Eudoxie Pepelassi

National and Kapodistrian University of Athens, Athínai, Attica, Greece

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Publications (14)20.28 Total impact

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    ABSTRACT: Nonsurgical periodontal treatment controls periodontal inflammation. Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are implicated both in the destruction and in the healing of periodontal tissues. The aim of the present study was to compare the mRNA expression of MMP-1, -3, -8, -9 and -13 and TIMP-1 in chronic periodontitis before and after initial periodontal treatment. Ninety gingival samples were harvested from 30 patients with chronic periodontitis (15 nonsmokers and 15 smokers) before and after nonsurgical treatment and from 30 periodontally healthy control subjects (15 nonsmokers and 15 smokers). Clinical parameters were assessed before and after treatment. Total RNA was isolated, and mRNA expression of MMPs and TIMP-1 was assessed by RT-PCR. Periodontal treatment significantly increased TIMP-1 expression and decreased the ratios of MMPs/TIMP-1. Post-treatment, nonsmokers with periodontitis had significantly higher MMP-8 and TIMP-1 expression than healthy nonsmokers, and smokers with periodontitis had significantly higher MMP-13 and TIMP-1 expressions than healthy smokers. Post-treatment, smokers had significantly higher TIMP-1 expression and lower MMP-8/TIMP-1 ratio than nonsmokers. Post-treatment, there was no correlation among MMPs, and the expression of MMPs and TIMP-1 was not correlated with clinical measurements. Periodontal treatment increased TIMP-1 expression and decreased the ratios of MMPs/TIMP-1 in chronic periodontitis. The post-treatment increase in TIMP-1 expression was higher for smokers. The TIMP-1 expression was higher post-treatment than in health. Post-treatment, MMP-8 expression was higher in nonsmokers with periodontitis than in healthy nonsmokers, whereas MMP-13 expression was higher in smokers with periodontitis than in healthy smokers.
    Journal of Periodontal Research 04/2012; 47(4):532-42. · 1.99 Impact Factor
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    ABSTRACT: The aim of this interventional animal study was to assess histologically the effect of experimental diabetes in rats with experimental periodontitis in terms of alveolar bone loss and the effect of experimental periodontitis on glucose levels in diabetes. Forty-seven Wistar rats were studied: 12 healthy controls (C), 10 with experimental diabetes (D), 12 with experimental diabetes and experimental periodontitis (DP) and 13 with experimental periodontitis (P). Diabetes was induced by streptozotocin injection and periodontitis was induced at the right second maxillary molar by ligation. Serum glucose levels were measured at specific time points. Sixty-one days after ligation, the rats were sacrificed. Histometric analysis assessed alveolar crest level. For ligated groups, alveolar bone loss was expressed as the difference in alveolar crest level between right and left maxillary molars. Diabetes alone did not statistically significantly affect alveolar crest level. The combination of diabetes and periodontitis caused greater alveolar bone loss (946.1 +/- 719.9 microm) than periodontitis alone (639.7 +/- 294.2 microm); however, the difference did not reach statistical significance. Periodontitis did not significantly increase glucose levels in diabetic rats. The average glucose levels were 545.4 (499 - 563) and 504.5 (445 - 560) mg/dL for diabetic and diabetic ligated rats, respectively. Within its limits, this study demonstrated that the severity of alveolar bone loss in periodontitis was not significantly aggravated by diabetes and the serum glucose levels in diabetes were not affected by periodontitis.
    Journal of the International Academy of Periodontology 04/2012; 14(2):35-41.
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    ABSTRACT: The aim of the study was to compare the serum levels of adiponectin and interleukin-6 (IL-6) in insulin-treated diabetic rats with or without periodontitis. Forty male Wistar rats were randomly divided into 2 groups (20 rats each): a) insulin-treated diabetic group (control, DI) and b) insulin-treated diabetic periodontitis group (test, DIP). Diabetes was induced, and insulin treatment was initiated on day 5. On day 16, periodontitis was induced in the DIP group. All rats were euthanized on day 77. Adiponectin and IL-6 were assessed on days 16 and 77. At the end of the experiment, 14 and 11 rats survived in the DI and DIP groups, respectively. Adiponectin levels were statistically significantly higher at the end of the experiment compared with levels on day 16 in the periodontitis group (p < 0.05), but not in the control group. At the end of the experiment, adiponectin levels were statistically significantly higher in the periodontitis group compared with the control group (p < 0.05). Within-group and between-group comparisons of IL-6 levels showed no statistically significant difference. In conclusion, serum adiponectin was increased in insulin-treated diabetic rats with periodontitis in comparison with insulin-treated diabetic rats, while IL-6 levels did not differ between groups.
    Brazilian oral research 02/2012; 26(1):71-6.
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    ABSTRACT: To explore the possible relationship between the osteoporotic condition and the severity of periodontitis in women aged 45-70 years. Ninety women with generalized chronic periodontitis, aged 45-70 years, were studied. Areal bone mineral density (BMDa) was assessed using standardized dual energy X-ray absorptiometry (normal: T-score ≥ -1, osteopenic: -2.5 ≤ T-score <-1, osteoporotic: T-score < -2.5). Gingival index (GI), bleeding on probing, clinical attachment loss (CAL), probing pocket depth and gingival recession (GR) were recorded. Periodontitis severity was represented by CAL. Menopausal condition and smoking were documented. Mean GI, bleeding on probing, CAL and GR were significantly greater for osteoporotic women than women with normal BMDa (P = 0.002, P = 0.01, P = 0.04, respectively). Osteopenic women and women with normal BMDa significantly differed in mean GI (P = 0.02). The associations found between osteoporotic women and women with normal BMDa and the associations found between osteopenic women and women with normal BMDa existed even after adjusting for smoking and menopausal status. Subjects with osteoporosis (OPR) presented with greater CAL than the subjects with normal BMDa, which suggests a greater severity of periodontitis. Subjects with OPR had greater GR than the subjects with normal BMDa. Subjects with osteopenia and subjects with normal BMDa did not differ in CAL, which might suggest that the early diagnosis of reduced BMDa, prior to the establishment of a significant negative impact on the periodontal tissues, might be important. Smoking and menopausal status did not alter these associations.
    Oral Diseases 11/2011; 18(4):353-9. · 2.38 Impact Factor
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    ABSTRACT: Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are important for extracellular matrix. Expression of MMPs has been evaluated in gingiva without studying smoking. The aim of this study was to explore the effect of smoking on mRNA expression of MMP-1, -3, -8, -9 and -13 and TIMP-1 in untreated chronic periodontitis and in periodontal health. Gingival samples were harvested from 30 subjects with untreated chronic periodontitis (15 nonsmokers and 15 smokers) and 30 periodontally healthy subjects (15 nonsmokers and 15 smokers). Full-mouth plaque score, gingival index, bleeding on probing, probing depth and clinical attachment level were recorded. Total RNA was isolated, and the mRNA expression of MMPs and TIMP-1 was assessed by RT-PCR. Periodontitis groups were comparable in clinical measurements. Nonsmoker subjects with periodontitis had statistically significantly higher MMP-1, lower MMP-9 and TIMP-1 expression and higher MMP-1/TIMP-1 ratio than smokers; and higher MMP-8 expression and MMP-8/TIMP-1 and MMP-1/TIMP-1 ratios than healthy nonsmokers. Healthy nonsmokers had statistically significantly higher MMP-13 expression than healthy smokers. Smoker periodontitis and healthy subjects had similar expression levels of MMPs and TIMP-1 and MMPs/TIMP-1 ratios. There was correlation among the MMPs only for smoker periodontitis subjects. Expression of MMP-13 was correlated with mean clinical attachment level. Within its limits, this study demonstrated that smoking affected mRNA expression of MMPs and TIMP-1, MMPs/TIMP-1 ratios and relationships among MMPs in untreated chronic periodontitis and expression of MMPs in health. In the absence of smoking, chronic periodontitis affected expression of MMPs and MMPs/TIMP-1 ratios.
    Journal of Periodontal Research 10/2011; 46(5):576-83. · 1.99 Impact Factor
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    ABSTRACT: This study assessed root proximity (RP) in patients with and without periodontitis in terms of prevalence, distribution, location along the root, width and severity, and explored the role of RP characteristics in the type of alveolar bone loss (horizontal or angular). Root proximity was studied in the interdental spaces of 250 patients with periodontitis and 80 patients without disease. Linear measurements were performed in digitized radiographs. Root proximity was classified by location along the root, width and severity. Bone defect type (horizontal or angular) at the RP site was recorded. Root proximity prevalence did not differ between periodontitis and non-periodontitis groups. For both groups, most RPs were located at the middle root third. Root proximity width and severity in periodontitis sites were different between horizontal and angular bone loss sites. Root proximity width was greater in horizontal bone loss sites. In periodontitis, a unit (pixel) increase in the RP width decreased the probability to detect an angular bone defect by 20%, while a unit decrease in RP severity increased the possibility to detect angular bone loss by 71%. Root proximity prevalence was similar for both patients with and without periodontitis. The RP location along the root was not related to the existence of periodontitis. Root proximity width and severity differed between horizontal and angular bone loss sites. Root proximities had greater width in horizontal than angular bone loss sites.
    Journal of the International Academy of Periodontology 10/2011; 13(3):73-9.
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    ABSTRACT: On the basis of systematic reviews and randomized controlled trials, the authors provide reports of two cases in which platelet-rich plasma (PRP) combined with demineralized freeze-dried bone allograft (DFDBA) was used to treat periodontal endosseous defects. Clinicians treated two circumferential endosseous defects with a probing pocket depth of 5 and 8 millimeters, respectively (case 1), and a combined 1-2-3-wall endosseous defect with a probing pocket depth of 6 mm (case 2) by using the combination of PRP and DFDBA. At six months, complete periodontal pocket resolution occurred in all defects, and clinical attachment level and radiographic defect fill in all defects exhibited significant improvement compared with presurgical values. The combination of PRP and DFDBA may be clinically and radiographically efficacious in the treatment of periodontal endosseous defects.
    Journal of the American Dental Association (1939) 08/2010; 141(8):967-78. · 1.82 Impact Factor
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    ABSTRACT: Platelet-rich plasma (PRP) alone or combined with other regenerative materials was previously studied in human periodontal endosseous defects. There are no sufficient data evaluating to what extent the addition of demineralized freeze-dried bone allograft (DFDBA) to PRP may enhance the effectiveness of PRP. The aim of this randomized, double-masked, controlled clinical trial was to compare the effectiveness of autologous PRP alone to PRP + DFDBA in periodontal endosseous defects. Twenty-four proximal endosseous defects in 24 patients with severe chronic periodontitis were randomly treated with PRP alone or in combination with DFDBA. The final evaluation at 6 months was based on clinical and radiographic parameters. Subtraction radiography was used. The primary outcome variable was clinical attachment level (CAL). The two treatment groups were initially comparable (mean CAL: 8.67 +/- 2.19 mm for PRP + DFDBA and 8.25 +/- 1.96 mm for PRP). Both treatments achieved statistically significant and similar CAL gain (3.08 +/- 1.17 mm for PRP + DFDBA and 3.08 +/- 0.95 mm for PRP), probing depth, defect depth, and area surface reduction. The percentage of defect fill did not significantly differ between the two treatments. There was a non-significant trend to greater defect fill (45.42% versus 41.29%), defect depth (54.05% versus 49.52%), and area surface (58.43% versus 52.16%) reduction with the graft. In both groups, 66.66% of the defects gained > or =3 mm of CAL. Within its limits, this study demonstrates that both PRP and PRP combined with DFDBA resulted in significant clinical and radiographic improvement in human periodontal endosseous defects at 6 months, and the addition of DFDBA to PRP did not significantly enhance the treatment outcome.
    Journal of Periodontology 12/2009; 80(12):1911-9. · 2.40 Impact Factor
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    ABSTRACT: The evidence for the efficacy of the adjunctive use of platelet-rich plasma (PRP) in periodontal intraosseous defects has not been systematically evaluated. The objective of this review was to address the focused question, 'What is the efficacy, with respect to clinical, radiographical and patient-centred outcomes, of combinations of PRP with other therapeutic bioactive agents/procedures, compared with the efficacy of the same agents/procedures without the adjunctive use of PRP in the therapy of periodontal intraosseous defects in patients with chronic periodontitis and without systemic diseases that could potentially influence the outcome of periodontal therapy?' by performing a systematic review of randomized controlled clinical trials (RCTs) published in the dental literature in any language, up to and including September 2008. Data sources principally included electronic databases, manually searched journals and contact with experts. In the first phase of study selection, the titles and abstracts, and in the second phase, full papers were screened independently and in duplicate by two reviewers. In the first phase, 6124 potentially relevant titles and abstracts were examined. In the second phase, the full text of 20 publications was thoroughly evaluated. Eventually, 10 RCTs were selected. Diverse outcomes (positive and negative) have been reported for the efficacy of PRP combined with various therapeutic bioactive agents/procedures, reflecting the limited and heterogeneous data available and possibly suggesting that the specific selection of agents/procedures combined with PRP could be important. Additional research on the efficacy of each specific combination of PRP is necessary.
    Journal of Periodontal Research 11/2009; 45(3):428-43. · 1.99 Impact Factor
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    ABSTRACT: Investigators have evaluated predictive parameters of tooth loss during the maintenance phase (MP). The authors conducted a retrospective study to evaluate the rate of tooth loss and to explore the parameters that affect tooth loss during MP in a Greek population. A periodontist administered periodontal treatment and maintenance care to 280 participants with severe periodontitis for a mean period +/- standard deviation of 10.84 +/- 2.13 years. The periodontist recorded the following parameters for each participant: oral hygiene index level, simplified gingival index level, clinical attachment level, probing depth measurements, initial tooth prognosis, smoking status, tooth loss during active periodontal treatment and MP, and compliance with suggested maintenance visits. The authors found that total tooth loss during active treatment (n = 1,427) was greater than during MP (n = 918) and was associated with the initial tooth prognosis, tooth type group, participants' compliance with suggested maintenance visits, smoking status and acceptability of the quality of tooth restorations. Most of the teeth extracted during maintenance had an initial guarded prognosis (n = 612). Participants whose compliance was erratic had a greater risk of undergoing tooth extraction than did participants whose compliance was complete. Participants' initial tooth prognosis, tooth type, compliance with suggested maintenance visits and smoking status affected tooth loss during MP. Initial guarded prognosis and erratic compliance increased the risk of undergoing tooth extraction during maintenance. Determining predictive parameters for disease progression and tooth loss provides critical information to clinicians so that they can develop and implement rational treatment planning.
    Journal of the American Dental Association (1939) 10/2009; 140(9):1100-7. · 1.82 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the gingival fibroblast proliferative response derived from patients with chronic and aggressive periodontitis to homologous platelet-rich plasma (PRP). Gingival fibroblasts derived from nine patients with chronic periodontitis, aggressive periodontitis and healthy periodontium were grown. Medium was replaced with DMEM containing 0.5% FBS in which cells remained for two days. Cells were incubated and cultured with medium containing 50 microl/ml homologous platelet-rich plasma (PRP) or not containing PRP (control) for 24 and 48 hours. PRP originated from three donors. Cell proliferation effect was evaluated at 24 and 48 hours. Cell viability was assessed with a hemocytometer. Viable cells were counted under a phase contrast microscope. The results revealed that incubation of human gingival fibroblasts, derived from healthy and intact periodontium, chronic periodontitis and aggressive periodontitis, in culture medium containing homologous PRP statistically significantly increased the cell proliferation at 24 and 48 hours of culture. The addition of PRP to human gingival fibroblast cultures significantly increased the proliferative response, irrespective of the presence of periodontitis, type of periodontitis and PRP donor.
    Journal of the International Academy of Periodontology 02/2009; 11(1):160-8.
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    ABSTRACT: In periodontal regeneration, the growth factor concentrations and the delivery system used are of great importance. In an attempt to assess the mitogenic effect of basic fibroblast growth factor (bFGF) on periodontal ligament (PDL) cells combined with different bone replacement materials, two allografts of cortical (DFDBA) and cancellous (DFBA) bone and an anorganic bovine material with a synthetic peptide (ABM P-15) were used. The purpose of this study was to evaluate the in vitro mitogenic effect of different doses of bFGF alone or in combination with DFDBA, DFBA and ABM P-15 on human PDL cells in a time-dependent mode. PDL cell cultures were derived from the mid-root of four maxillary premolars. Cells were grown and reached confluence. On day 2 of quiescence, new medium was added along with (1) 1, 5, 10 and 25 ng/ml of bFGF alone, (2) 10 mg of DFDBA, DFBA and ABM P-15 alone and (3) their combination. The mitogenic effect was determined at 24 and 48 h of culture by using a hemocytometer chamber. The cells were counted under a phase contrast microscope. The results revealed that bFGF at the highest concentrations and after 48 h exerted a significant mitogenic effect on PDL cells, and also DFDBA and DFBA supported cell proliferation. Furthermore, DFDBA and DFBA enriched with bFGF had a significant mitogenic effect after 48 h of culture. ABM P-15 with 10 and 25 ng/ml of bFGF up-regulated PDL cell proliferation after 48 h of incubation. The findings of this study demonstrate the beneficial role of bFGF combined with DFDBA and DFBA as carriers in periodontal repair.
    Clinical Oral Implants Research 11/2006; 17(5):554-9. · 3.43 Impact Factor
  • Eudoxie Pepelassi, Alexandra Tsami, Mando Komboli
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    ABSTRACT: The purpose of this study is to investigate the correlation between the degree of patient compliance with the suggested periodontal maintenance treatment intervals and the new root caries development 5 years after the completion of the active periodontal treatment. The percentage of root surfaces with new root caries was low for both the erratic and the complete compliance patient groups. Erratic compliance with the suggested maintenance intervals 5 years after the active periodontal treatment leads to greater root caries prevalence, greater percentages of patients and root surfaces with new root caries, greater root caries prevalence for smokers, and greater percentages of new defects in root surfaces with further clinical attachment loss and plaque retention. The prevention of root caries development is based on the daily plaque removal and the high patient compliance with the therapist's suggestions for periodontal maintenance intervals.
    Compendium of continuing education in dentistry (Jamesburg, N.J.: 1995) 01/2006; 26(12):835-44; quiz 845.
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    ABSTRACT: The purpose of this in vitro study was to evaluate the effect of two concentrations of homologous platelet-rich plasma (PRP) on the proliferative response of osteoblasts derived from a patient with aggressive periodontitis. 8.5 ml of venous blood were taken from 1 healthy and non-smoker volunteer. PRP was prepared following the protocol of Curasan. Osteoblasts were derived from alveolar bone chips obtained from a patient with aggressive periodontitis during conventional periodontal surgery and a clinically healthy person during crown lengthening surgical procedure. Cells were grown in 24-well dishes and on day 2 of quiescence were treated with 1% and 5% (v/v) of PRP. The effect on cell proliferation was estimated by measuring [3H] thymidine incorporation. After 48h of incubation, cells were processed to subject to scintillation counting. Counts per minute were determined for each sample. The addition of 1% and 5% of PRP provoked a statistical significant (p<0.05) increase in cell growth. Data revealed significant enhancement of proliferative response of osteoblasts in the presence of PRP, which might serve as a source of growth factors promoting periodontal repair by modulating cell response and activities.
    Journal of musculoskeletal & neuronal interactions 9(3):167-72. · 2.45 Impact Factor