AIM: To study whether cytokine levels and bacterial counts in p atients with peri-implantitis reflect clinical treatment outcome following non-surgical management.

MATERIALS AND METHODS: Luminex magnet bead technology and checkerboard DNA-DNA hybridization were used to assess treatment outcome after treatment at the implant with the most severe peri-implantitis in 41 participants.

RESULTS: Study group mean age was 40.3 years (SD ± 9.9). Stable treatment outcome after 6 months (no further bone loss, probing pocket depth decrease ≥0.5 mm, no bleeding/suppuration) was identified in 9 of 41 (22%) participants. Peri-implant crevicular fluid (PICF) levels were also lower for Il-1β (P < 0.01), and with trends of lower cytokine levels in PICF for TNF-α (P = 0.071), PDGFBB (P = 0.071), as well as for VEGF (vascular endothelial growth factor) (P = 0.071), and bacterial counts for Actinomyces israelii, Aggregatibacter actonomycetemcomitans (Y4), Campylobacter gracilis, Echerichia coli, Fusobacterium periodonticum, Leptotrichia buccalis, Parvimonas micra, Staphylococcus haemolyticus, Streptococcus anginosus, and Tannerella forsythia. Increasing levels of IL-1 β and S. aureus (r(2)  = 0.856) were found only at implants with non-stable outcome. A reduction of PICF levels for selected cytokines and bacteria studied had a sensitivity of 0.77, and a specificity of 0.80 against the clinical outcome as gold standard. Data analysis failed to differences in treatments (PerioFlow(®) versus YAG: ER laser) for changes in the expression of cytokines and bacteria studied.

CONCLUSIONS: At 6 months, clinically stable treatment outcome of peri-implantitis is associated lower levels of putative pathogens total bacterial load with ≥30% reduction of IL1-β, L-6, and VEGF levels in PICF.

There is currently an interest in the possible anti-inflammatory effects of intake of fruits and berries. The aim of this study was to determine whether the twice daily administration of a berry beverage rich in polyphenols had effects on salivary levels of a selected group of pro-inflammatory cytokines for one week in a pre-and post-study design. Levels of selected cytokines were compared in whole saliva and saliva obtained using commercially available collection devices (Salivette (R) Cotton and Salivette (R) Synthetic rolls). Twenty healthy subjects drank 200 mL of a berry beverage consisting of equal parts of bilberries (Vaccinium myrtillus), black currant (Ribes nigrum), lingonberries (Vaccinium vitis-idaea), sea buckthorn (Hippophae rhamnoides) diluted with 50% water. Levels of cytokines, IL-1 beta, IL-8, IL-12 and TNF-alpha were assessed. Levels of cytokines differed between sources of collection but were highest in whole saliva. The use of cotton or synthetic rolls does not seem to be useful as a method for saliva collection and cytokine analysis. There was no significant change in the levels of selected cytokines at baseline and after intake of the berry beverage in whole stimulated saliva. There was a large inter-individual variation in cytokine levels.

AIM: A causative relationship between acute coronary syndrome (ACS) and periodontitis has yet to be defined. The aim of this study was to assess differences in levels of serum cytokines between individuals with or without ACS or periodontal comorbidity.

MATERIAL AND METHODS: In a case-control study, individuals with ACS (78 individuals, 10.3% females) and matching healthy controls (78 individuals, 28.2% females) were included. Medical and dental examinations were performed to diagnose ACS and periodontitis. Serum levels of cytokines were assessed using Luminex technology.

RESULTS: A diagnosis of periodontitis in the ACS and control group was diagnosed in 52.6% and 12.8% of the individuals, respectively. The unadjusted odds-ratio that individuals with ACS also had periodontitis was 7.5 (95% CI: 3.4, 16.8, p<0.001). Independent of periodontal conditions, individuals with ACS had significantly higher serum levels of IL8 (mean: 44.3 and 40.0 pg/ml) and vascular endothelial growth factor (VEGF) (mean: 82.3 and 55.3 pg/ml) than control individuals. A diagnosis of periodontitis made no difference in serum cytokine expressions.

CONCLUSION: Elevated serum levels of VEGF were associated with ACS. Serum cytokine expression in individuals with ACS is unrelated to periodontal conditions. This article is protected by copyright. All rights reserved.

Aim: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on intra-oral halitosis 3months after therapy. Material and methods: Sixty-eight adults with intra-oral halitosis were included in a case series. Intra-oral halitosis was evaluated at baseline, and at 3months after treatment using the organoleptic scores (OLS), Halimeter (R), and a gas chromatograph. Results: Significant reductions for OLS (p<0.01), total sum of volatile sulphur compounds (T-VSC) (p<0.01) and methyl mercaptan (MM) (p<0.05) values were found after treatment. Hydrogen sulphide (H2S) levels were not significantly reduced. The numbers of probing pockets 4mm, 5mm and 6mm were significantly reduced as a result of therapy (p<0.001). Bleeding on probing (BOP) and plaque indices were also significantly reduced (p<0.001). For the 34 individuals with successful periodontal treatment (BOP<20% and a 50% reduction of total pocket depth) reductions in OLS (p<0.01) and T-VSC scores (p<0.01) were found. Eleven individuals were considered effectively treated for intra-oral halitosis presenting with a T-VSC value <160ppb, a H2S value <112ppb and a MM value <26ppb. Conclusion: Non-surgical periodontal therapy resulted in reduction of OLS, MM and T-VSC values 3months after therapy. Few individuals were considered as effectively treated for intra-oral halitosis.

Within the next 40 years the number of older adults worldwide will more than double. This will impact periodontal treatment needs and presents a challenge to health-care providers and governments worldwide, as severe periodontitis has been reported to be the sixth most prevalent medical condition in the world. Older adults (≥ 80 years of age) who receive regular dental care retain more teeth than those who do not receive such care, but routine general dental care for these individuals is not sufficient to prevent the progression of periodontitis with the same degree of success as in younger individuals. There is a paucity of data on the efficacy of different periodontal therapies for older individuals. However, considering the higher prevalence of chronic medical conditions seen in older adults, it cannot be assumed that periodontal therapy will yield the same degree of success seen in younger individuals. Furthermore, medications can influence the status of the periodontium and the delivery of periodontal care. As an example, anticoagulant drugs are common among older patients and may be a contraindication to certain treatments. Newer anticoagulants will, however, facilitate surgical intervention in older patients. Furthermore, prescription medications taken for chronic conditions, such as osteoporosis and cardiovascular diseases, can affect the periodontium in a variety of ways. In summary, consideration of socio-economic factors, general health status and multiple-drug therapies will, in the future, be an important part of the management of periodontitis in older adults.

OBJECTIVE: To evaluate if the presence of periodontitis is associated with carotid arterial calcifications diagnosed on panoramic radiographs in an elderly population.

MATERIALS AND METHODS: Study individuals were randomly selected from the Swedish civil registration database representing the aging population (60-96 years) in Karlskrona, Sweden. Bleeding on probing (BOP) and the deepest probing measurement at each tooth were registered. The proportions of teeth with a probing depth ≥5 mm and the proportion of teeth with bleeding on probing were calculated. Analog panoramic radiographs were taken and the proportion of sites with a distance ≥5 mm between the alveolar bone level and the cement-enamel junction (CEJ) were assessed. A diagnosis of periodontitis was declared if a distance between the alveolar bone level and the CEJ ≥5 mm could be identified from the panoramic radiographs at >10% of sites, probing depth of ≥5 mm at one tooth or more and with BOP at >20% of teeth.

RESULTS: Readable radiographs were obtained from 499 individuals. Carotid calcification was identified in 39.1%. Individuals were diagnosed with periodontitis in 18.4%. Data analysis demonstrated that individuals with periodontitis had a higher prevalence of carotid calcifications (Pearson χ (2) = 4.05 p < 0.05) and with a likelihood of 1.5 (95% CI = 1.0, 2.3, p < 0.05).

CONCLUSIONS: Data analysis demonstrated a significant association between periodontitis and carotid calcification.

Objective

The aim of the present study was to evaluate in vitro antibacterial activities of blackcurrant and sea buckthorn juices on bacteria associated with gingival inflammation.

Materials and methods

The growth of selected bacteria (Streptococcus mitis, Streptococcus mutans, Streptococcus sanguinis, Streptococcus gordonii, Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa) was studied in vitro on agar plates. The content of phenols in the different extracts was measured with HPLC-ESI-MS.

Results

The spectrometric analysis identified that the highest level of the single phenols studied was found for ferulic acid (113 μg/ml) in blackcurrant juice. Sea buckthorn contained low levels of selected phenols. Total bacterial inhibition for all bacterial species studied was found at 20% berry juice concentration with pH varying between 4.1-5.4.

Conclusions

The present study identified that in vitro bacterial growth on agar plates was inhibited by blackcurrant and sea buckthorn juices and that low juice pH explains bacterial in vitro growth. This may have clinical implications in biofilm development, reducing the risks for both tooth decay and gingivitis.

Bioactive molecules in berries may be helpful in reducing the risk of oral diseases. The aim of this study was to determine the effect of bilberry consumption on the outcome of a routine dental clinical parameter of inflammation, bleeding on probing (BOP), as well as the impact on selected biomarkers of inflammation, such as cytokines, in gingival crevicular fluid (GCF) in individuals with gingivitis. Study individuals who did not receive standard of care treatment were allocated to either a placebo group or to groups that consumed either 250 or 500 g bilberries daily over seven days. The placebo group consumed an inactive product (starch). A study group, receiving standard of care (debridement only) was also included to provide a reference to standard of care treatment outcome. Cytokine levels were assayed using the Luminex MagPix system. The mean reduction in BOP before and after consumption of test product over 1 week was 41% and 59% in the groups that consumed either 250 or 500 g of bilberries/day respectively, and was 31% in the placebo group, and 58% in the standard of care reference group. The analysis only showed a significant reduction in cytokine levels in the group that consumed 500 g of bilberries/day. A statistically significant reduction was observed for IL-1b (p = 0.025), IL-6 (p = 0.012) and VEGF (p = 0.017) in GCF samples in the group that consumed 500 g of bilberries daily. It appears that berry intake has an ameliorating effect on some markers of gingival inflammation reducing gingivitis to a similar extent compared to standard of care.

AIM: The aim was to assess clinical inflammatory parameters, cytokine levels, and bacterial counts in samples from implant crevicular fluid in cases with untreated peri-implantitis.

MATERIAL AND METHODS: Several bacterial species known to up-regulate pro-inflammatory cytokines have been associated with peri-implantitis. The Luminex magnet bead technology was used to study cytokines in crevicular fluid. The checkerboard DNA-DNA hybridization method was used to study bacterial counts in samples from 41 implants (41 individuals).

RESULTS: Profuse bleeding and suppuration was found in 25/41 (61.0%) and 17/41 (41.5%) of the implants. The reliability of duplicate cytokine processing was high. In the presence of profuse bleeding, higher pg/ml levels of IL-1β (p = 0.016), IL-8 (p = 0.003), TNF-α (p = 0.024), and VEGF (p = 0.004) were found. Higher concentrations of IL-1β were found in the presence of suppuration, and if Escherichia coli (p = 0.001) or Staphylococcus epidermidis (p = 0.05) could be detected.

CONCLUSION: Profuse bleeding and/or suppuration in untreated peri-implantitis can be associated with higher concentrations of IL-1β, IL-8, TNF-α and VEGF in peri-implant crevicular fluid. A higher concentration of IL-1β in peri-implant crevicular fluid was found in samples that were positive for E. coli or S. epidermidis.