Clinical attachment loss and molecular profile of inflamed sites before treatment

Objective: To monitor early periodontal disease progression and to investigate clinical and molecular profile of inflamed sites by means of crevicular fluid and gingival biopsy analysis. Methodology: Eighty-one samples of twenty-seven periodontitis subjects and periodontally healthy individuals were collected for the study. Measurements of clinical parameters were recorded at day −15, baseline and 2 months after basic periodontal treatment aiming at monitoring early variations ofthe clinical attachment level. Saliva, crevicular fluid and gingival biopsies were harvested from clinically inflamed and non-inflamed sites from periodontal patients and from control sites of healthy patients for the assessment of IL-10, MMP-8, VEGF, RANKL, OPG and TGF-β1 protein and gene expression levels. Results:Baseline IL-10 protein levels from inflamed sites were higher in comparison to both non-inflamed and control sites (p<0.05). Higher expression of mRNA for IL-10, RANK-L, OPG, e TGF-β1 were also observed in inflamed sites at day −15 prior treatment (p<0.05). After the periodontal treatment and the resolution of inflammation, seventeen percent of evaluated sites still showed clinically detectable attachment loss without significant differences in the molecular profile. Conclusions: Clinical attachment loss is a negative event that may occur even after successful basic periodontal therapy, but it is small and limited to a small percentage of sites. Elevated inflammation markers of inflamed sites from disease patients reduced to the mean levels of those observed in healthy subjects after successful basic periodontal therapy. Significantly elevated both gene and protein levels of IL-10 in inflamed sites prior treatment confirms its modulatory role in the disease status

New tendencies in non-surgical periodontal therapy

The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies

Effects of platelet-rich fibrin produced by three centrifugation protocols on bone neoformation in defects created in rat calvaria.

This study evaluated the potential of Leukocyte-platelet-rich fibrin (L-PRF; fixed angle centrifugation protocol), Advanced-platelet-rich fibrin (A-PRF; low-speed fixed angle centrifugation protocol), and Horizontal-platelet-rich fibrin (H-PRF; horizontal centrifugation protocol) in bone neoformation in critical size defects (CSDs) in rat calvaria. Thirty-two rats were divided into groups: Control (C), L-PRF, A-PRF, and H-PRF. 5 mm diameter CSDs were created in the animals' calvaria. Defects from group Control (C) were filled with blood clots, while defects from groups L-PRF, A-PRF, and H-PRF were filled with respective platelet-rich fibrin (PRF) membranes. L-PRF, A-PRF, and H-PRF were prepared from animal blood collection and specific centrifugation protocols. At 14 and 30 days, calcein (CA) and alizarin (AL) injections were performed, respectively. Animals were euthanized at 35 days. Microtomographic, laser confocal microscopy, and histomorphometric analyzes were performed. Data were statistically analyzed (ANOVA, Tukey, p < .05). L-PRF, A-PRF, and H-PRF groups showed higher values of bone volume (BV), newly formed bone area (NFBA), and precipitation of CA and AL than the C group (p < .05). The H-PRF group showed higher values of BV, number of trabeculae (Tb. N), NFBA, and higher precipitation of AL than the A-PRF and L-PRF groups (p < .05). Therefore, it can be concluded that: i) L-PRF, A-PRF, and H-PRF potentiate bone neoformation in CSDs in rat calvaria; ii) H-PRF demonstrated more biological potential for bone healing

Cicatrização de enxertos de osso alógeno fresco congelado (OAFC) associados ou não ao plasma rico em plaquetas (PRP): estudo histológico e histométrico em mandíbulas de cães

O propósito deste estudo foi avaliar, histologicamente, a cicatrização de enxertos de osso alógeno fresco congelado (OAFC) associados ou não ao plasma rico em plaquetas (PRP) em defeitos ósseos criados cirurgicamente em mandíbulas de cães. Defeitos ósseos bilaterais, medindo 1,5 cm de largura x 1 cm de altura, foram criados na borda inferior da mandíbula de 10 cães adultos machos. Os defeitos foram divididos em 3 grupos experimentais: C (controle), OAFC, OAFC/PRP. No Grupo C (n=7), os defeitos foram preenchidos apenas com coágulo sangüíneo. No Grupo OAFC (n=7), os defeitos foram preenchidos com enxertos de OAFC. No Grupo OAFC/PRP (n=6), os defeitos foram preenchidos com enxertos de OAFC associados ao PRP. A eutanásia dos animais foi realizada em 12 semanas pós-operatórias. Foram realizadas análises histológica e histométrica. Os dados foram analisados estatisticamente (ANOVA, Tukey, p < 0,05). Nenhum defeito regenerou completamente com tecido ósseo. Os enxertos de OAFC foram bem incorporados. A quantidade média de osso neoformado e os desvios-padrão dos Grupos C, OAFC e OAFC/PRP foram 70,55 8,01%, 71,31 14,36% e 65,57 11,55%, respectivamente. Não foram observadas diferenças estatisticamente significativas entre os grupos (ANOVA, p = 0,642). Os enxertos de OAFC foram biocompatíveis e bem incorporados, mas não proporcionaram maior formação óssea que os defeitos controle em mandíbulas de cães. O uso do PRP não promoveu nenhum benefício adicional à cicatrização desses enxertos em 12 semanas pós-operatórias.The purpose of this study was to histologically analyze the healing of fresh frozen bone allograft (FFBA) with or without platelet-rich plasma (PRP) in bony defects surgically created in mandible of dogs. Bilateral bony defects, measuring 1.5 cm in width vs. 1 cm in height, were created in the inferior border of the mandible of 10 adult male dogs. The defects were divided into three groups: C (control), FFBA and FFBA/PRP. In Group C (n=7), the defect was filled with blood clot only. In Group FFBA (n=7), the defect was filled with FFBA. In Group FFBA/PRP (n=6), the defect was filled with FFBA combined with PRP. All animals were euthanized at 12 weeks post-operative. Histologic and histometric analyses were performed. Data were statistically analyzed (ANOVA, Tukey, p < 0.05). No defect completely regenerated with bone. The FFBA was well incorporated. The mean percentage of newly formed bone and the standard-deviations of Groups C, FFBA and FFBA/PRP were 70.55 8.01%, 71.31 14.36% and 65.57 11.55%, respectively. Statistically significant differences were not found among the groups (ANOVA, p = 0,642). FFBA were biocompatible and well incorporated. However, these grafts did not promote a greater bone formation than the control defects in mandible of dogs. The use of PRP promoted no additional benefit to the healing of these grafts at 12 weeks post-operative

Probiotic therapy reduces inflammation and improves intestinal morphology in rats with induced oral mucositis

Abstract The aim of the present study was to evaluate the effect of systemic administration of probiotics (PROB) on the progression of experimentally induced oral and intestinal mucositis in rats immunosuppressed by chemotherapy (5-fluorouracil: 5-FU). Twenty-four rats were divided into the following groups (n=6): GC (control), GPROB, G5FU and G5-FU/PROB. Groups GPROB and G5-FU/PROB received 1 g of probiotic incorporated into each 100 g of feed (Bacillus subtilis, Bifidobacterium bifidum, Enterococcus faecium and Lactobacilllus acidophilus), beginning 30 days before oral mucositis induction. Groups G5FU and G5-FU/PROB received 60 mg/kg of 5-FU on days 0 and 2. The left oral mucosa of each animal was irritated by mechanical trauma (days 1 and 2). On days 3 and 7, three animals from each group were sacrificed, and their oral mucosa and small intestine were biopsied and processed for histopathological analysis. Groups G5-FU and G5-FU/PROB showed ulcerated oral lesions at day 3, with progression in group G5-FU and regression in group G5-FU/PROB at day 7. Histologically, less severe signs of inflammation in the oral mucosa were observed in group G5-FU/PROB than in group G5-FU. Regarding the intestine, villus-related defects of lesser magnitude were observed in group G5-FU/PROB, compared with group G5-FU. Group GPROB showed greater villus height than group GC. It can be concluded that probiotic supplementation reduced oral and intestinal inflammation in immunosuppressed rats with experimentally induced mucositis, and may protect the intestine from changes induced by chemotherapy, thus contributing to overall health

A standartized research protocol for platelet-rich plasma (PRP) preparation in rats

Introduction: The urgent need for studies using standardized protocols to evaluate the real biological effects of PRP has been emphasized by several authors. Objective: The purpose of this study was to standardize a methodology for autologous Platelet-Rich Plasma (PRP) preparation in rats. Material and methods: Twentyfour, 5 to 6-month-old, male rats, weighing 450 to 500 g were used. After general anesthesia, 3.15 ml of blood was collected from each animal, via cannulation of the jugular vein. A standardized technique of double centrifugation was used to prepare PRP. PRP samples and peripheral blood platelets were then manually counted using a Neubauer chamber. Student’s t-test was used to compare the differences between the number of platelets in peripheral blood and PRP samples (p < 0.05). In addition, PRP and peripheral blood smears were stained to see platelets’ morphology. Results: All surgical procedures were well tolerated by the animals and they were healthy during the entire experimental period. PRP samples showed higher significantly platelet concentrations than peripheral blood samples (2,677,583 and 683,680 respectively). Conclusion: Within the limits of this study, it can be concluded that the method used produced autologous PRP with appropriated platelet quantity and quality, in rats