Periodontitis and Tooth Loss Have Negative Systemic Impact on Circulating Progenitor Cell Levels: A Clinical Study

Abstract

The aim of the present study was to investigate the association and impact of periodontitis and tooth loss on a subtype of endothelial progenitor cell (EPC) levels (CD133+/KDR+). Furthermore, the objective was to determine if the periodontal status influenced CD133+/KDR+ levels. In all, 88 patients with periodontitis and 79 healthy controls (HCs) were enrolled in the study. Enrolled patients were examined and characterized by clinical and blood sample analysis. Spearman’s correlation test was applied in order to assess the interdependence between CD133+/KDR+ levels and all periodontal parameters. In order to estimate a statistically significant trend (p-trend) for ordered CD133++/KDR+ quartiles, the Jonckheere–Terpstra test was applied for all variables. Patients in the periodontitis group presented significantly lower CD133+/KDR+ levels (66.4 (45.5–269.6 cells/µL)) compared to the HC group (76.7 (24.3–313.2 cells/µL), p < 0.001). Lower CD133+/KDR+ levels negatively correlated with C-reactive protein (CRP), with the number of teeth, and with all periodontal parameters (p < 0.001). Moreover, there was a proportional increase in CD133+/KDR+ levels with a progressive increase in number of teeth (p-trend < 0.001), while there was a proportional decrease in CD133+/KDR+ levels with a proportional increase in clinical attachment level (CAL, p-trend = 0.003), probing depth (PD, p-trend = 0.007), and bleeding sites (bleeding on probing (BOP), p-trend < 0.001) as an extent measure of periodontitis. This study demonstrated that patients with periodontitis presented significantly lower CD133+/KDR+ levels compared to HCs. Moreover, all patients presented an increase in the CD133+/KDR+ EPC levels with an extended level of periodontitis and tooth loss.

Analysis of Endothelin-1 Concentrations in Individuals with Periodontitis

“…More recently, observational reports have shown an correlation between periodontal disease and cardiovascular disease, including coronary heart disease (CHD), stroke, and endothelial dysfunction 4,5 . Moreover, some studies demonstrated a specifi correlation among periodontal disease and augmented risk of stroke and, in general, CHD [6][7][8] .…”

Description of a Digital Work-Flow for CBCT-Guided Construction of Micro-Implant Supported Maxillary Skeletal Expander

“…The use of skeletal anchorage is getting widespread among orthodontists since it facilitates the management of complex orthodontic biomechanics; as a consequence, skeletal anchorage can be useful in treating borderline cases such as transversal maxillary deficiency in adults. In this respect, miniscrews-assisted rapid maxillary expansion was found to effectively open the mid-palatal suture in adults without the necessity to undergo orthognathic surgery [12,24,[28][29][30][31][32][33][34][35][36][37].…”

“…The availability of sufficient supporting bone and the perforation of both cortical laminas (bi-corticalism) are two mandatory parameters for mini-screw stability, especially when orthopedic forces are used, as during skeletal maxillary expansion. In this respect, a quantitative and qualitative evaluation of bone characteristics [30][31][32][33][34][37][38][39][40], as well as the assessment of the most suitable position of the miniscrews in the palate, are critical for the success of maxillary expansion assisted by skeletal anchorage. In this paper, we followed the recent guidelines for digital workflow planning proposed by Cantarella et al [23] for the MSE appliance, however, we utilized the patient CBCT DICOM file that allows discriminating between cortical and cancellous bone.…”

New Technologies in Orthodontics: A Digital Workflow to Enhance Treatment Plan and Photobiomodulation to Expedite Clinical Outcomes

“…First, photobiomodulation increases the production of mitochondrial ATP by upregulating the cytochrome c oxidase [12,14,[39][40][41][42][43][44][45] and promotes the cellular viability and the expression of osteocalcin in the tension areas of PDL [12][13][14][15][39][40][41][42][43]. This increased metabolic activity accelerates cellular turnover (osteoclast, osteoblast, and fibroblasts) [44][45][46][47][48][49][50][51][52][53] and the production of cytokines involved in the bone remodeling, mainly the IL-1b [46,[54][55][56][57]. Second, photobiomodulation activates the receptor of nuclear factor kappa B (RANK) and macrophage- Post-treatment radiographic examination such as dental panorex was not required considering the young age of the patient and the short overall treatment time (4 months), thus avoiding useless radiation according to the A.L.A.R.A.…”