601
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Emery DC, Cerajewska TL, Seong J, Davies M, Paterson A, Allen-Birt SJ, West NX. Comparison of Blood Bacterial Communities in Periodontal Health and Periodontal Disease. Front Cell Infect Microbiol 2021; 10:577485. [PMID: 33469518 PMCID: PMC7813997 DOI: 10.3389/fcimb.2020.577485] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022] Open
Abstract
The use of Next Generation Sequencing (NGS) techniques has generated a wide variety of blood microbiome data. Due to the large variation in bacterial DNA profiles between studies and the likely high concentrations of cell-free bacterial DNA in the blood, it is still not clear how such microbiome data relates to viable microbiota. For these reasons much remains to be understood about the true nature of any possible healthy blood microbiota and of bacteraemic events associated with disease. The gut, reproductive tracts, skin, and oral cavity are all likely sources of blood-borne bacteria. Oral bacteria, especially those associated with periodontal diseases, are also commonly associated with cardiovascular diseases such as infective endocarditis, and also have been linked to rheumatoid arthritis and Alzheimer's disease. Periodontal treatment, dental probing, and toothbrushing have been shown to cause transient bacteraemia and oral bacteria from the phyla Firmicutes (e.g. Streptococci) and Bacteroidetes (e.g. Porphyromonas) are found in cardiovascular lesions (CVD). Many studies of blood bacterial DNA content however, find Proteobacteria DNA to be the dominant microbiome component, suggesting a gut origin. Most studies of this type use total DNA extracted from either whole blood or blood fractions, such as buffy coat. Here, using a method that purifies DNA from intact bacterial cells only, we examined blood donated by those with active, severe periodontitis and periodontally healthy controls and show that 43-52% of bacterial species in blood are classified as oral. Firmicutes, consisting largely of members of the Streptococcus mitis group and Staphylococcus epidermidis, were predominant at 63.5% of all bacterial sequences detected in periodontal health and, little changed at 66.7% in periodontitis. Compared to studies using total DNA Proteobacteria were found here at relatively low levels in blood at 13.3% in periodontitis and 17.6% in health. This study reveals significant phylogenetic differences in blood bacterial population profiles when comparing periodontal health to periodontal disease cohorts.
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Affiliation(s)
- David C. Emery
- Bristol Medical School, Translational Health Sciences, Learning & Research, Southmead Hospital, Bristol, United Kingdom
| | - Tanya L. Cerajewska
- Periodontology, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Joon Seong
- Periodontology, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Maria Davies
- Periodontology, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Alex Paterson
- University of Bristol Genomics Facility, School of Biological Sciences, Bristol, United Kingdom
| | - Shelley J. Allen-Birt
- Bristol Medical School, Translational Health Sciences, Learning & Research, Southmead Hospital, Bristol, United Kingdom
| | - Nicola X. West
- Periodontology, Bristol Dental School, University of Bristol, Bristol, United Kingdom
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602
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Hypertension and Periodontitis: An Upcoming Joint Report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP). High Blood Press Cardiovasc Prev 2021; 28:1-3. [PMID: 33400213 DOI: 10.1007/s40292-020-00430-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/23/2020] [Indexed: 01/03/2023] Open
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603
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Martínez M, Postolache TT, García-Bueno B, Leza JC, Figuero E, Lowry CA, Malan-Müller S. The Role of the Oral Microbiota Related to Periodontal Diseases in Anxiety, Mood and Trauma- and Stress-Related Disorders. Front Psychiatry 2021; 12:814177. [PMID: 35153869 PMCID: PMC8833739 DOI: 10.3389/fpsyt.2021.814177] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/30/2021] [Indexed: 12/12/2022] Open
Abstract
The prevalence of anxiety, mood and trauma- and stress-related disorders are on the rise; however, efforts to develop new and effective treatment strategies have had limited success. To identify novel therapeutic targets, a comprehensive understanding of the disease etiology is needed, especially in the context of the holobiont, i.e., the superorganism consisting of a human and its microbiotas. Much emphasis has been placed on the role of the gut microbiota in the development, exacerbation, and persistence of psychiatric disorders; however, data for the oral microbiota are limited. The oral cavity houses the second most diverse microbial community in the body, with over 700 bacterial species that colonize the soft and hard tissues. Periodontal diseases encompass a group of infectious and inflammatory diseases that affect the periodontium. Among them, periodontitis is defined as a chronic, multi-bacterial infection that elicits low-grade systemic inflammation via the release of pro-inflammatory cytokines, as well as local invasion and long-distance translocation of periodontal pathogens. Periodontitis can also induce or exacerbate other chronic systemic inflammatory diseases such as atherosclerosis and diabetes and can lead to adverse pregnancy outcomes. Recently, periodontal pathogens have been implicated in the etiology and pathophysiology of neuropsychiatric disorders (such as depression and schizophrenia), especially as dysregulation of the immune system also plays an integral role in the etiology and pathophysiology of these disorders. This review will discuss the role of the oral microbiota associated with periodontal diseases in anxiety, mood and trauma- and stress-related disorders. Epidemiological data of periodontal diseases in individuals with these disorders will be presented, followed by a discussion of the microbiological and immunological links between the oral microbiota and the central nervous system. Pre-clinical and clinical findings on the oral microbiota related to periodontal diseases in anxiety, mood and trauma- and stress-related phenotypes will be reviewed, followed by a discussion on the bi-directionality of the oral-brain axis. Lastly, we will focus on the oral microbiota associated with periodontal diseases as a target for future therapeutic interventions to alleviate symptoms of these debilitating psychiatric disorders.
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Affiliation(s)
- María Martínez
- Etiology and Therapy of Periodontal and Peri-Implant Diseases Research Group, University Complutense Madrid, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Teodor T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
| | - Borja García-Bueno
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Juan C Leza
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Hospital 12 de Octubre Research Institute (Imas12), Neurochemistry Research Institute, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Elena Figuero
- Etiology and Therapy of Periodontal and Peri-Implant Diseases Research Group, University Complutense Madrid, Madrid, Spain.,Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Christopher A Lowry
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States.,Department of Integrative Physiology, Center for Neuroscience, Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,inVIVO Planetary Health of the Worldwide Universities Network, New York, NY, United States
| | - Stefanie Malan-Müller
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain
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604
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AlSakr A, Blanchard S, Wong P, Thyvalikakath T, Hamada Y. Association between intracranial carotid artery calcifications and periodontitis. Cone-beam computed tomography (CBCT) study. J Periodontol 2020; 92:1402-1409. [PMID: 33382097 DOI: 10.1002/jper.20-0607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/30/2020] [Accepted: 11/30/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Intracranial carotid artery calcifications (ICACs) are one type of calcification that may be detected as incidental findings in cone-beam computed tomography (CBCT). This retrospective study aimed to examine the prevalence of ICACs on CBCT images and their associations among age, gender, chronic periodontitis, and patient-reported cardiovascular diseases (CVDs). METHODS A total of 303 CBCT scans were reviewed and a total of 208 patients met the inclusion criteria. The presence or absence of ICACs was evaluated in the ophthalmic and cavernous segments of each scan. Patient demographic data, including age, gender, and medical history, specifically focused on CVDs were recorded. The presence or absence of periodontitis was recorded from each subject with full mouth radiographs and clinical measurements. Odds ratios (ORs) were calculated as part of the logistic regression analysis. RESULTS Overall, ICACs were found in 93 subjects (45%). The bilateral ICACs were found in 43 subjects (21% of the total subjects, 46% of the subjects with ICACs). There were statistically significant associations between presence of ICACs and periodontitis (OR = 4.55), hypertension (OR = 3.02), hyperlipidemia (OR = 2.87), increasing age (OR = 2.24), and the male gender (OR = 1.85). Smoking status was not significantly correlated with ICACs. CONCLUSION This study revealed that nearly half (45%) of the subjects displayed ICACs on the CBCT images. ICACs are significantly related to the status of chronic periodontitis, age, gender, and CVDs. A more careful review of CBCT scans is highly recommended to detect these calcifications and refer patients for further medical evaluation.
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Affiliation(s)
- Abdulaziz AlSakr
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Steven Blanchard
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Phillip Wong
- Department of Oral Pathology, Medicine, and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Thankam Thyvalikakath
- Dental Informatics Core, Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Yusuke Hamada
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana
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605
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Brun A, Nuzzo A, Prouvost B, Diallo D, Hamdan S, Meseguer E, Guidoux C, Lavallée P, Amarenco P, Lesèche G, Bouchard P, Michel JB, Rangé H. Oral microbiota and atherothrombotic carotid plaque vulnerability in periodontitis patients. A cross-sectional study. J Periodontal Res 2020; 56:339-350. [PMID: 33368263 DOI: 10.1111/jre.12826] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 09/13/2020] [Accepted: 11/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND An increased risk of atherothrombotic vascular events has been reported in periodontitis patients. Periodontitis is associated with dysbiotic subgingival biofilms and bacteremia. OBJECTIVE We hypothesized (a) that the oral microbiome is associated with the carotid microbiome and (b) that periodontitis could contribute to plaque vulnerability. The aim of this study was to determine the associations between periodontitis, the carotid microbiome, and the local innate immune response in carotid atherothrombotic plaques vulnerable to rupture. METHODS In this cross-sectional study, 45 patients admitted for carotid endarterectomy underwent a preoperative periodontal examination. The volume of intraplaque hemorrhage reflected by the hemoglobin level released in carotid-conditioned media was considered as a criterion of carotid plaque vulnerability. Levels of antibodies against periodontal bacteria were determined in sera. The signature of the oral microbiota was assessed by microbial whole-genome sequencing, nested PCR, and immunostaining in carotid plaque samples. Markers of neutrophil recruitment (leukotriene B4), neutrophil activation (myeloperoxidase, defensins), and cytokines were measured in carotid-conditioned media and/or plasma. RESULTS All patients exhibited periodontitis. One hundred and forty-four bacterial genera were detected in the carotid microbiome. While Streptococcus was found in 84% of the carotid samples, periodontitis-associated genera were detected in 21%. P. gingivalis DNA and gingipains were also identified in carotid samples. There were significant inverse correlations between periodontal attachment loss/serum anti-P. gingivalis Immunoglobulin A and cytokine inhibiting neutrophils (all P < .01). There were also significant positive correlations between lipopolysaccharides, myeloperoxidase/human neutrophil peptides1-3, and hemoglobin levels (all P < .01). CONCLUSIONS In patients at risk of stroke, the carotid plaque microbiome was highly diverse and compatible with an oral origin. Periodontitis was significantly associated with neutrophil activation markers and plaque vulnerability to rupture.
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Affiliation(s)
- Adrian Brun
- Department of Periodontology, Faculty of Dental Surgery Montrouge, Université de Paris, Montrouge, France.,Division of Periodontology, Department of Oral Medicine, AP-HP, Henri Mondor Hospital, Créteil, France.,Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France
| | - Alexandre Nuzzo
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Gastroenterology, Faculty of Medicine Xavier Bichat-Beaujon, Université de Paris, Clichy, France.,IBD and Intestinal Failure Unit, Department of Gastroenterology, APHP, Beaujon Hospital, Paris, France
| | - Bastien Prouvost
- Department of Periodontology, Faculty of Odontology Garancière, Université de Paris, Paris, France
| | - Devy Diallo
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France
| | - Sandrella Hamdan
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France
| | - Elena Meseguer
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Neurology, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Neurology and Stroke Centre, APHP, Bichat Hospital, Paris, France
| | - Céline Guidoux
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Neurology, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Neurology and Stroke Centre, APHP, Bichat Hospital, Paris, France
| | - Philippa Lavallée
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Neurology, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Neurology and Stroke Centre, APHP, Bichat Hospital, Paris, France
| | - Pierre Amarenco
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Neurology, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Neurology and Stroke Centre, APHP, Bichat Hospital, Paris, France
| | - Guy Lesèche
- Laboratory for Vascular Translational Science, Inserm UMRS 1148, Paris, France.,Department of Vascular Surgery, Faculty of Medicine Xavier Bichat, Université de Paris, Paris, France.,Department of Vascular Surgery, APHP, Bichat Hospital, Paris, France
| | - Philippe Bouchard
- Department of Periodontology, Faculty of Odontology Garancière, Université de Paris, Paris, France.,Division of Periodontology, Department of Odontology, APHP, Rothschild Hospital, Paris, France.,Orofacial Pathologies, Imaging and Biotherapies laboratory, UR2496, Université de Paris, Montrouge, France
| | | | - Hélène Rangé
- Department of Periodontology, Faculty of Odontology Garancière, Université de Paris, Paris, France.,Division of Periodontology, Department of Odontology, APHP, Rothschild Hospital, Paris, France.,Orofacial Pathologies, Imaging and Biotherapies laboratory, UR2496, Université de Paris, Montrouge, France
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606
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Del Pinto R, Pietropaoli D, Monaco A, Desideri G, Ferri C, Grassi D. Non-pharmacological Strategies Against Systemic Inflammation: Molecular Basis and Clinical Evidence. Curr Pharm Des 2020; 26:2620-2629. [PMID: 32242777 DOI: 10.2174/1381612826666200403122600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/19/2020] [Indexed: 12/19/2022]
Abstract
Systemic inflammation is a common denominator to a variety of cardiovascular (CV) and non-CV diseases and relative risk factors, including hypertension and its control, metabolic diseases, rheumatic disorders, and those affecting the gastrointestinal tract. Besides medications, a non-pharmacological approach encompassing lifestyle changes and other complementary measures is mentioned in several updated guidelines on the management of these conditions. We performed an updated narrative review on the mechanisms behind the systemic impact of inflammation and the role of non-pharmacological, complementary measures centered on lowering systemic phlogosis for preserving or restoring a good global health. The central role of genetics in shaping the immune response is discussed in conjunction with that of the microbiome, highlighting the interdependence and mutual influences between the human genome and microbial integrity, diversity, and functions. Several plausible strategies to modulate inflammation and restore balanced crosstalk between the human genome and the microbiome are then recapitulated, including dietary measures, active lifestyle, and other potential approaches to manipulate the resident microbial community. To date, evidence from high-quality human studies is sparse to allow the unconditioned inclusion of understudied, though plausible solutions against inflammation into public health strategies for global wellness. This gap claims further focused, well-designed research targeted at unravelling the mechanisms behind future personalized medicine.
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Affiliation(s)
- Rita Del Pinto
- University of L'Aquila, Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy
| | - Davide Pietropaoli
- University of L'Aquila, Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy
| | - Annalisa Monaco
- University of L'Aquila, Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy
| | - Giovambattista Desideri
- University of L'Aquila, Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy
| | - Claudio Ferri
- University of L'Aquila, Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy
| | - Davide Grassi
- University of L'Aquila, Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy
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607
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Elevated Coronary Artery Calcium scores are associated with tooth loss. PLoS One 2020; 15:e0243232. [PMID: 33326424 PMCID: PMC7743922 DOI: 10.1371/journal.pone.0243232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/17/2020] [Indexed: 12/17/2022] Open
Abstract
Aim This study explores the association between Coronary Artery Calcium (CAC) scores and dental pathology such as missing teeth, the (peri-apical) health status and restoration grade of the teeth, and the grade of alveolar bone loss seen on a dental panoramic radiograph (Orthopantomograph–OPG). Materials and methods In this retrospective cross-sectional study, data was collected from three hospitals spread in the Netherlands. Patients were included when a CAC score and an OPG were available, both recorded within a maximum period of 365 days from 2009–2017. The CAC score was measured on a CT scan, using the Agatston method. To assess dental pathology, the number of missing teeth, the number of dental implants, alveolar bone loss, caries, endodontic treatments, peri-apical radiolucencies, bone loss at implants, impacted teeth and dental cysts, were determined on the OPG. All observers were calibrated. The electronic health records provided information about: gender, age, smoking, Diabetes Mellitus, hypercholesterolemia, hypertension and Body Mass Index (BMI). Results 212 patients were included. We found a statistically significant association between the number of missing teeth and the CAC score. When modeling age, sex, and other well-known risk factors for cardiovascular disease, the significant correlation was no longer present after multivariate correction. Furthermore, the results showed a trend for more teeth with peri-apical lesions and a higher percentage of mean alveolar bone loss in the group with the highest CAC scores. Conclusion This study showed that being edentulous or missing teeth is correlated to higher CAC scores however failed to be an independent predictor of atherosclerotic cardiovascular diseases. The number of (missing) teeth is an easily accessible marker and could be used as a marker for atherosclerotic cardiovascular disease (ACVD) risk by almost any healthcare worker. The current study needs to be considered as an explorative pilot study and could contribute to the design of further (prospective) studies on the relationship between dental pathology and coronary artery calcification by adding clinical information and extra cardiovascular biomarkers.
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608
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Mekhemar M, Hassan Y, Dörfer C. Nigella sativa and Thymoquinone: A Natural Blessing for Periodontal Therapy. Antioxidants (Basel) 2020; 9:E1260. [PMID: 33322636 PMCID: PMC7764221 DOI: 10.3390/antiox9121260] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/14/2022] Open
Abstract
Thymoquinone (TQ), the chief active constituent of Nigella sativa (NS), shows very valuable biomedical properties such as antioxidant, antimicrobial, anticancer, anti-inflammatory, antihypertensive, hypoglycemic, antiparasitic and anti-asthmatic effects. Several studies have examined the pharmacological actions of TQ in the treatment of oral diseases but its potential role in periodontal therapy and regeneration is not yet fully defined. The present investigation has been designed to review the scientific studies about the effects of TQ as an adjunct to periodontal treatment to promote healing and periodontal regeneration. Along with clinical experiments, in vitro studies exhibit the beneficial effects of TQ during periodontal therapy. Nevertheless, additional comprehensive clinical and preclinical studies at cellular and molecular levels are essential to examine the particular action mechanisms of Nigella sativa and its elements, particularly TQ, during periodontal treatment or regeneration.
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Affiliation(s)
- Mohamed Mekhemar
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrecht’s University, 24105 Kiel, Germany; (Y.H.); (C.D.)
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609
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Abstract
Periodontitis is increasingly associated with increased risk of cardiovascular and other systemic diseases. The Gram-negative anaerobe, Porphyromonas gingivalis, is a key periodontal pathogen, and several lines of evidence link the presence of this bacterium in the circulation with vascular disease. The outer membrane vesicles (OMVs) produced by P. gingivalis have been shown to play a role in periodontitis, although, to date, little is known about their interaction with the vasculature; therefore, this study assessed the effects of P. gingivalis OMVs on the endothelium. OMVs were isolated from wild-type strain W83 and the gingipain-deficient strain ΔK/R-ab. Immunoblotting along with cryo-EM showed gingipain expression in W83 but not ΔK/R-ab-derived OMVs, where gingipains were localized to the cell wall surface. Confluent endothelial cell monolayers infected with either W83 or W83-derived OMV displayed significantly increased dextran permeability over those infected with ΔK/R-ab or its OMV. Moreover, W83-derived OMVs induced significantly more vascular disease in a zebrafish larvae systemic infection model over 72 h compared to those injected with gingipain-deficient OMVs or controls. In line with these data, human microvascular endothelial cells (HMEC-1) displayed an OMV-associated, gingipain-dependent decrease in cell surface levels of the intercellular adhesion molecule PECAM-1 (CD31) when examined by flow cytometry. These data show, for the first time, that OMVs from P. gingivalis mediate increased vascular permeability, leading to a diseased phenotype both in vitro and in vivo. Moreover, these data strongly implicate gingipains present on the OMV surface in mediating these vascular events, most likely via a mechanism that involves proteolytic cleavage of endothelial cell-cell adhesins such as PECAM-1. These data provide important evidence for the role of bacterial-derived OMVs in mediating systemic disease.
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Affiliation(s)
- C. Farrugia
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - G.P. Stafford
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - C. Murdoch
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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610
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Botelho J, Mascarenhas P, Mendes JJ, Machado V. Network Protein Interaction in Parkinson's Disease and Periodontitis Interplay: A Preliminary Bioinformatic Analysis. Genes (Basel) 2020; 11:E1385. [PMID: 33238395 PMCID: PMC7700320 DOI: 10.3390/genes11111385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/19/2022] Open
Abstract
Recent studies supported a clinical association between Parkinson's disease (PD) and periodontitis. Hence, investigating possible interactions between proteins associated to these two conditions is of interest. In this study, we conducted a protein-protein network interaction analysis with recognized genes encoding proteins with variants strongly associated with PD and periodontitis. Genes of interest were collected via the Genome-Wide Association Studies (GWAS) database. Then, we conducted a protein interaction analysis, using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database, with a highest confidence cutoff of 0.9 and sensitivity analysis with confidence cutoff of 0.7. Our protein network casts a comprehensive analysis of potential protein-protein interactions between PD and periodontitis. This analysis may underpin valuable information for new candidate molecular mechanisms between PD and periodontitis and may serve new potential targets for research purposes. These results should be carefully interpreted, giving the limitations of this approach.
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Affiliation(s)
- João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (P.M.); (J.J.M.)
| | - Paulo Mascarenhas
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (P.M.); (J.J.M.)
- Center for Medical Genetics and Pediatric Nutrition Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal
| | - José João Mendes
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (P.M.); (J.J.M.)
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
- Evidence-Based Hub, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal; (P.M.); (J.J.M.)
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611
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Nishi H, Takahashi S, Ohta K, Takamoto M, Shigeishi H, Go S, Obayashi T, Yoshioka Y, Konishi M, Shimizu Y, Yano K, Miyagawa T, Kakimoto N, Ohge H, Kawaguchi H, Kurihara H. Effects of perioperative oral care on postoperative inflammation following heart valve surgery. Oral Dis 2020; 27:1542-1550. [PMID: 33067895 DOI: 10.1111/odi.13682] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/12/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Whether oral health care during the perioperative period can lead to a better outcome after heart valve surgery has not been adequately elucidated. We examined the effects of perioperative oral care on postoperative inflammation response in patients who underwent heart valve surgery. MATERIALS AND METHODS In this retrospective cohort study, 223 patients scheduled for single valve heart surgery were divided into the oral care, who underwent professional teeth cleaning or scaling within 3 days prior to surgery, and also following surgery at least twice a week (n = 111), and non-oral care (n = 112) groups. After propensity score matching, records of both groups (80:80) were examined after surgery to evaluate inflammation markers (white blood cell count [WBC], neutrophil/white blood cell ratio [NWR], C-reactive protein [CRP] level, body temperature [BT]). RESULTS WBC, NWR, CRP level, and BT were increased in both groups the day following surgery. Thereafter, CRP level, WBC, NWR, and BT on various days after surgery in the oral care group showed greater decreases as compared to the non-oral care group. CONCLUSIONS Perioperative oral health care can decrease postoperative inflammation in patients undergoing heart valve surgery and may be important to ensure a better outcome in those patients.
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Affiliation(s)
- Hiromi Nishi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Shinya Takahashi
- Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Megumi Takamoto
- Department of Dentistry and Oral Surgery, Shinshu University Hospital, Nagano, Japan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seimei Go
- Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Taiji Obayashi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Yoshioka
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kanako Yano
- Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Tsuyoshi Miyagawa
- Center for Integrated Medical Research, Hiroshima University Hospital, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Hiroki Ohge
- Department of Infectious diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroyuki Kawaguchi
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Hidemi Kurihara
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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612
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Lim G, Janu U, Chiou LL, Gandhi KK, Palomo L, John V. Periodontal Health and Systemic Conditions. Dent J (Basel) 2020; 8:E130. [PMID: 33227918 PMCID: PMC7711538 DOI: 10.3390/dj8040130] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/11/2020] [Accepted: 11/17/2020] [Indexed: 12/05/2022] Open
Abstract
According to the new classification proposed by the recent 2017 World Workshop on Periodontal and Peri-implant Diseases and Conditions, periodontitis, necrotizing periodontal diseases, periodontitis as a manifestation of systemic diseases, and systemic diseases or conditions affecting the periodontal supporting tissues, are considered as separate entities. Scientific evidence has demonstrated that periodontal diseases are not just simple bacterial infections but rather complex diseases of multifactorial complexity that interplay with the subgingival microbes, the host immune, and inflammatory responses. Despite dental plaque biofilm being considered the primary risk factor for periodontitis in the vast majority of patients that dentists encounter on a daily basis, there are other factors that can also contribute and/or accelerate pathologic progressive attachment loss. In this article, the authors aim to briefly review and discuss the present evidence regarding the association between periodontal diseases and systemic diseases and conditions.
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Affiliation(s)
- Glendale Lim
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
| | - Upasna Janu
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
| | - Lan-Lin Chiou
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
| | - Kaveri Kranti Gandhi
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
| | - Leena Palomo
- Department of Periodontology, Case Western University, School of Dentistry, Indianapolis, IN 46202, USA;
| | - Vanchit John
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
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613
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Clinical and Microbiological Efficacy of Pyrophosphate Containing Toothpaste: A Double-Blinded Placebo-Controlled Randomized Clinical Trial. Microorganisms 2020; 8:microorganisms8111806. [PMID: 33212981 PMCID: PMC7698517 DOI: 10.3390/microorganisms8111806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/27/2020] [Accepted: 11/16/2020] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Dental calculus works as a niche wherein pathogenic bacteria proliferate in the oral cavity. Previous studies revealed the anticalculus activity of pyrophosphates, however there was no clinical study that evaluated microbiome changes associated with calculus inhibition. Therefore, the aim of this randomized clinical trial was to evaluate the calculus inhibition of pyrophosphate-containing toothpaste and its effect on oral microbiome changes. (2) Methods: Eighty subjects with a calculus index ≥2 on the lingual of the mandibular anterior tooth were randomly allocated to the test group that pyrophosphate-containing toothpaste was given to or the placebo control group. Full mouth debridement and standardized tooth brushing instruction were given before the allocation. Plaque index, gingival index, calculus index, probing depth, and bleeding on probing were measured at the baseline, and at 4, 8 and 12 weeks. Genomic DNA was extracted from the plaque samples collected at the baseline and at 12 weeks, and 16S ribosomal RNA gene amplicon sequencing was applied for microbiome analysis. (3) Results: None of the clinical parameters showed significant differences by visits or groups, except the plaque index of the test group, which reduced significantly between 4 and 12 weeks. A significant difference of microbiome between the baseline and 12 weeks was observed in the test group. Between baseline and 12 weeks, the proportion of Spirochetes decreased in the control group, and the proportions of Proteobacteria, Fusobacteria and Spirochetes in the phylum level and the proportions of Haemophilus, Fusobacterium and Capnocytophaga in the genus level decreased in the test group. In the test group, as plaque index decreased, Streptococcus increased, and Fusobacterium and Haemophilus parainfluenza decreased. (4) Conclusion: The use of pyrophosphate-containing toothpaste effectively inhibited the dysbiosis of the oral microbiome and the proliferation of pathogenic species in periodontal disease. Clinically, plaque formation in the pyrophosphate-containing toothpaste group was effectively decreased, however there was no significant change in calculus deposition.
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614
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Influence of Probiotics on the Salivary Microflora Oral Streptococci and Their Integration into Oral Biofilm. Antibiotics (Basel) 2020; 9:antibiotics9110803. [PMID: 33202719 PMCID: PMC7697717 DOI: 10.3390/antibiotics9110803] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 02/07/2023] Open
Abstract
Probiotics’ ability to integrate into dental biofilms is not yet clarified. The aim of this trial was to detect probiotic bacteria from probiotic products in dental biofilm and saliva during and after intake. In this parallel, randomized clinical trial, 39 subjects wore customized appliances to build up intra-oral biofilms (72-h periods). The trial was divided into screening (S) to determine baseline biofilm flora, intervention (I), and wash out (WO). During I (28 days), subjects consumed a product containing (a) Enterococcus faecalis (b) Lactobacilluscasei, or (c) Lactobacillus rhamnosus GG. Probiotic bacteria and Streptococci spp. were detected in the biofilms and saliva of the 35 subjects that were included in the analysis. During I and WO, the ratio of probiotics in the biofilm was very low compared to total bacterial load, while saliva had slightly but not significantly higher values. No significant changes of probiotic bacteria (p > 0.05) were found at any visit during I or WO. The proportion of streptococci was significantly reduced (p < 0.05) during I and even lower in WO, compared to S. Probiotic bacteria could neither integrate nor persist in dental biofilm and saliva but did influence the growth of streptococci in biofilm and saliva.
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615
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Winning L, Patterson CC, Linden K, Evans A, Yarnel J, McKeown PP, Kee F, Linden GJ. Periodontitis and risk of prevalent and incident coronary heart disease events. J Clin Periodontol 2020; 47:1446-1456. [DOI: 10.1111/jcpe.13377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/24/2020] [Accepted: 09/22/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Lewis Winning
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK
- Dublin Dental University HospitalTrinty College Dublin Dublin Ireland
| | - Christopher C. Patterson
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK
| | - Katie Linden
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK
| | - Alun Evans
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK
| | - John Yarnel
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK
| | - Pascal P. McKeown
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK
| | - Frank Kee
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK
| | - Gerard J. Linden
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences Queen’s University Belfast Belfast UK
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616
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Moura MF, Cota LOM, Silva TA, Cortelli SC, Ferreira GA, López MM, Cortelli JR, Costa FO. Clinical and microbiological effects of non-surgical periodontal treatment in individuals with rheumatoid arthritis: a controlled clinical trial. Odontology 2020; 109:484-493. [PMID: 33145632 DOI: 10.1007/s10266-020-00566-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/18/2020] [Indexed: 12/12/2022]
Abstract
The effect of periodontal treatment on clinical, microbiological and serological parameters of patients with rheumatoid arthritis (RA) are scarce and controversial. The aim of this study was to investigate the influence of non-surgical periodontal treatment on clinical periodontal status, subgingival bacterial levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and RA activity through a controlled clinical trial on individuals with RA and periodontitis (PE). From a convenience sample, 107 individuals were considered eligible and consecutively allocated in four groups: (1) individuals without PE and RA (- PE-RA, n = 30); (2) individuals without PE and with RA (- PE + RA, n = 23); (3) individuals with PE and RA (+ PE + RA, n = 24); and (4) individuals with PE and without RA (+ PE-RA, n = 30). Full-mouth periodontal clinical examinations, microbiological analysis and Disease Activity Score (DAS-28) evaluations were performed at baseline (T1) and 45 days after non-surgical periodontal treatment (T2). At T1, individuals + PE + RA showed greater severity of PE than + PE-RA individuals. At T2, significant reductions were observed in all periodontal clinical parameters in both groups (p < 0.001) with a significant reduction in DAS-28 in + PE + RA (p = 0.011). Individuals + PE-RA and + PE-RA showed significant reductions for all bacteria (p < 0.001). Additionally, P. gingivalis demonstrated an expressively significant reduction in + PE + RA (p < 0.001). Non-surgical periodontal treatment was effective on improving the clinical periodontal condition, improving the RA clinical status and reducing the presence of periodontal pathogens. Brazilian Registry of Clinical Trials (ReBEC) protocol #RBR-8g2bc8 ( https://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/ ).
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Affiliation(s)
- Marcela F Moura
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Luís O M Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Tarcília A Silva
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | | | - Gilda A Ferreira
- Faculty of Medicine Federal, University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marina M López
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - José R Cortelli
- Faculty of Dentistry, University of Taubaté, São Paulo, Brazil
| | - Fernando O Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
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617
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Periodontal treatment and vascular inflammation in patients with advanced peripheral arterial disease: A randomized controlled trial. Atherosclerosis 2020; 313:60-69. [DOI: 10.1016/j.atherosclerosis.2020.09.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 02/04/2023]
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618
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Shen L, Shen K, Bai J, Wang J, Singla RK, Shen B. Data-driven microbiota biomarker discovery for personalized drug therapy of cardiovascular disease. Pharmacol Res 2020; 161:105225. [PMID: 33007417 DOI: 10.1016/j.phrs.2020.105225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease (CVD) is the most wide-spread disorder all over the world. The personalized and precision diagnosis, treatment and prevention of CVD is still a challenge. With the developing of metagenome sequencing technologies and the paradigm shifting to data-driven discovery in life science, the computer aided microbiota biomarker discovery for CVD is becoming reality. We here summarize the data resources, knowledgebases and computational models available for CVD microbiota biomarker discovery, and review the present status of the findings about the microbiota patterns associated with the therapeutic effects on CVD. The future challenges and opportunities of the translational informatics on the personalized drug usages in CVD diagnosis, prognosis and treatment are also discussed.
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Affiliation(s)
- Li Shen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Ke Shen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jinwei Bai
- Library of West-China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiao Wang
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Rajeev K Singla
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Bairong Shen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
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619
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Pietropaoli D, Monaco A, D'Aiuto F, Muñoz Aguilera E, Ortu E, Giannoni M, Czesnikiewicz-Guzik M, Guzik TJ, Ferri C, Del Pinto R. Active gingival inflammation is linked to hypertension. J Hypertens 2020; 38:2018-2027. [PMID: 32890278 DOI: 10.1097/hjh.0000000000002514] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cardiovascular diseases (CVD) including hypertension, are characterized by underlying systemic inflammation. Periodontitis, which can impact the systemic inflammatory burden has recently been linked to high blood pressure (BP). However, the relationship of gingival bleeding, as an easily accessible marker of periodontal disorder, with hypertension, remains unclear. METHODS Survey-based propensity score matching (PSM) incorporating major confounders shared between hypertension and periodontal diseases was applied to cross-sectional NHANES III data from 5396 adults at least 30 years old who underwent BP measurement and periodontal examination, identifying two matched groups with and without gingival bleeding. The association of bleeding gums with SBP (mmHg) and high/uncontrolled BP was then assessed with generalized additive models incorporating inflammatory markers. Stratification by periodontal status (healthy; gingivitis; stable periodontitis; unstable periodontitis) was performed. Variables importance was estimated using machine learning. RESULTS Gingival bleeding (gingivitis; unstable periodontitis) was independently associated with +2.6 mmHg (P < 0.001) SBP compared with no bleeding (healthy periodontium; stable periodontitis), and with greater odds (OR = 1.42; 95% CI = 1.19-1.68; P < 0.001) of high/uncontrolled BP. Participants with unstable periodontitis had higher SBP than those with stable periodontitis (+2.1 mmHg; P < 0.001) or gingivitis (+5.3 mmHg; P < 0.001). Unstable periodontitis and gingivitis were consistently associated with increased risk of high/uncontrolled BP (OR = 1.65, 95% CI = 2.14-1.82; OR = 1.49, 95% CI = 1.22-1.82, respectively). Inflammatory markers allowed a maximum of 12% gain in the models' predictive power. CONCLUSION Gingival bleeding contributes to shaping the relationship between periodontal diseases and BP, but the burden represented by periodontitis is also crucial. Periodontal evaluation might be of importance in difficult to control hypertension.
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Affiliation(s)
- Davide Pietropaoli
- Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila - Dental Clinic - Unit of Oral Diseases, Prevention and Translational Research - Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy
| | - Annalisa Monaco
- Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila - Dental Clinic - Unit of Oral Diseases, Prevention and Translational Research - Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy
| | - Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London
| | - Eva Muñoz Aguilera
- Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London
| | - Eleonora Ortu
- Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila - Dental Clinic - Unit of Oral Diseases, Prevention and Translational Research - Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy
| | - Mario Giannoni
- Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila - Dental Clinic - Unit of Oral Diseases, Prevention and Translational Research - Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy
| | - Marta Czesnikiewicz-Guzik
- Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow, UK
- Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Tomasz J Guzik
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Department of Internal and Agricultural Medicine, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila - Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention - Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy
| | - Rita Del Pinto
- Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila - Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention - Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy
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620
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Perio & Cardio campaign highlights key messages. Br Dent J 2020; 229:408. [DOI: 10.1038/s41415-020-2257-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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621
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Çetin MB, Sezgin Y, Yilmaz MNN, Seçgin CK. Assessment of carotid artery calcifications on digital panoramic radiographs and their relationship with periodontal condition and cardiovascular risk factors. Int Dent J 2020; 71:160-166. [PMID: 32996164 PMCID: PMC9275109 DOI: 10.1111/idj.12618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The main purpose of this study is to determine the presence of carotid artery calcification (CAC) detected on digital panoramic radiographs (DPRs) retrospectively and correlate the findings with cardiovascular risk factors including gender, age, smoking status, hypertension, diabetes, and hyperlipidemia, along with atherosclerotic cardiovascular disease and periodontal status. METHODS This clinical study is registered at ClinicalTrials.gov as NCT04017078. DPRs, periodontal status and cardiovascular risk factors of 1,101 patients (576 males, 525 females) were evaluated. The patients were grouped based on whether CAC was detected in dental DPRs [CAC (+)] or not [CAC (-)]. Periodontal status was categorised as gingivitis, periodontitis, and gingivitis with reduced periodontium (periodontally stable patient). RESULTS Out of 1,101 patients, whose mean age was 42.1 ± 15.5 years and 525 (47.7%) were female, 34 (3.1%) were diagnosed with CAC on DPRs. No significant difference was observed between groups considering gender, hypertension, diabetes, hyperlipidemia, smoking, and periodontal status. Patients aged 40-55 years (n = 398, 36.15%) and patients older than 55 years (n = 222, 20.16%) were associated with CAC (odds ratio = 4.49, 95% confidence interval = 1.65-12.17, P = 0.003; odds ratio = 4.41, 95% confidence interval = 1.33-14.61, P = 0.015, respectively). CONCLUSION Among all parameters, only age exhibited significant correlation with an increased risk of carotid calcification. Further studies with prospective designs and larger study populations are needed.
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Affiliation(s)
- Mehtap Bilgin Çetin
- Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Yasemin Sezgin
- Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | | | - Cansu Köseoğlu Seçgin
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University, Ankara, Turkey
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622
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Hamdi Z, Detzen L, Fessi S, Julia C, Hercberg S, Czernichow S, Boillot A, Touvier M, Bouchard P, Andreeva VA, Carra MC. Alcoholic beverage consumption, smoking habits, and periodontitis: A cross-sectional investigation of the NutriNet-Santé study. J Periodontol 2020; 92:727-737. [PMID: 32895953 DOI: 10.1002/jper.20-0192] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recent evidence suggests that dietary habits influence the development and severity of periodontitis. The present cross-sectional study evaluated the association between different types and quantity of alcoholic beverage consumption (alone and interacting with smoking) and the probability to suffer from severe periodontitis in the French e-cohort NutriNet-Santé. METHODS The study population consisted of 35,390 adults (mean age: 49.04 ± 13.94 years), who filled oral health questionnaires and completed at least three non-consecutive 24-hour dietary records. Data on type and frequency of alcoholic beverage consumption were obtained from a semi-quantitative self-reported alcohol frequency questionnaire; the daily quantity (g/day) was estimated from the 24-hour dietary records. The probability of severe periodontitis (main dependent variable) was assessed by calculating the modified periodontal screening score (mPESS) from selected questions. RESULTS A total of 7263 individuals (20.5%) presented a high probability of suffering from severe periodontitis (high-mPESS). After adjusting for confounding factors, the frequency of alcoholic beverage consumption was significantly higher among high-mPESS group than their low-mPESS counterparts, especially for hard liquor/spirits (1.9 ± 1.4 days/week for high-PESS versus 1.6 ± 1.1 days/week the low-PESS [P < 0.0001]). The mean daily quantity of ethanol was also higher in high-mPESS versus low-mPESS individuals (11.2 ± 15.6 versus 7.9 ± 12.3 g/day; P = 0.011). A stronger association with self-report severe periodontitis was noted when alcohol consumption exceeding > 20 g/day for women and > 30 g/day for men was combined with smoking habit (OR = 7.30 [95% CI: 6.1-8.73]). CONCLUSION The present results support an association between alcoholic beverage consumption and self-report severe periodontitis, particularly when it is associated with current smoking.
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Affiliation(s)
- Zeineb Hamdi
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France
| | - Laurent Detzen
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France
| | - Sabrine Fessi
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inra U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inra U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Sébastien Czernichow
- Department of Nutrition, Georges-Pompidou European Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Université de Paris, Paris, France
| | - Adrien Boillot
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inra U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Philippe Bouchard
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France.,EA 2496 Dental School, Université de Paris, U.F.R. of Odontology, Paris, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, Inserm U1153, Inra U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Maria Clotilde Carra
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France.,Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France
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623
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Räisänen IT, Umeizudike KA, Pärnänen P, Heikkilä P, Tervahartiala T, Nwhator SO, Grigoriadis A, Sakellari D, Sorsa T. Periodontal disease and targeted prevention using aMMP-8 point-of-care oral fluid analytics in the COVID-19 era. Med Hypotheses 2020; 144:110276. [PMID: 33254580 PMCID: PMC7492808 DOI: 10.1016/j.mehy.2020.110276] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/02/2020] [Accepted: 09/12/2020] [Indexed: 02/06/2023]
Abstract
Periodontal disease is a chronic multifactorial infectious and inflammatory disease associated with several chronic systemic diseases, such as diabetes, cardiovascular diseases (CVD), chronic obstructive pulmonary disease, hypertension, Alzheimer’s disease and so on. These same systemic diseases have been associated with severe COVID-19 infections. Several recent studies have suggested hypotheses for the potential association between periodontal disease and severe COVID-19. Periodontal disease is also one of the most prevalent diseases globally. All this supports the importance of good oral health, also in the COVID-19 era. Thus, new strategies and approaches to identify patients at risk of periodontal disease could be beneficial to enhance secondary prevention, especially if targeted to COVID-19 risk groups. Diagnostic biomarkers for periodontal disease have been researched extensively. Potential biomarkers in oral fluid with currently available rapid non-invasive point-of-care technology, such as aMMP-8, could help to extend screening and identification of patients at risk for periodontal disease also to situations and places where professional dental expertise and equipment are limited or unavailable. i.e., nursing and care homes, and rural and distant places. The oral fluid point-of-care technologies could also be useful in the hands of medical professionals (diabetes, CVD, etc.) to identify patients at risk for undiagnosed periodontal disease and to refer them to a dentist for examination and evaluation. Finally, if there is a causality between periodontal disease and severe COVID-19 infections, these point-of-care oral fluid biomarker technologies could possibly also help in the assessment of the risk of deterioration and complications.
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Affiliation(s)
- Ismo T Räisänen
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland.
| | - Kehinde A Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| | - Pia Heikkilä
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland
| | - Solomon O Nwhator
- Department of Preventive and Community Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Andreas Grigoriadis
- Department of Periodontology, 424 General Army Hospital, Thessaloniki, Greece; Department of Preventive Dentistry, Periodontology, and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Sakellari
- Department of Preventive Dentistry, Periodontology, and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Helsinki University and University Hospital, Helsinki, Finland; Department of Oral Diseases, Karolinska Institutet, Huddinge, Sweden
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624
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The relationship between periodontal status and rheumatoid arthritis - systematic review. Reumatologia 2020; 58:236-242. [PMID: 32921831 PMCID: PMC7477472 DOI: 10.5114/reum.2020.98436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/16/2020] [Indexed: 01/14/2023] Open
Abstract
There have been numerous publications investigating the relationship between periodontitis (PD) and rheumatoid arthritis (RA) so far. This publication presents the common risk factors for the development of PD and RA. The major impact of the pathological bacterial factor and cigarette smoking with chronic inflammation playing the key role in both diseases has been confirmed by numerous studies in various populations over the years. More research focuses nowadays also on the role of improper diet and obesity. Pathophysiological pathways, such as increased concentration of proinflammatory cytokines, indirectly affecting the cardiovascular complications and coagulation disorders, which has an impact on function disorders of tissue metalloproteinase inhibitors and the plasminogen activation system, were also researched. This systematic review of current literature has shown numerous discrepancies in previous analyses and the need for further detailed research on the relationship between periodontal status and RA.
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625
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Graham L, Turner W. Periodontal Disease in an Ageing Population: Key Considerations in Diagnosis and Management for the Dental Healthcare Professional. Prim Dent J 2020; 9:23-28. [PMID: 32940593 DOI: 10.1177/2050168420943407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
With patients living longer and retaining their natural teeth for longer, dental healthcare professionals are presented with new challenges. This paper outlines considerations for dental health care professionals managing periodontal disease in an ageing population. Although age itself is not considered an independent risk factor for periodontal disease, there may be complicating factors associated with ageing that impact upon the planning and delivery of care. This paper describes current evidence for the management of periodontal disease in the context of health conditions associated with ageing. It identifies aspects to consider and provides advice on how treatment planning for this patient population may be tailored.
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Affiliation(s)
- Laura Graham
- Dental Core Trainee, School of Dentistry, Belfast Health and Social Care Trust, The Royal Hospitals, Belfast UK
| | - Wendy Turner
- Centre for Dentistry, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast UK
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626
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Scarmozzino F, Poli A, Visioli F. Microbiota and cardiovascular disease risk: A scoping review. Pharmacol Res 2020; 159:104952. [DOI: 10.1016/j.phrs.2020.104952] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 02/08/2023]
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627
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Romandini M, Baima G, Antonoglou G, Bueno J, Figuero E, Sanz M. Periodontitis, Edentulism, and Risk of Mortality: A Systematic Review with Meta-analyses. J Dent Res 2020; 100:37-49. [PMID: 32866427 DOI: 10.1177/0022034520952401] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Periodontitis has been independently associated with the chronic noncommunicable diseases that most frequently lead to death worldwide. The aim of the present systematic review was to study whether people with periodontitis/edentulism are at increased risk of all-cause and cause-specific mortality as compared with those without periodontitis/edentulism. Cohort studies were included that 1) evaluated periodontitis or edentulism as exposures in relation to all-cause or cause-specific mortality as an outcome and 2) reported effect estimates as hazard ratios, risk ratios, or odds ratios with 95% CIs or crude numbers. Two review authors independently searched for eligible studies, screened the titles and abstracts, did full-text analysis, extracted the data from the published reports, and performed the risk-of-bias assessment. In case of disagreement, a third review author was consulted. Study results were summarized through random effects meta-analyses. A total of 57 studies were included, involving 48 cohorts and 5.71 million participants. Periodontitis was associated with increased risk of all-cause mortality (risk ratio, 1.46 [95% CI, 1.15 to 1.85]) and mortality due to cardiovascular diseases (1.47 [1.14 to 1.90]), cancer (1.38 [1.24 to 1.53]), coronary heart disease (2.58 [2.20 to 3.03]), cerebrovascular diseases (3.11 [2.42 to 3.98]), but not pneumonia (0.98 [0.69 to 1.38]). Edentulism (all types) was associated with increased risk of all-cause mortality (1.66 [1.46 to 1.88]) and mortality due to cardiovascular diseases (2.03 [1.50 to 2.74]), cancer (1.55 [1.24 to 1.94]), pneumonia (1.72 [1.07 to 2.78]), coronary heart disease (2.98 [2.43 to 3.65]), and cerebrovascular diseases (3.18 [2.24 to 4.51]). Periodontitis and its ultimate sequela (edentulism) are associated with an increased risk of all-cause and cause-specific mortality (PROSPERO CRD42018100095).
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Affiliation(s)
- M Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - G Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - G Antonoglou
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - J Bueno
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - E Figuero
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP Research Group (Etiology and Therapy of Periodontal and Peri-implant Diseases), University Complutense, Madrid, Spain
| | - M Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP Research Group (Etiology and Therapy of Periodontal and Peri-implant Diseases), University Complutense, Madrid, Spain
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628
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Kirchberg M, Eick S, Buchholz M, Rosche F, Kiesow A, Sarembe S, Mäder K. Controlled release minocycline-lipid-complex extrudates for the therapy of periodontitis with enhanced flexibility. Int J Pharm 2020; 586:119578. [PMID: 32615242 DOI: 10.1016/j.ijpharm.2020.119578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 11/16/2022]
Abstract
We describe the development of flexible minocycline-lipid-complex extrudates with optimized mechanical and drug release properties. These extrudates contain a minocycline - magnesium stearate chelate complex with a higher stability in aqueous media, which has now been incorporated in a PEG-PLGA (polyethylene glycol - poly(lactic-co-glycolic acid)) matrix. PEG 1500 has been utilized in different concentrations to serve as plasticizer. The novel formulations have been characterized by texture analysis, X-Ray powder diffraction (XRPD) and differential scanning calorimetry (DSC). Extrudates with a reduced diameter of 300 µm (previously 600 µm) were introduced, and a more sensitive quantification method with a tandem-mass spectrometry detector was developed. From all tested formulations, the extrudates consisting of Expansorb DLG 50 - 6P (PEG-PLGA, molar weight 30-60 kDa) paired with 10% PEG 1500 emerged as best formulation. These extrudates feature a drug content of 11.5% and a controlled release over at least 42 days. The release profile is without a lag time and shows initially a slightly higher release rate, which is desired. Compared to previous developments, the extrudates now offer a high flexibility combined with a large mechanical resilience, which will ease the handling and administration.
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Affiliation(s)
- Martin Kirchberg
- Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Straße 3, 06120 Halle (Saale), Germany.
| | - Sigrun Eick
- School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland.
| | - Mirko Buchholz
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Drug Design and Analytical Chemistry, Weinbergweg 22, 06120 Halle (Saale), Germany; Periotrap Pharmaceuticals GmbH, Weinbergweg 22, 06120 Halle (Saale), Germany.
| | - Fred Rosche
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Drug Design and Analytical Chemistry, Weinbergweg 22, 06120 Halle (Saale), Germany.
| | - Andreas Kiesow
- Fraunhofer Institute for Microstructures and Materials IMWS, Characterization of Medical and Cosmetic Products, Walter-Hülse-Strasse 1, 06120 Halle (Saale), Germany.
| | - Sandra Sarembe
- Fraunhofer Institute for Microstructures and Materials IMWS, Characterization of Medical and Cosmetic Products, Walter-Hülse-Strasse 1, 06120 Halle (Saale), Germany.
| | - Karsten Mäder
- Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Straße 3, 06120 Halle (Saale), Germany.
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629
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Scherbaum I, Heidecke H, Bunte K, Peters U, Beikler T, Boege F. Autoantibodies against M 5-muscarinic and beta 1-adrenergic receptors in periodontitis patients. Aging (Albany NY) 2020; 12:16609-16620. [PMID: 32857064 PMCID: PMC7485715 DOI: 10.18632/aging.103864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022]
Abstract
Autoantibodies against muscarinic and beta1-adrenergic receptors are considered a potential cause and/or risk factor for chronic heart failure. Association of periodontitis with such autoantibodies and with impaired heart function has been observed in patients exposed to endemic Chagas' disease, which triggers by itself cardiomyopathy and receptor immunization.Here we studied the association between periodontitis, markers of cardiac injury and receptor autoimmunization in periodontitis patients (n = 147) not exposed to Chagas' disease. The autoantibodies were determined by IgG binding to native intact muscarinic and beta1-adrenergic receptors or to a cyclic peptide mimicking the disease-relevant conformational autoepitope presented by the active beta1-adrenergic receptor. Possible cardiac injury and inflammatory status were judged by serum levels of proBNP/Troponin I and CRP/IL-6, respectively. These parameters were analysed in healthy and periodontally diseased individuals as well as before and after periodontal therapy.Patients with periodontitis had significantly (p < 0.001) higher levels of autoantibodies against M5-muscarinic and beta1-adrenergic receptors, which further increased following periodontal therapy. Receptor autoantibodies were associated with increased inflammatory status but not with increased markers of cardiac injury. Thus, our data indicate that periodontitis triggers systemic inflammation, which is associated with receptor autoimmunization, and, independently thereof, with cardiac injury.
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Affiliation(s)
- Isabel Scherbaum
- Central Institute for Clinical Chemistry and Laboratory Diagnostics, Heinrich Heine University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | | | - Kübra Bunte
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fritz Boege
- Central Institute for Clinical Chemistry and Laboratory Diagnostics, Heinrich Heine University Düsseldorf, Medical Faculty, Düsseldorf, Germany
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630
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Xu X, Ren S, Li L, Zhou Y, Peng W, Xu Y. Biodegradable engineered fiber scaffolds fabricated by electrospinning for periodontal tissue regeneration. J Biomater Appl 2020; 36:55-75. [PMID: 32842852 DOI: 10.1177/0885328220952250] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Considering the specificity of periodontium and the unique advantages of electrospinning, this technology has been used to fabricate biodegradable tissue engineering materials for functional periodontal regeneration. For better biomedical quality, a continuous technological progress of electrospinning has been performed. Based on property of materials (natural, synthetic or composites) and additive novel methods (drug loading, surface modification, structure adjustment or 3 D technique), various novel membranes and scaffolds that could not only relief inflammation but also influence the biological behaviors of cells have been fabricated to achieve more effective periodontal regeneration. This review provides an overview of the usage of electrospinning materials in treatments of periodontitis, in order to get to know the existing research situation and find treatment breakthroughs of the periodontal diseases.
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Affiliation(s)
- Xuanwen Xu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China *These authors contributed equally to this article
| | - Shuangshuang Ren
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China *These authors contributed equally to this article
| | - Lu Li
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China *These authors contributed equally to this article
| | - Yi Zhou
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China *These authors contributed equally to this article
| | - Wenzao Peng
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China *These authors contributed equally to this article
| | - Yan Xu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China *These authors contributed equally to this article
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631
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Parkinson's Disease, Periodontitis and Patient-Related Outcomes: A Cross-Sectional Study. ACTA ACUST UNITED AC 2020; 56:medicina56080383. [PMID: 32751544 PMCID: PMC7466334 DOI: 10.3390/medicina56080383] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/20/2020] [Accepted: 07/29/2020] [Indexed: 02/08/2023]
Abstract
Background and objectives: People with Parkinson’s disease (PD) may be at risk of having bad periodontal status. A consistent periodontal examination is critical to investigate how it impacts on PD quality of life. We aimed to assess the periodontal status of people with PD, and its association with quality of life and self-perceived xerostomia. Materials and Methods: To this end, from February to March 2020, we consecutively enrolled 28 PD individuals, and motor and non-motor symptoms of PD were assessed using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). We performed full-mouth periodontal examination and gathered information on self-perceived quality of life in PD, oral health impact profile (OHIP-14) and xerostomia. Results: The prevalence of periodontitis was 75.0% and most cases were identified as severe (46.4%). Upper extremity rigidity, hand posture and kinetic tremors were significantly correlated with worse periodontal status. PDQ-8 showed to be correlated with self-perceived oral health-related quality of life and xerostomia levels. Conclusions: This group of people with PD had a high prevalence of periodontitis. Deteriorated levels of the upper extremities in advanced stages of PD were associated with worse periodontal status and hygiene habits. Quality of life in PD appears to be associated with self-perceived OHRQoL and xerostomia.
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632
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Johnston W, Paterson M, Piela K, Davison E, Simpson A, Goulding M, Ramage G, Sherriff A, Culshaw S. The systemic inflammatory response following hand instrumentation versus ultrasonic instrumentation-A randomized controlled trial. J Clin Periodontol 2020; 47:1087-1097. [PMID: 32628781 DOI: 10.1111/jcpe.13342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 06/28/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study sought to investigate whether the immediate systemic inflammatory response following full-mouth debridement differs following use of hand compared with ultrasonic instruments. METHODS Thirty-nine periodontitis patients were randomized to treatment with full-mouth debridement using either hand or ultrasonic instrumentation completed within 24 hr. Serum and periodontal clinical parameters were collected at baseline, day 1, day 7 and day 90 post-treatment. Differences in systemic inflammatory markers were assessed using general linear models at each timepoint, corrected for age, gender, smoking status, body mass index and baseline levels of each marker. RESULTS Across all patients, serum C-reactive protein increased at day 1, with no differences between hand and ultrasonic groups (p(adjusted) = .22). There was no difference between groups in interleukin-6 (p(adjusted) = .29) or tumour necrosis factor α (p(adjusted) = .53) at day 1. Inflammatory markers returned to baseline levels by day 7. Treatment resulted in equal and marked improvements in clinical parameters in both groups; however, total treatment time was on average shorter for ultrasonic instruments (p(adjusted) = .002). CONCLUSIONS Ultrasonic instrumentation resulted in shorter treatment time with comparable clinical outcomes. Levels of serum C-reactive protein at day 1 were similar following debridement with hand or ultrasonic instruments.
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Affiliation(s)
- William Johnston
- Oral Sciences, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Michael Paterson
- Oral Sciences, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Krystyna Piela
- Oral Sciences, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Division of Dentistry, Medical University of Lodz, Lodz, Poland
| | - Emily Davison
- Oral Sciences, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Annabel Simpson
- Oral Sciences, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Gordon Ramage
- Oral Sciences, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Andrea Sherriff
- Community Oral Health, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Shauna Culshaw
- Oral Sciences, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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633
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Machado V, Lobo S, Proença L, Mendes JJ, Botelho J. Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:E2177. [PMID: 32708032 PMCID: PMC7468917 DOI: 10.3390/nu12082177] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 02/06/2023] Open
Abstract
To explore the vitamin D levels of periodontitis patients in comparison with periodontally healthy ones, and to assess the influence of vitamin D supplementation as an adjunctive during nonsurgical periodontal treatment (NSPT). Five databases (Pubmed, Embase, Scholar, Web of Sciences, and Cochrane Library) were searched until May 2020. Mean difference (MD) meta-analysis with corresponding 95% confidence interval (95% CI) and sensitivity tests via meta-regression were used. We followed Strength of Recommendation Taxonomy (SORT) to appraise the strength and quality of the evidence. Sixteen articles were included, fourteen case-control and two intervention studies, all reporting 25-hydroxyvitamin D (25(OH)D) levels. Compared with the healthy controls, the circulating 25(OH)D levels were significantly lower in chronic periodontitis patients (pooled MD = -6.80, 95% CI: -10.59 to -3.02). Subgroup analysis revealed differences among 25(OH)D measurements, with liquid chromatography-mass spectrometry being the most homogeneous method (pooled MD = -2.05, 95% CI: -3.40 to -0.71). Salivary levels of 25(OH)D showed no differences between groups. Due to the low number of studies, conclusions on aggressive periodontitis and in the effect of vitamin D supplementation after NSPT were not possible to ascribe. Compared with healthy controls, 25(OH)D serum levels are significantly lower in chronic periodontitis patients, with an overall SORT A recommendation. Future studies are needed to clarify the effect of vitamin D supplementation and the biological mechanisms linking vitamin D to the periodontium.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (J.B.)
- Periodontology Department, CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - Sofia Lobo
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (J.B.)
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - José João Mendes
- Periodontology Department, CiiEM, IUEM, 2829-511 Almada, Portugal;
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (J.B.)
- Periodontology Department, CiiEM, IUEM, 2829-511 Almada, Portugal;
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634
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Bertl K, Tangl S, Rybaczek T, Berger B, Traindl-Prohazka M, Schuller-Götzburg P, Grossschmidt K. Prevalence and severity of periodontal disease in a historical Austrian population. J Periodontal Res 2020; 55:931-945. [PMID: 32658361 PMCID: PMC7689777 DOI: 10.1111/jre.12785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/16/2020] [Accepted: 06/21/2020] [Indexed: 01/18/2023]
Abstract
Objective To assess the prevalence and severity of periodontitis based on different diagnostic methods in a historical Austrian population from the early middle ages. Background The description of the oral health status of archaeological material can provide interesting insights into prevalence, severity, and extent of oral diseases. Herein, the periodontal health status of the skeletal remains of medieval Avars (700‐800 AD), which were considered as one of the earliest Avarian settlements in Austria, was investigated. Methods The skeletal remains of 128 Avars were examined; age and gender were estimated by standard forensic methods and tooth loss and root caries were recorded. Periodontitis was assessed by (a) measurement of the alveolar bone levels (ABL) and (b) evaluation of the interdental septa. Results A mean ABL of 4.8 mm was determined, root caries tended to accumulate in teeth with a higher alveolar bone loss, and on average, 6.2 teeth were lost antemortem. Independent of the diagnostic method >90% of the subjects were judged as periodontally diseased, and age and tooth type were significant predictors. However, on the tooth level the presence of periodontitis varied considerably depending on the diagnostic method; that is, 7.6% versus 47.2% of the teeth were judged as healthy based on ABL or interdental septa, respectively. Conclusion The periodontal status of the skeletal remains of medieval Avars revealed a considerable high prevalence of periodontitis (ie, >90% of this population displayed periodontal tissue breakdown). However, the diagnostic method, disease definition, and data presentation should be considered when comparing results of archaeological material.
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Affiliation(s)
- Kristina Bertl
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Tina Rybaczek
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Barbara Berger
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | | | - Peter Schuller-Götzburg
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Karl Grossschmidt
- Bone and Biomaterials Research, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
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635
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Wynimko M, Walicka M, Sanchak Y, Gozdowski D, Błach A, Więcek A, Śliwczyński A, Franek E, Kolonko A. Influence of Chronic Periodontitis on the Long-Term Mortality and Cardiovascular Events in Kidney Transplant Recipients. J Clin Med 2020; 9:jcm9061968. [PMID: 32585986 PMCID: PMC7355563 DOI: 10.3390/jcm9061968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022] Open
Abstract
Chronic periodontitis (CP) is associated with cardiovascular disease and mortality in different populations. The aim of this study was to examine an association of CP with hard endpoints in patients after kidney transplantation during a 15-year follow-up period. Study group consist of 117 patients (77M/40F, median age 44 years) divided into two subgroups: those with initially advanced CP (CPITN 3-4) and those with no or moderate CP (CPITN 0-2). All cardiovascular events, graft losses, and re-transplantations were recorded. All deaths were noted and verified, including those occurred after the return to dialysis therapy, the causes of death were identified. Cox regression with Firth's penalized maximum likelihood models were used for data analysis. During the observation period, 49 deaths occurred. Advanced CP (n = 35) was not associated with overall mortality but was associated with increased risk of death with functioning graft (DWFG) [HR 3.54 (1.20-10.45); p < 0.05]. Risk of graft loss was not associated with CP status. In conclusion, an advanced CP was independently associated with increased risk of DWFG, but not all-cause or cardiovascular mortality after renal transplantation.
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Affiliation(s)
- Marta Wynimko
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Yaroslav Sanchak
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
| | - Dariusz Gozdowski
- Department of Biometry, Warsaw University of Life Sciences, Nowoursynowska 166, 02-787 Warsaw, Poland;
| | - Anna Błach
- Department of Cardiology, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
- Voxel SA Nuclear Medicine Center, Ceglana 35, 40-514 Katowice, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
| | - Andrzej Śliwczyński
- Sattelite Campus, University of Humanities and Economics in Lodz, Wolność 2a, 01-018 Warsaw, Poland;
- National Health Fund, Grójecka 186, 02-390 Warsaw, Poland
| | - Edward Franek
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland; (M.W.); (M.W.); (Y.S.); (E.F.)
- Mossakowski Clinical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106 Warsaw, Poland
| | - Aureliusz Kolonko
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland;
- Correspondence: ; Tel.: +48-32-259-1429
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636
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Alhassani AA, Al-Zahrani MS. Is inadequate sleep a potential risk factor for periodontitis? PLoS One 2020; 15:e0234487. [PMID: 32544165 PMCID: PMC7297327 DOI: 10.1371/journal.pone.0234487] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/26/2020] [Indexed: 12/15/2022] Open
Abstract
This study was undertaken to investigate the potential association between sleep duration and periodontitis. The study population consisted of 10,291 individuals who participated in the United States National Health and Nutrition Examination Survey (NHANES) from the 2009–2014 cycles. Sleep duration was categorized into sleep deficient (< 7 hours), sleep adequate (7–8 hours), and sleep excessive (> 8 hours). We used the Center for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) periodontitis case definition. Descriptive statistics and logistic regression models were used for data analyses. The prevalence of periodontitis was 36% higher in individuals who reported sleep deficiency when compared to the sleep adequate group (odds Ratio (OR) = 1.36, 95% confidence interval (CI): 1.23–1.50). Those who reported excessive sleep had 41% higher odds of periodontitis (OR: 1.40, 95% CI: 1.16–1.71). After adjusting for confounding factors, sleep deficient individuals were 19% more likely to have periodontitis when compared to sleep adequate individuals (OR: 1.19, 95% CI: 1.06–1.38). Among sleep excessive individuals, the association was non-significant (OR: 1.16, 95% CI: 0.94–1.43). Sleep deficiency was associated with a higher prevalence of periodontitis in this study population. The association however needs to be confirmed in longitudinal studies.
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Affiliation(s)
- Ahmed A. Alhassani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- * E-mail: ,
| | - Mohammad S. Al-Zahrani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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637
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Wan Y, Xu W, Ren X, Wang Y, Dong B, Wang L. Microporous Frameworks as Promising Platforms for Antibacterial Strategies Against Oral Diseases. Front Bioeng Biotechnol 2020; 8:628. [PMID: 32596233 PMCID: PMC7304413 DOI: 10.3389/fbioe.2020.00628] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/22/2020] [Indexed: 12/21/2022] Open
Abstract
Nowadays, the heavy burden of oral diseases such as dental caries, periodontitis, endodontic infections, etc., and their consequences on the patients' quality of life indicate a strong need for developing effective therapies. Bacterial infections played an important role in the field of oral diseases, in-depth insight of such oral diseases have given rise to the demand for antibacterial therapeutic strategies. Recently, microporous frameworks have attracted tremendous interest in antibacterial application due to their well-defined porous structures for drug delivery. In addition, intensive efforts have been made to enhance the antibacterial performance of microporous frameworks, such as ion doping, photosensitizer incorporation as building blocks, and surface modifications. This review article aims on the major recent developments of microporous frameworks for antibacterial applications against oral diseases. The first part of this paper puts concentration on the cutting-edge researches on the versatile antibacterial strategies of microporous materials via drug delivery, inherent activity, and structural modification. The second part discusses the antibacterial applications of microporous frameworks against oral diseases. The applications of microporous frameworks not only have promising therapeutic potential to inhibit bacterial plaque-initiated oral infectious diseases, but also have a wide applicability to other biomedical applications.
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Affiliation(s)
- Yao Wan
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
| | - Wenzhou Xu
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Xuan Ren
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
| | - Yu Wang
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Biao Dong
- State Key Laboratory on Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, Changchun, China
| | - Lin Wang
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
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638
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Periodontitis and Hypertension: Is the Association Causal? High Blood Press Cardiovasc Prev 2020; 27:281-289. [PMID: 32500479 DOI: 10.1007/s40292-020-00392-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/30/2020] [Indexed: 02/07/2023] Open
Abstract
High blood pressure (BP) and periodontitis are two highly prevalent conditions worldwide with a significant impact on cardiovascular disease (CVD) complications. Poor periodontal health is associated with increased prevalence of hypertension and may have an influence on BP control. Risk factors such as older age, male gender, non-Caucasian ethnicity, smoking, overweight/obesity, diabetes, low socioeconomic status, and poor education have been considered the common denominators underpinning this relationship. However, recent evidence indicates that the association between periodontitis and hypertension is independent of common risk factors and may in fact be causal in nature. Low-grade systemic inflammation and redox imbalance, in particular, represent the major underlying mechanisms in this relationship. Neutrophil dysfunction, imbalance in T cell subtypes, oral-gut dysbiosis, hyperexpression of proinflammatory genes, and increased sympathetic outflow are some of the pathogenetic events involved. In addition, novel findings indicate that common genetic bases might shape the immune profile towards this clinical phenotype, offering a rationale for potential therapeutic and prevention strategies of public health interest. This review summarizes recent advances, knowledge gaps and possible future directions in the field.
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639
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Machado V, Aguilera EM, Botelho J, Hussain SB, Leira Y, Proença L, D’Aiuto F, Mendes JJ. Association between Periodontitis and High Blood Pressure: Results from the Study of Periodontal Health in Almada-Seixal (SoPHiAS). J Clin Med 2020; 9:E1585. [PMID: 32456145 PMCID: PMC7291060 DOI: 10.3390/jcm9051585] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 12/11/2022] Open
Abstract
Periodontitis is a common chronic inflammatory disease which could have an important impact on blood pressure (BP). This study aimed to explore (a) the association between periodontal health and BP in a large representative cohort, (b) the predictive value of diagnosis of periodontitis in undiagnosed raised BP and (c) whether age is a mediator of this relationship. In total, 1057 randomly recruited individuals (mean age, 60.9 ± 16.3 years, 57.7% women) underwent periodontal clinical assessment and one-single BP measurement using an automated sphygmomanometer device. Logistic and linear regression models were used to estimate the odds of hypertension based on periodontitis case definitions. Mediation analysis was performed to understand the effect of age on the association of periodontitis with hypertension. Adjusted logistic model for gender, smoking habits and body mass index confirmed the association between high BP and periodontitis (OR = 2.31, 95%CI: 1.75-3.04, p < 0.001). Among 168 participants with undiagnosed high BP (15.9% of the study sample), 62.5% had periodontitis (n = 105). In this study, the association between periodontitis with both systolic blood pressure (SBP) (77.6%, p < 0.001) and diastolic blood pressure (DBP) (66.0%, p < 0.001) was mediated by age. Periodontitis is closely linked to BP in a representative Portuguese population.
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Affiliation(s)
- Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
| | - Eva Muñoz Aguilera
- Periodontology Unit, University College London Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK; (E.M.A.); (S.B.H.); (Y.L.); (F.D.)
- Department of Periodontology, Faculty of Dentistry, Universitat Internacional de Catalonia, 08195 Barcelona, Spain
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
| | - Syed Basit Hussain
- Periodontology Unit, University College London Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK; (E.M.A.); (S.B.H.); (Y.L.); (F.D.)
| | - Yago Leira
- Periodontology Unit, University College London Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK; (E.M.A.); (S.B.H.); (Y.L.); (F.D.)
- Medical-Surgical Research Group, Health Research Institute of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
| | - Francesco D’Aiuto
- Periodontology Unit, University College London Eastman Dental Institute, 21 University Street, London WC1E 6DE, UK; (E.M.A.); (S.B.H.); (Y.L.); (F.D.)
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal;
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640
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Changing the Focus to the Whole Patient instead of One Oral Disease: The Concept of Individualized Prevention. Adv Prev Med 2020; 2020:6752342. [PMID: 32518697 PMCID: PMC7256733 DOI: 10.1155/2020/6752342] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/14/2020] [Accepted: 05/06/2020] [Indexed: 12/18/2022] Open
Abstract
Oral diseases are highly prevalent and a global burden. Accordingly, their prevention appears essential. Recently, different strategies have been developed, mainly focusing on the presence of singular oral diseases or conditions. This article aims to construct a contemporary concept of individualized preventive care in dentistry whereby the focus is switched from viewing oral health in isolation to viewing the patient as a whole. The basis for individualized prevention measures is the case-oriented profile, including the synthesis of risk- and need-oriented parameters. The risk profile comprises different risk factors within the fields of systemic diseases, medications, and lifestyle that inherently pose a potential risk of complications (e.g., infectious endocarditis) and/or oral diseases (e.g., periodontitis). The needs profile includes factors originating from the aspects of oral diseases, dental restorations/appliances, and dental results with a potential risk of pathogenesis (e.g., the de novo development of caries) and/or the potential progression of oral diseases (e.g., an existing caries lesion). Based on these parameters, the general framework and content of prevention measures, as well as the maintenance interval, should be adapted to the individual patient. The implications of this concept might increase the safety, effectiveness, and efficiency of prevention in dental care. A further area of focus is primary prevention, that is, a focus on the preservation of oral health instead of a disease-related approach. However, clinical validation is needed to prove the benefits of the model presented. Individualized prevention promotes a shift from a disease-focused model to a whole-patient-focused model and provides a potential approach for establishing a contemporary concept for preventive care in dentistry.
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641
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Meilhac O, Tanaka S, Couret D. High-Density Lipoproteins Are Bug Scavengers. Biomolecules 2020; 10:biom10040598. [PMID: 32290632 PMCID: PMC7226336 DOI: 10.3390/biom10040598] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022] Open
Abstract
Lipoproteins were initially defined according to their composition (lipids and proteins) and classified according to their density (from very low- to high-density lipoproteins—HDLs). Whereas their capacity to transport hydrophobic lipids in a hydrophilic environment (plasma) is not questionable, their primitive function of cholesterol transporter could be challenged. All lipoproteins are reported to bind and potentially neutralize bacterial lipopolysaccharides (LPS); this is particularly true for HDL particles. In addition, HDL levels are drastically decreased under infectious conditions such as sepsis, suggesting a potential role in the clearance of bacterial material and, particularly, LPS. Moreover, "omics" technologies have unveiled significant changes in HDL composition in different inflammatory states, ranging from acute inflammation occurring during septic shock to low-grade inflammation associated with moderate endotoxemia such as periodontal disease or obesity. In this review, we will discuss HDL modifications associated with exposure to pathogens including bacteria, viruses and parasites, with a special focus on sepsis and the potential of HDL therapy in this context. Low-grade inflammation associated with atherosclerosis, periodontitis or metabolic syndrome may also highlight the protective role of HDLs in theses pathologies by other mechanisms than the reverse transport of cholesterol.
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Affiliation(s)
- Olivier Meilhac
- Université de la Réunion, Inserm, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), F-97490 Sainte-Clotilde, France; (S.T.); (D.C.)
- CHU de La Réunion, Centre d’Investigations Clinique 1410, 97410 Saint-Pierre, France
- Correspondence: ; Tel.: +33-262-93-88-11
| | - Sébastien Tanaka
- Université de la Réunion, Inserm, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), F-97490 Sainte-Clotilde, France; (S.T.); (D.C.)
- AP-HP, Service d’Anesthésie-Réanimation, CHU Bichat-Claude Bernard, 75018 Paris, France
| | - David Couret
- Université de la Réunion, Inserm, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), F-97490 Sainte-Clotilde, France; (S.T.); (D.C.)
- CHU de La Réunion, Neurocritical Care Unit, 97410 Saint-Pierre, France
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642
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Graziani F, Peric M, Marhl U, Petrini M, Bettini L, Tonetti M, Gennai S. Local application of enamel matrix derivative prevents acute systemic inflammation after periodontal regenerative surgery: A randomized controlled clinical trial. J Clin Periodontol 2020; 47:747-755. [PMID: 32163634 DOI: 10.1111/jcpe.13270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/13/2020] [Accepted: 02/10/2020] [Indexed: 12/14/2022]
Abstract
AIM The aim of this study was to compare surgical treatment of periodontal intra-bony defects (IBD) with or without the adjunct of enamel matrix derivative (EMD) in terms of acute-phase responses in healthy patients. METHODS Thirty-eight periodontitis-affected subjects, one IDB each, were randomized to minimally invasive periodontal surgery (MIS) with or without EMD. Periodontal parameters were recorded at baseline and 6-months. Blood samples were collected at baseline, 1, 7 and 180 days after treatment. RESULTS At 24 hr, the group treated MIS with EMD showed lower values of C-reactive protein (CRP; p < .01) as no inflammatory perturbation was noticed. Conversely, MIS group resulted in an acute inflammatory response at 24 hr (p < .05) that regressed to its baseline values at day 7. The EMD group showed a higher number of cases without residual BOP or PPD ≥ 5mm 6 months after surgery (p < .05), and post-surgical gingival recession was lower (p < .05). CONCLUSIONS The adjunctive application of EMD during surgical treatment resulted in a minor increase in serum CRP 24-hr after surgery. These findings suggest a possible systemic anti-inflammatory effect of EMD. Within its limitations, this pilot trial confirmed better clinical periodontal outcomes in the EMD group. NCT03590093.
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Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Marina Peric
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Urska Marhl
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Morena Petrini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Laura Bettini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Maurizio Tonetti
- Faculty of Dentistry, University of Hong Kong, Hong Kong, SAR China
| | - Stefano Gennai
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
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643
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Sanz M, Marco del Castillo A, Jepsen S, Gonzalez‐Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel J, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol 2020; 47:268-288. [PMID: 32011025 PMCID: PMC7027895 DOI: 10.1111/jcpe.13189] [Citation(s) in RCA: 637] [Impact Index Per Article: 159.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/13/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. MATERIAL AND METHODS There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations RESULTS AND CONCLUSIONS: The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.
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Affiliation(s)
- Mariano Sanz
- Department of Dental Clinical SpecialtiesETEP Research GroupFaculty of OdontologyUniversity Complutense of MadridMadridSpain
| | | | - Søren Jepsen
- Department of Periodontology, Operative and Preventive DentistryUniversity of BonnBonnGermany
| | - Jose R. Gonzalez‐Juanatey
- Cardiology DepartmentUniversity HospitalIDISCIBERCVUniverity of Santiago de CompostelaSantiago de CompostelaSpain
| | - Francesco D’Aiuto
- Department of PeriodontologyEastman Dental Institute and HospitalUniversity College LondonLondonUK
| | - Philippe Bouchard
- U.F.R. d'odontologieUniversité Paris DiderotHôpital Rothschild AP‐HPParisFrance
| | - Iain Chapple
- School of DentistryInstitute of Clinical SciencesCollege of Medical & Dental SciencesThe University of BirminghamBirminghamUK
| | - Thomas Dietrich
- School of DentistryInstitute of Clinical SciencesCollege of Medical & Dental SciencesThe University of BirminghamBirminghamUK
| | - Israel Gotsman
- Heart InstituteHadassah University HospitalJerusalemIsrael
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care MedicineUniversity of PisaPisaItaly
| | - David Herrera
- Department of Dental Clinical SpecialtiesETEP Research GroupFaculty of OdontologyUniversity Complutense of MadridMadridSpain
| | | | - Phoebus Madianos
- Department of PeriodontologySchool of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Jean‐Baptiste Michel
- Inserm Unit 1148Laboratory for Translational CV ScienceX. Bichat HospitalParisFrance
| | - Pablo Perel
- World Heart FederationGenevaSwitzerland
- Centre for Global Chronic ConditionsLondon School of Hygiene & Tropical MedicineLondonUK
| | - Burkert Pieske
- Department of Internal Medicin & CardiologyCharité Universitätsmedizin BerlinBerlinGermany
- DZHK (German Center for Cardiovascular Research) Partnersite BerlinGerman Heart Institut BerlinBerlinGermany
| | - Lior Shapira
- Department of PeriodontologyHebrew University – Hadassah Faculty of Dental MedicineJerusalemIsrael
| | - Michael Shechter
- Leviev Heart CenterChaim Sheba Medical Centertel Hashomer and the Sackler Faculty of MedicineTel Aviv UniversityTel Aviv‐YafoIsrael
| | - Maurizio Tonetti
- Department of PeriodontologyPrince Philip Dental HospitalThe University of Hong KongHong KongHong Kong
| | | | - Gernot Wimmer
- Department of Prosthetic DentistrySchool of Dental MedicineKarl‐Franzens University GrazGrazAustria
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