Periodontitis:An often-neglected complication of diabetes

The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)after cardiovascular disease,eye disease,neuropathy,nephropathy,and peripheral vascular disease.DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease.On the other hand,the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM.Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss.A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM.The prevalence of periodontitis was found to be 75.7%in this study.Based on logistic regression analysis,the predictive factors for higher risk were low tooth brushing frequency[odds ratio(OR)=4.3],high triglycerides(TG;OR=3.31),high total cholesterol(TC;OR=2.87),higher glycated hemoglobin(HbA1c;OR=2.55),and higher age(OR=1.05)while higher education level was protective(OR=0.53).However,the most influential variables were HbA1c followed by age,TC,TG,low education level,brushing frequency,and sex on the random forest model(this model showed higher sensitivity for predicting the risk).A good understanding of the predictors for periodontitis in T2DM patients is important in prevention,early detection of susceptible patients,and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.

Link between periodontitis and diabetic retinopathy:Inflammatory pathways and clinical implications

The bidirectional relationship between periodontitis and type 2 diabetes mellitus has been well-established.However,the underlying molecular mechanisms remain unclear.Diabetic retinopathy(DR)is an important complication of diabetes,but there are few studies on the relationship between DR and periodontitis,especially on the intrinsic inflammatory pathway mechanism.This article reviews the latest clinical data on how diabetes promotes susceptibility to periodontitis from the epidemiological and molecular perspectives,with a special focus on the key roles of systemic inflammation and endothelial dysfunction in the interplay between DR and periodontitis.Comprehension of the intertwined pathogenesis of DR and periodontitis can better guide the development of comprehensive management strategies for glycemic control and periodontal health,with the aim of mitigating the progression of DR and enhancing overall well-being.

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.

Analysis of influencing factors of anxiety and depression in patients with periodontitis

BACKGROUND Periodontitis is a chronic oral disease caused by pathogenic microorganisms that corrode tooth tissue,form periodontal pockets,absorb alveolar bone,and finally lead to tooth loss.During treatment,patients are prone to anxiety,tension,and other negative emotions,which affect their ability to face the disease and may also lead to aggravation of the original condition and affect oral health.Therefore,it is important to improve the negative psychology of patients with periodontitis to clarify the factors that may lead to negative psychological emotions.AIM To investigate the risk factors that may lead to anxiety and depression in patients with periodontitis.METHODS One hundred patients with periodontitis were selected between March 2022 and March 2023 at our hospital.All patients were assessed with the Zung Self-rating Depression Scale(SDS)(≥53 points indicate a depressive state)and Zung Selfrating Anxiety Scale(SAS)(≥50 points indicates an anxious state).In this study,patients who experienced anxiety or depression were included in the occurrence group and those without anxiety or depression were included in the nonoccurrence group.The baseline data of the two groups were compared to explore the risk factors for anxiety and depression in patients with periodontitis.RESULTS A total of 100 patients with periodontitis were included in this study.According to the SDS,38 patients(38.00%)developed depression,with an average SDS score of(68.52±5.85)points.According to the SAS,40 patients(40.00%)developed anxiety,and the average SAS score was(72.15±4.15)points.In this study,56 patients with anxiety or depression were included.Compared with the nonoccurrence group,the occurrence group had higher ages(≥60 years),lower level of hope(low level),educational level(high school or below),disease perception(poor),and sleep disorder(yes).The negative coping dimension scores of the simplified coping style questionnaire(SCSQ)and Dental Fear Scale(DFS)in the occurrence group were higher,whereas the score of the positive coping dimension of the SCSQ was significantly lower(P<0.05).There were no significant differences in the other data between the groups(P>0.05).The results of multiple logistics regression analysis showed that age(≥60 years),level of hope(low level),educational level(high school or below),disease perception(poor),sleep disorder(yes),high negative coping dimension scores of SCSQ,high score of DFS,and low positive coping dimension scores of SCSQ were all factors contributing to the anxiety and depression in patients with periodontitis(odds ratio>1,P<0.05).CONCLUSION Age,hope level,educational level,disease perception,sleep disorders,coping style,and dental fear were all associated with anxiety and depression in patients with periodontitis.

Role of viruses in periodontitis:An extensive review of herpesviruses,human immunodeficiency virus,coronavirus-19,papillomavirus and hepatitis viruses

Periodontitis is the inflammation of the supporting structures around the dentition.Several microbial agents,mostly bacteria,have been identified as causative factors for periodontal disease.On the other hand,oral cavity is a rich reservoir for viruses since it contains a wide variety of cell types that can be targeted by viruses.Traditionally,the focus of research about the oral flora has been on bacteria because the most widespread oral diseases,like periodontitis and dental caries,are outcomes of bacterial infection.However,recently and especially after the emergence of coronavirus disease 2019,there is a growing tendency toward including viruses also into the scope of oral microbiome investigations.The global high prevalence of periodontitis and viral infections may point out to a concomitant or synergistic effect between the two.Although the exact nature of the mechanism still is not clearly understood,this could be speculated through the manipulation of the immune system by viruses;hence facilitating the furthermore colonization of the oral tissues by bacteria.This review provides an extensive and detailed update on the role of the most common viruses including herpes family(herpes simplex,varicella-zoster,Epstein-Barr,cytomegalovirus),Human papillomaviruses,Human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2 in the initiation,progression and prognosis of periodontitis.

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.

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.

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.

Exploring the mechanisms of magnolol in the treatment of periodontitis by integrating network pharmacology and molecular docking

Background:Magnolol,a bioactive extract of the Chinese herb Magnolia officinalis has a protective effect against periodontitis.This study is aimed to explore the mechanisms involved in the functioning of magnolol against periodontitis and provide a basis for further research.Methods:Network pharmacology analysis was performed based on the identification of related targets from public databases.The Protein-protein interaction(PPI)network was constructed to visualize the significance between the targets of magnolol and periodontitis.Subsequently,Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis were performed to predict the functions and the signal regulatory pathways involved in the action of magnolol against periodontitis.The“functiontarget-pathway”networks were constructed to analyze the core targets and pathways of magnolol against periodontitis.Molecular docking was used to verify the interaction of magnolol and core targets.Results:A total of 58 active targets of magnolol and 644 periodontitis-related targets were collected from public databases.A total of 25 targets of magnolol against periodontitis were identified based on the Venn diagram.GO analysis showed that magnolol has a role in the response to oxidative stress,nicotine,and lipopolysaccharide.KEGG enrichment analysis indicated that the mechanism of magnolol against periodontitis was mainly related to the tumor necrosis factor(TNF),phosphoinositide 3-kinase(PI3K/Akt),and mitogen-activated protein kinase(MAPK)signaling pathways.Combined with PPI network and molecular docking results,the core targets of magnolol against periodontitis included AKT1,MAPK8,MAPK14,TNF,and TP53.Conclusion:To summarize,the anti-periodontitis mechanisms of magnolol are potentially through regulating the TNF,PI3K/Akt,and MAPK signaling pathways.

Establishment of models to predict factors influencing periodontitis in patients with type 2 diabetes mellitus

BACKGROUND Type 2 diabetes mellitus(T2DM)is associated with periodontitis.Currently,there are few studies proposing predictive models for periodontitis in patients with T2DM.AIM To determine the factors influencing periodontitis in patients with T2DM by constructing logistic regression and random forest models.METHODS In this a retrospective study,300 patients with T2DM who were hospitalized at the First People’s Hospital of Wenling from January 2022 to June 2022 were selected for inclusion,and their data were collected from hospital records.We used logistic regression to analyze factors associated with periodontitis in patients with T2DM,and random forest and logistic regression prediction models were established.The prediction efficiency of the models was compared using the area under the receiver operating characteristic curve(AUC).RESULTS Of 300 patients with T2DM,224 had periodontitis,with an incidence of 74.67%.Logistic regression analysis showed that age[odds ratio(OR)=1.047,95%confidence interval(CI):1.017-1.078],teeth brushing frequency(OR=4.303,95%CI:2.154-8.599),education level(OR=0.528,95%CI:0.348-0.800),glycosylated hemoglobin(HbA1c)(OR=2.545,95%CI:1.770-3.661),total cholesterol(TC)(OR=2.872,95%CI:1.725-4.781),and triglyceride(TG)(OR=3.306,95%CI:1.019-10.723)influenced the occurrence of periodontitis(P<0.05).The random forest model showed that the most influential variable was HbA1c followed by age,TC,TG, education level, brushing frequency, and sex. Comparison of the prediction effects of the two models showedthat in the training dataset, the AUC of the random forest model was higher than that of the logistic regressionmodel (AUC = 1.000 vs AUC = 0.851;P < 0.05). In the validation dataset, there was no significant difference in AUCbetween the random forest and logistic regression models (AUC = 0.946 vs AUC = 0.915;P > 0.05).CONCLUSION Both random forest and logistic regression models have good predictive value and can accurately predict the riskof periodontitis in patients with T2DM.

The Dual Role of Non-coding RNAs in the Development of Periodontitis

This review aims to sum up how Non-coding RNAs(ncRNAs)regulate the development of periodontitis and provides a new perspective for understanding the pathogenesis of periodontitis.We explored the ncRNA's dual role in the development of periodontitis by summarizing evidence from previous in vivo and in vitro studies as well as clinical samples.In our review,the downregulation of 18 miRNAs,22 lncRNAs and 10 circRNAs demonstrates protective roles in periodontitis.In contrast,the expression of other 11 miRNAs,7 lncRNAs and 6 circRNAs are upregulated in periodontitis,which promote the progression of periodontitis.These dysregulated ncRNAs exert their protective or destructive roles by mainly influencing cell proliferation,differentiation and apoptosis via cross-talking with various molecules or signaling pathways.Our findings suggested which and how ncRNAs promote or delay the progression of periodontitis,which may greatly contribute to diagnose and therapy development of periodontitis based on ncRNAs in the future.

High incidence of periodontitis in patients with ascitic decompensated cirrhosis

BACKGROUND Periodontitis has been associated with various liver diseases.However,the relevance of periodontitis in the progression of decompensated cirrhosis remains inconclusive.In particular,it is unclear whether the common periodontitis pathogens,Porphyromonas gingivalis(P.gingivalis)and Actinobacillus actinomycetemcomitans(A.actinomycetemcomitans),can be detected not only in the oral mucosa but also in ascites and stool.AIM To investigate the significance of periodontitis,P.gingivalis,and A.actinomycetemcomitans in cirrhosis patients with ascitic decompensation.METHODS This prospective study was conducted at the University Hospital Hamburg Eppendorf,a tertiary center in Northern Germany.A cohort of 27 patients with ascitic decompensated liver cirrhosis underwent dental examinations to assess the association between periodontitis and various clinical parameters of cirrhosis,as well as patient outcomes.PCR was used to test gingival samples,ascites,and stool for the presence of P.gingivalis and A.actinomycetemcomitans.Gingival samples were collected by probing the deepest gum pocket of a sextant and wiping them on a cotton swab.RESULTS Periodontitis was diagnosed in 22 out of 27(82%)ascite patients,which is significantly more common than in a control cohort of 100 unselected patients(59%,P=0.04).P.gingivalis was detected in the gingiva of six patients,and one of them also had P.gingivalis in their stool.However,P.gingivalis was not found in the ascites of any patient.Five out of six patients with P.gingivalis had periodontitis(83%).A.actinomycetemcomitans was not detected in any sample.Patients without periodontitis had a significantly higher mortality rate compared to those with periodontitis,and survival(Kaplan-Meier analysis)was longer in patients with periodontitis(P=0.02).Transplantfree survival was also more common in patients with periodontitis compared to those without(63%vs 0%,P=0.02).CONCLUSION Decompensated cirrhotic patients frequently suffer from periodontitis.However,there was no evidence of the translocation of P.gingivalis or A.actinomycetemcomitans into ascites.The survival of cirrhotic patients with periodontitis was not reduced.

Effect of puerarin on inflammation and alveolar bone resorption in experimental rats with periodontitis

Objective:To investigate the effect of puerarin on inflammation and alveolar bone resorption in rats with experimental periodontitis.Methods:Thirty-six 7-week-old Sprague-Dawley rats were randomly divided into three groups(n=12).Twelve rats as the control group and the remaining rats were to establish a chronic periodontitis model ligated with orthodontic ligature wire on the cervical part of the left maxillary first molar under general anesthesia.All three groups were administered by gavage for 14 days:equal amounts of saline were given to the control and periodontitis groups,and 400 mg/kg concentration of puerarin was given to the puerarin group.All rats were anesthetized after 24 h of the last administration,blood was collected from the abdominal aorta,and the serum was centrifuged for the detection of IL-4,IL-10,IL-6,and IFN-γin peripheral blood,then all rats were executed,some rats separated from the left maxilla,fresh gingival tissue removed from the buccal-palatal side of the left maxillary first molar,and the remaining maxillary bone tissue used for the detection of Micro-CT;some rats subjected to the left maxillary bone specimens taken with the gingival tissues,used for HE staining detection.Results:HE staining showed that inflammatory cell infiltration was significantly reduced in the puerarin group compared to the periodontitis group.ELISA analysis showed that puerarin promoted IL-4 and IL-10 expression and decreased IL-6 and IFN-γexpression levels in serum(P<0.05).Micro-CT showed that puerarin significantly reduced alveolar bone resorption compared to the periodontitis group(P<0.05).Conclusion:Puerarin may inhibit inflammation and alveolar bone resorption in experimental periodontitis rats.

Five-year outcomes of immediate implant placement for mandibular molars with and without chronic apical periodontitis:A retrospective study

BACKGROUND Most physicians consider molars with chronic apical periodontitis(CAP)lesions as contraindications for immediate implant placement.At the patient’s request,we perform immediate implant placement of the mandibular molars with CAP in clinical practice.AIM To retrospectively analyze and compare the 5-year outcomes of immediate implant placement of the mandibular molars with CAP and those without obvious inflammation.METHODS The clinical data of patients with immediate implant placement of the mandibular molars in the Department of Oral and Maxillofacial Surgery,the Affiliated Hospital of Qingdao University,from June 2015 to June 2017 were collected.The patients were divided into CAP(n=52)and no-CAP(n=45)groups.Changes in bone mineral density and bone mass around implants were analyzed 5 years after implant restoration.RESULTS At 5 years after implantation,the peri-implant bone mineral density was 528.2±78.8 Hounsfield unit(HU)in the CAP group and 562.6±82.9 HU in the no-CAP group(P=0.126).Marginal bone resorption around implants did not differ significantly between the two groups,including buccal(P=0.268)or lingual(P=0.526)resorption in the vertical direction or buccal(P=0.428)or lingual(P=0.560)resorption in the horizontal direction.Changes in the peri-implant jump space did not differ significantly between the two groups,including the buccal(P=0.247)or lingual(P=0.604)space in the vertical direction or buccal(P=0.527)or lingual(P=0.707)space in the horizontal direction.The gray value of cone-beam computed tomography measured using Image J software can reflect the bone mineral density.In the CAP area,the gray values of the bone tissue immediately and 5 years after implant placement differed significantly from those of the surrounding bone tissue(P<0.01).CONCLUSION The results of this study suggest that immediate implant placement of the mandibular molars with CAP can achieve satisfactory 5-year clinical results,without significant differences in the complications,survival rate,or bone tissue condition from the no-CAP mandibular molars.

Daily Lifestyle Habits as Risk Factors for Plaque-Induced Gingivitis and Periodontitis Severity and Grading among Samples of Dental Students at King Khalid University

Objective: To assess daily lifestyle habits as risk factors for plaque-induced gingivitis and periodontitis severity and grading among samples of dental students at King Khalid University. Material and Methods: This study included 150 male participants. They were divided according to the levels into three equal groups: levels 5, 6, and 7 (group I), levels 8, 9, 10 (group II) and levels 11, 12, and interns (group III). This study consisted of questions related to age, gender, educational level, father’s education, mother’s education, home ownership, brushing teeth more than or twice a day, in addition to daily lifestyle habits that were daily smoking, daily use of sugary drinks, and daily use of sugary foods. Some clinical parameters of plaque-induced gingivitis and periodontitis and the percentage of radiographic bone loss were recorded. All data were collected and analyzed using Tukey’s test and Chi-square test. A P-value of less than 0.5 (p Results: One hundred fifty male dental students of different levels in the college of dentistry at King Khalid University participated in the study in three groups (I, II, and III). The mean age of group III is more than that of group II and group I, with highly statistically significant differences (p 30%) were more among the participants in group I than the participants in groups III and II. There was an increase in the percentage of affected participants with stages III and IV of clinical attachment loss (CAL), periodontal pocket depth (PPD), radiographic bone loss (%RBL), tooth mobility, as well as glycated hemoglobin (HbA1c) test values (>7%), and the number of cigarettes smoked per day (>10 cigs) in group III more than in group II and I. Conclusion: We conclude that the severity and grading of plaque-induced gingivitis were higher among the participants in group I, while the severity and grading of periodontitis were higher among the participants in group III due to the different impact of their daily lifestyle habits.

Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis

A growing body of evidence from multiple areas proposes that periodontal disease,accompanied by oral inflammation and pathological changes in the microbiome,induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease(NAFLD).A subgroup of NAFLD patients have a severely progressive form,namely nonalcoholic steatohepatitis(NASH),which is characterized by histological findings that include inflammatory cell infiltration and fibrosis.NASH has a high risk of further progression to cirrhosis and hepatocellular carcinoma.The oral microbiota may serve as an endogenous reservoir for gut microbiota,and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome dysbiosis.Gut dysbiosis increases the production of potential hepatotoxins,including lipopolysaccharide,ethanol,and other volatile organic compounds such as acetone,phenol and cyclopentane.Moreover,gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall,leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal circulation.In particular,many animal studies support that oral administration of Porphyromonas gingivalis,a typical periodontopathic bacterium,induces disturbances in glycolipid metabolism and inflammation in the liver with gut dysbiosis.NAFLD,also known as the hepatic phenotype of metabolic syndrome,is strongly associated with metabolic complications,such as obesity and diabetes.Periodontal disease also has a bidirectional relationship with metabolic syndrome,and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation cooperatively.In this review,we will describe the link between periodontal disease and NAFLD with a focus on basic,epidemiological,and clinical studies,and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the microbiome.In conclusion,it is presumed that the pathogenesis of NAFLD involves a complex crosstalk between periodontal disease,gut microbiota,and metabolic syndrome.Thus,the conventional periodontal treatment and novel microbiome-targeted therapies that include probiotics,prebiotics and bacteriocins would hold great promise for preventing the onset and progression of NAFLD and subsequent complications in patients with periodontal disease.

Management of diabolical diabetes mellitus and periodontitis nexus: Are we doing enough?

Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the &#x0201c;sixth&#x0201d; major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A &#x0201c;two way&#x0201d; relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.

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.

Expression and distribution of TNF-α and PGE_2 of periodontal tissues in rat periodontitis model

Objective:To simulate the expression of TNF-α and PGE2 of periodontal tissues in rat periodontitis model.Methods:40 Wistar rats were randomly divided into the periodontitis group and the control group（n=20）.After the successful establishment of periodontitis rat model,raising for six weeks before the animals were sacrificed.The periodontal tissues were obtained and made into slices.Observed the histopathological changes of the periodontal tissues and measured TNF-α,PGE2 levels change by immunohistochemistry.Western blot analysis and EI.ISA.Results:TNF-α,PGE2 expression of the periodontitis group was significantly higher than that in the control group,the difference was significant（P【0.0S）.Conclusions:The TNF-α.PGE2expression of the rat periodontal tissue in the periodontitis group was significantly higher than the control group.