Current status of drug therapy for chronic hepatitis B

In this editorial,we comment on the article by Meng et al.Chronic hepatitis B(CHB)is a significant global health problem,particularly in developing countries.Hepatitis B virus(HBV)infection is one of the most important risk factors for cirrhosis and hepatocellular carcinoma.Prevention and treatment of HBV are key measures to reduce complications.At present,drug therapy can effectively control virus replication and slow disease progression,but completely eliminating the virus remains a challenge.Anti-HBV treatment is a long-term process,and there are many kinds of antiviral drugs with different mechanisms of action,it is essential to evaluate the safety and efficacy of these drugs to reduce side effects and improve patients’compliance.We will summarize the current status of CHB drug treatment,hoping to provide a reference for the selection of clinical antiviral drugs.

Meta-analysis of the association between chronic periodontitis and chronic kidney disease

BACKGROUND Many scholars have performed several clinical studies have investigated the association between chronic periodontitis(CP)and chronic kidney disease(CKD).However,there are still differences between these research results,and there is no unified conclusion.Therefore,a systematic review is required to understand this issue fully.AIM To explore the correlation between CP and CKD.METHODS Literature on the correlation between CP and CKD,as well as the clinical attachment level(CAL)and pocket probing depth(PPD)of CKD and non-CKD,were retrieved from PubMed,Embase,the Cochrane Library,and Web of Science repositories until January 2024.After the effective data were extracted,data processing and statistics were performed using Stata 12.0.RESULTS Of the 22 studies,13 were related to CP and CKD,and 9 reported CAL and PPD in patients with CKD and healthy controls.Meta-analysis of the correlation between CP and CKD revealed that CKD probability in people with CP was 1.54 times that of healthy individuals[relative risk=1.54,95%confidence interval(CI):1.40-1.70],and CP incidence in patients with CKD was 1.98 times that of healthy individuals[overall risk(OR)=1.98,95%CI:1.53-2.57].Meta-analysis of CAL and PPD evaluations between CKD patients and healthy individuals showed that CAL and PPD levels were higher in CKD patients[standard mean difference(SMD)of CAL=0.65,95%CI:0.29-1.01;SMD of PPD=0.33,95%CI:0.02-0.63].CONCLUSION A bidirectional association exists between CP and CKD.CKD risk is increased in CP patients and vice versa.Periodontal tissue or tooth loss risks increase over time in CKD patients.

Periodontitis and chronic kidney disease:A bidirectional relationship based on inflammation and oxidative stress

Chronic kidney disease(CKD)and chronic periodontitis(CP)are prevalent conditions which significantly impact public health worldwide.Both diseases share inflammatory and oxidative stress mechanisms,an indication of a likely bidirectional relationship.This editorial explored the association between CKD and CP by highlighting common inflammatory mechanisms and recent research findings that address this interrelationship.Through reviews of recent studies,we discussed how periodontal bacteria may activate systemic immune responses that affect both periodontal and renal tissues.Additionally,meta-analysis data indicated an increased risk of CKD development in patients with CP,and vice versa.The results suggest the need for more rigorous research in the future in order to address the confounding factors and evaluate specific periodontal health interventions and their direct effects on kidney function.We emphasized the importance of comprehensive and multidisciplinary care for the improvement of the overall health of patients affected by CP and CKD.

Research Progress on the Immunomodulatory Effect of Mesenchymal Stem Cells on Chronic Periodontitis

Periodontal disease is an inflammatory and destructive disease of periodontal support tissue caused by microorganisms in dental plaque. During the development of periodontal disease, host immune regulation plays an important role, and unnecessary excessive immune regulation often exacerbates the course of chronic periodontal disease. Mesenchymal stem cells (MSCs) are adult stem cells with self replication ability and multi-directional differentiation potential. Many studies have found that MSCs have strong immunosuppressive effects on both adaptive and innate immunity. In recent years, literature has reported that MSCs are involved in the immune regulatory effect of chronic periodontal disease, inhibiting its inflammatory response and alveolar bone resorption, but the specific regulatory mechanism has not been elucidated. This article reviews the current research status of the immune regulatory effects of MSCs on chronic periodontitis.

Nonsurgical periodontal-therapy improves glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis

AIM To evaluate the effect of nonsurgical periodontal therapy on glycosylated haemoglobin levels in pre-diabetic patients with chronic periodontitis(CHP).METHODS Sixty pre-diabetic patients with CHP were selected and equally allocated to case and control group. All subjects were evaluated at base line for periodontal parameters(plaque index, oral hygiene index, modified gingival index, probing pocket depth, clinical attachment level) and systemic parameters [glycosylated hemoglobin(HbA1c), fasting lipid profile, and fasting blood glucose]. The case group received non-surgical periodontal therapy. Subjects were re-evaluated for periodontal and systemic parameters after three months.RESULTS Both groups were comparable at baseline. Three months after non surgical periodontal therapy(NSPT), there was significant improvement in periodontal parameters in case group. The mean difference in systemic parameters like HbA1c and fasting plasma glucose from baseline to fourth month for case group was 0.22 ± 0.11 and 3.90 ± 8.48 respectively and control group was-0.056 ± 0.10 and-1.66 ± 6.04 respectively, which was significant between case and control group(P < 0.05). In the case group there was a significant decrease in HbA1c from baseline to three months following NSPT(P < 0.05).CONCLUSION This study showed that periodontal inflammation could affect the glycemic control in otherwise systemically healthy individuals. Periodontal therapy improved periodontal health status and decreased glycosylated haemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.

Effectiveness of Oral Care in Implant Denture Restoration in Chronic Periodontitis

Objective:To explore the effect of observation of oral care in implant denture restoration of chronic periodontitis.Methods:80 patients with chronic periodontitis implant denture restoration admitted from March 2022 to March 2023 in the hospital were selected.They were randomly divided into an observation group and a control group,with 40 cases in each group.Both groups of patients received routine treatment and care.The patients in the control group used routine oral care methods to carry out oral care,the patients in the observation group carried out oral care on the basis of the control group,observation and analysis of the patients'mastery of oral knowledge,as well as the depth of the probing and the level of clinical attachment.Results:The oral knowledge mastery of the observation group was 72.31±6.98 after the nursing intervention,which was significantly higher than the score of 86.12±7.36 of the patients in the control group who used conventional oral care,and the difference was statistically significant at P<0.05;the depth of probing and the clinical attachment level of the observation group were 2.43±0.58 and 4.31±0.86 respectively,which were significantly better than those of the control group.The depth of probing and clinical attachment level scores of the observation group were 2.99±0.54 and 5.36±1.02 respectively,and P<0.05 was considered statistically significant.Conclusion:The combination of conventional treatment and oral care can effectively improve the treatment effect of implant denture prosthesis for chronic periodontitis.However,it is necessary to pay attention to the psychological counseling of the patients in the specific clinical application to ensure that the patients can actively cooperate with the clinical treatment.

Evaluation of the Effectiveness and Safety of One-Time Endodontics in the Treatment of Chronic Apical Periodontitis with Sinus Tract in Pediatric Deciduous Teeth

Objective:To observe the effectiveness and safety of one-time endodontics in the treatment of chronic apical periodontitis with sinus tract in pediatric deciduous teeth.Methods:109 cases of children with chronic apical periodontitis with sinus tract in the deciduous teeth treated in our hospital from January 2022 to December 2023 were selected and grouped by the randomized numerical table method,with 54 cases in the experimental group and 55 cases in the control group.The experimental group was treated with one-time endodontics and the control group was treated with conventional endodontics.Results:After the treatment,the total effective rate of treatment was higher in the experimental group than in the control group(P<0.05);the incidence of adverse events was lower in the experimental group than in the control group(P<0.05);the satisfaction of the children's family members was higher in the experimental group than in the control group(P<0.05);the pain duration was lower in the experimental group than in the control group(P<0.05).Conclusion:In the experimental group,children with chronic apical periodontitis with sinus tract of the deciduous teeth were given one-time endodontic treatment,and the results of its implementation were relatively good.

Treatment effects and periodontal status of chronic periodontitis after routine Er:YAG laser-assisted therapy

BACKGROUND Routine preclinical interventions for patients with chronic periodontitis such as supragingival cleaning and subgingival curettage,establishing a balanced occlusal relationship,and irrigation with 3%hydrogen peroxide can relieve the symptoms to some extent.However,there is room for improvement in the overall effect.For example,Er:YAG lasers can quickly increase the temperature of the irradiated tissue,effectively eliminate dental plaque and calculus,reduce periodontal pockets,adjust periodontal microecology,and reduce the gingival sulcus.The content of factors in the liquid,and then achieve the purpose of treatment.AIM The aim was evaluate the effect of Er:YAG laser-assisted routine therapy on the periodontal status in chronic periodontitis.METHODS Between October 2018 and January 2020,106 patients with chronic periodontitis in our hospital were randomly assigned to either the study or control group,with 53 patients in each group.The control group underwent routine therapy,and the study group underwent Er:YAG laser therapy in addition to routine therapy.We evaluated the treatment outcome in both groups.Periodontal status was determined by clinical attachment loss(CAL),gingival index(GI),periodontal probing depth(PD),dental plaque index(PLI),and sulcular bleeding index(SBI),inflammatory factors in the gingival crevicular fluid,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8],and colony forming units(CFUs).RESULTS Total effectiveness in the study group(94.34%)was higher than that in the control group(79.25%,P<0.05).The clinical parameters in the study group(PD,5.28±1.08 mm;CAL,4.81±0.79 mm;SBI,3.37±0.59;GI,1.38±0.40;PLI,2.05±0.65)were not significantly different from those in the control group(PD,5.51±1.14 mm;CAL,5.09±0.83 mm;SBI,3.51±0.62;GI,(1.41±0.37;PLI,1.98±0.70)before treatment(P>0.05).However,after treatment,the parameters in the study group(PD,2.97±0.38 mm;CAL,2.71±0.64 mm;SBI,2.07±0.32;GI,0.51±0.11;PLI,1.29±0.34)were lower than those in the control group(PD,3.71±0.42 mm;CAL,3.60±0.71 mm;SBI,2.80±0.44;GI,0.78±0.23;PLI,1.70±0.51)(P<0.05).Differences in crevicular TNF-α,IL-6,and IL-8 levels in the study(TNF-α,7.82±3.43 ng/mL;IL-6,11.67±2.59 ng/mL;IL-8,12.12±3.19 pg/mL)and control groups(TNF-α,9.06±3.89 ng/ml,IL-6,12.13±2.97 ng/mL,IL-8,10.99±3.30 pg/mL)before therapy(P>0.05)were not significant.Following treatment,the parameters were significantly lower in the study group(TNF-α,2.04±0.89 ng/mL;IL-6,4.60±1.26 ng/mL;IL-8,3.15±1.08 pg/mL)than in the control group(TNF-α,3.11±1.07 ng/mL;IL-6,6.25±1.41 ng/mL;IL-8,4.64±1.23 pg/mL,P<0.05).The difference in the CFU of the study group[(367.91±74.32)×104/mL and control group(371.09±80.25)×104/mL]before therapy was not significant(P>0.05).The CFU decreased in both groups following therapy,however,the CFU values were lower in the study group[(36.09±15.26)×104/mL]than in the control group[(45.89±18.08)×104/mL](P<0.05).CONCLUSION Combining Er:YAG lasers with routine measures significantly improved the overall periodontal therapy outcomes by improving periodontal status and reducing oral levels of inflammatory factors and CFUs.

Expression of RUNX2 and MDM21 in rats with periodontitis under chronic intermittent hypoxia

Objective: To discuss the expression of RUNX2 and MDM21 in rats with periodontitis under the chronic intermittent hypoxia. Methods: A total of 32 SD healthy rats were randomly divided into four groups, with 8 rats in each group. The molecular biological techniques of immunohistochemistry, RT-PCR and Western blotting were employed to detect the effect of different hypoxia time(0, 6, 12, 24 and 48 h) and different concentrations of hypoxia(0.000, 0.001, 0.010, 0.060 and 0.100 ppm) on the expression of RUNX2 and MDM21 in rats of four groups. Results: The expression of RUNX2 and MDM21 in each group was significantly higher than the one at other concentrations when the concentration was 0.010 ppm, with the statistical difference(P<0.05). The expression of RUNX2 and MDM21 was that normoxic control group > periodontitis group> chronic intermittent hypoxia group > compound group under the action with the concentration of 0.010 ppm for 12 h, but there was no significant difference for the comparison among groups(P>0.05). Conclusions: The condition of chronic intermittent hypoxia can reduce the expression of RUNX2 and MDM21 in rats with periodontitis and aggravate the damage of periodontal bone.

Correlation of chronic periodontitis in tropical area and IFN-γ,IL-10,IL-17 levels

Objective:To evaluate the correlation of chronic periodontitis in tropical area and IFN- 7,IL-10 and IL-17 levels.Methods:One hundred and forty-eight patients and one hundred and thirty-two healthy control subjects were included in the study.Clinical parameters(PI.CI and PD) and GCF levels of IFN- 7.II.—10 and IL-17 were measured at baseline,week 8,week 16 and week 24 after mechanical removal of dental plaque.IFN- 7 and IL-10 were determined with EL1SA methods and IL-17 was determined with the cytometric bead array.Results:Removal of dental plaque resulted in improvement in all clinical parameters.Meanwhile,GCF IL-17 declined to control levels,while GCF IFN- 7 and IL-10 levels remained unchanged.Conclusions:The decline of GCF IL-17 levels in patients with resolution of periodontitis suggests that IL-17 is involved in the periodontal inflammatory process.

Generalized periodontitis treated with periodontal,orthodontic,and prosthodontic therapy:A case report

BACKGROUND Generalized periodontitis is a severe periodontal disease characterized by rapid periodontal destruction in healthy persons.This case report describes the treatment of a severe crowding,large overjet,and occlusal collapse due to the loss of anterior guidance with generalized periodontitis.CASE SUMMARY A 35-year-old female patient with a chief complaint of crowding and maxillary protrusion was diagnosed with generalized periodontitis by clinical and radiographic examinations.To improve crowding and overjet,orthodontic treatment was performed after basic periodontal therapy.Severely damaged upper right lateral incisor and left canine were extracted,and lower right first premolar and left second premolar were also removed to treat severe crowding.After orthodontic treatment,periodontal flap surgery for upper left molars and guided tissue regeneration for the lower left second molar was performed.Then,a dental implant was inserted in the upper left canine legion.The esthetics of the maxillary anterior tooth was improved by prosthetic restorations.The treatment result showed a well-improved occlusion with proper anterior guidance and healthy periodontal tissue after a retention period of 10 years.CONCLUSION Periodontal,orthodontic,and prosthodontic treatments are extremely useful to improve function and stable periodontal tissue for generalized periodontitis.

Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis

BACKGROUND Severe periodontitis is a major oral health concern today as it can lead to loss of teeth.Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.AIM To investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β(IL-1β)and IL-10 in gingival crevicular fluid(GCF)in patients with severe periodontitis.METHODS Eighty-six patients with severe periodontitis were randomly divided into a research group(n=43)and a control group(n=43).The control group was treated with simple periodontal therapy,and the research group was treated with dental pulp periodontal therapy.The total effective rates of the treatments;periodontal status before and after treatment through the measurement of the periodontal pocket probing depth(PPD),gingival sulcus bleeding index(SBI),mobility(MD),and plaque index(PLI);the levels of inflammatory factors IL-1βand IL-10 in the GCF;and the incidence of complications were calculated for both groups and compared using the Student’s t test and theχ^(2) test.RESULTS The total effective rate of treatment in the study group(93.02%)was higher than that in the control group(76.74%;P<0.05).While before treatment,there was no significant difference in the PLI,MD,SBI,or PPD between the two groups,the post-treatment values of PLI,MD,SBI,and PPD(4.71±0.16 mm,0.61±0.09 mm,0.96±0.17 mm,and 0.76±0.26 mm,respectively)were significantly lower(P<0.05)in the research group than in the control group(5.35±0.24 mm,0.93±0.15 mm,1.35±0.30 mm,and 1.04±0.41 mm,respectively).There was no significant difference in the level of IL-1βor IL-10 in the GCF before treatment between the two groups;after treatment,the IL-1βlevel in the research group(139.04±15.54 pg/mL)was significantly lower than that in the control group(156.35±18.10 pg/mL),and the level of IL-10 in the research group(7.98±1.01 ug/L)was higher than that in the control group(5.56±0.96 ug/L)(P<0.05).The incidence of complications in the study group(4.65%)was significantly lower than that of the control group(18.60%;P<0.05).CONCLUSION Endodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction.In addition,it can improve the periodontal condition and the overall treatment effect,reduce the risk of complications,and ensure the safety of treatment.

Amino acid profiles in relation to chronic periodontitis and rheumatoid arthritis

Chronic periodontitis (CP) and rheumatoid arthritis (RA) are chronic inflammatory conditions, and share many pathologic features. Plasma amino acid profiles have been shown to be associated with RA, but their relevance to CP remains unclear. The aim of the present study is to evaluate amino acid profiles in relation to CP and RA. The study participants consisted of 62 patients with RA (RA group), 30 patients with CP (CP group) and 29 healthy controls (H group) in age-, gender-, smoking status-balanced condition. Clinical periodontal and rheumatologic parameter values and plasma levels of 21 amino acids, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were determined. Multiple comparison analyses revealed that the RA group exhibited similar periodontal conditions but significantly higher levels of CRP, IL-6, and TNF-α than the CP group (P < 0.01). A total of four amino acids (glycine, histidine, ornithine, and alpha-aminobutyric acid) were significantly different in the concentrations among the three groups (P < 0.01). The RA group displayed significantly lower levels of glycine and histidine and significantly higher ornithine level than the CP and H groups (P < 0.01). The CP group showed significantly higher alpha-aminobutyric acid level than the RA and H groups (P < 0.01). Of these four amino acids, a significantly positive correlation was found between ornithine level and % of sites with bleeding on probing (P = 0.006) in the RA group. These results suggest a possibility that profiles of four amino acids may play a role in the pathogenesis of CP and RA.

Clinical efficacy of magnetic vibration magnetoelectric therapy in the treatment of chronic prostatitischronic pelvic pain syndrome

BACKGROUND The prominent symptoms of chronic pelvic pain syndrome(CPPS)are urogenital pain,lower urinary tract symptoms,psychological problems,and sexual dysfunction.Traditional pharmacological treatments have poor efficacy and more untoward reaction and complications.Magnetic vibration magnetoelectric therapy is a non-invasive form of physiotherapy.Nevertheless,its effectiveness in improving urinary discomfort and relieving pain in patients requires further exploration.AIM To investigate the clinical efficacy of the magnetic vibration magnetoelectric therapy instrument in the treatment of chronic prostatitis(CP)/CPPS.METHODS Seventy patients with CP/CPPS were collected from the outpatient clinic and ward of the Department of Male Medicine,Jiangsu Province Hospital of Traditional Chinese Medicine,and were treated with magnetic vibration magnetoelectric therapy once a day for a period of 14 d.National Institutes of healthchronic prostatitis symptom index(NIH-CPSI),international index of erectile function 5(IIEF-5),premature ejaculation diagnostic tool(PEDT),generalized anxiety disorder(GAD),patient health questionnaire,the pain catastrophizing scale(PCS)and traditional Chinese medicine syndrome(TCMS)scores were performed before and after treatment.RESULTS The total effective rate of treatment was 58.5%,and the total NIH-CPSI score,pain symptoms,voiding symptoms,quality of life,IIEF-5,PEDT,GAD,PCS and TCMS scores all decreased significantly(P<0.05).CONCLUSION Magnetic vibration magnetotherapy is effective in improving urinary discomfort,relieving pain,improving quality of life,improving sexual dysfunction and relieving negative emotions such as anxiety in patients with CP/CPPS.

Profile of Aggressive and Chronic Periodontitis in Kinshasa Dental Hospitals, DR Congo

Periodontitis is a prevalent destructive gum disease, characterized by loss of tissues supporting the teeth. The two main forms, chronic and aggressive have not been assessed in Kinshasa, DR Congo. Aim: The aim of this study was to investigate the Prevalence and the pattern of chronic periodontitis (CP) and aggressive periodontitis (AP) in order to improve its management. Materials and Methods: A cross sectional study of 404 subjects attending the dental services of the four hospitals of Kinshasa city, from October 2013 to April 2014 was carried out. The plaque index (PlI), bleeding on probing (BOP), probing pocket depth (PPD) and frequency of tooth brushing (FTB) were the parameters assessed. The SPSS software version 20.0 was used. Results: Out of 404 patients examined, 322 (79.7%) had chronic periodontitis versus to 44 (10.9%) of aggressive periodontitis. The female was higher than males with a sex ratio of 1.49:1 and the age group between 20 and 29 was the most represented. PPP of ≥6 mm was found in 24.6%, 5 or 5.5 mm in 27.3% and PPP of 3.5 to 4.5 mm in 48.1% of patients with periodontitis. Significant difference was found between CP and AP according to age variable, p-value < 0.001. PlI for CP was 0.97 (SD ± 0.38) while that for AP was 0.90 (SD ± 0.43). No significant differences were found between PlI, p-value = 0.47;FTB (p = 0.055) and BOP of subjects with AP and those with CP (p = 0.105). Conclusion: The two main forms of periodontitis diseases are more prevalent in patients attending dental services in Kinshasa and affect male as well as female. Age remains an essential variable to distinguish between CP and AP.

Preliminary evidence of renal function improvement in chronic progressive kidney disease using autologous CD34+cell therapy:A clinical trial

BACKGROUND To date,no specific treatment has been established to reverse progressive chronic kidney disease(CKD).AIM To evaluate the safety and efficacy of autologous CD34^(+)cell transplantation in CKD patients who exhibited a progressive decline in renal function.METHODS The estimated glomerular filtration rate(eGFR)at the beginning of the study was 15.0-28.0 mL/minute/1.73 m^(2).After five days of treatment with the granulocyte colony-stimulating factor,mononuclear cells were harvested and CD34^(+)cells were magnetically collected.CD34^(+)cells were directly injected into the bilateral renal arteries twice(at 0 and 3 months),and their safety and efficacy were evaluated for 6 months.RESULTS Four patients were enrolled and completed the study.Three of four patients showed improvement in eGFR slope(eGFR slope>0 mL/minute/1.73 m^(2)),with the monthly slope of eGFR(delta eGFR)changing from-1.36±1.1(pretreatment)to^(+)0.22±0.71(at 6 months)mL/minute/1.73 m^(2)/month(P=0.135)after cell therapy.Additionally,intrarenal resistive index(P=0.004)and shear wave velocity(P=0.04)were significantly improved after cell therapy.One patient experienced transient fever after cell therapy,and experienced bone pain during granulocyte colony-stimulating factor administration.However,no severe adverse events were reported.CONCLUSION In conclusion,our findings suggest that repetitive peripheral blood-derived autologous CD34^(+)cell transplantation into the renal arteries is safe,feasible,and may be effective for patients with progressive CKD.However,a large-scale clinical trial is warranted to validate the efficacy of repetitive regenerative cell therapy using autologous CD34^(+)cells in patients with progressive CKD.

Development and validation of a self-management ability questionnaire for patients with chronic periodontitis

Objective: This study aimed to develop and validate a self-management ability questionnaire for patients with chronic periodontitis.Methods: A questionnaire was developed through theoretical research,literature review,semistructured interview,and expert consultation.A total of 231 patients with chronic periodontitis from the Department of Periodontics in the Stomatological Hospital of Tianjin Medical University were recruited by convenient sampling.Validity and reliability were analyzed.Results: The questionnaire consisted of 24 items.Exploratory factor analysis identified three principal factors,which explained 66.949% of the total variance.The item-level content validity was between 0.800 and 1.000,and the scale-level content validity was 0.969.The coefficient of correlation between the gold standard and the whole questionnaire was 0.869.Cronbach's α of the whole questionnaire was 0.931,and the test-retest reliability coefficient was 0.825.Conclusion: The questionnaire developed in this study satisfies the measurement standard and has good reliability and validity.It is useful for clinical work to measure self-management among patients with chronic periodontitis.

Evaluation of Glutathione-S-transferase and ceruloplasmin levels in gingival crevicular fluid and gingival tissue as diagnostic markers for chronic periodontitis

Periodontitis, is an infectious ailment of multifactorial origin, that brings about destruction of bone and surrounding tissues. There are various oral pathogens that may be responsible for the destruction. The host encounters these microbial invasions and their products by the production and release of inflammatory mediators from the cells within the body. Glutathione-S-transferase (GST) are a group of enzymes that utilize glutathione in conditions resulting in oxidative stress. These enzymes play a key role in the detoxifycation of such substance. It aids in preventing damage to important cellular components caused by release of free reactive oxygen species. Ceruloplasmin is a ferroxidase enzyme. It plays a role as an anti-inflammatory agent, by its ability to scavenge free radicals within the body. The present study was targeted at evaluating the levels of Glutathione-S-Transferase (GST) and Ceruloplasmin as diagnostic markers for patients with chronic periodontitis in gingival crevicular fluid (GCF) and the gingival tissues. Thirty patients were divided into two groups. Experimental group comprising of 15 subjects with chronic perio- dontitis and the control group was composed of 15 healthy individuals. Highly significant changes in GST between the diseased and normal patients (P = 0.001) were detected. There was a decrease in GST level in both gingival tissue & GCF in diseased patients when compared to the control patients. The ceruloplasmin levels in GCF and gingival tissues showed no difference between the control and diseased group. Hence,these results indicate a relationship suggesting that GST produced during chronic inflammation could be used as biomarker that indicate periodontal disease .

A Comparable Study of Combinational Regenerative Therapies Comprising Enamel Matrix Derivative plus Deproteinized Bovine Bone Mineral with or without Collagen Membrane in Periodontitis Patients with Intrabony Defects

Aim: The aim of the present study was to examine the effectiveness of collagen membrane (CM) in regenerative therapy with deproteinized bovine bone mineral (DBBM) and enamel matrix derivative (EMD) for periodontal intrabony defects. Methods: Eighteen periodontal intrabony defects of nine chronic periodontitis patients were evaluated. Two defects per patient with probing pocket depth (PPD) ≥ 6 mm were assigned to two different types of treatments: EMD + DBBM + CM or EMD + DBBM. Clinical parameters including Gingival Index (GI), PPD, clinical attachment level (CAL), gingival recession (GR), bleeding on probing (BOP), tooth mobility (MOB), and the filled bone volume/rate (FBV/FBR), which was measured by cone beam computed tomography, were compared at baseline and 12 months post-treatment. Differences between groups were determined by the chisquare test, McNemar’s test, and Wilcoxon signed-rank test. Results: Clinically, PPD, CAL, and FBR significantly improved in both groups (p Conclusion: Periodontal regenerative therapies comprising EMD and DBBM with and without CM resulted in positive clinical outcomes. The use of CM may result in better outcomes in MOB decrease;however, long-term prognosis must be further studied.

Prediction model for hepatitis B e antigen seroconversion in chronic hepatitis B with peginterferon-alfa treated based on a responseguided therapy strategy

BACKGROUND Models for predicting hepatitis B e antigen(HBeAg)seroconversion in patients with HBeAg-positive chronic hepatitis B(CHB)after nucleos(t)ide analog treatment are rare.AIM To establish a simple scoring model based on a response-guided therapy(RGT)strategy for predicting HBeAg seroconversion and hepatitis B surface antigen(HBsAg)clearance.METHODS In this study,75 previously treated patients with HBeAg-positive CHB underwent a 52-week peginterferon-alfa(PEG-IFNα)treatment and a 24-wk follow-up.Logistic regression analysis was used to assess parameters at baseline,week 12,and week 24 to predict HBeAg seroconversion at 24 wk post-treatment.The two best predictors at each time point were used to establish a prediction model for PEG-IFNαtherapy efficacy.Parameters at each time point that met the corresponding optimal cutoff thresholds were scored as 1 or 0.RESULTS The two most meaningful predictors were HBsAg≤1000 IU/mL and HBeAg≤3 S/CO at baseline,HBsAg≤600 IU/mL and HBeAg≤3 S/CO at week 12,and HBsAg≤300 IU/mL and HBeAg≤2 S/CO at week 24.With a total score of 0 vs 2 at baseline,week 12,and week 24,the response rates were 23.8%,15.2%,and 11.1%vs 81.8%,80.0%,and 82.4%,respectively,and the HBsAg clearance rates were 2.4%,3.0%,and 0.0%,vs 54.5%,40.0%,and 41.2%,respectively.CONCLUSION We successfully established a predictive model and diagnosis-treatment process using the RGT strategy to predict HBeAg and HBsAg seroconversion in patients with HBeAg-positive CHB undergoing PEG-IFNαtherapy.