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Omega-3 and probiotics were shown to improve periodontal health by modulating the host immune response. Recently, the combination of omega-3 and probiotics has been shown to have a potential synergistic effect on host modulation. The aim of this study was to evaluate the prophylactic role of an omega-3 and probiotic combination on alveolar bone loss (ABL) via inflammatory response in an experimental periodontitis model. Forty-three rats were divided into 5 groups as control (C, n = 8), periodontitis (P, n = 8), omega-3 + periodontitis (O, n = 8), probiotic + periodontitis (Pro, n = 10), and omega-3 + probiotic + periodontitis (OPro, n = 9). Additionally to a standardized diet, omega-3 and/or probiotics were supplemented with oral gavage to the O, Pro, and OPro groups for 44 days. Periodontitis was induced by ligature to the P, O, Pro, and OPro groups on the 30th day for 2 weeks. ABL levels were measured histopathologically, and serum interleukin (IL) 1 beta, IL6, and IL10 levels were analysed by enzyme-linked immunosorbent assay. ABL increased in all periodontitis groups (P, O, Pro, and OPro), compared to C group. Compared to P group, all oral gavage groups (O, Pro, and OPro) revealed decreased ABL, which was lowest in OPro group. IL1 beta and IL6 decreased and IL10 increased in OPro group, compared to P group. In conclusion, prophylactic administration of omega-3 and probiotic combination reduced ABL and improved serum IL1 beta, IL6, and IL10 levels more than their single use.

The aim of this study was to evaluate the levels of salivary and serum interleukin (IL)-1β, visfatin, and omentin-1 in the relationship between periodontal disease and overweight/obesity as well as to reveal the possible role of periodontal inflamed surface area (PISA) in this association.Ninety-six individuals (69 females, 27 males) were divided into 4 groups as systemically healthy (H) and non-periodontitis (HnP, n = 23), systemically healthy and periodontitis (HP, n = 24), overweight/obese (O) and non-periodontitis (OnP, n = 25), and overweight/obese and periodontitis (OP, n = 24). Periodontal parameters were measured, and PISA was calculated. IL-1β, visfatin, and omentin-1 levels in saliva and serum samples were analysed.Periodontal parameters deteriorated, salivary and serum IL-1β and visfatin levels were increased, and omentin-1 levels were decreased in OnP and OP groups, compared to HnP and HP groups. Salivary and serum IL-1β and visfatin levels were increased and omentin-1 levels were decreased in periodontitis groups, compared to HnP and OnP groups. PISA was negatively correlated with salivary omentin-1 and positively correlated with salivary and serum visfatin in H and O groups, whereas a positive relationship was found between PISA and salivary and serum IL-1β in H group.PISA may be negatively associated with salivary omentin-1, while positively correlated with salivary and serum visfatin in overweight/obese patients.Co-evaluation of PISA and adipokines seems to be an innovative approach to evaluate the association between periodontitis and overweight/obesity.

Purpose An unresolved inflammatory state contributes to the pathogenesis of periodontal disease and metabolic syndrome (MetS). Therefore, the purpose of this study was to evaluate the role of lipoxin A4 (LXA4), a proresolving lipid mediator, in the association between periodontal disease and MetS. Methods Sixty-seven patients with MetS and 65 patients without MetS were included in the study. Sociodemographic information was obtained via a questionnaire, and detailed medical diagnoses were made. Periodontal parameters (plaque index [PI], gingival index [GI], probing pocket depth [PD], and clinical attachment level [CAL]) and metabolic parameters were measured, and serum LXA4 levels were determined. The associations among MetS, periodontal parameters, and serum LX levels were evaluated by adjusted multivariate linear regression analyses. Results Patients with MetS were older and had a higher body mass index than patients without MetS. Periodontal parameters (PI, GI, PD, and CAL) were higher in patients with MetS than in those without MetS. Serum LXA4 levels were higher in patients without MetS. Multivariate linear regression analysis indicated a positive association between MetS and periodontal parameters (PD and CAL). Negative associations were established between MetS and LXA4 levels, and between LXA4 and periodontal parameters (PI, PD, and CAL). Conclusions The presence of higher values of periodontal parameters in patients with MetS and the negative relationship of LXA4 with MetS and periodontal disease may support the protective role of proresolving lipid mediators in the association between periodontal disease and MetS., Graphical Abstract

Aim: Omega 3 and probiotics have been demonstrated to have beneficial effects in periodontal disease pathogenesis. Inducible nitric oxide synthase is an important mediator regulating immune response. The objective of this study was to compare the impacts of omega 3 and probiotic supplementation on alveolar bone loss and gingival inducible nitric oxide synthase levels in an experimental periodontitis model.Material and Methods: Thirty-two rats were separated into 4 equal groups as control, periodontitis, omega 3, and probiotic. Omega 3 or probiotic was supplemented by oral gavage and experimental periodontitis was induced to the rats in periodontitis, omega 3, and probiotic groups by ligature. Alveolar bone loss was measured histometrically. The number of neutrophils was counted and gingival inducible nitric oxide synthase levels were analysed immunohistochemically.Results: Alveolar bone loss significantly increased in periodontitis induced groups, compared to control group and decreased in omega 3 and probiotic groups, compared to the periodontitis group (p

Impairment of the lipid metabolism could affect the periodontal disease; increased oxidative stress may have a role in this relationship. The aim of the present study was to evaluate the role of menopause in the relationship between hyperlipidemia and periodontal disease via oxidative stress markers in saliva.Sixty-seven women were enrolled in the study and divided into four groups as systemically healthy and premenopause (C) (n = 18), hyperlipidemia and premenopause (H) (n = 16), systemically healthy and postmenopause (M) (n = 17), and hyperlipidemia and postmenopause (MH) (n = 16). Sociodemographics, periodontal and metabolic parameters, and saliva oxidative markers (myeloperoxidase [MPO] and 8-hydroxy-2'-deoxyguanosine [8-OHdG]) were evaluated.Menopause and/or hyperlipidemia were associated with an increase in all evaluated periodontal parameters. Saliva 8-OHdG and MPO levels were higher in menopausal groups (M and MH). Multivariate linear regression analyses revealed that hyperlipidemia was related to an increase in periodontal parameters. Salivary oxidative stress markers and periodontal parameters were also positively associated with menopause and hyperlipidemia.Saliva 8-OHdG and MPO levels may indicate that the relationship between periodontal disease and hyperlipidemia is aggravated by menopause.

Background Periodontal disease is shown to be aggravated by an increase in the count of metabolic risk factors. This study aims to evaluate the effects of metabolic risk factors on periodontal parameters and salivary oxidative stress markers related to menopausal status. Methods One hundred and seventy-six women were categorized according to menopausal status, either premenopause (Pre/M) (n = 86) or postmenopause (Post/M) (n = 90). The count of metabolic risk factors was evaluated. Sociodemographics and systemic status were determined via questionnaire and medical records. After clinical periodontal measurements and saliva collection, myeloperoxidase (MPO), total oxidant status (TOS) and total antioxidant capacity (TAOC) were determined by enzyme-linked immunosorbent assay and automatic colorimetric method. Oxidative stress index (OSI) was also calculated. Results The count of metabolic risk factors was higher in the Post/M group than the Pre/M group. Periodontal parameters and TOS levels were elevated by an increase in the count of metabolic risk factors. Multivariate regression analyses revealed that periodontal (clinical attachment level and missed teeth) and oxidative (MPO and OSI) parameters increased and TAOC levels decreased due to menopause. Additionally, positive relationships between periodontal and oxidative parameters were determined. Conclusion These findings suggest that salivary oxidative stress level may be an indicator of worsened periodontal status related to menopause and the count of metabolic risk factors.

Purpose The aim of this study was to evaluate the serum levels of oxidized low-density lipoprotein (oxLDL), anti-oxLDL, and myeloperoxidase (MPO) in hyperlipidemic patients with periodontal disease. Methods This study included 123 patients with hyperlipidemia categorized based on metabolic control as mild to moderate (H1) (n=66) or poor (H2) (n=57), as well as systemically healthy controls (C) (n=68). Serum levels of lipids, oxLDL, anti-oxLDL, and MPO were evaluated, along with clinical periodontal parameters. Results The percentage of bleeding on probing (BOP%) and the clinical attachment level were significantly higher in the H2 group than in the C group. Patients with hyperlipidemia had a relatively high risk of developing periodontal disease. The oxLDL and anti-oxLDL levels were higher in H2 patients with periodontitis than in the control or H1 patients with periodontitis. In the H1 and H2 groups, the ratio of total cholesterol to high-density lipoprotein was significantly correlated with gingival index, BOP%, and oxLDL levels. Conclusions Our findings indicate that the lipoprotein-associated inflammatory mediators of oxLDL, anti-oxLDL, and MPO may play an important role in the relationship between periodontal disease and hyperlipidemia., Graphical Abstract

OZET Sagligin devam ettirilebilmesi icin akut enflamatuvar yanitin tamamen cozulmesi ve vucudun homeostazise donmesi gerekmektedir. Enflamatuvar yanitta rol alan lokositlerin, ortamda olu hucre ve urunlerini birakmayacak sekilde kaldirilmasi ideal sonuc olmakla birlikte periodontal hastalikta ve bircok farkli sistemik hastalikta, benzer sekilde kontrol altina alinamayan ve cozulememis bir enflamatuvar durumun olustugu gorulmektedir. Bugune kadar calisilan antienflamatuvar ajanlardan steroidler, steroid olmayan antienflamatuvar ilaclar ve antihistaminikler, akut enflamatuvar yanitin baslamasinda rol alan anahtar proenflamatuvar medyator yollarini bloke ederler ve enflamasyonun kardinal bulgularinin kontrolunde rol almaktadirlar. Bu terapotik yaklasim, bircok enflamatuvar hastaligin tedavisinde temel konumda yer alsa da beraberinde olusan yan etkilerin de goz ardi edilmemesi gerektigi bir gercektir. Son yillarda, enflamasyonla iliskili molekuler temellerin ortaya konulmasiyla birlikte, enflamasyonun cozulmesinin aktif ve agonist iliskili bir surec oldugu ve doku homeostazisine donusun cok dikkatli bir sekilde duzenlendigi anlasilmistir. Enflamasyonun cozulmesinin yeni bir sinif olan ileri basamak cozucu lipid medyatorleri (IBCLM) tarafindan duzenlendiginin anlasilmasiyla birlikte, periodontal patolojinin onlenmesinde ve enflamatuvar lokositlerin eliminasyonunda, IBCLM molekullerinin potansiyel kullanimlarina olan ilginin arttigi gorulmektedir. Bu derlemede, IBCLM’lerin enflamatuvar surecte ve periodontal hastalik patogenezindeki onemi ortaya konulmaya calisilmistir. Anahtar sozcukler: Periodontal hastaliklar, inflamasyon, yag asidleri A NEW APPROACH IN PERIODONTAL TREATMENT: PRORESOLVING LIPID MEDIATORS ABSTRACT Complete resolution of acute inflammatory response and returning the body to homeostasis is crucial for on-going health. Although removing of leukocytes in inflammation area without leaving any dead cells or their products behind is an ideal result, it appears that uncontrolled and unresolved inflammatory condition occurs in periodontal disease and various systemic diseases similarly. Most of the antiinflammatory agents studied up to now such as steroids, non-steroid antiinflammatory drugs and antihistamines bloke key proinflammatory mediator ways in the initiation of acute inflammatory response or take part in the control of the cardinal symptoms. Despite this therapeutic approach is a basic principle for the treatment of many inflammatory diseases, it’s clear that adverse effects should not be ignored. Recently, after the determination of the inflammatory basics, we understood that inflammatory resolution is an active and agonist related process and returning to the tissue homeostasis is arranged very carefully. Together with the understanding of the inflammatory resolution is arranged by new classification of proresolving lipid mediators (PRLMs), the interest on these molecules related to the prevention of periodontal pathology and elimination of inflammatory leukocytes have increased. In this review, we aimed to put forward the importance of the PRLMs on the inflammatory process and periodontal pathogenesis. Keywords: Periodontal diseases, inflammation, fatty acids