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Background: We have recently developed a periodontal diagnostic tool that was validated in non-smokers with periodontitis. Tobacco smoking is a recognized risk factor for periodontal diseases that can mask gingival bleeding and lead to a false negative diagnosis. Therefore, the purpose of current study is to further validate this instrument in smokers with periodontal diseases., Methods: Using a portable optical near-infrared spectrometer, optical spectra were obtained, processed and evaluated from healthy (n = 108), gingivitis (n = 100), and periodontitis (n = 79) sites of 54 systemically healthy smokers. A modified Beer-Lambert unmixing model that incorporates a non-parametric scattering loss function was used to determine the relative contribution of deoxygenated haemoglobin (Hb) and oxygenated haemoglobin (HbO2 ) to the overall spectrum. The balance between tissue oxygen delivery and utilization in periodontal tissues was then assessed., Results: Tissue oxygen saturation was significantly decreased in the gingivitis (p = 0.016) and periodontitis (p = 0.007) sites, compared to the healthy sites. There was a trend towards increased concentration of Hb and decreased concentration of HbO2 from healthy to diseased sites, without statistical significance (p > 0.05)., Conclusions: Optical spectroscopy can determine tissue oxygenation profiles of healthy and diseased sites in smokers. The spectral profile of periodontal sites in smokers generally resembles those from non-smoking patients., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: The aim of this study was to evaluate the serum levels of lipids in patients with normal weight (NW) or obesity with or without chronic periodontitis (ChP). Materials and methods: One hundred and sixty non-smoking patients without history of diabetes and/or cardiovascular events were allocated into one of the following groups: NW patients with periodontal health (NWH; n = 40), NW patients with ChP (NWChP; n = 40), obese patients with periodontal health (ObH; n = 40), and obese patients with ChP (ObChP; n = 40). Serum levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TRG) were estimated. Results: After adjustments for gender and age, both NW groups presented lower levels of TRG than both obese groups ( p < 0.05). The NWH group presented lower levels of LDL than both periodontitis groups ( p < 0.05) and the lowest TC/HDL ratio when compared to the other groups ( p < 0.05). Females from the NWH group exhibited higher levels of HDL and lower LDL/HDL ratio than females from the ObChP group ( p < 0.05). Furthermore, individuals from the ObChP group were more likely to have levels of LDL ≥130 mg/dl and HDL ≤40 mg/dl, compared to those from the NWH group ( p < 0.05). Conclusions: ChP and obesity, jointly or individually, are associated with undesirable pro-atherogenic lipid profiles. Clinical relevance: There is interest in identifying clinical conditions associated with dyslipidemia to improve preventive and treatment strategies. This study demonstrated that ChP, obesity, and the association of both conditions might be related to pro-atherogenic lipid profiles. [ABSTRACT FROM AUTHOR]

Aim To evaluate whether obesity affects the subgingival microbial composition of patients with periodontal health or chronic periodontitis ( CP). Materials and Methods Based on periodontal parameters, body mass index and waist-hip ratio, 166 patients were allocated into one of the following groups: Normal weight ( NW) patients with periodontal health ( n = 44), NW patients with CP ( n = 40), obese patients with periodontal health ( n = 40) and obese patients with CP ( n = 42). Six subgingival biofilm samples per patient were analysed for their content of 40 bacterial species using checkerboard DNA- DNA hybridization. Results Obese patients with CP harboured higher levels and/or higher proportions of several periodontal pathogens than those with NW and CP, including Aggregatibacter actinomycetemcomitans, Eubacterium nodatum, Fusobacterium nucleatum ss vincentii, Parvimonas micra, Prevotella intermedia, Tannerella forsythia, Prevotella melaninogenica and Treponema socranskii. The proportions of most of these pathogens, as well Campylobacter rectus and Eikenella corrodens, were more increased in the diseased sites of the obese patients than in those with NW. Furthermore, the healthy sites of the obese patients, presenting or not CP, also exhibited higher proportions of some of the pathogens than patients with NW. Conclusions Obesity is associated with increased levels and proportions of periodontal pathogens, especially in patients with CP. [ABSTRACT FROM AUTHOR]

Background: Despite several investigations suggesting that obesity is a risk indicator for periodontitis, little is known about the effect of obesity on periodontal treatment response. The aim of this study is to evaluate the effects of scaling and root planing (SRP) on clinical parameters and circulating levels of leptin and adiponectin in patients with obesity with chronic periodontitis (CP). Methods: Twenty-four patients with obesity and CP and 24 patients without obesity with CP were submitted to SRP. Clinical parameters were assessed at baseline and 3 and 6 months after therapy. Serum levels of leptin and adiponectin were evaluated at all time points, using enzyme-linked immunosorbent assay. Results: SRP improved the clinical parameters of both groups at 3 and 6 months (P<0.05). Nonetheless, the patients without obesity presented a lower mean probing depth (PD) at 6 months after therapy and a greater reduction in PD from baseline to 6 months in the full-mouth analysis (primary outcome variable) and in initially deep sites (P <0.05). Leptin serum levels were higher in patients with obesity than in patients without obesity at all time points (P <0.05). No changes in the serum levels of leptin and adiponectin were observed in groups with and without obesity after therapy (P>0.05). Conclusions: Patients with obesity and CP presented lower reductions in PD than patients without obesity with CP at 6 months after SRP. Furthermore, the treatment did not affect the circulating levels of leptin and adiponectin in any group. [ABSTRACT FROM AUTHOR]

Background: It has been established previously that infrared spectroscopy (IRS) can be used to identify periodontitis-specific molecular signatures in gingival crevicular fluid (GCF) and to confirm clinical diagnoses. This follow-up study is designed to assess whether this novel technique is also able to differentiate diseased from healthy sites in patients with diabetes mellitus (DM) by analyzing the molecular fingerprints embedded in the QCF. Methods: A total of 65 patients with DM with moderate-to-severe chronic periodontitis (CP) was recruited, and 15 individuals without DM (65 sites) without periodontal diseases were used as control. Clinical examination and GCF samples were taken from a total of 351 sites, including periodontitis (109), gingivitis (115), and healthy (127) sites. Corresponding absorption spectra of GCF samples were acquired and processed, and the relative contributions of key functional groups in the infrared spectra were identified and analyzed. The qualitative assessment of clinical relevance of these GCF spectra was interpreted with multivariate statistical analysis: linear discriminant analysis (LDA). Results: Spectral analysis revealed several molecular signatures representing vibrations in protein (amide I and II), lipid ester, and sugar moieties in the GCF of patients with DM with CP and non-DM controls. The diagnostic accuracy for distinction between healthy and CP sites in patients with DM determined by LDA of GCF spectra was 95.3% for the training set of samples and 87.5% for the validation set. Additional LDA of GCF spectra from healthy sites of non-DM controls and patients with DM revealed 100% diagnostic accuracy for the training set and 86.7% for the validation set. The regions robotically selected by LDA for the two analyses were slightly different in that first LDA identified major regions clustered with the side chain vibrations originating from protein and DNA contents, whereas the second was predominantly the glycation and protein components. Conclusion: IRS is a feasible method to differentiate disease-specific molecular signatures in GCF in the presence of DM and to generate a complex biochemical profile of GCF to identify DM-specific spectral features. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate the local and circulating levels of adipocytokines (resistin, adiponectin, leptin, tumor.necrosis factor [TNF]-α, and interleukin [IL]-6) in individuals who are obese and individuals who are normal weight (NW) with chronic periodontitis (CP). Methods: Periodontal and anthropometric examinations were performed. Based on these measurements, the individuals were divided into one of the following groups: NW non-periodontitis (NP) (NWNP; n = 20); NWCP (n = 20); obese NP (ONP; n = 18); and obese CP (OCP; n = 20). The levels of adipocytokines were evaluated in the serum and gingival crevicular fluid of shallow and deep sites by enzyme-linked immunosorbent assay. Results: In serum, resistin levels were higher whereas adiponectin levels were lower in periodontitis than in NP groups (P<0.05). The NWNP group presented the lowest serum leptin levels (P <0.05). The ONP and OCP groups demonstrated higher TNF-α levels in periodontal sites than the NWNP and NWCP groups (P<0.05). Serum levels of IL-6 (P= 0.04) and leptin (P= 0.01) were correlated with the OCP group, with odds ratios of 0.99 (95% confidence interval [CI]: -0.01 to -0.00) and 0.99 (95% CI: -0.00 to -0.00), respectively. Conclusions: Periodontitis mainly influenced the circulating levels of resistin and adiponectin, whereas both obesity and periodontitis affected the circulating level$ of leptin in favor of proinflammation. In addition, obesity upregulated the local levels of TNF-α. [ABSTRACT FROM AUTHOR]

Aim The aim of this randomized controlled clinical trial was to evaluate the clinical effects of chlorhexidine ( CHX) application in a full-mouth disinfection ( FMD) protocol in poorly controlled type-2 diabetic subjects with generalized chronic periodontitis. Material and Methods Thirty-eight subjects were randomly assigned into FMD group ( n=19): full-mouth scaling and root planing ( FMSRP) within 24 h + local application of CHX gel + CHX rinses for 60 days or Control group ( n = 19): FMSRP within 24 h + local application of placebo gel + placebo rinses for 60 days. Clinical parameters, glycated haemoglobin and fasting plasma glucose were assessed at baseline, 3, 6 and 12 months post-therapies. Results All clinical parameters improved significantly at 3, 6 and 12 months post-therapies for both groups ( p < 0.05). There were no significant differences between groups for any clinical parameters, and glycemic condition at any time-point ( p > 0.05). Conclusions The treatments did not differ with respect to clinical parameters, including the primary outcome variable (i.e. changes in clinical attachment level in deep pockets), for up to 12 months post-treatments. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate the gene expression of immune-inflammatory markers in gingival biopsies of patients with type 2 diabetes with chronic periodontitis (CP). Methods: Gingival biopsies were harvested from systemically and periodontally healthy patients (SPH), systemically healthy patients with CP (SHCP), and patients with better-controlled and poorly controlled diabetes and CP. The levels of mRNA of interleukin (IL)-17, IL-6, IL-23, IL-10, IL-4, interferon-γ toll-like receptor (TLR)-2, TLR-4, osteoprotegerin, receptor activator of nuclear factor-kappa B ligand (RANKL), tumor necrosis factor-s, transforming growth factor-β, transcription factor forkhead box p3, transcription factor orphan nuclear receptor C2 (RORC2), and receptor of advanced glycation end products (RAGE) were evaluated by quantitative real-time polymerase chain reaction. Results: All CP groups presented higher levels of mRNA of TLR-2, TLR-4, IL- 17, RANKL, and RAGE and a higher frequency of IL-17 and TLR-2 mRNA-positive biopsies when compared to SPH (P<0.05). There was a higher frequency of detection of RORC2 in the biopsies from both groups with diabetes compared to the other groups (P<0.05). The frequency of IL-4 mRNA-positive tissues was lower in patients with diabetes compared to SHCP (P<0.05). Conclusion: CP, but not type 2 diabetes mellitus, significantly affected the expressions of the evaluated genes related to the innate and adaptive immune responses. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate the levels of osteoclastogenesis-related factors (soluble receptor activator of nuclear factor-kappa B ligand [sRANKL] and osteoprotegerin [OPG]) in gingival crevicular fluid (GCF) from subjects with poorly and well-controlled type 2 diabetes and chronic periodontitis before and after periodontal therapy. Methods: Eighteen subjects with well-controlled diabetes (glycated hemoglobin [HbAlc] levels <8%) and 20 subjects with poorly controlled diabetes (HbAlc levels >8%) were enrolled in this study. All subjects were submitted to non-surgical periodontal therapy. GCF sampling and clinical periodontal parameters were assessed at baseline and 3 and 6 months post-therapy. Total amounts and concentrations of sRANKL and OPG in GCF were analyzed by enzyme-linked immunosorbent assay (ELISA). Results: Total amounts and concentrations of sRANKL and RANKL/OPG ratios were higher in poorly controlled subjects than in well-controlled subjects at baseline and 3 and 6 months post-therapy (P <0.05). In addition, RANKL/OPG ratios decreased in well-controlled subjects (P<0.05) but not in poorly controlled subjects (P >0.05) at 3 months post-therapy. Almost all clinical parameters improved significantly for both groups post-treatment (P <0.05). Conclusion: RANKL/OPG ratios in untreated and treated periodontitis sites may be negatively influenced by poor glycemic control in subjects with type 2 diabetes. [ABSTRACT FROM AUTHOR]