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Woelber JP, Tennert C, Ernst SF, Vach K, Ratka-Krüger P, Bertz H, Urbain P. Effects of a Non-Energy-Restricted Ketogenic Diet on Clinical Oral Parameters. An Exploratory Pilot Trial. Nutrients 2021; 13:nu13124229. [PMID: 34959780 PMCID: PMC8703871 DOI: 10.3390/nu13124229] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 01/01/2023] Open
Abstract
Ketogenic diets (KDs) may be a helpful complement in the prevention of and therapy for several diseases. Apart from their non-cariogenic properties, it is still unclear how KDs affect oral parameters. The aim of this study was to investigate the influence of a KD on clinical periodontal parameters. Twenty generally healthy volunteers with an average age of 36.6 years underwent a KD for 6 weeks. Their compliance was monitored by measuring their urinary ketones daily and by keeping 7-day food records. Clinical oral parameters included plaque (PI), gingival inflammation (GI), a complete periodontal status (probing depths, bleeding on probing), and general physical and serologic parameters at baseline and after 6 weeks. The results showed a trend towards lower plaque values, but with no significant changes from baseline to the end of the study with regard to the clinical periodontal parameters. However, their body weight and BMI measurements showed a significant decrease. The regression analyses showed that the fat mass and the BMI were significantly positively correlated to periodontal inflammation, while HDL, fiber, and protein intake were negatively correlated to periodontal inflammation. The KD change did not lead to clinical changes in periodontal parameters in healthy participants under continued oral hygiene, but it did lead to a significant weight loss.
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Affiliation(s)
- Johan Peter Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; si.- (S.F.E.); (P.R.-K.)
- Correspondence:
| | - Christian Tennert
- Department of Restorative, Preventive and Pediatric Dentistry, University of Berne, Freiburgstrasse 7, 3010 Bern, Switzerland;
| | - Simon Fabian Ernst
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; si.- (S.F.E.); (P.R.-K.)
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Zinkmattenstr. 6A, 79108 Freiburg, Germany;
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; si.- (S.F.E.); (P.R.-K.)
| | - Hartmut Bertz
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (H.B.); (P.U.)
| | - Paul Urbain
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (H.B.); (P.U.)
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Bartha V, Exner L, Schweikert D, Peter Woelber J, Vach K, Meyer AL, Basrai M, Bischoff SC, Meller C, Wolff D. Effect of the Mediterranean diet on gingivitis: A randomized controlled trial. J Clin Periodontol 2021; 49:111-122. [PMID: 34818686 DOI: 10.1111/jcpe.13576] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/03/2021] [Accepted: 11/12/2021] [Indexed: 12/12/2022]
Abstract
AIM This study aimed to investigate the effects of a 6-week Mediterranean diet (MD) intervention on gingival inflammatory and anthropometric parameters of patients with gingivitis. MATERIALS AND METHODS Forty-two participants were allocated to MD group (MDG) or control group (CG). After a 2-week equilibration period regarding dental care procedures, only MDG changed their diet to MD for 6 weeks, supported by a diet counselling. Gingival and anthropometric parameters were assessed at baseline (T0), Week 2 (T1, beginning of MD intervention), and Week 8 (T2). Adherence to MD was assessed by the Mediterranean Diet Adherence Screener (MEDAS); dietary behaviour was evaluated by the German Health Interview and Examination Survey for Adults Food Frequency Questionnaire (DEGS-FFQ). RESULTS Plaque values remained constant in both groups. Inflammatory periodontal and anthropometric parameters decreased in the MDG only (gingival index: T1 1.51 ± 0.21, T2 1.49 ± 0.24; bleeding on probing: T1 51.00 ± 14.65, T2 39.93 ± 13.74; body weight: T1 79.01 ± 15.62, T2 77.29 ± 17.00; waist circumference: T1 84.41 ± 10.1, T2 83.17 ± 10.47 (p < .05). MEDAS revealed a sufficient diet adherence for MDG. CONCLUSION Within this study, gingival inflammatory parameters were significantly reduced by MD, whereas plaque parameters remained constant. The diet counselling achieved sufficient adherence with beneficial changes in weight loss and waist circumference.
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Affiliation(s)
- Valentin Bartha
- Department for Conservative Dentistry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Lea Exner
- Department for Conservative Dentistry, University Hospital of Tübingen, Tuebingen, Germany
| | - Daniela Schweikert
- Nutrition Support Team, University Hospital of Tuebingen, Tuebingen, Germany
| | - Johan Peter Woelber
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Anna-Lisa Meyer
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Maryam Basrai
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Christian Meller
- Department for Conservative Dentistry, University Hospital of Tübingen, Tuebingen, Germany
| | - Diana Wolff
- Department for Conservative Dentistry, University Hospital of Heidelberg, Heidelberg, Germany
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53
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Lenk M, Noack B, Weidner K, Lorenz K. Psychopathologies and socioeconomic status as risk indicators for periodontitis: a survey-based investigation in German dental practices. Clin Oral Investig 2021; 26:2853-2862. [PMID: 34748106 PMCID: PMC8898229 DOI: 10.1007/s00784-021-04263-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/26/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Periodontitis is a highly prevalent multifactorial disease associated with various mental disorders. However, study results about this association are still contradictory. One methodological reason could be the neglect of potential confounders, such as socioeconomic factors or mental comorbidity. Our study examined a wide range of potential psychosocial risk indicators to identify those with relevant associations to periodontitis. MATERIALS AND METHODS In a cross-sectional study, 111 patients with periodontitis (PERIO) (> 30% teeth with approximal attachment loss ≥ 5 mm) and 110 patients without periodontitis (NON-PERIO) were recruited in four dental practices in Germany. Clinical attachment loss, pocket depth, plaque, bleeding on probing, and DMFT were measured. Psychopathologic symptoms and socioeconomic status were recorded using self-report questionnaires (DAS, PHQ-8, GAD-7, CTS, SCOFF, AUDIT, FTND, SSS-8, SES). RESULTS The PERIO group reported significantly lower socioeconomic status (Cohen's d = 0.49) and higher psychopathological symptom burden than the NON-PERIO regarding dental anxiety (d = 0.86) and avoidance behavior, nicotine dependency (d = 0.84), depressiveness (d = 0.46), general anxiety (d = 0.45), somatic symptoms (d = 0.42), and childhood traumatization (d = 0.34). No significant group differences existed for alcohol abuse and eating disorders. Dental anxiety was the strongest predictor of periodontitis and showed significant correlations with other psychopathologies and social status. CONCLUSIONS Out of all psychosocial factors, socioeconomic status and dental anxiety showed the greatest association with periodontitis. CLINICAL RELEVANCE Dentists should encourage socially disadvantaged and dentally anxious patients in the utilization of prevention and dental care. Furthermore, physicians and psychotherapists can contribute to the early detection of dental anxiety, oral diseases, and avoidance behavior.
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Affiliation(s)
- Maria Lenk
- Department of Psychotherapy and Psychosomatics, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Barbara Noack
- Department of Periodontology, Technische Universität Dresden, Fetscherstr, 74, 01307, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatics, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Katrin Lorenz
- Department of Periodontology, Technische Universität Dresden, Fetscherstr, 74, 01307, Dresden, Germany.
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Ganesan SM, Vazana S, Stuhr S. Waistline to the gumline: Relationship between obesity and periodontal disease-biological and management considerations. Periodontol 2000 2021; 87:299-314. [PMID: 34463987 DOI: 10.1111/prd.12390] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Obesity is a pandemic and periodontitis is the sixth most prevalent disease in the world. These two noncommunicable diseases share several risk determinants. Epidemiologic evidence from the last 2 decades has established an increase in periodontitis prevalence in obese and overweight individuals. Biologic mechanisms potentially linking obesity and periodontal disease are adiposity-associated hyperinflammation, microbial dysbiosis, altered immune response, specific genetic polymorphisms, and increased stress. However, because of the lack of longitudinal interventional studies and randomized clinical trials, there is insufficient evidence to determine the cause-effect relationship between these two diseases. Despite this, the negative impact of obesity on oral health is well established. Several logistic and physiologic complications are associated with treating obese patients in a dental setting, and it requires an interprofessional team approach. Oral health care professionals need to be aware of the specific management considerations while rendering for this cohort, including modified practice facility and equipment, tailored supportive periodontal therapy, and heightened precaution during conscious sedation and surgical procedures.
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Affiliation(s)
- Sukirth M Ganesan
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Stephanie Vazana
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Sandra Stuhr
- Department of Periodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
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Bidinotto AB, Martinez-Steele E, Thomson WM, Hugo FN, Hilgert JB. Investigation of direct and indirect association of ultra-processed food intake and periodontitis. J Periodontol 2021; 93:603-612. [PMID: 34337743 DOI: 10.1002/jper.21-0274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Ultra-processed foods are associated with both sugar intake and non-communicable diseases. We aimed to assess whether the intake of ultra-processed food is associated with periodontal disease and whether this association, if present, is dependent on non-communicable diseases. METHODS This analysis used data from cycles 2009 to 2010, 2011 to 2012, and 2013 to 2014 of the National Health and Nutrition Examination Survey (NHANES), including participants aged 30 years or older. Dietary recalls were categorized according to the NOVA classification, and total contribution of ultra-processed foods to daily energy intake (%E) was calculated. Cases of periodontitis were defined as moderate or severe according to the CDC working group criteria for use in population surveillance of periodontitis. Adjustment variables to estimate total and direct associations were defined with directed acyclic graphs. Odds ratios were estimated with logistic regression for moderate/severe periodontitis and severe periodontitis, and ordinal logistic regression for the trichotomized outcome. Analyses were performed using NHANES fasting subsample weights. RESULTS Sample participants numbered 4809 (52.2% female), with a mean age of 52.1 years (SE, 0.3). The prevalence of periodontal disease was 27.8% for moderate and 6.5% for severe cases. Mean %E from ultra-processed foods was 54.4 (SE, 0.5). No significant crude, direct, or total association between ultra-processed %E and periodontal disease was found. CONCLUSION Intake of ultra-processed foods is not associated with periodontal disease in US non-institutionalized adults over 30 years old, whether directly or by mediation.
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Affiliation(s)
- Augusto Bacelo Bidinotto
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eurídice Martinez-Steele
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | | | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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56
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Li A, Chen Y, Schuller AA, van der Sluis LWM, Tjakkes GHE. Dietary inflammatory potential is associated with poor periodontal health: A population-based study. J Clin Periodontol 2021; 48:907-918. [PMID: 33899265 PMCID: PMC8251843 DOI: 10.1111/jcpe.13472] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/18/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022]
Abstract
Aim To investigate the association between dietary inflammatory potential and poor periodontal health. Material and Methods A cross‐sectional analysis of a nationally representative sample of participants was performed. NHANES 2011–2014 (n = 7081) and NHANES 2001–2004 (n = 5098) were used as discovery and validation datasets, respectively. The energy‐adjusted dietary inflammatory index (E‐DII) score was calculated for each participant based on 24‐h dietary recalls to assess diet‐associated inflammation. Periodontitis was defined by the CDC/AAP using clinical periodontal parameters. Natural cubic spline was applied to identify any non‐linear associations of the E‐DII score with moderate/severe periodontitis. Furthermore, interaction analyses were performed by age, gender, and race/ethnicity to explore the moderating roles of these factors. Results In the discovery dataset, a non‐linear positive relationship with periodontitis was identified for the E‐DII score (pnon‐linearity < .001) after adjustment for potential confounders. Compared with those individuals in the lowest tertile of E‐DII, participants in the highest tertile who consumed a pro‐inflammatory diet were 53% more likely to be periodontitis (OR tertile3vs1 = 1.53, 95% CI: 1.33–1.77). The validation dataset showed similar associations. Relatively stronger associations were seen in older adults and males. Conclusion Consuming a pro‐inflammatory diet indicated by the E‐DII score is associated with periodontal disease in the U.S. general adult population.
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Affiliation(s)
- An Li
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
| | - Yuntao Chen
- Medical Statistics and Decision Making, Department of Epidemiology, UMCG, University of Groningen, Groningen, the Netherlands
| | - Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands.,Department of Child Health, the Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Luc W M van der Sluis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
| | - Geerten-Has E Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands
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57
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Zhang J, Sun M, Zhao Y, Geng G, Hu Y. Identification of Gingivitis-Related Genes Across Human Tissues Based on the Summary Mendelian Randomization. Front Cell Dev Biol 2021; 8:624766. [PMID: 34026747 PMCID: PMC8134671 DOI: 10.3389/fcell.2020.624766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Abstract
Periodontal diseases are among the most frequent inflammatory diseases affecting children and adolescents, which affect the supporting structures of the teeth and lead to tooth loss and contribute to systemic inflammation. Gingivitis is the most common periodontal infection. Gingivitis, which is mainly caused by a substance produced by microbial plaque, systemic disorders, and genetic abnormalities in the host. Identifying gingivitis-related genes across human tissues is not only significant for understanding disease mechanisms but also disease development and clinical diagnosis. The Genome-wide association study (GWAS) a commonly used method to mine disease-related genetic variants. However, due to some factors such as linkage disequilibrium, it is difficult for GWAS to identify genes directly related to the disease. Hence, we constructed a data integration method that uses the Summary Mendelian randomization (SMR) to combine the GWAS with expression quantitative trait locus (eQTL) data to identify gingivitis-related genes. Five eQTL studies from different human tissues and one GWAS studies were referenced in this paper. This study identified several candidates SNPs and genes relate to gingivitis in tissue-specific or cross-tissue. Further, we also analyzed and explained the functions of these genes. The R program for the SMR method has been uploaded to GitHub(https://github.com/hxdde/SMR).
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Affiliation(s)
- Jiahui Zhang
- Department of Stomatology and Dental Hygiene, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Mingai Sun
- General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, China
| | - Yuanyuan Zhao
- General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, China
| | - Guannan Geng
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yang Hu
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
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Machado V, Botelho J, Viana J, Pereira P, Lopes LB, Proença L, Delgado AS, Mendes JJ. Association between Dietary Inflammatory Index and Periodontitis: A Cross-Sectional and Mediation Analysis. Nutrients 2021; 13:nu13041194. [PMID: 33916342 PMCID: PMC8066166 DOI: 10.3390/nu13041194] [Citation(s) in RCA: 36] [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: 02/22/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 01/08/2023] Open
Abstract
Inflammation-modulating elements are recognized periodontitis (PD) risk factors, nevertheless, the association between dietary inflammatory index (DII) and PD has never been appraised. We aimed to assess the association between DII and PD and the mediation effect of DII in the association of PD with systemic inflammation. Using the National Health and Nutrition Examination Survey 2009–2010, 2011–2012 and 2013–2014, participants who received periodontal exam and provided dietary recall data were included. The inflammatory potential of diet was calculated via DII. PD was defined according to the 2012 case definition. White blood cells (WBC), segmented neutrophils and C-reactive protein (CRP) were used as proxies for systemic inflammation. The periodontal measures were regressed across DII values using adjusted multivariate linear regression and adjusted mediation analysis. Overall, 10,178 participants were included. DII was significantly correlated with mean periodontal probing depth (PPD), mean clinical attachment loss (CAL), thresholds of PPD and CAL, WBC, segmented neutrophils and DII (p < 0.01). A linear regression logistic adjusted for multiple confounding variables confirmed the association between DII and mean PPD (B = 0.02, Standard Error [SE]: 0.02, p < 0.001) and CAL (B = −0.02, SE: 0.01, p < 0.001). The association of mean PPD and mean CAL with both WBC and segmented neutrophils were mediated by DII (from 2.1 to 3.5%, p < 0.001). In the 2009–2010 subset, the association of mean CAL with serum CRP was mediated by DII (52.0%, p < 0.01). Inflammatory diet and PD may be associated. Also, the inflammatory diet significantly mediated the association of leukocyte counts and systemic inflammation with PD.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.V.); (L.B.L.); (A.S.D.); (J.J.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal;
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.V.); (L.B.L.); (A.S.D.); (J.J.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal;
- Correspondence: ; Tel.: +351-212-946-800
| | - João Viana
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.V.); (L.B.L.); (A.S.D.); (J.J.M.)
| | - Paula Pereira
- Grupo de Estudos em Nutrição Aplicada (GENA), CiiEM, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal;
| | - Luísa Bandeira Lopes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.V.); (L.B.L.); (A.S.D.); (J.J.M.)
| | - Luís Proença
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal;
- Quantitative Methods for Health Research (MQIS), CiiEM, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - Ana Sintra Delgado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.V.); (L.B.L.); (A.S.D.); (J.J.M.)
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.V.); (L.B.L.); (A.S.D.); (J.J.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal;
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Rowińska I, Szyperska-Ślaska A, Zariczny P, Pasławski R, Kramkowski K, Kowalczyk P. The Influence of Diet on Oxidative Stress and Inflammation Induced by Bacterial Biofilms in the Human Oral Cavity. MATERIALS (BASEL, SWITZERLAND) 2021; 14:1444. [PMID: 33809616 PMCID: PMC8001659 DOI: 10.3390/ma14061444] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022]
Abstract
The article is a concise compendium of knowledge on the etiology of pathogenic microorganisms of all complexes causing oral diseases. The influence of particular components of the diet and the role of oxidative stress in periodontal diseases were described. The study investigated the bacteriostatic effect of the diet of adults in in vivo and in vitro tests on the formation of bacterial biofilms living in the subgingival plaque, causing diseases called periodontitis. If left untreated, periodontitis can damage the gums and alveolar bones. Anaerobic bacteria, called periopathogens or periodontopathogens, play a key role in the etiopathogenesis of periodontitis. The most important periopathogens of the oral microbiota are bacteria of all complexes, including the red complex. The obtained results suggest the possibility of using a specific diet in the prevention and treatment of periodontal diseases-already treated as a disease of civilization. The quoted article is an innovative compilation of knowledge on this subject and it can be a valuable source of knowledge for professional hygienists, dentists, peridontologists, dentistry students and anyone who cares about proper oral hygiene. The obtained results suggest the possibility of using this type of diet in the prophylaxis of the oral cavity in order to avoid periodontitis.
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Affiliation(s)
- Ilona Rowińska
- The Medical and Social Center for Vocational and Continuing Education in Toruń, St. Jana 1/3, 87-100 Toruń, Poland; (I.R.); (A.S.-Ś.)
| | - Adrianna Szyperska-Ślaska
- The Medical and Social Center for Vocational and Continuing Education in Toruń, St. Jana 1/3, 87-100 Toruń, Poland; (I.R.); (A.S.-Ś.)
| | - Piotr Zariczny
- Toruń City Hall, Business Support Center in Toruń, ul. Marii Konopnickiej 13, 87-100 Toruń, Poland;
| | - Robert Pasławski
- Veterinary Insitute, Nicolaus Copernicus University in Toruń, str. Gagarina 7, 87-100 Toruń, Poland;
| | - Karol Kramkowski
- Department of Physical Chemistry, Medical University of Bialystok, Kilińskiego 1str, 15-089 Bialystok, Poland;
| | - Paweł Kowalczyk
- Department of Animal Nutrition, The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Instytucka 3, 05-110 Jabłonna, Poland
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Vilarrasa J, Peña M, Gumbau L, Monje A, Nart J. Exploring the relationship among dental caries, nutritional habits, and peri-implantitis. J Periodontol 2021; 92:1306-1316. [PMID: 33599333 DOI: 10.1002/jper.20-0879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND A study was made of the prevalence, co-occurrence and association among caries, nutritional habits, and peri-implant disease, with an analysis of the influence of other patient and implant factors upon peri-implant disease. METHODS The included subjects underwent a clinical examination and were asked to complete a questionnaire. Demographic data and potential lifestyle/behavioral variables were collected. Clinical and radiographic assessment allowed calculation of the decayed, missing and filled teeth (DMFT) index and peri-implant diagnosis. Uni- and multivariate multinomial logistic regression analyses were applied to identify predictors of peri-implant disease. RESULTS A total of 169 patients with 311 implants were studied. At patient level, 92.2% of the subjects presented at least one carious lesion, whereas 22.5% and 56.2% were diagnosed with peri-implantitis and mucositis, respectively. Those patients with more than two caries had a higher risk of mucositis (OR = 3.33). Statistically significant associations for peri-implantitis included full mouth periodontal indexes, sugar-rich diets, keratinized mucosa width, number of missing teeth and interproximal untreated caries or fillings adjacent to implants. CONCLUSION High caries risk profiles and mucositis/peri-implantitis tended to accumulate within subjects. A sugar-enriched diet and untreated caries or fillings adjacent to implant sites may be further considered as risk indicators of peri-implantitis.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Peña
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Laura Gumbau
- Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Hujoel PP, Kato T, Hujoel IA, Hujoel MLA. Bleeding tendency and ascorbic acid requirements: systematic review and meta-analysis of clinical trials. Nutr Rev 2021; 79:964-975. [PMID: 33517432 DOI: 10.1093/nutrit/nuaa115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
CONTEXT The World Health Organization set the recommended daily vitamin C intake, henceforth referred to as ascorbic acid (AA), on the basis of scurvy prevention. Double-blind AA depletion-repletion studies suggest that this recommended AA dose may be too low to prevent microvascular fragility. OBJECTIVES (1) To conduct a systematic review and meta-analysis of controlled clinical trials on whether AA supplementation leads to a reduced gingival bleeding tendency, a manifestation of microvascular fragility; and (2) to relate AA plasma levels to retinal hemorrhaging, another manifestation of microvascular fragility. DATA SOURCES Data were reviewed from 15 trials conducted in 6 countries with 1140 predominantly healthy participants with measures of gingival bleeding tendency, and from the National Health and Nutrition Examination Survey (NHANES) III of 8210 US residents with measures of retinal hemorrhaging. RESULTS In clinical trials, AA supplementation reduced gingival bleeding tendency when estimated baseline AA plasma levels were < 28 μmol/L (standardized mean difference [SMD], -0.83; 95%CI, -1.16 to -0.49; P < 0.002). Supplementation with AA did not unequivocally reduce gingival bleeding tendency when baseline estimated AA plasma levels were >48 μmol/L or unknown (respective standardized mean differences: -0.23, 95%CI, -0.45 to -0.01, P < 0.05; and -0.56; 95%CI: -1.19 to 0.06, P < 0.08). In NHANES III, prevalence of both retinal hemorrhaging and gingival bleeding tendency increased when AA plasma levels were within the range that protects against scurvy (11-28 μmol/L; respective prevalence ratios adjusted for age and sex: 1.47; 95%CI: 1.22-1.77; and 1.64; 95%CI: 1.32-2.03; P < 0.001 for both). CONCLUSION Consistent evidence from controlled clinical trials indicates that setting human AA requirements based on scurvy prevention leads to AA plasma levels that may be too low to prevent an increased gingival bleeding tendency. Gingival bleeding tendency and retinal hemorrhaging coincide with low AA plasma levels and thus may be reflective of a systemic microvascular pathology that is reversible with an increased daily AA intake.
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Affiliation(s)
- Philippe P Hujoel
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA.,Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Tomotaka Kato
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Isabel A Hujoel
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Margaux L A Hujoel
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Ulvik IM, Sæthre T, Bunæs DF, Lie SA, Enersen M, Leknes KN. A 12-month randomized controlled trial evaluating erythritol air-polishing versus curette/ultrasonic debridement of mandibular furcations in supportive periodontal therapy. BMC Oral Health 2021; 21:38. [PMID: 33478480 PMCID: PMC7819243 DOI: 10.1186/s12903-021-01397-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/06/2021] [Indexed: 12/22/2022] Open
Abstract
Background Due to complex morphology and limited access, the cleaning of the furcation area is extremely challenging. Therefore, novel therapeutic approaches need to be tested to potentially overcome debridement limitations. The aim of the present prospective 12-month study was to compare clinical and microbiological effects following erythritol air-polishing versus conventional mechanical debridement of furcation defects in a cohort of periodontal maintenance patients.
Methods Twenty patients with grade II mandibular molar furcation defects volunteered to enroll in this single-centre, examiner masked, randomized controlled trial. In a split-mouth study design, two furcation sites in each patient were randomly assigned to either receive subgingival debridement using erythritol air-polishing (test) or conventional ultrasonic/curette debridement (control) at baseline, and at 3, 6, 9 and 12 months. Probing depth, clinical attachment level and bleeding on probing were recorded at 3-month intervals. Subgingival microbiological samples obtained at baseline, 6 and 12 months were analyzed using checkerboard DNA–DNA hybridization. Discomfort from treatment was scored at 12 months using a visual analogue scale. The differences between treatments, and time-points, were tested using multilevel analysis (mixed effect models and robust variance estimates). Results A significant reduction in probing depth took place following both treatments (p < 0.001). Control sites experienced a significant mean gain in clinical attachment level of 0.5 mm (± 0.2) (p = 0.004), whereas a non-significant gain of 0.4 mm (± 0.3) was observed at test sites (p = 0.119). At 6 months, a significant between-treatment difference of 0.8 mm (± 0.4) was observed in favor of the control (p = 0.032). No significant between-treatment differences were observed in microbial load or composition. Notably, at 12 months patients experienced significantly less discomfort following air-polishing compared with control (p = 0.001). Conclusions The 12-month observations indicate that erythritol air-polishing and conventional mechanical debridement both support clinical improvements. A significant between-treatment difference in clinical attachment level was, however, detected in favour of control debridement at 6 months. In terms of patient comfort, erythritol air-polishing is superior. Trial Registration: The clinical trial was retrospectively registered in ClinicalTrial.gov with registration NCT04493398 (07/28/2020).
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Affiliation(s)
- Ingvild M Ulvik
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Terje Sæthre
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Dagmar F Bunæs
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Stein Atle Lie
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway
| | - Morten Enersen
- Faculty of Dentistry, Institute for Oral Biology, University of Oslo, Oslo, Norway
| | - Knut N Leknes
- Faculty of Medicine, Department of Clinical Dentistry, University of Bergen, Aarstadveien 19, 5009, Bergen, Norway.
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63
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2020; 124:274-349. [PMID: 32811666 DOI: 10.1016/j.prosdent.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/20/2023]
Abstract
This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.
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64
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Analysing the Relationship between Nutrition and the Microbial Composition of the Oral Biofilm-Insights from the Analysis of Individual Variability. Antibiotics (Basel) 2020; 9:antibiotics9080479. [PMID: 32759753 PMCID: PMC7460051 DOI: 10.3390/antibiotics9080479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 11/28/2022] Open
Abstract
The influence of a change in nutrition on the oral microbiota are discussed in literature, but usually only changes of population mean values are reported. This paper introduces simple methods to also analyse and report the variability of patients’ reactions considering data from the culture analysis of oral biofilm. The framework was illustrated by an experimental study exposing eleven participants to different nutrition schemes in five consecutive phases. Substantial inter-individual variations in the individual reactions were observed. A new coherence index made it possible to identify 14 instances where the direction of individual changes tended to coincide with the direction of the mean change with more than 95% probability. The heterogeneity in variability across different bacteria species was limited. This allowed us to develop recommendations for sample sizes in future studies. For studies measuring the concentration change of bacteria as a reaction to nutrition change, the use of replications and analysis of the variability is recommended. In order to detect moderate effects of a change in nutrition on the concentration of single bacterial taxa, 30 participants with three repetitions are often adequate. Insights into the relationship between nutrition and the microbial composition can be helpful for the development of dietary habits that promote the establishment of a healthy microbial flora and can therefore prevent the initiation of oral diseases such as caries and periodontitis.
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65
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Ramseier CA, Woelber JP, Kitzmann J, Detzen L, Carra MC, Bouchard P. Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: A systematic review. J Clin Periodontol 2020; 47 Suppl 22:90-106. [DOI: 10.1111/jcpe.13240] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Christoph A. Ramseier
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Johan P. Woelber
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
| | - Julia Kitzmann
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
- Private Practice Hamburg Germany
| | - Laurent Detzen
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
| | - Maria Clotilde Carra
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- Population‐based Epidemiologic Cohorts Unit INSERM UMS 011 Villejuif France
| | - Philippe Bouchard
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- EA 2496 Université de Paris U.F.R. of Odontology Paris France
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66
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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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67
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Magrin GL, Strauss FJ, Benfatti CAM, Maia LC, Gruber R. Effects of Short-Chain Fatty Acids on Human Oral Epithelial Cells and the Potential Impact on Periodontal Disease: A Systematic Review of In Vitro Studies. Int J Mol Sci 2020; 21:ijms21144895. [PMID: 32664466 PMCID: PMC7402343 DOI: 10.3390/ijms21144895] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 12/22/2022] Open
Abstract
Short-chain fatty acids (SCFA), bacterial metabolites released from dental biofilm, are supposed to target the oral epithelium. There is, however, no consensus on how SCFA affect the oral epithelial cells. The objective of the present study was to systematically review the available in vitro evidence of the impact of SCFA on human oral epithelial cells in the context of periodontal disease. A comprehensive electronic search using five databases along with a grey literature search was performed. In vitro studies that evaluated the effects of SCFA on human oral epithelial cells were eligible for inclusion. Risk of bias was assessed by the University of Bristol's tool for assessing risk of bias in cell culture studies. Certainty in cumulative evidence was evaluated using GRADE criteria (grading of recommendations assessment, development, and evaluation). Of 3591 records identified, 10 were eligible for inclusion. A meta-analysis was not possible due to the heterogeneity between the studies. The risk of bias across the studies was considered "serious" due to the presence of methodological biases. Despite these limitations, this review showed that SCFA negatively affect the viability of oral epithelial cells by activating a series of cellular events that includes apoptosis, autophagy, and pyroptosis. SCFA impair the integrity and presumably the transmigration of leucocytes through the epithelial layer by changing junctional and adhesion protein expression, respectively. SCFA also affect the expression of chemokines and cytokines in oral epithelial cells. Future research needs to identify the underlying signaling cascades and to translate the in vitro findings into preclinical models.
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Affiliation(s)
- Gabriel Leonardo Magrin
- Department of Oral Biology, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria; (G.L.M.); (F.J.S.)
- Department of Dentistry, Center for Education and Research on Dental Implants, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima s/n, Florianopolis 88040-900, Brazil;
| | - Franz Josef Strauss
- Department of Oral Biology, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria; (G.L.M.); (F.J.S.)
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Av. Sergio Livingstone 943, Santiago 7500566, Chile
| | - Cesar Augusto Magalhães Benfatti
- Department of Dentistry, Center for Education and Research on Dental Implants, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima s/n, Florianopolis 88040-900, Brazil;
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 325, Rio de Janeiro 21941-617, Brazil;
| | - Reinhard Gruber
- Department of Oral Biology, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria; (G.L.M.); (F.J.S.)
- Correspondence:
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68
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Kruse AB, Kowalski CD, Leuthold S, Vach K, Ratka-Krüger P, Woelber JP. What is the impact of the adjunctive use of omega-3 fatty acids in the treatment of periodontitis? A systematic review and meta-analysis. Lipids Health Dis 2020; 19:100. [PMID: 32438906 PMCID: PMC7240972 DOI: 10.1186/s12944-020-01267-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 04/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background Host modulation therapy has gained increasing interest in periodontal therapy. This systematic review aimed to evaluate the effects of adjunctive administration of omega-3 fatty acids in periodontal therapy. Methods The search strategy was determined using the “patient, intervention, comparison, outcome” model. A resulting search term was generated using keywords, and the databases were fed. The databases PubMed, Cochrane Library, and LIVIVO were used. Studies were selected for the literature review based on previously specified inclusion and exclusion criteria. Randomized, controlled, blinded studies, longitudinal studies, comparative studies, and clinical studies were included in the review. Additionally, they used omega-3 fatty acids in the treatment of periodontitis. The following parameters were observed: clinical attachment level (CAL), probing depth (PD), gingival index (GI), bleeding on probing (BOP) and plaque index (PI). A meta-analysis was performed for PD and CAL after 3 months. By analyzing the risk of bias, the validity of the results of each study was demonstrated, and its credibility and quality were assessed. Results Of 14 studies found, six were included. The results showed a significant reduction in PD and CAL compared to that in the placebo groups in four out of six involved studies, which was confirmed by the meta-analysis. In one study, a significant reduction in BOP was found. GI was significantly reduced in three included studies. PI also showed a significant reduction in three studies. Conclusions Within the study limitations, omega-3 fatty acids appear to have a positive effect on periodontal wound healing with regard to reduction in CAL and PD. Based on the results, patients receiving periodontal treatment might benefit from nutritional counseling.
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Affiliation(s)
- Anne B Kruse
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Carolyn D Kowalski
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.,Private Dental Practice zahngenehm Grenzweg 28, Reinbek, DE, Germany
| | - Sylvia Leuthold
- Private Dental Practice Dr. med. dent. Theres Wyss AG, Löwenstrasse 65 / Bahnhofplatz, Zürich, Switzerland
| | - Kirstin Vach
- Department of Medical Biometry and Medical Informatics, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Johan P Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Holde GE, Jönsson B, Oscarson N, Müller H. To what extent does smoking affect gingival bleeding response to supragingival plaque? Site‐specific analyses in a population‐based study. J Periodontal Res 2020; 55:277-286. [DOI: 10.1111/jre.12713] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/10/2019] [Accepted: 11/12/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Gro Eirin Holde
- Department of Clinical Dentistry Faculty of Health Sciences UiT the Arctic University of Norway Tromsø Norway
- The Public Dental Health Service Competence Centre of Northern Norway Tromsø Norway
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway Tromsø Norway
- Department of Periodontology Institute of Odontology The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Nils Oscarson
- Department of Clinical Dentistry Faculty of Health Sciences UiT the Arctic University of Norway Tromsø Norway
- The Public Dental Health Service Competence Centre of Northern Norway Tromsø Norway
| | - Hans‐Peter Müller
- Department of Clinical Dentistry Faculty of Health Sciences UiT the Arctic University of Norway Tromsø Norway
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Millen AE, Pavlesen S. Could Vitamin D influence risk for Periodontal Disease - to "D" or not to "D"? CURRENT ORAL HEALTH REPORTS 2020; 7:98-111. [PMID: 33457183 PMCID: PMC7810034 DOI: 10.1007/s40496-020-00253-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the literature on associations between vitamin D and periodontal disease, including its strengths and weaknesses. Future direction for continued work in this area is provided. RECENT FINDINGS Research in cross-sectional cohorts, surveys, and case-control studies provide support for a role of vitamin D in periodontal disease, especially using clinical indicators such as bleeding on probing and clinical attachment loss. However, these studies have a number of limitations. They cannot establish temporality of these associations. Most case-control studies have been limited in sample size and have inconsistent findings. A number of cross-sectional studies are restricted to select populations (e.g., persons with HIV, diabetes, rheumatoid arthritis) limiting extrapolation of findings to the general aging population.Fewer prospective studies have been conducted, and only three have examined associations using a biomarker for vitamin D that reflects exposure from all its sources (sunlight, diet and supplements). One study is limited by using self-reported measures of disease outcomes, and only two used measures of alveolar crestal height. However, of the prospective studies published, there is a suggestion that vitamin D might prevent against tooth loss. Only two randomized controlled trials have examined these associations, and they support the effects of vitamin D supplementation on prevention of tooth loss and gingival bleeding. SUMMARY We strongly suggest that new research should focus on prospective study designs with followup of participants longer than a decade and long-term clinical trials. Such studies should incorporate measures of alveolar bone loss and tooth loss with indication for reason for tooth loss. Such clinical trials should be designed to examine both the influence of vitamin D supplementation alone as well as with other nutrients (e.g., calcium) or therapeutic medications (e.g., bisphosphonates). Currently, there is no strong evidence to suggest that vitamin D protects against development of periodontal disease.
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Affiliation(s)
- Amy E Millen
- Farber Hall 270F, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY. 14214
| | - Sonja Pavlesen
- Buffalo General Medical Center 6D501, 100 High St., Department of Orthopedic Surgery, Jacobs School of Medicine and Biomedical Science, University at Buffalo, State University of New York, Buffalo, NY. 14203
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Magrin GL, Di Summa F, Strauss FJ, Panahipour L, Mildner M, Magalhães Benfatti CA, Gruber R. Butyrate Decreases ICAM-1 Expression in Human Oral Squamous Cell Carcinoma Cells. Int J Mol Sci 2020; 21:ijms21051679. [PMID: 32121422 PMCID: PMC7084181 DOI: 10.3390/ijms21051679] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 12/15/2022] Open
Abstract
Short-chain fatty acids (SCFA) are bacterial metabolites that can be found in periodontal pockets. The expression of adhesion molecules such as intercellular adhesion molecule-1 (ICAM-1) within the epithelium pocket is considered to be a key event for the selective transmigration of leucocytes towards the gingival sulcus. However, the impact of SCFA on ICAM-1 expression by oral epithelial cells remains unclear. We therefore exposed the oral squamous carcinoma cell line HSC-2, primary oral epithelial cells and human gingival fibroblasts to SCFA, namely acetate, propionate and butyrate, and stimulated with known inducers of ICAM-1 such as interleukin-1-beta (IL1β) and tumor necrosis factor-alfa (TNFα). We report here that butyrate but not acetate or propionate significantly suppressed the cytokine-induced ICAM-1 expression in HSC-2 epithelial cells and primary epithelial cells. The G-protein coupled receptor-43 (GPR43/ FFAR2) agonist but not the histone deacetylase inhibitor, trichostatin A, mimicked the butyrate effects. Butyrate also attenuated the nuclear translocation of p65 into the nucleus on HSC-2 cells. The decrease of ICAM-1 was independent of Nrf2/HO-1 signaling and phosphorylation of JNK and p38. Nevertheless, butyrate could not reverse an ongoing cytokine-induced ICAM-1 expression in HSC-2 cells. Overall, these observations suggest that butyrate can attenuate cytokine-induced ICAM-1 expression in cells with epithelial origin.
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Affiliation(s)
- Gabriel Leonardo Magrin
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, Vienna 1090, Austria; (G.L.M.); (F.D.S.); (F.-J.S.); (L.P.)
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, School of Dentistry, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima s/n, Florianopolis – SC 88040-900, Brazil;
| | - Francesca Di Summa
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, Vienna 1090, Austria; (G.L.M.); (F.D.S.); (F.-J.S.); (L.P.)
| | - Franz-Josef Strauss
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, Vienna 1090, Austria; (G.L.M.); (F.D.S.); (F.-J.S.); (L.P.)
- Department of Conservative Dentistry, School of Dentistry, University of Chile, Av. Sergio Livingstone 943, Santiago 7500566, Chile
- Clinic of Reconstructive Dentistry, University of Zurich, 8032 Zurich, Switzerland
| | - Layla Panahipour
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, Vienna 1090, Austria; (G.L.M.); (F.D.S.); (F.-J.S.); (L.P.)
| | - Michael Mildner
- Department of Dermatology, Medical University of Vienna, Spitalgasse 23, Vienna 1090, Austria;
| | - Cesar Augusto Magalhães Benfatti
- Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, School of Dentistry, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima s/n, Florianopolis – SC 88040-900, Brazil;
| | - Reinhard Gruber
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, Vienna 1090, Austria; (G.L.M.); (F.D.S.); (F.-J.S.); (L.P.)
- Department of Periodontology, University Bern, Hochschulstrasse 4, 3012 Bern, Switzerland
- Correspondence:
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72
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Nyvad B, Takahashi N. Integrated hypothesis of dental caries and periodontal diseases. J Oral Microbiol 2020; 12:1710953. [PMID: 32002131 PMCID: PMC6968559 DOI: 10.1080/20002297.2019.1710953] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/14/2022] Open
Abstract
This review considers an integrated hypothesis of dental caries and periodontal diseases that builds on theoretical ecological principles. The backbone of the hypothesis is based on the dynamic stability stage of the oral microbiota, at which intrinsic (mainly saliva and gingival crevicular fluid) and bacterial (mainly metabolic) resilience factors maintain ecological dynamic stability, compatible with clinical health. However, loss of intrinsic resilience factors and/or prolonged changes in the availability of microbial metabolic substrates may shift the ecological balance of the microbiota into either saccharolytic (acidogenic) or amino acid-degrading/proteolytic (alkalinogenic) stages, depending on the nature of the predominant substrates, leading to clinical diseases. Therefore, to maintain and restore the dynamic stability of the oral microbiota, it is necessary to control the drivers of disease, such as salivary flow and influx of bacterial nutrients into the oral cavity. Contrary to conventional wisdom, excessive intake of fermentable carbohydrates may contribute to inflammation in periodontal tissues resulting from hyperglycaemia. An integrated hypothesis emphasizes that both dental caries and periodontal diseases originate in the dynamic stability stage and emerge in response to nutritional imbalances in the microbiota. Periodontal diseases may belong to the sugar driven inflammatory diseases, similar to diabetes, obesity, and cardiovascular diseases.
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Affiliation(s)
- Bente Nyvad
- Section of Dental Pathology, Operative Dentistry and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Nobuhiro Takahashi
- Division of Oral Ecology and Biochemistry, Department of Oral Biology, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Abstract
BACKGROUND This study aims to explore the effectiveness of vitamin D for the management of adult patients with gingivitis. METHODS We will perform a comprehensive search from the following electronic databases: Cochrane Library, PUBMED, EMBASE, AMED, CINAHL, WANGFANG, VIP, CBM, and China National Knowledge Infrastructure. All databases will be searched from their inceptions to the present without language limitation. We will also search for unpublished data to avoid missing more potential studies. Two authors will carry out study selection, data extraction, and methodological quality evaluation, respectively. RevMan 5.3 software will be utilized for statistical analysis. RESULTS This study will summarize the up-to-date evidence about the anti-inflammatory effect of vitamin D for the management of adult patients with gingivitis through assessing modified gingival, gingival bleeding indices, inflammatory factors, plaque, quality of life, and any adverse events. CONCLUSION This study may provide helpful evidence of vitamin D for the management of adult patients with gingivitis for clinical practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019156561.
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Affiliation(s)
- Yao Feng
- First Unit of Dental Pulp Disease Department
| | | | | | - Yuan-Sheng Ding
- Department of Orthodontics, Second Affiliated Hospital of Jiamusi University, Jiamusi, China
| | - Xiao-Guang Li
- Department of Orthodontics, Second Affiliated Hospital of Jiamusi University, Jiamusi, China
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Jauhiainen LM, Ylöstalo PV, Knuuttila M, Männistö S, Kanerva N, Suominen AL. Poor diet predicts periodontal disease development in 11‐year follow‐up study. Community Dent Oral Epidemiol 2019; 48:143-151. [DOI: 10.1111/cdoe.12513] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 11/20/2019] [Accepted: 11/29/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Leena Maria Jauhiainen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- City of Kuopio Health Centre Oral Health Care Services Kuopio Finland
| | - Pekka Viljo Ylöstalo
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
- Unit of Oral Health Sciences Medical Research Center Oulu (MRC Oulu) Oulu University Hospital and University of Oulu Oulu Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
| | - Satu Männistö
- Department of Public Health Promotion Finnish Institute for Health and Welfare Helsinki Finland
| | - Noora Kanerva
- Department of Public Health Promotion Finnish Institute for Health and Welfare Helsinki Finland
- Department of Public Health and Department of Food and Nutrition University of Helsinki Helsinki Finland
| | - Anna Liisa Suominen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
- Public Health Evaluation and Projection Unit Finnish Institute for Health and Welfare Helsinki Finland
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