• Journal of Periodontal and Implant Science
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• v.51 no.6
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• pp.409-421
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• 2021

Purpose: The aim of this study was to compare the prevalence and bacterial load of 6 main periodontal pathogens between pairs of periodontal patients with and without type 2 diabetes mellitus. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans genotypes were also investigated. Methods: Twenty patients affected by chronic periodontitis and type 2 diabetes were retrospectively selected and matched to 20 patients without diabetes on the basis of the degree and severity of periodontal disease. Microbiological data of subgingival biofilms were analysed and compared for the examined pathogens: A. actinomycetemcomitans, P. gingivalis, Prevotella intermedia, Treponema denticola, Fusobacterium nucleatum, and Tannerella forsythia. Results: The pairs were balanced in terms of demographic and clinical parameters, except for bleeding on probing and suppuration. In the microbiological test sites (4 for each patient), the mean probing pocket depth was 6.34±1.63 mm in patients with diabetes and 6.41±1.78 mm in patients without diabetes. No significant difference between pairs in the prevalence of P. gingivalis or the distribution of its genotypes was recorded. Patients with diabetes had a significantly greater amount of total bacterial load, P. gingivalis, T. denticola, T. forsythia, and F. nucleatum (P<0.05). Moreover, patients with diabetes had a higher number of sites with a greater cell count than patients without diabetes. When compared to the total bacterial load, only T. forsythia maintained its relative load in patients with diabetes (P=0.001). Conclusions: This retrospective matched study supports the hypothesis that microbiological differences exist among periodontal patients with and without diabetes mellitus.

• Journal of Periodontal and Implant Science
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• v.43 no.5
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• pp.227-232
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• 2013

Purpose: The receptor activator of nuclear factor kappa B (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) system plays a significant role in osteoclastogenesis, activation of osteoclasts, and regulation of bone resorption. This study aimed to evaluate the use of the salivary soluble RANKL (sRANKL)/OPG ratio as a diagnostic marker for periodontitis in nonsmokers. Methods: Twenty-five patients with chronic periodontitis and 25 individuals with a healthy periodontium were enrolled in this study. Samples containing 5 mL of unstimulated saliva were obtained from each subject. Salivary sRANKL and OPG concentrations were determined using a standard enzyme-linked immunosorbent assay. Statistical analysis was performed using SPSS ver. 18.0. Results: The levels of sRANKL and OPG were detectable in all of the samples. Positive relationships were found between the plaque index and clinical attachment level and both the salivary concentration of sRANKL and the salivary sRANKL/OPG ratio (P<0.05). The salivary concentration of sRANKL and the sRANKL/OPG ratio were significantly higher in the periodontitis group than in the healthy group (P=0.004 and P=0.001, respectively). In contrast, the OPG concentration showed no significant differences between the groups (P=0.455). Conclusions: These findings suggest that the salivary sRANKL/OPG ratio may be helpful in the screening and diagnosis of periodontitis. However, longitudinal studies with larger populations are needed to confirm these results.

• International Journal of Oral Biology
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• v.45 no.2
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• pp.42-50
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• 2020

Lysophosphatidic acid (LPA) is a lipid messenger mediated by G protein-coupled receptors (LPAR1-6). It is involved in the pathogenesis of certain chronic inflammatory and autoimmune diseases. In addition, it controls the self-renewal and differentiation of stem cells. Recent research has demonstrated the close relationship between periodontitis and various diseases in the human body. However, the precise role of LPA in the development of periodontitis has not been studied. We identified that LPAR1 was highly expressed in human periodontal ligament stem cells (PDLSCs). In periodontitis-mimicking conditions with Porphyromonas gingivalis-derived lipopolysaccharide (Pg-LPS) treatment, PDLSCs exhibited a considerable reduction in the cellular viability and osteogenic differentiation potential, in addition to an increase in the inflammatory responses including tumor necrosis factor-α and interleukin-1β expression and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) activation. Of the various LPAR antagonists, pre-treatment with AM095, an LPAR1 inhibitor, showed a positive effect on the restoration of cellular viability and osteogenic differentiation, accompanied by a decrease in NF-κB signaling, and action against Pg-LPS. These findings suggest that the modulation of LPAR1 activity will assist in checking the progression of periodontitis and in its treatment.

• The Journal of Advanced Prosthodontics
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• v.4 no.4
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• pp.210-217
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• 2012

PURPOSE. The purpose of this study was to analyze the current literatures and to assess outcomes of implant treatment in patients with generalized aggressive periodontitis. MATERIALS AND METHODS. Studies considered for inclusion were searched in Pub-Med. The literature search for studies published in English between 2000 and 2012 was performed. Our findings included literature assessing implant treatment in patients with a history of generalized aggressive periodontitis (GAP). All studies were screened according to inclusion criteria. The outcome measures were survival rate of superstructures, marginal bone loss around implant and survival rate of implants. All studies were divided into two follow-up period: short term study (< 5 years) and long term study (${\geq}5$ years). RESULTS. Seven prospective studies were selected, including four short-term and three long-term studies. The survival rates of the superstructures were generally high in patients with GAP, i.e. 95.9-100%. Marginal bone loss around implant in patients with GAP as compared with implants in patients with chronic periodontitis or periodontally healthy patients was not significantly greater in short term studies but was significantly greater in long term studies. In short term studies, the survival rates of implants were between 97.4% and 100% in patients with GAP-associated tooth loss, except one study. The survival rates of implants were between 83.3% and 96% in patients with GAP in long term studies. CONCLUSION. Implant treatment in patients with GAP is not contraindicated provided that adequate infection control and an individualized maintenance program are assured.

• Journal of Periodontal and Implant Science
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• v.37 no.sup2
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• pp.325-338
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• 2007

The purposes of this study were to compare and quantify the expression of IL-6, e1stase and ${\alpha}_1-PI$ in the gingival tissues of patients with type 2 diabetes mellitus and healthy adults with chronic periodontitis. Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was devided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflammed gingiva from patients with chronic periodontitis. Group 3 (n=8) is inflammed gingiva from patients with chronic periodontitis associated with type 2 diabetes. Tissue samples were prepared and analyzed by Western blotting. The quantification of IL-6, elastase and ${\alpha}_1-PI$ were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. 1. The expression levels of IL-6 showed increasing tendency in group 2 and 3, and It was highest in group 3. 2. The expression of elastase showed increasing tendency in group 2 and 3, and It was highest in group 3. 3. The expression of ${\alpha}_1-PI$ showed increasing tendency in group 3 compared to group 1. 4. The ${\alpha}_1-PI$/elastase ratio was decreased in group 2 and 3 compared to group 1, especially most decreased in group 3. 5. As IL-6 levels were increasing, elastase showed increasing tendency in group 3, and although IL-6 and elastase levels were increasing, ${\alpha}_1-PI$ level in group 3 showed slightly increasing pattern comparing to group 1. In conclusion, this study demonstrated that the expression levels of IL-6 and elastase will be inflammatory markers of periodontal inflammed tissue and DM. The ${\alpha}_1-PI$/elastase ratio also may be important measuring inflmmatory factors in the progression of periodontal inflammation associated to type 2DM.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.661-674
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• 2005

The purpose of this study was to quantify and compare the level of MMP-2, MMP-8 in the healthy, inflammed gingival tissue and inflammed gingival tissue associated with type 2 DM. We investigate whether expression of MMP-2, MMP-8 is increased by chronic periodontitis associated with type 2 DM. Gingival tissue samples were obtained during periodontal surgery or tooth extraction. Based on patient's systemic condition & clinical criteria of gingiva, each gingival samples were divided into three groups. Group l(n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from 8 systemically healthy patients. Group 2(n=8) is inflammed gingiva from patients with chronic periodontitis. Group 3(n=8) is inflammed gingiva from type 2 diabetic patients with chronic periodontitis. Tissue samples were prepared and analyzed by Western blotting. The quantification of MMP-2, MMP-8 was performed using a densitometer and statistically analyzed by ANOVA. MMP-2, MMP-8 was expressed in all samples including healthy gingiva and increased in group 3 compared to group 1 and 2, and showed that significant variation was observed between group 1 & 3 in MMP-8 results. In conclusion, this study demonstrated that human gingival tissue with chronic periodontitis associated to type 2 diabetes showed slightly elevated MMP-2, MMP-8 levels compared to healthy gingiva and non-diabetic inflamed gingiva.

• Journal of Periodontal and Implant Science
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• v.50 no.3
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• pp.171-182
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• 2020

Purpose: The aims of this study were to examine the salivary microbiota in conditions of periodontal health and disease and to explore microbial changes following nonsurgical periodontal treatment. Methods: Non-stimulated saliva samples were collected from 4 periodontally healthy participants at baseline and from 8 patients with chronic periodontitis at baseline and 3 months following nonsurgical periodontal therapy. The V3 and V4 regions of the 16S rRNA gene from the DNA of saliva samples were amplified and sequenced. The salivary microbial compositions of the healthy participants and patients with periodontitis prior to and following nonsurgical treatment of periodontitis were compared based on the relative abundance of various taxa. Results: On average, 299 operational taxonomic units were identified in each sample. The phylogenetic diversity in patients with periodontitis was higher than that in healthy participants and decreased following treatment. The abundance of the phylum Spirochaetes and the genus Treponema in patients with periodontitis was 143- and 134-fold higher than in the healthy control group, respectively, but decreased significantly following treatment. The species that were overabundant in the saliva of patients with periodontitis included the Peptostreptococcus stomatis group, Porphyromonas gingivalis, the Fusobacterium nucleatum group, Parvimonas micra, Porphyromonas endodontalis, Filifactor alocis, and Tannerella forsythia. The phylum Actinobacteria, the genus Streptococcaceae_uc, and the species Streptococcus salivarius group were more abundant in healthy participants than in those with periodontitis. There was a trend toward a decrease in disease-associated taxa and an increase in health-associated taxa following treatment. Conclusions: Our results revealed differences in the taxa of salivary microbiota between conditions of periodontal health and disease. The taxa found to be associated with health or disease have potential for use as salivary biomarkers for periodontal health or disease.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.1
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• pp.55-62
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• 2018

Purpose : Preeclampsia(PE) is a pregnancy-specific disease which is characterized by hypertension and proteinuria. This disease occurs in about 2-8 % of pregnancies in developing countries and remains among the major causes of maternal and neonatal mortality and morbidity throughout the world. Although the causes of PE are not fully understood, the infection has been considered as the main risk factor for this diseases. Periodontal disease may provide a chronic burden of endotoxin and inflammatory cytokines and the disease has been considered as risk factors of systemic illnesses including cardiovascular disease, atherosclerosis, and cerebrovascular ischemia. So, studies performed over the last 15 years have suggested that periodontal disease may be associated with adverse pregnancy outcomes such as PE. However, this association has not been found in all populations. The aim of this review article was to evaluate whether periodontal status and the presence of specific periodontal pathogens may influence the incidence of PE. Methods : Many research articles searched at the electronic databases(MEDLINE; 2000 to July 2017) including search term as periodontal disease and preeclampsia. Result : There were 10 case-control studies and 5 cohort studies meeting our inclusion criteria. The results showed that maternal periodontitis (adjusted odds ratio: 1.5 to 9.3) was associated with preeclampsia in 15 epidemiological studies. Conclusion : It is clear that maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

• The Journal of the Korean dental association
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• v.25 no.7 s.218
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• pp.665-672
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• 1987

In order to study the effects of advanced periodontitis on pulps, 36 human teeth were examined histologically. In addition, a medical and dental history was elicited. The pulps were intact, uninflammed in only 9 teeth (25%) of 36 periodontally involved teeth. 27 teeth (75%) had pulps exhibiting inflammatory lesions of varing intensities. Of 27 teeth with pathological pulp tissue alterations, focal reversible pulpitis was found in 4 teeth, chronic pulpitis in 13 teeth, pulp abscess in 6 teeth, and pulp necrosis in 4 teeth. These observations appeared to indicate that teeth with dvanced periodontitis produce a high incidence of degenertion and inflammation of the pulp. Responses to electric pulp test were not found to be reliable indicators of the state of the pulp in periodontally involved teeth.

• Journal of Periodontal and Implant Science
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• v.43 no.1
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• pp.3-11
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• 2013

Periodontitis is a chronic inflammation of periodontal tissue caused by subgingival plaque-associated bacteria. Periodontitis has long been understood to be the result of an excessive host response to plaque bacteria. In addition, periodontal pathogens have been regarded as the causative agents that induce a hyperinflammatory response from the host. In this brief review, host-microbe interaction of nonperiodontopathic versus periodontopathic bacteria with innate immune components encountered in the gingival sulcus will be described. In particular, we will describe the susceptibility of these microbes to antimicrobial peptides (AMPs) and phagocytosis by neutrophils, the induction of tissue-destructive mediators from neutrophils, the induction of AMPs and interleukin (IL)-8 from gingival epithelial cells, and the pattern recognition receptors that mediate the regulation of AMPs and IL-8 in gingival epithelial cells. This review indicates that true periodontal pathogens are poor activators/suppressors of a host immune response, and they evade host defense mechanisms.