Salivary cytokines as biomarkers of periodontal diseases

Periodontal disease is time consuming and expensive to treat and therefore its prevention, early detection and management are issues which, if effectively addressed, are likely to yield considerable health-care benefit (97). However, despite numerous advances in our understanding of the pathogenesis of chronic inflammatory diseases, periodontitis is still only diagnosed once connective tissue and bone destruction has occurred. Furthermore, monitoring disease progression is a highly skilled and technically demanding process, involving measurement of bleeding on probing, probing depth and attachment loss coupled with radiographic assessment and (subjective) visual observations (76). It would be highly desirable to develop biomarkers for early detection of periodontal disease and to identify progression because current diagnostic approaches do not reflect current disease activity but simply assess the cumulative effects of historical tissue destruction (53). Rational diagnosis would also have concomitant patient benefit because the paucity of evidence-based knowledge of disease progression in individual patients may lead to unintentional clinical mismanagement (97). In addition, studies of the salivary mediators associated with disease may help in the development of novel therapies aimed at controlling cytokine bioavailability (e.g. through anti-cytokine antibodies, antagonists or soluble receptors) or by targeting the intracellular signaling pathways they activate, approaches which have been successful in the treatment of other chronic inflammatory diseases, such as rheumatoid arthritis (60, 91, 95). Cytokines have been defined as soluble factors produced by one (immune) cell that act on another cell within the same milieu (26). However, it is now recognized that the range of molecules with cytokine-like activity can be extended to include, for example, growth factors and adipokines, which also have immunoregulatory functions. Importantly, cytokine functions often overlap or merge, building a complex immunoregulatory network in the immune system that is often perturbed in disease. It is increasingly appreciated that cytokines have vital roles in the development and homeostasis of numerous cell types and, in a wide range of tissues, have roles in resolution of inflammation, wound healing, repair and regeneration. In the following review, the term ‘cytokine’ will be used in this broad context. In addition to direct analysis of cytokines, the levels of molecules such as matrix metalloproteinases and tissue inhibitors of metalloproteinases, which are regulated by cytokines, have also been given considerable attention as potential periodontitis biomarkers, as reviewed elsewhere in this volume of Periodontology 2000

Epidemiological analysis of dental caries in 12-year-old children residing in urban and rural settings in the Podlaskie region of north-eastern Poland

Introduction. Dental caries is still a social problem in many countries, including Poland. Through epidemiological studies conducted in index groups among children and adults, it is possible to monitor its progress and take appropriate action. The Podlaskie region is an area where the severity of dental caries in children has been the highest in the country for a few years, both in urban and rural settings. Objective. Evaluation and comparison of indicators of the progress of caries – Decayed Missing Filled Teeth (DMFT) – in 12-year-olds from the urban and rural areas of north-eastern Poland, measured between 2003–2010. Materials and method. In 2003 and 2010, respectively, 445 children were examined: in 2003 – 188: 101 boys, 87 girls; 98 from urban areas, 90 from rural areas, and in 2010 – 257 adolescents: 134 boys, 123 girls; 157 from urban areas and 70 from rural areas. The study protocol was strictly subordinated to the WHO study monitor guidelines. DMFT indices were evaluated in particular years. The distribution of their individual components was then compared and analyzed. The outcomes resulting from the place of residence and gender of the adolescents were taken into account. In the statistical analysis, Shapiro-Wilk test and Mann-Whitney U test were used. Results. In 2003, the mean value of DMFT was 4.76, and in 2010 it decreased to 3.36 (p<0.0001). In 2003, DMFT was 4.42 in the rural areas, and after 7 years it has risen to 4.77. There was a significant decrease in the value of the index (from 5.08 to 2.82, p<0.0001) in the urban areas. No significant differences based on gender were observed between these years. Conclusions. The values of caries intensity among 12-year-olds from the Podlaskie region, both in rural and urban areas, are still high. Among children from the rural areas, dental caries progression is more visible and has not improved during the years 2003–2010. These findings should lead to the development of programmes for the inhabitants of rural areas