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Chopra A, Jayasinghe TN, Eberhard J. Are Inflamed Periodontal Tissues Endogenous Source of Advanced Glycation End-Products (AGEs) in Individuals with and without Diabetes Mellitus? A Systematic Review. Biomolecules 2022; 12:biom12050642. [PMID: 35625570 PMCID: PMC9138899 DOI: 10.3390/biom12050642] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022] Open
Abstract
Advanced glycation end-products (AGEs) are heterogeneous compounds formed when excess sugars condense with the amino groups of nucleic acids and proteins. Increased AGEs are associated with insulin resistance and poor glycemic control. Recently, inflamed periodontal tissues and certain oral bacteria were observed to increase the local and systemic AGE levels in both normoglycemic and hyperglycemic individuals. Although hyperglycemia induced AGE and its effect on the periodontal tissues is known, periodontitis as an endogenous source of AGE formation is not well explored. Hence, this systematic review is aimed to explore, for the first time, whether inflamed periodontal tissues and periodontal pathogens have the capacity to modulate AGE levels in individuals with or without T2DM and how this affects the glycemic load. Six electronic databases were searched using the following keywords: (Periodontitis OR Periodontal disease OR Periodontal Inflammation) AND (Diabetes mellitus OR Hyperglycemia OR Insulin resistance) AND Advanced glycation end products. The results yielded 1140 articles, of which 13 articles were included for the review. The results showed that the mean AGE levels in gingival crevicular fluid was higher in individuals with diabetes mellitus and periodontitis (521.9 pg/mL) compared to healthy individuals with periodontitis (234.84 pg/mL). The serum AGE levels in normoglycemic subjects having periodontitis was higher compared to those without periodontitis (15.91 ng/mL vs. 6.60 ng/mL). Tannerella forsythia, a common gram-negative anaerobe periodontal pathogen in the oral biofilm, was observed to produce methylglyoxal (precursor of AGE) in the gingival tissues. Increased AGE deposition and activate of AGE receptors was noted in the presence of periodontitis in both normoglycemic and hyperglycemic individuals. Hence, it can be concluded that periodontitis can modulate the local and systemic levels of AGE levels even in absence of hyperglycemia. This explains the bidirectional relationship between periodontitis and development of prediabetes, incident diabetes, poor glycemic control, and insulin resistance.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, India
- Correspondence:
| | - Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (T.N.J.); (J.E.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (T.N.J.); (J.E.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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102
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Feng Y, Chen Z, Tu SQ, Wei JM, Hou YL, Kuang ZL, Kang XN, Ai H. Role of Interleukin-17A in the Pathomechanisms of Periodontitis and Related Systemic Chronic Inflammatory Diseases. Front Immunol 2022; 13:862415. [PMID: 35371044 PMCID: PMC8968732 DOI: 10.3389/fimmu.2022.862415] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/28/2022] [Indexed: 01/02/2023] Open
Abstract
Periodontitis is a chronic inflammatory and destructive disease caused by periodontal microbial infection and mediated by host immune response. As the main cause of loosening and loss of teeth in adults, it is considered to be one of the most common and serious oral diseases in the world. The co-existence of periodontitis and systemic chronic inflammatory diseases such as rheumatoid arthritis, psoriasis, inflammatory bowel disease, diabetes and so on is very common. It has been found that interleukin-17A (IL-17A) secreted by various innate and adaptive immune cells can activate a series of inflammatory cascade reactions, which mediates the occurrence and development of periodontitis and related systemic chronic inflammatory diseases. In this work, we review the role of IL-17A in the pathomechanisms of periodontitis and related systemic chronic inflammatory diseases, and briefly discuss the therapeutic potential of cytokine targeted agents that modulate the IL-17A signaling. A deep understanding of the possible molecular mechanisms in the relationship between periodontitis and systemic diseases will help dentists and physicians update their clinical diagnosis and treatment ideas.
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103
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Exploring the pharmacological components and effective mechanism of Mori Folium against periodontitis using network pharmacology and molecular docking. Arch Oral Biol 2022; 139:105391. [DOI: 10.1016/j.archoralbio.2022.105391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 12/25/2022]
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104
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Bai L, Chen BY, Liu Y, Zhang WC, Duan SZ. A Mouse Periodontitis Model With Humanized Oral Bacterial Community. Front Cell Infect Microbiol 2022; 12:842845. [PMID: 35273925 PMCID: PMC8902145 DOI: 10.3389/fcimb.2022.842845] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/31/2022] [Indexed: 12/03/2022] Open
Abstract
Increasing evidence suggests that periodontitis, characterized by oral dysbiosis, is a critical player in the progression of multiple systemic diseases in humans. However, there is still a lack of a proper mouse model of periodontitis with the colonization of human periodontitis-associated bacteria. We here established a new mouse periodontitis model by combining ligation of the second molars with application of subgingival plaques from periodontitis patients. Using 16S rRNA gene sequencing and Taxonomic classification, we found that human periodontitis-associated bacteria efficiently colonized in the mouse model and were enriched in both ligature silk and mouse saliva. Furthermore, the well-recognized periodontal pathogens including Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia, and Tannerella forsythia were enriched in the new model, but not in ligature-induced periodontitis model or Sham mice. The human periodontitis-associated bacteria potently aggravated mouse periodontitis, as demonstrated by more severe bone resorption and higher expression of inflammatory and osteoclastogenesis genes. In summary, the new mouse periodontitis model paves the way for studying human periodontitis-associated bacteria in oral diseases and systemic diseases.
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Affiliation(s)
- Lan Bai
- Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Bo-Yan Chen
- Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yan Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wu-Chang Zhang
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- *Correspondence: Sheng-Zhong Duan, ; Wu-Chang Zhang,
| | - Sheng-Zhong Duan
- Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- *Correspondence: Sheng-Zhong Duan, ; Wu-Chang Zhang,
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105
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King S, Chow CK, Eberhard J. Oral health and cardiometabolic disease: understanding the relationship. Intern Med J 2022; 52:198-205. [DOI: 10.1111/imj.15685] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/14/2021] [Accepted: 12/24/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Shalinie King
- Sydney Dental School, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Westmead Applied Research Centre The University of Sydney Sydney New South Wales Australia
| | - Clara K. Chow
- Westmead Applied Research Centre The University of Sydney Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Westmead Hospital, WSLHD Sydney New South Wales Australia
| | - Joerg Eberhard
- Sydney Dental School and the Charles Perkins Centre, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
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106
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Thim T, Scholz KJ, Hiller KA, Buchalla W, Kirschneck C, Fleiner J, Woelber JP, Cieplik F. Radiographic Bone Loss and Its Relation to Patient-Specific Risk Factors, LDL Cholesterol, and Vitamin D: A Cross-Sectional Study. Nutrients 2022; 14:864. [PMID: 35215516 PMCID: PMC8877125 DOI: 10.3390/nu14040864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 02/01/2023] Open
Abstract
The influence of patient-specific factors such as medical conditions, low-density lipoprotein cholesterol (LDL-C) or levels of 25-hydroxyvitamin D (25OHD) on periodontal diseases is frequently discussed in the literature. Therefore, the aim of this retrospective cross-sectional study was to evaluate potential associations between radiographic bone loss (RBL) and patient-specific risk factors, particularly LDL-C and 25OHD levels. Patients from a dental practice, who received full-mouth cone beam CTs (CBCTs) and blood-sampling in the course of implant treatment planning, were included in this study. RBL was determined at six sites per tooth from CBCT data. LDL-C and 25OHD levels were measured from venous blood samples. Other patient-specific risk factors were assessed based on anamnesis and dental charts. Statistical analysis was performed applying non-parametric procedures (Mann-Whitney U tests, error rates method). Data from 163 patients could be included in the analysis. RBL was significantly higher in male patients, older age groups, smokers, patients with high DMFT (decayed/missing/filled teeth) score, lower number of teeth, and high LDL-C levels (≥160 mg/dL). Furthermore, patients with high 25OHD levels (≥40 ng/mL) exhibited significantly less RBL. In summary, RBL was found to be associated with known patient-specific markers, particularly with age and high LDL-C levels.
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Affiliation(s)
- Teresa Thim
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
- Private Practice, 63110 Rodgau, Germany
| | - Konstantin Johannes Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Jonathan Fleiner
- Center of Dental Implantology, Periodontology and 3D-Imaging, 78462 Konstanz, Germany;
| | - Johan Peter Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany;
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
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107
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Wang L, Li Y, Ren M, Wang X, Li L, Liu F, Lan Y, Yang S, Song J. pH and lipase-responsive nanocarrier-mediated dual drug delivery system to treat periodontitis in diabetic rats. Bioact Mater 2022; 18:254-266. [PMID: 35387157 PMCID: PMC8961308 DOI: 10.1016/j.bioactmat.2022.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 01/17/2022] [Accepted: 02/09/2022] [Indexed: 12/11/2022] Open
Abstract
Precise and controlled drug delivery to treat periodontitis in patients with diabetes remains a significant clinical challenge. Nanoparticle-based drug delivery systems offer a potential therapeutic strategy; however, the low loading efficiency, non-responsiveness, and single effect of conventional nanoparticles hinder their clinical application. In this study, we designed a novel self-assembled, dual responsive, and dual drug-loading nanocarrier system, which comprised two parts: the hydrophobic lipid core formed by 1, 2-Distearoyl-sn-glycero-3-phosphoethanolamine-Poly (ethylene glycol) (DSPE-PEG) loaded with alpha-lipoic acid (ALA); and a hydrophilic shell comprising a poly (amidoamine) dendrimer (PAMAM) that electrostatically adsorbed minocycline hydrochloride (Mino). This unique design allows the controlled release of antioxidant/ALA under lipase stimulation from periodontal pathogens and antimicrobial/Mino under the low pH of the inflammatory microenvironment. In vivo and in vitro studies confirmed that this dual nanocarrier could inhibit the formation of subgingival microbial colonies while promoting osteogenic differentiation of cells under diabetic pathological conditions, and ameliorated periodontal bone resorption. This effective and versatile drug-delivery strategy has good potential applications to inhibit diabetes-associated periodontal bone loss. The nanocarriers are pH and lipase sensitive for controlled drug release. The nanocarriers simultaneously exert antibacterial, antioxidant, anti-inflammatory, and osteogenic functions via the controlled release of antibacterial/Mino and antioxidant/ALA. The nanocarriers offer a promising strategy to treat periodontitis under DM conditions.
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Affiliation(s)
- Lu Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Yuzhou Li
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Mingxing Ren
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xu Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lingjie Li
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Fengyi Liu
- College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yiqing Lan
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Sheng Yang
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Corresponding author. College of Stomatology, Chongqing Medical University, Chongqing, China.
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Corresponding author. College of Stomatology, Chongqing Medical University, Chongqing, China.
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108
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Plemmenos G, Piperi C. Pathogenic Molecular Mechanisms in Periodontitis and Peri-Implantitis: Role of Advanced Glycation End Products. Life (Basel) 2022; 12:life12020218. [PMID: 35207505 PMCID: PMC8874682 DOI: 10.3390/life12020218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 12/17/2022] Open
Abstract
Advanced Glycation End Products (AGEs), the products of the non-enzymatic oxidation of proteins, nucleic acids, and lipids, are accumulated in periodontal tissues under hyperglycemic conditions such as Diabetes Mellitus (DM) and are responsible for sustained periodontal destruction. AGEs mediate their intracellular effects either directly or indirectly through receptor binding (via RAGE) in all types of periodontal ligament cells (osteocytes, gingival fibroblasts, stem cells, epithelial cells), indicating an important target for intervention. In combination with lipopolysaccharides (LPS) from Porphyromonas gingivalis (Pg), the negative impact of AGEs on periodontal tissue is further enhanced and accentuated. In addition, AGE accumulation is evident in peri-implantitis, yet through different underlying molecular mechanisms. Novel therapeutic approaches targeting the effects of AGEs in periodontal ligament cells show beneficial effects in pre-clinical studies. Herein, we provide evidence on the detrimental role of AGE accumulation in oral cavity tissues and their associated signaling pathways in periodontitis and peri-implantitis to further highlight the significance of oral or topical use of AGE blockers or inhibitors along with dental biofilms’ removal and DM regulation in patients’ management.
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Affiliation(s)
- Grigorios Plemmenos
- School of Dentistry, National and Kapodistrian University of Athens, Goudi, 11527 Athens, Greece; or
| | - Christina Piperi
- School of Dentistry, National and Kapodistrian University of Athens, Goudi, 11527 Athens, Greece; or
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Goudi, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-2107462610
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109
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Negrini TDC, Carlos IZ, Duque C, Caiaffa KS, Arthur RA. Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors-An Overview. FRONTIERS IN ORAL HEALTH 2022; 2:697428. [PMID: 35048037 PMCID: PMC8757730 DOI: 10.3389/froh.2021.697428] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
This comprehensive review of the literature aimed to investigate the interplay between the oral microbiome, oral cavity conditions, and host immune response in Diabetes mellitus (DM). Moreover, this review also aimed to investigate how DM related risk factors, such as advanced age, hyperglycemia, hyperlipidemia, obesity, hypertension and polycystic ovary syndrome (PCOS), act in promoting or modifying specific mechanisms that could potentially perpetuate both altered systemic and oral conditions. We found that poorly controlled glycemic index may exert a negative effect on the immune system of affected individuals, leading to a deficient immune response or to an exacerbation of the inflammatory response exacerbating DM-related complications. Hyperglycemia induces alterations in the oral microbiome since poor glycemic control is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of individuals with DM. A bidirectional relationship between periodontal diseases and DM has been suggested: DM patients may have an exaggerated inflammatory response, poor repair and bone resorption that aggravates periodontal disease whereas the increased levels of systemic pro-inflammatory mediators found in individuals affected with periodontal disease exacerbates insulin resistance. SARS-CoV-2 infection may represent an aggravating factor for individuals with DM. Individuals with DM tend to have low salivary flow and a high prevalence of xerostomia, but the association between prevalence/experience of dental caries and DM is still unclear. DM has also been associated to the development of lesions in the oral mucosa, especially potentially malignant ones and those associated with fungal infections. Obesity plays an important role in the induction and progression of DM. Co-affected obese and DM individuals tend to present worse oral health conditions. A decrease in HDL and, an increase in triglycerides bloodstream levels seem to be associated with an increase on the load of periodontopathogens on oral cavity. Moreover, DM may increase the likelihood of halitosis. Prevalence of impaired taste perception and impaired smell recognition tend to be greater in DM patients. An important interplay among oral cavity microbiome, DM, obesity and hypertension has been proposed as the reduction of nitrate into nitrite, in addition to contribute to lowering of blood pressure, reduces oxidative stress and increases insulin secretion, being these effects desirable for the control of obesity and DM. Women with PCOS tend to present a distinct oral microbial composition and an elevated systemic response to selective members of this microbial community, but the association between oral microbiome, PCOS are DM is still unknown. The results of the studies presented in this review suggest the interplay among the oral microbiome, oral cavity conditions, host immune response and DM and some of the DM associated risk factors exist. DM individuals need to be encouraged and motivated for an adequate oral health care. In addition, these results show the importance of adopting multidisciplinary management of DM and of strengthening physicians-dentists relationship focusing on both systemic and on oral cavity conditions of DM patients.
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Affiliation(s)
- Thais de Cássia Negrini
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University, Araraquara, Brazil
| | - Iracilda Zeppone Carlos
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University, Araraquara, Brazil
| | - Cristiane Duque
- Department of Restorative and Preventive Dentistry, Araçatuba Dental School, São Paulo State University, Araçatuba, Brazil
| | - Karina Sampaio Caiaffa
- Department of Restorative and Preventive Dentistry, Araçatuba Dental School, São Paulo State University, Araçatuba, Brazil
| | - Rodrigo Alex Arthur
- Department of Preventive and Community Dentistry, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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110
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Barutta F, Bellini S, Durazzo M, Gruden G. Novel Insight into the Mechanisms of the Bidirectional Relationship between Diabetes and Periodontitis. Biomedicines 2022; 10:biomedicines10010178. [PMID: 35052857 PMCID: PMC8774037 DOI: 10.3390/biomedicines10010178] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 02/01/2023] Open
Abstract
Periodontitis and diabetes are two major global health problems despite their prevalence being significantly underreported and underestimated. Both epidemiological and intervention studies show a bidirectional relationship between periodontitis and diabetes. The hypothesis of a potential causal link between the two diseases is corroborated by recent studies in experimental animals that identified mechanisms whereby periodontitis and diabetes can adversely affect each other. Herein, we will review clinical data on the existence of a two-way relationship between periodontitis and diabetes and discuss possible mechanistic interactions in both directions, focusing in particular on new data highlighting the importance of the host response. Moreover, we will address the hypothesis that trained immunity may represent the unifying mechanism explaining the intertwined association between diabetes and periodontitis. Achieving a better mechanistic insight on clustering of infectious, inflammatory, and metabolic diseases may provide new therapeutic options to reduce the risk of diabetes and diabetes-associated comorbidities.
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111
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Impact of Impaired Glucose Metabolism on Periodontitis Progression over Three Years. Dent J (Basel) 2022; 10:dj10010010. [PMID: 35049608 PMCID: PMC8774522 DOI: 10.3390/dj10010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 02/05/2023] Open
Abstract
We evaluated the relationship between glucose abnormalities and periodontitis in overweight/obese individuals. Eight hundred and seventy (870) diabetes-free participants aged 40-65 years completed the three-year follow-up in the San Juan Overweight Adults Longitudinal Study. The ADA thresholds for fasting and 2-h post-load glucose and HbA1c were used to define prediabetes. The NHANES methods were used to assess periodontitis. Multivariable linear regression was used to evaluate the relationship between baseline glucose metabolism measures and periodontitis at follow-up, adjusting for potential confounders. There was no association between impaired glucose measures and mean pocket depth (PD), mean clinical attachment loss (CAL), or mean percent of sites ≥5 mm PD. Impaired glucose tolerance (IGT) was associated with a lower mean percent of sites ≥5 mm CAL (β = -1.6, p = 0.037). Prediabetes and impaired fasting glucose (IFG) were associated with improvement in mean percent of sites ≥5 mm PD (β = -1.4, p = 0.022; β = -1.6, p = 0.032; respectively). IFG and IGT were associated with improvement in mean percent of sites with ≥5 mm CAL (β = -1.6, p = 0.038; β = -1.9, p = 0.020; respectively). In conclusion, there were no consistent associations between baseline prediabetes or insulin resistance and periodontitis progression over a three-year period.
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112
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Chen Y, Hu Y. Therapeutic potential of PPARα agonist in ligature-induced experimental periodontitis. J Appl Oral Sci 2022; 30:e20210648. [PMID: 35293424 PMCID: PMC8957283 DOI: 10.1590/1678-7757-2021-0648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/31/2022] [Indexed: 02/18/2023] Open
Abstract
Inflammation-related immune responses and bone metabolism lead to extensive tooth loss in periodontitis.
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113
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Yang M, Pang Y, Pei M, Li Y, Yuan X, Tang R, Wang J. Therapeutic Potential of Liraglutide for Diabetes-Periodontitis Comorbidity: Killing Two Birds with One Stone. J Diabetes Res 2022; 2022:8260111. [PMID: 35845316 PMCID: PMC9279102 DOI: 10.1155/2022/8260111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/11/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The relationship between diabetes and periodontitis is bidirectional, and there is now consensus that periodontitis and diabetes are comorbid. There is a quest for a drug that can be used to treat both conditions simultaneously. This study evaluated the anti-inflammatory and osteoprotective effects of liraglutide (LIRA) on periodontitis in diabetic rats. METHODS Male Wistar rats (n = 46) were randomly divided into four groups: control group (n = 8), LIRA group (n = 8), diabetes-associated periodontitis+0.9% saline group (diabetic periodontitis (DP)+NaCl group, n = 15), and diabetes-associated periodontitis+LIRA group (DP+LIRA group, n = 15). LIRA treatment lasted for 4 weeks (300 μg/kg/d) after establishment of a rat model of DP. The expression of IL-6, TNF-α, and IL-1β was detected by enzyme-linked immunosorbent assay. The morphological changes of periodontal tissues were observed by hematoxylin-eosin staining. The absorption of alveolar bone and its ultrastructural changes were observed by histomorphometry and microcomputed tomography. The expression of receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) in alveolar bone was detected by immunohistochemistry. The levels of Runx2 mRNA and ALP mRNA in the gingival epithelium were examined by quantitative real-time polymerase chain reaction. RESULTS LIRA decreased alveolar bone resorption, improved the microstructure of alveolar bone, and reduced periodontal inflammation and damage (P < 0.05). LIRA also reduced blood glucose level and inhibited the secretion of serum IL-6, TNF-α, and IL-1β (P < 0.05). In addition, after treatment with LIRA, the ratio of RANKL/OPG was reduced, and the expression levels of ALP mRNA and Runx2 mRNA were upregulated (P < 0.05). CONCLUSIONS LIRA not only controls blood glucose level but also reduces inflammation and bone loss and enhances osteogenic differentiation in diabetes-associated periodontitis. Those indicate that LIRA may be used as a potential medicine for the adjunctive therapy of diabetes-periodontitis comorbidity.
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Affiliation(s)
- Man Yang
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
- Key Laboratory of Stomatology of the State Ethnic Affairs Commission, China
- Hospital of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yunqing Pang
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Oral Diseases, Gansu Province, China
| | - Minyu Pei
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
- Key Laboratory of Stomatology of the State Ethnic Affairs Commission, China
- Gansu Province Clinical Research Center for Oral Diseases, Gansu Province, China
| | - Yuanyuan Li
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Oral Diseases, Gansu Province, China
| | - Xuemin Yuan
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
- Hospital of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Rongbing Tang
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Oral Diseases, Gansu Province, China
| | - Jing Wang
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
- Key Laboratory of Stomatology of the State Ethnic Affairs Commission, China
- Gansu Province Clinical Research Center for Oral Diseases, Gansu Province, China
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Tan Y, Feng J, Xiao Y, Bao C. Grafting Resveratrol onto Mesoporous Silica Nanoparticles towards Efficient Sustainable Immunoregulation and Insulin Resistance Alleviation for Diabetic Periodontitis Therapy. J Mater Chem B 2022; 10:4840-4855. [PMID: 35678150 DOI: 10.1039/d2tb00484d] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The treatment of diabetic periodontitis (DP) has become a tough challenge in dental clinic mainly due to the intrinsic drawbacks of conventional therapy strategy and currently unclear mechanisms to elucidate...
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Affiliation(s)
- Yujie Tan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Med-X Center for Materials, Sichuan University, No. 14, Section 3, Renmin Nan Road, Chengdu 610041, Sichuan, China.
| | - Jing Feng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Med-X Center for Materials, Sichuan University, No. 14, Section 3, Renmin Nan Road, Chengdu 610041, Sichuan, China.
| | - Yu Xiao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Med-X Center for Materials, Sichuan University, No. 14, Section 3, Renmin Nan Road, Chengdu 610041, Sichuan, China.
| | - Chongyun Bao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Med-X Center for Materials, Sichuan University, No. 14, Section 3, Renmin Nan Road, Chengdu 610041, Sichuan, China.
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Salhi L, Reners M. Update on the Bidirectional Link Between Diabetes and Periodontitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:231-240. [DOI: 10.1007/978-3-030-96881-6_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hodovanyi OV. NON-SURGICAL PERIODONTAL TREATMENT AS AN IMPORTANT COMPONENT OF EFFECTIVE PERIODONTAL DISEASES PREVENTION MEASURES. BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-3-166-523-539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Li Y, Lu Z, Zhang L, Kirkwood CL, Kirkwood KL, Lopes-Virella MF, Huang Y. Inhibition of acid sphingomyelinase by imipramine abolishes the synergy between metabolic syndrome and periodontitis on alveolar bone loss. J Periodontal Res 2022; 57:173-185. [PMID: 34748647 PMCID: PMC8766925 DOI: 10.1111/jre.12951] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/08/2021] [Accepted: 10/26/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Clinical studies have shown that metabolic syndrome (MetS) exacerbates periodontitis. However, the underlying mechanisms remain largely unknown. Since our animal study has shown that high-fat diet-induced MetS exacerbates lipopolysaccharide (LPS)-stimulated periodontitis in mouse model and our in vitro study showed that acid sphingomyelinase (aSMase) plays a key role in the amplification of LPS-triggered pro-inflammatory response by palmitic acid (PA) in macrophages, we tested our hypothesis that inhibitor of aSMase attenuates MetS-exacerbated periodontitis in animal model. Furthermore, to explore the potential underlying mechanisms, we tested our hypothesis that aSMase inhibitor downregulates pro-inflammatory and pro-osteoclastogenic gene expression in macrophages in vitro. MATERIAL AND METHODS We induced MetS and periodontitis in C57BL/6 mice by feeding high-fat diet (HFD) and periodontal injection of A. actinomycetemcomitans LPS, respectively, and treated mice with imipramine, a well-established inhibitor of aSMase. Micro-computed tomography (micro-CT), tartrate-resistant acid phosphatase staining, histological and pathological evaluations as well as cell cultures were performed to evaluate alveolar bone loss, osteoclast formation, periodontal inflammation and pro-inflammatory gene expression. RESULTS Analysis of metabolic parameter showed that while HFD induced MetS by increasing bodyweight, insulin resistance, cholesterol and free fatty acids, imipramine reduced free fatty acids but had no significant effects on other metabolic parameters. MicroCT showed that either MetS or periodontitis significantly reduced bone volume fraction (BVF) of maxilla and the combination of MetS and periodontitis further reduced BVF. However, imipramine increased BVF in mice with both MetS and periodontitis to a level similar to that in mice with periodontitis alone, suggesting that imipramine abolished the synergy between MetS and periodontitis on alveolar bone loss. Consistently, results showed that imipramine inhibited osteoclast formation and periodontal inflammation in mice with both MetS and periodontitis. To elucidate the mechanisms by which imipramine attenuates MetS-exacerbated periodontitis, we showed that imipramine inhibited the upregulation of pro-inflammatory cytokines and transcription factor c-FOS as well as ceramide production by LPS plus PA in macrophages. CONCLUSION This study has shown that imipramine as an inhibitor of aSMase abolishes the synergy between MetS and periodontitis on alveolar bone loss in animal model and inhibits pro-inflammatory and pro-osteoclastogenic gene expression in macrophages in vitro. This study provides the first evidence that aSMase is a potential therapeutic target for MetS-exacerbated periodontitis.
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Affiliation(s)
- Yanchun Li
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425
| | - Zhongyang Lu
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425
| | - Lixia Zhang
- Department of Oral Biology, School of Dental Medicine, University at Buffalo
| | - Cameron L. Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo
| | - Keith L. Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo,,Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14214
| | - Maria F. Lopes-Virella
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401
| | - Yan Huang
- Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401,Correspondence to Yan Huang, M.D., Ph.D., Ralph H. Johnson Veterans Affairs Medical Center, and Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, Medical University of South Carolina, 114 Doughty St. Charleston, SC29403, Tel: (843) 789-6824; Fax: (843) 876-5133;
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Montevecchi M, Valeriani L, Gatto MR, D'Alessandro G, Piana G. Subgingival pathogens in chronic periodontitis patients affected by type 2 diabetes mellitus: a retrospective case-control study. J Periodontal Implant Sci 2021; 51:409-421. [PMID: 34965620 PMCID: PMC8718332 DOI: 10.5051/jpis.2100180009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/20/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this study was to compare the prevalence and bacterial load of 6 main periodontal pathogens between pairs of periodontal patients with and without type 2 diabetes mellitus. Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans genotypes were also investigated. Methods Twenty patients affected by chronic periodontitis and type 2 diabetes were retrospectively selected and matched to 20 patients without diabetes on the basis of the degree and severity of periodontal disease. Microbiological data of subgingival biofilms were analysed and compared for the examined pathogens: A. actinomycetemcomitans, P. gingivalis, Prevotella intermedia, Treponema denticola, Fusobacterium nucleatum, and Tannerella forsythia. Results The pairs were balanced in terms of demographic and clinical parameters, except for bleeding on probing and suppuration. In the microbiological test sites (4 for each patient), the mean probing pocket depth was 6.34±1.63 mm in patients with diabetes and 6.41±1.78 mm in patients without diabetes. No significant difference between pairs in the prevalence of P. gingivalis or the distribution of its genotypes was recorded. Patients with diabetes had a significantly greater amount of total bacterial load, P. gingivalis, T. denticola, T. forsythia, and F. nucleatum (P<0.05). Moreover, patients with diabetes had a higher number of sites with a greater cell count than patients without diabetes. When compared to the total bacterial load, only T. forsythia maintained its relative load in patients with diabetes (P=0.001). Conclusions This retrospective matched study supports the hypothesis that microbiological differences exist among periodontal patients with and without diabetes mellitus. Trial Registration ClinicalTrials.gov Identifier: NCT03786133
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Affiliation(s)
- Marco Montevecchi
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
| | - Leoluca Valeriani
- Division of Periodontology and Implantology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Maria Rosaria Gatto
- Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Giovanni D'Alessandro
- Dentistry Service for Patients with Special Needs, Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Gabriela Piana
- Dentistry Service for Patients with Special Needs, Department of Biomedical and Neuromotor Sciences, School of Dentistry, Alma Mater Studiorum - University of Bologna, Bologna, Italy
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Pyroptosis-Mediated Periodontal Disease. Int J Mol Sci 2021; 23:ijms23010372. [PMID: 35008798 PMCID: PMC8745163 DOI: 10.3390/ijms23010372] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 12/17/2022] Open
Abstract
Pyroptosis is a caspase-dependent process relevant to the understanding of beneficial host responses and medical conditions for which inflammation is central to the pathophysiology of the disease. Pyroptosis has been recently suggested as one of the pathways of exacerbated inflammation of periodontal tissues. Hence, this focused review aims to discuss pyroptosis as a pathological mechanism in the cause of periodontitis. The included articles presented similarities regarding methods, type of cells applied, and cell stimulation, as the outcomes also point to the same direction considering the cellular events. The collected data indicate that virulence factors present in the diseased periodontal tissues initiate the inflammasome route of tissue destruction with caspase activation, cleavage of gasdermin D, and secretion of interleukins IL-1β and IL-18. Consequently, removing periopathogens’ virulence factors that trigger pyroptosis is a potential strategy to combat periodontal disease and regain tissue homeostasis.
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Tavares RDCR, Ortigara GB, Tatsch KF, Ferreira CM, Boligon J, Moreira CHC. Association between periodontitis and glycated hemoglobin levels in individuals living in rural Southern Brazil. Clin Oral Investig 2021; 25:6901-6907. [PMID: 34059955 DOI: 10.1007/s00784-021-03980-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/05/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To estimate the prevalence of prediabetes in individuals with moderate or severe periodontitis and to verify the association between periodontitis and glycated hemoglobin levels. MATERIAL AND METHODS A cross-sectional study was conducted including individuals age 18-93 years from a representative sample residing in rural Southern Brazil. Data collection included full mouth periodontal clinical examinations, laboratory screens, and structured questionnaires. Glycemic levels were based on glycated hemoglobin. Periodontitis case definition was based on criteria established by the Centers for Disease Control and Prevention and the American Academy of Periodontology. A logistic regression model adjusted for body mass index was used to estimate odds ratios (OR) and 95% confidence intervals (CI). The association between periodontal parameters and changes in glycated hemoglobin levels was evaluated using linear regression models. RESULTS A higher prevalence of prediabetes was observed among individuals with moderate (39.6%) and severe periodontitis (49.7%) than in individuals with mild (23.8%) or no periodontitis (27.8%). Adjusting for body mass index, individuals with severe periodontitis exhibited a 2.5 greater chance of being prediabetic (OR=2.5; 95% CI: 1.3-4.9) that was significantly associated with an increase of 0.10% in HbA1c. CONCLUSION Severe periodontitis was associated with elevated blood glucose levels. Individuals with this condition having a higher percentage HbA1c are more likely to be prediabetic. CLINICAL RELEVANCE This study highlights the importance of the clinicians' awareness of the association between severe periodontitis and prediabetes allowing its early detection in the dental office.
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Affiliation(s)
- Rodrigo da Cunha Rossignollo Tavares
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Gabriela Barbieri Ortigara
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Karen Finger Tatsch
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Ciandra Miraglia Ferreira
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Jociana Boligon
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Carlos Heitor Cunha Moreira
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
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The Factors Affecting Orthodontic Pain with Periodontitis. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:8942979. [PMID: 34760143 PMCID: PMC8575604 DOI: 10.1155/2021/8942979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
The occurrence of pain is often closely related to the psychological status, and the threshold for pain tolerance varies from patient to patient. In short, the factors affecting orthodontic pain are diverse and have individual differences. Tooth pain after the first force of intraoral malocclusion orthodontic treatment is one of the common complications of fixed orthodontic treatment, which often affects the outcome of treatment of patients with malocclusion and their subjective satisfaction with fixed orthodontic treatment. The purpose of the paper was to investigate the basic patterns and influencing factors of dental pain in fixed orthodontic patients within seven days after the initial wearing of straight arch aligners and the analysis of the effect of psychological intervention on dental pain using the visual simulation scoring method. According to the inclusion criteria of the experimental design, 89 patients who visited the Department of Orthodontics of Hospital for malocclusion were randomly divided into observation group and control group, and the observation group used chewing gum as psychological intervention, while the control group did not use any intervention. The effect of psychological intervention on periodontal pain was analyzed. The results of the paper were that all but 3 of the 89 patients had no pain, and all the patients had different degrees of dental pain at different points in time.
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Locatelli FRF, da Silva Santos I, Visioli F, Hugo FN, Rados PV. Evaluation of oral alterations in patients of a private hospital in the southern region of Brazil. SPECIAL CARE IN DENTISTRY 2021; 42:319-322. [PMID: 34755362 DOI: 10.1111/scd.12672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/10/2021] [Accepted: 10/15/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Fabiola Rampanelli Franco Locatelli
- Department of Conservative Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ingrid da Silva Santos
- Department of Conservative Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Visioli
- Department of Conservative Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Neves Hugo
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Pantelis Varvaki Rados
- Department of Conservative Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Narita LE, Mester A, Onisor F, Bran S, Onicas MI, Voina-Tonea A. The Outcomes of Enamel Matrix Derivative on Periodontal Regeneration under Diabetic Conditions. MEDICINA-LITHUANIA 2021; 57:medicina57101071. [PMID: 34684108 PMCID: PMC8539975 DOI: 10.3390/medicina57101071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 12/23/2022]
Abstract
Background and Objectives: Enamel matrix derivative (EMD) is a biomaterial used for periodontal regenerative therapy due to its properties of stimulating cementum development and bone synthesis. Diabetes is a chronic condition that affects healing and predisposes to infection. The aim of this review was to evaluate the current studies available on the application and results of EMD for periodontal regenerative therapy under diabetic conditions. Materials and Methods: Five databases (PubMed, ResearchGate, Scopus, Web of Science and Google Scholar) were searched for relevant articles, using specific keywords in different combinations. The inclusion criteria were clinical trials, case reports, case studies, and animal studies published in English, where periodontal treatment for bone defects includes EMD, and it is performed under diabetic conditions. Results: Of the 310 articles resulted in search, five studies published between 2012 and 2020 met the inclusion criteria and were selected for the current review. In human studies, the use of EMD in infrabony defects showed favorable results at follow-up. In animal studies, periodontal regeneration was reduced in diabetic rats. Conclusions: EMD might promote bone healing when used under diabetic conditions for the regenerative periodontal therapy. Due to limited number of studies, more data are required to sustain the effects of EMD therapy in diabetic settings.
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Affiliation(s)
- Laura Elena Narita
- Faculty of Dental Medicine, University of Medicine and Pharmacy „Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (L.E.N.); (M.I.O.)
| | - Alexandru Mester
- Department of Oral Health, University of Medicine and Pharmacy „Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania
- Correspondence: (A.M.); (F.O.)
| | - Florin Onisor
- Department of Maxillofacial Surgery and Implantology, University of Medicine and Pharmacy „Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania;
- Correspondence: (A.M.); (F.O.)
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, University of Medicine and Pharmacy „Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania;
| | - Maria Ioana Onicas
- Faculty of Dental Medicine, University of Medicine and Pharmacy „Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (L.E.N.); (M.I.O.)
| | - Andrada Voina-Tonea
- Department of Dental Materials, University of Medicine and Pharmacy „Iuliu Hațieganu”, 400012 Cluj-Napoca, Romania;
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Zheng M, Wang C, Ali A, Shih YA, Xie Q, Guo C. Prevalence of periodontitis in people clinically diagnosed with diabetes mellitus: a meta-analysis of epidemiologic studies. Acta Diabetol 2021; 58:1307-1327. [PMID: 34028620 DOI: 10.1007/s00592-021-01738-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/06/2021] [Indexed: 12/19/2022]
Abstract
AIMS The relationship between diabetes mellitus and periodontitis has long been discussed, but the conclusion of this relationship was controversial. We conducted this meta-analysis to explore the association between diabetes mellitus and the prevalence of periodontitis. METHODS PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies reporting associations of periodontitis with diabetes. Gray literature was integrated from the Open-Gray database. Prevalence estimates and odds ratios were extracted by two independent reviewers and synthesized through meta-analyses. RESULTS Twenty-seven papers met the inclusion criteria involving 3092 diabetic patients and 23,494 controls. Overall prevalence of periodontitis was 67.8% in diabetics (combined types) and 35.5% in patients without diabetes (OR, 1.85; 95%CI, 1.61-2.11). Probing depth (MD 0.23; 95% CI, 0.17-0.29; I2 = 25%) and plaque index (MD, 0.20; 95% CI, 0.18-0.23; P = 0.59; I2 = 0%) severity scores were significantly greater among the diabetic group. CONCLUSIONS The prevalence and severity of periodontitis are greater in patients with diabetes than in non-diabetic populations.
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Affiliation(s)
- Mengwen Zheng
- Department of Stomatology, School of Medicine, The First Affiliated Hospital, Shihezi University, Shihezi, Xinjiang, China
| | - Cheng Wang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ali Ali
- Sheffield Teaching Hospitals NIHR Biomedical Research Centre, Glossop Rd, Sheffield, S10 2JF, UK
| | - Yi An Shih
- School of Nursing, Peking University, Beijing, China
| | - Qinqin Xie
- Department of Stomatology, The Second Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Chao Guo
- Department of Stomatology, School of Medicine, The First Affiliated Hospital, Shihezi University, Shihezi, Xinjiang, China.
- The Affiliated Hospital of Qingdao University, Qingdao,Shangdong, China.
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Silva GA, Moreira ALG, Silva PHF, Salvador SL, Casarin RCV, Vicente RM, Ferreira GC, Dos Santos JET, Furlaneto FAC, Messora MR. The use of probiotics can reduce the severity of experimental periodontitis in rats with metabolic syndrome: an immunoenzymatic and microtomographic study. J Periodontol 2021; 93:e1-e12. [PMID: 34374081 DOI: 10.1002/jper.21-0285] [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] [Received: 05/07/2021] [Revised: 07/08/2021] [Accepted: 07/29/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study evaluated the effects of Bifidobacterium animalis subsp. lactis HN019 (B. lactis HN019) in the development of periodontitis (PE), associated or not with metabolic syndrome, (MS) in rats. METHODS 96 rats were grouped according to a food protocol: high-fat diet for induction of MS or standard diet for the control groups (C). They were subdivided into groups with (+) and without (-) PE, receiving (*) or not (**) probiotic (PROB): C -**, CP-*, PE+**, PEP+*, MS-**, MSP-*, MSPE+** and MSPEP+*. PROB administration started on the 8th week of the study and PE was induced on the 14th week by placing ligature on the animals' lower first molars. Euthanasia occurred in the 16th week. Biomolecular analyzes, immunoenzymatic assays, and microtomographic analyses were performed. The data obtained were analyzed statistically (p <0.05). RESULTS The PEP and MSPEP groups showed lower levels of alveolar bone loss when compared to the PE and MSPE groups, respectively (p <0.05). The immunoenzymatic analysis showed higher levels of interleukin (IL)-1β and a higher receptor activator of NF-kappaB ligand (RANKL)/ osteoprotegerin (OPG) ratio in the MSPE group when compared to the MSPEP group (p <0.05). The PEP group showed lower levels of tumor necrosis factor (TNF)-α and IL-6 when compared to the PE group. The use of PROB attenuated dyslipidemia parameters in animals with MS, with or without PE. CONCLUSION B. lactis HN019 reduced more significantly the severity of PE in rats with MS, modulating both systemic metabolic and immunoinflammatory parameters in periodontal tissues. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Giselle A Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - André L G Moreira
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Pedro H F Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Sérgio L Salvador
- Department of Clinical Analyses, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Renato C V Casarin
- Department of Prosthodontics and Periodontics, School of Dentistry, Campinas State University, Piracicaba, São Paulo, Brazil
| | - Raphael M Vicente
- Department of Orthopedics and Anesthesiology, Ribeirao Preto Medical School, University of Sao Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Graziele C Ferreira
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - José E T Dos Santos
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Flávia A C Furlaneto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Michel R Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
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Jeftha A, Roberts T, Kimmie-Dhansay F. The Effect of Periodontal Disease on Metabolic Control in Patients With Diabetes Mellitus in South Africa: Protocol for a Systematic Review. JMIR Res Protoc 2021; 10:e27471. [PMID: 34292169 PMCID: PMC8367174 DOI: 10.2196/27471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/26/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The increase in the prevalence of type 2 diabetes mellitus (T2DM) and its associated complications is burdensome to the South African health system. Understanding the role of comorbid diseases, such as periodontal disease (PD), and their effect on metabolic control in patients with DM in South Africa will raise awareness about the importance of periodontal interventions among patients with DM in South Africa. OBJECTIVE The review will aim to determine the effect of PD on the metabolic control of T2DM in a South African population. METHODS A systematic review of the relationship between PD and metabolic control in patients with T2DM in a South African population will be conducted. Cohort, cross-sectional, and case-controlled studies will be considered in which the outcome of interest is diabetic control. A search will be done in the following sources: EBSCOhost (academic search complete; dentistry and oral sciences), PubMed, ScienceDirect, and the South African National ETD Portal for articles published in English. There will be no limit placed on the date of the publication. The reference list of articles will be reviewed for further inclusion of critical articles. Two independent reviewers (AJ and FK-D) will do study selection, data extraction, and quality analysis. All disputes will be resolved by discussion, and the entire team will verify final decisions. RESULTS The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO). A preliminary search was conducted using the keywords ((perio*) AND (diabet*)) AND ("South Africa"). The review process should be completed by December 2021. CONCLUSIONS The review will determine the effect of PD on metabolic control in patients with T2DM in South Africa. The outcome would inform health policy to highlight the need to include periodontal care into treatment protocols in patients with T2DM. In this process, the feasibility for future research in this area of interest will also be defined. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020221064; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=221064. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/27471.
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Affiliation(s)
- Anthea Jeftha
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Tina Roberts
- Department of Oral Pathology, University of the Western Cape, Cape Town, South Africa
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Santonocito S, Polizzi A, Palazzo G, Isola G. The Emerging Role of microRNA in Periodontitis: Pathophysiology, Clinical Potential and Future Molecular Perspectives. Int J Mol Sci 2021; 22:5456. [PMID: 34064286 PMCID: PMC8196859 DOI: 10.3390/ijms22115456] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 02/07/2023] Open
Abstract
During the last few decades, it has been established that messenger ribonucleic acid (mRNA) transcription does not inevitably lead to protein translation, but there are numerous processes involved in post-transcriptional regulation, which is a continuously developing field of research. MicroRNAs (miRNAs) are a group of small non-coding RNAs, which negatively regulate protein expression and are implicated in several physiological and pathological mechanisms. Aberrant expression of miRNAs triggers dysregulation of multiple cellular processes involved in innate and adaptive immune responses. For many years, it was thought that miRNAs acted only within the cell in which they were synthesised, but, recently, they have been found outside cells bound to lipids and proteins, or enclosed in extracellular vesicles, namely exosomes. They can circulate throughout the body, transferring information between cells and altering gene expression in the recipient cells, as they can fuse with and be internalised by the recipient cells. Numerous studies on miRNAs have been conducted in order to identify possible biomarkers that can be used in the diagnosis of periodontal disease. However, as therapeutic agents, single miRNAs can target several genes and influence multiple regulatory networks. The aim of this review was to examine the molecular role of miRNAs and exosomes in the pathophysiology of periodontal disease and to evaluate possible clinical and future implications for a personalised therapeutical approach.
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Affiliation(s)
| | | | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy; (S.S.); (A.P.); (G.P.)
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128
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Jamil NA, Chau SH, Abdul Razak NI, Shamsul Kamar II, Mohd-Said S, Rani H, Sameeha MJ. Development and evaluation of an integrated diabetes-periodontitis nutrition and health education module. BMC MEDICAL EDUCATION 2021; 21:278. [PMID: 34001119 PMCID: PMC8126504 DOI: 10.1186/s12909-021-02721-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/06/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND A good understanding of the bi-directional relationship between diabetes and periodontitis is essential to ensure the successful management of both diseases. This study aimed to develop and evaluate an integrated diabetes-periodontitis nutrition and health education module. METHODS The module was developed as an iterative and review process by five experts in nutrition and dietetics, periodontics, and dental public health. It consisted of three phases: (i) needs assessment on module contents and characteristics, (ii) module development and (iii) module evaluation by experts. Twelve healthcare professionals aged between 30 and 53 years (average 13.5 years of working experience) validated the module contents and its comprehensibility using the Patient Education Materials Assessment Tool for printable materials (PEMAT-P) and audio-visual materials (PEMAT-A/V). Scores of 0 (disagree) or 1 (agree) were given for sets of understandability and actionability statements and presented as a total percentage. RESULTS Seventeen infographic-flip charts and 13 short-videos were developed in the Malay language and grouped into four topics: (i) Introduction to Diabetes and Periodontitis, (ii) Diabetes and Periodontitis Care, (iii) Lifestyle Modification, and (iv) Myths and Facts. Flip charts were rated between 76-100% for understandability and 80-100% for actionability, while videos rated between 90-100% for understandability and 100% for actionability, respectively. CONCLUSION Overall, the newly developed module ranked high median scores for understandability and actionability. This finding reflects positive acceptance of the integrated module among the various healthcare professionals involved in managing patients with diabetes and periodontitis.
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Affiliation(s)
- Nor Aini Jamil
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia.
| | - Shin Hwa Chau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Nabihah Iman Abdul Razak
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Iffa Izzwani Shamsul Kamar
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Shahida Mohd-Said
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan, Kuala Lumpur, 50300, Malaysia
| | - Haslina Rani
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan, Kuala Lumpur, 50300, Malaysia
| | - Mohd Jamil Sameeha
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
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Romano F, Perotto S, Mohamed SEO, Bernardi S, Giraudi M, Caropreso P, Mengozzi G, Baima G, Citterio F, Berta GN, Durazzo M, Gruden G, Aimetti M. Bidirectional Association between Metabolic Control in Type-2 Diabetes Mellitus and Periodontitis Inflammatory Burden: A Cross-Sectional Study in an Italian Population. J Clin Med 2021; 10:jcm10081787. [PMID: 33924022 PMCID: PMC8073754 DOI: 10.3390/jcm10081787] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
This study assessed the periodontal conditions of type 2 diabetes (T2DM) patients attending an Outpatient Center in North Italy and explored the associations between metabolic control and periodontitis. Periodontal health of 104 T2DM patients (61 men and 43 women, mean age of 65.3 ± 10.1 years) was assessed according to CDC/AAP periodontitis case definitions and Periodontal Inflamed Surface Area (PISA) Index. Data on sociodemographic factors, lifestyle behaviors, laboratory tests, and glycated hemoglobin (HbA1c) levels were collected by interview and medical records. Poor glycemic control (HbA1c ≥ 7%), family history of T2DM, and C-reactive protein levels were predictors of severe periodontitis. An increase in HbA1c of 1% was associated with a rise in PISA of 89.6 mm2. On the other hand, predictors of poor glycemic control were severe periodontitis, waist circumference, unbalanced diet, and sedentary lifestyle. A rise in PISA of 10 mm2 increased the odds of having HbA1c ≥ 7% by 2%. There is a strong bidirectional connection between periodontitis and poor glycemic control. The inflammatory burden posed by periodontitis represents the strongest predictor of poor glycemic control.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Stefano Perotto
- Postgraduate Program in Periodontology, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
| | - Sara Elamin Osman Mohamed
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Sara Bernardi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Marta Giraudi
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Paola Caropreso
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, 10126 Turin, Italy; (P.C.); (G.M.)
| | - Giulio Mengozzi
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, 10126 Turin, Italy; (P.C.); (G.M.)
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Filippo Citterio
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
| | - Giovanni Nicolao Berta
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy
- Correspondence: (G.N.B.); (M.A.)
| | - Marilena Durazzo
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Gabriella Gruden
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.B.); (M.D.); (G.G.)
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, 10126 Turin, Italy; (F.R.); (S.E.O.M.); (M.G.); (G.B.); (F.C.)
- Correspondence: (G.N.B.); (M.A.)
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Salivary Biomarkers and Oral Health in Liver Transplant Recipients, with an Emphasis on Diabetes. Diagnostics (Basel) 2021; 11:diagnostics11040662. [PMID: 33916950 PMCID: PMC8067605 DOI: 10.3390/diagnostics11040662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 12/12/2022] Open
Abstract
Salivary biomarkers have been linked to various systemic diseases. We examined the association between salivary biomarkers, periodontal health, and microbial burden in liver transplant (LT) recipients with and without diabetes, after transplantation. We hypothesized that diabetic recipients would exhibit impaired parameters. This study included 84 adults who received an LT between 2000 and 2006 in Finland. Dental treatment preceded transplantation. The recipients were re-examined, on average, six years later. We evaluated a battery of salivary biomarkers, microbiota, and subjective oral symptoms. Periodontal health was assessed, and immunosuppressive treatments were recorded. Recipients with impaired periodontal health showed higher matrix metalloproteinase-8 (MMP-8) levels (p < 0.05) and MMP-8/tissue inhibitor of matrix metalloproteinase 1 (TIMP1) ratios (p < 0.001) than recipients with good periodontal health. Diabetes post-LT was associated with impaired periodontal health (p < 0.05). No difference between groups was found in the microbial counts. Salivary biomarker levels did not seem to be affected by diabetes. However, the advanced pro-inflammatory state induced by and associated with periodontal inflammation was reflected in the salivary biomarker levels, especially MMP-8 and the MMP-8/TIMP-1 molar ratio. Thus, these salivary biomarkers may be useful for monitoring the oral inflammatory state and the course of LT recipients.
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Chen Q, Liu X, Wang D, Zheng J, Chen L, Xie Q, Liu X, Niu S, Qu G, Lan J, Li J, Yang C, Zou D. Periodontal Inflammation-Triggered by Periodontal Ligament Stem Cell Pyroptosis Exacerbates Periodontitis. Front Cell Dev Biol 2021; 9:663037. [PMID: 33869229 PMCID: PMC8049442 DOI: 10.3389/fcell.2021.663037] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/11/2021] [Indexed: 01/09/2023] Open
Abstract
Periodontitis is an immune inflammatory disease that leads to progressive destruction of bone and connective tissue, accompanied by the dysfunction and even loss of periodontal ligament stem cells (PDLSCs). Pyroptosis mediated by gasdermin-D (GSDMD) participates in the pathogenesis of inflammatory diseases. However, whether pyroptosis mediates PDLSC loss, and inflammation triggered by pyroptosis is involved in the pathological progression of periodontitis remain unclear. Here, we found that PDLSCs suffered GSDMD-dependent pyroptosis to release interleukin-1β (IL-1β) during human periodontitis. Importantly, the increased IL-1β level in gingival crevicular fluid was significantly correlated with periodontitis severity. The caspase-4/GSDMD-mediated pyroptosis caused by periodontal bacteria and cytoplasmic lipopolysaccharide (LPS) dominantly contributed to PDLSC loss. By releasing IL-1β into the tissue microenvironment, pyroptotic PDLSCs inhibited osteoblastogenesis and promoted osteoclastogenesis, which exacerbated the pathological damage of periodontitis. Pharmacological inhibition of caspase-4 or IL-1β antibody blockade in a rat periodontitis model lead to the significantly reduced loss of alveolar bone and periodontal ligament damage. Furthermore, Gsdmd deficiency alleviated periodontal inflammation and bone loss in mouse experimental periodontitis. These findings indicate that GSDMD-driven PDLSC pyroptosis and loss plays a pivotal role in the pathogenesis of periodontitis by increasing IL-1β release, enhancing inflammation, and promoting osteoclastogenesis.
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Affiliation(s)
- Qin Chen
- Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingguang Liu
- National Key Laboratory of Medical Immunology, Navy Military Medical University, Shanghai, China
| | - Dingyu Wang
- State Key Laboratory of Pharmaceutical Biotechnology and Ministry of Education, Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Nanjing University, Nanjing, China
| | - Jisi Zheng
- Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Lu Chen
- Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Qianyang Xie
- Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaohan Liu
- Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Sujuan Niu
- College of Stomatology, Inner Mongolia Medical University, Hohhot, China
| | - Guanlin Qu
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Jianfeng Lan
- Guangxi Key Laboratory of Molecular Medicine in Liver Injury and Repair, The Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Jing Li
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, China
| | - Chi Yang
- Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Duohong Zou
- Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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Are occupational and environmental noises associated with periodontitis? Evidence from a Korean representative cross-sectional study. BMC Public Health 2021; 21:616. [PMID: 33781265 PMCID: PMC8008658 DOI: 10.1186/s12889-021-10672-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidences have shown that noise could be a risk factor for cardiovascular and metabolic diseases. Since periodontitis and CVD are characterized by inflammation, it is reasonable to doubt that occupational/environmental noise is a risk factor for periodontitis. The aim of this study was to examine the relationship between occupational/environmental noise and periodontitis in a nationally representative sample of Korean adults. METHODS This cross-sectional study used data from the 7th Korean National Health and Nutrition Examination Survey. The study sample included 8327 adults aged 40 to 80 years old. Noise exposure and the duration of the exposure were assessed with self-report questionnaires. The dependent variable was periodontitis. Age, gender, place of residence, income, marital status, smoking, frequency of daily tooth brushing, recent dental checkup, and diabetes were included as covariates. Logistic regression analyses estimated the association between noise exposure and periodontitis. RESULTS Those who were exposed to environmental noise during their lifetime had an increased prevalence of severe periodontitis (odds ratio [OR] 1.88; 95% confidence interval [CI] 1.05 to 3.40), and this association was strengthened as the duration of the environmental noise exposure was longer (OR of > 120 months 2.35 and OR of ≤120 months 1.49). There was a combined relationship for severe periodontitis between occupational and environmental noise exposure (OR of both exposures 2.62, OR of occupational exposure only 1.12, and OR of environmental exposure only 1.57). CONCLUSION Our study shows that noise exposure is associated with periodontitis, and the association was higher in the synergism between occupational and environmental interaction.
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Betancur D, Muñoz Grez C, Oñate A. Comparative Analysis of Cytokine Expression in Oral Keratinocytes and THP-1 Macrophages in Response to the Most Prevalent Serotypes of Aggregatibacter actinomycetemcomitans. Microorganisms 2021; 9:622. [PMID: 33802988 PMCID: PMC8002688 DOI: 10.3390/microorganisms9030622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammatory disease associated with a dysbiotic biofilm. Many pathogens have been related with its progression and severity, one of which is Aggregatibacter actinomycetemcomitans, a Gram-negative bacteria with seven serotypes (a-g) according with the structure of its LPS, with serotype b defined as the most virulent compared with the other serotypes. The aim of this study was to evaluate the response of oral keratinocytes and macrophages to A. actinomycetemcomitans. METHODS Oral keratinocytes (OKF6/TERT2) and macrophages (THP-1) were infected with A. actinomycetemcomitans serotypes a, b and c. The expression of IL-1β, IL-6, IL-8, IL-18, TNF-α, MMP-9, RANKL, TLR-2, TLR-4, TLR-6, thymic stromal lymphopoietin (TSLP), and ICAM-1 was evaluated by qPCR at 2 and 24 h after infection. RESULTS An increase in the expression of these molecules was induced by all serotypes at both times of infection, with macrophages showing higher levels of expression at 24 h compared to epithelial cells in which the highest levels were observed in the first hours after infection. CONCLUSIONS Keratinocytes and macrophages contribute to the inflammation in periodontitis from the early stages of infection, producing the first waves of cytokines, acting as the first signal for professional immune cell recruitment and modulation of more specific immune responses.
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Affiliation(s)
| | | | - Angel Oñate
- Laboratory of Molecular Immunology, Department of Microbiology, Faculty of Biological Sciences, Universidad de Concepción, Concepción 4030000, Chile; (D.B.); (C.M.G.)
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Karaaslan F, Dikilitaş A, Aydın EÖ, Şen V, Kurt ŞE. Are there correlations between radiographic grade levels and modified grade levels of periodontitis? J Indian Soc Periodontol 2021; 25:102-105. [PMID: 33888940 PMCID: PMC8041079 DOI: 10.4103/jisp.jisp_49_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 09/24/2020] [Accepted: 10/11/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND At the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions, periodontitis was reclassified according to a multidimensional staging and grading system. Grading takes variabilities in the rate of disease progression into account, relying on recognized progression risk factors, and is based on the assessment of bone loss at the worst-affected tooth in the dentition as a function of age, which is then modified by factors such as smoking and diabetes mellitus. In this context, the aim of this study was to determine whether there are correlations between radiographically calculated grades and grades modified by the presence of smoking or diabetes. MATERIALS AND METHODS In this descriptive study, individuals diagnosed with periodontitis according to the 2017 classifications were examined. The grade of periodontitis was measured using periapical radiography. A modified-grade level was assigned to the patients according to their glycated hemoglobin levels (in diabetics) or their smoking status. RESULTS The study included 341 individuals. No statistically significant relationship was revealed by Chi-square testing (P > 0.05) or in the kappa agreement index between the modified grades and the radiographic grades. CONCLUSIONS Although there was no correlation between radiographic grade and modified grade in smokers and diabetic individuals, increasing the grade score in these individuals in accordance with the 2017 classification provides clinicians the opportunity to develop a risk-based treatment plan, commensurate with the severity of periodontal disease and the level of risk.
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Affiliation(s)
- Fatih Karaaslan
- Department of Periodontology, Faculty of Dentistry, Usak, Turkey
| | - Ahu Dikilitaş
- Department of Periodontology, Faculty of Dentistry, Usak, Turkey
| | - Esra Özge Aydın
- Department of Periodontology, Faculty of Dentistry, Usak, Turkey
| | - Vesile Şen
- Department of Periodontology, Faculty of Dentistry, Usak, Turkey
| | - Şerife Esra Kurt
- Department of Periodontology, Faculty of Dentistry, Usak, Turkey
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135
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Ndjidda Bakari W, Diallo AM, Danwang C, Nzalie RNT, Benoist HM. Long-term effect of non-surgical periodontal treatment on glycaemic control in patients with diabetes with periodontitis: a systematic review and meta-analysis protocol. BMJ Open 2021; 11:e043250. [PMID: 33619190 PMCID: PMC7903101 DOI: 10.1136/bmjopen-2020-043250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Non-surgical periodontal therapy consisting of scaling and root planning has been shown to be effective in the improvement of glycaemic control in patients with diabetes with periodontitis for up to 3 months. However, questions remain about this beneficial effect over a longer period of time. This systematic review and meta-analysis aims to determine the long-term effect (at least 6 months from the therapy) of non-surgical periodontal therapy with or without adjuvant on glycaemic control of patients with diabetes with periodontitis. METHODS AND ANALYSIS This systematic review will include randomised control trials with a follow-up period of at least 6 months after initial therapy, with measurement of glycated haemoglobin as the primary endpoint. A literature search will be conducted in MEDLINE, CENTRAL, EMBASE, CINAHL, The Cochrane Oral Health Group Trials Register, and the US National Institutes of Health Trials Registry: ClinicalTrials.gov, from inception to 30 June 2020. Selection of studies, data extraction and bias assessment will be conducted independently by two reviewers. A DerSimonian-Laird random-effect meta-analysis will be conducted to pool studies deemed to be homogeneous. A subgroup analysis will be conducted in case of substantial heterogeneity. Egger's test and observation of the funnel plot will be used to assess publication bias. The statistical analysis will be done using R V.4.0.0 software. ETHICS AND DISSEMINATION Since primary data are not collected, ethical approval is not required. The final report will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020192635.
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Affiliation(s)
- William Ndjidda Bakari
- Periodontology, Faculty of Medicine Pharmacy and Dentistry, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Ahmad Moustapha Diallo
- Periodontology, Faculty of Medicine Pharmacy and Dentistry, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Celestin Danwang
- Epidemiology and Biostatistics Unit, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | | | - Henri Michel Benoist
- Periodontology, Faculty of Medicine Pharmacy and Dentistry, Cheikh Anta Diop University of Dakar, Dakar, Senegal
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136
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Anton DM, Martu MA, Maris M, Maftei GA, Sufaru IG, Tatarciuc D, Luchian I, Ioanid N, Martu S. Study on the Effects of Melatonin on Glycemic Control and Periodontal Parameters in Patients with Type II Diabetes Mellitus and Periodontal Disease. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:140. [PMID: 33562452 PMCID: PMC7915328 DOI: 10.3390/medicina57020140] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 12/03/2022]
Abstract
Background and Objectives: There is evidence that melatonin could improve the periodontal status and also glycemic control of patients with diabetes mellitus. Therefore, the aim of this study was to assess the effects of scaling and root planing plus adjunctive systemic treatment with melatonin on periodontal parameters and glycemic control in patients with type 2 diabetes and chronic periodontitis. Materials and Methods: The study was conducted on 54 subjects with periodontitis and diabetes mellitus randomly assigned to the study group (n = 27, subjects with scaling and root planing + melatonin) or control group (n = 27, subjects with scaling and root planing + placebo). Periodontal parameters (probing depth-PD; clinical attachment loss-CAL; bleeding on probing-BOP; and hygiene level) and glycated hemoglobin (HbA1c) were assessed at baseline and 8 weeks after. Results: At baseline, there were no significant differences between groups, but at the second evaluation 8 weeks later the association of melatonin with the non-surgical periodontal therapy exerted statistically significant improvements, both in periodontal parameters, with a significant decrease in periodontal disease severity, and glycated hemoglobin when compared to the control subjects. Conclusions: In our study, combined non-surgical periodontal treatment and systemic treatment with melatonin provided additional improvements to severe periodontal condition and the glycemic control of patients with diabetes type 2 when compared to non-surgical periodontal treatment alone.
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Affiliation(s)
- Diana-Maria Anton
- Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (D.-M.A.); (G.-A.M.); (I.-G.S.); (I.L.); (N.I.); (S.M.)
| | - Maria-Alexandra Martu
- Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (D.-M.A.); (G.-A.M.); (I.-G.S.); (I.L.); (N.I.); (S.M.)
| | - Marius Maris
- Faculty of Dental Medicine, “Titu Maiorescu” University, 67A Gheorghe Petrascu Str., 031593 Bucharest, Romania
| | - George-Alexandru Maftei
- Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (D.-M.A.); (G.-A.M.); (I.-G.S.); (I.L.); (N.I.); (S.M.)
| | - Irina-Georgeta Sufaru
- Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (D.-M.A.); (G.-A.M.); (I.-G.S.); (I.L.); (N.I.); (S.M.)
| | - Diana Tatarciuc
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania;
| | - Ionut Luchian
- Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (D.-M.A.); (G.-A.M.); (I.-G.S.); (I.L.); (N.I.); (S.M.)
| | - Nicoleta Ioanid
- Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (D.-M.A.); (G.-A.M.); (I.-G.S.); (I.L.); (N.I.); (S.M.)
| | - Silvia Martu
- Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (D.-M.A.); (G.-A.M.); (I.-G.S.); (I.L.); (N.I.); (S.M.)
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137
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Desai R, Khobaragade B, McCracken G, Wassall R, Taylor JJ, Bissett SM, Pumerantz AS, Preshaw PM. Impact of diabetes and periodontal status on life quality. BDJ Open 2021; 7:9. [PMID: 33542186 PMCID: PMC7862251 DOI: 10.1038/s41405-021-00061-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/23/2020] [Accepted: 12/06/2020] [Indexed: 11/10/2022] Open
Abstract
Objectives To investigate impact of periodontal status on quality of life (QoL) in type-1 (T1D) and type-2 (T2D) diabetes patients pre- and post-periodontal treatment using the Well-being Questionnaire 12 (W-BQ12) and Audit of Diabetes-Dependent Quality of Life-19 (ADDQoL-19). Methods W-BQ12 and ADDQoL-19 were self-completed by 56 T1D and 77 T2D patients at baseline and by those with periodontitis 3 and 6-months after therapy. Results At baseline, T1D patients had significantly higher general W-BQ12 [Median (IQR); 24.00 (20.25–27.75)] and positive well-being scores [8.00 (6.00–9.00)] (indicating better QoL) compared to T2D patients [22.00 (15.50–26.00) and 6.00 (3.50–9.00)], respectively (p < 0.05). Within both groups, general W-BQ12 scores did not differ significantly between patients with periodontal health, gingivitis, or periodontitis (p > 0.05). Significantly higher general W-BQ12 scores were observed in T1D patients at month 3 [28.00 (22.00–29.50)] compared to baseline [22.00 (17.00–24.50)] (p < 0.01), suggesting an initial improvement in QoL post-treatment. ADDQoL-19 identified that diabetes had greatest impact on the domain ‘freedom to eat’, with participants placing most importance on ‘family life’. No significant changes in ADDQoL-19 scores were seen post-treatment (p > 0.05). Conclusions Diabetes had impacts upon aspects of life quality in both T1D and T2D patients, though any additional impact based on periodontal status was not observed when using W-BQ12 and ADDQoL-19.
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Affiliation(s)
- Radhika Desai
- University of Bristol Dental School, University of Bristol, Bristol, UK.
| | | | - Giles McCracken
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Rebecca Wassall
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - John J Taylor
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Susan M Bissett
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew S Pumerantz
- Department of Population Health, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Philip M Preshaw
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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138
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Pappe CL, Steckhan N, Hoedke D, Jepsen S, Rauch G, Keller T, Michalsen A, Dommisch H. Prolonged multimodal fasting modulates periodontal inflammation in female patients with metabolic syndrome: A prospective cohort study. J Clin Periodontol 2021; 48:492-502. [PMID: 33393121 DOI: 10.1111/jcpe.13419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/19/2020] [Accepted: 12/23/2020] [Indexed: 12/15/2022]
Abstract
AIM To determine the potential anti-inflammatory effect of a multimodal periodic fasting programme on surrogate parameters of periodontal inflammation in hospitalized patients diagnosed for metabolic syndrome (MetS). MATERIAL AND METHODS A total of 47 patients were recruited and hospitalized in an integrative ward for an intensified two-week multimodal fasting, diet and lifestyle programme. Patients were periodontally examined at baseline (t1), after the 2-week fasting protocol (t2) and, subsequently, 4 months after fasting (t3). The following parameters were determined: periodontal screening index (PSI), bleeding on probing (BOP), gingival crevicular fluid volume (GCF), plaque index (PI), C-reactive protein (CRP), blood pressure (BP), waist circumference (WC), fasting glucose (FGLU), triglycerides (TRG), high-density lipoprotein (HDL) and HbA1c. RESULTS A total of 28 female and 8 male patients fulfilled the defined criteria for MetS and were analysed separately by gender. At t2, BOP and GCF were reduced when compared to t1 (median: t2 = 39; t1 = 33.1%; p < .001 and t2 = 73.9; t1 = 59.3 Periotron units p = .02, respectively). BOP reduction correlated to FGLU (R = .37, p = .049) and weight reduction (R = .4, p = .04). CONCLUSION This study showed for the first time that clinically supervised periodic fasting in female patients with MetS may facilitate the reduction of periodontal inflammation.
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Affiliation(s)
- Christina Laetitia Pappe
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nico Steckhan
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany.,Digital Engineering Faculty, Hasso Plattner Institute, University of Potsdam, Germany
| | - Daniela Hoedke
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Geralinde Rauch
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Theresa Keller
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Michalsen
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Periodontology, Health Science Center, University of Washington, Seattle, WA, USA
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139
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Escalda C, Botelho J, Mendes JJ, Machado V. Association of bacterial vaginosis with periodontitis in a cross-sectional American nationwide survey. Sci Rep 2021; 11:630. [PMID: 33436651 PMCID: PMC7803979 DOI: 10.1038/s41598-020-79496-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/09/2020] [Indexed: 01/29/2023] Open
Abstract
To explore the association between bacterial vaginosis (BV) and periodontitis (PD) and to determine whether PD and BV might be linked with systemic serum alterations. We used the National Health and Nutrition Examination Survey 2001-2004, with women aged 18-49 years old and diagnosed with or without BV according to Nugent's method. PD was defined according to the 2012 case definition. We compared serum counts according to the presence of PD and the presence of BV. Multivariable regression was used to explore and identify relevant variables towards the presence of BV. 961 women fulfilled the inclusion criteria. In women with BV, PD was associated with higher inflammation, characterized by increased white blood cells (p = 0.006) and lymphocyte (p = 0.009) counts. Predictive models presented a statistically significant association between PD and BV [Odds Ratio (OD) = 1.69, 95% Confidence Interval (CI): 1.09-2.61 for periodontitis; OD = 2.37, 95% CI: 1.30-4.29 for severe PD]. Fully adjusted models for age, smoking, body mass index, diabetes mellitus and number of systemic conditions reinforced this association [OD = 1.71, 95% CI: 1.06-2.76 for PD; OD = 2.21, 95% CI: 1.15-4.25 for severe PD]. An association between BV and PD is conceivable. PD was associated with higher systemic markers of inflammation in women with BV. Our data is novel and could serve as a foundation to guide future studies in the confirmation of this association and the underlying mechanisms.
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Affiliation(s)
- Cláudia Escalda
- Evidence-Based Hub Egas Moniz, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - João Botelho
- Evidence-Based Hub Egas Moniz, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, CRL, Almada, Portugal
- Periodontology Department, Egas Moniz Dental Clinic, Clinical Research Unit (CRU), Egas Moniz Interdisciplinary Research Center (EMIRC), IUEM, Egas Moniz University, Campus Universitário, Quinta da Granja, Monte de Caparica, Caparica, 2829 - 511, Almada, Portugal
| | - José João Mendes
- Evidence-Based Hub Egas Moniz, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, CRL, Almada, Portugal
| | - Vanessa Machado
- Evidence-Based Hub Egas Moniz, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, CRL, Almada, Portugal.
- Periodontology Department, Egas Moniz Dental Clinic, Clinical Research Unit (CRU), Egas Moniz Interdisciplinary Research Center (EMIRC), IUEM, Egas Moniz University, Campus Universitário, Quinta da Granja, Monte de Caparica, Caparica, 2829 - 511, Almada, Portugal.
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140
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Martinon P, Fraticelli L, Giboreau A, Dussart C, Bourgeois D, Carrouel F. Nutrition as a Key Modifiable Factor for Periodontitis and Main Chronic Diseases. J Clin Med 2021; 10:jcm10020197. [PMID: 33430519 PMCID: PMC7827391 DOI: 10.3390/jcm10020197] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/26/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Nutrition is recognized as an essential component in the prevention of a number of chronic diseases, including periodontal disease. Based on these considerations, a better understanding is required regarding how the diet, and more particularly the intake of macronutrients and micronutrients, could impact the potential relationship between nutrition and periodontal diseases, periodontal diseases and chronic diseases, nutrition and chronic diseases. To overcome this complexity, an up-to-date literature review on the nutriments related to periodontal and chronic diseases was performed. High-sugar, high-saturated fat, low-polyols, low-fiber and low-polyunsaturated-fat intake causes an increased risk of periodontal diseases. This pattern of nutrients is classically found in the Western diet, which is considered as an ‘unhealthy’ diet that causes cardiovascular diseases, diabetes and cancers. Conversely, low-sugar, high-fiber and high-omega-6-to-omega-3 fatty acid ratio intake reduces the risk of periodontal diseases. The Mediterranean, DASH, vegetarian and Okinawa diets that correspond to these nutritional intakes are considered as ‘healthy’ diets, reducing this risk of cardiovascular diseases, diabetes and cancers. The role of micronutrients, such as vitamin D, E, K and magnesium, remains unclear, while others, such as vitamin A, B, C, calcium, zinc and polyphenols have been shown to prevent PDs. Some evidence suggests that probiotics and prebiotics could promote periodontal health. Periodontal and chronic diseases share, with a time delay, nutrition as a risk factor. Thus, any change in periodontal health should be considered as a warning signal to control the dietary quality of patients and thus reduce the risk of developing chronic diseases later on.
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Affiliation(s)
- Prescilla Martinon
- Laboratory “Systemic Health Care”, University of Lyon, University Claude Bernard Lyon 1, EA4129, 69008 Lyon, France; (P.M.); (L.F.); (C.D.); (D.B.)
| | - Laurie Fraticelli
- Laboratory “Systemic Health Care”, University of Lyon, University Claude Bernard Lyon 1, EA4129, 69008 Lyon, France; (P.M.); (L.F.); (C.D.); (D.B.)
| | - Agnes Giboreau
- Institute Paul Bocuse Research Center, 69130 Ecully, France;
| | - Claude Dussart
- Laboratory “Systemic Health Care”, University of Lyon, University Claude Bernard Lyon 1, EA4129, 69008 Lyon, France; (P.M.); (L.F.); (C.D.); (D.B.)
| | - Denis Bourgeois
- Laboratory “Systemic Health Care”, University of Lyon, University Claude Bernard Lyon 1, EA4129, 69008 Lyon, France; (P.M.); (L.F.); (C.D.); (D.B.)
| | - Florence Carrouel
- Laboratory “Systemic Health Care”, University of Lyon, University Claude Bernard Lyon 1, EA4129, 69008 Lyon, France; (P.M.); (L.F.); (C.D.); (D.B.)
- Correspondence: ; Tel.: +33-4-78-78-57-44
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141
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Cirelli T, Nepomuceno R, Goveia JM, Orrico SRP, Cirelli JA, Theodoro LH, Barros SP, Scarel-Caminaga RM. Association of type 2 diabetes mellitus and periodontal disease susceptibility with genome-wide association-identified risk variants in a Southeastern Brazilian population. Clin Oral Investig 2021; 25:3873-3892. [PMID: 33392810 DOI: 10.1007/s00784-020-03717-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Genome-wide association studies (GWAS) and literature have identified polymorphisms in the KCNJ11, HNF1A, IRS1, TCF7L2, CDKAL1, CDKN2B, RPSAP52, GPR45 HHEX, IL18, and RUNX2 genes associated with type 2 diabetes mellitus (T2DM) and/or periodontitis (P) in diverse populations, and we sought to evaluate them as genetic risk variants for these diseases in the Brazilian population. MATERIAL AND METHODS Periodontal, glycemic, and lipid data were obtained from 931 individuals divided into: control (n = 334), periodontitis (P; n = 358), and periodontitis associated with T2DM (P + T2DM; n = 239). After genotyping, associations between polymorphisms and pathologies were tested by multiple logistic and linear regressions, adjusting for age, sex, and smoking habits. RESULTS Considering the studied subjects, the increased risk to develop periodontitis in the periodontitis P + T2DM group was found for HNF1A-rs7957197-TA, CDKAL1-rs7754840-CG, RPSAP52-rs1531343-GC, TCF7L2-rs7903146-TT, and CDKN2B-rs7018475-GG. The association of these genetic variants for TCF7L2 and CDKN2B was confirmed for female, never smokers, and poorly controlled P + T2DM. CDKN2B-rs7018475 was associated with worse glycemic condition and periodontal parameters. CONCLUSION These five reported genetic variants were associated in the studied Southeastern Brazilian population as genetic risk variants of periodontitis and T2DM associated to periodontitis as comorbidity. Gene-phenotype associations with sex and smoking habits and the CDKN2B-rs7018475 with the poor glycemic control and more severe periodontal conditions should be further investigated. CLINICAL RELEVANCE Polymorphisms in the CDKAL1-rs7754840, HNF1A-rs7957197, RPSAP52-rs1531343, TCF7L2-rs7903146, and CDKN2B-rs7018475 might predispose to periodontitis and T2DM associated with periodontitis. These findings may be useful in public health genomics and future advanced clinical practice, since genetic carriage can be measured before disease onset, being of potential great benefit for treatment planning and prognosis in early disease stages.
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Affiliation(s)
- Thamiris Cirelli
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil.,Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Rafael Nepomuceno
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil.,Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Jéssica Marina Goveia
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Silvana R P Orrico
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil.,Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto, SP, Brazil
| | - Joni A Cirelli
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Letícia Helena Theodoro
- Department of Surgery and Integrated Clinic, São Paulo State University - UNESP, School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| | - Silvana P Barros
- Department of Comprehensive Oral Health - Periodontology, University of North Carolina at Chapel Hill - UNC, School of Dentistry, Chapel Hill, NC, USA
| | - Raquel M Scarel-Caminaga
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil.
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142
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AL-Haddad A, Hassona Y, Silawi A, Al Kayed A. A narrative review of Diabetes mellitus: An update for dentists. SAUDI JOURNAL OF ORAL SCIENCES 2021. [DOI: 10.4103/sjos.sjoralsci_68_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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143
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Seidel A, Seidel CL, Weider M, Junker R, Gölz L, Schmetzer H. Influence of Natural Killer Cells and Natural Killer T Cells on Periodontal Disease: A Systematic Review of the Current Literature. Int J Mol Sci 2020; 21:E9766. [PMID: 33371393 PMCID: PMC7767411 DOI: 10.3390/ijms21249766] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 01/01/2023] Open
Abstract
Natural killer (NK) cells, as members of the innate immune system, and natural killer T (NKT) cells, bridging innate and adaptive immunity, play a prominent role in chronic inflammatory diseases and cancerogenesis, yet have scarcely been examined in oral diseases. Therefore, systematic research on the latest literature focusing on NK/NKT cell-mediated mechanisms in periodontal disease, including the time period 1988-2020, was carried out in MEDLINE (PubMed) using a predetermined search strategy, with a final selection of 25 studies. The results showed that NK cells tend to have rather proinflammatory influences via cytokine production, cytotoxic effects, dendritic-cell-crosstalk, and autoimmune reactions, while contrarily, NKT cell-mediated mechanisms were proinflammatory and immunoregulatory, ranging from protective effects via B-cell-regulation, specific antibody production, and the suppression of autoimmunity to destructive effects via cytokine production, dendritic-cell-crosstalk, and T-/B-cell interactions. Since NK cells seem to have a proinflammatory role in periodontitis, further research should focus on the proinflammatory and immunoregulatory properties of NKT cells in order to create, in addition to antibacterial strategies in dental inflammatory disease, novel anti-inflammatory therapeutic approaches modulating host immunity towards dental health.
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Affiliation(s)
- Andreas Seidel
- Dental Practice, Bahnhofstraße 10, 82223 Eichenau, Germany
| | - Corinna L. Seidel
- Department of Orthodontics and Orofacial Orthopedics, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Glückstr. 11, 91054 Erlangen, Germany; (M.W.); (L.G.)
| | - Matthias Weider
- Department of Orthodontics and Orofacial Orthopedics, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Glückstr. 11, 91054 Erlangen, Germany; (M.W.); (L.G.)
| | - Rüdiger Junker
- Center for Dental Prosthetics and Biomaterials, Danube Private University Krems, Steiner Landstraße 124, 3500 Krems-Stein, Austria;
| | - Lina Gölz
- Department of Orthodontics and Orofacial Orthopedics, Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Glückstr. 11, 91054 Erlangen, Germany; (M.W.); (L.G.)
| | - Helga Schmetzer
- Department of Medical III, University Hospital LMU Munich, Marchioninistraße 15, 81377 Munich, Germany;
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144
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Alshihayb TS, Kaye EA, Zhao Y, Leone CW, Heaton B. A quantitative bias analysis to assess the impact of unmeasured confounding on associations between diabetes and periodontitis. J Clin Periodontol 2020; 48:51-60. [PMID: 33031608 DOI: 10.1111/jcpe.13386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/16/2020] [Accepted: 10/01/2020] [Indexed: 01/13/2023]
Abstract
AIM To investigate unmeasured confounding in bidirectional associations between periodontitis and diabetes using quantitative bias analysis. METHODS Subsamples from the Veterans Affairs Dental Longitudinal Study were selected. Adjusted for known confounders, we used Cox proportional hazards models to estimate associations between pre-existing clinical periodontitis and incident Type II Diabetes (n = 672), and between pre-existing diabetes and incident severe periodontitis (n = 521), respectively. Hypothetical confounders were simulated into the dataset using Bernoulli trials based on pre-specified distributions of confounders within categories of each exposure and outcome. We calculated corrected hazard ratios (HR) over 10,000 bootstrapped samples. RESULTS In models using periodontitis as the exposure and incident diabetes as the outcome, adjusted HR = 1.21 (95% CI: 0.64-2.30). Further adjustment for simulated confounders positively associated with periodontitis and diabetes greatly attenuated the association or explained it away entirely (HR = 1). In models using diabetes as the exposure and incident periodontitis as the outcome, adjusted HR = 1.35 (95% CI: 0.79-2.32). After further adjustment for simulated confounders, the lower bound of the simulation interval never reached the null value (HR ≥ 1.03). CONCLUSIONS Presence of unmeasured confounding does not explain observed associations between pre-existing diabetes and incident periodontitis. However, presence of weak unmeasured confounding eliminated observed associations between pre-existing periodontitis and incident diabetes. These results clarify the bidirectional periodontitis-diabetes association.
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Affiliation(s)
- Talal S Alshihayb
- Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.,College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Elizabeth A Kaye
- Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Yihong Zhao
- Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.,Center of Alcohol and Substance Use Studies, Department of Applied Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, NJ, USA
| | - Cataldo W Leone
- Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Brenda Heaton
- Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
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145
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Jain A, Chawla M, Kumar A, Chawla R, Grover V, Ghosh S, Pandit N, Chawla P. Management of periodontal disease in patients with diabetes- good clinical practice guidelines: A joint statement by Indian Society of Periodontology and Research Society for the Study of Diabetes in India. J Indian Soc Periodontol 2020; 24:498-524. [PMID: 33424167 PMCID: PMC7781257 DOI: 10.4103/jisp.jisp_688_20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022] Open
Abstract
There is a huge body of literature suggesting an association and a bidirectional relationship between periodontal disease and diabetes. Diabetes and periodontal diseases are both chronic diseases with a high prevalence. Dentists/periodontists, in their daily clinical practice, very often attend to diabetes patients with diverse oral health conditions and cater to their dental treatment needs. Safe and effective periodontal therapy in this population requires a broad understanding of diabetes, medical management of diabetes, and essential modifications to dental/periodontal therapy that may be required. This paper describes a joint statement put forth by the Indian Society of Periodontology and the Research Society for the Study of Diabetes in India aiming to provide expert consensus and evidence-based guidelines for optimal clinical management of periodontal conditions in diabetes patients or patients at risk for diabetes. Although this paper is not envisioned to be a comprehensive review of this topic, it intends to provide the guidelines for dental professionals and periodontists.
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Affiliation(s)
- Ashish Jain
- Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Manoj Chawla
- Lina Diabetes Care Centre, Mumbai, Maharashtra, India
| | - Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Rajeev Chawla
- North Delhi Diabetes Centre, Rohini, New Delhi, India
| | - Vishakha Grover
- Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Sujoy Ghosh
- Department of Endocrinology and Metabolism, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Nymphea Pandit
- Department of Periodontology, D. A. V. Dental College and Hospital, Yamunanagar, Haryana, India
| | - Purvi Chawla
- Lina Diabetes Care Centre, Mumbai, Maharashtra, India
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146
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Schmalz G, Wolf C, Merle C, Kottmann T, Haak R, Ziebolz D. Evaluation of a questionnaire-based diabetes screening concept in German patients with Stage III or IV periodontitis: A practice-based study. J Periodontol 2020; 92:1163-1170. [PMID: 33155276 DOI: 10.1002/jper.20-0297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/13/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND This practice-based retrospective study evaluated a screening method for diabetes mellitus (DM) in patients with Stage III or IV periodontitis using the FINDRISC questionnaire. METHODS Patients with Stage III or IV periodontitis who received FINDRISC screening in a German private dental practice were recruited. Individuals with positive FINDRISC scores (≥12, FINDRISC+) were referred for diabetological examination. Several general and periodontal findings from the patients' documentation were recorded and analyzed. RESULTS A total of 179 patients (52.65 ± 11.49 years) were included. In DM screening, 24.6% (n = 44) patients were FINDRISC+, including all patients with currently known DM (21 of 21). Of the remaining FINDRISC+ patients, 82.6% (19 of 23) visited their general practitioner, and 63.2% (12 of 19, 7.6% of total cohort) had an HbA1c ≥5.7%. Accordingly, 75% of the FINDRISC+ patients were diabetologically conspicuous (HbA1c ≥ 5.7%), including those with already known DM. Patients with previously unknown DM showed higher mean age, more missing teeth, a higher periodontitis stage (more Stage IV) and more frequently teeth with suppuration compared with the diabetologically inconspicuous individuals (P <0.01). CONCLUSION The FINDRISC questionnaire is appropriate for patients with Stage III or IV periodontitis and can be recommended in dental practice setting.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | | | - Cordula Merle
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | | | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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147
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Al-Zawawi AS, Bukhari IA, Bello-Correa FO, Sheikh SA, Albaijan R, Vohra F. Influence of root debridement with adjunct photodynamic therapy on periodontal parameters and gingival crevicular fluid cortisol levels among patients with and without type-2 diabetes mellitus. Photodiagnosis Photodyn Ther 2020; 32:102076. [PMID: 33152543 DOI: 10.1016/j.pdpdt.2020.102076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of the present study was to assess the influence of scaling and root planing (SRP) with adjunct antimicrobial photodynamic therapy (aPDT) on periodontal parameters and gingival crevicular fluid (GCF) cortisol levels in type-2 diabetic and non-diabetic patients with periodontitis. METHODS One hundred and twenty-eight patients with periodontitis (64 with and 64 without type-2 diabetes mellitus, respectively) were included. In the test- and control-groups, patients underwent SRP with and without aPDT, respectivey. In both groups, plaque and gingival indices (PI and GI), probing depth (PD), clinical attachment loss (CAL), marginal bone loss (MBL) and GCF volume and cortisol levels were assessed at baseline and three and six-months after SRP with or without aPDT. The aPDT was performed at baseline using methylene blue and photobiomodulation. The Kruskall-Wallis test was used to assess data normality; and group-comparisons were done. P-values, which were below 0.01 indicated statistical significance. RESULTS Sixty-four type-2 diabetic patients with and 64 non-diabetic patients with periodontitis were included. All individuals had Stage-III/Grade-C periodontitis. Among patients with type-2 diabetes mellitus (DM), there was no statistically significant difference in hemoblobin A1c, PI, GI, PD, CAL and MBL at baseline and at 3- and 6-months intervals. Amongst diabetic patietns, there was no difference in the GCF volume and cortisol levels in the test- and control-groups at all time intervals. In non-diabetic patients, there was a significqnt reductionin GCF volume and cortisol levels when SRP was done with aPDT than when SRP was carried out as the sole treatment strategy CONCLUSION: Among non-diabetic patients, SRP with aPDT helps reduce periodontal inflammation and GCF cortisol levels for up to 6-months; however poorly-controlled DM compromises the beneficial effects of this treatment strategy.
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Affiliation(s)
- Abeer S Al-Zawawi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ishfaq A Bukhari
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fernanda O Bello-Correa
- Department of Dentistry, Life Sciecnes Institute, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil
| | - Saeed A Sheikh
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Refal Albaijan
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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148
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Kawasaki M, Ikeda Y, Ikeda E, Takahashi M, Tanaka D, Nakajima Y, Arakawa S, Izumi Y, Miyake S. Oral infectious bacteria in dental plaque and saliva as risk factors in patients with esophageal cancer. Cancer 2020; 127:512-519. [PMID: 33156979 DOI: 10.1002/cncr.33316] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND High levels of periodontopathic bacteria as well as Streptococcus anginosus were detected in cancer tissue from patients with esophageal cancer. An association between oral infectious bacteria and esophageal cancer has been reported. METHODS Characteristics of the oral microbiota and periodontal conditions were studied as clinicopathologic factors in patients with esophageal cancer. The study included 61 patients with esophageal cancer and 62 matched individuals without any cancers. Samples of subgingival dental plaque and unstimulated saliva were collected to evaluate the prevalence and abundance of the following oral bacteria using a real-time polymerase chain reaction assay: Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Treponema denticola, and S. anginosus. RESULTS In the cancer group, the prevalence of all bacteria, with the exception of F. nucleatum, in dental plaque; the prevalence of A. actinomycetemcomitans in saliva; the abundance of all bacteria, with the exception of F. nucleatum and P. intermedia, in dental plaque; and the abundance of A. actinomycetemcomitans and S. anginosus in saliva were significantly higher. Furthermore, a logistic regression analysis suggested that the prevalence of T. forsythia and S. anginosus in dental plaque and of A. actinomycetemcomitans in saliva, as well as a drinking habit, were associated with a high risk of esophageal cancer, with a high odds ratio. CONCLUSIONS The current findings have potential implications for the early diagnosis of esophageal cancer.
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Affiliation(s)
- Machiko Kawasaki
- Department of Clinical Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Ikeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Eri Ikeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Momoko Takahashi
- Department of Clinical Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daiki Tanaka
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Shinichi Arakawa
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Izumi
- Oral Care Perio Center, Southern TOHOKU General Hospital, Southern TOHOKU Research Institute for Neuroscience, Fukushima, Japan
| | - Satoshi Miyake
- Department of Clinical Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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149
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Tegelberg P, Tervonen T, Knuuttila M, Jokelainen J, Keinänen-Kiukaanniemi S, Auvinen J, Ylöstalo P. Association of hyperglycaemia with periodontal status: Results of the Northern Finland Birth Cohort 1966 study. J Clin Periodontol 2020; 48:24-36. [PMID: 33048362 DOI: 10.1111/jcpe.13388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
AIM To investigate the association of hyperglycaemia and changes in glycaemic control with periodontal status in non-diabetic individuals. MATERIALS AND METHODS A sub-population (n = 647) of the Northern Finland Birth Cohort 1966 was studied. We categorized long-term glucose balance based on fasting plasma glucose (FPG) at ages 31 and 46: FPG <5.0 mmol/l (strict normoglycaemia), FPG 5.0-5.59 mmol/l (slightly elevated FPG) and FPG 5.6-6.9 mmol/l (prediabetes). Probing pocket depth (PPD) and alveolar bone level (BL) data were collected at age 46. Relative risks (RR, 95% CI) were estimated using Poisson regression models. RESULTS Periodontal status was poorer in individuals whose glucose balance worsened from age 31 to 46 years than in those with a stable glucose balance. In the case of strict normoglycaemia at age 31 and slightly elevated FPG or prediabetes at age 46, the RRs for PPD ≥4 mm were 1.8 (95% CI 1.4-2.2) and 2.8 (95% CI 2.0-3.8) and for BL ≥5 mm 1.1 (95% CI 0.8-1.4) and 1.8 (95% CI 1.2-2.8), respectively. CONCLUSION The results of this population-based cohort study suggest that impairment in glucose control in non-diabetic individuals is associated with periodontal pocketing and alveolar bone loss.
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Affiliation(s)
- Paula Tegelberg
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tellervo Tervonen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Epidemiology and Systems Medicine, University of Oulu and Unit of Primary Care, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Healthcare and Social Services of Selänne, Pyhäjärvi, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Health Centre of Oulu, Oulu, Finland
| | - Juha Auvinen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Health Centre of Oulu, Oulu, Finland.,Oulunkaari Health Centre, Ii, Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
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150
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Silva BRD, Cirelli T, Nepomuceno R, Theodoro LH, Orrico SRP, Cirelli JA, Barros SP, Scarel-Caminaga RM. Functional haplotype in the Interleukin8 (CXCL8) gene is associated with type 2 Diabetes Mellitus and Periodontitis in Brazilian population. Diabetes Metab Syndr 2020; 14:1665-1672. [PMID: 32905938 DOI: 10.1016/j.dsx.2020.08.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Type 2 Diabetes Mellitus (T2DM) and Periodontitis (P) are prevalent multifactorial disorders worldwide, sharing a bidirectional relationship influenced by the genetic susceptibility of the host immune system. We investigated whether SNPs in the Interleukin 8 (IL8, alias CXCL8) gene could be associated with T2DM and Periodontitis. METHODS Genomic DNA was obtained from 874 Brazilian individuals divided into: Healthy group (n = 307), Periodontitis group (n = 334), and individuals affected by both T2DM and Periodontitis (T2DM_P) group (n = 233). The SNPs -251(T>A) rs4073, +396(T>G) rs2227307 and +781(C>T) rs2227306 were genotyped by TaqMan®. Multiple logistic regressions were used to determine the degree of association between polymorphisms (and haplotypes) with periodontitis and T2DM adjusted for known confounders. RESULTS The additive model revealed that the heterozygous AT(-251), GT(+396) and CT(+781) genotypes showed a lower risk for the diseased phenotypes, and carriers of the TTC/TTC haplotype were significantly susceptible to T2DM and Periodontitis concomitantly, as well to isolated Periodontitis (mainly the severe form). CONCLUSIONS We concluded, for the first time, that these functional CXCL8 SNPs, and the homozygous TTC haplotype are relevant genetic factors for T2DM and Periodontitis as comorbidities, as well as for severe Periodontitis susceptibility in Brazilian population.
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Affiliation(s)
- Bárbara Roque da Silva
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil; Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Thamiris Cirelli
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil; Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Rafael Nepomuceno
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil; Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Letícia Helena Theodoro
- Department of Surgery and Integrated Clinic, São Paulo State University - UNESP, School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| | - Silvana R P Orrico
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil; Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto, SP, 15030-070, Brazil
| | - Joni A Cirelli
- Department of Diagnosis and Surgery, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Silvana P Barros
- Department of Comprehensive Oral Health - Periodontology, University of North Carolina at Chapel Hill - UNC, School of Dentistry, Chapel Hill, NC, USA
| | - Raquel M Scarel-Caminaga
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University - UNESP, School of Dentistry at Araraquara, Araraquara, SP, Brazil.
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