Effect of Non-surgical Periodontal Therapy on Levels of Inflammatory Markers in Gingival Crevicular Fluid and Serum of Patients With Breast Cancer and Periodontitis.

Purpose: studies have demonstrated the positive impact of non-surgical periodontal therapy (NSPT) on the control of local and systemic infection/inflammation in normosystemic and systemically compromised patients, represented by the improvement of periodontal clinical parameters and reduction in the levels of inflammatory markers in the gingival crevicular fluid (GCF), saliva and serum. This study aimed to evaluate periodontal clinical parameters and inflammatory mediators in GCF and serum, before and after NSPT, in patients with periodontitis and breast cancer, before chemotherapy. Methods: seventeen women with histopathological diagnosis of invasive ductal carcinoma and periodontitis were submitted to the evaluation of clinical periodontal parameters (plaque index – PI, bleeding on probing – BOP, probing depth – PD, clinical attachment level – CAL) and submitted to scaling and root planing (SRP), at an interval of 24 hours. At the beginning of the study (baseline), before NSPT, samples of tumor microenvironment fluid (TM), GCF and peripheral blood (serum) were collected for the determination of inflammatory markers IL-1β, TNF-α, TGF-β and IL-17, using the LUMINEX methodology. Seven days after SRP, new GCF and serum samples were obtained and analyzed.Results: TGF-β levels were significantly decreased in GCF and serum (p<0.05), while IL-17 concentrations were statistically reduced in GCF (p<0.05). Conclusion: NSPT decreased local and systemic inflammatory markers and may be an important tool in the multidisciplinary approach of women with breast cancer and periodontitis before chemotherapy.

Microbiota in Gingival Crevicular Fluid Before and After Mechanical Debridement With Antimicrobial Photodynamic Therapy in Peri-Implantitis

ObjectivesThis study aims to compare the microbiota of gingival crevicular fluid (GCF) before and after mechanical debridement (MD) with antimicrobial photodynamic therapy (aPDT) and determine the core efficient microbiota in peri-implantitis after treatment.MethodsWe recruited 9 patients (14 implants) treated with MD+aPDT for peri-implantitis at our center from February 1, 2018, to February 1, 2019. GCF was collected using filter paper strip before and after the treatment. The bacterial 16S rRNA was amplified and sequenced using an Illumina MiSeq platform to characterize the GCF. Bioinformatics and statistical analyses were performed using QIIME2 and R.ResultsA total of 4,110,861 high-quality sequences were obtained from GCF samples. Based on the reference database, 1,120 amplicon sequence variants (ASVs) were finally harvested. Principal coordinates analysis indicated significant differences in the bacterial community structure between the 180 days after-treatment group and pre-treatment group. Difference analysis and least discriminant analysis showed that the differences were mainly reflected in non-dominant bacteria between these two groups. The non-dominant genera with significantly different distribution between the 180 days after-treatment group and the pre-treatment group included Lactobacillus, Pedobacter, Bulleidia, Centipeda, Desulfovibrio, Ochrobactrum, Staphylococcus, Microbacterium, Brevundimonas, Desulfobulbus, and Parvimonas. Moreover, a total of 29 predictive functional categories at KEGG level 2 were identified. The significant difference pathways at KEGG level 2 between after-treatment and pre-treatment were concentrated in infectious disease-related pathways.ConclusionsPatients with peri-implantitis have significant changes in the low-abundance bacteria of the GCF before and after MD+aPDT. MD+aPDT may change the composition of GCF microbiota by increasing the abundance of cluster 1 (beneficial) and decreasing that of cluster 4 (harmful), which may decrease metabolic response to infection and thus improve peri-implantitis.

SARS Antibody Testing in Children: Development of Oral Fluid Assays for IgG Measurements

We report on the first large-scale assessment of the suitability of oral fluids for detection of SARS-CoV-2 antibody obtained from healthy children attending school. The sample type (gingiva-crevicular fluid, which is a transudate of blood but is not saliva) can be self collected.

Fluctuation of bone turnover markers’ levels in samples of gingival crevicular fluid after orthodontic stimulus: a systematic review

Background The aim of the present study was to provide an overview of gingival crevicular fluid (GCF) bone turnover markers (BTMs) concerning the physiology of orthodontic tooth movement (OTM) and assess their potential contributions to regulating bone remodeling, that could prove useful in designing future approaches to modulating orthodontic tooth movement. Methods Multiple electronic databases (MEDLINE/PubMed, Ovid MEDLINE, Ovid Embase, LILACS, and Cochrane Library) were searched up to October 1st, 2020. Randomized controlled trials (RCTs), controlled clinical trials, observational studies of prospective and retrospective designs, and cross-sectional studies reporting on levels of BTMs in GCF were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0), whereas the risk of bias of the included cohort studies was assessed using the Risk Of Bias In Non-randomized Studies of Interventions tool. Results Five RCTs, 9 prospective cohort studies, and 1 cross-sectional study fulfilled the inclusion criteria. The risk of bias was deemed as high for the RCTs and 4 of the prospective studies and moderate for the rest of the studies. The following biomarkers for bone formation were assessed: bone alcaline phosphatase (BALP), alcaline phosphatase (ALP), and osteocalcin (OC). For bone resorption, the following BTMs were assessed: deoxypyridinoline (DPD) and pyridinoline (PYD), N-terminal telopeptide (NTX), osteopontin (OPN), and tartrate-resistant acid phosphatase (TRAP). The follow-up period ranged mainly from baseline to 45 days, although one study had an expanded follow-up period of up to 16 months. The results of the included studies comparing different BTMs were heterogeneous and qualitatively reported. Conclusions Current evidence continues to support the potential for BTMs to provide clinically useful information particularly for adjusting or standardizing the orthodontic stimulus. The present systematic review has retrieved studies of high, overall, risk of bias, and has unveiled a substantial clinical and methodological heterogeneity among included studies. Further data of the relationships between the clinical assays and the physiological or pre-analytical factors contributing to variability in BTMs’ concentrations are required. Systematic review registration CRD42020212056.

Clinical and Biochemical Assessment of Lycopene Gel Combined With Nanohydroxyapatite Graft in Treatment of Grade II Furcation Defects: A Randomized Controlled Clinical Study

Background: This study aimed to evaluate the effects of lycopene gel, as a natural antioxidant, mixed with a nanohydroxyapatite graft (NHG) covered by an occlusive resorbable collagen membrane (CM) in the surgical treatment of grade II furcation defects and on the gingival crevicular fluid (GCF) levels of 8-hydroxydeoxyguanosine (8-OHdG), as a marker of oxidative injury. Methods: In this randomized controlled clinical study a total of 24 patients with grade II furcation defects were randomly assigned into three equal groups. Furcation defects in group I were managed with lycopene gel mixed with NHG and CM, group II with NHG and CM, and group III with open flap debridement only. Site-specific changes in clinical parameters including probing depth (PD), vertical clinical attachment level (VCAL), horizontal clinical attachment level (HCAL), radiographic maximum vertical depth (MAX V), and maximum horizontal depth (MAX H) were measured at baseline and six months postoperatively. Gingival crevicular fluid levels of 8-OHdG were analyzed using enzyme-linked immunosorbent assay (ELISA) at baseline, one week, and three months. Results: Surgical management of grade II furcation defects resulted in a significant reduction in PD and 8-OHdG levels and a gain in CAL, MAX V, and MAX H in all groups. The differences between lycopene treated sites compared to NHG and CM alone were not significant at six months but demonstrated significantly superior clinical parameters compared to open flap debridement alone. Conclusion: Lycopene does not confer a benefit when combined with NHG in the surgical treatment of grade II furcation defects.

Oral cavity status in menopausal and postmenopausal women

The purpose of this review was to analyze and summarize the available literature data on changes of oral tissues in menopausal/postmenopausal women. We searched for the relevant references in Pubmed database using appropriate key words. We had revealed about 3,500 references on these topics and analyzed the most relevant. Postmenopausal women have an increased risk of the decrease of bone mineral density due to estrogen deficiency. Estrogens induce osteoclast apoptosis and intensity of this protective mechanism decreases after the cessation of menstruation. Most cross-sectional radiographic studies have confirmed an association between age-related osteoporosis and decreased alveolar bone height. It has been established that postmenopausal women with generalized chronic periodontitis are characterized by severe destruction of the periodontium, which progresses in parallel to a decrease in bone mineral density. Sex hormones maintaining bone integrity and strength, involved in regulating the proliferation, differentiation, and growth of keratinocytes and fibroblasts of the gums. The effect of low estrogen levels on keratinization of the gum epithelium and decreased salivation can lead to menopausal gingivostomatitis. Estrogen deficiency also adversely affects the microenvironment of gingival sulcus, including the composition and circulation of crevicular fluid. Postmenopausal women have lower salivary pH and lower salivation, which is associated with deterioration of periodontal tissues. In addition, the postmenopausal period is characterized by the changes in the microbial composition of the oral cavity, IgG decreases in the crevicular fluid and prooxidant changes of saliva. Conclusions. The oral cavity status in menopausal and postmenopausal women undergoes significant changes: a decrease in bone mineral density, dryness of mucous membranes, microbiome changes, and activation of oxidative and immune processes. These changes necessitate regular examinations, timely treatment and application of all measures of preventive dentistry. There is also a need for randomized clinical trials and create standardized guidelines for the management of postmenopausal patients with periodontal disease.