唾液中一氧化氮含量与牙周炎的相关性研究

目的:研究牙周炎患者唾液中一氧化氮(NO)含量与牙周炎各种临床指标的相关性,探讨一氧化氮在牙周炎发展过程中可能发挥的作用.方法:选择牙周健康者28人(对照组),慢性牙周炎32人(实验组),用Griess反应测定牙周基础治疗前后唾液中亚硝酸盐含量,间接反映NO水平,分析牙周临床指标与NO含量的关系.结果:实验组唾液中NO含量较对照组显著增加,牙周炎患者唾液NO含量与牙周探诊深度,附着水平之间有显著正相关.结论:NO的产生与牙周炎症过程有关.牙周基础治疗后,随着局部炎症逐渐减轻,唾液NO含量呈下降趋势.     

牙周炎患者全唾液中游离氨基酸研究

牙周炎患者全唾液中游离氨基酸研究第四军医大学口腔医学院李焰，司徒镇强，吴军正，吴织芬第四军医大学中学心实验室陈镔，刘智广近年来，生理体液中某些游离氨基酸（ＦＡＡ）含量的测定已逐步成为一些临床疾病的辅助诊断指标。本文采用氨基酸分析仪测定正常人和牙周炎患...     

不同类型牙周炎患者唾液中8-OHdG含量的比较

目的:检测不同类型牙周炎患者非刺激性全唾液中8-OHdG的含量并评价其与PD,CAL等临床指标的关系。方法:留取10名侵袭性牙周炎,10名慢性牙周炎和10名健康对照非刺激性全唾液,并记录全口PD,CAL,PLI,BI。ELLISA试剂盒检测唾液中8-OHdG含量。结果:8-OHdG含量在3组间存在统计学差异,AgP组:(3.8 ±1.0) μg/L, CP组:(2.37±0.7) μg/L,H组:(1.0±0.6) μg/L。PD,BI,PLI,CAL与8-OHdG含量存在相关关系,慢性与侵袭组中8-OHdG含量与平均CAL, CAL>5mm位点所占百分比,CAL>7 mm位点所占百分比相关。结论:唾液中8-OHdG含量可以反映牙周组织的破坏程度并与牙周炎类型存在相关关系。     

牙周炎患者唾液GSH-PX活性的检测

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牙周炎和青少年牙周炎患者唾液中SIgA及血中IgA的研究

免疫球蛋白的水平,反映了机体的免疫活性,免疫球蛋白参与全身和局部的防御反应,也有报道牙周病患者血液和唾液中的免疫球蛋白量发生改变,作者采用放射免疫法(双抗体—PEG 法)分别检测牙周炎和青少年牙周炎患者血清 IgA 及唾液中的 SIgA 的含量,为探讨牙周病免疫学病因提供依据。     

一氧化氮及一氧化氮合成酶与牙周炎

一氧化氮是生物体内重要的信号分子,参与多种系统生理功能的调节和病理过程的发生、发展.近年来许多研究表明一氧化氮与牙周炎的形成和发展有着极为密切的关系.本文就一氧化氮的特性及其与牙周炎的相关性作一综述.     

成人牙周炎患者全唾液IgA、IgG水平分析

目的：分析成人牙周炎患者全唾液IgA、IgG水平及其与临床牙周检测指标、指数之间的相关关系。方法：收集成人牙周炎患者25例,年龄、性别配对正常对照25例,采集非刺激性全唾液,对成人牙周炎组治疗前及牙周基础治疗后四周进行临床牙周检查与记录,并用自动分析仪测定唾液中IgA、IgG浓度。结果：成人牙周炎组牙周基础治疗后牙周袋探诊深度、牙龈指数、探诊出血显著下降;成人牙周炎组初诊唾液IgG浓度显著高于对照组,并与牙周袋探诊深度、牙龈指数间存在显著正相关关系,治疗后IgG浓度明显下降;初诊唾液IgG、IgA与基础治疗后四周牙周袋探诊深度变化绝对值间有显著正相关关系。结论：唾液IgG水平可以反映成人牙周炎炎症程度与牙周袋深度。唾液IgG、IgA水平可能成为牙周炎患者短期基础治疗预后判断的指标。     

慢性牙周炎患者唾液蛋白酶谱分析

目的 比较慢性牙周炎患者和牙周健康者的唾液蛋白谱差异,以期为慢性牙周炎的诊断和治疗监测提供依据。方法 收集慢性牙周炎患者和牙周健康者刺激性唾液,采用蛋白芯片技术,对慢性牙周炎患者和正常人的唾液蛋白酶谱进行分析。结果 慢性牙周炎患者和牙周健康者唾液蛋白酶的表达具有统计学差异。其中,慢性牙周炎患者唾液中去整合素金属蛋白酶（ADAM）8,基质金属蛋白酶（MMP）-8、-12,脑啡肽酶/CD10,尿激酶纤维蛋白溶酶原激活剂/尿激酶的表达高于牙周健康者（P<0.01）;ADAM9,含凝血酶敏感素基序的去整合素金属蛋白酶（ADAMTS）1、13,组织蛋白酶B、E、L、V、X/Z/P,激肽释放酶6、7、11、13,MMP-9,蛋白酶3、早老素1和前蛋白转化酶9的表达低于牙周健康者（P<0.05）。结论 慢性牙周炎患者的唾液蛋白酶谱与牙周健康者具有显著差异,唾液蛋白酶谱分析将有望成为慢性牙周炎临床诊断和治疗监测的实验检查手段。     

牙周炎伴糖尿病患者全唾液中Pro-CT含量的检测及其意义

目的:比较糖尿病合并牙周炎患者、单纯糖尿病患者、单纯牙周炎患者以及健康者全唾液中降钙素原(Pro-CT)水平,及其与血糖控制情况及牙周病炎严重程度之间的关系。方法:采用病例对照研究,纳入糖尿病合并牙周炎患者(DM+CP组)24例,单纯糖尿病患者(DM组)、单纯牙周炎患者(CP组)以及健康人群各30例,收集受检者静息全唾液,采用酶联免疫吸附试验(ELISA)检测全唾液中Pro-CT水平。结果:DM+CP组全唾液中Pro-CT水平显著高于其他3组,差异极具统计学意义(P<0.01);全唾液中Pro-CT水平随牙周炎严重程度加重而增高,随血糖控制情况的不理想而增高,差异有统计学意义;全唾液中Pro-CT水平与探诊深度(PD)、探诊出血指数(BI)、附着丧失(AL)、缺失牙数均呈正相关,且相关程度由高到低依次为PD、BI、AL、缺失牙数,差异有统计学意义(P<0.05)。结论:糖尿病患者体内的微炎症状态可能与牙周炎症有关,全唾液中Pro-CT水平既受牙周炎症影响也受全身因素的调控。     

Association Between Periodontitis and Salivary Nitric Oxide Metabolites Among Community Elderly Koreans

Background: Nitric oxide (NO) is known to play an important role in many biologic systems, although the relationship between NO metabolites and periodontitis remains controversial. Moreover, little evidence of an association between salivary NO (S‐NO) and periodontitis in the general population has been reported. This study aims to investigate the relationship between S‐NO and periodontitis in an elderly Korean population. Methods: A cross‐sectional study was conducted using participants and salivary samples from Sunchang Elderly Cohort Study. The total number of final participants was 242 (91 males and 151 females; 48 to 93 years old). Periodontitis was determined by a clinical attachment loss of >6 mm at six probe points on 12 index teeth. NO was measured in unstimulated saliva via the Griess reaction. Sociodemographic status, general/oral health, and health‐related behaviors were investigated as confounders. Bivariate analysis and multivariable linear regression analyses including confounders were applied. Results: After controlling for age, sex, education, salivary flow rate, number of teeth, smoking status, physical activity, hypertension, and diabetes, three metabolites of S‐NO (total NO, nitrite, and nitrate) were independently associated with the percentage of probe points exhibiting periodontitis. Of these linear associations, total NO was found to have the strongest correlation with periodontitis (partial r = 0.181, P = 0.009). These associations were most pronounced in females (except for nitrate), non‐smokers, those without hypertension, and those without diabetes. Conclusions: Our data suggest that high concentrations of S‐NO are associated with severe periodontitis. Thus, S‐NO may serve as a potential biologic marker for detecting and monitoring periodontitis.     

慢性牙周炎患者牙龈组织内诱导型一氧化氮合酶表达的研究

目的:研究牙周健康者和慢性牙周炎患者牙龈组织中诱导型一氧化氮合酶的表达强度,探讨一氧化氮在牙周病发病过程中的作用.方法:选择牙周健康组、慢性牙周炎活动期组,慢性牙周炎静止期组各20例,采取免疫组织化学的方法染色,光镜下观察牙龈组织内诱导型一氧化氮合酶的表达强度.结果:慢性牙周炎时牙龈组织中诱导型一氧化氮合酶主要在鳞状上皮和间质组织的细胞胞浆中阳性表达,正常组表达强度弱于慢性牙周炎静止期组和活动期组,慢性牙周炎静止期组表达强度弱于慢性牙周炎活动期组.结论:一氧化氮参与了慢性牙周炎的发生和发展过程,牙龈组织中诱导型一氧化氮合酶的表达强度与慢性牙周炎的炎症程度密切相关.     

Nitric oxide synthesis is decreased in periodontitis

OBJECTIVES: In order to study the possible role of nitric oxide (NO) in the development of periodontitis, we measured the concentration of its stable metabolite nitrite (NO2-) in the saliva of patients with periodontitis and healthy subjects. MATERIALS AND METHODS: We have analysed salivary NO2- concentrations in 25 subjects with rapidly progressive periodontitis (RPP), 25 with adult periodontitis (AP) and in 25 periodontally-healthy persons. The concentrations of NO2- were determined by the Griess reaction in microtitration plates. Periodontal tissue destruction was determined by measuring the attachment level loss using standard methods. RESULTS: Subjects with periodontitis had significantly less NO2- in saliva than healthy subjects. Subjects with RPP had lower NO2- concentrations than those with AP Parotid gland saliva contained less NO2- than sublingual gland or total saliva. CONCLUSIONS: Local NO production is decreased in patients with periodontitis. This effect is more pronounced in those with severe types of disease.     

Non‐Surgical Periodontal Therapy Reduces Saliva Adipokine and Matrix Metalloproteinase Levels in Periodontitis

Background: Adipokines enhance the synthesis of proinflammatory cytokines and matrix metalloproteinases (MMPs), which play a role in extracellular matrix degeneration. The aim of this study is to determine the levels of some adipokines, proinflammatory cytokines, and MMPs in the saliva of patients with periodontitis and healthy individuals and to evaluate the changes after non‐surgical periodontal therapy (NSPT). Methods: Of 32 individuals included in the study, 17 had periodontitis and 15 had healthy gingiva. Saliva samples were obtained from all individuals. In patients with periodontitis, samples were recollected 3 and 6 months after NSPT. Visfatin, chemerin, progranulin, interleukin (IL)‐1β, IL‐8, MMP‐8, and MMP‐13 levels were measured using enzyme‐linked immunosorbent assay. Results: In patients with periodontitis, all of the parameters measured in the saliva were higher than those of healthy individuals. At 3 months, visfatin, progranulin, IL‐8, and MMP‐8 levels were significantly decreased compared with baseline values. The levels of other biochemical parameters, chemerin and IL‐1β, were significantly decreased compared with baseline values at 6 months, and the levels became similar to those in healthy individuals. In the periodontitis group, positive correlations were found among visfatin and IL‐8 (r = 0.909, P <0.01), MMP‐8 (r = 0.702, P = 0.02), and MMP‐13 (r = 0.781, P = 0.01); chemerin and IL‐8 (r = 0.913, P <0.01), MMP‐8 (r = 0.770, P <0.01), and MMP‐13 (r = 0.788, P <0.01); and progranulin and IL‐8 (r = 0.762, P <0.01), MMP‐8 (r = 0.845, P <0.01), and MMP‐13 (r = 0.813, P <0.01). Conclusion: Adipokines may contribute to the breakdown of periodontal tissue in periodontitis by stimulating the expression of proinflammatory cytokines and MMPs.     

Intracanal Metformin Promotes Healing of Apical Periodontitis via Suppressing Inducible Nitric Oxide Synthase Expression and Monocyte Recruitment

IntroductionWe have previously shown that intracanal metformin ameliorates apical periodontitis, partially by modulation of osteoblast apoptosis. The action of metformin on other cell types pertinent to the development of apical periodontitis needs to be examined. In the present study, we aimed to analyze whether its effects on the expression of inducible nitric oxide synthase (iNOS) and monocyte recruitment contribute to the therapeutic effect on apical periodontitis.MethodsLipopolysaccharide (LPS)-induced expression of iNOS in a human monocytic cell line, Mono-Mac-6, was assessed by Western blot. The amount of nitrite in culture medium was assessed to quantify nitric oxide (NO) production. C-C motif chemokine ligand-2 (CCL-2) synthesis was measured by enzyme-linked immunosorbent assay. Experimental apical periodontitis in rats was treated with root canal debridement with or without intracanal metformin medication. Lesion progression was assessed by conventional radiography and micro–computed tomographic imaging. Cellular expression of iNOS and the number of monocytes/macrophages were assessed by immunohistochemistry.ResultsMetformin suppressed LPS-induced iNOS and NO production by monocytes. More importantly, metformin inhibited LPS-enhanced CCL-2 synthesis through modulation of the iNOS/NO pathway. Intracanal metformin reduced bone resorption associated with apical periodontitis and suppressed iNOS expression and monocyte recruitment.ConclusionsOur results confirmed the therapeutic efficacy of intracanal metformin for apical periodontitis. Suppression of monocyte recruitment through modulation of iNOS expression and NO production is an important mechanism underlying the beneficial effect of metformin.     

Effects of Diabetes on Salivary Gland Protein Expression of Tetrahydrobiopterin and Nitric Oxide Synthesis and Function

Background: Xerostomia is defined as dry mouth resulting from a change in the amount or composition of saliva and is often a major oral health complication associated with diabetes mellitus (DM). Studies have shown that xerostomia is more common in females at the onset of DM. Evidence suggests that nitric oxide (NO) plays a critical role in healthy salivary gland function. However, the specific mechanisms by which NO regulates salivary gland function at the onset of DM have yet to be determined. This study has two aims: 1) to determine whether protein expression or dimerization of NO synthase enzymes (neuronal [nNOS] and endothelial [eNOS]) are altered in the onset of diabetic xerostomia; and 2) to determine whether the changes in nNOS/eNOS protein expression or dimerization are correlated with changes in NO cofactor tetrahydrobiopterin (BH₄) biosynthetic enzymes (guanosine triphosphate cyclohydrolase‐1 and dihydrofolate reductase). Methods: Functional and Western blot studies were performed in streptozotocin‐induced and control Sprague‐Dawley female rats with DM (type 1 [t1DM]) using standardized protocols. Confirmation of xerostomia was determined by increased water intake and decreased salivary flow rate. Results: The results showed that in female rats with DM, salivary hypofunction is correlated with decreased submandibular and parotid gland sizes. The results also show a decrease in NOS and BH₄ biosynthetic enzyme in submandibular glands. Conclusions: These results indicate that a decrease in submandibular NO‐BH₄ protein expression may provide insight pertaining to mechanisms for the development of hyposalivation in DM‐induced xerostomia. Furthermore, understanding the role of the NO‐BH₄ pathway may give insight into possible treatment options for the patient with DM experiencing xerostomia.     

正常人、牙龈炎和牙周炎患者龈沟液内一氧化氮含量的检测

目的：检测正常人和牙周病患者龈沟液中NO含量,探讨NO在牙周病发病过程中的作用。方法：选择牙周健康组20例,牙龈炎组22例,慢性牙周炎组32例,分别采集龈沟液标本,免疫荧光法检测龈沟液内NO的含量。结果：慢性牙周炎患者和牙龈炎患者龈沟液内NO含量与牙周健康组相比均有高度显著性差异（P〈0．01）,慢性牙周炎患者龈沟液内NO含量与牙龈炎组相比有高度显著性差异（P〈0．01）。结论：牙周健康者、牙龈炎患者、慢性牙周炎患者龈沟液中能检测出NO的存在,NO参与了慢性牙周炎的发展过程,龈沟液内NO含量与慢性牙周炎炎症程度密切相关。     

Saliva and Serum Levels of Pentraxin‐3 and Interleukin‐1β in Generalized Aggressive or Chronic Periodontitis

Background: Pentraxin‐3 (PTX3) is a multifactorial protein involved in immunity and inflammation, which is rapidly produced and released by several cell types in response to inflammatory signals. The aim of the present study is to evaluate saliva, serum levels of PTX3, interleukin (IL)‐1β in patients with generalized chronic periodontitis (CP) or aggressive periodontitis (AgP), and periodontally healthy individuals. Methods: A total of 94 participants (25 patients with AgP, 25 patients with CP, and 44 periodontally healthy individuals matched with AgP and CP groups) were recruited. Saliva and serum samples were collected. Clinical periodontal measurements were recorded. PTX3, IL‐1β levels in serum, and saliva samples were determined by enzyme‐linked immunosorbent assay. Data were tested statistically using Kruskal‐Wallis, Mann‐Whitney U, and Spearman ρ rank test. Results: Serum and saliva data were similar in CP and AgP groups. Saliva levels of IL‐1β were significantly higher in the AgP and CP groups than controls (P <0.05). Salivary PTX3 levels were similar in the CP and control groups. Significantly higher salivary concentrations of PTX3 were detected in the AgP group than the control group (P <0.05). Saliva PTX3 levels correlated with plaque index and bleeding on probing in the CP group (P <0.05). Serum and saliva PTX3 levels correlated with those of IL‐1β in the AgP group (P <0.05). Conclusions: It may be suggested that PTX3 is related with periodontal tissue inflammation. Its salivary concentrations may have a diagnostic potential. Additional intervention and follow‐up studies coupling PTX3 concentrations with microbiologic analysis would better clarify its role in periodontal diseases.     

Microbial Analysis of Subgingival Plaque Samples Compared to That of Whole Saliva in Patients With Periodontitis

Background: The detection of special bacterial species in patients with periodontitis is considered to be useful for clinical diagnosis and treatment. The collection of subgingival plaque samples is the common way for the determination of periodontopathic bacteria. However, recently, salivary analysis has been discussed as an advantageous future diagnostic method for periodontitis because it offers simple quantitative sampling and the possibility to assess various bacteria. The aim of this cross‐sectional study is to investigate whether there is a correlation between the results of different bacterial species in saliva and subgingival plaque samples from individuals with aggressive periodontitis (AgP) and chronic periodontitis (CP). Methods: Whole saliva and subgingival plaque samples from the deepest pocket of each quadrant were collected from 43 patients with CP and 33 patients with AgP. Twenty different bacterial species from both samplings were determined by the 16S ribosomal RNA‐based polymerase chain reaction with microarray technique. Results: All bacterial species were detected in salivary and subgingival plaque samples. For Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, as well as Actinomyces viscosus, Campylobacter rectus/showae, Prevotella intermedia, Parvimonas micra, Eubacterium nodatum, and Campylobacter gracilis, a significant positive correlation between salivary and subgingival plaque samples was detected in patients with both types of periodontitis. There were no significant differences in bacteria in salivary and subgingival plaque samples between AgP and CP. Conclusion: Salivary analysis might be discussed as a potential alternative to subgingival plaque sampling for microbiologic analysis in both AgP and CP.     

Immunophenotyping in Saliva as an Alternative Approach for Evaluation of Immunopathogenesis in Chronic Periodontitis

Background: To date, flow cytometric immunophenotyping has not been used to investigate immune patterns in saliva samples from individuals with inflammatory processes in the oral cavity, such as chronic periodontitis (CP). Saliva analysis could be a non‐invasive method for evaluating oral health. The objective of this study is to determine the phenotype of leukocytes and total immunoglobulin A (IgA), IgG, and IgM titers in the saliva of individuals with CP. Methods: Saliva samples were obtained from patients with CP (n = 12) and from a control group (n = 27) without oral diseases. Flow cytometry was performed to determine the frequency of T cells (CD4⁺ and CD8⁺), B cells, and natural killer (NK) cells as well as the total leukocyte population. Immunoglobulin titers were determined by dot enzyme‐linked immunosorbent assay. Results: Cell immunophenotyping revealed that patients with CP had a higher frequency of total leukocytes (47.94% ± 5.1%; P < 0.001), B cells (43.93% ± 6.2%; P = 0.006), NK cells (0.16% ± 0.04%; P = 0.03), and CD4⁺ T cells (38.99% ± 4.4%; P = 0.002) than individuals without oral pathologies (24.75% ± 2.2%, 20.60% ± 2.7%, 0.09% ± 0.03%, and 16.82% ± 3.5%, respectively). No significant differences in salivary total IgA, IgG, and IgM titers were found between the two cohorts studied. Nevertheless, higher total IgG levels were observed in patients with CP, which could indicate a possible correlation between clinical attachment level and salivary IgG (P = 0.07; r² = 0.08). Conclusion: These results show that cell phenotyping by flow cytometry could be an effective tool for determining leukocyte profiles in saliva samples from patients with CP and healthy individuals.