Salivary human beta-defensins and cathelicidin levels in relation to periodontitis and type 2 diabetes mellitus

Objective: Type 2 diabetes mellitus (T2DM) is a well-defined risk factor of periodontitis and it can affect expression of human beta-defensins (hBDs) and cathelicidin (LL-37) as well. The aim of the present study was to evaluate the impact of periodontitis and T2DM on salivary concentrations of these antimicrobial peptides.Material and methods: Unstimulated saliva samples, together with full-mouth periodontal recordings were collected from 92 individuals with periodontitis (63 with T2DM and 21 smokers) and 86 periodontally healthy controls (58 with T2DM and 21 smokers). Salivary hBD-1, -2, -3, LL-37, and advanced glycalization end products (AGE) concentrations were measured by enzyme-linked immunosorbent assay.Results: Among the periodontitis patients, T2DM group demonstrated lower levels of hBD-1 (p = .006), hBD-2 (p p p p = .002) and LL-37 (p Conclusion: In the limits of this study, hyperglycaemia can be proposed as a regulator of salivary hBD and cathelicidin levels. Periodontitis, on the other hand, affects only salivary LL-37 levels.</p

Estetik Zonda Gerçekleştirilen Dental Implant Uygulamalarına İlişkin Hasta Memnuniyetinin Değerlendirilmesi

The aims of the present study were; to evaluate dental implant patients' general level of satisfaction and the various parameters that have a potential impact on satisfaction level and quality of life. The present study also aimed to evaluate the possible differences in the aesthetic perception between patients, dentists, and dental specialists. A total of 103 patients, who were provided with dental implant treatment between years 2003-2011 were volunteered to participate. A total of 164 implant-supported fixed prothesis and 264 dental implant sites in the anterior esthetic zone were included. During the routine examination probing depth (PD), plaque index (PI), gingival index (GI), presence of bleeding on gentle probing (BOP) and gingival recession (GR) were recorded. Marginal bone levels were evaluated by periapical radiographs using parallelling technique. Oral health related quality of life was measured by Oral Health Impact Profile-14 (OHIP-14) questionnare and supported with VAS questionnare to evaluate patient satisfaction, esthetics and how patients perceived their implant-supported fixed partial dentures. Besides patients, esthetics features of the implant-supported prothesis were also comparetively evaluated by one periodontist, one prosthodontist and one orthodontist. Dentists used visual analog scale (VAS) to evaluate all implant-supported fixed prothesis and also Pink Esthetic Score/White Esthetic Score (PES/WES) for implant-supported single tooth restorations. The mean patient satisfaction score was 87.42 ± 11.86. OHIP scores, patient satisfaction, chewing and speech comfort, cleanability, phonetics, patient expectations, willingness to go under the same treatment or suggestion to friends/relatives have been shown to be unaffected by age and gender variables. Individuals who have implant-supported bridge are shown to be more dissatisfied about pre-treatment information regarding surgery, cleaning ability, phonetics, discomfort regarding surgery and have higher OHIP scores compared to single-tooth restorations. Patients who had been provided with hard/soft tissue augmentation have significantly higher overall satisfaction scores, on the other hand these patients are shown to avoid cleaning their implant-supported restorations compared to their non-augmented counterparts. In the present study no correlation was found between patient and dentist esthetic VAS scores. When the mean esthetic VAS scores were considered, orthodontist had significantly lower scores compared to periodontist and prosthodontist. Dentists' esthetics VAS scores were significantly lower for implant-supported bridge group and implants with a history of periodontitis. Although significantly lower PES scores for periodontist, lower WES scores for prosthodontist were detected, overall PES/WES scores did not significantly differ among the observers. Inter-observer agreement was found to be 47% for VAS scores, and 86% for PES/WES scores. When the high VAS scores and low OHIP scores were considered, it can be concluded that, patients with fixed implant-supported restorations in the esthetic zone have high satisfaction rates and good oral health related quality of life. In the limits of the present study, it can be suggested that type of prosthesis, presence of soft/hard tissue augmentation, augmentation type, reason for tooth loss may have an impact on patient satisfaction and esthetic perception.Çalışmamızın amacı; dental implant uygulanan hastaların genel memnuniyet düzeyini ve bu memnuniyet düzeyi ve yaşam kalitesine etki eden çeşitli ölçütleri aynı çalışma dizaynı kapsamında değerlendirmek, estetik algının profesyonel branşlara, farklı hekimlere ve hastalara göre olası farklılığını incelemektir. Çalışmamıza 2003-2011 yılları arasında fakültemiz Periodontoloji A.D.'da anterior parsiyel dişsizlik nedeniyle dental implant tedavisi gören toplam 103 hasta, 164 implant destekli sabit protez ve 246 implant alanı dahil edilmiştir. Hastaların rutin kontrolleri sırasında peri-implant sondlama derinliği (PD), plak indeksi (PI) ve gingival indeks (GI) değerleri, sondlamada kanama (SK) varlığı, dişeti çekilmesi (DÇ) miktarı kaydedilmiştir. Paralel teknikle radyograflar alınarak implant etrafındaki marjinal kemik seviyesi değerlendirmeleri yapılmıştır. Her hastaya Ağız Sağlığı Etki Profili-14 (OHIP-14, Oral Health Impact Profile-14) anketi uygulanarak ağız sağlığı ile ilgili yaşam kalitesi ölçümü, çeşitli görsel analog skala (VAS, Visual Analog Scale) soruları yönelterek hasta memnuniyeti ve estetik değerlendirme gerçekleştirilmiştir. İmplant destekli restorasyon estetiği hastaların haricinde, bir periodontist, bir prostodontist ve bir ortodontist tarafından da değerlendirilmiştir. Hekimler estetik değerlendirmelerini, tüm restorasyonlar için VAS ve tek diş restorasyonlar için Pembe Estetik Skor/Beyaz Estetik Skor (PES/BES, Pink Esthetic Score/White Esthetic Score, PES/WES) kullanarak gerçekleştirmiştir. Hastaların ortalama memnuniyet skoru 87.42±11.86'dır. OHIP skorları, hasta memnuniyeti, çiğneme ve konuşma rahatlığı, temizlenebilirlik, fonetik, hasta beklentisi, tekrar implant yaptırma veya bir yakınına önerme isteğinin yaş ve cinsiyet faktörlerinden etkilenmediği gözlemlenmiştir. İmplant destekli köprüye sahip bireylerin, tek diş restorasyonlarla kıyaslandığında, tedavi öncesi yapılan bilgilendirmenin yetersiz olduğunu düşündükleri, protezlerini temizlerken zorlandıkları, konuşurken kendilerini rahatsız hissetikleri, cerrahi aşamayı rahatsız edici buldukları ve daha düşük yaşam kalitesine sahip oldukları gösterilmiştir. Sert doku ve/veya yumuşak doku ogmentasyonu yapılan bireylerin genel memnuniyet skorlarının ogmentasyon yapılmayan bireylere kıyasla daha fazla olduğu ancak bu hastaların zarar vereceği düşüncesiyle implantlarını temizlemekten kaçındıkları gösterilmiştir. Hasta ve hekimlerin estetik skorları arasında anlamlı bir korelasyon tespit edilememiştir. Hastaların estetik VAS skorları hekimlere kıyasla anlamlı derecede daha düşük bulunmuştur. Hekimlerin ortalama skorları göz önüne alındığında ortodontistin ortalama estetik skorunun diğer iki hekime göre daha düşük olduğu tespit edilmiştir. Hekimlerin estetik skorunun köprü tip restorasyonlar ve periodontal nedenle diş kaybı söz konusu olduğunda daha düşük olduğu saptanmıştır. PES skoru açısından en düşük skoru periodontistin, BES skoru açısından en düşük skoru protez uzmanının vermiş olmasına rağmen, toplam PES/BES skorları açısından hekimler arasında fark bulunamamıştır. Gözlemciler arası uyum VAS skorları açısından %47, PES/BES skorları açısından %86 olarak bulunmuştur. Elde edilen VAS ve OHIP skorları göz önüne alındığında estetik zonda implant destekli sabit protetik restorasyona sahip bireyler oldukça yüksek memnuniyete ve iyi yaşam kalitesine sahip olduğu söylenebilir. Bu çalışmanın limitleri dahilinde protez tipi, ogmentasyon varlığı ve tipi, diş kayıp nedeninin hastanın memnuniyetini ve estetik algısını etkileyebileceği önerilebilir

Salivary human beta-defensins and cathelicidin levels in relation to periodontitis and type 2 diabetes mellitus

Objective: Type 2 diabetes mellitus (T2DM) is a well-defined risk factor of periodontitis and it can affect expression of human beta-defensins (hBDs) and cathelicidin (LL-37) as well. The aim of the present study was to evaluate the impact of periodontitis and T2DM on salivary concentrations of these antimicrobial peptides. Material and methods: Unstimulated saliva samples, together with full-mouth periodontal recordings were collected from 92 individuals with periodontitis (63 with T2DM and 21 smokers) and 86 periodontally healthy controls (58 with T2DM and 21 smokers). Salivary hBD-1, -2, -3, LL-37, and advanced glycalization end products (AGE) concentrations were measured by enzyme-linked immunosorbent assay. Results: Among the periodontitis patients, T2DM group demonstrated lower levels of hBD-1 (p = .006), hBD-2 (p < .001) and hBD-3 (p < .001), and higher levels of LL-37 (p < .001) compared to systemically healthy controls. When only periodontally healthy controls were included into the analysis, higher hBD-1 (p = .002) and LL-37 (p < .001) levels were found in T2DM patients in comparison to systemically healthy controls. Salivary LL-37 levels were associated with HbA1c and periodontitis, while hBD-2, hBD-3 and levels associated only with HbA1c. Conclusion: In the limits of this study, hyperglycaemia can be proposed as a regulator of salivary hBD and cathelicidin levels. Periodontitis, on the other hand, affects only salivary LL-37 levels

Nitrite And Nitrate Levels Of Gingival Crevicular Fluid And Saliva In Subjects With Gingivitis And Chronic Periodontitis

Objectives Nitrosative stress plays an essential role in the pathogenesis of periodontal disease. The aim of this study is to analyze the gingival crevicular fluid and saliva nitrite and nitrate levels in periodontally healthy and diseased sites. Material and Methods A total of 60 individuals including, 20 chronic periodontitis and 20 gingivitis patients and 20 periodontally healthy controls participated in the present study. Probing depth, clinical attachment level, bleeding on probing, gingival index and plaque index were assessed, gingival crevicular fluid (GCF) and saliva samples were obtained from the subjects, including 480 GCF samples and 60 unstimulated whole saliva samples. Nitrite and nitrate were analyzed by Griess reagent. Results Total GCF nitrite levels were higher in gingivitis and periodontitis groups (1.07 [SD 0.62] nmol and 1.08 [SD 0.59] nmol) than the control group (0.83 [SD 0.31] nmol) (P 0.05). The difference in GCF nitrate level was not significant among the control, gingivitis and periodontitis groups (7.7 [SD 2.71] nmol, 7.51 [SD 4.16] nmol and 7.38 [SD 1.91] nmol). Saliva nitrite and nitrate levels did not differ significantly among three study groups. Saliva nitrate/nitrite ratios were higher in periodontitis and gingivitis groups than the control group. A gradual decrease in nitrate/nitrite ratio in GCF was detected with the presence of inflammation. Conclusions It may be suggested that nitrite in gingival crevicular fluid is a better periodontal disease marker than nitrate and may be used as an early detection marker of periodontal inflammation, and that local nitrosative stress markers don’t show significant difference between the initial and advanced stages of periodontal disease.PubMe