This paper focused on the relationship between periodontitis and Type 2 diabetes mellitus (T2DM). There is an abundance of evidence that diabetes mellitus play important etiological roles in periodontal diseases. In addition, periodontal diseases have powerful and multiple influences on the occurrence and severity of systemic conditions and diseases, such as diabetes mellitus, cardiovascular disease, respiratory disease and pregnancy complications. The relationship of periodontitis and diabetes has been supported by sufficient evidences in the past twenty years: (1) diabetes is an independent risk factor of chronic periodontitis; (2) metabolic control will improve the prognosis of chronic periodontitis; (3) the treatment of chronic periodontitis will improve the metabolic level. Our recent investigation on periodontal status in the families of type 2 diabetes mellitus further confirmed the relationship. It was showed that the periodontal index such as probing depth (PD), attachment loss (AL) and numbers of tooth loss in diabetes family members were significantly higher than non-diabetes family members, while no difference of periodontal parameters was found between well control family members and non diabetes family members. In the development of type 2 diabetes (T2DM) and its complications, the advanced glycation end products (AGEs) and its receptors were to be recognized as important factors. The distributions of AGEs and the receptor for AGEs (RAGE) are highly consistent in various tissues. One study in our laboratory demonstrated that RAGE was strongly expressed in gingival tissues gathered from T2DM patients with periodontitis compared with systemically healthy chronic periodontitis patients, the expression of RAGE was positively correlated with the expression of TNF-?, indicating that AGE-RAGE pathway was involved in the development of periodontitis in T2DM patients. It is known that inflammation could induce the prediabetic status characterized by insulin resistance and dyslipidemia. However, it is still unclear whether periodontitis is a risk factor of type 2 diabetes mellitus or not. In a current study, the effect of periodontitis on serum levels of lipid and glucose of aggressive periodontitis (AgP) patients was implied, as the average serum levels of triglycerides and glucose of a large number of AgP patients were both significantly higher than healthy control group, and serum level of total cholesterol in AgP group was positively associated with the percentage of severe attachment loss sites. It seems that periodontitis may alter serum lipid and glucose levels. Furthermore, the effect of periodontitis on diabetes in an animal study has also demonstrated that experimental moderate periodontitis as well as castration could induce insulin resistance and ? cell impairment in rats, and that combination of the two factors would aggravate the degree of insulin resistance (IR). In conclusion, interrelationship between periodontitis and diabetes has been further approved recently.

Alveolar Bone Loss ; Dental Implants ; Humans ; Peri-Implantitis ; epidemiology ; prevention & control ; therapy ; Risk Factors

Objective To study the ultrastrueture of 3 types of periodontal cells, including periodontal ligament cells (PDLC), os-teoblast cells (OB) and eementoblast cells (CB). Methods After culturing 3 kinds of periodontal cells - PDLC, OB and CB, we observed them with transmission electron microscope. Results There was rich rough endoplasmic reticulum and lots of microfilaments in the cyto-plasm of CB and PDLC cells. There was rich rough endoplasmic in the cytoplasm of OB cells. Conclusion The main characteristic ultra-structure feature of the bovine CB and PDLC was rich rough endoplasmic reticulum and microfilaments in the cytoplasm. Compared with CB and PDLC, OB contained fewer microfilaments in the cytoplasm.

Objective:To establish a stable primary culture method of human gingival epithelial cells, with a higher successful rate and shorter culture time.Methods:Nine patients who received “crown-lengthening surgery”with relatively healthy periodontal conditions were selected (n =9).Gingival sam-ples were collected from the 9 donors during gingivectomy.Gingival epithelial cells were isolated and cul-tured by both an advanced enzyme digestion method and a tissue explant method.In the advanced enzyme digestion culture process,2.5 g/L DispaseⅡwas used to separate the epithelial tissue part from the con-nective tissue part,which lasted for one night.Then the epithelial tissues were digested by 0.025% tryp-sin without EDTA for 10 minutes,and centrifuged by keeping the digested epithelial tissues that re-mained.This advanced method not only decreased the concentration and digesting time of the two above-mentioned enzymes,but also simplified the centrifugel process.The tissue explant method was not changed too much compared with the original method.Growing processes of the primary cells cultured by the two methods were observed and recorded respectively,and indirect immunocytochemical staining was used to identify the type of cultured cells.At the same time,successful rates and cell culture time were also compared between the two methods.Results:Human gingival epithelial cells with typical morpholo-gy could be cultured within a shorter period by the advanced enzyme digestion method with a successful rate of 88.9%,and proliferated rapidly as sheets.After 10 -14 d cells could be passaged,gradually turned to be like fibroblasts when passaged to the third generation,and eventually went to apoptosis.The primary culture time was longer by using the tissue explant method,and approximately after 17 -22 d cells could be passaged,although the successful rate was the same as the enzyme digestion method.Cy-tokeratin staining was both positive by indirect immunocytochemical staining of cells.Conclusion:Pri-mary human gingival epithelial cells cultured by the advanced enzyme digestion method could grow faster and be passaged to the second generation successfully,which could supply a stable origin for cellular ex-periments.

Objective: To investigate whether initial periodontal therapy may affect the presence of oral Helicobacter pylori(Hp), and to compare the genotype of Helicobacter pylori in oral cavity and that in stomach. Methods: 56 patients with gastric Hp and periodontitis were enrolled in this study. PCR was carried out to identify the presence of Hp in the samples before and after initial periodontal therapy(group 1) or medicine therapy(group 2). DNA sequence of PCR products of 5 patients and 1 Hp infected patient's relative was compared and analyzed. Results: Four weeks after medicine therapy, the rate of Hp in oral cavity was singnificantly lower in group 1 than that in group 2 (3.0% vs 26.1%, P

Objective: To investigate whether periodontitis might adversely affect the outcome of eradication of gastric Helicobacter pylori(Hp) . Methods: Ninety one patients with gastric Helicobacter pylori and periodontitis were enrolled. The patients were treated by medicine therapy, meanwhile 33 of them were treated by initial periodontal therapy. After treatment, the effect of initial periodontal therapy on the eradication of gastric( Hp ) was examined with 13 C urea breath test. The correlation between the gastric eradication rate and periodontitis was analyzed. Results: Four weeks and one year after medicine therapy, the eradication rate was singnificantly lower in the patients with PD≥4 mm than in those with PD

Objective:To observe the changes of plaque microflora during the experimental gingivitis and to analyze the relationship between the plaque microflora and the clinical parameters.Methods:11 young male subjects with healthy gingiva and without systemic disease were selected.Subgingival plaque samples(2 sites /person)were collected and then smeared by Gongo red at baseline(0 day),the 7th,14th,21st day(without oral hygiene)and 28th day(7 days after reestablishing oral hygiene)respectively during experimental gingivitis.At the same time the clinical parameters were recorded.The results of smear and the clinical parameters were analyzed.Results:The percentage of spirochete was the lowest at the baseline and increased during the experimental gingivitis,and then reached the highest level on the 21st day.The percentage of spirochete of the 21st day showed the significant different compared with that of baseline(P0.05)Conclusion:Spirochete is correlated to the development of the gingivitis.

Objective: To measure GCF calprotectin and total protein for evaluating whether the calprotectin could be a sensitive marker for the initial inflammation of gingiva. Methods: Eleven young male subjects with healthy gingiva, who had no systemic diseases, were selected for this study. GCF samples (4 teeth /person) were collected with strips of filter paper at baseline (0 day), on the 7 th, 14 th, 21 st days (without oral hygiene), and 28 th day (7 days after reestablishing oral hygiene) during experimental gingivitis. The amount of calprotectin was measured by ELISA. The amount of total protein was assessed with protein dye binding assay. Results: The amount of calprotectin increased during the experimental gingivitis, and reached the highest level on the 21 st day. After oral hygiene was reestablished it reduced to the level of baseline. The amount of total protein had the same tendency as calprotectin. Conclusion: The amount of calprotectin and the total protein in GCF can reflect the initial inflammation of gingiva.

Objective To investigate sequential expression of bone sialoprotein(BSP), alkaline phosphatase(ALP) and cementum attachment protein(CAP) in cementoblast(CB) during mineralized culture in vitro, and study the morphological and biologic characters of the CB in this process. Methods CB was seeded on the glass coverslips, and cultured for 6h, 12h, 1d, 2d, 3d, 4d, 5d, 6d, 8d, 10d, 12d and 16d, respectively. The expression of BSP, ALP and CAP proteins was detected using immunocytochemical method. Results 6 hours after plated, cementoblast expressed all of the three proteins. In the second and third days after plated, the cells became confluent and formed multiple layers, BSP and ALP expression decreased, and CAP did not be expressed at all. From the forth day, the cells formed cell nodules with mineralizing function. The cells in the nodules strongly expressed BSP,ALP and CAP, the cells around the nodule weakly expressed BSP and ALP, and did not express ALP. During the following 10 to 16 days, the cell nodules became mineralized nodules. Conclusion These results elucidated the changes of ALP, BSP and CAP expression as well as cell morphology during the CB proliferation, differentiation and mineralization in vitro, and provided some valuable information for studying the formation of cementum and CB proliferation, differentiation and mineralization in vivo.

Objective: To investigate the changes of osteoprotegerin ( OPG) and receptor activator of nuclear factor kappa B ligand ( RANKL) level in perio-implant crevicular fluid ( PICF) and to monitor the development of the stability of Straumann ? tissue-level implants by resonance frequency analysis ( RFA) during the early phases of healing .Methods: A total of 35 implants ( length 10 mm ) were placed.PICF samples were collected with filter paper strips at baseline , 1, 2, 3, 4, 6, 8, and 12 weeks post-surgery, respectively.The OPG, RANKL levels were determined by ELISA method .At the same time points, the implant stability quotient (ISQ) values were determined with Osstell TM mentor.Results:During healing , PICF-OPG levels increased significantly 2 weeks after surgery when compared with the 4th-, 6th-, 8th-and 12th-week reevaluation (P<0.05).The OPG/RANKL ratio in PICF was significantly higher ( P<0 .05 ) than that in gingival crevicular fluid at 1 week post-surgery .ISQ slightly fluctuated within the first 4 weeks after installation .Following this, the ISQ values increased steadily for all the implants and up to 12 weeks.Significant differences were noted between the mean ISQ values at the 12th-week and other observation time points .Conclusion: The PICF-OPG levels may be effective in monito-ring the process of osseointegration .All the ISQ values indicated the stability of Straumann ? implants over a 12-week healing period .RFA is a reliable and effective assistant to monitor implant stability .