| Objective: Periodontitis is a chronic and destructive disease that occurs in gingiva,periodontal ligament and alveolar bone.Dental plaque biofilm is a bacterial community attached by biofilm,which is the direct cause of periodontitis.Bacteria directly destroy periodontal tissues by secreting infectious substances such as endotoxin or stimulate host immune system,which indirectly causes periodontitis.Host autoimmune response to inflammation affects the development of periodontitis [1],T lymphocyte will differentiate into different subtypes after stimulation: Th1,Th2,Th17,Treg,etc.These cells and related cytokines affect the development and prognosis of periodontitis.Interleukin 17(IL-17)is a pro-inflammatory factor secreted mainly by Th17 cells[2],which can destroy the homeostasis of neutrophils during periodontal inflammation,promote their aggregation to inflammatory sites,and act as osteoclasts to promote alveolar bone resorption[3].Transforming growth factor-beta(TGF-?)is an important cytokine for the production and maintenance of Treg cells.It is a multipotent regulator of cell activity.It has dual effects of anti-inflammation and anti-inflammation.It can act on immune response,inflammation response,tissue repair and embryonic development.It is believed that TGF-? is involved in the development of periodontal inflammation[4].Smoking is an important risk factor of periodontal disease,which promotes the occurrence and development of periodontal disease and affects the therapeutic effect of periodontal disease.So whether smoking affects the expression of IL-17 and TGF-? in gingival crevicular fluid in periodontal disease or not,we will discuss this issue through this experiment.Methods:1 Case selection 1.1 General materials:General materials: Twenty-seven patients with chronic periodontitis were selected from May to December 2018 in the Department of Dental Periodontology,Stomatology Hospital,Hebei Medical University.They were divided into two groups according to smoking status: non-smoking Periodontits(NP group)12 cases,Smoking Periodontits(SP group)15 cases,all male,aged 30-56 years,smoking group average age 46.2 years,nonsmoking group average age 49.3 years.1.2 Inclusion criteria:Han nationality;adults;at least 20 functional teeth in the mouth;no history of systemic diseases such as diabetes,cardiovascular disease,coagulation dysfunction,nervous system disease,rheumatoid disease;no antibiotics,non-steroidal anti-inflammatory drugs,immunomodulators,etc.within 3 months before treatment;no systemic periodontal treatment within one year,no obvious malocclusion.2 Empirical method 2.1 Recording general information: name,health status,medication history,smoking status,periodontal treatment history,contact information,initial date of diagnosis,etc.2.2 Check the periodontal condition of the patients and fill in the periodontal condition form.Periodontal examination included probing depth(PD),attachment loss(AL),bleeding index(BI),mobility and bifurcation lesions.Surface tomography was also taken to assist diagnosis.2.3 The patients' molars or second premolars with periodontal lesions were selected to take gingival crevicular fluid.The selected teeth had no caries,pulp and apical lesions and occlusal trauma.Before sampling,6 tips of No.30 hygroscopic paper were subtracted 5 mm and placed in Ep tube for weighing and disinfection under high temperature and pressure.The gingival crevicular fluid was collected before scaling.The plaque and massive upper gingival calculus on the teeth were removed during sampling.The tips of moisture absorbent paper were placed in the proximal,central and distal parts of the periodontal pockets on the buccal and lingual sides of the teeth to be measured.After 30 seconds,the tips of moisture absorbent paper were taken out and weighed in the original Ep tube.The difference between the two measurements was the weight of gingival crevicular fluid,which was converted into volume according to 1 g/m L.EP tube is stored in-80 degree cryogenic refrigerator.2.4 The patients were subgingival scaling,subgingival scaling and root surface smoothing(subgingival scaling twice in maxilla and mandible).After curettage,3% hydrogen peroxide solution was rinsed and iodophenol and iodine glycerin were applied in periodontal pockets.2.5 Give patients oral hygiene guidance,teach patients the correct method of brushing teeth and the use of dental floss interspace brush,and advise smokers to change their smoking habits.2.6 Four weeks after non-surgical treatment,gingival crevicular fluid was collected from the same buccal-lingual periodontal pocket by the same method,and PD,AL and other indicators of the patient were examined and recorded.EP tubes with moisture-absorbing paper tips were weighed before and after sampling.The difference between the first and last two times was the weight of gingival crevicular fluid,which was converted into volume according to 1g/ml.Store EP tube in low temperature refrigerator.2.7 Elution of gingival crevicular fluid: 150 ml PBS buffer was added to EP tube,and the supernatant was taken after shock and centrifugation for 2000 r/min x 10 min.The concentrations of IL-17 and TGF-beta in GCF were detected by double antibody sandwich ELISA.Data obtained by statistical software analysis.Result: 1 Clinical Indicators 1.1 Probing depth Before treatment,the depth of periodontal exploration in non-smoking group and smoking group was 6.00±1.20 mm and 5.93±1.16 mm,respectively.There was no significant difference between non-smoking group and smoking group(P>0.05).The diagnostic depth of non-smoking group and smoking group after periodontal non-surgical treatment was 3.58±0.79 mm and 4.53±1.06 mm,respectively.The non-smoking group was lower than the smoking group,the difference was significant(P<0.05).After treatment,the visiting depth of smoking group and non-smoking group decreased compared with that before treatment,and the difference was statistically significant(P<0.05).Before and after non-surgical treatment,the visiting depth of non-smoking group and smoking group were improved.The declining value of non-smoking group(2.41±0.67)was higher than that of smoking group(1.40±0.73),and the difference was statistically significant(P <0.05).1.2 Attachment loss The levels of attachment loss before treatment in non-smoking group and smoking group were 4.83±1.26 mm and 4.66±1.34 mm,respectively,with no significant difference(P > 0.05).The levels of attachment loss in non-smoking group and smoking group after treatment were 4.58±1.24 mm and 4.46±1.12 mm,respectively.Before and after treatment,the attachment loss of smoking group and non-smoking group decreased slightly,with no significant difference(P > 0.05).2 Levels of IL-17 and TGF-? in gingival crevicular fluid 2.1 Level of IL-17 in gingival crevicular fluid The concentrations of IL-17 in gingival crevicular fluid of non-smoking group and smoking group before treatment were 66.78±24.47 ng/ml and 100.34±35.28 ng/ml,respectively.The non-smoking group was lower than the smoking group,the difference was significant(P < 0.05).The concentrations of IL-17 in gingival crevicular fluid of non-smoking group and smoking group after treatment were 30.97±11.81 ng/ml and 79.32 ±30.72 ng/ml,respectively.The non-smoking group was lower than the smoking group,the difference was significant(P < 0.05).After treatment,the concentration of smoking group and non-smoking group decreased compared with that before treatment,the difference was statistically significant(P < 0.05).The decrease of IL-17 concentration in gingival crevicular fluid of non-smoking group before and after treatment(35.80±18.52)was higher than that of smoking group(21.01±10.18),and the difference was statistically significant(P < 0.05).2.2 Level of TGF-? in gingival crevicular fluid The concentrations of TGF-?in gingival crevicular fluid of non-smoking group and smoking group before treatment were 288.90±51.36 ng/ml and 352.87±38.15 ng/ml,respectively.The non-smoking group was lower than the smoking group,the difference was significant(P < 0.05).The concentrations of TGF-?in gingival crevicular fluid of non-smoking group and smoking group after treatment were 176.46±49.61ng/ml and 270.67±52.21ng/ml,respectively.The non-smoking group was lower than the smoking group,the difference was significant(P < 0.05).After treatment,the concentration of smoking group and non-smoking group decreased compared with before treatment,the difference was statistically significant(P < 0.05).The decrease of TGF-?concentration in gingival crevicular fluid of non-smoking group before and after treatment(112.44±42.12)was higher than that of non-smoking group(82.21±25.31),and the difference was statistically significant(P < 0.05).Conclusion: 1.The concentrations of IL-17 and TGF-? in smoking group were higher than those in non-smoking group before and after treatment,suggesting that smoking aggravates periodontal inflammation.2.Non-surgical periodontal therapy can effectively improve the inflammatory state of periodontal tissue,reduce the probing depth,IL-17,TGF-? concentration.3.The probing depth and the level of attachment loss,the decrease of IL-17 and TGF-? in smoking group were lower than those in non-smoking group before and after treatment,suggesting that smoking affects the effect of periodontal non-surgical therapy?... |
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