Receptor activator of nuclear factor-kappa B ligand/osteoprotegerin ratio in sites of chronic periodontitis of subjects with poorly and well-controlled type 2 diabetes.
ABSTRACT The aim of this study is to evaluate the levels of osteoclastogenesis-related factors (soluble receptor activator of nuclear factor-kappa B ligand [sRANKL] and osteoprotegerin [OPG]) in gingival crevicular fluid (GCF) from subjects with poorly and well-controlled type 2 diabetes and chronic periodontitis before and after periodontal therapy.
Eighteen subjects with well-controlled diabetes (glycated hemoglobin [HbA1c] levels ≤ 8%) and 20 subjects with poorly controlled diabetes (HbA1c levels >8%) were enrolled in this study. All subjects were submitted to non-surgical periodontal therapy. GCF sampling and clinical periodontal parameters were assessed at baseline and 3 and 6 months post-therapy. Total amounts and concentrations of sRANKL and OPG in GCF were analyzed by enzyme-linked immunosorbent assay (ELISA).
Total amounts and concentrations of sRANKL and RANKL/OPG ratios were higher in poorly controlled subjects than in well-controlled subjects at baseline and 3 and 6 months post-therapy (P <0.05). In addition, RANKL/OPG ratios decreased in well-controlled subjects (P <0.05) but not in poorly controlled subjects (P >0.05) at 3 months post-therapy. Almost all clinical parameters improved significantly for both groups post-treatment (P <0.05).
RANKL/OPG ratios in untreated and treated periodontitis sites may be negatively influenced by poor glycemic control in subjects with type 2 diabetes.
- SourceAvailable from: Marcelo Faveri[Show abstract] [Hide abstract]
ABSTRACT: Background: Excessive gingival display (EGD) has a negative impact on a pleasant smile. Minimally-invasive therapeutic modalities have become the standard treatment in many dentistry fields. Therefore, the aim of this study was to compare the clinical outcomes of open-flap (OF) and minimally-invasive flapless (FL) esthetic crown lengthening (ECL) for the treatment of EGD. Methods: A split-mouth randomized controlled trial was conducted in 28 patients presenting EGD. Contralateral quadrants received ECL using OF or FL techniques. Clinical parameters were evaluated at baseline, 3, 6 and 12 months post-surgeries. The local levels of receptor activator of NF-КB ligand (RANKL) and osteoprotegerin (OPG) were assessed by ELISA at baseline and 3 months. Patients' perceptions regarding morbidity and esthetic appearance were also evaluated. Periodontal tissue dimensions were obtained by computed tomography at baseline and correlated with the changes in the gingival margin (GM). Results: Patients reported low morbidity and high satisfaction with esthetic appearance for both procedures (p>0.05). RANKL and OPG concentrations were increased in the OF group at 3 months (p<0.05). The probing depths were reduced for both groups at all time-points, compared to baseline (p<0.05). There were no differences between groups for the GM reduction at any time-point (p>0.05). Conclusion: FL and OF surgeries produced stable and similar clinical results up to 12 months. FL ECL may be a predictable alternative approach for the treatment of EGD.Journal of Periodontology 07/2013; · 2.40 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The current study was devised with the objective of using a split-mouth, controlled clinical trial to compare conventional mechanical debridement (scaling and root planing) treatment (T1) with conventional mechanical treatment followed by photodynamic therapy (PDT) (T2) in patients with severe periodontitis. Four PDT sessions were completed, and clinical parameters such as bleeding upon probing (BOP positive), plaque index (PI), probing pocket depth (PPD) and clinical attachment loss (CAL) were evaluated before and after the treatment series. In addition, gingival biopsies were collected at the start and finish of treatment, and were used for qPCR gene expression analysis of TNFA, IL1B, IL8, IL10, IL17, MMP13, FGF2, RANK, RANKL and OPG. The clinical results showed a significant improvement in BOP with treatment T2 (p=0.03). The molecular data showed an up-regulation of FGF2, RANK and OPG gene expression after T2. The expression levels of the other genes were not significantly different between T1 and T2. PDT increased the expression of RANK and OPG, which could indicate a reduction in osteoclastogenesis. Furthermore, the use of PDT in conjunction with conventional treatment significantly increased the expression of FGF2, which has an important role in the periodontal repair process. PDT technology could be a means to improve conventional periodontitis treatment. Our results suggest that PDT acts in part by controlling bone resorption and increasing the expression of genes important for tissue repair.Photodiagnosis and photodynamic therapy 10/2013;
- [Show abstract] [Hide abstract]
ABSTRACT: Background: The aim of this study was to assess the short-term effects of nonsurgical periodontal therapy (NSPT) on the gingival crevicular fluid (GCF) cytokine profile in sites with standardized periodontal bony defects in beagle dogs with and without diabetes. Methods: Four beagle dog with streptozotocin (STZ)-induced diabetes and four healthy dogs were included. Fasting blood glucose levels (FBGL) were measured using a glucometer. In all animals, a three-walled bony defect was created on the mesial surface of the second premolar and first molar in all quadrants. After 12 weeks, all animals underwent weekly NSPT for 3-weeks. Baseline and post-NSPT GCF samples were collected and levels of interleukin (IL)-1, IL-1beta, IL-6, IL-8 and tumor necrosis factor (TNF)-α were measured using enzyme linked immune sorbent assay (ELISA). Statistical analyses were performed using a software program and p-values less than 0.05 were considered statistically significant. Results: Mean FBGL were significantly higher in dogs with induced diabetes than those without diabetes (P<0.01). At baseline, mean IL-6 (P<0.01) and IL-8 (P<0.05) levels were higher in dogs with diabetes than those without diabetes. A significant reduction in levels of IL-1, IL-1β, IL-6, IL-8 and TNF-α was noted in dogs without diabetes 1 week after NSPT. However, this significant reduction (P<0.05) only appeared 2 weeks after NSPT in dogs with diabetes. Conclusion: NSPT reduces GCF levels of proinflammatory cytokines in dogs with and without STZ-induced diabetes; however, chronic hyperglycemia seems to retard the effect of NSPT on GCF cytokine concentration.Journal of periodontology. 05/2014;