Metabolomic Evaluation of Chronic Periodontal Disease in Older Adults

Periodontal disease is an infectious inflammatory disease related to the destruction of supporting tissues of the teeth, leading to a functional loss of the teeth. Inflammatory molecules present in the exudate are catalyzed and form different metabolites that can be identified and quantified. Thus, we evaluated the inflammatory exudate present in crevicular fluid to identify metabolic biological markers for diagnosing chronic periodontal disease in older adults. Research participants were selected from long-term institutions in Brazil. Participants were individuals aged 65 years or older, healthy, or with chronic periodontal disease. Gas chromatography/mass spectrometry was used to evaluate potential biomarkers in 120 crevicular fluid samples. We identified 969 metabolites in the individuals. Of these, 15 metabolites showed a variable importance with projection score > 1 and were associated with periodontal disease. Further analysis showed that among the 15 metabolites, two (5-aminovaleric acid and serine, 3TMS derivative) were found at higher concentrations in the crevicular fluid, indicating their potential diagnostic power for periodontal disease in older adults. Our findings indicated that some metabolites are present at high concentrations in the crevicular fluid in older adults with periodontal disease and can be used as biomarkers of periodontal disease.

Salivary Irisin and periodontal clinical parameters in patients of chronic periodontitis and healthy individuals: A novel salivary myokine for periodontal disease

Objective: To evaluate changes in the levels of salivary irisin in chronic periodontitis, and to correlate the two. Methods: The analytical cross-sectional study was conducted at Fatima Memorial Hospital & College of Dentistry, Lahore, Pakistan, from September 2017 to March 2018, and comprised patients of either gender visiting the periodontic out-patient department. The subjects were divided into group I, which had periodontally healthy controls, and group II, which had an equal number of chronic periodontitis patients. Chronic periodontitis was assessed on basis of pocket probing depth, clinical attachment level, plaque percentage and bleeding on probing. Also, 4ml of un-stimulated saliva was collected for the quantification of irisin protein using enzyme-linked immunosorbent assay. Data was analysed using SPSS 25. Results: Of the 40 subjects, there were 20 (50%) in group I with 10 (50%) males and 10 (50%) females having an overall mean age of 37.60±2.58 years. The remaining 20 (50%) subjects were in group II with 16 (80%) males and 4 (20%) females having an overall mean age of 43.25±6.10 years. Mean salivary irisin level in group II was 6.80±3.97ng/ml compared to 3.99±2.48 ng/ml in group I (p=0.009). Periodontal clinical parameters in both the groups were positively but non-significantly correlated with salivary irisin levels (p>0.05) except for decreased plaque percentage in group I (p<0.05). Conclusion: Salivary irisin levels increased in chronic periodontitis and decreased with decreasing plaque percentage in healthy individuals, indicating that this myokine can act as a biomarker for chronic periodontal disease. Continuous...

Blowout fracture-associated orbital cellulitis progressing to panophthalmitis: a case report

Background Parvimonas micra is known as a causative agent of chronic periodontal disease. This Gram-positive obligate anaerobic coccus was cultured from the ocular surface of blowout fracture-related orbital cellulitis progressing to panophthalmitis. Case presentation The patient was a woman in her fifties who had panic disorder and subsequently was a victim of domestic violence. These factors led to delayed consultation. At the initial visit to an ophthalmologist, the ocular surface of the right eye was covered with pus. Swelling of the upper and lower eyelids prevented the eyelid from closing and exophthalmos, severe corneal ulcer, panophthalmitis, and no light perception were observed. Head computed tomography revealed an old blowout fracture and chronic sinusitis with orbital cellulitis. P. micra were isolated from culture of pus samples from the sinus and from the ocular surface. Conclusions There is a possibility that P. micra invaded the orbit via the fragile bony site and caused orbital cellulitis, severe corneal ulcer, and panophthalmitis that required enucleation. In cases of coexisting old blowout fracture and chronic sinusitis, the chronic sinusitis should be treated as quickly as possible.

The Role of Periodontopathogens and Oral Microbiome in the Progression of Oral Cancer. A Review

Chronic periodontal disease and oral bacteria dysbiosis can lead to the accumulation of genetic mutations that eventually stimulate Oral Squamous Cell Cancer (OSCC). The annual incidence of OSCC is increasing significantly, and almost half of the cases are diagnosed in an advanced stage. Worldwide there are more than 380,000 new cases diagnosed every year, and a topic of extensive research in the last few years is the alteration of oral bacteria, their compositional changes and microbiome. This review aims to establish the relationship between bacterial dysbiosis and OSCC. Several bacteria implicated in periodontal disease, including Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, and some Streptococcus species, promote angiogenesis, cell proliferation, and alteration in the host defense process; these same bacteria have been present in different stages of OSCC. Our review showed that genes involved in bacterial chemotaxis, the lipopolysaccharide (LPS) of the cell wall membrane of gram negatives bacteria, were significantly increased in patients with OSCC. Additionally, some bacterial diversity, particularly with Firmicutes, and Actinobacteria species, has been identified in pre-cancerous stage samples. This review suggests the importance of an early diagnosis and more comprehensive periodontal therapy for patients by the dental care professional.

Endothelial Dysfunction, its Relationship with Chronic Periodontal Disease, and other Associated Risk Factors

Background: Chronic periodontitis is related to individual characteristics. However, it is precisely infectious in nature with the possibility of generating a chronic systemic inflammatory response that could favour its association with diseases, such as endothelial dysfunction, hypertension, CVD, and diabetes. Purpose: The aim of the study was to analyze the relationship of endothelial dysfunction measured by flow-mediated vasodilation in the brachial artery with periodontal disease and other possible factors. Methods: A case-control study was carried out in which those who had periodontitis were defined as cases, and those who were periodontally healthy or had gingivitis were defined as controls. A clinical history was obtained from all patients, and all patients underwent biofilm control and periodontal examinations. Blood tests were performed to determine CBC, glycaemia, total cholesterol, HDL-C, and LDL-C levels, and standardized procedures were used to measure flow-mediated dilation. Results: A total of 202 patients were included in this study: 101 controls [healthy/gingivitis] and 101 cases [periodontitis]. Regarding sex, glycaemia [p = 0.019] and triglycerides [p = 0.001] levels and initial flow-mediated vasodilation [p = 0.001] and final flow-mediated vasodilation [p = 0.001] values were higher in men, while HDL values ​​were lower [p = 0.001. The average age was higher for those in the group that presented dysfunction than for those in the group without dysfunction [p = 0.014]. When analyzing the percentage of patients with endothelial dysfunction in each of the groups, there were very few positive results obtained [5 per group]. Conclusion: Initial and final arterial vasodilation was lower in women than in men. Likewise, there were more cases of endothelial dysfunction in women. In this study, patients with endothelial dysfunction were older. Periodontitis was not associated with endothelial dysfunction.

Role of gender & age in chronic periodontal disease

There is lot of literature suggesting a gender based heterogeneity in many human chronic diseases including periodontal disease. To analyze and compare the clinical periodontal disease parameters & serum biochemical markers of periodontal inflammation in systemically healthy age stratified adult male and female patients suffering from chronic destructive periodontal disease. Cross sectional observational study in a hospital setting A total of 300 subjects, both genders were enrolled based on predefined criteria and were categorized in 6 groups of 50 subjects each. Complete medical and dental history was taken to screen before enrollment. All subjects underwent complete periodontal examination, including evaluation of Plaque index (PI), Probing pocket depth (PPD) and Clinical attachment level (CAL), Bleeding on Probing (BOP). Blood samples were taken for analysis of inflammatory biomarkers viz interleukin (IL)-1β, osteoprotegrin (OPG), matrix metalloproteinase (MMP)- 8 & interleukin (IL)- 6. IBM SPSS STATISTICS (version 22.0) Clinical parameters of periodontal status were higher in females as compared to males except BOP. However, only PPD and CAL showed significant difference. Higher serum levels of IL-1β, OPG and Il-6 were observed in females (2.10 + 26.82, 168.18 + 49.84 , 29.17 + 99.20 pg/ml) than males (1.90 + 7.27 , 145.00 + 39.60 , (25.83 + 189.09pg/ml) respectively, but significant difference was observed only for OPG. A statistically significant higher level of MMP-8 was observed in males (3003.33 + 772.33 pg/ml) as compared to females (1398.33 + 1218.10 pg/ml). The findings of current investigation has identified significant differences in the clinical and specific biochemical mediators(IL-1β, IL-6, OPG, MMP-8) across groups and subgroups of the population To ascertain the impact of gender and age in the causation and pathogenesis of inflammatory periodontal disease, further well designed prospective investigations are needed . The study findings point towards the identification of specific biomarkers in individual subgroup/group based on age and gender. These shall pave path to develop predictive models, screening tools and early diagnostic strategies for chronic periodontal disease for Indian population.

Ozone Gel in Chronic Periodontal Disease: A Randomized Clinical Trial on the Anti-Inflammatory Effects of Ozone Application

The search for new topical treatments able to display not only antimicrobial properties but also a multiplicity of other beneficial effects while expressing safe cytocompatibility toward host tissues is being progressively developed. Antiseptics represent an aid to the gold standard nonsurgical treatment Scaling-and-Root-Planing (SRP) for periodontal disease. This split-mouth study aims to assess the efficacy of the ozonized gel GeliO3 (Bioemmei Srl, Vicenza, Italy) plus SRP (experimental treatment), with respect to SRP + chlorhexidine gel. Ten participants were treated with SRP + chlorhexidine gel (control sites) and with SRP + ozone gel (trial sites). After 1 (T1) and 3 months (T2) from baseline (T0), patients were revisited. At each time-point, the following indexes were assessed: probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BoP). It has been assessed that the use of the ozonized gel in addition to SRP did not show significant differences if compared to conventional SRP + chlorhexidine. Chlorhexidine was found to be more effective than ozone in reducing CAL and GI at T2. Ozone deserves consideration for its wide applicability in several clinical fields. In this connection, we also glance at the latest research on ozone therapy.

Is Periodontal Disease a Red Flag for Breast Cancer Among Postmenopausal Female Smokers? An Update of the Last Decade

Periodontal disease is characterized by a chronic inflammation produced in response to a disease-associated, multispecies bacterial community in the subgingival region. In recent years, interest has focused on the potential role of periodontal disease in cancer pathogenesis. In this review, we presented a summary showing a strong association between breast cancer and poor oral health, presence of periodontitis-associated bacteria, tooth loss, and clinical signs of periodontitis. Proinflammatory pathways are activated either by mono- or polymicrobial infections, resulting in an increase in the expression of proinflammatory molecules such as interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α. In addition, it has been shown that several periodontitis-associated species induce the expression of genes related to cell proliferation, cell cycle, apoptosis, transport, and immune and inflammatory responses. Intriguingly, many of these pathways are linked to carcinogenesis. Among them, the activation of Toll-like receptors (TLRs) and antiapoptotic pathways (such as the phosphoinositide-3-kinase-protein kinase B/Akt [PI3K-PKB/Akt], Janus kinase/signal transducers and activators of transcription [JAK/STAT], and mitogen-activated protein kinase [MAPK] pathways), the reduction of proapoptotic protein expression, the increase in cell migration and invasion, and the enhancement in metastasis are addressed. Cigarette smoking is one of the major causes of carcinogenesis. The incidence of breast cancer is increasing worldwide, making it the most common type of cancer among women. The etiology of breast cancer is multifactorial and cigarette smoking is one of the risk factors that has recently been shown to be associated with breast cancer. The relationship between cigarette smoking and breast cancer is due to one of the important components of cigarette smoke, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), which is a representative carcinogen of N-nitrosamines that has gained focus in breast cancer carcinogenesis. The purpose of this review is to investigate the relationship between breast cancer and chronic periodontal disease changes that can occur at the oral level, including alterations of the oral microbiome, and pathological conditions among postmenopausal female smokers. Chronic periodontal disease and tooth loss were highly prevalent in postmenopausal breast cancer survivors. Based on this traditional review, the importance of dentists is clear in proposing to patients with breast cancer appropriate therapies and dedicated prevention sessions.