Antioxidantes dietéticos para la prevención de la periodontitis crónica y su tratamiento. Una revisión de las evidencias actuales procedentes de estudios en animales y humanos

Objetivos. Dada la relación existente entre periodontitis crónica y altos niveles de estrés oxidativo, esta revisión pretende clarificar qué papel puede desempeñar la ingesta de los diferentes antioxidantes de la dieta en el mantenimiento de un periodonto saludable y en la reducción del riesgo de padecer periodontitis crónica, así como el posible uso de terapias dietéticas basadas en estos para el tratamiento de dicha enfermedad. Métodos. Se utilizó la base de datos de la National Library of Medicine, Washington, DC (MEDLINE: PubMed) y todos los estudios en animales y humanos tratando el tema de interés en escritos Inglés disponibles online desde la creación de la base de datos hasta Mayo de 2015 fueron recopilados. Resultados. Los antioxidantes analizados a este respecto incluyen a la vitamina C, la vitamina A, algunos carotenoides y polifenoles, y el coenzima Q; así como los minerales, hierro, cobre y zinc que forman parte de enzimas antioxidantes. Aun así hay una escasez generalizada de estudios con pocos estudios en humanos, la mayoría de tipo observacional. Entre los diferentes antioxidantes, la vitamina E y los polifenoles parecen ser los que más evidencias a favor de su efecto beneficioso suman, pero en general los estudios son insuficientes para descartar o establecer qué antioxidantes son útiles y cuáles no. Conclusiones. En general, los datos presentados indicarían que los antioxidantes de la dieta resultan beneficiosos para la salud periodontal, al menos bajo ciertas circunstancias. Sin embargo se necesitan más estudios para establecer la relación entre la periodontitis crónica y cada antioxidante concreto así como para diseñar intervenciones dietéticas útiles en la gestión de esta enfermedad.Objectives. Given the relationship between chronic periodontitis and high levels of oxidative stress, this review aims to clarify what role can played the dietary intake of different antioxidants in maintaining a healthy periodontium and in reducing chronic periodontitis risk, as well as possible use of dietary therapies based on them for this disease treatment. Methods. The database of the National Library of Medicine, Washington, DC (MEDLINE PubMed) was used and all the studies in animals and humans are on the subject of interest in English writing online available from inception of the database until May 2015 were collected. Results. Antioxidants analyzed in this regard include vitamin C, vitamin A, carotenoids and some polyphenols, and coenzyme Q; as well as minerals iron, copper and zinc that are constituents of antioxidant enzymes. Still, there is a paucity of studies with few human studies, mostly observational. Among the various antioxidants, vitamin E and polyphenols seem to have more evidence for its beneficial effect, but in general the studies are insufficient to rule out or establish what antioxidants are useful and which are not. Conclusions. Overall, the data presented indicate that dietary antioxidants are beneficial for periodontal health, at least under certain circumstances. However more studies are needed to establish the relationship between chronic periodontitis and each specific antioxidant and to design useful dietary interventions for this disease managemen

Diagnóstico por el laboratorio de las enfermedades periodontales y periimplantarias. Diagnóstico de la periodontitis.

Desde el punto de vista epidemiológico la enfermedad periodontal tiene una enorme trascendencia. El diagnóstico del proceso es una necesidad para, con arreglo a él, realizar el tratamiento y la prevención mas apropiada. El enfoque del diagnóstico depende del concepto que sobre la patogenia se tiene en un momento dado. Desde esa perspectiva se hace un análisis de los distintos métodos de diagnóstico que existen. Se llega a la conclusión de que acutalmente el método clínico, mediante el sondaje periodontal, es el mas apropiado para conocer elestado de gravedad del proceso y enfocar el tratamiento. Tras la revisión de los distintos procesos que estudian: los patógenos responsables, los mediadores de la inflamación, los parámetros de destrucción osea y del conectivo, los factores genéticos y de riesgo ambiental y adquirido, se llega a la conclusión de que actualmente no existe ningún método capaz de identificar a la población de riesgo de padecer la enfermedad periodontal ni los períodos de actividad. Ello en gran medida se debe a que existen muchas incógnitas en la patogenia del proceso y que es preciso seguir la búsqueda de un parámetro eficaz que me ayude en la toma de decisiones a la hora de enfocar el tratamiento y la prevención del proceso.The periodontal disease is very important in the general health status of our patients. We need an adequate diagnosis of the process to treat and prevent successfully. The diagnosis depends on the concept about the illness is generally accepted nowadays. We revise all the diagnostic procedures we can use in the clinic. We coclude that the clinic diagnostic method with the periodontal probe is the best way to know the destructive bone process and treat it. The others methods that study the bacteria, inflammatory mediators, parameters of bone and collagen resorption, genetic tests cannot identify the high-risk patients and the period of activity. The reason could be the lack of a compltely knowledge of the pathogenic process involved in the periodontal disease. We have to work in this field in the future to improve the treatment and prevention of the priodontitis

Influence of the Periodontal Disease, the Most Prevalent Inflammatory Event, in Peroxisome Proliferator-Activated Receptors Linking Nutrition and Energy Metabolism

Periodontal disease is considered one of the main pathologic diseases occurring in humans. Its pathologic process involves inflammatory reactions producing periodontal bone resorption and the tooth loss. But some patients do not present an evident clinical inflammation with bone resorption, and in others, the inflammation is prominent without bone resorption. A key question could be to investigate a different way of responding to aggression. Inflammation requires a complex intracellular metabolic process, starting with the harmful recognition and activation of the inflammasome, continues the energy supply with the alteration of oxidative stress conditions, and finishes with the elimination of the aggression with autophagy/apoptosis mechanisms, then concludes with recovery. Peroxisome proliferator-activated receptors (PPARs) are essential molecules produced in inflammation, and its genes and its activation have been related to periodontal disease. Also, an important aspect is the influence of PPARs in bone metabolism; the main periodontitis symptom is bone loss and PPARγ activation that can downregulate the bone resorption in experimental periodontitis, PPARγ-coated titanium dental implant surfaces could carry the antiinflammatory gene and restrain inflammation. PPARs could be one of the meeting background points with atherosclerosis/cardiovascular disease, diabetes and metabolic syndrome showing a modified proinflammatory statement such as it is described in periodontitis

A Systematic Review on the Implication of Minerals in the Onset, Severity and Treatment of Periodontal Disease

Periodontal disease is an inflammatory disease with high prevalence in adults that leads to destruction of the teeth-supporting tissues. Periodontal therapy has been traditionally directed at reduction of the bacterial load to a level that encourages health-promoting bacteria and maintenance of oral-hygiene. The role of nutrition in different chronic inflammatory diseases has been the subject of an increasing body of research in the last decades. In this sense, there has been an important increase in the volume of research on role of nutrition in periodontitis since the diet has known effects on the immune system and inflammatory cascades. Minerals play a key role in all these processes due to the multiple pathways where they participate. To clarify the role of the different minerals in the establishment, progression and/or treatment of this pathology, a systemically review of published literature cited in PubMed until May 2016 was conducted, which included research on the relationship of these elements with the onset and progression of periodontal disease. Among all the minerals, calcium dietary intake seems important to maintain alveolar bone. Likewise, dietary proportions of minerals that may influence its metabolism also can be relevant. Lastly, some observations suggest that all those minerals with roles in immune and/or antioxidant systems should be considered in future research

Serum, Saliva, and Gingival Crevicular Fluid Osteocalcin: Their Relation to Periodontal Status and Bone Mineral Density in Postmenopausal Women

Background: Periodontitis and osteoporosis are characterized by the loss of bone mass. Osteocalcin levels have been postulated as a marker of inhibition of bone formation. The aim of the present study was to assess plasma, saliva, and gingival crevicular fluid (GCF) levels of osteocalcin and correlate them with periodontitis and osteoporosis. Methods: Seventy-three postmenopausal women, over 35 years old, were recruited for the study. Serum, saliva, and GCF osteocalcin were measured. Vertebral bone mineral density was measured by dual-energy x-ray absorptiometry. Differences between groups were assessed by analysis of variance (ANOVA), chi-square test, and non-parametric Kruskal-Wallis test. Results: Thirty-four (46.6%) were classified in the normal healthy bone group, 11 women (15.1%) in the osteopenic group, and 28 women (38.4%) in the osteoporotic group. No statistically significant differences between these densitometric groups were observed in probing depth (P = 0.24); clinical attachment level (P = 0.11); or mean osteocalcin concentrations in serum, saliva, and GCF. Twenty-seven (37.0%) of the women were classified without periodontitis (NPG) and 63.0% (N = 46) with periodontal disease (PG). There were no statistical differences in serum and saliva osteocalcin concentrations between these two groups. GCF osteocalcin concentrations were significantly higher in the PG women than in the NPG group (P = 0.008). Mean probing depth correlated significantly with GCF osteocalcin concentrations (r = 0.35; P = 0.002). Conclusion: The results further support the concept that osteocalcin levels in GCF correlates with periodontal but not with osteoporosis status

Mitochondrial dysfunction promoted by Porphyromonas gingivalis lipopolysaccharide as a possible link between cardiovascular disease and periodontitis

Oxidative stress is one of the factors that could explain the pathophysiological mechanism of inflammatory conditions that occur in cardiovascular disease (CVD) and periodontitis. Such inflammatory response is often evoked by specific bacteria, as the lipopolysaccharide (LPS) of Porphyromonas gingivalis is a key factor in this process. The aim of this research was to study the role of mitochondrial dysfunction in peripheral blood mononuclear cells (PBMCs) from periodontitis patients and to evaluate the influence of LPS on fibroblasts to better understand the pathophysiology of periodontitis and its relationship with CVD. PBMCs from patients showed lower CoQ10 levels and citrate synthase activity, together with high levels of ROS production. LPS-treated fibroblasts provoked increased oxidative stress and mitochondrial dysfunction by a decrease in mitochondrial protein expression, mitochondrial mass, and mitochondrial membrane potential. Our study supports the hypothesis that LPS-mediated mitochondrial dysfunction could be at the origin of oxidative stress in periodontal patients. Abnormal PBMC performance may promote oxidative stress and alter cytokine homeostasis. In conclusion, mitochondrial dysfunction could represent a possible link to understanding the interrelationships between two prominent inflammatory diseases: periodontitis and CV

Oral lichenoid lesions related to contact with dental materials: A literature review

Oral lichenoid lesions related to contact are defined as oral-cavity eruptions with an identifiable etiology, and are clinically and histologically similar to oral lichen planus. Within this group are found oral lichenoid lesions related to contact with dental materials (OLLC), the most common being those related to silver amalgam. Currently, it remains difficult to diagnose these lesions due to the clinical and histopathological similarity with oral lichen planus and other oral mucosa lesions of lichenoid characteristics. In the present paper, we carry out an updated review of the tests for, and the different characteristics of OLLC, which may aid the diagnosis. For this review, we made searches in the Pubmed® and Cochrane® databases. Among the literature we found several published papers, from which we have used review papers, case papers, cohort studies, case and control studies, and a meta-analysis study. After carrying out this review, we can conclude that the diagnosis of these lesions is still difficult and controversial. However, there are different aspects in the clinical presentation, pathological study and results obtained when replacing suspect materials, which, when taken together, may be useful when establishing the final diagnosis of OLLC

Is Inflammation a Mitochondrial Dysfunction-Dependent Event in Fibromyalgia?

Fibromyalgia (FM) is a complex disorder that affects up to 5% of the general population worldwide. Both mitochondrial dysfunction and inflammation have been implicated in the pathophysiology of FM. We have investigated the possible relationship between mitochondrial dysfunction, oxidative stress, and inflammation in FM. We studied 30 women diagnosed with FM and 20 healthy women. Blood mononuclear cells (BMCs) from FM patients showed reduced level of coenzyme Q10 (CoQ10) and mtDNA contents and high level of mitochondrial reactive oxygen species (ROS) and serum tumor necrosis factor (TNF)-alpha and transcript levels. A significant negative correlation between CoQ10 and TNF-alpha levels (r= -0.588; p < 0.01), and a positive correlation between ROS and TNF-alpha levels (r = 0.791; p < 0.001) were observed accompanied by a significant correlation of visual analogical scale with serum TNF-alpha and transcript levels (r = 0.4507; p < 0.05 and r = 0.7089; p < 0.001, respectively). TNF-alpha release was observed in an in vitro (BMCs) and in vivo (mice) CoQ10 deficiency model. Oral CoQ10 supplementation restored biochemical parameters and induced a significant improvement in clinical symptoms ( p < 0.001). These results lead to the hypothesis that inflammation could be a mitochondrial dysfunction-dependent event implicated in the pathophysiology of FM in several patients indicating at mitochondria as a possible new therapeutic target.Unión Europea FIS PI10/00543Servicio Andaluz de Salud Junta de Andalucía SAS 111242Junta de Andalucía CTS-572

AMPK Phosphorylation Modulates Pain by Activation of NLRP3 Inflammasome

Impairment in adenosine monophosphate-activated protein kinase (AMPK) activity and NOD-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome activation are associated with several metabolic and inflammatory diseases. In this study, we investigated the role of AMPK/NLRP3 inflammasome axis in the molecular mechanism underlying pain perception. Results: Impairment in AMPK activation induced by compound C or sunitinib, two AMPK inhibitors, provoked hyperalgesia in mice ( p < 0.001) associated with marked NLRP3 inflammasome protein activation and increased serum levels of interleukin-1b (IL-1b) (24.56 – 0.82 pg/ml) and IL-18 (23.83 – 1.882 pg/ml) compared with vehicle groups (IL-1b: 8.15 – 0.44; IL-18:4.92 – 0.4). This effect was rescued by increasing AMPK phosphorylation via metformin treatment ( p < 0.001), caloric restriction diet ( p < 0.001), or NLRP3 inflammasome genetic inactivation using NLRP3 knockout (nlrp3-/ - ) mice ( p < 0.001). Deficient AMPK activation and overactivation of NLRP3 inflammasome axis were also observed in blood cells from patients with fibromyalgia (FM), a prevalent human chronic pain disease. In addition, metformin treatment (200 mg/daily), which increased AMPK activation, restored all biochemical alterations examined by us in blood cells and significantly improved clinical symptoms, such as, pain, fatigue, depression, disturbed sleep, and tender points, in patients with FM. Innovation and Conclusions: These data suggest that AMPK/NLRP3 inflammasome axis participates in chronic pain and that NLRP3 inflammasome inhibition by AMPK modulation may be a novel therapeutic target to fight against chronic pain and inflammatory diseases as FM. Antioxid. Redox Signal. 24, 157–170.Junta de Andalucía CTS11

Fibroblasts Collagen Production and Histological Alterations in Hereditary Gingival Fibromatosis

Hereditary gingival fibromatosis is a disorder for which the etiology remains unknown. We aimed to evaluate the fibroblasts and histological alterations to give new clues. A father and a daughter of a family showing gingival hereditary fibromatosis were treated, and gingival biopsies were obtained. A histological study revealed dense fibrous tissue, basal lamina disruption, and epithelial cell migration into the connective tissue. Fibroblasts were cultured from the father and daughter and compared with those from a healthy control patient. The results of the biochemical analysis showed increased collagen synthesis, reduced antioxidant CoQ10 content, and high levels of lipid peroxidation. Additionally, fibroblasts culture incubation with the oxidant H2O2 increased collagen levels that have been reduced by the addition of the antioxidant CoQ10. We conclude that some fibroblasts metabolic alterations play a significant role in initiating and maintaining persistent fibrotic tissue. Oxidative stress influences the fibroblasts collagen production and could play a particular role in the pathogenesis of hereditary gingival fibromatosis