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The aim of this analysis was to assess how different tooth-prognosis systems could predict tooth loss in a cohort of periodontitis patients followed up prospectively during supportive periodontal care (SPC).Clinical and radiographic data of 97 patients undergoing regular SPC for 5 years were used to assign tooth prognosis using four different systems (McGuireNunn, 1996; KwokCaton, 2007; Graetz et al., 2011; Nibali et al., 2017). Three independent examiners assigned tooth prognosis using all four systems, following a calibration exercise. The association between prognostic categories and tooth loss was tested for each prognostic system separately and across prognostic systems.All four systems showed good reproducibility and could identify teeth at higher risk of being lost during 5 years of SPC; the risk of tooth loss increased with the worsening of tooth-prognosis category (p .0001). Although specificity and negative predictive values were good, low sensitivity and positive predictive values were detected for all systems.Previously published periodontal prognostic systems exhibited good reproducibility and predictive ability for tooth retention. However, low sensitivity was detected, with several teeth in the worst prognosis category being retained at 5 years. Some modifications in the number of categories and their definitions are suggested.

The objective of this systematic review and meta-analysis was to evaluate the effect of periodontal surgery on the subgingival microbiome.Periodontitis is a chronic inflammation of the tooth supporting tissues caused by the dysbiosis of the subgingival biofilm. It is managed through different non-surgical and surgical treatment modalities. Recent EFP S3 guidelines recommended performing periodontal surgery as part of Step 3 periodontitis treatment after Step 1 and Step 2 periodontal therapy, with the aim to achieve pocket closure of persisting sites. Changes in the sub-gingival microbiome may explain the treatment outcomes observed at different time points. Various microbiological detection techniques for disease-associated pathogens have been evolved over time and have been described in the literature. However, the impact of different types of periodontal surgery on the subgingival microbiome remains unclear.A systematic literature search was conducted in Medline, Embase, LILACS and Cochrane Library supplemented by manual search (23DEC2019, updated 21APR2022).From an initial search of 3046 studies, 28 were included according to our specific inclusion criteria. Seven microbiological detection techniques were used to analyse disease-associated species in subgingival plaque samples: optical microscope, culture, polymerase chain reaction (PCR), checkerboard, enzymatic reactions, immunofluorescence and 16S gene sequencing. The included studies exhibited differences in various aspects of their methodologies such as subgingival plaque sample collection or treatment modalities. Clinical data showed a significant decrease in probing pocket depths (PPD) and clinical attachment loss (CAL) after periodontal surgery. Microbiological findings were overall heterogeneous. Meta-analysis was performed on a sub-cohort of studies all using checkerboard as a microbiological detection technique. Random effect models for Treponema denticola (T. denticola), Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia (T. forsythia) did not show a significant effect on mean counts 3 months after periodontal surgery. Notably, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) showed a significant increase 3 months after periodontal surgery. 16S gene sequencing was used in one included study and reported a decrease in disease-associated species with an increase in health-associated species after periodontal surgery at 3 and 6 months.This systematic review has shown that the effect of periodontal surgery on the changes in subgingival microbiome is heterogeneous and may not always be associated with a decrease in disease-associated species. The variability could be attributed to the microbiological techniques employed for the analysis. Therefore, there is a need for well-designed and adequately powered studies to understand how periodontal surgery influences the subgingival microbiome and how the individual's microbiome affects treatment outcomes after periodontal surgery.

AIMS The primary aim of this investigation was to analyse the periodontal microbiome in patients with aggressive periodontitis (AgP) following treatment. METHODS Sixty-six AgP patients were recalled on average 7 years after completion of active periodontal treatment and had subgingival plaque samples collected and processed for 16S rRNA gene sequencing analyses. RESULTS Of 66 participants, 52 showed persistent periodontal disease, while 13 participants were considered as "successfully treated AgP" (no probing pocket depths >4 mm) and 1 was fully edentulous. Genera associated with persistent generalized disease included Actinomyces, Alloprevotella, Capnocytophaga, Filifactor, Fretibacterium, Fusobacterium, Leptotrichia, Mogibacterium, Saccharibacteria [G-1], Selenomonas and Treponema. "Successfully treated" patients harboured higher proportions of Haemophilus, Rothia, and Lautropia and of Corynebacterium, Streptococcus and Peptidiphaga genera. Overall, patients with persistent generalized AgP (GAgP) revealed higher alpha diversity compared to persistent localized AgP (LAgP) and stable patients (p

Background and Objective: Evidence suggests that periodontitis has a negative effect on the quality of life of an individual, with increased impacts by greater disease severity. The aim of this study was to assess the association between quality of life and the presence of different severity and forms of periodontitis (aggressive and chronic), compared to a disease-free control group. Materials and Methods: Four hundred and seventy one study participants were classified according to periodontal diagnosis using the 1999 Consensus Classification into chronic periodontitis (CP), aggressive periodontitis (AgP) and periodontally healthy. Oral health-related quality of life was assessed using the OHIP-14 questionnaire. Outcomes consisted of the prevalence of oral impacts reported occasionally, fairly often or very often (OFOVO) as well as fairly often or very often (FOVO), OHIP-14 total and domain scores. Logistic and linear regression analyses were carried out to test associations between periodontal diagnosis and quality of life outcomes, adjusted for smoking, age, ethnicity and body mass index. Results: Over 90% of periodontitis patients reported at least one oral impact experienced occasionally, fairly often or very often (OFOVO) compared with 53.8% of periodontally healthy controls (P

Background Periodontal intrabony defects are usually treated surgically with the aim of increasing attachment and bone levels and reducing risk of progression. However, recent studies have suggested that a minimally invasive non-surgical therapy (MINST) leads to considerable clinical and radiographic defect depth reductions in intrabony defects. The aim of this study is to compare the efficacy of a modified MINST approach with a surgical approach (modified minimally invasive surgical therapy, M-MIST) for the treatment of intrabony defects. Methods This is a parallel-group, single-centre, examiner-blind non-inferiority randomised controlled trial with a sample size of 66 patients. Inclusion criteria are age 25–70, diagnosis of periodontitis stage III or IV (grades A to C), presence of ≥ 1 ‘intrabony defect’ with probing pocket depth (PPD) > 5 mm and intrabony defect depth ≥ 3 mm. Smokers and patients who received previous periodontal treatment to the study site within the last 12 months will be excluded. Patients will be randomly assigned to either the modified MINST or the M-MIST protocol and will be assessed up to 15 months following initial therapy. The primary outcome of the study is radiographic intrabony defect depth change at 15 months follow-up. Secondary outcomes are PPD and clinical attachment level change, inflammatory markers and growth factors in gingival crevicular fluid, bacterial detection, gingival inflammation and healing (as measured by geometric thermal camera imaging in a subset of 10 test and 10 control patients) and patient-reported outcomes. Discussion This study will produce evidence about the clinical efficacy and potential applicability of a modified MINST protocol for the treatment of periodontal intrabony defects, as a less invasive alternative to the use of surgical procedures. Trial registration ClinicalTrials.gov, NCT03797807. Registered on 9 January 2019.

Aim This review critically appraises the available knowledge on the pre-clinical and clinical use of bioactive factors for bone regeneration in the cranial and maxillofacial area. Materials and methods The use of growth factors, amelogenins and autologous platelet concentrates (APCs) for bone regeneration was reviewed in a systematic manner. More specifically, pre-clinical and clinical studies on ridge preservation, alveolar ridge augmentation, regeneration of peri-implant defects and sinus augmentation models were considered. Results Amongst different bioactive factors, the highest pre-clinical and clinical evidence of a positive effect on bone formation is associated with rhBMP-2 and the lowest with amelogenins. While APCs seem to accelerate clinical healing and reduce postoperative discomfort, there is insufficient and contrasting evidence of a significant effect on hard tissue regeneration for the different clinical applications. Conclusions Although there is increasing evidence that bioactive factors might enhance the bone regeneration process, the great heterogeneity of the available studies and the limited number of RCTs do not allow to draw robust conclusions. Issues that still need to be investigated include the optimal carriers for bioactive agents (direct vs. indirect), the dosage, the timing of administration, as well as the possibility of combining different agents to promote synergistic effects.

ObjectivesTo adapt the supranational European Federation for Periodontology (EFP) S3-Level Clinical Practice Guideline for treatment of periodontitis (stage I-III) to a UK healthcare environment, taking into account the views of a broad range of stakeholders, and patients.SourcesThis UK version is based on the supranational EFP guideline (Sanz et al., 2020) published in the Journal of Clinical Periodontology. The source guideline was developed using the S3-level methodology, which combined the assessment of formal evidence from 15 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 62 clinical recommendations for the treatment of stage I–III periodontitis, based on a step-wise process mapped to the 2017 classification system.MethodologyThe UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for the adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework and following the S3-process, the underlying systematic reviews were updated and a representative guideline group of 75 delegates from 17 stakeholder organisations was assembled into three working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly.Results and conclusionUsing the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the dental community in the UK.Clinical significanceThe aim of S3-level guidelines is to combine the evaluation of formal evidence, grading and synthesis with the clinical expertise of a broad range of stakeholders to form clinical recommendations. Herein, the first major international S3-level guideline in dentistry, the EFP guideline, was implemented for direct clinical applicability in the UK healthcare system.

Objectives This publication reports on the EAO workshop group 1 summaries, discussions and consensus statements based on four systematic reviews evaluating the impact of timing of dental implant placement and loading. Materials and methods The first of the systematic reviews was on the influence of the timing of implant placement and loading in the biological outcomes of implant-supported fixed partial dentures. The second systematic review evaluated the influence of the timing of implant placement and loading on the aesthetic outcomes in single-tooth implants. The third systematic review was on the long-term outcomes of maxillary single-tooth implants in relation to timing protocols of implant placement and loading and the fourth on patient's perception of timing concepts in implant dentistry. The group evaluated these systematic reviews, provided comments and additions as required and agreed on the relevant consensus statements as well as on clinical and research recommendations. Results Different timings of implant placement/loading presented with high implant survival rates. The systematic reviews evaluated from this working group provided a number of conclusions based on the available/current literature. However, the specific topic of timing is an area that further research is required in order to provide detailed guidelines for the different protocols to be employed.

BACKGROUND Peri-implantitis is a challenging condition to manage and is frequently treated using non-surgical debridement. The local delivery of antimicrobial agents has demonstrated benefit in mild to moderate cases of peri-implantitis. This study compared the safety and efficacy of chlorhexidine gluconate 2.5 mg chip (CHX chips) as an adjunctive treatment to subgingival debridement in patients afflicted with peri-implantitis. METHODS A multicenter, randomized, single-blind, two-arm, parallel Phase-3 study was conducted. Peri-implantitis patients with implant pocket depths (IPD) of 5-8 mm underwent subgingival implant surface debridement followed by repeated bi-weekly supragingival plaque removal and chlorhexidine chips application (ChxC group) for 12 weeks, or similar therapy but without application of ChxC (control group). All patients were followed for 24 weeks. Plaque and gingival indices were measured at every visit whereas IPD, recession, and bleeding on probing were assessed at 8, 12, 16, 24 week. RESULTS A total of 290 patients were included: 146 in the ChxC group and 144 in the control. At 24 weeks, a significant reduction in IPD (P = 0.01) was measured in the ChxC group (1.76 ± 1.13 mm) compared with the control group (1.54 ± 1.13 mm). IPD reduction of ≥2 mm was found in 59% and 47.2% of the implants in the ChxC and control groups, respectively (P = 0.03). Changes in gingival recession (0.29 ± 0.68 mm versus 0.15 ± 0.55 mm, P = 0.015) and relative attachment gain (1.47 ± 1.32 mm and 1.39 ± 1.27 mm, P = 0.0017) were significantly larger in the ChxC group. Patients in the ChxC group that were

Background and Aims To review the regenerative technologies used in bone regeneration: bone grafts, barrier membranes, bioactive factors and cell therapies. Material and Methods Four background review publications served to elaborate this consensus report. Results and Conclusions Biomaterials used as bone grafts must meet specific requirements: biocompatibility, porosity, osteoconductivity, osteoinductivity, surface properties, biodegradability, mechanical properties, angiogenicity, handling and manufacturing processes. Currently used biomaterials have demonstrated advantages and limitations based on the fulfilment of these requirements. Similarly, membranes for guided bone regeneration (GBR ) must fulfil specific properties and potential biological mechanisms to improve their clinical applicability. Pre‐clinical and clinical studies have evaluated the added effect of bone morphogenetic proteins (mainly BMP ‐2) and autologous platelet concentrates (APC s) when used as bioactive agents to enhance bone regeneration. Three main approaches using cell therapies to enhance bone regeneration have been evaluated: (a) “minimally manipulated” whole tissue fractions; (b) ex vivo expanded “uncommitted” stem/progenitor cells; and (c) ex vivo expanded “committed” bone‐/periosteum‐derived cells. Based on the evidence from clinical trials, transplantation of cells, most commonly whole bone marrow aspirates (BMA ) or bone marrow aspirate concentrations (BMAC ), in combination with biomaterial scaffolds has demonstrated an additional effect in sinus augmentation and horizontal ridge augmentation, and comparable bone regeneration to autogenous bone in alveolar cleft repair.

OBJECTIVES: The task of this working group was to update the knowledge about the use of drugs and biologicals affecting healing of soft tissue and bone during implant treatment or procedures associated with it. Moreover, the impact of titanium particles and biocorrosion on complications and implant survival has been analysed. MATERIALS AND METHODS: The literature in the areas of interest (platelet concentrates, antiresorptive drugs as well as implant-host interaction) was screened using systematic reviews for the former two areas, whereas a narrative critical review was performed for the latter topic. Two manuscripts on platelet concentrates, one manuscript on antiresorptive drugs and one manuscript on the effects of biocorrosion, were presented for group analysis with subsequent discussion in the plenum and final consensus approval. RESULTS: Results and conclusions of the individual reviews of the three topics are presented in the respective papers. Conclusions of the group on strengths and weaknesses of available evidence as well as consensus statements and directions for further research are provided in this study. The following papers were subject to group discussions and formed the basis for the consensus statements: Stähli A, Strauss FJ, Gruber R. () The use of platelet-rich-plasma to enhance the outcomes of implant-related therapies: a systematic review Strauss FJ, Stähli A, Gruber R. (2018) The use of platelet-rich-fibrin to enhance the outcomes of implant-related therapies: a systematic review Mombelli A, Hashim D, Cionca N. () What is the impact of titanium particles and bio-corrosion on implant survival and complications? A critical review Stavropoulos A, Bertl K, Pietschmann P, Pandis N, Morten Schiødt, Klinge B. () The effect of antiresorptive drugs on implant therapy: a systematic review. ispartof: CLINICAL ORAL IMPLANTS RESEARCH vol:29 pages:93-99 ispartof: location:SWITZERLAND, Pfaffikon status: published

Heat-shock protein (Hsp) 27 is a major intracellular molecular chaperone and controller of intracellular responses to inflammatory signals. In the extracellular space, recombinant Hsp27 has been described to exert anti-inflammatory activities. The aim of this study was to assess the association between circulating levels of Hsp27 and different types of periodontitis. Pro- and anti-inflammatory cytokines and the stress proteins Hsp27 and Hsp60 with proposed anti- and pro-inflammatory properties, respectively, were measured by two-site ELISA in the serum of patients with aggressive periodontitis (AgP, n = 30), chronic periodontitis (CP, n = 29) and periodontally healthy controls (H, n = 28). Furthermore, Hsp27 and Hsp60 levels were also measured longitudinally in 12 AgP patients at 6 time points up to 3 months after treatment. AgP patients had lower levels of Hsp27 compared to CP patients and healthy subjects (adjusted one-way ANOVA, p

BACKGROUND: While leukocytosis is a common feature of severe periodontitis, a smaller amount of evidence has been produced on erythrocytes counts in periodontitis, suggesting a possible tendency to anemia. The aim of this study was to investigate the associations between periodontitis and circulating leukocytes, erythrocytes, and platelets. METHODS: The study included 471 patients with periodontitis (including aggressive periodontitis [AgP], and chronic periodontitis [CP]) and periodontal health. A separate sample of 333 patients from a previous study (127 AgP and 206 periodontally healthy) was used as replication. Periodontal clinical data were collected and a blood sample was obtained from each participant for hematological analysis of leukocytes, erythrocytes and platelets. RESULTS: Adjusted linear regression analyses revealed associations between periodontitis and total leukocytes counts (p < 0.001), neutrophil counts (P CONCLUSION: This paper, reporting results of periodontal examination and blood sampling in over 800 patients, suggest that not just leukocytosis but also tendency to "anemia of inflammation" are typical features of periodontitis.

The study aim was to investigate the predictive role of obesity on clinical response following non-surgical periodontal therapy in individuals with severe periodontitis.A total of 57 BMI obese and 58 BMI normal non-smoker adults with periodontitis (defined as probing pocket depths (PPD) of ≥5 mm and alveolar bone loss of30% with50% of the teeth affected) received non-surgical periodontal therapy. Periodontal status was based upon PPD, clinical attachment level (CAL) and full-mouth bleeding score (FMBS). Mean PPD, percentage sites PPD4 mm, percentage sites PPD5 mm and FMBS at 2 and 6 months were outcome variables. Propensity score analysis was used to assess the effect of obesity on outcome variables after adjusting for confounders.Statistically significant higher clinical measures (mean PPD, mean percentage of sites with PPD4 mm, mean percentage of sites with PPD5 mm and FMBS) were observed in the obese group than the normal group at baseline, 2 and 6 months after therapy (p .01). At 2 and 6 months, obesity was associated with worse mean PPD (p .05), percentage sites with PPD4 mm (p .05), percentage sites with PPD 5mm (p .05) and FMBS (p .01), independent of age, gender, ethnicity or plaque levels.Obesity compared to normal BMI status was an independent predictor of poorer response following non-surgical periodontal therapy.

Background: Periodontal intrabony defects are usually treated surgically with the aim to increase attachment and bone levels and reduce risk of progression. However, recent studies have suggested that a minimally-invasive non-surgical therapy (MINST) leads to considerable clinical and radiographic defect depth reductions in intrabony defects. The aim of this study is to compare the efficacy of a modified MINST approach with a surgical approach (modified minimally-invasive surgical therapy, M-MIST) for the treatment of intrabony defects. Methods: This is a parallel-group single-centre examiner-blind non-inferiority randomised controlled trial with a sample size of 66 patients. Inclusion criteria are age 25-70, diagnosis of periodontitis stage III or IV (grades A to C), presence of ≥1 ‘intrabony defect’ with probing pocket depth (PPD) >5 mm and intrabony defect depth ≥3mm. Smokers and patients who received previous periodontal treatment to the study site within the last 12 months will be excluded. Patients will be randomly assigned to either the modified MINST or the M-MIST protocol and will be assessed up to 15 months following initial therapy. The primary outcome of the study is radiographic intrabony defect depth change at 15 months follow-up. Secondary outcomes are PPD and clinical attachment loss (CAL) change, inflammatory markers and growth factors in gingival crevicular fluid, bacterial detection, gingival inflammation and healing (as measured by geometric/thermal camera imaging in a subset of 10 test and 10 control patients) and patient-reported outcomes. Discussion: This study will produce evidence about the clinical efficacy and potential applicability of a modified MINST protocol for the treatment of periodontal intrabony defects, as a less invasive alternative to the use of surgical procedures. Trial registration: This study was registered on clinicaltrials.gov NCT03797807 (date registered: 9 January 2019). Keywords: Periodontitis, intrabony defect, minimally-invasive, quality of life, bone

Aim To analyse, using a meta-analytical approach, the diagnostic accuracy of single molecular biomarkers in saliva for the detection of periodontitis in systemically healthy subjects. Materials and methods Articles on molecular biomarkers in saliva providing a binary contingency table (or sensitivity and specificity values and group sample sizes) in individuals with clinically diagnosed periodontitis were considered eligible. Searches for candidate articles were conducted in six electronic databases. The methodological quality was assessed through the tool Quality Assessment of Diagnostic Studies. Meta-analyses were performed using the Hierarchical Summary Receiver Operating Characteristic model. Results Meta-analysis was possible for 5 of the 32 biomarkers studied. The highest values of sensitivity for the diagnosis of periodontitis were obtained for IL1beta (78.7%), followed by MMP8 (72.5%), IL6 and haemoglobin (72.0% for both molecules); the lowest sensitivity value was for MMP9 (70.3%). In terms of specificity estimates, MMP9 had the best result (81.5%), followed by IL1beta (78.0%) and haemoglobin (75.2%); MMP8 had the lowest specificity (70.5%). Conclusions MMP8, MMP9, IL1beta, IL6 and Hb were salivary biomarkers with good capability to detect periodontitis in systemically healthy subjects. MMP8 and IL1beta are the most researched biomarkers in the field, both showing clinically fair effectiveness for the diagnosis of periodontitis.

A bstract Background Only a handful of studies have assessed tooth loss risk in chronic periodontitis patients following active therapy and factors associated with it. Aims The aim of this retrospective study was to assess tooth loss in a cohort of chronic periodontitis patients undergoing maintenance care in a UK private practice setting. Materials and Methods One hundred chronic periodontitis patients treated with active periodontal therapy (APT) were followed up in supportive periodontal therapy (SPT) for at least 5 years. Tooth loss rates and the effect of patient- and tooth-factors on tooth loss were assessed. Existing patient-based prognosis systems and a novel tooth-based prognosis system were tested for their association with tooth loss. Results Excluding third molars, 34 teeth were extracted during SPT, with an overall average tooth loss of 0.06 teeth/patient/year (0.02 for periodontal reasons). Multivariable analysis showed that age, patient-prognosis based on the PRA system, tooth prognosis, furcation involvement and previous endodontic therapy were significantly associated with tooth loss during SPT. Conclusion Good overall stability and a small tooth loss rate were observed in this cohort of chronic periodontitis cases under SPT in private practice. Patient-based and tooth-based prognosis systems may be used to estimate the risk of tooth loss. This article is protected by copyright. All rights reserved.

BACKGROUND It is unclear whether patients with specific subgingival microbiological profiles benefit more from adjunctive systemic antibiotics. AIMS To answer the question: "What is the clinical benefit in periodontitis patients taking adjunctive systemic antimicrobials to non-surgical therapy, depending on pre-treatment detection of periodontopathogenic bacteria?" MATERIALS AND METHODS A search was conducted in four electronic databases for randomized controlled trials reporting clinical outcomes following adjunctive antibiotic therapy for patients divided by baseline microbiological profiles. RESULTS The initial search resulted in 643 papers, reduced to five after screening and author contact. Four of these studies were suitable for a fixed effects two-stage individual participant data meta-analysis adjusted for baseline data. Collectively, adjunctive amoxicillin and metronidazole yielded superior clinical results (measured as reduction of PPDs) compared to placebo. No significant differences were detected for the effect of adjunctive antibiotics by the detection of Aggregatibacter actinomycetemcomitans on PPDs ≥ 5 mm (WMD = 1.16, 95% CI [-5.37, 7.68], I2 = 37.8%) or other clinical outcomes. All included studies had low risk of bias. CONCLUSION There is no evidence to suggest that baseline detection of periodontopathogenic bacteria should be used as criterion for prescribing adjunctive antibiotics, although only limited information on microbial data and specific antimicrobials was available for analysis.

Svrha: Defensini su kationski antimikrobni peptidi koji se pojavljuju u epitelnim stanicama. Imaju antimikrobna, antifungalna i antivirusna svojstva te su prirođena komponenta imunosnog odgovora. Jedna od hipoteza jest da peptidi štite usnu šupljinu. U ovom istraživanju procijenili smo polimorfizam gena DEFB1 kod dijabetičara s parodontitisom ili bez njega i rezultate usporedili sa zdravom kontrolnom skupinom. Materijali i metode: Koristili smo se testom Hairpin-Shaped Primer (HP) kako bismo istražili rasprostranjenost - 44 C/G SNP-a (rsl1800972) u 119 uzoraka ljudske DNK dobivene od dijabetičara i zdravih pacijenata. Rezultati: Rezultati su pokazali da između grupa nema razlika u rasprostranjenosti, te da je kod dijabetičara s parodontitisom češći homozigotni mutant. Zaključak: Potrebna su daljnja istraživanja kako bi se otkrila uloga polimorfizma DEFB1 kod dijabetičara s parodontitisom te utjecaj peptida na parodontne patogene., Aim: Defensins are cationic antimicrobial peptides expressed in epithelial cells. Such peptides exhibit antibacterial, antifungal and antiviral properties, and are a component of the innate immune response. It has been suggested that they have a protective role in the oral cavity. This study evaluated the DEFB1 polymorphism in diabetic patients with or without periodontitis in comparison to healthy controls. Material and Methods: We used Hairpin-Shaped Primer (HP) assay to study the distribution of the -44 C/G SNP (rs1800972) in 119 human DNAs obtained from diabetic patients and healthy control patients. Results: The results indicate that there are no differences in distribution between groups and that in diabetic periodontitis patients the homozygous mutant could be found more frequently. Conclusion: Further studies are necessary in order to investigate the role of DEFB1 polymorphisms in diabetic periodontitis patients and the influence of the peptide in periodontal pathogens.

Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis.AimThe aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches.MethodsTwo meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus.ResultsData support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2 min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2 min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group.

Summary Background Chronic inflammation is believed to be a major mechanism underlying the pathophysiology of type 2 diabetes. Periodontitis is a cause of systemic inflammation. We aimed to assess the effects of periodontal treatment on glycaemic control in people with type 2 diabetes. Methods In this 12 month, single-centre, parallel-group, investigator-masked, randomised trial, we recruited patients with type 2 diabetes, moderate-to-severe periodontitis, and at least 15 teeth from four local hospitals and 15 medical or dental practices in the UK. We randomly assigned patients (1:1) using a computer-generated table to receive intensive periodontal treatment (IPT; whole mouth subgingival scaling, surgical periodontal therapy [if the participants showed good oral hygiene practice; otherwise dental cleaning again], and supportive periodontal therapy every 3 months until completion of the study) or control periodontal treatment (CPT; supra-gingival scaling and polishing at the same timepoints as in the IPT group). Treatment allocation included a process of minimisation in terms of diabetes onset, smoking status, sex, and periodontitis severity. Allocation to treatment was concealed in an opaque envelope and revealed to the clinician on the day of first treatment. With the exception of dental staff who performed the treatment and clinical examinations, all study investigators were masked to group allocation. The primary outcome was between-group difference in HbA 1c at 12 months in the intention-to-treat population. This study is registered with the ISRCTN registry, number ISRCTN83229304. Findings Between Oct 1, 2008, and Oct 31, 2012, we randomly assigned 264 patients to IPT (n=133) or CPT (n=131), all of whom were included in the intention-to-treat population. At baseline, mean HbA 1c was 8·1% (SD 1·7) in both groups. After 12 months, unadjusted mean HbA 1c was 8·3% (SE 0·2) in the CPT group and 7·8% (0·2) in the IPT group; with adjustment for baseline HbA 1c , age, sex, ethnicity, smoking status, duration of diabetes, and BMI, HbA 1c was 0·6% (95% CI 0·3–0·9; p Interpretation Compared with CPT, IPT reduced HbA 1c in patients with type 2 diabetes and moderate-to-severe periodontitis after 12 months. These results suggest that routine oral health assessment and treatment of periodontitis could be important for effective management of type 2 diabetes. Funding Diabetes UK and UK National Institute for Health Research.

OBJECTIVES: Working Group 5 was assigned the task to review the current knowledge in the area of digital technologies. Focused questions on accuracy of linear measurements when using CBCT, digital vs. conventional implant planning, using digital vs. conventional impressions and assessing the accuracy of static computer-aided implant surgery (s-CAIS) and patient-related outcome measurements when using s-CAIS were addressed. MATERIALS AND METHODS: The literature was systematically searched, and in total, 232 articles were selected and critically reviewed following PRISMA guidelines. Four systematic reviews were produced in the four subject areas and amply discussed in the group. After emendation, they were presented to the plenary where after further modification, they were accepted. RESULTS: Static computer-aided surgery (s-CAIS), in terms of pain & discomfort, economics and intraoperative complications, is beneficial compared with conventional implant surgery. When using s-CAIS in partially edentulous cases, a higher level of accuracy can be achieved when compared to fully edentulous cases. When using an intraoral scanner in edentulous cases, the results are dependent on the protocol that has been followed. The accuracy of measurements on CBCT scans is software dependent. CONCLUSIONS: Because the precision intraoral scans and of measurements on CBCT scans and is not high enough to allow for the required accuracy, s-CAIS should be considered as an additional tool for comprehensive diagnosis, treatment planning, and surgical procedures. Flapless s-CAIS can lead to implant placement outside of the zone of keratinized mucosa and thus must be executed with utmost care. ispartof: CLINICAL ORAL IMPLANTS RESEARCH vol:29 pages:436-442 ispartof: location:Denmark status: published

The presence of periodontal disease (PD) in subjects affected by the metabolic syndrome (MetS) may affect their risk of developing cardiovascular disease. The aim of this cross-sectional study was to investigate the systemic impact of PD in MetS, by assessing measures of sub-clinical atherosclerosis and left ventricular mass and geometry. A total of 103 patients undergoing treatment for MetS were examined for confirmation of diagnosis, blood sampling, and measures of pulse wave velocity (PWV), carotid intima-media thickness (c-IMT), left ventricular mass index (LVM), and relative wall thickness (RWT). All subjects underwent a detailed dental assessment, including measurements of DMFT (decayed-missing-filled teeth) and periodontal parameters. Ten patients (10%) were diagnosed with healthy-mild periodontitis, 38 patients (37%) were diagnosed in the moderate periodontitis group, and 55 (53%) had severe periodontitis. A total of 37% of subjects were affected by dental caries. Linear regression analysis revealed that patients with severe PD had increased average ventricular RWT (adjusted p = 0.032). Average full mouth probing pocket depth (PPD) was also associated with RWT (adjusted p = 0.006). No associations between PD and c-IMT, PWV, and LVM were detected after adjusted analyses. This study suggests that periodontitis may be associated with concentric left ventricular remodeling, a predictive index of cardiovascular events. The presence of periodontitis in patients with MetS might have an effect on left ventricular geometry. These findings stress the importance of prevention, diagnosis, and management of periodontitis in patients with MetS. NCT03297749

Background Periodontal involvement of the furcation area (furcation involvement, FI) has been reported to confer molars a higher risk of tooth loss. Aims The aim of this retrospective analysis was to assess the effect of FI on disease progression and tooth loss in molars of patients with chronic periodontitis undergoing supportive periodontal therapy (SPT) in a UK private practice setting. Materials and methods Six-hundred and thirty-three molars were analysed in 100 chronic periodontitis patients treated with active periodontal therapy (APT) and followed up in SPT for at least 5 years. Molars were treated with a combination of resective, regenerative or conservative approaches, according to the different clinical needs. Results Twenty-three molars were extracted during APT and a further 23 were lost during SPT. Multivariable analysis showed that both horizontal FI and vertical furcation component were associated with increased risk of tooth loss during SPT (OR 5.26, 95% CI: 1.46-19.03, p = .012 and OR 9.83, 95% CI: 1.83-50.11, p = .006, respectively). Conclusion Attention should be placed on both horizontal and vertical FI in molars, owing to their association with tooth loss during SPT.

Background: Diagnosis of periodontal disease for epidemiologic survey is difficult due to complexity of periodontal exam. The aim of this study was to compare data from a full-mouth examination and a partial-mouth examination, observing the agreement between both methods of presenting the Community Periodontal Index (CPI). Methods and Findings: The population comprised of male and female subjects, aged 18 years and over, attending public health centers in the city of Recife, Brazil. A total of 505 patients participated in this study. Each participant completed a form and underwent periodontal examination. Firstly, for each tooth present one of the periodontal conditions was determined: periodontal health, gingival bleeding, dental calculus, shallow periodontal pockets and deep periodontal pockets, according to CPI. Finally, partial data (10 index teeth) was recorded derived from the total version of CPI. Bivariate analysis of frequencies and means was performed. Mc Nemar test was used to calculate the level of statistical significance of the association tested. There are significant statistical differences between partial and full-mouth examination (p

Major advances in the knowledge about the aetiopathogenesis of aggressive periodontitis (AgP) have been achieved. An ever increasing number of scientific articles related to AgP are published every year contributing significantly to the knowledge of this unique and complex disease. AgP has been classified into localised and generalised forms based on their extent and disease progression with distinct clinical and radiological features. A classification of AgP based on severity (mild, moderate and severe) exists; however, it is not easily applicable. Therefore, studies on AgP do not categorise the disease based on severity. A disease staging index for AgP is proposed based on clinical and radiological features, as well as risk factors. Based on the presence or absence of risk factors confirmed by longitudinal studies, cases of AgP can be divided into low risk, medium risk and high risk profiles for disease progression. Clinicians can devise a broad treatment plan for their AgP cases based on this staging. More frequent recall intervals are proposed for patients at medium and high risk for disease progression. Ten cases of AgP with 10-year follow-up were used to validate the staging index by retrospectively assigning prognosis and associating it with tooth loss. The use of this staging by researchers would increase external validity of research on AgP. Long-term analysis of AgP cases are needed to validate this staging index longitudinally.

The literature surrounding necrotising ulcerative gingivitis (NUG) is extensive, yet the rare nature of this disease means that there is a lack of good quality research available. This paper aims to scrutinise the literature and provide an up-to-date summary of the available information.A literature search was performed electronically using the Cochrane Library, Ovid Medline, Embase, PubMed Clinical Queries and Google Scholar. Keyword searches were carried out, utilising MeSH terms and free text. English language articles primarily were included, with key foreign language (French and German) articles included where possible from the 1900s to the present day.Necrotising ulcerative gingivitis is a rare disease (prevalence1%), with an acute, painful and destructive presentation. It is an opportunistic bacterial infection which is predominantly associated with spirochetes. Treatment of NUG must be provided on a case-by-case basis, tailored to what the individual can tolerate and the extent of the infection.Although there is low prevalence of NUG, its importance should not be underestimated as one of the most severe responses to the oral biofilm. Risk factors must be investigated and addressed. Treatment should consist of gentle superficial debridement, oral hygiene instruction and prescription of mouthwash and antibiotics in severe cases.

Aim We aimed to assess the association between furcation involvement (FI) and tooth loss for subjects not undergoing regular periodontal treatment. Materials and Methods Data from 2333 subjects participating in the baseline and 11-year follow-up of the Study of Health in Pomerania (SHIP) were used. All subjects had half-mouth periodontal examinations, including FI in one upper and one lower molar, at baseline. A total of 1897 subjects and 3267 molars were included in the final analysis. Results In total, 375 subjects (19.8%) lost molars during the follow-up period. Respectively, 5.6%, 12.7%, 34.0% and 55.6% of molars without FI, degree I FI, degree II FI and degree III FI were lost. Initial probing pocket depth (PPD) and clinical attachment level (CAL) were associated with molar loss (p

While the research base is limited, studies have consistently reported poor oral health in elite athletes since the first report from the 1968 Olympic Games. The finding is consistent both across selected samples attending dental clinics at major competitions and more representative sampling of teams and has led to calls from the International Olympic Committee for more accurate data on oral health. Poor oral health is an important issue directly as it can cause pain, negative effects on appearance and psychosocial effects on confidence and quality of life and may have long-term consequences for treatment burden. Self-reported evidence also suggests an impact on training and performance of athletes. There are many potential challenges to the oral health of athletes including nutritional, oral dehydration, exercise-induced immune suppression, lack of awareness, negative health behaviours and lack of prioritisation. However, in theory, oral diseases are preventable by simple interventions with good evidence of efficacy. The consensus statement aims to raise awareness of the issues of oral health in elite sport and recommends strategies for prevention and health promotion in addition to future research strategies.

Thousands of bacterial phylotypes colonise the human body and the host response to this bacterial challenge greatly influences our state of health or disease. The concept of infectogenomics highlights the importance of host genetic factors in determining the composition of human microbial biofilms and the response to this microbial challenge. We hereby introduce the term ‘genetic dysbiosis’ to highlight the role of human genetic variants affecting microbial recognition and host response in creating an environment conducive to changes in the normal microbiota. Such changes can, in turn, predispose to, and influence, diseases such as: cancer, inflammatory bowel disease, rheumatoid arthritis, psoriasis, bacterial vaginosis and periodontitis. This review presents the state of the evidence on host genetic factors affecting dysbiosis and microbial misrecognition (i.e. an aberrant response to the normal microbiota) and highlights the need for further research in this area.Keywords: genetic; dysbiosis; microbiome; inflammation(Published: 25 February 2014)Citation: Journal of Oral Microbiology 2014, 6: 22962 - http://dx.doi.org/10.3402/jom.v6.22962

Periodontal diseases are common inflammatory conditions of the supporting apparatus of the teeth which lead to early tooth loss. This review discusses the evidence for a role of reactive oxygen species in inducing periodontal tissue damage and focuses on recent evidence showing increased local and systemic alterations in the redox balance of periodontitis. An appraisal of the methods for analysis of oxidative stress in periodontal disease research is provided, showing an increase in oxidative stress measures and oxidative damage fingerprints detected in studies investigating periodontitis cases compared to healthy controls. Hypotheses on the relationships between oxidative stress and inflammatory responses and on the role of redox status in periodontal medicine are discussed. Finally, the review provides an overview of possible intervention pathways for the use of antioxidants as adjuncts to mechanical biofilm removal for the treatment of periodontitis.

AIM: To investigate the effect of hospitalization on oral health as assessed by dental plaque. MATERIALS AND METHODS: Observational study in a critical care unit (CCU). Participants were recruited within 24 h of admission. Dental plaque amount was assessed at baseline, 1 and 2 weeks using the Debris index-soft deposits (Greene & Vermillion 1960). RESULTS: Fifty participants were recruited with 36 available for outcome assessment at 1 week and 10 at 2 weeks. The principal reason for losses was early discharge with no evidence of a difference between patients present only at baseline and those present at 1 week. The median value for dental plaque at baseline was 4 (95% CI: 4, 6). The median dental plaque increase from baseline to week 1 was 1.5 (95% CI: -1, 4), and this was statistically significant (p = 0.04). The median increase from week 1 to week 2 was 1.0 (95% CI -8, 6) and not statistically significant (p = 0.68). CONCLUSIONS: Oral health as assessed by dental plaque deteriorates following hospitalization in CCU. Such change could lead to impairment of quality of life and well-being as well as to increasing the risk of important healthcare-associated infections such as nosocomial pneumonia.

Resumen pt: Objetivo: Avaliar a condicao periodontal dos pacientes diabeticos tipo 2, relacionando com o controle de marcadores metabolicos. Metodo: Para este estudo...

Background There is a lack of consensus on measures to assess implant performance in clinical research. Objectives To investigate the outcomes measures and reference groups employed to evaluate and compare implant success and failure. Data Sources MEDLINE (OVID) and Web of Science with searching reference lists of included papers. Study Eligibility Criteria Inclusion: root form, titanium implants in dentate or edentulous individuals. Longitudinal studies reporting survival or success outcomes on at least 20 participants ≥ mean 5 years. Study Appraisal and Synthesis Methods Descriptive statistics. Results Two-hundred and sixteen studies were included. Implant survival was the most commonly reported primary outcome (60%) with success at 15.7%. Success constituted a wide variety of measures with little consistency. A percentage of 98.6% of studies employed the implant as the unit of analysis with little consideration of clustering within patients. The status of periodontal and general heath of study groups was unclear for more than 80% studies. The proportion of studies comprising randomized trials or using appropriate analytical methods increased from 1980 to 2011. Limitations Considers only English language and there was no author contact. Conclusion In view of the disparate outcome measures employed to assess dental implant performance, agreement is needed both on a core set of implant outcomes and their statistical management.

Objectives To evaluate by histology the effect of loading on the regenerated bone at dehiscence type defects around implants when treated with a combined approach of bone grafting and guided bone regeneration (GBR). Materials and methods In twelve Gottingen mini-pigs, the lower premolars and first molars were extracted and the alveolar process was reduced in width. After 3 months, two Straumann SLActive® (Straumann AG, Basel, Switzerland) implants were placed in each hemi-mandible. Twelve implants were placed into the reduced alveolar ridge (group P) with no further defect or treatment on the site, while on 36 implants, buccal dehiscence defects were created and treated as follows: Group T1: synthetic bone substitute (Straumann Bone Ceramic®, SBC, Straumann AG). Group T2: SBC with a polyethylene glycol membrane (Straumann MembraGel®, Straumann AG); Group N: the dehiscence remained untreated. Three months following implantation, long, custom-made, healing abutments were placed in one hemi-mandible only to ensure functional loading. After 2 months, histological analysis was performed. Results A trend for lower residual defect height and higher bone-to-implant contact was observed in the loaded sites compared with non-loaded sites in groups P, T1 and N. In group T2, the opposite effect was observed. In terms of bone formation, sites treated with SBC grafting and GBR (group T2) exhibited the largest surface area of regenerated bone followed by T1 and N. Significant resorption of the graft particles was noted in group T2 and the graft surface area occupied by SBC was significantly higher in group T1 compared with group T2 (P

Summary Overweight and obesity have been suggested to be associated with periodontitis as published in studies and narrative summaries. This project presents results of a systematic review investigating the association between overweight or obesity (as defined by the World Health Organization) and periodontitis. Search strategy included electronic and hand searching to December 2009. Ovid MEDLINE, EMBASE, LILACS, and SIGLE were searched. RCTs, cohort, case–control and cross-sectional study designs that included measures of periodontitis and body composition were eligible. Duplicate, independent screening and data abstraction were performed. Meta-analyses were performed when appropriate. A total of 526 titles and abstracts were screened, resulting in 61 full text articles and abstracts assessed for eligibility with 33 being included. Nineteen studies provided sufficient information for inclusion in meta-analyses. Meta-analyses indicated statistically significant associations between periodontitis and body mass index (BMI) category obese OR 1.81(1.42, 2.30), overweight OR 1.27(1.06, 1.51) and obese and overweight combined OR 2.13(1.40, 3.26). In conclusion, these results support an association between BMI overweight and obesity and periodontitis although the magnitude is unclear. Additional prospective studies to further quantify, or understand the mechanisms, of this association are merited. There is insufficient evidence to provide guidelines to clinicians on the clinical management of periodontitis in overweight and obese individuals.

There is incomplete and inconclusive evidence for the association between periodontal disease markers and arterial blood pressure, particularly from large national epidemiological studies. This study assessed the relationship between different markers of periodontal inflammation and disease with arterial blood pressure in people aged 17 years and over in USA. We analysed data from the Third National Health and Nutrition Examination Survey on 6617 men and 7377 women who received a periodontal examination. Blood pressure was analysed in both a continuous format and a binary variable for case definition of hypertension. Periodontal disease markers (extent of gingival bleeding, pocket depth, and loss of attachment, and a case definition of periodontitis) were associated on the arterial blood pressure outcomes through a series of regression models, incrementally adjusting for confounders (demographic, inflammation markers, chronic conditions, smoking, BMI, socio-economic status). All periodontal measures had significant crude associations with SBP and hypertension. Gingival bleeding, a marker of current periodontal inflammation, was the only measure consistently and significantly associated with raised SBP and an increased odds of hypertension in the US adult population throughout the adjustment process. For a 10% greater extent of gingival bleeding, the average SBP was higher by 0.5 (0.3, 0.6) mmHg in the fully adjusted model. By referring to the general population and the whole distribution of blood pressure, not only to those at higher risk for hypertension, this association might have some important implications for clinical practice and public health strategies.

P>Background and AimThe aim of this retrospective study was to analyse the clinical and radiographic response of infrabony defects following non-surgical therapy and to detect the factors associated with such a response.Materials and MethodsClinical and radiographic data were retrieved from 143 consecutive patients treated with non-surgical periodontal therapy and re-assessed by the same clinician. Linear radiographic measurements of infrabony periodontal defects were performed on baseline and follow-up (12-18 months post-treatment) radiographs. Multilevel analysis was performed to analyse the associations between subject and site factors and healing of infrabony defects.ResultsA total of 126 infrabony defects from 68 of these patients were identified at baseline and included in the analysis. Statistically significant reductions in probing pocket depth, clinical attachment loss, radiographic defect depth and a widening of the radiographic infrabony defect angle were detected following treatment. Initial defect depth and use of adjunctive antibiotics were positively associated with a reduction of radiographic defect depth, whereas smoking showed a negative association.ConclusionsWithin the limitations of a retrospective analysis with no control group, this study shows favourable clinical and radiographic outcomes in periodontal infrabony defects following non-surgical therapy, with complete bone fill in some cases.

Radiographic outcomes are important for the diagnosis and treatment of periodontal diseases. However, the assessment of radiographic measurements is affected by many factors, and it is therefore difficult to ascertain changes in radiographic outcomes. In this study, we proposed a latent variable approach to correct for the distortion in the radiographic measurements in pairs of periapical radiographs taken before and after periodontal treatment. Clinical data from 123 patients treated with non-surgical periodontal therapy was used to illustrate the latent variable approach in assessing radiographic changes in infrabony defect depth. Results were compared with a correction factor method. Computer simulations were also undertaken to evaluate the performance of these two methods compared with uncorrected, raw measurements by calculating their intraclass correlation coefficients (ICCs). The example data set showed that the latent variable method (LVM) and the correction factor method (CFM) were comparable. Simulations showed that both methods achieved very high ICCs in different scenarios, whilst uncorrected raw measurements had relatively low ICCs. This study suggests that correction for errors in radiographic measurements is required for routine radiographs. Whilst both LVM and CFM achieve excellent results, LVM is more flexible in handling missing values, and may provide better results when treatment effects are large.

Oral Diseases (2011) 17, 232–237 Aim: Genetic factors have recently been associated with presence of Aggregatibacter actinomycetemcomitans subgingivally in populations living in industrialized countries. The aim of this study was to analyse associations between Interleukin-6 (IL6) single nucleotide polymorphisms and presence and levels of A. actinomycetemcomitans and other subgingival microbes in a rural Indian population. Subjects and Methods: A total of 251 individuals from a rural village in India with a periodontal phenotype ranging from healthy to severe periodontitis were included. Checkerboard DNA-DNA analysis was performed to detect 40 periodontal taxa in subgingival plaque samples. Genomic DNA was extracted to genotype five polymorphisms in the IL6 promoter region. Results: The IL6 −174 GG genotype was associated with high (above median) counts of A. actinomycetemcomitans (both in all subjects and in periodontally healthy only) and with presence and counts of Capnocytophaga sputigena. Differences in detection of several other bacteria were noted between periodontitis and healthy subjects. Conclusions: These findings support the influence of genetic factors on the subgingival microbiota.

Franch-Chillida F, Nibali L, Madden I, Donos N, Brett P. Association between interleukin-6 polymorphisms and periodontitis in Indian non-smokers. J Clin Periodontol 2010; 37: 137–144. doi: 10.1111/j.1600-051X.2009.01501.x. Abstract Aim: Genetic polymorphisms (SNPs) in the interleukin-6 (IL-6) gene have been associated with the presence of periodontitis. The aim of this study was to investigate the association between five SNPs in the IL-6 promoter region and the periodontal status of a rural Indian population. Materials and Methods: Two hundred and fifty-one systemically healthy volunteers were clinically assessed by a single calibrated examiner and divided into: healthy individuals and periodontitis patients based on the European Workshop on Periodontitis definitions and on a recently suggested definition, which takes into account age and clinical attachment levels. Their genomic DNA was analysed blindly using real-time polymerase chain reaction to study IL-6 variants. The association between genetic factors and the presence of periodontitis was assessed by logistic regression. Results: The IL-6−174 GG genotype was associated with periodontitis in non-smokers and older subjects (>45 years old). No statistically significant associations were detected between IL-6 haplotypes and periodontal status, after adjusting for confounders. Conclusions: The IL-6−174 polymorphism showed some evidence of an association with the periodontal status in non-smokers and older subjects in this rural Indian population. This association might be mediated by the effect of IL-6 on inflammatory responses.

P>BackgroundViruses such as Human Cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) have been proposed to be periodontal pathogens. The aim of this study was to analyse the presence of herpesvirus DNA in subgingival plaque samples of patients with different forms of periodontitis and in healthy periodontia.Materials and MethodsA total of 140 ethnically mixed (prevalently Caucasian) subjects took part in the study. Sixteen were affected by localized aggressive periodontitis (LAgP), 64 by generalized aggressive periodontitis (GAgP), 20 by chronic periodontitis (CP) and 40 were periodontally healthy. Polymerase chain reaction (PCR) analyses were performed to detect HCMV and EBV. Sera were tested for anti-HCMV and EBV IgG antibodies. PCRs for herpes simplex (HSV) and varicella zoster virus (VZV) were performed in subgingival samples from a subset of 20 AgP subjects.ResultsHCMV DNA was not detected in any plaque samples. EBV DNA was detected in four LAgP (25%), two GAgP (3%) subjects and four healthy individuals (10%). HSV DNA and VZV DNA were not detected in the subset of studied individuals.ConclusionsThis study challenges the previously reported high prevalence of herpesvirus DNA in subgingival samples from periodontitis patients and so questions whether they act as pathogens in such patients.