201
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Pirih FQ, Monajemzadeh S, Singh N, Sinacola RS, Shin JM, Chen T, Fenno JC, Kamarajan P, Rickard AH, Travan S, Paster BJ, Kapila Y. Association between metabolic syndrome and periodontitis: The role of lipids, inflammatory cytokines, altered host response, and the microbiome. Periodontol 2000 2021; 87:50-75. [PMID: 34463996 PMCID: PMC8457155 DOI: 10.1111/prd.12379] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontitis has been associated with many systemic diseases and conditions, including metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur concomitantly and together they increase the risk of cardiovascular disease and double the risk of type 2 diabetes. In this review, we focus on the association between metabolic syndrome and periodontitis; however, we also include information on diabetes mellitus and cardiovascular disease, since these two conditions are significantly intertwined with metabolic syndrome. With regard to periodontitis and metabolic syndrome, to date, the vast majority of studies point to an association between these two conditions and also demonstrate that periodontitis can contribute to the development of, or can worsen, metabolic syndrome. Evaluating the effect of metabolic syndrome on the salivary microbiome, data presented herein support the hypothesis that the salivary bacterial profile is altered in metabolic syndrome patients compared with healthy patients. Considering periodontitis and these three conditions, the vast majority of human and animal studies point to an association between periodontitis and metabolic syndrome, diabetes, and cardiovascular disease. Moreover, there is evidence to suggest that metabolic syndrome and diabetes can alter the oral microbiome. However, more studies are needed to fully understand the influence these conditions have on each other.
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Affiliation(s)
- Flavia Q Pirih
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, California
| | | | - Neelima Singh
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | | | - Jae Min Shin
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Tsute Chen
- The Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Pachiyappan Kamarajan
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
| | - Alexander H Rickard
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Suncica Travan
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Bruce J Paster
- The Forsyth Institute, Cambridge, Massachusetts.,Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Yvonne Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California
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202
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AlDukhail S, Alhazmi H, Riedy C, Barrow JR, Chamut S. Oral health outcomes among adults with diabetes served at HRSA-funded health centers. J Diabetes Complications 2021; 35:107979. [PMID: 34243996 DOI: 10.1016/j.jdiacomp.2021.107979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/06/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To examine the association of diabetes with tooth loss and oral manifestations among adult health center patients (HCPs). METHODS This cross-sectional study utilized the nationally representative 2014 HCPs-Survey. Descriptive and logistic regression analyses limited to adults (n = 5524) were used to compare self-reported responses of tooth loss and oral manifestations (i.e., loose teeth, bleeding gums, mouth sores, and dry mouth) among HCPs with and without diabetes. RESULTS Almost a quarter of the HCPs reported having diabetes. Among patients with diabetes, more than half were 45-64 years old, had low-income status, and attended rural health centers. Analyses revealed that diabetes was significantly associated with permanent tooth loss and presence of at least one oral manifestation after controlling for confounders. Among adults with diabetes, probability of "missing at least one tooth." were two times higher compared to not missing any teeth [AOR = 2.10, (95%CI 1.40-3.16); P ≤0.001]. Adults with diabetes had higher odds of having one or more "oral manifestations" compared to adults without diabetes [AOR = 1.60, (95%CI 1.22-2.11); P = 0.001]. CONCLUSION Diabetes disproportionately affects HCP adults (23%) compared to the general U.S. adult population (10%). In HCPs having diabetes was associated with a higher prevalence of oral manifestations (i.e., loose teeth, bleeding gums) and losing "At least one" of their permanent teeth. These findings suggest that adults with diabetes had higher prevalence of oral manifestations and tooth loss, highlighting the need for innovative interprofessional models for early screening and identification.
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Affiliation(s)
- Shaikha AlDukhail
- Department of Preventive Dental Sciences, College of Dentistry, Prnicess Nourah Bint Abdulrahman University, Saudi Arabia; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, United States of America.
| | - Hesham Alhazmi
- Department of Preventive Dentistry, Faculty of Dentistry, Umm Al Qura University, Makkah, Saudi Arabia; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, United States of America
| | - Christine Riedy
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, United States of America
| | - Jane R Barrow
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, United States of America; Office of Global and Community Health, Harvard School of Dental Medicine, United States of America
| | - Steffany Chamut
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, United States of America; Office of Global and Community Health, Harvard School of Dental Medicine, United States of America
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203
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Alsaleh A, Kapila A, Shahriar I, Kapila YL. Dental informed consent challenges and considerations for cognitively impaired patients. Periodontol 2000 2021; 87:43-49. [PMID: 34463995 PMCID: PMC8456831 DOI: 10.1111/prd.12397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Because the US population is living to an older age, the number of individuals with cognitive impairment and periodontitis is increasing, as both conditions/diseases increase with age. Dental informed consent best practices for dental/periodontal treatment of individuals with cognitive impairment have not been explored, yet warrant consideration, because complex dental treatments to address periodontal needs/edentulism raise challenges for informed consent in the elderly with cognitive impairment. The purpose of this review is to help practitioners better understand this topic and develop best practices in dentistry for informed consent of patients with cognitive impairment that need extensive dental treatment, including surgical and implant therapy.
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Affiliation(s)
- Ahmed Alsaleh
- Department of Orofacial Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Anjuli Kapila
- College of Letters and Science, University of California, Davis, Davis, California, USA
| | - Iftee Shahriar
- College of Letters and Science, University of California, Davis, Davis, California, USA
| | - Yvonne L Kapila
- Department of Orofacial Sciences, University of California, San Francisco, San Francisco, California, USA
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204
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Kwack KH, Maglaras V, Thiyagarajan R, Zhang L, Kirkwood KL. Myeloid-derived suppressor cells in obesity-associated periodontal disease: A conceptual model. Periodontol 2000 2021; 87:268-275. [PMID: 34463977 DOI: 10.1111/prd.12384] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Periodontitis is a common chronic inflammatory disease characterized by destruction of the supporting structures of the teeth. Severe periodontitis is highly prevalent-affecting 10%-15% of adults-and carries several negative comorbidities, thus reducing quality of life. Although a clear relationship exists between severity of obesity and incidence of periodontal disease, the biologic mechanisms that support this link are incompletely understood. In this conceptual appraisal, a new "two-hit" model is presented to explain obesity-exacerbated periodontal bone loss. This proposed model recognizes a previously unappreciated aspect of myeloid-derived suppressor cell population expansion, differentiation, and activity that can participate directly in periodontal bone loss, providing new mechanistic and translational perspectives.
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Affiliation(s)
- Kyu Hwan Kwack
- Department of Oral Biology, University at Buffalo, Buffalo, New York, USA
| | - Victoria Maglaras
- Department of Oral Biology, University at Buffalo, Buffalo, New York, USA
| | - Ramkumar Thiyagarajan
- Division of Geriatrics and Palliative Medicine, University at Buffalo, Buffalo, New York, USA.,Research Service, Western New York Veterans Affairs Healthcare Service, Buffalo, New York, USA
| | - Lixia Zhang
- Department of Oral Biology, University at Buffalo, Buffalo, New York, USA
| | - Keith L Kirkwood
- Department of Oral Biology, University at Buffalo, Buffalo, New York, USA.,Department of Head and Neck/Plastic and Reconstructive Surgery, Buffalo, New York, USA
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205
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Di Spirito F, Iacono VJ, Alfredo I, Alessandra A, Sbordone L, Lanza A. Evidence-based Recommendations on Periodontal Practice and the Management of Periodontal Patients During and After the COVID-19 Era: Challenging Infectious Diseases Spread by Airborne Transmission. Open Dent J 2021. [DOI: 10.2174/1874210602115010325] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background:
Periodontal care, which was completely suspended during the peak of the SARS-Cov-2 pandemic and was delayed and recurrently discontinued during the succeeding waves, must be safely provided in the COVID-19 era.
Objectives:
The study aimed to provide recommendations on periodontal practice, optimizing safety, ergonomics, and economic resources, and the management of periodontal patients, ensuring continuity, timing, and effectiveness of periodontal care in the COVID-19 era.
Methods:
Reported protocols for the dental practice in the context of the COVID-19 and current evidence on periodontitis treatment and prevention were reviewed.
Results:
Evidence-based recommendations on contamination control and ergonomic improvements for periodontal practice and the management of periodontal patients challenging COVID-19 and airborne infectious diseases have been provided.
Conclusion:
Due to the economic, ergonomic, and ethical concerns raised by limited periodontal care due to the SARS-Cov-2 pandemic, and awareness of other emerging airborne transmitted infections, the periodontal practice should integrate measures minimizing airborne cross-infections and optimizing time-space and economic resources. The management of periodontal patients in the COVID-19 era should comprise less complex treatments and more comprehensive and definitive approaches, reducing emergencies, session length and number, and, concurrently, extending the recall and maintenance intervals. Moreover, it should implement prevention strategies through teledentistry tools and apps, improving periodontal awareness and self-care, and also through the self-reporting of periodontitis and periodontal risk assessment tools, performing both “population-based” and “high-risk” surveillance of periodontitis. Finally, it should enhance inter-professional collaboration, through telehealth networks, especially targeting subjects at high-risk of both periodontitis and systemic disorders, each of the two variously linked to COVID-19 onset and worsening.
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206
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Nguyen VTN, Furuta M, Zaitsu T, Oshiro A, Shimazaki Y, Ando Y, Miyazaki H, Kambara M, Fukai K, Aida J. Periodontal health predicts self-rated general health: A time-lagged cohort study. Community Dent Oral Epidemiol 2021; 50:421-429. [PMID: 34418132 DOI: 10.1111/cdoe.12691] [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: 03/31/2021] [Revised: 06/17/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES There is limited evidence of a temporal relationship between periodontal diseases and self-perceived general health. To plug this knowledge gap, we aimed to assess how periodontal health affects future self-rated health (SRH). METHODS We collected data from five waves of an annual nationwide Japanese survey of dental patients from 2015 to 2019. The analysis of repeated measurements included 9306 observations from 4242 patients aged 20 years or older. The clinical periodontitis measurements were bleeding on probing, deepest periodontal pocket depth and most severe clinical attachment loss (CAL). We used a self-administered questionnaire to collect data on sociodemographic characteristics, diabetes history, health behaviour, SRH and self-reported periodontitis. We applied 2-level ordered logistic regression models for repeated measurements to examine the relationships between SRH (time t) and 1-year-lagged periodontal health (time t-1) after adjusting for covariates. RESULTS The percentage of SRH responses recorded at time t as 'good', 'moderate' and 'poor' were 36.9%, 52.4% and 10.7%, respectively. Multivariate analyses showed that the risk of poorer SRH at time t increased in patients with CAL ≥7 mm (odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.02-1.30), those who reported bleeding gums (OR = 1.33, 95% CI = 1.21-1.46) and those who perceived swollen gums (OR = 1.40, 95% CI = 1.26-1.56) at time t-1. Sensitivity analyses using the 4-year follow-up model and 3-year-lagged cohort model also showed consistent results. CONCLUSION Periodontitis shows a gradual contribution to future SRH in dental patients, even after adjusting for sociodemographic characteristics, general health and health-related behaviours.
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Affiliation(s)
- Vy Thi Nhat Nguyen
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Faculty of Odonto-Stomatology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science, Fukuoka, Japan.,8020 Promotion Foundation, Tokyo, Japan
| | - Takashi Zaitsu
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akiko Oshiro
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihiro Shimazaki
- 8020 Promotion Foundation, Tokyo, Japan.,Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Yuichi Ando
- 8020 Promotion Foundation, Tokyo, Japan.,National Institute of Public Health, Saitama, Japan
| | - Hideo Miyazaki
- 8020 Promotion Foundation, Tokyo, Japan.,Meirin College, Niigata, Japan
| | - Masaki Kambara
- 8020 Promotion Foundation, Tokyo, Japan.,Department of Dentistry, Osaka Dental University, Osaka, Japan
| | - Kakuhiro Fukai
- 8020 Promotion Foundation, Tokyo, Japan.,Fukai Institute of Health Science, Saitama, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,8020 Promotion Foundation, Tokyo, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
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207
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Zhang S, Philips KH, Moss K, Wu D, Adam HS, Selvin E, Demmer RT, Norby FL, Mustapha IZ, Beck JD. Periodontitis and Risk of Diabetes in the Atherosclerosis Risk In Communities (ARIC) Study: A BMI-Modified Association. J Clin Endocrinol Metab 2021; 106:e3546-e3558. [PMID: 33982107 PMCID: PMC8372648 DOI: 10.1210/clinem/dgab337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine whether periodontal disease is positively associated with incident diabetes across the continuum of body mass levels (BMI) and test the hypothesis that the periodontal risk for incident diabetes is modified by BMI. METHODS We included 5569 diabetes-free participants from Visit 4 (1996-1998) of the Atherosclerosis Risk in Communities study and followed them until 2018. Periodontal disease status was classified by periodontal profile class (PPC)-Stages , and incident diabetes was based on participant report of physician diagnosis. We estimated the hazard ratios (HR) for diabetes using a competing risk model for each PPC-Stage. We assessed multiplicative interactions between periodontal disease and BMI (as a continuous variable) on risk of diabetes. RESULTS During a median time of 19.4 years of follow-up, 1348 incident diabetes cases and 1529 deaths occurred. Compared to the "Health/Incidental Disease" stage, participants with PPC "Severe Periodontal Disease" or "Severe Tooth Loss" stage and lower BMI had elevated risk for diabetes adjusting for demographic, smoking, education, and biological variables when accounting for death as a competing risk with HRs of 1.76 (95% CI 1.10-2.80) and 2.11 (95% CI 1.46-3.04), respectively. The interaction between PPC-Stages and BMI was significant (P = 0.01). No significant associations of PPC-Stages with incident diabetes were present when BMI was above 31 kg/m2. CONCLUSION Periodontal disease was associated with incident diabetes, especially in nonobese participants. Dentists should be aware that periodontal disease is associated with incident diabetes but the association may be modified for patient's at higher BMI levels.
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Affiliation(s)
- Shaoping Zhang
- Periodontics Department, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Kamaira H Philips
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kevin Moss
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Di Wu
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hamdi S Adam
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Division of Epidemiology, Mailman School of Public Health, Columbia University, NY, NY, USA
| | - Faye L Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Indra Z Mustapha
- Department of Periodontics, School of Dentistry, Howard University, Washington, DC, USA
| | - James D Beck
- Division of Comprehensive Oral Health/Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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208
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Borgnakke WS, Poudel P. Diabetes and Oral Health: Summary of Current Scientific Evidence for Why Transdisciplinary Collaboration Is Needed. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.709831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This Perspective provides a brief summary of the scientific evidence for the often two-way links between hyperglycemia, including manifest diabetes mellitus (DM), and oral health. It delivers in a nutshell examples of current scientific evidence for the following oral manifestations of hyperglycemia, along with any available evidence for effect in the opposite direction: periodontal diseases, caries/periapical periodontitis, tooth loss, peri-implantitis, dry mouth (xerostomia/hyposalivation), dysbiosis in the oral microbiome, candidiasis, taste disturbances, burning mouth syndrome, cancer, traumatic ulcers, infections of oral wounds, delayed wound healing, melanin pigmentation, fissured tongue, benign migratory glossitis (geographic tongue), temporomandibular disorders, and osteonecrosis of the jaw. Evidence for effects on quality of life will also be reported. This condensed overview delivers the rationale and sets the stage for the urgent need for delivery of oral and general health care in patient-centered transdisciplinary collaboration for early detection and management of both hyperglycemia and oral diseases to improve quality of life.
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209
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Linabarger M, Brown M, Patel N. A Pilot Study of Integration of Medical and Dental Care in 6 States. Prev Chronic Dis 2021; 18:E72. [PMID: 34296994 PMCID: PMC8300541 DOI: 10.5888/pcd18.210027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction Poor oral health affects overall health. Chronic diseases and related risk factors such as tobacco use or consuming sugar-sweetened beverages can also increase a person’s risk of periodontitis. Given the linkages between oral health and certain chronic diseases, we conducted a pilot study to facilitate intradepartmental collaborations between state chronic disease and oral health programs. Methods State health departments in 6 states (Alaska, Colorado, Georgia, Maryland, Minnesota, and New York) collaborated to develop and implement projects that addressed oral health and the following chronic diseases or risk factors: obesity, diabetes, heart disease, stroke, and tobacco use. States developed various projects, including media campaigns, clinical education, and screening and referrals. We used a mixed-methods approach to understand barriers to and facilitators of states’ increasing collaboration and implementation of pilot projects. In-depth interviews were conducted with 12 staff (1 from oral health and 1 from chronic disease for each state). We also reviewed state-submitted documents and performance measures. Results All 6 states increased collaboration between their oral health and chronic disease programs and successfully implemented pilot projects. Collaboration was facilitated by investing in relationships, championing medical–dental integration, and meeting and communicating frequently. Barriers to collaboration included the perception of oral health in chronic disease programs as separate and distinct from other chronic diseases and the structure of funding. The pilot projects were facilitated by partner support, providing technical assistance to clinics, and working early on referral networks. Barriers to implementing the pilot projects included gaining clinician buy-in and establishing referral networks. Conclusion This pilot study demonstrated that by fostering collaboration, state health departments are able to train dental and medical clinicians, deliver clinical preventive education to patients, implement referral systems, and deliver impressions via media campaigns.
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Affiliation(s)
- Molly Linabarger
- Centers for Disease Control and Prevention, Division of Oral Health, Atlanta, Georgia in 2018-2020.,Deloitte Consulting LLP, 191 Peachtree Street NE, Suite 2000, Atlanta, GA 30303. E-mail:
| | - Monique Brown
- Centers for Disease Control and Prevention, Division of Oral Health, Atlanta, Georgia
| | - Nita Patel
- Centers for Disease Control and Prevention, Division of Oral Health, Atlanta, Georgia
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210
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Stødle IH, Verket A, Høvik H, Sen A, Koldsland OC. Prevalence of periodontitis based on the 2017 classification in a Norwegian population: The HUNT study. J Clin Periodontol 2021; 48:1189-1199. [PMID: 34101228 DOI: 10.1111/jcpe.13507] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/10/2021] [Accepted: 05/20/2021] [Indexed: 11/30/2022]
Abstract
AIM This cross-sectional study assesses the prevalence of periodontitis in a large Norwegian population, based on the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions. The prevalence of periodontitis was determined by bone loss recorded on radiographs (orthopantomogram [OPG] and bitewing [BW]) and by clinical examination. MATERIALS AND METHODS As part of a large population health study (The HUNT Study), 7347 participants aged 19 years and older were invited to the HUNT4 Oral Health Study. Radiographic bone loss (RBL) and periodontal stage and grade were assessed in 4863 participants. RESULTS Periodontal examination was performed in 4863 participants. RBL and clinical registrations corresponding to periodontitis as defined were observed in 72.4%. The prevalence of periodontitis increased after 40 years of age, with severe forms occurring primarily after 60 years of age. Stage I was observed in 13.8%, Stage II in 41.1%, Stage III in 15.3%, and Stage IV in 2.3% of the population. Grade A, B, and C was observed in 5.7%, 60.2%, and 6.2%, respectively. CONCLUSION Periodontitis was frequently observed in the investigated population. The prevalence of periodontitis Stage III and Stage IV combined was observed in 17.6% of the study population.
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Affiliation(s)
- Ida Haukåen Stødle
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anders Verket
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hedda Høvik
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Abhijit Sen
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Odd Carsten Koldsland
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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211
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Rocha FG, Berges A, Sedra A, Ghods S, Kapoor N, Pill L, Davey ME, Fairman J, Gibson FC. A Porphyromonas gingivalis Capsule-Conjugate Vaccine Protects From Experimental Oral Bone Loss. FRONTIERS IN ORAL HEALTH 2021; 2:686402. [PMID: 35048031 PMCID: PMC8757777 DOI: 10.3389/froh.2021.686402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/01/2021] [Indexed: 01/09/2023] Open
Abstract
Periodontal diseases are chronic inflammatory diseases of the periodontium that result in progressive destruction of the soft and hard tissues supporting the teeth, and it is the most common cause of tooth loss among adults. In the US alone, over 100 million individuals are estimated to have periodontal disease. Subgingival bacteria initiate and sustain inflammation, and, although several bacteria have been associated with periodontitis, Porphyromonas gingivalis has emerged as the key etiological organism significantly contributing to the disease. Currently, intensive clinical maintenance strategies are deployed to mitigate the further progression of disease in afflicted individuals; however, these treatments often fail to stop disease progression, and, as such, the development of an effective vaccine for periodontal disease is highly desirable. We generated a conjugate vaccine, comprising of the purified capsular polysaccharide of P. gingivalis conjugated to eCRM®, a proprietary and enhanced version of the CRM197 carrier protein with predetermined conjugation sites (Pg-CV). Mice immunized with alum adjuvanted Pg-CV developed robust serum levels of whole organism-specific IgG in comparison to animals immunized with unconjugated capsular polysaccharide alone. Using the murine oral bone loss model, we observed that mice immunized with the capsule-conjugate vaccine were significantly protected from the effects of P. gingivalis-elicited oral bone loss. Employing a preclinical model of infection-elicited oral bone loss, our data support that a conjugate vaccine incorporating capsular polysaccharide antigen is effective in reducing the main clinical endpoint of periodontal disease-oral bone destruction. Further development of a P. gingivalis capsule-based conjugate vaccine for preventing periodontal diseases is supported.
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Affiliation(s)
- Fernanda G. Rocha
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, United States
| | - Aym Berges
- Vaxcyte Inc., Foster City, CA, United States
| | - Angie Sedra
- Vaxcyte Inc., Foster City, CA, United States
| | - Shirin Ghods
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, United States
| | | | - Lucy Pill
- Vaxcyte Inc., Foster City, CA, United States
| | - Mary Ellen Davey
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, United States
| | | | - Frank C. Gibson
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL, United States
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212
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Lee CT, Li R, Zhu L, Tribble GD, Zheng WJ, Ferguson B, Maddipati KR, Angelov N, Van Dyke TE. Subgingival Microbiome and Specialized Pro-Resolving Lipid Mediator Pathway Profiles Are Correlated in Periodontal Inflammation. Front Immunol 2021; 12:691216. [PMID: 34177951 PMCID: PMC8222734 DOI: 10.3389/fimmu.2021.691216] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/11/2021] [Indexed: 12/17/2022] Open
Abstract
Failure of resolution pathways in periodontitis is reflected in levels of specialized pro-resolving lipid mediators (SPMs) and SPM pathway markers but their relationship with the subgingival microbiome is unclear. This study aimed to analyze and integrate lipid mediator level, SPM receptor gene expression and subgingival microbiome data in subjects with periodontitis vs. healthy controls. The study included 13 periodontally healthy and 15 periodontitis subjects that were evaluated prior to or after non-surgical periodontal therapy. Samples of gingival tissue and subgingival plaque were collected prior to and 8 weeks after non-surgical treatment; only once in the healthy group. Metabololipidomic analysis was performed to measure levels of SPMs and other relevant lipid mediators in gingiva. qRT-PCR assessed relative gene expression (2-ΔΔCT) of known SPM receptors. 16S rRNA sequencing evaluated the relative abundance of bacterial species in subgingival plaque. Correlations between lipid mediator levels, receptor gene expression and bacterial abundance were analyzed using the Data Integration Analysis for Biomarker discovery using Latent cOmponents (DIABLO) and Sparse Partial Least Squares (SPLS) methods. Profiles of lipid mediators, receptor genes and the subgingival microbiome were distinct in the three groups. The strongest correlation existed between lipid mediator profile and subgingival microbiome profile. Multiple lipid mediators and bacterial species were highly correlated (correlation coefficient ≥0.6) in different periodontal conditions. Comparing individual correlated lipid mediators and bacterial species in periodontitis before treatment to healthy controls revealed that one bacterial species, Corynebacterium durum, and five lipid mediators, 5(S)6(R)-DiHETE, 15(S)-HEPE, 7-HDHA, 13-HDHA and 14-HDHA, were identified in both conditions. Comparing individual correlated lipid mediators and bacterial species in periodontitis before treatment to after treatment revealed that one bacterial species, Anaeroglobus geminatus, and four lipid mediators, 5(S)12(S)-DiHETE, RvD1, Maresin 1 and LTB4, were identified in both conditions. Four Selenomonas species were highly correlated with RvD1, RvE3, 5(S)12(S)-DiHETE and proinflammatory mediators in the periodontitis after treatment group. Profiles of lipid mediators, receptor gene and subgingival microbiome are associated with periodontal inflammation and correlated with each other, suggesting inflammation mediated by lipid mediators influences microbial composition in periodontitis. The role of correlated individual lipid mediators and bacterial species in periodontal inflammation have to be further studied.
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Affiliation(s)
- Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Ruoxing Li
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Lisha Zhu
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Gena D. Tribble
- Department of Periodontics and Dental Hygiene, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - W. Jim Zheng
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Brittney Ferguson
- Department of Periodontics and Dental Hygiene, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | | | - Nikola Angelov
- Department of Periodontics and Dental Hygiene, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Thomas E. Van Dyke
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, United States
- Department of Oral Medicine, Infection, and Immunity, Faculty of Medicine, Harvard University, Boston, MA, United States
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213
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Deng K, Pelekos G, Jin L, Tonetti MS. Diagnostic accuracy of self-reported measures of periodontal disease: A clinical validation study using the 2017 case definitions. J Clin Periodontol 2021; 48:1037-1050. [PMID: 33998009 DOI: 10.1111/jcpe.13484] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/10/2021] [Accepted: 04/20/2021] [Indexed: 02/03/2023]
Abstract
AIM To clinically validate a self-reported questionnaire for periodontal disease and assess its accuracy for differentiating periodontal health and different stages of periodontitis. METHODS A Chinese (Cantonese) version of a self-reported questionnaire was prepared by translating and validating the original English questions proposed by the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP). The utility of the CDC/AAP questionnaire and its individual questions was assessed against a full-mouth periodontal examination. Periodontal case definition was based on the 2017 World Workshop classification of periodontal diseases. Multivariable logistic regression and the area under the receiver operating characteristic curve (AUROC) analysis were performed to assess the accuracy of the questionnaire. RESULTS 408 subjects enrolled in this study, including those with periodontal health (16.2%), gingivitis (15.2%), Stages I/II periodontitis (31.8%) and Stages III/IV periodontitis (36.8%). Overall, the questionnaire had poor accuracy in detecting the presence of Stages I/II periodontitis with an AUROC 0.608. While it showed moderate to high accuracy for identifying periodontal disease (gingivitis and periodontitis), periodontitis and Stages III/IV periodontitis with an AUROC of 0.837, 0.803 and 0.870, respectively. Self-reported measures in combination with age and tobacco smoking showed excellent performance for identifying Stages III/IV periodontitis with a high AUROC of 0.953, a sensitivity of 95.7%, and a specificity of 89.0%. Specific questions and combinations provided greater utility to discriminate the various periodontal case definitions. CONCLUSIONS The self-reported CDC/AAP questionnaire may be a feasible tool for detecting periodontitis, and its combination with demographic and lifestyle factors is useful for the identification of individuals with Stages III/IV periodontitis. This questionnaire seems less helpful in screening of Stages I/II periodontitis. Further studies are needed to test the validity in larger community-based populations.
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Affiliation(s)
- Ke Deng
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, National Center of Stomatology, National Clinical Research Center of Oral Diseases, Shanghai key Laboratory of Stomatology, Shanghai, China
| | - George Pelekos
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Maurizio S Tonetti
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Implantology, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, National Center of Stomatology, National Clinical Research Center of Oral Diseases, Shanghai key Laboratory of Stomatology, Shanghai, China.,European Research Group on Periodontology, Genova, Italy
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214
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Erim D, Obadan-Udoh E, Agaku I. Cost savings from averted prescription opioidattributable dental diseases in the United States between 2013 and 2019. POPULATION MEDICINE 2021. [DOI: 10.18332/popmed/136488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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215
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Botelho J, Machado V, Leira Y, Proença L, Chambrone L, Mendes JJ. Economic burden of periodontitis in the United States and Europe - an updated estimation. J Periodontol 2021; 93:373-379. [PMID: 34053082 DOI: 10.1002/jper.21-0111] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The aim of this study is to estimate the direct and indirect economic burdens of periodontal disease in the US and in Europe. METHODS We used the most recent data available for the US and for Europe (32 European countries) to estimate the cost of periodontal disease. Global health, dental and periodontal expenditures were estimated. We tried to estimate the direct and the indirect costs of periodontitis. Indirect costs, those related to productivity losses, are a consequence of periodontal disease proper, plus edentulism and caries because of periodontal disease. RESULTS In 2018, the aggregate cost in the US was estimated at $3.49B and €2.52B in Europe. Indirect costs because of periodontal disease amounted to $150.57B (95% confidence interval [CI]: 103.32-189.87) in the US countries and €156.12B (95% CI: 123.72-221.86) in Europe. The majority of the projected indirect costs were because of edentulism related to periodontal disease and periodontal disease. Indirect costs were the majority of the estimated economic impact with an average of 0.73% (95% CI: 0.50%-0.93%) of annual gross domestic product in the US and 0.99% (95% CI: 0.78%-1.40%) in Europe. CONCLUSIONS Periodontal disease caused an estimated loss of $154.06B in the US and €158.64B in Europe, in 2018. These results show that the economic burden of periodontal disease is significant and its indirect costs are impactful.
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Affiliation(s)
- João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal.,Evidenced-Based Hub, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal.,Evidenced-Based Hub, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal
| | - Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre, University College London, London, UK.,Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.,Medical-Surgical Dentistry (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Luís Proença
- Evidenced-Based Hub, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal.,Quantitative Methods for Health Research (MQIS), CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal
| | - Leandro Chambrone
- Evidenced-Based Hub, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal.,Graduate Dentistry Program, School of Dentistry, Ibirapuera University, São Paulo, Brazil.,Unit of Basic Oral Investigation (UIBO), Universidad El Bosque, Bogota, Colombia
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal.,Evidenced-Based Hub, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Almada, Portugal
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216
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Lee J, Choi MK, Kim J, Chun S, Kim HG, Lee H, Kim J, Lee D, Han SH, Yoon DY. Development and Optimization of a Rapid Colorimetric Membrane Immunoassay for Porphyromonas gingivalis. J Microbiol Biotechnol 2021; 31:705-709. [PMID: 33820889 PMCID: PMC9706014 DOI: 10.4014/jmb.2103.03029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/15/2022]
Abstract
Porphyromonas gingivalis (P. gingivalis) is a major bacterial pathogen that causes periodontitis, a chronic inflammatory disease of tissues around the teeth. Periodontitis is known to be related to other diseases, such as oral cancer, Alzheimer's disease, and rheumatism. Thus, a precise and sensitive test to detect P. gingivalis is necessary for the early diagnosis of periodontitis. The objective of this study was to optimize a rapid visual detection system for P. gingivalis. First, we performed a visual membrane immunoassay using 3,3',5,5'-tetramethylbenzidine (TMB; blue) and coating and detection antibodies that could bind to the host laboratory strain, ATCC 33277. Antibodies against the P. gingivalis surface adhesion molecules RgpB (arginine proteinase) and Kgp (lysine proteinase) were determined to be the most specific coating and detection antibodies, respectively. Using these two selected antibodies, the streptavidin-horseradish peroxidase (HRP) reaction was performed using a nitrocellulose membrane and visualized with a detection range of 103-105 bacterial cells/ml following incubation for 15 min. These selected conditions were applied to test other oral bacteria, and the results showed that P. gingivalis could be detected without crossreactivity to other bacteria, including Streptococcus mutans and Escherichia fergusonii. Furthermore, three clinical strains of P. gingivalis, KCOM 2880, KCOM 2803, and KCOM 3190, were also recognized using this optimized enzyme immunoassay (EIA) system. To conclude, we established optimized conditions for P. gingivalis detection with specificity, accuracy, and sensitivity. These results could be utilized to manufacture economical and rapid detection kits for P. gingivalis.
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Affiliation(s)
- Jiyon Lee
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Republic of Korea
| | - Myoung-Kwon Choi
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Republic of Korea
| | - Jinju Kim
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Republic of Korea
| | - SeChul Chun
- Department of Environmental Health Science, Konkuk University, Seoul 0509, Republic of Korea
| | | | - HoSung Lee
- STARGO Inc., Bucheon 14727, Republic of Korea
| | - JinSoo Kim
- STARGO Inc., Bucheon 14727, Republic of Korea
| | - Dongwook Lee
- Department of Oral Microbiology and Immunology, DRI and BK21 Plus Program, School of Dentistry, Seoul National University, 08826, Republic of Korea
| | - Seung-Hyun Han
- Department of Oral Microbiology and Immunology, DRI and BK21 Plus Program, School of Dentistry, Seoul National University, 08826, Republic of Korea
| | - Do-Young Yoon
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Republic of Korea,Corresponding author Tel: +82-2-450-4119 (or 6271) Fax: +82-2-444-4218 E-mail:
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217
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Naavaal S, Garcia DT, Deng X, Bandyopadhyay D. Association between periodontal disease and oral cancer screening among US adults: NHANES 2011-2014. Community Dent Oral Epidemiol 2021; 50:216-224. [PMID: 34032297 DOI: 10.1111/cdoe.12655] [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: 08/26/2020] [Revised: 04/07/2021] [Accepted: 04/18/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD. MATERIALS AND METHODS We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥30 years. PD status was classified as no PD, mild/moderate PD and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral or both types of oral cancer screenings among adults with PD. Control variables included age, sex, race/ethnicity, health insurance, education, income level, smoking status, alcohol use and last dental visit. RESULTS The analytic sample included 6962 adults weighted to the national population of adults who had a periodontal examination during 2011-2014. Overall, 31.5%, 26.8% and 20.9% of adults reported receipt of intraoral, extraoral and both types of oral cancer screening, respectively. Almost 40% of adults had some form of PD (7.6% severe and 32.4% mild/moderate PD). A higher proportion of 45-64-year-olds, males, non-Hispanic Blacks, those with less than high school education, with income level less than 200% federal poverty level, or those with no insurance had severe PD than no PD. In adjusted analyses, adults with severe PD were significantly more likely to report no receipt of intraoral (RR = 1.25, 95% CI = 1.12-1.40), extraoral (RR = 1.17, 95% CI = 1.07-1.27) or both types of oral cancer screenings (RR = 1.18, 95% CI = 1.10-1.27) than those with no PD. CONCLUSIONS Significantly low proportion of adult's age ≥30 years with severe PD reported receiving any type of oral cancer screening. The association between PD and risk of oral cancers points to the need to improve oral cancer screening rates among adults with PD.
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Affiliation(s)
- Shillpa Naavaal
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA.,Oral Health Equity Core, Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, USA
| | - Dina T Garcia
- Oral Health Equity Core, Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, USA.,Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Xiaoyan Deng
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Dipankar Bandyopadhyay
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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218
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Lagosz-Cwik KB, Wielento A, Lipska W, Kantorowicz M, Darczuk D, Kaczmarzyk T, Gibbs S, Potempa J, Grabiec AM. hTERT-immortalized gingival fibroblasts respond to cytokines but fail to mimic primary cell responses to Porphyromonas gingivalis. Sci Rep 2021; 11:10770. [PMID: 34031466 PMCID: PMC8144196 DOI: 10.1038/s41598-021-90037-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/05/2021] [Indexed: 01/30/2023] Open
Abstract
In periodontitis, gingival fibroblasts (GFs) interact with and respond to oral pathogens, significantly contributing to perpetuation of chronic inflammation and tissue destruction. The aim of this study was to determine the usefulness of the recently released hTERT-immortalized GF (TIGF) cell line for studies of host–pathogen interactions. We show that TIGFs are unable to upregulate expression and production of interleukin (IL)-6, IL-8 and prostaglandin E2 upon infection with Porphyromonas gingivalis despite being susceptible to adhesion and invasion by this oral pathogen. In contrast, induction of inflammatory mediators in TNFα- or IL-1β-stimulated TIGFs is comparable to that observed in primary GFs. The inability of TIGFs to respond directly to P. gingivalis is caused by a specific defect in Toll-like receptor-2 (TLR2) expression, which is likely driven by TLR2 promoter hypermethylation. Consistently, TIGFs fail to upregulate inflammatory genes in response to the TLR2 agonists Pam2CSK4 and Pam3CSK4. These results identify important limitations of using TIGFs to study GF interaction with oral pathogens, though these cells may be useful for studies of TLR2-independent processes. Our observations also emphasize the importance of direct comparisons between immortalized and primary cells prior to using cell lines as models in studies of any biological processes.
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Affiliation(s)
- Katarzyna B Lagosz-Cwik
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387, Kraków, Poland
| | - Aleksandra Wielento
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387, Kraków, Poland
| | - Weronika Lipska
- Department of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Malgorzata Kantorowicz
- Department of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Dagmara Darczuk
- Department of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Kaczmarzyk
- Department of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,Department of Oral Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Susan Gibbs
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387, Kraków, Poland. .,Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, USA.
| | - Aleksander M Grabiec
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387, Kraków, Poland.
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219
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Vieth MP, Deas DE, Archontia Palaiologou A, Diogenes A, Mader MJ, Mealey BL. Effect of intravenous dexamethasone on postoperative pain and swelling following periodontal flap surgery: A randomized controlled trial of patient-centered outcomes. J Periodontol 2021; 93:237-245. [PMID: 34021915 DOI: 10.1002/jper.21-0153] [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: 03/11/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND This randomized, crossover trial sought to determine if a preoperative intravenous (IV) dose of dexamethasone reduces pain, swelling, and analgesic usage following periodontal surgery. METHODS Thirty-seven patients planned for two similar periodontal flap surgeries under IV sedation were enrolled. Patients were randomized to receive either 2 mL (8 mg) dexamethasone sodium phosphate or 2 mL of IV solution (placebo) before the first surgery, and 2 mL of the other solution before the second surgery. Postoperative discomfort was managed with a standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen. A smartphone application was used to record self-assessed pain and swelling scores using 21-point numerical (NRS-21) and 4-point verbal (VRS-4) rating scales as well as the number of analgesic medications taken at 12-, 24-, 48-, 72-, 168-, and 336-hours following each surgery. RESULTS IV dexamethasone was associated with a significant reduction in pain at 12, 24, 48, and 72 hours (P <0.05), and swelling at 12, 24, 48, and 168 hours (P < 0.05) postoperatively when compared with placebo based on NRS-21 responses. VRS-4 data showed significant reductions in pain at 12, 72, and 168 hours and swelling at 12, 24, and 168 hours postoperatively with dexamethasone. No significant differences were found in the number of tablets of ibuprofen or acetaminophen between dexamethasone and placebo surgeries. CONCLUSIONS Preoperative, intravenously administered dexamethasone reduces pain and swelling within the first postoperative week following periodontal flap surgery and should be considered a useful adjunct for perioperative management.
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Affiliation(s)
- Michael P Vieth
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | - David E Deas
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | | | - Anibal Diogenes
- Department of Endodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | - Michael J Mader
- Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX
| | - Brian L Mealey
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
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220
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Zhang Y, Leveille SG, Shi L, Camhi SM. Disparities in Preventive Oral Health Care and Periodontal Health Among Adults With Diabetes. Prev Chronic Dis 2021; 18:E47. [PMID: 33988497 PMCID: PMC8139443 DOI: 10.5888/pcd18.200594] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION People with diabetes are more vulnerable to periodontal disease than those without; thus, practicing preventive oral health care is an important part of diabetes self-care. Our objective was to examine disparities in preventive oral health care among US adults with diabetes. METHODS We performed a secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Periodontal examinations were conducted in adults aged 30 and older. We compared the weighted prevalence of periodontal disease and the practice of preventive oral health care, including practicing dental interproximal cleaning (flossing or using other interproximal cleaning devices) and use of preventive dental services, among people with and without diabetes. Multivariable logistic regressions were performed to examine the relationship between the presence of diabetes, periodontal disease, and preventive oral health care practices. RESULTS Weighted prevalence of periodontal disease in the US population was higher among adults with diabetes than those without (58.0% vs 37.6%). This difference persisted after controlling for sociodemographic characteristics and smoking status. People with diabetes were more likely to have periodontal disease (adjusted odds ratio [aOR] 1.39; 95% CI, 1.17-1.65), less likely to practice daily interproximal cleaning (aOR 0.85; 95% CI, 0.75-0.95), and less likely to visit a dentist for preventive care in the past year (aOR 0.86; 95% CI, 0.76-0.96) than people without diabetes. CONCLUSION Adults with diabetes reported suboptimal preventive oral health care behaviors in use of preventive dental services and interproximal dental cleaning than people without diabetes, despite their health disparity related to periodontal disease. Educating people to improve their preventive oral health care is essential for good oral health and diabetes self-management.
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Affiliation(s)
- Yuqing Zhang
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
- 100 William T. Morrissey Blvd, Boston, MA 02125-3393.
| | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Ling Shi
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
| | - Sarah M Camhi
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
- College of Arts and Sciences, Kinesiology Department, University of San Francisco, San Francisco, California
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221
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Hsiao T, Ho Y, Chen M, Lee S, Sun C. Disease activation maps for subgingival dental calculus identification based on intelligent dental optical coherence tomography. TRANSLATIONAL BIOPHOTONICS 2021. [DOI: 10.1002/tbio.202100001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Tien‐Yu Hsiao
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
| | - Yi‐Ching Ho
- School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan, ROC
- Department of Stomatology Taipei Veterans General Hospital Taipei Taiwan, ROC
| | - Mei‐Ru Chen
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
| | - Shyh‐Yuan Lee
- School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan, ROC
- Department of Stomatology Taipei Veterans General Hospital Taipei Taiwan, ROC
- Department of Dentistry Yangming Branch of Taipei City Hospital Taipei Taiwan, ROC
| | - Chia‐Wei Sun
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering National Yang Ming Chiao Tung University Hsinchu City Taiwan, ROC
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222
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Abou-Arraj RV, Kaur M, Alkhoury S, Swain TA, Geurs NC, Souccar NM. The new periodontal disease classification: Level of agreement on diagnoses and treatment planning at various dental education levels. J Dent Educ 2021; 85:1627-1639. [PMID: 33955000 DOI: 10.1002/jdd.12636] [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: 01/12/2021] [Revised: 04/14/2021] [Accepted: 04/18/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE/OBJECTIVES Using the periodontal diseases classification published in 2018, this study evaluated the level of agreement among predoctoral and postgraduate students of different education levels and specialties in the diagnosis and treatment planning of periodontal conditions. METHODS Second-year (D2) and fourth-year (D4) dental students, postgraduate orthodontic students (OS), and periodontology students (PS) were presented with an anonymous survey of 10 cases, each with five choices of diagnosis and seven therapeutic approaches. The cases included a patient summary, photographs, radiographs, periodontal charting, and ranged from health to periodontitis. Consensus diagnosis, used as a gold standard, was established between two experienced periodontists. Diagnosis and treatment choices for each case were compared across educational groups using Fisher's exact test. The level of agreement among educational groups was assessed using a multirater kappa coefficient. RESULTS The survey was completed in 2020 with a 72.4% overall response rate (57-D2, 45-D4, 17-OS, and 12-PS). The overall level of agreement on diagnosis was fair (κ = 0.24, p <.0001) with PS showing the most agreement (κ = 0.55, p <.0001). There were tendencies to prioritize stage over grade and extent in assigning diagnoses and to overdiagnose disease severity and underdiagnose localized periodontitis. Nonsurgical periodontal therapies had the highest overall agreement (κ = 0.63 for scaling/root planing and κ = 0.44 for maintenance, p <.0001). Response distribution per case and per level of education indicated that PS more consistently agreed with the gold standard than any other group. CONCLUSIONS OS, D2, and D4 students demonstrated inferior agreement levels compared to PS, successfully recognized health from disease, suggested appropriate treatment plans, and tended to overdiagnose milder periodontal conditions.
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Affiliation(s)
- Ramzi V Abou-Arraj
- Department of Periodontology, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Maninder Kaur
- Department of Periodontology, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Shadi Alkhoury
- Department of Orthodontics, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas A Swain
- Department of Ophthalmology, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nicolaas C Geurs
- Department of Periodontology, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nada M Souccar
- Department of Orthodontics, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Sen S, Redd K, Trivedi T, Moss K, Alonso A, Soliman EZ, Magnani JW, Chen LY, Gottesman RF, Rosamond W, Beck J, Offenbacher S. Periodontal Disease, Atrial Fibrillation and Stroke. Am Heart J 2021; 235:36-43. [PMID: 33503409 PMCID: PMC8084947 DOI: 10.1016/j.ahj.2021.01.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/10/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND We recently described the association between periodontal disease (PD) and stroke risk. PURPOSE The purpose of this study was to test the association between PD, dental care utilization and incident atrial fibrillation (AF), as well as AF as a mediator to PD- stroke association. METHODS In dental cohort of the Atherosclerosis Risk in Communities Study (ARIC), participants without prior AF underwent full-mouth periodontal measurements. PD was defined on an ordinal scale as healthy (referent), mild, moderate and severe. In ARIC main cohort, participants were classified as regular or episodic dental care users. These patients were followed for AF, over 17 years. Cox proportional hazards models adjusted for AF risk factors were used to study relationships between PD severity, dental care utilization and AF. Mediation analysis was used to test if AF mediated the PD- stroke association. RESULTS In dental ARIC cohort, 5,958 were assessed without prior AF, 754 were found to have AF. Severe PD was associated with AF on both univariable (crude HR, 1.54; 95% CI, 1.26-1.87) and multivariable (adjusted HR, 1.31, 95% CI, 1.06-1.62) analyses. Mediation analysis suggested AF mediates the association between PD and stroke. In the main ARIC cohort, 9,666 participants without prior AF were assessed for dental care use, 1558 were found to have AF. Compared with episodic users, regular users had a lower risk for AF on univariable (crude HR, 0.82, 95% CI, 0.74-0.90) and multivariable (adjusted HR, 0.88, 95% CI, 0.78-0.99) analyses. CONCLUSIONS PD is associated with AF. The association may explain the PD-stroke risk. Regular users had a lower risk of incident AF compared with episodic users.
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Affiliation(s)
- Souvik Sen
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC.
| | - Kolby Redd
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Tushar Trivedi
- Department of Neurology, University of South Carolina, School of Medicine, Columbia, SC
| | - Kevin Moss
- Department of Periodontology, University of North Carolina, Chapel Hill, NC
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Elsayed Z Soliman
- Department of Epidemiology and Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC
| | - Jared W Magnani
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Lin Y Chen
- Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Rebecca F Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Wayne Rosamond
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC
| | - James Beck
- Department of Periodontology, University of North Carolina, Chapel Hill, NC
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Alshihayb TS, Heaton B. Simulation of Random Differential Periodontitis Outcome Misclassification with Perfect Specificity. JDR Clin Trans Res 2021; 7:174-181. [PMID: 33899555 DOI: 10.1177/23800844211007145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Misclassification of clinical periodontitis can occur by partial-mouth protocols, particularly when tooth-based case definitions are applied. In these cases, the true prevalence of periodontal disease is underestimated, but specificity is perfect. In association studies of periodontal disease etiology, misclassification by this mechanism is independent of exposure status (i.e., nondifferential). Despite nondifferential mechanisms, differential misclassification may be realized by virtue of random errors. OBJECTIVES To gauge the amount of uncertainty around the expectation of differential periodontitis outcome misclassification due to random error only, we estimated the probability of differential outcome misclassification, its magnitude, and expected impacts via simulation methods using values from the periodontitis literature. METHODS We simulated data sets with a binary exposure and outcome that varied according to sample size (200, 1,000, 5,000, 10,000), exposure effect (risk ratio; 1.5, 2), exposure prevalence (0.1, 0.3), outcome incidence (0.1, 0.4), and outcome sensitivity (0.6, 0.8). Using a Bernoulli trial, we introduced misclassification by randomly sampling individuals with the outcome in each exposure group and repeated each scenario 10,000 times. RESULTS The probability of differential misclassification decreased as the simulation parameter values increased and occurred at least 37% of the time across the 10,000 repetitions. Across all scenarios, the risk ratio was biased, on average, toward the null when the sensitivity was higher among the unexposed and away from the null when it was higher among the exposed. The extent of bias for absolute sensitivity differences ≥0.04 ranged from 0.05 to 0.19 regardless of simulation parameters. However, similar trends were not observed for the odds ratio where the extent and direction of bias were dependent on the outcome incidence, sensitivity of classification, and effect size. CONCLUSIONS The results of this simulation provide helpful quantitative information to guide interpretation of findings in which nondifferential outcome misclassification mechanisms are known to be operational with perfect specificity. KNOWLEDGE TRANSFER STATEMENT Measurement of periodontitis can suffer from classification errors, such as when partial-mouth protocols are applied. In this case, specificity is perfect and sensitivity is expected to be nondifferential, leading to an expectation for no bias when studying periodontitis etiologies. Despite expectation, differential misclassification could occur from sources of random error, the effects of which are unknown. Proper scrutiny of research findings can occur when the probability and impact of random classification errors are known.
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Affiliation(s)
- T S Alshihayb
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
- Department of Preventive Science, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - B Heaton
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
- Department of Epidemiology, School of Public Health, Boston University
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Ravidà A, Qazi M, Rodriguez MV, Galli M, Saleh MHA, Troiano G, Wang HL. The influence of the interaction between staging, grading and extent on tooth loss due to periodontitis. J Clin Periodontol 2021; 48:648-658. [PMID: 33484162 DOI: 10.1111/jcpe.13430] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/25/2020] [Accepted: 01/15/2021] [Indexed: 01/10/2023]
Abstract
AIM To assess the ability of two-way interactions between baseline stage, grade and extent to predict tooth loss due to periodontitis (TLP) over a long-term follow-up period. MATERIALS AND METHODS Patients treated for periodontal disease with a complete medical history, baseline periodontal chart, full mouth radiographs and a minimum of ≥10 years follow-up were recruited. Supportive periodontal therapy (SPT) visits were recorded during the entire follow-up period. Patients were categorized according to their stage, grade and extent. The absolute survival at 10-, 20-, and 30-year follow-up was calculated for TLP. Kaplan-Meier survival curves were plotted at the tooth-level and multilevel Cox regression frailty models were constructed in order to assess the association among predictive variables and TLP by taking into account the hierarchical patient-teeth structure. RESULTS 442 patients (11,125 teeth) with a mean follow-up of 23 years met the inclusion criteria and were included in this study. The most prevalent diagnosis at baseline was stage III grade B (30.3%), followed by stage II grade B (23.5%). Among the parameters analysed, stage and grade were found to be the best predictors of TLP. Statistically significant differences were observed for extent only in patients with severe disease (stage IV or grade C). The multilevel Cox regression analysis demonstrated that patients with higher concomitant baseline staging and grading developed greater TLP over the follow-up period. CONCLUSIONS Higher concomitant staging and grading corresponded to greater risk for TLP and generalized extent only became a significant predictor in patients with stage IV or grade C disease.
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Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Musa Qazi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Maria V Rodriguez
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Matthew Galli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Muhammad H A Saleh
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Sphingolipid-Containing Outer Membrane Vesicles Serve as a Delivery Vehicle To Limit Macrophage Immune Response to Porphyromonas gingivalis. Infect Immun 2021; 89:IAI.00614-20. [PMID: 33361202 PMCID: PMC8090959 DOI: 10.1128/iai.00614-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/17/2020] [Indexed: 01/01/2023] Open
Abstract
Sphingolipids (SLs) are essential structural components of mammalian cell membranes. Our group recently determined that the oral anaerobe Porphyromonas gingivalis delivers its SLs to host cells and that the ability of P. gingivalis to synthesize SLs limits the elicited host inflammatory response during cellular infection. Sphingolipids (SLs) are essential structural components of mammalian cell membranes. Our group recently determined that the oral anaerobe Porphyromonas gingivalis delivers its SLs to host cells and that the ability of P. gingivalis to synthesize SLs limits the elicited host inflammatory response during cellular infection. As P. gingivalis robustly produces outer membrane vesicles (OMVs), we hypothesized that OMVs serve as a delivery vehicle for SLs, that the SL status of the OMVs may impact cargo loading to OMVs, and that SL-containing OMVs limit elicited host inflammation similar to that observed by direct bacterial challenge. Transwell cell culture experiments determined that in comparison to the parent strain W83, the SL-null mutant elicited a hyperinflammatory immune response from THP-1 macrophage-like cells with elevated tumor necrosis factor alpha (TNF-α), interleukin 1β (IL-1β), and IL-6. Targeted assessment of Toll-like receptors (TLRs) identified elevated expression of TLR2, unchanged TLR4, and elevated expression of the adaptor molecules MyD88 and TRIF (Toll/IL-1 receptor domain-containing adaptor-inducing beta interferon) by SL-null P. gingivalis. No significant differences in gingipain activity were observed in our infection models, and both strains produced OMVs of similar sizes. Using comparative two-dimensional gel electrophoresis, we identified differences in the protein cargo of the OMVs between parent and SL-null strain. Importantly, use of purified OMVs recapitulated the cellular inflammatory response observed in the transwell system with whole bacteria. These findings provide new insights into the role of SLs in P. gingivalis OMV cargo assembly and expand our understanding of SL-OMVs as bacterial structures that modulate the host inflammatory response.
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227
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Wu Z, Li M, Zhu F, Lei L, Cheng R, Hu T. The effects of oral health education regarding periodontal health on non-dental undergraduates in southwestern China-exploring the feasibility of an e-learning course for oral health promotion. BMC Oral Health 2021; 21:119. [PMID: 33726713 PMCID: PMC7962077 DOI: 10.1186/s12903-021-01476-5] [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: 11/22/2020] [Accepted: 02/26/2021] [Indexed: 02/08/2023] Open
Abstract
Background The high prevalence of periodontal diseases is an important oral health problem worldwide. It is necessary to increase public knowledge on and influence attitudes towards periodontal diseases in order to prevent them. However, the effect of oral health education (OHE) as a primary preventive method in China is unsatisfactory. The aim of this study is to investigate the feasibility of extending an e-learning course regarding periodontal health by comparing the effects of oral health education regarding periodontal health (OHE-PH) on dental and non-dental students and the effects between a traditional course and an e-learning course among non-dental students at Sichuan University. Methods A quasi-experimental study with a pre-test and a post-test was performed. A total of 217 dental students and 134 non-dental students attended a traditional course; 69 non-dental students attended an e-learning course. Before- and after-course questionnaires about periodontal health knowledge, attitudes and behaviours were administered. Results After the traditional/e-learning course, the knowledge of both dental and non-dental students about periodontal diseases and self-reported behaviours for gingival bleeding and oral care improved. The non-dental students reached or surpassed the level of dental students before the course. The non-dental students taking the e-learning course performed better in some areas than those taking the traditional course. Conclusions OHE-PH was effective for dental and non-dental students. The e-learning course on OHE-PH was sufficient for improving knowledge and self-reported behaviours among non-dental undergraduates and was even better than the traditional course in some areas. The e-learning course may be an effective method for periodontal health education and oral health promotion among undergraduates.
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Affiliation(s)
- Zhiwu Wu
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Mingming Li
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Fangzhi Zhu
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lei Lei
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ran Cheng
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Tao Hu
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Abstract
Filifactor alocis, a fastidious Gram-positive obligate anaerobic bacterium, is a newly appreciated member of the periodontal community that is now proposed to be a diagnostic indicator of periodontal disease. Its pathogenic characteristics are highlighted by its ability to survive in the oxidative stress-rich environment of the periodontal pocket and to significantly alter the microbial community dynamics by forming biofilms and interacting with several oral bacteria. Here, we describe the current understanding of F. alocis virulence attributes, such as its comparative resistance to oxidative stress, production of unique proteases and collagenases that can cause structural damage to host cells, and dysregulation of the immune system, which enable this bacterium to colonize, survive, and outcompete other traditional pathogens in the inflammatory environment of the periodontal pocket. Furthermore, we explore the recent advancements and future directions for F. alocis research, including the potential mechanisms for oxidative stress resistance and our evolving understanding of the interactions and mechanisms of bacterial survival inside neutrophils. We also discuss the current genetic tools and challenges involved in manipulating the F. alocis genome for the functional characterization of the putative virulence genes. Collectively, this information will expedite F. alocis research and should lead to the identification of prime targets for the development of novel therapeutics to aid in the control and prevention of periodontal disease.
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Affiliation(s)
- E Aja
- Division of Microbiology and Molecular Genetics, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - M Mangar
- Division of Microbiology and Molecular Genetics, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - H M Fletcher
- Division of Microbiology and Molecular Genetics, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - A Mishra
- Division of Microbiology and Molecular Genetics, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA, USA
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Abstract
The population of older adults is projected to increase dramatically as Baby Boomers continue to reach age 65 into 2029. This article discusses key shifts in this demographic, including changes in overall health status and living arrangements, that can aid in defining older adults and their medical needs. It also highlights the changes in dental use patterns and the increase in demand for comprehensive dental services for older adults in recent years. The article focuses on the fact that oral health contributes to overall health and the dental workforce must be prepared to treat older adults in their practices.
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Affiliation(s)
- Joseph M Calabrese
- Department of General Dentistry, Student Affairs, Boston University Henry M. Goldman School of Dental Medicine, 635 Albany Street, Suite G158, Boston, MA 02118, USA; Department of Medicine, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131, USA; Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA
| | - Kadambari Rawal
- Department of Medicine, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131, USA; Department of General Dentistry, Faculty Practice, Dental Health Center, Boston University Henry M. Goldman School of Dental Medicine.
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Abstract
The number of individuals 65 and older living in the United States is increasing substantially and becoming more racially and ethnically diverse. This shift will affect the demographics of the patient population seeking dental care. It will also impact the future treatment needs of older adults. In older adults, similar to the general adult population, oral health disparities continue to exist related to race, ethnicity, gender, and socioeconomic level. Dental practitioners must understand these changes in order to meet the challenges of providing oral health care to the increasing numbers of diverse, medically compromised, and cognitively impaired older adults.
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Affiliation(s)
- Michelle M Henshaw
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, 560 Harrison Avenue, Suite 301, Boston, MA 02118, USA.
| | - Steven Karpas
- Department of General Dentistry, Boston University Henry M. Goldman School of Dental Medicine, 635 Albany Street, Boston, MA 02118, USA
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Byrd KM, Gulati AS. The "Gum-Gut" Axis in Inflammatory Bowel Diseases: A Hypothesis-Driven Review of Associations and Advances. Front Immunol 2021; 12:620124. [PMID: 33679761 PMCID: PMC7933581 DOI: 10.3389/fimmu.2021.620124] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/05/2021] [Indexed: 12/18/2022] Open
Abstract
In modern medicine, the oral cavity has often been viewed as a passive conduit to the upper airways and gastrointestinal tract; however, its connection to the rest of the body has been increasingly explored over the last 40 years. For several diseases, the periodontium and gingiva are at the center of this oral-systemic link. Over 50 systemic conditions have been specifically associated with gingival and periodontal inflammation, including inflammatory bowel diseases (IBD), which have recently been elevated from simple "associations" to elegant, mechanistic investigations. IBD and periodontitis have been reported to impact each other's progression via a bidirectional relationship whereby chronic oral or intestinal inflammation can impact the other; however, the precise mechanisms for how this occurs remain unclear. Classically, the etiology of gingival inflammation (gingivitis) is oral microbial dysbiosis in the subgingival crevice that can lead to destructive periodontal disease (periodontitis); however, the current understanding of gingival involvement in IBD is that it may represent a separate disease entity from classical gingivitis, arising from mechanisms related to systemic inflammatory activation of niche-resident immune cells. Synthesizing available evidence, we hypothesize that once established, IBD can be driven by microbiomial and inflammatory changes originating specifically from the gingival niche through saliva, thereby worsening IBD outcomes and thus perpetuating a vicious cycle. In this review, we introduce the concept of the "gum-gut axis" as a framework for examining this reciprocal relationship between the periodontium and the gastrointestinal tract. To support and explore this gum-gut axis, we 1) provide a narrative review of historical studies reporting gingival and periodontal manifestations in IBD, 2) describe the current understanding and advances for the gum-gut axis, and 3) underscore the importance of collaborative treatment and research plans between oral and GI practitioners to benefit this patient population.
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Affiliation(s)
- Kevin M. Byrd
- Division of Oral & Craniofacial Health Sciences, University of North Carolina Adams School of Dentistry, Chapel Hill, NC, United States
- Department of Innovation & Technology Research, ADA Science & Research Institute, Gaithersburg, MD, United States
| | - Ajay S. Gulati
- Division of Gastroenterology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Mohammadipour HS, Forouzanfar F, Forouzanfar A. The Role of Type 2 Fibroblast Growth Factor in Periodontal Therapy. Curr Drug Targets 2021; 22:310-317. [PMID: 33153420 DOI: 10.2174/1389450121999201105152639] [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: 06/12/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 11/22/2022]
Abstract
The prevalence of periodontitis is around 20-50% in the global population. If it is not treated, it can cause tooth loss. Periodontal treatment aims at preserving the patient's teeth from various damages, including infection control and restoring lost periodontal tissue. The periodontium has great biological regenerative potential, and several biomaterials can be used to improve the outcome of periodontal treatment. To achieve the goal of periodontal tissue regeneration, numerous studies have used fibroblast growth factor 2 (FGF2) to stimulate the regeneration of both the soft tissue and bone. FGF2 induced a significant increment in the percentage of bone fill, bone mineral levels of the defect sites, length of the regenerated periodontal ligament, angiogenesis, connective tissue formation on the root surface, formation of dense fibers bound to the alveolar bone and newly synthesized cementum in teeth. This review will open further avenues to better understand the FGF2 therapy for periodontal regeneration.
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Affiliation(s)
| | - Fatemeh Forouzanfar
- Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Forouzanfar
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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233
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Periodontitis increases risk of viable bacteria in freshly drawn blood donations. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2021; 19:376-383. [PMID: 33539285 DOI: 10.2450/2021.0336-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/09/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND The aim of the study was to determine if periodontitis, which often causes transient bacteraemia, associates with viable bacteria in standard blood donations. MATERIALS AND METHODS This was a cross-sectional study of 60 self-reported medically healthy blood donors aged over 50 years. According to standard procedures, whole blood was separated by fractionation into plasma, buffy-coat, and red blood cell (RBC)-fractions. The buffy-coat was screened for bacterial contamination using BacT/ALERT. Samples from plasma and RBC-fractions were incubated anaerobically and aerobically at 37°C for 7 days on trypticase soy blood agar (TSA). For identification, colony polymerase chain reaction was performed using primers targeting 16S rDNA. RESULTS From 62% of the donors with periodontitis, bacterial growth was observed on at least 1 out of 4 plates inoculated with plasma or RBCs, whereas only 13% of plates inoculated with plasma or RBCs from periodontally healthy controls yielded bacterial growth (relative risk 6.4, 95% CI: 2.1; 19.5; p=0.0011). None of the donors tested positive for bacterial contamination using BacT/ALERT. Cutibacterium acnes was found in 31% of the donations from donors with periodontitis and in 10% of the donations from periodontally healthy donors. In addition, Staphylococcus species, Bacillus mycoides, Aggregatibacter aphrophilus, and Corynebacterium kroppenstedtii were detected. DISCUSSION Periodontitis increased the risk of bacterial contamination of blood products. Contaminating bacteria are often associated with the RBC-fraction. As the BacT/ALERT test is generally performed on platelet products, routine screening fails to detect many occurrences of viable bacteria in the RBC-fraction.
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Untreated caries among US working-aged adults and association with reporting need for oral health care. J Am Dent Assoc 2021; 152:55-64. [PMID: 33413851 DOI: 10.1016/j.adaj.2020.09.019] [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: 04/21/2020] [Revised: 08/17/2020] [Accepted: 09/15/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND National data indicate that working-aged adults (20-64 years) are more likely to report financial barriers to receiving needed oral health care relative to other age groups. The aim of this study was to examine the burden of untreated caries (UC) and its association with reporting an unmet oral health care need among working-aged adults. METHODS The authors used National Health and Nutrition Examination Survey data from 2011 through 2016 for 10,286 dentate adults to examine the prevalence of mild to moderate (1-3 affected teeth) and severe (≥ 4 affected teeth) UC. The authors used multivariable logistic regression to identify factors that were associated with reporting an unmet oral health care need. RESULTS Low-income adults had mild to moderate UC (26.2%) 2 times more frequently and severe UC (13.2%) 3 times more frequently than higher-income adults. After controlling for covariates, the variables most strongly associated with reporting an unmet oral health care need were UC, low income, fair or poor general health, smoking, and no private health insurance. The model-adjusted prevalence of reporting an unmet oral health care need among low-income adults with mild to moderate and severe UC were 35.7% and 45.1%, respectively. CONCLUSIONS The burden of UC among low-income adults is high; prevalence was approximately 40% with approximately 3 affected teeth per person on average. Reporting an unmet oral health care need appears to be capturing primarily differences in UC, health, and financial access to oral health care. PRACTICAL IMPLICATIONS Data on self-reported unmet oral health care need can have utility as a surveillance tool for monitoring UC and targeting resources to decrease UC among low-income adults.
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Szabo YZ, Slavish DC. Measuring salivary markers of inflammation in health research: A review of methodological considerations and best practices. Psychoneuroendocrinology 2021; 124:105069. [PMID: 33316694 PMCID: PMC8412951 DOI: 10.1016/j.psyneuen.2020.105069] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/20/2022]
Abstract
There is an increasing interest in using saliva to measure inflammatory biomarkers. Compared to blood, saliva is non-invasive, requires a lower biosafety classification, and requires less specialized personnel to collect. As the assessment of inflammation in saliva becomes more popular in psychoneuroimmunology research, the development of gold-standard methodological practices is paramount. This paper reviews different considerations for designing studies to assess salivary measures of inflammation. We review saliva collection procedures, sample storage and processing considerations, assay techniques, flow rate, correspondence with blood-based markers, and potential demographic and health moderators of levels of salivary markers of inflammation. Together, this review highlights critical gaps for future research, including calls for standardization of study protocols, transparent reporting of results, assessing predictive validity of markers of salivary inflammation for disease, and the need for assessment of participants' oral and general health status. Although additional work is needed to elucidate gold standards for study design, measurement, and analysis, salivary markers of inflammation may be a useful tool for understanding oral and peripheral inflammation dynamics non-invasively.
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Affiliation(s)
- Yvette Z. Szabo
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA,Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, USA, Corresponding Authors: Yvette Z. Szabo, 4800 Memorial Drive (151C), Waco, Texas 76711 (254) 297-3179;
| | - Danica C. Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
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236
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Johnson TM, Bice RW, Gilbert WA. Orthodontic Treatment of Periodontally Compromised Teeth After Laser Periodontal Therapy: A Case Report. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:528-534. [PMID: 33493411 DOI: 10.1089/photob.2020.4910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: To assess stability of laser periodontal therapy (LPT) results after orthodontic tooth movement. Background: Periodontitis and malocclusion each exhibit high global prevalence. Thus, dentists inevitably face increasing demand for orthodontic treatment in patients with reduced periodontal support. Many of these patients benefit from orthodontic treatment, provided that periodontal inflammation is controlled. Materials and methods: We present a case demonstrating successful orthodontic treatment of periodontally compromised teeth after LPT. A patient with severe attachment and alveolar bone loss received orthodontic treatment 13 months after neodymium-doped: yttrium aluminum garnet LPT (1064 nm). We utilized three laser parameter sets for various purposes during the procedure-ablation of the periodontal pocket epithelium (2.8 W, 20 Hz, 100 μs), clot stabilization (2.8 W, 20 Hz, 550 μs), and photobiomodulation (2.8 W, 20 Hz, 100 μs, noncontact). Results: Treatment resulted in improved radiographic bone levels, clinical parameters consistent with periodontal health, and favorable occlusal relationships. Conclusions: In the presented case, we successfully treated a patient presenting with malocclusion and reduced periodontal support while avoiding the risk and morbidity of conventional periodontal surgery. Controlled clinical research to establish the predictability of the described approach appears warranted.
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Affiliation(s)
- Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia, USA
| | - Ronald W Bice
- Department of Orthodontics, United States Army Dental Health Activity, Fort Gordon, Georgia, USA
| | - William A Gilbert
- Deputy Consultant to the Surgeon General for Periodontics, United States Army Dental Health Activity, Joint Base Lewis-McChord, Washington, USA
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237
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Shimpi N, McRoy S, Zhao H, Wu M, Acharya A. Development of a periodontitis risk assessment model for primary care providers in an interdisciplinary setting. Technol Health Care 2021; 28:143-154. [PMID: 31282445 DOI: 10.3233/thc-191642] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Periodontitis (PD), a form of gum disease, is a major public health concern as it is globally prevalent and harms both individual quality of life and economic productivity. Global cost in lost productivity is estimated at US$54 billion annually. Moreover, current PD assessment applies only after the damage has already occurred. OBJECTIVE This study proposes and tests a new PD risk assessment model applicable at point-of-care, using supervised machine learning methods. METHODS We compare the performance of five algorithms using retrospective clinical data: Naïve Bayes (NB), Logistic Regression (LR), Support Vector Machine (SVM), Artificial Neural Network (ANN), and Decision Tree (DT). RESULTS DT and ANN demonstrated higher accuracy in classifying the patients with high or low PD risk as compared to NB, LR and SVM. The resultant model with DT showed a sensitivity of 87.08% (95% CI 84.12% to 89.76%) and specificity of 93.5% (95% CI 91% to 95.49%). CONCLUSIONS A predictive model with high sensitivity and specificity to stratify individuals into low and high PD risk tiers was developed. Validation in other populations will inform translational value of this approach and its potential applicability as clinical decision support tool.
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Affiliation(s)
- Neel Shimpi
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Susan McRoy
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Huimin Zhao
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Min Wu
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Amit Acharya
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
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238
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Ghassib IH, Batarseh FA, Wang HL, Borgnakke WS. Clustering by periodontitis-associated factors: A novel application to NHANES data. J Periodontol 2021; 92:1136-1150. [PMID: 33315260 DOI: 10.1002/jper.20-0489] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/28/2020] [Accepted: 12/03/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Unsupervised clustering is a method used to identify heterogeneity among groups and homogeneity within a group of patients. Without a prespecified outcome entry, the resulting model deciphers patterns that may not be disclosed using traditional methods. This is the first time such clustering analysis is applied in identifying unique subgroups at high risk for periodontitis in National Health and Nutrition Examination Surveys (NHANES 2009 to 2014 data sets using >500 variables. METHODS Questionnaire, examination, and laboratory data (33 tables) for >1,000 variables were merged from 14,072 respondents who underwent clinical periodontal examination. Participants with ≥6 teeth and available data for all selected categories were included (N = 1,222). Data wrangling produced 519 variables. k-means/modes clustering (k = 2:14) was deployed. The optimal k-value was determined through the elbow method, formula = ∑ (xi 2 ) - ((∑ xi )2 /n). The 5-cluster model showing the highest variability (63.08%) was selected. The 2012 Centers for Disease Control and Prevention/American Academy of Periodontology (AAP) and 2018 European Federation of Periodontology/AAP periodontitis case definitions were applied. RESULTS Cluster 1 (n = 249) showed the highest prevalence of severe periodontitis (43%); 39% self-reported "fair" general health; 55% had household income <$35,000/year; and 48% were current smokers. Cluster 2 (n = 154) had one participant with periodontitis. Cluster 3 (n = 242) represented the greatest prevalence of moderate periodontitis (53%). In Cluster 4 (n = 35) only one participant had no periodontitis. Cluster 5 (n = 542) was the systemically healthiest with 77% having no/mild periodontitis. CONCLUSION Clustering of NHANES demographic, systemic health, and socioeconomic data effectively identifies characteristics that are statistically significantly related to periodontitis status and hence detects subpopulations at high risk for periodontitis without costly clinical examinations.
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Affiliation(s)
- Iya H Ghassib
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| | | | - Hom-Lay Wang
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| | - Wenche S Borgnakke
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
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239
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4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2021. Diabetes Care 2021; 44:S40-S52. [PMID: 33298415 DOI: 10.2337/dc21-s004] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc21-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc21-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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240
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Riis JL, Ahmadi H, Hamilton KR, Hand T, Granger DA. Best practice recommendations for the measurement and interpretation of salivary proinflammatory cytokines in biobehavioral research. Brain Behav Immun 2021; 91:105-116. [PMID: 32931871 PMCID: PMC8164445 DOI: 10.1016/j.bbi.2020.09.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 12/11/2022] Open
Abstract
Despite the integration of salivary inflammatory cytokines into research across the biobehavioral, psychological, clinical, and health-related disciplines, there is little guidance regarding the biospecimen collection, handling, and storage practices that maximize the quality and validity of salivary cytokine data. Furthermore, associations between salivary cytokines and measures related to oral health are rarely assessed and accounted for in studies outside the oral health fields. To address these gaps, we examine the sensitivity of salivary interleukin-1β (IL-1β), IL-6, IL-8, and tumor necrosis factor-α (TNF-α) to changes in saliva sample collection technique and cold chain management procedures. Using subsets of saliva samples collected from 150 healthy adults, we measure salivary IL-1β, IL-6, IL-8, TNF-α, and other oral health-related indices (i.e., blood contamination [transferrin], and salivary matrixmallotprotienase-8). In addition to examining changes in cytokine levels associated with sample collection technique and cold chain management procedures, we assess relations between cytokine concentrations and levels of other oral health-related measures. We found that IL-1β, IL-6, and IL-8 were more robust to changes in sample collection and cold chain management procedures than TNF-α, and all cytokines were positively associated with other oral health-related measures. Based on our findings, we recommend analyte-specific guidance for measuring and interpreting salivary cytokine concentrations.
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Affiliation(s)
- Jenna L. Riis
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, CA, USA,Department of Psychological Science, University of California, Irvine, CA, USA,Correspondence: Jenna L. Riis (), Institute for Interdisciplinary Salivary Bioscience Research, University of California at Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine CA 92697-7085
| | - Hedyeh Ahmadi
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, CA, USA
| | - Katrina R. Hamilton
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, CA, USA
| | - Tracey Hand
- Center for Interdisciplinary Salivary Bioscience Research, Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Douglas A. Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, CA, USA,Department of Psychological Science, University of California, Irvine, CA, USA,Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, MD, USA,Department of Pediatrics Johns Hopkins University School of Medicine, Baltimore, MD, USA,Salivary Bioscience Laboratory and Department of Psychology, University of Nebraska, Lincoln, NE, USA
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241
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AlSakr A, Blanchard S, Wong P, Thyvalikakath T, Hamada Y. Association between intracranial carotid artery calcifications and periodontitis. Cone-beam computed tomography (CBCT) study. J Periodontol 2020; 92:1402-1409. [PMID: 33382097 DOI: 10.1002/jper.20-0607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/30/2020] [Accepted: 11/30/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Intracranial carotid artery calcifications (ICACs) are one type of calcification that may be detected as incidental findings in cone-beam computed tomography (CBCT). This retrospective study aimed to examine the prevalence of ICACs on CBCT images and their associations among age, gender, chronic periodontitis, and patient-reported cardiovascular diseases (CVDs). METHODS A total of 303 CBCT scans were reviewed and a total of 208 patients met the inclusion criteria. The presence or absence of ICACs was evaluated in the ophthalmic and cavernous segments of each scan. Patient demographic data, including age, gender, and medical history, specifically focused on CVDs were recorded. The presence or absence of periodontitis was recorded from each subject with full mouth radiographs and clinical measurements. Odds ratios (ORs) were calculated as part of the logistic regression analysis. RESULTS Overall, ICACs were found in 93 subjects (45%). The bilateral ICACs were found in 43 subjects (21% of the total subjects, 46% of the subjects with ICACs). There were statistically significant associations between presence of ICACs and periodontitis (OR = 4.55), hypertension (OR = 3.02), hyperlipidemia (OR = 2.87), increasing age (OR = 2.24), and the male gender (OR = 1.85). Smoking status was not significantly correlated with ICACs. CONCLUSION This study revealed that nearly half (45%) of the subjects displayed ICACs on the CBCT images. ICACs are significantly related to the status of chronic periodontitis, age, gender, and CVDs. A more careful review of CBCT scans is highly recommended to detect these calcifications and refer patients for further medical evaluation.
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Affiliation(s)
- Abdulaziz AlSakr
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Steven Blanchard
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Phillip Wong
- Department of Oral Pathology, Medicine, and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Thankam Thyvalikakath
- Dental Informatics Core, Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Yusuke Hamada
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana
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242
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Iao S, Pei X, Ouyang X, Liu J, Liu W, Cao C. Natural progression of periodontal diseases in Chinese villagers based on the 2018 classification. J Periodontol 2020; 92:1232-1242. [PMID: 33277921 DOI: 10.1002/jper.20-0199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 11/09/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Based on the 2018 classification, we aimed to determine the prevalence, distribution, and progression of periodontitis in the rural Chinese population without access to dental care. METHODS In all, 404 subjects (28.7 ± 8.9 years, M:F = 182:222) were randomly enrolled in 1992 and re-called in 1996. With the new classification, the prevalence and distribution of stage, grade, and extent were characterized. Stage progression was compared with the progression of clinical attachment loss (CAL) and radiographic bone loss (RBL). RESULTS At baseline, 94.1% villagers suffered from periodontitis, of whom 53.7% were in stage III/IV. The prevalence of stage III/IV increased from 18.2% in the age group of 15 to 24 years to 60.9% in 25 to 34-year-old group and 88.7% in the 35 to 44-year-old group. Significantly more stage III/IV, generalized, and grade C periodontitis were found in male villagers than female villagers. In 1996, the prevalence rate of periodontitis increased to 98.5%, with 80.0% in stage III/IV. Further, 84.2% villagers presented with grade C periodontitis based on longitudinal ΔCAL. The rate of progression (≥1 site with ΔCAL ≥3 mm) was 63.7%. Stage progression correlated significantly with CAL and RBL progression in stage I/II, but this association was not found in stage III/IV. Among subjects with disease progression in stage III/IV, 90.4% shifted from localized to generalized cases. Furthermore, ceiling effects were observed in stage III/IV. CONCLUSIONS In villagers without access to dental care, 94.1% suffered from periodontitis, with more than half having stage III/IV disease based on the 2018 classification. The majority cases presented with rapid periodontal progression. Although stage progression correlated significantly with CAL and RBL progression in stage I/II, ceiling effects existed in stage III/IV.
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Affiliation(s)
- Siniong Iao
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiyan Pei
- First Clinic Division, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jianru Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenyi Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Caifang Cao
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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243
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Lamont EI, Gadkari A, Kerns KA, To TT, Daubert D, Kotsakis G, Bor B, He X, McLean JS. Modified SHI medium supports growth of a disease-state subgingival polymicrobial community in vitro. Mol Oral Microbiol 2020; 36:37-49. [PMID: 33174294 PMCID: PMC7984074 DOI: 10.1111/omi.12323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 01/04/2023]
Abstract
Developing a laboratory model of oral polymicrobial communities is essential for in vitro studies of the transition from healthy to diseased oral plaque. SHI medium is an enriched growth medium capable of supporting in vitro biofilms with similar diversity to healthy supragingival inocula; however, this medium does not maintain the diversity of gram‐negative bacteria more associated with subgingival plaque. Here, we systematically modified SHI medium components to investigate the impacts of varying nutrients and develop a medium capable of supporting a specific disease‐state subgingival community. A diseased subgingival plaque sample was inoculated in SHI medium with increasing concentrations of sucrose (0%, 0.1%, 0.5%), fetal bovine serum (FBS) (0%, 10%, 20%, 30%, 50%), and mucin (0.1, 2.5, 8.0 g/L) and grown for 48 hrs, then the 16S rRNA profiles of the resulting biofilms were examined. In total, these conditions were able to capture 89 of the 119 species and 43 of the 51 genera found in the subgingival inoculum. Interestingly, biofilms grown in high sucrose media, although dominated by acidogenic Firmicutes with a low final pH, contained several uncultured taxa from the genus Treponema, information that may aid culturing these periodontitis‐associated fastidious organisms. Biofilms grown in a modified medium (here named subSHI‐v1 medium) with 0.1% sucrose and 10% FBS had a high diversity closest to the inoculum and maintained greater proportions of many gram‐negative species of interest from the subgingival periodontal pocket (including members of the genera Prevotella and Treponema, and the Candidate Phyla Radiation phylum Saccharibacteria), and therefore best represented the disease community.
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Affiliation(s)
- Eleanor I Lamont
- Department of Periodontics, University of Washington, Seattle, WA, USA
| | - Archita Gadkari
- Department of Periodontics, University of Washington, Seattle, WA, USA
| | | | - Thao T To
- Department of Periodontics, University of Washington, Seattle, WA, USA
| | - Diane Daubert
- Department of Periodontics, University of Washington, Seattle, WA, USA
| | - Georgios Kotsakis
- Department of Periodontics, University of Texas Health Science Center, San Antonio, TX, USA
| | - Batbileg Bor
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Xuesong He
- Department of Microbiology, The Forsyth Institute, Cambridge, MA, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Jeffrey S McLean
- Department of Periodontics, University of Washington, Seattle, WA, USA
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244
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Jia M, Wu Z, Vogtmann E, O'Brien KM, Weinberg CR, Sandler DP, Gierach GL. The Association Between Periodontal Disease and Breast Cancer in a Prospective Cohort Study. Cancer Prev Res (Phila) 2020; 13:1007-1016. [PMID: 32727823 PMCID: PMC7718282 DOI: 10.1158/1940-6207.capr-20-0018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/27/2020] [Accepted: 07/22/2020] [Indexed: 12/21/2022]
Abstract
Periodontal disease may be associated with increased breast cancer risk, but studies have not considered invasive breast cancer and ductal carcinoma in situ (DCIS) separately in the same population. We assessed the relationship between periodontal disease and breast cancer in a large prospective cohort study. The Sister Study followed women without prior breast cancer ages 35 to 74 years from 2003 to 2017 (N = 49,968). Baseline periodontal disease was self-reported, and incident breast cancer was ascertained over a mean follow-up of 9.3 years. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards regression, adjusting for multiple potential confounders, including smoking status. Heterogeneity in risk for invasive breast cancer versus DCIS was also estimated. About 22% of participants reported a history of periodontal disease at baseline. A total of 3,339 incident breast cancers (2,607 invasive breast cancer, 732 DCIS) were identified. There was no clear association between periodontal disease and overall breast cancer risk (HR = 1.02; 95% CI, 0.94-1.11). However, we observed a nonstatistically significant suggestive increased risk of invasive breast cancer (HR = 1.07; 95% CI, 0.97-1.17) and decreased risk of DCIS (HR = 0.86; 95% CI, 0.72-1.04) associated with periodontal disease, with evidence for heterogeneity in the risk associations (relative HR for invasive breast cancer versus DCIS = 1.24; 95% CI, 1.01-1.52). A case-only analysis for etiologic heterogeneity confirmed this difference. We observed no clear association between periodontal disease and overall breast cancer risk. The heterogeneity in risk associations for invasive breast cancer versus DCIS warrants further exploration.
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Affiliation(s)
- Mengmeng Jia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zeni Wu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Emily Vogtmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
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245
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Lack of association between Mannose Binding Lectin-2 gene polymorphisms and periodontitis: A meta-analysis. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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246
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Abstract
Although the composition of the oral human microbiome is now well studied, regulation of genes within oral microbial communities remains mostly uncharacterized. Current concepts of periodontal disease and caries highlight the importance of oral biofilms and their role as etiological agents of those diseases. Currently, there is increased interest in exploring and characterizing changes in the composition and gene-expression profiles of oral microbial communities. These efforts aim to identify changes in functional activities that could explain the transition from health to disease and the reason for the chronicity of those infections. It is now clear that the functions of distinct species within the subgingival microbiota are intimately intertwined with the rest of the microbial community. This point highlights the relevance of examining the expression profile of specific species within the subgingival microbiota in the case of periodontal disease or caries lesions, in the context of the other members of the biofilm in vivo. Metatranscriptomic analysis of the oral community is the starting point for identifying environmental signals that modulate the shift in metabolism of the community from commensal to dysbiotic. These studies give a snapshot of the expression patterns of microbial communities and also allow us to determine triggers to diseases. For example, in the case of caries, studies have unveiled a potential new pathway of sugar metabolism, namely the use of sorbitol as an additional source of carbon by Streptococcus mutans; and in the case of periodontal disease, high levels of extracellular potassium could be a signal of disease. Longitudinal studies are needed to identify the real markers of the initial stages of caries and periodontal disease. More information on the gene-expression profiles of the host, along with the patterns from the microbiome, will lead to a clearer understanding of the modulation of health and disease. This review presents a summary of these initial studies, which have opened the door to a new understanding of the dynamics of the oral community during the dysbiotic process in the oral cavity.
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Affiliation(s)
- Ana E Duran-Pinedo
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
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247
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Larvin H, Wilmott S, Wu J, Kang J. The Impact of Periodontal Disease on Hospital Admission and Mortality During COVID-19 Pandemic. Front Med (Lausanne) 2020; 7:604980. [PMID: 33330570 PMCID: PMC7719810 DOI: 10.3389/fmed.2020.604980] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/30/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction: COVID-19 has had a huge impact on society and healthcare and it has been suggested that people with periodontal disease are at risk of having worse outcomes from the disease. The aim of this study was to quantify the impact of periodontal disease on hospital admission and mortality during the COVID-19 pandemic. Materials and Methods: The study extracted UK Biobank participants who had taken a COVID-19 test between March and June 2020 (n = 13,253), of which 1,616 were COVID-19 positive (12%) and 11,637 were COVID-19 negative (88%). Self-reported oral health indicators of painful or bleeding gums and loose teeth were used as surrogates for periodontal disease, participants who did not report any of the aforementioned indicators were used as controls. Multivariable logistic regressions were used to obtain crude and adjusted odds ratios of COVID-19 infection, subsequent hospital admission and mortality adjusted for demographics, BMI, biomarkers, lifestyle and co-morbidities. Results: Painful gums, bleeding gums and loose teeth were reported in 2.7, 11.2 and 3.3% of participants with COVID-19 infection, respectively. Risk of COVID-19 infection in participants with painful or bleeding gums and loose teeth compared to controls was not increased (odds ratio [OR]: 1.10, 95% CI: 0.72–1.69; OR: 1.15, 95% CI: 0.84–1.59). COVID-19 positive participants with painful or bleeding gums had a higher risk of mortality (OR: 1.71, 95% CI: 1.05–2.72) but not hospital admission (OR: 0.90, 95% CI: 0.59–1.37). Participants with loose teeth did not show higher risk of hospital admission or mortality compared to the control group (OR = 1.55, 95% CI: 0.87–2.77; OR: 1.85; 95% CI: 0.92–2.72). Conclusion: There was insufficient evidence to link periodontal disease with an increased risk of COVID-19 infection. However, amongst the COVID-19 positive, there was significantly higher mortality for participants with periodontal disease. Utilization of linked dental and hospital patient records would improve the understanding of the impact of periodontal disease on COVID-19 related outcomes.
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Affiliation(s)
- Harriet Larvin
- School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Sheryl Wilmott
- Leeds Dental Institute, Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, United Kingdom.,Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | - Jing Kang
- Oral Biology, School of Dentistry, University of Leeds, Leeds, United Kingdom
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248
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Lim G, Janu U, Chiou LL, Gandhi KK, Palomo L, John V. Periodontal Health and Systemic Conditions. Dent J (Basel) 2020; 8:E130. [PMID: 33227918 PMCID: PMC7711538 DOI: 10.3390/dj8040130] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/11/2020] [Accepted: 11/17/2020] [Indexed: 12/05/2022] Open
Abstract
According to the new classification proposed by the recent 2017 World Workshop on Periodontal and Peri-implant Diseases and Conditions, periodontitis, necrotizing periodontal diseases, periodontitis as a manifestation of systemic diseases, and systemic diseases or conditions affecting the periodontal supporting tissues, are considered as separate entities. Scientific evidence has demonstrated that periodontal diseases are not just simple bacterial infections but rather complex diseases of multifactorial complexity that interplay with the subgingival microbes, the host immune, and inflammatory responses. Despite dental plaque biofilm being considered the primary risk factor for periodontitis in the vast majority of patients that dentists encounter on a daily basis, there are other factors that can also contribute and/or accelerate pathologic progressive attachment loss. In this article, the authors aim to briefly review and discuss the present evidence regarding the association between periodontal diseases and systemic diseases and conditions.
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Affiliation(s)
- Glendale Lim
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
| | - Upasna Janu
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
| | - Lan-Lin Chiou
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
| | - Kaveri Kranti Gandhi
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
| | - Leena Palomo
- Department of Periodontology, Case Western University, School of Dentistry, Indianapolis, IN 46202, USA;
| | - Vanchit John
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, IN 46202, USA; (G.L.); (U.J.); (L.-L.C.); (K.K.G.)
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249
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da Silva FRP, Pessoa LDS, Shin JI, Alves EHP, Koga RS, Smith CV, Vasconcelos DFP, Pereira ACTDC. Polymorphisms in the interleukin genes and chronic periodontitis: A field synopsis and revaluation by Bayesian approaches. Cytokine 2020; 138:155361. [PMID: 33223448 DOI: 10.1016/j.cyto.2020.155361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/03/2020] [Accepted: 11/02/2020] [Indexed: 12/17/2022]
Abstract
Periodontitis is a high prevalent disease into the clinical dentistry. Genetic variations in interleukins (IL) genes were associated with chronic periodontitis (CP) and were focus of several meta-analyses. This study aimed to assess the noteworthiness in the meta-analyses by means of a Bayesian approach to determinate possible false report associations. A systematic search was performed for meta-analyses with associations between gene polymorphisms in interleukins and CP. The calculations for the False-Positive Rate Probability (FPRP) and the Bayesian False Discovery Probability (BFDP) were performed to assess the noteworthiness with a statistical power of 1.2 and 1.5 of Odds Ratio at a prior probability of 10-3 and 10-6. As results, eight meta-analyses approaching the IL1A/rs1800587, IL1B/rs1143634, IL1RN/rs2234663, IL4/rs2243250, IL6/rs1800795/rs1800796, IL17A/rs2275913 and IL18/rs1946518/rs187238 polymorphisms have been identified. Twenty-two from 270 calculations (8.15%) were noteworthy. Herein, we have identified the IL1A and IL1B polymorphisms as noteworthy biomarkers for CP susceptibility.
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Affiliation(s)
- Felipe Rodolfo Pereira da Silva
- Doctorate in Post-Graduation Program in Basic and Applied Immunology, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Larissa Dos Santos Pessoa
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaiba, Piaui, Brazil
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Even Herlany Pereira Alves
- Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of the Parnaiba Delta (UFDPar), Parnaiba, Piaui, Brazil
| | - Reyce Santos Koga
- Doctorate in Post-Graduation Program in Basic and Applied Immunology, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Camila Valente Smith
- Master Student in the Post-Graduation Program in Dentistry, Dentistry College, Federal University of Amazonas, Manaus, Amazonas, Brazil
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250
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Jiao J, Jing W, Si Y, Feng X, Tai B, Hu D, Lin H, Wang B, Wang C, Zheng S, Liu X, Rong W, Wang W, Li W, Meng H, Wang X. The prevalence and severity of periodontal disease in Mainland China: Data from the Fourth National Oral Health Survey (2015-2016). J Clin Periodontol 2020; 48:168-179. [PMID: 33103285 DOI: 10.1111/jcpe.13396] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 09/17/2020] [Accepted: 10/21/2020] [Indexed: 11/30/2022]
Abstract
AIM To evaluate periodontal conditions in adults in mainland China based on data from the 4th National Oral Health Survey. MATERIALS AND METHODS Data of adult subjects (35- to 44-year-old group [N = 4409], 55- to 64-year-old group [N = 4622], and 65- to 74-year-old group [N = 4428]) were analysed. Demographic, socio-economic, personal habit, dental history, and health attitude data were obtained using a questionnaire. Periodontal condition was assessed using the standardized case definitions of the 2018 classification scheme. A multivariate analysis was performed to investigate the relationship between periodontitis severity and age, smoking status, gender, and region using generalized additive models after adjusting for confounders. RESULTS The frequency of subjects with periodontitis was 52.8%, 69.3%, and 64.6% in the three age groups, respectively. The frequency of subjects with severe periodontitis (stage III or IV) was 10.6%, 37.3%, and 43.5% in the three age groups, respectively. The severity of periodontal disease was positively associated with age. Current and former smokers exhibited significantly greater disease severity than non-smokers after adjustment for confounders. No significant difference of severity was found between males and females. CONCLUSION Within the limitations of the study, the prevalence of periodontitis is very high among adults in mainland China. Periodontal status is associated with age and smoking status.
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Affiliation(s)
- Jian Jiao
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wudi Jing
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yan Si
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiping Feng
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Baojun Tai
- School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Deyu Hu
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Huancai Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yetsen University, Guangzhou, China
| | - Bo Wang
- Chinese Stomatological Association, Beijing, China
| | - Chunxiao Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuguo Zheng
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xuenan Liu
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wensheng Rong
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Weijian Wang
- Department of Preventive Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wenjing Li
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xing Wang
- Chinese Stomatological Association, Beijing, China
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