PURPOSE: Periodontal pathogens can invade the host tissue. Morphologic studies have revealed bacteria within the pocket epithelium, gingival connective tissues, alveolar bone, and oral epithelium. The objective of this study was to visualize and evaluate presence of Porphyromonas gingivalis and Tannerella forsythia in crevicular epithelial cells of periodontally healthy subjects and chronic periodontitis patients. MATERIALS AND METHODS: A total of 666 crevicular epithelial cells in the samples obtained from 27 chronic periodontitis patients and 9 healthy volunteers were examined. Specific probes for P. gingivalis and T. forsythia and a universal probe for detection of all eubacteria targeting 16S rRNA for fluorescence in situ hybridization was used in conjunction with confocal laser scanning microscopy. RESULTS: 98.99% of sulcular epithelial cells from healthy volunteers and 84.40% of pocket epithelial cells from periodontitis patients were found to harbor bacteria. P. gingivalis and T. forsythia were discovered more often in crevicular epithelial cells from periodontitis patients. CONCLUSION: P. gingivalis and T. forsythia can invade crevicular epithelial cells and intracellular bacteria may act as a source of bacteria for persistent infection.
Bacteria ; Chronic Periodontitis ; Collodion ; Connective Tissue ; Epithelial Cells ; Epithelium ; Fluorescence ; Forsythia ; Humans ; In Situ Hybridization ; Periodontitis ; Porphyromonas gingivalis

PURPOSE: Surface alterations of titanium discs following instrumentation with either a nylon brush or a metal brush were evaluated. METHODS: A total of 27 titanium discs with 3 surface types (9 discs for each type), including machined (M) surfaces, sandblasted and acid-etched (SA) surfaces, and surfaces treated by resorbable blast media (RBM), were used. Three discs were instrumented with a nylon brush, another 3 discs were instrumented with a metal brush, and the remaining 3 discs were used as controls for each surface type. Surface properties including the arithmetic mean value of a linear profile (Ra), maximum height of a linear profile (Rz), skewness of the assessed linear profile (Rsk), arithmetic mean height of a surface (Sa), maximum height of a surface (Sz), developed interfacial area ratio (Sdr), skewness of a surface profile (Ssk), and kurtosis of a surface profile (Sku) were measured using confocal microscopy. RESULTS: Instrumentation with the nylon brush increased the Ra, Sa, and Sdr of the M surfaces. On the SA surfaces, Ra, Sa and Sdr decreased after nylon brush use. Meanwhile, the roughness of the RBM surface was not affected by the nylon brush. The use of the metal brush also increased the Ra, Sa, and Sdr of the M surface; however, the increase in Sdr was not statistically significant (P=0.119). The decreases in the Rz, Sz, Ra, Sa, and Sdr of the SA surfaces were remarkable. On the RBM surfaces, the use of the metal brush did not cause changes in Ra and Sa, whereas Rz, Sz, and Sdr were reduced. CONCLUSIONS: Titanium surfaces were altered when instrumented either with a nylon brush or a metal brush. Hence, it is recommended that nylon or metal brushes be used with caution in order to avoid damaging the implant fixture/abutment surface.
Dental Implants ; Microscopy, Confocal ; Nylons ; Peri-Implantitis ; Surface Properties ; Titanium

PURPOSE: This in vitro study was performed to assess the adherence of Porphyromonas gingivalis to a resorbable blast media (RBM) titanium surface pretreated with an ultrasonic scaler or toothbrush and to evaluate the effects of the treatment of the RBM titanium discs on the bacterial removal efficiency of brushing by crystal violet assay and scanning electron microscopy. METHODS: RBM titanium discs were pretreated with one of several ultrasonic scaler tips or cleaned with a toothbrush. Then the titanium discs were incubated with P. gingivalis and the quantity of adherent bacteria was compared. The disc surfaces incubated with bacteria were brushed with a toothbrush with dentifrice. Bacteria remaining on the disc surfaces were quantified. RESULTS: A change in morphology of the surface of the RBM titanium discs after different treatments was noted. There were no significant differences in the adherence of bacteria on the pretreated discs according to the treatment modality. Pretreatment with various instruments did not produce significant differences in the bacterial removal efficiency of brushing with dentifrice. CONCLUSIONS: Within the limits of this study, various types of mechanical instrumentation were shown to cause mechanical changes on the RBM titanium surface but did not show a significant influence on the adherence of bacteria and removal efficiency of brushing.
Bacteria ; Dental Scaling ; Dentifrices ; Gentian Violet ; Microscopy, Electron, Scanning ; Porphyromonas gingivalis ; Surface Properties ; Titanium* ; Toothbrushing ; Ultrasonics*

Purpose: Developmental endothelial locus-1 (DEL-1) plays a role in regulating neutrophil migration within the periodontium. The objective of this study was to evaluate the levels of DEL-1 in saliva and gingival crevicular fluid (GCF), as well as the number of neutrophils in patients with periodontitis. Methods: Forty systemically healthy, non-smoking periodontitis patients participated in this study. Clinical periodontal parameters, including the plaque index, probing pocket depth (PPD), clinical attachment level, bleeding on probing, modified sulcular bleeding index, and marginal bone level, were measured. Levels of DEL-1, interleukin (IL)-1β, IL-6, and IL-8 in unstimulated saliva samples, as well as DEL-1 in the GCF of 3 teeth from each participant, were assessed. Neutrophil counts in oral rinse and GCF samples were recorded. Spearman correlation coefficients were used to examine the correlation between protein levels, clinical parameters, and neutrophil quantities. Participants were divided into 2 age groups (those under 50 years and those 50 years or older) in order to investigate potential age-related differences. Results: DEL-1 levels in the GCF showed a negative relationship with PPD (sum). Neutrophils in oral rinse samples were positively correlated with PPD, IL-8, and IL-1β levels. Neutrophils in GCF exhibited a positive correlation with PPD (sum). Salivary DEL-1 levels showed correlations with IL-8 and IL-1β, but not with the clinical parameters of periodontitis. Conclusions The negative relationship observed between PPD and GCF DEL-1 levels is consistent with the proposed protective role of DEL-1.

Purpose: Developmental endothelial locus-1 (DEL-1) plays a role in regulating neutrophil migration within the periodontium. The objective of this study was to evaluate the levels of DEL-1 in saliva and gingival crevicular fluid (GCF), as well as the number of neutrophils in patients with periodontitis. Methods: Forty systemically healthy, non-smoking periodontitis patients participated in this study. Clinical periodontal parameters, including the plaque index, probing pocket depth (PPD), clinical attachment level, bleeding on probing, modified sulcular bleeding index, and marginal bone level, were measured. Levels of DEL-1, interleukin (IL)-1β, IL-6, and IL-8 in unstimulated saliva samples, as well as DEL-1 in the GCF of 3 teeth from each participant, were assessed. Neutrophil counts in oral rinse and GCF samples were recorded. Spearman correlation coefficients were used to examine the correlation between protein levels, clinical parameters, and neutrophil quantities. Participants were divided into 2 age groups (those under 50 years and those 50 years or older) in order to investigate potential age-related differences. Results: DEL-1 levels in the GCF showed a negative relationship with PPD (sum). Neutrophils in oral rinse samples were positively correlated with PPD, IL-8, and IL-1β levels. Neutrophils in GCF exhibited a positive correlation with PPD (sum). Salivary DEL-1 levels showed correlations with IL-8 and IL-1β, but not with the clinical parameters of periodontitis. Conclusions The negative relationship observed between PPD and GCF DEL-1 levels is consistent with the proposed protective role of DEL-1.

Purpose: Developmental endothelial locus-1 (DEL-1) plays a role in regulating neutrophil migration within the periodontium. The objective of this study was to evaluate the levels of DEL-1 in saliva and gingival crevicular fluid (GCF), as well as the number of neutrophils in patients with periodontitis. Methods: Forty systemically healthy, non-smoking periodontitis patients participated in this study. Clinical periodontal parameters, including the plaque index, probing pocket depth (PPD), clinical attachment level, bleeding on probing, modified sulcular bleeding index, and marginal bone level, were measured. Levels of DEL-1, interleukin (IL)-1β, IL-6, and IL-8 in unstimulated saliva samples, as well as DEL-1 in the GCF of 3 teeth from each participant, were assessed. Neutrophil counts in oral rinse and GCF samples were recorded. Spearman correlation coefficients were used to examine the correlation between protein levels, clinical parameters, and neutrophil quantities. Participants were divided into 2 age groups (those under 50 years and those 50 years or older) in order to investigate potential age-related differences. Results: DEL-1 levels in the GCF showed a negative relationship with PPD (sum). Neutrophils in oral rinse samples were positively correlated with PPD, IL-8, and IL-1β levels. Neutrophils in GCF exhibited a positive correlation with PPD (sum). Salivary DEL-1 levels showed correlations with IL-8 and IL-1β, but not with the clinical parameters of periodontitis. Conclusions The negative relationship observed between PPD and GCF DEL-1 levels is consistent with the proposed protective role of DEL-1.

PURPOSE: Laser treatment has become a popular method in implant dentistry, and lasers have been used for the decontamination of implant surfaces when treating peri-implantitis. This study was performed to evaluate the effects of an Erbium-doped:Yttrium-Aluminum-Garnet (Er:YAG) laser with different settings on machined (MA), sand-blasted and acid-etched (SA), and resorbable blast media (RBM) titanium surfaces using scanning electron microscopy and confocal microscopy. MATERIALS AND METHODS: Four MA, four SA, and four RBM discs were either irradiated at 40 mJ/20 Hz, 90 mJ/20 Hz, or 40 mJ/25 Hz for 2 minutes. The specimens were evaluated with scanning electron microscopy and confocal microscopy. RESULT: Four MA, four SA, and four RBM discs were either irradiated at 40 mJ/20 Hz, 90 mJ/20 Hz, or 40 mJ/25 Hz for 2 minutes. The specimens were evaluated with scanning electron microscopy and confocal microscopy. Result: The untreated MA surface demonstrated uniform roughness with circumferential machining marks, and depressions were observed after laser treatment. The untreated SA surface demonstrated a rough surface with sharp spikes and deep pits, and the laser produced noticeable changes on the SA titanium surfaces with melting and fusion. The untreated RBM surface demonstrated a rough surface with irregular indentation, and treatment with the laser produced changes on the RBM titanium surfaces. The Er:YAG laser produced significant changes on the roughness parameters, including arithmetic mean height of the surface (Sa) and maximum height of the surface (Sz), of the MA and SA surfaces. However, the Er:YAG laser did not produce notable changes on the roughness parameters, such as Sa and Sz, of the RBM surfaces. CONCLUSION: This study evaluated the effects of an Er:YAG laser on MA, SA, and RBM titanium discs using confocal microscopy and scanning electron microscopy. Treatment with the laser produced significant changes in the roughness of MA and SA surfaces, but the roughness parameters of the RBM discs were not significantly changed. Further research is needed to evaluate the efficiency of the Er:YAG laser in removing the contaminants, adhering bacteria, and the effects of treatment on cellular attachment, proliferation, and differentiation.
Bacteria ; Decontamination ; Dentistry ; Depression ; Freezing ; Lasers, Solid-State ; Methods ; Microscopy, Confocal* ; Microscopy, Electron, Scanning* ; Peri-Implantitis ; Surface Properties ; Titanium*

PURPOSE: Actinomycosis is an uncommon chronic granulomatous disease that presents as a slowly progressive, indolent, indurated infiltration with multiple abscesses, fistulas, and sinuses. The purpose of this article is to report on a case of actinomycosis with clinical findings similar to periodontitis. METHODS: A 46-year-old female presented with recurrent throbbing pain on the right first and second molar of the mandible three weeks after root planing. Exploratory flap surgery was performed, and the bluish-gray tissue fragment found in the interproximal area between the two molars was sent for histopathology. RESULTS: The diagnosis from the biopsy was actinomycosis. The clinical and radiographic manifestations of this case were clinically indistinguishable from periodontitis. The patient did not report any symptoms, and she is scheduled for a follow-up visit. CONCLUSIONS: The present study has identified periodontitis-mimicking actinomycosis. Actinomycosis should be included in the differential diagnosis in cases with periodontal pain and inflammation that do not respond to nonsurgical treatment for periodontitis. More routine submissions of tissue removed from the oral cavity for biopsies may be beneficial for differential diagnosis.
Abscess ; Actinomycosis ; Anti-Bacterial Agents ; Biopsy ; Debridement ; Diagnosis, Differential ; Female ; Fistula ; Follow-Up Studies ; Granulomatous Disease, Chronic ; Humans ; Inflammation ; Mandible ; Molar ; Mouth ; Periodontitis ; Root Planing

PURPOSE: The reaction of cells to a titanium implant depends on the surface characteristics of the implant which are affected by decontamination. The aim of this study was to evaluate the cytocompatibility of titanium disks treated with various decontamination methods, using salivary bacterial contamination with dental pellicle formation as an in vitro model. METHODS: Sand-blasted and acid-etched (SA) titanium disks were used. Three control groups (pristine SA disks [SA group]; salivary pellicle-coated SA disks [pellicle group]; and biofilm-coated, untreated SA disks [NT group]) were not subjected to any decontamination treatments. Decontamination of the biofilm-coated disks was performed by 14 methods, including ultrasonic instruments, rotating instruments, an air-powder abrasive system, a laser, and chemical agents. MG63 cells were cultured in the presence of the treated disks. Cell proliferation assays were performed on days 2 and 5 of cell culture, and cell morphology was analyzed by immunofluorescence and scanning electron microscopy (SEM). A vascular endothelial growth factor (VEGF) assay was performed on day 5 of culture. RESULTS: The cell proliferation assay revealed that all decontaminated disks, except for the 2 groups treated using a plastic tip, showed significantly less cell proliferation than the SA group. The immunofluorescence and SEM analyses revealed that most groups showed comparable cell density, with the exception of the NT group, in which the cell density was lower and bacterial residue was observed. Furthermore, the cells grown with tetracycline-treated titanium disks showed significantly lower VEGF production than those in the SA group. CONCLUSIONS: None of the decontamination methods resulted in cytocompatibility similar to that of pristine SA titanium. However, many methods caused improvement in the biocompatibility of the titanium disks in comparison with the biofilm-coated, untreated titanium disks. This suggests that decontamination is indispensable for the treatment of peri-implantitis, even if the original biocompatibility cannot be restored.
Biocompatible Materials ; Cell Count ; Cell Culture Techniques ; Cell Proliferation ; Decontamination ; Dental Implants ; Dental Pellicle ; Fluorescent Antibody Technique ; In Vitro Techniques ; Methods ; Microscopy, Electron, Scanning ; Peri-Implantitis ; Plastics ; Titanium ; Ultrasonics ; Vascular Endothelial Growth Factor A

Purpose: The aims of this study were to examine the salivary microbiota in conditions of periodontal health and disease and to explore microbial changes following nonsurgical periodontal treatment. Methods: Non-stimulated saliva samples were collected from 4 periodontally healthy participants at baseline and from 8 patients with chronic periodontitis at baseline and 3 months following nonsurgical periodontal therapy. The V3 and V4 regions of the 16S rRNA gene from the DNA of saliva samples were amplified and sequenced. The salivary microbial compositions of the healthy participants and patients with periodontitis prior to and following nonsurgical treatment of periodontitis were compared based on the relative abundance of various taxa. Results: On average, 299 operational taxonomic units were identified in each sample. The phylogenetic diversity in patients with periodontitis was higher than that in healthy participants and decreased following treatment. The abundance of the phylum Spirochaetes and the genus Treponema in patients with periodontitis was 143- and 134-fold higher than in the healthy control group, respectively, but decreased significantly following treatment. The species that were overabundant in the saliva of patients with periodontitis included the Peptostreptococcus stomatis group, Porphyromonas gingivalis, the Fusobacterium nucleatum group, Parvimonas micra, Porphyromonas endodontalis, Filifactor alocis, and Tannerella forsythia. The phylum Actinobacteria, the genus Streptococcaceae_uc, and the species Streptococcus salivarius group were more abundant in healthy participants than in those with periodontitis. There was a trend toward a decrease in disease-associated taxa and an increase in health-associated taxa following treatment. Conclusions Our results revealed differences in the taxa of salivary microbiota between conditions of periodontal health and disease. The taxa found to be associated with health or disease have potential for use as salivary biomarkers for periodontal health or disease.