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8-hydroxy-deoxyguanosine levels in gingival crevicular fluid and saliva in patients with chronic periodontitis after initial periodontal treatment.

BACKGROUND This study evaluates the effects of initial periodontal treatment on the gingival crevicular fluid (GCF) and salivary levels of 8-hydroxy-deoxyguanosine (8-OHdG) as a marker of oxidative deoxyribonucleic acid (DNA) damage in patients with chronic periodontitis (CP). METHODS At baseline, clinical parameters were determined and GCF and saliva samples were obtained from 24 patients with CP and 24 individuals with clinically healthy periodontium. GCF, saliva samples, and clinical periodontal measurements were repeated at day 10, 1 month, and 3 months following initial periodontal therapy in patients with CP. 8-OHdG levels of GCF and saliva samples were investigated by using an enzyme-linked immunosorbent assay. RESULTS Statistically significant higher 8-OHdG levels of GCF and a significant decrease after initial periodontal therapy were determined in the CP group (P <0.001). A significant positive correlation was found between 8-OHdG levels of GCF and clinical periodontal measurements (P <0.001). However, salivary levels of 8-OHdG did not differ between groups or during initial periodontal therapy (P >0.05). CONCLUSIONS This study reveals that DNA injury and oxidative stress increase in tissue cells and especially in periodontal pockets in patients with CP, and the periodontal treatment results in a significant decrease of 8-OHdG levels in the GCF samples. To the best of our knowledge, this study evaluates for the first time, 8-OHdG levels in GCF, which is shown to be more useful as a biomarker than saliva. 8-OHdG was found to be important and may reveal the severity of periodontal disease and the effect of periodontal therapy.

Gingival Crevicular Fluid Levels of Sclerostin, Osteoprotegerin, and Receptor Activator of Nuclear Factor-κB Ligand in Periodontitis.

BACKGROUND To investigate changes in the levels and relative ratios of sclerostin, osteoprotegerin (OPG), and receptor activator of nuclear factor-κB ligand (RANKL) in the gingival crevicular fluid (GCF) of patients with periodontitis after non-surgical periodontal treatment. METHODS Fifty-four individuals (27 healthy controls and 27 patients with chronic periodontitis [CP]) were enrolled in the study. Periodontitis patients received non-surgical periodontal therapy. GCF sampling and clinical periodontal parameters were assessed before and 6 weeks after therapy. Sclerostin, OPG, and RANKL levels were measured by enzyme-linked immunosorbent assay, and their relative ratios were calculated. RESULTS Total amounts and concentrations of sclerostin were significantly higher in patients with CP than in healthy individuals (P <0.025) and decreased after treatment (P <0.05). The RANKL/OPG ratio was significantly lower in healthy individuals than in patients with periodontitis before and after treatment (P <0.025), but no significant difference was observed in patients with periodontitis after treatment (P >0.05). The sclerostin/OPG and sclerostin/RANKL ratios were significantly lower in healthy individuals than in patients with periodontitis before and after treatment (P <0.025) and decreased in patients with periodontitis after treatment (P <0.05). CONCLUSIONS The GCF sclerostin level may be more reliable than the RANKL/OPG ratio as a diagnostic and prognostic marker of periodontal disease and treatment outcome. Regulation of sclerostin levels may aid the development of new therapeutic strategies for the treatment of periodontal disease.

Concentrated growth factor in the treatment of adjacent multiple gingival recessions: a split‐mouth randomized clinical trial

AIM The aim of this study was to determine the clinical effect of concentrated growth factor (CGF) in combination with coronally advanced flap (CAF) compared to CAF alone for the treatment of multiple adjacent gingival recessions (GRs). MATERIALS AND METHODS Twenty patients with a total of 119 Miller Class I and II GRs in the maxilla were included to this study. Recessions were randomly treated according to a split-mouth design by means of CAF + CGF (test; 60 defects) or CAF (control; 59 defects). Clinical outcomes were evaluated at baseline and 6 months after surgery. RESULTS The mean root coverage (MRC) was 82.06% and 86.67%, complete root coverage (CRC) was 45.8% (27/59) and 56.7% (34/60) for CAF and CAF + CGF, respectively at 6th month. Statistically no difference was demonstrated between the two groups in terms of recession depth (RD), MRC and CRC at 6th month. The increase in width of keratinized gingiva (KGW) and gingival thickness (GT) were statistically significant in the CAF + CGF group compared to the CAF group at 6th month. CONCLUSIONS The use of CGF in combination with CAF did not provide additional benefits in RD, CRC and MRC. This study suggests that use of CGF + CAF may increase the success of GRs because of a significant increase in KGW and GT.

Chemerin as a Novel Crevicular Fluid Marker of Patients With Periodontitis and Type 2 Diabetes Mellitus

BACKGROUND The objectives of the present study are to: 1) determine whether gingival crevicular fluid (GCF) chemerin is a novel predictive marker for patients with chronic periodontitis (CP) with and without type 2 diabetes mellitus (t2DM); 2) analyze the relationship between chemerin and interleukin (IL)-6 in periodontally healthy individuals and in patients with CP and with and without t2DM; and 3) evaluate the effect of non-surgical periodontal therapy on GCF chemerin levels. METHODS Eighty individuals were split into four groups: 20 who were systemically and periodontally healthy (CTRL), 20 with t2DM and periodontally healthy (DM-CTRL), 20 systemically healthy with CP (CP), and 20 with CP and t2DM (DM-CP). Individuals with periodontitis were treated with non-surgical periodontal therapy. GCF sampling procedures and clinical periodontal measures were performed before and 6 weeks after treatment. Enzyme-linked immunosorbent assay was used to measure chemerin and IL-6 levels. RESULTS Greater values for GCF chemerin and IL-6 levels were found in CP groups than in periodontally healthy groups, in DM-CP than in CP, and in DM-CTRL than in CTRL (P <0.008). GCF chemerin and IL-6 levels decreased following therapy in CP groups (P <0.02). A comprehensive overview of all groups showed a statistically significant positive correlation of chemerin with IL-6, glycated hemoglobin, sampled-site clinical attachment level, and gingival index (P <0.05). CONCLUSIONS In this study, periodontitis and t2DM induced aberrant secretion of chemerin, and non-surgical periodontal therapy influenced the decrease of GCF chemerin levels in patients with CP with and without t2DM. Furthermore, it suggests GCF chemerin levels may be considered a potential proinflammatory marker for diabetes, periodontal disease, and treatment outcomes.

Histological Evaluation of the Effect of Concentrated Growth Factor on Bone Healing.

Objectives:The aim of this study was to evaluate the effects of concentrated growth factors (CGF) on the healing of peri-implant bone defects in an animal model. Study Design:Twenty 4-month-old New Zealand White rabbits, each with an average weight of 3.5 kg, were used in this blinded, prospective, experimental study. Two implants were placed and 2 peri-impant defects were prepared in each rabbit tibia. Bone defects were created monocortically in the tibia of each rabbit using a trephine burr with a diameter of 8 mm. The implants were installed in each hole. The rabbits were divided into 4 groups: in group E, the defect was left empty; in group CGF, the defects were filled only with CGF; in group AB, the defects were filled with autogenous bone; and in group AB+CGF, the defects were filled with autogenous bone and CGF. The animals were euthanized at week 8 postimplantation. All implants from the 20 animals were fixed in 10% formalin and evaluated histomorphometrically. Results:The mean defect area was highest in group E and lowest in group CGF+AB (P <0.05). The area of the defect differed significantly between groups AB and CGF+AB (P <0.05), but not between groups CGF and E. Implant-to-bone contact was lowest in group E. In the defect areas of groups CGF, AB and CGF+AB, a small amount of new bone formed around the implant. Conclusions:In this animal model of a peri-implant bone defect, restoration was achieved using a combination of autogenous bone and CGF. Further studies are needed to determine the behavior of CGF when used in the repair of bone defects in humans.

The effect of initial periodontal treatment on plasma, gingival crevicular fluid and salivary levels of 8-hydroxy-deoxyguanosine in obesity

OBJECTIVE Recent studies have shown adverse effects on the periodontium from the increased production of reactive oxygen species (ROS) in obesity. The purpose of this study was to investigate the effects of obesity on 8-hydroxy-deoxyguanosine (8-OHdG) levels in the bodily fluids of patients with and without periodontal disease and to evaluate changes after initial periodontal treatment. DESIGN Forty-five obese individuals and 45 normal-weight individuals were included in this study. Obese and normal-weight groups were classified into three sub-groups: chronic periodontitis (CP), gingivitis (G) and periodontally healthy controls (CTRL). Gingival crevicular fluid (GCF), plasma, saliva samples and clinical measurements were obtained at baseline and a month after initial periodontal treatment. Levels of 8-OHdG were analysed by ELISA. RESULTS While plasma 8-OHdG levels were significantly higher at baseline in the obese patients with periodontal disease than in the normal-weight individuals (P<0.05), no significant differences in GCF and saliva 8-OHdG levels were found (P ˃ 0.05). GCF and salivary 8-OHdG levels in obese patients with G and CP were significantly higher than in CTRL groups at baseline (P<0.05). After treatment, 8-OHdG levels were decreased in all groups with periodontal disease (P<0.01). Statistically significant positive correlations were observed between GCF 8-OHdG levels and GI in all the groups (P<0.001). CONCLUSIONS The significant increase of plasma 8-OHdG levels in obese patients did not correlate with saliva and GCF 8-OHdG levels when compared to normal-weight individuals. Periodontal treatment had a positive effect on the periodontal parameters and 8-OHdG levels of both obese and normal-weight individuals.

Gingival crevicular fluid levels of neuropeptides following dental restorations

Purpose Local neuropeptide release has a critical role in the initiation and progression of an inflammatory response. This study investigated the effects of different restorative materials on periodontium in this regard, by evaluating their neuropeptide-producing effects on gingival crevicular fluid (GCF). Methods The study included 14 patients suitable for metal-ceramic, composite and amalgam restorations. Four weeks after periodontal therapy, the restorations were performed. Study groups were constituted regarding the tooth/restoration surfaces contacting gingiva in each patient: 1 ceramic surface of a metal-ceramic crown (ceramic group), its opposite metal surface (metal group), 1 composite surface (composite group), its opposite enamel surface (opposite-composite group), 1 amalgam surface (amalgam group), its opposite enamel surface (opposite-amalgam group) and 1 nonrestored enamel surface (enamel group). Four weeks after dental restorations, clinical data and GCF were obtained from the group sites. Clinical data, GCF volume and its proinflammatory cytokine profile were utilized to evaluate the periodontal health. GCF levels of substance P (SP), neurokinin A (NKA) and calcitonin-gene related peptide (CGRP) were determined by ELISA for revealing the neuropeptide levels. Results GCF volume was found to increase in all groups compared with the enamel group (p<0.05). SP and NKA levels were higher in the ceramic, composite and amalgam groups than those in the enamel group (p<0.05). SP and NKA levels were also higher in the composite and amalgam groups than those in the opposite-composite/amalgam groups (p<0.05). Conclusions These results suggest that ceramic, composite and amalgam materials may uniquely trigger local neuropeptide release in periodontium.