sodium-dodecyl-sulfate and Periodontitis

Topics: Anti-Bacterial Agents; Benzoates; Clinical Trials as Topic; Dental Research; Meta-Analysis as Topic; Mouthwashes; Outcome Assessment, Health Care; Periodontal Diseases; Periodontitis; Research Design; Sodium Dodecyl Sulfate; Tetracycline

Antimicrobial photodymanic therapy mediated by methylene blue has been investigated as an adjunctive to periodontal treatment but the dimerization of photosensitizer molecules reduces the phototoxic effects. Sodium dodecyl sulfate is a surfactant that may control this aggregation. The aim of this study was evaluated the photodynamic effect of methylene blue in sodium dodecyl sulfate in periodontitis.. 36 participants with periodontitis were selected and allocated randomly in two group for intervention and other two for control - all of them were treated with scaling and root planing before aPDT. Three periodontal evaluations were done: at the selection time, at the day of intervention and thirty-day after this. Pre-irradiation time was 1 min and 2 min for irradiation. Laser (Therapy XT, DMC, São Carlos, Brazil) with wavelength of 660 nm and 100 mW of power was used. Two photosensitizer solutions with 100 µM methylene blue was used, one of them was in water and other in 0,25% of sodium dodecyl sulfate. Two sites of each participant were selected for the experimental procedures. Microbiological evaluations were performed to quantify microorganisms before and immediately after intervention. Quantitative microbiological evaluation was the primary outcome; morphological aspects of bacterial colony, and clinical probing depth was the secondary one.. There was no significant difference between the groups in both bacterial reduction and the clinical parameter evaluated.. The effect of methylene blue in surfactant did not cause enough phototoxic effects that could promote reduction of periodontal pocket depth.

Topics: Adjuvants, Immunologic; Anti-Infective Agents; Chronic Periodontitis; Combined Modality Therapy; Dental Scaling; Humans; Methylene Blue; Periodontitis; Photochemotherapy; Photosensitizing Agents; Root Planing; Sodium Dodecyl Sulfate; Surface-Active Agents

The present clinical trial was performed to evaluate short-term effects of a triclosan-containing dentifrice/gel combination on soft tissue healing, when applied supra-/sub-gingivally at periodontal sites treated with scaling and root planing. 16 subjects with moderate periodontitis participated in a 2x 2-week, split-mouth designed clinical trial. 2 combinations of gel/dentifrice (the test combination containing triclosan) were used. 2 pairs of contralateral sites with probing pocket depth (PPD) > or 5 mm, and which bled on probing (BoP +) were selected in each patient as experimental units. A baseline examination included assessments of PPD, BoP, gingival index scores, plaque index scores, and the composition of the subgingival microbiota (dark-field microscopy). The assigned quadrant was anaesthetized and the teeth exposed to meticulous scaling and root planing. Immediately after the completion of mechanical therapy, either the test or control gel was applied subgingivally at the experimental sites. The volunteer was instructed to brush his/her teeth with an assigned dentifrice and to apply the gel (via a custom-made stent) supra-gingivally 2x daily for the following 2 weeks. He/she was recalled on day 7 for a second professional subgingival gel application. Re-examinations were carried out on days 2, 7 and 14 after treatment. 1-week wash-out periods separated the 2 experimental periods. The mean PPD reductions (between days 0 and 14) were 1.8 mm and 1.9 mm for the test and control gel/dentifrice sites. The reduction in BoP and gingival index scores was significantly greater during the test than during the control regimen. No significant differences were observed between the 2 regimens regarding plaque scores and composition of the subgingival microbiota. The findings from the present investigation demonstrated that triclosan, applied both sub- and supra-gingivally reduced soft tissue inflammation following scaling and root planing.

Topics: Anti-Infective Agents, Local; Bacteria; Dental Plaque Index; Dental Scaling; Dentifrices; Evaluation Studies as Topic; Female; Follow-Up Studies; Gels; Gingiva; Gingival Hemorrhage; Gingivitis; Humans; Male; Maleates; Middle Aged; Periodontal Index; Periodontal Pocket; Periodontitis; Placebos; Polyvinyls; Root Planing; Sodium Dodecyl Sulfate; Surface-Active Agents; Triclosan; Wound Healing

This study was intended to determine the salivary protein factors related to adult periodonititis.. Twenty-five patients with adult periodontitis (AP group) and twenty-five normal controls (NC group, 25) were adopted in the study. Salivary protein composition in unstimulated whole saliva samples obtained before and after basic treatment was analyzed by SDS-PAGE.. The volume of proteins with 66 kD, 18 kD, 15 kD, 13 kD in AP group before treatment were all remarkably higher than those in NC group. In addition, 51 kD, 34 kD, 19 kD, 17 kD protein bands were more frequently observed in AP group by comparison with NC group. However, after initial therapy, all the variables mentioned above decreased remarkably.. The results demonstrated that protein bands with 18 kD, 15 kD, 13 kD might be closely related to the occurrence and recovery of periodontitis, and serum-derived proteins in saliva increased in patients with adult periodontitis.

Topics: Adult; Electrophoresis, Polyacrylamide Gel; Female; Humans; Male; Middle Aged; Periodontitis; Saliva; Salivary Proteins and Peptides; Sodium Dodecyl Sulfate

The significance of chemical and conservative treatments of cemental tissue proximal to periodontal pockets has been pointed out in recent years. This in vitro scanning electron microscopy (SEM) study aimed to investigate the surface effects of topical applications of 0.1% cetylpyridinium chloride (CPC) and 2% sodium lauryl sulfate (SLS) and polishing on the periodontally involved root surfaces of human teeth. Ten single-rooted teeth from 8 patients with advanced adult periodontitis were included. Following extraction, any calculus was removed with extreme care to preserve as much cementum as possible. Eighty root specimens were prepared. Fresh solutions of CPC and SLS were applied for 1, 3 and 5 minutes each to 10 segments of root cementum. A total of 20 segments formed the polished (P) and control (C) groups, respectively. The results showed that the surfaces treated with CPC or SLS differed considerably from polished and control specimens. Depending on time, the surface coating was partly or wholly removed, leaving a nodular cementum structure, uncovering a fibrillar collagen substrate and the openings of dentinal tubules. Scarce debris was present on both control and polished surfaces, whereas bacteria were observed only on the control specimens. In view of these results, further definitive in vitro and in vivo research must be done to determine the advantages of chemical treatment and its effect on periodontal regeneration.

Topics: Adult; Anti-Infective Agents, Local; Bacteria; Cetylpyridinium; Collagen; Dental Cementum; Dental Prophylaxis; Dentin; Humans; Microscopy, Electron, Scanning; Middle Aged; Periodontitis; Sodium Dodecyl Sulfate; Surface-Active Agents; Time Factors; Tooth Root

Matrix metalloproteinases (MMPs) are capable of cleaving almost all macromolecules of the extracellular connective tissue matrix and are thought to play a major role in tissue destructive inflammatory diseases such as periodontitis. The aim of this study was to determine the effects of siderophores, which are iron-chelating molecules produced by a variety of microorganisms, on the activity of MMP-2. Heat-denatured type I collagen (gelatin) was incubated with p-aminophenylmercuric acetate-activated MMP-2 and siderophores. Degradation of gelatin was monitored by SDS-PAGE and Coomassie blue staining. Ferrichrome, rhodotorulic acid, desferoxamine mesylate and 2,3-dihydroxybenzoic acid were found to inhibit the MMP-2 activity whereas beta-phenylpyruvic acid had no effect. The inhibition could be reversed by adding an excess calcium chloride or ferric chloride to the assay mixtures. Our study suggests that microbial siderophores may represent new-potential therapeutic molecules for the treatment of destructive inflammatory diseases involving excess MMP-2 activity, such as periodontitis.

Topics: Bacteria; Calcium Chloride; Chelating Agents; Chlorides; Chromium; Collagen; Connective Tissue; Deferoxamine; Electrophoresis, Polyacrylamide Gel; Enzyme Inhibitors; Extracellular Matrix; Ferric Compounds; Ferrichrome; Gelatinases; Humans; Hydroxybenzoates; Indicators and Reagents; Iron Chelating Agents; Macromolecular Substances; Matrix Metalloproteinase 2; Metalloendopeptidases; Periodontitis; Phenylmercuric Acetate; Phenylpyruvic Acids; Piperazines; Rosaniline Dyes; Siderophores; Sodium Dodecyl Sulfate; Sulfhydryl Reagents

The purpose of this study was to examine avidity of immunoglobulin G (IgG) antibody for surface antigens of Porphyromonas gingivalis in sera from patients with adult periodontitis. The antigens used were whole cell antigens, lipopolysaccharides (LPS), and fimbriae of non-invasive P. gingivalis ATCC 33277 and invasive 16-1. Serum IgG titers for the P. gingivalis antigens were measured by enzyme-linked immunosorbent assay (ELISA) before and after periodontal initial preparation. IgG avidity was measured by diethylamine dissociation ELISA. IgG titers for the whole cell antigens of 16-1, LPS, and the fimbria antigens from both P. gingivalis strains were significantly higher in the patient group than those in the control group, whereas values for avidities were significantly lower in patient sera. Although we found a statistically significant decrease in the IgG titers of patients following initial preparation, avidities against the fimbria antigen of invasive 16-1 strain increased. The present study showed that IgG antibodies elicited in patients were different in their ability to respond to invasive P. gingivalis 16-1 and to non-invasive 33277. The patient sera with high IgG titers demonstrated low values for avidity, suggesting that IgG responses in patients play a limited role in colonization inhibition or elimination of P. gingivalis. The data indicate that periodontally healthy individuals may have highly functional antibodies which may protect against P. gingivalis colonization. Our findings suggest that the ability to produce functional antibodies in the patient group is lower than that in the periodontally healthy group, but the functional antibodies can be induced by the initial preparation.

Topics: Adult; Antibodies, Bacterial; Antibody Affinity; Antigens, Bacterial; Antigens, Surface; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Female; Fimbriae, Bacterial; Humans; Immunoblotting; Immunoglobulin G; Lipopolysaccharides; Male; Middle Aged; Periodontitis; Periodontium; Porphyromonas gingivalis; Sodium Dodecyl Sulfate

Previous studies have shown increased susceptibility to periodontal diseases in children with Down's syndrome (DS). The mechanisms involved in the periodontal inflammatory processes in DS are not fully understood. The present study characterized the periodontal status of 9 non-institutionalized DS children 9 to 17 years old (mean 13.6 years) relative to their age-matched systemically and periodontally healthy controls. The periodontal status was assessed by visible plaque index (VPI), gingival bleeding index (GBI), and probing depth. We also assessed, by sodium dodecyl sulphate polyacrylamide gel electrophoresis/laser densitometry and by zymography, the collagenase and gelatinase activities in the gingival crevicular fluid (GCF) and saliva samples collected from DS patients and from the controls. Eight of the nine DS children showed a periodontium comparable to that seen in healthy controls; beginning alveolar bone loss was radiographically seen in the DS patient with deep periodontal pockets. The endogenously active collagenase and total collagenase activities were slightly higher in GCF of DS children compared to healthy controls. Western blot demonstrated that GCF collagenase of DS patients was human neutrophil collagenase (MMP-8 or collagenase-2), which occurred in 75 kDa proMMP-8 and in DS patients, but not in controls, also in 65 kDa active MMP-8 form and occasionally lower 40-50 kDa MMP-8 species. Zymographic analysis revealed the presence of 120 kDa (MMP-9 complexed with neutrophil gelatinase associated lipocalin or NGAL), 92 kDa (MMP-9) and 72 kDa (MMP-2) gelatinases in DS and control GCF. Especially in DS GCF MMP-9 occurred in part in 82-85 kDa activated form. Salivary collagenase in DS was high when compared to controls but of the same MMP-8 type as in control saliva. Our findings suggest that in vivo activated MMP-8 in GCF derived from triggered PMNs and/or cytokine-induced periodontal fibroblasts may reflect periodontal tissue and alveolar bone destruction seen in the early stages of gingivitis/periodontitis associated with Down's syndrome.

Topics: Adolescent; Alveolar Bone Loss; Blotting, Western; Case-Control Studies; Child; Collagenases; Densitometry; Dental Plaque Index; Disease Susceptibility; Down Syndrome; Electrophoresis, Polyacrylamide Gel; Female; Fibroblasts; Gingival Crevicular Fluid; Gingivitis; Humans; Lasers; Male; Matrix Metalloproteinase 8; Matrix Metalloproteinase 9; Neutrophils; Periodontal Index; Periodontal Pocket; Periodontitis; Radiography; Saliva; Salivary Proteins and Peptides; Sodium Dodecyl Sulfate

Immunological studies examining the homogeneity of the major antigenic components of P. gingivalis have suggested 3 serotypes and have indicated a limited distribution of the serotypes in an individual patient. These studies prompted us to define the immunodominant antigens and distribution of immune responses to P. gingivalis serotypes. Serum IgG antibody levels in periodontitis patients in the present study were most frequently elevated above the normal subjects when tested against P. gingivalis serotype A (i.e., 33277). Nearly 1/3 of the patients showed significantly elevated antibody to multiple serotypes of the P. gingivalis apparently resulting from cross-reacting antigens. We determined distinctive differences among outer envelope protein and antigen patterns obtained from the three serotypes. Moreover, the results identified considerable similarities in the qualitative and quantitative antigen response patterns among patients to a particular serotype. There was a strong positive correlation between IgG antibody levels (ELISA) and the total level of reactivity determined in the immunoblots, as well as a positive correlation to the proportion of antibody to particular antigens. These findings suggest that responses to these antigens comprised a major portion of the response to the intact microorganism. Additionally, the detection of antibody to particular antigen bands was indicative of early responses to each of the P. gingivalis serotypes. The results of our study indicate that a subpopulation of periodontitis patients develop an extensive serum antibody response often to multiple serotypes of P. gingivalis and may define a patient population with a P. gingivalis disease. Finally, our results indicate a more consistent antigenic composition for P. gingivalis which may enhance the potential for strategies to immunologically interfere with disease caused by this microorganism.

Topics: Adolescent; Adult; Aggressive Periodontitis; Antibodies, Bacterial; Antigens, Bacterial; Bacterial Outer Membrane Proteins; Blotting, Western; Cross Reactions; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin G; Male; Middle Aged; Periodontitis; Periodontium; Porphyromonas gingivalis; Serotyping; Sodium Dodecyl Sulfate

We previously reported that low-dose doxycycline (DOXY) therapy reduces host-derived collagenase activity in gingival tissue of adult periodontitis (AP) patients. However, it was not clear whether this in vivo effect was direct or indirect. In the present study, inflamed human gingival tissue, obtained from AP patients during periodontal surgery, was extracted and the extracts partially purified by (NH4)2SO4 precipitation. The extracts were then analyzed for collagenase activity using SDS-PAGE/fluorography/laser densitometry, and for gelatinase activity using type I gelatin zymography as well as a new quantitative assay using biotinylated type I gelatin as substrate. DOXY was added to the incubation mixture at a final concentration of 0-1000 microM. The concentration of DOXY required to inhibit 50% of the gingival tissue collagenase (IC50) was found to be 16-18 microM in the presence or absence of 1.2 mM APMA (an optimal organomercurial activator of latent procollagenases); this IC50 for DOXY was similar to that exhibited for collagenase or matrix metalloproteinase (MMP)-8 from polymorphonuclear leukocytes (PMNs) and from gingival crevicular fluid (GCF) of AP patients. Of interest, Porphyromonas gingivalis collagenase was also inhibited by similar DOXY levels (IC50 = 15 microM), however the collagenase activity observed in the gingival tissue extracts was found to be of mammalian not bacterial origin based on the production of the specific alpha A (3/4) and alpha B (1/4) collagen degradation fragments. In contrast, the inhibition of collagenase purified from culture media of human gingival fibroblasts (MMP-1) required much greater DOXY levels (IC50 = 280 microM). The predominant molecular forms of gelatinolytic activity presented in the AP patients gingival tissue extracts were found to closely correspond to the 92 kD PMN-type gelatinase (MMP-9) although small quantities of 72 kD fibroblast-type gelatinase (MMP-2), and some other low molecular weight gelatinases, were also detected. The IC50 of DOXY versus gingival tissue gelatinolytic activity was estimated at 30-50 microM measure using either type I gelatin zymography or the biotinylated type I gelatin assay. We conclude that MMPS in inflamed gingival tissue of AP patients, like those in GCF, originate primarily from infiltrating PMNs rather than resident gingival cells (fibroblasts and epithelial cells) or monocyte/macrophages, and that their pathologically-elevated tissue-degrading activities can be d

Topics: Adult; Cells, Cultured; Collagenases; Doxycycline; Electrophoresis, Polyacrylamide Gel; Female; Fibroblasts; Gelatinases; Gingiva; Gingival Crevicular Fluid; Humans; Male; Matrix Metalloproteinase 1; Matrix Metalloproteinase 8; Matrix Metalloproteinase Inhibitors; Neutrophils; Periodontitis; Phenylmercuric Acetate; Porphyromonas gingivalis; Sodium Dodecyl Sulfate

Alkaline phosphatase (ALPase) activity was quantitatively compared in various kinds of oral bacteria. High ALPase activity was detected in 3 species of periodontal bacteria, Porphyromonas gingivalis, Prevotella intermedia and Capnocytophaga sputigena. The ALPase activity detected in these bacteria was almost completely inhibited in the presence of 1% sodium dodecyl sulfate (SDS). By contrast, the activity of mammalian ALPase isoenzymes was not inhibited at all even in the presence of 1% SDS. These results indicate that the ALPase assay in combination with 1% SDS can identify the origin of ALPase detected in gingival crevicular fluid as being from bacteria or from a host response. Clinical examination with adult periodontitis revealed that ALPase activity in gingival crevicular fluid from the patients consisted of a combination of SDS-sensitive and SDS-resistant activities. These findings indicate that ALPase activity detected in gingival crevicular fluid originates not only from bacteria but also from a host response.

Topics: Adult; Aggregatibacter actinomycetemcomitans; Alkaline Phosphatase; Bacteria, Anaerobic; Capnocytophaga; Clinical Enzyme Tests; Gingival Crevicular Fluid; Humans; Microbial Sensitivity Tests; Periodontitis; Porphyromonas gingivalis; Prevotella intermedia; Sensitivity and Specificity; Sodium Dodecyl Sulfate; Species Specificity; Streptococcus; Surface-Active Agents

The aim of the present study was to characterize the eventual presence and molecular forms of gelatinase/type IV collagenase activities in gingival crevicular fluid (GCF) and saliva in different forms of periodontitis; patients with clinically healthy periodontium served as controls. Enzyme activities were monitored electrophoretically by zymography using gelatin and type IV collagen as substrates and analyzed visually and/or densitometrically. Both saliva and GCF collected from adult periodontitis, localized juvenile periodontitis and type II diabetes mellitus periodontitis patients contained species moving identically with gelatinase isolated from human neutrophils or MMP-9 (mean 98 kD), and species with mobility similar to gelatinase in fibroblast cell culture supernatants or MMP-2 (mean 76 kD). Hitherto, undescribed high molecular weight forms (mean 128 kD), were found, possibly representing polymerized or complexed enzyme active/activated in situ in the gel matrix. Small molecular forms of gelatinases (mean 51 kD and 46 kD), unable to cleave type IV collagen, were also found, most likely representing in vivo proteolytically activated, truncated enzymes. Although multiple forms of gelatinases/type IV collagenases in saliva and GCF may take part in the tissue destruction in periodontitis, their profile judged according to molecular weights does not differentiate between different forms of periodontitis.

Topics: Adult; Aggressive Periodontitis; Collagenases; Diabetes Mellitus, Type 2; Electrophoresis, Polyacrylamide Gel; Female; Gelatinases; Gingival Crevicular Fluid; Humans; Male; Matrix Metalloproteinase 9; Middle Aged; Molecular Weight; Periodontal Pocket; Periodontitis; Periodontium; Saliva; Sodium Dodecyl Sulfate

Elevated serum IGG antibody levels against B. gingivalis have been found in patients with periodontitis. In this study, we determined the antigenic specificity of the serum antibodies directed towards antigens of B. gingivalis. The serum samples collected from 19 control subjects with clinically healthy gingiva, 26 adult periodontitis (AP), and 21 rapidly progressive periodontitis (RPP) patients were analyzed by using SDS-PAGE and Western blots. The sonicated cell extract of B. gingivalis 381 was solubilized in sodium dodecyl sulfate solution by heating at 100 degrees C for 5 minutes. After SDS-PAGE, the proteins were transferred to nitrocellulose membrane, and then were probed with serum samples. The strong reaction observed at the apparent molecular weight of 44 kDa protein suggested that it might be an important component which was specific to the antibody of patients (P less than 0.01). A clear difference in the antibody binding between the serum samples from AP and RPP was also recognized. The antibodies from AP frequently reacted with high molecular weight proteins (82, 57, and 44 kDa) while those from RPP frequently reacted with lower molecular weight proteins (44, 27, 25, and 18 kDa). The results indicate that the antigenic components detected in B. gingivalis are in sufficient amounts and specificities to be immunogenic to the host, particularly in patients with periodontitis.

Topics: Adolescent; Adult; Aged; Antibodies, Bacterial; Antibody Specificity; Antigens, Bacterial; Bacteroides; Blotting, Western; Bone Resorption; Electrophoresis, Polyacrylamide Gel; Female; Humans; Immunoglobulin G; Male; Middle Aged; Molecular Weight; Periodontitis; Sodium Dodecyl Sulfate

The molecular forms of fibronectin (FN) in gingival crevicular fluid of five subjects with at least two sites exhibiting clinical signs of inflammation and pockets of at least 4 mm (test group) and five subjects with clinically healthy periodontium (control group) were investigated. Samples were collected with standard filter paper strips. In the test group samples from both diseased and healthy sites were collected. After collection the test group received one episode of periodontal treatment (scaling and root planning). The sampling and clinical recording were repeated for the diseased sites after about 2 wk. The crevicular fluid FN was analyzed using sodium dodecyl sulphate gel electrophoresis followed by western blotting with polyclonal antibodies against FN. Both intact FN and FN fragments were found in all samples. A larger proportion of FN was in degraded form in the diseased sites than in the healthy or the treated sites. FN was also degraded into smaller peptide fragments in the diseased than in the treated sites. These results suggest that crevicular fluid FN is partially degraded both in periodontal health and disease and that the degree of degradation of FN increases with periodontal inflammation and decreases with periodontal treatment.

Topics: Adult; Blotting, Western; Electrophoresis, Polyacrylamide Gel; Female; Fibronectins; Gingival Crevicular Fluid; Gingival Pocket; Gingivitis; Humans; Male; Middle Aged; Periodontitis; Periodontium; Sodium Dodecyl Sulfate

Topics: Bacterial Proteins; Electrophoresis, Polyacrylamide Gel; Humans; Periodontitis; Sodium Dodecyl Sulfate; Treponema

In the gingiva and other connective tissues, alteration in the collagens is primarily responsible for their functional impairment during disease. To study the collagen alterations, we extracted diseased human gingival tissue with neutral and acidic solvents and then with pepsin. The pepsin extract was separated into proteins soluble in 2.5 and 1.5 M NaCl and proteins insoluble in 1.5 M NaCl. By the criteria of solubility behavior in NaCl solutions, elution from (carboxymethyl)cellulose (CM-cellulose) columns, sodium dodecyl sulfate (NaDodSO4)-polyacrylamide gel electrophoresis, CNBr peptide pattern, and amino acid composition, the collagens of acidic and neutral solvent extracts and 1.5 M soluble fraction of pepsin extract were characterized as type I collagen and the 1.5 M NaCl insoluble collagen as type III. The 2.5 M NaCl fraction contained alpha 2, A, and B chains. The alpha 1 chains resembled alpha 1[I] in amino acid composition, and, since alpha 2 chains were lacking, it appeared that these chains derived from type I trimer collagen. The A and B chains were purified from the 2.5 M NaCl fractions by salting out at acidic pH. The final (A plus B) chain fraction was resolved into two major and one minor protein peaks by phosphocellulose chromatography. The major peaks were characterized as A and B chains on the basis of amino acid composition and CNBr peptide patterns. The minor peak had electrophoretic mobility slightly less than B chains, and the amino acid composition was different. Analysis of the proportion of different collagen types extracted indicated that type III collagen, which is the second major fraction in other connective tissues, is only a minor constituent in the gingiva. More interestingly, A and B chains accounted for a greater proportion than type III. Unlike the fibroblast cultures, the type I trimer formed only a small proportion of collagens of diseased gingival tissue.

Topics: Acetates; Amino Acids; Chromatography, Ion Exchange; Collagen; Electrophoresis, Polyacrylamide Gel; Gingiva; Humans; Periodontitis; Skin; Sodium Chloride; Sodium Dodecyl Sulfate