The pathogenesis of periodontitis involves a complex immune/inflammatory cascade that is initiated by the bacteria of the oral biofilm that forms naturally on the teeth. The susceptibility to periodontitis appears to be determined by the host response; specifically, the magnitude of the inflammatory response and the differential activation of immune pathways. The purpose of this review was to delineate our current knowledge of the host response in periodontitis. The role of innate immunity, the failure of acute inflammation to resolve (thus becoming chronic), the cytokine pathways that regulate the activation of acquired immunity and the cells and products of the immune system are considered. New information relating to regulation of both inflammation and the immune response will be reviewed in the context of susceptibility to, and perhaps control of, periodontitis.

Multiplexing arrays increase the throughput and decrease sample requirements for studies employing multiple biomarkers. The goal of this project was to examine the performance of Multiplex arrays for measuring multiple protein biomarkers in saliva and serum. Specimens from the OsteoPerio ancillary study of the Women’s Health Initiative Observational Study were used. Participants required the presence of at least 6 teeth and were excluded based on active cancer and certain bone issues but were not selected on any specific condition. Quality control (QC) samples were created from pooled serum and saliva. Twenty protein markers were measured on five multiplexing array panels. Sample pretreatment conditions were optimized for each panel. Recovery, lower limit of quantification (LLOQ) and imprecision were determined for each analyte. Statistical adjustment at the plate level was used to reduce imprecision estimates and increase the number of usable observations. Sample pre-treatment improved recovery estimates for many analytes. The LLOQ for each analyte agreed with manufacturer specifications except for MMP-1 and MMP-2 which were significantly higher than reported. Following batch adjustment, 17 of 20 biomarkers in serum and 9 of 20 biomarkers in saliva demonstrated acceptable precision, defined as <20% coefficient of variation (<25% at LLOQ). The percentage of cohort samples having levels within the reportable range for each analyte varied from 10% to 100%. The ratio of levels in saliva to serum varied from 1∶100 to 28∶1. Correlations between saliva and serum were of moderate positive magnitude and significant for CRP, MMP-2, insulin, adiponectin, GM-CSF and IL-5. Multiplex arrays exhibit high levels of analytical imprecision, particularly at the batch level. Careful sample pre-treatment can enhance recovery and reduce imprecision. Following statistical adjustments to reduce batch effects, we identified biomarkers that are of acceptable quality in serum and to a lesser degree in saliva using Multiplex arrays.

These results demonstrate that the fluctuation of sex steroid hormones impact gingival inflammation during menstruation.

Objective: To determine the oral status, salivary flow rate,

A key criterion of success following dental implants is the marginal bone level. Long-term clinical and radiographic evaluation is necessary to test the results of in vitro studies investigating how cantilevering of restorations or implant size affect bone level changes around implants. There is no consensus on the effect of several variables such as age, gender, implant size, and cantilever prostheses on marginal bone levels around fixed dentures supported by dental implants. Patients who received cemented, fixed restorations supported by implants and who were examined in routine recall sessions 6, 12, 24, and 36 months after loading were included in the study group. Comparative bone level measurements were obtained from images of radiographs at ×20 magnification using the CorelDraw 11.0 software program. Statistical analysis was performed using the Student t test and 1-way analysis of variance. In the 36-month observation period, there were no incidences of implant failure, excessive bone loss around implants, or peri-implant inflammation. One hundred twenty-six implants in 36 patients were evaluated, and the effect of several factors on marginal bone loss (MBL) during the 36 months after loading was analyzed statistically. There was no significant relationship between MBL and implant length or diameter, whereas age, gender, and cantilevers affected bone loss rates. MBL was elevated in older and female patients as well as in patients who received cantilevers. In cases of limiting anatomic conditions, short and/or narrow implants should be preferred over cantilever extensions.

Astra Tech, Brånemark, and ITI implants supporting fixed prostheses had same survival rates (100%) in this study. ITI and Astra Tech implants had similar changes in marginal bone levels, whereas Brånemark implants had higher marginal bone loss, particularly in the first year of function.

Objective The aim of this study was to determine differences in GCF and serum levels of fractalkine/CX3CL1 and its receptor/ CX3CR1 between the patients with stage III/grade B periodontitis and periodontally healthy subjects. Background Fractalkine (CX3CL1), the only member of CX3C chemokine family, is involved in the pathogenesis of several systemic inflammatory diseases’ disorders including rheumatoid arthritis, cardiovascular diseases, tonsillitis, and diabetes mellitus. It has critical functions in inflammatory cell migration, adhesion, and proliferation. Methods 20 stage III/grade B periodontitis (P) and 20 healthy individuals (control; C) were included in this clinical study (all never smokers and systemically healthy). Clinical periodontal parameters were measured. Serum and GCF levels of CX3CL1, CX3CR1, and IL‐1β were quantified by enzyme‐linked immunosorbent assay and reported as total amounts and concentration. Results The GCF concentrations and also total amount of CX3CL1, CX3CR1, and IL‐1β were statistically significantly higher in the patients with periodontitis compared with control group (P < 0.05). CX3CL1, CX3CR1, and IL‐1β levels in the GCF were significantly and positively correlated with all the clinical periodontal parameters (PI, PPD, BOP, and CAL; P < 0.01, P < 0.05). There was a significant correlation between IL‐1β, CX3CL1, and CX3CR1 concentrations in the GCF (respectively; r = 0.838 and r = 0.874, P < 0.01). Conclusion Fractalkine and its receptor may play role in mechanisms through the regulation of inflammation or on the pathogenesis of periodontal disease.

Background: Periodontal regeneration is dependent on the uninterrupted adhesion, maturation and absorption of fibrin clots to a periodontally compromised root surface. The modification of the root surface with different agents has been used for better fibrin clot formation and blood cell attachment. It is known that Er:YAG laser application on dentin removes the smear layer succesfully.Aim: The aim of this study is to observe blood cell attachment and fibrin network formation following ER:YAG laser irradiation on periodontally compromised root surfaces in comparison to chemical root conditioning techniques in vitro.Materials and methods: 40 dentin blocks prepared from freshly extracted periodontally compromised hopeless teeth. Specimens were divided in 5 groups; those applied with PBS, EDTA, Citric acid and Er:YAG. They were further divided into two groups: those which had received these applications, and the control group. The specimens were evaluated with scanning electron microscope and micrographs were taken. Smear layer and blood cell attachment scoring was performed.Results: In the Er:YAG laser applied group, smear layer were totally removed. In the blood applied specimens, better fibrin clot formation and blood cell attachment were observed in the Er:YAG group. In the group that had been applied with citric acid, the smear layer was also removed. The smear layer could not be fully removed in the EDTA group.Conclusion: Er:YAG laser application on the root dentin seems to form a suitable surface for fibrin clot formation and blood cell attachment. Further clinical studies to support these results are necessitated.