Different periodontitis definitions have been used in periodontal research. This study assessed the impact of case definition on the prevalence and extent rates of periodontitis. A data set including 340 periodontal records, collected in Belo Horizonte, Brazil, was used. Periodontitis was defined as: 1) one site with probing depth (PD) >or= 4 mm; 2) clinical attachment level (CAL) >or= 5 mm in >or= 4 sites + one site with PD >or= 4 mm; 3) CAL >or= 6 mm in >or= 2 teeth + one site with PD >or= 5 mm; 4) >or= 4 teeth with >or= 1 sites with PD >or= 4 mm + CAL >or= 3 mm; 5a) interproximal CAL or PD >or= 4 mm at >or= 2 sites, not on the same tooth; and 5b) interproximal CAL of >or= 6 mm at >or= 2 sites, not on the same tooth + PD >or= 5 mm at >or= 1 proximal site. Definition 5 was determined to be the gold standard and the definitions were compared by means of agreement, sensitivity, specificity, and positive and negative predictive values. Prevalence and extent rates greatly varied, from 13.8% to 65.3% and from 9.7% to 55.6%, respectively. The use of different case definitions has a great impact on the prevalence and extent rates of periodontitis.
Porphyromonas gingivalis has been strongly associated to active periodontitis sites. A number of studies have tried to elucidate the association between female steroid sex hormones and gingival health. However, until now, there is limited knowledge on estradiol effects on the virulence traits of P. gingivalis. The aim of the study was to investigate the impact of estradiol exposure on the virulence characteristics of P. gingivalis strain W50. We found that a pre- and postmenopausal concentration of estradiol increased the growth and biofilm formation of P. gingivalis W50. We also found that estradiol increased the release of lysine and arginine gingipains from W50. We then showed that IL-1β, CXCL10 and TGF-β1 release from gingival epithelial cells was significantly lowered by W50 pre-exposed to estradiol compared to W50 alone. Real time-qPCR showed that the gene expression of IL-18, IL-6, IL-8, TGF-β1 and NLRP3 in gingival epithelial cells was significantly lowered by W50 pre-exposed to estradiol compared to W50 alone. We also found that estradiol in a dose-dependent manner increased P. gingivalis colonization and invasion of gingival epithelial cells. Taken together, our findings show that estradiol has the ability to alter the virulence traits of P. gingivalis.
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