osteoprotegerin and Gingivitis

Assess the ability of a panel of gingival crevicular fluid (GCF) biomarkers as predictors of periodontal disease progression (PDP).. In this study, 100 individuals participated in a 12-month longitudinal investigation and were categorized into four groups according to their periodontal status. GCF, clinical parameters and saliva were collected bi-monthly. Subgingival plaque and serum were collected bi-annually. For 6 months, no periodontal treatment was provided. At 6 months, patients received periodontal therapy and continued participation from 6 to 12 months. GCF samples were analysed by ELISA for MMP-8, MMP-9, Osteoprotegerin, C-reactive Protein and IL-1β. Differences in median levels of GCF biomarkers were compared between stable and progressing participants using Wilcoxon Rank Sum test (p = 0.05). Clustering algorithm was used to evaluate the ability of oral biomarkers to classify patients as either stable or progressing.. Eighty-three individuals completed the 6-month monitoring phase. With the exception of GCF C-reactive protein, all biomarkers were significantly higher in the PDP group compared to stable patients. Clustering analysis showed highest sensitivity levels when biofilm pathogens and GCF biomarkers were combined with clinical measures, 74% (95% CI = 61, 86).. Signature of GCF fluid-derived biomarkers combined with pathogens and clinical measures provides a sensitive measure for discrimination of PDP (ClinicalTrials.gov NCT00277745).

Topics: Biofilms; Biomarkers; C-Reactive Protein; Chronic Periodontitis; Cohort Studies; Dental Plaque; Dental Scaling; Disease Progression; Follow-Up Studies; Forecasting; Gingival Crevicular Fluid; Gingivitis; Humans; Interleukin-1beta; Longitudinal Studies; Matrix Metalloproteinase 8; Matrix Metalloproteinase 9; Osteoprotegerin; Periodontitis; Root Planing; Saliva; Sensitivity and Specificity

Periodontitis is the major cause of tooth loss in adults and is linked to systemic illnesses, such as cardiovascular disease and stroke. The development of rapid point-of-care (POC) chairside diagnostics has the potential for the early detection of periodontal infection and progression to identify incipient disease and reduce health care costs. However, validation of effective diagnostics requires the identification and verification of biomarkers correlated with disease progression. This clinical study sought to determine the ability of putative host- and microbially derived biomarkers to identify periodontal disease status from whole saliva and plaque biofilm.. One hundred human subjects were equally recruited into a healthy/gingivitis group or a periodontitis population. Whole saliva was collected from all subjects and analyzed using antibody arrays to measure the levels of multiple proinflammatory cytokines and bone resorptive/turnover markers.. Salivary biomarker data were correlated to comprehensive clinical, radiographic, and microbial plaque biofilm levels measured by quantitative polymerase chain reaction (qPCR) for the generation of models for periodontal disease identification. Significantly elevated levels of matrix metalloproteinase (MMP)-8 and -9 were found in subjects with advanced periodontitis with Random Forest importance scores of 7.1 and 5.1, respectively. The generation of receiver operating characteristic curves demonstrated that permutations of salivary biomarkers and pathogen biofilm values augmented the prediction of disease category. Multiple combinations of salivary biomarkers (especially MMP-8 and -9 and osteoprotegerin) combined with red-complex anaerobic periodontal pathogens (such as Porphyromonas gingivalis or Treponema denticola) provided highly accurate predictions of periodontal disease category. Elevated salivary MMP-8 and T. denticola biofilm levels displayed robust combinatorial characteristics in predicting periodontal disease severity (area under the curve = 0.88; odds ratio = 24.6; 95% confidence interval: 5.2 to 116.5).. Using qPCR and sensitive immunoassays, we identified host- and bacterially derived biomarkers correlated with periodontal disease. This approach offers significant potential for the discovery of biomarker signatures useful in the development of rapid POC chairside diagnostics for oral and systemic diseases. Studies are ongoing to apply this approach to the longitudinal predictions of disease activity.

Topics: Adult; Aged; Alveolar Bone Loss; Bacteria; Biofilms; Biomarkers; Chronic Periodontitis; Dental Plaque; Disease Progression; Female; Gingivitis; Humans; Interferon-gamma; Interleukins; Leukocyte L1 Antigen Complex; Male; Matrix Metalloproteinase 8; Matrix Metalloproteinase 9; Middle Aged; Osteoprotegerin; Periodontal Attachment Loss; Periodontal Diseases; Periodontium; Porphyromonas gingivalis; Saliva; Treponema denticola; Tumor Necrosis Factor-alpha; Young Adult

Miniscrew has been frequently used, considering that anchorage control is a critical point in orthodontic treatment, and its failure, the main adverse problem. Using two groups of stable (successful) and unstable (failed) mini-implants, this in vivo study aimed to quantify proinflammatory cytokines IL-1 α, IL-6, IL-17, and TNF-α and osteoclastogenesis marker RANK, RANKL, and OPG in gingival tissue, using the real-time polymerase chain reaction technique.. Thirteen patients of both sexes (11-49 years old) under orthodontic treatment were selected, obtaining 11 successful and 7 failed mini-implants. The mini-implants were placed and removed by the same surgeon, in both jaws. The mean time of permanence in the mouth was 29.4 months for successful and 7.6 months for failed mini-implants. At removal time, peri-mini-implant gingival tissue samples were collected and processed for quantification of the proinflammatory cytokines and osteoclastogenesis markers. Nonparametric Wilcoxon rank-sum test considering the clusters and Kruskal-Wallis test were used for statistical analysis (α=0.05).. No significant difference (p>0.05) was observed between the groups for either quantification of cytokines or osteoclastogenesis markers, except for IL-6 (p<0.05).. It may be concluded that the expression of IL-1α, IL-17, TNF-α, RANK, RANKL, and OPG in peri-implant gingival tissue were not determinant for mini-implant stability loss, but the higher IL-6 expression could be associated with mini-implant failure.

Topics: Adolescent; Adult; Alveolar Bone Loss; Biomarkers; Child; Cytokines; Dental Implants; Female; Gingivitis; Humans; Male; Middle Aged; Orthodontic Anchorage Procedures; Osteogenesis; Osteoprotegerin; Peri-Implantitis; Real-Time Polymerase Chain Reaction; Reference Values; Statistics, Nonparametric; Time Factors; Treatment Outcome; Young Adult

To test the following two hypotheses: 1) different types of retainers result in distinct levels of biomarkers in gingival crevicular fluid (GCF) and 2) the retainer bonded to all mandibular anterior teeth induces more detrimental outcomes to the periodontium.. The Department of Orthodontics at the University of Florida. The population consisted of individuals in the retention phase of orthodontic treatment.. This was a cross-sectional study that enrolled 36 individuals. Subjects in group 1 had retainers bonded to the mandibular canines only. Group 2 consisted of individuals having retainers bonded to all mandibular anterior teeth. Group 3 included patients using mandibular removable retainers. After clinical examination, GCF was collected from the mandibular incisor and biomarker levels were compared between the groups.. Plaque accumulation and gingivitis differed significantly among groups, with the highest median values in group 2 subjects. Pairwise comparison of the groups with respect to gingivitis showed significant differences between groups 1 and 2. Significant differences among groups were detected for RANKL, OPG, OPN, M-CSF, MMP-3, and MMP-9. The ratio RANKL/OPG was significantly higher in group 2 subjects, with pairwise comparisons indicating that groups 1 and 2 differed from group 3.. An association was found between orthodontic retention groups and GCF biomarker levels, which should be further explored in longitudinal studies. The presence of retainers bonded to all anterior teeth seems to increase plaque accumulation and gingivitis.

Topics: Adolescent; Adult; Biomarkers; Cross-Sectional Studies; Cuspid; Dental Bonding; Dental Plaque; Dental Plaque Index; Female; Gingival Crevicular Fluid; Gingival Recession; Gingivitis; Humans; Incisor; Interleukin 1 Receptor Antagonist Protein; Interleukin-1beta; Interleukin-6; Interleukin-8; Macrophage Colony-Stimulating Factor; Male; Mandible; Matrix Metalloproteinase 3; Matrix Metalloproteinase 9; Middle Aged; Orthodontic Appliance Design; Orthodontic Retainers; Osteopontin; Osteoprotegerin; Periodontal Index; RANK Ligand

Gestational diabetes mellitus (GDM) is defined as varying glucose intolerance, with first onset or recognition in pregnancy. This study evaluates clinical and biochemical parameters in a possible association between GDM and gingivitis.. A total of 167 pregnant females was included in the study. There were 101 females with GDM and 66 females without GDM. Subgroups were created according to the presence or absence of gingival inflammation. Plaque index, bleeding on probing, and probing depth were recorded at four sites per tooth. Serum, saliva, and gingival crevicular fluid (GCF) levels of interleukin (IL)-6, IL-8, soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), osteoprotegerin (OPG), B-cell activating factor (BAFF), and a proliferation-inducing ligand (APRIL) were determined by enzyme-linked immunosorbent assay. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests and Spearman correlation analysis.. Age and anthropometric indices were higher in the GDM than non-GDM group (P <0.0001). Clinical periodontal recordings, serum BAFF, IL-8, and saliva sRANKL levels were higher in the GDM group (P <0.05). Saliva IL-6 level was higher in the GDM with gingivitis group than non-GDM with gingivitis group (P = 0.044). Serum and GCF BAFF (P <0.0001), serum, saliva, and GCF APRIL (P <0.0001; P <0.0001; P = 0.032, respectively), GCF OPG (P = 0.036), and serum and saliva sRANKL (P <0.0001) were higher in the GDM with gingivitis group than GDM without gingivitis group.. The inflammatory response seems to be more pronounced in females with GDM. The observed increase in both local and systemic levels of inflammatory cytokines may suggest an interaction between gingivitis and GDM.

Topics: Adult; B-Cell Activating Factor; Body Mass Index; Dental Plaque Index; Diabetes, Gestational; Female; Gingival Crevicular Fluid; Gingivitis; Glucose Tolerance Test; Humans; Interleukin-6; Interleukins; Maternal Age; Osteoprotegerin; Periodontal Index; Periodontal Pocket; Pregnancy; RANK Ligand; Saliva; Tumor Necrosis Factor Ligand Superfamily Member 13

The aim of this cross-sectional study is to compare the local and systemic levels of soluble receptor activator of nuclear factor-κB ligand (sRANKL), osteoprotegerin (OPG), a proliferation-inducing ligand (APRIL), B-cell activating factor (BAFF), interleukin (IL)-6, and IL-8 in biofluids of patients with thalassemia major (TM) with or without gingivitis.. Seventy-seven patients are included in this study (TM, n = 29; systemically healthy, n = 48). Gingival crevicular fluid (GCF), saliva, and serum levels of IL-6, IL-8, sRANKL, OPG, BAFF, and APRIL were determined by enzyme-linked immunosorbent assay. Data were analyzed by appropriate non-parametric or parametric statistical tests.. Median GCF, serum, and saliva levels for BAFF (P <0.001) and IL-6 and IL-8 (P <0.005) were higher in TM gingivitis than in systemically healthy gingivitis (P <0.001). GCF, serum, and saliva levels for APRIL, sRANKL, IL-6, and IL-8 were higher in TM than in systemically and periodontally healthy comparison groups (P <0.05). Positive correlations were found between bleeding on probing (BOP), plaque index (PI) scores, and GCF APRIL, serum sRANKL, serum OPG, and sRANKL concentrations in TM groups (P <0.05). Several significant positive correlations were found between BOP, PI scores, and biofluid parameters also in systemically healthy groups.. TM may have a role in the underlying systemic hematologic condition and potentially affect gingival inflammation via dysregulation of lymphocytes and increased activation of osteoclasts.

Topics: Adolescent; Adult; B-Cell Activating Factor; beta-Thalassemia; Cross-Sectional Studies; Dental Plaque Index; Female; Gingival Crevicular Fluid; Gingivitis; Humans; Interleukin-6; Interleukin-8; Male; Middle Aged; Osteoprotegerin; Periodontal Index; RANK Ligand; Saliva; Tumor Necrosis Factor Ligand Superfamily Member 13; Young Adult

This study evaluates the effects of probiotic therapy (PT) in rats with ligature-induced periodontitis associated with restraint stress.. Sixty-four rats were divided into control, stress (STR), probiotic (PROB), periodontal disease (PD), STR-PROB, STR-PD, STR-PROB-PD, and PROB-PD groups. The probiotic was added to the drinking water for 44 days. PD was induced by a ligature. In STR groups, the animals were subjected to restraint stress for 2.5 hours per day for 30 days.. Rats with PD exhibited increased alveolar bone loss (P <0.05), as well as increased levels of cyclooxygenase-2, serum C-terminal telopeptide (CTX), p38 mitogen-activated protein kinase (p38), and receptor activator of nuclear factor-κB ligand and decreased levels of osteoprotegerin (OPG). Stressed rats presented high levels of C-peptide, corticosterone, and glucose (P <0.05). In general, the presence of stress reduced the expression of CTX and p38 (P <0.05). PT reduced alveolar bone loss in unstressed animals. It also decreased expression of CTX and induced increased expression of OPG in unstressed animals with PD. However, PT was not effective in preventing bone loss or altering the expression of inflammatory markers in stressed animals. PT decreased the number of inflammatory cells in the periodontal tissue (P <0.05). Groups with stress and PD showed decreased villous height and crypt depth. Stress seemed to prevent part of the probiotic beneficial effects on the small intestine.. Based on the methodology used, PT may reduce tissue breakdown resulting from PD in unstressed rats. The protocol used for restraint stress influenced the immunomodulatory effects of PT in intestinal and periodontal tissues.

Topics: Alveolar Bone Loss; Animals; Blood Glucose; C-Peptide; Collagen Type I; Corticosterone; Cyclooxygenase 2; Gingivitis; Intestinal Mucosa; Intestine, Small; Male; Osteoprotegerin; p38 Mitogen-Activated Protein Kinases; Peptides; Periodontitis; Probiotics; RANK Ligand; Rats; Rats, Wistar; Stress, Physiological; Stress, Psychological

Systemic conditions may affect host susceptibility, disease progression and severity as well as treatment response. Previously, low oestrogen (E(2)) levels were associated with increased bone resorption, due to increased osteoclastogenesis and decreased osteoclast apoptosis. Osteoprotegerin (OPG) is an essential cytokine for osteoclastogenesis. The aim of this study was to evaluate gingival crevicular fluid (GCF) OPG levels in menopausal and premenopausal patients with or without periodontitis, and effects of phase I periodontal therapy on GCF OPG levels.. Forty-four systemically healthy premenopausal and menopausal patients were recruited and divided into subgroups of periodontitis and control. Bone mineral density (BMD) and serum E(2) levels were measured. Before and after phase I periodontal therapy clinical indices, including clinical attachment levels (CAL) were recorded, and GCF samples were collected. GCF OPG levels were detected by enzyme-linked immunosorbent assay. Repeated measurement ANOVA and Spearman correlation tests were used.. All clinical indices improved significantly after treatment(p<0.001), except Pre-M/C groups CAL reduction(p>0.05). Periodontitis groups' OPG levels were lower than gingivitis groups(p>0.05). Following periodontal phase I therapy, GCF OPG levels increased markedly in all groups, however this alteration was found statistically insignificant (p>0.05).. The current data revealed that GCF OPG levels were lower in periodontitis patients and phase I therapy resulted with increased GCF OPG levels, however those alterations were statistically insignificant. In addition, present data suggested that menopause do not seem to have a significant effect on periodontal status or response to phase I treatment, within the limits of this study.

Topics: Absorptiometry, Photon; Aged; Bone Density; Case-Control Studies; Chronic Periodontitis; Dental Plaque Index; Dental Scaling; Estrogens; Female; Gingival Crevicular Fluid; Gingival Hemorrhage; Gingivitis; Humans; Lumbar Vertebrae; Middle Aged; Osteoprotegerin; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Postmenopause; Premenopause; Root Planing

Inflammatory mediators, especially cytokine, play a central role in the pathogenesis of gingivitis. The aim of this study was to identify and quantify the various growth factors, and cytokines in the gingival crevicular fluid (GCF) of patients with gingivitis, as compared with those of control subjects. The levels of cytokine in the samples were determined by their respective ELISAs. The transforming growth factor (TGF)-alpha and osteoprotegerin (OPG) level were significantly lower in patients with gingivitis than in the controls (p < 0.05). Also, there was a positive correlation between TGF-alpha and OPG levels (r = 0.761). These results suggest that the decrease in growth factor TGF-alpha is associated with the pathophysiology and/or the progress of gingivitis.

Topics: Adolescent; Adult; Female; Gingival Crevicular Fluid; Gingivitis; Humans; Male; Middle Aged; Osteoprotegerin; Transforming Growth Factor alpha

Receptor activator of NF-kappaB ligand (RANKL) and osteoprotegerin (OPG) are a system of molecules that regulate bone resorption. This study aims to compare the levels of RANKL, OPG and their relative ratio in gingival crevicular fluid (GCF) of healthy and periodontal disease subjects.. GCF was obtained from healthy (n=21), gingivitis (n=22), chronic periodontitis (n=28), generalized aggressive periodontitis (n=25) and chronic periodontitis subjects under immunosuppressant therapy (n=11). RANKL and OPG concentrations in GCF were measured by enzyme-linked immunosorbent assays.. RANKL levels were low in health and gingivitis groups, but increased in all three forms of periodontitis. OPG levels were higher in health than all three periodontitis, or gingivitis groups. There were no differences in RANKL and OPG levels between chronic and generalized aggressive periodontitis groups, whereas these were lower in the immunosuppressed chronic periodontitis group. The RANKL/OPG ratio was significantly elevated in all three periodontitis forms, compared with health or gingivitis, and positively correlated to probing pocket depth and clinical attachment level.. GCF RANKL and OPG levels were oppositely regulated in periodontitis, but not gingivitis, resulting in an enhanced RANKL/OPG ratio. This ratio was similar in all three periodontitis groups and may therefore predict disease occurrence.

Topics: Adolescent; Adult; Alveolar Bone Loss; Case-Control Studies; Female; Gingival Crevicular Fluid; Gingivitis; Humans; Immunosuppression Therapy; Male; Middle Aged; Osteoprotegerin; Periodontitis; RANK Ligand; Statistics, Nonparametric