Antibodies against Porphyromonas gingivalis in serum and saliva and their association with rheumatoid arthritis and periodontitis. Data from two rheumatoid arthritis cohorts in Sweden

BackgroundPeriodontitis and oral pathogenic bacteria can contribute to the development of rheumatoid arthritis (RA). A connection between serum antibodies to Porphyromonas gingivalis (P. gingivalis) and RA has been established, but data on saliva antibodies to P. gingivalis in RA are lacking. We evaluated antibodies to P. gingivalis in serum and saliva in two Swedish RA studies as well as their association with RA, periodontitis, antibodies to citrullinated proteins (ACPA), and RA disease activity.MethodsThe SARA (secretory antibodies in RA) study includes 196 patients with RA and 101 healthy controls. The Karlskrona RA study includes 132 patients with RA ≥ 61 years of age, who underwent dental examination. Serum Immunoglobulin G (IgG) and Immunoglobulin A (IgA) antibodies and saliva IgA antibodies to the P. gingivalis–specific Arg-specific gingipain B (RgpB) were measured in patients with RA and controls.ResultsThe level of saliva IgA anti-RgpB antibodies was significantly higher among patients with RA than among healthy controls in multivariate analysis adjusted for age, gender, smoking, and IgG ACPA (p = 0.022). Saliva IgA anti-RgpB antibodies were associated with RA disease activity in multivariate analysis (p = 0.036). Anti-RgpB antibodies were not associated with periodontitis or serum IgG ACPA.ConclusionPatients with RA had higher levels of saliva IgA anti-RgpB antibodies than healthy controls. Saliva IgA anti-RgpB antibodies may be associated with RA disease activity but were not associated with periodontitis or serum IgG ACPA. Our results indicate a local production of IgA anti-RgpB in the salivary glands that is not accompanied by systemic antibody production

Diagnosis and non-surgical treatment of peri-implant diseases and maintenance care of patients with dental implants - Consensus report of working group 3

The following consensus report is based on four background reviews. The frequency of maintenance visits is based on patient risk indicators, homecare compliance and prosthetic design. Generally, a 6-month visit interval or shorter is preferred. At these visits, peri-implant probing, assessment of bleeding on probing and, if warranted, a radiographic examination is performed. Diagnosis of peri-implant mucositis requires: (i) bleeding or suppuration on gentle probing with or without increased probing depth compared with previous examinations; and (ii) no bone loss beyond crestal bone level changes resulting from initial bone remodelling. Diagnosis of peri-implantitis requires: (i) bleeding and/or suppuration on gentle probing; (ii) an increased probing depth compared with previous examinations; and (iii) bone loss beyond crestal bone level changes resulting from initial bone remodelling. If diagnosis of disease is established, the inflammation should be resolved. Non-surgical therapy is always the first choice. Access and motivation for optimal oral hygiene are key. The patient should have a course of mechanical therapy and, if a smoker, be encouraged not to smoke. Non-surgical mechanical therapy and oral hygiene reinforcement are useful in treating peri-implant mucositis. Power-driven subgingival air-polishing devices, Er: YAG lasers, metal curettes or ultrasonic curettes with or without plastic sleeves can be used to treat peri-implantitis. Such treatment usually provides clinical improvements such as reduced bleeding tendency, and in some cases a pocket-depth reduction of --1 mm. In advanced cases, however, complete resolution of the disease is unlikely.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151295/1/idj12490_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151295/2/idj12490.pd

Water and ethanol extracts of Plantago major leaves show anti-inflammatory activity on oral epithelial cells

Context: The leaves of Plantago major have been used for the treatment of wounds and inflammation in folk medicine from prehistoric times. However there is no report on the use of P. major to treat inflammation in oral epithelial cell lines. Objective: The present study was undertaken to reveal possible anti-inflammatory effects of Plantago major leaf extracts on oral epithelial cells in-vitro. Materials and methods: Water- and ethanol-based extracts of P. major leaves were prepared from freezedried plant material, and tested in-vitro using the oral epithelial cell line H400. The anti-inflammatory activity of P. major was tested against E. coli lipopolysaccharide (LPS) using the nuclear factor kappa beta (NF-kB) assay. Results: Both the water- and the ethanol-based extracts, as well as a combination of the two extracts, showed anti-inflammatory activity. A concentration of 0.1 mg/mL (on dry weight basis) yielded the best results for all extracts. Discussion and conclusion: The results show that synergistic effects of both polyphenols and watersoluble compounds (possibly polysaccharides) are responsible for anti-inflammatory activities of P. major

Consumption of bilberries controls gingival inflammation

Bioactive molecules in berries may be helpful in reducing the risk of oral diseases. The aim of this study was to determine the effect of bilberry consumption on the outcome of a routine dental clinical parameter of inflammation, bleeding on probing (BOP), as well as the impact on selected biomarkers of inflammation, such as cytokines, in gingival crevicular fluid (GCF) in individuals with gingivitis. Study individuals who did not receive standard of care treatment were allocated to either a placebo group or to groups that consumed either 250 or 500 g bilberries daily over seven days. The placebo group consumed an inactive product (starch). A study group, receiving standard of care (debridement only) was also included to provide a reference to standard of care treatment outcome. Cytokine levels were assayed using the Luminex MagPix system. The mean reduction in BOP before and after consumption of test product over 1 week was 41% and 59% in the groups that consumed either 250 or 500 g of bilberries/day respectively, and was 31% in the placebo group, and 58% in the standard of care reference group. The analysis only showed a significantreduction in cytokine levels in the group that consumed 500 g of bilberries/day. A statistically significant reduction was observed for IL-1β (p = 0.025), IL-6 (p = 0.012) and VEGF (p = 0.017) in GCF samples in the group that consumed 500 g of bilberries daily. It appears that berry intake has an ameliorating effect on some markers of gingival inflammation reducing gingivitis to a similar extent compared to standard of care

Systemic inflammatory impact of periodontitis on acute coronary syndrome

Aim: A causative relationship between acute coronary syndrome (ACS) and periodontitis has yet to be defined. The aim of this study was to assess differences in levels of serum cytokines between individuals with or without ACS or periodontal comorbidity. Material and Methods: In a case–control study, individuals with ACS (78 individuals, 10.3% females) and matching healthy controls (78 individuals, 28.2% females) were included. Medical and dental examinations were performed to diagnose ACS and periodontitis. Serum levels of cytokines were assessed, using Luminex technology. Results: A diagnosis of periodontitis in the ACS and control group was diagnosed in 52.6% and 12.8% of the individuals, respectively. The unadjusted odds-ratio that individuals with ACS also had periodontitis was 7.5 (95% CI: 3.4, 16.8,

Porównanie występowania bakterii szpitalnej w gardle środkowym i górnych drogach oddechowych przy zastosowaniu dwóch metod pielęgnacji jamy ustnej: badania na próbie losowej

Introduction. To compare changes in oral and respiratory nosocomial colonization during the first week of mechanical ventilation in adult Neuroscience ICU patients randomized to a standard or comprehensive oral care protocol. Development of ventilator associated pneumonia (VAP) within each protocol was also investigated.Material and methods. Patients were randomized to one of two groups. The standard oral care protocol included a manual pediatric toothbrush, toothpaste, and watersoluble lubricant. The comprehensive protocol consisted of tongue scraping, an electric toothbrush with a non-foaming toothpaste, followed by a moisturizing agent. Both groups received the assigned oral care protocol twice daily, with tooth brushing lasting two minutes per occasion. Oral and sputum cultures were obtained on admission and every 48 hours while intubated.Results. Data from a total of 78 patients were analyzed. The standard protocol included 40 patients (mean age 51 ± 18 years); the comprehensive protocol 38 patients (mean age 51 ± 18 years). No significant differences in Glasgow Coma Score, diagnosis, or co-morbidities were found on admission. Oral colonization on admission was noted in 25% of patients in each protocol. There was a trend of reduced oral and respiratory nosocomial colonization among those in the comprehensive protocol but no significant differences were noted between groups. Incidence of VAP was equivalent (p=0.61) for the standard and comprehensive groups at day six.Conclusions. Use of a tongue scraper, electric toothbrush, and oral gel resulted in less oral and respiratory colonization by known nosocomial pathogens. Larger studies are necessary to further investigate comprehensive oral care. (PNN 2012;1(1):10-18)Wprowadzenie. Porównanie zmian wywołanych bakterią szpitalną w obrębie jamy ustnej i górnych dróg oddechowych podczas pierwszego tygodnia wentylowania u dorosłych pacjentów neurologicznych, przebywających na oddziale intensywnej opieki medycznej, losowo wybranych do pielęgnacji jamy ustnej w sposób standardowy lub rozszerzony. Zbadanie przypadków odrespiratorowego zapalenia płuc w obu metodach zachowania higieny jamy ustnej.Materiał i metody. Pacjenci zostali losowo przydzieleni do jednej z dwóch grup. Standardowy sposób postępowania w pielęgnacji jamy ustnej polegał na zastosowaniu tradycyjnej dziecięcej szczoteczki do zębów, pasty do zębów i rozpuszczalnego w wodzie środka nawilżającego. Metoda rozszerzona polegała na szczotkowaniu języka, z zastosowaniem elektrycznej szczoteczki do zębów niepieniącą się pastą oraz środka nawilżającego. U każdej z grup przypisaną metodę stosowano dwa razy dziennie, każdorazowo szczotkując zęby przez 2 minuty. Przy przyjęciu na oddział oraz co 48 godzin pobierano od zaintubowanych pacjentów próbki śliny i wymaz z jamy ustnej w celu zbadania kultur bakterii.Wyniki. Analizie poddano wyniki 78 pacjentów. Standardowy sposób postępowania w higienie jamy ustnej zastosowano u 40 pacjentów (średni wiek 51-18 lat), natomiast rozszerzony u 38 pacjentów (średni wiek 51-18 lat). W chwili przyjęcia na oddział nie zaobserwowano statystycznie istotnych różnic w skali śpiączki Glasgow (GlasgowComa Scale), diagnozie ani współwystępujących chorobach. Bakterie w jamie ustnej w chwili przyjęcia na oddział zaobserwowano u 25 % pacjentów w każdej z dwóch grup. Zauważono tendencję spadkową w odniesieniu do liczby szpitalnych bakterii w jamie ustnej i układzie oddechowym u pacjentów przypisanych do metody rozszerzonej, ale nie znaleziono znaczących różnic pomiędzy grupami. W szóstym dniu odsetek odrespiratorowego zapalenia płuc w obu grupach (standardowej i rozszerzonej) był taki sam (p=0,61).Wnioski. W wyniku zastosowania szczoteczki do języka, szczoteczki elektrycznej oraz żelu do higieny jamy ustnej liczba bakterii szpitalnych atakujących jamę ustną i układ oddechowy była mniejsza. Potrzebne są szersze badania w celu dalszego zbadania działania rozszerzonej metody zachowania higieny jamy ustnej. (PNN 2012;1(1):10-18

The Severity of Human Peri-Implantitis Lesions Correlates with the Level of Submucosal Microbial Dysbiosis

AIM To cross-sectionally analyse the submucosal microbiome of peri-implantitis (PI) lesions at different severity levels. MATERIALS AND METHODS Microbial signatures of 45 submucosal plaque samples from untreated PI lesions obtained from 30 non-smoking, systemically healthy subjects were assessed by 16s sequencing. Linear mixed models were used to identify taxa with differential abundance by probing depth, after correction for age, gender, and multiple samples per subject. Network analyses were performed to identify groups of taxa with mutual occurrence or exclusion. Subsequently, the effects of peri-implant probing depth on submucosal microbial dysbiosis were calculated using the microbial dysbiosis index. RESULTS In total, we identified 337 different taxa in the submucosal microbiome of PI. Total abundance of 12 taxa correlated significantly with increasing probing depth; a significant relationship with lower probing depth was found for 16 taxa. Network analysis identified two mutually exclusive complexes associated with shallow pockets and deeper pockets, respectively. Deeper peri-implant pockets were associated with significantly increased dysbiosis. CONCLUSION Increases in peri-implant pocket depth are associated with substantial changes in the submucosal microbiome and increasing levels of dysbiosis

Prediction of Hip and Hand Fractures in older persons with or without a diagnosis of Periodontitis

Purpose: In a prospective study, we assessed if a diagnosis of osteoporosis and periodontitis could predict hip and hand fractures in older persons. Materials and Methods: Bone density was assessed by a Densitometer. Periodontitis was defined by evidence of alveolar bone loss. Results: 788 Caucasians (52.4% women, overall mean age: 76 years, S.D. ? 9.0, range: 62 to 96) were enrolled and 7.4% had a hip/hand fracture in 3 years. Calcaneus PIXI T-values < -1.6 identified osteoporosis in 28.2% of the older persons predicting a hip/hand fracture with an odds ratio of 3.3:1 (95% CI: 1.9, 5.7, p < 0.001). Older persons with osteoporosis had more severe periodontitis (p < 0.01). Periodontitis defined by ? 30% of sites with ? 5 mm distance between the cemento-enamel junction (CEJ) to bone level (ABL) was found in 18.7% of the older persons predicting a hip/hand fracture with an odds ratio of 1.8:1 (95% CI: 1.0, 3.3, p < 0.05). Adjusted for age, the odds ratio of a hip/hand fracture in older persons with osteoporosis (PIXI T value < -2,5) and periodontitis was 12.2:1 (95% CI: 3.5, 42.3, p < 0.001). Conclusions: Older persons with osteoporosis and periodontitis have an increased risk for hip/hand fractures

Risk indicators for peri-implantitis. A narrative review

To examine the existing evidence in identifying risk indicators in the etiology of peri-implantitis.status: publishe