Expression of endocan and vascular endothelial growth factor in recurrent minor aphthous ulcers

Background: Recurrent aphthous ulcers (RAU) are common painful inflammatory lesions of the mucous lining of the mouth. Endocan, previously identified as endothelial cell specific molecule-1, is implicated as a vital player in the regulation of several inflammatory processes. A number of inflammatory cytokines and pro-angiogenic growth factors including VEGF upregulate endothelial cells synthesis and expression of endocan. Material and Methods: Clinical scores of pain and ulcer size as well as level of endocan and VEGF were determined in swaps from aphthous ulcer and contra lateral normal mucosa in 30 patients (nine males and twenty one females) with age ranging from 18 to 45 years and mean age is 31.5 years. Results: In the early days of ulcer development, ulcer showed statistically significantly higher mean endocan (8.2 ±5.3) and VEGF levels (1220.7 ±294.6) than control healthy mucosal site (1.1 ±0.5) and (518.6 ± 61.7) respectively. An increase in endocan is associated with an increase in pain score and vice versa. A statistically significant positive correlation were also found between endocan and VEGF levels. Conclusions: Endocan and VEGF are strongly associated with the destructive phase of minor aphthous ulcers especially Endocan which was positively correlated with pain severit

Evaluation of Local and Systemic Levels of Vitamin D3 and Fibroblast Growth Factor 23 After Non-Surgical Periodontal Therapy

Background: Vitamin D is an important micronutrient possessing valuable and diverse biological effects that are related to periodontal disease pathogenesis. Vitamin D levels are regulated by fibroblast growth factor 23 (FGF23) which is strongly associated with inflammation. The aim of the present study was to explore the relation of vitamin D and FGF23 with periodontal disease through the assessment of their levels in gingival crevicular fluid (GCF) and serum in periodontitis patients before and after non-surgical periodontal therapy and to compare those levels with healthy controls in order to identify any possible correlation between them. Methods: Serum and GCF samples were collected at baseline and 3 months after therapy to evaluate levels of vitamin D3 and FGF23 using enzyme-linked immunosorbent assay (ELISA) in both study groups. Group I consisted of 15 controls who were systematically and periodontally healthy, while group II consisted of 15 subjects who were systematically healthy with stage II periodontitis. Results: A significant elevation in vitamin D3 levels in both GCF and serum were recorded 3 months after therapy with a 25.98% and 39.29% increase respectively. On the contrary, a significant reduction in mean values of FGF23 in both GCF and serum were found after treatment with a 49.75% and 39.28% decrease respectively. Conclusion: The results of the present investigation have shed light on a vital association of both FGF23 and vitamin D3 with periodontitis, where FGF23 is associated with periodontal inflammation and vitamin D3 is associated with periodontal health.

Effect of Locally Delivered Melatonin as an Adjunct to Nonsurgical Therapy on GCF Antioxidant Capacity and MMP-9 in Stage II Periodontitis Patients: A Randomized Controlled Clinical Trial

Objectives. Periodontitis is characterized by inflammatory destruction of periodontal tissue, loss of attachment, and bone resorption. The increase in reactive oxygen species (ROS) is responsible for the oxidative damage occurring in periodontal tissues. Melatonin has important immunomodulatory, anti-inflammatory, and powerful antioxidant functions. The current study was carried out to evaluate the effect of topical melatonin gel as an adjunct to nonsurgical periodontal therapy. Methods. This split-mouth randomized controlled clinical trial was performed on 24 patients with grade II periodontitis. Two sites in each patient were randomly assigned; test sites were treated by nonsurgical therapy followed by intrapocket application of 5% melatonin gel. Control sites were treated by nonsurgical therapy followed by intrapocket application of placebo gel. Both the melatonin and placebo gel were applied weekly once for four weeks. Assessment of clinical parameters (PD and CAL) was done at baseline and 3 months after therapy. Total antioxidative capacity (TAC) and matrix metalloproteinase-9 (MMP-9) levels in GCF were also evaluated utilizing commercially available enzyme-linked immunosorbent assay kits (ELISA) at baseline and 3 months after therapy. Results. Treatment with topical melatonin was associated with a reduction in periodontal inflammation reflected as an improvement in the clinical periodontal parameters. Melatonin-treated sites showed a more statistically significant percent reduction in PD and more statistically significant percent gain in CAL than the control site. Additionally, a significant increase in TAC and a significant decrease in MMP-9 levels in GCF were found in melatonin-treated sites in comparison to control sites. Conclusions. The adjunctive use of topical melatonin gel with nonsurgical periodontal therapy has potent anti-inflammatory and antioxidant activity in the treatment of grade II periodontitis patients

Effect of Using a Plastic Stent with Apically Repositioned Flap in Peri-Implant Soft Tissue Augmentation: A Randomized Controlled Clinical Trial

Objectives. This study aimed to clinically assess and compare the width of peri-implant keratinized mucosa following the use of a readymade plastic stent with apically repositioned flap versus conventional apically repositioned flap with papillary sparing incisions during single-stage implant placement protocol. Materials and Methods. A total of 20 patients were enrolled in this study. In the test group, a prefabricated implant-retained stent was clipped on the healing abutment after implant surgery to reposition the keratinized tissue buccoapically. In the control group, simple interrupted sutures were applied instead of using a stent. After the surgical procedure, the width of the buccal keratinized mucosa was measured at the mesial, middle, and distal aspects of the healing abutment. The change in the width of the buccal keratinized mucosa was assessed at 3 months and 6 months. Results. No statistically significant difference was found between the stent group and control group in 6 months’ interval where p=0.840, where both groups showed the same mean value of 4.70 ± 0.35 and 4.70 ± 0.63, respectively. The percent of change in the width of KM was found to be higher in the stent group than in the control group with no statistical significance. Conclusion. The use of a readymade plastic stent in combined full/partial-thickness apically repositioned flap shows to be effective in increasing the width of KM compared to the conventional technique. This trial is registered with NCT03754894