Bruksizm Varlığında ve Yokluğunda, Periodontal Sağlık ve Hastalıkta Vasküler Endotelyal Büyüme Faktörü, Hipoksi ile İndüklenebilir Faktör 1-Alfa ve Bakteriyel Plak Kompozisyonunun Değerlendirilmesi: Randomize Olmayan Klinik Çalışma

Yıl 2021, Cilt: 26 Sayı: 2, 207 - 215, 29.05.2021

Nihat Akbulut Özkan Karataş Hatice Balci Yuce Sibel Akbulut Ahmet Altan Mehmet Taşkan

https://doi.org/10.21673/anadoluklin.736505

Öz

Amaç: Bu çalışmada periodontitis ve bruksizm hastalarında hipoksi belirteçlerindeki ve bakteriyel bileşen¬lerdeki olası değişiklikleri değerlendirmek amaçlanmıştır.

Yöntem: Dört çalışma grubu oluşturuldu: bruksizmi olmayan 20 sağlıklı birey (Grup 1), bruk-sizmi olmayan 20 periodontitis hastası (Grup 2), bruksizmi olan 20 sağlıklı birey (Grup 3) ve bruksizmi olan 20 periodontitis hastası (Grup 4). Plak indeksi, gingival indeks ve klinik ataçman seviyesi kaydedildi, dişeti oluğu sıvısı (DOS) ve dental plak örnekleri alındı. DOS’taki vasküler endotelyal büyüme faktörü (VEBF) ve hipoksi ile indüklenebilir faktör 1-alfa (HİF-1α) seviyeleri belirlendi. Subgingival plak örnekleri 5 bakteri türü (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola ve Fusobacterium nucleatum) için değerlendirildi.

Bulgular: Plak indeksi, gingival indeks ve klinik ataçman seviyesi periodontitis hastalarına kıyasla sağlıklı bireylerde anlamlı biçimde daha düşüktü. DOS ve serum VEBF ve HİF-1α seviyeleri benzerdi (p>0,05). A. actinomycetemcomitans, T. denticola ve F. nucleatum sayıları çalışma grupları arasında anlamlı farklılık göstermedi (p>0,05). P. gingivalis sayıları Grup 1’de en düşük olup hem periodontitis hem de bruksizm ile artmaktaydı. T. forsythia sayıları Grup 1 ve Grup 2’de Grup 3 ve Grup 4’e göre daha yüksekti. Grup 1’deki seviyeler ise Grup 2’dekinden düşüktü.

Sonuç: Bruksizmi olan ve olmayan bireyler, periodontal sağlık ve hastalıkta hipoksi bakımın¬dan benzer bulunmuştur. Bununla birlikte, başlıca oral patojenlerden biri olan P. gingivalis, periodontitisten bağımsız olarak bruksizm varlığından etkilenmektedir.

Anahtar Kelimeler

bruksizm, hiperkoklüzyon, hipoksi, periodontitis;, subgingival mikroorganizmalar

Destekleyen Kurum

Tokat Gaziosmanpaşa Üniversitesi

Proje Numarası

2016/19

Evaluation of Vascular Endothelial Growth Factor, Hypoxia-inducible Factor 1-Alpha, and Bacterial Plaque Composition in Periodontal Health and Disease, with or without Bruxism: A Non-Randomized Clinical Study

Öz

Aim: In this study, we aimed to evaluate the possible changes in hypoxia markers and bacterial compo-nents in patients with periodontitis and bruxism.

Methods: Four study groups were created: 20 healthy individuals without bruxism (Group 1), 20 periodontitis patients without bruxism (Group 2), 20 healthy individuals with bruxism (Group 3), and 20 periodontitis patients with bruxism (Group 4). Plaque index, gingival index, and clinical attach-ment levels were recorded and gingival crevicular fluid (GCF) and dental plaque samples were taken. The GCF vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1-alpha (HIF-1α) levels were determined. Subgingival plaque samples were evaluated for 5 bacterial species (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fu¬sobacterium nucleatum).

Results: Compared to patients with periodontitis, plaque index, gingival index, and clinical attachment levels were significantly lower in healthy individuals. The GCF and serum levels of VEGF and HIF-1α were similar (p>0.05). The A. actinomycetemcomitans, T. denticola, and F. nucleatum counts did not differ significantly between the study groups (p>0.05). P. gingivalis counts were lowest in Group 1 and increased with both periodontitis and bruxism. T. forsythia counts were higher in Group 1 and Group 2 than in Group 3 and Group 4. The levels in Group 1 were lower than those in Group 2.

Conclusion: Individuals with and without bruxism were found to be similar in terms of hypoxia in periodontal health and disease. However, one of the major oral pathogens, P. gingivalis, is af¬fected by the presence of bruxism, regardless of periodontitis.

Anahtar Kelimeler

bruxism, hyperocclusion, hypoxia, periodontitis, subgingival microorganisms

Proje Numarası

2016/19

Kaynakça

• Caton JG, Armitage G, Berglundh T, Chapple IL, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri‐implant diseases and conditions— Introduction and key changes from the 1999 classifica¬tion. J Periodontol. 2018;89(Suppl. 1):S1–8.
• Murakami S, Mealey BL, Mariotti A, Chapple IL. Dental plaque–induced gingival conditions. J Clin Periodontol. 2018;45(Suppl. 20):S17–27.
• Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89(Suppl. 1):S159–72.
• Deshpande RG, Mhatre S. TMJ disorders and occlusal splint therapy—a review. Int J Dent Clin. 2010;2(2):22–9.
• Hallmon WW. Occlusal trauma: effect and impact on the periodontium. Ann Periodontol. 1999;4(1):102–8.
• Campos M, Corrêa M, Junior F, Casati M, Sallum E, Sal¬lum A. Cigarette smoke inhalation increases the alveo¬lar bone loss caused by primary occlusal trauma in a rat model. J Periodontal Res. 2014;49(2):179–85.
• Ispas A, Mihu C, Crăciun A, Constantiniuc M. Mor¬pho-histological assessment of the periodontal support structures under the action of excessive occlusal forces and under the influence of nicotine. Rom J Morphol Embryol. 2018;59(1):211.
• Grant DA, Grant DA, Flynn MJ, Slots J. Periodontal mi¬crobiota of mobile and non‐mobile teeth. J Periodontol. 1995;66(5):386–90.
• Cheng R, Liu W, Zhang R, Feng Y, Bhowmick NA, Hu T. Porphyromonas gingivalis-derived lipopolysaccha¬ride combines hypoxia to induce Caspase-1 activation in periodontitis. Front Cell Infect Microbiol. 2017;7:474.
• Takedachi M, Iyama M, Sawada K, Mori K, Yamamoto S, Morimoto C, et al. Hypoxia‐inducible factor‐1α inhib¬its interleukin‐6 and‐8 production in gingival epithelial cells during hypoxia. J Periodontal Res. 2017;52(1):127– 34.
• Ebersole JL, Novak MJ, Orraca L, Martinez‐Gonzalez J, Kirakodu S, Chen KC, et al. Hypoxia‐inducible tran¬scription factors, HIF1A and HIF2A, increase in aging mucosal tissues. Immunology. 2018;154(3):452–64.
• Gölz L, Memmert S, Rath-Deschner B, Jäger A, Appel T, Baumgarten G, et al. Hypoxia and P. gingivalis syn¬ergistically induce HIF-1 and NF-κB activation in PDL cells and periodontal diseases. Mediators Inflamm. 2015;2015:438085.
• Mendes RT, Nguyen D, Stephens D, Pamuk F, Fernandes D, Hasturk H, et al. Hypoxia‐induced endothelial cell re-sponses–possible roles during periodontal disease. Clin Exp Dent Res. 2018;4(6):241–8.
• Weng Y, Liu Y, Du H, Li L, Jing B, Zhang Q, et al. Glyco¬sylation of DMP1 is essential for chondrogenesis of con¬dylar cartilage. J Dent Res. 2017;96(13):1535–45.
• Tsuzuki T, Kajiya H, Kazuko T, Tsutsumi T, Nemoto T, Okabe K, et al. Hyperocclusion stimulates the expression of collagen type XII in periodontal ligament. Arch Oral Biol. 2016;66:86–91.
• Kvinnsland S, Kvinnsland I, Kristiansen AB. Effect of experimental traumatic occlusion on blood flow in the temporomandibular joint of the rat. Acta Odontol Scand. 1993;51(5):293–8.
• Kvinnsland S, Kristiansen AB, Kvinnsland I, Heyeraas KJ. Effect of experimental traumatic occlusion on peri¬odontal and pulpal blood flow. Acta Odontol Scand. 1992;50(4):211–9.
• Motohira H, Hayashi J, Tatsumi J, Tajima M, Sakagami H, Shin K. Hypoxia and reoxygenation augment bone‐resorbing factor production from human periodontal ligament cells. J Periodontol. 2007;78(9):1803–9.
• Song ZC, Zhou W, Shu R, Ni J. Hypoxia induces apop¬tosis and autophagic cell death in human periodontal ligament cells through HIF‐1α pathway. Cell Prolif. 2012;45(3):239–48.
• Afacan B, Öztürk VÖ, Paşalı Ç, Bozkurt E, Köse T, Em¬ingil G. Gingival crevicular fluid and salivary HIF‐1α, VEGF, and TNF‐α levels in periodontal health and dis¬ease. J Periodontol. 2019;90(7):788–97.
• Frede S, Freitag P, Otto T, Heilmaier C, Fandrey J. The proinflammatory cytokine interleukin 1β and hypoxia cooperatively induce the expression of adrenomedullin in ovarian carcinoma cells through hypoxia inducible factor 1 activation. Cancer Res. 2005;65(11):4690–7.
• Li JP, Li FY, Xu A, Cheng B, Tsao SW, Fung ML, et al. Lipopolysaccharide and hypoxia‐induced HIF‐1 ac¬tivation in human gingival fibroblasts. J Periodontol. 2012;83(6):816–24.
• Toker H, Balci Yuce H, Lektemur Alpan A, Gevrek F, El¬mastas M. Morphometric and histopathological evalua¬tion of the effect of grape seed proanthocyanidin on al¬veolar bone loss in experimental diabetes and periodon¬titis. J Periodontal Res. 2018;53(3):478–86.
• Vasconcelos RC, Costa ALL, Freitas RA, Bezerra BA, Santos BR, Pinto LP, et al. Immunoexpression of HIF-1α and VEGF in periodontal disease and healthy gingival tissues. Braz Dent J. 2016;27(2):117–22.
• Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89(Suppl. 1):S159–72.
• Silness J, Loe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal con¬dition. Acta Odontol Scand. 1964;22:121–35.
• Loe H, Silness J. Periodontal disease in pregnan¬cy I. Prevalence and severity. Acta Odontol Scand. 1963;21:533–51.
• Hallmon WW. Occlusal trauma—periodontal concerns. Tex Dent J. 2001;118(10):956–60.
• Biancu S, Ericsson I, Lindhe J. Periodontal ligament tis¬sue reactions to trauma and gingival inflammation. An experimental study in the beagle dog. J Clin Periodontol. 1995;22(10):772–9.
• Shimizu N, Ozawa Y, Yamaguchi M, Goseki T, Ohzeki K, Abiko Y. Induction of COX-2 expression by mechani¬cal tension force in human periodontal ligament cells. J Periodontol. 1998;69(6):670–7.
• Kong J, Yang Y, Sun S, Xie J, Lin X, Ji P. Effect of toll-like receptor 4 on synovial injury of temporomandibular joint in rats caused by occlusal interference. Mediators of Inflamm. 2016;2016:7694921.
• Huang LE, Bunn HF. Hypoxia-inducible factor and its bio¬medical relevance. J Biol Chem. 2003;278(22):19575–8.
• Yu XJ, Xiao CJ, Du YM, Liu S, Du Y, Li S. Effect of hy¬ poxia on the expression of RANKL/OPG in human periodontal ligament cells in vitro. Int J Clin Exp Pathol. 2015;8(10):12929–35.
• Kim MS, Magno CL, Day CJ, Morrison NA. Induction of chemokines and chemokine receptors CCR2b and CCR4 in authentic human osteoclasts differentiated with RANKL and osteoclast like cells differentiated by MCP‐1 and RANTES. J Cell Biochem. 2006;97(3):512–8.
• Kaku M, Uoshima K, Yamashita Y, Miura H. Investiga¬tion of periodontal ligament reaction upon excessive oc¬clusal load–osteopontin induction among periodontal ligament cells. J Periodontal Res. 2005;40(1):59–66.
• Höpfl G, Ogunshola O, Gassmann M. HIFs and tu¬mors—causes and consequences. Am J Physiol. 2004;286(4):R608–23.
• Amemiya H, Matsuzaka K, Kokubu E, Ohta S, Inoue T. Cellular responses of rat periodontal ligament cells under hypoxia and re‐oxygenation conditions in vitro. J Peri¬odontal Res. 2008;43(3):322–7.
• Chae HS, Park HJ, Hwang HR, Kwon A, Lim WH, Yi WJ, et al. The effect of antioxidants on the production of pro-inflammatory cytokines and orthodontic tooth movement. Mol Cells. 2011;32(2):189–96.
• Balci Yuce H, Karatas Ö, Tulu F, Altan A, Gevrek F. Ef¬fect of diabetes on collagen metabolism and hypoxia in human gingival tissue: a stereological, histopathological, and immunohistochemical study. Biotech Histochem. 2019;94(1):65–73.
• Gölz L, Memmert S, Rath-Deschner B, Jäger A, Appel T, Baumgarten G, et al. LPS from P. gingivalis and hy¬poxia increases oxidative stress in periodontal ligament fibroblasts and contributes to periodontitis. Mediators Inflamm. 2014;2014:986264.
• Xiao X, Li Y, Zhang G, Gao Y, Kong Y, Liu M, et al. De¬tection of bacterial diversity in rat’s periodontitis model under imitational altitude hypoxia environment. Arch Oral Biol. 2012;57(1):23–9.
• Jian C, Li C, Ren Y, He Y, Li Y, Feng X, et al. Hypoxia augments lipopolysaccharide-induced cytokine ex-pression in periodontal ligament cells. Inflammation. 2014;37(5):1413–23.
• Eick S, Pfister W. Comparison of microbial cultivation and a commercial PCR based method for detection of periodontopathogenic species in subgingival plaque samples. J Clin Periodontol. 2002;29(7):638–44.
• Santigli E, Leitner E, Wimmer G, Kessler HH, Feierl G, Grube M, et al. Accuracy of commercial kits and pub¬lished primer pairs for the detection of periodonto¬pathogens. Clin Oral Investig. 2016;20(9):2515–28.
• Petelin M, Perkič K, Seme K, Gašpirc B. Effect of repeat¬ed adjunctive antimicrobial photodynamic therapy on subgingival periodontal pathogens in the treatment of chronic periodontitis. Lasers Med Sci. 2015;30(6):1647– 56.
• Haffajee AD, Yaskell T, Torresyap G, Teles R, Socransky SS. Comparison between polymerase chain reaction‐based and checkerboard DNA hybridization techniques for microbial assessment of subgingival plaque samples. J Clin Periodontol. 2009;36(8):642–9.