Relationship between periodontal disease and systemic health

Health Lifestyle Behaviors among U.S. Adults

Existing research that studies individual health behaviors and conceive of behaviors as simplistically reflecting narrow intentions toward health may obscure the social organization of health behaviors. Instead, we examine how eight health behaviors group together to form distinct health behavior niches. Using nationally-representative data from U.S. adults aged 18 and over from the 2004-2009 National Health Interview Survey (NHIS), we use Latent Class Analysis to identify classes of behavior based on smoking status, alcohol use, physical activity, physician visits, and flu vaccination. We identify 7 distinct health behavior classes including concordant health promoting (44%), concordant health compromising (26%), and discordant classes (30%). We find significant race/ethnic, sex, regional, and age differences in class membership. We show that health behavior classes are associated with prospective mortality, suggesting that they are valid representations of health lifestyles. We discuss the implications of our results for sociological theories of health behaviors, as well as for multiple behavior interventions seeking to improve population health.

Assessment of the association between dentate status and self-rated general health

OBJECTIVE

Aiming at preparing the basis for evidence-based dental public health policy making in Slovenia, the objective of the study was to assess the strength of association between oral health status measured by the number of missing teeth and self-rated health (SRH).

METHODS

The study was designed as a pooled individual-level data study from four national cross-sectional studies carried out in the period 2001-2012, based on CINDI Health Monitor methodology. Altogether, 34,412 participants were included. A logistic regression model with poor SRH as observed outcome and the number of teeth as explanatory factor (adjusted for selected biologic, socio-economic and health factors) was proposed.

RESULTS

In the sample, women represented 55.7% and men 44.3%, median age was 45 years. Persons with more missing teeth more likely rated their health as poor. The association was persistent even when different confounding variables were included in the model. In the group with 1-5 missing teeth, in comparison to the group with none missing teeth, OR was 1.23 (p=0.049), whereas for the group with 6-10 missing teeth, OR was 1.32 (p=0.019); for the group with >10 missing teeth, but not all, OR was 1.77 (p<0.001), and for the group with all missing teeth, OR was 2.19 (p<0.001).

CONCLUSIONS

Study results showed clear association of SRH with dentate status, which confirms the oral-general health connection. This indicates the need for the development of proper dental public health policies for better oral health, and presents a new view on the importance of preserving teeth.

A randomized clinical trial of oral hygiene care programmes during stroke rehabilitation

OBJECTIVES

The objectives of this study were to evaluate and compare the effectiveness of an advanced oral hygiene care programme (AOHCP) and a conventional oral hygiene care programme (COHCP) in improving oral hygiene, and reducing gingival bleeding among patients with stroke during outpatient rehabilitation.

METHODS

Subjects were randomized to receive (i) the COHCP comprising a manual toothbrush, toothpaste, and oral hygiene instruction, or (ii) the AOHCP comprising a powered toothbrush, 0.2% chlorhexidine mouthrinse, toothpaste, and oral hygiene instruction. Dental plaque, gingival bleeding, and other clinical oral health outcomes were assessed at baseline, the end of the clinical trial, and the end of observation period. Development of infectious complications was also monitored.

RESULTS

Participants of both programmes had a significant reduction in the percentages of sites with moderate to abundant dental plaque (p<0.001) and with gingival bleeding (p<0.05). Those in the AOHCP had significantly less plaque and gingival bleeding than those in the COHCP controlling for other factors at the end of the clinical trial period (both p<0.001) and the observational period (plaque: p<0.05, gingival bleeding: p<0.01).

CONCLUSIONS

Although both oral hygiene care programmes were effective in terms of plaque and gingival bleeding control, the AOHCP was more effective than the COHCP in reducing dental plaque and gingival bleeding.

CLINICAL SIGNIFICANCE

This study highlighted the value of oral hygiene programmes within stroke outpatient rehabilitation and provides evidence to advocate for the inclusion of oral hygiene care programmes within stroke outpatient rehabilitation for patients with normal cognitive abilities.

Periodontal Status and Quality of Life: Impact of Fear of Pain and Dental Fear

Background. Oral health-related quality of life (OHRQoL) is impacted by periodontal disease and orofacial pain. There is a limited research examining the impact of avoidance of care or physiological arousal related to the fear of pain response on periodontal-related OHRQoL. Methods. Data are from the Center for Oral Health Research in Appalachia family-based study focusing on 1,339 adults. Measures included a modified Periodontal Screening and Recording Index across sextants of dentition, dental fear survey, Fear of Pain Questionnaire-9, and Oral Health Impact Profile-14. Structural equation modeling was used to estimate the effects of periodontal disease screening indicators on OHRQoL including the mediating role of dental fear while accounting for fear of pain. Results. A significant total effect was found for the mandibular anterior sextant, components of dental anxiety/fear, and indicators of OHRQoL (pain and discomfort, β = .165, p = .001; psychosocial impact, β = .199, p < .001). The maxillary anterior region was significantly associated with pain discomfort (β = .116, p = .017) and functionality (β = .130, p = .011). Conclusions. Findings provide a granular perspective of periodontal disease indicators and OHRQoL. Dental avoidance/anticipatory fear and physiological arousal mediate OHRQoL in individuals who have indicators of periodontal disease in sextants that may be visible and susceptible to higher pain and psychosocial impact.

Salivary and serum inflammatory mediators among pre-conception women with periodontal disease

BACKGROUND

There have been inconsistent conclusions regarding the levels of inflammatory mediators in saliva and serum among people with or without periodontal disease. Although pre-conception has been put forward as the optimal time for the periodontal treatment in order to improving pregnancy outcomes, few studies have been conducted to examine inflammatory mediators in saliva and serum among pre-conception women.

METHODS

Pre-conception women were recruited between January 2012 and December 2014. Women were provided with an oral health examination to detect periodontal disease. Salivary and serum samples were collected at the same of examination. Inflammatory mediators includinginterleukin-1 beta (IL-1β), IL-6, tumor necrosis factor alpha (TNF-α) and beta-glucuronidase (β-glucuronidase) were tested and analyzed among women with overall periodontal disease (n = 442) or moderate/severe periodontal disease (n = 247). Results were compared to that in women with a healthy periodontium (n = 91).

RESULTS

Significantly increased concentrations of inflammatory mediators of IL-1β, IL-6, TNF-α and β-glucuronidase in saliva and IL-1β, β-glucuronidase and TNF-α in serum were found among pre-conception women with moderate/severe periodontal disease, compared with women without periodontal disease. Significantly increased levels were also found in all the above saliva inflammatory mediators and in serum IL-1β and TNF-α among women with overall periodontal disease. The levels of all inflammatory mediators in saliva and almost all inflammatory mediators except IL-6 in serum significantly increased with severity of periodontal disease.

CONCLUSION

Periodontal disease is highly associated with the elevated levels of inflammatory mediators in saliva and some mediators in serum among pre-conception women.

Prevalence and risk factors of periodontal disease among pre-conception Chinese women

BACKGROUND

Periodontal disease is one of the most common chronic infectious diseases. It has been reported that periodontal disease is associated with various adverse pregnancy outcomes including preterm birth, low birth weight, and gestational diabetes mellitus. Given the fact that the treatment for periodontal disease during pregnancy was ineffective in improving pregnancy outcomes by most of studies, the pre-conception period has been put forward as a more optimal time. However, very few studies have reported the prevalence of periodontal disease among pre-conception women. This study aimed to examine the prevalence and risk factors of periodontal disease among Chinese pre-conception women.

METHODS

A survey was conducted among pre-conception women at the Maternal and Child Health Hospital, Changzhou, China between January 2012 and December 2014. A total of 987 pre-conception women were recruited for a full-mouth dental examination after providing informed consent. A dental examination was carried out by probing six sites per tooth using a manual UNC-15 probe and a recording form.

RESULTS

The overall rate of periodontal disease among participants was 73.9% (729/987) (95% confidence interval (CI): 71.0-76.6%). Among women with periodontal disease, 48.0% of cases were mild, 50.9% were moderate and 1.1% were severe. Self-reported bleeding during tooth brushing was the only significant predictive factor for overall periodontal disease (adjusted odds ratio (aOR): 3.71, 95% CI: 2.24, 6.15, P < 0.001) and moderate/severe periodontal disease (aOR: 5.17, 95% CI: 3.05, 8.79, P < 0.001).

CONCLUSION

A high prevalence of periodontal disease was found in pre-conception Chinese women. Women who have bleeding during tooth brushing could be at increased risk of periodontal disease, and might require further oral health care.

Periodontitis: a potential risk factor for Alzheimer's disease

The role of periodontitis as a risk factor for multiple systemic diseases is widely accepted and there is growing evidence of an association between periodontitis and sporadic late onset Alzheimer's disease (SLOAD). Recent epidemiologic, microbiologic and inflammatory findings strengthen this association, indicating that periodontal pathogens are possible contributors to neural inflammation and SLOAD. The aim of this article is to present contemporary evidence of this association.

A specific Streptococcus mutans strain aggravates non-alcoholic fatty liver disease

OBJECTIVE

Streptococcus mutans, a major dental caries pathogen, has shown to be associated with the aggravation of cerebral hemorrhage and inflammatory bowel diseases. In this study, we evaluated the effects ofS. mutans on the development of non-alcoholic steatohepatitis (NASH) in a mouse model.

MATERIALS AND METHODS

Streptococcus mutans oral strain MT8148 (serotype c) and a blood isolate TW871 (k) were used. C57BL/6J mice (6 weeks old)were fed a high-fat diet for 4 weeks; the test strains or phosphate-buffered saline was then intravenously administered. Mice were euthanized after 8 or 12 weeks. Whole body, extirpated liver, and visceral fat weights were determined, and histopathological evaluations of the liver specimens were performed.

RESULTS

Mice infected with TW871 showed significantly greater body and liver weights than those administered MT8148 or phosphate-buffered saline. Histopathological analyses revealed prominent infiltration of inflammatory cells and adipocellular deposition in livers extirpated 8 weeks after an infection with TW871; fibrosis was also observed in livers extirpated after 12 weeks.

CONCLUSION

These results suggest that a specific strain of S. mutans could induce NASH.

The paradox of painless periodontal disease

Periodontal diseases, primarily gingivitis and periodontitis, are characterised by progressive inflammation and tissue destruction. However, they are unusual in that they are not also accompanied by the pain commonly seen in other inflammatory conditions. This suggests that interactions between periodontal bacteria and host cells create a unique environment in which the pro-algesic effects of inflammatory mediators and factors released during tissue damage are directly or indirectly inhibited. In this review, we summarise the evidence that periodontal disease is characterised by an accumulation of classically pro-algesic factors from bacteria and host cells. We then discuss several mechanisms by which inflammatory sensitisation of nociceptive fibres could be prevented through inactivation or inhibition of these factors. Further studies are necessary to fully understand the molecular processes underlying the endogenous localised hypoalgesia in human periodontal disease. This knowledge might provide a rational basis to develop future therapeutic interventions, such as host modulation therapies, against a wide variety of other human pain conditions.

Relationship between periodontal disease and preterm low birth weight: systematic review

Introduction

Periodontal disease is a neglected bacterial infection that causes destruction of the periodontium in pregnant women. Yet its impact on the occurrence of adverse pregnancy outcomes has not systematically evaluated and there is no clear statement on the relationship between periodontal disease and preterm low birth weight. The objective of this study was to summarize the evidence on the impact of periodontal disease on preterm low birth weight.

Methods

We searched the following data bases from January 2005 to December 2015: CINAHL (cumulative index to nursing and allied health literature), MEDLINE, AMED, EMBASE (excerpta medica database), Cochrane library and Google scholar. Only case-control studies with full text in English were eligible. Critical appraisal of the identified articles was done by two authors independently to provide the possible relevance of the papers for inclusion in the review process. The selected Case control studies were critically appraised with 12 items structured checklist adapted from national institute of health (NIH). Odds ratio (OR) or risk ratios (RR) were extracted from the selected studies. The two reviewers who selected the appropriate studies also extracted the data and evaluated the risk of bias.

Results

Of 229 articles, ten studies with a total of 2423 participants with a mean age ranged from 13 to 49 years were met the inclusion criteria. The studies focused on preterm birth, low birth weight and /or preterm low birth weight and periodontitis. Of the selected studies, 9 implied an association between periodontal disease and increased risk of preterm birth, low birth weight and /or preterm low birth weight outcome (ORs ranging from 2.04 to 4.19) and only one study found no evidence of association.

Conclusion

Periodontal disease may be one of the possible risk factor for preterm low birth weight infant. However, more precise studies with randomized clinical trial with sufficient follow-up period must be done to confirm the association.

Clinical research activity in periodontal medicine: a systematic mapping of trial registers

AIM

The primary aim of the study was to systematically map registration records on periodontal medicine in clinical trial registers. The secondary aim was to assess the evolution of periodontal medicine in clinical periodontal research as a whole.

MATERIAL AND METHODS

We searched all registration records related to periodontology in the World Health Organization International Clinical Trials Registry Platform. For registration records classified in the field of periodontal medicine, we assigned the 2015 MeSH(®) term for the most precisely corresponding systemic condition.

RESULTS

Fifty-seven systemic conditions have been hypothesized to be linked with periodontal diseases, covering nearly 2% of the diseases indexed in MeSH. In addition to diabetes, cardiovascular disease or preterm birth, other systemic conditions have been the subject of registration records, such as anaemia, liver diseases, dyspepsia or ankylosing spondylitis. A trend towards increasing diversification of systemic conditions has appeared over time. About a third of registration records in clinical periodontal research deals with periodontal medicine.

CONCLUSIONS

Periodontal medicine now constitutes an important part of clinical periodontal research. Research activity in periodontal medicine has grown continuously since the early 2000s, and exploration of registers gives a useful up-to-date snapshot of this constantly evolving field of research.

[Update in family medicine: Periodontal disease]

About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis.

Comparative analysis of dentognathic pathologies in the Dmanisi mandibles

OBJECTIVES

Due to the scarcity of the fossil record, in vivo changes in the dentognathic system of early Homo are typically documented at the level of individual fossil specimens, and it remains difficult to draw population-level inferences about dietary habits, diet-related activities and lifestyle from individual patterns of dentognathic alterations. The Plio-Pleistocene hominin sample from Dmanisi (Georgia), dated to 1.77 million years ago, offers a unique opportunity to study in vivo changes in the dentognathic system of individuals belonging to a single paleodeme of early Homo.

MATERIALS AND METHODS

We analyze dentognathic pathologies in the Dmanisi sample, and in comparative samples of modern Australian and Greenlander hunter-gatherer populations, applying clinical protocols of dentognathic diagnostics.

RESULTS

The Dmanisi hominins exhibit a similarly wide diversity and similar incidence of dentognathic pathologies as the modern human hunter-gatherer population samples investigated here. Dmanisi differs from the modern population samples in several respects: At young age tooth wear is already advanced, and pathologies are more prevalent. At old age, hypercementosis is substantial.

CONCLUSIONS

Results indicate that dentognathic pathologies and disease trajectories are largely similar in early Homo and modern humans, but that the disease load was higher in early Homo, probably as an effect of higher overall stress on the dentognathic system. Am J Phys Anthropol 160:229-253, 2016. © 2016 Wiley Periodicals, Inc.

In silico analyses of heparin binding proteins expression in human periodontal tissues

BACKGROUND

Periodontitis is described as a group of inflammatory diseases of the gingiva and supporting structures of the periodontium. The accumulation of plaque bacteria, which include putative periodontal pathogens, is known to initiate the disease but the host immune response is the major contributing factor for destruction of periodontal tissues. Proteins that bind to heparin heparin-binding protein (HBPs) play important roles in health and disease and interact with each other via networks known as 'heparin interactomes'. This study aimed at evaluating published datasets of HBPs and its role in periodontitis.

METHODS

To elucidate the role of HBPs in periodontitis, bioinformatics analyses of published data was used. In silico analyses of published datasets were used to construct a putative HBPs interactome using an online database resource, 'STRING' (Search Tool for the Retrieval of Interacting Genes).

RESULTS

PubMed searches identified 249 genes that were up regulated and 146 genes that were down regulated in periodontal disease, compared with periodontal disease-free gingival samples. In silico analyses using published datasets revealed 25 up-regulated and 23 down-regulated HBPs in periodontitis. Of these HBPs; chemokines, such as CXCL12 was up regulated where as some of the matrixmetalloproteinases (MMPs; MMP-2 and MMP9) were up-regulated while MMP-14 was down regulated.

CONCLUSIONS

The results indicate that HBP analyses will provide multiple targets for the biological mechanisms underlying periodontal disease (such as MMPs, cytokines and chemokines) that will have important clinical implications in the future drug design and management of periodontal disease.

Self-report of gingival problems and periodontitis in indigenous and non-indigenous populations in Chiapas, Mexico

OBJECTIVE

To estimate the prevalence of self-reported gingival and periodontal conditions and their association with smoking, oral hygiene, indigenous origin, diabetes and location (urban or rural) in indigenous and non-indigenous adults in Chiapas, Mexico.

METHODS

A cross-sectional study of 1,749 persons, ≥20 years of age, living in four rural and four urban marginal localities in Comitán (Chiapas, México). The variables investigated were: age; sex; indigenous origin; oral hygiene; halitosis; chewing ability; gingival conditions; periodontitis; smoking; alcoholism; diabetes; and location. Bivariate analysis and a logistic regression model were used to identify the association of periodontitis with the independent variables.

RESULTS

In total, 762 (43.6%) indigenous and 987 (56.4%) non-indigenous persons were interviewed. Their mean age was 41 ± 14 years, 66.7% were women and 43.8% lived in rural locations. Gingival problems were reported by 68.5% and periodontitis by 8.7%. In total, 17.9% had used dental services during the previous year, 28.7% wore a removable partial or a complete dental prosthesis, 63.7% had lost at least one tooth, the prevalence of diabetes was 9.2% and the prevalence of smoking was 12.2%. The logistic regression model showed that age, diabetes and the interaction between rural location and indigenous origin were associated with the presence of periodontitis.

CONCLUSIONS

Indigenous people living in rural areas are more likely to have periodontitis. It is necessary to promote oral health practices in indigenous and marginalised populations with a focus on community-oriented primary care.

Periodontal treatment outcomes in post menopausal women receiving hormone replacement therapy

Purpose:

To evaluate the effect of hormone replacement therapy(HRT) on periodontal treatment outcomes in a group of postmenopausal women with periodontitis.

Materials and Methods:

23 post-menopausal chronic periodontitis patients were included in this study. The test group(n=11) consisted of women who started HRT with this study and received conjugated estrogen and medroxyprogesteron. The control group(n=12) was women not taking any HRT or supplement therapy. Study groups received the same periodontal treatment. All subjects examiend by recording the following: plaque index (PI), sulcus bleeding index (SBI), periodontal pocket depth (PD) and relative attachment level (RAL) from 6 sites in each tooth. Measurements were recorded at the baseline, 1 month, 3 months, and 6 months following periodontal treatment. Serum estrogene level and bone mineral density was recorded at baseline and 6 months following periodontal treatment.

Results:

The GI change was greater in the control group. There wasn’t significant difference by means of PD, the attachment gain was significantly greater in the HRT receiving group.

Conclusion:

HRT seems to have a positive effect on periodontal treatment outcomes.

Periodontal disease and liver cirrhosis: A systematic review

OBJECTIVES

Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease and liver cirrhosis and to identify opportunities and directions for future research in this area.

METHODS

A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including 'liver cirrhosis', 'end-stage liver disease', 'liver diseases', 'oral health', 'periodontal disease', 'mouth disease', 'gingivitis', and 'periodontitis'.

RESULTS

Thirteen studies published between 1981 and 2014 were found to include data on oral health and periodontal disease in cirrhotic patients. Studies indicated an increased incidence of periodontal disease in patients with liver cirrhosis, measured with several different periodontal indices. The reported prevalence of periodontal disease in cirrhosis patients ranged from 25.0% to 68.75% in four studies and apical periodontitis was found in 49%-79% of the patients. One study found that mortality was lower among patients who underwent dental treatment versus non-treated patients. Another study suggested an association between periodontal disease and the progression of liver cirrhosis, but data are sparse and conflicting as to whether periodontal disease is correlated to cirrhosis aetiology and severity.

CONCLUSION

Despite the clinical reality of periodontal disease in liver cirrhosis patients, there are few published studies. Before clinical implications can be addressed, more data on the prevalence of and correlation between periodontal disease and liver cirrhosis aetiology, duration, and progression are needed.

Association Between Periodontitis and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis

BACKGROUND

To the best of the authors' knowledge, there is no systematic review of the potential association between periodontitis and gestational diabetes mellitus (GDM) in the current literature. The aim of the present systematic review and meta-analysis is to search for scientific evidence regarding the association between periodontitis and GDM.

METHODS

The present study was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered (CRD2014010728) with PROSPERO (International prospective register for systematic reviews, University of York, York, UK). A search was conducted in three electronic databases without restrictions regarding language or date of publication. From 190 studies selected, 15 underwent full-text analysis. Eight studies were eligible (five cross-sectional and three case-control studies), and seven were entered in the meta-analysis. Meta-analysis was performed with tests for sensitivity and statistical heterogeneity. Summary effect measures were calculated by odds ratio (OR) and 95% confidence interval (CI).

RESULTS

There was a significant association between periodontitis and GDM in the meta-analyses of four cross-sectional studies (OR 1.67, 95% CI 1.20 to 2.32) and two case-control studies (OR 2.66, 95% CI 1.52 to 4.65). However, sensitivity tests for case-control studies showed a lack of consistency in data; when including one case-control study, the significance was null (meta-analysis of three case-control studies: OR 1.69, 95% CI 0.68 to 4.21).

CONCLUSIONS

There was substantial clinical, methodologic, and statistical heterogeneity among the studies. The scientific evidence cannot affirm a positive association between periodontitis and GDM. Future studies with different designs in distinct populations should be conducted to investigate this association.

Secretory IgA reactivity to social threat in youth: Relations with HPA, ANS, and behavior

Although the role of immune marker secretory immunoglobulin A (SIgA) in stress-related health outcomes is gaining recognition, SIgA responsiveness to acute stress has rarely been assessed in adults, and not at all in children. This study was designed to clarify developmental origins of differential immune function-related health risks by investigating youth SIgA responses to psychosocial stressors, including both normative responses and variability related to behavioral problems. Children and adolescents from a larger study (n=82) gave 6 saliva samples during a laboratory session in which they were exposed to a series of performance or interpersonal stressors. Samples were assayed for SIgA, as well as cortisol (representing hypothalamic-pituitary-adrenal axis activity) and alpha-amylase (sAA; representing autonomic nervous system activity). Behavioral problems were assessed with parent-report measures of youth internalizing and externalizing. Youth SIgA trajectories followed a normative pattern of reactivity and recovery around the stressors; however, these responses were blunted in youth with higher externalizing scores. SIgA showed differential associations with cortisol and sAA, and with positive and negative affect; whereas overall levels of SIgA related to cortisol output and positive affect, changes in SIgA over time synchronized with changes in sAA and negative affect. In contrast to SIgA, neither cortisol nor sAA related significantly to behavioral problems. Implications for the role of SIgA during psychosocial stress in the development of immune function-related health risks are discussed.

Association between Periodontitis and Alzheimer's Disease

Alzheimer's disease (AD) is a neurodegenerative disease which significantly increases with age. Its onset can be either early or late. AD is characterized by the salient inflammatory features, microglial activation, and increased levels of proinflammatory cytokines which contribute to the inflammatory status of the central nervous system (CNS). Whereas, periodontitis is a common oral infection associated with the gram negative anaerobic bacteria. Periodontitis can be marked as a "low-grade systemic disease" by release of proinflammatory cytokines into systemic circulation and elevation of C-reactive protein (CRP). Inflammation is known to play a pivotal role in both the disease process serving as a connecting link between periodontitis and AD. The present review throws a light on possible enigmatic link between AD and periodontitis. This review is designed by collecting data from PubMed database using key words like "Alzheimer's disease", "inflammation", "periodontitis", and "proinflammatory cytokines".

Potential use of gallium-doped phosphate-based glass material for periodontitis treatment

This study aimed at evaluating the potential effect of gallium-incorporated phosphate-based glasses towards periodontitis-associated bacteria, Porphyromonas gingivalis, and matrix metalloproteinase-13. Periodontitis describes a group of inflammatory diseases of the gingiva and supporting structures of the periodontium. They are initiated by the accumulation of plaque bacteria, such as the putative periodontal pathogen Porphyromonas gingivalis, but the host immune response such as elevated matrix metalloproteinases are the major contributing factor for destruction of periodontal tissues. Antibacterial assays of gallium-incorporated phosphate-based glasses were conducted on Porphyromonas gingivalis ATCC 33277 using disc diffusion assay on fastidious anaerobe agar and liquid broth assay in a modified tryptic soy broth. In vitro study investigated the effect of gallium on purified recombinant human matrix metalloproteinase-13 activity using matrix metalloproteinase assay kit. In vivo biocompatibility of gallium-incorporated phosphate-based glass was evaluated in rats as subcutaneous implants. Antibacterial assay of gallium displayed activity against Porphyromonas gingivalis (inhibition zone of 22 ± 0.5 mm compared with 0 mm for control glass, c-PBG). Gallium in the glass contributed to growth inhibitory effect on Porphyromonas gingivalis (up to 1.30 reductions in log 10 values of the viable counts compared with control) in a modified tryptic soy broth. In vitro study showed gallium-incorporated phosphate-based glasses inhibited matrix metalloproteinase activity significantly ( p ≤ 0.01) compared with c-PBG. Evaluation of in vivo biocompatibility of gallium-incorporated phosphate-based glasses in rats showed a non-toxic and foreign body response after 2 weeks of implantation. The results indicate that gallium ions might act on multiple targets of biological mechanisms underlying periodontal disease. Moreover, gallium-incorporated phosphate-based glasses are biocompatible in a rat model. The findings warrant further investigation and will have important clinical implications in the future treatment and management of periodontitis.

Iron- and hemin-dependent gene expression of Porphyromonas gingivalis

Although iron under anaerobic conditions is more accessible and highly reactive because of its reduced form, iron-dependent regulation is not well known in anaerobic bacteria. Here, we investigated iron- and hemin-dependent gene regulation in Porphyromonas gingivalis, an established periodontopathogen that primarily inhabits anaerobic pockets. Whole-genome microarrays of P. gingivalis genes were used to compare the levels of gene expression under iron-replete and iron-depleted conditions as well as under hemin-replete and hemin-depleted conditions. Under iron-depleted conditions, the expression of genes encoding proteins that participate in iron uptake and adhesion/invasion of host cells was increased, while that of genes encoding proteins involved in iron storage, energy metabolism, and electron transport was decreased. Interestingly, many of the genes with altered expression had no known function. Limiting the amount of hemin also resulted in a reduced expression of the genes encoding proteins involved in energy metabolism and electron transport. However, hemin also had a significant effect on many other biological processes such as oxidative stress protection and lipopolysaccharide synthesis. Overall, comparison of the data from iron-depleted conditions to those from hemin-depleted ones showed that although some regulation is through the iron derived from hemin, there also is significant distinct regulation through hemin only. Furthermore, our data showed that the molecular mechanisms of iron-dependent regulation are novel as the deletion of the putative Fur protein had no effect on the expression of iron-regulated genes. Finally, our functional studies demonstrated greater survivability of host cells in the presence of the iron-stressed bacterium than the iron-replete P. gingivalis cells. The major iron-regulated proteins encoded by PG1019-20 may play a role in this process as deletion of these sequences also resulted in reduced survival of the bacterium when grown with eukaryotic cells. Taken together, the results of this study demonstrated the utility of whole-genome microarray analysis for the identification of genes with altered expression profiles during varying growth conditions and provided a framework for the detailed analysis of the molecular mechanisms of iron and hemin acquisition, metabolism and virulence of P. gingivalis.

A comparison of female and male oral health in skeletal populations from late Roman Britain: implications for diet

OBJECTIVES

Textual sources from the Roman period point to the existence of dietary differences between the sexes. The aim of this study was to assess the palaeopathological evidence for such gender differences in dietary habits in Roman Britain by comparing the oral health of sexed individuals from two late Romano-British sites (Ancaster, Lincolnshire, and Winchester, Hampshire, England).

MATERIALS AND METHODS

Eighty-seven females (1243 teeth and 1950 sockets) and 112 males (1984 teeth and 2903 sockets) were examined for the presence of five dento-alveolar conditions, namely caries, calculus, periapical lesions, periodontal disease, and antemortem tooth loss. The frequency of each condition was calculated at the per individual and per tooth/socket level, and the results were compared between the sexes using Fisher's exact tests.

RESULTS

Caries and antemortem tooth loss were slightly more common among women, but differences between the sexes were generally not significant. Males experienced higher rates of calculus and periodontal disease. There were no sex differences in the frequency of periapical lesions.

CONCLUSIONS

Comparable rates of caries, periapical lesions and antemortem tooth loss in females and males indicate broad similarity in the diets of men and women. The greater levels of calculus and periodontal disease in males might point to some dietary differences, but could also be explained by non-dietary factors. Overall, the findings suggest that significant gender differences in diet, described in some contemporaneous textual sources, were not widely observed in Roman Britain.

[Doxycycline or how to create new with the old?]

Tetracyclines are broad-spectrum antibiotics that interfere with protein synthesis. They were first widely prescribed by dermatologists in the early 1950s in the treatment of acne. More recently, their biological actions on inflammation, proteolysis, angiogenesis, apoptosis, metal chelation, ionophoresis, and bone metabolism were studied. Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes that degrade components of the extracellular matrix (ECM). MMPs have direct or indirect effects on the vascular endothelium and the vascular relaxation/contraction system. The therapeutic effects of tetracyclines and analogues were studied in rosacea, bullous dermatoses, neutrophilic diseases, pyoderma gangrenosum, sarcoidosis, aortic aneurysms, cancer metastasis, periodontitis and autoimmune diseases autoimmune diseases such as rheumatoid arthritis and scleroderma. In addition, downregulation of MMP using doxycycline could be beneficial in reducing vascular dysfunction mediated by MMPs and progressive damage of the vascular wall. We review the nonantibiotic properties of doxycycline and its potential clinical applications.

Severity of periodontitis in patients with isolated coronary artery ectasia

The concept that coronary artery ectasia (CAE) is an inflammatory-related disease has been increasingly recognized. Periodontitis induced low-grade chronic systemic inflammation has been shown to be associated with cardiovascular diseases. The aim of the present study was to evaluate the association between periodontitis and CAE.Thirty-two patients with isolated CAE, and 28 age, sex and smoking status-matched subjects with normal coronary arteries (NCA) underwent full dental examinations. Periodontal disease was evaluated using the following clinical parameters; number of remaining teeth, plaque index (PI), gingival index (GI), bleeding on probing (BOP), and pocket depth (PD).Cases and controls did not differ according to their baseline characteristics and prevalence of traditional cardiovascular risk factors. Patients with isolated CAE had higher periodontal indices when compared to subjects with NCA (PD: 3.6 ± 1.26 mm versus 2.3 ± 0.79 mm; GI: 2.29 ± 0.86 versus 1.43 ± 1.19; BOP (%): 52.18 ± 20.1 versus 27.8 ± 10.9, P < 0.001, P < 0.05 and P < 0.05, respectively). Moreover, in multivariate analysis higher values for PD were found to be significant predictors for the likelihood of having coronary ectasia.The results of the present study demonstrate for the first time that there is an association between periodontitis and isolated CAE.

Relationship between Type 2 Diabetic Retinopathy and Periodontal Disease in Iranian Adults

Background:

Periodontal disease in diabetic patients can compromise a patient's ability to maintain a proper metabolic control and may be associated with diabetic complication.

Aims:

This study was designed to evaluate the frequency of periodontal disease in patients with type 2 diabetes mellitus (DM) and how this was related with the presence of diabetic retinopathy (DR).

Materials and Methods:

A comparison was made of periodontal parameters (plaque index (PI), community periodontal index of treatment needs (CPITN), periodontal disease severity measured in quartiles of probing depth (PD), and clinical attachment loss (CAL)) in a group of diabetic patients with retinopathy (n = 84) versus a group of diabetic patients without retinopathy (n = 129). In addition, 73 age- and sex-matched individuals were selected to serve as the control group. Analysis was performed to evaluate the relationships between periodontal disease and DR.

Results:

In terms of PI, no statistically significant differences were observed, so, oral hygiene was similar in both groups. Diabetic patients with retinopathy had greater CPITN (P < 0.001) and more severe periodontal disease (P < 0.001) than no retinopathy. Also, our results indicated a relationship between type 2 DM and periodontal disease.

Conclusions:

The patients with diabetes retinopathy appear to show increased periodontal disease susceptibility.

A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes

Background

Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized controlled trial (RCT) has examined if treating periodontal disease before pregnancy reduces adverse birth outcomes. This study aims to examine if the pre-conception treatment of periodontal disease will lead to improved periodontal status during late pregnancy and subsequent birth outcomes.

Methods/Design

A sample of 470 (235 in each arm of the study) pre-conception women who plan to conceive within one year and with periodontal disease will be recruited for the study. All participants will be randomly allocated to the intervention or control group. The intervention group will receive free therapy including dental scaling and root planning (the standard therapy), supragingival prophylaxis, and oral hygiene education. The control group will only receive supragingival prophylaxis and oral hygiene education. Women will be followed throughout their pregnancy and then to childbirth. The main outcomes include periodontal disease status in late pregnancy and birth outcomes measured such as mean birth weight (grams), and mean gestational age (weeks). Periodontal disease will be diagnosed through a dental examination by measuring probing depth, clinical attachment loss and percentage of bleeding on probing (BOP) between gestational age of 32 and 36 weeks. Local and systemic inflammatory mediators are also included as main outcomes.

Discussion

This will be the first RCT to test whether treating periodontal disease among pre-conception women reduces periodontal disease during pregnancy and prevents adverse birth outcomes. If the effect of pre-pregnancy periodontal treatment is confirmed, this intervention could be recommended for application in low- or middle-income countries to improve both oral health and maternal and child health.

Trial registration

This trial is registered with Chinese Clinical Trial Registry (ChiCTR): ChiCTR-TRC-12001913.

Evaluation of an oral health scale of infectious potential using a telematic survey of visual diagnosis

Objective: To compare the results of a subjective estimation of oral health through review of a set of intraoral photographs with those of an objective oral health scale of infectious potential. Method: The pool of patients was made up of 100 adults. Using an infectious-potential scale based on dental and periodontal variables, we assigned 1 of the 4 grades of the scale (range, 0 to 3; 0 corresponds to an excellent oral health status and 3 to the poorest oral health status) to each subject. A total of 20 representative subjects were selected from the pool of patients, 5 subjects for each one of the grades of the scale, and a standardized photographic record was made. One thousand dentists practicing in Spain were sent the survey by e-mail and 174 completed forms were received. We then calculated the concordance of the oral health status indicated by the respondents after visualising the photographs on comparison with the results of the oral health scale of infectious potential; concordance was termed correct grade allocation (CGA). Results: The majority of respondents (69.1%) achieved a CGA in 8 to 12 cases and none achieved more than 15 CGAs. The poorest CGA rates were found with grades 1 and 2, with a mean of 1.74 ± 1.09 and 1.87 ± 1.18, respectively, out of a maximum of 5. The concordance in terms of CGA was high for grade 0 (70.5%), very low for grade 1 (10.8%), low for grade 2 (37.3%), and moderate for grade 3 (42.6%). Conclusion: In comparison with visual examination of the oral cavity, the use of objective scale that establishes a reliable diagnosis of oral health in terms of infectious potential was found to be advantageous.

Key words:Diagnosis, intraoral photographies, oral health scale, objective estimation, visual examination.

Insights into the virulence of oral biofilms: discoveries from proteomics

This review covers developments in the study of polymicrobial communities, biofilms and selected areas of host response relevant to dental plaque and related areas of oral biology. The emphasis is on recent studies in which proteomic methods, particularly those using mass spectrometry as a readout, have played a major role in the investigation. The last 5-10 years have seen a transition of such methods from the periphery of oral biology to the mainstream, as in other areas of biomedical science. For reasons of focus and space, the authors do not discuss biomarker studies relevant to improved diagnostics for oral health, as this literature is rather substantial in its own right and deserves a separate treatment. Here, global gene regulation studies of plaque-component organisms, biofilm formation, multispecies interactions and host-microbe interactions are discussed. Several aspects of proteomics methodology that are relevant to the studies of multispecies systems are commented upon.

Assessment of serum levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in periodontitis patients

BACKGROUND AND OBJECTIVES

Periodontal disease is a destructive inflammatory disease inducing profound changes in the plasma concentrations of cytokines leading to a catabolic state characterized by altered lipid metabolism and hypertriglyceridemia. The main objective of the present study was to evaluate the effect of periodontal infection on serum levels of triglycerides (TGL), total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol.

MATERIALS AND METHODS

A sample of 90 subjects; 30 periodontally healthy individuals, 30 chronic gingivitis cases (n=30), and 30 chronic periodontitis cases (n=30) with an age range of 25 to 65 years were included in the study. Periodontal parameters including Plaque Index, Gingival Index, Probing Depth, and Clinical Attachment Level were recorded. Venous blood samples were obtained after 12 hours fasting period from antecubital vein and serum levels of TGL, TC, HDL, and LDL cholesterol were measured.

RESULTS

The levels of TGL, TC, and LDL cholesterol were significantly higher for periodontitis group (P<0.05) as compared to gingivitis and periodontally healthy groups. HDL cholesterol levels were significantly lower in periodontitis group (P<0.05) as compared to periodontally healthy and gingivitis groups.

CONCLUSION

The results of the present study indicate that periodontal infection has a definite role in altering lipid metabolism leading to hyperlipidemia. However, further studies are required to clarify the relationship between periodontitis and serum lipid levels and to determine whether oral healthcare has the potential to reduce serum lipid levels in otherwise systemically healthy individuals.

Periodontal disease as a potential risk factor for the development of diabetes in women with a prior history of gestational diabetes mellitus

OBJECTIVE

To examine if periodontal disease is associated with later development of impaired glucose metabolism in women with a recent history of gestational diabetes (GDM).

METHODS

Women with (n = 19) and without (n = 20) a history of GDM were prospectively followed at 22 months postpartum. All subjects underwent: a) a 75-gram oral glucose tolerance test (OGTT); and b) an oral examination for measuring periodontal disease. Insulin sensitivity and pancreatic β-cell secretory capacity derived from fasting (HOMA-IR) and glucose-stimulated measures (SI(OGTT) and IGI/HOMA-IR) were determined. Periodontitis was defined as the presence of any site with a probing depth ≥ 4 mm or a clinical attachment loss ≥ 4 mm.

RESULTS

Compared to women without a history of GDM, prior GDM women had significantly higher fasting glucose and insulin concentrations, increased insulin resistance and decreased β-cell function. Although not statistically significant, prior GDM women had a higher prevalence of periodontal disease (42.1%) than women without a history of GDM (25.0%). Women with periodontal disease showed greater insulin resistance and lower β-cell function. Women with both prior GDM and periodontal disease had the most impaired glucose metabolism; the insulin secretion-sensitivity index was significantly lower in women with both prior GDM and periodontal disease (208.20 ± 2.60) than in women without prior GDM and periodontal disease (742.93 ± 1.78) (P < 0.05).

CONCLUSIONS

Women with prior GDM show reduced insulin sensitivity and inadequate β-cell secretory function at 22 months postpartum. Periodontal disease may contribute to their impaired glucose metabolism and future risk of developing diabetes.

Predictive power of the severity measure of attachment loss for periodontal care need

BACKGROUND

The prevalence of periodontal diseases is high, and >15% of adults have severe gum disease. Clinical attachment loss (AL) is one of the most important measures for periodontal disease severity. With AL, one could measure the worst scenario, the average, or the cumulative sum of AL among all teeth. The objective of this study is to evaluate which of the 15 measures of periodontal problems (e.g., maximum, mean, and cumulative AL) best predict the need for periodontal treatment.

METHODS

Using detailed periodontal data obtained through clinical examination from the National Health and Nutrition Examination Survey 1999 to 2002, weighted logistic regression was used to model the periodontal treatment need of 15 different periodontal disease measures. The outcome measure is the clinically determined periodontal need.

RESULTS

After adjustment for the covariates of age, sex, ethnicity, education, smoking status, and diabetes, the three most predictive measures were identified as: 1) the sum of the maximum mid-buccal (B) and mesio-buccal (MB) measures, which reflects the worst case of both B and MB measures; 2) the sum of the maximum MB measure or the worst case of the MB measure; and 3) the sum of all B and MB measures, or the cumulative AL measures.

CONCLUSIONS

Cumulative periodontal morbidity, particularly the worst case of B and MB measures, has the strongest impact on the need for periodontal care. All the demographic variables and covariates follow the classic pattern of association with periodontal disease.

Adiponectin regulates functions of gingival fibroblasts and periodontal ligament cells

BACKGROUND AND OBJECTIVE

Adiponectin is a cytokine constitutively produced by adipocytes and exhibits multiple biological functions by targeting various cell types. However, the effects of adiponectin on primary gingival fibroblasts and periodontal ligament cells are still unexplored. Therefore, we investigated the effects of adiponectin on gingival fibroblasts and periodontal ligament cells.

MATERIAL AND METHODS

The expression of adiponectin receptors (AdipoR1 and AdipoR2) on human gingival fibroblasts (HGFs), mouse gingival fibroblasts (MGFs) and human periodontal ligament (HPDL) cells was examined using RT-PCR and western blotting. HGFs and MGFs were stimulated with interleukin (IL)-1β in the presence or absence of adiponectin, and the expression of IL-6 and IL-8 at both mRNA and protein levels was measured by real-time PCR and ELISA, respectively. Furthermore, small interfering RNAs (siRNAs) in MGFs were used to knock down the expression of mouse AdipoR1 and AdipoR2. The effects of adiponectin on the expression of alkaline phosphatase (ALP) and runt-related transcription factor 2 (Runx2) genes were evaluated by real-time PCR. Mineralized nodule formation of adiponectin-treated HPDL cells was revealed by Alizarin Red staining.

RESULTS

AdipoR1 and AdipoR2 were expressed constitutively in HGFs, MGFs and HPDL cells. Adiponectin decreased the expression of IL-6 and IL-8 in IL-1β-stimulated HGFs and MGFs. AdipoR1 siRNA in MGFs revealed that the effect of adiponectin on reduction of IL-6 expression was potentially mediated via AdipoR1. Adiponectin-treated HPDL cells promoted the expression of ALP and Runx2 mRNAs and up-regulated ALP activity. Furthermore, adiponectin enhanced mineralized nodule formation of HPDL cells.

CONCLUSION

Our observations demonstrate that adiponectin exerts anti-inflammatory effects on HGFs and MGFs, and promotes the activities of osteoblastogenesis of HPDL cells. We conclude that adiponectin has potent beneficial functions to maintain the homeostasis of periodontal health, improve periodontal lesions, and contribute to wound healing and tissue regeneration.

Porphyromonas gingivalis accelerates atherosclerosis in C57BL/6 mice fed a high-fat diet

OBJECTIVE

Porphyromonas gingivalis has been shown to accelerate atherosclerotic lesion development in atherosclerotic apo E-deficient mice. Here, we investigated whether repeated P. gingivalis injection affected the inflammatory and atherosclerotic responses of C57BL/6 mice fed a high-fat diet (HFD).

MATERIALS AND METHODS

Eight-week-old C57BL/6 mice fed either HFD or a regular chow diet (RD) were inoculated intravenously with P. gingivalis or phosphate-buffered saline three times per week for 10 weeks and sacrificed at 19 weeks of age. Atheromatous lesions in the proximal aorta of each animal were analyzed histomorphometrically, and the serum cytokine and C-reactive protein (CRP) levels were determined.

RESULTS

Long-term HFD feeding as compared to RD feeding led to a slight increase in atheromatous lesions in the aortic sinus as well as increases in the levels of serum monocyte chemoattractant protein 1. Further, P. gingivalis injection significantly enhanced the formation of atherosclerotic plaque, and increased CRP and inflammatory cytokine levels, in mice fed the HFD, although no further increase in LDL was observed.

CONCLUSION

These results suggest that bacteremia-induced by repeated injection with P. gingivalis accelerates atherosclerosis in normal C57BL/6 mice by initiating inflammation, and is therefore implicated in chronic infection-related pathogenicity.

Causal relationship between periodontitis and chronic obstructive pulmonary disease

CONTEXT

Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases. An association between periodontal disease and chronic obstructive pulmonary disease (COPD) has been observed.

AIMS

The aim of the present study was to evaluate the potential association between periodontal health and COPD and to assess the potential health status of patients with and without COPD.

SETTINGS AND DESIGN

In this observational study, the association between periodontal disease and COPD has been assessed.

MATERIALS AND METHODS

HUNDRED PATIENTS WERE CHOSEN FOR THE STUDY: group A comprising 50 COPD patients and group B consisting of 50 patients without COPD. Gingival Index (GI) and Papilla Bleeding Index (PBI) were used to assess the gingival status. Periodontal indices included Russell's Periodontal Index (PI) and Periodontal Index for Risk of Infectiousness (PIRI), which were assessed in all 100 patients. Analysis of covariance (ANCOVA) was the statistical analysis used.

RESULTS

After eliminating age affects using ANCOVA, the mean indices of all variables between groups were found to be highly significant (P<0.001). The scores were highly significant in COPD group than in non-COPD group.

CONCLUSIONS

The findings of the present study show that there is an association between periodontal disease and COPD. It is suggested that periodontitis is one of the risk factors for COPD.

The oral microbiome in health and disease and the potential impact on personalized dental medicine

Every human body contains a personalized microbiome that is essential to maintaining health but capable of eliciting disease. The oral microbiome is particularly imperative to health because it can cause both oral and systemic disease. The oral microbiome rests within biofilms throughout the oral cavity, forming an ecosystem that maintains health when in equilibrium. However, certain ecological shifts in the microbiome allow pathogens to manifest and cause disease. Severe forms of oral disease may result in systemic disease at different body sites. Microbiomics and metagenomics are two fields of research that have emerged to identify the presence of specific microbes in the body and understand the nature of the microbiome activity during both health and disease. The analysis of the microbiome and its genomes will pave the way for more effective therapeutic and diagnostic techniques and, ultimately, contribute to the development of personalized medicine and personalized dental medicine.

Risk factors for chronic kidney diseases may include periodontal diseases, as estimated by the correlations of plasma pentraxin-3 levels: a case-control study

BACKGROUND

Pentraxins are classical mediators of inflammation and markers of acute-phase reactions. Pentraxin-3 (PTX3) is believed to be a true independent indicator of disease activity. It has been associated with clinical outcomes in incident chronic kidney disease (CKD) and periodontal diseases. Periodontitis is lately being considered as a risk factor for CKD. However, no data are available on elevated PTX3 in patients with CKD associated with periodontitis.

METHOD

Sixty subjects were divided into three groups (n = 20) based on glomerular filtration rate (GFR) and periodontal parameters: healthy (group-1), CKD (group-2), and CKD with periodontitis (group-3). Plasma samples obtained from each patient were quantified for PTX3 using Enzyme-linked Immunosorbent Assay (ELISA).

RESULTS

Both patient groups with CKD had higher plasma PTX3 concentrations than control subjects. However, there was no significant difference between the two groups (groups 2 and 3). In all groups, plasma PTX3 correlated positively with periodontal parameters. Group 3 patients had higher concentrations of PTX3 (6.338 ng/ml) than group 2 (5.41 ng/ml) and group 1 (1.835 ng/ml).

CONCLUSIONS

Within the limits of the present study, the difference in plasma PTX3 levels between groups 2 and 3 was not found to be statistically significant (P > 0.05). However, as PTX3 values correlated positively with periodontal parameters, this model could contribute to identifying individuals with periodontitis at high risk of CKD. Thus, periodontal disease could serve as a risk factor for developing CKD. Further large-scale studies nullifying the confounders for CKD are warranted to confirm positive results.

Association between Periodontopathogens and CRP Levels in Patients with Periodontitis in Serbia

Background and aims

Recent epidemiological studies have shown that individuals with periodontitis have a significantly higher risk of developing coronary heart disease, which might be attributed to the complex microbiota in the dental plaque. Periodontopathogens have been reported as risk factors for cardiovascular disease. This study evaluated association of chronic periodontitis and periodontopathogens with CRP in systemically healthy Serbian adults.

Materials and methods

Serum C-reactive protein levels were measured in 24 patients with moderate periodontitis, 26 patients with severe periodontitis, and 25 periodontally healthy subjects. Periodontal health indicators included gingival bleeding on probing and periodontal disease status. Patients with moderate periodontitis had low attachment loss and pocket depths of <4 mm. Patients with severe periodontitis had high AL and pocket depth of >5 mm. The control group with healthy gingiva had gingival sulcus of <2 mm and no attachment loss. Presence of periodontopathogens in subgingival plaque samples was analyzed by polymerase chain reaction.

Results

The periodontal parameters and CRP levels were significantly higher in the patients with periodontitis. Patients who had both severe and moderate periodontitis had higher mean CRP levels. The percentage of subjects with elevated CRP leves of >5 mol/L was greater in the higher clinical AL group compared to the group with less attachment loss. Presence of periodontopathogens was also associated with elevated CRP levels and poor periodontal status.

Conclusion

PD and subgingival periodontopathogens are associated with increased CRP levels. These findings suggest that periodontal infection may contribute to systemic inflammatory burden in otherwise healthy individuals.