Özlem Fentoğlu

Pro‐inflammatory cytokine levels in association between periodontal disease and hyperlipidaemia

AIM The aim of this study was to evaluate serum and gingival crevicular fluid (GCF) pro-inflammatory cytokine levels in association between periodontal disease and hyperlipidaemia. MATERIAL AND METHODS One hundred and twenty-three subjects with hyperlipidaemia and 68 systemically healthy controls (C) were included in the study. Hyperlipidaemic groups were divided into two groups as suggested diet (HD) and prescribed statin (HS). Both groups were divided into three subgroups as healthy (h), gingivitis (g) and periodontitis (p). The clinical periodontal parameters, fasting venous blood and GCF samples were obtained, and serum tumour necrosis factor-alpha (TNF-α), interleukin (IL)-1β (IL-1β) and IL-6 levels were evaluated. RESULTS The ratio of total cholesterol to high-density lipoprotein (TC/HDL) was associated with gingival index and percentage of bleeding on probing (BOP%) in both hyperlipidaemic groups. In HS group, GCF and serum IL-6 were positively correlated with BOP% and TC/HDL. GCF TNF-α was positively associated with probing pocket depth and clinical attachment level, whereas serum TNF-α was associated with BOP% in the HD group. Serum and GCF TNF-α and IL-1β were significantly associated with TC/HDL in the HD group. CONCLUSIONS Serum pro-inflammatory cytokines may play an important role in the association between periodontal disease and hyperlipidaemia.

Proinflammatory cytokine levels in hyperlipidemic patients with periodontitis after periodontal treatment

OBJECTIVE The aim of this study was to evaluate the effects of periodontal treatment on serum and gingival crevicular fluid (GCF) proinflammatory cytokine levels in hyperlipidemic patients with periodontitis. MATERIALS AND METHODS Fifty-two patients with hyperlipidemia and periodontitis and 28 systemically healthy controls with periodontitis (C) were included in the study. Hyperlipidemic groups were divided into two groups as suggested diet (HD) and prescribed statin (HS). The clinical periodontal parameters, fasting venous blood, and GCF samples were obtained, and serum tumor necrosis factor-alpha (TNF-α), interleukin (IL) 1-beta, and IL-6 levels were evaluated at baseline and at 3 months follow-up (3MFU) after the completion of the non-surgical periodontal treatment that included scaling and root planning. RESULTS Percentage of bleeding on probing was significantly higher in the HS group than both the HD and C groups. In the HD and HS groups, there were significant decreases in serum IL-6 and GCF TNF-α levels between the 3MFU and baseline. A significant decrease was also found in GCF IL-6 at the end of the study period in the HS group. CONCLUSION The combination of the periodontal therapy and antilipemic treatment may provide beneficial effects on the metabolic and inflammatory control of hyperlipidemia.

Short-term effects of periodontal therapy as an adjunct to anti-lipemic treatment

OBJECTIVE This study was conducted to assess the effect of improved periodontal health following periodontal treatment on metabolic lipid control of patients on anti-lipemic treatment. MATERIALS AND METHODS The study population consisted of 20 patients aged 34-62 years with diagnoses of hyperlipidemia and chronic periodontitis. All patients used statin to treat their elevated levels of low-density lipoprotein cholesterol. Blood samples were obtained for measurement of serum lipids, fasting plasma glucose, and high sensitive C-reactive protein. Periodontal parameters, including plaque index, gingival index, probing pocket depth, clinical attachment level, and percentage of bleeding on probing, were evaluated. All parameters were assessed in each subject at baseline, after 3 months as a control (at the time of periodontal treatment), and 3 months after the non-surgical periodontal treatment that included scaling and root planning. RESULTS All lipid parameters decreased after the periodontal treatment, but only the decreases in total cholesterol and low-density lipoprotein cholesterol levels reached statistical significance compared to baseline (P = 0.002 and P = 0.003, respectively). CONCLUSION Improved periodontal health may influence metabolic control of hyperlipidemia and could be considered as an adjunct to the standard measures of hyperlipidemic patient care.

Evaluation of Lipid Peroxidation and Oxidative DNA Damage in Patients With Periodontitis and Hyperlipidemia

BACKGROUND The purpose of this study is to determine the serum levels of malondialdehyde (MDA), as a lipid peroxidation marker, and 8-hydroxydeoxyguanosine (8-OHdG), as an oxidative DNA damage marker, in patients with chronic periodontitis (CP) and hyperlipidemia. METHODS A total of 74 individuals were divided into four age- and sex-matched groups: 18 patients with hyperlipidemia and CP (HLp), 18 periodontally healthy patients with hyperlipidemia (HLh), 19 systemically healthy individuals with CP (Cp), and 19 systemically and periodontally healthy controls (Ch). Clinical periodontal parameters were measured, and serum lipids, MDA, and 8-OHdG levels were assessed in blood samples. RESULTS 8-OHdG, MDA, probing depth, clinical attachment level, and percentage of sites bleeding on probing (BOP) were significantly higher in the HLp group than the Cp group. In the hyperlipidemic group, BOP was significantly correlated with total cholesterol, the ratio of total cholesterol to high-density lipoprotein cholesterol, and 8-OHdG levels. A significant correlation between 8-OHdG and MDA was also observed in the hyperlipidemia group. CONCLUSIONS In this study, serum MDA and 8-OHdG were found to be highest in the HLp group. The increased levels of MDA and 8-OHdG in HLp patients may be a result of a harmful oxidative status in association with hyperlipidemia and periodontitis.

Serum Lipoprotein-Associated Phospholipase A2 and C-Reactive Protein Levels in Association With Periodontal Disease and Hyperlipidemia

BACKGROUND The aim of this study is to evaluate the levels of serum lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) and high-sensitivity C-reactive protein (hsCRP) in association with periodontal disease and hyperlipidemia. METHODS A total of 123 subjects with hyperlipidemia and 68 systemically healthy controls were included in the study. Subjects with hyperlipidemia were divided into two groups: the suggested-diet (HD) and prescribed-statin (HS) groups and then into three subgroups: the healthy (HDh and HSh), gingivitis (HDg and HSg), and periodontitis (HDp and HSp) groups. Periodontal parameters were recorded and included the plaque index, gingival index (GI), probing depth (PD), clinical attachment level (CAL), and percentage of sites with bleeding on probing (BOP). Fasting venous blood samples were obtained, and serum lipid, Lp-PLA(2), and hsCRP levels were evaluated. RESULTS Median values for the GI, PD, BOP(%), and CAL in the HSg group were statistically significantly higher than those in the HDg and systemically healthy with gingivitis (Cg) groups. The HSp group had higher percentages of BOP compared to those of the chronic periodontitis and HDp groups. The HDg group had higher serum Lp-PLA(2) and hsCRP levels compared to those of the Cg and HSg groups. The ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL) was significantly associated with the GI, PD, and BOP(%) in both groups with hyperlipidemia. Serum Lp-PLA(2) and hsCRP levels were significantly correlated with TC/HDL, the GI, PD, and BOP(%) in the HD group. CONCLUSIONS Serum Lp-PLA(2) and hsCRP levels may play an important role in the association between periodontal disease and hyperlipidemia, and the control of these mediators may affect the inflammatory control of patients with hyperlipidemia and periodontal disease.

Serum Placental Growth Factor, Vascular Endothelial Growth Factor, Soluble Vascular Endothelial Growth Factor Receptor-1 and -2 Levels in Periodontal Disease, and Adverse Pregnancy Outcomes

BACKGROUND The aim of this study is the evaluation of levels of serum interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor (TNF)-α, vascular endothelial growth factor (VEGF), placental growth factor (PIGF), and soluble VEGF receptor (sVEGFR)-1 and -2 in the association between periodontal disease and adverse pregnancy outcomes. METHODS One hundred and nine mothers, who recently gave birth, and 51 women who were not recently pregnant, aged 18 to 35 years, were included in this study. The mothers were classified as term birth, preterm birth (PTB), and preterm low birth weight (PLBW) in respect to their gestational age and babys birth weight. The birth mothers were grouped as having gingivitis or periodontitis. The non-pregnant group also included periodontally healthy patients. Venous blood samples were collected to evaluate serum IL-1β, IL-6, IL-10, TNF-α, VEGF, PIGF, and sVEGFR-1 and -2 levels. RESULTS Mothers weight, education, and income level were significantly associated with pregnancy outcomes. Serum levels of IL-1β, TNF-α, IL-6, VEGF, and sVEGFR-1 and -2 showed an increase in significance when related to pregnancy. Whereas in the PLBW group IL-1β, VEGF, and sVEGFR-2 levels were increased, in the PTB group sVEGFR-1 levels were increased. Additionally, the patients in the PLBW group with periodontitis had higher serum levels of IL-1β, VEGF, sVEGFR-2, and IL-1β/IL-10. CONCLUSION The serum levels of IL-1β, VEGF, and sVEGFR-1 and -2 may have a potential effect on the mechanism of the association between periodontal disease and adverse pregnancy outcomes.

Serum Plasminogen Activator Inhibitor-1 and Tumor Necrosis Factor-α Levels in Obesity and Periodontal Disease

BACKGROUND Several studies have shown a possible association between periodontal disease and obesity. The aim of this study is to evaluate serum plasminogen activator inhibitor 1 (PAI-1), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hsCRP) levels in the association between obesity and periodontal disease. METHODS Two hundred individuals participated in this study. Body mass index (BMI), waist-to-hip ratio, plasma triglyceride (TRG), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), hsCRP, TNF-α, PAI-1, and periodontal parameters (including plaque index [PI], probing depth [PD], clinical attachment level [CAL], and percentage of sites with bleeding on probing) were evaluated. RESULTS The groups with BMI ≥ 25 had higher median values for FBG, TRG, hsCRP, PAI-1, PI, and CAL than did the groups with a BMI < 25 (P <0.01). Serum TRG levels were positively correlated with PI, PD, and CAL. There were negative associations between clinical periodontal parameters and HDL-C. There were statistically significant correlations between PAI-1 and clinical periodontal parameters (PI, PD, and CAL). CONCLUSION Serum PAI-1 levels may play an important role in the association between periodontal disease and obesity.

Is a Cholestrol-Enriched Diet a Risk Factor for Alveolar Bone Loss?

BACKGROUND This study aims to investigate the effects of a 2% cholesterol-enriched diet on alveolar bone loss (ABL) and serum levels of pro-oxidants and antioxidant enzymes in rats with experimental periodontitis. METHODS Rats were randomized into the four groups: 1) group C (standard diet/periodontally healthy); 2) group Hc (high-cholesterol diet); 3) group HcP (high-cholesterol diet/periodontitis); and 4) group P (standard diet/periodontitis). All rats were fed for 8 weeks. At 6 weeks, experimental periodontitis was induced. At the end of week 8, the rats were sacrificed. Histomorphometric and histopathologic analyses were performed. Malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase, and glutathione peroxidase (GPX) levels in serum were measured with enzyme-linked immunosorbent assay. RESULTS Experimental groups exhibited increases in: 1) total cholesterol, 2) low-density lipoprotein, and 3) high-density lipoprotein compared to group C. The cholesterol-enriched diet induced ABL in group Hc; groups HcP and P had more extensive ABL. The most polymorphonuclear leukocyte infiltration in periodontal tissues was found in group HcP. MDA levels were higher in all experimental groups than in group C, but significant in the HcP group. A high-cholesterol diet, with or without periodontitis, resulted in more decreases in GPX and more increases in NO compared to group P. CONCLUSION Although any additive effect of cholesterol-enriched diet to ABL was not found in rats with ligature-induced experimental periodontitis, these findings revealed that a cholesterol-enriched diet could lead to ABL and an increase in periodontal inflammation and serum pro-oxidants.

Comparison of bone mineral density in the jaws of patients with and without chronic periodontitis

OBJECTIVES Although several studies have addressed the relationship between systemic bone mineral status and the severity of periodontitis, there is little knowledge of the relationship between periodontal disease and locally detected bone mineral density. The aim of this study was to compare the mandibular bone mineral density of patients with chronic periodontitis with that of periodontally healthy subjects. METHODS 48 systemically healthy subjects were included in the study and underwent a periodontal examination to determine their status. 24 subjects were periodontally healthy and the other 24 had moderate or severe chronic periodontitis. The mandibular bone mineral density of the subjects was determined by dual energy X-ray absorptiometry. The region of interest on the body of the mandible was independently determined on the dual energy absorptiometry radiographs, and a computer calculated the bone mineral density of these regions. RESULTS The mandibular bone mineral density of the subjects with periodontitis was significantly lower than that of the periodontally healthy subjects (p < 0.01). There were significant negative correlations between the mandibular bone mineral density values and parameters related to the amount of periodontal destruction. CONCLUSIONS Low bone mineral density in the jaw may be associated with chronic periodontitis.

Lipoxin A4 and Neutrophil/Lymphocyte Ratio: A Possible Indicator in Achieved Systemic Risk Factors for Periodontitis

Background The aim of this study was to evaluate the serum lipoxin A4 (LXA4) and neutrophil/lymphocyte (Ne/Ly) ratio in individuals with achieved systemic risk factors for periodontitis. Material/Methods One hundred and eighty volunteers (69 male, 111 female) who were categorized as systemically healthy control, diabetes, hyperlipidemia, obese and menopause were recruited for this cross-sectional study. Sociodemographic characteristics and oral health behaviors were recorded via questionnaire. Clinical periodontal parameters, including plaque index (PI), gingival index (GI), probing pocket depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI) and decayed, missing, and filled teeth index (DMFT), were assessed. Systemic parameters and LXA4 levels were evaluated in serum samples. Results Clinical periodontal parameters and DMFT were higher in subjects with achieved systemic risk factors than in healthy subjects. The systemically healthy with periodontitis group had higher serum LXA4 levels than the systemically healthy with non-periodontitis group (P<0.05). The Ne/Ly ratio was higher in the hyperlipidemic group with periodontitis than in the hyperlipidemic group with non-periodontitis (P<0.05). In the control group, serum LXA4 levels were positively correlated with the PD, CAL and SBI. Conclusions In the presence of periodontitis, an increase in LXA4 levels and the Ne/Ly ratio in hyperlipidemic patients could contribute to the hypothesis that these parameters could be an indicator in periodontitis and its systemic risk factors.