In this systematic review, we explore and summarize the peer-reviewed literature on putative genetic risk factors for susceptibility to aggressive and chronic periodontitis. A comprehensive literature search on the PubMed database was performed using the keywords ‘periodontitis’ or ‘periodontal disease’ in combination with the words ‘genes’, ‘mutation’, ‘SNP’ or ‘polymorphism’. The studies selected were written in English, had a case-control design, and reported genotype distribution. Only studies with at least 100 individuals in either the case or control group were included. Research on genetic polymorphisms has only had limited success in identifying significant and reproducible genetic factors for susceptibility to aggressive periodontitis and chronic periodontitis. Taking together the data published on gene polymorphisms in aggressive and chronic periodontitis, we conclude that there are differences among the various studies for the rare allele carriage rates. Nevertheless, there is some evidence that polymorphisms in the IL1B, IL1RN, FcγRIIIb, VDR and TLR4 genes may be associated with aggressive periodontitis susceptibility, and polymorphisms in the IL1B, IL1RN, IL6, IL10, VDR, CD14, TLR4 and MMP1 genes may be associated with chronic periodontitis susceptibility as a single genetic factor in certain populations. Future studies should apply stricter disease classifications, use larger study cohorts, adjust for relevant risk factors in aggressive and chronic periodontiti,s and include analysis of multiple genes and polymorphisms. Establishing consortia and performing collaborative studies may help to conquer the limitations of small sample size and limited statistical power.

Genetic susceptibility to periodontitis.

Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested inoral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficultto sort and interpret. In periodontology and dentoalveolar surgery, the literature is particularly dense about the use ofthe various forms of Platelet-Rich Plasma (PRP) - Pure Platelet-Rich Plasma (P-PRP) or Leukocyte- and Platelet-RichPlasma (L-PRP) - but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this first article, we describe and discussthe current published knowledge about the use of PRP and PRF during tooth avulsion or extraction, mucogingivalsurgery, Guided Tissue Regeneration (GTR) or bone filling of periodontal intrabony defects, and regeneration of alveolarridges using Guided Bone Regeneration (GBR), in a comprehensive way and in order to avoid the traps of a confusing literatureand to highlight the underlying universal mechanisms of these products. Finally, we particularly insist on the perspectivesin this field, through the description and illustration of the systematic use of L-PRF (Leukocyte- and Platelet-Rich Fibrin) clots and membranes during tooth avulsion, cyst exeresis or the treatment of gingival recessions by root coverage.The use of L-PRF also allowed to define new therapeutic principles: NTR (Natural Tissue Regeneration) for thetreatment of periodontal intrabony lesions and Natural Bone Regeneration (NBR) for the reconstruction of the alveolarridges. In periodontology, this field of research will soon find his golden age by the development of user-friendly plateletconcentrate procedures, and the definition of new efficient concepts and clinical protocols.

http://www.francescoinchingolo.it/media/PRP_PRFOral_MaxFacP1CPB.pdf

Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: Periodontal and dentoalveolar surgery.

Matrix metalloproteinase-8 is a promising candidate biomarker for oral fluid (gingival crevicular fluid, peri-implant sulcular fluid and saliva) and mouthrinse chair-side/point-of-care diagnostics to predict, diagnose and determine the progressive phases of episodic periodontitis and peri-implantitis, as well as to monitor the treatments and medications. Matrix metalloproteinase-8 can be used alone or together with interleukin-1beta and Porphyromonas gingivalis to calculate cumulative risk score at the subject level as a successful diagnostic tool, especially in large-scale public health surveys, in which a thorough periodontal examination is not feasible.

Analysis of matrix metalloproteinases, especially MMP-8, in gingival creviclular fluid, mouthrinse and saliva for monitoring periodontal diseases.

Aim: The purpose of the present review was to determine the clinical effect of the use of bioactive agents (BAs) for the treatment of intra-osseous and furcation defects. Material and Methods: The effectiveness of the BAs was evaluated when used in addition to open flap debridement either alone or in association with grafts and/or guided tissue regeneration (GTR). Among the included agents, recombinant human platelet-derived growth factor-BB (rhPDGF-BB), platelet-rich plasma (PRP), commercially available enamel matrix derivative (cEMD) and peptide P-15 (P-15) have been clinically tested for treating periodontal defects. Results and Conclusions: The results of the present review indicate that: (1) cEMD either alone or in combination with grafts can be effectively used to treat intra-osseous defects and the clinical results appear to be stable long term; (2) the additional use of a graft seems to enhance the clinical outcome of cEMD; (3) the combined use of rhPDGF-BB and P-15 with a graft biomaterial has shown beneficial effects in intra-osseous defects; (4) contrasting results were reported for PRP and graft combinations; and (5) limited evidence supports the use of BAs either alone or in association with graft/GTR for the treatment of furcation defects.

Clinical outcomes with bioactive agents alone or in combination with grafting or guided tissue regeneration

www.fob.usp.br/jaos or www.scielo.br/jaos J Appl Oral Sci. 2009;17(5):388-91 COLOR STABILITY OF A NANOFILL COMPOSITE: EFFECTOF DIFFERENT IMMERSION MEDIA Silvia Terra FONTES 1 , Maria Raquel FERNANDEZ 1 , Claudia Modena de MOURA 2 , Sonia Saeger MEIRELES 3 1- DDS, MS, PhD student, Department of Operative Dentistry, Dental School, Federal University of Pelotas, Pelotas, RS, Brazil.2- DDS, Private Practice, Porto Alegre, RS, Brazil.3- DDS, MS, PhD, Adjunct Professor, Department of Operative Dentistry, Federal University of Paraiba, Joao Pessoa, PB, Brazil . Corresponding address: Sonia Saeger Meireles - Avenida Umbuzeiro, 755 apt 901, Bairro: Manaira - 58038-180, Joao Pessoa - PB - Brazil - Phone:+55 83 32167250 - e-mail: soniasaeger@hotmail.com Received: August 13, 2008 - Modification: May 18, 2009 - Accepted: November 09, 2008 bjective: The aim of this in vitro study was to evaluate the color stability of a nanofill composite resin (Filtek Z350) in differentimmersion media. Materials and methods: Twelve resin-based composite specimens were prepared using a silicon cylindrical moldmeasuring ≅1mm of thickness and ≅ 10mm of diameter. Specimens were light-cured for 40 s from both sides using a LED Radii at1400 mW/cm

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Color stability of a nanofill composite: effect of different immersion media

The purpose of this study was to evaluate the discoloration of two nanohybrids, two microhybrids, and a posterior composite resin restorative material upon exposure to different drinks — namely tea, cola, coffee, red wine, and water. The colors of all specimens before and after storage in the solutions were measured by a colorimeter based on CIE Lab system, and the color differences thereby calculated. Data were analyzed by two-way analysis of variance (ANOVA) and Tukey's HSD test. According to ANOVA, the restorative material, staining agent, and their interaction were found to play a statistically significant role (P=0.0001) in color change. Among the staining agents, water consistently showed the lowest ΔE* value for all materials, whereas red wine showed the highest ΔE* value. In other words, for all the materials tested, their color change in staining agents ranked in this increasing order: water < cola < tea < coffee < red wine. In terms of comparison among the five restorative materials, Filtek P60 and Z250 were observed to manifest less color change than the nanohybrids and Quadrant LC.

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Color stability of resin composites after immersion in different drinks.

Background: Interleukin-10 (IL-10), an anti-inflammatory cytokine, plays a role in periodontal disease by inhibiting synthesis of proinflammatory cytokines and stimulating protective antibody production. Genetic polymorphisms in the IL-10 gene might be useful as a marker to diagnose susceptibility to periodontitis. Therefore, the aim of this study was to investigate the association between IL-10 gene polymorphisms and severe generalized chronic periodontitis (CP) in a Turkish population. Methods: Samples of venous blood and DNA were obtained from 75 patients with severe generalized CP and 73 healthy subjects. The IL-10 promoter sequences at positions -597 and -824 were amplified by polymerase chain reaction, and polymorphisms were detected by restriction enzyme cleavage. Genotype and allele frequencies were calculated, and data were analyzed using the x 2 test. Results: There was a statistically significant difference in frequencies of genotypes (AA/CC + CA: P = 0.00007, odds ratio = 12.37, 95% confidence intervals = 2.74 to 7.77; CC/ CA + AA: P = 0.001, odds ratio = 3.05, 95% confidence intervals = 1.47 to 6.33) and alleles (P = 0.0002, odds ratio = 2.61, 95% confidence intervals = 1.52 to 4.51) at position -597 C to A between patients with severe generalized CP and healthy controls, whereas there was no significant difference in genotypes and allele frequencies at position -824 C to T between patients with CP and healthy subjects. Conclusion: Within the limitations of sample selection and number, the IL-10 gene polymorphism at position -597 seems to be associated with severe generalized CP. J Periodontol 2007; 78:493-497.

Association of interleukin-10 gene polymorphisms with severe generalized chronic periodontitis.

Background & objective Genetic polymorphisms in the vitamin D receptor (VDR) gene are related to bone mineral density, bone turnover, and diseases with bone loss. Alveolar bone loss is a key feature in periodontitis. The aim of this study was to determine whether severe generalized chronic periodontitis (CP) in a Turkish population was associated with polymorphisms in the VDR gene. Methods Samples of venous blood and DNA were obtained from 72 patients with severe generalized chronic periodontitis and 102 healthy controls. The polymorphic regions were amplified using PCR followed by digestion with restriction enzymes BsmI A/G(rs1544410), ApaI G/T(rs11168271), TaqI T/C(rs731236), and analyzed electrophoretically. Genotype and allele frequencies were calculated. Results There were no statistically significant differences in the frequencies of VDR BsmI, ApaI, TaqI genotypes between the CP patients and healthy controls. The GTT haplotype, constructed from the three adjacent restriction fragment length polymorphisms was found to be over-represented among CP cases. This corresponded an OR of 2.4 (95% confidence interval, 1.12-5.18) for heterozygous carriers and 2.27 (95% confidence interval, 0.95-5.4) for homozygous carrier of the risk haplotype. Interpretation & conclusion The present findings indicated that BsmI, ApaI, TaqI polymorphisms of the VDR gene were not associated with the severe generalized CP in the studied Turkish patients. Moreover, the VDR genotypes based on haplotype analysis may be associated with chronic periodontitis. In the future, diagnostic periodontal risk assessments like polymorphisms may be useful in detection of individuals susceptible for periodontitis.

Analysis of vitamin D receptor gene polymorphisms in patients with chronic periodontitis.

Background: Matrix metalloproteinases (MMPs) are related to tissue destruction and remodeling events in periodontal diseases. A single nucleotide polymorphism in the promoter region of human MMP-9 gene is associated with the risk of some inflammatory diseases. Therefore, the aim of this study was to investigate the association between MMP-9 promoter polymorphism and severe generalized chronic periodontitis in a Turkish population. Methods: Samples of venous blood and DNA were obtained from 70 severe generalized chronic periodontitis patients and 70 healthy subjects. The alleles of the C/T polymorphism at position -1562 in the promoter region of the MMP-9 gene were distinguished by cutting with the SphI restriction enzyme. Genotype and allele frequencies were calculated, and data were analyzed by the x 2 test. Results: There was a significant difference in MMP-9 genotypes between chronic periodontitis patients and healthy controls. The odds ratios for the CT genotype and the combination of CT and TT genotypes were 0.4 (95% confidence interval, 0.17 to 0.93; P = 0.02) and 0.37 (95% confidence interval, 016 to 0.85; P = 0.01) relative to the subjects with the CC genotype, respectively. Conclusion: MMP-9 promoter gene polymorphism seems to be associated with severe generalized chronic periodontitis. J Periodontol 2006;77:1510-1514.

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Association of Matrix Metalloproteinase-9 Promoter Gene Polymorphism With Chronic Periodontitis

Objective. In recent years, platelet-rich plasma combined with graft materials has been used for periodontal regeneration. The individual role of blood products with guided tissue regeneration in periodontal regenerative therapy is unclear and needs to be elucidated. The purpose of this study was to compare the clinical and radiological effectiveness of platelet pellet/guided tissue regeneration (PP/GTR) and bioactive glass/GTR (BG/GTR) treatments in patients with periodontal disease.Material and methods. Using a split mouth design, 15 chronic periodontitis patients with pocket depths ≥ 6 mm following periodontal initial therapy were randomly assigned to treatment with a combination of PP/GTR or BG/GTR in contralateral dentition areas. An absorbable membrane of polylactic acid was used GTR. The criteria for the comparative study were preoperative and postoperative 6 months pocket depth, clinical attachment level, and radiological alveolar bone level.Results. Both treatment modalities resulted in significa...

Hülya Köprülü

Papers

Color stability of resin composites after immersion in different drinks.

Association of interleukin-10 gene polymorphisms with severe generalized chronic periodontitis.

Analysis of vitamin D receptor gene polymorphisms in patients with chronic periodontitis.

Association of Matrix Metalloproteinase-9 Promoter Gene Polymorphism With Chronic Periodontitis

Comparison of platelet pellet and bioactive glass in periodontal regenerative therapy