201
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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: 78] [Impact Index Per Article: 26.0] [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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202
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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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203
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Bugueno IM, Benkirane-Jessel N, Huck O. Implication of Toll/IL-1 receptor domain containing adapters in Porphyromonas gingivalis-induced inflammation. Innate Immun 2021; 27:324-342. [PMID: 34018827 PMCID: PMC8186158 DOI: 10.1177/17534259211013087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Periodontitis is induced by periodontal dysbiosis characterized by the predominance of anaerobic species. TLRs constitute the classical pathway for cell activation by infection. Interestingly, the Toll/IL-1 receptor homology domain adapters initiate signaling events, leading to the activation of the expression of the genes involved in the host immune response. The aim of this study was to evaluate the effects of Porphyromonas gingivalis on the expression and protein-protein interactions among five TIR adapters (MAL, MyD88, TRIF, TRAM and SARM) in gingival epithelial cells and endothelial cells. It was observed that P. gingivalis is able to modulate the signaling cascades activated through its recognition by TLR4/2 in gingival epithelial cells and endothelial cells. Indeed, MAL-MyD88 protein-protein interactions associated with TLR4 was the main pathway activated by P. gingivalis infection. When transient siRNA inhibition was performed, cell viability, inflammation, and cell death induced by infection decreased and such deleterious effects were almost absent when MAL or TRAM were targeted. This study emphasizes the role of such TIR adapter proteins in P. gingivalis elicited inflammation and the precise evaluation of TIR adapter protein interactions may pave the way for future therapeutics in both periodontitis and systemic disease with a P. gingivalis involvement, such as atherothrombosis.
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Affiliation(s)
- Isaac M Bugueno
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Nadia Benkirane-Jessel
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Olivier Huck
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, France
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204
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Izawa K, Okamoto-Shibayama K, Kita D, Tomita S, Saito A, Ishida T, Ohue M, Akiyama Y, Ishihara K. Taxonomic and Gene Category Analyses of Subgingival Plaques from a Group of Japanese Individuals with and without Periodontitis. Int J Mol Sci 2021; 22:ijms22105298. [PMID: 34069916 PMCID: PMC8157553 DOI: 10.3390/ijms22105298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 12/11/2022] Open
Abstract
Periodontitis is an inflammation of tooth-supporting tissues, which is caused by bacteria in the subgingival plaque (biofilm) and the host immune response. Traditionally, subgingival pathogens have been investigated using methods such as culturing, DNA probes, or PCR. The development of next-generation sequencing made it possible to investigate the whole microbiome in the subgingival plaque. Previous studies have implicated dysbiosis of the subgingival microbiome in the etiology of periodontitis. However, details are still lacking. In this study, we conducted a metagenomic analysis of subgingival plaque samples from a group of Japanese individuals with and without periodontitis. In the taxonomic composition analysis, genus Bacteroides and Mycobacterium demonstrated significantly different compositions between healthy sites and sites with periodontal pockets. The results from the relative abundance of functional gene categories, carbohydrate metabolism, glycan biosynthesis and metabolism, amino acid metabolism, replication and repair showed significant differences between healthy sites and sites with periodontal pockets. These results provide important insights into the shift in the taxonomic and functional gene category abundance caused by dysbiosis, which occurs during the progression of periodontal disease.
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Affiliation(s)
- Kazuki Izawa
- Department of Computer Science, School of Computing, Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8550, Japan; (K.I.); (T.I.); (M.O.); (Y.A.)
| | | | - Daichi Kita
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 101-0061, Japan; (D.K.); (S.T.); (A.S.)
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Sachiyo Tomita
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 101-0061, Japan; (D.K.); (S.T.); (A.S.)
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 101-0061, Japan; (D.K.); (S.T.); (A.S.)
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Takashi Ishida
- Department of Computer Science, School of Computing, Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8550, Japan; (K.I.); (T.I.); (M.O.); (Y.A.)
| | - Masahito Ohue
- Department of Computer Science, School of Computing, Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8550, Japan; (K.I.); (T.I.); (M.O.); (Y.A.)
| | - Yutaka Akiyama
- Department of Computer Science, School of Computing, Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8550, Japan; (K.I.); (T.I.); (M.O.); (Y.A.)
| | - Kazuyuki Ishihara
- Department of Microbiology, Tokyo Dental College, Chiyoda-ku, Tokyo 101-0061, Japan;
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 101-0061, Japan
- Correspondence: ; Tel.: +81–3-6380−9558
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205
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Discepoli N, Marruganti C, Mirra R, Pettinari G, Ferrari Cagidiaco E, Ferrari M. Patients' illness perception before and after non-surgical periodontal therapy. A pre-post quasi-experimental study. J Periodontol 2021; 93:123-134. [PMID: 33997985 DOI: 10.1002/jper.21-0052] [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] [Received: 01/26/2021] [Revised: 04/24/2021] [Accepted: 04/24/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patient's illness perception, assessed through the Brief-Illness Perception Questionnaire (Brief-IPQ), plays a decisive role in the treatment effectiveness of a wide range of chronic diseases; nonetheless, evidence is still lacking regarding periodontitis. The aim of the present pre-post quasi-experimental study was to evaluate the change in the Brief-IPQ before and after non-surgical periodontal treatment (NST) and to evaluate its ability to foresee the efficacy of NST. METHODS A total of 126 periodontitis participants starting NST were asked to participate in the study. The nine-item Brief-IPQ together with a full periodontal chart were recorded at baseline and at the 3-month follow up (reevaluation) after NST. Pre-post comparisons of psychometric and periodontal variables were carried out through the Wilcoxon signed-rank test (α = 0.05). A predictive model was built to test the ability of the Brief-IPQ items to foresee the efficacy of NST. RESULTS NST led to a significant reduction in all periodontal parameters (P < 0.001); the proportion of pockets closed was 64.18%. Although the overall sum score of the Brief-IPQ remained fairly stable (P = 0.0673), significant changes occurred for items seven ("understanding") (P < 0.001) and 8 ("emotional response") (P < 0.05). The best model (R2 = 0.068, F = 2.15, P = 0.033) obtained from the multivariate linear regression analysis demonstrated that item five ("identity") (β = 2.340, P = 0.017) and item eight ("emotional response") (β = -2.569, P = 0.008) significantly predict the efficacy of NST (i.e., the proportion of pockets closed at reevaluation). CONCLUSIONS NST significantly ameliorates patient's understanding and emotional burden related to periodontitis. Baseline values of perceived symptoms and emotional response are predictive for the short-term efficacy of NST.
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Affiliation(s)
- Nicola Discepoli
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Crystal Marruganti
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Raffaele Mirra
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Gessica Pettinari
- Unit of Periodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Marco Ferrari
- Unit of Dental Material and Fixed Prosthodontics, University of Siena, Siena, Italy
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206
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Hussain AM, van der Weijden GAF, Slot DE. Effect of a sodium hypochlorite mouthwash on plaque and clinical parameters of periodontal disease-a systematic review. Int J Dent Hyg 2021; 20:40-52. [PMID: 33971082 PMCID: PMC9292655 DOI: 10.1111/idh.12510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/10/2021] [Accepted: 05/04/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease. METHODS MEDLINE-PubMed, Embase and Cochrane-CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl-MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies. RESULTS Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta-analysis. Two of the three studies in which NaOCl-MW was compared with a negative control showed that NaOCl-MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl-MW was assessed using chlorhexidine mouthwash (CHX-MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl-MW. One study measured PPD and found it to be significant in favour of NaOCl-MW. CONCLUSIONS Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl-MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl-MW had a similar effect as CHX-MW on PI, GI and BI scores. The outcome for PPD was inconclusive.
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Affiliation(s)
- Ahsan Mehran Hussain
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - G A Fridus van der Weijden
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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207
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Nassar D, Tagger-Green N, Tal H, Nemcovsky C, Mijiritsky E, Beitlitum I, Barnea E, Kolerman R. The Incidence and Nature of Claims against Dentists Related to Periodontal Treatment in Israel during the Years 2005-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4153. [PMID: 33919971 PMCID: PMC8070963 DOI: 10.3390/ijerph18084153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In recent years, worldwide dental malpractice claims have dramatically increased. The purpose of the present study is to analyze periodontal therapy related claims in Israel that led to legal decisions. METHODS This retrospective cohort study includes malpractice claims against dental practitioners related to periodontology between 2005 and 2019. Only closed cases where a final decision was made were included. The chi-square test or Fisher exact test for categorical variables were performed and a p value of <0.05 was considered statistically significant. RESULTS During the study period there were 508 legal claims related to periodontal disease. Most plaintiffs were women (63.4%), and 71.3% of the patients were >35 years old. Most claims (82.8%) were settled out of court and ended in compromise. Claims concerning the treatment of periodontal disease by periodontists accounted only for 4.5% (23/508) of the cases while 95.5% (485/508) of the claims were for complications secondary to another treatment. Prosthodontic treatment was involved with the highest number 54.5%, followed by dental implants 17.7%, and endodontics 11.6%. The allegations were related to pain and distress (84.8%), aggravation of existent periodontal disease (83.3%), tooth loss (78.1%), and violation of autonomy (47%). CONCLUSIONS The main cause for lawsuits was related to aggravation of periodontal disease during prosthetic or implant therapy and related to suspected faulty or inexistent preoperative diagnosis and planning. PRACTICAL IMPLICATIONS Periodontal consultation before dental treatment may reduce malpractice risks, adverse events, and un-necessary changes of treatment plans.
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Affiliation(s)
- Dima Nassar
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- General Practitioner, Private Clinic, Tel-Aviv 6100000, Israel
| | - Nirit Tagger-Green
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (N.T.-G.); (H.T.); (C.N.); (I.B.); (R.K.)
| | - Haim Tal
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (N.T.-G.); (H.T.); (C.N.); (I.B.); (R.K.)
| | - Carlos Nemcovsky
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (N.T.-G.); (H.T.); (C.N.); (I.B.); (R.K.)
| | - Eitan Mijiritsky
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel;
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel
| | - Ilan Beitlitum
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (N.T.-G.); (H.T.); (C.N.); (I.B.); (R.K.)
| | - Eitan Barnea
- Prosthodontist, Private Practice, Tel-Aviv 6100000, Israel;
| | - Roni Kolerman
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (N.T.-G.); (H.T.); (C.N.); (I.B.); (R.K.)
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208
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Ortigara GB, Mário Ferreira TDG, Tatsch KF, Romito GA, Ardenghi TM, Sfreddo CS, Moreira CHC. The 2018 EFP/AAP periodontitis case classification demonstrates high agreement with the 2012 CDC/AAP criteria. J Clin Periodontol 2021; 48:886-895. [PMID: 33755241 DOI: 10.1111/jcpe.13462] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/20/2021] [Accepted: 03/15/2021] [Indexed: 11/28/2022]
Abstract
AIM To investigate the agreement between the 2018 EFP/AAP periodontitis case classification and the 2012 CDC/AAP criteria. MATERIALS AND METHODS This cross-sectional study assessed a population-based sample from a rural area in southern Brazil. A complete periodontal examination was performed at six sites/tooth. The periodontitis case definition was estimated and compared according to the 2018 EFP/AAP classification and the 2012 CDC/AAP criteria (reference). Diagnostic tests included sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and area under ROC curve (AUC). RESULTS Five hundred and eighty-eight subjects with ≥6 teeth each were included. Based on the 2018 EFP/AAP classification, 71.1% of the subjects were classified as stage III/IV showing 100% agreement with 2012 CDC/AAP criteria for the severe category. For the moderate and severe classification, the 2018 EFP/AAP SN was 99.8% and 100%, SP 13.6% and 43.6%, PPV 83.4% and 47.4%, and NPV 93.7% and 100%, respectively. The AUC was 0.9059 (95% CI = 0.879-0.933) and the optimal cut-off based on the curve was stage III. CONCLUSIONS The 2018 EFP/AAP periodontitis case classification showed high agreement with the 2012 CDC/AAP criteria in a rural sample with high periodontitis occurrence.
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Affiliation(s)
- Gabriela Barbieri Ortigara
- Postgraduate Program in Dentistry, Department of Stomatology, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Karen Finger Tatsch
- Postgraduate Program in Dentistry, Department of Stomatology, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Thiago Machado Ardenghi
- Postgraduate Program in Dentistry, Department of Stomatology, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Carlos Heitor Cunha Moreira
- Postgraduate Program in Dentistry, Department of Stomatology, Emphasis on Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
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209
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Wu P, Zhang X, Zhou P, Zhang W, Li D, Lv M, Liao X. Assessment of Bidirectional Relationships Between Polycystic Ovary Syndrome and Periodontitis: Insights From a Mendelian Randomization Analysis. Front Genet 2021; 12:644101. [PMID: 33868379 PMCID: PMC8044848 DOI: 10.3389/fgene.2021.644101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/10/2021] [Indexed: 02/01/2023] Open
Abstract
Background Observational studies have indicated an association between polycystic ovary syndrome (PCOS) and periodontitis, but it is unclear whether the association is cofounded or causal. We conducted a two-sample Mendelian randomization (MR) study to investigate the bidirectional relationship between genetically predicted PCOS and periodontitis. Methods From two genome-wide association studies we selected 13 and 7 single nucleotide polymorphisms associated with PCOS and periodontitis, respectively, as instrumental variables. We utilized publicly shared summary-level statistics from European-ancestry cohorts. To explore the causal effect of PCOS on periodontitis, 12,289 cases of periodontitis and 22,326 controls were incorporated, while 4,890 cases of PCOS and 20,405 controls in the reverse MR. Inverse-variance weighted method was employed in the primary MR analysis and multiple sensitivity analyses were implemented. Results Genetically determined PCOS was not causally associated with risk of periodontitis (odds ratio 0.97; 95% confidence interval 0.88-1.06; P = 0.50) per one-unit increase in the log-odds ratio of periodontitis. Similarly, no causal effect of periodontitis on PCOS was shown with the odds ratio for PCOS was 1.17 (95% confidence interval 0.91-1.49; P = 0.21) per one-unit increase in the log-odds ratio of periodontitis. Consistent results were yielded via additional MR methods. Sensitivity analyses demonstrated no presence of horizontal pleiotropy or heterogeneity. Conclusion The bidirectional MR study couldn't provide convincing evidence for the causal relationship between genetic liability to PCOS and periodontitis in the Europeans. Triangulating evidence across further observational and genetic-epidemiological studies is necessary.
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Affiliation(s)
- Pengfei Wu
- Hunan Key Laboratory of Animal Models for Human Diseases, Department of Laboratory Animals, Third Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Center for Medical Genetics, Central South University, Changsha, China
| | - Xinghao Zhang
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ping Zhou
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, China
| | - Wan Zhang
- Department of Biology, College of Arts and Sciences, Boston University, Boston, MA, United States
| | - Danyang Li
- Department of Biology, College of Arts and Sciences, Boston University, Boston, MA, United States
| | - Mingming Lv
- Department of Oral Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiaoyao Liao
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
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Periodontitis Prevalence, Severity, and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073459. [PMID: 33810461 PMCID: PMC8037399 DOI: 10.3390/ijerph18073459] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. METHODS We included 488 participants aged 35-74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). RESULTS The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III-IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. CONCLUSION It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors.
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211
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Hjerppe J, Rodas S, Korvala J, Pesonen P, Kaisanlahti A, Özcan M, Suojanen J, Reunanen J. Surface Roughness and Streptococcus mutans Adhesion on Metallic and Ceramic Fixed Prosthodontic Materials after Scaling. MATERIALS 2021; 14:ma14041027. [PMID: 33671563 PMCID: PMC7926524 DOI: 10.3390/ma14041027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/12/2022]
Abstract
The aim of this study was to evaluate the surface roughness of fixed prosthodontic materials after polishing or roughening with a stainless steel curette or ultrasonic scaler and to examine the effect of these on Streptococcus mutans adhesion and biofilm accumulation. Thirty specimens (10 × 10 × 3 mm3) of zirconia (Zr), pressed lithium disilicate (LDS-Press), milled lithium disilicate glazed (LDS-Glaze), titanium grade V (Ti) and cobalt-chromium (CoCr) were divided into three groups (n = 10) according to surface treatment: polished (C), roughened with stainless steel curette (SC), roughened with ultrasonic scaler (US). Surface roughness values (Sa, Sq) were measured with a spinning disc confocal microscope, and contact angles and surface free energy (SFE) were measured with a contact angle meter. The specimens were covered with sterilized human saliva and immersed into Streptococcus mutans suspensions for bacterial adhesion. The biofilm was allowed to form for 24 h. Sa values were in the range of 0.008–0.139 µm depending on the material and surface treatment. Curette and ultrasonic scaling increased the surface roughness in LDS-Glaze (p < 0.05), Ti (p < 0.01) and CoCr (p < 0.001), however, surface roughness did not affect bacterial adhesion. Zr C and US had a higher bacterial adhesion percentage compared to LDS-Glaze C and US (p = 0.03). There were no differences between study materials in terms of biofilm accumulation.
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Affiliation(s)
- Jenni Hjerppe
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland
- Correspondence: ; Tel.:+ 41-44-634-0404
| | - Sampo Rodas
- Biocenter Oulu & Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (S.R.); (J.K.); (A.K.); (J.R.)
| | - Johanna Korvala
- Biocenter Oulu & Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (S.R.); (J.K.); (A.K.); (J.R.)
| | - Paula Pesonen
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland;
| | - Anna Kaisanlahti
- Biocenter Oulu & Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (S.R.); (J.K.); (A.K.); (J.R.)
| | - Mutlu Özcan
- Center of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, University of Zürich, 8032 Zürich, Switzerland;
| | - Juho Suojanen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillo-facial Surgery, 15850 Lahti, Finland;
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Justus Reunanen
- Biocenter Oulu & Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (S.R.); (J.K.); (A.K.); (J.R.)
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212
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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: 56] [Impact Index Per Article: 18.7] [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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213
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Vilarrasa J, Peña M, Gumbau L, Monje A, Nart J. Exploring the relationship among dental caries, nutritional habits, and peri-implantitis. J Periodontol 2021; 92:1306-1316. [PMID: 33599333 DOI: 10.1002/jper.20-0879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND A study was made of the prevalence, co-occurrence and association among caries, nutritional habits, and peri-implant disease, with an analysis of the influence of other patient and implant factors upon peri-implant disease. METHODS The included subjects underwent a clinical examination and were asked to complete a questionnaire. Demographic data and potential lifestyle/behavioral variables were collected. Clinical and radiographic assessment allowed calculation of the decayed, missing and filled teeth (DMFT) index and peri-implant diagnosis. Uni- and multivariate multinomial logistic regression analyses were applied to identify predictors of peri-implant disease. RESULTS A total of 169 patients with 311 implants were studied. At patient level, 92.2% of the subjects presented at least one carious lesion, whereas 22.5% and 56.2% were diagnosed with peri-implantitis and mucositis, respectively. Those patients with more than two caries had a higher risk of mucositis (OR = 3.33). Statistically significant associations for peri-implantitis included full mouth periodontal indexes, sugar-rich diets, keratinized mucosa width, number of missing teeth and interproximal untreated caries or fillings adjacent to implants. CONCLUSION High caries risk profiles and mucositis/peri-implantitis tended to accumulate within subjects. A sugar-enriched diet and untreated caries or fillings adjacent to implant sites may be further considered as risk indicators of peri-implantitis.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Peña
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Laura Gumbau
- Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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214
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Exacerbation of AMD Phenotype in Lasered CNV Murine Model by Dysbiotic Oral Pathogens. Antioxidants (Basel) 2021; 10:antiox10020309. [PMID: 33670526 PMCID: PMC7922506 DOI: 10.3390/antiox10020309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 12/13/2022] Open
Abstract
Emerging evidence underscores an association between age-related macular degeneration (AMD) and periodontal disease (PD), yet the biological basis of this linkage and the specific role of oral dysbiosis caused by PD in AMD pathophysiology remains unclear. Furthermore, a simple reproducible model that emulates characteristics of both AMD and PD has been lacking. Hence, we established a novel AMD+PD murine model to decipher the potential role of oral infection (ligature-enhanced) with the keystone periodontal pathogen Porphyromonas gingivalis, in the progression of neovasculogenesis in a laser-induced choroidal-neovascularization (Li-CNV) mouse retina. By a combination of fundus photography, optical coherence tomography, and fluorescein angiography, we documented inflammatory drusen-like lesions, reduced retinal thickness, and increased vascular leakage in AMD+PD mice retinae. H&E further confirmed a significant reduction of retinal thickness and subretinal drusen-like deposits. Immunofluorescence microscopy revealed significant induction of choroidal/retinal vasculogenesis in AMD+PD mice. qPCR identified increased expression of oxidative-stress, angiogenesis, pro-inflammatory mediators, whereas antioxidants and anti-inflammatory genes in AMD+PD mice retinae were notably decreased. Through qPCR, we detected Pg and its fimbrial 16s-RrNA gene expression in the AMD+PD mice retinae. To sum-up, this is the first in vivo study signifying a role of periodontal infection in augmentation of AMD phenotype, with the aid of a pioneering AMD+PD murine model established in our laboratory.
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215
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Murakami Y, Nagano K, Hasegawa Y. Separation of Glycosylated OmpA-Like Proteins from Porphyromonas gingivalis and Tannerella forsythia. Methods Mol Biol 2021; 2210:143-155. [PMID: 32815135 DOI: 10.1007/978-1-0716-0939-2_14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OmpA-like proteins located in the outer bacterial membrane are potential virulence factors from the major periodontal pathogens Porphyromonas gingivalis and Tannerella forsythia. Our previous studies have shown that OmpA-like proteins are glycosylated by O-linked N-acetylglucosamine (O-GlcNAc) and are strongly reactive to wheat germ agglutinin (WGA) lectin, which shows sugar specificity to GlcNAc. Utilizing this property, we have developed a separation method for OmpA-like proteins by affinity chromatography using WGA lectin-agarose. The purity of enriched native OmpA-like proteins were confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Coomassie Brilliant Blue (CBB) staining. More importantly, the purified OmpA-like proteins formed a unique trimeric structure keeping their bioactivity intact. In this chapter, we describe a detailed procedure to separate OmpA-like proteins, which may be used to further progress the biological studies of OmpA-like proteins.
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Affiliation(s)
- Yukitaka Murakami
- Department of Dental Basic Education (Biology), Asahi University School of Dentistry, Mizuho, Gifu, Japan.
| | - Keiji Nagano
- Division of Microbiology, Department of Oral Biology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - Yoshiaki Hasegawa
- Department of Microbiology, School of Dentistry, Aichi Gakuin University, Nisshin, Aichi, Japan
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216
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Eke PI, Borgnakke WS, Thornton-Evans G. Public Health Aspects of Periodontitis: Recent Advances and Contributions by Dr. Robert J. Genco. CURRENT ORAL HEALTH REPORTS 2021; 8:1-8. [PMID: 39184312 PMCID: PMC11342794 DOI: 10.1007/s40496-020-00290-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 08/27/2024]
Abstract
Purpose of review This review provides an overview of the objectives, activities and accomplishments of the CDC-AAP collaboration on public health aspects of periodontitis focusing mostly on surveillance. Dr. Robert Genco was co-chair of this effort. Recent findings This initiative developed new standard periodontitis case definitions for surveillance and implemented for the first time a full-mouth periodontal examination protocol for NHANES 2009 -2014. Measurements from this survey resulted in significantly greater estimate for the national prevalence of periodontitis in US adults and our understanding of population risk factors associations with periodontitis. Notably, this initiative also developed, and validated field-testing a battery of eight questions for multivariable modeling of self-report measures for predicting periodontitis in populations. Summary This Initiative resulted in significant improvements of surveillance of periodontitis and produced unique findings with important implications for advancing our understanding of population aspects of periodontitis in US adults at the national, state, and local levels.
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Affiliation(s)
- Paul I. Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Wenche S. Borgnakke
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Gina Thornton-Evans
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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217
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Deng Y, He S, Wang J. Validation of the Hospital Anxiety and Depression Scale and the Perceived Stress Scale and psychological features in patients with periodontitis. J Periodontol 2021; 92:1601-1612. [PMID: 33386608 DOI: 10.1002/jper.20-0756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/09/2020] [Accepted: 12/20/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND To investigate the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) and 10-item Perceived Stress Scale (PSS-10) in patients with periodontitis and to evaluate the psychological features of patients with periodontitis. METHODS Overall, 460 individuals with periodontitis were enrolled. The HADS and the PSS-10 were administered to all patients. Methodology testing included the exploratory factor analysis, the confirmatory factor analysis (CFA), test-retest reliability, as well as internal consistency. RESULTS Regarding the CFA results of the HADS, as well as the PSS-10, a bifactor model fitted the data best. The Cronbach alpha value, as well as the intra-class correlation coefficients value of the two measures were all >0.70. The anxiety, depression, distress manifestations, and moderate-to-high perceived stress prevalence were 35.2%, 18.2%, 24.6%, and 43.9%, respectively. Severity of periodontitis, age, smoking, and disease comorbidities were identified as independent prognosticators of the presence of psychological manifestations in periodontitis. CONCLUSION The HADS and the PSS-10 can be used as general measures for psychological assessment in patients with periodontitis.
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Affiliation(s)
- Yongmei Deng
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Songlin He
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jinhua Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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218
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Zini A, Mann J, Mazor S, Vered Y. Beneficial effect of aged garlic extract on periodontitis: a randomized controlled double-blind clinical study. J Clin Biochem Nutr 2020; 67:297-301. [PMID: 33293771 PMCID: PMC7705088 DOI: 10.3164/jcbn.20-52] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 05/09/2020] [Indexed: 12/18/2022] Open
Abstract
The purpose of this study is to assess the long-term efficacy of aged garlic extract to improve periodontitis. Two hundred and one participants were randomly stratified and assigned equally to the regimen group or the control group. At the start, 12 month, and 18 month subjects received dental examination and periodontal evaluation. Probing Pocket Depth and Gingival Recession were examined. For each efficacy parameter, the mean value of examination was calculated and assessed using paired-difference t tests. Statistical tests were two-sided using a 5% significance level. The mean value of pocket depth for the aged garlic extract group at 18 month was 1.06 ± 0.49 as compared to the baseline value of 1.89 ± 0.74 (p<0.001) and the corresponding value of 1.50 ± 0.46 for the placebo group (p<0.001), indicating the beneficial effect of aged garlic extract on periodontitis. According to a Multiple linear regression analysis the only three variables which reached statistical significance as predictors of PPD level were the baseline PPD scores (p<0.001), smoking (p = 0.020), and consumption of daily dose of aged garlic extract (p<0.001). These results demonstrated that aged garlic extract is an effective supplement for preventing or improving periodontal disease. The well demonstrated benefits of aged garlic extract for the oral disease may also be used as a means to improve general health because of the close relationship between periodontitis and some systemic diseases such as diabetes, hypertension, atherosclerosis, and others.
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Affiliation(s)
- Avraham Zini
- Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University and Hadassah, Faculty of Dental Medicine, P.O. Box 12272, Jerusalem 91120, Israel
| | - Jonathan Mann
- Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University and Hadassah, Faculty of Dental Medicine, P.O. Box 12272, Jerusalem 91120, Israel
| | - Sigal Mazor
- Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University and Hadassah, Faculty of Dental Medicine, P.O. Box 12272, Jerusalem 91120, Israel
| | - Yuval Vered
- Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University and Hadassah, Faculty of Dental Medicine, P.O. Box 12272, Jerusalem 91120, Israel
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219
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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: 5] [Impact Index Per Article: 1.3] [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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220
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Fragkioudakis I, Riggio MP, Apatzidou DA. Understanding the microbial components of periodontal diseases and periodontal treatment-induced microbiological shifts. J Med Microbiol 2020; 70. [PMID: 33295858 DOI: 10.1099/jmm.0.001247] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
In the mid-1960s the microbial aetiology of periodontal diseases was introduced based on classical experimental gingivitis studies . Since then, numerous studies have addressed the fundamental role that oral microbiota plays in the initiation and progression of periodontal diseases. Recent advances in laboratory identification techniques have contributed to a better understanding of the complexity of the oral microbiome in both health and disease. Modern culture-independent methods such as human oral microbial identification microarray and next-generation sequencing have been used to identify a wide variety of microbial taxa residing in the gingival sulcus and the periodontal pocket. The first theory of the 'non-specific plaque' hypothesis gave rise to the 'ecological plaque' hypothesis and more recently to the 'polymicrobial synergy and dysbiosis hypothesis'. Periodontitis is now considered to be a multimicrobial inflammatory disease in which the various bacterial species within the dental biofilm are in a dysbiotic state and this imbalance favours the establishment of chronic inflammatory conditions and ultimately the destruction of tooth-supporting tissues. Apart from the known putative periodontal pathogens, the whole biofilm community is now considered to play a role in the establishment of inflammation and the initiation and progression of periodontitis in a susceptible host. Treatment is unlikely to eliminate putative pathogens but, when it is thoroughly performed it has the potential to establish a healthy ecosystem by altering the microbial community in numbers and composition and also contribute to the maturation of the host immune response.
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Affiliation(s)
- Ioannis Fragkioudakis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Marcello P Riggio
- Oral Sciences Research Group, Dental School, College of Medical Veterinary and Life Sciences, University of Glasgow, UK
| | - Danae Anastasia Apatzidou
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
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Dicembrini I, Serni L, Monami M, Caliri M, Barbato L, Cairo F, Mannucci E. Type 1 diabetes and periodontitis: prevalence and periodontal destruction-a systematic review. Acta Diabetol 2020; 57:1405-1412. [PMID: 32318875 DOI: 10.1007/s00592-020-01531-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/27/2020] [Indexed: 12/12/2022]
Abstract
AIMS Data about the association between periodontal disease or periodontitis (PD), diabetes and hyperglycemia have been reported mostly in patients with type 2 diabetes. Conversely, information about PD in type 1 diabetes (T1DM) is relatively scarce. The aim of this meta-analysis is therefore: (1) to assess the prevalence and severity of PD in patients affected by T1DM in comparison with the general population and (2) to verify the association between severity of PD and glycemic control in type 1 diabetics. METHODS An electronic search was performed on MEDLINE, Cochrane Central Register of Trials and EMBASE, up to October 31, 2019. Estimates of prevalence of PD in T1DM were calculated together with Mantel-Haenszel odds ratios (MH-OR) of the risk of PD associated with T1DM; weighed mean difference in CAL between T1DM and control and weighed mean difference in CAL in patients with T1DM and unsatisfactory glycemic control as compared with those in good glycemic control were also evaluated.. RESULTS The prevalence of PD in type 1 diabetes was 18.5 [8.0; 37.1] %; the MH-OR for PD is 2.51 (1.32;4.76) in T1DM patients versus general population (p = 0.005). The weighed mean difference in CAL depth between T1DM patients and controls is 0.506 [0.181; 0.832] mm (p < 0.005), and in T1DM patients with good glycemic control CAL depth is - 0.71 [- 1.00; - 0.42] mm less deep than in subjects with HbA1c > 7%. CONCLUSIONS The present data confirm that T1DM is a relevant risk factor for the development of PD. The proportion of patients affected by PD is more than doubled in subjects with T1DM in comparison with non-diabetic individual, and among patients with T1DM, PD seems to be more severe and the differences appear very wide between subjects in optimal and suboptimal glycemic control.
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Affiliation(s)
- Ilaria Dicembrini
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Lapo Serni
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Matteo Monami
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Mariasmeralda Caliri
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy
| | - Luigi Barbato
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Edoardo Mannucci
- Diabetes Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50127, Florence, Italy.
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222
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Arjunan P. Eye on the Enigmatic Link: Dysbiotic Oral Pathogens in Ocular Diseases; The Flip Side. Int Rev Immunol 2020; 40:409-432. [PMID: 33179994 DOI: 10.1080/08830185.2020.1845330] [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] [Indexed: 12/29/2022]
Abstract
Mouth and associated structures were regarded as separate entities from the rest of the body. However, there is a paradigm shift in this conception and oral health is now considered as a fundamental part of overall well-being. In recent years, the subject of oral-foci of infection has attained a resurgence in terms of systemic morbidities while limited observations denote the implication of chronic oral inflammation in the pathogenesis of eye diseases. Hitherto, there is a paucity for mechanistic insights underlying the reported link between periodontal disease (PD) and ocular comorbidities. In light of prevailing scientific evidence, this review article will focus on the understudied theme, that is, the impact of oral dysbiosis in the induction and/or progression of inflammatory eye diseases like diabetic retinopathy, scleritis, uveitis, glaucoma, age-related macular degeneration (AMD). Furthermore, the plausible mechanisms by which periodontal microbiota may trigger immune dysfunction in the Oro-optic-network and promote the development of PD-associated AMD have been discussed.
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Affiliation(s)
- Pachiappan Arjunan
- Department of Periodontics, Dental College of Georgia, Augusta, GA, USA.,James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA, USA
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223
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Bailly C. The implication of the PD-1/PD-L1 checkpoint in chronic periodontitis suggests novel therapeutic opportunities with natural products. JAPANESE DENTAL SCIENCE REVIEW 2020; 56:90-96. [PMID: 32612718 PMCID: PMC7310691 DOI: 10.1016/j.jdsr.2020.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/13/2020] [Accepted: 04/21/2020] [Indexed: 12/12/2022] Open
Abstract
An analysis of the implication of the PD-1/PD-L1 immune checkpoint in periodontitis is provided with the objective to propose a novel therapeutic approach. An exhaustive survey of the literature has been performed to answer two questions: (1) Is there a role for PD-1 and/or PD-L1 in the development of periodontitis? (2) Which natural products interfere with the checkpoint activity and show activity against periodontitis? All online published information was collected and analyzed. The pathogenic bacteria Porphyromonas gingivalis, through its membrane-attached peptidoglycans, exploits the PD-1/PD-L1 checkpoint to evade immune response and to amplify the infection. Three anti-inflammatory natural products (and derivatives or plant extracts) active against periodontitis and able to interfere with the checkpoint were identified. Both curcumin and baicalin attenuate periodontitis and induce a down-regulation of PD-L1 in cells. The terpenoid saponin platycodin D inhibits the growth of P. gingivalis responsible for periodontitis and shows a rare capacity to induce the extracellular release of a soluble form of PD-L1, thereby restoring T cell activation. A potential PD-L1 shedding mechanism is discussed. The targeting of the PD-1/PD-L1 immune checkpoint could be considered a suitable approach to improve the treatment of chronic periodontitis. The plant natural products curcumin, baicalin and platycodin D should be further evaluated as PD-1/PD-L1 checkpoint modulators active against periodontitis.
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224
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D'Ângelo MQ, Queiroz-Junior CM, Maltos KLDM, Ferreira AJ, Pacheco CMDF, Soares RV. The blockade of kappa opioid receptors exacerbates alveolar bone resorption in rats. Arch Oral Biol 2020; 120:104923. [PMID: 33091661 DOI: 10.1016/j.archoralbio.2020.104923] [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] [Received: 08/03/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Bone resorption associated to chronic diseases, such as arthritis and periodontitis, results from exacerbated immuno-inflammatory host response that leads to tissue breakdown. The significance of opioid pathways as endogenous modulators of inflammatory events has already been described. Thus, the aim of this work is to determine whether some of the main three opioid receptors are endogenously activated to prevent bone loss during experimentally-induced alveolar bone resorption. DESIGN This study used an experimental model of alveolar bone resorption induced by ligature in rats. A silk thread was placed around the 2nd maxillary molar of male Wistar rats. In the 3rd, 4th and 5th day after ligation the rats received a local injection of different concentrations of opioid antagonists Cyprodime, Naltrindole, or Nor-binaltorphimine, which specifically block mü, delta and kappa opioid receptors, respectively. In the 7th experimental day, rats were euthanized and their maxillae collected for evaluation of alveolar bone and fiber attachment loss, morphometric counting of osteoclasts and osteoblasts, as well as the levels of cytokines IL-1β, IFN-γ, and IL-6 by ELISA. RESULTS Selective antagonism of kappa opioid receptors, but not mü and delta, exacerbated alveolar bone resorption induced by ligature in rats. The increased bone loss associated with higher number of osteoclasts surrounding alveolar bone, although osteoblasts' counting remained unchanged. The concentrations of IL-1β and IL-6 in periodontal tissues were also significantly higher in the rats treated with the kappa antagonist. CONCLUSION Inhibiting kappa opioid receptors exacerbates alveolar bone resorption.
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Affiliation(s)
- Marcelo Queiroz D'Ângelo
- Graduate Program in Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUCMINAS), Pontifícia Universidade Católica de Minas Gerais (PUCMINAS), Rua Dom José Gaspar 500, Coração Eucarístico, Belo Horizonte, MG, Brazil
| | - Celso Martins Queiroz-Junior
- Translational Biology Laboratory, Morphology Department, Institute of Biological Sciences, Universidade Federal de Minas Gerais (ICB-UFMG), Avenida Antônio Carlos 6627, Belo Horizonte, MG, Brazil
| | - Kátia Lucy de Melo Maltos
- School of Dentistry, Universidade Federal de Minas Gerais (FOUFMG), Avenida Antônio Carlos 6627, Belo Horizonte, MG, Brazil
| | - Anderson José Ferreira
- Translational Biology Laboratory, Morphology Department, Institute of Biological Sciences, Universidade Federal de Minas Gerais (ICB-UFMG), Avenida Antônio Carlos 6627, Belo Horizonte, MG, Brazil
| | | | - Rodrigo Villamarim Soares
- Graduate Program in Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUCMINAS), Pontifícia Universidade Católica de Minas Gerais (PUCMINAS), Rua Dom José Gaspar 500, Coração Eucarístico, Belo Horizonte, MG, Brazil
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225
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Elazazy O, Amr K, Abd El Fattah A, Abouzaid M. Evaluation of serum and gingival crevicular fluid microRNA-223, microRNA-203 and microRNA-200b expression in chronic periodontitis patients with and without diabetes type 2. Arch Oral Biol 2020; 121:104949. [PMID: 33157494 DOI: 10.1016/j.archoralbio.2020.104949] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 12/11/2022]
Abstract
microRNA dysregulation is a reported feature of multiple pathologies, including periodontal disease, as demonstrated on cell lines, in animal models, and tissues biopsies, but serum and gingival crevicular fluid microRNA expression data in humans is scarce, especially with the diabetes (type 2) systemic complication. OBJECTIVE To assess serum and gingival crevicular fluid relative quantification levels of miR-223, miR-203, and miR-200b in chronic periodontitis and type 2 diabetic chronic periodontitis patients to address their possible implication in chronic periodontitis pathogenesis and its systemic complications and also to correlate their differential expression with some inflammatory (serum tumor necrosis factor-α and interleukin-10) parameters. METHODS Sixty subjects were recruited and divided into three groups; chronic periodontitis (n = 20), type 2 diabetic chronic periodontitis (n = 20), and healthy control (n = 20). Both serum and gingival crevicular fluid were collected from each participant for miRNA expression analysis and serum inflammatory parameters assessment. RESULTS A significant increase in the relative quantification levels of miR-223 and miR-200b were detected in patient groups along with a positive correlation with tumor necrosis factor-α. However, miR-203 was significantly decreased in patient groups associated with a negative correlation with tumor necrosis factor-α. CONCLUSIONS miR-223 and miR-200b have a potential role in chronic periodontitis pathogenesis associated with type 2 diabetes, with the ability to induce tumor necrosis factor-α secretion, while miR-203 might have a protective and healing role due to the negative correlation with the serum tumor necrosis factor-α levels found. Therefore, they may be considered as a promising therapeutic target and effective serum disease biomarkers.
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Affiliation(s)
- Ola Elazazy
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Cairo, Egypt.
| | - Khalda Amr
- Department of Medical Molecular Genetics, National Research Center, Cairo, Egypt
| | - Abeer Abd El Fattah
- Department of Biochemistry, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt
| | - Maha Abouzaid
- Department of Orodental Genetics, National Research Center, Cairo, Egypt
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226
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Barbe AG, Javadian S, Rott T, Scharfenberg I, Deutscher HCD, Noack MJ, Derman SHM. Objective masticatory efficiency and subjective quality of masticatory function among patients with periodontal disease. J Clin Periodontol 2020; 47:1344-1353. [DOI: 10.1111/jcpe.13364] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/11/2020] [Accepted: 08/27/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Anna Greta Barbe
- Department of Operative Dentistry and Periodontology University of Cologne Cologne Germany
| | - Simin Javadian
- Department of Operative Dentistry and Periodontology University of Cologne Cologne Germany
| | - Thea Rott
- Department of Operative Dentistry and Periodontology University of Cologne Cologne Germany
| | - Isabel Scharfenberg
- Department of Operative Dentistry and Periodontology University of Cologne Cologne Germany
| | | | - Michael Johannes Noack
- Department of Operative Dentistry and Periodontology University of Cologne Cologne Germany
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227
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Romandini M, Baima G, Antonoglou G, Bueno J, Figuero E, Sanz M. Periodontitis, Edentulism, and Risk of Mortality: A Systematic Review with Meta-analyses. J Dent Res 2020; 100:37-49. [PMID: 32866427 DOI: 10.1177/0022034520952401] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Periodontitis has been independently associated with the chronic noncommunicable diseases that most frequently lead to death worldwide. The aim of the present systematic review was to study whether people with periodontitis/edentulism are at increased risk of all-cause and cause-specific mortality as compared with those without periodontitis/edentulism. Cohort studies were included that 1) evaluated periodontitis or edentulism as exposures in relation to all-cause or cause-specific mortality as an outcome and 2) reported effect estimates as hazard ratios, risk ratios, or odds ratios with 95% CIs or crude numbers. Two review authors independently searched for eligible studies, screened the titles and abstracts, did full-text analysis, extracted the data from the published reports, and performed the risk-of-bias assessment. In case of disagreement, a third review author was consulted. Study results were summarized through random effects meta-analyses. A total of 57 studies were included, involving 48 cohorts and 5.71 million participants. Periodontitis was associated with increased risk of all-cause mortality (risk ratio, 1.46 [95% CI, 1.15 to 1.85]) and mortality due to cardiovascular diseases (1.47 [1.14 to 1.90]), cancer (1.38 [1.24 to 1.53]), coronary heart disease (2.58 [2.20 to 3.03]), cerebrovascular diseases (3.11 [2.42 to 3.98]), but not pneumonia (0.98 [0.69 to 1.38]). Edentulism (all types) was associated with increased risk of all-cause mortality (1.66 [1.46 to 1.88]) and mortality due to cardiovascular diseases (2.03 [1.50 to 2.74]), cancer (1.55 [1.24 to 1.94]), pneumonia (1.72 [1.07 to 2.78]), coronary heart disease (2.98 [2.43 to 3.65]), and cerebrovascular diseases (3.18 [2.24 to 4.51]). Periodontitis and its ultimate sequela (edentulism) are associated with an increased risk of all-cause and cause-specific mortality (PROSPERO CRD42018100095).
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Affiliation(s)
- M Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - G Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - G Antonoglou
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - J Bueno
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - E Figuero
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP Research Group (Etiology and Therapy of Periodontal and Peri-implant Diseases), University Complutense, Madrid, Spain
| | - M Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP Research Group (Etiology and Therapy of Periodontal and Peri-implant Diseases), University Complutense, Madrid, Spain
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228
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Sekundo C, Langowski E, Kilian S, Frese C. Periodontal and peri-implant diseases in centenarians. J Clin Periodontol 2020; 47:1170-1179. [PMID: 32748427 DOI: 10.1111/jcpe.13350] [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: 05/08/2020] [Revised: 06/18/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023]
Abstract
AIMS To report the prevalence of periodontal and peri-implant diseases in centenarians in South-Western Germany, examine associations with sociodemographic factors and explore age-related trends. MATERIAL AND METHODS Eligible persons born before 1920 were identified from population registries in South-Western Germany. A total of 55 centenarians were visited at home or in nursing care facilities. Of them, 35 were dentate, 33 of which underwent periodontal examination. Implants in 2 edentulous patients were also registered. RESULTS The mean number of teeth was 9.5 ± 7.1; centenarians in need of nursing care had considerably less teeth than others (8.5 versus. 17.0 teeth, p = .03). Mean probing depth was 2.7 ± 0.8mm; mean clinical attachment loss was 4.2 ± 1.7 mm. Severe tooth mobility (degree 2 or 3) and furcation involvement were present in approximately 3% of eligible teeth. According to CDC/AAP classification, 25.8% of centenarians had no or mild periodontitis, 54.8% of centenarians had moderate periodontitis, and only 19.4% were severely affected. Of 27 implants examined in 5 centenarians, 59.3% were classified as healthy, 29.6% had peri-implant mucositis, and 11.1% had peri-implantitis. CONCLUSIONS This study reveals the predominance of moderately severe disease in centenarians. While there were high levels of moderate periodontitis and peri-implant mucositis, signs of severe periodontitis, severe furcation involvement, tooth mobility or peri-implantitis were less frequent.
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Affiliation(s)
- Caroline Sekundo
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Eva Langowski
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Samuel Kilian
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Cornelia Frese
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
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229
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Zhou T, Huang WK, Xu QY, Zhou X, Shao LQ, Song B. Nec-1 attenuates inflammation and cytotoxicity induced by high glucose on THP-1 derived macrophages through RIP1. Arch Oral Biol 2020; 118:104858. [PMID: 32805637 DOI: 10.1016/j.archoralbio.2020.104858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This research aimed to study whether necrostain-1 (Nec-1) could alleviate inflammatory injury induced by high glucose upon THP-1 derived macrophages through RIP1. DESIGN Firstly, THP-1 derived macrophages were incubated with 5.5 mM glucose (normal glucose, NG), 25 mM glucose (high glucose, HG), and mannitol as the high osmotic pressure group (5.5 mM glucose+19.5 mM mannitol) for 24, 48, and 72 h respectively. TNF-α, IL-1β, IL-6, and IL-8 levels were measured by ELISA. Secondly, macrophages were exposed to NG, HG, or HG plus 5 μM necrostatin-1 (Nec-1) for 72 h. mRNA expression of inflammatory cytokine was measured by RT-PCR, and protein levels of inflammatory cytokines and LDH leakage were determined by ELISA. RIP1 expression was determined by RT-PCR and WB. Thirdly, macrophages were transfected with si-RIP1 or negative control (si-NC). Wild type and RIP1-silenced macrophages were incubated with NG or HG, and TNF-α, IL-1β, IL-6, IL-8, and LDH levels were measured again by ELISA. RESULTS 1) TNF-α, IL-1β, IL-6, and IL-8 levels were elevated in the HG group, as compared with that the NG group. Inflammation remained unchanged in the mannitol group. 2) Inflammatory response and LDH levels in the HG plus Nec-1 group were remarkably lower than in the HG group. 3) Inflammatory injury in the si-NC group was more severe than in the si-RIP1 group. CONCLUSIONS Current results indicated that Nec-1 could alleviate HG-caused inflammatory injury on THP-1 derived macrophages by regulating RIP1. These findings could help cast light on the relationships between diabetes and periodontitis.
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Affiliation(s)
- Ting Zhou
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Wei-Kun Huang
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Qiu-Yan Xu
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Xue Zhou
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Long-Quan Shao
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Bin Song
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
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230
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Wang X, Jiang M, He X, Zhang B, Peng W, Guo L. N‑acetyl cysteine inhibits the lipopolysaccharide‑induced inflammatory response in bone marrow mesenchymal stem cells by suppressing the TXNIP/NLRP3/IL‑1β signaling pathway. Mol Med Rep 2020; 22:3299-3306. [PMID: 32945495 PMCID: PMC7453581 DOI: 10.3892/mmr.2020.11433] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 07/22/2020] [Indexed: 12/14/2022] Open
Abstract
N-acetyl cysteine (NAC) has been used to inhibit lipopolysaccharide (LPS)-induced inflammation. However, the molecular mechanism underlying its anti-inflammatory effects remains to be elucidated. The present study aimed to determine the effect of NAC on the LPS-induced inflammatory response in bone marrow mesenchymal stem cells (BMSCs) and elucidate the underlying molecular mechanism. First, BMSCs were stimulated by LPS following pretreatment with NAC (0, 0.1, 0.5, 1 or 2 mM). A Cell Counting Kit 8 assay was used to determine the number of viable cells and 1 mM NAC was selected as the experimental concentration. Then, the secretion of inflammatory factors, including interleukin (IL)-1β, IL-6 and tumor necrosis factor-α was evaluated by enzyme-linked immunosorbent assay. Finally, the expression levels of mRNA and proteins, including apoptosis-associated speck-like protein containing a CARD (ASC), nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), caspase-1, thioredoxin-interacting protein (TXNIP), and thioredoxin (TRX), were evaluated by reverse transcription-quantitative PCR and western blot analysis, respectively. The results demonstrated that the secretion of inflammatory factors, which was increased by the administration of LPS, was reduced by pretreatment with NAC. Furthermore, NAC reduced the expression of ASC, NLRP3, caspase-1 and TXNIP, but enhanced that of TRX. To conclude, NAC had anti-inflammatory effects on LPS-stimulated BMSCs, which was closely associated with the TXNIP/NLRP3/IL-1β signaling pathway. Thus, NAC may be a promising treatment to attenuate the inflammatory response in LPS-induced BMSCs.
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Affiliation(s)
- Xuemei Wang
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Mengyi Jiang
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xiaoping He
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Bo Zhang
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Wei Peng
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Ling Guo
- Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
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231
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Papathanasiou E, Conti P, Carinci F, Lauritano D, Theoharides TC. IL-1 Superfamily Members and Periodontal Diseases. J Dent Res 2020; 99:1425-1434. [PMID: 32758110 DOI: 10.1177/0022034520945209] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Periodontitis is a complex, multifactorial chronic disease involving continuous interactions among bacteria, host immune/inflammatory responses, and modifying genetic and environmental factors. More than any other cytokine family, the interleukin (IL)-1 family includes key signaling molecules that trigger and perpetuate periodontal inflammation. Over the years, the IL-1 family expanded to include 11 members of cytokines, some with agonist activity (IL-1α, IL-1β, IL-18, IL-33, IL-36α, IL-36β, and IL-36γ), receptor antagonists (IL-1Ra, IL-36Ra), and 2 anti-inflammatory cytokines (IL-37, IL-38). The IL-1 receptor antagonist (IL-1Ra) has emerged as a pivotal player in the defense against periodontitis. IL-33 primarily induces the production of Th2-associated cytokines but acts as an "alarmin" via stimulation of mast cells. The IL-36 subclass of cytokines may be important in regulating mucosal inflammation and homeostasis. IL-37 suppresses innate and acquired immune responses. IL-38 is the most recent member of the IL-1 superfamily and has anti-inflammatory properties similar to those of IL-37 but through different receptors. However, limited evidence exists regarding the role of IL-37 and IL-38 in periodontitis. Despite the development of IL-1 blocking agents, therapeutic blockade of select IL-1 family members for periodontitis has only been partially investigated in preclinical and clinical research, while the development of IL-37 and IL-38 as novel anti-inflammatory drugs has not been considered adequately. Here, we review the key properties of the IL-1 family members and provide insights into targeting or promoting select cytokines as new therapeutic agents.
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Affiliation(s)
- E Papathanasiou
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA.,Center for Clinical and Translational Research, Forsyth Institute, Cambridge, MA, USA
| | - P Conti
- Immunology Division, Postgraduate Medical School, University of Chieti, Pescara, Italy
| | - F Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - D Lauritano
- Department of Medicine and Surgery, Centre of Neuroscience of Milan, University of Milano-Bicocca, Milan, Italy
| | - T C Theoharides
- Department of Immunology, Tufts University School of Medicine, Boston, MA, USA.,School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA.,Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, MA, USA
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232
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Slots J. Primer on etiology and treatment of progressive/severe periodontitis: A systemic health perspective. Periodontol 2000 2020; 83:272-276. [PMID: 32385884 DOI: 10.1111/prd.12325] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontology is an infectious disease-based discipline. The etiopathology of progressive/severe periodontitis includes active herpesviruses, specific bacterial pathogens, and proinflammatory cytokines. Herpesviruses and periodontopathic bacteria may interact synergistically to produce periodontal breakdown, and periodontal herpesviruses may contribute to systemic diseases. The infectious agents of severe periodontitis reside in deep pockets, furcation lesions, and inflamed gingiva, sites inaccessible by conventional (purely mechanical) surgical or nonsurgical therapy but accessible by systemic antibiotic treatment. This brief overview presents an effective anti-infective treatment of severe periodontitis, which includes systemic chemotherapy/antibiotics against herpesviruses (valacyclovir [acyclovir]) and bacterial pathogens (amoxicillin + metronidazole or ciprofloxacin + metronidazole) plus common antiseptics (povidone-iodine and sodium hypochlorite) and select ultrasonic scaling. The proposed treatment can cause a marked reduction or elimination of major periodontal pathogens, is acceptably safe, and can be carried out in minimal time with minimal cost.
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Affiliation(s)
- Jørgen Slots
- Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
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233
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Abstract
The United States continues to be an incubator for new concepts and approaches to the diagnosis, treatment, and prevention of periodontal diseases. This volume of Periodontology 2000 presents some of these newer areas of research and paradigms that have emerged in the United States from both long-established and new investigators. These areas include: (1) more comprehensive approaches to assessing the total periodontal microbiome, including bacteria, viruses, and fungi, and their interactions with both the local and systemic inflammatory and immune responses, as well as with other oral and systemic conditions and diseases; (2) new developments for a more comprehensive characterization of the patient genome, transcriptome, and proteome profiles and the role of these profiles in periodontal disease pathogenesis; (3) new developments in nonsurgical approaches to periodontal diseases, including broad-based lines of attack using natural antimicrobials and host-modulation therapies and more focused approaches that target specific interactions in the host response; and (4) new big data analysis, machine learning, and imaging approaches, both for understanding the pathogenesis of periodontal diseases and for developing improved risk-assessment tools and better treatment outcomes.
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Affiliation(s)
- Mark I Ryder
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, California, USA
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