Nd: YAG laser, a near-infrared laser, offers advantages such as sterilization, hemostasis, and tissue ablation, making it a promising adjunctive tool for minimally invasive periodontal treatment. This study aimed to evaluate the clinical efficacy of Nd: YAG laser-assisted nonsurgical treatment in stage III–IV periodontitis and its impact on the subgingival microbial community structure using 16 S rRNA sequencing. A total of 20 patients with stage III-IV periodontitis were randomly divided into a subgingival scaling and root planning (SRP group) (n = 10) and a Nd: YAG laser-assisted SRP group (Nd group) (n = 10). Clinical parameters were compared before and after treatment for 3 months, and subgingival plaque samples were collected for 16 S rRNA microbial analysis. Both groups exhibited significant improvements in periodontal clinical parameters after treatment (P < 0.01), with greater gains in the Nd group (P < 0.05). Alpha diversity decreased after treatment in both (P < 0.05), more markedly in the Nd group (P < 0.01). Beta diversity analysis showed that significant clustering was formed in the subgingival plaque samples before and after treatment in both groups, with larger microbial shifts in the Nd group(P < 0.05). After treatment, the relationship network was significantly simplified. Non-surgical treatment significantly improved periodontal parameters in stage III-IV periodontitis patients, reducing subgingival microbiota diversity and optimizing its composition. Nd: YAG laser-assisted SRP demonstrated superior clinical outcomes versus SRP alone, with microbiological analysis confirming its adjunctive benefits and enhanced clinical efficacy.

Background Odontogenic brain abscess is a rare, but potentially fatal, central nervous system infection, with insidious onset and unclear etiology.Methods This case reports a 70-year-old male patient who developed an odontogenic brain abscess secondary to periodontal infection and underwent neurological surgery. Extract pus during surgery for the metagenomic next-generation sequencing (mNGS).Results The mNGS of pus samples obtained from brain abscess aspiration identified the periodontal pathogens Porphyromonas gingivalis and Streptococcus constellatus. Consequently, he was referred to the department of stomatology for further examination and treatment.Conclusions Our study found that major periodontal pathogens including P. gingivalis and S. constellatus were essential in the development of odontogenic brain abscesses; thus, timely intervention and preventive measures are important for treatment.

BackgroundPeriodontitis, recognized as the second most prevalent oral disease globally, is strongly linked to systemic disorders like diabetes and cardiovascular diseases, highlighting the critical need for effective prevention and treatment strategies. Oxidative stress plays an important role in periodontitis pathogenesis and progression, yet their specific association remains unclear. This study aims to explore the association between oxidative stress and periodontitis pathogenesis while identifying potential diagnostic biomarkers and therapeutic targets for this condition.MethodsTranscriptomic data from gingival tissues of periodontitis patients and controls were obtained from the Gene Expression Omnibus (GEO) database. Key genes linked to oxidative stress in periodontitis were identified through a comprehensive analytical approach, including differential expression analysis, weighted gene co-expression network analysis (WGCNA), gene set enrichment analysis (GSEA), and functional enrichment analyses (GO and KEGG). Machine learning algorithms were subsequently employed to refine the selection of key genes. The relationship between oxidative stress and the expression of these key genes was validated using external datasets and a periodontitis rat model. Additionally, single-cell RNA sequencing (scRNA-seq) data were interrogated to delineate the cellular subpopulations expressing the key genes, leveraging clustering and annotation approaches.ResultsComprehensive bioinformatics analysis identified COL4A2, CYR61, and CXCL6 as key genes associated with oxidative stress in periodontitis. Among these genes, COL4A2 and CXCL6 showed elevated expression levels in the gingival tissues of periodontitis rats. Single-cell RNA-seq analysis further demonstrated that COL4A2 exhibited predominant expression within endothelial and stromal cell clusters, whereas CXCL6 was predominantly localized to epithelial cell clusters.ConclusionsThis study demonstrates a correlation between oxidative stress and the progression of periodontitis. COL4A2 and CXCL6 were identified as potential therapeutic targets for the treatment of periodontitis.

Aim or purpose: The development of periodontitis involves oxidative stress, but its exact mechanism has not been fully elucidated. This study aimed to reveal the role of oxidative stress in periodontitis and to search for potential diagnostic markers and therapeutic targets. Materials and methods: Transcriptomic data were obtained from the Gene Expression Omnibus (GEO) database for gingival tissues from periodontitis and controls. Through weighted gene co-expression network analysis (WGCNA), differential expression analysis, gene set enrichment analysis (GSEA), we systematically identified oxidative stress-associated key genes in periodontitis. These candidate genes were first screened by machine learning algorithms and then validated through independent external datasets. Results: Differential expression profiling analysis identified 139 significantly differentially expressed genes (DEGs) in periodontitis samples. WGCNA revealed the 154 genes had the strongest link to oxidative stress. Integration of DEGs and co-expressed module genes via Venn diagram screening yielded 13 oxidative stress-related signature genes. Subsequently, feature selection using three machine learning algorithms ultimately identified CXCL6, COL4A2, and CYR61 as core hub genes regulating the oxidative stress microenvironment in periodontitis, with their diagnostic efficacy validated by ROC curve analysis. Conclusions: Through systematic analysis, this study reveals the important role of oxidative stress in the development of periodontitis and identifies CXCL6, COL4A2, and CYR61 as novel therapeutic targets.

Background: Porphyromonas gingivalis lipopolysaccharide (P.g-LPS), a key virulence factor in periodontitis, contributes to systemic vascular diseases, notably atherosclerosis. MicroRNA-21 (miR-21), a critical post-transcriptional regulator, influences inflammation and vascular pathology, but its role in endothelial responses to P.g-LPS remains unclear. Methods: Gingival biopsies from eight patients with periodontitis and eight healthy controls were analyzed using immunofluorescence co-labeling for Cluster of Differentiation 31 (CD31) with TUNEL or Interleukin-6 (IL-6) to assess endothelial apoptosis and inflammation. MiR-21 levels were quantified using quantitative Reverse Transcription Polymerase Chain Reaction (RT-PCR). Human umbilical vein endothelial cells (HUVECs) were treated with P.g-LPS and transfected with miR-21 mimics or inhibitors. Apoptosis, proliferation, and migration were evaluated by flow cytometry, Cell Counting Kit-8 (CCK-8) assay, and wound healing analysis, respectively. Western blotting and Enzyme-Linked Immunosorbent Assay(ELISA) measured inflammatory and apoptotic markers. Luciferase reporter assays confirmed that PDCD4 was a direct target of miR-21, and the effects of Programmed Cell Death 4(PDCD4) knockdown on Nuclear Factor kappa B (NF-κB)/Inducible Nitric Oxide Synthase (iNOS)/Nitric Oxide (NO) signaling were examined. Results: Endothelial cells from patients with periodontitis exhibited increased apoptosis and inflammation. P.g-LPS significantly reduced miR-21 expression in HUVECs. MiR-21 inhibition exacerbated apoptosis and inflammatory mediator expression, while suppressing proliferation and migration.MiR-21 overexpression mitigated these effects. PDCD4 was validated as a direct miR-21 target. Suppression of miR-21 enhanced NF-κB/iNOS/NO activation, and PDCD4 knockdown attenuated this pathway, indicating a regulatory mechanism. Conclusion: MiR-21 acts as a protective regulator against P.g-LPS-induced endothelial injury by targeting PDCD4 and modulating the NF-κB/iNOS/NO pathway, thereby reducing inflammation and apoptosis. These findings indicate that miR-21 is a potential therapeutic target for vascular complications associated with chronic inflammatory diseases like periodontitis.

Adverse cardiac mechanical remodeling is critical for the progression of heart failure following myocardial infarction (MI). We previously demonstrated the involvement of RIP3-mediated necroptosis in the loss of functional cardiomyocytes and cardiac dysfunction post-MI. Herein, we investigated the role of RIP3 in NOD-like receptor protein 3 (NLRP3)-mediated inflammation and evaluated the effects of RIP3 knockdown on myocardial mechanics and functional changes after MI. Our findings revealed that mice with MI for 4 weeks exhibited impaired left ventricular (LV) myocardial mechanics, as evidenced by a significant decrease in strain and strain rate in each segment of the LV wall during both systole and diastole. However, RIP3 knockdown ameliorated cardiac dysfunction by improving LV myocardial mechanics not only in the anterior wall but also in other remote nonischemic segments of the LV wall. Mechanistically, knockdown of RIP3 effectively inhibited the activation of the nuclear factor kappa-B (NF-κB)/NLRP3 pathway, reduced the levels of interleukin-1β (IL-1β) and interleukin-18 (IL-18) in the heart tissues, and mitigated adverse cardiac remodeling following MI. These results suggest that downregulation of RIP3 holds promise for preventing myocardial inflammation and cardiac mechanical remodeling following MI by regulating the NF-κB/NLRP3 pathway.

Background Accumulating evidences indicate that periodontitis is closely associated with endothelial dysfunction. Trimethylamine-N-oxide (TMAO), a harmful microbiota generated metabolite, has been implicated as a nontraditional risk factor for impaired endothelial function. However, whether increased circulating levels of TMAO in periodontitis patients induces endothelial dysfunction remains unknown. Methods Patients with periodontitis and periodontally healthy controls were enrolled. Periodontal inflamed surface area (PISA) was calculated to assess the inflammatory burden posed by periodontitis. The circulating TMAO was measured by high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). Vascular endothelial function including peripheral endothelial progenitor cells (EPCs), brachial arterial flow-mediated vasodilation (FMD), and brachial-ankle pulse wave velocity (baPWV) were assessed. We also isolated and cultured EPCs from participants' peripheral blood to investigate the effect of TMAO on EPC functions in vitro. Results One hundred and twenty two patients with Stage III-IV periodontitis and 81 healthy controls were included. Patients with periodontitis presented elevated TMAO (P = 0.002), lower EPCs (P = 0.025), and declined FMD levels (P = 0.005). The TMAO concentrations were correlated with reduced circulating EPCs and FMD levels. Moreover, TMAO can injury EPCs function in vitro, and may induce cell pyroptosis via Bax/caspase-3/GSDME pathway. Conclusions The present study demonstrates for the first time that circulating TMAO levels are increased in patients with Stage III-IV periodontitis, and correlated with vascular endothelial dysfunction. These findings may provide a novel insight into the mechanism of vascular endothelial dysfunction in patient with periodontitis via TMAO-downregulated EPC functions.

目的:探讨牙周非手术治疗对慢性牙周炎患者的内皮功能以及血浆氧化三甲胺的影响.方法:2019年11月～2021年2月按照牙周炎新分类在中山大学附属第一医院招募III～IV期牙周炎患者68例,随机分为牙周非手术治疗组(34例)和对照组(34例),前者进行洁治术和刮治术,后者仅进行洁治术.分别在治疗前和治疗后3个月评估牙周状况、循环内皮祖细胞(EPCs)、肱踝脉搏波传导速度(baPWV)、血浆氧化三甲胺(TMAO)以及相关炎性标志物的水平.结果:治疗3个月后,非手术治疗组患者循环CD34+/CD309+/CD45-EPCs水平较治疗前升高,且高于对照组(P<0.01),同时牙周指标、baPWV、超敏C反应蛋白和TMAO水平均较治疗前降低,且低于对照组(P<0.05).相关分析表明,非手术治疗组治疗前后EPCs的升高伴随着TMAO的下降(r=0.787,P<0.001).结论:牙周非手术治疗可明显改善III～IV期牙周炎患者的血管内皮功能,降低血浆TMAO以及相关炎症因子水平.

Using genomics techniques and strategies, metagenomics can be used to study the genetic composition and colony function of all microbiotas contained in environmental samples, which effectively break through the limitations of conventional microbiology culture and might provide new ideas or methods for the overall study of microbial communities in the body. The oral cavity and intestinal tract are important parts of the human body where a large number of microbial communities inhabit. Under normal condition, the microbial communities maintain local homeostasis in a healthy situation. However, the dysbacteriosis from oral-gut axis can not only lead to local tissue lesions in oral and intestine tract, but also might contribute to the pathological progress in other systems through the oral-gut axis. In recent years, metagenomics has been widely used to detect the composition and functional changes of microbial flora related to the oral-intestinal axis and analyze the possible role of dysbacteriosis in oral diseases. Hopefully, it can provide a new perspective for the study of pathogenesis of oral related diseases. This article reviewed the application of metagenomics in oral diseases related to the oral-gut axis.

Periodontitis is one of the most common oral diseases in the world. It is a chronic inflammatory disease of periodontal supporting tissue caused by periodontal pathogen. In recent years, studies have shown that periodontitis is related to a variety of systemic diseases, among which the relationship between periodontitis and digestive system diseases is the latest research hotspot. This article reviews the clinical and pathological correlation between periodontitis and some digestive diseases from three aspects: common intestinal diseases, liver diseases and pancreatic diseases. In addition, recommendations for future research are also provided.

目的:研究炎症性肠病(inflammatory bowel disease,IBD)的活动性、病程、用药类型与口腔黏膜病和口腔症状的关系.方法:采用横断面研究对389例IBD患者[265例克罗恩病(CD组)和124例溃疡性结肠炎(UC组)]和265例健康者(对照组)进行问卷调查和口腔黏膜检查.数据分析运用χ2检验和Logistic回归.结果:CD组沟纹舌的患病率比对照组增加(P=0.021),其患病风险增加7.76倍.相比对照组,CD和UC组口干和口腔异味的发生率均明显增加(P<0.05),口干的发生风险分别增加1.98倍和1.48倍,口腔异味的发生风险分别增加0.96倍和0.72倍.活动期CD患者复发性阿弗他溃疡和沟纹舌的患病率比缓解期者增加(P=0.048,P=0.009).口腔扁平苔藓的患病率随CD病程的延长而增加(P=0.035).CD组中应用氨基水杨酸制剂者口腔黏膜异常检出率比免疫抑制剂者增加(P=0.003).结论:IBD患者口腔黏膜病的患病风险和口腔症状的发生风险增加,并与IBD的活动性、病程、用药类型相关,亟需口腔卫生宣教和多学科综合治疗.

OBJECTIVES:Inflammatory bowel disease (IBD) may be associated with oral diseases, but few relevant studies have been reported in China. This study aimed to compare the prevalence, severity and extent of dental caries and periodontal disease in Chinese IBD patients and healthy controls.MATERIALS AND METHODS:In this cross-sectional study, questionnaires and oral examinations were completed for 389 IBD patients [265 with Crohn's disease (CD) and 124 with ulcerative colitis (UC)] and 265 healthy controls based on the established criteria of the World Health Organization. Tobit regression, multiple linear regression and logistic regression were performed to analyse the data.RESULTS:After adjusting for confounders, the decayed, missing and filled surfaces indices were significantly increased in the CD and UC patients compared with those in the controls (P < 0.001). Patients with CD [odds ratio (OR) = 4.27, 95% confidence interval (95% CI): 2.63-6.95, P < 0.001] and UC (OR = 2.21, 95% CI: 1.24-3.94, P = 0.007) had significantly higher risks of dental caries than controls. Significantly higher percentages of sites with probing pocket depth ≥ 5 mm and clinical attachment loss ≥ 4 mm were observed in CD and UC patients compared with controls (P < 0.001). A fully adjusted model revealed that CD and UC were risk indicators for periodontitis (OR = 4.46, 95% CI: 2.50-7.95, P < 0.001; OR = 4.66, 95% CI: 2.49-8.71, P < 0.001, respectively). No significant differences in dental caries and periodontal disease were observed between the CD and UC patients.CONCLUSIONS:Chinese IBD patients have a higher prevalence, severity and extent of dental caries and/or periodontal disease than controls, and require oral health education and multidisciplinary treatment.

目的 探讨牙周强化治疗对正常高值血压合并重度牙周炎患者血压的影响.方法 2013年3-12月在中山大学附属第一医院门诊纳入正常高值血压合并重度牙周炎患者28例.通过随机单盲平行对照试验,将患者分为强化治疗组(14例)进行洁治术和牙周强化治疗,对照组(14例)仅进行洁治术.分别在治疗前和治疗后3、6个月评价血压、牙周状况和炎性标志物的变化.结果 干预后6个月,与对照组比较,强化治疗组血压较低[收缩压(125.6±5.4)比(135.7±5.6)mm Hg;舒张压(77.5±3.7)比(83.7±7.3) mm Hg],同时牙周指标(探诊深度、临床附着丧失和探诊出血)和炎症指标(高敏C反应蛋白和白细胞介素6)亦降低(均P＜0.05).结论 牙周强化治疗能降低正常高值血压合并重度牙周炎患者的血压和炎症反应水平.

目的:研究牙龈卟啉单胞菌脂多糖(Porphyromonas gingivalis lipopolysaccharide,P.g-LPS)对人脐静脉内皮细胞(human umbilical vein endothelial cells,HUVECs)增值和凋亡影响,并探讨其中的细胞信号机制.方法:实验分为对照组、5μg/mL组和10μg/ml组P.g-LPS,分别与HUVECs共培养.应用CCK-8法流式细胞术、Western Blot、硝酸酶还原法等测定HUVECs的增殖、凋亡、NO生成量和NF-κB p65、iNOS蛋白的表达.结果:与P.g-LPS共培养24 h后HUVECs增殖活力较对照组下降(P<0.05);HUVECs早期凋亡较对照组上升(P<0.05),并随着P.g-LPS浓度增加,HUVEC早期凋亡比例升高(P<0.05).同时NO、NF-κB蛋白、iNOS蛋白的表达上调(P<0.05).结论:P.g-LPS可诱导HUVECs增殖凋亡失衡,其作用机制可能是通过NF-κB/iNOS/NO通路介导的.

BACKGROUND: Benzalkonium chloride has been used in dental restorative materials to enhance the long-lasting antibacterial properties of materials. OBJECTIVE: To evaluate the antibacterial activity of benzalkonium chloride on oral common pathogenic bacteria in vitro. METHODS: The agar diffusion method was used to determine the inhibitory effects of antibacterial agents, 0.1% benzalkonium chloride, 3% H2O2and 5.25% sodium hypochlorite, on five kind of oral pathogens, Porphyromonas gingivalis (P.g), Prevotella intermedia (P.i), Actinobacillus actionmycemcomitans (A.a), Streptococcus mutans (S.m) and Enterococcus faecalis (E.f). The tube dilution method was used to detect the minimal inhibitory concentration of benzalkonium chloride against the five bacteria mentioned above. RESULTS AND CONCLUSION: The antibacterial effect of 0.1% benzalkonium chloride on P.g was not significantly different from that of 3% hydrogen peroxide (P＞0.05), while 0.1% benzalkonium chloride showed better effect on P.i than 3% hydrogen peroxide (P＜0.05). On P.g and P.i, the antibacterial effect of 0.1% benzalkonium chloride was worse than that of 5.25% sodium hypochloritethe ( P＜0.05). The antibacterial effect of 0.1% benzalkonium chloride on A.a and S.m was better than that of 3% hydrogen peroxide (P＜0.05), and similar to that of 5.25% sodium hypochlorite (P＞0.05). The antibacterial effect of 0.1% benzalkonium chloride on E.f was better than that of 3% hydrogen peroxide (P ＜ 0.05), but worse than that of 5.25% sodium hypochlorite (P ＜ 0.05). The minimal inhibitory concentration of benzalkonium chloride to P.g, P.i, A.a, S.m, E.f was 16, 2, 4, 2, 4 mg/L, respectively. To conclude, 0.1% benzalkonium chloride has strong antibacterial effects on P.g, P.i, A.a, S.m and E.f.

BACKGROUND:Although some studies show a positive association between periodontitis and blood pressure (BP) elevation, research on the effect of intensive periodontal treatment on decline in BP levels and endothelial microparticles (EMPs) without any antihypertensive management is lacking. Therefore, the present clinical trial explores whether intensive periodontal therapy would lower BP levels and EMPs of patients with prehypertension with periodontitis.METHODS:From a total 107 patients, 95 underwent randomization (47 assigned to control-treatment [CT] group and 48 assigned to intensive-treatment [IT] group) and completed the trial. Patients received intervention for 4 consecutive weeks and were followed for 6 months. Levels of BP and EMPs were evaluated at baseline and 1, 3, and 6 months after intervention.RESULTS:Periodontal conditions were significantly improved (P <0.05) 6 months after intensive periodontal treatment. In parallel, the primary outcomes including systolic and diastolic BP and EMPs were markedly reduced in the IT group compared with the CT group (absolute difference: 12.57 and 9.65 mm Hg and 581.59/μL, respectively; 95% confidence intervals: 10.45 to 14.69, 7.06 to 12.24, and 348.12 to 815.06, respectively; P <0.05). Reduction in BP levels and EMPs was related to improvement in probing depth (r = 0.358, 0.363, and 0.676, respectively, by the Pearson product-moment correlation; P = 0.009, 0.008, and P <0.001, respectively).CONCLUSION:To the best knowledge of the authors, the present study demonstrates for the first time that intensive periodontal intervention without any antihypertensive medication therapy may be an effective means to lower levels of BP and EMPs in patients with prehypertension with periodontitis.

Background: Previous studies showed that there is a linkage between periodontitis and hypertension, however, direct clinical evidence is lacking. We conducted a prospective intervention clinical tr...

Periodontitis,a chronic inflammatory disease caused by a variety of microbes,causes periodontal tissue damage associated with the host immune response inducing inflammation. It′s widely accepted that the occurrence and development of periodontitisis associated with patients′ immune status can be partly reflected by CD4-positive T-lymphocytes(CD4+T cells). Their relationship with periodontitis has become a hotspot in recent years. This review summarizes the recent studies on the differentiation and function of CD4+T cells and their relationship with periodontitis,and aims to elucidate the role of CD4+T cells in the genesis and progression of periodontitis.

Objective To evaluate the antibacterial potential of benzalkonium chloride in root canals infected by Enterococcus faecalis(E.faecalis). Methods Sixty-four human premolars extracted for orthodontics were prepared and inoculated with E.faecalis. Two teeth were selected respectively using random lottery method before and after inoculation,then split in to two halves along the mesiodistal axis. One half was processed with light microscopic(Brown & Brenn stain)to check the bacteria in dentinal tubules,and the other was observed with SEM to investigate the bacterial status in infected root canals. The rest of the teeth were randomly assigned to the following groups:0.05% benzalkonium chloride,0.1%benzalkonium chloride,3% hydrogen peroxide,2.5% sodium hypochlorite,5.25% sodium hypochlorite, 0.9% sodium chloride for endodontic irrigation. Before and after irrigating,microbiological samples were collected from root canals for bacteriological culture,and colony forming units(CFU)were counted. The t-test was used to analyze the difference of bacterial counts in root canals before and after irrigation. The difference of bacterial descent among the six groups were analyzed by ANOVA. Bacterial status after irrigation was assessed with SEM. Results (1)E.faecalis was found to penetrate into the dentinal tubules about 250 ~ 1050 μm. In the infected root canal samples,E.faecalis was attached to the root canal wall to form a biofilm structure.(2)The number of E.faecalis in root canal in each group was effectively reduced excepted 0.9% sodium chloride group (P<0.05). The bacterial descent of 0.05% ,0.1%benzalkonium chloride groups(7.90 ± 2.18,8.30 ± 2.21)was significantly more than that of 3% hydrogen peroxide group(5.30 ± 2.31)and 2.5% sodium hypochlorite group(6.10 ± 1.20,P<0.05). There were no statistical difference among 0.05% benzalkonium chloride group,0.1% benzalkonium chloride group and 5.25% sodium hypochlorite group(8.70±1.89,P>0.05). Root canal surfaces were cleaner in benzalkonium chloride and 5.25% sodium hypochlorite groups than 3% hydrogen peroxide group and 2.5% sodium hypochloritethe group with SEM observation. Conclusion It was suggested that benzalkonium chloride solution had potential antibacterial activity against E.faecalis when it was used for root canal irrigation.

Objective To explore the possible relationship of serum neopterin levels with chronic periodontitis and coronary heart disease(CHD). Methods A total of 120 patients were recruited in this study,including 30 patients with periodontitis and coronary heart disease (C+P),30 patients with periodontitis(P),30 patients with coronary heart disease(C),30 healthy controls(H). All parameters, including age,gender and periodontal clinic index,were recorded. Serum neopterin levels and lipid levels were examined at the same time. Differences in parameters among the four groups were analyzed by ANOVA. Correlations of each serum parameters with periodontal indexes were analyzed by Pearson correlation. Results The periodontal indexes were significantly different among the four groups (P<0.05). In(C+P)group,serum neopterin levels were significantly higher than that of P,C and H groups (P<0.05). The serum neopterin levels of P and C groups were significantly higher than that of H group (P<0.05). Serum neopterin levels were significantly correlated to probing depth and clinical attachment loss. Conclusions A certain correlation might exist between periodontitis and CHD,and neopterin might be closely related with the pathogenesis of these two diseases.