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Journal of Oral Biology and... 2024Proper management of orthodontic treatment in diabetic patients is essential due to the heightened risk of periodontal tissue breakdown associated with hyperglycemia....
OBJECTIVE
Proper management of orthodontic treatment in diabetic patients is essential due to the heightened risk of periodontal tissue breakdown associated with hyperglycemia. Cacao bean extracts (CBE) are known to reduce the inflammatory response and increase synthesis and angiogenesis in periodontitis. Therefore, this study aims to examine the effect of CBE on preventing periodontal tissue breakdown in diabetes with orthodontic force.
METHODS
A total of 25 Wistar rats were divided randomly into 5 groups, including non-diabetes, diabetes, diabetes cacao 125, 250, and 500 mg/kg BW. Diabetic rats were induced with the stratified dose of Streptozotocin, and a 30-g-force from orthodontic device was applied in all groups. Diabetes cacao group was given CBE for 7 days using a gastric probe. GCF samples were used to analyze the eNOS level through the ELISA method. NFκB, Collagen-1, and FGF-2 expression were then assessed using the immunohistochemical method, while the number of fibroblasts and blood vessels was observed using hematoxylin-eosin stained tissue. The data obtained were analyzed with one-way ANOVA and post hoc tests, with p < 0.05.
RESULTS
CBE at a dose of 250 mg/kg BW significantly increased eNOS level, Collagen-1, and FGF-2 expression, and the number of fibroblasts and blood vessels in diabetes groups. Meanwhile, the treatment decreased NFκB expression in diabetes groups (p < 0.05).
CONCLUSION
This study proved that CBE increased periodontal ligament synthesis and angiogenesis and decreased inflammatory response, thereby preventing periodontal tissue breakdown in diabetic rat models with tooth movement.
PubMed: 38832299
DOI: 10.1016/j.jobcr.2024.05.013 -
Journal of Oral Biology and... 2024Root resorption poses a significant challenge in dental practice, with external cervical resorption (ECR) being a common manifestation. ECR is often asymptomatic until...
INTRODUCTION
Root resorption poses a significant challenge in dental practice, with external cervical resorption (ECR) being a common manifestation. ECR is often asymptomatic until advanced stages, complicating its diagnosis and management. Various factors contribute to its etiology, ranging from trauma to orthodontic treatment. The classification system proposed by Patel et al. (2018) offers a comprehensive framework for characterizing ECR lesions based on location and extent. Treatment strategies for ECR involve a combination of endodontic intervention and restorative techniques, with bioactive materials like mineral trioxide aggregate (MTA) and Biodentine emerging as promising options. However, the biomechanical behavior of teeth restored with these materials in the context of ECR remains underexplored.
MATERIALS AND METHODS
This study utilized finite element analysis (FEA) to assess stress distribution in teeth with simulated ECR lesions of varying sizes and locations, restored with MTA or Biodentine. Three-dimensional models of maxillary central incisors were generated based on CBCT scans, incorporating periodontal ligament and surrounding bone structures. Eight experimental models representing different ECR configurations were created and subjected to FEA using Optistruct software based on dimensional classification given by Patel et al., in 2018, A70 M & A70B: 1Ap, A130 M & A130B: 1Bp, B70 M & B70B: 2Ap, B130 M & B130B: 2Bp. All the models were tested for stress distribution by restoring the lesions with either M: MTA or B: Biodentine. Oblique load of 100 N was applied at 45°angle to the long axis 2 mm lingual to incisal edge. vonMises Stress distribution in enamel, dentine, restoration and at all the interfaces were observed.
RESULTS
The analysis revealed that both MTA and Biodentine restorations exhibited uniform stress distribution around ECR lesions, with no significant differences based on lesion location or size. Maximum stress concentrations were observed around the restorations, particularly in subcrestal lesions. However, overall stress levels were comparable between MTA and Biodentine restorations, indicating similar biomechanical performance.
CONCLUSION
Finite element analysis provides valuable insights into the biomechanical behavior of teeth with ECR lesions restored with MTA and Biodentine. Both materials exhibit similar stress distribution patterns and offer adequate reinforcement against mechanical forces. Clinicians can confidently utilize MTA or Biodentine in the management of ECR, considering their favorable biomechanical properties and clinical outcomes. Further research is necessary to validate these findings and optimize treatment protocols for ECR.
PubMed: 38832294
DOI: 10.1016/j.jobcr.2024.04.012 -
Periodontology 2000 Jun 2024In patients with advanced periodontal disease, pathological tooth migration may occur, which may require subsequent orthodontic treatment for both aesthetic and... (Review)
Review
In patients with advanced periodontal disease, pathological tooth migration may occur, which may require subsequent orthodontic treatment for both aesthetic and functional purposes. When planning orthodontic treatment mechanics, intrusive or extrusive forces are frequently indicated. Understanding tissue reactions during these movements is essential for clinicians when devising a comprehensive orthodontic-periodontal treatment plan. This knowledge enables clinicians to be fully aware of and account for the potential effects on the surrounding tissues. The majority of our understanding regarding the behavior of periodontal tissues in both healthy and compromised periodontal conditions is derived from animal studies. These studies offer the advantage of conducting histological and other assessments that would not be feasible in human research. Human studies are nevertheless invaluable in being able to understand the clinically relevant response elicited by the periodontal tissues following orthodontic tooth movement. Animal and human data show that in dentitions with reduced periodontal support, orthodontic intrusion of the teeth does not induce periodontal damage, provided the periodontal tissues do not have inflammation and plaque control with excellent oral hygiene is maintained. On the contrary, when inflammation is not fully controlled, orthodontic intrusion may accelerate the progression of periodontal destruction, with bacterial plaque remnants being displaced subgingivally, leading to further loss of attachment. Orthodontic extrusion, on the other hand, does not seem to cause further periodontal breakdown in dentitions with reduced periodontal support, even in cases with deficient plaque control. This is attributed to the nature of the tooth movement, which directs any plaque remnants coronally (supragingivally), reducing the risk of adverse effects on the periodontal tissues. This specific type of tooth movement can be leveraged to benefit periodontal conditions by facilitating the regeneration of lost hard and soft periodontal tissues in a coronal direction. As a result, orthodontic extrusion can be employed in implant site development, offering an advantageous alternative to more invasive surgical procedures like bone grafting. Regardless of the tooth movement prescribed, when periodontal involvement is present, it is essential to prioritize periodontal therapy before commencing orthodontic treatment. Adequate plaque control is also imperative for successful outcomes. Additionally, utilizing light orthodontic forces is advisable to achieve efficient tooth movement while minimizing the risk of adverse effects, notably root resorption. By adhering to these principles, a more favorable and effective combined orthodontic-periodontal approach can be ensured. The present article describes indications, mechanisms, side effects, and histological and clinical evidence supporting orthodontic extrusion and intrusion in intact and reduced periodontal conditions.
PubMed: 38831560
DOI: 10.1111/prd.12578 -
Polishing methods for composites restoration: the influence on human gingival fibroblasts behaviour.BMC Oral Health Jun 2024Carious/Non-carious cervical lesions with gingival recessions may require both dental and periodontal reconstructive therapy, where flaps/grafts may be placed in contact...
BACKGROUND
Carious/Non-carious cervical lesions with gingival recessions may require both dental and periodontal reconstructive therapy, where flaps/grafts may be placed in contact with a dental filling material. Human Gingival Fibroblasts (HGF-1) response during the early phase of healing could vary according to the procedures employed to cure the dental composite. Moreover, oxygen diffusion into dental composite inhibits the polymerization reaction, creating an oxygen-inhibited layer (OIL) that presents residual unreacted monomers. The aim of this study was to assess the effect of different polishing techniques and OIL on HGF-1.
METHODS
Composite discs polished with different techniques (diamond rubber, abrasive discs and tungsten carbide burr) were used. An additional not polished smooth group obtained with and without OIL was used as control. Samples were physically characterized through the analysis of their hydrophilicity and surface topography through contact angle measurement and SEM, respectively; afterwards the biologic response of HGF-1 when cultured on the different substrates was analyzed in terms of cytotoxicity and gene expression.
RESULTS
The finishing systems caused alterations to the wettability, even if without a proportional relation towards the results of the proliferation essay, from which emerges a greater proliferation on surfaces polished with one-step diamond rubber and with abrasive discs as well as a direct effect of the glycerin layer, confirming that surface roughness can heavily influence the biological response of HGF-1.
CONCLUSIONS
Surfaces wettability as well as cellular behavior seem to be affected by the selection of the finishing system used to lastly shape the restoration. Especially, the presence of OIL act as a negative factor in the regards of human gingival fibroblasts. The present study may provide the first clinical instruction regarding the best polishing system of composite material when the restoration is placed directly in contact with soft tissue cells. Understanding HGF-1 behavior can help identifying the polishing treatment for direct restoration of carious/non-carious cervical lesions associated with gingival recessions.
Topics: Humans; Fibroblasts; Gingiva; Dental Polishing; Composite Resins; Surface Properties; Microscopy, Electron, Scanning; Cell Proliferation; Wettability; Dental Restoration, Permanent; Tungsten Compounds; Cells, Cultured
PubMed: 38831398
DOI: 10.1186/s12903-024-04418-z -
F1000Research 2023To investigate and compare the effect of four commercially used dental cement at 24 hours, 48 hours,72 hours (h) and 6 days on the cellular response of human gingival...
BACKGROUND
To investigate and compare the effect of four commercially used dental cement at 24 hours, 48 hours,72 hours (h) and 6 days on the cellular response of human gingival fibroblast (HGF).
METHODS
3 cement pellet samples were made for each 4-test cement (n=12). The cement used for this study were zinc phosphate (ZP), zinc oxide non-eugenol (ZOE), RelyX U200 (RU200), and glass ionomer cement (GIC). The cytotoxicity of peri-implant tissues was investigated using one commercial cell line. All processing was done following International Organization for Standardization (ISO) methods 10993-5 and 10993-12 (MTT assay Test). Cell cultures without dental cement were considered as control. Standard laboratory procedures were followed to permit cell growth and confluence over 48 hrs after sub-cultivation. Before being subjected to analysis, the cells were kept in direct contact with the cement samples for the suggested time period. To validate the results the specimens were tested three times each. Cell death and inhibition of cell growth were measured quantitatively. Results were analyzed using 1-way ANOVA (a=0.05) followed by Tukey B post hoc test.
RESULTS
The study showed the dental cement test material was cytotoxic. ZOE, ZP, GIC, and RU200 were cytotoxic in decreasing order, respectively, significantly reducing cell viability after exposure to HGF (p <0.001).
CONCLUSIONS
Within the limitations of this in-vitro cellular study, results indicated that HGF were vulnerable to the test the dental cement. The highest cytotoxicity was observed in ZOE, followed by ZP, GIC, and RU200.
Topics: Humans; Dental Cements; Fibroblasts; Gingiva; Dental Implants; Time Factors; Cell Proliferation; Cell Line; Cell Survival; Materials Testing
PubMed: 38826571
DOI: 10.12688/f1000research.140071.2 -
The Journal of Experimental Medicine Aug 2024Th17 cell plasticity is crucial for development of autoinflammatory disease pathology. Periodontitis is a prevalent inflammatory disease where Th17 cells mediate key...
Th17 cell plasticity is crucial for development of autoinflammatory disease pathology. Periodontitis is a prevalent inflammatory disease where Th17 cells mediate key pathological roles, yet whether they exhibit any functional plasticity remains unexplored. We found that during periodontitis, gingival IL-17 fate-mapped T cells still predominantly produce IL-17A, with little diversification of cytokine production. However, plasticity of IL-17 fate-mapped cells did occur during periodontitis, but in the gingiva draining lymph node. Here, some Th17 cells acquired features of Tfh cells, a functional plasticity that was dependent on IL-6. Notably, Th17-to-Tfh diversification was important to limit periodontitis pathology. Preventing Th17-to-Tfh plasticity resulted in elevated periodontal bone loss that was not simply due to increased proportions of conventional Th17 cells. Instead, loss of Th17-to-Tfh cells resulted in reduced IgG levels within the oral cavity and a failure to restrict the biomass of the oral commensal community. Thus, our data identify a novel protective function for a subset of otherwise pathogenic Th17 cells during periodontitis.
Topics: Th17 Cells; Animals; Periodontitis; Cell Plasticity; Interleukin-17; Mice; Interleukin-6; Mice, Inbred C57BL; T Follicular Helper Cells; Gingiva; Immunoglobulin G; Alveolar Bone Loss
PubMed: 38819409
DOI: 10.1084/jem.20232015 -
Cureus Apr 2024One of the important things to preserve during crown lengthening is the biologic width (BW), recently called supracrestal tissue attachment. A healthy periodontium with...
BACKGROUND
One of the important things to preserve during crown lengthening is the biologic width (BW), recently called supracrestal tissue attachment. A healthy periodontium with adequate BW is very essential for the success of restored teeth. There are various techniques to perform crown lengthening procedures. Most of the studies have focused on assessing the changes in the position of the marginal gingiva and bone as outcome parameters rather than BW. Also, most of the research was done on animal models.
AIM
The purpose of this study was to assess the periodontal tissue changes at three months and six months following two different surgical crown lengthening procedures.
MATERIALS AND METHODS
Sixty mandibular first molars among 60 patients that required surgical crown lengthening were enrolled in the study and subjected to two different procedures, gingivectomy (Group I; n=30) and apically positioned flap with ostectomy (Group II; n=30). The following parameters were recorded at baseline, three months, and six months, position of free gingival margin (FGM), probing depth (PD), relative attachment level (RAL), bone level (BL), and BW. These measurements were made at three sites in every patient: treated tooth sites (TT), adjacent tooth's adjacent sites (AD), and adjacent tooth's non-adjacent sites (NAD). The data was then subjected to statistical analysis using SPSS software (Version 20.0). Statistical significance was set to p<0.05.
RESULTS
When groups I and II were compared at three and six months, there was no statistical difference in terms of position of FGM, PD, and RAL (p>0.05). When BW was compared between the two groups at three and six months, group II showed better reestablishment of BW at any given time period and was statistically significant (p<0.05).
CONCLUSION
Following surgical crown lengthening, the bone level was shifted apically and allowed for the reestablishment of BW. At six months of follow-up, the apically positioned flap with ostectomy was superior in restoring the BW compared to gingivectomy.
PubMed: 38817532
DOI: 10.7759/cureus.59325 -
Stem Cell Research & Therapy May 2024Mesenchymal stromal cells (MSCs) isolated from the periodontal ligament (hPDL-MSCs) have a high therapeutic potential, presumably due to their immunomodulatory...
BACKGROUND
Mesenchymal stromal cells (MSCs) isolated from the periodontal ligament (hPDL-MSCs) have a high therapeutic potential, presumably due to their immunomodulatory properties. The interaction between hPDL-MSCs and immune cells is reciprocal and executed by diverse cytokine-triggered paracrine and direct cell-to-cell contact mechanisms. For the first time, this study aimed to directly compare the contribution of various mechanisms on this reciprocal interaction using different in vitro co-culture models at different inflammatory milieus.
METHODS
Three co-culture models were used: indirect with 0.4 μm-pored insert, and direct with or without insert. After five days of co-culturing mitogen-activated CD4 T lymphocytes with untreated, interleukin (IL)-1β, or tumor necrosis factor (TNF)-α- treated hPDL-MSCs, the CD4 T lymphocyte proliferation, viability, and cytokine secretion were investigated. The gene expression of soluble and membrane-bound immunomediators was investigated in the co-cultured hPDL-MSCs.
RESULTS
Untreated hPDL-MSCs decreased the CD4 T lymphocyte proliferation and viability more effectively in the direct co-culture models. The direct co-culture model without inserts showed a strikingly higher CD4 T lymphocyte cell death rate. Adding IL-1β to the co-culture models resulted in substantial CD4 T lymphocyte response alterations, whereas adding TNF resulted in only moderate effects. The most changes in CD4 T lymphocyte parameters upon the addition of IL-1β or TNF-α in a direct co-culture model without insert were qualitatively different from those observed in two other models. Additionally, the co-culture models caused variability in the immunomediator gene expression in untreated and cytokine-triggered hPDL-MSCs.
CONCLUSION
These results suggest that both paracrine and cell-to-cell contact mechanisms contribute to the reciprocal interaction between hPDL-MSCs and CD4 T lymphocytes. The inflammatory environment affects each of these mechanisms, which depends on the type of cytokines used for the activation of MSCs' immunomodulatory activities. This fact should be considered by comparing the outcomes of the different models.
Topics: Humans; Mesenchymal Stem Cells; Periodontal Ligament; CD4-Positive T-Lymphocytes; Coculture Techniques; Paracrine Communication; Immunomodulation; Cell Proliferation; Cells, Cultured; Cell Communication; Interleukin-1beta; Tumor Necrosis Factor-alpha; Cytokines
PubMed: 38816862
DOI: 10.1186/s13287-024-03759-4 -
Journal of Medicine and Life Feb 2024Periodontitis is an infection-driven inflammatory condition of the periodontium. Neutrophils are one of the most important first-line immune cells that protect against...
Periodontitis is an infection-driven inflammatory condition of the periodontium. Neutrophils are one of the most important first-line immune cells that protect against pathogen microorganisms in the saliva, but they may also mediate tissue death in inflammatory disorders. The aim of our study was to estimate salivary levels of azurocidin and extracellular azurophilic granules cluster of differentiation (CD63) as biomarkers of neutrophil activation in patients with periodontal diseases and to study the correlation between the levels of these two biomarkers and clinical periodontal parameters. The study included 60 patients with periodontal disease (30 patients with periodontitis and 30 with gingivitis) and 25 healthy controls. The assessed parameters were bleeding on probing, the plaque index, clinical attachment loss, and probing pocket depth. Saliva samples were taken from each study participant, and azurocidin and CD63 levels were measured using ELISA. Azurocidin and CD63 levels were significantly higher in patients with periodontitis and patients with gingivitis than in controls ( < 0.05), and significantly higher in patients with periodontitis than in patients with gingivitis ( < 0.05). Moreover, we found a significant positive correlation between the two biomarkers with clinical attachment loss in the periodontitis group. This study has shown that increased salivary azurocidin and extracellular CD63 levels are associated with enhanced innate response in periodontal disease and can be considered biomarkers of neutrophil activation.
Topics: Humans; Saliva; Male; Female; Adult; Biomarkers; Periodontal Diseases; Antimicrobial Cationic Peptides; Middle Aged; Case-Control Studies; Gingivitis; Periodontitis; Salivary Proteins and Peptides; Neutrophils; Blood Proteins
PubMed: 38813360
DOI: 10.25122/jml-2023-0286 -
Journal of Medicine and Life Feb 2024Numerous studies have established a link between gene variants within the inflammasome complex and the incidence of periodontitis and cardiovascular illness across...
Numerous studies have established a link between gene variants within the inflammasome complex and the incidence of periodontitis and cardiovascular illness across various ethnic groups. This study investigated the association between gene polymorphism and susceptibility to periodontal disease and coronary heart disease (CHD) and their correlation with clinical periodontal indices. A total of 120 participants were enrolled, categorized into four groups: 30 healthy controls (C), 30 patients with generalized periodontitis (P), 30 patients with atherosclerotic CHD but clinically healthy periodontium (AS-C), and 30 patients with both atherosclerotic CHD and generalized periodontitis (AS-P). We recorded demographic data, collected blood samples, and measured periodontal indices, including plaque index, clinical attachment loss, bleeding on probing, and pocket depth. The genomic variant of the gene was analyzed using a conventional polymerase reaction. A significant prevalence of T and G allele mutations and a higher distribution of CT and TT genotypes in C/T (rs8056505) and the AG genotype in A/G (rs372507365) were observed in groups P, AS-P, and AS-C. These single nucleotide polymorphisms (SNPs) were also positively correlated with the severity of clinical periodontitis indices. Our findings suggest that the increased frequency of T and G alleles and the distribution of CT, TT, and AG genotypes in SNPs are significantly associated with an elevated risk for periodontal disease and CHD. These SNPs may participate in the pathogenesis of these conditions. The study reinforces the potential role of these genetic markers as risk factors for both diseases in the Iraqi population.
Topics: Adult; Female; Humans; Male; Middle Aged; Alleles; CARD Signaling Adaptor Proteins; Case-Control Studies; Coronary Disease; Genetic Predisposition to Disease; Genotype; Periodontal Diseases; Periodontitis; Polymorphism, Single Nucleotide
PubMed: 38813354
DOI: 10.25122/jml-2023-0263