasminogen Activator in Rats

Thrombosis and Haemostasis ◽

10.1055/s-0038-1656039 ◽

1997 ◽

Vol 77 (04) ◽

pp. 710-717 ◽

Cited By ~ 5

Author(s):

Marieke E van der Kaaden ◽

Dingeman C Rijken ◽

J Kar Kruijt ◽

Theo J C van Berkel ◽

Johan Kuiper

Keyword(s):

Plasminogen Activator ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Single Chain ◽

Liver Uptake ◽

Type Plasminogen Activator ◽

Parenchymal Liver ◽

Urokinase Type Plasminogen Activator ◽

Density Lipoprotein Receptor

SummaryUrokinase-type plasminogen activator (u-PA) is used as a thrombolytic agent in the treatment of acute myocardial infarction. In vitro, recombinant single-chain u-PA (rscu-PA) expressed in E.coli is recognized by the Low-Density Lipoprotein Receptor-related Protein (LRP) on rat parenchymal liver cells. In this study we investigated the role of LRP in the liver uptake and plasma clearance of rscu-PA in rats. A preinjection of the LRP inhibitor GST-RAP reduced the maximal liver uptake of 125I-rscu-PA at 5 min after injection from 50 to 30% of the injected dose and decreased the clearance of rscu-PA from 2.37 ml/min to 1.58 ml/min. Parenchymal, Kupffer and endothelial cells were responsible for 40, 50 and 10% of the liver uptake, respectively. The reduction in liver uptake of rscu-PA by the preinjection of GST-RAP was caused by a 91 % and 62% reduction in the uptake by parenchymal and Kupffer cells, respectively. In order to investigate the part of rscu-PA that accounted for the interaction with LRP, experiments were performed with a mutant of rscu-PA lacking residues 11-135 (= deltal25- rscu-PA). Deletion of residues 11-135 resulted in a 80% reduction in liver uptake and a 2.4 times slower clearance (0.97 ml/min). The parenchymal, Kupffer and endothelial cells were responsible for respectively 60, 33 and 7% of the liver uptake of 125I-deltal25-rscu-PA. Preinjection of GST-RAP completely reduced the liver uptake of delta 125-rscu-PA and reduced its clearance to 0.79 ml/min. Treatment of isolated Kupffer cells with PI-PLC reduced the binding of rscu-PA by 40%, suggesting the involvement of the urokinase-type Plasminogen Activator Receptor (u-PAR) in the recognition of rscu-PA. Our results demonstrate that in vivo LRP is responsible for more than 90% of the parenchymal liver cell mediated uptake of rscu-PA and for 60% of the Kupffer cell interaction. It is also suggested that u-PAR is involved in the Kupffer cell recognition of rscu-PA.

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The Role of the Endothelium in Premature Atherosclerosis: Molecular Mechanisms

Current Medicinal Chemistry ◽

10.2174/0929867326666190911141951 ◽

2020 ◽

Vol 27 (7) ◽

pp. 1041-1051 ◽

Cited By ~ 1

Author(s):

Michael Spartalis ◽

Eleftherios Spartalis ◽

Antonios Athanasiou ◽

Stavroula A. Paschou ◽

Christos Kontogiannis ◽

...

Keyword(s):

Molecular Mechanisms ◽

Low Density Lipoprotein ◽

Critical Role ◽

Density Lipoprotein ◽

Number Of Genes ◽

Causes Of Mortality ◽

Artery Disease ◽

Genetic And Environmental Factors ◽

Made In

Atherosclerotic disease is still one of the leading causes of mortality. Atherosclerosis is a complex progressive and systematic artery disease that involves the intima of the large and middle artery vessels. The inflammation has a key role in the pathophysiological process of the disease and the infiltration of the intima from monocytes, macrophages and T-lymphocytes combined with endothelial dysfunction and accumulated oxidized low-density lipoprotein (LDL) are the main findings of atherogenesis. The development of atherosclerosis involves multiple genetic and environmental factors. Although a large number of genes, genetic polymorphisms, and susceptible loci have been identified in chromosomal regions associated with atherosclerosis, it is the epigenetic process that regulates the chromosomal organization and genetic expression that plays a critical role in the pathogenesis of atherosclerosis. Despite the positive progress made in understanding the pathogenesis of atherosclerosis, the knowledge about the disease remains scarce.

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