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Background: Gingiva acts as a barrier to prevent further invasion of pathogens in periodontitis. The gingival structure consists of epithelial tissue and connective tissue. As the aging process continues, there are several changes in the periodontium. Previous studies have tried to investigate the complex interaction between the host immune system and bacteria by using animal models, especially rodents. Objective: The aim of the study was to evaluate the effectiveness of collecting gingival tissue from the palate and retromolar pad. Materials and Methods: The aging experimental model had two age categories of male rodents of 18 and 58 weeks. Tissue was collected from the mandible retromolar pad and palate with full-thickness excision. Tissues were transferred to a complete medium at 4°C. Gingival tissue was cultured in a 37°C culture incubator at 5% CO2. Tissue proliferation was observed on the first, third, and fifth days using the hemocytometer. The cell metabolism rate between the two age categories was checked using the MTT Assay. Two-way ANOVA was used for statistical analysis. Results: Gingival tissues obtained from the experimental models of two age categories were alive, and proliferation was observed. The old rodent group showed no significant result in terms of cell morphology on the first vs. third day (p>0.05), but significant results were found on the first vs. fifth day and third day vs. the fifth day (p Conclusion: Rodent gingival tissue collection from the retromolar pad and palate was found suitable for tissue culture in the aging experimental study.

Latar belakang. Masalah pulpa dan periodontal menyebabkan lebih dari 50% kehilangan gigi. Kasus pada laporan kasus ini merupakan lesi primer endodontik dan lesi sekunder periodontal dan secara klinis terdapat sinus tract. Kondisi ini merupakan kasus yang secara kolaborasi dikerjakan oleh bidang konservasi gigi dan bidang periodonsia untukmemdapatkan hasil yang maksimal. Kasus. Terdapat tiga kasus lesi endodonti-periodontal, dua merupakan kasus (gigi 21 dan 37) yang setelah beberapa tahun dilakukan perawatan saluran akar (PSA) mengalami pembentukan sinus tract, dan satu kasus (gigi 47) yang setelah PSA namun tidak memeperlihatkan perbaikan sinus tract yang terbentuk di gingiva. Tindakan bedah flap periodontal dilakukan untuk mencari penyebab, menghilangkan jaringan granulasi, dan memperbaiki kerusakan tulang alveolar yang terjadi. Seluruh kasus terlihat terdapat kerusakan tulang anguler di daerah furkasi pada gigi posterior (37 dan 47), dan daerah interdental pada gigi anterior (21); satu kasus (gigi 21) mengalami fenestrasi di fasial. Defek tulang anguler dan daerah fenestrasi setelah dibersihkan dari jaringan granulasi yang terinfeksi, diisi dengan graf tulang dan ditutup oleh membran pericardium sebagai guided tissue regeneration (GTR), kemudian dijahit. Kontrol 14 hari setelah tindakan bedah, sinus tract telah hilang dan warna gingiva normal. Kesimpulan. Lesi endodontik-periodontal yang memperlihatkan sinus tract yang persisten setelah perawatan saluran akar merupakan indikasi adanya kerusakan periodontal yang kompleks. Defek periodontal kompleks bisa diperbaiki dengan tindakan bedah regeneratif.Kata kunci. Lesi endodontik-periodontal, sinus tract, defek tulang anguler, fenestrasi Abstract Background. Dental pulp and periodontal problems account for more than 50% of tooth loss. The cases in this case report were primary endodontic lesions and secondary periodontal lesions and clinically contained a sinus tract. This report is a collaborative carried out by the conservative dentistry and periodontics to obtain maximum results. Case. There were three cases of endodontic-periodontal lesions, two were cases (teeth 21 and 37) where after several years of root canal treatment had sinus tract formation, and one case (tooth 47) after endodontic treatment but did not show any improvement in the sinus tract in the gingiva. Periodontal flap surgery is performed to find the cause, remove the granulation tissue, and repair the alveolar bone damage that has occurred. All cases showed angular bone defects in the furcation areas of the posterior teeth (37 and 47), and the interdental areas of the anterior teeth (21); one case (tooth 21) had facial fenestration. Angular bone defects and areas of fenestration after cleaning of infected granulation tissue, filled with bone graft and covered by pericardial membrane as guided tissue regeneration (GTR), then sutured. Control 14 days after surgery, the sinus tract was gone and the gingival color was normal. Conclusion. Endodontic-periodontal lesions showing persistent sinus tracts after root canal treatment are indicated of complex periodontal damage. Complex periodontal defects can be corrected with regenerative surgery.Keywords. endodontic-periodontal lesions, sinus tract, angular bone defect, fenestration

Background:Implant placement on the anterior maxilla requires a comprehensive concern of adequate alveolar bone and gingival biotype. Insufficient support for hard and soft tissues becomes one of the main causes of implant complications. To avoid this problem, pre-surgical treatment with Guided Bone Regeneration (GBR) is suggested with respect to the alveolar ridge defect.Objective:In this study, we reported the predictability of a sandwich technique of GBR prior to implant placement.Case Presentation:Case: Thirty-four-year-old male was referred with a chief complaint of missing teeth on area #21 accompanied by labial bone dehiscence due to trauma. Bone thickness measurement displayed was approximately 3/4/5 mm (coronal/middle third/apical third of the alveolar ridge). This case was diagnosed as soft and hard tissue deformity on area #21 prior to implant. Case management: GBR and implant placement were performed in two stages of surgery. GBR was executed by using a combination of Biphasic Calcium Phosphate (BCP) (consisting of 40% Beta-Tri Calcium Phosphate (β-TCP) and 60% Hydroxyapatite (HA)) and Demineralized Freeze-Dried Bone Allografts (DFDBA) bone graft materials. Alveolar ridge re-measurement five months after GBR showed significant bone augmentation, 6/6/6 mm (coronal/middle third/apical third of the alveolar ridge). Furthermore, a 3.5 mm (diameter) x 10 mm (length) bone-level implant was inserted accordingly. The two-year follow-up exhibited gingival stability and no sign of either recession or bone resorption.Conclusion:Herein, we demonstrated the effectiveness of BCP and DFDBA bone substitutes to obtain proper conditions for the long-termed stability and predictability of implant.

ObjectiveChronic periodontitis has been proposed to be linked to coronavirus disease (COVID-19) on the basis of its inflammation mechanism. We aimed to evaluate this association by investigating the expression of Angiotensin Converting Enzyme-2 (ACE2) in periodontal compartments, which contain dysbiosis-associated pathogenic bacteria, and how it can be directly or indirectly involved in exacerbating inflammation in periodontal tissue.Material and MethodsThis observational clinical study included 23 adult hospitalized patients admitted to Universitas Indonesia Hospital with PCR-confirmed COVID-19, while 6 non-COVID-19 participants come to periodontal clinic were included as control. Using real time-PCR (qPCR) and gingival crevicular fluids (GCF) samples from COVID-19 patients with and without diabetes and periodontitis, we assessed the mRNA expression of angiotensin-converting enzyme 2 (ACE2), IL-6, IL-8, complement C3, and LL-37 as well as the relative proportion of Porphyromonas gingivalis, Fusobacterium nucleatum, and Veillonella parvula to represent the dysbiosis condition in periodontal microenvironment. All analyses were performed to determine their relationship.ResultsACE2 mRNA expression was detected in the GCF of periodontitis-COVID-19 patients with and without diabetes. However, only periodontitis-COVID-19 patients with diabetes showed a positive relationship between ACE2 expression and inflammatory conditions in the periodontal microenvironment. In addition, the interplay between pro-inflammatory cytokine (IL-6) and complement C3 could be used as a predictor of the severity of periodontal inflammation in COVID-19 patients with diabetes.ConclusionThe study data show that the SARS-CoV-2 entry gene is expressed in the GCF of patients with COVID-19, and its expression correlates with inflammatory markers.

Background: The available evidence suggests that inflammatory responses, in both systemic and oral tissue, contribute to the pathology of COVID-19 disease. Hence, studies of inflammation biomarkers in oral fluids, such as saliva, might be useful to better specify COVID-19 features. Methods: In the current study, we performed quantitative real-time PCR to measure salivary levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in saliva obtained from patients diagnosed with mild COVID-19, in a diabetic group (DG; n = 10) and a non-diabetic group (NDG; n = 13). All participants were diagnosed with periodontitis, while six participants with periodontitis but not diagnosed with COVID-19 were included as controls. Results: We found increases in salivary total protein levels in both the DG and NDG compared to control patients. In both groups, salivary CRP and IL-6 levels were comparable. Additionally, the levels of salivary CRP were significantly correlated with total proteins, in which a strong and moderate positive correlation was found between DG and NDG, respectively. A linear positive correlation was also noted in the relationship between salivary IL-6 level and total proteins, but the correlation was not significant. Interestingly, the association between salivary CRP and IL-6 levels was positive. However, a moderately significant correlation was only found in COVID-19 patients with diabetes, through which the association was validated by a receiver operating curve. Conclusions: These finding suggest that salivary CRP and IL-6 are particularly relevant as potential non-invasive biomarker for predicting diabetes risk in mild cases of COVID-19 accompanied with periodontitis.

Objective: Through this work, we aimed to clarify the association between the severity of periodontitis and osteocalcin (OC) gene C298T polymorphismin Indonesian male subjects.Methods: DNA was extracted from blood serum samples of 100 consenting Indonesian men whose periodontitis was classified as mild, moderate,or severe. Polymerase chain reaction and restriction fragment length polymorphism techniques were applied to evaluate the status of OC (C298T)polymorphism using HindIII restriction enzyme and electrophoresis in agarose gel to separate the indicated fragments.Results: Although genotype distribution of the OC C298T polymorphism showed a trend for more frequent occurrence of genotype hh (and allele h)with increasing severity of periodontitis, this trend was not statistically significant in the tested sample population, in whom the HH genotypeappeared to be relatively rare.Conclusion: The results showed no significant association between the severity of periodontitis and OC C298T polymorphism in Indonesian malesubjects.

BACKGROUND The bioactive metabolite KetoC, generated by intestinal bacteria, exerts various beneficial effects. Nevertheless, its function in the pathogenesis of periodontitis remains unclear. Here, we investigated the effect of KetoC in a mouse model of periodontitis and explored the underlying mechanism. METHODS Thirty-one 8-week-old male C57BL/6N mice were randomly divided into four groups (non-ligation, non-ligation + KetoC, ligation + Porphyromonas gingivalis, and ligation + P. gingivalis + KetoC) (n = 7/8 mice/group) and given a daily oral gavage of KetoC (15 mg/mL) or vehicle for 2 weeks. To induce periodontitis, a 5-0 silk ligature was placed on the maxillary left second molar on day 7, and P. gingivalis W83 (109 colony-forming unit [CFU]) was administered orally every 3 days. On day 14, all mice were euthanized. Alveolar bone destruction was determined from the level of the cemento-enamel junction to the alveolar bone crest. Moreover, bone loss level was confirmed from gingival tissue sections stained with hematoxylin and eosin. The presence of P. gingivalis was quantified using real-time polymerase chain reaction. In vitro, the bacteriostatic and bactericidal effects of KetoC were assessed by analyzing its suppressive activity on the proliferation of P. gingivalis and using a live/dead bacterial staining kit, respectively. A double-bond-deficient metabolite (KetoB) was then used to investigate the importance of double-bond structure in the antimicrobial activity of KetoC on P. gingivalis. RESULTS In vivo, KetoC attenuated alveolar bone destruction and suppressed P. gingivalis in the periodontitis group. In vitro, KetoC (but not KetoB) downregulated the proliferation and viability of P. gingivalis in a dose-dependent manner. CONCLUSIONS KetoC reduced alveolar bone destruction in a periodontitis model via its antimicrobial function. Therefore, this bioactive metabolite may be valuable in clinical applications to support periodontal therapy.

Objective To highlight the shifting paradigm of periodontitis, describe mechanism of periodontal bone destruction, and propose an updated host modulation therapy (HMT) strategy. To add further clinical relevance, related studies investigating the efficacy of several HMT agents in periodontitis will be discussed. Design Literature searches were conducted from articles published in PubMed using keywords “periodontal disease AND periodontitis AND host modulation therapy AND anti-inflammatory AND antioxidant”, and then the findings were comprehensively summarized and elaborated. Result Accumulating evidence indicates that periodontitis is no longer defined solely as a pathogen-induced disease; rather, it is now recognized as a consequence of uncontrolled immune response and oxidative stress leading to periodontal tissue damage. Although periodontopathic bacteria initiate the disease, inflammation and oxidative stress were reported to be the main causes for the severity of tissue destruction. Thus, since the concept of periodontitis has shifted, our approach to its management needs to be adjusted to accommodate the latest paradigm. Nowadays, the modulation of inflammation and oxidative stress is considered a target of HMT. HMT agents, such as probiotics, anti-inflammatory drugs, anti-chemokines, lipid mediators, and bio-active fatty acids, have been extensively investigated for their remarkable functions in modulating the immune response and providing antioxidant effects. Conclusion Findings from in vitro, in vivo, and human studies frequently demonstrate positive association by the administration of HMT in periodontitis. HMT strategy targeted on anti-inflammatory and antioxidant in periodontitis might serve as an excellent therapeutic approach to reach the level of clinical benefit.

Periodontal disease and its associated systemic diseases have gained public attention due to their increasing global prevalence. Still, the gold standard for the management of periodontitis is scaling and root planing (SRP). However, bacterial recolonization is considered a limitation of this approach. Further, the efficacy of adjunctive agents such as antibiotics, antimicrobials, and probiotics has been investigated extensively. Nowadays, drug resistance development due to antibiotics and antimicrobials abuse has become a global problem and our concern. In order to reduce the spread of drug resistance development, many investigations have been focused on the use of nutritional compounds rather than synthetic drugs for treating periodontitis, a relatively low-grade inflammatory disease. Moreover, if periodontitis is understood as a bacterial dysbiosis-induced inflammatory disease, then its treatment could be designed not only to eliminate periodontopathogens, but also to modify the host immune response. Therefore, this review will highlight the effectiveness of some pertinent nutrients towards periodontal condition. Nutrients are known to possess anti-inflammatory, antioxidant, and antimicrobial properties that maintain homeostasis. In vivo and in vitro studies have demonstrated the positive effects of nutrient intake on the maintenance and restoration of periodontal health. Vitamins, fatty acids, and probiotics are increasingly being found to have remarkable benefits and valuable properties. Further, considering the oral-systemic connection, nutritional supplementation is encouraged as a possible adjunct therapy for the improvement of both oral and systemic health.

Background: A relationship between oral microbiota and susceptibility to SARS-CoV-2 infection has been extensively studied. However, the relationship between oral commensal flora and expression of angiotensin-converting enzyme 2 (ACE2) remains to be established. In this observational study, we collected saliva from patients with COVID-19 and evaluated the relationship between ACE2 expression and Candida albicans as well as with selected gram-negative bacteria (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Veillonella parvula). We investigated how this may be directly or indirectly involved in oral dysbiosis in patients with COVID-19. Methods: We included 23 hospitalized patients admitted to Universitas Indonesia Hospital with PCR-confirmed COVID-19, with six healthy participants serving as controls. Saliva and tongue surface swabs were collected from patients with diabetes (DG) and without diabetes (NDG) and subject controls. Using quantitative PCR (qPCR) we assessed the mRNA expression of ACE2, the abundance of C. albicans, and the transcription levels of its biofilm-associated genes, agglutinin-like protein 3 (ALS3), hyphal wall protein 1 (HWP1), and yeast-form wall protein 1 (YWP1). We also counted the relative proportion of the three selected gram-negative oral bacteria in saliva. All analyses were performed to determine the relationship between ACE2 expression and C. albicans and gram-negative bacteria. Results: ACE2 mRNA expression was significantly higher in tongue swab samples than in saliva. However, no significant difference was observed between the patient groups. Conversely, DG patients had a significantly higher abundance of C. albicans in saliva compared to NDG patients and control group patients. The correlation and sensitivity/specificity relationship between ACE2 expression and C. albicans or the selected oral bacteria were also observed. Conclusions: The data show that ACE2 expression can be detected in saliva of patients with COVID-19 and its association with C. albicans and gram-negative oral bacteria might contribute toward developing an oral dysbiosis based predictor for prognosis of COVID-19 severity.

Background The COVID-19 pandemic has become a global health issue and has had a major impact on education. Consequently, half way through the second semester of the academic year 2019/2020, learning methods were delivered through distance learning (DL). We aimed to evaluate the student perspective of DL compared to classroom learning (CL) in the undergraduate dentistry study program at the Faculty of Dentistry Universitas Indonesia. Methods An online questionnaire was sent at the end of the semester. A total of 301 students participated in the study. Results Duration of study influenced student preference. Higher number of first-year students preferred DL compared to their seniors (p Conclusion Despite some challenges, dental students could adapt to the new learning methods of full DL and the majorities agreed blended learning that combined classroom and distance learning can be implemented henceforth. This current COVID-19 pandemic, changes not only the utilization of technology in education but the pedagogy strategies in the future.

Background: The COVID-19 pandemic has become a global health issue and has had a major impact on education. Consequently, half way through the even semester of the academic year 2019/2020, learning methods were delivered through distance learning. This study aimed to evaluate the s tudent perspective of distance learning compared to the classroom learning in the undergraduate dentistry study program at the Faculty of Dentistry Universitas Indonesia. Methods: An online questionnaire was sent to dental students of Universitas Indonesia at the end of the semester. Three hundred and one undergraduate dental students participated in the study, with 83.4% response rate. The internal consistency reliability questionnaire was measured by Cronbach’s alpha. Logistic regression analyses were conducted to identify factors associated with the students’ preference towards distance learning. Results: Duration of study influenced student preference on distance learning (DL). Significantly higher number of first-year students preferred DL compared to their seniors (pConclusion: Despite some challenges, dental students could adapt to the new learning methods of full DL and the majorities agreed blended learning that combined classroom and distance learning can be implemented henceforth. This current COVID-19 pandemic, changes not only the utilization of technology in education but the pedagogy strategies in the future.

Objective This study aimed to evaluate the effects of ingested periodontal pathogens on experimental colitis in mice and to elucidate its underlying mechanisms. Background Inflammatory bowel disease (IBD) is defined as a chronic intestinal inflammation that results in damage to the gastrointestinal tract. Epidemiological studies have shown an association between IBD and periodontitis. Although a large number of ingested oral bacteria reach gastrointestinal tract constantly, the effect of ingested periodontal pathogens on intestinal inflammation is still unknown. Methods Experimental colitis was induced by inclusion of dextran sodium sulfate solution in drinking water of the mice. Major periodontal pathogens (Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum) were administered orally every day during the experiment. The severity of colitis between the groups was compared. In vitro studies of the intestinal epithelial cell line were conducted to explore the molecular mechanisms by which periodontal pathogens affect the development of colitis. Results The oral administration of P. gingivalis significantly increased the severity of colitis when compared to other pathogens in the DSS-induced colitis model. The ingested P. gingivalis disrupted the colonic epithelial barrier by decreasing the expression of tight junction proteins in vivo. In vitro permeability assays using the intestinal epithelial cell line suggested the P. gingivalis-specific epithelial barrier disruption. The possible involvement of gingipains in the exacerbation of colitis was implied by using P. gingivalis lacking gingipains. Conclusion Porphyromonas gingivalis exacerbates gastrointestinal inflammation by directly interacting with the intestinal epithelial barrier in a susceptible host.

Background There is rapidly developing interest into the role of several anti-inflammatory agents to resolve inflammation in periodontal disease. A bioactive polyunsaturated fatty acid, 10-oxo-trans-11-octadecenoic acid (KetoC), is known to have various beneficial physiological effects; however, the effect of KetoC on inflammation remains unclear. Here, we investigated the effect of KetoC on RAW 264.7 cells stimulated with Porphyromonas gingivalis lipopolysaccharide, and explored the intracellular mechanism responsible for its anti-inflammatory effects. Methods RAW 264.7 cells were pre-treated with or without KetoC, and then stimulated with or without P. gingivalis lipopolysaccharide. Levels of tumor necrosis factor α (TNFα), interleukin (IL)-6 and IL-1β were determined by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Specific antagonists for G protein-coupled receptor (GPR)40 and GPR120 were used to clarify the receptor for KetoC. The intracellular mechanism was investigated using western blotting analysis to separate nuclear and cytosolic NF-κB p65 protein. Result KetoC (5 μmol/L) was not toxic to RAW 264.7 cells, and significantly reduced the expression of TNFα and IL-6 mRNA and protein, and IL-1β mRNA. No protein production of IL-1β was observed. Additionally, when bound to GPR120, KetoC trended to downregulate nuclear NF-κB p65 protein levels. However, the antagonist for GPR40 failed to diminish the action of KetoC. Conclusion KetoC suppressed the proinflammatory cytokines TNFα, IL-6 and IL-1β via NF-κB p65, by binding to its receptor GPR120. KetoC is a promising candidate in future studies as a bioactive anti-inflammatory agent in treating periodontal disease.

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Background and objectives Recent evidence suggests that oral bacteria can affect extra-oral diseases by modulating aspects of the gut environment such as the microbiome, metabolome, and immune profiles. However, differences in the effects of different types of oral bacteria, particularly periodontopathic and health-associated bacteria, remain elusive. Materials and methods Five-week-old germ-free mice were orally administered with either periodontopathic bacteria as oral pathobionts (Porphyromonas gingivalis, Filifactor alocis, and Fusobacterium nucleatum) or bacteria associated with periodontal health (Actinomyces naeslundii, Streptococcus mitis, and Veillonella rogosae) twice a week for five weeks. The presence of all bacterial species in the feces and the livers of the mice was analyzed via polymerase chain reaction (PCR), using specific primers for 16S rRNA genes. Alveolar bone resorption was evaluated histologically. The expression profiles of various genes in the liver and small intestine were analyzed using real-time PCR. Sera were analyzed to determine the levels of antibodies and endotoxin. The proportions of T helper 17 (Th17) and regulatory T (Treg) cells in mesenteric lymph nodes and Peyer's patches were analyzed using flow cytometry. Results Neither of the types of bacteria administered in this experiment induced alveolar bone resorption. All bacteria elicited some degree of systemic antibody response in the mice, although the response to S. mitis was not obvious. The response to P. gingivalis and V. rogosae was strongest. Generally, the health-associated bacteria but not the periodontitis-associated bacteria were detected in fecal samples. Interestingly, only Fusobacterium nucleatum DNA was detected in the liver, despite that live Fusobacterium nucleatum were not detected in the liver. The levels of interleukin-17 in the intestine and genes related to lipid accumulation in the liver were significantly higher in the mice that received periodontitis-associated bacteria. In addition, expression of the gene associated with endoplasmic reticulum stress was higher and that of the gene controlling circadian rhythm was lower in the periodontitis group. There was no difference in serum endotoxin, T-cell phenotypes in the lymphatic tissues, or genes related to the gut barrier. Conclusion Oral administration of periodontitis-associated bacteria can induce pathological changes in the liver and intestine that are implicated in the process of periodontitis. These findings further support the importance of the oral–gut connection.

Objective Oxidative stress, which is defined as an imbalance between pro-oxidant and antioxidant systems, has been implicated in the development and/or progression of several inflammatory diseases, including periodontal disease. The reactive oxygen species (ROS) are the primary inducers of oxidative stress. In the induction of cytoprotective enzymes, the nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) signaling in antioxidant systems takes a main role. Notably, 10-oxo-trans-11-octadecenoic acid (KetoC), known as a bioactive metabolite generated by intestinal microorganisms, has been reported to have beneficial effects on several biological responses. Therefore, we investigated the antioxidant effect of KetoC on gingival epithelial cells (GECs) in this present study. Methods An SV40-T antigen-transformed human gingival epithelial cell line (Epi4) was used for experiments. The alteration of anti-oxidative stress related genes was analyzed by qPCR. The cellular ROS levels were evaluated by flow cytometry. To explore its molecular mechanisms, ARE promotor activity was analyzed by luciferase assay; the involvement of mitogen-activated protein kinase (MAPK) and G protein-coupled receptor 120 (GPR120) were evaluated by Western blotting and luciferase assay, respectively. Results KetoC significantly increased the expression of antioxidant-related genes in GECs. The level of ROS was significantly inhibited by the pretreatment of KetoC. Extracellular signal-regulated kinase (ERK) phosphorylation by KetoC promoted both the nuclear translocation of Nrf2 and its binding to the ARE in GECs. Further, GPR120 regulated the activation of KetoC induced-Nrf2-ARE signaling. Conclusion KetoC exerts a protective function against the oxidative stress in GECs through GPR120-dependent ERK-Nrf2-ARE signaling.

Background Periodontitis is an inflammatory disease that results in alveolar bone resorption due to inflammatory cytokine production induced by bacterial antigens such as lipopolysaccharides (LPS). Here, the preventive effect of the Amyl-1-18 peptide derived from rice in an experimental model of periodontitis and the effect on the anti-inflammatory response were assessed. Methods Alveolar bone resorption, gene transcription of proinflammatory cytokines in the gingiva, and the endotoxin level in the oral cavity were evaluated after oral administration of the Amyl-1-18 peptide for 14 days using a ligature-induced periodontitis model in mice. Additionally, murine macrophages were incubated with LPS of Escherichia coli or Porphyromonas gingivalis in the presence of Amyl-1-18 to analyze the suppressive effects of Amyl-1-18 on the cell signaling pathways associated with proinflammatory cytokine production, including inflammasome activities. Results Oral administration of Amyl-1-18 suppressed alveolar bone resorption and gene transcription of interleukin (il)6 in the gingiva of the periodontitis model, and decreased endotoxin levels in the oral cavity, suggesting modulation of periodontal inflammation by inhibition of endotoxin activities in vivo. Also, Amyl-1-18 suppressed IL-6 production induced by LPS and recombinant IL-1β in macrophages in vitro but had no effect on inflammasome activity. Conclusions The Amyl-1-18 peptide from rice inhibited alveolar bone destruction in mouse periodontitis model via suppressing inflammatory cytokine production induced by LPS. It was suggested that Amyl-1-18 peptide has anti-inflammatory property against LPS, not only by neutralization of LPS and subsequent inhibition of nuclear factor-κB signaling but also by inhibition of the IL-1R-related signaling cascade.

Several studies have demonstrated the remarkable properties of microbiota and their metabolites in the pathogenesis of several inflammatory diseases. 10-Hydroxy-cis-12-octadecenoic acid (HYA), a bioactive metabolite generated by probiotic microorganisms during the process of fatty acid metabolism, has been studied for its protective effects against epithelial barrier impairment in the intestines. Herein, we examined the effect of HYA on gingival epithelial barrier function and its possible application for the prevention and treatment of periodontal disease. We found that GPR40, a fatty acid receptor, was expressed on gingival epithelial cells; activation of GPR40 by HYA significantly inhibited barrier impairment induced by Porphyromonas gingivalis, a representative periodontopathic bacterium. The degradation of E-cadherin and beta-catenin, basic components of the epithelial barrier, was prevented in a GPR40-dependent manner in vitro. Oral inoculation of HYA in a mouse experimental periodontitis model suppressed the bacteria-induced degradation of E-cadherin and subsequent inflammatory cytokine production in the gingival tissue. Collectively, these results suggest that HYA exerts a protective function, through GPR40 signaling, against periodontopathic bacteria-induced gingival epithelial barrier impairment and contributes to the suppression of inflammatory responses in periodontal diseases.

Background: Dental implant is one of an alternative solutions reconstruction therapy for missing teeth. Complication of dental implant could occurs and leading to implant failure. In order to restore the complication, surgical treatment with guided bone regeneration (GBR) is indicated. The potential use of bone substitutes is widely known to be able to regenerate the bone surrounding the implant and maintain bone volume. Purpose: The study aimed to demonstrate the effectiveness of implant-bone fully coverage by using sandwich technique of biphasic calcium phosphate (BCP) and demineralized freeze-dried bone allografts (DFDBA) bone substitutes combined with collagen resorbable membrane. Case: A 24-year-old male came with diagnosis of peri-implantitis on implant #11. Clinical finding indicated that implant thread was exposed on the labial aspect. Case management: After initial therapy including oral hygiene improvement performed, an operator did a contemporary GBR to correct the defect. Bone graft materials used were 40% β -tri calcium phosphate ( β -TCP)-60% hydroxyapatite (HA) on the outer layer and DFDBA on the inner layer of the defect. Resorbable collagen membrane was used to cover the graft. Conclusion: GBR with sandwich technique could serve as one of the treatment choices for correcting an exposed anterior implant that would enhance the successful aesthetic outcome.