Abstracts for 41:3 (May 2024)

Berkay Gur, Beral Afacan, Ozge Cevik, Timur Kose, Gulner Emingil

Gingival crevicular fluid periodontal ligament-associated protein-1, sclerostin, and tumor necrosis factor-alpha levels in periodontitis. J Periodontol. 2023:94(10):1166-1175. https://doi.org/10.1002/JPER.22-0750

Background: In periodontitis, the equilibrium between bone formation and resorption skews in favor of bone loss. Periodontal ligament-associated protein-1 (PLAP-1) and sclerostin play a significant role in the suppression of bone formation. Tumor necrosis factor-alpha (TNF-α) is a central proinflammatory cytokine related to periodontal bone loss. This study aims to assess gingival crevicular fluid (GCF) PLAP-1, sclerostin, and TNF-α levels in individuals with periodontal disease. Methods: Seventy-one individuals diagnosed with generalized stage III grade C periodontitis (n = 23), gingivitis (n = 24), and periodontal health (n = 24) were included in the study. Full-mouth clinical periodontal measurements were performed. PLAP-1, sclerostin, and TNF-α total amounts in GCF were quantified by ELISA. Nonparametric methods were used for the data analyses. Results: Periodontitis group exhibited significantly higher GCF PLAP-1, sclerostin, and TNF-α levels compared with gingivitis and periodontally healthy groups (P < .05). GCF PLAP-1 and TNF-α levels of gingivitis group were higher than healthy controls (P < .05) whereas GCF sclerostin levels were similar in 2 groups (P > .05). Significant positive correlations were found between GCF PLAP-1, sclerostin and TNF-α levels and all clinical parameters (P < .01). Conclusions: To our knowledge, this is the first study showing GCF PLAP-1 levels in periodontal health and disease. Increased GCF PLAP-1 and sclerostin levels and their correlations with TNF-α in periodontitis imply that those molecules might be involved in the pathogenesis of periodontal disease. Further studies in larger mixed cohorts are needed to enlighten the possible role of PLAP-1 and sclerostin in periodontal bone loss.

Akira Aoki, Koji Mizutani, Risako Mikami, et al

Er:YAG laser-assisted comprehensive periodontal pocket therapy for residual periodontal pocket treatment: A randomized controlled clinical trial. J Periodontol. 2023:94(10):1187-1199 https://doi.org/10.1002/JPER.22-0552

Background: This study evaluated the effectiveness of a novel pocket therapy (Er:YAG laser-assisted comprehensive periodontal pocket therapy [Er-LCPT]) for residual pocket treatment, compared with conventional mechanical treatment alone, in a randomized controlled clinical trial. Methods: Two sites in 18 patients having residual periodontal pockets of ≥5 mm depth, extant following initial active therapy, or during supportive therapy, were randomized into 2 groups in a split-mouth design: the control group received scaling and root planing (SRP) by curette, and the test group received Er-LCPT using curette and laser. With Er-LCPT, after root debridement, the inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided. Furthermore, the removal of the proximate oral epithelium and coagulation of the blood clot in the pocket entrance were performed with a laser. Clinical parameters were evaluated, before and after treatment, through 12 months. Results: Both groups showed significant improvements in clinical parameters. With Er-LCPT, pocket debridement was thoroughly and safely performed, without any adverse side effects and complications, and favorable healing was observed in most of the cases. At 12 months, Er-LCPT demonstrated significantly higher probing pocket depth reduction (2.78 mm vs 1.89 mm on average; P = .012, Wilcoxon signed-rank test), clinical attachment gain (1.67 mm vs 1.06 mm; P = .004) as primary outcomes, and reduced BOP value (0.89 vs 0.56; P = .031), compared with SRP alone. Conclusion: The results of this study indicate that Er-LCPT is more effective for residual pocket treatment, compared with SRP alone.

Yann Gager, Jonas Koppe, Ina Vogl, Jorg Gabert, Holger Jentsch

Antibiotic resistance genes in the subgingival microbiome and implications for periodontitis therapy. J Periodontol. 2023:94(11):1295-1301. https://doi.org/10.1002/JPER.22-0696

Background: Antibiotic resistance is emerging as a global public threat. However, it remains poorly investigated in the context of periodontal therapy. The aim of the study was to investigate the complete diversity of antibiotic-resistance genes in a German population. Methods: Thirty-nine volunteers with periodontitis contributed to the present study with one to 4 periodontal pockets for a total of 124 subgingival samples. Samples were analyzed using shotgun metagenomics. Results: A total of 19 antibiotic resistance genes from 6 antibiotic classes were detected in subgingival biofilm. Two-thirds of the volunteers (n = 26/39) showed antibiotic resistance genes for at least one of the antibiotic classes used for periodontal treatment in dental practice or research: beta-lactam, lincosamide, macrolide, nitroimidazole, and tetracycline. Macrolide was the most abundant class detected (21/39 patients). Conclusions: Findings from our study suggest a high prevalence of antibiotic-resistance genes in periodontal pockets from German volunteers. We recommend the development and broader use of molecular diagnostic tests for antibiotic resistance in dental practice to ensure treatment success and to minimize antibiotic resistance.

Masahiro Morita

Use of an intraoral scanner to evaluate orthodontic treatment for dental malocclusion in a dog. J Am Vet Med Assoc. Published 17 Nov 2023. doi: https://doi.org/10.2460/javma.23.09.0532

Objective: In human dental practice, intraoral scanners (IOSs) are increasingly used to evaluate the oral cavity. However, there have been no reports concerning the evaluation of the canine oral cavity using IOSs in veterinary dentistry. In this case, optical impressions obtained with an IOS were used for 3D evaluation of the orthodontic treatment outcome. Additionally, few reports have addressed the optimal orthodontic force for canine teeth. Therefore, this case explored whether sufficient tooth movement into the extraction site could be achieved with a lighter orthodontic force than previously reported. Animal: An 8-month-old spayed female dog. Clinical Presentation, Progression, and Procedures: A retained right maxillary third deciduous incisor (503) caused distoversion of the right maxillary third permanent incisor (103), leading to dental malocclusion that involved contact between 103 and the right mandibular canine teeth. Treatment and Outcome: All retained deciduous teeth were extracted. Mesial tipping movement of 103 into the extraction site of 503 was achieved with light orthodontic force using an elastomeric chain. An IOS was used to construct 3D optical impression data from oral stone models taken before and after treatment, and tooth movement was evaluated. The results showed that 103 had sufficient tipping movement and no anchorage loss; comfortable occlusion was achieved. In addition to crown length extension, labioversion, and mesioversion of maxillary incisors (other than 103) were observed. Clinical Relevance: Detailed intraoral evaluation with optical impressions was beneficial in the orthodontic treatment of a dog. Light orthodontic force may be sufficient for movement into the extraction site.

Nicole du Toit

Advances in dental management in the equine geriatric patient: strategies for improved welfare. J Am Vet Med Assoc. Publication Date: 01 Dec 2023. doi: https://doi.org/10.2460/javma.23.06.0350

Geriatric horses have a high prevalence of dental disease, which is a culmination of age-related dental changes and dental disease throughout the life of the horse that may have long-term consequences. Wear abnormalities, diastemata with periodontal disease, pulpitis and endodontic disease, infundibular caries, and equine odontoclastic tooth resorption and hypercementosis become more prevalent with age. Recognition of age-related dental disease at an early stage can help to treat and possibly preserve teeth for longer. With a natural decrease in masticatory efficiency, it is even more important to preserve teeth where possible and prevent any painful dental disease. Regular routine dental examination and maintenance will help to prevent many dental conditions such as wear disorders and possibly secondary diastemata. Successful treatment and management of most dental diseases are possible even in older patients and will ensure that we are able to maintain a high standard of welfare as horses age.